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Backup Documents 12/11/2018 Item #16E 6 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERSdOFFI CE FOR �, ttyA Attorney Print on pink paper. Attach to original document. The completed routing slip and original Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the cousty,)Altfrgy Office no later than Monday preceding the Board meeting. DECDuu (...UV I0 **NEW** ROUTING SLIP Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is alread co 11. t • the exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to tll iunt Amey Office. Route to Addressee(s) (List in routing order) Office Initials Date 1. Risk Risk Management JZ l ►1>� 2. County Attorney Office County Attorney Office .\SL\ /z-/ tZ.V5\1.1. 4. BCC Office Board of County bLiA Commissioners kZ-\kVa) 4. Minutes and Records Clerk of Court's OfficeKT/tit) [$ ‘?-1(aik 5. Procurement Services Procurement Services PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above,may need to contact staff for additional or missin information. Name of Primary Staff Ana Reynoso/PURCHASIN Contact Information 239-252-8950 Contact/ Department Agenda Date Item was December 11, 2018 Agenda Item Number 16.E.6. Approved by the BCC Type of Document ASSUMPTION AGREEMENT 1 Number of Original 2 Attached Documents Attached PO number or account N/A 12-5856 Maranath e Care, number if document is Maranatha Home Career Inc. dba A-Better to be recorded Inc. dba A Better Health Care. Health Care 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 STAMP OK N/A 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 AR 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 AR 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 AR signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip N/A should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on12/11/2018 and all changes made during yx- 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 y� Chairman's signature. �iY\Y 1 6 E MEMORANDUM Date: December 14, 2018 To: Ana Reynoso, Procurement Services From: Martha Vergara, Sr. Deputy Clerk Minutes & Records Department Re: Assumption Agreement - Contract #12-5856 "Services for Seniors" Contractor: Maranatha Home Care, Inc., LLC d/b/a A Better Health Care Attached for your records is an original of each referenced document above, (Item #16E6) adopted by the Board of County Commissioners on Tuesday, December 11, 2018. The Board's Minutes & Records Department has kept an original as part of the Board's Official Records. If you have any questions, please feel free to contact me at 252-7240. Thank you. Attachment 16E6 ASSUMPTION AGREEMENT This Assumption Agreement is made and entered into on this 11th of December, 2018,by and between Maranatha Home Care, Inc. d/b/a A Better Health Care, a Florida corporation, ("Maranatha" or "Vendor") and Collier County, a political subdivision of the State of Florida ("County"). WHEREAS, on December 11, 2012 (Agenda Item No. 16.D.26) the County awarded Agreement #12-5856 for "Services for Seniors" to Accu-Care Nursing Service, Inc. A copy of Agreement#12-5856 is attached hereto as Exhibit A,together with all amendments,change orders, extensions and renewals thereto, and hereinafter referred to as "Agreement;"and WHEREAS, Maranatha hereby represents to Collier County that through an Asset Purchase Agreement, it is the successor in interest to and in relation to the Agreement; and WHEREAS, the parties wish to formalize Maranatha's assumption of rights and obligations under the Agreement effective as of the date first above written. NOW THEREFORE, IN CONSIDERATION of the mutual promises in this Assumption Agreement, and for other good and valuable consideration, the receipt and sufficiency of which are acknowledged by the parties, it is agreed as follows: 1. Maranatha accepts and assumes all rights, duties, benefits, and obligations of the Vendor under the Agreement, including all existing and future obligations to pay and perform under the Agreement. 2. Maranatha will promptly deliver to County evidence of insurance consistent with the Agreement. 3. Further supplements to, or modifications of, the Agreement shall be approved in writing by both parties. 4. Notices required under the Agreement sent to Vendor shall be directed to: VENDOR: Maranatha Home Care, Inc. d/b/a A Better Health Care One North Lexington Avenue Mezzanine, Suite 200 White Plains,New York 10601 Main Phone: (914) 428-7722 Attention: Carmen Beltre, Director of Contract Services Email: Cbeltre@phhc.com 5. The County hereby consents to Vendor's assumption of the Agreement to continue the services provided under Agreement #12-5856. No waivers of performance or extensions of time to perform are granted or authorized. Except as provided herein, all other terms and conditions of the Agreement remain in full force and effect. [18-PRC-03788/1448116/1] 1 16E6 IN WITNESS WHEREOF, the undersigned have executed and delivered this Assumption Agreement effective as of the date first above written. ATTEST: BOARD OF C TY COMMISSIONERS Crystal K. Kinzel,Clerk of Courts&Comptroller COLLIER , FLO "y� s o By: +,R By: Attest as to Chairman's >:)ept Cle Andy Solis, Chairman signature only. ` s• j -. Cont is Wit sses: MARANATHA HOME CARE, INC. D/B/A A BETTER HEALTH CARE (U J ign re________,� ^G��� CCvtt.� .,2 c�-� By: _ Print Name [[�� k��[�1.4L c v1/410 AiS.iiJ c.EO Print Name/Title A,_ Date: lI/zss I t�� Si nature v s kr Print Name Approved f to fo and legality: By: i Jeffrey A.k atzkow County Atto y [18-PRC-03788/1448116/1] 2 I6E 6 A DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 11/19/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Margie Lagazon Miller&Miller Insurance Agency Inc PHONE FAX 720 Commerce Street rJC.No.Eat)914-741 6400 WC.No):914-741-6407 Thornwood NY 10594 ADDRESS: MargieL@Miller-Ins.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:ACE AMERICAN INSURANCE COMPANY 22667 INSURED PREMI-4 INSURER B:National Continental Ins 10243 Maranatha Home Care Inc INSURERc:COVERYS SPECIALTY INSURANCE COMPANY 15686 DBA A Better Health Care 2375 Tamiami Trail N., Suite 300 INSURERD:The Charter Oak Fire Ins Co 25615 Naples FL 34103 INSURER E:TRAVELERS IND CO 25658 INSURER F: HISCOX INS CO INC 10200 COVERAGES CERTIFICATE NUMBER:1444410847 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTRR TYPE OF INSURANCE ADDLS y VD POLICY NUMBER POLICY EFF POLICY EXYT VMITS (MM/DD/YYYY) (MMIDD/YYYYI A X COMMERCIAL GENERAL LIABILITY Y MLPG28210851002 2/2/2018 2/2/2019 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES Ea occurrence) $100,000 X Prof-Claims Made MED EXP(Any one person) $5,000 X Sexual AbUSe PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICY PECOT- LOC PRODUCTS-COMP/OP AGG $1,000,000 OTHER: Prof Aggregate Limit $3,000,000 B AUTOMOBILELIABILITY CNY00070829938 2/2/2018 2/2/2019 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY _ AUTOS ONLY (Per accident) $ C UMBRELLA LIAB X OCCUR 510035 2/2/2018 2/2/2019 EACH OCCURRENCE $25,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $25,000,000 DED X RETENTION$in nnn Follow Form $Prof Liability D WORKERS COMPENSATION TC2OUB1006A37218 6/30/2018 6/30/2019 X E AND EMPLOYERS'UABIUTY Y/N TROUB3612A49618 6/30/2018 6/30/2019 STATUTE ER ANYPROPRIET EXCLUDED ECUTIVE N N/A E.L.EACH ACCIDENT $1,000,000 OFFICER/MEM(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 F Employee Theft UC2118450518 2/8/2018 2/8/2019 Limit $50,000 i DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) *Policies shown are subject to terms,conditions,exclusions,sublimits and deductibles not listed on this certificate. We recommend that requests for policy copies be directed to the Named Insured shown above.* Work Comp Policy #TC2OUB1006A37218-Covers the following States-CT,IL,NC,NJ,NY Work Comp Policy# TRKUB3612A49618 -Covers the following States-FL,MA Collier County Board of County Commissioners,or Board of County Commissioners in Collier County,or Collier County Govemment is included as an additional insured under the captioned Commercial General Liability and Automobile Liability policies on a primary and non-contributory basis if and to the extent required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Collier County Board of County Commissioners 3295 Tamiami Trail East Naples FL 34112 AUTHORIZED RE ESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 16E6 EXHIBIT A AGREEMENT12-5856 for Services for Seniors THIS AGREEMENT, made and entered into on this If day of he40 , 2012, by and between Accu-Care Nursing Service, Inc. authorized to do business in the State of Florida, whose business address is 2375 Tamiami Trail North, Suite 300, Naples, Florida 34103, hereinafter called the "Vendor" and Collier County, a political subdivision of the State of Florida, Collier County, Naples, hereinafter called the "County": WITNESSETH: 1. COMMENCEMENT. This Agreement shall commence on it j 1'e( n , 2012 and shall terminate onto.6ee_ehilati, 2014. The Contract award is a two (2) year contract, with the possibility of two (2) additional two (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 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). 2. STATEMENT OF WORK. The Vendor shall provide Services for Seniors in accordance with the terms and conditions of RFP #12-5856, the terms, conditions and requirements of the grant, and the Vendor's proposal referred to herein and made an integral part of this agreement. This Agreement contains the entire understanding between the parties and any modifications to this Agreement shall be mutually agreed upon in writing by the Vendor and the County Contract Manager or his designee, in compliance with the County Purchasing Policy and Administrative Procedures in effect at the time such services are authorized. 3. COMPENSATION. The County shall pay the Vendor for the performance of this Agreement the aggregate of the units actually ordered and furnished at the unit price, together with the cost of any other charges/fees submitted in the proposal as set forth in Attachment A, Contract Rates, attached hereto and made an integral part hereof. Payment will be made upon receipt of a proper invoice as per Attachment B, Invoice and Logs, attached herein and incorporated by reference, and upon approval by the Contract Manager or his designee, and in compliance with Section 218.70, Fla. Stats., otherwise known as the "Local Government Prompt Payment Act". Page 1 of 11 16E6 3.1 Payments will be made for services furnished, delivered, and accepted, upon receipt and approval of invoices submitted on the date of services or within six (6) months after completion of contract. Any untimely submission of invoices beyond the specified deadline period is subject to non-payment under the legal doctrine of "laches" as untimely.subnutted. Time shall be deemed of the essence with respect to the timely submission of invoices under this agreement. 4. SALES TAX. Vendor shall pay all sales, consumer, use and other similar taxes associated with the Work or portions thereof, which are applicable during the performance of the Work. 5. NOTICES. All notices from the County to the Vendor shall be deemed duly served if mailed or faxed to the Vendor at the following Address: Accu-Care Nursing Service, Inc. 2375 Tamiami Trail N., Suite 300, Naples, FL 34103 Attention: Kathleen Hughes, Executive Director Telephone: 239-263-301;Facsimile: 239-263-1552 E-mail: accucare@aol.com All Notices from the Vendor to the County shall be deemed duly served if mailed or faxed to the County to: Collier County Government Center Purchasing Department-Purchasing Building 3327 Tamiarni Trail, East Naples, Florida 34112 Attention: Joanne Markiewicz, Purchasing/GS Director Telephone: 239-252-8407; Facsimile: 239-252-6480 The Vendor and the County may change the above contact information at any time upon giving the other party written notification. All notices under this Agreement must be in writing. 6. NO PARTNERSHIP. Nothing herein contained shall create or be construed as creating a partnership between the County and the Vendor or to constitute the Vendor as an agent of the County. 7. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, F.S., all permits necessary for the prosecution of the Work shall be obtained by the Vendor. Payment for all such permits issued by the County shall be processed internally by the County. All non-County permits necessary for the prosecution of the Work shall be procured and paid for by the Vendor. The Vendor shall also be solely responsible for payment of any and all taxes levied on the Vendor. In addition, the Vendor shall comply with all rules, regulations and laws of Collier County, the State of Florida, or the U. S. Government Page 2 of 1 I I 6 Eb now in force or hereafter adopted. The Vendor agrees to comply with all laws governing the responsibility of an employer with respect to persons employed by the Vendor. 8. NO IMPROPER USE. The Vendor will not use, nor suffer or permit any person to use in any manner whatsoever, County facilities for any improper, immoral or offensive purpose, or for any purpose in violation of any federal, state, county or municipal ordinance, rule, order or regulation, or of any governmental rule or regulation now in effect or hereafter enacted or adopted. In the event of such violation by the Vendor or if the County or its authorized representative shall deem any conduct on the part of the Vendor to be objectionable or improper, the County shall have the right to suspend the contract of the Vendor. Should the Vendor fail to correct any such violation, conduct, or practice to the satisfaction of the County within twenty-four (24) hours after receiving notice of such violation, conduct, or practice, such suspension to continue until the violation is cured. The Vendor further agrees not to commence operation during the suspension period until the violation has been corrected to the satisfaction of the County. 9. TERMINATION. Should the Vendor be found to have failed to perform his services in a manner satisfactory to the County as per this Agreement, the County may terminate said agreement for cause; further the County may terminate this Agreement for convenience with a thirty (30) day written notice. The County shall be sole judge of non-performance. 10. NO DISCRIMINATION. The Vendor agrees that there shall be no discrimination as to race, sex, color, creed or national origin. 11. INSURANCE. The Vendor shall provide insurance as follows: A. Commercial General Liability: Coverage shall have minimum limits of$1,000,000 Per Occurrence, Combined Single Limit for Bodily Injury Liability and Property Damage Liability. This shall include Premises and Operations; Independent Vendors;Products and Completed Operations and Contractual Liability. B. Business Auto Liability: Coverage shall have minimum limits of $1,000,000 Per Occurrence, Combined Single Limit for Bodily Injury Liability and Property Damage Liability. This shall include: Owned Vehicles, Hired and Non-Owned Vehicles and Employee Non-Ownership. C. Workers' Compensation: Insurance covering all employees meeting Statutory Limits in compliance with the applicable state and federal laws. Special Requirements: Collier County Government shall be listed as the Certificate Holder and included as an Additional Insured on the Comprehensive General Liability Policy. Page 3of11 16E6 Current, valid insurance policies meeting the requirement herein identified shall be maintained by Vendor during the duration of this Agreement. The Vendor shall provide County with certificates of insurance meeting the required insurance provisions. Renewal certificates shall be sent to the County ten (10) days prior to any expiration date. Coverage afforded under the policies will not be canceled or.allowed to expire until the greater of: ten (10) days prior written notice, or in accordance with policy provisions. Vendor shall also notify County, in a like manner, within twenty-four (24) hours after receipt, of any notices of expiration, cancellation, non-renewal or material change in coverage or limits received by Vendor from its insurer, and nothing contained herein shall relieve Vendor of this requirement to provide notice. 12. INDEMNIFICATION. To the maximum extent permitted by Florida law, the Vendor shall indemnify and hold harmless Collier County, its officers and employees from any and all liabilities, damages, losses and costs, including, but not limited to, reasonable attorneys' fees and paralegals' fees, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the Vendor or anyone employed or utilized by the Vendor in the performance of this Agreement. This indemnification obligation shall not be construed to negate, abridge or reduce arty other rights or remedies which otherwise may be available to an indemnified party or person described in this paragraph. This section does not pertain to any incident arising from the sole negligence of Collier County. 12.1 The duty to defend under this Article 12 is independent and separate from the duty to indemnify, and the duty to defend exists regardless of any ultimate liability of the Vendor, County and any indemnified party. The duty to defend arises immediately upon presentation of a claim by any party and written notice of such claim being provided to Vendor. Vendor's obligation to indemnify and defend under this Article 12 will survive the expiration or earlier termination of this Agreement until it is determined by final judgment that an action against the County or an indemnified party for the matter indemnified hereunder is fully and finally barred by the applicable statute of limitations. 13. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf of the County by the Housing, Human and Veterans Services Department. 14. CONFLICT OF IN I'EREST: Vendor represents that it presently has no interest and shall acquire no interest, either direct or indirect, which would conflict in any manner with the performance of services required hereunder. Vendor further represents that no persons having any such interest shall be employed to perform those services. 15. COMPONENT PARTS OF THIS CONTRACT. This Contract consists of the attached component parts, all of which are as fully a part of the contract as if herein set out Page 4 of 11 16E6 verbatim: Vendor's Proposal, Insurance Certificate, and RFP #12-5856 Specifi- cations/Scope of Services, Attachment A Contract Rates and Attachment B Invoice and Logs. If a conflict arises between the documents, the order of precedence shall be: this Contract, the County's RFP #12-5856, the terms and conditions of the grant, and the Vendor's proposal. 16. SUBJECT TO APPROPRIATION. It is further understood and agreed by and between the parties herein that this agreement is subject to appropriation by the Board of County Commissioners. 17. PROHIBITION OF GIFTS TO COUNTY EMPLOYEES. No organization or individual shall offer or give, either directly or indirectly, any favor, gift, loan, fee, service or other item of value to any County employee, as set forth in Chapter 112, Part III, Florida Statutes, Collier County Ethics Ordinance No. 2004-05, and County Administrative Procedure 5311. Violation of this provision may result in one or more of the following consequences: a.) Prohibition by the individual, firm, and/or any employee of the firm from contact with County staff for a specified period of time; b.) Prohibition by the individual and/or firm from doing business with the County for a specified period of time, including but not limited to: submitting bids, RFP, and/or quotes; and, c.) immediate termination of any contract held by the individual and/or firm for cause. 18. IMMIGRATION LAW COMPLIANCE. By executing and entering into this agreement, the Vendor is formally acknowledging without exception or stipulation that it is fully responsible for complying with the provisions of the Immigration Reform arid Control Act of 1986 as located at 8 U.S.C. 1324, et seq. and regulations relating thereto, as either may be amended. Failure by the Vendor to comply with the laws referenced herein shall constitute a breach of this agreement and the County shall have the discretion to unilaterally terminate this agreement immediately. 19. OFFER EXTENDED TO OTHER GOVERNMENTAL ENTITIES. Collier County encourages and agrees to the successful proposer extending the pricing, terms and conditions of this solicitation or resultant contract to other governmental entities at the discretion of the successful proposer. 20. AGREEMENT TERMS. If any portion of this Agreement is held to be void, invalid, or otherwise unenforceable, in whole or in part, the remaining portion of this Agreement shall remain in effect. 21. ADDITIONAL ITEMS/SERVICES. Additional items and/ services may be added to this contract in compliance with the Purchasing Policy and Grantor Agency Requirements. 22. DISPUTE RESOLUTION. Prior to the initiation of any action or proceeding permitted by this Agreement to resolve disputes between the parties, the parties shall make a good Page 5 of 11 16E6 faith effort to resolve any such disputes by negotiation. The negotiation shall be attended by representatives of Vendor with full decision-making authority and by County's staff person who would make the presentation of any settlement reached during negotiations to County for approval. Failing resolution, and prior to the commencement of depositions in any litigation between the parties arising out of this Agreement, the parties shall attempt to resolve the dispute through Mediation before an agreed-upon Circuit Court Mediator certified,by the State of Florida. The mediation shall be attended by representatives of Vendor with full decision-making authority and by County's staff person who would make the presentation of any settlement reached at mediation to County's board for approval. Should either party fail to submit to mediation as required hereunder, the other party may obtain a court order requiring mediation under section 44.102, Fla. Stat. Any suit or action brought by either party to this Agreement against the other party relating to or arising out of this Agreement must be brought in the appropriate federal or state courts in Collier County, Florida, which courts have sole and exclusive jurisdiction on all such matters. *****************Remainder of Page Intentionally Left Blank***************************** Page 6 of 11 1 6E 6 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 and year first above written. BOARD OF COUNTY COMMISSIONERS ATTEST: , - , COLLIER COUNTY, FLORIDA D-Wi.,ht E. BroCV,.Clerk of Courts esisAimpit c Dated: Fred k 1 I Fred W. Coyle, Chairman Atte(nE V hi 2)to truss t s Otylature )2,4 Accu-Care Nursing Service,Inc. Vendor tN.P-1* First Wi _ s Signature W_Ifte_ e/pr. itnesnamet ___ Second Witness Typed signature and title 4"-RN SS 12-ll ('— ',e'2•Grt-t— trype/print witness nameT Approved as to form and legal sufficiency: illf . rl Assistant County attorney 'Eflikki 1Z Pp - Print Name Page 7 of 1 1 16E 6 Agreement#12-5856 "Services for Seniors" Attachment A Contract Rates Total Cost Per Reimbursement Item Service Description Grant Service Unit Service Unit Rate Per Unit to Supplier 1. Adult Day Care CCE Per Hour 511.00 $9.90 2. Chore CCE Per Hour 19.57 17.61 3. Enhanced Chore CCE Per Hour 25.21 22.69 (Requires two(2)or more workers performing multiple tasks a.t the same time.) I 4, Companion CCE Per Hour 19.60 17.64 5. Homemaker' (includes CCE Per Hour 18.56 16.70 Shopping Assistance (RFP#6 Shopping Assistance Service) 6. Shopping Assistance See Item#5 7. Personal Care(RFP#10 CCE Per Hour 21,46 19.31 Escort Service) 8a. Respite (In-Home) CCE Per Hour 20.00 18.00 8b. Respite(In-Home) ADI Per Hour 20.00 20.00 9. Respite(In-Facility) ADI Per Hour 11.00 11.00 10. Escort See Item#7 11. Skilled Nursing CCE Per Hour 35.26 31.73 12. Emergency Alert CCE Per Day 1.09 .98 Response System 13a. Specialized Medical CCE Per Episode Catalog in effect Catalog-ten (10) Equipment, Services, in September percent in effect in and Supplies 2012 September 2012 13b. Specialized Medical ADI Per Episode Catalog in effect Catalog in effect in Equipment,Services, in September September 2012 and Supplies 1 2012 Notes: 1. Services for Seniors grant includes Shopping Assistance under Homemaking and Escort under Personal Care. 2. The Total Cost per Service Unit will be used for HCE applied grants(no match is required). 16E6 Attachment B Invoice and Logs (Minimum Standard Invoice Information) Vendor Name Invoice Number Vendor Address From Date and To Date County Purchasing Order Number I Reimbursement TOTAL Total Rate Per Unit AMOUNT Service In Kind to Supplier 11VIultiply the Description Referenced i Cost MMatch (Subtract In I.nit Reimbursement (identified Grant Per Amount ; Kind Match Quantityj Rate Per Unit byline) Ser��ic e Amount from to Supplier x Unit Total Cost Per ! the t nit Service Unit) Quantity) I I 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: Adjustments Reasons: Lead Agency Authorization: Attachments: Weekly Service Log and Weekly Client Service Time Sheet Page 9 of 11. bE 6 i , _ _, ›, 1 , 1 _, ,., w cj '+,' p a) 6, a p en C m > g .4 cn a.,E ar W I N, I I x i i ' i et ct em v J i et •� 1 1 I ' Er' .< fri rd La I — 0 1 I a) .[ I a C 1 a 1 an i 0 O I I r -0 • V a, �. 0) 0- — es - I et v co) ++ Q 1 a i ra z . = I '✓, j `L.- U Q OJ it 1 e -- -- = m ( m 0 y C c .:..0 16E6 ____; , _ m, , , ,_ . _ ..y V444 v c w. 5 m yz I a 0 -ciea .-. 1 Z v CO v cn cn v i 4. _ v I I I o a r v y w cC 4 Q N � E- . � A 5 v p., ° v, --t Y v �. i 4 w A '0 I 1 4 _ 0 .p. 0 v �„ . 0 v i . 0 16E6 DATE (MM/DDKEYY) 1 Aga CERTIFICATE OF LIABILITY INSURANCE 12/18/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER ?non(2: (954)828-9545 =ax' r94)828.9949 CONTACT Dana Cavic NAME: _....._ SABAL INSURANCE GROUP,INC. PHONE (954)828-9948 WC. (954 828-9949 — I (AM,No,EorE NNC.NPI_ `.__ ) 805 E.BROWARD BLVD.,SUITE 303 MAIL dcavic@sabalinsurance.com ^f 'FORT LAUDERDALE FL 33301 �p9REss,._.. I INSURER(S) AFFORDING COVERAGE NAIC# Agency Lilt.L002130 INSURER A ! American Alternative Ins Corp 19720 IACCU-CARE NURSING SERVICE,INC. INSURERS .. )2375 TAMIAM)TRAIL N,#300 INSURER C : NAPLES FL 34103 INSURER D: INSURER INSURERS ' J COVERAGES CERTIFICATE NUMBER: 16512 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE L.CTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM ORCONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 1 TYPE OF INSURANCE f AMYL)sUBR; I POLICY RFC POUDY EXP I LIMITS TR I INS M, WVO POLICY NUMBER 1 IMonrerrn imeroorYYYYI A ,GENERAL LIABILITY I VHHG3052541-04 I 06/21/12 ' 06/21/13 :EACH OCCURRENCE I S 1,000,000 X COMMERCIAL GENERAL LIABILITY I DAMAGE TO oR om-ur6 1,000,000 PREMISES(Ee oG:unnaal $ I MEG.EXP(Any oneperson) j S 50,000+ __ 1 X !CLAIMS-MADE !OCCUR X 1 Protesslonol Liability t I PERSONAL 8 ACV INJURY ; S 1,000,000 r---i I ! I GENERAL AGGREGATE I S 3,000,000 X I Retro Date 06/21/03 ,... I GEN'L AGGREGATE Lim APPLIES PER: _ I PRODUCTS-COMP/OP AGG I S 3,060,000 I POLICY JEC' OC % AUTOMOBILE LIABILITY VHHG3052541-04 06/21/12 06/21/13 I COMBINED SINOLGUMIT E $ Included A I!Ea acadent) I ANY AUTO 'BODILY INJURY(Per person) $ 'AL:OWNED SCHEDULED i ;BODILY INJURY(Per accioent) S AUTOS (AUTOS r .._— I EINON-OWNED i PROPERTY DAMAGE S X I HIRED AUTOS I X ;AUTCS I ! I I (Per eaideno I 1 S _ I I UMBRELLA LIAR ;OCCUR I EACH OCCURRENCE 1 S '.—t EXCESS UAB j CLAIMS-MADEI IAGGREGATE 1 S I IS I DE^ !RETENTION$ i I r—_..__ -...._ I WC ETATU- I OTH I I WORKERS COMPENSATION ' % :'TCRY LIMITS ER $ AND EMPLOYERS' LIABILITY 1 ANY PROPWETOR(PARTNERlEXECtRiVE — E.L.EACH ACCIDENT I OFFICER/MEMBER EXCLUDED? Il N,A E.L.DISEASE-EA EMPLOYEE I S (Mandatory in NN) 'Ir yes,Scoote unael EL.DIS ASE-?OUC LIMIT j $ I DESCRIPTION OF OPERATIONS below i 1 l DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 10'1,Additional Remarks Schedule.R more space is required) The certificate holder is named as an additional insured. CERTIFICATE HOLDER CANCELLATION Collier County Government Center I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Board of County Commissioners THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 3301 Tamiami Trail East ACCORDANCE WITH THE POLICY PROVISIONS. Naples,Florida 34112 AUTHORIZED REPRESENTATIVE Attention: `aaaaalC� ". "' r-''- '' Dana Cavic ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1 OE 6 DATE{MMIDDIYYYY) ....A. 1 CERTIFICATE OF LIABILITY INSURANCE l4.ttK-'1....�T`ti 4�+y at/Jai:I:1:3 t1:24 >.M THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the cerficate holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED, subject to the terms and Conditions of the policy,certain policies may require an endorsement,a statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER rrwrnrr ruble: Highpoint Risk Services LLC aw,,t INc,w,edr. (8001/28-062J Isnap+c,m-n (372)404-0300 5501 LBJ Freeway, Suite 1200 YatAL KeM!<at Dallas, TX 75240 INSURERS AFFORDING COVERAGE NAIC A INSURER A ,.a,a.. ,y e ,.,,,t-Y f .,,<.. w v ?.-. INSURED: Equity t'y Uro,ip Teasing 1, inc '-i;- '" INSURER B. INSURER C. A;;(:::-(:ARE NAP7.2::; 13'1 Io N. 1'/IMIAMI TILF.1L STE 3C0 INSURER ,1.1,:S, 11., i4103 INSURERS. •,Hne%; z'9) 2C i-3011 I'ax: ( S9) 2G3-15;52 INSURER F: COVERAGES CERTIFICATE NUMBER: AC13-15400104-1172552 REVISION NUMBER: THIS IS TO GER r IF Ir TiATTRFPDLTCT OF IRSURANC.. TO THE TNSDRE6 FA4v1EAUOVEF0>YTT T'OLICPFERTOD INOTCATED NOTW'ITHSTANDINC ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OI HER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED DY PAID CLAIMS LIMITS LT RR TYPE OF INSURANCE ADM SUER- POLICY NUMBER POLICY EFF POLICY EXP NSR WVD DATE(MMIDDIYYI DATE(MMIDDIY YI EACH OCCURRENCE g GENERAL LIABILITY ,,,,,,,opfc5ria:!+"fep COMMERCIAL GENERAL LIABILITY PRB 1/ F lIT/li nerw0 CLAIMS MADE (—"� OCCUR 0 0 MED CZ'(Ary one hereon) $ ( J PERSONAL&ADS INJURY 1 GENERAL,AGGREGATE $ PRODUCTS-COMP;OP AOG '' taEP7'L.1G{iREGA rE EMIT APPLIES PER ^'(POLICY fl AQ7 L. $ 1 l n l l COMBINED SINGLE L'Fd1T AUTOMOBILE LIABILITY (Ea aMcien') $ --.ANY'Aura Bwn_YLVJunr(PerpdrlSrl s r-ALA.OWNED AUTOS a ❑ BODILY INURY(Per ecGidcnt) S ^—SCHEDULED AUTOS pRCPERTY OAMAGF' $ �...,~HIRED AUTOS E'er strident NON-OWNED AUTOS EACH OCCURRENCE S UMBRELLA LIAR CLAIMS-MADE — EXCESS USESOCCUR AGGREGATE 1 DEDUCTIBLE 0 $ $ RETENTION $ WORKERS COMPENSATION AND X. I rroktAnkq J1(( EMPLOYERS'LIABILITY YIN Ally PROPERIETOR:EXECUTIVE E L EACH ACCIDENT 1 $ T f U pri`fCER MEMBERP.XCLUDEO'7 0 N/A Ei D PE26272740260 01/01/201'2 04/01/2013 EL DISEASE-CA EMPLOYEE 'S 1000000 (t MEa ,sdry ribe N uHnd er E DISEASE-P ICY EMIT $ (',000(JQ SPECIAL PROVISION below DESCRIPTION OP OPERATIONSrLOCATIONSNEHICLESIAttachad ACORD101,Additional Remarks Schedule.P more space Is required ll 'f111 C ELlf)sate reiSd.r•.s in effect rovi e ' the client' acc;ouaL L ii oad (Uru'lJn with Equity C1 Y'OUp 1.easinc 1. .'.n-. t,:ove aae 1? not rgvl'eo lo' any em J.o E�to w �Ce t� eep c:inyEo J,CS1 riot Gro'ap repo tit waCOS' to qu ty r0k e/s it gc. . ppi 1Q"' 8 iS aftgrdeG QYkers ompen EEC ee eG to �1CCa- E as d c e ctevA DLe/U1 2e nsure Km� n gas' on,easing Ioyers laaDll1Iy as a co-employer Un er e policy Or employees leased from Equity CERTIFICATE HOLDER _ CANCELLATION SHOULC ANY OF 1 HE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORF THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH I ," i.r e l P:.0 pus;^s 01.1y.., THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �*` "''�' `- ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION.All right reserved 16E6 Contract Amendment#1 Contract # 12-5856 "Services for Seniors" This CONTRACT AMENDMENT#1, dated A4 7:3 , 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-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 flub AND OAA 111bS 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 TIFF Caregiver Support (OAA MF) and Older American Title T1TFS Caregiver Support Supplemental Services(OAA T1TFS)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: —164...• 3 , 2013 VENDOR: Accu-Care Nursing Service, Inc. (�I�F .s '.s;ssA ,( O , y • • -_ _ �► rte' , pe/print witness Orb, 1n,` „ ti Second Witne Pnnt/Type Name and Ti 10 r1 r1 () r YPe/p rint witness name 1 16E 6 COUNTY: ATTEST: BOARD OF COUNTY COMMISSIONERS DWIGHT E. BROCK, CLERK OF COLLIER COUNTY, FLORIDA • By:,, :� , DPTTTY CLERK GEORGIA A. I'' LER, ESQ. .•,� ,; Altesf aslo airman's CHAIRWOMAN �tf(fl Itra only t , ,AI3 proval for form and legal Sufficiency: � v w�— Jennife'r B. White Assistant County Attorney 2 1 E6 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 16E 6 ATTACHMENT C 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 II 16E 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 1 E14, 6 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 I320d.), 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 C�' 16 E6 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 1 6 E 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 LP 1 6E 6 r1 M 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 LP ,.A ,L 16E6 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 0 1 6 E 6 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 GP r. . 16E6 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 CP 1 6 E 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 1 6 6 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. D 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. D 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 Nome 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:htto://elderaffairs.state.fl.us/english/backgroundscreening.php 12 GP 1 6 E 6 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 �,P 16E6 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 13.1 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 LA 1 6 E 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 LP pir. 1ÔE 6 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 Specialized Medical Equipment, Services and Supplies Episode 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 �,A • 16E 6 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 coo 4. 16E b 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 A, 16E 6 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 1 6 E 6 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 16E 6 (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 1 6E 6 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 16E b 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 E ty .' 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 16E 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 h. � 1 6 E 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 .CA E suspected of having AD or a related disorder; and (2) Not be enrolled in a Medicaid capitated long-term care program. 13.3 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. 23 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 6E 6 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 CA( 16E 6 RECORDS AM)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 OAT) 16 f 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 'C 16E 6 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 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 CAO •, 1 6 E 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 16E6 (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 C�� J6 Y044" 1 A 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 gin() .. 16E6 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 GP 16E61 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.Al. .4 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. L 6E 6 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 :i.ii 11)'51= 1 v � , a ',a . i 11'0)1 t ai'a(C tR f't' . '' ' ' it.1:-:1,71 1 it 1,,..„,t'ri , ,t-b)141.7.1,91 i totilt.410‘. iir.:- ,' * 'm.l: ' } 4 i)! '• ' 3 3M' ' < y .,X1113 1 4#f��; �.is�a;�T 't °old„ . • ' '' ' , 1[ ,-;7, ,, 1 ''' ' i ' i 1.-6'91II'rf*:11 1 '' ° I, Q.1(Silili°,`,1 e _ e- $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 1 16E 6 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 1 6E 6 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. 4-411-370 it t�1 i { i "4is,tta i ik;#1 .� SSE L ( t 41 ‘/� 3. 6E 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 Pi 16E 6 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 1 6 E i Clean Kitchen Floor Wash Dishes Mop Sweep_ Grocery Shop Errands Arrive: RESPITE Depart: Arrive: COMPANION Depart: EMPLOYEE'S Signature/Title 44 _ 1 6 E 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: O Did not exceed the $500,000 federal/state expenditure threshold for the fiscal year indicated above ❑ Are a for-profit organization O 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 ' L 1 6 E Procurement Services Ca ?E?i" �Y Change Order Form ® Contract Modification ❑Work Order Modification ❑Amendment Contract#: 12-5856 Change#: 2 Purchase Order#: Project#: Contractor/Firm Name: Accu-Care Nursing Service, Inc. Contract/Project: Services for Seniors Project Manager Name: Lisa Carr Division Name: Community and Human Services Original Contract/Work Order Amount N/Al2/11/12 16D26 Original BCC Approval Date; Agenda Item# Current BCC Approved Amount Last BCC Approval Date; Agenda Item# Current Contract/Work Order Amount SAP Contract Expiration Date(Master) Dollar Amount of this Change N/A #VALUE! Total Change from Original Amount Revised Contract/Work Order Total $ 0.00 #DIV/0! Change from Current BCC Approved Amount Cumulative Changes #VALUE! #DIV/0! Change from Current Amount Completion Date,Description of the Task(s)Change,and Rationale for the Change Notice to Proceed N/A Original Last Approved Revised Date Date Completion Date Date (Includes this change) #of Days Added N/A Select Tasks ❑Add new task(s) ❑ Delete task(s) ❑ Change task(s) ®Other(see below) Provide a response to the following: 1.) detailed and specific explanation/rationale of the requested change(s)to the task(s) and I or the additional days added (if requested); 2.) why this change was not included in the original contract; and, 3.) describe the impact if this change is not processed. Attach additional information from the Design Professional and/or Contractor if needed. 1. This modification is to include an additional grant funding source for the 12-5856 Services for Seniors Program. 2. A new grant program was awarded to Collier County post solicitation issuance. The following language shall be added in the 12- 5856 contracts for the newly awarded Older American Act III B funding The maximum duration for this Contract for CCE, HCE, ADI, OAA IIIE AND OAA IIIES and OAA IIIE 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), and OAA111B Programs. Words that have been deleted are struck through,words underlined have been added. 3. The execution of this change order will ensure that reimbursement for the Services for Senior Program will not be delayed. Prepared by: /7 Date: (Project onager Name and Division) Acceptance of this Change Order shall constitute a modification to contract/work order identified above and will be subject to all the same terms and conditions as contained in the contract I work order indicated above, as fully as if the same were stated in this acceptance. The adjustment, if any,to the Contract shall constitute a full and final settlement of any and all claims of the Contractor/Vendor/Consultant/ Design Professional arising out of or related to the changet forth herein, including claims for impact and delay costs. Accepted,by t: s - , 4 ' Date: \- (Contractor/Vendor/Consultant%TDe5ign Professional and Name of Firm, if project applicable) Approved by: Date: (Design Professional and Name of Firm, if project applicable) Approved by: Date:("-' (Procurement Professignal) Revised: 10/28/2014 (Divisions who may require additional signatures may include on separate sheet.) PROCUREMENT USE ONLY Admin Rp BCC ES 1 6 E 2392631552 03:33'22 p.m. 04-01-2014 2/3 TAY County Administrative Services Division Purchasing March 31, 2014 Ms. Kathleen HLrghes, Executive Director Accu-Care Home Health Service, Inc. 2375 Tamiami Trail N Naples, FL 34103 FAX 263.1552 Email: accucare(a�eol.com RE: Contract Renewal for#12-5856 "Services for Seniors" Dear Ms. Hughes: Collier County would like to renew the above agreement under the same terms and conditions for two(2) additional years in accordance with the renewal clause in the agreement. This renewal is . contingent upon Project Manager approval. If you are agreeable please indicate your intentions by providing the information as requested below: I am agreeable to renewing the above referenced contract under the same terms, conditions, and pricing as the existing contract. The following attached documentation must be provided with response. • Provide updated and current insurance certificate I am not agreeable to renewal of this contract. II By signature this contract will be in effect from June, 30, 2014 through June 29, 2016. Please take a moment to review the Collier County Online Bidding System and refresh your business profile information. Log into the County's site at httR;//bid.coliieraov_net/bid/, select My Profile and My Commodities, and review information and commodities to ensure they accurately reflect your business. .a�LI 44. L1* pund.ng Depair rt•3327 Tamiami Trail East•Naples.Florida 341124901•www.caitlergau.netiPurchasirl 16E 6 2392631552 03;33:56 p.m. 04-01-2014 3/3 Page 2 of 2 RE: Contract Renewal for#12-5856"Services for Seniors' Please return this letter to the Purchasing Department with your response at your earliest convenience. If you have any questions you may contact Brenda Reaves at 239-252-6020, email brendareavesCcltcolliercov,net or FAX 239-252-6592. Respectfully, Markiewicz l� , Director- Procurement S E. 01.1,14O{ltliiCl�Re[7 la .�r� l . + iy.V F" ,.4'.... Name of Company r u -(A-0 r t\ft t r c i c -Y k<<<' 63 4- Company Signature CLq, o n , x 0Z,--iii 121" (Corporate Officer) Print Corporate Officer 4 vJ d&• ')s (-4 4 Name j Signature Date t�L t .i rs 'T 'r IL_ F 1^[ r *'L Fh4 ir"'mr r}i -�. .fi n•LLn IL i ns! _+! 1a U ] �•lit Sr tUpdater� ontaEt1nformati R �4 0`7''^t'4r�a r a r l•. i- ,{� (irioft er`ta nk Vure-our contact infor atationit eatrefiri uy ..-. ,z.... l T .. Contact Name �•� Telephone Number FAX Number 1 3ck--, i^`7)- Email Address C it .l , efr►N- Address 'j :l C: Lisa Carr, Grants Coordinator, HHVS • J,..,.1,....Jo.NJ.1k. ,..4..,..t a.,y LP NJ N.I .1 0 1,..0 4{.“0.....,0 Go • ,I-.1. • V SS C/A ,2-1,11 A.4 i..0 I V,e./"a L ir.A.A. ta 1,I'IL V'V it 6 E 6 1.. Co :ler . ..... . •:14,-14-ty Administrative Services Department Procurement Ser\pces Division April 15, 2016 Ms. Kathleen K. Berghuis Accu-Care Home Health Services, Inc 2375 Tamiarni Trail North, Suite #300 Naples, FL 34103 FAX: 263-1552 Email: accucare@aol.com RE; Contract Renewal for# 12-5856 "Services for Seniors" Dear Ms, Berghuis: Collier County would like to renew the above agreement under the same terms and conditions for two (2) additional year in accordance with the renewal clause in the agreement. This renewal is contingent upon Project Manager approval. If you are agreeable please indicate your intentions by providing the information as requested below. I am agreeable to renewing the above referenced contract under the same terms, conditions, and pricing as the existing contract. The following attached documentation must be provided with response I am not agreeable to renewal of this contract. By signature this contract will be in effect from June 30, 2016 until June 29, 2018. Please take a moment to review the Collier County Online Bidding System and refresh your business profile information. Log into the County's site at: httolibid.00llieroov.netibidl, select My Profile and My Commodities, and review information and commodities to ensure they accurately reflect your business. )V...0.040.~641....101.0,00.90000..041....V. • • . . , . • .: 4 ,ANNOWNOCOMIOMPANNOMAKOM".0.016.16**606~5tOSONS6.0.00~01411.04...K.: PrICUMITIVI .,'S'iW,P:,i0 ‘332/Tami Tra East.11-nplts.;1,...,*jri:M112-4'30.239-2524V-:41(4w.r,difrapy.r.eti;Alo.nnt(mte,ervivs vv as aVa v.i MsvJ ✓VV a♦ aV♦ anVaV .n . Va . MV ♦ !• ataVL a. NVa Sial% VVa ♦V Page 2 of 2 RE: Contract Renewal for#12-5856 "Services for Seniors" Please return this letter to the Purchasing Department with your response at your earliest convenience. if you have any questions you may contact E_issett De La Rosa at 239-252-60.20, email lissettdelarosa@coitiemov.net gv.net or FAX 239-252-2860 Respectfully, ne Markiewicz ~} Director* Procurement SerNlitet Acceptance of Contract Ren•ewal • Name of Company14- _.. . . _...rr c..ct c. -- Q..CLct. til�a r� 5.02V..) e-e-...v_....__..._. Company Signature P .vo Print Name 7771 nts-2(\-Lt--\--> Signature Date 1A Updated Contact Information - j (In order to make sure our�contact information is current.) Contact Name _.. L . ... ----- .-.. u..1. _ r. Telephone Number P _. FAX Number _._. • a r Email Address (41tbag--r6- Address C arc► Address C: Lisa Carr, CHS 1 6E 6 0 1 county Administrative Services Department Procurement Services Division June 7, 2018 Ms. Kathleen K. Berghuis Accu-Care Nursing Services, Inc. 2375 Tamiami Trail North, Suite#300 Naples, FL 34103 Email: accucare@aol.com Re: Extension of Contract#12-5856 "SERVICES FOR SENIORS" Dear Ms. Berghuis: The above contract will expire 6/29/18. In order to maintain required service levels in the interim, we request an extension of your contract as provided for in the Collier County Procurement Ordinance until 12/26/18 or until the new contract is awarded and fully executed, whichever is sooner. The previous contract will be terminated on issuance of the new contract. However, any Purchase Order/Work Order that extends beyond the expiration date of the original contract will survive and remain subject to the terms and conditions of that contract until the completion or termination of the Purchase Order/Work Order, This extension is contingent upon the Board approving the extension,which is anticipated to be presented to the Board on June 26, 2018. Should the Board not approve the extension, this letter will be automatically nullified. If you are agreeable to extension of the referenced contract, please indicate your intentions by providing the appropriate information as requested below: i( I am agreeable to extending the present contract for the time period indicated under the same terms and conditions as the existing contract. I am not agreeable to extension of this contract. riimA Proc tr ernerc Services Drsision•3295 Tamiami Trail East•Naples Florida 34112-4901•tmvor colliergav neUprocurementsenrices 16E6 Page 2 of 2 Re: Extension of Contract 1112-5856 "SERVICES FOR SENIORS" Your prompt attention is urgently requested. Please return this letter to the Procurement Services Division with your response by 6/14/18. You may email your response to: renewalsa.colliergov.net. If you have any questions you may contact 239-252-8407. Regards, HerreraSan dra Sandra Herrera Procurement Contract Manager—Procurement Services Division Acceptance: Accu-Care Nursing Services, Inc. ContractorNendor B . .► .._1 • & - L"- Signature 9j,IINAkrilec tvi A2rL‘ Name and Title Date: to C: Lisa Carr, Community& Human Services