Agenda 11/14/2017 Item #16D1911/14/2017
EXECUTIVE SUMMARY
Recommendation to approve “after-the-fact” amendments and attestation statements with the Area
Agency on Aging for Southwest Florida, Inc. (Agency), Community Care for the Elderly (CCE,
Alzheimer’s Disease Initiative (ADI), and Home Care for the Elderly (HCE) grant programs for
Services for Seniors and authorize Budget Amendments to ensure continuous funding for
FY2017/2018. (Net Fiscal Impact $179,372.45).
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
CCE, ADI, and 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. These grant fund services enable
clients to remain in their homes and live with independence and dignity.
The current service agreements for CCE, ADI and HCE were approved after-the-fact by the Board on
September 26, 2017 (Agenda item 16.D.14) to prevent disruption in services, and ensure compliance with
the grant service agreement requirement. The contracts have a one-year term, effective July 1, 2017
through June 30, 2018, with a three-year renewal option. The proposed amendment is the first amendment
to each contract.
By means of the proposed amendment, the Agency has increased the CCE and ADI overall fundin g to the
grant award as shown in the chart below for the FY 2017-2018 contract year. The Agency agrees to pay
for contracted services in the amount of $878,656 for the CCE program, $386,957 for the ADI program
and $49,250 for the HCE program. The stated amounts represent an overall increase in funding for CCE
and ADI programs. The budget adjustments reflect fluctuations in the caseworkers’ 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
the last date the amendments have been signed by both parties.
The following table provides a detailed breakdown of the increased award adjustment:
Program Proje
ct
Current
Budget
Revised
Budget
Increase /
(Decrease)
Local Match
Increase/(Decrease)*
Community Care for
the Elderly (CCE)
33514 $794,335 $878,656 $84,321 $9,369
Alzheimer’s Disease
Initiative Program
(ADI)
33515 $312,663 $386,957 $74,294 $0
Home Care for the
Elderly (HCE) Basic
Subsidy**
33516 $49,250 $49,250 $0 $0
Total $1,156,248 $1,314,863 $158,615 $9,369
*10% Match is Award divided by .9, multiplied by .1, per grantor requirements, rounded to nearest dollar
**The HCE Basic Subsidy of $13,356 is to be retained by the grantor agency and therefore is not included in Collier County’s
budget.
16.D.19
Packet Pg. 1364
11/14/2017
Program Project Estimated
Budget
Actual Co-Payment
Budget
Increase /
(Decrease)
CCE Co-Payment Budget 33351 $72,896.00 $80,294.45 $7,398.45
ADI Co-Payment Budget 33352 $19,136.00 $23,126.00 $3,990.00
Total $11,388.45
The Agency routinely send CCSS amendments which require a 30-day turnaround time. This timeframe
makes it impossible to process the documents for the Board’s approval in the time requested by the
Agency. The amendments for the CCE, ADI, and HCE programs are being presented “after-the-fact”
because Collier County received the ADI grant amendments on August 30, 2017, and the CCE grant
amendment on August 18, 2017, with an effective contract date of the last day the amendment has been
signed by both parties. Consequently, 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
$1,314,863 for the SFY 17-18 CCE, ADI, and HCE grant programs funded by the Florida Department of
Elder Affairs which reflects an increase of $158,615 in grant revenue and the required local match of
$9,369. The Actual budgets were previously approved. Funding will reside in Human Services Grant
Fund 707 Projects 33514 (CCE), 33515 (ADI), 33516 (HCE). The local match is available through carry
forward (Reserves) in Human Services Grant Fund 707. Budget amendments are also required to
recognize co-pays from previous years for CCE (33351) $7,398.45 and ADI (33352) $3,990.
GROWTH MANAGEMENT: There is no Growth Management impact.
LEGAL CONSIDERATIONS: This item is approved for form and legality and requires a majority vote
for Board action. - JAB
RECOMMENDATIONS: To approve “after-the-fact” amendments and attestation statements with Area
Agency on Aging for Southwest Florida, Inc. and authorize the budget amendments.
Prepared by: Jody Paley, Coordinator, Community and Human Services Division
ATTACHMENT(S)
1. ADI 203-17-001 Amend #1 (PDF)
2. [Linked] ADI 203-17 CONTRACT (PDF)
3. CCE 203-17-001 Amend #1 (PDF)
4. [Linked] CCE 203-17 CONTRACT (PDF)
5. HCE 203-17-001 Amend #1 (PDF)
6. [Linked] HCE 203-17 CONTRACT (PDF)
16.D.19
Packet Pg. 1365
11/14/2017
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.D.19
Doc ID: 4064
Item Summary: Recommendation to approve “after-the-fact” amendments and attestation
statements with the Area Agency on Aging for Southwest Florida, Inc. (Agency), Community Care for
the Elderly (CCE, Alzheimer’s Disease Initiative (ADI), and Home Care for the Elderly (HCE) grant
programs for Services for Seniors and authorize Budget Amendments to ensure continuous funding for
FY2017/2018. (Net Fiscal Impact $179,372.45).
Meeting Date: 11/14/2017
Prepared by:
Title: Grants Coordinator – Community & Human Services
Name: Jody Paley
10/24/2017 11:45 AM
Submitted by:
Title: Division Director - Cmnty & Human Svc – Public Services Department
Name: Kimberley Grant
10/24/2017 11:45 AM
Approved By:
Review:
Community & Human Services Dora Carrillo Additional Reviewer Completed 10/24/2017 2:55 PM
Community & Human Services Maggie Lopez Additional Reviewer Completed 10/25/2017 1:29 PM
Public Services Department Kimberley Grant Additional Reviewer Completed 10/25/2017 4:43 PM
Operations & Veteran Services Sean Callahan Additional Reviewer Completed 10/26/2017 5:03 PM
Public Services Department Joshua Hammond Level 1 Division Reviewer Completed 10/27/2017 7:17 AM
Public Services Department Steve Carnell Level 2 Division Administrator Review Completed 10/27/2017 4:18 PM
Grants Erica Robinson Level 2 Grants Review Completed 10/27/2017 4:50 PM
County Attorney's Office Jennifer Belpedio Level 2 Attorney of Record Review Completed 11/02/2017 10:46 AM
County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 11/02/2017 11:31 AM
Office of Management and Budget Valerie Fleming Level 3 OMB Gatekeeper Review Completed 11/02/2017 11:46 AM
Budget and Management Office Ed Finn Additional Reviewer Completed 11/03/2017 9:11 AM
Grants Therese Stanley Additional Reviewer Completed 11/04/2017 10:10 AM
County Manager's Office Leo E. Ochs Level 4 County Manager Review Completed 11/06/2017 10:14 AM
Board of County Commissioners MaryJo Brock Meeting Pending 11/14/2017 9:00 AM
16.D.19
Packet Pg. 1366
16.D.19.aPacket Pg. 1367Attachment: ADI 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
16.D.19.aPacket Pg. 1368Attachment: ADI 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
16.D.19.aPacket Pg. 1369Attachment: ADI 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
16.D.19.aPacket Pg. 1370Attachment: ADI 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
16.D.19.aPacket Pg. 1371Attachment: ADI 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
July 2017 — June 2018 ADI 203.17
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC.
ALZHEIMER'S DISEASE INITIATIVE PROGRAM STANDARD CONTRACT
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc., (Agency) and Collier
County Board of County Commissioners, ('Contractor), 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 and exhibits, which constitute the contract document.
The contract will incorporate attachments, proposal(s), state plan(s), grant agreements, relevant Department handbooks,
manuals or desk books, as an integral part of the contract, except to the extent that the contract explicitly provides to
the contrary. In the event of conflict in language among any of the documents referenced above, the specific provisions
and requirements of the contract document(s) shall prevail over inconsistent provisions in the proposal(s) or other
general materials not specific to this contract document and identified attachments.
11
This contract shall begin at twelve (12:00) A.M., Eastern Standard Time July 1, 2017 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, 2018.
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 $312,663.00, 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.
By mutual agreement of the Parties, in accordance with Section 287.058(1)(g), Florida Statutes (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.
�_ur .i rM11 grin
6.1 If this contract contains federal funds this section shall apply.
6.1.1 The Contractor shall comply with the provisions of 45 Code of Federal Regulations (CFR) 75 and/or 45
CFR Part 92, 2 CFR Part 200 and other applicable regulations.
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ADI 203.17
6.1.2 If this contract contains federal funds and is over $100,000.00, the Contractor shall comply with all
applicable standards, orders, or regulations issued under Section 306 of the Clean Air Act as amended (42
United States Code (U.S.C.) 7401, et seq.), Section 508 of the Federal Water Pollution Control Act as
amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable
Environmental Protection Agency regulations 2 CFR Part 1500. The Contractor shall report any violations
of the above to the Agency.
6.1.3 The Contractor, or agent acting for the Contractor, may not use any federal funds received in connection
with this contract to influence legislation or appropriations pending before the Congress or any state
legislature. The Contractor must complete all disclosure forms as required, specifically the Certification
and Assurances Attachment, which must be completed and returned to the Contract Manager prior to the
execution of this contract.
6.1.4 In accordance with Appendix II to 2 CFR Part 200, the Contractor shall comply with Executive Order
11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as
supplemented in Department of Labor regulations 41 CFR Part 60 and in Department of Health and Human
Services regulations 45 CFR Part 92, if applicable.
6.1.5 A contract award with an amount expected to equal or exceed $25,000.00 and certain other contract awards
will not be made to parties listed on the government -wide Excluded Parties List System, in accordance with
the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 and 12689, "Debarment and
Suspension." The Excluded Parties List System contains the names of parties debarred, suspended, or
otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority
other than Executive Order 12549. The Contractor shall comply with these provisions before doing
business or entering into subcontracts receiving federal funds pursuant to this contract. The Contractor
shall complete and sign the Certifications and Assurances Attachment prior to the execution of this contract.
6.2 The Contractor shall not employ an unauthorized alien. The Agency will consider the employment of
unauthorized aliens a violation of the Immigration and Nationality Act (8 U.S.C. 1324a) and the Immigration
Reform and Control Act of 1986 (8 U.S.C. 1101). Such violation will be cause for unilateral cancellation of this
contract by the Agency.
6.3 If the Contractor is a non-profit provider and is subject to Internal Revenue Service (IRS) tax exempt organization
reporting requirements (filing a Form 990 or Form 990-N) and has its tax exempt status revoked for failing to
comply with the filing requirements of the Pension Protection Act of 2006 or for any other reason, the Contractor
must notify the Agency in writing within thirty (30) days of receiving the IRS notice of revocation.
6.4 The Contractor shall comply with Title 2 CFR Part 175 regarding Trafficking in Persons.
6.5 Unless exempt under 2 CFR § 170.110(b), the Contractor shall comply with the reporting requirements of the
Transparency Act as expressed in 2 CFR Part 170.
6.6 To comply with Presidential Executive Order 12989, as amended, and State of Florida Executive Order Number
11-116, Contractor agrees to utilize the U.S. Department of Homeland Security's E -verify system to verify the
employment of all new employees hired by Contractor during the contract term. Contractor shall include in
related subcontracts a requirement that Subcontractors performing work or providing services pursuant to the
state contract utilize the E -verify system to verify employment of all new employees hired by the Subcontractor
during the contract term. Contractors meeting the terms and conditions of the E -Verify System are deemed to be
in compliance with this provision.
7.1 This contract is executed and entered into in the State of Florida, and shall be construed, performed and enforced
in all respects in accordance with Florida law, including Florida provisions for conflict of laws.
7.2 If this contract contains state financial assistance funds, the Contractor shall comply with Section 215.97, F.S.,
and Section 215.971, F.S., and expenditures must be in compliance with laws, rules, and regulations, including,
but not limited to, the Reference Guide for State Expenditures.
[17-GRC-00624/1353101/1] 2
July 2017 — June 2018
ADI 203.17
7.3 The Contractor shall comply with the requirements of Section 287.058, F.S. as amended.
7.3.1 The Contractor shall perform all tasks contained in Attachment I.
7.3.2 The Contractor shall provide units of deliverables, including reports, findings, and drafts, as specified in
Attachment I, to be received and accepted by the contract manager prior to payment.
7.3.3 The Contractor shall comply with the criteria and final date by which such criteria must be met for
completion of this contract as specified in Attachment I, Section III. Method of Payment.
7.3.4 The Contractor shall submit bills for fees or other compensation for services or expenses in sufficient detail
for a proper pre -audit and post -audit.
7.3.5 If itemized payment for travel expenses is permitted in this contract, the Contractor shall submit bills for
any travel expenses in accordance with Section 112.061, F.S., or at such lower rates as may be provided in
this contract.
7.3.6 The Contractor shall allow public access to all documents, papers, letters, or other public records as defined
in subsection 119.011(12), F.S., made or received by the Contractor in conjunction with this contract except
for those records which are made confidential or exempt by law. The Contractor's refusal to comply with
this provision will constitute an immediate breach of contract for which the Agency may unilaterally
terminate this contract.
7.4 If clients are to be transported under this contract, the Contractor shall comply with the provisions of Chapter
427, F.S., and Rule Chapter 41-2, Florida Administrative Code (F.A.C).
7.5 Subcontractors who are on the Discriminatory Vendor List may not transact business with any public entity, in
accordance with the provisions of Section 287.134, F.S.
7.6 The Contractor shall comply with the provisions of Section 11.062, F.S., and Section 216.347, F.S., which prohibit
the expenditure of contract funds for the purpose of lobbying the legislature, judicial branch or a state agency.
7.7 In accordance with Section 287.135 F.S., any Contractor on the Scrutinized Companies with Activities in Sudan
List, or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, or the Scrutinized
Companies that Boycott Israel List (Lists), created pursuant to Section 215.473 F.S. and 215.4725, F.S., or is
engaged in a boycott of Israel, or is engaged in business operations in Cuba or Syria, is ineligible to enter into or
renew a contract with the Agency for goods or services of $1,000,000 or more. Pursuant to Section 287.135
F.S., the Agency may terminate this contract if the Contractor is found to have submitted a false certification of
its status on the Lists or has been placed on the Lists or is engaged in a boycott of Israel or has been engaged in
business operations in Cuba or Syria. Further, the Contractor is subject to civil penalties, attorney's fees and
costs and any costs for investigations that led to the finding of false certification. The Contractor shall complete
and sign the Certifications and Assurances Attachment, prior to the execution of this contract.
,. MMU171 W11104NUT1 M1
The Contractor shall ensure that the requirements of Section 430.0402 and Chapter 435, F.S., as amended, are met
regarding background screening for all persons who meet the definition of a direct service provider and who are not
exempt from the Agency's and/or Department's level 2 background screening pursuant to Section 430.0402(2)-(3),
F.S. The Contractor must also comply with any applicable rules promulgated by the Agency and/or Department and
the Agency for Health Care Administration regarding implementation of Section 430.0402 and Chapter 435, F.S. To
demonstrate compliance with this provision, Contractor shall submit to the Agency, the Background Screening
Affidavit of Compliance (Screening Form) upon thirty (30) days of execution of this contract. Should the Agency
have a completed Screening Form on file for the Contractor, a new Screening Form will be required every twelve
(12) months.
8.1 Further information concerning the procedures for background screening may be found at
http://elderaffairs.state.fl.us/doea/backgi,oundscreening.php.
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9. Grievance Procedures:
ADI 203.17
The Contractor shall develop, implement, and ensure that its Subcontractors have established grievance procedures to
process and resolve client dissatisfaction with or denial of service(s), and address complaints regarding the termination,
suspension or reduction of services, as required for receipt of funds. These procedures, at a minimum, will provide for
notice of the grievance procedure and an opportunity for review of the Subcontractor's determination(s).
i ' ' I_ . _ : i t
10.1 By execution of this contract, Contractor agrees to all provisions of Chapter 119, F.S., and any other applicable
law, and shall:
10.1.1 Keep and maintain public records required by the Agency to perform the contracted services.
10.1.2 Upon request from the Agency's custodian of public records, provide the Agency a copy of the
requested records or allow the records to be inspected or copied within a reasonable time at a cost that does
not exceed the cost provided in Chapter 119, F.S., or as otherwise provided by law.
10.1.3 Ensure that public records that are exempt, or confidential and exempt, from public records disclosure
requirements are not disclosed except as authorized by law for the duration of the contract term and
following completion of the contract if the Contractor does not transfer the records to the Agency.
10.1.4 Upon completion of the contract, the Contractor will either transfer, at no cost to the Agency, all public
records in possession of the Contractor, or will keep and maintain public records required by the Agency.
If the Contractor transfers all public records to the Agency upon completion of the contract,
Contractor shall destroy any duplicate public records that are exempt, or confidential and exempt, from
public records disclosure requirements. If the Contractor keeps and maintains public records upon
completion of the contract, the Contractor shall meet all applicable requirements for retaining public
records. All records stored electronically must be provided to the Agency in a format that is compatible
with the information technology systems of the Agency.
10.2 The Agency may unilaterally cancel this contract, notwithstanding any other provisions of this contract, for
refusal by the Contractor to comply with Section 10 of this contract by not allowing public access to all documents,
papers, letters, or other material made or received by the Contractor in conjunction with this contract, unless the
records are exempt, or confidential and exempt, from Section 24(a) of Article I of the State Constitution and
Section 119.07(1), F.S.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION
OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO
PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT
THE CUSTODIAN OF PUBLIC RECORDS AT:
Public Records Coordinator
Area Agency on Aging for Southwest Florida, Inc.
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
239-652-6900 or 866-413-5337
11. Audits, InsUections. Investigations:
11.1 The Contractor shall establish and maintain books, records and documents (including electronic storage media)
sufficient to reflect all assets, obligations, unobligated balances, income, interest and expenditures of funds
provided by the Agency under this contract. Contractor shall adequately safeguard all such assets and assure
they are used solely for the purposes authorized under this contract. Whenever appropriate, financial information
should be related to performance and unit cost data.
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ADI 203.17
11.2 The Contractor shall retain and maintain all client records, financial records, supporting documents, statistical
records, and any other documents (including electronic storage media) pertinent to this contract for a period of
six (6) years after completion of the contract or longer when required by law. In the event an audit is required
by this contract, records shall be retained for a minimum period of six (6) years after the audit report is issued or
until resolution of any audit findings or litigation based on the terms of this contract, at no additional cost to the
Agency.
11.3 Upon demand, at no additional cost to the Agency, the Contractor shall facilitate the duplication and transfer of
any records or documents during the required retention period.
11.4 The Contractor shall assure that the records described in this section will be subject at all reasonable times to
inspection, review, copying, or audit by federal, state, or other personnel duly authorized by the Agency.
11.5 At all reasonable times for as long as records are maintained, persons duly authorized by the Agency and/or
Department and federal auditors, pursuant to 45 CFR Part 75, will be allowed full access to and the right to
examine any of the Contractor's contracts and related records and documents pertinent to this specific
contract, regardless of the form in which kept.
11.6 The Contractor shall provide a Financial and Compliance Audit Attachment to the Agency as specified in
this contract and ensure that all related third -party transactions are disclosed to the auditor.
11.7 Contractor agrees to comply with the Inspector General in any investigation, audit, inspection, review, or hearing
performed pursuant to Section 20.055, Florida Statutes. Contractor further agrees that it shall include in related
subcontracts a requirement that subcontractors performing work or providing services pursuant to this contract
agree to cooperate with the Inspector General in any investigation, audit, inspection, review, or hearing pursuant
to Section 20.055(5), F.S. By execution of this contract the Contractor understands and will comply with this
subsection.
12.1 The Contractor shall execute Assurances as stated in the Assurances -Non -Construction Programs Attachment that
it will not discriminate against any person in the provision of services or benefits under this contract or in
employment because of age, race, religion, color, disability, national origin, marital status or sex in compliance
with state and federal law and regulations. The Contractor further assures that all Contractors, Subcontractors,
Sub -grantees, or others with whom it arranges to provide services or benefits in connection with any of its
programs and activities are not discriminating against clients or employees because of age, race, religion, color,
disability, national origin, marital status or sex.
12.2 During the term of this contract, the Contractor shall complete and retain on file a timely, complete and accurate
Civil Rights Compliance Checklist, attached to this contract.
12.3 The Contractor shall establish procedures pursuant to federal law to handle complaints of discrimination involving
services or benefits through this contract. These procedures will include notifying clients, employees, and
participants of the right to file a complaint with the appropriate federal or state entity.
12.4 If this contract contains federal funds, these assurances are a condition of continued receipt of or benefit from
federal financial assistance, and are binding upon the Contractor, its successors, transferees, and assignees for the
period during which such assistance is provided. The Contractor further assures that all Subcontractors, Vendors,
or others with whom it arranges to provide services or benefits to participants or employees in connection with
any of its programs and activities are not discriminating against those participants or employees in violation of
the above statutes, regulations, guidelines, and standards. In the event of failure to comply, the Contractor
understands that the Agency and/or Department may, at its discretion, seek a court order requiring compliance
with the terms of this assurance or seek other appropriate judicial or administrative relief, including but not
limited to, termination of and denial of further assistance.
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ADI 203.17
The Contractor shall permit persons duly authorized by the Agency and/or Department to inspect and copy any
records, papers, documents, facilities, goods, and services of the Contractor which are relevant to this contract, and
to interview any clients, employees, and Subcontractor employees of the Contractor to assure the Agency of
the satisfactory performance of the terms and conditions of this contract. Following such review, the Agency will
provide a written report of its findings to the Contractor, and where appropriate, the Contractor shall develop a
Corrective Action Plan (CAP). The Contractor hereby agrees to correct all deficiencies identified in the CAP in a
timely manner as determined by the Agency's Contract Manager.
14. Provision of Services:
The Contractor shall provide services in the manner described in Attachment I.
If the Contractor receives funding from one or more State of Florida human service agencies, in addition to the
Area Agency on Aging for Southwest Florida, Inc., then a joint monitoring visit including such other agencies may
be scheduled. For the purposes of this contract, and pursuant to Section 287.0575, F.S. as amended, Florida's
human service agencies shall include the Department of Children and Families, the Department of Health, the
Department for Persons with Disabilities, the Department of Veterans' Affairs, and the Department of Elder
Affairs. Upon notification and the subsequent scheduling of such a visit by the designated agency's lead
administrative coordinator, the Contractor shall comply and cooperate with all monitors, inspectors, and/or
investigators.
16. Indemnification:
The Contractor shall indemnify, save, defend, and hold harmless the Agency and its agents and employees from
any and all claims, demands, actions, causes of action of whatever nature or character, arising out of or by reason of the
execution of this contract or performance of the services provided for herein. It is understood and agreed that the
Contractor is not required to indemnify the Agency for claims, demands, actions or causes of action arising solely
out of the negligence of the Agency.
16.1 Except to the extent permitted by Section 768.28, F.S., or other Florida law, this section 16 is not applicable to
contracts executed between the Agency and state agencies or subdivisions defined in Section 768.28(2), F.S.
11:: ]i i1 1.1_.
17.1 The Contractor shall provide continuous adequate liability insurance coverage during the existence of this
contract and any renewal(s) and extension(s) of it. By execution of this contract, unless it is a state agency or
subdivision as defined by Section 768.28(2), F.S., the Contractor accepts full responsibility for identifying and
determining the type(s) and extent of liability insurance necessary to provide reasonable financial protections
for the Contractor and the clients to be served under this contract. The limits of coverage under each policy
maintained by the Contractor do not limit the Contractor's liability and obligations under this contract. The
Contractor shall ensure that the Agency has the most current written verification of insurance coverage
throughout the term of this contract. Such coverage may be provided by a self-insurance program established
and operating under the laws of the State of Florida. The Agency reserves the right to require additional
insurance as specified in this contract.
17.2 Throughout the term of this contract, the Contractor shall maintain an insurance bond from a responsible
commercial insurance company covering all officers, directors, employees and agents of the Contractor
authorized to handle funds received or disbursed under all agreements and/or contracts incorporating this
contract by reference in an amount commensurate with the funds handled, the degree of risk as determined by
the insurance company and consistent with good business practices.
W.WRITIM, ..__m a HI__�_
The Contractor shall not use or disclose any information concerning a recipient of services under this contract for any
purpose prohibited by state or federal law or regulations except with the written consent of a person legally authorized
[ 17-GRC-00624/13 53 101/1] 6
July 2017 — June 2018
to give that consent or when authorized by law.
ADI 203.17
Where applicable, the Contractor shall comply with the Health Insurance Portability and Accountability Act (42 USC
1320d.), as well as all regulations promulgated thereunder (45 CFR Parts 160, 162, and 164).
20. Incident Reporting:
20.1 The Contractor shall notify the Agency immediately but no later than forty-eight (48) hours from the
Contractor's awareness or discovery of conditions that may materially affect the Contractors or Subcontractors
ability to perform the services required to be performed under this contract. Such notice shall be made orally to
the Agency's Contract Manager (by telephone) with an email to immediately follow.
20.2 The Contractor shall immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of
a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone number
(1-800-96ABUSE). As required by Chapters 39 and 415, F.S., this provision is binding upon the Contractor,
Subcontractors, and their employees.
21. New Contract(s) Re orn ting:
The Contractor shall notify the Agency within ten (10) days of entering into a new contract with any of the remaining
four (4) state human service agencies. The notification shall include the following information: (1) contracting state
agency and the applicable office or program issuing the contract; (2) contract name and number; (3) contract start and
end dates; (4) contract amount; (5) contract description and commodity or service; (6) Contract Manager name and
contact information. In complying with this provision, and pursuant to Section 287.0575, F.S., as amended, the
Contractor shall complete the Contractor's State Contracts List, ask the Area Agency for a copy of this form..
22. Bankrujtcy Notification:
During the term of this contract, the Contractor shall immediately notify the Area Agency on Aging for Southwest
Florida, Inc. if the Contractor, its assignees, Subcontractors or affiliates file a claim for bankruptcy. Within ten (10)
days after notification, the Contractor must also provide the following information to the Area Agency on Aging for
Southwest Florida, Inc.: (1) the date of filing of the bankruptcy petition; (2) the case number; (3) the court name and
the division in which the petition was filed (e.g., Middle District of Florida, Fort Myers, Florida); and (4) the name,
address, and telephone number of the bankruptcy attorney.
23. Snonsorshin and Publicity:
23.1 As required by Section 286.25, F.S., if the Contractor is a non-governmental organization which sponsors a
program financed wholly or in part by state funds, including any funds obtained through this contract, it shall,
in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by (Contractor's
name), the Area Agency on Aging for Southwest Florida and/or the State of Florida, Department of Elder
Affairs." If the sponsorship reference is in written material, the words "Area Agency on Aging for Southwest
Florida, Inc. and the State of Florida, Department of Elder Affairs" shall appear in at least the same size letters
or type as the name of the organization.
23.2 The Contractor shall not use the words "Area Agency on Aging for Southwest Florida, Inc. and/or the State of
Florida, Department of Elder Affairs" to indicate sponsorship of a program otherwise financed, unless specific
authorization has been obtained by the Agency and/or Department prior to use.
24.1 The Contractor shall not assign the rights and responsibilities under this contract without the prior written
approval of the Agency, which shall not be unreasonably withheld. Any sublicense, assignment, or transfer
otherwise occurring without prior written approval of the Agency will constitute a material breach of the
contract.
24.2 The State of Florida and/or the Area Agency is, at all times, entitled to assign or transfer, in whole or part, its
rights, duties, or obligations under this contract to another governmental agency in the State of Florida, upon
giving prior written notice to the Contractor. In the event the State of Florida and/or the Area Agency approves
[17-GRC-00624/1353101/1] 7
July 2017 — June 2018
ADI 203.17
transfer of the Contractor's obligations, the Contractor remains responsible for all work performed and all
expenses incurred in connection with this contract.
24.3 This contract shall remain binding upon the successors in interest of either the Contractor or the Agency.
25. Subcontracts:
25.1 The Contractor is responsible for all work performed and for all commodities produced pursuant to this contract,
whether actually furnished by the Contractor or its Subcontractors. Any subcontracts shall be evidenced by a
written document and subject to any conditions of approval the Agency deems necessary. The Contractor
further agrees that the Agency will not be liable to the Subcontractor in any way or for any reason. The
Contractor, at its expense, shall defend the Agency against any such claims.
25.2 The Contractor shall promptly pay any Subcontractors upon receipt of payment from the Agency or other
state agency. Failure to make payments to any Subcontractor in accordance with Section 287.0585, F.S., unless
otherwise stated in the contract between the Contractor and Subcontractor, will result in a penalty as provided
by statute.
26. Independent Capacity of Contractor:
It is the intent and understanding of the Parties that the Contractor, and any of its Subcontractors, are independent
Contractors and are not employees of the Agency and shall not hold themselves out as employees or agents of the
Agency without specific authorization from the Agency. It is the further intent and understanding of the Parties that
the Agency does not control the employment practices of the Contractor and will not be liable for any wage and
hour, employment discrimination, or other labor and employment claims against the Contractor or its
Subcontractors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment
compensation funds and all necessary insurance for the Contractor are the sole responsibility of the Contractor.
27. Payment:
Payments shall be made to the Contractor for all completed and approved deliverables (units of service) as defined in
Attachment I. The Contract Manager will have final approval of the Contractor's invoice submitted for payment, and
will approve the invoice for payment only if the Contractor has met all terms and conditions of the contract, unless the
bid specifications, purchase order, or this contract specify otherwise. The approved invoice will be submitted to the
Agency's finance section for budgetary approval and processing. Disputes arising over invoicing and payments
will be resolved in accordance with the provisions of Section 215.422, F.S. A Vendor Ombudsman has been established
within the Florida Department of Financial Services and may be contacted at 800-342-2762.
The Contractor shall return to the Agency any overpayments due to unearned funds or funds disallowed and any
interest attributable to such funds pursuant to the terms and conditions of this contract that were disbursed to the
Contractor by the Agency. In the event that the Contractor or its independent auditor discovers that an overpayment
has been made, the Contractor shall repay said overpayment immediately without prior notification from the
Agency. In the event that the Agency first discovers an overpayment has been made, the Contract Manager will
notify the Contractor in writing of such findings. Should repayment not be made forthwith, the Contractor shall be
charged at the lawful rate of interest on the outstanding balance pursuant to Section 55.03, F.S., after Agency
notification or Contractor discovery.
The Contractor shall ensure an appropriate level of data security for the information the Contractor is collecting or using
in the performance of this contract. An appropriate level of security includes approving and tracking all Contractor
employees that request system or information access and ensuring that user access has been removed from all terminated
employees. The Contractor, among other requirements, must anticipate and prepare for the loss of information
processing capabilities. All data and software shall be routinely backed up to ensure recovery from losses or outages
[ 17-GRC-00624/ 13 5 3101/1]
July 2017 — June 2018 ADI 203.17
of the computer system. The security over the backed -up data is to be as stringent as the protection required of the
primary systems. The Contractor shall ensure all Subcontractors maintain written procedures for computer system
backup and recovery. The Contractor shall complete and sign the Certification Regarding Data Integrity Compliance
for Agreements, Grants, Loans, and Cooperative Agreements prior to the execution of this contract.
30. Computer Use and Social Media Policy:
The Florida Department of Elder Affairs has implemented a Social Media Policy, in addition to its Computer Use Policy,
which applies to all employees, contracted employees, consultants, OPS and volunteers, including all personnel
affiliated with third parties, such as, but not limited to, contractors and subcontractors. Any entity that uses the
Department's computer resource systems must comply with the Department's policy regarding social media. Social
Media includes, but is not limited to blogs, podcasts, discussion forums, Wikis, RSS feeds, video sharing, social
networks like MySpace, Facebook and Twitter, as well as content sharing networks such as flickr and YouTube. This
policy is available on the Department's website at: http://elderaffairs.state.fl.us/doea/financial.php.
The Contractor shall establish safeguards to prohibit employees, board members, management and Subcontractors from
using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of
interest or personal gain. No employee, officer or agent of the Contractor or Subcontractor shall participate in the
selection, or in the award of a contract supported by state or federal funds if a conflict of interest, real or apparent, would
be involved. Such a conflict would arise when: (a) the employee, officer or agent; (b) any member of his/her immediate
family; (c) his or her partner; or (d) an organization which employs, or is about to employ, any of the above, has a
financial or other interest in the firm selected for award. The Contractor or Subcontractor's officers, employees or
agents will neither solicit nor accept gratuities, favors or anything of monetary value from Contractors, potential
Contractors, or parties to Subcontracts. The Contractor's board members and management must disclose to the
Agency any relationship which may be, or may be perceived to be, a conflict of interest within thirty (30) calendar
days of an individual's original appointment or placement in that position, or if the individual is serving as an incumbent,
within thirty (30) calendar days of the commencement of this contract. The Contractor's employees and Subcontractors
must make the same disclosures described above to the Agency's board of directors. Compliance with this provision
will be monitored.
32. Public Entity Crime:
Pursuant to Section 287.133, F.S., a person or affiliate who has been placed on the Convicted Vendor List following a
conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods or
services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the construction
or repair of a public building or public work; may not submit bids, proposals, or replies on leases of real property to a
public entity; may not be awarded or perform work as a Contractor, Supplier, Subcontractor, or Consultant under a
contract with any public entity; and may not transact business with any public entity in excess of the threshold amount
provided in Section 287.017, F.S., for CATEGORY TWO for a period of thirty six (36) months following the date of
being placed on the Convicted Vendor List.
33. Purchasing:
33.1 The Contractor may purchase articles which are the subject of or are required to carry out this contract from
Prison Rehabilitative Industries and Diversified Enterprises, Inc., (PRIDE) identified under Chapter 946, F.S.,
in the same manner and under the procedures set forth in subsections 946.515(2) and (4), F.S. For purposes of
this contract, the Contractor shall be deemed to be substituted for the Agency insofar as dealings with PRIDE.
This clause is not applicable to Subcontractors unless otherwise required by law. An abbreviated list of
products/services available from PRIDE may be obtained by contacting PRIDE, 800-643-8459.
33.2 The Contractor may procure any recycled products or materials, which are the subject of or are required to carry
out this contract, in accordance with the provisions of Section 403.7065, F.S.
33.3 The Contractor may purchase articles that are the subject of, or required to carry out, this contract from a
nonprofit agency for the Blind or for the Severely Handicapped that is qualified pursuant to Chapter 413, F.S.,
[1 7-GRC-00624/13 53101/1] 9
July 2017 — June 2018 ADI 203.17
in the same manner and under the same procedures set forth in Section 413.036(1) and (2), F.S. For purposes of
this contract, the Contractor shall be deemed to be substituted for the Agency insofar as dealings with such
qualified nonprofit agency are concerned. Additional information about the designated nonprofit agency and
the products it offers is available at http://www.respectofflorida.org. This clause is not applicable to
Subcontractors unless otherwise required by law.
34. Patents. CoUrights. Royalties:
If this contract is awarded state funding and if any discovery, invention or copyrightable material is developed, produced
or for which ownership was purchased in the course of or as a result of work or services performed under this contract,
the Contractor shall refer the discovery, invention or material to the Agency to be referred to the Agency and/or
Department of State. Any and all patent rights or copyrights accruing under this contract are hereby reserved to the
State of Florida in accordance with Chapter 286, F.S. Pursuant to Section 287.0571(5)(k), as amended, the only
exceptions to this provision shall be those that are clearly expressed and reasonably valued in this contract.
34.1 If the primary purpose of this contract is the creation of intellectual property, the State of Florida shall retain an
unencumbered right to use such property, notwithstanding any agreement made pursuant to this Section 34.
34.2 If this contract is awarded solely federal funding, the terms and conditions are governed by 2 CFR § 200.315.
34.3 Notwithstanding the foregoing provisions, if the Contractor or one of its Subcontractors is a university and a
member of the State University System of Florida, then Section 1004.23, F.S., shall apply, but the Agency
shall retain a perpetual, fully -paid, nonexclusive license for its use and the use of its Contractors, Subcontractors
or Assignees of any resulting patented, copyrighted or trademarked work products.
35.1 If the tasks to be performed pursuant to this contract include the physical care and control of clients, or the
administration and coordination of services necessary for client health, safety or welfare, the Contractor shall,
within thirty (30) calendar days of the execution of this contract, submit to the Agency's Contract Manager
verification of an Emergency Preparedness Plan. In the event of an emergency, the Contractor shall notify the
Agency of emergency provisions.
35.2 In the event a situation results in a cessation of services by a Subcontractor, the Contractor shall retain
responsibility for performance under this contract and must follow procedures to ensure continuity of operations
without interruption.
36. EEquiUment•
36.1 Equipment means: (a) an article of nonexpendable, tangible personal property having a useful life of more than
one year and a per-unit acquisition cost which equals or exceeds the lesser of the capitalization level established
by the organization for the financial statement purposes, or $5,000.00 [for federal funds], or (b); nonexpendable,
tangible personal property of a non -consumable nature with an acquisition cost of $1,000.00 or more per unit,
and expected useful life of at least one (1) year; and hardback bound books not circulated to students or the
general public, with a value or cost of $250.00 or more [for state funds].
36.2 Contractors and Subcontractors who are Institutions of Higher Education, Hospitals, and Other Non -Profit
Organizations shall have written property management standards in compliance with 2 CFR Part 200
Administrative Requirements (formerly OMB Circular A-110) that include: (a) a property list with all the
elements identified in the circular; (b) a procedure for conducting a physical inventory of equipment at least once
every two (2) years; (c) a control system to insure adequate safeguards to prevent loss, damage, or theft of the
equipment; and (d) maintenance procedures to keep the equipment in good condition. The property records must
be maintained on file and shall be provided to the Agency upon request. The Contractor shall promptly
ied.
equipment. The Contractor shall provide the results of the investigation to the Agency's Contract Manager.
[ 17-GRC-00624/ 13 53101 / 1 ] 10
July 2017 — June 2018 ADI 203.17
36.3 The Contractor's property management standards for equipment acquired with federal funds and federally -owned
equipment shall include accurately maintained equipment records with the following information:
36.3.1 A description of the equipment;
36.3.2 Manufacturer's serial number, model number, federal stock number, national stock number, or other
identification number;
36.3.3 Source of the equipment, including the award number;
36.3.4 Whether title vests in the Contractor or the federal government;
36.3.5 Acquisition date (or date received, if the equipment was furnished by the federal government) and cost;
36.3.6 Information from which one can calculate the percentage of federal participation in the cost of the
equipment (not applicable to equipment furnished by the federal government);
36.3.7 Location and condition of the equipment and the date the information was reported;
36.3.8 Unit acquisition cost; and
36.3.9 Ultimate disposition data, including date of disposal and sales price or the method used to determine
current fair market value where a Contractor compensates the federal awarding agency for its share.
36.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased with
state funds with an acquisition cost over $1,000.00 that is specifically identified in the area plan approved by the
Agency is part of the cost of carrying out the activities and functions of the grant awards and Title (ownership)
will vest in the Contractor, subject to the conditions of 2 CFR Pail 200. Equipment purchased under these
thresholds is considered supplies and is not subject to property standards. Equipment purchased with funds
identified in the budget attachments to agreements covered by this contract, or identified in the sub -agreements
with Subcontractors (not included in a cost methodology), is subject to the conditions of Chapter 273, F. S. and
60A-1.017, F. A. C. and 45 CFR Part 75.
36.5 The Contractor shall not dispose of any equipment or materials provided by the Agency, or purchased with
funds provided through this contract without first obtaining the approval of the Agency's Contract Manager.
When disposing of property or equipment the Contractor must submit a written request for disposition
instructions to the Agency's Contract Manager. The request should include a brief description of the
property, purchase price, funding source, and percentage of state or federal participation, acquisition date and
condition of the property. The request should also indicate the Contractor's proposed disposition (i.e., transfer
or donation to another agency that administers federal programs, offer the items for sale, destroy the items, etc.).
36.6 The Agency's Contract Manager will issue disposition instructions. If disposition instructions are not
received within one hundred twenty (120) days of the written request for disposition, the Contractor is authorized
to proceed as directed in 2 CFR §200.313.
36.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto, but
excludes movable machinery and equipment. Real property may not be purchased with state or federal funds
through agreements covered under this contract without the prior approval of the Agency. Real property
purchases from Older Americans Act funds are subject to the provisions of Title 42, Chapter 35, Subchapter III,
Part A., Section 3030b U.S.C. Real property purchases from state funds can only be made through fixed capital
outlay grants and aids appropriations and therefore are subject to the provisions of Section 216.348, F.S.
36.8 Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted and tested prior
to disposal to ensure no confidential information remains.
36.9 The Contractor must adhere to the Agency's procedures and standards when purchasing Information
Technology Resources (ITR) as part of any agreement(s) incorporating this contract by reference. An ITR
worksheet is required for any computer related item costing $1,000.00 or more, including data processing
hardware, software, services, supplies, maintenance, training, personnel and facilities. The completed ITR
worksheet shall be maintained in the LAN administrator's file and must be provided to the Agency upon
[17-GRC-00624/1353101/1] 11
July 2017 — June 2018 ADI 203.17
request. The Contractor has the responsibility to require any Subcontractors to comply with the Agency's ITR
procedures.
tY
_11Wi"il
The PUR 1000 Form is hereby incorporated by reference and available at:
http://www.myflorida.com/apps/vbs/adoc/F7740 PUR1000.pdf
In the event of any conflict between the PUR 1000 Form and any terms or conditions of this contract the terms or
conditions of this contract shall take precedence over the PUR 1000 Form. However, if the conflicting terms or
conditions in the PUR 1000 Form are required by any section of the Florida Statutes, the terms or conditions contained
in the PUR 1000 Form shall take precedence.
38. Use of State Funds to Purchase or Improve Real Pro en rtv:,
Any state funds provided for the purchase of or improvements to real property are contingent upon the Contractor or
political subdivision granting to the state a security interest in the property at least to the amount of state funds provided
for at least five (5) years from the date of purchase or the completion of the improvements or as further required by law.
Any dispute concerning performance of the contract shall be decided by the Agency's Contract Manager, who shall
reduce the decision to writing and serve a copy on the Contractor.
40. Financial Consequences:
If the Contractor fails to meet the minimum level of service or performance identified in this contract, the Agency
will impose financial consequences as stated in Attachment I.
Nothing contained in this contract is intended to serve as a waiver of sovereign immunity by any entity to which
sovereign immunity may be applicable.
42. Venue:
If any dispute arises out of this contract, the venue of such legal recourse shall be Lee County, Florida.
43. Entire Contract:
This contract contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations
shall be valid or binding upon the Agency or the Contractor unless expressly contained herein or by a written
amendment to this contract signed by both Parties.
44. Force Majeure:
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control,
provided the party experiencing the force majeure condition provides immediate written notification to the other party
and takes all reasonable efforts to cure the condition.
45. Severability Clause:
The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or unenforceable the
other provisions are severable to that void provision and shall remain in full force and effect.
46. Condition Precedent to Contract A111ronriations:
The Parties agree that the Agency's performance and obligation to pay under this contract is contingent upon an
annual appropriation by the Legislature.
47. Addition/Deletion:
The Parties agree that the Agency reserves the right to add or to delete any of the services required under this
contract when deemed to be in the State of Florida's best interest and reduced to a written amendment signed by both
Parties. The Parties shall negotiate compensation for any additional services added.
[17-GRC-00624/1353101/1] 12 ���
July 2017 — June 2018
48. Waiver:
ADI 203.17
The delay or failure by the Agency to exercise or enforce any of its rights under this contract will not constitute or be
deemed a waiver of the Agency's right thereafter to enforce those rights, nor will any single or partial exercise of any
such right preclude any other or further exercise thereof or the exercise of any other right.
49. Com In •ance:
The Contractor shall abide by all applicable current federal statutes, laws, rules and regulations as well as applicable
current state statutes, laws, rules and regulations. The Parties agree that failure of the Contractor to abide by these laws
shall be deemed an event of default of the Contractor, and subject the contract to immediate, unilateral cancellation of
the contract at the discretion of the Agency.
50. Final Invoice:
The Contractor shall submit the final invoice for payment to the Agency no later than thirty (30) days upon the
contract ending date unless otherwise specified in Attachment I. If the Contractor fails to do so, all right to payment is
forfeited and the Agency may not honor any requests submitted after the aforesaid time period. Any payment due
under the terms of this contract may be withheld until all required documentation and reports due from the Contractor
and necessary adjustments thereto have been approved by the Agency.
Modifications of the provisions of this contract shall be valid only when they have been reduced to writing and duly
signed by both parties. The rate of payment and the total dollar amount may be adjusted retroactively to reflect price
level increases and changes in the rate of payment when these have been established through the appropriations process
and subsequently identified in the Agency's operating budget.
52. Suspension of Work:
The Agency may in its sole discretion suspend any or all activities under the contract or purchase order, at any time,
when in the best interests of the State to do so. The Agency shall provide the Contractor written notice outlining the
particulars of suspension. Examples of the reason for suspension include, but are not limited to, budgetary
constraints, declaration of emergency, or other such circumstances. After receiving a suspension notice, the Contractor
shall comply with the notice and shall not accept any purchase orders. Within ninety (90) days, or any longer period
agreed to by the Contractor, the Agency shall either (1) issue a notice authorizing resumption of work, at which
time activity shall resume, or (2) terminate the contract or purchase order. Suspension of work shall not entitle the
Contractor to any additional compensation.
53. Termination:
53.1 Termination for Convenience. The Agency, by written notice to the Contractor, may terminate this contract in
whole or in part when the Agency determines in its sole discretion that it is in the State's interest to do so. The
Contractor shall not furnish any product after it receives the notice of termination, except as necessary to
complete the continued portion of this contract, if any. The Contractor shall not be entitled to recover any
cancellation charges or lost profits.
53.2 Termination for Cause. The Agency may terminate this contract if the Contractor fails to (1) deliver the
product within the time specified in the contract or any extension, (2) maintain adequate progress, thus
endangering performance of the contract, (3) honor any term of the contract, or (4) abide by any statutory,
regulatory, or licensing requirement. Rule 60A-1.006(3), F.A.C., governs the procedure and consequences of
default. The Contractor shall continue work on any work not terminated. Except for defaults of Subcontractors
at any tier, the Contractor shall not be liable for any excess costs if the failure to perform the contract arises from
events completely beyond the control, and without the fault or negligence, of the Contractor. If the failure to
perform is caused by the default of a Subcontractor at any tier, and if the cause of the default is completely beyond
the control of both the Contractor and the Subcontractor, and without the fault or negligence of either, the
Contractor shall not be liable for any excess costs for failure to perform, unless the subcontracted products were
obtainable from other sources in sufficient time for the Contractor to meet the required delivery schedule. If, after
termination, it is determined that the Contractor was not in default, or that the default was excusable, the rights
and obligations of the Parties shall be the same as if the termination had been issued for the convenience of the
Agency. The rights and remedies of the Agency in this clause are in addition to any other rights and
[I 7-GRC-00624/1353 101/1 ] 13
July 2017 — June 2018
remedies provided by law or under the contract.
ADI 203.17
53.3 Upon termination of this contract, the Contractor and Subcontractors shall, at no cost to the Agency, transfer all
public records in their possession to the Agency and destroy any duplicate public records that are exempt, or
confidential and exempt, from public records disclosure requirements. All records stored electronically shall be
provided to the Agency in a format that is compatible with the information technology systems of the
Agency.
The Agency authorizes, but does not require, the Contractor to create and retain electronic records and to use
electronic signatures to conduct transactions necessary to carry out the terms of this contract. A Contractor that creates
and retains electronic records and uses electronic signatures to conduct transactions shall comply with the requirements
contained in the Uniform Electronic Transaction Act, Section 668.50, F.S. All electronic records must be fully
auditable; are subject to Florida's Public Records Law, Chapter 119, F.S.; must comply with Section 29, Data Integrity
and Safeguarding Information; must maintain all confidentiality, as applicable; and must be retained and maintained by
the Contractor to the same extent as non -electronic records are retained and maintained as required by this contract.
54.1 The Agency's authorization pursuant to this section does not authorize electronic transactions between the
Contractor and the Agency. The Contractor is authorized to conduct electronic transactions with the
Agency only upon further written consent by the Agency.
54.2 Upon request by the Agency, the Contractor shall provide the Agency with non -electronic (paper) copies of
records. Non -electronic (paper) copies provided to the Agency of any document that was originally in
electronic form with an electronic signature must identify the person and the person's capacity who electronically
signed the document on any non -electronic copy of the document.
55. Contract Manager:
The Agency may substitute any Agency employee to serve as the Contract Manager.
REMAINDER OF THE PAGE INTENTIONALL Y LEFT BLANK
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July 2017 — June 2018 ADI 203.17
56. Official Pavee and Representatives (Names. Addresses. and Telephone Numbers):
57. All Terms and Conditions Included:
This contract and its Attachments, I — XI including 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 COUNTY COMMISSIONERS
SIGNED BY:
M, all
NAME: Steve Y. Carvell
TITLE: Public Services Department Head
DATE. 0 5
Federal T ID: 59-6000558
Fiscal Year Ending Date: 09/30
DUNS: 833441814
[17-GRC-00624/1353101/1] 15
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA, INC.
SIGNED BY:
NAME: MARIANNE G LORINI
TITLE: PRESIDENT/CEO
DATE:
Approved as to form and legality
Assistant County Attorney \ A.
►��` i
The Contractor name, as shown on page 1 ofo
Collier County Board of County Commissioners
/oCollier County Community and Human Services
a.
this contract, and mailing address of the official
3339 E Tamiami Trail, Suite 211
payee to whom the payment shall be made is:
Naples, FL 34112
The name of the contact person and streetKimberley
Grant, Director
Collier County Board of County Commissioners
b.
address where financial and administrative
%Collier County Community and Human Services
records are maintained is:
3339 E Tamiami Trail, Suite 211
Naples, FL 34112
Kimberley Grant, Director
The name, address, and telephone number of
Collier County Board of County Commissioners
C.
the representative of the Contractor responsible
%Collier County Community and Human Services
for administration of the program under this
3339 E Tamiami Trail, Suite 211
contract is:
Naples, FL 34112
(239) 252-2273
Area Agency on Aging for Southwest Florida, Inc.
d.
The section and location within the Agency
15201 North Cleveland Avenue, Suite 1100
where Requests for Payment and Receipt and
North Fort Myers, FL 33903
Expenditure forms are to be mailed is:
Tammy Rhoades, Vice President of Finance
e.
The name, address, and telephone number
Area Agency on Aging for Southwest Florida, Inc.
of the 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.
57. All Terms and Conditions Included:
This contract and its Attachments, I — XI including 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 COUNTY COMMISSIONERS
SIGNED BY:
M, all
NAME: Steve Y. Carvell
TITLE: Public Services Department Head
DATE. 0 5
Federal T ID: 59-6000558
Fiscal Year Ending Date: 09/30
DUNS: 833441814
[17-GRC-00624/1353101/1] 15
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA, INC.
SIGNED BY:
NAME: MARIANNE G LORINI
TITLE: PRESIDENT/CEO
DATE:
Approved as to form and legality
Assistant County Attorney \ A.
►��` i
July 2017 — June 2018
INDEX OF ATTACHMENTS
ADI 203.17
ATTACHMENTI...........................................................................................................................................17
STATEMENTOF WORK.......................................................................................................................................17
ATTACHMENTII......................................................................................................................................... 28
FINANCIALAND COMPLIANCE A UDIT...................................................................................................... 28
ATTACHMENTIII........................................................................................................................................ 34
CERTIFICATIONS AND ASSURANCES......................................................................................................... 34
ATTACHMENTIV........................................................................................................................................ 39
ASSURANCES—NON-CONSTRUCTION PROGRAMS................................................................................. 39
ATTACHMENTV......................................................................................................................................... 41
FLORIDA DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST ................ 41
ATTACHMENTVI........................................................................................................................................ 45
BACKGROUNDSCREENING........................................................................................................................ 45
ATTACHMENTVII...................................................................................................................................... 46
INVOICE REPORT SCHEDULE..................................................................................................................... 46
ATTACHMENTVIII..................................................................................................................................... 47
ANNUALBUDGET SUMMARY...................................................................................................................... 47
ATTACHMENTIX........................................................................................................................................ 48
REQUESTFOR PAYMENT............................................................................................................................. 48
ATTACHMENTX......................................................................................................................................... 49
RECEIPT AND EXPENDITURE REPORT..................................................................................................... 49
ATTACHMENTXI........................................................................................................................................ 50
SERVICERATE REPORT................................................................................................................................. 50
[17-GRC-00624/1353101/1] 16
July 2017 — June 2018
ATTACHMENT
STATEMENT OF WORK
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
I. SERVICES TO BE PROVIDED
A. Definitions of Terms
1. 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 Administrative Code (F.A.C.)
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.)
2. Program -Specific Terms
ADI 203.17
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 Section 306 of the Older Americans
Act (42 U.S.C. 3026), as amended, and Department instructions. The Area Plan includes performance
measures and unit rates per service offered per county.
Area Plan Update: A revision to the Area Plan wherein the Agency enters ADI -specific data into the
CIRTS. An update may also include other revisions to the Area Plan as instructed by the Department.
Department of Elder Affairs Programs and Services Handbook: An official document of DOEA. The
Handbook includes program policies, procedures, and standards applicable to agencies which are
recipients/providers of DOEA funded programs. An annual update is provided through a Notice of Instruction.
Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to
remain independent and in the least restrictive living arrangement.
Memory Disorder Clinic: Research oriented programs created pursuant to Sections 430.502(1) and (2), F.S.,
to provide diagnostic and referral services, conduct basic and service -related multidisciplinary research, and
develop training materials and educational opportunities for lay and professional caregivers of individuals with
AD.
Notice of Instruction (NOI): The Department's established method to communicate to the Agency the
requirement to perform a task or activity. NOIs are located on the Department's website at
http://elderaffairs.state.fl.us/doea/nois.php.
[17-GRC-00624/1353101/1] 17
July 2017 — June 2018
ADI 203.17
Proviso: Language used in a general appropriations bill to qualify or restrict the way in which a specific
appropriation is to be expended.
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.
B. GENERAL DESCRIPTION
1. General Statement
The purpose of the ADI is to address the special needs of individuals with AD, their families and caregivers.
2. Alzheimer's Disease Initiative Program Mission Statement
The ADI Program assists persons afflicted with AD and other forms of dementia to live as independently as
possible with support to family members and caregivers.
3. Authority
The relevant authority governing the ADI Program includes:
a. Rule Chapter 5813-1, F.A.C.;
b. Sections 430.501, 430.502, 430.503, and 430.504, F.S.; and;
c. The Catalog of State Financial Assistance (CSFA) Numbers are 65004 and 65002.
4. Scope of Service
The Agency 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 Agency's Area Plan, as updated,
and the current DOEA Programs and Services Handbook, which are incorporated by reference.
5. Major Program Goal
The major goal of the ADI Program is to provide services to meet the needs of caregivers and individuals with
AD or other related disorders.
C. Clients to be Served
1. General Description
The ADI Program addresses the special needs of individuals with AD or other related disorders, and their
caregivers.
2. Client Eligibility
Clients eligible to receive services under this contract must:
a. Be 18 years of age or older and have a diagnosis of AD or a related disorder, or be suspected of having
AD or a related disorder; and
b. Not be enrolled in any Medicaid capitated long-term care program.
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.
[ 17-GRC-00624/ 13 53101/1 ] 18
July 2017 — June 2018 ADI 203.17
4. Client Determination
The Agency shall have final authority for the determination of client eligibility.
II. MANNER OF SERVICE PROVISION
A. 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
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 Section I.C.2.
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 Department and Agency to remove existing clients from services in
order to serve new clients being assessed and prioritized for service delivery.
a. 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.
b. Service priority for individuals not included 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.
3. Program Services
The Contractor shall ensure the provision of program services is consistent with the Agency's current area
plan, as updated and approved by the Agency, and the current DOEA Programs and Services Handbook.
B. 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 circumstance occurs that may result in a delay for
a period of 60 days or more the initiation of the subcontract or the performance of the Subcontractor, the Contractor
shall notify the Agency's Contract Manager and the Agency's Vice President Financial Officer in writing of
such delay. The Contractor shall not permit a Subcontractor to perform services related to this contract without
having a binding Subcontractor agreement executed. The Agency will not be responsible or liable for any
obligations or claims resulting from such action.
1. Copies of Subcontracts
The Contractor shall submit a copy of all subcontracts to the Contract Manager within thirty days of the
subcontract being executed.
2. Monitoring the Performance of Subcontractors
The Contractor shall monitor, at least once per year, each of its Subcontractors, Sub -recipients, 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.
[I 7-GRC-00624/13 53101/11 19
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C. Staffing Requirements
ADI 203.17
1. Staffing Levels
The Contractor shall dedicate the staff necessary to meet the obligations of this contract and ensure that
subcontractors dedicate adequate staff accordingly.
2. Professional Qualifications
The Contractor shall ensure that the staff responsible for performing any duties or functions within this contract
have the qualifications as specified in the DOEA Programs and Services Handbook.
3. 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, or as otherwise specified in Proviso or the
Subcontractor's approved service provider application. Normal business hours are defined as Monday through
Friday, 8:00 a.m. to 5:00 p.m. local time.
D. Deliverables
The following section provides the specific quantifiable units of deliverables and source documentation required
to evidence the completion of the tasks specified in this contract.
1. 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 Agency's current Department -approved Area Plan, the current
DOEA Programs and Services Handbook, which is incorporated by reference, and Section II.A.1-3 of this
contract. Documentation of service delivery must include a report consisting of the following: number of
clients served, number of service units provided by service, and rate per service unit with calculations that
equal the total invoice amount. The services include the following categories:
a. Respite and Other Services
(1) Caregiver Training/Support;
(2) Case Aide;
(3) Case Management;
(4) Counseling (Gerontological);
(5) Counseling (Mental Health/Screening);
(6) Education/Training;
(7) Intake;
(8) Respite (Facility -Based);
(9) Respite (In -Home);
(10) Specialized Medical Equipment, Services, and Supplies; and
(11) Transportation.
b. Memory Disorder Clinics
The Contractor shall maintain coordination with the memory disorder clinics, the Alzheimer's Disease
Brain Bank, and all other components of the Alzheimer's Disease Initiative, as well as Silver Alert, in the
designated planning and service area. Memory Disorder Clinics (MDCs) are required to provide annual
in-service training to all respite, in -facility respite and model day care center staff in their designated
service areas, and plan and develop service -related research projects with model day care and respite
providers. The Contractor shall respond to requests for statistical data concerning its consumers, based on
information requirements of the MDCs and the Brain Bank, and assist the MDCs in carrying out Silver
Alert protocol activities.
2. Services and Units of Service
The Agency shall ensure that the provision of services described in this contract is in accordance with the
[I 7-GRC-00624/1353 101/1] 20
July 2017 — June 2018 ADI 203.17
current DOEA Programs and Services Handbook and the service tasks described in Section II.A. The Service
Rate Report 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 the Service Rate Report, and approved by the Agency.
E. Reports
The Contractor shall respond to additional routine 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.
1. CIRTS Reports
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:
a. Client Reports;
b. Monitoring Reports;
c. Services Reports;
d. Miscellaneous Reports;
e. Fiscal Reports;
f. Aging and Disability Resource Center Reports; and
g. Outcome Measurement Reports.
2. Service Cost Reports
a. The Agency shall require the Contractor to submit Annual Service Cost Reports, which reflect actual
costs of providing each service by program. Service Cost Reports for all contracts are due by
February 25, 2017 for the prior calendar year.
b. Unit Cost Methodology worksheets must be submitted by August 15 of each year, if a rate increase is
being requested for any contract in the next calendar year.
3. Surplus/Deficit Report
The Contractor shall submit a Consolidated Surplus/Deficit Report, Lead Agency Spending Report, in a
format provided by the Agency, to the Agency Contract Manager by the 18th of each month. This
Consolidated Surplus/Deficit Report is for all agreements and contracts between the Contractor and the
Agency and must include the following:
a. A list of all subcontractors and their current status regarding surplus/deficit;
b. The Contractor's detailed plan on how the surplus/deficit spending exceeding the threshold specified by
the Agency will be resolved;
c. Recommendations to transfer funds to resolve surplus/deficit spending;
d. Input from the Agency and/or Board of Directors on resolution of spending issues, if applicable;
e. Number of clients currently on APCL that receive a priority ranking score of 4 or 5; and
f. Number of clients currently on the APCL designated as Imminent Risk.
F. Records and Documentation
1. Requests for Payment
The Contractor shall maintain documentation to support Requests for Payment that shall be available to the
Agency or authorized individuals, such as the Department of Financial Services, upon request.
[ 17-GRC-00624/1353101/1 1 21
July 2017 — June 2018 ADI 203.17
2. CIRTS Data and Maintenance
The Contractor shall ensure, on a monthly basis, collection and maintenance of client and service information
in CIRTS or any such system designated by the Agency. Maintenance includes accurate and current data, and
valid exports and backups of all data and systems according to Agency standards.
3. Data Integrity and Back up Procedures
Each Contractor shall anticipate and prepare for the loss of information processing capabilities. The routine
backing up of all data and software is required to recover from losses or outages of the computer system. Data
and software essential to the continued operation of contractor functions must be backed up. The security
controls over the backup resources shall be as stringent as the protection required of the primary resources. It
is recommended that a copy of the backed up data be stored in a secure, offsite location.
4. Policies and Procedures for Records and Documentation
The Contractor shall maintain written policies and procedures for computer system backup and recovery and
shall have the same requirement of its subcontractors. These policies and procedures shall be made available
to the Agency upon request.
G. Performance Specifications
1. Outcomes and Outputs (Performance Measures)
The Contractor must:
a. Ensure the prioritization and service provision of clients in accordance with Section II.A.1-3 of this
contract;
b. Ensure the provision of the services described in this contract are in accordance with the current DOEA
Programs and Services Handbook and Section II.D of this contract;
c. Timely and accurately submit to the Agency all required documentation and reports described in
Section II.E; and
d. Timely (in accordance with the Annual Budget Summary) and accurately submit the Request for Payment,
the Receipt and Expenditure Report, and supporting documentation.
2. Monitoring and Evaluation Methodology
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, and/or
on-site visit(s). 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:
a. Desk reviews and analytical reviews;
b. Scheduled, unscheduled, and follow-up on-site visits;
c. Client visits;
d. Review of independent auditor's reports;
e. Review of third -party documents and/or evaluation;
f. Review of progress reports;
g. Review of customer satisfaction surveys;
h. Agreed-upon procedures review by an external auditor or consultant;
i. Limited -scope reviews; and
j. Other procedures as deemed necessary.
H. Contractor Responsibilities
1. Contractor Accountability
All service tasks and deliverables pursuant to this contract are solely and exclusively the responsibility of the
[17-GRC-00624/1353101/1) 22
July 2017 — June 2018 ADI 203.17
Contractor and for which, by execution of this contract, the Contractor agrees to be held accountable.
2. Coordination with Other Providers and/or Entities
Notwithstanding that services for which the Contractor is held accountable involve coordination with other
entities in performing the requirements of this contract, the failure of other entities does not alleviate the
Contractor from any accountability for tasks or services that the Contractor is obligated to perform pursuant
to this contract.
I. Agency Responsibilities
1. Agency Obligations
The Agency may provide technical support to assist the Contractor in meeting the requirements of this
contract. The support, or lack thereof, shall not relieve the Contractor from full performance of contract
requirements.
2. Agency Determinations
The Agency reserves the exclusive right to make certain determinations in the tasks and approaches. The
absence of the Agency setting forth a specific reservation of rights does not mean that all other areas of the
contract are subject to mutual agreement.
III. METHOD OF PAYMENT
A. Payment Methods Used
The Method of Payment for this contract is a combination of fixed-fee/unit rate, cost reimbursement, and advance
payments, subject to the availability of funds and Contractor performance. The Agency will pay the Contractor
upon satisfactory completion of the Tasks/Deliverables, as specified in Section II, Manner of Service Provision,
and in accordance with other terms and conditions of this contract.
1. Fixed Fee/Unit Rate
Payments for Fixed Fee/Unit Rate shall not exceed amounts established in the Service Rate Report.
2. Cost Reimbursement
Payment may be authorized only for allowable expenditures, which are in accordance with the services
specified in the Service Rate Report. All Cost Reimbursement Requests for Payment must include the Receipt
and Expenditure Report, beginning with the first month of the contract.
3. Advance Payments
The Contractor may request up to two (2) 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's requests for advance require the approval of the Agency Contract Manager. The
Contractor shall provide the Agency Contract Manager documentation justifying the need for an advance and
describing how the funds will be distributed. If sufficient budget is available, the Agency will issue approved
advanced payments after July 1 st of the contract year.
a. Any advanced payments the Contractor requested for subcontractors must be distributed within seven (7)
days of receipt of payment from the Agency. The Contractor shall submit to the Agency documentation
to support full distribution of advanced funds with report number 5, due to the Agency on October 9, in
accordance with the Invoice Report Schedule.
b. All advanced payments retained by the Contractor must be fully expended no later than September 30,
2017. Any portion of advanced payments not expended must be recouped on the Invoice Report Schedule,
report number 5, due to the Agency on October 9, in accordance with the Invoice Report Schedule.
[17-GRC-00624/1353101/1] 23
July 2017 — June 2018 ADI 203.17
c. All advance payments made to the Contractor shall be reimbursed to the Agency as follows: At least
one—tenth of the advance payment received shall be reported as an advance recoupment on each Request
for Payment, starting with report number 5, in accordance with the Invoice Report Schedule.
B. Method of Invoice Payment
Payment shall be made upon the Contractor's presentation of an invoice subsequent to the acceptance and approval
by the Agency of the deliverables shown on the invoice. The form and substance of each invoice submitted by the
Contractor shall be as follows:
1. Have a Remittance Address that corresponds exactly to the "Remit To" address provided to MFMP during
registration;
2. Request payment on a monthly basis for the units of services established in the Agency's approved Area
Plan, provided in conformance with the requirements as described in the DOEA Programs and Services
Handbook, at the rates established in the Service Rate Report of the contract. Documentation of service
delivery must include a report consisting of the following: number of clients served, number of service units
provided by service, and rate per service unit with calculations that equal the total invoice amount. Any
requested changes to the approved budget subsequent to the execution of this contract must be submitted to
the Contract Manager for approval. Any change to the total contract amount requires a formal amendment;
3. The Contractor shall consolidate all subcontractors' Requests for Payment and Expenditure Reports that
support Requests for Payment and shall submit to the Agency using the attached Request for Payment
form, Receipt and Expenditure Report for services, which must include itemized expenditure categories; and
4. All Requests for Payment shall be based on the submission of monthly Expenditure Reports beginning with
the first month of this contract. The schedule for submission of advance requests (when available) and
invoices is listed in the Invoice Schedule.
C. 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 disallowances.
D. Final Invoice Instructions
The Contractor shall submit the final Request for Payment to the Agency no later than July 25, 2018.
E. CIRTS Data Entries for Subcontractors
The Contractor must require Subcontractors 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 Contractor. The Contractor
shall establish deadlines for completing CIRTS data entry and to ensure compliance with due dates for the requests
for payment and expenditure reports that Contractor must submit to the Agency.
F. Contractors' Monthly CIRTS Reports
The Agency must require Contractors to 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.
G. Corrective Action Plan
1. Contractor shall ensure 100% of the deliverables identified in Section II.D.1-3 of this contract are performed
[ 17-GRC-00624/ 13 53101/1 ] 24
July 2017 — June 2018
pursuant to contract requirements.
ADI 203.17
2. If at any time the Contractor is notified by the Agency Contract Manager that it has failed to correctly,
completely, or adequately perform contract deliverables identified in Section II.D.1-3 of this contract, the
Contractor will have ten (10) days to submit a Corrective Action Plan ("CAP") to the Agency Contract Manager
that addresses the deficiencies and states how the deficiencies will be remedied within a time period approved
by the Agency Contract Manager. The Agency shall assess a Financial Consequence for Non -Compliance on
the Contractor as referenced in Section III.I. of this contract 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. If the Contractor fails to correct an identified deficiency within the approved time period specified in the CAP,
the Agency shall deduct the percentage established in Section III.I. of this contract from the payment for the
invoice of the following month.
4. If the Contractor fails to timely submit a CAP, the Agency shall deduct the percentage established in
Section III.I. of this contract for each day the CAP is overdue. The deduction will be made from the payment
for the invoice of the following month.
H. Financial Consequences
1. The Agency will withhold or reduce payment if the Contractor fails to perform the deliverables to the
satisfaction of the Agency according to the requirements referenced in Section ILD of this contract. The
following financial consequences will be imposed if the deliverables stated do not meet in part or in whole the
performance criteria as outlined in Section II.D. of this contract.
2. Delivery of services to eligible clients as referenced in Section II.A.1-3 and Section II.D.1 of this contract —
Failure to comply with established assessment and prioritization criteria, as evidenced by CIRTS reports, will
result in a 2% reduction of payment per business day. The reduction of payment will begin on the first business
day following the Agency's notification to the Contractor that the identified deficiency was not cured or
satisfactorily addressed in accordance with the Agency -approved CAP, referenced in Section III.H.
3. Timely submission of a CAP — Failure to timely submit a CAP within ten (10) business days after notification
of a deficiency by the Agency Contract Manager will result in a 2% reduction of payment per business day the
CAP is not received. The reduction of payment will begin the first business day following the Agency's
notification to the Contractor that the identified deficiency was not cured or satisfactorily addressed in
accordance with the Agency approved CAP, referenced in Section IIIH.
4. Exceptions may be granted solely, in writing, by the Agency contract manager.
IV. SPECIAL PROVISIONS
A. Final Budget and Funding Revision Requests
Final requests for budget revisions or adjustments to contract funds based on expenditures for provided services
must be submitted to the Agency Contract Manager in writing no later than June 30, 2018. Email requests are
considered acceptable.
B. Contractor's Financial Obligations
[17-GRC-00624/1353101/1] 25
July 2017 — June 2018 ADI 203.17
1. Use of Service Dollars and Management of the Assessed Priority Consumer List
The Contractor is expected to spend all funds provided by the Agency for the purpose specified in this
contract. The Contractor must manage the service dollars in such a manner so as to avoid having a wait list
and a surplus of funds at the end of the contract period, for each program managed by the Contractor. If the
Agency determines that the Contractor is not spending service funds accordingly, the Agency may transfer
funds to other AAAs during the contract period and/or adjust subsequent funding allocations accordingly, as
allowable under state and federal law.
2. Cost Sharing and Co -payments
The Agency shall 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'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.
C. Remedies for Nonconforming Services
1. 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 will only be
delivered to eligible program participants.
2. 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.
D. Investigation of Criminal Allegations - Any report that implies criminal intent on the part of the Contractor or
any Subcontractors and referred to a governmental or investigatory agency must be sent to the Agency. If the
Contractor has reason to believe that the allegations will be referred to the State Attorney, a law enforcement agency,
the United States Attorney's office, or other governmental agency, the Contractor shall notify the Inspector General
at the Agency immediately. A copy of all documents, reports, notes or other written material concerning the
investigation, whether in the possession of the Contractor or Subcontractors, must be sent to the Agency and
DOEA's Inspector General with a summary of the investigation and allegations.
E. Volunteers — If applicable, the Contractor shall ensure the use of trained volunteers in providing direct services
delivered to older individuals and individuals with disabilities needing such services. If possible, the Contractor
shall work in coordination with organizations that have experience in providing training, placement, and stipends
for volunteers or participants (such as organizations carrying out federal service programs administered by the
Corporation for National and Community Service).
F. Enforcement
1. In accordance with Section 430.04, F.S., the Agency may, without taking any intermediate measures
available to it against the Contractor, rescind the Contractors designation as a lead agency, if the Agency
finds that any of the following have occurred:
a. An intentional or negligent act of the Contractor has materially affected the health, welfare, or safety of
clients, or substantially and negatively affected the operation of services covered pursuant to this contract.
b. The Contractor lacks financial stability sufficient to meet contractual obligations or that contractual funds
have been misappropriated.
[ 17-GRC-00624/1353101/1 1 26
July 2017 — June 2018 ADI 203.17
c. Contractor has committed multiple or repeated violations of legal and regulatory requirements, regardless
of whether such laws or regulations are enforced by the Agency, or the Contractor has committed
multiple or repeated violations of Agency standards.
d. The Contractor has failed to continue the provision or expansion of services after the declaration of a state
of emergency.
e. The Contractor has failed to adhere to the terms of this contract.
f. The Contractor has failed to properly determine client eligibility as defined by the Agency or efficiently
manage program budgets.
g. The Contractor has failed to implement and maintain an Agency -approved client grievance resolution
procedure.
2. The Agency may, at its sole discretion, in accordance with Section 430.04, F.S., take intermediate measures
against the Contractor, including corrective action, unannounced special monitoring, temporary assumption of
the operation of one or more contractual services, placement of the Contractor on probationary status, imposing
a moratorium on Contractor action, imposing financial penalties for nonperformance, or other administrative
action pursuant to Chapter 120, F.S.
3. In making any determination under this provision the Agency may rely upon findings of another state or
federal agency, or other regulatory body. Any claims for damages for breach of contract are exempt from
administrative proceedings and shall be brought before the appropriate entity in the venue of Lee County. In
the event the Agency initiates action to rescind an area agency on aging designation, the Agency shall follow
the procedures set forth in 42 U. S. C. §3025(b).
END OFATTA CHMENT I
[17-GRC-00624/1353101/1] 27
July 2017 — June 2018
ATTACHMENT II
FINANCIAL AND COMPLIANCE AUDIT
ADI 203.17
The administration of resources awarded by the Agency to the Contractor may be subject to audits and/or monitoring by
the Area Agency on Aging for Southwest Florida, Inc., as described in this section.
MONITORING
In addition to reviews of audits conducted in accordance with 2 CFR Part 200 (formerly OMB Circular A-133 as revised),
and Section 215.97, F.S., (see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits
by the Agency and/or Department staff, limited scope audits as defined by OMB Circular A-133, as revised, and/or other
procedures. By entering into this contract, the Contractor agrees to comply and cooperate with any monitoring
procedures/processes deemed appropriate by the Agency and/or Department. In the event the Agency and/or
Department determines that a limited scope audit of the Contractor is appropriate, the Contractor agrees to comply with
any additional instructions provided by the Agency and/or Department to the Contractor regarding such audit. The
Contractor further agrees to comply and cooperate with any inspections, reviews, investigations, or audits deemed
necessary by the Agency's Vice President of Finance.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the Contractor is a State or local government or a non-profit organization as defined in 2 CFR Part
200, Subpart A.
In the event that the Contractor expends $750,000.00 or more in federal awards during its fiscal year, the Contractor must
have a single or program -specific audit conducted in accordance with the provisions of 2 CFR Part 200. Financial
Compliance Audit Attachment, Exhibit 2 indicates federal resources awarded through the Agency by this contract. In
determining the federal awards expended in its fiscal year, the Contractor shall consider all sources of Federal awards,
including federal resources received from the Agency. The determination of amounts of Federal awards expended
should be in accordance with 2 CFR Part 200. An audit of the Contractor conducted by the Auditor General in accordance
with the provisions of 2 CFR Part 200 will meet the requirements of this part.
In connection with the audit requirements addressed in Part 1, paragraph 1, the Contractor shall fulfill the requirements
relative to auditee responsibilities as provided in 2 CFR §200.508.
If the Contractor expends less than $750,000.00 in federal awards in its fiscal year, an audit conducted in accordance with
the provisions of 2 CFR Part 200 is not required. In the event that the Contractor expends less than $750,000.00 in federal
awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of 2 CFR Part 200 the cost
of the audit must be paid from non-federal resources (i.e., the cost of such audit must be paid from Contractor resources
obtained from other than federal entities.)
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to contracts with the Agency shall be based on the contract's requirements, including any
rules, regulations, or statutes referenced in the contract. The financial statements shall disclose whether or not the matching
requirement was met for each applicable contract. All questioned costs and liabilities due to the Agency shall be fully
disclosed in the audit report with reference to the Area Agency on Aging for Southwest Florida, Inc. contract involved. If
not otherwise disclosed as required by 2 CFR §200.510 the schedule of expenditures of federal awards shall identify
expenditures by contract number for each contract with the Agency in effect during the audit period. Financial
reporting packages required under this part must be submitted within the earlier of 30 days after receipt of the audit report
or 9 months after the end of the Contractor's fiscal year end.
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July 2017 — June 2018 ADI 203.17
PART II: STATE FUNDED
This part is applicable if the Contractor is a non -state entity as defined by Section 215.97(2), F.S.
In the event that the Contractor expends a total amount of state financial assistance equal to or in excess of $750,000.00 in
any fiscal year of such Contractor, the Contractor must have a State single or project -specific audit for such fiscal year in
accordance with Section 215.97, F.S.; applicable rules of the Department of Financial Services; and Chapters 10.550 (local
governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General. Financial
Compliance Audit Attachment, Exhibit 2 indicates state financial assistance awarded through the Agency by this
contract. In determining the state financial assistance expended in its fiscal year, the Contractor shall consider all sources
of state financial assistance, including state financial assistance received from the Agency, other state agencies, and
other nonstate entities. State financial assistance does not include Federal direct or pass-through awards and resources
received by a nonstate entity for Federal program matching requirements.
In connection with the audit requirements addressed in Part II, paragraph 1, the Contractor shall ensure that the audit
complies with the requirements of Section 215.97(8), F.S. This includes submission of a financial reporting package as
defined by Section 215.97(2), F.S., and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit
organizations), Rules of the Auditor General.
If the Contractor expends less than $750,000.00 in state financial assistance in its fiscal year, an audit conducted in
accordance with the provisions of Section 215.97, F.S., is not required. In the event that the Contractor expends less than
$750,000.00 in state financial assistance in its fiscal year and elects to have an audit conducted in accordance with the
provisions of Section 215.97, F.S., the cost of the audit must be paid from the nonstate entity's resources (i.e., the cost of
such an audit must be paid from the Contractor resources obtained from other than State entities).
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to contracts with the Agency shall be based on the contract's requirements, including any
applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching requirement
was met for each applicable contract. All questioned costs and liabilities due to the Agency shall be fully disclosed in the
audit report with reference to the Agency contract involved. If not otherwise disclosed as required by Rule 691- 5.003,
F.A.C., the schedule of expenditures of state financial assistance shall identify expenditures by contract number for each
contract with the Agency in effect during the audit period. Financial reporting packages required under this part must be
submitted within 45 days after delivery of the audit report, but no later than 12 months after the Contractor's fiscal year
end for local governmental entities. Non-profit or for-profit organizations are required to be submitted within 45 days after
delivery of the audit report, but no later than 9 months after the Contractor's fiscal year end. Notwithstanding the
applicability of this portion, the Agency retains all right and obligation to monitor and oversee the performance of this
contract as outlined throughout this document and pursuant to law.
PART III: REPORT SUBMISSION
Copies of reporting packages for audits conducted in accordance with 2 CFR Part 200 and required by Part I of this Financial
Compliance Audit Attachment, shall be submitted, when required by 2 CFR §200.512 by or on behalf of the Contractor
directly to each of the following:
The Area Agency on Aging for Southwest Florida, Inc. at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Tammy Rhoades, VP of Finance
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
[I 7-GRC-00624/1353101/11 29
July 2017 — June 2018 ADI 203.17
For fiscal year 2013 and earlier to the Federal Audit Clearinghouse designated in 2 CFR §200.36 at the following address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 101" Street
Jeffersonville, IN 47132
For fiscal year 2014 and later, pursuant to 2 CFR §200.512, the reporting package and the data collection form must be
submitted electronically to the Federal Audit Clearinghouse.
Pursuant to 2 CFR §200.512, all other Federal agencies, pass-through entities and others interested in a reporting package
and data collection form must obtain it by accessing the Federal Audit Clearinghouse.
The Contractor shall submit a copy of any management letter issued by the auditor, to the Area Agency on Aging for
Southwest Florida, Inc. at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Tammy Rhoades, VP of Finance
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
Additionally, copies of financial reporting packages required by this contract's Financial Compliance Audit Attachment,
Part II shall be submitted by or on behalf of the Contractor directly to each of the following: Area Agency on Aging for
Southwest Florida, Inc. at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Tammy Rhoades, VP of Finance
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
The Auditor General's Office at the following address:
State of Florida Auditor General
Claude Pepper Building, Room 574
111 West Madison Street
Tallahassee, Florida 32399-1450
Any reports, management letter, or other information required to be submitted to the Agency pursuant to this contract
shall be submitted timely in accordance with 2 CFR Part 200, Florida Statutes, and Chapters 10.550 (local governmental
entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, as applicable.
Contractors, when submitting financial reporting packages to the Agency for audits done in accordance with 2 CFR Part 200
or Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor
General, should indicate the date that the reporting package was delivered to the Contractor in correspondence
accompanying the reporting package.
PART IV: RECORD RETENTION
The Contractor shall retain sufficient records demonstrating its compliance with the terms of this contract for a period of
six (6) years from the date the audit report is issued, and shall allow the Agency or its designee, the CFO or Auditor
General access to such records upon request. The Contractor shall ensure that audit working papers are made available to
the Agency or its designee, CFO, or Auditor General upon request for a period of six (6) years from the date the audit
report is issued, unless extended in writing by the Agency.
[ 17-GRC-00624/1353101/11 30
July 2017 — June 2018
ATTACHMENT II -EXHIBIT I
PART I: AUDIT RELATIONSHIP DETERMINATION
ADI 203.17
Contractors who receive state or federal resources may or may not be subject to the audit requirements of 2 CFR Part 200
and/or Section 215.97, F.S. Contractors who are determined to be recipients or sub -recipients of federal awards and/or
state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I
and/or Part II of Exhibit 1 are met. Contractors who have been determined to be vendors are not subject to the audit
requirements of 2 CFR §200.38, and/or Section 215.97, F.S. Regardless of whether the audit requirements are met,
Contractors who have been determined to be recipients or sub -recipients of Federal awards and/or state financial
assistance must comply with applicable programmatic and fiscal compliance requirements.
In accordance with 2 CFR Part 200 and/or Rule 69I-5.006, F.A.C., Contractor has been determined to be:
Vendor not subject to 2 CFR §200.38 and/or Section 215.97, F.S.
_X Recipient/sub-recipient subject to 2 CFR §200.86 and §200.93 and/or Section 215.97, F.S.
Exempt organization not subject to 2 CFR Part 200 and/or Section 215.97, F.S. For Federal awards, for-profit
organizations are exempt; for state financial assistance projects, public universities, community colleges, district
school boards, branches of state (Florida) government, and charter schools are exempt. Exempt organizations must
comply with all compliance requirements set forth within the contract or award document.
NOTE: If a Contractor is determined to be a recipient/sub-recipient of federal and or state financial assistance and has been
approved by the Agency to subcontract, they must comply with Section 215.97(7), F.S., and Rule 69I-5.006, F.A.C.
[state financial assistance] and 2 CFR §200.330[federal awards].
PART II: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Contractors who receive Federal
awards, state maintenance of effort funds, or state matching funds on Federal awards and who are determined to be a sub -
recipient must comply with the following fiscal laws, rules and regulations:
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR §200.416 - §200.417 — Special Considerations for States, Local Governments and Indian Tribes*
2 CFR §200.201 — Administrative Requirements**
2 CFR §200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
NON-PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR §200.400 - §200.411 — Cost Principles*
2 CFR §200.100 — Administrative Requirements
2 CFR §200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT)
MUST FOLLOW:
2 CFR §200.418 — §200.419 — Special Considerations for Institutions of Higher Education*
2 CFR §200.100 — Administrative Requirements
2 CFR §200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
[17-GRC-00624/1353101/1] 31
July 2017 —June 2018
ADI 203.17
*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in 2 CFR
§200.400(5) (c).
**For funding passed through U.S. Health and Human Services, 45 CFR Part 75; for funding passed through U.S.
Department of Education, 34 CFR Part 80.
STATE FINANCIAL ASSISTANCE. Contractors who receive state financial assistance and who are determined to be a
recipient/sub-recipient must comply with the following fiscal laws, rules and regulations:
Sections 215.97 & 215.971, F.S.
Chapter 69I-5, F.A.C.
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
[ 17-GRC-00624/1353101/11 32
July 2017 — June 2018
ATTACHMENT II -EXHIBIT 2
FUNDING SUMMARY
ADI 203.17
Note: Title 2 CFR & 2 CFR Part 200, as revised, and Section 215.971, F.S. require that the information about Federal
Programs and State Projects included in Attachment I1, Exhibit 1 be provided to the recipient. Information contained
herein is a prediction of funding sources and related amounts based on the contract budget.
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT
CONSIST OF THE FOLLOWING:
GRANT AWARD (FAIN#): FEDERAL AWARD DATE:
DUNS NUMBER: 833441814
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT
TO THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS:
2 CFR Part 200 — Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards,
OMB Circular A-133 — Audits of States, Local Governments, and Non -Profit Organizations
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF
THE FOLLOWING:
MATC 14 NG RF,SOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD
STATE FINANCIAL ASSISTANCE SUBJECT TO SECTION 215.97, F.S.
PROGRAM TITLE
FUNDING SOURCE
CSFA
AMOUNT
Alzheimer's Disease Initiative
General Revenue-TSTF Collier
65004
$ 312,663.00
TOTAL AWARD
$ 312,663.00
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS
CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL. ASSISTANCE
Sections 215.97 & 215.971, F.S., Chapter 69I-5, F.A.C, State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
[17-GRC-00624/1353101/1] 33
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ATTACHMENT III
CERTIFICATIONS AND ASSURANCES
ADI 203.17
DOEA will not award this Contract unless Contractor completes this CERTIFICATIONS AND ASSURANCES. In
performance of this contract, Contractor provides the following certifications and assurances:
A. Debarment
.1! Suspension '. . 1 9 CFR Part
95 and ►. Part 75)
BCertification
Regarding L' Lob _L' 29 CFR Part 93 and
45 CFR P:_
C. Nondiscrimination
& Equal 011Uortunily Assurance (29
CFR Part 37 and 45 CFR
Part
80
D. Certification
Regarding Public Entily Crimes. section
287,133, F.S.
E. Association
1 1 .1J_ J1.. 1.. X Organizations for . Reform
Nl (ACORN) _► N) ! ' Restrictions
Assurance (Pub.
1 1 �"' 1 J' 1 tralTuron, 1 1 i
e. 1 1. ► '' a 1 .!' e e u "' _ 1 n. 1_ I _ 1 1 i_ I '' '
111' MON-111
UMIMMITt 1 _I 1 I_ to 1.1 .L1. " 1 _ i 1
I. Records and Documentation
J. Certification Regarding Inspection of Public Records
A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY
MATTERS — PRIMARY COVERED TRANSACTION.
The undersigned Contractor certifies to the best of its knowledge and belief, that it and its principals:
1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
covered transactions by a Federal department or agency;
2. Have not within a three-year period preceding this Contract been convicted or had a civil judgment rendered against
them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing
a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State
antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records,
making false statements, or receiving stolen property;
3. Are not presently indicted or otherwise criminally or civilly charged by a government entity (Federal, State or local)
with commission of any of the offenses enumerated in paragraph A.2. of this certification; and/or
4. Have not within a three-year period preceding this application/proposal had one or more public transactions
(Federal, State, or local) terminated for cause of default.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants and contracts under grants, loans and cooperative agreements) and that all sub
recipients and contractors shall provide this certification accordingly.
B. CERTIFICATION REGARDING LOBBYING — CERTIFICATION FOR CONTRACTS, GRANTS, LOANS,
AND COOPERATIVE AGREEMENTS.
The undersigned Contractor certifies, to the best of its knowledge and belief, that:
[ 17-GRC-00624/ 13 53101/1] 34
July 2017 — June 2018
ADI 203.17
No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of Congress, or an employee of a Member of Congress in
connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan,
the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification
of any Federal contract, grant, loan or cooperative agreement.
If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of
Congress, or employee of a Member of Congress in connection with a Federal contract, grant, loan, or cooperative
agreement, the undersigned shall also complete and submit Standard Form — LLL, "Disclosure Form to Report
Lobbying," in accordance with its instructions.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants and contracts under grants, loans and cooperative agreements) and that all sub -
recipients and contractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this Contract was made or
entered into. Submission of this certification is a prerequisite for making or entering into this Contract imposed by 31
U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than
$10,000 and not more than $100,000 for each such failure.
C. NON DISCRIMINATION & EQUAL OPPORTUNITY ASSURANCE (29 CFR PART 37 AND 45 CFR PART
80). - As a condition of the Contract, Contractor assures that it will comply fully with the nondiscrimination and equal
opportunity provisions of the following laws:
1. Section 188 of the Workforce Investment Act of 1998 (WIA), (Pub. L. 105-220), which prohibits discrimination
against all individuals in the United States on the basis of race, color, religion, sex national origin, age, disability,
political affiliation, or belief, and against beneficiaries on the basis of either citizenship/status as a lawfully admitted
immigrant authorized to work in the United States or participation in any WIA Title I -financially assisted program
or activity.
2. Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352), as amended, and all requirements imposed by or pursuant
to the Regulation of the Department of Health and Human Services (45 CFR Part 80), to the end that, in accordance
with Title VI of that Act and the Regulation, no person in the United States shall, on the ground of race, color, or
national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to
discrimination under any program or activity for which the Applicant receives Federal financial assistance from the
Agency.
3. Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112) as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 84), to the end that, in
accordance with Section 504 of that Act, and the Regulation, no otherwise qualified handicapped individual in the
United States shall, solely by reason of his handicap, be excluded from participation in, be denied the benefits of,
or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial
assistance from the Agency.
4. The Age Discrimination Act of 1975 (Pub. L. 94-135), as amended, and all requirements imposed by or pursuant
to the Regulation of the Department of Health and Human Services (45 CFR Part 91), to the end that, in accordance
with the Act and the Regulation, no person in the United States shall, on the basis of age, be denied the benefits of,
be excluded from participation in, or be subjected to discrimination under any program or activity for which the
Applicant receives Federal financial assistance from the Agency.
5. Title IX of the Education Amendments of 1972 (Pub. L. 92-318), as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 86), to the end that, in
accordance with Title IX and the Regulation, no person in the United States shall, on the basis of sex, be excluded
from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any education
program or activity for which the Applicant receives Federal financial assistance from the Agency.
6. The American with Disabilities Act of 1990 (Pub. L. 101-336), which prohibits discrimination in all employment
practices, including, job application procedures, hiring, firing, advancement, compensation, training, and other
[17-GRC-00624/1353101/1] 35
July 2017 — June 2018
ADI 203.17
terms, conditions, and privileges of employment. It applies to recruitment, advertising, tenure, layoff, leave, fringe
benefits, and all other employment-related activities.
Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws listed
above. This assurance applies to Contractor's operation of the WIA Title I — financially assisted program or activity,
and to all contracts, Contractor makes to carry out the WIA Title I — financially assisted program or activity. Contractor
understands that DOEA and the United States have the right to seek judicial enforcement of the assurance.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants and contracts under grants, loans and cooperative agreements) and that all sub
recipients and contractors shall provide this assurance accordingly.
D. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES, SECTION 287.133, F.S.
Contractor hereby certifies that neither it, nor any person or affiliate of Contractor, has been convicted of a Public Entity
Crime as defined in section 287.133, F.S., nor placed on the convicted vendor list.
Contractor understands and agrees that it is required to inform the Area Agency and DOEA immediately upon any
change of circumstances regarding this status.
E. ASSOCIATION OF COMMUNITY ORGANIZATIONS FOR REFORM NOW (ACORN) FUNDING
RESTRICTIONS ASSURANCE (Pub. L. 111-117).
As a condition of the Contract, Contractor assures that it will comply fully with the federal funding restrictions
pertaining to ACORN and its subsidiaries per the Consolidated Appropriations Act, 2010, Division E, Section 511 (Pub.
L. 111-117). The Continuing Appropriations Act, 2011, Sections 101 and 103 (Pub. L. 111-242), provides that
appropriations made under Pub. L. 111-117 are available under the conditions provided by Pub. L. 111-117.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants and contracts under grants, loans and cooperative agreements) and that all sub
recipients and contractors shall provide this assurance accordingly.
F. SCRUTINIZED COMPANIES LISTS CERTIFICATION, SECTION 287.135, F.S.
If this Contract is in the amount of $1 million or more, in accordance with the requirements of Section 287.135, F.S.,
Contractor hereby certifies that it is not participating in a boycott of Israel, is not listed on either the Scrutinized
Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy
Sector List, and that it does not have business operations in Cuba or Syria. Both lists are created pursuant to Section
215.473, F.S.
Contractor understands that pursuant to Section 287.135, F.S., the submission of a false certification may subject
Contractor to civil penalties, attorney's fees, and/or costs.
If Contractor is unable to certify any of the statements in this certification, Contractor shall attach an explanation to
this Contract.
G. CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR CONTRACTS, AGREEMENTS,
GRANTS, LOANS AND COOPERATIVE AGREEMENTS
The Contractor and any Subcontractors of services under this contract have financial management systems
capable of providing certain information, including: (1) accurate, current, and complete disclosure of the financial
results of each grant -funded project or program in accordance with the prescribed reporting requirements; (2) the
source and application of funds for all contract supported activities; and (3) the comparison of outlays with
budgeted amounts for each award. The inability to process information in accordance with these requirements
could result in a return of grant funds that have not been accounted for properly.
[I 7-GRC-00624/13 53101/11 36
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ADI 203.17
2. Management Information Systems used by the Contractor, Subcontractors, or any outside entity on which the
Contractor is dependent for data that is to be reported, transmitted or calculated, have been assessed and verified
to be capable of processing data accurately, including year -date dependent data. For those systems identified to be
non-compliant, Contractors will take immediate action to assure data integrity.
3. If this contract includes the provision of hardware, software, firmware, microcode or imbedded chip technology,
the undersigned warrants that these products are capable of processing year -date dependent data accurately. All
versions of these products offered by the Contractor (represented by the undersigned) and purchased by the state
will be verified for accuracy and integrity of data prior to transfer.
4. In the event of any decrease in functionality related to time and date related codes and internal subroutines that
impede the hardware or software programs from operating properly, the Contractor agrees to immediately make
required corrections to restore hardware and software programs to the same level of functionality as warranted
herein, at no charge to the state, and without interruption to the ongoing business of the state, time being of the
essence.
5. The Contractor and any Subcontractors of services under this contract warrant their policies and procedures
include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies
arising from data integrity compliance issues.
H. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION
As a condition of contracting with the Area Agency on Aging for Southwest Florida, Inc., Contractor certifies the use
of the U.S. Department of Homeland Security's E -verify system to verify the employment eligibility of all new
employees hired by Contractor during the contract term to perform employment duties pursuant to this contract and
that any subcontracts include an express requirement that Subcontractors performing work or providing services
pursuant to this Contract utilize the E -verify system to verify the employment eligibility of all new employees hired
by the Subcontractor during the entire contract term.
The Contractor shall require that the language of this certification be included in all sub -agreements, sub -grants, and
other agreements/contracts and that all Subcontractors shall certify compliance accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made
or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed
by Circulars A-102 and 2 CFR Part 200, and 215 (formerly OMB Circular A-110).
L RECORDS AND DOCUMENTATION
The Contractor agrees to make available to Agency staff and/or any party designated by the Agency any and all
contract related records and documentation. The Contractor shall ensure the collection and maintenance of all
program related information and documentation on any such system designated by the Agency. Maintenance includes
valid exports and backups of all data and systems according to Agency standards.
J. CERTIFICATION REGARDING INSPECTION OF PUBLIC RECORDS
1. In addition to the requirements of sections, 10.1, 10.2 of the Standard Contract, and 119.0701(3) and (4) F.S., and any
other applicable law, if a civil action is commenced as contemplated by Section 119.0701(4), F.S., and the Agency is
named in the civil action, Contractor agrees to indemnify and hold harmless the Agency for any costs incurred by the
Agency, and any attorneys' fees assessed or awarded against the Agency from a Public Records Request made
pursuant to Chapter 119, F.S., concerning this contract or services performed thereunder.
a. Notwithstanding Section 119.0701, F.S., or other Florida law, this section is not applicable to contracts executed
between the Agency and state agencies or subdivisions defined in Section 768.28(2), F.S.
[17-GRC-00624/1353101/1] 37
July 2017 — June 2018
ADI 203.17
2. Section 119.01(3), F.S., states if public funds are expended by an agency in payment of dues or membership
contributions for any person, corporation, foundation, trust, association, group, or other organization, all the financial,
business, and membership records of such an entity which pertain to the public agency (Area Agency on Aging
for Southwest Florida, Inc.) are public records. Section 119.07, F.S, states that every person who has custody of such a
public record shall permit the record to be inspected and copied by any person desiring to do so, under reasonable
circumstances.
Additionally, I certify this organization does does not
provide for institutional memberships.
Contractor's signature below attests that records pertaining to the dues or membership application by the Agency are
available for inspection as stated above.
By execution of this contract, Contactor must include these provisions in all related subcontract agreements (if applicable).
By execution of this contact, Contactor must include these provisions (A -J) in all related subcontract agreements (if
applicable).
By signing below, Contractor certifies the representations outlined in parts A through J above, are true and correct.
Ste o �, Ca ell, Public Services De a ment Head
3339 East Tamiami Trail, Suite 211
Signatu a and U& of Authorized Representative
Street Address
Collier County Board of County
Commissioners S
aples, FL 34112
Contractor Da
City, State, Zip code
Approved as to form and legality
Assistant County Attorney
[ 17-GRC-00624/1353101/1 ] 38
July 2017 —June 2018
ATTACHMENT IV
ASSURANCES—NON-CONSTRUCTION PROGRAMS
ADI 203.17
Public reporting burden for this collection of information is estimated to average forty-five (45) minutes per response, including time
for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing
the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348-0043),
Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND
BUDGET, SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions please
contact the awarding agency. Further, certain federal awarding agencies may require applicants to certify to
additional assurances. If such is the case, you will be notified.
1. Has the legal authority to apply for federal assistance, and the institutional, managerial and financial capability
(including funds sufficient to pay the non-federal share of project cost) to ensure proper planning, management, and
completion of the project described in this application.
2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the state, through any
authorized representative, access to and the right to examine all records, books, papers, or documents related to the
award; and will establish a proper accounting system in accordance with generally accepted accounting standards or
agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the
appearance of personal or organizational conflict of interest, or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §4728-4763) relating to prescribed standards
for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's
Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).
Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of
the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin;
(b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §1681-1683, and 1685-1686), which
prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C.
§794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended
(42 U.S.C. §6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment
Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive
Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended,
relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §523 and 527 of the Public Health Service
Act of 1912 (42 U.S.C. §290 dd-3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug abuse
patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §3601 et seq.), as amended, relating to
nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific
statute(s) under which application for federal assistance is being made; and 0) the requirements of any other
nondiscrimination statute(s) which may apply to the application.
7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance
and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of
persons displaced or whose property is acquired as a result of federal or federally assisted programs. These requirements
apply to all interests in real property acquired for project purposes regardless of federal participation in purchases.
[I 7-GRC-00624/1353101/1] 39
July 2017 — June 2018 ADI 203.17
8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. §1501-1508 and 7324-7328), which limit
the political activities of employees whose principal employment activities are funded in whole or in part with federal
funds.
9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C. §276a to 276a-7), the Copeland Act
(40 U.S.C. 276c and 18 U.S.C. §874) and the Contract Work Hours and Safety Standards Act (40 U.S.C. §327-333),
regarding labor standards for federally assisted construction sub -contracts.
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the
program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or
more.
11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and
Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of
project consistency with the approved State management program developed under the Coastal Zone Management Act
of 1972 (16 U.S.C. §1451 et seq.); (f) conformity of federal actions to State (Clear Air) Implementation Plans under
Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. §7401 et seq.); (g) protection of underground
sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h) protection
of endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93-205).
12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §1721 et seq.) related to protecting components
or potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of
1966, as amended (16 U.S.C. §470), EO 11593 (identification and protection of historic properties), and the
Archaeological and Historic Preservation Act of 1974 (16 U.S.C. §469a-1 et seq.).
14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related
activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. §2131 et seq.)
pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities
supported by this award of assistance.
16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. §4801 et seq.), which prohibits the use of
lead- based paint in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act
Amendments of 1996 and 2 CFR Part 200.
18. Will comply with all applicable requirements of all other federal laws, executive orders, regulations and policies
governing this program.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL
(")r\ /1 i i /I it -1,-7
APPLICANT ORGANIZATION
Board of County Commissioners
[ 17-GRC-00624/ 13 5 3101/11
i '
TITLE
Services Department Head
DATE SUBMITTED
A mr%mved
Assistant County Attorney
R
July 2017 — June 2018
ADI 203.17
ATTACHMENT V
FLORIDA DFPARTMFNT OF FI,DFR AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST
Program/FacilityNarne: Collier County Community and Human Services
County: Collier
AAA/Contractor: AAA of
Southwest Florida, Inc.
Address: 3339 East Tamiami Trail, Suite 211
Completed By: Lisa N. Carr
City, State, Zip Code: Naples, FL 34112
Date: June 28, 2017
Telephone: (239) 252-4228
PART I: READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU COMPLETE
THIS FORM.
1. Briefly describe the geographic area served by the program/facility and the type of service provided: The Collier County Community and
Human Services (CHS) Division, Services for Seniors provide services to clients covering over a 2,300 -square mile area. CHS provides
case management, in-home care, facility respite, adult day care and nutrition services to frail, elderly residents of Collier County.
For questions 2-5 please indicate the f
2. Population of area served
3. Staff currently employed
4. Clients currently enrolled/registered
5. Advisory/Governing Board if
ollowing:
Total #
%
I White
%
Black
%
Hispanic
%
Other
Female
Disabled
Over 40
Source of data:2010 Census 321,520 57.98
6.56%
25.87%
9.65%
50.70%
n/a
58.4%
Effective date 6/28/17
8
0%
20%
0%
%
90%
0%
100%
Effective date: 6/28/17
561
37%
7%
39%
17%
35%
n/a
100%
Collier County BCC
5
100%
0%
0%
%
20%
0%
100%
PART II: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. IF N/A or NO EXPLAIN.
6. Is an Assurance of Compliance on file with DOEA?
N/A
YES
NO
❑
■
❑
7. Compare the staff composition to the population. Is staff representative of the population?
N/A
YES
NO
❑
■
❑
8. Are eligibility requirements for services applied to clients and applicants without regard to race, color, national
N/A
YES
NO
origin, sex, age, religion or disability?
❑
0
❑
9. Are all benefits, services and facilities available to applicants and participants in an equally effective manner
N/A
YES
NO
regardless of race, sex, color, age, national origin, religion or disability?
❑
■
❑
10. For in-patient services, are room assignments made without regard to race, color, national origin or disability?
N/A
YES
NO
■
❑
❑
11. Is the program/facility accessible to non-English speaking clients?
N/A
YES
NO
❑
■
❑
12. Are employees, applicants and participants informed of their protection against discrimination? If YES, how?
N/A
YES
NO
Verbal !!Written ❑ Poster N i
❑
N
❑
k0
[ 17-GRC-00624/1353101/1 ] 41
July 2017 — June 2018 ADI 203.17
13. Give the number and current status of any discrimination complaints regarding services or employment filed
N/A
NUMBER
against the program/facility.
■
❑
14. Is the program/facility physically accessible to mobility, hearing, and sight -impaired individuals?
N/A
YES NO
YES
❑
■ ❑
PART III: THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES. IF NO
EXPLAIN.
15. Has as a self-evaluation been conducted to identify any barriers to serving disabled individuals, and to make any
YES
NO
necessary modifications?
❑
16. Is there an established grievance procedure that incorporates due process in the resolution of complaints?
YES
NO
In Compliance: YES ❑ NO* ❑
❑
❑
Date
Telephone Response Due
17. Has a person been designated to coordinate Section 504 compliance activities?
YES
NO
❑
❑
18. Do recruitment and notification materials advise applicants, employees and participants of nondiscrimination on
YES
NO
the basis of disability?
❑
YES
NO
19. Are auxiliary aids available to assure accessibility of services to hearing and sight -impaired individuals?
❑
❑
PART IV: FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $50,000.00 OR MORE.
20. Do you have a written affirmative action plan? If NO, explain.
YES
NO
❑
❑
1/-UKU-VV0Z4/ 13JJ 1 V 1/ 1 J 41
1ITMR.TTIMM
Reviewed by
In Compliance: YES ❑ NO* ❑
Program Office
*Notice of Corrective Action Sent
Date
Telephone Response Due
On -Site ❑ Desk Review ❑
Response Received
1/-UKU-VV0Z4/ 13JJ 1 V 1/ 1 J 41
July 2017 — June 2018
ADI 203.17
ATTACHMENT V
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST
1. Describe the geographic service area such as a district, county, city or other locality. If the program/facility serves
a specific target population such as adolescents, describe the target population. Also, define the type of service
provided.
2. Enter the percent of the population served by race and sex. The population served includes persons in the
geographical area for which services are provided such as a city, county or other regional area. Population statistics
can be obtained from local chambers of commerce, libraries, or any publication from the 1980 Census containing
Florida population statistics. Include the source of your population statistics. ("Other" races include Asian/Pacific
Islanders and American Indian/Alaskan Natives.)
Enter the total number of full-time staff and their percent by race, sex and disability. Include the effective date of
your summary.
4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and list
their percent by race, sex and disability. Include the date that enrollment was counted.
Enter the total number of advisory board members and their percent by race, sex, and disability. If there is no
advisory or governing board, leave this section blank.
6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in
compliance with all nondiscriminatory provisions as required in 45 CFR 80. This is usually a standard part of the
contract language for DOEA Recipients and their Sub -grantees, 45 CFR 80.4 (a).
7. Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the
population is Hispanic, is there a comparable percentage of Hispanic staff?
8. Where there is a significant variation between the race, sex or ethnic composition of the clients and their availability
in the population, the program/facility has the responsibility to determine the reasons for such variation and take
whatever action may be necessary to correct any discrimination. Some legitimate disparities may exist when
programs are sanctioned to serve target populations such as elderly or disabled persons, 45 CFR 80.3 (b) (6).
9. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or
employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also
through on-site record analysis of persons who applied but were denied services or employment, 45 CFR 80.3 (a)
and 45 CFR 80.1 (b) (2).
10. Participants or clients must be provided services such as medical, nursing and dental care, laboratory services,
physical and recreational therapies, counseling and social services without regard to race, sex, color, national origin,
religion, age or disability. Courtesy titles, appointment scheduling and accuracy of record keeping must be applied
uniformly and without regard to race, sex, color, national origin, religion, age or disability. Entrances, waiting
rooms, reception areas, restrooms and other facilities must also be equally available to all clients, 45 CFR 80.3 (b).
11. For in-patient services, residents must be assigned to rooms, wards, etc., without regard to race, color, national
origin or disability. Also, residents must not be asked whether they are willing to share accommodations with
persons of a different race, color, national origin, or disability, 45 CFR 80.3 (a).
12. The program/facility and all services must be accessible to participants and applicants, including those persons who
may not speak English. In geographic areas where a significant population of non-English speaking people live,
program accessibility may include the employment of bilingual staff. In other areas, it is sufficient to have a policy
[17-GRC-00624/1353101/1] 43
July 2017 — June 2018
ADI 203.17
or plan for service, such as a current list of names and telephone numbers of bilingual individuals who will assist
in the provision of services, 45 CFR 80.3 (a).
13. Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to their
participants, beneficiaries or any other interested parties. This should include information on their right to file a
complaint of discrimination with either the Area Agency on Aging for Southwest Florida, Inc. and/or the
Florida Department of Elder Affairs or the U.S. Department of HHS. The information may be supplied verbally
or in writing to every individual, or may be supplied through the use of an equal opportunity policy poster
displayed in a public area of the facility, 45 CFR 80.6 (d).
14. Report number of discrimination complaints filed against the program/facility. Indicate the basis, e.g., race, color,
creed, sex, age, national origin, disability, retaliation; the issues involved, e.g., services or employment, placement,
termination, etc. Indicate the civil rights law or policy alleged to have been violated along with the name and
address of the local, state or federal agency with whom the complaint has been filed. Indicate the current status,
e.g., settled, no reasonable cause found, failure to conciliate, failure to cooperate, under review, etc.
15. The program/facility must be physically accessible to disabled individuals. Physical accessibility includes
designated parking areas, curb cuts or level approaches, ramps and adequate widths to entrances. The lobby, public
telephone, restroom facilities, water fountains, information and admissions offices should be accessible. Door
widths and traffic areas of administrative offices, cafeterias, restrooms, recreation areas, counters and serving lines
should be observed for accessibility. Elevators should be observed for door width, and Braille or raised numbers.
Switches and controls for light, heat, ventilation, fire alarms, and other essentials should be installed at an
appropriate height for mobility impaired individuals.
16. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self-
evaluation to identify any accessibility barriers. Self-evaluation is a four step process:
a. With the assistance of a disabled individual/organization, evaluate current practices and policies which do not
comply with Section 504.
b. Modify policies and practices that do not meet Section 504 requirements.
c. Take remedial steps to eliminate any discrimination that has been identified.
d. Maintain self-evaluation on file. (This checklist may be used to satisfy this requirement if these four steps have
been followed.), 45 CFR 84.6.
17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate appropriate
due process standards and provide for the prompt and equitable resolution of complaints alleging any action
prohibited by Section 504.45 CFR 84.7 (b).
18. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to
comply with Section 504.45 CFR 84.7 (a).
19. Continuing steps must be taken to notify employees and the public of the program/facility's policy of
nondiscrimination on the basis of disability. This includes recruitment material, notices for hearings, newspaper
ads, and other appropriate written communication, 45 CFR 84.8 (a).
20. Programs/facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with impaired
sensory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to, interpreters
for hearing impaired individuals, taped or Braille materials, or any alternative resources that can be used to provide
equally effective services, 45 CFR 84.52 (d).
21. Programs/facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement and
maintain a written affirmative action compliance program in accordance with Executive Order 11246, 41 CFR 60
and Title VI of the Civil Rights Act of 1964, as amended.
[1 7-GRC-00624/13 53101/11 44
July 2017 — June 2018
DEPARTMENT OF
ELDER
AFFAIRS
STATE OF FLORIDA
ATTACHMENT VI
BACKGROUND SCREENING
BACKGROUND SCREENING
Affidavit of Compliance - Employer
AUTHORITY: This form is required annually of all employers to comply with the attestation
requirements set forth in section 435.05(3), Florida Statutes.
ADI 203.17
The term "employer" means any person or entity required by law to conduct background screening,
including but not limited to, Area Agencies on Aging, Aging Resource Centers, Aging and Disability
Resource Centers, Lead Agencies, Long -Term Care Ombudsman Program, Serving Health Insurance Needs
of Elders Program, Service Providers, Diversion Providers, and any other person or entity which hires
employees or has volunteers in service who meet the definition of a direct service provider. See §§
435.02, 430.0402, Fla. Stat.
➢ A direct service provider is "a person 18 years of age or older who, pursuant to a program to provide
services to the elderly, has direct, face-to-face contact with a client while providing services to the client
and has access to the client's living area, funds, Personal property, or personal identification information
as defined in s. 817.568. The term includes coordinators, managers, and supervisors of residential
facilities; and volunteers." § 430.0402(1)(b), Fla. Stat.
ATTESTATION:
As the duly authorized representative of Collier County Community and Human Services
Employer Name
located at 3339 East Tamiami Trail, Suite 211, Naples, FL 34112
StreetAddress City State ZIP code
Kimberley Grant, Director do hereby affirm under penalty of perjury
I,
Name of Representative
that the above named employer is in compliance with the provisions of Chapter 435 and section
430.0402, Florida Statutes, regarding level 2 background screening.
f'
Signature of Representative Date'
STATE OF FLORIDA, COUNTY OF
Collier
Sworn to (o affirm d) and subscribed before me this° day of'�(L,1/ W 20J by
kI n�� �L/ iCpn (Name of Representative) who isl§ersonally rn—owq
o me r produced as proof of identification.
�R ��. •� l �7r
Print,Type, or Stamp CommissronedName ofNotaryPublrc Notary Public
DOEA Form 235, Affidavit of Compliance - Employer, Effective April 2012 Section 435.05(3), F.S.
Form available at: htMV/elderaffalrs,state.fl.us/eryltsh/backgroundscr-enlrw.oFv
ANA I. DIA2
+: r MY COMMISSION Y FF 235771
•A EXPIRES: July 1, 2019 45
;qf4`'` Bonded Thru Notary Public Undelwiters
July 2017 — June 2018
Report Number
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Legend:
ATTACHMENT VII
INVOICE REPORT SCHEDULE
ALZHEIMER'S DISEASE INITIATIVE
Based On
July Advance*
August Advance*
July Expenditure Report
August Expenditure Report
September Expenditure Report
October Expenditure Report
November Expenditure Report
December Expenditure Report
January Expenditure Report
February Expenditure Report
March Expenditure Report
April Expenditure Report
May Expenditure Report
June Expenditure Report
Final Request for Payment
* Advance based on projected cash need
ADI 203.17
Submit to Agency on This Date
July 1
July 1
August 9
September 9
October 9
November 9
December 9
January 9
February 9
March 9
April 9
May 9
June 9
July 9
July 25
Note # 1: Report #1 for Advance Basis Contracts cannot be submitted to the Area Agency
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 Area Agency on Aging for
Southwest Florida, Inc. Actual submission of the vouchers to the Agene)
dependent on the accuracy of the expenditure report.
Note # 2: Report numbers 5 through 14 shall reflect an adjustment of at least one-tenth
of the total advance amounts, repaying advances issued the first two months of
the agreement. All advance payments made to the Contractor shall be returned
to the A g e n c y a n d reported as an advance recoupment on each request
for payment. The adjustment shall be recorded in Part C, Line 1 of the report
(ATTACHMENT X).
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.
[17-GRC-00624/1353101/1] 46
July 2017 — June 2018
ATTACHMENT VIII
ANNUAL BUDGET SUMMARY
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
For
Collier County Board of County Commissioners
ALLOCATION TOTAL
Collier
$ 312,663.00
ADI 203,17
[17-GRC-00624/1353101/1] 47 0\
July 2017 - June 2018 ADI 203.17
ATTACHMENT IX
REQUEST FOR PAYMENT
ALZHEIMERS DISEASE INITIATIVE PROGRAM
[17-GRC-00624/1353101/1] 48
RECIPIENT NAME, ADDRESS, PHONE# and FEID#
TYPE OF REPORT:
This Request Period_
PSA# _
A. PAYMENT REQUEST:
Report #
Regular Supplemental
Contract#_
B. METHOD OF PAYMENT:
ContractPeriod _
Advance Reimbursement
CERTIFICATION: I herebycertifyto the best of my Mowledge thatthis request is complete and correct and conforms with the terms and the purposes ofthe above contract.
Prepared by Date: Approved by._ _ Date:_
(1)
(2)
PART A BUDGET SUMMARY
Respite
Model Da Ca e
TOTAL
1. Approved Contract Amount
$0.00
$0.00
$0.00
2. Previous Fads 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: CON TRACT FUNS REQUEST
1. Anticipated Cash Needs (1 st- 2nd month, Aftach Justification)
$0.00
$0.00
$0.00
2. Net E;renditures For Month
WOO
$0.00
$0.00
(DOEAForm 106Z Part B, Line 3)
3. TOTAL
$0.00
$0.00
$0.00
PART C: NET FUNDS REQUESTED
1. Less Advance Applied
$0.00
$0.00
$0.00
2. Contract Funds are Hereby Requested for (Part B, Line 3
$0.00
$0.00
$0.00
minus Pad C, Line 1)
List of Services /Unts / Rates provided - See attached report.
DOEA FORM 106Z
iRetis ed &W 12
[17-GRC-00624/1353101/1] 48
July 2017 - June 2018
ATTACHMENT X
RECEIPT AND EXPENDITURE REPORT
ALZHEIMERS DISEASE INITIATIVE PROGRAM
ADI 203.17
PROVIDER NAME, ADDRESS, PHONE # and FEID'
Program Funding:
THIS REPORT PERIOD:
From
To
Respite
CONTRACT PERIOD:
Model Day Care _
CONTRACT #
REPORT #
PSA#
CERTI FI CATI ON : 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/01
2. Program Income
$0.00
$0.00
$0.00
#DIV/01
3. Local Cash Match
$0.00
$0.00
$0.00
#DIV/01
4. SUBTOTAL: CASH RECEIPTS
5. Local In -Kind Match
6. TOTAL RECEIPTS
$0.00
$0.00
$0.00
#DIV/01
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. TOTAL EXPENDITURES
$0.00
$0.00
$0.00
#DIV/01
PART C: OTHER REVENUE AND EXPENDITURES
II. Interest:
II1. Advance Recouped
I. Program I ncome (PI)
1. Earned on G R Advance $
_
$
1. ADI: PI Collected YTD $
2. Return of GR Advance $
(Includes co -payments collected)
3. Other Earned
$
PART D: CO -PAYMENTS
CURRENT MONTH
YEAR-TO-DATE
1. Total of Co -payments assessed
$_
$_
2. Total of Co -payments collected
$_
(For Tracking Purposes only)
DOEA FORM 105Z
Revised 5252010
[17-GRC-00624/1353101/1] 49 Cep
July 2017 — June 2018
ATTACHMENT XI
SERVICE RATE REPORT
Rate Summary
ADI 203.17
[17-GRC-00624/1353101/1 ] 50 �;�.
HIGHEST
METHOD OF
DELIVERABLES
REIMBURSEMENT
PAYMENTS
UNIT RATE
Case Aid: 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
Transportation
Cost Reimbursement
[17-GRC-00624/1353101/1 ] 50 �;�.
Revised August 2007
Attestation Statement
Agreement/Contract Number ADI 203.17
Amendment Number n/s
I, Steve Y. Carnell , attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
Public Services Department Head
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting, due to the differences in
electronic data processing media, which has no affect on the agreement/contract content.
,,
Signature of Recipient/Contractor representative
Approved as to form and Icgality
Assistant County Attorney
Revised August 2007
16.D.19.cPacket Pg. 1372Attachment: CCE 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
16.D.19.cPacket Pg. 1373Attachment: CCE 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
16.D.19.cPacket Pg. 1374Attachment: CCE 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
16.D.19.cPacket Pg. 1375Attachment: CCE 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
16.D.19.cPacket Pg. 1376Attachment: CCE 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
16.D.19.cPacket Pg. 1377Attachment: CCE 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
16.D.19.cPacket Pg. 1378Attachment: CCE 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
16.D.19.cPacket Pg. 1379Attachment: CCE 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
16.D.19.cPacket Pg. 1380Attachment: CCE 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
16.D.19.cPacket Pg. 1381Attachment: CCE 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
July 2017 — June 2018
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC.
COMMUNITY CARE FOR THE ELDERLY
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
CCE 203.17
THIS CONTRACT is entered into between Area Agency on Aging for Southwest Florida, Inc.(Agency) and Collier
County Board of County Commissioners, (Contractor), 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 and exhibits, which constitute the contract document.
_.r I TIOTFUrl-_ 111 0I U ��. .
The contract will incorporate attachments, proposal(s), state plan(s), grant agreements, relevant Department handbooks,
manuals or desk books, as an integral part of the contract, except to the extent that the contract explicitly provides to
the contrary. In the event of conflict in language among any of the documents referenced above, the specific provisions
and requirements of the contract document(s) shall prevail over inconsistent provisions in the proposal(s) or other
general materials not specific to this contract document and identified attachments.
3. Term of Contract:
This contract shall begin at twelve (12:00) A.M., Eastern Standard Time July 1, 2017 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, 2018.
:ate ' _' r_r ' .
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount not
to exceed $794,335.00 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.
By mutual agreement of the Patties, in accordance with Section 287.058(1)(g), Florida Statutes (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.
6. Compliance with Federal Law:
6.1 If this contract contains federal funds this section shall apply.
6.1.1 The Contractor shall comply with the provisions of 45 Code of Federal Regulations (CFR) 75 and/or 45
CFR Part 92, 2 CFR Part 200 and other applicable regulations.
6.1.2 If this contract contains federal funds and is over $100,000.00, the Contractor shall comply with all
applicable standards, orders, or regulations issued under Section 306 of the Clean Air Act as amended (42
July 2017 — June 2018
CCE 203.17
United States Code (U.S.C.) 7401, et seq.), Section 508 of the Federal Water Pollution Control Act as
amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable
Environmental Protection Agency regulations, 2 CFR Part 1500. The Contractor shall report any violations
of the above to the Agency.
6.1.3 The Contractor, or agent acting for the Contractor, may not use any federal funds received in connection
with this contract to influence legislation or appropriations pending before the Congress or any state
legislature. The Contractor must complete all disclosure forms as required, specifically the Certification
and Assurances Attachment, which must be completed and returned to the Agency Contract Manager
prior to the execution of this contract.
6.1.4 In accordance with Appendix II to 2 CFR Part 200, the Contractor shall comply with Executive Order
11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as
supplemented in Department of Labor regulations 41 CFR Part 60 and in Department of Health and Human
Services regulations 45 CFR Part 92, if applicable.
6.1.5 A contract award with an amount expected to equal or exceed $25,000.00 and certain other contract awards
will not be made to parties listed on the government -wide Excluded Parties List System, in accordance with
the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 and 12689, "Debarment and
Suspension." The Excluded Parties List System contains the names of parties debarred, suspended, or
otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority
other than Executive Order 12549. The Contractor shall comply with these provisions before doing
business or entering into subcontracts receiving federal funds pursuant to this contract. The Contractor
shall complete and sign the Certifications and Assurances Attachment prior to the execution of this contract.
6.2 The Contractor shall not employ an unauthorized alien. The Agency will consider the employment of
unauthorized aliens a violation of the Immigration and Nationality Act (8 U.S.C. 1324a) and the Immigration
Reform and Control Act of 1986 (8 U.S.C. 1101). Such violation will be cause for unilateral cancellation of this
contract by the Agency.
6.3 If the Contractor is a non-profit provider and is subject to Internal Revenue Service (IRS) tax exempt organization
reporting requirements (fling a Form 990 or Form 990-N) and has its tax exempt status revoked for failing to
comply with the filing requirements of the Pension Protection Act of 2006 or for any other reason, the Contractor
must notify the Agency in writing within thirty (30) days of receiving the IRS notice of revocation.
6.4 The Contractor shall comply with Title 2 CFR Part 175 regarding Trafficking in Persons.
6.5 Unless exempt under 2 § 170.110(b), the Contractor shall comply with the reporting requirements of the
Transparency Act as expressed in 2 CFR Part 170.
6.6 To comply with Presidential Executive Order 12989, as amended, and State of Florida Executive Order Number
11-116, Contractor agrees to utilize the U.S. Agency of Homeland Security's E -verify system to verify the
employment of all new employees hired by Contractor during the contract term. Contractor shall include in
related subcontracts a requirement that Subcontractors performing work or providing services pursuant to the
state contract utilize the E -verify system to verify employment of all new employees hired by the Subcontractor
during the contract term. Contractors meeting the terms and conditions of the E -Verify System are deemed to be
in compliance with this provision.
7.1 This contract is executed and entered into in the State of Florida, and shall be construed, performed and enforced
in all respects in accordance with Florida law, including Florida provisions for conflict of laws.
7.2 If this contract contains state financial assistance funds, the Contractor shall comply with Section 215.97, F.S.,
and Section 215.971, F.S., and expenditures must be in compliance with laws, rules, and regulations, including,
but not limited to, the Reference Guide for State Expenditures.
7.3 The Contractor shall comply with the requirements of Section 287.058, F.S. as amended.
2
July 2017 — June 2018 CCE 203.17
7.3.1 The Contractor shall perform all tasks contained in Attachment I.
7.3.2 The Contractor shall provide units of deliverables, including reports, findings, and drafts, as specified in
Attachment I, to be received and accepted by the contract manager prior to payment.
7.3.3 The Contractor shall comply with the criteria and final date by which such criteria must be met for
completion of this contract as specified in Attachment I, Section III. Method of Payment.
7.3.4 The Contractor shall submit bills for fees or other compensation for services or expenses in sufficient detail
for a proper pre -audit and post -audit.
7.3.5 If itemized payment for travel expenses is permitted in this contract, the Contractor shall submit bills for
any travel expenses in accordance with Section 112.061, F.S., or at such lower rates as may be provided in
this contract.
7.3.6 The Contractor shall allow public access to all documents, papers, letters, or other public records as defined
in subsection 119.011(12), F.S., made or received by the Contractor in conjunction with this contract except
for those records which are made confidential or exempt by law. The Contractors refusal to comply with
this provision will constitute an immediate breach of contract for which the Agency may unilaterally
terminate this contract.
7.4 If clients are to be transported under this contract, the Contractor shall comply with the provisions of Chapter
427, F.S., and Rule Chapter 41-2, Florida Administrative Code (F.A.C).
7.5 Subcontractors who are on the Discriminatory Vendor List may not transact business with any public entity, in
accordance with the provisions of Section 287.134, F.S.
7.6 The Contractor shall comply with the provisions of Section 11.062, F.S., and Section 216.347, F.S., which prohibit
the expenditure of contract funds for the purpose of lobbying the legislature, judicial branch or a state agency.
7.7 In accordance with Section 287.135, F.S., any Contractor on the Scrutinized Companies with Activities in Sudan
List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List (Lists), created
pursuant to Section 215.473, F.S., is ineligible to enter into or renew a contract with the Agency for goods or
services of $750,000.00 or more. Pursuant to Section 287.135, F.S., the Agency may terminate this contract if
the Contractor is found to have submitted a false certification of its status on the Lists or has been placed on
the Lists. Further, the Contractor is subject to civil penalties, attorney's fees and costs and any costs for
investigations that led to the finding of false certification. The Contractor shall complete and sign the
Certifications and Assurances Attachment, prior to the execution of this contract.
The Contractor shall ensure that the requirements of Section 430.0402 and Chapter 435, F.S., as amended, are met
regarding background screening for all persons who meet the definition of a direct service provider and who are not
exempt from the Agency's level 2 background screening pursuant to Section 430.0402(2)-(3), F.S. The Contractor
must also comply with any applicable rules promulgated by the Agency and/or Department and the Department for
Health Care Administration regarding implementation of Section 430.0402 and Chapter 435, F.S. To demonstrate
compliance with this provision, Contractor shall submit to the Agency, the Background Screening Affidavit of
Compliance (Screening Form) upon thirty (30) days of execution of this contract. Should the Agency have a
completed Screening Form on file for the Contractor, a new Screening Form will be required every twelve (12)
months.
8.1 Further information concerning the procedures for background screening may be found at
littp:Helderaffairs.state.fl.us/doea/backgroundscreening.plip.
9. Grievance Procedures:
The Contractor shall develop, implement, and ensure that its Subcontractors have established grievance procedures to
process and resolve client dissatisfaction with or denial of service(s), and address complaints regarding the termination,
suspension or reduction of services, as required for receipt of funds. These procedures, at a minimum, will provide for
notice of the grievance procedure and an opportunity for review of the Subcontractors determination(s).
July 2017 — June 2018
CCE 203.17
10.1 By execution of this contract, Contractor agrees to all provisions of Chapter 119, F.S., and any other applicable
law, and shall;
10.1.1 Keep and maintain public records required by the Agency to perform the contracted services.
10.1.2 Upon request from the Agency's custodian of public records, provide the Agency a copy of the
requested records or allow the records to be inspected or copied within a reasonable time at a cost that does
not exceed the cost provided in Chapter 119, F. S., or as otherwise provided by law.
10.1.3 Ensure that public records that are exempt, or confidential and exempt, from public records disclosure
requirements are not disclosed except as authorized by law for the duration of the contract term and
following completion of the contract if the Contractor does not transfer the records to the Agency.
10.1.4 Upon completion of the contract, the Contractor will either transfer, at no cost to the Agency, all public
records in possession of the Contractor, or will keep and maintain public records required by the Agency.
If the Contractor transfers all public records to the Agency upon completion of the contract,
Contractor shall destroy any duplicate public records that are exempt, or confidential and exempt, from
public records disclosure requirements. If the Contractor keeps and maintains public records upon
completion of the contract, the Contractor shall meet all applicable requirements for retaining public
records. All records stored electronically must be provided to the Agency in a format that is compatible
with the information technology systems of the Agency.
10.2 The Agency may unilaterally cancel this contract, notwithstanding any other provisions of this contract, for
refusal by the Contractor to comply with Section 10 of this contract by not allowing public access to all documents,
papers, letters, or other material made or received by the Contractor in conjunction with this contract, unless the
records are exempt, or confidential and exempt, from Section 24(a) of Article I of the State Constitution and
Section 119.07(1), F.S.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION
OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO
PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT
THE CUSTODIAN OF PUBLIC RECORDS AT:
Public Records Coordinator
Area Agency on Aging for Southwest Florida, Inc.
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
239-652-6900 or 866-413-5337
11. Audits. Inspections. Investigations:
11.1 The Contractor shall establish and maintain books, records and documents (including electronic storage media)
sufficient to reflect all assets, obligations, unobligated balances, income, interest and expenditures of funds
provided by the Agency under this contract. Contractor shall adequately safeguard all such assets and assure
they are used solely for the purposes authorized under this contract. Whenever appropriate, financial information
should be related to performance and unit cost data.
11.2 The Contractor shall retain and maintain all client records, financial records, supporting documents, statistical
records, and any other documents (including electronic storage media) pertinent to this contract for a period of
six (6) years after completion of the contract or longer when required by law. In the event an audit is required
by this contract, records shall be retained for a minimum period of six (6) years after the audit report is issued or
until resolution of any audit findings or litigation based on the terms of this contract, at no additional cost to the
Agency.
11.3 Upon demand, at no additional cost to the Agency, the Contractor shall facilitate the duplication and transfer of
any records or documents during the required retention period.
4
July 2017 — June 2018
CCE 203.17
11.4 The Contractor shall assure that the records described in this section will be subject at all reasonable times to
inspection, review, copying, or audit by federal, state, or other personnel duly authorized by the Agency.
11.5 At all reasonable times for as long as records are maintained, persons duly authorized by the Agency and
federal auditors, pursuant to 45 CFR Part 75, will be allowed full access to and the right to examine any of the
Contractors contracts and related records and documents pertinent to this specific contract, regardless of the form
in which kept.
11.6 The Contractor shall provide a Financial and Compliance Audit Attachment to the Agency as specified in this
contract and ensure that all related third -party transactions are disclosed to the auditor.
11.7 Contractor agrees to comply with the Agency and the Inspector General in any investigation, audit, inspection,
review, or hearing performed pursuant to Section 20.055, Florida Statutes. Contractor further agrees that it
shall include in related subcontracts a requirement that subcontractors performing work or providing services
pursuant to this contract agree to cooperate with the Agency and the Inspector General in any investigation,
audit, inspection, review, or hearing pursuant to Section 20.055(5), F.S. By execution of this contract the
Contractor understands and will comply with this subsection.
12. Nondiscrimination -Civil Rights Com 1p •ance:
12.1 The Contractor shall execute Assurances as stated in the Assurances -Non -Construction Programs Attachment that
it will not discriminate against any person in the provision of services or benefits under this contract or in
employment because of age, race, religion, color, disability, national origin, marital status or sex in compliance
with state and federal law and regulations. The Contractor further assures that all Contractors, Subcontractors,
Sub -grantees, or others with whom it arranges to provide services or benefits in connection with any of its
programs and activities are not discriminating against clients or employees because of age, race, religion, color,
disability, national origin, marital status or sex.
12.2 During the term of this contract, the Contractor shall complete and retain on file a timely, complete and accurate
Civil Rights Compliance Checklist, attached to this contract.
12.3 The Contractor shall establish procedures pursuant to federal law to handle complaints of discrimination involving
services or benefits through this contract. These procedures will include notifying clients, employees, and
participants of the right to file a complaint with the appropriate federal or state entity.
12.4 If this contract contains federal funds, these assurances are a condition of continued receipt of or benefit from
federal financial assistance, and are binding upon the Contractor, its successors, transferees, and assignees for the
period during which such assistance is provided. The Contractor further assures that all Subcontractors, Vendors,
or others with whom it arranges to provide services or benefits to participants or employees in connection with
any of its programs and activities are not discriminating against those participants or employees in violation of
the above statutes, regulations, guidelines, and standards. In the event of failure to comply, the Contractor
understands that the Agency and/or Department may, at its discretion, seek a court order requiring compliance
with the terms of this assurance or seek other appropriate judicial or administrative relief, including but not
limited to, termination of and denial of further assistance.
The Contractor shall permit persons duly authorized by the A g e n c y a n d / o r Department to inspect and copy
any records, papers, documents, facilities, goods, and services of the Contractor which are relevant to this contract,
and to interview any clients, employees, and Subcontractor employees of the Contractor to assure the Agency
of the satisfactory performance of the terms and conditions of this contract. Following such review, the Agency will
provide a written report of its findings to the Contractor, and where appropriate, the Contractor shall develop a
Corrective Action Plan (CAP). The Contractor hereby agrees to correct all deficiencies identified in the CAP in a
timely manner as determined by the Agency's Contract Manager.
14. Provision of Services:
The Contractor shall provide services in the manner described in Attachment I.
July 2017 — June 2018
CCE 203.17
If the Contractor receives funding from one or more State of Florida human service agencies, in addition to the
Area Agency on Aging for Southwest Florida, Inc., then a joint monitoring visit including such other agencies may
be scheduled. For the purposes of this contract, and pursuant to Section 287.0575, F.S. as amended, Florida's
human service agencies shall include the Department of Children and Families, the Department of Health, the
Department for Persons with Disabilities, the Department of Veterans' Affairs, and the Department of Elder
Affairs. Upon notification and the subsequent scheduling of such a visit by the designated agency's lead
administrative coordinator, the Contractor shall comply and cooperate with all monitors, inspectors, and/or
investigators.
The Contractor shall indemnify, save, defend, and hold harmless the Agency and its agents and employees from
any and all claims, demands, actions, causes of action of whatever nature or character, arising out of or by reason of the
execution of this agreement or performance of the services provided for herein. It is understood and agreed that the
Contractor is not required to indemnify the Agency for claims, demands, actions or causes of action arising solely out
of the negligence of the Agency.
16.1 Except to the extent permitted by Section 768.28, F.S., or other Florida law, this section 16 is not applicable to
contracts executed between the Agency and state agencies or subdivisions defined in Section 768.28(2), F.S.
17. Insurance and BondinLF:
17.1 The Contractor shall provide continuous adequate liability insurance coverage during the existence of this
contract and any renewal(s) and extension(s) of it. By execution of this contract, unless it is a state agency or
subdivision as defined by Section 768.28(2), F.S., the Contractor accepts full responsibility for identifying and
determining the type(s) and extent of liability insurance necessary to provide reasonable financial protections
for the Contractor and the clients to be served under this contract. The limits of coverage under each policy
maintained by the Contractor do not limit the Contractors liability and obligations under this contract. The
Contractor shall ensure that the Agency has the most current written verification of insurance coverage
throughout the term of this contract. Such coverage may be provided by a self-insurance program established
and operating under the laws of the State of Florida. The Agency reserves the right to require additional
insurance as specified in this contract.
17.2 Throughout the term of this agreement, the Contractor shall maintain an insurance bond from a responsible
commercial insurance company covering all officers, directors, employees and agents of the Contractor
authorized to handle funds received or disbursed under all agreements and/or contracts incorporating this
contract by reference in an amount commensurate with the funds handled, the degree of risk as determined by
the insurance company and consistent with good business practices.
18. Confidentiality of Information:
The Contractor shall not use or disclose any information concerning a recipient of services under this contract for any
purpose prohibited by state or federal law or regulations except with the written consent of a person legally authorized
to give that consent or when authorized by law.
Where applicable, the Contractor shall comply with the Health Insurance Portability and Accountability Act (42 USC
1320d.), as well as all regulations promulgated thereunder (45 CFR Parts 160, 162, and 164).
20.1 The Contractor shall notify the Agency immediately but no later than forty-eight (48) hours from the
Contractors awareness or discovery of conditions that may materially affect the Contractors or Subcontractors
ability to perform the services required to be performed under this contract. Such notice shall be made orally to
the Agency's Contract Manager (by telephone) with an email to immediately follow.
0
July 2017 — June 2018
CCE 203.17
20.2 The Contractor shall immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of
a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone number
(1-800-96ABUSE). As required by Chapters 39 and 415, F.S., this provision is binding upon the Contractor,
Subcontractors, and their employees.
The Contractor shall notify the Agency within ten (10) days of entering into a new contract with any of the remaining
four (4) state human service agencies. The notification shall include the following information: (1) contracting state
agency and the applicable office or program issuing the contract; (2) contract name and number; (3) contract start and
end dates; (4) contract amount; (5) contract description and commodity or service; (6) Contract Manager name and
contact information. In complying with this provision, and pursuant to Section 287.0575, F.S., as amended, the
Contractor shall complete the Provider's State Contracts List, ask Area Agency for a copy of this form.
►iii$
oil
During the term of this contract, the Contractor shall immediately notify the Area Agency on Aging for Southwest
Florida, Inc. if the Contractor, its assignees, Subcontractors or affiliates file a claim for bankruptcy. Within ten (10)
days after notification, the Contractor must also provide the following information to the Area Agency on Aging for
Southwest Florida, Inc.: (1) the date of filing of the bankruptcy petition; (2) the case number; (3) the court name and
the division in which the petition was filed (e.g., Middle District of Florida, Fort Myers, Florida); and (4) the name,
address, and telephone number of the bankruptcy attorney.
23. Snonsorshin and Publicity:
23.1 As required by Section 286.25, F.S., if the Contractor is a non-governmental organization which sponsors a
program financed wholly or in part by state funds, including any funds obtained through this contract, it shall,
in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by (Contractors
name) the Area Agency on Aging for Southwest Florida, Inc. and/or the State of Florida, Department of Elder
Affairs." If the sponsorship reference is in written material, the words "Area Agency on Aging for Southwest
Florida, Inc. and/or the State of Florida, Department of Elder Affairs" shall appear in at least the same size
letters or type as the name of the organization.
23.2 The Contractor shall not use the words "Area Agency on Aging for Southwest Florida, Inc. and/or the State of
Florida, Department of Elder Affairs" to indicate sponsorship of a program otherwise financed, unless specific
authorization has been obtained by the Agency and/or Department prior to use.
24. Assignments:
24.1 The Contractor shall not assign the rights and responsibilities under this contract without the prior written
approval of the Agency, which shall not be unreasonably withheld. Any sublicense, assignment, or transfer
otherwise occurring without prior written approval of the Agency will constitute a material breach of the
contract.
24.2 The State of Florida and/or the Area Agency is, at all times, entitled to assign or transfer, in whole or part, its
rights, duties, or obligations under this contract to another governmental agency in the State of Florida, upon
giving prior written notice to the Contractor. In the event the State of Florida and/or the Area Agency approves
transfer of the Contractor's obligations, the Contractor remains responsible for all work performed and all
expenses incurred in connection with this contract.
24.3 This contract shall remain binding upon the successors in interest of either the Contractor or the Agency.
25. Subcontracts:
25.1 The Contractor is responsible for all work performed and for all commodities produced pursuant to this contract,
whether actually furnished by the Contractor or its Subcontractors. Any subcontracts shall be evidenced by a
written document and subject to any conditions of approval the Agency deems necessary. The Contractor
further agrees that the Agency will not be liable to the Subcontractor in any way or for any reason. The
Contractor, at its expense, shall defend the Agency against any such claims.
7
July 2017 — June 2018
CCE 203.17
25.2 The Contractor shall promptly pay any Subcontractors upon receipt of payment from the Agency or other
state agency. Failure to make payments to any Subcontractor in accordance with Section 287.0585, F.S., unless
otherwise stated in the contract between the Contractor and Subcontractor, will result in a penalty as provided
by statute.
26. Independent Capacity of Contractor:
It is the intent and understanding of the Parties that the Contractor, and any of its Subcontractors, are independent
Contractors and are not employees of the Agency and shall not hold themselves out as employees or agents of the
Agency without specific authorization from the Agency. It is the further intent and understanding of the Parties that
the Agency does not control the employment practices of the Contractor and will not be liable for any wage and
hour, employment discrimination, or other labor and employment claims against the Contractor or its
Subcontractors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment
compensation funds and all necessary insurance for the Contractor are the sole responsibility of the Contractor.
27. Payment:
Payments shall be made to the Contractor for all completed and approved deliverables (units of service) as defined in
Attachment I. The Agency Contract Manager will have final approval of the Contractor's invoice submitted for
payment, and will approve the invoice for payment only if the Contractor has met all terms and conditions of the
contract, unless the bid specifications, purchase order, or this contract specify otherwise. The approved invoice will
be submitted to the Agency's finance section for budgetary approval and processing. Disputes arising over
invoicing and payments will be resolved in accordance with the provisions of Section 215.422, F.S. A Vendor
Ombudsman has been established within the Florida Agency of Financial Services and may be contacted at 800-342-
2762.
The Contractor shall return to the Agency any overpayments due to unearned funds or funds disallowed and any
interest attributable to such funds pursuant to the terms and conditions of this contract that were disbursed to the
Contractor by the Agency. In the event that the Contractor or its independent auditor discovers that an overpayment
has been made, the Contractor shall repay said overpayment immediately without prior notification from the
Agency. In the event that the Agency first discovers an overpayment has been made, the Agency Contract
Manager will notify the Contractor in writing of such findings. Should repayment not be made forthwith, the
Contractor shall be charged at the lawful rate of interest on the outstanding balance pursuant to Section 55.03,
F.S., after Agency notification or Contractor discovery.
29. Data Integrily and Safeguarding Information:
The Contractor shall ensure an appropriate level of data security for the information the Contractor is collecting or using
in the performance of this contract. An appropriate level of security includes approving and tracking all Contractor
employees that request system or information access and ensuring that user access has been removed from all terminated
employees. The Contractor, among other requirements, must anticipate and prepare for the loss of information
processing capabilities. All data and software shall be routinely backed up to ensure recovery from losses or outages
of the computer system. The security over the backed -up data is to be as stringent as the protection required of the
primary systems. The Contractor shall ensure all Subcontractors maintain written procedures for computer system
backup and recovery. The Contractor shall complete and sign the Certification Regarding Data Integrity Compliance
for Agreements, Grants, Loans, and Cooperative Agreements prior to the execution of this contract.
The Florida Department of Elder Affairs has implemented a Social Media Policy, in addition to its Computer Use Policy,
which applies to all employees, contracted employees, consultants, OPS and volunteers, including all personnel
affiliated with third parties, such as, but not limited to, Contractors and subcontractors. Any entity that uses the
Department's computer resource systems must comply with the Department's policy regarding social media. Social
Media includes, but is not limited to blogs, podcasts, discussion forums, Wikis, RSS feeds, video sharing, social
8
July 2017 — June 2018 CCE 203.17
networks like MySpace, Facebook and Twitter, as well as content sharing networks such as flickr and YouTube. This
policy is available on the Department's website at: http://eideraffaii-s.state.fl.us/doea/financial.php.
31. Conflict of Interest:
The Contractor shall establish safeguards to prohibit employees, board members, management and Subcontractors from
using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of
interest or personal gain. No employee, officer or agent of the Contractor or Subcontractor shall participate in the
selection, or in the award of an agreement supported by state or federal funds if a conflict of interest, real or apparent,
would be involved. Such a conflict would arise when: (a) the employee, officer or agent; (b) any member of his/her
immediate family; (c) his or her partner; or (d) an organization which employs, or is about to employ, any of the above,
has a financial or other interest in the firm selected for award. The Contractor or Subcontractors officers, employees or
agents will neither solicit nor accept gratuities, favors or anything of monetary value from Contractors, potential
Contractors, or parties to Subcontracts. The Contractors board members and management must disclose to the
Agency any relationship which may be, or may be perceived to be, a conflict of interest within thirty (30) calendar
days of an individual's original appointment or placement in that position, or if the individual is serving as an incumbent,
within thirty (30) calendar days of the commencement of this contract. The Contractor's employees and Subcontractors
must make the same disclosures described above to the Agency's board of directors. Compliance with this provision
will be monitored.
32. Public Entity Crime:
Pursuant to Section 287.133(2)(a), F.S., a person or affiliate who has been placed on the Convicted Vendor List
following a conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any
goods or services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the
construction or repair of a public building or public work; may not submit bids, proposals, or replies on leases of real
property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant
under a contract with any public entity; and may not transact business with any public entity in excess of the threshold
amount provided in Section 287.017, F.S., for CATEGORY TWO for a period of thirty six (36) months following the
date of being placed on the Convicted Vendor List.
33. Purchasing:
33.1 The Contractor may purchase articles which are the subject of or are required to carry out this contract from
Prison Rehabilitative Industries and Diversified Enterprises, Inc., (PRIDE) identified under Chapter 946, F.S.,
in the same manner and under the procedures set forth in subsections 946.515(2) and (4), F.S. For purposes of
this contract, the Contractor shall be deemed to be substituted for the Agency insofar as dealings with PRIDE.
This clause is not applicable to Subcontractors unless otherwise required by law. An abbreviated list of
products/services available from PRIDE may be obtained by contacting PRIDE, 800-643-8459.
33.2 The Contractor may procure any recycled products or materials, which are the subject of or are required to carry
out this contract, in accordance with the provisions of Section 403.7065, F.S.
33.3 The Contractor may purchase articles that are the subject of, or required to carry out, this contract from a
nonprofit agency for the Blind or for the Severely Handicapped that is qualified pursuant to Chapter 413, F.S.,
in the same manner and under the same procedures set forth in Section 413.036(1) and (2), F.S. For purposes of
this contract, the Contractor shall be deemed to be substituted for the Agency insofar as dealings with such
qualified nonprofit agency are concerned. Additional information about the designated nonprofit agency and
the products it offers is available at http://www.respectofflorida.ora. This clause is not applicable to
Subcontractors unless otherwise required by law.
34. Patents, Copyrights. Royalties:
If this contract is awarded state funding and if any discovery, invention or copyrightable material is developed, produced
or for which ownership was purchased in the course of or as a result of work or services performed under this contract,
the Contractor shall refer the discovery, invention or material to the Agency to be referred to the Agency and/or
Department of State. Any and all patent rights or copyrights accruing under this contract are hereby reserved to the
State of Florida in accordance with Chapter 286, F.S. Pursuant to Section 287.0571(5)(k), as amended, the only
exceptions to this provision shall be those that are clearly expressed and reasonably valued in this contract.
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July 2017 — June 2018
CCE 203.17
34.1 If the primary purpose of this contract is the creation of intellectual property, the State of Florida shall retain an
unencumbered right to use such property, notwithstanding any agreement made pursuant to this section 34.
34.2 If this contract is awarded solely federal funding, the terms and conditions are governed by 2 CFR § 200.315.
34.3 Notwithstanding the foregoing provisions, if the Provider or one of its Subcontractors is a university and a
member of the State University System of Florida, then Section 1004.23, F.S., shall apply, but the Agency
shall retain a perpetual, fully -paid, nonexclusive license for its use and the use of its Contractors, Subcontractors
or Assignees of any resulting patented, copyrighted or trademarked work products.
MMIKOMMUT =&I 0107M.
35.1 If the tasks to be performed pursuant to this contract include the physical care and control of clients, or the
administration and coordination of services necessary for client health, safety or welfare, the Contractor shall,
within thirty (30) calendar days of the execution of this contract, submit to the Agency's Contract Manager
verification of an Emergency Preparedness Plan. In the event of an emergency, the Contractor shall notify the
Agency of emergency provisions.
35.2 In the event a situation results in a cessation of services by a Subcontractor, the Contractor shall retain
responsibility for performance under this contract and must follow procedures to ensure continuity of operations
without interruption.
36. Eiluinment:
36.1 Equipment means: (a) an article of nonexpendable, tangible personal property having a useful life of more than
one year and a per-unit acquisition cost which equals or exceeds the lesser of the capitalization level established
by the organization for the financial statement purposes, or $5,000.00 [for federal funds], or (b); nonexpendable,
tangible personal property of a non -consumable nature with an acquisition cost of $1,000.00 or more per unit,
and expected useful life of at least one (1) year; and hardback bound books not circulated to students or the
general public, with a value or cost of $250.00 or more [for state funds].
36.2 Contractors and Subcontractors who are Institutions of Higher Education, Hospitals, and Other Non -Profit
Organizations shall have written property management standards in compliance with 2 CFR Part 200
Administrative Requirements (formerly OMB Circular A-110) that include: (a) a property list with all the
elements identified in the circular; (b) a procedure for conducting a physical inventory of equipment at least once
every two (2) years; (c) a control system to insure adequate safeguards to prevent loss, damage, or theft of the
equipment; and (d) maintenance procedures to keep the equipment in good condition. The property records must
be maintained on file and shall be provided to the Agency upon request. The Contractor shall promptly
investigate, fully document and notify the Agency's Contract Manager of any loss, damage, or theft of
equipment. The Contractor shall provide the results of the investigation to the Agency's Contract Manager.
36.3 The Contractor's property management standards for equipment acquired with federal funds and federally -owned
equipment shall include accurately maintained equipment records with the following information:
36.3.1 A description of the equipment;
36.3.2 Manufacturer's serial number, model number, federal stock number, national stock number, or other
identification number;
36.3.3 Source of the equipment, including the award number;
36.3.4 Whether title vests in the Contractor or the federal government;
36.3.5 Acquisition date (or date received, if the equipment was furnished by the federal government) and cost;
36.3.6 Information from which one can calculate the percentage of federal participation in the cost of the
equipment (not applicable to equipment furnished by the federal government);
36.3.7 Location and condition of the equipment and the date the information was reported;
36.3.8 Unit acquisition cost; and
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July 2017 — June 2018
CCE 203.17
36.3.9 Ultimate disposition data, including date of disposal and sales price or the method used to determine
current fair market value where a Contractor compensates the federal awarding agency for its share.
36.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased with
state funds with an acquisition cost over $1,000.00 that is specifically identified in the area plan approved by the
Agency is part of the cost of carrying out the activities and functions of the grant awards and Title (ownership) will
vest in the Contractor, subject to the conditions of 2 CFR Part 200. Equipment purchased under these
thresholds is considered supplies and is not subject to property standards. Equipment purchased with funds
identified in the budget attachments to agreements covered by this contract, or identified in the sub -agreements
with Subcontractors (not included in a cost methodology), is subject to the conditions of Chapter 273, F. S. and
60A-1.017, F. A. C. and 45 CFR Part 75.
36.5 The Contractor shall not dispose of any equipment or materials provided by the Agency, or purchased with
funds provided through this contract without first obtaining the approval of the Agency's Contract Manager.
When disposing of property or equipment, the Contractor must submit a written request for disposition
instructions to the Agency's Contract Manager. The request should include a brief description of the
property, purchase price, funding source, and percentage of state or federal participation, acquisition date and
condition of the property. The request should also indicate the Contractors proposed disposition (i.e., transfer or
donation to another agency that administers federal programs, offer the items for sale, destroy the items, etc.).
36.6 The Agency's Contract Manager will issue disposition instructions. If disposition instructions are not
received within one hundred twenty (120) days of the written request for disposition, the Contractor is authorized
to proceed as directed in 2 CFR §200.313.
36.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto, but
excludes movable machinery and equipment. Real property may not be purchased with state or federal funds
through agreements covered under this contract without the prior approval of the Agency. Real property
purchases from Older Americans Act funds are subject to the provisions of Title 42, Chapter 35, Subchapter 11I,
Part A., Section 3030b USC. Real property purchases from state funds can only be made through fixed capital
outlay grants and aids appropriations and therefore are subject to the provisions of Section 216.348, F.S.
36.8 Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted and tested prior
to disposal to ensure no confidential information remains.
36.9 The Contractor must adhere to the Agency's procedures and standards when purchasing Information
Technology Resources (ITR) as part of any agreement(s) incorporating this contract by reference. An ITR
worksheet is required for any computer related item costing $1,000.00 or more, including data processing
hardware, software, services, supplies, maintenance, training, personnel and facilities. The completed ITR
worksheet shall be maintained in the LAN administrator's file and must be provided to the Agency upon
request. The Contractor has the responsibility to require any Subcontractors to comply with the Agency's ITR
procedures.
37. PUR 1000 Form:
The PUR 1000 Form is hereby incorporated by reference and available at:
http://www.inytloi-ida.com/apps/vbs/adoc/F7740 PUR1000.pdf
In the event of any conflict between the PUR 1000 Form and any terms or conditions of this contract the terms or
conditions of this contract shall take precedence over the PUR 1000 Form. However, if the conflicting terms or
conditions in the PUR 1000 Form are required by any section of the Florida Statutes, the terms or conditions contained
in the PUR 1000 Form shall take precedence.
Any state funds provided for the purchase of or improvements to real property are contingent upon the Contractor or
political subdivision granting to the state a security interest in the property at least to the amount of state funds provided
for at least five (5) years from the date of purchase or the completion of the improvements or as further required by law.
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July 2017 — June 2018
39. Dispute Resolution:
CCE 203.17
Any dispute concerning performance of the contract shall be decided by the Agency's Contract Manager, who shall
reduce the decision to writing and serve a copy on the Contractor.
40. Financial Consequences:
If the Contractor fails to meet the minimum level of service or performance identified in this contract, the Agency will
impose financial consequences as stated in Attachment I.
01 A : �1 �1
Nothing contained in this agreement is intended to serve as a waiver of sovereign immunity by any entity to which
sovereign immunity may be applicable.
42. Venue:
If any dispute arises out of this contract, the venue of such legal recourse shall be Lee County, Florida.
43. Entire Contract:
This contract contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations
shall be valid or binding upon the Agency or the Contractor unless expressly contained herein or by a written
amendment to this contract signed by both Parties.
44. Force Majeure:
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control,
provided the party experiencing the force majeure condition provides immediate written notification to the other party
and takes all reasonable efforts to cure the condition.
45. Severability Clause:
The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or unenforceable the
other provisions are severable to that void provision and shall remain in full force and effect.
46. Condition Precedent to Contract AllUrouriations:
The Parties agree that the Agency's performance and obligation to pay under this contract is contingent upon an
annual appropriation by the Legislature.
47. Addition/Deletion:
The Parties agree that the Agency reserves the right to add or to delete any of the services required under this
contract when deemed to be in the State of Florida's best interest and reduced to a written amendment signed by both
Parties. The Patties shall negotiate compensation for any additional services added.
48, Waiver:
The delay or failure by the Agency to exercise or enforce any of its rights under this contract will not constitute or be
deemed a waiver of the Agency's right thereafter to enforce those rights, nor will any single or partial exercise of any
such right preclude any other or further exercise thereof or the exercise of any other right.
49. Com lily ance:
The Contractor shall abide by all applicable current federal statutes, laws, rules and regulations as well as applicable
current state statutes, laws, rules and regulations. The Parties agree that failure of the Contractor to abide by these laws
shall be deemed an event of default of the Contractor, and subject the contract to immediate, unilateral cancellation of
the contract at the discretion of the Agency.
50. Final Invoice:
The Contractor shall submit the final invoice for payment to the Agency no later than thirty (30) days upon the
contract ending date unless otherwise specified in Attachment I. If the Contractor fails to do so, all right to payment is
12We
July 2017 — June 2018
CCE 203.17
forfeited and the Agency may not honor any requests submitted after the aforesaid time period. Any payment due
under the terms of this contract may be withheld until all required documentation and reports due from the Contractor
and necessary adjustments thereto have been approved by the Agency.
Modifications of the provisions of this contract shall be valid only when they have been reduced to writing and duly
signed by both parties. The rate of payment and the total dollar amount may be adjusted retroactively to reflect price
level increases and changes in the rate of payment when these have been established through the appropriations process
and subsequently identified in the Agency's operating budget.
The Agency may in its sole discretion suspend any or all activities under the contract or purchase order, at any time,
when in the best interests of the State to do so. The Agency shall provide the Contractor written notice outlining the
particulars of suspension. Examples of the reason for suspension include, but are not limited to, budgetary
constraints, declaration of emergency, or other such circumstances. After receiving a suspension notice, the Contractor
shall comply with the notice and shall not accept any purchase orders. Within ninety (90) days, or any longer period
agreed to by the Contractor, the Agency shall either (1) issue a notice authorizing resumption of work, at which
time activity shall resume, or (2) terminate the contract or purchase order. Suspension of work shall not entitle the
Contractor to any additional compensation.
53. Termination:
53.1 Termination for Convenience. The Agency, by written notice to the Contractor, may terminate the contract in
whole or in part when the Agency determines in its sole discretion that it is in the State's interest to do so. The
Contractor shall not furnish any product after it receives the notice of termination, except as necessary to
complete the continued portion of the contract, if any. The Contractor shall not be entitled to recover any
cancellation charges or lost profits.
53.2 Termination for Cause. The Agency may terminate the contract if the Contractor fails to (1) deliver the
product within the time specified in the contract or any extension, (2) maintain adequate progress, thus
endangering performance of the contract, (3) honor any term of the contract, or (4) abide by any statutory,
regulatory, or licensing requirement. Rule 60A-1.006(3), F.A.C., governs the procedure and consequences of
default. The Contractor shall continue work on any work not terminated. Except for defaults of Subcontractors
at any tier, the Contractor shall not be liable for any excess costs if the failure to perform the contract arises from
events completely beyond the control, and without the fault or negligence, of the Contractor. If the failure to
perform is caused by the default of a Subcontractor at any tier, and if the cause of the default is completely beyond
the control of both the Contractor and the Subcontractor, and without the fault or negligence of either, the
Contractor shall not be liable for any excess costs for failure to perform, unless the subcontracted products were
obtainable from other sources in sufficient time for the Contractor to meet the required delivery schedule. If, after
termination, it is determined that the Contractor was not in default, or that the default was excusable, the rights
and obligations of the Parties shall be the same as if the termination had been issued for the convenience of the
Agency. The rights and remedies of the Agency in this clause are in addition to any other rights and
remedies provided by law or under the contract.
53.3 Upon termination of the contract, the Contractor and Subcontractors shall, at no cost to the Agency, transfer all
public records in their possession to the Agency and destroy any duplicate public records that are exempt, or
confidential and exempt, from public records disclosure requirements. All records stored electronically shall be
provided to the Agency in a format that is compatible with the information technology systems of the
Agency.
54. Electronic Records and Signature:
The Agency authorizes, but does not require, the Contractor to create and retain electronic records and to use
electronic signatures to conduct transactions necessary to carry out the terms of this Agreement. A Contractor that
creates and retains electronic records and uses electronic signatures to conduct transactions shall comply with the
requirements contained in the Uniform Electronic Transaction Act, Section 668.50, F.S. All electronic records must be
fully auditable; are subject to Florida's Public Records Law, Chapter 119, F.S.; must comply with Section 29, Data
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July 2017 — June 2018
CCE 203.17
Integrity and Safeguarding Information; must maintain all confidentiality, as applicable; and must be retained and
maintained by the Contractor to the same extent as non -electronic records are retained and maintained as required by
this Agreement.
54.1 The Agency's authorization pursuant to this section does not authorize electronic transactions between the
Contractor and the Agency. The Contractor is authorized to conduct electronic transactions with the
Agency only upon further written consent by the Agency.
54.2 Upon request by the Agency, the Contractor shall provide the Agency with non -electronic (paper) copies of
records. Non -electronic (paper) copies provided to the Agency of any document that was originally in
electronic form with an electronic signature must identify the person and the person's capacity who electronically
signed the document on any non -electronic copy of the document.
55. Contract Manager:
The Agency may substitute any Agency employee to serve as the Contract Manager.
REMAINDER OF THE PAGE INTENTIONALL Y LEFT BLANK
14
July 2017 — June 2018
56. ffici 1 Pavee andReDresentatives (Names,Addresses. nd TeIeDhone Number1j,
CCE 203.17
57. All Terms and Conditions Included:
This contract and its Attachments, I — XII including 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
COUNTY CO SS ONERS
SIGNED BY:
NAME: Steve Y. Carnell
TITLE: Public Services Department Head
DATE: o
Federal Tax : )59-60(Q558
Fiscal Year Ending Date: 09/30
DUNS: 833441814
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA, INC.
SIGNED BY:
NAME: MARIANNE G LORI II
TITLE: PRESIDENT/CEO
DATE:
Approved as to form and legality
15 Assish011 Ctionty Attonicy
or 13
The Contractor name, as shown on page 1 ofo
Collier County Board of County Commissioners
/oCollier County Community and Human Services
a.
this contract, and mailing address of the official
3339 E Tamiami Trail, Suite 211
payee to whom the payment shall be made is:
Naples, FL 34112
The name of the contact person and street
Kimberley Grant, Director
Collier County Board of County Commissioners
b.
address where financial and administrative
%Collier County Community and Human Services
records are maintained is:
3339 E Tamiami Trail, Suite 211
Naples, FL 34112
Kimberley Grant, Director
The name, address, and telephone number of
Collier County Board of County Commissioners
C.
the representative of the Contractor responsible
%Collier County Community and Human Services
for administration of the program under this
3339 E Tamiami Trail, Suite 211
contract is:
Naples, FL 34112
(239) 252-2273
The section and location within the Agency where
Area Agency on Aging for Southwest Florida, Inc.
d.
Requests for Payment and Receipt and
15201 North Cleveland Avenue, Suite 1100
Expenditure forms are to be mailed is:
North Fort Myers, FL 33903
Tammy Rhoades, Vice President of Finance
e.
The name, address, and telephone number
Area Agency on Aging for Southwest Florida, Inc.
of the 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.
57. All Terms and Conditions Included:
This contract and its Attachments, I — XII including 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
COUNTY CO SS ONERS
SIGNED BY:
NAME: Steve Y. Carnell
TITLE: Public Services Department Head
DATE: o
Federal Tax : )59-60(Q558
Fiscal Year Ending Date: 09/30
DUNS: 833441814
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA, INC.
SIGNED BY:
NAME: MARIANNE G LORI II
TITLE: PRESIDENT/CEO
DATE:
Approved as to form and legality
15 Assish011 Ctionty Attonicy
or 13
July 2017 — June 2018
INDEX OF ATTACHMENTS
CCE 203.17
ATTACHMENTI...........................................................................................................................................17
STATEMENTOF WORK................................................................................................................................ 17
ATTACHMENTII.......................................................................................................................................... 30
FINANCIAL AND COMPLIANCE AUDIT................................................................................................... 30
ATTACHMENTIII........................................................................................................................................ 36
CERTIFICATIONS AND ASSURANCES...................................................................................................... 36
ATTACHMENTIV..............................................................................................................................................41
ASSURANCES—NON-CONSTRUCTION PROGRAMS ....... :........................ ............................................. 41
ATTACHMENTV......................................................................................................................................... 42
FLORIDA AGENCY OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST ...................... 42
ATTACHMENTVII...................................................................................................................................... 47
BACKGROUNDSCREENING....................................................................................................................... 47
ATTACHMENTVIII..................................................................................................................................... 48
ANNUALBUDGET SUMMARY................................................................................................................... 48
ATTACHMENTIX........................................................................................................................................ 49
INVOICEREPORT SCHEDULE.................................................................................................................... 49
ATTACHMENTX......................................................................................................................................... 50
REQUESTFOR PAYMENT............................................................................................................................ 50
ATTACHMENTXI........................................................................................................................................ 51
RECEIPT AND EXPENDITURE REPORT.................................................................................................... 51
ATTACHMENTXII...................................................................................................................................... 52
SERVICERATE REPORT.............................................................................................................................. 52
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July 2017 — June 2018
ATTACHMENT I
STATEMENT OF WORK
I. SERVICES TO BE PROVIDED
A. Definitions of Terms
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 (CODA)
Community Care for the Elderly (CCE)
Client Information and Registration Tracking System (CIRTS) Agency
of Children and Families (DCF)
Florida Agency of Elder Affairs (DOEA)/Agency Florida
Statutes (F.S.)
Home Care for Disabled Adults (HCDA)
Notice of Instruction (NOI)
Planning and Service Area (PSA)
Summary of Programs and Services (SOPS)
2. Program Specific Terms
CCE 203.17
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 sixty (60) years of age and being transitioned from DCF, CCDA, or
HCDA services to DOEA's community-based services.
Area Plan: A plan developed by the AAA outlining a comprehensive and coordinated service delivery system
in its PSA in accordance with Section 306 (42 U.S.C. 3026) of the Older Americans Act and DOEA 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 AAA enters CCE specific data in the CIRTS. An
update may also include other revisions to the Area Plan as instructed by DOEA.
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 of DOEA-funded programs, and providers of program -funded services. 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 living independently in the least restrictive living arrangement.
Notice of Instruction (NOI): DOEA's established method to communicate to the Contractor and subcontractor
the requirements to perform particular tasks or activities. NOIs are located on the DOEA website at
http://elderaffairs.state.fl.us/doea/nois.php.
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July 2017 — June 2018
CCE 203.17
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 DOER and updated yearly to provide
the public and the Legislature with information about programs and services for Florida's elders.
B. General Description
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.
2. Community Care for the Elderly Mission Statement
The CCE Program assists functionally -impaired elderly persons in living as independently as possible, in the
least restrictive environment suitable to their needs. The program provides a .continuum of care through the
development, expansion, reorganization, and coordination of multiple community-based services.
3. Authority
The relevant authority governing the CCE Program include:
a. Rule 58C-1, Florida Administrative Code;
b. Sections 430.201 through 430.207, F.S.; and
c. The Catalog of State Financial Assistance (CSFA) Number 65010.
4. Scope of Service
The Agency is responsible for the programmatic, fiscal, and operational management of CCE. The program
services shall be provided in a manner consistent with the Agency's current Area Plan, as updated, and the
current DOEA Programs and Services Handbook, which are hereby incorporated by reference.
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 to provide a continuum of service
alternatives that meets the diverse needs of functionally -impaired elders.
C. Clients to be Served
1. General Description
The CCE Program provides a continuum of services for functionally -impaired elders.
2. Client Eligibility
In order to receive services under this contract, an applicant must:
a. Be at least sixty (60) years of age;
b. Be functionally impaired as determined through the comprehensive assessment;
c. Not be dually enrolled in the CCE program and a Medicaid -capitated long-term care program; and
d. Be aging out as defined in Section I.A.2. of this contract.
3. 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.
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July 2017 — June 2018 CCE 203.17
4. Client Determination
The Agency shall have final authority for the determination of client eligibility.
II. MANNER OF SERVICE PROVISION
A. 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
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 section I.C.2.
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 in the
sequence below. It is not the intent of the Agency and Department to remove existing clients from services in
order to serve new clients being assessed and prioritized for service delivery.
a. DCF APS High Risk individuals: The Contractor shall ensure that pursuant to Section 430.205(5)(a), F.S.,
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 seventy-two (72) hours after referral to the Agency or
as established in accordance with local protocols developed between Agency service contractors and APS.
The Contractor shall follow guidelines for DCF APS High Risk referrals established in the APS
Operations Manual, which is incorporated by reference.
b. For DCF APS Low, Intermediate, and High Risk Referrals for individuals enrolled in a Medicaid long-term
care program at the time of referral to the Contractor or Subcontractor, the Contractor shall:
i. Ensure that the intake entity contacts and notifies the DCF APS protective investigator that the referral
was not accepted because the referred individual is enrolled in a Medicaid long-term care program; and
ii. 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.
c. 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.
d. 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 Department when services are not currently available.
e. Service priority for individuals not included in a., c., and d. 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.
3. Referrals for Medicaid Waiver Services
a. 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.
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July 2017 — June 2018 CCE 203.17
b. 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.
c. 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.
4. Program Services
The Contractor shall ensure the provision of program services is consistent with the Agency's current area
plan, as updated and approved by the Agency, and the current DOEA Programs and Services Handbook.
B. 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 circumstance occurs that may result in a delay for
a period of sixty (60) days or more the initiation of the subcontract or the performance of the Subcontractor, the
Contractor shall notify the Agency's Contract Manager and the Agency's Vice President Financial Officer in writing
of such delay. The Contractor shall not permit a Subcontractor to perform services related to this Contract without
having a binding Subcontractor agreement executed. The Agency will not be responsible or liable for any
obligations or claims resulting from such action.
1. Copies of Subcontracts
The Contractor shall submit a copy of all subcontracts to the Contract Manager within thirty (30) days of the
subcontract being executed.
2. 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.
3. Copies of Subcontractor Monitoring Reports
The Contractor shall forward a copy of all subcontractor monitoring reports to the Agency's Contract
Manager within thirty (30) days of the report being issued to the Subcontractors, Subrecipients, Vendors,
and/or Consultants.
C. Staffing Requirements
1. Staffing Levels
The Contractor shall assign its own administrative and support staff as needed to perform the tasks,
responsibilities and duties under the contract.
2. Professional Qualifications
The Contractor shall ensure that the staff responsible for performing any duties or functions within this contract
have the qualifications as specified in the DOEA Programs and Services Handbook.
3. 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. EST.
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July 2017 — June 2018 CCE 203.17
4. Client Determination
The Agency shall have final authority for the determination of client eligibility.
5. Contract Limits
In no case shall the provider be required to incur costs in excess of the contract amount in providing services to
the clients.
6. Clients Served
This contract may perform direct services to clients.
D. Deliverables
The following section provides the specific quantifiable units of deliverables and source documentation required to
evidence the completion of the tasks specified in this contract.
1. Delivery of Service to Eligible Clients
The Contractor shall ensure the provision of a continuum of services that meets the diverse, individual, and
assessed needs of each functionally -impaired elder. The Contractor shall ensure performance and reporting of
the following services in accordance with the Contractor's current Agency -approved Area Plan, the current
DOEA Programs and Services Handbook, which is incorporated by reference, and Section ILA.1-4 of this
contract. Documentation of service delivery must include a report consisting of the following: number of clients
served, number of service units provided by service, and rate per service unit with calculations that equal the
total invoice amount. The services include the following categories:
a. Core Services for Programmatic Operation
The Contractor shall ensure that core services include a variety of in-home 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 Agency's Area Plan, as updated, include the following:
(1)
Adult Day Care;
(2)
Chore Services;
(3)
Companionship;
(4)
Escort;
(5)
Financial Risk Reduction;
(6)
Home Delivered Meals;
(7)
Homemaker;
b. Health Maintenance Services
(8) Housing Improvement;
(9) Legal Assistance;
(10) Pest Control Services;
(11) Respite Services;
(12) Shopping Assistance; and
(13) Transportation.
The Contractor shall ensure that health maintenance services are made available as necessary to maintain
the health of functionally -impaired elders. These services are limited to medical therapeutic services and
non-medical prevention services. Typical services to be provided at the unit rate identified in the
Agency's Area Plan, as updated, include the following:
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July 2017 — June 2018
(1) Adult Day Health Care;
(2) Emergency Alert Response;
(3) Gerontological Counseling;
(4) Health Support;
(5) Home Health Aide;
(6) Medication Management;
(7) Mental Health Counseling/Screening;
(8) Nutrition Counseling;
(9) Occupational Therapy;
(10) Personal Care;
(11) Physical Therapy;
(12) Skilled Nursing Services;
(13) Specialized Medical Equipment,
Services and Supplies; and
(14) Speech Therapy
c. Other Support Services
CCE 203.17
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 Agency's Area Plan, as updated, include the following:
(1) Caregiver Training/Support: (4) Material Aid; and
(2) Case Aid; (5) Other services, as approved by the Agency
(3) Case Management;
2. Services and Units of Services
The Contractor shall ensure that the provision of services described in the contract is in accordance with the
current DOEA Programs and Services Handbook and the service tasks described in Section II.A. Attachment
XII 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 Agency's Area Plan as
updated, as shown in Attachment XII, and approved by the Agency.
E. Reports
The Contractor shall respond within ten (10) business days to the Agency's request for routine and/or special
requests for information and ad hoc reports. The Contractor must establish due dates for any subcontractors that
permit the Contractor to meet the Agency's reporting requirements.
1. CIRTS Reports
The Contractor shall ensure timely input of CCE -specific data into CIRTS. To ensure CIRTS data accuracy,
the Contractor shall use CIRTS-generated reports which include the following:
a. Client Reports;
b. Monitoring Reports;
c. Services Reports;
d. Miscellaneous Reports;
e. Fiscal Reports;
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July 2017 — June 2018 CCE 203.17
f. Aging and Disability Resource Center Reports; and
g. Outcome Measurement Reports.
2. Service Cost Reports
a. The Agency shall require the Contractor to submit Annual Service Cost Reports, which reflect actual costs
of providing each service by program. Service Cost Reports for all contracts are due by February 25, 2018
for the prior calendar year.
b. Unit Cost Methodology worksheets must be submitted by August 15 of each year, if a rate increase is being
requested for any contract in the next calendar year.
3. Surplus/Deficit Report
The Contractor shall submit a Consolidated Surplus/Deficit Report Lead Agency Spending Report, in a format
provided by the Agency, to the Agency Contract Manager by the 18th of each month. This Consolidated
Surplus/Deficit Report is for all agreements and contracts between the Contractor and the Agency and must
include the following:
a. A list of all subcontractors and their current status regarding surplus/deficit;
b. The Contractor's detailed plan on how the surplus/deficit spending exceeding the threshold specified by the
Agency will be resolved;
c. Recommendations to transfer funds to resolve surplus/deficit spending;
d. Input from the Agency's and/or Contractor's Board of Directors on resolution of spending issues, if
applicable;
e. Number of clients currently on APCL that receive a priority ranking score of 4 or 5; and
f. Number of clients currently on the APCL designated as Imminent Risk,
F. Records and Documentation
1. The Contractor agrees to make available to Agency staff and/or any party designated by the Agency any
and all contract related records and documentation. The Contractor shall ensure the collection and
maintenance of all program related information and documentation on any such system designated by the
Agency. Maintenance includes valid exports and backups of all data and systems according to Agency
standards.
2. Requests for Payment
The Contractor shall maintain documentation to support Requests for Payment that shall be available to the
Agency or authorized individuals, such as the Department of Financial Services, upon request.
3. CIRTS Data and Maintenance
The Contractor shall ensure, on a monthly basis, collection and maintenance of client and service information
in CIRTS or any such system designated by the Agency. Maintenance includes accurate and current data, and
valid exports and backups of all data and systems according to Agency standards.
4. Data Integrity and Back up Procedures
Each Contractor shall anticipate and prepare for the loss of information processing capabilities. The routine
backing up of all data and software is required to recover from losses or outages of the computer system. Data
and software essential to the continued operation of contractor functions must be backed up. The security
controls over the backup resources shall be as stringent as the protection required of the primary resources. It
is recommended that a copy of the backed up data be stored in a secure, offsite location.
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5. Policies and Procedures for Records and Documentation
CCE 203.17
The Contractor shall maintain written policies and procedures for computer system backup and recovery and
shall have the same requirement of its subcontractors. These policies and procedures shall be made available
to the Agency upon request.
G. Performance Specifications
1. Outcomes and Outputs (Performance Measures)
The Contractor must:
a. Ensure the prioritization and service provision of clients in accordance with Section II.A.2. of this contract;
b. Ensure the provision of the services described in this contract are in accordance with the current DOEA
Programs and Services Handbook and Section II.A.1-4 of this contract;
c. Timely and accurately submit to the Agency all required documentation and reports described in
Section II.E.; and
d. Timely (in accordance with Attachment IX) and accurately submit to the Agency Attachments X and XI,
and supporting documentation.
2. Monitoring and Evaluation Methodology
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, and/or
on-site visit(s). 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:
a. Desk reviews and analytical reviews;
b. Scheduled, unscheduled, and follow-up on-site visits;
c. Client visits;
d. Review of independent auditor's reports;
e. Review of third -party documents and/or evaluation;
f. Review of progress reports;
g. Review of customer satisfaction surveys;
h. Agreed-upon procedures review by an external auditor or consultant;
i. Limited -scope reviews; and
j. Other procedures as deemed necessary.
H. Contractor Responsibilities
1. Contractor Accountability
All service tasks and deliverables pursuant to this contract are solely and exclusively the responsibility of the
Contractor and for which, by execution of this contract, the Contractor agrees to be held accountable.
2. Coordination with Other Providers and/or Entities
Notwithstanding that services for which the Contractor is held accountable involve coordination with other
entities in performing the requirements of the contract, the failure of other entities does not alleviate the
Contractor from any accountability for tasks or services that the Contractor is obligated to perform pursuant to
this contract.
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I. Agency Responsibilities
1. Agency Obligations
CCE 203.17
The Agency may provide technical support and assistance to the Contractor within the resources of the
Agency to assist the Contractor in meeting the required tasks in Section II.
2. Agency Determinations
The Agency reserves the exclusive right to make certain determinations in the tasks and approaches. The
absence of the Agency setting forth a specific reservation of rights does not mean that all other areas of the
contract are subject to mutual agreement.
III. METHOD OF PAYMENT
A. Payment Methods Used
The Method of Payment for this contract is a combination of fixed-fee/unit rate, cost reimbursement, and advance
payments, subject to the availability of funds and Contractor performance. The Agency will pay the Contractor
upon satisfactory completion of the Tasks/Deliverables, as specified in Section II. D., and in accordance with
other terms and conditions of the contract.
1. Fixed Fee/Unit Rate
Payment for Fixed Fee/Unit Rates shall not exceed amounts established in Attachment XII, per unit of service.
2. Cost Reimbursement
Payment may be authorized only for allowable expenditures, which are in accordance with the services specified
in Attachment XII. All Cost Reimbursement Requests for Payment must include Attachment X Request for
Payment, as well as Attachment XI Receipt and Expenditure Report, beginning with the first month of the
contract.
3. Advance Payments
The Contractor may request up to two (2) months of advances at the start of the contract period to cover
program service costs. The payment of an advance will be contingent upon the sufficiency and amount of
funds released to the Agency and by the State of Florida ("budget release"). The Contractor's requests for
advance require the approval of the Agency's Contract Manager. The Contractor shall provide the Agency
Contract Manager documentation justifying the need for an advance and describing how the funds will be
distributed. If sufficient budget is available, the Agency will issue approved advanced payments after July
1 st of the contract year.
a. Any advanced payments the Contractor requested for subcontractors must be distributed within seven (7)
days of receipt of payment from the Agency. The Contractor shall submit to the Agency documentation
to support full distribution of advanced funds with report number 5, due to the Agency on October 9,
2017, in accordance with Attachment IX and Attachment X.
b. All advanced payments retained by the Contractor must be fully expended no later than September 30,
2017. Any portion of advanced payments not expended must be recouped on the Invoice Schedule, report
number 5, due to the Agency on October 9, 2017, in accordance with Attachment IX and Attachment X.
c. All advance payments made to the Contractor shall be reimbursed to the Agency as follows: At least
one—tenth of the advance payment received shall be reported as an advance recoupment on each Request
for Payment, starting with report number five (5), in accordance with Attachment IX and Attachment X.
B. Method of Invoice Payment
Payment shall be made upon the Contractor's presentation of an invoice subsequent to the acceptance and approval
by the Agency of the deliverables shown on the invoice. The form and substance of each invoice submitted by the
Contractor shall be as follows:
1. Have a Remittance Address that corresponds exactly to the "Remit To" address provided to MFMP during
registration;
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July 2017 — June 2018
CCE 203.17
2. Request payment on a monthly basis for the units of services established in the Agency's approved Area
Plan, provided in conformance with the requirements as described in the DOEA Programs and Services
Handbook, at the rates established in Attachment XII of the contract. Documentation of service delivery must
include a report consisting of the following: number of clients served, number of service units provided by
service, and rate per service unit with calculations that equal the total invoice amount. Any requested changes
to the approved budget subsequent to the execution of the contract must be submitted to the. Agency
Contract Manager for approval. Any change to the total contract amount requires a formal amendment;
3. The Contractor shall consolidate all subcontractors' Requests for Payment and Expenditure Reports that support
Requests for Payment and shall submit to the Agency using forms Attachment X and Attachment XI for
services, which must include itemized expenditure categories; and
4. All Requests for Payment shall be based on the submission of monthly Expenditure Reports beginning with the
first month of the contract. The schedule for submission of advance requests (when available) and invoices is
Attachment IX.
C. 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.
D. Final Invoice Instructions
The Contractor shall submit the final Request for Payment to the Agency no later than July 25, 2018.
E. CIRTS Data Entries for Subcontractors
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 for the previous month's billing no
later than the 9"' of each month into CIRTS prior to submitting their requests for payment and expenditure reports
to the Agency. The Contractor shall establish deadlines for completing CIRTS data entry and to ensure
compliance with due dates for the requests for payment and expenditure reports that Contractor must submit to the
Agency.
F. Contractors' Monthly CIRTS Reports
The Agency must require Contractors to 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.
G. Corrective Action Plan
1. Contractor shall ensure 100% of the deliverables identified in Section II. D.1-3 of this contract, are performed
pursuant to contract requirements.
2. If at any time the Contractor is notified by the Agency Contract Manager that it has failed to correctly,
completely, adequately perform contract deliverables identified in Section II. D.1-3 of this contract, the
Contractor will have ten (10) days to submit a Corrective Action Plan ("CAP") to the Agency Contract
Manager that addresses the deficiencies and states how the deficiencies will be remedied within a time period
approved by the Agency Contract Manager. The Agency shall assess a Financial Consequence for Non -
Compliance on the Contractor as referenced in Section III.I of this contract 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. If the Contractor fails to correct an identified deficiency within the approved time period specified in the CAP,
the Agency shall deduct the percentage established in Section III.I. of this contract from the payment for the
invoice of the following month.
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CCE 203.17
4. If Contractor fails to timely submit a CAP, the Agency shall deduct the percentage established in Section
III.I. of this contract for each day the CAP is overdue. The deduction will be made from the payment for the
invoice of the following month.
H. Financial Consequences
The Agency will withhold or reduce payment if the Contractor fails to perform the deliverables to the
satisfaction of the Agency according to the requirements referenced in Section II.D of this contract. The
following financial consequences will be imposed if the deliverables stated do not meet in part or in whole the
performance criteria as outlined in Section II.D. of this contract.
1. Delivery of services to eligible clients as referenced in Section II.A.2 and Section II.D.1 of this contract —
Failure to comply with established assessment and prioritization criteria, as evidenced by CIRTS reports, will
result in a 2% reduction of payment per business day. The reduction of payment will begin on the first business
day following the Agency's notification to the Contractor that the identified deficiency was not cured or
satisfactorily addressed in accordance with the Agency -approved CAP, referenced in Section III.H.
2. Services and units of services as referenced in Section ILD.2 of this contract — Failure to provide services in
accordance with the current DOEA Programs and Services Handbook, the service tasks described in Section
II.A, Attachment XII, and submission of required documentation will result in a 2% reduction of payment per
business day. The reduction of payment will begin the first business day following the Agency's notification to
the Contractor that the identified deficiency is not cured or satisfactorily addressed in accordance with the
Agency approved CAP, referenced in Section III.H.
3. Timely submission of a CAP — Failure to timely submit a CAP within ten (10) business days after notification
of a deficiency by the Agency's Contract Manager will result in a 2% reduction of payment per business day
the CAP is not received. The reduction of payment will begin the first business day following the Agency's
notification to the Contractor that the identified deficiency was not cured or satisfactorily addressed in
accordance with the Agency approved CAP, referenced in Section III.H.
4. Exceptions may be granted solely, in writing, by the Agency contract manager.
IV. SPECL4L PROVISIONS
A. Final Budget and Funding Revision Requests
Final requests for budget revisions or adjustments to contract funds based on expenditures for provided services
must be submitted to the Agency Contract Manager in writing no later than June 2 5, 2018; email requests
are considered acceptable.
B. Contractor's Financial Obligations
1. Matching, Level of Effort, and Earmarking Requirement
The Contractor must provide a match of at least ten (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. 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'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 N.B.1.
3. Use of Service Dollars and Management of the Assessed Priority Consumer List
The Contractor is expected to spend all funds provided by the Agency for the purpose specified in this
contract. The Contractor must manage the service dollars in such a manner so as to avoid having a wait list and
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July 2017 — June 2018
CCE 203.17
a surplus of funds at the end of the contract period. If the Agency determines that the Contractor is not
spending service funds accordingly, the Agency may transfer funds to other Lead Agencies in the PSA
during the contract period and/or adjust subsequent funding allocations accordingly, as allowable under state
and federal law.
C. Remedies for Nonconforming Services
1. 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 will only be
delivered to eligible program participants.
2. 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.
D. Investigation of Criminal Allegations:
Any report that implies criminal intent on the part of the Contractor or any Subcontractors and referred to a
governmental or investigatory agency must be sent to the Agency. If the Contractor has reason to believe that the
allegations will be referred to the State Attorney, a law enforcement agency, the United States Attorney's office, or
other governmental agency, the Contractor shall notify the Agency and DOEA's Inspector General immediately. A
copy of all documents, reports, notes or other written material concerning the investigation, whether in the
possession of the Contractor or Subcontractors, must be sent to the Agency and DOEA's Inspector General with a
summary of the investigation and allegations.
E. Volunteers:
If applicable, the Contractor shall ensure the use of trained volunteers in providing direct services delivered to
older individuals and individuals with disabilities needing such services. If possible, the Contractor shall work in
coordination with organizations that have experience in providing training, placement, and stipends for
volunteers or participants (such as organizations carrying out federal service programs administered by the
Corporation for National and Community Service), in community service settings.
F. Enforcement:
1. In accordance with Section 430.04, F.S., the Agency may, without taking any intermediate measures
available to it against the Contractor, rescind the Contractors designation as a lead agency, if the Agency
finds that any of the following have occurred:
a. An intentional or negligent act of the Contractor has materially affected the health, welfare, or safety of
clients served pursuant to any contract or agreement, or substantially and negatively affected the operation
of services covered under any contact or agreement;
b. The Contractor lacks financial stability sufficient to meet contactual obligations or that contractual funds
have been misappropriated;
c. The Contractor has committed multiple or repeated violations of legal and regulatory requirements
standards, regardless of whether such laws or regulations are enforced by the Agency, or the Contractor has
committed multiple or repeated violations of Agency standards;
d. The Contractor has failed to continue the provision or expansion of services after the declaration of a state
of emergency; and
e. The Contactor has failed to adhere to the terms of any contract or agreement.
f. The Contractor has failed to properly determine client eligibility as defined by the Agency or efficiently
manage program budgets.
I:
July 2017 — June 2018
CCE 203.17
g. The Contractor has failed to implement and maintain an Agency approved client grievance resolution
procedure.
2. In the alternative, the Agency may, at its sole discretion, in accordance with section 430.04, F.S., take
immediate measures against the Contractor, including: corrective action, unannounced special monitoring,
temporary assumption of the operation of one or more contractual services, placement of the Contractor on
probationary status, imposing a moratorium on Contractor action, imposing financial penalties for
nonperformance, or other administrative action pursuant to Chapter 120, F.S.
3. In making any determination under this provision, the Agency may rely upon the findings of another state or
federal agency, or other regulatory body. Any claims for damages for breach of any contract or agreement
are exempt from administrative proceedings and shall be brought before the appropriate entity in the venue of
Lee County. In the event the Agency initiates action to rescind an area agency on aging's designation, the
Agency shall follow the procedures set forth in 42 U.S.C. § 3025(b).
END OF ATTACHMENT
C
July 2017 — June 2018
ATTACHMENT II
FINANCIAL AND COMPLIANCE AUDIT
CCE 203.17
The administration of resources awarded by the Agency to the Contractor may be subject to audits and/or monitoring by
the Agency of Elder Affairs, as described in this section.
KROM 00 411110
In addition to reviews of audits conducted in accordance with 2 CFR Part 200 (formerly OMB Circular A-133 as revised),
and Section 215.97, F.S., (see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits
by the Agency and/or Department staff, limited scope audits as defined by OMB Circular A-133, as revised, and/or other
procedures. By entering into this agreement, the Contractor agrees to comply and cooperate with any monitoring
procedures/processes deemed appropriate by the Agency and/or Department. In the event the Agency and/or
Department determines that a limited scope audit of the Contractor is appropriate, the Contractor agrees to
comply with any additional instructions provided by the Agency and/or Department to the Contractor regarding such
audit. The Contractor further agrees to comply and cooperate with any inspections, reviews, investigations, or audits
deemed necessary by the Agency's Vice President of Finance.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the Contractor is a State or local government or a non-profit organization as defined in 2 CFR
Part 200, Subpart A.
In the event that the Contractor expends $750,000.00 or more in federal awards during its fiscal year, the Contractor must
have a single or program -specific audit conducted in accordance with the provisions of 2 CFR Part 200. EXHIBIT 2 to
this agreement indicates federal resources awarded through the Agency by this agreement. In determining the federal awards
expended in its fiscal year, the Contractor shall consider all sources of Federal awards, including federal resources
received from the Agency. The determination of amounts of Federal awards expended should be in accordance with 2
CFR Part An audit of the Contractor conducted by the Auditor General in accordance with the provisions of 2 CFR Part
200 will meet the requirements of this part.
In connection with the audit requirements addressed in Part I, paragraph 1, the Contractor shall fulfill the requirements
relative to auditee responsibilities as provided in 2 CFR §200.508.
If the Contractor expends less than $750,000.00 in federal awards in its fiscal year, an audit conducted in accordance with
the provisions of 2 CFR Part 200 is not required. In the event that the Contractor expends less than $750,000.00 in federal
awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of 2 CFR Part 200 the
cost of the audit must be paid from non-federal resources (i.e., the cost of such audit must be paid from Contractor
resources obtained from other than federal entities.)
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Agency shall be based on the agreement's requirements, including any
rules, regulations, or statutes referenced in the agreement. The financial statements shall disclose whether or not the
matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the Agency
shall be fully disclosed in the audit report with reference to the Area Agency on Aging for Southwest Florida, Inc.
agreement involved. If not otherwise disclosed as required by 2 CFR §200.510 the schedule of expenditures of federal
awards shall identify expenditures by agreement number for each agreement with the Agency in effect during the audit
period. Financial reporting packages required under this part must be submitted within the earlier of 30 days after receipt
of the audit report or 9 months after the end of the Contractor's fiscal year end.
30
July 2017 — June 2018 CCE 203.17
PART II: STATE FUNDED
This part is applicable if the Contractor is a non -state entity as defined by Section 215.97(2), F.S.
In the event that the Contractor expends a total amount of state financial assistance equal to or in excess of $750,000.00
in any fiscal year of such Contractor, the Contractor must have a State single or project -specific audit for such fiscal
year in accordance with Section 215.97, F.S.; applicable rules of the Department of Financial Services; and Chapters
10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General.
EXHIBIT 2 to this agreement indicates state financial assistance awarded through the Agency by this agreement. In
determining the state financial assistance expended in its fiscal year, the Contractor shall consider all sources of state
financial assistance, including state financial assistance received from the Agency, other state agencies, and other
nonstate entities. State financial assistance does not include Federal direct or pass-through awards and resources
received by a nonstate entity for Federal program matching requirements.
In connection with the audit requirements addressed in Part II, paragraph 1, the Contractor shall ensure that the audit
complies with the requirements of Section 215.97(8), F.S. This includes submission of a financial reporting package as
defined by Section 215.97(2), F.S., and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit
organizations), Rules of the Auditor General.
If the Contractor expends less than $750,000.00 in state financial assistance in its fiscal year, an audit conducted in
accordance with the provisions of Section 215.97, F.S., is not required. In the event that the Contractor expends less than
$750,000.00 in state financial assistance in its fiscal year and elects to have an audit conducted in accordance with the
provisions of Section 215.97, F.S., the cost of the audit must be paid from the nonstate entity's resources (i.e., the cost of
such an audit must be paid from the Contractor resources obtained from other than State entities).
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Agency shall be based on the agreement's requirements, including any
applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching
requirement was met for each applicable agreement. All questioned costs and liabilities due to the Agency shall be fully
disclosed in the audit report with reference to the Agency agreement involved. If not otherwise disclosed as required by
Rule 69I-5.003, F.A.C., the schedule of expenditures of state financial assistance shall identify expenditures by
agreement number for each agreement with the Agency in effect during the audit period. Financial reporting packages
required under this part must be submitted within 45 days after delivery of the audit report, but no later than 12 months after
the Contractor's fiscal year end for local governmental entities. Non-profit or for-profit organizations are required to
be submitted within 45 days after delivery of the audit report, but no later than 9 months after the Contractor's fiscal year
end. Notwithstanding the applicability of this portion, the Agency retains all right and obligation to monitor and oversee
the performance of this agreement as outlined throughout this document and pursuant to law.
PART III: REPORT SUBMISSION
Copies of reporting packages for audits conducted in accordance with 2 CFR Part 200 and required by PART I of this
agreement shall be submitted, when required by 2 CFR §200.512 by or on behalf of the Contractor directly to each of
the following:
The Area Agency on Aging for Southwest Florida, Inc.at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Tammy Rhoades, VP of Finance
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
31
July 2017 — June 2018 CCE 203.17
For fiscal year 2013 and earlier to the Federal Audit Clearinghouse designated in 2 CFR §200.36 at the following address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10" Street
Jeffersonville, IN 47132
For fiscal year 2014 and later, pursuant to 2 CFR §200.512, the reporting package and the data collection form must be
submitted electronically to the Federal Audit Clearinghouse.
Pursuant to 2 CFR §200.512, all other Federal agencies, pass-through entities and others interested in a reporting package
and data collection form must obtain it by accessing the Federal Audit Clearinghouse.
The Contractor shall submit a copy of any management letter issued by the auditor, to the Area Agency on Aging for
Southwest Florida, Inc.at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Tammy Rhoades, VP of Finance
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
Additionally, copies of financial reporting packages required by PART II of this agreement shall be submitted by or on
behalf of the Contractor directly to each of the following:
The Area Agency on Aging for Southwest Florida, Inc.at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Tammy Rhoades, VP of Finance
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
The Auditor General's Office at the following address:
State of Florida Auditor General
Claude Pepper Building, Room 574
111 West Madison Street
Tallahassee, Florida 32399-1450
Any reports, management letter, or other information required to be submitted to the Agency pursuant to this agreement
shall be submitted timely in accordance with 2 CFR Part 200, Florida Statutes, and Chapters 10.550 (local governmental
entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, as applicable.
Contractors, when submitting financial reporting packages to the Agency for audits done in accordance with 2 CFR Part
200 or Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor
General, should indicate the date that the reporting package was delivered to the Contractor in correspondence
accompanying the reporting package.
PART IV: RECORD RETENTION
The Contractor shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period
of six (6) years from the date the audit report is issued, and shall allow the Agency or its designee, the CFO or Auditor
General access to such records upon request. The Contractor shall ensure that audit working papers are made available to
the Agency or its designee, CFO, or Auditor General upon request for a period of six (6) years from the date the audit report
is issued, unless extended in writing by the Agency.
32
July 2017 — June 2018
EXHIBIT I
PART I: AUDIT RELATIONSHIP DETERMINATION
CCE 203.17
Contractors who receive state or federal resources may or may not be subject to the audit requirements of 2 CFR Part 200
and/or Section 215.97, F.S. Contractors who are determined to be recipients or sub -recipients of federal awards and/or
state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I
and/or' Part II of Exhibit 1 are met. Contractors who have been determined to be vendors are not subject to the audit
requirements of 2 CFR §200.38, and/or Section 215.97, F.S. Regardless of whether the audit requirements are met,
Contractors who have been determined to be recipients or sub -recipients of Federal awards and/or state financial
assistance must comply with applicable programmatic and fiscal compliance requirements.
In accordance with 2 CFR Part 200 and/or Rule 69I-5.006, FAC, Contractor has been determined to be:
Vendor not subject to 2 CFR §200.38 and/or Section 215.97, F.S.
X Recipient/sub-recipient subject to 2 CFR §200.86 and §200.93 and/or Section 215.97, F.S.
Exempt organization not subject to 2 CFR Part 200 and/or Section 215.97, F.S. For Federal awards, for-profit
organizations are exempt; for state financial assistance projects, public universities, community colleges, district
school boards, branches of state (Florida) government, and charter schools are exempt. Exempt organizations must
comply with all compliance requirements set forth within the contract or award document.
NOTE: If a Contractor is determined to be a recipient/sub-recipient of federal and or state financial assistance and has
been approved by the Agency to subcontract, they must comply with Section 215.97(7), F.S., and Rule 69I-5.006,
F.A.C. [state financial assistance] and 2 CFR §200.3 3 0 [federal awards].
PART II: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Contractors who receive
Federal awards, state maintenance of effort funds, or state matching funds on Federal awards and who are determined to
be a sub- recipient must comply with the following fiscal laws, rules and regulations:
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR §200.416 - §200.417 — Special Considerations for States, Local Governments and Indian Tribes*
2 CFR §200.201 — Administrative Requirements**
2 CFR §200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
NON-PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR §200.400 - §200.411 — Cost Principles*
2 CFR §200.100 — Administrative Requirements
2 CFR §200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT)
MUST FOLLOW:
2 CFR §200.418 — §200.419 — Special Considerations for Institutions of Higher Education*
2 CFR §200.100 — Administrative Requirements
2 CFR §200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
33
July 2017 — June 2018
CCE 203.17
*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in 2 CFR
§200.400(5) (c).
**For funding passed through U.S. Health and Human Services, 45 CFR 75; for funding passed through U.S.
Department of Education, 34 CFR 80.
STATE FINANCIAL ASSISTANCE. Contractors who receive state financial assistance and who are determined to be
a recipient/sub-recipient must comply with the following fiscal laws, rules and regulations:
Section 215.97, F.S.
Chapter 69I-5, F.A.C.
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
34
t%ti�3
July 2017 — June 2018
EXHIBIT 2
FUNDING SUMMARY
CCE 203.17
Note: Title 2 CFR & 2 CFR Part 200, as revised, and Section 215.97(5), F.S. require that the information about Federal
Programs and State Projects included in Exhibit 1 be provided to the recipient. Information contained herein is a
prediction of funding sources and related amounts based on the contract budget.
1. FEDERAL RESOURCES AWARDED TO THE SUBRECH'IENT PURSUANT TO THIS CONTRACT
CONSIST OF THE FOLLOWING:
GRANT AWARD (FAIN#): FEDERAL AWARD DATE:
DUNS NUMBER: 833441814
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT
TO THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS:
2 CFR Part 200 — Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards.
OMB Circular A-133 — Audits of States, Local Governments, and Non -Profit Organizations
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF
THE FOLLOWING:
MATO HTN(:' RFSOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFD A AMOUNT
TOTAL STATE AWARD
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 $ 794,335.00
TOTAL AWARD
794 335.00
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS
CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE
Section 215.97, F.S., Chapter 69I-5, F.A.C, State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
35
July 2017 — June 2018 CCE 203.17
ATTACHMENT III
CERTIFICATIONS AND ASSURANCES
DOEA will not award this Contract unless Contractor completes this CERTIFICATIONS AND ASSURANCES. In
performance of this contract, Contractor provides the following certifications and assurances:
A. Debarment and Suspension
Certification (29 CFR Part 95 and 45 CFR Part 75)
Certification :•g
B. •
:_! Lobbying 9 CFRPart 93 and 45 CFR_':
C. Nondiscrimination
& Egual OUpo!y Assurance9 CFR Part 37 and 45 CFR_':r :I
D. Certification Regarding
Public Entity Crimes. Section 287,133. F.S.
E. Association of Communily
Organizations for Reform Now (ACORM Funding Restrictions Assurance (Eub.
F. Certification Regarding Scrutinized Companies Lists. Section 287,135. F.S.
G. Certification Regarding Data Integrill Compliance For Agreements Grants. Loans And Cooperative
Agreements
H. Verification of Employment Status Certification
I. Certification Regarding Inspection of Public Records
A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY
MATTERS — PRIMARY COVERED TRANSACTION.
The undersigned Contractor certifies to the best of its knowledge and belief, that it and its principals:
1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
covered transactions by a Federal Agency or agency;
2. Have not within a three-year period preceding this Contract been convicted or had a civil judgment rendered against
them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing
a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State
antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records,
making false statements, or receiving stolen property;
3. Are not presently indicted or otherwise criminally or civilly charged by a government entity (Federal, State or local)
with commission of any of the offenses enumerated in paragraph A.2. of this certification; and/or
4. Have not within a three-year period preceding this application/proposal had one or more public transactions
(Federal, State, or local) terminated for cause of default.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants and contracts under grants, loans and cooperative agreements) and that all sub
recipients and contractors shall provide this certification accordingly.
B. CERTIFICATION REGARDING LOBBYING — Certification for Contracts, Grants, Loans, and Cooperative
Agreements.
The undersigned Contractor certifies, to the best of its knowledge and belief, that:
No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of Congress, or an employee of a Member of Congress in
connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan,
July 2017 — June 2018 CCE 203.17
the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification
of any Federal contract, grant, loan or cooperative agreement.
If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of
Congress, or employee of a Member of Congress in connection with a Federal contract, grant, loan, or cooperative
agreement, the undersigned shall also complete and submit Standard Form — LLL, "Disclosure Form to Report
Lobbying," in accordance with its instructions.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants and contracts under grants, loans and cooperative agreements) and that all sub -
recipients and contractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this Contract was made or
entered into. Submission of this certification is a prerequisite for making or entering into this Contract imposed by 31
U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than
$10,000 and not more than $100,000 for each such failure.
C. NON DISCRIMINATION & EQUAL OPPORTUNITY ASSURANCE (29 CFR PART 37 AND 45 CFR PART
80). - As a condition of the Contract, Contractor assures that it will comply fully with the nondiscrimination and equal
opportunity provisions of the following laws:
1. Section 188 of the Workforce Investment Act of 1998 (WIA), (Pub. L. 105-220), which prohibits discrimination
against all individuals in the United States on the basis of race, color, religion, sex national origin, age, disability,
political affiliation, or belief, and against beneficiaries on the basis of either citizenship/status as a lawfully admitted
immigrant authorized to work in the United States or participation in any WIA Title I -financially assisted program
or activity.
2. Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352), as amended, and all requirements imposed by or pursuant
to the Regulation of the Agency of Health and Human Services (45 CFR Part 80), to the end that, in accordance
with Title VI of that Act and the Regulation, no person in the United States shall, on the ground of race, color, or
national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to
discrimination under any program or activity for which the Applicant receives Federal financial assistance from the
Department and/or Agency.
3. Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112) as amended, and all requirements imposed by or
pursuant to the Regulation of the Agency of Health and Human Services (45 CFR Part 84), to the end that, in
accordance with Section 504 of that Act, and the Regulation, no otherwise qualified handicapped individual in the
United States shall, solely by reason of his handicap, be excluded from participation in, be denied the benefits of,
or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial
assistance from the Agency.
4. The Age Discrimination Act of 1975 (Pub. L. 94-135), as amended, and all requirements imposed by or pursuant
to the Regulation of the Agency of Health and Human Services (45 CFR Part 91), to the end that, in accordance
with the Act and the Regulation, no person in the United States shall, on the basis of age, be denied the benefits of,
be excluded from participation in, or be subjected to discrimination under any program or activity for which the
Applicant receives Federal financial assistance from the Agency.
5. Title IX of the Education Amendments of 1972 (Pub. L. 92-318), as amended, and all requirements imposed by or
pursuant to the Regulation of the Agency of Health and Human Services (45 CFR Part 86), to the end that, in
accordance with Title IX and the Regulation, no person in the United States shall, on the basis of sex, be excluded
from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any education
program or activity for which the Applicant receives Federal financial assistance from the Agency.
6. The American with Disabilities Act of 1990 (Pub. L. 101-336), which prohibits discrimination in all employment
practices, including, job application procedures, hiring, firing, advancement, compensation, training, and other
terms, conditions, and privileges of employment. It applies to recruitment, advertising, tenure, layoff, leave, fringe
benefits, and all other employment-related activities.
Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws listed
above. This assurance applies to Contractor's operation of the WIA Title I — financially assisted program or activity,
37
July 2017 — June 2018
CCE 203.17
and to all agreements Contractor makes to cavy out the WIA Title I — financially assisted program or activity.
Contractor understands that the Agency and/or DOEA and the United States have the right to seek judicial enforcement
of the assurance. The undersigned shall require that language of this assurance be included in the documents for all
subcontracts at all tiers (including subcontracts, sub -grants and contracts under grants, loans and cooperative
agreements) and that all sub recipients and contractors shall provide this assurance accordingly.
D. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES, SECTION 287.133, F.S.
Contractor hereby certifies that neither it, nor any person or affiliate of Contractor, has been convicted of a Public Entity
Crime as defined in Section 287.133, F.S., nor placed on the Convicted Vendor List.
Contractor understands and agrees that it is required to inform Area Agency and DOEA immediately upon any change
of circumstances regarding this status.
E. ASSOCIATION OF COMMUNITY ORGANIZATIONS FOR REFORM NOW (ACORN) FUNDING
RESTRICTIONS ASSURANCE (Pub. L. 111-117).
As a condition of the Contract, Contractor assures that it will comply fully with the federal funding restrictions
pertaining to ACORN and its subsidiaries per the Consolidated Appropriations Act, 2010, Division E, Section 511 (Pub.
L. 111-117). The Continuing Appropriations Act, 2011, Sections 101 and 103 (Pub. L. 111-242), provides that
appropriations made under Pub. L. 111-117 are available under the conditions provided by Pub. L. 111-117.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants and contracts under grants, loans and cooperative agreements) and that all sub
recipients and contractors shall provide this assurance accordingly.
F. SCRUTINIZED COMPANIES LISTS CERTIFICATION, SECTION 287.135, F.S.
If this Contract is in the amount of $1 million or more, in accordance with the requirements of Section 287.135, F.S.,
Contractor hereby certifies that it is not participating in a boycott of Israel, is not listed on either the Scrutinized
Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy
Sector List, and that it does not have business operations in Cuba or Syria. Both lists are created pursuant to Section
215.473, F.S.
Contractor understands that pursuant to Section 287.135, F.S., the submission of a false certification may subject
Contractor to civil penalties, attorney's fees, and/or costs.
If Contractor is unable to certify any of the statements in this certification, Contractor shall attach an explanation to
this Contract.
G. CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS,
LOANS AND COOPERATIVE AGREEMENTS
1. The Contractor and any Subcontractors of services under this contract have financial management systems
capable of providing certain information, including: (1) accurate, current, and complete disclosure of the financial
results of each grant -funded project or program in accordance with the prescribed reporting requirements; (2) the
source and application of funds for all agreement supported activities; and (3) the comparison of outlays with
budgeted amounts for each award. The inability to process information in accordance with these requirements
could result in a return of grant funds that have not been accounted for properly.
2. Management Information Systems used by the Contractor, Subcontractors, or any outside entity on which the
Contractor is dependent for data that is to be reported, transmitted or calculated, have been assessed and verified
to be capable of processing data accurately, including year -date dependent data. For those systems identified to be
non-compliant, Contractors will take immediate action to assure data integrity.
3. If this contract includes the provision of hardware, software, firmware, microcode or imbedded chip technology,
the undersigned warrants that these products are capable of processing year -date dependent data accurately. All
versions of these products offered by the Contractor (represented by the undersigned) and purchased by the state
will be verified for accuracy and integrity of data prior to transfer.
July 2017 — June 2018
CCE 203.17
4. In the event of any decrease in functionality related to time and date related codes and internal subroutines that
impede the hardware or software programs from operating properly, the Contractor agrees to immediately make
required corrections to restore hardware and software programs to the same level of functionality as warranted
herein, at no charge to the state, and without interruption to the ongoing business of the state, time being of the
essence.
5. The Contractor and any Subcontractors of services under this contract warrant their policies and procedures
include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies
arising from data integrity compliance issues.
H. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION
As a condition of contracting with the Area Agency on Aging for Southwest Florida, Inc., Contractor certifies the use
of the U.S. Department of Homeland Security's E -verify system to verify the employment eligibility of all new
employees hired by Contractor during the contract term to perform employment duties pursuant to this contract and
that any subcontracts include an express requirement that Subcontractors performing work or providing services
pursuant to this Agreement utilize the E -verify system to verify the employment eligibility of all new employees
hired by the Subcontractor during the entire contract term.
The Contractor shall require that the language of this certification be included in all sub -agreements, sub -grants, and
other agreements and that all Subcontractors shall certify compliance accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made
or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed
by Circulars A-102 and 2 CFR Part 200, and 215 (formerly OMB Circular A-110).
I. RECORDS AND DOCUMENTATION
The Contractor agrees to make available to Agency staff and/or any party designated by the Agency any and all
contract related records and documentation. The Contractor shall ensure the collection and maintenance of all
program related information and documentation on any such system designated by the Agency. Maintenance includes
valid exports and backups of all data and systems according to Agency standards.
J. CERTIFICATION REGARDING INSPECTION OF PUBLIC RECORDS
1. In addition to the requirements of Sections 10.1, 10.2 of the Standard Contract, and 119.0701(3) and (4) F.S., and any other
applicable law, if a civil action is commenced as contemplated by Section 119.0701(4), F.S., and the Agency is named in
the civil action, Contractor agrees to indemnify and hold harmless the Agency for any costs incurred by the
Agency, and any attorneys' fees assessed or awarded against the Agency from a Public Records Request made
pursuant to Chapter 119, F.S., concerning this contract or services performed thereunder.
39
July 2017 — June 2018
CCE 203.17
2. Section 119.01(3), F.S., states if public funds are expended by an agency in payment of dues or membership contributions
for any person, corporation, foundation, trust, association, group, or other organization, all the financial, business, and
membership records of such an entity which pertain to the public agency (Area Agency on Aging for Southwest
Florida, Inc.) are public records. Section 119.07, F.S, states that every person who has custody of such a public record
shall permit the record to be inspected and copied by any person desiring to do so, under reasonable circumstances.
Additionally, I certify this organization does does not provide for institutional memberships.
Contractor's signature below attests that records pertaining to the dues or membership application by the Agency are
available for inspection as stated above.
By execution of this agreement, Contractor must include these provisions in all related subcontract agreements (if applicable).
By execution of this agreement, Contractor must include these provisions (A -I) in all related subcontract agreements (if
applicable). By signing below, Contractor certifies the representations outlined in parts A through J above, are true and correct.
AA
Steve Y. Carnell, Public Services Department Head
(Signature and Title of Authorized Representative)
3339 East Tamiami Trail Suite 211
(Street Address)
Collier County Board of County Commissioners Naples, FL 34112
(Contractor) �ISate) (City, State, ZIP code)
Approved as to form anti legality
Assistant County Attorney
40
July 2017 – June 2018
ATTACHMENT IV
ASSURANCES—NON-CONSTRUCTION PROGRAMS
CCE 203.17
Public reporting burden for this collection of information is estimated to average forty-five (45) minutes per response, including time
for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing
the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348-0043),
Washington, DC 20503,
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND
BUDGET, SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions please
contact the awarding agency. Further, certain federal awarding agencies may require applicants to certify to
additional assurances. If such is the case, you will be notified.
1. Has the legal authority to apply for federal assistance, and the institutional, managerial and financial capability
(including funds sufficient to pay the non-federal share of project cost) to ensure proper planning, management, and
completion of the project described in this application.
2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the state, through any
authorized representative, access to and the right to examine all records, books, papers, or documents related to the
award; and will establish a proper accounting system in accordance with generally accepted accounting standards or
agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the
appearance of personal or organizational conflict of interest, or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §4728-4763) relating to prescribed standards
for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's
Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).
6. Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of
the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin;
(b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §1681-1683, and 1685-1686), which
prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C.
§794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended
(42 U.S.C. §6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment
Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive
Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended,
relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §523 and 527 of the Public Health Service
Act of 1912 (42 U.S.C. §290 dd-3 and 290 ee 3), as amended., relating to confidentiality of alcohol and drug abuse
patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §3601 et seq.), as amended, relating to
nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific
statute(s) under which application for federal assistance is being made; and 0) the requirements of any other
nondiscrimination statute(s) which may apply to the application.
7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance
and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of
persons displaced or whose property is acquired as a result of federal or federally assisted programs. These requirements
apply to all interests in real property acquired for project purposes regardless of federal participation in purchases.
41
July 2017 — June 2018
CCE 203.17
8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. §1501-1508 and 7324-7328), which limit
the political activities of employees whose principal employment activities are funded in whole or in part with federal
funds.
9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C. §276a to 276a-7), the Copeland Act
(40 U.S.C. 276c and 18 U.S.C. §874) and the Contract Work Hours and Safety Standards Act (40 U.S.C. §327-333),
regarding labor standards for federally assisted construction sub -agreements.
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the
program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or
more.
11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and
Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 1173 8; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of
project consistency with the approved State management program developed under the Coastal Zone Management Act
of 1972 (16 U.S.C. §1451 et seq.); (f) conformity of federal actions to State (Clear Air) Implementation Plans under
Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. §7401 et seq.); (g) protection of underground
sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h) protection
of endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93-205).
12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §1721 et seq.) related to protecting components
or potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of
1966, as amended (16 U.S.C. §470), EO 11593 (identification and protection of historic properties), and the
Archaeological and Historic Preservation Act of 1974 (16 U.S.C. §469a-1 et seq.).
14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related
activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. §2131 et seq.)
pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities
supported by this award of assistance.
16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. §4801 et seq.), which prohibits the use of
lead- based paint in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act
Amendments of 1996 and 2 CFR Part 200.
18. Will comply with all applicable requirements of all other federal laws, executive orders, regulations and policies
governing this program.
OF
TION
TIFYING OFFICIAL
Collier County Board of County Commissioners
TITLE
Public Services Department Head
DATE SUBMITTED
asi �l �-
Ap ved as to form and lega7c�
42
Assistunt County Altorncy �� ��
July 2017 — June 2018 CCE 203.17
ATTACHMENT V
FI,ORMA DEPARTMENT OF EI,DFR AFFAIRS CIVIT. RIGHTS COMPLIANCE CHECKLIST
Program/Facility Name: Collier County Community and Human Services
County: Collier
AAA/Contractor: AAA of
Southwest Florida, Inc.
Address: 3339 East Tamiami Trail Suite 211
Completed By: Lisa N. Carr
City, State, Zip Code: Naples, FL 34112
Date: June 28, 2017
Telephone:239-252-4228
PART I: READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU COMPLETE
THIS FORM.
A. 1. Briefly describe the geographic area served by the program/facility and the type of service provided: The Collier County Community
and Human Services (CHS) Division, Services for Seniors provide services to clients covering over a 2,300 -square mile area. CHS
provides case management, in-home care, facility respite, adult day care and nutrition services to frail, elderly residents of Collier
County.
For questions 2-5 please indicate the fo
2. Population of area served
3. Staff currently employed
4. Clients currently enrolled/registered
5. Advisory/Governing Board if applicable
Mowing:
Total #
%
I White
%
Black Hispanic
Other
Female
Disabled
Over 40
Source of data: 2010 Census
321,520 57.98%
6.56%
25.87%
9.65%
50.70%
n/a
58.4%
Effective 2
8
0%
0%
0%
%
90%
0
100%
Effective date: 6/28/17
561
37%
%
39%
17%
35%
n/a
100%
011ier County BCC
5
100%
%
%
%
20%
10
100%
PART Il: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. IF N/A or NO EXPLAIN.
6. Is an Assurance of Compliance on file with DOEA?
N/A
YES
NO
❑
■
❑
7. Compare the staff composition to the population. Is staff representative of the population?
N/A
YES
NO
❑
■
❑
8. Are eligibility requirements for services applied to clients and applicants without regard to race, color, national
N/A
YES
NO
origin, sex, age, religion or disability?
El
t
❑
9. Are all benefits, services and facilities available to applicants and participants in an equally effective manner
N/A
YES
NO
regardless of race, sex, color, age, national origin, religion or disability?
❑
t
❑
I O.For in-patient services, are room assignments made without regard to race, color, national origin or disability?
N/A
YES
NO
N
❑
❑
11. Is the program/facility accessible to non-English speaking clients?
N/A
YES
NO
12. Are employees, applicants and participants informed of their protection against discrimination? If YES, how?
N/A
YES
NO
❑
Verbal 01 Written❑ Poster!
❑
43
July 2017 — June 2018
CCE 203.17
13.Give the number and current status of any discrimination complaints regarding services or employment fled
N/A
NUMBER
against the program/facility.
Program Office
*Notice of Corrective Action Sent
14.Is the program/facility physically accessible to mobility, hearing, and sight -impaired individuals?
N/A
YES NO
Response Received
❑
o
PART III: THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES.
IF NO
EXPLAIN.
15.Has as a self-evaluation been conducted to identify any barriers to serving disabled individuals, and to make any
YES
NO
necessary modifications?
❑
❑
16.Is there an established grievance procedure that incorporates due process in the resolution of complaints?
YES
NO
❑
❑
17.Has a person been designated to coordinate Section 504 compliance activities?
YES
NO
M
❑
18.Do recruitment and notification materials advise applicants, employees and participants of nondiscrimination on the
YES
NO
basis of disability?
❑
El
19.Are auxiliary aids available to assure accessibility of services to hearing and sight -impaired individuals?
YES
NO
❑
o
PART IV: FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $50,000.00 OR MORE.
20.Do you have a written affirmative action plan? If NO, explain. YES NO
El ❑
11TORTWIRM
Reviewed by
In Compliance: YES ❑ NO* ❑
Program Office
*Notice of Corrective Action Sent
Date
Telephone Response Due
On -Site ❑ Desk Review ❑
Response Received
July 2017 — June 2018 CCE 203.17
ATTACHMENT V
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST
Describe the geographic service area such as a district, county, city or other locality. If the program/facility serves
a specific target population such as adolescents, describe the target population. Also, define the type of service
provided.
2. Enter the percent of the population served by race and sex. The population served includes persons in the
geographical area for which services are provided such as a city, county or other regional area. Population statistics
can be obtained from local chambers of commerce, libraries, or any publication from the 1980 Census containing
Florida population statistics. Include the source of your population statistics. ("Other" races include Asian/Pacific
Islanders and American Indian/Alaskan Natives.)
3. Enter the total number of full-time staff and their percent by race, sex and disability. Include the effective date of
your summary.
4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and list
their percent by race, sex and disability. Include the date that enrollment was counted.
5. Enter the total number of advisory board members and their percent by race, sex, and disability. If there is no
advisory or governing board, leave this section blank.
6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in
compliance with all nondiscriminatory provisions as required in 45 CFR 80. This is usually a standard part of the
contract language for DOEA Recipients and their Sub -grantees, 45 CFR 80.4 (a).
7. Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the
population is Hispanic, is there a comparable percentage of Hispanic staff?
Where there is a significant variation between the race, sex or ethnic composition of the clients and their availability
in the population, the program/facility has the responsibility to determine the reasons for such variation and take
whatever action may be necessary to correct any discrimination. Some legitimate disparities may exist when
programs are sanctioned to serve target populations such as elderly or disabled persons, 45 CFR 80.3 (b) (6).
Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or
employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also
through on-site record analysis of persons who applied but were denied services or employment, 45 CFR 80.3 (a)
and 45 CFR 80.1 (b) (2).
10. Participants or clients must be provided services such as medical, nursing and dental care, laboratory services,
physical and recreational therapies, counseling and social services without regard to race, sex, color, national origin,
religion, age or disability. Courtesy titles, appointment scheduling and accuracy of record keeping must be applied
uniformly and without regard to race, sex, color, national origin, religion, age or disability. Entrances, waiting
rooms, reception areas, restrooms and other facilities must also be equally available to all clients, 45 CFR 80.3 (b).
11. For in-patient services, residents must be assigned to rooms, wards, etc., without regard to race, color, national
origin or disability. Also, residents must not be asked whether they are willing to share accommodations with
persons of a different race, color, national origin, or disability, 45 CFR 80.3 (a).
12. The program/facility and all services must be accessible to participants and applicants, including those persons who
may not speak English. In geographic areas where a significant population of non-English speaking people live,
program accessibility may include the employment of bilingual staff. In other areas, it is sufficient to have a policy
45
July 2017 — June 2018
CCE 203.17
or plan for service, such as a current list of names and telephone numbers of bilingual individuals who will assist
in the provision of services, 45 CFR 80.3 (a).
13. Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to their
participants, beneficiaries or any other interested parties. This should include information on their right to file a
complaint of discrimination with either the Area Agency on Aging for Southwest Florida, Inc. and/or
the Florida Agency of Elder Affairs or the U.S. Agency of HHS. The information may be supplied verbally or in
writing to every individual, or may be supplied through the use of an equal opportunity policy poster displayed in
a public area of the facility, 45 CFR 80.6 (d).
14. Report number of discrimination complaints fled against the program/facility. Indicate the basis, e.g., race, color,
creed, sex, age, national origin, disability, retaliation; the issues involved, e.g., services or employment, placement,
termination, etc. Indicate the civil rights law or policy alleged to have been violated along with the name and
address of the local, state or federal agency with whom the complaint has been filed. Indicate the current status,
e.g., settled, no reasonable cause found, failure to conciliate, failure to cooperate, under review, etc.
15. The program/facility must be physically accessible to disabled individuals. Physical accessibility includes
designated parking areas, curb cuts or level approaches, ramps and adequate widths to entrances. The lobby, public
telephone, restroom facilities, water fountains, information and admissions offices should be accessible. Door
widths and traffic areas of administrative offices, cafeterias, restrooms, recreation areas, counters and serving lines
should be observed for accessibility. Elevators should be observed for door width, and Braille or raised numbers.
Switches and controls for light, heat, ventilation, fire alarms, and other essentials should be installed at an
appropriate height for mobility impaired individuals.
16. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self-
evaluation to identify any accessibility barriers. Self-evaluation is a four step process:
a. With the assistance of a disabled individual/organization, evaluate current practices and policies which do not
comply with Section 504.
b. Modify policies and practices that do not meet Section 504 requirements.
c. Take remedial steps to eliminate any discrimination that has been identified.
d. Maintain self-evaluation on file. (This checklist may be used to satisfy this requirement if these four steps have
been followed.), 45 CFR 84.6.
17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate appropriate
due process standards and provide for the prompt and equitable resolution of complaints alleging any action
prohibited by Section 504.45 CFR 84.7 (b).
18. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to
comply with Section 504.45 CFR 84.7 (a).
19. Continuing steps must be taken to notify employees and the public of the program/facility's policy of
nondiscrimination on the basis of disability. This includes recruitment material, notices for hearings, newspaper
ads, and other appropriate written communication, 45 CFR 84.8 (a).
20. Programs/facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with impaired
sensory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to, interpreters
for hearing impaired individuals, taped or Braille materials, or any alternative resources that can be used to provide
equally effective services, 45 CFR 84.52 (d).
21. Programs/facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement and
maintain a written affirmative action compliance program in accordance with Executive Order 11246, 41 CFR 60
and Title VI of the Civil Rights Act of 1964, as amended.
46
July 2017 — June 2018
DEPARTMENT OF
ELDER
AFFAIRS
STATE OF FLORIDA
ATTACHMENT VII
BACKGROUND SCREENING
BACKGROUND SCREENING
Affidavit of Compliance - Employer
AUTHORITY: This form is required annually of all employers to comply with the attestation
requirements set forth in section 435.05(3), Florida Statutes.
➢ The term "employer" means any person or entity required by law to conduct background screening,
including but not limited to, Area Agencies on Aging, Aging Resource Centers, Aging and Disability
Resource Centers, Lead Agencies, Long -Term Care Ombudsman Program, Serving Health Insurance Needs
of Elders Program, Service Providers, Diversion Providers, and any other person or entity which hires
employees or has volunteers in service who meet the definition of a direct service provider. See §y
435.02, 430.0402, Fla. Stat.
A direct service provider is "a person 18 years of age or older who, pursuant to a program to provide
services to the elderly, has direct, face-to-face contact with a client while providing services to the client
and has access to the client's living area, funds, personal property, or personal identification information
as defined in s. 817.568. The term includes coordinators, managers, and supervisors of residential
facilities; and volunteers." § 430.0402(1)(b), Fla. Stat.
ATTESTATION:
As the duly authorized representative of
CCE 203.17
Collier County Community and Human Services
Employer Name
located at 3339 East Tamiami Trail Suite Naples, FL 34112
StreetAddress city State ZIP code
Kim berely Grant, Director do hereby affirm under penalty of perjury
Name of Representative
that the above named employer is in compliance with the provisions of Chapter 435 and section
430.0402, Florida Statutes, regarding level 2 background screening.
qs� �Wrl
Signature of Representative Date
STATE OF FLORIDA, COUNTY OF Collier 1
Sworn to (or affirmed) subscribed before me this day of✓GL/yl 200 , by
/l/ (Name of Representative ho is personally know
to me or produced as proof of identification.
i -S / &2–
Print,Type, or Stamp Commissioned Name of Notary Public Notary Public
DOEA Form 235, Affidavit of Compitance -Employer, Effective April 2012 Section 435.05(3), F.S.
Form available at: htto)/eideraffafrs.statefl.us/ecwl(4i/backgroundscreenity.ohc
10 YI `.
MY COMMISSION M FF 235771
`•a EXPIRES: July 1, 2019
Bonded Th. Notary Public Undeiwdlers
47 Approved as to form and legality
Assistant County Attorney tla
July 2017 — June 2018
ATTACHMENT VIII
ANNUAL BUDGET SUMMARY
COMMUNITY CARE FOR THE ELDERLY PROGRAM
Collier County Board of County Commissioners
Collier
CCE Services Allocations $ 794,335.00
a -V
CCE 203.17
July 2017 — June 2018
Report Number
2
3
4
6
7
8
9
10
11
12
13
14
15
Legend:
ATTACHMENT IX
INVOICE REPORT SCHEDULE
COMMUNITY CARE FOR THE ELDERLY
Based On
July Advance*
August Advance*
July Expenditure Report
August Expenditure Report
September Expenditure Report
October Expenditure Report
November Expenditure Report
December Expenditure Report
January Expenditure Report
February Expenditure Report
March Expenditure Report
April Expenditure Report
May Expenditure Report
June Expenditure Report
Final Request for Payment
* Advance based on projected cash need
CCE 203.17
Submit to Agency on This Date
July 1
July 1
August 9
September 9
October 9
November 9
December 9
January 9
February 9
March 9
April 9
May 9
June 9
July 9
July 25
Note # 1: Report #1 for Advance Basis Contracts cannot be submitted to the Area Agency
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 Area Agency on Aging for
Southwest Florida, Inc. Actual submission of the vouchers to the Agency is
dependent on the accuracy of the expenditure report.
Note # 2: Report numbers 5 through 14 shall reflect an adjustment of at least one-tenth
of the total advance amounts, repaying advances issued the first two months of
the agreement. All advance payments made to the Contractor shall be returned
to the A g e n c y a n d reported as an advance recoupment on each request
for payment. The adjustment shall be recorded in Part C, Line 1 of the report
(ATTACHMENT X).
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.
July 2017 - June 2018
ATTACHMENT X
REQUEST FOR PAYMENT
COMMUNITY CARE FOR THE ELDERLY
CCE 203.17
RECIPIENT NAME, ADDRESS, PHONE# and FEID#
TYPE OF PAYMENT:
Regular_
Advance
This Request Period:
Contract Period
Contract #
Report #
PSA #
From:___
To:____
CERTIFICATION: I hereby certify to the best of my knowledge that this request or refund conforms with the terms and the purposes of the above contract.
Prepared by:__Date:___ Approved by: _ _ _ _ Date:
PART A: BUDGET SUMMARY
I. Approved Contract Amount
2. Previous Funds Received for Contract Period
3. Contract Balance (line 1 minus line 2)
4. Previous Funds Requested and Not Received for Contract Period
5. CONTRACT BALANCE (line 3 minus line 4)
CCE Admin.
$
0.00
CCE Services
$
0.00
$
TOTAL
0.00
$ 0.00
$ 0.00
$
0.00
$ 0.00
$ 0.00
$
0.00
$ 0.00
$ 0.00
$
0.00
$ 0.00
$ 0.00
$
0.00
PART B: CONTRACT FUNDS REQUEST
1. Anticipated Cash Need (1st- 2nd months)
2. Net Expenditures For Month
(DOEA Form 105C, Part B, Line 4)
3. TOTAL
$
0.00
$
0.00
$
0.00
$ 0.00
$ 0.00
$
0.00
$ 0.00
$ 0.00
$
0.00
PARTC: NET FUNDS REQUESTED
1. Less Advance Applied
2. TOTAL FUNDS REQUESTED (Part B Line 3, minus Part C Line 1)
$
0.00
$
0.00
$
0.00
$ 0.00
$ 0.00
$
0.00
List of Services / Units / Rates provided - See attached report.
DOEA FORM 106C
Revised 5/4/12
50
July 2017 - June 2018
ATTACHMENT XI
RECEIPT AND EXPENDITURE REPORT
RECEIPT AND EXPENDITURE REPORT
COMMUNITY CARE FORTH E ELDERLY
CCE 203.17
PROVIDER NAME, ADDRESS, PHONE # and FEID#
Program Funding:
THIS REPORT PERIOD:
From
To
CCEAdmin.
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/Ol
3. Local Cash Match
$0.00
$0.00
$0.00
#DIV/01
4. SUBTOTAL: CASH RECEIPTS
5. Local In -Kind Match
6. TOTAL RECEIPTS
$0.00
$0.00
$0.00
#DIV/0!
PART B: EXPENDITURES
1. Approved
2. Expenditures
3. Expenditures
4. Percent of
Budget
For This Report
Year to Date
Approved Budget
1. Administrative Services
$0.00
$0.00
$0.00
#DIV/Ol
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/01
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 $ (In
2. Return of GR Advance $
3. Other Earned $
PART D: CO -PAYMENTS
CURRENTMONTH
YEAR-TO-DATE
1. Total of Co -payments assessed
$
$
2. Total of Co -payments collected
$
$
(For Tracking Purposes only)
DOEA FORM 105C
Revised 5/25/2010
51
July 2017 — June 2018
ATTACHMENT XII
SERVICE RATE REPORT
for
Collier County Board of County Commissioners
CCE 203.17
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
Skilled Nursing
$42.00
$37.80
EARS
$ 1.31
$ 1.18
Escort
$21.67
$19.50
Home Delivered Meals
$ 7.78
$ 7.00
Homemaking
$21.50
$19.35
Personal Care
$25.67
$23.10
Respite -in -Facility
$12.83
$11.55
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
Other
$ Cost Reimbursement
90% Cost Reimbursement
52 D�
Revised August 2007
Attestation Statement
Agreement/Contract Number CCE 203.17
Amendment Number n/s
I, Steve 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.
71 C�O)
Signature of ecipient/Contractor representative to
Approved as to form and legality
Assistant County Attorney \ —�
4 �
Revised August 2007
16.D.19.ePacket Pg. 1382Attachment: HCE 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
16.D.19.ePacket Pg. 1383Attachment: HCE 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
16.D.19.ePacket Pg. 1384Attachment: HCE 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
16.D.19.ePacket Pg. 1385Attachment: HCE 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
16.D.19.ePacket Pg. 1386Attachment: HCE 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
16.D.19.ePacket Pg. 1387Attachment: HCE 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
16.D.19.ePacket Pg. 1388Attachment: HCE 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
16.D.19.ePacket Pg. 1389Attachment: HCE 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
16.D.19.ePacket Pg. 1390Attachment: HCE 203-17-001 Amend #1 (4064 : ADI, CCE & HCE Amendment to authorize budget amendments FY17-18)
July 2017 — June 2018
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC.
HOME CARE FOR THE ELDERLY
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
HCE 203.17
THIS CONTRACT is entered into between Area Agency on Aging for Southwest Florida, Inc. (Agency) and Collier
County Board of County Commissioners (Contractor), 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 and exhibits, 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, 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, 2017 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, 2018.
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 $49,250.00 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 Section 287.058(1)(g), Florida Statutes (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.
6. Compliance with Federal Law:
6.1 If this contract contains federal funds this section shall apply.
6.1.1 The Contractor shall comply with the provisions of 45 Code of Federal Regulations (CFR) 75 and/or 45
CFR Part 92, 2 CFR Part 200 and other applicable regulations.
6.1.2 If this contract contains federal funds and is over $100,000.00, the Contractor shall comply with all
July 2017 — June 2018
HCE 203.17
applicable standards, orders, or regulations issued under Section 306 of the Clean Air Act as amended (42
United States Code (U.S.C.) 7401, et seq.), Section 508 of the Federal Water Pollution Control Act as
amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable
Environmental Protection Agency regulations , 2 CFR Part 1500, The Contractor shall report any violations
of the above to the Agency.
6.1.3 The Contractor, or agent acting for the Contractor, may not use any federal funds received in connection
with this contract to influence legislation or appropriations pending before the Congress or any state
legislature. The Contractor must complete all disclosure forms as required, specifically the Certification
and Assurances Attachment, which must be completed and returned to the Contract Manager prior to the
execution of this contract.
6.1.4 In accordance with Appendix II to 2 CFR Part 200, the Contractor shall comply with Executive Order
11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as
supplemented in Department of Labor regulations 41 CFR Part 60 and in Department of Health and Human
Services regulations 45 CFR Part 92, if applicable.
6.1.5 A contract award with an amount expected to equal or exceed $25,000.00 and certain other contract awards
will not be made to parties listed on the government -wide Excluded Parties List System, in accordance with
the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 and 12689, "Debarment and
Suspension." The Excluded Parties List System contains the names of parties debarred, suspended, or
otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority
other than Executive Order 12549, The Contractor shall comply with these provisions before doing
business or entering into subcontracts receiving federal funds pursuant to this contract. The Contractor
shall complete and sign the Certifications and Assurances Attachment prior to the execution of this contract.
6.2 The Contractor shall not employ an unauthorized alien. The Agency will consider the employment of
unauthorized aliens a violation of the Immigration and Nationality Act (8 U.S.C. 1324a) and the Immigration
Reform and Control Act of 1986 (8 U.S.C. 1101). Such violation will be cause for unilateral cancellation of this
contract by the Agency.
6.3 If the Contractor is a non-profit provider and is subject to Internal Revenue Service (IRS) tax exempt organization
reporting requirements (filing a Form 990 or Form 990-N) and has its tax exempt status revoked for failing to
comply with the filing requirements of the Pension Protection Act of 2006 or for any other reason, the Contractor
must notify the Agency in writing within thirty (30) days of receiving the IRS notice of revocation.
6.4 The Contractor shall comply with Title 2 CFR Part 175 regarding Trafficking in Persons.
6.5 Unless exempt under 2 § 170.110(b), the Contractor shall comply with the reporting requirements of the
Transparency Act as expressed in 2 CFR Part 170.
6.6 To comply with Presidential Executive Order 12989, as amended, and State of Florida Executive Order Number
11-116, Contractor agrees to utilize the U.S. Department of Homeland Security's E -verify system to verify the
employment of all new employees hired by Contractor during the contract term. Contractor shall include in
related subcontracts a requirement that Subcontractors performing work or providing services pursuant to the
state contract utilize the E -verify system to verify employment of all new employees hired by the Subcontractor
during the contract term. Contractors meeting the terms and conditions of the E -Verify System are deemed to be
in compliance with this provision.
7. Compliance with State L,aw:
7.1 This contract is executed and entered into in the State of Florida, and shall be construed, performed and enforced
in all respects in accordance with Florida law, including Florida provisions for conflict of laws.
7.2 If this contract contains state financial assistance funds, the Contractor shall comply with Section 215.97, F.S.,
and Section 215.971, F.S., and expenditures must be in compliance with laws, rules, and regulations, including,
but not limited to, the Reference Guide for State Expenditures.
7.3 The Contractor shall comply with the requirements of Section 287.058, F.S. as amended.
2
July 2017 — June 2018
HCE 203.17
7.3.1 The Contractor shall perform all tasks contained in ATTACHMENT I.
7.3.2 The Contractor shall provide units of deliverables, including reports, findings, and drafts, as specified in
ATTACHMENT I, to be received and accepted by the contract manager prior to payment.
7.3.3 The Contractor shall comply with the criteria and final date by which such criteria must be met for
completion of this contract as specified in ATTACHMENT I, SECTION IH. METHOD OF
PAYMENT.
7.3.4 The Contractor shall submit bills for fees or other compensation for services or expenses in sufficient detail
for a proper pre -audit and post -audit.
7.3.5 If itemized payment for travel expenses is permitted in this contract, the Contractor shall submit bills for
any travel expenses in accordance with Section 112.061, F.S., or at such lower rates as may be provided in
this contract.
7.3.6 The Contractor shall allow public access to all documents, papers, letters, or other public records as defined
in subsection 119.011(12), F.S., made or received by the Contactor in conjunction with this contract except
for those records which are made confidential or exempt by law. The Contractors refusal to comply with
this provision will constitute an immediate breach of contract for which the Agency may unilaterally
terminate this contract.
7.4 If clients are to be transported under this contract, the Contractor shall comply with the provisions of Chapter
427, F.S., and Rule Chapter 41-2, Florida Administrative Code (F.A.C).
7.5 Subcontractors who are on the Discriminatory Vendor List may not transact business with any public entity, in
accordance with the provisions of Section 287.134, F.S.
7.6 The Contractor shall comply with the provisions of Section 11.062, F.S., and Section 216.347, F.S., which prohibit
the expenditure of contract funds for the purpose of lobbying the legislature, judicial branch or a state agency.
7.7 In accordance with Section 287.135, F.S., any Contractor on the Scrutinized Companies with Activities in Sudan
List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List (Lists), created
pursuant to Section 215.473, F.S., is ineligible to enter into or renew a contract with the Agency for goods or
services of $750,000.00 or more. Pursuant to Section 287.135, F.S., the Agency may terminate this contract if
the Contractor is found to have submitted a false certification of its status on the Lists or has been placed on
the Lists. Further, the Contractor is subject to civil penalties, attorney's fees and costs and any costs for
investigations that led to the finding of false certification. The Contractor shall complete and sign the
Certifications and Assurances Attachment, prior to the execution of this contract.
8. Background Screening:
The Contractor shall ensure that the requirements of Section 430.0402 and Chapter 435, F.S., as amended, are met
regarding background screening for all persons who meet the definition of a direct service provider and who are not
exempt from the Departments level 2 background screening pursuant to Section 430.0402(2)-(3), F.S. The Contractor
must also comply with any applicable rules promulgated by the Department and the Agency for Health Care
Administration regarding implementation of Section 430.0402 and Chapter 435, F.S. To demonstrate compliance with
this provision, Contactor shall submit to the Agency, the Background Screening Affidavit of Compliance (Screening
Form) upon thirty (30) days of execution of this contract. Should the Agency have a completed Screening Form on
file for the Contractor, a new Screening Form will be required every twelve (12) months.
8.1 Further information concerning the procedures for background screening may be found at
http://elderaffairs state fl.usHbackgroundscreening.php.
9. Grievance Procedures:
The Contractor shall develop, implement, and ensure that its Subcontractors have established grievance procedures to
process and resolve client dissatisfaction with or denial of service(s), and address complaints regarding the termination,
suspension or reduction of services, as required for receipt of finds. These procedures, at a minimum, will provide for
notice of the grievance procedure and an opportunity for review of the Subcontractors determination(s).
3
July 2017 — June 2018
10. Public Records and Retention:
HCE 203.17
10.1 By execution of this contract, Contractor agrees to all provisions of Chapter 119, F.S., and any other applicable
law, and shall:
10.1.1 Keep and maintain public records required by the Agency to perform the contracted services.
10.1.2 Upon request from the Agency's custodian of public records, provide the Agency a copy of the
requested records or allow the records to be inspected or copied within a reasonable time at a cost that does
not exceed the cost provided in Chapter 119, F.S., or as otherwise provided by law.
10.1.3 Ensure that public records that are exempt, or confidential and exempt, from public records disclosure
requirements are not disclosed except as authorized by law for the duration of the contract term and
following completion of the contract if the Contractor does not transfer the records to the Agency.
10.1.4 Upon completion of the contract, the Contractor will either transfer, at no cost to the Agency, all public
records in possession of the Contractor, or will keep and maintain public records required by the Agency.
If the Contractor transfers all public records to the Agency upon completion of the contract,
Contractor shall destroy any duplicate public records that are exempt, or confidential and exempt, from
public records disclosure requirements. If the Contractor keeps and maintains public records upon
completion of the contract, the Contractor shall meet all applicable requirements for retaining public
records. All records stored electronically must be provided to the Agency in a format that is compatible
with the information technology systems of the Agency.
10.2 The Agency may unilaterally cancel this contract, notwithstanding any other provisions of this contract, for
refusal by the Contractor to comply with Section 10 of this contract by not allowing public access to all documents,
papers, letters, or other material made or received by the Contractor in conjunction with this contract, unless the
records are exempt, or confidential and exempt, from Section 24(a) of Article I of the State Constitution and
Section 11 9.07(l), F.S.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION
OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO
PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT
THE CUSTODIAN OF PUBLIC RECORDS AT:
Public Records Coordinator
Area Agency on Aging for Southwest Florida, Inc.
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
239-652-6900 or 866-413-5337
11. Audits, Inspections. Investigations:
11.1 The Contractor shall establish and maintain books, records and documents (including electronic storage media)
sufficient to reflect all assets, obligations, unobligated balances, income, interest and expenditures of funds
provided by the Agency under this contract. Contractor shall adequately safeguard all such assets and assure
they are used solely for the purposes authorized under this contract. Whenever appropriate, financial information
should be related to performance and unit cost data.
11.2 The Contractor shall retain and maintain all client records, financial records, supporting documents, statistical
records, and any other documents (including electronic storage media) pertinent to this contact for a period of
six (6) years after completion of the contract or longer when required by law. In the event an audit is required
by this contract, records shall be retained for a minimum period of six (6) years after the audit report is issued or
until resolution of any audit findings or litigation based on the terms of this contract, at no additional cost to the
Agency.
4
July 2017 — June 2018 HCE 203.17
11.3 Upon demand, at no additional cost to the Agency, the Contractor shall facilitate the duplication and transfer of
any records or documents during the required retention period.
11.4 The Contractor shall assure that the records described in this section will be subject at all reasonable times to
inspection, review, copying, or audit by federal, state, or other personnel duly authorized by the Agency.
11.5 At all reasonable times for as long as records are maintained, persons duly authorized by the Agency and
federal auditors, pursuant to 45 CFR Part 75, will be allowed full access to and the right to examine any of the
Contractors contracts and related records and documents pertinent to this specific contract, regardless of the form
in which kept.
11.6 The Contractor shall provide a Financial and Compliance Audit Attachment to the Agency as specified in
this contract and ensure that all related third -party transactions are disclosed to the auditor.
11.7 Contractor agrees to comply with the Inspector General in any investigation, audit, inspection, review, or hearing
performed pursuant to Section 20.055, Florida Statutes. Contractor further agrees that it shall include in related
subcontracts a requirement that subcontractors performing work or providing services pursuant to this contract
agree to cooperate with the Inspector General in any investigation, audit, inspection, review, or hearing pursuant
to Section 20.055(5), F.S. By execution of this contract the Contractor understands and will comply with this
subsection.
12. Nondiscrimination -Civil Rights Com lid ance:
12.1 The Contractor shall execute Assurances as stated in the Assurances -Non -Construction Programs Attachment that
it will not discriminate against any person in the provision of services or benefits under this contract or in
employment because of age, race, religion, color, disability, national origin, marital status or sex in compliance
with state and federal law and regulations. The Contractor further assures that all Contractors, Subcontractors,
Sub -grantees, or others with whom it arranges to provide services or benefits in connection with any of its
programs and activities are not discriminating against clients or employees because of age, race, religion, color,
disability, national origin, marital status or sex.
12.2 During the term of this contract, the Contractor shall complete and retain on file a timely, complete and accurate
Civil Rights Compliance Checklist, attached to this contract.
12.3 The Contractor shall establish procedures pursuant to federal law to handle complaints of discrimination involving
services or benefits through this contract. These procedures will include notifying clients, employees, and
participants of the right to file a complaint with the appropriate federal or state entity.
12.4 If this contract contains federal funds, these assurances are a condition of continued receipt of or benefit from
federal financial assistance, and are binding upon the Contractor, its successors, transferees, and assignees for the
period during which such assistance is provided. The Contractor further assures that all Subcontractors, Vendors,
or others with whom it arranges to provide services or benefits to participants or employees in connection with
any of its programs and activities are not discriminating against those participants or employees in violation of
the above statutes, regulations, guidelines, and standards. In the event of failure to comply, the Contractor
understands that the Agency may, at its discretion, seek a court order requiring compliance with the terms of
this assurance or seek other appropriate judicial or administrative relief, including but not limited to, termination
of and denial of further assistance.
110010roriffrO71 M1. MOM
The Contractor shall permit persons duly authorized by the Agency to inspect and copy any records, papers,
documents, facilities, goods, and services of the Contractor which are relevant to this contract, and to interview any
clients, employees, and Subcontractor employees of the Contractor to assure the Agency of the satisfactory
performance of the terms and conditions of this contract. Following such review, the Agency will provide a written
report of its findings to the Contractor, and where appropriate, the Contractor shall develop a Corrective Action Plan
(CAP). The Contractor hereby agrees to correct all deficiencies identified in the CAP in a timely manner as determined
by the Contract Manager.
5
July 2017 —June 2018 HCE 203.17
14. Provision of Services:
The Contractor shall provide services in the manner described in ATTACHMENT I.
15. Coordinated Monitoring with Other Agencies:
If the Contractor receives funding from one or more State of Florida human service agencies, in addition to the
A r e a A g e n c y a n d/ o r Department of Elder Affairs, then a joint monitoring visit including such other
agencies may be scheduled. For the purposes of this contract, and pursuant to Section 287.0575, F.S. as amended,
Florida's human service agencies shall include the Department of Children and Families, the Department of Health,
the Agency for Persons with Disabilities, the Department of Veterans' Affairs, and the Department of Elder
Affairs. Upon notification and the subsequent scheduling of such a visit by the designated agency's lead
administrative coordinator, the Contractor shall comply and cooperate with all monitors, inspectors, and/or
investigators.
16. Indemnification:
The Contractor shall indemnify, save, defend, and hold harmless the Agency and its agents and employees from
any and all claims, demands, actions, causes of action of whatever nature or character, arising out of or by reason of the
execution of this agreement or performance of the services provided for herein. It is understood and agreed that the
Contractor is not required to indemnify the Agency for claims, demands, actions or causes of action arising solely out
of the negligence of the Agency.
16.1 Except to the extent permitted by Section 768.28, F.S., or other Florida law, this section 16 is not applicable to
contracts executed between the Agency and state agencies or subdivisions defined in Section 768.28(2), F.S.
17.1 The Contractor shall provide continuous adequate liability insurance coverage during the existence of this
contract and any renewal(s) and extension(s) of it. By execution of this contract, unless it is a state agency or
subdivision as defined by Section 768.28(2), F.S., the Contractor accepts full responsibility for identifying and
determining the type(s) and extent of liability insurance necessary to provide reasonable financial protections
for the Contractor and the clients to be served under this contract. The limits of coverage under each policy
maintained by the Contractor do not limit the Contractors liability and obligations under this contract. The
Contractor shall ensure that the Agency has the most current written verification of insurance coverage
throughout the term of this contract. Such coverage may be provided by a self-insurance program established
and operating under the laws of the State of Florida. The Agency reserves the right to require additional
insurance as specified in this contract.
17.2 Throughout the term of this agreement, the Contractor shall maintain an insurance bond from a responsible
commercial insurance company covering all officers, directors, employees and agents of the Contractor
authorized to handle funds received or disbursed under all agreements and/or contracts incorporating this
contract by reference in an amount commensurate with the funds handled, the degree of risk as determined by
the insurance company and consistent with good business practices.
18. Confidentiality of Information:
The Contractor shall not use or disclose any information concerning a recipient of services under this contract for any
purpose prohibited by state or federal law or regulations except with the written consent of a person legally authorized
to give that consent or when authorized by law.
19. Health Insurance Portability and Accountability Act:
Where applicable, the Contractor shall comply with the Health Insurance Portability and Accountability Act (42 USC
1320d.), as well as all regulations promulgated thereunder (45 CFR Parts 160, 162, and 164).
20. Incident Re ortin :
20.1 The Contractor shall notify the Agency immediately but no later than forty-eight (48) hours from the
Contractors awareness or discovery of conditions that may materially affect the Contractors or Subcontractors
ability to perform the services required to be performed under this contract. Such notice shall be made orally to
the Contract Manager (by telephone) with an email to immediately follow.
0
July 2017 — June 2018 HCE 203.17
20.2 The Contractor shall immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of
a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone number
(1-800-96ABUSE). As required by Chapters 39 and 415, F.S., this provision is binding upon the Contractor,
Subcontractors, and their employees.
21. New Contract(s) Re on rti=
The Contractor shall notify the Agency within ten (10) days of entering into a new contract with any of the remaining
four (4) state human service agencies. The notification shall include the following information: (1) contracting state
agency and the applicable office or program issuing the contract; (2) contract name and number; (3) contract start and
end dates; (4) contract amount; (5) contract description and commodity or service; (6) Contract Manager name and
contact information. In complying with this provision, and pursuant to Section 287.0575, F.S., as amended, the
Contractor shall complete the Contractor's State Contracts List, ask the Area Agency for a copy of this form.
22. Bankruptcy Notification:
During the term of this contract, the Contractor shall immediately notify the Area Agency and/or the Florida
Department of Elder Affairs if the Contractor, its assignees, Subcontractors or affiliates file a claim for bankruptcy.
Within ten (10) days after notification, the Contractor must also provide the following information to the Area
Agency and/or Florida of Elder Affairs: (1) the date of filing of the bankruptcy petition; (2) the case number; (3) the
court name and the division in which the petition was filed (e.g., Middle District of Florida, Fort Myers, Florida); and
(4) the name, address, and telephone number of the bankruptcy attorney.
23. SnonsorshiU and Publicity:
23.1 As required by Section 286.25, F.S., if the Contractor is a non-governmental organization which sponsors a
program financed wholly or in part by state funds, including any funds obtained through this contract, it shall,
in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by (Contractors
name) and the Area Agency on Aging for Southwest Florida, and the State of Florida, of Elder Affairs." If the
sponsorship reference is in written material, the words "Area Agency on Aging for Southwest Florida, and the
State of Florida, Department of Elder Affairs" shall appear in at least the same size letters or type as the name
of the organization.
23.2 The Contractor shall not use the words "Area Agency on Aging for Southwest Florida, and the State of Florida,
Department of Elder Affairs" to indicate sponsorship of a program otherwise financed, unless specific
authorization has been obtained by the Agency prior to use.
24. Assignments:
24.1 The Contractor shall not assign the rights and responsibilities under this contract without the prior written
approval of the Agency, which shall not be unreasonably withheld. Any sublicense, assignment, or transfer
otherwise occurring without prior written approval of the Agency will constitute a material breach of the
contract.
24.2 The State of Florida and/or the Area Agency is, at all times, entitled to assign or transfer, in whole or part, its
rights, duties, or obligations under this contract to another governmental agency in the State of Florida, upon
giving prior written notice to the Contractor. In the event the State of Florida and/or the Area Agency approves
transfer of the Contractor's obligations, the Contractor remains responsible for all work performed and all
expenses incurred in connection with this contract.
24.3 This contract shall remain binding upon the successors in interest of either the Contractor or the Agency.
25. Subcontracts:
25.1 The Contractor is responsible for all work performed and for all commodities produced pursuant to this contract,
whether actually furnished by the Contractor or its Subcontractors. Any subcontracts shall be evidenced by a
written document and subject to any conditions of approval the Agency deems necessary. The Contractor
further agrees that the Agency will not be liable to the Subcontractor in any way or for any reason. The
Contractor, at its expense, shall defend the Agency against any such claims.
25.2 The Contractor shall promptly pay any Subcontractors upon receipt of payment from the Agency or other
state agency. Failure to make payments to any Subcontractor in accordance with Section 287.0585, F.S., unless
7
July 2017 — June 2018
HCE 203.17
otherwise stated in the contract between the Contractor and Subcontractor, will result in a penalty as provided
by statute.
26. Independent Capacity of Contractor:
It is the intent and understanding of the Parties that the Contractor, and any of its Subcontractors, are independent
Contractors and are not employees of the Agency and shall not hold themselves out as employees or agents of the
Agency without specific authorization from the Agency. It is the further intent and understanding of the Parties that
the Agency does not control the employment practices of the Contractor and will not be liable for any wage and
hour, employment discrimination, or other labor and employment claims against the Contractor or its
Subcontractors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment
compensation funds and all necessary insurance for the Contractor are the sole responsibility of the Contractor.
27. m r
Payments shall be made to the Contractor for all completed and approved deliverables (units of service) as defined in
ATTACHMENT I. The Contract Manager will have final approval of the Contractor's invoice submitted for
payment, and will approve the invoice for payment only if the Contractor has met all terms and conditions of the
contract, unless the bid specifications, purchase order, or this contract specify otherwise. The approved invoice will
be submitted to the Agency's finance section for budgetary approval and processing. Disputes arising over
invoicing and payments will be resolved in accordance with the provisions of Section 215.422, F.S. A Vendor
Ombudsman has been established within the Florida Department of Financial Services and may be contacted at 800-
342-2762.
28. Return of Funds:
The Contractor shall return to the Agency any overpayments due to unearned funds or funds disallowed and any
interest attributable to such funds pursuant to the terms and conditions of this contract that were disbursed to the
Contractor by the Agency. In the event that the Contractor or its independent auditor discovers that an overpayment has
been made, the Contractor shall repay said overpayment immediately without prior notification from the Agency. In
the event that the Agency first discovers an overpayment has been made, the Contract Manager will notify the
Contractor in writing of such findings. Should repayment not be made forthwith, the Contractor shall be charged at
the lawful rate of interest on the outstanding balance pursuant to Section 55.03, F.S., after Agency notification or
Contractor discovery.
29. Data Integrity and Safeguarding Information:
The Contractor shall ensure an appropriate level of data security for the information the Contractor is collecting or using
in the performance of this contract. An appropriate level of security includes approving and tracking all Contractor
employees that request system or information access and ensuring that user access has been removed from all terminated
employees. The Contractor, among other requirements, must anticipate and prepare for the loss of information
processing capabilities. All data and software shall be routinely backed up to ensure recovery from losses or outages
of the computer system. The security over the backed -up data is to be as stringent as the protection required of the
primary systems. The Contractor shall ensure all Subcontractors maintain written procedures for computer system
backup and recovery. The Contractor shall complete and sign the Certification Regarding Data Integrity Compliance
for Agreements, Grants, Loans, and Cooperative Agreements prior to the execution of this contract.
30. Computer Use and Social Media Policy:
The Florida Department of Elder Affairs has implemented a Social Media Policy, in addition to its Computer Use Policy,
which applies to all employees, contracted employees, consultants, OPS and volunteers, including all personnel
affiliated with third parties, such as, but not limited to, Contractors and subcontractors. Any entity that uses the
Department's and Area Agency's computer resource systems must comply with the Department's and/or Area
Agency's policy regarding social media. Social Media includes, but is not limited to blogs, podcasts, discussion
forums, Wikis, RSS feeds, video sharing, social networks like MySpace, Facebook and Twitter, as well as content
sharing networks such as flickr and YouTube. This policy is available on the Department's website at:
http//elderaffairs.state.fl.usHfi nancial.php.
July 2017 — June 2018
31. Conflict of Interest:
HCE 203.17
The Contractor shall establish safeguards to prohibit employees, board members, management and Subcontractors from
using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of
interest or personal gain. No employee, officer or agent of the Contractor or Subcontractor shall participate in the
selection, or in the award of an agreement supported by state or federal funds if a conflict of interest, real or apparent,
would be involved. Such a conflict would arise when: (a) the employee, officer or agent; (b) any member of his/her
immediate family; (c) his or her partner; or (d) an organization which employs, or is about to employ, any of the above,
has a financial or other interest in the firm selected for award. The Contractor or Subcontractors officers, employees or
agents will neither solicit nor accept gratuities, favors or anything of monetary value from Contractors, potential
Contractors, or parties to Subcontracts. The Contractors board members and management must disclose to the
Agency any relationship which may be, or may be perceived to be, a conflict of interest within thirty (30) calendar
days of an individual's original appointment or placement in that position, or if the individual is serving as an incumbent,
within thirty (30) calendar days of the commencement of this contract. The Contractor's employees and Subcontractors
must make the same disclosures described above to the Contractors board of directors. Compliance with this provision
will be monitored.
32. Public Entity Crime:.
Pursuant to Section 287.133(2)(a), F.S., a person or affiliate who has been placed on the Convicted Vendor List
following a conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any
goods or services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the
construction or repair of a public building or public work; may not submit bids, proposals, or replies on leases of real
property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant
under a contract with any public entity; and may not transact business with any public entity in excess of the threshold
amount provided in Section 287.017, F.S., for CATEGORY TWO for a period of thirty six (36) months following the
date of being placed on the Convicted Vendor List.
33. Purchasing:
33.1 The Contractor may purchase articles which are the subject of or are required to carry out this contract from
Prison Rehabilitative Industries and Diversified Enterprises, Inc., (PRIDE) identified under Chapter 946, F.S.,
in the same manner and under the procedures set forth in subsections 946.515(2) and (4), F.S. For purposes of
this contract, the Contractor shall be deemed to be substituted for the Agency insofar as dealings with PRIDE.
This clause is not applicable to Subcontractors unless otherwise required by law. An abbreviated list of
products/services available from PRIDE may be obtained by contacting PRIDE, 800-643-8459.
33.2 The Contractor may procure any recycled products or materials, which are the subject of or are required to cavy
out this contract, in accordance with the provisions of Section 403.7065, F.S.
33.3 The Contractor may purchase articles that are the subject of, or required to carry out, this contract from a
nonprofit agency for the Blind or for the Severely Handicapped that is qualified pursuant to Chapter 413, F.S.,
in the same manner and under the same procedures set forth in Section 413.036(1) and (2), F.S. For purposes of
this contract, the Contractor shall be deemed to be substituted for the Agency insofar as dealings with such
qualified nonprofit agency are concerned. Additional information about the designated nonprofit agency and
the products it offers is available at http://www.respectofflorida.org. This clause is not applicable to
Subcontractors unless otherwise required by law.
34. Patents, CoIlXrights, Royalties:
If this contract is awarded state funding and if any discovery, invention or copyrightable material is developed, produced
or for which ownership was purchased in the course of or as a result of work or services performed under this contract,
the Contractor shall refer the discovery, invention or material to the Agency to be referred to the Agency and/or
Department of State. Any and all patent rights or copyrights accruing under this contract are hereby reserved to the
State of Florida in accordance with Chapter 286, F.S. Pursuant to Section 287.0571(5)(k), as amended, the only
exceptions to this provision shall be those that are clearly expressed and reasonably valued in this contract.
9
July 2017 — June 2018
HCE 203.17
34.1 If the primary purpose of this contract is the creation of intellectual property, the State of Florida shall retain an
unencumbered right to use such property, notwithstanding any agreement made pursuant to this section 34.
34.2 If this contract is awarded solely federal funding, the terms and conditions are governed by 2 CFR § 200.315.
34.3 Notwithstanding the foregoing provisions, if the Contractor or one of its Subcontractors is a university and
a member of the State University System of Florida, then Section 1004.23, F.S., shall apply, but the Agency
shall retain a perpetual, fully -paid, nonexclusive license for its use and the use of its Contractors, Subcontractors
or Assignees of any resulting patented, copyrighted or trademarked work products.
35. Emergency Preparedness and Continuity of Operations:
35.1 If the tasks to be performed pursuant to this contract include the physical care and control of clients, or the
administration and coordination of services necessary for client health, safety or welfare, the Contractor shall,
within thirty (30) calendar days of the execution of this contract, submit to the Agency's Contract Manager
verification of an Emergency Preparedness Plan. In the event of an emergency, the Contractor shall notify the
Agency of emergency provisions.
35.2 In the event a situation results in a cessation of services by a Subcontractor, the Contractor shall retain
responsibility for performance under this contract and must follow procedures to ensure continuity of operations
without interruption.
36. EEquiU m� ent:
36.1 Equipment means: (a) an article of nonexpendable, tangible personal property having a useful life of more than
one year and a per-unit acquisition cost which equals or exceeds the lesser of the capitalization level established
by the organization for the financial statement purposes, or $5,000.00 [for federal funds], or (b); nonexpendable,
tangible personal property of a non -consumable nature with an acquisition cost of $1,000.00 or more per unit,
and expected useful life of at least one (1) year; and hardback bound books not circulated to students or the
general public, with a value or cost of $250.00 or more [for state funds].
36.2 Contractors and Subcontractors who are Institutions of Higher Education, Hospitals, and Other Non -Profit
Organizations shall have written property management standards in compliance with 2 CFR Part 200
Administrative Requirements (formerly OMB Circular A-110) that include: (a) a property list with all the
elements identified in the circular; (b) a procedure for conducting a physical inventory of equipment at least once
every two (2) years; (c) a control system to insure adequate safeguards to prevent loss, damage, or theft of the
equipment; and (d) maintenance procedures to keep the equipment in good condition. The property records must
be maintained on file and shall be provided to the Agency upon request. The Contractor shall promptly
investigate, fully document and notify the Agency's Contract Manager of any loss, damage, or theft of
equipment. The Contractor shall provide the results of the investigation to the Agency's Contract Manager.
36.3 The Contractor's property management standards for equipment acquired with federal funds and federally -owned
equipment shall include accurately maintained equipment records with the following information:
36.3.1 A description of the equipment;
36.3.2 Manufacturer's serial number, model number, federal stock number, national stock number, or other
identification number;
36.3.3 Source of the equipment, including the award number;
36.3.4 Whether title vests in the Contractor or the federal government;
36.3.5 Acquisition date (or date received, if the equipment was furnished by the federal government) and cost;
36.3.6 Information from which one can calculate the percentage of federal participation in the cost of the
equipment (not applicable to equipment furnished by the federal government);
36.3.7 Location and condition of the equipment and the date the information was reported;
36.3.8 Unit acquisition cost; and
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July 2017 — June 2018
HCE 203.17
36.3.9 Ultimate disposition data, including date of disposal and sales price or the method used to determine
current fair market value where a Contractor compensates the federal awarding agency for its share.
36.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased with
state funds with an acquisition cost over $1,000.00 that is specifically identified and approved by the Agency area
plan is part of the cost of carrying out the activities and functions of the grant awards and Title (ownership) will
vest in the Contractor, subject to the conditions of 2 CFR Part 200. Equipment purchased under these
thresholds is considered supplies and is not subject to property standards. Equipment purchased with funds
identified in the budget attachments to agreements covered by this contract, or identified in the sub -agreements
with Subcontractors (not included in a cost methodology), is subject to the conditions of Chapter 273, F. S. and
60A-1.017, F. A. C. and 45 CFR Part 75.
36.5 The Contractor shall not dispose of any equipment or materials provided by the Agency, or purchased with
funds provided through this contract without first obtaining the approval of the Agency's Contract Manager.
When disposing of property or equipment the Contractor must submit a written request for disposition
instructions to the Agency's Contract Manager. The request should include a brief description of the
property, purchase price, funding source, and percentage of state or federal participation, acquisition date and
condition of the property. The request should also indicate the Contractors proposed disposition (i.e., transfer or
donation to another agency that administers federal programs, offer the items for sale, destroy the items, etc.).
36.6 The Agency's Contract Manager will issue disposition instructions. If disposition instructions are not
received within one hundred twenty (120) days of the written request for disposition, the Contractor is authorized
to proceed as directed in 2 CFR §200.313.
36.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto, but
excludes movable machinery and equipment. Real property may not be purchased with state or federal funds
through agreements covered under this contract without the prior approval of the Agency. Real property
purchases from Older Americans Act funds are subject to the provisions of Title 42, Chapter 35, Subchapter III,
Part A., Section 3030b USC. Real property purchases from state funds can only be made through fixed capital
outlay grants and aids appropriations and therefore are subject to the provisions of Section 216.348, F.S.
36.8 Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted and tested prior
to disposal to ensure no confidential information remains.
36.9 The Contractor must adhere to the Agency's procedures and standards when purchasing Information
Technology Resources (ITR) as part of any agreement(s) incorporating this contract by reference. An ITR
worksheet is required for any computer related item costing $1,000.00 or more, including data processing
hardware, software, services, supplies, maintenance, training, personnel and facilities. The completed ITR
worksheet shall be maintained in the LAN administrator's file and must be provided to the Agency upon
request. The Contractor has the responsibility to require any Subcontractors to comply with the Agency's ITR
procedures.
37. PIJR 1000 Form:
The PUR 1000 Form is hereby incorporated by reference and available at:
http://www.myflorida.com/apps/vbs/adoe/F7740 PUR1000.pdf
In the event of any conflict between the PUR 1000 Form and any terms or conditions of this contract the terms or
conditions of this contract shall take precedence over the PUR 1000 Form. However, if the conflicting terms or
conditions in the PUR 1000 Form are required by any section of the Florida Statutes, the terms or conditions contained
in the PUR 1000 Form shall take precedence.
38, Use of State Funds to Purchase or ImUrove Real Pro er :
Any state funds provided for the purchase of or improvements to real property are contingent upon the Contractor or
political subdivision granting to the state a security interest in the property at least to the amount of state funds provided
for at least five (5) years from the date of purchase or the completion of the improvements or as further required by law.
0"
July 2017 — June 2018
39. Dispute Resolution:
HCE 203.17
Any dispute concerning performance of the contract shall be decided by the Agency's Contract Manager, who shall
reduce the decision to writing and serve a copy on the Contractor.
40. Financial Consequences:
If the Contractor fails to meet the minimum level of service or performance identified in this contract, the Agency will
impose financial consequences as stated in ATTACHMENT I.
11W ♦ 1 . Is itu_
Nothing contained in this agreement is intended to serve as a waiver of sovereign immunity by any entity to which
sovereign immunity may be applicable.
42. Venue:
If any dispute arises out of this contract, the venue of such legal recourse shall be Lee County, Florida.
43. Entire Contract:
This contract contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations
shall be valid or binding upon the Agency or the Contractor unless expressly contained herein or by a written
amendment to this contract signed by both Parties.
44. Force Majeure:
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control,
provided the party experiencing the force majeure condition provides immediate written notification to the other party
and takes all reasonable efforts to cure the condition.
45. Severability Clause:.
The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or unenforceable the
other provisions are severable to that void provision and shall remain in full force and effect.
46. Condition Precedent to Contract Appropriations:
The Parties agree that the Agency's performance and obligation to pay under this contract is contingent upon an
annual appropriation by the Legislature.
47. Addition/Deletion:
The Parties agree that the Agency reserves the right to add or to delete any of the services required under this
contract when deemed to be in the State of Florida's best interest and reduced to a written amendment signed by both
Parties. The Parties shall negotiate compensation for any additional services added.
48. Waiver:
The delay or failure by the Agency to exercise or enforce any of its rights under this contract will not constitute or be
deemed a waiver of the Agency's right thereafter to enforce those rights, nor will any single or partial exercise of any
such right preclude any other or further exercise thereof or the exercise of any other right.
49.om lin ance:
The Contractor shall abide by all applicable current federal statutes, laws, rules and regulations as well as applicable
current state statutes, laws, rules and regulations. The Parties agree that failure of the Contractor to abide by these laws
shall be deemed an event of default of the Contractor, and subject the contract to immediate, unilateral cancellation of
the contract at the discretion of the Agency.
50. Final Invoice:
The Contractor shall submit the final invoice for payment to the Agency no later than thirty (30) days upon the
contract ending date unless otherwise specified in ATTACHMENT I. If the Contractor fails to do so, all right to
payment is forfeited and the Agency may not honor any requests submitted after the aforesaid time period. Any
payment due
12
July 2017 — June 2018
HCE 203.17
under the terms of this contract may be withheld until all required documentation and reports due from the Contractor
and necessary adjustments thereto have been approved by the Agency.
51. Renegotiations of Modifications:
Modifications of the provisions of this contract shall be valid only when they have been reduced to writing and duly
signed by both parties. The rate of payment and the total dollar amount may be adjusted retroactively to reflect price
level increases and changes in the rate of payment when these have been established through the appropriations process
and subsequently identified in the Agency's operating budget.
52. Suspension of Work:
The Agency may in its sole discretion suspend any or all activities under the contract or purchase order, at any time,
when in the best interests of the State to do so. The Agency shall provide the Contractor written notice outlining the
particulars of suspension. Examples of the reason for suspension include, but are not limited to, budgetary
constraints, declaration of emergency, or other such circumstances. After receiving a suspension notice, the Contractor
shall comply with the notice and shall not accept any purchase orders. Within ninety (90) days, or any longer period
agreed to by the Contractor, the Agency shall either (1) issue a notice authorizing resumption of work, at which
time activity shall resume, or (2) terminate the contract or purchase order. Suspension of work shall not entitle the
Contractor to any additional compensation.
53. Termination:
53.1 Termination for Convenience. The Agency, by written notice to the Contractor, may terminate the contract in
whole or in part when the Agency determines in its sole discretion that it is in the State's interest to do so. The
Contractor shall not furnish any product after it receives the notice of termination, except as necessary to
complete the continued portion of the contract, if any. The Contractor shall not be entitled to recover any
cancellation charges or lost profits.
53.2 Termination for Cause. The Agency may terminate the contract if the Contractor fails to (1) deliver the
product within the time specified in the contract or any extension, (2) maintain adequate progress, thus
endangering performance of the contract, (3) honor any term of the contract, or (4) abide by any statutory,
regulatory, or licensing requirement. Rule 60A-1.006(3), F.A.C., governs the procedure and consequences of
default. The Contractor shall continue work on any work not terminated. Except for defaults of Subcontractors
at any tier, the Contractor shall not be liable for any excess costs if the failure to perform the contract arises from
events completely beyond the control, and without the fault or negligence, of the Contractor. If the failure to
perform is caused by the default of a Subcontractor at any tier, and if the cause of the default is completely beyond
the control of both the Contractor and the Subcontractor, and without the fault or negligence of either, the
Contractor shall not be liable for any excess costs for failure to perform, unless the subcontracted products were
obtainable from other sources in sufficient time for the Contractor to meet the required delivery schedule. If, after
termination, it is determined that the Contractor was not in default, or that the default was excusable, the rights
and obligations of the Parties shall be the same as if the termination had been issued for the convenience of the
Agency. The rights and remedies of the Agency in this clause are in addition to any other rights and
remedies provided by law or under the contract.
53.3 Upon termination of the contract, the Contractor and Subcontractors shall, at no cost to the Agency, transfer all
public records in their possession to the Agency and destroy any duplicate public records that are exempt, or
confidential and exempt, from public records disclosure requirements. All records stored electronically shall be
provided to the Agency in a format that is compatible with the information technology systems of the
Agency.
54. Electronic Records and Signature:
The Agency authorizes, but does not require, the Contractor to create and retain electronic records and to use
electronic signatures to conduct transactions necessary to carry out the terms of this Agreement. A Contractor that
creates and retains electronic records and uses electronic signatures to conduct transactions shall comply with the
requirements contained in the Uniform Electronic Transaction Act, Section 668.50, F.S. All electronic records must be
fully auditable; are subject to Florida's Public Records Law, Chapter 119, F.S.; must comply with Section 29, Data
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July 2017 — June 2018
HCE 203.17
Integrity and Safeguarding Information; must maintain all confidentiality, as applicable; and must be retained and
maintained by the Contractor to the same extent as non -electronic records are retained and maintained as required by
this Agreement.
54.1 The Agency's authorization pursuant to this section does not authorize electronic transactions between the
Contractor and the Agency. The Contractor is authorized to conduct electronic transactions with the
Agency only upon further written consent by the Agency.
54.2 Upon request by the Agency, the Contractor shall provide the Agency with non -electronic (paper) copies of
records. Non -electronic (paper) copies provided to the Agency of any document that was originally in
electronic form with an electronic signature must identify the person and the person's capacity who electronically
signed the document on any non -electronic copy of the document.
55. Contract Manager:
The Agency may substitute any Agency employee to serve as the Contract Manager.
REMAINDER OF THE PAGE INTENTIONALL Y LEFT BLANK
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July 2017 — June 2018
56. Official PaXge and Representatives (Names Addressee and Telephone Numbers):
HCE 203.17
57. All Terms and Conditions Included:
This contract and its ATTACHMENT I — XI including 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
COUNTY COMMS pN S
SIGNED BY.
NAME: Steve Y. Carnell
TITLE: Public Services Department Head
DATE: \ 1-i O
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA, INC.
SIGNED BY:
NAME: MARIANNE G LORINI
TITLE: PRESIDENT/CEO
DATE:
Federal Tabb: 59-600558 Approved as to form and legality
Fiscal Year Ending Date: 09/30
DUNS: 833441814
15 Arsyiatunt County Attorney
Collier County Board of County Commissioners
The Contractor name, as shown on page 1 of thiso
/oCollier County Community and Human Services
a.
contract, and mailing address of the official payee to
3339 E Tamiami Trail, Suite 211
whom the payment shall be made is:
Naples, FL 34112
Kimberley Grant, Director
The name of the contact person and street address
Collier County Board of County Commissioners
b.
where financial and administrative records are
%Collier County Community and Human Services
maintained is:
3339 E Tamiami Trail, Suite 211
Naples, FL 34112
Kimberley Grant, Director
The name, address, and telephone number of the
Collier County Board of County Commissioners
C.
representative of the Contractor responsible for
%Collier County Community and Human Services
administration of the program under this contract is:
3339 E Tamiami Trail, Suite 211
Naples, FL 34112
(239) 252-2273
Area Agency on Aging for Southwest Florida, Inc.
d'
The section and location within the Agency where
15201 North Cleveland Avenue, Suite 1100
Requests for Payment and Receipt and Expenditure
North Fort Myers, FL 33903
forms are to be mailed is:
Tammy Rhoades, Vice President of Finance
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.
57. All Terms and Conditions Included:
This contract and its ATTACHMENT I — XI including 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
COUNTY COMMS pN S
SIGNED BY.
NAME: Steve Y. Carnell
TITLE: Public Services Department Head
DATE: \ 1-i O
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA, INC.
SIGNED BY:
NAME: MARIANNE G LORINI
TITLE: PRESIDENT/CEO
DATE:
Federal Tabb: 59-600558 Approved as to form and legality
Fiscal Year Ending Date: 09/30
DUNS: 833441814
15 Arsyiatunt County Attorney
July 2017 — June 2018
INDEX OF ATTACHMENTS
HCE 203.17
ATTACHMENTI...........................................................................................................................................17
STATEMENTOF WORK................................................................................................................................ 17
ATTACHMENTII......................................................................................................................................... 30
FINANCIAL AND COMPLIANCE AUDIT................................................................................................... 30
ATTACHMENTIII........................................................................................................................................ 36
CERTIFICATIONS AND ASSURANCES...................................................................................................... 36
ATTACHMENTIV.............................................................................................................................................. 41
ASSURANCES—NON-CONSTRUCTION PROGRAMS............................................................................. 41
ATTACHMENTV......................................................................................................................................... 43
FLORIDA DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST............ 43
ATTACHMENTVI........................................................................................................................................ 47
BACKGROUNDSCREENING....................................................................................................................... 47
ATTACHMENTVII............................................................................................................................................48
ANNUALBUDGET SUMMARY................................................................................................................... 48
ATTACHMENTVIII..................................................................................................................................... 49
INVOICEREPORT SCHEDULE.................................................................................................................... 49
ATTACHMENTIX........................................................................................................................................ 50
REQUESTFOR PAYMENT............................................................................................................................ 50
ATTACHMENTX......................................................................................................................................... 51
RECEIPTAND EXPENDITURE REPORT.................................................................................................... 51
ATTACHMENTXI........................................................................................................................................ 52
SERVICERATE REPORT.............................................................................................................................. 52
16
July 2017 —June 2018
ATTACHMENT
STATEMENT OF WORK
I. SERVICES TO BE PROVIDED
A. Definitions of Terms
1. Acronyms
Area Agency on Aging (AAA)
Adult Protective Services (APS)
Adult Protective Services Referral Tracking Tool (ARTT)
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 Q
Florida Statutes (F.S.)
Home Care for Disabled Adults (HCDA)
Home Care for the Elderly (HCE)
Institutional Care Program (ICP)
Notice of Instruction (NOI)
Planning and Service Area (PSA)
Summary of Programs and Services (SOPS)
United States Code (U.S.C.)
2. Program -Specific Terms
HCE 203.17
Aging Out: The condition of reaching sixty (60) years of age and being transitioned from 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 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 CIRTS. An update may also include other revisions to the Area Plan as instructed by the
Department.
Department of Elder Affairs Programs and Services Handbook (Handbook or Handbook): An official
document of D O E A . Handbook includes program policies, procedures, and standards applicable to
agencies which are recipients/providers of 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 the
requirement to perform a particular task or activity. NOIs are located on the Department's website at
http://elderaffairs.state.fl.usHnois.php.
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July 2017 — June 2018
HCE 203.17
Program Highlights: Success stories, quotes, testimonials, or human -interest vignettes that are used in the
SOPS 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.
B. GENERAL DESCRIPTION
1. General Statement
The purpose of the HCE Program is to encourage the provision of care for elders in family -type living
arrangements in private homes as an alternative to nursing homes or other institutional care settings.
Home Care for the Elderly Program Mission Statement
The HCE Program assists caregivers of three (3) or fewer elders, living in private homes, through the provision
of a basic subsidy for maintenance and supervision, as well as other necessary specialized services.
2. Authority
The relevant authority governing the HCE Program includes:
a. Rule Chapter 58H-1, Florida Administrative Code;
b. Sections 430.601, 430.602, 430.603, 430.604, 430.605, 430.606, 430.608, F.S.; and
c. The Catalog of State Financial Assistance (CSFA) Number 65001.
Scope of Service
The Agency is responsible for the programmatic, fiscal and operational management of HCE. The program
services shall be provided in a manner consistent with the Agency's current Area Plan, as updated, and the
current Department of Elder Affairs Programs and Services Handbook, which are incorporated by reference.
4. Major Program Goals
The major goals of the HCE Program are to ensure that:
a. A basic Subsidy is provided to the caregiver of each client; and
b. A special Subsidy is provided when essential to the well-being of the client.
C. Clients to be Served
1. General Description
The HCE Program serves elders age sixty (60) and older at risk of placement in a nursing home or other
institutional setting who are able to remain in a family -style setting with a caregiver through the provision of
subsidies.
2. Client Eligibility
Clients eligible to receive services under this contract must:
a. Be sixty (60) years of age or older;
b. Have income no greater than the ICP standard;
c. Meet the ICP asset limitation;
d. Be at risk of nursing home placement;
e. Have an approved adult caregiver living in the home with them who is willing and able to provide care or
assist in arranging for care; and
f. Not be enrolled in a Medicaid capitated long-term care program.
3. Caregiver Eligibility
Caregivers eligible to receive services under this contract must:
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HCE 203.17
a. Be at least eighteen (18) years of age;
b. Be capable of providing a family -type living environment;
c. 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;
d. Be willing to accept responsibility for the social, physical, and emotional needs of the care recipient;
e. Be physically present and live in the home to provide supervision and to assist in arrangement of services
for the client;
f. 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
g. Be without record of conviction of abuse, neglect or exploitation of another person.
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.
5. Client Determination
The Agency shall have final authority for the determination of client eligibility.
II. MANNER OF SERVICE PROVISION
A. Service Tasks
To achieve the goals of the HCE Program, the Contractor shall perform, or ensure that its Subcontractors perform,
the following tasks:
1. Client Eligibility Determination
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 Section I.C.2. and 3.
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.
a. DCF APS High Risk individuals: The Contractor shall ensure that pursuant to Section 430.205(5)(a), F.S.,
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 HCE services. As used in this subsection, "primary consideration" means that
an assessment and services must commence within seventy-two (72) hours after referral to the Agency or
as established in accordance with local protocols developed between Agency service contractors and APS.
The Contractor shall follow guidelines for DCF APS High Risk referrals established in the APS
Operations Manual, which is incorporated by reference.
b. For DCF APS Low, Intermediate, and High Risk Referrals for individuals 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 and notifies the DCF APS protective investigator 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.
c. 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.
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HCE 203.17
d. 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
Department when services are not currently available.
e. Service priority for individuals not included in a., c., and d. 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.
3. Program Services
The Contractor shall ensure the provision of program services is consistent with the Contractor's current area
plan, as updated and approved by the Agency and/or Department, and the current DOEA Programs and
Services Handbook.
B. Staffing Requirements
1. Staffing Levels
The Contractor shall dedicate the staff necessary to meet the obligations of this contract and ensure that
subcontractors dedicate adequate staff accordingly.
2. Professional Qualifications
The Contractor shall ensure that the staff responsible for performing any duties or functions within this contract
have the qualifications as specified in the DOEA Programs and Services Handbook.
3. 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 EST.
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 circumstance occurs that may result in a delay
for a period of sixty (60) days or more the initiation of the subcontract or the performance of the Subcontractor,
the Contractor shall notify the Agency's Contract Manager and the Agency's Vice President Financial
Officer in writing of such delay. The Contractor shall not permit a Subcontractor to perform services related
to this contract without having a binding Subcontractor agreement executed. The Agency will not be
responsible or liable for any obligations or claims resulting from such action.
a. Copies of Subcontracts
The Contractor shall submit a copy of all subcontracts to the Contract Manager within thirty (30) days of
the subcontract being executed.
b. 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.
c. Copies of Subcontractor Monitoring Reports
The Contractor shall forward a copy of all subcontractor monitoring reports to the Agency's Contract
Manager within thirty (30) days of the report being issued to the Subcontractors, Subrecipients, Vendors,
and/or Consultants.
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July 2017 —June 2018
C. Deliverables
HCE 203.17
The following section provides the specific quantifiable units of deliverables and source documentation required to
evidence the completion of the tasks specified in this contract.
1. Delivery of Services to Eligible Clients
The Contractor shall ensure the provision of a continuum of services that meets the diverse needs of the
functionally impaired elders and their caregivers. The Contractor shall ensure performance and reporting of
the following services in accordance with the Agency's current Department -approved Area Plan, the current
DOEA Programs and Services Handbook, which is incorporated by reference, and Section II.A.1-3 of
this contract. Documentation of service delivery must include a report consisting of the following: number of
clients served, number of service units provided by service, and rate per service unit with calculations that
equal the total invoice amount. The services include the following categories:
a. Basic Subsidy
The Contractor shall ensure that the Basic Subsidy is a cash payment made to an approved caregiver each
month to reimburse expenses incurred in caring for the client as detailed in II.C. Lb, and the
D O E A Handbook. 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 thirty (30) days or less,
the full Basic Subsidy shall be provided to the caregiver as if the client were in the home.
b. 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.
c. Special Subsidy Services
The Contractor shall ensure that the 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 the following:
1)
Adult Day Care
11) Housing Improvement
2)
Adult Day Health Care
12) Material Aid
3)
Caregiver Training/Support
13) Occupational Therapy
4)
Chore
14) Other
5)
Chore (Enhanced)
15) Outreach
6)
Counseling (Gerontological)
16) Personal Care
7)
Counseling (Mental Health/Screening)
17) Physical Therapy
8)
Home Health Aide Service
18) Respite (Facility Based or In -Home)
9)
Homemaker
19) Skilled Nursing Services
10) Home Delivered Meals
20) Specialized Medical Equipment, Services and
Supplies
21) Speech Therapy
221 Transportation
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d. Access to and Coordination of Services
HCE 203.17
The Contractor shall ensure, through case management and case aide services, that the HCE client's needs
are documented and needed services are planned, arranged and coordinated for the client and caregiver.
2. Service Units
The Contractor shall ensure that the provision of services described in this contract is in accordance with the
current DOEA Programs and Services Handbook and the service tasks described in Section II.A. Service
Rate Report 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
Agency's Area Plan as updated, as shown in the Service Rate Report, and approved by the Agency.
D. Reports
The Contractor shall respond within ten (10) business days to the Agency's request for routine and/or special
requests for information and ad hoc reports. The Contractor must establish due dates for any subcontractors that
permit the Contractor to meet the Agency's reporting requirements.
1. CIRTS Reports
The Contractor shall input HCE-specific data into CIRTS. To ensure CIRTS data accuracy, the Contractor shall
use CIRTS-generated reports which include the following:
a. Client Reports;
b. Monitoring Reports;
c. Services Reports;
d. Miscellaneous Reports;
e. Fiscal Reports;
f. Aging and Disability Resource Center Reports; and
g. Outcome Measurement Reports.
2. Service Cost Reports
a. The Agency shall require the Contractor to submit Annual Service Cost Reports, which reflect actual costs
of providing each service by program. Service Cost Reports for all contracts are due by February 25, 2018
for the prior calendar year.
b. Unit Cost Methodology worksheets must be submitted by August 15 of each year, if a rate increase is being
requested for any contract in the next calendar year.
3. Surplus/Deficit Report
The Contractor shall submit a Consolidated Surplus/Deficit Report Lead Agency Spending Report, in a format
provided by the Agency, to the Agency Contract Manager by the 18th of each month. This Consolidated
Surplus/Deficit Report is for all agreements and contracts between the Contractor and the Agency and must
include the following:
a. Contractor's current status regarding surplus/deficit;
b. The Contractor's detailed plan on how the surplus/deficit spending exceeding the threshold specified by the
Agency will be resolved;
c. Recommendations to transfer funds to resolve surplus/deficit spending;
d. Input from the Agency's Board of Directors on resolution of spending issues, if applicable;
e. Number of clients currently on APCL that receive a priority ranking score of 4 or 5; and
f. Number of clients currently on the APCL designated as Imminent Risk.
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E. Records and Documentation
HCE 203.17
1. The Contractor agrees to make available to Agency staff and/or any party designated by the Agency any
and all contract related records and documentation. The Contractor shall ensure the collection and
maintenance of all program related information and documentation on any such system designated by the
Agency. Maintenance includes valid exports and backups of all data and systems according to Agency
standards.
2. Requests for Payment
The Contractor shall maintain documentation to support Requests for Payment that shall be available to the
Agency or authorized individuals, such as Department of Financial Services, upon request.
3. CIRTS Data and Maintenance
The Contractor shall ensure, on a monthly basis, collection and maintenance of client and service information
in CIRTS or any such system designated by the Agency. Maintenance includes accurate and current data, and
valid exports and backups of all data and systems according to Agency standards.
4. Data Integrity and Back up Procedures
Each Contractor shall anticipate and prepare for the loss of information processing capabilities. The routine
backing up of all data and software is required to recover from losses or outages of the computer system. Data
and software essential to the continued operation of contractor functions must be backed up. The security
controls over the backup resources shall be as stringent as the protection required of the primary resources. It
is recommended that a copy of the backed up data be stored in a secure, offsite location.
5. Policies and Procedures for Records and Documentation
The Contractor shall maintain written policies and procedures for computer system backup and recovery and
shall have the same requirement of its subcontractors. These policies and procedures shall be made available
to the Agency upon request.
F. Performance Specifications
1. Outcomes and Outputs (Performance Measures)
The Contractor must:
a. Ensure the prioritization and service provision of clients in accordance with Section II.A.1-2. of this
contract;
b. Ensure the provision of the services described in this contract are in accordance with the current
D O E A Programs and Services Handbook and Section 1I.13 of this contract;
c. Timely and accurately submit to the Agency all required documentation and reports described in
Section II.E; and
d. Timely (in accordance with ATTACHMENT VIII) and accurately submit ATTACHMENTS IX,
and ATTACHMENT X, and supporting documentation.
2. Monitoring and Evaluation Methodology
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, and/or
on-site visit(s). 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:
a. Desk reviews and analytical reviews;
b. Scheduled, unscheduled, and follow-up on-site visits;
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July 2017 — June 2018
c. Client visits;
d. Review of independent auditor's reports;
e. Review of third -party documents and/or evaluation;
L Review of progress reports;
g. Review of customer satisfaction surveys;
h. Agreed-upon procedures review by an external auditor or consultant;
i. Limited -scope reviews; and
j. Other procedures as deemed necessary.
G. Contractor Responsibilities
1. Contractor Accountability
HCE 203.17
All service tasks and deliverables pursuant to this contract are solely and exclusively the responsibility of the
Contractor and for which, by execution of this contract, the Contractor agrees to be held accountable.
2. Coordination with Other Providers and/or Entities
Notwithstanding that services for which the Contractor is held accountable involve coordination with other
entities in performing the requirements of the contract, the failure of other entities does not alleviate the
Contractor from any accountability for tasks or services that the Contractor is obligated to perform pursuant to
this contract.
H. Agency Responsibilities
1. Agency Obligations
The Agency may provide technical support and assistance to the Contractor within the resources of the
Agency to assist the Contractor in meeting the required tasks in the above Section II. The support and
assistance, or lack thereof, shall not relieve the Contractor from full performance of contract requirements.
Agency Determinations
The Agency reserves the exclusive right to make certain determinations in the tasks and approaches. The
absence of the Agency setting forth a specific reservation of rights does not mean that all other areas of the
contract are subject to mutual agreement.
III. METHOD OF PAYMENT
A. Payment Methods Used
The Method of Payment for this contract is a combination of fixed-fee/unit rate, cost reimbursement, and advance
payments, subject to the availability of funds and Contractor performance. The Agency will pay the Contractor
upon satisfactory completion of the Tasks/Deliverables, as specified in Section II, Manner of Service Provision,
and in accordance with other terms and conditions of the contract.
1. Fixed Fee/Unit Rate
Payments for Fixed Fee/Unit Rate shall not exceed amounts established in ATTACHMENT XI.
2. Cost Reimbursement
Payment may be authorized only for allowable expenditures, which are in accordance with the services specified
in ATTACHMENT X I. All Cost Reimbursement m u s t i n c l u d e Requests for Payment
(ATTACHMENT IX) and the Receipt and Expenditure Report (ATTACHMENT X), beginning with the
first month of the contract.
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HCE 203.17
3. Caregiver Direct Deposit Payment
All enrolled caregivers will receive payment via direct deposit. Any client, whose caregiver is not set up for
direct deposit after one (1) month of enrollment, will not be eligible to receive HCE services.
Advance Payments
The Contractor may request up to two (2) 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's requests for advance require the approval of the Area Agency Contract Manager. The Contractor
shall provide the Area Agency Contract Manager documentation justifying the need for an advance and
describing how the funds will be distributed. If sufficient budget is available, the Agency will issue
approved advanced payments after July 1 st of the contract year.
a. Any advanced payments the Contractor requested for subcontractors must be distributed within seven days
of receipt of payment from the Agency. The Contractor shall submit to the Agency documentation to
support full distribution of advanced funds with report number 5, due to the Agency on October 9, 2017,
in accordance with the Invoice Report Schedule.
b. All advanced payments retained by the Contractor must be fully expended no later than September 30,
2017. Any portion of advanced payments not expended must be recouped on the Invoice Schedule, report
number 5, due to the Department on October 9, 2017, in accordance with the Invoice Report Schedule.
c. All advance payments made to the Contractor shall be reimbursed to the Agency as follows: At least
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.
B. Method of Invoice Payment
Payment shall be made upon the Contractor's presentation of an invoice subsequent to the acceptance and approval
by the Agency of the deliverables shown on the invoice. The form and substance of each invoice submitted by the
Contractor shall be as follows:
1. Have a Remittance Address that corresponds exactly to the "Remit To" address provided to MFMP during
registration;
2. Request payment on a monthly basis for the units of services established in the Agency's approved Area
Plan, provided in conformance with the requirements as described in the DOEA Programs and Services
Handbook, at the rates established in Service Rate Report of the contract. Documentation of service delivery
must include a report consisting of the following: number of clients served, number of service units
provided by service, and rate per service unit with calculations that equal the total invoice amount. Any
requested changes to the approved budget subsequent to the execution of the contract, must be submitted to
the Contract Manager for approval. Any change to the total contract amount requires a formal amendment;
3. The Contractor shall consolidate all subcontractors' Requests for Payment and Expenditure Reports that support
Requests for Payment and shall submit to the Agency using the attached Request for Payment form, Receipt
and Expenditure Report for services, which must include itemized expenditure categories; and
4. All Requests for Payment shall be based on the submission of monthly Expenditure Reports beginning with
the first month of the contract. The schedule for submission of advance requests (when available) and
invoices is Invoice Schedule.
C. 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.
D. Final Invoice Instructions
The Contractor shall submit the final Request for Payment to the Agency no later than July 25, 2018.
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HCE 203.17
E. HCE Subsidy Data Entries Schedule
The Contractor must ensure all data for HCE subsidies are entered in 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 including billing up to the 15th of the current month. The Contractor shall ensure data
entry for HCE subsidies will cease on the 15th of the month and the CIRTS Monthly Service Utilization Report, by
consumer and by worker identification is generated. The Contractor shall ensure the Monthly Utilization Report by
consumer and by worker identification is verified, corrected, and certified no later than the 20th of the month in
which the Report is generated. (Case management data entered into CIRTS by the entered prior to the 9th of the
month shall be for units of service provided during the previous billing month from the I` and up to and including
the last day of the previous month and also entered before submitting billing reports which are due by the 91h of
each month)
F. CIRTS Data Entries for Subcontractors
The Contractor must enter all required data for clients and services in 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, CAV and CMV for the previous month's
billing, no later than the 9"' of each month into CIRTS prior to submitting their requests for payment and
expenditure reports to the Agency. When the Area Agency requests backup documentation,
the Contractor must submit billing receipts over $150 (total for the month).
G. Time Limits
Upon request from the Area Agency, the caregiver must submit the receipts to the case manager within 30 days.
Caregivers will be reimbursed within 60 days of submitting the original receipt to the Contractor. The receipts
must be less than 60 days.
H. Contractors' Monthly CIRTS Reports
The Agency must require Contractors to run monthly CIRTS reports and verify client and service data in the
CIRTS is accurate. This report must be submitted to the Agency with the monthly Request for Payment and
Expenditure Report and must be reviewed by the Agency before the Contractor's Request for Payment and
Expenditure Reports can be approved by the Agency.
I. Corrective Action Plan
1. Contractor shall ensure 100% of the deliverables identified in Section II.C.1-3 of this contract, are performed
pursuant to contract requirements.
2. If at any time the Contractor is notified by the Area Agency Contract Manager that it has failed to
correctly, completely, or adequately perform contract deliverables identified in Section II.C.1-3 of this
contract, the Contractor will have ten (10) days to submit a Corrective Action Plan ("CAP") to the Area
Agency Contract Manager that addresses the deficiencies and states how the deficiencies will be remedied
within a time period approved by the Area Agency Contract Manager. The Agency shall assess a Financial
Consequence for Non -Compliance on the Contractor as referenced in Section III.J. of this contract 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. If the Contractor fails to correct an identified deficiency within the approved time period specified in the CAP,
the Agency shall deduct the percentage established in Section III.J. of this contract from the payment for the
invoice of the following month.
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HCE 203.17
4. If Contractor fails to timely submit a CAP, the Agency shall deduct the percentage established in Section
III.J. of this contract for each day the CAP is overdue. The deduction will be made from the payment for the
invoice of the following month.
J. Financial Consequences
1. The Agency will withhold or reduce payment if the Contractor fails to perform the deliverables to the
satisfaction of the Agency according to the requirements referenced in Section II.0 of this contract. The
following financial consequences will be imposed if the deliverables stated do not meet in part or in whole the
performance criteria as outlined in Section II. C. of this contract.
2. Delivery of services to eligible clients as referenced in Section II.A.1-2 and Section II.C.1 of this contract —
Failure to comply with established assessment and prioritization criteria, as evidenced by CIRTS reports, will
result in a 2% reduction of payment per business day. The reduction of payment will begin on the first business
day following the Agency's notification to the Contractor that the identified deficiency was not cured or
satisfactorily addressed in accordance with the Agency -approved CAP, referenced in Section III.I.
3. Timely submission of a CAP — Failure to timely submit a CAP within ten (10) business days after notification
of a deficiency by the Area Agency Contract Manager will result in a 2% reduction of payment per business
day the CAP is not received. The reduction of payment will begin the first business day following the
Agency's notification to the Contractor that the identified deficiency was not cured or satisfactorily
addressed in accordance with the Agency approved CAP, referenced in Section ILLI.
4. Exceptions may be granted solely, in writing, by the contract manager.
II. SPECIAL PROVISIONS
A. Final Budget and Funding Revision Requests
Final requests for budget revisions or adjustments to contract funds based on expenditures for provided services
must be submitted to the Area Agency Contract Manager in writing no later than June 25, 2018; email requests
are considered acceptable.
B. Contractor's Financial Obligations
1. Use of Service Dollars and Management of the Assessed Priority Consumer List
The Contractor is expected to spend all funds provided by the Agency for the purpose specified in this
contract. The Contractor must manage the service dollars in such a manner so as to avoid having a wait list and
a surplus of funds at the end of the contract period. If the Agency determines that the Contractor is not
spending service funds accordingly, the Agency and/or DOEA may transfer funds to other AAAs during
the contract period and/or adjust subsequent funding allocations accordingly, as allowable under state and
federal law.
C. Remedies for Nonconforming Services
1. 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 will only be
delivered to eligible program participants.
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HCE 203.17
2. 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.
D. Investigation of Criminal Allegations:
Any report that implies criminal intent on the part of the Contractor or any Subcontractors and referred to a
governmental or investigatory agency must be sent to the Agency. If the Contractor has reason to believe that the
allegations will be referred to the State Attorney, a law enforcement agency, the United States Attorney's office, or
other governmental agency, the Contractor shall notify the Inspector General at the Agency immediately. A copy
of all documents, reports, notes or other written material concerning the investigation, whether in the
possession of the Contractor or Subcontractors, must be sent to the Agency's and/or the Department's Inspector
General with a summary of the investigation and allegations.
E. Volunteers:
III. If applicable, the Contractor shall ensure the use of trained volunteers in providing direct services delivered to
older individuals and individuals with disabilities needing such services. If possible, the Contractor shall work in
coordination with organizations that have experience in providing training, placement, and stipends for
volunteers or participants (such as organizations carrying out federal service programs administered by the
Corporation for National and Community Service), in community service settings.
F. Enforcement
1. In accordance with Section 430.04, F.S., the Agency may, without taking any intermediate measures
available to it against the Contractor, rescind the Contractors designation as a lead agency, if the Agency finds
that any of the following have occurred:
a. An intentional or negligent act of the Contractor has materially affected the health, welfare, or safety of
clients served, or substantially and negatively affected the operation of services covered pursuant to this
contract.
b. The Contractor lacks financial stability sufficient to meet contractual obligations or that contractual funds
have been misappropriated.
c. Contractor has committed multiple or repeated violations of legal and regulatory requirements regardless
of whether such laws or regulations are enforced by the Agency, or the Contractor has committed
multiple or repeated violations of Agency standards.
d. The Contractor has failed to continue the provision or expansion of services after the declaration of a state
of emergency.
e. The Contractor has failed to adhere to the terms of this contract.
L The Agency may, at its sole discretion, in accordance with Section 430.04, F.S., take immediate
measures against the Contractor, including: Corrective action, unannounced special monitoring, temporary
assumption of the operation of one or more contractual services, placement of the Contractor on
probationary status, imposing a moratorium on Contractor action, imposing financial penalties for
nonperformance, or other administrative action pursuant to Chapter 120, F.S.
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HCE 203.17
g. In making any determination under this provision the Agency may rely upon findings of another state or
federal agency, or other regulatory body. Any claims for damages for breach of contract are exempt
from administrative proceedings and shall be brought before the appropriate entity in the venue of Lee
County. In the event the Agency initiates action to rescind an area agency on aging designation, the
Agency shall follow the procedures set forth in 42 U.S.C. 3025(b).
END OFATTA CHMENT
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July 2017 — June 2018
ATTACHMENT II
FINANCIAL AND COMPLIANCE AUDIT
HCE 203.17
The administration of resources awarded by the Agency to the Contractor may be subject to audits and/or monitoring by
the Area Agency on Aging for Southwest Florida, Inc., as described in this section.
IuT[�7`►1 it IG7�1`►C11
In addition to reviews of audits conducted in accordance with 2 CFR Part 200 (formerly OMB Circular A-133 as revised),
and Section 215.97, F.S., (see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits
by the Agency and/or Department staff, limited scope audits as defined by OMB Circular A-133, as revised, and/or other
procedures. By entering into this agreement, the Contractor agrees to comply and cooperate with any monitoring
procedures/processes deemed appropriate by the A g e n c y a n d/ o r Department. In the event the A g e n c y a n d/ o r
Department determines that a limited scope audit of the Contractor is appropriate, the Contractor agrees to comply
with any additional instructions provided by the Agency and/or Department to the Contractor regarding such audit.
The Contractor further agrees to comply and cooperate with any inspections, reviews, investigations, or audits deemed
necessary by the Agency's Vice President of Finance.
AUDITS
PART L• FEDERALLY FUNDED
This part is applicable if the Contractor is a State or local government or a non-profit organization as defined in 2 CFR
Part 200, Subpart A.
In the event that the Contractor expends $750,000.00 or more in federal awards during its fiscal year, the Contractor must
have a single or program -specific audit conducted in accordance with the provisions of 2 CFR Part 200. EXHIBIT 2 to
this agreement indicates federal resources awarded through the Agency by this agreement. In determining the federal awards
expended in its fiscal year, the Contractor shall consider all sources of Federal awards, including federal resources
received from the Agency. The determination of amounts of Federal awards expended should be in accordance with 2
CFR Part 200. An audit of the Contractor conducted by the Auditor General in accordance with the provisions of 2 CFR
Part 200 will meet the requirements of this part.
In connection with the audit requirements addressed in Part I, paragraph 1, the Contractor shall fulfill the requirements
relative to auditee responsibilities as provided in 2 CFR §200.508.
If the Contractor expends less than $750,000.00 in federal awards in its fiscal year, an audit conducted in accordance with
the provisions of 2 CFR Part 200 is not required. In the event that the Contractor expends less than $750,000.00 in federal
awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of 2 CFR Part 200 the
cost of the audit must be paid from non-federal resources (i.e., the cost of such audit must be paid from Contractor
resources obtained from other than federal entities.)
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Agency shall be based on the agreement's requirements, including any
rules, regulations, or statutes referenced in the agreement. The financial statements shall disclose whether or not the
matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the Agency
shall be fully disclosed in the audit report with reference to the Area Agency on Aging for Southwest Florida, Inc.
agreement involved. If not otherwise disclosed as required by 2 CFR §200.510 the schedule of expenditures of federal
awards shall identify expenditures by agreement number for each agreement with the Agency in effect during the audit
period. Financial reporting packages required under this part must be submitted within the earlier of 30 days after receipt
of the audit report or 9 months after the end of the Contractor's fiscal year end.
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July 2017 — June 2018 HCE 203.17
PART II: STATE FUNDED
This part is applicable if the Contractor is a non state entity as defined by Section 215.97(2), F.S.
In the event that the Contractor expends a total amount of state financial assistance equal to or in excess of $750,000.00
in any fiscal year of such Contractor, the Contractor must have a State single or project -specific audit for such fiscal
year in accordance with Section 215.97, F.S.; applicable rules of the Department of Financial Services; and Chapters
10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General.
EXHIBIT 2 to this agreement indicates state financial assistance awarded through the Agency by this agreement. In
determining the state financial assistance expended in its fiscal year, the Contractor shall consider all sources of state
financial assistance, including state financial assistance received from the Agency, other state agencies, and other
nonstate entities. State financial assistance does not include Federal direct or pass-through awards and resources
received by a nonstate entity for Federal program matching requirements.
In connection with the audit requirements addressed in Part II, paragraph 1, the Contractor shall ensure that the audit
complies with the requirements of Section 215.97(8), F.S. This includes submission of a financial reporting package as
defined by Section 215.97(2), F.S., and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit
organizations), Rules of the Auditor General.
If the Contractor expends less than $750,000.00 in state financial assistance in its fiscal year, an audit conducted in
accordance with the provisions of Section 215.97, F.S., is not required. In the event that the Contractor expends less than
$750,000.00 in state financial assistance in its fiscal year and elects to have an audit conducted in accordance with the
provisions of Section 215.97, F.S., the cost of the audit must be paid from the nonstate entity's resources (i.e., the cost of
such an audit must be paid from the Contractor resources obtained from other than State entities).
An audit conducted in accordance with this pant shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Agency shall be based on the agreement's requirements, including any
applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching
requirement was met for each applicable agreement. All questioned costs and liabilities due to the Agency shall be fully
disclosed in the audit report with reference to the Agency agreement involved. If not otherwise disclosed as required by
Rule 69I-5.003, F.A.C., the schedule of expenditures of state financial assistance shall identify expenditures by
agreement number for each agreement with the Agency in effect during the audit period. Financial reporting packages
required under this part must be submitted within 45 days after delivery of the audit report, but no later than 12 months after
the Contractor's fiscal year end for local governmental entities. Non-profit or for-profit organizations are required to
be submitted within 45 days after delivery of the audit report, but no later than 9 months after the Contractor's fiscal year
end. Notwithstanding the applicability of this portion, the Agency retains all right and obligation to monitor and oversee
the performance of this agreement as outlined throughout this document and pursuant to law.
PART III: REPORT SUBMISSION
Copies of reporting packages for audits conducted in accordance with 2 CFR Part 200 and required by PART I of this
agreement shall be submitted, when required by 2 CFR §200.512 by or on behalf of the Contractor directly to each of
the following:
The Area Agency on Aging for Southwest Florida, Inc.at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Tammy Rhoades, VP of Finance
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
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July 2017 — June 2018 HCE 203.17
For fiscal year 2013 and earlier to the Federal Audit Clearinghouse designated in 2 CFR §200.36 at the following address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 101h Street
Jeffersonville, IN 47132
For fiscal year 2014 and later, pursuant to 2 CFR §200.512, the reporting package and the data collection form must be
submitted electronically to the Federal Audit Clearinghouse.
Pursuant to 2 CFR §200.512, all other Federal agencies, pass-through entities and others interested in a reporting package
and data collection form must obtain it by accessing the Federal Audit Clearinghouse.
The Contractor shall submit a copy of any management letter issued by the auditor, to the Area Agency on Aging for
Southwest Florida, Inc.at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Tammy Rhoades, VP of Finance
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
Additionally, copies of financial reporting packages required by PART II of this agreement shall be submitted by or on
behalf of the Contractor directly to each of the following:
The Area Agency on Aging for Southwest Florida, Inc.at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Tammy Rhoades, VP of Finance
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
The Auditor General's Office at the following address:
State of Florida Auditor General
Claude Pepper Building, Room 574
111 West Madison Street
Tallahassee, Florida 32399-1450
Any reports, management letter, or other information required to be submitted to the Agency pursuant to this agreement
shall be submitted timely in accordance with 2 CFR Part 200, Florida Statutes, and Chapters 10.550 (local governmental
entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, as applicable.
Contractors, when submitting financial reporting packages to the Agency for audits done in accordance with 2 CFR Part
200 or Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor
General, should indicate the date that the reporting package was delivered to the Contractor in correspondence
accompanying the reporting package.
PART IV: RECORD RETENTION
The Contractor shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period
of six (6) years from the date the audit report is issued, and shall allow the Agency or its designee, the CFO or Auditor
General access to such records upon request. The Contractor shall ensure that audit working papers are made available to
the Agency or its designee, Agency Vice President of Finance, or Auditor General upon request for a period of six (6) years
from the date the audit report is issued, unless extended in writing by the Agency.
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July 2017 — June 2018
EXHIBIT I
PART I: AUDIT RELATIONSHIP DETERMINATION
HCE 203.17
Contractors who receive state or federal resources may or may not be subject to the audit requirements of 2 CFR Part 200
and/or Section 215.97, F.S. Contractors who are determined to be recipients or sub -recipients of federal awards and/or
state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I
and/or Part II of Exhibit 1 are met. Contractors who have been determined to be vendors are not subject to the audit
requirements of 2 CFR §200.38, and/or Section 215.97, F.S. Regardless of whether the audit requirements are met,
Contractors who have been determined to be recipients or sub -recipients of Federal awards and/or state financial
assistance must comply with applicable programmatic and fiscal compliance requirements.
In accordance with 2 CFR Part 200 and/or Rule 69I-5.006, FAC, Contractor has been determined to be:
Vendor not subject to 2 CFR §200.38 and/or Section 215.97, F.S.
X Recipient/sub-recipient subject to 2 CFR §200.86 and §200.93 and/or Section 215.97, F.S.
Exempt organization not subject to 2 CFR Part 200 and/or Section 215.97, F.S. For Federal awards, for-profit
organizations are exempt; for state financial assistance projects, public universities, community colleges, district
school boards, branches of state (Florida) government, and charter schools are exempt. Exempt organizations must
comply with all compliance requirements set forth within the contract or award document.
NOTE: If a Contractor is determined to be a recipient/sub-recipient of federal and or state financial assistance and has
been approved by the Agency to subcontract, they must comply with Section 215.97(7), F.S., and Rule 69I-5.006,
F.A.C. [state financial assistance] and 2 CFR §200.3 3 0 [federal awards].
PART H: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Contractors who receive
Federal awards, state maintenance of effort funds, or state matching funds on Federal awards and who are determined to
be a sub- recipient must comply with the following fiscal laws, rules and regulations:
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR §200.416 - §200.417 — Special Considerations for States, Local Governments and Indian Tribes*
2 CFR §200.201 — Administrative Requirements**
2 CFR §200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
NON-PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR §200.400 - §200.411 — Cost Principles*
2 CFR §200.100 — Administrative Requirements
2 CFR §200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT)
MUST FOLLOW:
2 CFR §200.418 — §200.419 — Special Considerations for Institutions of Higher Education*
2 CFR §200.100 — Administrative Requirements
2 CFR §200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
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HCE 203.17
*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in 2 CFR
§200.400(5) (c).
**For funding passed through U.S. Health and Human Services, 45 CFR 75; for funding passed through U.S.
Department of Education, 34 CFR 80.
STATE FINANCIAL ASSISTANCE. Contractors who receive state financial assistance and who are determined to be
a recipient/sub-recipient must comply with the following fiscal laws, rules and regulations:
Section 215.97, F.S.
Chapter 69I-5, F.A.C.
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
34
July 2017 — June 2018 HCE 203.17
EXHIBIT 2
FUNDING SUMMARY
Note: Title 2 CFR & 2 CFR Pant 200, as revised, and Section 215.97(5), F.S. require that the information about Federal
Programs and State Projects included in Exhibit 1 be provided to the recipient. Information contained herein is a
prediction of funding sources and related amounts based on the contract budget.
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT
CONSIST OF THE FOLLOWING:
GRANT AWARD (FAIN#): FEDERAL AWARD DATE:
DUNS NUMBER: 833441814
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT
TO THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS:
2 CFR Part 200 — Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards.
OMB Circular A-133 — Audits of States, Local Governments, and Non -Profit Organizations
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF
THE FOLLOWING:
MATCHYN(, RFgnTTRCVR FOR FFT)FRA1, PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD
STATE FINANCIAL ASSISTANCE SUBJECT TO Sec. 215.97, F.S
PROGRAM TITLE FUNDING SOURCE CSFA
AMOUNT
Home Care for the Elderly General Revenue -Collier 65001
$ 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, F.S., Chapter 691-5, F.A.C, State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
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July 2017 — June 2018 HCE 203.17
ATTACHMENT III
CERTIFICATIONS AND ASSURANCES
will not award this Contract unless Contractor completes this CERTIFICATIONS AND ASSURANCES. In
performance of this contract, Contractor provides the following certifications and assurances:
A. Debarment and Suspension Certification (29 CFR Part 95 and 45 Part 75)
B. Certification Regarding Lobbying (29 CFR Part 93 and 45 CFR Part 93)
C. Nondiscrimination & Equal 01111ortunily Assurance (29 CFR Part 37 and 45 CFR Part 80)
D. g_ Public
E. Association of CommunilX Organizations for Reform Now (ACORN) Funding Restrictions Assurance (Pub.
L. 111-117)
F. Certification Regarding Scrutinized Companies Lists, Section 287.135. F.S.
G. Certification Regarding Data Integrily Compliance For Agreements Grants, Loans And Cooperative
Agreements
H. Verification of EmUlvment Status Certification
I. Certification Regarding Inspection of Public Records
A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY
MATTERS — PRIMARY COVERED TRANSACTION.
The undersigned Contractor certifies to the best of its knowledge and belief, that it and its principals:
1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
covered transactions by a Federal department or agency;
2. Have not within a three-year period preceding this Contract been convicted or had a civil judgment rendered against
them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing
a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State
antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records,
making false statements, or receiving stolen property;
3. Are not presently indicted or otherwise criminally or civilly charged by a government entity (Federal, State or local)
with commission of any of the offenses enumerated in paragraph A.2. of this certification; and/or
4. Have not within a three-year period preceding this application/proposal had one or more public transactions
(Federal, State, or local) terminated for cause of default.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants and contracts under grants, loans and cooperative agreements) and that all sub
recipients and contractors shall provide this certification accordingly.
B. CERTIFICATION REGARDING LOBBYING — Certification for Contracts, Grants, Loans, and Cooperative
Agreements.
The undersigned Contractor certifies, to the best of its knowledge and belief, that:
No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of Congress, or an employee of a Member of Congress in
connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan,
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HCE 203.17
the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification
of any Federal contract, grant, loan or cooperative agreement.
If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of
Congress, or employee of a Member of Congress in connection with a Federal contract, grant, loan, or cooperative
agreement, the undersigned shall also complete and submit Standard Form — LLL, "Disclosure Form to Report
Lobbying," in accordance with its instructions.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants and contracts under grants, loans and cooperative agreements) and that all sub -
recipients and contractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this Contract was made or
entered into. Submission of this certification is a prerequisite for making or entering into this Contract imposed by 31
U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than
$10,000 and not more than $100,000 for each such failure.
C. NON DISCRIMINATION & EQUAL OPPORTUNITY ASSURANCE (29 CFR PART 37 AND 45 CFR PART
80). - As a condition of the Contract, Contractor assures that it will comply fully with the nondiscrimination and equal
opportunity provisions of the following laws:
1. Section 188 of the Workforce Investment Act of 1998 (WIA), (Pub. L. 105-220), which prohibits discrimination
against all individuals in the United States on the basis of race, color, religion, sex national origin, age, disability,
political affiliation, or belief, and against beneficiaries on the basis of either citizenship/status as a lawfully admitted
immigrant authorized to work in the United States or participation in any WIA Title I -financially assisted program
or activity.
2. Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352), as amended, and all requirements imposed by or pursuant
to the Regulation of the Department of Health and Human Services (45 CFR Part 80), to the end that, in accordance
with Title VI of that Act and the Regulation, no person in the United States shall, on the ground of race, color, or
national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to
discrimination under any program or activity for which the Applicant receives Federal financial assistance from the
Department and/or Agency.
3. Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112) as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 84), to the end that, in
accordance with Section 504 of that Act, and the Regulation, no otherwise qualified handicapped individual in the
United States shall, solely by reason of his handicap, be excluded from participation in, be denied the benefits of,
or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial
assistance from Agency.
4. The Age Discrimination Act of 1975 (Pub. L. 94-135), as amended, and all requirements imposed by or pursuant
to the Regulation of the Department of Health and Human Services (45 CFR Part 91), to the end that, in accordance
with the Act and the Regulation, no person in the United States shall, on the basis of age, be denied the benefits of,
be excluded from participation in, or be subjected to discrimination under any program or activity for which the
Applicant receives Federal financial assistance from the Agency.
5. Title IX of the Education Amendments of 1972 (Pub. L. 92-318), as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 86), to the end that, in
accordance with Title IX and the Regulation, no person in the United States shall, on the basis of sex, be excluded
from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any education
program or activity for which the Applicant receives Federal financial assistance from the Agency.
6. The American with Disabilities Act of 1990 (Pub. L. 101-336), which prohibits discrimination in all employment
practices, including, job application procedures, hiring, firing, advancement, compensation, training, and other
terms, conditions, and privileges of employment. It applies to recruitment, advertising, tenure, layoff, leave, fringe
benefits, and all other employment-related activities.
Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws listed
above. This assurance applies to Contractor's operation of the WIA Title I — financially assisted program or activity,
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HCE 203.17
and to all agreements Contractor makes to cavy out the WIA Title I — financially assisted program or activity.
Contractor understands that Agency and/or and the United States have the right to seek judicial enforcement of the
assurance. The undersigned shall require that language of this assurance be included in the documents for all
subcontracts at all tiers (including subcontracts, sub -grants and contracts under grants, loans and cooperative
agreements) and that all sub recipients and contractors shall provide this assurance accordingly.
D. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES, SECTION 287.133, F.S.
Contractor hereby certifies that neither it, nor any person or affiliate of Contractor, has been convicted of a Public Entity
Crime as defined in Section 287.133, F.S., nor placed on the Convicted Vendor List.
Contractor understands and agrees that it is required to inform Area Agency and immediately upon any change of
circumstances regarding this status.
E. ASSOCIATION OF COMMUNITY ORGANIZATIONS FOR REFORM NOW (ACORN) FUNDING
RESTRICTIONS ASSURANCE (Pub. L. 111-117).
As a condition of the Contract, Contractor assures that it will comply fully with the federal funding restrictions
pertaining to ACORN and its subsidiaries per the Consolidated Appropriations Act, 2010, Division E, Section 511 (Pub.
L. 111-117). The Continuing Appropriations Act, 2011, Sections 101 and 103 (Pub. L. 111-242), provides that
appropriations made under Pub. L. 111-117 are available under the conditions provided by Pub. L. 111-117.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants and contracts under grants, loans and cooperative agreements) and that all sub
recipients and contractors shall provide this assurance accordingly.
F. SCRUTINIZED COMPANIES LISTS CERTIFICATION, SECTION 287.135, F.S.
G. If this Contract is in the amount of $1 million or more, in accordance with the requirements of Section 287.135, F.S.,
Contractor hereby certifies that it is not participating in a boycott of Israel, is not listed on either the Scrutinized
Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy
Sector List, and that it does not have business operations in Cuba or Syria. Both lists are created pursuant to Section
215.473, F.S.
Contractor understands that pursuant to Section 287.135, F.S., the submission of a false certification may subject
Contractor to civil penalties, attorney's fees, and/or costs.
If Contractor is unable to certify any of the statements in this certification, Contractor shall attach an explanation to
this Contract.
H. CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS,
LOANS AND COOPERATIVE AGREEMENTS
1. The Contractor and any Subcontractors of services under this contract have financial management systems
capable of providing certain information, including: (1) accurate, current, and complete disclosure of the financial
results of each grant -funded project or program in accordance with the prescribed reporting requirements; (2) the
source and application of funds for all agreement supported activities; and (3) the comparison of outlays with
budgeted amounts for each award. The inability to process information in accordance with these requirements
could result in a return of grant funds that have not been accounted for properly.
2. Management Information Systems used by the Contractor, Subcontractors, or any outside entity on which the
Contractor is dependent for data that is to be reported, transmitted or calculated, have been assessed and verified
to be capable of processing data accurately, including year -date dependent data. For those systems identified to be
non-compliant, Contractors will take immediate action to assure data integrity.
3. If this contract includes the provision of hardware, software, firmware, microcode or imbedded chip technology,
the undersigned warrants that these products are capable of processing year -date dependent data accurately. All
versions of these products offered by the Contractor (represented by the undersigned) and purchased by the state
will be verified for accuracy and integrity of data prior to transfer.
9.1
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HCE 203.17
4. In the event of any decrease in functionality related to time and date related codes and internal subroutines that
impede the hardware or software programs from operating properly, the Contractor agrees to immediately make
required corrections to restore hardware and software programs to the same level of functionality as warranted
herein, at no charge to the state, and without interruption to the ongoing business of the state, time being of the
essence.
5. The Contractor and any Subcontractors of services under this contract warrant their policies and procedures
include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies
arising from data integrity compliance issues.
I. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION
As a condition of contracting with the Area Agency on Aging for Southwest Florida, Inc., Contractor certifies the use
of the U.S. Department of Homeland Security's E -verify system to verify the employment eligibility of all new
employees hired by Contractor during the contract term to perform employment duties pursuant to this contract and
that any subcontracts include an express requirement that Subcontractors performing work or providing services
pursuant to this Agreement utilize the E -verify system to verify the employment eligibility of all new employees
hired by the Subcontractor during the entire contract term.
The Contractor shall require that the language of this certification be included in all sub -agreements, sub -grants, and
other agreements and that all Subcontractors shall certify compliance accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made
or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed
by Circulars A-102 and 2 CFR Part 200, and 215 (formerly OMB Circular A-110).
III. RECORDS AND DOCUMENTATION
The Contractor agrees to make available to Agency staff and/or any party designated by the Agency any and all
contract related records and documentation. The Contractor shall ensure the collection and maintenance of all
program related information and documentation on any such system designated by the Agency. Maintenance includes
valid exports and backups of all data and systems according to Agency standards.
J. CERTIFICATION REGARDING INSPECTION OF PUBLIC RECORDS
1. In addition to the requirements of Sections 10. 1, 10.2 of the Standard Contract, and 119.0701(3) and (4) F.S., and any other
applicable law, if a civil action is commenced as contemplated by Section 119.0701(4), F.S., and the Agency is named in
the civil action, Contractor agrees to indemnify and hold harmless the Agency for any costs incurred by the
Agency, and any attorneys' fees assessed or awarded against the Agency from a Public Records Request made
pursuant to Chapter 119, F.S., concerning this contract or services performed thereunder.
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HCE 203.17
2. Section 119.01(3), F.S., states if public funds are expended by an agency in payment of dues or membership contributions
for any person, corporation, foundation, trust, association, group, or other organization, all the financial, business, and
membership records of such an entity which pertain to the public agency (Area Agency on Aging for Southwest
Florida, Inc.) are public records. Section 119.07, F.S, states that every person who has custody of such a public record
shall permit the record to be inspected and copied by any person desiring to do so, under reasonable circumstances.
Additionally, I certify this organization does does not
provide for institutional memberships.
Contractor's signature below attests that records pertaining to the dues or membership application by the Agency are
available for inspection as stated above.
By execution of this agreement, Contractor must include these provisions in all related subcontract agreements (if applicable).
By execution of this agreement, Contractor must include these provisions (A -I) in all related subcontract agreements (if
applicable). y signi , below, Con actor ce ifies the representations outlined in parts A through I above, are true and correct.
3339 East Tamiami Trail, Suite 211
(Signature and itle of A&horized Representative) (Street Address)
Collier County Burd of County C;ommissiou-s-,�
(Contractor) (llate)
Naples. FL 34112
40
(City, State, ZIP code)
July 2017 – June 2018
ATTACHMENT IV
ASSURANCES—NON-CONSTRUCTION PROGRAMS
HCE 203.17
Public reporting burden for this collection of information is estimated to average forty-five (45) minutes per response, including time
for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing
the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348-0043),
Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND
BUDGET, SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions please
contact the awarding agency. Further, certain federal awarding agencies may require applicants to certify to
additional assurances. If such is the case, you will be notified.
1) Has the legal authority to apply for federal assistance, and the institutional, managerial and financial capability
(including funds sufficient to pay the non-federal share of project cost) to ensure proper planning, management, and
completion of the project described in this application.
2) Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the state, through any
authorized representative, access to and the right to examine all records, books, papers, or documents related to the
award; and will establish a proper accounting system in accordance with generally accepted accounting standards or
agency directives.
3) Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the
appearance of personal or organizational conflict of interest, or personal gain.
4) Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
5) Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §4728-4763) relating to prescribed standards
for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's
Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).
6) Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of
the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin;
(b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §1681-1683, and 1685-1686), which
prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C.
§794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended
(42 U.S.C. §6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment
Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive
Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended,
relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §523 and 527 of the Public Health Service
Act of 1912 (42 U.S.C. §290 dd-3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug abuse
patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §3601 et seq.), as amended, relating to
nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific
statute(s) under which application for federal assistance is being made; and 0) the requirements of any other
nondiscrimination statute(s) which may apply to the application.
7) Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance
and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of
persons displaced or whose property is acquired as a result of federal or federally assisted programs. These requirements
apply to all interests in real property acquired for project purposes regardless of federal participation in purchases.
41
July 2017 — June 2018 HCE 203.17
8) Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. §1501-1508 and 7324-7328), which limit
the political activities of employees whose principal employment activities are funded in whole or in part with federal
funds.
9) Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C. §276a to 276a-7), the Copeland Act
(40 U.S.C. 276c and 18 U.S.C. §874) and the Contract Work Hours and Safety Standards Act (40 U.S.C. §327-333),
regarding labor standards for federally assisted construction sub -agreements.
10) Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the
program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or
more.
11) Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and
Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of
project consistency with the approved State management program developed under the Coastal Zone Management Act
of 1972 (16 U.S.C. §1451 et seq.); (f) conformity of federal actions to State (Clear Air) Implementation Plans under
Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. §7401 et seq.); (g) protection of underground
sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h) protection
of endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93-205).
12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §1721 et seq.) related to protecting components
or potential components of the national wild and scenic rivers system.
11) Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of
1966, as amended (16 U.S.C. §470), EO 11593 (identification and protection of historic properties), and the
Archaeological and Historic Preservation Act of 1974 (16 U.S.C. §469a-1 et seq.).
12) Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related
activities supported by this award of assistance.
13) Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. §2131 et seq.)
pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities
supported by this award of assistance.
14) Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. §4801 et seq.), which prohibits the use of
lead- based paint in construction or rehabilitation of residence structures.
15) Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act
Amendments of 1996 and 2 CFR Part 200.
16) Will comply with all applicable requirements of all other federal laws, executive orders, regulations and policies
governing this program.
SIGN O AUTHORIZED CERTI ING OFFICIAL TITLE
Public Services Department Head
A7
APPLICANT ORGANIZATION DATE SUBMITTED
Collier County Board of County Commissioners '*1A1_ ,� S' o)-ol
L, YJ
July 2017 — June 2018
HCE 203.17
ATTACHMENT V
FLORIDA DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST
Program/Facility Name: Collier County Services for Seniors County: Collier County AAA/Contractor: Area Agency on
Aging for Southwest Florida, Inc.
Address: 3339
City, State, Zip Code:
Completed By: Lisa
Date: June 28, 2017 1 Telephone: (239) 252-4228
PART I: READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU COMPLETE
THIS FORM.
1. Briefly describe the geographic area served by the program/facility and the type of service provided: The Collier County Community and
Human Services (CHS) Division, Services for Seniors program, provide services to clients covering over a 2,300 -square mile area. CHS
provides case management, in-home care, facility respite, adult day care and nutrition services to frail, elderly residents of Collier County.
For questions 2-5 please indicate the fol
2. Population of area served
3. Staff currently employed
4. Clients currently enrolled/registered
5. Advisory/Governing Board if applicable
PART II: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. IF N/A or NO EXPLAIN.
%
N/A
YES
NO
❑
0
lowing:
Total #
I White
Black
Hispanic
Other
Female
Disabled
Over 40
Source of data: 2010 Census
321,520 57.98%
6.56%
25.87%
9.6%
50.70% n/a
58.4%
Effective date:6/28/17
8
0%
0%
0%
%
90%
0%
100%
Effective date:6/28/17
561
37%
7%
39%
17%
35%
❑
100%
011ier County BCC
5
100%
%
P%
%
20%
Inla
0%
100%
PART II: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. IF N/A or NO EXPLAIN.
6. Is an Assurance of Compliance on file with DOEA?
N/A
YES
NO
❑
0
❑
7. Compare the staff composition to the population. Is staff representative of the population?
N/A
YES
NO
❑
0
❑
8. Are eligibility requirements for services applied to clients and applicants without regard to race, color, national
N/A
YES
NO
origin, sex, age, religion or disability?
❑
■ i
❑
9. Are all benefits, services and facilities available to applicants and participants in an equally effective manner
N/A
YES
NO
regardless of race, sex, color, age, national origin, religion or disability?
10. For in-patient services, are room assignments made without regard to race, color, national origin or disability?
N/A
YES
NO
0
❑
❑
11. Is the program/facility accessible to non-English speaking clients?
N/A
YES
NO
❑
N
❑
12) Are employees, applicants and participants informed of their protection against discrimination? If YES, how?
N/A
YES
NO
Verbal ■ I Written❑ PosterN1
❑
01
❑
43
July 2017 — June 2018
HCE 203.17
13.Give the number and current status of any discrimination complaints regarding services or employment filed
N/A
NUMBER
against the program/facility.
■
*Notice of Corrective Action Sent
14.Is the program/facility physically accessible to mobility, hearing, and sight -impaired individuals?
N/A
YES NO
Response Received
❑
N ❑
PART III: THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES.
IF NO
EXPLAIN.
15.Has as a self-evaluation been conducted to identify any barriers to serving disabled individuals, and to make any
YES
NO
necessary modifications?
❑
❑
16.1s there an established grievance procedure that incorporates due process in the resolution of complaints?
YES
NO
17.Has a person been designated to coordinate Section 504 compliance activities?
YES
NO
❑
❑
18.Do recruitment and notification materials advise applicants, employees and participants of nondiscrimination on the
YES
NO
basis of disability?
❑
❑
19.Are auxiliary aids available to assure accessibility of services to hearing and sight -impaired individuals?
YES
NO
❑
❑
PART IV: FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $50,000.00 OR MORE.
20.Do you have a written affirmative action plan? If NO, explain.
YES
NO
❑
❑
Reviewed by
In Compliance: YES ❑ NO*
Program Office
*Notice of Corrective Action Sent
Date
Telephone Response Due
On Site ❑ Desk Review ❑
Response Received
July 2017 — June 2018 HCE 203.17
ATTACHMENT V
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST
Describe the geographic service area such as a district, county, city or other locality. If the program/facility serves
a specific target population such as adolescents, describe the target population. Also, define the type of service
provided.
2. Enter the percent of the population served by race and sex. The population served includes persons in the
geographical area for which services are provided such as a city, county or other regional area. Population statistics
can be obtained from local chambers of commerce, libraries, or any publication from the 1980 Census containing
Florida population statistics. Include the source of your population statistics. ("Other" races include Asian/Pacific
Islanders and American Indian/Alaskan Natives.)
3. Enter the total number of full-time staff and their percent by race, sex and disability. Include the effective date of
your summary.
4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and list
their percent by race, sex and disability. Include the date that enrollment was counted.
5. Enter the total number of advisory board members and their percent by race, sex, and disability. If there is no
advisory or governing board, leave this section blank.
6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in
compliance with all nondiscriminatory provisions as required in 45 CFR 80. This is usually a standard part of the
contract language for Recipients and their Sub -grantees, 45 CFR 80.4 (a).
7. Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the
population is Hispanic, is there a comparable percentage of Hispanic staff?
8. Where there is a significant variation between the race, sex or ethnic composition of the clients and their availability
in the population, the program/facility has the responsibility to determine the reasons for such variation and take
whatever action may be necessary to correct any discrimination. Some legitimate disparities may exist when
programs are sanctioned to serve target populations such as elderly or disabled persons, 45 CFR 80.3 (b) (6).
9. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or
employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also
through on-site record analysis of persons who applied but were denied services or employment, 45 CFR 80.3 (a)
and 45 CFR 80.1 (b) (2).
10. Participants or clients must be provided services such as medical, nursing and dental care, laboratory services,
physical and recreational therapies, counseling and social services without regard to race, sex, color, national origin,
religion, age or disability. Courtesy titles, appointment scheduling and accuracy of record keeping must be applied
uniformly and without regard to race, sex, color, national origin, religion, age or disability. Entrances, waiting
rooms, reception areas, restrooms and other facilities must also be equally available to all clients, 45 CFR 80.3 (b).
11. For in-patient services, residents must be assigned to rooms, wards, etc., without regard to race, color, national
origin or disability. Also, residents must not be asked whether they are willing to share accommodations with
persons of a different race, color, national origin, or disability, 45 CFR 80.3 (a).
12. The program/facility and all services must be accessible to participants and applicants, including those persons who
may not speak English. In geographic areas where a significant population of non-English speaking people live,
program accessibility may include the employment of bilingual staff. In other areas, it is sufficient to have a policy
45
July 2017 — June 2018
HCE 203.17
or plan for service, such as a current list of names and telephone numbers of bilingual individuals who will assist
in the provision of services, 45 CFR 80.3 (a).
13. Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to their
participants, beneficiaries or any other interested parties. This should include information on their right to file a
complaint of discrimination with either the Florida Department of Elder Affairs or the U.S. Department of HHS.
The information may be supplied verbally or in writing to every individual, or may be supplied through the use of
an equal opportunity policy poster displayed in a public area of the facility, 45 CFR 80.6 (d).
14. Report number of discrimination complaints filed against the program/facility. Indicate the basis, e.g., race, color,
creed, sex, age, national origin, disability, retaliation; the issues involved, e.g., services or employment, placement,
termination, etc. Indicate the civil rights law or policy alleged to have been violated along with the name and
address of the local, state or federal agency with whom the complaint has been filed. Indicate the current status,
e.g., settled, no reasonable cause found, failure to conciliate, failure to cooperate, under review, etc.
15. The program/facility must be physically accessible to disabled individuals. Physical accessibility includes
designated parking areas, curb cuts or level approaches, ramps and adequate widths to entrances. The lobby, public
telephone, restroom facilities, water fountains, information and admissions offices should be accessible. Door
widths and traffic areas of administrative offices, cafeterias, restrooms, recreation areas, counters and serving lines
should be observed for accessibility. Elevators should be observed for door width, and Braille or raised numbers.
Switches and controls for light, heat, ventilation, fire alarms, and other essentials should be installed at an
appropriate height for mobility impaired individuals.
16. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self-
evaluation to identify any accessibility barriers. Self-evaluation is a four step process:
a. With the assistance of a disabled individual/organization, evaluate current practices and policies which do not
comply with Section 504.
b. Modify policies and practices that do not meet Section 504 requirements.
c. Take remedial steps to eliminate any discrimination that has been identified.
d. Maintain self-evaluation on file. (This checklist may be used to satisfy this requirement if these four steps have
been followed.), 45 CFR 84.6.
17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate appropriate
due process standards and provide for the prompt and equitable resolution of complaints alleging any action
prohibited by Section 504.45 CFR 84.7 (b).
18. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to
comply with Section 504.45 CFR 84.7 (a).
19. Continuing steps must be taken to notify employees and the public of the program/facility's policy of
nondiscrimination on the basis of disability. This includes recruitment material, notices for hearings, newspaper
ads, and other appropriate written communication, 45 CFR 84.8 (a).
20. Programs/facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with impaired
sensory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to, interpreters
for hearing impaired individuals, taped or Braille materials, or any alternative resources that can be used to provide
equally effective services, 45 CFR 84.52 (d).
21. Programs/facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement and
maintain a written affirmative action compliance program in accordance with Executive Order 11246, 41 CFR 60
and Title VI of the Civil Rights Act of 1964, as amended.
July 2017 — June 2018
DEPA RTbtENT OF
ELDER
AFFAIRS
STATE OF FLORIDA
ATTACHMENT VI
BACKGROUND SCREENING
BACKGROUND SCREENING
Affidavit of Compliance - Employer
AUTHORITY: This form is required annually of all employers to comply with the attestation
requirements set forth in section 435.05(3), Florida Statutes.
➢ The term "employer" means any person or entity required by law to conduct background screening,
including but not limited to, Area Agencies on Aging, Aging Resource Centers, Aging and Disability
Resource Centers, Lead Agencies, Long -Term Care Ombudsman Program, Serving Health Insurance Needs
of Elders Program, Service Providers, Diversion Providers, and any other person or entity which hires
employees or has volunteers in service who meet the definition of a direct service provider. See §§
435.02, 430.0402, Fla. Stat.
➢ A direct service provider is "a person 18 years of age or older who, pursuant to a program to provide
services to the elderly, has direct, face-to-face contact with a client while providing services to the client
and has access to the client's living area, funds, personal property, or personal identification information
as defined in s. 817.568. The term includes coordinators, managers, and supervisors of residential
facilities; and volunteers." § 430.0402(1)(b), Fla. Stat.
ATTESTATION:
As the duly authorized representative of
HCE 203.17
Collier County Community and Human Services
Employer Name
located at 3339 East Tamiami Trail Suite 211, Naples, FL 34112
Street Address city State Zip code
Kim berely Grant, Director do hereby affirm under penalty of perjury
Name of Representative
that the above named employer is in compliance with the provisions of Chapter 435 and section
430.0402, Florida Statutes, regarding level background screening.
Signature of Representative Date
STATE OF FLORIDA, COUNTY OF
Collier
(or affirmed) and subscribed before me thiAs- day 0;3U�('� 20 1 T� by
(Name of Representative) who is personally known
to me or produced -PV-fWng /l ! K hJ IV n [ y t -n 2 as proof of identification.
Print, Type, or Stamp Commissioned Name of Notary Public
Notary Public
DOEA Form 235, Affidavit of Compliance- Employer, Effective April 2012 Section 435.05(3), F.S.
Form available at: hLin://elderaffairs state.flus/eralish/backeroundsaeenfrs.oho
,,,
�M" °k,ANA I. D1AZ
MY COMMISSION N FF 235771
cP EXPIRES: July 1, 2019
Bonded Th. Notary Public Underwriters
47
Approved as to form and legality
�?4
Assistant County Atturncy
�- a
n\a
July 2017 — June 2018
ATTACHMENT VII
ANNUAL BUDGET SUMMARY
(2017 — 2018)
Collier County Board of County Commissioners
Collier
HCE Case Management/Case Aide
HCE Basic and Special Subsidies
Total
M
$ 3805.00
45,445.00
$ 49,250.00
HCE 203.17
July 2017 — June 2018 HCE 203.17
ATTACHMENT VIII
Legend: * Advance based on projected cash need.
Note # 1: Report #I 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: Report numbers 5 through 14 shall reflect an adjustment of at least one-tenth of the total advance
amounts, repaying advances issued the first two months of the agreement. All advance payments
made to the Contractor shall be returned to the Agency and reported as an advance recoupment
on each request for payment. 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.
49
HOME CARE FOR THE ELDERLY
INVOICE REPORT SCHEDULE
Report Number
Based On
Submit to Agency on this Date
1
July Advance*
July 1
2
August Advance*
July 1
Monthly Utilization Report (7/1-7/15)
July 20
3
July Expenditure Reports (105 & 106)
August 9
Monthly Utilization Report (7/16-8/15)
August 20
4
August Expenditure Report (105 & 106)
September 9
Monthly Utilization Report (8/16-9/15)
September 20
5
September Expenditure Report (105 & 106)
October 9
Monthly Utilization Report (9/16-10/15)
October 20
6
October Expenditure Report (105 & 106)
November 9
Monthly Utilization Report (10/16-11/15)
November 20
7
November Expenditure Report (105 & 106)
December 9
Monthly Utilization Report (11/16-12/15
December 20
8
December Expenditure Report (105 & 106)
January 9
Monthly Utilization Report (12/16-1/15)
January 20
9
January Expenditure Report (105 & 106)
February 9
Monthly Utilization Report (1/16-2/15)
February 20
10
February Expenditure Report (105 & 106)
March 9
Monthly Utilization Report (2/16-3/15)
March 20
11
March Expenditure Report (105 & 106)
April 9
Monthly Utilization Report (3/16-4/15)
April 20
12
April Expenditure Report (105 & 106)
May 9
Monthly Utilization Report (4/16-5/15)
May 20
13
May Expenditure Report (105 & 106)
June 9
Monthly Utilization Report (5/16-6/15)
June 20
14
June Expenditure Report (105 & 106)
July 9
Monthly Utilization Report (6/15-6/30)
July 20
15
Final Expenditure Report (105 & 106)
July 25
Legend: * Advance based on projected cash need.
Note # 1: Report #I 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: Report numbers 5 through 14 shall reflect an adjustment of at least one-tenth of the total advance
amounts, repaying advances issued the first two months of the agreement. All advance payments
made to the Contractor shall be returned to the Agency and reported as an advance recoupment
on each request for payment. 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.
49
July 2017 - June 2018
ATTACHMENT IX
REQUEST FOR PAYMENT
HOME CARE FOR THE ELDERLY PROGRAM
HCE 203.17
RECIPIENT NAME, ADDRESS, PHONE# and FEID#
TYPE OF PAYMENT:
This Request Period: From: To:
Contract Period
Regular
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
AAAAdmin.
Case Management
Subsidies
TOTAL
1. Approved Contract Amount
$0.00
$0.00
.$0.00
$0.00
2. Previous Funds Received for Contract Period
$0.00
$0.00
$0.00
$0.00
3. Contract Balance (line 1 minus line 2)
$0.00
$0.00
$0.00
$0.00
4. Previous Funds Requested and Not Received for Contract Period
$0.00
$0.00
$0.00
$0.00
5. CCNTRACT 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
(DOEA Form 105H, Part B, Line 4)
3. TOTAL
$0.00
$0.00
$0.00
$0.00
PART C: NET FUNDS REQUESTED
1. Less Advance Applied
$0.00
$0.00
$0.00
$0.00
2. TOTAL FUNDS REQUESTED (Part B Line 3, minus Part C Line 1)
$0.00
$0.00
$0.00
$0.00
List of Services / Units / Rates provided - See attached report.
DOEA FORM 106H
Revised 5/4/12
50
July 2017 - June 2018
ATTACHMENT X
RECEIPT AND EXPENDITURE REPORT
HOME CARE FOR THE ELDERLY PROGRAM
HCE 203.17
PROVIDER NAME, ADDRESS, PHONE # and FEID#
Program Funding :
THIS REPORT PERIOD:
From To
AAA Admin.
CONTRACT PERIOD:
Case Management
CONTRACT #
Subsidies:
REPORT #
Basic
Special
PSA#
CERTIFICATION: I certify to the best of my knowledge and belief that the report is complete and correct and all outlays
herein are for purposes set forth In the contract.
Prepared by : Date : Approved by : Date
PART A: BUDGETED INCOME / RECEIPTS
1. Approved
2. Actual Receipts
3. Total Receipts
4. Percent of
Budget
For This Report
Year to Date
roved Budget
1. State Funds
$0.00
$0.00
$0.00
#DIV/0!
2. TOTAL RECEIPTS
$0.00
$0.00
$0.00
#DIV/0!
PART B: EXPENDITURES
1. Approved
2. Expenditures
3. Expenditures
4. Percent of
Budget
For This Report
Year to Date
Approved Budget
$0.00
$0.00
$0.00
#DIV/01
1. AAA Program Administration
2. Service Subcontractors: Case Management
$0.00
$0.00
$0.00
#DIV/0!
3. Service Subcontractors: Subsidy
$0.00
$0.00
$0.00
#DIV/0!
a. Basic Subsidy
$0.00
$0.00
$0.00
#DIV/O!
b. Special Subsidy
$0.00
$0.00
$0.00
#DIV/0!
4. TOTAL EXPENDITURES
$0.00
$0.00
$0.00
#DIV/0!
PART C: OTHER REVENUE AND EXPENDITURES
1, Interest:
11. Advance Recoupment
1. Earned on GR Advance $
2. Return of GR Advance $
1. Advance Recouped $
3. Other Earned $
DOEA FORM 105H
Revised 512512010
51
July 2017 — June 2018
ATTACHMENT XI
SERVICE RATE REPORT
Collier County Board of County Commissioners
Collier
RATE SUMMARY
HCE 203.17
52
HIGHEST
METHOD OF
DELIVERABLES
REIMBURSEMENT
PAYMENTS
UNIT RATE
Case Aide (CAV): Collier
$33.88
Fixed Fee / Unit Rate
Case Management (CMV): Collier
$60.00
Fixed Fee / Unit Rate
Respite In-Home(RESP): Collier
$10.00
Fixed Fee / Unit Rate
Respite Vendor Payment (RESV): Collier
$25.67
Fixed Fee / Unit Rate
Homemaking Vendor Payment (HMKV): Collier $21.50
Fixed Fee / Unit Rate
Personal Care -Vendor (PECV): Collier
$25.67
Fixed Fee / Unit Rate
Other -Background Screen -Vendor (OTHBKV):
$41.25
Fixed Fee / Unit Rate
Collier
Housing Improvement (HOIM): Collier
Cost Reimbursement
Cost Reimbursement
Housing Improvement Vendor (HOIV): Collier
Cost Reimbursement
Cost Reimbursement
Material Aid Vendor (MATE): Collier
Cost Reimbursement
Cost Reimbursement
Transportation (TRS): Collier
Cost Reimbursement
Cost Reimbursement
Specialized Medical Equipment, Services and
Cost Reimbursement
Cost Reimbursement
Supplies (SCSM): Collier
Specialized Medical Equipment, Services and
Cost Reimbursement
Cost Reimbursement
Supplies- Vendor Payment (SCSV): Collier
52
Revised August 2007
Attestation Statement
Agreement/Contract Number HCE 203.17
Amendment Number n/s
I, Steve Y. Carnell , attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
Public Services Department Head
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting, due to the differences in
electronic data processing media, which has no affect on the agreement/contract content.
Signature of Recipient/Contractor representative
Revised August 2007
w/q
Approved as to form and legality
Assistant County Attorney 'Of \�
L:)