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Agenda 11/15/2016 Item #16D 9 16D.9 11/15/2016 EXECUTIVE SUMMARY Recommendation to approve an "after-the-fact" Amendment and Attestation Statement with Area Agency on Aging for Southwest Florida, Inc. for the Services for Seniors Community Care for the Elderly program(No Fiscal Impact). OBJECTIVE: To provide uninterrupted support services to Collier County Services for Seniors' (CCSS) elderly clients. CONSIDERATIONS: The Community and Human Services' Services for Seniors program has been providing support to Collier County's frail and elderly citizens for over thirty years through the Federal and State of Florida grants. The Community Care for the Elderly(CCE)program is funded by the Florida Department of Elder Affairs (DOEA) through the Area Agency on Aging for Southwest Florida, Inc. (Agency). This grant-funded service enables seniors to remain in their homes and live with independence and dignity. On July 26, 2016,the County Manger approved the current grant contract with Area Agency on Aging for Southwest Florida, Inc. (Absentia Agenda item 11A) and it was ratified by the Board on September 13, 2016. This contract has a one-year term, effective July 1, 2016 through June 30, 2017. The proposed amendment is the second amendment to the contract. The proposed CCE amendment adds the County's DUNS Number to Attachment III-Exhibit 2 and the word"other" as a service with a 90% cost reimbursement in Attachment VI. The amendment is effective September 30,2016. This item is being presented "after-the-fact" because Collier County received the grant agreement on September 29, 2016 from the Agency with a request for a 30-day turnaround time frame. The Agency routinely sends CCSS amendments with an effective date that doesn't allow time for processing before the required time frame. Pursuant to CMA 5330 and Resolution No. 2010-122, the County Manager authorized Steve Carne11, Public Services Department Head, to sign the agreement. This amendment is being presented for Board ratification. Collier County, as the Lead Agency, is responsible to respond to seniors' needs and to manage the spending authority for the CCE program services. FISCAL IMPACT: Funding from the Department of Elder Affairs via the Area Agency on Aging under the 2016 grant award is available in Human Services Grant Fund 707, Project 33462 (CCE). There is no fiscal impact associated with this action. GROWTH MANAGEMENT: There is no growth management impact associated with this action. LEGAL CONSIDERATIONS: This is a standard form amendment provided by the Area Agency on Aging for Southwest Florida, Inc. This item has been approved for form and legality and requires a majority vote for Board approval. -JAB RECOMMENDATIONS: That the Board of County Commissioners approves the "after-the-fact" Community Care for the Elderly Amendment and Attestation Statement with Area Agency on Aging for Southwest Florida, Inc. Packet Pg. 1055 16.D.9 11/15/2016 Prepared by: Lisa N. Can,Grants Coordinator, Community and Human Services ATTACHMENT(S) 1. CCE 203 16 002 Executed (PDF) 2.CCE 203.16.001 Executed (PDF) 3.CCE 203,16 Contract Executed (PDF) Packet Pg. 1056 16.D.9 11/15/2016 COLLIER COUNTY Board of County Commissioners Item Number: 16.D.9 Item Summary: Recommendation to approve an "after-the-fact" Amendment and Attestation Statement with Area Agency on Aging for Southwest Florida, Inc. for the Services for Seniors Community Care for the Elderly program(No Fiscal Impact). Meeting Date: 11/15/2016 Prepared by: Title: Grants Coordinator—Community&Human Services Name: Lisa Carr 10/21/2016 10:56 AM Submitted by: Title: Division Director-Cmnty&Human Svc—Public Services Department Name: Kimberley Grant 10/21/2016 10:56 AM Approved By: Review: /—*N, Community&Human Services Dora Carrillo Additional Reviewer Completed 10/21/2016 11:11 AM Community&Human Services Kristi Sonntag Additional Reviewer Completed 10/21/2016 11:31 AM Public Services Department Amanda O.Townsend Additional Reviewer Completed 10/24/2016 9:57 AM Community&Human Services Maggie Lopez Additional Reviewer Completed 10/25/2016 4:40 PM Public Services Department Kimberley Grant Additional Reviewer Completed 10/25/2016 4:48 PM Public Services Department Hailey Margarita Alonso Level 1 Division Reviewer Completed 10/26/2016 4:22 PM Grants Erica Robinson Level 2 Grants Review Completed 10/27/2016 2:38 PM Public Services Department Steve Carnell Level 2 Division Administrator Review Completed 10/28/2016 9:34 AM County Attorneys Office Jennifer Belpedio Level 2 Attorney of Record Review Completed 11/01/2016 9:18 AM County Attorney's Office Jeffrey A.Klatzkow Level 3 County Attorneys Office Review Completed 11/01/2016 9:37 AM Office of Management and Budget Valerie Fleming Level 3 OMB Gatekeeper Review Completed 11/02/2016 11:09 AM Grants Therese Stanley Additional Reviewer Completed 11/07/2016 4:53 PM County Manager's Office Nick Casalanguida Level 4 County Manager Review Completed 11/07/2016 8:44 PM Board of County Commissioners MaryJo Brock Meeting Pending 11/15/2016 9:00 AM Packet Pg. 1057 July 2016—June 2017 CCE 203.16.002 16.D.9.a AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC. COMMUNITY CARE FOR THE ELDERLY PROGRAM COLLIER COUNTY BOARD OF COUNTY COMIIIISSIONERS THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and Collier County Board of County Commissioners ("Contractor"), amends agreement CCE 203.16. N The purpose of this amendment is to revise ATTACHMENT III—EXHIBIT 2 by adding the DUNS Numbers and add `Other' as a service in ATTACHMENT VI. a) w m All provisions in the contract and any attachments thereto in conflict with this Amendment shall be and are hereby changed to conform to this Amendment. L its All provisions not in conflict with this Amendment are still in effect and are to be performed at the level specified in the contract. E This Amendment and all its attachments are hereby made part of the contract. U IN WITNESS THEREOF, the Parties hereto have caused this 3 page amendment, to be executed by their undersigned officials as duly authorized; and agree to abide by the terms, conditions and provisions of this CCE contract as amended. This Amendment is effective on September 30,2016. >- Contractor: COLLIER COUNTY BOARD AREA AGENCY ON AGING FOR OF COUNTY COMMISSIONERS SOUTHWEST FLORIDA,INC. 13 SIGNED BY: !-41.0Filif ✓ SIGNED BY: 7/t/AL(Q. m NAME: STEVE Y. CARNELL NAME: MARIANNE G LORINI to O TITLE: PUBLIC SERVICES DEPARTMENT HEAD TITLE: PRESIDENT/CEO / (�: DATE: OCTOBER ! , 2016 DATE: /0/ 7//4 ni 11.1 Federal Tax ID: 59-6000558 Fiscal Year Ending Date: 09/30 ai E Approved as to form and legality Assis..nt County Attorney 1 O�� Packet Pg. 1058 July 2016—June 2017 CCE 203.16.002 16.D9.a ATTACHMENT II /-� EXHIBIT FINANCIAL AND COMPLIANCE AUDIT ATTACHMENT EXHIBIT 2-FUNDING SUMMARY Note: Title 2 CFR§200.331,As Revised, and Section 215.97(5),Florida Statutes,Require That Information About Federal Programs and State Projects Be Provided to the Recipient and Are Stated in the Financial and Compliance Audit Attachment and Exhibit 1. Financial and Compliance Audit Attachment, Exhibit 2-Funding Summary Provides Information Regarding the Funding Sources Applicable to This Contract,Contained Herein,Is A Prediction of Funding Sources and Related Amounts Based on the Contract Budget. • FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF THE FOLLOWING: GRANT AWARD (FAIN#): N/A FEDERAL AWARD DATE: -a DUNS NUMBER: 076997790 w PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT r Cu TOTAL FEDERAL AWARD COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT E TO THIS CONTRACT ARE AS FOLLOWS: FEDERAL FUNDS: 2 CFR Part 200—Uniform Administrative Requirements,Cost Principles,and Audit Requirements for Federal Awards. '_° /'\OMB Circular A-133,As amended—Audits of States,Local Governments,and Non-Profit Organizations • STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF THE FOLLOWING: MATCHING RESOURCES FOR FEDERAL PROGRAMS PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT w N TOTAL STATE AWARD rs STATE FINANCIAL ASSISTANCE SUBJECT TO Sec.215.97,F.S. N PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT v Community Care for the Elderly General Revenue-Collier 65010 $ 802,100.00 c TOTAL AWARD $ 802,100.00 < COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: STATE FINANCIAL ASSISTANCE: Section 215.97, F.S., Chapter 691-5, FL Admin Code, Reference Guide for State Expenditures, Other fiscal requirements set forth in program laws,rules and regulations. �., 2 Packet Pg. 1059 July 2016 to June 2017 CCE 203. 16.D.9.a ATTACHMENT VI COMMUNITY CARE FOR THE ELDERLY PROGRAM ANNUAL BUDGET SUMMARY for Collier County Board of County Commissioners N 0 A Collier a, CCE Services Allocations $ 802,100.00 LL1 w RATE SUMMARY for Collier County Board of County Commissioners E E E Collier County Total Unit Cost Reimbursement Rate-90% Case Management $60.00 $54.00 Case Aide $33.88 $30.50 Adult Day Care $12.83 $11.55 LL Chore $23.33 $21.00 r• Enhanced Chore $30.33 $27.30 N Companion $23.33 $21.00 Skilled Nursing $42.00 $37.80 EARS $ 1.31 $ 1.18 Escort $21.67 $19.50 Home Delivered Meals $ 7.78 $ 7.00 cv Homemaking $21.50 $19.35 Personal Care $25.67 $23.10 Respite-in-Facility $12.83 $11.55 Respite-in-Home $25.67 $23.10 cV w Home Improvement $ Cost Reimbursement 90% Cost Reimbursement Material Aid $Cost Reimbursement 90% Cost Reimbursement = Specialized Medical Equipment, ai Service& Supplies $ Cost Reimbursement 90% Cost Reimbursement Transportation $Cost Reimbursement 90% Cost Reimbursement m Other $Cost Reimbursement 90% Cost Reimbursement 3 • v� Packet Pg. 1060 16.D.9.a Revised August 2007 Attestation Statement Agreement/Contract Number:CCE 203.16 Amendment Number: 002 N O O > L I,Steve Carnell ,attest that no changes or revisions have been made to the (Recipient/Contractor representative) W d content of the above referenced agreement/contract or amendment between the Area Agency on Aging for Southwest Florida and Public Services Department Head V (Recipient/Contractor name) The only exception to this statement would be for changes in page formatting,due to the differences in electronic data processing media,which has no affect on the agreement/contract content. E 0 U ti 4 �-� ?a,/ j/1 October 18 , 2016 u. Signatur of Recipient/Contractor repr entative Date •• r•- (NI N V d X w N Approved as to form and legality co M Ass t County Attorn wN • \\Ne E \01 R a.. Revised August 2007 GQ�4 Packet Pg. 1061 .Q (zoo A iopi3 eql aoj eieo Aponwwo3 L1,/91, AA : L'PZZ) palnoex3 400.96°£0Z 333 :luawyaellty N 0 0 fuly 2016 to June 2017 CCE 203.16.001 a AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC. .-- as a � COMMUNITY CARE FOR THE ELDERLY PROGRAM COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and Collier County Board of County Commissioners ("Contractor"),amends agreement CCE 203,16. The purpose of this amendment is to change language in ATTACHMENT I,E Reports,#2 Service Cost Reports. ATTACHMENT I E. Reports 2. Service Cost Reports a. The Agency shall require the Contractor to submit Annual Service Cost Reports, which reflect actual costs of providing each service by program, Service Cost Reports for all contracts are due by February 15, 2017 for the prior calendar year. b. Unit Cost Methodology worksheets must be submitted by August 1 of each year, if a rate increase is being requested for any contract in the next calendar year. All provisions in the contract and any attachments thereto in conflict with this Amendment shall be and are hereby changed to conform to this Amendment. All provisions not in conflict with this Amendment are still in effect and are to be performed at the level specified in the contract. This Amendment and all its attachments are hereby made part of the contract. IN WITNESS THEREOF, the Parties hereto have caused this 1 page amendment, to be executed by their undersigned officials as duly authorized; and agree to abide by the terms, conditions and provisions of this CCE contract as amended. This Amendment is effective on the last date the Amendment has been signed by both Parties. Contractor: COLLIER COUNTY BOARD AREA AGENCY ON AGING FOR OF COUNTY Ft ihSSIONERS SOUTHWEST FLtORIDA,INC. SIGNED BY: ,�a`'k/v� ()1 (..../C/61 SIGNED BY: /( ` z-t-' LA..-- NAME: STEVE CARNELL NAME: MARIANNE G LORINI TITLE: PUBLIC SERVICES DEPARTMENT HEAD TITLE: PRESIDENT/CEO,T DATE: Ti 1 1 6 ''I 4 DATE: .2`57:,/ ' Federal Tax ID: 59-6000558 Fiscal Year Ending Date: 09/30 Approved as to form and legality • Assistant County Attorney C -) NN� S i (Z00 Al1ap13 aql ao}ono A;lunwwoo L4/94 AJ : LpZZ) pe;n3ex3 400.94'E0Z 330 :luewyoelltf to oi, Revised August 2007 t OL ca Attestation Statement Agreement/Contract Number CCE 203.16 Amendment Number 001 I, Steve Carnell ,attest that no changes or revisions have been made to the (Recipient/Contractor representative) content of the above referenced agreement/contract or amendment between the Area Agency on Aging for Southwest Florida and Collier County Board of County Commissioners (Recipient/Contractor name) The only exception to this statement would be for changes in page formatting,due to the differences in electronic data processing media,which has no affect on the agreement/contract content. Signature of Recipie Contractor representative Date Approved as to form and legality Assistant County Attorney (17 l.0 \� Revised August 2007 .' (zoo AiaapE3 eql ao¢&1e0 Altunwwoo LI/91. L'PZZ) pa4noax3 loe.,quoo 91,`£OZ 333 :luawgoellV b. of CO m July 2016—June 2017 CCE 203,16 a a) AREA AGENCY ON AGING FOR1SOUTHWEST FLORIDA,INC. o- l COMMUNITY CARE FOR THE ELDERLY PROGRAM CONTRACT COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc. (Agency) and Collier County Board of County Commissioners (Contractor), and collectively referred to as the "Patties." The term Contractor for this purpose may designate a Vendor, Subgrantee or Subrecipient. WITNESSETH THAT: WHEREAS,the Agency has determined that it is in need of certain services as described herein;and WHEREAS, the Contractor has demonstrated that it has the requisite expertise and ability to faithfully perform such services as an independent Contractor of the Agency. NOW THEREFORE,in consideration of the services to be performed and payments to be made,together with the mutual covenants and conditions hereinafter set forth,the Parties agree as follows: 1. Purpose of Contract The purpose of this contract is to provide services in accordance with the terms and conditions specified in this contract including all attachments,forms,exhibits and references incorporated,which constitute the contract document. 2, Incorporation of Documents within the Contract The contract will incorporate attachments,proposal(s),state plan(s),grant agreements,relevant Department handbooks, manuals or desk books and Master Contract number HM014,as an integral part of the contract,except to the extent that the contract explicitly provides to the contrary. In the event of conflict in language among any of the documents referenced above,the specific provisions and requirements of the contract document(s)shall prevail over inconsistent provisions in the proposal(s)or other general materials not specific to this contract document and identified attachments. 3. Term of Contract This contract shall begin at twelve(12:00)A.M., Eastern Standard Time July 1,2016 or on the date the contract has been signed by the last party required to sign it,whichever is later. It shall end at eleven fifty-nine(11:59)P.M.,Eastern Standard Time June 30,2017. 4. onl,_'act Amount The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount not to exceed $802,100.00, or the rate schedule, subject to the availability of funds. Any costs or services paid for under any other contract or from any other source are not eligible for payment under this contract. 5. Renewals By mutual agreement of the Parties,in accordance with s. 287.058(1)(g), Florida Statutes,the Agency may renew the contract for a period not to exceed three years,or the term of the original contract,whichever is longer. The renewal price,or method for determining a renewal price,is set forth in the bid,proposal,or reply. No other costs for the renewal may be charged.Any renewal is subject to the same terms and conditions as the original contract and contingent upon satisfactory performance evaluations by the Agency and the availability of funds. • 1 (ZOO/tla3Pl3 eq;aoj 0180 A;lunwwo0 Lt•191. LpZZ) pamex3 loaa;uo.D 91.`£OZ 303 :;uauape;;b d !,;g1'I July 2016—June 2017 CCE 203.16 ,o. 6. Official Payee and Representatives(Names.Addresses.and Telephone Numbers): The Contractor name,as shown on page 1 of this o Collier County Board of County Commissioners /oCollier County Community and Human Services a. contract,and mailing address of the official payee to 3339 E Tamiami Trail,Suite 211 whom the payment shall be made is: Naples,FL 34112 The name of the contact person and street address where KimberleyyGrant,CDounty Commissioners financial and administrative records are maintained is: %Collier County Community and Human Services 3339 E Tamiami Trail,Suite 211 Naples,FL 34112 The name,address,and telephone number of the Kimberley Grant,Director c. 1 Collier County Board of County Commissioners representative of the Contractor responsible for %Collier County Community and Human Services administration of the program under this contract is: 3339 E Tamiami Trail,Suite 211 Naples,FL 34112 (239)252-2273 The section and location within the Agency where Area Agency on Aging for Southwest Florida,Inc. Requests for Payment and Receipt and Expenditure 15201 North Cleveland Avenue,Suite 1100 d. forms are to be mailed is: North Fort Myers,FL 33903 Tammy Rhoades,Vice President of Finance e. The name,address,and telephone number of the Area Agency on Aging for Southwest Florida,Inc. Contract Manager for this contract is: 15201 North Cleveland Avenue,Suite 1100 North Fort Myers,FL 33903 239-652-6900 Upon change of representatives(names,addresses,telephone nmbers)by either party,notice shall be provided in writing to the other party and the notification attached to the originals of this contract. 7. All Terms and Conditions Lrcludled: This contract and its Attachments, I—Ili, VI---IX and any exhibits referenced in said attachments,together with any documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There are no provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all previous communications,representations or agreements,either written or verbal between the Parties. By signing this contract, the Parties agree that they have read and agree to the entire contract. IN WITNESS THEREOF,the Parties hereto have caused this 29 page contract,to be executed by their undersigned officials as duly authorized. Contractor:COLLIER COUNTY BOARD OF AREA AGENCY ON AGING FOR SOUTHWEST COUNTY COMMISSIONERS FLORIDA,INC. SIGNED BY: 'lklhJ SIGNED BY: / r i NAME:Steve Carnell NAME: MARIANNE G LORINI TITLE: Public Services Department Head TITLE: PRESIDENT/CEO DATE: 1 I Z.-b' t DATE: 044 Federal Tax ID: 59-6000558 • Approved as to form and legality '' Fiscal Year Ending Date:09/30 Assistant County Attorney :4 • •.< i o (ZOO ilaap13 eqa ao}ale°A lunwwoo 16191, Ad : LtrZZ) pe noex3 pea;uoo 96`£OZ 333 :IuauayoeUd co os 0 G July 2016—June 2017 CCE 203,16 x '; ea INDEX OF ATTACHMENTS a. I ATTACHMENT I 4 STATEMENT OF WORK ATTACHMENT II 17 CERTIFICATIONS AND ASSURANCES ATTACHMENT III ,.20 EXHIBIT I: FINANCIAL AND COMPLIANCE AUDIT EXHIBIT 2:FUNDING SUMMARY ATTACHMENT VI •••26 ANNUAL BUDGET SUMMARY and RATE SUMMARY ATTACHMENT VII 27 INVOICE REPORT SCHEDULE ATTACHMENT VIII 28 REQUEST FOR PAYMENT ATTACHMENT IX 29 RECEIPT AND EXPENDITURE REPORT /'\ 3 1 (ZOO APepl3 ay;Jo}a.re3 4unwura3 L6191. AA : Lt7ZZ) painoax3 ioei uo3 9I:COZ 330 :Iuewyoewy r- ai - 0 fi July 2016—June 2017 CCE203.16 :4 to ATTACHMENT I ctii a: AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC. STATEMENT OF WORK I. SERVICES TO BE PROVIDED A. Definitions of Terms 1. Contract Acronyms Area Agency on Aging(AAA) Adult Protective Services(APS) Adult Protective Services Referral Tracking Tool(ARTT) Corrective Action Plan(CAP) Community Care for the Disabled Adult(CCDA) Community Care for the Elderly(CCE) Client Information and Registration Tracking System(CIRTS) Department of Children and Families(DCF) (DOEA)/Department Florida Statutes(F.S.) Home Care for Disabled Adults(HCDA) Notice of Instruction(NOI) Planning and Service Area(PSA) Summary of Programs and Services(SOPS) 2. Program Specific Terms Adult Protective Services Referral Tracldng Tool: A system designed to track DCF APS referrals to AAAs and CCE Lead Agencies for victims of second party abuse, neglect, and exploitation who need home and community-based services as identified by APS staff. Aging Out: The condition of reaching 60 years of age and being transitioned from the DCF,CCDA,or HCDA services to DOEA's community-based services. Area Plan: A plan developed by the Area Agency on Aging for Southwest Florida, Inc. outlining a comprehensive and coordinated service delivery system in its PSA in accordance with the Section 306 (42 U.S.C. 3026) of the Older Americans Act and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the AAA enters CCE specific data in the CIRTS. An update may also include other revisions to the Area Plan as instructed by DOEA. Department of Elder Affairs Programs and Services Handbook: An official document of the State of Florida, DOEA. The Handbook includes program policies, procedures, and standards applicable to agencies which are recipients of DOEA-funded programs,and providers of program-funded services. An annual update is provided through a Notice of Instruction. Functional Assessment: A comprehensive, systematic,and multidimensional review of a person's ability to remain living independently in the least restrictive living arrangement. 4 • �1 (ZOO Apapl3 eq1 aoJ oleo Apunwwo3 L6/9l• AA Li'ZZ) palnaex3 laeiluo3 94`£OZ 333 :luauagae11V w G co July 2016—June 2017 CCE 203.16 n. a co Notice of Instruction (NOI): The Department's established method to communicate to the Agency and/or Contractor the requirements to perform particular tasks or activities. NOLs are located on the Department's website at http://elderaffairs.state.fl.us/does/'nois/php. Program Highlights: Success stories, quotes, testimonials, or human-interest vignettes that are used in the Summary of Programs and Services to demonstrate how programs and services help elders, families, and caregivers. Summary of Programs and Services(SOPS):A document produced by DOEA and updated yearly to provide the public and the Legislature with information about programs and services for Florida's elders, B. General Description 1. General Statement The primary purpose of the CCE Program is to prevent, decrease, or delay premature or inappropriate and expensive placement of elders in nursing homes and other institutions. 2. Community Care for the Elderly Mission Statement The CCE Program assists functionally-impaired elderly persons in living as independently as possible, in the least restrictive environment suitable to their needs. The program provides a continuum of care through the development,expansion,reorganization,and coordination of multiple community-based services. 3. Authority The relevant authorities governing the CCE Program are: a.Rule 58C-1,Florida Administrative Code; b.Sections 430.201 through 430.207,F.S.;and c.The Catalog of State Financial Assistance(CSFA)Number 65010. 4. Scope of Service The Agency is responsible for the programmatic,fiscal,and operational management of CCE. The program services shall be provided in a manner consistent with the Agency's current Area Plan,as updated,and the current DOEA Programs and Services Handbook,which are hereby incorporated by reference. 5. Major Program Goal The major goals of the program are to preserve the independence of elders and prevent or delay more costly institutional care through a community care service system that provides case management and other in-home and community services as needed under the direction of a lead agency and to provide a continuum of service alternatives that meets the diverse needs of functionally-impaired elders. C. Clients to be Served 1. General Description The CCE Program provides a continuum of services for functionally-impaired elders. 2. Client Eligibility In order to receive services under this contract,an applicant must: a. Be at least 60 years of age; b. Be functionally impaired as determined through the comprehensive assessment;and 5 (Zoo Alaap13 oto ao}eieo Allunwwo3 LC/96 AA : LpZZ) painoax3;oei;uo3 91'COZ 333 :luewiloe;iy e a': July 2016—June 2017 CCE 203.16 c. Not be dually enrolled in the CCE program and a Medicaid-capitated long-term care program. as d. Be aging out as defined in Section I.A.2,of this contract. — 3. Targeted Groups Priority for services provided under this contract shall be given to those eligible persons assessed to be at risk of placement in an institution or who are abused,neglected,or exploited. IL MANNER OF SERVICE PROVISION A.Service Tasks To achieve the goals of the CCE Program,the Contractor shall perform,or ensure that its Subcontractors perform, the following tasks: 1.Client Eligibility Determination The Contractor shall ensure that applicant data is evaluated to determine eligibility.Eligibility to become a client is based on meeting the requirements described in section I.C.2. 2.Assessment and Prioritization of Service Delivery for New Clients The Contractor shall ensure the following criteria are used to prioritize new clients for service delivery in the sequence below.It is not the intent of the Department and/or Agency to remove existing clients from services in order to serve new clients being assessed and prioritized for service delivery. a. DCF APS High Risk individuals:The Contractor shall ensure that pursuant to Section 430.205(5)(a),Florida Statutes,those elderly persons who are determined by DCF APS to be victims of abuse,neglect,or exploitation who are in need of immediate services to prevent further harm,and are referred by APS,will be given primary consideration for receiving CCE services. As used in this subsection, "primary consideration" means that an assessment and services must commence within 72 hours after referral to the Agency or as established in accordance with local protocols developed between Agency service contractors and APS. The Contractor shall follow guidelines for DCF APS High Risk referrals established in the APS Operations Manual,which is incorporated by reference. b. For DCF APS Low, Intermediate, and High Risk Referrals for individuals enrolled in a Medicaid long-term care program at the time of referral to the Contractor or Subcontractor,the Contractor shall: (1) Ensure that the intake entity contacts and notifies the DCF APS protective investigator that the referral was not accepted because the referred individual is enrolled in a Medicaid long-term care program;and (2) Ensure that the intake entity notes that the referred individual is enrolled in a Medicaid long-term care program in the ARTT as the reason for rejection. c. Imminent Risk individuals: Individuals in the community whose mental or physical health condition has deteriorated to the degree that self-care is not possible, there.is no capable caregiver, and nursing home placement is likely within a month or very likely within 3 months. d. Aging Out individuals:Individuals receiving CODA and HCDA services through the Department of Children and Families' Adult Services transitioning to community-based services provided through the Department when services are not currently available. e. Service priority for individuals not included in a., c., and d. above, regardless of referral source, will be determined through the Agency's functional assessment administered to each applicant, to the extent funding is available.The Contractor shall ensure that first priority is given to applicants at the higher levels of 6 ct (ZOO Al10p13 ett aoJ ono Illunwuro3 Lb196 A3 : L1qZ) pe noax3 toe•quo3 96`£OZ 393 :;uewyoellV 0 0 g' July2016—June 2017 CCE 203.16 frailty and risk of nursing home placement. For individuals assessed at the same priority and risk of nursing g home placement,priority will be given to applicants with the lesser ability to pay for services. 3.Referrals for Medicaid Waiver Services a. The Contractor must require Subcontractors, through the performance of the client assessment, to identify potential Medicaid eligible CCE clients and to refer these individuals for application for Medicaid Waiver services. b. The Contractor must require individuals who have been identified as being potentially Medicaid Waiver eligible to apply for Medicaid Waiver services in order to receive CCE services.These individuals may only receive CCE services while the Medicaid Waiver eligibility determination is pending. If the client is found ineligible for Medicaid Waiver services for any reason other than failure to provide required documentation, then the individual may continue to receive CCE services. c. The Contractor must advise individuals who have been identified as being potentially Medicaid Waiver eligible of the responsibility to apply for Medicaid Waiver services as a condition of receiving CCE services while the eligibility determination is being processed. 4. Program Services The Contractor shall ensure the provision of program services is consistent with the Agency's current area plan,as updated and approved by the Agency,and the current DOEA Programs and Services Handbook. B. Use of Subcontractors If this contract involves the use of a Subcontractor or third party, then the Contractor shall not delay the implementation of its agreement with the Subcontractor. If any circumstance occurs that may result in a delay for a period of 60 days or more the initiation of the subcontract or the performance of the Subcontractor, the Contractor shall notify the Agency's Contract Manager and the Agency's Vice President Financial Officer in writing of such delay. The Contractor shall not permit a Subcontractor to perform services related to this agreement without having a binding Subcontractor agreement executed. In accordance with Section 23.1 of Master Contract, the Agency will not be responsible or liable for any obligations or claims resulting from such action. 1. Copies of Subcontracts The Contractor shall submit a copy of all subcontracts to the Contract Manager within thirty days of the subcontract being executed. 2. Monitoring the Performance of Subcontractors The Contractor shall monitor, at least once per year,each of its Subcontractors, Subrecipients,Vendors,and/or Consultants paid from funds provided under this contract.The Contractor shall perform fiscal,administrative and programmatic monitoring to ensure contractual compliance,fiscal accountability,programmatic performance and compliance with applicable state and federal laws and regulations. The Contractor shall monitor to ensure that time schedules are met,the budget and scope of work are accomplished within the specified time periods,and other performance goals stated in this contract are achieved. C. Staffing Requirements 1. Staffing Levels The Contractor shall dedicate the staff necessaty to meet the obligations of this contract and ensure that subcontractors dedicate adequate staff,accordingly. 7 it (zoo Alaapl3 alp aol a.ie3 I llunwwoo LL/96 A3 Lt/ZZ) pe;noax3;oea;uoo 96`£OZ 333 :;uawyoe;;d July 2016—June 2017 CCE 203,16obe, 2. Professional Qualifications The Contractor shall ensure that the staff responsible for performing any duties or functions within this contract have the qualifications as specified in the DOEA Programs and Services Handbook, 3. Service Times The Contractor shall ensure the availability of services listed in this contract at times appropriate to meet client service needs, at a minimum during normal business hours,Normal business hours are defined as Monday through Friday,8:00 a.m.to 5:00 p.m. D.Deliverables The following section provides the specific quantifiable units of deliverables and source documentation required to evidence the completion of the tasks specified in this contract. 1.Delivery of Service to Eligible Clients The Contractor shall ensure the provision of a continuum of services that meets the diverse, individual, and assessed needs of each functionally-impaired elder, The Contractor shall ensure performance and reporting of the following services in accordance with the Contractor's current Agency-approved Area Plan, the current DOEA Programs and Services Handbook, which is incorporated by reference, and Section IL A.1-4 of this contract. Documentation of service delivery must include a report consisting of the following: number of clients served,number of service units provided by service,and rate per service unit with calculations that equal the total invoice amount.The services include the following categories: a. Core Services for Programmatic Operation The Contractor shall ensure that core services include a variety of in-home services, day care services, and other basic services that are most needed to prevent unnecessary institutionalization. Core services, to be provided at the unit rate identified in the Contractor's Area Plan,as updated,include the following: (1) Adult Day Care; (8) Housing Improvement; (2) Chore Services; (9) Legal Assistance; (3) Companionship; (10) Pest Control Services; (4) Escort; (11) Respite Services; (5) Financial Risk Reduction; (12) Shopping Assistance;and (6) Home Delivered Meals; (13) Transportation. (7) Homemaker; b. Health Maintenance Services The Contractor shall ensure that health maintenance services are made available as necessary to maintain the health of functionally-impaired elders. These services are limited to medical therapeutic services and non- medical prevention services.Typical services to be provided at the unit rate identified in the Contractor's Area Plan, as updated,include the following: (1) Adult Day Health Care; (8) Nutrition Counseling; (2) Emergency Alert Response; (9) Occupational Therapy; (3) Gerontological Counseling; (10) Personal Care; (4) Health Support; (11) Physical Therapy; (5) Home Health Aide; (12) Skilled Nursing Services; 8 (Z00 APap13 eul ioj eJe0/(l'unwwo3 L619I.AA : LOU) pa1noex3 loealuo0 9"'En 300 :Wow rloell t ci G July 2016—June 2017 CCE 203.16 a (6) Medication Management; (13) Specialized Medical Equipment, t ca (7) Mental Health Services and Supplies;and o- Counseling/Screening; (14) Speech Therapy. c. Other Support Services The Contractor shall ensure that support services expand the continuum of care options to assist functionally- impaired elders and their caregivers. Support services to be provided at the unit rate identified in the Contractor's Area Plan as updated,include the following: (1) Caregiver Training/Support; (4) Material Aid;and (2) Case Aid; (5) Other services,as approved by the Agency. (3) Case Management; 2. Services and Units of Services The Contractor shall ensure that the provision of services described in the contract is in accordance with the current DOEA Programs and Services Handbook and the service tasks described in A T TACH- MENT VI lists the services that can be performed,the highest reimbursement unit rate,the method of payment, and the service unit type. Units of service will be paid pursuant to the rate established in the Agency's Area Plan as updated,as shown in ATTACHMENT VI,and approved by the Agency. E.Reports The Contractor shall respond to additional routine or special requests for information and reports required by the Agency in a timely manner as determined by the Contract Manager. The Contractor shall establish reporting deadlines and due dates for Subcontractors that permit the Contractor to review and validate the data, and meet the Agency's reporting requirements. 1. CIRTS Reports The Contractor shall ensure timely input of CCE-specific data into C1RTS.To ensure CIRTS data accuracy,the Contractor shall use CIRTS-generated reports which include the following: (a) Client Reports; (b) Monitoring Reports; (c) Services Reports; (d) Miscellaneous Reports; (e) Fiscal Reports; (f) Aging and Disability Resource Center Reports;and (g) Outcome Measurement Reports. 2. Service Cost Reports The Agency shall require the Contractor to submit Annual Service Cost Reports, which reflect actual costs of providing each service by program. This Annual Service Cost Report provides information for planning and negotiating unit rates. The General Revenue Service Cost Reports are due by August 15, 2016 for the prior year. 9 (Z00 Alaapl3 eq;aoj ono Allunwwoo Ll.19I A3 : Lt/ZZ) palnoex3 loe3;uo3 91,`£OZ 333 :luewuloellti v.)- 01' 0 g July 2016—June 2017 CCE 203,16 th 3.Surplus/Deficit Report(Lead Spending Report) «�- The Contractor shall submit a Consolidated Surplus/Deficit Report, in a format provided by the Agency to the Area Agency Contract Manager, by the 18th of each month. This Consolidated Surplus/Deficit Report is for all agreements and contracts between the Contractor and the Agency and must include the following: (a) Contractor's current status regarding surplus/deficit; (b) The Contractor's detailed plan on how the surplus/deficit spending exceeding the threshold specified by the Agency will be resolved; (c) Recommendations to transfer funds to resolve surplus/deficit spending; (d) Input from the Agency's Board of Directors on resolution of spending issues, if applicable; (e) Number of clients currently on APCL that receive a priority ranking score of 4 or 5;and (f) Number of clients currently on the APCL designated as Imminent Risk. F.Records and Documentation 1. Requests for Payment The Contractor shall maintain documentation to support Requests for Payment that shall be available to the Agency or authorized individuals upon request. 2. CIRTS Data and Maintenance The Contractor shall ensure,on a monthly basis,collection and maintenance of client and service information in CIRTS or any such system designated by the Agency, Maintenance includes accurate and current data, and valid exports and backups of all data and systems according to Agency standards. 3. Data Integrity and Back up Procedures Each Contractor shall anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system.Data and software essential to the continued operation of contractor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources.It is recommended that a copy of the backed up data be stored in a secure,offsite location. 4. Policies and Procedures for Records and Documentation The Contractor shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement of its subcontractors. These policies and procedures shall be made available to the Agency upon request. G.Performance Specifications 1. Outcomes and Outputs(Performance Measures) The Contractor must: a. Ensure the prioritization and service provision of clients in accordance with Section II.A.2,of this contract; b. Ensure the provision of the services described in this contract are in accordance with the current DOEA Programs and Services Handbook and Section IhA.1-4 of this contract; c. Timely submit to the Agency all required documentation and reports described in Section II.E.;and d. Timely(in accordance with ATTACHMENT VII)and accurately submit to the Agency ATTACHMENTS VIII&IX,and supporting documentation. 10 (zoo Apapl3 e4;Jo}euea Allunw woo LW9l. : LbzZ) po noex3 ;oeJ}uo3 9l.' 02 333 :}uac.uu.laefly of • 6' July 2016—June 2017 CCE 203.16 c a.2, Monitoring and Evaluation Methodology The Agency will review and evaluate the performance of the Contractor under the terms of this contract. a') Monitoring shall be conducted through direct contact with the Contractor through telephone, in writing, and/or on-site visit(s). The Agency's determination of acceptable performance shall be conclusive. The Contractor agrees to cooperate with the Agency in monitoring the progress of completion of the service tasks and deliverables. The Agency may use,but is not limited to,one or more of the following methods for monitoring: a. Desk reviews and analytical reviews; b. Scheduled,unscheduled,and follow-up on-site visits; c. Client visits; d. Review of independent auditor's reports; e. Review of third-party documents and/or evaluation; f. Review of progress reports; g. Review of customer satisfaction surveys; h. Agreed-upon procedures review by an external auditor or consultant; i. Limited-scope reviews;and j. Other procedures as deemed necessary. H. Contractor Responsibilities 1. Contractor Accountability All service tasks and deliverables pursuant to this contract are solely and exclusively the responsibility of the Contractor,and for which,by execution of the contract,the Contractor agrees to be held accountable. 2. Coordination with Other Providers and/or Entities Notwithstanding that services for which the Contractor is held accountable involve coordination with other entities in performing the requirements of the contract;the failure of other entities does not alleviate the Contractor from any accountability for tasks or services that the Contractor is obligated to perform pursuant to this contract. I. Agency Responsibilities 1. Agency Obligations The Agency will provide technical support to assist the Contractor in meeting the requirements of this contract. 2. Agency Determinations The Agency reserves the exclusive right to make certain determinations in the tasks and approaches. The absence of the Agency setting forth a specific reservation of rights does not mean that all other areas of the contract are subject to mutual agreement. III.METHOD OF PAYMENT A.Payment Methods Used The Method of Payment for this contract is a combination of fixed-fee/unit rate, cost reimbursement, and advance payments,subject to the availability of funds and Contractor performance. The Agency will pay the Contractor upon satisfactory completion of the Tasks/Deliverables,as specified in Section 11.D.,and in accordance with other terms and conditions of the contract, Il (Z00 ANapl3 ay;aoi aJe3 A;lunwwoo LLp'ZZ) pa;noex343ea;uo3 91.`£02 333 :;ueuagoe;;y 1,6 July 2016—June 2017 CCE 203.16 ti 1. Fixed Fee/Unit Rate Payment for Fixed Fee/Unit Rates shall not exceed amounts established in ATTACHMENT VI, per unit of service. 2. Cost Reimbursement Payment may be authorized only for allowable expenditures,which are in accordance with the services specified in ATTACHMENT VI. All Cost Reimbursement Requests for Payment must include the Request for Payment Report(ATTACHMENT VIII)and Receipt and Expenditure Report (ATTACHMENT IX) beginning with the first month of the contract. 3. Advance Payments The Contractor may request up to two(2)months of advances at the start of the contract period to cover program service costs.The payment of an advance will be contingent upon the sufficiency and amount of funds released to the Agency and the Department by the State of Florida ("budget release"). The Contractor's requests for advances require the approval of the Agency and/or DOEA Contract Manager.The Contractor shall provide the Agency Contract Manager documentation justifying the need for an advance and describing how the funds will be distributed. If sufficient budget is available,the Agency will issue approved advanced payments after July 1st of the contract year. a. All advanced payments retained by the Contractor must be fully expended no later than September 30,2016. Any portion of advanced payments not expended must be recouped on the Invoice Schedule,report number 5, due to the Agency on October 9,2016,in accordance with the Invoice Schedule,ATTACHMENT VII. b. All advance payments made by the Contractor shall be reimbursed to the Agency as follows: At least one- tenth of the advance payment received shall be reported as an advance recoupment on each Request for Payment,starting with report number five,in accordance with the Invoice Schedule,ATTACHMENT VII. B.Method of Invoice Payment Payment shall be made upon the Contractor's presentation of an invoice subsequent to the acceptance and approval by the Agency of the deliverables shown on the invoice.The form and substance of each invoice submitted by the Contractor shall be as follows: 1. Have a Remittance Address that corresponds exactly to the "Remit To" address provided to MFMP during registration; 2. Request payment on a monthly basis for the units of services established in the Agency's approved Area Plan and provided in conformance with the requirements as described in the DOEA Programs and Services Handbook,at the rates established in ATTACHMENT VI of the contract. Documentation of service delivery must include a report consisting of the following: number of clients served, number of service units provided by service, and rate per service unit with calculations that equal the total invoice amount. Any requested changes to the approved budget subsequent to the execution of the contract, must be submitted to the Contract Manager for approval.Any change to the total contract amount requires a formal amendment; 3. All Requests for Payment shall.be based on the submission of monthly Expenditure Reports beginning with the first month of the contract.The schedule for submission of advance requests(when available) and invoices is Invoice Schedule,ATTACHMENT VII. 12 (Z00 Apepl3 ay;io}amp 4unwwo3 LW91• A3 : LpZZ) pa;n3ex3;3a.►luo3 96`£OZ 333 :luewyoali.y m' os r CO July 2016—June 2017 CCE 203.16 a T C.Payment Withholding Any payment due by the Agency under the terms of this contract may be withheld pending the receipt and approval by the Agency of all financial and programmatic reports due from the Contractor and any adjustments thereto,including any disallowance not resolved as outlined in Section 26 of the Master Contract. D.Final Invoice Instructions The Contractor shall submit the final Request for Payment to the Agency no later than July 25,2017. E. CIRTS Data Entries for Subcontractors The Contractor must enter all required data for clients and services in the CIRTS database per the DOEA Programs and Services Handbook and the CIRTS User Manual — Aging Provider Network users(located in Documents on the CIRTS Enterprise Application Services). Contractors must enter this data for the previous month's billing no later than the 9th of each month into CIRTS prior to submitting their requests for payment and expenditure reports to the Agency. F. Contractor's Monthly CIRTS Reports The Contractor must run monthly CIRTS reports and verify client and service data in the CIRTS is accurate. This report must be submitted to the Agency with the monthly request for payment and expenditure report and must be reviewed by the Contractor before the Contractor's request for payment and expenditure reports can be approved by the Agency. G.Corrective Action Plan 1. Contractor shall ensure 100% of the deliverables identified in Section II. D. 1-3 of this contract, are performed pursuant to contract requirements. 2.If at any time the Contractor is notified by the Agency Contract Manager that it has failed to correctly,completely, or adequately perform contract deliverables identified in Section II. D. I-3 of this contract, the Contractor will have 10 days to submit a Corrective Action Plan ("CAP") to the Agency Contract Manager that addresses the deficiencies and states how the deficiencies will be remedied within a time period approved by the Agency Contract Manager.The Agency shall assess a Financial Consequence for Non-Compliance on the Contractor as referenced in Section III.I of this contract for each deficiency identified in the CAP which is not corrected pursuant to the CAP. The Agency will also assess a Financial Consequence for failure to timely submit a CAP. 3.If the Contractor fails to correct an identified deficiency within the approved time period specified in the CAP,the Agency shall deduct the percentage established in Section 111. I. of this contract, from the payment for the invoice of the following month. 4. If Contractor fails to timely submit a CAP,the Agency shall deduct the percentage established in Section III. 1,of this contract for each clay the CAP is overdue. The deduction will be made from the payment for the invoice of the following month. If,or to the extent,there is any conflict between Section H, 1-4 above,and paragraphs 39.1 and 39.2 of the Master Contract,this section shall take precedence. H.Financial Consequences The Agency will withhold or reduce payment if the Contractor fails to perform the deliverables to the satisfaction of the Agency according to the requirements referenced in Section ILD of this contract. The following financial consequences will be imposed if the deliverables stated do not meet in part or in whole the performance criteria as outlined in Section 11.D.of this contract. 1. Delivery of services to eligible clients as referenced in Section 1I.A.2 and Section ILD.1 of this contract— Failure to comply with established assessment and prioritization criteria, as evidenced by CIRTS reports, 13 • v (coo 4I/ap13 ayl ao1 a1BD/(Ilunuwwo3 Lt/ZZ) palnoax3 loeiluoo 96`£OZ 333 :41011143ellti or a te July 2016—June 2017 CCE 203,16 Tom. 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 l- oured or satisfactorily addressed in accordance with the Agency-approved CAP, referenced in Section III.H. 2. Services and units of services as referenced in Section II.D.2 of this contract—Failure to provide services in accordance with the current DOEA Programs and Services Handbook,the service tasks described in Section II.A, ATTACHMENT VI, and submission of required documentation will result in a 2% reduction of payment per business day. The reduction of payment will begin the first business day following the Agency's notification to the Contractor that the identified deficiency is not cured or satisfactorily addressed in accordance with the Agency approved CAP,referenced in Section I11.H. 3. Timely submission of a CAP--Failure to timely submit a CAP within 10 business days after notification of a deficiency by the Agency Contract Manager will result in a 2% reduction of payment per business day the CAP is not received.The reduction of payment will begin the first business day following the Agency's notification to the Contractor that the identified deficiency was not cured or satisfactorily addressed in accordance with the Agency approved CAP,referenced in Section III,H. 4. Exceptions may be granted solely,in writing,by the Agency contract manager. IV.SPECIAL PROVISIONS A. Final Budget and Funding Revision Requests Final requests for budget revisions or adjustments to contract funds based on expenditures for provided services must be submitted to the Agency Contract Manager in writing no later than June 25,2017; email requests are considered acceptable. B. Contractor's Financial Obligations 1. Matching,Level of Effort,and Earmarking Requirement The Contractor must provide a match of at least 10 percent of the cost for all CCE services. The match must be made in the form of cash and/or in-kind resources. At the end of the contract period, all CCE funds expended must be properly matched.State funds shall not be used to match another state-funded program. 2. Cost Sharing and Co-Payments The Contractor must establish annual co-payment goals. The Agency has the option to withhold a portion of the Contractor's request for payment if goals are not met according to the Agency's co-payment guidelines, in accordance with the current DOEA Programs and Services Handbook, which is incorporated by reference. Co-payments include only the amounts assessed to consumers by the Contractor or the amounts consumers opt to contribute in lieu of an assessed co-payment. The consumer's contribution must be equal to or greater than the assessed co-payment. Co-payments collected in the CCE Program can be used as part of the local match,as detailed above in Section N.B. 3. Use of Service Dollars and Management of the Assessed Priority Consumer List The Contractor is expected to spend all funds provided by the Agency for the purpose specified in this contract. The Contractor must manage the service dollars in such a manner so as to avoid having a wait list and (4 (Z00 Aleph ail;Jai.aae3 i(;lunwwoo LE/91.Ad : LVZZ) patnaax3 Ioealuo3 91,`£OZ 303 :Iuauayaa;;y as of 0 • 0 • . co' July 2016—June 2017 CCE 203.16 a a surplus of fluids at the end of the contract period. If the Agency determines that the Contractor is not spending service funds accordingly, the Agency may transfer funds to their other Lead Agencies in the PSA a during the contract period and/or adjust subsequent funding allocations accordingly,as allowable under state and federal law. C. Remedies for Nonconforming Services I. The Contractor shall ensure that all goods and/or services provided under this contract are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants. 2. If the Contractor fails to meet the prescribed quality standards for services,such services will not be reimbursed under this contract. In addition, any nonconforming goods (including home delivered meals)and/or services not meeting such standards will not be reimbursed under this contract.The Contractor's signature on the Request for Payment Form certifies maintenance of supporting documentation and.acknowledgement that the Contractor shall solely bear the costs associated with preparing or providing nonconforming goods and/or services. The Agency requires immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. I5 (Z00 Aiiepi3 an;ao}ono I(;lunwwo3 L6196 AA : tiZZ) pe noex3}oea}uo3 91.`£OZ 333 :}uowyoelld July 2016—June 2017 CCE 203.16 .'' ATTACHMENT II CERTIFICATIONS AND ASSURANCES a The Agency and/or Department will not award this contract unless Contractor completes the CERTIFICATIONS AND ASSURANCES contained in this Attachment. In performance of this contract,Contractor provides the following certifications and assurances: A. Debarment and Suspension Certification 129 CFR Part 95 and 45 CFR Part 74) B, Certification Regarding Lobbying(29 CFR Part 93 and 45 CFR Part 93) C. Nondiscrimination&Equal Opportunity Assurance(29 CFR Part 37 and 45 SFR Part 80) D. • r ion Re.,r1 t• r. ' • • , 3 E. Association of Community Organizations for Reform Now(ACORN)Funding Restrictions Assurance(Pub. L.111-117) F. • • . . . • G. Certification Regarding Data Integrity Compliance for Agreements. Grants. Loans And Cooperative Agreementg H. Verification of Employment Status Certification A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS—PRIMARY COVERED TRANSACTION. The undersigned Contractor certifies to the best of its knowledge and belief,that it and its principals: 1. Are not presently debarred,suspended, proposed for debarment, declared ineligible,or voluntarily excluded from covered transactions by a Federal department or agency; 2. Have not within a three-year period preceding this Contract been convicted or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain,or performing a public(Federal, State, or local)transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements,or receiving stolen property; 3. Are not presently indicted or otherwise criminally or civilly charged by a government entity(Federal,State or local) with commission of any of the offenses enumerated in paragraph A.2.of this certification;and/or 4. Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal,State,or local)terminated for cause of default. 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. 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 employees of 16 (Z00 4101013 eq;IN eaeo 4unwwo3 L6I9l. Ad : LtrZZ) pe noax3 ;oei;uoo 91.`EOZ 300 :;uew113e;;`d o' of o0 o' July 2016—June 2017 CCE 203.16 a Congress,or employee of a Member of Congress in connection with a Federal contract,grant,loan, or cooperative v agreement, the undersigned shall also complete and submit Standard Form — LLL, "Disclosure Form to Report Lobbying,"in accordance with its instructions. The undersigned shall require that language of this certification be included in the documents for all subcontracts at all tiers (including subcontracts, sub-grants and contracts under grants, loans and cooperative agreements) and that all sub-recipients and contractors shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this Contract was made or entered into. Submission of this certification is a prerequisite for making or entering into this Contract imposed by 31 U.S.C. 1352.Any person who fails to file the required certification shall be subject to a civil penalty of not less than$10,000 and not more than$100,000 for each such failure, C. NON DISCRIMINATION&EQUAL OPPORTUNITY ASSURANCE(29 CFR PART 37 AND 45 CFR PART 80). As a condition of the Contract, Contractor assures that it will comply fully with the nondiscrimination and equal opportunity provisions of the following laws: 1, Section 188 of the Workforce Investment Act of 1998 (WIA), (Pub. L. 105-220), which prohibits discrimination against all individuals in the United States on the basis of race, color, religion, sex national origin, age, disability, political affiliation,or belief,and against beneficiaries on the basis of either citizenship/status as a lawfully admitted immigrant authorized to work in the United States or participation in any WIA Title I-financially assisted program or activity; 2. Title VI of the Civil Rights Act of 1964(Pub.L.88-352),as amended,and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services(45 CFR Part 80),to the end that,in accordance with Title VI of that Act and the Regulation,no person in the United States shall, on the ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Department and/or Agency. 3. Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112) as amended, and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services(45 CFR Part 84), to the end that, in accordance with Section 504 of that Act, and the Regulation,no otherwise qualified handicapped individual in the United States shall,solely by reason of his handicap,be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from 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 Educational 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),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,and; 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 17 • v (ZOO AIaaP13 au;iol eie3/tilunururo3 L1491,A3 : p ) Painaax3;oei;uo3 9t`£OZ 333 :;uauryoe;;'d CO o July 2016—June 2017 CCE 203.16tss t- a. agreements Contractor makes to early out the WIA Title 1—financially assisted program or activity. Contractor understands IS that the Agency and/or DOEA and the United States have the right to seek judicial enforcement of t the assurance. D. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES,SECTION 287.133,F.S. Contractor hereby certifies that neither it,nor any person or affiliate of Contractor,has been convicted of a Public Entity Crime as defined in section 287.133,F.S.,nor placed on the convicted vendor list. Contractor understands and agrees that it is required to inform the Agency and/or DOEA immediately upon any change of circumstances regarding this status. E. ASSOCIATION OF COMMUNITY ORGANIZATIONS FOR REFORM NOW (ACORN) FUNDING RESTRICTIONS ASSURANCE(Pub.L. 111-117). As a condition of the Contract, Contractor assures that it will comply fully with the federal funding restrictions pertaining to ACORN and its subsidiaries per the Consolidated Appropriations Act,2010,Division E,Section 511(Pub. L. 111-117). The Continuing Appropriations Act, 2011, Sections 101 and 103 (Pub. L. 111-242), provides that appropriations made under Pub.L. 111-117 are available under the conditions provided by Pub.L. 111-117. The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all tiers(including subcontracts,sub-grants and contracts under grants,loans and cooperative agreements)and that all sub recipients and contractors shall provide this assurance accordingly. F. SCRUTINIZED COMPANIES LISTS CERTIFICATION,SECTION 287.135,F.S. If this Contract is in the amount of$1 million or more, in accordance with the requirements of section 287.135,F.S., Contractor hereby certifies that it is not listed on either the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List. Both lists are created pursuant to section 215.473,F.S. Contractor understands that pursuant to section 287.135, F.S., the submission of a false certification may subject Contractor to civil penalties,attorney's fees,and/or costs. If Contractor is unable to certify to any of the statements in this certification, Contractor shall attach an explanation to this Contract. G. CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS, LOANS AND COOPERATIVE AGREEMENTS 1.The Contractor and any Subcontractors of services under this contract have financial management systems capable of providing certain information, including: (1)accurate,current,and complete disclosure of the financial results of • each grant-funded project or program in accordance with the prescribed reporting requirements;(2)the source and application of funds for all agreement supported activities;and(3)the comparison of outlays with budgeted amounts for each award.The inability to process information in accordance with these requirements could result in a return of grant funds that have not been accounted for properly. 2. Management Information Systems used by the Contractor, Subcontractors, or any outside entity on which the Contractor is dependent for data that is to be reported,transmitted or calculated,have been assessed and verified to be capable of processing data accurately,including year-date dependent data.For those systems identified to be non- compliant,Contractors will take immediate action to assure data integrity. 3.1f 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. IS (zoo hpaPl3 944 101 a.re3 Rllunuaw03 LW9G Ad Li7ZZ) palnoax3 loe.rluoo 91,`£0Z 333 :luawyoellV c' co o July 2016—June 2017 CCE 203.16 a d 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 a required corrections to restore hardware and software programs to the same level of functionality as warranted herein, at no charge to the state,and without interruption to the ongoing business of the state,time being of the essence. 4.The Contractor and any Subcontractors of services under this contract warrant their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data integrity compliance issues. H. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION As a condition of contracting with the Area Agency on Aging for Southwest Florida, Inc.,Contractor certifies the use of the U.S, Department of Homeland Security's E-verify system to verify the employment eligibility of all new employees hired by Contractor during the contract term to perform employment duties pursuant.to this contract and that any subcontracts include an express requirement that Subcontractors performing work or providing services pursuant to this Agreement utilize the E-verify system to verify the employment eligibility of all new employees hired by the Subcontractor during the entire contract term. The Contractor shall require that the language of this certification be included in all subagreements,subgrants,and other agreements and that all Subcontractors shall certify compliance accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB Circulars A-102 and 2 CFR Part 200,and 215(formerly OMB Circular A-110). By signing below, Contractor certifies the representations outlined in parts A through II above are true and correct. (Signature and Title of Authorized Representative) Collier County Board of County Commissioners 2-S-14- Contractor .-5"j!-Contractor Date 3339 E.Tamiami Trail,Suite 211 (Street) Approved as to form and legality Napt FL34112 Assistant County Attorney lk + (City, State,ZIP Code) l9 77 (Z00 ilaapl3 044 aoj amp Allunwwoo Ll•In A LlZZ) Peinoax3 pealuo3 91,`£0Z 333 :41-fau143e44dco a� July 2016—June 2017 CCE 203.16 ATTACHMENT III a FINANCIAL AND COMPLIANCE AUDIT The administration of resources awarded by the Agency to the provider may be subject to audits and/or monitoring by the Area Agency on Aging for Southwest Florida,Inc.,as described in this section. I. MONITORING In addition to reviews of audits conducted in accordance with OMB Circular A-133,as revised, and Section 215.97, F.S., (see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits by the Agency staff, limited scope audits as defined by OMB Circular A-133, as revised, and/or other procedures. By entering into this agreement, the provider agrees to comply and cooperate with any monitoring procedures/processes deemed appropriate by the Agency. In the event the Agency determines that a limited scope audit of the provider is appropriate,the provider agrees to comply with any additional instructions provided by the Agency to the provider regarding such audit. The provider further agrees to comply and cooperate with any inspections, reviews,investigations, or audits deemed necessary by the Chief Financial Officer(CFO)or Auditor General. AUDITS PART I:FEDERALLY FUNDED This part is applicable if the provider is a State or local government or a non-profit organization as defined in OMB Circular A-133,as revised. In the event that the provider expends$750,000.00 or more in federal awards during its fiscal year,the provider must have a single or program-specific audit conducted in accordance with the provisions of OMB Circular A-133, as revised. EXHIBIT 2 to this agreement indicates federal resources awarded through the Agency by this agreement. In determining the federal awards expended in its fiscal year, the provider 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 the guidelines established by OMB Circular A-133, as revised. An audit of the provider conducted by the Auditor General in accordance with the provisions of OMB Circular A-133, as revised, will meet the requirements of this part. In connection with the audit requirements addressed in Part I,paragraph 1,the provider shall fulfill the requirements relative to auditee responsibilities as provided in Subpart C of OMB Circular A-133,as revised, If the provider expends less than$750,000.00 in federal awards in its fiscal year,an audit conducted in accordance with the provisions of OMB Circular A-133,as revised,is not required. In the event that the provider expends less than$750,000.00 in federal awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of OMB Circular A-133, as revised, the cost of the audit must be paid from non-federal resources(i.e., the cost of such audit must be paid from provider resources obtained from other than federal entities.) An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year. Compliance findings related to agreements with the Agency shall be based on the agreement's requirements, including any rules, regulations, or statutes referenced in the agreement. The financial statements shall disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and liabilities clue to the Agency shall be fully disclosed in the audit report with reference to the Agency on Aging for Southwest Florida, Inc. agreement involved. If not otherwise disclosed as required by Section .310(b)(2)of OMB Circular A-133,as revised,the schedule of expenditures of federal awards shall identify expenditures by agreement number for each agreement with the 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 provider's fiscal year end. 20 (zoo A iepl3 eq;acrd aae3 Allunwwo3 L1491.AA : LppZZ) palnoex3 loealuo3 9I. OZ 333 :luawyoelly 't of °° or • July 2016—June 2017 CCE 203.16 a PART II; STATE FUNDEDto This part is applicable if the provider is a non-state entity as defined by Section 215.97(2),F.S. In the event that the provider expends a total amount of state financial assistance equal to or in excess of$750,000.00 in any fiscal year of such provider(for fiscal years ending September 30,2004 or thereafter),the provider must have a State single or project-specific audit for such fiscal year in accordance with Section 215.97, F.S.; applicable rules of the Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General. EXHIBIT 2 to this agreement indicates state financial assistance awarded through the Agency by this agreement. In determining the state financial assistance expended in its fiscal year, the provider shall consider all sources of state financial assistance, including state financial assistance received from the Agency, other state agencies, and other nonstate entities. State financial assistance does not include Federal direct or pass-through awards and resources received by a nonstate entity for Federal program matching requirements. • In connection with the audit requirements addressed in Part II,paragraph 1,the provider 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 provider expends less than$750,000.00 in state financial assistance in its fiscal year(for fiscal years ending September 30,2004 or thereafter),an audit conducted in accordance with the provisions of Section 215.97,F.S.,is not required. In the event that the provider expends less than$750,000.00 in state financial assistance in its fiscal year and elects to have an audit conducted in accordance with the provisions of Section 215.97, F.S., the cost of the audit must be paid from the nonstate entity's resources(i.e.,the cost of such an audit must be paid from the provider resources obtained from other than State entities). An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year. Compliance findings related to agreements with the Agency shall be based on the agreement's requirements, including any applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the Agency shall be fully disclosed in the audit report with reference to the Agency agreement involved. If not otherwise disclosed as required by Rule 69I-5.003, Fla.Admin. Code,the schedule of expenditures of state financial assistance shall identify expenditures by agreement number for each agreement with the Agency in effect during the audit period. Financial reporting packages required under this part must be submitted within 45 days after delivery of the audit report, but no later than 12 months after the provider's fiscal year end for local governmental entities. Non-profit or for-profit organizations are required to be submitted within 45 days after delivery of the audit report, but no later than 9 months after the provider's fiscal year end. Notwithstanding the applicability of this portion,the Agency retains all right and obligation to monitor and oversee the performance of this agreement as outlined throughout this document and pursuant to law. II. PART III: REPORT SUBMISSION Copies of reporting packages for audits conducted in accordance with OMB Circular A-133, as revised, and required by PART I of this agreement shall be submitted,when required by Section.320(d),OMB Circular A-133, as revised,by or on behalf of the provider directly to each of the following: The Area Agency on Aging for Southwest Florida,Inc.at the following address: Arca Agency on Aging for Southwest Florida,Inc. Attn:Tammy Rhoades,VP of Finance 15201 N Clevelaiid'Ave,,Suite 1100 North Fort Myers,FL 33903 21 i'i; `t (Z00 Ai eP13 aqI iol a.ieo Al!unwwo3 L6191.AA : LPZZ) palnoax3 loeiluoo 91,`£OZ 333 :luawrr{oellb► os0„co. V July 2016—June 2017 CCB 203.16 The Federal Audit Clearinghouse designated in OMB Circular A-133,as revised(the number of copies required by Sections .320 (d)(1) and (2), OMB Circular A-133, as revised, should be submitted to the Federal Audit Clearinghouse), at the a " following address: Federal Audit Clearinghouse Bureau of the Census 1201 East 10`h Street Jeffersonville,IN 47132 Other Federal agencies and pass-through entities in accordance with Sections .320 (e) and (f), OMB Circular A-133, as revised. Pursuant to Sections .320(f), OMB Circular A-133, as revised,the provider shall submit a copy of the reporting package described in Section .320(c), OMB Circular A-133, as revised, and any management letter issued by the auditor, to the Area Agency on Aging for Southwest Florida,Inc.at the following addresses: Area Agency on Aging for Southwest Florida,Inc. Attn:Tammy Rhoades,VP of Finance 15201 N Cleveland Ave.,Suite 1100 North Fort Myers,FL 33903 Additionally,copies of financial reporting packages required by Part II of this agreement shall be submitted by or on behalf of the provider directly to each of the following: The Area Agency on Aging for Southwest Florida,Inc.at the following addresses: Area Agency on Aging for Southwest Florida,Inc. Attn:Tammy Rhoades,VP of Finance 15201 N Cleveland Ave.,Suite 1100 North Fort Myers,FL 33903 The Auditor General's Office at the following address: State of Florida Auditor General Claude Pepper Building,Room 574 111 West Madison Street Tallahassee,Florida 32399-1450 Any reports, management letter, or other information required to be submitted to the Agency pursuant to this agreement shall be submitted timely in accordance with OMB Circular A-133,F.S.,and Chapters 10.550(local governmental entities) or 10.650(nonprofit and for-profit organizations),Rules of the Auditor General,as applicable. Providers, when submitting financial repotting packages to the Agency for audits done in accordance with OMB Circular A-133 or Chapters 10.550(local governmental entities) or I0.650 (nonprofit and for-profit organizations), Rules of the Auditor General,should indicate the date that the reporting package was delivered to the provider in correspondence accompanying the reporting package. M.PART IV:RECORD RETENTION The provider shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of six (6) years from the date the audit report is issued, and shall allow the Agency or its designee, the CFO or Auditor General Access to such records upon request. The provider 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. 22 s . i (Z00 Rlaap13 eq io}aaa3 Al!unuruao3 16/91, Ad : LPZZ) palnoex3 ;oeJ;uo3 94`£0Z 330 :luewgoellg co of o 0 •• July 2016—June 2017 CCE 203.16 a ATTACHMENT III .ci EXHIBIT 1 PART I; AUDIT RELATIONSHIP DETERMINATION Providers who receive state or federal resources may or may not be subject to the audit requirements of 2 CFR Part §200,500,and/or Section 215,97,Fla. Stat. Providers who are determined to be recipients or subrecipients of federal awards and/or state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I and/or Part II of Exhibit 1 is met, Providers who have been determined to be vendors are not subject to the audit requirements of 2 CFR Part§200.38,and/or Section 215.97,Fla,Stat. Regardless of whether the audit requirements are met,providers who have been determined to be recipients or subrecipients of Federal awards and/or state financial assistance must comply with applicable programmatic and fiscal compliance requirements. In accordance with 2 CFR Part§200 and/or Rule 691-5.006,FAC,provider has been determined to be: Vendor not subject to 2 CFR Part§200.38 and/or Section 215.97, F.S. Recipient/subrecipient subject to 2 CFR Part§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 provider is determined to be a recipient/subrecipient of federal and or state financial assistance and has been approved by the Agency to subcontract, they must comply with Section 215,97(7), F.S., and Rule 691-,5006, FAC [state financial assistance]and 2 CFR Part§200.330[federal awards]. PART H: FISCAL COMPLIANCE REQUIREMENTS FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Providers who receive Federal awards, state maintenance of effort funds, or state matching finds on Federal awards and who are determined to be a subrecipient must comply with the following fiscal laws,rules and regulations: STATES,LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW: 2 CFR Part§200.416—Cost Principles* 2 CFR Part§200.201 —Administrative Requirements** 2 CFR Part§200.500--Audit Requirements Reference Guide for State Expenditures Other fiscal requirements set forth in program laws,rules and regulations NON-PROFIT ORGANIZATIONS MUST FOLLOW: 2 CFR Part§200.400-.41 I —Cost Principles* 2 CFR Part§200.100—Administrative Requirements 2 CFR Part§200.500—Audit Requirements Reference Guide for State Expenditures Other fiscal requirements set forth in program laws,rules and regulations EDUCATIONAL INSTITUTIONS(EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT) MUST FOLLOW; 2 CFR Part§200.418--Cost Principles* 2 CFR Part§200.100--Administrative Requirements 2 CFR Part§200.500—Audit Requirements Reference Guide for State Expenditures Other fiscal requirements set forth in program laws,rules and regulations 23 • o" (Z00 AIa0p13 eq;ao;aiea 44!unwwo316196 AA : Lnz) pa;noax343e4uo3 96`£OZ 333 :;uewgoe;;y op 46 July 2016—June 2017 CCE 203.16 =cir *Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in the 2 CFR Part§200.400(5)(c). or. *"For funding passed through U.S. Health and Human Services, 45 CFR 92; for funding passed through U.S. — Department of Education,34 CFR 80. STATE FINANCIAL ASSISTANCE. Providers who receive state financial assistance and who are determined to be a recipient/subrecipient must comply with the following fiscal laws,rules and regulations: Section 215.97,Fla.Stat. Chapter 691-5,Fla.Admin.Code State Projects Compliance Supplement Reference Guide for State Expenditures Other fiscal requirements set forth in program laws,rules and regulations • 24 (ZOO Aliepi3 eql Jol axe°AliunwwoD L1491, AA : LppZZ) painoex3 loe.sluo3 91,`COZ ao3 :luewgoell'd co 0) 00 0 `°'' July 2016—June 2017 CCE 203.16 a m ATTACHMENT III a EXHIBIT 2 FINANCIAL AND COMPLIANCE AUDIT ATTACHMENT EXHIBIT 2-FUNDING SUMMARY Note:Title 2 CFR§200.331,As Revised,and Section 215.97(5),Florida Statutes,Require That Information About Federal Programs and State Projects Be Provided to the Recipient and Are Stated in the Financial and Compliance Audit Attachment and Exhibit 1. Financial and Compliance Audit Attachment, Exhibit 2-Funding Summary Provides Information Regarding the Funding Sources Applicable to This Contract,Contained Herein,Is A Prediction of Funding Sources and Related Amounts Based on the Contract Budget. 1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF THE FOLLOWING: GRANT AWARD (FAIN#): N/A FEDERAL AWARD DATE: DUNS NUMBER: 966190837 PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT TOTAL FEDERAL AWARD COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: FEDERAL FUNDS; 2 CFR Part 200—Uniform Administrative Requirements,Cost Principles,and Audit Requirements for Federal Awards, OMB Circular A-133,As amended—Audits of States,Local Governments, and Non-Profit Organizations 2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF THE FOLLOWING: MATCHING RESOURCES FOR FEDERAL PROGRAMS PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT TOTAL STATE AWARD STATE FINANCIAL ASSISTANCE SUBJECT TO Sec,215.97,F.S. PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT Community Care for the Elderly General Revenue-Collier 65010 $ 802,100.00 TOTAL AWARD $ 802,100.00 COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: STATE FINANCIAL_ASS_ISTANCE: Section 215.97, F.S., Chapter 691-5, FL Admit:Code,Reference Guide for State Expenditures, Other fiscal requirements set forth in program laws,rules and regulations. 25 (Z001c13ap13 eq ao}eieo A;iunwwo3 LLi94 AA : LpZZ) pe;n3ex3}oea}uo3 91.`£OZ 333 :luew i3e41V is July 2016—June 2017 CCE 203.16 a /- ATTACHMENT VI COMMUNITY CARE FOR THE ELDERLY PROGRAM ANNUAL BUDGET SUMMARY for Collier County Board of County Commissioners Collier CCE Services Allocations $ 802,100.00 RATE SUMMARY for Collier County Board of County Commissioners Collier County Total Unit Cost Reimbursement Rate-90% Case Management $60.00 $54.00 Case Aide $33.88 $30.50 Adult Day Care $12.83 $11.55 Chore $23.33 $21.00 Enhanced Chore $30.33 $27.30 Companion $23.33 $21.00 Skilled Nursing $42.00 $37.80 EARS $ 1.31 $ 1.18 Escort $21.67 $19.50 Home Delivered Meals $ 7.78 $ 7.00 Homemaking $21.50 $19.35 Personal Care $25.67 $23.10 Respite-in-Facility $12.83 $11.55 Respite-in-Rome $25.67 $23.10 Home Improvement $Cost Reimbursement 90%Cost Reimbursement Material Aid $Cost Reimbursement 90%Cost Reimbursement Specialized Medical Equipment, Service&Supplies $Cost Reimbursement 90%Cost Reimbursement Transportation $Cost Reimbursement 90% Cost Reimbursement 26 (200 Aliep13 ey;ao;aaeo Allunwwo3 L1,191.AA : Lt7ZZ) pa}noex3 pe.quo3 91.`£OZ 300 :luauartoe;;y r July 2016—June 2017 CCE 203.16 a' ATTACHMENT VII • INVOICE REPORT SCHEDULE COMMUNITY CARE FOR THE ELDERLY Report Number Based On Submit to State on this Date 1 July Advance* July 1 2 August Advance* July 1 3 July Expenditure Report August 9 4 August Expenditure Report September 9 5 September Expenditure Report October 9 6 October Expenditure Report November 9 7 November Expenditure Report December 9 8 December Expenditure Report January 9 9 January Expenditure Report February 9 10 February Expenditure Report March 9 11 March Expenditure Report April 9 12 April Expenditure Report May 9 13 May Expenditure Report June 9 14 June Expenditure Report July 9 15 Final Expenditure Report July 25 16 Closeout Report August 1 Legend: * Advance based on projected cash need. Note# 1: Report#1 for Advance Basis Agreements cannot be submitted to the Area Agency on Aging for Southwest Florida,Inc.prior to July 1 or until the agreement with the Agency has been executed and a copy sent to the Area Agency on Aging for Southwest Florida,Inc. Actual submission of the vouchers to the Area Agency on Aging for Southwest Florida,Inc.is dependent on the accuracy of the expenditure report. Note#2: All advance payments made to the Contractor shall be returned to the Agency as follows: one — tenth of the advance payment received shall be reported as an advance recoupment on each request for payment,starting with report number five. The adjustment shall be recorded in Part C, Line 1 of the report(ATTACHMENT VIII). 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 agreement. The adjustment shall be recorded in Part C, 1 of the report(ATTACHMENT VIII). 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. 27 u (ZOO AIaePI3 eq;ao;eie3/C;Iunwwo3 L6/9I.A3 : LpZZ) Pelnoex3;oe,l;uo3 96w ;;d `COZ 333 :;uaL(oe e.i C., © t July 2016-June 2017 CCE 203.16 01 I 0- /0"1 ATTACHMENT VIII 03 REQUEST FOR PAYMENT COMMUNITY CARE FOR THE ELDERLY RECIPIENT NAME,ADDRESS.PHONE*and FEID# TYPE OF PAYMENT: This Request Period:From: To: Regular Contract Period Contract C Affiance Report* PSA ft CERTIFICATION:I hereby certify to the best of myknoxtedge that this request or refund oonfonns with the terms and the purposes of the above contract. Prepared by: Date: Approved by: Date: PART A: BUDGET SUMMARY CCE Admin. CCE Services TOTAL 1.Approved Contract Amount 5 0.00 S 0.00 $ 0.00 2,Previous Funds Received for Contract Period $ 0.00 $ 0.00 $ 0.00 3.Contract Balance pine I minus Ire 2) $ 0.00 S 0.00 $ 0.00 4.Previous Funds Requested and Not Received for Contract Period $ 0.00 $ 0.00 $ 0.00 5.CONTRACT BALANCE pine 3 minus line 4) $ 0.00 $ 0,00 S 0.00 PART B:CONTRACT FUNDS REQUEST 1.Anticipated Cash Need(1st-2nd months) $ 0.00 $ 0.00 $ 0.00 2.Net ExpendturesFor Month $ 0.00 $ 0.00 $ 0.00 (DOPA Form 105C,Part B,Une 4) 3.TOTAL S 0.00 $ 0.00 $ 0,00 PARTC:NET FUNDS REQUESTED 1.Less Affiance Applied 5, 0.00 $ 0.00 $ 0.00 2.TOTAL FUNDS REQUESTED(Part B Une 3,minus Part C Use 1) $ 0.00 5 0.00 $ 0.00 List of Services/Units I Rates provided-See attached report. DOEA FORM 1060 Revised 614/12 /-N 28 o (Z00 AIpap13 ayl ao}ale° Allunwwo9 L1491. Ad : Li7ZZ) palneex3 lae.tluOD 91,`£OZ 333 :luawtiaelly co 0 July 2016-June 2017 CCE203.16 a,; I- 4., ATTACHMENT IX 0 a RECEIPT AND EXPENDITURE REPORT COMMUNITY CARE FOR THE ELDERLY PROVIDER NAME,ADDRESS,PHONE#and FEID# Program Funding: THIS REPORT PERIOD: From To CCE Admin. CONTRACT PERIOD: CCE Services CONTRACT# REPORT# PSA# CERTIFICATION: i certify to the best of my knowledge and belief that the report Is complete and correct and all outlays herein are for purposes set forth In the contract. Prepared by: Dale: Approved by: Data• PART A:BUDGETED INCOME/ RECEIPTS 1.Approved 2.Actual Receipts 3.Total Receipts 4.Percent of Budget For This Report Year to Date Approved Budget 1.State Funds $0.00 $0.00 $0.00 #DIV/01 2.Program Income $0.00 $0.00 $0.00 #DIV/01 3.Local Cash Match $0.00 $0.00 $0.00 #DIV/0i 4.SUBTOTAL:CASH RECEIPTS 5.Local In-Kind Match 6.TOTAL RECEIPTS $0.00 $0.00 $0.00 #DIV/01 PART B:EXPENDITURES 1.Approved 2.Expenditures 3.Expenditures 4.Percent of Budget For This Report Year to Date Approved Budget 1.Administrative Services $0.00 $0,00 $0.00 #DIV/01 2.Service Subcontractor(s) $0.00 $0.00 $0.00 #DIV/Ol 3.Adult Protective Services $0.00 $0.00 $0.00 #DIV/01 4.TOTAL EXPENDITURES $0.00 $0.00 $0.00 #DIV/OI PART C:OTHER REVENUE AND EXPENDITURES II.Interest: III.Advance Recouped I.Program Income(PI) 1.Earned on OR Advance$ $ 1.CCE:PI Collected YTD $ 2.Return of GR Advance $ (Includes fees collected) 3.Other Earned $ PART D:CO-PAYMENTS CURRENT MONTH YEAR-TO-DATE 1.Total of Co-payments assessed $ $ 2.Total of Co-payments collected $ $ (For Tracking Purposes only) DOEA FORM 1050 Revised 505/2010 ..eft. 29 o (Zoo Riiepi3 eti;ao}oleo A;iunwwo3 L6/9i.AA pa;n3ex3;yea;uo3 91.`£OZ 333 :;uewtloeDy a Ci cit Revised August 2007 to a_ Attestation Statement Agreement/Contract Number:CCE 203.16 Amendment Number:ma 1,Steve Cannell ,attest that no changes or revisions have been made to the (Recipient/Contractor representative) content of the above referenced agreement/contract or amendment between the Area Agency on Aging for Southwest Florida and Public Services Department Head (Recipient/Contractor name) The only exception to this statement would be for changes in page formatting,due to the differences in electronic data processing media,which has no affect on the agreement/contract content. OW 7/ / ii Signa 'wet t f Recip ent/Contractor representative Date Approved as to form and legality Assistant County Attorney Revised August 2007 i I