Agenda 07/28/2009 Item #16D12Agenda Item No. 16D12
July 28, 2009
Page 1 of 46
EXECUTIVE SUMMARY
Recommendation for the Board of County Commissioners to approve and authorize the
Chairman to sign an agreement between the Collier County Board of County
Commissioners and the Area Agency on Aging for Southwest Florida, Inc. and approve a
budget amendment to reflect a decrease of $17,515 in the Community Care for the Elderly
(CCE) grant program,
OBJECTIVE: The execution of this agreement and budget amendments is necessary for
uninterrupted support services to Services for Seniors' frail and elderly clients.
CONSIDERATIONS: Collier County Services for Seniors has been providing in -home support
services to Collier County's frail elderly for over 30 years through the Community Care for the
Elderly program.
In order to prevent disruptions in service to the elderly, a budget amendment equal to the
previous year's allocation of $672,993 was approved by the Board of County Commissioners on
June 9, 2009, item 16D4. The agreement for the 2009 -2010 program year has been received and
reflects a decrease of $17,515 in the allocation. Therefore, a budget amendment is required to
reflect the actual allocation stated in the agreement.
The total grant amount of $655,478 is for the period July 1, 2009 through June 30, 2010.
Funding is available from the State of Florida grants and aids appropriation. Of the total grant
award, $212,322 will be recognized as the direct funding portion of the County for case
management, transportation and administration costs. The remaining $443,156 will be budgeted
to pay the local in -home service providers. A total of $97,1.00 in local matching funds was
approved in the FY09 budget as a contribution from the General Fund (001) to Services for
Seniors (123).
Program Component
Original
Budget
Revised Budget
Net Change
CCE Spending Authority
$459,044
$443,156
($15,888)
CCE Lead Agency Services
$100,949
$114,000
$13,051.
CCE Lead Agency Operations
S113,000
$98,322
($14,678)
Total
$672,993
1 $655,478
($17,515)
GROWTH MANAGEMENT: There are no growth management impacts from this
recommendation.
FISCAL IMPACT: FY09 budget in Services for Seniors fund (123) will decrease by $17,515.
No additional matching funds are required.
LEGAL CONSIDERATIONS: This item has been reviewed and approved by the County
Attorney's Office. This itern is not quasi judicial, and as such ex parte disclosure is not
Agenda Item No. 16D12
July 28, 2009
Page 2 of 46
required. This item requires majority vote only. This item is legally sufficient for Board action. -
CMG
RECOMMENDATIONS: Staff recommends that the Board of County Commissioners approve
and authorize the Chairman to sign the agreement and approve the necessary budget amendment
to recognize the decrease in funding.
Prepared by: Terri Daniels, Accounting Supervisor, Housing and Human Services Department
Page 1 of 1
Agenda Item No. 16D12
July 28, 2009
Page 3 of 46
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COLLIER COUNTY
BOARD OF COUNTY COMMISSIONERS
Item Number:
16D12
Item Summary:
Recommendation for the Board of County Commissioners to approve and authorize the
Chairman to sign an agreement between the Collier County Board of County Commissioners
and the Area Agency on Aging for Southwest Florida,
Inc. and approve a budget amendment
to reflect a decrease of $17,514 in the Community Care for the Elderly (CCE) grant program.
Meeting Date:
7/28/2009 9:00:00 AM
Prepared By
Terri A. Daniels
Grants Coordinator
Date
Public Services
Housing & Human Services
7/10/2009 6:46:37 PM
Approved By
Marcy Krumbine
Director
Date
Public Services
Housing & Human Services
7/13/2009 11:33 AM
Approved By
Kathy Carpenter
Executive Secretary
Date
Public Services
Public Services Admin.
7/13/2009 1:54 PM
Approved By
Colleen Greene
Assistant County Attorner
Date
County Attorney
County Attorney Office
711312009 2:32 PM
Approved By
Marla Ramsey
Public Services Administrator
Date
Public Services
Public Services Admin.
7/15/2009 2 :09 PM
Approved By
Jeff Klatzkow
County Attorney
Date
County Attorney
County Attorney Office
7/15/2009 5:51 PM
Approved By
OMB Coordinator
OMB Coordinator
Date
County Manager's Office
Office of Management & Budget
7/16/2009 7:54 AM
Approved By
Marlene J. Foord
Grants Coordinator
Date
Administrative Services
Administrative Services Admin.
7116/2009 9:19 PM
Approved By
Sherry Pryor
Management & Budget Analyst
Date
County Manager's Office
Office of Management & Budget
7117/2009 12:22 PM
Approved By
Leo E. Ochs, Jr.
Deputy County Manager
Date
Board of County
County Manager's Office
7/17/2009 4:24 PM
Commissioners
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Agenda Item No. 16D12
July 28, 2009
July 2009 page 4CC5203.09
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC.
STANDARD CONTRACT
COMMUNITY CARE FOR THE ELDERLY PROGRAM
THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc., hereinafter referred
to as the "Agency" and Collier County Board of County Commissioners, hereinafter referred to as the "Recipient," and
collectively referred to as the "Parties." The term recipient for this purpose may designate a vendor, subgrantee or
subrecipient, the status to be further identified in ATTACHMENT 111, Exhibit -2 as necessary.
WITNESSETH THAT:
WHEREAS, the Agency has determined that it is in need of certain services as described herein; and
WHEREAS, the Recipient has demonstrated that it has the requisite expertise and ability to faithfully perform such
services as an independent contractor of the Agency.
NOW THEREFORE, in consideration of the services to be performed and payments to be made, together with the
mutual covenants and conditions hereinafter set forth, the Parties agree as follows:
1. Purpose of Contract
The purpose of this contract is to provide services in accordance with the terms and conditions specified in
this contract including all attachments and exhibits, which constitute the contract document.
2. Incorporation of Documents within the Contract
The contract will incorporate attachments, proposal(s), state plan(s), grant agreements, relevant Department
of Elder Affairs handbooks, manuals or desk books, as an integral part of the contract, except to the extent
that the contract explicitly provides to the contrary. In the event of conflict in language among any of the
documents referenced above, the specific provisions and requirements of the contract document(s) shall
prevail over inconsistent provisions in the Proposal(s) or other general materials not specific to this contract
document and identified attachments.
3. Term of Contract
This contract shall begin on July 1, 2009 or on the date on which the contract has been signed by the last party
required to sign it, whichever is later. It shall end at midnight, local time in Fort Myers, Florida on June 30,
2010.
4. Contract Amount
The agency agrees to pay for contracted services according to the terms and conditions of this contract in an
amount not to exceed $655,478.00 or the rate schedule, subject to the availability of funds. Any costs or
services paid for under any other contract or from any other source are not eligible for payment under this
contract.
5. Renewals
By mutual agreement of the parties, in accordance with section 287.058(1)(f), F.S., the agency may renew the
contract for a period not to exceed three years, or the term of the original contract, whichever is longer. The
renewal price, or method for determining a renewal price, is set forth in the bid, proposal, or reply. No other
costs for the renewal may be charged. Any renewal is subject to the same terms and conditions as the original
contract and contingent upon satisfactory performance evaluations by the agency and the availability of
funds.
Agenda Item No. 16D12
July 28, 2009
July 2009 Page Vt 03.09
6. Compliance with Federal Law
6.1. If this contract contains federal funds the provider shall comply with the provisions of 45 CFR 74 and /or 45
CFR 92, and other applicable regulations.
6.2. If this contract contains federal funds and is over $100,000, the recipient shall comply with all applicable
standards, orders, or regulations issued under section 306 of the Clean Air Act as amended (42 USC 7401 et
seq.), section 508 or the Federal Water Pollution Control Act as amended (33 USC 1251 et seq.), Executive
Order 11738, as amended, and where applicable Environmental Protection Agency regulations 40 CFR 30.
The recipient shall report any violations of the above to the agency.
6.3. The recipient, or agent acting for the recipient, may not use any federal funds received in connection with this
contract to influence legislation or appropriations pending before the Congress or any State legislature. If this
contract contains federal funding in excess of $100,000, the recipient must, prior to contract execution,
complete the Certification Regarding Lobbying form, ATTACHMENT II. All disclosure forms as required by
the Certification Regarding Lobbying form must be completed and returned to the Contract Manager, prior to
payment under this contract.
6.4. The recipient shall not employ an unauthorized alien. The agency shall consider the employment of
unauthorized aliens a violation of the Immigration and Nationality Act (8 USC 1324 a) and the
Immigration Reform and Control Act of 1986 (8 USC 1101). Such violation shall be cause for
unilateral cancellation of this contract by the agency.
6.5. That if this contract contains $10,000 or more of federal funds, the recipient 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.
6.6. That if this contract contains federal funds and provides services to children up to age 18, the
recipient shall comply with the Pro - Children Act of 1994 (20 USC 6081).
6.7. That a contract award with an amount expected to equal or exceed 25,000.00 and certain other
contract awards shall 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
recipient will comply with these provisions before doing business or entering into subcontracts
receiving federal funds pursuant to this contract. The recipient shall complete and sign
ATTACHMENT V prior to the execution of this contract.
7. Compliance with State Law
7.1. That this contract is executed and entered into in the State of Florida, and shall be construed,
performed and enforced in all respects in accordance with the Florida law, including Florida
provisions for conflict of laws.
7.2. Requirements of Section 287.058. F.S.
7.2.1. The recipient will provide units of deliverables, including reports, findings, and drafts, as specified in
this contract, which the Contract Manager must receive and accept in writing prior to payment.
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Agenda Item No. 16D12
July 28, 2009
July 2009 Page 0Fs4203.09
7.2.2. The recipient will submit bills for fees or other compensation for services or expenses in sufficient
detail for a proper pre -audit and post- audit.
7.2.3. If itemized payment for travel expenses is permitted in this contract, the recipient will submit bills
for any travel expenses in accordance with section 112.061.F.S., or at such lower rates as may be
provided in this contract.
7.2.4. The recipient will allow public access to all documents, papers, letters, or other public records as
defined in subsection 119.011 (11), F.S., made or received by the recipient in conjunction with this
contract except for those records which are made confidential or exempt by law. The recipient's
refusal to comply with this provision shall constitute an immediate breach of contract for which the
agency may unilaterally terminate the contract.
7.3. If clients are to be transported under any agreements and /or contracts incorporating this contract,
the recipient shall comply with the provisions of Chapter 427.F.S., and rule 41, F.A.C.
7.4. Subcontractors who are on the discriminatory vendor list may not transact business with any public
entity, in accordance with the provisions of section 287.134.F.S.
7.5. The recipient will comply with the provisions of section 1.062.F.D., and section 216.347.F.S., which
prohibit the expenditure of contract funds for the purpose of lobbying the legislature, judicial branch
or a state agency.
8. Grievance Procedures
The recipient shall develop and implement, and ensure that its subcontractors have established,
grievance procedures to process and resolve client dissatisfaction with or denial of service(s), or
address complaints regarding the termination, suspension or reduction of services, as required for
receipt of funds. These procedures, at a minimum, should provide for notice of the grievance
procedure and an opportunity for review of the subcontractor's determination (s).
9. Audits, Inspections. Investigations. Public Records and Retention
9.1. To establish and maintain books, records and documents (including electronic storage media)
sufficient to reflect all income and expenditures of funds provided by the agency under this contract.
9.2. To retain all client records, financial records, supporting documents, statistical records, and any
other documents (including electronic storage media) pertinent to this contract for a period of six
(6) years after completion of the contract or Ionger when required by law. In the event an audit is
required by this contract, records shall be retained for a minimum period of six (6) years after the
audit report is issued or until resolution or any audit findings or litigation based on the terms of this
contract, at no additional cost to the agency.
9.3. Upon demand, at no additional cost to the agency, the recipient will facilitate the duplication and
transfer of any records or documents during the required retention period in Paragraph 9.2.
9.4. To assure that these records shall be subject at all reasonable times to inspection, review, copying,
or audit by Federal, State, or other personnel duly authorized by the agency.
9.5. At all reasonable times for as long as records are maintained, persons duly authorized by the agency
and Federal auditors, pursuant to 45 CFR 92.36(i) (10), shall be allowed full access to and the right to
examine any of the recipient's contracts and related records and documents, regardless of the form
in which kept.
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Agenda Item No. 16D12
July 28, 2009
July 2009 Page 7OR203.09
9.6. To provide a financial and compliance audit to the agency as specified in this contract and in
ATTACHMENT III and to ensure that all related party transactions are disclosed to the auditor.
9.7. To comply and cooperate immediately with any inspections, reviews, investigations, or audits
deemed necessary by the office of the Inspector General pursuant to s. 20.055.F.S.
10. Nondiscrimination - Civil Rights Compliance
10.1. The recipient will execute assurances in ATTACHMENT VI that it will not discriminate against any
person in the provision of services or benefits under this contract or in employment because of age,
race, religion, color, disability, national origin, marital status or sex in compliance with state and
federal law and regulations. The recipient further assures that all contractors, subcontractors, sub
grantees, or others with whom it arranges to provide services or benefits in connection with any of
its programs and activities are not discriminating against clients or employees because of age, race,
religion, color, disability, national origin, marital status or sex.
10.2. The recipient will retain, on file, during the term of this agreement a timely, complete and accurate
Civil Rights Compliance Checklist (ATTACHMENT B).
10.3. The recipient agrees to establish procedures pursuant to federal law to handle complaints of
discrimination involving services or benefits through this contract. These procedures shall include
notifying clients, employees, and participants of the right to file a complaint with the appropriate
federal or state entity.
10.4. These assurances are a condition of continued receipt of or benefit from federal financial assistance,
and are binding upon the recipient, its successors, transferees, and assignees for the period during
which such assistance is provide. The recipient further assures that all subcontractors, vendors, or
others with whom it arranges to provide services or benefits to participants or employees in
connection with any of its programs and activities are not discriminating against those participants
or employees in violation of the above statutes, regulations, guidelines, and standards. In the event
of failure to comply, the recipient understands that the agency may, at its discretion, seek a court
order requiring compliance with the terms of this assurance or seek other appropriate judicial or
administrative relief, including but not limited to, termination of and denial of further assistance.
11. Provisions of Services
The recipient will provide services in the manner described in ATTACHMENT I.
12. Monitoring by the Agency
The recipient permits persons duly authorized by the agency to inspect and copy any records,
papers, documents, facilities, goods and services of the recipient which are relevant to this contract,
and to interview any clients, employees and subcontractor employees of the recipient to assure the
agency of the satisfactory performance of the terms and conditions of this contract. Following such
review, the agency will deliver to the recipient a written report of its findings and request for
development, by the recipient, of a corrective action plan where appropriate. The recipient hereby
agrees to timely correct all deficiencies identified in the corrective action plan.
13. Indemnification
13.1. Subject to the limits of section 768.28, F.S., the recipient shall indemnify, save, defend, and hold
harmless the agency and its agents and employees from any and all claims, demands, actions, causes
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Agenda Item No. 16D12
July 28, 2009
July 2009 Page 80203.09
character, arising out of or by reason of the execution of this agreement or performance of the
services provided for herein. It is understood and agreed that the provider is not require to
indemnify the agency for claims, demands, actions or causes of action arising solely out of the
agency's negligence.
14. Insurance and Bonding
14.1. To provide continuous adequate liability insurance coverage during the existence of this contract
and any renewal(s) and extension(s) of it. By execution of this contract, unless it is a state agency or
subdivision as defined by subsection 768.28(2), F.S. the recipient accepts full responsibility for
identifying and determining the type(s) and extent of liability insurance necessary to provide
reasonable financial protections for the recipient and the clients to be served under this contract.
The limits of coverage under each policy maintained by the recipient do not limit the recipient's
liability and obligations under this contract. The recipient shall ensure that the agency has the most
current written verification of insurance coverage throughout the term of this contract. Such
coverage may be provided by a self - insurance program established and operating under the laws of
the State of Florida. The agency reserves the right to require additional insurance as specified in this
contract.
14.2. Throughout the term of this agreement, the recipient agrees to maintain an insurance bond from a
responsible commercial insurance company covering all officers, directors, employees and agents of
the recipient authorized to handle funds received or disbursed under all agreements and /or
contracts incorporation this contract by reference in an amount commensurate with the funds
handled, the degree of risk as determined by he insurance company and consistent with good
business practices.
15. Confidentiality of Information
The recipient shall not use or disclose any information concerning a recipient of services under this
contract for any purpose prohibited by state or federal law or regulations except with the written
consent of a person legally authorized to give that consent or when authorized by law.
16. Health Insurance Portability and Accountability Act
Where applicable, to comply with the Health Insurance Portability and Accountability Act (42 USC
1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162, and 164).
17. Incident Reporting
17.1. The recipient shall notify the agency immediately, but no later than forty-eight (48) hours from, the
recipient's awareness or discovery of conditions that may materially affect the recipient or
subcontractor's ability to perform, such as problems, delays or adverse conditions which may impair
the ability to meet the objectives of this contract.
17.2. To immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of a
child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll -free
telephone number (1- 800- 96ABUSE). As required by Chapters 39 and 415, F.S., this provision is
binding upon both the recipient and its employees.
Agenda Item No. 16x12
July 28. 2009
July 2009 Page 5WIF 403.09
18. Sponsorship and Publicity
18.1. As required by section 286.25 F.S., if the recipient is a non - governmental organization which
sponsors a program financed wholly or in part by state funds, including any funds obtained through
this contract, it shall in publicizing, advertising, or describing the sponsorship of the program, state:
"Sponsored by (recipient's name), The Area Agency on Aging for Southwest Florida and the State of
Florida, Department of Elder Affairs." If the sponsorship reference is in written material, the words
"The Area Agency on Aging for Southwest Florida and the State of Florida, Department of Elder
Affairs" shall appear in at least the same size letters or type as the name of the organization.
18.2. The contractor shall not use the words " The Area Agency on Aging for Southwest Florida and the
State of Florida, Department of Elder Affairs" to indicate sponsorship of a program otherwise
financed, unless, specific authorization has been obtained by the agency prior to use.
19. Assignments
19.1. The recipient shall not assign the rights and responsibilities under this Contract without the prior
written approval of the agency, which shall not be unreasonably withheld. Any sublicense,
assignment, or transfer otherwise occurring without prior written approval of the agency will
constitute a material breach of the contract.
19.2. The State of Florida shall at all times be entitled to assign or transfer, in whole or part, its rights,
duties, or obligations under this contract to another governmental agency in the State of Florida,
upon giving prior written notice to the recipient. In the event the State of Florida approves transfer
of the recipient's obligations, the recipient remains responsible for all work performed and all
expenses incurred in connection with the contract.
19.3. This contract shall remain binding upon the successors in interest of either the recipient or the
agency.
20. Subcontracts
20.1. The recipient is responsible for all work performed and for commodities produced pursuant to this
contract, whether actually furnished by the recipient or its subcontractors. Any subcontracts shall
be evidenced by a written document and subject to any conditions of approval the agency deems
necessary. The recipient further agrees that the agency shall not be liable to the subcontractor in
any way or for any reason. The recipient, at its expense, will defend the agency against any such
claims.
20.2. The recipient shall promptly pay any subcontractors upon receipt of payment from the agency or
other state agency. Failure to make payments to any subcontractor in accordance with s. 287.0585,
F.S., unless otherwise stated in the contract between the recipient and subcontractor, will result in a
penalty as provided by statute.
21. Independent Capacity of Recipient
It is the intent and understanding of the parties that the recipient, or any of its subcontractors, are
independent contractors and are not employees of the agency and shall not hold themselves out as
employees or agents of the agency without specific authorization from the agency. It is further
intent and understanding of the parties that the agency does not control the employment practices
of the recipient and shall not be liable for any wage and hour, employment discrimination, or other
labor and employment claims against the recipient or its subcontractors. All deductions for social
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Agenda Item No. 16D12
July 28, 2009
July 2009 Page 10C&F4203.09
security, withholding taxes, income taxes, contributions to unemployment compensation funds and
all necessary insurance for the recipient shall be the sole responsibility of the recipient.
22. Paymen
Payments will be made to the recipient pursuant to s. 215,422, F.S., as services are rendered and
invoiced by the recipient. The agency's Contract Manager will have final approval of the invoice for
payment, and will approve the invoice for payment only if the recipient has met all terms and
conditions of the contract, unless the bid specifications, purchase order, or this contract specify
otherwise. The approved invoice will be submitted to the agency's finance section for budgetary
approval and processing. Disputes arising over invoicing and payments will be resolved in
accordance with the provisions of s. 215.422 F.S. A Vendor Ombudsman has been established with
the Department of Financial Services and may be contacted at (850) 413 -5665.
23. Return of Funds
The recipient will return to the agency any overpayments due to unearned funds or funds
disallowed and any interest attributable to such funds pursuant to the terms and conditions of this
contract that were disbursed to the recipient by the agency. In the event that the recipient or its
independent auditor discovers that an overpayment has been made, the recipient shall repay said
overpayment immediately without prior notification from the agency. In the event that the agency
first discovers an overpayment has been made, the Contract Manager, on behalf of the agency, will
notify the recipient by letter of such findings. Should repayment not be forthwith, the recipient will
be charged at the lawful rate of interest on the outstanding balance pursuant to Section 55.03, F.S.,
after agency notification or recipient discovery.
24. Data Integrity and Safeguarding Information
The recipient shall insure an appropriate level of data security for the information the recipient is
collecting or using in the performance of this contract. An appropriate level of security includes
approving and tracking all recipient employees that request system or information access and
ensuring that user access has been removed from all terminated employees. The recipient, among
other requirements, must anticipate and prepare for the loss of information processing capabilities.
All data and software must be routinely backed up to insure 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 recipient shall insure all subcontractors maintain written
procedures for computer system back -up and recovery. The recipient shall complete and sign
ATTACHMENT IV prior to the execution of this contract.
25. Conflict of Interest
The recipient will establish safeguards to prohibit employees, board members, management and
subcontractors from using their positions for a purpose that constitutes or presents the appearance
of personal or organizational conflict of interest or personal gain. No employee, officer or agent of
the recipient or subcontractor shall participate in selection, or in the award or administration of an
agreement supported by State or Federal funds if a conflict of interest, real or apparent, would be
involved. Such a conflict would arise when: (a) the employee, officer or agent; (b) any member of
his /her immediately family; (c) his or her partner, or; (d) an organization which employs, or is about
to employ, any of the above has a financial or other interest in the firm selected for award. The
recipient or subcontractor's officers, employees or agents will neither solicit nor accept gratuities,
Agenda Item No. 16D12
July 28. 2009
July 2009 Page 11.#F 303.09
favors or anything of monetary value from contractors, potential contractors, or parties to
subcontracts. The recipient's board members and management must disclose to the agency any
relationship which may be, or may be perceived to be, a conflict or interest within thirty (30) days of
an individual's original appointment or placement in that position, or if the individual is serving as
an incumbent, within thirty (30) days of the commencement of this contract. The recipient's
employees and subcontractors must make the same disclosures described above to the recipient's
board of directors. Compliance with this provision will be monitored.
26. Public Entity Crime
Pursuant to s. 287.133, F.S., the following restrictions are placed on the ability of persons convicted
of public entity crimes to transact business with the agency. A person or affiliate who has been
placed on the convicted vendor list following a conviction for a public entity crime may not submit a
bid, proposal, or reply on a contract with a public entity for the construction or repair of a public
building or public work; may not submit bids, proposals, or replies on leases of real property to a
public entity; may not be awarded or perform work as a contractor, supplier, subcontractor, or
consultant under a contract with any public entity; and may not transact business with any public
entity in excess of the threshold amount provided in 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.
27. Purchasing
27.1. To purchase articles which are the subject of or are required to carry out this contract from Prison
Rehabilitative Industries and Diversified Enterprises, Inc., (PRIDE) identified under Chapter 946,
F.S., in the same manner and under the procedures set forth in subsections 946.515(2) and (4), F.S.
For purposes of this contract, the recipient shall be deemed to be substituted for the agency insofar
as dealings with PRIDE. This clause is not applicable to subcontractors unless otherwise required by
law. An abbreviated list of products /services available from PRIDE may be obtained by contacting
PRIDE (800) 643 -8459.
27.2. To procure any recycled products or materials, which are the subject of or are required to carry out
this contract, in accordance with the provisions of sections 403.7065 and 287.045, F.S.
28. Patents. CopWg ts. Royalties
If any discovery, invention or copyrightable material is developed or produced in the course of or as
a result of work or services performed under this contract, the recipient shall refer the discovery,
invention or material to the agency to be referred to the Department of State. Any and all patent
rights or copyrights accruing under this contract are hereby reserved to the State of Florida in
accordance with Chapter 286, F.S.
29. Emerggnncy Preparedness and Continuity of Operations
29.1. If the tasks to be performed pursuant to this contract, include the physical care and control of clients,
or the administration and coordination of services necessary for client health, safety or welfare, the
recipient shall within 30 days of the execution of this contract, submit to the Contract Manager
verification of an emergency preparedness plan. In the event of an emergency, the recipient shall
notify the agency of emergency provisions.
Agenda Item No. 16D12
July 28,,, 403.09
July 2009 Page 1 _ff�r44
29.2. In the event, a situation results in a cessation of services by a subcontractor, the recipient will retain
responsibility for performance under this contract and must follow procedures to ensure continuit
of operations without interruption.
30. PUR 1000 Form
The PUR 1000 Form is hereby incorporated by reference. In the event of any conflict between the
PUR 1000 Form and any terms or conditions of this contract the terms or conditions of this contract
shall take precedence over the PUR 1000 Form. However, if the conflicting terms or conditions in
the PUR 1000 Form are required by any section of the Florida Statutes, the terms or conditions
contained in the PUR 1000 Form shall take precedence.
31. Use of State Funds to Purchase or Improve Real Property
Any state funds provided for the purchase of or improvements to real property are contingent upon
the recipient or political subdivision granting to the state a security interest in the property at least
to the amount of state funds provided for at least 5 years from the date of purchase or the
completion of the improvements or as further required by law.
32. Dispute Resolution
Any dispute concerning performance of the contract shall be decided by the Contract Manager, who
shall reduce the decision to writing and serve a copy on the recipient.
33. 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.
34. Venue
If any dispute arises out of this contract, the venue of such legal recourse will be Lee County, Florida.
35. Entire Contract
This contract contains all the terms and conditions agreed upon by the parties. No oral agreements
or representations shall be valid or binding upon the agency or the recipient unless expressly
contained herein or by a written amendment to this contract.
36. Force Majeure
Neither party shall be liable for any delays or failures in performance due to circumstances beyond
its 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.
37. 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.
38. Condition Precedent to Contract: Appropriations
The parties agree that the agency's performance and obligation to pay under this contract is
contingent upon an annual appropriation by the Legislature. In the event such an appropriation is
not made, the recipient shall not be entitled to file a claims bill.
Agenda Item No. 16D12
July 28, 2009
July 2009 Page 1 �# 203.09
39. Addition ./Deletion
1 The parties agree that the agency reserves the right to add or to delete any of the services required
under this contract when deemed to be in the State's best interest. The parties shall negotiate
compensation for any additional services added.
40. Waiver
The delay or failure by the agency to exercise or enforce any of its rights under this contract shall not
constitute or be deemed a waiver of the agency's right thereafter to enforce those rights, nor shall
any single or partial exercise of any such right preclude any other or further exercise thereof or the
exercise of any other right.
41. Compliance
The recipient agrees to abide by all applicable current federal statutes, laws, rules and regulations as
well as applicable current State statutes, laws, rules and regulations. The parties agree that failure of
the recipient to abide by these laws shall be deemed an event of default of the recipient, and subject
the contract to immediate, unilateral cancellation of the contract at the discretion of the agency.
42. Final invoice
The recipient shall submit the final invoice for payment to the agency as specified in Section 3.3.5
(date for final request for payment) of ATTACHMENT I. If the recipient fails to submit final request
for payment by the deadline, then all rights to payment may be forfeited and the agency may not
honor any requests submitted after the aforesaid time period. Any payment due under the terms of
this contract may be withheld until all reports due from the recipient and necessary adjustments
thereto have been approved by the agency.
43. Renegotiations or Modifications
Modifications of the provisions of this contract shall be valid only when they have been reduced to
writing and duly signed by both parties. The rate of payment and the total dollar amount may be
adjusted retroactively to reflect price level increases and changes in the rate of payment when these
have been established through the appropriations process and subsequently identified in the
agency's operating budget.
44. Termination
44.1. This contract may be terminated by either party without cause upon no less than thirty (30)
calendar days notice in writing to the other parry unless a sooner time is mutually agreed upon in
writing. Said notice shall be delivered y U.S. Postal Service or any expedited delivery service that
provides verification of delivery or by hand delivery to the Contract Manager or the representative
of the recipient responsible for administration of the contract.
44.2. In the event funds for payment pursuant to this contract become unavailable, the agency may
terminate this contract upon no less than twenty -four (24) hours notice in writing to the provider.
Said notice shall be delivered by U.S. Postal Service or any expedited delivery service that provides
verification of delivery or by hand delivery to the Contract Manager or the representative of the
recipient responsible for administration of the contract. The agency shall be the final authority as to
the availability and adequacy of funds. In the event of termination of this contract the provider will
be compensated for any work satisfactorily completed.
-° 10
Agenda Item No. 16D12
July 28. 0
July 2009 Page 1 03.09
44.3. This contract may be terminated for cause upon no less than twenty -four (24) hours notice in
writing to the recipient. If applicable, the agency may employ the default provisions in Rule 60A-
1.006(3), F.A.C. Waiver of breach of any provisions of this contract shall not be deemed to be a
waiver of any other breach and shall not be construed to be a modification of the terms and
conditions of this contract. The provisions herein do not limit the agency's right to remedies at law
or in equity.
44.4. Failure to have performed any contractual obligations with the agency in a manner satisfactory to
the agency will be a sufficient cause for termination. To be terminated as a recipient under this
provision, the recipient must have (1) previously failed to satisfactorily perform in a contract with
the agency, been notified by the agency of the unsatisfactory performance and failed to correct the
unsatisfactory performance to the satisfaction of the agency; or (2) had a contract terminated by the
agency for cause.
45. Official Payee and Representatives (Names, Addresses, and Telephone Numbers):
46. All Terms and Conditions Included
This contract and its Attachments, I - X, A and B, and any exhibits referenced in said attachments, together
with any documents incorporated by reference, contain all the terms and conditions agreed upon by the
parties. There are no provisions, terms, conditions, or obligations other than those contained herein, and
11
The recipient name, as shown on page 1 of this
Collier County Housing and Human Services
a.
contract, and mailing address of the official
3301 East Tamiami Trail, Bldg H
payee to whom the payment shall be made is:
Naples, FL 34112
Marcy Krumbine, Director
The name of the contact person and street
Collier County Housing and Human Services
b.
address where financial and administrative
3301 East Tamiami Trail, Bldg H
records are maintained is:
Naples, FL 34112
239 252 -2273
The name, address, and telephone number of
Marcy Krumbine, Director
the representative of the recipient responsible
Collier County Housing and Human Services
C.
for administration of the program under this
3301 East Tamiami Trail, Bldg H
Naples, FL 34112
contract is:
239 252 -2273
The section and location within the Agency
Area Agency on Aging for Southwest Florida,
d.
where Requests for Payment and Receipt and
Inc.
2285 First Street
Expenditure forms are to be mailed is:
Fort Myers, Florida 33901
Leigh Wade - Schield, Executive Director
The name, address, and telephone number of
Area Agency on Aging for Southwest Florida,
e.
the Contract Manager for the Agency for this
Inc.
contract is:
2285 First Street
Fort Myers, Florida 33901
Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall
be provided in writing to the other party and the notification attached to the originals of this
contract.
46. All Terms and Conditions Included
This contract and its Attachments, I - X, A and B, and any exhibits referenced in said attachments, together
with any documents incorporated by reference, contain all the terms and conditions agreed upon by the
parties. There are no provisions, terms, conditions, or obligations other than those contained herein, and
11
Agenda Item No. 16D12
July 28, 2009
July 2009 Page 1 x&03.09
this contract shall supersede all previous communications, representations or agreements, either written or
verbal between the parties.
By signing this contract, the parties agree that they have read and agree to the entire contract
IN WITNESSING THEREOF, the parties hereto have caused this 42 page contract, to be executed by their
undersigned officials as duly authorized.
ATTEST:
DWIGHT E. BROCK, Clerk
Approved as to form and
legal sufficiency:
A opt,
_- 091"_
Assistant County Attorney
FEDERAL ID NUMBER 59- 6000558
FISCAL YEAR -END DATE: 9/30
RECEPIENT:
COLLIER COUNTY HOUSING
AND HUMAN SERVICES
By:
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
Rv:
DONNA FIALA, CHAIRMAN
Date: July 28, 2009
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA, INC.
SIGNED BY:
NAME: Naomi Manning
TITLE: Board President
DATE:
12
July 2009
ATTACHMENT
ATTACHMENT I
ATTACHMENT II
ATTACHMENT III
ATTACHMENT IV
ATTACHMENT V
ATTACHMENT VI
ATTACHMENT VII
ATTACHMENT VIII
ATTACHMENT IX
ATTACHMENT X
ATTACHMENT XI
ATTACHMENT A
ATTACHMENT B
INDEX TO CONTRACT ATTACHMENTS
ATTACHMENT DESCRIPTION
STATEMENT OF WORK
CERTIFICATION REGARDING LOBBYING
FINANCIAL COMPLIANCE AUDIT ATTACHMENT
CERTIFICATION REGARDING DATA INTEGRITY
COMPLIANCE
CERTIFICATION REGARDING DEBARMENT, SUSPENSION,
INELIGIBILITY, AND VOLUNTARY EXCLUSION
ASSURANCES - NON - CONSTRUCTION PROGRAMS
COMMUNITY CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
COMMUNITY CARE FOR THE ELDERLY PROGRAM
RATE SUMMARY
COMMUNITY CARE FOR THE ELDERLY PROGRAM
INVOICE SCHEDULE
REQUEST FOR PAYMENT
RECEIPTS AND EXPENDITURES
DEPARTMENT OF ELDER AFFAIRS PROGRAMS & SERVICES
HANDBOOK (ON CD)
DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS
Agenda Item No. 16D12
July 28, 2009
Page 160fiBI003.09
PAGE
14 -21
22
23 -27
28
29
30 -31
32
33
34
35
36
37
38 -41
Agenda Item No. 16D12
July 28 200
July 2009 Page 103.09
ATTACHMENTI
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC.
STATEMENT OF WORK
COMMUNITY CARE FOR THE ELDERLY PROGRAM
SECTION 1: SERVICES TO BE PROVIDED
1.1 DEFINITION OF TERMS AND ACRONYMS
1.1.1 CONTRACT 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 Tracldng System (CIRTS)
Department of Children and Families (DCF)
Home Care for Disabled Adults (HCDA)
Instrumental Activities of Daily Living (IADL)
Planning and Service Area (PSA)
Web -based Database System (WebDB)
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 or Home Care for Disabled Adults
services to the department's community-based services.
Area Plan: A plan developed by the Area Agency on Aging outlining a comprehensive and coordinated
service delivery system in its planning and service area in accordance with the Section 306 (42 U.S.C. 3026) of
the Older Americans Act and Department of Elder Affairs instructions.
Area Plan Update: A revision to the area plan wherein the Area Agency on Aging enters CCE specific data in
the web -based database system (WebDB). An update may also include other revisions to the area plan as
instructed by the department.
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. AGENCY MISSION STATEMENT
Mission: To help aging adults, 60 and older, achieve greater independence through awareness of resources
and access to qualified service providers.
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.
14
Agenda Item No. 16D12
July 28, 2009
July 2009 Page 1lCCE4203.09
Values: The Agency believes the 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;
• Personal and professional accountability from all stakeholders.
Lead agencies and local service providers as partners and stakeholders in Florida's aging services network
are expected to support the agency's mission, vision, and priorities.
1.2.1. Community Care for the Elderly Program Mission Statement
The Community Care for the Elderly (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.
1.3 GENERAL DESCRIPTION
1.3.1 General Statement
The primary purpose of the CCE program is to prevent, decrease or delay premature or inappropriate and
expensive placement of older persons in nursing homes and other institutions.
1.3.2. Authority
The relevant authority governing Community Care for the Elderly program are:
(1) Rule 58C -1, Florida Administrative Code
(2) Sections 430.201 through 430.207, F.S.
1.3.3. Scope of Service
The Area Agency on Aging is responsible for the programmatic, fiscal and operational management of CCE.
The recipient shall provide services in a manner consistent with and described in the agency's current area
plan update and the current Department of Elder Affairs Programs and Services Handbook, ATTACHMENT A.
1.3.4. Major Program Goals
The major goals of the Community Care for the Elderly program are to preserve the independence of elders
and prevent or delay more costly institutional care through a community care service system that provides
case management and other in -home and community services as needed under the direction of a lead agency
and provide a continuum of service alternatives that meet the diverse needs of functionally impaired elders.
1.4. INDIVIDUALS TO BE SERVED
1.4.1. Eligibility
In order to receive services under this contract, an applicant must:
(1) Be at least 60 years of age; and
(2) Be functionally impaired as determined through the initial comprehensive assessment.
15
Agenda Item No. 16D12
July 2009 Page 18� 03.09
With the exception of Adult Protective Services (APS) high risk referrals, consumers may not be dually
enrolled in the Community Care for the Elderly (CCE) program and a Medicaid capitated long -term care
program.
1.4.2. Targeted Groups
Priority for services provided under this contract shall be given to those eligible persons assessed to be at risk
of placement in an institution or who are abused, neglected or exploited.
SECTION II — MANNER OF SERVICE PROVISION
2.1. SERVICE TASKS
In order to achieve the goals of the CCE program, the recipient shall ensure the following tasks are performed:
(1) Client Eligibility Determination as listed in ATTACHMENT I, SECTION 1.4;
(2) Assessment and Prioritization of Service Delivery for New Clients;
(3) Delivery of Services to Eligible Clients; and
In addition, the recipient shall monitor the performance of its contractors.
2.1.1. Adult Protective Services High -Risk Referrals
Adult Protective Services (APS) high -risk referrals who are enrolled in a Medicaid capitated long -term care
program at the time of referral may receive crisis - resolving CCE funded services only under the following
circumstances:
(1) The long -term care program provider is contacted regarding the referral as soon as it is received;
(2) The CCE lead agency receives notification from the long -term care program provider that the long -term
program in which the consumer is enrolled will address the consumer's needs; and
(3) The CCE lead agency may only provide services until the crisis is resolved.
2.1.2. Assessment and Prioritization of Service Delivery for New Clients
The following are the criteria to prioritize new clients for service delivery. It is not the intent of the agency to
remove existing clients from services in order to serve new clients being assessed and prioritized for service
delivery.
2.1.2.1. Abuse Neglect and Exploitation
The contractor will ensure that pursuant to Section 430.205(5), Florida Statutes, those elderly persons who
are determined by adult protective services to be victims of abuse, neglect, or exploitation who are in need of
immediate services to prevent further harm and are referred by adult protective services, will be given
primary consideration for receiving CCE services. As used in this subsection, "primary consideration" means
that an assessment and services must commence within 72 hours after referral to the department or as
established in accordance with agency contracts by local protocols developed between Department of Elder
Affairs service recipients and adult protective services.
2.1.2.3. Priority Criteria for Service Delivery:
(1) Individuals in nursing homes under Medicaid who could be transferred to the community;
(2) Individuals in nursing homes whose Medicare coverage is exhausted and may be diverted to the
community;
(3) Individuals in nursing homes that are closing and can be discharged to the community; or
(4) Individuals whose mental or physical health condition has deteriorated to the degree that self care is not
possible, there is no capable caregiver, and institutional placement will occur within 72 hours;
(5) For the purpose of transitioning individuals receiving Community Care for the Disabled Adults (CCDA)
and Home Care for Disabled Adults (HCDA) services through the Department of Children and Families (DCF)
16
Agenda Item No. 16D12
July 2009 July 28. 2009
Page 2T�04303.09
Adult Services to community -based services provided through the department, when services are not
currently available, Area Agency on Aging staff and lead agency case managers shall ensure that "Aging Out"
individuals are prioritized for services only after Adult Protective Services (APS) High Risk and Imminent
Risk individuals.
2.1.2.4. Priority Criteria for Service Delivery for Other Assessed Individuals:
The assessment and provision of services should always consider the most cost effective means of service
delivery. Service priority for individuals not included in groups one, two, or three above, regardless of
referral source, shall be determined through the Department of Elder Affairs' client assessment form
administered to each applicant, to the extent funding is available. First priority will be given to applicants at
the higher levels of frailty and risk of nursing home placement. For individuals assessed at the same priority
and risk of nursing home placement, priority will be given to applicants with the lesser ability to pay for
services.
2.1.2.5. Referrals for Medicaid Waiver Services:
(1) The recipient must require subcontractors, through the client assessment, to identify potential Medicaid
eligible CCE clients and to refer these individuals for application for Medicaid Waiver services.
(2) Individuals who have been identified as being potentially Medicaid Waiver eligible are required to apply
for Medicaid Waiver services in order to receive CCE services and can only receive CCE services while the
Medicaid Waiver eligibility is pending. If the client is found ineligible for Medicaid Waiver services for any
reason other than failure to provide required documentation, then the individual may continue to receive CCE
services.
(3) Individuals who have been identified as being potentially Medicaid Waiver eligible must be advised of the
responsibility to apply for Medicaid Waiver services as a condition of receiving CCE services while the
eligibility determination is being processed.
2.1.3 Delivery of Service to Eligible Clients
The recipient shall provide a continuum of service that meet the diverse needs of functionally impaired
elders. The recipient shall perform and report performance of the following services in accordance with the
current Department of Elder Affairs Programs and Services Handbook. The services include the following
categories:
(1) Core Services;
(2) Health Maintenance Services; and
(3) Other Support Services
2.1.3.1. Core Services
Core Services include a variety of home - delivered services, day care services, and other basic services that are
most needed to prevent unnecessary institutionalization.
(1) Adult Day Care (9) Homemaker
(2) Case Aid (10) Housing Improvement
(3) Case Management (11) Legal Assistance
(4) Chore Services (12) Pest Control Services
(S) Companionship (13) Respite Services
(6) Escort (14) Shopping Assistance; and
(7) Financial Risk Reduction (15) Transportation
(8) Home Delivered Meals
2.1.3.2. Health Maintenance Services
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
17
Agenda Item No. 16D12
July 28 ' 03.09
July 2009 Page 2 T_b'4
prevention services, personal care services, home health aide services, home nursing services, and emergency
response systems.
(1) Adult Day Health Care
(8) Nutrition Counseling
(2) Emergency Alert Response
(9) Occupational Therapy
(3) Gerontological Counseling
(10) Personal Care
(4) Health Support
(11) Physical Therapy
(5) Home Health Aide
(12) Skilled Nursing Services
(6) Medication Management
(13) Specialized Medical Equipment, Services
(7) Mental Health Counseling /Screening
and Supplies; and
(14) Speech Therapy
2.1.3.3. Other Support Services
Support Services expand the continuum of care options to assist functionally impaired elders and their
caregivers.
(1) Caregiver Training /Support
(2) Intake
(3) Material Aid; and
(4) Other
2.1.4. Monitoring the Performance of Subcontractors
The recipient shall conduct at least one monitoring per year of each subcontractor. The recipient shall
perform fiscal, administrative and programmatic monitoring of each subcontractor to ensure contractual
compliance, fiscal accountability, programmatic performance, and compliance with applicable state and
federal laws and regulations.
2.2. SERVICE LOCATION AND EQUIPMENT
2.2.1. Service Times
The recipient 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, 8:00am to 5:00pm.
2.3 Equipment
2.3.1 Equipment means: (a) an article of nonexpendable, tangible personal property having a useful life of
more than one year and an acquisition cost which equals or exceeds the lesser of (a) the
capitalization level established by the organization for the financial statement purposes, or $5,000
[for federal funds], or nonexpendable, tangible personal property of a nonconsumable nature with
an acquisition cost of $1,000 or more per unit, and expected useful life of at least one year; and
hardback bound books not circulated to students or the general public, with a value or cost of $250
or more [for state funds].
2.3.2. Contractors and sub - contractors who are Institutions of Higher Education, Hospitals, and Other Non -
Profit Organizations shall have written property management standards incompliance with 2 CFR
Part 215 Administrative Requirements (formerly OMB Circular A -110) that include: (a) a property
list with all the elements identified in the circular; and (b) a procedure for conducting a physical
inventory of equipment at least once every two years. The property records must be maintained on
file and shall be provided to the agency upon request.
2.3.3. The recipient's property management standards for equipment acquired with public funds and federally -
owned equipment shall include accurately maintained equipment records with the following information.
18
July 2009
Agenda Item No. 16D12
July 28. 2009
Page 2Sg03.09
(1) A description of the equipment
(2) Manufacturer's serial number, model number, Federal stock number, national stock number, or other
identification number
(3) Source of the equipment, including the award number
(4) Whether title vests in the recipient or the Federal Government
(5) Acquisition date (or date received, if the equipment was furnished by the Federal Government) and cost
(6) Information from which one can calculate the percentage of Federal participation in the cost of the
equipment (not applicable to equipment furnished by the Federal Government)
(7) Location and condition of the equipment and the date the information was reported
(8) Unit acquisition cost; and
(9) Ultimate disposition data, including date of disposal and sales price or the method used to determine
current fair market value where a recipient compensates the Federal awarding agency for its share.
2.3.4 Equipment purchased with federal funds with an acquisition cost over $5,000 and equipment purchased with
state funds with an acquisition cost over $1,000 that is part of the cost of carrying out the activities and
functions of the grant awards and Title (ownership) will vest with the recipient, subject to the conditions of 2
CFR Part 215 Administrative Requirements (formerly OMB Circular A -110), Subpart C, paragraph 34.
Equipment purchased under these thresholds is considered supplies and is not subject to property standards.
Equipment purchased with state funds identified in the budget attachments to agreements covered by this
contract, or identified in the sub - agreements with sub - contractors (not included in a cost methodology), is
subject to the conditions of section 273, F.S. and 60A- 1.0017, F.A.C. or Title 45 CFR part 74.
2.3.5. The recipient shall not dispose of any equipment or materials provided by the agency, or purchased with
funds provided through this contract without first obtaining the approval of the agency's Contract Manager.
When disposing of property or equipment the recipient must submit a written request for disposition
instructions to the respective Contract Manager. The request should include a brief description of the
property, purchase price, funding source, percentage of state or federal participation, acquisition date and
condition of the property. The request should also indicate the recipient's proposed disposition (i.e. transfer
or donation to another agency that administers federal programs, offer the item for sale, destroy the items,
etc.).
2.3.6. The agency's Contract Manager will issue disposition instructions. If disposition instructions are not received
within 120 days of the written request for disposition, the recipient is authorized to proceed as directed in 2
CFR Part 215 Administrative Requirements (formerly OMB Circular A -110).
2.3.7. Real property means land (including land improvements), buildings, structures and appurtenances thereto,
but excludes movable machinery and equipment Real property may not be purchased with state or federal
funds through agreements covered under this contract without the prior approval of the agency. Real
property purchases from Older Americans Act funds are subject to the provisions of Title 42, Chapter 35,
Subchapter III, Part A, Section 3030b United States Code (USC). Real property purchases from state funds can
only be made through a fixed capital outlay grants and aids appropriation and therefore are subject to the
provisions of section 216.348, F.S.
2.3.8. Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted and tested
prior to disposal to ensure no confidential information remains.
2.3.9. The recipient must adhere to the agency's procedures and standards when purchasing Information
Technology Resources (ITR) as part of any agreement(s) incorporating this contract by reference. An ITR
worksheet is required for any computer related item costing $1,000 or more, including data processing
19
Agenda Item No. 16D12
July 28 200
July 2009 Page 2 03.09
hardware, software, services, supplies, maintenance, training, personnel and facilities. The completed ITR
worksheet shall be maintained in the LAN administrator's file and must be provided to the agency upon
request. The recipient has the responsibility to require any subcontractors to comply with the agency's ITR
procedures.
2.4 DELIVERABLES
2.4.1 Service Unit
.The recipient shall provide the services described in this contract in accordance with the Department of Elder
Affairs Programs and Services Handbook The chart below lists the services that can be performed and the
unit of measurement:
Service
Unit of Service
Adult Day Care Health Support
Case Aid Home Health Aide
Case Management Medication Management
Chore Services Mental Health Counseling/Screening
Companionship Nutrition Counseling
Escort Occupational Therapy
Hour
Financial Risk Reduction Personal Care
Homemaker Physical Therapy
Housing Improvement Skilled Nursing Services
Legal Assistance Speech Therapy
Respite Services Caregiver Training/Support
Adult Day Health Care Intake
Gerontological Counseling
Emergency Alert Response
Da
Material Aid
Medication Management
Pest Control Services
Episode
Other
Specialized Medical Equipment, Services and Supplies
Escort
Shopping Assistance
One -Way Trip
Transportation
Home Delivered Meals
Meal
2.5. REPORTS
The recipient is responsible for responding in a timely fashion to additional routine and /or special requests
for information and reports required by the agency. The recipient must establish due dates for any
subcontractors that permit the recipient to meet the agency's reporting requirements. Reports and
information that the recipient shall provide to the agency include, but are not limited to:
Client Information and Registration Tracking System (CIRTS)
The recipient is required to use CIRTS reports in the web -based CIRTS database system to ensure CIRTS data
accuracy. The report categories include:
20
July 2009
(1) Client Reports
(2) Monitoring Reports
(3) Services Reports
(4) Miscellaneous Reports
(5) Fiscal Reports
(6) Aging Resource Center Reports
(7) Outcome Measurement Reports
Service Cost Reports
Agenda Item No. 16D12
Page i8 a�03.09
The recipient shall require its subcontractors to submit to it the recipient semi - annual service cost reports,
which reflect actual cost of providing each service by program. This report provides information for planning
and negotiating unit rates.
Surplus /deficit Report
The recipient will submit a consolidated surplus /deficit report in a format provided by the agency to the
agency's Contract Manager by the 18th of each month. This report is for all agreements and /or contracts
between the recipient and the agency. The report will include the following:
(1) A list of all subcontractors and their current status regarding surplus or deficit
(2) The recipient's detailed plan on how the surplus or deficit spending exceeding the threshold specified by
the agency will be resolved.
(3) Recommendations to transfer funds to resolve the surplus /deficit spending
(4) Input from the recipient's Board of Directors on resolution of spending issues, if applicable
(5) Number of clients currently on Assessed Priority Consumer List (APCL) that receive a priority ranking
score of 4 or 5; and
(6) Number of clients currently on the APCL designated as Imminent Risk
2.6. RECORDS AND DOCUMENTATION
2.6.1 The recipient shall ensure the collection and maintenance of client and service information on a monthly
basis from the Client Information and Registration Tracking System (CIRTS) or any such system designated
by the agency. Maintenance includes valid exports and backups of all data and systems according to agency
standards.
2.6.2. Each recipient and subcontractor, among other requirements, must anticipate and prepare for the loss of
information processing capabilities. The routine backing up of all data and software is required to recover
from losses or outages of the computer system. Data and software essential to the continued operation of
recipient 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 recipient shall maintain written policies and procedures for computer
system backup and recovery and shall have the same requirement in its contracts and /or agreements with
subcontractors. These policies and procedures hall be made available to the agency upon request.
21
Agenda Item No. 16D12
July 28 03.09
July 2009 Page 2� 4
2.7 PERFORMANCE SPECIFICATIONS
2.7.1 Outcomes
(1) The recipient shall timely submit to the agency all reports described in ATTACHMENT I, SECTION 2.5
REPORTS;
(2) The recipient shall timely submit to the agency all information described in ATTACHMENT I, SECTION
2.6, RECORDS AND DOCUMENTATION;
(3) The recipient shall ensure provision of services in this contract in accordance with the current
Department of Elder Affairs Programs and Services Handbook, ATTACHMENT A.
2.7.2. The performance of the recipient in providing the services described in this contract shall be measured by the
current Area Plan strategies for the following criteria:
(1) Percent of most frail elders who remain at home or in the community instead of going into a nursing
home
(2) Percent of Adult Protective Services (APS) referrals who are in need of immediate services to prevent
further harm who are served within 72 hours.
(3) Average monthly savings per consumer for home and community -based care versus nursing home care
for comparable group clients
(4) Percent of elders assessed with high or moderate risk environments who improved their environment
score
(5) Percent of new service recipients with high -risk nutrition scores whose nutritional status improved
(6) Percent of new service recipients whose ADL assessment score has been maintained or improved
(7) Percent of new service recipients whose IADL assessment score has been maintained or improved
(8) Percent of family and family- assisted caregivers who self -report they are likely to provide care
(9) Percent of caregivers whose ability to provide care is maintained or improved after one year of service
intervention (as determined by the caregiver and the assessor)
(10) Average time in the Community Care for the Elderly Program for Medicaid Waiver probable customers
(11) Percent of customers who are at imminent risk of nursing home placement who are served with
community based services
2.7.3. Monitoring and Evaluation Methodology
The department will review and evaluate the performance of the contractor under the terms of this contract.
Monitoring shall be conducted through direct contact with the recipient through telephone, in writing, or an
on -site visit. The agency's determination of acceptable performance shall be conclusive. The contractor
agrees to cooperate with the agency in monitoring the progress of completion of the service tasks and
deliverables.
2.8. RECIPIENT'S FINANCIAL OBLIGATIONS
2.8.1. Matching, Level of Effort, and Earmarking Requirements
The recipient 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 contract period, all CCE
funds expended must be properly matched. State funds cannot be used to match another state - funded
program.
2.8.2. Cost Sharing and Co- payments
The agency will ensure the recipient establishes annual co- payments goals. The agency has the option to
withhold a portion of the recipient's Request for Payment if goals are not met according to the agency's and
department's co- payment guidelines.
22
Agenda Item No. 16D12
July 28
July 2009 Page 2� 03.09
Co- payments include only the amounts assessed consumers or the amounts consumers opt to contribute in
lieu of an assessed co- payment. The contribution must be equal to or great than the assessed co- payment.
Co- payments collected in the CCE program can be used as part of the local match.
2.8.3. Use of Service Dollars and Assessed Priority Consumer List Management
The recipient is expected to spend all federal, state and other funds provided by the agency, for the purpose
specified in each contract. The recipient must manage the service dollars in such a manner so as to avoid
having a wait list and a surplus of funds at the end of the contract period, for each program managed by the
recipient If the agency determines that the recipient is not spending service funds accordingly, the agency
may transfer funds to other planning and service areas during the contract period and /or adjust subsequent
funding allocations accordingly, as allowable under state and federal law.
2.8.4. The recipient agrees to distribute funds as detailed in ATTACHMENT VII, the Budget Summary, and
ATTACHMENT VIII, the Rate Summary, to this contract. Any changes in the total amounts of the funds
identified on the Budget Summary form require a contract amendment.
2.9 AGENCY RESPONSIBILITIES
2.9.1. Program Guidance and Technical Assistance
The agency shall provide to the recipient guidance and technical assistance as needed to ensure the successful
completion of the contract by the recipient.
2.9.2. Contract Monitoring
The agency shall, at its own discretion, conduct monitoring concerning any aspect of the recipient's
performance of this contract.
SECTION III: METHOD OF PAYMENT
3.1. General Statement of Method of Payment
The method of payment for this contract includes advances, cost reimbursement for administration costs, and
fixed rate for services. The recipient shall ensure fixed rates for services include only those costs that are in
accordance with all applicable state and federal statutes and regulations and are based on audited historical
costs in instances where an independent audit is required. The recipient shall consolidate all requests for
payment from subcontractors and expenditure reports that support requests for payment and shall submit to
the agency on forms 106C (ATTACHMENT X) and 105C (ATTACHMENT XI)
3.1.1. The recipient agrees to implement the distribution of funds as detailed in ATTACHMENT VII, Budget
Summary. An amendment is required to change the total amount of the contract.
3.2 Advance Payments
3.2.1 The recipient may request up to two months of advances at the start of the contract period to cover program
administrative and service costs. The payment of an advance will be contingent upon the sufficiency and
amount of funds released to the agency by the State of Florida ( "budget release "). The recipient shall provide
the agency's Contract Manager with documentation justifying the need for an advance and describing how the
funds will be distributed.
3.2.2. The recipient's requests for advance require the approval of the agency's Contract Manager. If sufficient
budget is available, the agency will issue approved advance payments after July 1, 2009.
23
Agenda Item No. 16D12
July 28, 2009
July 2009 Page 2�CCAZ03.09
3.2.3. Requests for the third through the twelfth months shall be based on the submission of actual monthly
expenditure reports beginning with the first month of the contract. The schedule for submission of advance
requests, of available, is shown on ATTACHMENT IX to this contract.
3.2.4 All advance payments made to the recipient shall be recouped in accordance with the Invoice Schedule,
ATTACHMENT IX, to this contract.
3.2.5. The recipient may temporarily place advanced funds in an insured interest bearing account. All interest
earned on contract fund advances must be returned to the agency within thirty (30) days of the end of each
quarter of the contract period.
3.3 Invoice Submittal and Requests for Payment
All requests for payment and expenditure reports submitted to support requests for payment shall be on
DOEA forms 106C (ATTACHMENT X) and 105C (ATTACHMENT XI). Duplication or replication of both
forms via data processing equipment is permissible, provided that all data elements are in the same format as
included on Department of Elder Affairs' forms.
3.3.1. All payment requests shall be based on the submission of actual monthly expenditure reports beginning with
the first month of the contract. The schedule for submission of advance requests (when available) and
invoices is ATTACHMENT IX to this contract.
3.3.2 Any payment due by the agency under the terms of this contract may be withheld pending the receipt and
approval by the agency of all financial and programmatic reports due from the recipient and any adjustments
thereto, including any disallowance not resolved as outlined in section 22 of this contract
3.3.3. Payment may be authorized only for allowable expenditures, which are in accord with the limits specified in
ATTACHMENT VII.
3.3.4. Date for Final Request For Budget Revisions
Final requests for budget revisions or adjustments to contract funds based on expenditures for services
provided through June 30, 2010, must be submitted to the agency's Contract Manager by July 10, 2010.
3.3.5. Date for Final Request for Payment
The final request for payment will be due to the agency no later than August 10, 2010.
3.4. Documentation for Payment
The recipient shall maintain documentation to support payment requests that shall be available to the agency
or authorized individuals upon request Such documentation shall be provided upon request to the agency or
the Department of Financial Services.
3.4.1 The agency will require recipients to enter all required data per the Department of Elder Affair' CIRTS Policy
Guidelines for clients and services in the CIRTS database. The data must be entered into the CIRTS before the
recipients submit their requests for payment and expenditure reports to the recipient. The recipient shall
establish time frames to assure compliance with due dates for the requests for payment and expenditure
reports to the agency.
3.4.2. The agency will require recipients to run monthly CIRTS reports and verify client and service data in the
CIRTS is accurate. This report must be submitted to the agency with the monthly request for payment and
expenditure report and must be reviewed by the agency before the recipient's request for payment and
expenditure reports can be approved by the agency.
24
July 2009
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND
AGREEMENTS
L
Agenda Item No. 16D12
July 28
Page 2103.09
ATTACHMENT II
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 or federal agency, 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 legislature, 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 contract, 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 any agency, a member of congress, an officer
or employee of congress, or an employee of a member of congress in connection with this federal contract,
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) If any funds other than federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a member of congress, an officer
or employee of congress, or an employee of a member of congress in connection with this federal contract,
grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form -LLL,
"Disclosure Form to Report Lobbying," in accordance with its instructions.
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 $10,000.00 and not more than $100,000.00 for each such failure.
Signature
Donna Fiala, Chairman
Name of Authorized Individual
Collier County Board of County Commissioners
3301 Tamiami Trail East
Naples, Florida 34112
Name Address of Organization
i�lW{/t--
Assistant County Attorney
DOEA Form 103
(Revised Nov 2002)
July 28, 2009
Date:
CCE 203.09
Application or Agreement Number
PW
ATTEST:
DWIGHT E. BROCK, Lief. -k
Agenda Item No. 16D12
July 28. 2009
July 2009 Page 2�W A ?03.09
ATTACHMENT III
FINANCIAL AND COMPLIANCE AUDIT
The administration of resources awarded by the Area Agency on Aging of Southwest Florida, Inc. to the provider may
be subject to audits and /or monitoring by the Area Agency on Aging of Southwest Florida, Inc., as described in this
section.
MONITORING
In addition to reviews of audits conducted in accordance with OMB Circular A -133, as revised, and Section 215.97,
F.S., (see "AUDITS below), monitoring procedures may include, but not be limited to, on -site visits by the Agency
staff, limited scope audits as defined by OMB Circular A -133, as revised, and /or other procedures. By entering into
this agreement, the provider agrees to comply and cooperate with any monitoring procedures/ processes deemed
appropriate by the Area Agency on Aging of Southwest Florida, Inc. In the event the Area Agency on Aging of
Southwest Florida, Inc. determines that a limited scope audit of the provider is appropriate, the provider agrees to
comply with any additional instructions provided by the Area Agency on Aging of Southwest Florida, Inc. to the
provider regarding such audit. The provider further agrees to comply and cooperate with any inspections, reviews,
investigations, or audits deemed necessary by the Director of Finance of the Area Agency on Aging of Southwest
Florida, Inc.
AUDITS
PART 1: FEDERALLY FUNDED
This part is applicable if the provider is a State or local government or a non - profit organization as defined in OMB
Circular A133, as revised.
In the event that the provider expends $500,000.00 or more in Federal awards during its fiscal year, the provider
must have a single or program - specific audit conducted in accordance with the provisions of OMB Circular A -133, as
revised. EXHIBIT 1 to this agreement indicates Federal resources awarded through the Department of Elder Affairs
by this agreement. In determining the Federal awards expended in its fiscal year, the provider shall consider all
sources of Federal awards, including Federal resources received from the Department of Elder Affairs. The
determination of amounts of Federal awards expended should be in accordance with the guidelines established by
OMB Circular A -133, as revised. An audit of the provider conducted by the Auditor General in accordance with the
provisions of OMB Circular A -133, as revised, will meet the requirements of this part.
In connection with the audit requirements addressed in Part I, paragraph 1, the provider shall fulfill the requirements
relative to auditee responsibilities as provided in Subpart C of OMB Circular A -133, as revised.
If the provider expends less than $500,000.00 in Federal awards in its fiscal year, an audit conducted in accordance
with the provisions of OMB Circular A -133, as revised, is not required. In the event that the provider expends less
than $500,000.00 in Federal awards in its fiscal year and elects to have an audit conducted in accordance with the
provisions of OMB Circular A133, as revised, the cost of the audit must be paid from non - Federal resources (i.e., the
cost of such audit must be paid from provider resources obtained from other than Federal entities.)
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Area Agency on Aging of Southwest Florida, Inc. shall be based on
the agreement's requirements, including any rules, regulations, or statutes referenced in the agreement. The financial
statements shall disclose whether or not the matching requirement was met for each applicable agreement. All
questioned costs and liabilities due to the Area Agency on Aging of Southwest Florida, Inc. shall be fully disclosed in
the audit report with reference to the Area Agency on Aging of Southwest Florida, Inc. agreement involved. If not
otherwise disclosed as required by Section .310(b)(2) of OMB Circular A -133, as revised, the schedule of
expenditures of Federal awards shall identify expenditures by agreement number for each agreement with the
26
W
Agenda Item No. 16D12
July 28. 2009
July 2009 Page YC 03.09
Department of Elder Affairs in effect during the audit period. Financial reporting packages required under this part
must be submitted within the earlier of 30 days after receipt of the audit report or 9 months after the end of the
provider's fiscal year end.
PART II: STATE FUNDED
This part is applicable if the provider is a nonstate entity as defined by Section 215.97(2), Florida Statutes.
In the event that the provider expends a total amount of state financial assistance equal to or in excess of $500,000.00
in any fiscal year of such provider (for fiscal years ending September 30, 2004 or thereafter), the provider must have
a State single or project - specific audit for such fiscal year in accordance with Section 215.97, Florida Statutes;
applicable rules of the Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650
(nonprofit and for -profit organizations), Rules of the Auditor General. EXHIBIT I to this agreement indicates state
financial assistance awarded through the Department of Elder Affairs by this agreement. In determining the state
financial assistance expended in its fiscal year, the provider shall consider all sources of state financial assistance,
including state financial assistance received from the Department of Elder Affairs, other state agencies, and other
nonstate entities. State financial assistance does not include Federal direct or pass- through awards and resources
received by a nonstate entity for Federal program matching requirements.
In connection with the audit requirements addressed in Part I1, paragraph 1, the provider shall ensure that the audit
complies with the requirements of Section 215.97(8), Florida Statutes. This includes submission of a financial
reporting package as defined by Section 215.97(2), Florida Statutes, and Chapter 10.550 (local governmental entities)
or 10.650 (nonprofit and for - profit organizations), Rules of the Auditor General.
If the provider expends less than $500,000.00 in state financial assistance in its fiscal year (for fiscal years ending
September 30, 2004 or thereafter), an audit conducted in accordance with the provisions of Section 215.97, Florida
Statutes, is not required. In the event that the provider expends less than $500,000.00 in state financial assistance in
its fiscal year and elects to have an audit conducted in accordance with the provisions of Section 215.97, Florida
Statutes, the cost of the audit must be paid from the nonstate entity's resources (i.e., the cost of such an audit must b
paid from the provider resources obtained from other than State entities).
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Area Agency on Aging of Southwest Florida, Inc. shall be based on
the agreement's requirements, including any applicable rules, regulations, or statutes. The financial statements shall
disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and
liabilities due to the Area Agency on Aging of Southwest Florida, Inc. shall be fully disclosed in the audit report with
reference to the Area Agency on Aging of Southwest Florida, Inc. agreement involved. If not otherwise disclosed as
required by Rule 69I- 5.003, Fla. Admin. Code, the schedule of expenditures of state financial assistance shall identify
expenditures by agreement number for each agreement with the Area Agency on Aging of Southwest Florida, Inc. in
effect during the audit period. Financial reporting packages required under this part must be submitted within 45
days after delivery of the audit report, but no later than 12 months after the provider's fiscal year end for local
governmental entities. Non -profit or for - profit organizations are required to be submitted within 45 days after
delivery of the audit report, but no later than 9 months after the provider's fiscal year end. Notwithstanding the
applicability of this portion, the Area Agency on Aging of Southwest Florida, Inc. retains all right and obligation to
monitor and oversee the performance of this agreement as outlined throughout this document and pursuant to law.
PART III: REPORT SUBMISSION
Copies of reporting packages for audits conducted in accordance with OMB Circular A -133, as revised, and required
by PART I of this agreement shall be submitted, when required by Section .320 (d), OMB Circular A -133, as revised,
by or on behalf of the provider directl to each of the following:
27
July 2009
The Area Agency on Aging for Southwest Florida, Inc. at each of the following addresses:
Leigh Wade - Schield, Executive Director
Area Agency on Aging for Southwest Florida, Inc.
2285 First Street
Fort Myers, Florida 33901
Agenda Item No. 16D12
July 28. 2009
Page 3fff4903.09
The Federal Audit Clearinghouse designated in OM13 Circular A -133, as revised (the number of copies required by
Sections .320 (d)(1) and (2), OMB Circular A -133, as revised, should be submitted to the Federal Audit
Clearinghouse), at the following address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10th Street
Jefferson, IN 47132
Other Federal agencies and pass- through entities in accordance with Sections .320 (e) and (0, OMB Circular A -133, as
revised.
Pursuant to Sections .320(f), OMB Circular A -133, as revised, the provider shall submit a copy of the reporting
package described in Section .320(c), OMB Circular A -133, as revised, and any management letter issued by the
auditor, to The Area Agency on Aging of Southwest Florida, Inc. at each of the following addresses:
Leigh Wade- Schield, Executive Director
Area Agency on Aging for Southwest Florida, Inc.
2285 First Street
Fort Myers, Florida 33901
Additionally, copies of financial reporting packages required by Part II of this agreement shall be submitted by or on
behalf of the provider directl to each of the following:
The Area Agency on Aging of Southwest Florida, Inc. at each of the following addresses:
Leigh Wade - Schield, Executive Director
Area Agency on Aging for Southwest Florida, Inc.
2285 First Street
Fort Myers, Florida 33901
The Auditor General's Office at the following address:
State of Florida Auditor General
Claude Pepper Building, Room 574
111 West Madison Street
Tallahassee, Florida 32399 -1450
Any reports, management letter, or other information required to be submitted to the Area Agency on Aging for
Southwest Florida, Inc. pursuant to this agreement shall be submitted timely in accordance with OMB Circular A -133,
Florida Statutes, and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for - profit
organizations), Rules of the Auditor General, as applicable.
28
July 2009
L-J
Agenda Item No. 16D12
July 28. 2009
Page 32C8'4003.09
Providers, when submitting financial reporting packages to the Area Agency on Aging for Southwest Florida, Inc. for
audits done in accordance with OMB Circular A -133 or Chapters 10.550 (local governmental entities) or 10.650
(nonprofit and for -profit organizations), Rules of the Auditor General, should indicate the date that the reporting
package was delivered to the provider in correspondence accompanying the reporting package.
PART IV: RECORD RETENTION
The provider shall retain sufficient records demonstrating its compliance with the terms of this agreement for a
period of six years from the date the audit report is issued, and shall allow the Area Agency on Aging for Southwest
Florida, Inc. or its designee, the Director of Finance access to such records upon request. The provider shall ensure
that audit working papers are made available to the Area Agency on Aging for Southwest Florida, Inc. or its designee,
Director of Finance upon request for a period of six years from the date the audit report is issued, unless extended in
writing by the Area Agency on Aging for Southwest Florida, Inc.
Agenda Item No. 16D12
July 28. 200
July 2009 Page 3T.W403.09
ATTACHMENT III
m. EXHIBIT 1
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF
THE FOLLOWING:
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO THIS
AGREEMENT ARE AS FOLLOWS:
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE
FOLLOWING:
uRATrurnrr RFCnlTRCF.S FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD
.......n It A CCrC rA WCU C1IDTVf T Tn Qar 71 K Q7 F C_
-- PROGRAM TITLE
FUNDING SOURCE
CFDA
AMOUNT
Community Care for the
Elderly - Collier
General Revenue/TSTF
65010
$655,478.00
TOTAL AWARD
$655.478.00
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS
AGREEMENT ARE AS FOLLOWS:
30
July 2009
ATTACHMENT III
PART I: AUDIT RELATIONSHIP DETERMINATION
Agenda Item No. 16D12
July 28. 2009
Page 34WE403.09
EXHIBIT
Providers who receive state or federal resources mayor may not be subject to the audit requirements of OMB Circular A -133, as
revised, and /or Section 215.97, Fla. Stat Providers who are determined to be recipients or subrecipients of federal awards
and /or state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I
and /or Part 11 of Exhibit 1 are met Providers who have been determined to be vendors are not subject to the audit requirements
of OMB Circular A -133, as revised, and /or Section 215.97, Fla. Stat Regardless of whether the audit requirements are met,
providers who have been determined to be recipients or subrecipients of Federal awards and /or state financial assistance, must
comply with applicable programmatic and fiscal compliance requirements.
In accordance with Sec. 210 of OMB Circular A -133 and /or Rule 691 - 5.066, FAC, provider has been determined to be:
_Vendor or exempt entity and not subject to OMB Circular A -133 and /or Section 215.97, F.S.
_X Recipient /subrecipient subject to OMB Circular A -133 and /or Section 25.97, F.S.
NOTE: If a provider is determined to a recipient /subrecipient of federal and or state financial assistance and has been approved
by the Agency to subcontract, they must comply with Section 215.97(7), F.S., and Rule 691 - .006(2), FAC [state financial
assistance] and Section _.400 OMB Circular A -133 [federal awards].
PART II: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Providers who receive Federal awards or
state matching funds on Federal awards and who are determined to be a subrecipient, must comply with the following fiscal laws,
rules and regulations:
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR Part 225 Cost Principles for State, Local and Indian Tribal Governments (Formerly OMB Circular A -87)*
OMB Circular A-102 - Administrative requirements
OMB Circular A -133 - Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations.
NON - PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR Part 230 Cost Principles for Non -Profit Organizations (Formerly OMB Circular A -22 -Cost Principles)*
2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A -110 - Adminisrative Requirements)
OMB Circular A -133 - Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations.
EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT) MUST FOLLOW:
2 CFR Part 220 Cost Principles for Educational Institutions OMB (Formerly Circular A -21 -Cost Principles)*
2 CFR 215Administrative Requirements (Formerly OMB Circular A -110- Administrative Requirements)
OMB Circular A -133 - Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations.
*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in the OMB
Circular A -133 Compliance Supplement, Appendix 1.
STATE FINANCIAL ASSISTANCE. Providers who receive state financial assistance and who are determined to be a
recipient /subrecipient, must comply with the following fiscal laws, rules and regulations:
Section 215 -97, Fla. Stat.
Chapter 619 -5, Fla. Admin. Code
State Projects Compliance Supplement
Reference Guide for State expenditures
Other fiscal requirements set forth in program laws, rules and regulations.
31
Agenda Item No. 16D12
July 28, 2009
July 2009 Page 3,,C,6F4 &03.09
ATTACHMENT IV
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE
FOR AGREEMENTS, GRANTS, LAND AND
COOPERATIVE AGREEMENTS
The undersigned, an authorized representative of the recipient named in the contract or agreement to which this form is an
attachment, hereby certifies that:
(1) The recipient and any sub - contractors of services under this contract have financial management systems capable of
providing certain information, including: (1) accurate, current, and complete disclosure of the financial results of each grant -
funded project or program in accordance with the prescribed reporting requirements; (2) the source and application of funds for
all agreement supported activities; and 93) 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 grand funds that have not been accounted
for properly.
(2) Management Information Systems used by the recipient, sub - contractor(s) or any outside entity on which the recipient
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, recipient(s)
will take immediate action to assure data integrity.
(3) If this contract includes the provision of hardware, software, firmware, microcode or imbedded chip technology, the
undersigned warrants that these products are capable of processing year -date dependent data accurately. All versions of these
products offered by the recipient (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 recipient 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 recipient and any sub - contractor(s) of services under this contract warrant their policies and procedures include a
disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data
integrity compliance issues.
The recipient shall require that the language of this certification be included in all subagreements, subgrants, and other
agreements and that all sub - contractors 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).
Signature
Donna Fiala, Chairman
Name of Authorized Individual
Collier County Board of County Commissioners
3301 Tamiami Trail East
Naples, Florida 34112
Name and Address of Organization
July 28.2009
Date:
CCE 203.09 ATTEST.
Application or AR-W tTAff MROCK, olefiS
c6eg -ham
Assistant County Attorney
DOEA Form 103 (Revised Nov 2002)
32
Agenda Item No. 16D12
July 2009 Pag 3E44J03.09
ATTACHMENT V
CERTIFICATION REGARDING DEPARTMENT, SUSPENSION, INELIGIBILITY AND
VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS
(1) The prospective contractor certifies, by signing this certification, neither it nor its principals are presently
debated, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation
in this transaction by any federal department or agency.
(2) Where the prospective contractor is unable to certify to any of the statements in this certification, such
prospective participant shall attach an explanation to this certification.
Signature
luly 28.2009
Date
Donna Fiala, Chairman Collier County Board of CoungKIZM ioners
Title Agency/ Organization DWIGHT E. BROCK, Cjetr;
C��-- By.__� -
Assistant County Attorney
(Certification signature should be same as Contract 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 Contract Manager for assistance in obtaining a copy of thos.
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 recipient knowingly rendered an erroneous
certification, in addition to other remedies available to the federal government the Agency may pursue
available remedies, including suspension and /or debarment.
3. The recipient will provide immediate written notice to the Contract Manager if at any time the recipient
learns that its certification was erroneous when submitted or has become erroneous by reason of changed
circumstances. The recipient 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 recipient 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.
The recipient 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.
33
Agenda Item No. 16D12
July 28. 200
July 2009 Page 3r; 03.09
6. If the recipient 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 Agency may pursue available remedies, including
suspension, and /or debarment.
The recipient may rely upon a certification of a prospective participant in a lower tier covered transaction,
unless it knows that the certification is erroneous.
34
July 2009
ASSURANCES -NON- CONSTRUCTION PROGRAMS
Agenda Item No. 16D12
July 28. 2009
Page 3 F4903.09
ATTACHMENT VI
Public reporting burden for this collection of information is estimated to average 45 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and
reviewing the collection of information. Send comments regarding the burden estimate or any other s= aspect of this collection
information, including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction
Project (0348- 0043), Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET, SEND IT TO THE
ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions, please
contact the awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional
assurances. If such is the case, you will be notified.
1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability
(including funds sufficient to pay the non- Federal share of project cost) to ensure proper planning, management, and
completion of the project described in this applications.
2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through
any authorized representative, access to and the right to examine all records, books, papers, or documents related to the
award; and will establish a proper accounting system in accordance with generally accepted accounting standards or
agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents
the appearance of personal or organizational conflict of interest, or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding
agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C., 4728 -4763) relating to prescribed standardF
for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's
Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).
6. Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of
the Civil Rights Act of 1964 (P.L. 88 -352) which prohibits discrimination on the basis of race, color or national origin;
(b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C., 1681 -1683 and 1685 - 1686), which prohibits
discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 794), which
prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C., 6101-
6107) which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-
255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and
Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91 -616), as amended, relating to
nondiscrimination on the basis of alcohol abuse or alcoholism; (g) 523 and 527 of the Public Health service Act of 1912
(42 U.S.C., 290 dd -3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h)
Title VIII of the Civil Rights Act of 1968 (42 U.S.C., 3601 et seq.) as amended, relating to nondiscrimination in the sale,
rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s) under which
application for Federal assistance is being made; and 0) the requirements of any other nondiscrimination statute(s)
which may apply to the application.
7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance
and Real Property Acquisition Policies Act of 1970 (P.L. 91 -646) which provide for fair and e quitable treatment of
persons displaced or whose property is acquired as a result of Federal or federally assisted programs. These
requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in
purchases.
B. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C., 1501 -1508 and 7324 - 7328), which limit the
political activities of employees whose principal employment activities are funded in whole or in part with Federal
funds.
35
xGhN6Pn'WINa 4kE FkFn rHgRdpWXK+W',M1WR�.n Wk swxe� ., �_'. �...
Agenda Item No. 16D12
July 28 2009
July 2009 Page 3103.09
9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C., 276a to 276a -7), the Copeland Act (40
U.S.C. 276c and 18 U.S.C., 874) and the Contract Work Hours and Safety Standards Act (40 U.S.C., 327 -333), regarding
labor standards for federally assisted construction subagreements.
10. Will comply, if applicable, with flood insurance purchase requirements of section 102(a) of the Flood Disaster
Projection Act of 1973 (P.L. 93 -234) which requires recipients in a special flood hazard area to participate in the
program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or
more.
11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91- 190)and
Executive Order (ED) 11514; (b) notification of violating facilities pursuant to EO 1738 (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of
project consistency with the approved State management program developed under the Coastal Zone Management
Act of 1972 (16 U.S.C. 1451 et seq.); (f) conformity of Federal actions of State (Clear Air) Implementation Plans under
Section 176(c) or the Clear Air Act of 1955, as amended (42 U.S.C. 7401 et seq.); (g) protection of underground sources of
drinking water under the Safe Drinking Water Act of 1974, as amended (P.L. 93 -523); and (h) protection of endangered
species under the Endangered Species Act of 1973, as amended, (P.L. 93 -205).
12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. 1721 et seq.) related to protecting components or
potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation
Act of 1966, as amended (16 U.S.C. 470), EO 11593 (identification and protection of historic properties), and the
Archaeological and Historic Preservation Act of 1974 (16 U.S.C. 469a -1 et seq).
14. Will comply with P.L. 93 -348 regarding the protection of human subjects involved in research, development, and
related activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89 -544, as amended, 7 U.S.C: 2131 et seq.) pertaining
to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this
award of assistance.
16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C: 4801 et seq.), which prohibits the use of lead -
based paint in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act
Amendments of 1996 and OMB Circular No. A -133, Audits of States, Local Governments, and Non -Profit Organizations.
18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies
governing this program.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL
TITLE
Chairman
Donna Fiala
APPLICANT ORGANIZATION
DATE SUBMITTED
Collier County Board of County Commissioners
July 28, 2009
Housing and Human Services Department
OAQ�0� &XA-C-
Assistant County Attorney
W
ATTEST,
DWIGHT E. SF100k, i��rJu
July 2009
COMMUNITY CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
Collier County Housing and Human Services
1. CCE Spending Authority
Agenda Item No. 16D12
CCE�U�jj, 2009
of 46
ATTACHMENT VII
$443,156.00
2. Lead Agency Services - (CM, CA, Intake) $114,000.00
3. Lead Agency Operations
3. Total
$98,322.00
$655,478.00
July 2009
COMMUNITY CARE FOR THE ELDERLY PROGRAM
RATE SUMMARY
Collier County
Agenda Item No. 16D12
July 28, 2009
Page 41CcS£R203.09
ATTACHMENT VIII
Services
Total Rate
Reimbursement Rate
Case Management
$50.51
$45.45
Case Aide
$26.34
$23.70
Chore
$20.00
$18.00
EARS
$.83
$35
EARS Plus
$1.11
$1.00
Homemaking
$20.00
$18.00
Personal Care
$22.22
$20.00
Respite — In Home
$20.00
$18.00
Skilled Nursing
$38.89
$35.00
Adult Day Care
$10.00
$9.00
Spec. Medical Equipment
100% Cost
90% Cost
m
July 2009
COMMUNITY CARE FOR THE ELDERLY
INVOICE SCHEDULE
Report Number Based On
1
July Advance*
2
August Advance*
3
July Expenditure
4
August Expenditure
5
September Expenditure
6
October Expenditure
7
November Expenditure
8
December Expenditure
9
January Expenditure
10
February Expenditure
11
March Expenditure
12
April Expenditure
13
May Expenditure
14
June Expenditure
15
Final Expenditure and Closeout Report
Legend:* Advance based on projected cash need.
Agenda Item No. 16012
July 28. 2009
Page 42C RM -09
ATTACHMENT IX
Submit to AAA
On This Date
July 1
July 1
August 10
September 10
October 10
November 10
December 10
January 10
February 10
March 10
April 10
May 10
June 10
July 10
July 25
Note #1: Report #1 for Advance Basis Contracts cannot be submitted to the Area Agency on Aging prior to July 1 or
until the contract with the department has been executed and a copy sent to DFS. Actual submission of the
vouchers to AAA is dependent on the accuracy of the expenditure report.
Note #2: Report numbers 13 and 14 shall reflect an adjustment of one half of the total advance amount, on each of
the two reports respectively, repaying advances for the first two months of the contract. The adjustment
shall be recorded in Part C, 1 of the report (Attachment X).
Note #3: Submission of expenditure reports may or may not generate a payment request. If final expenditure report
reflects funds due back to the department, payment is to accompany the report.
39
July 2009
REQUEST FOR PAYMENT
COMMUNITY CARE FOR THE ELDERLY
Agenda Item No. 16D12
July 28, 2009
Page 430&203.09
ATTACHMENT X
RECIPIENT NAME, ADDRESS, PHONE# and FEID#
TYPE OF REPORT:
THIS REQUEST PERIOD:
FOR
A. PAYMENT REQUEST:
Regular Supplemental
REPORT#
B. METHOD OF PAYMENT:
CONTRACT#
Advance
PSA#
CERTIFICATION: I hereby certify that this request or refund conforms with the terms of the above contract.
Prepared By: Date: Approved By: Date:
PART A: BUDGET
SUMMARY:
(1)
CCE Lead
(2)
CCE CM,
(3)
CCE
(4)
(5)
Other
(6)
TOTAL
Operations
CA, Intake
Spending Auth
1. Approved Contract Amount
2. Previous Funds Received
For Contract Period
3. Contract Balance
4. Previous Funds Requested
For Contract Period
5. Contract Balance
PART B: CONTRACT FUNDS
REQUEST:
1. Anticipated Cash Needs
(1st -2nd Months)
2. Net Expenditures For Month
(DOEA Form 105C, Part B
Line 13)
3. Extraordinary Cash Needs
(Attach Doc.)
4. Total
PART C: NET FUNDS
REQUESTED:
1. Less Advance Applied
2. Contract Funds Are Hereby
Requested For (Part B Line 4
minus Part C Line 1)
DOEA FORM 106C, Dated May 2006
M: \CONTRACTS \CONTRACTS & AMENDMENTS \CCEQ005 -2006 CCE \CCE TEMPLATE 2.2.05.DOC
40
July 2009
RECEIPTS AND EXPENDITURES
COMMUNITY CARE FOR THE ELDERLY
Agenda Iiern No. 16D12
July 28. 2009
Page 444903.09
ATTACHMENT "'
RECIPIENT NAME, ADDRESS, PHONE#
PROGRAM FUNDING SOURCE:
THIS REPORT PERIOD:
FROM TO
CCE Lead Operations
CONTRACT
CCE CM, CA, Intake
PERIOD
CCE Spending Auth.
CONTRACT#
REPORT#
PSA#
CERTIFICATION: I certify to the best of my knowledge and belief that the report is complete and correct and all outlays herein are for purposes
set forth in the contract.
Prepared By: Date Approved By: Date:
PART A: BUDGETED INCOME /RECEIPTS
1. Approved
2. Actual
3. Total
4. Percent of
Budget
Receipts for
Receipts
Approved
This Report
Year to Date
Budget
1. Federal Funds ............. ...............................
$
$
$
2. State Funds ................ ...............................
$
$
$
_%
$
3. Program Income .......... ...............................
$
$
_%
$
$
4. Local Cash Match ........ ...............................
$
$
5. SUBTOTAL: CASH RECEIPTS .....................
$
$
_%
_%
6. Local In -Kind Match ..... ...............................
$
$
$
_%
7. TOTAL RECEIPTS ....... ...............................
$
$
$
PART B: EXPENDITURES*
1. Approved
2. Expenditures for
3. Expenditures
4. Percent of
Budget
This Report
Year to Date
Approved
Budget
1. Administrative Services . ...............................
$
$
$
_%
$
$
2. Service Subcontractor ( s ) ..............................
$
_%
$
3. TOTAL .......................... ...............................
$
$
%
PART C: Other Expenditures (For Tracking Purposes
Only)
PART D: OTHER REVENUE AND EXPENDITURES
II. Interest:
III. Advance Recoupment:
I. Program Income (PI):
1. Earned on GR Advance
1. Recoupment of Advance $
1. CCE: PI Collected YTD
$
$
2. Rtn. of GR Advance $
(INCLUDES FEES COLLECTED)
3. Other Eamed $
PART E: Co- payments
11. Total - Current Month
III. Total - Year To Date
I. Total Amount of Co- payments Assessed
$
$
11. Total Amount of Co- payments Collected
$
$
FOR TRACKING PURPOSES ONLY
'Expenditures of State Funds only - no local resources or program income.
DOEA FORM 105C, REV. MAY 2007
41
Agenda Item No, 16D12
July 28, 2009
July 2009 CCE 357,358.96ge 45 of 46
ATTACHMENT A
Department of Elder Affairs Programs and Services Handbook, provided on CD.
Also, available at the Department's Intranet site under, "Publications."
42
Agenda Item No. 16D12
July 28, 2009
Page 46 of 46
Attestation Statement
Agreement/Contract Number: CCE 203.09
Amendment Number:
I, Donna Fiala, Chairman, attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on
Aging and
Collier County Board of County Commissioners
(Recipient /Contractor name)
The only exception to this statement would be for changes in page formatting, due to the differences
in electronic data processing media, which has no affect on the agreement/contract content.
July 28, 2009
Signature of Recipient/Contractor representative Date
cob'4— pL.o�
Assistant Count Attorney
ATTEST:
DWIGHT BROCK, Clerk
By:
DOEA Contract Manager to initial and date indicating signatures /initials appropriate on all
documents; ready for DOEA Secretary /designee signature
uuuM UaLV
Revised August 2007