Agenda 07/24/2012 Item #16D157/24/2012 Item 16.D.15.
EXECUTIVE SUMMARY
Recommendation to approve after - the -fact Community Care for the Elderly, Home Care for the
Elderly, and Alzheimer's Disease Initiative 2 year contract with Senior Choices f /k/a Area Agency
on Aging for SWFL and approve budget amendments reflecting the difference between estimated
and actual funding for FY12 -13 State General Revenue Seniors Programs (First Year Fiscal Net
Impact: $3,916).
OBJECTIVE: To continue as Lead Agency for the Community Care for the Elderly, the Home
Care for the Elderly, the Alzheimer's Disease Initiative programs and approve the first two year
contract for each program, approve budget amendments to reflect the difference between
estimated and actual funding for FY12 -13 State General Revenue Seniors Programs in the net
amount of $3,916, and authorize continued payment of grant expenditures in order to manage
associated grants and continue providing senior care case management services.
CONSIDERATIONS: The Services for Seniors program managed within the Housing Human
and Veteran Services (HHVS) Department has been providing support services to Collier
County's frail and elderly citizens for over 32 years through the Community Care for the Elderly
(CCE), Home Care for the Elderly (HCE), and the Alzheimer's Disease Initiative (ADI) grant
programs. All three grants are allotted to Collier County, the entity holding the Lead Agency
title only. The Board approved Lead Agency designation on May 22, 2012, Item No. 16 D. 4.
At that time budget amendments were approved for the estimated grant awards. The grants are
received from the Florida Department of Elder Affairs (DOER) and are managed by Senior
Choices of Southwest Florida (SCSF). The Lead Agency is then a grantee of SCSF. These
grants enable the County's Services for Seniors Program to provide in home services to seniors
and their caregivers so that they can remain in their homes and live with independence and
dignity.
The current grant contract awarded to Collier County as the Lead Agency commenced on July 1,
2012. This item is being presented as an after - the -fact approval because Collier County received
the grant agreements on June 28, 2012, which needed to be executed by June 30, 2012 to become
effective on July 1, 2012 and assure continuity of services. Consequently, pursuant to CMA
5330 and Resolution No. 2010 -122, the County Manager authorized Steve Carrell, Interim
Administrator, to sign the contract. While the awarded Lead Agency designation is for a six year
period, there is a two year grant contract with annual fiscal allocations. Collier County as the
Lead Agency is responsible to respond to seniors needs and to manage the spending authority for
the CCE, HCE, and ADI program services.
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7/24/2012 Item 16.D.15.
The following table provides a detailed breakdown of the annual award amount under each
program:
Program Component
Anticipated
Award
Amount
Actual
Award
Amount
Adjusted
Budget
Amount
Alzheimer's Disease Initiative
$94,256
$94,719
$463
Home Care for the Elderly (Case Management)
$5,248
$4,601
($647)
Home Care for the Elderly (Subsidies)*
$0
$57,108*
$0*
Community Care for the Elderly
$657,667
$661,357
$3,690
Community Care for the Elderly Match
$73,074
$73,484
$410
Total Award
$830,245
$834,161
$3,916
1 neseJunds are retained by the grantor agency and do not require a budget amendment.
FISCAL IMPACT: The allocations for these grants will reside in Human Services Fund 707,
Projects 33215 (ADI), 33216 (CCE) and 33217 (HCE). Only the CCE grant requires a 10%
match. A portion of this match will be provided in -kind by the vendors that will provide services
and supplies as part of their agreement with Collier County. Cash match will be provided from
Board reserves in Human Services Match Fund 708 and Collier County Seniors Fund 123. The
application process will have no further fiscal impact.
GROWTH MANAGEMENT IMPACT: There is no growth management impact due to this
request.
LEGAL CONSIDERATIONS: This item is legally sufficient and requires a majority vote for
Board action. - JBW
RECOMMENDATION: Recommendation to provide after - the -fact approval of three contracts
for the CCE Lead Agency Designation to Seniors Choices of Southwest Florida, approval of
budget amendments to reflect the difference between estimated and actual funding for FYI 2-13
State General Revenue Seniors Programs in the net amount of $3,916, and authorize continued
payment of grant expenditures in order to manage associated grants and continue providing
senior care case management services.
Prepared by: Louise Pelletier, Case Management Supervisor, Housing, Human, and Veteran
Services
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7/24/2012 Item 16.D.15.
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.D.15.
Item Summary: Recommendation to annrov,- =fter- the -fact Community Care for the
Elderly, Home Care for the Elderly, and Alzheimer's Disease Initiative 2 year contract with
Senior Choices f /k /a Area Agency on AprinQ for SWFL and approve budget amendments
reflecting the difference between estimated and actual funding for FY12 -13 State General
Revenue Seniors Programs (First Year Fiscal Net Impact: $3,916).
Meeting Date: 7/24/2012
Prepared By
Approved By
Name: AlonsoHailey
Title: Operations Analyst, Public Service Division
Date: 7/6/2012 11:25:49 AM
Name: GrantKimberley
Title: Interim Director, HHVS
Date: 7/6/2012 4:34:21 PM
Name: CarnellSteve
Title: Director - Purchasing /General Ser, ces,Purchasing
Date: 7/9/2012 8:28:45 AM
Name: AckermanMaria
Title: Senior Account,: :,t, Grants
Date: 7/10/2012 +:06:14 PM
Frame: W`,* *° TAnnifer
Title: Assistant County Attorney,Count_ _ .aorney
Date: 7/13/2012 1:39:25 PM
Name: KlatzkowJeff
Title: County Attorney
Date: 7/16/2012 9:48:39 AM
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7/24/2012 Item 16.D.15.
Name: StanleyTherese
Title: Management /Budget Analyst, Senior,Office of Management & Budget
Date: 7/16/2012 10:17:10 AM
Name: PryorCheryl
Title: Management/ Budget Analyst. Seninr.Office of Mamvement & Budget
Date: 7/16/2012 5:09:50 PM
Name: KlatzkowJeff
Title: County Attorney
Date: 7/17/2012 8:25:37 AM
Name: IsacksonMark
Title: Director -Corp Financial and Mgmt Svs,CMO
Date: 7/17/2012 8:58:11 AM
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July 2012 - June 2014 7/24/2012 Item 16.D.15.
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDj-., --
dba SENIOR CHOICES OF SOUTHWEST FLORIDA
STANDARD CONTRACT
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of
Southwest Florida ( "Agency ") and Collier County Board of County Commissioners, ( "Recipient "), and collectively
referred to as the "Parties." The term Recipient for this purpose may designate a vendor, subgrantee or subrecipient, the
status to be further identified in ATTACHMENT III, Exhibit -2 as necessary.
WITNESSETH THAT:
WHEREAS, the Agency has determined that it is in need of certain services as described herein; and
WHEREAS, the Recipient has demonstrated that it has the requisite expertise and ability to faithfully perform such
services as an independent Recipient of the Agency.
NOW THEREFORE, in consideration of the services to be performed and payments to be made, together with the
mutual covenants and conditions hereinafter set forth, the Parties agree as follows:
1. Purpose of Contract
The purpose of this contract is to provide services in accordance with the terms and conditions specified in this
contract including all attachments and exhibits, which constitute the contract document.
1.1 AGENCY MISSION STATEMENT
Mission: To help aging adults, 60 and older, achieve greater independence through awareness of resources and
access to qualified service providers.
Vision: To be the recognized leader in supporting older adults and their families with access to trustworthy
resources and services in their communities while empowering them to live with independence and dignity.
Values: The Agency believes the residents of Southwest Florida are entitled to:
➢ Comprehensive information about their choices of care;
v Timely access to resources and services;
➢ High standards of quality and performance;
Personal and professional accountability from all stakeholders.
Lead agencies and local service providers as partners and stakeholders in Florida's aging services network are
expected to support the agency's mission, vision, and priorities.
2. Incorporation of Documents wi,; i>in the C rntraet
The contract will incorporate attachments, proposal(s), a ca plan(s), grant agreements, relevant Department
handbooks, manuals or c.k books, as an integral part r the contract, except to the extent that the contract
explicitly provides to the contrary. In ",e event of confl' . t in language among any of the documents referenced
above, the specific pro ,isions -..d requirements of tl:e contract document(s) shall prevail over inconsistent
provisions in the pry_ sal(s) or other general materials not specific to this contract document and identified
attachments.
3. Term of Contract
This is a two -year contract shall begin on July 1, 2012 or on the _.ate on which the contract has been signed by
the last party required to sign it, whichever is later. It shall e, J at midnight, local time in North Fort Myers,
Florida, on _June 30, 2014.
4. Contract Amount
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an
amount not to exceed $94,719.00 for year one, 2012 - 2013, 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.
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July 2012 — June 2014 7/24/2012 Item 16.D.15.
5. Renewals
By mutual agreement of the Parties, in accordance with s. 287.058(l)(f), F.S., the Agency may renew the
contract every two years within the six year bid term , 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 six year 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.
6. Comnliance with Federal Law
6.1 If this contract contains federal funds the following shall apply:
6.1.1 The Recipient shall comply with the provisions of 45 CFR 74 and /or 45 CFR 92, and other applicable
regulations.
6.1.2 If this contract contains federal funds and is over $100,000.00, the Recipient shall comply with all applicable
standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s.
508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as
amended, and where applicable Environmental Protection Agency regulations 40 CFR 30. The Recipient shall
report any violations of the above to the Agency.
6.1.3 The Recipient, or agent acting for the Recipient, may not use any federal fiords received in connection with this
contract to influence legislation or appropriations pending before the Congress or any state legislature. If this
contract contains federal funding in excess of $100,000.00, the Recipient must, prior to contract execution,
complete the Certification Regarding Lobbying form, ATTACHMENT H. All disclosure forms as required by
the Certification Regarding Lobbying form must be completed and returned to the Contract Manager prior to
payment under this contract.
6.1.4 In accordance with Appendix A to 2 CFR 215, the Recipient shall comply with Executive Order 11246, Equal
Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in
Department of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable.
6.1.5 if this contract contains federal funds and provides services to children up to age 18, the Recipient shall comply
with the Pro - Children Act of 1994 (20 U.S.C. 6081).
6.1.6 A contract award with an amount expected to equal or exceed $25,000.00 and certain other contract awards will
not be made to parties listed on the government -wide Excluded Patties List System, in accordance with the OMB
guidelines at 2 CFR 180 that implement Executive Orders 12549 and 12689, "Debarment and Suspension." The
Excluded Parties List System contains the names of parties debarred, suspended, or otherwise excluded by
agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order
12549. The Recipient shall comply with these provisions before doing business or entering into subcontracts
receiving federal funds pursuant to this contract. The Recipient shall complete and sign ATTACHMENT V
prior to the execution of this contract.
6.2 The Recipient shall not employ an unauthorized alien. The Agency will consider the employment of
unauthorized aliens a violation of the Irnmigration and Nationality Act (8 U.S.C. 1324a) and the Immigration
Reform and Control Act of 1986 (8 U.S.C. 1101). Such violation will be cause for unilateral cancellation of this
contract by the Agency.
6.3 If the Recipient is a non -profit provider and is subject to Internal Revenue Service (IRS) tax exempt organization
reporting requirements (filing a Form 990 or Form 990 -N) and has its tax exempt status revoked for failing to
comply with the filing requirements of the Pension Protection Act of 2006 or for any other reason, the Recipient
must notify the Agency in writing within thirty (30) days of receiving the IRS notice of revocation.
6.4 The Recipient shall comply with Title 2 CFR Part 275 regarding Trafficking in Persons.
6.5 Unless exempt under 2 CFR Part 170.110(b), the Recipient shall comply with the reporting requirements of the
Transparency Act as expressed in 2 CFR 170.
0)
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7/24/2012 Item 16.D.15.
July 2012- June 2014
ADI 203.12
Transparency Act as expressed in 2 CFR 170.
6.6 To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number I1 -116,
Recipient agrees to utilize the U.S. Department of Homeland Security's E- verify system to verify the
employment of all new employees hired by Contractor during the contract term. Recipient shall include in
related subcontracts a requirement that subcontractors performing work or providing services pursuant to the
state contract utilize the E- verify system to vGriry employment of all new employees hired by the
subcontractor dur= jg the contract term. Recipients meeting the terms and conditions of the E- Verify System
are deemed to �)e in compliance with this provision.
7. Compliance with State Law
7.1 This contract is executed and entered into in the State of Florida, and shall be construed, performed and enforced
in all respects in accordance with the Florida law, including Florida provisions for conflict of laws.
7.2 The Recipient shall comply with requirements of s. 287.058, F.S. as amended.
7.2.1 The Recipient shall provide units of deliverables, including various client services, and in some instances may
include reports, findings, and drafts, as specified in this contract, which the Contract Manager must receive and
accept in writing prior to payment in accordance with s. 215.971, F.S. (1) and (2).
7.2.2 The Recipient shall submit bills for fees or other compensation for services or expenses in sufficient detail for a
proper pre -audit and post- audit.
7.2.3 If itemized payment for travel expenses is permitted in this contract,. the Recipient shall submit bills for any
travel expenses in accordance with s. 112.061, F.S., or at such lower rates as may be provided in this contract.
.2.4 The Recipient shall allow public access to all documents, papers, letters, or other public records as defined in
subsection 119.011(12), F.S., made or received by the Recipient in conjunction with this contract except for
those records which are made confidential or exempt by law. The Recipient's refusal to comply with this
provision will constitute an immediate breach of contract for which the Agency may unilaterally terminate the
contract.
7.3 If clients are to be transported under this contract, the Recipient shall comply with the provisions of Chapter 427,
F.S., and Rule 41 -2, F. A. C.
7.4 Subcontractors who are on the discriminatory vendor list may not ';-ansact business with any public entity, in
accordance with the provisions of s. 287.134, F.S.
7.5 The Recipient shall comply with the provisions of s. 11.062, F..;., and s. 216.347, F.S., which prohibit the
expenditure of contract funds for the purpose of lobbying the iegi_ - ._, al branch or a state agency.
7.6 In accordance with s. 287.135 F.S., any contractor on the Scru'._iized Companies with Activities in Sudan List
or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List (Lists), created pursuant
to s.215.473 F.S., is ineligible to enter into or renew a contract with the Department for goods or services of $1
million or more. Pursuant to s. 287.135 F.S., the Department may terminate this contract if the Contractor is
found to have submitted a false certification of its status on the Lists or has been placed on the Lists. Further,
the Contractor is subject to civil penalties, attorney's fees and costs ,.id any costs for investigations that led to
the finding of false certification. If this contract contains $1 million- or more, the Contractor shall complete and
sign the Certification Regarding Scrutinized Companies Lists, pri, _ to the execution of this contract
8. B_ackLround Screening
The Recipient shall ensure that the requirements of s. 430. J402 and ch. 435, F.S., as amended, are met
regarding background screening for all persons who meet the definition of a direct service provider and who
are not exempted from the Department's level 2 background screening pursuant to s. 430.0402(2) -(3), F.S.
The Recipient must also comply with any applicable rules promulgated by the Department and the Agency for
Health Care Administration regarding -P� ^'^ 0402 and ch. 435, F.S.
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7/24/2012 Item 16.D.15.
ADI 203.12
Further information concerning the procedures for background screening are found at
http : / /elderaffairs. state. fl, us /doea /backgrounds creening. php,
9. Grievance and Compliant Procedures
9.1 Grievance Procedures
The Recipient shall comply with and ensure subcontractor compliance with the Minimum Guidelines for
Recipient Grievance Procedures, Appendix D, Department of Elder Affairs Programs and Services Handbook,
to address complaints regarding the termination, suspension or reduction of services, as required for receipt of
funds.
9.2 Complaint Procedures
The Recipient shall develop and implement complaint procedures and ensure that subcontractors develop and
implement complaint procedures to process and resolve client dissatisfaction with services. Complaint
procedures shall address the quality and timeliness of services, provider and direct service worker complaints, or
any other complaints not related to termination, suspension or reduction in services which require the grievance
process as described in Appendix D, Department of Elder Affairs Programs and Services Handbook. The
complaint procedures shall include notification to all clients of the complaint procedures and include tracking the
date, nature of complaint and the determination of each complaint.
10. Audits, Inspections InvestiLyations Public Records and Retention
10.1 The Recipient shall establish and maintain books, records and documents (including electronic storage media)
sufficient to reflect all assets, obligations, unobligated balances, income, interest and expenditures of funds
provided by the Agency under this contract. Recipient shall adequately safeguard all such assets and assure they
are used solely for the purposes authorized under this contract. Whenever appropriate, financial information
should be related to performance and unit cost data.
10.2 The Recipient shall retain all client records, financial records, supporting documents, statistical records, and any
other documents (including electronic storage media) pertinent to this contract for a period of six (6) years after
completion of the contract or longer when required by law. In the event an audit is required by this contract,
records shall be retained for a minimum period of six (6) years after the audit report is issued or until resolution
of any audit findings or litigation based on the terms of this contract, at no additional cost to the Agency.
10.3 Upon demand, at no additional cost to the Agency, the Recipient shall facilitate the duplication and transfer of
any records or documents during the required retention period in Paragraph 10.2.
10.4 The Recipient shall assure that the records described in Paragraph 10 will be subject at all reasonable times to
inspection, review, copying, or audit by federal, state, or other personnel duly authorized by the Agency.
10.5 At all reasonable times for as long as records are maintained, persons duly authorized by the Agency and federal
auditors, pursuant to 45 CFR 92.36(i)(10), will be allowed full access to and the right to examine any of the
Recipient's contracts and related records and documents pertinent to ,'is specific contract, regardless of the form
in which kept.
10.6 The Recipient shall provide a financial and compliance audit to 'ite Agency as specified in this contract and in
ATTACHMENT III and ensure that all related third -party tray—actions are disclosed to the auditor.
10.7 The Recipient shall comply and cooperate immediately with any inspections, reviews, investigations, or audits
deemed necessary by the office of the Inspector General pursuant to s. 20.055, F.S.
11. Nondiscrimination -Civil Rights Compliance
11.1 The Recipient shall execute assurances in ATTACHMENT VI that it will not discriminate against any person in
the provision of services or benefits under this contract or in employment because of age, race, religion, color,
disability, national origin, marital status or sex in compliance with state and federal law and regulations. The
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7/24/2012 Item 16.D.15.
July 2012- June 2014 ADI 203.12
Recipient further assures that all contractors, subcontractors, subgrantees, or others with whom it arranges to
provide services or benefits in connection with any of its programs and activities are not discriminating against
clients or employees because of age, race, religion, color, disability, national origin, marital status or sex.
11.2 During the term of this contract, the Recipient shall complete and retain on file a timely, complete and accurate
Civil Rights Compliance Checklist
11.3 The Recipient shall establish procedures to icu'cr8i law to handle complaints of discrimination involving
services or benefits through this contract. These procedures will include notifying clients, employees, and
participants of the right to file a complaint with the appropriate federal or state entity.
11.4 If this contract contains federal funds, these assurances are a condition of continued receipt of or benefit from
federal financial assistance, and are binding upon the Recipient, its successors, transferees, and assignees for the
period during which such assistance is provided. The Recipient further assures that all subcontractors, vendors,
or others with whom it arranges to provide services or benefits to participants or employees in connection with
any of its programs and activities are not discriminating against those participants or employees in violation of
the above statutes, regulations, guidelines, and standards. In the event of failure to comply, the Recipient
understands that the Agency may, at its discretion, seek a court order requiring compliance with the terms of this
assurance or seek other appropriate judicial or administrative relief, including but not limited to, termination of
and denial of further assistance.
12. Provision of Services
The Recipient shall provide services in the manner described in ATTACHMENT I.
13. Monitoring by the Agency
The Recipient shall permit persons duly authorized by the Agency to inspect and copy any records, papers,
documents, facilities, goods and services of the Recipient which are relevant to this contract, and to interview any
clients, employees and subcontractor employees of the Recipient to assure the Agency of the satisfactory
performance of the terms and conditions of this contract. Following such review, the Agency will provide a
written report of its findings to the Recipient, and where appropriate, the Recipient shall develop a corrective
action plan. The Recipient hereby agrees to correct all deficiencies identified in the corrective action plan in a
timely manner as determined by the Contract Manager.
14. Coordinated Monitoring-with Other A encies
If the Recipient receives funding from one or more of the State of Florida other human service agencies, in
addition to the Department of Elder Affairs, then a joint monitoring visit including such other agencies may be
scheduled. For the purposes of this contract, and pursuant to s. 287.0575, F.S. as amended, Florida's human
service agencies shall include the Department of Children Pnd Families, the Department of Health, the Agency
for Persons with Disabilities, the Department of Veterans .:affairs, and the Department of Elder Affairs. Upon
notification and the subsequent scheduling of such a V: it by the designated agency's lead administrative
coordinator, the Recipient shall comply and cooperate with all monitors, inspectors, and/or investigators.
15. Indemnification
The Recipient shall inrt`-_ lif}, save, defend, and hold harmless the ' -ency and its agents and employees from
any and all claims, demands, actions, causes of action if whatever .re or character, arising out of or by reason
of the execution of this agreement or performance of the sery _s provided for herein. It is understood and
agreed that the Recipient is not required t.j indemnify the A, me ✓ for claims, demands, actions or causes of
action arising solely out of the Agency's negligence.
15.1 Except to the extent permitted by s. 768.28, F.S., or other r_ orida law, Paragraph 15 is not applicable to contracts
executed between the Department and state agencies or F ,bdivisions defined in s. 768.28(2), F.S.
Insurance and Bonding
16.1 The Recipient shall provide continuous adequate liability insurance coverage during the existence of this contract
and any renewal(s) and extension(s) of it. By execution of this contract, unless it is a state agency or subdivision
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7/24/2012 Item 16.D.15.
ADI 203.12
as defined by subsection 768.28(2), F.S., the Recipient accepts full responsibility for identifying and determining
.0
the type(s) and extent of liability insurance necessary to provide reasonable financial protections for the
Recipient and the clients to be served under this contract. The limits of coverage under each policy maintained by
the Recipient do not limit the Recipient's liability and obligations under this contract. The Recipient shall ensure
that the Agency has the most current written verification of insurance coverage throughout the term of this
contract. Such coverage may be provided by a self - insurance program established and operating under the laws
of the State of Florida. The Agency reserves the right to require additional insurance as specified in this contract.
16.2 Throughout the term of this agreement, the Recipient shall maintain an insurance bond from a responsible
commercial insurance company covering all officers, directors, employees and agents of the Recipient authorized
to handle funds received or disbursed under all agreements and/or contracts incorporating this contract by
reference in an amount commensurate with the funds handled, the degree of risk as determined by the insurance
company and consistent with good business practices.
17. Confidentiality of Information
The Recipient shall not use or disclose any information concerning a recipient of services under this contract for
any purpose prohibited by state or federal law or regulations except with the written consent of a person legally
authorized to give that consent or when authorized by law.
18. Health Insurance Portabi. and Accountability Act
Where applicable, the Recipient shall comply with the Health Insurance Portability and Accountability Act (42
USC 1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162, and 164).
19. Incident Reportinx
19.1 The Recipient shall notify the Agency immediately, but no later than forty -eight (48) hours from, the Recipient's
awareness or discovery of conditions that may materially affect the Recipient or subcontractor's ability to
perform the services required to be performed under this contract. Such notice shall be made orally to the
Contract Manager (by telephone) with an email to immediately follow.
19.2 The Recipient shall immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of a
child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll -free telephone number
(1- 800- 96ABUSE). As required by Chapters 39 and 415, F.S., this provision is binding upon both the Recipient
and its employees.
20. New Contract(s) Reuortina
The Recipient shall notify the Agency within ten (10) days of entering into a new contract with any of the
remaining four (4) state human service agencies. The notification shall include the following information: (1)
contracting state agency; (2) contract name and number; (3) contract start and end dates; (4) contract amount; (5)
contract description and commodity or service; and (6) Contract Manager name and number. In complying with
this provision, and pursuant to s. 287.0575, F.S. as amended, the Recipient shall complete and provide the
information to the Agency's Contract Manager.
21. Bankruptcy Notification
During the term of this contract, the Recipient shall immediately notify the Agency if the Recipient, its assignees,
subcontractors or affiliates file a claim for bankruptcy. Within ten (I0) days after notification, the Recipient must
also provide the following information to the Area Agency on Aging for Southwest Florida, Inc.: (1) the date of
filing of the bankruptcy petition; (2) the case number; (3) the court name and the division in which the petition
was filed (e.g., United States Bankruptcy Court Middle District of Florida, Fort Myers, FL ); and, (4) the name,
address, and telephone number of the bankruptcy attorney.
22. Sponsorship and Publicity
22.1 As required by s. 286.25, F.S., if the Recipient is a non - governmental organization which sponsors a program
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ADI 203.12
financed wholly or in part by state funds, including any funds obtained through this contract, it shall, in
publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by Hope Hospice and
Community Services, the State Agency of Elder Affairs, and the Area Agency on Aging for Southwest Florida,
Inc." If the sponsorship reference is in the written material, the words "State of Florida, Department of Elder
Affairs and the Area Agency on Aging for Southwest Florida, Inc." shall appear in at least the same size letters
or type as the name of the organization.
22.2 The Recipient shall not use the words "The State of Florida Department of Elder Affairs or the Area Agency on
Aging for Southwest Florida, Inc." to indicate sponsorship of a program otherwise financed, unless specific
authorization has been obtained by the State and Agency prior to use.
23. AssiZnments
23.1 The Recipient shall not assign the rights and responsibilities under this contract without the prior written
approval of the Agency, which shall not be unreasonably withheld. Any sublicense, assignment, or transfer
otherwise occurring without prior written approval of the Agency will constitute a material breach of the
contract.
23.2 The State of Florida is at all times entitled to assign or transfer, in whole or part, its rights, duties, or obligations
under this contract to another governmental agency in the State of Florida, upon giving prior written notice to the
Recipient. In the event the State of Florida approves transfer of the Recipient's obligations, the Recipient
remains responsible for all work performed and all expenses incurred in connection with the contract.
23.3 This contract shall remain binding upon the successors in interest of either the Recipient or the Agency.
24. Subcontracts
24.1 The Recipient is responsible for all work performed and for all commodities produced pursuant to this contract,
whether actually furnished by the Recipient or its subcontractors. Any subcontracts shall be evidenced by a
written document and subject to any conditions of approval the Agency deems necessary. The Recipient further
agrees that the Agency will not be liable to the subcontractor in any way or for any reason. The Recipient, at its
expense, shall defend the Agency against any such claims.
24.2 The Recipient shall promptly pay any subcontractors upon receipt of payment from the Agency or other state
agency. Failure to make payments to any subcontractor in accordance with s. 287.0585, F.S., unless otherwise
stated in the contract between the Recipient and subcontractor, will result in a penalty as provided by statute.
25. Independent Capacity of Recipient
It is the intent and understanding of th . Parties that the Recipient, or any of its subcontractors, are independent
contractors and are not employees of .ie Agency and shall not hold themselves out as employees or agents of the
Agency without specific authorization from the Agency. It is the further intent and understanding of the Parties
that the Agency does not control the employment practices of the Recipient and will not be liable for any wage
and hour, employment discrimination, or other labor and employment claims against the Recipient or its
subcontract) °s. All deductions for social security, withholding taxes, income taxes, contributions to
unemployment ._,:__densation funds and all necessary insurance for the Recipient are the sole responsibility of the
Recipient.
26. Payment
Payments shall be made to the Recipient pursuant to s. 215.422, F.S., as services are rendered and invoiced by
the Recipient. The Contract Manager will have final approval of the invoice for payment, and will approve the
invoice for payment only if the Recipient has met all terms and conditions of the contract, unless the bid
specifications, purchase order, or this contract specify otherwise. The approved invoice will be submitted to the
Agency's finance section for budgetary approval and processing. Disputes arising over invoicing and payments
will be resolved in accordance with the provisions of s. 215.422 F.S. A Vendor Ombudsman has been
established within the Department of Financial Services and may be contacted at (850) 413 -5665.
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27. Return of Funds
The Recipient shall return to the Agency any overpayments due to unearned funds or funds disallowed and any
interest attributable to such funds pursuant to the terms and conditions of this contract that were disbursed to the
Recipient by the Agency. In the event that the Recipient or its independent auditor discovers that an
overpayment has been made, the Recipient shall repay said overpayment immediately without prior notification
from the Agency. In the event that the Agency first discovers an overpayment has been made, the Contract
Manager will notify the Recipient in writing of such findings. Should repayment not be made forthwith, the
Recipient will be charged at the lawful rate of interest on the outstanding balance pursuant to s. 55.03, F.S., after
Agency notification or Recipient discovery.
28. Data Integrity and Safeguarding Information
The Recipient shall ensure an appropriate Ievel of data security for the information the Recipient is collecting or
using in the performance of this contract. An appropriate level of security includes approving and tracking all
Recipient employees that request system or information access and ensuring that user access has been removed
from all terminated employees. The Recipient, among other requirements, must anticipate and prepare for the
loss of information processing capabilities. All data and software shall be routinely backed up to ensure recovery
from losses or outages of the computer system. The security over the backed -up data is to be as stringent as the
protection required of the primary systems. The Recipient shall ensure all subcontractors maintain written
procedures for computer system backup and recovery. The Recipient shall complete and sign ATTACHMENT
IV prior to the execution of this contract.
29. Computer Use and Social Media Policy
The Department of Elder Affairs has implemented a new Social Media Policy, in addition to its Computer Use
Policy, which applies to all employees, contracted employees, consultants, OPS and volunteers, including all
personnel affiliated with third parties, such as, but not Iimited to, Area Agencies on Aging and vendors. Any
entity that uses the Department's computer resource systems must comply with the Department's policy
regarding social media. Social Media includes, but is not limited to blogs, podcasts, discussion forums, Wikis,
RSS feeds, video sharing, social networks like MySpace, Facebook and Twitter, as well as content sharing
networks such as flickr and YouTube.
30. Conflict of Interest
The Recipient shall establish safeguards to prohibit employees, board members, management and subcontractors
from using their positions for a purpose that constitutes or presents the appearance of personal or organizational
conflict of interest or personal gain. No employee, officer or agent of the Recipient or subcontractor shall
participate in selection, or in the award of an agreement supported by state or federal funds if a conflict of
interest, real or apparent, would be involved. Such a conflict would arise when: (a) the employee, officer or
agent; (b) any member of his/her immediate fainiiy; (c) his or her partner, or; (d) an organization which employs,
or is about to employ, any of the above, has a r- ancial or other interest in the firm selected for award. The
Recipient or subcontractor's officers, empl- .;s or agents will neither solicit nor accept gratuities, favors or
anything of monetary value fi•om contr, .Lors, potential contractors, or parties to subcontracts. The Recipient's
board members and mana!_, ' - _ast disclose to the Agency any relationship which may be, or may be
perceived to be, a conflict U.111Lerest within thirty (30) calendar days of an individual's original appointment or
placement in that position, or if the is s.. ,; _" ,s an incumbent, within thirty (30) calendar days of the
commencement of this contract. The Recipient's employees and subcontractors must make the same disclosures
described above to the Recipient's board of directors. Compliance with this provision will be monitored.
31. Public Entity Crime
Pursuant to s. 287.133, F.S., a person or affiliate who has been placed on the convicted vendor list following a
conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods
or services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the
construction or repair of a public building or public work; may not submit bids, proposals, or replies on leases of
real property to a public entity, may not be awarded or perform work as a Recipient, supplier, subcontractor, or
consultant under a contract with any public entity; and may not transact business with any public entity in excess
of the threshold amount provided in s. 287.017, F.S., for CATEGORY TWO for a period of 36 months following
the date of being placed on the convicted vendor list.
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32. Purchasing
7/24/2012 Item 16.D.15.
ADI 203.12
32.1 The Recipient may purchase articles which are the subject of or are required to carry out this contract from Prison
Rehabilitative Industries and Diversified Enterprises, Inc., (PRIDE) identified under Chapter 946, F.S., in the
same manner and under the procedures set forth in subsections 946.515(2) and (4), F.S. For purposes of this
contract, the Recipient shall be deemed t- ?,.P * substituted for the Agency insofar as dealings with PRIDE. This
clause is not applicable to subcontractors unless otherwise required by law. An abbreviated Iist of
products /services available from PRIDE may be obtained by contacting PRIDE, (800) 643 -8459.
32.2 The Recipient may proc".- -y recycled products or materials, which are the subject of or are required to carry
out this contract, in accordance with the pi ovisions of s. 403.7065, F.S.
32.3 The Recipient may purchase articles that are the subject of, or required to carry out, this contract from a nonprofit
agency for the Blind or for the Severely Handicapped that is qualified pursuant to Chapter 413, F.S., in the same
manner and under the same procedures set forth in s. 413.036(1) and (2), F.S. For purposes of this contract, the
Recipient shall be deemed to be substituted for the Agency insofar as dealings with such qualified nonprofit
agency are concerned. Additional information about the designated nonprofit agency and the products it offers is
available at http: / /Www.respectofflorida.org. This clause is not applicable to subcontractors unless otherwise
required by law.
33. Patents, Copyrights Royalties
If this contract is awarded state funding and if any discovery, invention or copyrightable material is developed,
produced or for which ownership was purchased in the, course of or as a result of work or services performed
under this contract, the Recipient shall refer the discovery, invention or material to the Agency to be referred to
the Department of State and the Department of Elder Affairs. Any and all patent rights or copyrights accruing
under this contract are hereby reserved to the State of Florida in accordance with Chapter 286, F.S. Pursuant to s.
287.0571 (5) (k) 1 and 2 as amended, the only exceptions to this provision shall be those that are clearly
expressed and reasonably valued in the contract.
33.1 If the primary purpose of this contract is the creation of intellectual property, the State of Florida shall retain an
unencumbered right to use such property, notwithstanding any agreement made pursuant to Paragraph 33.
33.2 If this contract is awarded solely federal fimding, the terms and conditions are governed by 2 CFR 215.36.
34. Emergency Preparedness and Continuity A Operations
34.1 If the tasks to be performed pursuant to this contract include the physical care and control of clients, or the
administration and coordination of services necessary for client ? ealth, safety or welfare, the Recipient shall,
within thirty (30) calendar days of the execution of this contract, submit to the Contract Manager verification of
an emergency preparedness plan. In the event of an emer -ency, the Recipient shall notify the Agency of
emergency provisions.
34.2 In the event a situation results in a cessation of services by a subcontractor, the Recipient shall retain
responsibility for performance under this contract and must follow procedures to ensure continuity of operations
without interruption.
35. EQUIPMENT
If the contract tasks to be performed require the purchase of equipment with state or federal funds, the following
paragraphs apply:
35.1 Equipment means: (a) an article of nonexpendable, tangible personal property having a useful life of more than
one year and an acquisition cost which equals or exceeds the lesser of the capitalization level established by the
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7/24/2012 Item 16.D.15.
ADI 203.12
organization for the financial statement purposes, or $5,000.00 [for federal funds]; or (b) nonexpendable, tangible "*P'`
personal property of a nonconsumable nature with an acquisition cost of $1,000.00 or more per unit and
,
expected useful life of at least one year; and hardback bound books not circulated to students or the general
public, with a value or cost of $250.00 or more [for state funds].
35.2 Recipients and subcontractors who are Institutions of Higher Education, Hospitals, and Other Non - Profit
Organizations shall have written property management standards in compliance with 2 CFR Part 215
Administrative Requirements (formerly OMB Circular A -110) that include: (a) a property list with all the
elements identified in the circular; and, (b) a procedure for conducting a physical inventory of equipment at least
once every two years, (c) a control system to insure adequate safeguards to prevent loss, damage, or theft of the
equipment; and (d) maintenance procedures to keep the equipment in good condition. The property records must
be maintained on file and shall be provided to the Agency upon request. The Recipient shall promptly
investigate, fully document and notify the Contract Manager of any loss, damage, or theft of equipment. The
Recipient shall provide the results of the investigation to the Contract Manager.
35.3 The Recipient's property management standards for equipment acquired with Federal funds and federally -owned
equipment shall include accurately maintained equipment records with the following information:
(1) A description of the equipment;
(2) Manufacturer's serial number, model number, Federal stock number, national stock number, or other
identification number;
(3) Source of the equipment, including the award number;
(4) Whether title vests in the Recipient or the Federal Government;
(5) Acquisition date (or date received, if the equipment was furnished by the Federal Government) and cost;
(6) Information from which one can calculate the percentage of Federal participation in the cost of the
equipment (not applicable to equipment furnished by the Federal Government);
(7) Location and condition of the equipment and the date the information was reported;
(S) Unit acquisition cost; and
(9) Ultimate disposition data, including date of disposal and sales price or the method used to determine current
fair market value where a Recipient compensates the Federal awarding agency for its share.
35.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased with
state funds with an acquisition cost over $1,000.00 that is specifically identified in the area plan approved by the
Department is part of the cost of carrying out the activities and functions of the grant awards and Title
(ownership) will vest in the Agency, subject to the conditions of 2 CFR Part 215 Administrative Requirements
(formerly OMB Circular A -110), Subpart C, paragraph 34. Equipment purchased under these thresholds is
considered supplies and is not subject to property standards. Equipment purchased with funds identified in the
budget attachments to agreements covered by this contract, or identified in the sub - agreements with
subcontractors (not included in a cost methodology), is subject to the conditions of section 273, F. S. and 60A-
1.0017, F. A. C. or Title 45 CFR Part 74.
35.5 The Recipient shall not dispose of any equipment or materials provided by the Agency, or purchased with funds
provided through this contract without first obtaining the approval of the Contract Manager. When disposing of
property or equipment the Recipient must submit a written request for disposition instructions to the respective
Contract Manager. The request should include a brief description of the property, purchase price, funding
source, percentage of state or federal participation, acquisition date and condition of the property. The request
should also indicate the Recipient's proposed disposition (i.e., transfer or donation to another agency that
administers federal programs, offer the items for sale, destroy the items, etc).
35.6 The Contract Manager will issue disposition instructions. If disposition instructions are not received within 120
days of the written request for disposition, the Recipient is authorized to proceed as directed in 2 CFR Part 215
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July 2012- June 2014 ADI 203.12
Administrative Requirements (formerly OMB Circular A -110).
35.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto, but
excludes movable machinery and equipment. Real property may not be purchased with state or federal funds
through agreements covered under this contract without the prior approval of the Agency. Real property
purchases from Older Americans Act funds are subject to the provisions of Title 42, Chapter 35, Subchapter III,
Part A., Sec. 3030b United States Code (USC). Real property purchases from state Hinds can only be made
through fixed c .i ~' ' .1 : ' , 1.,..... „ - u.L l i:
216.348, F. S. a,;rc ore are subject to the provisions of section
tr. 1 ..
35.8 Any permanent storage devices (e.g., hard drives, removable storage media) must be reformatted and tested prior
to disposal to ensure no confidential information remains.
35.9 The Recipient must adhere to the Agency's procedures and standards when purchasing Information Technology
Resources (ITR) as part of any agreement(s) incorporating this contract by reference. An ITR worksheet is
required for any computer related item costing $1,000.00 or more, including data processing hardware, software,
services, supplies, maintenance, training, personnel and facilities. The completed ITR worksheet shall be
maintained in the LAN administrator's file and must be provided to the Agency upon request. The Recipient has
the responsibility to require any subcontractors to comply with the Agency's ITR procedures.
36. PUR 1000 Form
The PUR 1000 Form is hereby 'incorporated by reference. In the event of any conflict between the PUR 1000
Form and any terms or conditions of this contract the terms or conditions of this contract shall take precedence
over the PUR 1000 Form. However, if the conflicting terms or conditions in the PUR 1000 Form are required by
any section of the Florida Statutes, the terns or conditions contained in the PUR 1000 Form shall take
precedence.
37. Use of State Funds to Purchase or Improve Real Property
Any state funds provided for the purchase of or improvements to real property are contingent upon the Recipient
or political subdivision granting to the state a security interest in the property at least to the amount of state funds
provided for at least 5 years from the date of purchase or the completion of the improvements or as further
required by law.
38. Dispute Resolution
Any dispute concerning performance of the contract shall be decided by the Contract Manager, who shall reduce
the decision to writing and serve a copy on the Recipient.
39. Financial Consequences of Non - Performance
If the Recipient fails to meet the minimum level of service or performan.oe identified in this agreement, or that is
customary for the industry, then the Agency must apply financk_' consequences commensurate with the
deficiency. Financial consequences may include, but are not limited :o, contract suspension, refusing payment,
withholding paymcl- -ntiI deficiency is cured, tendering only parti,:l payments, and /or cancellation of contract
and reacquiring services from an alternate source.
39.1 The Recipient will not be charged with financial consequences, when a failure to perform arises out of causes
that were the responsibility of the Agency.
40. No Waiver of Sovereign Immunity
Nothing contained in this agreement is intended to serve as a waiver of sovereign immunity by any entity to
which sovereign immunity may be applicable.
41. Venue
If any dispute arises out of this contract, the venue of such legal re- ;urse will be Lee County, Florida.
Entire Contract
This contract contains all the terms and conditions agreed upon by the Parties. No oral agreements or
representations shall be valid or binding upon the Agency or the Recipient unless expressly contained herein or
by a written amendment to this contract sieved by both Parties_
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43. Force Maieure
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control,
provided the party experiencing the force majeure condition provides immediate written notification to the other
party and takes all reasonable efforts to cure the condition.
44. Severability Clause
The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or
unenforceable the other provisions are severable to that void provision and shall remain in full force and effect.
45. Condition Precedent to Contract: Appropriations
The Parties agree that the Agency's performance and obligation to pay under this contract is contingent upon an
annual appropriation by the Legislature.
46. Addition/Deletion
The Parties agree that the Agency reserves the right to add or to delete any of the services required under this
contract when deemed to be in the State of Florida's best interest and reduced to a written amendment signed by
both Parties. The Parties shall negotiate compensation for any additional services added.
47. Waiver
The delay or failure by the Agency to exercise or enforce any of its rights under this contract will not constitute
or be deemed a waiver of the Agency's right thereafter to enforce those rights, nor will any single or partial
exercise of any such right preclude any other or further exercise thereof or the exercise of any other right.
48. _Compliance
The Recipient shall abide by all applicable current federal statutes, laws, rules and regulations as well as
applicable current state statutes, laws, rules and regulations. The Parties agree that failure of the Recipient to
abide by these laws shall be deemed an event of default of the Recipient, and subject the contract to immediate,
unilateral cancellation of the contract at the discretion of the Agency.
49. Final Invoice
The Recipient shall submit the final invoice for payment to the Agency as specified in Paragraph 3.3.5. (date for
final request for payment) of ATTACHMENT I. If the Recipient faiIs to submit final request for payment by
the deadline, then all rights to payment may be forfeited and the Agency may not honor any requests submitted
after the aforesaid time period. Any payment due under the terms of this contract may be withheld until all
reports due from the Recipient and necessary adjustments thereto have been approved by the Agency.
50. Renegotiations or Modifications
Modifications of the provisions of this contract shall be valid only when they have been reduced to writing and
duly signed by both parties. The rate of payment and the total dollar amount may be adjusted retroactively to
reflect price level increases and changes in the rate of payment when these have been established through the
appropriations process and subsequently identified in the Agency's operating budget.
51. Termination
51.1 This contract may be terminated by either party without cause upon no less than thirty (30) calendar days notice
in writing to the other party unless a sooner time is mutually agreed upon in writing. Said notice shall be
delivered by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by
hand delivery to the Contract Manager or the representative of the Recipient responsible for administration of the
contract.
51.2 In the event fiends for payment pursuant to this contract become unavailable, the Agency may terminate this
contract upon no less than twenty -four (24) hours notice in writing to the Recipient. Said notice shall be
delivered by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by
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ADI 203.12
hand delivery to the Contract Manager or the representative of the Recipient responsible for administration of the
contract. The Agency will be the final authority as to the availability and adequacy of funds. In the event of
termination of this contract, the Recipient will be compensated for any work satisfactorily completed prior to the
date of termination.
51.3 This contract may be terminated for cause upon no less than twenty -four (24) hours notice in writing to the
Recipient. If applicable, the Agency may employ the default provisions in Rule 60A- 1.006(3), F.A.C. Waiver of
breach of any provisions of this contract shall not be deemed to be a waiver of any other breach and shall not be
construed to be a modification of the terms and conditions of this contract. The provisions herein do not limit the
Agency's or the Recipient's rights to remedies at law or in equity.
51.4 Failure to have performed any contractual obligations with the Agency in a manner satisfactory to the Agency
will be a sufficient cause for termination. To be terminated as a Recipient under this provision, the Recipient
must have (1) previously failed to satisfactorily perform in a contract with the Agency, been notified by the
Agency of the unsatisfactory performance and failed to correct the unsatisfactory performance to the satisfaction
of the Agency; or (2) had a contract terminated by the Agency for cause.
52. Electronic Records and Signature
The Agency authorizes, but does not require, the Recipient to create and retain electronic records and to use
electronic signatures to conduct transactions necessary to carry out the terms of this Agreement. A Recipient
that creates and retains electronic records and uses electronic signatures to conduct transactions shall comply
with the requirements contained in the Uniform Electronic Transaction Act, s. 668.50, Fla. Stat. All electronic
records must be fully auditable; are subject to Florida's Public Records Law, ch. 119, Fla. Stat.; must comply
with section 28, Data Integrity and Safeguarding Information; must maintain all confidentiality, as applicable;
and must be retained and maintained by the Recipient to the same extent as non - electronic records are retained
and maintained as required by this Agreement.
52.1 The Agency's authorization pursuant to this section does not authorize electronic transactions between the
Recipient and the Agency. The Recipient is authorized to conduct electronic transactions with the Agency only
upon further written consent by the Agency.
52.2 Upon request by the Agency, the Recipient shall provide the Agency with non - electronic (paper) copies of
records. Non - electronic (paper) copies provided to the Agency of any document that was originally in electronic
form with an electronic signature must indicate the person and the person's capacity who electronically signed the
document on any non - electronic copy of the document.
53. Official Payee and Representatives (Names, Addresses, and Telephone Numbers):
a.
The Recipient name, as shown on page 1 of this contract,
and mailing address of the official payee to whom the
payment shall be made is:
Collier County Board of County Commissioners
Housing and Human Services Departments
3339 Tamiami Trail E Bldg H, Rm 211
Naples, FL 34112
Kimberly Grant, Interim Director
b.
The name of the contact person and street address where
Collier County Board of County Commissioners
financial and administrative records are maintained is:
Housing and Human Services Departments
3339 Tamiami Trail E Bldg H, Rm 211
Naples, FL 34112
Kimberly Grant, Interim Director
Collier County Board of County Commissioners
c•
The name, address, and telephone number of the
Housing and Human Services Departments
representative of the Recipient responsible for
3339 Tamiami Trail E Bldg H, Rm 211
administration of the program under this contract is:
Naples, FL 34112
(239) 252 -2273
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d IThe section and location within the Agency where
Requests for Payment and Receipt and Expenditure forms
are to be mailed is:
7/24/2012 Item 16.D.15.
ADI 203.12
Area Agency on Aging for Southwest Florida, Inc.
dba Senior Choices of Southwest Florida
15201 N. Cleveland Ave, Suite 1100
North Fort Myers, Florida 33903
Leigh Wade, Executive Director
e The name, address, and telephone number of the Contract Area Agency on Aging for Southwest Florida, Inc.
Manager for this contract is: dba Senior Choices of Southwest Florida
15201 N. Cleveland Ave, Suite 1100
North Fort Myers, Florida 33903
(239) 652 -6900
Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided in
writing to the other party and the notification attached to the originals of this contract.
54. All Terms and Conditions Included
This contract and its Attachments, I — X 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 38 page contract, to be executed by their undersigned
officials as duly authorized.
Recipient: COLLIER COUNTY BOARD OF COUNTY
COMMISSIONERS
SIGNED BY: / .
NAME:
TITLE:'l
DATE: {�
Federal Tax ID: 59- 6000588
Fiscal Year Ending Date: 09/30
AREA AGENCY ON AGING FOR SOUTIIWEST'
FLORIDA, INC. DBA SENIOR CHOICES OF
SOUTHWEST FLORIDA
SIGNED BY:
NAME: LEIGH ANNA NOWAK
TITLE: BOARD PRESIDENT
DATE:
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INDEX TO CONTRACT ATTACHMENTS
7/24/2012 Item 16.D.15.
ADI 203.12
ATTACHMENT
ATTACHMENT DESCRIPTION
PAGE
ATTACHMENT I
STATEMENT OF WORK
16.24
ATTACHMENT II
CERTIFICATION REGARDING LOBBYING
25
ATTACHMENT III
FINANCIAL AND COMPLIANCE AUDIT ATTACHMENT
26 -30
ATTACHMENT IV
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE
31
ATTACHMENT V
CERTIFICATION REGARDING DEBARMENT, SUSPENSION,
32
INELIGIBILITY AND VOLUNTARY EXCLUSION
CONTRACTS /SUBCONTRACTS
ATTACHMENT VI
ASSURANCES —NON- CONSTRUCTION PROGRAMS
33 -34
ATTACHMENT VII
ALZHEIMER'S DISEASE INITIATIVE INVOICE REPORT SCHEDULE
35
ATTACHMENT VIII
ALZHEIMER'S DISEASE INITIATIVE PROGRAM BUDGET SUMMARY
36
ATTACHMENT IX
REQUEST FOR PAYMENT DOEA FORM 106Z
37
ATTACHMENT X
RECEIPTS AND EXPENDITURES REPORT, DOEA FORM 105Z
38
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STATEMENT OF WORT{
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
SECTION I: SERVICES TO BE PROVIDED
1.1 DEFINITIONS OF CONTRACT TERMS AND ACRON10,-
1.1.1 '' —LNITIONS C %iy ACkONYMS
Alzheimer's Disease (AD)
Alzheimer's Disease Initiative (ADI)
Activities of Daily Living (ADL)
Assessed Priority Consumer List (APCL)
Adult Protective Services (APS)
Client Information and Registration Tracking System XIRTS)
Community Care for Disabled Adults (CCDA)
Department of Elder Affairs (DOEA)
Home Care For Disabled Adults (HCDA)
Instrumental Activities of Daily Living (IAilL)
Memory Disorder Clinic (MDC)
Planning and Service Area (PSA)
1.1.2 PROGRAM SPECIFIC TERMS
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ADI 203.12
ATTACHMENT I
Aging Out Clients: Individu aching 60 ;ears of age who are being transitioned from the Department of
Children and Families Servi_ �s Conumuni0, Care for Disabled Adults (CCDA) or Home Care for Disabled
Adults (HCDA) services to th ')epartmer 3 community -based services.
Area Plan: A plan developed by th, _,ency outlining a comprehensive and coordinated service delivery system
in the respective planning and se �e area, in accordance with the Section 306 of the OIder Americans Act (42
U.S.C. 3026) and Departine"' instructions. The Area Plan includes performance measures and unit rates per
service offered per county.
Area Plan Update: /-; rev; -`,n to the Area Plan wherein the Agency enters ADI specific data into the CIRTS.
An ul)( -ate may also inc_ :r revisions to the Area Plan as instructed by the Department.
Ftencflnnal Assessmeaft- a 111sive, systematic, and multidimensional review Of person's ability to remain
independent and in the least restrictive tiviug arrangement. DOER Form 701B is used by case managers to con
the functional assessment. b duct
Memory Disorder C : research oriented programs created pursuant to Sections 430.502(1) and (2), F.S., to
provide diagnostic and referral services, condl-ct hacic and service_
develop training materials and educational opportunities for lay and prof ssi nalcaregiverslof individuals with
AD.
Model Day Care: A program of therapeutic, social and health activities specific to clients with memory
disorders. Services and activities include, but are not limited to, active and quiet games, reminiscence, validation
therapy, pet therapy, water therapy and other failure free activities appropriate to the cIient's Level of functioning.
Model day care centers will also provide training for health care and social service personnel in the care of
persons having AD or related memory disorders.
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July 2012- June 2014 ADI 203.12
1.2 GENERAL DESCRIPTION
1.2.1 General Statement
The ADI program provides a continuum of services addressing the special needs of individuals with AD, their
families and caregivers.
1.2.1.1 Alzheimer's Disea_^ T- ;,- ;_tive Pro -r-- Mis0m, et;Ete lent
The ADI program ensures that persons afflicted with AD and other forms of dementia are given essential
services to help them age in place in an elder - friendly environment with security, dignity, and purpose. The
program support to family members and caregivers of persons afflicted with AD.
1.2.2 Authority
The relevant authority governing the Alzheimer's Disease Initiative Program are as follows:
(1) Rule Chapter 58D -1, Florida Administrative Code; and
(2) Sections 430.501 through 430.504, Florida Statutes.
1.2.2.1 Incorporation of Reference Memoranda
In accordance with s. 287 F.S., as amended, and Department of Financial Services' Chief Financial Officer
Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by
reference:
(1) CFO Memo No. 02: Release date, August 20, 2010;
(2) CFO Iv err, No. 03: Release date, June 29, 2010; and
(3) CFO M1, no No. 06: Release date, June 30, 2010.
1.2.3 Scope of Se ice
The Recipi: .t is responsible for the programmatic, fiscal, and operational management of the ADI program. The
program se; vices shall be provided in a manner consistent with and described in the current Recipient's Request
for Propo., al, RFP, and the Agency's current area plan and the current Department of Eider Affairs Programs and
Services Handbook.
1.2A Major Program Goal
The major goal of the ADI program is to provide services to icet the needs of caregivers and individuals with
AD and related memory disorders.
1.3 INDIVIDUALS TO BE SERVED
1.3.1 General Eligibility
The ADI Program addresses the special needs of individual- 4th AD and their caregivers.
1.3.2 Individual Eligibility
Those individuals eligible to receive services under this contract m * `.' following conditions:
{l} Be 18 years of age or older and have a diagnosis of AD or .-A related disorder, or be suspected of having AD
or a related disorder; and
(2) Not be enrolled in a Medicaid capitated long -term care j-)rograin.
1.3.3 Targeted Groups
Priority for services under this contract will be given to those eligible persons assessed to be at risk of placement
in an institution.
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SECTION H: MANNER OF SERVICE PROVISION
2.1 SERVICE TASKS
In order to achieve the goals of the ADI program, the Recipient shall ensure the following tasks are performed:
(1) Client eligibility determination;
(2) Assessment and prioritizatirr - � ^ rvice delivery for new �i �•, +�•
(3) Delivery of services to eligible clients; and
(4) monitor the performance of subcontractors.
2.1.1 Client Eligibility Determinatw"
The Recipient shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a
client is based on meeting the requirements described in this ATTACHMENT I, SECTION 1.3.
2.1.2 Assessment and Prioritization of Service Delivery for New Clients
The Recipient shall ensure the following criteria are used to prioritize new clients for service delivery. It is not
the intent of the Agency to remove existing clients from any services in order to serve new clients being
assessed and prioritized for service delivery.
2.1.2.1 Priority Criteria for Service Delivery
(1) Individuals in nursing homes under Medicaid who could be transferred to the community;
(2) Individuals in nursing homes whose Medicare coverage is exhausted and may be diverted to the
community;
(3) Individuals in nursing homes that are closing and can be discharged to the community;
(4) individuals whose mental or physical health ndition has deteriorated to the degree self care is not
ilossible, there is no capable caregiver, and inst 'innal placement will occur within 72 hours; and
(5) For the purpose of transitioning individuals ,vng CCDA and HCDA services through the Department
of Children and Families' Adult Services . , community -based services provided through DOEA when
services are not currently available, area a,,�mcy on aging staff and lead agency case managers will ensure
that "Aging Out" individuals are prioril. zed for services only after APS High Risk and Imminent Risk
individuals.
2.1.2.2 Priority Criteria for Service Deliver, for Other Assessed Individuals
The assessment and provision of sz:rviccs should always consider the most cost effective means of service
delivery. Functional impairment will be determined through the Agency and or Department's functional
assessment form adm piste: pplicant. The most frail individuals not prioritized as described in this
attachment, Para graph 2.1 , r will receive servi -es to the extent funding is available.
2.1.3 i.L,., � ^Ic i,_s to Eligible CY
The Recipient shall ensure the p- rsion of a continuum of services addressing the diverse needs of individuals
with AL w. ,a,Pni rs. `FhP r r 0-11 ens,, - scm,4c °s are performed in accordance with the current
Department i:ider Affairs Programs and Services I )ok. Services categories include:
(1) Caregiver Training /Support;
(2) Case Aid;
(3) Case Management;
(4) Counseling (Gerontological);
(5) Counseling (Mental Health/Screening);
(6) Education/Training;
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(7) Model Day Care;
( 8) Respite (Facility- Based);
( 9) Respite (In- Home); and
(10) Specialized Medical Equipment, Services, and Supplies.
Caregivers benefit from receiving training, respite and related support services to assist them in caring for the
ADI client.
2.1.4 Use of Subcontractors
If ilis contra;., it Lhe use of a subcontractor or third party, then the Recipient the
implementation of its agreement with the „ti :,,actor. If any circumstances occur that may shall
in aadelay
for a period of 60 days or more of the initiation of the subcontract or in the performance of the subcontractor,
Recipient shall notify the Contract Manager and the Agency's Director of Finance in writing of such delay. the
2.1.4.1 The Recipient shall not permit a subcontractor to perform services related to this agr
Agency will not be res eement without having a
binding subcontractor agreement executed. In accordance with Section 24.1 of the Standard Contract, the
ponsible or liable for any obligations or claims resulting from such action.
2.1.4.2 Monitoring the Performance of Subcontractors
The Recipient will monitor at least once per year each of its subcontractors, subrecipients, vendors and/or
consultants paid from funds provided under this contract. The Recipient will 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 Recipient will 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.
2.2 SERVICE TIMES
.2.1 Service Times
The Recipient shall ensure the services listed in this contract are available at times appropriate to meet client
service needs, at a minimum, during normal business hours. Normal business hours are defined as Monday
through Friday, 8:00 a.m. to 5:00 p.m.
23 DELIVERABLES
2.3.1 Service Unit
The Recipient shall ensure the provision of the services de bed in the contract in accordance with the
current Department of Elder Affairs Programs and Servic [andbe and the service tasks described in
Section 2.1. The chart below lists the type of services alloy and 0 -ait of measurement. Units of service
will be paid pursuant to the rate established in this con' ct as al
rre ortin re uv,enients. and approved by the Agency's
vice e V F egiver Training /Support; -
iJu
Case Aid;
' -T
Case Management;
Counseling (Gerontological);
Counseling (Mental Health/Screening);
Respite (Facility - Based);
Respite (In- Home);
Hour
Hour
Hour
No
F,)Ur
Education/Training;
Specialized Medical Equipment, Services, and
Supplies.
Episc
Episode
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2.4 REPORTS Aft-
The Recipient shall respond to additional routine and/or special requests for information and reports required by
the Agency in a timely manner as determined by the Contract Manager. The Recipient shall establish due d_ ates
for any subcontractors that permits the Recipient to meet the Agency's reporting requirements.
2.4.1 Client Information and Registration Tracking System ( CIRTS)
The Recipient shall input ADI specific data into CIRTS database system to ensure CIRTS data accuracy. The
Recipient shall use CIRTS generated reports which include the following:
(1) Client Reports;
(2) Monitoring Reports;
(3) Services Reports;
(4) Miscellaneous Reports;
(5) Fiscal Reports;
(6) Aging and Disability Resource Center Reports; and
(7) Outcome Measurement Reports.
2.4.2 Service Costs Reports
The Recipient shall require its subcontractors to submit to it the Recipient semi - annual service cost reports,
February 15 and August 15 of each year, which reflect actual costs of providing each service by program. This
report provides information for planning and negotiating unit rates.
2.4.3 Surplus/Deficit Report
The Recipient shall submit a consolidated surplus /deficit report in a format provided by the Agency to the
Contract Manager by the 18th of each month. This report is for all agreements and/or contracts between the
Recipient and the Agency. This report will include the following:
(1) The Recipient's detailed plan on how the surplus or deficit spending exceeding the threshold specified by
the Agency will be resolved; and
(2) Recommendations to transfer funds to resolve surplus; ' :;ficit spending;
2.5 RECORDS AND DOCUMENTATION
2.5.1 The Recipient shall ensure the collection and maintenance e_ client and service information on a monthly basis
from the CIRTS or any such system designated by the Agency and the State of Florida Department of Elder
Affairs. Maintenance includes valid exports and backups of _;II data and systems according to Department and/or
Agency standal-ds.
2.5.2 Each Recipient and subcontractor, among other rep u`nlerits, ust anticipate and prepare for the loss of
information processing capabilities. The routine bacr :. :.� up of r' data and software is required to recover from
losses or outages of the computer system. Data and software sential to the continued operation of Recipient
functions must be backed up. The security controls over t' j backup resources shall be as stringent as the
protection required of the primary resources. It is recommer :.d that a copy of the backed up data be stored in a
secure, offsite location. The Recipient shall maintain yr .tten policies and procedures for computer system
backup and recovery and shall have the same requirement a its contracts and/or agreements with subcontractors.
These policies and procedures shall be made available to _ ie Agency upon request.
2.6 PERFORMANCE SPECIFICATIONS
2.6.1 Outcomes
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(1) The Recipient shall ensure services provided under this contract are in accordance with the current
Department of Elder Affairs Programs and Services Handbook.
(2) The Recipient shall timely submit to the Agency all reports described in ATTACHMENT I, SECTION
2.4 REPORTS; and
(3) The Recipient shall timely submit to the Agency all information described in ATTACHMENT I,
SECTION 2.5 RECORDS AND DOCUMENTATION.
2.6.2 The Recipient shall develop and document strategies in the Request for Proposal (RFP) to support performance
achievement of the following:
(1) Percent of most frail elders who remain at home or in the community instead of going into a nursing
home;
(2) Average monthly savings per consumer for home and community -based care versus nursing home care
for comparable client groups;
(3) Percent of elders assessed with high or moderate risk environments who improved their environment
score;
(4) Percent of new service recipients with high -risk nutrition scores whose nutritional status improved;
(5) Percent of new service recipients whose ADL assessment score has been maintained or improved;
(6) Percent of new service recipients whose IADL assessment score has been maintained or improved;
(7) Percent of family and family- assisted caregivers who self -report they are very likely to provide care;
(8) Percent of caregivers whose ability to provide care is maintained or improved after one year of service
intervention (as determined by the caregiver and the assessor); and
(9) Percent of customers who are at imminent risk of nursing home placement who are served with
community -based services.
The Recipient's performance of these measures will be documented in the Agency's annual monitoring
reports.
2.7 RECIPIENT'S FINANCIAL OBLIGATIONS
2.7.1 Cost Sharing and Co- payments
The Recipient shall establish annual co- payment goals. The Agency has the option to withhold a portion of the
Recipient's request for payment if goals are not met according to the Agency and the Department of Elder
Affairs' co- payment guidelines.
2.7.1.1 Co- payments include only the amounts assessed consumers or the amounts consumers opt to contribute in lieu of
an assessed co- payment. The contribution must be equal to or greater thai: the assessed co- payment.
2.7.2 Use of Service Dollars and Assessed Priority Consumer List Manag rent
The Recipient is expected to spend all federal, state and other fund, .)rovided by the Agency for the purpose
specified in each contract. The Recipient must manage service fund-. . in such a manner so as to avoid having a
wait list and a surplus of funds at the end of the contract period for each program managed by the Agency. If the
Agency determines that the Recipient is not spending service funds accordingly, the Agency may transfer funds
to other planning and service areas during the contract period and/or adjust subsequent funding allocations
accordingly, as allowable under state and federal law.
AGENCY RESPONSIBILITIES
2.8.1 Program Guidance and Technical Assistance
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The Agency will provide the Recipient with guidance and toelmical assistance as needed to ensure the successful
fulfillment of the contract by the Recipient.
2.8.2 Contract Monitoring
The Agency will review and evaluate the performance of the Recipient under the terms of this contract.
Monitoring shall be conducted through direct contact with the Recipient through telephone, in writing, or an on-
site visit. The Agency's determination of acceptable performance shall be conclusive. The Recipient 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:
(I) Desk reviews and analytical reviews;
(2) Scheduled, unscheduled and follow -up on -site visits;
(3) Client visits;
(4) Review of independent auditor's reports;
(5) Review of third -party documents and/or evaluation;
(6) Review of progress reports;
(7) Review of customer satisfaction surveys;
(8) Agreed -upon procedures review by an external auditor or consultant;
(9) Limited -scope reviews; and
(10) Other procedures as deemed necessary.
SECTION III: METHOD OF PAYMENT
3.1 General Statement of Method of Payment
The method of payment for this contract includes advances, cost reimbursement for administration costs, and
fixed rate for services. The Recipient shall ensure fixed rates for services include only those costs that are in
accordance with all applicable state and federal statutes and regulations and are based on audited historical costs
in instances where an independent audit is required. The Recipient shall consolidate all requests for payment
from subcontractors and expenditure reports that support requests for payment and shall submit to the Agency on
forms 106Z (ATTACHMENT IX) and 105Z (ATTACHMENT X).
3.1.1 The Recipient agrees to distribute funds as detailed in the area plan update and the Budget Summary,
ATTACHMENT VIII to this contract. Any changes in the total amounts of funds identified on the Budget
Summary form require a contract amendment.
3.2 Advance Payments
3.2.1 The Recipient may request up to two months of advances at the start of the contract period to cover program
administrative and service costs. The schedule for submission of advance requests, if available, is shown on
ATTACHMENT VII to this contract. The payment of an advance will be contingent upon the sufficiency and
amount of funds released to the Agency and the State of Florida Department of Elder Affairs ( "budget release"),
The Recipient shall provide the Contract Manager documentation justifying the need for an advance and
describing how the funds will be distributed.
3.2.2 The Recipient's requests for advance require the approval of the Contract Manager. If sufficient budget is
available, the Agency will issue approved advance payments after July I, 2011.
3.2.3 All advance payments made to the Recipient shall be returned to the Agency as follows: one — twelfth of the
advance payment received shall be reported as an advance recoupment on each request for payment, starting with
report number three, in accordance with the Invoice Schedule, ATTACHIIZENT VII to this contract,
3.2.4 The Recipient may temporarily place advanced funds in a FMC insured interest bearing account. All interest
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earned on contract fund advances must be returned to the Agency within thirty (30) days of the end of each
quarter of the contract period.
3.3 Invoice Submittal and Requests for Payment
All requests for payment and expenditure reports submitted to support requests for payment shall be on DOEA
forms 106Z (ATTACHMENT X) and 105Z (ATTACHMENT XI).
3.3.1 All payment requests shall be based on the submission of actual monthly expenditure reports beginning with the
first month of the contract. The schedule for submission of advance requests (when available) and invoices is
ATTACHMENT VHI to this contract.
3.2 Advance Payments
3.2.1 The Recipient may request up to two months of advances at the start of the contract period to cover program
administrative and service costs. The payment of an advance will be contingent upon the sufficiency and amount
of funds released to the Department by the State of Florida ( "budget release "). The Recipient shall provide the
Contract Manager documentation justifying the need for an advance and describing how the funds will be
distributed.
3.2.2 The Recipient's requests for advance require the approval of the Contract Manager. If sufficient budget is
available, the Agency will issue approved advance payments after July 1, 2012.
3.2.3 All advance payments made to the Recipient shall be returned to the Agency as follows: one — twelfth of the
advance payment received shall be reported as an advance recoupment on each request for payment, starting with
report number three, in accordance with the Invoice Schedule, ATTACHMENT VII to this contract.
3.2.4 The Recipient may temporarily place advanced funds in a FL insured interest bearing account. All interest
earned on contract fund advances must be returned to the A icy within thirty (30) days of the end of each
quarter of the contract period.
3.3 Invoice Submittal and Requests for Payment
All requests for payment documentation and expenditure reports submitted to support requests for payment
shall be on DOEA forms 106Z (ATTACHMENT IX) and 105Z (ATTACHMENT X).
3.3.1 Remedies - Nonconforming Services
The Recipient shall ensure that all goods and/or servic, provided trnde- contract are delivered timely,
completely and commensurate with reCtai.cu Sla.� , . r S �, and/or services will only be
delivered to eligible program participants.
If the Recipient fails to meet the prescribed quali- _,wards fr :services, such services will not be reimbursed
under this contract. In addition, any nonconform ; goods (in( _., t;ome delivered meals) and/or services not
meeting such standards will not be reimbursed r;;der this cor sct. The Recipient's signature on the request for
payment form certifies maintenance of supporting documer ion and acknowledgement that the Recipient shall
solely bare the costs associated with preparing or providir nonconforming goods and/or services. The Agency
and or Department require immediate notice of any sigr .cant and/or systemic infractions that compromise the
quality, security or continuity of services to clients.
3.3.2 Financial Consequences
Recipient shall ensure the provision of services to the projected number of clients in accordance with the Area
Plan as updated and within the contract amount. The Recipient shall ensure expenditure of 100% of the
contract amount budgeted for services to clients at the unit rates established in the Area Plan. In the event the
Recipient has a surplus of 1% or more at the end of the first year of the contract term, the Agency will
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reallocate I% of the budget for the second year of the contract term to other area agencies found to be serving
clients to the fullest extent of their allocated budgets. If, or to the extent, there is any conflict between this
paragraph and paragraphs 39 and 39.1 of the standard contract, this paragraph shall have precedence.
3.3.3 All payment requests shall be based on the submission of actual monthly expenditure reports beginning with the
first month of the contract. The schedule for submission of advance requests (when available) and invoices is
ATTACHMENT VII to this contract.
3.3.4 Payment may be authorized only for allowable expenditures, which are in accordance with the limits specified in
ATTACHMENT VIII; Budget Summary.
3.3.5 Any payment due by the Agency under the terms of this contract may be withheld pending the receipt and
approval by the Agency of all financial and programmatic reports due from the Recipient and any adjustments
thereto, including any disallowance not resolved as outlined in Section 26 of this contract.
3.3.6 Date for Final Request for Payment
The final request for payment for contract year one's expenditures will be due to the Agency no
later than August 1, 2013. The final request for payment for contract year two expenditures will be
no later than August 1, 2014.
3.4 Documentation for Payment
The Recipient shall maintain documentation to support payment requests that shall be available to the Agency or
authorized individuals, such as the Department of Financial Services, upon request.
3.4.1 The Recipient must enter all required data per the Department's CIRTS Policy Guidelines for clients and services
in the CIRTS database. The data must be entered into the CIRTS before the Recipient submits their request for AMC
payment and expenditure reports to the Agency. The Agency shall establish time frames to assure compliance{;.
with due dates for the requests for payment and expenditure reports to the Agency and the Department.
3.4.2 The Recipient must run monthly CIRTS reports and verify that the client and service data in the CIRTS is
accurate. This report must be submitted to the Agency with the monthly request for payment and expenditure
report and must be reviewed by the Agency before the Recipient's request for payment and expenditure reports
can be approved by the Agency.
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ATTACHMENT II
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND
AGREEMENTS
The undersigned ce! tifies, to the best of his or her knowledge and belief, that:
(1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of any state or federal agency, a member of congress, an
officer or employee of congress, an employee of a member of congress, or an officer or employee of the state
legislator, in connection with the awarding of any federal grant, the making of any federal loan, the entering into of
any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal
contract, grant, loan, or cooperative agreement.
(2) If any funds other than federal appropriated. funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a member of congress, an officer or employee of
congress, or an employee of a member of congress in connection with this federal contract, grant, loan, or cooperative
agreement, the undersigned shall complete and submit Standard Form -LLL, 'Disclosure Form to Report Lobbying,"
in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents for all sub -
awards at all tiers (including subcontracts, sub - grants, and contracts under grants, loans and cooperative agreements)
and that all subcontractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made
or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed
by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil
penalty of not less than $1 0,000 and not more than $100,000 for each such failure.
Signature
Name of Authorized Individual
Collier County Board of
Commissioners
3299 Tamiami Trail E
Naples, FL 34112
�7' (1
Date
Application or Agreeme, : Number
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FINANCIAL AND COMPLIANCE AUDIT ATTACHMENT I
The administration of resources awarded by the Area Agency on Aging for Southwest Florida, Inc.dba Senior Choices of
Southwest Florida and/or the Department of Elder Affairs to the provider may be subject to audits and/or monitoring by the
Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and/or the Department of
Elder Affairs as described in this section.
MONITORING
In addition to reviews of audits conducted in accordance with OMB Circular A -133, as revised, and Section 215.97, F.S., (see
"AUDITS" below), monitoring procedures may include, but not be limited to, on -site visits by the Agency staff, Iimited scope
audits as defined by OMB Circular A -133, as revised, and/or other procedures. By entering into this agreement, the provider
agrees to comply and cooperate with any monitoring procedures /processes deemed appropriate by the Area Agency on Aging
for Southwest Florida, Inc. In the event the Area Agency on Aging for Southwest Florida, Inc. determines that a limited scope
audit of the provider is appropriate, the provider agrees to comply with any additional instructions provided by the Area Agency
on Aging for Southwest Florida, Inc. to the provider regarding such audit. The provider further agrees to comply and cooperate
with any inspections, reviews, investigations, or audits deemed necessary by the 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 $500,000 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 I to this
agreement indicates federal resources awarded through the Area Agency on Aging for Southwest Florida, Inc. Senior .
Choices of Southwest Florida and/or the Department of Elder Affairs by this agreement. In determining the federal awards
expended in its fiscal year, the provider shall consider all sources of federal awards, including federal resources received from
the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and/or the Department of Elder
Affairs. The determination of amounts of federal awards expended should be in accordance with the guidelines established by
OMB Circular A -133, as revised. An audit of the provider conducted by the Auditor General in accordance with the provisions
of OMB Circular A -133, as revised, will meet the requirements of this part.
In connection with the audit requirements addressed in Part I, paragraph 1, the provider shall fulfill the requirements relative to
auditee responsibilities as provided in Subpart C of OMB Circular A -133, as revised.
If the provider expends less than $500,000 in federal awards in its fiscal year, an audit conducted in accordance with the
provisions of OMB Circular A -133, as revised, is not required. In the event that the provider expends less than $500,000 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 fi•om other than federal entities.)
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Area Agency on Aging for Southwest Florida, Inc. and/or the Department
of Elder Affairs shall be based on the agreement's requirements, including ar_, rules, regulations, or statutes referenced in the
agreement. The financial statements shall disclose whether or not the ma ::ring requirement was met for each applicable
agreement. All questioned costs and Iiabilities due to the Area Agency on Aging for Southwest Florida, Inc. dba Senior
Choices of Southwest Florida and/or the Department of EIder Affairs shall 1)2 fully disclosed in the audit report with reference
to the Area Agency on Aging for Southwest Florida, Inc. and/or the Depar ;ment of Elder Affairs agreement involved. If not
otherwise disclosed as required by Section .310(b)(2) of OMB Circular A -133, as revised, the schedule of expen ditures of
federal awards shall identify expenditures by agreement number for each agreement with the Area Agency on Aging for
Southwest Florida, Inc. dba Senior Choices of Southwest Florida and/or the Department of Elder Affairs in effect during the
audit period. Financial reporting packages required under this part m� t 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.
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PART H: STATE FUNDED
This part is applicable if the provider is a nonstate entity as defined by Section 215.97(2), Florida Statutes.
In the event that the provider expends a total amount of state financial assistance equal to or in excess of $500,000 in any fiscal
year of such provider (for fiscal years ending September 30, 2004 or thereafter), the provider must have a State single or
project- specific audit for such fiscal year in accordance with Section 215.97, Florida Statutes; applicable rules of the
Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for - profit
organizations), Rules of the Auditor General. EXHIBIT 1 to this agreement indicates state financial assistance awarded through
the Area Agency on Aging for Southwest Florida, Inc. and/or the Department of Elder Affairs by this agreement. In
determining the state financial assistance expended in its fiscal year, the provider shall consider all sources of state financial
assistance, including state financial assistance received from the Area Agency on Aging for Southwest Florida, Inc.dba Senior
Choices of Southwest Florida and/or the Department of Elder Affairs, other state agencies, and other nonstate entities. State
financial assistance does not include federal direct or pass - through awards and resources received by a nonstate entity for
federal program matching requirements.
In connection with the audit requirements addressed in Part II, paragraph 1, the provider shall ensure that the audit complies
with the requirements of Section 215.97(8), Florida Statutes. This includes submission of a financial reporting package as
defined by Section 215.97(2), Florida Statutes, and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for -
profit organizations), Rules of the Auditor General.
If the provider expends less than $500,000 in state financial assistance in its fiscal year (for fiscal years ending September 30,
2004 or thereafter), an audit conducted in accordance with the provisions of Section 215.97, Florida Statutes, is not required. In
the event that the provider expends less than $500,000 in state financial assistance in its fiscal year and elects to have an audit
conducted in accordance with the provisions of Section 215.97, Florida Statutes, the cost of the audit must be paid from the
nonstate entity's resources (i.e., the cost of such an audit must 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 Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of
Southwest Florida and/or the Department of Elder Affairs shall be based on the agreement's requirements, including any
applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching requirement was
met for each applicable agreement. All questioned costs and liabilities due to the Area Agency on Aging for Southwest Florida,
Inc. dba Senior Choices of Southwest Florida and/or the Department of Elder Affairs shall be fully disclosed in the audit report
with reference to the Area Agency on Aging for Southwest Florida, Inc. and/or the Department of Elder Affairs agreement
involved. If not otherwise disclosed as required by Rule 69I- 5.003, Fla. Admin. Code, the schedule of expenditures of state
financial assistance shall identify expenditures by agreement number for each agreement with the Area Agency on Aging for
Southwest Florida, Inc. dba Senior Choices of Southwest Florida and/or the Department of Elder Affairs 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 Iater than 9 months after the
provider's fiscal year end. Notwithstanding the applicability of this portion, the Area Agency on Aging for Southwest Florida,
Inc. dba Senior Choices of Southwest Florida and/or the Department of Elder Affairs retains all right and obligation to monitor
and oversee the performance of this agreement as outlined throughout this document and pursuant to law.
PART III: REPORT SUBMISSION
Copies of reporting packages for audits conducted in accordance with OMB Circular A -133, as revised, and required by PART I
of this agreement shall be submitted, when required by Section .320 (d), OMB Circular A -133, as revised, by or on behalf of the
provider directly to each of the following:
The Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida at the following address:
Area Agency on Aging for Southwest Florida, Inc.
dba Senior Choices of Southwest Florida
Attn: Leigh Wade, Executive Director
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
Packet Page -2754-
July 2012- June 2014 7/24/2012 Item 16.D.15.
ADI 203.12
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
following address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10Th Street
-Tefferconville. 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 " .320(f), OMB Circular A -133, as revised, the provider sha11 submit a copy of the
described in Section .320(,), C :; � Circular A -133, as revised, and any management Ietter issued by the audittor,rto the Area
Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida at the following address:
Area Agency on Aging for Southwest Florida, Inc.
dba Senior Choices of Southwest Florida
Attn: Leigh Wade, Executive Director
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. dba Senior Choices of Southwest Florida at the following address:
Area Agency on Aging for Southwest Florida, Inc.
dba Senior Choices of Southwest Florida
Attn: Leigh Wade, Executive Director
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
CIaude Pepper Building, Room 574
111 West Madison Street
Tallahassee, Florida 32399 -1450
Any reports, management letter, or other information required to be submitted to the Area Agency on Aging for Southwest
Florida, Inc. pursuant to this agreement shall be submitted timely in accordance with OMB Circular A -133, Florida Statutes,
and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for -profit organizations), Rules of the Auditor
General, as applicable.
Providers, when submitting financial reporting packages to the Area An(-_,;y on Aging for Southwest Florida, Inc. for audits
done in accordance with OMB Circular A -133 or Chapters 10.550 (It�cal governmental entities) or 10.650 (nonprofit and for -
profit organizations), Rules of the Auditor General, should indica ?:' Lite Mate That the reporting package was delivered to the
provider in correspondence accompanying the reporting package.
PART IV: RECORD RETENTION
The provider shall retain sufficient records demonstrating its compliancy with the terms of this agreement for a period of six
years from the date the audit report is issued, and shall allow the Area )' oency on Aging for Southwest Florida, Inc. dba Senior
Choices of Southwest Florida and or the Department of Elder Affairs 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 Area Agency on Aging for
Southwest Florida, Inc. dba Senior Choices of Southwest Florida and/or the Department of Elder Affairs, or its designee, CFO,
or Auditor General upon request for a period of six years from the date the audit report is issued, unless extended in writing by
the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and/or the Department of Elder
Affairs.
Packet Page -2755-
July 2012- June 2014
7/24/2012 Item 16.D.15.
ADI 203.12
ATTACHMENT III
EXHIBIT —1
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS
AGREEMENT CONSIST OF THE FOLLOWING:
PROGRAM TITLE
TOTAL FEDERAL AWARD
FUNDING SOURCE CFDA I IOUNT
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT
TO THIS AGREEMENT ARE AS FOLLOWS:
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT
CONSIST OF THE FOLLOWING:
MATCI -IING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD
STATE FINANCIAL ASSISTANCE SUBJECT TO CPr I t c ory 1p c
PROGRAM TITLE
Alzheimer's Disease Initiative
FUNDING SOURCE
General Revenue
CSFA AMOUNT
65004 $94,719.00
TOTAL AWARD
$94,719.00
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO
THIS AGREEMENT ARE AS FOLLOWS:
Packet Page -2756-
July 2012- June 2014
PART I: AUDIT RELATIONSHIP DETERMINATION
7/24/2012 Item 16.D.15.
ADI 203.12
ATTACHMENT III
EXHIBIT -2
Providers who receive state or federal resources may or may not be subject to the audit requirements of OMB Circular A -133, as
revised, and/or Section 215.97, Fla. Stat. Providers who are determined to be recipients or subrecipients of federal awards and/or state
financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I and/or Part II of
Exhibit 1 are met. Providers who have been determined to be vendors are not subject to the audit requirements of OMB Circular A-
133, as revised, and/or Section 215.97, Fla. Stat. Regardless of whether the audit requirements are met, providers who have been
determined to be recipients or subrecipients of Federal awards and /or state financial assistance, must comply with applicable
programmatic and fiscal compliance requirements.
In accordance with Sec. 210 of OMB Circular A -133 and/or Rule 691 - 5.006, FAC, provider has been determined to be:
Vendor or exempt entity and not subject to OMB Circular A -133 and /or Section 215.97, F.S.
X Recipient/subrecipient subject to OMB Circular A -133 and/or Section 215.97, F.S.
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 69I- .006(2), FAC [state financial assistance] and
Section — .400 OMB Circular A -133 [federal awards].
PART II: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Providers who receive Federal awards or
state matching funds on Federal awards and who are determuned to be a subrecipient, must comply with the following fiscal laws,
rules and regulations:
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR Part 225 Cost Principles for State, Local and Indian Tribal Governments (Formerly OMB Circular A -87)*
OMB Circular A -102 — Administrative Requirements
OMB Circular A -133 — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
NON - PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR Part 230 Cost Principles for Non -Profit Organizations (Formerly OMB Circular A -122 — Cost Principles)*
2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A -110 — Administrative Requirements)
Requirements)
OMB Circular A -133 — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT) MUST
FOLLOW:
2 CFR Part 220 Cost Principles for Educational Institutions OMB (Formerly Circular A -21 — Cost Principles)*
2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A -110 — Administrative Requirements)
OMB Circular A -133 —Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in the OMB Circular
A -133 Compliance Supplement, Appendix 1.
STATE FINANCIAL ASSISTANCE. Providers who receive state financial assistance and who are determined to be a
recipient/subrecipient, must comply with the following fiscal laws, rules and regulations:
Section 215.97, Fla. Stat.
Chapter 69I -5, Fla. Admin. Code
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
Packet Page -2757-
July 2012- June 2014 7/24/2012 Item 16.D.15.
ADI 203.12
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE ATTACHMENT IV
FOR AGREEMENTS, GRANTS, LOANS AND
COOPERATIVE AGREEMENTS
The undersigned, an authorized representative of the Recipient named in the contract or agreement to which this form is
an attachment, hereby certifies that:
(1) The Recipient and any 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 Recipient, subcontractor(s), or any outside entity on which the
Recipient is dependent for data that is to be reported, transmitted or calculated, have been assessed and verified to be
capable of processing data accurately, including year -date dependent data. For those systems identified to be non-
compliant, Recipient(s) will take immediate action to assure data integrity.
(3) If this contract includes the provision of hardware, software, firmware, microcode or imbedded chip technology, the
undersigned warrants that these products are capable of processing year -date dependent data accurately. All versions
of these products offered by the Recipient (represented by the undersigned) and purchased by the State will be
verified for accuracy and integrity of data prior to transfer.
In the event of any decrease in functionality related to time and date related codes and internal subroutines that
impede the hardware or software programs from operating properly, the Recipient agrees to immediately make
required corrections to restore hardware and software programs to the same level of functionality as warranted herein,
at no charge to the State, and without interruption to the ongoing business of the state, time being of the essence.
(4) The Recipient and any subcontractor(s) of services under this contract warrant their policies and procedures include a
disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from
data integrity compliance issues.
The Recipient shall require that the language of this certification be included in all subagreements, subgrants, and other
agreements and that all 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 215 (formerly OMB Circular A -110).
Name and Address of Recipient °— t
lr
Signature "s � a 7
Tithe Date
Name of Authorized Signer ,....
jollier County Board of
3mmissioners
.299 Tamiami Trail E
Naples, FL 34112
Packet Page -2758-
July 2012- June 2014
7/24/2012 Item 16.D.15.
ADI 203.12
C ATTACHMENT V
ERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND
VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS
(1) The prospective Recipient certifies, by signing this certification, neither it nor its principals rinci al s is presently
debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in
tiiiS trdiiSa l f
"y ally
(2) Where the prosPe�,Ive Recipien± is unable to certify to any of the statements in this certification, such
prospects r -. acipant shall attach an explanation to this certification.
A(.
Signature
Title
lZA
Date
Agency/Organization
(Certification signature should be same as Contract signature.)
Instructions for Certification -° — - -�'
L The terms "covered transaction," "debarred " "
If covered transaction," and "voluntarily excluded," "ineligible,,, "lower tier covered transaction," "person,"
of rules implementing Executive Order 12549. (2 CFRa 180.5 80.1020a� s t supplemented set
by 2 in
CFR 3761 10- s
376.995). You may contact the Contract Manager for assistance in obtaining a copy of those regulations.
2. This certification is a material representation of facts upon which reliance was placed whent
this transaction. If it is later determined that the Recipient knowingly rendered an eirorieous certification, addition
n the parties ent ered into
to other remedies available to the federal government, the Department or Agency may pursue available remedies
including suspension and/or debarment,
3. The Recipient will provide immediate written notice to the Contract Manager if at any time the Recipient learns that
its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The
Recipient may decide the method and frequency by which it determines the eligibility of its principals. Each
participant to a lower tier covered transaction may, but is not required to, check the Excluded Parties List System
(EPLS).
4. The Recipient will include a "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion
- Lower Tier Covered Transaction" in all its lower tier covered transactions and in all solicitations for lower tier
covered transactions.
5. The Recipient agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is
debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise authorized
ederal government.
by the f
6. If the Recipient knowingly enters into a lower tier covered transaction with a person who is suspended, debarred
ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the
federal government, the Department or Agency
debarment. g Y ma Y pursue available remedies, including suspension, and/or
7. The Recipient may rely upon a certification of a prospective participant in a lower tier covered transaction that it is
not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the
certification is erroneous.
Packet Page -2759-
July 2012- June 2014 7/24/2012 item 16.D.15.
!11/1 LVJ. 1 L
ASSURANCES —NON- CONSTRUCTION PROGRAMS ATTACHMENT VI
Public reporting burden for this collection of information is estimated to average 45 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the
collection of information. - Send comments regarding the burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348- 0043),
Washington, DC 20503,
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET,
SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions, please contact the
awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances.
If such is the case, you will be notified.
1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including funds
sufficient to pay the non - Federal share ofproject cost) to ensure proper planning, management, and com pletion of the project
described in this application,
2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized
representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish
a proper accounting system in accordance with generally accepted accounting standards or agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the
appearance of personal or organizational conflict of interest, or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. 4728 -4763) relating to prescribed standards for merit
systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Merit
System of Personnel Administration (5 C.F.R 900, Subpart F).
6. Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil
Rights Act of 1964 (P.L. 88 -352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the
Education Amendments of 1972, as amended (20 U.S.C., 1681 -1683, and 1685 - 1686), which prohibits discrimination on the basis
of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C., 794), which prohibits discrimination on the basis
of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C., 6101 - 6107), which prohibits discrimination on the
basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92 -255), as amended, relating to nondiscrimination on
the basis of drug abuse; (� the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of
1970 (P.L. 91 -616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) 523 and S27 of the
Public Health Service Act of 1912 (42 U.S.C._ 290 dd -3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug
abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. 3601 et seq.), as amended, relating to
nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s)
under which application for Federal assistance is being made; and 0) the requirements of any other nondiscrimination statute {s)
which may apply to the application.
7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance and Real
Property Acquisition Policies Act of 1970 (P.L. 91 -646) which provide for fair and equitable treatment of persons displaced or
whose property is acquired as a result of Federal or federally assisted programs. These requirements apply to all interests in real
property acquired for project purposes regardless of Federal participation in purchases.
S. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C., 1501 -1508 and 7324 - 7328), which limit the political
activities of employees whose principal employment activities are funded in whole or in part with Federal funds.
9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C., 276a to 276a -7), the Copeland Act (40 U.S.C.
276c and 18 U.S.C., 874) and the Contract Work Hours and Safety Standards Act (40 U.S.C.. 327 -333), regarding labor standards
for federally assisted construction subagreements.
31
Packet Page -2760-
July 2012- June 2014 7/24/2012 Item 16.D.15.
11 J1 GU.3. 1 L
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of
1973 (P.L. 93 -234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood
insurance if the total cost of insurable construction and acquisition is $10,000 or more.
11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental
quality control measures under the National Environmental Policy Act of 1969 (P.L. 91 -190) and Executive Order (EO) 11514;
(b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of
flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State
management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C., 1451 et seq.); (f) conformity of
Federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42
U.S.C., 7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as
amended, (P.L. 93 -523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L.
93 -205).
12. Will comply with die Wild and Scenic Rivers Act of 1968 (16 U.S.C. 1721 et seq.) related to protecting components or potential
components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as
amended (16 U.S.C., 470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic
Preservation Act of 1974 (16 U.S.C.,469a -t et seq.).
14. Will comply with P.L. 93 -348 regarding the protection of human subjects involved in research, development, and related
activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89 -544, as amended, 7 U.S.C. 2131 et seq.) pertaining to the
care, handling, and treatment of warm blooded animals held for research, teaching, or other activi
assistance. ties supported by this award of
16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C., 4801 et seq.), which prohibits the use of lead- based
paint in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of
1996 and OMB Circular No. A -133, Audits of States, Local Governments, and Non -Profit Organizations.
18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing this
program.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL
APPLICANT ORGANIZATION
"RJ
TITLE
ZA
Packet Page -2761-
3 f
DATE SUBMITTED
(zq
q
July 201.2- June 2014
ALZHEIMER'S DISEASE INITIATIVE (ADI)
INVOICE SCHEDULE
7/24/2012 Item 16.D.15.
ADI 203.12
ATTACHMENT VII
Report
Number
Based On
Submit to Agency
I
July Advance*
On This Date
July 1
2
3
August Advance*
July 1
4
July Expenditure Report
Au August 15
5
August Expenditure Report
p
September 15
6
September Expenditure Report
October ] 5
7
October Expenditure Report
November 15
8
November Expenditure Report
December Dec
Dec er i 5
9
December Expenditure Report
January 5
10
January Expenditure Report
11
February Expenditure Report
March 1
1 5
12
March Expenditure Report
Aril
p
13
April Expenditure Report
May 15
14
E
May Expenditure Report
June 15
15
June Expenditure Report
JuI 15
y
16
Final Request for Payment
July 25
Closeout Report
August 1
Legend: * Advance based on projected cash need.
Note # 1: Report #1 for Advance Basis Contracts cannot be submitted to the Area Agency on Aging
for Southwest Florida, Inc. dba Senior Choices of Southwest Florida prior to July l or until
the contract with the Agency has been executed and a copy sent to Area Agency on Aging
for Southwest Florida, Inc. dba Senior Choices of Southwest Florida. Actual submission of the
vouchers to DFS is dependent on the accuracy of the expenditure report.
Note # 2: All advance payments made to the Reci - ient shall be returned to the Agency as follows:
one — twelfth of the advance payer at received Al be reported as an advance
recoupment on each request for pa;; ;r� ant, starti- with report number three. The
adjustment shall be recorded in Part C, 1 of the re, A (Attachment X).
Note # 3: Submission of expenditure .,t,; is may or -,aN. of Lyenerate a payment request. If final
expenditure report reflects funds c:� .r, ; k to j Agency, payment is to accompany the
report.
35
Packet Page -2762-
July 2012- June 2014
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
BUDGET SUMMARY
for
Collier County Board of County Commissioners
1. Respite
2. Case Management and Case Aide Allocation
3. Total
RATE SUMMARY
for
Collier County Board of County Commissioners
SERVICES
Case Management
Case Aide
In -Home Respite
Respite Facility
Specialized Medical Equipment,
Services and Supplies
36
Packet Page -2763-
7/24/2012 Item 16. D.15.
ADI 203.12
ATTACHMENT VIII
$93,969.00
750.00
$94,719.00
UNIT RATE
$55.50
$30.00
$24.44
$12.22
100% Reimbursement
July 2012- June 2014
REQUEST FOR PAYMENT
ALZHEIMERS DISEASE INITIATIVE PROGRAM
7/24/2012 Item 16.D.15.
ADI 203.12
ATTACHMENT IX
7tECIPIEN7NAld= , ADD Ri_,r'iy,p110N[kaid t'EIDfI
TYPE OF REPORT
T Request PadUd
A. PAYML•N1' kFULIL51;
Ragular _......_
Supplsnlanial it B. METHOD OF PAYMENT;
Advance Period
Raimbt,rcomont
CERTIFICATION: t IrOreby t ^rtiy to the tress of my knavvicdge that t1d5 request Is oonVele and correct and conforms with the terms and the Furroses 01 the abova contract.
Date: .— APpruved by;
PARTA: RUDG_TSUMMARY
t. Approved Conlracl Arnounl
2. Previous Fundo Rcn;,ived fur cordieul Perin!
'3. C:Onlrart Ralarw (ine 1 minus ine 2)
4. Provious Furds RaquO.910 and Nnl Recolved Iw Gont•tc: PedOd
ft c;ontrarl Halarr._n (kne 3 minus Ilne 4)
PAR I'R• [ :I7t4TRACT FUNDS RrQUEST
1. Anticipatod Cash Neede (1st • 2nd month, Attach Justi6ca:ion)
!.
Net Expenditutes For Month
(DOCA form 1052 Part 0. Una, 3)
TWAL
AR' c NF.T JFl.11JDS RE0l1F.,S7FU
Lac t Advanco Aapl ed
Contract Funds are HcrcbyPcquostcd for ,Pert R, Llre 3
m'(Ius Part C, Line t)
List of Services / Unas 1 Ra;os provided -See alladred repvd.
D0EA FORtvf 1067.
Raviscd 5rd1 i2
50.00
50.00
50.00
30 00
50.00
$0.00
30.00
80.00
$0,00
S0.00
$0.00 $0.00
50.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
37
Packet Page -2764-
De t0:
sn
July 2012- June 2014
7/24/2012 Item 16.D.15.
RECEIPT AND EXPENDITURE REPORT
ALZHEIMERS DISEASE INITIATIVE PROGRAM
From 'f0
Respite CONTRACT PERIOD:
Modal Day Care CONTRACT #
IREPORT #
(CERTIFICATION : I cerliy to the bast of my knowledge and balier the t the report is complete and
herein
are for purposes set fort
h in the wntrect.
correct
and all outlays
Proparod by: Oato ;
Approved by :
.__.......__dale:
PART A : BUDGETED INCOME/ RECEIPT 5
1. Approved
2, Actual Receipts
3.
Bu- at
For This Ro art
Total Recelpls
Year to Dole
I. States Funds
2. Program Income
$0 00
$0.00
$0.00
3. Local Cash Match
$0.00
$0.00
$0.00
•1. SUBTOTAL: CASH RECEIPTS
$0.00
50.00
SO.00
b. Local in -Kind Match
0. TOTAL RECEIPTS
$0.00
$0.00
$0.00
'At2 r 0 : LXPLNOITURI= S
1. Approved
2, Expenditures
Bud at __
For Thic Report,
3. Expenditures
Year 10 Uatc
1. Administrative Services
2. Service Subcontractor
Subcontractor(s)
$0.00
$0.00
$0.00
$o.o0
5a,ao
$0,00
3. TOTAL EXPENDITURES
50,00
$0.00
$0.00
PART C: OTHER REVENUE AND EXPENDII URES it. Interest:
L Prograrn hrcome (PI) I. Earned on GH Advance $
1. AD[: PI Collected YTD $ 2. Return of GR Advances $ ��
(Includes co- payments collected) 3. Other Earned $
PARI D :CO- f'AYMLNTS
t. Total of Co- payments assessed
2. Tutat or Co- payments wilectod
Wor Tracking Purposes only)
D011A FORM 1852
Ru• 6-j EP42010
CURRENT MONTH YEAR -TO -DATE
38
Packet Page -2765-
ADI 203.12
ATTACHMENT X
4. Percent of
woved Dud at
#DIV /01
BD1V /Ol
HD1V /Ot
HDIV /01
4. POrCOnt of
l Pj xoved IluLdILei_ -.
#DIWOI ,.
FIDI V /Ot
#DIV /Di
Ill, Advance Rocouped
7/24/2012 Item 16.D.15.
Attestation Statement
Agreement /Contract Number ADI 203.I2
Amendment Number
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 dba as Senior Choices of Southwest Florida and
Collier County Board of 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.
Steve Carnell, Interim Administrator
Collier County Public Services Division
Date
Packet Page -2766-
7/24/2012 Item 16.D.15.
Verification of Employment Status Certification
As a condition of contracting with the Area Agency on Aging for Southwest Florida, Inc. dba
Senior Choices of Southwest Florida, Collier County Board of County Commissioners, hereby
referred to as Recipient, 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 Recipient during the
contract term to perform employment duties pursuant to this Agreement 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 contract term.
Signature
(Same as contract signature)
Steve Carnell, Interim Administrator
Collier County Public Services Division
Title
Collier County Board of Commissioners
Company
Date
Packet Page -2767-
7/24/2012 Item 16.D.15.
VERIFICATION OF EMERGENCY PREPAREDNESS PLAN
Contract # ADI 203.12
I, Steve Carnell certify that Collier County Board of Conunissioners
(Name of authorized contractor representative) (Name of contractor)
has a current and properly maintained Emergency Preparedness Plan. Assurance is given that
the plan will be made available to the Area Agency on Aging for Southwest Florida, Inc. dba
Senior Choices of Southwest Florida, upon request.
Gb 4,U
Signature of authorized contractor representative
Interim Administrator. Collier County Public Services Division
Title
-(' �A� or
Date
Collier County Board of Commissioners
Company
October 2003
Packet Page -2768-
7/24/2012 Item 16.D.15.
CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS
The undersigned, an authorized representative of the Contractor named in the contract or agreement to
which this form is an attachment, hereby certifies that:
(1) The Contractor understands that pursuant to s. 287.135 F.S., any company at the time of bidding or
submitting a proposal for a new contract or renewal of an existing contract, that is on the "Scrutinized
Companies with Activities in Sudan List" or the "Scrutinized Companies with Activities in the Iran
Petroleum Sector List (collectively, "the Lists ") is ineligible for, and may not bid on, submit a
proposal for, or enter into or renew a contract with the Agency and or Department of EIder Affairs
Department) for goods or services of $1 million or more.
(2) The Contractor understands that, pursuant to s. 287.135 F.S., any company that submits a false
certification to the Department is subject to civil penalties, attorney's fees and costs and any costs for
investigations that led to the finding of false certification.
(3) The Contractor understands that the contract to which this form is an attachment may be terminated by
the Agency and /or Department if the Contractor submits a false certification or has been placed on the
Lists.
This certification, required by Florida law, 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.
Signature Date
(Same as contract signature)
Steve Carnell, Interim Administrator
Collier County Public Services Division
Title
Collier County Board of Commissioners
Company Name
Packet Page -2769-
July 2012 — June 2014
AREA AGENCY ON AGING FOR SOUTHWEST FLORID,, /24 /2012 Item 16.D.15.
dba SENIOR CHOICES OF SOUTHWEST FLORIDA
STANDARD CONTRACT
HOME CARE FOR THE ELDERLY PROGRAM
THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of
Southwest Florida ( "Agency ") and Collier County Board of County Commissioners, ( "Recipient "), and collectively
referred to as the "Parties." The term Recipient for this purpose may designate a vendor, subgrantee or subrecipient, the
status to be further identified i^ ' TTACHMENT III, Exhibit -2 as necessary.
WITNESSETH THAT.-
WHEREAS, the A- .,icy has dete, ::; ined that it is in need of certain services as described herein; and
WHEREAS, i.iie Recipient has demonstrated that it has the requisite expertise and ability to faithfully perform such
services as an independent Recipient 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:
I. _Purpose of Contract
The purpose of this contract is to provide services in accordance with the terms and conditions specified in this
contract including all attachments and exhibits, which constitute the contract document.
I.1 AGENCY MISSION STATEMENT
Mission: To help aging adults, 60 and older, achieve greater independence through awareness of resources and
access to qualified service providers.
Vision: To be the recognized leader in supporting older adults and their families with access to trustworthy
resources and services in their communities while empowering them to live with independence and dignity.
Values: The Agency believes the residents of Southwest Florida are entitled to:
➢ Comprehensive information about their choices of care;
➢ Timely access to resources and services;
➢ High standards of quality and performance;
➢ Personal and professional accountability from all stakeholders.
Lead agencies and local service providers as partners and stakeholders in Florida's aging services network are
expected to support the agency's mission, vision, and priorities.
2. Incortroration of Documents within the Contract
The contract will incorporate attachments, pi•oposal(s), area pl., ,$), grant agreements, relevant Department
handbooks, manuals or desk books, as an integral pail of the itract, except to the extent that the contract
explicitly provides to the contrary. In the event of conflict in 10. _wage among any of the documents referenced
above, the specific provisions and requirements of the contra A document(s) shall prevail over inconsistent
provisions in the proposal(s) or other general materials not spe "c to this contract document and identified
attachments.
3. Term of Contract
This is a two -year contract shall begin on July 1, 2012 or or: the date r which the contract has been signed by
the last party required to sign it, whichever is later. It sl -.'l end at ;idnight, local time in North Fort Myers,
Florida, on June 30, 2014.
4. Contract Amount
The Agency agrees to pay for contracted services according to = terms and conditions of this contract in an
amount not to exceed $61,709.00 for year one, 2012 - 2013, o, .ae rate schedule, subject to the availability of
finds. Any costs or services paid for under any other contr ,t or from any other source are not eligible for
payment under this contract.
Packet Page -2770-
July 2012 —June 2014
5. Renewals 7/24/2012 Item 16.D.15.
By mutual agreement of the Parties, in accordance with s. 287.058(1)(f), F.S., the Agency may renew the
contract every two years within the six year bid term , 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 six year 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.
6. Compliance with Federal Law
6.1 If this contract contains federal funds the following shall apply:
6.1.1 The Recipient shall comply with the provisions of 45 CFR 74 and /or 45 CFR 92, and other applicable
regulations.
6.1.2 If this contract contains federal finds and is over $100,000.00, the Recipient shall comply with all applicable
standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s.
508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as
amended, and where applicable Environmental Protection Agency regulations 40 CFR 30. The Recipient shall
report any violations of the above to the Agency.
6.1.3 The Recipient, or agent acting for the Recipient, may not use any federal funds received in connection with this
contract to influence legislation or appropriations pending before the Congress or any state legislature. If this
contract contains federal funding in excess of $100,000.00, the Recipient must, prior to contract execution,
complete the Certification Regarding Lobbying form, ATTACHMENT II. All disclosure forms as required by
the Certification Regarding Lobbying form must be completed and returned to the Contract Manager prior to
payment under this contract.
6.1.4 In accordance with Appendix A to 2 CFR 215, the Recipient shall comply with Executive Order 11246, Equal
Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in
Department of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable.,.
6.1.5 If this contract contains federal funds and provides services to children up to age 18, the Recipient shall comply
with the Pro - Children Act of 1994 (20 U.S.C. 6081).
6.1.6 A contract award with an amount expected to equal or exceed $25,000.00 and certain other contract awards will
not be made to parties listed on the government -wide Excluded Parties List System, in accordance with the OMB
guidelines at 2 CFR 180 that implement Executive Orders 12549 and 12689, "Debarment and Suspension." The
Excluded Parties List System contains the names of parties debarred, suspended, or otherwise excluded by
agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order
12549. The Recipient shall comply with these provisions before doing business or entering into subcontracts
receiving federal funds pursuant to this contract. The Recipient shall complete and sign ATTACHMENT V
prior to the execution of this contract.
6.2 The Recipient shall not employ an unauthorized alien. The ' gency will consider the employment of
unauthorized aliens a violation of the Immigration and Nationali' Act (8 U.S.C. 1324a) and the Immigration
Reform and Control Act of 1986 (8 U.S.C. 1101). Such violation .will be cause for unilateral cancellation of this
contract by the Agency.
6.3 If the Recipient is a non -profit provider and is subject to Internal Revernre Service (IRS) tax exempt organization
reporting requirements (filing a Form 990 or Form 990 -N) �..d has its tax exempt status revoked for failing to
comply with the filing requirements of the Pension Protectic:r Act of 2006 or for any other reason, the Recipient
must notify the Agency in writing within thirty (30) days of receiving the IRS notice of revocation.
6.4 The Recipient shall comply with Title 2 CFR Part 275 reca-iing Trafficking in Persons.
6.5 Unless exempt under 2 CFR Part 170.110(b), the Recipient shall -omply with the reporting requirements of the
Transparency Act as expressed in 2 CFR 170.
6.6 To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number 11 -116,
Recipient agrees to utilize the U.S. Department of Homeland Security's E- verify system to verify the
2
Packet Page -2771-
July 2012 —June 2014
7/24/2012 Item 16.D.15.
To comply with Presidential Executive Order 12989 and State of Florida Exf,,,,.,,.,, �I.,,,.. ,
Recipient agrees to utilize the U.S. Department of Homeland Security's E- verify system to verify the
employment of all new employees hired by Contractor during the contract term. Recipient shall include in
related subcontracts a requirement that subcontractors performing work or providing services pursuant to the
state contract utilize the E- verify system to verify employment of all new employees hired by the
subcontractor during the contract term. Recipients meeting the terms and conditions of the E- Verify System
are deemed to be in compliance with this provision.
7. Compliance with State Law
7.1 This contract is executed and entered into One State of Florida, and shall be construed, performed and enforced
in all respects in accordance with the Florida law, including Florida provisions for conflict of laws.
7.2 The Recipient shall comply with requirements of s. 287.058, F.S. as amended.
7.2.1 The Recipient shall provide units of deliverables, including various client services, and in some instances may
include reports, findings, and drafts, as specified in this contract, which the Contract Manager must receive and
accept in writing prior to payment in accordance with s. 215.971, F.S. (1) and (2).
7.2.2 The Recipient shall submit bills for fees or other compensation for services or expenses in sufficient detail for a
proper pre - audit and post- audit.
7.2.3 If itemized payment for travel expenses is permitted in this contract, the Recipient shall submit bills for any
travel expenses in accordance with s. 112.061, F.S., or at such lower rates as may be provided in this contract.
7.2.4 The Recipient shall allow public access to all documents, papers, letters, or other public records as defined in
subsection 1 19.011(12), F.S., made or received by the Recipient in conjunction with this contract except for
those records which are made confidential or exempt by law. The Recipient's refusal to comply with this
Provision will constitute an immediate breach of contract for which the Agency may unilaterally terminate the
contract.
7.3 If clients are to be transported under this contract, the Recipient shall comply with the provisions of Chapter 427,
F.S., and Rule 41 -2, F. A. C.
7.4 Subcontractors who are on the discriminatory vendor list may not transact business with any public entity, in
accordance with the provisions of s. 287.134, F.S.
7.5 The Recipient shall comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the
expenditure of contract fiends for the purpose of lobbying the legislature, judicial branch or a state agency.
7.6 In accordance with s. 287.135 F.S., any contractor on the Scrutinized Companies with Activities in Sudan List
or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List (Lists), created pursuant
to s.215.473 F.S., is ineligible to enter into or renew a contract with the Department for goods or services of $1
million or more. Pursuant to s. 287.135 F.S., the Department may terminate this contract if the Contractor is
found to have submitted a false certification of its status on the Lists or has been placed on the Lists. Further,
the Contractor is subject to civil penalties, attorney's fees and costs and any costs for investigations that led to
the finding of false certification. If this contract contains $1 million or more, the Contractor shall complete and
sign the Certification Regarding Scrutinized Companies Lists, prior to the execution of this contract
8. Background Screening
The Recipient shall ensure that the requirements of s. 430.0402 and ch. 435, F.S., as amended, are met
regarding background screening for all persons who meet the definition of a direct service provider and who
are not exempted from the Department's level 2 background screening pursuant to s. 430.0402(2) -(3), F.S.
The Recipient must also comply with any applicable rules promulgated by the Department and the Agency for
Health Care Administration regarding implementation of s. 430.0402 and ch. 435, F.S.
Further information concerning the procedures for background screening are found at
http: / /elderaffairs. state .fl.us /doea/backgroundscreen ing.phl).
3
Packet Page -2772-
July 2012 — June 2014 7/24/2012 Item 16.D.15.
9. Grievance and Compliant Procedures
9.1 Grievances Procedures
The Recipient shall comply with and ensure subcontractor compliance with the Minimum Guidelines for
Recipient Grievance Procedures, Appendix D, Department of Elder Affairs Programs and Services Handbook,
to address complaints regarding the termination, suspension or reduction of services, as required for receipt of
funds.
9.2 Complaint Procedures
The Recipient shall develop and implement complaint procedures and ensure that subcontractors develop and
implement complaint procedures to process and resolve client dissatisfaction with services. Complaint
procedures shall address the quality and timeliness of services, provider and direct service worker complaints, or
any other complaints not related to termination, suspension or reduction in services, which require the grievance
process as described in Appendix D, Department of Elder Affairs Programs and Services Handbook. The
complaint procedures shall include notification to all clients of the complaint procedures and include tracking the
date, nature of complaint and the determination of each complaint.
10. Audits, Inspections, Investigations, Public Records and Retention
10.1 The Recipient shall establish and maintain books, records and documents (including electronic storage media)
sufficient to reflect all assets, obligations, unobligated balances, income, interest and expenditures of funds
provided by the Agency under this contract. Recipient shall adequately safeguard all such assets and assure they
are used solely for the purposes authorized under this contract. Whenever appropriate, financial information
should be related to performance and unit cost data.
10.2 The Recipient shall retain all client records, financial records, supporting documents, statistical records, and any
other documents (including electronic storage media) pertinent to this contract for a period of six (6) years after
completion of the contract or longer when required by law. In the event an audit is required by this contract,
records shall be retained for a minimum period of six (6) years after the audit report is issued or until resolution
of any audit findings or litigation based on the terms of this contract, at no additional cost to the Agency.
10.3 Upon demand, at no additional cost to the Agency, the Recipient shall facilitate the duplication and transfer of
any records or documents during the required retention period in Paragraph 10.2.
10.4 The Recipient shall assure that the records described in Paragraph 10 will be subject at all reasonable times to
inspection, review, copying, or audit by federal, state, or other personnel duly authorized by the Agency.
10.5 At all reasonable times for as long as records are maintained, persons duly authorized by the Agency and federal
auditors, pursuant to 45 CFR 9236(i)(10), will be allowed full access to and the right to examine any of the
Recipient's contracts and related records and documents pertinent to this specific contract, regardless of the form
in which kept.
10.6 The Recipient shall provide a financial and compliance audit to the Agency as specified in this contract and in
ATTACHMENT III and ensure that all related third -party transactions are disclosed to the auditor.
10.7 The Recipient shall comply and cooperate immediately with any inspections, reviews, investigations, or audits
deemed necessary by the office of the Inspector General pursuant to s. 20.055, F.S.
11. Nondiscrimination -Civil Rights Compliance
11.1 The Recipient shall execute assurances in ATTACHMENT VI that it will not discriminate against any person in
the provision of services or benefits under this contract or in employment because of age, race, religion, color,
disability, national origin, marital status or sex in compliance with state and federal law and regulations. The
Recipient further assures that all contractors, subcontractors, subgrantees, or others with whom it arranges to
provide services or benefits in connection with any of its programs and activities are not discriminating against:
clients or employees because of age, race, religion, color, disability, national origin, marital status or sex.
11.2 During the term of this contract, the Recipient shall complete and retain on file a timely, complete and accurate
4
Packet Page -2773-
July 2012 — June 2014
Civil Rights Compliance Checklist
7/24/2012 Item 16.D.15.
11.3 The Recipient shall establish procedures pursuant to federal law to handle complaints of discrimination involving
services or benefits through this contract. These procedures will include notifying clients, employees, and
participants of the right to file a complaint with the appropriate federal or state entity.
11.4 If this contract contains federal funds, these assurances are a condition of continued receipt of or benefit from
federal financial assistance, and are binding upon the Recipient, its successors, transferees, and assignees for the
period during which such assistance is provided. The Recipient further assures that all subcontractors, vendors,
or others with whom it arranges to provide services or benefits to participants or employees in connection with
any of its programs and �, �:,,�;, , 4,, ,, ;i,,� ,_ ti ,arose participants or employees in violation of
the above statutes, regulations, guidelines, and standards. In the event of failure to comply, the Recipient
understands that the A -ency may, at its discretion, seek a court order requiring compliance with the terms of this
assurance or seek other appn�,,:-` -te judicial or administrative relief, including but not limited to, termination of
and denial of further assistance.
12. Provision of Services
The Recipient shall provide services in the manner described in ATTACHMENT I.
13. Monitoring by the Agency
The Recipient shall permit persons duly authorized by the Agency to inspect and copy any records, papers,
documents, facilities, goods and services of the Recipient which are relevant to this contract, and to interview any
clients, employees and subcontractor employees of the Recipient to assure the Agency of the satisfactory
performance of the terms and conditions of this contract. Following such review, the Agency will provide a
written report of its findings to the Recipient, and where appropriate, the Recipient shall develop a corrective
action plan. The Recipient hereby agrees to correct all deficiencies identified in the corrective action plan in a
timely manner as determined by the Contract Manager.
14. Coordinated Monitoring with Other Agencies
If the Recipient receives funding from one or more of the State of Florida other human service agencies, in
addition to the Department of Elder Affairs, then a joint monitoring visit including such other agencies may be
scheduled. For the purposes of this contract, and pursuant to s. 287.0575, F.S. as amended, Florida's human
service agencies shall include the Department of Children and Families, the Department of Health, the Agency
for Persons with Disabilities, the Department of Veterans Affairs, and the Department of Elder Affairs. Upon
notification and the subsequent scheduling of such a visit by the designated agency's lead administrative
coordinator, the Recipient shall comply and cooperate with all monitors, inspectors, and /or investigators.
15. Indemnification
The Recipient shall indemnify. save, defend, and hold harmless the Av -ncy and its agents and employees from
any and all claims, demands, actions, causes of action of whatever natu or character, arising out of or by reason
of the execution of this agreement or performance of the services , rovided for herein. It is understood and
agreed that the Recipient is not r;quired to indemnify the Agency sor claims, demands, actions or causes of
action arising soleI) .A of the A, ncy's negligence.
15.1 Except to the extent permitte ny s. 768.28_ r. �., or other Florida law, Paragraph 15 is not applicable to contracts
executed between the Der- _,vent -Td sty agencies or subdivisior. defined in s. 768.28(2), F.S.
16. Insurance and W i.-iingg
16.1 The Recipient shall provide continuous adequate liability insurance coverage during the existence of this contract
and any renewal(s) and extension(s) of it. By executio : of this contact, unless it is a state agency or subdivision
as defined by subsection 768.28(2), F.S., the Recipient accepts fu': responsibility for identifying and determining
the type(s) and extent of liability insurance necessary to p ovide reasonable financial protections for the
Recipient and the clients to be served under this contract. The L'i'mits of coverage under each policy maintained by
the Recipient do not limit the Recipient's liability and obligations under this contract. The Recipient shall ensure
that the Agency has the most current written verification of insurance coverage throughout the term of this
contract. Such coverage may be provided by a self - insurance program established and operating under the laws
Packet Page -2774-
July 2012 — June 2014
7/24/2012 Item 1U.D.15.
of the State of Florida. The Agency reserves the right to require additional insurai,k,� as ayt,%,u,ou u, «,,, _.«, _, .
16.2 Throughout the term of this agreement, the Recipient shall maintain an insurance bond from a responsible
commercial insurance company covering all officers, directors, employees and agents of the Recipient authorized
to handle funds received or disbursed under all agreements and /or contracts incorporating this contract by
reference in an amount commensurate with the funds handled, the degree of risk as determined by the insurance
company and consistent with good business practices.
17. Confidentiality of Information
The Recipient shall not use or disclose any information concerning a recipient of services under this contract for
any purpose prohibited by state or federal law or regulations except with the written consent of a person legally
authorized to give that consent or when authorized by law.
1s. Health Insurance Portability and Accountability Act
Where applicable, the Recipient shall comply with the Health Insurance Portability and Accountability Act (42
USC 1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162, and 164).
19. Incident Reporting
19.1 The Recipient shall notify the Agency immediately, but no later than forty-eight (48) hours from, the Recipient's
awareness or discovery of conditions that may materially affect the Recipient or subcontractor's ability to
perform the services required to be performed under this contract. Such notice shall be made orally to the
Contract Manager (by telephone) with an email to immediately follow.
19.2 The Recipient shall immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of a
child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll -free telephone number
(1- 800- 96ABUSE). As required by Chapters 39 and 415, F.S., this provision is binding upon both the Recipient
and its employees.
20. New Contract(s) Reporting
The Recipient shall notify the Agency within ten (10) days of entering into a new contract with any of the
retraining four (4) state human service agencies. The notification shall include the following information:
(1) contracting state agency; (2) contract name and number; (3) contract start and end dates; (4) contract amount;
(5) contract description and commodity or service; and (6) Contract Manager name and number. In complying
with this provision, and pursuant to s. 287.0575, F.S. as amended, the Recipient shall complete and provide the
information to the Agency's Contract Manager.
21. Bankruptcv Notification
During the term of this contract, the Recipient shall immediately notify the Agency if the Recipient, its assignees,
subcontractors or affiliates file a claim for bankruptcy. Within ten (10) days after notification, the Recipient must
also provide the following information to the Area Agency on Aging for Southwest Florida, Inc.: (1) the date of
filing of the banl:r uptcy petition: ' e number; (3 .ire court name and the division in which the petition
was filed (e.g., United S<. s ,ankruptcy Court Mida:3 District of Florida, Fort Myers, FL ); and, (4) the name,
address, and telephone rnur' er of the bankruptcy attorney.
22. SPonsorshin and Publicity
22.1 As required by s. 286.25, F.S., if the Recipient is a non - govern rental organization which sponsors a program
financed wholly or in part by state funds, including any f .ids obtained through this contract, it shall, in
publicizing, advertising, or describing the sponsorship of the )rogram, state: "Sponsored by Hope Hospice and
Community Services, the State Agency of Elder Affairs, a, J the Area Agency on Aging for Southwest Florida,
Inc." If the sponsorship reference is in the written mate _al, the words "State of Florida, Department of Elder
Affairs and the Area Agency on Aging for Southwest F'.orida, Inc." shall appear in at least the same size letters
or type as the name of the organization.
Packet Page -2775-
July 2012 — June 2014
7/24/2012 Item 16.D.15.
22.2 The Recipient shall not use the words "The State of Florida Department of Elder Affairs or the Area Agency on
Aging for Southwest Florida, Inc." to indicate sponsorship of a program otherwise financed, unless specific
authorization has been obtained by the State and Agency prior to use.
23. Assilznrnents
23.1 The Recipient shall not assign the rights and responsibilities under this contract without the prior written
approval of the Agency, which shall not be unreasonably withheld. Any sublicense, assignment, or transfer
otherwise occurring without prior written approval of the Agency will constitute a material breach of the
contract.
23.2 The State of Florida is at all times entitled to assign or transfer, in whole or part, its rights, duties, or obligations
under this contract to another governmental agency in the State of Florida, upon giving prior written notice to the
Recipient. In the event the State of Florida approves transfer of the Recipient's obligations, the Recipient
remains responsible for all work performed and all expenses incurred in connection with the contract.
23.3 This contract shall remain binding upon the successors in interest of either the Recipient or the Agency
24. Subcontracts
24.1 The Recipient is responsible for all work performed and for all commodities produced pursuant to this contract,
whether actually furnished by the Recipient or its subcontractors. Any subcontracts shall be evidenced by a
written document and subject to any conditions of approval the Agency deems necessary. The Recipient further
agrees that the Agency will not be liable to the subcontractor in any way or for any reason. The Recipient, at its
expense, shall defend the Agency against any such claims.
24.2 The Recipient shall promptly pay any subcontractors upon receipt of payment from the Agency or other state
agency. Failure to make payments to any subcontractor in accordance with s. 287.0585, F.S., unless otherwise
stated in the contract between the Recipient and subcontractor, will result in a penalty as provided by statute.
25. Independent Capacity of Recipient
It is the intent and understanding of the Patties that the Recipient, or any of its subcontractors, are independent
contractors and are not employees of the Agency and shall not hold themselves out as employees or agents of the
Agency without specific authorization from the Agency. It is the further intent and understanding of the Parties
that the Agency does not control the employment practices of the Recipient and will not be liable for any wage
and hour, employment discrimination, or other labor and employment Maims against the Recipient or its
subcontractors. All deductions for social security, withholding ta} :s, income taxes, contributions to
unemployment compensation fimds and all necessary insurance for the R pient are the sole responsibility of the
Recipient.
26. Payment
Payments shall be made to the Recipient pursuant to s. 215 ^712 as services are rendered and invoiced by
the Recipient. The Contract Manager will have approval i the invoice for payment, and will approve the
invoice for payment only if the Recipient has ;net all ter, � and conditions of the contract, unless the bid
specifications, purchase order, or this coat- specify othe- ; ise. The approved invoice will be submitted to the
Agency's finance section for budgetary approval and pro --ssing. Disputes arising over invoicing and payments
will be resolved in accordance with the provisions _,3.422 F.S. A Vendor Ombudsman has been
established within the Department of Financial Services, and may be contacted at (850) 413 -5665.
27. Return of Funds
The Recipient shall return to the Agency any overpayments due to unearned funds or funds disallowed and ally
interest attributable to such funds pursuant to the terns and conditions of this contract that were disbursed to the
Recipient by the Agency. In the event that the Recipient or its independent auditor discovers that an
overpayment has been made, the Recipient shall repay said overpayment immediately without prior notification
from the Agency. In the event that the Agency first discovers an overpayment has been made, the Contract.
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July 2012 -June 2014 7/24/2012 Item 16.D.15.
Manager will notify the Recipient in writing of such findings. Should repayn.,,... —.1
Recipient will be charged at the lawful rate of interest on the outstanding balance pursuant to s. 55.03, F.S., after
Agency notification or Recipient discovery.
28. Data Integrity and Safeguarding Information
The Recipient shall ensure an appropriate level of data security for the information the Recipient is collecting or
using in the performance of this contract. An appropriate level of security includes approving and tracking all
Recipient employees that request system or information access and ensuring that user access has been removed
from all terminated employees. The Recipient, among other requirements, must anticipate and prepare for the
loss of information processing capabilities. All data and software shall be routinely backed up to ensure recovery
from losses or outages of the computer system. The security over the backed -up data is to be as stringent as the
protection required of the primary systems. The Recipient shall ensure all subcontractors maintain written
procedures for computer system backup and recovery. The Recipient shall complete and sign ATTACHMENT
IV prior to the execution of this contract.
29. Computer Use and Social Media Policy
The Department of Elder Affairs has implemented a new Social Media Policy, in addition to its Computer Use
Policy, which applies to all employees, contracted employees, consultants, OPS and volunteers, including all
personnel affiliated with third parties, such as, but not limited to, Area Agencies on Aging and vendors. Any
entity that uses the Department's computer resource systems must comply with the Department's policy
regarding social media. Social Media includes, but is not limited to blogs, podeasts, discussion forums, Wikis,
RSS feeds, video sharing, social networks like MySpace, Facebook and Twitter, as well as content sharing
networks such as flickr and YouTube.
30. Conflict of Interest
The Recipient shall establish safeguards to prohibit employees, board members, management and subcontractors
from using their positions for a purpose that constitutes or presents the appearance of personal or organizational
conflict of interest or personal gain. No employee, officer or agent of the Recipient or subcontractor shall
participate in selection, or in the award of an agreement supported by state or federal funds if a conflict of
interest, real or apparent, would be involved. Such a conflict would arise when: (a) the employee, officer or
agent; (b) any member of his/her immediate family; (c) his or her partner, or; (d) an organization which employs,
or is about to employ, any of the above, has a financial or other interest in the firm selected for award. The
Recipient or subcontractor's officers, employees or agents will neither solicit nor accept gratuities, favors or
anything of monetary value from contractors, potential contractors, or parties to subcontracts. The Recipient's
board members and management must disclose to the Agency any relationship which may be, or may be
perceived to be, a conflict of interest within thirty (30) calendar days of an individual's original appointment or
placement in that position, or if the individual is serving as an incumbent, within thirty (30) calendar days of the
commencement of this contract. The Recipient's employees and subcontractors must make the same disclosures
described above to the Recipient's board of directors. Compliance with this provision will be monitored.
31. Public Entity Crime
Pursuant to s. 287.133, F.S., a person or affiliate who has been placed on the convicted vendor list following a
conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods
or services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the
construction or repair of a public building or public work; may not submit bids, proposals, or replies on leases of
real property to a public entity; may not be awarded or perform work as a Recipient, supplier, subcontractor, or
consultant under a contract with any public entity; and may not transact business with any public entity in excess
of the threshold amount provided in s. 287.017, F.S., for CATEGORY TWO for a period of 36 months following
the date of being placed on the convicted vendor list.
32. Purchasing
32.1 The Recipient may purchase articles which are the subject of or are required to carry out this contract from Prison
Rehabilitative industries and Diversified Enterprises, Inc., (PRIDE) identified under Chapter 946, F.S., in the
same manner and under the procedures set forth in subsections 946.515(2) and (4), F.S. For purposes of this
contract, the Recipient shall be deemed to be substituted for the Agency insofar as dealings with PRIDE. This
clause is not applicable to subcontractors unless otherwise required by law. An abbreviated list of
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July 2012 -.rune 2014 7/24/2012 Item 16.D.15.
products /services available from PRIDE may be obtained by contacting PRIDE, (".1
32.2 The Recipient may procure any recycled products or materials, which are the subject of or are required to carry
out this contract, in accordance with the provisions of s. 403.7065, F.S.
32.3 The Recipient may purchase articles that are the subject of, or required to cart' out, this contract from a nonprofit
agency for the Blind or for the Severely Handicapped that is qualified pursuant to Chapter 413, F.S., in the same
manner and under the same procedures set forth in s. 413.036(1) and (2), F.S. For purposes of this contract, the
Recipient shall be deemed to be substituted for the Agency insofar as dealings with such qualified nonprofit
agency are concerned. Additional information about the designated nonprofit agency and the products it offers is
available at http: / /www.respectofflorida.org. This clause is not applicable to subcontractors unless otherwise
required by law.
33. Patents, Copyrights, Royalties
If this contract is awarded state funding and if any discovery, invention or copyrightable material is developed,
produced or for which ownership was purchased in the course of or as a result of work or services performed
under this contract, the Recipient shall refer the discovery, invention or material to the Agency to be referred to
the Department of State and the Department of Elder Affairs. Any and all patent rights or copyrights accruing
under this contract are hereby reserved to the State of Florida in accordance with Chapter 286, F.S. Pursuant to s.
287.0571 (5) (k) I and 2 as amended, the only exceptions to this provision shall be those that are clearly
expressed and reasonably valued in the contract.
33.1 If the primary purpose of this contract is the creation of intellectual property, the State of Florida shall retain an
unencumbered right to use such property, notwithstanding any agreement made pursuant to Paragraph 33.
33.2 If this contract is awarded solely federal funding, the terns and conditions are governed by 2 CFR 215.36.
34. Emert3ency Preparedness and Continuity of Operations
X4.1 If the tasks to be performed pursuant to this contract include the physical care and control of clients, or the
administration and coordination of services necessary for client health, safety or welfare, the Recipient shall,
within thirty (30) calendar days of the execution of this contract, submit to the Contract Manager verification of
an emergency preparedness plan. In the event of an emergency, the Recipient shall notify the Agency of
emergency provisions.
34.2 In the event a situation results in a cessation of services by a subcontractor, the Recipient shall retain
responsibility for performance under this contract and must follow procedures to ensure continuity of operations
without interruption.
35. EQUIPMENT
If the contract tasks to be performed require the purchase of equipm, t with state or federal funds, the following
paragraphs apply:
35.1 Equipment means: (a) an article of nonexpendable, tangible pers al property having a useful life of more than
one year and an acquisition cost which equals or exceeds the le: _r of the capitalization level established by the
organization for the financial statement purposes, or $5,000.00 [ r federal funds]; or (b) nonexpendable, tangible
personal property of a nonconsumable nature with an acqui�`.ion cost of $1,000.00 or more per unit, and
expected useful life of at least one year; and hardback boun ' cooks not circulated to students or the general
public, with a value or cost of $250.00 or more [for state fund,].
35.2 Recipients and subcontractors who are Institutions of Higher Education, Hospitals, and Other Non -Profit
Organizations shall have written property management standa ds in compliance with 2 CFR Part 215
Administrative Requirements (formerly OMB Circular A -110) ghat include: (a) a property list with all the
elements identified in the circular; and, (b) a procedure for conducting a physical inventory of equipment at least
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July 2012 – June 2014 7/24/2012 Item 16.D.15.
once every two years, (c) a control system to insure adequate safeguards to prey -1 1"a., uulSiN6v, V. ...vas - ..._
equipment; and (d) maintenance procedures to keep the equipment in good condition. The property records must
be maintained on file and shall be provided to the Agency upon request. The Recipient shall promptly
investigate, fully document and notify the Contract Manager of any loss, damage, or theft of equipment. The Aoftl
Recipient shall provide the results of the investigation to the Contract Manager.
35.3 The Recipient's property management standards for equipment acquired with Federal funds and federally -owned
equipment shall include accurately maintained equipment records with the following information:
(1) A description of the equipment;
(2) Manufacturer's serial number, model number, Federal stock number, national stock number, or other
identification number;
(3) Source of the equipment, including the award number;
(4) Whether title vests in the Recipient or the Federal Government;
(5) Acquisition date (or date received, if the equipment was furnished by the Federal Government) and cost;
(6) Information from which one can calculate the percentage of Federal participation in the cost of the
equipment (not applicable to equipment furnished by the Federal Government);
(7) Location and condition of the equipment and the date the information was reported;
(8) Unit acquisition cost; and
(9) Ultimate disposition data, including date of disposal and sales price or the method used to determine current
fair market value where a Recipient compensates the Federal awarding agency for its share.
35.4 Equipment purchased with federal finds with an acquisition cost over $5,000.00 and equipment purchased with
state fiends with an acquisition cost over S 1,000.00 that is specifically identified in the area plan approved by the
Department is part of the cost of carrying out the activities and functions of the grant awards and Title
(ownership) will vest in the Agency, subject to the conditions of 2 CFR Part 215 Administrative Requirements
(formerly OMB Circular A -110), Subpart C, paragraph 34. Equipment purchased under these thresholds is
considered supplies and is not subject to property standards. Equipment purchased with funds identified in the
budget attachments to agreements covered by this contract, or identified in the sub - agreements with
subcontractors (not included in a cost methodology), is subject to the conditions of section 273, F. S. and 60A-
1.0017, F. A. C. or Title 45 CFR Part 74.
35.5 The Recipient shall not dispose of any equipment or materials provided by the Agency, or purchased with funds
provided through this contract without first obtaining the approval of the Contract Manager. When disposing of
property or equipment the Recipient must submit a written request for disposition instructions to the respective
Contract Manager. The request should include a brief description of the property, purchase price, funding
source, percentage of state or federal participation, acquisition date and condition of the property. The request
should also indicate the Recipient's proposed disposition (i.e., transfer or donation to another agency that
administers federal programs, offer the items for sale, destroy the items, etc).
35.6 The Contract Manager will issue disposition instructions. If disposition instructions are not received within 120
days of the written request for disposition, the Recipient is authorized to proceed as directed in 2 CFR Part 215
Administrative Requirements (formerly OMB Circular A -110).
35.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto, but
excludes movable machinery and equipment. Real property may not be purchased with state or federal funds
through agreements covered under this contract without the prior approval of the Agency. Real property
purchases from Older Americans Act finds are subject to the provisions of Title 42, Chapter 35, Subchapter 111,
Part A., Sec. 3030b United States Code (USC). Real property purchases from state funds can only be made
through fixed capital outlay grants and aids appropriations and therefore are subject to the provisions of section
216.348, F. S.
35.8 Any permanent storage devices (e.g., hard drives, removable storage media) must be reformatted and tested prior
to disposal to ensure no confidential information remains.
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35.9 The Recipient must adhere to the Agency's procedures and standards when purctnasmg tntormatron i ecnnoiogy
Resources (ITR) as part of any agreement(s) incorporating this contract by reference. An ITR worksheet is
required for any computer related item costing $1,000.00 or more, including data processing hardware, software,
services, supplies, maintenance, training, personnel and facilities. The completed ITR worksheet shall be
maintained in the LAN administrator's file and must be provided to the Agency upon request. The Recipient has
the responsibility to require any subcontractors to comply with the Agency's ITR procedures.
36. PUR 1000 Form
The PUR 1000 Form is hereby incorporated by reference. In the event of any conflict between the PUR J 000
Form and any tenr� mot• condi`- -- of this * +11. +A . ^ondi ±rcros of this contract shall take precedence
over the PUR 1000 Form. i ;ver, if the conflicting terms or conditions in the PUR 1000 Form are required by
any section of the Florida Statutes, the terms or conditions contained in the PUR 1000 Form shall take
precedence.
37. Use of State Funds to Pr►r ^x --
Property
Any state funds provided for the purchase of or improvements to real property are contingent upon the Recipient
or political subdivision granting to the state a security interest in the property at least to the amount of state funds
provided for at least 5 years from the date of purchase or the completion of the improvements or as further
required by law.
38. Dispute Resolution
Any dispute concerning performance of the contract shall be decided by the Contract Manager, who shall reduce
the decision to writing and serve a copy on the Recipient.
39. Financial Consequences of Non - Performance
If the Recipient fails to meet the minimum level of service or performance identified in this agreement, or that is
customary for the industry, then the Agency must apply financial consequences commensurate with the
deficiency. Financial consequences may include, but are not limited to, contract suspension, refusing payment,
withholding payments until deficiency is cured, tendering only partial payments, and /or cancellation of contract
and reacquiring services from an alternate source.
),I The Recipient will not be charged with financial consequences, when a failure to perform arises out of causes
that were the responsibility of the Agency.
40. No Waiver of Sovereign Immunity
Nothing contained in this agreement is intended to serve as a waiver of sovereign immunity by any entity to
which sovereign immunity may be applicable.
41. Venue
If any dispute arises out of this contract, the venue of such legal recd, �c will be Lee County, Florida.
42. Entire Contract
This contract contains all the terms and conditions agreed tip t by the Parties. No oral agreements or
representations shall be valid or binding upon the Agency or the r: i ;;; nt unless expressly contained herein or
by a written amendment to this contract signed by both Parties.
43. Force Maieure
The Parties will not be !:able for any delays or failures in performance due to circumstances beyond their control,
provided the party experiencing the force majeure condition proN idcs ilm:riz-diate written notification to the other
party and takes all reasonable efforts to cure the condition.
44. Severability Clause
The Parties agree that if a court of competent jurisdiction de is any term or condition herein void or
unenforceable the other provisions are severable to that void prov' in and shall remain in full force and effect.
Condition Precedent to Contract-L. Appropriations
The Parties agree that the Agency's performance and obligation to pay under this contract is contingent upon an
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July 2012 — June 2014
annual appropriation by the Legislature.
7/24/2012 Item 16.D.15.
46. Addition /Deletion
The Parties agree that the Agency reserves the right to add or to delete any of the services required under this
contract when deemed to be in the State of Florida's best interest and reduced to a written amendment signed by
both Parties. The Parties shall negotiate compensation for any additional services added.
47. Waiver
The delay or failure by the Agency to exercise or enforce any of its rights under this contract will not constitute
or be deemed a waiver of the Agency's right thereafter to enforce those rights, nor will any single or partial
exercise of any such right preclude any other or further exercise thereof or the exercise of any other right.
48. Compliance
The Recipient shall abide by all applicable current federal statutes, laws, rules and regulations as well as
applicable current state statutes, laws, rules and regulations. The Parties agree that failure of the Recipient to
abide by these laws shall be deemed an event of default of the Recipient, and subject the contract to immediate,
unilateral cancellation of the contract at the discretion of the Agency.
49, Final Invoice
The Recipient shall submit the final invoice for payment to the Agency as specified in Paragraph 3.3.5. (date for
final request for payment) of ATTACHMENT I. if the Recipient fails to submit final request for payment by
the deadline, then all rights to payment may be forfeited and the Agency may not honor any requests submitted
after the aforesaid time period. Any payment due under the terms of this contract may be withheld until all
reports due from the Recipient and necessary adjustments thereto have been approved by the Agency.
50. Renegotiations or Modifications
Modifications of the provisions of this contract shall be valid only when they have been reduced to writing and
duly signed by both parties. The rate of payment and the total dollar amount may be adjusted retroactively to
reflect price level increases and changes in the rate of payment when these have been established through the
appropriations process and subsequently identified in the Agency's operating budget.
51. Termination
51.1 This contract may be terminated by either party without cause upon no less than thirty (30) calendar days notice
in writing to the other party unless a sooner time is mutually agreed upon in writing. Said notice shall be
delivered by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by
hand delivery to the Contract Manager or the representative of the Recipient responsible for admuiistration of the
contract.
51.2 In the event funds for payment pursuant to this contract become unavailable, the Agency may terminate this
contract upon no less than twenty -four (24) hours notice in writing to the Recipient. Said notice shall be
delivered by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by
hand delivery to the Contract Manager or rep. esentative of the Recipient responsible for administration of the
contract. The Agency will be the final authority as to the availability and adequacy of funds. In the event of
termination of this contract, the Recipient will be compensated for any work satisfactorily completed prior to the
date of termination.
51.3 This contract may be terminated for cause upon no less than twenty -four (24) hours notice in writing to the
Recipient. If applicable, the Agency may employ the default provisions in Rule 60A- 1.006(3), F.A.C. Waiver of
breach of any provisions of this contract shall not be deemed to be a waiver of any other breach and shall not be
construed to be a modification of the terms and conditions of this contract. The provisions herein do not limit the
Agency's or the Recipient's rights to remedies at law or in equity.
51.4 Failure to have performed any contractual obligations with the Agency in a manner satisfactory to the Agency
will be a sufficient cause for termination. To be terminated as a Recipient under this provision, the Recipient
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must have (1) previously failed to satisfactorily perform in a contract with the ..b..., y, . , , .. A. .... - -, ....,
Agency of the unsatisfactory performance and failed to correct the unsatisfactory performance to the satisfaction
of the Agency; or (2) had a contract terminated by the Agency for cause.
52. Electronic Records and Signature
The Agency authorizes, but does not require, the Recipient to create and retain electronic records and to use
electronic signatures to conduct transactions necessary to carry out the terns of this Agreement. A Recipient
that creates and retains electronic records and uses electronic signatures to conduct transactions shall comply
with the requirements contained in the Uniform Electronic Transaction Act, s. 668.50, Fla. Stat. All electronic
records must be frilly auditable; are subject to Florida's Public Records Law, ch. 119, Fla. Stat.; must comply
with section 28, Data Integrity and Safeguarding Information; must maintain all confidentiality, as applicable;
and must be retained and maintained by the Recipient to the same extent as non - electronic records are retained
and maintained as required by this Agreement.
52.1 The Agency's authorization pursuant to this section does not authorize electronic transactions between the
Recipient and the Agency. The Recipient is authorized to conduct electronic transactions with the Agency only
upon further written consent by the Agency.
52.2 Upon request by the Agency, the Recipient shall provide the Agency with non - electronic (paper) copies of
records. Non - electronic (paper) copies provided to the Agency of any document that was originally in electronic
form with an electronic signature must indicate the person and the person's capacity who electronically signed the
document on any non - electronic copy of the document.
53. Official Pavee and Representatives (Names, Addresses, and Telephone Numbers):
;4. All Ternis and Conditions Included
This contract and its Attachments, I - X and any exhibits referenced in said attachments, together with any
13
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The Recipient name, as shown on page I of this contract,
Collier County Board of County Commissioners
a.
and mailing address of the official payee to whom the
Housing and Human Services Departments
payment shall be trade is:
3339 Tamiami Trail E Bldg H, Rm 211
Naples, FL 34112
Kimberly Grant, Interim Director
b.
The name of the contact person and street address where
Collier County Board of County Commissioners
financial and administrative records are maintained is:
Housing and Human Services Departments
3339 Tamiami Trail E Bldg H, Rm 211
Naples, FL 34112
Kimberly Grant, Interim Director
Collier County Board of County Commissioners
C.
The name, address, and telephone number of the
Housing and Human Services Departments
representative of the Recipient responsible for
3339 Tamiami Trail E Bldg H, Rm 211
administration of the program under this contract is:
Naples, FL 34112
(239) 252 -2273
Area Agency on Aging for Southwest Florida, Inc.
d
The section and location within the Agency where
dba Senior Choices of Southwest Florida
Requests for Payment and Receipt and Expenditure forms
15201 N. Cleveland Ave, Suite 1100
are to be mailed is:
North Fort Myers, Florida 33903
Leigh Wade, Executive Director
Area Agency on Aging for Southwest Florida, Inc.
e.
The name, address, and telephone number of the Contract
dba Senior Choices of Southwest Florida
Manager for this contract is:
15201 N. Cleveland Ave, Suite 1100
lworth Fort Myers, Florida 33903
(239) 652 -6900
Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided in
writing to the other party and the notification attached to the originals of this contract.
;4. All Ternis and Conditions Included
This contract and its Attachments, I - X and any exhibits referenced in said attachments, together with any
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July 2012 —June 2014 7/24/2012 Item 16.D.15.
docurnents incorporated by reference, contain all the terms and conditions agrecu L,p, ,, 'y L11N 1 a, U� . ..L-- w
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 38 page contract, to be executed by their undersigned
officials as duly authorized.
Recipient: COLLIER COUNTY BOARD OF COUNTY
COMMISSIONERS
SIGNED BY: • . "'
NAME:�,t`�• L•.,_.-U,( it CA]
T, -.
TITLE: .r'' o tY` L &, o
DATE: G —7-9 -
Federal Tax ID: 59- 6000588
Fiscal Year Ending Date: 09/30
14
AREA AGENCY ON AGING FOR SOUTHWEST
FLORIDA, INC. DBA SENIOR CHOICES OF
SOUTHWEST FLORIDA
SIGNED BY: L'21 %_,. . - �__.•
NAME: LEIGH ANNA NOWAK
TITLE: BOARD .PRESIDENT
DATE:
AppMvod as to kirtr 8a legal SuffitArbricy
Packet Page -2783-
Ausistant Couniy Attorney
E r it a Lq__. i -5 . i
July 2012 – June 2014
INDEX TO CONTRACT ATTACHMENTS
7/24/2012 Item 16.D.15.
ATTACHMENT
ATTACHMENT DESCRIPTION
PAGE
ATTACHMENT I
STATEMENT OF WORK
16 -24
ATTACHMENT II
CERTIFICATION REGARDING LOBBYING
25
ATTACHMENT III
FINANCIAL AND COMPLIANCE AUDIT ATTACHMENT
26 -30
ATTACHMENT IV
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE
31
ATTACHMENT V
CERTIFICATION REGARDING DEBARMENT, SUSPENSION,
32
INELIGIBILITY AND VOLUNTARY EXCLUSION
CONTRACTS /SUBCONTRACTS
ATTACHMENT VI
ASSURANCES—NON-CONSTRUCTION PROGRAMS
33 -34
ATTACHMENT VII
HOME CARE FOR THE ELDERLY PROGRAM INVOICE REPORT
35
SCHEDULE
ATTACHMENT VIII
HOME CARE FOR THE ELDERLY PROGRAM BUDGET SUMMARY
36
ATTACHMENT IX
REQUEST FOR PAYMENT DOEA FORM 106H
37
ATTACHMENT X
RECEIPTS AND EXPENDITURES REPORT, DOEA FORM 105H
38
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7/24/2012 Item 16.D.15.
AViL1ra1J1
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC. A A l I a a
STATEMENT OF WORK
HOME CARE FOR THE ELDERLY PROGRAM
SECTION I: SERVICES TO BE PROVIDED
1.1 DEFINITION OF CONTRACT TERMS AND ACRONYMS
1.1.1 DEFINITIONS OF ACRONYMS
Adult Protective Services (APS)
Activities of Daily Living (ADL)
Assessed Priority Consumer List (APCL)
Community Care for Disabled Adults (CCDA)
Community Care for the Elderly (CCE)
Client Information and Registration Tracking System (CIRTS)
Department of Children and Families (DCF)
Home Care for Disabled Adults (HCDA)
Home Care for the Elderly (HCE)
Institutional Care Program (ICP)
Instrumental Activities of Daily Living (IADL)
Planning and Service Area (PSA)
1.1.2 PROGRAM SPECIFIC TERMS
Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of
Children and Families Services Community Care for Disabled Adults (CCDA) or Home Care for Disabled
Adults (HCDA) services to the Department's community -based services.
Area Plan: A plan developed by the Agency outlining a comprehensive and coordinated service delivery
system in the respective planning and service area, in accordance with the Section 306 of the Older Americans
Act (42 U.S.C. 3026) and Department instructions. The Area Plan includes performance measures and unit
rates per service offered per county.
Area Plan Update: A revision to the Area Plan wherein the Agency enters ADI specific data into the CIRTS.
An update may also include other revisions to the Area Plan as instructed by the Department.
Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to
remain independent and in the Ieast restrictive living arrangement. DOEA Form 701 B is used by case managers to
conduct the functional assessment.
1.2 GENERAL DESCRIPTION
1.2.1 General Statement
Area Agencies on Aging may contract with CCE lead agencies or other case management entities for the
provision of the HCE program. Approved caregivers receive a Basic Subsidy to reimburse some of their
expenses each month for caring for the consumer and may receive a Special Subsidy for other necessary
services and essential supplies. Caregivers may be approved for rip to three HCE clients in their home.
1.2.2 Home Care for the Elderly Program Mission Statement
The Horne Care for the Elderly Program supports family style living arrangements, on a non -profit basis, as an
alternative to nursing homes or other institutional care. Through the program, a caregiver for three or fewer
elders living in a private home provides basic services of maintenance and supervision as well as coordinating
other necessary specialized services, AOW,
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July 2012 - June 2014 7/24/2012 Item 16.D.15.
1.2.3 Authority
The relevant authority governing the HCE program include:
(1) Rule Chapter 58H -1, Florida Administrative Code; and
(2) Sections 430.601 through 430.608, F.S.
1.2.3.1 Incorporation of Reference Memoranda
In accordance with s. 287 F.S., as amended, and Department of Financial Services', Chief Financial Officer
Memoranda, the following memoranda are provided for informational purposes and are hereby incorporated by
reference:
CFO Memo No. 02: Release date, August 20, 2010;
CFO Memo No. 03: Release date, June 29, 2010; and
CFO Memo No. 06: Release date, June 30, 2010.
1.2.4 Scope of Service
The Recipient is responsible for the programmatic, fiscal and operational management of HCE. The Recipient
shall provide services in a manner consistent with and described in the current Agency's area plan update and the
current Department of Elder Affairs Programs and Services Handbook.
1.2.5 Major Program Goals
The major goals of the HCE program are to ensure that:
(1) Basic Subsidy is provided to the caregiver of each client and
(2) Special Subsidy is provided when essential to the well -being of the client.
1.3 INDIVIDUALS TO BE SERVED
1.3.1 General Eligibility
The Home Care for the Elderly program serves elders age 60 and older at risk of placement in a nursing home
or other institutional settings who can remain in a family style setting through the provision of subsidies.
1.3.2 Client Eligibility
Clients eligible to receive services under this contract must:
(1) Be 60 years of age or older; .
(2) Have income less than the Institutional Care Program (ICP) standard.
(3) Meet the ICP asset limitation;
(4) Be at risk of nursing home placement;
(5) Have an approved adult caregiver living in the home with them who is willing to provide care or assist in
arranging for care; and
(6) Not be enrolled in the Aged and Disabled Adult Medicaid waiver or a Medicaid capitated long -term care
program.
1.3.3 Caregiver Eligibility
Caregivers eligible to receive services under this contract must:
(1) Be at least 18 years of age, capable of providing a family -type living environment;
(2) Be a relative or a friend who has been accepted by the client as a surrogate family or is a responsible adult
with whom the client has made an arrangement to provide home care services;
(3) Be willing to accept responsibility for the social, physical and emotional needs of the care recipient;
(4) Be physically present and live in the home to provide supervision and to assist in arrangement of services
for the client;
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July 2012 —June 2014 7/24/2012 Item 16.D.15.
(5) Maintain the residential dwelling free of conditions that pose an i nmediat, L111VQL LW L11\, 111V, Julyt�, 1lvuaay
and well -being of the home care client; and
(6) Be without record of conviction of abuse, neglect or exploitation of another person.
1.3.3 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.
SECTION 11: MANNER OF SERVICE PROVISION
2.1 SERVICE TASKS
In order to achieve the goals of the HCE program, the Recipient shall ensure the following tasks are performed:
(1) Client Eligibility Determination;
(2) Assessment and Prioritization of Service Delivery for Eligible Clients;
(3) Delivery of Services to Eligible Clients; and
(4) Monitor the Performance of Subcontractors.
2.1.1 Client Eligibility Determination
The Recipient shall ensure that applicant data is evaluated to determine eligibility. Eligibility to
become a client is based on meeting the requirements described in this ATTACHMENT I,
SECTION 1.3.
2.1.2 Assessment and Prioritization of Service Delivery for New Clients
The Recipient shall ensure the following criteria are used to prioritize new clients for service delivery.
It is not the intent of the Agency to remove existing clients from any services in order to serve new
clients being assessed and prioritized for service delivery.
2.1.2.1 Priority Criteria for Service Delivery:
(1) Individuals in nursing homes under Medicaid who could be transferred to the community;
(2) Individuals in nursing homes whose Medicare coverage is exhausted and may be diverted to the
community;
(3) Individuals in nursing homes that are closing and can be discharged to the community;
(4) Individuals whose mental or physical health condition has deteriorated to the degree self care is not
possible; there is no capable caregiver, and institutional placement will occur within 72 hours; and
(5) For the purpose of transitioning individuals receiving CCDA and HCDA services through the Department
of Children and Families' Adult Services to community -based services provided through DOEA when
services are not currently available, area agency on aging staff and lead agency case managers will ensure
that "Aging Out" individuals are prioritized for services only after APS High Risk and Imminent Risk
individuals.
2.1.2.2 Priority Criteria for Service Delivery for Other Assessed Ind;, iduals:
The assessment and provision of services should always co,-. ,;der the most cost effective means of service
delivery. Functional impairment will be determined throe the Agency and or Department's functional
assessment form administered to each applicant. The most ;:::il individuals not prioritized as described in this
attachment, Paragraph 2.1.2.1 will receive services to the e;,tent funding is available.
2.1.3 Delivery of Services to Eligible Clients
The Recipient shall ensure the provision of a continuum of services that meet the diverse needs of the
functionally impaired elders and their caregivers. The Recipient shall ensure Basic Subside and Special
Subsidy services are performed in accordance with the cu re A Department of Elder Affairs Programs and
Services Handbook.
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July 2012 - June 2014 7/24/2012 Item 16.D.15.
2.1.3.1 Basic Subsidy
The Basic Subsidy is a cash payment made to an approved caregiver each month to reimburse some expenses
incurred in caring for the client. The Basic Subsidy is provided for support and maintenance of the care
recipient, including housing, food, clothing, and medical costs not covered by Medicaid, Medicare or any other
insurance. A Basic Subsidy shall be paid to approved caregivers when the client is in the home for any part of
the month. If the client is hospitalized or in any other temporary institution for 30 days or less, the full Basic
Subsidy shall be provided to the caregiver as if the client were in the home.
2.1.3.1.1 Calculating the Basic Subsidy
The Basic Subsidy shall be based on the financial status of the client receiving care. In the event that both a
husband and wife are clients, their combined financial status shall be used to determine the amount of the
Basic Subsidy.
2.1.3.2 Special Subsidy Services
Though every eligible HCE client receives a Basic Subsidy, Special Subsidy payments are pre - authorized and
are based on additional specialized medical or health care services, supplies or equipment needed to maintain
the health and well -being of the individual elder. The Special Subsidy for additional medical support and
special services is a cash payment to reimburse the costs of any other service or special care not covered by
Medicaid, Medicare, or private insurance when these services are determined to be essential to maintain the
well -being of the home care recipient. A Special Subsidy shall be paid to approved caregivers when the client is
in the home for any part of the month. Special Subsidy may be authorized through a vendor agreement. All
Special Subsidy services must be performed in accordance with the Department of Elder Affairs Programs and
Services Handbook. Special Subsidy services include:
(1) Adult Day Care; (8) Other;
(2) Chore; (9) Personal Care;
(3) Chore (Enhanced); (10) Respite (Facility Based or In- .Home);
(4) Homemaker; (11) Skilled Nursing Services;
(S) Housing Improvement; (12) Specialized Medical Equipment, Services and Supplies; and
(6) Vendor Payment; (13) Transportation.
(7) Material Aid;
2.1.3.3 ACCESS TO AND COORDINATION OF SERVICES
Through intake, case management and case aide services, the HCE client's needs are documented and needed
services are planned, arranged and coordinated for the client.
2.1.4 Use of Subcontractors
If this contract involves the use of a subcontractor or third party, then the Recipient shall not delay the
implementation of its agreement with the subcontractor. If any circumstances occur that may result in a delay
for a period of 60 days or more of the initiation of the subcontract or in the performance of the subcontractor,
the Recipient shall notify the Contract Manager and the Director of Finance in writing of such delay.
2.1.4.1 The Recipient shall not permit a subcontractor to perform services related to this agreement without having a
binding subcontractor agreement executed. In accordance with Paragraph 24.1 of the Standard Agreement, the
Agency or Department will not be responsible or liable for any obligations or claims resulting from such
action.
2.1.4.2 Monitoring the Performance of Subcontractors
The Recipient will monitor at least once per year each of its subcontractors, subrecipients, vendors and /or
consultants paid from funds provided under this contract. The Recipient will 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 Recipient will 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.
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2.2 SERVICE LOCATION AND EQUIPMENT 7/24/2012 Item 16.D.15.
2.2.1 Service Times
The Recipient shall ensure the provision of the services listed in this contract are available at times appropriate
to meet client service needs at a minimum, during normal business hours. Normal business hours are defined
as Monday through Friday, 8:00 a.m, to 5:00 p.m.
2.3 DELIVERABLES
2.3.1 Service Unit
The Recipient shall ensure the provision of the services described in the contract in accordance with the
current Department of Elder Affairs Programs and Services Handbook and the service tasks described in
Section 2.1. The chart below lists the type of services allowed and the unit of measurement. Units of service
will be paid pursuant to the rate established in this contract as updated, and approved by the Agency's
reporting requirements.
Service Unit of Service
Adult Day Care Housing Improvement
Case Aide Other
Case Management Personal Care
Chore Respite (Facility Based or In -Home) Hour
Chore (Enhanced) Skilled Nursing Services
Homemaker
Material Aid
Specialized Medical E ui ment, Services and Supplies Episode
Transportation One -Way Tri
2.4 REPORTS
The Recipient shall respond to additional routine and /or special requests for information and reports required
by the Agency in a timely manner as determined by the Contract Manager. The Recipient shall establish due
dates for any subcontractors that permits the Recipient to meet the Agency's reporting requirements.
2.4.1 Client Information and Registration Tracking System ( CIRTS) Reports
The Recipient shall input HCE specific data into CIRTS database system to ensure CIRTS data accuracy. The
Recipient shall use CIRTS generated reports which include the following:
(1) Client Reports;
(2) Monitoring Reports;
(3) Services Reports;
(4) Miscellaneous Reports;
(5) Fiscal Reports;
(6) Aging and Disability Resource Center Reports; and
(7) Outcome Measurement Reports.
2.4.2 Service Costs Reports
The Recipient shall require its subcontractors to submit to it the Recipient semi - annual service cost reports,
February 15 and August 15 of each year, which reflect actual costs of providing each service by program. This
report provides information for planning and negotiating unit rates.
2.4.3 Surplus/Deficit Report
The Recipient shall submit a consolidated surplus /deficit report in a format provided by the Agency to the
Contract Manager by the 1 8th of each month. This report is for all agreements and /or contracts between the
Recipient and the Agency. This report will include the following:
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(1) The Recipient detailed plan on how the surplus or deficit spending exce. 7/24,/2012 Item 16.D.15.
the Agency will be resolved; and
(2) Recommendations to transfer funds to resolve surplus /deficit spending.
2.5 RECORDS AND DOCUMENTATION
2.5.1 The Recipient shall ensure the collection and maintenance of client and service information on a monthly basis
from the CIRTS or any such system designated by the Agency and the State of Florida Department of Elder
Affairs. Maintenance includes valid exports and backups of all data and systems according to Department
and /or Agency standards.
2.5.2 The Recipient must ensure all data for HCE subsidies are entered in the Client Information and Registration
Tracking System (CIRTS) by the 15th of each month. HCE subsidy data entered into the CIRTS by the 15th of
the month will be for payments incurred between the 16th of the previous month and the 15th of the current
month. Case management data entered into the CIRTS by the 15th of the month will be for units of service
provided during the previous month from the 16th and up to and including the 15th of the current month or
case management units of service may be entered according to the Recipient schedule, in aggregate on the 31 st
or daily, weekly or monthly.
2.5.3 The Recipient and each subcontractor, among other requirements, must anticipate and prepare for the loss of
information processing capabilities. The routine backing up of all data and software is required to recover from
Iosses 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, offshe location. The Recipient shall maintain written policies and procedures for computer system
backup and recovery and shall have the same requirement in its contracts and /or agreements with
subcontractors. These policies and procedures shall be made available to the Agency upon request.
2.5.4 The Recipient will ensure data entry for HCE subsidies will cease on the 15th of the month and the CIRTS
Monthly Service Utilization Report, by consumer and by worker identification is generated.
_.5.5 The Recipient will ensure the Monthly Utilization Report, by consumer and by worker identification is verified,
corrected, certified no later than the 20th of the month in which the report is generated.
2.5.6 The Recipient will ensure copies of receipts for all HCE special subsidies of $150 and over will accompany the
Monthly Utilization Report. These receipts should be no older than 90 days. Payment of HCE spial
subsidies will not he processed until supporting documentation is received by the agency no later than the 20' ►'
ec
of the month in which the report is generated.
2.6 PERFORMANCE SPECIFICATIONS
2.6.1 Outcomes
(1) The Recipient shall ensure services provided under this car -act are in accordance with the current DOEA
Programs and Services Handbook.
(2) The Recipient shall timely submit to the Agency all repo -is described in ATTACHMENT I, SECTION
2.4 REPORTS; and
(3) The Recipient shall timely submit to the Agency all information described in ATTACHMENT I,
SECTION 2.5 RECORDS AND DOCUMENTATION.
2.6.2 The Recipient shall develop and document strategies in the Request for Proposal (RFP) to support performance
achievement of the following:
(1) Percent of most frail elders who remain at home or in t':e community instead of going into a nursing
home;
(2) Average monthly savings per consumer for home and community -based care versus nursing home care for
comparable group clients;
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July 2012 — June 2014
7124/2012 item 16. D.15.
(3) Percent of elders assessed with high or moderate risk environments w11., 11AIFI U VV U «1„11 CAI v ii viaiiiv,
score;
(4) Percent of new service recipients with high -risk nutrition scores whose nutritional status unproved;
(5) Percent of new service recipients whose ADL assessment score has been maintained or improved;
(6) Percent of new service recipients whose IADL assessment score has been maintained or improved;
(7) Percent of family and family- assisted caregivers who self -report they are likely to provide care;
(8) Percent of caregivers whose ability to provide care is maintained or improved after one year of service
intervention (as determined by the caregiver and the assessor); and
(9) Percent of customers who are at imminent risk of nursing home placement who are served with
community based services;
2.7 RECIPIENT'S FINANCIAL OBLIGATIONS
Special subsidy payments for each client and for the program overall must be maintained within the amount
of program funding available. The Recipient will refund the Agency for any subsidy payments made to
vendors and /or caregivers for services performed after the death of the client.
2.7.1 Use of Service Dollars /Assessed Priority Consumer List Management
The Recipient is expected to spend all federal, state and other funds provided by the Agency for the purpose
specified in each contract. The Recipient must manage service funds in such a manner so as to avoid having a
wait list and a surplus of fiends at the end of the contract period for each program managed by the Agency. If
the Agency determines that the Recipient is not spending service funds accordingly, the Agency may transfer
funds to other planning and service areas during the contract period and /or adjust subsequent funding
allocations accordingly, as allowable under state and federal law.
2.8 AGENCY RESPONSIBILITIES
2.8.1 Program Guidance and Technical Assistance
The Agency will provide to the Recipient guidance and technical assistance as needed to ensure the successful
fulfillment of the contract by the Recipient.
2.8.2 Contract Monitoring
The Agency will review and evaluate the performance of the Recipient under the terms of this contract.
Monitoring shall be conducted through direct contact with the Recipient through telephone, in writing,
or an onsite visit. The Agency's determination of acceptable performance shall be conclusive. The
Recipient 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:
(1) Desk reviews and analytical reviews;
(2) Scheduled, unscheduled and follow -up on -site visits;
(3) Client visits;
(4) Review of independent auditor's reports;
(5) Review of third -party documents and /or evaluation;
(6) Review of progress reports;
(7) Review of customer satisfaction surveys;
(8) Agreed -upon procedures review by an external auditor or consultant;
(9) Limited -scope reviews; and
(10) Other procedures as deerned necessary.
SECTION III: METHOD OF PAYMENT
3.1 General Statement of Method of Payment
The method of payment for this contract includes advances, cost reimbursement for administration costs, and
fixed rate for services. The Recipient shall ensure fixed rates for services include only those costs that are in
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July 2012 – June 2014 7/24/2012 Item 16.D.15.
accordance with all applicable state and federal statutes and regulations and — VLtJV4 �., .,u..,..,, ---- --
costs in instances where an independent audit is required. The Recipient shall consolidate all requests for
payment from subcontractors and expenditure reports that support requests for payment and shall submit to the
Agency on forms 106H (ATTACHMENT IX) and 105H (ATTACHMENT X).
3.1.1 The Recipient agrees to distribute funds as detailed in the area plan update and the Budget Summary,
ATTACHMENT VII to this contract. Any changes in the total amounts of the Rinds identified on the Budget
Summary form require a contract amendment.
3.1.2 Effective July 1, 201.2, all newly enrolled caregivers will receive payment via direct deposit. The case
managers will have until Decemner .i1, 2UiZ ro get current ciienis' caregivers set up for HCE direct deposit.
Any client, whose caregiver is not set up for direct deposit, will not be eligible to receive HCE services.
3.2 Advance Payments
3.2.1 The Recipient may request up to two months of advances at the start of the contract period to cover program
administrative and service costs. The schedule for submission of advance requests, if available, is shown on
ATTACHMENT VII to this contract. The payment of an advance will be contingent upon the sufficiency and
amount of finds released to the Agency and the State of Florida Department of Elder Affairs ( "budget
release ").
The Recipient shall provide the Contract Manager documentation justifying the need for an advance and
describing how the funds will be distributed.
3.2.2. The Recipient's requests for advance require the approval of the Contract Manager. If sufficient budget is
available, the Agency will issue approved advance payments after July 1, 2012,
3.2.3 All advance payments made to the Recipient shall be returned to the Agency as follows: one – twelfth
of the advance payment received shall be reported as an advance recoupment on each request for payment,
starting with report number three, in accordance with the Invoice Schedule, ATTACHMENT VIII to this
contract.
3.2.4 The Recipient may temporarily place advanced finds in an FDIC insured interest bearing account. All interest
earned on contract fund advances must be returned to the Agency within thirty (30) days of the end of each
quarter of the contract period.
3.3 Invoice Submittal and Requests for Payment
All requests for payment and expenditure reports submitted to support requests for payment for Case
Managernent/Case Aide shall be on DOEA forms 106H (ATTACHMENT IX) and 105H
(ATTACHMENT X). Duplication or replication of both forms via data processing equipment is permissible,
provided all data elements are in the same format as included on Agency forms.
3.3.1 All payment requests shall be based on the submission of actual monthly expenditure reports beginning with
the first month of the contract. The schedule for submission of advance requests and invoices is
ATTACHMENT VIII to this co,- :Tact.
3.3.2 Remedies- Nonconforrr` Services
The Recipient shall ensure that all goods and /ors :Vices P;_0V:' -1 under this contract for HCE funded
prograrns are delivered timely, completely and commensurate w; : required standards of quality Such goods
and /or services shall only be delivered to eligible program partic" ants.
If the Recipient fails to meet the prescribed quality standards ;)r services, such services will not be reimbursed
under this contract. In addition, any nonconforming good ;including home delivered meals) and /or services
not meeting such standards will not be reimbursed under t' ;s contract. The Recipient's signature on the request
for payment form certifies maintenance of supporting documentation and acknowledgement that the Recipient
shall solely bare the costs associated with preparing or providing nonconforming goods and /or services. The
Agency and or Department require immediate notice of any significant and/or systemic infractions that
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July 2012 —June 2014
compromise the quality, security or continuity of services to clients. 724/2012 Item 16. D.15.
3.3.3 Financial Consequences
Recipient shall ensure the provision of services to the projected number of clients in accordance with the Area
Plan as updated and within the contract amount. The Recipient shall ensure expenditure of 100% of the
contract amount budgeted for services to clients at the unit rates established in the Area Plan. In the event the
Recipient has a surplus of 1% or more at the end of the first year of the contract term, the Agency will
reallocate I% of the budget for the second year of the contract term to other area agencies found to be serving
clients to the fullest extent of their allocated budgets. If, or to the extent, there is any conflict between this
paragraph and paragraphs 39 and 39.1 of the standard contract, this paragraph shall have precedence.
3.3.4 All payment requests shall be based on the submission of actual monthly expenditure reports beginning with
the first month of the contract. The schedule for submission of advance requests (when available) and invoices
is ATTACHMENT VII to this contract.
3.3.5 Any payment due by the Agency under the terns of this contract may be withheld pending the receipt and
approval by the Agency of all financial and programmatic reports due from the Recipient and any adjustments
thereto, including any disallowance not resolved as outlined in Section 26 of this contract.
3.3.6 Payment may be authorized only for allowable expenditures, which are in accordance with the limits specified
in ATTACHMENT VIII, Budget Summary.
3.3.7 Date For Final Request For Budget Revisions
Final requests for budget revisions or adjustments to contract funds based on expenditures for services provided
through June 30, 2013, must be submitted to the Contract Manager no later than the contract end date of
June 30, 2013.
3.3.8 Date for Final Request for Payment
The final request for payment for contract year one's expenditures will be due to the Agency no later than
August 1, 2013. The final request for payment for contract year two expenditures will be no later than
August 1, 2014.
3.4 Documentation for Payment
The Recipient shall maintain documentation to support payment requests that shall be available to the Agency
or authorized individuals upon request. Such documentation shall be provided upon request to the Agency or
the Department of Financial Services.
3.4.1 The Recipient must ensure all data for HCE subsidies are entered in the Client Information and Registration
Tracking System (CIRTS) by the 15th of each month. HCE subsidy data entered into the CIRTS by the 15th of
the month will be for payments incurred between the 16th of the previous month and the 15th of the current
month. Case management data entered into the CIRTS by the 15th of the month will be for units of service
provided during the previous month from the 16th and up to and including the 15th of the current month or
case management units of service may be entered according to the Recipient schedule, in aggregate on the 31st
or daily, weekly or monthly. The Recipient will ensure data entry for HCE subsidies will cease on the 15th of
the month and the CIRTS Monthly Service Utilization Report, by consumer and by worker identification is
generated. The Recipient will ensure the Monthly Utilization Report, by consumer and by worker -
identification is verified, corrected, certified no later than the 20,1-1 of the month in which the report is
generated.
3.4.2 The Recipient will be required to enter all required data per the " ;partment's CIRTS Policy Guidelines for
clients and services in the CIRTS database. The data must be c . -,red into the CIRTS before the Recipient
submits their request for payment and expenditure reports to the agency by the twentieth, 20°i, of the month.
See ATTACHMENT VII for all invoice dates. The Agency s' .,11 establish time frames to assure compliance
with dire dates for the requests for payment and expenditure re, offs to the Agency and the Department.
3.4.3 The Agency will require the Recipient to run monthly CIRTS reports and verify that the client and service data
in the CIRTS is accurate. This report must be submitted to the Agency with the monthly request for payment
and expenditure report and must be reviewed by the Agency before the Recipient's request for payment and
expenditure reports can be approved by the Agency.
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July 2012 — June 2014
7/24/2012 Item 16.D.15.
ATTACHMENT II
ATTACHMENT II
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND
AGREEMENTS
The undersigned certifies, to Ll.c l;est of his or
(1) No federal appropriated finds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of any state or federal agency, a member of congress, an
officer or employee of congress, an employee of a member of congress, or an officer or employee of the state
legislator, in connection with the awarding of any federal grant, the making of any federal loan, the entering into of
any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal
contract, grant, loan, or cooperative agreement.
(2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a member of congress, an officer or employee of
congress, or an employee of a member of congress in connection with this federal contract, grant, loan, or cooperative
agreement, the undersigned shall complete and submit Standard Form -LLL, "Disclosure Form to Report Lobbying,"
in accordance with its instructions.
(3) The undersigned. shall require that the language of this certification be included in the award documents for all sub -
awards at all tiers (including subcontracts, sub- grants, and contracts under grants, loans and cooperative agreements)
and that all subcontractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made
or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed
by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil
penalty of not less than $10,000 and not more than $100,000 for each such failure.
Signature
Name of Authorized Individual
Collier County Board' of
Name Commissioners
3299 Tamiami Trail E
Naples, FL 34112
Date
Application or Agreeme .Limber
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' kra r er:t r ;. lo,i: tilt €i
Aria t r`l y.' n �-
U!�1 � ,fit +r�;
July 2012 — June 2014
7/24/2012 Item 16.D.15.
K 1 1 t1LII1�1L' 1 t i lil
FINANCIAL AND COMPLIANCE AUDIT
The administration of resources awarded by the Area Agency on Aging for Southwest Florida, Ino,dba Senior Choices of '00 '
Southwest Florida and /or the Department of Elder Affairs to the provider may be subject to audits and /or monitoring by the
Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or the Department of
Elder Affairs as described in this section.
MONITORING
In addition to reviews of audits conducted in accordance with OMB Circular A -133, as revised, and Section 215.97, F.S., (see
"AUDITS" below), monitoring procedures may include, but not be limited to, on -site visits by the Agency staff, limited scope
audits as defined by OMB Circular A -133, as revised, and /or other procedures. By entering into this agreement, the provider
agrees to comply and cooperate with any monitoring procedures /processes deemed appropriate by the Area Agency on Aging
for Southwest Florida, Inc. In the event the Area Agency on Aging for Southwest Florida, Inc. determines that a limited scope
audit of the provider is appropriate, the provider agrees to comply with any additional instructions provided by the Area Agency
on Aging for Southwest Florida, Inc. to the provider regarding such audit. The provider further agrees to comply and cooperate
with any inspections, reviews, investigations, or audits deemed necessary by the 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
CircularA -133, as revised.
In the event that the provider expends $500,000 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 I to this
agreement indicates federal resources awarded through the Area Agency on Aging for Southwest Florida, Inc.dba Senior
Choices of Southwest Florida and /or the Department of Elder Affairs by this agreement. in determining the federal awards
expended in its fiscal year, the provider shall consider all sources of federal awards, including federal resources received from
the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or the Department of Elder
Affairs. The determination of amounts of federal awards expended should be in accordance with the guidelines established by
OMB Circular A -133, as revised. An audit of the provider conducted by the Auditor General in accordance with the provisions
of OMB Circular A -133, as revised, will meet the requirements of this part.
In connection with the audit requirements addressed in Pant I, paragraph 1, the provider shall fulfill the requirements relative to
auditee responsibilities as provided in Subpart C of OMB Circular A -133, as revised.
If the provider expends less than $500,000 in federal awards in its fiscal year, an audit conducted in accordance with the
provisions of OMB Circular A -133, as revised, is not required. In the event that the provider expends less than $500,000 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 pact shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Area Agency on Aging for Southwest Florida, Inc. and /or the Department
of Elder Affairs shall be based on the agreement's requirements, including any rules, regulations, or statutes referenced in the
agreement. The financial statements shall disclose whether or not the matching requirement was met for each applicable
agreement. All questioned costs and liabilities due to the Area Agency on Aging for Southwest Florida, Inc. dba Senior
Choices of Southwest Florida and /or the Department of Elder Affairs shall be :Lilly disclosed in the audit report with reference
to the Area Agency on Aging for Southwest Florida, Inc. and /or the Depart. ent of Elder Affairs 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 Area Agency on Aging for
Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or t!le Department of Elder Affairs in effect during the
audit period. Financial reporting packages required under this part must be submitted within the earlier of 30 days after receipt
of the audit report or 9 months after the end of the provider's fiscal year end.
26
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July 2012 — June 2014
PART II: STATE FUNDED
7/24/2012 Item 16.D.15.
This part is applicable if the provider is a nonstate entity as defined by Section 215.97(2), Florida Statutes.
In the event that the provider expends a total amount of state financial assistance equal to or in excess of $500,000 in any fiscal
year of such provider (for fiscal years ending September 30, 2004 or thereafter), the provider must have a State single or
project - specific audit for such fiscal year in accordance with Section 215.97, Florida Statutes; applicable rules of the
Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for - profit
organizations), Rules of the Auditor General. EXHIBIT I to this agreement indicates state financial assistance awarded through
the Area Agency on Aging for Southwest Florida, Inc. and /or the Department of Elder Affairs by this agreement. In
determining the state financial assistance expended in its fiscal near, the provider shall consider all sources of state financial
assistance, including state financial assistance received from the Area Agency on Aging for Southwest Florida, Inc.dba Senior
Choices of Southwest Florida and/or the Department of Elder Affairs, other state agencies, and other nonstate entities. State
financial assistance does not include federal direct or pass - through awards and resources received by a nonstate entity for
federal program matching requirements.
In connection with the audit requirements addressed in Part I1, paragraph 1, the provider shall ensure that the audit complies
with the requirements of Section 215.97(8), Florida Statutes. This includes submission of a financial reporting package as
defined by Section 215.97(2), Florida Statutes, and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for -
profit organizations), Rules of the Auditor General.
If the provider expends less than $500,000 in state financial assistance in its fiscal year (for fiscal years ending September 30,
2004 or thereafter), an audit conducted in accordance with the provisions of Section 215.97, Florida Statutes, is not required. In
the event that the provider expends less than $500,000 in state financial assistance in its fiscal year and elects to have an audit
conducted in accordance with the provisions of Section 215.97, Florida Statutes, the cost of the audit must be paid from the
nonstate entity's resources (i.e., the cost of such an audit must 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 Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of
Southwest Florida and /or the Department of Elder Affairs shall be based on the agreement's requirements, including any
applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching requirement was
met for each applicable agreement. All questioned costs and liabilities due to the Area Agency on Aging for Southwest Florida,
.ic. dba Senior Choices of Southwest Florida and /or the Department of Elder Affairs shall be fully disclosed in the audit report
with reference to the Area Agency on Aging for Southwest Florida, Inc. and /or the Department of Elder Affairs agreement
involved. If not otherwise disclosed as required by Rule 69I- 5.003, Fla. Admin. Code, the schedule of expenditures of state
financial assistance shall identify expenditures by agreement number for each agreement with the Area Agency on Aging for
Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or the Department of Elder Affairs 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 gov„ inmental entities. Non- profit or for - profit
organizations are required to be submitted within 45 da• after delivery of the audit report, but no later than 9 months after the
provider's fiscal year end. Notwithstanding the applic, . 11ity of this portion, the ea Agency on Aging for Southwest Florida,
Inc. dba Senior Choices of Southwest Florida and /oi ")epartment of Elder A' airs retains all right and obligation to monitor
and oversee the performance of this agreement as ughout this doCli? -,nt and pursuant to law.
PART III: REPORT SUBMISSION
Copies of reporting packages for audits conducted in accordance with OMR Cir„ular A -133, as revised, and required by PART I
of this agreement shall be submitted, NO- ..au "y Section .32C ' ), (Y C�.. "lar A -133, as revised, by or on behalf of the
provider directly to each ofthe foll-
The Area Agency on Aging for South, ,* 7 iorida, Inc. dba Sonic "hoices of Sout ~- , - Florida at the following address:
Area. Agency on Agiu outhwest Florida, Inc.
dba Senior Choices of Southwest Florida
Attn: Leigh Wade, Exec - ive Director
15201 N Cleveland 4 Suit. 1100
No: th F',;-i v%yers, t i. 339;`t3)
27
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July 2012 — June 2014 7/24/2012 Item 16. D.15.
The Federal Audit Clearinghouse designated in OMB Circular A -133, as revised (the _ r._
Sections .320 (d)(1) and (2), OMB Circular A -133, as revised, should be submitted to the Federal Audit Clearinghouse), at the
following address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10`' 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), OR Fi s revise,4 "h '"mvider shall submit a copy of the reporting package
described in Section .320(c), OMB Circular A -133, as rev' .,a, and any management Ietter issued by the auditor, to the Area
Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida at the following address:
Area Agency on Aging for Southwest Florida, Inc.
dba Senior Choices of Southwest Florida
Attn: Leigh Wade, Executive Director
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. dba Senior Choices of Southwest Florida at the following address:
Area Agency on Aging for Southwest Florida, Inc.
dba Senior Choices of Southwest Florida
Attn: Leigh Wade, Executive Director
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
Ill West Madison Street
Tallahassee, Florida 32399 -1450
Any reports, management letter, or other information required to be submitted to the Area Agency on Aging for Southwest
Florida, Inc. pursuant to this agreement shall be submitted timely in accordance with OMB Circular A -133, Florida Statutes,
and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for -profit organizations), Rules of the Auditor
General, as applicable.
Providers, when submitting financial reps, ping packages to the Area Agency n Aging for Southwest Florida, Inc, for audits
done in accordance with OMB Circular A -133 or Cfi ,rs 10.550 (local „. nmental entities) or 10.650 (nonprofit and for -
profit organizations), Rules of the Aud",lor �1, ,,.., ,,, ...�. � u ..,� � u � d Iivered to the
provider in correspondence accom n r,: .ne reporting package.
PART IV: R FCG:r_O RETENTION
The provider shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of six
years from the date the audit report is issued, and shall allow the Area Agency on Aging for Southwest Florida, Inc. dba Senior
Choices of Southwest Florida and or the Department of Elder Affairs 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 Area Agency on Aging for
Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or the Department of Elder Affairs, or its designee, CFO,
or Auditor General upon request for a period of six years from the date the audit report is issued, unless extended in writing by
the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or the Department of Elder
Affairs.
NX
Packet Page -2797-
July 2012 — June 2014
7/24/2012 Item 16.D.15.
ATTACHMENT III
EXHIBIT —1
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT
CONSIST OF THE FOLLOWING:
TOTAL FEDERAL AWARD
CFDA I AMOUNT
$0
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT
TO THIS AGREEMENT ARE AS FOLLOWS:
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT
CONSIST OF THE FOLLOWING:
ATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE � CFDA AMOUNT
TOTAL STATE AWARD
i $0
STATE FINA1'YNCL i, ASSISTANCE SUBJECT TO See. 215.97, F.S.
PROGRAM TITLE m FUNT't_NG SOUR(-' 'A AMOUNT
Hoe Cate for the Elderly Pro- ; ain -
1eT wenu, 65001 $61,709.00
TOTAL AWARD $61,709,00
COMPLIANCE REQUIREMENTS APPLICABLE TO STAT- RESOURCES AWARDED PURSUANT TO
THIS AGREEMENT ARE AS FOLLOWS:
29
Packet Page -2798-
_JUIyl.U1L-
Jutie lU 14
7/24/2012 Item 16.D.15.
ATTACHMENT III
PART is AUDIT RELATIONSHIP DETERMINATION EXHIBIT -2
Providers who receive state or federal resources may or may not be subject to the audit requirements of OMB Circular A -133, as
revised, and/or Section 215.97, Fla. Stat. Providers who are determined to be recipients or subrecipients of federal awards and /or state
financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I and /or Part I1 of
Exhibit 1 are met. Providers who have been determined to be vendors are not subject to the audit requirements of OMB Circular A-
133, as revised, and /or Section 215.97, Fla. Stat. Regardless of whether the audit requirements are met, providers who have been
determined to be recipients or subrecipients of federal awards and/or state financial assistance, must comply with applicable
programmatic and fiscal compliance requireme-
In accordance with Sec. 210 of OMR `;. ular A -133 and /or Rule 691 - 5.006, FAC, provider has been determined to be:
Vendor or ;_n of enti *. , ..,d not subject to OMB Circular A -133 and /or Section 215.97, F.S.
X Recipient /subrecipient subject to OMB Circu'at ", -133 snr1 /or Section 215.97, F.S.
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 69I- .006(2), FAC [state financial assistance and
Section _ .400 OMB Circular A -133 [federal awards]. ]
PART II: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Providers who receive federal awards or
state matching funds on federal awards and who are determined to be a subrecipient, must comply with the following fiscal laws, rules
and regulations:
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR Part 225 Cost Principles for State, Local and Indian Tribal Governments (Formerly OMB Circular A -87)*
OMB Circular A -102 — Administrative Requirements
OMB Circular A -133 — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
NON - PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR Part 230 Cost Principles for Non - Profit Organizations (Formerly OMB Circular A -] 22 — Cost Principles)*
2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A -1 10 — Administrative Requirements)
Requirements)
OMB Circular A -133 —Audit Requirements
Reference Guide for S *ate Expenditures
Other fiscal requiren- tits set forth in program laws, rules and : gulations
EDUCATIONAL INSTIT' TIONS (EVEN IF A PART OF A ST.` E OR LOCAL GOVERNMENT) MUST
FOLLOW:
2 CFR Part 2- Cost Principles for Educational Institutior OMB (Formerly Cir ular A -21 — Cost Principles)*
2 CFR Parr ' 5 Administrative Requirements (Formerly ''13 Circular A -1 10 —'Administrative Requirements)
OMB Ci °::j)ar A -] 33 —Audit Requirements
Refer ,nce Guide for State Expenditures
"2r fiscal requirements set forth in rn•, ram laws, ri! and regulatir
*Some federal programs may be exempted from compliu, hh the O .L r .aciples Circulars as noted in the OMB Circular
A -133 Compliance Supplement, Appendix 1.
STATE FINANCIAL ASSISTANCE. Providers who recei�: state fina ' rs: >i.cnce and who are determined to be a
recipient /subrecipient, must comply with the following fiscal laws. ; ,Jes and re ations:
Section 215.97, Fla. Stat.
Chapter 69I -5, Fla. Admin. Code
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
30
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July 2012 - Ame 2014 7/24/2012 Item 16.D.15.
ATTACHMENT IV
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE
FOR AGREEMENTS, GRANTS, LOANS AND
COOPERATIVE AGREEMENTS
The undersigned, an authorized representative of the Recipient named in the contract or agreement to which this form is
an attachment, hereby certifies that:
(1) The Recipient and any 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 finds 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 Recipient, subcontractor(s), or any outside entity on which the
Recipient is dependent for data that is to be reported, transmitted or calculated, have been assessed and verified to be
capable of processing data accurately, including year -date dependent data. For those systems identified to be non-
compliant, contractor(s) will talce immediate action to assure data integrity.
(3) If this contract includes the provision of hardware, software, firmware, microcode or imbedded chip technology, the
undersigned warrants that these products are capable of processing year -date dependent data accurately. All versions
of these products offered by the Recipient (represented by the undersigned) and purchased by the State will be
verified for accuracy and integrity of data prior to transfer.
In the event of any decrease in functionality related to time and date related codes and internal subroutines that
impede the hardware or software programs from operating properly, the Recipient agrees to immediately make
required corrections to restore hardware and software programs to the same level of functionality as warranted herein,
at no charge to the State, and without interruption to the ongoing business of the state, time being of the essence.
(4) The Recipient and any subcontractor(s) of services under this contract warrant their policies and procedures include a
disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from
data integrity compliance issues.
The Recipient shall require that the language of this certification be included in all subagreements, subgrants, and other
agreements and that all 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 e:,tering into this transaction imposed by
OMB Circulars A -102 and 2 CFR Part 215 (formerly OMB Circular A -110).
Name and Address of Recipient
Signature Title Date
Name of Authorized Signer
# C
:(ii' till `<ei94e�11fiEv+'i:
(Revised dune 2008)
Collier County Board of !!
Commissioners i A S'' ! i�rliiltrG "ilay�
3299 Tamiami Trail E
Naples, FL 34112 31
Packet Page -2800-
July 2012 — June 2014 7/24/2012 Item 16.D.15.
na i11— 1 -
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND
VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS ,
(1) The prospective Recipient certifies, by signing this certification, neither it nor its principals is presently
debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in
this transaction by any federal department or agency.
(2) Where the prospective Recipient is unable to certify to any of the statements in this certification, such
prospective participant shall attach an explanation to this certification.
Signature Date
Title Agency /Organization
(Certification signature should be same as Contract signature.)
Instructions for Certification
1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction,"
"person," "primary covered transaction," and "voluntarily excluded," as used herein, have the meanings set out
in the sections of rules implementing Executive Order 12549. (2 CFR 180.5- 180.1020, as supplemented by 2
CFR 376.10- 376.995). You may contact the Contract Manager for assistance in obtaining a copy of those
regulations.
2. This certification is a material representation of facts upon which reliance was placed when the parties entered
into this transaction. If it is later determined that the Recipient knowingly rendered an erroneous certification,
in addition to other remedies available to the federal government, the Agency may pursue available remedies,
inchrding suspension and /or debarment.
3. The Recipient will provide immediate written notice to the Contract Manager if at any tirne the Recipient learns
that its certification was erroneous when submitted or has become erroneous by reason of changed
circumstances. The Recipient may decide the method and frequency by which it determines the eligibility of its
principals. Each participant to a lower tier covered transaction may, but is not required to, check the Excluded
Parties List System (EPLS).
4. The Recipient will include a "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary
Exclusion - Lower Tier Covered Transaction" in all its lower tier covered transactions and in all solicitations
for lower tier covered transactions.
5. The Recipient agrees that it shall not laiowingly enter into any lower tier covered transaction with a person who
is debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise
authorized by the federal government.
6. If the Recipient knowingly enters into a lower tier- covered transaction with a person who is suspended,
debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies
available to the federal government, the Agency may pursue available remedies, inchrding suspension, and /or
debarment.
7. The Recipient may rely upon a certification of a prospective participant in a lower tier covered transaction that
it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows
that the certification is erroneous.
(Revised June 2005)
a Sly ]41! '�Ef �t�f }r "aitl..
Packet Page -2801-
July 2012 – June 2014
7/24/2012 Item 160.15.
ASSURANCES— NON - CONSTRUCTION PROGRAMS ATTACHMENT VI
Public reporting burden for this collection of information is estimated to average 45 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the
collection of infonmation. Send comments regarding the burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348 - 0043),
Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND
BUDGET, SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions please contact the
awarding agency. Further, certain federal awarding agencies may require applicants to certify to additional assurances.
If such is the case, you will be notified.
1. Has the legal authority to apply for federal assistance, and the institutional, managerial and financial capability (including funds
sufficient to pay the non - federal share of project cost) to ensure proper planning, management, and completion of the project
described in this application.
2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized
representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish
a proper accounting system in accordance with generally accepted accounting standards or agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the
appearance of personal or organizational conflict of interest, or personal gain.
4. Will initiate and complete the work within the applicable time fi-ame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C..4728 -4763) relating to prescribed standards for merit
systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Merit
System of Personnel Administration (5 C.F.R. 900, Subpart F).
6. Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil
Rights Act of 1964 (P.L. 88 -352) which prohibits discrimination on the basis of race, color or national origin; (b) Title 1X of the
Education Amendments of 1972, as amended (20 U.S.C. 1681 -1683, and 1685 - 1686), which prohibits discrimination on the basis
Of sex; (c) Section 504 of the Rehabilitation Act of I973, as amended (29 U.S.C. 794), which prohibits discrimination on the basis
of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C., 6101 - 6107), which prohibits discrimination on the
basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92 -255), as amended, relating to nondiscrimination on
the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of
1970 (P.L. 91 -616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g). 523 and 527 of the
Public Health Service Act of 1912 (42 U.S.C., 290 dd -3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug
abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C., 3601 et seq.), as amended, relating to
nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statutes}
under which application for federal assistance is being made; and 0? the requirements of any other nondiscrirination statute(s)
which may apply to the application.
7. Will comply, or has already complied, with the requirements of Titles 1i and III of the uniform Relocation Assistance and Real
Property Acquisition Policies Act of 1970 (P.L. 91 -646) which provide for fair an i equitable treatment of persons displaced or
whose property is acquired as a result of federal or federally assisted programs. T! es-, requirements apply to all interests in real
property acquired for project purposes regardless of federal participation in purch : es.
8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C.. 15r l - l _"08 and 7324 - 7328), which limit the political
activities of employees whose principal employment activities are funded in r,` 'Ole or in part with federal funds.
a. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C.. 276a to 276a -7), the Copeland Act (40 U.S.C.
276c and 18 U.S.C., 874) and the Contract Work Hours and Safety Standards Act (40 U.S.C. 327 -333), regarding labor standards
for federally assisted construction subagreements.
33
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July 2012 —,rune 2014 7/24/2012 Item 16.D.15.
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) oft:., , ., ,, .., ... , _
1973 (P.L. 93 -234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood
insurance if the total cost of insurable construction and acquisition is $10,000 or more.
H. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental
quality control measures under the National Environmental Policy Act of 1969 (P.L. 91 -190) and Executive Order (EO) 11514;
(b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of
flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State
managem6nt program. developed under the Coastal Zone Management Act of 1972 (16 U.S.C. 1451 et seq.); (f) conformity of
federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1.955, as amended (42
U.S.C. 7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as
amended, (P.L. 93 -523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L.
93 -205).
12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C._ 1721 et seq.) related to protecting components or potential
components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as
amended (16 U.S.C._470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic
Preservation Act of 1974 (16 U.S.C.,469a -1 et seq.).
14. Will comply with P.L. 93 -348 regarding the protection of human subjects involved in research, development, and related
activities supported bythis award of assistance.
15. Will comply with the Laboratory Animal. Welfare Act of 1966 (P.L. 89 -544, as amended, 7 U.S.C.,2131 et seq.) pertaining to the
care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of
assistance.
16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C.,4801 et seq.), which prohibits the use of lead- based
paint in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of
1996 and OMB Circular No. A -133, Audits of States, Local Governments, and Non - Profit Organizations.
] 8. Will comply with all applicable requirements of all other federal laws, executive orders, regulations and policies governing this
program.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL
TITLE
K
APPLICANT ORGANIZATION
DATE SUBMITTED
�t
34
Packet Page -2803-
July 2012 — June 2014
HOME CARE FOR THE ELDERLY
INVOICE SCHEDULE
7/24/2012 Item 16.D.15.
t1 • it ♦ a 1 as
Report
Submit to Agency
Number
Based On
On This Date
,inc(-*
July 1
2
August Adva�ice*
July 1
3
July Expenditure Report
August 20
4
August Expenditure Report
September 20
5
qP ' - -mber Expenditure Report
October 20
6
October rnpenditure keport
November 20
7
November Expenditure Report
December 20
8
December Expenditure Report
January 20
9
January Expenditure Report
February 20
10
February Expenditure Report
March 20
11
March Expenditure Report
April 20
22
April Expenditure Report
May 20
13
May Expenditure Report
June 20
14
June Expenditure Report
July 20
15
Final Request for Payment
August 1
16
Closeout Report
August 15
Legend: * Advance based on projected cash need.
Note # l: Report #1 for Advance Basis Contracts cannot be submitted to the Area Agency on Aging
for Southwest Florida, Inc. dba Senior Choices of Southwest Florida prior to July 1 or until
the contract with the Agency has been exe Jted and a copy sent to Area Agency on Aging
for Southwest Florida, Inc. dba Senior Choic of Southwest Florida. Actual submission of the
vouchers to DFS is dependent on the ac( icy of the expenditure report.
Note # 2: All advance payments made to the Re :ent shall be returned to the Agency as follows:
one — twelfth of the advance pad ,;nt received shall be reported as an advance
recoupment on each request for 1- _ ;Went, starting v,'ith report number three. The
adjustment shall be recorded in Par, , 1 of the repor+ ' Attachment X).
Note # 3: Submission of expenditure reports may or may
expenditure report reflects funds due back to +'
rek?nrt:
35
Packet Page -2804-
generate a payment request. If final
payment is to accompany the
July 2012 — June 2014
HOME CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
Collier County Board of Commissioners
HCE Case Mana,,�ciueu,
HCE Basic Subsidies 13 -27 -HCE l llci: *s
HCE Special Subsidies
Total
7/24/2012 Item 16.D.15.
$ 4,601.00
16,428.00
40,680.00
$61,709.00
HOME CARE FOR THE ELDERLY PROGRAM
RATE SUMMARY
SERVICES
Case Management
Case Aide
36
Packet Page -2805-
REIMBURSEMENT RATE
$55.50
$30.00
v
July 2012 — June 2014
7/24/2012 Item 16.D.15.
ATTACHMENT IX
REQUEST FOR PAYMENT
HOME CARE FOR THE ELDERLY PROGRAM
RECIPIGHT NAME, ADDRESS, PHONEt and FEIDt
TYPE OF PAYMENT:
Tate, Requeal Period. From
Ta:
Regrda
Contract Pa+od
Contract x
kwanca
Repurtt
PSA I
CERTIFICATION: I Item" caa;ty to the bast of my krorvtedge that Iris request is cor ptek and correct and canfams �NAh the Iermt and the purposes of the above, contrad.
Propared by. Date.
Approved by
we
PART A BUDGET SOMMARY
AAA Admin.
Case Management
SLbdt9u
TOTAL
t. Approved Cc Mead Amount
$0.00
$000
$000
60 00
2. Prevlau Funds Recelved for Cbntrest p*—d
SOAR
$0.00
SO4D
$0.00
3. Contract Salance (fine I minus fires 2)
$0.00
$0 -00
6040
$0.00
4. Previous Funds Roquo oed and Not Received for Contract Period
$0.00
$000
$000
5000
S, CONTRACTPALANCE(rne3 Minus fine 4)
$0.00
$000
5080
$0 00
PARTS: CONTRACT FUNDS REOUEEESTt)SO.00
1. Ardicipated caste deed (t st - 2nd mon
$
$0.00
2. Nat Expandkures For Month
iDOc'A Form 10fitL Part B Lined)
$
SO 00
3. TOTAL
WOO
$000
PART C; NET FUNDS REQUESTED
1. Less Advance Applied
2. TOTAL FUNDS REOUESTEO (Peel R L
$000
5000
00
SOW
List at F.arvicas f Unfts I Rates Ptovided- Sea ahechad report.
DOEA FORM 108H
37
Packet Page -2806-
July 2012 — June 2014
RECEIPT AND EXPENDITURE REPORT
HOME CARE FOR THE ELDERLY PROGRAM
7/24/2012 Item 16.D.15.
ATTACHMENT X
PROVIDER NAME, ADDRESS. PHONE # and FEIDo
Program Funding:
THIS REPORT PERIOD:
From To
AAA Admin
-
CONTRACT PERIOD
--
Cast Management
CONTRACT N
Subsf dies'
REPORT #
Basic
Spedal
PSA#
CERTIFICATION.- I certify to the best of my knowledge and belief that the report Is complete
herein are for purposes set forth in the contract.
and
corned and all outlays
Prepared by ., Oate :
ApRa+ad by :
Oale :
PART A: BUDGETED INCOME / RECEIPTS
1. Approved
2. Actual Receipts
3. Total Recdpls
4. Percent of
Bud
For This R
Yew to Date
roved Bud-cat
1, State Funds
$000
x.00
SO 00
NDN/OI
2. TOTAL RECEIPTS
50.00
s0.00
So.00
#DIVrol
PART 8: EXPENDITURES
t. Approved
Bud t
2. Expenditures
3. Expendtures
4. percent of
For This R ort
Year to Date
roved Bud et
1, AAA Program Administration
2 Service Subcontractors: Case Management
S;0 00
SD.DO
$0.00
#?Ntt31
3. Service Subcontractors: Subsidy
WOO
150.00
PDIVIOI
e. Basic Subsidy
$0.00
$0.00
$0.00
#DIVl0f
b, Special Sub5roy
50.00
50 DO
$0.00
SO-OD
t#DIVIDI
$0.00
$0 DO
trcO. IVlOI
4. TOTAL EXPENDITURES
50.00
60.00
50.00
#JNIOt
PART C: OTHER REVENUE AND EXPENDITURES
i, Interest:
II Advance Recoupment
t. Earned on C3R Advance $
2, Return of GR Advance 5
3. Other Eamed S
t. Advance Recouped $
DC�k FirF,:d 1Cf,N
38
Packet Page -2807-
7/24/2012 Item 16.D.15.
Attestation Statement
Agreement /Contract Number HCE 203.12
Amendment Number
1, 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 dba as Senior Choices of Southwest Florida and
Collier County Board of 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.
Steve Carn`ell, Interim Administrator
Collier County Public Services Division Date
Packet Page -2808-
7/24/2012 Item 16.D.15.
Verification of Employment Status Certification
As a condition of contracting with the Area Agency on Aging for Southwest Florida, Inc. dba
Senior Choices of Southwest Florida, Collier County Board of County Commissioners, hereby
referred to as Recipient, 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 Recipient during the
contract term to perform employment duties pursuant to this Agreement 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 contract term.
Signature
(Same as contract signature)
Steve Carnell, Interim Administrator
Collier County Public Services Division
Title
Collier- County Board of Commissioner
Company
(?,q I 1 -Z
Date
Packet Page -2809-
7/24/2012 Item 16.D.15.
VERIFICATION OF EMERGENCY PREPAREDNESS PLAN
Contract # HCE 203.12
I, Steve Carrell certify that Collier County Board of Commissioners
(Name of authorized contractor representative) (Name of contractor)
has a current and properly maintained Emergency Preparedness Plan. Assurance is given that
the plan will be made available to the Area Agency on Aging for Southwest Florida, Inc. dba
Senior Choices of Southwest Florida, upon request.
Signature of authorized contractor representative
Interim Administrator Collier County Public Services Division
Title
9
Date
Collier County Board of Commissioners
Company
October 2008
Packet Page -2810-
7/24/2012 Item 16.D.15.
CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS
The undersigned, an authorized representative of the Contractor named in the contract or agreement to
which this form is an attaclunent, hereby certifies that:
(1) The Contractor understands that pursuant to s. 287.135 F.S., any company at the time of bidding or
submitting a proposal for a new contract or renewal of an existing contract, that is on the "Scrutinized
Companies with Activities in Sudan List" or the "Scrutinized Companies with Activities in the Iran
Petroleum Sector List (collectively, "the Lists ") is ineligible for, and may not bid on, submit a
proposal for, or enter into or renew a contract with the Agency and or Department of Elder Affairs
Department) for goods or services of $1 million or more.
(2) The Contractor understands that, pursuant to s. 287.135 F.S., any company that submits a false
certification to the Department is subject to civil penalties, attorney's fees and costs and any costs for
investigations that led to the finding of false certification.
(3) The Contractor understands that the contract to which this form is an attachment may be terminated by
the Agency and /or Department if the Contractor submits a false certification or has been placed on the
Lists.
This certification, required by Florida law, 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,
Signature lz�
Date
(Same as contract signature)
Steve Carnell, Interim Administrator
Collier County Public Services Division
Title
Collier County Board of Commissioners
Company Name
Packet Page -2811-
July 2012 — June 2014 7/24/2012 Item 16.D.15.
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC,
dba SENIOR CHOICES OF SOUTHWEST FLORIDA
STANDARD CONTRACT
COMMUNITY CARE FOR THE ELDERLY PROGRAM
THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of
Southwest Florida ( "Agency ") and Collier County Board of County Commissioners, ( "Recipient "), and collectively
referred to as the "Parties." The term Recipient for this purpose may designate a vendor, subgrantee or subrecipient, the
status to be further identified in ATTACHMENT III, Exhibit -2 as necessary.
WITNESSETH THAT:
WHEREAS, the Agency has determined that it is in need of certain services as described herein; and
WHEREAS, the Recipient has demonstrated that it has the requisite expertise and ability to faithfully perform such
services as an independent Recipient 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:
Y. Purnose of Contract
The purpose of this contract is to provide services in accordance with the terms and conditions specified in this
contract including all attachments and exhibits, which constitute the contract document.
1.1 AGENCY MISSION STATEMENT
Mission: To help aging adults, 60 and older, achieve greater independence through awareness of resources and
access to qualified service providers.
Vision: To be the recognized leader in supporting older adults and their families with access to trustworthy
resources and services in their communities while empowering them to live with independence and dignity.
Values: The Agency believes the residents of Southwest Florida are entitled to:
➢ Comprehensive information about their choices of care;
➢ Timely access to resources and services;
High standards of quality and performance;
➢ Personal and professional accountability from all stakeholders.
Lead agencies and local service providers as partners and stakeholders in Florida's aging services network are
expected to support the agency's mission, vision, and priorities.
2. Incorporation of Documents within the Contract
The contract will incorporate attachments, proposal(s), area plan(s), grant agreements, relevant Department
handbooks, manuals or desk books, as an integral part of the contract, except to the extent that the contract
explicitly provides to the contrary. In the event of conflict in language among any of the documents referenced
above, the specific provisions and requirements of the contract document(s) shall prevail provisions in the proposal(s) or other general materials not specific to this contract document and incons
d
attachments.
3. Term of Contract
This is a two -year contract shall begin on July 1, 2012 or on the date on which the contract has been signed by
the last party required to sign it, whichever is Iater. It shall end at midnight, local time in North Fort Myers,
Florida, on June 30 2014.
4. Contract Amount
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an
amount not to exceed $661,357.00 for year one, 2012 - 2013, 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.
Packet Page -2812-
July 2012 — June 2014 7/24/2012 Item 16-D.15.
VVL 4VJ. 1!r
5. Renewals
By mutual agreement of the Parties, in accordance with s. 287.058(1)(f), F.S., the Agency may renew the
contract every two years within the six year bid term , 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 six year 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.
6. Compliance with Federal Law
6.1 If this contract contains federal funds the following shall apply:
6.1.1 The Recipient shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable
regulations.
6.1.2 If this contract contains federal funds and is over $100,000.00, the Recipient shall comply with all applicable
standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s.
508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as
amended, and where applicable Environmental Protection Agency regulations 40 CFR 30. The Recipient shall
report any violations of the above to the Agency.
6.1.3 The Recipient, or agent acting for the Recipient, may not use any federal funds received in connection with this
contract to influence legislation or appropriations pending before the Congress or any state legislature. If this
contract contains federal funding in excess of $100,000.00, the Recipient must, prior to contract execution,
complete the Certification Regarding Lobbying form, ATTACHMENT H. All disclosure forms as required by
the Certification Regarding Lobbying form must be completed and returned to the Contract Manager prior to
payment under this contract.
6.1.4 In accordance with Appendix A to 2 CFR 215, the Recipient shall comply with Executive Order 11246, Equal ow
Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in
Department of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable.
6.1.5 If this contract contains federal funds and provides services to children up to age 18, the Recipient shall comply
with the Pro - Children Act of 1994 (20 U.S.C. 6081).
6.1.6 A contract award with an amount expected to equal or exceed $25,000.00 and certain other contract awards will
not be made to parties listed on the government -wide Excluded Parties List System, in accordance with the OMB
guidelines at 2 CFR 180 that implement Executive Orders 12549 and 12689, "Debarment and Suspension." The
Excluded Parties List System contains the names of parties debarred, suspended, or otherwise excluded by
agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order
12549. The Recipient shall comply with these provisions before doing business or entering into subcontracts
receiving federal funds pursuant to this contract. The Recipient shall complete and sign ATTACHMENT V
prior to the execution of this contract.
6.2 The Recipient shall not employ an unauthorized alien. The Agency will consider the employment of
unauthorized aliens a violation of the Immigration and Nationality Act (8 U.S.C. 1324a) and the Immigration
Reform and Control Act of 1986 (8 U.S.C. 1101). Such violation will be cause for unilateral cancellation of this
contract by the Agency.
6.3 If the Recipient is a non -profit provider and is subject to Internal Revenue Service (IRS) tax exempt organization
reporting requirements (filing a Form 990 or Form 990 -N) and has its tax exempt status revoked for failing to
comply with the filing requirements of the Pension Protection Act of 2006 or for any other reason, the Recipient
must notify the Agency in writing within thirty (30) days of receiving the IRS notice of revocation.
6.4 The Recipient shall comply with Title 2 CFR Part 275 regarding Trafficking in Persons.
6.5 Unless exempt under 2 CFR Part 170.110(b), the Recipient shall comply with the reporting requirements of the
Transparency Act as expressed in 2 CFR 170.
2
Packet Page -2813-
July 2012 — June 2014
6.6
7/24/2012 Item 16.D.15.
To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number 11 -116,
Recipient agrees to utilize the U.S. Department of Homeland Security's E- verify system to verify the
employment of all new employees hired by Contractor during the contract term. Recipient shall include in
related subcontracts a requirement that subcontractors performing work or providing services pursuant to the
state contract utilize the E- verify system to verify employment of all new employees hired by the
subcontractor during the contract term. Recipients meeting the terms and conditions of the E- Verify System
are deemed to be in compliance with thus provision.
7. Compliance with State Law
7.1 This contract is executed and entered into in the State of Florida, and shall be construed, performed and enforced
in all respects in accordance with the Florida law, including Florida provisions for conflict of laws.
7.2 The Recipient shall comply with requirements of s. 287.058, F.S. as amended.
7.2.1 The Recipient shall provide units of deliverables, including various client services, and in some instances may
include reports, findings, and drafts, as specified in this contract, which the Contract Manager must receive and
accept in writing prior to payment in accordance with s. 215.971, F.S. (1) and (2).
7.2.2 The Recipient shall submit bills for fees or other compensation for services or expenses in sufficient detail for a
proper pre -audit and post - audit.
7.2.3 If itemized payment for travel expenses is permitted in this contract, the Recipient shall submit bills for any
travel expenses in accordance with s. 112.061, F.S., or at such lower rates as may be provided in this contract.
7.2.4 The Recipient shall allow public access to all documents, papers, letters, or other public records as defined in
subsection 119.011(12), F.S., made or received by the Recipient in conjunction with this contract except for
those records which are made confidential or exempt by law. The Recipient's refusal to comply with this
provision will constitute an immediate breach of contract for which the Agency may unilaterally terminate the
contract.
.3 If clients are to be transported under this contract, the Recipient shall comply with the provisions of Chapter 427,
F.S., and Rule 41 -2, F. A. C.
7.4 Subcontractors who are on the discriminatory vendor list may not transact business with any public entity, in
accordance with the provisions of s. 287.134, F.S.
7.5 The Recipient shall comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the
expenditure of contract funds for the purpose of lobbying the legislature, judicial branch or a state agency.
7.6 In accordance with s. 287.135 F.S., any contractor on the Scrutinized Companies with Activities in Sudan List
or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List (Lists), created pursuant
to s.215.473 F.S., is ineligible to enter into or renew a contract with the Department for goods or services of $1
million or more. Pursuant to s. 287.135 F.S., the Department may terminate this contract if the Contractor is
found to have submitted a false certification of its status on the Lists or has been placed on the Lists. Further,
the Contractor is subject to civil penalties, attorney's fees and costs a;1d any costs for investigations that led to
the finding of false certification. If this contract contains $1 million cr more, the Contractor shall complete and
sign the Certification Regarding Scrutinized Companies Lists, prior the execution of this contract
8. Background Screening
The Recipient shall ensure that the requirements of s. 430.0102 and ch. 435, F.S., as amended, are met
regarding background screening for all persons who meet the definition of a direct service provider and who
are not exempted from the Department's level 2 background screening pursuant to s. 430.0402(2) -(3), F.S.
The Recipient must also comply with any applicable rules promulgated by the Department and the Agency for
Health Care Administration regarding implementation of s. 430.0402 and ch. 435, F.S.
Further information concerning the procedures for background screening are found at
http : / /elderaffairs,state.fl. us /doea/backgroun dscreening.php.
3
Packet Page -2814-
July 2012 — rune 2014 7/24/2012 Item 16.D.15.
9. Grievance and Compliant Procedures
9.1 Grievance Procedures
The Recipient shall comply with and ensure subcontractor compliance with the Minimum Guidelines for
Recipient Grievance Procedures, Appendix D, Department of Eider Affairs Programs and Services Handbook,
to address complaints regarding the termination, suspension or reduction of services, as required for receipt of -
funds.
9.2 Complaint Procedures
The Recipient shall develop and implement complaint procedures and ensure that subcontractors develop and
implement complaint procedures to process and resolve client dissatisfaction with services. Complaint
procedures shall address the quality and timeliness of services, provider and direct service worker complaints, or
any other complaints not related to termination, suspension or reduction in services which require the grievance
process as described in Appendix D, Department of Elder Affairs Programs and Services Handbook. The
complaint procedures shall include notification to all clients of the complaint procedures and include tracking the
date, nature of complaint and the determination of each complaint.
10. Audits, Inspections, Investigations Public Records and Retention
10.1 The Recipient shall establish and maintain books, records and documents (including electronic storage media)
sufficient to reflect all assets, obligations, unobligated balances, income, interest and expenditures of fluids
provided by the Agency under this contract. Recipient shall adequately safeguard all such assets and assure they
are used solely for the purposes authorized under this contract. Whenever appropriate, financial information
should be related to performance and unit cost data.
10.2 The Recipient shall retain all client records, financial records, supporting documents, statistical records, and any
other documents (including electronic storage media) pertinent to this contract for a period of six (6) years after
completion of the contract or longer when required by law. In the event an audit is required by this contract,
records shall be retained for a minimum period of six (6) years after the audit report is issued or until resolution
of any audit findings or litigation based on the terns of this contract, at no additional cost to the Agency.
10.3 Upon demand, at no additional cost to the Agency, the Recipient shall facilitate the duplication and transfer of
any records or documents during the required retention period in Paragraph 10.2.
10.4 The Recipient shall assure that the records described in Paragraph 10 will be subject at all reasonable times to
inspection, review, copying, or audit by federal, state, or other personnel duly authorized by the Agency.
10.5 At all reasonable times for as long as records are maintained, persons duly authorized by the Agency and federal
auditors, pursuant to 45 CFR 92.36(i)(10), will be allowed full access to and the right to examine any of the
Recipient's contracts and related records and documents pertinent to this specific contract, regardless of the form
in which kept.
10.6 The Recipient shall provide a financial and compliance audit to the Agency as specified in this contract and in
ATTACHMENT III and ensure that all related third -party transactions are disclosed to the auditor.
10.7 The Recipient shall comply and cooperate immediately with any inspe ;bons, reviews, investigations, or audits
deemed necessary by the office of the Inspector General pursuant to s. 20.055, F.S.
11. Nondiscrimination -Civil Rights Compliance
11.1 The Recipient shall execute assurances in ATTACHMENT VI V} at it will not discriminate against any person in
the provision of services or benefits under this contract or in employment because of age, race, religion, color,
disability, national origin, marital stairs or sex in compliance with state and federal law and regulations. The
Recipient further assures that all contractors, subcontractors, subgrantees, or others with whom it arranges to
provide services or benefits in connection with any of its programs and activities are not discriminating against
clients or employees because of age, race, religion, color, disability, national origin, marital status or sea.
0
Packet Page -2815-
July 2012 — June 2014 7/24/2012 Item 16.D.15.
11.2 During the term of this contract, the Recipient shall complete and retain on file
Civil Rights Compliance Checklist
11.3 The Recipient shall establish procedures pursuant to federal law to handle complaints of discrimination involving
services or benefits through this contract. These procedures will include notifying clients, employees, and
participants of the right to file a complaint with the appropriate federal or state entity.
11.4 If this contract contains federal funds, these assurances are a condition of continued receipt of or benefit from
federal financial assistance, and are binding upon the Recipient, its successors, transferees, and assignees for the
period during which such assistance is provided. The Recipient further assures that all subcontractors, vendors,
or others with whom it arranges to provide services or benefits to participants or employees in connection with
any of its programs and activiLk s are riot u1scriminat ng against those participants or employees in violation of
the above statutes, regulations, guidelines, and standards. In the event of failure to comply, the Recipient
understands that the Agency may, at its discretion, seek a court order requiring compliance with the terms of this
assurance or seek other appropriate judicial or administrative relief, including but not limited to, termination of
and denial of further assistance.
12. Provision of Services
The Recipient shall provide services in the manner described in ATTACHMENT I.
13. Monitoring by the Agency
The Recipient shall permit persons duly authorized by the Agency to inspect and copy any records, papers,
documents, facilities, goods and services of the Recipient which are relevant to this contract, and to interview any
clients, employees and subcontractor employees of the Recipient to assure the Agency of the satisfactory
performance of the terms and conditions of this contract. Following such review, the Agency will provide a
written report of its findings to the Recipient, and where appropriate, the Recipient shall develop a corrective
action plan. The Recipient hereby agrees to correct all deficiencies identified in the corrective action plan in a
timely manner as determined by the Contract Manager.
14. Coordinated Monitoring with Other Agencies
If the Recipient receives funding from one or more of the State of Florida other human service agencies, in
addition to the Department of Elder Affairs, then a joint monitoring visit including such other agencies may be
scheduled. For the purposes of this contract, and pursuant to s. 287.0575, F.S. as amended, Florida's human
service agencies shall include the Department of Children and Families, the Department of Health, the Agency
for Persons with Disabilities, the Department of Veterans Affairs, and the Department of Elder Affairs. Upon
notification and the subsequent scheduling of such a visit by the designated agency's lead administrative
coordinator, the Recipient shall comply and cooperate with all monitors, inspectors, and /or investigators.
15. Indemnification
The Recipient shall indemnify, save, defend, and hold harmless the Agency and its agents and employees from
any and all claims, demands, actions, causes of action of whatever nature or character, arising out of or by reason
of the execution of this agreement or performance of the services provided for herein. It is understood and
agreed that the Recipient is not required to indemnify the Agency for claims, demands, actions or causes of
action arising solely out of the Agency's negligence.
15.1 Except to the extent permitted by s. 768.28, F.S., or other Florida law, Paragraph IS is not applicable to contracts
executed between the Department and state agencies or subdivisions defined in s. 768.28(2), F.S.
16. Insurance and Bonding
16.1 The Recipient shall provide continuous adequate liability insurance coverage during the existence of this contract
and any renewal(s) and extension(s) of it. By execution of this c<.,,,ract, unless it is a state agency or subdivision
as defined by subsection 768.28(2), F.S., the Recipient accepts f :11 responsibility for identifying and determining
the type(s) and extent of liability insurance necessary to - - •ride reasonable financial protections for the
Recipient and the clients to be served under this contract. Th.: :nits of coverage under each policy maintained by
the Recipient do not limit the Recipient's liability and obli�- :ions under this contract. The Recipient shall ensure
that the Agency has the most current written verificati of insurance coverage throughout the term of this
Packet Page -2816-
July 2012 — June 2014 7/24/2012 Item 16.D.15.
contract. Such coverage may be provided by a self - insurance program establish(.,.....,. „r, .... b ".....,...... • ..,
of the State of Florida. The Agency reserves the right to require additional insurance as specified in this contract.
16.2 Throughout the term of this agreement, the Recipient shall maintain an insurance bond from a responsible
commercial insurance company covering all officers, directors, employees and agents of the Recipient authorized
to handle Rinds received or disbursed under all agreements and /or contracts incorporating this contract by
reference in an amount commensurate with the funds handled, the degree of risk as determined by the insurance
company and consistent with good business practices.
17. Confidentiality of Information
The Recipient shall not use or disclose any information concerning a recipient of services under this contract for
any purpose prohibited by state or federal law or regulations except with the written consent of a person legally
authorized to give that consent or when authorized by law.
18. Health Insurance Portability and Accountability Act
Where applicable, the Recipient shall comply with the Health Insurance Portability and Accountability Act (42
USC 1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162, and 164).
19. Incident Reporting
19.1 The Recipient shall notify the Agency immediately, but no later than forty -eight (48) hours from, the Recipient's
awareness or discovery of conditions that may materially affect the Recipient or subcontractor's ability to
perform the services required to be performed under this contract. Such notice shall be made orally to the
Contract Manager (by telephone) with an email to immediately follow.
19.2 The Recipient shall immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of a
child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll -free telephone number
(1- 800- 96ABUSE). As required by Chapters 39 and 415, F.S., this provision is binding upon both the Recipient
and its employees.
20. New Contract(s) Reporting
The Recipient shall notify the Agency within ten (10) days of entering into a new contract with any of the
remaining four (4) state human service agencies. The notification shall include the following information: (1)
contracting state agency; (2) contract name and number; (3) contract start and end dates; (4) contract amount; (5)
contract description and commodity or service; and (6) Contract Manager name and number. In complying with
this provision, and pursuant to s. 287.0575, F.S. as amended, the Recipient shall complete and provide the
information to the Agency's Contract Manager.
21. _Bankruptcy Notification
During the term of this contract, the Recipient shall immediately notify the Agency if the Recipient, its assignees,
subcontractors or affiliates file a claim for bankruptcy. Within ten (10) days after notification, the Recipient must
also provide the following information to the Area Agency on Aging for Southwest Florida, Inc.: (1) the date of
filing of the bankruptcy petition; (2) the case number; (3) the court name and the division in which the petition
was filed (e.g., United States Bankruptcy Court Middle District of Florida, Fort Myers, FL ); and, (4) the name,
address, and telephone number of the bankruptcy attorney.
22. Sponsorship and Publicity
22.1 As required by s. 286.25, F.S., if the Recipient is a non - governmental organization which sponsors a program
financed wholly or in part by state fiends, including any funds obtained through this contract, it shall, in
publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by Hope Hospice and
Community Services, the State Agency of Elder Affairs, and the Area Agency on Aging for Southwest Florida,
Inc." If the sponsorship reference is in the written material, the words "State of Florida, Department of Elder
Affairs and the Area Agency on Aging for Southwest Florida, Inc." shall appear in at least the same size letters
or type as the name of the organization.
C'!
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July 2012 — June 2014
7/24/2012 Item 16.D.15.
22.2 The Recipient shall not use the words "The State of Florida Department of Elder Affairs or the Area Agency on
Aging for Southwest Florida, Inc." to indicate sponsorship of a program otherwise financed, unless specific
authorization has been obtained by the State and Agency prior to use..
23. Assignments
23.1 The Recipient shall not assign the rights and responsibilities under this contract without the prior written
approval of the Agency, which shall not be unreasonably withheld. Any sublicense, assignment, or transfer
otherwise occurring without prior written approval of the Agency will constitute a material breach of the
contract.
23.2 The State of Florida is at all times entitled to assign or transfer, in whole or part, its rights, duties, or obligations
under this contract to another governmental agency in the State of Florida, upon giving prior written notice to the
Recipient. In the event the State of Florida approves transfer of the Recipient's obligations, the Recipient
remains responsible for all work performed and all expenses incurred in connection with the contract.
23.3 This contract shall remain binding upon the successors in interest of either the Recipient or the Agency.
24. Subcontracts
24.1 The Recipient is responsible for all work performed and for all commodities produced pursuant to this contract,
whether actually furnished by the Recipient or its subcontractors. Any subcontracts shall be evidenced by a
written document and subject to any conditions of approval the Agency deems necessary. The Recipient further
agrees that the Agency will not be liable to the subcontractor in any way or for any reason. The Recipient, at its
expense, shall defend the Agency against any such claims.
24.2 The Recipient shall promptly pay any subcontractors upon receipt of payment from the Agency or other state
agency. Failure to make payments to any subcontractor in accordance with s. 287.0585, F.S., unless otherwise
stated in the contract between the Recipient and subcontractor, will result in a penalty as provided by statute.
25. Independent Capacity of Recipient
It is the intent and understanding of the Parties that the Recipient, or any of its subcontractors, are independent
contractors and are not employees of the Agency and shall not hold themselves out as employees or agents of the
Agency without specific authorization from the Agency. It is the further intent and understanding of the Parties
that the Agency does not control the employment practices of the Recipient and will not be liable for any wage
and hour, employment discrimination, or other labor and employment claims against the Recipient or its
subcontractors. All deductions for social security, withholding taxes, income taxes, contributions to
unemployment compensation funds and all necessary insurance for thr- Recipient are the sole responsibility of the
Recipient.
26. Payment
Payments shall be made to the Recii,ie:,,jursuar �is.42? F.S., as services are rendered and invoiced by
the Recipient. The Contract Manager will have ::::1 ; pproval of fl- invoice for payment, and will approve the
invoice for payment only if the Reci� c has met all terms and conditions of the contract, unless the bid
specifications, purchase order tract specify ot'—: ,vise. The approved invoice will be submitted to the
Agency's finance sectie:, icx b�vugetar° ,,. ,,.; d _,cessing. Disputes arising over invoicing and payments
will be resoi\ e.: in accordance , ;-Lh the provisio of s. 2I ._� A Vendor Ombudsman has been
established within the Department of Financial Services and may be contacted at (850) 413 -5665.
27. Return of Funds
The Recipient shall return to the Agency any overpayments due to unearned funds or funds disallowed and any
interest attributable to such funds pursuant to the terms and conditions of this contract that were disbursed to the
Recipient by the Agency. In the event that the Recipient or its independent auditor discovers that an
overpayment has been made, the Recipient shall repay said overpayment immediately without prior notification
from the Agency. In the event that the Agency first discovers an overpayment has been made, the Contract
7
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July 2012 — June 2014
Manager will notify the Recipient in writing of such findings. Should repayn...., 2012 Item 16....
Recipient will be charged at the lawful rate of interest on the outstanding balance pursuant to s. 55.03, F.S., after
Agency notification or Recipient discovery.
28. Data Integrity and Safeguarding Information
The Recipient shall ensure an appropriate level of data security for the information the Recipient is collecting or
using in the performance of this contract. An appropriate level of security includes approving and tracking all
Recipient employees that request system or information access and ensuring that user access has been removed
from all terminated employees. The Recipient, among other requirements, must anticipate and prepare for the
loss of information processing capabilities. All data and software shall be routinely backed up to ensure recovery
from losses or outages of the computer system. The security over the backed -up data is to be as stringent as the
Protection required of the primary systems. The Recipient shall ensure all subcontractors maintain written
procedures for computer system backup and recovery. The Recipient shall complete and sign ATTACHMENT
IV prior to the execution of this contract.
29. Computer Use and Social Media Poliev
The Department of Elder Affairs has implemented a new Social Media Policy, in addition to its Computer Use
Policy, which applies to all employees, contracted employees, consultants, OPS and volunteers, including all
personnel affiliated with third patties, such as, but not limited to, Area Agencies on Aging and vendors. Any
entity that uses the Department's computer resource systems must comply with the Department's policy
regarding social media. Social Media includes, but is not limited to blogs, podcasts, discussion forums, Wikis,
RSS feeds, video sharing, social networks like MySpace, Facebook and Twitter, as well as content sharing
networks such as flickr and YouTube.
30. Conflict of Interest
The Recipient shall establish safeguards to prohibit employees, board members, management and subcontractors
from using their positions for a purpose that constitutes or presents the appearance of personal or organizational
conflict of interest or personal gain. No employee, officer or agent of the Recipient or subcontractor shall
participate in selection, or in the award of an agreement supported by state or federal fluids if a conflict of
interest, real or apparent, would be involved. Such a conflict would arise when: (a) the employee, officer or
agent; (b) any member of his /her immediate family; (c) his or her partner, or; (d) an organization which employs,
or is about to employ, any of the above, has a financial or other interest in the finn selected for award. The
Recipient or subcontractor's officers, employees or agents will neither solicit not accept gratuities, favors or
anything of monetary value from contractors, potential contractors, or parties to subcontracts. The Recipient's
board members and management must disclose to the Agency any relationship which may be, or may be
perceived to be, a conflict of interest within thirty (30) calendar days of an individual's original appointment or
placement in that position, or if the individual is serving as an incumb: —t, within thirty (30) calendar days of the
commencement of this contract. The Recipient's employees and subc :;tractors must make the same disclosures
described above to the Recipient's board of directors. Compliance w : this provision will be monitored.
31. Public Entity Crime
Pursuant to s. 287.133, F.S., a person or affiliate who has been , ;ed on the convicted vendor list following a
conviction for a public entity crime may not submit a bid, pror, .1, or reply on a contract to provide any goods
or services to a public entity; may not submit a bid, rropcs l contract with a public entity for the
construction or repair of a public building or public wo:.,; F submit bids, proposals, or replies on ]cases of
real property to a public entity; may not be awarded or r .jrrn work as a Recipient, supplier, subcontractor, or
consultant under a contract with any public entity; ,:id . .y not transact business with any public entity in excess
of the threshold amount provided in s. 287.017 r.:;.. _,, CATEGORY TWO for a period of 36 months following
the date of being placed on the convicted ; ; .,dor Its'
32. Purchasing
hasing
32.1 The Recipient may purchase articles which are the subject of or are required to carry out this contract from Prison
Rehabilitative Industries and Diversified Enterprises, Inc., (PRIDE) identified under Chapter 946, F.S., in the
same manner and under the procedures set forth in subsections 946.515(2) and (4), F.S. For purposes of this
contract, the Recipient shall be deemed to be substituted for the Agency insofar as dealings with PRIDE. This
clause is not applicable to subcontractors unless otherwise required by law. An abbreviated list of
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July 2012 — June 2014
products /services available from PRIDE may be obtained by contacting PRIDE (7/24/2012 Item 16.D.15. -...
32.2 The Recipient may procure any recycled products or materials, which are the subject of or are required to carry
out this contract, in accordance with the provisions of s. 403.7065, F.S.
32.3 The Recipient may purchase articles that are the subject of, or required to carry out, this contract from a nonprofit
agency for the Blind or for the Severely Handicapped that is qualified pursuant to Chapter 413, F.S., in the same
manner and under the same procedures set forth in s. 413.036(l) and (2), F.S. For purposes of this contract, the
Recipient shall be deemed to be substituted for the Agency insofar as dealings with such qualified nonprofit
agency are concerned. Additional information about the designated nonprofit agency and the products it offers is
available at http : / /www.respectorrroriva.urg. l ws cause is not app!,'--wble to subcontractors unless otherwise
required by law.
33. Patents, Conyriahts Rovalt ?es
If this contract is awarded state funding and if any discovery, invention or copyrightable material is developed,
produced or for which ownership was purchased hi the course of or as a result of work or services performed
under this contract, the Recipient shall refer the discovery, invention or material to the Agency to be referred to
the Department of State and the Department of Elder Affairs. Any and all patent rights or copyrights accruing
under this contract are hereby reserved to the State of Florida in accordance with Chapter 286, F.S. Pursuant to s.
287.0571 (5) (k) 1 and 2 as amended, the only exceptions to this provision shall be those that are clearly
expressed and reasonably valued in the contract.
33.1 If the primary purpose of this contract is the creation of intellectual property, the State of Florida shall retain an
unencumbered right to use such property, notwithstanding any agreement made pursuant to Paragraph 33.
33.2 If this contract is awarded solely federal funding, the tenns and conditions are governed by 2 CFR 215.36.
34. Emeraeney Preparedness and Continuity of Operations
'4.1 If the tasks to be performed pursuant to this contract include the physical care and control of clients, or the
administration and coordination of services necessary for client health, safety or welfare, the Recipient shall,
within thirty (30) calendar days of the execution of this contract, submit to the Contract Manager verification of
an emergency preparedness plan. hi the event of an emergency, the Recipient shall notify the Agency of
emergency provisions.
34.2 in the event a situation results in a cessation of services by a subcontractor, the Recipient shall retain
responsibility for performance under this contract and must follow procedures to ensure continuity of operations
without interruption.
35. EQUIPMENT
If the contract tasks to be rued require the purchase f equipment h state or federal fiords, the following
paragraphs apply:
35.1 Equipment means: (a) an article of nonexpendabie, tar. ible perso, . property having a useful life of more than
one year and an acquisition cost which equals or exceeds the less of the capitalization level established by the
organrzatiun fc: 'financial statement purp,-- �S.r ')p :rleral fiends]; or (b) nonexpendable, tangible
personal property of a nonconsumable natu ;n an acqu' .1011 cost of $1,000.00 or more per unit, and
expected useful life of at least one year; and hardback bou books not circulated to students or the
public, with a value
e or cost of $250.00 or more [for state fir .;].
35.2 Recipients and subcontractors who are Institutions of tligher Education, Hospitals, and Other Non -Profit
Organizations shall have written property manager- ant standards in compliance with 2 CFR Part 215
Administrative Requirements (formerly OMB Circu'ar A -110) that include: (a) a property list with all the
elements identified in the circular, and, (b) a proced,u-e for conducting a physical inventory of equipment at least
9
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July 2012 —June 2014 2 Item 16. D.15. 7/24/201
once every two years, (c) a control system to insure adequate safeguards to prev...� ..,..1
equipment; and (d) maintenance procedures to keep the equipment in good condition. The property records must
be maintained on file and shall be provided to the Agency upon request. The Recipient shall promptly
investigate, fully document and notify the Contract Manager of any loss, damage, or theft of equipment. The
Recipient shall provide the results of the investigation to the Contract Manager.
35.3 The Recipient's property management standards for equipment acquired with Federal funds and federally -owned
equipment shall include accurately maintained equipment records with the following information:
(1) A description of the equipment;
(2) Manufacturer's serial number, model number, Federal stock number, national stock number, or other
identification number;
(3) Source of the equipment, including the award number;
(4) Whether title vests in the Recipient or the Federal Government;
(5) Acquisition date (or date received, if the equipment was furnished by the Federal Government) and cost;
(6) Information from which one can calculate the percentage of Federal participation in the cost of the
equipment (not applicable to equipment furnished by the Federal Government);
(7) Location and condition of the equipment and the date the information was reported;
(8) Unit acquisition cost; and
(9) Ultimate disposition data, including date of disposal and sales price or the method used to determine current
fair market value where a Recipient compensates the Federal awarding agency for its share.
35.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased with
state funds with an acquisition cost over $1,000.00 that is specifically identified in the area plan approved by the
Department is part of the cost of carrying out the activities and functions of the grant awards and Title
(ownership) will vest in the Agency, subject to the conditions of 2 CFR Part 215 Administrative Requirements
(formerly OMB Circular A -110), Subpart C, paragraph 34. Equipment purchased under these thresholds is
considered supplies and is not subject to property standards. Equipment purchased with funds identified in the
budget attachments to agreements covered by this contract, or identified in the sub - agreements with
subcontractors (not included in a cost methodology), is subject to the conditions of section 273, F. S. and 60A-
1.0017, F. A. C. or Title 45 CFR Part 74.
35.5 The Recipient shall not dispose of any equipment or materials provided by the Agency, or purchased with funds
provided through this contract without first obtaining the approval of the Contract Manager. When disposing of
property or equipment the Recipient must submit a written request for disposition instructions to the respective
Contract Manager. The request should include a brief description of the property, purchase price, funding
source, percentage of state or federal participation, acquisition d- c and condition of the property. The request
should also indicate the Recipient's proposed disposition (i.e., transfer or donation to another agency that
administers federal programs, offer the items for sale, destroy the items, etc).
35.6 Tile Contract Manager will issue disposition instructions. If disposition instructions are not received within 120
days of the written request for disposition, the Recipient is au?irorized to proceed as directed in 2 CFR Part 215
Administrative Requirements (formerly OMB Circular A -1 I,)),
3 5. 7 Real property means land (including land improvements), -s, structures and appurtenances thereto, but
excludes movable machinery and equipment. Real prollr y may not be purchased with state or federal funds
through agreements covered under this contract without the prior approval of the Agency. Real property
purchases from Older Americans Act funds are subject to the provisions of Title 42, Chapter 35, Subchapter 111,
Part A., Sec. 3030b United States Code (USC). Real property purchases from state funds can only be made
through fixed capital outlay grants and aids appropriations and therefore are subject to the provisions of section
216.348, F. S.
35.8 Any permanent storage devices (e.g., hard drives, removable storage media) must be reformatted and tested prior
to disposal to ensure no confidential information remains.
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July 2012 — June 2014
35.9 The Recipient must adhere to the Agency's procedures and standards when pure_. ... 7/24/2012 Item 16.D.15.
Resources (ITR) as part of any agreement(s) incorporating this contract by reference. An ITR worksheet is
required for any computer related item costing $1,000.00 or more, including data processing hardware, software,
services, supplies, maintenance, training, personnel and facilities. The completed ITR worksheet shall be
maintained in the LAN administrator's file and must be provided to the Agency upon request. The Recipient has
the responsibility to require any subcontractors to comply with the Agency's ITR procedures.
36. PUR 1000 Form
The PUR 1000 Form is hereby incorporated by reference. In the event of any conflict between the PUR 1000
Form and any terns or conditions of this contract the terms or conditions of this contract shall take precedence
over the PUR 1000 For " 1 ��,,,�r;ng terms or conditions in the PUR 1000 Form are required by
any section of the rlorida Statutes, the terms or conditions contained in the PUR 1000 Form shall take
precedence.
37. Use of State Funds to Purchase or Improve Real Property
Any state funds provided for the purchase of or improvements to real property are contingent upon the Recipient
or political subdivision granting to the state a security interest in the property at least to the amount of state funds
provided for at least 5 years from the date of purchase or the completion of the improvements or as further
required by law.
38. Dispute Resolution
Any dispute concerning performance of the contract shall be decided by the Contract Manager, who shall reduce
the decision to writing and serve a copy on the Recipient.
39. Financial Consequences of Non- Performance
If the Recipient fails to meet the minimum level of service or performance identified in this agreement, or that is
customary for the industry, then the Agency must apply financial consequences commensurate with the
deficiency. Financial consequences may include, but are not limited to, contract suspension, refusing payment,
withholding payments until deficiency is cured, tendering only partial payments, and /or cancellation of contract
and reacquiring services from an alternate source.
.I The Recipient will not be charged with financial consequences, when a failure to perform arises out of causes
that were the responsibility of the Agency.
40. No Waiver of Soverei n Immunitv
Nothing contained in this agreement is intended to serve as a waiver of sovereign immunity by any entity to
which sovereign immunity may be applicable.
41. Venue
If any dispute arises out of this contract, the venue of such legal recourse will be Lee County, Florida.
42. Entire Contract
This contract contains all the terms and conditions agreed upon by the Parties. No oral agreements or
representations shalt be valid or binding upon the Agency or the Recipient unless expressly contained herein or
by a written amendment to this contract signed by both Parties.
43. _Force Maieure
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control,
provided the party experiencing the force majeure condition provides immediate written notification to the other
party and takes all reasonable efforts to cure the condition.
44. Sever ability Clause
The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or
unenforceable the other provisions are severable to that void provision and shall remain in full force and effect.
,4- Condition Precedent to Contract: AMronriations
The Parties agree that the Agency's performance and obligation to pay under this contract is contingent upon an
I1
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July 2012 — June 2014
annual appropriation by the Legislature.
7/24/2012 Item 16.D.15.
46. Addition/Deletion
The Parties agree that the Agency reserves the right to add or to delete any of the services required under this
contract when deemed to be hi the State of Florida's best interest and reduced to a written amendment signed by
both Parties. The Parties shall negotiate compensation for any additional services added.
47. Waiver
The delay or failure by the Agency to exercise or enforce any of its rights under this contract will not constitute
or be deemed a waiver of the Agency's right thereafter to enforce those rights, nor will any single or partial
exercise of any such right preclude any other or further exercise thereof or the exercise of any other right.
48. Compliance
The Recipient shall abide by all applicable current federal statutes, laws, rules and regulations as well as
applicable current state statutes, laws, rules and regulations. The Parties agree that failure of the Recipient to
abide by these laws shall be deemed an event of default of the Recipient, and subject the contract to immediate,
unilateral cancellation of the contract at the discretion of the Agency.
49. Final Invoice
The Recipient shall submit the final invoice for payment to the Agency as specified in Paragraph 3.3.5. (date for
final request for payment) of ATTACHMENT I. If the Recipient fails to submit final request for payment by
the deadline, then all rights to payment may be forfeited and the Agency may not honor any requests submitted
after the aforesaid time period. Any payment due under the terms of this contract may be withheld until all
reports due from the Recipient and necessary adjustments thereto have been approved by the Agency.
50. Renegotiations or Modifications
Modifications of the provisions of this contract shall be valid only when they have been reduced to writing and
duly signed by both parties. The rate of payment and the total dollar amount may be adjusted retroactively to
reflect price level increases and changes in the rate of payment when these have been established through the
appropriations process and subsequently identified in the Agency's operating budget.
51. Termination
51.1 This contract may be terminated by either party without cause upon no less than thirty (30) calendar days notice
in writing to the other party unless a sooner time is mutually agreed upon in writing. Said notice shall be
delivered by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by
hand delivery to the Contract Manager or the representative of the Recipient responsible for administration Of the
contract.
51.2 In the event fiords for payment pursuant to this contract become unavailable, the Agency may terminate this
contract upon no less than twenty -four (24) hours notice in writing to the Recipient. Said notice shall be
delivered by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by
hand delivery to the Contract Manager or the representative of the Recipient responsible for administration of the
contract. The Agency will be the final authority as to the availability and adequacy of funds. In the event of
termination of this contract, the Recipient will be compensated for any work satisfactorily completed prior to the
date of termination.
51.3 This contract may be terminated for cause upon no less than twenty-four (24) hours notice in writing to the
Recipient. If applicable, the Agency may employ the default provisions in Rule 60A- 1.006(3), F.A.C. Waiver of
breach of any provisions of this contract shall not be deemed to be a waiver of any other breach and shall not be
construed to be a modification of the terms and conditions of this contract. The provisions herein do not limit the
Agency's or the Recipient's rights to remedies at law or in equity.
51.4 Failure to have performed any contractual obligations with the Agency in a manner satisfactory to the Agency
will be a sufficient cause for termination. To be terminated as a Recipient under this provision, the Recipient
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July 2012 — June 2014
must have (1) previously failed to satisfactorily perform in a contract with the 7/24/2012 Item 16.D.15.
Agency of the unsatisfactory performance and failed to correct the unsatisfactory performance to the satisfaction
of the Agency; or (2) had a contract terminated by the Agency for cause.
52. Electronic Records and Signature
The Agency authorizes, but does not require, the Recipient to create and retain electronic records and to use
electronic signatures to conduct transactions necessary to carry out the terms of this Agreement. A Recipient
that creates and retains electronic records and uses electronic signatures to conduct transactions shall comply
with the requirements contained in the Uniform Electronic Transaction Act, s, 668.50, Fla. Stat. All electronic
records must be filly auditable; are subject to Florida's Public Records Law, ch. 119, Fla. Stat.; must comply
with section 28, Data Integrity and Safeguarding Information; must maintain all confidentiality, as applicable;
and must be retained and maintained by the Recipient to the same extent as non - electronic records are retained
and maintained as required by this Agreement.
52.1 The Agency's authorization pursuant to this section does not authorize electronic transactions between the
Recipient and the Agency. The Recipient is authorized to conduct electronic transactions with the Agency only
upon further written consent by the Agency.
52.2 Upon request by the Agency, the Recipient shall provide the Agency with non- electronic (paper) copies of
records. Non - electronic (paper) copies provided to the Agency of any document that was originally in electronic
form with an electronic signature must indicate the person and the person's capacity who electronically signed the
document on any non - electronic copy of the document,
53. Official Pavee and Representatives (Names, Addresses, and Telephone Numbers):
The Recipient name, as shown on page 1 of this contract,
a. and mailing address of the official payee to whom the
payment shall be made is:
b IThe name of the contact person and street address where
financial and administrative records are maintained is:
c• IThe name, address, and telephone number of the
representative of the Recipient responsible for
administration of the program under this contract is:
d The section and location within the Agency where
Requests for Payment and Receipt and Expenditure forms
are to be mailed is:
e• IThe name, address, and telephone number of the Contract
Manager for this contract is:
Collier County Board of County Commissioner;
Housing and Human Services Departments
3339 Tamiami Trail E Bldg H, Rm 211
Naples FL 34112
Kimberly Grant, Interim Director
Collier County Board of County Commissioners
Housing and Human Services Departments
3339 Tamiami Trail E Bldg H, Rm 211
Naples, FL 34112 _
Kimberly Grant, Interim Director
Collier County Board of County Commissioners
Housing and Human Services Departments
3339 Tamiami Trail E Bldg H, Rm 211
Naples, FL 34112
(239) 252 -2273
Area Agency on Aging for Southwest Florida, Inc.
dba Senior Choices of Southwest Florida
15201 N. Cleveland Ave, Suite 1 100
North Fort Myers, Florida 33903
Leigh Wade, Executive Director
Area Agency on Aging for Southwest Florida, Inc.
dba Senior Choices of Southwest Florida
15201 N. Cleveland Ave, Suite l 100
North Fort Myers, Florida 33903
(239) 652 -6900
Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided in
'iting to the other party and the notification attached to the originals of this contract.
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July 2012 — June 2014
7/24/2012 Item 16.D.15.
54, All Terms and Conditions Included;,,,
This contract and its Attachments, I — X and any exhibits referenced in said attachments, together with any
documents incorporated by reference, contain all the tenns 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 coin munications, 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 WTINESS THEREOF, the Parties hereto have caused this 39 page contract, to be executed by their undersigned
officials as duly authorized.
Recipient: COLLIER COUNTY BOARD OF
COUNTY COMMISSIONERS
3
SIGNED BY: r J
..
TITLE:
DATE:
Federal Tax 1D: 59- 6000588
Fiscal Year Ending Date: 09/30
AREA AGENCY ON AGING FOR SOUTHWEST
FLORIDA, INC. DBA SENIOR CHOICES OF
SOUTHWEST FLORIDA
SIGNED BY:
NAME: LEIGH ANNA NOWAK
TITLE: BOARD PRESIDENT
DATE:,.
a]
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July 2012 — June 2014
ATTACHMENT
ATTACHMENT I
ATTACHMENT II
INDEX TO CONTRACT ATTACHMENTS
ATTACHMENT DESCRIPTION
STATEMENT OF WORK
CERTIFICATION REGARDING LOBBYING
7/24/2012 Item 16.D.15.
PAGE
17 -25
26
ATTACHMENT III
FINANCIAL AND COMPLIANCE AUDIT ATTACHMENT
27 -31
ATTACHMENT IV
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE
32
ATTACHMENT V
CERTIFICATION REGARDING DEBARMENT, SUSPENSION,
33
INELIGIBILITY AND VOLUNTARY EXCLUSION
CONTRACTS /SUBCONTRACTS
ATTACHMENT VI
ASSURANCES— NON - CONSTRUCTION PROGRAMS
34 -35
ATTACHMENT VII
COMMUNITY CARE FOR THE ELDERLY INVOICE REPORT SCHEDULE
36
ATTACHMENT VIII
COMMUNITY CARE FOR THE ELDERLY BUDGET SUMMARY
37
ATTACHMENT IX
REQUEST FOR PAYMENT DOEA FORM 106C
38
ATTACHMENT X
RECEIPTS AND EXPENDITURES REPORT, DOEA FORM 105C
39
15
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July 2012 — June 2014 7/24/2012 Item 16.D.15.
%-%-I- L.VJ. 14
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC. ATTACHMENT
STATEMENT OF WORK
COMMUNITY CARE FOR THE ELDERLY PROGRAM
SECTION I: SERVICES TO BE PROVIDED
1.1. DEFINITIONS OF TERMS AND ACRONYMS
1.1.1 CONTRACT ACRONYMS
Activities of Daily Living (ADL)
Adult Protective Services (APS)
Assessed Priority Consumer List (APCL)
Comprehensive Assessment and Review for Long -Term Care Services (CARES)
Community Care for the Disabled Adult (CCDA)
Community Care for the Elderly (CCE)
Client Information and Registration Tracking System (CIRTS)
Department of Children and Families (DCF)
Department of Elder Affairs (DOEA)
Home Care for Disabled Adults (HCDA)
Instrumental Activities of Daily Living (IADL)
Planning and Service Area (PSA)
1.1.2 PROGRAM SPECIFIC TERMS
Aging Out: The condition of reaching 60 years of age and being transitioned from the Department of
Children and Families (DCF) Services, Community Care for Disabled Adults (CCDA) or Home Care for
Disabled Adults (HCDA) services to the Department's community-based services.
Area Plan: A plan developed by the Agency outlining a comprehensive and coordinated service delivery
system in its planning and service area in accordance with the Section 306 (42 U.S.C. 3026) of the Older
Americans Act and Department instructions. The Area Plan includes performance measures and unit rates per
service offered per county.
Area Plan Update: A revision to the Area Plan wherein the Agency enters CCE specific data in the C1RTS.
An update may also include other revisions to the area plan as instructed by the Agency or Department of
Elder Affairs.
Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to
remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case
managers to conduct the functional assessment.
1.2 GENERAL DESCRIPTION
1.2.1 General Statement
The primary purpose of the CCE program is to prevent, decrease or delay premature or inappropriate and
expensive placement of older persons in nursing homes and other institutions.
1.2.2 Community Care for the Elderly Mission Statement
The CCE Program assists functionally impaired elderly persons in living as independently as
possible in their own homes or in the homes of relatives or caregivers. The program provides a
continuum of care through the development, expansion, reorganization and coordination of
multiple community -based services to assist elders to reside in the least restrictive environment
suitable to their needs.
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1.2.3 Authority
The relevant authority governing CCE program are:
(1) Rule 58C -1, Florida Administrative Code
(2) Sections 430.201 through 430.207, F.S.
7/24/2012 Item 16.D.15.
1.2.3.1 incorporation of Reference Memoranda
In accordance with s. 287 F.S., as amended, and Department of Financial Services Chief Financial Officer
Memoranda the following memoranda are provided for informational purposes and are hereby incorporated by
reference:
(1) CFO Memo No. 02: Release date, August 20, 2010;
(2) CFO Memo No. 03: Release date, June 29, 2010; and
(3) CFO Memo No. 06: Release date, June 30, 2010.
1.2.4 Scope of Service
The Recipient is responsible for the programmatic, fiscal, and operational management of CCE. The program
services shall be provided in a manner consistent with and described in the current Recipient's Request for
Proposal, RFP, and the Agency's current area plan and the current Department of Elder Affairs Programs and
Services Handbook.
1.2.5 Major Program Goals
The major goals of the program are to preserve the independence of elders and prevent or delay more costly
institutional care through a community care service system that provides case management and other in -home
and community services as needed under the direction of a lead agency and provide a continuum of service
alternatives that meet the diverse needs of functionally impaired elders.
..3. INDIVIDUALS TO BE SERVED
1.3.1 General Eligibility
The CCE program provides a continuum of services for functional impaired elders.
1.3.2 Individual Eligibility
In order to receive services under this contract, an applicant must:
(1) Be at least 60 years of age;
(2) Be functionally impaired as determined through the initial comprehensive assessment; and
(3) With the exception of APS high -risk referrals, consumers may not be dually enrolled in the CCE program
and a Medicaid capitated long -term care program.
1.3.2.1 Targeted Groups
Priority for services provided under this contract shall be given to those eligible persons assessed to be at risk
of placement in an institution or who are abused, neglected or exploited.
SECTION II: MANNER OF SERVICE PROVISION
2.1 SERVICE TASKS
To achieve the goals of the CCE program, the Recipient shall ensure the following tasks are performed:
(1) Client Eligibility Determination;
(2) Assessment and Prioritization of Service Delivery for New Clients;
(3) Delivery of Services to Eligible Clients; and
(4) Monitoring the performance of subcontractors.
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7/24/2012 Item 16.D.15.
L+�..L LV✓. AL..
2.1.1 Client Eligibility Determination
The Recipient shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a
client is based on meeting the requirements described in this ATTACHMENT I, Section 1.3.
2.1.1.1 APS High -Risk Referrals
APS high -risk referrals who are enrolled in a Medicaid long -term care program at the time of referral may
receive crisis - resolving CCE- funded services only under the following circumstances:
(1) The long -term care program provider is contacted regarding the referral as soon as it is received;
(2) The CCE lead agency receives notification from the long -term care program provider that the long -tern
care program in which the consumer is enrolled will address the consumer's needs; and
(3) The CCE lead agency may only provide services until the crisis is resolved.
2.1.1.2 APS Intermediate and Low Risk Referrals
The Recipient shall ensure that APS low and medium referrals who are enrolled in a Medicaid capitated long-
term care program at the time of referral will be referred to the long-term care provider.
2.1.2 Assessment and Prioritization of Service Delivery for New Clients
The Recipient shall ensure that the following criteria are used to prioritize new clients for service delivery. It is
not the intent of the Agency to remove existing clients from services in order to serve new clients being
assessed and prioritized for service delivery.
2.1.2.1 Abuse, Neglect and Exploitation
The Recipient will ensure that pursuant to Section 430.205(5), Florida Statutes, those elderly persons who are
determined by 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 Agency contracts by local
protocols developed between the Agency and Department service contractors and APS.
2.1.2.2 Priority Criteria for Individuals in Nursing Homes in Receivership:
The Recipient will ensure that pursuant to Section 400.126 (12), Florida Statutes, those elderly persons
determined, through a CARES assessment, to be a resident who could be cared for in a less restrictive setting
or who do not meet the criteria for skilled or intermediate care in a nursing home, will be referred for such
care, as appropriate for the resident. Residents referred pursuant to this subsection shall be given primary
consideration for receiving services under the CCE program in a manner as persons classified to receive such
services pursuant to Section 430.205, Florida Statutes.
2.1.2.3 Priority Criteria for Service Delivery:
(1) Individuals in nursing homes under Medicaid who could be transferred to the community;
(2) Individuals in nursing homes whose Medicare coverage is exhausted and may be diverted to the
community;
(3) Individuals in nursing homes that are closing and can be discharged to the community; or
(4) Individuals whose mental or physical health condition has deteriorated to the degree self care is not
possible, there is no capable caregiver, and institutional placement will occur within 72 hours;
(5) For the purpose oftransitioning individuals receiving CCDA and HCDA services through the DCF Adult
Services to community-based services provided through the Agency, when services are not currently
available, area agency on aging staff and lead agency case managers shall ensure that "Aging Out"
individuals are prioritized for services only after APS High Risk and Imminent Risk individuals.
2.1.2.4 Priority Criteria for Service Delivery for Other Assessed Individuals:
The assessment and provision of services should always consider the most cost effective means of service
delivery. Service priority for individuals not included in groups one, two or three above, regardless of referral
source, will be determined through the Department's client assessment form administered to each applicant, to
the extent funding is available. The Recipient shall ensure that first priority will be given to applicants at the
higher levels of frailty and risk of nursing home placement. For individuals assessed at the same priority and
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risk of nursing home placement, priority will be given to applicants with the lesser ability to pay far services.
2.1.2.5 Referrals for Medicaid Waiver Services:
(1) The Recipient must require subcontractors, through the client assessment, to identify potential Medicaid
eligible CCE clients and to refer these individuals for application for Medicaid Waiver services.
(2) Individuals who have been identified as being potentially Medicaid Waiver eligible are required to apply
for Medicaid Waiver services in order to receive CCE services and can only receive CCE services while
the Medicaid Waiver eligibility 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.
(3) Individuals who have been identified as being potentially Medicaid Waiver eligible must be advised of
the responsibility to apply for Medicaid Waiver services as a condition of receiving CCE services while
the eligibility determination is being processed.
2.1.3 Delivery of Service to Eligible Clients
The Recipient shall ensure the provision of a continuum of service that meet the diverse needs of functionally
impaired elders. The Recipient shall ensure performance and reporting of the following service provision in
accordance with the current DOEA Programs and Services Handbook. The services include the following
categories:
(1) Core Services;
(2) Health Maintenance Services; and
(3) Other Support Services.
2.1.3.1 Core Services for Programmatic Operation
The Recipient shall ensure that core services include a variety of home- delivered services, day care services, and
other basic services that are most needed to prevent unnecessary institutionalization. Core services, to be
provided at the unit rate identified in this contract, include the following:
(1)
Adult Day Care;
(2)
Chore Services;
(3)
Enhanced Chore;
(4)
Companionship;
(5)
Horne Delivered Meals;
(6)
Homemaker;
(7) Housing Improvement;
(8) Respite Services; and
(9) Transportation
2.1.3.2 Health Maintenance Services
The Recipient shall ensure that health maintenance services are routine health services that are necessary to
help maintain the health of functionally impaired elders. The services are limited to medical therapeutic
services, non - medical prevention services, personal care services, hoarse health aide services, home nursing
services, and emergency response systems. Typical services to be provided at the unit rate identified in this
contract, are the following:
(1) Adult Day Health Care;
(2) Emergency Alert Response;
(3) Nutrition Counseling
(4) Personal Care
(5) Skilled Nursing Services; and
(6) Specialized Medical Equipment, Services and
Supplies
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2.1.3.3 Other Support Services L.VJ. 14
Support Services expand the continuum of care options to assist functionally impaired elders and their
caregivers. Support services include the following:
(1) Caregiver Training/Support;
(2) Case Aid;
(3) Case Management;
(4) Material Aid; and
(5) Other.
2.1.4 Use of Subcontractors
If this contract involves the use of a subcontractor or third party, then the Recipient shall not delay the
implementation of its agreement with the subcontractor. If any circumstances occur that may result in a delay
for a period of 60 days or more of the initiation of the subcontract or in the performance of the subcontractor,
the Recipient shall notify the Contract Manager and the Agency's Director of Finance in writing of such delay.
2.4.4.1 The Recipient shall not permit a subcontractor to perform services related to this agreement without having a
binding subcontractor agreement executed. In accordance with Section 24.1 of the Standard Contract, the
Agency will not be responsible or liable for any obligations or claims resulting from such action.
2.1.4.1 Monitoring the Performance of Subcontractors
The Recipient will monitor at least once per year each of its subcontractors, subrecipients, vendors and /or
consultants paid from funds provided under this contract. The Recipient will 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 Recipient will 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.
2.2 SERVICE TIMES
2.2.1 Service Times
The Recipient shall ensure the provision of the services listed in this contract are available at times appropriate
to meet client service needs at a minimum, during normal business hours. Normal business hours are defined
as Monday through Friday, 8 :00 a.m. to 5:00 p.m.
2.3 DELIVERABLES
2.3.1 Service Unit
The Recipient shall ensure the provision of the services `_ cribed in the contract in accordance with the
current Department of Elder -affairs Programs and Servi _�s Handbook and the service tasks described in
Section 2.1. The chart bete- ists the type of services all ,,ed and the unit of measurement. Units of service
will be paid pursuant to rate esta'iiished in t`-;s � ,tract as IT * It d
e
requirements. an approved by the Agency s
Service
Adult Day Care
Case Aide
Case Management
Chore Services
Enhanced Chore
Companionship
Homemaker
Housing Improveme• .
Respite Services
Personal Care
Physical They- ,y
Skilled Nursing .ervices
Emergency Alert Response
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Unit of Service
Hour
Day
July 2012 — June 2014
7/24/2012 Item 16.D.15.
2.4 REPORTS
The Recipient shall respond to additional routine and /or special requests for information and reports required
by the Agency in a timely manner as determined by the Contract Manager. The Recipient shall establish due
dates for any subcontractors that permits the Recipient to meet the Agency's reporting requirements.
2.4.1 Client Information and Registration Tracking System ( CIRTS
The Recipient shall input CCE specific data into CIRTS to ensure CIRTS data accuracy. The Recipient shall
use CIRTS generated reports, which include the following:
(1) Client Reports;
(2) Monitoring Reports;
(3) Services Reports;
(4) Miscellaneous Reports;
(5) Fiscal Reports;
(6) Aging Resource Center Reports; and
(7) Outcome Measurement Reports.
2.4.2 Service Costs Reports
The Recipient shall require subcontractors to submit to the Recipient semi - annual service cost reports,
February 15 and August 15 of each year which reflect actual costs of providing each service by program.. This
report provides information for planning and negotiating unit rates.
2.4.3 Surplus/Deficit Report
The Recipient will submit a consolidated surplus /deficit report in a format provided by the Agency to the
Contract Manager by the 18 °' of each month. This report is for all agreements and /or contracts between the
Recipient and the Agency. The report will include the following:
(1) The Recipient's detailed plan on how the surphrs or deficit spending exceeding the threshold specified
by the Agency will be resolved; and
(2) Recommendations to transfer funds to resolve surplus /deficit <., °!)ding;
2.5 RECORDS AND DOCUMENTATION
The Recipient will ensure the collection and maim; ,,nce of ciic� . and service information on a monthly basis
2'5'1 from the Client Information and Registration Tr-. y ) y },
b� �g S stern �IRTS or an such system designated by the
Agency and the State of Florida Department o'L: der Affairs Maintenance includes valid exports and
backups of all data and systems according to Departm-�.nt a- : ur Agency standards.
2.5.2 Each Recipient and subcontractor, arnong other requi .,nents, must anticipate and prepare for the loss of
information processing capabilities. The routine bac' .ng up of all data and software is required to recover
from losses or outages of the computer system. D ,a and software essential to the continued operation of
Recipient functions must be backed up. The secur' y controls over the backup resources shall be as stringent
as the protection required of the primary resoure, s. It is recommended that a copy of the backed up data be
stored in a secure, offsite location. The Recipient shall maintain written policies and procedures for computer
system backup and recovery and shall have the same requirement in its contracts and /or agreements with
subcontractors. These policies and procedures will be made available to the Agency upon request.
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Material Aid
Specialized Medical Equipment, Services and Supplies
Episode
Escort
Shopping Assistance
One -Way Trip
Transportation
Service
Unit of Service
Home Delivered Meals
Meal
2.4 REPORTS
The Recipient shall respond to additional routine and /or special requests for information and reports required
by the Agency in a timely manner as determined by the Contract Manager. The Recipient shall establish due
dates for any subcontractors that permits the Recipient to meet the Agency's reporting requirements.
2.4.1 Client Information and Registration Tracking System ( CIRTS
The Recipient shall input CCE specific data into CIRTS to ensure CIRTS data accuracy. The Recipient shall
use CIRTS generated reports, which include the following:
(1) Client Reports;
(2) Monitoring Reports;
(3) Services Reports;
(4) Miscellaneous Reports;
(5) Fiscal Reports;
(6) Aging Resource Center Reports; and
(7) Outcome Measurement Reports.
2.4.2 Service Costs Reports
The Recipient shall require subcontractors to submit to the Recipient semi - annual service cost reports,
February 15 and August 15 of each year which reflect actual costs of providing each service by program.. This
report provides information for planning and negotiating unit rates.
2.4.3 Surplus/Deficit Report
The Recipient will submit a consolidated surplus /deficit report in a format provided by the Agency to the
Contract Manager by the 18 °' of each month. This report is for all agreements and /or contracts between the
Recipient and the Agency. The report will include the following:
(1) The Recipient's detailed plan on how the surphrs or deficit spending exceeding the threshold specified
by the Agency will be resolved; and
(2) Recommendations to transfer funds to resolve surplus /deficit <., °!)ding;
2.5 RECORDS AND DOCUMENTATION
The Recipient will ensure the collection and maim; ,,nce of ciic� . and service information on a monthly basis
2'5'1 from the Client Information and Registration Tr-. y ) y },
b� �g S stern �IRTS or an such system designated by the
Agency and the State of Florida Department o'L: der Affairs Maintenance includes valid exports and
backups of all data and systems according to Departm-�.nt a- : ur Agency standards.
2.5.2 Each Recipient and subcontractor, arnong other requi .,nents, must anticipate and prepare for the loss of
information processing capabilities. The routine bac' .ng up of all data and software is required to recover
from losses or outages of the computer system. D ,a and software essential to the continued operation of
Recipient functions must be backed up. The secur' y controls over the backup resources shall be as stringent
as the protection required of the primary resoure, s. It is recommended that a copy of the backed up data be
stored in a secure, offsite location. The Recipient shall maintain written policies and procedures for computer
system backup and recovery and shall have the same requirement in its contracts and /or agreements with
subcontractors. These policies and procedures will be made available to the Agency upon request.
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2.6 PERFORMANCE SPECIFICATIONS
2.6.1 Outcomes ;.
(1) The Recipient shall ensure services provided under this contract are in accordance with the current
Department of Elder Affairs Programs and Services Handbook.
(2) The Recipient shall timely submit to the Agency all information described in ATTACHMENT I,
SECTION 2.4 REPORTS; and
(3) The Recipient shall timely submit to the Agency all information described in ATTACHMENT I,
SECTION 2.5 RECORDS AND DOCUMENTATION.
2.6.2 The Recipient shall develop and document strategies in the Area Plan to support performance achievement of
the following:
(1) Percent of most frail elders who remain at home or in the community instead of going into a nursing
home;
(2) Average monthly savings per consumer for home and community -based care versus nursing home care
for comparable client groups;
(3) Percent of elders assessed with high or moderate risk environments who improved their environment
score;
(4) Percent of new service recipients with high -risk nutrition scores whose nutritional status improved;
(5) Percent of new service recipients whose ADL assessment score has been maintained or improved;
(6) Percent of new service recipients whose IADL assessment score has been maintained or improved;
(7) Percent of family and family- assisted caregivers who self - report they are likely to provide care;
(8) Percent of caregivers whose ability to provide care is maintained or improved after one year of service
intervention (as determined by the caregiver and the assessor);
(9) Percent of customers who are at imminent risk of nursing home placement who are served with
community -based services;
(10) Average time in the CCE Program for Medicaid Waiver probable customers; and
(11) Percent of customers who are at imminent risk of nursing home placement who are served with the
community -based services.
The Recipient's performance of these measures will be documented in the Agency's annual monitoring
reports.
2.7. RECIPIENT'S FINANCIAL OBLIGATIONS
2.7.1 Matching, Level of Effort, and Earmarking Requirement
The Recipient will assure a match requirement of at least 10 percent of the cost for all CCE services. The
match will be made in the form of cash and /or- in -kind resources. At the end of the contract period, all CCE
funds expended must be properly matched. State finds cannot be used to match another state - funded program.
2.7.2 Cost Sharing and Co- payments
The Recipient shall establish annual co- payment goals. The Agency has the option to withhold a portion of the
Recipient's request for payment if goals are not met according to the Agency and the Department of Elder
Affairs' co- payment guidelines. Co- payments include only the amounts assessed consumers or the amounts
consumers opt to contribute in lieu of an assessed co- payment. The contribution must be equal to or greater
than the assessed co- payment. Co- payments collected in the CCE program can be used as part of the local
match.
2.7.3 Use of Service Dollars and Assessed Priority Consumer List Management
The Recipient is expected to spend all federal, state and other funds provided by the Agency, for the purpose
specified in each contract. The Recipient must manage the service dollars in such a manner so as to avoid
having a wait list and a surplus of hinds at the end of the contract period, for each program managed by the
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7/24/2012 Item 16.D.15.
July 2012 — June 2014 \��.L 1
Agency. if the Agency determines that the Recipient is not spending service funds accordingly, the Agency
may transfer funds to other planning and service areas during the contract period and/ or adjust subsequent
funding allocations accordingly, as allowable under state and federal law.
2.8 AGENCY RESPONSIBILITIES
2.8.1 Program Guidance and Technical Assistance
The Agency will provide to the Recipient guidance and technical assistance as needed to ensure the successful
fulfillment of th2 contract by the Recipient.
2.8.2 Contract Monitoring
The Agency will review and evaluate the performance of the Recipient under the terms of this contract.
Monitoring shall be conducted through direct contact with the Recipient through telephone, in writing, or an
on -site visit. The Agency's determination of acceptable performance shall be conclusive. The Recipient 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:
(1) Desk reviews and analytical reviews;
(2) Scheduled, unscheduled and follow -up on -site visits;
(3) Client visits;
(4) Review of independent auditor's reports;
(5) Review of third -party documents and /or evaluation;
(6) Review of progress reports;
(7) Review of customer satisfaction surveys;
(8) Agreed -upon procedures review by an external auditor or consultant;
(9) Limited -scope reviews; and
(10) Other procedures as deemed necessary.
SECTION III: METHOD OF PAYMENT
3.1 General Statement of Method of Payment
The method of payment for this contract includes advances, cost reimbursement for administration costs, and
fixed rate for services. The Recipient shall ensure fixed rates for services include only those costs that are in
accordance with all applicable state and federal statutes and regulations and are based on audited historical
costs in instances where an independent audit is required. The Recipient shall consolidate all requests for
payment from subcontractors and expenditure reports that support requests for payment and shall submit to the
Agency on forms 106C (ATTACHMENT IX) and I OSC (ATTACHMENT X).
3.1.1 The Recipient agrees to distribute funds as detailed in the area plan update and the Budget Summary,
ATTACHMENT VIII to this contract. Any changes in the total amounts of funds identified on the Budget
Summary form require a contract amendment.
3.2 Advance Payments
3.2.1 The Recipient may request up to two months of advances at the start of the contract period to cover program
administrative and service costs. The schedule for submission of advance requests, if available, is shown on
ATTACHMENT VII to this contract. The payment of an advance will be contingent upon the sufficiency
and amount of finds released to the Agency and the State of Florida Department of Elder Affairs ( "budget.
release ").
The Recipient shall provide the Contract Manager documentation justifying the need for an advance and
describing how the funds will be distributed.
3.2.2 The Recipient's requests for an advance require the approval of the Contract Manager, if sufficient budget is
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7/24/2012 Item 16.D.15.
July 2012 — June 2014
available, the Agency will issue approved advance payments after July 1, 2012.
3.2.3 All advance payments made to the Recipient shall be returned to the Agency as follows: one — twelfth
of the advance payment received shall be reported as an advance recoupment on each request for payment,
starting with report number three, in accordance with the Invoice Schedule, ATTACHMENT VIII to this
contract.
3.2.4 The Recipient may temporarily place advanced funds in a FDIC insured interest bearing account. All interest
earned on contract find advances must be returned to the Agency within thirty (30) days of the end of each
quarter of the contract period.
3.3 Invoice Submittal and Requests for Payment
All requests for payment and expenditure reports submitted to support requests for payment shall be on DOEA
forms 106C (ATTACHMENT IX) and 105C (ATTACHMENT X).
3.3.1 Remedies - Nonconforming Services
The Recipient shall ensure that all goods and /or services provided under this contract for CCE funded
programs are delivered timely, completely and commensurate with required standards of quality. Such goods
and /or services will only be delivered to eligible program participants.
If the Recipient 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 Recipient's signature on the
request for payment form certifies maintenance of supporting documentation and acknowledgement that the
Recipient shall solely bare the costs associated with preparing or providing nonconforming goods and /or
services. The Agency and or Department require immediate notice of any significant and /or systemic
infractions that compromise the quality, security or continuity of services to clients.
3.3.2 Financial Consequences
Recipient shall ensure the provision of services to the projected number of clients in accordance with the Area
Plan as updated and within the contract amount. The Recipient shall ensure expenditure of 100% of the
contract amount budgeted for services to clients at the unit rates established in the Area Plan. In the event the
Recipient has a surplus of 1% or more at the end of the first year of the contract term, the Agency will
reallocate 1% of the budget for the second year of the contract term to other area agencies found to be serving
clients to the fullest extent of their allocated budgets. If, or to the extent, there is any conflict between this
paragraph and paragraphs 39 and 39.1 of the standard contract, this paragraph shall have precedence.
3.3.3 All payment requests shall be based on the submission of actual monthly expenditure reports beginning with
the first month of the contract. The schedule for submission of advance requests (when available) and invoices
is ATTACHMENT VII to this contract.
3.3.4 Payment may be authorized only for allowable e�,penditures, which are in accordance with the limits specified
in ATTACHMENT VIII, Budget Summary.
3.3.5 Any payment due by the Agency uO.: ;r the terns of this contract may be withheld pending the receipt and
approval by the Agency of all f:, .,,eial and programmatic reports due from the Recipient and any adjustments
thereto, including any disallowance not resolved as ou11`;:c;d in Section 26 of this contract.
3.3.6 Date for Final Request for Paymcnt
The final request for payment for contract year one expenditures will be due to the Agency no later than
August 1, 2013. The final request for payment for contract year two expenditures xvill be no later than
August 1, 2014,
3.4 Documentation for Payment
The Recipient shall maintain documentation to support payment requests that shall be available to the Agency
or authorized individuals, such as the Department of Financial Services, upon request.
3.4.1 The Recipient must enter all required data per the Department's CIRTS Policy Guidelines for clients and
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7/24/2012 Item 16.D.15.
July 2012 — June 2014 ..L
services in the CIRTS database. The data must be entered into the CIRTS before the Recipient submits their
request for payment and expenditure reports to the Agency. The Agency shall establish time frames to assure
compliance with due dates for the requests for payment and expenditure reports to the Agency and the
Department,
3.4.2 The Recipient must run monthly CIRTS reports and verify that the client and service data in the CIRTS is
accurate. This report must be submitted to the Agency with the monthly request for payment and expenditure
report and must be reviewed by the Agency before the Recipient's request for payment and expenditure reports
can be approved by the Agency.
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ATTACHMENT II
CERTIFICATION REGARDING LOBBYING ft .
CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND
AGREEMENTS
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of any state or federal agency, a member of congress, an
officer or employee of congress, an employee of a member of congress, or an officer or employee of the state
legislator, in connection with the awarding of any federal grant, the making of any federal loan, the entering into of
any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal
contract, grant, loan, or cooperative agreement.
(2) If any finds other than federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a member of congress, an officer or employee of
congress, or an employee of a member of congress in connection with this federal contract, grant, loan, or cooperative
agreement, the undersigned shall complete and submit Standard Form -LLL, "Disclosure Form to Report Lobbying,"
in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents for all sub -
awards at all tiers (including subcontracts, sub - grants, and contracts under grants, loans and cooperative agreements)
and that all subcontractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made
or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed
by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil
penalty of not less than $10,000 and not more than $100,000 for each such failure.
{ 67 Z
Signature Date
Gicm' �'QrAofl C— F—
Name of Authorized Individual Application or Agreement Number
Collier County Board of
Commissioners
Name 3299 Tamiami Trail E
Naples, FL 34112
7.6
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July 2012 — June 2014
FINANCIAL AND COMPLIANCE AUDIT
7/24/2012 Item 16.D.15.
I.VL GV.1. t L
ATTACHMENT III
The administration of resources awarded by the Area Agency on Aging for Southwest Florida, Inc.dba Senior Choices of
Southwest Florida and /or the Department of Elder Affairs to the provider may be subject to audits and/or monitoring by the
Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or the Department of
Elder Affairs as described in this section.
MONITORING
In addition to reviews of audits conducted in accordance with OMB Circular A -133, as revised, and Section 215.97, F.S., (see
"AUDITS" below), monitoring procedures may include, but not be limited to, on -site visits by the Agency staff, limited scope
audits as defined by OMB Circular A -133, as revised, and /or other procedures. By entering into this agreement, the provider
agrees to comply and cooperate with any monitoring procedures /processes deemed appropriate by the Area Agency on Aging
for Southwest Florida, Inc. In the event the Area Agency on Aging for Southwest Florida, Inc. determines that a limited scope
audit of the provider is appropriate, the provider agrees to comply with any additional instructions provided by the Area Agency
on Aging for Southwest Florida, Inc. to the provider regarding such audit. The provider further agrees to comply and cooperate
with any inspections, reviews, investigations, or audits deemed necessary by the 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 $500,000 or more in federal awards during its fiscal year, the provider must have a single
or program - specific audit conducted in accordance with the provisions of OMB Circular A -133, as revised. EXHIBIT 1 to this
agreement indicates federal resources awarded through the Area Agency on Aging for Southwest Florida, Inc.dba Senior
Choices of Southwest Florida and /or the Department of Elder Affairs by this agreement. In determining the federal awards
.xpended in its fiscal year, the provider shall consider all sources of federal awards, including federal resources received from
the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or the Department of Elder
Affairs. The determination of amounts of federal awards expended should be in accordance with the guidelines established by
OMB Circular A -133, as revised. An audit of the provider conducted by the Auditor General in accordance with the provisions
of OMB Circular A -133, as revised, will meet the requirements of this part.
In connection with the audit requirements addressed in Part I, paragraph 1, the provider shall fulfill the requirements relative to
auditee responsibilities as provided in Subpart C of OMB Circular A -133, as revised.
If the provider expends less than $500,000 in federal awards in its fiscal year, an audit conducted in accordance with the
provisions of OMB Circular A -133, as revised, is not required. In the event that the provider expends less than $500,000 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 Area Agency on Aging for Southwest Florida, Inc. and /or the Department
of Elder Affairs shall be based on the agreement's requirements, including any rules, regulations, or statutes referenced in the
agreement. The financial statements shall disclose whether or not the matching requirement was met for each applicable
agreement. All questioned costs and liabilities due to the Area Agency on Aging for Southwest Florida, Inc. dba Senior
Choices of Southwest Florida and /or the Department of Elder Affairs shall be frilly disclosed in the audit report with reference
to the Area Agency on Aging for Southwest Florida, Inc. and /or the Department of Elder Affairs 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 Area Agency on Aging for
Southwest Florida, inc. dba Senior Choices of Southwest Florida and /or the Department of Elder Affairs in effect during the
audit period. Financial reporting packages required under this part must be submitted within the earlier of 30 days after receipt
of the audit report or 9 months after the end of the provider's fiscal year end.
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PART II: STATE FUNDED
7/24/2012 Item 16.D.15.
% -% -L L-VJ. 1L
This part is applicable if the provider is a nonstate entity as defined by Section 215.97(2), Florida Statutes
In the event that the provider expends a total amount of state financial assistance equal to or in excess of $500,000 in any fiscal
year of such provider (for fiscal years ending September 30, 2004 or thereafter), the provider must have a State single or
project - specific audit for such fiscal year in accordance with Section 215.97, Florida Statutes; applicable rules of the
Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for - profit
organizations), Rules of the Auditor General. EXHIBIT i to this agreement indicates state financial assistance awarded through
the Area Agency on Aging for Southwest Florida, Inc. and /or the Department of Elder Affairs by this agreement. In
determining the state financial assistance expended in its fiscal year, the provider shall consider all sources of state financial
assistance, including state financial assistance received from the Area Agency on Aging for Southwest Florida, lne.dba Senior
Choices of Southwest Florida and /or the Department of Elder Affairs, other state agencies, and other nonstate entities. State
financial assistance does not include federal direct or pass - through awards and resources received by a nonstate entity for
federal program matching requirements.
In connection with the audit requirements addressed in Part 11, paragraph 1, the provider shall'ensure that the audit complies
with the requirements of Section 215.97(8), Florida Statutes. This includes submission of a financial reporting package as
defined by Section 215.97(2), Florida Statutes, and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for -
profit organizations), Rules of the Auditor General.
If the provider expends less than $500,000 in state financial assistance in its fiscal year (for fiscal years ending September 30,
2004 or thereafter), an audit conducted in accordance with the provisions of Section 215.97, Florida Statutes, is not required. In
the event that the provider expends Iess than $500,000 in state financial assistance in its fiscal year and elects to have an audit
conducted in accordance with the provisions of Section 215.97, Florida Statutes, the cost of the audit must be paid from the
nonstate entity's resources (i.e., the cost of such an audit must 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. Osft
Compliance findings related to agreements with the Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of
Southwest Florida and /or the Department of Elder Affairs shall be based on the agreement's requirements, including any
applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching requirement was
met for each applicable agreement. All questioned costs and liabilities due to the Area Agency on Aging for Southwest Florida,
Inc. dba Senior Choices of Southwest Florida and /or the Department of Elder Affairs shall be fully disclosed in the audit report
with reference to the Area Agency on Aging for Southwest Florida, Inc. and /or the Department of Elder Affairs agreement
involved. If not otherwise disclosed as required by Rule 691 - 5.003, Fla. Admin. Code, the schedule of expenditures of state
financial assistance shall identify expenditures by agreement number for each ab eement with the Area Agency on Aging for
Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or the Department of Elder Affairs in effect during the
audit period. Financial reporting packages required under this part must be submitted within 45 days after delivery of the audit
report, but no later than 12 months after the provider's fiscal year end for local governmental entities. Non -profit or for -profit
organizations are required to be submitted within 45 days after delivery of the audit report, but no later than 9 months after the
provider's fiscal year end. Notwithstanding the applicability of this portion, the Area Agency on Aging for Southwest Florida,
Inc. dba Senior Choices of Southwest Florida and /or the Department of Elder Affairs retains all right and obligation to monitor
and oversee the performance of this agreement as outlined throughout this document and pursuant to law.
PART III: REPORT SUBMISSION
Copies of reporting packages for audits conducted in accordance with OMB Circular A -133, as revised, and required by PART I
of this agreement shall be submitted, when required by Section .320 (d), OMB Circular A -133, as revised, by or on behalf of the
provider directly to each of the following:
The Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida at the following address:
Area Agency on Aging for Southwest Florida, Inc.
dba Senior Choices of Southwest Florida
Attn: Leigh Wade, Executive Director
15201 N Cleveland Ave., Suite 1.100
North Fort Myers, FL 33903
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7/24/2012 Item 16.D.15.
July 2012 — June 2014
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
following address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10 "' Street
Jeffersonville, IN 47132
Other Federal agencies and pass - through entities in accordance with Sections .320 (e) and (0, OMB Circular A -133, as revised.
Pursuant to Sections 320(f), OMB Circular A -133, as revised, the provider shall submit a copy of the reporting package
described in Section .320(c), OMB Circular A -133, as revised, and any management letter issued by the auditor, to the Area
Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida at the following address:
Area Agency on Aging for Southwest Florida, Inc.
dba Senior Choices of Southwest Florida
Attn: Leigh Wade, Executive Director
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. dba Senior Choices of Southwest Florida at the following address:
Area Agency on Aging for Southwest Florida, Inc.
dba Senior Choices of Southwest Florida
Attn: Leigh Wade, Executive Director
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
'he Auditor General's Office at the following address:
State of Florida Auditor General
Claude Pepper Building, Room 574
111 West Madison Street
Tallahassee, Florida 32399 -1450
Any reports, management letter, or other information required to be submitted to the Area Agency on Aging for Southwest
Florida, Inc. pursuant to this agreement shall be submitted timely in accordance with OMB Circular A -133, Florida Statutes,
and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for - profit organizations), Rules of the Auditor
General, as applicable.
Providers, when submitting financial reporting packages to the Area Agency on Aging for Southwest Florida, Inc. for audits
done in accordance with OMB Circular A -133 or Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for -
profit organizations), Rules of the Auditor General, should indicate the date that the reporting package was delivered to the
provider in correspondence accompanying the reporting package.
PART IV: RECORD RETENTION
The provider shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of six
years from the date the audit report is issued, and shall allow the Area Agency on Aging for Southwest Florida, Inc. dba Senior
Choices of Southwest Florida and or the Department of Elder Affairs 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 Area Agency on Aging for
Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or the Department of Elder Affairs, or its designee, CFO,
or Auditor General upon request for a period of six years from the date the audit report is issued, unless extended in writing by
Area Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida and /or the Department of Elder
.,ffairs.
29
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7/24/2012 Item 16.D.15.
VVL LV✓.1L
ATTACHMENT III
EXHIBIT —1 ow
I. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT
CONSIST OF THE FOLLOWING:
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL FEDERAL A vt ntZii
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT
TO THIS AGREEMENT ARE AS FOLLOWS:
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS
AGREEMENT CONSIST OF THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD
STATE FINANCIAL ASSISTANCE SUBJECT TO See. 215.97, F.S.
PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT
Community Care for the Elderly Program General Revenue
65010 1 $661,357.00
TOTAL AWARD
$661,357.00
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOUT';-'ES AWARDED PURSUANT TO
THIS AGREEMENT ARE AS FOLLOWS:
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July 2012 — June 2014 7/24/2012 Item 16 -D.15.
ATTACHMENT III
PART 1: AUDIT RELATIONSHIP DETERMINATION EXHIBIT -2
Providers who receive state or federal resources may or may not be subject to the audit requirements of OMB Circular A -133, as
revised, and /or Section 215.97, Fla. Stat. Providers who are determined to be recipients or subrecipients of federal awards and /or state
financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I and /or Part 11 of
Exhibit 1 are met. Providers who have been determined to be vendors are not subject to the audit requirements of OMB Circular A-
133, as revised, and /or Section 215.97, Fla. Stat. Regardless of whether the audit requirements are met, providers who have been
detennined to be recipients or subrecipients of Federal awards and /or state financial assistance, must comply with applicable
programmatic and fiscal compliance requirements.
In accordance with Sec. 210 of 014413 Circular A -133 arruir ^ „' 691- 5.006, FAC, provider has been determined to be:
Vendor or exempt entity and not subject to OMB Circular A -133 and/or Section 215.97, F.S.
X Recipient /subrecipient subject to OMB Circular A -I33 and /or Section 215.97, F.S.
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 69I- .006(2), FAC [state financial assistance] and
Section _ .400 OMB Circular A -133 [federal awards].
PART II: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Providers who receive Federal awards or
state matching funds on Federal awards and who are detennined to be a subrecipient, must comply with the following fiscal laws,
rules and regulations:
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR Part 225 Cost Principles for State, Local and Indian Tribal Governments (Formerly OMB Circular A -87)*
OMB Circular A -102— Administrative Requirements
OMB Circular A -133 — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
NON - PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR Part 230 Cost Principles for Non - Profit Organizations (Formerly OMB Circular A -] 22 — Cost Principles)*
2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A -110 — Administrative Requirements)
Requirements)
OMB Circular A -I33 — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT) MUST
FOLLOW:
2 CFR Part 220 Cost Principles for Educational Institutions OMB (Formerly Circular A -21 — Cost Principles)*
2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A -110 — Administrative Requirements)
OMB Circular A -133 — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules a,d regulations
*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in the OMB Circular
A -133 Compliance Supplement, Appendix 1.
STATE FINANCIAL ASSISTANCE. Providers who receive state financial ;sistance and who are determined to be a
recipient /subrecipient, must comply with the following fiscal laws, rules and regular' s:
Section 215.97, Fla. Stat.
Chapter 69I -5, Fla. Admin. Code
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regu'ations
31
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July 2012 . — June 2014 7/24/2012 Item 16.D.15.
VVL LVJ.1L
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE ATTACHMENT IV
FOR AGREEMENTS, GRANTS, LOANS AND
COOPERATIVE AGREEMENTS
The undersigned, an authorized representative of the Recipient named in the contract or agreement to which this form is
an attachment, hereby certifies that:
(1) The Recipient and any 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 Recipient, subcontractor(s), or any outside entity on which the
Recipient is dependent for data that is to be reported, transmitted or calculated, have been assessed and verified to be
capable of processing data accurately, including year -date dependent data. For those systems identified to be non-
compliant, Recipient(s) will tale immediate action to assure data integrity.
(3) if this contract includes the provision of hardware, software, firmware, microcode or imbedded chip technology, the
undersigned warrants that these products are capable of processing year -date dependent data accurately. All versions
of these products offered by the Recipient (represented by the undersigned) and purchased by the State will be
verified for accuracy and integrity of data prior to transfer.
In the event of any decrease in functionality related to time and date related codes and internal subroutines that
impede the hardware or software programs from operating properly, the Recipient agrees to immediately make
required corrections to restore hardware and software programs to the same level of functionality as warranted herein,
at no charge to the State, and without interruption to the ongoing business of the state, time being of the essence.
(4) The Recipient and any 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.
The Recipient shall require that the laruage of this certification be included in all subagreements, subgrants, and other
agreements and that all subcontractorF shall certify compliance accordingly.
This certification is a material re� �zsentation of fact upon which reliance was placed when this transaction was made or
entered into. Submission of tl : certification is a prerequisite for making or entering into this transaction imposed by
OMB Circulars A -1 02 and 2 CFR Part 215 (formerly OM.B Circular A -1 10).
r� h E
Name and Address of gecipient —
Signatures� _ Title
Name of Authorized Signer
Collier County Board of
Commissioners
3299 Tamiami Trail E
Maples, FL 34112
32
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(.r
Date
July 2012 — June 2014
7/24/2012 Item 16.D.15.
Vl�J.:. GV.J.1G
ATTACHMENT V
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND
VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS
(1) The prospective Recipient certifies, by signing this certification, neither it nor its principals is presently
debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in
this transaction by any federal department or agency.
(2) Where the prospective Recipient is unable to certify to any of the statements in this certification, such
prospective participant shall attach an explanation to this certification.
Signature Date cc
j__ P IJ 4 IN W, f �, (61� I 0�-Fx, r (-� � Title Agency /Organization
(Certification signature should be same as Contract signature.)
"N
Instructions for Certification -`
az -� ct2 !3_ ,A-
1. T he terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction," "person,"
"primary covered transaction," and "voluntarily excluded," as used herein, have the meanings set out in the sections
of rules implementing Executive Order 12549. (2 CFR 180.5- 180.1020, as supplemented by 2 CFR 376.10-
376.995). You may contact the Contract Manager for assistance in obtaining a copy of those regulations.
2. This certification is a material representation of facts upon which reliance was placed when the parties entered into
this transaction. If it is later determined that the Recipient knowingly rendered an erroneous certification, in addition
to other remedies available to the federal government, the Department or Agency may pursue available remedies,
including suspension and/or debarment.
3. The Recipient will provide immediate written notice to the Contract Manager if at any time the Recipient learns that
its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The
Recipient may decide the method and frequency by which it determines the eligibility of its principals. Each
participant to a lower tier covered transaction may, but is not required to, check the Excluded Parties List System
(EPLS).
4. The Recipient will include a "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion
- Lower Tier Covered Transaction" in all its lower tier covered transactions and in all solicitations for lower tier
covered transactions.
S. The Recipient agrees that it shall not knowingly enter into any lower tier ; over•ed transaction with a person who is
debarred, suspended, determined ineligible or voluntarily excluded front participation, unless otherwise authorized
by the federal government.
6. If the Recipient knowingly enters into a lower tier covered transacts: n with a person who is suspended, debarred,
ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the
federal government, the Department or Agency may pursue available remedies, including suspension, and /or
debarment.
7. The Recipient may rely upon a certification of a prospective participant in a l06ver tier covered transaction that it is
not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the
certification is erroneous.
33
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July 2012 — June 2014 7/24/2012 Item 16.D.15.
ASSURANCES —NON- CONSTRUCTION PROGRAMS
Public reporting burden for this collection of information is estimated to average 45 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the
collection of information. Send comments regarding the burden estimate or any other aspect of this collection of infornation,
including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348 - 0043),
Washington, DC 20503,
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET,
SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions, please contact the
awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances.
If such is the case, you will be notified.
I. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including funds
sufficient to pay the non - Federal share of project cost) to ensure proper planning, management, and completion of the project
described in this application.
2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized
representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish
a proper accounting system in accordance with generally accepted accounting standards or agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the
appearance of personal or organizational conflict of interest, or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C..4728 -4763) relating to prescribed standards for merit
systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Merit
System of Personnel Administration (5 C.F.R. 900, Subpart F).
6. Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil
Rights Act of 1964 (P.L. 88 -352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the
Education Amendments of 1972, as amended (20 U.S.C. 1681 -1683, and 1685- 1686), which prohibits discrimination on the basis
of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C., 794), which prohibits discrimination on the basis
of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. 6101- 6107), which prohibits discrimination on the
basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92 -255), as amended, relating to nondiscrimination on
the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of
1970 (P.L. 91 -616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g). 523 and 527 of the
Public Health Service Act of 1912 (42 U.S.C. 290 dd -3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug
abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C.. 3601 et seq.), as amended, relating to
nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s)
under which application for Federal assistance is being made; and 0) the requirements of any other nondiscrimination statute(s)
which may apply to the application.
7. Will comply, or has already complied, with the requirements of Titles 11 and III of the uniform Relocation Assistance and Real
Properly Acquisition Policies Act of 1970 (P.L. 91 -646) which provide for fair and equitable treatment of persons displaced or
whose property is acquired as a result of Federal or federally assisted programs. These requirements apply to all interests in real
property acquired for project purposes regardless of Federal participation in purchases.
S. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C., 1501 -1508 and 7324 - 7328), which limit the political
activities of employees whose principal employment activities are funded in whole or in part with Federal funds.
9. Will comply, as applicable, with the provisions of tine Davis -Bacon Act (40 U.S.C..276a to 276a -7), the Copeland. Act (40 U.S.C.
276c and 18 U.S.C., 874) and the Contract Work Hours and Safety Standards Act (40 U.S.C. 327 -333), regarding labor standards
for federally assisted construction subagreernents.
34
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July 2012 - June 2014 7/24/2012 Item 16.D.15.
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of 0. .. �. .... ._.
1973 (P.L. 93 -234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood
insurance if the total cost of insurable construction and acquisition is 510,000 or more.
11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental
quality control measures under the National Environmental Policy Act of 1969 (P.L. 91 -190) and Executive Order (EO) 11514;
(b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of
flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State
management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C., 1451 et seq.); (f) conformity of
Federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42
U.S.C. 7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as
amended, (P.L. 93 -523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L.
93 -205).
12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C., 1721 et seq.) related to protecting components or potential
components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as
amended (16 U.S.C..470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic
Preservation Act of 1974 (16 U.S.C., 469a -I et seq.).
14. Will comply with P.L. 93 -348 regarding the protection of human subjects involved in research, development, and related
activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89 -544, as amended, 7 U.S.C. 2131 et seq.) pertaining to the
care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of
assistance.
16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C._4801 et seq.), which prohibits the use of lead- based
paint in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of
1996 and OMB Circular No. A -133, Audits of States, Local Governments, and Non - Profit Organizations.
18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing this
program.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL
TITLE
r /
p/
C
RA(; C �l e Nrqto_s f r"
APPLICANT ORGANIZATION
DATE SUBMITTED
_
al "J-
(4-,- i
35
Packet Page -2846-
July 2012 — June 2014
COMMUNITY CARE FOR THE ELDERLY
INVOICE REPORT SCHEDULE
7/24/2012 Item 16.D.15.
t11 1 1t1L%- "1V1r11\ 1 V 11
Report
Submit to Agency
Number
Based On
On This Date
1
July Advance*
July 1
2
August Advance*
July 1
3
July Expenditure Report
August 15
4
August Expenditure Report
September 15
5
September Expenditure Report
October 15
6
October Expenditure Report
November 15
7
November Expenditure Report
December 15
8
December Expenditure Report
January 15
9
January Expenditure Report
February 15
10
February Expenditure Report
March 15
11
March Expenditure Report
April 15
12
April Expenditure Report
May 15
13
May Expenditure Report
June 15
14
June Expenditure Report
July 15
15
Final Request for Payment
July 25
16
Closeout Report
August 1
Legend: * Advance based on projected cash need.
Note # 1: Report #1 for Advance Basis Contracts cannot be submitted to the Area Agency on
Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida prior to
July I or until the contract with the Agency has been executed and a copy sent to Area
Agency on Aging for Southwest Florida, Inc. dba Senior Choices of Southwest Florida.
Actual submission of the vouchers to DFS is dependent on the accuracy of the
expenditure report.
Note # 2: All advance payments made to the Recipient shall be returned to the Agency as follows:
one — twelfth of the advance payment received shall be reported as an advance
recoupment on each request for payment, starting with report number three. The
adjustment shall be recorded in Part C, 1 of the report (Attachment X).
Note # 3: Submission of expenditure reports may or may not generate a payment request. If final
expenditure report reflects funds due back to the Agency, payment is to accompany the
report.
36
Packet Page -2847-
July 2012 — June 2014
7/24/2012 Item 16.D.15.
COMMUNITY CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
for
Collier County Board of Commissioners
Collier County
1. CCE Spending Authority $589,107.00
2. Case Management and 72,250.00
Case Aide
Total _ $661,357.00
RATE SUMMARY
for
Collier County Board of Commissioners
Collier County
ATTACFEEWENT VIII
Collier County
Total Unit Cost
Reimbursement Rate- 90 °°
Case Management
$55.50
$50.00
Case Aide
$30.00
$27.00
Adult Day Care
$12.22
$11.00
Chore
$22.22
$20.00
Enhanced Chore
$28.89
$26.00
Companion
$22.22
$20.00
Skilled Nursing
$40.00
$36.00
EARS
$ 1.24
$ 1.12
Homemaking
$21.11
$19.00
Personal Care
$24.44
$22.00
Respite -in Home
$24.44
$22.00
Home Improvement
$ Cost Reimbursement
$90°6 Cost Reimbursement
Material Aid
$ Cost Reimbursement
$90% Cost Reimbursement
Specialized Medical Equipment,
Service & Supplies
$ Cost Reimbursement
$90% Cost Reimbursement
Transportation
$ Cost Reimbursement
$90°6 Cost Reimbursement
37
Packet Page -2848-
July 2012 - June 2014
REQUEST FOR PAYMENT
COMMUNITY CARE FOR THE ELDERLY
7/24/2012 Item 16.D.15.
!'l l 1 tit.111t1L' 1\ 1 LL
RECIPIENT NAME, ADDRESS, PHONE* and FEW
TYPE OF PAYMENT:
Regular
Advance
This Request Period: From: To:
Contract Period
Contract 0
Report if
PSA #
CERTIFICATION: I hereby certiWo the best of my knovAedge that this request is complete and correct and conforms with the terms and the purposes of the above contract.
Prepared by Date: Approved by: Dale:
PARTA: BUDGET SUMMARY
1. Approved Contract Amount
2. Previous Funds Recelved for Contract Period
3. Contract Balance Qine 1 minus line 2)
4. Previous Funds Requested and Not Received for Contract Period
5. CONTRACT BALANCE (line 3 rmnus line 4)
CCE Adrrdn.
S 0.00
CCE Services
; 0.0-
TOTAL.
0.00
$ 0.00
; 0.00
; 0.00
$ 0.00
$ 0.00
; 0.00
S 0.00
; 0.00
; 0.00
$ 0.00
; 0.00
; 0.00
PARTS: CONTRACT FUNDS RECUEST
1. Anticipated Cash Need (1st- 2nd months)
2. Net Expenditures For Month
(DOER Form 1 DSC, Pad 0, Line 4)
3. TOTAL
S 0.00
$ 0.00
S 0.00
S 0.00
$ O.DO
$ 0.00
S 0.00
$ 0.00
S 0.D0
PARTC: NETFUNDSREOUESTED
1. Less Advance Applied
2. TOTAL FUNDS REQUESTED (Part B Line 3, minus Part C Line 1)
S 0.00
; 0.00
f 0.00
S 0.00
; O.00
; O.DQ
List of Services f Units! Rates provided- See attached report.
DOEA FORM 1000
Revis *d 5/4/12
38
Packet Page -2849-
July 2012 - June 2014
RECEIPT AND EXPENDITURE REPORT
COMMUNITY CARE FOR THE ELDERLY
7/24/2012 Item 16.D.15.
!11 1 Al..l llrtl.Jl \ 1 A
PROVIDER NATAE, ADDRESS, PHONE =and FEtD=
Program Funding:
THIS REPORT PERIOD:
From To
CCE Admin.
CONTRACT PERIOD:
CCEcrvlcca
CONTRACT ft
REPORT;'-
PSA=
CERTIFICATION; I certify to the bect of my Imowledge and I >eliof that tree report is complete and correct and all outlays
herein are for purpoces Cot forth In the contract.
Prepxred by: Date :
Appravod by:
D.I.
PART A: BUD[_ ETEO INCOME t RECEIPTS
1. Approved
2. Actual Poceipm
3. Total Receipts
A. Percent of
Bud et
For Thio Re port
Year to Date
A
roved Bud pet
50.00
$0.00
$0.00
=DIV /01
1. State Funda
2. Program Income
SO.00
$0.00
$0.00
ftDIV /of
3. Local Cash t0atch
$0.00
$0.00
$0.00
�D1V /01
d. SUBTOTAL, CASH RECEIPTS
S. Local In -Kind klatch
G. TOTAL RECEIPTS
50.00
50.00
$0.00
= DIVf01
PART B : EXPENDITURES
1. Approved
2. Expenditures
Z. Expenditures
.1, Percent of
Budget
For This Report
Year to Date
Approved Budget
SO.00
$0.00
$0.00
�DIV%Of
1. Admh,iatrotive Services
_sery ice Subcontractor(c)
50.00
$0.00
$0.00
O-DIV/01
3. Adult Protective Services
SO.00
10.00
50.00
�eDIV/OI
4. TOTAL EXPENDITURES
110.00
."..0.00
$0.00
CDIV101
PART C : OTHER REVENUE AND EXPENDITURES
It. Interest:
Ill. Advance Recouped
1. Program Income (PI)
1. Earned on GP. Advance S
S
1. CCE: PI Collected '.'TD S
2. Return of GR Advance 2
(Uicludec fees collected)
3. Other Earned
S
PART D : CO- PAYMENTS
CURRENT MONTH
YEAR -TO -DATE
1. Total of Co- I>aymentc acoeoaed
s
5
2. Total of Co- payment[ Collected
a:
(For Tracking Purposes only)
RM 105C
rcovpssd s+.^b:2010
39
Packet Page -2850-
7/24/2012 Item 16.D.15.
Attestation Statement
Agreement /Contract Number CCE 263.12
Amendment Number
1, 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 dba as Senior Choices of Southwest Florida and
Collier Countv Board of 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.
Steve Car`nell, Interim Administrator
Collier County Public Services Division Date
Packet Page -2851-
7/24/2012 Item 16.D.15.
Verification of Employment Status Certification
As a condition of contracting with the Area Agency on Aging for Southwest Florida, Inc. dba
Senior Choices of Southwest Florida, Collier County Board of County Commissioners, hereby
referred to as Recipient, 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 Recipient during the
contract term to perform employment duties pursuant to this Agreement 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 contract term.
V (Zq
Signat 4e Date
(Same as contract signature)
Steve Camell, Interim Administrator
Collier County Public Services Division
Title
Collier County Boar
Company
Packet Page -2852-
7/24/2012 Item 16.D.15.
VERIFICATION OF EMERGENCY PREPAREDNESS PLAN
Contract # CCE 203.12
I, Steve Carnell certify that Collier County Board of Commissioners
(Name of authorized contractor representative) (dame of contractor)
has a current and properly maintained Emergency Preparedness Plan. Assurance is given that
the plan will be made available to the Area Agency on Aging for Southwest Florida, Inc. dba
Senior Choices of Southwest Florida, upon request.
Signature of authorized contractor representative
Interim Administrator, Collier County Public Services Division
Title
6
{
Date
Collier County Board of Commissioners
Company
October 2008
Packet Page -2853-
7/24/2012 Item 16.D.15.
CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS
The undersigned, an authorized representative of the Contractor named in the contract or agreement to
which this form is an attachment, hereby certifies that:
(1) The Contractor understands that pursuant to s. 287.135 F.S., any company at the time of bidding or
submitting a proposal for a new contract or renewal of an existing contract, that is on the "Scrutinized
Companies with Activities in Sudan List" or the "Scrutinized Companies with Activities in the Iran
Petroleum Sector List (collectively, "the Lists ") is ineligible for, and may not bid on, submit a
proposal for, or enter into or renew a contract with the Agency and or Department of Elder Affairs
Department) for goods or services of $1 million or more.
(2) The Contractor understands that, pursuant to s. 287.135 F.S., any company that submits a false
certification to the Department is subject to civil penalties, attorney's fees and costs and any costs for
investigations that led to the finding of false certification.
(3) The Contractor understands that the contract to which this form is an attachment may be terminated by
the Agency and /or Department if the Contractor submits a false certification or has been placed on the
Lists.
This certification, required by Florida law, 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.
Signature
(Same as contract signature)
Steve Carnell, Interim Administrator
Collier County Public Services Division
Title
Collier County Board of Commissioners
Company Name
Packet Page -2854-
Date
_.�'zs 'rte..^.. 1'` —:i.R i .��.�..v. i.�3 �,i•..«`- "..``a. \ 4