Backup Document 02/22/2022 Item #16D 7 $ 6 01
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the
exception of the Chairman's signature,draw a line through routing_lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office _ Initials Date
1. Wendy Klopf Community and Human 02/22/22
Services
2. Minutes & Records Clerk of Court's Office )1/tA) Vi.,/70103- 1:349114
3.
4.
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the
addressees above,may need to contact staff for additional or missing information.
Name of Primary Staff Wendy Klopf/CHS Phone Number 252-2901
Contact/ Department
Agenda Date Item was 02/22/2022 Agenda Item Number 16D7
Approved by the BCC
Type of Document AAA/OAA Agreement 203.22 Number of Original 1
Attached Documents Attached
PO number or account NA
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature? NA
2. Does the document need to be sent to another agency for additional signatures? If yes, NA
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be WK
signed by the Chairman,with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's NA
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the NA
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's NA
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip NA
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on_02/22/22 and all changes made during WK
the meeting have been incorporated in the attached document. The County
Attorney's Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the WK
BCC,all changes directed by the BCC have been made,and the document is ready for the
Chairman's signature.
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12
160 7
January 2022-December 2022 OAA 203.22
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
STANDARD CONTRACT
THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc. (Agency) and Collier
County Board of County Commissioners(Contractor),collectively referred to as the"Parties."The term Contractor for this
purpose may designate a Vendor,Subgrantee,or Subrecipient.
WITNESSETH THAT:
WHEREAS,the Agency has determined that it is in need of certain services as described herein;and WHEREAS,
the Contractor has demonstrated that it has the requisite expertise and ability to faithfully perform suchservices 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 set forth herein,the Parties agree as follows:
1. Purpose of Contract:
The purpose of this contract is to provide services in accordance with the terms and conditions specified in this contract
including all attachments,forms,and exhibits which constitute the contract document.
2. Incorporation of Documents within the Contract:
The contract will incorporate attachments, proposal(s), state plan(s), grant agreements, relevant Agency handbooks,
manuals and/or desk books,as an integral part of the contract, except to the extent that the contract explicitly provides
to the contrary. In the event of conflict in language among any of the documents referenced above, the specific
provisions and requirements of the contract document(s)shall prevail over inconsistent provisions in the proposal(s)or
other general materials not specific to this contract document and identified attachments.
3. Term of Contract:
This contract shall begin at twelve(12:00)A.M., Eastern Standard Time January 1, 2022 or on the date the contract
has been signed by the last party required to sign it, whichever is later. It shall end at eleven fifty-nine (11:59) P.M.,
Eastern Standard Time December 31,2022.
4. Contract Amount:
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amountnot
to exceed$1,388,954.83,subject to the availability of funds. Any costs or services paid for under any other contract or
from any other source are not eligible for payment under this contract.
5. Renewals:
By mutual agreement of the Parties, in accordance with Section 287.058(1)(g),Florida Statutes(F.S.),the Agencymay
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 costsfor
the renewal may be charged. Any renewal is subject to the same terms and conditions as the original contract and
contingent upon satisfactory performance evaluations by the Agency and the availability of funds.
6. Compliance with Federal Law:
6.1 If this contract contains federal funds this section shall apply.
6.1.1 The Contractor shall comply with the provisions of 45 Code of Federal Regulations (CFR)Part 75 and/or
45 CFR Part 92,2 CFR Part 200,and other applicable regulations.
6.1.2 If this contract contains federal funds and is over $100,000.00, the Contractor shall comply with all
applicable standards, orders,or regulations issued under Section 306 of the Clean Air Act as amended(42
United States Code (U.S.C.) § 7401, et seq.), Section 508 of the Federal Water Pollution Control Act as
amended (33 U.S.C. § 1251, et seq.), Executive Order 11738, as amended, and, where applicable,
Environmental Protection Agency regulations 2 CFR Part 1500. The Contractor shall report any violations
of the above to the Agency.
6.1.3 Neither the Contractor nor any agent acting on behalf of the Contractor may use any federal funds received
in connection with this contract to influence legislation or appropriations pending before Congress or any
state legislature. The Contractor must complete all disclosure forms as required, specifically the
Certification and Assurances Attachment,which must be completed and returned to the Contract Manager
prior to the execution of this contract.
Page 1 of 93 060
I 6 0 7
January 2022-December 2022 OAA 203.22
6.1.4 In accordance with Appendix II to 2 CFR Part 200, the Contractor shall comply with Executive Order
11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as
supplemented in Department of Labor regulations 41 CFR Part 60 and in Department of Health and Human
Services regulations 45 CFR Part 92,if applicable.
6.1.5 A contract award with an amount expected to equal or exceed$25,000.00 and certain other contract awards
will not be made to parties listed on the government-wide Excluded Parties List System,in accordance with
the Office of Management and Budget (OMB) guidelines at 2 CFR Part 180 that implement Executive
Orders 12549 and 12689, "Debarment and Suspension." The Excluded Parties List System contains the
names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared
ineligible under statutory or regulatory authority other than Executive Order 12549. The Contractor shall
comply with these provisions before doing business or entering into subcontracts receiving federal funds
pursuant to this contract. The Contractor shall complete and sign the Certifications and Assurances
Attachment prior to the execution of this contract.
6.2 The Contractor shall not employ an unauthorized alien. The Agency will consider the employment of
unauthorized aliens a violation of the Immigration and Nationality Act(8 U.S.C. § 1324a) and the Immigration
Reform and Control Act of 1986 (8 U.S.C. § 1101). Such violation will be cause for unilateral cancellation of
this contract by the Agency.
6.3 If the Contractor is a non-profit provider and is subject to Internal Revenue Service(IRS)tax exempt organization
reporting requirements (filing a Form 990 or Form 990-N), and has its tax exempt status revoked for failing to
comply with the filing requirements of the Pension Protection Act of 2006 or for any other reason,the Contractor
must notify the Agency in writing within thirty(30)days of receiving the IRS notice of revocation.
6.4 The Contractor shall comply with Title 2 CFR Part 175 regarding Trafficking in Persons.
6.5 Unless exempt under 2 CFR § 170.110(b), the Contractor shall comply with the reporting requirements of the
Transparency Act as expressed in 2 CFR Part 170.
6.6 To comply with Presidential Executive Order 12989,as amended,and State of Florida Executive Order Number
11-116, Contractor agrees to utilize the U.S. Department of Homeland Security's E-verify system to verify the
employment of all new employees hired by Contractor during the contract term.Contractor shall include in related
subcontracts a requirement that Subcontractors performing work or providing services pursuant to the state
contract utilize the E-verify system to verify employment of all new employees hired by the Subcontractorduring
the contract term. Contractors meeting the terms and conditions of the E-Verify System are deemed to bein
compliance with this provision.
7. Compliance with State Law:
7.1 This contract is executed and entered into in the State of Florida,and shall be construed,performed,and enforced
in all respects in accordance with Florida law,including Florida provisions for conflict of laws.
7.2 If this contract contains state financial assistance funds, the Contractor shall comply with Section 215.97, F.S.,
and Section 215.971, F.S., and expenditures must be in compliance with laws, rules, and regulations including,
but not limited to,the Reference Guide for State Expenditures.
7.3 The Contractor shall comply with the requirements of Section 287.058,F.S.,as amended.
7.3.1 The Contractor shall perform all tasks contained in Attachment I.
7.3.2 The Contractor shall provide units of deliverables, including reports, findings, and drafts, as specified in
Attachment I,to be received and accepted by the Agency Contract Manager prior to payment.
7.3.3 The Contractor shall comply with the criteria and final date by which such criteria must be met for
completion of this contract as specified in Attachment I,Section III.Method of Payment.
7.3.4 The Contractor shall submit bills for fees or other compensation for services or expenses in sufficient detail
for a proper pre-audit and post-audit.
7.3.5 If itemized payment for travel expenses is permitted in this contract, the Contractor shall submit invoices
for any travel expenses in accordance with Section 112.061,F.S.,or at such lower rates as may be provided
in this contract.
7.3.6 The Contractor shall allow public access to all documents,papers,letters,or other public records as defined
in Section 119.011(12), F.S., made or received by the Contractor in conjunction with this contract except
Page 2 of 93 OVID
160 7
January 2022-December 2022 OAA 203.22
for those records which are made confidential or exempt by law. The Contractor's refusal to comply with
this provision will constitute an immediate breach of contract for which the Agency may unilaterally
terminate this contract.
7.4 If clients are to be transported under this contract, the Contractor shall comply with the provisions of Chapter
427,F.S.,and Rule Chapter 41-2,Florida Administrative Code(F.A.C).
7.5 Subcontractors who are on the Discriminatory Vendor List may not transact business with any public entity, in
accordance with the provisions of Section 287.134,F.S.
7.6 The Contractor shall comply with the provisions of Section 11.062,F.S.,and Section 216.347,F.S.,which prohibit
the expenditure of contract funds for the purpose of lobbying the legislature,judicial branch or a state agency.
7.7 The Agency may, at its option, terminate the Contract if the Contractor is found to have submitted a false
certification as provided under Section 287.135(5), F.S., has been placed on the Scrutinized Companies with
Activities in the Iran Petroleum Energy Sector List,the Scrutinized Companies with Activities in Sudan List, or
the Scrutinized Companies that Boycott Israel List,or if the Contractor has been engaged in business operations
in Cuba or Syria or is engaged in a boycott of Israel.
8. Background Screening:
The Contractor shall ensure that the requirements of Section 430.0402 and Chapter 435, F.S., as amended, are met
regarding background screening for all persons who meet the definition of a direct service provider and who are not
exempt from the Agency's level 2 background screening pursuant to Sections 430.0402(2)-(3),F.S. The Contractor must
also comply with any applicable rules promulgated by the Agency and the Agency for Health CareAdministration
regarding implementation of Section 430.0402 and Chapter 435, F.S. To demonstrate compliance withthis provision,
Contractor shall submit the Background Screening Affidavit of Compliance (Screening Form) to the Agency within
thirty (30) days of execution of this contract. Should the Agency have a completed Screening Form on file for the
Contractor,a new Screening Form will be required every twelve(12)months.
8.1 Further information concerning the procedures for background screening may be found at
https://elderaffairs.org/about-us/background-screening/
9. Grievance Procedures:
The Contractor shall develop, implement, and ensure that its Subcontractors have established grievance procedures to
process and resolve client dissatisfaction with, or denial of, service(s) and to address complaints regarding the
termination,suspension or reduction of services,as required for receipt of funds. These procedures,at a minimum,will
provide for notice of the grievance procedure and an opportunity for review of the Subcontractor's determination(s).
10. Public Records and Retention:
10.1 By execution of this contract, Contractor agrees to all provisions of Chapter 119, F.S., and any other applicable
law,and shall:
10.1.1 Keep and maintain public records required by the Agency to perform the contracted services.
10.1.2 Upon request from the Agency's custodian of public records, provide the Agency a copy of the requested
records or allow the records to be inspected or copied within a reasonable time at a cost that doesnot exceed
the cost provided in Chapter 119,F.S.,or as otherwise provided by law.
10.1.3 Ensure that public records that are exempt, or confidential and exempt, from public records disclosure
requirements are not disclosed except as authorized by law for the duration of the contract term and
following completion of the contract if the Contractor does not transfer the records to the Agency.
10.1.4 Upon completion of the contract, the Contractor will either transfer, at no cost to the Agency, all public
records in possession of the Contractor to the Agency or will keep and maintain public records requiredby
the Agency. If the Contractor transfers all public records to the Agency upon completion of thecontract,
Contractor shall destroy any duplicate public records that are exempt, or confidential and exempt,from
public records disclosure requirements. If the Contractor keeps and maintains public records upon
completion of the contract, the Contractor shall meet all applicable requirements for retaining public
records.All records stored electronically must be provided to the Agency in a format that is compatiblewith
the information technology systems of the Agency.
10.2 The Agency may unilaterally cancel this contract,notwithstanding any other provisions of this contract,for refusal
by the Contractor to comply with Section 10 of this contract by not allowing public access to all documents,
Page 3 of 93 0
��
160 7
January 2022-December 2022 OAA 203.22
papers, letters, or other material made or received by the Contractor in conjunction with this contract, unless the
records are exempt,or confidential and exempt,from Section 24(a)of Article I of the State Constitution and Section
119.07(1),F.S.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION
OF CHAPTER 119,FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO
PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT
THE CUSTODIAN OF PUBLIC RECORDS AT:
Public Records Coordinator
Area Agency on Aging for Southwest Florida,Inc.
2830 Winkler Ave, Suite 112
Fort Myers,FL 33916
239-652-6900
10.3 Upon termination of this contract,whether for convenience or for cause as detailed in section 53 of this contract,
the Contractor and Subcontractors shall,at no cost to the Agency,transfer all public records in their possession to
the Agency and destroy any duplicate public records that are exempt, or confidential and exempt, from public
records disclosure requirements. All records stored electronically shall be provided to the Agency in a format that
is compatible with the information technology systems of the Agency.
11. Audits,Inspections,Investigations:
11.1 The Contractor shall establish and maintain books,records,and documents(including electronic storage media)
sufficient to reflect all assets, obligations, unobligated balances, income, interest, and expenditures of funds
provided by the Agency under this contract. Contractor shall adequately safeguard all such assets and ensure that
they are used solely for the purposes authorized under this contract.Whenever appropriate,financial information
should be related to performance and unit cost data.
11.2 The Contractor shall retain and maintain all client records, financial records, supporting documents, statistical
records, and any other documents (including electronic storage media) pertinent to this contract for a period of
six(6)years after completion of the contract, or longer when required by law. In the event an audit is required
by this contract,records shall be retained for a minimum period of six(6)years after the audit report is issued or
until resolution of any audit findings or litigation based on the terms of this contract,at no additional cost to the
Agency.
11.3 Upon demand, at no additional cost to the Agency,the Contractor shall facilitate the duplication and transferof
any records or documents during the required retention period.
11.4 The Contractor shall ensure that the records described in this section will be subject at all reasonable times to
inspection,review,copying,or audit by federal,state,or other personnel duly authorized by the Agency.
11.5 At all reasonable times for as long as records are maintained,persons duly authorized by the Agency and federal
auditors, pursuant to 45 CFR Part 75, shall be allowed full access to and the right to examine any of the
Contractor's contracts and related records and documents pertinent to this specific contract, regardless of the
form in which kept.
11.6 The Contractor shall provide a Financial and Compliance Audit to the Agency as specified in this contract and
ensure that all related third-party transactions are disclosed to the auditor.
11.7 Contractor agrees to comply with the Inspector General in any investigation,audit,inspection,review,or hearing
performed pursuant to Section 20.055,F.S. Contractor further agrees that it shall include in related subcontracts
a requirement that subcontractors performing work or providing services pursuant to this contract agree to
cooperate with the Inspector General in any investigation, audit, inspection, review, or hearing pursuant to
Section 20.055(5), F.S. By execution of this contract the Contractor understands and will comply with this
subsection.
11.8 In accordance with Executive Order 20-44 which requires executive agencies to submit a list of entities named
in statute with which a state agency must form a sole-source,public-private agreement or an entity that,through
contract or other agreement with the state,annually receives 50%or more of their budget from the State or from
a combination of State and Federal funds.Any Contractor that meets one or both of the criteria listed must submit
Cl
Page 4 of 93 ,y
0
160 7
January 2022-December 2022 OAA 203.22
an annual report, including the most recent IRS Form 990, detailing the total compensation for the entities'
executive leadership teams within thirty(30)days of execution of this contract.
11.8.1 The report must include total compensation including salary,bonuses,cashed-in leave,cash equivalents,
severance pay,retirement benefits,deferred compensation,real-property gifts,and any other payout.
11.8.2 The Contractor shall inform the agency of any changes in total executive compensation between the
annual reports as those changes occur.
11.8.3 All compensation reports must indicate what percent of compensation comes directly from the State or
Federal allocations to the contracted entity.
12. Nondiscrimination-Civil Rights Compliance:
12.1 The Contractor shall execute Assurances as stated in the Assurances-Non-Construction Programs Attachment that
it will not discriminate against any person in the provision of services or benefits under this contract or in
employment because of age,race, religion,color, disability, national origin, marital status, or sex in compliance
with state and federal law and regulations. The Contractor further assures that all Contractors, Subcontractors,
Sub-grantees, or others with whom it arranges to provide services or benefits in connection with any of its
programs and activities are not discriminating against clients or employees because of age, race, religion, color,
disability,national origin,marital status,or sex.
12.2 During the term of this contract,the Contractor shall complete and retain on file a timely,complete,and accurate
Civil Rights Compliance Checklist,attached to this contract.
12.3 The Contractor shall establish procedures pursuant to federal law to handle complaints of discrimination involving
services or benefits through this contract. These procedures shall include notifying clients, employees, and
participants of the right to file a complaint with the appropriate federal or state entity.
12.4 If this contract contains federal funds, these assurances are a condition of continued receipt of or benefit from
federal financial assistance,and are binding upon the Contractor,its successors,transferees,and assignees for the
period during which such assistance is provided. The Contractor further assures that all Subcontractors,Vendors,
or others with whom it arranges to provide services or benefits to participants or employees in connection with
any of its programs and activities are not discriminating against those participants or employees in violation of
the any statutes, regulations, guidelines, and standards. In the event of failure to comply, the Contractor
understands that the Agency may, at its discretion,seek a court order requiring compliance with the terms ofthis
assurance or seek other appropriate judicial or administrative relief including, but not limited to, terminationof
the contract and denial of further assistance.
13. Monitoring by the Agency:
The Contractor shall permit persons duly authorized by the Agency to inspect and copy any records,papers,documents,
facilities, goods, and services of the Contractor which are relevant to this contract, and to interview any clients,
employees, and Subcontractor employees of the Contractor to assure the Agency the satisfactory performance of the
terms and conditions of this contract. Following such review,the Agency will provide a written report of its findings to
the Contractor and, where appropriate, the Contractor shall develop a Corrective Action Plan(CAP). The Contractor
hereby agrees to correct all deficiencies identified in the CAP in a timely manner as determinedby the Agency's Contract
Manager.
14. Provision of Services:
The Contractor shall provide services in the manner described in Attachment I.
Page 5 of 93 Cl Q
O 7
January 2022-December 2022 AA 203.22
15. Coordinated Monitoring with Other Agencies:
If the Contractor receives funding from one or more State of Florida human service agencies,in addition to the Agency,
then a joint monitoring visit including such other agencies may be scheduled. For the purposes of this contract, and
pursuant to Section 287.0575, F.S., as amended, Florida's human service agencies shall include the Agency, the
Department of Children and Families, the Department of Health, the Agency for Persons with Disabilities, and the
Department of Veterans' Affairs. Upon notification and the subsequent scheduling of such a visitby the designated
agency's lead administrative coordinator,the Contractor shall comply and cooperate with all monitors,inspectors,and/or
investigators.
16. New Contract(s)Reporting:
The Contractor shall notify the Agency within ten(10)days of entering into a new contract with any of the remainingfour
(4)state human service agencies.The notification shall include the following information: (1)contracting state agency
and the applicable office or program issuing the contract;(2)contract name and number;(3)contract start and end dates;
(4) contract amount; (5) contract description and commodity or service; and (6) Contract Manager name and contact
information.In complying with this provision,and pursuant to Section 287.0575,F.S.,as amended,the Contractor shall
complete the Contractor's State Contracts List attached to this contract.
17. Indemnification:
The Contractor shall indemnify, save, defend, and hold harmless the Agency and its agents and employees from any
and all claims, demands, actions, and causes of action of whatever nature or character arising out of, or by reason of,
the execution of this contract or performance of the services provided for herein. It is understood and agreed that the
Contractor is not required to indemnify the Agency for claims, demands, actions,or causes of action arising solely out
of the negligence of the Agency.
17.1 Except to the extent permitted by Section 768.28,F.S.,or other Florida law,this Section 17 is not applicable to
contracts executed between the Agency and state agencies or subdivisions defined in Section 768.28(2),F.S.
18. Insurance and Bonding:
18.1 The Contractor shall provide continuous adequate liability insurance coverage during the existence of this
contract and any renewal(s) and extension(s) of it. By execution of this contract, unless it is a state agency or
subdivision as defined by Section 768.28(2), F.S.,the Contractor accepts full responsibility for identifying and
determining the type(s) and extent of liability insurance coverage necessary to provide reasonable financial
protections for the Contractor and the clients to be served under this contract. The limits of coverage under each
policy maintained by the Contractor do not limit the Contractor's liability and obligations under this contract.
The Contractor shall ensure that the Agency has the most current written verification of insurance coverage
throughout the term of this contract. Such coverage may be provided by a self-insurance program established
and operating under the laws of the State of Florida.The Agency reserves the right to require additional insurance
as specified in this contract.
18.2 Throughout the term of this contract, the Contractor shall maintain an insurance bond from a responsible
commercial insurance company covering all officers, directors, employees, and agents of the Contractor
authorized to handle funds received or disbursed under all agreements and/or contracts incorporating this contract
by reference in an amount commensurate with the funds handled, the degree of risk as determined by the
insurance company,and consistent with good business practices.
19. Confidentiality of Information:
The Contractor shall not use or disclose any information concerning a recipient of services under this contract for any
purpose prohibited by state or federal law or regulations except with the written consent of a person legally authorized
to give that consent or when authorized by law.
20. Health Insurance Portability and Accountability Act:
Where applicable,the Contractor shall comply with the Health Insurance Portability and Accountability Act of 1996,
Public Law 104-191, as well as all regulations promulgated thereunder(45 CFR Parts 160, 162,and 164).
21. Incident Reporting:
21.1 The Contractor shall notify the Agency immediately but no later than forty-eight(48)hours from the Contractor's
awareness or discovery of conditions that may materially affect the Contractor's or Subcontractor's
Page 6 of 93 CAO
160 7
January 2022-December 2022 OAA 203.22
ability to perform the services required to be performed under this contract. Such notice shall be made orally to
the Agency's Contract Manager(by telephone)with an email to immediately follow.
21.2 The Contractor shall immediately report knowledge or reasonable suspicion of abuse,neglect,or exploitation of
a child, aged person,or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone number
(1-800-96ABUSE).As required by Chapters 39 and 415,F.S.,this provision is binding upon the Contractor,its
Subcontractors,and their employees.
22. Bankruptcy Notification:
During the term of this contract, the Contractor shall immediately notify the Agency if the Contractor, its assignees,
Subcontractors,or affiliates file a claim for bankruptcy.Within ten(10)days after notification,the Contractor must also
provide the following information to the Agency: (1)the date of filing of the bankruptcy petition; (2)the casenumber;
(3) the court name and the division in which the petition was filed (e.g., Northern District of Florida, Tallahassee
Division);and(4)the name, address,and telephone number of the bankruptcy attorney.
23. Sponsorship and Publicity:
23.1 As required by Section 286.25, F.S., if the Contractor is a non-governmental organization which sponsors a
program financed wholly or in part by state funds, including any funds obtained through this contract, it shall,
in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by (Contractor's
name)and the State of Florida,Department of Elder Affairs." If the sponsorship reference is in written material,
the words"State of Florida,Department of Elder Affairs"shall appear in at least the same size letters or type as
the name of the organization.
23.2 The Contractor shall not use the words"State of Florida, Department of Elder Affairs"to indicate sponsorship
of a program otherwise financed, unless specific written authorization has been obtained by the Agency priorto
such use.
24. Assignments:
24.1 The Contractor shall not assign the rights and responsibilities under this contract without the prior written
approval of the Agency. Any sublicense, assignment, or transfer otherwise occurring without prior written
approval of the Agency shall constitute a material breach of the contract. In the event the State of Florida
approves assignment of the Contractor's obligations,the Contractor remains responsible for all work performed
and all expenses incurred in connection with this contract.
24.2 The State of Florida is,at all times,entitled to assign or transfer,in whole or part,its rights,duties,or obligations
under this contract to another governmental agency in the State of Florida upon giving prior written notice to the
Contractor.
24.3 This contract shall remain binding upon the successors in interest of the Contractor and the Agency.
25. Subcontracts:
25.1 The Contractor is responsible for all work performed and for all commodities produced pursuant to this contract,
whether actually furnished by the Contractor or its Subcontractors. Any subcontracts shall be evidenced by a
written document and subject to any conditions of approval the Agency deems necessary.The Contractor further
agrees that the Agency will not be liable to the Subcontractor in any way or for any reason. The Contractor, at
its expense,shall defend the Agency against any such claims.
25.2 The Contractor shall promptly pay any Subcontractors upon receipt of payment from the Agency or other state
agency. Failure to make payments to any Subcontractor in accordance with Section 287.0585, F.S., unless
otherwise stated in the contract between the Contractor and Subcontractor, will result in a penalty as provided
by statute.
26. Independent Capacity of Contractor:
It is the intent and understanding of the Parties that the Contractor and any of its Subcontractors are independent
Contractors and are not employees of the Agency, and that they shall not hold themselves out as employees or agents
of the Agency without prior specific authorization from the Agency. It is the further intent and understanding of the
Parties that the Agency does not control the employment practices of the Contractor and will not be liable for any wage
and hour, employment discrimination, or other labor and employment claims against the Contractor or its
Subcontractors. All deductions for social security,withholding taxes, income taxes, contributions to
Page 7 of 93 C
A®
160 7
January 2022-December 2022 OAA 203.22
unemployment compensation funds, and all necessary insurance for the Contractor are the sole responsibility of the
Contractor.
27. Payment:
Payments shall be made to the Contractor for all completed and approved deliverables (units of service)as defined in
Attachment I. The Agency Contract Manager will have final approval of the Contractor's invoice submitted for payment
and will approve the invoice for payment only if the Contractor has met all terms and conditions of the contract,unless
the bid specifications,purchase order,or this contract specify otherwise. The approved invoice will be submitted to the
Agency's finance section for budgetary approval and processing.Disputes arising over invoicing and payments will be
resolved in accordance with the provisions of Section 215.422,F.S. A Vendor Ombudsman has been establishedwithin
the Florida Department of Financial Services and may be contacted at 800-342-2762.
28. Return of Funds:
The Contractor shall return to the Agency any overpayments due to unearned funds or funds disallowed,and any interest
attributable to such funds pursuant to the terms and conditions of this contract,that were disbursed to the Contractor by
the Agency.In the event that the Contractor or its independent auditor discovers that an overpayment has been made,the
Contractor shall repay said overpayment immediately without prior notification from the Agency. In the event that the
Agency first discovers an overpayment has been made, the Agency Contract Manager will notify the Contractor in
writing of such findings. Should repayment not be made forthwith,the Contractorshall be charged at the lawful rate of
interest on the outstanding balance pursuant to Section 55.03,F.S.,after Agency notification or Contractor discovery.
29. Data Integrity and Safeguarding Information:
The Contractor shall ensure an appropriate level of data security for the information the Contractor is collecting or using
in the performance of this contract. An appropriate level of security includes approving and tracking all Contractor
employees that request system or information access and ensuring that user access has been removed from all terminated
employees. The Contractor, among other requirements, must anticipate and prepare for the loss of information
processing capabilities.All data and software shall be routinely backed up to ensure recovery from losses or outages of
the computer system.The security over the backed-up data is to be as stringent as the protection required of the primary
systems. The Contractor shall ensure all Subcontractors maintain written procedures for computer system backup and
recovery. The Contractor shall complete and sign the Certification Regarding Data Integrity Compliance for
Agreements,Grants,Loans,and Cooperative Agreements prior to the execution of this contract.
30. Social Media and Personal Cell Phone use:
30.1 Inappropriate use of social media and personal cell phones may pose risks to Agency's confidential and proprietary
information and may jeopardize compliance with legal obligations.By signing this contract,Contractor agrees to
the following social media and personal cell phone use requirements.
30.2 Social Media Defined. The term Social Media and /or personal cellular communication includes, but is not
limited to, social networking websites, blogs, podcasts, discussion forums, RSS feeds, video sharing, SMS
(including Direct Messages (DMs), iMessages, text messages, etc.); social networks like Instagram, TikTok,
Snapchat,Google Hangouts, WhatsApp, Signal,Facebook, Pinterest,and Twitter; and content sharing networks
such as Flickr and YouTube. This includes the transmission of social media through any cellular or online
transmission via any electronic, interne,intranet,or other wireless communication.
30.3 Application to any direct or incidental Agency or other state business.This contract applies to any Agency
orother state business conducted on any of the Contractor's, Subcontractor's, or their employees' social media
accounts or through personal cellular communication.
30.4 Application to Agency and Contractors Equipment. This contract applies regardless of whether the social
media is accessed using Agency's IT facilities and equipment or equipment belonging to Contractor,
Subcontractor, or their respective employees. Equipment includes, but is not limited to, personal computers,
cellular phones,personal digital assistants,smart watches,or smart tablets.
30.5 Florida Government in the Sunshine, Florida Public Records Law, and HIPAA. Contractor acknowledges
that any Agency or other state business conducted by social media or through personal cellular communication is
subject to Florida's Government in the Sunshine Law, Florida's Public Records Law (Chapter 119, Florida
Statutes),and the Health Insurance Portability and Accountability Act(HIPAA).Compliance with these laws and
other applicable laws are further detailed in the contract.
Page 8 of 93 C
A0
160 7
January 2022-December 2022 OAA 203.22
30.6 Prohibited or Restricted Postings. Contractors may not take or post photos or videos of, or include names or
identifying information, about any of Agency's clients. Any social media posts which include photos,videos,or
names of volunteers, staff, or other affiliates of Agency may only be posted with the permission of those
individuals. Any such posts related to volunteer service at Agency may only include individuals over the age of
18.
30.7 Assist Agency with Communications. Contactors may be asked periodically to assist in distributing certain
Agency communications through their social media outlets. Any such requests should be posted in adherence to
the social media requirements herein and the other provisions of this contract.
31. Conflict of Interest:
The Contractor shall establish safeguards to prohibit employees,board members,management,and Subcontractors from
using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of
interest or personal gain. No employee, officer, or agent of the Contractor or Subcontractor shall participate in the
selection or in the award of a contract supported by state or federal funds if a conflict of interest,real or apparent,would
be involved. Such a conflict would arise when:(a)the employee,officer or agent;(b)any member of his/her immediate
family;(c)his or her partner;or(d)an organization which employs,or is about to employ,any of the above individuals,
has a financial or other interest in the firm being selected for award. The Contractor's or Subcontractor's officers,
employees, or agents will neither solicit nor accept gratuities, favors,or anything of monetary value from Contractors,
potential Contractors, or parties to Subcontracts. The Contractor's board members and management must disclose to
the Agency any relationship which may be,or may be perceived to be,a conflict of interest within thirty(30)calendar
days of an individual's original appointment or placement in that position,or,if the individual is serving as an incumbent,
within thirty(30)calendar days of the commencement of this contract.The Contractor's employees and Subcontractors
must make the same disclosures described above to the Contractor's board of directors.Compliance with this provision
will be monitored.
32. Public Entity Crime:
Pursuant to Section 287.133,F.S.,a person or affiliate who has been placed on the Convicted Vendor List following a
conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods or
services to a public entity;may not submit a bid,proposal,or reply on a contract with a public entity for the construction
or repair of a public building or public work; may not submit bids,proposals, or replies on leases of real property to a
public entity; may not be awarded or perform work as a Contractor, Supplier, Subcontractor, or Consultant under a
contract with any public entity; and may not transact business with any public entity in excess of the threshold amount
provided in Section 287.017, F.S., for CATEGORY TWO for a period of thirty six(36)months following the date of
being placed on the Convicted Vendor List.
33. Purchasing:
33.1 The Contractor shall procure products and/or services required to perform this contract in accordance with section
413.036,F.S.
33.1.1 IT IS EXPRESSLY UNDERSTOOD AND AGREED THAT ANY ARTICLES THAT ARE THE
SUBJECT OF,OR REQUIRED TO CARRY OUT,THIS CONTRACT SHALL BE PURCHASED FROM
A NONPROFIT AGENCY FOR THE BLIND OR FOR THE SEVERELY HANDICAPPED THAT IS
QUALIFIED PURSUANT TO CHAPTER 413,FLORIDA STATUTES,IN THE SAME MANNER AND
UNDER THE SAME PROCEDURES SET FORTH IN SECTION 413.036(1) AND (2), FLORIDA
STATUTES; AND FOR PURPOSES OF THIS CONTRACT THE PERSON, FIRM, OR OTHER
BUSINESS ENTITY CARRYING OUT THE PROVISIONS OF THIS CONTRACT SHALL BE
DEEMED TO BE SUBSTITUTED FOR THE STATE AGENCY INSOFAR AS DEALINGS WITH
SUCH QUALIFIED NONPROFIT AGENCY ARE CONCERNED.
33.1.2 Pursuant to sections 413.036(1)and(4),F.S.,the Contractor shall not be required to procure a product or
service from RESPECT if:(a)the product or service is not available within a reasonable delivery time,(b)
the Contractor is required by law to procure the product or service from any agency of the state, or(c)the
Contractor determines that the performance specifications,price, or quality of the product or service is not
comparable to the Contractor's requirements.
33.1.3 This act shall have precedence over any law requiring state agency procurement of products or services
from any other nonprofit corporation unless such precedence is waived by the Agency in accordance with
its rules.
Page 9 of 93 CA0
ib
07
January 2022-December 2022 OAA 203.22
33.1.4 Additional information about the designated nonprofit agency and the products it offers is available at
http://www.respectofflorida.org.
33.2 The Contractor shall procure any recycled products or materials which are the subject of,or are required to carry
out,this contract when the Department of Management Services determines that those products are available, in
accordance with the provisions of section 403.7065, F.S.
33.3 The Contractor shall procure products and/or services required to perform this contract in accordance with
section 946.515, F.S.
33.3.1 IT IS EXPRESSLY UNDERSTOOD AND AGREED THAT ANY ARTICLES WHICH ARE THE
SUBJECT OF, OR REQUIRED TO CARRY OUT,THIS CONTRACT SHALL BE PURCHASED FROM
THE CORPORATION IDENTIFIED UNDER CHAPTER 946, F.S., IN THE SAME MANNER AND
UNDER THE SAME PROCEDURES SET FORTH IN SECTION 946.515(2) AND (4), F.S.; AND FOR
PURPOSES OF THIS CONTRACT THE PERSON, FIRM,OR OTHER BUSINESS ENTITY CARRYING
OUT THE PROVISIONS OF THIS CONTRACT SHALL BE DEEMED TO BE SUBSTITUTED FOR
THIS AGENCY INSOFAR AS DEALINGS WITH SUCH CORPORATION ARE CONCERNED.
33.3.2 The corporation identified is Prison Rehabilitative Industries and Diversified Enterprises, Inc. (PRIDE).
Additional information about PRIDE and the commodities or contractual services it offers is available at
https://pride-enterprises.org/.
33.4 The Agency shall provide a Certified Minority Business Subcontractor Expenditure (CMBE) Report
summarizing the participation of certified suppliers for the current reporting period and project to date.The CMBE
Report shall include the names, addresses, and dollar amount of each certified participant, and a copy must be
forwarded to the Agency, Division of Financial Administration, and must accompany each invoice submitted to
the Agency. The Office of Supplier Diversity (850-487-0915) will assist in furnishing names of
qualified minorities. The DOEA Minority Coordinator (850-414-2153) will assist with questions and
answers. The CMBE Report is attached to this contract.
34. Patents,Copyrights,Royalties:
If this contract is awarded state funding and 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 or in any way connected with
this contract, or if ownership of any discovery, invention, or copyrightable material was purchased in the course of or
as a result of work or services performed under this contract, the Contractor shall refer the discovery, invention, or
copyrightable 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.Pursuant to
Section 287.0571(5)(k), F.S., the only exceptions to this provision shall be those that are clearly expressed and
reasonably valued in this contract.
34.1 If the primary purpose of this contract is the creation of intellectual property, the State of Florida shall retain an
unencumbered right to use such property,notwithstanding any agreement made pursuant to this Section 34.
34.2 If this contract is awarded solely federal funding,the terms and conditions are governed by 2 CFR§ 200.315 or
45 CFR § 75.322, as applicable.
34.3 Notwithstanding the foregoing provisions, if the Contractor or one of its Subcontractors is a university and a
member of the State University System of Florida,then Section 1004.23, F.S., shall apply, but the Agency shall
retain a perpetual, fully-paid, nonexclusive license for its use and the use of its Contractors, Subcontractors,or
Assignees of any resulting patented, copyrighted,or trademarked work products.
Page 10 of 93 —'
160 7
January 2022-December 2022 OAA 203.22
35. Emergency Preparedness and Continuity of Operations:
35.1 If the tasks to be performed pursuant to this contract include the physical care and control of clients, or the
administration and coordination of services necessary for client health, safety, or welfare,the Contractor shall,
within thirty (30) calendar days of the execution of this contract, submit to the Agency Contract Manager,
verification of an Emergency Preparedness Plan. In the event of an emergency, the Contractor shall notify the
Agency emergency provisions.
35.2 In the event a situation results in a cessation of services by a Subcontractor, the Contractor shall remain
responsible for performance under this contract and must follow procedures to ensure continuity of operations
without interruption.
36. Equipment:
36.1 Equipment means:(a)tangible personal property(including information technology systems)having a useful life
of more than one year and a per-unit acquisition cost which equals or exceeds the lesser of the capitalization level
established by the organization for the financial statement purposes, or$5,000.00 [for federal funds- 2 CFR §
200.33 and 45 CFR§75.2,as applicable],or(b);nonexpendable,tangible personal property of a non-consumable
nature with an acquisition cost of$5,000.00 or more per unit, and expected useful life of at least one (1) year;
and hardback bound books not circulated to students or the general public, with a value or cost of$250.00 or
more [for state funds].
36.2 Contractors and Subcontractors who are Institutions of Higher Education, Hospitals, and Other Non-Profit
Organizations shall have written property management standards in compliance with 2 CFR Part 200
Administrative Requirements (formerly OMB Circular A-110) that include: (a) a property list with all the
elements identified in the circular;(b)a procedure for conducting a physical inventory of equipment at least once
every two (2) years; (c) a control system to insure adequate safeguards to prevent loss, damage, or theft of the
equipment;and(d)maintenance procedures to keep the equipment in good condition.The property records must
be maintained on file and shall be provided to the Agency upon request. The Contractor shall promptly
investigate,fully document,and notify the Agency Contract Manager of any loss,damage,or theft of equipment.
The Contractor shall provide the results of the investigation to the Agency Contract Manager,
36.3 The Contractor's property management standards for equipment (including replacement equipment), whether
acquired in whole or in part with federal funds and federally-owned equipment shall, at a minimum, meet the
following requirements and shall include accurately maintained equipment records with the following
information:
36.3.1 Property records must be maintained that include a description of the equipment;
36.3.2 Manufacturer's serial number, model number, federal stock number, national stock number, or other
identification number;
36.3.3 Source of funding for the equipment,including the federal award identification number;
36.3.4 Whether title vests in the Contractor or the federal government;
36.3.5 Acquisition date(or date received,if the equipment was furnished by the federal government);
36.3.6 Information from which one can calculate the percentage of federal participation in the cost of the
equipment(not applicable to equipment furnished by the federal government);
36.3.7 Location,use and condition of the equipment and the date the information was reported;
36.3.8 Unit acquisition cost;and
36.3.9 Ultimate disposition data, including date of disposal and sales price or the method used to determine
current fair market value where a Contractor compensates the federal awarding agency for its share.
36.3.10 A physical inventory must be taken, and the results reconciled with the property records at least once
every two(2)years.
36.3.11 A control system must be developed to ensure adequate safeguards to prevent loss,damage,or theft of
the property. Any loss,damage,or theft must be investigated.45 CFR§ 75.320(d)(3).
36.3.12 Adequate maintenance procedures must be developed to keep the property in good condition.
Page 11 of 93 Coo
160 7
January 2022-December 2022 OAA 203.22
36.3.13 If the Contractor is authorized or required to sell the equipment,proper sales procedures must be
established to ensure the highest possible return.
36.4 Equipment purchased with federal funds with an acquisition cost over$5,000.00 and equipment purchased with
state funds with an acquisition cost over$5,000.00 is part of the cost of carrying out the activities and functions
of the grant awards and title (ownership)will vest in the Contractor [for federal funds see 2 CFR § 200.313(a)
and 45 CFR § 75.320(a), as applicable], subject to the conditions of 2 CFR Part 200 and/or 45 CFR Part 75.
Equipment purchased under these thresholds is considered supplies and is not subject to property standards.
Equipment purchased with funds identified in the budget attachments to agreements covered by this contract or
identified in the sub-agreements with Subcontractors (not included in a cost methodology), is subject to the
conditions of Chapter 273,F.S.,rule 60A-1.017,F.A.C.,and 2 CFR Part 200 and/or 45 CFR Part 75.
36.5 The Contractor shall not dispose of any equipment or materials provided by the Agency or purchased with funds
provided through this contract without first obtaining the approval of the Agency Contract Manager. When
disposing of property or equipment the Contractor must submit a written request for disposition instructions to
the Agency's Contract Manager. The request should include a brief description of the property, purchase price,
funding source, and percentage of state or federal participation, acquisition date and condition of the property.
The request should also indicate the Contractor's proposed disposition of the property(i.e., transfer ordonation
to another agency that administers federal programs,offer of the items for sale,destroy the items,etc.).
36.6 The Agency Contract Manager will issue disposition instructions. If disposition instructions are not received
within one hundred twenty (120) days of the written request for disposition, the Contractor is authorized to
proceed as directed in 2 CFR§200.313 or 45 CFR§75.320,as applicable.
36.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto, but
excludes movable machinery and equipment. Real property may not be purchased with state or federal funds
through agreements covered under this contract without the prior approval of the Agency. Real property
purchases from Older Americans Act funds are subject to the provisions of Title 42, Chapter 35, Subchapter III,
Part A., Section 3030b United States Code(U.S.C.). Real property purchases from state funds can only be made
through fixed capital outlay grants and aids appropriations and therefore are subject to the provisions of Section
216.348,F.S.
36.8 Any permanent storage devices(e.g.:hard drives,removable storage media)must be reformatted and tested prior
to disposal to ensure no confidential information remains.
36.9 The Contractor must adhere to the Agency's procedures and standards when purchasing Information Technology
Resources (ITR) as part of any agreement(s) incorporating this contract by reference. An ITR worksheet is
required for any computer related item costing$1,000.00 or more, including data processing hardware, software,
services, supplies, maintenance, training, personnel, and facilities. The completed ITR worksheet shall be
maintained in the LAN administrator's file and must be provided to the Agency upon request.The Contractor has
the responsibility to require any Subcontractors to comply with the Agency's ITRprocedures.
37. PUR 1000 Form:
The PUR 1000 Form is hereby incorporated by reference and available at:
http://dms.myflorida.com/purchasing
In the event of any conflict between the PUR 1000 Form and any terms or conditions of this contract, the terms or
conditions of this contract shall take precedence over the PUR 1000 Form. However, if the conflicting terms or
conditions in the PUR 1000 Form are required by any section of the Florida Statutes,the terms or conditions contained
in the PUR 1000 Form shall take precedence.
38. Use of State Funds to Purchase or Improve Real Property:
Any state funds provided for the purchase of or improvements to real property are contingent upon the Contractor or
political subdivision granting to the state a security interest in the property at least to the amount of state funds provided
for at least five(5)years from the date of purchase or the completion of the improvements or as further required by law.
Page 12 of 93 C`7o
16D 7
January 2022-December 2022 OAA 203.22
39. Dispute Resolution:
Any dispute concerning performance of the contract shall be decided by the Agency Contract Manager,who shall reduce
the decision to writing and serve a copy on the Contractor.
40. Financial Consequences:
If the Contractor fails to meet the minimum level of service or performance identified in this contract,the Agency shall
impose financial consequences as stated in Attachment I.
41. No Waiver of Sovereign Immunity:
Nothing contained in this contract is intended to serve as a waiver of sovereign immunity by any entity to which
sovereign immunity may be applicable.
42. Venue:
If any dispute arises out of this contract,the venue of such legal recourse shall be Leon County,Florida.
43. Entire Contract:
This contract contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations
shall be valid or binding upon the Agency or the Contractor unless expressly contained herein or by a written amendment
to this contract signed by both Parties.
44. Force Maieure:
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control,
provided the party experiencing the force majeure condition provides immediate written notification to the other party
and takes all reasonable efforts to cure the condition.
45. Severability Clause:
The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or unenforceable,
the other provisions are severable to that void provision and shall remain in full force and effect.
46. Condition Precedent to Contract Appropriations:
The Parties agree that the Agency's performance and obligation to pay under this contract are contingent upon an annual
appropriation by the Legislature.
47. Addition/Deletion:
The Parties agree that the Agency reserves the right to add or to delete any of the services required under this contract
when deemed to be in the State of Florida's best interest and reduced to a written amendment signed by both Parties.
The Parties shall negotiate compensation for any additional services added.
48. Waiver:
The delay or failure by the Agency to exercise or enforce any of its rights under this contract will not constitute orbe
deemed a waiver of the Agency's right thereafter to enforce those rights, nor will any single or partial exercise of any
such right preclude any other or further exercise thereof or the exercise of any other right.
49. Compliance:
The Contractor shall abide by all applicable current federal statutes, laws, rules, and regulations as well as applicable
current state statutes,laws,rules and regulations. The Parties agree that failure of the Contractor to abide by these laws
shall be deemed an event of default of the Contractor and subject the contract to immediate unilateral cancellation of
the contract at the discretion of the Agency.
50. Final Invoice:
The Contractor shall submit the final invoice for payment to the Agency no later than thirty(30)days after the contract
ending date unless otherwise specified in Attachment I. If the Contractor fails to do so,all right to payment is forfeited
and the Agency shall not honor any requests submitted after the aforesaid time period.Any payment due under the terms
of this contract shall be withheld until all required documentation and reports due from the Contractorand necessary
adjustments thereto have been approved by the Agency.
Page 13 of 93 C14Q
160 7
January 2022-December 2022 OAA 203.22
51. Renegotiations of Modifications:
Modifications of the provisions of this contract shall be valid only when they have been reduced to writing and duly
signed by both parties. The rate of payment and the total dollar amount may be adjusted retroactively to reflect price
level increases and changes in the rate of payment when these have been established through the appropriations process
and subsequently identified in the Agency's operating budget.
52. Suspension of Work:
The Agency may, in its sole discretion, suspend any or all activities under the contract or purchase order,at any time,
when in the interest of the State to do so.The Agency shall provide the Contractor written notice outlining the particulars
of suspension.Examples of the reason for suspension include,but are not limited to,budgetary constraints,declaration
of emergency, or other such circumstances. After receiving a suspension notice, the Contractorshall comply with the
notice and shall not accept any purchase orders. Within ninety (90) days, or any longer period agreed to by the
Contractor, the Agency shall either: (1) issue a notice authorizing resumption of work, at which time activity shall
resume, or (2) terminate the contract or purchase order. Suspension of work shall not entitle the Contractor to any
additional compensation.
53. Termination:
53.1 Termination for Convenience. The Agency,by written notice to the Contractor, may terminate this contractin
whole or in part when the Agency determines in its sole discretion that it is in the State's interest to do so.The
Contractor shall not furnish any product after it receives the notice of termination,except as necessary to complete
the continued portion of this contract, if any. The Contractor shall not be entitled to recover any cancellation
charges or lost profits.
53.2 Termination for Cause.The Agency may terminate this contract if the Contractor fails to:(1)deliver the product
within the time specified in the contract or any extension, (2) maintain adequate progress, thusendangering
performance of the contract, (3) honor any term of the contract, or (4) abide by any statutory, regulatory, or
licensing requirement. Rule 60A-1.006(3), F.A.C., governs the procedure and consequences of default. The
Contractor shall continue work on any work not terminated. Except for defaults of Subcontractors at any tier,the
Contractor shall not be liable for any excess costs if the failure to perform the contract arises from events
completely beyond the control,and without the fault or negligence,of the Contractor. If the failure to perform is
caused by the default of a Subcontractor at any tier,and if the cause of the default is completely beyond the control
of both the Contractor and the Subcontractor, and without the fault or negligence of either,the Contractor shall
not be liable for any excess costs for failure to perform, unless the subcontracted products were obtainable from
other sources in sufficient time for the Contractor to meet the required delivery schedule. If,after termination,it is
determined that the Contractor was not in default,or that the default was excusable,the rights and obligations of
the Parties shall be the same as if the termination had been issued for the convenience of the Agency.The rights
and remedies of the Agency in this clause are in addition to any other rights and remedies provided by law or
under the contract.
54. Electronic Records and Signature:
The Agency authorizes,but does not require,the Contractor to create and retain electronic records and to use electronic
signatures to conduct transactions necessary to carry out the terms of this contract. A Contractor that createsand retains
electronic records and uses electronic signatures to conduct transactions shall comply with the requirementscontained in
the Uniform Electronic Transaction Act,Section 668.50,F.S.All electronic records must be fully auditable;are subject
to Florida's Public Records Law, Chapter 119, F.S.; must comply with contract Section 29, Data Integrity and
Safeguarding Information;must maintain all confidentiality,as applicable; and must be retained and maintained by the
Contractor to the same extent as non-electronic records are retained and maintained as required by this contract.
54.1 The Agency's authorization pursuant to this section does not authorize electronic transactions between the
Contractor and the Agency.The Contractor is authorized to conduct electronic transactions with the Agency only
upon further written consent by the Agency.
54.2 Upon request by the Agency, the Contractor shall provide the Agency with non-electronic (paper) copies of
records. Non-electronic (paper) copies provided to the Agency any document that was originally in electronic
form with an electronic signature must identify the person and the person's capacity who electronically signed the
document on any non-electronic copy of the document.
Page 14 of 93 CA
160 7
January 2022-December 2022 OAA 203.22
55. Contract Manager:
The Agency may substitute any Agency employee to serve as the Agency Contract Manager.
REMAINDER OF THE PAGE INTENTIONALLY LEFT BLANK
Page 15 of 93 C11
160 7
January 2022-December 2022 OM 203.22
56.Official Payee and Representatives(Names.Addresses,and Telephone Numbers);
The Contractor name,as shown on page 1 of this Collier County Board of County Commissioners
a. contract,and mailingaddress of the officialpayee to 3339 iJ' ml Naples, l.3Trail,Building H
F(,34 112
whom the payment shall be made is:
The name of the contact person and street address Krisli Sonntag,Director
Collier County Board of County Commissioners
b. where financial and administrative records are Community and Human Services
maintained is: 3339 E Tnmiaml Trail,Building H
---. ...._ _._ Naples,FL 34112
Kristi Sontag,Director
The name,address,and telephone number of the Collier County Board of County Commissioners
c. representative of the Contractor responsible for Community and Human Services
administration of the program under this contract is: 333913 Tarniami Trail,Building H
Naples,FL 34112
(239)252-2273
Area Agency on Aging for Southwest Florida,inc,
The section and location within the Agency wlrereRequests 2830 Winkler Ave.,Suite 112
d. for Payment and Receipt and Expenditure forms are to be Fort Myers,FL 33916
mailed is:
Richard Cocchieri
The name,address,and telephone number of the Area Agency on Aging for Southwest Florida,Inc.
e. Contract Manager for this contract is: 2830 Winkler Ave,,Suite 112
Fort Myers,FL 33916
(239)652-6900 x58279
Upon change of representatives(names,addresses,telephone numbers)by either patty,notice shall be providedin
writing to the other party.
57. All Terms and Conditions Included;
This contract and its Attachments 1—XVI,including any exhibits referenced In said attachments,together with any
documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties,There are no
provisions, terms, conditions, or obligations other than those contained herein,and this contract shall supersede nil
previous communications,representations,or agreements,either written or verbal,between the Parties.
By signing this contract,the Parties agree that they have read and agree to the entire contract.
IN WITNESS WHEREOF,the Parties hereto have caused this contract to he executed by their undersigned officials
as duly authorized.
CONTRACTOR:COLLIER COUNT RD OF AREA AGENCY ON AGING FOR
COUNTY C(O MISRIONER • SO1!TH W FLORIDA,INC.
• l9'UV�I �42.
SIGNATURi SIGNATURE
NAME No RMA i ADORN°
NAME
TITLE PUBLIC SERVICE DEPARTMENT HEAD TITLE PRESIDENT&CEO
DATE �' 2. 1` )--O 2:7
DATE 0I/4'12022
Approved as to form and legality
Federal Tax ID:59-6000558 Duns:076997790
Assiannt County Attorney
l(la l as
Page le or 93
c10
I D 7
January 2022-December 2022 OAA 203.22
INDEX OF ATTACHMENTS
ATTACHMENT I 18
STATEMENT OF WORK 18
ATTACHMENT II 56
FINANCIAL AND COMPLIANCE AUDIT 56
ATTACHMENT III 63
CERTIFICATIONS AND ASSURANCES 63
ATTACHMENT IV 68
ASSURANCES—NON-CONSTRUCTION PROGRAMS 68
ATTACHMENT V 70
FLORIDA Department of ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST 70
ATTACHMENT VI 74
CONTRACTOR'S STATE CONTRACT LIST 74
ATTACHMENT VIII 76
CERTIFIED MINORITY BUSINESS SUBCONTRACTOR EXPENDITURES(CMBE FORM) 76
ATTACHMENT IX 78
BUDGET SUMMARY 78
ATTACHMENT X 79
INVOICE SCHEDULE 79
EXHIBIT 1 80
EXHIBIT 2 81
ATTACHMENT XI 82
REQUEST FOR PAYMENT 82
ATTACHMENT XII 83
RECEIPTS AND EXPENDITURE REPORT 83
EXHIBIT 1 83
EXHIBIT 2 84
EXHIBIT 3 85
EXHIBIT 4 86
EXHIBIT 5 87
EXHIBIT 6 88
EXHIBIT 7 89
ATTACHMENT XIII 90
COMPUTATION OF CARRYFORWARD AND OVERADVANCE OAA TITLE HI 90
ATTACHMENT XIV 91
COST REIMBURSEMENT SUMMARY 91
ATTACHMENT XV 92
SERVICE RATE REPORT 92
ATTACHMENT XVI 95
OAA ANNUAL VOLUNTEER ACTIVITY REPORT SPECIFICATIONS 95
Page 17 of 93 eA
0
160 7
January 2022-December 2022 OAA 203.22
ATTACHMENT I
STATEMENT OF WORK
I. SERVICES TO BE PROVIDED
A. Definitions of Terms
1. Contract Acronyms
Area Agency on Aging(AAA)
Activities of Daily Living(ADL)
Administration on Aging(AoA)
Administration on Community Living(ACL)
Alliance of Information&Referral Systems(AIRS)
Assessed Priority Consumer List(APCL)
Adult Protective Services(APS)
Chronic Disease Self-Management Education(CDSME)
Chronic Disease Self-Management Program(CDSMP)
Dietary Reference Intake(DRI)
Enterprise Client Information and Registration Tracking System(eCIRTS)
Evidence-Based Disease Prevention and Health Promotion(EBDPHP)
Florida Department of Business and Professional Regulations(DBPR)
Florida Department of Elder Affairs(Agency or Agency)
Florida Department of Health(DOH)
Information and Referral(I&R)
Instrumental Activities of Daily Living(IADL)
National Council on Aging(NCOA)
Nutrition Services Incentive Program(NSIP)
Older Americans Act(OAA)
Planning and Service Area(PSA)
State of Florida(State)
Statewide Medicaid Managed Care Long-Term Care(SMMC LTC)
United States Department of Agriculture(USDA)
United States Department of Health and Human Services(USDHHS)
2. Program Specific Terms
Adult Child with a Disability:A child who is age 18 or older and is financially dependent on an older individual who is
a parent of the child and has a disability.
Area Plan:A plan developed by the AAA outlining a comprehensive and coordinated service delivery systemin its PSA in
accordance with Section 306 of the OAA[42 United States Code(U.S.C.)§3026]and Agencyinstructions.
Area Plan Update: A revision to the Area Plan wherein the AAA enters OAA specific data in eCIRTS.An update may
also include other revisions to the Area Plan as instructed by the Agency.
Child: An individual who is not more than eighteen(18)years of age or an individual with a disability.
Criteria:A standard which the AoA/ACL set for the Title IIID Program.AoA/ACL's standard criterion consists of three
tiers:Minimal Criteria,Intermediate Criteria,and Highest-Level Criteria.
Page 18 of 93 e
160 7
January 2022-December 2022 OAA 203.22
Family Caregiver: An adult family member, or another individual, who is an informal provider of in-home
and community care to an older individual.
Frail: When an older individual is(1)determined to be unable to perform at least two activities of daily living
without substantial human assistance, including verbal reminding,physical cueing,or supervision or(2)unable
to perform at least three such activities without such assistance; or, (3) due to a cognitive or other mental
impairment, requires substantial supervision because the individual behaves in a manner that poses a serious
health or safety hazard to the individual or to another individual.
Grandparent: A grandparent or step-grandparent of a child, or a relative of a child by blood, marriage or
adoption, who: (1) lives with the child, (2) is the primary caregiver of the child because the biological or
adoptive parents are unable or unwilling to serve as the primary caregiver of the child, and (3) has a legal
relationship to the child,such as legal custody or guardianship,or is raising the child informally.
B. General Description
1. General Statement
The primary purpose of the OAA Program is to foster the development and implementation of comprehensive
and coordinated systems to serve older individuals.These systems assist older individuals to attain and maintain
maximum independence with supportive services.
The NSIP provides incentives for the effective delivery of nutritious meals to older individuals. NSIP allows
programs to increase the number and/or the quality of meals served. NSIP is a cash allotment or commodity
program that supplements funding or food used in meals served under the OAA. Florida has opted for cash
payments in lieu of donated foods.
2. Authority
All applicable federal laws, regulations, action transmittals, program instructions, review guides and similar
documentation related to the following:
a. Catalog of Federal Domestic Assistance Nos.93.043,93.044,93.045,93.052,and 93.053;
b. Older Americans Act of 1965,as amended 2020;
c. 42 U.S.C. §303 and§604;
d. Rule 58A-1,Florida Administrative Code(F.A.C.);
e. Section 430.101,Florida Statutes(F.S.);and
f. Agency Programs and Services Handbook, which is hereby incorporated by reference, to include any
subsequent revisions thereof.
3. Scope of Service
The Contractor is responsible for the programmatic,fiscal,and operational management of the OAA Title IIIB,
Title IIIC1,Title IIIC2,Title IIID,and Title IIIE Programs and NSIP,within its designated PSA. The program
services shall be provided in a manner consistent with the Contractor's current Area Plan,as updated and hereby
incorporated by reference,and the current Agency Programs and Services Handbook.The Contractor shall use
the NSIP funding to supplement funding for food used in meals served by OAA Nutrition Program Providers.
4. Major Program Goals
The major goals of the OAA Program are to improve older individuals' quality of life, preserve their
independence, and prevent or delay their need for costlier institutional care. These goals are achieved through
the implementation of a comprehensive and coordinated service system that provides a continuum of service
alternatives and effective delivery of nutritious meals that meet the diverse needs of elders and their caregivers.
C. Clients to be Served
1. General Description
The OAA Program gives preference to older individuals with greatest economic need and older individuals
with greatest social need (with particular attention to low-income older individuals, including low-income
minority older individuals,older individuals with limited English proficiency,and older individuals residing in
rural areas),
Page 19 of 93 040
January 2022-December 2022 1 6 EL 20722
2. Client Eligibility
a. OAA Title III
Consumers shall not be dually enrolled in an OAA Program and a Medicaid capitated Long-Term Care
Program, except consumers in need of OAA Legal Assistance services and OAA Congregate Nutrition
Services,including transportation to and from congregate meal sites.
b. NSIP
Meals served to an elderly individual, funded in whole or in part under the SMMC LTC, Home Care for
the Elderly,Community Care for the Elderly Programs,or other means tested programs may not be included
in the NSIP count. OAA-funded congregate meals provided to SMMC LTC clients may be included in the
NSIP count.
c. OAA Title IIIB,Supportive Services
i. Individuals must be age sixty(60)or older;and
ii. I&R/Assistance services are provided to individuals regardless of age.
d. OAA Titles IIIC1 and IIIC2,Nutrition Services,General
General factors that shall be considered in establishing priority for the receipt of nutrition services include
those older persons who:
i. Cannot afford to eat adequately;
ii. Lack the skills or knowledge to select and prepare nourishing and well-balanced meals;
iii. Have limited mobility which may impair their capacity to shop and cook for themselves;
iv. Have a disabling illness or physical condition requiring nutritional support;or
v. Have been screened at a high nutritional risk.
e. OAA Title IIIC1,Congregate Nutrition Services
In addition to meeting the general nutrition services eligibility requirements listed in Section I.C.2.d.above,
individuals must be mobile, not homebound, and physically, mentally, and medically able to attend a
congregate nutrition program. Individuals eligible to receive congregate meals include the following:
i. Individuals age sixty(60)or older;
ii. Any spouse(regardless of age)who attends the dining center with his/her eligible spouse;
iii. Persons with a disability,regardless of age,who reside in a housing facility occupied primarily by older
individuals where congregate nutrition services are provided;
iv. Disabled persons who reside at home with and accompany an eligible person to the dining center;and
v. Volunteers,regardless of age,who provide essential services on a regular basis during meal hours.
f. OAA Title IIIC2,Home Delivered Nutrition Services
In addition to meeting the general nutrition services eligibility requirements as listed in Section I.C.2.d.,
individuals must be homebound and physically, mentally, or medically unable to attend a congregate
nutrition program. Individuals eligible to receive home delivered meals include the following:
i. Individuals age sixty(60)or older who are incapacitated or unable to attend a congregate nutrition site
due to illness, disability,isolation,or caring for a loved one who is ill at home;
ii. Individuals age sixty (60) or older who are unable to attend a congregate nutrition site due to teeth
and/or mouth issues which makes it difficult to eat in public;
iii. Individuals age sixty (60) or older who are at nutritional risk who have physical, emotional, or
behavioral conditions which would make their presence at congregate nutrition sites inappropriate;
iv. Individuals age sixty (60) or older who are at nutritional risk who are socially or otherwise isolated,
including those who are self-isolating at home due to health or other reasons, and unable to attend a
congregate nutrition site;
Page 20 of 93
C440
January 2022-December 2022 600 203.7
v. Individuals age sixty(60) or older who are unable to prepare meals due to a lack of or inadequacy of
facilities;an inability to shop,cook,or prepare meals safely;a lack of funds to purchase nutritious food;
or a lack of appropriate knowledge or skill;
vi. A home delivered meals recipient's spouse, regardless of age, if the provision of the collateral meal
supports maintaining the person at home;and
vii. Individuals with disabilities, regardless of age, who reside at home with home delivered meals
recipients and are dependent on them for care.
g. OAA Title IIID,Disease Prevention and Health Promotion Services
i. Target individuals age sixty(60)or older;and
ii. Priority will be given to individuals residing in medically underserved areas.
h. OAA Title IIIE,Caregiver Support Services
Eligibility for OAA Title IIIE,Caregiver Support Services,is as follows:
i. Eligible individuals include:
(1) Family caregivers of individuals age sixty(60)or older; and
(2) Grandparents [age fifty-five (55) or older] or older individuals [age fifty-five (55) or older] who
are relative caregivers.
ii. For respite and supplemental services,a family caregiver must be providing care for an older individual
who meets the definition of the term"frail"as defined above.
iii. For Home Delivered Meals for IIIE and IIIEG,caregivers and individuals who reside in the home and
are dependent on the caregiver for care.
iv. Priority will be given to family caregivers who provide care for individuals with Alzheimer's disease
and related disorders with neurological and organic brain dysfunction and to grandparents or older
individuals who are relative caregivers who provide care for children with severe disabilities.
II. MANNER OF SERVICE PROVISION
A. Service Tasks
To achieve the goals of the OAA Program,the Contractor shall ensure performance of the following tasks:
1. Client Eligibility Determination
The Contractor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a
client is based on meeting the requirements described in Section I.C.2.
2. Targeting and Screening New Clients for Service Delivery
The Contractor shall develop and implement policies and procedures consistent with OAA targeting and
screening criteria for new clients.
3. Program Services
The Contractor shall ensure the provision of program services is consistent with the Contractor's current Area
Plan,as updated and approved by the Agency,and the current Agency Programs and Services Handbook.
4. Program Eligibility Requirements
a. Eligibility Criteria
To be eligible for program participation,an entity must:
i. Be an agency that has received a grant under OAA Title III [OAA section 311(42 U.S.C. § 3030a)];
and
ii. Partner with a nutrition service provider that serves meals and is under the jurisdiction, control,
management,and audit authority of the AAA and the Agency.:
Page 21 of 93 C`i®
January 2022-December 2022 AA203.2 2
b. Provider's Nutrition Service Operations
The Contractor shall ensure that the nutrition service operations of the provider meet the requirements of
this contract, as well as any other applicable regulations and policies prescribed by the current Agency
Programs and Services Handbook,USDHHS,USDA,DOH and local health Agencys,DBPR,or any other
agency designated to inspect meal quality for the State.
c. Prescribed Nutritional Requirements
The Contractor shall ensure that each meal provided under this contract meets the following criteria:
i. Complies with the current Dietary Guidelines for Americans, published by the Secretaries of the
USDHHS and USDA;and
ii. Provides a minimum of thirty-three and a third percent (33 1/3%) of the dietary reference
intakes/adequate intakes for a female age seventy(70)or older as established by the Food and Nutrition
Board of the National Academy of Sciences.
d. Food Origin and Commodities Requirements
Consistent with existing requirements of the NSIP,the Contractor and its service providers may use NSIP
cash to purchase foods of U.S. origin for their nutrition projects under Title III of the OAA. NSIP funds
must be used to expand meal services to older adults.
B. Use of Subcontractors
If this contract involves the use of a subcontractor or third party, then the Contractor shall not delay the
implementation of its agreement with the Subcontractor.If any circumstance occurs that may result in a delay for a
period of sixty(60) days or more of the initiation of the subcontract or the performance of the Subcontractor, the
Contractor shall notify the Agency Contract Manager and the Agency's Chief Financial Officer in writing of such
delay. The Contractor shall not permit a Subcontractor to perform services related to this contract without having a
binding Subcontractor agreement executed. The Agency will not be responsible or liable for any obligations or
claims resulting from such action.
1. Copies of Subcontracts
The Contractor shall submit copies of all subcontracts to the Agency Contract Manager within thirty(30)days
of execution of each subcontract agreement.
2. Monitoring the Performance of Subcontractors
The Contractor shall monitor,at least once per year,each of its subcontractors, sub-recipients,vendors,and/or
consultants paid from funds provided under this contract. The Contractor shall perform fiscal, administrative,
and programmatic monitoring to ensure contractual compliance, fiscal accountability, programmatic
performance, and compliance with applicable state and federal laws and regulations. The Contractor shall
monitor its subcontractors to ensure that the budget and scope of work are accomplished within the specified
time periods,and that all performance goals stated in this contract are achieved.
a. The Contractor shall require subcontractors to enter all required data per the Agency's eCIRTS Policy
Guidelines for clients and services into the eCIRTS database. The data must be entered into the eCIRTS
database before the subcontractors submit their Request for Payment and Receipts and Expenditure Reports
to the Contractor. The Contractor shall establish time frames to ensure compliance with due dates for the
Requests for Payment and Receipts Expenditure Reports to the Agency.
b. The Contractor shall require subcontractors to run monthly eCIRTS reports and to verify that the client and
service data in the eCIRTS database is accurate. This report must be submitted to the Contractor with the
monthly Request for Payment and Receipts and Expenditure Report and must be reviewed by the Contractor
before the subcontractor's Request for Payment and Receipts and Expenditure Reports can be approved by
the Contractor.
c. The Contractor shall require subcontractors to report on outreach activities at least semi-annually using a
uniform reporting format established by the Contractor.Subcontractor reports must include the total number
of outreach events or activities performed by the subcontractor as well as the following information for
each event or activity: date, location, type of event or activity, total number of participants, individual
service needs identified,and referral sources or information provided to participants.
Page 22 of 93 CA
160 7
January 2022-December 2022 OAA 203.22
C. Staffing Requirements
1. Staffing Levels
The Contractor shall assign its own administrative and support staff as needed to perform the tasks,
responsibilities, and duties under this contract and ensure that subcontractors dedicate adequate staff
accordingly.
2. Professional Qualifications
The Contractor shall ensure that the staff responsible for performing any duties or functions within this contract
have the qualifications specified in the Agency Programs and Services Handbook.
3. Service Times
The Contractor shall ensure the availability of services listed in this contract at times appropriate to meet client
service needs, including, at a minimum, during normal business hours.Normal business hours are defined as
Monday through Friday, 8:00 a.m.to 5:00 p.m. local time.
D. Deliverables
The following section provides the specific quantifiable units of deliverables and the source documentation required
to evidence the completion of the tasks specified in this contract. The Contractor must submit all required
documentation in the time and manner specified for the minimum performance levels to be met. Each deliverable
must be accepted in writing by the Agency Contract Manager based on the requirements for each deliverable before
the Contractor submits an invoice requesting payment.
1. Delivery of Services to Eligible Clients
The Contractor shall ensure the provision of a continuum of services that meets the diverse needs of elders and
their caregivers. Documentation of service delivery must include a report consisting of the following: number
of clients served, number of service units provided by service, and rate per service unit with calculations that
equal the total invoice amount. The Contractor shall ensure the performance and reporting of the following
types of services,in accordance with the Contractor's current Agency-approved Area Plan,the current Agency
Programs and Services Handbook,and Section II.A.
a. Supportive Services(IIIB Program)
Supportive services include a variety of community-based and home-delivered services that support older
individuals' quality of life by helping them remain independent and productive. Services include the
following:
i. Adult Day Care/Adult Day Health Care;
ii. Caregiver Training/Support;
iii. Caregiver Support Groups;
iv. Case Aid/Case Management;
v. Chore and Chore(Enhanced);
vi. Companionship;
vii. Counseling(Gerontological and Mental Health/Screening);
viii. Education/Training;
ix. Emergency Alert Response;
x. Escort;
xi. Health Support;
xii. Home Health Aid;
xiii. Homemaker;
xiv. Housing Improvement;
xv. Information;
Page 23 of 93 q
160 7
January 2022-December 2022 OAA 203.22
xvi. Intake;
xvii. Interpreter/Translating;
xviii. Legal Assistance;
xix. Material Aid;
xx. Occupational Therapy;
xxi. Outreach;
xxii. Personal Care;
xxiii. Physical Therapy;
xxiv. Recreation;
xxv. Referral/Assistance;
xxvi. Respite Services(In-Home and Facility Based);
xxvii. Screening/Assessment;
xxviii. Shopping Assistance;
xxix. Skilled Nursing;
xxx. Specialized Medical Equipment,Services,and Supplies;
xxxi. Speech Therapy;
xxxii. Telephone Reassurance;and
xxxiii. Transportation.
b. Congregate Nutrition Services(IIIC1 Program)
Nutrition services are provided in congregate settings and are designed to reduce hunger and food insecurity
and to promote socialization and the health and well-being of older individuals through access to nutrition
and other disease prevention and health promotion services. Services include the following:
i. Congregate meals;
ii. Congregate meals screening;
iii. Nutrition education and nutrition counseling;
iv. Outreach;
v. Shopping Assistance;and
vi. Telephone Reassurance.
c. Home Delivered Nutrition Services(IIIC2 Program)
In-home nutrition services are provided to reduce hunger and food insecurity; promote socialization and
the health and well-being of older individuals by assisting such individuals to gain access to nutrition and
other disease prevention and health promotion services. Services include the following:
i. Home delivered meals;
ii. Nutrition education and counseling;
iii. Outreach; and
iv. Screening/Assessment.
v. Shopping Assistance;and
vi. Telephone Reassurance.
Page 24 of 93 Cq0
160 7
January 2022-December 2022 OAA 203.22
d. Disease Prevention and Health Promotion Services(Title IIID Program)
Evidence-Based Disease Prevention and Health Promotion (EBDPHP) services have been demonstrated
through evaluation to be effective for improving health and wellbeing or reducing disease,disability,and/or
injury among older adults. The ACL defines EBDPHP services as meeting highest-level criteria. Only
services that meet the highest-level criteria are allowable under the IIID Program. EBDPHP services must
be delivered per the requirements of the program and ensure program fidelity. EBDPHP services include
the following:
i. A Matter of Balance;
ii. Active Living Every Day;
iii. Arthritis Foundation Exercise Program;
iv. Arthritis Foundation Tai Chi Program(Tai Chi for Arthritis);
v. Arthritis Self-Management Program;
vi. Brief Intervention&Treatment for Elders(BRITE);
vii. Chronic Disease Self-Management Program;
viii. Chronic Pain Self-Management Program;
ix. Diabetes Empowerment Education Program(DEEP);
x. Diabetes Self-Management Program;
xi. Disease Information
xii. Enhance Fitness;
xiii. Enhance Wellness;
xiv. Fit and Strong!;
xv. Healthy Eating Every Day;
xvi. Healthy Ideas;
xvii. Healthy Moves for Aging Well;
xviii. Home Injury Control;
xix. HomeMeds;
xx. Physical Fitness;
xxi. Powerful Tools for Caregivers;
xxii. Program to Encourage Active Rewarding Lives for Seniors(PEARLS);
xxiii. Programa de Manejo Personal de la Arthritis;
xxiv. Programa de Manejo Personal de la Diabetes;
xxv. Shopping Assistance;
xxvi. Stepping On;
xxvii.Stay Active and Independent for Life(SAIL);
xxviii. Tai Chi/Tai Ji Quan Moving for Better Balance(Highest-Level);
xxix. Telephone Reassurance;
xxx. Tomando Control de su Salud;
xxxi. Un Asunto de Equilibrio;and
xxxii.Walk with Ease.
Page 25 of 93 q®
t69 7
January 2022-December 2022 OAA 203.22
e. Caregiver Support Services(IIIE Program)
The following services are intended to provide direct aid to caregivers in the areas of health,nutrition,and
financial literacy, and to assist them with decision-making and problem-solving related to their caregiving
roles and responsibilities:
i. Adult Day Care/Adult Day Health Care;
ii. Caregiver Training/Support;
iii. Caregiver Support Groups;
iv. Counseling(Gerontological and Mental Health/Screening);
v. Education/Training;
vi. Financial Risk Reduction(Assessment and Maintenance);
vii. Home Delivered Meals;
viii. Information;
ix. Intake;
x. Outreach;
xi. Powerful Tools for Caregivers;
xii. Referral/Assistance;
xiii. Respite Services(In-Home and Facility Based);
xiv. Screening/Assessment;
xv. Shopping Assistance;
xvi. Telephone Reassurance;and
xvii. Transportation.
(1) Caregiver Support Supplemental Services(IIIES Program)
At least ten percent(10%),but no more than twenty percent(20%),of the total Title IIIE funds
shall be used to provide supplemental support services. The following services are provided to
complement the care provided by caregivers:
(a) Chore and Chore(Enhanced);
(b) Housing Improvement;
(c) Legal Assistance;
(d) Material Aid;and
(e) Specialized Medical Equipment, Services and Supplies.
(2) Caregiver Support Grandparent Services(IIIEG Program)
At least five percent(5%),but no more than ten percent(10%),of the total Title IIIE funds shall be
used to provide support services to grandparents and older individuals who are relative caregivers.
Services for grandparents or older individuals who are relative caregivers that are designed to help
them meet their caregiving obligations include the following:
(a) Caregiver Training/Support;
(b) Caregiver Support Groups;
(c) Child Day Care;
(d) Counseling(Gerontological and Mental Health/Screening);
(e) Education/Training;
(t) Legal Assistance;
Page 26 of 93 C
40
i 60 7
January 2022-December 2022 OAA 203.22
(g) Outreach;
(h) Referral/Assistance;
(i) Screening/Assessment;
(j) Shopping Assistance;
(k) Sitter;
(I) Telephone Reassurance;and
(m)Transportation.
f. Information and Referral/Assistance Services(Elder Helplines)
The Contractor shall ensure, through training and periodic quality assurance, that Elder Helpline
Information and Referral/Assistance Services adhere to the Alliance of Information and Referral Systems
(AIRS) Summary of Standards for Professional Information & Referral, provided as Attachment I. The
Agency's standards are based on the current AIRS standards. The standards have been amended by the
Agency to address the unique needs of the Elder Helpline Information and Referral system.
2. Provision of Services
The Contractor shall ensure the provision of the services described in this contract are in accordance with the
current Agency Programs and Services Handbook, the Contractor's current Agency-approved Area Plan, and
the tasks described in Section ILA.
3. Administrative Responsibilities
The Contractor shall provide management and oversight of OAA Program operations in accordance with the
current Agency Programs and Services Handbook and the Contractor's current Agency-approved Area Plan.
Management and oversight of OAA Program Operations include the following:
a. Develop an Area Plan and updating it annually,at a minimum,as directed by the Agency.
b. Establish written policies,procedures,criteria,and standards for purchasing and procurement of goods and
services on an open and competitive basis.
c. Review routine and special reports submitted by subcontractors and vendors.
d. Provide technical assistance to subcontractors and vendors to ensure provision of quality services.
e. Monitor and evaluate subcontractors and vendors for fiscal,administrative,and programmatic compliance.
f. Appropriately and timely submit payments to subcontractors.
g. Establish procedures for handling recipient complaints and grievances concerning such adverse actions as
service termination,suspension,or reduction.
i. Complaint Procedures
The Contractor shall develop and implement complaint procedures and ensure that subcontractors
develop and implement complaint procedures to process and resolve client dissatisfaction with services.
Complaint procedures shall address the quality and timeliness of services,provider and direct service
worker complaints, and all other issues except the termination, suspension, or reduction of services,
which shall be addressed through the grievance process as described in Appendix D of the Agency
Programs and Services Handbook. Complaint procedures shall include notification to all clients of the
complaint procedure and include tracking the date,nature,and disposition of each complaint.
ii. Legal Provider Grievance Procedures
The Contractor shall ensure that legal providers have an internal grievance procedure that addresses
both denial of service and complaints by clients about manner or quality of legal assistance.Grievance
procedures that comport with the requirements of the Legal Services Corporation as provided in 45
Page 27 of 93 C
40
I 6 O 7
January 2022-December 2022 OAA 203.22
Code of Federal Regulation(CFR) Part 1621 are sufficient to meet this standard. At a minimum, the
procedure must provide applicants with:
(1) Adequate notice of the grievance procedures;
(2) Information on how to file a grievance or complaint,and
(3) Prompt consideration of each complaint by the Executive Director or the Executive Director's
designee.
The Contractor may not serve in an appellate capacity or otherwise interfere in the grievance review
process for legal providers.However,the Contractor may request that legal providers maintain a file of
complaints and statements of disposition of complaints, with redacted client identifying information,
for examination by the Contractor during monitoring.
h. Ensure compliance with eCIRTS regulations.
i. Monitor performance objective achievements per targets set by the Agency.
j. Conduct annual client satisfaction surveys to evaluate and improve service delivery.
E. Reports
The Contractor shall respond to additional, routine, or special requests for information and reports required by the
Agency in a timely manner as determined by the Agency Contract Manager.The Contractor shall establish reporting
deadlines and due dates for subcontractors that permit the Contractor to review and validate the data andmeet the
Agency's reporting requirements.
1. OAA Annual Volunteer Activity Report
The Contractor shall submit an OAA Annual Volunteer Activity Report electronically,at the following interne
address:http://elderaffairs.state.fl.us/doea/volunteers.php,per the report specifications provided in Attachment
XVI. The Annual Volunteer Activity Report must be completed and submitted to the Agency by January 15,
2022.
2. eCIRTS Reports
a. Contractor shall input OAA-specific and NSIP-specific data into eCIRTS.To ensure eCIRTS data accuracy,
the Contractor shall use eCIRTS-generated reports which include the following:
i. Client Reports;
ii. Monitoring Reports;
iii. Services Reports;
iv. Miscellaneous Reports;
v. Fiscal Reports;and
vi. Outcome Measurement Reports.
b. eCIRTS Data Entries for Contractors
The Contractor must require subcontractors to enter all required data for clients and services in the eCIRTS
database per the Agency Programs and Services Handbook and the eCIRTS User Manual—Aging Provider
Network users (located in Documents on the eCIRTS Enterprise Application Services). Subcontractors
must enter this data into the eCIRTS database prior to submitting their Requests for Payment and Receipts
and Expenditure Reports to the Contractor.The Contractor shall establish deadlines for completing eCIRTS
data entry to ensure compliance with due dates for the Requests for Payment and Receipts and Expenditure
Reports that Contractor must submit to the Agency.
c. Monthly eCIRTS Reports
The Contractor must run monthly eCIRTS reports and verify that client and service data in the eCIRTS
database is accurate. This report must be submitted to the Contractor with the monthly Request for
Payment and Receipts and Expenditure Reports and must be reviewed by the
Page 28 of 93 0.40
16Q 7
January 2022-December 2022 OAA 203.22
Contractor before the subcontractor's Request for Payment and Receipts and Expenditure Reports can be
approved by the Contractor.
d. Quarterly Mental Distress Reports
The Contractor must run at a minimum quarterly eCIRTS Mental Distress Reports and provide follow-up
contacts to all active clients (other than clients who are active in SMMC LTC) identified with new(from
their most recent assessment) and persistent (from their two most recent) mental distress. Follow-up
information must be submitted in eCIRTS and will be reviewed by the Agency's Contract Manager ona
quarterly basis. Follow-ups shall include wellness checks(either over the phone or in person),address the
client's needs for mental health counseling or support, care through a medical professional, referrals to
aging network services,referrals to community resources,etc.
3. Lead Spending Report
The Contractor shall submit a spending report, in a format provided by the Agency, tothe Agency Contract
Manager by the 18th of each month.This Report is for all agreements and/or contracts between the Contractor
and the Agency and must include the following:
a. Status regarding surplus/deficit;
b. The Contractor's detailed plan on how the surplus/deficit spending which exceeds the threshold specified
by the Agency will be resolved;
c. Recommendations to transfer funds to resolve surplus/deficit spending;
d. Input from the Contractor's Board of Directors on resolution of spending issues,if applicable;
4. OAA National Aging Program Information System(NAPIS)Report
Data required for the OAA NAPIS Report that is not recorded in eCIRTS will be provided to the Agency
Contract Manager in the format and on the date established by the Agency.
a. .
5. Program Highlight Narratives
The Contractor shall submit brief written narratives to the Agency for publication in the Program Highlight
sections of the Agency's Summary of Programs and Services, which is hereby incorporated by reference, to
include any subsequent revisions thereof.The narratives shall reference specific events that have occurred since
the last submission of Program Highlight narratives, including new success stories, quotes, testimonials,or
human-interest vignettes.The narratives shall be written for a general audience,with no acronyms or technical
terms.For all agencies or organizations that are referenced in the narratives,the Contractor shall provide a brief
description of their mission or role. The active tense shall be consistently used in the narrativesto identify the
specific individuals or entities that performed the activities described in the narratives. The Contractor shall
review and edit narratives for clarity, readability, relevance, specificity, human interest, and grammar prior to
submitting them to the Agency.
F. Records and Documentation
1. The Contractor agrees to make available to Agency staff and any party designated by the Agency all contract
related records and documentation.The Contractor shall ensure the collection and maintenance of all program
related information and documentation on any system designated by the Agency. Maintenance
Page 29 of 93 eA
160 7
January 2022-December 2022 OAA 203.22
includes valid exports and backups of all data and systems according to Agency standards.Data must be usable
and must be maintained in a format that is readable to the Agency.
2. eCIRTS Data and Maintenance
The Contractor shall ensure monthly collection and maintenance of client and service information in eCIRTS,
or any other system designated by the Agency. Maintenance includes ensuring that all data is accurate and
current and performing valid exports and backups of all data and systems according to Agency standards.
3. Policies and Procedures for Records and Documentation
The Contractor shall maintain written policies and procedures for computer system backup and recovery and
shall have the same requirement of its subcontractors.These policies and procedures shall be made available to
the Agency upon request.
4. eCIRTS Address Validation
The Contractor shall work with the Agency to ensure that client addresses are correct in eCIRTS for disaster
preparedness efforts. At least annually, and more frequently as needed, the Agency will provide direction on
how to validate eCIRTS addresses to ensure they can be mapped.The Contractor will receive a list of unmatched
addresses that cannot be mapped, and the Contractor will be responsible for working with the localservice
providers to correct addresses and send a list to the Agency with confirmed addresses.The Agency will use this
information to update maps, client rosters, and unmatched addresses and disseminatethis information to the
local service providers.
G. Performance Specifications
1. Outcomes and Outputs(Performance Measures)
At a minimum,the Contractor shall:
a. Ensure the provision of the services described in this contract are in accordance with the Agency Programs
and Services Handbook,the Contractor's current Agency-approved Area Plan,and Section II.A.
b. Timely and accurately submit to the Agency all documentation and reports described in Attachment I,
Section II.E.
c. Timely and accurately,per Attachment X,submit to the Agency Attachments XI and XII,Exhibits 1 —7.
d. Develop and document strategies in the Area Plan to support the Agency's standard of performance
achievement, including increases in the following:
i. Percentage of most frail elders who remain at home or in the community instead of going into a nursing
home;
ii. Percentage of APS referrals who need immediate services to prevent further harm who are served within
seventy-two(72)hours;
iii. Percentage of active clients eating two or more meals per day;
iv. Percentage of new service recipients whose ADL assessment score has been maintained or improved;
v. Percentage of new service recipients whose IADL assessment score has been maintained or improved;
vi. Percentage of caregivers who, after service intervention, self-report being very confident about their
ability to continue to provide care; and
vii. Percentage of customers who are at imminent risk of nursing home placement who are served with
community-based services.
2. The Contractor's performance of the measures in G.1,above,will be reviewed and documented in theAgency's
Annual Programmatic Monitoring Reports.
3. Monitoring and Evaluation Methodology
The Agency will review and evaluate the performance of the Contractor under the terms of this contract.
Monitoring shall be conducted through direct contact with the Contractor via telephone, in writing, or an on-
site visit. The primary, secondary, or signatory of the contract must be available for any on-site programmatic
monitoring visit. The Agency reserves the right to conduct an on-site visit unannounced by persons duly
Page 30 of 93 CA
`7®
160 7
January 2022-December 2022 OAA 203.22
authorized by the Agency. 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 servicetasks and
deliverables.The Agency may use,but is not limited to,one or more of the following methods for monitoring:
a. Desk reviews and analytical reviews;
b. Scheduled,unscheduled,and follow-up on-site visits;
c. Client visits;
d. Review of independent auditor's reports;
e. Review of third-party documents and/or evaluation;
f. Review of progress reports;
g. Review of customer satisfaction surveys;
h. Agreed-upon procedures review by an external auditor or consultant;
i. Limited-scope reviews;and
j. Other procedures as deemed necessary by the Agency.
4. Performance Definitions
"Work day" shall mean a provider's staff member's eight (8) hour work period, unless specifically noted
otherwise."Day"shall mean a calendar day,unless specifically noted otherwise.
H. Contractor Responsibilities
1. Contractor Unique Activities
All tasks listed above in Section II.are solely and exclusively the responsibility of the Contractor and are tasks
for which,by execution of this contract,the Contractor agrees to be held accountable.
2. Coordination with Other Providers and/or Entities
Notwithstanding that services for which the Contractor is held accountable involve coordination with other
entities in performing the requirements of this contract, the failure of other providers or entities does not
alleviate the Contractor from any accountability for tasks or services that the Contractor is obligated to perform
pursuant to this contract.
I. Agency Responsibilities
1. Agency Obligations
The Agency may,within its resources,provide technical support and/or assistance to the Contractor to assist
the Contractor in meeting the requirements of this contract. The Agency's support and assistance,or lack
thereof, shall not relieve the Contractor from full performance of contract requirements.
2. Agency Determinations
The Agency reserves the exclusive right to make certain determinations in the tasks performed by the Contractor
and the approaches used by the Contractor to perform those tasks. The absence of the Agency setting forth a
specific reservation of rights does not mean that all other areas of the contract are subject to mutual agreement.
III.METHOD OF PAYMENT
A. Payment Method Used
The method of payment for this contract is a combination of Fixed-Fee/Unit Rate, Cost Reimbursement, and
Advance Payments subject to the availability of funds and Contractor performance. The Agency will pay the
Contractor upon satisfactory completion of the Tasks/Deliverables,as specified in Section II.D.,and in accordance
with all other terms and conditions of this contract.
Page 31 of 93 C90
160 7
January 2022-December 2022 OAA 203.22
B. Unit of Service
1. Fixed Fee/Unit Rate
Contractor must meet the minimum level of performance stated in the contract to receive payment. Payments
for Fixed Fee/Unit Rates shall not exceed amounts established in Attachment XV.
2. Fixed Rates for NSIP Program
Payments for NSIP Fixed rate shall not exceed the unit rate of service identified below:
Service to be Provided Unit of Service Unit Rate
Eligible Congregate and Home Delivered Meals 1 unit= 1 meal $.72
3. Cost Reimbursement
Payment shall only be authorized for allowable expenditures, per the limits specified in the Budget Summary
(Attachment IX). All cost reimbursement Requests for Payment must include the actual Receipts and
Expenditure Reports, beginning with the first month of the contract. The Contractor must meet the minimum
level of performance stated in the contract to receive payment.
The Contractor agrees to distribute funds as detailed in the Area Plan Update and the Budget Summary
(Attachment IX).Any change in the total amounts of the funds identified on the Budget Summary form requires
a contract amendment.
C. Advance Payments
The Contractor may request up to two(2)months of advances at the start of the contract period to cover program
administration,outreach,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 Contractor's requests for
advance payments require the written approval of the Agency's Contract Manager. For the first month's advance
request, the Contractor shall provide the Agency's Contract Manager documentation justifying the need for an
advance and describing how the funds will be distributed.If the Contractor is requesting two(2)monthsof advances,
documentation must be provided reflecting the cash needs of the Contractor within the initial two(2)months and
should be supported through a cash-flow analysis or other information appropriate to demonstrate the Contractor's
financial need for the second month of advances.If sufficient budget is available,and the Agency's Contract Manager,
in his or her sole discretion, has determined that there is a justified need for an advance, the Agency may issue
approved advance payments up to 30 days after,but not prior to,the contract execution date.Advance payments will
not be issued for NSIP.
1. Any advance payments the Contractor requests for subcontractors must be distributed within seven(7)days of
receipt of payment from the Agency.The Contractor shall submit to the Agency documentation to support full
distribution of advanced funds with Request for Payment,report number 5,due to the Agencyon April 15,2022,
in accordance with Invoice Schedule(Attachment X).
2. All advance payments retained by the Contractor must be fully expended no later than March 31, 2022. Any
portion of advanced payments not expended must be recouped on the Request for Payment, report number 5,
due to the Agency on April 15,2022,in accordance with the Invoice Schedule(Attachment X).
3. Advance recoupment shall start with the third monthly Request for Payment submission, in accordance with
the Invoice Schedule (Attachment X). The amount of recoupment shall be equally divided between the
remaining number of Requests for Payment invoices due for the contract year.All advances should be recorded
in Part C,1 of the report (attachment XI), and shall be fully recouped by the end of the contract year or when
funds are fully expended,whichever is first.
4. Interest earned on advances must be identified separately by source of funds(state or federal).Contractors shall
maintain advanced payments of federal funds in FDIC interest bearing accounts unless an exception is made in
accordance with 45 CFR§75.305.Earned interest must be returned to the Agency at the end of each quarterof the
contract period.
Page 32 of 93
410
160 7
January 2022-December 2022 OAA 203.22
D. Invoice Instructions
Payment shall be made upon the Contractor's presentation of an invoice subsequent to the acceptance by the Agency
the deliverables shown on the invoice. The form and substance of each invoice submitted by the Contractor shall
be as follows:
1. The invoice shall include a"Remit to"address that corresponds exactly to the remittance address identified in
the MyFloridaMarketPlace(MFMP)registration.
2. The monthly invoice shall include the units of services established in the Contractor's Agency-approved Area
Plan, per the requirements in the Agency Programs and Services Handbook, at the rates established in
Attachment XV, Service Rate Report. Documentation of service delivery shall include a report consisting of
the following:number of clients served,number of service units provided by service,and rate per service unit,
with calculations that equal the total invoice amount. Reimbursement amounts for administrative costs shall be
reflected on the Cost Reimbursement Summary form (Attachment XIV) and include only items contained on
the Contractor's Agency-approved budget. Any change to the Contractor's Agency-approved budget after the
execution of this contract shall require approval from the Agency Contract Manager prior to being made. Any
change to the total contract amount requires a contract amendment.
3. The Contractor shall consolidate requests for payment from subcontractors and receipts and expenditure reports
that support the requests for payment and shall submit to the Agency Requests for Payment(Attachment XI),
Receipt and Expenditure Reports(Attachment XII),and Cost Reimbursement Summaries(Attachment XIV).
4. The Contractor shall include with the Fixed Fee/Unit Rate portion of its invoice the units of services provided
based on rates established in Attachment XV,number of clients, and the rates for the services provided per the
requirements described in the deliverables and service tasks. The Contractor shall clearly state the provider
name,the report month,and the invoice number on the invoice.
5. All Requests for Payment shall be based on the submission of actual monthly Receipts and Expenditure Reports
beginning with the first month of the contract. The schedule for submission of advanced payment requests
(when available)and invoices can be found in the Invoice Schedule(Attachment X).
6. The Certified Minority Business Subcontractor Expenditures Report (Attachment VIII) is considered a
deliverable and must be completed in its entirety and submitted with each invoice.
7. Final contract invoices must be submitted to the Agency no later than February 15,2023.
E. Payment Withholding
Any payment due by the Agency under the terms of this contract may be withheld pending receipt and approvalby
the Agency all financial and programmatic reports due from the Contractor and any adjustments thereto,including
any disallowance not resolved.
F. Corrective Action Plan
1. Contractor shall ensure 100%of the deliverables identified in Section II.D. are performed pursuant to contract
requirements.
2. If at any time the Contractor is notified by the Agency Contract Manager that it has failed to correctly,
completely,or adequately perform contract deliverables identified in Section II.D.,the Contractor will have ten
(10) days to submit a Corrective Action Plan (CAP) to the Agency Contract Manager that addresses the
deficiencies and states how the deficiencies will be remedied within a time period approved by the Agency
Contract Manager. The Agency shall assess a financial consequence for non-compliance on the Contractor as
referenced in Section M.G. for each deficiency identified in the CAP which is not corrected pursuant to the
CAP. The Agency will also assess a financial consequence for failure to timely submit a CAP to the Agency.
3. If the Contractor fails to correct an identified deficiency within the Agency-approved period specified in the
CAP,the Agency shall deduct the percentage established in Section M.G. from the payment for the invoice of
the following month.
4. If the Contractor fails to timely submit a CAP to the Agency,the Agency shall deduct the percentage established
in Section III.G.for each day the CAP is overdue.The deduction will be made from the payment for the invoice
of the following month.
Page 33 of 93 c�0
160 7
January 2022-December 2022 OAA 203.22
G. Financial Consequences
The Agency will withhold or reduce payment if the Contractor fails to perform the deliverables to the satisfaction
of the Agency according to the requirements referenced in Section II.D.The following financial consequences will
be imposed if the deliverables stated do not meet in part or in whole the performance criteria asoutlined in Section
II.D.:
1. Delivery of services to eligible clients as referenced in Section II.A.3. and Section II.D.1. of this contract—
Failure to comply with established assessment and prioritization criteria,as evidenced by eCIRTS reports,will
result in a 2%reduction of payment per business day.The reduction of payment will begin on the first business
day following the Agency's notification to the Contractor that the identified deficiency was not cured or
satisfactorily addressed in accordance with the Agency-approved CAP.
2. Services and units of services as referenced in Section II.D.2. of this contract—Failure to provide services in
accordance with the current Agency Programs and Services Handbook,the service tasks described in Section
II.A.,and Attachment XV,or failure to submit required documentation will result in a 2%reduction of payment
per business day.The reduction of payment will begin the first business day following the Agency's notification
to the Contractor that the identified deficiency is not cured or satisfactorily addressed in accordancewith the
Agency-approved CAP.
3. Administrative duties as referenced in Section II.D.3. of this contract—Failure to perform management and
oversight of program operations will result in a 2%reduction of payment per business day.The reduction of
payment will begin the first business day following the Agency's notification to the Contractor that the
identified deficiency was not cured or satisfactorily addressed in accordance with the Agency approved CAP.
4. Timely submission of a CAP—Failure to timely submit a CAP within ten(10)business days after notification
of a deficiency by the Agency Contract Manager will result in a 2%reduction of payment per business day the
CAP is not received. The reduction of payment will begin with the subsequent invoice received from the
Contractor and shall be prorated for each day the CAP was late following the due date specified by the Agency
and shall remain in effect until the contractor complies with the submission requirement.
5. Exceptions may be granted solely, in writing,by the Agency Contract Manager.
IV. SPECIAL PROVISIONS
A. Final Budget and Funding Revision Requests
Final requests for budget revisions or adjustments to contract funds based on expenditures for provided services
must be submitted to the Agency Contract Manager in writing no later than December 31,2022;email requests
are considered acceptable.
B. Contractor's Financial Obligations
1. Matching,Level of Effort,and Earmarking Requirements
The Contractor will assure,through a provision in subcontracts, a match requirement of at least ten percent
(10%) of the cost for services funded through this contract, except for services provided pursuant to OAA
Title IIID. The subcontractor's match will be made in the form of cash and/or in-kind resources. The
Contractor shall report match funds by title each month. At the end of the contract period,the Contractor must
properly match OAA funds that require a match.
2. Consumer Contributions
Consumer contributions are to be used under the following terms:
a. The Contractor assures compliance with Section 315 of the OAA,as amended in 2020,regarding consumer
contributions;
b. Voluntary contributions are not to be used for cost sharing or matching;
c. Voluntary contributions are to be used only to expand services;and
d. Accumulated voluntary contributions are to be used prior to requesting federal reimbursement.
Page 34 of 93 0
160 7
January 2022-December 2022 OAA 203.22
3. Use of Service Dollars and Management of the Assessed Priority Consumer List
The Contractor is expected to spend all federal, state,and other funds provided by the Agency for the purpose
specified in this contract.For each program managed by the Contractor,the Contractor must manage the service
dollars in such a manner as to avoid having a wait list and a surplus of funds at the end of the contractperiod. If
the Agency determines that the Contractor is not spending service funds accordingly,the Agency may transfer
funds to other AAAs during the contract period and/or adjust subsequent funding allocations as allowable under
state and federal law.
4. Title III Funds
The Contractor assures compliance with Section 306 of the OAA,as amended in 2020, and will not use funds
received under Title III to pay any part of a cost(including an administrative cost) incurred by the Contractor
to maintain a contractual or commercial relationship that is not carried out to implement Title III.
5. Carry Forward Funds
Carry forward funds must be identified on Attachment XIII,Computation of Carry Forward and Over-Advance
OAA Title III,and submitted with the Closeout Report due to the Agency no later than March 1,2023.Requests
for carry forward funds must be justified by the Contractor and approved by the Agency.All OAAcarry forward
funds must be budgeted in the same title as originally awarded.
C. Remedies for Nonconforming Services
1. The Contractor shall ensure that all goods and/or services provided under this contract are delivered timely,
completely, and commensurate with required standards of quality. Such goods and/or services will only be
delivered to eligible program participants.
2. If the Contractor fails to meet the prescribed quality standards for services,such services will not be reimbursed
under this contract. In addition, any nonconforming goods (including home delivered meals) and/or services
not meeting such standards will not be reimbursed under this contract. The Contractor's signature on the
Request for Payment Form certifies maintenance of supporting documentation and acknowledgement that the
Contractor shall solely bear the costs associated with preparing or providing nonconforming goods and/or
services.The Agency requires immediate notice of any significant and/or systemic infractions thatcompromise
the quality,security,or continuity of services to clients.
D. Incident Reporting
The Contractor shall notify the Agency immediately but no later than forty-eight (48) hours from theContractors
awareness or discovery of changes that may materially affect the Contractor or any subcontractor's ability to
perform the services required to be performed under this contract. Such notice shall be made orally to theAgency
Contract Manager(by telephone)with an email to immediately follow,including the Contractor's plan for provision
of services required by contract.This plan must detail the Contractor's anticipated plan for ensuring a continuity in
services for each client impacted by and for the duration of the incident. Following submission of theplan, the
Contractor's is expected to provide the Agency updates in a frequency determined by the Agencyas appropriate until
the incident is resolved.
E. Volunteers
The Contractor shall ensure the use of trained volunteers in providing direct care services delivered to older
individuals and those individuals with disabilities needing such services. If possible,the Contractor shall work in
coordination with organizations that have experience in providing training,placement, and stipends for volunteers
or participants(such as the Senior Community Service Employment Program or organizations carrying out federal
service programs administered by the Corporation for National and Community Service).
F. Enforcement
1. In accordance with Section 430.04, F.S.,the Agency shall rescind designation of an area agency on aging or
take intermediate measures against the Contractor, including corrective action, unannounced special
monitoring, temporary assumption of operation of one or more programs by the Agency, placement on
probationary status, imposing a moratorium on Contractor action, imposing financial penalties for
nonperformance, or other administrative action pursuant to Chapter 120, F.S., if the Agency finds that anyof
the following have occurred:
a. An intentional or negligent act of the Contractor has materially affected the health, welfare, or safety of
clients,or substantially and negatively affected the operation of an aging services program.
Page 35 of 93 e o
January 2022-December 2022 0§
2003.22
b. The Contractor lacks financial stability sufficient to meet contractual obligations or that contractual funds
have been misappropriated.
c. The Contractor has committed multiple or repeated violations of legal and regulatory requirements or
Agency standards.
d. The Contractor has failed to continue the provision or expansion of services after the declaration of a state
of emergency.
e. The Contractor has exceeded its authority or otherwise failed to adhere to the terms of this contract with
the Agency or has exceeded its authority or otherwise failed to adhere to the provisions specifically provided
by statute or rule adopted by the Agency.
f. The Contractor has failed to properly determine client eligibility as defined by the Agency or efficiently
manage program budgets.
g. The Contractor has failed to implement and maintain a Agency-approved client grievance resolution
procedure.
2. In making any determination under this provision the Agency may rely upon findings of another state or federal
agency,or other regulatory body.Any claims for damages for breach of contract are exempt from administrative
proceedings and shall be brought before the appropriate entity in the venue of Leon County, Florida. In the
event the Agency initiates action to rescind an area agency on aging designation,the Agency shall follow the
procedures set forth in 42 U.S.C. §3025(b).
G. Investigation of Criminal Allegations
Any report that implies criminal intent on the part of the Contractor or any subcontractors and referred to a
governmental or investigatory agency must be sent to the Agency. If the Contractor has reason to believe that the
allegations will be referred to the State Attorney,a law enforcement agency,the United States Attorney's office, or
governmental agency, the Contractor shall notify the Inspector General at the Agency immediately. A copyof all
documents, reports, notes, or other written material concerning the investigation,whether in the possession of the
Contractor or subcontractors, must be sent to the Agency's Inspector General with a summary of the investigation
and allegations.
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
Page 36 of 93 C'90
160 7
January 2022-December 2022 OAA 203.22
ATTACHMENT I—EXHIBIT 1
SUMMARY OF STANDARDS FOR PROFESSIONAL INFORMATION& REFERRAL
OLDER AMERICANS ACT PROGRAM
The Department of Elder Affairs has adopted the following requirements based on the "Standards for Professional
Information and Referral"developed by the Alliance of Information&Referral Systems(AIRS)to address the unique needs
of the Elder Helpline(Helpline)Information and Referral(I&R)system.
SERVICE DELIVERY
The Service Delivery standards describe essential functions for providing information and referral services to optimize
access to accurate,comprehensive,and unbiased information provided in a confidential and nonjudgmental manner.
1) The Helpline hours of operation shall be appropriate to address community needs. At a minimum, the Helpline must
maintain business hours from 8:00 a.m. to 5:00 p.m., Monday through Friday, except for state and national holiday
observances.If there is a planned office closure during normal business hours,the Helpline manager must notify Agency
staff via email at least twenty-four(24)hours before the office closure.
a) If I&R services are not available twenty-four(24)hours a day,an answering system must be in place that identifies
the agency,provides hours of operation,gives the caller the option to leave a message, and gives the number of an
organization that will offer service in an emergency (e.g., directing callers to dial 9-1-1 if it is an emergency).
Messages shall be responded to within the next business day.
b) If the Helpline has arrangements with another agency to provide after-hours or twenty-four(24)-hour coverage,the
arrangement must be documented in a formal memorandum of agreement/understanding(MOA/MOU).
2) During hours of operation, the Helpline shall provide timely access to an I&R specialist. Recorded messages on the
Helpline's voicemail system must be responded to within the next business day, when possible. Exceptions will be
during periods when the Helpline is experiencing higher than normal call volume(i.e.,SHINE annual enrollment period,
public awareness campaigns or disaster/weather-related events).
a) The Helpline must provide an option for the caller to leave a message at any time when a call is holding in queue.
b) The Helpline shall have a method of tracking call volume,including timeliness of response,and call abandonment.
c) A record of the messages to the Helpline's voicemail system must be maintained and shall include the date the call
was received and the telephone number of the caller. It is recommended the successful or unsuccessful return call
attempt be recorded in eCIRTS.
3) The Helpline shall ensure I&R services are provided by trained I&R specialists.At a minimum,an I&R specialist must
have a high school diploma or GED and three years of experience in I&R services,case management,call center services,
or related social services work experience.
4) The Helpline shall ensure I&R specialists:
a) Have the skills to meet the needs of people who are angry and hostile,manipulative, call frequently with the same
problem,or are otherwise difficult to serve;and
b) Have the skills to meet the needs of older adults,adults with disabilities,and other special populations.
5) The Helpline shall have a policy to ensure the privacy, confidentiality, and security of Helpline inquirers' personal
information and comply with all applicable state and federal law to ensure the protection of inquirer records,including the
Health Insurance Portability and Accountability Act(HIPAA).Staff with access to confidential information shall have a
signed agreement form on file that documents compliance with the confidentiality requirements of this paragraph.The
identity of inquirers,their requests,and the information given to staff may be communicated to others if:
a) The release of such information is required by law or court order(e.g.reporting abuse);
b) Careful consideration by I&R specialists of the information provided by the inquirer indicates the presence or risk of
serious harm to the inquirer or another person, and the communication is limited to those persons who must be
informed to reduce the risk of harm;or
c) The inquirer has authorized another person or agency to receive the information. The inquirer specifies what
information may be given and to whom.
6) The Helpline shall have a policy to resolve complaints from inquirers and community service agencies,including those
related to potential breaches of privacy and confidentiality.
Page 37 of 93 C4/
t 6 0 7
January 2022-December 2022 OAA 203.22
7) The Helpline shall provide barrier-free access to its services to individuals and groups who have special needs (e.g.
applicable technology or communication methods for people with hearing or speech impairments,language translation
for inquirers with limited English proficiency, and Americans with Disability compliance access for individuals with
physical disabilities if the Helpline assists inquirers at its facility).Helpline staff assisting inquirers with limited English
proficiency via the language interpreter service shall document the activity in the information and referral system and
submit a report of the Language Line activity to the Agency by the 10th of each month.
8) The Helpline shall make every effort to ensure that its telephone service is accessible from all telecommunication devices
within its coverage area(e.g.wireless and competitive local exchange carriers).
9) The Helpline shall ensure, through appropriate queue management techniques such as schedule adherence, that an
appropriate number of specialists are scheduled to meet the needs of callers. I.A minimum of 2.5 I&R staff members shall
be scheduled to work at all times).
10) The Helpline shall utilize technology that improves access to service and enhances its ability to serve inquirers
efficiently and effectively while preserving the level and quality of its core services. The main role of technology is to
enhance or strengthen person-to-person contact, not to reduce or discourage such contact or make it more difficult.
"Technology"includes telephone systems,telephony,telecommunications,e-mail,online chat,I&R software packages,
electronic directories, and self-service mechanisms such as automated attendants/interactive voice response systems,
fax-on-demand,video relay services,community kiosks,and searchable I&R databases on the internet.
a) If the Helpline service uses telephone technology which allows for the collection of inquirers' personal identifying
information without his or her explicit permission,it shall develop policies and procedures that protect the inquirer's
right to privacy and anonymity while preserving the I&R specialist's ability to provide for the individual's safety
should personal identification become necessary.
b) If the Helpline provides resource information through an automated attendant (a menu-driven telephone system),
it shall develop procedures to encourage inquirers to transfer to a live specialist if consultation or guidance is required.
Inquirers shall be able to make the transfer without having to make another telephone call.
c) When the Helpline provides multi-channel access services simultaneously (e.g. in-person, telephone, email, live
chat, SMS/text,or social media,etc.),it shall ensure I&R specialists divide their attention across all such services,
as appropriate to the situation,without compromising customer service or timeliness of responses.
11) The Helpline provides its service at no cost to the inquirer.
Standard 1:Information Provision
Information provision involves one-to-one interaction between an I&R specialist and an inquirer,wherein the I&R specialist
provides appropriate information and referrals in response to a direct request for such information. Information can range
from a limited response (such as an organization's name, telephone number, and address) to a detailed description of
community service system (such as explaining how intake works and required documentation by an agency), to help
inquirers make an informed choice.The I&R process consists of active listening and effective questioning to determine the
needs of the inquirer,clarifying those needs, providing requested information and/or identifying appropriate resources and
providing enough information about each organization to help inquirers make an informed choice. In situations where
services are unavailable,the specialist is encouraged to help identify alternative strategies..
1) The Helpline shall ensure through training,monitoring,and coaching that I&R specialists:
a) Identify themselves and the Helpline according to agency guidelines.
b) Establish and maintain rapport with the inquirer and use active listening skills and empathy to discern the presenting
problem;
c) Respond to each inquirer in a professional,nonjudgmental,culturally appropriate,and timely manner;
d) Use clear,jargon-free language and an appropriate tone of voice and inflection to convey empathy and engagement
with the inquirer's situation.
e) Identify underlying or unstated problems,when appropriate.
f) Determine any specific needs or preferences to access services (e.g. language needs, evening or weekend hours,
proximity to public transportation,or disability access).;
g) Clarify and confirm the inquirer's needs using techniques such as paraphrasing before providing
Page 38 of 93 C�o
160
January 2022-December 2022 OAA 203.22
referrals/resources;
h) Explore the inquirer's own resources(e.g., friends, family, faith-based organization)
i) If demographic information is being collected that is not directly relevant for an"information only"contact but is
required by contract or to enhance community reports, provide an explanation to the inquirer about why the
information is needed. The primary goal of data collection is to garner enough information about inquirers to help
them address or resolve their problems;
j) Effectively utilize the resource information system to identify resources to meet the inquirer's needs.
k) When possible and practical,provide at least three referrals to give the inquirer a choice while being careful not to
overwhelm the inquirer with too many options;
I) Encourage inquirers to contact the Helpline again if needs were unmet, information was incorrect, or for future
needs.
m) Accurately record what occurred during the course of the inquiry,the call/contact type,and the problems and needs
that were addressed.
2) The Helpline shall ensure that every call, including information only calls, is documented at the end of the call in the
information and referral system.
Standard 2: Referral/Assistance and Client Advocacy
The Helpline shall offer referral/assistance, or client advocacy, when necessary, to ensure individuals receive the benefits
and services for which they are eligible. The provision of referral/assistance services involves one-to-one interaction
between an I&R specialist and an inquirer, wherein the I&R specialist determines the needs of the inquirer, identifies
appropriate resources, makes referrals to organizations capable of meeting the inquirer's needs, and provides enough
information about each organization to help inquirers make an informed choice about the service and resources most
appropriate to meet the consumer's need. In situations where resources are unavailable,the I&R specialist shall assist the
inquirer in problem-solving to identify alternative strategies and manage expectations. When necessary,the I&R specialist
will actively participate in linking the inquirer to needed services.
Client advocacy seeks to meet the inquirer's needs without attempting to change social situations,and for purposes of these
standards, does not include system advocacy or legislative advocacy (lobbying). All advocacy efforts are consistent with
written policies established by the Area Agency on Aging(AAA)and proceed only with the permission of the inquirer.
1) Make an accurate assessment of the inquirer's problems and needs asking relevant questions to obtain the information
necessary for an accurate referral.
2) Clarify and confirm the inquirer's need(s)using techniques such as paraphrasing before offering referrals.
3) Intervention, when necessary, on behalf of individuals to help them obtain needed services. When warranted,the I&R
service makes one or more additional calls or takes other actions on the inquirer's behalf and uses an appropriate agency
mechanism to ensure inquirers get the information and/or help they need. When warranted and with the inquirer's
permission, the I&R specialist shall make direct contact with an agency and communicate on behalf of the inquirer
through three-way calling,notify the agency of the inquirer's forthcoming contact,or schedule an appointment with the
agency for the inquirer.
4) The Helpline refers individuals to an organization that specializes in providing advocacy when the level of advocacy
required by the inquirer exceeds the limits of the Helpline's advocacy policy or an effective use of its own resources.
5) The Helpline shall have policies to ensure the privacy, confidentiality, and security of personal inquirer
information; and has agreement forms that staff, visitors, and others with access to confidential information
sign to document their compliance.Identifying information about inquirers,their requests and the information
given to them is not communicated to others unless either:
a) Release of information is required by law or court order.
b) Careful consideration indicates the presence or risk of serious harm to the inquirer or another person,and
then communication may be only to those who must be informed in order to reduce harm or risk.
c) The inquirer has given explicit permission for the information to be disclosed to another person or agency.
The inquirer specifies what information may be given and to whom. This applies to individual advocacy
situations as well as those involving shared case coordination.
Page 39 of 93 CA
C
1 6 D
January 2022-December 2022 OAA 203.22
6) The Helpline may engage in enhancements to the initial I&R transaction such as prompting inquirers
regarding their interest in additional resources, application assistance, and appointment setting. These
enhancements are clear in terms of their scope and expectations.
7) The Helpline shall have a process to resolve complaints from inquirers and community service agencies,
including those related to customer satisfaction, accuracy of referrals, and potential breaches of privacy and
confidentiality.
8) Accurately record what occurred during the inquiry as well as the problems and needs that were addressed in the
information and referral for use in reports and as needed.
9) Follow-up to determine the outcome of the referral/assistance is conducted within 14 business days for each referral
when assistance and/or advocacy is provided and is conducted with the referred person and/or the resource.The referral
cannot be counted as a unit of service until follow-up is complete.If follow-up is not completed on a referral,the service
must be documented as an"Information"contact type.
Standard 3: Crisis Intervention
The Helpline shall be prepared to assess and meet the immediate,short-term needs of inquirers who are experiencing a crisis
and contact the Helpline for assistance. Included may be individuals at risk of suicide,homicide or assault,family or friends
who have experienced suicide, victims of domestic abuse or other forms of violence, elder/dependent adult abuse/neglect,
sexual assault survivors, people experiencing a psychiatric emergency; people with substance use disorder(s) who are in
crisis; survivors of a traumatic experience; and others in distress.
1) The Helpline shall have written crisis intervention policies and procedures that include protocols for specific types of
emergencies.. Included shall be safety risk assessment procedures,protective measures for individuals in endangerment
situations, and protocols that address inquirers who wish to remain anonymous yet require direct intervention.
2) If the Helpline does not provide formal crisis intervention service,the Helpline shall have a prearranged agreement and
documented protocol with an appropriate crisis center that provides formal crisis intervention service.
3) The Helpline shall ensure through training, monitoring,and coaching that l&R specialists have the skills to:
a) Recognize when an inquirer is experiencing a crisis.
b) Determine whether the individual is in immediate danger and take appropriate steps to ensure that the inquirer is
safe before continuing with an assessment.
c) Recognize when an inquirer is in immediate need of intervention (e.g., when a person is in medical crisis
due to a substance use disorder, has taken steps to end her or his life, is a victim of recent violence or is
experiencing a psychiatric emergency).
d) De-escalate and stabilize the inquirer and help him/her remain calm.
e) When necessary, follow the organization's rescue protocol for when to access 911 or other emergency
personnel to request that they intervene. In these circumstances, the individual's safety overrides
confidentiality concerns.
f) Keep the inquirer on the telephone pending referral or rescue.
4) In case of suspected elder abuse, the Helpline has protocols that comply regarding mandatory reporting and
completes a report when required.
5) In situations involving suicide or homicide, the Helpline understands the circumstances under which a safety
risk assessment is required and conducts an appropriate assessment when necessary. Risk assessments are
documented and include a description of specific actions taken in response to the situation.
6) The Helpline shall have a protocol for debriefing I&R specialists following a crisis call.
7) In cases of domestic violence and other endangerment situations, the Helpline shall ensure that I&R specialists take
special precautions to safeguard the inquirer's identity and all aspects of their interaction.
Page 40 of 93 090
D 7
January 2022-December 2022 AA 203.22
8) The Helpline shall use a variety of means to support its ability to connect with 911 or other emergency rescue services,
including Caller ID or a call tracing arrangement with the telephone company or the identification of an IP address. At
a minimum, there is a separate external telephone line that is available for initiating rescue procedures without
interrupting the crisis call. I&R specialists shall follow the agency's I&R service protocol for addressing callers who
wish to remain anonymous yet require rescue.
9) The Helpline shall ensure, when feasible, that I&R specialists connect inquirers in crisis situations to a formal crisis
intervention service in the community for assistance and support once the inquirer's immediate, short-term needs have
been met. The connection shall be made by direct transfer, when possible, and the I&R specialist shall follow the
protocol established by the Helpline's prearranged agreement with the crisis center.
10) For inquirers in crisis situations who are not at imminent risk, the I&R specialist assesses their immediate,
short-term needs and connects them with a crisis intervention service for ongoing assistance. The connection
is made by warm transfer,when possible,and the I&R specialist follows the protocol established by agreement
with the crisis service.
11) If possible, I&R specialist are encouraged to participate in crisis intervention professional development
training to upgrade existing skills and learn new skills.
12) The Helpline shall record acts of crisis intervention and its outcomes for use in reports.
Standard 4: Follow-Up
The primary purpose of follow-up is to contact inquirers to find out if their needs were met and if not,why.Follow-
up with inquirers who are at risk and/or vulnerable and in situations where the specialist believes the inquirers do not have
the necessary capacity to take the needed actions to resolve their own situation..Additional assistance in locatingor accessing
services may be necessary.Follow-up is required for each referral when assistance and/or advocacy is provided and must be
completed within 14 business days unless a crisis suggests a more immediate follow-up.
1) .Examples of situations in which follow-up should normally occur include:
a) Vulnerable households that are without heat during winter.
b) Older adults having trouble expressing their needs.
c) Older adults with disabilities who have received an eviction order.
d) Older adults with no health insurance who need health care.
e) Individuals needing emergency shelter.
2) The Helpline shall ensure follow-up with inquirers who are at risk or vulnerable and in situations where the I&R
specialist believes the inquirer lacks the capacity to follow through to resolve the problem; If the inquirer cannot be
contacted, the Helpline shall ensure follow-up with the organization to which a referral was made to determine if the
individual's need was addressed.Unsuccessful attempts to contact the inquirer shall not conclude the follow-up process
and shall not be counted as a completed referral.
3) During follow-up, if it is determined that the inquirer has not received services or the need has not been met,the I&R
specialist shall determine whether there is a continued need and make additional appropriate referrals or engage in
enhanced problem solving. The I&R specialist shall also determine whether the inquirer has additional new needs and
makes appropriate referrals prior to completing the contact.
4) The I&R specialist shall document the follow-up results(whether service was received or there was an unmet need)in
information and referral system for use in reports and as needed. Information gathered during the follow-up process
shall be used to evaluate the effectiveness of existing community service providers and to identify gaps in community
services.
Standard 5: Independent Access to Resource Information
The Helpline shall provide community resource information in a variety of ways to facilitate independent access for the
public and other human services professionals. These options provide additional choices for inquirers and
complement the alternative of one-to-one interaction with an I&R specialist.
Page 41 of 93 `IQ
160 7
January 2022-December 2022 OAA 203.22
1) The Helpline shall expand access options for the public by making all or a portion of its resource database available on
the Internet at no cost.
The elements that increase the effectiveness of a publicly accessible resource database include:
a) An easy-to-remember URL;
b) A prominently displayed search button;
c) A search page that is clean,well-organized,and easy to navigate;
d) A keyword search window,that employs search logic which produces an inclusive search results list.
e) Keyword searches that include partial and full-word matching. Entered text must appear at the beginning of words
for the term to be retrieved.For example, a search on"aging"would ignore words like"managing";
f) The ability to search agency,site,program,and AKA names.
g) The ability to filter results by geographic location/area served;and
h) A cleanly designed search results list that includes the data elements that are most important in providing inquirers
with the details they need to make informed choices about their options.
2) If the Helpline provides a mechanism for independent public access to community resource information,the Helpline
shall ensure that it includes information about how to connect with an I&R specialist if consultation and guidance are
required(for example,the ability to press"0"at any time when listening to a recorded message or to engage in instant
messaging(IM)or chat when searching for resources on a website).
Standard 6: Service Delivery Data Collection,Analysis and Reporting
Service delivery generates valuable information about the problems/needs of a community and the availability of resources
to meet those needs. The Helpline shall collect, analyze, and report insightful data concerning inquirers and their needs in
ways that are useful to the Helpline and its community partners. The Helpline shall use a secure, confidential system for
collecting and organizing inquirer data collection that provides a basis for describing requests for services and unmet needs,
identifying service gaps, and informing decisions about the scope of the resource database. Inquirer data includes
information gathered during the original contact,follow-up,and customer satisfaction/quality assurance calls.
Data collected for I&R service analysis and reporting purposes are based on I&R agency policies and local, state, and/or
national requirements.
1) The Helpline shall ensure that inquirer data is made available in aggregate form to protect the confidentiality of
individual inquirers.
2) The Helpline shall maintain documentation on all inquiries has a defined set of inquirer data elements to be used for
reporting purposes and recognizes that inquirers have the right to withhold information.
3) The data collected provides enough information about inquirer needs, whether gathered through the original
contact, during follow-up or via customer satisfaction survey/quality assurance surveys.
4) The I&R service may use data collection and analysis strategies that employ sampling techniques. Sample
size should also reflect the confidence level in the data presented. The chart below illustrates a range of
appropriate sample size with such random samples gathered on a quarterly or monthly basis.
Page 42 of 93
coo
160 7
January 2022-December 2022 OAA 203.22
Required completed samples with a Required completed samples with a
Call Center Annual Call Volume 95%confidence level and a 5% 95%confidence level and a 3%
margin of error. margin of error.
5,000 357 880
10,000 370 965
30,000 380 1,031
5) The Helpline shall ensure that inquirer data collection and reporting activities facilitate the analysis needed to support:
a) The human service needs of inquirers;
b) Outreach to diverse communities
c) Community needs assessments;
d) Community planning;
e) Allocation of funding;and
f) System Advocacy
6) The Helpline shall ensure that the data collected provides enough information about inquirer needs to identify the
following:
a) Service requests;
b) Met and unmet needs(gathered through the original contact,follow-up,and customer satisfaction/quality assurance
surveys);
c) Trends in community service provision and/or gaps in service;
d) Demographic data;and
e) Profiles of inquirers served(aggregate data only).
7) The data collected for reporting purposes shall include:
a) The total number of incoming contacts/inquiries by phone (incoming calls) recorded by the phone system and
answered by the I&R specialist, including transaction calls(calls in which problems or needs are addressed and
for each problem/need,the type of service provided by the I&R specialist(information only, referral,referral-
advocacy, referral-crisis, and crisis intervention services); or non-transaction calls (calls answered by the I&R
specialist that are hang-ups, wrong numbers, incoming administrative or personal calls, or other calls in which
there is no productive conversation between the I&R specialist and the inquirer and no assistance is provided).
b) The total number of I&R contacts/inquiries from calls and other sources recorded in the I&R system in which
inquirer problems or needs are addressed.Other sources include the following:
i) Transaction calls;
ii) Face-to-face contacts(walk-ins or I&R interactions in other settings such as community facilities);
iii) Email contacts;
iv) Voicemail contact responses;
v) Social media interactions;
vi) Text/SMS messaging contacts;
vii)Online chat contacts;
viii) Video relay/chat contacts;and
ix) Regular mail contacts.
c) The total number and types of problems/needs presented by inquirers.
d) The geographic and demographic profiles of inquirers(i.e.,who is calling and where they are calling from).
Page 43 of 93 CAO
160 7
January 2022-December 2022 OAA 203.22
e) The programs that received referrals.
8) The Helpline may also collect information about other types of I&R activities, in addition to I&R inquiries, but those
figures will not be added to the contact/inquiry total.Included are:
a) Website visitor activity(e.g.,total visits,unique visitors,individual page visits,searches conducted);
b) People accessing recorded information;
c) Social media postings;
d) Outreach presentations;
e) Brochures and/or other publications distributed;
f) Outgoing advocacy calls;
g) Outgoing customer satisfaction/quality assurance calls;
h) Outgoing follow-up calls;
i) Outgoing calls to verify resource information;and
j) Community problems/needs reporting.
9) The Helpline may also report,as necessary,on key performance indicators derived from its quality assurance and related
activities such as average times of transactions, results of internal and independent call monitoring processes,average
answering times,unmet demand(such as abandoned calls),complaints and commendations, as well as case stories that
illustrate recent examples of situations and outcomes secured by the I&R service.
RESOURCE DATABASE
The Resource Database standards require that the Helpline develop, maintain, use, and disseminate an accurate up-to-date
online resource database that contains information about available community resources including details about the services
provided and the conditions under which they are available.
Standard 7:Inclusion/Exclusion Criteria
The inclusion or exclusion criteria provides the parameters for human services agencies and programs in the resource
database.The criteria are uniformly applied and available so that staff and the public are aware of the scope and limitations
of the database.
The Helpline shall have a document that describes the inclusion/exclusion criteria for the contents of the resource database.
The criteria are uniformly applied and available so that staff and the public are aware of the scope and limitations of the
database.
The inclusion/exclusion criteria shall be consistent with and support the ability of the I&R service to maintain the resource
database per the quality requirements of the AIRS standards.
The Helpline shall not charge a fee for the inclusion of any organization in its published resource database.
1) The inclusion/exclusion document includes an appeal process for organizations seeking clarification on either the
document itself of the application of the criteria.
2) The Helpline shall ensure the inclusion/exclusion criteria is reviewed and updated, at a minimum, every three years
to ensure that it continues to meet the changing needs of the community.
Standard 8: Data Elements
The resource database contains data elements that provide information about organizations that meet criteria for inclusion,
the services provided by each organization, and the locations(sites) where those services are available. Each record shall
contain all required data elements,where applicable.
1) Mandatory and Recommended Data Elements: The chart below lists data elements for the Agency/Main Site portion
of an organizational record,Location/Branch data elements,where additional sites exist,and the programs and services
provided by the organization.The Mandatory or Recommended status of each data element is also indicated.Note that
"Mandatory"means that a data element will be entered if that information is available(for example, if documentation
is needed to apply for a service,then that information must be added.If no documentation is required,then the field can
be left empty). "X"is a designation for"non-applicable."
Page 44 of 93 CAO
January 2022-December 2022 1 *AA3.22
7
AIRS Data Elements AIRS Data Record Category
Agency Site Service/Program
Name Mandatory Mandatory Mandatory
AKA(Also Known As)Name(s) Mandatory Mandatory Mandatory
Legal Status Mandatory X X
Federal Employer Identification Number(EIN/FEIN) Recommended X X
IRS Status Recommended X X
Street/Physical Address(es) X Mandatory X
Mailing Address(es) X Mandatory X
Phone Number(s)and Types Mandatory Mandatory Mandatory
Website URL(s)including Social Media Recommended Recommended Recommended
Email Address(es) Recommended Recommended Recommended
Name and Title of Director/Manager Recommended Recommended Recommended
Description Mandatory Mandatory Mandatory
Days/Hours of Operation Mandatory Recommended Mandatory
Access for People with Disabilities X Recommended X
Travel Information X Recommended X
Eligibility X X Mandatory
Geographic Area Served X X Recommended
Languages Available X X Recommended
Documents Required X X Recommended
Application/Intake Process X X Recommended
Fees/Payment Options X X Mandatory
Taxonomy Term(s)for Services/Targets X X Mandatory
2) Database Record Administration Data Elements: Data elements that relate to the database record itself and are purely
administrative in nature are included in a separate table. Most are automatically assigned by the system,not maintained
by resource specialists,and not shown when records are published.The exception is the date of last formal verification
which many Helplines choose to include.
AIRS Data Elements: Record Administration
Unique ID Number Mandatory
Record Ownership Code Mandatory
Date of Last Formal Verification Mandatory
Contact for Formal Verification Recommended
Page 45 of 93
Cq®
160 7
January 2022-December 2022 OAA 203.22
Date of Last Interim Change Mandatory
Contact of Last Change Recommended
Resource Specialist for Last Change Mandatory
Record Status(Active/Inactive) Mandatory
Standard 9:Classification System(Taxonomy)
The I&R service uses the AIRS/211 LA County Taxonomy of Human Services to index and facilitate retrieval of resource
information, increase the reliability of planning data,make evaluation processes consistent and reliable,and facilitate state
and national aggregations and comparisons data. Additional classification structures such as keywords, if used, are
connected to the Taxonomy rather than functioning as independent indexing systems.
Standard 10:Content Management and Indexing
The Helpline shall ensure through training, database management procedures, and supervision that a resource specialist
organizes information about human services organizations into database records that accurately and concisely reflect the
agency, its location and its services/programs; index the services provided by each organization using the AIRS/211 LA
County Taxonomy of Human Services in accordance with recognized and consistently applied practices; and assign other
search keys in a way that accurately reflects the conditions under which services are available.
1) The Helpline shall ensure use of I&R software that supports the AIRS Resource Database standards as follows:
a) Information in the resource database is accessible in ways that support the I&R process;and
b) The software module used by I&R specialists allows for search and retrieval by:
i) Organization,service site,and program name and related AKAs;
ii) Type of services provided(using Taxonomy terms including use references and see also references);
iii) Target population served,where applicable(using Taxonomy target terms);and
iv) Area served.
2) The Helpline shall ensure through training,database audits,and coaching that resource specialists understand the human
service delivery system including the sectors it comprises;the differences between the public and private sectors; how
government, nonprofit, and for-profit organizations are organized and funded; the major types of service providers in
their community; the broad range of programs and services they provide; and how these organizations and the sectors
they represent relate to one another and the people they serve.
3) The Helpline shall ensure documented procedures are in place for identifying new resources, acquiring information
about them and,upon inclusion in the database,verification by the organization.
a) To collect information/data elements uniformly across organizations, the Helpline shall develop and use a
standardized profile("survey")for new organizations to be included in the resource database.
4) The Helpline shall ensure documented procedures are in place for gathering and integrating interim information changes
(i.e.changes that occur between the annual updates).
5) Organizations that do not respond after multiple attempts but cannot be deleted because they offer critical services,shall
be updated via alternative methods (phone, website, or site visits). However, documentation on how the update was
obtained and the reason for the decision not to delete the record are required. If updated by telephone,the name of the
person who confirmed the information and the date shall be recorded.If updated through a website,information that the
update was verified via the Internet and the date shall be included as documentation. If updated by site visit,the names
of the people visited, and the date shall be recorded. Once the I&R service is satisfied that it has obtained the best
information possible and has documented how and when the update was performed as well as the reason for the decision
not to delete the record,it is permissible to mark the agency as having received its annual review.
6) The Helpline shall ensure the update form, or the accompanying cover letter,has a statement that the Helpline reserves
the right to edit information for brevity,clarity,and content,and to publish the information in a variety of media,subject
to confidentiality issues.
Standard 11: Database Search Methods
Page 46 of 93
CA®
60 7
January 2022-December 2022 OAA 203.22
The quality assurance review process ensures that information in the resource database is accurate and complete.
1) The Helpline shall have a documented process for verifying information in the resource database either annually or
on a continuing basis throughout the year that involves multiple attempts to achieve a 100%verification rate within
a 12-month cycle. Information that cannot be verified may be considered for removal for the database.
2) The Helpline shall be able to generate a report that lists resource records according to the date of last formal update
to identify records that are out of compliance.The report shall be run at least quarterly.If more than 50%of records
are out of date,the Helpline shall create a plan to bring the database up to date.
3) The Helpline shall ensure the resource Agency provides feedback to other I&R staff regarding important changes that
have been made in the database as a result of information I&R specialists have supplied.
Standard 12: Resource Database Data Collection,Analysis and Reporting
The creation and maintenance of I&R resource databases generates valuable information about the services and programs
available within a community.The I&R service collects,analyzes,and reports insightful information regarding the types of
services available, the organizations that provide them, and the areas in which services are available (and unavailable) in
ways that are useful to themselves and community partners.An analysis of the resource database maintenance process also
reveals information that can enhance both the quality and productivity of each I&R service (for example, by identifying
issues for staff training).
The Helpline's resource database is the prime source of information about the programs and services available to the
community served by the Helpline.
Standard 13: Cooperative Relationships within the I&R System
In communities that have comprehensive and specialized I&R providers, the Helpline shall develop cooperative and
respectful relationships to build a coordinated I&R system which ensures broad access to I&R services, maximizes the
utilization of existing I&R resources, avoids duplication of effort and encourages seamless access to community resource
information.
1) It is recommended that the Helpline participates in ongoing cooperative program planning and development activities
that take into consideration community needs,existing resources,and the activities of other I&R services.
2) The Helpline shall work cooperatively with other community I&R providers to identify changing community needs and
to respond to those needs in a timely and appropriate fashion. Regular cooperation ensures that there is an immediate
and effective response to the following:
a) Sudden changes in community conditions(e.g. community wide disaster)that may require special outreach efforts
or other forms of collaborative response;
b) Changes in legislation;and
c) New information related to the area served that needs to be incorporated.
Standard 14: Cooperative Relationships with Service Providers
The Helpline shall develop cooperative working relationships with local human services providers(e.g. food pantries and
local homeless shelters)and larger service systems to build an integrated service delivery system that provides broad access
to community services, maximizes the use of existing resources, and facilitates the ability of people who need services to
easily find the most appropriate provider. I&R services with broader geographic reach (e.g. statewide, province-wide,
regional,or national level programs)shall strive to develop similar working relationships within the area they serve.
The Helpline shall work cooperatively with service providers to address issues that have a critical impact on the community
such as disaster relief and recovery,homelessness,health care service delivery,and one-stop collocated human services.
DISASTER PREPAREDNESS: The Helpline shall assess its role in meeting the needs of the community during times of
disaster, which may vary depending on the population served. The role the Helpline plays in disaster situations may vary
by the phase of the disaster(i.e.,preparedness,response,relief,and recovery).The Helpline shall provide information and
referrals for inquirers who are experiencing a crisis due to a disaster of natural or human origin. Preparation includes
development of an emergency operations and business contingency plan that enables the Helpline to continue providing
services if its own facility is damaged or destroyed; and to support its ability to effectively accumulate, validate, and
disseminate accurate disaster related information, the Helpline shall provide information and referral assistance for
individuals impacted by a disaster,and provide community reports regarding inquirer needs and referrals.
Page 47 of 93 cAp
160 7
January 2022-December 2022 OAA 203.22
Standard 15: Emergency Operations and Business Contingency Plan
1) The Helpline shall have a written disaster plan that specifically addresses incidents common to the area, and
comprehensively prepare staff for most typical emergencies 1.The plan shall have two components:
a) An emergency operations component that defines what constitutes a disaster as well as the organization's disaster
response expectations,both internally and from the perspective of external stakeholders,and describes the steps the
organization must take to meet the needs of the community in the aftermath of an event; and
b) A Continuity of Operations Plan (COOP) component that references emergency preparedness and mitigation
activities, such as structural alterations and changes in business operations, and delineates the steps to be taken
before,during,and after an emergency to prevent or minimize interruptions in business operations and ensure long-
term recovery.
2) The Helpline shall have emergency operation procedures in place for maintaining service delivery during and after an
emergency that may occur in the same area in which the program is located or in an area that impacts service delivery.
The written procedures related to
a) Personnel Coordination
i) Designation of key staff;
ii) Delegations of authority;
iii) Order of succession;
iv) Expectations of personnel during duty and non-duty hours. Notification of personnel during duty and non-duty
hours;
b) Designation of mission-essential functions;
c) Designation of alternative facilities;
d) Continuity of communications among staff before,during,and after a disaster;
e) Securing access to vital records and databases;and
f) Plans for reconstitution and termination of emergency measures.
3) The Helpline shall have written procedures that address specific types of emergencies including power outages, fires,
medical emergencies, bomb threats, radiological threats, workplace violence, and other incidents that may require
different forms of response(e.g.duck,cover,and hold during an earthquake or sheltering in place during a radiological
emergency).Procedures for contacting emergency personnel shall be included.
4) The Helpline shall have written procedures for emergency evacuation of the facility following a disaster that impacts
the immediate area surrounding the facility and potentially threatens staff safety. Procedures shall include special
arrangements for helping staff or visitors with a disability leave the building.
5) The Helpline shall have written procedures for maintaining service delivery(e.g.answering inquiries and continuing to
update community resources) during and after an emergency, including relocation or alternative modes of service
delivery. If the I&R service plans to relocate in the event of loss of facilities,alternative sites will be identified.
6) The Helpline shall maintain critical contact and infrastructure information(e.g.telephone service provider and building
management information).
Standard 16: Relationships with Emergency and Relief Operations
The Helpline shall participate in ongoing cooperative disaster response planning in the community and establish
relationships, as necessary, to become recognized as an integral part of the community's emergency preparedness and
response network.
1) The Helpline shall ensure understanding of the command-and-control structure within its jurisdiction (i.e. the
responsibilities and authority of officials at city,county,state/provincial,and federal levels)and its role and that of other
organizations in the response,relief,and recovery phases of a disaster.
2) The Helpline shall ensure active participation in community meetings that address plans for disaster preparedness,
mitigation,response,relief,and recovery.
Page 48 of 93 CA
160 7
January 2022-December 2022 OAA 203.22
Standard 17: Disaster Resources
The Helpline shall develop, maintain, and/or use an accurate, up-to-date computerized resource database containing
information about available community resources that provide services in times of disaster.Database records shall include
descriptions of the services organizations provide and the conditions under which services are available and shall be indexed
and accessed using the Disaster Services section of the AIRS/211 LA County Taxonomy of Human Services.
1) The Helpline shall ensure the resource database includes information about permanent local,state,and federal disaster-
related resources.
2) The Helpline shall ensure the addition of information in the resource database about organizations that have no formal
role in emergency response but emerge in the context of particular disaster, specific relief and recovery services that
come to life in response to the specific needs of the community, and specific services offered by organizations with a
permanent record in the database(such as Red Cross Service Centers,special needs shelters,etc.).
3) The Helpline shall update the disaster resources annually, immediately prior to an anticipated disaster and throughout
the response,relief,and recovery periods.
4) The Helpline shall have an alternative means for allowing staff to access disaster resources if computerized access is
unavailable.
5) The Helpline shall verify all information before sharing it with others during a disaster. A streamlined verification
process must provide a sufficient level of data validation to ensure accuracy.
Standard 18: Disaster-Related I&R Service Delivery
The Helpline shall provide information and referral services to the community during(when appropriate) and following a
disaster or other emergency.This service shall include assessing the needs of the inquirer,evaluating appropriate resources,
indicating organizations capable of meeting those needs,and helping inquirers for whom services are unavailable by locating
alternative resources and actively participating in linking inquirers to needed services or volunteer opportunities.
1) The Helpline shall ensure adequate staff to meet potential increases in inquirer contacts and needs.
2) The Helpline shall have in place mutual assistance agreements with other I&R services that include provisions for
relocation of staff and/or redirection of calls.
3) The Helpline shall have a written protocol for staff who are assigned to provide information and referral at local
assistance centers(LACs)or other off-site locations.
4) The Helpline shall ensure I&R specialists have the skills to respond effectively to people in crisis, work cooperatively
with other organizations, remain flexible in a rapidly changing environment, are willing to work under adverse
conditions(e.g.long hours or uncomfortable surroundings),are aware of their own stress level and coping mechanisms,
respond appropriately in face-to-face communications,and work within boundaries of their I&R role.
5) The Helpline shall ensure I&R specialists are knowledgeable about the government emergency response service
delivery system,the types of services people typically need before, during,and following a disaster,the organizations
that generally provide such services,the types of organizations that may be closed or otherwise unable to deliver services
due to an emergency (e.g. government offices and courts), atypical services people may need to access (e.g. open
hardware stores and functioning ATM machines), and the structure and contents of the disaster database and/or other
approved sources of disaster-related information.
Standard 19:Disaster-Related Data Collection/Reports
The Helpline shall track inquirer requests for service and referrals, collect demographic information from inquirers, and
produce reports regarding requests for disaster-related services and referral activity.
1) The Helpline shall collect and organize inquirer data that facilitates appropriate referrals and provides a basis for
describing requests for disaster-related services and identifying gaps and overlaps in service.
2) Following all emergencies that necessitate implementation of the provisions of the Disaster Preparedness standards,the
Helpline shall produce an after-action report that documents the special activities of the agency with a focus on what
worked well and what needs to be improved through revisions of the agency's disaster plan and/or additional training
or staff.
Page 49 of 93 CA0
January 2022-December 2022 106 2II3.22
Standard 20: Disaster-Related Technology Requirements
The Helpline shall have technology in place that facilitates the ability of the organization to maintain service delivery during
times of disaster or a localized emergency. Recommendations for continued operations include an emergency generator,
back-up systems for telephones,or an alternate phone number in a different location for staff to access the agency, in case
of an emergency that makes the regular phone lines inaccessible.
1) The Helpline shall ensure regular and emergency methods of electronic communication(via email, instant messaging,
text/SMS messaging, satellite phones or mobile devices) between staff and management for use internally, for after-
hours contacts,and when necessary for pre-and post-disaster events.
2) The Helpline shall establish relationships with its telephone service provider, Internet Service Provider(ISP), website
hosting vendor,and I&R software vendor to ensure that the organization is given high priority for continued service in
times of disaster.
3) The Helpline I&R service shall have the ability to reroute calls to another location if its own business site is not
accessible.
Standard 21: Disaster Training and Exercise
The Helpline shall train staff on emergency operations and business expectations upon hiring and provide ongoing training
at least annually. It is recommended that the Helpline actively participate in community disaster exercises to test the
Helpline's emergency operations plan.
The Helpline shall provide general training for staff that addresses the specific types of disasters common to the area, the
Helpline's role, and mission in times of disaster,the phases of disaster, federal, state/provincial, and local response plans
and resources,and other topics that will help prepare staff for an emergency and ensure that they understand their Helpline's
commitments.
ORGANIZATIONAL EFFECTIVENESS
The Organizational Effectiveness standards describe the governance and operational structure the Helpline needs to fulfill
its mission,including development of policies and procedures.
Standard 22: Governance and Oversight
The Helpline shall operate under the auspices of the AAA, which is governed by representatives of the diverse interest of
the community.
1) The governing body shall oversee implementation of program goals and objectives to ensure quality of service and
sustainability of the AAA and the Helpline.The governing body(Board of Directors),at a minimum, shall:
a) Ensure that the Helpline has an adequate number of staff and a program manager who is accountable for the
operation of the Helpline;
b) Assist in procuring financial and technical assistance to sustain the I&R service;
c) Adopt an annual budget, maintain financial records, and provide for an annual audit by an independent certified
public accountant;
d) Promote the Helpline system throughout the community ensuring appropriate publicity, public relations, and
outreach.
2) The Helpline shall formally adopt, date, and regularly review written policies that clearly articulate the general
principles by which the Helpline is managed.The Helpline shall ensure that organizational policies are available to all
employees and that they include employee and hiring policies and procedures.
3) The Helpline shall have a formal process for registering and resolving complaints from inquirers, staff members, and
the community,and shall provide protections for whistleblowers.
4) The AAA and Helpline shall have a Code of Ethics that establishes fundamental values and professional standards of
conduct for staff in their relationships with their colleagues,their employers,the people they serve,the human service
professionals with whom they interact,and the community.
5) The AAA and Helpline shall have a statement approved by the organization's governing body prohibiting discrimination
in all its forms and documenting its intention to comply with all laws,orders,and regulations addressing this issue.
6) The Helpline shall provide accessible space and equipment sufficient to ensure confidential interviewing in order for
staff to effectively perform their duties.
Page 50 of 93 C.q®
IfiD 7
January 2022-December 2022 OAA 203.22
Standard 23: Technology
The Helpline shall use technology that improves access to information and enhances its ability to serve inquirers efficiently
and effectively. The main role of technology is to enhance and strengthen information sharing while accommodating
people's communication preferences.Technology includes telephone systems,telecommunications,computer systems and
applications,assistive technology for people with disabilities,and searchable I&R databases on the Internet.
1) The Helpline shall ensure that individuals with disabilities seeking information or services have access to its searchable
I&R database that is comparable to that provided to persons without disabilities. The Helpline shall also ensure that
employees with disabilities and the public have access to I&R software with reasonable accommodations including
features such as speech to text,text to speech,captioning,audio description,and other types of assistive technology.
2) The Helpline shall have policies and procedures that protect the inquirer's right to privacy and anonymity while
preserving the I&R specialist's ability to provide for the individual's safety should personal identification become
necessary.
3) The Helpline shall ensure that the I&R service has access to professional technical expertise to appropriately maintain
all technology and that provisions are in place to ensure a priority response to any breakdowns in key infrastructure.
Standard 24:Personnel Management
The Helpline shall have in place a framework and mechanisms for program and personnel management that provide for the
continuity and consistency required for effective service delivery.
1) The Helpline shall recruit and hire staff who are competent,ethical,qualified,sufficient in number to implement service
policies,and reflect the community they serve.
2) The Helpline shall have up-to-date job descriptions for all employees and volunteers outlining responsibilities,essential
job functions,and lines of accountability.The job descriptions must be dated within the last three years.
3) The Helpline shall provide ongoing supervision and annual evaluation of employees and volunteers by qualified I&R
managers,using standardized observation and performance appraisal forms. Performance problems shall be identified,
documented, and addressed in an individual performance improvement plan. Staff evaluations shall address specific
responsibilities and job functions outlined in individual job descriptions.Quality indicators for the Helpline may include
the following:
a) Call Monitoring/Remote Listening:Live or recorded calls that are randomly selected for review and feedback on a
regular basis.
b) Secret Shopper Calls: Sometimes known as mystery calls,these are calls conducted by staff or a designated third
party without the knowledge of the I&R specialist handling the call. They allow for the "real feeling"of a typical
call (including the voice messaging in queue)to be experienced in the same way as a typical client. The results of
these calls can be scored in the same manner as other monitored interactions.
c) Mentoring/Coaching:The use of individual sessions,team discussions,role playing,and other techniques to mentor
and coach I&R specialist to ensure quality service delivery.
d) Call Management System Reports,Measures and Metrics:The call management component of the telephone system
produces weekly and monthly reports that provide data on the following items which may be analyzed to assess
individual staff and Helpline efficiency and productivity:
i) Calls received;
ii) Calls answered;
iii) Calls refused;and
iv) Average call handling time.
e) Case Examples: Examples of calls submitted monthly by an I&R specialist that illustrate their call handling
techniques.A case example is a written,detailed analysis of how an information and referral calls was handled.The
components of a case example include the following:
i) Demographic Information(non-identifying name of I&R specialist,date of call, language of call, subject, line
of service(e.g. 211,victim support line).
ii) Presenting situation/problem.
iii) Assessment.
Page 51 of 93
CA®
A 71
January 2022-December 2022 0-AA 203.22
iv) Actions/referrals provided.
v) Follow-up/advocacy if appropriate.
1) Complaints and commendations an I&R specialist has received.
4) If the Helpline permit staff to work off-site,the Helpline must ensure the security and confidentiality of inquirer data
and ensure the availability of technology to support the ability of staff to do all or part of their work off-site. For the
most part,this innovation provides flexibility and responsiveness to the needs of individual staff.However, in the case
of I&R specialists who may be directly serving the public from an off-site location, procedures must be in place to
ensure compliance with all service delivery standards regardless of where an I&R inquiry is handled.To ensure that the
public experiences no discernible difference in the quality of service, special requirements for off-site I&R service
delivery shall be in place,including provisions for I&R specialists to:
a) Make three-way calls to connect the inquirer to external services including language translation services;
b) Contact emergency services while maintaining a connection with the inquirer;
c) Work in a distraction-free environment;
d) Access supervisory assistance,when required,and for supervisors to exercise quality assurance measures;and
e) Access personnel policies and training opportunities that reflect off-site circumstances.
5) The Helpline shall track employee turnover or attrition and have a process for identifying when the turnover percentage
impacts service quality.
Standard 25: Staff Training
The Helpline shall maintain a training policy and make training available to employees and volunteers.
1) The Helpline shall provide training for employees and volunteers based on pre-determined training goals with
curriculum objectives defining behavioral outcomes for each module.
2) The Helpline shall provide an orientation for new employees and volunteers that addresses the role, mission, and
function of the I&R service;the role of the governing body;federal,state,and local laws affecting service delivery(e.g.,
abuse reporting); and the structure,policies,and procedures of the AAA.
3) The Helpline shall ensure that training for I&R specialists includes:
a) Pre-service training appropriate to the knowledge and skills of new staff to ensure that they meet organizational
expectations;
b) On-the-job training that involves increasing levels of responsibility in handling inquiries;and
c) In-service training that focuses on refining and updating the staff's knowledge about the aging network, state and
federally funded programs,and skills and work-related attitudes and behaviors.
4) The Helpline shall ensure training for resource staff includes an overview of the local community service delivery
system, inclusion/exclusion criteria for the resource database,data elements,taxonomy indexing,database maintenance
procedures,use of the I&R service's software,development,and distribution of database products and,when appropriate,
training in the I&R service's area of specialization(e.g. disability issues or aging issues).
5) The Helpline shall ensure that the content of the staff training program is consistent with the ABCs of I&R published by
AIRS or the Department of Elder Affairs Information and Referral/Assistance training module.
6) The Helpline shall systematically evaluate the effectiveness of its training program and the performance of its trainers
and modify the training based on evaluation results.
7) It is recommended that I&R specialists and resource specialists seek professional certification through recognized
programs at the state/provincial,regional,or national level.
Standard 26: Promotion and Outreach
The Helpline shall establish and maintain a program that increases public awareness of I&R services, its objectives,and its
value to the community. At least two outreach projects targeting low-income older individuals, including low-income
minority,older individuals with limited English proficiency,and older individuals residing in rural areas,must be completed
annually.
1) The Helpline shall have an outreach plan that employs a systematic methodology for publicizing the organization's
services to its targeted population and to other community resources(e.g.other agencies,faith-based organizations,law
Page 52 of 93 CA
January 2022-December 2022 1 6AO03.27
enforcement, and schools). The I&R service may publicize its services using a variety of methods, including social
media,which are tailored to meet the needs of diverse populations and may include:
a) Personal contact;
b) Speaking engagements;
c) Community meetings;
d) Feature articles;
e) News stories;
t) Displays;
g) Public service announcements or listings;
h) Telephone Directories;
i) Printed materials such as brochures;
j) Posters and billboards;
k) Booths at fairs;
I) Radio;
m) Television;and
n) Internet web page.
2) The I&R service shall publicize its services to people in the community who may experience barriers to accessing
services due to physical, mental, or developmental disabilities; homelessness or social isolation; language or cultural
background;or other vulnerabilities.
Standard 27: Quality Assurance
The Helpline shall have the ability to assess the quality and effectiveness of all aspects of its operation including its service
delivery, resource database, reports and measures, cooperative relationships, disaster preparedness and organizational
structure. These determinations shall be made through on-going quality assurance procedures supported by the collection
and utilization of information that can be used to manage and continuously improve resource database management and the
service delivery process,and through periodic formal evaluations that are used to implement measurable improvements.
1) The Helpline shall have a process for examining its viability as an organization, the effectiveness of its services, its
appropriate involvement in the community,and its overall impact on the people it serves.
2) To support management information needs,the Helpline shall have a method for tracking key performance indicators
(KPIs)such as:
a) Call volume;
b) Abandoned calls;
c) Average abandonment rate;
d) Average speed of answer;
e) Average call handling time;and
t) Average talk time.
3) The Helpline shall conduct regular customer satisfaction/quality assurance surveys with a minimum of 3 percent(3%)
of inquirers [one percent(1%) of the specified percentage must include individuals with limited English proficiency,
persons with a disability, or low-income minorities residing in a rural area] to assess overall service performance and
I&R service outcomes.The surveys may occur during the original contact with an inquirer,in conjunction with follow-
up (after determining whether the inquirer's needs have been met), or in a separate call made for quality assurance
purposes. It is important that survey participants be randomly selected. Customer satisfaction questions shall include
the following:
a) Was the I&R specialist polite and helpful?
b) Did the inquirer feel they were listened to?
Page 53 of 93 C
140
1 6 0 7
January 2022-December 2022 OAA 203.22
c) Did the inquirer receive a choice of referrals where appropriate?
d) Would the inquirer contact the Helpline again?
e) Would the inquirer recommend the Helpline I&R service to family and friends?
If while conducting client satisfaction/quality assurance surveys, it is determined that the original need of the inquirer has
not been met or that the inquirer has new needs, the Helpline shall have procedures in place to provide additional
information,referrals,or advocacy.
Reference: The Older Americans Act (OAA) contract standards have been adopted with modifications from the AIRS
Standards for Professional Information and Referral.
END OF ATTACHMENT I
Page 54 of 93 Cal0
January 2022-December 2022 1 6fiO3.227
ATTACHMENT II
FINANCIAL AND COMPLIANCE AUDIT
The administration of resources awarded by the Agency to the Contractor may be subject to audits and/or monitoring by the
Agency,as described in this section.
MONITORING
In addition to reviews of audits conducted in accordance with 2 CFR Part 200(formerly OMB Circular A-133 as revised),
and Section 215.97, F.S., (see"AUDITS"below), monitoring procedures may include, but not be limited to, on-site visits
by the Agency staff, limited scope audits and/or other procedures. By entering into this contract, the Contractor agreesto
comply and cooperate with any monitoring procedures/processes deemed appropriate by the Agency. In the event the
Agency determines that a limited scope audit of the Contractor is appropriate, the Contractor agrees to comply with any
additional instructions provided by the Agency to the Contractor regarding such audit. The Contractor further agrees to
comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Chief Financial
Officer(CFO)or Auditor General.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the Contractor is a State or local government or a non-profit organization as defined in 2 CFR Part
200, Subpart A.
In the event that the Contractor expends $750,000.00 or more in federal awards during its fiscal year,the Contractor must
have a single or program-specific audit conducted in accordance with the provisions of 2 CFR Part 200. Financial and
Compliance Audit Attachment, Exhibit 2 indicates federal resources awarded through the Agency by this contract. In
determining the federal awards expended in its fiscal year, the Contractor shall consider all sources of Federal awards,
including federal resources received from the Agency. The determination of amounts of Federal awards expended should
be in accordance with 2 CFR Part 200.An audit of the Contractor conducted by the Auditor General in accordance with the
provisions of 2 CFR Part 200 will meet the requirements of this part.
In connection with the audit requirements addressed in Part I, paragraph 1, the Contractor shall fulfill the requirements
relative to auditee responsibilities as provided in 2 CFR§200.508.
If the Contractor expends less than$750,000.00 in federal awards in its fiscal year, an audit conducted in accordance with
the provisions of 2 CFR Part 200 is not required. In the event that the Contractor expends less than$750,000.00 in federal
awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of 2 CFR Part 200,the cost
of the audit must be paid from non-federal resources (i.e., the cost of such audit must be paid from Contractor resources
obtained from other than federal entities.)
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to contracts with the Agency shall be based on the contract's requirements,including anyrules,
regulations, or statutes referenced in the contract. The financial statements shall disclose whether or not the matching
requirement was met for each applicable contract. All questioned costs and liabilities due to the Agency shall be fully
disclosed in the audit report with reference to the Agency contract involved. If not otherwise disclosed as required by 2
CFR § 200.510, the schedule of expenditures of federal awards shall identify expenditures by contract number for each
contract with the Agency in effect during the audit period. Financial reporting packages required under this part must be
submitted within the earlier of 30 days after receipt of the audit report or 9 months after the end of the Contractor's fiscal year
end.
PART II: STATE FUNDED
This part is applicable if the Contractor is a non-state entity as defined by Section 215.97(2),F.S.
Page 55 of 93 c,1®
160 7
January 2022-December 2022 OAA 203.22
In the event that the Contractor expends a total amount of state financial assistance equal to or in excess of$750,000.00 in
any fiscal year of such Contractor, the Contractor must have a State single or project-specific audit for such fiscal year in
accordance with Section 215.97, F.S.; applicable rules of the Department of Financial Services; and Chapter 10.550(local
governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General. Financial
Compliance Audit Attachment, Exhibit 2 indicates state financial assistance awarded through the Agency by this contract.
In determining the state financial assistance expended in its fiscal year, the Contractor shall consider all sources of state
financial assistance, including state financial assistance received from the Agency,other state agencies,and other non-state
entities. State financial assistance does not include Federal direct or pass-through awards and resources received by a non-
state entity for Federal program matching requirements.
In connection with the audit requirements addressed in Part II, paragraph 1, the Contractor shall ensure that the audit
complies with the requirements of Section 215.97(8), F.S. This includes submission of a financial reporting package as
defined by Section 215.97(2), F.S., and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit
organizations),Rules of the Auditor General.
If the Contractor expends less than $750,000.00 in state financial assistance in its fiscal year, an audit conducted in
accordance with the provisions of Section 215.97,F.S., is not required. In the event that the Contractor expends less than
$750,000.00 in state financial assistance in its fiscal year and elects to have an audit conducted in accordance with the
provisions of Section 215.97, F.S.,the cost of the audit must be paid from the non-state entity's resources(i.e.,the cost of
such an audit must be paid from the Contractor resources obtained from other than State entities).
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to contracts with the Agency shall be based on the contract's requirements, including any
applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching requirement
was met for each applicable contract. All questioned costs and liabilities due to the Agency shall be fully disclosed in the
audit report with reference to the Agency contract involved. If not otherwise disclosed as required by Rule 69I- 5.003,
F.A.C., the schedule of expenditures of state financial assistance shall identify expenditures by contract number for each
contract with the Agency in effect during the audit period. For local governmental entities, financial reporting packages
required under this part must be submitted within 45 days after delivery of the audit report,but no later than 12 months after
the Contractor's fiscal year end. For non-profit or for-profit organizations,financial reporting packages required under this
part must be submitted within 45 days after delivery of the audit report, but no later than 9 months afterthe Contractor's
fiscal year end.Notwithstanding the applicability of this portion,the Agency retains all right and obligation to monitor and
oversee the performance of this contract as outlined throughout this document and pursuant to law.
PART III: REPORT SUBMISSION
Copies of financial reporting packages for audits conducted in accordance with 2 CFR Part 200 and required by Part I of
this Financial Compliance Audit Attachment,shall be submitted,when required by 2 CFR§200.512 by or on behalf of the
Contractor directly to each of the following:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10th Street
Jeffersonville,IN 47132
Pursuant to 2 CFR§200.512,all other Federal agencies,pass-through entities and others interested in a reporting package
and data collection form must obtain it by accessing the Federal Audit Clearinghouse.
The Contractor shall submit a copy of any management letter issued by the auditor directly to the Agency.
Page 56 of 93 Cry®
160 7
January 2022-December 2022 OAA 203.22
Florida Department of Elder Affairs
Attn: Audit Repository
4040 Esplanade Way,Suite 235S
Tallahassee,Florida 32399-7000
Additionally, copies of financial reporting packages required by this contract's Financial Compliance Audit Attachment,
Part II,shall be submitted by or on behalf of the Contractor directly to each of the following:
The Area Agency on Aging for Southwest Florida,Inc.at the following address:
Area Agency on Aging for Southwest Florida,Inc.
Attn: Chief Financial Officer
2830 Winkler Ave., Suite 112
Fort Myers, FL 33916
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 letters,or other information required to be submitted to the Agency pursuant to this contractshall
be submitted timely in accordance with 2 CFR Part 200, F.S., and Chapter 10.550 (local governmental entities) or 10.650
(nonprofit and for-profit organizations),Rules of the Auditor General,as applicable.
Contractors,when submitting financial reporting packages to the Agency for audits done in accordance with 2 CFR Part 200
or Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor
General, should indicate the date that the reporting package was delivered to the Contractor in correspondence
accompanying the reporting package.
PART IV:RECORD RETENTION
The Contractor shall retain sufficient records demonstrating its compliance with the terms of this contract for a period of
six(6)years from the date the audit report is issued,and shall allow the Agency or its designee,the CFO,or Auditor General
access to such records upon request.The Contractor shall ensure that audit working papers are made available to the Agency
or its designee, CFO, or Auditor General upon request for a period of six(6)years from the date the audit report is issued,
unless extended in writing by the Agency.
Page 57 of 93
C_ 0
160 7
January 2022-December 2022 OAA 203.22
ATTACHMENT II-EXHIBIT 1
PART I: AUDIT RELATIONSHIP DETERMINATION
Contractors who receive state or federal resources may or may not be subject to the audit requirements of 2 CFR Part 200
and/or Section 215.97,F.S. Contractors who are determined to be recipients or sub-recipients of federal awards and/or
state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I
and/or Part II of Exhibit 1 are met.Contractors who have been determined to be vendors are not subject to the audit
requirements of 2 CFR§200.38 and/or Section 215.97,F.S.Regardless of whether the audit requirements are met,
Contractors who have been determined to be recipients or sub-recipients of Federal awards and/or state financial
assistance must comply with applicable programmatic and fiscal compliance requirements.
In accordance with 2 CFR Part 200 and/or Rule 69I-5.006,F.A.C.,Contractor has been determined to be:
Vendor not subject to 2 CFR§200.38 and/or Section 215.97,F.S.
Recipient/sub-recipient subject to 2 CFR§§200.86 and 200.93 and/or Section 215.97,F.S.
Exempt organization not subject to 2 CFR Part 200 and/or Section 215.97, F.S. For Federal awards, for-profit
organizations are exempt; for state financial assistance projects, public universities, community colleges, district
school boards, branches of state (Florida)government, and charter schools are exempt. Exempt organizations must
comply with all compliance requirements set forth within the contract or award document.
NOTE: If a Contractor is determined to be a recipient/sub-recipient of federal and/or state financial assistance,and has been
approved by the Agency to subcontract,they must comply with Section 215.97(7), F.S., and Rule 69I-5.006,F.A.C. [state
financial assistance] and/or 2 CFR§200.330 [federal awards].
PART II: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Contractors who receive Federal
awards, state maintenance of effort funds, or state matching funds on Federal awards and who are determined to be a sub-
recipient must comply with the following fiscal laws,rules,and regulations:
STATES,LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR§ 200.416- § 200.417—Special Considerations for States,Local Governments,and Indian Tribes*
2 CFR§ 200.201 —Administrative Requirements**
2 CFR§200 Subpart F—Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules,and regulations
NON-PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR§ 200.400- § 200.411 —Cost Principles*
2 CFR§200.100—Administrative Requirements
2 CFR§200 Subpart F—Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules,and regulations
EDUCATIONAL INSTITUTIONS(EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT)
MUST FOLLOW:
2 CFR§200.418—§200.419—Special Considerations for Institutions of Higher Education*
2 CFR§200.100—Administrative Requirements
2 CFR§200 Subpart F—Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules,and regulations
*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in 2 CFR
§200.400(5)(c).
**For funding passed through U.S.Health and Human Services,45 CFR Part 75;for funding passed through U.S.
Department of Education, 34 CFR Part 80.
Page 58 of 93
CA0
loll 7
January 2022-December 2022 OAA 203.22
STATE FINANCIAL ASSISTANCE.Contractors who receive state financial assistance and who are determined to be a
recipient/sub-recipient must comply with the following fiscal laws,rules, and regulations:
Sections 215.97&215.971,F.S.
Chapter 69I-5,F.A.C.
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules,and regulations
Page 59 of 93 C
AO
160 7
January 2022-December 2022 OAA 203.22
ATTACHMENT II - EXHIBIT 2- FUNDING SUMMARY
Note: Title 2 CFR§200331,as revised,and Section 21597(5),F.S.,require that the information about federal programs and StateProjects be
trovided to the Recipient and Ire stated in TheFinancial And Compliance Audit Attachment II,Exhibit 1 provided to the recipient. Information
contained herein is a prediction offundingsourcesand related amounts based on the contract budget.
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT CONSIST
OF THE FOLLOWING:
COLLIER COUNTY
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
Older Americans Act Title IIIB—
Transportation $ 8,296.26
Support Services U.S.Health and Human Services 93.044 $ 205,669.57
Total IIIB $ 213,965.83
OAA Title IIIC1 -Congregate Meals U.S. Health and Human Services 93.045 $ 552,670.89
Total IIICI
OAA Title III C2—Home Delivered Meals U.S. Health and Human Services 93.045 $ 390,360.45
Total IIIC2
Older Americans Act Title III E
Services(Title III E) $ 160,002.44
Supplement Services(Title III ES) U.S.Health and Human Services 93.052 $ 14,143.40
Grandparent Services(Title III EG) $ 6,083.23
TotalIIIE $ 180,229.07
Nutrition Services Incentive Program(NSIP) U.S. Health and Human Services 93.053 $ 51,728.59
TOTAL FEDERAL AWARD $1,388,954.83
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO
THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS:
2 CFR Part 200Uniform Administrative Requirements,Cost Principles,and Audit Requirements for Federal Awards/
OMB Circular A-133—Audits of States,Local Governments,and Non-Profit Organizations
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF
THE FOLLOWING.
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS
CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE
Section 215.97&215.971,F.S.,Chapter 69I-5,F.A.C., State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules,and regulations
Page 60 of 93 CA®
10. 11 7
January 2022-December 2022 OAA 203.22
ATTACHMENT III
CERTIFICATIONS AND ASSURANCES
Agency will not award this contract unless Contractor completes this CERTIFICATIONS AND ASSURANCES. In
performance of this contract,Contractor provides the following certifications and assurances:
A. Debarment and Suspension Certification(29 CFR Part 95 and 45 CFR Part 75)
B. Certification Regarding Lobbying(29 CFR Part 93 and 45 CFR Part 93)
C. Nondiscrimination & Equal Opportunity Assurance(29 CFR Part 37 and 45 CFR Part 80)
D. Certification Regarding Public Entity Crimes,section 287.133,F.S.
E. Association of Community Organizations for Reform Now (ACORN) Funding Restrictions Assurance
(Pub. L. 111-117)
F. Scrutinized Companies Lists and No Boycott of Israel Certification,section 287.135,F.S.
G. Certification Regarding Data Integrity Compliance for Contracts, Agreements, Grants, Loans, and
Cooperative Agreements
H. Verification of Employment Status Certification
I. Records and Documentation
J. Certification Regarding Inspection of Public Records
A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY
MATTERS—PRIMARY COVERED TRANSACTION.
The undersigned Contractor certifies,to the best of its knowledge and belief,that it and its principals:
1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
covered transactions by a Federal Agency or agency;
2. Have not within a three-year period preceding this contract been convicted or had a civil judgment rendered against
them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain,or performing
a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State
antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records,
making false statements, or receiving stolen property;
3. Are not presently indicted or otherwise criminally or civilly charged by a government entity (Federal, State, or
local)with commission of any of the offenses enumerated in paragraph A.2. of this certification; and/or
4. Have not within a three-year period preceding this application/proposal had one or more public transactions
(Federal, State,or local)terminated for cause of default.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at all
tiers (including subcontracts, sub-grants, and contracts under grants, loans, and cooperative agreements) and that all
sub-recipients and contractors shall provide this certification accordingly.
B. CERTIFICATION REGARDING LOBBYING—CERTIFICATION FOR CONTRACTS, GRANTS, LOANS,
AND COOPERATIVE AGREEMENTS.
The undersigned Contractor certifies,to the best of its knowledge and belief,that:
No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of Congress or an employee of a Member of Congress in
connection with the awarding of any Federal contract,the making of any Federal grant,the making of any Federal loan,
the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification
of any Federal contract,grant, loan,or cooperative agreement.
Page 61 of 93 CIA
160 7
January 2022-December 2022 OAA 203.22
If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of
Congress, or employee of a Member of Congress in connection with a Federal contract, grant, loan, or cooperative
agreement, the undersigned shall also complete and submit Standard Form — LLL, "Disclosure Form to Report
Lobbying,"in accordance with its instructions.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at all
tiers (including subcontracts, sub-grants, and contracts under grants, loans, and cooperative agreements) and that all
sub-recipients and contractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this contract was made or
entered into. Submission of this certification is a prerequisite for making or entering into this contract imposed by 31
U.S.C. § 1352.Any person who fails to file the required certification shall be subject to a civil penalty of not less than
$10,000 and not more than$100,000 for each such failure.
C. NON-DISCRIMINATION&EQUAL OPPORTUNITY ASSURANCE(29 CFR PART 37 AND 45 CFR PART
80). -As a condition of the Contract,Contractor assures that it will comply fully with the nondiscrimination and equal
opportunity provisions of the following laws:
1. Section 188 of the Workforce Investment Act of 1998 (WIA), (Pub. L. 105-220), which prohibits discrimination
against all individuals in the United States on the basis of race,color,religion, sex, national origin, age,disability,
political affiliation,or belief,and against beneficiaries on the basis of either citizenship/status as a lawfully admitted
immigrant authorized to work in the United States or participation in any WIA Title I-financially assisted program
or activity.
2. Title VI of the Civil Rights Act of 1964(Pub.L.88-352),as amended,and all requirements imposed by or pursuant
to the Regulation of the Department of Health and Human Services(45 CFR Part 80),to the end that,in accordance
with Title VI of that Act and the Regulation,no person in the United States shall, on the ground of race, color, or
national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to
discrimination under any program or activity for which the Applicant receives Federal financial assistance from the
Agency.
3. Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112), as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 84),to the end that, in
accordance with Section 504 of that Act and the Regulation,no otherwise qualified handicapped individual in the
United States shall, solely by reason of his handicap,be excluded from participation in, be denied the benefits of,
or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial
assistance from the Agency.
4. The Age Discrimination Act of 1975 (Pub. L. 94-135), as amended, and all requirements imposed by or pursuant
to the Regulation of the Department of Health and Human Services(45 CFR Part 91),to the end that,in accordance
with the Act and the Regulation,no person in the United States shall,on the basis of age,be denied the benefits of,
be excluded from participation in, or be subjected to discrimination under any program or activity for which the
Applicant receives Federal financial assistance from the Agency.
5. Title IX of the Education Amendments of 1972(Pub. L. 92-318), as amended,and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services(45 CFR Part 86),to the end that, in
accordance with Title IX and the Regulation,no person in the United States shall,on the basis of sex,be excluded
from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any education
program or activity for which the Applicant receives Federal financial assistance from the Agency.
6. The American with Disabilities Act of 1990 (Pub. L. 101-336), which prohibits discrimination in all employment
practices including job application procedures,hiring,firing,advancement,compensation,training,and other terms,
conditions,and privileges of employment.It applies to recruitment,advertising,tenure,layoff,leave,fringe benefits,
and all other employment-related activities.
7. Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws
listed above. This assurance applies to Contractor's operation of the WIA Title I—financially assisted program or
activity,and to all contracts Contractor makes to carry out the WIA Title I—financially assisted program or activity.
Contractor understands that Agency and the United States have the right to seek judicial enforcement of the
assurance.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub-grants, and contracts under grants, loans, and cooperative agreements) and that all
sub-recipients and contractors shall provide this assurance accordingly.
Page 62 of 93 CAo
16 D ,7
January 2022-December 2022 OAA 203.22
D. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES,SECTION 287.133,F.S.
Contractor hereby certifies that neither it,nor any person or affiliate of Contractor,has been convicted of a Public Entity
Crime as defined in section 287.133,F.S.,nor placed on the convicted vendor list.
Contractor understands and agrees that it is required to inform Agency immediately upon any change of circumstances
regarding this status.
E. ASSOCIATION OF COMMUNITY ORGANIZATIONS FOR REFORM NOW (ACORN) FUNDING
RESTRICTIONS ASSURANCE(Pub. L. 111-117).
As a condition of the Contract,Contractor assures that it will comply fully with the federal funding restrictions pertaining
to ACORN and its subsidiaries per the Consolidated Appropriations Act,2010,Division E,Section 511 (Pub.
L. 111-117). The Continuing Appropriations Act, 2011, Sections 101 and 103 (Pub. L. 111-242), provides that
appropriations made under Pub.L. 111-117 are available under the conditions provided by Pub.L. 111-117.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers(including subcontracts,sub-grants and contracts under grants,loans and cooperative agreements)and that all sub-
recipients and contractors shall provide this assurance accordingly.
F. SCRUTINIZED COMPANIES LISTS AND NO BOYCOTT OF ISRAEL CERTIFICATION,SECTION
287.135,F.S.
In accordance with section 287.135, F.S., Contractor hereby certifies that it has not been placed on the Scrutinized
Companies that Boycott Israel List and that it is not engaged in a boycott of Israel.
If this contract is in the amount of$1 million or more, in accordance with the requirements of section 287.135, F.S.,
Contractor hereby certifies that it is not listed on either the Scrutinized Companies with Activities in Sudan List or the
Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List and that it is not engaged in business
operations in Cuba or Syria.
Contractor understands that pursuant to section 287.135, F.S.,the submission of a false certification may result in the
Agency terminating this contract and the submission of a false certification may subject Contractor to civil penaltiesand
attorney fees and costs, including any costs for investigations that led to the finding of false certification.
If Contractor is unable to certify any of the statements in this certification,Contractor shall attach an explanation to
this contract.
G. CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR CONTRACTS, AGREEMENTS,
GRANTS,LOANS,AND COOPERATIVE AGREEMENTS
1. The Contractor and any Subcontractors of services under this contract have financial management systems capable
of providing certain information, including: (1) accurate, current, and complete disclosure of the financialresults
of each grant-funded project or program in accordance with the prescribed reporting requirements; (2)the source
and application of funds for all contract supported activities; and (3) the comparison of outlays with budgeted
amounts for each award. The inability to process information in accordance with these requirements could result
in a return of grant funds that have not been accounted for properly.
2. Management Information Systems used by the Contractor, Subcontractors, or any outside entity on which the
Contractor is dependent for data that is to be reported,transmitted,or calculated have been assessed and verified to
be capable of processing data accurately, including year-date dependent data. For those systems identified to be
non-compliant,Contractors will take immediate action to assure data integrity.
3. If this contract includes the provision of hardware,software,firmware,microcode,or imbedded chip technology,
the undersigned warrants that these products are capable of processing year-date dependent data accurately. All
versions of these products offered by the Contractor(represented by the undersigned)and purchased by the state
will be verified for accuracy and integrity of data prior to transfer.
Page 63 of 93
Ap
160 7
January 2022-December 2022 OAA 203.22
4. In the event of any decrease in functionality related to time and date related codes and internal subroutines that
impede the hardware or software programs from operating properly,the Contractor agrees to immediately make
required corrections to restore hardware and software programs to the same level of functionality as warranted
herein, at no charge to the state, and without interruption to the ongoing business of the state,time being of the
essence.
5. The Contractor and any Subcontractors of services under this contract warrant that their policies and procedures
include a disaster plan to provide for service delivery to continue in case of an emergency, including emergencies
arising from data integrity compliance issues.
H. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION
As a condition of contracting with the Agency,Contractor certifies the use of the U.S. Department of Homeland
Security's E-verify system to verify the employment eligibility of all new employees hired by Contractor during the
contract term to perform employment duties pursuant to this contract,and that any subcontracts include an express
requirement that Subcontractors performing work or providing services pursuant to this contract utilize the E-verify
system to verify the employment eligibility of all new employees hired by the Subcontractor during the entire contract
term.
The Contractor shall require that the language of this certification be included in all sub-agreements,sub-grants,and
other agreements/contracts and that all Subcontractors shall certify compliance accordingly.
This certification is a material representation of fact upon which reliance was placed when this contract was made or
entered into. Submission of this certification is a prerequisite for making or entering into this contract imposed by
Circulars A-102 and 2 CFR Part 200 and 215 (formerly OMB Circular A-110).
I. RECORDS AND DOCUMENTATION
The Contractor agrees to make available to Agency staff and/or any party designated by the Agency any andall
contract related records and documentation.The Contractor shall ensure the collection and maintenance of all
program related information and documentation on any such system designated by the Agency.Maintenance
includes valid exports and backups of all data and systems according to Agency standards.
J. CERTIFICATION REGARDING INSPECTION OF PUBLIC RECORDS
1. In addition to the requirements of Section 10 of the Standard Contract,sections 119.0701(3)and(4)F.S.,and any other
applicable law,if a civil action is commenced as contemplated by section 119.0701(4),F.S.,and the Agency is named
in the civil action,Contractor agrees to indemnify and hold harmless the Agency for any costs incurred bythe Agency
and any attorneys' fees assessed or awarded against the Agency from a Public Records Request made pursuant to
Chapter 119,F.S.,concerning this contract or services performed thereunder.
a. Notwithstanding section 119.0701, F.S., or other Florida law, this section is not applicable to contracts executed
between the Agency and state agencies or subdivisions defined in section 768.28(2),F.S.
2. Section 119.01(3), F.S., states if public funds are expended by an agency in payment of dues or membership
contributions for any person, corporation,foundation,trust,association,group,or other organization,all the financial,
business, and membership records of such an entity which pertain to the public agency (Florida Department of
Elder Affairs)are public records.Section 119.07,F.S,states that every person who has custody of such a public record
shall permit the record to be inspected and copied by any person desiring to do so,under reasonable circumstances.
Additionally,I certify this organization does El does not ❑ provide for institutional memberships.
Contractor's signature below attests that records pertaining to the dues or membership application by the Agency areavailable
for inspection if applicable,as stated above.
By execution of this contract, Contractor must include these provisions (A-J) in all related subcontract agreements (if
applicable).
Page 64 of 93 C40
160 7
January 2022-December 2022 OAA 203.22
By signing below,Contractor certifies that the representations outlined in parts A through J above are true and correct.
3299 TAMIAMI TRAIL E
Signatur and Title o A rOentative Street Address
Daniel R Rodriguez-Puhlic, ice artment Head
CO1,1.IF.R COUNTY ROART)OF COUNTY COMMISSTONRRS NAPLES,FL 34112
Contractor Il Da_te City,State,Zip code
019n2Approved as to form and legality
Assist t County Attorney
tIIQ a
Page 65 of 93 C,90
I 6O 7
January 2022-December 2022 OAA 203.22
ATTACHMENT IV ASSURANCES—
NON-CONSTRUCTION PROGRAMS
Public reporting burden for this collection of information is estimated to average forty-five(45)minutes per response, including time
for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing
the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden,to the Office of Management and Budget. Paperwork Reduction Project(0348-0043),
Washington,DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND
BUDGET,SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions please
contact the awarding agency.Further,certain federal awarding agencies may require applicants to certify to
additional assurances. If such is the case,you will be notified.
1. Has the legal authority to apply for federal assistance, and the institutional, managerial and financial capability
(including funds sufficient to pay the non-federal share of project cost)to ensure proper planning,management,and
completion of the project described in this application.
2. Will give the awarding agency,the Comptroller General of the United States,and if appropriate,the state,through any
authorized representative, access to and the right to examine all records, books, papers, or documents related to the
award; and will establish a proper accounting system in accordance with generally accepted accounting standards or
agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes,or presents the
appearance of,personal or organizational conflict of interest or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §§ 4728-4763) relating to prescribed
standards for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of
OPM's Standards for a Merit System of Personnel Administration(5 C.F.R. 900, Subpart F).
6. Will comply with all federal statutes relating to nondiscrimination.These include but are not limited to: (a)Title VI of
the Civil Rights Act of 1964(P.L. 88-352)which prohibits discrimination on the basis of race,color or national origin;
(b) Title IX of the Education Amendments of 1972, as amended(20 U.S.C. §§ 1681-1683 and §§ 1685-1686), which
prohibits discrimination on the basis of sex;(c) Section 504 of the Rehabilitation Act of 1973,as amended(29 U.S.C.
§794),which prohibits discrimination on the basis of handicaps;(d)the Age Discrimination Act of 1975,as amended
(42 U.S.C.§§6101-6107),which prohibits discrimination on the basis of age;(e)the Drug Abuse Office and Treatment
Act of 1972(P.L.92-255),as amended,relating to nondiscrimination on the basis of drug abuse;(f)the Comprehensive
Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended,
relating to nondiscrimination on the basis of alcohol abuse or alcoholism;(g)Sections523 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 (j) the requirements of any other
nondiscrimination statute(s)which may apply to the application.
7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance
and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of
persons displaced or whose property is acquired as a result of federal or federally assisted programs. These requirements
apply to all interests in real property acquired for project purposes regardless of federal participation in purchases.
8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. §§ 1501-1508 and §§ 7324-7328), which
limit the political activities of employees whose principal employment activities are funded in whole or in part with
federal funds.
Page 66 of 93 Cq
O
160 7
January 2022-December 2022 OAA 203.22
9. Will comply, as applicable, with the provisions of the Davis-Bacon Act(40 U.S.C. §§ 276a to 276a-7), the Copeland
Act(40 U.S.C. §276c and 18 U.S.C. §874)and the Contract Work Hours and Safety Standards Act(40 U.S.C.§§327-
333),regarding labor standards for federally assisted construction sub-contracts.
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the
program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or
more.
11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and
Executive Order(EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e)assurance of
project consistency with the approved State management program developed under the Coastal Zone Management Act
of 1972 (16 U.S.C. § 1451 et seq.); (f) conformity of federal actions to State(Clear Air) Implementation Plans under
Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. § 7401 et seq.); (g) protection of underground
sources of drinking water under the Safe Drinking Water Act of 1974,as amended(P.L. 93-523); and(h)protection of
endangered species under the Endangered Species Act of 1973,as amended(P.L.93-205).
12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. § 1721 et seq.) related to protecting components
or potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of
1966, as amended (16 U.S.C. § 470), EO 11593 (identification and protection of historic properties), and the
Archaeological and Historic Preservation Act of 1974(16 U.S.C. §469a-1 et seq.).
14. Will comply with P.L.93-348 regarding the protection of human subjects involved in research,development,and related
activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. § 2131 et seq.)
pertaining to the care,handling,and treatment of warm blooded animals held for research, teaching,or other activities
supported by this award of assistance.
16. Will comply with the Lead-Based Paint Poisoning Prevention Act(42 U.S.C. §4801 et seq.), which prohibits the use
of lead-based paint in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act
Amendments of 1996 and 2 CFR Part 200.
18. Will comply with all applicable requirements of all other federal laws, executive orders, regulations, and policies
governing this program.
SIGNA UR OF AU ':/ � G FICIAL TITLE
S PUBLIC SERVICE DEPARTMENT HEAD
fANTFT R RCMRTC; T.Fr`7.
APPLICANT ORGANIZATION DATE SUBMITTED
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS 01/ • /2022
Approved as to form and legality
cub
Assist t County Attorney
tilalaa
Page 67 of 93 C,4
0
160 7
January 2022-December 2022 OAA 203.22
ATTACHMENT V
FLORIDA Department of ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST
Program/Facility Name County AAA/Contractor
Address Completed By
City,State,Zip Code Date Telephone
PART I:READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU COMPLETE
THIS FORM.
1. Briefly describe the geographic area served by the program/facility and the type of service provided:
Total# % %
For questions 2-5 please indicate the following: White Black Hispanic Other Female Disabled Over 40
2. Population of area served Source of data: _
3.Staff currently employed Effective date:
4.Clients currently enrolled/registered Effective date:
5. Advisory/Governing Board if applicable
PART II: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. IF N/A or NO,EXPLAIN.
6. Is an Assurance of Compliance on file with Agency? N/A YES NO
❑ ❑ ❑
7. Compare the staff composition to the population. Is staff representative of the population? N/A YES NO
❑ ❑ ❑
8.Are eligibility requirements for services applied to clients and applicants without regard to race,color,national N/A YES NO
origin,sex,age,religion,or disability? ❑ ❑ ❑
9.Are all benefits,services and facilities available to applicants and participants in an equally effective manner N/A YES NO
regardless of race,sex,color,age,national origin,religion,or disability? ❑ ❑ El
10. For in-patient services,are room assignments made without regard to race,color,national origin or disability? N/A YES NO
11. Is the program/facility accessible to non-English speaking clients? N/A YES NO
12.Are employees,applicants and participants informed of their protection against discrimination? If YES,how? N/A YES NO
Verbal El Written❑Poster 0 0 0 ❑
Page 68 of 93 C
Ap
I 6 0 7
January 2022-December 2022 OAA 203.22
13.Give the number and current status of any discrimination complaints regarding services or employment filed N/A NUMBER
against the program/facility. ❑
14. Is the program/facility physically accessible to mobility,hearing,and sight-impaired individuals? N/A YES NO
PART III:THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES.IF NO,
EXPLAIN.
15.Has as a self-evaluation been conducted to identify any barriers to serving disabled individuals and to make any YES NO
necessary modifications? ❑ ❑
16. Is there an established grievance procedure that incorporates due process in the resolution of complaints? YES NO
❑ ❑
17. Has a person been designated to coordinate Section 504 compliance activities? YES NO
❑ ❑
18.Do recruitment and notification materials advise applicants,employees,and participants of nondiscrimination on YES NO
the basis of disability? ❑ ❑
19.Are auxiliary aids available to ensure accessibility of services to hearing and sight-impaired individuals? YES NO
❑ ❑
PART IV:FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF$50,000.00 OR MORE.
20. Do you have a written affirmative action plan? If NO,explain. YES NO
❑ ❑
A ency USE
ONLY
Reviewed by In Compliance: YES ❑ NO* ❑
Program Office *Notice of Corrective Action Sent / /
Date ❑ Telephone Response Due / /
On-Site Desk Review Response Received / /
Page 69 of 93 040
160 7
January 2022-December 2022 OAA 203.22
ATTACHMENT V
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST
1. Describe the geographic service area such as a district, county, city, or other locality. If the program/facility serves a
specific target population such as adolescents,describe the target population. Also,define the type of service provided.
2. Enter the percent of the population served by race,sex,disability,and over the age of 40. The population served includes
persons in the geographical area for which services are provided such as a city,county or other regional area. Population
statistics can be obtained from local chambers of commerce, libraries, or any publication from the 1980 Census
containing Florida population statistics. Include the source of your population statistics. ("Other" races include
Asian/Pacific Islanders and American Indian/Alaskan Natives.)
3. Enter the total number of full-time staff and their percent by race, sex, disability, and over the age of 40. Include the
effective date of your summary.
4. Enter the total number of clients who are enrolled,registered or currently served by the program or facility,and list their
percent by race,sex,disability,and over the age of 40. Include the date that enrollment was counted.
a. Where there is a significant variation between the race,sex,or ethnic composition of the clients and their availability
in the population, the program/facility has the responsibility to determine the reasons for such variation and take
whatever action may be necessary to correct any discrimination. Some legitimate disparities may exist when
programs are sanctioned to serve target populations such as elderly or disabled persons.
5. Enter the total number of advisory board members and their percent by race, sex, disability, and over the age of 40. If
there is no advisory or governing board,leave this section blank.
6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in
compliance with all nondiscriminatory provisions as required in 45 CFR Part 80. This is usually a standard part of the
contract language for Agency Recipients and their Sub-grantees. 45 CFR§ 80.4(a).
7. Is the race,sex,and national origin of the staff reflective of the general population? For example,if 10%of the population
is Hispanic,is there a comparable percentage of Hispanic staff?
8. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or
employment?Evidence of such may be indicated in staff and client representation(Questions 3 and 4)and also through
on-site record analysis of persons who applied but were denied services or employment. 45 CFR§ 80.3(a)and 45 CFR
§ 80.1.
9. Participants or clients must be provided services such as medical, nursing, and dental care, laboratory services,physical
and recreational therapies, counseling, and social services without regard to race, sex, color, national origin, religion,
age, or disability. Courtesy titles, appointment scheduling, and accuracy of record keeping must be applied uniformly
and without regard to race, sex, color, national origin, religion, age, or disability. Entrances, waiting rooms, reception
areas,restrooms,and other facilities must also be equally available to all clients. 45 CFR§ 80.3(b).
10. For in-patient services,residents must be assigned to rooms,wards,etc.,without regard to race,color,national origin,or
disability.Also,residents must not be asked whether they are willing to share accommodations with persons of a different
race,color,national origin,or disability. 45 CFR§ 80.3(a).
11. The program/facility and all services must be accessible to participants and applicants,including those persons who may
not speak English. In geographic areas where a significant population of non-English speaking people live, program
accessibility may include the employment of bilingual staff. In other areas, it is sufficient to have a policy or plan for
service, such as a current list of names and telephone numbers of bilingual individuals who will assist in the provision
of services. 45 CFR§ 80.3(a).
12. Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to their
participants, beneficiaries, or any other interested parties. 45 CFR § 80.6(d). This should include information on their
right to file a complaint of discrimination with either the Agency or the U.S.Department of Health and Human Services.
The information may be supplied verbally or in writing to every individual or may be supplied through the useof an equal
opportunity policy poster displayed in a public area of the facility.
13. Report number of discrimination complaints filed against the program/facility. Indicate the basis(e.g.race,color,creed,
sex,age,national origin,disability, and/or retaliation)and the issues involved(e.g. services or employment, placement,
termination,etc.). Indicate the civil rights law or policy alleged to have been violated along with the name and address
Page 70 of 93 Cil
160 7
January 2022-December 2022 OAA 203.22
of the local,state,or federal agency with whom the complaint has been filed. Indicate the current status of the complaint
(e.g. settled,no reasonable cause found,failure to conciliate,failure to cooperate,under review, etc.).
14. The program/facility must be physically accessible to mobility, hearing, and sight-impaired individuals. Physical
accessibility includes designated parking areas,curb cuts or level approaches,ramps, and adequate widths to entrances.
The lobby, public telephone, restroom facilities, water fountains, and information and admissions offices should be
accessible. Door widths and traffic areas of administrative offices,cafeterias,restrooms,recreation areas,counters,and
serving lines should be observed for accessibility. Elevators should be observed for door width and Braille or raised
numbers. Switches and controls for light, heat, ventilation, fire alarms, and other essentials should be installed at an
appropriate height for mobility impaired individuals.
15. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self-
evaluation to identify any accessibility barriers. Self-evaluation is a four-step process:
a. Evaluate, with the assistance of disabled individual(s)/organization(s), current policies and practices that do not or
may not comply with Section 504;
b. Modify policies and practices that do not meet Section 504 requirements.
c. Take remedial steps to eliminate the effects of any discrimination that resulted from adherence to these policies and
practices; and
d. Maintain self-evaluation on file,including a list of the interested persons consulted,a description of areas examined,
and any problems identified, and a description of any modifications made and of any remedial steps taken 45 CFR
§ 84.6.(This checklist may be used to satisfy this requirement if these four steps have been followed).
16. Programs or facilities that employ 15 or more persons shall adopt grievance procedures that incorporate appropriate due
process standards and that provide for the prompt and equitable resolution of complaints alleging any action prohibited
by Part 84 of Title 45,CFR45 CFR§ 84.7(b).
17. Programs or facilities that employ 15 or more persons shall designate at least one person to coordinate its efforts to
comply with Part 84 of Title 45, CFR. 45 CFR§ 84.7(a).
18. Programs or facilities that employ 15 or more persons shall take appropriate initial and continuing steps to notify
participants, beneficiaries, applicants, and employees that the program/facility does not discriminate on the basis of
handicap in violation of Section 504 and Part 84 of Title 45, CFR. Methods of initial and continuing notification may
include the posting of notices, publication in newspapers and magazines, placement of notices in publications of the
programs or facilities,and distribution of memoranda or other written communications. 45 CFR§ 84.8(a).
19. Programs or facilities that employ 15 or more persons shall provide appropriate auxiliary aids to persons with impaired
sensory, manual, or speaking skills where necessary to afford such persons an equal opportunity to benefit from the
service in question. Auxiliary aids may include,but are not limited to,brailed and taped materials,interpreters,and other
aids for persons with impaired hearing or vision. 45 CFR§ 84.52(d).
20. Programs or facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement, and
maintain a written affirmative action compliance program in accordance with Executive Order 11246, 41 CFR Part 60
and Title VI of the Civil Rights Act of 1964,as amended.
Page 71 of 93 C4®
1 6 0 7
(N
N
ri
N
"
* C)
0
... , . . . . ,,..tIc ,
<0 0 — -69- +A- -69- +A- -66- +A- 69- 6A- +A- 49- 6A- 6A- 6A- +A- -EA- *A- -69- -111-
;'• .
- 0 o ! 0
7.
.c .
•
•,,L)
0 cn
c c
•
0 2
•••
•
••
.,
n) .4..—
uu '.0.
.....
cn c tS/D
'Z' o
t.)4",
4.. ...'
U 0 tn
g c a
0 >.
0.,'`...
i-o C N S
4 u tu ca.
in =
44 47 CL co
0
()
Z .
...' in
a..)
— ,‘")
C c (13
I.0 ci
a_
C.)
E-1
U t w
g ....1.— 4.i
45 ci
4
C.)
Ct V OS
at) e cL,
. In
0
C....)
: .. ..
0
..s •
+2, :*'.7. ' E • — ,...-
. ....
.....• itt —• .
i-71‘NCr ,"•• ts E . :e.
\kW
,..,
,...
: ag.
a) =
a.) Ct ....• itt
177
N I ••• ,..r t
-et ns
4.0
0
E
'III'
C.., Z "/.1 C.:. •
Ia.)
ccl
c ,--1 esi cri M- 11.1 '0 1*-'• CO 01 "-; ,--1 "-o ..-1 •"-1 .-4 .-1 ..-1 "-i •,--I N i•cv .-.,
N ,...—.,
0
N
a'
ct7
7
C
03
—7
Ciin
....
I6O 7
January 2022-December 2022 OAA 203.22
BACKGROUND SCREENING
Ron DeSantis
i)op;vuncnt co' Governor
ELDER AFFAIRS
Richard Prudont
STATE OF FLORIDA Sectermy
•
N ,...< ,
BACKGROUNDSCREENING
Attestation of Compliance-Employer
AUTHORITY:This form is required annually of all employers to comply with the attestation
requirements set forth in section 435.05(3),Florida Statutes.
Y The term"employer"means any person or entity required by law to conduct background screenings,
including but not limited to,Area Agencies on Aging/Aging and Disability Resource Centers, Lead
Agencies, and Service Providers that contract directly or indirectly with the Department of Elder
Affairs(Agency),and any other person or entity which hires employees or has volunteers in service
who meet the definition of a direct service provider.See§§435.02,430.0402,Fla.Stat.
Y A direct service provider is"a person 18 years of age or older who,pursuant to a program to provide
services to the elderly, has direct, face-to-face contact with a client while providing services to the
client and has access to the client's living area, funds, personal property,or personal identification
information as defined in s. 817.568.The term includes coordinators, managers, and supervisors of
residential facilities and volunteers."§430.0402(1)(b),Fla.Stat.
ATTESTATION:
As the duly authorized representative of
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
Employer Name
located at 3299 TAMIAMI TRAIL.F. NAPI.ES FT. 34112 ,
Street Address City State ZIP code
1, DANIEI R RODRIGUEZ do hereby affirm under penalty of
Name of Representative
perjury that the above-named employer is in compliance with the provisions of Chapter 435 and section
430.04 2;Florida Statutes,re ard' level 2 background screening.
47 oli'/2022
v�
Signature of Repres nlalive Date
Agency Form 235,Attestation of.Compliance-Employer,Effective January 19,2021 Section 435.05(3),
VS.Form mailable at:Lugs: aletgllairs.org irp-comeru-uploads:doea-Juno-235-alfestalion-nrrompliance-empkmer.pcl/'
Approved as to form and legality
^, LL
Assist&ttt County Attorney
I I t a I a a Page 73 of 93 /140
I ' o
January 2022-December 2022 OAA 203.22
ATTACHMENT VIII
CERTIFIED MINORITY BUSINESS SUBCONTRACTOR EXPENDITURES(CMBE FORM)
CMBE FORM MUST ACCOMPANY INVOICES SUBMITTED TO Agency
CONTRACTOR NAME:
Agency CONTRACT NUMBER:
*REPORTING PERIOD-FROM: TO:
*(DATE RANGE OF RENDERED SERVICES,MUST MATCH INVOICE SUBMITTED TO
Agency)Agency CONTRACT MANAGER:
REPORT ALL EXPENDITURES MADE TO CERTIFIED MINORITY BUSINESS(SUBCONTRACTORS).
CONTACT Agency CMBE COORDINATOR FOR ANY QUESTIONS, AT 850-414-2153.
SUBCONTRACTOR NAME SUBCONTRACTOR'S CMBE EXPENDITURES
FEID
DOEA USE ONLY--REPORTING ENTITY(DIVISION,OFFICE,ETC)
SEND COMPLETED FORMS VIA INTEROFFICE MAIL TO:JUSTIN TAYLOR
CMBE COORDINATOR,CONTRACT ADMINISTRATION&PURCHASING,TALLAHASSEE,FLORIDA 32399-7000.
If unsure if subcontractor is a certified minority supplier,click on the hyperlink below. Enter the name of the supplier,click
"search". Only Certified Minority Business Entities will be displayed.
https://osd.dms.myflorida.com/directories
Page 74 of 93
o4o
! 60 7
January 2022-December 2022 OAA 203.22
INSTRUCTIONS
(A) ENTER THE COMPANY NAME AS IT APPEARS ON YOUR Agency CONTRACT.
(B) ENTER THE Agency CONTRACT NUMBER.
(C) ENTER THE SERVICE PERIOD MATCHING THE CURRENT INVOICE'S SERVICE PERIOD.
(D) ENTER ALL CERTIFIED MINORITY BUSINESS EXPENDITURES FOR THE TIME PERIOD COVERED BY
THE INVOICE:
1. ENTER CERTIFIED MINORITY BUSINESS NAME.
2. ENTER THE CERTIFIED MINORITY BUSINESS FEID NUMBER.
3. ENTER THE CERTIFIED MINORITY BUSINESS CMBE NUMBER.
4. ENTER THE AMOUNT EXPENDED WITH THE CERTIFIED MINORITY BUSINESS FOR THE TIME
PERIOD COVERED BY THE INVOICE.
(E) MBE FORM MUST ACCOMPANY INVOICE PACKAGE SUBMITTED TO Agency FINANCIAL
ADMINISTRATION FOR PROCESSING.
(F) FINANCIAL ADMINISTRATION WILL FORWARD ALL COMPLETED CMBE FORMS TO CONTRACT
ADMINISTRATION&PURCHASING OFFICE.
Page 75 of 93 e
January 2022-December 2022 OAA 203.22
ATTACHMENT IX-
BUDGET SUMMARY
COLLIER COUNTY
1. Title III B Support Services $ 213,965.83
2. Title III Cl Congregate Meals $ 552,670.89
3. Title III C2 Home Delivered Meals $ 390,360.45
4. Title III E Services $ 160,002.44
5. Title III ES Services $ 14,143.40
6. Title III EG Services $ 6,083.23
7. NSIP $ 51,728.59
TOTAL $ 1,388,954.83
Page 76 of 93
C40
160 7
January 2022-December 2022 OAA 203.22
ATTACHMENT X
INVOICE SCHEDULE
Report Based On Submit to State
Number On This Date
1 January Advance* January 1
2 February Advance* January 1
3 January Receipts and Expenditure Report February 9
and Request for Payment
4 February Receipts and Expenditure Report March 9
and Request for Payment
5 March Receipts and Expenditure Report April 9
and Request for Payment
6 April Receipts and Expenditure Report May 9
and Request for Payment
7 May Receipts and Expenditure Report June 9
and Request for Payment
8 June Receipts and Expenditure Report July 9
and Request for Payment
9 July Receipts and Expenditure Report August 9
and Request for Payment
10 August Receipts and Expenditure Report September 9
and Request for Payment
11 September Receipts and Expenditure Report October 9
and Request for Payment
12 October Receipts and Expenditure Report November 9
and Request for Payment
13 November Receipts and Expenditure Report December 9
and Request for Payment
14 December Receipts and Expenditure Report January 9
and Request for Payment
15 Final Receipts and Expenditure Report February 9
and Request for Payment
Legend: * Advance based on projected cash need as supported by a cash-flow analysis or other
information appropriate to demonstrate the contractor's financial need for the advance.
Page 77 of 93 0,4
160 7
January 2022-December 2022 OAA 203.22
Note=I: Report=1 for Advance Basis Agreements cannot be submitted to the Agency prior to
January 1 or until the agreement with the Agency has been executed.
Note=2: Report numbers 5 through 14 shall reflect an adjustment of one-tenth of the total advance
amount,on each of the reports,repaying advances issued the first two months of the agree-
ment. 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 Agency,payment is to accompany the
report.
Y.to.4 ALL Expenditure Reports are due by 12:00 p.m.on the 9:+.,of each month. IF the 9 falls on a Saturday,then the report
will be due by the g;by 12:00 p.m. AND IF the 90 falls on a Sundae,the report will be due by the 10 by 12:00 p.m.
Actual submission of the vouchers to Dept.of Elder Affairs is dependent on the accuracy of the expenditure report,
which is verified and paid by CIRTS data only.AFTER Militia submitted.DO NOT ADD any additional units(retro or
next billing period)until after the 15-of the month.
ATTACHMENT XI
INFORMATION AND REFERRAL REPORT SCHEDULE
EX IIBIT 1
Report Reporting Requirement Report Due Date
Pro ram Name
Reports must include the data elements identified in
Information and Referral Quarter 1 Attachment I,Exhibit 1,Standard 14:Data Analysis April 10
and Reporting for January—March.
Reports must include the data elements identified in
Information and Referral Quarter 2 Attachment I,Exhibit 1,Standard 14:Data Analysis July 10
and Reporting for April—June.
Reports must include the data elements identified in
Information and Referral Quarter 3 Attachment I,Exhibit 1,Standard 14:Data Analysis October 10
and Reporting for July—September.
Reports must include the data elements identified in
Information and Referral Quarter 4 Attachment I,Exhibit 1,Standard 1.1:Data Analysis January- 10
and Reporting_for October—December.
Page 78 of 93
0A0
160 7
January 2022-December 2022 OAA 203.22
REQUEST FOR PAYMENT
TYPE OF REPORT:
PROVIDER NAME,ADDRESS,PHONE 8 FED ID NUMBER Contract*
Advance
Contract Period:
Reimbursement Report Period
Report*
PSA
CERTIFICATION:I hereby certify to the best of my knowledge that this request conforms with the terms and the purposes set forth in the above contract.
Prepared By: Date: Approved By: Date:
PART A: (1) (2) (3) (4) (5) (6) (7) (8)
BUDGET SUMMARY ADMIN. IIIB IIIC1 IIIC2 IIID 111E NSIP TOTAL
I.Approved
Contract Amount 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.Previous Funds
RECEIVED for
Contract period 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
3.Contract Balance 0.00 0.00 0 00 0.00 0.00 0.00 0.00 0.00
(Line 1 minus line 2)
4.Previous Funds _.
REQUESTED and
Not Reoaived. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5.Contract Balance 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
(Line 3 minus line 4)
PART B:
FUNDS REQUESTED
1.1st-2nd Months
Request Only 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.Net Expenditures
For Month 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
3.Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
PART C:
NET FUNDS REQUESTED:
1.Less:Over-Advance 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.Contract Funds are
Hereby Requested 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
List of Services/Units/Rates provided-See attached report.
AgenoyOnly Use
A enc FORM 106A revised
Page 79 of 93
(CA®
January 2022-December 2022 1 6 ilk 20372
RECEIPTS AND EXPENDITURE REPORT
EXHIBIT 1
PROVIDER NAME,ADDRESS, PHONE#AND FEID# PROGRAM FUNDING SOURCE: Contract#
0
0 Title III&General Revenue Contract Period:
0
0 Administration Report Period
0
0 Report#
0 PSA
0 Invoice#
0
CERTIFICATION: I certify to the best of my knowledge and belief that this report is complete and all outlays herein are for purposes set forth
in the contract.
Prepared by: , .Date: Approved by: Date:
PART A:BUDGETED INCOME/RECEIPTS 1.Approved 2.Actual Receipts 3.Total Receipts 4.Percent of
Budget For This Report Year to Date Approved Budget
1.Federal Funds $0.00 $0.00 $0.00 #DIV/0!
2.State Funds $0.00 $0.00 $0.00 #DIV/0!
3.Local Cash Match $0.00 $0.00 $0.00 #DIV/0!
4.State Match $0.00 $0.00 $0.00 #DIV/0!
5.Local In-Kind Match $0.00 $0.00 $0.00 #DIV/0!
6.TOTAL RECEIPTS $0.00 $0.00 $0.00 #DIV/0!
PART B:CONTRACTED EXPENDITURES 1.Approved 2. Expenditures 3.Expenditures 4. Percent of
Budget For This Report Year to Date Approved Budget
1.Administrative Expenses $0.00 $0.00 $0.00 r #DIV/0!
PART C:OTHER EXPENDITURES 1.Approved 2. Expenditures 3.Expenditures 4. Percent of
(For tracking purposes only) Budget For This Report Year to Date Approved Budget
1. Match: CCE/GR $0.00 $0.00 $0.00 #DIV/0!
HCE/GR $0.00 $0.00 $0.00 ' #DIV/0!
Other and In-Kind $0.00 $0.00 $0.00 e #DIV/0!
2. Local Match $0.00 $0.00 $0.00 ' #DIV/0!
3.TOTAL $0.00 $0.00 $0.00 ' #DIV/0!
D:INTEREST
1. Earned on Advances $0.00
2. Returned on Advances $0.00
Agency FORM 105as-ADMIN revised 10/19/18
Page 80 of 93
cAo
January 2022-December 2022 I 6 4 20342
PROVIDER NAME,ADDRESS, PHONE#AND FEID# PROGRAM FUNDING SOURCE: Contract#
0
0 Title III Contract Period:
0
0 IIIB Report Period
0
0 PSA Report#
0
0 Invoice#
0
CERTIFICATION: I certify to the best of my knowledge and belief that this report is complete 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 Budget 2.Actual Receipts 3.Total Receipts 4.Percent of
For This Report Year to Date Approved Budget
1.Federal Funds $0.00 $0.00 $0.00 #DIV/0!
2.State Funds $0.00 $0.00 $0.00 #DIV/01
3.Program Income-Non Match $0.00 $0.00 $0.00 #DIV/01
4.Local Cash Match $0.00 $0.00 $0.00 #DIV/0!
5.SUBTOTAL:CASH RECEIPTS $0.00 $0.00 $0.00 #DIV/0!
6.Local In-Kind Match $0.00 $0.00 $0.00 #DIV/0!
7.TOTAL RECEIPTS $0.00 $0.00 $0.00 #DIV/0!
PART B: EXPENDITURES 1.Approved Budget 2.Expenditures 3.Expenditures 4.Percent of
For This Report Year to Date Approved Budget
1.AM Direct Services $0.00 $0.00 $0.00 #DIV/0!
2.Subcontractor $0.00 $0.00 $0.00 #DIV/0!
3.IIIB Set Aside $0.00 $0.00 $0.00 #DIV/0!
4.IIIB Set Aside DRR(Disaster Recovery Reserve) $0.00 $0.00 $0.00 #DIV/0!
5.TOTAL EXPENDITURES $0.00 $0.00 $0.00 ' #DIV/0!
PART C:OTHER EXPENDITURES 1.Approved Budget 2.Expenditures 3.Expenditures 4.Percent of
(For Tracking Purposes only) For This Report Year to Date Approved Budget
1.Match
a.Other and In-Kind $0.00 $0.00 $0.00 ' #DIV/0!
b.Local Match $0.00 $0.00 $0.00 ' #DIV/0!
2.Program Income $0.00 $0.00 $0.00 ' #DIV/0!
3.TOTAL OTHER $0.00 $0.00 $0.00 ' #DIV/0!
PART D:INTEREST
1.Earned on Advances $0.00
2.Return on Advances $0.00
3.Other Earned $0.00
Agency FORM 105as-IIIB revised 10/19/18
Page 81 of 93 C
440
January 2022-December 2022 1 6 QAA 20722
PROVIDER NAME,ADDRESS, PHONE#AND FEID# PROGRAM FUNDING SOURCE: Contract#
0
O Title III Contract Period:
0
O C1 Report Period
0
O PSA Report#_
0
O Invoice#
0
CERTIFICATION: I certify to the best of my knowledge and belief that this report is complete and all outlays herein are for purposes set forth
in the contract.
Prepared by: Date: Approved by: Date:
PART :BUDGETED INCOME/RECEIPTS 1.Approved Budget 2.Actual Receipts 3.Total Receipts 4.Percent of
For This Report Year to Date Approved Budget
1.Federal Funds $0.00 $0.00 $0.00 #DIV/0!
2.State Funds $0.00 $0.00 $0.00 #DIV/0!
3.Program Income-Non Match $0.00 $0.00 $0.00 #DIV/0!
4.Local Cash Match $0.00 $0.00 $0.00 #DIV/0!
5.SUBTOTAL:CASH RECEIPTS $0.00 $0.00 $0.00 #DIV/0!
6.Local In-Kind Match $0.00 $0.00 $0.00 #DIV/0!
7.TOTAL RECEIPTS $0.00 $0.00 $0.00 #DIV/0!
PART B:EXPENDITURES 1.Approved Budget 2.Expenditures 3.Expenditures 4.Percent of
For This Report Year to Date Approved Budget
1. Subcontractor $0.00 $0.00 $0.00 #DIV/0!
2. C1 Set Aside DRR(Disaster Recovery Reserve) $0.00 $0.00 $0.00 #DIV/0!
3.TOTAL EXPENDITURES $0.00 $0.00 $0.00 #DIV/0!
PART C:OTHER EXPENDITURES 1.Approved Budget 2.Expenditures 3.Expenditures 4.Percent of
(For Tracking Purposes only) For This Report Year to Date Approved Budget
1. Match
a. Other and In-Kind $0.00 $0.00 $0.00 . #DIV/0!
b. Local Match $0.00 $0.00 $0.00 r #DIV/01
2. Program Income $0.00 $0.00 $0.00 " #DIV/0!
3.TOTAL OTHER $0.00 $0.00 $0.00 " #DIV/0!
PART D: INTEREST
1.Earned on Advances $0.00
2.Return on Advances $0.00
3.Other Earned $0.00
Agency FORM 105as-C1 revised 10/19/2018
Page 82 of 93
c'1®
160 7
January 2022-December 2022 OAA 203.22
PROVIDER NAME,ADDRESS, PHONE#AND FEID# PROGRAM FUNDING SOURCE: Contract#
0
0 Title III Contract Period: _
0
0 C2 Report Period
0
0 PSA Report#
0
0 Invoice#
0
CERTIFICATION: I certify to the best of my knowledge and belief that this report is complete 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 Budget 2.Actual Receipts 3.Total Receipts 4.Percent of
For This Report Year to Date Approved Budget
1.Federal Funds $0.00 $0.00 $0.00 #DIV/0!
2.State Funds $0.00 $0.00 $0.00 #DIV/0!
3.Program Income-Non Match $0.00 $0.00 $0.00 #DIV/0!
4.Local Cash Match $0.00 $0.00 $0.00 #DIV/01
5.SUBTOTAL:CASH RECEIPTS $0.00 $0.00 $0.00 #DIV/0!
6.Local In-Kind Match $0.00 $0.00 $0.00 #DIV/O!
7.TOTAL RECEIPTS $0.00 $0.00 $0.00 #DIV/0!
PART B: EXPENDITURES 1.Approved Budget 2.Expenditures 3.Expenditures 4. Percent of
For This Report Year to Date Approved Budget
1.Subcontractor $0.00 $0.00 $0.00 #DIV/0!
2. C2 Set Aside DRR(Disaster Recovery Reserve) $0.00 $0.00 $0.00 #DIV/0!
3.TOTAL EXPENDITURES $0.00 $0.00 $0.00 #DIV/0!
PART C:OTHER EXPENDITURES 1.Approved Budget 2.Expenditures 3.Expenditures 4.Percent of
(For Tracking Purposes only) For This Report Year to Date Approved Budget
1. Match
a.Other and In-Kind $0.00 $0.00 $0.00 ' #DIV/0!
b. Local Match $0.00 $0.00 $0.00 ' #DIV/Ol
2. Program Income $0.00 $0.00 $0.00 - #DIV/01
3.TOTAL OTHER $0.00 $0.00 $0.00 ' #DIV/0!
PART D:INTEREST
1.Earned on Advances $0.00
2.Return on Advances $0.00
3.Other Earned $0.00
Agency FORM 105as-C2 revised 10/19/18
Page 83 of 93 CA
160 7
January 2022-December 2022 OAA 203.22
PROVIDER NAME,ADDRESS, PHONE#AND FEID# PROGRAM FUNDING SOURCE: Contract#
0
0 Title III Contract Period:
0
0 IIID Report Period
0
0 PSA Report#
0
0 Invoice#
0
CERTIFICATION: I certify to the best of my knowledge and belief that this report is complete 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 Budget 2.Actual Receipts 3.Total Receipts 4.Percent of
For This Report Year to Date Approved Budget
1.Federal Funds $0.00 $0.00 $0.00 #DIV/0!
2.TOTAL RECEIPTS $0.00 $0.00 $0.00 #DIV/0!
PART B: EXPENDITURES 1.Approved Budget 2.For This Report 3.Year to Date 4.Percent of
Approved Budget
1.AAA Direct Services $0.00 $0.00 $0.00 #DIV/0!
2. Subcontractor $0.00 $0.00 $0.00 #DIV/0!
3.TOTAL EXPENDITURES $0.00 $0.00 $0.00 #DIV/0!
PART C:OTHER EXPENDITURES 1.Approved 2.Expenditures 3.Expenditures 4. Percent of
(For Tracking Purposes only) Budget For This Report Year to Date Approved Budget
1.Program Income $0.00 $0.00 $0.00 . #DIV/0!
PART D: INTEREST
1.Earned on Advances $0.00
2.Return on Advances $0.00
3.Other Earned $0.00
Agency FORM 105as-IIID revised 10/19/2018
Page 84 of 93 CA
0
I 6 0 7
January 2022-December 2022 OAA 203.22
PROVIDER NAME,ADDRESS, PHONE#AND FEID# PROGRAM FUNDING SOURCE: Contract#
0
O Title III Contract Period:
0
O IIIE Report Period
0
O PSA Report# „-
0
O Invoice#
0
CERTIFICATION:I certify to the best of my knowledge and belief that this report is complete 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 Budget 2.Actual Receipts 3.Total Receipts 4.Percent of
For This Report Year to Date Approved Budget
1.Federal Funds $0.00 $0.00 $0.00 #DIV/01
2.State Funds $0.00 $0.00 $0.00 #DIV/01
3.Program Income-Non Match $0.00 $0.00 $0.00 #DIV/01
4.Local Cash Match $0.00 $0.00 $0.00 #DIV/01
5.SUBTOTAL:CASH RECEIPTS $0.00 $0.00 $0.00 #DIV/01
6.Local In-Kind Match $0.00 $0.00 $0.00 #DIV/01
7.TOTAL RECEIPTS $0.00 $0.00 $0.00 #DIV/01
PART B:EXPENDITURES 1.Approved Budget 2.Expenditures 3.Expenditures 4.Percent of
For This Report Year to Date Approved Budget
1.AAA Direct Services $0.00 $0.00 $0.00 #DIV/01
2.Sub-Contracted Services $0.00 $0.00 $0.00 #DIV/01
3.TOTAL EXPENDITURES $0.00 $0.00 $0.00 #DIV/0!
PART C:OTHER EXPENDITURES 1.Approved Budget 2.Expenditures 3.Expenditures 4.Percent of
(For Tracking Purposes only) For This Report Year to Date Approved Budget
1.Match
a.Other and In-Kind $0.00 $0.00 $0.00 #DIV/0!
b.Local Match $0.00 $0.00 $0.00 #DIV/01
2.Program Income $0.00 $0.00 $0.00 #DIV/01
3.TOTAL OTHER $0.00 $0.00 $0.00 #DIV/01
PART D:EXPENDITURES ANALYSIS
1.Expenditures by Services Year to Date: 2.Units of Services Year to Date 3.Number of People Served Year to Date
1.Information $0.00 0 0
2.Assistance $0.00 0 0
3.Counseling $0.00 0 0
4.Respite $0.00 . 0 0
5.Supplemental Services...... $0.00 0 0
6.TOTAL $0.00
Part B Line 3,column 3 should be equal to this total.
PART E:GRANDPARENT SERVICES(reported by Federal Fiscal Year)
FFY $ FFY $ FFY $
Match$ Match$ Match$
PART F:INTEREST
1.Earned on Advances $0.00
2.Returned on Advances $0.00
3.Other Earned $0.00
Agency FORM 105as-IIIE revised 10/19/18
Page 85 of 93
Cd4o
160 7
January 2022-December 2022 OAA 203.22
PROVIDER NAME,ADDRESS, PHONE#AND FEID# PROGRAM FUNDING SOURCE: Contract#
0
0 Title III Contract Period:
0
0 NSIP Report Period
0
0 PSA Report#
0
0 Invoice#
0
CERTIFICATION: I certify to the best of my knowledge and belief that this report is complete and all outlays herein are for purposes set forth
in the contract.
Prepared by: Date: Approved by: Date:
PART A:EXPENDITURE COMPUTATION YEAR TO DATE CURRENT MONTH
CONGREGATE HOME DELIVERED CONGREGATE HOME DELIVERED
1.Number of Meals Served 0 0 0 0
2.Line 1 Times$.72 cents per Meal $u.uu $u.uu $u.uu $u.uu
Year To Date Total Meals 0 Current Month Total Meals 0
Year To Date Total Expenditures $0.00 Total Current Expenditures $0.00
PART B:CONTRACT SUMMARY
1. Approved Contract Amount $0.00
2. Actual Expenditures for this Report $0.00
3. Total Expenditures Year to Date $0.00
4. Contract Balance $0.00
Agency FORM 105as-NSIP revised 10/19/18
Page 86 of 93 0,10 O
January 2022-December 2022 1 &AQ203.2?
COMPUTATION OF CARRYFORWARD AND OVERADVANCE OAA TITLE III
PSA Contract Period:
Contract#
AAA ADMINISTRATION TITLE III B TITLE IIIC1 TITLE III C2 TITLE III D 11TLE III E NSIP
FED FUND OEN REV FED FUND FED FUND FED FUND FED FUND FED FUND FED FUND TOTAL
CARRYFORWARD
1.CURRENT YEAR FUNDING:FFY 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.PRIOR YEAR CARRYFORWARD:FFY 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
3.PRIOR YEAR CARRYFORWARD:FFY 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
4.CONTRACT TOTALS 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5.NET EXPENDITURES FOR CONTRACT YEAR 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0,00
6.CURRENT FFY CARRYFORWARD 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
7.CARRYFORWARD PERCENTAGE r #DIV/01 r #DIV/01 r #DIVI01 r #DIV/01 r #DIV/01 r #DIV/01 r #DIV/0! r #DIV/01 r #DIV/0!
OVERADVANCES
8.TOTAL FUNDS ADVANCED AND/OR REIMBURSED 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
9.LESS:EXPENDITURES FROM LINE 5 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10.AMOUNT OF OVERADVANCE 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
11.REPORT APPROVED FOR AAA BY: 12.REPORT APPROVED BY Agency DIVISION OF FINANCIAL ADMINISTRATION:
Signature Date Signature Date
13.REPORT APPROVED BY Agency CONTRACT MANAGEMENT:
Signature Date
Agency FORM 124A,Revised 10/19/18
Page 87 of 93 C
January 2022-December 2022 1 6 203.27
COST REIMBURSEMENT SUMMARY
PSA Contract#
Contract Period:
Report Period
Report#
Budget
Category Description Number of units Amount
0
a
H
TOTAL ADMINISTRATION $0.00
a
a
a
a
a
x
w
TOTAL EXPENSES $0.00
Page 88 of 93 C AQ
160 7
January 2022-December 2022 OAA 203.22
ATTACHMENT XV
BUDGET AND RATE SUMMARY
COLLIER COUNTY
IIIB
SERVICE REIMBURSEMENT METHOD OF UNIT
UNIT RATE PAYMENT TYPE
CASE MANAGEMENT $54.00 Fixed Fee/Unit Rate HOURS
CHORE $22.29 Fixed Fee/Unit Rate HOURS
EMERGENCY ALERT RESPONSE $ 1.35 Fixed Fee/Unit Rate DAYS
HOMEMAKER $25.44 Fixed Fee/Unit Rate HOURS
HOUSING IMPROVEMENT Cost Reimbursement 90%of Cost EPISODE
MATERIAL AID Cost Reimbursement 90%of Cost EPISODE
PERSONAL CARE $25.44 Fixed Fee/Unit Rate HOURS
RECREATION MATERIALS
(EMERGENCIES ONLY) Cost Reimbursement 100%of Cost EPISODE
RESPITE IN-HOME $25.44 Fixed Fee/Unit Rate HOURS
SHOPPING ASSISTANCE—COVID-19 $34.12 Fixed Fee/Unit Rate ONE-WAY TRIPS
SKILLED NURSING SERVICES $41.55 Fixed Fee/Unit Rate HOURS
SPECIALIZED MEDICAL
EQUIPMENT, SERVICES,AND Cost Reimbursement 90%of Cost EPISODE
TELEPHONE REASSURANCE—COVID-19 $13.40 Fixed Fee/Unit Rate EPISODE
TRANSPORTATION Cost Reimbursement 100%of Cost TRIPS
Page 89 of 93 Cq
160 7
January 2022-December 2022 OAA 203.22
ATTACHMENT VIII
BUDGET AND RATE SUMMARY
COLLIER COUNTY
C-1 &C-2
SERVICE REIMBURSEMENT
UNIT RATE UNIT TYPE
CI -- CONGREGATE MEALS $11.72 MEALS
HOME DELIVERED MEALS $ 8.07 MEALS
NUTRITION EDUCATION $ 1.59 PARTICIPANTS
CONGREGATE MEAL SCREENING $28.00 HOUR
CONGREGATE MEALS FOR MANAGED $11.72 MEALS
LONG TERM CLIENTS
OUTREACH $4.32 PER PERSON EPISODE
SHOPPING ASSISTANCE-COVID-19 $34.12 ONE-WAY TRIPS
TELEPHONE REA S SURANCE-COVID-19 $13.40 EPISODE
SERVICE REIMBURSEMENT
UNIT RATE UNIT TYPE
C2 -- HOME DELIVERED MEALS $ 8.07 MEALS
NUTRITION EDUCATION $ 1.59 PARTICIPANTS
SCREENING &ASSESSMENT $48.76 HOUR
OUTREACH $4.32 PER PERSON EPISODE
SHOPPING ASSISTANCE-COVID-19 $34.12 ONE-WAY TRIPS
TELEPHONE REASSURANCE-COVID-19 $13.40 EPISODE
Page 90 of 93 C4
160 7
January 2022-December 2022 OAA 203.22
ATTACHMENT VIII
BUDGET AND RATE SUMMARY
COLLIER COUNTY
IIIE,IIIES,& IIIEG
REIMBURSEMENT METHOD OF UNIT
SERVICE UNIT RATE PAYMENT TYPE
IIIE --ADULT DAY CARE $108.00 Fixed Fee/Unit Rate DAYS
RECREATION MATERIALS Cost Reimbursement 100%of Cost EPISODE
(EMERGENCIES ONLY)
RESPITE IN-HOME $25.44 Fixed Fee/Unit Rate HOURS
RESPITE IN-FACILITY $11.05 Fixed Fee/Unit Rate HOURS
SCREENING &ASSESSMENT $55.17 Fixed Fee/Unit Rate HOURS
SHOPPING ASSISTANCE—COVID-19 $34.12 Fixed Fee/Unit Rate ONE-WAY
TELEPHONE REASSURANCE—COVID-19 $13.40 Fixed Fee/Unit Rate EPISODE
IIIES--CHORE $22.29 Fixed Fee/Unit Rate HOURS
Specialized Medical Equipment, Cost Reimbursement 90%of Cost EPISODE
Service & Supplies
MATERIAL AID Cost Reimbursement 90%of Cost EPISODE
IIIEG--CHILD DAY CARE $15.00 Fixed Fee/Unit Rate HOURS
RECREATION MATERIALS
(EMERGENCIES ONLY) Cost Reimbursement 100%of Cost EPISODE
SCREENING AND ASSESSMENT $55.17 Fixed Fee/Unit Rate HOURS
SHOPPING ASSISTANCE—COVID-19 $34.12 Fixed Fee/Unit Rate ONE-WAY
TELEPHONE REASSURANCE—COVID-19 $13.40 Fixed Fee/Unit Rate EPISODE
Page 91 of 93 Clo
! 60 7
January 2022-December 2022 OAA 203.22
ATTACHMENT XVI
OAA ANNUAL VOLUNTEER ACTIVITY REPORT SPECIFICATIONS
I. Categories&Definitions
Direct Volunteers:Volunteers who have person-to-person contact with clients(e.g. I&R specialists,SHINE counselors,
and individuals providing respite and companionship).
Indirect Volunteers: Volunteers who coordinate,manage, or participate in specific services,programs,or activities that
assist paid staff in planning,implementing,and evaluating the goals and objectives of an organization(e.g. speaker's
bureau volunteer,data entry,board members,etc.).
Episodic Volunteers: Volunteers who participate in a specific,one-time event for a limited time,regardless of direct or
indirect volunteers.
NOTE: A volunteer can only be counted once. Select the category(direct,indirect,or episodic)that best describes the
individual volunteer and his/her volunteer work.
Unduplicated direct or indirect volunteers:Number of volunteers who perform service activities.
II. Survey Questions
User input:Email address
i. User input: Survey questions
1. Number of unduplicated direct service volunteers.
1. Number of unduplicated indirect service volunteers.
2. Number of episodic volunteers engaged during the contract year.
3. Total number of direct volunteer hours served.
4. Total number of indirect volunteer hours served.
5. Total number of episodic volunteer hours served.
6. Number of clients served by volunteers.
7. Number of volunteers age 60 or older.
8. Number of volunteers under age 60.
III. Service Categories
Groupings for reporting the number of volunteers providing services during the data collection period(January 1 —
December 31). If there are no activities during the year,enter zero.
Adult Day Care: Non-residential facility specializing in providing activities for elderly individuals or individuals with
disabilities.Operates ten to twelve(10— 12)hours per day and provides meals,social or recreational outings,and general
supervision.
Advisory Council/Board Membership: Group of experts and leaders in an industry who share knowledge,contacts, and
leadership skills to benefit an organization; comprised of people who have no material interests in the organization other
than their directorship and who are responsible for a fiduciary role within the organization.
AmeriCorps:Network of national service programs that engage members and community volunteers in intensive service
to meet needs in education,public health,and the environment. This service produces volunteers who will provide direct
services to clients.
AmeriCorps Vista: VISTA members commit to serve full-time for a year at a nonprofit organization or local government
agency,working to fight illiteracy, improve health services,create businesses, strengthen community groups,and much
more. This service produces volunteers who will provide direct services to clients.
Clerical/Administration: Complex work tasks performed under direction in support of one or more persons serving in an
administrative or professional capacity; completion of routine administrative tasks directly related to the work of
supervisor(s).
Companionship Programs: Programs that help elders to help other elders with their daily lives.Tasks may include
grocery shopping,household chores,going out to lunch,or simply visiting the elders to keep them company.
Congregate Meals: Meal service in a group setting to individuals who cannot prepare or obtain nutritionally adequate
meals themselves. Meals assist individuals to maintain a nutritious diet.
Consumer Education/Counseling: Enhances the capacity of mature consumers to navigate the increasingly complex
marketplace. Consumer education programs provide significant benefits, including identification of market information,
compliant and consumer redress procedures,and understanding of a technology-based consumer environment.
Page 92 of 93 CAO
160 .7
January 2022-December 2022 OAA 203.22
Disaster Preparation/Recovery: Services provided in coordination with American Red Cross,FEMA,and local task
forces in response or in preparation of a disaster.
Education: Community outreach program of an academic institution that offers educational and cultural programs
specifically designed to foster and support lifelong learning.
Foster Grandparents: Provides a way for volunteers age 55 and older to stay active by serving children and youth in
their communities,through tutoring and mentoring.
Fundraising: Any service directly related to the solicitation of contributions for a committee,program,or organization.
Health Promotion: Programs specifically for older adults in the areas of health education,physical activity,coordinated
screening, and mental health.
Home Delivered Meals:Meal service delivered to the homes to individuals who cannot prepare or obtain nutritionally
adequate meals for themselves.Meals assist individuals to maintain a nutritious diet.
Homemaker Programs: Programs provide in-home services to elders at-risk of premature placement in a nursing home.
Clients must be 60 years of age or older.
Home Repair:Home improvement,remodeling,or handyman work,including small,odd jobs,and routine tasks.
Information and Referral: One-to-one services directing elders to appropriate programs and resources based on elders'
needs and specialized knowledge of aging services within the community.
Intergenerational: Activities or programs that increase cooperation, interaction,or exchange between any two or more
generations.
Legal Assistance: Legal services to elders age 60 and older that deal with issues such as property taxes,mobile home,
and other landlord tenant issues,advance directives,Medicaid eligibility, Social Security denial,and state and local
welfare benefit denials.
RSVP: Retired Senior Volunteer Program includes a network for individuals age 55 and older who use their skills and
talents in volunteer activities such as home repairs,tutoring and mentoring,and assisting victims of natural disasters.
Recreation: Programs for older adults including health education,physical activity, and coordinated screening for
physical and mental health.
RELIEF: Respite for Elders Living in Everyday Families offers respite services to caregivers of frail elders and those
with Alzheimer's disease and related dementia.
Respite: Service that provides a temporary break for a family member from daily caregiving responsibilities.
Safety Education Programs: Programs on home safety,driver's safety fall prevention,and other general safety
educational topics provided by a volunteer to the aging network.
Senior Companions: Volunteers provide services to elders at risk of institutionalization due to chronic illness,disability,
or isolation. Services may include transportation to medical appointments,shopping assistance,meal preparation,
companionship,and advocacy,as well as respite for caregivers.
Elder Abuse Prevention Programs: Prevention strategies for elder abuse neglect,and exploitation,fraud, scams,identity
theft,and programs on home safety. SHINE and Florida SHINE/SMP: The SHINE Program provides free and unbiased
counseling through a dedicated network of volunteers,empowering Florida seniors to make informed decisions.Through
the SHINE Program, SHINE volunteers help Medicare beneficiaries,their families, and caregivers through education,
counseling, and assistance.Through the SHINE/SMP(Senior Medicare Patrol)Program,volunteers also educate
beneficiaries to protect,detect and report potential errors, fraud,and abuse with their Medicare Coverage.
Special Events:Time-limited events.
Speakers' Bureau: Service that provides the right professional speaker for every type of event.
Telephone Reassurance: Scheduled telephone calls to check on homebound elders,which may include a friendly visit
from law enforcement or volunteers.
Transportation: Service provided for older adults and individuals with disabilities including lift-equipped vehicles for
wheelchair transport and medical transportation for appointments,dialysis,and chemotherapy
Page 93 of 93 C1A0
160 7
Revised August 2007
Attestation Statement
Agreement/Contract Number OAA 203,22
Amendment Number
I, DANIEL R RODRIGUEZ ,attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting,due to the differences in
electronic data processing media,which has no affect o►n.-the agreement/contract content.
//.
� nu 0072
Signature of Recipient/Contr r represents J ` Date
Approved as to form and legality
Assista4St County Attorney
'1 ►Qla
Revised August 2007
C40