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Backup Documents 05/28/2013 Item #16D 2 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO D Al THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE / 6 Varammanumiummais Routed by Purchasing Department to Office Initials Date the Following Addressee(s) (In routing,order) 1. Risk Management Risk 2. County Attorney Office County Attorney Office -p� 5,3 113 3. BCC Office Board of County 'Sys Commissioners � � ��-- 5\31\�3 4. Minutes and Records Clerk of Court's Office -Pa\ 5i3i it3 `t 1 l 5. Return to Purchasing Department Purchasing Contact: Diana DeLeon PRIMARY CONTACT INFORMATION Name of Primary Diana DeLeon for Lisa Can,HHVS, Phone Number 252-8375 Purchasing Staff May 29,2013 Contact and Date Agenda Date Item was May 28,2013 Agenda Item Number 16.D.2 Approved by the BCC Type of Document Contract Amendment Number of Original 2 Attached Documents Attached PO number or account N/A Solicitation/Contract Amend#1 to Contract 12- number if document is Number/Vendor Name 5856 Lifeline/Philips to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature? DD 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A provide the Contact Information(Name; Agency; Address; Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's DD signature and initials are required. 7. In most cases(some contracts are an exception),an electronic copy of the document and DD this routing slip should be provided to the County Attorney's Office before the item is input into SIRE. 8. The document was approved by the BCC on the date above and all changes made DD during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes, if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the �bv) BCC,all changes directed by the BCC have been made, and the document is ready for the Chairman's signature. 1613 2 MEMORANDUM Date: June 3, 2013 To: Diana DeLeon, Contract Technician Purchasing Department From: Teresa Cannon, Deputy Clerk Minutes & Records Department Re: Amendment #1 to Contract #12-5856 "Services for Seniors" Contractor: Lifeline Systems Company Attached is an original copy of the contract referenced above, (#16D2) approved by the Board of County Commissioners on Tuesday, May 28, 2013. The second original will be held on file in the Minutes and Record's Department for the Board's Official Record. If you have any questions, please feel free to contact me at 252-8411. Thank you. Attachment 1602 Contract Amendment#1 Contract # 12-5856 "Services for Seniors" This CONTRACT AMENDMENT #1, dated Mctk( 2a , 2013 to the referenced agreement shall be by and between the parties to the original Agreement, Lifeline Systems Company d/b/a Philips Lifeline (to be referred to as "Vendor") and Collier County, Florida, (to be referred to as "County"). Statement of Understanding RE: Contract# 12-5856 "Services for Seniors" In order to continue services for the original Contract document referenced above, the Vendor agrees to the terms and conditions set forth in Exhibit A-1A, which includes Attachments C-H and Exhibits 1-10 attached hereto and incorporated by reference. The Vendor further agrees to amend Section 1, Commencement, as follows: 1. COMMENCEMENT. This Agreement shall Commence on December 11, 2012 and shall terminate on December 10, 201'l June 30, 2014. The Contract award is a two (2) year contract, with the possibility of two (2) additional (2) year terms pending funding from grantors and acceptable performance by the awarded vendor. Any such renewals shall be mutually agreed upon in writing by the parties. The maximum duration for this Contract for CCE, HCE, and ADI, OAA ME AND OAA IITF.S funding will not exceed six (6) years (through June 30, 2018). As outlined in RFP #12-5856, the County requires the Vendor to contribute a cash or in-kind match of no less than ten (10) percent for all services related to the Community Care for the Elderly Program, (CCE), Older American Title IIIE Caregiver Support (OAA HIE) and Older American Title HIES Caregiver Support Supplemental Services (OAA HIES)Programs. Words that have been deleted are struck through, words underlined have been added. Modification made herein shall apply as if incorporated into the Contract on the date of Commencement. All other terms and conditions of the agreement shall remain in force. IN WITNESS WHEREOF, the Vendor and the County have each, respectively, by an authorized person or agent, hereunder set their hands and seals on the date(s) indicated below. - Accepted: ✓'lai : y. , 2013 VENDOR: 6..A.A../4 .e, ''-hi '-*-1-e-,(6.- Lifeline Systems Company d/b/a First Witness Philips Lifeline App;A, )-f. 're((r, 1 / a,, Ty t w' ess ame Second Witness —1 on:c e Jq ,SOT ,�yl. COn�-a-c l S fl 1, p I .A tk-, Print/Type Name and Title Type/print witness name 1 16D p COUNTY: ATTEST: BOARD OF COUNTY COMMISSIONERS DWIGHT E. BROCK, CLERK OF COLLIER COUNTY, FLORIDA ft, 4 ,011 By: ' ,p't;y CLERK GEORGIA.A. II ER, ESQ. Attest f ;.��� an S CIIAIRWOMAN Approval for foiin and legal Sufficiency: Jennifer B. White Assistant County Attorney Item# L Agenda Date Recd Date b t3. a Deputy Clerk EXHIBIT A-lA 1 6 2 AGREEMENT 12-5856 SERVICES FOR SENIORS ATTACHMENTS ATTACHMENT ATTACHMENT DESCRIPTION PAGE Attachment C Core Standards for CCE, HCE, ADI, OAA IIIE & IIIES 2 Attachment D Certification Regarding Lobbying 8 Attachment E Certification Regarding Data Integrity Compliance 9 Attachment F Certification Regarding Debarment, Suspension, 10 Ineligibility and Voluntary Exclusion Contracts/ Subcontracts Attachment G Sub-Recipient Invoice Submission 11 Attachment H Background Screening Affidavit of Compliance 12 Exhibit 1 CCE Statement of work 13 Exhibit 2 HCE Statement of work 19 Exhibit 3 ADI Statement of work 25 Exhibit 4 OAA IIE and OAA IIIES Statement of work 31 Exhibit 5 Invoice 39 Exhibit 6 Detail Weekly Log 40 Exhibit 7 Monthly Log 41 Exhibit 8 Day Care/Respite Time Sheet 42 Exhibit 9 Program Time Sheet 43 Exhibit 10 Annual Audit Monitoring Report 45 1 ATTACHMENT C 16 D 2 Core Standards for CCE,HCE,ADI, OAA IIIE & HIES 1. Compliance with Federal Law 1.1 If this agreement contains federal funds the following shall apply: 1.1.1 The vendor shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable regulations. 1.1.2 If this agreement contains federal funds and is over$100,000.00,the vendor shall comply with all applicable standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s. 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable Environmental Protection County regulations 40 CFR 30. The vendor shall report any violations of the above to the County. 1.1.3 The vendor may not use any federal funds received in connection with this agreement to influence legislation or appropriations pending before the Congress or any state legislature. If this agreement contains federal funding in excess of$100,000.00, the vendor must, prior to agreement execution, complete the Certification Regarding Lobbying form, ATTACHMENT D. All disclosure forms as required by the Certification Regarding Lobbying form must be completed and returned to the Grant Coordinator prior to payment under this agreement. 1.1.4 In accordance with Appendix A to 2 CFR 215, the vendor shall comply with Executive Order 11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in Department of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable. 1.1.5 If this agreement contains federal funds and provides services to children up to age 18,the vendor shall comply with the Pro-Children Act of 1994 (20 U.S.C. 6081). 1.1.6 A agreement award with an amount expected to equal or exceed $25,000.00 and certain other agreement 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 vendor shall comply with these provisions before doing business or entering into sub-agreements receiving federal funds pursuant to this agreement. The vendor shall complete and sign ATTACHMENT F prior to the execution of this agreement. 1.2 The vendor shall not employ an unauthorized alien. The County 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 agreement by the County. 2 1602 1.3 If the vendor 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 vendor must notify the County in writing within thirty (30) days of receiving the IRS notice of revocation. 1.4 The vendor shall comply with Title 2 CFR Part 275 regarding Trafficking in Persons. 1.5 Unless exempt under 2 CFR Part 170.110(b), the vendor shall comply with the reporting requirements of the Transparency Act as expressed in 2 CFR 170. 1.6 To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number 11-116, vendor agrees to utilize the U.S. Department of Homeland Security's E-verify system to verify the employment of all new employees hired by vendor during the agreement term. Vendor meeting the terms and conditions of the E-Verify System are deemed to be in compliance with this provision. 2. Compliance with State Law 2.1 This agreement is executed and entered into in the State of Florida, and shall be construed, performed and enforced in all respects in accordance with the Florida law, including Florida provisions for conflict of laws. 2.2 The vendor shall comply with requirements of s. 287.058, F.S. as amended. 2.2.1 The vendor shall provide units of deliverables, including various client services, and in some instances may include reports, findings, and drafts, as specified in this agreement,which the Grant Coordinator must receive and accept in writing prior to payment in accordance with s. 215.971, F.S. (1)and(2). 2.2.2 The vendor shall submit bills for fees or other compensation for services or expenses in sufficient detail for a proper pre-audit and post-audit. 2.2.3 The vendor 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 vendor in conjunction with this agreement except for those records which are made confidential or exempt by law. The vendor's refusal to comply with this provision will constitute an immediate breach of agreement for which the County may unilaterally terminate the agreement. 2.3 If clients are to be transported under this agreement, the vendor shall comply with the provisions of Chapter 427,F.S., and Rule 41-2, F. A. C. 2.4 Vendors who are on the discriminatory vendor list may not transact business with any public entity, in accordance with the provisions of s. 287.134, F.S. 2.5 The vendor shall comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the expenditure of agreement funds for the purpose of lobbying the legislature,judicial branch or a state agency. 3. Background Screening The vendor shall ensure that the requirements of s. 430.0402 and ch. 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 exempted from the Department's level 2 background screening 3 1602 pursuant to s. 430.0402(2)-(3), F.S. The vendor must also comply with any applicable rules promulgated by the Depai Intent and the Agency for Health Care Administration regarding implementation of s. 430.0402 and ch. 435, F.S. Further information concerning the procedures for background screening are found at http://elderaffairs.state.fl.us/doea/backgroundscreeninu.php. 4. Provision of Services The vendor shall provide services in the manner described herein. 5. Monitoring by the County The vendor shall permit persons duly authorized by the County to inspect and copy any records, papers, documents, facilities, goods and services of the vendor which are relevant to this agreement, and to interview any clients, employees and vendor employees of the vendor to assure the County of the satisfactory performance of the terms and conditions of this agreement. Following such review, the County will provide a written report of its findings to the vendor, and where appropriate,the vendor shall develop a corrective action plan. The vendor hereby agrees to correct all deficiencies identified in the corrective action plan in a timely manner as determined by the Grant Coordinator. 6. Confidentiality of Information The vendor shall not use or disclose any information concerning a vendor of services under this agreement 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. 7. Health Insurance Portability and Accountability Act Where applicable, the vendor shall comply with the Health Insurance Portability and Accountability Act (42 USC 1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162, and 164). 8. Bankruptcy Notification During the term of this agreement,the vendor shall immediately notify the County if the Vendor, its assignees,vendors or affiliates file a claim for bankruptcy. Within ten (10)days after notification,the vendor must also provide the following information to the County.: (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., United States Bankruptcy Court Middle District of Florida,Naples, FL); and, (4)The name, address, and telephone number of the bankruptcy attorney. 9. Sponsorship and Publicity 9.1 As required by s. 286.25, F.S., if the vendor is a non-governmental organization which sponsors a program financed wholly or in part by state funds, including any funds obtained through this agreement, it shall, in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by Hope Hospice and Community Services, the State County of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County." If the sponsorship reference is in the written material, the words "State of Florida, Department of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County" shall appear in at least the same size letters or type as the name of the organization. 9.2 The vendor shall not use the words "The State of Florida Department of Elder Affairs or the Area County on Aging for Southwest Florida, Inc. or Collier County" to indicate sponsorship of a program otherwise financed, unless specific authorization has been obtained by Collier County, or the Area Aging on Aging prior to use. 4 r:it 1602 10. Independent Capacity of Vendor It is the intent and understanding of the Parties that the vendor, or any of its vendors, are independent vendors and are not employees of the County and shall not hold themselves out as employees or agents of the County without specific authorization from the County. It is the further intent and understanding of the Parties that the County does not control the employment practices of the vendor and will not be liable for any wage and hour, employment discrimination, or other labor and employment claims against the vendor or its vendors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary insurance for the vendor are the sole responsibility of the vendor. 11. Payment Payments shall be made to the vendor pursuant to s. 215.422, F.S., as services are rendered and invoiced by the vendor. The Grant Coordinator will have final approval of the invoice for payment, and will approve the invoice for payment only if the vendor has met all terms and conditions of the agreement, unless the bid specifications, purchase order, or this agreement specify otherwise. The approved invoice will be submitted to the County's Grant Coordinator approval and processing. 12. Return of Funds The vendor shall return to the County any overpayments due to unearned funds or funds disallowed and any interest attributable to such funds pursuant to the terms and conditions of this agreement that were disbursed to the vendor by the County. In the event that the vendor or its independent auditor discovers that an overpayment has been made, the vendor shall repay said overpayment immediately without prior notification from the County. In the event that the County first discovers an overpayment has been made, the Grant Coordinator will notify the vendor in writing of such findings. 13. Data Integrity and Safeguarding Information The vendor shall ensure an appropriate level of data security for the information the vendor is collecting or using in the performance of this agreement. An appropriate level of security includes approving and tracking all vendor employees that request system or information access and ensuring that user access has been removed from all terminated employees. The vendor, 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 vendor shall ensure all vendors maintain written procedures for computer system backup and recovery. The vendor shall complete and sign Attachment E prior to the execution of this agreement. 14. Computer Use and Social Media Policy The Depai tment of Elder Affairs has implemented a new 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, Area Agencies on Aging and vendors. 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. 15. Public Entity Crime Pursuant to s. 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 5 1602 agreement to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on a agreement 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 vendor, supplier, vendor, or consultant under a agreement with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in s. 287.017, F.S., for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted vendor list. 16. Patents, Copyrights,Royalties If this agreement 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 agreement, the vendor shall refer the discovery, invention or material to the County to be referred to the Department of State and the Department of Elder Affairs. Any and all patent rights or copyrights accruing under this agreement are hereby reserved to the State of Florida in accordance with Chapter 286, F.S. Pursuant to s. 287.0571 (5) (k) 1 and 2 as amended, the only exceptions to this provision shall be those that are clearly expressed and reasonably valued in the agreement. 16.1 If the primary purpose of this agreement 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 Paragraph 33. 16.2 If this agreement is awarded solely federal funding, the terms and conditions are governed by 2 CFR 215.36. 17. Emergency Preparedness and Continuity of Operations 17.1 If the tasks to be performed pursuant to this agreement include the physical care and control of clients, or the administration and coordination of services necessary for client health, safety or welfare, the vendor shall, within thirty (30) calendar days of the execution of this agreement, submit to the Grant Coordinator verification of an emergency preparedness plan. In the event of an emergency,the vendor shall notify the County of emergency provisions. 17.2 In the event a situation results in a cessation of services by a vendor, the vendor shall retain responsibility for performance under this agreement and must follow procedures to ensure continuity of operations without interruption. 18. Financial Consequences of Non-Performance If the vendor fails to meet the minimum level of service or performance identified in this agreement, or that is customary for the industry, then the County must apply financial consequences commensurate with the deficiency.Financial consequences may include,but are not limited to, agreement suspension, refusing payment, withholding payments until deficiency is cured, tendering only partial payments, and/or cancellation of agreement and reacquiring services from an alternate source. 18.1 The vendor will not be charged with financial consequences, when a failure to perform arises out of causes that were the responsibility of the County. 19. No Waiver of Sovereign Immunity 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. 20. Venue If any dispute arises out of this agreement,the venue of such legal recourse will be Collier 6 16 (32 County, Florida. 21. Entire Agreement This agreement contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations shall be valid or binding upon the County or the vendor unless expressly contained herein or by a written amendment to this agreement signed by both Parties. 22. 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. 23. 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. 24. Waiver The delay or failure by the County to exercise or enforce any of its rights under this agreement will not constitute or be deemed a waiver of the County'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. 25. Compliance The vendor shall abide by all applicable current federal statutes, laws, rules and regulations as well as applicable current state statutes, laws, rules, regulations and County rules, ordinances and regulations. The Parties agree that failure of the vendor to abide by these laws shall be deemed an event of default of the vendor, and subject the agreement to immediate, unilateral cancellation of the agreement at the discretion of the County. 26. Final Invoice The vendor shall submit the final CCE, HCE, ADI, IIE and TTTES invoice for payment to the County on July 3, 2013. If the vendor fails to submit final request for payment by the deadline, then all rights to payment may be forfeited and the County may not honor any requests submitted after the aforesaid time period. Any payment due under the terms of this agreement may be withheld until all reports due from the vendor and necessary adjustments thereto have been approved by the County. 27. Renegotiations or Modifications Modifications of the provisions of this agreement shall be valid only when they have been reduced to writing and duly signed by both parties. The rate of payment, contract requirements and the total dollar amount may be adjusted retroactively to reflect price level increases and changes in the rate of payment or language. 28. All Terms and Conditions Included This agreement and its Attachments, A-H and exhibits 1-4 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 agreement shall supersede all previous communications, representations or agreements, either written or verbal between the Parties. 7 C/i c, 1602 ATTACHMENT D CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR AGREEMENTS, GRANTS,LOANS AND AGREEMENTS The undersigned certifies,to the best of his or her knowledge and belief,that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any State ,Federal or County, a member of congress, an officer or employee of congress, an employee of a member of congress, or an officer or employee of the state legislator, in connection with the awarding of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal agreement, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of the County, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this federal agreement, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including vendors, sub-grants, and agreements under grants, loans and cooperative agreements)and that all vendors shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Signature Date Name of Authorized Individual Name and Address of Organization 8 ATTACHMENT E 1 602 2 CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS,GRANTS,LOANS AND COOPERATIVE AGREEMENTS The undersigned, an authorized representative of the vendor named in the agreement or agreement to which this form is an attachment, hereby certifies that: (1) The vendor and any vendors of services under this agreement have financial management systems capable of providing certain information, including: (1) accurate, current, and complete disclosure of the fmancial 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 vendor, vendor(s), or any outside entity on which the vendor 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,vendor(s)will take immediate action to assure data integrity. (3) If this agreement 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 vendor (represented by the undersigned) and purchased by the State will be verified for accuracy and integrity of data prior to transfer. In the event of any decrease in functionality related to time and date related codes and internal subroutines that impede the hardware or software programs from operating properly, the vendor agrees to immediately make required corrections to restore hardware and software programs to the same level of functionality as warranted herein, at no charge to the State, and without interruption to the ongoing business of the state,time being of the essence. (4) The vendor and any vendor(s) of services under this agreement warrant their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data integrity compliance issues. The vendor shall require that the language of this certification be included in all vendors and other agreements and that all vendor shall certify compliance accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB Circulars A-102 and 2 CFR Part 215 (formerly OMB Circular A-110). Name and Address of vendor Signature Title Date Name of Authorized Signer 9 CCU 1602 2 EXFIIBIT F CERTIFICATION REGARDING DEBARMENT, SUSPENSION,INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS (1) The prospective vendor certifies, by signing this certification, neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or County. (2) Where the prospective vendor is unable to certify to any of the statements in this certification,such prospective participant shall attach an explanation to this certification. Signature Date Title County/Organization (Certification signature should be same as Agreement signature.) Instructions for Certification 1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "person," "primary covered transaction," and"voluntarily excluded," as used herein,have the meanings set out in the sections of rules implementing Executive Order 12549. (2 CFR 180.5-180.1020,as supplemented by 2 CFR 376.10-376.995). You may contact the Agreement Manager for assistance in obtaining a copy of those regulations. 2. This certification is a material representation of facts upon which reliance was placed when the parties entered into this transaction. If it is later determined that the vendor knowingly rendered an erroneous certification,in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension and/or debarment. 3. The vendor will provide immediate written notice to the Agreement Manager if at any time the vendor learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The vendor may decide the method and frequency by which it determines the eligibility of its principals. Each participant to a lower tier covered transaction may,but is not required to,check the Excluded Parties List System(EPLS). 4. The vendor will include a"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transaction"in all its lower tier covered transactions and in all solicitations for lower tier covered transactions. 5. The vendor agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise authorized by the federal government. 6. If the vendor knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension,and/or debarment. 7. The vendor may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended,ineligible,or voluntarily excluded from the covered transaction,unless it knows that the certification is erroneous. 10 r. 1602 EX BBIT G SUBRECIPIENT INVOICE SUMNIISSION The County shall reimburse the SUBRECIPIENT for the performance of this Agreement upon completion or partial completion of the work tasks as accepted and approved by HHVS pursuant to the submittal of quarterly progress reports. Invoices for work performed are required every month. If no work has been performed during that month, or if the SUBRECIPIENT is not yet prepared to send the required backup, a$0 invoice will be required. Explanations will be required if two consecutive months of$0 invoices are submitted. Payments shall be made to the SUBRECIPIENT when requested as work progresses but, not more frequently than once per month. Final invoices are due no later than 90 days after the end of the agreement. Work performed during the term of the program but not invoiced within 90 days without written exception from the Grant Coordinator will not be reimbursed. No payment will be made until approved by HHVS for grant compliance and adherence to any and all applicable local, state or Federal requirements. Payment will be made upon receipt of a properly completed invoice and in compliance with §218.70, Florida Statutes, otherwise known as the "Local Government Prompt Payment Act." 11 DEPARTMENT OF EXHIBIT H 1 6 D2 BACKGROUND SCREENING ELDER AFFAIRS Affidavit of Compliance -Employer STATE OF FLORIDA 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 Employer Name located at Street Address City State ZIP code I, 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. Signature of Representative Date STATE OF FLORIDA,COUNTY OF Sworn to(or affirmed)and subscribed before me this day of , 20 , by (Name of Representative)who is personally known to me or produced 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:http://elderaffairs.state.fl.us/english/backgrouddscreening.php 12 1602 EXHIBIT 1 STATEMENT OF WORK COMMUNITY CARE FOR THE ELDERLY PROGRAM(CCE) SECTION I: SERVICES TO BE PROVIDED 1.1. DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 AGREEMENT ACRONYMS Activities of Daily Living(ADL) Adult Protective Services(APS) Assessed Priority Consumer List(APCL) Comprehensive Assessment and Review for Long-Term Care Services(CARES) Community Care for the Disabled Adult(CCDA) Community Care for the Elderly(CCE) Client Information and Registration Tracking System(CIRTS) Department of Children and Families(DCF) Department of Elder Affairs(DOEA) Home Care for Disabled Adults (HCDA) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out: The condition of reaching 60 years of age and being transitioned from the Department of Children and Families(DCF) Services, Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults (HCDA) services to the Department's community- based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in its planning and service area in accordance with the Section 306 (42 U.S.C. 3026) of the Older Americans Act and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the County enters CCE specific data in the CIRTS. An update may also include other revisions to the area plan as instructed by the County or Department of Elder Affairs. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The primary purpose of the CCE program is to prevent, decrease or delay premature or inappropriate and expensive placement of older persons in nursing homes and other institutions. 13 1602 1.2.2 Community Care for the Elderly Mission Statement The CCE Program assists functionally impaired elderly persons in living as independently as possible in their own homes or in the homes of relatives or caregivers. The program provides a continuum of care through the development, expansion, reorganization and coordination of multiple community-based services to assist elders to reside in the least restrictive environment suitable to their needs. 1.2.3 Authority The relevant authority governing CCE program are: (1)Rule 58C-1, Florida Administrative Code (2) Sections 430.201 through 430.207, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services Chief Financial Officer Memoranda the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1) CFO Memo No. 02: Release date, August 20, 2010; (2) CFO Memo No. 03: Release date, June 29, 2010; and (3) CFO Memo No. 06: Release date, June 30,2010. 1.2.4 Scope of Service The vendor shall provide services in a manner consistent with and descried in the current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the program are to preserve the independence of elders and prevent or delay more costly institutional care through a community care service system that provides case management and other in-home and community services as needed under the direction of the County and provide a continuum of service alternatives that meet the diverse needs of functionally impaired elders. 1.3. INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The CCE program provides a continuum of services for functional impaired elders. 1.3.2 Individual Eligibility In order to receive services under this agreement, an applicant must: (1) Be at least 60 years of age; (2) Be functionally impaired as determined through the initial comprehensive assessment; and (3) With the exception of APS high-risk referrals, consumers may not be dually enrolled in the CCE program and a Medicaid capitated long-term care program. 1.3.2.1 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution or who are abused,neglected or exploited. 14 1 60 p SECTION II: MANNER OF SERVICE PROVISION 2. Delivery of Service to Eligible Clients The vendor shall ensure the provision of a continuum of service that meet the diverse needs of functionally impaired elders. The vendor shall ensure performance and reporting of the following service provision in accordance with the current DOEA Programs and Services Handbook. The services may include the following categories: (1) Core Services; (2) Health Maintenance Services;and (3) Other Support Services. Core Services for Programmatic Operation 2.1. The vendor may deliver core services include a variety of home-delivered services, day care services,and other basic services that are most needed to prevent unnecessary institutionalization. Core services,to be provided at the unit rate identified in this agreement, include the following: (1) Adult Day Care; (7) Housing Improvement; (2) Chore Services; (8) Respite Services; and (3) Enhanced Chore; (9) Transportation (4) Companionship; (5) Home Delivered Meals; (6) Homemaker; 2.1.1 Health Maintenance Services The vendor shall ensure that health maintenance services are routine health services that are necessary to help maintain the health of functionally impaired elders. The services are limited to medical therapeutic services, non-medical prevention services, personal care services, home health aide services, home nursing services, and emergency response systems. Typical services to be provided at the unit rate identified in this agreement, are the following: (1) Adult Day Health Care; (2) Emergency Alert Response; (3) Nutrition Counseling (4) Personal Care (5) Skilled Nursing Services; and (6) Specialized Medical Equipment Services and Supplies 2.2 SERVICE TIMES 2.2.1 Service Times 15 ��i 16132 2 The vendor shall ensure the provisions of the services listed in this agreement are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m. to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the agreement in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this agreement as updated, and approved by the County's reporting requirements. Service Unit of Service Adult Day Care Homemaker Case Aide Housing Improvement Case Management Respite Services Chore Services Personal Care Hour Enhanced Chore Physical Therapy Companionship Skilled Nursing Services Emergency Alert Response Day Material Aid Episode Specialized Medical Equipment, Services and Supplies Escort Shopping Assistance One-Way Trip Transportation Service Unit of Service Home Delivered Meals Meal 2.4 REPORTS The vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The vendor shall establish due dates for any agreement that permits the vendor to meet the County's reporting requirements. Service Costs Reports The vendor shall submit to the County semi-annual service cost reports, August 1, 2013 and February 1, 2014, of each year which reflects actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.5 RECORDS AND DOCUMENTATION 2.5.1 Each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup 16 r; 2.6 COUNTY RESPONSIBILITIES 1 60 2 2.6.1 Program Guidance and Technical Assistance The County will provide to the vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the vendor. resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures will be made available to the County upon request. 2.7 PERFORMANCE SPECIFICATIONS 2.7.1 Outcomes (1) The vendor shall ensure services provided under this agreement are in accordance with the current Department of Elder Affairs Programs and Services Handbook. (2) The vendor shall timely submit to the County all information described in EXHIBIT 1, SECTION 2.4 REPORTS; and (3) The vendor shall timely submit to the County all information described in EXHIBIT 1, SECTION 2.5 RECORDS AND DOCUMENTATION. 2.8. VENDOR'S FINANCIAL OBLIGATIONS 2.8.1 Matching,Level of Effort,and Earmarking Requirement The vendor will assure a match requirement of at least 10 percent of the cost for all CCE services. The match will be made in the form of cash and/or in-kind resources. At the end of the agreement period, all CCE funds expended must be properly matched. State funds cannot be used to match another state-funded program. 3. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 17 e, 1602 2 3.4 Payment may be authorized only for allowable services, which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 18 160 2 EXFIIBIT 2 STATEMENT OF WORK HOME CARE FOR THE ELDERLY PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Adult Protective Services(APS) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) 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) Home Care for Disabled Adults (HCDA) Home Care for the Elderly(HCE) Institutional Care Program(ICP) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults(HCDA) services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026) and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the County enters HCE specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement Area Agencies on Aging may contract with CCE lead agencies or other case management entities for the provision of the HCE program. Approved caregivers receive a Basic Subsidy to reimburse some of their expenses each month for caring for the consumer and may receive a Special Subsidy for other necessary services and essential supplies. Caregivers may be approved 19 1602 for up to three HCE clients in their home. 1.2.2 Home Care for the Elderly Program Mission Statement The Home Care for the Elderly Program supports family style living arrangements, on a non- profit basis,as an alternative to nursing homes or other institutional care. Through the program, a caregiver for three or fewer elders living in a private home provides basic services of maintenance and supervision as well as coordinating other necessary specialized services. 1.2.3 Authority The relevant authority governing the HCE program include: (1) Rule Chapter 58H-1,Florida Administrative Code; and (2) Sections 430.601 through 430.608, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services', Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: CFO Memo No. 02: Release date,August 20,2010; CFO Memo No. 03: Release date, June 29, 2010; and CFO Memo No. 06: Release date,June 30, 2010. 1.2.4 Scope of Service The Vendor shall provide services in a manner consistent with and described in the current County's area plan update and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the HCE program are to ensure that: (1) Basic Subsidy is provided to the caregiver of each client and (2) Special Subsidy is provided when essential to the well-being of the client. 1.3 INDIVIDUAL TO BE SERVED 1.3.1 General Eligibility The Home Care for the Elderly program serves elders age 60 and older at risk of placement in a nursing home or other institutional settings who can remain in a family style setting through the provision of subsidies. 1.3.2 Client Eligibility Clients eligible to receive services under this agreement must: (1) Be 60 years of age or older; (2) Have income less than the Institutional Care Program(ICP) standard. (3) Meet the ICP asset limitation; (4) Be at risk of nursing home placement; 20 1602 (5) Have an approved adult caregiver living in the home with them who is willing to provide care or assist in arranging for care; and (6) Not be enrolled in the Aged and Disabled Adult Medicaid waiver or a Medicaid capitated long-term care program. 1.3.3 Caregiver Eligibility Caregivers eligible to receive services under this agreement must: (1) Be at least 18 years of age, capable of providing a family-type living environment; (2) 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; (3) Be willing to accept responsibility for the social, physical and emotional needs of the care Vendor; (4) Be physically present and live in the home to provide supervision and to assist in arrangement of services for the client; (5) 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 (6) Be without record of conviction of abuse, neglect or exploitation of another person. 1.3.4 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meet the diverse needs of the functionally impaired elders and their caregivers. The Vendor shall ensure Basic Subside and Special Subsidy services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. 2.1. Basic Subsidy The Basic Subsidy is a cash payment made to an approved caregiver each month to reimburse some expenses incurred in caring for the client. The Basic Subsidy is provided for support and maintenance of the client, including housing, food, clothing, and medical costs not covered by Medicaid, Medicare or any other insurance. A Basic Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. If the client is hospitalized or in any other temporary institution for 30 days or less,the full Basic Subsidy shall be provided to the caregiver as if the client were in the home. 2.2. Special Subsidy Services Though every eligible HCE client receives a Basic Subsidy, Special Subsidy payments are pre-authorized and are based on additional specialized medical or health care services, supplies or equipment needed to maintain the health and well-being of the individual elder. The Special Subsidy for additional medical support and special services is a cash payment to reimburse the costs of any other service or special care not covered by Medicaid, Medicare, or private insurance when these services are determined to be 21 160 2 essential to maintain the well-being of the home care recipient. A Special Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. Special Subsidy 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: 2.2.1 SERVICE LOCATION AND EQUIPMENT 2.2.2 Service Times The vendor shall ensure the provision of the services listed in this contract are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m. to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the Agency's reporting requirements. Service Unit of Service Adult Day Care Housing Improvement Case Aide Other Case Management Personal Care Hour Chore Respite(Facility Based or In-Home) Chore(Enhanced) Skilled Nursing Services Homemaker Material Aid Episode Specialized Medical Equipment, Services and Supplies Transportation One-Way Trip 2.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permits the Vendor to meet the County's reporting requirements. 2.2.1 Service Costs Reports The Vendor shall submit to the County the semi-annual service cost reports, August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.3 RECORDS AND DOCUMENTATION 2.3.1 The Vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The 22 2 Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 2.4 PERFORMANCE SPECIFICATIONS 2.4.1 Outcomes (1) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (2) The Vendor shall timely submit to the County all reports described in SECTION 2.2 REPORTS; and (3) The Vendor shall timely submit to the County all information described in, SECTION 2.3 RECORDS AND DOCUMENTATION. 2.5 COUNTY RESPONSIBILITIES 2.5.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-up on-site visits; (3) Client visits; (4) Review of independent auditor's reports; (5) Review of third-party documents and/or evaluation; (6) Review of progress reports; (7) Review of customer satisfaction surveys; (8) Agreed-upon procedures review by an external auditor or consultant; (9) Limited-scope reviews; and (10) Other procedures as deemed necessary. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The 23 1602 2 vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services,which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 24 EXIIIBIT 3 1 6 fj STATEMENT OF WORK ALZHEIMER'S DISEASE INITIATIVE PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Alzheimer's Disease(AD) Alzheimer's Disease Initiative(ADI) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System(CIRTS) Community Care for Disabled Adults(CCDA) Department of Elder Affairs (DOEA) Home Care For Disabled Adults(HCDA) Instrumental Activities of Daily Living(IADL) Memory Disorder Clinic (MDC) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults(HCDA) services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026. 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 County enters ADI specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 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. Model Day Care: A program of therapeutic, social and health activities specific to clients with memory disorders. Services and activities include, but are not limited to, active and quiet 25 -�l 16132 games, reminiscence, validation therapy, pet therapy, water therapy and other failure free activities appropriate to the client's level of functioning. Model day care centers will also provide training for health care and social service personnel in the care of persons having AD or related memory disorders. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The ADI program provides a continuum of services addressing the special needs of individuals with AD,their families and caregivers. 1.2.2 Alzheimer's Disease Initiative Program Mission Statement The ADI program ensures that persons afflicted with AD and other forms of dementia are given essential services to help them age in place in an elder-friendly environment with security, dignity, and purpose. The program also provides support to family members and caregivers of persons afflicted with AD. 1.2.3 Authority The relevant authority governing the Alzheimer's Disease Initiative Program are as follows: (1) Rule Chapter 58D-1, Florida Administrative Code; and (2) Sections 430.501 through 430.504, Florida Statutes. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1) CFO Memo No. 02: Release date,August 20,2010; (2) CFO Memo No. 03: Release date, June 29, 2010; and CFO Memo No. 06: Release date,June 30,2010. 1.2.3.2 Scope of Service The Vendor is responsible for the programmatic, fiscal, and operational management of the ADI program. The program services shall be provided in a manner consistent with and described in the current Vendor's Request for Proposal, RFP, and the County's current area plan and the current Depai liuent of Elder Affairs Programs and Services Handbook. 1.2.3.4 Major Program Goals The major goal of the ADI program is to provide services to meet the needs of caregivers and individuals with AD and related memory disorders. 1.3 INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The ADI Program addresses the special needs of individuals with AD and their caregivers. 1.3.2 Individual Eligibility Those individuals eligible to receive services under this contract must meet the following conditions: (1) Be 18 years of age or older and have a diagnosis of AD or a related disorder, or be 26 16p suspected of having AD or a related disorder; and 2 (2) Not be enrolled in a Medicaid capitated long-term care program. 1.3.3 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. SERVICE TASKS In order to achieve the goals of the ADI program, the Vendor shall ensure the following tasks are performed: (1) Client eligibility determination; (2) Assessment and prioritization of service delivery for new clients; (3) Delivery of services to eligible clients; and (4) Monitor the performance of vendors. 2.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described in this SECTION 1.3. 2.2 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services addressing the diverse needs of individuals with AD and their caregivers. The Vendor shall ensure services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. Services categories include: (1) Caregiver Training/Support; (2) Case Aid; (3) Case Management; (4) Counseling(Gerontological); (5) Counseling(Mental Health/Screening); (6) Education/Training; (7) Model Day Care; ( 8) Respite (Facility-Based); ( 9) Respite(In-Home); and (10) Specialized Medical Equipment, Services,and Supplies. Caregivers benefit from receiving training, respite and related support services to assist them in caring for the ADI client. 2.3 Service Times The Vendor shall ensure the provisions of the services listed in this contract are available 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. 27 3. DELIVERABLES 1 6 2 3.1. Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the County's reporting requirements. Service Unit of Service Caregiver Training/Support; Hour Case Aid; Hour Case Management; Hour Counseling(Gerontological); Hour Counseling(Mental Health/Screening); Hour Respite(Facility-Based); Hour Respite(In-Home); Hour Education/Training; Episode Episode 3.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. 3.2.1 Service Costs Reports Vendor must submit to the County the semi-annual service cost reports August 1, 2013 and February 1,2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 3.3 RECORDS AND DOCUMENTATION 3.3.1 The Vendor and each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 4. PERFORMANCE SPECIFICATIONS 4.1 Outcomes (4) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (5) The Vendor shall timely submit to the County all reports described in SECTION 3.2 REPORTS; and (6) The Vendor shall timely submit to the County all information described in SECTION 3.3 28 RECORDS AND DOCUMENTATION. 1 613 5. COUNTY RESPONSIBILITIES 5.1. Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-up on-site visits; (3) Client visits (4) Review of independent auditor's reports (5) Review third-party documents and/or evaluations (6) Review of progress reports (7) Review of customer satisfaction surveys (8)Agreed-upon procedures review by an external auditor or consultant; (9)Limited-scope reviews; and (10)Other procedures as deemed necessary. 6. SECTION III: METHOD OF PAYMENT 6.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 6.1.2 Remedies-Nonconforming Services The Vendor shall ensure that all goods and/or services provided under this agreement for HCE funded programs are delivered timely, completely and commensurate with required standards of quality Such goods and/or services shall only be delivered to eligible program participants. If the Vendor fails to meet the prescribed quality standards for services, such services will not be reimbursed under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be reimbursed under this agreement. The Vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the Vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County requires immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 6.1.3 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the Vendor and any adjustments thereto, including any disallowance not resolved. 6.1.4 Date for Final Request for Payment 29 1611 ? The final request for payment for agreement year one's expenditures will be due to the County no later than August 1,2013. The final request for payment for agreement year two expenditures will be no later than August 1,2014. 6.2 Documentation for Payment The Vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals upon request. Such documentation shall be provided upon request to the County or the Clerk of Court. 30 Gaol EXHIBIT 4 I 6 0 #, STATEMENT OF WORK OLDER AMERICANS ACT PROGRAM TITLE III SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 CONTRACT ACRONYMS Area Agency on Aging(AAA) Activities of Daily Living(ADL) Alliance of Information&Referral Systems(AIRS) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System(CIRTS) Information and Referral(I&R) Instrumental Activities of Daily Living(IADL) Older Americans Act(OAA) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in Its PSA in accordance with the Section 306(42 U.S.C. 3026) of the OAA and Department instructions. Child: An individual who is not more than 18 years of age or an individual with disability. Family Caregiver: An adult family member, or another individual,who is an informal provider of in-home and community care to an older individual. Frail: When an older individual is unable to perform at least two ADLs without substantial human assistance, including verbal reminding,physical cueing or supervision; or due to cognitive or other mental impairment, requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to another individual. 1.2 County Mission,Vision and Values Statement The County's mission: To help aging adults achieve greater independence through awareness of resources and access to qualified service providers.The County's vision: To be the recognized leader in supporting older adults and their families with access to trustworthy resources and services in their communities while empowering them to live with independence and dignity. The County's values: We believe residents of Southwest Florida are entitled to: Comprehensive information about their choices of care; Timely access to resources and services; High standards of quality and performance; and Personal and professional accountability from all stakeholders. 1.2.1 Older Americans Act Program Mission Statement The Older Americans Act(OAA)Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. 31 1.3 GENERAL DESCRIPTION 1 6 Dp 1.3.1 General Statement The OAA Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. The primary purpose of the OAA program is to foster the development and implementation of comprehensive and coordinated systems to serve older individuals. The OAA program uses these systems to assist older individuals to attain and maintain maximum independence and dignity in a home environment and allows for the capability of self- care with appropriate supportive services. 1.3.2 Authority The relevant references authority governing the OAA program are: 1. Older Americans Act of 2006, as amended; 2. Rule 58A-1, Florida Administrative Code; and 3. Section 430.101, Florida Statutes. 1.3.2.1 Incorporation of Reference Memoranda In accordance with Ch. 287 F.S., as amended, and Agency of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and incorporated by reference: 1. CFO Memo No. 02: Release date, August 20,2010; 2. CFO Memo No. 03: Release date,June 29,2010; and 3. CFO Memo No. 06: Release date, June 30, 2010. 1.3.3 Scope of Service The Vendor shall provide services in a manner consistent with and descried in the current area plan and current Depar Inient of Elder Affairs Programs and Services Handbook. 1.3.4 Major Program Goals The major goals of the OAA program are to improve the quality of life for older individuals, preserve their independence and prevent or delay more costly institutional care. These goals are achieved through the implementation of a comprehensive and coordinated service system that provides a continuum of service alternatives that meet the diverse needs of elders and their caregivers. 1.4 INDIVIDUALS TO BE SERVED 1.4.1 Eligibility(Title III Programs) 1.4.1.1 OAA Title III,General Consumers shall not be dually enrolled in an OAA program and a Medicaid capitates long-term care program. 1.4.1.2 OAA Title ME, Caregiver Support Services Eligibility for OAA Title IIIE, Caregiver Support Services, are as follows: 1. Family caregivers of individuals age 60 or older; 32 1602 2. Grandparents(age 55 or older)or older individuals(age 55 or older)who are relative caregivers; 3. Priority will be given to family caregivers who provide care for individuals with Alzheimer's disease and related disorders with neurological and organic brain dysfunction and for grandparents or older individuals who are relative caregivers who provide care for children with severe disabilities; and 4. For respite and supplemental services, a family caregiver must be providing care for an older individual who meets the definition of the term"frail" in OAA, Section 102 Paragraph 22. 1.4.2 Targeted Groups Preference shall be given to those with the greatest economic and social need,with particular attention to low-income older individuals, including those that are low-income minorities,have limited English proficiency, and older individuals residing in rural areas. SECTION II—MANNER OF SERVICE PROVISION 2.1 SERVICE TASKS In order to achieve the goals of the OAA program,the Vendor shall ensure the following tasks are performed: 1. Client eligibility determination; 2. Targeting and screening of service delivery for new clients; 3. Delivery of services to eligible clients; 4. Use of volunteers to expand the provision of available services; 5. Monitoring the performance of its vendors. 6. Grievance and Compliance Procedures 2.1.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described herein. 2.1.2 Targeting and Screening of Service Delivery for New Clients The Vendor shall develop and implement policies and procedures consistent with OAA targeting and screening Criteria 2.1.3 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meets the diverse needs of elders and their caregivers. The Vendor shall ensure the performance and report performance of the following services in accordance with the current Department of Elder Affairs Programs and Services Handbook. The services funded pursuant to this contract are in accordance with the OAA, Title III, sections 321,331,336 and 373 as follows: 1. Section 321,Title IIIB Supportive Services; 2. Section 373,Title HIE Caregiver Support Services. 2.1.3.1 Supportive Services Supportive services include a variety of community-based and home-delivered services that support the qualities of life for older individuals by helping them remain independent and productive. Services include the following: 33 1602 (1) Adult Day Care/Adult Day Health Care; (17) Homemaker; (2) Caregiver Training/Support; (18) Housing Improvement; (3) Case Aide/Case Management; (19) Information; (4) Chore Services; (20) Intake; (5) Companionship; (21) Interpreter/Translating; (6) Counseling(Gerontological and Mental Health); (22) Referral/Assistance; (7) Education/Training; (23) Personal Care; (8) Legal Assistance; (24) Physical Therapy; (9) Material Aid; (25) Shopping Assistance; (10) Occupational Therapy; (26) Skilled Nursing; (11) Outreach; (27) Specialized Medical Equipment, Services, and Supplies (12) Recreation; (28) Respite Services; (13) Emergency Alert Response; (29) Screening/Assessment; (14) Escort; (30) Speech Therapy; (15) Health Support; (31) Telephone Reassurance; and (16) Home Health Aide; (32) Transportation 2.1.3.4 Caregiver Support Services (Title IIIE Program) The following services are intended to provide direct help to caregivers, assist in the areas of health, nutrition and financial literacy and assist caregivers in making decisions and problem solving related to their caregiving roles and responsibilities: (1) Adult Day Care/Adult Day Health Care; (2) Caregiver Training/Support; (3) Counseling(Gerontological and Mental Health); (4) Education/Training; (5) Financial Risk Reduction(Assessment and Maintenance); (6) Information; (7) Intake; (8) Outreach; (9) Respite Services; (10) Screening/Assessment; and (11) Transportation 2.1.3.5 Caregiver Support Supplemental Services (Title DES Program): The following services are provided to complement the care provided by caregivers: (1) Chore Services; (2) Housing Improvement; (3) Legal Assistance; (4) Material Aid; and (5) Specialized Medical Equipment, Services and Supplies. 2.2 SERVICE LOCATION 34 16132 2 2.2.1 Service Times The Vendor shall ensure the provision of the services listed in the contract during normal business hours unless other times are more appropriate to meet the performance requirements of the contract, and it shall monitor its vendors to ensure they are available to provide services during hours responsive to client needs and during those times which best meet the needs of the relevant service community. 2.3 DELIVERABLES 2.3.1 Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the services tasks described in Section 2.1. The chart below lists the services allowed and the units of measurement. Units of service will be paid pursuant to the rate established in the 2010 RFP and approved by the County. Services Unit of Service Adult Day Care/Adult Day Interpreter/Translating Health Care Legal Assistance Caregiver Training/Support Medication Management Case Aid/Case Management Mental Health Counseling/Screening Chore Services Nutrition Counseling Companionship Occupational Therapy Counseling Services Personal Care Escort Physical Therapy Hour Financial Risk Reduction Recreation Services Respite Services Health Support Screening/Assessment Home Health Aide Sitter Homemaker Skilled Nursing Services Housing Improvement Speech Therapy Intake Emergency Alert Response Day Education/Training Episode Information Material Aid Referral/Assistance Specialized Medical Equipment, Services and Supplies Telephone Reassurance Escort One-Way Trip Shopping Assistance Transportation 2.4 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permit the Vendor to meet the County's reporting requirements. 35 rcxi 1602 2.4.2 Service Costs Reports The Vendor shall require vendors to submit to the Vendor semi-annual service cost reports on August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.4.5 Background Screening Affidavit of Compliance To demonstrate compliance with section 8 of the Standard Contract,the Vendor shall submit ATTACHMENT H, Background Screening Affidavit of Compliance annually, by January 15t. 2.5 RECORECORDS AND DOCUMENTATION Each Vendor and vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement in its contracts and/or agreements with vendors. These policies and procedures shall be made available to the County upon request. 2.6 PERFORMANCE SPECIFICATIONS 2.6.1 Outcomes (1)The Vendor shall ensure services provided under this contract are in accordance with the current DOEA Programs and Services Handbook, (2)The Vendor shall timely submit to the County all reports described herein (3)The Vendor shall timely submit to the County all information described in, Paragraph 2.5 RECORDS AND DOCUMENTATION. 2.7 VENDOR'S FINANCIAL OBLIGATIONS 2.7.1 Matching,Level of Effort,and Earmarking Requirements The Vendor shall provide match of at least 10 percent of the federal funds received. The Vendor's match will be made in the form of cash and/or in-kind resources. The Vendor will assure,through a provision in subcontracts,a match requirement of at least 10 percent of the cost for all services funded through this contract. The vendor's match will be made in the form of cash and/or in-kind resources. The Vendor shall report match by title each month. At the end of the contract period, the Vendor must properly match all OAA funds. 2.7.2 Title III Funds The Vendor assures compliance with Section 306 of the OAA, as amended in 2006,that funds received under Title III will not be used to pay any part of a cost incurred by the Vendor to maintain a contractual or commercial relationship that is not carried out to implement Title III. 2.8 COUNTY RESPONSIBILITIES 2.8.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the Vendor. 2.8.2 Program/Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this contract. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an on-site visit. The County's determination of acceptable performance shall be conclusive. The Vendor 36 16132 agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: 1. Desk reviews and analytical reviews; 2. Scheduled, unscheduled and follow-up on-site visits; 3. Client visits; 4. Review of independent auditor's reports-Exhibit 10; 5. Review of third-party documents and/or evaluation; 6. Review of progress reports; 7. Review of customer satisfaction surveys; 8. Agreed-upon procedures review by an external auditor or consultant; 9. Limited-scope reviews; and 10. Other procedures as deemed necessary. 2.8.3 Contract Monitoring The County shall, at its own discretion, conduct monitoring concerning any aspect of the vendor's performance of this contract. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for OAA IIIE and OAA HIES funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rate for services is ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services, which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 37 1613 2 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1,2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 38 1602 EXHIBIT 5 Agreement#12-5856 "Services for Seniors Attachment B Invoice and Logs (Minimum Standard Invoice Information) County Purchasing Order Number: Invoice Number: Grant Name: From Date To Date Reimburse ment Rate Per Unit to Total Supplier TOTAL AMOUNT Cost In Kind (Subtract (Multiply the Service Description In Kind Unit Reimbursement (identified by line) Per Match Match Quantity Rate Per Unit to Service Amount Amount Supplier x the Unit Unit from Total Quantity) Cost Per Service Unit) $0.00 $0.00 $0.00 Total $0.00 I certify to the best of my knowledge and belief that this invoice, and attached service detail log, is complete and correct and all outlay herein are for the purposes set forth in the contract, and that services are ordered by the case manager as agreed on the Contract. Legible copies of the dated timesheet, signed by the client and the worker supporting this invoice must be available upon request. Collier County reserves the right to correct computation of errors to assure proper payment amount. Prepared by: Date: Adjustment Reasons Lead Agency Authorization Attachments: Monthly Service log, Weekly Detail log and Client Service time sheets. 39 160p EXHIBIT 6 Detail Weekly for CCE Services Week Ending: Invoice No. Personal CLIENT Care Homemaker Respite Skilled Companion Chore Total Total Total Total Total Total NAME Units Units Units Units Units Units Total Hours - - - - - - $ PECA - HMK - $ RESPITE - $ SKILLED - $ COMPANION - $ CHORE - $ TOTAL - 40 c�? 16132 Monthly Detail Service Log Grant Name: Vendor Name, Address: From Date To Date By client, provide the total number of hours provided during the dates of service. This log must be submitted with your monthly invoice for the Invoice From Date and To Date. Respite Adult Respite Emergency Client Personal Home- Skilled Enhance Corn— Shopping Alert Name Care (In- Day (In- Chore Escort maker Nursing Chore panion Assist Response Home) Care Facility System :o v. 41 EXHIBIT 8 16112 Daycare Grant: Grant Service: ADC or RESF Vendor Name and Address By client, provide the Weekly Client Service Time Sheet provided during the dates of service. This log must be submitted with all invoices for the invoice From Date and To Date. TO FROM DATE: DATE: Client Thur Uni Client Name signature Mon Tue Wed s Fri Sat Sun Match is Service Dates 42 C-46 EXHIBIT 9 16 D 2 YOUR COMPANY NAME HERE Collier County Services for Seniors Homemaker/Personal Care/Respite/Companion Work Sheet Client Name: Client Signature: Week Ending: Each Time You Perform one of the Activities Below: Put in arrival and departure times for the day worked: ****Client should Initial time of arrival and departure. ****Client should Sign form at top. ****you should sign your name at the bottom. Date: Day: MON TIES WED THUR FRI SAT SUN TOTAL TIME ARRIVAL TIME: DEPARTURE TIME: ****CLIENT INITIALS: Arrive: PERSONAL CARE Depart: Assist W/Bath tub Shower Bed Assist W/Dressing Bathroom Assist Shave (Face Only) Oral Hygiene Walking/Ambulation Feeding Assistance Wash/Set Hair Backrub Soak Feet Nails (File only) Change_Make Take out Trash Clean Bedroom Clean Bathroom Prepare Meals Laundry Arrive: HOME MAKING Depart: Vacuum/Sweep Light Dusting 43 16132 Clean Kitchen Floor Wash Dishes Mop Sweep_ Grocery Shop Errands Arrive: RESPITE Depart: Arrive: COMPANION Depart: EMPLOYEE'S Signature/Title 44 cao 16132 EXHIBIT 10 OMB Circular A-133 Audits of States, Local Governments, and Non-Profit Organizations requires the Collier County Housing, Human and Veterans Services Department to monitor our subrecipients of federal awards and determine whether they have met the audit requirements of the circular and whether they are in compliance with federal laws and regulations. Accordingly, we are requiring that you check one of the following, provide all appropriate documentation regarding your organization's compliance with the audit requirements, sign and date this form. Subrecipient Fiscal Year Name Period Total State Financial Assistance Expended during $ most recently completed Fiscal Year Total Federal Financial Assistance Expended during most $ recently completed Fiscal Year Check Appropriate Boxes We have exceeded the $500,000 federal/state expenditure threshold for our fiscal year I I ending as indicated above and have completed our Circular A-133 audit. A copy of the audit report and management letter are attached. We exceeded the $500,000 federal/state expenditure threshold for our fiscal year n ending as indicated above and expect to complete our Circular A-133 audit by . Within 30 days of completion of the A-133 audit, we will provide a copy of the audit report and management letter. We are not subject to the requirements of OMB Circular A-133 because we: H Did not exceed the $500,000 federal/state expenditure threshold for the fiscal year indicated above H Are a for-profit organization Are exempt for other reasons — explain An audited financial statements is attached and if applicable, the independent auditor's management letter. (If findings were noted, please enclose a copy of the responses and corrective action plan.) Certification Statement I hereby certify that the above information is true and accurate. Signature Date Print Name and Title 45 CAC ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE 1 6 Li 2 masaismaiimmeig Routed by Purchasing Department to Office Initials Date the Following Addressee(s) (In routing order) 1. Risk Management Risk 2. County Attorney Office County Attorney Office �� S V3N\\3 3. BCC Office Board of County s��rcd Commissioners V\c .-c a..kv-_513\V3 4. Minutes and Records Clerk of Court's Office sf 3 I /13 pm 5. Return to Purchasing Department Purchasing Contact: Diana DeLeon PRIMARY CONTACT INFORMATION Name of Primary Diana DeLeon for Lisa Carr, HHVS, Phone Number 252-8375 Purchasing Staff May 29,2013 Contact and Date Agenda Date Item was May 28,2013 Agenda Item Number 16.D.2 Approved by the BCC Type of Document Contract Amendment Number of Original 2 Attached Documents Attached PO number or account N/A Solicitation/Contract Amend#1 to Contract 12- number if document is Number/Vendor Name 5856 Sunrise Community to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever.is Yes N/A(Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature? DD 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A provide the Contact Information(Name; Agency;Address;Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be signed by the Chairman, with the exception of most letters,must be reviewed and signed S),P,)\■1/4) by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's DD signature and initials are required. 7. In most cases(some contracts are an exception), an electronic copy of the document and DD this routing slip should be provided to the County Attorney's Office before the item is input into SIRE. 8. The document was approved by the BCC on the date above and all changes made DD during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the , 1 BCC,all changes directed by the BCC have been made, and the document is ready for the QQ Chairman's signature. 1602 MEMORANDUM Date: June 3, 2013 To: Diana DeLeon, Contract Technician Purchasing Department From: Teresa Cannon, Deputy Clerk Minutes & Records Department Re: Amendment #1 to Contract #12-5856 "Services for Seniors" Contractor: Sunrise Community, Inc. Attached is an original copy of the contract referenced above, (#16D2) approved by the Board of County Commissioners on Tuesday, May 28, 2013. The second original will be held on file in the Minutes and Record's Department for the Board's Official Record. If you have any questions, please feel free to contact me at 252-8411. Thank you. Attachment 16fi Contract Amendment #1 Contract # 12-5856 "Services for Seniors" This CONTRACT AMENDMENT #1, dated $16 it 7 , 2013 to the referenced agreement shall be by and between the parties to the original Agreement) Sunrise Community, Inc. (to be referred to as "Vendor")and Collier County, Florida, (to be referred to as"County"). Statement of Understanding RE: Contract# 12-5856 "Services for Seniors" In order to continue services for the original Contract document referenced above, the Vendor agrees to the terms and conditions set forth in Exhibit A-1A, which includes Attachments C-H and Exhibits 1-10 attached hereto and incorporated by reference. The Vendor further agrees to amend Section 1, Commencement, as follows: 1. COMMENCEMENT. This Agreement shall Commence on December 11, 2012 and shall terminate on December 10, 2014 June 30, 2014. The Contract award is a two (2) year contract, with the possibility of two (2) additional (2) year terms pending funding from grantors and acceptable performance by the awarded vendor. Any such renewals shall be mutually agreed upon in writing by the parties. The maximum duration for this Contract for CCE, HCE, and ADI, OAA HIE AND OAA HIES funding will not exceed six (6) years (through June 30, 2018). As outlined in RFP #12-5856, the County requires the Vendor to contribute a cash or in-kind match of no less than ten (10) percent for all services related to the Community Care for the Elderly Program, (CCE), Older American Title HIE Caregiver Support (OAA IIIE) and Older American Title HIES Caregiver Support Supplemental Services (OAA HIES)Programs. Words that have been deleted are struck through, words underlined have been added. Modification made herein shall apply as if incorporated into the Contract on the date of Commencement. All other teiiiis and conditions of the agreement shall remain in force. fN WITNESS WHEREOF, the Vendor and the County have each, respectively, by an authorized person or agent,hereunder set their hands and seals on the date(s) indicated below. / Accepted: I ` , 2013 VENDOR: Sunrise Community, Inc. First Witness Q S Cv By: 47v / Type/print itness name )c-•A.e_,5 Wetkcs - Sec ITvece.s . and Witness Print/Type Name and Title C-yr.4=1462. i.t›c:,r-}-t.,o U Type/print witness name 1 16fl � COUNTY: ATTEST BOARD OF COUNTY COMMISSIONERS DWIGJT'E:BOCK, CLERK OF COLLIER COUNTY, FLORIDA W. a • H- B DEPUTY CLERK . . �:i� • . 'Attest s ytt a CIIAIRWOMAN signature only. Approval for form and legal Sufficiency: Jennifer B. White Assistant County Attorney Item# _L C9.ba Agendaaal Date Rate b l 3 I�� Recd l 2 Deputy Clerk EXHIBIT A-lA 1 AGREEMENT 12-5856 SERVICES FOR SENIORS ATTACHMENTS ATTACHMENT ATTACHMENT DESCRIPTION PAGE Attachment C Core Standards for CCE, HCE, ADI, OAA IIIE & IIIES 2 Attachment D Certification Regarding Lobbying 8 Attachment E Certification Regarding Data Integrity Compliance 9 Attachment F Certification Regarding Debarment, Suspension, 10 Ineligibility and Voluntary Exclusion Contracts/ Subcontracts Attachment G Sub-Recipient Invoice Submission 11 Attachment H Background Screening Affidavit of Compliance 12 Exhibit 1 CCE Statement of work 13 Exhibit 2 HCE Statement of work 19 Exhibit 3 ADI Statement of work 25 Exhibit 4 OAA IIE and OAA IIIES Statement of work 31 Exhibit 5 Invoice 39 Exhibit 6 Detail Weekly Log 40 Exhibit 7 Monthly Log 41 Exhibit 8 Day Care/Respite Time Sheet 42 Exhibit 9 Program Time Sheet 43 Exhibit 10 Annual Audit Monitoring Report 45 1 0 ATTACHMENT C / EI Core Standards for CCE,HCE,ADI,OAA IIIE & HIES 1. Compliance with Federal Law 1.1 If this agreement contains federal funds the following shall apply: 1.1.1 The vendor shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable regulations. 1.1.2 If this agreement contains federal funds and is over $100,000.00, the vendor shall comply with all applicable standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s. 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable Environmental Protection County regulations 40 CFR 30. The vendor shall report any violations of the above to the County. 1.1.3 The vendor may not use any federal funds received in connection with this agreement to influence legislation or appropriations pending before the Congress or any state legislature. If this agreement contains federal funding in excess of$100,000.00, the vendor must, prior to agreement execution, complete the Certification Regarding Lobbying form, ATTACHMENT D. All disclosure forms as required by the Certification Regarding Lobbying form must be completed and returned to the Grant Coordinator prior to payment under this agreement. 1.1.4 In accordance with Appendix A to 2 CFR 215, the vendor shall comply with Executive Order 11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in Department of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable. 1.1.5 If this agreement contains federal funds and provides services to children up to age 18,the vendor shall comply with the Pro-Children Act of 1994 (20 U.S.C. 6081). 1.1.6 A agreement award with an amount expected to equal or exceed $25,000.00 and certain other agreement 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 vendor shall comply with these provisions before doing business or entering into sub-agreements receiving federal funds pursuant to this agreement. The vendor shall complete and sign ATTACHMENT F prior to the execution of this agreement. 1.2 The vendor shall not employ an unauthorized alien. The County 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 agreement by the County. 2 1.3 If the vendor 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 vendor must notify the County in writing within thirty(30) days of receiving the IRS notice of revocation. 1.4 The vendor shall comply with Title 2 CFR Part 275 regarding Trafficking in Persons. 1.5 Unless exempt under 2 CFR Part 170.110(b), the vendor shall comply with the reporting requirements of the Transparency Act as expressed in 2 CFR 170. 1.6 To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number 11-116, vendor agrees to utilize the U.S. Department of Homeland Security's E-verify system to verify the employment of all new employees hired by vendor during the agreement term. Vendor meeting the terms and conditions of the E-Verify System are deemed to be in compliance with this provision. 2. Compliance with State Law 2.1 This agreement is executed and entered into in the State of Florida, and shall be construed, performed and enforced in all respects in accordance with the Florida law, including Florida provisions for conflict of laws. 2.2 The vendor shall comply with requirements of s. 287.058, F.S. as amended. 2.2.1 The vendor shall provide units of deliverables, including various client services, and in some instances may include reports, findings, and drafts, as specified in this agreement,which the Grant Coordinator must receive and accept in writing prior to payment in accordance with s. 215.971, F.S. (1)and (2). 2.2.2 The vendor shall submit bills for fees or other compensation for services or expenses in sufficient detail for a proper pre-audit and post-audit. 2.2.3 The vendor 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 vendor in conjunction with this agreement except for those records which are made confidential or exempt by law. The vendor's refusal to comply with this provision will constitute an immediate breach of agreement for which the County may unilaterally terminate the agreement. 2.3 If clients are to be transported under this agreement, the vendor shall comply with the provisions of Chapter 427, F.S., and Rule 41-2, F. A. C. 2.4 Vendors who are on the discriminatory vendor list may not transact business with any public entity, in accordance with the provisions of s. 287.134,F.S. 2.5 The vendor shall comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the expenditure of agreement funds for the purpose of lobbying the legislature,judicial branch or a state agency. 3. Background Screening The vendor shall ensure that the requirements of s. 430.0402 and ch. 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 exempted from the Department's level 2 background screening 3l r� pursuant to s. 430.0402(2)-(3), F.S. The vendor must also comply with any applicable rules 16132 promulgated by the Department and the Agency for Health Care Administration regarding implementation of s. 430.0402 and ch. 435, F.S. Further information concerning the procedures for background screening are found at http://elderaffairs.state.fl.us/doea/backroundsereenin.q.php. 4. Provision of Services The vendor shall provide services in the manner described herein. 5. Monitoring by the County The vendor shall permit persons duly authorized by the County to inspect and copy any records, papers, documents, facilities, goods and services of the vendor which are relevant to this agreement, and to interview any clients, employees and vendor employees of the vendor to assure the County of the satisfactory performance of the terms and conditions of this agreement. Following such review, the County will provide a written report of its findings to the vendor, and where appropriate,the vendor shall develop a corrective action plan. The vendor hereby agrees to correct all deficiencies identified in the corrective action plan in a timely manner as determined by the Grant Coordinator. 6. Confidentiality of Information The vendor shall not use or disclose any information concerning a vendor of services under this agreement 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. 7. Health Insurance Portability and Accountability Act Where applicable, the vendor shall comply with the Health Insurance Portability and Accountability Act (42 USC 1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162, and 164). 8. Bankruptcy Notification During the term of this agreement, the vendor shall immediately notify the County if the Vendor, its assignees, vendors or affiliates file a claim for bankruptcy. Within ten (10)days after notification, the vendor must also provide the following information to the County.: (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., United States Bankruptcy Court Middle District of Florida,Naples, FL); and, (4)The name, address, and telephone number of the bankruptcy attorney. 9. Sponsorship and Publicity 9.1 As required by s. 286.25, F.S., if the vendor is a non-governmental organization which sponsors a program financed wholly or in part by state funds, including any funds obtained through this agreement, it shall, in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by Hope Hospice and Community Services. the State County of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County." If the sponsorship reference is in the written material, the words "State of Florida, Department of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County" shall appear in at least the same size letters or type as the name of the organization. 9.2 The vendor shall not use the words "The State of Florida Department of Elder Affairs or the Area County on Aging for Southwest Florida, Inc. or Collier County" to indicate sponsorship of a program otherwise financed, unless specific authorization has been obtained by Collier County, or the Area Aging on Aging prior to use. 4 160 ? 10. Independent Capacity of Vendor It is the intent and understanding of the Parties that the vendor, or any of its vendors, are independent vendors and are not employees of the County and shall not hold themselves out as employees or agents of the County without specific authorization from the County. It is the further intent and understanding of the Parties that the County does not control the employment practices of the vendor and will not be liable for any wage and hour, employment discrimination, or other labor and employment claims against the vendor or its vendors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary insurance for the vendor are the sole responsibility of the vendor. 11. Payment Payments shall be made to the vendor pursuant to s. 215.422, F.S., as services are rendered and invoiced by the vendor. The Grant Coordinator will have final approval of the invoice for payment, and will approve the invoice for payment only if the vendor has met all terms and conditions of the agreement, unless the bid specifications, purchase order, or this agreement specify otherwise. The approved invoice will be submitted to the County's Grant Coordinator approval and processing. 12. Return of Funds The vendor shall return to the County any overpayments due to unearned funds or funds disallowed and any interest attributable to such funds pursuant to the terms and conditions of this agreement that were disbursed to the vendor by the County. In the event that the vendor or its independent auditor discovers that an overpayment has been made, the vendor shall repay said overpayment immediately without prior notification from the County. In the event that the County first discovers an overpayment has been made, the Grant Coordinator will notify the vendor in writing of such fmdings. 13. Data Integrity and Safeguarding Information The vendor shall ensure an appropriate level of data security for the information the vendor is collecting or using in the performance of this agreement. An appropriate level of security includes approving and tracking all vendor employees that request system or information access and ensuring that user access has been removed from all terminated employees. The vendor, 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 vendor shall ensure all vendors maintain written procedures for computer system backup and recovery. The vendor shall complete and sign Attachment E prior to the execution of this agreement. 14. Computer Use and Social Media Policy The Department of Elder Affairs has implemented a new 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, Area Agencies on Aging and vendors. Any entity that uses the Department's computer resource systems must comply with the Depaitment'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. 15. Public Entity Crime Pursuant to s. 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 5 1602 agreement to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on a agreement 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 vendor, supplier, vendor, or consultant under a agreement with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in s. 287.017, F.S., for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted vendor list. 16. Patents, Copyrights,Royalties If this agreement 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 agreement, the vendor shall refer the discovery, invention or material to the County to be referred to the Department of State and the Department of Elder Affairs. Any and all patent rights or copyrights accruing under this agreement are hereby reserved to the State of Florida in accordance with Chapter 286, F.S. Pursuant to s. 287.0571 (5) (k) 1 and 2 as amended, the only exceptions to this provision shall be those that are clearly expressed and reasonably valued in the agreement. 16.1 If the primary purpose of this agreement 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 Paragraph 33. 16.2 If this agreement is awarded solely federal funding, the terms and conditions are governed by 2 CFR 215.36. 17. Emergency Preparedness and Continuity of Operations 17.1 If the tasks to be performed pursuant to this agreement include the physical care and control of clients, or the administration and coordination of services necessary for client health, safety or welfare, the vendor shall, within thirty (30) calendar days of the execution of this agreement, submit to the Grant Coordinator verification of an emergency preparedness plan. In the event of an emergency,the vendor shall notify the County of emergency provisions. 17.2 In the event a situation results in a cessation of services by a vendor, the vendor shall retain responsibility for performance under this agreement and must follow procedures to ensure continuity of operations without interruption. 18. Financial Consequences of Non-Performance If the vendor fails to meet the minimum level of service or performance identified in this agreement, or that is customary for the industry, then the County must apply financial consequences commensurate with the deficiency. Financial consequences may include,but are not limited to, agreement suspension, refusing payment, withholding payments until deficiency is cured, tendering only partial payments, and/or cancellation of agreement and reacquiring services from an alternate source. 18.1 The vendor will not be charged with financial consequences, when a failure to perform arises out of causes that were the responsibility of the County. 19. No Waiver of Sovereign Immunity 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. 20. Venue If any dispute arises out of this agreement,the venue of such legal recourse will be Collier 6 County,Florida. 1 6 I] 2 21. Entire Agreement This agreement contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations shall be valid or binding upon the County or the vendor unless expressly contained herein or by a written amendment to this agreement signed by both Parties. 22. 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. 23. 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. 24. Waiver The delay or failure by the County to exercise or enforce any of its rights under this agreement will not constitute or be deemed a waiver of the County'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. 25. Compliance The vendor shall abide by all applicable current federal statutes, laws, rules and regulations as well as applicable current state statutes, laws, rules, regulations and County rules, ordinances and regulations. The Parties agree that failure of the vendor to abide by these laws shall be deemed an event of default of the vendor, and subject the agreement to immediate, unilateral cancellation of the agreement at the discretion of the County. 26. Final Invoice The vendor shall submit the final CCE, HCE, ADI, IIE and HIES invoice for payment to the County on July 3, 2013. If the vendor fails to submit final request for payment by the deadline, then all rights to payment may be forfeited and the County may not honor any requests submitted after the aforesaid time period. Any payment due under the terms of this agreement may be withheld until all reports due from the vendor and necessary adjustments thereto have been approved by the County. 27. Renegotiations or Modifications Modifications of the provisions of this agreement shall be valid only when they have been reduced to writing and duly signed by both parties. The rate of payment, contract requirements and the total dollar amount may be adjusted retroactively to reflect price level increases and changes in the rate of payment or language. 28. All Terms and Conditions Included This agreement and its Attachments, A-H and exhibits 1-4 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 agreement shall supersede all previous communications, representations or agreements, either written or verbal between the Parties. 7 ATTACHMENT D 1602 CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR AGREEMENTS,GRANTS,LOANS AND AGREEMENTS The undersigned certifies,to the best of his or her knowledge and belief,that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any State ,Federal or County, a member of congress, an officer or employee of congress, an employee of a member of congress, or an officer or employee of the state legislator, in connection with the awarding of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal agreement, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of the County, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this federal agreement, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including vendors, sub-grants, and agreements under grants, loans and cooperative agreements) and that all vendors shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than$100,000 for each such failure. Signature Date Name of Authorized Individual Name and Address of Organization 8 ATTACHMENT E 1 602 CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS,LOANS AND COOPERATIVE AGREEMENTS The undersigned, an authorized representative of the vendor named in the agreement or agreement to which this form is an attachment, hereby certifies that: (1) The vendor and any vendors of services under this agreement 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 vendor, vendor(s), or any outside entity on which the vendor 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, vendor(s)will take immediate action to assure data integrity. (3) If this agreement 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 vendor (represented by the undersigned) and purchased by the State will be verified for accuracy and integrity of data prior to transfer. In the event of any decrease in functionality related to time and date related codes and internal subroutines that impede the hardware or software programs from operating properly, the vendor agrees to immediately make required corrections to restore hardware and software programs to the same level of functionality as warranted herein, at no charge to the State, and without interruption to the ongoing business of the state,time being of the essence. (4) The vendor and any vendor(s) of services under this agreement warrant their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data integrity compliance issues. The vendor shall require that the language of this certification be included in all vendors and other agreements and that all vendor shall certify compliance accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB Circulars A-102 and 2 CFR Part 215 (formerly OMB Circular A-110). Name and Address of vendor Signature Title Date Name of Authorized Signer 9 1602 EXHIBIT F CERTIFICATION REGARDING DEBARMENT, SUSPENSION,INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS (1) The prospective vendor certifies, by signing this certification, neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or County. (2) Where the prospective vendor is unable to certify to any of the statements in this certification,such prospective participant shall attach an explanation to this certification. Signature Date Title County/Organization (Certification signature should be same as Agreement signature.) Instructions for Certification 1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "person," "primary covered transaction," and"voluntarily excluded," as used herein,have the meanings set out in the sections of rules implementing Executive Order 12549. (2 CFR 180.5-180.1020,as supplemented by 2 CFR 376.10-376.995). You may contact the Agreement Manager for assistance in obtaining a copy of those regulations. 2. This certification is a material representation of facts upon which reliance was placed when the parties entered into this transaction. If it is later determined that the vendor knowingly rendered an erroneous certification,in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension and/or debarment. 3. The vendor will provide immediate written notice to the Agreement Manager if at any time the vendor learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The vendor may decide the method and frequency by which it determines the eligibility of its principals. Each participant to a lower tier covered transaction may,but is not required to,check the Excluded Parties List System(EPLS). 4. The vendor will include a "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transaction"in all its lower tier covered transactions and in all solicitations for lower tier covered transactions. 5. The vendor agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise authorized by the federal government. 6. If the vendor knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension,and/or debarment. 7. The vendor may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended,ineligible,or voluntarily excluded from the covered transaction,unless it knows that the certification is erroneous. 10 1602 EXIIIBIT G SUBRECIPIENT INVOICE SUATIVIISSION The County shall reimburse the SUBRECIPIENT for the performance of this Agreement upon completion or partial completion of the work tasks as accepted and approved by HHVS pursuant to the submittal of quarterly progress reports. Invoices for work performed are required every month. If no work has been performed during that month, or if the SUBRECIPIENT is not yet prepared to send the required backup, a$0 invoice will be required. Explanations will be required if two consecutive months of$0 invoices are submitted. Payments shall be made to the SUBRECIPIENT when requested as work progresses but, not more frequently than once per month. Final invoices are due no later than 90 days after the end of the agreement. Work performed during the teiui of the program but not invoiced within 90 days without written exception from the Grant Coordinator will not be reimbursed.No payment will be made until approved by HHVS for grant compliance and adherence to any and all applicable local, state or Federal requirements. Payment will be made upon receipt of a properly completed invoice and in compliance with §218.70, Florida Statutes, otherwise known as the "Local Government Prompt Payment Act." 11 t DEPARTMENT OF EXHIBIT H 1 6 2 BACKGROUND SCREENING ELDER AFFAIRS Affidavit of Compliance -Employer STATE OF FLORIDA 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 Employer Name located at Street Address City State ZIP code 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. Signature of Representative Date STATE OF FLORIDA,COUNTY OF Sworn to (or affirmed)and subscribed before me this day of , 20 , by (Name of Representative)who is personally known to me or produced 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:http://elderaffairs.state.fl.us/english/backgroundscreening.php 12 16 (32 EXHIBIT 1 STATEMENT OF WORK COMMUNITY CARE FOR THE ELDERLY PROGRAM(CCE) SECTION I: SERVICES TO BE PROVIDED 1.1. DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 AGREEMENT ACRONYMS Activities of Daily Living(ADL) Adult Protective Services(APS) Assessed Priority Consumer List(APCL) Comprehensive Assessment and Review for Long-Term Care Services(CARES) Community Care for the Disabled Adult(CCDA) Community Care for the Elderly(CCE) Client Information and Registration Tracking System(CIRTS) Department of Children and Families (DCF) Department of Elder Affairs (DOEA) Home Care for Disabled Adults (HCDA) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out: The condition of reaching 60 years of age and being transitioned from the Depai tnient of Children and Families(DCF) Services, Community Care for Disabled Adults (CCDA)or Home Care for Disabled Adults (HCDA) services to the Department's community- based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in its planning and service area in accordance with the Section 306 (42 U.S.C. 3026) of the Older Americans Act and Depaitnient 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 County enters CCE specific data in the CIRTS. An update may also include other revisions to the area plan as instructed by the County or Department of Elder Affairs. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The primary purpose of the CCE program is to prevent, decrease or delay premature or inappropriate and expensive placement of older persons in nursing homes and other institutions. 1., 1.2.2 Community Care for the Elderly Mission Statement 0 2 The CCE Program assists functionally impaired elderly persons in living as independently as possible in their own homes or in the homes of relatives or caregivers. The program provides a continuum of care through the development, expansion, reorganization and coordination of multiple community-based services to assist elders to reside in the least restrictive environment suitable to their needs. 1.2.3 Authority The relevant authority governing CCE program are: (1)Rule 58C-1,Florida Administrative Code (2) Sections 430.201 through 430.207, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services Chief Financial Officer Memoranda the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1) CFO Memo No. 02: Release date,August 20, 2010; (2) CFO Memo No. 03: Release date, June 29, 2010; and (3) CFO Memo No. 06: Release date,June 30, 2010. 1.2.4 Scope of Service The vendor shall provide services in a manner consistent with and descried in the current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the program are to preserve the independence of elders and prevent or delay more costly institutional care through a community care service system that provides case management and other in-home and community services as needed under the direction of the County and provide a continuum of service alternatives that meet the diverse needs of functionally impaired elders. 1.3. INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The CCE program provides a continuum of services for functional impaired elders. 1.3.2 Individual Eligibility In order to receive services under this agreement, an applicant must: (1) Be at least 60 years of age; (2) Be functionally impaired as determined through the initial comprehensive assessment; and (3) With the exception of APS high-risk referrals, consumers may not be dually enrolled in the CCE program and a Medicaid capitated long-term care program. 1.3.2.1 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution or who are abused, neglected or exploited. 14 L /r 16 (32 2 SECTION II: MANNER OF SERVICE PROVISION 2. Delivery of Service to Eligible Clients The vendor shall ensure the provision of a continuum of service that meet the diverse needs of functionally impaired elders. The vendor shall ensure performance and reporting of the following service provision in accordance with the current DOEA Programs and Services Handbook. The services may include the following categories: (1) Core Services; (2) Health Maintenance Services; and (3) Other Support Services. Core Services for Programmatic Operation 2.1. The vendor may deliver core services include a variety of home-delivered services, day care services, and other basic services that are most needed to prevent unnecessary institutionalization. Core services,to be provided at the unit rate identified in this agreement, include the following: (1) Adult Day Care; (7) Housing Improvement; (2) Chore Services; (8) Respite Services; and (3) Enhanced Chore; (9) Transportation (4) Companionship; (5) Home Delivered Meals; (6) Homemaker; 2.1.1 Health Maintenance Services The vendor shall ensure that health maintenance services are routine health services that are necessary to help maintain the health of functionally impaired elders. The services are limited to medical therapeutic services, non-medical prevention services, personal care services, home health aide services, home nursing services, and emergency response systems. Typical services to be provided at the unit rate identified in this agreement, are the following: (1) Adult Day Health Care; (2) Emergency Alert Response; (3) Nutrition Counseling (4) Personal Care (5) Skilled Nursing Services; and (6) Specialized Medical Equipment Services and Supplies 2.2 SERVICE TIMES 2.2.1 Service Times 15 1 6 0 2 The vendor shall ensure the provisions of the services listed in this agreement are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m.to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the agreement in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this agreement as updated, and approved by the County's reporting requirements. Service Unit of Service Adult Day Care Homemaker Case Aide Housing Improvement Case Management Respite Services Chore Services Personal Care Hour Enhanced Chore Physical Therapy Companionship Skilled Nursing Services Emergency Alert Response Day Material Aid Episode Specialized Medical Equipment, Services and Supplies Escort Shopping Assistance One-Way Trip Transportation Service Unit of Service Home Delivered Meals Meal 2.4 REPORTS The vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The vendor shall establish due dates for any agreement that permits the vendor to meet the County's reporting requirements. Service Costs Reports The vendor shall submit to the County semi-annual service cost reports, August 1, 2013 and February 1, 2014, of each year which reflects actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.5 RECORDS AND DOCUMENTATION 2.5.1 Each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup 16 2.6 COUNTY RESPONSIBILITIES 16 D 2 2.6.1 Program Guidance and Technical Assistance The County will provide to the vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the vendor. resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures will be made available to the County upon request. 2.7 PERFORMANCE SPECIFICATIONS 2.7.1 Outcomes (1) The vendor shall ensure services provided under this agreement are in accordance with the current Department of Elder Affairs Programs and Services Handbook. (2) The vendor shall timely submit to the County all information described in EXHIBIT 1, SECTION 2.4 REPORTS; and (3) The vendor shall timely submit to the County all information described in EXHIBIT 1, SECTION 2.5 RECORDS AND DOCUMENTATION. 2.8. VENDOR'S FINANCIAL OBLIGATIONS 2.8.1 Matching,Level of Effort,and Earmarking Requirement The vendor will assure a match requirement of at least 10 percent of the cost for all CCE services. The match will be made in the form of cash and/or in-kind resources. At the end of the agreement period, all CCE funds expended must be properly matched. State funds cannot be used to match another state-funded program. 3 SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 17 1602 3.4 Payment may be authorized only for allowable services, which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Depat talent of Financial Services, upon request. 18 EXHIBIT 2 1602 STATEMENT OF WORK HOME CARE FOR THE ELDERLY PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Adult Protective Services(APS) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) 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) Home Care for Disabled Adults (HCDA) Home Care for the Elderly(HCE) Institutional Care Program (ICP) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults (HCDA) services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026) and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the County enters HCE specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement Area Agencies on Aging may contract with CCE lead agencies or other case management entities for the provision of the HCE program. Approved caregivers receive a Basic Subsidy to reimburse some of their expenses each month for caring for the consumer and may receive a Special Subsidy for other necessary services and essential supplies. Caregivers may be approved 19 r for up to three HCE clients in their home. 1602 1.2.2 Home Care for the Elderl y Program ram Mission Statement The Home Care for the Elderly Program supports family style living arrangements, on a non- profit basis,as an alternative to nursing homes or other institutional care. Through the program, a caregiver for three or fewer elders living in a private home provides basic services of maintenance and supervision as well as coordinating other necessary specialized services. 1.2.3 Authority The relevant authority governing the HCE program include: (1) Rule Chapter 58H-1, Florida Administrative Code; and (2) Sections 430.601 through 430.608, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services', Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: CFO Memo No. 02: Release date,August 20, 2010; CFO Memo No. 03: Release date,June 29, 2010; and CFO Memo No. 06: Release date,June 30,2010. 1.2.4 Scope of Service The Vendor shall provide services in a manner consistent with and described in the current County's area plan update and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the HCE program are to ensure that: (1) Basic Subsidy is provided to the caregiver of each client and (2) Special Subsidy is provided when essential to the well-being of the client. 1.3 INDIVIDUAL TO BE SERVED 1.3.1 General Eligibility The Home Care for the Elderly program serves elders age 60 and older at risk of placement in a nursing home or other institutional settings who can remain in a family style setting through the provision of subsidies. 1.3.2 Client Eligibility Clients eligible to receive services under this agreement must: (1) Be 60 years of age or older; (2) Have income less than the Institutional Care Program(ICP) standard. (3) Meet the ICP asset limitation; (4) Be at risk of nursing home placement; 20 1613 (5) Have an approved adult caregiver living in the home with them who is willing to provide care or assist in arranging for care; and (6) Not be enrolled in the Aged and Disabled Adult Medicaid waiver or a Medicaid capitated long-term care program. 1.3.3 Caregiver Eligibility Caregivers eligible to receive services under this agreement must: (1) Be at least 18 years of age, capable of providing a family-type living environment; (2) 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; (3) Be willing to accept responsibility for the social, physical and emotional needs of the care Vendor; (4) Be physically present and live in the home to provide supervision and to assist in arrangement of services for the client; (5) 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 (6) Be without record of conviction of abuse, neglect or exploitation of another person. 1.3.4 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meet the diverse needs of the functionally impaired elders and their caregivers. The Vendor shall ensure Basic Subside and Special Subsidy services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. 2.1. Basic Subsidy The Basic Subsidy is a cash payment made to an approved caregiver each month to reimburse some expenses incurred in caring for the client. The Basic Subsidy is provided for support and maintenance of the client, including housing, food, clothing, and medical costs not covered by Medicaid, Medicare or any other insurance. A Basic Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. If the client is hospitalized or in any other temporary institution for 30 days or less,the full Basic Subsidy shall be provided to the caregiver as if the client were in the home. 2.2. Special Subsidy Services Though every eligible HCE client receives a Basic Subsidy, Special Subsidy payments are pre-authorized and are based on additional specialized medical or health care services, supplies or equipment needed to maintain the health and well-being of the individual elder. The Special Subsidy for additional medical support and special services is a cash payment to reimburse the costs of any other service or special care not covered by Medicaid, Medicare, or private insurance when these services are determined to be 21 at 1602 essential to maintain the well-being of the home care recipient. A Special Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. Special Subsidy 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: 2.2.1 SERVICE LOCATION AND EQUIPMENT 2.2.2 Service Times The vendor shall ensure the provision of the services listed in this contract are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m. to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the Agency's reporting requirements. Service Unit of Service Adult Day Care Housing Improvement Case Aide Other Case Management Personal Care Hour Chore Respite(Facility Based or In-Home) Chore(Enhanced) Skilled Nursing Services Homemaker Material Aid Episode Specialized Medical Equipment, Services and Supplies Transportation One-Way Trip 2.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permits the Vendor to meet the County's reporting requirements. 2.2.1 Service Costs Reports The Vendor shall submit to the County the semi-annual service cost reports, August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.3 RECORDS AND DOCUMENTATION 2.3.1 The Vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The 22 1602 2 Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 2.4 PERFORMANCE SPECIFICATIONS 2.4.1 Outcomes (1) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (2) The Vendor shall timely submit to the County all reports described in SECTION 2.2 REPORTS; and (3) The Vendor shall timely submit to the County all information described in, SECTION 2.3 RECORDS AND DOCUMENTATION. 2.5 COUNTY RESPONSIBILITIES 2.5.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-up on-site visits; (3) Client visits; (4) Review of independent auditor's reports; (5) Review of third-party documents and/or evaluation; (6) Review of progress reports; (7) Review of customer satisfaction surveys; (8) Agreed-upon procedures review by an external auditor or consultant; (9) Limited-scope reviews; and (10) Other procedures as deemed necessary. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The 23 'rte, vendor's signature on the request for payment form certifies maintenance of su o � q Pym D � documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services, which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 24 1602 EXHIBIT 3 STATEMENT OF WORK ALZHEIMER'S DISEASE INITIATIVE PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Alzheimer's Disease(AD) Alzheimer's Disease Initiative(ADI) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System(CIRTS) Community Care for Disabled Adults (CCDA) Department of Elder Affairs (DOEA) Home Care For Disabled Adults (HCDA) Instrumental Activities of Daily Living(IADL) Memory Disorder Clinic(MDC) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults (HCDA) services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026. 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 County enters ADI specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 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. Model Day Care: A program of therapeutic, social and health activities specific to clients with memory disorders. Services and activities include, but are not limited to, active and quiet 25 1602 games, reminiscence, validation therapy, pet therapy, water therapy and other failure free activities appropriate to the client's level of functioning. Model day care centers will also provide training for health care and social service personnel in the care of persons having AD or related memory disorders. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The ADI program provides a continuum of services addressing the special needs of individuals with AD,their families and caregivers. 1.2.2 Alzheimer's Disease Initiative Program Mission Statement The ADI program ensures that persons afflicted with AD and other forms of dementia are given essential services to help them age in place in an elder-friendly environment with security, dignity, and purpose. The program also provides support to family members and caregivers of persons afflicted with AD. 1.2.3 Authority The relevant authority governing the Alzheimer's Disease Initiative Program are as follows: (1) Rule Chapter 58D-1, Florida Administrative Code; and (2) Sections 430.501 through 430.504, Florida Statutes. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1) CFO Memo No. 02: Release date, August 20,2010; (2) CFO Memo No. 03: Release date,June 29,2010; and CFO Memo No. 06: Release date,June 30,2010. 1.2.3.2 Scope of Service The Vendor is responsible for the programmatic, fiscal, and operational management of the ADI program. The program services shall be provided in a manner consistent with and described in the current Vendor's Request for Proposal, RFP, and the County's current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.3.4 Major Program Goals The major goal of the ADI program is to provide services to meet the needs of caregivers and individuals with AD and related memory disorders. 1.3 INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The ADI Program addresses the special needs of individuals with AD and their caregivers. 1.3.2 Individual Eligibility Those individuals eligible to receive services under this contract must meet the following conditions: (1) Be 18 years of age or older and have a diagnosis of AD or a related disorder, or be 26 1602 suspected of having AD or a related disorder; and (2) Not be enrolled in a Medicaid capitated long-term care program. 1.3.3 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. SERVICE TASKS In order to achieve the goals of the ADI program, the Vendor shall ensure the following tasks are performed: (1) Client eligibility determination; (2) Assessment and prioritization of service delivery for new clients; (3) Delivery of services to eligible clients; and (4) Monitor the performance of vendors. 2.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described in this SECTION 1.3. 2.2 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services addressing the diverse needs of individuals with AD and their caregivers. The Vendor shall ensure services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. Services categories include: (1) Caregiver Training/Support; (2) Case Aid; (3) Case Management; (4) Counseling(Gerontological); (5) Counseling(Mental Health/Screening); (6) Education/Training; (7) Model Day Care; ( 8) Respite(Facility-Based); ( 9) Respite (In-Home); and (10) Specialized Medical Equipment, Services, and Supplies. Caregivers benefit from receiving training, respite and related support services to assist them in caring for the ADI client. 2.3 Service Times The Vendor shall ensure the provisions of the services listed in this contract are available 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. 27 3. DELIVERABLES 16132 3.1. Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the County's reporting requirements. Service Unit of Service Caregiver Training/Support; Hour Case Aid; Hour Case Management; Hour Counseling(Gerontological); Hour Counseling(Mental Health/Screening); Hour Respite(Facility-Based); Hour Respite(In-Home); Hour Education/Training; Episode Episode 3.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. 3.2.1 Service Costs Reports Vendor must submit to the County the semi-annual service cost reports August 1, 2013 and February 1,2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 3.3 RECORDS AND DOCUMENTATION 3.3.1 The Vendor and each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 4. PERFORMANCE SPECIFICATIONS 4.1 Outcomes (4) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (5) The Vendor shall timely submit to the County all reports described in SECTION 3.2 REPORTS; and (6) The Vendor shall timely submit to the County all information described in SECTION 3.3 28 11rr RECORDS AND DOCUMENTATION. 1602 5. COUNTY RESPONSIBILITIES 5.1. Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-up on-site visits; (3) Client visits (4) Review of independent auditor's reports (5) Review third-party documents and/or evaluations (6) Review of progress reports (7) Review of customer satisfaction surveys (8)Agreed-upon procedures review by an external auditor or consultant; (9)Limited-scope reviews; and (10)Other procedures as deemed necessary. 6. SECTION III: METHOD OF PAYMENT 6.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 6.1.2 Remedies-Nonconforming Services The Vendor shall ensure that all goods and/or services provided under this agreement for HCE funded programs are delivered timely, completely and commensurate with required standards of quality Such goods and/or services shall only be delivered to eligible program participants. If the Vendor fails to meet the prescribed quality standards for services, such services will not be reimbursed under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be reimbursed under this agreement. The Vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the Vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County requires immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 6.1.3 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the Vendor and any adjustments thereto, including any disallowance not resolved. 6.1.4 Date for Final Request for Payment 29 1 1602 The final request for payment for agreement year one's expenditures will be due to the County no later than August 1,2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 6.2 Documentation for Payment The Vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals upon request. Such documentation shall be provided upon request to the County or the Clerk of Court. (1:.; EXHIBIT 4 1602 STATEMENT OF WORK OLDER AMERICANS ACT PROGRAM TITLE III SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 CONTRACT ACRONYMS Area Agency on Aging(AAA) Activities of Daily Living(ADL) Alliance of Information&Referral Systems (AIRS) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System (CIRTS) Information and Referral (I &R) Instrumental Activities of Daily Living(IADL) Older Americans Act(OAA) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in Its PSA in accordance with the Section 306 (42 U.S.C. 3026)of the OAA and Department instructions. Child: An individual who is not more than 18 years of age or an individual with disability. Family Caregiver: An adult family member, or another individual, who is an informal provider of in-home and community care to an older individual. Frail: When an older individual is unable to perform at least two ADLs without substantial human assistance, including verbal reminding, physical cueing or supervision; or due to cognitive or other mental impairment, requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to another individual. 1.2 County Mission,Vision and Values Statement The County's mission: To help aging adults achieve greater independence through awareness of resources and access to qualified service providers. The County's vision: To be the recognized leader in supporting older adults and their families with access to trustworthy resources and services in their communities while empowering them to live with independence and dignity. The County's values: We believe residents of Southwest Florida are entitled to: Comprehensive information about their choices of care; Timely access to resources and services; High standards of quality and performance; and Personal and professional accountability from all stakeholders. 1.2.1 Older Americans Act Program Mission Statement The Older Americans Act(OAA)Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. 31 1602 1.3 GENERAL DESCRIPTION 1.3.1 General Statement The OAA Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. The primary purpose of the OAA program is to foster the development and implementation of comprehensive and coordinated systems to serve older individuals. The OAA program uses these systems to assist older individuals to attain and maintain maximum independence and dignity in a home environment and allows for the capability of self- care with appropriate supportive services. 1.3.2 Authority The relevant references authority governing the OAA program are: 1. Older Americans Act of 2006, as amended; 2. Rule 58A-1, Florida Administrative Code; and 3. Section 430.101, Florida Statutes. 1.3.2.1 Incorporation of Reference Memoranda In accordance with Ch. 287 F.S., as amended, and Agency of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and incorporated by reference: 1. CFO Memo No. 02: Release date, August 20, 2010; 2. CFO Memo No. 03: Release date,June 29, 2010; and 3. CFO Memo No. 06: Release date, June 30, 2010. 1.3.3 Scope of Service The Vendor shall provide services in a manner consistent with and descried in the current area plan and current Depaltiiient of Elder Affairs Programs and Services Handbook. 1.3.4 Major Program Goals The major goals of the OAA program are to improve the quality of life for older individuals, preserve their independence and prevent or delay more costly institutional care. These goals are achieved through the implementation of a comprehensive and coordinated service system that provides a continuum of service alternatives that meet the diverse needs of elders and their caregivers. 1.4 INDIVIDUALS TO BE SERVED 1.4.1 Eligibility (Title III Programs) 1.4.1.1 OAA Title HI, General Consumers_shall not be dually enrolled in an OAA program and a Medicaid capitates long-term care program. 1.4.1.2 OAA Title HIE, Caregiver Support Services Eligibility for OAA Title IIIE, Caregiver Support Services, are as follows: 1. Family caregivers of individuals age 60 or older; 32 1602 2 2. Grandparents 55 or older)or older individuals (age 55 or older)who are relative caregivers; Grandpare is(age 5 ) o m i ( g ) 3. Priority will be given to family caregivers who provide care for individuals with Alzheimer's disease and related disorders with neurological and organic brain dysfunction and for grandparents or older individuals who are relative caregivers who provide care for children with severe disabilities; and 4. For respite and supplemental services, a family caregiver must be providing care for an older individual who meets the definition of the term"frail" in OAA, Section 102 Paragraph 22. 1.4.2 Targeted Groups Preference shall be given to those with the greatest economic and social need, with particular attention to low-income older individuals, including those that are low-income minorities, have limited English proficiency, and older individuals residing in rural areas. SECTION H—MANNER OF SERVICE PROVISION 2.1 SERVICE TASKS In order to achieve the goals of the OAA program,the Vendor shall ensure the following tasks are performed: 1. Client eligibility determination; 2. Targeting and screening of service delivery for new clients; 3. Delivery of services to eligible clients; 4. Use of volunteers to expand the provision of available services; 5. Monitoring the performance of its vendors. 6. Grievance and Compliance Procedures 2.1.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described herein. 2.1.2 Targeting and Screening of Service Delivery for New Clients The Vendor shall develop and implement policies and procedures consistent with OAA targeting and screening Criteria 2.1.3 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meets the diverse needs of elders and their caregivers. The Vendor shall ensure the performance and report performance of the following services in accordance with the current Depai tiuent of Elder Affairs Programs and Services Handbook. The services funded pursuant to this contract are in accordance with the OAA, Title III, sections 321, 331, 336 and 373 as follows: 1. Section 321,Title LOB Supportive Services; 2. Section 373,Title ME Caregiver Support Services. 2.1.3.1 Supportive Services Supportive services include a variety of community-based and home-delivered services that support the qualities of life for older individuals by helping them remain independent and productive. Services include the following: 33 c;� � 6 02 (1) Adult Day Care/Adult Day Health Care; (17) Homemaker; O Y Y � ( ) (2) Caregiver Training/Support; (18) Housing Improvement; (3) Case Aide/Case Management; (19) Information; (4) Chore Services; (20) Intake; (5) Companionship; (21) Interpreter/Translating; (6) Counseling(Gerontological and Mental Health); (22) Referral/Assistance; (7) Education/Training; (23) Personal Care; (8) Legal Assistance; (24) Physical Therapy; (9) Material Aid; (25) Shopping Assistance; (10) Occupational Therapy; (26) Skilled Nursing; (11) Outreach; (27) Specialized Medical Equipment, Services, and Supplies (12) Recreation; (28) Respite Services; (13) Emergency Alert Response; (29) Screening/Assessment; (14) Escort; (30) Speech Therapy; (15) Health Support; (31) Telephone Reassurance; and (16) Home Health Aide; (32) Transportation 2.1.3.4 Caregiver Support Services (Title 111E Program) The following services are intended to provide direct help to caregivers, assist in the areas of health, nutrition and financial literacy and assist caregivers in making decisions and problem solving related to their caregiving roles and responsibilities: (1) Adult Day Care/Adult Day Health Care; (2) Caregiver Training/Support; (3) Counseling(Gerontological and Mental Health); (4) Education/Training; (5) Financial Risk Reduction(Assessment and Maintenance); (6) Information; (7) Intake; (8) Outreach; (9) Respite Services; (10) Screening/Assessment; and (11) Transportation 2.1.3.5 Caregiver Support Supplemental Services (Title ll1ES Program): The following services are provided to complement the care provided by caregivers: (1) Chore Services; (2) Housing Improvement; (3) Legal Assistance; (4) Material Aid; and (5) Specialized Medical Equipment, Services and Supplies. 2.2 SERVICE LOCATION 34 X 613 2 2.2.1 Service Times The Vendor shall ensure the provision of the services listed in the contract during normal business hours unless other times are more appropriate to meet the performance requirements of the contract, and it shall monitor its vendors to ensure they are available to provide services during hours responsive to client needs and during those times which best meet the needs of the relevant service community. 2.3 DELIVERABLES 2.3.1 Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the services tasks described in Section 2.1. The chart below lists the services allowed and the units of measurement. Units of service will be paid pursuant to the rate established in the 2010 RFP and approved by the County. Services Unit of Service Adult Day Care/Adult Day Interpreter/Translating Health Care Legal Assistance Caregiver Training/Support Medication Management Case Aid/Case Management Mental Health Counseling/Screening Chore Services Nutrition Counseling Companionship Occupational Therapy Counseling Services Personal Care Escort Physical Therapy Hour Financial Risk Reduction Recreation Services Respite Services Health Support Screening/Assessment Home Health Aide Sitter Homemaker Skilled Nursing Services Housing Improvement Speech Therapy Intake Emergency Alert Response Day Education/Training Episode Information Material Aid Referral/Assistance Specialized Medical Equipment, Services and Supplies Telephone Reassurance Escort One-Way Trip Shopping Assistance Transportation 2.4 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permit the Vendor to meet the County's reporting requirements. 35 16112 2.4.2 Service.Costs Reports The Vendor shall require vendors to submit to the Vendor semi-annual service cost reports on August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.4.5 Background Screening Affidavit of Compliance To demonstrate compliance with section 8 of the Standard Contract,the Vendor shall submit ATTACHMENT H, Background Screening Affidavit of Compliance annually, by January 15t. 2.5 RECORECORDS AND DOCUMENTATION Each Vendor and vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement in its contracts and/or agreements with vendors. These policies and procedures shall be made available to the County upon request. 2.6 PERFORMANCE SPECIFICATIONS 2.6.1 Outcomes (1)The Vendor shall ensure services provided under this contract are in accordance with the current DOEA Programs and Services Handbook, (2)The Vendor shall timely submit to the County all reports described herein (3)The Vendor shall timely submit to the County all information described in, Paragraph 2.5 RECORDS AND DOCUMENTATION. 2.7 VENDOR'S FINANCIAL OBLIGATIONS 2.7.1 Matching,Level of Effort,and Earmarking Requirements The Vendor shall provide match of at least 10 percent of the federal funds received. The Vendor's match will be made in the form of cash and/or in-kind resources. The Vendor will assure,through a provision in subcontracts,a match requirement of at least 10 percent of the cost for all services funded through this contract. The vendor's match will be made in the form of cash and/or in-kind resources. The Vendor shall report match by title each month. At the end of the contract period, the Vendor must properly match all OAA funds. 2.7.2 Title III Funds The Vendor assures compliance with Section 306 of the OAA, as amended in 2006, that funds received under Title III will not be used to pay any part of a cost incurred by the Vendor to maintain a contractual or commercial relationship that is not carried out to implement Title III. 2.8 COUNTY RESPONSIBILITIES 2.8.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the Vendor. 2.8.2 Program/Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this contract. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an on-site visit. The County's determination of acceptable performance shall be conclusive. The Vendor 36 16132 agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: 1. Desk reviews and analytical reviews; 2. Scheduled, unscheduled and follow-up on-site visits; 3. Client visits; 4. Review of independent auditor's reports-Exhibit 10; 5. Review of third-party documents and/or evaluation; 6. Review of progress reports; 7. Review of customer satisfaction surveys; 8. Agreed-upon procedures review by an external auditor or consultant; 9. Limited-scope reviews; and 10. Other procedures as deemed necessary. 2.8.3 Contract Monitoring The County shall, at its own discretion, conduct monitoring concerning any aspect of the vendor's performance of this contract. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for OAA IIIE and OAA IIIES funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rate for services is ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services, which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 37 (r 16132 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 38 EXHIBIT 5 1 6 D 2 Agreement#12-5856 "Services for Seniors Attachment B Invoice and Logs (Minimum Standard Invoice Information) County Purchasing Order Number: Invoice Number: Grant Name: From Date To Date Reimburse ment Rate Per Unit to Total Supplier TOTAL AMOUNT Cost In Kind (Subtract (Multiply the Service Description In Kind Unit Reimbursement Per Match (identified by line) Match Quantity Rate Per Unit to Service Amount Amount Supplier x the Unit Unit from Total Quantity) Cost Per Service Unit) $0.00 $0.00 $0.00 Total $0.00 I certify to the best of my knowledge and belief that this invoice, and attached service detail log, is complete and correct and all outlay herein are for the purposes set forth in the contract, and that services are ordered by the case manager as agreed on the Contract. Legible copies of the dated timesheet, signed by the client and the worker supporting this invoice must be available upon request. Collier County reserves the right to correct computation of errors to assure proper payment amount. Prepared by: Date: Adjustment Reasons Lead Agency Authorization Attachments: Monthly Service log, Weekly Detail log and Client Service time sheets. 39 0 . 16132 EXHIBIT 6 Detail Weekly for CCE Services Week Ending: Invoice No. Personal CLIENT Care Homemaker Respite Skilled Companion Chore Total Total Total Total Total Total NAME Units Units Units Units Units Units Total Hours - - - - - - PECA - HMK - RESPITE - $ SKILLED - $ COMPANION - $ CHORE - $ TOTAL - 40 EXHIBIT 7 1 60 2 Monthly Detail Service Log Grant Name: Vendor Name, Address: From Date To Date By client,provide the total number of hours provided during the dates of service. This log must be submitted with your monthly invoice for the Invoice From Date and To Date. Respite Adult Respite Emergency Client Personal Home- Skilled Enhance Com— Shopping Alert Name Care maker (In- Nursing Day (In- Chore p Escort p Chore anion Assist Response Home) Care Facility System to 41 EXHIBIT 8 1613 ? Daycare Grant: Grant Service: ADC or RESF Vendor Name and Address By client, provide the Weekly Client Service Time Sheet provided during the dates of service. This log must be submitted with all invoices for the invoice From Date and To Date. TO FROM DATE: DATE: Client Thur Uni Client Name signature Mon Tue Wed s Fri Sat Sun Match is Service Dates 42 EXHIBIT 9 16132 YOUR COMPANY NAME HERE Collier County Services for Seniors Homemaker/Personal Care/Respite/Companion Work Sheet Client Name: Client Signature: Week Ending: Each Time You Perform one of the Activities Below: Put in arrival and departure times for the day worked: ****Client should Initial time of arrival and departure. ****Client should Sign form at top. ****You should sign your name at the bottom. Date: Day: MON TUES WED THUR FRI SAT SUN TOTAL TIME ARRIVAL TIME: DEPARTURE TIME: ****CLIENT INITIALS: Arrive: PERSONAL CARE Depart: Assist W/Bath tub Shower Bed Assist W/Dressing Bathroom Assist Shave (Face Only) Oral Hygiene Walking/Ambulation Feeding Assistance Wash/Set Hair Backrub_Soak Feet_ Nails (File only) Change_Make Bed Take out Trash Clean Bedroom Clean Bathroom Prepare Meals Laundry Arrive: HOME MAKING Depart: Vacuum/Sweep Light Dusting 43 �1 1602 Clean Kitchen Floor Wash Dishes Mop Sweep Grocery Shop Errands Arrive: RESPITE Depart Arrive: COMPANION Depart EMPLOYEE'S Signature/Title 44 , U 1602 EXHIBIT 10 I.OMB Circular A-1'33 Audits of States, Local Governments, and Non-Profit Organizations requires the Collier County Housing, Human and Veterans Services Department to monitor our subrecipients of federal awards and determine whether they have met the audit requirements of the circular and whether they are in compliance with federal laws and regulations. Accordingly, we are requiring that you check one of the following, provide all appropriate documentation regarding your organization's compliance with the audit requirements, sign and date this form. Subrecipient Fiscal.Year Name Period Total State Financial Assistance Expended during $ most recently completed Fiscal Year Total Federal Financial Assistance Expended during most $ recently completed Fiscal Year Check Appropriate Boxes We have exceeded the $500,000 federal/state expenditure threshold for our fiscal year �] ending as indicated above and have completed our Circular A-133 audit. A copy of the audit report and management letter are attached. We exceeded the $500,000 federal/state expenditure threshold for our fiscal year ❑ ending as indicated above and expect to complete our Circular A-133 audit by . Within 30 days of completion of the A-133 audit, we will provide a copy of the audit report and management letter. We are not subject to the requirements of OMB Circular A-133 because we: U Did not exceed the $500,000 federal/state expenditure threshold for the fiscal year indicated above ❑ Are a for-profit organization ❑ Are exempt for other reasons — explain An audited financial statements is attached and if applicable, the independent auditor's management letter. (If findings were noted, please enclose a copy of the responses and corrective action plan.) Certification Statement I hereby certify that the above information is true and accurate. Signature Date Print Name and Title 45 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 D 2 TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Routed by Purchasing Department to Office Initials Date the Following Addressee(s)(In routing order) 1. Risk Management Risk 2. County Attorney Office County Attorney Office „J s\3\\\\ 3. BCC Office Board of County ∎q+-mod. Commissioners \icr._.c\--c1/4.■v- 5\3�\� 4. Minutes and Records Clerk of Court's Office 'TM 5/31 l(3 (.pm 5. Return to Purchasing Department Purchasing Contact: Diana DeLeon PRIMARY CONTACT INFORMATION Name of Primary Diana DeLeon for Lisa Carr, HHVS, Phone Number 252-8375 Purchasing Staff May 29,2013 Contact and Date Agenda Date Item was May 28,2013 Agenda Item Number 16.D.2 Approved by the BCC Type of Document Contract Amendment Number of Original 2 Attached Documents Attached PO number or account N/A Solicitation/Contract Amend#1 to Contract 12- number if document is Number/Vendor Name 5856 Bidwell/Home Instead to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature? DD 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A provide the Contact Information(Name; Agency;Address; Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be signed by the Chairman, with the exception of most letters,must be reviewed and signed . by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's DD signature and initials are required. 7. In most cases(some contracts are an exception),an electronic copy of the document and DD this routing slip should be provided to the County Attorney's Office before the item is input into SIRE. 8. The document was approved by the BCC on the date above and all changes made DD during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the cA3 BCC, all changes directed by the BCC have been made, and the document is ready for th Chairman's signature. 1602 MEMORANDUM Date: June 3, 2013 To: Diana DeLeon, Contract Technician Purchasing Department From: Teresa Cannon, Deputy Clerk Minutes & Records Department Re: Amendment #1 to Contract #12-5856 "Services for Seniors" Contractor: Bidwell Home Care Service, LLC Attached is an original copy of the contract referenced above, (#16D2) approved by the Board of County Commissioners on Tuesday, May 28, 2013. The second original will be held on file in the Minutes and Record's Department for the Board's Official Record. If you have any questions, please feel free to contact me at 252-8411. Thank you. Attachment 1602 Contract Amendment #1 Contract # 12-5856 "Services for Seniors" This CONTRACT AMENDMENT #1, dated CL , 2013 to the referenced agreement shall be by and between the parties to the original Agreement, idwell Home Care Service LLC d/b/a Home Instead Senior Care (to be referred to as "Vendor") and Collier County, Florida, (to be referred to as "County"). Statement of Understanding RE: Contract# 12-5856 "Services for Seniors" In order to continue services for the original Contract document referenced above, the Vendor agrees to the terms and conditions set forth in Exhibit A-1A, which includes Attachments C-H and Exhibits 1-10 attached hereto and incorporated by reference. The Vendor further agrees to amend Section 1, Commencement, as follows: 1. COMMENCEMENT. This Agreement shall Commence on December 11, 2012 and shall terminate on December 10, 2011 June 30, 2014. The Contract award is a two (2) year contract, with the possibility of two (2) additional (2) year terms pending funding from grantors and acceptable performance by the awarded vendor. Any such renewals shall be mutually agreed upon in writing by the parties. The maximum duration for this Contract for CCE, HCE, and ADI, OAA IIIE AND OAA IIIES funding will not exceed six (6) years (through June 30, 2018). As outlined in RFP #12-5856, the County requires the Vendor to contribute a cash or in-kind match of no less than ten (10) percent for all services related to the Community Care for the Elderly Program, (CCE), Older American Title IIIE Caregiver Support (OAA IIIE) and Older American Title IIIES Caregiver Support Supplemental Services (OAA IIIES) Programs. Words that have been deleted are struck through, words underlined have been added. Modification made herein shall apply as if incorporated into the Contract on the date of Commencement. All other terms and conditions of the agreement shall remain in force. IN WITNESS WHEREOF, the Vendor and the County have each, respectively, by an authorized person or agent, hereunder set their hands and seals on the date(s) indicated below. Accepted: Aa1 2. , 2013 VENDOR: Bidwell Home Care Se ice LLC d/b/a % `-- Ho e I ead Senit C: e is Home Care First Witness - td - T /pr' fitness ame vk rA &(\'A vl V1►SOr° r Second V�itn�ess Print/Type Name and Title Cr G�(,�\!NA� � Cy-) Type/prirtt witness name 1 1602 2 COUNTY: ATTEST: BOARD OF COUNTY COMMISSIONERS DWIGHT E:RBROCK, CLERK OF COLLIER COUNTY, FLORIDA S�AF ^i , ♦rs ( � �lT� B y. � ��#�� 1 Y CLERK GEORGIA A. II LER, ESQ.- ..r as CHAIRWOMA Sicgt*u L Approval for form and legal Sufficiency: Jennifer-id. White Assistant County Attorney Item# 1( as Agenda 1-- 116 Date Date Rec'd 3 2 Deputy clerk EXHIBIT A-lA p AGREEMENT 12-5856 SERVICES FOR SENIORS ATTACHMENTS ATTACHMENT ATTACHMENT DESCRIPTION PAGE Attachment C Core Standards for CCE, HCE, ADI, OAA IIIE & IIIES 2 Attachment D Certification Regarding Lobbying 8 Attachment E Certification Regarding Data Integrity Compliance 9 Attachment F Certification Regarding Debarment, Suspension, 10 Ineligibility and Voluntary Exclusion Contracts/ Subcontracts Attachment G Sub-Recipient Invoice Submission 11 Attachment H Background Screening Affidavit of Compliance 12 Exhibit 1 CCE Statement of work 13 Exhibit 2 HCE Statement of work 19 Exhibit 3 ADI Statement of work 25 Exhibit 4 OAA IIE and OAA IIIES Statement of work 31 Exhibit 5 Invoice 39 Exhibit 6 Detail Weekly Log 40 Exhibit 7 Monthly Log 41 Exhibit 8 Day Care/Respite Time Sheet 42 Exhibit 9 Program Time Sheet 43 Exhibit 10 Annual Audit Monitoring Report 45 1 �9 , , , . , 1602 ADDENDUM TO AGREEMENT 12-5856 SERVICES FOR SENIORS ATTACHMENTS ATTACHMENT ATTACHMENT DESCRIPTION PAGE Attachment C Core Standards for CCE, HCE, ADI, OAA IIIE & IIIES 2 Attachment D Certification Regarding Lobbying 8 Attachment E Certification Regarding Data Integrity Compliance 9 Attachment F Certification Regarding Debarment, Suspension, 10 Ineligibility and Voluntary Exclusion Contracts/ Subcontracts Attachment G Sub-Recipient Invoice Submission 11 Attachment H Background Screening Affidavit of Compliance 12 Exhibit 1 CCE Statement of work 13 Exhibit 2 HCE Statement of work 19 Exhibit 3 ADI Statement of work 25 Exhibit 4 OAA IIE and OAA IIIES Statement of work 31 Exhibit 5 Invoice 39 Exhibit 6 Detail Weekly Log 40 Exhibit 7 Monthly Log 41 Exhibit 8 Day Care/Respite Time Sheet 42 Exhibit 9 Program Time Sheet 43 Exhibit 10 Annual Audit Monitoring Report 45 1 0 ATTACHMENT C 16 2 Core Standards for CCE,HCE,ADI,OAA IIIE &HIES 1. Compliance with Federal Law 1.1 If this agreement contains federal funds the following shall apply: 1.1.1 The vendor shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable regulations. 1.1.2 If this agreement contains federal funds and is over $100,000.00, the vendor shall comply with all applicable standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s. 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable Environmental Protection County regulations 40 CFR 30. The vendor shall report any violations of the above to the County. 1.1.3 The vendor may not use any federal funds received in connection with this agreement to influence legislation or appropriations pending before the Congress or any state legislature. If this agreement contains federal funding in excess of$100,000.00, the vendor must, prior to agreement execution, complete the Certification Regarding Lobbying form, ATTACHMENT D. All disclosure forms as required by the Certification Regarding Lobbying form must be completed and returned to the Grant Coordinator prior to payment under this agreement. 1.1.4 In accordance with Appendix A to 2 CFR 215, the vendor shall comply with Executive Order 11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in Department of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable. 1.1.5 If this agreement contains federal funds and provides services to children up to age 18,the vendor shall comply with the Pro-Children Act of 1994(20 U.S.C. 6081). 1.1.6 A agreement award with an amount expected to equal or exceed $25,000.00 and certain other agreement 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 vendor shall comply with these provisions before doing business or entering into sub-agreements receiving federal funds pursuant to this agreement. The vendor shall complete and sign ATTACHMENT F prior to the execution of this agreement. 1.2 The vendor shall not employ an unauthorized alien. The County 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 agreement by the County. 2 16 ® 2 1.3 If the vendor 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 vendor must notify the County in writing within thirty(30) days of receiving the IRS notice of revocation. 1.4 The vendor shall comply with Title 2 CFR Part 275 regarding Trafficking in Persons. 1.5 Unless exempt under 2 CFR Part 170.110(b), the vendor shall comply with the reporting requirements of the Transparency Act as expressed in 2 CFR 170. 1.6 To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number 11-116, vendor agrees to utilize the U.S. Department of Homeland Security's E-verify system to verify the employment of all new employees hired by vendor during the agreement term. Vendor meeting the terms and conditions of the E-Verify System are deemed to be in compliance with this provision. 2. Compliance with State Law 2.1 This agreement is executed and entered into in the State of Florida, and shall be construed, performed and enforced in all respects in accordance with the Florida law, including Florida provisions for conflict of laws. 2.2 The vendor shall comply with requirements of s. 287.058,F.S. as amended. 2.2.1 The vendor shall provide units of deliverables, including various client services, and in some instances may include reports, findings, and drafts, as specified in this agreement,which the Grant Coordinator must receive and accept in writing prior to payment in accordance with s. 215.971, F.S. (1)and(2). 2.2.2 The vendor shall submit bills for fees or other compensation for services or expenses in sufficient detail for a proper pre-audit and post-audit. 2.2.3 The vendor 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 vendor in conjunction with this agreement except for those records which are made confidential or exempt by law. The vendor's refusal to comply with this provision will constitute an immediate breach of agreement for which the County may unilaterally terminate the agreement. 2.3 If clients are to be transported under this agreement, the vendor shall comply with the provisions of Chapter 427,F.S., and Rule 41-2, F. A. C. 2.4 Vendors who are on the discriminatory vendor list may not transact business with any public entity, in accordance with the provisions of s. 287.134, F.S. 2.5 The vendor shall comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the expenditure of agreement funds for the purpose of lobbying the legislature,judicial branch or a state agency. 3. Background Screening The vendor shall ensure that the requirements of s. 430.0402 and ch. 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 exempted from the Department's level 2 background screening 3 pursuant to s. 430.0402(2)-(3), F.S. The vendor must also comply with any applicable ru s 2 p pY Y pp promulgated by the Department and the Agency for Health Care Administration regarding implementation of s. 430.0402 and ch. 435,F.S. Further information concerning the procedures for background screening are found at http://elderaffairs.state.fl.us/doea/backgroundscreening.php. 4. Provision of Services The vendor shall provide services in the manner described herein. 5. Monitoring by the County The vendor shall permit persons duly authorized by the County to inspect and copy any records, papers, documents, facilities, goods and services of the vendor which are relevant to this agreement, and to interview any clients, employees and vendor employees of the vendor to assure the County of the satisfactory performance of the terms and conditions of this agreement. Following such review, the County will provide a written report of its findings to the vendor, and where appropriate,the vendor shall develop a corrective action plan. The vendor hereby agrees to correct all deficiencies identified in the corrective action plan in a timely manner as determined by the Grant Coordinator. 6. Confidentiality of Information The vendor shall not use or disclose any information concerning a vendor of services under this agreement 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. 7. Health Insurance Portability and Accountability Act Where applicable, the vendor shall comply with the Health Insurance Portability and Accountability Act (42 USC 1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162, and 164). 8. Bankruptcy Notification During the term of this agreement,the vendor shall immediately notify the County if the Vendor, its assignees,vendors or affiliates file a claim for bankruptcy. Within ten (10)days after notification,the vendor must also provide the following information to the County.: (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., United States Bankruptcy Court Middle District of Florida,Naples,FL); and, (4)The name, address, and telephone number of the bankruptcy attorney. 9. Sponsorship and Publicity 9.1 As required by s. 286.25, F.S., if the vendor is a non-governmental organization which sponsors a program financed wholly or in part by state funds, including any funds obtained through this agreement, it shall, in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by Hope Hospice and Community Services,the State County of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County." If the sponsorship reference is in the written material, the words "State of Florida, Department of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County" shall appear in at least the same size letters or type as the name of the organization. 9.2 The vendor shall not use the words "The State of Florida Department of Elder Affairs or the Area County on Aging for Southwest Florida, Inc. or Collier County" to indicate sponsorship of a program otherwise financed, unless specific authorization has been obtained by Collier County, or the Area Aging on Aging prior to use. 4 1613 p 10. Independent Capacity of Vendor It is the intent and understanding of the Parties that the vendor, or any of its vendors, are independent vendors and are not employees of the County and shall not hold themselves out as employees or agents of the County without specific authorization from the County. It is the further intent and understanding of the Parties that the County does not control the employment practices of the vendor and will not be liable for any wage and hour, employment discrimination, or other labor and employment claims against the vendor or its vendors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary insurance for the vendor are the sole responsibility of the vendor. 11. Payment Payments shall be made to the vendor pursuant to s. 215.422, F.S., as services are rendered and invoiced by the vendor. The Grant Coordinator will have final approval of the invoice for payment, and will approve the invoice for payment only if the vendor has met all terms and conditions of the agreement, unless the bid specifications, purchase order, or this agreement specify otherwise. The approved invoice will be submitted to the County's Grant Coordinator approval and processing. 12. Return of Funds The vendor shall return to the County any overpayments due to unearned funds or funds disallowed and any interest attributable to such funds pursuant to the terms and conditions of this agreement that were disbursed to the vendor by the County. In the event that the vendor or its independent auditor discovers that an overpayment has been made, the vendor shall repay said overpayment immediately without prior notification from the County. In the event that the County first discovers an overpayment has been made, the Grant Coordinator will notify the vendor in writing of such findings. 13. Data Integrity and Safeguarding Information The vendor shall ensure an appropriate level of data security for the information the vendor is collecting or using in the performance of this agreement. An appropriate level of security includes approving and tracking all vendor employees that request system or information access and ensuring that user access has been removed from all terminated employees. The vendor, 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 vendor shall ensure all vendors maintain written procedures for computer system backup and recovery. The vendor shall complete and sign Attachment E prior to the execution of this agreement. 14. Computer Use and Social Media Policy The Department of Elder Affairs has implemented a new 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, Area Agencies on Aging and vendors. 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. 15. Public Entity Crime Pursuant to s. 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 5 \r, •/ 1 6 2 agreement to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on a agreement 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 vendor, supplier, vendor, or consultant under a agreement with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in s. 287.017, F.S., for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted vendor list. 16. Patents,Copyrights,Royalties If this agreement 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 agreement, the vendor shall refer the discovery, invention or material to the County to be referred to the Department of State and the Department of Elder Affairs. Any and all patent rights or copyrights accruing under this agreement are hereby reserved to the State of Florida in accordance with Chapter 286, F.S. Pursuant to s. 287.0571 (5) (k) 1 and 2 as amended, the only exceptions to this provision shall be those that are clearly expressed and reasonably valued in the agreement. 16.1 If the primary purpose of this agreement 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 Paragraph 33. 16.2 If this agreement is awarded solely federal funding, the terms and conditions are governed by 2 CFR 215.36. 17. Emergency Preparedness and Continuity of Operations 17.1 If the tasks to be performed pursuant to this agreement include the physical care and control of clients, or the administration and coordination of services necessary for client health, safety or welfare, the vendor shall, within thirty (30) calendar days of the execution of this agreement, submit to the Grant Coordinator verification of an emergency preparedness plan. In the event of an emergency,the vendor shall notify the County of emergency provisions. 17.2 In the event a situation results in a cessation of services by a vendor, the vendor shall retain responsibility for performance under this agreement and must follow procedures to ensure continuity of operations without interruption. 18. Financial Consequences of Non-Performance If the vendor fails to meet the minimum level of service or performance identified in this agreement, or that is customary for the industry, then the County must apply financial consequences commensurate with the deficiency.Financial consequences may include,but are not limited to, agreement suspension, refusing payment, withholding payments until deficiency is cured, tendering only partial payments, and/or cancellation of agreement and reacquiring services from an alternate source. 18.1 The vendor will not be charged with financial consequences, when a failure to perform arises out of causes that were the responsibility of the County. 19. No Waiver of Sovereign Immunity 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. 20. Venue If any dispute arises out of this agreement,the venue of such legal recourse will be Collier 6 0 .• 1 6 0 2 County, Florida. 21. Entire Agreement This agreement contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations shall be valid or binding upon the County or the vendor unless expressly contained herein or by a written amendment to this agreement signed by both Parties. 22. 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. 23. 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. 24. Waiver The delay or failure by the County to exercise or enforce any of its rights under this agreement will not constitute or be deemed a waiver of the County'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. 25. Compliance The vendor shall abide by all applicable current federal statutes, laws, rules and regulations as well as applicable current state statutes, laws, rules, regulations and County rules, ordinances and regulations. The Parties agree that failure of the vendor to abide by these laws shall be deemed an event of default of the vendor, and subject the agreement to immediate, unilateral cancellation of the agreement at the discretion of the County. 26. Final Invoice The vendor shall submit the final CCE, HCE, ADI, IIE and IIIES invoice for payment to the County on July 3, 2013. If the vendor fails to submit final request for payment by the deadline, then all rights to payment may be forfeited and the County may not honor any requests submitted after the aforesaid time period. Any payment due under the terms of this agreement may be withheld until all reports due from the vendor and necessary adjustments thereto have been approved by the County. 27. Renegotiations or Modifications Modifications of the provisions of this agreement shall be valid only when they have been reduced to writing and duly signed by both parties. The rate of payment, contract requirements and the total dollar amount may be adjusted retroactively to reflect price level increases and changes in the rate of payment or language. 28. All Terms and Conditions Included This agreement and its Attachments, A-H and exhibits 1-4 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 agreement shall supersede all previous communications, representations or agreements, either written or verbal between the Parties. 7 v, ATTACHMENT D 16 D 2 CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR AGREEMENTS,GRANTS,LOANS AND AGREEMENTS The undersigned certifies,to the best of his or her knowledge and belief,that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any State ,Federal or County, a member of congress, an officer or employee of congress, an employee of a member of congress, or an officer or employee of the state legislator, in connection with the awarding of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal agreement, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of the County, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this federal agreement, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers(including vendors, sub-grants, and agreements under grants, loans and cooperative agreements)and that all vendors shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Signature Date Name of Authorized Individual Name and Address of Organization 8 CA 1602 0 ATTACHMENT E CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS,GRANTS,LOANS AND COOPERATIVE AGREEMENTS The undersigned, an authorized representative of the vendor named in the agreement or agreement to which this form is an attachment, hereby certifies that: (1) The vendor and any vendors of services under this agreement 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 vendor, vendor(s), or any outside entity on which the vendor 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,vendor(s)will take immediate action to assure data integrity. (3) If this agreement 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 vendor (represented by the undersigned) and purchased by the State will be verified for accuracy and integrity of data prior to transfer. In the event of any decrease in functionality related to time and date related codes and internal subroutines that impede the hardware or software programs from operating properly, the vendor agrees to immediately make required corrections to restore hardware and software programs to the same level of functionality as warranted herein, at no charge to the State, and without interruption to the ongoing business of the state,time being of the essence. (4) The vendor and any vendor(s) of services under this agreement warrant their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data integrity compliance issues. The vendor shall require that the language of this certification be included in all vendors and other agreements and that all vendor shall certify compliance accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB Circulars A-102 and 2 CFR Part 215 (formerly OMB Circular A-110). Name and Address of vendor Signature Title Date Name of Authorized Signer 9 Cq 1 6 2 EXHIBIT F CERTIFICATION REGARDING DEBARMENT, SUSPENSION,INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS (1) The prospective vendor certifies, by signing this certification, neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or County. (2) Where the prospective vendor is unable to certify to any of the statements in this certification,such prospective participant shall attach an explanation to this certification. Signature Date Title County/Organization (Certification signature should be same as Agreement signature.) Instructions for Certification 1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "person," "primary covered transaction,"and"voluntarily excluded,"as used herein,have the meanings set out in the sections of rules implementing Executive Order 12549. (2 CFR 180.5-180.1020,as supplemented by 2 CFR 376.10-376.995). You may contact the Agreement Manager for assistance in obtaining a copy of those regulations. 2. This certification is a material representation of facts upon which reliance was placed when the parties entered into this transaction. If it is later determined that the vendor knowingly rendered an erroneous certification,in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension and/or debarment. 3. The vendor will provide immediate written notice to the Agreement Manager if at any time the vendor learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The vendor may decide the method and frequency by which it determines the eligibility of its principals. Each participant to a lower tier covered transaction may,but is not required to,check the Excluded Parties List System(EPLS). 4. The vendor will include a"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transaction"in all its lower tier covered transactions and in all solicitations for lower tier covered transactions. 5. The vendor agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise authorized by the federal government. 6. If the vendor knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction,in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension,and/or debarment. 7. The vendor may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended,ineligible,or voluntarily excluded from the covered transaction,unless it knows that the certification is erroneous. 10 C;q r l r 16132 EXHIBIT G SUBRECIPIENT INVOICE SUMMISSION The County shall reimburse the SUBRECIPIENT for the performance of this Agreement upon completion or partial completion of the work tasks as accepted and approved by HHVS pursuant to the submittal of quarterly progress reports. Invoices for work performed are required every month. If no work has been performed during that month, or if the SUBRECIPIENT is not yet prepared to send the required backup, a$0 invoice will be required. Explanations will be required if two consecutive months of$0 invoices are submitted. Payments shall be made to the SUBRECIPIENT when requested as work progresses but, not more frequently than once per month. Final invoices are due no later than 90 days after the end of the agreement. Work performed during the term of the program but not invoiced within 90 days without written exception from the Grant Coordinator will not be reimbursed.No payment will be made until approved by HHVS for grant compliance and adherence to any and all applicable local, state or Federal requirements. Payment will be made upon receipt of a properly completed invoice and in compliance with §218.70, Florida Statutes, otherwise known as the "Local Government Prompt Payment Act." 11 C,� I DEPARTMENT OF EXHIBIT H I u BACKGROUND SCREENING ELDER AFFAIRS Affidavit of Compliance -Employer STATE OF FLORIDA 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 Employer Name located at Street Address City State ZIP code 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. Signature of Representative Date STATE OF FLORIDA,COUNTY OF Sworn to(or affirmed)and subscribed before me this day of , 20 , by (Name of Representative)who is personally known to me or produced 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:http://elderaffairs.state.fl.us/english/backgroundscreening.php 12 CP 16 13 EXHIBIT 1 STATEMENT OF WORK COMMUNITY CARE FOR THE ELDERLY PROGRAM(CCE) SECTION I: SERVICES TO BE PROVIDED 1.1. DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 AGREEMENT ACRONYMS Activities of Daily Living(ADL) Adult Protective Services(APS) Assessed Priority Consumer List(APCL) Comprehensive Assessment and Review for Long-Term Care Services(CARES) Community Care for the Disabled Adult(CCDA) Community Care for the Elderly(CCE) Client Information and Registration Tracking System(CIRTS) Department of Children and Families(DCF) Department of Elder Affairs(DOEA) Home Care for Disabled Adults(HCDA) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out: The condition of reaching 60 years of age and being transitioned from the Department of Children and Families(DCF) Services,Community Care for Disabled Adults (CCDA)or Home Care for Disabled Adults(HCDA)services to the Department's community- based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in its planning and service area in accordance with the Section 306 (42 U.S.C. 3026) of the Older Americans Act and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the County enters CCE specific data in the CIRTS. An update may also include other revisions to the area plan as instructed by the County or Department of Elder Affairs. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The primary purpose of the CCE program is to prevent, decrease or delay premature or inappropriate and expensive placement of older persons in nursing homes and other institutions. 13 CNO 1602 1.2.2 Community Care for the Elderly Mission Statement The CCE Program assists functionally impaired elderly persons in living as independently as possible in their own homes or in the homes of relatives or caregivers. The program provides a continuum of care through the development, expansion, reorganization and coordination of multiple community-based services to assist elders to reside in the least restrictive environment suitable to their needs. 1.2.3 Authority The relevant authority governing CCE program are: (1) Rule 58C-1,Florida Administrative Code (2) Sections 430.201 through 430.207, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services Chief Financial Officer Memoranda the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1)CFO Memo No. 02: Release date,August 20,2010; (2)CFO Memo No. 03: Release date,June 29,2010; and (3) CFO Memo No. 06: Release date,June 30, 2010. 1.2.4 Scope of Service The vendor shall provide services in a manner consistent with and descried in the current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the program are to preserve the independence of elders and prevent or delay more costly institutional care through a community care service system that provides case management and other in-home and community services as needed under the direction of the County and provide a continuum of service alternatives that meet the diverse needs of functionally impaired elders. 1.3. INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The CCE program provides a continuum of services for functional impaired elders. 1.3.2 Individual Eligibility In order to receive services under this agreement, an applicant must: (1) Be at least 60 years of age; (2) Be functionally impaired as determined through the initial comprehensive assessment; and (3) With the exception of APS high-risk referrals, consumers may not be dually enrolled in the CCE program and a Medicaid capitated long-term care program. 1.3.2.1 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution or who are abused, neglected or exploited. 14 1602 ' SECTION II: MANNER OF SERVICE PROVISION 2. Delivery of Service to Eligible Clients The vendor shall ensure the provision of a continuum of service that meet the diverse needs of functionally impaired elders. The vendor shall ensure performance and reporting of the following service provision in accordance with the current DOEA Programs and Services Handbook. The services may include the following categories: (1) Core Services; (2) Health Maintenance Services; and (3) Other Support Services. Core Services for Programmatic Operation 2.1. The vendor may deliver core services include a variety of home-delivered services, day care services,and other basic services that are most needed to prevent unnecessary institutionalization. Core services,to be provided at the unit rate identified in this agreement, include the following: (1) Adult Day Care; (7) Housing Improvement; (2) Chore Services; (8) Respite Services; and (3) Enhanced Chore; (9) Transportation (4) Companionship; (5) Home Delivered Meals; (6) Homemaker; 2.1.1 Health Maintenance Services The vendor shall ensure that health maintenance services are routine health services that are necessary to help maintain the health of functionally impaired elders. The services are limited to medical therapeutic services, non-medical prevention services, personal care services, home health aide services, home nursing services, and emergency response systems. Typical services to be provided at the unit rate identified in this agreement, are the following: (1) Adult Day Health Care; (2) Emergency Alert Response; (3) Nutrition Counseling (4) Personal Care (5) Skilled Nursing Services; and (6) Specialized Medical Equipment Services and Supplies 2.2 SERVICE TIMES 2.2.1 Service Times 15 P The vendor shall ensure the provisions of the services listed in this agreement are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m.to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the agreement in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this agreement as updated, and approved by the County's reporting requirements. Service Unit of Service Adult Day Care Homemaker Case Aide Housing Improvement Case Management Respite Services Chore Services Personal Care Hour Enhanced Chore Physical Therapy Companionship Skilled Nursing Services Emergency Alert Response Day Material Aid Episode Specialized Medical Equipment, Services and Supplies Escort Shopping Assistance One-Way Trip Transportation Service Unit of Service Home Delivered Meals Meal 2.4 REPORTS The vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The vendor shall establish due dates for any agreement that permits the vendor to meet the County's reporting requirements. Service Costs Reports The vendor shall submit to the County semi-annual service cost reports, August 1, 2013 and February 1, 2014, of each year which reflects actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.5 RECORDS AND DOCUMENTATION 2.5.1 Each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup 16 C:�' . $ 1 6 0 2 2.6 COUNTY RESPONSIBILITIES 2.6.1 Program Guidance and Technical Assistance The County will provide to the vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the vendor. resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures will be made available to the County upon request. 2.7 PERFORMANCE SPECIFICATIONS 2.7.1 Outcomes (1) The vendor shall ensure services provided under this agreement are in accordance with the current Department of Elder Affairs Programs and Services Handbook. (2) The vendor shall timely submit to the County all information described in EXHIBIT 1, SECTION 2.4 REPORTS; and (3) The vendor shall timely submit to the County all information described in EXHIBIT 1, SECTION 2.5 RECORDS AND DOCUMENTATION. 2.8. VENDOR'S FINANCIAL OBLIGATIONS 2.8.1 Matching,Level of Effort,and Earmarking Requirement The vendor will assure a match requirement of at least 10 percent of the cost for all CCE services. The match will be made in the form of cash and/or in-kind resources. At the end of the agreement period, all CCE funds expended must be properly matched. State funds cannot be used to match another state-funded program. 3. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 17 161) 2 3.4 Payment may be authorized only for allowable services,which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1,2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 18 C:0) ► 1 EXHIBIT 2 1 6 2 STATEMENT OF WORK HOME CARE FOR THE ELDERLY PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Adult Protective Services(APS) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) 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) Home Care for Disabled Adults(HCDA) Home Care for the Elderly(HCE) Institutional Care Program(ICP) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults(HCDA) services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026) and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the County enters HCE specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement Area Agencies on Aging may contract with CCE lead agencies or other case management entities for the provision of the HCE program. Approved caregivers receive a Basic Subsidy to reimburse some of their expenses each month for caring for the consumer and may receive a Special Subsidy for other necessary services and essential supplies. Caregivers may be approved 19 for up to three HCE clients in their home. 1 6 1.2.2 Home Care for the Elderly Program Mission Statement The Home Care for the Elderly Program supports family style living arrangements, on a non- profit basis,as an alternative to nursing homes or other institutional care. Through the program, a caregiver for three or fewer elders living in a private home provides basic services of maintenance and supervision as well as coordinating other necessary specialized services. 1.2.3 Authority The relevant authority governing the HCE program include: (1) Rule Chapter 58H-1, Florida Administrative Code; and (2) Sections 430.601 through 430.608,F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services', Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: CFO Memo No. 02: Release date,August 20, 2010; CFO Memo No. 03: Release date,June 29, 2010; and CFO Memo No. 06: Release date,June 30,2010. 1.2.4 Scope of Service The Vendor shall provide services in a manner consistent with and described in the current County's area plan update and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the HCE program are to ensure that: (1) Basic Subsidy is provided to the caregiver of each client and (2) Special Subsidy is provided when essential to the well-being of the client. 1.3 INDIVIDUAL TO BE SERVED 1.3.1 General Eligibility The Home Care for the Elderly program serves elders age 60 and older at risk of placement in a nursing home or other institutional settings who can remain in a family style setting through the provision of subsidies. 1.3.2 Client Eligibility Clients eligible to receive services under this agreement must: (1) Be 60 years of age or older; (2) Have income less than the Institutional Care Program(ICP)standard. (3) Meet the ICP asset limitation; (4) Be at risk of nursing home placement; 20 1 6 o (5) Have an approved adult caregiver living in the home with them who is willing to provide care or assist in arranging for care; and (6) Not be enrolled in the Aged and Disabled Adult Medicaid waiver or a Medicaid capitated long-term care program. 1.3.3 Caregiver Eligibility Caregivers eligible to receive services under this agreement must: (1) Be at least 18 years of age,capable of providing a family-type living environment; (2) 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; (3) Be willing to accept responsibility for the social, physical and emotional needs of the care Vendor; (4) Be physically present and live in the home to provide supervision and to assist in arrangement of services for the client; (5) 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 (6) Be without record of conviction of abuse,neglect or exploitation of another person. 1.3.4 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meet the diverse needs of the functionally impaired elders and their caregivers. The Vendor shall ensure Basic Subside and Special Subsidy services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. 2.1. Basic Subsidy The Basic Subsidy is a cash payment made to an approved caregiver each month to reimburse some expenses incurred in caring for the client. The Basic Subsidy is provided for support and maintenance of the client, including housing, food, clothing, and medical costs not covered by Medicaid, Medicare or any other insurance. A Basic Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. If the client is hospitalized or in any other temporary institution for 30 days or less,the full Basic Subsidy shall be provided to the caregiver as if the client were in the home. 2.2. Special Subsidy Services Though every eligible HCE client receives a Basic Subsidy, Special Subsidy payments are pre-authorized and are based on additional specialized medical or health care services, supplies or equipment needed to maintain the health and well-being of the individual elder. The Special Subsidy for additional medical support and special services is a cash payment to reimburse the costs of any other service or special care not covered by Medicaid, Medicare, or private insurance when these services are determined to be 21 . 1602 'II essential to maintain the well-being of the home care recipient. A Special Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. Special Subsidy 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: 2.2.1 SERVICE LOCATION AND EQUIPMENT 2.2.2 Service Times The vendor shall ensure the provision of the services listed in this contract are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m. to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the Agency's reporting requirements. Service Unit of Service Adult Day Care Housing Improvement Case Aide Other Case Management Personal Care Chore Respite(Facility Based or In-Home) Hour Chore(Enhanced) Skilled Nursing Services Homemaker Material Aid Episode Specialized Medical Equipment, Services and Supplies Transportation One-Way Trip 2.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permits the Vendor to meet the County's reporting requirements. 2.2.1 Service Costs Reports The Vendor shall submit to the County the semi-annual service cost reports, August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.3 RECORDS AND DOCUMENTATION 2.3.1 The Vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The 22 1602 Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 2.4 PERFORMANCE SPECIFICATIONS 2.4.1 Outcomes (1) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (2) The Vendor shall timely submit to the County all reports described in SECTION 2.2 REPORTS; and (3) The Vendor shall timely submit to the County all information described in, SECTION 2.3 RECORDS AND DOCUMENTATION. 2.5 COUNTY RESPONSIBILITIES 2.5.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled,unscheduled and follow-up on-site visits; (3) Client visits; (4) Review of independent auditor's reports; (5) Review of third-party documents and/or evaluation; (6) Review of progress reports; (7) Review of customer satisfaction surveys; (8) Agreed-upon procedures review by an external auditor or consultant; (9) Limited-scope reviews; and (10) Other procedures as deemed necessary. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The 23 16132 vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services,which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 24 <<J . . ' s 1602 EXHIBIT 3 STATEMENT OF WORK ALZHEIMER'S DISEASE INITIATIVE PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Alzheimer's Disease(AD) Alzheimer's Disease Initiative(ADI) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System(CIRTS) Community Care for Disabled Adults(CCDA) Department of Elder Affairs(DOEA) Home Care For Disabled Adults(HCDA) Instrumental Activities of Daily Living(IADL) Memory Disorder Clinic(MDC) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults(HCDA) services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026. 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 County enters ADI specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701 B is used by case managers to conduct the functional assessment. 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. Model Day Care: A program of therapeutic, social and health activities specific to clients with memory disorders. Services and activities include, but are not limited to, active and quiet 25 16132 games, reminiscence, validation therapy, pet therapy, water therapy and other failure free activities appropriate to the client's level of functioning. Model day care centers will also provide training for health care and social service personnel in the care of persons having AD or related memory disorders. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The ADI program provides a continuum of services addressing the special needs of individuals with AD,their families and caregivers. 1.2.2 Alzheimer's Disease Initiative Program Mission Statement The ADI program ensures that persons afflicted with AD and other forms of dementia are given essential services to help them age in place in an elder-friendly environment with security, dignity, and purpose. The program also provides support to family members and caregivers of persons afflicted with AD. 1.2.3 Authority The relevant authority governing the Alzheimer's Disease Initiative Program are as follows: (1) Rule Chapter 58D-1, Florida Administrative Code; and (2) Sections 430.501 through 430.504, Florida Statutes. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1) CFO Memo No. 02: Release date, August 20,2010; (2) CFO Memo No. 03: Release date,June 29, 2010; and CFO Memo No. 06: Release date,June 30,2010. 1.2.3.2 Scope of Service The Vendor is responsible for the programmatic, fiscal, and operational management of the ADI program. The program services shall be provided in a manner consistent with and described in the current Vendor's Request for Proposal, RFP, and the County's current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.3.4 Major Program Goals The major goal of the ADI program is to provide services to meet the needs of caregivers and individuals with AD and related memory disorders. 1.3 INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The ADI Program addresses the special needs of individuals with AD and their caregivers. 1.3.2 Individual Eligibility Those individuals eligible to receive services under this contract must meet the following conditions: (1) Be 18 years of age or older and have a diagnosis of AD or a related disorder, or be 26 r suspected of having AD or a related disorder; and 2 (2) Not be enrolled in a Medicaid capitated long-term care program. 1.3.3 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. SERVICE TASKS In order to achieve the goals of the ADI program, the Vendor shall ensure the following tasks are performed: (1) Client eligibility determination; (2) Assessment and prioritization of service delivery for new clients; (3) Delivery of services to eligible clients; and (4) Monitor the performance of vendors. 2.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described in this SECTION 1.3. 2.2 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services addressing the diverse needs of individuals with AD and their caregivers. The Vendor shall ensure services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. Services categories include: (1) Caregiver Training/Support; (2) Case Aid; (3) Case Management; (4) Counseling(Gerontological); (5) Counseling(Mental Health/Screening); (6) Education/Training; (7) Model Day Care; ( 8) Respite(Facility-Based); ( 9) Respite(In-Home); and (10) Specialized Medical Equipment, Services,and Supplies. Caregivers benefit from receiving training, respite and related support services to assist them in caring for the ADI client. 2.3 Service Times The Vendor shall ensure the provisions of the services listed in this contract are available 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. 27 , 1 1 � D 3. DELIVERABLES 2 3.1. Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the County's reporting requirements. Service Unit of Service Caregiver Training/Support; Hour Case Aid; Hour Case Management; Hour Counseling(Gerontological); Hour Counseling(Mental Health/Screening); Hour Respite(Facility-Based); Hour Respite(In-Home); Hour Education/Training; Episode Episode 3.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. 3.2.1 Service Costs Reports Vendor must submit to the County the semi-annual service cost reports August 1, 2013 and February 1,2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 3.3 RECORDS AND DOCUMENTATION 3.3.1 The Vendor and each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 4. PERFORMANCE SPECIFICATIONS 4.1 Outcomes (4) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (5) The Vendor shall timely submit to the County all reports described in SECTION 3.2 REPORTS; and (6) The Vendor shall timely submit to the County all information described in SECTION 3.3 28 1 6 RECORDS AND DOCUMENTATION. 5. COUNTY RESPONSIBILITIES 5.1. Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-up on-site visits; (3) Client visits (4) Review of independent auditor's reports (5) Review third-party documents and/or evaluations (6) Review of progress reports (7) Review of customer satisfaction surveys (8)Agreed-upon procedures review by an external auditor or consultant; (9)Limited-scope reviews; and (10)Other procedures as deemed necessary. 6. SECTION III: METHOD OF PAYMENT 6.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 6.1.2 Remedies-Nonconforming Services The Vendor shall ensure that all goods and/or services provided under this agreement for HCE funded programs are delivered timely, completely and commensurate with required standards of quality Such goods and/or services shall only be delivered to eligible program participants. If the Vendor fails to meet the prescribed quality standards for services, such services will not be reimbursed under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be reimbursed under this agreement. The Vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the Vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County requires immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 6.1.3 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the Vendor and any adjustments thereto, including any disallowance not resolved. 6.1.4 Date for Final Request for Payment 29 Ari The final request for payment for agreement year one's expenditures will be due to the Coun 602 no later than August 1,2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 6.2 Documentation for Payment The Vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals upon request. Such documentation shall be provided upon request to the County or the Clerk of Court. 30 EXHIBIT 4 1 2 STATEMENT OF WORK OLDER AMERICANS ACT PROGRAM TITLE III SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 CONTRACT ACRONYMS Area Agency on Aging(AAA) Activities of Daily Living(ADL) Alliance of Information&Referral Systems(AIRS) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System(CIRTS) Information and Referral(I&R) Instrumental Activities of Daily Living(IADL) Older Americans Act(OAA) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in Its PSA in accordance with the Section 306 (42 U.S.C. 3026)of the OAA and Department instructions. Child: An individual who is not more than 18 years of age or an individual with disability. Family Caregiver: An adult family member, or another individual,who is an informal provider of in-home and community care to an older individual. Frail: When an older individual is unable to perform at least two ADLs without substantial human assistance, including verbal reminding,physical cueing or supervision; or due to cognitive or other mental impairment, requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to another individual. 1.2 County Mission,Vision and Values Statement The County's mission: To help aging adults achieve greater independence through awareness of resources and access to qualified service providers. The County's vision: To be the recognized leader in supporting older adults and their families with access to trustworthy resources and services in their communities while empowering them to live with independence and dignity. The County's values: We believe residents of Southwest Florida are entitled to: Comprehensive information about their choices of care; Timely access to resources and services; High standards of quality and performance; and Personal and professional accountability from all stakeholders. 1.2.1 Older Americans Act Program Mission Statement The Older Americans Act(OAA) Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. 31 1 613 1.3 GENERAL DESCRIPTION 2 1.3.1 General Statement The OAA Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. The primary purpose of the OAA program is to foster the development and implementation of comprehensive and coordinated systems to serve older individuals. The OAA program uses these systems to assist older individuals to attain and maintain maximum independence and dignity in a home environment and allows for the capability of self- care with appropriate supportive services. 1.3.2 Authority The relevant references authority governing the OAA program are: 1. Older Americans Act of 2006,as amended; 2. Rule 58A-1, Florida Administrative Code; and 3. Section 430.101, Florida Statutes. 1.3.2.1 Incorporation of Reference Memoranda In accordance with Ch. 287 F.S., as amended, and Agency of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and incorporated by reference: 1. CFO Memo No. 02: Release date,August 20,2010; 2. CFO Memo No. 03: Release date,June 29,2010; and 3. CFO Memo No. 06: Release date,June 30,2010. 1.3.3 Scope of Service The Vendor shall provide services in a manner consistent with and descried in the current area plan and current Department of Elder Affairs Programs and Services Handbook. 1.3.4 Major Program Goals The major goals of the OAA program are to improve the quality of life for older individuals, preserve their independence and prevent or delay more costly institutional care. These goals are achieved through the implementation of a comprehensive and coordinated service system that provides a continuum of service alternatives that meet the diverse needs of elders and their caregivers. 1.4 INDIVIDUALS TO BE SERVED 1.4.1 Eligibility(Title III Programs) 1.4.1.1 OAA Title III,General Consumers shall not be dually enrolled in an OAA program and a Medicaid capitates long-term care program. 1.4.1.2 OAA Title IIIE,Caregiver Support Services Eligibility for OAA Title IIIE, Caregiver Support Services, are as follows: 1. Family caregivers of individuals age 60 or older; 32 ( ,� . ,, . , 1 6 0 p 2. Grandparents(age 55 or older)or older individuals(age 55 or older)who are relative caregivers; 3. Priority will be given to family caregivers who provide care for individuals with Alzheimer's disease and related disorders with neurological and organic brain dysfunction and for grandparents or older individuals who are relative caregivers who provide care for children with severe disabilities; and 4. For respite and supplemental services, a family caregiver must be providing care for an older individual who meets the definition of the term"frail" in OAA, Section 102 Paragraph 22. 1.4.2 Targeted Groups Preference shall be given to those with the greatest economic and social need, with particular attention to low-income older individuals, including those that are low-income minorities,have limited English proficiency, and older individuals residing in rural areas. SECTION II—MANNER OF SERVICE PROVISION 2.1 SERVICE TASKS In order to achieve the goals of the OAA program,the Vendor shall ensure the following tasks are performed: 1. Client eligibility determination; 2. Targeting and screening of service delivery for new clients; 3. Delivery of services to eligible clients; 4. Use of volunteers to expand the provision of available services; 5. Monitoring the performance of its vendors. 6. Grievance and Compliance Procedures 2.1.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described herein. 2.1.2 Targeting and Screening of Service Delivery for New Clients The Vendor shall develop and implement policies and procedures consistent with OAA targeting and screening Criteria 2.1.3 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meets the diverse needs of elders and their caregivers. The Vendor shall ensure the performance and report performance of the following services in accordance with the current Department of Elder Affairs Programs and Services Handbook. The services funded pursuant to this contract are in accordance with the OAA,Title III, sections 321,331, 336 and 373 as follows: 1. Section 321,Title IIIB Supportive Services; 2. Section 373,Title IIIE Caregiver Support Services. 2.1.3.1 Supportive Services Supportive services include a variety of community-based and home-delivered services that support the qualities of life for older individuals by helping them remain independent and productive. Services include the following: 33 0 16132 2 (1) Adult Day Care/Adult Day Health Care; (17) Homemaker; O Y Y (2) Caregiver Training/Support; (18) Housing Improvement; (3) Case Aide/Case Management; (19) Information; (4) Chore Services; (20) Intake; (5) Companionship; (21) Interpreter/Translating; (6) Counseling(Gerontological and Mental Health); (22) Referral/Assistance; (7) Education/Training; (23) Personal Care; (8) Legal Assistance; (24) Physical Therapy; (9) Material Aid; (25) Shopping Assistance; (10) Occupational Therapy; (26) Skilled Nursing; (11) Outreach; (27) Specialized Medical Equipment, Services, and Supplies (12) Recreation; (28) Respite Services; (13) Emergency Alert Response; (29) Screening/Assessment; (14) Escort; (30) Speech Therapy; (15) Health Support; (31) Telephone Reassurance; and (16) Home Health Aide; (32) Transportation 2.1.3.4 Caregiver Support Services (Title HIE Program) The following services are intended to provide direct help to caregivers,assist in the areas of health, nutrition and financial literacy and assist caregivers in making decisions and problem solving related to their caregiving roles and responsibilities: (1) Adult Day Care/Adult Day Health Care; (2) Caregiver Training/Support; (3) Counseling(Gerontological and Mental Health); (4) Education/Training; (5) Financial Risk Reduction(Assessment and Maintenance); (6) Information; (7) Intake; (8) Outreach; (9) Respite Services; (10) Screening/Assessment; and (11) Transportation 2.1.3.5 Caregiver Support Supplemental Services(Title HIES Program): The following services are provided to complement the care provided by caregivers: (1) Chore Services; (2) Housing Improvement; (3) Legal Assistance; (4) Material Aid; and (5) Specialized Medical Equipment, Services and Supplies. 2.2 SERVICE LOCATION 34 EN) 1602 2.2.1 Service Times The Vendor shall ensure the provision of the services listed in the contract during normal business hours unless other times are more appropriate to meet the performance requirements of the contract, and it shall monitor its vendors to ensure they are available to provide services during hours responsive to client needs and during those times which best meet the needs of the relevant service community. 2.3 DELIVERABLES 2.3.1 Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the services tasks described in Section 2.1. The chart below lists the services allowed and the units of measurement. Units of service will be paid pursuant to the rate established in the 2010 RFP and approved by the County. Services Unit of Ser■ice Adult Day Care/Adult Day Interpreter/Translating Health Care Legal Assistance Caregiver Training/Support Medication Management Case Aid/Case Management Mental Health Counseling/Screening Chore Services Nutrition Counseling Companionship Occupational Therapy Counseling Services Personal Care Escort Physical Therapy Hour Financial Risk Reduction Recreation Services Respite Services Health Support Screening/Assessment Home Health Aide Sitter Homemaker Skilled Nursing Services Housing Improvement Speech Therapy Intake Emergency Alert Response Day Education/Training Episode Information Material Aid Referral/Assistance Specialized Medical Equipment, Services and Supplies Telephone Reassurance Escort One-Way Trip Shopping Assistance Transportation 2.4 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permit the Vendor to meet the County's reporting requirements. 35 16 ® 2 2.4.2 Service Costs Reports The Vendor shall require vendors to submit to the Vendor semi-annual service cost reports on August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.4.5 Background Screening Affidavit of Compliance To demonstrate compliance with section 8 of the Standard Contract,the Vendor shall submit ATTACHMENT H,Background Screening Affidavit of Compliance annually, by January 15`h 2.5 RECORECORDS AND DOCUMENTATION Each Vendor and vendor,among other requirements, must anticipate and prepare for the loss of information processing capabilities.The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement in its contracts and/or agreements with vendors. These policies and procedures shall be made available to the County upon request. 2.6 PERFORMANCE SPECIFICATIONS 2.6.1 Outcomes (1)The Vendor shall ensure services provided under this contract are in accordance with the current DOEA Programs and Services Handbook, (2)The Vendor shall timely submit to the County all reports described herein (3)The Vendor shall timely submit to the County all information described in, Paragraph 2.5 RECORDS AND DOCUMENTATION. 2.7 VENDOR'S FINANCIAL OBLIGATIONS 2.7.1 Matching,Level of Effort,and Earmarking Requirements The Vendor shall provide match of at least 10 percent of the federal funds received. The Vendor's match will be made in the form of cash and/or in-kind resources. The Vendor will assure,through a provision in subcontracts,a match requirement of at least 10 percent of the cost for all services funded through this contract. The vendor's match will be made in the form of cash and/or in-kind resources. The Vendor shall report match by title each month. At the end of the contract period, the Vendor must properly match all OAA funds. 2.7.2 Title III Funds The Vendor assures compliance with Section 306 of the OAA, as amended in 2006,that funds received under Title III will not be used to pay any part of a cost incurred by the Vendor to maintain a contractual or commercial relationship that is not carried out to implement Title III. 2.8 COUNTY RESPONSIBILITIES 2.8.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the Vendor. 2.8.2 Program/Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this contract. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an on-site visit. The County's determination of acceptable performance shall be conclusive. The Vendor 36 C.2) . • 1602 agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: 1. Desk reviews and analytical reviews; 2. Scheduled, unscheduled and follow-up on-site visits; 3. Client visits; 4. Review of independent auditor's reports-Exhibit 10; 5. Review of third-party documents and/or evaluation; 6. Review of progress reports; 7. Review of customer satisfaction surveys; 8. Agreed-upon procedures review by an external auditor or consultant; 9. Limited-scope reviews; and 10. Other procedures as deemed necessary. 2.8.3 Contract Monitoring The County shall, at its own discretion, conduct monitoring concerning any aspect of the vendor's performance of this contract. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for OAA IIIE and OAA IIIES funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rate for services is ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services,which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 37 16132 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services,upon request. 38 1602 EXHIBIT 5 Agreement#12-5856 "Services for Seniors Attachment B Invoice and Logs (Minimum Standard Invoice Information) County Purchasing Order Number: Invoice Number: Grant Name: From Date To Date Reimburse ment Rate Per Unit to Total Supplier TOTAL AMOUNT Cost In Kind (Subtract (Multiply the Service Description In Kind Unit Reimbursement identified by Per Match ( y line Match Service Amount Quantity Rate Per Unit to Unit Amount Supplier x the Unit from Total Quantity) Cost Per Service Unit) $0.00 $0.00 $0.00 Total $0.00 I certify to the best of my knowledge and belief that this invoice, and attached service detail log, is complete and correct and all outlay herein are for the purposes set forth in the contract, and that services are ordered by the case manager as agreed on the Contract. Legible copies of the dated timesheet, signed by the client and the worker supporting this invoice must be available upon request. Collier County reserves the right to correct computation of errors to assure proper payment amount. Prepared by: Date: Adjustment Reasons Lead Agency Authorization Attachments: Monthly Service log, Weekly Detail log and Client Service time sheets. 39 GP 1 6 p EXHIBIT 6 Detail Weekly for CCE Services Week Ending: Invoice No. Personal CLIENT Care Homemaker Respite Skilled Companion Chore Total Total Total Total Total Total NAME Units Units Units Units Units Units Total Hours - - - - - - $ PECA - HMK - $ RESPITE - $ SKILLED - $ COMPANION - $ CHORE - $ TOTAL - 40 EXHIBIT 7 1 6 D Mo Monthly Detail Service Log Grant Name: Vendor Name, Address: From Date To Date By client,provide the total number of hours provided during the dates of service. This log must be submitted with your monthly invoice for the Invoice From Date and To Date. Respite Adult Respite Emergency Client Personal Home- Skilled Enhance Com— Shopping Alert (In- Day (In- Chore Escort Name Care maker Home) Nursing Care Facility Chore panion Assist Response ty System Total 41 M 4 � EXHIBIT 8 1 6 fl 2 Daycare Grant: Grant Service: ADC or RESF Vendor Name and Address By client,provide the Weekly Client Service Time Sheet provided during the dates of service. This log must be submitted with all invoices for the invoice From Date and To Date. TO FROM DATE: DATE: Client Thur Uni Client Name signature Mon Tue Wed s Fri Sat Sun Match is Service Dates 42 - EXHIBIT 9 161J2 YOUR COMPANY NAME HERE Collier County Services for Seniors Homemaker/Personal Care/Respite/Companion Work Sheet Client Name: Client Signature: Week Endin• : Each Time You Perform one of the Activities Below: Put in arrival and departure times for the day worked: ****Client should Initial time of arrival and departure. ****Client should Sign form at top. ****you should sign your name at the bottom. Date: Day: MON TUES WED THUR FRI SAT SUN TOTAL TIME ARRIVAL TIME: DEPARTURE TIME: ****CLIENT INITIALS: Arrive: PERSONAL CARE Depart: Assist W/Bath tub Shower Bed Assist W/Dressing Bathroom Assist Shave (Face Only) Oral Hygiene Walking/Ambulation Feeding Assistance Wash/Set Hair Backrub Soak Feet Nails (File only) Change_Make Bed Take out Trash Clean Bedroom Clean Bathroom Prepare Meals Laundry Arrive: HOME MAKING Depart: Vacuum/Sweep Light Dusting 43 �^% N* t. 16132 Clean Kitchen Floor Wash Dishes Mop Sweep_ Grocery Shop Errands Arrive: RESPITE Depart: Arrive: COMPANION Depart: EMPLOYEE'S Signature/Title 44 1 6 n EXHIBIT 10 OMB Circular A-133 Audits of States, Local Governments, and Non-Profit Organizations requires the Collier County Housing, Human and Veterans Services Department to monitor our subrecipients of federal awards and determine whether they have met the audit requirements of the circular and whether they are in compliance with federal laws and regulations. Accordingly, we are requiring that you check one of the following, provide all appropriate documentation regarding your organization's compliance with the audit requirements, sign and date this form. Subrecipient Fiscal Year Name Period Total State Financial Assistance Expended during $ most recently completed Fiscal Year Total Federal Financial Assistance Expended during most $ recently completed Fiscal Year Check Appropriate Boxes We have exceeded the $500,000 federal/state expenditure threshold for our fiscal year ❑ ending as indicated above and have completed our Circular A-133 audit. A copy of the audit report and management letter are attached. We exceeded the $500,000 federal/state expenditure threshold for our fiscal year ❑ ending as indicated above and expect to complete our Circular A-133 audit by . Within 30 days of completion of the A-133 audit, we will provide a copy of the audit report and management letter. We are not subject to the requirements of OMB Circular A-133 because we: TI Did not exceed the $500,000 federal/state expenditure threshold for the fiscal year indicated above ❑ Are a for-profit organization ❑ Are exempt for other reasons — explain An audited financial statements is attached and if applicable, the independent auditor's management letter. (If findings were noted, please enclose a copy of the responses and corrective action plan.) Certification Statement I hereby certify that the above information is true and accurate. Signature Date Print Name and Title 45 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 602 THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Routed by Purchasing Department to Office Initials Date the Following Addressee(s) (In routing order) 1. Risk Management Pack 2. County Attorney Office County Attorney Office 9�v.) 131113 3. BCC Office Board of County 5.ck�r.A Commissioners yloe._draMe" 513 \\.3 4. Minutes and Records Clerk of Court's Office 1)(Y) 5/3 3 -tpm 5. Return to Purchasing Department Purchasing Contact: Diana DeLeon PRIMARY CONTACT INFORMATION Name of Primary Diana DeLeon for Lisa Carr, HHVS, Phone Number 252-8375 Purchasing Staff May 29,2013 Contact and Date Agenda Date Item was May 28,2013 Agenda Item Number 16.D.2 Approved by the BCC Type of Document Contract Amendment Number of Original 2 Attached Documents Attached PO number or account N/A Solicitation/Contract Amend#1 to Contract 12- number if document is NumberNendor Name 5856 Eleven Ash/Health to be recorded Force INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature? DD 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A provide the Contact Information(Name; Agency; Address; Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be \\ signed by the Chairman, with the exception of most letters,must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's DD signature and initials are required. 7. In most cases(some contracts are an exception), an electronic copy of the document and DD this routing slip should be provided to the County Attorney's Office before the item is input into SIRE. 8. The document was approved by the BCC on the date above and all changes made DD during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes, if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC,all changes directed by the BCC have been made, and the document is ready for the Q,?l Chairman's signature. 1602 MEMORANDUM Date: June 3, 2013 To: Diana DeLeon, Contract Technician Purchasing Department From: Teresa Cannon, Deputy Clerk Minutes & Records Department Re: Amendment #1 to Contract #12-5856 "Services for Seniors" Contractor: Eleven Ash, Inc. Attached is an original copy of the contract referenced above, (#16D2) approved by the Board of County Commissioners on Tuesday, May 28, 2013. The second original will be held on file in the Minutes and Record's Department for the Board's Official Record. If you have any questions, please feel free to contact me at 252-8411. Thank you. Attachment 16 ® 2 Contract Amendment #1 Contract # 12-5856 "Services for Seniors" This CONTRACT AMENDMENT #1, dated tk. , 2013 to the referenced agreement shall be by and between the parties to the original Agreemen , Eleven Ash, Inc. d/b/a Health Force (to be referred to as"Vendor") and Collier County, Florida, (to be referred to as"County"). Statement of Understanding RE: Contract# 12-5856 "Services for Seniors" In order to continue services for the original Contract document referenced above, the Vendor agrees to the terms and conditions set forth in Exhibit A-1A, which includes Attachments C-H and Exhibits 1-10 attached hereto and incorporated by reference. The Vendor further agrees to amend Section 1, Commencement, as follows: 1. COMMENCEMENT. This Agreement shall Commence on December 11, 2012 and shall terminate on December 10, 2011 June 30, 2014. The Contract award is a two (2) year contract, with the possibility of two (2) additional (2) year terms pending funding from grantors and acceptable performance by the awarded vendor. Any such renewals shall be mutually agreed upon in writing by the parties. The maximum duration for this Contract for CCE, HCE, and ADI, OAA IIIE AND OAA IIIES funding will not exceed six (6) years (through June 30, 2018). As outlined in RFP #12-5856, the County requires the Vendor to contribute a cash or in-kind match of no less than ten (10) percent for all services related to the Community Care for the Elderly Program, (CCE), Older American Title IIIE Caregiver Support (OAA IIIE) and Older American Title IIIES Caregiver Support Supplemental Services(OAA IIIES)Programs. Words that have been deleted are struck through, words underlined have been added. Modification made herein shall apply as if incorporated into the Contract on the date of Commencement. All other terms and conditions of the agreement shall remain in force. IN WITNESS WHEREOF, the Vendor and the County have each, respectively, by an authorized person or agent, hereunder set their hands and seals on the date(s) indicated below. Accepted y : c1 I , 2013 VENDOR: QJ/Y Eleven Ash, Inc. d/b/a Health Force rst Wit ss By: ype/print witness a e L L A'Th" l en e ``t I I U- i rtS*Z I i Second Witness Print/Type Name and Title )(lc-\ 1�0 Type/print witness name 1 1602 COUNTY: ATTEST: BOARD OF COUNTY COMMISSIONERS DWIGHT E. BROCK, CLERK OF COLLIER COUNTY, FLORIDA t % 41 ti�0 �_y By. Attest as,t4 T :,. e • • • _ b� t 5 Y CLERK CHAIRWOMAN r signatpre,Qttly. > Appr'owl for form and legal Sufficiency: Jnifer B. White Assistant County Attorney Item# 16b2_ Agenda c e (15 Date DR:tebI3 � 2 Deputy Clerk EXHIBIT A-lA 16 0 2 AGREEMENT 12-5856 SERVICES FOR SENIORS ATTACHMENTS ATTACHMENT ATTACHMENT DESCRIPTION PAGE Attachment C Core Standards for CCE, HCE, ADI, OAA IIIE & IIIES 2 Attachment D Certification Regarding Lobbying 8 Attachment E Certification Regarding Data Integrity Compliance 9 Attachment F Certification Regarding Debarment, Suspension, 10 Ineligibility and Voluntary Exclusion Contracts/ Subcontracts Attachment G Sub-Recipient Invoice Submission 11 Attachment H Background Screening Affidavit of Compliance 12 Exhibit 1 CCE Statement of work 13 Exhibit 2 HCE Statement of work 19 Exhibit 3 ADI Statement of work 25 Exhibit 4 OAA IIE and OAA IIIES Statement of work 31 Exhibit 5 Invoice 39 Exhibit 6 Detail Weekly Log 40 Exhibit 7 Monthly Log 41 Exhibit 8 Day Care/Respite Time Sheet 42 Exhibit 9 Program Time Sheet 43 Exhibit 10 Annual Audit Monitoring Report 45 1 ATTACHMENT C 16 D 2 Core Standards for CCE,HCE,ADI,OAA IIIE &IIIES 1. Compliance with Federal Law 1.1 If this agreement contains federal funds the following shall apply: 1.1.1 The vendor shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable regulations. 1.1.2 If this agreement contains federal funds and is over $100,000.00,the vendor shall comply with all applicable standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s. 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable Environmental Protection County regulations 40 CFR 30. The vendor shall report any violations of the above to the County. 1.1.3 The vendor may not use any federal funds received in connection with this agreement to influence legislation or appropriations pending before the Congress or any state legislature. If this agreement contains federal funding in excess of$100,000.00,the vendor must, prior to agreement execution, complete the Certification Regarding Lobbying form, ATTACHMENT D. All disclosure forms as required by the Certification Regarding Lobbying form must be completed and returned to the Grant Coordinator prior to payment under this agreement. 1.1.4 In accordance with Appendix A to 2 CFR 215, the vendor shall comply with Executive Order 11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in Department of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable. 1.1.5 If this agreement contains federal funds and provides services to children up to age 18,the vendor shall comply with the Pro-Children Act of 1994(20 U.S.C. 6081). 1.1.6 A agreement award with an amount expected to equal or exceed $25,000.00 and certain other agreement 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 vendor shall comply with these provisions before doing business or entering into sub-agreements receiving federal funds pursuant to this agreement. The vendor shall complete and sign ATTACHMENT F prior to the execution of this agreement. 1.2 The vendor shall not employ an unauthorized alien. The County 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 agreement by the County. 2 16132 1.3 If the vendor 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 vendor must notify the County in writing within thirty(30) days of receiving the IRS notice of revocation. 1.4 The vendor shall comply with Title 2 CFR Part 275 regarding Trafficking in Persons. 1.5 Unless exempt under 2 CFR Part 170.110(b), the vendor shall comply with the reporting requirements of the Transparency Act as expressed in 2 CFR 170. 1.6 To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number 11-116, vendor agrees to utilize the U.S. Department of Homeland Security's E-verify system to verify the employment of all new employees hired by vendor during the agreement term. Vendor meeting the terms and conditions of the E-Verify System are deemed to be in compliance with this provision. 2. Compliance with State Law 2.1 This agreement is executed and entered into in the State of Florida, and shall be construed, performed and enforced in all respects in accordance with the Florida law, including Florida provisions for conflict of laws. 2.2 The vendor shall comply with requirements of s. 287.058, F.S. as amended. 2.2.1 The vendor shall provide units of deliverables, including various client services, and in some instances may include reports,findings, and drafts, as specified in this agreement,which the Grant Coordinator must receive and accept in writing prior to payment in accordance with s. 215.971, F.S. (1)and(2). 2.2.2 The vendor shall submit bills for fees or other compensation for services or expenses in sufficient detail for a proper pre-audit and post-audit. 2.2.3 The vendor 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 vendor in conjunction with this agreement except for those records which are made confidential or exempt by law. The vendor's refusal to comply with this provision will constitute an immediate breach of agreement for which the County may unilaterally terminate the agreement. 2.3 If clients are to be transported under this agreement, the vendor shall comply with the provisions of Chapter 427, F.S., and Rule 41-2, F.A. C. 2.4 Vendors who are on the discriminatory vendor list may not transact business with any public entity, in accordance with the provisions of s. 287.134, F.S. 2.5 The vendor shall comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the expenditure of agreement funds for the purpose of lobbying the legislature,judicial branch or a state agency. 3. Background Screening The vendor shall ensure that the requirements of s. 430.0402 and ch. 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 exempted from the Department's level 2 background screening 3 0 pursuant to s. 430.0402 , F.S. The vendor must also comply applicable ru es6 2 p 2 - 3 1 Y with any Pp( ) ( ) P promulgated by the Department and the Agency for Health Care Administration regarding implementation of s. 430.0402 and ch. 435,F.S. Further information concerning the procedures for background screening are found at http://elderaffairs.state.fl.us/doea/backgroundscreening.php. 4. Provision of Services The vendor shall provide services in the manner described herein. 5. Monitoring by the County The vendor shall permit persons duly authorized by the County to inspect and copy any records, papers, documents, facilities, goods and services of the vendor which are relevant to this agreement, and to interview any clients, employees and vendor employees of the vendor to assure the County of the satisfactory performance of the terms and conditions of this agreement. Following such review, the County will provide a written report of its findings to the vendor, and where appropriate,the vendor shall develop a corrective action plan. The vendor hereby agrees to correct all deficiencies identified in the corrective action plan in a timely manner as determined by the Grant Coordinator. 6. Confidentiality of Information The vendor shall not use or disclose any information concerning a vendor of services under this agreement 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. 7. Health Insurance Portability and Accountability Act Where applicable, the vendor shall comply with the Health Insurance Portability and Accountability Act (42 USC 1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162,and 164). 8. Bankruptcy Notification During the term of this agreement,the vendor shall immediately notify the County if the Vendor, its assignees,vendors or affiliates file a claim for bankruptcy. Within ten (10)days after notification,the vendor must also provide the following information to the County.: (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.,United States Bankruptcy Court Middle District of Florida,Naples, FL); and, (4)The name, address, and telephone number of the bankruptcy attorney. 9. Sponsorship and Publicity 9.1 As required by s. 286.25, F.S., if the vendor is a non-governmental organization which sponsors a program financed wholly or in part by state funds, including any funds obtained through this agreement, it shall, in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by Hope Hospice and Community Services, the State County of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County." If the sponsorship reference is in the written material, the words "State of Florida, Department of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County" shall appear in at least the same size letters or type as the name of the organization. 9.2 The vendor shall not use the words "The State of Florida Department of Elder Affairs or the Area County on Aging for Southwest Florida, Inc. or Collier County" to indicate sponsorship of a program otherwise financed, unless specific authorization has been obtained by Collier County, or the Area Aging on Aging prior to use. 4 Cz..) ,. , , . 16132 4 10. Independent Capacity of Vendor It is the intent and understanding of the Parties that the vendor, or any of its vendors, are independent vendors and are not employees of the County and shall not hold themselves out as employees or agents of the County without specific authorization from the County. It is the further intent and understanding of the Parties that the County does not control the employment practices of the vendor and will not be liable for any wage and hour, employment discrimination, or other labor and employment claims against the vendor or its vendors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary insurance for the vendor are the sole responsibility of the vendor. 11. Payment Payments shall be made to the vendor pursuant to s. 215.422, F.S., as services are rendered and invoiced by the vendor. The Grant Coordinator will have final approval of the invoice for payment, and will approve the invoice for payment only if the vendor has met all terms and conditions of the agreement, unless the bid specifications, purchase order, or this agreement specify otherwise. The approved invoice will be submitted to the County's Grant Coordinator approval and processing. 12. Return of Funds The vendor shall return to the County any overpayments due to unearned funds or funds disallowed and any interest attributable to such funds pursuant to the terms and conditions of this agreement that were disbursed to the vendor by the County. In the event that the vendor or its independent auditor discovers that an overpayment has been made, the vendor shall repay said overpayment immediately without prior notification from the County. In the event that the County first discovers an overpayment has been made, the Grant Coordinator will notify the vendor in writing of such findings. 13. Data Integrity and Safeguarding Information The vendor shall ensure an appropriate level of data security for the information the vendor is collecting or using in the performance of this agreement. An appropriate level of security includes approving and tracking all vendor employees that request system or information access and ensuring that user access has been removed from all terminated employees. The vendor, 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 vendor shall ensure all vendors maintain written procedures for computer system backup and recovery. The vendor shall complete and sign Attachment E prior to the execution of this agreement. 14. Computer Use and Social Media Policy The Department of Elder Affairs has implemented a new 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, Area Agencies on Aging and vendors. 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. 15. Public Entity Crime Pursuant to s. 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 5 3 16D2 agreement to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on a agreement 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 vendor, supplier, vendor, or consultant under a agreement with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in s. 287.017, F.S., for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted vendor list. 16. Patents,Copyrights,Royalties If this agreement 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 agreement, the vendor shall refer the discovery, invention or material to the County to be referred to the Department of State and the Department of Elder Affairs. Any and all patent rights or copyrights accruing under this agreement are hereby reserved to the State of Florida in accordance with Chapter 286, F.S. Pursuant to s. 287.0571 (5) (k) 1 and 2 as amended, the only exceptions to this provision shall be those that are clearly expressed and reasonably valued in the agreement. 16.1 If the primary purpose of this agreement 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 Paragraph 33. 16.2 If this agreement is awarded solely federal funding, the terms and conditions are governed by 2 CFR 215.36. 17. Emergency Preparedness and Continuity of Operations 17.1 If the tasks to be performed pursuant to this agreement include the physical care and control of clients, or the administration and coordination of services necessary for client health, safety or welfare, the vendor shall, within thirty (30) calendar days of the execution of this agreement, submit to the Grant Coordinator verification of an emergency preparedness plan. In the event of an emergency,the vendor shall notify the County of emergency provisions. 17.2 In the event a situation results in a cessation of services by a vendor, the vendor shall retain responsibility for performance under this agreement and must follow procedures to ensure continuity of operations without interruption. 18. Financial Consequences of Non-Performance If the vendor fails to meet the minimum level of service or performance identified in this agreement, or that is customary for the industry, then the County must apply financial consequences commensurate with the deficiency. Financial consequences may include,but are not limited to, agreement suspension, refusing payment, withholding payments until deficiency is cured, tendering only partial payments, and/or cancellation of agreement and reacquiring services from an alternate source. 18.1 The vendor will not be charged with financial consequences, when a failure to perform arises out of causes that were the responsibility of the County. 19. No Waiver of Sovereign Immunity 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. 20. Venue If any dispute arises out of this agreement,the venue of such legal recourse will be Collier 6 County,Florida. 16132 21. Entire Agreement This agreement contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations shall be valid or binding upon the County or the vendor unless expressly contained herein or by a written amendment to this agreement signed by both Parties. 22. 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. 23. 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. 24. Waiver The delay or failure by the County to exercise or enforce any of its rights under this agreement will not constitute or be deemed a waiver of the County'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. 25. Compliance The vendor shall abide by all applicable current federal statutes, laws, rules and regulations as well as applicable current state statutes, laws, rules, regulations and County rules, ordinances and regulations. The Parties agree that failure of the vendor to abide by these laws shall be deemed an event of default of the vendor, and subject the agreement to immediate, unilateral cancellation of the agreement at the discretion of the County. 26. Final Invoice The vendor shall submit the final CCE, HCE, ADI, IIE and IIIES invoice for payment to the County on July 3, 2013. If the vendor fails to submit final request for payment by the deadline, then all rights to payment may be forfeited and the County may not honor any requests submitted after the aforesaid time period. Any payment due under the terms of this agreement may be withheld until all reports due from the vendor and necessary adjustments thereto have been approved by the County. 27. Renegotiations or Modifications Modifications of the provisions of this agreement shall be valid only when they have been reduced to writing and duly signed by both parties. The rate of payment, contract requirements and the total dollar amount may be adjusted retroactively to reflect price level increases and changes in the rate of payment or language. 28. All Terms and Conditions Included This agreement and its Attachments, A-H and exhibits 1-4 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 agreement shall supersede all previous communications, representations or agreements, either written or verbal between the Parties. 7 16132 ATTACHMENT D CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR AGREEMENTS,GRANTS,LOANS AND AGREEMENTS The undersigned certifies,to the best of his or her knowledge and belief,that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any State ,Federal or County, a member of congress, an officer or employee of congress, an employee of a member of congress, or an officer or employee of the state legislator, in connection with the awarding of any federal grant,the making of any federal loan,the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal agreement, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of the County, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this federal agreement, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers(including vendors, sub-grants, and agreements under grants, loans and cooperative agreements)and that all vendors shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Signature Date Name of Authorized Individual Name and Address of Organization 8 ATTACHMENT E � � D CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE L). FOR AGREEMENTS,GRANTS,LOANS AND COOPERATIVE AGREEMENTS The undersigned, an authorized representative of the vendor named in the agreement or agreement to which this form is an attachment, hereby certifies that: (1) The vendor and any vendors of services under this agreement 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 vendor, vendor(s), or any outside entity on which the vendor 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,vendor(s)will take immediate action to assure data integrity. (3) If this agreement 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 vendor (represented by the undersigned) and purchased by the State will be verified for accuracy and integrity of data prior to transfer. In the event of any decrease in functionality related to time and date related codes and internal subroutines that impede the hardware or software programs from operating properly, the vendor agrees to immediately make required corrections to restore hardware and software programs to the same level of functionality as warranted herein, at no charge to the State, and without interruption to the ongoing business of the state,time being of the essence. (4) The vendor and any vendor(s) of services under this agreement warrant their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data integrity compliance issues. The vendor shall require that the language of this certification be included in all vendors and other agreements and that all vendor shall certify compliance accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB Circulars A-102 and 2 CFR Part 215 (formerly OMB Circular A-110). Name and Address of vendor Signature Title Date Name of Authorized Signer 9 1 16132 EXHIBIT F CERTIFICATION REGARDING DEBARMENT, SUSPENSION,INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS (1) The prospective vendor certifies, by signing this certification, neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or County. (2) Where the prospective vendor is unable to certify to any of the statements in this certification,such prospective participant shall attach an explanation to this certification. Signature Date Title County/Organization (Certification signature should be same as Agreement signature.) Instructions for Certification 1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "person," "primary covered transaction,"and"voluntarily excluded,"as used herein,have the meanings set out in the sections of rules implementing Executive Order 12549. (2 CFR 180.5-180.1020,as supplemented by 2 CFR 376.10-376.995). You may contact the Agreement Manager for assistance in obtaining a copy of those regulations. 2. This certification is a material representation of facts upon which reliance was placed when the parties entered into this transaction. If it is later determined that the vendor knowingly rendered an erroneous certification,in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension and/or debarment. 3. The vendor will provide immediate written notice to the Agreement Manager if at any time the vendor learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The vendor may decide the method and frequency by which it determines the eligibility of its principals. Each participant to a lower tier covered transaction may,but is not required to,check the Excluded Parties List System(EPLS). 4. The vendor will include a"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion-Lower Tier Covered Transaction"in all its lower tier covered transactions and in all solicitations for lower tier covered transactions. 5. The vendor agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise authorized by the federal government. 6. If the vendor knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction,in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension,and/or debarment. 7. The vendor may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended,ineligible,or voluntarily excluded from the covered transaction,unless it knows that the certification is erroneous. 10 � . 16132 EXHIBIT G SUBRECIPIENT INVOICE SUMMISSION The County shall reimburse the SUBRECIPIENT for the performance of this Agreement upon completion or partial completion of the work tasks as accepted and approved by HHVS pursuant to the submittal of quarterly progress reports. Invoices for work performed are required every month. If no work has been performed during that month, or if the SUBRECIPIENT is not yet prepared to send the required backup, a$0 invoice will be required. Explanations will be required if two consecutive months of$0 invoices are submitted. Payments shall be made to the SUBRECIPIENT when requested as work progresses but, not more frequently than once per month. Final invoices are due no later than 90 days after the end of the agreement. Work performed during the term of the program but not invoiced within 90 days without written exception from the Grant Coordinator will not be reimbursed. No payment will be made until approved by HHVS for grant compliance and adherence to any and all applicable local, state or Federal requirements. Payment will be made upon receipt of a properly completed invoice and in compliance with §218.70, Florida Statutes, otherwise known as the "Local Government Prompt Payment Act." 11 DEPARTMENT OF EXHIBIT H 1P EXH BACKGROUND SCREENING ELDER AFFAIRS Affidavit of Compliance -Employer STATE OF FLORIDA 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 Employer Name located at Street Address City State ZIP code I, 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. Signature of Representative Date STATE OF FLORIDA,COUNTY OF Sworn to(or affirmed)and subscribed before me this day of , 20 , by (Name of Representative)who is personally known to me or produced 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:http://elderaffairs.state.fl.us/english/backgroundscreening.php 12 • ! a l 1602 EXHIBIT 1 STATEMENT OF WORK COMMUNITY CARE FOR THE ELDERLY PROGRAM(CCE) SECTION I: SERVICES TO BE PROVIDED 1.1. DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 AGREEMENT ACRONYMS Activities of Daily Living(ADL) Adult Protective Services(APS) Assessed Priority Consumer List(APCL) Comprehensive Assessment and Review for Long-Term Care Services(CARES) Community Care for the Disabled Adult(CCDA) Community Care for the Elderly(CCE) Client Information and Registration Tracking System(CIRTS) Department of Children and Families(DCF) Department of Elder Affairs (DOEA) Home Care for Disabled Adults(HCDA) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out: The condition of reaching 60 years of age and being transitioned from the Department of Children and Families(DCF) Services,Community Care for Disabled Adults (CCDA)or Home Care for Disabled Adults(HCDA)services to the Department's community- based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in its planning and service area in accordance with the Section 306 (42 U.S.C. 3026) of the Older Americans Act and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the County enters CCE specific data in the CIRTS. An update may also include other revisions to the area plan as instructed by the County or Department of Elder Affairs. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The primary purpose of the CCE program is to prevent, decrease or delay premature or inappropriate and expensive placement of older persons in nursing homes and other institutions. 13 y I „ , 16132 1.2.2 Community Care for the Elderly Mission Statement The CCE Program assists functionally impaired elderly persons in living as independently as possible in their own homes or in the homes of relatives or caregivers. The program provides a continuum of care through the development, expansion, reorganization and coordination of multiple community-based services to assist elders to reside in the least restrictive environment suitable to their needs. 1.2.3 Authority The relevant authority governing CCE program are: (1)Rule 58C-1, Florida Administrative Code (2) Sections 430.201 through 430.207, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services Chief Financial Officer Memoranda the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1)CFO Memo No. 02: Release date,August 20,2010; (2)CFO Memo No. 03: Release date,June 29,2010; and (3) CFO Memo No. 06: Release date,June 30,2010. 1.2.4 Scope of Service The vendor shall provide services in a manner consistent with and descried in the current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the program are to preserve the independence of elders and prevent or delay more costly institutional care through a community care service system that provides case management and other in-home and community services as needed under the direction of the County and provide a continuum of service alternatives that meet the diverse needs of functionally impaired elders. 1.3. INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The CCE program provides a continuum of services for functional impaired elders. 1.3.2 Individual Eligibility In order to receive services under this agreement, an applicant must: (1) Be at least 60 years of age; (2) Be functionally impaired as determined through the initial comprehensive assessment; and (3) With the exception of APS high-risk referrals, consumers may not be dually enrolled in the CCE program and a Medicaid capitated long-term care program. 1.3.2.1 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution or who are abused, neglected or exploited. 14 • 4 1613 2 SECTION II: MANNER OF SERVICE PROVISION 2. Delivery of Service to Eligible Clients The vendor shall ensure the provision of a continuum of service that meet the diverse needs of functionally impaired elders. The vendor shall ensure performance and reporting of the following service provision in accordance with the current DOEA Programs and Services Handbook. The services may include the following categories: (1) Core Services; (2) Health Maintenance Services;and (3) Other Support Services. Core Services for Programmatic Operation 2.1. The vendor may deliver core services include a variety of home-delivered services, day care services, and other basic services that are most needed to prevent unnecessary institutionalization. Core services,to be provided at the unit rate identified in this agreement, include the following: (1) Adult Day Care; (7) Housing Improvement; (2) Chore Services; (8) Respite Services; and (3) Enhanced Chore; (9) Transportation (4) Companionship; (5) Home Delivered Meals; (6) Homemaker; 2.1.1 Health Maintenance Services The vendor shall ensure that health maintenance services are routine health services that are necessary to help maintain the health of functionally impaired elders. The services are limited to medical therapeutic services, non-medical prevention services, personal care services, home health aide services, home nursing services, and emergency response systems. Typical services to be provided at the unit rate identified in this agreement, are the following: (1) Adult Day Health Care; (2) Emergency Alert Response; (3) Nutrition Counseling (4) Personal Care (5) Skilled Nursing Services; and (6) Specialized Medical Equipment Services and Supplies 2.2 SERVICE TIMES 2.2.1 Service Times 15 •' 1602 The vendor shall ensure the provisions of the services listed in this agreement are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m.to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the agreement in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this agreement as updated, and approved by the County's reporting requirements. Service Unit of Service Adult Day Care Homemaker Case Aide Housing Improvement Case Management Respite Services Chore Services Personal Care Hour Enhanced Chore Physical Therapy Companionship Skilled Nursing Services Emergency Alert Response Day Material Aid Episode Specialized Medical Equipment, Services and Supplies Escort Shopping Assistance One-Way Trip Transportation Service Unit of Service Home Delivered Meals Meal 2.4 REPORTS The vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The vendor shall establish due dates for any agreement that permits the vendor to meet the County's reporting requirements. Service Costs Reports The vendor shall submit to the County semi-annual service cost reports, August 1, 2013 and February 1, 2014, of each year which reflects actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.5 RECORDS AND DOCUMENTATION 2.5.1 Each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup 16 c-;), a• ✓ 1, 2.6 COUNTY RESPONSIBILITIES 16 D 2 2.6.1 Program Guidance and Technical Assistance The County will provide to the vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the vendor. resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures will be made available to the County upon request. 2.7 PERFORMANCE SPECIFICATIONS 2.7.1 Outcomes (1) The vendor shall ensure services provided under this agreement are in accordance with the current Department of Elder Affairs Programs and Services Handbook. (2) The vendor shall timely submit to the County all information described in EXHIBIT 1, SECTION 2.4 REPORTS; and (3) The vendor shall timely submit to the County all information described in EXHIBIT 1, SECTION 2.5 RECORDS AND DOCUMENTATION. 2.8. VENDOR'S FINANCIAL OBLIGATIONS 2.8.1 Matching,Level of Effort,and Earmarking Requirement The vendor will assure a match requirement of at least 10 percent of the cost for all CCE services. The match will be made in the form of cash and/or in-kind resources. At the end of the agreement period, all CCE funds expended must be properly matched. State funds cannot be used to match another state-funded program. 3. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 17 0 1602 3.4 Payment may be authorized only for allowable services,which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 18 EXHIBIT 2 1 6 ® 2 STATEMENT OF WORK HOME CARE FOR THE ELDERLY PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Adult Protective Services(APS) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) 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) Home Care for Disabled Adults(HCDA) Home Care for the Elderly(HCE) Institutional Care Program (ICP) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults(HCDA) services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026) and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the County enters HCE specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement Area Agencies on Aging may contract with CCE lead agencies or other case management entities for the provision of the HCE program. Approved caregivers receive a Basic Subsidy to reimburse some of their expenses each month for caring for the consumer and may receive a Special Subsidy for other necessary services and essential supplies. Caregivers may be approved 19 0 for up to three HCE clients in their home. 1 60 2 1.2.2 Home Care for the Elderly Program Mission Statement The Home Care for the Elderly Program supports family style living arrangements, on a non- profit basis,as an alternative to nursing homes or other institutional care. Through the program, a caregiver for three or fewer elders living in a private home provides basic services of maintenance and supervision as well as coordinating other necessary specialized services. 1.2.3 Authority The relevant authority governing the HCE program include: (1) Rule Chapter 58H-1, Florida Administrative Code; and (2) Sections 430.601 through 430.608, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services', Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: CFO Memo No. 02: Release date,August 20,2010; CFO Memo No. 03: Release date,June 29, 2010; and CFO Memo No. 06: Release date,June 30, 2010. 1.2.4 Scope of Service The Vendor shall provide services in a manner consistent with and described in the current County's area plan update and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the HCE program are to ensure that: (1) Basic Subsidy is provided to the caregiver of each client and (2) Special Subsidy is provided when essential to the well-being of the client. 1.3 INDIVIDUAL TO BE SERVED 1.3.1 General Eligibility The Home Care for the Elderly program serves elders age 60 and older at risk of placement in a nursing home or other institutional settings who can remain in a family style setting through the provision of subsidies. 1.3.2 Client Eligibility Clients eligible to receive services under this agreement must: (1) Be 60 years of age or older; (2) Have income less than the Institutional Care Program(ICP)standard. (3) Meet the ICP asset limitation; (4) Be at risk of nursing home placement; 20 1613 2 (5) Have an approved adult caregiver living in the home with them who is willing to provide care or assist in arranging for care; and (6) Not be enrolled in the Aged and Disabled Adult Medicaid waiver or a Medicaid capitated long-term care program. 1.3.3 Caregiver Eligibility Caregivers eligible to receive services under this agreement must: (1) Be at least 18 years of age,capable of providing a family-type living environment; (2) 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; (3) Be willing to accept responsibility for the social, physical and emotional needs of the care Vendor; (4) Be physically present and live in the home to provide supervision and to assist in arrangement of services for the client; (5) 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 (6) Be without record of conviction of abuse, neglect or exploitation of another person. 1.3.4 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meet the diverse needs of the functionally impaired elders and their caregivers. The Vendor shall ensure Basic Subside and Special Subsidy services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. 2.1. Basic Subsidy The Basic Subsidy is a cash payment made to an approved caregiver each month to reimburse some expenses incurred in caring for the client. The Basic Subsidy is provided for support and maintenance of the client, including housing, food, clothing, and medical costs not covered by Medicaid, Medicare or any other insurance. A Basic Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. If the client is hospitalized or in any other temporary institution for 30 days or less,the full Basic Subsidy shall be provided to the caregiver as if the client were in the home. 2.2. Special Subsidy Services Though every eligible HCE client receives a Basic Subsidy, Special Subsidy payments are pre-authorized and are based on additional specialized medical or health care services, supplies or equipment needed to maintain the health and well-being of the individual elder. The Special Subsidy for additional medical support and special services is a cash payment to reimburse the costs of any other service or special care not covered by Medicaid, Medicare, or private insurance when these services are determined to be 21 0 1 6 0 2 essential to maintain the well-being of the home care recipient. A Special Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. Special Subsidy 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: 2.2.1 SERVICE LOCATION AND EQUIPMENT 2.2.2 Service Times The vendor shall ensure the provision of the services listed in this contract are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m. to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the Agency's reporting requirements. Service Unit of Service Adult Day Care Housing Improvement Case Aide Other Case Management Personal Care Chore Respite(Facility Based or In-Home) Hour Chore(Enhanced) Skilled Nursing Services Homemaker Material Aid Episode Specialized Medical Equipment, Services and Supplies Transportation One-Way Trip 2.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permits the Vendor to meet the County's reporting requirements. 2.2.1 Service Costs Reports The Vendor shall submit to the County the semi-annual service cost reports, August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.3 RECORDS AND DOCUMENTATION 2.3.1 The Vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The 22 0 1 6B2 Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 2.4 PERFORMANCE SPECIFICATIONS 2.4.1 Outcomes (1) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (2) The Vendor shall timely submit to the County all reports described in SECTION 2.2 REPORTS; and (3) The Vendor shall timely submit to the County all information described in, SECTION 2.3 RECORDS AND DOCUMENTATION. 2.5 COUNTY RESPONSIBILITIES 2.5.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-up on-site visits; (3) Client visits; (4) Review of independent auditor's reports; (5) Review of third-party documents and/or evaluation; (6) Review of progress reports; (7) Review of customer satisfaction surveys; (8) Agreed-upon procedures review by an external auditor or consultant; (9) Limited-scope reviews; and (10) Other procedures as deemed necessary. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The 23 1602 6 vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services, which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 24 • . 1602 EXHIBIT 3 STATEMENT OF WORK ALZHEIMER'S DISEASE INITIATIVE PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS L1.1 DEFINITIONS OF ACRONYMS Alzheimer's Disease(AD) Alzheimer's Disease Initiative(ADI) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System(CIRTS) Community Care for Disabled Adults(CCDA) Department of Elder Affairs(DOEA) Home Care For Disabled Adults(HCDA) Instrumental Activities of Daily Living(IADL) Memory Disorder Clinic(MDC) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults(HCDA) services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026. 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 County enters ADI specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 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. Model Day Care: A program of therapeutic, social and health activities specific to clients with memory disorders. Services and activities include, but are not limited to, active and quiet 25 X14 . • 16 ® 2 games, reminiscence, validation therapy, pet therapy, water therapy and other failure free activities appropriate to the client's level of functioning. Model day care centers will also provide training for health care and social service personnel in the care of persons having AD or related memory disorders. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The ADI program provides a continuum of services addressing the special needs of individuals with AD,their families and caregivers. 1.2.2 Alzheimer's Disease Initiative Program Mission Statement The ADI program ensures that persons afflicted with AD and other forms of dementia are given essential services to help them age in place in an elder-friendly environment with security, dignity,and purpose. The program also provides support to family members and caregivers of persons afflicted with AD. 1.2.3 Authority The relevant authority governing the Alzheimer's Disease Initiative Program are as follows: (1) Rule Chapter 58D-1, Florida Administrative Code; and (2) Sections 430.501 through 430.504, Florida Statutes. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1) CFO Memo No. 02: Release date,August 20,2010; (2) CFO Memo No. 03: Release date,June 29,2010; and CFO Memo No. 06: Release date,June 30,2010. 1.2.3.2 Scope of Service The Vendor is responsible for the programmatic, fiscal, and operational management of the ADI program. The program services shall be provided in a manner consistent with and described in the current Vendor's Request for Proposal, RFP, and the County's current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.3.4 Major Program Goals The major goal of the ADI program is to provide services to meet the needs of caregivers and individuals with AD and related memory disorders. 1.3 INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The ADI Program addresses the special needs of individuals with AD and their caregivers. 1.3.2 Individual Eligibility Those individuals eligible to receive services under this contract must meet the following conditions: (1) Be 18 years of age or older and have a diagnosis of AD or a related disorder, or be 26 CA0 • suspected of having AD or a related disorder;and 16 D 2 (2) Not be enrolled in a Medicaid capitated long-term care program. 1.3.3 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. SERVICE TASKS In order to achieve the goals of the ADI program,the Vendor shall ensure the following tasks are performed: (1) Client eligibility determination; (2) Assessment and prioritization of service delivery for new clients; (3) Delivery of services to eligible clients; and (4) Monitor the performance of vendors. 2.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described in this SECTION 1.3. 2.2 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services addressing the diverse needs of individuals with AD and their caregivers. The Vendor shall ensure services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. Services categories include: (1) Caregiver Training/Support; (2) Case Aid; (3) Case Management; (4) Counseling(Gerontological); (5) Counseling(Mental Health/Screening); (6) Education/Training; (7) Model Day Care; ( 8) Respite(Facility-Based); ( 9) Respite(In-Home); and (10) Specialized Medical Equipment, Services, and Supplies. Caregivers benefit from receiving training, respite and related support services to assist them in caring for the ADI client. 2.3 Service Times The Vendor shall ensure the provisions of the services listed in this contract are available 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. 27 CA • 3. DELIVERABLES j a 2 3.1. Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated,and approved by the County's reporting requirements. Service Unit of Service Caregiver Training/Support; Hour Case Aid; Hour Case Management; Hour Counseling(Gerontological); Hour Counseling(Mental Health/Screening); Hour Respite(Facility-Based); Hour Respite(In-Home); Hour Education/Training; Episode Episode 3.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. 3.2.1 Service Costs Reports Vendor must submit to the County the semi-annual service cost reports August 1, 2013 and February 1,2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 3.3 RECORDS AND DOCUMENTATION 3.3.1 The Vendor and each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 4. PERFORMANCE SPECIFICATIONS 4.1 Outcomes (4) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (5) The Vendor shall timely submit to the County all reports described in SECTION 3.2 REPORTS; and (6) The Vendor shall timely submit to the County all information described in SECTION 3.3 28 cno RECORDS AND DOCUMENTATION. 1 6 ® 2 5. COUNTY RESPONSIBILITIES 5.1. Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-up on-site visits; (3) Client visits (4) Review of independent auditor's reports (5) Review third-party documents and/or evaluations (6) Review of progress reports (7) Review of customer satisfaction surveys (8)Agreed-upon procedures review by an external auditor or consultant; (9)Limited-scope reviews; and (10)Other procedures as deemed necessary. 6. SECTION III: METHOD OF PAYMENT 6.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 6.1.2 Remedies-Nonconforming Services The Vendor shall ensure that all goods and/or services provided under this agreement for HCE funded programs are delivered timely, completely and commensurate with required standards of quality Such goods and/or services shall only be delivered to eligible program participants. If the Vendor fails to meet the prescribed quality standards for services, such services will not be reimbursed under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be reimbursed under this agreement. The Vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the Vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County requires immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 6.1.3 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the Vendor and any adjustments thereto, including any disallowance not resolved. 6.1.4 Date for Final Request for Payment 29 vt 7 1602 The final request for payment for agreement year one's expenditures will be due to the County no later than August 1,2013. The final request for payment for agreement year two expenditures will be no later than August 1,2014. 6.2 Documentation for Payment The Vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals upon request. Such documentation shall be provided upon request to the County or the Clerk of Court. 30 (.0 , 0 4 1602 EXHIBIT 4 STATEMENT OF WORK OLDER AMERICANS ACT PROGRAM TITLE HI SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 CONTRACT ACRONYMS Area Agency on Aging(AAA) Activities of Daily Living(ADL) Alliance of Information&Referral Systems(AIRS) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System(CIRTS) Information and Referral(I&R) Instrumental Activities of Daily Living(IADL) Older Americans Act(OAA) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in Its PSA in accordance with the Section 306(42 U.S.C. 3026)of the OAA and Department instructions. Child: An individual who is not more than 18 years of age or an individual with disability. Family Caregiver: An adult family member,or another individual,who is an informal provider of in-home and community care to an older individual. Frail: When an older individual is unable to perform at least two ADLs without substantial human assistance, including verbal reminding,physical cueing or supervision; or due to cognitive or other mental impairment,requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to another individual. 1.2 County Mission,Vision and Values Statement The County's mission: To help aging adults achieve greater independence through awareness of resources and access to qualified service providers. The County's vision: To be the recognized leader in supporting older adults and their families with access to trustworthy resources and services in their communities while empowering them to live with independence and dignity. The County's values: We believe residents of Southwest Florida are entitled to: Comprehensive information about their choices of care; Timely access to resources and services; High standards of quality and performance; and Personal and professional accountability from all stakeholders. 1.2.1 Older Americans Act Program Mission Statement The Older Americans Act(OAA)Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. 31 7r) . • • 1.3 GENERAL DESCRIPTION 1 6 0 2 1.3.1 General Statement The OAA Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. The primary purpose of the OAA program is to foster the development and implementation of comprehensive and coordinated systems to serve older individuals.The OAA program uses these systems to assist older individuals to attain and maintain maximum independence and dignity in a home environment and allows for the capability of self- care with appropriate supportive services. 1.3.2 Authority The relevant references authority governing the OAA program are: 1. Older Americans Act of 2006, as amended; 2. Rule 58A-1, Florida Administrative Code; and 3. Section 430.101, Florida Statutes. 1.3.2.1 Incorporation of Reference Memoranda In accordance with Ch. 287 F.S., as amended,and Agency of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and incorporated by reference: 1. CFO Memo No. 02: Release date, August 20,2010; 2. CFO Memo No. 03: Release date,June 29, 2010; and 3. CFO Memo No. 06: Release date,June 30,2010. 1.3.3 Scope of Service The Vendor shall provide services in a manner consistent with and descried in the current area plan and current Department of Elder Affairs Programs and Services Handbook. 13.4 Major Program Goals The major goals of the OAA program are to improve the quality of life for older individuals, preserve their independence and prevent or delay more costly institutional care. These goals are achieved through the implementation of a comprehensive and coordinated service system that provides a continuum of service alternatives that meet the diverse needs of elders and their caregivers. 1.4 INDIVIDUALS TO BE SERVED 1.4.1 Eligibility(Title III Programs) 1.4.1.1 OAA Title III,General Consumers shall not be dually enrolled in an OAA program and a Medicaid capitates long-term care program. 1.4.1.2 OAA Title IIIE,Caregiver Support Services Eligibility for OAA Title IIIE, Caregiver Support Services, are as follows: 1. Family caregivers of individuals age 60 or older; 32 . « 1602 2. Grandparents(age 55 or older)or older individuals(age 55 or older)who are relative caregivers; 3. Priority will be given to family caregivers who provide care for individuals with Alzheimer's disease and related disorders with neurological and organic brain dysfunction and for grandparents or older individuals who are relative caregivers who provide care for children with severe disabilities; and 4. For respite and supplemental services,a family caregiver must be providing care for an older individual who meets the definition of the term"frail" in OAA, Section 102 Paragraph 22. 1.4.2 Targeted Groups Preference shall be given to those with the greatest economic and social need,with particular attention to low-income older individuals, including those that are low-income minorities,have limited English proficiency,and older individuals residing in rural areas. SECTION II—MANNER OF SERVICE PROVISION 2.1 SERVICE TASKS In order to achieve the goals of the OAA program,the Vendor shall ensure the following tasks are performed: 1. Client eligibility determination; 2. Targeting and screening of service delivery for new clients; 3. Delivery of services to eligible clients; 4. Use of volunteers to expand the provision of available services; 5. Monitoring the performance of its vendors. 6. Grievance and Compliance Procedures 2.1.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described herein. 2.1.2 Targeting and Screening of Service Delivery for New Clients The Vendor shall develop and implement policies and procedures consistent with OAA targeting and screening Criteria 2.1.3 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meets the diverse needs of elders and their caregivers. The Vendor shall ensure the performance and report performance of the following services in accordance with the current Department of Elder Affairs Programs and Services Handbook. The services funded pursuant to this contract are in accordance with the OAA,Title III, sections 321,331, 336 and 373 as follows: 1. Section 321,Title IIIB Supportive Services; 2. Section 373,Title IIIE Caregiver Support Services. 2.1.3.1 Supportive Services Supportive services include a variety of community-based and home-delivered services that support the qualities of life for older individuals by helping them remain independent and productive. Services include the following: 33 , „ 161) 2 (1) Adult Day Care/Adult Day Health Care; (17) Homemaker; (2) Caregiver Training/Support; (18) Housing Improvement; (3) Case Aide/Case Management; (19) Information; (4) Chore Services; (20) Intake; (5) Companionship; (21) Interpreter/Translating; (6) Counseling(Gerontological and Mental Health); (22) Referral/Assistance; (7) Education/Training; (23) Personal Care; (8) Legal Assistance; (24) Physical Therapy; (9) Material Aid; (25) Shopping Assistance; (10) Occupational Therapy; (26) Skilled Nursing; (11) Outreach; (27) Specialized Medical Equipment, Services, and Supplies (12) Recreation; (28) Respite Services; (13) Emergency Alert Response; (29) Screening/Assessment; (14) Escort; (30) Speech Therapy; (15) Health Support; (31) Telephone Reassurance; and (16) Home Health Aide; (32) Transportation 2.1.3.4 Caregiver Support Services (Title HIE Program) The following services are intended to provide direct help to caregivers, assist in the areas of health, nutrition and financial literacy and assist caregivers in making decisions and problem solving related to their caregiving roles and responsibilities: (1) Adult Day Care/Adult Day Health Care; (2) Caregiver Training/Support; (3) Counseling(Gerontological and Mental Health); (4) Education/Training; (5) Financial Risk Reduction(Assessment and Maintenance); (6) Information; (7) Intake; (8) Outreach; (9) Respite Services; (10) Screening/Assessment; and (11) Transportation 2.1.3.5 Caregiver Support Supplemental Services (Title HIES Program): The following services are provided to complement the care provided by caregivers: (1) Chore Services; (2) Housing Improvement; (3) Legal Assistance; (4) Material Aid; and (5) Specialized Medical Equipment, Services and Supplies. 2.2 SERVICE LOCATION 34 1602•Kj 2.2.1 Service Times The Vendor shall ensure the provision of the services listed in the contract during normal business hours unless other times are more appropriate to meet the performance requirements of the contract, and it shall monitor its vendors to ensure they are available to provide services during hours responsive to client needs and during those times which best meet the needs of the relevant service community. 2.3 DELIVERABLES 2.3.1 Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the services tasks described in Section 2.1. The chart below lists the services allowed and the units of measurement. Units of service will be paid pursuant to the rate established in the 2010 RFP and approved by the County. Services Unit of Service Adult Day Care/Adult Day Interpreter/Translating Health Care Legal Assistance Caregiver Training/Support Medication Management Case Aid/Case Management Mental Health Counseling/Screening Chore Services Nutrition Counseling Companionship Occupational Therapy Counseling Services Personal Care Escort Physical Therapy Hour Financial Risk Reduction Recreation Services Respite Services Health Support Screening/Assessment Home Health Aide Sitter Homemaker Skilled Nursing Services Housing Improvement Speech Therapy Intake Emergency Alert Response Day Education/Training Episode Information Material Aid Referral/Assistance Specialized Medical Equipment, Services and Supplies Telephone Reassurance Escort One-Way Trip Shopping Assistance Transportation 2.4 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permit the Vendor to meet the County's reporting requirements. 35 C ip 1 613 2.4.2 Service Costs Reports The Vendor shall require vendors to submit to the Vendor semi-annual service cost reports on August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.4.5 Background Screening Affidavit of Compliance To demonstrate compliance with section 8 of the Standard Contract,the Vendor shall submit ATTACHMENT H,Background Screening Affidavit of Compliance annually, by January 15th 2.5 RECORECORDS AND DOCUMENTATION Each Vendor and vendor,among other requirements,must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure,offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement in its contracts and/or agreements with vendors. These policies and procedures shall be made available to the County upon request. 2.6 PERFORMANCE SPECIFICATIONS 2.6.1 Outcomes (1)The Vendor shall ensure services provided under this contract are in accordance with the current DOEA Programs and Services Handbook, (2)The Vendor shall timely submit to the County all reports described herein (3)The Vendor shall timely submit to the County all information described in, Paragraph 2.5 RECORDS AND DOCUMENTATION. 2.7 VENDOR'S FINANCIAL OBLIGATIONS 2.7.1 Matching,Level of Effort,and Earmarking Requirements The Vendor shall provide match of at least 10 percent of the federal funds received. The Vendor's match will be made in the form of cash and/or in-kind resources. The Vendor will assure,through a provision in subcontracts,a match requirement of at least 10 percent of the cost for all services funded through this contract. The vendor's match will be made in the form of cash and/or in-kind resources. The Vendor shall report match by title each month. At the end of the contract period, the Vendor must properly match all OAA funds. 2.7.2 Title III Funds The Vendor assures compliance with Section 306 of the OAA, as amended in 2006,that funds received under Title III will not be used to pay any part of a cost incurred by the Vendor to maintain a contractual or commercial relationship that is not carried out to implement Title III. 2.8 COUNTY RESPONSIBILITIES 2.8.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the Vendor. 2.8.2 Program/Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this contract. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an on-site visit. The County's determination of acceptable performance shall be conclusive. The Vendor 36 4 • Ir. agrees to coo erate with the County ty in monitoring the progress of completion of the service ta s 2 deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: 1. Desk reviews and analytical reviews; 2. Scheduled, unscheduled and follow-up on-site visits; 3. Client visits; 4. Review of independent auditor's reports-Exhibit 10; 5. Review of third-party documents and/or evaluation; 6. Review of progress reports; 7. Review of customer satisfaction surveys; 8. Agreed-upon procedures review by an external auditor or consultant; 9. Limited-scope reviews; and 10. Other procedures as deemed necessary. 2.8.3 Contract Monitoring The County shall, at its own discretion, conduct monitoring concerning any aspect of the vendor's performance of this contract. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for OAA IIIE and OAA HIES funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rate for services is ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services,which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 37 , . •. 1602 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1,2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 38 EXHIBIT 5 1 60 2 Agreement#12-5856 "Services for Seniors Attachment B Invoice and Logs (Minimum Standard Invoice Information) County Purchasing Order Number: Invoice Number: Grant Name: From Date To Date Reimburse ment Rate Per Unit to Total Supplier TOTAL AMOUNT Cost In Kind (Subtract (Multiply the Service Description In Kind Unit Reimbursement (identified by line) Per Match Match Quantity Rate Per Unit to Service Amount Amount Supplier x the Unit Unit from Total Quantity) Cost Per Service Unit) $0.00 $0.00 $0.00 Total $0.00 I certify to the best of my knowledge and belief that this invoice, and attached service detail log, is complete and correct and all outlay herein are for the purposes set forth in the contract, and that services are ordered by the case manager as agreed on the Contract. Legible copies of the dated timesheet, signed by the client and the worker supporting this invoice must be available upon request. Collier County reserves the right to correct computation of errors to assure proper payment amount. Prepared by: Date: Adjustment Reasons Lead Agency Authorization Attachments: Monthly Service log, Weekly Detail log and Client Service time sheets. 39 • , 1613 2 EXHIBIT 6 Detail Weekly for CCE Services Week Ending: Invoice No. Personal CLIENT Care Homemaker Respite Skilled Companion Chore Total Total Total Total Total Total NAME Units Units Units Units Units Units Total Hours - - - - - - $ PECA - $ HMK - RESPITE - $ SKILLED - $ COMPANION - $ CHORE - $ TOTAL - 40 CF� 1 6 n EXHIBIT 7 Monthly Detail Service Log Grant Name: Vendor Name, Address: From Date To Date By client,provide the total number of hours provided during the dates of service. This log must be submitted with your monthly invoice for the Invoice From Date and To Date. Client Personal Home- Respite Adult Respite Emergency (In- Nursing Day (In- Chore Enhance Com— Shopping Escort Alert Name Care maker Nursing Chore panion Assist Response Home) Care Facility System 4. 41 EXHIBIT 8 1 61J Daycare Grant: Grant Service: ADC or RESF Vendor Name and Address By client, provide the Weekly Client Service Time Sheet provided during the dates of service. This log must be submitted with all invoices for the invoice From Date and To Date. TO FROM DATE: DATE: Client Thur Uni Client Name signature Mon Tue Wed s Fri Sat Sun Match is Service Dates 42 S .w 01 1 6 0 EXHIBIT 9 YOUR COMPANY NAME HERE Collier County Services for Seniors Homemaker/Personal Care/Respite/Companion Work Sheet Client Name: Client Signature: Week Ending: Each Time You Perform one of the Activities Below: Put in arrival and departure times for the day worked: ****Client should Initial time of arrival and departure. ****Client should Sign form at top. ****you should sign your name at the bottom. Date: Day: MON TUES WED THUR FRI SAT SUN TOTAL TIME ARRIVAL TIME: DEPARTURE TIME: ****CLIENT INITIALS: Arrive: PERSONAL CARE Depart: Assist W/Bath tub Shower Bed Assist W/Dressing Bathroom Assist Shave (Face Only) Oral Hygiene Walking/Ambulation Feeding Assistance Wash/Set Hair Backrub Soak Feet Nails (File only) Change_Make_Bed Take out Trash Clean Bedroom Clean Bathroom _ Prepare Meals Laundry Arrive: HOME MAKING Depart: Vacuum/Sweep Light Dusting 43 �,, ) "• tio 16I] 2 Clean Kitchen Floor Wash Dishes Mop Sweep___ Grocery Shop Errands Arrive: RESPITE Depart: Arrive: COMPANION Depart: EMPLOYEE'S Signature/Title 44 0 16132 EXHIBIT 10 OMB Circular A-133 Audits of States, Local Governments, and Non-Profit Organizations requires the Collier County Housing, Human and Veterans Services Department to monitor our subrecipients of federal awards and determine whether they have met the audit requirements of the circular and whether they are in compliance with federal laws and regulations. Accordingly, we are requiring that you check one of the following, provide all appropriate documentation regarding your organization's compliance with the audit requirements, sign and date this form. Subrecipient Fiscal Year Name Period Total State Financial Assistance Expended during $ most recently completed Fiscal Year Total Federal Financial Assistance Expended during most $ recently completed Fiscal Year Check Appropriate Boxes We have exceeded the $500,000 federal/state expenditure threshold for our fiscal year ❑ ending as indicated above and have completed our Circular A-133 audit. A copy of the audit report and management letter are attached. We exceeded the $500,000 federal/state expenditure threshold for our fiscal year I I ending as indicated above and expect to complete our Circular A-133 audit by . Within 30 days of completion of the A-133 audit, we will provide a copy of the audit report and management letter. We are not subject to the requirements of OMB Circular A-133 because we: ❑ Did not exceed the $500,000 federal/state expenditure threshold for the fiscal year indicated above I Are a for-profit organization I I Are exempt for other reasons — explain An audited financial statements is attached and if applicable, the independent auditor's management letter. (If findings were noted, please enclose a copy of the responses and corrective action plan.) Certification Statement I hereby certify that the above information is true and accurate. Signature Date Print Name and Title 45 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 6f) THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Routed by Purchasing Department to Office Initials Date the Following Addressee(s) (In routing order) 1. Risk Management P,isk 2. County Attorney Office County Attorney Office 9-)Vi 5 \3` 3. BCC Office Board of County S■w,�66.` Commissioners \« `r 5\•.,``\3 4. Minutes and Records Clerk of Court's Office c-.1:1(Y 5/3i ft3 q 5. Return to Purchasing Department Purchasing Contact: Diana DeLeon PRIMARY CONTACT INFORMATION Name of Primary Diana DeLeon for Lisa Carr, HHVS, Phone Number 252-8375 Purchasing Staff May 29,2013 Contact and Date Agenda Date Item was May 28,2013 f Agenda Item Number 16.D.2 Approved by the BCC Type of Document Contract Amendment Number of Original 2 Attached Documents Attached PO number or account N/A Solicitation/Contract Amend#1 to Contract 12- number if document is Number/Vendor Name 5856 Summitt Home to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) I. Does the document require the chairman's original signature? DD 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A provide the Contact Information(Name; Agency; Address; Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be signed by the Chairman, with the exception of most letters, must be reviewed and signed (,) by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's DD signature and initials are required. 7. In most cases(some contracts are an exception), an electronic copy of the document and DD this routing slip should be provided to the County Attorney's Office before the item is input into SIRE. 8. The document was approved by the BCC on the date above and all changes made DD during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes, if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC, all changes directed by the BCC have been made, and the document is ready for th Chairman's signature. 1602 MEMORANDUM Date: June 3, 2013 To: Diana DeLeon, Contract Technician Purchasing Department From: Teresa Cannon, Deputy Clerk Minutes & Records Department Re: Amendment #1 to Contract #12-5856 "Services for Seniors" Contractor: Summit Home Respiratory, Inc. Attached is an original copy of the contract referenced above, (#16D2) approved by the Board of County Commissioners on Tuesday, May 28, 2013. The second original will be held on file in the Minutes and Record's Department for the Board's Official Record. If you have any questions, please feel free to contact me at 252-8411. Thank you. Attachment Contract Amendment #1 160 Contract# 12-5856 "Services for Seniors" This CONTRACT AMENDMENT #1, dated , 2013 to the referenced agreement shall be by and between the parties to the original Agreement, S mmit Home Respiratory Services, Inc. d/b/a Summit Home Healthcare Products (to be referred to as "Vendor") and Collier County, Florida, (to be referred to as"County"). Statement of Understanding RE: Contract# 12-5856 "Services for Seniors" In order to continue services for the original Contract document referenced above, the Vendor agrees to the terms and conditions set forth in Exhibit A-1A, which includes Attachments C-H and Exhibits 1-10 attached hereto and incorporated by reference. The Vendor further agrees to amend Section 1, Commencement, as follows: 1. COMMENCEMENT. This Agreement shall Commence on December 11, 2012 and shall terminate on December 10, 2014 June 30, 2014. The Contract award is a two (2) year contract, with the possibility of two (2) additional (2) year terms pending funding from grantors and acceptable performance by the awarded vendor. Any such renewals shall be mutually agreed upon in writing by the parties. The maximum duration for this Contract for CCE, HCE, and ADI, OAA IIIE AND OAA IIIES funding will not exceed six (6) years (through June 30, 2018). As outlined in RFP #12-5856, the County requires the Vendor to contribute a cash or in-kind match of no less than ten (10) percent for all services related to the Community Care for the Elderly Program, (CCE), Older American Title IIIE Caregiver Support (OAA IIIE) and Older American Title IIIES Caregiver Support Supplemental Services(OAA IIIES)Programs. Words that have been deleted are struck through, words underlined have been added. Modification made herein shall apply as if incorporated into the Contract on the date of Commencement. All other teuus and conditions of the agreement shall remain in force. IN WITNESS WHEREOF, the Vendor and the County have each, respectively, by an authorized person or agent, hereunder set their hands and seals on the date(s) indicated below. itk 27' , 2013 VENDOR: f( Summit Home Respiratory Services, Inc. d/b/a First Witn Summit Home Healthcare Products I7 _ / A % w' name By: t_ econd A. /I / t, T � rtn Print/Type Name and Title Type/print witness name 1 16132 COUNTY: ATTEST: BOARD OF COUNTY COMMISSIONERS DWIGHT E. BROCK, CLERK OF COLLIER COUNTY, FLORIDA ilikg 40,. ...__4'' 1 ' l' ‘41i.:1,_521_1-4kA, ' By-NI: a-L._C •tZw. i'`1Y CLERK GEORGIA A. HILL ES Attest as to G ESQ. CHAIRWOMAN IAIRWOMAN signature on .', `\ �{ doh- -\Q-`Rnkn \R� `-►Rlvr ter\gn Approval for form and legal Sufficiency: Jennifer B. White Assistant County Attorney Item# _ Agenda GicAto Date Date 6 t I � 10 Recd a 2 Deputy Clerk EDIT A-lA AGREEMENT 12-5856 1 60 . SERVICES FOR SENIORS ATTACHMENTS ATTACHMENT ATTACHMENT DESCRIPTION PAGE Attachment C Core Standards for CCE, HCE, ADI, OAA IIIE & IIIES 2 Attachment D Certification Regarding Lobbying 8 Attachment E Certification Regarding Data Integrity Compliance 9 Attachment F Certification Regarding Debarment, Suspension, 10 Ineligibility and Voluntary Exclusion Contracts/ Subcontracts Attachment G Sub-Recipient Invoice Submission 11 Attachment H Background Screening Affidavit of Compliance 12 Exhibit 1 CCE Statement of work 13 Exhibit 2 HCE Statement of work 19 Exhibit 3 ADI Statement of work 25 Exhibit 4 OAA ITR and OAA IIIES Statement of work 31 Exhibit 5 Invoice 39 Exhibit 6 Detail Weekly Log 40 Exhibit 7 Monthly Log 41 Exhibit 8 Day Care/Respite Time Sheet 42 Exhibit 9 Program Time Sheet 43 Exhibit 10 Annual Audit Monitoring Report 45 1 ATTACHMENT C 1 6 2 Core Standards for CCE,HCE,ADI, OAA LEE & DIES 1. Compliance with Federal Law 1.1 If this agreement contains federal funds the following shall apply: 1.1.1 The vendor shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable regulations. 1.1.2 If this agreement contains federal funds and is over $100,000.00, the vendor shall comply with all applicable standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s. 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable Environmental Protection County regulations 40 CFR 30. The vendor shall report any violations of the above to the County. 1.1.3 The vendor may not use any federal funds received in connection with this agreement to influence legislation or appropriations pending before the Congress or any state legislature. If this agreement contains federal funding in excess of$100,000.00,the vendor must, prior to agreement execution, complete the Certification Regarding Lobbying form, ATTACHMENT D. All disclosure forms as required by the Certification Regarding Lobbying form must be completed and returned to the Grant Coordinator prior to payment under this agreement. 1.1.4 In accordance with Appendix A to 2 CFR 215, the vendor shall comply with Executive Order 11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in Department of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable. 1.1.5 If this agreement contains federal funds and provides services to children up to age 18,the vendor shall comply with the Pro-Children Act of 1994 (20 U.S.C. 6081). 1.1.6 A agreement award with an amount expected to equal or exceed $25,000.00 and certain other agreement 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 vendor shall comply with these provisions before doing business or entering into sub-agreements receiving federal funds pursuant to this agreement. The vendor shall complete and sign ATTACHMENT F prior to the execution of this agreement. 1.2 The vendor shall not employ an unauthorized alien. The County 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 agreement by the County. 2 1602 1.3 If the vendor 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 vendor must notify the County in writing within thirty(30) days of receiving the IRS notice of revocation. 1.4 The vendor shall comply with Title 2 CFR Part 275 regarding Trafficking in Persons. 1.5 Unless exempt under 2 CFR Part 170.110(b), the vendor shall comply with the reporting requirements of the Transparency Act as expressed in 2 CFR 170. 1.6 To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number 11-116, vendor agrees to utilize the U.S. Department of Homeland Security's E-verify system to verify the employment of all new employees hired by vendor during the agreement term. Vendor meeting the terms and conditions of the E-Verify System are deemed to be in compliance with this provision. 2. Compliance with State Law 2.1 This agreement is executed and entered into in the State of Florida, and shall be construed, performed and enforced in all respects in accordance with the Florida law, including Florida provisions for conflict of laws. 2.2 The vendor shall comply with requirements of s. 287.058, F.S. as amended. 2.2.1 The vendor shall provide units of deliverables, including various client services, and in some instances may include reports, findings, and drafts, as specified in this agreement,which the Grant Coordinator must receive and accept in writing prior to payment in accordance with s. 215.971, F.S. (1) and(2). 2.2.2 The vendor shall submit bills for fees or other compensation for services or expenses in sufficient detail for a proper pre-audit and post-audit. 2.2.3 The vendor 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 vendor in conjunction with this agreement except for those records which are made confidential or exempt by law. The vendor's refusal to comply with this provision will constitute an immediate breach of agreement for which the County may unilaterally terminate the agreement. 2.3 If clients are to be transported under this agreement, the vendor shall comply with the provisions of Chapter 427, F.S., and Rule 41-2, F. A. C. 2.4 Vendors who are on the discriminatory vendor list may not transact business with any public entity, in accordance with the provisions of s. 287.134, F.S. 2.5 The vendor shall comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the expenditure of agreement funds for the purpose of lobbying the legislature, judicial branch or a state agency. 3. Background Screening The vendor shall ensure that the requirements of s. 430.0402 and ch. 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 exempted from the Department's level 2 background screening 3 pursuant to s. 430.0402(2)-(3), F.S. The vendor must also comply with any applicable licable rules 1 6 02 promulgated by the Department and the Agency for Health Care Administration regarding implementation of s. 430.0402 and ch. 435, F.S. Further information concerning the procedures for background screening are found at http://elderaffairs.state.fl.us/doea/back aroundscreeninz.php. 4. Provision of Services The vendor shall provide services in the manner described herein. 5. Monitoring by the County The vendor shall permit persons duly authorized by the County to inspect and copy any records, papers, documents, facilities, goods and services of the vendor which are relevant to this agreement, and to interview any clients, employees and vendor employees of the vendor to assure the County of the satisfactory performance of the terms and conditions of this agreement. Following such review, the County will provide a written report of its fmdings to the vendor, and where appropriate, the vendor shall develop a corrective action plan. The vendor hereby agrees to correct all deficiencies identified in the corrective action plan in a timely manner as determined by the Grant Coordinator. 6. Confidentiality of Information The vendor shall not use or disclose any information concerning a vendor of services under this agreement 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. 7. Health Insurance Portability and Accountability Act Where applicable, the vendor shall comply with the Health Insurance Portability and Accountability Act (42 USC 1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162, and 164). 8. Bankruptcy Notification During the term of this agreement,the vendor shall immediately notify the County if the Vendor, its assignees, vendors or affiliates file a claim for bankruptcy. Within ten (10)days after notification,the vendor must also provide the following information to the County.: (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., United States Bankruptcy Court Middle District of Florida,Naples, FL); and, (4)The name, address, and telephone number of the bankruptcy attorney. 9. Sponsorship and Publicity 9.1 As required by s. 286.25, F.S., if the vendor is a non-governmental organization which sponsors a program financed wholly or in part by state funds, including any funds obtained through this agreement, it shall, in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by Hope Hospice and Community Services, the State County of Elder Affairs. the Area County on Aging for Southwest Florida, Inc. and Collier County." If the sponsorship reference is in the written material, the words "State of Florida, Department of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County" shall appear in at least the same size letters or type as the name of the organization. 9.2 The vendor shall not use the words "The State of Florida Department of Elder Affairs or the Area County on Aging for Southwest Florida, Inc. or Collier County" to indicate sponsorship of a program otherwise financed, unless specific authorization has been obtained by Collier County, or the Area Aging on Aging prior to use. 4 10. Independent Capacity of Vendor 60 2 It is the intent and understanding of the Parties that the vendor, or any of its vendors, are independent vendors and are not employees of the County and shall not hold themselves out as employees or agents of the County without specific authorization from the County. It is the further intent and understanding of the Parties that the County does not control the employment practices of the vendor and will not be liable for any wage and hour, employment discrimination, or other labor and employment claims against the vendor or its vendors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary insurance for the vendor are the sole responsibility of the vendor. 11. Payment Payments shall be made to the vendor pursuant to s. 215.422, F.S., as services are rendered and invoiced by the vendor. The Grant Coordinator will have final approval of the invoice for payment, and will approve the invoice for payment only if the vendor has met all terms and conditions of the agreement, unless the bid specifications, purchase order, or this agreement specify otherwise. The approved invoice will be submitted to the County's Grant Coordinator approval and processing. 12. Return of Funds The vendor shall return to the County any overpayments due to unearned funds or funds disallowed and any interest attributable to such funds pursuant to the terms and conditions of this agreement that were disbursed to the vendor by the County. In the event that the vendor or its independent auditor discovers that an overpayment has been made, the vendor shall repay said overpayment immediately without prior notification from the County. In the event that the County first discovers an overpayment has been made, the Grant Coordinator will notify the vendor in writing of such findings. 13. Data Integrity and Safeguarding Information The vendor shall ensure an appropriate level of data security for the information the vendor is collecting or using in the performance of this agreement. An appropriate level of security includes approving and tracking all vendor employees that request system or information access and ensuring that user access has been removed from all terminated employees. The vendor, 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 vendor shall ensure all vendors maintain written procedures for computer system backup and recovery. The vendor shall complete and sign Attachment E prior to the execution of this agreement. 14. Computer Use and Social Media Policy The Department of Elder Affairs has implemented a new 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, Area Agencies on Aging and vendors. 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. 15. Public Entity Crime Pursuant to s. 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 5 1602 2 agreement to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on a agreement 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 perfouu work as a vendor, supplier, vendor, or consultant under a agreement with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in s. 287.017, F.S., for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted vendor list. 16. Patents, Copyrights,Royalties If this agreement 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 agreement, the vendor shall refer the discovery, invention or material to the County to be referred to the Department of State and the Department of Elder Affairs. Any and all patent rights or copyrights accruing under this agreement are hereby reserved to the State of Florida in accordance with Chapter 286, F.S. Pursuant to s. 287.0571 (5) (k) 1 and 2 as amended, the only exceptions to this provision shall be those that are clearly expressed and reasonably valued in the agreement. 16.1 If the primary purpose of this agreement 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 Paragraph 33. 16.2 If this agreement is awarded solely federal funding, the terms and conditions are governed by 2 CFR 215.36. 17. Emergency Preparedness and Continuity of Operations 17.1 If the tasks to be performed pursuant to this agreement include the physical care and control of clients, or the administration and coordination of services necessary for client health, safety or welfare, the vendor shall, within thirty (30) calendar days of the execution of this agreement, submit to the Grant Coordinator verification of an emergency preparedness plan. In the event of an emergency, the vendor shall notify the County of emergency provisions. 17.2 In the event a situation results in a cessation of services by a vendor, the vendor shall retain responsibility for perfoiniance under this agreement and must follow procedures to ensure continuity of operations without interruption. 18. Financial Consequences of Non-Performance If the vendor fails to meet the minimum level of service or performance identified in this agreement, or that is customary for the industry, then the County must apply financial consequences commensurate with the deficiency. Financial consequences may include, but are not limited to, agreement suspension, refusing payment, withholding payments until deficiency is cured, tendering only partial payments, and/or cancellation of agreement and reacquiring services from an alternate source. 18.1 The vendor will not be charged with financial consequences, when a failure to perform arises out of causes that were the responsibility of the County. 19. No Waiver of Sovereign Immunity 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. 20. Venue If any dispute arises out of this agreement,the venue of such legal recourse will be Collier 6 County,Florida. 1 6 0 2 21. Entire Agreement This agreement contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations shall be valid or binding upon the County or the vendor unless expressly contained herein or by a written amendment to this agreement signed by both Parties. 22. 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. 23. SeverabiIity 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. 24. Waiver The delay or failure by the County to exercise or enforce any of its rights under this agreement will not constitute or be deemed a waiver of the County'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. 25. Compliance The vendor shall abide by all applicable current federal statutes, laws, rules and regulations as well as applicable current state statutes, laws, rules, regulations and County rules, ordinances and regulations. The Parties agree that failure of the vendor to abide by these laws shall be deemed an event of default of the vendor, and subject the agreement to immediate, unilateral cancellation of the agreement at the discretion of the County. 26. Final Invoice The vendor shall submit the fmal CCE, HCE, ADI, lIE and lIIES invoice for payment to the County on July 3, 2013. If the vendor fails to submit final request for payment by the deadline, then all rights to payment may be forfeited and the County may not honor any requests submitted after the aforesaid time period. Any payment due under the terms of this agreement may be withheld until all reports due from the vendor and necessary adjustments thereto have been approved by the County. 27. Renegotiations or Modifications Modifications of the provisions of this agreement shall be valid only when they have been reduced to writing and duly signed by both parties. The rate of payment, contract requirements and the total dollar amount may be adjusted retroactively to reflect price level increases and changes in the rate of payment or language. 28. All Terms and Conditions Included This agreement and its Attachments, A-H and exhibits 1-4 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 agreement shall supersede all previous communications, representations or agreements, either written or verbal between the Parties. 7 ATTACHMENT D 1 6 0 2 CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR AGREEMENTS, GRANTS,LOANS AND AGREEMENTS The undersigned certifies,to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any State ,Federal or County, a member of congress, an officer or employee of congress, an employee of a member of congress, or an officer or employee of the state legislator, in connection with the awarding of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal agreement, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of the County, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this federal agreement, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including vendors, sub-grants, and agreements under grants, loans and cooperative agreements) and that all vendors shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Signature Date Name of Authorized Individual Name and Address of Organization 8 ATTACHMENT E 1 6 13 CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS,LOANS AND COOPERATIVE AGREEMENTS The undersigned, an authorized representative of the vendor named in the agreement or agreement to which this form is an attachment, hereby certifies that: (1) The vendor and any vendors of services under this agreement 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 pr-escribed 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 vendor, vendor(s), or any outside entity on which the vendor 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, vendor(s)will take immediate action to assure data integrity. (3) If this agreement 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 vendor (represented by the undersigned) and purchased by the State will be verified for accuracy and integrity of data prior to transfer. In the event of any decrease in functionality related to time and date related codes and internal subroutines that impede the hardware or software programs from operating properly, the vendor agrees to immediately make required corrections to restore hardware and software programs to the same level of functionality as warranted herein, at no charge to the State, and without interruption to the ongoing business of the state,time being of the essence. (4) The vendor and any vendor(s) of services under this agreement warrant their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data integrity compliance issues. The vendor shall require that the language of this certification be included in all vendors and other agreements and that all vendor shall certify compliance accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB Circulars A-102 and 2 CFR Part 215 (formerly OMB Circular A-110). Name and Address of vendor Signature Title Date Name of Authorized Signer 9 i'= EXIT F 1602 CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS (1) The prospective vendor certifies, by signing this certification, neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or County. (2) Where the prospective vendor is unable to certify to any of the statements in this certification,such prospective participant shall attach an explanation to this certification. Signature Date Title County/Organization (Certification signature should be same as Agreement signature.) Instructions for Certification 1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "person," "primary covered transaction,"and"voluntarily excluded," as used herein,have the meanings set out in the sections of rules implementing Executive Order 12549. (2 CFR 180.5-180.1020,as supplemented by 2 CFR 376.10-376.995). You may contact the Agreement Manager for assistance in obtaining a copy of those regulations. 2. This certification is a material representation of facts upon which reliance was placed when the parties entered into this transaction. If it is later determined that the vendor knowingly rendered an erroneous certification,in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension and/or debarment. 3. The vendor will provide immediate written notice to the Agreement Manager if at any time the vendor learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The vendor may decide the method and frequency by which it determines the eligibility of its principals. Each participant to a lower tier covered transaction may,but is not required to,check the Excluded Parties List System(EPLS). 4. The vendor will include a "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transaction"in all its lower tier covered transactions and in all solicitations for lower tier covered transactions. 5. The vendor agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise authorized by the federal government. 6. If the vendor knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction,in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension,and/or debarment. 7. The vendor may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended,ineligible,or voluntarily excluded from the covered transaction,unless it knows that the certification is erroneous. 10 1 D2 EX IT G SUBRECIPIENT INVOICE SUNIlVIISSION The County shall reimburse the SUBRECIPIENT for the perfoiniance of this Agreement upon completion or partial completion of the work tasks as accepted and approved by HEWS pursuant to the submittal of quarterly progress reports. Invoices for work performed are required every month. If no work has been performed during that month, or if the SUBRECIPIENT is not yet prepared to send the required backup, a$0 invoice will be required. Explanations will be required if two consecutive months of$0 invoices are submitted. Payments shall be made to the SUBRECIPIENT when requested as work progresses but, not more frequently than once per month. Final invoices are due no later than 90 days after the end of the agreement. Work performed during the term of the program but not invoiced within 90 days without written exception from the Grant Coordinator will not be reimbursed. No payment will be made until approved by HHVS for grant compliance and adherence to any and all applicable local, state or Federal requirements. Payment will be made upon receipt of a properly completed invoice and in compliance with §218.70, Florida Statutes, otherwise known as the "Local Government Prompt Payment Act." 11 , 1 DEPARTMENT OF EXHIBIT H 16f BACKGROUND SCREENING ELDER AFFAIRS Affidavit of Compliance -Employer STATE OF FLORIDA 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 Employer Name located at Street Address City State ZIP code 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. Signature of Representative Date STATE OF FLORIDA,COUNTY OF Sworn to (or affirmed)and subscribed before me this day of , 20 , by (Name of Representative)who is personally known to me or produced 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:httn://elderaffairs.state.fl.us/english/backgroundscreening.php 12 , ,I 1602 EXHIBIT 1 STATEMENT OF WORK COMMUNITY CARE FOR THE ELDERLY PROGRAM(CCE) SECTION I: SERVICES TO BE PROVIDED 1.1. DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 AGREEMENT ACRONYMS Activities of Daily Living(ADL) Adult Protective Services (APS) Assessed Priority Consumer List (APCL) Comprehensive Assessment and Review for Long-Term Care Services (CARES) Community Care for the Disabled Adult(CCDA) Community Care for the Elderly(CCE) Client Information and Registration Tracking System (CIRTS) Department of Children and Families(DCF) Department of Elder Affairs (DOEA) Home Care for Disabled Adults (HCDA) Instrumental Activities of Daily Living (IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out: The condition of reaching 60 years of age and being transitioned from the Department of Children and Families (DCF) Services, Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults (HCDA) services to the Department's community- based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in its planning and service area in accordance with the Section 306 (42 U.S.C. 3026) of the Older Americans Act and Depallnient 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 County enters CCE specific data in the CIRTS. An update may also include other revisions to the area plan as instructed by the County or Depai lucent of Elder Affairs. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The primary purpose of the CCE program is to prevent, decrease or delay premature or inappropriate and expensive placement of older persons in nursing homes and other institutions. 13 ;r 1602 1.2.2 Community Care for the Elderly Mission Statement The CCE Program assists functionally impaired elderly persons in living as independently as possible in their own homes or in the homes of relatives or caregivers. The program provides a continuum of care through the development, expansion, reorganization and coordination of multiple community-based services to assist elders to reside in the least restrictive environment suitable to their needs. 1.2.3 Authority The relevant authority governing CCE program are: (1)Rule 58C-1, Florida Administrative Code (2) Sections 430.201 through 430.207, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services Chief Financial Officer Memoranda the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1) CFO Memo No. 02: Release date, August 20, 2010; (2) CFO Memo No. 03: Release date, June 29, 2010; and (3) CFO Memo No. 06: Release date, June 30, 2010. 1.2.4 Scope of Service The vendor shall provide services in a manner consistent with and descried in the current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the program are to preserve the independence of elders and prevent or delay more costly institutional care through a community care service system that provides case management and other in-home and community services as needed under the direction of the County and provide a continuum of service alternatives that meet the diverse needs of functionally impaired elders. 1.3. INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The CCE program provides a continuum of services for functional impaired elders. 1.3.2 Individual Eligibility In order to receive services under this agreement, an applicant must: (1) Be at least 60 years of age; (2) Be functionally impaired as determined through the initial comprehensive assessment; and (3) With the exception of APS high-risk referrals, consumers may not be dually enrolled in the CCE program and a Medicaid capitated long-term care program. 1.3.2.1 Targeted.Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution or who are abused,neglected or exploited. 14 SECTION II: 1 60 MANNER OF SERVICE PROVISION 2. Delivery of Service to Eligible Clients The vendor shall ensure the provision of a continuum of service that meet the diverse needs of functionally impaired elders. The vendor shall ensure performance and reporting of the following service provision in accordance with the current DOEA Programs and Services Handbook. The services may include the following categories: (1) Core Services; (2) Health Maintenance Services; and (3) Other Support Services. Core Services for Programmatic Operation 2.1. The vendor may deliver core services include a variety of home-delivered services, day care services, and other basic services that are most needed to prevent unnecessary institutionalization. Core services,to be provided at the unit rate identified in this agreement, include the following: (1) Adult Day Care; (7) Housing Improvement; (2) Chore Services; (8) Respite Services; and (3) Enhanced Chore; (9) Transportation (4) Companionship; (5) Home Delivered Meals; (6) Homemaker; 2.1.1 Health Maintenance Services The vendor shall ensure that health maintenance services are routine health services that are necessary to help maintain the health of functionally impaired elders. The services are limited to medical therapeutic services, non-medical prevention services, personal care services, home health aide services, home nursing services, and emergency response systems. Typical services to be provided at the unit rate identified in this agreement, are the following: (1) Adult Day Health Care; (2) Emergency Alert Response; (3) Nutrition Counseling (4) Personal Care (5) Skilled Nursing Services; and (6) Specialized Medical Equipment Services and Supplies 2.2 SERVICE TIMES 2.2.1 Service Times 15 The vendor shall ensure the provisions of the services listed in this agreement are avails} e 6 times appropriate to meet client service needs at a minimum, during normal business hours. b Normal business hours are defined as Monday through Friday, 8:00 a.m. to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the agreement in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this agreement as updated, and approved by the County's reporting requirements. Service Unit of Service Adult Day Care Homemaker Case Aide Housing Improvement Case Management Respite Services Chore Services Personal Care Hour Enhanced Chore Physical Therapy Companionship Skilled Nursing Services Emergency Alert Response Day Material Aid Specialized Medical Equipment, Services and Supplies Episode Escort Shopping Assistance One-Way Trip Transportation Service Unit of Service Home Delivered Meals Meal 2A REPORTS The vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The vendor shall establish due dates for any agreement that permits the vendor to meet the County's reporting requirements. Service Costs Reports The vendor shall submit to the County semi-annual service cost reports, August 1, 2013 and February 1, 2014, of each year which reflects actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.5 RECORDS AND DOCUMENTATION 2.5.1 Each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup 16 2.6 COUNTY RESPONSIBILITIES 6 ri 2.6.1 Program Guidance and Technical Assistance The County will provide to the vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the vendor. resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures will be made available to the County upon request. 2.7 PERFORMANCE SPECIFICATIONS 2.7.1 Outcomes (1) The vendor shall ensure services provided under this agreement are in accordance with the current Department of Elder Affairs Programs and Services Handbook. (2) The vendor shall timely submit to the County all information described in EDIT 1, SECTION 2.4 REPORTS; and (3) The vendor shall timely submit to the County all information described in EDIT 1, SECTION 2.5 RECORDS AND DOCUMENTATION. 2.8. VENDOR'S FINANCIAL OBLIGATIONS 2.8.1 Matching,Level of Effort, and Earmarking Requirement The vendor will assure a match requirement of at least 10 percent of the cost for all CCE services. The match will be made in the form of cash and/or in-kind resources. At the end of the agreement period, all CCE funds expended must be properly matched. State funds cannot be used to match another state-funded program. 3 SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality,security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 17 6 3.4 Payment may be authorized only for allowable services, which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as.the Department of Financial Services, upon request. 18 Vic . EDIT 2 1 602 STATEMENT OF WORK HOME CARE FOR THE ELDERLY PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Adult Protective Services (APS) Activities of Daily Living(ADL) Assessed Priority Consumer List (APCL) 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) Home Care for Disabled Adults (HCDA) Home Care for the Elderly(HCE) Institutional Care Program(ICP) Instrumental Activities of Daily Living (IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults (HCDA) services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026) and Depadment 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 County enters HCE specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement Area Agencies on Aging may contract with CCE lead agencies or other case management entities for the provision of the HCE program. Approved caregivers receive a Basic Subsidy to reimburse some of their expenses each month for caring for the consumer and may receive a Special Subsidy for other necessary services and essential supplies. Caregivers may be approved 19 for up to three HCE clients in their home. 1 p 1.2.2 Home Care for the Elderly Program Mission Statement The Home Care for the Elderly Program supports family style living arrangements, on a non- profit basis, as an alternative to nursing homes or other institutional care. Through the program, a caregiver for three or fewer elders living in a private home provides basic services of maintenance and supervision as well as coordinating other necessary specialized services. 1.2.3 Authority The relevant authority governing the HCE program include: (1) Rule Chapter 58H-1, Florida Administrative Code; and (2) Sections 430.601 through 430.608, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Depai talent of Financial Services', Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: CFO Memo No. 02: Release date,August 20,2010; CFO Memo No. 03: Release date,June 29, 2010; and CFO Memo No. 06: Release date, June 30, 2010. 1.2.4 Scope of Service The Vendor shall provide services in a manner consistent with and described in the current County's area plan update and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the HCE program are to ensure that: (1) Basic Subsidy is provided to the caregiver of each client and (2) Special Subsidy is provided when essential to the well-being of the client. 1.3 INDIVIDUAL TO BE SERVED 1.3.1 General Eligibility The Home Care for the Elderly program serves elders age 60 and older at risk of placement in a nursing home or other institutional settings who can remain in a family style setting through the provision of subsidies. 1.3.2 Client Eligibility Clients eligible to receive services under this agreement must: (1) Be 60 years of age or older; (2) Have income less than the Institutional Care Program (ICP) standard. (3) Meet the ICP asset limitation; (4) Be at risk of nursing home placement; 20 r r) ed adult caregiver living in the home with them who is willing to rov e (5) Have an approved ng g b g P e p. care or assist in arranging for care; and (6) Not be enrolled in the Aged and Disabled Adult Medicaid waiver or a Medicaid capitated long-term care program. 1.3.3 Caregiver Eligibility Caregivers eligible to receive services under this agreement must: (1) Be at least 18 years of age, capable of providing a family-type living environment; (2) 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; (3) Be willing to accept responsibility for the social, physical and emotional needs of the care Vendor; (4) Be physically present and live in the home to provide supervision and to assist in arrangement of services for the client; (5) 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 (6) Be without record of conviction of abuse, neglect or exploitation of another person. 1.3.4 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meet the diverse needs of the functionally impaired elders and their caregivers. The Vendor shall ensure Basic Subside and Special Subsidy services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. 2.1. Basic Subsidy The Basic Subsidy is a cash payment made to an approved caregiver each month to reimburse some expenses incurred in caring for the client. The Basic Subsidy is provided for support and maintenance of the client, including housing, food, clothing, and medical costs not covered by Medicaid, Medicare or any other insurance. A Basic Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. If the client is hospitalized or in any other temporary institution for 30 days or less,the full Basic Subsidy shall be provided to the caregiver as if the client were in the home. 2.2. Special Subsidy Services Though every eligible HCE client receives a Basic Subsidy, Special Subsidy payments are pre-authorized and are based on additional specialized medical or health care services, supplies or equipment needed to maintain the health and well-being of the individual elder. The Special Subsidy for additional medical support and special services is a cash payment to reimburse the costs of any other service or special care not covered by Medicaid, Medicare, or private insurance when these services are deteimined to be 21 C'1 - Special Subsidy shl essential to maintain the well-being of the home care recipient. A p y C be paid to approved caregivers when the client is in the home for any part of the month. Special Subsidy 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: 2.2.1 SERVICE LOCATION AND EQUIPMENT 2.2.2 Service Times The vendor shall ensure the provision of the services listed in this contract are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m. to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the contract in accordance with the current Depar tuient of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the Agency's reporting requirements. Service Unit of Service Adult Day Care Housing Improvement Case Aide Other Case Management Personal Care Chore Respite(Facility Based or In-Home) Hour Chore(Enhanced) Skilled Nursing Services Homemaker Material Aid Episode Specialized Medical Equipment, Services and Supplies Transportation One-Way Trip 2.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permits the Vendor to meet the County's reporting requirements. 2.2.1 Service Costs Reports The Vendor shall submit to the County the semi-annual service cost reports, August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.3 RECORDS AND DOCUMENTATION 2.3.1 The Vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The 22 r; i Vendor shall maintain written P olicies and procedures for computer system bacicup 1 6 r:1 recovery. These policies and procedures shall be made available to the County upon request. 2.4 PERFORMANCE SPECIFICATIONS 2.4.1 Outcomes (1) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (2) The Vendor shall timely submit to the County all reports described in SECTION 2.2 REPORTS; and (3) The Vendor shall timely submit to the County all infonnation described in, SECTION 2.3 RECORDS AND DOCUMENTATION. 2.5 COUNTY RESPONSIBILITIES 2.5.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-up on-site visits; (3) Client visits; (4) Review of independent auditor's reports; (5) Review of third-party documents and/or evaluation; (6) Review of progress reports; (7) Review of customer satisfaction surveys; (8) Agreed-upon procedures review by an external auditor or consultant; (9) Limited-scope reviews; and (10) Other procedures as deemed necessary. SECTION III: ME'T'HOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The 23 1 6 0 2 vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services,which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 24 �r 6 "4 EDIT 3 STATEMENT OF WORK ALZHEIMER'S DISEASE INITIATIVE PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Alzheimer's Disease (AD) Alzheimer's Disease Initiative (ADI) Activities of Daily Living (ADL) Assessed Priority Consumer List(APCL) Adult Protective Services (APS) Client Information and Registration Tracking System (CIRTS) Community Care for Disabled Adults (CCDA) Department of Elder Affairs (DOEA) Home Care For Disabled Adults (HCDA) Instrumental Activities of Daily Living(IADL) Memory Disorder Clinic(MDC) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults (HCDA) services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026. 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 County enters ADI specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 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. Model Day Care: A program of therapeutic, social and health activities specific to clients with memory disorders. Services and activities include; but are not limited to, active and quiet 25 c1 16 e validation therapy, et thera water therapy and other failure free games, reminiscence, pet therapy, py activities appropriate to the client's level of functioning. Model day care centers will also provide training for health care and social service personnel in the care of persons having AD or related memory disorders. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The ADI program provides a continuum of services addressing the special needs of individuals with AD,their families and caregivers. 1.2.2 Alzheimer's Disease Initiative Program Mission Statement The ADI program ensures that persons afflicted with AD and other forms of dementia are given essential services to help them age in place in an elder-friendly environment with security, dignity, and purpose. The program also provides support to family members and caregivers of persons afflicted with AD. 1.2.3 Authority The relevant authority governing the Alzheimer's Disease Initiative Program are as follows: (1) Rule Chapter 58D-1, Florida Administrative Code; and (2) Sections 430.501 through 430.504,Florida Statutes. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1) CFO Memo No. 02: Release date, August 20, 2010; (2) CFO Memo No. 03: Release date, June 29, 2010; and CFO Memo No. 06: Release date, June 30,2010. 1.2.3.2 Scope of Service The Vendor is responsible for the programmatic, fiscal, and operational management of the ADI program. The program services shall be provided in a manner consistent with and described in the current Vendor's Request for Proposal, RFP, and the County's current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.3.4 Major Program Goals The major goal of the ADI program is to provide services to meet the needs of caregivers and individuals with AD and related memory disorders. 1.3 INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The ADI Program addresses the special needs of individuals with AD and their caregivers. 1.3.2 Individual Eligibility Those individuals eligible to receive services under this contract must meet the following conditions: (1) Be 18 years of age or older and have a diagnosis of AD or a related disorder, or be 26 suspected of having AD or a related disorder; and 1 6 2 (2) Not be enrolled in a Medicaid capitated long-term care program. 1.3.3 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. SERVICE TASKS In order to achieve the goals of the ADI program, the Vendor shall ensure the following tasks are performed: (1) Client eligibility determination; (2) Assessment and prioritization of service delivery for new clients; (3) Delivery of services to eligible clients; and (4) Monitor the performance of vendors. 2.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described in this SECTION 1.3. 2.2 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services addressing the diverse needs of individuals with AD and their caregivers. The Vendor shall ensure services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. Services categories include: (1) Caregiver Training/Support; (2) Case Aid; (3) Case Management; (4) Counseling(Gerontological); (5) Counseling(Mental Health/Screening); (6) Education/Training; (7) Model Day Care; ( 8) Respite(Facility-Based); ( 9) Respite(In-Home); and (10) Specialized Medical Equipment, Services, and Supplies. Caregivers benefit from receiving training, respite and related support services to assist them in caring for the ADI client. 2.3 Service Times The Vendor shall ensure the provisions of the services listed in this contract are available 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. 27 �J1 3. DELIVERABLES 1. 6n 3.1. Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the County's reporting requirements. Service Unit of Service Caregiver Training/Support; Hour Case Aid; Hour Case Management; Hour Counseling(Gerontological); Hour Counseling (Mental Health/Screening); Hour Respite (Facility-Based); Hour Respite (In-Home); Hour Education/Training; Episode Episode 3.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. 3.2.1 Service Costs Reports Vendor must submit to the County the semi-annual service cost reports August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 3.3 RECORDS AND DOCUMENTATION 3.3.1 The Vendor and each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 4. PERFORMANCE SPECIFICATIONS 4.1 Outcomes (4) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (5) The Vendor shall timely submit to the County all reports described in SECTION 3.2 REPORTS; and (6) The Vendor shall timely submit to the County all information described in SECTION 3.3 28 RECORDS AND DOCUMENTATION. 1 6 El 2 5. COUNTY RESPONSIBILITIES 5.1. Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-up on-site visits; (3) Client visits (4) Review of independent auditor's reports (5) Review third-party documents and/or evaluations (6) Review of progress reports (7) Review of customer satisfaction surveys (8)Agreed-upon procedures review by an external auditor or consultant; (9)Limited-scope reviews; and (l0)Other procedures as deemed necessary. 6. SECTION III: METHOD OF PAYMENT 6.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 6.1.2 Remedies-Nonconforming Services The Vendor shall ensure that all goods and/or services provided under this agreement for HCE funded programs are delivered timely, completely and commensurate with required standards of quality Such goods and/or services shall only be delivered to eligible program participants. If the Vendor fails to meet the prescribed quality standards for services, such services will not be reimbursed under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be reimbursed under this agreement. The Vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the Vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County requires immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 6.1.3 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the Vendor and any adjustments thereto, including any disallowance not resolved. 6.1.4 Date for Final Request for Payment 29 16021 The final request for payment for agreement year one's expenditures will be due to the County no later than August 1,2013. The final request for payment for agreement year two expenditures will be no later than August 1,2014. 6.2 Documentation for Payment The Vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals upon request. Such documentation shall be provided upon request to the County or the Clerk of Court. 30 EXElli3IT 4 1602 STATEMENT OF WORK OLDER AMERICANS ACT PROGRAM TITLE HE SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 CONTRACT ACRONYMS Area Agency on Aging(AAA) Activities of Daily Living(ADL) Alliance of Information &Referral Systems (AIRS) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System(CIRTS) Information and Referral (I&R) Instrumental Activities of Daily Living(IADL) Older Americans Act(OAA) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in Its PSA in accordance with the Section 306 (42 U.S.C. 3026) of the OAA and Department instructions. Child: An individual who is not more than 18 years of age or an individual with disability. Family Caregiver: An adult family member, or another individual, who is an informal provider of in-home and community care to an older individual. Frail: When an older individual is unable to perform at least two ADLs without substantial human assistance, including verbal reminding, physical cueing or supervision; or due to cognitive or other mental impairment, requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to another individual. 1.2 County Mission,Vision and Values Statement The County's mission: To help aging adults achieve greater independence through awareness of resources and access to qualified service providers. The County's vision: To be the recognized leader in supporting older adults and their families with access to trustworthy resources and services in their communities while empowering them to live with independence and dignity. The County's values: We believe residents of Southwest Florida are entitled to: Comprehensive information about their choices of care; Timely access to resources and services; High standards of quality and performance; and Personal and professional accountability from all stakeholders. 1.2.1 Older Americans Act Program Mission Statement The Older Americans Act(OAA)Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain indepeindient and productive. 31 0) 1.3 GENERAL DESCRIPTION 2 1.3.1 General Statement The OAA Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. The primary purpose of the OAA program is to foster the development and implementation of comprehensive and coordinated systems to serve older individuals.The OAA program uses these systems to assist older individuals to attain and maintain maximum independence and dignity in a home environment and allows for the capability of self- care with appropriate supportive services. 1.3.2 Authority The relevant references authority governing the OAA program are: 1. Older Americans Act of 2006, as amended; 2. Rule 58A-1, Florida Administrative Code; and 3. Section 430.101, Florida Statutes. 1.3.2.1 Incorporation of Reference Memoranda In accordance with Ch. 287 F.S., as amended, and Agency of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and incorporated by reference: 1. CFO Memo No. 02: Release date, August 20, 2010; 2. CFO Memo No. 03: Release date, June 29, 2010; and 3. CFO Memo No. 06: Release date,June 30, 2010. 1.3.3 Scope of Service The Vendor shall provide services in a manner consistent with and descried in the current area plan and current Depai Lucent of Elder Affairs Programs and Services Handbook. 1.3.4 Major Program Goals The major goals of the OAA program are to improve the quality of life for older individuals, preserve their independence and prevent or delay more costly institutional care. These goals are achieved through the implementation of a comprehensive and coordinated service system that provides a continuum of service alternatives that meet the diverse needs of elders and their caregivers. 1.4 INDIVIDUALS TO BE SERVED 1.4.1 Eligibility (Title III Programs) 1.4.1.1 OAA Title III,General Consumers shall not be dually enrolled in an OAA program and a Medicaid capitates long-term care program. 1.4.1.2 OAA Title H E, Caregiver Support Services Eligibility for OAA Title ITTE, Caregiver Support Services, are as follows: 1. Family caregivers of individuals age 60 or older; 32 6 ® r 2. Grandparents(age 55 or older)or older individuals(age 55 or older)who are relative caregivers; 3. Priority will be given to family caregivers who provide care for individuals with Alzheimer's disease and related disorders with neurological and organic brain dysfunction and for grandparents or older individuals who are relative caregivers who provide care for children with severe disabilities; and 4. For respite and supplemental services, a family caregiver must be providing care for an older individual who meets the definition of the term"frail"in OAA, Section 102 Paragraph 22. 1.4.2 Targeted Groups Preference shall be given to those with the greatest economic and social need,with particular attention to low-income older individuals, including those that are low-income minorities, have limited English proficiency, and older individuals residing in rural areas. SECTION II—MANNER OF SERVICE PROVISION 2.1 SERVICE TASKS In order to achieve the goals of the OAA program, the Vendor shall ensure the following tasks are performed: 1. Client eligibility determination; 2. Targeting and screening of service delivery for new clients; 3. Delivery of services to eligible clients; 4. Use of volunteers to expand the provision of available services; 5. Monitoring the performance of its vendors. 6. Grievance and Compliance Procedures 2.1.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described herein. 2.1.2 Targeting and Screening of Service Delivery for New Clients The Vendor shall develop and implement policies and procedures consistent with OAA targeting and screening Criteria 2.1.3 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meets the diverse needs of elders and their caregivers. The Vendor shall ensure the performance and report performance of the following services in accordance with the current Department of Elder Affairs Programs and Services Handbook. The services funded pursuant to this contract are in accordance with the OAA,Title III, sections 321, 331, 336 and 373 as follows: 1. Section 321,Title IIIB Supportive Services; 2. Section 373,Title DIE Caregiver Support Services. 2.1.3.1 Supportive Services Supportive services include a variety of community-based and home-delivered services that support the qualities of life for older individuals by helping them remain independent and productive. Services include the following: 33 (1) Adult Day Care/Adult Day Health Care; (17) Homemaker; 2 1 6 (2) Caregiver Training/Support; (18) Housing Improvement; (3) Case Aide/Case Management; (19) Information; (4) Chore Services; (20) Intake; (5) Companionship; (21) Interpreter/Translating; (6) Counseling(Gerontological and Mental Health); (22) Referral/Assistance; (7) Education/Training; (23) Personal Care; (8) Legal Assistance; (24) Physical Therapy; (9) Material Aid; (25) Shopping Assistance; (10) Occupational Therapy; (26) Skilled Nursing; (11) Outreach; (27) Specialized Medical Equipment, Services. and Supplies (12) Recreation; (28) Respite Services; (13) Emergency Alert Response; (29) Screening/Assessment; (14) Escort; (30) Speech Therapy; (15) Health Support; (31) Telephone Reassurance; and (16) Home Health Aide; (32) Transportation 2.1.3.4 Caregiver Support Services (Title IIIE Program) The following services are intended to provide direct help to caregivers, assist in the areas of health, nutrition and financial literacy and assist caregivers in making decisions and problem solving related to their caregiving roles and responsibilities: (1) Adult Day Care/Adult Day Health Care; (2) Caregiver Training/Support; (3) Counseling(Gerontological and Mental Health); (4) Education/Training; (5) Financial Risk Reduction(Assessment and Maintenance); (6) Information; (7) Intake; (8) Outreach; (9) Respite Services; (10) Screening/Assessment; and (11) Transportation 2.1.3.5 Caregiver Support Supplemental Services (Title E ES Program): The following services are provided to complement the care provided by caregivers: (1) Chore Services; (2) Housing Improvement; (3) Legal Assistance; (4) Material Aid; and (5) Specialized Medical Equipment, Services and Supplies. 2.2 SERVICE LOCATION 34 E, 2.2.1 Service Times 16132 The Vendor shall ensure the provision of the services listed in the contract during normal business hours unless other times are more appropriate to meet the performance requirements of the contract, and it shall monitor its vendors to ensure they are available to provide services during hours responsive to client needs and during those times which best meet the needs of the relevant service community. 2.3 DELIVERABLES 2.3.1 Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Depai lucent of Elder Affairs Programs and Services Handbook and the services tasks described in Section 2.1. The chart below lists the services allowed and the units of measurement. Units of service will be paid pursuant to the rate established in the 2010 RFP and approved by the County. Services Unit of Service Adult Day Care/Adult Day Interpreter/Translating Health Care Legal Assistance Caregiver Training/Support Medication Management Case Aid/Case Management Mental Health Counseling/Screening Chore Services Nutrition Counseling Companionship Occupational Therapy Counseling Services Personal Care Escort Physical Therapy Hour Financial Risk Reduction Recreation Services Respite Services Health Support Screening/Assessment Home Health Aide Sitter Homemaker Skilled Nursing Services Housing Improvement Speech Therapy Intake Emergency Alert Response Day Education/Training Episode Information Material Aid Referral/Assistance Specialized Medical Equipment, Services and Supplies Telephone Reassurance Escort One-Way Trip Shopping Assistance Transportation 2.4 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permit the Vendor to meet the County's reporting requirements. 35 1602 2.4.2 Service Costs Reports The Vendor shall require vendors to submit to the Vendor semi-annual service cost reports on August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.4.5 Background Screening Affidavit of Compliance To demonstrate compliance with section 8 of the Standard Contract,the Vendor shall submit ATTACHMENT H, Background Screening Affidavit of Compliance annually,by January 15"'. 2.5 RECORECORDS AND DOCUMENTATION Each Vendor and vendor, among other requirements,must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement in its contracts and/or agreements with vendors. These policies and procedures shall be made available to the County upon request. 2.6 PERFORMANCE SPECIFICATIONS 2.6.1 Outcomes (1)The Vendor shall ensure services provided under this contract are in accordance with the current DOEA Programs and Services Handbook, (2)The Vendor shall timely submit to the County all reports described herein (3)The Vendor shall timely submit to the County all information described in, Paragraph 2.5 RECORDS AND DOCUMENTATION. 2.7 VENDOR'S FINANCIAL OBLIGATIONS 2.7.1 Matching,Level of Effort,and Earmarking Requirements The Vendor shall provide match of at least 10 percent of the federal funds received. The Vendor's match will be made in the form of cash and/or in-kind resources. The Vendor will assure,through a provision in subcontracts, a match requirement of at least 10 percent of the cost for all services funded through this contract. The vendor's match will be made in the form of cash and/or in-kind resources. The Vendor shall report match by title each month. At the end of the contract period, the Vendor must properly match all OAA funds. 2.7.2 Title III Funds The Vendor assures compliance with Section 306 of the OAA, as amended in 2006,that funds received under Title 111 will not be used to pay any part of a cost incurred by the Vendor to maintain a contractual or commercial relationship that is not carried out to implement Title III. 2.8 COUNTY RESPONSIBILITIES 2.8.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the Vendor. 2.8.2 Program/Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this contract. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an on-site visit. The County's determination of acceptable performance shall be conclusive. The Vendor 36 1 613 p agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: 1. Desk reviews and analytical reviews; 2. Scheduled, unscheduled and follow-up on-site visits; 3. Client visits; 4. Review of independent auditor's reports-Exhibit 10; 5. Review of third-party documents and/or evaluation; 6. Review of progress reports; 7. Review of customer satisfaction surveys; 8. Agreed-upon procedures review by an external auditor or consultant; 9. Limited-scope reviews; and 10. Other procedures as deemed necessary. 2.8.3 Contract Monitoring The County shall, at its own discretion, conduct monitoring concerning any aspect of the vendor's performance of this contract. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for OAA ME and OAA TILES funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rate for services is ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services,which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 37 16D2 3,6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1,2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 38 EXHIBIT 5 16132 Agreement "Services for Seniors Attachment S Invoice and Logs (Minimum Standard Invoice Information) County Purchasing Order Number: Invoice Number: Grant Name: From Date To Date r'- m `fl, a r r Reliblll'Se z �,,7�'.,.� ms's �.,, - k'`s.- 4,P- :Ii k,= a�+- '" „°' . c"-.itl e' e..„ ,w"TMaa..,- "^'-�t3 . , h '" 0 ment Rate } — z �- r$ Sib . �` �ni z - a'� x, _x 7�-'' �` S '- xAios1 .r a�w i' v�e�p�nit;to ,r ., '31,- ao a;.' '4.-44,..-4- 4,,i,,, ..4.._ '- -..mss- ++` 9. $ ».-.s-.. t-�.' yr ' 4'�' a .� ..AM� V� s otara wair w Sup�Le_r T T� btract ulti 1 th -4.7 "-lg . Cost # Tnn kind rS (M, .P . ServiceDescri tion" p ., d InK-I -i mt=5� Reimbu_rsement (identi ed$Jr line) �Pe"r Match-t4-'1 . . tch� Quan hate '>er I nitto ' Service Amount °� - , � � `. Amount . �Snppher��th m 1 -'' ''''' sa;. .,.a+ nrt a ..' --� 5+` - te. :tee- t -. ;` :- . E tfrom Tot ii ti : . h - uanhty)k" �� � �: � p Cost Perms, , .,� - �� �� Service �, 3 $0.00 $0.00 $0.00 Total $0.00 I certify to the best of my knowledge and belief that this invoice, and attached service detail log, is complete and correct and all outlay herein are for the purposes set forth in the contract, and that services are ordered by the case manager as agreed on the Contract. Legible copies of the dated timesheet, signed by the client and the worker supporting this invoice must be available upon request. Collier County reserves the right to correct computation of errors to assure proper payment amount. Prepared by: Date: Adjustment Reasons Lead Agency Authorization Attachments: Monthly Service log, Weekly Detail log and Client Service time sheets. 39 0 1602 EXHIBIT 6 Detail Weekly for CCE Services Week Ending: Invoice No. Personal CLIENT Care Homemaker Respite Skilled Companion Chore Total Total Total Total Total Total NAME Units Units Units Units Units Units Total Hours - - - - - - $ PECA - HMK - $ RESPITE - $ SKILLED - $ COMPANION - $ CHORE - $ TOTAL - 40 EXHIBIT 7 1 6 I 1602 Monthly Detail Service Log Grant Name: Vendor Name, Address: From Date To Date By client,provide the total number of hours provided during the dates of service. This log must be submitted with your monthly invoice for the Invoice From Date and To Date. ,afro r p 'Adult Res i e E Client Eersonal Home-- � Stalled —Da Chore EnhancesSho scurt91e .i Y Asstst Res once Named Care makes: 1Vursmg Chore F pamon�, -BornO Care EaciLty System 41 EXHIBIT 8 1 6 2 Daycare Grant: Grant Service: ADC or RESF Vendor Name and Address By client, provide the Weekly Client Service Time Sheet provided during the dates of service. This log must be submitted with all invoices for the invoice From Date and To Date. TO FROM DATE: DATE: Client Thur Uni Client Name signature Mon Tue Wed s Fri Sat Sun Match is Service Dates 42 EXHIBIT 9 161) 2 YOUR COMPANY NAME HERE Collier County Services for Seniors Homemaker/Personal Care/Respite/Companion Work Sheet Client Name: Client Signature: Week Ending: Each Time You Perform one of the Activities Below: Put in arrival and departure times for the day worked: ****Client should Initial time of arrival and departure. ****Client should Sign form at top. • ****you should sign your name at the bottom. Date: Day: MON TUES WED THUR FRI SAT SUN TOTAL TIME ARRIVAL TIME: DEPARTURE TIME: ****CLIENT INITIALS: ■ Arrive: PERSONAL CARE Depart: Assist W/Bath tub Shower Bed Assist W/Dressing Bathroom Assist Shave (Face Only) Oral Hygiene Walking/Ambulation Feeding Assistance Wash/Set Hair Backrub_Soak Feet Nails (File only) Change Make Bed Take out Trash Clean Bedroom Clean Bathroom Prepare Meals Laundry Arrive: HOME MAKING Depart: Vacuum/Sweep Light Dusting 43 /CSI Clean Kitchen 2 16 Floor Wash Dishes Mop Sweep_ Grocery Shop Errands Arrive: RESPITE Depart: Arrive: COMPANION Depart: EMPLOYEE'S Signature/Title 44 co. 16112 EXHIBIT 10 OMB Circular A-1'33 Audits of States, Local Governments, and Non-Profit Organizations requires the Collier County Housing, Human and Veterans Services Department to monitor our subrecipients of federal awards and determine whether they have met the audit requirements of the circular and whether they are in compliance with federal laws and regulations. Accordingly, we are requiring that you check one of the following, provide all appropriate documentation regarding your organization's compliance with the audit requirements, sign and date this form. Subrecipient Fiscal Year Name Period Total State Financial Assistance Expended during $ most recently completed Fiscal Year Total Federal Financial Assistance Expended during most $ recently completed Fiscal Year Check Appropriate Boxes We have exceeded the$500,000 federal/state expenditure threshold for our fiscal year n ending as indicated above and have completed our Circular A-133 audit. A copy of the audit report and management letter are attached. We exceeded the $500,000 federal/state expenditure threshold for our fiscal year ending as indicated above and expect to complete our Circular A-133 audit by Within 30 days of completion of the A-133 audit, we will provide a copy of the audit report and management letter. We are not subject to the requirements of OMB Circular A-133 because we: I-1 Did not exceed the $500,000 federal/state expenditure threshold for the fiscal year indicated above n Are a for-profit organization f Are exempt for other reasons - explain An audited financial statements is attached and if applicable, the independent auditor's management letter. (If findings were noted, please enclose a copy of the responses and corrective action plan.) Certification Statement I hereby certify that the above information is true and accurate. Signature Date Print Name and Title 45 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY COMMISSIONERS C F TO THE BOARD O COUNTY FICE FOR GNATURE 1 6 D 2 Routed by Purchasing Department to Office Initials Date the Following Addressee(s) (In routing order) 1. Risk Management Risk 2. County Attorney Office County Attorney Office g� '.)' ,� \-3‘"\\3 3. BCC Office Board of County <N%-.c_ck17"-,\ Commissioners C - -- S 3\ `7 4. Minutes and Records Clerk of Court's Office -PM 5 1 f3 q`Pfrn 5. Return to Purchasing Department Purchasing Contact: Diana DeLeon PRIMARY CONTACT INFORMATION Name of Primary Diana DeLeon for Lisa Carr, HHVS, Phone Number 252-8375 Purchasing Staff May 29,2013 Contact and Date I Agenda Date Item was May 28,2013 Agenda Item Number 16.D.2 Approved by the BCC Type of Document Contract Amendment Number of Original 2 Attached Documents Attached PO number or account N/A Solicitation/Contract Amend#1 to Contract 12- number if document is Number/Vendor Name 5856 Care Club to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature? DD 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A provide the Contact Information(Name; Agency; Address;Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be ` - signed by the Chairman,with the exception of most letters,must be reviewed and signed C -C W by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's DD signature and initials are required. 7. In most cases(some contracts are an exception), an electronic copy of the document and DD this routing slip should be provided to the County Attorney's Office before the item is input into SIRE. 8. The document was approved by the BCC on the date above and all changes made DD during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes, if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC,all changes directed by the BCC have been made, and the document is ready for the( 9_6,3 Chairman's signature. 1602 MEMORANDUM Date: June 3, 2013 To: Diana DeLeon, Contract Technician Purchasing Department From: Teresa Cannon, Deputy Clerk Minutes & Records Department Re: Amendment #1 to Contract #12-5856 "Services for Seniors" Contractor: Care Club of Collier County, Inc. Attached is an original copy of the contract referenced above, (#16D2) approved by the Board of County Commissioners on Tuesday, May 28, 2013. The second original will be held on file in the Minutes and Record's Department for the Board's Official Record. If you have any questions, please feel free to contact me at 252-8411. Thank you. Attachment Contract Amendment #1 1 6 D Contract # 12-5856 "Services for Seniors" This CONTRACT AMENDMENT #1, dated , 2013 to the referenced agreement shall be by and between the parties to the original Agreement, are Club of Collier County, Inc. (to be referred to as"Vendor") and Collier County, Florida, (to be referred to as"County"). Statement of Understanding RE: Contract# 12-5856 "Services for Seniors" In order to continue services for the original Contract document referenced above, the Vendor agrees to the terms and conditions set forth in Exhibit A-1A, which includes Attachments C-H and Exhibits 1-10 attached hereto and incorporated by reference. The Vendor further agrees to amend Section 1, Commencement, as follows: 1. COMMENCEMENT. This Agreement shall Commence on December 11, 2012 and shall terminate on December 10, 2011 June 30, 2014. The Contract award is a two (2) year contract, with the possibility of two (2) additional (2) year terms pending funding from grantors and acceptable performance by the awarded vendor. Any such renewals shall be mutually agreed upon in writing by the parties. The maximum duration for this Contract for CCE, HCE, afiEl ADI, OAA IIIE AND OAA IIIES funding will not exceed six (6) years (through June 30, 2018). As outlined in RFP #12-5856, the County requires the Vendor to contribute a cash or in-kind match of no less than ten (10) percent for all services related to the Community Care for the Elderly Program, (CCE), Older American Title IIIE Caregiver Support (OAA IIIE) and Older American Title IIIES Caregiver Support Supplemental Services(OAA IIIES)Programs. Words that have been deleted are,truck through, words underlined have been added. Modification made herein shall apply as if incorporated into the Contract on the date of Commencement. All other terms and conditions of the agreement shall remain in force. IN WITNESS WHEREOF, the Vendor and the County have each, respectively, by an authorized person or agent, hereunder set their hands and seals on the date(s) indicated below. Accepted: May 2_2 , 2013 VENDOR: 1 A4, APAR* Care Cl�b of Collier C•unty In . First itilKs By: e. iJ, 4 J�YPC�L o j . AL?..:1e ` p e 2Ua,he C(hhl-s*cm �X• . Ati► Print/Type Name and Title econ• Witness t oberg- 6,161,0 Type/print witness name 1 1602 COUNTY: ATTEST: .s. ;, BOARD OF COUNTY COMMISSIONERS DWIGHT E�:-BROCT , CLERK OF COLLIER COUNTY, FLORIDA 4 L Bye l Attest'aO: I , Y CLERK GFORQIA A H FR, ESQ tt y.' CIIAIRW\OMA signature onl Tow\ r2C\. .∎vn ` ‘cc-- A -r,-1a`-1 Approval for form and legal Sufficiency: Jenni er B. White Assistant County Attorney Item# 1 6.0 03 Agenda Date a'( ..) Date Recd c. ` .5 0.) - Deputy Clerk 2 EXHIBIT A-lA 1 6 D 2 AGREEMENT 12-5856 SERVICES FOR SENIORS ATTACHMENTS ATTACHMENT ATTACHMENT DESCRIPTION PAGE Attachment C Core Standards for CCE, HCE, ADI, OAA IIIE & IIIES 2 Attachment D Certification Regarding Lobbying 8 Attachment E Certification Regarding Data Integrity Compliance 9 Attachment F Certification Regarding Debarment, Suspension, 10 Ineligibility and Voluntary Exclusion Contracts/ Subcontracts Attachment G Sub-Recipient Invoice Submission 11 Attachment H Background Screening Affidavit of Compliance 12 Exhibit 1 CCE Statement of work 13 Exhibit 2 HCE Statement of work 19 Exhibit 3 ADI Statement of work 25 Exhibit 4 OAA IIE and OAA IIIES Statement of work 31 Exhibit 5 Invoice 39 Exhibit 6 Detail Weekly Log 40 Exhibit 7 Monthly Log 41 Exhibit 8 Day Care/Respite Time Sheet 42 Exhibit 9 Program Time Sheet 43 Exhibit 10 Annual Audit Monitoring Report 45 1 cy ATTACHMENT C 16 D 2 Core Standards for CCE,HCE,ADI,OAA HIE & HIES 1. Compliance with Federal Law 1.1 If this agreement contains federal funds the following shall apply: 1.1.1 The vendor shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable regulations. 1.1.2 If this agreement contains federal funds and is over$100,000.00,the vendor shall comply with all applicable standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s. 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable Environmental Protection County regulations 40 CFR 30. The vendor shall report any violations of the above to the County. 1.1.3 The vendor may not use any federal funds received in connection with this agreement to influence legislation or appropriations pending before the Congress or any state legislature. If this agreement contains federal funding in excess of$100,000.00, the vendor must, prior to agreement execution, complete the Certification Regarding Lobbying form, ATTACHMENT D. All disclosure forms as required by the Certification Regarding Lobbying form must be completed and returned to the Grant Coordinator prior to payment under this agreement. 1.1.4 In accordance with Appendix A to 2 CFR 215, the vendor shall comply with Executive Order 1 1246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in Department of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable. 1.1.5 If this agreement contains federal funds and provides services to children up to age 18,the vendor shall comply with the Pro-Children Act of 1994(20 U.S.C. 6081). 1.1.6 A agreement award with an amount expected to equal or exceed $25,000.00 and certain other agreement 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 vendor shall comply with these provisions before doing business or entering into sub-agreements receiving federal funds pursuant to this agreement. The vendor shall complete and sign ATTACHMENT F prior to the execution of this agreement. 1.2 The vendor shall not employ an unauthorized alien. The County 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 agreement by the County. 2 c,� 1602 1.3 If the vendor 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 vendor must notify the County in writing within thirty(30) days of receiving the IRS notice of revocation. 1.4 The vendor shall comply with Title 2 CFR Part 275 regarding Trafficking in Persons. 1.5 Unless exempt under 2 CFR Part 170.110(b), the vendor shall comply with the reporting requirements of the Transparency Act as expressed in 2 CFR 170. 1.6 To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number 11-116, vendor agrees to utilize the U.S. Department of Homeland Security's E-verify system to verify the employment of all new employees hired by vendor during the agreement term. Vendor meeting the terms and conditions of the E-Verify System are deemed to be in compliance with this provision. 2. Compliance with State Law 2.1 This agreement is executed and entered into in the State of Florida, and shall be construed, performed and enforced in all respects in accordance with the Florida law, including Florida provisions for conflict of laws. 2.2 The vendor shall comply with requirements of s. 287.058,F.S. as amended. 2.2.1 The vendor shall provide units of deliverables, including various client services, and in some instances may include reports, findings, and drafts, as specified in this agreement,which the Grant Coordinator must receive and accept in writing prior to payment in accordance with s. 215.971, F.S. (1)and(2). 2.2.2 The vendor shall submit bills for fees or other compensation for services or expenses in sufficient detail for a proper pre-audit and post-audit. 2.2.3 The vendor shall allow public access to all documents, papers, letters, or other public records as deemed in subsection 119.011(12), F.S., made or received by the vendor in conjunction with this agreement except for those records which are made confidential or exempt by law. The vendor's refusal to comply with this provision will constitute an immediate breach of agreement for which the County may unilaterally terminate the agreement. 2.3 If clients are to be transported under this agreement, the vendor shall comply with the provisions of Chapter 427, F.S., and Rule 41-2, F. A. C. 2.4 Vendors who are on the discriminatory vendor list may not transact business with any public entity, in accordance with the provisions of s. 287.134,F.S. 2.5 The vendor shall comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the expenditure of agreement funds for the purpose of lobbying the legislature,judicial branch or a state agency. 3. Background Screening The vendor shall ensure that the requirements of s. 430.0402 and ch. 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 exempted from the Department's level 2 background screening 3 1602 pursuant to s. 430.0402(2)-(3), F.S. The vendor must also comply with any applicable rules promulgated by the Department and the Agency for Health Care Administration regarding implementation of s.430.0402 and ch. 435, F.S. Further information concerning the procedures for background screening are found at http://elderaffairs.state.fl.us/doea/backgroundscreening.php. 4. Provision of Services The vendor shall provide services in the manner described herein. 5. Monitoring by the County The vendor shall permit persons duly authorized by the County to inspect and copy any records, papers, documents, facilities, goods and services of the vendor which are relevant to this agreement, and to interview any clients, employees and vendor employees of the vendor to assure the County of the satisfactory performance of the terms and conditions of this agreement. Following such review, the County will provide a written report of its findings to the vendor, and where appropriate,the vendor shall develop a corrective action plan. The vendor hereby agrees to correct all deficiencies identified in the corrective action plan in a timely manner as determined by the Grant Coordinator. 6. Confidentiality of Information The vendor shall not use or disclose any information concerning a vendor of services under this agreement 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. 7. Health Insurance Portability and Accountability Act Where applicable, the vendor shall comply with the Health Insurance Portability and Accountability Act (42 USC 1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162, and 164). 8. Bankruptcy Notification During the term of this agreement, the vendor shall immediately notify the County if the Vendor, its assignees,vendors or affiliates file a claim for bankruptcy. Within ten (10)days after notification,the vendor must also provide the following information to the County.: (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., United States Bankruptcy Court Middle District of Florida,Naples,FL); and, (4)The name, address, and telephone number of the bankruptcy attorney. 9. Sponsorship and Publicity 9.1 As required by s. 286.25, F.S., if the vendor is a non-governmental organization which sponsors a program financed wholly or in part by state funds, including any funds obtained through this agreement, it shall, in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by Hope Hospice and Community Services, the State County of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County." If the sponsorship reference is in the written material, the words "State of Florida, Department of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County" shall appear in at least the same size letters or type as the name of the organization. 9.2 The vendor shall not use the words "The State of Florida Department of Elder Affairs or the Area County on Aging for Southwest Florida, Inc. or Collier County" to indicate sponsorship of a program otherwise financed, unless specific authorization has been obtained by Collier County, or the Area Aging on Aging prior to use. 4 r. 10. Independent Capacity of Vendor s 6 1:1 2 It is the intent and understanding of the Parties that the vendor, or any of its vendors, are independent vendors and are not employees of the County and shall not hold themselves out as employees or agents of the County without specific authorization from the County. It is the further intent and understanding of the Parties that the County does not control the employment practices of the vendor and will not be liable for any wage and hour, employment discrimination, or other labor and employment claims against the vendor or its vendors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary insurance for the vendor are the sole responsibility of the vendor. 11. Payment Payments shall be made to the vendor pursuant to s. 215.422, F.S., as services are rendered and invoiced by the vendor. The Grant Coordinator will have final approval of the invoice for payment, and will approve the invoice for payment only if the vendor has met all terms and conditions of the agreement, unless the bid specifications, purchase order, or this agreement specify otherwise. The approved invoice will be submitted to the County's Grant Coordinator approval and processing. 12. Return of Funds The vendor shall return to the County any overpayments due to unearned funds or funds disallowed and any interest attributable to such funds pursuant to the terms and conditions of this agreement that were disbursed to the vendor by the County. In the event that the vendor or its independent auditor discovers that an overpayment has been made, the vendor shall repay said overpayment immediately without prior notification from the County. In the event that the County first discovers an overpayment has been made, the Grant Coordinator will notify the vendor in writing of such findings. 13. Data Integrity and Safeguarding Information The vendor shall ensure an appropriate level of data security for the information the vendor is collecting or using in the performance of this agreement. An appropriate level of security includes approving and tracking all vendor employees that request system or information access and ensuring that user access has been removed from all terminated employees. The vendor, 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 vendor shall ensure all vendors maintain written procedures for computer system backup and recovery. The vendor shall complete and sign Attachment E prior to the execution of this agreement. 14. Computer Use and Social Media Policy The Department of Elder Affairs has implemented a new 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, Area Agencies on Aging and vendors. Any entity that uses the Depth talent'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. 15. Public Entity Crime Pursuant to s. 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 5 or services to a public entity; may not submit a bid, proposal, 6 D 2 agreement to provide any goods o p ty, y , p p reply on a agreement 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 vendor, supplier, vendor, or consultant under a agreement with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in s. 287.017, F.S., for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted vendor list. 16. Patents,Copyrights,Royalties If this agreement 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 agreement, the vendor shall refer the discovery, invention or material to the County to be referred to the Department of State and the Department of Elder Affairs. Any and all patent rights or copyrights accruing under this agreement are hereby reserved to the State of Florida in accordance with Chapter 286, F.S. Pursuant to s. 287.0571 (5) (k) 1 and 2 as amended, the only exceptions to this provision shall be those that are clearly expressed and reasonably valued in the agreement. 16.1 If the primary purpose of this agreement 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 Paragraph 33. 16.2 If this agreement is awarded solely federal funding, the terms and conditions are governed by 2 CFR 215.36. 17. Emergency Preparedness and Continuity of Operations 17.1 If the tasks to be performed pursuant to this agreement include the physical care and control of clients, or the administration and coordination of services necessary for client health, safety or welfare, the vendor shall, within thirty (30) calendar days of the execution of this agreement, submit to the Grant Coordinator verification of an emergency preparedness plan. In the event of an emergency,the vendor shall notify the County of emergency provisions. 17.2 In the event a situation results in a cessation of services by a vendor, the vendor shall retain responsibility for performance under this agreement and must follow procedures to ensure continuity of operations without interruption. 18. Financial Consequences of Non-Performance If the vendor fails to meet the minimum level of service or performance identified in this agreement, or that is customary for the industry, then the County must apply financial consequences commensurate with the deficiency. Financial consequences may include,but are not limited to, agreement suspension, refusing payment, withholding payments until deficiency is cured, tendering only partial payments, and/or cancellation of agreement and reacquiring services from an alternate source. 18.1 The vendor will not be charged with financial consequences, when a failure to perform arises out of causes that were the responsibility of the County. 19. No Waiver of Sovereign Immunity 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. 20. Venue If any dispute arises out of this agreement,the venue of such legal recourse will be Collier 6 r, 1602 County,Florida. 21. Entire Agreement This agreement contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations shall be valid or binding upon the County or the vendor unless expressly contained herein or by a written amendment to this agreement signed by both Parties. 22. 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. 23. 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. 24. Waiver The delay or failure by the County to exercise or enforce any of its rights under this agreement will not constitute or be deemed a waiver of the County'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. 25. Compliance The vendor shall abide by all applicable current federal statutes, laws, rules and regulations as well as applicable current state statutes, laws, rules, regulations and County rules, ordinances and regulations. The Parties agree that failure of the vendor to abide by these laws shall be deemed an event of default of the vendor, and subject the agreement to immediate, unilateral cancellation of the agreement at the discretion of the County. 26. Final Invoice The vendor shall submit the final CCE, HCE, ADI, TIE and HIES invoice for payment to the County on July 3, 2013. If the vendor fails to submit final request for payment by the deadline, then all rights to payment may be forfeited and the County may not honor any requests submitted after the aforesaid time period. Any payment due under the terms of this agreement may be withheld until all reports due from the vendor and necessary adjustments thereto have been approved by the County. 27. Renegotiations or Modifications Modifications of the provisions of this agreement shall be valid only when they have been reduced to writing and duly signed by both parties. The rate of payment, contract requirements and the total dollar amount may be adjusted retroactively to reflect price level increases and changes in the rate of payment or language. 28. All Terms and Conditions Included This agreement and its Attachments, A-H and exhibits 1-4 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 agreement shall supersede all previous communications, representations or agreements, either written or verbal between the Parties. 7 ATTACHMENT D 16 D 2 CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR AGREEMENTS, GRANTS,LOANS AND AGREEMENTS The undersigned certifies,to the best of his or her knowledge and belief,that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any State ,Federal or County, a member of congress, an officer or employee of congress, an employee of a member of congress, or an officer or employee of the state legislator, in connection with the awarding of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal agreement, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of the County, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this federal agreement, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including vendors, sub-grants, and agreements under grants, loans and cooperative agreements) and that all vendors shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than$100,000 for each such failure. Signature Date Name of Authorized Individual Name and Address of Organization 8 ATTACHMENT E 1 6 D CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS,LOANS AND COOPERATIVE AGREEMENTS The undersigned, an authorized representative of the vendor named in the agreement or agreement to which this form is an attachment, hereby certifies that: (1) The vendor and any vendors of services under this agreement 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 vendor, vendor(s), or any outside entity on which the vendor 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,vendor(s)will take immediate action to assure data integrity. (3) If this agreement 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 vendor (represented by the undersigned) and purchased by the State will be verified for accuracy and integrity of data prior to transfer. In the event of any decrease in functionality related to time and date related codes and internal subroutines that impede the hardware or software programs from operating properly, the vendor agrees to immediately make required corrections to restore hardware and software programs to the same level of functionality as warranted herein, at no charge to the State, and without interruption to the ongoing business of the state,time being of the essence. (4) The vendor and any vendor(s) of services under this agreement warrant their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data integrity compliance issues. The vendor shall require that the language of this certification be included in all vendors and other agreements and that all vendor shall certify compliance accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB Circulars A-102 and 2 CFR Part 215 (formerly OMB Circular A-110). Name and Address of vendor Signature Title Date Name of Authorized Signer 9 16132 EXHIBIT F CERTIFICATION REGARDING DEBARMENT, SUSPENSION,INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS (1) The prospective vendor certifies, by signing this certification, neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or County. (2) Where the prospective vendor is unable to certify to any of the statements in this certification,such prospective participant shall attach an explanation to this certification. Signature Date Title County/Organization (Certification signature should be same as Agreement signature.) Instructions for Certification 1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "person," "primary covered transaction,"and"voluntarily excluded," as used herein,have the meanings set out in the sections of rules implementing Executive Order 12549. (2 CFR 180.5-180.1020,as supplemented by 2 CFR 376.10-376.995). You may contact the Agreement Manager for assistance in obtaining a copy of those regulations. 2. This certification is a material representation of facts upon which reliance was placed when the parties entered into this transaction. If it is later determined that the vendor knowingly rendered an erroneous certification,in addition to other remedies available to the federal govemment,the Department or County may pursue available remedies,including suspension and/or debarment. 3. The vendor will provide immediate written notice to the Agreement Manager if at any time the vendor learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The vendor may decide the method and frequency by which it determines the eligibility of its principals. Each participant to a lower tier covered transaction may,but is not required to,check the Excluded Parties List System(EPLS). 4. The vendor will include a "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion-Lower Tier Covered Transaction"in all its lower tier covered transactions and in all solicitations for lower tier covered transactions. 5. The vendor agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise authorized by the federal government. 6. If the vendor knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension,and/or debarment. 7. The vendor may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended,ineligible,or voluntarily excluded from the covered transaction,unless it knows that the certification is erroneous. 10 C___C;(1) 1602 EXIIIBIT G SUBRECIPIENT INVOICE SUMMISSION The County shall reimburse the SUBRECIPIENT for the performance of this Agreement upon completion or partial completion of the work tasks as accepted and approved by HHVS pursuant to the submittal of quarterly progress reports. Invoices for work performed are required every month. If no work has been performed during that month, or if the SUBRECIPIENT is not yet prepared to send the required backup, a$0 invoice will be required. Explanations will be required if two consecutive months of$0 invoices are submitted. Payments shall be made to the SUBRECIPIENT when requested as work progresses but, not more frequently than once per month. Final invoices are due no later than 90 days after the end of the agreement. Work performed during the term of the program but not invoiced within 90 days without written exception from the Grant Coordinator will not be reimbursed. No payment will be made until approved by HHVS for grant compliance and adherence to any and all applicable local, state or Federal requirements. Payment will be made upon receipt of a properly completed invoice and in compliance with §218.70, Florida Statutes, otherwise known as the "Local Government Prompt Payment Act." 11 DEPARTMENT OF EXHIBIT H 1602 BACKGROUND SCREENING ELDER AFFAIRS Affidavit of Compliance -Employer STATE OF FLORIDA 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 Employer Name located at Street Address City State ZIP code 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. Signature of Representative Date STATE OF FLORIDA,COUNTY OF Sworn to (or affirmed)and subscribed before me this day of , 20 , by (Name of Representative)who is personally known to me or produced 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:http://elderaffairs.state.fl.us/enRlish/backgroundscreening.php 12 rTh 16132 EXHIBIT 1 STATEMENT OF WORK COMMUNITY CARE FOR THE ELDERLY PROGRAM(CCE) SECTION I: SERVICES TO BE PROVIDED 1.1. DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 AGREEMENT ACRONYMS Activities of Daily Living(ADL) Adult Protective Services(APS) Assessed Priority Consumer List(APCL) Comprehensive Assessment and Review for Long-Term Care Services(CARES) Community Care for the Disabled Adult(CCDA) Community Care for the Elderly(CCE) Client Information and Registration Tracking System(CIRTS) Department of Children and Families(DCF) Department of Elder Affairs (DOEA) Home Care for Disabled Adults (HCDA) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out: The condition of reaching 60 years of age and being transitioned from the Department of Children and Families(DCF) Services, Community Care for Disabled Adults (CCDA)or Home Care for Disabled Adults (HCDA) services to the Department's community- based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in its planning and service area in accordance with the Section 306 (42 U.S.C. 3026) of the Older Americans Act and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the County enters CCE specific data in the CIRTS. An update may also include other revisions to the area plan as instructed by the County or Department of Elder Affairs. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 70 1B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The primary purpose of the CCE program is to prevent, decrease or delay premature or inappropriate and expensive placement of older persons in nursing homes and other institutions. 13 lc 1602 1.2.2 Community Care for the Elderly Mission Statement The CCE Program assists functionally impaired elderly persons in living as independently as possible in their own homes or in the homes of relatives or caregivers. The program provides a continuum of care through the development, expansion, reorganization and coordination of multiple community-based services to assist elders to reside in the least restrictive environment suitable to their needs. 1.2.3 Authority The relevant authority governing CCE program are: (1)Rule 58C-1, Florida Administrative Code (2) Sections 430.201 through 430.207, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services Chief Financial Officer Memoranda the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1) CFO Memo No. 02: Release date,August 20, 2010; (2) CFO Memo No. 03: Release date,June 29,2010; and (3) CFO Memo No. 06: Release date, June 30,2010. 1.2.4 Scope of Service The vendor shall provide services in a manner consistent with and descried in the current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the program are to preserve the independence of elders and prevent or delay more costly institutional care through a community care service system that provides case management and other in-home and community services as needed under the direction of the County and provide a continuum of service alternatives that meet the diverse needs of functionally impaired elders. 1.3. INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The CCE program provides a continuum of services for functional impaired elders. 1.3.2 Individual Eligibility In order to receive services under this agreement, an applicant must: (1) Be at least 60 years of age; (2) Be functionally impaired as determined through the initial comprehensive assessment; and (3) With the exception of APS high-risk referrals, consumers may not be dually enrolled in the CCE program and a Medicaid capitated long-term care program. 1.3.2.1 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution or who are abused, neglected or exploited. 14 1602 SECTION H: MANNER OF SERVICE PROVISION 2. Delivery of Service to Eligible Clients The vendor shall ensure the provision of a continuum of service that meet the diverse needs of functionally impaired elders. The vendor shall ensure performance and reporting of the following service provision in accordance with the current DOEA Programs and Services Handbook. The services may include the following categories: (1) Core Services; (2) Health Maintenance Services; and (3) Other Support Services. Core Services for Programmatic Operation 2.1. The vendor may deliver core services include a variety of home-delivered services, day care services, and other basic services that are most needed to prevent unnecessary institutionalization. Core services,to be provided at the unit rate identified in this agreement, include the following: (1) Adult Day Care; (7) Housing Improvement; (2) Chore Services; (8) Respite Services; and (3) Enhanced Chore; (9) Transportation (4) Companionship; (5) Home Delivered Meals; (6) Homemaker; 2.1.1 Health Maintenance Services The vendor shall ensure that health maintenance services are routine health services that are necessary to help maintain the health of functionally impaired elders. The services are limited to medical therapeutic services, non-medical prevention services, personal care services, home health aide services, home nursing services, and emergency response systems. Typical services to be provided at the unit rate identified in this agreement, are the following: (1) Adult Day Health Care; (2) Emergency Alert Response; (3) Nutrition Counseling (4) Personal Care (5) Skilled Nursing Services; and (6) Specialized Medical Equipment Services and Supplies 2.2 SERVICE TIMES 2.2.1 Service Times 15 1602 The vendor shall ensure the provisions of the services listed in this agreement are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m.to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the agreement in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this agreement as updated, and approved by the County's reporting requirements. Service Unit of Service Adult Day Care Homemaker Case Aide Housing Improvement Case Management Respite Services Chore Services Personal Care Hour Enhanced Chore Physical Therapy Companionship Skilled Nursing Services Emergency Alert Response Day Material Aid Episode Specialized Medical Equipment, Services and Supplies Escort Shopping Assistance One-Way Trip Transportation Service Unit of Service Home Delivered Meals Meal 2.4 REPORTS The vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The vendor shall establish due dates for any agreement that permits the vendor to meet the County's reporting requirements. Service Costs Reports The vendor shall submit to the County semi-annual service cost reports, August 1, 2013 and February 1, 2014, of each year which reflects actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.5 RECORDS AND DOCUMENTATION 2.5.1 Each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup 16 2.6 COUNTY RESPONSIBILITIES 1 61) Z 2.6.1 Program Guidance and Technical Assistance The County will provide to the vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the vendor. resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures will be made available to the County upon request. 2.7 PERFORMANCE SPECIFICATIONS 2.7.1 Outcomes (1) The vendor shall ensure services provided under this agreement are in accordance with the current Department of Elder Affairs Programs and Services Handbook. (2) The vendor shall timely submit to the County all information described in EXHIBIT 1, SECTION 2.4 REPORTS; and (3) The vendor shall timely submit to the County all information described in EXHIBIT 1, SECTION 2.5 RECORDS AND DOCUMENTATION. 2.8. VENDOR'S FINANCIAL OBLIGATIONS 2.8.1 Matching,Level of Effort,and Earmarking Requirement The vendor will assure a match requirement of at least 10 percent of the cost for all CCE services. The match will be made in the form of cash and/or in-kind resources. At the end of the agreement period, all CCE funds expended must be properly matched. State funds cannot be used to match another state-funded program. 3. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 17 . 16D2 3.4 Payment may be authorized only for allowable services,which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services,upon request. 18 EXHIBIT 2 1602 STATEMENT OF WORK HOME CARE FOR THE ELDERLY PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Adult Protective Services(APS) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) 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) Home Care for Disabled Adults (HCDA) Home Care for the Elderly(HCE) Institutional Care Program (ICP) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults(HCDA)services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026) and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the County enters HCE specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement Area Agencies on Aging may contract with CCE lead agencies or other case management entities for the provision of the HCE program. Approved caregivers receive a Basic Subsidy to reimburse some of their expenses each month for caring for the consumer and may receive a Special Subsidy for other necessary services and essential supplies. Caregivers may be approved 19 ) for up to three HCE clients in their home. 1 60 P 2 1.2.2 Home Care for the Elderly Program Mission Statement The Home Care for the Elderly Program supports family style living arrangements, on a non- profit basis,as an alternative to nursing homes or other institutional care. Through the program, a caregiver for three or fewer elders living in a private home provides basic services of maintenance and supervision as well as coordinating other necessary specialized services. 1.2.3 Authority The relevant authority governing the HCE program include: (1) Rule Chapter 58H-1,Florida Administrative Code; and (2) Sections 430.601 through 430.608, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services', Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: CFO Memo No. 02: Release date,August 20, 2010; CFO Memo No. 03: Release date, June 29, 2010; and CFO Memo No. 06: Release date,June 30,2010. 1.2.4 Scope of Service The Vendor shall provide services in a manner consistent with and described in the current County's area plan update and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the HCE program are to ensure that: (1) Basic Subsidy is provided to the caregiver of each client and (2) Special Subsidy is provided when essential to the well-being of the client. 1.3 INDIVIDUAL TO BE SERVED 1.3.1 General Eligibility The Home Care for the Elderly program serves elders age 60 and older at risk of placement in a nursing home or other institutional settings who can remain in a family style setting through the provision of subsidies. 1.3.2 Client Eligibility Clients eligible to receive services under this agreement must: (1) Be 60 years of age or older; (2) Have income less than the Institutional Care Program(ICP) standard. (3) Meet the ICP asset limitation; (4) Be at risk of nursing home placement; 20 1602 (5) Have an approved adult caregiver living in the home with them who is willing to provide care or assist in arranging for care; and (6) Not be enrolled in the Aged and Disabled Adult Medicaid waiver or a Medicaid capitated long-term care program. 1.3.3 Caregiver Eligibility Caregivers eligible to receive services under this agreement must: (1) Be at least 18 years of age, capable of providing a family-type living environment; (2) 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; (3) Be willing to accept responsibility for the social, physical and emotional needs of the care Vendor; (4) Be physically present and live in the home to provide supervision and to assist in arrangement of services for the client; (5) 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 (6) Be without record of conviction of abuse, neglect or exploitation of another person. 1.3.4 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meet the diverse needs of the functionally impaired elders and their caregivers. The Vendor shall ensure Basic Subside and Special Subsidy services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. 2.1. Basic Subsidy The Basic Subsidy is a cash payment made to an approved caregiver each month to reimburse some expenses incurred in caring for the client. The Basic Subsidy is provided for support and maintenance of the client, including housing, food, clothing, and medical costs not covered by Medicaid, Medicare or any other insurance. A Basic Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. If the client is hospitalized or in any other temporary institution for 30 days or less, the full Basic Subsidy shall be provided to the caregiver as if the client were in the home. 2.2. Special Subsidy Services Though every eligible HCE client receives a Basic Subsidy, Special Subsidy payments are pre-authorized and are based on additional specialized medical or health care services, supplies or equipment needed to maintain the health and well-being of the individual elder. The Special Subsidy for additional medical support and special services is a cash payment to reimburse the costs of any other service or special care not covered by Medicaid, Medicare, or private insurance when these services are determined to be 21 �� 1602 essential to maintain the well-being of the home care recipient. A Special Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. Special Subsidy 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: 2.2.1 SERVICE LOCATION AND EQUIPMENT 2.2.2 Service Times The vendor shall ensure the provision of the services listed in this contract are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m. to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the Agency's reporting requirements. Service Unit of Service Adult Day Care Housing Improvement Case Aide Other Case Management Personal Care Hour Chore Respite(Facility Based or In-Home) Chore(Enhanced) Skilled Nursing Services Homemaker Material Aid Episode Specialized Medical Equipment, Services and Supplies Transportation One-Way Trip 2.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permits the Vendor to meet the County's reporting requirements. 2.2.1 Service Costs Reports The Vendor shall submit to the County the semi-annual service cost reports, August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.3 RECORDS AND DOCUMENTATION 2.3.1 The Vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The 22 16132 Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 2.4 PERFORMANCE SPECIFICATIONS 2.4.1 Outcomes (1) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (2) The Vendor shall timely submit to the County all reports described in SECTION 2.2 REPORTS; and (3) The Vendor shall timely submit to the County all information described in, SECTION 2.3 RECORDS AND DOCUMENTATION. 2.5 COUNTY RESPONSIBILITIES 2.5.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-up on-site visits; (3) Client visits; (4) Review of independent auditor's reports; (5) Review of third-party documents and/or evaluation; (6) Review of progress reports; (7) Review of customer satisfaction surveys; (8) Agreed-upon procedures review by an external auditor or consultant; (9) Limited-scope reviews; and (10) Other procedures as deemed necessary. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The 23 16D2 vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services, which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 24 16132 EXHIBIT 3 STATEMENT OF WORK ALZHEIMER'S DISEASE INITIATIVE PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Alzheimer's Disease(AD) Alzheimer's Disease Initiative(ADI) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System(CIRTS) Community Care for Disabled Adults (CCDA) Department of Elder Affairs(DOEA) Home Care For Disabled Adults(HCDA) Instrumental Activities of Daily Living(IA.DL) Memory Disorder Clinic(MDC) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults(HCDA) services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026. 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 County enters ADI specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 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. Model Day Care: A program of therapeutic, social and health activities specific to clients with memory disorders. Services and activities include, but are not limited to, active and quiet 25 1602 2 games, reminiscence, validation therapy, pet therapy, water therapy and other failure free g � PY P PY activities appropriate to the client's level of functioning. Model day care centers will also provide training for health care and social service personnel in the care of persons having AD or related memory disorders. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The ADI program provides a continuum of services addressing the special needs of individuals with AD,their families and caregivers. 1.2.2 Alzheimer's Disease Initiative Program Mission Statement The ADI program ensures that persons afflicted with AD and other forms of dementia are given essential services to help them age in place in an elder-friendly environment with security, dignity, and purpose. The program also provides support to family members and caregivers of persons afflicted with AD. 1.2.3 Authority The relevant authority governing the Alzheimer's Disease Initiative Program are as follows: (1) Rule Chapter 58D-1, Florida Administrative Code; and (2) Sections 430.501 through 430.504, Florida Statutes. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1) CFO Memo No. 02: Release date,August 20,2010; (2) CFO Memo No. 03: Release date,June 29, 2010; and CFO Memo No. 06: Release date, June 30,2010. 1.2.3.2 Scope of Service The Vendor is responsible for the programmatic, fiscal, and operational management of the ADI program. The program services shall be provided in a manner consistent with and described in the current Vendor's Request for Proposal, RFP, and the County's current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.3.4 Major Program Goals The major goal of the ADI program is to provide services to meet the needs of caregivers and individuals with AD and related memory disorders. 1.3 INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The ADI Program addresses the special needs of individuals with AD and their caregivers. 1.3.2 Individual Eligibility Those individuals eligible to receive services under this contract must meet the following conditions: (1) Be 18 years of age or older and have a diagnosis of AD or a related disorder, or be 26 suspected of having AD or a related disorder; and 16 ® 2 (2) Not be enrolled in a Medicaid capitated long-term care program. 1.3.3 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. SERVICE TASKS In order to achieve the goals of the ADI program, the Vendor shall ensure the following tasks are performed: (1) Client eligibility determination; (2) Assessment and prioritization of service delivery for new clients; (3) Delivery of services to eligible clients; and (4) Monitor the performance of vendors. 2.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described in this SECTION 1.3. 2.2 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services addressing the diverse needs of individuals with AD and their caregivers. The Vendor shall ensure services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. Services categories include: (1) Caregiver Training/Support; (2) Case Aid; (3) Case Management; (4) Counseling(Gerontological); (5) Counseling(Mental Health/Screening); (6) Education/Training; (7) Model Day Care; ( 8) Respite(Facility-Based); ( 9) Respite(In-Home); and (10) Specialized Medical Equipment, Services,and Supplies. Caregivers benefit from receiving training,respite and related support services to assist them in caring for the ADI client. 2.3 Service Times The Vendor shall ensure the provisions of the services listed in this contract are available 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. 27 3. DELIVERABLES 1 6 1) 3.1. Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Depai tment of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the County's reporting requirements. Service Unit of Service Caregiver Training/Support; Hour Case Aid; Hour Case Management; Hour Counseling(Gerontological); Hour Counseling(Mental Health/Screening); Hour Respite(Facility-Based); Hour Respite(In-Home); Hour Education/Training; Episode Episode 3.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. 3.2.1 Service Costs Reports Vendor must submit to the County the semi-annual service cost reports August 1, 2013 and February 1,2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 3.3 RECORDS AND DOCUMENTATION 3.3.1 The Vendor and each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 4. PERFORMANCE SPECIFICATIONS 4.1 Outcomes (4) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (5) The Vendor shall timely submit to the County all reports described in SECTION 3.2 REPORTS; and (6) The Vendor shall timely submit to the County all information described in SECTION 3.3 28 ,f it '; RECORDS AND DOCUMENTATION. 1 0 02 5. COUNTY RESPONSIBILITIES 5.1. Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-up on-site visits; (3) Client visits (4) Review of independent auditor's reports (5) Review third-party documents and/or evaluations (6) Review of progress reports (7) Review of customer satisfaction surveys (8)Agreed-upon procedures review by an external auditor or consultant; (9)Limited-scope reviews; and (10)Other procedures as deemed necessary. 6. SECTION III: METHOD OF PAYMENT 6.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 6.1.2 Remedies-Nonconforming Services The Vendor shall ensure that all goods and/or services provided under this agreement for HCE funded programs are delivered timely, completely and commensurate with required standards of quality Such goods and/or services shall only be delivered to eligible program participants. If the Vendor fails to meet the prescribed quality standards for services, such services will not be reimbursed under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be reimbursed under this agreement. The Vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the Vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County requires immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 6.1.3 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the Vendor and any adjustments thereto, including any disallowance not resolved. 6.1.4 Date for Final Request for Payment 29 1602 ry The final request for payment for agreement year one's expenditures will be due to the County no later than August 1,2013. The final request for payment for agreement year two expenditures will be no later than August 1,2014. 6.2 Documentation for Payment The Vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals upon request. Such documentation shall be provided upon request to the County or the Clerk of Court. 30 EXIIIBIT 4 16 (12 STATEMENT OF WORK OLDER AMERICANS ACT PROGRAM TITLE III SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 CONTRACT ACRONYMS Area Agency on Aging(AAA) Activities of Daily Living(ADL) Alliance of Information&Referral Systems (AIRS) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System(CIRTS) Information and Referral(I&R) Instrumental Activities of Daily Living(IADL) Older Americans Act(OAA) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in Its PSA in accordance with the Section 306 (42 U.S.C. 3026) of the OAA and Department instructions. Child: An individual who is not more than 18 years of age or an individual with disability. Family Caregiver: An adult family member, or another individual,who is an informal provider of in-home and community care to an older individual. Frail: When an older individual is unable to perform at least two ADLs without substantial human assistance, including verbal reminding, physical cueing or supervision; or due to cognitive or other mental impairment, requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to another individual. 1.2 County Mission,Vision and Values Statement The County's mission: To help aging adults achieve greater independence through awareness of resources and access to qualified service providers. The County's vision: To be the recognized leader in supporting older adults and their families with access to trustworthy resources and services in their communities while empowering them to live with independence and dignity. The County's values: We believe residents of Southwest Florida are entitled to: Comprehensive information about their choices of care; Timely access to resources and services; High standards of quality and performance; and Personal and professional accountability from all stakeholders. 1.2.1 Older Americans Act Program Mission Statement The Older Americans Act(OAA)Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. 31 >i 1.3 GENERAL DESCRIPTION 1602 1.3.1 General Statement The OAA Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. The primary purpose of the OAA program is to foster the development and implementation of comprehensive and coordinated systems to serve older individuals. The OAA program uses these systems to assist older individuals to attain and maintain maximum independence and dignity in a home environment and allows for the capability of self- care with appropriate supportive services. 1.3.2 Authority The relevant references authority governing the OAA program are: 1. Older Americans Act of 2006, as amended; 2. Rule 58A-1, Florida Administrative Code; and 3. Section 430.101, Florida Statutes. 1.3.2.1 Incorporation of Reference Memoranda In accordance with Ch. 287 F.S., as amended, and Agency of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and incorporated by reference: 1. CFO Memo No. 02: Release date, August 20, 2010; 2. CFO Memo No. 03: Release date,June 29, 2010; and 3. CFO Memo No. 06: Release date,June 30, 2010. 1.3.3 Scope of Service The Vendor shall provide services in a manner consistent with and descried in the current area plan and current Depai intent of Elder Affairs Programs and Services Handbook. 1.3.4 Major Program Goals The major goals of the OAA program are to improve the quality of life for older individuals, preserve their independence and prevent or delay more costly institutional care. These goals are achieved through the implementation of a comprehensive and coordinated service system that provides a continuum of service alternatives that meet the diverse needs of elders and their caregivers. 1.4 INDIVIDUALS TO BE SERVED 1.4.1 Eligibility(Title III Programs) 1.4.1.1 OAA Title III, General Consumers shall not be dually enrolled in an OAA program and a Medicaid capitates long-term care program. 1.4.1.2 OAA Title IIIE,Caregiver Support Services Eligibility for OAA Title IIIE, Caregiver Support Services, are as follows: 1. Family caregivers of individuals age 60 or older; 32 16132 6 2. Grandparents (age 55 or older)or older individuals (age 55 or older)who are relative caregivers; 3. Priority will be given to family caregivers who provide care for individuals with Alzheimer's disease and related disorders with neurological and organic brain dysfunction and for grandparents or older individuals who are relative caregivers who provide care for children with severe disabilities; and 4. For respite and supplemental services, a family caregiver must be providing care for an older individual who meets the definition of the term"frail" in OAA, Section 102 Paragraph 22. 1.4.2 Targeted Groups Preference shall be given to those with the greatest economic and social need,with particular attention to low-income older individuals, including those that are low-income minorities, have limited English proficiency, and older individuals residing in rural areas. SECTION II—MANNER OF SERVICE PROVISION 2.1 SERVICE TASKS In order to achieve the goals of the OAA program, the Vendor shall ensure the following tasks are performed: 1. Client eligibility determination; 2. Targeting and screening of service delivery for new clients; 3. Delivery of services to eligible clients; 4. Use of volunteers to expand the provision of available services; 5. Monitoring the performance of its vendors. 6. Grievance and Compliance Procedures 2.1.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described herein. 2.1.2 Targeting and Screening of Service Delivery for New Clients The Vendor shall develop and implement policies and procedures consistent with OAA targeting and screening Criteria 2.1.3 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meets the diverse needs of elders and their caregivers. The Vendor shall ensure the performance and report performance of the following services in accordance with the current Department of Elder Affairs Programs and Services Handbook. The services funded pursuant to this contract are in accordance with the OAA,Title III, sections 321, 331,336 and 373 as follows: 1. Section 321,Title IIIB Supportive Services; 2. Section 373,Title TILE Caregiver Support Services. 2.1.3.1 Supportive Services Supportive services include a variety of community-based and home-delivered services that support the qualities of life for older individuals by helping them remain independent and productive. Services include the following: 33 1602 (1) Adult Day Care/Adult Day Health Care; (17) Homemaker; (2) Caregiver Training/Support; (18) Housing Improvement; (3) Case Aide/Case Management; (19) Information; (4) Chore Services; (20) Intake; (5) Companionship; (21) Interpreter/Translating; (6) Counseling(Gerontological and Mental Health); (22) Referral/Assistance; (7) Education/Training; (23) Personal Care; (8) Legal Assistance; (24) Physical Therapy; (9) Material Aid; (25) Shopping Assistance; (10) Occupational Therapy; (26) Skilled Nursing; (11) Outreach; (27) Specialized Medical Equipment, Services, and Supplies (12) Recreation; (28) Respite Services; (13) Emergency Alert Response; (29) Screening/Assessment; (14) Escort; (30) Speech Therapy; (15) Health Support; (31) Telephone Reassurance; and (16) Home Health Aide; (32) Transportation 2.1.3.4 Caregiver Support Services (Title DIE Program) The following services are intended to provide direct help to caregivers, assist in the areas of health, nutrition and financial literacy and assist caregivers in making decisions and problem solving related to their caregiving roles and responsibilities: (1) Adult Day Care/Adult Day Health Care; (2) Caregiver Training/Support; (3) Counseling(Gerontological and Mental Health); (4) Education/Training; (5) Financial Risk Reduction(Assessment and Maintenance); (6) Information; (7) Intake; (8) Outreach; (9) Respite Services; (10) Screening/Assessment; and (11) Transportation 2.1.3.5 Caregiver Support Supplemental Services (Title DIES Program): The following services are provided to complement the care provided by caregivers: (1) Chore Services; (2) Housing Improvement; (3) Legal Assistance; (4) Material Aid; and (5) Specialized Medical Equipment, Services and Supplies. 2.2 SERVICE LOCATION 34 16132 2.2.1 Service Times The Vendor shall ensure the provision of the services listed in the contract during normal business hours unless other times are more appropriate to meet the performance requirements of the contract, and it shall monitor its vendors to ensure they are available to provide services during hours responsive to client needs and during those times which best meet the needs of the relevant service community. 2.3 DELIVERABLES 2.3.1 Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the services tasks described in Section 2.1. The chart below lists the services allowed and the units of measurement. Units of service will be paid pursuant to the rate established in the 2010 RFP and approved by the County. Services Unit of Service Adult Day Care/Adult Day Interpreter/Translating Health Care Legal Assistance Caregiver Training/Support Medication Management Case Aid/Case Management Mental Health Counseling/Screening Chore Services Nutrition Counseling Companionship Occupational Therapy Counseling Services Personal Care Escort Physical Therapy Hour Financial Risk Reduction Recreation Services Respite Services Health Support Screening/Assessment Home Health Aide Sitter Homemaker Skilled Nursing Services Housing Improvement Speech Therapy Intake Emergency Alert Response Day Education/Training Episode Information Material Aid Referral/Assistance Specialized Medical Equipment, Services and Supplies Telephone Reassurance Escort One-Way Trip Shopping Assistance Transportation 2.4 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permit the Vendor to meet the County's reporting requirements. 35 16132 2.4.2 Service Costs Reports The Vendor shall require vendors to submit to the Vendor semi-annual service cost reports on August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.4.5 Background Screening Affidavit of Compliance To demonstrate compliance with section 8 of the Standard Contract,the Vendor shall submit ATTACHMENT H, Background Screening Affidavit of Compliance annually, by January 15`". 2.5 RECORECORDS AND DOCUMENTATION Each Vendor and vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement in its contracts and/or agreements with vendors. These policies and procedures shall be made available to the County upon request. 2.6 PERFORMANCE SPECIFICATIONS 2.6.1 Outcomes (1)The Vendor shall ensure services provided under this contract are in accordance with the current DOEA Programs and Services Handbook, (2)The Vendor shall timely submit to the County all reports described herein (3)The Vendor shall timely submit to the County all information described in, Paragraph 2.5 RECORDS AND DOCUMENTATION. 2.7 VENDOR'S FINANCIAL OBLIGATIONS 2.7.1 Matching,Level of Effort,and Earmarking Requirements The Vendor shall provide match of at least 10 percent of the federal funds received. The Vendor's match will be made in the form of cash and/or in-kind resources. The Vendor will assure,through a provision in subcontracts,a match requirement of at least 10 percent of the cost for all services funded through this contract. The vendor's match will be made in the form of cash and/or in-kind resources. The Vendor shall report match by title each month. At the end of the contract period, the Vendor must properly match all OAA funds. 2.7.2 Title III Funds The Vendor assures compliance with Section 306 of the OAA, as amended in 2006,that funds received under Title III will not be used to pay any part of a cost incurred by the Vendor to maintain a contractual or commercial relationship that is not carried out to implement Title III. 2.8 COUNTY RESPONSIBILITIES 2.8.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the Vendor. 2.8.2 Program/Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this contract. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an on-site visit. The County's determination of acceptable performance shall be conclusive. The Vendor 36 1602 agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: 1. Desk reviews and analytical reviews; 2. Scheduled, unscheduled and follow-up on-site visits; 3. Client visits; 4. Review of independent auditor's reports- Exhibit 10; 5. Review of third-party documents and/or evaluation; 6. Review of progress reports; 7. Review of customer satisfaction surveys; 8. Agreed-upon procedures review by an external auditor or consultant; 9. Limited-scope reviews; and 10. Other procedures as deemed necessary. 2.8.3 Contract Monitoring The County shall, at its own discretion, conduct monitoring concerning any aspect of the vendor's performance of this contract. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for OAA IIIE and OAA IIIES funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rate for services is ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services, which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 37 1602 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 38 ,ri EXHIBIT 5 16132 Agreement#12-5856 "Services for Seniors Attachment B Invoice and Logs (Minimum Standard Invoice Information) County Purchasing Order Number: Invoice Number: Grant Name: From Date To Date Reimburse ment Rate r' ,u " Per Unit to Total Supplier TOTAL AMOUNT (Subtract (Multiply the Cost In Kind In Kind Unit Reimbursement Service Description Per Match (identified by line) Match Quantity Rate Per Unit to Service Amount Amount Supplier x the Unit Unit from Total Quantity) Cost Per Service Unit) $0.00 $0.00 $0.00 Total $0.00 I certify to the best of my knowledge and belief that this invoice, and attached service detail log, is complete and correct and all outlay herein are for the purposes set forth in the contract, and that services are ordered by the case manager as agreed on the Contract. Legible copies of the dated timesheet, signed by the client and the worker supporting this invoice must be available upon request. Collier County reserves the right to correct computation of errors to assure proper payment amount. Prepared by: Date: Adjustment Reasons Lead Agency Authorization Attachments: Monthly Service log, Weekly Detail log and Client Service time sheets. 39 cA 16132 EXHIBIT 6 Detail Weekly for CCE Services Week Ending: Invoice No. Personal CLIENT Care Homemaker Respite Skilled Companion Chore Total Total Total Total Total Total NAME Units Units Units Units Units Units Total Hours - - - - - - $ PECA - $ HMK - $ RESPITE - $ SKILLED - $ COMPANION - $ CHORE - $ TOTAL - 40 EXHIBIT 7 1 613 2 Monthly Detail Service Log Grant Name: Vendor Name, Address: From Date To Date By client,provide the total number of hours provided during the dates of service. This log must be submitted with your monthly invoice for the Invoice From Date and To Date. Respite Adult Respite Emergency Client Personal Home- In- Skilled Day (In- Chore Enhance Com— Shopping Escort Alert Name Care maker ( Nursing Y Chore panion Assist Response Home) Care Facility System Iota a, 41 EXHIBIT 8 16132 Daycare Grant: Grant Service: ADC or RESF Vendor Name and Address By client, provide the Weekly Client Service Time Sheet provided during the dates of service. This log must be submitted with all invoices for the invoice From Date and To Date. TO FROM DATE: DATE: Client Thur Uni Client Name signature Mon Tue Wed s Fri Sat Sun Match is Service Dates 42 1602 EXHIBIT 9 YOUR COMPANY NAME HERE Collier County Services for Seniors Homemaker/Personal Care/Respite/Companion Work Sheet Client Name: Client Signature: Week Ending: Each Time You Perform one of the Activities Below: Put in arrival and departure times for the day worked: ****Client should Initial time of arrival and departure. ****Client should Sign form at top. ****you should sign your name at the bottom. Date: Day: MON TUES WED THUR FRI SAT SUN TOTAL TIME ARRIVAL TIME: DEPARTURE TIME: ****CLIENT INITIALS: Arrive: PERSONAL CARE Depart: Assist W/Bath tub Shower Bed Assist W/Dressing Bathroom Assist Shave (Face Only) Oral Hygiene Walking/Ambulation Feeding Assistance Wash/Set Hair Backrub Soak Feet Nails (File only) Change_Make_._Bed Take out Trash Clean Bedroom Clean Bathroom Prepare Meals Laundry Arrive: HOME MAKING Depart: Vacuum/Sweep Light Dusting 43 16D2 Clean Kitchen Floor Wash Dishes Mop Sweep_ Grocery Shop Errands Arrive: RESPITE Depart: Arrive: COMPANION Depart: EMPLOYEE'S Signature/Title 44 1602 EXHIBIT 10 OMB Circular A-133 Audits of States, Local Governments, and Non-Profit Organizations requires the Collier County Housing, Human and Veterans Services Department to monitor our subrecipients of federal awards and determine whether they have met the audit requirements of the circular and whether they are in compliance with federal laws and regulations. Accordingly, we are requiring that you check one of the following, provide all appropriate documentation regarding your organization's compliance with the audit requirements, sign and date this form. Subrecipient Fiscal Year Name Period Total State Financial Assistance Expended during $ most recently completed Fiscal Year Total Federal Financial Assistance Expended during most $ recently completed Fiscal Year Check Appropriate Boxes We have exceeded the $500,000 federal/state expenditure threshold for our fiscal year �] ending as indicated above and have completed our Circular A-133 audit. A copy of the audit report and management letter are attached. We exceeded the $500,000 federal/state expenditure threshold for our fiscal year I I ending as indicated above and expect to complete our Circular A-133 audit by . Within 30 days of completion of the A-133 audit, we will provide a copy of the audit report and management letter. We are not subject to the requirements of OMB Circular A-133 because we: Did not exceed the $500,000 federal/state expenditure threshold for the fiscal year indicated above I I Are a for-profit organization I I Are exempt for other reasons — explain An audited financial statements is attached and if applicable, the independent auditor's management letter. (If findings were noted, please enclose a copy of the responses and corrective action plan.) Certification Statement I hereby certify that the above information is true and accurate. Signature Date Print Name and Title 45 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE 6 0 2 Routed by Purchasing Department to Office Initials Date the Following Addressee(s) (In routing order) • 1. Risk Management Risk 2. County Attorney Office County Attorney Office Qv) `3\\\\ 3. BCC Office Board of County Svw.c btA Commissioners C13�`\� 4. Minutes and Records Clerk of Court's Office 72'm 5( 1/13 qp 5. Return to Purchasing Department Purchasing Contact: Diana DeLeon PRIMARY CONTACT INFORMATION Name of Primary Diana DeLeon for Lisa Carr, HHVS, Phone Number 252-8375 Purchasing Staff May 29,2013 Contact and Date Agenda Date Item was May 28,2013 Agenda Item Number 16.D.2 Approved by the BCC Type of Document Contract Amendment Number of Original 2 Attached Documents Attached PO number or account N/A Solicitation/Contract Amend#1 to Contract 12- number if document is Number/Vendor Name 5856 Accu-Care to be recorded INSTRUCTIONS & CHECKLIST Initial:the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature? DD 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A provide the Contact Information(Name;Agency; Address; Phone)on ah attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be signed by the Chairman, with the exception of most letters, must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's DD signature and initials are required. 7. In most cases(some contracts are an exception), an electronic copy of the document and DD this routing slip should be provided to the County Attorney's Office before the item is input into SIRE. 8. The document was approved by the BCC on the date above and all changes made D . during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the 43 BCC, all changes directed by the BCC have been made, and the document is ready for the Chairman's signature. 1602 MEMORANDUM Date: June 3, 2013 To: Diana DeLeon, Contract Technician Purchasing Department From: Teresa Cannon, Deputy Clerk Minutes & Records Department Re: Amendment #1 to Contract #12-5856 "Services for Seniors" Contractor: Accu-Care Nursing Services, Inc. Attached is an original copy of the contract referenced above, (#16D2) approved by the Board of County Commissioners on Tuesday, May 28, 2013. The second original will be held on file in the Minutes and Record's Department for the Board's Official Record. If you have any questions, please feel free to contact me at 252-8411. Thank you. Attachment 1602 Contract Amendment #1 Contract# 12-5856 "Services for Seniors" This CONTRACT AMENDMENT #1, dated Ma1/4( , 2013 to the referenced agreement shall be by and between the parties to the original Agreement, Accu-Care Nursing Service, Inc. (to be referred to as"Vendor")and Collier County, Florida, (to be referred to as"County"). Statement of Understanding RE: Contract# 12-5856 "Services for Seniors" In order to continue services for the original Contract document referenced above, the Vendor agrees to the terms and conditions set forth in Exhibit A-1A, which includes Attachments C-H and Exhibits 1-10 attached hereto and incorporated by reference. The Vendor further agrees to amend Section 1, Commencement, as follows: 1. COMMENCEMENT. This Agreement shall Commence on December 11, 2012 and shall terminate on December 10, 2014 June 30, 2014. The Contract award is a two (2) year contract, with the possibility of two (2) additional (2) year terms pending funding from grantors and acceptable performance by the awarded vendor. Any such renewals shall be mutually agreed upon in writing by the parties. The maximum duration for this Contract for CCE, HCE, and ADI, OAA IIIE AND OAA IIIES funding will not exceed six (6) years (through June 30, 2018). As outlined in RFP #12-5856, the County requires the Vendor to contribute a cash or in-kind match of no less than ten (10) percent for all services related to the Community Care for the Elderly Program, (CCE), Older American Title IIIE Caregiver Support (OAA IIIE) and Older American Title IIIES Caregiver Support Supplemental Services(OAA IIIES)Programs. Words that have been deleted are struck through, words underlined have been added. Modification made herein shall apply as if incorporated into the Contract on the date of Commencement. All other terms and conditions of the agreement shall remain in force. IN WITNESS WHEREOF, the Vendor and the County have each, respectively, by an authorized person or agent, hereunder set their hands and seals on the date(s) indicated below. Accepted: -wk.. 8 , 2013 VENDOR: n r d - - _1�LLL!a!L 1X1..1 Accu-Care Nursing Service, Inc. ' . ,• •: ke .� • , � ype/print witn- . na 40- •_ 4 ¢ O Second Witne Print/Type Name and Ti DO►1 ✓1c b re_u)er Type/print witness name 1 16132 COUNTY: ATTEST: BOARD OF COUNTY COMMISSIONERS DWIGHT E. BROCK, CLERK OF COLLIER COUNTY, FLORIDA A ,i t as t y M SCLERK • ' . P. I = • s6cilint o('P!;l y .. CHAIRWO ■rn Nth \cN t\/G <_. \Nr—%-r1c:Qr‘ Approval for form and legal Sufficiency: Jennifer B. White Assistant County Attorney liem# Ly!_1LZ- Agenda (—lag lib Date Date (oft 1,3 Recd Deputy Clerk 2 EXIiIBIT A-lA 613 2 AGREEMENT 12-5856 SERVICES FOR SENIORS ATTACHMENTS ATTACHMENT ATTACHMENT DESCRIPTION PAGE Attachment C Core Standards for CCE, HCE, ADI, OAA IIIE & IIIES 2 Attachment D Certification Regarding Lobbying 8 Attachment E Certification Regarding Data Integrity Compliance 9 Attachment F Certification Regarding Debarment, Suspension, 10 Ineligibility and Voluntary Exclusion Contracts/ Subcontracts Attachment G Sub-Recipient Invoice Submission 11 Attachment H Background Screening Affidavit of Compliance 12 Exhibit 1 CCE Statement of work 13 Exhibit 2 HCE Statement of work 19 Exhibit 3 ADI Statement of work 25 Exhibit 4 OAA IIE and OAA IIIES Statement of work 31 Exhibit 5 Invoice 39 Exhibit 6 Detail Weekly Log 40 Exhibit 7 Monthly Log 41 Exhibit 8 Day Care/Respite Time Sheet 42 Exhibit 9 Program Time Sheet 43 Exhibit 10 Annual Audit Monitoring Report 45 1 16Q ATTACHMENT C 2 Core Standards for CCE,HCE,ADI,OAA HIE & HIES 1. Compliance with Federal Law 1.1 If this agreement contains federal funds the following shall apply: 1.1.1 The vendor shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable regulations. 1.1.2 If this agreement contains federal funds and is over $100,000.00,the vendor shall comply with all applicable standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s. 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable Environmental Protection County regulations 40 CFR 30. The vendor shall report any violations of the above to the County. 1.1.3 The vendor may not use any federal funds received in connection with this agreement to influence legislation or appropriations pending before the Congress or any state legislature. If this agreement contains federal funding in excess of$100,000.00, the vendor must, prior to agreement execution, complete the Certification Regarding Lobbying form, ATTACHMENT D. All disclosure forms as required by the Certification Regarding Lobbying form must be completed and returned to the Grant Coordinator prior to payment under this agreement. 1.1.4 In accordance with Appendix A to 2 CFR 215, the vendor shall comply with Executive Order 11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in Department of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable. 1.1.5 If this agreement contains federal funds and provides services to children up to age 18,the vendor shall comply with the Pro-Children Act of 1994 (20 U.S.C. 6081). 1.1.6 A agreement award with an amount expected to equal or exceed $25,000.00 and certain other agreement 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 vendor shall comply with these provisions before doing business or entering into sub-agreements receiving federal funds pursuant to this agreement. The vendor shall complete and sign ATTACHMENT F prior to the execution of this agreement. 1.2 The vendor shall not employ an unauthorized alien. The County 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 agreement by the County. 2 GA 16132 1.3 If the vendor 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 vendor must notify the County in writing within thirty(30) days of receiving the IRS notice of revocation. 1.4 The vendor shall comply with Title 2 CFR Part 275 regarding Trafficking in Persons. 1.5 Unless exempt under 2 CFR Part 170.110(b), the vendor shall comply with the reporting requirements of the Transparency Act as expressed in 2 CFR 170. 1.6 To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number 11-116, vendor agrees to utilize the U.S. Depaitinent of Homeland Security's E-verify system to verify the employment of all new employees hired by vendor during the agreement term. Vendor meeting the terms and conditions of the E-Verify System are deemed to be in compliance with this provision. 2. Compliance with State Law 2.1 This agreement is executed and entered into in the State of Florida, and shall be construed, performed and enforced in all respects in accordance with the Florida law, including Florida provisions for conflict of laws. 2.2 The vendor shall comply with requirements of s. 287.058,F.S. as amended. 2.2.1 The vendor shall provide units of deliverables, including various client services, and in some instances may include reports,findings, and drafts, as specified in this agreement, which the Grant Coordinator must receive and accept in writing prior to payment in accordance with s. 215.971, F.S. (1)and(2). 2.2.2 The vendor shall submit bills for fees or other compensation for services or expenses in sufficient detail for a proper pre-audit and post-audit. 2.2.3 The vendor 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 vendor in conjunction with this agreement except for those records which are made confidential or exempt by law. The vendor's refusal to comply with this provision will constitute an immediate breach of agreement for which the County may unilaterally terminate the agreement. 2.3 If clients are to be transported under this agreement, the vendor shall comply with the provisions of Chapter 427, F.S., and Rule 41-2, F. A. C. 2.4 Vendors who are on the discriminatory vendor list may not transact business with any public entity, in accordance with the provisions of s. 287.134, F.S. 2.5 The vendor shall comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the expenditure of agreement funds for the purpose of lobbying the legislature,judicial branch or a state agency. 3. Background Screening The vendor shall ensure that the requirements of s. 430.0402 and ch. 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 exempted from the Department's level 2 background screening 3 GP 16132 pursuant to s. 430.0402(2)-(3), F.S. The vendor must also comply with any applicable rules promulgated by the Department and the Agency for Health Care Administration regarding implementation of s. 430.0402 and ch. 435,F.S. Further information concerning the procedures for background screening are found at http://elderaffairs.state.fl.us/doea/backgroundscreening.php. 4. Provision of Services The vendor shall provide services in the manner described herein. 5. Monitoring by the County The vendor shall permit persons duly authorized by the County to inspect and copy any records, papers, documents, facilities, goods and services of the vendor which are relevant to this agreement, and to interview any clients, employees and vendor employees of the vendor to assure the County of the satisfactory performance of the terms and conditions of this agreement. Following such review, the County will provide a written report of its findings to the vendor, and where appropriate,the vendor shall develop a corrective action plan. The vendor hereby agrees to correct all deficiencies identified in the corrective action plan in a timely manner as determined by the Grant Coordinator. 6. Confidentiality of Information The vendor shall not use or disclose any information concerning a vendor of services under this agreement 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. 7. Health Insurance Portability and Accountability Act Where applicable, the vendor shall comply with the Health Insurance Portability and Accountability Act (42 USC 1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162, and 164). 8. Bankruptcy Notification During the term of this agreement,the vendor shall immediately notify the County if the Vendor, its assignees, vendors or affiliates file a claim for bankruptcy. Within ten (10)days after notification,the vendor must also provide the following information to the County.: (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., United States Bankruptcy Court Middle District of Florida,Naples, FL); and, (4)The name, address, and telephone number of the bankruptcy attorney. 9. Sponsorship and Publicity 9.1 As required by s. 286.25, F.S., if the vendor is a non-governmental organization which sponsors a program financed wholly or in part by state funds, including any funds obtained through this agreement, it shall, in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by Hope Hospice and Community Services, the State County of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County." If the sponsorship reference is in the written material, the words "State of Florida, Department of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County" shall appear in at least the same size letters or type as the name of the organization. 9.2 The vendor shall not use the words "The State of Florida Depai tuient of Elder Affairs or the Area County on Aging for Southwest Florida, Inc. or Collier County" to indicate sponsorship of a program otherwise financed, unless specific authorization has been obtained by Collier County, or the Area Aging on Aging prior to use. 4 16D2 10. Independent Capacity of Vendor It is the intent and understanding of the Parties that the vendor, or any of its vendors, are independent vendors and are not employees of the County and shall not hold themselves out as employees or agents of the County without specific authorization from the County. It is the further intent and understanding of the Parties that the County does not control the employment practices of the vendor and will not be liable for any wage and hour, employment discrimination, or other labor and employment claims against the vendor or its vendors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary insurance for the vendor are the sole responsibility of the vendor. 11. Payment Payments shall be made to the vendor pursuant to s. 215.422, F.S., as services are rendered and invoiced by the vendor. The Grant Coordinator will have final approval of the invoice for payment, and will approve the invoice for payment only if the vendor has met all terms and conditions of the agreement, unless the bid specifications, purchase order, or this agreement specify otherwise. The approved invoice will be submitted to the County's Grant Coordinator approval and processing. 12. Return of Funds The vendor shall return to the County any overpayments due to unearned funds or funds disallowed and any interest attributable to such funds pursuant to the terms and conditions of this agreement that were disbursed to the vendor by the County. In the event that the vendor or its independent auditor discovers that an overpayment has been made, the vendor shall repay said overpayment immediately without prior notification from the County. In the event that the County first discovers an overpayment has been made, the Grant Coordinator will notify the vendor in writing of such findings. 13. Data Integrity and Safeguarding Information The vendor shall ensure an appropriate level of data security for the information the vendor is collecting or using in the performance of this agreement. An appropriate level of security includes approving and tracking all vendor employees that request system or information access and ensuring that user access has been removed from all terminated employees. The vendor, 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 vendor shall ensure all vendors maintain written procedures for computer system backup and recovery. The vendor shall complete and sign Attachment E prior to the execution of this agreement. 14. Computer Use and Social Media Policy The Department of Elder Affairs has implemented a new 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, Area Agencies on Aging and vendors. 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. 15. Public Entity Crime Pursuant to s. 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 5 caO 1602 agreement to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on a agreement 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 vendor, supplier, vendor, or consultant under a agreement with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in s. 287.017, F.S., for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted vendor list. 16. Patents,Copyrights,Royalties If this agreement 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 agreement, the vendor shall refer the discovery, invention or material to the County to be referred to the Department of State and the Depaitinent of Elder Affairs. Any and all patent rights or copyrights accruing under this agreement are hereby reserved to the State of Florida in accordance with Chapter 286, F.S. Pursuant to s. 287.0571 (5) (k) 1 and 2 as amended, the only exceptions to this provision shall be those that are clearly expressed and reasonably valued in the agreement. 16.1 If the primary purpose of this agreement 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 Paragraph 33. 16.2 If this agreement is awarded solely federal funding, the terms and conditions are governed by 2 CFR 215.36. 17. Emergency Preparedness and Continuity of Operations 17.1 If the tasks to be performed pursuant to this agreement include the physical care and control of clients, or the administration and coordination of services necessary for client health, safety or welfare, the vendor shall, within thirty (30) calendar days of the execution of this agreement, submit to the Grant Coordinator verification of an emergency preparedness plan. In the event of an emergency,the vendor shall notify the County of emergency provisions. 17.2 In the event a situation results in a cessation of services by a vendor, the vendor shall retain responsibility for performance under this agreement and must follow procedures to ensure continuity of operations without interruption. 18. Financial Consequences of Non-Performance If the vendor fails to meet the minimum level of service or performance identified in this agreement, or that is customary for the industry, then the County must apply financial consequences commensurate with the deficiency. Financial consequences may include, but are not limited to, agreement suspension, refusing payment, withholding payments until deficiency is cured, tendering only partial payments, and/or cancellation of agreement and reacquiring services from an alternate source. 18.1 The vendor will not be charged with financial consequences, when a failure to perform arises out of causes that were the responsibility of the County. 19. No Waiver of Sovereign Immunity 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. 20. Venue If any dispute arises out of this agreement,the venue of such legal recourse will be Collier 6 County, Florida. 21. Entire Agreement 1 6 2 This agreement contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations shall be valid or binding upon the County or the vendor unless expressly contained herein or by a written amendment to this agreement signed by both Parties. 22. 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. 23. 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. 24. Waiver The delay or failure by the County to exercise or enforce any of its rights under this agreement will not constitute or be deemed a waiver of the County'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. 25. Compliance The vendor shall abide by all applicable current federal statutes, laws, rules and regulations as well as applicable current state statutes, laws, rules, regulations and County rules, ordinances and regulations. The Parties agree that failure of the vendor to abide by these laws shall be deemed an event of default of the vendor, and subject the agreement to immediate, unilateral cancellation of the agreement at the discretion of the County. 26. Final Invoice The vendor shall submit the final CCE, HCE, ADI, IIE and IIIES invoice for payment to the County on July 3, 2013. If the vendor fails to submit final request for payment by the deadline, then all rights to payment may be forfeited and the County may not honor any requests submitted after the aforesaid time period. Any payment due under the terms of this agreement may be withheld until all reports due from the vendor and necessary adjustments thereto have been approved by the County. 27. Renegotiations or Modifications Modifications of the provisions of this agreement shall be valid only when they have been reduced to writing and duly signed by both parties. The rate of payment, contract requirements and the total dollar amount may be adjusted retroactively to reflect price level increases and changes in the rate of payment or language. 28. All Terms and Conditions Included This agreement and its Attachments, A-H and exhibits 1-4 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 agreement shall supersede all previous communications, representations or agreements, either written or verbal between the Parties. 7 , ‘ ATTACHMENT D 160 ' CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR AGREEMENTS,GRANTS,LOANS AND AGREEMENTS The undersigned certifies,to the best of his or her knowledge and belief,that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any State ,Federal or County, a member of congress, an officer or employee of congress, an employee of a member of congress, or an officer or employee of the state legislator, in connection with the awarding of any federal grant,the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal agreement, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of the County, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this federal agreement, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers(including vendors, sub-grants, and agreements under grants, loans and cooperative agreements)and that all vendors shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than$100,000 for each such failure. Signature Date Name of Authorized Individual Name and Address of Organization 8 C?Li ATTACHMENT E 1 60 2 CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS,LOANS AND COOPERATIVE AGREEMENTS The undersigned, an authorized representative of the vendor named in the agreement or agreement to which this form is an attachment, hereby certifies that: (1) The vendor and any vendors of services under this agreement 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 vendor, vendor(s), or any outside entity on which the vendor 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, vendor(s)will take immediate action to assure data integrity. (3) If this agreement 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 vendor (represented by the undersigned) and purchased by the State will be verified for accuracy and integrity of data prior to transfer. In the event of any decrease in functionality related to time and date related codes and internal subroutines that impede the hardware or software programs from operating properly, the vendor agrees to immediately make required corrections to restore hardware and software programs to the same level of functionality as warranted herein, at no charge to the State, and without interruption to the ongoing business of the state,time being of the essence. (4) The vendor and any vendor(s) of services under this agreement warrant their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data integrity compliance issues. The vendor shall require that the language of this certification be included in all vendors and other agreements and that all vendor shall certify compliance accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB Circulars A-102 and 2 CFR Part 215 (formerly OMB Circular A-110). Name and Address of vendor Signature Title Date Name of Authorized Signer 9 161) EXHIBIT F CERTIFICATION REGARDING DEBARMENT, SUSPENSION,INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS (1) The prospective vendor certifies, by signing this certification, neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or County. (2) Where the prospective vendor is unable to certify to any of the statements in this certification,such prospective participant shall attach an explanation to this certification. Signature Date Title County/Organization (Certification signature should be same as Agreement signature.) Instructions for Certification 1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "person," "primary covered transaction,"and"voluntarily excluded,"as used herein,have the meanings set out in the sections of rules implementing Executive Order 12549. (2 CFR 180.5-180.1020,as supplemented by 2 CFR 376.10-376.995). You may contact the Agreement Manager for assistance in obtaining a copy of those regulations. 2. This certification is a material representation of facts upon which reliance was placed when the parties entered into this transaction. If it is later determined that the vendor knowingly rendered an erroneous certification,in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension and/or debarment. 3. The vendor will provide immediate written notice to the Agreement Manager if at any time the vendor learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The vendor may decide the method and frequency by which it determines the eligibility of its principals. Each participant to a lower tier covered transaction may,but is not required to,check the Excluded Parties List System(EPLS). 4. The vendor will include a "Certification Regarding Debarment, Suspension,Ineligibility and Voluntary Exclusion-Lower Tier Covered Transaction"in all its lower tier covered transactions and in all solicitations for lower tier covered transactions. 5. The vendor agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise authorized by the federal government. 6. If the vendor knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension,and/or debarment. 7. The vendor may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended,ineligible,or voluntarily excluded from the covered transaction,unless it knows that the certification is erroneous. 10 160 ":71 EXHIBIT G SUBRECIPIENT INVOICE SUM MISSION The County shall reimburse the SUBRECIPIENT for the performance of this Agreement upon completion or partial completion of the work tasks as accepted and approved by HHVS pursuant to the submittal of quarterly progress reports. Invoices for work performed are required every month. If no work has been performed during that month, or if the SUBRECIPIENT is not yet prepared to send the required backup, a$0 invoice will be required. Explanations will be required if two consecutive months of$0 invoices are submitted. Payments shall be made to the SUBRECIPIENT when requested as work progresses but, not more frequently than once per month. Final invoices are due no later than 90 days after the end of the agreement. Work performed during the term of the program but not invoiced within 90 days without written exception from the Grant Coordinator will not be reimbursed.No payment will be made until approved by HHVS for grant compliance and adherence to any and all applicable local, state or Federal requirements. Payment will be made upon receipt of a properly completed invoice and in compliance with §218.70, Florida Statutes, otherwise known as the "Local Government Prompt Payment Act." 11 C p. DEPARTMENT OF EXHIBIT H D p BACKGROUND SCREENING ELDER AFFAIRS Affidavit of Compliance -Employer STATE OF FLORIDA 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 Employer Name located at Street Address City State ZIP code 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. Signature of Representative Date STATE OF FLORIDA,COUNTY OF Sworn to(or affirmed)and subscribed before me this day of , 20 , by (Name of Representative)who is personally known to me or produced 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:http://elderaffairs.state.fl.us/english/backgroundscreening.php 12 1602 EXHIBIT 1 STATEMENT OF WORK COMMUNITY CARE FOR THE ELDERLY PROGRAM(CCE) SECTION I: SERVICES TO BE PROVIDED 1.1. DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 AGREEMENT ACRONYMS Activities of Daily Living(ADL) Adult Protective Services(APS) Assessed Priority Consumer List(APCL) Comprehensive Assessment and Review for Long-Term Care Services(CARES) Community Care for the Disabled Adult(CCDA) Community Care for the Elderly(CCE) Client Information and Registration Tracking System(CIRTS) Department of Children and Families(DCF) Department of Elder Affairs(DOEA) Home Care for Disabled Adults (HCDA) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out: The condition of reaching 60 years of age and being transitioned from the Department of Children and Families(DCF) Services, Community Care for Disabled Adults (CCDA)or Home Care for Disabled Adults(HCDA) services to the Department's community- based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in its planning and service area in accordance with the Section 306 (42 U.S.C. 3026) of the Older Americans Act and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the County enters CCE specific data in the CIRTS. An update may also include other revisions to the area plan as instructed by the County or Department of Elder Affairs. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The primary purpose of the CCE program is to prevent, decrease or delay premature or inappropriate and expensive placement of older persons in nursing homes and other institutions. 13 �_hO 16132 2 1.2.2 Community Care for the Elderly Mission Statement The CCE Program assists functionally impaired elderly persons in living as independently as possible in their own homes or in the homes of relatives or caregivers. The program provides a continuum of care through the development, expansion, reorganization and coordination of multiple community-based services to assist elders to reside in the least restrictive environment suitable to their needs. 1.2.3 Authority The relevant authority governing CCE program are: (1)Rule 58C-1,Florida Administrative Code (2) Sections 430.201 through 430.207, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services Chief Financial Officer Memoranda the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1) CFO Memo No. 02: Release date,August 20,2010; (2) CFO Memo No. 03: Release date,June 29,2010; and (3) CFO Memo No. 06: Release date,June 30, 2010. 1.2.4 Scope of Service The vendor shall provide services in a manner consistent with and descried in the current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the program are to preserve the independence of elders and prevent or delay more costly institutional care through a community care service system that provides case management and other in-home and community services as needed under the direction of the County and provide a continuum of service alternatives that meet the diverse needs of functionally impaired elders. 1.3. INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The CCE program provides a continuum of services for functional impaired elders. 1.3.2 Individual Eligibility In order to receive services under this agreement, an applicant must: (1) Be at least 60 years of age; (2) Be functionally impaired as determined through the initial comprehensive assessment; and (3) With the exception of APS high-risk referrals, consumers may not be dually enrolled in the CCE program and a Medicaid capitated long-term care program. 1.3.2.1 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution or who are abused, neglected or exploited. 14 1602 SECTION H: MANNER OF SERVICE PROVISION 2. Delivery of Service to Eligible Clients The vendor shall ensure the provision of a continuum of service that meet the diverse needs of functionally impaired elders. The vendor shall ensure performance and reporting of the following service provision in accordance with the current DOEA Programs and Services Handbook. The services may include the following categories: (1) Core Services; (2) Health Maintenance Services; and (3) Other Support Services. Core Services for Programmatic Operation 2.1. The vendor may deliver core services include a variety of home-delivered services, day care services, and other basic services that are most needed to prevent unnecessary institutionalization. Core services,to be provided at the unit rate identified in this agreement, include the following: (1) Adult Day Care; (7) Housing Improvement; (2) Chore Services; (8) Respite Services; and (3) Enhanced Chore; (9) Transportation (4) Companionship; (5) Home Delivered Meals; (6) Homemaker; 2.1.1 Health Maintenance Services The vendor shall ensure that health maintenance services are routine health services that are necessary to help maintain the health of functionally impaired elders. The services are limited to medical therapeutic services, non-medical prevention services, personal care services, home health aide services, home nursing services, and emergency response systems. Typical services to be provided at the unit rate identified in this agreement, are the following: (1) Adult Day Health Care; (2) Emergency Alert Response; (3) Nutrition Counseling (4) Personal Care (5) Skilled Nursing Services; and (6) Specialized Medical Equipment Services and Supplies 2.2 SERVICE TIMES 2.2.1 Service Times 15 1602 The vendor shall ensure the provisions of the services listed in this agreement are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m.to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the agreement in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this agreement as updated, and approved by the County's reporting requirements. Service Unit of Service Adult Day Care Homemaker Case Aide Housing Improvement Case Management Respite Services Chore Services Personal Care Hour Enhanced Chore Physical Therapy Companionship Skilled Nursing Services Emergency Alert Response Day Material Aid Episode Specialized Medical Equipment, Services and Supplies Escort Shopping Assistance One-Way Trip Transportation Service Unit of Service Home Delivered Meals Meal 2.4 REPORTS The vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The vendor shall establish due dates for any agreement that permits the vendor to meet the County's reporting requirements. Service Costs Reports The vendor shall submit to the County semi-annual service cost reports, August 1, 2013 and February 1, 2014, of each year which reflects actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.5 RECORDS AND DOCUMENTATION 2.5.1 Each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup 16 2.6 COUNTY RESPONSIBILITIES 1 u 2.6.1 Program Guidance and Technical Assistance The County will provide to the vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the vendor. resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures will be made available to the County upon request. 2.7 PERFORMANCE SPECIFICATIONS 2.7.1 Outcomes (1) The vendor shall ensure services provided under this agreement are in accordance with the current Department of Elder Affairs Programs and Services Handbook. (2) The vendor shall timely submit to the County all information described in EXHIBIT 1, SECTION 2.4 REPORTS; and (3) The vendor shall timely submit to the County all information described in EXHIBIT 1, SECTION 2.5 RECORDS AND DOCUMENTATION. 2.8. VENDOR'S FINANCIAL OBLIGATIONS 2.8.1 Matching,Level of Effort,and Earmarking Requirement The vendor will assure a match requirement of at least 10 percent of the cost for all CCE services. The match will be made in the form of cash and/or in-kind resources. At the end of the agreement period, all CCE funds expended must be properly matched. State funds cannot be used to match another state-funded program. 3. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 17 1602 3.4 Payment may be authorized only for allowable services,which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 18 EXHIBIT 2 1 6 D 2 STATEMENT OF WORK HOME CARE FOR THE ELDERLY PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Adult Protective Services(APS) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) 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) Home Care for Disabled Adults(HCDA) Home Care for the Elderly(HCE) Institutional Care Program(ICP) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults (HCDA) services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026) and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the County enters HCE specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement Area Agencies on Aging may contract with CCE lead agencies or other case management entities for the provision of the HCE program. Approved caregivers receive a Basic Subsidy to reimburse some of their expenses each month for caring for the consumer and may receive a Special Subsidy for other necessary services and essential supplies. Caregivers may be approved 19 1602 for up to three HCE clients in their home. 1.2.2 Home Care for the Elderly Program Mission Statement The Home Care for the Elderly Program supports family style living arrangements, on a non- profit basis, as an alternative to nursing homes or other institutional care. Through the program, a caregiver for three or fewer elders living in a private home provides basic services of maintenance and supervision as well as coordinating other necessary specialized services. 1.2.3 Authority The relevant authority governing the HCE program include: (1) Rule Chapter 58H-1, Florida Administrative Code; and (2) Sections 430.601 through 430.608,F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services', Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: CFO Memo No. 02: Release date,August 20,2010; CFO Memo No. 03: Release date,June 29,2010; and CFO Memo No. 06: Release date,June 30,2010. 1.2.4 Scope of Service The Vendor shall provide services in a manner consistent with and described in the current County's area plan update and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the HCE program are to ensure that: (1) Basic Subsidy is provided to the caregiver of each client and (2) Special Subsidy is provided when essential to the well-being of the client. 1.3 INDIVIDUAL TO BE SERVED 1.3.1 General Eligibility The Home Care for the Elderly program serves elders age 60 and older at risk of placement in a nursing home or other institutional settings who can remain in a family style setting through the provision of subsidies. 1.3.2 Client Eligibility Clients eligible to receive services under this agreement must: (1) Be 60 years of age or older; (2) Have income less than the Institutional Care Program(ICP) standard. (3) Meet the ICP asset limitation; (4) Be at risk of nursing home placement; 20 1602 2 (5) Have an approved adult caregiver living in the home with them who is willing to provide ( ) PP g g g P care or assist in arranging for care; and (6) Not be enrolled in the Aged and Disabled Adult Medicaid waiver or a Medicaid capitated long-term care program. 1.3.3 Caregiver Eligibility Caregivers eligible to receive services under this agreement must: (1) Be at least 18 years of age, capable of providing a family-type living environment; (2) 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; (3) Be willing to accept responsibility for the social, physical and emotional needs of the care Vendor; (4) Be physically present and live in the home to provide supervision and to assist in arrangement of services for the client; (5) 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 (6) Be without record of conviction of abuse, neglect or exploitation of another person. 1.3.4 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meet the diverse needs of the functionally impaired elders and their caregivers. The Vendor shall ensure Basic Subside and Special Subsidy services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. 2.1. Basic Subsidy The Basic Subsidy is a cash payment made to an approved caregiver each month to reimburse some expenses incurred in caring for the client. The Basic Subsidy is provided for support and maintenance of the client, including housing, food, clothing, and medical costs not covered by Medicaid, Medicare or any other insurance. A Basic Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. If the client is hospitalized or in any other temporary institution for 30 days or less,the full Basic Subsidy shall be provided to the caregiver as if the client were in the home. 2.2. Special Subsidy Services Though every eligible HCE client receives a Basic Subsidy, Special Subsidy payments are pre-authorized and are based on additional specialized medical or health care services, supplies or equipment needed to maintain the health and well-being of the individual elder. The Special Subsidy for additional medical support and special services is a cash payment to reimburse the costs of any other service or special care not covered by Medicaid, Medicare, or private insurance when these services are determined to be 21 1602 essential to maintain the well-being of the home care recipient. A Special Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. Special Subsidy 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: 2.2.1 SERVICE LOCATION AND EQUIPMENT 2.2.2 Service Times The vendor shall ensure the provision of the services listed in this contract are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m.to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the Agency's reporting requirements. Service Unit of Service Adult Day Care Housing Improvement Case Aide Other Case Management Personal Care Hour Chore Respite(Facility Based or In-Home) Chore(Enhanced) Skilled Nursing Services Homemaker Material Aid Episode Specialized Medical Equipment, Services and Supplies Transportation One-Way Trip 2.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permits the Vendor to meet the County's reporting requirements. 2.2.1 Service Costs Reports The Vendor shall submit to the County the semi-annual service cost reports, August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.3 RECORDS AND DOCUMENTATION 2.3.1 The Vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The 22 1602 2 Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 2.4 PERFORMANCE SPECIFICATIONS 2.4.1 Outcomes (1) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (2) The Vendor shall timely submit to the County all reports described in SECTION 2.2 REPORTS; and (3) The Vendor shall timely submit to the County all information described in, SECTION 2.3 RECORDS AND DOCUMENTATION. 2.5 COUNTY RESPONSIBILITIES 2.5.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled,unscheduled and follow-up on-site visits; (3) Client visits; (4) Review of independent auditor's reports; (5) Review of third-party documents and/or evaluation; (6) Review of progress reports; (7) Review of customer satisfaction surveys; (8) Agreed-upon procedures review by an external auditor or consultant; (9) Limited-scope reviews; and (10) Other procedures as deemed necessary. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The 23 1602 vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services, which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1,2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 24 1602 EXHIBIT 3 STATEMENT OF WORK ALZHEIMER'S DISEASE INITIATIVE PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Alzheimer's Disease(AD) Alzheimer's Disease Initiative(ADI) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System(CIRTS) Community Care for Disabled Adults (CCDA) Department of Elder Affairs(DOEA) Home Care For Disabled Adults(HCDA) Instrumental Activities of Daily Living(IADL) Memory Disorder Clinic(MDC) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults (HCDA) services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026. 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 County enters ADI specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 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. Model Day Care: A program of therapeutic, social and health activities specific to clients with memory disorders. Services and activities include, but are not limited to, active and quiet 25 1602 2 games, reminiscence, validation therapy, pet therapy, water therapy and other failure free activities appropriate to the client's level of functioning. Model day care centers will also provide training for health care and social service personnel in the care of persons having AD or related memory disorders. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The ADI program provides a continuum of services addressing the special needs of individuals with AD,their families and caregivers. 1.2.2 Alzheimer's Disease Initiative Program Mission Statement The ADI program ensures that persons afflicted with AD and other forms of dementia are given essential services to help them age in place in an elder-friendly environment with security, dignity, and purpose. The program also provides support to family members and caregivers of persons afflicted with AD. 1.2.3 Authority The relevant authority governing the Alzheimer's Disease Initiative Program are as follows: (1) Rule Chapter 58D-1, Florida Administrative Code; and (2) Sections 430.501 through 430.504,Florida Statutes. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1) CFO Memo No. 02: Release date,August 20, 2010; (2) CFO Memo No. 03: Release date,June 29,2010; and CFO Memo No. 06: Release date, June 30, 2010. 1.2.3.2 Scope of Service The Vendor is responsible for the programmatic, fiscal, and operational management of the ADI program. The program services shall be provided in a manner consistent with and described in the current Vendor's Request for Proposal, RFP, and the County's current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.3.4 Major Program Goals The major goal of the ADI program is to provide services to meet the needs of caregivers and individuals with AD and related memory disorders. 1.3 INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The ADI Program addresses the special needs of individuals with AD and their caregivers. 1.3.2 Individual Eligibility Those individuals eligible to receive services under this contract must meet the following conditions: (1) Be 18 years of age or older and have a diagnosis of AD or a related disorder, or be 26 suspected of having AD or a related disorder; and 1 P g disorder; D 2 (2) Not be enrolled in a Medicaid capitated long-term care program. 1.3.3 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. SERVICE TASKS In order to achieve the goals of the ADI program, the Vendor shall ensure the following tasks are performed: (1) Client eligibility determination; (2) Assessment and prioritization of service delivery for new clients; (3) Delivery of services to eligible clients; and (4) Monitor the performance of vendors. 2.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described in this SECTION 1.3. 2.2 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services addressing the diverse needs of individuals with AD and their caregivers. The Vendor shall ensure services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. Services categories include: (1) Caregiver Training/Support; (2) Case Aid; (3) Case Management; (4) Counseling(Gerontological); (5) Counseling(Mental Health/Screening); (6) Education/Training; (7) Model Day Care; ( 8) Respite(Facility-Based); ( 9) Respite(In-Home); and (10) Specialized Medical Equipment, Services, and Supplies. Caregivers benefit from receiving training, respite and related support services to assist them in caring for the ADI client. 2.3 Service Times The Vendor shall ensure the provisions of the services listed in this contract are available 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. 27 1602 3. DELIVERABLES 3.1. Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the County's reporting requirements. Service Unit of Service Caregiver Training/Support; Hour Case Aid; Hour Case Management; Hour Counseling(Gerontological); Hour Counseling(Mental Health/Screening); Hour Respite(Facility-Based); Hour Respite(In-Home); Hour Education/Training; Episode Episode 3.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. 3.2.1 Service Costs Reports Vendor must submit to the County the semi-annual service cost reports August 1, 2013 and February 1,2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 3.3 RECORDS AND DOCUMENTATION 3.3.1 The Vendor and each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 4. PERFORMANCE SPECIFICATIONS 4.1 Outcomes (4) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (5) The Vendor shall timely submit to the County all reports described in SECTION 3.2 REPORTS; and (6) The Vendor shall timely submit to the County all information described in SECTION 3.3 28 16132 RECORDS AND DOCUMENTATION. 5. COUNTY RESPONSIBILITIES 5.1. Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-up on-site visits; (3) Client visits (4) Review of independent auditor's reports (5) Review third-party documents and/or evaluations (6) Review of progress reports (7) Review of customer satisfaction surveys (8)Agreed-upon procedures review by an external auditor or consultant; (9)Limited-scope reviews; and (10)Other procedures as deemed necessary. 6. SECTION III: METHOD OF PAYMENT 6.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 6.1.2 Remedies-Nonconforming Services The Vendor shall ensure that all goods and/or services provided under this agreement for HCE funded programs are delivered timely, completely and commensurate with required standards of quality Such goods and/or services shall only be delivered to eligible program participants. If the Vendor fails to meet the prescribed quality standards for services, such services will not be reimbursed under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be reimbursed under this agreement. The Vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the Vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County requires immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 6.1.3 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the Vendor and any adjustments thereto, including any disallowance not resolved. 6.1.4 Date for Final Request for Payment 29 1602 The final request for payment for agreement year one's expenditures will be due to the County no later than August 1,2013. The final request for payment for agreement year two expenditures will be no later than August 1,2014. 6.2 Documentation for Payment The Vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals upon request. Such documentation shall be provided upon request to the County or the Clerk of Court. 30 EXIT 4 1602 STATEMENT OF WORK OLDER AMERICANS ACT PROGRAM TITLE III SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 CONTRACT ACRONYMS Area Agency on Aging(AAA) Activities of Daily Living(ADL) Alliance of Information &Referral Systems(AIRS) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System (CIRTS) Information and Referral (I&R) Instrumental Activities of Daily Living(IADL) Older Americans Act(OAA) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in Its PSA in accordance with the Section 306 (42 U.S.C. 3026)of the OAA and Department instructions. Child: An individual who is not more than 18 years of age or an individual with disability. Family Caregiver: An adult family member, or another individual,who is an informal provider of in-home and community care to an older individual. Frail: When an older individual is unable to perform at least two ADLs without substantial human assistance, including verbal reminding, physical cueing or supervision; or due to cognitive or other mental impairment, requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to another individual. 1.2 County Mission,Vision and Values Statement The County's mission: To help aging adults achieve greater independence through awareness of resources and access to qualified service providers.The County's vision: To be the recognized leader in supporting older adults and their families with access to trustworthy resources and services in their communities while empowering them to live with independence and dignity. The County's values: We believe residents of Southwest Florida are entitled to: Comprehensive information about their choices of care; Timely access to resources and services; High standards of quality and performance; and Personal and professional accountability from all stakeholders. 1.2.1 Older Americans Act Program Mission Statement The Older Americans Act(OAA) Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. 31 1.3 GENERAL DESCRIPTION 1 6 1.3.1 General Statement Q The OAA Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. The primary purpose of the OAA program is to foster the development and implementation of comprehensive and coordinated systems to serve older individuals. The OAA program uses these systems to assist older individuals to attain and maintain maximum independence and dignity in a home environment and allows for the capability of self- care with appropriate supportive services. 1.3.2 Authority The relevant references authority governing the OAA program are: 1. Older Americans Act of 2006, as amended; 2. Rule 58A-1, Florida Administrative Code; and 3. Section 430.101, Florida Statutes. 1.3.2.1 Incorporation of Reference Memoranda In accordance with Ch. 287 F.S., as amended,and Agency of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and incorporated by reference: 1. CFO Memo No. 02: Release date,August 20, 2010; 2. CFO Memo No. 03: Release date,June 29,2010; and 3. CFO Memo No. 06: Release date, June 30,2010. 1.3.3 Scope of Service The Vendor shall provide services in a manner consistent with and descried in the current area plan and current Department of Elder Affairs Programs and Services Handbook. 1.3.4 Major Program Goals The major goals of the OAA program are to improve the quality of life for older individuals, preserve their independence and prevent or delay more costly institutional care. These goals are achieved through the implementation of a comprehensive and coordinated service system that provides a continuum of service alternatives that meet the diverse needs of elders and their caregivers. 1.4 INDIVIDUALS TO BE SERVED 1.4.1 Eligibility(Title III Programs) 1.4.1.1 OAA Title III, General Consumers shall not be dually enrolled in an OAA program and a Medicaid capitates long-term care program. 1.4.1.2 OAA Title ll1E, Caregiver Support Services Eligibility for OAA Title IIIE, Caregiver Support Services, are as follows: 1. Family caregivers of individuals age 60 or older; 32 1602 2. Grandparents(age 55 or older)or older individuals(age 55 or older)who are relative caregivers; 3. Priority will be given to family caregivers who provide care for individuals with Alzheimer's disease and related disorders with neurological and organic brain dysfunction and for grandparents or older individuals who are relative caregivers who provide care for children with severe disabilities; and 4. For respite and supplemental services,a family caregiver must be providing care for an older individual who meets the definition of the term"frail" in OAA, Section 102 Paragraph 22. 1.4.2 Targeted Groups Preference shall be given to those with the greatest economic and social need,with particular attention to low-income older individuals, including those that are low-income minorities, have limited.English proficiency, and older individuals residing in rural areas. SECTION II—MANNER OF SERVICE PROVISION 2.1 SERVICE TASKS In order to achieve the goals of the OAA program,the Vendor shall ensure the following tasks are performed: 1. Client eligibility determination; 2. Targeting and screening of service delivery for new clients; 3. Delivery of services to eligible clients; 4. Use of volunteers to expand the provision of available services; 5. Monitoring the performance of its vendors. 6. Grievance and Compliance Procedures 2.1.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described herein. 2.1.2 Targeting and Screening of Service Delivery for New Clients The Vendor shall develop and implement policies and procedures consistent with OAA targeting and screening Criteria 2.1.3 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meets the diverse needs of elders and their caregivers. The Vendor shall ensure the performance and report performance of the following services in accordance with the current Department of Elder Affairs Programs and Services Handbook. The services funded pursuant to this contract are in accordance with the OAA,Title III, sections 321,331, 336 and 373 as follows: 1. Section 321,Title MB Supportive Services; 2. Section 373,Title IIIR Caregiver Support Services. 2.1.3.1 Supportive Services Supportive services include a variety of community-based and home-delivered services that support the qualities of life for older individuals by helping them remain independent and productive. Services include the following: 33 I 6c (1) Adult Day Care/Adult Day Health Care; (17) Homemaker; (2) Caregiver Training/Support; (18) Housing Improvement; (3) Case Aide/Case Management; (19) Information; (4) Chore Services; (20) Intake; (5) Companionship; (21) Interpreter/Translating; (6) Counseling(Gerontological and Mental Health); (22) Referral/Assistance; (7) Education/Training; (23) Personal Care; (8) Legal Assistance; (24) Physical Therapy; (9) Material Aid; (25) Shopping Assistance; (10) Occupational Therapy; (26) Skilled Nursing; (11) Outreach; (27) Specialized Medical Equipment, Services, and Supplies (12) Recreation; (28) Respite Services; (13) Emergency Alert Response; (29) Screening/Assessment; (14) Escort; (30) Speech Therapy; (15) Health Support; (31) Telephone Reassurance; and (16) Home Health Aide; (32) Transportation 2.1.3.4 Caregiver Support Services (Title U E Program) The following services are intended to provide direct help to caregivers, assist in the areas of health, nutrition and financial literacy and assist caregivers in making decisions and problem solving related to their caregiving roles and responsibilities: (1) Adult Day Care/Adult Day Health Care; (2) Caregiver Training/Support; (3) Counseling(Gerontological and Mental Health); (4) Education/Training; (5) Financial Risk Reduction(Assessment and Maintenance); (6) Information; (7) Intake; (8) Outreach; (9) Respite Services; (10) Screening/Assessment; and (11) Transportation 2.1.3.5 Caregiver Support Supplemental Services (Title HIES Program): The following services are provided to complement the care provided by caregivers: (1) Chore Services; (2) Housing Improvement; (3) Legal Assistance; (4) Material Aid; and (5) Specialized Medical Equipment, Services and Supplies. 2.2 SERVICE LOCATION 34 1602 2.2.1 Service Times The Vendor shall ensure the provision of the services listed in the contract during normal business hours unless other times are more appropriate to meet the performance requirements of the contract, and it shall monitor its vendors to ensure they are available to provide services during hours responsive to client needs and during those times which best meet the needs of the relevant service community. 2.3 DELIVERABLES 2.3.1 Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the services tasks described in Section 2.1. The chart below lists the services allowed and the units of measurement. Units of service will be paid pursuant to the rate established in the 2010 RFP and approved by the County. Services Unit of Service Adult Day Care/Adult Day Interpreter/Translating Health Care Legal Assistance Caregiver Training/Support Medication Management Case Aid/Case Management Mental Health Counseling/Screening Chore Services Nutrition Counseling Companionship Occupational Therapy Counseling Services Personal Care Escort Physical Therapy Hour Financial Risk Reduction Recreation Services Respite Services Health Support Screening/Assessment Home Health Aide Sitter Homemaker Skilled Nursing Services Housing Improvement Speech Therapy Intake Emergency Alert Response Day Education/Training Episode Information Material Aid Referral/Assistance Specialized Medical Equipment, Services and Supplies Telephone Reassurance Escort One-Way Trip Shopping Assistance Transportation 2.4 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permit the Vendor to meet the County's reporting requirements. 35 1602 2.4.2 Service Costs Reports The Vendor shall require vendors to submit to the Vendor semi-annual service cost reports on August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.4.5 Background Screening Affidavit of Compliance To demonstrate compliance with section 8 of the Standard Contract,the Vendor shall submit ATTACHMENT H, Background Screening Affidavit of Compliance annually, by January 15t. 2.5 RECORECORDS AND DOCUMENTATION Each Vendor and vendor,among other requirements,must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up.The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement in its contracts and/or agreements with vendors. These policies and procedures shall be made available to the County upon request. 2.6 PERFORMANCE SPECIFICATIONS 2.6.1 Outcomes (1)The Vendor shall ensure services provided under this contract are in accordance with the current DOEA Programs and Services Handbook, (2)The Vendor shall timely submit to the County all reports described herein (3)The Vendor shall timely submit to the County all information described in, Paragraph 2.5 RECORDS AND DOCUMENTATION. 2.7 VENDOR'S FINANCIAL OBLIGATIONS 2.7.1 Matching,Level of Effort,and Earmarking Requirements The Vendor shall provide match of at least 10 percent of the federal funds received. The Vendor's match will be made in the form of cash and/or in-kind resources. The Vendor will assure,through a provision in subcontracts,a match requirement of at least 10 percent of the cost for all services funded through this contract. The vendor's match will be made in the form of cash and/or in-kind resources. The Vendor shall report match by title each month. At the end of the contract period, the Vendor must properly match all OAA funds. 2.7.2 Title III Funds The Vendor assures compliance with Section 306 of the OAA, as amended in 2006, that funds received under Title III will not be used to pay any part of a cost incurred by the Vendor to maintain a contractual or commercial relationship that is not carried out to implement Title III. 2.8 COUNTY RESPONSIBILITIES 2.8.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the Vendor. 2.8.2 Program/Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this contract. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an on-site visit. The County's determination of acceptable performance shall be conclusive. The Vendor 36 16132 2 agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: 1. Desk reviews and analytical reviews; 2. Scheduled, unscheduled and follow-up on-site visits; 3. Client visits; 4. Review of independent auditor's reports-Exhibit 10; 5. Review of third-party documents and/or evaluation; 6. Review of progress reports; 7. Review of customer satisfaction surveys; 8. Agreed-upon procedures review by an external auditor or consultant; 9. Limited-scope reviews; and 10. Other procedures as deemed necessary. 2.8.3 Contract Monitoring The County shall, at its own discretion, conduct monitoring concerning any aspect of the vendor's performance of this contract. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for OAA IIIE and OAA IIIES funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rate for services is ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services,which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 37 1602 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services,upon request. 38 1602 2 EXHIBIT 5 Agreement#12-5856 "Services for Seniors Attachment B Invoice and Logs (Minimum Standard Invoice Information) County Purchasing Order Number: Invoice Number: Grant Name: From Date To Date Reimburse ment Rate Per Unit to Total Supplier TOTAL AMOUNT Cost In Kind (Subtract (Multiply the Service Description In Kind Unit Reimbursement (identified by line) Per Match Match Quantity Rate Per Unit to Service Amount Amount Supplier x the Unit Unit from Total Quantity) Cost Per Service Unit) $0.00 $0.00 $0.00 Total $0.00 I certify to the best of my knowledge and belief that this invoice, and attached service detail log, is complete and correct and all outlay herein are for the purposes set forth in the contract, and that services are ordered by the case manager as agreed on the Contract. Legible copies of the dated timesheet, signed by the client and the worker supporting this invoice must be available upon request. Collier County reserves the right to correct computation of errors to assure proper payment amount. Prepared by: Date: Adjustment Reasons Lead Agency Authorization Attachments: Monthly Service log, Weekly Detail log and Client Service time sheets. 39 1602 EXHIBIT 6 Detail Weekly for CCE Services Week Ending: Invoice No Personal CLIENT Care Homemaker Respite Skilled Companion Chore Total Total Total Total Total Total NAME Units Units Units Units Units Units Total Hours - - - - - - $ PECA - HMK - $ RESPITE - $ SKILLED - $ COMPANION - $ CHORE - $ TOTAL - 40 1602 C EXHIBIT 7 Monthly Detail Service Log Grant Name: Vendor Name, Address: From Date To Date By client,provide the total number of hours provided during the dates of service. This log must be submitted with your monthly invoice for the Invoice From Date and To Date. Respite Adult Respite Emergency Client Personal Home- Skilled (In- Chore Enhance Com— Shopping Escort Alert (In- Day Name Care maker Nursing Chore panion Assist Response Home) Care Facility System 41 EXHIBIT 8 16D2 Daycare Grant: Grant Service: ADC or RESF Vendor Name and Address By client, provide the Weekly Client Service Time Sheet provided during the dates of service. This log must be submitted with all invoices for the invoice From Date and To Date. TO FROM DATE: DATE: Client Thur Uni Client Name signature Mon Tue Wed s Fri Sat Sun Match is Service Dates 42 1602 EXHIBIT 9 YOUR COMPANY NAME HERE Collier County Services for Seniors Homemaker/Personal Care/Respite/Companion Work Sheet Client Name: Client Signature: Week Ending: Each Time You Perform one of the Activities Below: Put in arrival and departure times for the day worked: ****Client should Initial time of arrival and departure. ****Client should Sign form at top. ****you should sign your name at the bottom. Date: Day: MON TIES WED THIR FRI SAT SUN TOTAL TIME ARRIVAL TIME: DEPARTURE TIME: ****CLIENT INITIALS: Arrive: PERSONAL CARE Depart: Assist W/Bath tub Shower Bed T Assist W/Dressing Bathroom Assist Shave (Face Only) Oral Hygiene Walking/Ambulation Feeding Assistance Wash/Set Hair Backrub_Soak Feet_ Nails (File only) Change_Make_Bed Take out Trash Clean Bedroom Clean Bathroom Prepare Meals Laundry Arrive: HOME MAKING Depart: Vacuum/Sweep Light Dusting 43 1613 2 Clean Kitchen Floor, Wash Dishes Mop Sweep__ Grocery Shop • Errands Arrive: RESPITE Depart: Arrive: COMPANION Depart: EMPLOYEE'S Signature/Title 44 16D2 EXHIBIT 10 OMB Circular A-133 Audits of States, Local Governments, and Non-Profit Organizations requires the Collier County Housing, Human and Veterans Services Department to monitor our subrecipients of federal awards and determine whether they have met the audit requirements of the circular and whether they are in compliance with federal laws and regulations. Accordingly, we are requiring that you check one of the following, provide all appropriate documentation regarding your organization's compliance with the audit requirements, sign and date this form. Subrecipient Fiscal Year Name Period Total State Financial Assistance Expended during $ most recently completed Fiscal Year Total Federal Financial Assistance Expended during most $ recently completed Fiscal Year Check Appropriate Boxes We have exceeded the $500,000 federal/state expenditure threshold for our fiscal year ending as indicated above and have completed our Circular A-133 audit. A copy of the audit report and management letter are attached. We exceeded the $500,000 federal/state expenditure threshold for our fiscal year n ending as indicated above and expect to complete our Circular A-133 audit by . Within 30 days of completion of the A-133 audit, we will provide a copy of the audit report and management letter. We are not subject to the requirements of OMB Circular A-133 because we: I I Did not exceed the $500,000 federal/state expenditure threshold for the fiscal year indicated above Are a for-profit organization Are exempt for other reasons — explain An audited financial statements is attached and if applicable, the independent auditor's management letter. (If findings were noted, please enclose a copy of the responses and corrective action plan.) Certification Statement I hereby certify that the above information is true and accurate. Signature Date Print Name and Title 45 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 ® 2 3 TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE \ ..i '- Routed by Purchasing Department to Office Initials Date the Following Addressee(s) (In routing order) 1. Risk Management Risk 2. County Attorney Office County Attorney Office 6 1 .!i3 3. BCC Office Board of County V dtG Commissioners il 4. Minutes and Records Clerk of Court's Office —Pm (Z: p" 5. Return to Purchasing Department Purchasing Contact: Diana DeLeon PRIMARY CONTACT INFORMATION Name of Primary Diana DeLeon for Lisa Can,HHVS, Phone Number 252-8375 Purchasing Staff June 10,2013 Contact and Date ./ Agenda Date Item was May 28,2013 V Agenda Item Number 16.D.2 Approved by the BCC Type of Document Contract Amendment Number of Original 2 Attached Documents Attached PO number or account N/A Solicitation/Contract Amend#1 to Contract 12- number if document is NumberNendor Name 5856 Gulf Coast Assisting to be recorded Hands INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature? DD 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's DD signature and initials are required. 7. In most cases(some contracts are an exception),an electronic copy of the document and DD this routing slip should be provided to the County Attorney's Office before the item is input into SIRE. 8. The document was approved by the BCC on the date above and all changes made DD during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC,all changes directed by the BCC have been made,and the document is ready for the Chairman's signature. 160 21 MEMORANDUM Date: June 17, 2013 To: Diana De Leon, Contract Technician Purchasing Department From: Martha Vergara, Deputy Clerk Minutes & Records Department Re: Amendment #1 - Contract #12-5856 "Services for Seniors" Contractor: Gulf Coast Assisting Hands, Inc. d/b/a Assisting Hands Home Care Attached, is an original of the assumption agreement referenced above (Agenda Item #16D2), approved by the Board of County Commissioners on Tuesday, May 28, 2013. The original will be held on file with the Minutes and Record's Lepartment in the Board's Official Records. If you have any questions, please contact me at 252-7240. Thank you. Attachment 160 2 Contract Amendment#1 Contract # 12-5856 "Services for Seniors" This CONTRACT AMENDMENT #1, dated • , 2013 to the referenced agreement shall be by and between the parties to the original Agree ent, Gulf Coast Assisting Hands, Inc. d/b/a Assisting Hands Home Care (to be referred to as"Vendor") and Collier County, Florida, (to be referred to as "County"). Statement of Understanding RE: Contract# 12-5856 "Services for Seniors" In order to continue services for the original Contract document referenced above, the Vendor agrees to the terms and conditions set forth in Exhibit A-1A, which includes Attachments C-H and Exhibits 1-10 attached hereto and incorporated by reference. The Vendor further agrees to amend Section 1, Commencement, as follows: 1. COMMENCEMENT. This Agreement shall Commence on December 11, 2012 and shall terminate on December 10, 2014 June 30, 2014. The Contract award is a two (2) year contract, with the possibility of two (2) additional (2) year terms pending funding from grantors and acceptable performance by the awarded vendor. Any such renewals shall be mutually agreed upon in writing by the parties. The maximum duration for this Contract for CCE, HCE, ADI, OAA IIIE AND OAA HIES funding will not exceed six (6) years (through June 30, 2018). As outlined in RFP #12-5856, the County requires the Vendor to contribute a cash or in-kind match of no less than ten (10) percent for all services related to the Community Care for the Elderly Program, (CCE), Older American Title HIE Caregiver Support (OAA HIE) and Older American Title HIES Caregiver Support Supplemental Services(OAA IIIES)Programs. Words that have been deleted are struck through, words underlined have been added. Modification made herein shall apply as if incorporated into the Contract on the date of Commencement. All other terms and conditions of the agreement shall remain in force. IN WITNESS WHEREOF, the Vendor and the County have each, respectively, by an authorized person or agent, hereunder set their hands and seals on the date(s) indicated below. Accepted: 4 , 2013 VENDOR: ��Gulf Coast Assisting Hands, Inc. d/b/a Assisting Hands Home Care. `First Witness By: 'ECG / ff7(/f 01/9/7/ fpe/print witne name Print/Type Name and Title s econd Witness Type/print witness name 1 160 21 COUNTY: ATTEST: BOARD OF COUNTY COMMISSIONERS DWIGHT.E.,$ROCK, CLERK OF COLLIER COUNTY, FLORIDA atallIKAI_/ By A r Pe t LE' ' G lu 'I IA A. HILLER, ESQ. Attest es .CMa 's. V C • IRWOMAN signature ealij � Approval for form and legal Sufficiency: Jenni B. White e. Assistant County Attorney 2 1 !) 2 1 EXHIBIT A-lA AGREEMENT 12-5856 SERVICES FOR SENIORS ATTACHMENTS ATTACHMENT ATTACHMENT DESCRIPTION PAGE Attachment C Core Standards for CCE, HCE, ADI, OAA IIIE & IIIES 2 Attachment D Certification Regarding Lobbying 8 Attachment E Certification Regarding Data Integrity Compliance 9 Attachment F Certification Regarding Debarment, Suspension, 10 Ineligibility and Voluntary Exclusion Contracts/ Subcontracts Attachment G Sub-Recipient Invoice Submission 11 Attachment H Background Screening Affidavit of Compliance 12 Exhibit 1 CCE Statement of work 13 Exhibit 2 HCE Statement of work 19 Exhibit 3 ADI Statement of work 25 Exhibit 4 OAA IIE and OAA IIIES Statement of work 31 Exhibit 5 Invoice 39 Exhibit 6 Detail Weekly Log 40 Exhibit 7 Monthly Log 41 Exhibit 8 Day Care/Respite Time Sheet 42 Exhibit 9 Program Time Sheet 43 Exhibit 10 Annual Audit Monitoring Report 45 1 cq ATTACHMENT C 1 6 "`j Core Standards for CCE,HCE,ADI,OAA HIE &HIES 1. Compliance with Federal Law 1.1 If this agreement contains federal funds the following shall apply: 1.1.1 The vendor shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable regulations. 1.1.2 If this agreement contains federal funds and is over$100,000.00,the vendor shall comply with all applicable standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s. 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable Environmental Protection County regulations 40 CFR 30. The vendor shall report any violations of the above to the County. 1.1.3 The vendor may not use any federal funds received in connection with this agreement to influence legislation or appropriations pending before the Congress or any state legislature. If this agreement contains federal funding in excess of$100,000.00,the vendor must, prior to agreement execution, complete the Certification Regarding Lobbying form, ATTACHMENT D. All disclosure forms as required by the Certification Regarding Lobbying form must be completed and returned to the Grant Coordinator prior to payment under this agreement. 1.1.4 In accordance with Appendix A to 2 CFR 215, the vendor shall comply with Executive Order 11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in Department of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable. 1.1.5 If this agreement contains federal funds and provides services to children up to age 18,the vendor shall comply with the Pro-Children Act of 1994(20 U.S.C. 6081). 1.1.6 A agreement award with an amount expected to equal or exceed $25,000.00 and certain other agreement 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 vendor shall comply with these provisions before doing business or entering into sub-agreements receiving federal funds pursuant to this agreement. The vendor shall complete and sign ATTACHMENT F prior to the execution of this agreement. 1.2 The vendor shall not employ an unauthorized alien. The County 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 agreement by the County. 2 16021 21 1.3 If the vendor 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 vendor must notify the County in writing within thirty(30) days of receiving the IRS notice of revocation. 1.4 The vendor shall comply with Title 2 CFR Part 275 regarding Trafficking in Persons. 1.5 Unless exempt under 2 CFR Part 170.110(b), the vendor shall comply with the reporting requirements of the Transparency Act as expressed in 2 CFR 170. 1.6 To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number 11-116, vendor agrees to utilize the U.S. Department of Homeland Security's E-verify system to verify the employment of all new employees hired by vendor during the agreement term. Vendor meeting the terms and conditions of the E-Verify System are deemed to be in compliance with this provision. 2. Compliance with State Law 2.1 This agreement is executed and entered into in the State of Florida, and shall be construed, performed and enforced in all respects in accordance with the Florida law, including Florida provisions for conflict of laws. 2.2 The vendor shall comply with requirements of s. 287.058, F.S. as amended. 2.2.1 The vendor shall provide units of deliverables, including various client services, and in some instances may include reports, findings, and drafts, as specified in this agreement,which the Grant Coordinator must receive and accept in writing prior to payment in accordance with s. 215.971, F.S. (1)and(2). 2.2.2 The vendor shall submit bills for fees or other compensation for services or expenses in sufficient detail for a proper pre-audit and post-audit. 2.2.3 The vendor 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 vendor in conjunction with this agreement except for those records which are made confidential or exempt by law. The vendor's refusal to comply with this provision will constitute an immediate breach of agreement for which the County may unilaterally terminate the agreement. 2.3 If clients are to be transported under this agreement, the vendor shall comply with the provisions of Chapter 427,F.S., and Rule 41-2, F.A. C. 2.4 Vendors who are on the discriminatory vendor list may not transact business with any public entity, in accordance with the provisions of s. 287.134,F.S. 2.5 The vendor shall comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the expenditure of agreement funds for the purpose of lobbying the legislature,judicial branch or a state agency. 3. Background Screening The vendor shall ensure that the requirements of s. 430.0402 and ch. 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 exempted from the Department's level 2 background screening 3 CA 0 160 pursuant to s. 430.0402(2)-(3), F.S. The vendor must also comply with any applicable rules promulgated by the Department and the Agency for Health Care Administration regarding implementation of s. 430.0402 and ch. 435,F.S. Further information concerning the procedures for background screening are found at http://elderaffairs.state.fl.us/doea/backgroundscreening.php. 4. Provision of Services The vendor shall provide services in the manner described herein. 5. Monitoring by the County The vendor shall permit persons duly authorized by the County to inspect and copy any records, papers, documents, facilities, goods and services of the vendor which are relevant to this agreement, and to interview any clients, employees and vendor employees of the vendor to assure the County of the satisfactory performance of the terms and conditions of this agreement. Following such review, the County will provide a written report of its findings to the vendor, and where appropriate,the vendor shall develop a corrective action plan. The vendor hereby agrees to correct all deficiencies identified in the corrective action plan in a timely manner as determined by the Grant Coordinator. 6. Confidentiality of Information The vendor shall not use or disclose any information concerning a vendor of services under this agreement 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. 7. Health Insurance Portability and Accountability Act Where applicable, the vendor shall comply with the Health Insurance Portability and Accountability Act (42 USC 1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162,and 164). 8. Bankruptcy Notification During the term of this agreement,the vendor shall immediately notify the County if the Vendor, its assignees,vendors or affiliates file a claim for bankruptcy. Within ten (10)days after notification,the vendor must also provide the following information to the County.: (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.,United States Bankruptcy Court Middle District of Florida,Naples, FL); and, (4)The name, address, and telephone number of the bankruptcy attorney. 9. Sponsorship and Publicity 9.1 As required by s. 286.25, F.S., if the vendor is a non-governmental organization which sponsors a program financed wholly or in part by state funds, including any funds obtained through this agreement, it shall, in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by Hope Hospice and Community Services,the State County of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County." If the sponsorship reference is in the written material, the words "State of Florida, Department of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County" shall appear in at least the same size letters or type as the name of the organization. 9.2 The vendor shall not use the words"The State of Florida Department of Elder Affairs or the Area County on Aging for Southwest Florida, Inc. or Collier County" to indicate sponsorship of a program otherwise financed, unless specific authorization has been obtained by Collier County, or the Area Aging on Aging prior to use. 4 CA D 2 10. Independent Capacity of Vendor It is the intent and understanding of the Parties that the vendor, or any of its vendors, are independent vendors and are not employees of the County and shall not hold themselves out as employees or agents of the County without specific authorization from the County. It is the further intent and understanding of the Parties that the County does not control the employment practices of the vendor and will not be liable for any wage and hour, employment discrimination, or other labor and employment claims against the vendor or its vendors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary insurance for the vendor are the sole responsibility of the vendor. 11. Payment Payments shall be made to the vendor pursuant to s. 215.422, F.S., as services are rendered and invoiced by the vendor. The Grant Coordinator will have final approval of the invoice for payment, and will approve the invoice for payment only if the vendor has met all terms and conditions of the agreement, unless the bid specifications, purchase order, or this agreement specify otherwise. The approved invoice will be submitted to the County's Grant Coordinator approval and processing. 12. Return of Funds The vendor shall return to the County any overpayments due to unearned funds or funds disallowed and any interest attributable to such funds pursuant to the terms and conditions of this agreement that were disbursed to the vendor by the County. In the event that the vendor or its independent auditor discovers that an overpayment has been made, the vendor shall repay said overpayment immediately without prior notification from the County. In the event that the County first discovers an overpayment has been made, the Grant Coordinator will notify the vendor in writing of such findings. 13. Data Integrity and Safeguarding Information The vendor shall ensure an appropriate level of data security for the information the vendor is collecting or using in the performance of this agreement. An appropriate level of security includes approving and tracking all vendor employees that request system or information access and ensuring that user access has been removed from all terminated employees. The vendor, 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 vendor shall ensure all vendors maintain written procedures for computer system backup and recovery. The vendor shall complete and sign Attachment E prior to the execution of this agreement. 14. Computer Use and Social Media Policy The Department of Elder Affairs has implemented a new 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, Area Agencies on Aging and vendors. 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. 15. Public Entity Crime Pursuant to s. 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 5 160 2 1 agreement to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on a agreement 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 vendor, supplier, vendor, or consultant under a agreement with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in s. 287.017, F.S., for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted vendor list. 16. Patents,Copyrights,Royalties If this agreement 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 agreement, the vendor shall refer the discovery, invention or material to the County to be referred to the Department of State and the Department of Elder Affairs. Any and all patent rights or copyrights accruing under this agreement are hereby reserved to the State of Florida in accordance with Chapter 286, F.S. Pursuant to s. 287.0571 (5) (k) 1 and 2 as amended, the only exceptions to this provision shall be those that are clearly expressed and reasonably valued in the agreement. 16.1 If the primary purpose of this agreement 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 Paragraph 33. 16.2 If this agreement is awarded solely federal funding, the terms and conditions are governed by 2 CFR 215.36. 17. Emergency Preparedness and Continuity of Operations 17.1 If the tasks to be performed pursuant to this agreement include the physical care and control of clients, or the administration and coordination of services necessary for client health, safety or welfare, the vendor shall, within thirty (30) calendar days of the execution of this agreement, submit to the Grant Coordinator verification of an emergency preparedness plan. In the event of an emergency,the vendor shall notify the County of emergency provisions. 17.2 In the event a situation results in a cessation of services by a vendor, the vendor shall retain responsibility for performance under this agreement and must follow procedures to ensure continuity of operations without interruption. 18. Financial Consequences of Non-Performance If the vendor fails to meet the minimum level of service or performance identified in this agreement, or that is customary for the industry, then the County must apply financial consequences commensurate with the deficiency.Financial consequences may include,but are not limited to, agreement suspension, refusing payment, withholding payments until deficiency is cured, tendering only partial payments, and/or cancellation of agreement and reacquiring services from an alternate source. 18.1 The vendor will not be charged with financial consequences, when a failure to perform arises out of causes that were the responsibility of the County. 19. No Waiver of Sovereign Immunity 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. 20. Venue If any dispute arises out of this agreement,the venue of such legal recourse will be Collier 6 �'t 160 21 County, Florida. 21. Entire Agreement This agreement contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations shall be valid or binding upon the County or the vendor unless expressly contained herein or by a written amendment to this agreement signed by both Parties. 22. 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. 23. 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. 24. Waiver The delay or failure by the County to exercise or enforce any of its rights under this agreement will not constitute or be deemed a waiver of the County'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. 25. Compliance The vendor shall abide by all applicable current federal statutes, laws, rules and regulations as well as applicable current state statutes, laws, rules, regulations and County rules, ordinances and regulations. The Parties agree that failure of the vendor to abide by these laws shall be deemed an event of default of the vendor, and subject the agreement to immediate, unilateral cancellation of the agreement at the discretion of the County. 26. Final Invoice The vendor shall submit the final CCE, HCE, ADI, IIE and IIIES invoice for payment to the County on July 3, 2013. If the vendor fails to submit final request for payment by the deadline, then all rights to payment may be forfeited and the County may not honor any requests submitted after the aforesaid time period. Any payment due under the terms of this agreement may be withheld until all reports due from the vendor and necessary adjustments thereto have been approved by the County. 27. Renegotiations or Modifications Modifications of the provisions of this agreement shall be valid only when they have been reduced to writing and duly signed by both parties. The rate of payment, contract requirements and the total dollar amount may be adjusted retroactively to reflect price level increases and changes in the rate of payment or language. 28. All Terms and Conditions Included This agreement and its Attachments, A-H and exhibits 1-4 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 agreement shall supersede all previous communications, representations or agreements, either written or verbal between the Parties. 7 Q 2 a ATTACHMENT D CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR AGREEMENTS,GRANTS,LOANS AND AGREEMENTS The undersigned certifies,to the best of his or her knowledge and belief,that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any State ,Federal or County, a member of congress, an officer or employee of congress, an employee of a member of congress, or an officer or employee of the state legislator, in connection with the awarding of any federal grant,the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal agreement, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of the County, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this federal agreement, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including vendors, sub-grants, and agreements under grants, loans and cooperative agreements)and that all vendors shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than$100,000 for each such failure. Signature Date Name of Authorized Individual Name and Address of Organization 8 1 6 '0 flig ATTACHMENT E CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS,GRANTS,LOANS AND COOPERATIVE AGREEMENTS The undersigned, an authorized representative of the vendor named in the agreement or agreement to which this form is an attachment,hereby certifies that: (1) The vendor and any vendors of services under this agreement 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 vendor, vendor(s), or any outside entity on which the vendor 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,vendor(s)will take immediate action to assure data integrity. (3) If this agreement 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 vendor (represented by the undersigned) and purchased by the State will be verified for accuracy and integrity of data prior to transfer. In the event of any decrease in functionality related to time and date related codes and internal subroutines that impede the hardware or software programs from operating properly, the vendor agrees to immediately make required corrections to restore hardware and software programs to the same level of functionality as warranted herein, at no charge to the State, and without interruption to the ongoing business of the state,time being of the essence. (4) The vendor and any vendor(s) of services under this agreement warrant their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data integrity compliance issues. The vendor shall require that the language of this certification be included in all vendors and other agreements and that all vendor shall certify compliance accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB Circulars A-102 and 2 CFR Part 215 (formerly OMB Circular A-110). Name and Address of vendor Signature Title Date Name of Authorized Signer 9 160 2 EXHIBIT F CERTIFICATION REGARDING DEBARMENT,SUSPENSION,INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS (1) The prospective vendor certifies, by signing this certification, neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or County. (2) Where the prospective vendor is unable to certify to any of the statements in this certification,such prospective participant shall attach an explanation to this certification. Signature Date Title County/Organization (Certification signature should be same as Agreement signature.) Instructions for Certification 1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "person," "primary covered transaction,"and"voluntarily excluded,"as used herein,have the meanings set out in the sections of rules implementing Executive Order 12549. (2 CFR 180.5-180.1020,as supplemented by 2 CFR 376.10-376.995). You may contact the Agreement Manager for assistance in obtaining a copy of those regulations. 2. This certification is a material representation of facts upon which reliance was placed when the parties entered into this transaction. If it is later determined that the vendor knowingly rendered an erroneous certification,in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension and/or debarment. 3. The vendor will provide immediate written notice to the Agreement Manager if at any time the vendor learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The vendor may decide the method and frequency by which it determines the eligibility of its principals. Each participant to a lower tier covered transaction may,but is not required to,check the Excluded Parties List System(EPLS). 4. The vendor will include a"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion- Lower Tier Covered Transaction"in all its lower tier covered transactions and in all solicitations for lower tier covered transactions. 5. The vendor agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise authorized by the federal government. 6. If the vendor knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction,in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension,and/or debarment. 7. The vendor may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended,ineligible,or voluntarily excluded from the covered transaction,unless it knows that the certification is erroneous. 10 16p 2 EXHIBIT G SUBRECIPIENT INVOICE SUMMISSION The County shall reimburse the SUBRECIPIENT for the performance of this Agreement upon completion or partial completion of the work tasks as accepted and approved by HHVS pursuant to the submittal of quarterly progress reports. Invoices for work performed are required every month. If no work has been performed during that month, or if the SUBRECIPIENT is not yet prepared to send the required backup, a$0 invoice will be required. Explanations will be required if two consecutive months of$0 invoices are submitted. Payments shall be made to the SUBRECIPIENT when requested as work progresses but, not more frequently than once per month. Final invoices are due no later than 90 days after the end of the agreement. Work performed during the term of the program but not invoiced within 90 days without written exception from the Grant Coordinator will not be reimbursed.No payment will be made until approved by HHVS for grant compliance and adherence to any and all applicable local, state or Federal requirements. Payment will be made upon receipt of a properly completed invoice and in compliance with §218.70, Florida Statutes, otherwise known as the "Local Government Prompt Payment Act." 11 DEPARTMENT OF h r Y r 1 EXHIBIT H 6 LJ n 21 BACKGROUND SCREENING ELDER AFFAIRS Affidavit of Compliance -Employer STATE OF FLORIDA 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 Employer Name located at Street Address City State ZIP code 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. Signature of Representative Date STATE OF FLORIDA,COUNTY OF Sworn to(or affirmed)and subscribed before me this day of , 20 , by (Name of Representative)who is personally known to me or produced 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:http://elderaffairs.state.fl.us/english/backgroundscreening.php 12 . . . . 161] 21 EXHIBIT 1 STATEMENT OF WORK COMMUNITY CARE FOR THE ELDERLY PROGRAM(CCE) SECTION I: SERVICES TO BE PROVIDED 1.1. DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 AGREEMENT ACRONYMS Activities of Daily Living(ADL) Adult Protective Services(APS) Assessed Priority Consumer List(APCL) Comprehensive Assessment and Review for Long-Term Care Services(CARES) Community Care for the Disabled Adult(CCDA) Community Care for the Elderly(CCE) Client Information and Registration Tracking System(CIRTS) Department of Children and Families(DCF) Department of Elder Affairs(DOEA) Home Care for Disabled Adults(HCDA) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out: The condition of reaching 60 years of age and being transitioned from the Department of Children and Families(DCF) Services,Community Care for Disabled Adults (CCDA)or Home Care for Disabled Adults(HCDA) services to the Department's community- based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in its planning and service area in accordance with the Section 306 (42 U.S.C. 3026) of the Older Americans Act and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the County enters CCE specific data in the CIRTS. An update may also include other revisions to the area plan as instructed by the County or Department of Elder Affairs. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The primary purpose of the CCE program is to prevent, decrease or delay premature or inappropriate and expensive placement of older persons in nursing homes and other institutions. 13 . . t . 16j3 2 1.2.2 Community Care for the Elderly Mission Statement The CCE Program assists functionally impaired elderly persons in living as independently as possible in their own homes or in the homes of relatives or caregivers. The program provides a continuum of care through the development, expansion, reorganization and coordination of multiple community-based services to assist elders to reside in the least restrictive environment suitable to their needs. 1.2.3 Authority The relevant authority governing CCE program are: (1)Rule 58C-1, Florida Administrative Code (2) Sections 430.201 through 430.207, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services Chief Financial Officer Memoranda the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1)CFO Memo No. 02: Release date,August 20, 2010; (2)CFO Memo No. 03: Release date,June 29, 2010; and (3) CFO Memo No. 06: Release date,June 30,2010. 1.2.4 Scope of Service The vendor shall provide services in a manner consistent with and descried in the current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the program are to preserve the independence of elders and prevent or delay more costly institutional care through a community care service system that provides case management and other in-home and community services as needed under the direction of the County and provide a continuum of service alternatives that meet the diverse needs of functionally impaired elders. 1.3. INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The CCE program provides a continuum of services for functional impaired elders. 1.3.2 Individual Eligibility In order to receive services under this agreement, an applicant must: (1) Be at least 60 years of age; (2) Be functionally impaired as determined through the initial comprehensive assessment; and (3) With the exception of APS high-risk referrals, consumers may not be dually enrolled in the CCE program and a Medicaid capitated long-term care program. 1.3.2.1 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution or who are abused, neglected or exploited. 14 1613 C SECTION II: MANNER OF SERVICE PROVISION 2. Delivery of Service to Eligible Clients The vendor shall ensure the provision of a continuum of service that meet the diverse needs of functionally impaired elders. The vendor shall ensure performance and reporting of the following service provision in accordance with the current DOEA Programs and Services Handbook. The services may include the following categories: (1) Core Services; (2) Health Maintenance Services;and (3) Other Support Services. Core Services for Programmatic Operation 2.1. The vendor may deliver core services include a variety of home-delivered services, day care services, and other basic services that are most needed to prevent unnecessary institutionalization. Core services,to be provided at the unit rate identified in this agreement, include the following: (1) Adult Day Care; (7) Housing Improvement; (2) Chore Services; (8) Respite Services; and (3) Enhanced Chore; (9) Transportation (4) Companionship; (5) Home Delivered Meals; (6) Homemaker; 2.1.1 Health Maintenance Services The vendor shall ensure that health maintenance services are routine health services that are necessary to help maintain the health of functionally impaired elders. The services are limited to medical therapeutic services, non-medical prevention services, personal care services, home health aide services, home nursing services, and emergency response systems. Typical services to be provided at the unit rate identified in this agreement, are the following: (1) Adult Day Health Care; (2) Emergency Alert Response; (3) Nutrition Counseling (4) Personal Care (5) Skilled Nursing Services; and (6) Specialized Medical Equipment Services and Supplies 2.2 SERVICE TIMES 2.2.1 Service Times 15 . . . . . 160 Z The vendor shall ensure the provisions of the services listed in this agreement are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m.to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the agreement in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this agreement as updated, and approved by the County's reporting requirements. Service Unit of Service Adult Day Care Homemaker Case Aide Housing Improvement Case Management Respite Services Chore Services Personal Care Hour Enhanced Chore Physical Therapy Companionship Skilled Nursing Services Emergency Alert Response Day Material Aid Episode Specialized Medical Equipment, Services and Supplies Escort Shopping Assistance One-Way Trip Transportation Service Unit of Service Home Delivered Meals Meal 2.4 REPORTS The vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The vendor shall establish due dates for any agreement that permits the vendor to meet the County's reporting requirements. Service Costs Reports The vendor shall submit to the County semi-annual service cost reports, August 1, 2013 and February 1, 2014, of each year which reflects actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.5 RECORDS AND DOCUMENTATION 2.5.1 Each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup 16 f • 16 211 2.6 COUNTY RESPONSIBILITIES 2.6.1 Program Guidance and Technical Assistance The County will provide to the vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the vendor. resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures will be made available to the County upon request. 2.7 PERFORMANCE SPECIFICATIONS 2.7.1 Outcomes (1) The vendor shall ensure services provided under this agreement are in accordance with the current Department of Elder Affairs Programs and Services Handbook. (2) The vendor shall timely submit to the County all information described in EXHIBIT 1, SECTION 2.4 REPORTS; and (3) The vendor shall timely submit to the County all information described in EXHIBIT 1, SECTION 2.5 RECORDS AND DOCUMENTATION. 2.8. VENDOR'S FINANCIAL OBLIGATIONS 2.8.1 Matching,Level of Effort,and Earmarking Requirement The vendor will assure a match requirement of at least 10 percent of the cost for all CCE services. The match will be made in the form of cash and/or in-kind resources. At the end of the agreement period, all CCE funds expended must be properly matched. State funds cannot be used to match another state-funded program. 3. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 17 1 0 21 3.4 Payment may be authorized only for allowable services,which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 18 1613 21 EXHIBIT 2 STATEMENT OF WORK HOME CARE FOR THE ELDERLY PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Adult Protective Services(APS) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) 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) Home Care for Disabled Adults(HCDA) Home Care for the Elderly(HCE) Institutional Care Program(ICP) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults(HCDA) services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026) and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the County enters HCE specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement Area Agencies on Aging may contract with CCE lead agencies or other case management entities for the provision of the HCE program. Approved caregivers receive a Basic Subsidy to reimburse some of their expenses each month for caring for the consumer and may receive a Special Subsidy for other necessary services and essential supplies. Caregivers may be approved 19 K:191 , . . . . 160 21 for up to three HCE clients in their home. 1.2.2 Home Care for the Elderly Program Mission Statement The Home Care for the Elderly Program supports family style living arrangements, on a non- profit basis,as an alternative to nursing homes or other institutional care. Through the program, a caregiver for three or fewer elders living in a private home provides basic services of maintenance and supervision as well as coordinating other necessary specialized services. 1.2.3 Authority The relevant authority governing the HCE program include: (1) Rule Chapter 58H-1, Florida Administrative Code; and (2) Sections 430.601 through 430.608, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services', Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: CFO Memo No. 02: Release date,August 20,2010; CFO Memo No. 03: Release date,June 29, 2010; and CFO Memo No. 06: Release date,June 30,2010. 1.2.4 Scope of Service The Vendor shall provide services in a manner consistent with and described in the current County's area plan update and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the HCE program are to ensure that: (1) Basic Subsidy is provided to the caregiver of each client and (2) Special Subsidy is provided when essential to the well-being of the client. 1.3 INDIVIDUAL TO BE SERVED 1.3.1 General Eligibility The Home Care for the Elderly program serves elders age 60 and older at risk of placement in a nursing home or other institutional settings who can remain in a family style setting through the provision of subsidies. 1.3.2 Client Eligibility Clients eligible to receive services under this agreement must: (1) Be 60 years of age or older; (2) Have income less than the Institutional Care Program(ICP) standard. (3) Meet the ICP asset limitation; (4) Be at risk of nursing home placement; 20 r*) 160a (5) Have an approved adult caregiver living in the home with them who is willing to provide care or assist in arranging for care; and (6) Not be enrolled in the Aged and Disabled Adult Medicaid waiver or a Medicaid capitated long-term care program. 1.3.3 Caregiver Eligibility Caregivers eligible to receive services under this agreement must: (1) Be at least 18 years of age,capable of providing a family-type living environment; (2) 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; (3) Be willing to accept responsibility for the social, physical and emotional needs of the care Vendor; (4) Be physically present and live in the home to provide supervision and to assist in arrangement of services for the client; (5) 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 (6) Be without record of conviction of abuse, neglect or exploitation of another person. 1.3.4 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meet the diverse needs of the functionally impaired elders and their caregivers. The Vendor shall ensure Basic Subside and Special Subsidy services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. 2.1. Basic Subsidy The Basic Subsidy is a cash payment made to an approved caregiver each month to reimburse some expenses incurred in caring for the client. The Basic Subsidy is provided for support and maintenance of the client, including housing, food, clothing, and medical costs not covered by Medicaid, Medicare or any other insurance. A Basic Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. If the client is hospitalized or in any other temporary institution for 30 days or less,the full Basic Subsidy shall be provided to the caregiver as if the client were in the home. 2.2. Special Subsidy Services Though every eligible HCE client receives a Basic Subsidy, Special Subsidy payments are pre-authorized and are based on additional specialized medical or health care services, supplies or equipment needed to maintain the health and well-being of the individual elder. The Special Subsidy for additional medical support and special services is a cash payment to reimburse the costs of any other service or special care not covered by Medicaid, Medicare, or private insurance when these services are determined to be 21 (2,-1 160 2 essential to maintain the well-being of the home care recipient. A Special Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. Special Subsidy 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: 2.2.1 SERVICE LOCATION AND EQUIPMENT 2.2.2 Service Times The vendor shall ensure the provision of the services listed in this contract are available at times appropriate to meet client service needs at a minimum,during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m.to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the Agency's reporting requirements. Service Unit of Service Adult Day Care Housing Improvement Case Aide Other Case Management Personal Care Hour Chore Respite(Facility Based or In-Home) Chore(Enhanced) Skilled Nursing Services Homemaker Material Aid Episode Specialized Medical Equipment, Services and Supplies Transportation One-Way Trip 2.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permits the Vendor to meet the County's reporting requirements. 2.2.1 Service Costs Reports The Vendor shall submit to the County the semi-annual service cost reports, August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.3 RECORDS AND DOCUMENTATION 2.3.1 The Vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The 22 c`' 160 2 Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 2.4 PERFORMANCE SPECIFICATIONS 2.4.1 Outcomes (1) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (2) The Vendor shall timely submit to the County all reports described in SECTION 2.2 REPORTS; and (3) The Vendor shall timely submit to the County all information described in, SECTION 2.3 RECORDS AND DOCUMENTATION. 2.5 COUNTY RESPONSIBILITIES 2.5.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-up on-site visits; (3) Client visits; (4) Review of independent auditor's reports; (5) Review of third-party documents and/or evaluation; (6) Review of progress reports; (7) Review of customer satisfaction surveys; (8) Agreed-upon procedures review by an external auditor or consultant; (9) Limited-scope reviews; and (10) Other procedures as deemed necessary. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The 23 C1_9 1602 vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services, which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 24 16 .0 2 EXHIBIT 3 STATEMENT OF WORK ALZHEIMER'S DISEASE INITIATIVE PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Alzheimer's Disease(AD) Alzheimer's Disease Initiative(ADI) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System(CIRTS) Community Care for Disabled Adults(CCDA) Department of Elder Affairs(DOEA) Home Care For Disabled Adults(HCDA) Instrumental Activities of Daily Living(IADL) Memory Disorder Clinic(MDC) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults(HCDA) services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026. 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 County enters ADI specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 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. Model Day Care: A program of therapeutic, social and health activities specific to clients with memory disorders. Services and activities include, but are not limited to, active and quiet 25 D games, reminiscence, validation therapy, pet therapy, water therapy and of er ailure free activities appropriate to the client's level of functioning. Model day care centers will also provide training for health care and social service personnel in the care of persons having AD or related memory disorders. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The ADI program provides a continuum of services addressing the special needs of individuals with AD,their families and caregivers. 1.2.2 Alzheimer's Disease Initiative Program Mission Statement The ADI program ensures that persons afflicted with AD and other forms of dementia are given essential services to help them age in place in an elder-friendly environment with security, dignity, and purpose. The program also provides support to family members and caregivers of persons afflicted with AD. 1.2.3 Authority The relevant authority governing the Alzheimer's Disease Initiative Program are as follows: (1) Rule Chapter 58D-1, Florida Administrative Code; and (2) Sections 430.501 through 430.504, Florida Statutes. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1) CFO Memo No. 02: Release date, August 20,2010; (2) CFO Memo No. 03: Release date,June 29,2010; and CFO Memo No. 06: Release date,June 30,2010. 1.2.3.2 Scope of Service The Vendor is responsible for the programmatic, fiscal, and operational management of the ADI program. The program services shall be provided in a manner consistent with and described in the current Vendor's Request for Proposal, RFP, and the County's current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.3.4 Major Program Goals The major goal of the ADI program is to provide services to meet the needs of caregivers and individuals with AD and related memory disorders. 1.3 INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The ADI Program addresses the special needs of individuals with AD and their caregivers. 1.3.2 Individual Eligibility Those individuals eligible to receive services under this contract must meet the following conditions: (1) Be 18 years of age or older and have a diagnosis of AD or a related disorder, or be 26 r T 160 -7 suspected of having AD or a related disorder; and (2) Not be enrolled in a Medicaid capitated long-term care program. 1.3.3 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. SERVICE TASKS In order to achieve the goals of the ADI program, the Vendor shall ensure the following tasks are performed: (1) Client eligibility determination; (2) Assessment and prioritization of service delivery for new clients; (3) Delivery of services to eligible clients; and (4) Monitor the performance of vendors. 2.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described in this SECTION 1.3. 2.2 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services addressing the diverse needs of individuals with AD and their caregivers. The Vendor shall ensure services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. Services categories include: (1) Caregiver Training/Support; (2) Case Aid; (3) Case Management; (4) Counseling(Gerontological); (5) Counseling(Mental Health/Screening); (6) Education/Training; (7) Model Day Care; ( 8) Respite(Facility-Based); ( 9) Respite(In-Home); and (10) Specialized Medical Equipment, Services,and Supplies. Caregivers benefit from receiving training, respite and related support services to assist them in caring for the ADI client. 2.3 Service Times The Vendor shall ensure the provisions of the services listed in this contract are available 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. 27 0 160 2 14 3. DELIVERABLES 3.1. Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the County's reporting requirements. Service Unit of Service Caregiver Training/Support; Hour Case Aid; Hour Case Management; Hour Counseling(Gerontological); Hour Counseling(Mental Health/Screening); Hour Respite(Facility-Based); Hour Respite(In-Home); Hour Education/Training; Episode Episode 3.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. 3.2.1 Service Costs Reports Vendor must submit to the County the semi-annual service cost reports August 1, 2013 and February 1,2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 3.3 RECORDS AND DOCUMENTATION 3.3.1 The Vendor and each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 4. PERFORMANCE SPECIFICATIONS 4.1 Outcomes (4) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (5) The Vendor shall timely submit to the County all reports described in SECTION 3.2 REPORTS; and (6) The Vendor shall timely submit to the County all information described in SECTION 3.3 28 0 160 RECORDS AND DOCUMENTATION. 5. COUNTY RESPONSIBILITIES 5.1. Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled,unscheduled and follow-up on-site visits; (3) Client visits (4) Review of independent auditor's reports (5) Review third-party documents and/or evaluations (6) Review of progress reports (7) Review of customer satisfaction surveys (8)Agreed-upon procedures review by an external auditor or consultant; (9)Limited-scope reviews; and (10)Other procedures as deemed necessary. 6. SECTION III: METHOD OF PAYMENT 6.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 6.1.2 Remedies-Nonconforming Services The Vendor shall ensure that all goods and/or services provided under this agreement for HCE funded programs are delivered timely, completely and commensurate with required standards of quality Such goods and/or services shall only be delivered to eligible program participants. If the Vendor fails to meet the prescribed quality standards for services, such services will not be reimbursed under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be reimbursed under this agreement. The Vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the Vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County requires immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 6.1.3 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the Vendor and any adjustments thereto, including any disallowance not resolved. 6.1.4 Date for Final Request for Payment 29 CA • 160 : The final request for payment for agreement year one's expenditures will be due to the County no later than August 1,2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 6.2 Documentation for Payment The Vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals upon request. Such documentation shall be provided upon request to the County or the Clerk of Court. 30 CAO EXHIBIT 4 160 2 STATEMENT OF WORK OLDER AMERICANS ACT PROGRAM TITLE III SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 CONTRACT ACRONYMS Area Agency on Aging(AAA) Activities of Daily Living(ADL) Alliance of Information&Referral Systems(AIRS) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System(CIRTS) Information and Referral (I& R) Instrumental Activities of Daily Living(IADL) Older Americans Act(OAA) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in Its PSA in accordance with the Section 306 (42 U.S.C. 3026)of the OAA and Department instructions. Child: An individual who is not more than 18 years of age or an individual with disability. Family Caregiver: An adult family member, or another individual,who is an informal provider of in-home and community care to an older individual. Frail: When an older individual is unable to perform at least two ADLs without substantial human assistance, including verbal reminding,physical cueing or supervision; or due to cognitive or other mental impairment,requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to another individual. 1.2 County Mission,Vision and Values Statement The County's mission: To help aging adults achieve greater independence through awareness of resources and access to qualified service providers. The County's vision: To be the recognized leader in supporting older adults and their families with access to trustworthy resources and services in their communities while empowering them to live with independence and dignity. The County's values: We believe residents of Southwest Florida are entitled to: Comprehensive information about their choices of care; Timely access to resources and services; High standards of quality and performance; and Personal and professional accountability from all stakeholders. 1.2.1 Older Americans Act Program Mission Statement The Older Americans Act(OAA)Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. 31 CA L3 GENERAL DESCRIPTION 16D 2 1.3.1 General Statement The OAA Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. The primary purpose of the OAA program is to foster the development and implementation of comprehensive and coordinated systems to serve older individuals. The OAA program uses these systems to assist older individuals to attain and maintain maximum independence and dignity in a home environment and allows for the capability of self- care with appropriate supportive services. 1.3.2 Authority The relevant references authority governing the OAA program are: 1. Older Americans Act of 2006, as amended; 2. Rule 58A-1,Florida Administrative Code; and 3. Section 430.101, Florida Statutes. 1.3.2.1 Incorporation of Reference Memoranda In accordance with Ch. 287 F.S., as amended,and Agency of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and incorporated by reference: 1. CFO Memo No. 02: Release date, August 20,2010; 2. CFO Memo No. 03: Release date,June 29,2010; and 3. CFO Memo No. 06: Release date,June 30,2010. 1.3.3 Scope of Service The Vendor shall provide services in a manner consistent with and descried in the current area plan and current Department of Elder Affairs Programs and Services Handbook. 1.3.4 Major Program Goals The major goals of the OAA program are to improve the quality of life for older individuals, preserve their independence and prevent or delay more costly institutional care. These goals are achieved through the implementation of a comprehensive and coordinated service system that provides a continuum of service alternatives that meet the diverse needs of elders and their caregivers. 1.4 INDIVIDUALS TO BE SERVED 1.4.1 Eligibility(Title III Programs) 1.4.1.1 OAA Title III,General Consumers shall not be dually enrolled in an OAA program and a Medicaid capitates long-term care program. 1.4.1.2 OAA Title HIE,Caregiver Support Services Eligibility for OAA Title IIIE, Caregiver Support Services, are as follows: 1. Family caregivers of individuals age 60 or older; 32 CA 1613 2k 2. Grandparents(age 55 or older)or older individuals(age 55 or older)who are relative caregivers; 3. Priority will be given to family caregivers who provide care for individuals with Alzheimer's disease and related disorders with neurological and organic brain dysfunction and for grandparents or older individuals who are relative caregivers who provide care for children with severe disabilities; and 4. For respite and supplemental services,a family caregiver must be providing care for an older individual who meets the definition of the term"frail" in OAA, Section 102 Paragraph 22. 1.4.2 Targeted Groups Preference shall be given to those with the greatest economic and social need,with particular attention to low-income older individuals, including those that are low-income minorities, have limited English proficiency, and older individuals residing in rural areas. SECTION II—MANNER OF SERVICE PROVISION 2.1 SERVICE TASKS In order to achieve the goals of the OAA program,the Vendor shall ensure the following tasks are performed: 1. Client eligibility determination; 2. Targeting and screening of service delivery for new clients; 3. Delivery of services to eligible clients; 4. Use of volunteers to expand the provision of available services; 5. Monitoring the performance of its vendors. 6. Grievance and Compliance Procedures 2.1.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described herein. 2.1.2 Targeting and Screening of Service Delivery for New Clients The Vendor shall develop and implement policies and procedures consistent with OAA targeting and screening Criteria 2.1.3 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meets the diverse needs of elders and their caregivers. The Vendor shall ensure the performance and report performance of the following services in accordance with the current Department of Elder Affairs Programs and Services Handbook. The services funded pursuant to this contract are in accordance with the OAA,Title III, sections 321, 331,336 and 373 as follows: 1. Section 321,Title IIIB Supportive Services; 2. Section 373,Title IIIE Caregiver Support Services. 2.1.3.1 Supportive Services Supportive services include a variety of community-based and home-delivered services that support the qualities of life for older individuals by helping them remain independent and productive. Services include the following: 33 S (1) Adult Day Care/Adult Day Health Care; (17) Homemaker; 1 6 D c (2) Caregiver Training/Support; (18) Housing Improvement; (3) Case Aide/Case Management; (19) Information; (4) Chore Services; (20) Intake; (5) Companionship; (21) Interpreter/Translating; (6) Counseling(Gerontological and Mental Health); (22) Referral/Assistance; (7) Education/Training; (23) Personal Care; (8) Legal Assistance; (24) Physical Therapy; (9) Material Aid; (25) Shopping Assistance; (10) Occupational Therapy; (26) Skilled Nursing; (11) Outreach; (27) Specialized Medical Equipment, Services, and Supplies (12) Recreation; (28) Respite Services; (13) Emergency Alert Response; (29) Screening/Assessment; (14) Escort; (30) Speech Therapy; (15) Health Support; (31) Telephone Reassurance; and (16) Home Health Aide; (32) Transportation 2.1.3.4 Caregiver Support Services (Title HIE Program) The following services are intended to provide direct help to caregivers, assist in the areas of health, nutrition and financial literacy and assist caregivers in making decisions and problem solving related to their caregiving roles and responsibilities: (1) Adult Day Care/Adult Day Health Care; (2) Caregiver Training/Support; (3) Counseling(Gerontological and Mental Health); (4) Education/Training; (5) Financial Risk Reduction(Assessment and Maintenance); (6) Information; (7) Intake; (8) Outreach; (9) Respite Services; (10) Screening/Assessment; and (11) Transportation 2.1.3.5 Caregiver Support Supplemental Services (Title HIES Program): The following services are provided to complement the care provided by caregivers: (1) Chore Services; (2) Housing Improvement; (3) Legal Assistance; (4) Material Aid; and (5) Specialized Medical Equipment, Services and Supplies. 2.2 SERVICE LOCATION 34 cA 2.2.1 Service Times . • 16Q The Vendor shall ensure the provision of the services listed in the contract during normal business hours unless other times are more appropriate to meet the performance requirements of the contract, and it shall monitor its vendors to ensure they are available to provide services during hours responsive to client needs and during those times which best meet the needs of the relevant service community. 2.3 DELIVERABLES 2.3.1 Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the services tasks described in Section 2.1. The chart below lists the services allowed and the units of measurement. Units of service will be paid pursuant to the rate established in the 2010 RFP and approved by the County. Services Unit of Service Adult Day Care/Adult Day Interpreter/Translating Health Care Legal Assistance Caregiver Training/Support Medication Management Case Aid/Case Management Mental Health Counseling/Screening Chore Services Nutrition Counseling Companionship Occupational Therapy Counseling Services Personal Care Escort Physical Therapy Hour Financial Risk Reduction Recreation Services Respite Services Health Support Screening/Assessment Home Health Aide Sitter Homemaker Skilled Nursing Services Housing Improvement Speech Therapy Intake Emergency Alert Response Day Education/Training Episode Information Material Aid Referral/Assistance Specialized Medical Equipment, Services and Supplies Telephone Reassurance Escort One-Way Trip Shopping Assistance Transportation 2.4 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permit the Vendor to meet the County's reporting requirements. 35 CNO 16D 2 2.4.2 Service Costs Reports The Vendor shall require vendors to submit to the Vendor semi-annual service cost reports on August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.4.5 Background Screening Affidavit of Compliance To demonstrate compliance with section 8 of the Standard Contract,the Vendor shall submit ATTACHMENT H, Background Screening Affidavit of Compliance annually,by January 15th 2.5 RECORECORDS AND DOCUMENTATION Each Vendor and vendor,among other requirements,must anticipate and prepare for the loss of information processing capabilities.The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement in its contracts and/or agreements with vendors. These policies and procedures shall be made available to the County upon request. 2.6 PERFORMANCE SPECIFICATIONS 2.6.1 Outcomes (1)The Vendor shall ensure services provided under this contract are in accordance with the current DOEA Programs and Services Handbook, (2)The Vendor shall timely submit to the County all reports described herein (3)The Vendor shall timely submit to the County all information described in, Paragraph 2.5 RECORDS AND DOCUMENTATION. 2.7 VENDOR'S FINANCIAL OBLIGATIONS 2.7.1 Matching,Level of Effort,and Earmarking Requirements The Vendor shall provide match of at least 10 percent of the federal funds received. The Vendor's match will be made in the form of cash and/or in-kind resources. The Vendor will assure,through a provision in subcontracts,a match requirement of at least 10 percent of the cost for all services funded through this contract. The vendor's match will be made in the form of cash and/or in-kind resources. The Vendor shall report match by title each month. At the end of the contract period, the Vendor must properly match all OAA funds. 2.7.2 Title III Funds The Vendor assures compliance with Section 306 of the OAA, as amended in 2006,that funds received under Title III will not be used to pay any part of a cost incurred by the Vendor to maintain a contractual or commercial relationship that is not carried out to implement Title III. 2.8 COUNTY RESPONSIBILITIES 2.8.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the Vendor. 2.8.2 Program/Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this contract. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an on-site visit. The County's determination of acceptable performance shall be conclusive. The Vendor 36 CA . . . . . 16132 agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: 1. Desk reviews and analytical reviews; 2. Scheduled, unscheduled and follow-up on-site visits; 3. Client visits; 4. Review of independent auditor's reports-Exhibit 10; 5. Review of third-party documents and/or evaluation; 6. Review of progress reports; 7. Review of customer satisfaction surveys; 8. Agreed-upon procedures review by an external auditor or consultant; 9. Limited-scope reviews; and 10. Other procedures as deemed necessary. 2.8.3 Contract Monitoring The County shall, at its own discretion, conduct monitoring concerning any aspect of the vendor's performance of this contract. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for OAA IIIE and OAA HIES funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rate for services is ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services,which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 37 c NO • , • 160 ° 1 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 38 EXHIBIT 5 i 6 D 2 Agreement#12-5856 "Services for Seniors Attachment B Invoice and Logs (Minimum Standard Invoice Information) County Purchasing tiari ,;-'-';;-"?ktr.72,... 7.-,',,-,; ;.",:. '-- .Order Number: Invoice Number: Grant Name: From Date To Date ent ' er .- i : y k"II II.,44.1;;!51'15,i,- 11174:11 ifS14-447j,� , APP ! . Sub rac e h 4 .tch , , i{ 1:-'1- ne 'Ceti, x ch a ce mu � ,, Amount h { t i I from Totals Q Q' :n ` Cost erg ' t S e ei-vic x $0.00 $0.00 $0.00 Total $0.00 I certify to the best of my knowledge and belief that this invoice, and attached service detail log, is complete and correct and all outlay herein are for the purposes set forth in the contract, and that services are ordered by the case manager as agreed on the Contract. Legible copies of the dated timesheet, signed by the client and the worker supporting this invoice must be available upon request. Collier County reserves the right to correct computation of errors to assure proper payment amount. Prepared by: Date: Adjustment Reasons Lead Agency Authorization Attachments: Monthly Service log,Weekly Detail log and Client Service time sheets. 39 160 2 " EXHIBIT 6 Detail Weekly for CCE Services Week Ending: Invoice No. Personal CLIENT Care Homemaker Respite Skilled Companion Chore Total Total Total Total Total Total NAME Units Units Units Units Units Units Total Hours - - - - - - $ PECA - HMK - $ RESPITE - $ SKILLED - $ COMPANION - $ CHORE - $ TOTAL - 40 EXHIBIT 7 1611a Monthly Detail Service Log Grant Name: Vendor Name, Address: From Date To Date By client,provide the total number of hours provided during the dates of service. This log must be submitted with your monthly invoice for the Invoice From Date and To Date. iIt es t' nt `'.... 1 Qiii e_, 4 .11 , ! Ile 3' ii $in 1;e".% i A U1'S10 8 r: re cih � � . t ame ty 41 L,P EXHIBIT 8 1 60 2 Daycare Grant: Grant Service: ADC or RESF Vendor Name and Address By client, provide the Weekly Client Service Time Sheet provided during the dates of service. This log must be submitted with all invoices for the invoice From Date and To Date. TO FROM DATE: DATE: Client Thur Uni Client Name signature Mon Tue Wed s Fri Sat Sun Match is Service Dates 42 CA ' 1613 2 '1 EXHIBIT 9 YOUR COMPANY NAME HERE Collier County Services for Seniors Homemaker/Personal Care/Respite/Companion Work Sheet Client Name: Client Signature: Week Ending: Each Time You Perform one of the Activities Below: Put in arrival and departure times for the day worked: ****Client should Initial time of arrival and departure. ****Client should Sign form at top. ****You should sign your name at the bottom. Date: Day: MON TUES WED THUR FRI SAT SUN TOTAL TIME ARRIVAL TIME: DEPARTURE TIME: ****CLIENT INITIALS: Arrive: PERSONAL CARE Depart: Assist W/Bath tub Shower Bed Assist W/Dressing Bathroom Assist Shave (Face Only) Oral Hygiene Walking/Ambulation Feeding Assistance Wash/Set Hair Backrub Soak Feet_ Nails (File only) Change_Make_Bed Take out Trash Clean Bedroom Clean Bathroom Prepare Meals Laundry Arrive: HOME MAKING Depart: Vacuum/Sweep Light Dusting 43 S 160 21 Clean Kitchen Floor Wash Dishes_ Mop Sweep_ Grocery Shop Errands Arrive: RESPITE Depart: Arrive: COMPANION Depart: EMPLOYEE'S Signature/Title 44 o 4, 160 2 EXHIBIT 10 OMB Circular A-133 Audits of States, Local Governments, and Non-Profit Organizations requires the Collier County Housing, Human and Veterans Services Department to monitor our subrecipients of federal awards and determine whether they have met the audit requirements of the circular and whether they are in compliance with federal laws and regulations. Accordingly, we are requiring that you check one of the following, provide all appropriate documentation regarding your organization's compliance with the audit requirements, sign and date this form. Subrecipient Fiscal Year Name Period Total State Financial Assistance Expended during $ most recently completed Fiscal Year Total Federal Financial Assistance Expended during most $ recently completed Fiscal Year Check Appropriate Boxes We have exceeded the $500,000 federal/state expenditure threshold for our fiscal year ❑ ending as indicated above and have completed our Circular A-133 audit. A copy of the audit report and management letter are attached. We exceeded the $500,000 federal/state expenditure threshold for our fiscal year ❑ ending as indicated above and expect to complete our Circular A-133 audit by . Within 30 days of completion of the A-133 audit, we will provide a copy of the audit report and management letter. We are not subject to the requirements of OMB Circular A-133 because we: ❑ Did not exceed the $500,000 federal/state expenditure threshold for the fiscal year indicated above ❑ Are a for-profit organization ❑ Are exempt for other reasons —explain An audited financial statements is attached and if applicable, the independent auditor's management letter. (If findings were noted, please enclose a copy of the responses and corrective action plan.) Certification Statement I hereby certify that the above information is true and accurate. Signature Date Print Name and Title 45 � �4 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP D TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 1 6 THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Routed by Purchasing Department to Office Initials Date the Following Addressee(s)(In routing order) 1. Risk Management Risk 2. County Attorney Office County Attorney Office . � � Cg. 3. BCC Office Board of County \rt,(.71 Commissioners �a/6/ I7'\vA\S 4. Minutes and Records Clerk of Court's Office -11N(\ r ,q[�3 t2jr''�_ 5. Return to Purchasing Department Purchasing {�1 '�"^ Contact: Diana DeLeon PRIMARY CONTACT INFORMATION Name of Primary Diana DeLeon for Lisa Carr,HHVS, Phone Number 252-8375 Purchasing Staff June 12,2013 Contact and Date Agenda Date Item was May 28,2013 Agenda Item Number 16.D.2 Approved by the BCC Type of Document Contract Amendment Number of Original 2 Attached Documents Attached PO number or account N/A Solicitation/Contract Amend#1 to Contract 12- number if document is NumberNendor Name 5856 Southern Home to be recorded (ResCare) INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature? DD 1/ 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A l� provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be signed by the Chairman,with the exception of most letters,must be reviewed and signed c?, .1431.° by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/At Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A l/ document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's DD signature and initials are required. 7. In most cases(some contracts are an exception),an electronic copy of the document and DD this routing slip should be provided to the County Attorney's Office before the item is input into SIRE. 8. The document was approved by the BCC on the date above and all changes made DD during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the �Ax) BCC,all changes directed by the BCC have been made,and the document is ready for the Chairman's signature. 1 6 D Z MEMORANDUM Date: June 17, 2013 To: Diana De Leon, Contract Technician Purchasing Department From: Martha Vergara, Deputy Clerk Minutes & Records Department Re: Amendment #1 - Contract #12-5856 "Services for Seniors" Contractor: Sothern Home Care Services, Inc. Attached, is an original of the assumption agreement referenced above (Agenda Item #16D2), approved by the Board of County Commissioners on Tuesday, May 28, 2013. The original will be held on file with the Minutes and Record's Department in the Board's Official Records. If you have any questions, please contact me at 252-7240. Thank you. Attachment 160 Contract Amendment#1 Contract # 12-5856 "Services for Seniors" This CONTRACT AMENDMENT #1, dated Ma`( Z , 2013 to the referenced agreement shall be by and between the parties to the original Agreement, Southern Home Care Services, Inc. d/b/a ResCare HomeCare (to be referred to as "Vendor") and Collier County, Florida, (to be referred to as "County"). Statement of Understanding RE: Contract# 12-5856 "Services for Seniors" In order to continue services for the original Contract document referenced above, the Vendor agrees to the terms and conditions set forth in Exhibit A-1A, which includes Attachments C-H and Exhibits 1-10 attached hereto and incorporated by reference. The Vendor further agrees to amend Section 1, Commencement, as follows: 1. COMMENCEMENT. This Agreement shall Commence on December 11, 2012 and shall terminate on December 10, 2011 June 30, 2014. The Contract award is a two (2) year contract, with the possibility of two (2) additional (2) year terms pending funding from grantors and acceptable performance by the awarded vendor. Any such renewals shall be mutually agreed upon in writing by the parties. The maximum duration for this Contract for CCE, HCE, and ADI, OAA HIE AND OAA HIES funding will not exceed six (6) years (through June 30, 2018). As outlined in RFP #12-5856, the County requires the Vendor to contribute a cash or in-kind match of no less than ten (10) percent for all services related to the Community Care for the Elderly Program, (CCE), Older American Title ME Caregiver Support (OAA ME) and Older American Title HIES Caregiver Support Supplemental Services (OAA I IES)Programs. Words that have been deleted are struck through, words underlined have been added. Modification made herein shall apply as if incorporated into the Contract on the date of Commencement. All other terms and conditions of the agreement shall remain in force. IN WITNESS WHEREOF, the Vendor and the County have each, respectively, by an authorized person or agent, hereunder set their hands and seals on the date(s) indicated below. Accepted: Le ' /1 , 2013 VENDOR: urn 401), Southern Ho are Services, Inc. d/b/a First ness ResCare me are She( ,-, T e/ v�itne�s n(194/Tie Second Witness j l P C ► -30 L.~4}-ti /-7 LiL2ir 4.) r/Jo_ Print/Type Name and Title Type/print witness name 1 160 21 COUNTY: ATTEST: BOARD OF COUNTY COMMISSIONERS DWIGHT L.'13,R—OCK CLERK OF COLLIER COUNTY, FLORIDA By 'Lis Z ' *`..1 By idt/ . . ' ,;D '} LE' `� G GIA A. HILLER, ESQ. Attest as toPChai a s1 ' CHAIRWOMAN signature`on1y Approval for form and legal Sufficiency: Jennif'r B. White Assistant County Attorney 5 2 16D 2 EXIIIBIT A-lA AGREEMENT 12-5856 SERVICES FOR SENIORS ATTACHMENTS ATTACHMENT ATTACHMENT DESCRIPTION PAGE Attachment C Core Standards for CCE, HCE, ADI, OAA IIIE & IIIES 2 Attachment D Certification Regarding Lobbying 8 Attachment E Certification Regarding Data Integrity Compliance 9 Attachment F Certification Regarding Debarment, Suspension, 10 Ineligibility and Voluntary Exclusion Contracts/ Subcontracts Attachment G Sub-Recipient Invoice Submission 11 Attachment H Background Screening Affidavit of Compliance 12 Exhibit 1 CCE Statement of work 13 Exhibit 2 HCE Statement of work 19 Exhibit 3 ADI Statement of work 25 Exhibit 4 OAA IIE and OAA IIIES Statement of work 31 Exhibit 5 Invoice 39 Exhibit 6 Detail Weekly Log 40 Exhibit 7 Monthly Log 41 Exhibit 8 Day Care/Respite Time Sheet 42 Exhibit 9 Program Time Sheet 43 Exhibit 10 Annual Audit Monitoring Report 45 1 rir 160 2 ATTACHMENT C Core Standards for CCE,HCE,ADI, OAA HIE& HIES 1. Compliance with Federal Law 1.1 If this agreement contains federal funds the following shall apply: 1.1.1 The vendor shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable regulations. 1.1.2 If this agreement contains federal funds and is over$100,000.00, the vendor shall comply with all applicable standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s. 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable Environmental Protection County regulations 40 CFR 30. The vendor shall report any violations of the above to the County. 1.1.3 The vendor may not use any federal funds received in connection with this agreement to influence legislation or appropriations pending before the Congress or any state legislature. If this agreement contains federal funding in excess of$100,000.00, the vendor must, prior to agreement execution, complete the Certification Regarding Lobbying form, ATTACHMENT D. All disclosure forms as required by the Certification Regarding Lobbying form must be completed and returned to the Grant Coordinator prior to payment under this agreement. 1.1.4 In accordance with Appendix A to 2 CFR 215, the vendor shall comply with Executive Order 11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in Department of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable. 1.1.5 If this agreement contains federal funds and provides services to children up to age 18, the vendor shall comply with the Pro-Children Act of 1994(20 U.S.C. 6081). 1.1.6 A agreement award with an amount expected to equal or exceed $25,000.00 and certain other agreement 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 vendor shall comply with these provisions before doing business or entering into sub-agreements receiving federal funds pursuant to this agreement. The vendor shall complete and sign ATTACHMENT F prior to the execution of this agreement. 1.2 The vendor shall not employ an unauthorized alien. The County 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 agreement by the County. 2 9 r� r) 16 © 2 1.3 If the vendor 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 vendor must notify the County in writing within thirty (30) days of receiving the IRS notice of revocation. 1.4 The vendor shall comply with Title 2 CFR Part 275 regarding Trafficking in Persons. 1.5 Unless exempt under 2 CFR Part 170.110(b), the vendor shall comply with the reporting requirements of the Transparency Act as expressed in 2 CFR 170. 1.6 To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number 11-116, vendor agrees to utilize the U.S. Department of Homeland Security's E-verify system to verify the employment of all new employees hired by vendor during the agreement term. Vendor meeting the terms and conditions of the E-Verify System are deemed to be in compliance with this provision. 2. Compliance with State Law 2.1 This agreement is executed and entered into in the State of Florida, and shall be construed, performed and enforced in all respects in accordance with the Florida law, including Florida provisions for conflict of laws. 2.2 The vendor shall comply with requirements of s. 287.058, F.S. as amended. 2.2.1 The vendor shall provide units of deliverables, including various client services, and in some instances may include reports, findings, and drafts, as specified in this agreement, which the Grant Coordinator must receive and accept in writing prior to payment in accordance with s. 215.971, F.S. (1)and(2). 2.2.2 The vendor shall submit bills for fees or other compensation for services or expenses in sufficient detail for a proper pre-audit and post-audit. 2.2.3 The vendor 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 vendor in conjunction with this agreement except for those records which are made confidential or exempt by law. The vendor's refusal to comply with this provision will constitute an immediate breach of agreement for which the County may unilaterally terminate the agreement. 2.3 If clients are to be transported under this agreement, the vendor shall comply with the provisions of Chapter 427, F.S., and Rule 41-2, F. A. C. 2.4 Vendors who are on the discriminatory vendor list may not transact business with any public entity, in accordance with the provisions of s. 287.134, F.S. 2.5 The vendor shall comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the expenditure of agreement funds for the purpose of lobbying the legislature,judicial branch or a state agency. 3. Background Screening The vendor shall ensure that the requirements of s. 430.0402 and ch. 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 exempted from the Department's level 2 background screening 3 160 2 pursuant to s. 430.0402(2)-(3), F.S. The vendor must also comply with any applicable rules promulgated by the Department and the Agency for Health Care Administration regarding implementation of s. 430.0402 and ch. 435,F.S. Further information concerning the procedures for background screening are found at http://elderaffairs.state.fl.us/doealbackgroundscreening.php. 4. Provision of Services The vendor shall provide services in the manner described herein. 5. Monitoring by the County The vendor shall permit persons duly authorized by the County to inspect and copy any records, papers, documents, facilities, goods and services of the vendor which are relevant to this agreement, and to interview any clients, employees and vendor employees of the vendor to assure the County of the satisfactory performance of the terms and conditions of this agreement. Following such review, the County will provide a written report of its findings to the vendor, and where appropriate,the vendor shall develop a corrective action plan. The vendor hereby agrees to correct all deficiencies identified in the corrective action plan in a timely manner as determined by the Grant Coordinator. 6. Confidentiality of Information The vendor shall not use or disclose any information concerning a vendor of services under this agreement 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. 7. Health Insurance Portability and Accountability Act Where applicable, the vendor shall comply with the Health Insurance Portability and Accountability Act (42 USC 1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162,and 164). 8. Bankruptcy Notification During the term of this agreement,the vendor shall immediately notify the County if the Vendor, its assignees, vendors or affiliates file a claim for bankruptcy. Within ten (10)days after notification,the vendor must also provide the following information to the County.: (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.,United States Bankruptcy Court Middle District of Florida,Naples,FL); and, (4)The name, address, and telephone number of the bankruptcy attorney. 9. Sponsorship and Publicity 9.1 As required by s. 286.25, F.S., if the vendor is a non-governmental organization which sponsors a program financed wholly or in part by state funds, including any funds obtained through this agreement, it shall, in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by Hope Hospice and Community Services, the State County of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County." If the sponsorship reference is in the written material, the words "State of Florida, Department of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County" shall appear in at least the same size letters or type as the name of the organization. 9.2 The vendor shall not use the words "The State of Florida Depai tiuent of Elder Affairs or the Area County on Aging for Southwest Florida, Inc. or Collier County" to indicate sponsorship of a program otherwise financed, unless specific authorization has been obtained by Collier County, or the Area Aging on Aging prior to use. 4 16 2 41 10. Independent Capacity of Vendor It is the intent and understanding of the Parties that the vendor, or any of its vendors, are independent vendors and are not employees of the County and shall not hold themselves out as employees or agents of the County without specific authorization from the County. It is the further intent and understanding of the Parties that the County does not control the employment practices of the vendor and will not be liable for any wage and hour, employment discrimination, or other labor and employment claims against the vendor or its vendors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary insurance for the vendor are the sole responsibility of the vendor. 11. Payment Payments shall be made to the vendor pursuant to s. 215.422, F.S., as services are rendered and invoiced by the vendor. The Grant Coordinator will have final approval of the invoice for payment, and will approve the invoice for payment only if the vendor has met all terms and conditions of the agreement, unless the bid specifications, purchase order, or this agreement specify otherwise. The approved invoice will be submitted to the County's Grant Coordinator approval and processing. 12. Return of Funds The vendor shall return to the County any overpayments due to unearned funds or funds disallowed and any interest attributable to such funds pursuant to the terms and conditions of this agreement that were disbursed to the vendor by the County. In the event that the vendor or its independent auditor discovers that an overpayment has been made, the vendor shall repay said overpayment immediately without prior notification from the County. In the event that the County first discovers an overpayment has been made, the Grant Coordinator will notify the vendor in writing of such fmdings. 13. Data Integrity and Safeguarding Information The vendor shall ensure an appropriate level of data security for the information the vendor is collecting or using in the performance of this agreement. An appropriate level of security includes approving and tracking all vendor employees that request system or information access and ensuring that user access has been removed from all terminated employees. The vendor, 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 vendor shall ensure all vendors maintain written procedures for computer system backup and recovery. The vendor shall complete and sign Attachment E prior to the execution of this agreement. 14. Computer Use and Social Media Policy The Department of Elder Affairs has implemented a new 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, Area Agencies on Aging and vendors. 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. 15. Public Entity Crime Pursuant to s. 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 5 1602 agreement to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on a agreement 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 vendor, supplier, vendor, or consultant under a agreement with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in s. 287.017, F.S., for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted vendor list. 16. Patents,Copyrights,Royalties If this agreement 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 agreement, the vendor shall refer the discovery, invention or material to the County to be referred to the Department of State and the Depail.nient of Elder Affairs. Any and all patent rights or copyrights accruing under this agreement are hereby reserved to the State of Florida in accordance with Chapter 286, F.S. Pursuant to s. 287.0571 (5) (k) 1 and 2 as amended, the only exceptions to this provision shall be those that are clearly expressed and reasonably valued in the agreement. 16.1 If the primary purpose of this agreement 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 Paragraph 33. 16.2 If this agreement is awarded solely federal funding, the terms and conditions are governed by 2 CFR 215.36. 17. Emergency Preparedness and Continuity of Operations 17.1 If the tasks to be performed pursuant to this agreement include the physical care and control of clients, or the administration and coordination of services necessary for client health, safety or welfare, the vendor shall, within thirty (30) calendar days of the execution of this agreement, submit to the Grant Coordinator verification of an emergency preparedness plan. In the event of an emergency,the vendor shall notify the County of emergency provisions. 17.2 In the event a situation results in a cessation of services by a vendor, the vendor shall retain responsibility for performance under this agreement and must follow procedures to ensure continuity of operations without interruption. 18. Financial Consequences of Non-Performance If the vendor fails to meet the minimum level of service or performance identified in this agreement, or that is customary for the industry, then the County must apply financial consequences commensurate with the deficiency. Financial consequences may include,but are not limited to, agreement suspension, refusing payment, withholding payments until deficiency is cured, tendering only partial payments, and/or cancellation of agreement and reacquiring services from an alternate source. 18.1 The vendor will not be charged with financial consequences, when a failure to perform arises out of causes that were the responsibility of the County. 19. No Waiver of Sovereign Immunity 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. 20. Venue If any dispute arises out of this agreement, the venue of such legal recourse will be Collier 6 x. 60 ' 2l County,Florida. 21. Entire Agreement This agreement contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations shall be valid or binding upon the County or the vendor unless expressly contained herein or by a written amendment to this agreement signed by both Parties. 22. 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. 23. 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. 24. Waiver The delay or failure by the County to exercise or enforce any of its rights under this agreement will not constitute or be deemed a waiver of the County'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. 25. Compliance The vendor shall abide by all applicable current federal statutes, laws, rules and regulations as well as applicable current state statutes, laws, rules, regulations and County rules, ordinances and regulations. The Parties agree that failure of the vendor to abide by these laws shall be deemed an event of default of the vendor, and subject the agreement to immediate, unilateral cancellation of the agreement at the discretion of the County. 26. Final Invoice The vendor shall submit the final CCE, HCE, ADI, 11h and HIES invoice for payment to the County on July 3, 2013. If the vendor fails to submit final request for payment by the deadline, then all rights to payment may be forfeited and the County may not honor any requests submitted after the aforesaid time period. Any payment due under the terms of this agreement may be withheld until all reports due from the vendor and necessary adjustments thereto have been approved by the County. 27. Renegotiations or Modifications Modifications of the provisions of this agreement shall be valid only when they have been reduced to writing and duly signed by both parties. The rate of payment, contract requirements and the total dollar amount may be adjusted retroactively to reflect price level increases and changes in the rate of payment or language. 28. All Terms and Conditions Included This agreement and its Attachments, A-H and exhibits 1-4 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 agreement shall supersede all previous communications, representations or agreements, either written or verbal between the Parties. 7 6 0 2 pi ATTACHMENT D CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR AGREEMENTS,GRANTS,LOANS AND AGREEMENTS The undersigned certifies,to the best of his or her knowledge and belief,that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any State ,Federal or County, a member of congress, an officer or employee of congress, an employee of a member of congress, or an officer or employee of the state legislator, in connection with the awarding of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal agreement, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of the County, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this federal agreement, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including vendors, sub-grants, and agreements under grants, loans and cooperative agreements)and that all vendors shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than$100,000 for each such failure. Signature Date Name of Authorized Individual Name and Address of Organization 8 161121 ATTACHMENT E CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS,LOANS AND COOPERATIVE AGREEMENTS The undersigned, an authorized representative of the vendor named in the agreement or agreement to which this form is an attachment, hereby certifies that: (1) The vendor and any vendors of services under this agreement 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 vendor, vendor(s), or any outside entity on which the vendor 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, vendor(s)will take immediate action to assure data integrity. (3) If this agreement 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 vendor (represented by the undersigned) and purchased by the State will be verified for accuracy and integrity of data prior to transfer. In the event of any decrease in functionality related to time and date related codes and internal subroutines that impede the hardware or software programs from operating properly, the vendor agrees to immediately make required corrections to restore hardware and software programs to the same level of functionality as warranted herein, at no charge to the State, and without interruption to the ongoing business of the state,time being of the essence. (4) The vendor and any vendor(s) of services under this agreement warrant their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data integrity compliance issues. The vendor shall require that the language of this certification be included in all vendors and other agreements and that all vendor shall certify compliance accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB Circulars A-102 and 2 CFR Part 215 (formerly OMB Circular A-110). Name and Address of vendor Signature Title Date Name of Authorized Signer 9 iLi) 160 21 EXHIBIT F CERTIFICATION REGARDING DEBARMENT, SUSPENSION,INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS (1) The prospective vendor certifies, by signing this certification, neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or County. (2) Where the prospective vendor is unable to certify to any of the statements in this certification,such prospective participant shall attach an explanation to this certification. Signature Date Title County/Organization (Certification signature should be same as Agreement signature.) Instructions for Certification 1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "person," "primary covered transaction," and"voluntarily excluded,"as used herein,have the meanings set out in the sections of rules implementing Executive Order 12549. (2 CFR 180.5-180.1020,as supplemented by 2 CFR 376.10-376.995). You may contact the Agreement Manager for assistance in obtaining a copy of those regulations. 2. This certification is a material representation of facts upon which reliance was placed when the parties entered into this transaction. If it is later determined that the vendor knowingly rendered an erroneous certification,in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension and/or debarment. 3. The vendor will provide immediate written notice to the Agreement Manager if at any time the vendor learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The vendor may decide the method and frequency by which it determines the eligibility of its principals. Each participant to a lower tier covered transaction may,but is not required to,check the Excluded Parties List System(EPLS). 4. The vendor will include a"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion-Lower Tier Covered Transaction"in all its lower tier covered transactions and in all solicitations for lower tier covered transactions. 5. The vendor agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise authorized by the federal government. 6. If the vendor knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension,and/or debarment. 7. The vendor may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended,ineligible,or voluntarily excluded from the covered transaction,unless it knows that the certification is erroneous. 10 16132 EXHIBIT G SUBRECIPIENT INVOICE SUMMISSION The County shall reimburse the SUBRECIPIENT for the performance of this Agreement upon completion or partial completion of the work tasks as accepted and approved by HHVS pursuant to the submittal of quarterly progress reports. Invoices for work performed are required every month. If no work has been performed during that month, or if the SUBRECIPIENT is not yet prepared to send the required backup, a$0 invoice will be required. Explanations will be required if two consecutive months of$0 invoices are submitted. Payments shall be made to the SUBRECIPIENT when requested as work progresses but, not more frequently than once per month. Final invoices are due no later than 90 days after the end of the agreement. Work performed during the term of the program but not invoiced within 90 days without written exception from the Grant Coordinator will not be reimbursed. No payment will be made until approved by HHVS for grant compliance and adherence to any and all applicable local, state or Federal requirements. Payment will be made upon receipt of a properly completed invoice and in compliance with §218.70, Florida Statutes, otherwise known as the "Local Government Prompt Payment Act." 11 DEPARTMENT OF 6 D } y§ EXHIBIT H BACKGROUND SCREENING ELDER AFFAIRS Affidavit of Compliance -Employer STATE OF FLORIDA 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 Employer Name located at Street Address City State ZIP code I, 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. Signature of Representative Date STATE OF FLORIDA,COUNTY OF Sworn to(or affirmed)and subscribed before me this day of , 20 , by (Name of Representative)who is personally known to me or produced 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: http://elderaffairs.state.fl.us/english/backgroundscreening.php 12 160 2 I k.,1 EXHIBIT 1 STATEMENT OF WORK COMMUNITY CARE FOR THE ELDERLY PROGRAM(CCE) SECTION I: SERVICES TO BE PROVIDED 1.1. DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 AGREEMENT ACRONYMS Activities of Daily Living(ADL) Adult Protective Services(APS) Assessed Priority Consumer List(APCL) Comprehensive Assessment and Review for Long-Term Care Services(CARES) Community Care for the Disabled Adult(CCDA) Community Care for the Elderly(CCE) Client Information and Registration Tracking System(CIRTS) Department of Children and Families(DCF) Department of Elder Affairs (DOEA) Home Care for Disabled Adults(HCDA) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out: The condition of reaching 60 years of age and being transitioned from the Department of Children and Families(DCF) Services, Community Care for Disabled Adults (CCDA)or Home Care for Disabled Adults(HCDA) services to the Department's community- based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in its planning and service area in accordance with the Section 306 (42 U.S.C. 3026) of the Older Americans Act and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the County enters CCE specific data in the CIRTS. An update may also include other revisions to the area plan as instructed by the County or Department of Elder Affairs. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The primary purpose of the CCE program is to prevent, decrease or delay premature or inappropriate and expensive placement of older persons in nursing homes and other institutions. 13 1 6 0 21 1.2.2 Community Care for the Elderly Mission Statement The CCE Program assists functionally impaired elderly persons in living as independently as possible in their own homes or in the homes of relatives or caregivers. The program provides a continuum of care through the development, expansion, reorganization and coordination of multiple community-based services to assist elders to reside in the least restrictive environment suitable to their needs. 1.2.3 Authority The relevant authority governing CCE program are: (1)Rule 58C-1, Florida Administrative Code (2) Sections 430.201 through 430.207, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services Chief Financial Officer Memoranda the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1)CFO Memo No. 02: Release date,August 20,2010; (2) CFO Memo No. 03: Release date, June 29,2010; and (3) CFO Memo No. 06: Release date,June 30, 2010. 1.2.4 Scope of Service The vendor shall provide services in a manner consistent with and descried in the current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the program are to preserve the independence of elders and prevent or delay more costly institutional care through a community care service system that provides case management and other in-home and community services as needed under the direction of the County and provide a continuum of service alternatives that meet the diverse needs of functionally impaired elders. 1.3. INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The CCE program provides a continuum of services for functional impaired elders. 1.3.2 Individual Eligibility In order to receive services under this agreement, an applicant must: (1) Be at least 60 years of age; (2) Be functionally impaired as determined through the initial comprehensive assessment; and (3) With the exception of APS high-risk referrals, consumers may not be dually enrolled in the CCE program and a Medicaid capitated long-term care program. 1.3.2.1 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution or who are abused, neglected or exploited. 14 fl 160 2 . SECTION II: MANNER OF SERVICE PROVISION 2. Delivery of Service to Eligible Clients The vendor shall ensure the provision of a continuum of service that meet the diverse needs of functionally impaired elders. The vendor shall ensure performance and reporting of the following service provision in accordance with the current DOEA Programs and Services Handbook. The services may include the following categories: (1) Core Services; (2) Health Maintenance Services; and (3) Other Support Services. Core Services for Programmatic Operation 2.1. The vendor may deliver core services include a variety of home-delivered services, day care services, and other basic services that are most needed to prevent unnecessary institutionalization. Core services,to be provided at the unit rate identified in this agreement, include the following: (1) Adult Day Care; (7) Housing Improvement; (2) Chore Services; (8) Respite Services; and (3) Enhanced Chore; (9) Transportation (4) Companionship; (5) Home Delivered Meals; (6) Homemaker; 2.1.1 Health Maintenance Services The vendor shall ensure that health maintenance services are routine health services that are necessary to help maintain the health of functionally impaired elders. The services are limited to medical therapeutic services, non-medical prevention services, personal care services, home health aide services, home nursing services, and emergency response systems. Typical services to be provided at the unit rate identified in this agreement, are the following: (1) Adult Day Health Care; (2) Emergency Alert Response; (3) Nutrition Counseling (4) Personal Care (5) Skilled Nursing Services; and (6) Specialized Medical Equipment Services and Supplies 2.2 SERVICE TIMES 2.2.1 Service Times 15 16021 The vendor shall ensure the provisions of the services listed in this agreement are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m.to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the agreement in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit o measurement. Units of service will be paid pursuant to the rate established in this agreement as updated, and approved by the County's reporting requirements. Service Unit of Service Adult Day Care Homemaker Case Aide Housing Improvement Case Management Respite Services Chore Services Personal Care Hour Enhanced Chore Physical Therapy Companionship Skilled Nursing Services Emergency Alert Response Day Material Aid Episode Specialized Medical Equipment, Services and Supplies Escort Shopping Assistance One-Way Trip Transportation Service Unit of Service Home Delivered Meals Meal 2.4 REPORTS The vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The vendor shall establish due dates for any agreement that permits the vendor to meet the County's reporting requirements. Service Costs Reports The vendor shall submit to the County semi-annual service cost reports, August 1, 2013 and February 1, 2014, of each year which reflects actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.5 RECORDS AND DOCUMENTATION 2.5.1 Each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup 16 j 160 2 , 2.6 COUNTY RESPONSIBILITIES 2.6.1 Program Guidance and Technical Assistance The County will provide to the vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the vendor. resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures will be made available to the County upon request. 2.7 PERFORMANCE SPECIFICATIONS 2.7.1 Outcomes (1) The vendor shall ensure services provided under this agreement are in accordance with the current Department of Elder Affairs Programs and Services Handbook. (2) The vendor shall timely submit to the County all information described in EXHIBIT 1, SECTION 2.4 REPORTS; and (3) The vendor shall timely submit to the County all information described in EXHIBIT 1, SECTION 2.5 RECORDS AND DOCUMENTATION. 2.8. VENDOR'S FINANCIAL OBLIGATIONS 2.8.1 Matching,Level of Effort,and Earmarking Requirement The vendor will assure a match requirement of at least 10 percent of the cost for all CCE services. The match will be made in the form of cash and/or in-kind resources. At the end of the agreement period, all CCE funds expended must be properly matched. State funds cannot be used to match another state-funded program. 3. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 17 161) 24 3.4 Payment may be authorized only for allowable services, which are in accordance with the limits specified in ATTACIIl1IENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 18 1 6 0 24 EXHIBIT 2 STATEMENT OF WORK HOME CARE FOR THE ELDERLY PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Adult Protective Services(APS) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) 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) Home Care for Disabled Adults (HCDA) Home Care for the Elderly(HCE) Institutional Care Program (ICP) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults (HCDA) services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026) and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the County enters HCE specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement Area Agencies on Aging may contract with CCE lead agencies or other case management entities for the provision of the HCE program. Approved caregivers receive a Basic Subsidy to reimburse some of their expenses each month for caring for the consumer and may receive a Special Subsidy for other necessary services and essential supplies. Caregivers may be approved 19 for up to three HCE clients in their home. i6EJ2 1.2.2 Home Care for the Elderly Program Mission Statement The Home Care for the Elderly Program supports family style living arrangements, on a non- profit basis, as an alternative to nursing homes or other institutional care. Through the program, a caregiver for three or fewer elders living in a private home provides basic services of maintenance and supervision as well as coordinating other necessary specialized services. 1.2.3 Authority The relevant authority governing the HCE program include: (1) Rule Chapter 58H-1, Florida Administrative Code; and (2) Sections 430.601 through 430.608, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services', Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: CFO Memo No. 02: Release date,August 20, 2010; CFO Memo No. 03: Release date,June 29, 2010; and CFO Memo No. 06: Release date,June 30,2010. 1.2.4 Scope of Service The Vendor shall provide services in a manner consistent with and described in the current County's area plan update and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the HCE program are to ensure that: (1) Basic Subsidy is provided to the caregiver of each client and (2) Special Subsidy is provided when essential to the well-being of the client. 1.3 INDIVIDUAL TO BE SERVED 1.3.1 General Eligibility The Home Care for the Elderly program serves elders age 60 and older at risk of placement in a nursing home or other institutional settings who can remain in a family style setting through the provision of subsidies. 1.3.2 Client Eligibility Clients eligible to receive services under this agreement must: (1) Be 60 years of age or older; (2) Have income less than the Institutional Care Program(ICP) standard. (3) Meet the ICP asset limitation; (4) Be at risk of nursing home placement; 20 1602 ' (5) Have an approved adult caregiver living in the home with them who is willing to provide care or assist in arranging for care; and (6) Not be enrolled in the Aged and Disabled Adult Medicaid waiver or a Medicaid capitated long-term care program. 1.3.3 Caregiver Eligibility Caregivers eligible to receive services under this agreement must: (1) Be at least 18 years of age, capable of providing a family-type living environment; (2) 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; (3) Be willing to accept responsibility for the social, physical and emotional needs of the care Vendor; (4) Be physically present and live in the home to provide supervision and to assist in arrangement of services for the client; (5) 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 (6) Be without record of conviction of abuse,neglect or exploitation of another person. 1.3.4 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meet the diverse needs of the functionally impaired elders and their caregivers. The Vendor shall ensure Basic Subside and Special Subsidy services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. 2.1. Basic Subsidy The Basic Subsidy is a cash payment made to an approved caregiver each month to reimburse some expenses incurred in caring for the client. The Basic Subsidy is provided for support and maintenance of the client, including housing, food, clothing, and medical costs not covered by Medicaid, Medicare or any other insurance. A Basic Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. If the client is hospitalized or in any other temporary institution for 30 days or less,the full Basic Subsidy shall be provided to the caregiver as if the client were in the home. 2.2. Special Subsidy Services Though every eligible HCE client receives a Basic Subsidy, Special Subsidy payments are pre-authorized and are based on additional specialized medical or health care services, supplies or equipment needed to maintain the health and well-being of the individual elder. The Special Subsidy for additional medical support and special services is a cash payment to reimburse the costs of any other service or special care not covered by Medicaid, Medicare, or private insurance when these services are determined to be 21 16D 21 essential to maintain the well-being of the home care recipient. A Special Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. Special Subsidy 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: 2.2.1 SERVICE LOCATION AND EQUIPMENT 2.2.2 Service Times The vendor shall ensure the provision of the services listed in this contract are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m. to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the Agency's reporting requirements. Service Unit of Service Adult Day Care Housing Improvement Case Aide Other Case Management Personal Care Chore Respite (Facility Based or In-Home) Hour Chore (Enhanced) Skilled Nursing Services Homemaker Material Aid Episode Specialized Medical Equipment, Services and Supplies Transportation One-Way Trip 2.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permits the Vendor to meet the County's reporting requirements. 2.2.1 Service Costs Reports The Vendor shall submit to the County the semi-annual service cost reports, August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.3 RECORDS AND DOCUMENTATION 2.3.1 The Vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The 22 fr 1602 Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 2.4 PERFORMANCE SPECIFICATIONS 2.4.1 Outcomes (1) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (2) The Vendor shall timely submit to the County all reports described in SECTION 2.2 REPORTS; and (3) The Vendor shall timely submit to the County all information described in, SECTION 2.3 RECORDS AND DOCUMENTATION. 2.5 COUNTY RESPONSIBILITIES 2.5.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-up on-site visits; (3) Client visits; (4) Review of independent auditor's reports; (5) Review of third-party documents and/or evaluation; (6) Review of progress reports; (7) Review of customer satisfaction surveys; (8) Agreed-upon procedures review by an external auditor or consultant; (9) Limited-scope reviews; and (10) Other procedures as deemed necessary. SECTION HI: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The 23 ,� 16D 2 vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services,which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 24 \� 1613 24 EXHIBIT 3 STATEMENT OF WORK ALZHEIMER'S DISEASE INITIATIVE PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Alzheimer's Disease(AD) Alzheimer's Disease Initiative(ADI) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) Adult Protective Services (APS) Client Information and Registration Tracking System(CIRTS) Community Care for Disabled Adults (CCDA) Department of Elder Affairs(DOEA) Home Care For Disabled Adults(HCDA) Instrumental Activities of Daily Living(IADL) Memory Disorder Clinic (MDC) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults (HCDA) services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026. 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 County enters ADI specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 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. Model Day Care: A program of therapeutic, social and health activities specific to clients with memory disorders. Services and activities include, but are not limited to, active and quiet 25 160 � { games, reminiscence, validation therapy, pet therapy, water therapy and other failure free activities appropriate to the client's level of functioning. Model day care centers will also provide training for health care and social service personnel in the care of persons having AD or related memory disorders. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The ADI program provides a continuum of services addressing the special needs of individuals with AD,their families and caregivers. 1.2.2 Alzheimer's Disease Initiative Program Mission Statement The ADI program ensures that persons afflicted with AD and other forms of dementia are given essential services to help them age in place in an elder-friendly environment with security, dignity, and purpose. The program also provides support to family members and caregivers of persons afflicted with AD. 1.2.3 Authority The relevant authority governing the Alzheimer's Disease Initiative Program are as follows: (1) Rule Chapter 58D-1, Florida Administrative Code; and (2) Sections 430.501 through 430.504,Florida Statutes. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Depaitnient of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1) CFO Memo No. 02: Release date, August 20,2010; (2) CFO Memo No. 03: Release date, June 29,2010; and CFO Memo No. 06: Release date,June 30,2010. 1.2.3.2 Scope of Service The Vendor is responsible for the programmatic, fiscal, and operational management of the ADI program. The program services shall be provided in a manner consistent with and described in the current Vendor's Request for Proposal, RFP, and the County's current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.3.4 Major Program Goals The major goal of the ADI program is to provide services to meet the needs of caregivers and individuals with AD and related memory disorders. 1.3 INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The ADI Program addresses the special needs of individuals with AD and their caregivers. 1.3.2 Individual Eligibility Those individuals eligible to receive services under this contract must meet the following conditions: (1) Be 18 years of age or older and have a diagnosis of AD or a related disorder, or be 26 160 2 suspected of having AD or a related disorder; and (2) Not be enrolled in a Medicaid capitated long-term care program. 1.3.3 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. SERVICE TASKS In order to achieve the goals of the ADI program, the Vendor shall ensure the following tasks are performed: (1) Client eligibility determination; (2) Assessment and prioritization of service delivery for new clients; (3) Delivery of services to eligible clients; and (4) Monitor the performance of vendors. 2.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described in this SECTION 1.3. 2.2 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services addressing the diverse needs of individuals with AD and their caregivers. The Vendor shall ensure services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. Services categories include: (1) Caregiver Training/Support; (2) Case Aid; (3) Case Management; (4) Counseling(Gerontological); (5) Counseling(Mental Health/Screening); (6) Education/Training; (7) Model Day Care; ( 8) Respite(Facility-Based); ( 9) Respite(In-Home); and (10) Specialized Medical Equipment, Services, and Supplies. Caregivers benefit from receiving training, respite and related support services to assist them in caring for the ADI client. 2.3 Service Times The Vendor shall ensure the provisions of the services listed in this contract are available 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. 27 160 2pi trd 3. DELIVERABLES 3.1. Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the County's reporting requirements. Service Unit of Service Caregiver Training/Support; Hour Case Aid; Hour Case Management; Hour Counseling(Gerontological); Hour Counseling(Mental Health/Screening); Hour Respite(Facility-Based); Hour Respite(In-Home); Hour Education/Training; Episode Episode 3.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. 3.2.1 Service Costs Reports Vendor must submit to the County the semi-annual service cost reports August 1, 2013 and February 1,2014,which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 3.3 RECORDS AND DOCUMENTATION 3.3.1 The Vendor and each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 4. PERFORMANCE SPECIFICATIONS 4.1 Outcomes (4) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (5) The Vendor shall timely submit to the County all reports described in SECTION 3.2 REPORTS; and (6) The Vendor shall timely submit to the County all information described in SECTION 3.3 28 160 2 RECORDS AND DOCUMENTATION. 5. COUNTY RESPONSIBILITIES 5.1. Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-up on-site visits; (3) Client visits (4) Review of independent auditor's reports (5) Review third-party documents and/or evaluations (6) Review of progress reports (7) Review of customer satisfaction surveys (8)Agreed-upon procedures review by an external auditor or consultant; (9)Limited-scope reviews; and (10)Other procedures as deemed necessary. 6. SECTION III: METHOD OF PAYMENT 6.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 6.1.2 Remedies-Nonconforming Services The Vendor shall ensure that all goods and/or services provided under this agreement for HCE funded programs are delivered timely, completely and commensurate with required standards of quality Such goods and/or services shall only be delivered to eligible program participants. If the Vendor fails to meet the prescribed quality standards for services, such services will not be reimbursed under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be reimbursed under this agreement. The Vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the Vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County requires immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 6.1.3 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the Vendor and any adjustments thereto, including any disallowance not resolved. 6.1.4 Date for Final Request for Payment 29 160 2 ri The final request for payment for agreement year one's expenditures will be due to the County no later than August 1,2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 6.2 Documentation for Payment The Vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals upon request. Such documentation shall be provided upon request to the County or the Clerk of Court. 30 16021 EXHIBIT 4 STATEMENT OF WORK OLDER AMERICANS ACT PROGRAM TITLE III SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 CONTRACT ACRONYMS Area Agency on Aging(AAA) Activities of Daily Living(ADL) Alliance of Information&Referral Systems (AIRS) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System(CIRTS) Information and Referral(I&R) Instrumental Activities of Daily Living(IADL) Older Americans Act(OAA) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in Its PSA in accordance with the Section 306 (42 U.S.C. 3026) of the OAA and Department instructions. Child: An individual who is not more than 18 years of age or an individual with disability. Family Caregiver: An adult family member, or another individual,who is an informal provider of in-home and community care to an older individual. Frail: When an older individual is unable to perform at least two ADLs without substantial human assistance, including verbal reminding,physical cueing or supervision; or due to cognitive or other mental impairment,requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to another individual. 1.2 County Mission,Vision and Values Statement The County's mission: To help aging adults achieve greater independence through awareness of resources and access to qualified service providers. The County's vision: To be the recognized leader in supporting older adults and their families with access to trustworthy resources and services in their communities while empowering them to live with independence and dignity. The County's values: We believe residents of Southwest Florida are entitled to: Comprehensive information about their choices of care; Timely access to resources and services; High standards of quality and performance; and Personal and professional accountability from all stakeholders. 1.2.1 Older Americans Act Program Mission Statement The Older Americans Act(OAA)Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. 31 160 2r4 1.3 GENERAL DESCRIPTION 1.3.1 General Statement The OAA Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. The primary purpose of the OAA program is to foster the development and implementation of comprehensive and coordinated systems to serve older individuals. The OAA program uses these systems to assist older individuals to attain and maintain maximum independence and dignity in a home environment and allows for the capability of self- care with appropriate supportive services. 1.3.2 Authority The relevant references authority governing the OAA program are: 1. Older Americans Act of 2006, as amended; 2. Rule 58A-1, Florida Administrative Code; and 3. Section 430.101, Florida Statutes. 1.3.2.1 Incorporation of Reference Memoranda In accordance with Ch. 287 F.S., as amended, and Agency of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and incorporated by reference: 1. CFO Memo No. 02: Release date, August 20,2010; 2. CFO Memo No. 03: Release date,June 29, 2010; and 3. CFO Memo No. 06: Release date, June 30, 2010. 1.3.3 Scope of Service The Vendor shall provide services in a manner consistent with and descried in the current area plan and current Department of Elder Affairs Programs and Services Handbook. 1.3.4 Major Program Goals The major goals of the OAA program are to improve the quality of life for older individuals, preserve their independence and prevent or delay more costly institutional care. These goals are achieved through the implementation of a comprehensive and coordinated service system that provides a continuum of service alternatives that meet the diverse needs of elders and their caregivers. 1.4 INDIVIDUALS TO BE SERVED 1.4.1 Eligibility(Title III Programs) 1.4.1.1 OAA Title III,General Consumers shall not be dually enrolled in an OAA program and a Medicaid capitates long-term care program. 1.4.1.2 OAA Title IIIE, Caregiver Support Services Eligibility for OAA Title IIIE, Caregiver Support Services, are as follows: 1. Family caregivers of individuals age 60 or older; 32 16O2 2. Grandparents(age 55 or older)or older individuals (age 55 or older)who are relative caregivers; 3. Priority will be given to family caregivers who provide care for individuals with Alzheimer's disease and related disorders with neurological and organic brain dysfunction and for grandparents or older individuals who are relative caregivers who provide care for children with severe disabilities; and 4. For respite and supplemental services,a family caregiver must be providing care for an older individual who meets the definition of the term"frail" in OAA, Section 102 Paragraph 22. 1.4.2 Targeted Groups Preference shall be given to those with the greatest economic and social need,with particular attention to low-income older individuals, including those that are low-income minorities,have limited English proficiency, and older individuals residing in rural areas. SECTION II—MANNER OF SERVICE PROVISION 2.1 SERVICE TASKS In order to achieve the goals of the OAA program,the Vendor shall ensure the following tasks are performed: 1. Client eligibility determination; 2. Targeting and screening of service delivery for new clients; 3. Delivery of services to eligible clients; 4. Use of volunteers to expand the provision of available services; 5. Monitoring the performance of its vendors. 6. Grievance and Compliance Procedures 2.1.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described herein. 2.1.2 Targeting and Screening of Service Delivery for New Clients The Vendor shall develop and implement policies and procedures consistent with OAA targeting and screening Criteria 2.1.3 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meets the diverse needs of elders and their caregivers. The Vendor shall ensure the performance and report performance of the following services in accordance with the current Department of Elder Affairs Programs and Services Handbook. The services funded pursuant to this contract are in accordance with the OAA,Title III, sections 321,331,336 and 373 as follows: 1. Section 321,Title LOB Supportive Services; 2. Section 373,Title HIE Caregiver Support Services. 2.1.3.1 Supportive Services Supportive services include a variety of community-based and home-delivered services that support the qualities of life for older individuals by helping them remain independent and productive. Services include the following: 33 w 160 2 (1) Adult Day Care/Adult Day Health Care; (17) Homemaker; (2) Caregiver Training/Support; (18) Housing Improvement; (3) Case Aide/Case Management; (19) Information; (4) Chore Services; (20) Intake; (5) Companionship; (21) Interpreter/Translating; (6) Counseling(Gerontological and Mental Health); (22) Referral/Assistance; (7) Education/Training; (23) Personal Care; (8) Legal Assistance; (24) Physical Therapy; (9) Material Aid; (25) Shopping Assistance; (10) Occupational Therapy; (26) Skilled Nursing; (11) Outreach; (27) Specialized Medical Equipment, Services, and Supplies (12) Recreation; (28) Respite Services; (13) Emergency Alert Response; (29) Screening/Assessment; (14) Escort; (30) Speech Therapy; (15) Health Support; (31) Telephone Reassurance; and (16) Home Health Aide; (32) Transportation 2.1.3.4 Caregiver Support Services (Title HIE Program) The following services are intended to provide direct help to caregivers, assist in the areas of health, nutrition and financial literacy and assist caregivers in making decisions and problem solving related to their caregiving roles and responsibilities: (1) Adult Day Care/Adult Day Health Care; (2) Caregiver Training/Support; (3) Counseling(Gerontological and Mental Health); (4) Education/Training; (5) Financial Risk Reduction(Assessment and Maintenance); (6) Information; (7) Intake; (8) Outreach; (9) Respite Services; (10) Screening/Assessment; and (11) Transportation 2.1.3.5 Caregiver Support Supplemental Services (Title DIES Program): The following services are provided to complement the care provided by caregivers: (1) Chore Services; (2) Housing Improvement; (3) Legal Assistance; (4) Material Aid; and (5) Specialized Medical Equipment, Services and Supplies. 2.2 SERVICE LOCATION 34 16D2 . 2.2.1 Service Times The Vendor shall ensure the provision of the services listed in the contract during normal business hours unless other times are more appropriate to meet the performance requirements of the contract, and it shall monitor its vendors to ensure they are available to provide services during hours responsive to client needs and during those times which best meet the needs of the relevant service community. 2.3 DELIVERABLES 2.3.1 Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the services tasks described in Section 2.1. The chart below lists the services allowed and the units of measurement. Units of service will be paid pursuant to the rate established in the 2010 RFP and approved by the County. Services Unit of Sergi ice Adult Day Care/Adult Day Interpreter/Translating Health Care Legal Assistance Caregiver Training/Support Medication Management Case Aid/Case Management Mental Health Counseling/Screening Chore Services Nutrition Counseling Companionship Occupational Therapy Counseling Services Personal Care Escort Physical Therapy Hour Financial Risk Reduction Recreation Services Respite Services Health Support Screening/Assessment Home Health Aide Sitter Homemaker Skilled Nursing Services Housing Improvement Speech Therapy Intake Emergency Alert Response Day Education/Training Episode Information Material Aid Referral/Assistance Specialized Medical Equipment, Services and Supplies Telephone Reassurance Escort One-Way Trip Shopping Assistance Transportation 2.4 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permit the Vendor to meet the County's reporting requirements. 35 161) 21 2.4.2 Service Costs Reports The Vendor shall require vendors to submit to the Vendor semi-annual service cost reports on August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.4.5 Background Screening Affidavit of Compliance To demonstrate compliance with section 8 of the Standard Contract,the Vendor shall submit ATTACHMENT H,Background Screening Affidavit of Compliance annually, by January 15t. 2.5 RECORECORDS AND DOCUMENTATION Each Vendor and vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up.The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement in its contracts and/or agreements with vendors. These policies and procedures shall be made available to the County upon request. 2.6 PERFORMANCE SPECIFICATIONS 2.6.1 Outcomes (1)The Vendor shall ensure services provided under this contract are in accordance with the current DOEA Programs and Services Handbook, (2)The Vendor shall timely submit to the County all reports described herein (3)The Vendor shall timely submit to the County all information described in, Paragraph 2.5 RECORDS AND DOCUMENTATION. 2.7 VENDOR'S FINANCIAL OBLIGATIONS 2.7.1 Matching,Level of Effort,and Earmarking Requirements The Vendor shall provide match of at least 10 percent of the federal funds received. The Vendor's match will be made in the form of cash and/or in-kind resources. The Vendor will assure,through a provision in subcontracts,a match requirement of at least 10 percent of the cost for all services funded through this contract. The vendor's match will be made in the form of cash and/or in-kind resources. The Vendor shall report match by title each month. At the end of the contract period, the Vendor must properly match all OAA funds. 2.7.2 Title III Funds The Vendor assures compliance with Section 306 of the OAA, as amended in 2006,that funds received under Title III will not be used to pay any part of a cost incurred by the Vendor to maintain a contractual or commercial relationship that is not carried out to implement Title III. 2.8 COUNTY RESPONSIBILITIES 2.8.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the Vendor. 2.8.2 Program/Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this contract. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an on-site visit. The County's determination of acceptable performance shall be conclusive. The Vendor 36 16O2 11 agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: 1. Desk reviews and analytical reviews; 2. Scheduled, unscheduled and follow-up on-site visits; 3. Client visits; 4. Review of independent auditor's reports-Exhibit 10; 5. Review of third-party documents and/or evaluation; 6. Review of progress reports; 7. Review of customer satisfaction surveys; 8. Agreed-upon procedures review by an external auditor or consultant; 9. Limited-scope reviews; and 10. Other procedures as deemed necessary. 2.8.3 Contract Monitoring The County shall, at its own discretion, conduct monitoring concerning any aspect of the vendor's performance of this contract. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for OAA IIIE and OAA II ES funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Depai lment require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rate for services is ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services, which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 37 160 t 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 38 . , 16021 EXHIBIT 5 Agreement#12-5856 "Services for Seniors Attachment B Invoice and Logs (Minimum Standard Invoice Information) County Purchasing Order Number: Invoice Number: Grant Name: From Date To Date �. 'f4' Y . ^' ; "1)11444 ..' i..-•vi,. ,. I 1 1 v : , Subtract d 1 1 '� ,� Os' i 11 Its ,, Se c 1 escription _ £� In nd I �F d'eim 1 u v. I n i i atch - ,, iden 1 e. 'by°hne) Match ®uanti i l .• t -� a? '. ,j I1OIIIIt Am0UII is 1 1 3_aiA1_�:� I s2, it l i: , & , , „ `' 1 ,- , om,Tota ®uan 1 it 4 _ :�-` q ., _ Cos ,•`r '7;1.474-'-'„ . 52. `".'. `- _ '31 ' {,I kr Unit " - $0.00 $0.00 $0.00 Total $0.00 I certify to the best of my knowledge and belief that this invoice, and attached service detail log, is complete and correct and all outlay herein are for the purposes set forth in the contract, and that services are ordered by the case manager as agreed on the Contract. Legible copies of the dated timesheet, signed by the client and the worker supporting this invoice must be available upon request. Collier County reserves the right to correct computation of errors to assure proper payment amount. Prepared by: Date: Adjustment Reasons Lead Agency Authorization Attachments: Monthly Service log,Weekly Detail log and Client Service time sheets. 39 "-mil ` J 161) 'e EXHIBIT 6 Detail Weekly for CCE Services Week Ending: Invoice No. Personal CLIENT Care Homemaker Respite Skilled Companion Chore Total Total Total Total Total Total NAME Units Units Units Units Units Units Total Hours - - - - - - PECA - HMK - $ RESPITE - $ SKILLED - $ COMPANION - $ CHORE - $ TOTAL - 40 EXHIBIT 7 160 2 Monthly Detail Service Log Grant Name: Vendor Name, Address: From Date To Date By client,provide the total number of hours provided during the dates of service. This log must be submitted with your monthly invoice for the Invoice From Date and To Date. ,f � .0 f ', �- * �} s �.."` a�� s n t Is � ,� y.s ty µ..; ..t.u' c. il per ,x44 'Iiesptte Adult .Respite t r merger! Client Personal a Home- '4, Skilled ''D nuance,'. Co" ho pm e .4' k m (In ��ng ay (In_ Cho V'Cho is IS:Y=4"Name aC maker Nursmg a Ramon x zhti ome '&°cakt, +�q-• Care a acill -' t a ""`�x Ra31Y ' �, '.¢k. `� �*+°+Ek.. fi -'"", ` • -... - $ •4�' SrtEm 3yrt31y1 41 `JJ 160 21 EXHIBIT 8 Daycare Grant: Grant Service: ADC or RESF Vendor Name and Address By client, provide the Weekly Client Service Time Sheet provided during the dates of service. This log must be submitted with all invoices for the invoice From Date and To Date. TO FROM DATE: DATE: Client Thur Uni Client Name signature Mon Tue Wed s Fri Sat Sun Match is Service Dates 42 160 2 EXHIBIT 9 YOUR COMPANY NAME HERE Collier County Services for Seniors Homemaker/Personal Care/Respite/Companion Work Sheet Client Name: Client Signature: Week Ending: Each Time You Perform one of the Activities Below: Put in arrival and departure times for the day worked: ****Client should Initial time of arrival and departure. ****Client should Sign form at top. ****you should sign your name at the bottom. Date: Day: MON TITS WED THUR FRI SAT SUN TOTAL TIME ARRIVAL TIME: DEPARTURE TIME: ****CLIENT INITIALS: Arrive: PERSONAL CARE Depart: Assist W/Bath tub Shower Bed Assist W/Dressing Bathroom Assist Shave (Face Only) Oral Hygiene Walking/Ambulation Feeding Assistance Wash/Set Hair Backrub Soak Feet Nails (File only) Change Make Bed Take out Trash Clean Bedroom Clean Bathroom Prepare Meals Laundry Arrive: HOME MAKING Depart: Vacuum/Sweep Light Dusting 43 ( I 160 2 Clean Kitchen Floor Wash Dishes Mop Sweep_ Grocery Shop Errands Arrive: RESPITE Depart: Arrive: COMPANION Depart: EMPLOYEE'S Signature/Title 44 1602 EXHIBIT 10 OMB Circular A-133 Audits of States, Local Governments, and Non-Profit Organizations requires the. Collier County Housing,. Human and Veterans Services: Department to monitor 'our subrecipientsi of federal awards and determine whether they have met the audit requirements of the circular and whether they are in compliance with federal laws and regulations. Accordingly, we are requiring that you check one of the following, provide all appropriate documentation regarding your organization's compliance with the audit requirements, sign and date this form. Subrecipient Fiscal Year Name Period Total State Financial Assistance Expended during $ most recently completed Fiscal Year Total Federal Financial Assistance Expended during most $ recently completed Fiscal Year Check Appropriate Boxes We have exceeded the$500,000 federal/state expenditure threshold for our fiscal year ❑ ending as indicated above and have completed our Circular A-133 audit. A copy of the audit report and management letter are attached. We exceeded the $500,000 federal/state expenditure threshold for our fiscal year ❑ ending as indicated above and expect to complete our Circular A-133 audit by . Within 30 days of completion of the A-133 audit, we will provide a copy of the audit report and management letter. We are not subject to the requirements of OMB Circular A-133 because we: • Did not exceed the $500,000 federal/state expenditure threshold for the fiscal year indicated above ❑ Are a for-profit organization ❑ Are exempt for other reasons - explain An audited financial statements is attached and if applicable, the independent auditor's management letter. (If findings were noted, please enclose a copy of the responses and corrective action plan.) Certification Statement I hereby certify that the above information is true and accurate. Signature Date Print Name and Title 45 ORIGINAL DOCUMENTS ORIGINAL ROUTING 160 OC OMPANYALL OC MENTS SENT TO 21 THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Routed by Purchasing Department,to Office Initials Date the Following Addressee(s) (In routing order) 1. Risk Management Risk 2. County Attorney Office County Attorney Office W1') 4, ` r] 113 3. BCC Office Board of County \(14 off, Commissioners G � 4 �yA\7 of Office �� 4. Minutes and Records Clerk o Court's O 5. Return to Purchasing Department Purchasing Contact: Diana DeLeon PRIMARY CONTACT INFORMATION Name of Primary Diana DeLeon for Lisa Carr, HHVS, Phone Number 252-8375 Purchasing Staff June 6,2013 Contact and Date / Agenda Date Item was May 28,2013 Agenda Item Number 16.D.2 �/ Approved by the BCC Type of Document Contract Amendment Number of Original 2 Attached Documents Attached PO number or account N/A Solicitation/Contract Amend#1 to Contract 12- number if document is Number/Vendor Name 5856 Always There to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A" in the Not Applicable,column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature? DD 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be signed by the Chairman, with the exception of most letters,must be reviewed and signed �� by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's DD signature and initials are required. 7. In most cases(some contracts are an exception), an electronic copy of the document and DD this routing slip should be provided to the County Attorney's Office before the item is input into SIRE. 8. The document was approved by the BCC on the date above and all changes made DD during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC,all changes directed by the BCC have been made, and the document is ready for the oi'e Chairman's signature. 1613 2 „, MEMORANDUM Date: June 17, 2013 To: Diana De Leon, Contract Technician Purchasing Department From: Martha Vergara, Deputy Clerk Minutes & Records Department Re: Amendment #1 - Contract #12-5856 "Services for Seniors” Contractor: Always There Home Health Care, Inc. Attached, is an original of the assumption agreement referenced above (Agenda Item #16D2), approved by the Board of County Commissioners on Tuesday, May 28, 2013. The original will be held on file with the Minutes and Record's Department in the Board's Official Records. If you have any questions, please contact me at 252-7240. Thank you. Attachment 1 613 2 Contract Amendment #1 Contract # 12-5856 "Services for Seniors" This CONTRACT AMENDMENT #1, dated M , 2013 to the referenced agreement shall be by and between the parties to the original Agreement`, Always There Home Health Care, Inc. (to be referred to as"Vendor") and Collier County, Florida, (to be referred to as "County"). Statement of Understanding RE: Contract# 12-5856 "Services for Seniors" In order to continue services for the original Contract document referenced above, the Vendor agrees to the terms and conditions set forth in Exhibit A-1 A, which includes Attachments C-H and Exhibits 1-10 attached hereto and incorporated by reference. The Vendor further agrees to amend Section 1, Commencement, as follows: 1. COMMENCEMENT. This Agreement shall Commence on December 11, 2012 and shall terminate on December 10, 2011 June 30,2014. The Contract award is a two (2) year contract, with the possibility of two (2) additional (2) year terms pending funding from grantors and acceptable performance by the awarded vendor. Any such renewals shall be mutually agreed upon in writing by the parties. The maximum duration for this Contract for CCE, HCE, and ADI, OAA IIIE AND OAA IIIES funding will not exceed six (6) years (through June 30, 2018). As outlined in RFP #12-5856, the County requires the Vendor to contribute a cash or in-kind match of no less than ten (10) percent for all services related to the Community Care for the Elderly Program, (CCE), Older American Title IIIE Caregiver Support (OAA IIIE) and Older American Title IIIES Caregiver Support Supplemental Services(OAA IIIES) Programs. Words that have been deleted are struck through, words underlined have been added. Modification made herein shall apply as if incorporated into the Contract on the date of Commencement. All other terms and conditions of the agreement shall remain in force. IN WITNESS WHEREOF, the Vendor and the County have each, respectively, by an authorized person or agent, hereunder set their hands and seals on the date(s) indicated below. Accepted: (0/ `4 I 13 , 2013 VENDO ' • tfitAt-kaghiL Aiwa/'. There H. e Health Care, Inc. First Witness By: /, %air W o rt t Type/print witn- s • m; 41 Print/Type Name and Title P-cond Witness n ' �.eanne.i1 (fit, e Type/print witness name 1 16 ® COUNTY: ATTEST: BOARD OF COUNTY COMMISSIONERS DWIGHT E.�BRO.CK, CLERK OF COL _ ER CO Y, FLORIDA f k Y By 47/`i/ By "D'.' 7711,v GEORGIA A. HILLER, ESQ. Attest as iO,Chairmry. CHAIRWOMAN signature only Approval for form and legal Sufficiency: Jenni er B. White Assistant County Attorney • 2 EXHIBIT A-1A 160 2 .. AGREEMENT 12-5856 SERVICES FOR SENIORS ATTACHMENTS ATTACHMENT ATTACHMENT DESCRIPTION PAGE Attachment C Core Standards for CCE, HCE, ADI, OAA IIIE & IIIES 2 Attachment D Certification Regarding Lobbying 8 Attachment E Certification Regarding Data Integrity Compliance 9 Attachment F Certification Regarding Debarment, Suspension, 10 Ineligibility and Voluntary Exclusion Contracts/ Subcontracts Attachment G Sub-Recipient Invoice Submission 11 Attachment H Background Screening Affidavit of Compliance 12 Exhibit 1 CCE Statement of work 13 Exhibit 2 HCE Statement of work 19 Exhibit 3 ADI Statement of work 25 Exhibit 4 OAA IIE and OAA IIIES Statement of work 31 Exhibit 5 Invoice 39 Exhibit 6 Detail Weekly Log 40 Exhibit 7 Monthly Log 41 Exhibit 8 Day Care/Respite Time Sheet 42 Exhibit 9 Program Time Sheet 43 Exhibit 10 Annual Audit Monitoring Report 45 1 16a 2 ATTACHMENT C Core Standards for CCE,HCE,ADI,OAA HIE & HIES 1. Compliance with Federal Law 1.1 If this agreement contains federal funds the following shall apply: 1.1.1 The vendor shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable regulations. 1.1.2 If this agreement contains federal funds and is over$100,000.00, the vendor shall comply with all applicable standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s. 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable Environmental Protection County regulations 40 CFR 30. The vendor shall report any violations of the above to the County. 1.1.3 The vendor may not use any federal funds received in connection with this agreement to influence legislation or appropriations pending before the Congress or any state legislature. If this agreement contains federal funding in excess of$100,000.00, the vendor must, prior to agreement execution, complete the Certification Regarding Lobbying form, ATTACHMENT D. All disclosure forms as required by the Certification Regarding Lobbying form must be completed and returned to the Grant Coordinator prior to payment under this agreement. 1.1.4 In accordance with Appendix A to 2 CFR 215, the vendor shall comply with Executive Order 11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in Department of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable. 1.1.5 If this agreement contains federal funds and provides services to children up to age 18,the vendor shall comply with the Pro-Children Act of 1994(20 U.S.C. 6081). 1.1.6 A agreement award with an amount expected to equal or exceed $25,000.00 and certain other agreement 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 vendor shall comply with these provisions before doing business or entering into sub-agreements receiving federal funds pursuant to this agreement. The vendor shall complete and sign ATTACHMENT F prior to the execution of this agreement. 1.2 The vendor shall not employ an unauthorized alien. The County 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 agreement by the County. 2 CA 0 160 2 1.3 If the vendor 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 vendor must notify the County in writing within thirty(30) days of receiving the IRS notice of revocation. 1.4 The vendor shall comply with Title 2 CFR Part 275 regarding Trafficking in Persons. 1.5 Unless exempt under 2 CFR Part 170.110(b), the vendor shall comply with the reporting requirements of the Transparency Act as expressed in 2 CFR 170. 1.6 To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number 11-116, vendor agrees to utilize the U.S. Department of Homeland Security's E-verify system to verify the employment of all new employees hired by vendor during the agreement term. Vendor meeting the terms and conditions of the E-Verify System are deemed to be in compliance with this provision. 2. Compliance with State Law 2.1 This agreement is executed and entered into in the State of Florida, and shall be construed, performed and enforced in all respects in accordance with the Florida law, including Florida provisions for conflict of laws. 2.2 The vendor shall comply with requirements of s. 287.058, F.S. as amended. 2.2.1 The vendor shall provide units of deliverables, including various client services, and in some instances may include reports, findings, and drafts, as specified in this agreement,which the Grant Coordinator must receive and accept in writing prior to payment in accordance with s. 215.971, F.S. (1)and(2). 2.2.2 The vendor shall submit bills for fees or other compensation for services or expenses in sufficient detail for a proper pre-audit and post-audit. 2.2.3 The vendor 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 vendor in conjunction with this agreement except for those records which are made confidential or exempt by law. The vendor's refusal to comply with this provision will constitute an immediate breach of agreement for which the County may unilaterally terminate the agreement. 2.3 If clients are to be transported under this agreement, the vendor shall comply with the provisions of Chapter 427, F.S., and Rule 41-2, F.A. C. 2.4 Vendors who are on the discriminatory vendor list may not transact business with any public entity, in accordance with the provisions of s. 287.134, F.S. 2.5 The vendor shall comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the expenditure of agreement funds for the purpose of lobbying the legislature,judicial branch or a state agency. 3. Background Screening The vendor shall ensure that the requirements of s. 430.0402 and ch. 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 exempted from the Department's level 2 background screening 3 Ctt 0 16n 2 pursuant to s. 430.0402(2)-(3), F.S. The vendor must also comply with any applica a rules promulgated by the Department and the Agency for Health Care Administration regarding implementation of s.430.0402 and ch. 435, F.S. Further information concerning the procedures for background screening are found at http://elderaffairs.state.fl.us/doea/backgroundscreening.php. 4. Provision of Services The vendor shall provide services in the manner described herein. 5. Monitoring by the County The vendor shall permit persons duly authorized by the County to inspect and copy any records, papers, documents, facilities, goods and services of the vendor which are relevant to this agreement, and to interview any clients, employees and vendor employees of the vendor to assure the County of the satisfactory performance of the terms and conditions of this agreement. Following such review, the County will provide a written report of its findings to the vendor, and where appropriate,the vendor shall develop a corrective action plan. The vendor hereby agrees to correct all deficiencies identified in the corrective action plan in a timely manner as determined by the Grant Coordinator. 6. Confidentiality of Information The vendor shall not use or disclose any information concerning a vendor of services under this agreement 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. 7. Health Insurance Portability and Accountability Act Where applicable, the vendor shall comply with the Health Insurance Portability and Accountability Act (42 USC 1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162,and 164). 8. Bankruptcy Notification During the term of this agreement,the vendor shall immediately notify the County if the Vendor, its assignees,vendors or affiliates file a claim for bankruptcy. Within ten (10)days after notification,the vendor must also provide the following information to the County.: (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., United States Bankruptcy Court Middle District of Florida,Naples,FL); and, (4)The name, address, and telephone number of the bankruptcy attorney. 9. Sponsorship and Publicity 9.1 As required by s. 286.25, F.S., if the vendor is a non-governmental organization which sponsors a program financed wholly or in part by state funds, including any funds obtained through this agreement, it shall, in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by Hope Hospice and Community Services, the State County of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County." If the sponsorship reference is in the written material, the words "State of Florida, Department of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County" shall appear in at least the same size letters or type as the name of the organization. 9.2 The vendor shall not use the words "The State of Florida Department of Elder Affairs or the Area County on Aging for Southwest Florida, Inc. or Collier County" to indicate sponsorship of a program otherwise financed, unless specific authorization has been obtained by Collier County, or the Area Aging on Aging prior to use. 4 ell 0 160 2 10. Independent Capacity of Vendor It is the intent and understanding of the Parties that the vendor, or any of its vendors, are independent vendors and are not employees of the County and shall not hold themselves out as employees or agents of the County without specific authorization from the County. It is the further intent and understanding of the Parties that the County does not control the employment practices of the vendor and will not be liable for any wage and hour, employment discrimination, or other labor and employment claims against the vendor or its vendors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary insurance for the vendor are the sole responsibility of the vendor. 11. Payment Payments shall be made to the vendor pursuant to s. 215.422, F.S., as services are rendered and invoiced by the vendor. The Grant Coordinator will have final approval of the invoice for payment, and will approve the invoice for payment only if the vendor has met all terms and conditions of the agreement, unless the bid specifications, purchase order, or this agreement specify otherwise. The approved invoice will be submitted to the County's Grant Coordinator approval and processing. 12. Return of Funds The vendor shall return to the County any overpayments due to unearned funds or funds disallowed and any interest attributable to such funds pursuant to the terms and conditions of this agreement that were disbursed to the vendor by the County. hi the event that the vendor or its independent auditor discovers that an overpayment has been made, the vendor shall repay said overpayment immediately without prior notification from the County. In the event that the County first discovers an overpayment has been made, the Grant Coordinator will notify the vendor in writing of such findings. 13. Data Integrity and Safeguarding Information The vendor shall ensure an appropriate level of data security for the information the vendor is collecting or using in the performance of this agreement. An appropriate level of security includes approving and tracking all vendor employees that request system or information access and ensuring that user access has been removed from all terminated employees. The vendor, 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 vendor shall ensure all vendors maintain written procedures for computer system backup and recovery. The vendor shall complete and sign Attachment E prior to the execution of this agreement. 14. Computer Use and Social Media Policy The Department of Elder Affairs has implemented a new 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, Area Agencies on Aging and vendors. 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. 15. Public Entity Crime Pursuant to s. 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 5 16D 2 agreement to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on a agreement 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 vendor, supplier, vendor, or consultant under a agreement with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in s. 287.017, F.S., for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted vendor list. 16. Patents,Copyrights,Royalties If this agreement 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 agreement, the vendor shall refer the discovery, invention or material to the County to be referred to the Department of State and the Department of Elder Affairs. Any and all patent rights or copyrights accruing under this agreement are hereby reserved to the State of Florida in accordance with Chapter 286, F.S. Pursuant to s. 287.0571 (5) (k) 1 and 2 as amended, the only exceptions to this provision shall be those that are clearly expressed and reasonably valued in the agreement. 16.1 If the primary purpose of this agreement 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 Paragraph 33. 16.2 If this agreement is awarded solely federal funding, the terms and conditions are governed by 2 CFR 215.36. 17. Emergency Preparedness and Continuity of Operations 17.1 If the tasks to be performed pursuant to this agreement include the physical care and control of clients, or the administration and coordination of services necessary for client health, safety or welfare, the vendor shall, within thirty (30) calendar days of the execution of this agreement, submit to the Grant Coordinator verification of an emergency preparedness plan. In the event of an emergency,the vendor shall notify the County of emergency provisions. 17.2 In the event a situation results in a cessation of services by a vendor, the vendor shall retain responsibility for performance under this agreement and must follow procedures to ensure continuity of operations without interruption. 18. Financial Consequences of Non-Performance If the vendor fails to meet the minimum level of service or performance identified in this agreement, or that is customary for the industry, then the County must apply financial consequences commensurate with the deficiency. Financial consequences may include,but are not limited to, agreement suspension, refusing payment, withholding payments until deficiency is cured, tendering only partial payments, and/or cancellation of agreement and reacquiring services from an alternate source. 18.1 The vendor will not be charged with financial consequences, when a failure to perform arises out of causes that were the responsibility of the County. 19. No Waiver of Sovereign Immunity 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. 20. Venue If any dispute arises out of this agreement,the venue of such legal recourse will be Collier 6 •,. X60 2 County,Florida. 21. Entire Agreement This agreement contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations shall be valid or binding upon the County or the vendor unless expressly contained herein or by a written amendment to this agreement signed by both Parties. 22. 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. 23. 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. 24. Waiver The delay or failure by the County to exercise or enforce any of its rights under this agreement will not constitute or be deemed a waiver of the County'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. 25. Compliance The vendor shall abide by all applicable current federal statutes, laws, rules and regulations as well as applicable current state statutes, laws, rules, regulations and County rules, ordinances and regulations. The Parties agree that failure of the vendor to abide by these laws shall be deemed an event of default of the vendor, and subject the agreement to immediate, unilateral cancellation of the agreement at the discretion of the County. 26. Final Invoice The vendor shall submit the final CCE, HCE, ADI, IIE and IIIES invoice for payment to the County on July 3, 2013. If the vendor fails to submit final request for payment by the deadline, then all rights to payment may be forfeited and the County may not honor any requests submitted after the aforesaid time period. Any payment due under the terms of this agreement may be withheld until all reports due from the vendor and necessary adjustments thereto have been approved by the County. 27. Renegotiations or Modifications Modifications of the provisions of this agreement shall be valid only when they have been reduced to writing and duly signed by both parties. The rate of payment, contract requirements and the total dollar amount may be adjusted retroactively to reflect price level increases and changes in the rate of payment or language. 28. All Terms and Conditions Included This agreement and its Attachments, A-H and exhibits 1-4 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 agreement shall supersede all previous communications, representations or agreements, either written or verbal between the Parties. 7 �'�r ATTACHMENT D 1613 CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR AGREEMENTS,GRANTS,LOANS AND AGREEMENTS The undersigned certifies,to the best of his or her knowledge and belief,that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any State ,Federal or County, a member of congress, an officer or employee of congress, an employee of a member of congress, or an officer or employee of the state legislator, in connection with the awarding of any federal grant,the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal agreement, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of the County, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this federal agreement, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers(including vendors, sub-grants, and agreements under grants, loans and cooperative agreements)and that all vendors shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Signature Date Name of Authorized Individual Name and Address of Organization 8 ATTACHMENT E 160 CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS,GRANTS,LOANS AND COOPERATIVE AGREEMENTS The undersigned, an authorized representative of the vendor named in the agreement or agreement to which this form is an attachment,hereby certifies that: (1) The vendor and any vendors of services under this agreement 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 vendor, vendor(s), or any outside entity on which the vendor 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,vendor(s)will take immediate action to assure data integrity. (3) If this agreement 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 vendor (represented by the undersigned) and purchased by the State will be verified for accuracy and integrity of data prior to transfer. In the event of any decrease in functionality related to time and date related codes and internal subroutines that impede the hardware or software programs from operating properly, the vendor agrees to immediately make required corrections to restore hardware and software programs to the same level of functionality as warranted herein, at no charge to the State, and without interruption to the ongoing business of the state,time being of the essence. (4) The vendor and any vendor(s) of services under this agreement warrant their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data integrity compliance issues. The vendor shall require that the language of this certification be included in all vendors and other agreements and that all vendor shall certify compliance accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB Circulars A-102 and 2 CFR Part 215 (formerly OMB Circular A-110). Name and Address of vendor Signature Title Date Name of Authorized Signer 9 -∎•6 r 160 2 EXHIBIT F CERTIFICATION REGARDING DEBARMENT, SUSPENSION,INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS (1) The prospective vendor certifies, by signing this certification, neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or County. (2) Where the prospective vendor is unable to certify to any of the statements in this certification,such prospective participant shall attach an explanation to this certification. Signature Date Title County/Organization (Certification signature should be same as Agreement signature.) Instructions for Certification 1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "person," "primary covered transaction,"and"voluntarily excluded,"as used herein,have the meanings set out in the sections of rules implementing Executive Order 12549. (2 CFR 180.5-180.1020,as supplemented by 2 CFR 376.10-376.995). You may contact the Agreement Manager for assistance in obtaining a copy of those regulations. 2. This certification is a material representation of facts upon which reliance was placed when the parties entered into this transaction. If it is later determined that the vendor knowingly rendered an erroneous certification,in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension and/or debarment. 3. The vendor will provide immediate written notice to the Agreement Manager if at any time the vendor learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The vendor may decide the method and frequency by which it determines the eligibility of its principals. Each participant to a lower tier covered transaction may,but is not required to,check the Excluded Parties List System(EPLS). 4. The vendor will include a"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion- Lower Tier Covered Transaction"in all its lower tier covered transactions and in all solicitations for lower tier covered transactions. 5. The vendor agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise authorized by the federal government. 6. If the vendor knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction,in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension,and/or debarment. 7. The vendor may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended,ineligible,or voluntarily excluded from the covered transaction,unless it knows that the certification is erroneous. 10 ( . ,. 1 6 EXHIBIT G SUBRECIPIENT INVOICE SUMMISSION The County shall reimburse the SUBRECIPIENT for the performance of this Agreement upon completion or partial completion of the work tasks as accepted and approved by HHVS pursuant to the submittal of quarterly progress reports. Invoices for work performed are required every month. If no work has been performed during that month, or if the SUBRECIPIENT is not yet prepared to send the required backup, a$0 invoice will be required. Explanations will be required if two consecutive months of$0 invoices are submitted. Payments shall be made to the SUBRECIPIENT when requested as work progresses but, not more frequently than once per month. Final invoices are due no later than 90 days after the end of the agreement. Work performed during the term of the program but not invoiced within 90 days without written exception from the Grant Coordinator will not be reimbursed. No payment will be made until approved by HHVS for grant compliance and adherence to any and all applicable local, state or Federal requirements. Payment will be made upon receipt of a properly completed invoice and in compliance with §218.70, Florida Statutes, otherwise known as the "Local Government Prompt Payment Act." 11 DEPARTMENT OF r Yi. EXHIBIT H BACKGROUND SCREENING ELDER AFFAIRS Affidavit of Compliance -Employer STATE OF FLORIDA 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 Employer Name located at Street Address City State ZIP code 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. Signature of Representative Date STATE OF FLORIDA,COUNTY OF Sworn to(or affirmed)and subscribed before me this day of , 20 , by (Name of Representative)who is personally known to me or produced 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:http://elderaffairs.state.fl.us/english/backgroundscreening.php 12 160 2 EXHIBIT 1 STATEMENT OF WORK COMMUNITY CARE FOR THE ELDERLY PROGRAM(CCE) SECTION I: SERVICES TO BE PROVIDED 1.1. DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 AGREEMENT ACRONYMS Activities of Daily Living(ADL) Adult Protective Services(APS) Assessed Priority Consumer List(APCL) Comprehensive Assessment and Review for Long-Term Care Services(CARES) Community Care for the Disabled Adult(CCDA) Community Care for the Elderly(CCE) Client Information and Registration Tracking System(CIRTS) Department of Children and Families(DCF) Department of Elder Affairs(DOEA) Home Care for Disabled Adults(HCDA) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out: The condition of reaching 60 years of age and being transitioned from the Department of Children and Families(DCF) Services, Community Care for Disabled Adults (CCDA)or Home Care for Disabled Adults(HCDA) services to the Department's community- based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in its planning and service area in accordance with the Section 306 (42 U.S.C. 3026) of the Older Americans Act and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the County enters CCE specific data in the CIRTS. An update may also include other revisions to the area plan as instructed by the County or Department of Elder Affairs. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The primary purpose of the CCE program is to prevent, decrease or delay premature or inappropriate and expensive placement of older persons in nursing homes and other institutions. 13 ,CI`o „. 160 2 1.2.2 Community Care for the Elderly Mission Statement The CCE Program assists functionally impaired elderly persons in living as independently as possible in their own homes or in the homes of relatives or caregivers. The program provides a continuum of care through the development, expansion, reorganization and coordination of multiple community-based services to assist elders to reside in the least restrictive environment suitable to their needs. 1.2.3 Authority The relevant authority governing CCE program are: (1)Rule 58C-1, Florida Administrative Code (2) Sections 430.201 through 430.207, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services Chief Financial Officer Memoranda the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1)CFO Memo No. 02: Release date,August 20,2010; (2) CFO Memo No. 03: Release date,June 29,2010; and (3) CFO Memo No. 06: Release date,June 30,2010. 1.2.4 Scope of Service The vendor shall provide services in a manner consistent with and descried in the current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the program are to preserve the independence of elders and prevent or delay more costly institutional care through a community care service system that provides case management and other in-home and community services as needed under the direction of the County and provide a continuum of service alternatives that meet the diverse needs of functionally impaired elders. 1.3. INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The CCE program provides a continuum of services for functional impaired elders. 1.3.2 Individual Eligibility In order to receive services under this agreement, an applicant must: (1) Be at least 60 years of age; (2) Be functionally impaired as determined through the initial comprehensive assessment; and (3) With the exception of APS high-risk referrals, consumers may not be dually enrolled in the CCE program and a Medicaid capitated long-term care program. 1.3.2.1 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution or who are abused,neglected or exploited. 14 160 2 SECTION II: MANNER OF SERVICE PROVISION 2. Delivery of Service to Eligible Clients The vendor shall ensure the provision of a continuum of service that meet the diverse needs of functionally impaired elders. The vendor shall ensure performance and reporting of the following service provision in accordance with the current DOEA Programs and Services Handbook. The services may include the following categories: (1) Core Services; (2) Health Maintenance Services;and (3) Other Support Services. Core Services for Programmatic Operation 2.1. The vendor may deliver core services include a variety of home-delivered services, day care services,and other basic services that are most needed to prevent unnecessary institutionalization. Core services,to be provided at the unit rate identified in this agreement, include the following: (1) Adult Day Care; (7) Housing Improvement; (2) Chore Services; (8) Respite Services; and (3) Enhanced Chore; (9) Transportation (4) Companionship; (5) Home Delivered Meals; (6) Homemaker; 2.1.1 Health Maintenance Services The vendor shall ensure that health maintenance services are routine health services that are necessary to help maintain the health of functionally impaired elders. The services are limited to medical therapeutic services, non-medical prevention services, personal care services, home health aide services, home nursing services, and emergency response systems. Typical services to be provided at the unit rate identified in this agreement, are the following: (1) Adult Day Health Care; (2) Emergency Alert Response; (3) Nutrition Counseling (4) Personal Care (5) Skilled Nursing Services; and (6) Specialized Medical Equipment Services and Supplies 2.2 SERVICE TIMES 2.2.1 Service Times 15 160 2 i The vendor shall ensure the provisions of the services listed in this agreement are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m.to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the agreement in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this agreement as updated, and approved by the County's reporting requirements. Service Unit of Service Adult Day Care Homemaker Case Aide Housing Improvement Case Management Respite Services Chore Services Personal Care Hour Enhanced Chore Physical Therapy Companionship Skilled Nursing Services Emergency Alert Response Day Material Aid Episode Specialized Medical Equipment, Services and Supplies Escort Shopping Assistance One-Way Trip Transportation Service Unit of Service Home Delivered Meals Meal 2.4 REPORTS The vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The vendor shall establish due dates for any agreement that permits the vendor to meet the County's reporting requirements. Service Costs Reports The vendor shall submit to the County semi-annual service cost reports, August 1, 2013 and February 1, 2014, of each year which reflects actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.5 RECORDS AND DOCUMENTATION 2.5.1 Each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup 16 C�< 160 2 , 2.6 COUNTY RESPONSIBILITIES 2.6.1 Program Guidance and Technical Assistance The County will provide to the vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the vendor. resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures will be made available to the County upon request. 2.7 PERFORMANCE SPECIFICATIONS 2.7.1 Outcomes (1) The vendor shall ensure services provided under this agreement are in accordance with the current Department of Elder Affairs Programs and Services Handbook. (2) The vendor shall timely submit to the County all information described in EXHIBIT 1, SECTION 2.4 REPORTS; and (3) The vendor shall timely submit to the County all information described in EXHIBIT 1, SECTION 2.5 RECORDS AND DOCUMENTATION. 2.8. VENDOR'S FINANCIAL OBLIGATIONS 2.8.1 Matching,Level of Effort,and Earmarking Requirement The vendor will assure a match requirement of at least 10 percent of the cost for all CCE services. The match will be made in the form of cash and/or in-kind resources. At the end of the agreement period, all CCE funds expended must be properly matched. State funds cannot be used to match another state-funded program. 3. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 17 160 2 3.4 Payment may be authorized only for allowable services,which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services,upon request. 18 . ,. . � 160 2 EXHIBIT 2 STATEMENT OF WORK HOME CARE FOR THE ELDERLY PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Adult Protective Services(APS) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) 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) Home Care for Disabled Adults(HCDA) Home Care for the Elderly(HCE) Institutional Care Program (ICP) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults(HCDA)services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026) and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the County enters HCE specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement Area Agencies on Aging may contract with CCE lead agencies or other case management entities for the provision of the HCE program. Approved caregivers receive a Basic Subsidy to reimburse some of their expenses each month for caring for the consumer and may receive a Special Subsidy for other necessary services and essential supplies. Caregivers may be approved 19 • 16D 2 for up to three HCE clients in their home. 1.2.2 Home Care for the Elderly Program Mission Statement The Home Care for the Elderly Program supports family style living arrangements, on a non- profit basis,as an alternative to nursing homes or other institutional care. Through the program, a caregiver for three or fewer elders living in a private home provides basic services of maintenance and supervision as well as coordinating other necessary specialized services. 1.23 Authority The relevant authority governing the HCE program include: (1) Rule Chapter 58H-1,Florida Administrative Code; and (2) Sections 430.601 through 430.608, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services', Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: CFO Memo No. 02: Release date,August 20,2010; CFO Memo No. 03: Release date,June 29, 2010; and CFO Memo No. 06: Release date,June 30,2010. 1.2.4 Scope of Service The Vendor shall provide services in a manner consistent with and described in the current County's area plan update and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the HCE program are to ensure that: (1) Basic Subsidy is provided to the caregiver of each client and (2) Special Subsidy is provided when essential to the well-being of the client. 1.3 INDIVIDUAL TO BE SERVED 1.3.1 General Eligibility The Home Care for the Elderly program serves elders age 60 and older at risk of placement in a nursing home or other institutional settings who can remain in a family style setting through the provision of subsidies. 1.3.2 Client Eligibility Clients eligible to receive services under this agreement must: (1) Be 60 years of age or older; (2) Have income less than the Institutional Care Program(ICP) standard. (3) Meet the ICP asset limitation; (4) Be at risk of nursing home placement; 20 (z) 160 2r (5) Have an approved adult caregiver living in the home with them who is willing to provide care or assist in arranging for care; and (6) Not be enrolled in the Aged and Disabled Adult Medicaid waiver or a Medicaid capitated long-term care program. 1.3.3 Caregiver Eligibility Caregivers eligible to receive services under this agreement must: (1) Be at least 18 years of age,capable of providing a family-type living environment; (2) 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; (3) Be willing to accept responsibility for the social, physical and emotional needs of the care Vendor; (4) Be physically present and live in the home to provide supervision and to assist in arrangement of services for the client; (5) 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 (6) Be without record of conviction of abuse, neglect or exploitation of another person. 1.3.4 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meet the diverse needs of the functionally impaired elders and their caregivers. The Vendor shall ensure Basic Subside and Special Subsidy services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. 2.1. Basic Subsidy The Basic Subsidy is a cash payment made to an approved caregiver each month to reimburse some expenses incurred in caring for the client. The Basic Subsidy is provided for support and maintenance of the client, including housing, food, clothing, and medical costs not covered by Medicaid, Medicare or any other insurance. A Basic Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. If the client is hospitalized or in any other temporary institution for 30 days or less,the full Basic Subsidy shall be provided to the caregiver as if the client were in the home. 2.2. Special Subsidy Services Though every eligible HCE client receives a Basic Subsidy, Special Subsidy payments are pre-authorized and are based on additional specialized medical or health care services, supplies or equipment needed to maintain the health and well-being of the individual elder. The Special Subsidy for additional medical support and special services is a cash payment to reimburse the costs of any other service or special care not covered by Medicaid, Medicare, or private insurance when these services are determined to be 21 t. • 4 160 21 essential to maintain the well-being of the home care recipient. A Special Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. Special Subsidy 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: 2.2.1 SERVICE LOCATION AND EQUIPMENT 2.2.2 Service Times The vendor shall ensure the provision of the services listed in this contract are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m.to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the Agency's reporting requirements. Service Unit of Service Adult Day Care Housing Improvement Case Aide Other Case Management Personal Care Hour Chore Respite(Facility Based or In-Home) Chore(Enhanced) Skilled Nursing Services Homemaker Material Aid Episode Specialized Medical Equipment, Services and Supplies Transportation One-Way Trip 2.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permits the Vendor to meet the County's reporting requirements. 2.2.1 Service Costs Reports The Vendor shall submit to the County the semi-annual service cost reports, August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.3 RECORDS AND DOCUMENTATION 2.3.1 The Vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The 22 c�� . ,, 160 2 1 Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 2.4 PERFORMANCE SPECIFICATIONS 2.4.1 Outcomes (1) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (2) The Vendor shall timely submit to the County all reports described in SECTION 2.2 REPORTS; and (3) The Vendor shall timely submit to the County all information described in, SECTION 2.3 RECORDS AND DOCUMENTATION. 2.5 COUNTY RESPONSIBILITIES 2.5.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-up on-site visits; (3) Client visits; (4) Review of independent auditor's reports; (5) Review of third-party documents and/or evaluation; (6) Review of progress reports; (7) Review of customer satisfaction surveys; (8) Agreed-upon procedures review by an external auditor or consultant; (9) Limited-scope reviews; and (10) Other procedures as deemed necessary. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The 23 160 2i vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services,which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 24 16021 EXHIBIT 3 STATEMENT OF WORK ALZHEIMER'S DISEASE INITIATIVE PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Alzheimer's Disease(AD) Alzheimer's Disease Initiative(ADI) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System(CIRTS) Community Care for Disabled Adults(CCDA) Department of Elder Affairs(DOEA) Home Care For Disabled Adults(HCDA) Instrumental Activities of Daily Living(IADL) Memory Disorder Clinic (MDC) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults(HCDA) services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026. 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 County enters ADI specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 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. Model Day Care: A program of therapeutic, social and health activities specific to clients with memory disorders. Services and activities include, but are not limited to, active and quiet 25 160 21 games, reminiscence, validation therapy, pet therapy, water therapy and other failure free activities appropriate to the client's level of functioning. Model day care centers will also provide training for health care and social service personnel in the care of persons having AD or related memory disorders. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The ADI program provides a continuum of services addressing the special needs of individuals with AD,their families and caregivers. 1.2.2 Alzheimer's Disease Initiative Program Mission Statement The ADI program ensures that persons afflicted with AD and other forms of dementia are given essential services to help them age in place in an elder-friendly environment with security, dignity, and purpose. The program also provides support to family members and caregivers of persons afflicted with AD. 1.2.3 Authority The relevant authority governing the Alzheimer's Disease Initiative Program are as follows: (1) Rule Chapter 58D-1, Florida Administrative Code; and (2) Sections 430.501 through 430.504, Florida Statutes. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1) CFO Memo No. 02: Release date, August 20,2010; (2) CFO Memo No. 03: Release date,June 29,2010; and CFO Memo No. 06: Release date,June 30,2010. 1.2.3.2 Scope of Service The Vendor is responsible for the programmatic, fiscal, and operational management of the ADI program. The program services shall be provided in a manner consistent with and described in the current Vendor's Request for Proposal, RFP, and the County's current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.3.4 Major Program Goals The major goal of the ADI program is to provide services to meet the needs of caregivers and individuals with AD and related memory disorders. 1.3 INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The ADI Program addresses the special needs of individuals with AD and their caregivers. 1.3.2 Individual Eligibility Those individuals eligible to receive services under this contract must meet the following conditions: (1) Be 18 years of age or older and have a diagnosis of AD or a related disorder, or be 26 4, 160 21 suspected of having AD or a related disorder; and (2) Not be enrolled in a Medicaid capitated long-term care program. 1.3.3 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. SERVICE TASKS In order to achieve the goals of the ADI program, the Vendor shall ensure the following tasks are performed: (1) Client eligibility determination; (2) Assessment and prioritization of service delivery for new clients; (3) Delivery of services to eligible clients; and (4) Monitor the performance of vendors. 2.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described in this SECTION 1.3. 2.2 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services addressing the diverse needs of individuals with AD and their caregivers. The Vendor shall ensure services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. Services categories include: (1) Caregiver Training/Support; (2) Case Aid; (3) Case Management; (4) Counseling(Gerontological); (5) Counseling(Mental Health/Screening); (6) Education/Training; (7) Model Day Care; ( 8) Respite(Facility-Based); ( 9) Respite(In-Home); and (10) Specialized Medical Equipment, Services, and Supplies. Caregivers benefit from receiving training, respite and related support services to assist them in caring for the ADI client. 2.3 Service Times The Vendor shall ensure the provisions of the services listed in this contract are available 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. 27 . ,• 16fl 21 3. DELIVERABLES 3.1. Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the County's reporting requirements. Service Unit of Service Caregiver Training/Support; Hour Case Aid; Hour Case Management; Hour Counseling(Gerontological); Hour Counseling(Mental Health/Screening); Hour Respite(Facility-Based); Hour Respite(In-Home); Hour Education/Training; Episode Episode 3.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. 3.2.1 Service Costs Reports Vendor must submit to the County the semi-annual service cost reports August 1, 2013 and February 1,2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 33 RECORDS AND DOCUMENTATION 3.3.1 The Vendor and each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 4. PERFORMANCE SPECIFICATIONS 4.1 Outcomes (4) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (5) The Vendor shall timely submit to the County all reports described in SECTION 3.2 REPORTS; and (6) The Vendor shall timely submit to the County all information described in SECTION 3.3 28 \`J1) 16D 24 RECORDS AND DOCUMENTATION. 5. COUNTY RESPONSIBILITIES 5.1. Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-up on-site visits; (3) Client visits (4) Review of independent auditor's reports (5) Review third-party documents and/or evaluations (6) Review of progress reports (7) Review of customer satisfaction surveys (8)Agreed-upon procedures review by an external auditor or consultant; (9)Limited-scope reviews; and (10)Other procedures as deemed necessary. 6. SECTION III: METHOD OF PAYMENT 6.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 6.1.2 Remedies-Nonconforming Services The Vendor shall ensure that all goods and/or services provided under this agreement for HCE funded programs are delivered timely, completely and commensurate with required standards of quality Such goods and/or services shall only be delivered to eligible program participants. If the Vendor fails to meet the prescribed quality standards for services, such services will not be reimbursed under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be reimbursed under this agreement. The Vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the Vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County requires immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 6.1.3 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the Vendor and any adjustments thereto, including any disallowance not resolved. 6.1.4 Date for Final Request for Payment 29 0 16 © 21 The final request for payment for agreement year one's expenditures will be due to the County no later than August 1,2013. The final request for payment for agreement year two expenditures will be no later than August 1,2014. 6.2 Documentation for Payment The Vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals upon request. Such documentation shall be provided upon request to the County or the Clerk of Court. 30 1 6 EXHIBIT 4 STATEMENT OF WORK OLDER AMERICANS ACT PROGRAM TITLE HI SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 CONTRACT ACRONYMS Area Agency on Aging(AAA) Activities of Daily Living(ADL) Alliance of Information&Referral Systems(AIRS) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System(CIRTS) Information and Referral (I&R) Instrumental Activities of Daily Living(IADL) Older Americans Act(OAA) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in Its PSA in accordance with the Section 306(42 U.S.C. 3026)of the OAA and Department instructions. Child: An individual who is not more than 18 years of age or an individual with disability. Family Caregiver: An adult family member, or another individual,who is an informal provider of in-home and community care to an older individual. Frail: When an older individual is unable to perform at least two ADLs without substantial human assistance, including verbal reminding, physical cueing or supervision; or due to cognitive or other mental impairment, requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to another individual. 1.2 County Mission,Vision and Values Statement The County's mission: To help aging adults achieve greater independence through awareness of resources and access to qualified service providers. The County's vision: To be the recognized leader in supporting older adults and their families with access to trustworthy resources and services in their communities while empowering them to live with independence and dignity. The County's values: We believe residents of Southwest Florida are entitled to: Comprehensive information about their choices of care; Timely access to resources and services; High standards of quality and performance; and Personal and professional accountability from all stakeholders. 1.2.1 Older Americans Act Program Mission Statement The Older Americans Act(OAA)Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. 31 • 161) 2 1.3 GENERAL DESCRIPTION 1.3.1 General Statement The OAA Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. The primary purpose of the OAA program is to foster the development and implementation of comprehensive and coordinated systems to serve older individuals. The OAA program uses these systems to assist older individuals to attain and maintain maximum independence and dignity in a home environment and allows for the capability of self- care with appropriate supportive services. 1.3.2 Authority The relevant references authority governing the OAA program are: 1. Older Americans Act of 2006, as amended; 2. Rule 58A-1, Florida Administrative Code; and 3. Section 430.101, Florida Statutes. 1.3.2.1 Incorporation of Reference Memoranda In accordance with Ch. 287 F.S., as amended, and Agency of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and incorporated by reference: 1. CFO Memo No. 02: Release date,August 20,2010; 2. CFO Memo No. 03: Release date,June 29,2010; and 3. CFO Memo No. 06: Release date,June 30,2010. 1.3.3 Scope of Service The Vendor shall provide services in a manner consistent with and descried in the current area plan and current Department of Elder Affairs Programs and Services Handbook. 1.3.4 Major Program Goals The major goals of the OAA program are to improve the quality of life for older individuals, preserve their independence and prevent or delay more costly institutional care. These goals are achieved through the implementation of a comprehensive and coordinated service system that provides a continuum of service alternatives that meet the diverse needs of elders and their caregivers. 1.4 INDIVIDUALS TO BE SERVED 1.4.1 Eligibility(Title III Programs) 1.4.1.1 OAA Title III,General Consumers shall not be dually enrolled in an OAA program and a Medicaid capitates long-term care program. 1.4.1.2 OAA Title IIIE,Caregiver Support Services Eligibility for OAA Title IIIE, Caregiver Support Services, are as follows: 1. Family caregivers of individuals age 60 or older; 32 • 160 2 2. Grandparents(age 55 or older)or older individuals(age 55 or older)who are relative caregivers; 3. Priority will be given to family caregivers who provide care for individuals with Alzheimer's disease and related disorders with neurological and organic brain dysfunction and for grandparents or older individuals who are relative caregivers who provide care for children with severe disabilities; and 4. For respite and supplemental services,a family caregiver must be providing care for an older individual who meets the definition of the term"frail" in OAA, Section 102 Paragraph 22. 1.4.2 Targeted Groups Preference shall be given to those with the greatest economic and social need,with particular attention to low-income older individuals, including those that are low-income minorities, have limited English proficiency, and older individuals residing in rural areas. SECTION II—MANNER OF SERVICE PROVISION 2.1 SERVICE TASKS In order to achieve the goals of the OAA program,the Vendor shall ensure the following tasks are performed: 1. Client eligibility determination; 2. Targeting and screening of service delivery for new clients; 3. Delivery of services to eligible clients; 4. Use of volunteers to expand the provision of available services; 5. Monitoring the performance of its vendors. 6. Grievance and Compliance Procedures 2.1.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described herein. 2.1.2 Targeting and Screening of Service Delivery for New Clients The Vendor shall develop and implement policies and procedures consistent with OAA targeting and screening Criteria 2.1.3 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meets the diverse needs of elders and their caregivers. The Vendor shall ensure the performance and report performance of the following services in accordance with the current Department of Elder Affairs Programs and Services Handbook. The services funded pursuant to this contract are in accordance with the OAA,Title III, sections 321, 331, 336 and 373 as follows: 1. Section 321,Title 11113 Supportive Services; 2. Section 373,Title IIIE Caregiver Support Services. 2.1.3.1 Supportive Services Supportive services include a variety of community-based and home-delivered services that support the qualities of life for older individuals by helping them remain independent and productive. Services include the following: 33 160 21 (1) Adult Day Care/Adult Day Health Care; (17) Homemaker; (2) Caregiver Training/Support; (18) Housing Improvement; (3) Case Aide/Case Management; (19) Information; (4) Chore Services; (20) Intake; (5) Companionship; (21) Interpreter/Translating; (6) Counseling(Gerontological and Mental Health); (22) Referral/Assistance; (7) Education/Training; (23) Personal Care; (8) Legal Assistance; (24) Physical Therapy; (9) Material Aid; (25) Shopping Assistance; (10) Occupational Therapy; (26) Skilled Nursing; (11) Outreach; (27) Specialized Medical Equipment, Services, and Supplies (12) Recreation; (28) Respite Services; (13) Emergency Alert Response; (29) Screening/Assessment; (14) Escort; (30) Speech Therapy; (15) Health Support; (31) Telephone Reassurance; and (16) Home Health Aide; (32) Transportation 2.1.3.4 Caregiver Support Services(Title HIE Program) The following services are intended to provide direct help to caregivers, assist in the areas of health, nutrition and financial literacy and assist caregivers in making decisions and problem solving related to their caregiving roles and responsibilities: (1) Adult Day Care/Adult Day Health Care; (2) Caregiver Training/Support; (3) Counseling(Gerontological and Mental Health); (4) Education/Training; (5) Financial Risk Reduction(Assessment and Maintenance); (6) Information; (7) Intake; (8) Outreach; (9) Respite Services; (10) Screening/Assessment; and (11) Transportation 2.1.3.5 Caregiver Support Supplemental Services(Title HIES Program): The following services are provided to complement the care provided by caregivers: (1) Chore Services; (2) Housing Improvement; (3) Legal Assistance; (4) Material Aid; and (5) Specialized Medical Equipment, Services and Supplies. 2.2 SERVICE LOCATION 34 ti 16D 2.2.1 Service Times The Vendor shall ensure the provision of the services listed in the contract during normal business hours unless other times are more appropriate to meet the performance requirements of the contract, and it shall monitor its vendors to ensure they are available to provide services during hours responsive to client needs and during those times which best meet the needs of the relevant service community. 2.3 DELIVERABLES 2.3.1 Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the services tasks described in Section 2.1. The chart below lists the services allowed and the units of measurement. Units of service will be paid pursuant to the rate established in the 2010 RFP and approved by the County. Services Unit of Service Adult Day Care/Adult Day Interpreter/Translating Health Care Legal Assistance Caregiver Training/Support Medication Management Case Aid/Case Management Mental Health Counseling/Screening Chore Services Nutrition Counseling Companionship Occupational Therapy Counseling Services Personal Care Escort Physical Therapy Hour Financial Risk Reduction Recreation Services Respite Services Health Support Screening/Assessment Home Health Aide Sitter Homemaker Skilled Nursing Services Housing Improvement Speech Therapy Intake Emergency Alert Response Day Education/Training Episode Information Material Aid Referral/Assistance Specialized Medical Equipment, Services and Supplies Telephone Reassurance Escort One-Way Trip Shopping Assistance Transportation 2.4 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permit the Vendor to meet the County's reporting requirements. 35 1 0 u 2.4.2 Service Costs Reports The Vendor shall require vendors to submit to the Vendor semi-annual service cost reports on August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.4.5 Background Screening Affidavit of Compliance To demonstrate compliance with section 8 of the Standard Contract,the Vendor shall submit ATTACHMENT H, Background Screening Affidavit of Compliance annually,by January 15`h 2.5 RECORECORDS AND DOCUMENTATION Each Vendor and vendor,among other requirements,must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement in its contracts and/or agreements with vendors. These policies and procedures shall be made available to the County upon request. 2.6 PERFORMANCE SPECIFICATIONS 2.6.1 Outcomes (1)The Vendor shall ensure services provided under this contract are in accordance with the current DOEA Programs and Services Handbook, (2)The Vendor shall timely submit to the County all reports described herein (3)The Vendor shall timely submit to the County all information described in, Paragraph 2.5 RECORDS AND DOCUMENTATION. 2.7 VENDOR'S FINANCIAL OBLIGATIONS 2.7.1 Matching,Level of Effort,and Earmarking Requirements The Vendor shall provide match of at least 10 percent of the federal funds received. The Vendor's match will be made in the form of cash and/or in-kind resources. The Vendor will assure,through a provision in subcontracts,a match requirement of at least 10 percent of the cost for all services funded through this contract. The vendor's match will be made in the form of cash and/or in-kind resources. The Vendor shall report match by title each month. At the end of the contract period, the Vendor must properly match all OAA funds. 2.7.2 Title IH Funds The Vendor assures compliance with Section 306 of the OAA, as amended in 2006,that funds received under Title III will not be used to pay any part of a cost incurred by the Vendor to maintain a contractual or commercial relationship that is not carried out to implement Title III. 2.8 COUNTY RESPONSIBILITIES 2.8.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the Vendor. 2.8.2 Program/Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this contract. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an on-site visit. The County's determination of acceptable performance shall be conclusive. The Vendor 36 • - 160 agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: 1. Desk reviews and analytical reviews; 2. Scheduled, unscheduled and follow-up on-site visits; 3. Client visits; 4. Review of independent auditor's reports-Exhibit 10; 5. Review of third-party documents and/or evaluation; 6. Review of progress reports; 7. Review of customer satisfaction surveys; 8. Agreed-upon procedures review by an external auditor or consultant; 9. Limited-scope reviews; and 10. Other procedures as deemed necessary. 2.8.3 Contract Monitoring The County shall, at its own discretion,conduct monitoring concerning any aspect of the vendor's performance of this contract. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for OAA IIIE and OAA IIIES funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rate for services is ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services,which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 37 it D .� r 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1,2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 38 i� 1. 21 EXHIBIT 5 160 Agreement#12-5856 "Services for Seniors Attachment B Invoice and Logs (Minimum Standard Invoice Information) County Purchasing Order Number: Invoice Number: Grant Name: From Date To Date °QImU r t : �it'®' i ¢ N 4 er I e- er up T e1` c ri �d Subra . ,I a i 1 n n ' I 4' Cos ' t C uan.- ach: o ,1 unaun c u mt.� i e Toat{ nI fom t D.. 44„„....Q.;os �'" Service .Ui) � $0.00 n $0.00 $0.00 --_ Total $0.00 I certify to the best of my knowledge and belief that this invoice, and attached service detail log, is complete and correct and all outlay herein are for the purposes set forth in the contract, and that services are ordered by the case manager as agreed on the Contract. Legible copies of the dated timesheet, signed by the client and the worker supporting this invoice must be available upon request. Collier County reserves the right to correct computation of errors to assure proper payment amount. Prepared by: Date: Adjustment Reasons Lead Agency Authorization Attachments: Monthly Service log,Weekly Detail log and Client Service time sheets. 39 6-1) 160 2 4 EXHIBIT 6 Detail Weekly for CCE Services Week Ending: Invoice No. Personal CLIENT Care Homemaker Respite Skilled Companion Chore Total Total Total Total Total Total NAME Units Units Units Units Units Units Total Hours - - - - - - $ PECA - HMK - $ RESPITE - $ SKILLED - $ COMPANION - $ CHORE - $ TOTAL - 40 • 160 2 EXHIBIT 7 Monthly Detail Service Log Grant Name: Vendor Name, Address: From Date To Date By client,provide the total number of hours provided during the dates of service. This log must be submitted with your monthly invoice for the Invoice From Date and To Date. es,I It Respite � �ry ame *are acilitty em 4ft t -`,- :' �' - .,„, ,�' '* ...,�: ` :.; :;. e,;. 41 �no 160 21 EXHIBIT 8 Daycare Grant: Grant Service: ADC or RESF Vendor Name and Address By client, provide the Weekly Client Service Time Sheet provided during the dates of service. This log must be submitted with all invoices for the invoice From Date and To Date. TO FROM DATE: DATE: Client Thur Uni Client Name signature Mon Tue Wed s Fri Sat Sun Match is Service Dates 42 160 2 '4 EXHIBIT 9 YOUR COMPANY NAME HERE Collier County Services for Seniors Homemaker/Personal Care/Respite/Companion Work Sheet Client Name: Client Signature: Week Ending: Each Time You Perform one of the Activities Below: Put in arrival and departure times for the day worked: ****Client should Initial time of arrival and departure. ****Client should Sign form at top. ****you should sign your name at the bottom. Date: Day: MON TUES WED THUR FRI SAT SUN TOTAL TIME ARRIVAL TIME: DEPARTURE TIME: ****CLIENT INITIALS: Arrive: PERSONAL CARE Depart: Assist W/Bath tub _ Shower Bed Assist W/Dressing Bathroom Assist Shave (Face Only) Oral Hygiene Walking/Ambulation Feeding Assistance Wash/Set Hair Backrub Soak Feet_ Nails (File only) Change Make Bed Take out Trash Clean Bedroom Clean Bathroom Prepare Meals Laundry Arrive: HOME MAKING Depart: Vacuum/Sweep_ Light Dusting 43 cn� 160 2 Clean Kitchen Floor Wash Dishes Mop Sweep_ Grocery Shop Errands Arrive: RESPITE Depart: Arrive: COMPANION Depart: EMPLOYEE'S Signature/Title 44 160 2 _ EXHIBIT 10 OMB Circular A-133 Audits of States, Local Governments, and Non-Profit Organizations requires the Collier County Housing, Human and Veterans Services Department to monitor our subrecipients of federal awards and determine whether they have met the audit requirements of the circular and whether they are in compliance with federal laws and regulations. Accordingly, we are requiring that you check one of the following, provide all appropriate documentation regarding your organization's compliance with the audit requirements, sign and date this form. Subrecipient Fiscal Year Name Period Total State Financial Assistance Expended during $ most recently completed Fiscal Year Total Federal Financial Assistance Expended during most $ recently completed Fiscal Year Check Appropriate Boxes We have exceeded the $500,000 federal/state expenditure threshold for our fiscal year ❑ ending as indicated above and have completed our Circular A-133 audit. A copy of the audit report and management letter are attached. We exceeded the $500,000 federal/state expenditure threshold for our fiscal year ❑ ending as indicated above and expect to complete our Circular A-133 audit by . Within 30 days of completion of the A-133 audit, we will provide a copy of the audit report and management letter. We are not subject to the requirements of OMB Circular A-133 because we: ❑ Did not exceed the $500,000 federal/state expenditure threshold for the fiscal year indicated above ❑ Are a for-profit organization ❑ Are exempt for other reasons — explain An audited financial statements is attached and if applicable, the independent auditor's management letter. (If findings were noted, please enclose a copy of the responses and corrective action plan.) Certification Statement I hereby certify that the above information is true and accurate. Signature Date Print Name and Title 45 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 L TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO j V 2 14 THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE COUNTY ATTORNEY PINK ROUTING SLIP Routed by Purchasing Department to Office Initials Date the Following Addressee(s) (In routing order) 1. Risk Management Risk 2. County Attorney Office County Attorney Office tcf 115 3. BCC Office Board of County Commissioners ,`s/ 1,\l A\∎ 4. Minutes and Records Clerk of Court's Office �(n (,143 t2-145p a, 5. Return to Purchasing Department Purchasing Contact: Diana DeLeon PRIMARY CONTACT INFORMATION Name of Primary Diana DeLeon for Lisa Carr, HHVS, Phone Number 252-8375 Purchasing Staff May 31,2013 Contact and Date Agenda Date Item was May 28,2013 Agenda Item Number 16.D.2 Approved by the BCC Type of Document Contract Amendment Number of Original 2 Attached Documents Attached PO number or account N/A Solicitation/Contract Amend#1 to Contract 12- number if document is Number/Vendor Name 5856 VIP America to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial)' Applicable) 1. Does the document require the chairman's original signature? DD 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A provide the Contact Information(Name; Agency; Address; Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be signed by the Chairman,with the exception of most letters, must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's DD signature and initials are required. 7. In most cases(some contracts are an exception),an electronic copy of the document and DD this routing slip should be provided to the County Attorney's Office before the item is input into SIRE. 8. The document was approved by the BCC on the date above and all changes made DD during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes, if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the 4`,3 BCC, all changes directed by the BCC have been made, and the document is ready for the Chairman's signature. 160 2 MEMORANDUM Date: June 17, 2013 To: Diana I)e Leon, Contract Technician Purchasing Department From: Martha Vergara, Deputy Clerk Minutes & Records Department Re: Amendment #1 - Contract #12-5856 "Services for Seniors" Contractor: VIP America of Southwest Florida, LLC Attached, is an original of the assumption agreement referenced above (Agenda Item #16D2), approved by the Board of County Commissioners on Tuesday, May 28, 2013. The original will be held on file with the Minutes and Record's Department in the Board's Official Records. If you have any questions, please contact me at 252-7240. Thank you. Attachment 16O2 Pi Contract Amendment #1 Contract # 12-5856 "Services for Seniors" This CONTRACT AMENDMENT #1, dated 5ij , 2013 to the referenced agreement shall be by and between the parties to the original Agreement, VIP America of Southwest Florida, LLC (to be referred to as"Vendor") and Collier County, Florida, (to be referred to as"County"). Statement of Understanding RE: Contract# 12-5856 "Services for Seniors" In order to continue services for the original Contract document referenced above, the Vendor agrees to the terms and conditions set forth in Exhibit A-1A, which includes Attachments C-H and Exhibits 1-10 attached hereto and incorporated by reference. The Vendor further agrees to amend Section 1, Commencement, as follows: 1. COMMENCEMENT. This Agreement shall Commence on December 11, 2012 and shall terminate on December 10,2014 June 30, 2014. The Contract award is a two (2) year contract, with the possibility of two (2) additional (2) year terms pending funding from grantors and acceptable performance by the awarded vendor. Any such renewals shall be mutually agreed upon in writing by the parties. The maximum duration for this Contract for CCE, HCE, and ADI, OAA IIIE AND OAA IIIES funding will not exceed six (6) years (through June 30, 2018). As outlined in RFP #12-5856, the County requires the Vendor to contribute a cash or in-kind match of no less than ten (10) percent for all services related to the Community Care for the Elderly Program, (CCE), Older American Title IIIE Caregiver Support (OAA IIIE) and Older American Title IIIES Caregiver Support Supplemental Services (OAA HIES)Programs. Words that have been deleted are struck through, words underlined have been added. Modification made herein shall apply as if incorporated into the Contract on the date of Commencement. All other terms and conditions of the agreement shall remain in force. IN WITNESS WHEREOF, the Vendor and the County have each, respectively, by an authorized person or agent, hereunder set.their hands and seals on the date(s) indicated below. Accepted: n114, , 2013 VENDOR: / 7� /L/ VIP America of Southwest Florida, LLC first Wit��i'" i Aiff �� By: LL Type/. '• �itn- s name �-•(tier e Wt4 TQ \ teS t Se ,•nd Witnes Print/Type Name and Title /� /J' jy..e�S61L. Type print'witness name Type p 1 160 2 COUNTY: ATTEST: BOARD OF COUNTY COMMISSIONERS DWIGHT' ., ROCK, CLERK OF COLLIER COUNTY, FLORIDA By_` By ) WIA S '4' GEORGIA A. HILLER, ESQ. Attess as-to Cht lan _ CHAIRWOMAN signaturermly.,� Approval for form and legal Sufficiency: Jenier B. White Assistant County Attorney Q \2 v 2 EXHIBIT A-lA 1 6 0 2 AGREEMENT 12-5856 SERVICES FOR SENIORS ATTACHMENTS ATTACHMENT ATTACHMENT DESCRIPTION PAGE Attachment C Core Standards for CCE, HCE, ADI, OAA IIIE & IIIES 2 Attachment D Certification Regarding Lobbying 8 Attachment E Certification Regarding Data Integrity Compliance 9 Attachment F Certification Regarding Debarment, Suspension, 10 Ineligibility and Voluntary Exclusion Contracts/ Subcontracts Attachment G Sub-Recipient Invoice Submission 11 Attachment H Background Screening Affidavit of Compliance 12 Exhibit 1 CCE Statement of work 13 Exhibit 2 HCE Statement of work 19 Exhibit 3 ADI Statement of work 25 Exhibit 4 OAA IIE and OAA IIIES Statement of work 31 Exhibit 5 Invoice 39 Exhibit 6 Detail Weekly Log 40 Exhibit 7 Monthly Log 41 Exhibit 8 Day Care/Respite Time Sheet 42 Exhibit 9 Program Time Sheet 43 Exhibit 10 Annual Audit Monitoring Report 45 1 CS) •. . 160 21 ATTACHMENT C Core Standards for CCE,HCE,ADI,OAA IIIE &HIES 1. Compliance with Federal Law 1.1 If this agreement contains federal funds the following shall apply: 1.1.1 The vendor shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable regulations. 1.1.2 If this agreement contains federal funds and is over$100,000.00, the vendor shall comply with all applicable standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s. 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable Environmental Protection County regulations 40 CFR 30. The vendor shall report any violations of the above to the County. 1.1.3 The vendor may not use any federal funds received in connection with this agreement to influence legislation or appropriations pending before the Congress or any state legislature. If this agreement contains federal funding in excess of$100,000.00,the vendor must, prior to agreement execution, complete the Certification Regarding Lobbying form, ATTACHMENT D. All disclosure forms as required by the Certification Regarding Lobbying form must be completed and returned to the Grant Coordinator prior to payment under this agreement. 1.1.4 In accordance with Appendix A to 2 CFR 215, the vendor shall comply with Executive Order 11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in Department of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable. 1.1.5 If this agreement contains federal funds and provides services to children up to age 18,the vendor shall comply with the Pro-Children Act of 1994 (20 U.S.C. 6081). 1.1.6 A agreement award with an amount expected to equal or exceed $25,000.00 and certain other agreement 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 vendor shall comply with these provisions before doing business or entering into sub-agreements receiving federal funds pursuant to this agreement. The vendor shall complete and sign ATTACHMENT F prior to the execution of this agreement. 1.2 The vendor shall not employ an unauthorized alien. The County 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 agreement by the County. 2 „ . 16B 1.3 If the vendor 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 vendor must notify the County in writing within thirty (30) days of receiving the IRS notice of revocation. 1.4 The vendor shall comply with Title 2 CFR Part 275 regarding Trafficking in Persons. 1.5 Unless exempt under 2 CFR Part 170.110(b), the vendor shall comply with the reporting requirements of the Transparency Act as expressed in 2 CFR 170. 1.6 To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number 11-116, vendor agrees to utilize the U.S. Department of Homeland Security's E-verify system to verify the employment of all new employees hired by vendor during the agreement term. Vendor meeting the terms and conditions of the E-Verify System are deemed to be in compliance with this provision. 2. Compliance with State Law 2.1 This agreement is executed and entered into in the State of Florida, and shall be construed, performed and enforced in all respects in accordance with the Florida law, including Florida provisions for conflict of laws. 2.2 The vendor shall comply with requirements of s. 287.058, F.S. as amended. 2.2.1 The vendor shall provide units of deliverables, including various client services, and in some instances may include reports,findings, and drafts, as specified in this agreement,which the Grant Coordinator must receive and accept in writing prior to payment in accordance with s. 215.971, F.S. (1)and(2). 2.2.2 The vendor shall submit bills for fees or other compensation for services or expenses in sufficient detail for a proper pre-audit and post-audit. 2.2.3 The vendor 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 vendor in conjunction with this agreement except for those records which are made confidential or exempt by law. The vendor's refusal to comply with this provision will constitute an immediate breach of agreement for which the County may unilaterally terminate the agreement. 2.3 If clients are to be transported under this agreement, the vendor shall comply with the provisions of Chapter 427, F.S., and Rule 41-2, F. A. C. 2.4 Vendors who are on the discriminatory vendor list may not transact business with any public entity, in accordance with the provisions of s. 287.134, F.S. 2.5 The vendor shall comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the expenditure of agreement funds for the purpose of lobbying the legislature,judicial branch or a state agency. 3. Background Screening The vendor shall ensure that the requirements of s. 430.0402 and ch. 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 exempted from the Department's level 2 background screening 3 cA 16D 21 pursuant to s. 430.0402(2)-(3), F.S. The vendor must also comply with any applicable rules promulgated by the Department and the Agency for Health Care Administration regarding implementation of s.430.0402 and ch. 435,F.S. Further information concerning the procedures for background screening are found at http://elderaffairs.state.fl.us/doea/backgroundscreening.php. 4. Provision of Services The vendor shall provide services in the manner described herein. 5. Monitoring by the County The vendor shall permit persons duly authorized by the County to inspect and copy any records, papers, documents, facilities, goods and services of the vendor which are relevant to this agreement, and to interview any clients, employees and vendor employees of the vendor to assure the County of the satisfactory performance of the terms and conditions of this agreement. Following such review, the County will provide a written report of its findings to the vendor, and where appropriate,the vendor shall develop a corrective action plan. The vendor hereby agrees to correct all deficiencies identified in the corrective action plan in a timely manner as determined by the Grant Coordinator. 6. Confidentiality of Information The vendor shall not use or disclose any information concerning a vendor of services under this agreement 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. 7. Health Insurance Portability and Accountability Act Where applicable, the vendor shall comply with the Health Insurance Portability and Accountability Act (42 USC 1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162,and 164). 8. Bankruptcy Notification During the term of this agreement,the vendor shall immediately notify the County if the Vendor, its assignees,vendors or affiliates file a claim for bankruptcy. Within ten (10)days after notification,the vendor must also provide the following information to the County.: (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., United States Bankruptcy Court Middle District of Florida,Naples,FL); and, (4)The name, address, and telephone number of the bankruptcy attorney. 9. Sponsorship and Publicity 9.1 As required by s. 286.25, F.S., if the vendor is a non-governmental organization which sponsors a program financed wholly or in part by state funds, including any funds obtained through this agreement, it shall, in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by Hope Hospice and Community Services, the State County of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County." If the sponsorship reference is in the written material, the words "State of Florida, Department of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County" shall appear in at least the same size letters or type as the name of the organization. 9.2 The vendor shall not use the words "The State of Florida Department of Elder Affairs or the Area County on Aging for Southwest Florida, Inc. or Collier County" to indicate sponsorship of a program otherwise financed, unless specific authorization has been obtained by Collier County, or the Area Aging on Aging prior to use. 4 CA 1611 21 10. Independent Capacity of Vendor It is the intent and understanding of the Parties that the vendor, or any of its vendors, are independent vendors and are not employees of the County and shall not hold themselves out as employees or agents of the County without specific authorization from the County. It is the - further intent and understanding of the Parties that the County does not control the employment practices of the vendor and will not be liable for any wage and hour, employment discrimination, or other labor and employment claims against the vendor or its vendors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary insurance for the vendor are the sole responsibility of the vendor. 11. Payment Payments shall be made to the vendor pursuant to s. 215.422, F.S., as services are rendered and invoiced by the vendor. The Grant Coordinator will have final approval of the invoice for payment, and will approve the invoice for payment only if the vendor has met all terms and conditions of the agreement, unless the bid specifications, purchase order, or this agreement specify otherwise. The approved invoice will be submitted to the County's Grant Coordinator approval and processing. 12. Return of Funds The vendor shall return to the County any overpayments due to unearned funds or funds disallowed and any interest attributable to such funds pursuant to the terms and conditions of this agreement that were disbursed to the vendor by the County. In the event that the vendor or its independent auditor discovers that an overpayment has been made, the vendor shall repay said overpayment immediately without prior notification from the County. In the event that the County first discovers an overpayment has been made, the Grant Coordinator will notify the vendor in writing of such findings. 13. Data Integrity and Safeguarding Information The vendor shall ensure an appropriate level of data security for the information the vendor is collecting or using in the performance of this agreement. An appropriate level of security includes approving and tracking all vendor employees that request system or information access and ensuring that user access has been removed from all terminated employees. The vendor, 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 vendor shall ensure all vendors maintain written procedures for computer system backup and recovery. The vendor shall complete and sign Attachment E prior to the execution of this agreement. 14. Computer Use and Social Media Policy The Department of Elder Affairs has implemented a new 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, Area Agencies on Aging and vendors. 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. 15. Public Entity Crime Pursuant to s. 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 5 CA C 160 2 agreement to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on a agreement 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 vendor, supplier, vendor, or consultant under a agreement with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in s. 287.017, F.S., for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted vendor list. 16. Patents,Copyrights,Royalties If this agreement 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 agreement, the vendor shall refer the discovery, invention or material to the County to be referred to the Department of State and the Department of Elder Affairs. Any and all patent rights or copyrights accruing under this agreement are hereby reserved to the State of Florida in accordance with Chapter 286, F.S. Pursuant to s. 287.0571 (5) (k) 1 and 2 as amended, the only exceptions to this provision shall be those that are clearly expressed and reasonably valued in the agreement. 16.1 If the primary purpose of this agreement 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 Paragraph 33. 16.2 If this agreement is awarded solely federal funding, the terms and conditions are governed by 2 CFR 215.36. 17. Emergency Preparedness and Continuity of Operations 17.1 If the tasks to be performed pursuant to this agreement include the physical care and control of clients, or the administration and coordination of services necessary for client health, safety or welfare, the vendor shall, within thirty (30) calendar days of the execution of this agreement, submit to the Grant Coordinator verification of an emergency preparedness plan. In the event of an emergency,the vendor shall notify the County of emergency provisions. 17.2 In the event a situation results in a cessation of services by a vendor, the vendor shall retain responsibility for performance under this agreement and must follow procedures to ensure continuity of operations without interruption. 18. Financial Consequences of Non-Performance If the vendor fails to meet the minimum level of service or performance identified in this agreement, or that is customary for the industry, then the County must apply financial consequences commensurate with the deficiency. Financial consequences may include,but are not limited to, agreement suspension, refusing payment, withholding payments until deficiency is cured, tendering only partial payments, and/or cancellation of agreement and reacquiring services from an alternate source. 18.1 The vendor will not be charged with financial consequences, when a failure to perform arises out of causes that were the responsibility of the County. 19. No Waiver of Sovereign Immunity 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. 20. Venue If any dispute arises out of this agreement,the venue of such legal recourse will be Collier 6 ciA 1 6 2 1 County,Florida. 21. Entire Agreement This agreement contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations shall be valid or binding upon the County or the vendor unless expressly contained herein or by a written amendment to this agreement signed by both Parties. 22. 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. 23. 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. 24. Waiver The delay or failure by the County to exercise or enforce any of its rights under this agreement will not constitute or be deemed a waiver of the County'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. 25. Compliance The vendor shall abide by all applicable current federal statutes, laws, rules and regulations as well as applicable current state statutes, laws, rules, regulations and County rules, ordinances and regulations. The Parties agree that failure of the vendor to abide by these laws shall be deemed an event of default of the vendor, and subject the agreement to immediate, unilateral cancellation of the agreement at the discretion of the County. 26. Final Invoice The vendor shall submit the final CCE, HCE, ADI, IIE and IIIES invoice for payment to the County on July 3, 2013. If the vendor fails to submit final request for payment by the deadline, then all rights to payment may be forfeited and the County may not honor any requests submitted after the aforesaid time period. Any payment due under the terms of this agreement may be withheld until all reports due from the vendor and necessary adjustments thereto have been approved by the County. 27. Renegotiations or Modifications Modifications of the provisions of this agreement shall be valid only when they have been reduced to writing and duly signed by both parties. The rate of payment, contract requirements and the total dollar amount may be adjusted retroactively to reflect price level increases and changes in the rate of payment or language. 28. All Terms and Conditions Included This agreement and its Attachments, A-H and exhibits 1-4 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 agreement shall supersede all previous communications, representations or agreements, either written or verbal between the Parties. 7 0 „, , 1613 2 ATTACHMENT D CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR AGREEMENTS,GRANTS,LOANS AND AGREEMENTS The undersigned certifies,to the best of his or her knowledge and belief,that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any State ,Federal or County, a member of congress, an officer or employee of congress, an employee of a member of congress, or an officer or employee of the state legislator, in connection with the awarding of any federal grant,the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal agreement, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of the County, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this federal agreement, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying,” in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including vendors, sub-grants, and agreements under grants, loans and cooperative agreements)and that all vendors shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than$100,000 for each such failure. Signature Date Name of Authorized Individual Name and Address of Organization 8 , 1613 2 to ATTACHMENT E CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS,GRANTS,LOANS AND COOPERATIVE AGREEMENTS The undersigned, an authorized representative of the vendor named in the agreement or agreement to which this form is an attachment,hereby certifies that: (1) The vendor and any vendors of services under this agreement 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 vendor, vendor(s), or any outside entity on which the vendor 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, vendor(s)will take immediate action to assure data integrity. (3) If this agreement 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 vendor (represented by the undersigned) and purchased by the State will be verified for accuracy and integrity of data prior to transfer. In the event of any decrease in functionality related to time and date related codes and internal subroutines that impede the hardware or software programs from operating properly, the vendor agrees to immediately make required corrections to restore hardware and software programs to the same level of functionality as warranted herein, at no charge to the State, and without interruption to the ongoing business of the state,time being of the essence. (4) The vendor and any vendor(s) of services under this agreement warrant their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data integrity compliance issues. The vendor shall require that the language of this certification be included in all vendors and other agreements and that all vendor shall certify compliance accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB Circulars A-102 and 2 CFR Part 215 (formerly OMB Circular A-110). Name and Address of vendor Signature Title Date Name of Authorized Signer 9 160 2 EXHIBIT F CERTIFICATION REGARDING DEBARMENT, SUSPENSION,INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS (1) The prospective vendor certifies, by signing this certification, neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or County. (2) Where the prospective vendor is unable to certify to any of the statements in this certification,such prospective participant shall attach an explanation to this certification. Signature Date Title County/Organization (Certification signature should be same as Agreement signature.) Instructions for Certification 1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "person," "primary covered transaction,"and"voluntarily excluded,"as used herein,have the meanings set out in the sections of rules implementing Executive Order 12549. (2 CFR 180.5-180.1020,as supplemented by 2 CFR 376.10-376.995). You may contact the Agreement Manager for assistance in obtaining a copy of those regulations. 2. This certification is a material representation of facts upon which reliance was placed when the parties entered into this transaction. If it is later determined that the vendor knowingly rendered an erroneous certification,in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension and/or debarment. 3. The vendor will provide immediate written notice to the Agreement Manager if at any time the vendor learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The vendor may decide the method and frequency by which it determines the eligibility of its principals. Each participant to a lower tier covered transaction may,but is not required to,check the Excluded Parties List System(EPLS). 4. The vendor will include a"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion-Lower Tier Covered Transaction"in all its lower tier covered transactions and in all solicitations for lower tier covered transactions. 5. The vendor agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise authorized by the federal government. 6. If the vendor knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction,in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension,and/or debarment. 7. The vendor may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended,ineligible,or voluntarily excluded from the covered transaction,unless it knows that the certification is erroneous. 10 S 160 2 WV EXHIBIT G SUBRECIPIENT INVOICE SUMMISSION The County shall reimburse the SUBRECIPIENT for the performance of this Agreement upon completion or partial completion of the work tasks as accepted and approved by HHVS pursuant to the submittal of quarterly progress reports. Invoices for work performed are required every month. If no work has been performed during that month, or if the SUBRECIPIENT is not yet prepared to send the required backup, a$0 invoice will be required. Explanations will be required if two consecutive months of$0 invoices are submitted. Payments shall be made to the SUBRECIPIENT when requested as work progresses but, not more frequently than once per month. Final invoices are due no later than 90 days after the end of the agreement. Work performed during the term of the program but not invoiced within 90 days without written exception from the Grant Coordinator will not be reimbursed. No payment will be made until approved by HHVS for grant compliance and adherence to any and all applicable local, state or Federal requirements. Payment will be made upon receipt of a properly completed invoice and in compliance with §218.70, Florida Statutes, otherwise known as the "Local Government Prompt Payment Act." 11 r_..a llEPAI2TME:NT OF 1 6 D EXHIBIT H BACKGROUND SCREENING ELDER AFFAIRS Affidavit of Compliance -Employer STATE OF FLORIDA 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 Employer Name located at Street Address City State ZIP code 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. Signature of Representative Date STATE OF FLORIDA,COUNTY OF Sworn to(or affirmed)and subscribed before me this day of , 20 , by (Name of Representative)who is personally known to me or produced 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:http://elderaffairs.state.fl.us/english/backgroundscreening.php 12 a ' ' 160 21 EXHIBIT 1 STATEMENT OF WORK COMMUNITY CARE FOR THE ELDERLY PROGRAM(CCE) SECTION I: SERVICES TO BE PROVIDED 1.1. DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 AGREEMENT ACRONYMS Activities of Daily Living(ADL) Adult Protective Services(APS) Assessed Priority Consumer List(APCL) Comprehensive Assessment and Review for Long-Term Care Services(CARES) Community Care for the Disabled Adult(CCDA) Community Care for the Elderly(CCE) Client Information and Registration Tracking System(CIRTS) Department of Children and Families(DCF) Department of Elder Affairs(DOEA) Home Care for Disabled Adults(HCDA) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out: The condition of reaching 60 years of age and being transitioned from the Department of Children and Families(DCF) Services,Community Care for Disabled Adults (CCDA)or Home Care for Disabled Adults(HCDA) services to the Department's community- based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in its planning and service area in accordance with the Section 306 (42 U.S.C. 3026) of the Older Americans Act and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the County enters CCE specific data in the CIRTS. An update may also include other revisions to the area plan as instructed by the County or Department of Elder Affairs. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The primary purpose of the CCE program is to prevent, decrease or delay premature or inappropriate and expensive placement of older persons in nursing homes and other institutions. 13 .. , 160 Z 1.2.2 Community Care for the Elderly Mission Statement The CCE Program assists functionally impaired elderly persons in living as independently as possible in their own homes or in the homes of relatives or caregivers. The program provides a continuum of care through the development, expansion, reorganization and coordination of multiple community-based services to assist elders to reside in the least restrictive environment suitable to their needs. 1.2.3 Authority The relevant authority governing CCE program are: (1)Rule 58C-1, Florida Administrative Code (2) Sections 430.201 through 430.207, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services Chief Financial Officer Memoranda the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1)CFO Memo No. 02: Release date,August 20, 2010; (2)CFO Memo No. 03: Release date,June 29,2010; and (3) CFO Memo No. 06: Release date,June 30, 2010. 1.2.4 Scope of Service The vendor shall provide services in a manner consistent with and descried in the current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the program are to preserve the independence of elders and prevent or delay more costly institutional care through a community care service system that provides case management and other in-home and community services as needed under the direction of the County and provide a continuum of service alternatives that meet the diverse needs of functionally impaired elders. 1.3. INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The CCE program provides a continuum of services for functional impaired elders. 1.3.2 Individual Eligibility In order to receive services under this agreement, an applicant must: (1) Be at least 60 years of age; (2) Be functionally impaired as determined through the initial comprehensive assessment; and (3) With the exception of APS high-risk referrals, consumers may not be dually enrolled in the CCE program and a Medicaid capitated long-term care program. 1.3.2.1 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution or who are abused, neglected or exploited. 14 r} 16021 SECTION II: MANNER OF SERVICE PROVISION 2. Delivery of Service to Eligible Clients The vendor shall ensure the provision of a continuum of service that meet the diverse needs of functionally impaired elders. The vendor shall ensure performance and reporting of the following service provision in accordance with the current DOEA Programs and Services Handbook. The services may include the following categories: (1) Core Services; (2) Health Maintenance Services;and (3) Other Support Services. Core Services for Programmatic Operation 2.1. The vendor may deliver core services include a variety of home-delivered services, day care services, and other basic services that are most needed to prevent unnecessary institutionalization. Core services,to be provided at the unit rate identified in this agreement, include the following: (1) Adult Day Care; (7) Housing Improvement; (2) Chore Services; (8) Respite Services; and (3) Enhanced Chore; (9) Transportation (4) Companionship; (5) Home Delivered Meals; (6) Homemaker; 2.1.1 Health Maintenance Services The vendor shall ensure that health maintenance services are routine health services that are necessary to help maintain the health of functionally impaired elders. The services are limited to medical therapeutic services, non-medical prevention services, personal care services, home health aide services, home nursing services, and emergency response systems. Typical services to be provided at the unit rate identified in this agreement, are the following: (1) Adult Day Health Care; (2) Emergency Alert Response; (3) Nutrition Counseling (4) Personal Care (5) Skilled Nursing Services; and (6) Specialized Medical Equipment Services and Supplies 2.2 SERVICE TIMES 2.2.1 Service Times 15 16 © The vendor shall ensure the provisions of the services listed in this agreement are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m.to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the agreement in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this agreement as updated, and approved by the County's reporting requirements. Service Unit of Service Adult Day Care Homemaker Case Aide Housing Improvement Case Management Respite Services Chore Services Personal Care Hour Enhanced Chore Physical Therapy Companionship Skilled Nursing Services Emergency Alert Response Day Material Aid Episode Specialized Medical Equipment, Services and Supplies Escort • Shopping Assistance One-Way Trip Transportation Service Unit of Service Home Delivered Meals Meal 2.4 REPORTS The vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The vendor shall establish due dates for any agreement that permits the vendor to meet the County's reporting requirements. Service Costs Reports The vendor shall submit to the County semi-annual service cost reports, August 1, 2013 and February 1, 2014, of each year which reflects actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.5 RECORDS AND DOCUMENTATION 2.5.1 Each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup 16 160 2 2.6 COUNTY RESPONSIBILITIES 2.6.1 Program Guidance and Technical Assistance The County will provide to the vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the vendor. resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures will be made available to the County upon request. 2.7 PERFORMANCE SPECIFICATIONS 2.7.1 Outcomes (1) The vendor shall ensure services provided under this agreement are in accordance with the current Department of Elder Affairs Programs and Services Handbook. (2) The vendor shall timely submit to the County all information described in EXHIBIT 1, SECTION 2.4 REPORTS; and (3) The vendor shall timely submit to the County all information described in EXHIBIT 1, SECTION 2.5 RECORDS AND DOCUMENTATION. 2.8. VENDOR'S FINANCIAL OBLIGATIONS 2.8.1 Matching,Level of Effort,and Earmarking Requirement The vendor will assure a match requirement of at least 10 percent of the cost for all CCE services. The match will be made in the form of cash and/or in-kind resources. At the end of the agreement period, all CCE funds expended must be properly matched. State funds cannot be used to match another state-funded program. 3 SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 17 7� 160 2 3.4 Payment may be authorized only for allowable services,which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 18 t. , 1 6 2 EXHIBIT 2 STATEMENT OF WORK HOME CARE FOR THE ELDERLY PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Adult Protective Services(APS) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) 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) Home Care for Disabled Adults(HCDA) Home Care for the Elderly(HCE) Institutional Care Program (ICP) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults(HCDA) services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026) and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the County enters HCE specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701 B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement Area Agencies on Aging may contract with CCE lead agencies or other case management entities for the provision of the HCE program. Approved caregivers receive a Basic Subsidy to reimburse some of their expenses each month for caring for the consumer and may receive a Special Subsidy for other necessary services and essential supplies. Caregivers may be approved 19 Ci\N • • , 160 2 for up to three HCE clients in their home. 1.2.2 Home Care for the Elderly Program Mission Statement The Home Care for the Elderly Program supports family style living arrangements, on a non- profit basis, as an alternative to nursing homes or other institutional care. Through the program, a caregiver for three or fewer elders living in a private home provides basic services of maintenance and supervision as well as coordinating other necessary specialized services. 1.2.3 Authority The relevant authority governing the HCE program include: (1) Rule Chapter 58H-1, Florida Administrative Code; and (2) Sections 430.601 through 430.608, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services', Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: CFO Memo No. 02: Release date,August 20,2010; CFO Memo No. 03: Release date,June 29,2010; and CFO Memo No. 06: Release date,June 30, 2010. 1.2.4 Scope of Service The Vendor shall provide services in a manner consistent with and described in the current County's area plan update and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the HCE program are to ensure that: (1) Basic Subsidy is provided to the caregiver of each client and (2) Special Subsidy is provided when essential to the well-being of the client. 1.3 INDIVIDUAL TO BE SERVED 1.3.1 General Eligibility The Home Care for the Elderly program serves elders age 60 and older at risk of placement in a nursing home or other institutional settings who can remain in a family style setting through the provision of subsidies. 1.3.2 Client Eligibility Clients eligible to receive services under this agreement must: (1) Be 60 years of age or older; (2) Have income less than the Institutional Care Program (ICP) standard. (3) Meet the ICP asset limitation; (4) Be at risk of nursing home placement; 20 • 1b ® 21 (5) Have an approved adult caregiver living in the home with them who is willing to provide care or assist in arranging for care; and (6) Not be enrolled in the Aged and Disabled Adult Medicaid waiver or a Medicaid capitated long-term care program. 1.3.3 Caregiver Eligibility Caregivers eligible to receive services under this agreement must: (1) Be at least 18 years of age, capable of providing a family-type living environment; (2) 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; (3) Be willing to accept responsibility for the social, physical and emotional needs of the care Vendor; (4) Be physically present and live in the home to provide supervision and to assist in arrangement of services for the client; (5) 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 (6) Be without record of conviction of abuse, neglect or exploitation of another person. 1.3.4 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meet the diverse needs of the functionally impaired elders and their caregivers. The Vendor shall ensure Basic Subside and Special Subsidy services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. 2.1. Basic Subsidy The Basic Subsidy is a cash payment made to an approved caregiver each month to reimburse some expenses incurred in caring for the client. The Basic Subsidy is provided for support and maintenance of the client, including housing, food, clothing, and medical costs not covered by Medicaid, Medicare or any other insurance. A Basic Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. If the client is hospitalized or in any other temporary institution for 30 days or less,the full Basic Subsidy shall be provided to the caregiver as if the client were in the home. 2.2. Special Subsidy Services Though every eligible HCE client receives a Basic Subsidy, Special Subsidy payments are pre-authorized and are based on additional specialized medical or health care services, supplies or equipment needed to maintain the health and well-being of the individual elder. The Special Subsidy for additional medical support and special services is a cash payment to reimburse the costs of any other service or special care not covered by Medicaid, Medicare, or private insurance when these services are determined to be 21 �9 16 [j 2 pi essential to maintain the well-being of the home care recipient. A Special Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. Special Subsidy 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: 2.2.1 SERVICE LOCATION AND EQUIPMENT 2.2.2 Service Times The vendor shall ensure the provision of the services listed in this contract are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m.to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the Agency's reporting requirements. Service Unit of Service Adult Day Care Housing Improvement Case Aide Other Case Management Personal Care Hour Chore Respite(Facility Based or In-Home) Chore(Enhanced) Skilled Nursing Services Homemaker Material Aid Episode Specialized Medical Equipment, Services and Supplies Transportation One-Way Trip 2.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permits the Vendor to meet the County's reporting requirements. 2.2.1 Service Costs Reports The Vendor shall submit to the County the semi-annual service cost reports, August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.3 RECORDS AND DOCUMENTATION 2.3.1 The Vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The 22 0 1613 2 Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 2.4 PERFORMANCE SPECIFICATIONS 2.4.1 Outcomes (1) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (2) The Vendor shall timely submit to the County all reports described in SECTION 2.2 REPORTS; and (3) The Vendor shall timely submit to the County all information described in, SECTION 2.3 RECORDS AND DOCUMENTATION. 2.5 COUNTY RESPONSIBILITIES 2.5.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-up on-site visits; (3) Client visits; (4) Review of independent auditor's reports; (5) Review of third-party documents and/or evaluation; (6) Review of progress reports; (7) Review of customer satisfaction surveys; (8) Agreed-upon procedures review by an external auditor or consultant; (9) Limited-scope reviews; and (10) Other procedures as deemed necessary. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The 23 �9 16D 2 vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services,which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 24 . 16 (1 Z EXHIBIT 3 STATEMENT OF WORK ALZHEIMER'S DISEASE INITIATIVE PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Alzheimer's Disease(AD) Alzheimer's Disease Initiative(ADI) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System(CIRTS) Community Care for Disabled Adults(CCDA) Department of Elder Affairs(DOEA) Home Care For Disabled Adults(HCDA) Instrumental Activities of Daily Living(IADL) Memory Disorder Clinic(MDC) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults(HCDA) services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026. 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 County enters ADI specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 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. Model Day Care: A program of therapeutic, social and health activities specific to clients with memory disorders. Services and activities include, but are not limited to, active and quiet 25 0 . . , 1602 . , games, reminiscence, validation therapy, pet therapy, water therapy and other failure free activities appropriate to the client's level of functioning. Model day care centers will also provide training for health care and social service personnel in the care of persons having AD or related memory disorders. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The ADI program provides a continuum of services addressing the special needs of individuals with AD,their families and caregivers. 1.2.2 Alzheimer's Disease Initiative Program Mission Statement The ADI program ensures that persons afflicted with AD and other forms of dementia are given essential services to help them age in place in an elder-friendly environment with security, dignity, and purpose. The program also provides support to family members and caregivers of persons afflicted with AD. 1.2.3 Authority The relevant authority governing the Alzheimer's Disease Initiative Program are as follows: (1) Rule Chapter 58D-1, Florida Administrative Code; and (2) Sections 430.501 through 430.504, Florida Statutes. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1) CFO Memo No. 02: Release date,August 20, 2010; (2) CFO Memo No. 03: Release date,June 29, 2010; and CFO Memo No. 06: Release date,June 30, 2010. 1.2.3.2 Scope of Service The Vendor is responsible for the programmatic, fiscal, and operational management of the ADI program. The program services shall be provided in a manner consistent with and described in the current Vendor's Request for Proposal, RFP, and the County's current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.3.4 Major Program Goals The major goal of the ADI program is to provide services to meet the needs of caregivers and individuals with AD and related memory disorders. 1.3 INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The ADI Program addresses the special needs of individuals with AD and their caregivers. 1.3.2 Individual Eligibility Those individuals eligible to receive services under this contract must meet the following conditions: (1) Be 18 years of age or older and have a diagnosis of AD or a related disorder, or be 26 T� 160 24 suspected of having AD or a related disorder; and (2) Not be enrolled in a Medicaid capitated long-term care program. 1.3.3 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. SERVICE TASKS In order to achieve the goals of the ADI program,the Vendor shall ensure the following tasks are performed: (1) Client eligibility determination; (2) Assessment and prioritization of service delivery for new clients; (3) Delivery of services to eligible clients; and (4) Monitor the performance of vendors. 2.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described in this SECTION 1.3. 2.2 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services addressing the diverse needs of individuals with AD and their caregivers. The Vendor shall ensure services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. Services categories include: (1) Caregiver Training/Support; (2) Case Aid; (3) Case Management; (4) Counseling(Gerontological); (5) Counseling(Mental Health/Screening); (6) Education/Training; (7) Model Day Care; ( 8) Respite(Facility-Based); ( 9) Respite(In-Home); and (10) Specialized Medical Equipment, Services, and Supplies. Caregivers benefit from receiving training, respite and related support services to assist them in caring for the ADI client. 2.3 Service Times The Vendor shall ensure the provisions of the services listed in this contract are available 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. 27 1 6 D 3. DELIVERABLES 3.1. Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the County's reporting requirements. Service Unit of Service Caregiver Training/Support; Hour Case Aid; Hour Case Management; Hour Counseling(Gerontological); Hour Counseling(Mental Health/Screening); Hour Respite(Facility-Based); Hour Respite(In-Home); Hour Education/Training; Episode Episode 3.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. 3.2.1 Service Costs Reports Vendor must submit to the County the semi-annual service cost reports August 1, 2013 and February 1,2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 3.3 RECORDS AND DOCUMENTATION 3.3.1 The Vendor and each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 4. PERFORMANCE SPECIFICATIONS 4.1 Outcomes (4) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (5) The Vendor shall timely submit to the County all reports described in SECTION 3.2 REPORTS; and (6) The Vendor shall timely submit to the County all information described in SECTION 3.3 28 , 160 Z i RECORDS AND DOCUMENTATION. 5. COUNTY RESPONSIBILITIES 5.1. Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-up on-site visits; (3) Client visits (4) Review of independent auditor's reports (5) Review third-party documents and/or evaluations (6) Review of progress reports (7) Review of customer satisfaction surveys (8)Agreed-upon procedures review by an external auditor or consultant; (9)Limited-scope reviews; and (10)Other procedures as deemed necessary. 6. SECTION III: METHOD OF PAYMENT 6.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 6.1.2 Remedies-Nonconforming Services The Vendor shall ensure that all goods and/or services provided under this agreement for HCE funded programs are delivered timely, completely and commensurate with required standards of quality Such goods and/or services shall only be delivered to eligible program participants. If the Vendor fails to meet the prescribed quality standards for services, such services will not be reimbursed under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be reimbursed under this agreement. The Vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the Vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County requires immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 6.1.3 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the Vendor and any adjustments thereto, including any disallowance not resolved. 6.1.4 Date for Final Request for Payment 29 '7r�J 160 2 The final request for payment for agreement year one's expenditures will be due to the County no later than August 1,2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 6.2 Documentation for Payment The Vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals upon request. Such documentation shall be provided upon request to the County or the Clerk of Court. 30 EXHIBIT 4 STATEMENT OF WORK OLDER AMERICANS ACT PROGRAM TITLE HI SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 CONTRACT ACRONYMS Area Agency on Aging(AAA) Activities of Daily Living(ADL) Alliance of Information&Referral Systems(AIRS) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System(CIRTS) Information and Referral(I& R) Instrumental Activities of Daily Living(IADL) Older Americans Act(OAA) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in Its PSA in accordance with the Section 306 (42 U.S.C. 3026)of the OAA and Department instructions. Child: An individual who is not more than 18 years of age or an individual with disability. Family Caregiver: An adult family member, or another individual,who is an informal provider of in-home and community care to an older individual. Frail: When an older individual is unable to perform at least two ADLs without substantial human assistance, including verbal reminding, physical cueing or supervision; or due to cognitive or other mental impairment, requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to another individual. 1.2 County Mission,Vision and Values Statement The County's mission: To help aging adults achieve greater independence through awareness of resources and access to qualified service providers. The County's vision: To be the recognized leader in supporting older adults and their families with access to trustworthy resources and services in their communities while empowering them to live with independence and dignity. The County's values: We believe residents of Southwest Florida are entitled to: Comprehensive information about their choices of care; Timely access to resources and services; High standards of quality and performance; and Personal and professional accountability from all stakeholders. 1.2.1 Older Americans Act Program Mission Statement The Older Americans Act(OAA)Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. 31 :1 160 1.3 GENERAL DESCRIPTION 1.3.1 General Statement The OAA Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. The primary purpose of the OAA program is to foster the development and implementation of comprehensive and coordinated systems to serve older individuals. The OAA program uses these systems to assist older individuals to attain and maintain maximum independence and dignity in a home environment and allows for the capability of self- care with appropriate supportive services. 1.3.2 Authority The relevant references authority governing the OAA program are: 1. Older Americans Act of 2006, as amended; 2. Rule 58A-1, Florida Administrative Code; and 3. Section 430.101, Florida Statutes. 1.3.2.1 Incorporation of Reference Memoranda In accordance with Ch. 287 F.S., as amended,and Agency of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and incorporated by reference: 1. CFO Memo No. 02: Release date,August 20,2010; 2. CFO Memo No. 03: Release date,June 29, 2010; and 3. CFO Memo No. 06: Release date,June 30, 2010. 1.3.3 Scope of Service The Vendor shall provide services in a manner consistent with and descried in the current area plan and current Department of Elder Affairs Programs and Services Handbook. 1.3.4 Major Program Goals The major goals of the OAA program are to improve the quality of life for older individuals, preserve their independence and prevent or delay more costly institutional care. These goals are achieved through the implementation of a comprehensive and coordinated service system that provides a continuum of service alternatives that meet the diverse needs of elders and their caregivers. 1.4 INDIVIDUALS TO BE SERVED 1.4.1 Eligibility(Title III Programs) 1.4.1.1 OAA Title III,General Consumers shall not be dually enrolled in an OAA program and a Medicaid capitates long-term care program. 1.4.1.2 OAA Title IIIE,Caregiver Support Services Eligibility for OAA Title IIIE, Caregiver Support Services, are as follows: 1. Family caregivers of individuals age 60 or older; 32 A 160 21 2. Grandparents(age 55 or older)or older individuals(age 55 or older)who are relative caregivers; 3. Priority will be given to family caregivers who provide care for individuals with Alzheimer's disease and related disorders with neurological and organic brain dysfunction and for grandparents or older individuals who are relative caregivers who provide care for children with severe disabilities; and 4. For respite and supplemental services, a family caregiver must be providing care for an older individual who meets the definition of the term "frail" in OAA, Section 102 Paragraph 22. 1.4.2 Targeted Groups Preference shall be given to those with the greatest economic and social need,with particular attention to low-income older individuals, including those that are low-income minorities,have limited English proficiency, and older individuals residing in rural areas. SECTION II—MANNER OF SERVICE PROVISION 2.1 SERVICE TASKS In order to achieve the goals of the OAA program,the Vendor shall ensure the following tasks are performed: 1. Client eligibility determination; 2. Targeting and screening of service delivery for new clients; 3. Delivery of services to eligible clients; 4. Use of volunteers to expand the provision of available services; 5. Monitoring the performance of its vendors. 6. Grievance and Compliance Procedures 2.1.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described herein. 2.1.2 Targeting and Screening of Service Delivery for New Clients The Vendor shall develop and implement policies and procedures consistent with OAA targeting and screening Criteria 2.1.3 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meets the diverse needs of elders and their caregivers. The Vendor shall ensure the performance and report performance of the following services in accordance with the current Department of Elder Affairs Programs and Services Handbook. The services funded pursuant to this contract are in accordance with the OAA,Title III, sections 321,331,336 and 373 as follows: 1. Section 321,Title IIIB Supportive Services; 2. Section 373,Title IIIE Caregiver Support Services. 2.1.3.1 Supportive Services Supportive services include a variety of community-based and home-delivered services that support the qualities of life for older individuals by helping them remain independent and productive. Services include the following: 33 0 . 16D 2 (1) Adult Day Care/Adult Day Health Care; (17) Homemaker; (2) Caregiver Training/Support; (18) Housing Improvement; (3) Case Aide/Case Management; (19) Information; (4) Chore Services; (20) Intake; (5) Companionship; (21) Interpreter/Translating; (6) Counseling(Gerontological and Mental Health); (22) Referral/Assistance; (7) Education/Training; (23) Personal Care; (8) Legal Assistance; (24) Physical Therapy; (9) Material Aid; (25) Shopping Assistance; (10) Occupational Therapy; (26) Skilled Nursing; (11) Outreach; (27) Specialized Medical Equipment, Services, and Supplies (12) Recreation; (28) Respite Services; (13) Emergency Alert Response; (29) Screening/Assessment; (14) Escort; (30) Speech Therapy; (15) Health Support; (31) Telephone Reassurance; and (16) Home Health Aide; (32) Transportation 2.1.3.4 Caregiver Support Services (Title HIE Program) The following services are intended to provide direct help to caregivers, assist in the areas of health, nutrition and financial literacy and assist caregivers in making decisions and problem solving related to their caregiving roles and responsibilities: (1) Adult Day Care/Adult Day Health Care; (2) Caregiver Training/Support; (3) Counseling(Gerontological and Mental Health); (4) Education/Training; (5) Financial Risk Reduction(Assessment and Maintenance); (6) Information; (7) Intake; (8) Outreach; (9) Respite Services; (10) Screening/Assessment; and (11) Transportation 2.1.3.5 Caregiver Support Supplemental Services (Title IIIES Program): The following services are provided to complement the care provided by caregivers: (1) Chore Services; (2) Housing Improvement; (3) Legal Assistance; (4) Material Aid; and (5) Specialized Medical Equipment, Services and Supplies. 2.2 SERVICE LOCATION 34 , , 160 2 2.2.1 Service Times The Vendor shall ensure the provision of the services listed in the contract during normal business hours unless other times are more appropriate to meet the performance requirements of the contract, and it shall monitor its vendors to ensure they are available to provide services during hours responsive to client needs and during those times which best meet the needs of the relevant service community. 2.3 DELIVERABLES 2.3.1 Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the services tasks described in Section 2.1. The chart below lists the services allowed and the units of measurement. Units of service will be paid pursuant to the rate established in the 2010 RFP and approved by the County. Services Unit of Service Adult Day Care/Adult Day Interpreter/Translating Health Care Legal Assistance Caregiver Training/Support Medication Management Case Aid/Case Management Mental Health Counseling/Screening Chore Services Nutrition Counseling Companionship Occupational Therapy Counseling Services Personal Care Escort Physical Therapy Hour Financial Risk Reduction Recreation Services Respite Services Health Support Screening/Assessment Home Health Aide Sitter Homemaker Skilled Nursing Services Housing Improvement Speech Therapy Intake Emergency Alert Response Day Education/Training Episode Information Material Aid Referral/Assistance Specialized Medical Equipment, Services and Supplies Telephone Reassurance Escort One-Way Trip Shopping Assistance Transportation 2.4 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permit the Vendor to meet the County's reporting requirements. 35 . 160 2 al 2.4.2 Service Costs Reports The Vendor shall require vendors to submit to the Vendor semi-annual service cost reports on August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.4.5 Background Screening Affidavit of Compliance To demonstrate compliance with section 8 of the Standard Contract,the Vendor shall submit ATTACHMENT H, Background Screening Affidavit of Compliance annually, by January 151h 2.5 RECORECORDS AND DOCUMENTATION Each Vendor and vendor,among other requirements,must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement in its contracts and/or agreements with vendors. These policies and procedures shall be made available to the County upon request. 2.6 PERFORMANCE SPECIFICATIONS 2.6.1 Outcomes (1)The Vendor shall ensure services provided under this contract are in accordance with the current DOEA Programs and Services Handbook, (2)The Vendor shall timely submit to the County all reports described herein (3)The Vendor shall timely submit to the County all information described in, Paragraph 2.5 RECORDS AND DOCUMENTATION. 2.7 VENDOR'S FINANCIAL OBLIGATIONS 2.7.1 Matching,Level of Effort,and Earmarking Requirements The Vendor shall provide match of at least 10 percent of the federal funds received. The Vendor's match will be made in the form of cash and/or in-kind resources. The Vendor will assure,through a provision in subcontracts,a match requirement of at least 10 percent of the cost for all services funded through this contract. The vendor's match will be made in the form of cash and/or in-kind resources. The Vendor shall report match by title each month. At the end of the contract period, the Vendor must properly match all OAA funds. 2.7.2 Title III Funds The Vendor assures compliance with Section 306 of the OAA, as amended in 2006,that funds received under Title III will not be used to pay any part of a cost incurred by the Vendor to maintain a contractual or commercial relationship that is not carried out to implement Title III. 2.8 COUNTY RESPONSIBILITIES 2.8.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the Vendor. 2.8.2 Program/Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this contract. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an on-site visit. The County's determination of acceptable performance shall be conclusive. The Vendor 36 �J 160 2 agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use,but is not limited to, one or more of the following methods for monitoring: 1. Desk reviews and analytical reviews; 2. Scheduled, unscheduled and follow-up on-site visits; 3. Client visits; 4. Review of independent auditor's reports-Exhibit 10; 5. Review of third-party documents and/or evaluation; 6. Review of progress reports; 7. Review of customer satisfaction surveys; 8. Agreed-upon procedures review by an external auditor or consultant; 9. Limited-scope reviews; and 10. Other procedures as deemed necessary. 2.8.3 Contract Monitoring The County shall, at its own discretion, conduct monitoring concerning any aspect of the vendor's performance of this contract. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for OAA IIIE and OAA IIIES funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rate for services is ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services,which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 37 • 160 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 38 rl I Agreement#12-585EXH6 "Services BIT 5 for Seniors 1613 2 Attt Ioice achmen and LogB s (Minimum Standard Invoice Information) County Purchasing Order Number: Invoice Number: Grant Name: From Date To Date en `' a , _ . Subtr cam. 'e ,. : Ce 'ou4 Amount u' e ter fit 4 Lit *}a 4« .^ ..3 £g q y: Tb« - from To"al .° Cost Per ! 1 Service Unit =. 5 .7 R .n '•ssa: ff x ;�. un.�;t,`'. 4114,1---1,,,,t $0.00 $0.00 $0.00 Total $0.00 I certify to the best of my knowledge and belief that this invoice, and attached service detail log, is complete and correct and all outlay herein are for the purposes set forth in the contract, and that services are ordered by the case manager as agreed on the Contract. Legible copies of the dated timesheet, signed by the client and the worker supporting this invoice must be available upon request. Collier County reserves the right to correct computation of errors to assure proper payment amount. Prepared by: Date: Adjustment Reasons Lead Agency Authorization Attachments: Monthly Service log,Weekly Detail log and Client Service time sheets. 39 (r) 160 . EXHIBIT 6 Detail Weekly for CCE Services Week Ending: Invoice No. Personal CLIENT Care Homemaker Respite Skilled Companion Chore Total Total Total Total Total Total NAME Units Units Units Units Units Units Total Hours - - - - - - $ PECA - HMK - $ RESPITE - $ SKILLED - $ COMPANION - $ CHORE - $ TOTAL - 40 6i) 160 2 EXHIBIT 7 Monthly Detail Service Log Grant Name: Vendor Name, Address: From Date To Date By client,provide the total number of hours provided during the dates of service. This log must be submitted with your monthly invoice for the Invoice From Date and To Date. xs x s t es �e rgency Client a nst ttome= p P Fx .:: e ni �° I &.-'°Yin` . pure x _ Name 440:;:e maker n m_ 51 ant, es�ponse ..r s ome r'acltifh �,' r ate`` 41 . 160 21 EXHIBIT 8 Daycare Grant: Grant Service: ADC or RESF Vendor Name and Address By client, provide the Weekly Client Service Time Sheet provided during the dates of service. This log must be submitted with all invoices for the invoice From Date and To Date. TO FROM DATE: DATE: Client Thur Uni Client Name signature Mon Tue Wed s Fri Sat Sun Match is Service Dates 42 C�� . • 160 2 EXHIBIT 9 YOUR COMPANY NAME HERE Collier County Services for Seniors Homemaker/Personal Care/Respite/Companion Work Sheet Client Name: Client Signature: Week Ending: Each Time You Perform one of the Activities Below: Put in arrival and departure times for the day worked: ****Client should Initial time of arrival and departure. ****Client should Sign form at top. ****you should sign your name at the bottom. Date: Day: MON TUES WED THUR FRI SAT SUN TOTAL TIME ARRIVAL TIME: DEPARTURE TIME: ****CLIENT INITIALS: Arrive: PERSONAL CARE Depart: Assist W/Bath tub Shower Bed Assist W/Dressing Bathroom Assist Shave (Face Only) Oral Hygiene Walking/Ambulation Feeding Assistance Wash/Set Hair Backrub_ Soak Feet Nails (File only) Change_Make Bed Take out Trash Clean Bedroom Clean Bathroom Prepare Meals Laundry Arrive: HOME MAKING Depart: Vacuum/Sweep _ Light Dusting 43 vj f w , 16 © 2M► Clean Kitchen Floor Wash Dishes Mop Sweep Grocery Shop Errands Arrive: RESPITE Depart: Arrive: COMPANION Depart: EMPLOYEE'S Signature/Title 44 160 2 EXHIBIT 10 OMB Circular A-133 Audits of States, Local Governments, and Non-Profit Organizations requires the Collier County Housing, Human and Veterans Services Department to monitor our subrecipients of federal awards and determine whether they have met the audit requirements of the circular and whether they are in compliance with federal laws and regulations. Accordingly, we are requiring that you check one of the following, provide all appropriate documentation regarding your organization's compliance with the audit requirements, sign and date this form. Subrecipient Fiscal Year Name Period Total State Financial Assistance Expended during $ most recently completed Fiscal Year Total Federal Financial Assistance Expended during most $ recently completed Fiscal Year Check Appropriate Boxes We have exceeded the $500,000 federal/state expenditure threshold for our fiscal year ❑ ending as indicated above and have completed our Circular A-133 audit. A copy of the audit report and management letter are attached. We exceeded the $500,000 federal/state expenditure threshold for our fiscal year ❑ ending as indicated above and expect to complete our Circular A-133 audit by . Within 30 days of completion of the A-133 audit, we will provide a copy of the audit report and management letter. We are not subject to the requirements of OMB Circular A-133 because we: ❑ Did not exceed the $500,000 federal/state expenditure threshold for the fiscal year indicated above ❑ Are a for-profit organization ❑ Are exempt for other reasons —explain An audited financial statements is attached and if applicable, the independent auditor's management letter. (If findings were noted, please enclose a copy of the responses and corrective action plan.) Certification Statement I hereby certify that the above information is true and accurate. Signature Date Print Name and Title 45 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGN b '' unismaimmarnammaim Routed by Purchasing Department to Office Initials Date the Following Addressee(s) (In routing order) 1. Risk Management Risk 2. County Attorney Office County Attorney Office VgW `2y 3. BCC Office Board of County Commissioners Gj a 6ig4/3 4. Minutes and Records Clerk of Court's Office -Pm h (( (13 to:224K. 5. Return to Purchasing Department Purchasing Contact: Diana DeLeon PRIMARY CONTACT INFORMATION Name of Primary Diana DeLeon for Lisa Carr,HHVS, Phone Number 252-8375 Purchasing Staff June 20,2013 Contact and Date Agenda Date Item was May 28,2013 ✓ Agenda Item Number 16.D.2 Approved by the BCC Type of Document Contract Amendment Number of Original 2 t.— Attached Documents Attached PO number or account N/A Solicitation/Contract Amend#1 to Contract 12- number if document is NumberNendor Name 5856 First Care Home ✓ to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature? DD(Initial),.. 2. Does the document need to be sent to another agency for additional signatures? If yes, I N/A provide the Contact Information(Name;Agency;Address; Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be `� signed by the Chairman,with the exception of most letters,must be reviewed and signed ��" by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board � / 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A V document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's DD signature and initials are required. 7. In most cases(some contracts are an exception),an electronic copy of the document and DD this routing slip should be provided to the County Attorney's Office before the item is input into SIRE. 8. The document was approved by the BCC on the date above and all changes made DD during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC, all changes directed by the BCC have been made,and the document is ready for t g Chairman's signature. 16D2 MEMORANDUM Date: July 5, 2013 To: Diana De Leon, Contract Technician Purchasing Department From: Ann Jennejohn, Deputy Clerk Minutes & Records Department Re: Contract #12-5856 Amendment No. 1 "Services for Seniors" Contractor: First Home Care Services, Inc. Attached is an original copy of the document referenced above, (Item #16D2) approved by the Board of County Commissioners on May 28, 2013. The second original document will be held on file in the Minutes and Record's Department for the Board's Official Record. If you have any questions, please contact me at 252-8406. Thank you. Attachment 1602 Contract Amendment #1 Contract # 12-5856 "Services for Seniors" This CONTRACT AMENDMENT #1, dated Akc , , 2013 to the referenced agreement shall be by and between the parties to the original Agreement, First Care Home Services, Inc. (to be referred to as "Vendor")and Collier County,Florida, (to be referred to as "County"). Statement of Understanding RE: Contract # 12-5856 "Services for Seniors" In order to continue services for the original Contract document referenced above, the Vendor agrees to the terms and conditions set forth in Exhibit A-lA, which includes Attachments C-H and Exhibits 1-10 attached hereto and incorporated by reference. The Vendor further agrees to amend Section 1, Commencement, as follows: 1. COMMENCEMENT. This Agreement shall Commence on December 11, 2012 and shall terminate on December 10, 201'1 June 30, 2014. The Contract award is a two (2) year contract, with the possibility of two (2) additional (2) year terms pending funding from grantors and acceptable performance by the awarded vendor. Any such renewals shall be mutually agreed upon in writing by the parties. The maximum duration for this Contract for CCE, HCE, afifl ADI, OAA IIIE AND OAA HIES funding will not exceed six (6) years (through June 30, 2018). As outlined in RFP #12-5856, the County requires the Vendor to contribute a cash or in-kind match of no less than ten (10) percent for all services related to the Community Care for the Elderly Program, (CCE), Older American Title IIIE Caregiver Support (OAA IIIE) and Older American Title IIIES Caregiver Support Supplemental Services(OAA IIIES)Programs. Words that have been deleted are struck through, words underlined have been added. Modification made herein shall apply as if incorporated into the Contract on the date of Commencement. All other terms and conditions of the agreement shall remain in force. IN WITNESS WHEREOF, the Vendor and the County have each, respectively, by an authorized person or agent,hereunder set their hands and seals on the date(s) indicated below. Accepted: , 2013 VENDOR: First :re Horn Services, Inc. 6rst itness 4 - -`I, - By: , r Type/p . t itne- ,ame • a 161. C. °can c -.- - - o d 'tness Print/Type Name and Titl- Ty.-/prin witness nar e 1 1602 COUNTY: ATTEST: BOARD OF COUNTY COMMIS:IONERS DWIGHT E. BROCK, CLERK OF COLLIER COUN Y, FLO' DA By: 0,4A014 * By ALI 0,.� gisERK GEORGIA A. HILLER, ESQ. Mies, . 0= r CHAIRWOMAN Approval for form and legal Sufficiency: • Jennifei:'B. White W w Assistant County Attorney ' Agenda S-r Date Date 1—,-13 Rec d 2 EXHIBIT A-lA 16 D 2 AGREEMENT 12-5856 SERVICES FOR SENIORS ATTACHMENTS ATTACHMENT ATTACHMENT DESCRIPTION PAGE Attachment C Core Standards for CCE, HCE, ADI, OAA IIIE & IIIES 2 Attachment D Certification Regarding Lobbying 8 Attachment E Certification Regarding Data Integrity Compliance 9 Attachment F Certification Regarding Debarment, Suspension, 10 Ineligibility and Voluntary Exclusion Contracts/ Subcontracts Attachment G Sub-Recipient Invoice Submission 11 Attachment H Background Screening Affidavit of Compliance 12 Exhibit 1 CCE Statement of work 13 Exhibit 2 HCE Statement of work 19 Exhibit 3 ADI Statement of work 25 Exhibit 4 OAA IIE and OAA IIIES Statement of work 31 Exhibit 5 Invoice 39 Exhibit 6 Detail Weekly Log 40 Exhibit 7 Monthly Log 41 Exhibit 8 Day Care/Respite Time Sheet 42 Exhibit 9 Program Time Sheet 43 Exhibit 10 Annual Audit Monitoring Report 45 1 0o ATTACHMENT C 16 0 2 Core Standards for CCE,HCE,ADI,OAA HIE & HIES 1. Compliance with Federal Law 1.1 If this agreement contains federal funds the following shall apply: 1.1.1 The vendor shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable regulations. 1.1.2 If this agreement contains federal funds and is over$100,000.00,the vendor shall comply with all applicable standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s. 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable Environmental Protection County regulations 40 CFR 30. The vendor shall report any violations of the above to the County. 1.1.3 The vendor may not use any federal funds received in connection with this agreement to influence legislation or appropriations pending before the Congress or any state legislature. If this agreement contains federal funding in excess of$100,000.00,the vendor must, prior to agreement execution, complete the Certification Regarding Lobbying form, ATTACHMENT D. All disclosure forms as required by the Certification Regarding Lobbying form must be completed and returned to the Grant Coordinator prior to payment under this agreement. 1.1.4 In accordance with Appendix A to 2 CFR 215, the vendor shall comply with Executive Order 11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in Department of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable. 1.1.5 If this agreement contains federal funds and provides services to children up to age 18, the vendor shall comply with the Pro-Children Act of 1994(20 U.S.C. 6081). 1.1.6 A agreement award with an amount expected to equal or exceed $25,000.00 and certain other agreement 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 vendor shall comply with these provisions before doing business or entering into sub-agreements receiving federal funds pursuant to this agreement. The vendor shall complete and sign ATTACHMENT F prior to the execution of this agreement. 1.2 The vendor shall not employ an unauthorized alien. The County 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 agreement by the County. 2 1602 1.3 If the vendor 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 vendor must notify the County in writing within thirty(30) days of receiving the IRS notice of revocation. 1.4 The vendor shall comply with Title 2 CFR Part 275 regarding Trafficking in Persons. 1.5 Unless exempt under 2 CFR Part 170.110(b), the vendor shall comply with the reporting requirements of the Transparency Act as expressed in 2 CFR 170. 1.6 To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number 11-116, vendor agrees to utilize the U.S. Department of Homeland Security's E-verify system to verify the employment of all new employees hired by vendor during the agreement term. Vendor meeting the terms and conditions of the E-Verify System are deemed to be in compliance with this provision. 2. Compliance with State Law 2.1 This agreement is executed and entered into in the State of Florida, and shall be construed, performed and enforced in all respects in accordance with the Florida law, including Florida provisions for conflict of laws. 2.2 The vendor shall comply with requirements of s. 287.058, F.S. as amended. 2.2.1 The vendor shall provide units of deliverables, including various client services, and in some instances may include reports,findings, and drafts, as specified in this agreement,which the Grant Coordinator must receive and accept in writing prior to payment in accordance with s. 215.971, F.S. (1)and(2). 2.2.2 The vendor shall submit bills for fees or other compensation for services or expenses in sufficient detail for a proper pre-audit and post-audit. 2.2.3 The vendor 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 vendor in conjunction with this agreement except for those records which are made confidential or exempt by law. The vendor's refusal to comply with this provision will constitute an immediate breach of agreement for which the County may unilaterally terminate the agreement. 2.3 If clients are to be transported under this agreement, the vendor shall comply with the provisions of Chapter 427, F.S., and Rule 41-2, F.A. C. 2.4 Vendors who are on the discriminatory vendor list may not transact business with any public entity, in accordance with the provisions of s. 287.134, F.S. 2.5 The vendor shall comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the expenditure of agreement funds for the purpose of lobbying the legislature,judicial branch or a state agency. 3. Background Screening The vendor shall ensure that the requirements of s. 430.0402 and ch. 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 exempted from the Department's level 2 background screening 3 1q2 4 1 comply with any applica le es pursuant to s. 430.0402(2)-(3), F.S. The vendor must also co p y y pp promulgated by the Department and the Agency for Health Care Administration regarding implementation of s.430.0402 and ch.435, F.S. Further information concerning the procedures for background screening are found at http://elderaffairs.state.fl.us/doea/backgroundscreening.php. 4. Provision of Services The vendor shall provide services in the manner described herein. 5. Monitoring by the County The vendor shall permit persons duly authorized by the County to inspect and copy any records, papers, documents, facilities, goods and services of the vendor which are relevant to this agreement, and to interview any clients, employees and vendor employees of the vendor to assure the County of the satisfactory performance of the terms and conditions of this agreement. Following such review, the County will provide a written report of its findings to the vendor, and where appropriate,the vendor shall develop a corrective action plan. The vendor hereby agrees to correct all deficiencies identified in the corrective action plan in a timely manner as determined by the Grant Coordinator. 6. Confidentiality of Information The vendor shall not use or disclose any information concerning a vendor of services under this agreement 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. 7. Health Insurance Portability and Accountability Act Where applicable, the vendor shall comply with the Health Insurance Portability and Accountability Act (42 USC 1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162, and 164). 8. Bankruptcy Notification During the term of this agreement,the vendor shall immediately notify the County if the Vendor, its assignees,vendors or affiliates file a claim for bankruptcy. Within ten (10)days after notification,the vendor must also provide the following information to the County.: (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., United States Bankruptcy Court Middle District of Florida,Naples,FL); and, (4)The name, address, and telephone number of the bankruptcy attorney. 9. Sponsorship and Publicity 9.1 As required by s. 286.25, F.S., if the vendor is a non-governmental organization which sponsors a program financed wholly or in part by state funds, including any funds obtained through this agreement, it shall, in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by Hope Hospice and Community Services, the State County of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County." If the sponsorship reference is in the written material, the words "State of Florida, Department of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County" shall appear in at least the same size letters or type as the name of the organization. 9.2 The vendor shall not use the words "The State of Florida Department of Elder Affairs or the Area County on Aging for Southwest Florida, Inc. or Collier County" to indicate sponsorship of a program otherwise financed, unless specific authorization has been obtained by Collier County, or the Area Aging on Aging prior to use. 4 10. Independent Capacity of Vendor It is the intent and understanding of the Parties that the vendor, or any of its vendors, are independent vendors and are not employees of the County and shall not hold themselves out as employees or agents of the County without specific authorization from the County. It is the further intent and understanding of the Parties that the County does not control the employment practices of the vendor and will not be liable for any wage and hour, employment discrimination, or other labor and employment claims against the vendor or its vendors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary insurance for the vendor are the sole responsibility of the vendor. 11. Payment Payments shall be made to the vendor pursuant to s. 215.422, F.S., as services are rendered and invoiced by the vendor. The Grant Coordinator will have final approval of the invoice for payment, and will approve the invoice for payment only if the vendor has met all terms and conditions of the agreement, unless the bid specifications, purchase order, or this agreement specify otherwise. The approved invoice will be submitted to the County's Grant Coordinator approval and processing. 12. Return of Funds The vendor shall return to the County any overpayments due to unearned funds or funds disallowed and any interest attributable to such funds pursuant to the terms and conditions of this agreement that were disbursed to the vendor by the County. hi the event that the vendor or its independent auditor discovers that an overpayment has been made, the vendor shall repay said overpayment immediately without prior notification from the County. In the event that the County first discovers an overpayment has been made, the Grant Coordinator will notify the vendor in writing of such findings. 13. Data Integrity and Safeguarding Information The vendor shall ensure an appropriate level of data security for the information the vendor is collecting or using in the performance of this agreement. An appropriate level of security includes approving and tracking all vendor employees that request system or information access and ensuring that user access has been removed from all terminated employees. The vendor, 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 vendor shall ensure all vendors maintain written procedures for computer system backup and recovery. The vendor shall complete and sign Attachment E prior to the execution of this agreement. 14. Computer Use and Social Media Policy The Department of Elder Affairs has implemented a new 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, Area Agencies on Aging and vendors. 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. 15. Public Entity Crime Pursuant to s. 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 5 • agre ement to provide an y g oods or services to a public entity; may not submit a bid, pro os , o reply on a agreement 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 vendor, supplier, vendor, or consultant under a agreement with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in s. 287.017, F.S., for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted vendor list. 16. Patents,Copyrights,Royalties If this agreement 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 agreement, the vendor shall refer the discovery, invention or material to the County to be referred to the Department of State and the Department of Elder Affairs. Any and all patent rights or copyrights accruing under this agreement are hereby reserved to the State of Florida in accordance with Chapter 286, F.S. Pursuant to s. 287.0571 (5) (k) 1 and 2 as amended, the only exceptions to this provision shall be those that are clearly expressed and reasonably valued in the agreement. 16.1 If the primary purpose of this agreement 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 Paragraph 33. 16.2 If this agreement is awarded solely federal funding, the terms and conditions are governed by 2 CFR 215.36. 17. Emergency Preparedness and Continuity of Operations 17.1 If the tasks to be performed pursuant to this agreement include the physical care and control of clients, or the administration and coordination of services necessary for client health, safety or welfare, the vendor shall, within thirty (30) calendar days of the execution of this agreement, submit to the Grant Coordinator verification of an emergency preparedness plan. In the event of an emergency,the vendor shall notify the County of emergency provisions. 17.2 In the event a situation results in a cessation of services by a vendor, the vendor shall retain responsibility for performance under this agreement and must follow procedures to ensure continuity of operations without interruption. 18. Financial Consequences of Non-Performance If the vendor fails to meet the minimum level of service or performance identified in this agreement, or that is customary for the industry, then the County must apply financial consequences commensurate with the deficiency. Financial consequences may include,but are not limited to, agreement suspension, refusing payment, withholding payments until deficiency is cured, tendering only partial payments, and/or cancellation of agreement and reacquiring services from an alternate source. 18.1 The vendor will not be charged with financial consequences, when a failure to perform arises out of causes that were the responsibility of the County. 19. No Waiver of Sovereign Immunity 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. 20. Venue If any dispute arises out of this agreement,the venue of such legal recourse will be Collier 6 16D2 County,Florida. 21. Entire Agreement This agreement contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations shall be valid or binding upon the County or the vendor unless expressly contained herein or by a written amendment to this agreement signed by both Parties. 22. 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. 23. 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. 24. Waiver The delay or failure by the County to exercise or enforce any of its rights under this agreement will not constitute or be deemed a waiver of the County'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. 25. Compliance The vendor shall abide by all applicable current federal statutes, laws, rules and regulations as well as applicable current state statutes, laws, rules, regulations and County rules, ordinances and regulations. The Parties agree that failure of the vendor to abide by these laws shall be deemed an event of default of the vendor, and subject the agreement to immediate, unilateral cancellation of the agreement at the discretion of the County. 26. Final Invoice The vendor shall submit the final CCE, HCE, ADI, IIE and IIIES invoice for payment to the County on July 3, 2013. If the vendor fails to submit final request for payment by the deadline, then all rights to payment may be forfeited and the County may not honor any requests submitted after the aforesaid time period. Any payment due under the terms of this agreement may be withheld until all reports due from the vendor and necessary adjustments thereto have been approved by the County. 27. Renegotiations or Modifications Modifications of the provisions of this agreement shall be valid only when they have been reduced to writing and duly signed by both parties. The rate of payment, contract requirements and the total dollar amount may be adjusted retroactively to reflect price level increases and changes in the rate of payment or language. 28. All Terms and Conditions Included This agreement and its Attachments, A-H and exhibits 1-4 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 agreement shall supersede all previous communications, representations or agreements, either written or verbal between the Parties. 7 c' ATTACHMENT D 1602 CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR AGREEMENTS,GRANTS,LOANS AND AGREEMENTS The undersigned certifies,to the best of his or her knowledge and belief,that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any State ,Federal or County, a member of congress, an officer or employee of congress, an employee of a member of congress, or an officer or employee of the state legislator, in connection with the awarding of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal agreement, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of the County, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this federal agreement, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including vendors, sub-grants, and agreements under grants, loans and cooperative agreements)and that all vendors shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Signature Date Name of Authorized Individual Name and Address of Organization 8 Y ATTACHMENT E 16 0 2 CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS,GRANTS,LOANS AND COOPERATIVE AGREEMENTS The undersigned, an authorized representative of the vendor named in the agreement or agreement to which this form is an attachment, hereby certifies that: (1) The vendor and any vendors of services under this agreement 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 vendor, vendor(s), or any outside entity on which the vendor 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,vendor(s)will take immediate action to assure data integrity. (3) If this agreement 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 vendor (represented by the undersigned) and purchased by the State will be verified for accuracy and integrity of data prior to transfer. In the event of any decrease in functionality related to time and date related codes and internal subroutines that impede the hardware or software programs from operating properly, the vendor agrees to immediately make required corrections to restore hardware and software programs to the same level of functionality as warranted herein, at no charge to the State, and without interruption to the ongoing business of the state,time being of the essence. (4) The vendor and any vendor(s) of services under this agreement warrant their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data integrity compliance issues. The vendor shall require that the language of this certification be included in all vendors and other agreements and that all vendor shall certify compliance accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB Circulars A-102 and 2 CFR Part 215 (formerly OMB Circular A-110). Name and Address of vendor Signature Title Date Name of Authorized Signer 9 1r a 1602 EXHIBIT F CERTIFICATION REGARDING DEBARMENT, SUSPENSION,INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS (1) The prospective vendor certifies, by signing this certification, neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or County. (2) Where the prospective vendor is unable to certify to any of the statements in this certification,such prospective participant shall attach an explanation to this certification. Signature Date Title County/Organization (Certification signature should be same as Agreement signature.) Instructions for Certification 1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "person," "primary covered transaction,"and"voluntarily excluded,"as used herein,have the meanings set out in the sections of rules implementing Executive Order 12549. (2 CFR 180.5-180.1020,as supplemented by 2 CFR 376.10-376.995). You may contact the Agreement Manager for assistance in obtaining a copy of those regulations. 2. This certification is a material representation of facts upon which reliance was placed when the parties entered into this transaction. If it is later determined that the vendor knowingly rendered an erroneous certification,in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension and/or debarment. 3. The vendor will provide immediate written notice to the Agreement Manager if at any time the vendor learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The vendor may decide the method and frequency by which it determines the eligibility of its principals. Each participant to a lower tier covered transaction may,but is not required to,check the Excluded Parties List System(EPLS). 4. The vendor will include a"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion-Lower Tier Covered Transaction"in all its lower tier covered transactions and in all solicitations for lower tier covered transactions. 5. The vendor agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise authorized by the federal government. 6. If the vendor knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction,in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension,and/or debarment. 7. The vendor may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended,ineligible,or voluntarily excluded from the covered transaction,unless it knows that the certification is erroneous. 10 1602 EXHIBIT G SUBRECIPIENT INVOICE SUMMISSION The County shall reimburse the SUBRECIPIENT for the performance of this Agreement upon completion or partial completion of the work tasks as accepted and approved by HHVS pursuant to the submittal of quarterly progress reports. Invoices for work performed are required every month. If no work has been performed during that month, or if the SUBRECIPIENT is not yet prepared to send the required backup, a$0 invoice will be required. Explanations will be required if two consecutive months of$0 invoices are submitted. Payments shall be made to the SUBRECIPIENT when requested as work progresses but, not more frequently than once per month. Final invoices are due no later than 90 days after the end of the agreement. Work performed during the term of the program but not invoiced within 90 days without written exception from the Grant Coordinator will not be reimbursed.No payment will be made until approved by HHVS for grant compliance and adherence to any and all applicable local, state or Federal requirements. Payment will be made upon receipt of a properly completed invoice and in compliance with §218.70, Florida Statutes, otherwise known as the "Local Government Prompt Payment Act." 11 �(J DEPARTMENT OF 0• EXHIBIT H 16 0 2 ,w BACKGROUND SCREENING ELDER AFFAIRS Affidavit of Compliance -Employer STATE OF FLORIDA 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 Employer Name located at Street Address City State ZIP code 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. Signature of Representative Date STATE OF FLORIDA,COUNTY OF Sworn to(or affirmed)and subscribed before me this day of , 20 , by (Name of Representative)who is personally known to me or produced 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:http://elderaffairs.state.fl.us/english/backgroundscreening.php 12 1602 P1 EXHIBIT 1 STATEMENT OF WORK COMMUNITY CARE FOR THE ELDERLY PROGRAM(CCE) SECTION I: SERVICES TO BE PROVIDED 1.1. DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 AGREEMENT ACRONYMS Activities of Daily Living(ADL) Adult Protective Services(APS) Assessed Priority Consumer List(APCL) Comprehensive Assessment and Review for Long-Term Care Services(CARES) Community Care for the Disabled Adult(CCDA) Community Care for the Elderly(CCE) Client Information and Registration Tracking System(CIRTS) Department of Children and Families(DCF) Department of Elder Affairs(DOEA) Home Care for Disabled Adults(HCDA) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out: The condition of reaching 60 years of age and being transitioned from the Department of Children and Families(DCF) Services, Community Care for Disabled Adults (CCDA)or Home Care for Disabled Adults(HCDA) services to the Department's community- based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in its planning and service area in accordance with the Section 306 (42 U.S.C. 3026) of the Older Americans Act and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the County enters CCE specific data in the CIRTS. An update may also include other revisions to the area plan as instructed by the County or Department of Elder Affairs. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The primary purpose of the CCE program is to prevent, decrease or delay premature or inappropriate and expensive placement of older persons in nursing homes and other institutions. 13 1.6 1.2.2 Community Care for the Elderly Mission Statement The CCE Program assists functionally impaired elderly persons in living as independently as possible in their own homes or in the homes of relatives or caregivers. The program provides a continuum of care through the development, expansion, reorganization and coordination of multiple community-based services to assist elders to reside in the least restrictive environment suitable to their needs. 1.2.3 Authority The relevant authority governing CCE program are: (1) Rule 58C-1, Florida Administrative Code (2) Sections 430.201 through 430.207, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services Chief Financial Officer Memoranda the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1) CFO Memo No. 02: Release date,August 20,2010; (2) CFO Memo No. 03: Release date,June 29,2010; and (3) CFO Memo No. 06: Release date,June 30,2010. 1.2.4 Scope of Service The vendor shall provide services in a manner consistent with and descried in the current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the program are to preserve the independence of elders and prevent or delay more costly institutional care through a community care service system that provides case management and other in-home and community services as needed under the direction of the County and provide a continuum of service alternatives that meet the diverse needs of functionally impaired elders. 1.3. INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The CCE program provides a continuum of services for functional impaired elders. 1.3.2 Individual Eligibility In order to receive services under this agreement, an applicant must: (1) Be at least 60 years of age; (2) Be functionally impaired as determined through the initial comprehensive assessment; and (3) With the exception of APS high-risk referrals, consumers may not be dually enrolled in the CCE program and a Medicaid capitated long-term care program. 1.3.2.1 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution or who are abused,neglected or exploited. 14 1602 tai SECTION II: MANNER OF SERVICE PROVISION 2. Delivery of Service to Eligible Clients The vendor shall ensure the provision of a continuum of service that meet the diverse needs of functionally impaired elders. The vendor shall ensure performance and reporting of the following service provision in accordance with the current DOEA Programs and Services Handbook. The services may include the following categories: (1) Core Services; (2) Health Maintenance Services; and (3) Other Support Services. Core Services for Programmatic Operation 2.1. The vendor may deliver core services include a variety of home-delivered services, day care services, and other basic services that are most needed to prevent unnecessary institutionalization. Core services,to be provided at the unit rate identified in this agreement, include the following: (1) Adult Day Care; (7) Housing Improvement; (2) Chore Services; (8) Respite Services; and (3) Enhanced Chore; (9) Transportation (4) Companionship; (5) Home Delivered Meals; (6) Homemaker; 2.1.1 Health Maintenance Services The vendor shall ensure that health maintenance services are routine health services that are necessary to help maintain the health of functionally impaired elders. The services are limited to medical therapeutic services, non-medical prevention services, personal care services, home health aide services, home nursing services, and emergency response systems. Typical services to be provided at the unit rate identified in this agreement, are the following: (1) Adult Day Health Care; (2) Emergency Alert Response; (3) Nutrition Counseling (4) Personal Care (5) Skilled Nursing Services; and (6) Specialized Medical Equipment Services and Supplies 2.2 SERVICE TIMES 2.2.1 Service Times 15 1602 The vendor shall ensure the provisions of the services listed in this agreement are available 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. 23 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the agreement in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this agreement as updated, and approved by the County's reporting requirements. Service Unit of Service Adult Day Care Homemaker Case Aide Housing Improvement Case Management Respite Services Chore Services Personal Care Hour Enhanced Chore Physical Therapy Companionship Skilled Nursing Services Emergency Alert Response Day Material Aid Episode Specialized Medical Equipment, Services and Supplies Escort Shopping Assistance One-Way Trip Transportation Service Unit of Service Home Delivered Meals Meal 2.4 REPORTS The vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The vendor shall establish due dates for any agreement that permits the vendor to meet the County's reporting requirements. Service Costs Reports The vendor shall submit to the County semi-annual service cost reports, August 1, 2013 and February 1, 2014, of each year which reflects actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.5 RECORDS AND DOCUMENTATION 2.5.1 Each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup 16 2.6 COUNTY RESPONSIBILITIES 16 D 2 2.6.1 Program Guidance and Technical Assistance The County will provide to the vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the vendor. resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures will be made available to the County upon request. 2.7 PERFORMANCE SPECIFICATIONS 2.7.1 Outcomes (1) The vendor shall ensure services provided under this agreement are in accordance with the current Department of Elder Affairs Programs and Services Handbook. (2) The vendor shall timely submit to the County all information described in EXHIBIT 1, SECTION 2.4 REPORTS; and (3) The vendor shall timely submit to the County all information described in EXHIBIT 1, SECTION 2.5 RECORDS AND DOCUMENTATION. 2.8. VENDOR'S FINANCIAL OBLIGATIONS 2.8.1 Matching,Level of Effort,and Earmarking Requirement The vendor will assure a match requirement of at least 10 percent of the cost for all CCE services. The match will be made in the form of cash and/or in-kind resources. At the end of the agreement period, all CCE funds expended must be properly matched. State funds cannot be used to match another state-funded program. 3. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 17 16 3.4 Payment may be authorized only for allowable services,which are in accordance with the lima s Y Y Y specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services,upon request. 18 EXHIBIT 2 16 D 2 Tyr STATEMENT OF WORK HOME CARE FOR THE ELDERLY PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Adult Protective Services(APS) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) 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) Home Care for Disabled Adults(HCDA) Home Care for the Elderly(HCE) Institutional Care Program(ICP) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults(HCDA) services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026) and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the County enters HCE specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement Area Agencies on Aging may contract with CCE lead agencies or other case management entities for the provision of the HCE program. Approved caregivers receive a Basic Subsidy to reimburse some of their expenses each month for caring for the consumer and may receive a Special Subsidy for other necessary services and essential supplies. Caregivers may be approved 19 for up to three HCE clients in their home. 1602 1.2.2 Home Care for the Elderly Program Mission Statement The Home Care for the Elderly Program supports family style living arrangements, on a non- profit basis, as an alternative to nursing homes or other institutional care. Through the program, a caregiver for three or fewer elders living in a private home provides basic services of maintenance and supervision as well as coordinating other necessary specialized services. 1.2.3 Authority The relevant authority governing the HCE program include: (1) Rule Chapter 58H-1, Florida Administrative Code; and (2) Sections 430.601 through 430.608, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services', Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: CFO Memo No. 02: Release date,August 20,2010; CFO Memo No. 03: Release date,June 29,2010; and CFO Memo No. 06: Release date,June 30,2010. 1.2.4 Scope of Service The Vendor shall provide services in a manner consistent with and described in the current County's area plan update and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the HCE program are to ensure that: (1) Basic Subsidy is provided to the caregiver of each client and (2) Special Subsidy is provided when essential to the well-being of the client. 1.3 INDIVIDUAL TO BE SERVED 1.3.1 General Eligibility The Home Care for the Elderly program serves elders age 60 and older at risk of placement in a nursing home or other institutional settings who can remain in a family style setting through the provision of subsidies. 1.3.2 Client Eligibility Clients eligible to receive services under this agreement must: (1) Be 60 years of age or older; (2) Have income less than the Institutional Care Program(ICP) standard. (3) Meet the ICP asset limitation; (4) Be at risk of nursing home placement; 20 1602 (5) Have an approved adult caregiver living in the home with them who is willing to provide care or assist in arranging for care; and (6) Not be enrolled in the Aged and Disabled Adult Medicaid waiver or a Medicaid capitated long-term care program. 1.3.3 Caregiver Eligibility Caregivers eligible to receive services under this agreement must: (1) Be at least 18 years of age,capable of providing a family-type living environment; (2) 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; (3) Be willing to accept responsibility for the social, physical and emotional needs of the care Vendor; (4) Be physically present and live in the home to provide supervision and to assist in arrangement of services for the client; (5) 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 (6) Be without record of conviction of abuse,neglect or exploitation of another person. 1.3.4 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meet the diverse needs of the functionally impaired elders and their caregivers. The Vendor shall ensure Basic Subside and Special Subsidy services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. 2.1. Basic Subsidy The Basic Subsidy is a cash payment made to an approved caregiver each month to reimburse some expenses incurred in caring for the client. The Basic Subsidy is provided for support and maintenance of the client, including housing, food, clothing, and medical costs not covered by Medicaid, Medicare or any other insurance. A Basic Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. If the client is hospitalized or in any other temporary institution for 30 days or less,the full Basic Subsidy shall be provided to the caregiver as if the client were in the home. 2.2. Special Subsidy Services Though every eligible HCE client receives a Basic Subsidy, Special Subsidy payments are pre-authorized and are based on additional specialized medical or health care services, supplies or equipment needed to maintain the health and well-being of the individual elder. The Special Subsidy for additional medical support and special services is a cash payment to reimburse the costs of any other service or special care not covered by Medicaid, Medicare, or private insurance when these services are determined to be 21 CI) 16132 essential to maintain the well-being of the home care recipient. A Special Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. Special Subsidy 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: 2.2.1 SERVICE LOCATION AND EQUIPMENT 2.2.2 Service Times The vendor shall ensure the provision of the services listed in this contract are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m.to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the Agency's reporting requirements. Service Unit of Service Adult Day Care Housing Improvement Case Aide Other Case Management Personal Care Chore Respite(Facility Based or In-Home) Hour Chore(Enhanced) Skilled Nursing Services Homemaker Material Aid Episode Specialized Medical Equipment, Services and Supplies Transportation One-Way Trip 2.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permits the Vendor to meet the County's reporting requirements. 2.2.1 Service Costs Reports The Vendor shall submit to the County the semi-annual service cost reports, August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.3 RECORDS AND DOCUMENTATION 2.3.1 The Vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The 22 o • 1602 Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 2.4 PERFORMANCE SPECIFICATIONS 2.4.1 Outcomes (1) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (2) The Vendor shall timely submit to the County all reports described in SECTION 2.2 REPORTS; and (3) The Vendor shall timely submit to the County all information described in, SECTION 2.3 RECORDS AND DOCUMENTATION. 2.5 COUNTY RESPONSIBILITIES 2.5.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-up on-site visits; (3) Client visits; (4) Review of independent auditor's reports; (5) Review of third-party documents and/or evaluation; (6) Review of progress reports; (7) Review of customer satisfaction surveys; (8) Agreed-upon procedures review by an external auditor or consultant; (9) Limited-scope reviews; and (10) Other procedures as deemed necessary. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The 23 ;C\ar> • 1602 0 2 • vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services, which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 24 1602 EXHIBIT 3 STATEMENT OF WORK ALZHEIMER'S DISEASE INITIATIVE PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Alzheimer's Disease(AD) Alzheimer's Disease Initiative(ADI) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System(CIRTS) Community Care for Disabled Adults(CCDA) Department of Elder Affairs(DOEA) Home Care For Disabled Adults(HCDA) Instrumental Activities of Daily Living(IADL) Memory Disorder Clinic (MDC) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults(HCDA)services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026. 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 County enters ADI specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701 B is used by case managers to conduct the functional assessment. 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. Model Day Care: A program of therapeutic, social and health activities specific to clients with memory disorders. Services and activities include, but are not limited to, active and quiet 25 _ . c M ' M games, reminiscence, validation therapy, pet therapy, water therapy and othe a rr activities appropriate to the client's level of functioning. Model day care centers will also provide training for health care and social service personnel in the care of persons having AD or related memory disorders. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The ADI program provides a continuum of services addressing the special needs of individuals with AD,their families and caregivers. 1.2.2 Alzheimer's Disease Initiative Program Mission Statement The ADI program ensures that persons afflicted with AD and other forms of dementia are given essential services to help them age in place in an elder-friendly environment with security, dignity,and purpose. The program also provides support to family members and caregivers of persons afflicted with AD. 1.2.3 Authority The relevant authority governing the Alzheimer's Disease Initiative Program are as follows: (1) Rule Chapter 58D-1, Florida Administrative Code; and (2) Sections 430.501 through 430.504, Florida Statutes. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1) CFO Memo No. 02: Release date,August 20,2010; (2) CFO Memo No. 03: Release date,June 29,2010; and CFO Memo No. 06: Release date,June 30,2010. 1.2.3.2 Scope of Service The Vendor is responsible for the programmatic, fiscal, and operational management of the ADI program. The program services shall be provided in a manner consistent with and described in the current Vendor's Request for Proposal, RFP, and the County's current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.3.4 Major Program Goals The major goal of the ADI program is to provide services to meet the needs of caregivers and individuals with AD and related memory disorders. 1.3 INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The ADI Program addresses the special needs of individuals with AD and their caregivers. 1.3.2 Individual Eligibility Those individuals eligible to receive services under this contract must meet the following conditions: (1) Be 18 years of age or older and have a diagnosis of AD or a related disorder, or be 26 P' suspected of having AD or a related disorder; and 16 0 2 (2) Not be enrolled in a Medicaid capitated long-term care program. 1.3.3 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. SERVICE TASKS In order to achieve the goals of the ADI program,the Vendor shall ensure the following tasks are performed: (1) Client eligibility determination; (2) Assessment and prioritization of service delivery for new clients; (3) Delivery of services to eligible clients; and (4) Monitor the performance of vendors. 2.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described in this SECTION 1.3. 2.2 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services addressing the diverse needs of individuals with AD and their caregivers. The Vendor shall ensure services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. Services categories include: (1) Caregiver Training/Support; (2) Case Aid; (3) Case Management; (4) Counseling(Gerontological); (5) Counseling(Mental Health/Screening); (6) Education/Training; (7) Model Day Care; ( 8) Respite(Facility-Based); ( 9) Respite(In-Home); and (10) Specialized Medical Equipment, Services,and Supplies. Caregivers benefit from receiving training, respite and related support services to assist them in caring for the ADI client. 2.3 Service Times The Vendor shall ensure the provisions of the services listed in this contract are available 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. 27 3. DELIVERABLES 16 3.1. Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the County's reporting requirements. Service Unit of Service Caregiver Training/Support; Hour Case Aid; Hour Case Management; Hour Counseling(Gerontological); Hour Counseling(Mental Health/Screening); Hour Respite(Facility-Based); Hour Respite(In-Home); Hour Education/Training; Episode Episode 3.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. 3.2.1 Service Costs Reports Vendor must submit to the County the semi-annual service cost reports August 1, 2013 and February 1,2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 3.3 RECORDS AND DOCUMENTATION 3.3.1 The Vendor and each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 4. PERFORMANCE SPECIFICATIONS 4.1 Outcomes (4) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (5) The Vendor shall timely submit to the County all reports described in SECTION 3.2 REPORTS; and (6) The Vendor shall timely submit to the County all information described in SECTION 3.3 28 RECORDS AND DOCUMENTATION. ' 5. COUNTY RESPONSIBILITIES 5.1. Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-up on-site visits; (3) Client visits (4) Review of independent auditor's reports (5) Review third-party documents and/or evaluations (6) Review of progress reports (7) Review of customer satisfaction surveys (8)Agreed-upon procedures review by an external auditor or consultant; (9)Limited-scope reviews; and (10)Other procedures as deemed necessary. 6. SECTION III: METHOD OF PAYMENT 6.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 6.1.2 Remedies-Nonconforming Services The Vendor shall ensure that all goods and/or services provided under this agreement for HCE funded programs are delivered timely, completely and commensurate with required standards of quality Such goods and/or services shall only be delivered to eligible program participants. If the Vendor fails to meet the prescribed quality standards for services, such services will not be reimbursed under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be reimbursed under this agreement. The Vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the Vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County requires immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 6.1.3 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the Vendor and any adjustments thereto, including any disallowance not resolved. 6.1.4 Date for Final Request for Payment 29 s 16 D .2 The final request for payment for agreement year one's expenditures will be due to the County no later than August 1,2013. The final request for payment for agreement year two expenditures will be no later than August 1,2014. 6.2 Documentation for Payment The Vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals upon request. Such documentation shall be provided upon request to the County or the Clerk of Court. 30 - EXHIBIT 4 16 2 STATEMENT OF WORK OLDER AMERICANS ACT PROGRAM TITLE HI SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 CONTRACT ACRONYMS Area Agency on Aging(AAA) Activities of Daily Living(ADL) Alliance of Information&Referral Systems(AIRS) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System(CIRTS) Information and Referral(I& R) Instrumental Activities of Daily Living(IADL) Older Americans Act(OAA) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in Its PSA in accordance with the Section 306(42 U.S.C. 3026)of the OAA and Department instructions. Child: An individual who is not more than 18 years of age or an individual with disability. Family Caregiver: An adult family member, or another individual,who is an informal provider of in-home and community care to an older individual. Frail: When an older individual is unable to perform at least two ADLs without substantial human assistance, including verbal reminding, physical cueing or supervision;or due to cognitive or other mental impairment,requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to another individual. 1.2 County Mission,Vision and Values Statement The County's mission: To help aging adults achieve greater independence through awareness of resources and access to qualified service providers. The County's vision: To be the recognized leader in supporting older adults and their families with access to trustworthy resources and services in their communities while empowering them to live with independence and dignity. The County's values: We believe residents of Southwest Florida are entitled to: Comprehensive information about their choices of care; Timely access to resources and services; High standards of quality and performance; and Personal and professional accountability from all stakeholders. 1.2.1 Older Americans Act Program Mission Statement The Older Americans Act(OAA)Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. 31 (:19 1.3 GENERAL DESCRIPTION 1 '3� 1.3.1 General Statement The OAA Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. The primary purpose of the OAA program is to foster the development and implementation of comprehensive and coordinated systems to serve older individuals. The OAA program uses these systems to assist older individuals to attain and maintain maximum independence and dignity in a home environment and allows for the capability of self- care with appropriate supportive services. 1.3.2 Authority The relevant references authority governing the OAA program are: 1. Older Americans Act of 2006, as amended; 2. Rule 58A-1, Florida Administrative Code; and 3. Section 430.101, Florida Statutes. 1.3.2.1 Incorporation of Reference Memoranda In accordance with Ch. 287 F.S., as amended, and Agency of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and incorporated by reference: 1. CFO Memo No. 02: Release date, August 20,2010; 2. CFO Memo No. 03: Release date,June 29,2010; and 3. CFO Memo No. 06: Release date,June 30,2010. 1.3.3 Scope of Service The Vendor shall provide services in a manner consistent with and descried in the current area plan and current Department of Elder Affairs Programs and Services Handbook. 1.3.4 Major Program Goals The major goals of the OAA program are to improve the quality of life for older individuals,preserve their independence and prevent or delay more costly institutional care. These goals are achieved through the implementation of a comprehensive and coordinated service system that provides a continuum of service alternatives that meet the diverse needs of elders and their caregivers. 1.4 INDIVIDUALS TO BE SERVED 1.4.1 Eligibility(Title III Programs) 1.4.1.1 OAA Title III,General Consumers shall not be dually enrolled in an OAA program and a Medicaid capitates long-term care program. 1.4.1.2 OAA Title IIIE,Caregiver Support Services Eligibility for OAA Title IIIE, Caregiver Support Services, are as follows: 1. Family caregivers of individuals age 60 or older; 32 1602 2. Grandparents(age 55 or older)or older individuals(age 55 or older)who are relative caregivers; 3. Priority will be given to family caregivers who provide care for individuals with Alzheimer's disease and related disorders with neurological and organic brain dysfunction and for grandparents or older individuals who are relative caregivers who provide care for children with severe disabilities; and 4. For respite and supplemental services,a family caregiver must be providing care for an older individual who meets the definition of the term"frail"in OAA, Section 102 Paragraph 22. 1.4.2 Targeted Groups Preference shall be given to those with the greatest economic and social need,with particular attention to low-income older individuals, including those that are low-income minorities,have limited English proficiency, and older individuals residing in rural areas. SECTION II—MANNER OF SERVICE PROVISION 2.1 SERVICE TASKS In order to achieve the goals of the OAA program,the Vendor shall ensure the following tasks are performed: 1. Client eligibility determination; 2. Targeting and screening of service delivery for new clients; 3. Delivery of services to eligible clients; 4. Use of volunteers to expand the provision of available services; 5. Monitoring the performance of its vendors. 6. Grievance and Compliance Procedures 2.1.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described herein. 2.1.2 Targeting and Screening of Service Delivery for New Clients The Vendor shall develop and implement policies and procedures consistent with OAA targeting and screening Criteria 2.1.3 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meets the diverse needs of elders and their caregivers. The Vendor shall ensure the performance and report performance of the following services in accordance with the current Department of Elder Affairs Programs and Services Handbook. The services funded pursuant to this contract are in accordance with the OAA,Title III, sections 321,331,336 and 373 as follows: 1. Section 321,Title IIIB Supportive Services; 2. Section 373,Title IIIE Caregiver Support Services. 2.1.3.1 Supportive Services Supportive services include a variety of community-based and home-delivered services that support the qualities of life for older individuals by helping them remain independent and productive. Services include the following: 33 (r'/) + r (1) Adult Day Care/Adult Day Health Care; (17) Homemaker; 16 0 2 O Y Y � ( ) (2) Caregiver Training/Support; (18) Housing Improvement; (3) Case Aide/Case Management; (19) Information; (4) Chore Services; (20) Intake; (5) Companionship; (21) Interpreter/Translating; (6) Counseling(Gerontological and Mental Health); (22) Referral/Assistance; (7) Education/Training; (23) Personal Care; (8) Legal Assistance; (24) Physical Therapy; (9) Material Aid; (25) Shopping Assistance; (10) Occupational Therapy; (26) Skilled Nursing; (11) Outreach; (27) Specialized Medical Equipment, Services, and Supplies (12) Recreation; (28) Respite Services; (13) Emergency Alert Response; (29) Screening/Assessment; (14) Escort; (30) Speech Therapy; (15) Health Support; (31) Telephone Reassurance; and (16) Home Health Aide; (32) Transportation 2.1.3.4 Caregiver Support Services (Title IIIE Program) The following services are intended to provide direct help to caregivers,assist in the areas of health, nutrition and financial literacy and assist caregivers in making decisions and problem solving related to their caregiving roles and responsibilities: (1) Adult Day Care/Adult Day Health Care; (2) Caregiver Training/Support; (3) Counseling(Gerontological and Mental Health); (4) Education/Training; (5) Financial Risk Reduction(Assessment and Maintenance); (6) Information; (7) Intake; (8) Outreach; (9) Respite Services; (10) Screening/Assessment; and (11) Transportation 2.1.3.5 Caregiver Support Supplemental Services(Title HIES Program): The following services are provided to complement the care provided by caregivers: (1) Chore Services; (2) Housing Improvement; (3) Legal Assistance; (4) Material Aid; and (5) Specialized Medical Equipment, Services and Supplies. 2.2 SERVICE LOCATION 34 2.2.1 Service Times 16 0 2 The Vendor shall ensure the provision of the services listed in the contract during normal business hours unless other times are more appropriate to meet the performance requirements of the contract, and it shall monitor its vendors to ensure they are available to provide services during hours responsive to client needs and during those times which best meet the needs of the relevant service community. 2.3 DELIVERABLES 2.3.1 Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the services tasks described in Section 2.1. The chart below lists the services allowed and the units of measurement. Units of service will be paid pursuant to the rate established in the 2010 RFP and approved by the County. Services Unit of Service Adult Day Care/Adult Day Interpreter/Translating Health Care Legal Assistance Caregiver Training/Support Medication Management Case Aid/Case Management Mental Health Counseling/Screening Chore Services Nutrition Counseling Companionship Occupational Therapy Counseling Services Personal Care Escort Physical Therapy Hour Financial Risk Reduction Recreation Services Respite Services Health Support Screening/Assessment Home Health Aide Sitter Homemaker Skilled Nursing Services Housing Improvement Speech Therapy Intake Emergency Alert Response Day Education/Training Episode Information Material Aid Referral/Assistance Specialized Medical Equipment, Services and Supplies Telephone Reassurance Escort One-Way Trip Shopping Assistance Transportation 2.4 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permit the Vendor to meet the County's reporting requirements. 35 1602 2 2.4.2 Service Costs Reports The Vendor shall require vendors to submit to the Vendor semi-annual service cost reports on August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.4.5 Background Screening Affidavit of Compliance To demonstrate compliance with section 8 of the Standard Contract,the Vendor shall submit ATTACHMENT H, Background Screening Affidavit of Compliance annually, by January 15th 2.5 RECORECORDS AND DOCUMENTATION Each Vendor and vendor,among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement in its contracts and/or agreements with vendors. These policies and procedures shall be made available to the County upon request. 2.6 PERFORMANCE SPECIFICATIONS 2.6.1 Outcomes (1)The Vendor shall ensure services provided under this contract are in accordance with the current DOEA Programs and Services Handbook, (2)The Vendor shall timely submit to the County all reports described herein (3)The Vendor shall timely submit to the County all information described in, Paragraph 2.5 RECORDS AND DOCUMENTATION. 2.7 VENDOR'S FINANCIAL OBLIGATIONS 2.7.1 Matching,Level of Effort,and Earmarking Requirements The Vendor shall provide match of at least 10 percent of the federal funds received. The Vendor's match will be made in the form of cash and/or in-kind resources. The Vendor will assure,through a provision in subcontracts,a match requirement of at least 10 percent of the cost for all services funded through this contract. The vendor's match will be made in the form of cash and/or in-kind resources. The Vendor shall report match by title each month. At the end of the contract period, the Vendor must properly match all OAA funds. 2.7.2 Title III Funds The Vendor assures compliance with Section 306 of the OAA, as amended in 2006,that funds received under Title III will not be used to pay any part of a cost incurred by the Vendor to maintain a contractual or commercial relationship that is not carried out to implement Title III. 2.8 COUNTY RESPONSIBILITIES 2.8.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the Vendor. 2.8.2 Program/Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this contract. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an on-site visit. The County's determination of acceptable performance shall be conclusive. The Vendor 36 -• ■ . 16 0 2 agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: 1. Desk reviews and analytical reviews; 2. Scheduled, unscheduled and follow-up on-site visits; 3. Client visits; 4. Review of independent auditor's reports-Exhibit 10; 5. Review of third-party documents and/or evaluation; 6. Review of progress reports; 7. Review of customer satisfaction surveys; 8. Agreed-upon procedures review by an external auditor or consultant; 9. Limited-scope reviews; and 10. Other procedures as deemed necessary. 2.8.3 Contract Monitoring The County shall, at its own discretion, conduct monitoring concerning any aspect of the vendor's performance of this contract. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for OAA IIIE and OAA IIIES funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rate for services is ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services,which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 37 1• R' 1602 2 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1, 2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services,upon request. 38 cwt 1602 EXHIBIT 5 Agreement#12-5856 "Services for Seniors Attachment B Invoice and Logs (Minimum Standard Invoice Information) County Purchasing Order Number: Invoice Number: Grant Name: From Date To Date lien er nit J• I,ie E .., , c ' k , q.Subtra ' = ni II' i p ,e i' OI v b Cu. i a a Am l uII ' e a x n pm Total �' 3'313:03'3 '-'3333394-3, 4333'1431.43.'33 1 3334343%.31,'131'NSI Cost Perm Service t) $0. $0.00 00 $0.00 Total $0.00 I certify to the best of my knowledge and belief that this invoice, and attached service detail log, is complete and correct and all outlay herein are for the purposes set forth in the contract, and that services are ordered by the case manager as agreed on the Contract. Legible copies of the dated timesheet, signed by the client and the worker supporting this invoice must be available upon request. Collier County reserves the right to correct computation of errors to assure proper payment amount. Prepared by: Date: Adjustment Reasons Lead Agency Authorization Attachments: Monthly Service log,Weekly Detail log and Client Service time sheets. 39 ..• 1602 !2 ir EXHIBIT 6 Detail Weekly for CCE Services Week Ending: Invoice No. Personal CLIENT Care Homemaker Respite Skilled Companion Chore Total Total Total Total Total Total NAME Units Units Units Units Units Units Total Hours - - - - - - $ PECA - $ HMK - RESPITE - $ SKILLED - $ COMPANION - $ CHORE - $ TOTAL - 40 eC7-f) EXHIBIT 7 16 0 2 Monthly Detail Service Log Grant Name: Vendor Name, Address: From Date To Date By client,provide the total number of hours provided during the dates of service. This log must be submitted with your monthly invoice for the Invoice From Date and To Date. CNlBieIInIe t x "• a nsI t` e t me° d .i er' T me gency ores.. • i t i 41 rift-) r< w. EXHIBIT 8 1602 Daycare Grant: Grant Service: ADC or RESF Vendor Name and Address By client, provide the Weekly Client Service Time Sheet provided during the dates of service. This log must be submitted with all invoices for the invoice From Date and To Date. TO FROM DATE: DATE: Client Thur Uni Client Name signature Mon Tue Wed s Fri Sat Sun Match is Service Dates 42 EXHIBIT 9 16 0 2 YOUR COMPANY NAME HERE Collier County Services for Seniors Homemaker/Personal Care/Respite/Companion Work Sheet Client Name: Client Signature: Week Ending: Each Time You Perform one of the Activities Below: Put in arrival and departure times for the day worked: ****Client should Initial time of arrival and departure. ****Client should Sign form at top. ****you should sign your name at the bottom. Date: Day: MON TUES WED THUR FRI SAT SUN TOTAL TIME ARRIVAL TIME: DEPARTURE TIME: ****CLIENT INITIALS: Arrive: PERSONAL CARE Depart: Assist W/Bath tub Shower Bed Assist W/Dressing Bathroom Assist Shave (Face Only) Oral Hygiene Walking/Ambulation Feeding Assistance Wash/Set Hair Backrub_Soak Feet_ Nails (File only) Change Make Bed Take out Trash Clean Bedroom Clean Bathroom Prepare Meals Laundry Arrive: HOME MAKING Depart: Vacuum/Sweep Light Dusting 43 r, ) 1602 Clean Kitchen Floor Wash Dishes Mop Sweep Grocery Shop Errands Arrive: RESPITE Depart: Arrive: COMPANION Depart: EMPLOYEE'S Signature/Title 44 162 EXHIBIT 10 OMB Circular A-133 Audits of States, Local Governments, and Non-Profit Organizations requires the Collier County Housing, Human and Veterans Services Department to monitor our subrecipients of federal awards and determine whether they have met the audit requirements of the circular and whether they are in compliance with federal laws and regulations. Accordingly, we are requiring that you check one of the following, provide all appropriate documentation regarding your organization's compliance with the audit requirements, sign and date this form. Subrecipient Fiscal Year Name Period Total State Financial Assistance Expended during $ most recently completed Fiscal Year Total Federal Financial Assistance Expended during most $ recently completed Fiscal Year Check Appropriate Boxes We have exceeded the $500,000 federal/state expenditure threshold for our fiscal year ❑ ending as indicated above and have completed our Circular A-133 audit. A copy of the audit report and management letter are attached. We exceeded the $500,000 federal/state expenditure threshold for our fiscal year ❑ ending as indicated above and expect to complete our Circular A-133 audit by . Within 30 days of completion of the A-133 audit, we will provide a copy of the audit report and management letter. We are not subject to the requirements of OMB Circular A-133 because we: ❑ Did not exceed the $500,000 federal/state expenditure threshold for the fiscal year indicated above ❑ Are a for-profit organization ❑ Are exempt for other reasons —explain An audited financial statements is attached and if applicable, the independent auditor's management letter. (If findings were noted, please enclose a copy of the responses and corrective action plan.) Certification Statement I hereby certify that the above information is true and accurate. Signature Date Print Name and Title 45 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURR 6132 y -UNTY ATM$ u Routed by Purchasing Department to Office Initials Date the Following Addressee(s) (In routing order) 1. Risk Management Risk 2. County Attorney Office County Attorney Office O3' \C7\�3 3. BCC Office Board of County CzAk Commissioners 4. Minutes and Records Clerk of Court's Office , 5. Return to Purchasing Department Purchasing Contact: Diana DeLeon PRIMARY CONTACT INFORMATION Name of Primary Diana DeLeon for Lisa Carr,HHVS, Phone Number 252-8375 Purchasing Staff August 14,2013 Contact and Date Agenda Date Item was May 28,2013 Agenda Item Number 16.D.2 i/ Approved by the BCC Type of Document Contract Amendment — Ix1 v.rse Core Number of Original 2 ✓ Attached v-v\ a. ce,r.Mt SeiJ ocuments Attached PO number or account N/A Solicitation/Contract Amend#1 to Contract 12- number if document is Number/Vendor Name 5856 NurseCore to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature? DD I./ 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A IZ provide the Contact Information(Name;Agency;Address; Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be cN 631 signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's DD ✓ signature and initials are required. 7. In most cases(some contracts are an exception),an electronic copy of the document and DD this routing slip should be provided to the County Attorney's Office before the item is input into SIRE. 8. The document was approved by the BCC on the date above and all changes made DD during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC,all changes directed by the BCC have been made, and the document is ready for the Chairman's signature. 1602 MEMORANDUM Date: August 27, 2013 To: Diana De Leon, Contract Technician Purchasing Department From: Teresa Cannon, Deputy Clerk Minutes & Records Department Re: Contract Amendment #1 to #12-5856 "Services for Seniors" Contractor: NurseCore of Ft. Myers Attached is an original of the assumption agreement referenced above (Agenda Item #16D2), approved by the Board of County Commissioners on Tuesday, May 28, 2013. The original will be held on file with the Minutes and Record's Department in the Board's Official Records. If you have any questions, please contact me at 252-8411. Thank you. Attachment 16132 Contract Amendment#1 Contract# 12-5856 "Services for Seniors" This CONTRACT AMENDMENT#1, dated MAy 223 , 2013 to the referenced agreement shall be by and between the parties to the original Agreement, NurseCore Management Services, LLC d/b/a NurseCore of Fort Myers (to be referred to as"Vendor")and Collier County,Florida, (to be referred to as "County"). Statement of Understanding RE: Contract# 12-5856 "Services for Seniors" I In order to continue services for the original Contract document referenced above, the Vendor agrees to the terms and conditions set forth in Exhibit A-1A, which includes Attachments C-H and Exhibits 1-10 attached hereto and incorporated by reference. The Vendor further agrees to amend Section 1,Commencement, as follows: 1. COMMENCEMENT. This Agreement shall Commence on December 11, 2012 and shall terminate on December 10,2014 June 30,2014. The Contract award is a two (2) year contract, with the possibility of two (2) additional (2) year terms pending funding from grantors and acceptable performance by the awarded vendor. Any such renewals shall be mutually agreed upon in writing by the parties. The maximum duration for this Contract for CCE, HCE, and ADI, OAA IIIE AND OAA IIIES funding will not exceed six (6) years (through June 30, 2018). As outlined in RFP #12-5856, the County requires the Vendor to contribute a cash or in-kind match of no less than ten (10) percent for all services related to the Community Care for the Elderly Program, (CCE), Older American Title IIIE Caregiver Support (OAA IIIE) and Older American Title IIIES Caregiver Support Supplemental Services(OAA IIIES)Programs. Words that have been deleted are struck ough,words underlined have been added. Modification made herein shall apply as if incorporated into the Contract on the date of Commencement. All other terms and conditions of the agreement shall remain in force. IN WITNESS WHEREOF, the Vendor and the County have each, respectively, by an authorized person or agent,hereunder set their hands and seals on the date(s) indicated below. Accepted: August 6 , 2013 VENDOR: ■ NurseCore ∎,r.nagement Services, LLC d/b/a First Witness NurseCo NurseCore Fort Myers June Rose ete/pri i s � By: �.�.�� . ( ,' b Second fitness Gay Kelley,Vice President David Guillory Print/Type Name and Title Type/print witness name 1 1602 COUNTY: ATTEST: BOARD 0 COUNTY COMMISSIONERS DWIGHT E. BROCK, CLERK OF COL I OUNTY, FLORIDA Tak 1. i CC— B Attesta$to Giiimitiv CLERK iri RGIA A. HILLER, ESQ. signature only. CHAIRWOMAN Approval for form and legal i.4 Jenriiter`/B. 4 lii1C Assistant County Att ey Item# l 1: Agenda 5-121?113 Date Date fR)a�10 Recd 2 A. teputy ork EXHIBIT A-lA AGREEMENT 12-5856 1 6 D 2 SERVICES FOR SENIORS ATTACHMENTS ATTACHMENT ATTACHMENT DESCRIPTION PAGE Attachment C Core Standards for CCE, HCE,ADI, OAA IIIE & IIIES 2 Attachment D Certification Regarding Lobbying 8 Attachment E Certification Regarding Data Integrity Compliance 9 Attachment F Certification Regarding Debarment, Suspension, 10 Ineligibility and Voluntary Exclusion Contracts/ Subcontracts Attachment G Sub-Recipient Invoice Submission 11 Attachment H Background Screening Affidavit of Compliance 12 Exhibit 1 CCE Statement of work 13 Exhibit 2 HCE Statement of work 19 Exhibit 3 ADI Statement of work 25 Exhibit 4 OAA IIE and OAA IIIES Statement of work 31 Exhibit 5 Invoice 39 Exhibit 6 Detail Weekly Log 40 Exhibit 7 Monthly Log 41 Exhibit 8 Day Care/Respite Time Sheet 42 Exhibit 9 Program Time Sheet 43 Exhibit 10 Annual Audit Monitoring Report 45 1 CA ATTACHMENT C 1 6D Core Standards for CCE,HCE,ADI,OAA IEEE&HIES C 1. Compliance with Federal Law 1.1 If this agreement contains federal funds the following shall apply: 1.1.1 The vendor shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable regulations. 1.1.2 If this agreement contains federal funds and is over$100,000.00,the vendor shall comply with all applicable standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s. 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable Environmental Protection County regulations 40 CFR 30. The vendor shall report any violations of the above to the County. 1.13 The vendor may not use any federal funds received in connection with this agreement to influence legislation or appropriations pending before the Congress or any state legislature. If this agreement contains federal funding in excess of$100,000.00,the vendor must,prior to agreement execution, complete the Certification Regarding Lobbying form, ATTACHMENT D. All disclosure forms as required by the Certification Regarding Lobbying form must be completed and returned to the Grant Coordinator prior to payment under this agreement. 1.1.4 In accordance with Appendix A to 2 CFR 215, the vendor shall comply with Executive Order 11246,Equal Employment Opportunity, as amended by Executive Order 1 1375 and others, and as supplemented in Department of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable. 1.1.5 If this agreement contains federal funds and provides services to children up to age 18,the vendor shall comply with the Pro-Children Act of 1994(20 U.S.C. 6081). 1.1.6 A agreement award with an amount expected to equal or exceed $25,000.00 and certain other agreement 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 vendor shall comply with these provisions before doing business or entering into sub-agreements receiving federal funds pursuant to this agreement. The vendor shall complete and sign ATTACHMENT F prior to the execution of this agreement. 1.2 The vendor shall not employ an unauthorized alien. The County 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 agreement by the County. 2 Ca 16D ' 1.3 If the vendor 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 vendor must notify the County in writing within thirty(30)days of receiving the IRS notice of revocation. 1.4 The vendor shall comply with Title 2 CFR Part 275 regarding Trafficking in Persons. 1.5 Unless exempt under 2 CFR Part 170.110(b), the vendor shall comply with the reporting requirements of the Transparency Act as expressed in 2 CFR 170. 1.6 To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number 11-116, vendor agrees to utilize the U.S. Department of Homeland Security's E-verify system to verify the employment of all new employees hired by vendor during the agreement term. Vendor meeting the terms and conditions of the E-Verify System are deemed to be in compliance with this provision. 2. Compliance with State Law 2.1 This agreement is executed and entered into in the State of Florida, and shall be construed, performed and enforced in all respects in accordance with the Florida law, including Florida provisions for conflict of laws. 2.2 The vendor shall comply with requirements of s. 287.058,F.S. as amended. 2.2.1 The vendor shall provide units of deliverables, including various client services, and in some instances may include reports,findings, and drafts,as specified in this agreement,which the Grant Coordinator must receive and accept in writing prior to payment in accordance with s. 215.971, F.S. (1)and(2). 2.2.2 The vendor shall submit bills for fees or other compensation for services or expenses in sufficient detail for a proper pre-audit and post-audit. 2.2.3 The vendor shall allow public access to all documents, papers, letters, or other public records as deemed in subsection 119.011(12), F.S., made or received by the vendor in conjunction with this agreement except for those records which are made confidential or exempt by law. The vendor's refusal to comply with this provision will constitute an immediate breach of agreement for which the County may unilaterally terminate the agreement. 2.3 If clients are to be transported under this agreement,the vendor shall comply with the provisions of Chapter 427,F.S., and Rule 41-2,F.A. C. 2.4 Vendors who are on the discriminatory vendor list may not transact business with any public entity, in accordance with the provisions of s. 287.134,F.S. 2.5 The vendor shall comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the expenditure of agreement funds for the purpose of lobbying the legislature,judicial branch or a state agency. 3. Background Screening The vendor shall ensure that the requirements of s.430.0402 and ch. 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 exempted from the Department's level 2 background screening 3 c9 pursuant to s. 430.0402(2)-(3), F.S. The vendor must also comply with any applicable cull 6D 2 promulgated by the Department and the Agency for Health Care Administration regarding implementation of s. 430.0402 and ch. 435,F.S. Further information concerning the procedures for background screening are found at http://elderaffairs.state.fl.us/doea/backgroundscreening.php. 4. Provision of Services The vendor shall provide services in the manner described herein. 5. Monitoring by the County The vendor shall permit persons duly authorized by the County to inspect and copy any records, papers, documents, facilities, goods and services of the vendor which are relevant to this agreement, and to interview any clients, employees and vendor employees of the vendor to assure the County of the satisfactory performance of the terms and conditions of this agreement. Following such review,the County will provide a written report of its findings to the vendor, and where appropriate,the vendor shall develop a corrective action plan. The vendor hereby agrees to correct all deficiencies identified in the corrective action plan in a timely manner as determined by the Grant Coordinator. 6. Confidentiality of Information The vendor shall not use or disclose any information concerning a vendor of services under this agreement 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. 7. Health Insurance Portability and Accountability Act Where applicable, the vendor shall comply with the Health Insurance Portability and Accountability Act (42 USC 1320d.), as well as all regulations promulgated thereunder(45 CFR 160, 162,and 164). 8. Bankruptcy Notification During the term of this agreement,the vendor shall immediately notify the County if the Vendor, its assignees,vendors or affiliates file a claim for bankruptcy. Within ten (10)days after notification,the vendor must also provide the following information to the County.: (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.,United States Bankruptcy Court Middle District of Florida,Naples,FL);and, (4)The name,address, and telephone number of the bankruptcy attorney. 9. Sponsorship and Publicity 9.1 As required by s. 286.25, F.S., if the vendor is a non-governmental organization which sponsors a program financed wholly or in part by state funds, including any funds obtained through this agreement, it shall, in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by Hope Hospice and Community Services, the State County of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County." If the sponsorship reference is in the written material, the words "State of Florida,Department of Elder Affairs, the Area County on Aging for Southwest Florida, Inc. and Collier County" shall appear in at least the same size letters or type as the name of the organization. 9.2 The vendor shall not use the words"The State of Florida Department of Elder Affairs or the Area County on Aging for Southwest Florida, Inc. or Collier County" to indicate sponsorship of a program otherwise financed, unless specific authorization has been obtained by Collier County, or the Area Aging on Aging prior to use. 4 1602 10. Independent Capacity of Vendor It is the intent and understanding of the Parties that the vendor, or any of its vendors, are independent vendors and are not employees of the County and shall not hold themselves out as employees or agents of the County without specific authorization from the County. It is the further intent and understanding of the Parties that the County does not control the employment practices of the vendor and will not be liable for any wage and hour, employment discrimination, or other labor and employment claims against the vendor or its vendors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary insurance for the vendor are the sole responsibility of the vendor. 11. Payment Payments shall be made to the vendor pursuant to s. 215.422, F.S., as services are rendered and invoiced by the vendor. The Grant Coordinator will have fmal approval of the invoice for payment, and will approve the invoice for payment only if the vendor has met all terms and conditions of the agreement, unless the bid specifications, purchase order, or this agreement specify otherwise. The approved invoice will be submitted to the County's Grant Coordinator approval and processing. 12. Return of Funds The vendor shall return to the County any overpayments due to unearned funds or funds disallowed and any interest attributable to such funds pursuant to the terms and conditions of this agreement that were disbursed to the vendor by the County. In the event that the vendor or its independent auditor discovers that an overpayment has been made, the vendor shall repay said overpayment immediately without prior notification from the County. In the event that the County first discovers an overpayment has been made, the Grant Coordinator will notify the vendor in writing of such findings. 13. Data Integrity and Safeguarding Information The vendor shall ensure an appropriate level of data security for the information the vendor is collecting or using in the performance of this agreement. An appropriate level of security includes approving and tracking all vendor employees that request system or information access and ensuring that user access has been removed from all terminated employees. The vendor, 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 vendor shall ensure all vendors maintain written procedures for computer system backup and recovery. The vendor shall complete and sign Attachment E prior to the execution of this agreement. 14. Computer Use and Social Media Policy The Department of Elder Affairs has implemented a new 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, Area Agencies on Aging and vendors. 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, Wilds, RSS feeds, video sharing, social networks like MySpace,Facebook and Twitter,as well as content sharing networks such as flickr and YouTube. 15. Public Entity Crime Pursuant to s. 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 5 (C9 16D2 agreement to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on a agreement 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 vendor, supplier, vendor, or consultant under a agreement with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in s. 287.017, F.S., for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted vendor list. 16. Patents,Copyrights,Royalties If this agreement 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 agreement, the vendor shall refer the discovery, invention or material to the County to be referred to the Department of State and the Department of Elder Affairs. Any and all patent rights or copyrights accruing under this agreement are hereby reserved to the State of Florida in accordance with Chapter 286, F.S. Pursuant to s. 287.0571 (5) (k) 1 and 2 as amended, the only exceptions to this provision shall be those that are clearly expressed and reasonably valued in the agreement. 16.1 If the primary purpose of this agreement 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 Paragraph 33. 16.2 If this agreement is awarded solely federal funding, the terms and conditions are governed by 2 CFR 215.36. 17. Emergency Preparedness and Continuity of Operations 17.1 If the tasks to be performed pursuant to this agreement include the physical care and control of clients, or the administration and coordination of services necessary for client health, safety or welfare, the vendor shall, within thirty (30) calendar days of the execution of this agreement, submit to the Grant Coordinator verification of an emergency preparedness plan. In the event of an emergency,the vendor shall notify the County of emergency provisions. 17.2 In the event a situation results in a cessation of services by a vendor, the vendor shall retain responsibility for performance under this agreement and must follow procedures to ensure continuity of operations without interruption. 18. Financial Consequences of Non-Performance If the vendor fails to meet the minimum level of service or performance identified in this agreement, or that is customary for the industry, then the County must apply financial consequences commensurate with the deficiency.Financial consequences may include,but are not limited to, agreement suspension, refusing payment, withholding payments until deficiency is cured,tendering only partial payments, and/or cancellation of agreement and reacquiring services from an alternate source. 18.1 The vendor will not be charged with financial consequences,when a failure to perform arises out of causes that were the responsibility of the County. 19. No Waiver of Sovereign Immunity 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. 20. Venue If any dispute arises out of this agreement,the venue of such legal recourse will be Collier 6 It,10 1602 County,Florida. 21. Entire Agreement This agreement contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations shall be valid or binding upon the County or the vendor unless expressly contained herein or by a written amendment to this agreement signed by both Parties. 22. 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. 23. 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. 24. Waiver The delay or failure by the County to exercise or enforce any of its rights under this agreement will not constitute or be deemed a waiver of the County'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. 25. Compliance The vendor shall abide by all applicable current federal statutes, laws, rules and regulations as well as applicable current state statutes, laws, rules, regulations and County rules, ordinances and regulations. The Parties agree that failure of the vendor to abide by these laws shall be deemed an event of default of the vendor, and subject the agreement to immediate, unilateral cancellation of the agreement at the discretion of the County. 26. Final Invoice The vendor shall submit the final CCE, HCE, ADI, DE and IIIES invoice for payment to the County on July 3, 2013. If the vendor fails to submit final request for payment by the deadline, then all rights to payment may be forfeited and the County may not honor any requests submitted after the aforesaid time period. Any payment due under the terms of this agreement may be withheld until all reports due from the vendor and necessary adjustments thereto have been approved by the County. 27. Renegotiations or Modifications Modifications of the provisions of this agreement shall be valid only when they have been reduced to writing and duly signed by both parties. The rate of payment, contract requirements and the total dollar amount may be adjusted retroactively to reflect price level increases and changes in the rate of payment or language. 28. All Terms and Conditions Included This agreement and its Attachments, A-H and exhibits 1-4 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 agreement shall supersede all previous communications, representations or agreements, either written or verbal between the Parties. 7 ATTACHMENT D 16D2 CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR AGREEMENTS,GRANTS,LOANS AND AGREEMENTS The undersigned certifies,to the best of his or her knowledge and belief,that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any State ,Federal or County, a member of congress, an officer or employee of congress, an employee of a member of congress, or an officer or employee of the state legislator, in connection with the awarding of any federal grant,the making of any federal loan,the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal agreement, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of the County, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this federal agreement, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers(including vendors, sub-grants, and agreements under grants, loans and cooperative agreements)and that all vendors shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than$100,000 for each such failure. Signature Date Name of Authorized Individual Name and Address of Organization 8 ATTACHMENT E 16D 2 CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS,GRANTS,LOANS AND COOPERATIVE AGREEMENTS The undersigned, an authorized representative of the vendor named in the agreement or agreement to which this form is an attachment,hereby certifies that: (1) The vendor and any vendors of services under this agreement 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 vendor, vendor(s), or any outside entity on which the vendor 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,vendor(s)will take immediate action to assure data integrity. (3) If this agreement 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 vendor (represented by the undersigned) and purchased by the State will be verified for accuracy and integrity of data prior to transfer. In the event of any decrease in functionality related to time and date related codes and internal subroutines that impede the hardware or software programs from operating properly, the vendor agrees to immediately make required corrections to restore hardware and software programs to the same level of functionality as warranted herein, at no charge to the State, and without interruption to the ongoing business of the state,time being of the essence. (4) The vendor and any vendor(s) of services under this agreement warrant their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data integrity compliance issues. The vendor shall require that the language of this certification be included in all vendors and other agreements and that all vendor shall certify compliance accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB Circulars A-102 and 2 CFR Part 215 (formerly OMB Circular A-110). Name and Address of vendor Signature Title Date Name of Authorized Signer 9 c/A 160 2 EXHIBIT F CERTIFICATION REGARDING DEBARMENT,SUSPENSION,INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS (1) The prospective vendor certifies, by signing this certification, neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or County. (2) Where the prospective vendor is unable to certify to any of the statements in this certification,such prospective participant shall attach an explanation to this certification. Signature Date Title County/Organization (Certification signature should be same as Agreement signature.) Instructions for Certification 1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "person," "primary covered transaction,"and"voluntarily excluded,"as used herein,have the meanings set out in the sections of rules implementing Executive Order 12549. (2 CFR 180.5-180.1020,as supplemented by 2 CFR 376.10-376.995). You may contact the Agreement Manager for assistance in obtaining a copy of those regulations. 2. This certification is a material representation of facts upon which reliance was placed when the parties entered into this transaction. If it is later determined that the vendor knowingly rendered an erroneous certification,in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension and/or debarment. 3. The vendor will provide immediate written notice to the Agreement Manager if at any time the vendor learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The vendor may decide the method and frequency by which it determines the eligibility of its principals. Each participant to a lower tier covered transaction may,but is not required to,check the Excluded Parties List System(EPLS). 4. The vendor will include a"Certification Regarding Debarment,Suspension,Ineligibility and Voluntary Exclusion-Lower Tier Covered Transaction"in all its lower tier covered transactions and in all solicitations for lower tier covered transactions. 5. The vendor agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise authorized by the federal government. 6. If the vendor knowingly enters into a lower tier covered transaction with a person who is suspended,debarred, ineligible, or voluntarily excluded from participation in this transaction,in addition to other remedies available to the federal government,the Department or County may pursue available remedies,including suspension,and/or debarment. 7. The vendor may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended,ineligible,or voluntarily excluded from the covered transaction,unless it knows that the certification is erroneous. 10 -q C 1602 EXIIIBIT G SUBRECIPIENT INVOICE SUNI IISSION The County shall reimburse the SUBRECIPIENT for the performance of this Agreement upon completion or partial completion of the work tasks as accepted and approved by HHVS pursuant to the submittal of quarterly progress reports. Invoices for work performed are required every month. If no work has been performed during that month, or if the SUBRECIPIENT is not yet prepared to send the required backup, a$0 invoice will be required. Explanations will be required if two consecutive months of$0 invoices are submitted. Payments shall be made to the SUBRECIPIENT when requested as work progresses but,not more frequently than once per month. Final invoices are due no later than 90 days after the end of the agreement. Work performed during the term of the program but not invoiced within 90 days without written exception from the Grant Coordinator will not be reimbursed.No payment will be made until approved by HHVS for grant compliance and adherence to any and all applicable local, state or Federal requirements. Payment will be made upon receipt of a properly completed invoice and in compliance with §218.70, Florida Statutes, otherwise known as the "Local Government Prompt Payment Act." 11 �'ac. DEPARTMENT OF EXHIBIT H 160 BACKGROUND SCREENING ELDER AFFAIRS Affidavit of Compliance-Employer STATE OF FLORIDA 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 Employer Name located at Street Address City State ZIP code I, 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. Signature of Representative Date STATE OF FLORIDA,COUNTY OF Sworn to(or affirmed)and subscribed before me this day of ,20 , by (Name of Representative)who is personally known to me or produced 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:http://elderaffairs.state.fl.us/english/backgroundscreeningphp 12 16 (12 EXHIBIT 1 STATEMENT OF WORK COMMUNITY CARE FOR THE ELDERLY PROGRAM(CCE) SECTION I: SERVICES TO BE PROVIDED 1.1. DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 AGREEMENT ACRONYMS Activities of Daily Living(ADL) Adult Protective Services(APS) Assessed Priority Consumer List(APCL) Comprehensive Assessment and Review for Long-Term Care Services(CARES) Community Care for the Disabled Adult(CCDA) Community Care for the Elderly(CCE) Client Information and Registration Tracking System(CIRTS) Department of Children and Families(DCF) Department of Elder Affairs(DOEA) Home Care for Disabled Adults(HCDA) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out: The condition of reaching 60 years of age and being transitioned from the Department of Children and Families(DCF) Services,Community Care for Disabled Adults (CCDA)or Home Care for Disabled Adults(HCDA)services to the Department's community- based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in its planning and service area in accordance with the Section 306 (42 U.S.C. 3026) of the Older Americans Act and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the County enters CCE specific data in the CIRTS. An update may also include other revisions to the area plan as instructed by the County or Department of Elder Affairs. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The primary purpose of the CCE program is to prevent, decrease or delay premature or inappropriate and expensive placement of older persons in nursing homes and other institutions. 13 1602 1.2.2 Community Care for the Elderly Mission Statement The CCE Program assists functionally impaired elderly persons in living as independently as possible in their own homes or in the homes of relatives or caregivers. The program provides a continuum of care through the development, expansion, reorganization and coordination of multiple community-based services to assist elders to reside in the least restrictive environment suitable to their needs. 1.2.3 Authority The relevant authority governing CCE program are: (1)Rule 58C-1,Florida Administrative Code (2) Sections 430.201 through 430.207, F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services Chief Financial Officer Memoranda the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1)CFO Memo No. 02: Release date,August 20,2010; (2)CFO Memo No. 03: Release date,June 29,2010; and (3)CFO Memo No. 06: Release date,June 30,2010. 1.2.4 Scope of Service The vendor shall provide services in a manner consistent with and descried in the current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the program are to preserve the independence of elders and prevent or delay more costly institutional care through a community care service system that provides case management and other in-home and community services as needed under the direction of the County and provide a continuum of service alternatives that meet the diverse needs of functionally impaired elders. 13. INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The CCE program provides a continuum of services for functional impaired elders. 1.3.2 Individual Eligibility In order to receive services under this agreement,an applicant must: (1) Be at least 60 years of age; (2) Be functionally impaired as determined through the initial comprehensive assessment; and (3) With the exception of APS high-risk referrals, consumers may not be dually enrolled in the CCE program and a Medicaid capitated long-term care program. 13.2.1 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution or who are abused,neglected or exploited. 14 16132 SECTION II: MANNER OF SERVICE PROVISION 2. Delivery of Service to Eligible Clients The vendor shall ensure the provision of a continuum of service that meet the diverse needs of functionally impaired elders. The vendor shall ensure performance and reporting of the following service provision in accordance with the current DOEA Programs and Services Handbook. The services may include the following categories: (1) Core Services; (2) Health Maintenance Services; and (3) Other Support Services. Core Services for Programmatic Operation 2.1. The vendor may deliver core services include a variety of home-delivered services, day care services,and other basic services that are most needed to prevent unnecessary institutionalization. Core services,to be provided at the unit rate identified in this agreement, include the following: (1) Adult Day Care; (7) Housing Improvement; (2) Chore Services; (8) Respite Services; and (3) Enhanced Chore; (9) Transportation (4) Companionship; (5) Home Delivered Meals; (6) Homemaker; 2.1.1 Health Maintenance Services The vendor shall ensure that health maintenance services are routine health services that are necessary to help maintain the health of functionally impaired elders. The services are limited to medical therapeutic services, non-medical prevention services, personal care services, home health aide services, home nursing services, and emergency response systems. Typical services to be provided at the unit rate identified in this agreement, are the following: (1) Adult Day Health Care; (2) Emergency Alert Response; (3) Nutrition Counseling (4) Personal Care (5) Skilled Nursing Services; and (6) Specialized Medical Equipment Services and Supplies 2.2 SERVICE TIMES 2.2.1 Service Times 15 1602 The vendor shall ensure the provisions of the services listed in this agreement are available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m.to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the agreement in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this agreement as updated, and approved by the County's reporting requirements. Service Unit of Service Adult Day Care Homemaker Case Aide Housing Improvement Case Management Respite Services Chore Services Personal Care Hour Enhanced Chore Physical Therapy Companionship Skilled Nursing Services Emergency Alert Response Day Material Aid Episode Specialized Medical Equipment, Services and Supplies Escort Shopping Assistance One-Way Trip Transportation Service Unit of Service Home Delivered Meals Meal 2.4 REPORTS The vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The vendor shall establish due dates for any agreement that permits the vendor to meet the County's reporting requirements. Service Costs Reports The vendor shall submit to the County semi-annual service cost reports, August 1, 2013 and February 1, 2014, of each year which reflects actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.5 RECORDS AND DOCUMENTATION 2.5.1 Each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup 16 2.6 COUNTY RESPONSIBILITIES 1602 2.6.1 Program Guidance and Technical Assistance The County will provide to the vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the vendor. resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures will be made available to the County upon request. 2.7 PERFORMANCE SPECIFICATIONS 2.7.1 Outcomes (1) The vendor shall ensure services provided under this agreement are in accordance with the current Department of Elder Affairs Programs and Services Handbook. (2) The vendor shall timely submit to the County all information described in EXHIBIT 1, SECTION 2.4 REPORTS;and (3) The vendor shall timely submit to the County all information described in EDIT 1, SECTION 2.5 RECORDS AND DOCUMENTATION. 2.8. VENDOR'S FINANCIAL OBLIGATIONS 2.8.1 Matching,Level of Effort,and Earmarking Requirement The vendor will assure a match requirement of at least 10 percent of the cost for all CCE services. The match will be made in the form of cash and/or in-kind resources. At the end of the agreement period,all CCE funds expended must be properly matched. State funds cannot be used to match another state-funded program. 3. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 17 tau 1602 3.4 Payment may be authorized only for allowable services,which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The final request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1,2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services,upon request. 18 0) EXHIBIT 2 16132 STATEMENT OF WORK HOME CARE FOR THE ELDERLY PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Adult Protective Services(APS) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) 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) Home Care for Disabled Adults(HCDA) Home Care for the Elderly(HCE) Institutional Care Program(ICP) Instrumental Activities of Daily Living(IADL) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults(HCDA)services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026) and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the County enters HCE specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement Area Agencies on Aging may contract with CCE lead agencies or other case management entities for the provision of the HCE program. Approved caregivers receive a Basic Subsidy to reimburse some of their expenses each month for caring for the consumer and may receive a Special Subsidy for other necessary services and essential supplies. Caregivers may be approved 19 for up to three HCE clients in their home. 16D 2 1.2.2 Home Care for the Elderly Program Mission Statement The Home Care for the Elderly Program supports family style living arrangements, on a non- profit basis,as an alternative to nursing homes or other institutional care. Through the program, a caregiver for three or fewer elders living in a private home provides basic services of maintenance and supervision as well as coordinating other necessary specialized services. 1.2.3 Authority The relevant authority governing the HCE program include: (1) Rule Chapter 5811-1,Florida Administrative Code; and (2) Sections 430.601 through 430.608,F.S. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services', Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: CFO Memo No. 02: Release date,August 20,2010; CFO Memo No. 03: Release date,June 29,2010; and CFO Memo No. 06: Release date,June 30,2010. 1.2.4 Scope of Service The Vendor shall provide services in a manner consistent with and described in the current County's area plan update and the current Department of Elder Affairs Programs and Services Handbook. 1.2.5 Major Program Goals The major goals of the HCE program are to ensure that: (1) Basic Subsidy is provided to the caregiver of each client and (2) Special Subsidy is provided when essential to the well-being of the client. 1.3 INDIVIDUAL TO BE SERVED 1.3.1 General Eligibility The Home Care for the Elderly program serves elders age 60 and older at risk of placement in a nursing home or other institutional settings who can remain in a family style setting through the provision of subsidies. 1.3.2 Client Eligibility Clients eligible to receive services under this agreement must: (1) Be 60 years of age or older; (2) Have income less than the Institutional Care Program(ICP) standard. (3) Meet the ICP asset limitation; (4) Be at risk of nursing home placement; 20 1 6 D 2 (5) Have an approved adult caregiver living in the home with them who is willing to provide care or assist in arranging for care; and (6) Not be enrolled in the Aged and Disabled Adult Medicaid waiver or a Medicaid capitated long-term care program. 13.3 Caregiver Eligibility Caregivers eligible to receive services under this agreement must: (1) Be at least 18 years of age,capable of providing a family-type living environment; (2) 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; (3) Be willing to accept responsibility for the social, physical and emotional needs of the care Vendor; (4) Be physically present and live in the home to provide supervision and to assist in arrangement of services for the client; (5) 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 (6) Be without record of conviction of abuse,neglect or exploitation of another person. 13.4 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meet the diverse needs of the functionally impaired elders and their caregivers. The Vendor shall ensure Basic Subside and Special Subsidy services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. 2.1. Basic Subsidy The Basic Subsidy is a cash payment made to an approved caregiver each month to reimburse some expenses incurred in caring for the client. The Basic Subsidy is provided for support and maintenance of the client, including housing, food, clothing, and medical costs not covered by Medicaid, Medicare or any other insurance. A Basic Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. If the client is hospitalized or in any other temporary institution for 30 days or less,the full Basic Subsidy shall be provided to the caregiver as if the client were in the home. 2.2. Special Subsidy Services Though every eligible HCE client receives a Basic Subsidy, Special Subsidy payments are pre-authorized and are based on additional specialized medical or health care services, supplies or equipment needed to maintain the health and well-being of the individual elder. The Special Subsidy for additional medical support and special services is a cash payment to reimburse the costs of any other service or special care not covered by Medicaid, Medicare, or private insurance when these services are determined to be 21 16f) essential to maintain the well-being of the home care recipient. A Special Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. Special Subsidy 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: 2.2.1 SERVICE LOCATION AND EQUIPMENT 2.2.2 Service Times The vendor shall ensure the provision of the services listed in this contract are available at times appropriate to meet client service needs at a minimum,during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m.to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1.The chart below lists the type of services allowed and the unit of measurement.Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the Agency's reporting requirements. Service Unit of Service Adult Day Care Housing Improvement Case Aide Other Case Management Personal Care Chore Respite(Facility Based or In-Home) Hour Chore(Enhanced) Skilled Nursing Services Homemaker Material Aid Episode Specialized Medical Equipment, Services and Supplies Transportation One-Way Trip 2.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permits the Vendor to meet the County's reporting requirements. 2.2.1 Service Costs Reports The Vendor shall submit to the County the semi-annual service cost reports, August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.3 RECORDS AND DOCUMENTATION 2.3.1 The Vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The 22 16D2 Vendor shall maintain written policies and procedures for computer system backup and recovery.These policies and procedures shall be made available to the County upon request. 2.4 PERFORMANCE SPECIFICATIONS 2.4.1 Outcomes (1) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (2) The Vendor shall timely submit to the County all reports described in SECTION 2.2 REPORTS; and (3) The Vendor shall timely submit to the County all information described in, SECTION 2.3 RECORDS AND DOCUMENTATION. 2.5 COUNTY RESPONSIBILITIES 2.5.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled,unscheduled and follow-up on-site visits; (3) Client visits; (4) Review of independent auditor's reports; (5) Review of third-party documents and/or evaluation; (6) Review of progress reports; (7) Review of customer satisfaction surveys; (8) Agreed-upon procedures review by an external auditor or consultant; (9) Limited-scope reviews; and (10) Other procedures as deemed necessary. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for CCE funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The 23 , vendor's signature on the request for payment form certifies maintenance of su o16111 2 � q PYm PP g documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rates for services are ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services, which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 3.6 Date for Final Request for Payment The fmal request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1,2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services, upon request. 24 1602 EXHIBIT 3 STATEMENT OF WORK ALZHEIMER'S DISEASE INITIATIVE PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS 1.1.1 _ DEFINITIONS OF ACRONYMS Alzheimer's Disease(AD) Alzheimer's Disease Initiative(ADI) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System(CIRTS) Community Care for Disabled Adults(CCDA) Department of Elder Affairs(DOEA) Home Care For Disabled Adults(HCDA) Instrumental Activities of Daily Living(IADL) Memory Disorder Clinic(MDC) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults(HCDA)services to community-based services. Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026. 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 County enters ADI specific data into the CIRTS. An update may also include other revisions to the Area Plan. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. 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. Model Day Care: A program of therapeutic, social and health activities specific to clients with memory disorders. Services and activities include, but are not limited to, active and quiet 25 1602 games, reminiscence, validation therapy, pet therapy, water therapy and other failure free activities appropriate to the client's level of functioning. Model day care centers will also provide training for health care and social service personnel in the care of persons having AD or related memory disorders. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The ADI program provides a continuum of services addressing the special needs of individuals with AD,their families and caregivers. 1.2.2 Alzheimer's Disease Initiative Program Mission Statement The ADI program ensures that persons afflicted with AD and other forms of dementia are given essential services to help them age in place in an elder-friendly environment with security, dignity,and purpose. The program also provides support to family members and caregivers of persons afflicted with AD. 1.2.3 Authority The relevant authority governing the Alzheimer's Disease Initiative Program are as follows: (1) Rule Chapter 58D-1, Florida Administrative Code; and (2) Sections 430.501 through 430.504,Florida Statutes. 1.2.3.1 Incorporation of Reference Memoranda In accordance with s. 287 F.S., as amended, and Department of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by reference: (1) CFO Memo No. 02: Release date,August 20,2010; (2) CFO Memo No. 03: Release date,June 29,2010; and CFO Memo No. 06: Release date,June 30,2010. 1.23.2 Scope of Service The Vendor is responsible for the programmatic, fiscal, and operational management of the ADI program. The program services shall be provided in a manner consistent with and described in the current Vendor's Request for Proposal, RFP, and the County's current area plan and the current Department of Elder Affairs Programs and Services Handbook. 1.23.4 Major Program Goals The major goal of the ADI program is to provide services to meet the needs of caregivers and individuals with AD and related memory disorders. 13 INDIVIDUALS TO BE SERVED 13.1 General Eligibility The ADI Program addresses the special needs of individuals with AD and their caregivers. 13.2 Individual Eligibility Those individuals eligible to receive services under this contract must meet the following conditions: (1) Be 18 years of age or older and have a diagnosis of AD or a related disorder, or be 26 =try suspected of having AD or a related disorder;and (2) Not be enrolled in a Medicaid capitated long-term care program. 1 6 0 1.33 Targeted Groups Priority for services provided under this agreement shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2. SERVICE TASKS In order to achieve the goals of the ADI program,the Vendor shall ensure the following tasks are performed: (1) Client eligibility determination; (2) Assessment and prioritization of service delivery for new clients; (3) Delivery of services to eligible clients; and (4) Monitor the performance of vendors. 2.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described in this SECTION 1.3. 2.2 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services addressing the diverse needs of individuals with AD and their caregivers. The Vendor shall ensure services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. Services categories include: (1) Caregiver Training/Support; (2) Case Aid; (3) Case Management; (4) Counseling(Gerontological); (5) Counseling(Mental Health/Screening); (6) Education/Training; (7) Model Day Care; ( 8) Respite(Facility-Based); ( 9) Respite(In-Home); and (10) Specialized Medical Equipment, Services,and Supplies. Caregivers benefit from receiving training,respite and related support services to assist them in caring for the ADI client. 2.3 Service Times The Vendor shall ensure the provisions of the services listed in this contract are available 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. 27 3. DELIVERABLES 1602 3.1. Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the service tasks described in Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service will be paid pursuant to the rate established in this contract as updated, and approved by the County's reporting requirements. Service Unit of Service Caregiver Training/Support; Hour Case Aid; Hour Case Management; Hour Counseling(Gerontological); Hour Counseling(Mental Health/Screening); Hour Respite(Facility-Based); Hour Respite(In-Home); Hour Education/Training; Episode Episode 3.2 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. 3.2.1 Service Costs Reports Vendor must submit to the County the semi-annual service cost reports August 1, 2013 and February 1,2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 3.3 RECORDS AND DOCUMENTATION 3.3.1 The Vendor and each vendor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery. These policies and procedures shall be made available to the County upon request. 4. PERFORMANCE SPECIFICATIONS 4.1 Outcomes (4) The Vendor shall ensure services provided under this agreement are in accordance with the current DOEA Programs and Services Handbook. (5) The Vendor shall timely submit to the County all reports described in SECTION 3.2 REPORTS; and (6) The Vendor shall timely submit to the County all information described in SECTION 3.3 28 RECORDS AND DOCUMENTATION. 5. COUNTY RESPONSIBILITIES 160 2 5.1. Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the agreement by the Vendor. Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this agreement. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an onsite visit. The County's determination of acceptable performance shall be conclusive. The Vendor agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled,unscheduled and follow-up on-site visits; (3) Client visits (4) Review of independent auditor's reports (5) Review third-party documents and/or evaluations (6) Review of progress reports (7) Review of customer satisfaction surveys (8)Agreed-upon procedures review by an external auditor or consultant; (9)Limited-scope reviews; and (10)Other procedures as deemed necessary. 6. SECTION III: METHOD OF PAYMENT 6.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 6.1.2 Remedies-Nonconforming Services The Vendor shall ensure that all goods and/or services provided under this agreement for HCE funded programs are delivered timely,completely and commensurate with required standards of quality Such goods and/or services shall only be delivered to eligible program participants. If the Vendor fails to meet the prescribed quality standards for services, such services will not be reimbursed under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be reimbursed under this agreement. The Vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the Vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County requires immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 6.1.3 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the Vendor and any adjustments thereto, including any disallowance not resolved. 6.1.4 Date for Final Request for Payment 29 11�i 16132 The final request for payment for agreement year one's expenditures will be due to the County no later than August 1,2013. The final request for payment for agreement year two expenditures will be no later than August 1,2014. 6.2 Documentation for Payment The Vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals upon request. Such documentation shall be provided upon request to the County or the Clerk of Court. 30 cC 1602 EXIIIBIT 4 STATEMENT OF WORK OLDER AMERICANS ACT PROGRAM TITLE III SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 CONTRACT ACRONYMS Area Agency on Aging(AAA) Activities of Daily Living(ADL) Alliance of Information&Referral Systems(AIRS) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System(CIRTS) Information and Referral(I&R) Instrumental Activities of Daily Living(IADL) Older Americans Act(OAA) Planning and Service Area(PSA) 1.1.2 PROGRAM SPECIFIC TERMS Area Plan: A plan developed by the County outlining a comprehensive and coordinated service delivery system in Its PSA in accordance with the Section 306(42 U.S.C.3026)of the OAA and Department instructions. Child: An individual who is not more than 18 years of age or an individual with disability. Family Caregiver: An adult family member, or another individual,who is an informal provider of in-home and community care to an older individual. Frail: When an older individual is unable to perform at least two ADLs without substantial human assistance, including verbal reminding,physical cueing or supervision;or due to cognitive or other mental impairment,requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to another individual. 1.2 County Mission,Vision and Values Statement The County's mission: To help aging adults achieve greater independence through awareness of resources and access to qualified service providers. The County's vision: To be the recognized leader in supporting older adults and their families with access to trustworthy resources and services in their communities while empowering them to live with independence and dignity. The County's values: We believe residents of Southwest Florida are entitled to: Comprehensive information about their choices of care; Timely access to resources and services; High standards of quality and performance; and Personal and professional accountability from all stakeholders. 1.2.1 Older Americans Act Program Mission Statement The Older Americans Act(OAA)Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. 31 1602 1.3 GENERAL DESCRIPTION 1.3.1 General Statement The OAA Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. The primary purpose of the OAA program is to foster the development and implementation of comprehensive and coordinated systems to serve older individuals.The OAA program uses these systems to assist older individuals to attain and maintain maximum independence and dignity in a home environment and allows for the capability of self- care with appropriate supportive services. 1.3.2 Authority The relevant references authority governing the OAA program are: 1. Older Americans Act of 2006,as amended; 2. Rule 58A-1,Florida Administrative Code; and 3. Section 430.101, Florida Statutes. 1.3.2.1 Incorporation of Reference Memoranda In accordance with Ch.287 F.S., as amended,and Agency of Financial Services' Chief Financial Officer Memoranda, the following memoranda are provided for informational purposes and incorporated by reference: 1. CFO Memo No. 02: Release date,August 20,2010; 2. CFO Memo No. 03: Release date,June 29,2010; and 3. CFO Memo No. 06: Release date,June 30,2010. 1.3.3 Scope of Service The Vendor shall provide services in a manner consistent with and descried in the current area plan and current Department of Elder Affairs Programs and Services Handbook. 1.3.4 Major Program Goals The major goals of the OAA program are to improve the quality of life for older individuals,preserve their independence and prevent or delay more costly institutional care. These goals are achieved through the implementation of a comprehensive and coordinated service system that provides a continuum of service alternatives that meet the diverse needs of elders and their caregivers. 1.4 INDIVIDUALS TO BE SERVED 1.4.1 Eligibility(Title III Programs) 1.4.1.1 OAA Title HI,General Consumers shall not be dually enrolled in an OAA program and a Medicaid capitates long-term care program. 1.4.1.2 OAA Title IIIE,Caregiver Support Services Eligibility for OAA Title IIIE, Caregiver Support Services,are as follows: 1. Family caregivers of individuals age 60 or older; 32 C-�U 1 60 2 2. Grandparents(age 55 or older)or older individuals(age 55 or older)who are relative caregivers; 3. Priority will be given to family caregivers who provide care for individuals with Alzheimer's disease and related disorders with neurological and organic brain dysfunction and for grandparents or older individuals who are relative caregivers who provide care for children with severe disabilities; and 4. For respite and supplemental services, a family caregiver must be providing care for an older individual who meets the definition of the term"frail"in OAA, Section 102 Paragraph 22. 1.4.2 Targeted Groups Preference shall be given to those with the greatest economic and social need,with particular attention to low-income older individuals, including those that are low-income minorities,have limited English proficiency, and older individuals residing in rural areas. SECTION H—MANNER OF SERVICE PROVISION 2.1 SERVICE TASKS In order to achieve the goals of the OAA program,the Vendor shall ensure the following tasks are performed: 1. Client eligibility determination; 2. Targeting and screening of service delivery for new clients; 3. Delivery of services to eligible clients; 4. Use of volunteers to expand the provision of available services; 5. Monitoring the performance of its vendors. 6. Grievance and Compliance Procedures 2.1.1 Client Eligibility Determination The Vendor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described herein. 2.1.2 Targeting and Screening of Service Delivery for New Clients The Vendor shall develop and implement policies and procedures consistent with OAA targeting and screening Criteria 2.1.3 Delivery of Services to Eligible Clients The Vendor shall ensure the provision of a continuum of services that meets the diverse needs of elders and their caregivers. The Vendor shall ensure the performance and report performance of the following services in accordance with the current Department of Elder Affairs Programs and Services Handbook. The services funded pursuant to this contract are in accordance with the OAA,Title III, sections 321,331,336 and 373 as follows: 1. Section 321,Title IIIB Supportive Services; 2. Section 373,Title 11th Caregiver Support Services. 2.1.3.1 Supportive Services Supportive services include a variety of community-based and home-delivered services that support the qualities of life for older individuals by helping them remain independent and productive. Services include the following: 33 (1) Adult Day Care/Adult Day Health Care; (17) Homemaker; 161) 2 (2) Caregiver Training/Support; (18) Housing Improvement; (3) Case Aide/Case Management; (19) Information; (4) Chore Services; (20) Intake; (5) Companionship; (21) Interpreter/Translating; (6) Counseling(Gerontological and Mental Health); (22) Referral/Assistance; (7) Education/Training; (23) Personal Care; (8) Legal Assistance; (24) Physical Therapy; (9) Material Aid; (25) Shopping Assistance; (10) Occupational Therapy; (26) Skilled Nursing; (11) Outreach; (27) Specialized Medical Equipment, Services, and Supplies (12) Recreation; (28) Respite Services; (13) Emergency Alert Response; (29) Screening/Assessment; (14) Escort; (30) Speech Therapy; (15) Health Support; (31) Telephone Reassurance; and (16) Home Health Aide; (32) Transportation 2.1.3.4 Caregiver Support Services(Title IIIE Program) The following services are intended to provide direct help to caregivers,assist in the areas of health, nutrition and financial literacy and assist caregivers in making decisions and problem solving related to their caregiving roles and responsibilities: (1) Adult Day Care/Adult Day Health Care; (2) Caregiver Training/Support; (3) Counseling(Gerontological and Mental Health); (4) Education/Training; (5) Financial Risk Reduction(Assessment and Maintenance); (6) Information; (7) Intake; (8) Outreach; (9) Respite Services; (10) Screening/Assessment; and (11) Transportation 2.1.3.5 Caregiver Support Supplemental Services(Title HIES Program): The following services are provided to complement the care provided by caregivers: (1) Chore Services; (2) Housing Improvement; (3) Legal Assistance; (4) Material Aid; and (5) Specialized Medical Equipment, Services and Supplies. 2.2 SERVICE LOCATION 34 c.a 1602 2.2.1 Service Times The Vendor shall ensure the provision of the services listed in the contract during normal business hours unless other times are more appropriate to meet the performance requirements of the contract, and it shall monitor its vendors to ensure they are available to provide services during hours responsive to client needs and during those times which best meet the needs of the relevant service community. 2.3 DELIVERABLES 2.3.1 Service Unit The Vendor shall ensure the provision of the services described in the contract in accordance with the current Department of Elder Affairs Programs and Services Handbook and the services tasks described in Section 2.1. The chart below lists the services allowed and the units of measurement. Units of service will be paid pursuant to the rate established in the 2010 RFP and approved by the County. Services Unit of Service Adult Day Care/Adult Day Interpreter/Translating Health Care Legal Assistance Caregiver Training/Support Medication Management Case Aid/Case Management Mental Health Counseling/Screening Chore Services Nutrition Counseling Companionship Occupational Therapy Counseling Services Personal Care Escort Physical Therapy Hour Financial Risk Reduction Recreation Services Respite Services Health Support Screening/Assessment Home Health Aide Sitter Homemaker Skilled Nursing Services Housing Improvement Speech Therapy Intake Emergency Alert Response Day Education/Training Episode Information Material Aid Referral/Assistance Specialized Medical Equipment, Services and Supplies Telephone Reassurance Escort One-Way Trip Shopping Assistance Transportation 2.4 REPORTS The Vendor shall respond to additional routine and/or special requests for information and reports required by the County in a timely manner as determined by the Grant Coordinator. The Vendor shall establish due dates for any vendors that permit the Vendor to meet the County's reporting requirements. 35 (C�, r ii 160 2 2.4.2 Service Costs Reports The Vendor shall require vendors to submit to the Vendor semi-annual service cost reports on August 1, 2013 and February 1, 2014, which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 2.4.5 Background Screening Affidavit of Compliance To demonstrate compliance with section 8 of the Standard Contract,the Vendor shall submit ATTACHMENT H,Background Screening Affidavit of Compliance annually,by January 151. 2.5 RECORECORDS AND DOCUMENTATION Each Vendor and vendor,among other requirements,must anticipate and prepare for the loss of information processing capabilities.The routine backing up of all data and software is required to recover from losses or outages of the computer system.Data and software essential to the continued operation of vendor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure,offsite location. The Vendor shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement in its contracts and/or agreements with vendors. These policies and procedures shall be made available to the County upon request. 2.6 PERFORMANCE SPECIFICATIONS 2.6.1 Outcomes (1)The Vendor shall ensure services provided under this contract are in accordance with the current DOEA Programs and Services Handbook, (2)The Vendor shall timely submit to the County all reports described herein (3)The Vendor shall timely submit to the County all information described in, Paragraph 2.5 RECORDS AND DOCUMENTATION. 2.7 VENDOR'S FINANCIAL OBLIGATIONS 2.7.1 Matching,Level of Effort,and Earmarking Requirements The Vendor shall provide match of at least 10 percent of the federal funds received. The Vendor's match will be made in the form of cash and/or in-kind resources. The Vendor will assure,through a provision in subcontracts,a match requirement of at least 10 percent of the cost for all services funded through this contract. The vendor's match will be made in the form of cash and/or in-kind resources. The Vendor shall report match by title each month. At the end of the contract period, the Vendor must properly match all OAA funds. 2.7.2 Title III Funds The Vendor assures compliance with Section 306 of the OAA, as amended in 2006,that funds received under Title III will not be used to pay any part of a cost incurred by the Vendor to maintain a contractual or commercial relationship that is not carried out to implement Title III. 2.8 COUNTY RESPONSIBILITIES 2.8.1 Program Guidance and Technical Assistance The County will provide to the Vendor guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the Vendor. 2.8.2 Program/Contract Monitoring The County will review and evaluate the performance of the Vendor under the terms of this contract. Monitoring shall be conducted through direct contact with the Vendor through telephone, in writing, or an on-site visit. The County's determination of acceptable performance shall be conclusive. The Vendor 36 16D 2 agrees to cooperate with the County in monitoring the progress of completion of the service tasks and deliverables. The County may use,but is not limited to, one or more of the following methods for monitoring: 1. Desk reviews and analytical reviews; 2. Scheduled,unscheduled and follow-up on-site visits; 3. Client visits; 4. Review of independent auditor's reports-Exhibit 10; 5. Review of third-party documents and/or evaluation; 6. Review of progress reports; 7. Review of customer satisfaction surveys; 8. Agreed-upon procedures review by an external auditor or consultant; 9. Limited-scope reviews; and 10. Other procedures as deemed necessary. 2.8.3 Contract Monitoring The County shall, at its own discretion,conduct monitoring concerning any aspect of the vendor's performance of this contract. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this agreement includes a fixed rate for services. 3.2 Remedies-Nonconforming Services The vendor shall ensure that all goods and/or services provided under this agreement for OAA IIIE and OAA HIES funded programs are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. If the vendor fails to meet the prescribed quality standards for services, such services will not be paid under this agreement. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be paid under this agreement. The vendor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the vendor shall solely bare the costs associated with preparing or providing nonconforming goods and/or services. The County and or Department require immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.3 All payment requests shall be based on the submission of actual monthly services beginning with the contract date the agreement. The contracted rate for services is ATTACHMENT A to this agreement. 3.4 Payment may be authorized only for allowable services,which are in accordance with the limits specified in ATTACHMENT A. 3.5 Any payment due by the County under the terms of this agreement may be withheld pending the receipt and approval by the County of all financial and programmatic reports due from the vendor and any adjustments thereto, including any disallowance not resolved. 37 ( ar) 1602 3.6 Date for Final Request for Payment The fmal request for payment for agreement year one expenditures will be due to the County no later than August 1, 2013. The final request for payment for agreement year two expenditures will be no later than August 1,2014. 3.7 Documentation for Payment The vendor shall maintain documentation to support payment requests that shall be available to the County or authorized individuals, such as the Department of Financial Services,upon request. II 38 EXHIBIT 5 1602 Agreement#12-5856 "Services for Seniors Attachment B Invoice and Logs (Minimum Standard Invoice Information) County Purchasing Order Number: Invoice Number: Grant Name: From Date To Date Id*"[ � 'eimbnrss y -4r , 2a ai _ - # k � �� men 4 � a TO 4°t" O Y� j cos i �. 1Sub f c _ `� ultiply h e }'c :�cn Lion n ; n : * 1 nit�@` •eim•ursement , `! `'a ch uanttt.�,�•. Rate 'er ni o`, 1 en+ I • up ft µ, pr 7,Y oun Sup lie i-the IIni ", r ni S r _A �^ s'S.^sy y'S w able z + g r x lro�� z o t crn S uantl -; ,v .� r t 'C COSt� er s .°�": �!:�P}}+ -Fa. �t e ♦ ,.Y 'd. e-V-M4 -5-$1,F'.,,F'., „ n11., '=' ua. ,i.w,A� tw= <. :.^.'":�r.: $0.00 $0.00 $0.00 Total $0.00 I certify to the best of my knowledge and belief that this invoice, and attached service detail log, is complete and correct and all outlay herein are for the purposes set forth in the contract, and that services are ordered by the case manager as agreed on the Contract. Legible copies of the dated timesheet, signed by the client and the worker supporting this invoice must be available upon request. Collier County reserves the right to correct computation of errors to assure proper payment amount. Prepared by: Date: Adjustment Reasons Lead Agency Authorization Attachments: Monthly Service log,Weekly Detail log and Client Service time sheets. 39 cao 1602 EXHIBIT 6 Detail Weekly for CCE Services Week Ending: Invoice No. Personal CLIENT Care Homemaker Respite Skilled Companion Chore Total Total Total Total Total Total NAME Units Units Units Units Units Units Total Hours - - - - - - $ PECA - $ HMK - $ RESPITE - $ SKILLED - $ COMPANION - $ CHORE - $ TOTAL - 40 S EXHIBIT 7 161) Monthly Detail Service Log Grant Name: Vendor Name, Address: From Date To Date By client,provide the total number of hours provided during the dates of service. This log must be submitted with your monthly invoice for the Invoice From Date and To Date. -01:11 l 3hn. d. Emefgency + a3.^. 40}i� " ..AaUI Respite z?t '- r,., .'.� Z 4 ^'` Q^=e .4 —' `rc r Clien Persona'l Hom , Skilled I Da 'Chore Enhan 0 Shopping Escort '` It Name mss? a mak '� Pursing ' Chore i panion Assist Response a � `ro lu 4 i me ' t.`ar acllltrii 'x.40 �:: y��-oc , ,e ( System!;svo s� ��A'-" � ,:� z � - �, ,'�`' ��� tea 41 EXHIBIT 8 1602 Daycare Grant: Grant Service: ADC or RESF Vendor Name and Address By client, provide the Weekly Client Service lime Sheet provided during the dates of service. This log must be submitted with all invoices for the invoice From Date and To Date. TO FROM DATE: DATE: Client Thur Uni Client Name signature Mon Tue Wed s Fri Sat Sun Match is Service Dates 42 ca EXHIBIT 9 1. 602 YOUR COMPANY NAME HERE Collier County Services for Seniors Homemaker/Personal Care/Respite/Companion Work Sheet Client Name: Client Signature: Week Endin• : Each Time You Perform one of the Activities Below: Put in arrival and departure times for the day worked: ****Client should Initial time of arrival and departure. ****Client should Sign form at top. ****you should sign your name at the bottom. Date: Day: MON TUES WED THUR FRI SAT SUN TOTAL TIME ARRIVAL TIME: DEPARTURE TIME: ****CLIENT INITIALS: Arrive: PERSONAL CARE Depart: Assist W/Bath tub Shower Bed Assist W/Dressing Bathroom Assist Shave (Face Only) Oral Hygiene Walking/Ambulation Feeding Assistance Wash/Set Hair Backrub Soak Feet_ Nails (File only) Change_Make_Bed Take out Trash Clean Bedroom Clean Bathroom Prepare Meals Laundry Arrive: HOME MAKING Depart: Vacuum/Sweep Light Dusting 43 c_�o 1602 Clean Kitchen Floor Wash Dishes Mop Sweep_ Grocery Shop Errands Arrive: RESPITE Depart: Arrive: COMPANION Depart: EMPLOYEE'S Signature/Title 44 EXHIBIT 10 1602 OMB Circular A-133 Audits of States, Local Governments, and Non-Profit Organizations requires the Collier County Housing, Human and Veterans Services Department to monitor our subrecipients of federal awards and determine whether they have met the audit requirements of the circular and whether they are in compliance with federal laws and regulations. Accordingly, we are requiring that you check one of the following, provide all appropriate documentation regarding your organization's compliance with the audit requirements, sign and date this form. Subrecipient Fiscal Year Name Period Total State Financial Assistance Expended during $ most recently completed Fiscal Year Total Federal Financial Assistance Expended during most $ recently completed Fiscal Year Check Appropriate Boxes We have exceeded the $500,000 federal/state expenditure threshold for our fiscal year ❑ ending as indicated above and have completed our Circular A-133 audit. A copy of the audit report and management letter are attached. We exceeded the $500,000 federal/state expenditure threshold for our fiscal year ❑ ending as indicated above and expect to complete our Circular A-133 audit by . Within 30 days of completion of the A-133 audit, we will provide a copy of the audit report and management letter. We are not subject to the requirements of OMB Circular A-133 because we: ❑ Did not exceed the $500,000 federal/state expenditure threshold for the fiscal year indicated above ❑ Are a for-profit organization ❑ Are exempt for other reasons —explain An audited financial statements is attached and if applicable, the independent auditor's management letter. (If findings were noted, please enclose a copy of the responses and corrective action plan.) Certification Statement I hereby certify that the above information is true and accurate. Signature Date Print Name and Title 45