Agenda 02/10/2009 Item #16D 7
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EXECUTIVE SUMMARY
Recommendation that the Board of County Commissioners approve and authorize the
Chairman to sign an agreement between Collier County Board of County
Commissioners and the Area Agency on Aging of Southwest Florida and approve
budget amendments to reflect the actual grant award for the Older Americans Aet
program.
OBJECTIVE: The execution of this agreement and budget amendments is necessa1)' to
accept the Older Americans Act grant for 2009 and recognize an increase in grant funding in
the Services for Seniors program.
CONSIDERA nONS: Collier County Services for Seniors has been providing support
services to Collier County's frail elderly for over 30 years through the Older Americans Act
program. The final contract has been received to reflect the actual allocation. The contract
period is from January 1,2009 through December 31, 2009.
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The total grant amount of $769,810 is for the period January I, 2009 through December 31,
2009. Funds are available from the State of Florida grants and aids appropriation. Of the
total grant award, $613,994 will be recognized as the direct funding portion of the County for
case management, transportation, client support and administration costs. The remaining
$155,816 will be retained by the grantor agency to pay for in-home support services provided
by local home health agencies.
Program Component Anticipated Actual Amount
A ward Award Increase/
(Decrease)
Title III-B Lead Agency/Services $96,000 $125,000 $29,000
Title C-1 Congregate Meals $21 1.800 $702,354 ( $9,446)
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Title C-2 Home Delivered Meals $235,400 $228.705 ( $6,695)
Title IlI-E Carcni vcr Support S23.177 $57,935 $34.758
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Program
Net OAA Fundin!! Increase $566,377 $613,994 $47,617
GROWTH MANAGEMENT: There IS no growth management impact from this
recommendation.
LEGAL CONSIDERA nONS: This item has been reviewed and approved by the County
Attorney's Office. This item is not quasi judicial, and as such ex pmie disclosure is not
required. This itenl fe,quires majority votc only. This itClTI is legally sufficient for Board
action.-CMG
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FISCAL IMPACT: FY 08-09 hun0et in the Older Americans Act cost center (1559721 will
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increase by $47,617. No additional matching funds are required. A continuation budgd
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request was previously approved by the BCC on 12/02/08 item 16D7, with a budgeted amount
of $566,377. No additional matching funds are required.
RECOMMENDA TJONS: Staff recommends that the Board of County Commissioners
accept the grant award, authorize the Chairman to sIgn the agreement and approve the
necessary budget amendments.
Prepared by: TelTi Daniels, Accounting Supervisor, Housing and Human Services
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COLLIER COUNTY
BOARD OF COUNTY COMMISSIONERS
Item Number:
'15D7
Item Summary:
Recommendation that the Board of County Commissioners approv,~s and authorizes the
Chairman to sign an agreement between Collier County Board of County Commissioners and
the Area ,lI.,gency on Aging of Southwest Florida and approve budget amendments to reflect
the actual ']rant award for the Older Amen:;;ans Act program
Meeting Date:
2/10/2009900:00 AM
Approved By
Marcy Krumbine
Public Services
Director
Date
nousing & Human Services
1123/2009 8e41 AI~
Approved By
Colleen Greene
Assistant County Attorner
Dute
County Attorney
County Attorney Office
1f27f2009 9:39 AM
Approved By
Marlene J. Foard
Grants Coordinator
Date
Administrative Services
Administrative Services Admin.
1/27f20091:16 PM
Approved By
County Attorney
Assistant County Attorney
County Attorney Office
Date
Jeff Klatzkow
1/27/20094:47 PM
Approved By
Marla Ramsey
Public Services Administrator
Date
Public Services
Public Services Admin,
1/28/200910:56 AM
Approved By
OMS Coordinator
OMS Coordinator
Date
County Manager's Office
Office of Man<'lgement & 8udget
1/28/2009 11 :35 AM
Appro\"t'd By
Sherry Pryor
Management & Budget Analyst
Date
County Manager's Office
Qffk.e of Management & Budget
1,':Z9f200S 10:38 AM
Approvt'd By
J?:rr;es V, Mudd
County Managi::'f
Date
Board of County
Commissioners
County Manager's Office
2/2/2009 10:~6 AM
file:l/C:\AQcndaTest\ExDOli\ 1 23-Februarv%20 I 0.%202009\ 16.%20CONSENT%20AGEND... 2/4/2009
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC
OLDER AMERICANS ACT
STANDARD CONTRACT
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2009
Collier County Housing and Human Services
THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc., hereinafter referred
to as the "Agency," and Collier County Housing and Human Services hereinafter referred to as the "recipient", and
collectively referred to as the "Parties:' The tenn 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:
\VHEREAS, the Agcncy has detennined 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 perfonn such services as an
independent contractor of the Agency.
NOW THEREFORE, in consideration of the services to be performed and payments to be made, together with the
mutual covenants and conditions hereinafter set forth, the Parties agree as follows:
I, Purpose of Contract
The purpose of this contract is to provide services in accordance with the tenns and conditions specified in this
contract including all attachments and exhibits, which constitute the contract document.
2. Incorporation of Documents within the Contract
The contract wiJJ incorporate attachments, proposal(s), state 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 over inconsistent
provisions in the Proposal(s) or other general materials not specific to this contract document and identified
attachments.
3. Term of Contract
This contract shall begin on January 1,2009, It shaJJ end at midnight, local time in Forl Myers, Florida, on
December 31, 2009.
4. Contract Amount
The Agency agrees to pay for contracted services according to the temlS and conditions of this contract in an
amount not to exceed $ 769.810.00 or the rate schedule, subject to the availability of funds. Any costs or
services paid for under any other contract or from any other source are not eligible for payment under this
contract.
5. Renewals By mutual agreement of the parties, in accordance with s, 287,058(1)(1), F.S" the Agency may renew
the contract for a period not to exceed three years, or the term of the original contract, whichever is longer. The
renewal price, or method for detennining a renewal price, is set forth in the bid. proposal. or reply. No other costs
for the renewal may be charged. Any rene\val is subject to the same terms and conditions as the original contract
and contingent upon satisfactOlY performance evaluations by the department and the availability of funds.
6. Compliance with Federal Law
6.1, If this contract contains federal funds the following shall apply:
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6, 1,1 The provider shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable
regulations.
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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 contractor, 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 $1 00,000.00, 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, I A That if this contract contains $10,000.00 or more of federal funds, the recipient shall comply with
Executive Order 11246, Equal Employment Opportunity, as amended by Executive Order 11375 and
others, and as supplemented in Department of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable.
6,1.5. That if this contract contains federal funds and provides services to children up to age 18, the recipient
shall comply with the Pro-Children Act of 1994 (20 U.S.C. 6081).
6.1.6. That a contract award with an amount expected to equal or exceed $25,000.00 and certain other contract
awards shall not be made to parties listed on the government-wide Excluded Parties List System, in
accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 and 12689,
"Debarment and Suspension." The Excluded Parties List System contains the names of parties debarred,
suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or
regulatory authority other than Executive Order 12549, The recipient will comply with these provisions
before doing business or entering into subcontracts receiving federal funds pursuant to this contract. The
recipient shall complete and sign ATTACHMENT V prior to the execution of this contract.
6.2. The recipient shall not employ an unauthorized alien, The Agency shall consider the employment of
unauthorized aliens a violation of the Immigration and Nationality Act (8 U's.c. 1324 a) and the
Immigration Reform and Control Act of 1986 (8 U.S.C. 1101). Such violation shall be cause for unilateral
cancellation of this contract by the Agency.
7. Compliance with State Law
7,1. That this contract is executed and entered into in the State of Florida, and shall be construed, performed
and enforced in all respects in accordance with the Florida law, including Florida provisions for conflict
oflaws.
7.2. Requirements of s. 287.058, F.S.
7.2.1. The recipient will provide units of deliverables, including reports, findings, and drafts, as specified in this
contract, which the Contract Manager must receive and accept in writing prior to payment.
7.2.2. The recipient will submit biils for fees or other compensation for serlices or expenses in sufficient detail
for a proper pre-audit and post-audit.
7.2.3. The recipient will allow public access to all documcnts, 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
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9A
9.5.
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this provision shall constitute an immediate breach of contract for which the Agency may unilaterally
terminate the contract
7J.
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.
7A.
Subcontractors who are on the discriminatory vendor list may not transact business with any public entity,
in accordance with the provisions ofs, 287.134, F,S.
7,5,
The recipient will comply with the provisions ofs, 11,062, FS, 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.
8,
Grievance Procedures
The recipient shall develop and implement, and ensure that its subcontractors have established grievance
procedures to process and resolve client dissatisfaction with or denial ofservice(s), and address
complaints regarding the termination, suspension or reduction of services, as required for receipt of funds.
These procedures, at a minimum, should provide for notice of the grievance procedure and an opportunity
for review of the subcontractor's detennination(s).
9,
Audits, Inspections, Investieations, Public Records and Retention
9.1.
To establish and maintain books, records and documents (including electronic storage media) sufficient to
reflect all income and expenditures of funds provided by the Agency under this contract.
9.2
To retain all client records, financial records, supporting documents, statistical records, and any other
documents (including electronic storage media) pertinent to this contract for a period of six (6) years after
completion of the contract or 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,
Upon demand, at no additional cost to the Agency, the recipient will facilitate the duplication and transfer
of any records or documents during the required retention period in Paragraph 9,2,
To assure that the records described in Paragraph 9 shall be subject at all reasonable times to inspection,
review, copying, or audit by Federal, State, or other personnel duly authorized by the Agency.
At all reasonable times for as long as records are maintained, persons duly authorized by the department
and Federal auditors, pursuant to 45 CFR 92J6(i)(10), shall be allowed full access to and the right to
examine any of the recipient's contracts and related records and documents peninent to this specific
contract, regardless of the form in which kept
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9,6. To provide a financial and compliance audit to the Agency as specified in this contract and in
ATTACHMENT III and to ensure that all related party transactions are disclosed to the auditor.
9.7 To comply and cooperate immediately with any inspections, reviews, investigations, or audits deemed
necessary by the office of the Inspector General pursuant to s. 20.055, F.S.
10.
10,1
Nondiscrimination~Ci\'il Rights Compliance
"
The recipient will execute assurances in A TT ACHMENT 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
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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.
10.2. The recipient will retain, on file, during the term of this agreement a timely, complete and accurate Civil
Rights Compliance Checklist (ATTACHMENT A).
10.3, The recipient agrees to establish procedures pursuant to federal law to handle complaints of
discrimination involving services or benefits through this contract. These procedures shall include
notifying clients, employees, and participants of the right to file a complaint with the appropriate federal
or state entity.
10.4. Ifthis contract contains federal funds, these assurances are a condition of continued receipt of or benefit
from federal financial assistance, and are binding upon the contractor, its successors, transferees, and
assignees for the period during which such assistance is provided. The 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.
II. Provision of Services
The recipient will provide services in the manner described in ATTACHMENT I and the recipient's
service provider application for the fiscal year 2008-2010.
12, Monitoring by the Agency
The recipient will 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 contractor to assure the Agency of
the satisfactory performance of the terms and conditions of this contract. Following such review, the
Agency will deliver to the recipient a written report of its findings and request for development, by the
recipient, of a corrective action plan where appropriate. The recipient hereby agrecs to timely correct all
deficiencies identified in the corrective action plan,
13. Indemnification
13, I. 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 provider is not required to indemnifY the Agency for claims, demands,
actions, or causes of action arising solely out of the Agency's negligence.
13.2. Except to the extent permitted by s. 768.28, F.S., or other Florida law, paragraph 13.1 is not applicable to
contracts executed between the Agency and state agencies or subdivisions defined in s. 768.28(2),F.S.
14. Insurance and Bonding
14. \. To provide continuous adequate liability insurance coverage during the existence of this contract and any
renewal(s) and extension(s) of it. By execution of this contract, unless it is a state agency or subdivision
as defined by subsection 768.28(2), F.S., the recipient accepts full responsibility for identifYing and
determining the type(s) and extent of liability insurance necessary to provide reasonable financial
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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 tenn of this contract. Such coverage may be provided by a self-insurance
program established and operating under the laws of the State of Florida, The Agency reserves the right
to require additional insurance as specified in this contract
14,2. TIlroughout the tenn of this agreement, the recipient agrees to maintain an insurance bond from a
responsible commercial insurance company covering all officers, directors, employees and agents of the
recipient authorized to handle funds received or disbursed under all agreements and/or contracts
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.
15. Confidentiality of Information
The recipient of this agreement shall not use or disclose any information concerning a recipient of
services under this contract for any purpose prohibited by state or federal law or regulations except with
the written consent of a person legally authorized to give that consent or when authorized by law.
16. Health Insurance Portabilitv and Accountabilitv Act
Where applicable, the recipient will comply with the Health Insurance Portability and Accountability Act
(42 USC 1320d,), as well as all regulations promulgated thereunder (45 CFR 160, 162, and 164).
17. Incident Reportin!!
17.1. The recipient shall notifY the Agency immediately, but no later than forty-eight (48) hours from, the
recipient's awareness or discovery of conditions that may materially affect the recipient or
subcontractor's ability to perform the services required to be perfonned under this contract.
17.2. To immediately report knowledge or reasonable suspicion of abuse, neglect, or eXploitation of a child,
aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone number
(I-800-96ABLSE), As required by Chapters 39 and 415, F.S" this provision is binding upon both the
recipient and its employees.
18. Sponsorship and Pnblicitv
18.1. 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 funds, including any funds obtained through this contract, it
shall, in publicizing, advertising, or describing the sponsorship o[the program, Slate: "Sponsored by the
Area Agency on Aging for Southwest Florida, Inc. and the State of Florida, Department of Elder Affairs."
If the sponsorship reference is in writtcn material. the words "Arca Agency on Aging for Southwest
Florida, Inc. and State of Florida, Department of Elder Affairs" shall appear in at least the same size
letters or type as the name of the organization,
18.2, The recipient shall not use the words "Area Agency on Aging for Southwest Florida, Inc, and The State of
Florida, Department of Elder Affairs" to indicate sponsorship of a program otheIWisc financed, unless,
specific authorization has been obtained by the Agency prior to use.
1 9. Asshmmcnts
19.1. The recipient shall not a",sign the rights and responsihilities under this rontract without the prior written
approval of the Agency. which shaH not be nnreasonably withheld. Any sublicense, assignment, or
transfer otheIWise occurring without prior written approval of the Agency will constitute a material
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breach of the contrac\'
192. This contract shall remain binding upon the successors in interest of either the recipient or the Agency.
20. Subcontracts
20.1. The recipient is responsible for all work performed and for 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 shall not be liable to the subcontractor in any way or for any
reason. The recipient, at its expense, will defend the Agency against any such claims.
202 Tne recipient shall promptly pay any subcontractors upon receipt of payment from the Agency. Failure to
make payments to any subcontractor in accordance with s. 287.0585, F.S., unless otherwise stated in the
contract between the recipient and subcontractor, will result in a penalty as provided by statute.
21. Independent Capacitv of Contractor
It is the intent and understanding of the parties that the recipient, or any of its subcontractors, are
independent contractors and are not employees ofthe 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 shall not be liable for any wage and hour, employment discrimination, or othcr labor
and employment claims agains! the recipient or its subcontractors. All deductions for social security,
withholding taxes, income taxes, contributions to unemployment compensation funds aod all oecessary
insurance for the recipient shall be the sole responsibility of the recipient.
22. Pavment
Payments will be made to the recipient pursuant to s. 215.422, F.S., as services are rendered and invoiced
by the recipient. The Agency's Contract Manager will have final approval of the invoice for payment, and
will approve the invoice for payment only if the recipient has met all terms and conditions of the contract,
unless the bid specifications, purchase order, or this contract specify otherwise. The approved invoice
will be submitted to the Agency's finance section for budgetary approval and processing. Disputes
arising over invoicing and payments will be resolved in accordance with the provisions ofs. 215.422 F.S.
A Vendor Ombudsman has been established within the Department of Financial Services and may be
contacted at (850) 413-5665.
23, Return of Funds
The recipient will return to the Agency any overpayments due to uncarned funds or funds disallowed and
any interest attributable to such funds pursuant to the terms and conditions of this contract that were
disbursed to the contractor by the Agency. In the event that the 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 thc event that the Agency first discovers an overpayment
has been made, the Contract Manager, on behalf of the Agency, will notify the recipient by letter of such
findings. Should repayment not be made forthwith, the recipient will be charged at the lawful rate of
interest on the outstanding balance pursuant to s, 55.03, FS, after agency notification or recipient
discovery.
24. Data Inteeritv and Safeeuardine Information
The recipient shall insure an appropriate level of data security for the information the recipient is
collecting or using in the performance of this contract. An appropriate level of security includes
approving and tracking all contractor employees that request system or infonnation 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
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software must be routinely backed up to insure recovery from losses or outages of the computer system.
The secunty over the backed-up data is to be as stringent as the protection required of the primary
systems. The recipient shall insure all subcontractors maintain written procedures for computer system
backup and recovery, Thc recipient shall complete and sign A TT ACHMENT IV prior to the execution
of this contract.
25. Conflict ofInterest
The recipient will establish safeguards to prohibit employees, board members, management and
subcontractors from using their positions for a purpose that constitutes or presents the appearance of
personal or organizational conflict of interest or personal gain, No employee, officer or agent ofthe
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.
26. Public Entitv Crime
Pursuant to s. 287,133, F.S., the following restrictions are placed on the ability of persons convicted of
public entity crimes to transact business with the department. A person or affiliate who has been placed
on the convicted vendor list following a conviction for a public entity crime may not submit a bid,
proposal, or reply on a contract to provide any goods or services to a public entity, may not submit a bid,
proposal, or reply on a contract with a public entity for the construction or repair of a public building or
public work; may not submit bids, proposals, or replies on leases of real property to a public entity; may
not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract
with any public entity; and may not transact business with any public entity in excess of the threshold
amount provided in s. 287.017. F.S" for CATEGORY TWO for a period of 36 months following the date
of being placed on the convicted vendor list.
27. Purchasin!!
27.1. To purchase articles which are the subject of or are required to carry out this contract from Prison
Rehabilitative Industries and Diversified Enterprises, Inc., (PRIDE) identified under Chapter 946, F.S" in
the same manner and under the procedures set forth in subsections 946.515(2) and (4), F.S. For purposes
of this contract, the recipient shall be deemed to be substituted for the Agency insofar as dealings with
PRIDE. This clause is not applicable to subcontractors unless otherwise required by law. An abbreviated
list of products/services available from PRIDE may be obtained by contacting PRIDE, (800) 643-8459.
27.2. To procure any recycled products or materials, which are the subject of or arc required to carry out this
contract, in accordance with the provisions ofs, 403,7065 and 287,045, F,S.
28. Patents, COllvri!!hts, Rovalties
If any discovcry, invention or copyrightable material is developed or produced in the course of or as a
result of work or services performed under this contract, the contractor shall refer the discovery, invention
or material to the agency to be refclTe:d to the Department of State. Any and all patent rights or
copyrights accruing under this contract are hereby reserved to the State of Florida in accordance with
Chapter 286. F.S.
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29. Emer!!encv Preparedness and Continuitv of Operations
29, I. If the tasks to be performed pursuant to this contract include the physical care and control of clients, or
the adm inistration 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 Agency's Disaster
Coordinator verification of an emergency preparedness plan. In the event of an emergency, the recipient
shall notiry the Agency of emergency provisions.
29,2. In the event, a situation results in a cessation of services by a subcontractor, the recipient will retain
responsibility for performance under this contract and must follow procedures to ensure continuity of
operations without interruption.
30. PUR 1000 Form
The PUR 1000 Form is hereby incorporated by reference. 10 the event of any conflict between the PUR
1000 Form aod any terms or conditions of this contract the terms or conditions of this contract shall take
precedence over the PUR 1000 Form. However, if the conflicting terms or conditions in the PUR 1000
Form are required by any section of the Florida Statutes, the terms or conditions contained in the PUR
1000 Fonn shall take precedence.
3 I. Dispnte 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.
32. No Waiver of Sovcrei!!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.
33. Venue
If any dispute arises out of this contract, the venue of such legal recourse will be Lee County, Florida.
34. 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 department or the contractor unless expressly contained
herein or by a written amendment to this contract signed by both parties.
35. Force Maieure
Neither party shall be liable for any delays or failures in performance due to circumstances beyond its
control, provided the party experiencing the force majeure condition provides immediate written
notification to the other party and takes all reasonable efforts to cure the condition.
36. Scverabilitv 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.
j
37.
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.
38. Additionffieletion
The parties agree that the Agency reserves the right to add or to delete any of the services required under
8
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41.
42.
43.
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this contract when deemed to be in the Agency's best interest and reduced to a written amendment signed
by both parties. The parties shall negotiate compensation for any additional services added,
39.
Waiver
The delay or failure by the Agency to exercise or enforce any of its rights under this contract shall not
constitute or be deemed a waiver of the Agency's right thereafter to enforce those rights, nor shall any
single or partial exercise of any such right preclude any other or further exercise thereof or the exercise of
any other right.
40.
Compliance
The recipient agrees to abide by all applicable current federal statutes, laws, rules and regulations as well
as applicable current State statutes, laws, rules and regulations. The parties agree that failure of the
recipient to abide by these laws shall be deemed an event of default of the recipient, and subject the
contract to immediate, unilateral cancellation of the contract at the discretion of the Agency.
Final Invoice
The recipient shall submit the final invoice for payment to the Agency as specified in Paragraph 33.4.
(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.
Renee-otiations 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.
Termination
43.1. This contract may be telminatcd 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 V.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.
.
43.2. In the event funds for payment pursuant to this contract become unavailable, the Agency may temlinate
this contract upon no less than twenty-four (24) hours notice in writing to the recipient. Said notice shall
be delivered by V,S. Postal Service or any expedited delivery service that provides verification of
delivery or by hand delivery to the Contract Manager or the representative of the recipient responsible for
administration of the contract. The Agency shall be the final authority as to the availability and adequacy
of funds. In the evcnt of termination of this contract, the rccipient will be compensated for any work
satisfactorily completed prior to the date of termination,
F,
'~:
433. This contract may be tcrminated 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-I.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.
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43.4. 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 ofthe Agency; or (2) had a contract tenninated by the Agency for cause.
44. Official Payee and Representatives (Names, Addresses, and Telephone Numbers):
The recipient name, as shown on page 1 of this contract, Collier County Board of County Commissioners
a. and mailing address of the official payee to whom the Collier County Housing and Human Services Department
payment shall be made is: 3301 Tamiami Trail East, H/21 1
Naoles, FL 34112
Marcy Krumbine, Director
The name of the contact person and street address where Collier County Housing and Human Services Department
b. financial and administrative records are maintained is: 3301 Tamiami Trail East, Hl21 1
Naples, FL 34112
239-252-2273
The name, address, and telephone number of the Marcy Krum bine, Director
c. representative of the recipient responsible for Collier County Housing and Human Services Department
administration of the program under this contract is: 239-252-2273
The section and location within the Agency where Area Agency on Aging for Southwest Florida, Inc.
d. Requests for Payment and Receipt and Expenditure forms 2285 First Street
are to be mailed is: Fort Myers, Florida 33901
Leigh Wade-Schield, Executive Director
e. The name, address, and telephone number of the Contract Area Agency on Aging for Southwest Florida, Inc.
Manager for the Agency for this contract is: 2285 First Street
Fort Myers, Florida 33901
I
I 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.
45. All Terms and Conditions Included
This contract and its Attachments, 1- X-C, A, 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,
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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 44-page contract, to be executed by their
undersigned officials as duly authorized.
COLLIER COUNTY HOUSING
AND HUMAN SERVICES
BY:
ATTEST:
D'vVIGHT E. BROCK, Clerk
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
By:
Deputy Clerk
By:
DONNA FIALA, CHAIRMAN
Date: February 10. 2009
Approved as to form and
legal sufficiency
(;oJ~7Y7~
Assistant County Attorney
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA, INe
By:
JOHN KOEHLER
IMMEDIA TE PAST BOARD PRESIDENT
Date: December 31. 2008
FEDERAL ID NUMBER: 59-6000558
FISCAL YEAR-END DATE: 9/30
I]
2009
ATTACHMENT
ATTACHMENT 1
ATTACHMENT II
ATTACHMENT III
ATTACHMENT IV
ATTACHMENT V
A TT ACHMENT VI
ATTACHMENT VII
ATTACHMENT VIII
A TT ACHMENTIX
ATTACHMENT X-A
ATTACHMENT X-B
ATTACHMENT X-C
ATTACHMENT A
INDEX TO CONTRACT ATTACHMENTS
ATTACHMENT DESCRIPTION
STATEMENT OF WORK
CERTIFICA TIOK REGARDING LOBBYING
FINANCIAL COMPLIANCE AUDIT ATTACHMENT
CERTIFICATION REGARDING DATE INTEGRITY COMPLIANCE
CERTIFICATIOK REGARDING DEBARMENT. SUSPENSION,
INELIGIBILITY AND VOLUNTARY EXCLUSION CONTRACTS!
SUBCONTRACTS
ASSURANCES - NON-CONSTRUCTION PROGRAMS
OLDER AMERICANS ACT PROGRAM BUDGET SUMMARY
OLDER AMERICANS ACT RATE SUMMARY
INVOICE SCHEDULE
RECEIPTS AND EXPENDITURES - TITLES lllB, Cl, AND C2
RECEIPTS AND EXPENDITURES - TITLE lllE
REQUEST FOR PA YMENT
DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE
CHECKLIST AND INSTRUCTIONS
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25
26-30
31
32
33-34
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36
37
38
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ATTACHMENT I
AREA AGENCY ON AGING FOR SOUTHWEST FLORiDA, INC.
STATEMENT OF WORK
OLDER AMERiCANS ACT 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)
Alliance of Infonnation & Referral Systems (AIRS)
Americans with Disabilities Act (ADA)
Area Agency on Aging (AAA)
Assessed Priority Consumer List (APCL)
Client Infonnation and Registration Tracking System (CIRTS)
Instrumental Activities of Daily Living (IADL)
Memorandum of Agrecmcnt (MOA)
Memorandum of Understanding (MOU)
Older Americans Act (OAA)
Planning and Service Areas (PSAs)
1.1.2. PROGRAM SPECIFIC TERMS
Service Provider Application: A service provider application plan developed by the recipient outlining a
comprehensive and coordinated service delivery system in its planning and service area in accordance with the
Scction 306 (42 USe. 3026) of the Older Americans Act and agency instructions.
Service Provider Application Update: A revision to the service provider application wherein the area agency
on aging enters OAA specific data in the web-based database system (WebDB). An update may also include
other revisions to the service provider application as instructed by the agency.
Child: An individual who is not more than 18 years of age or an individual with disability.
Family Caregiver: An adult family member, or another individual, who is an infonnal provider of in-home and
community carc to an older individual,
Frail: When an older individual is unable to perfol1TI at least two activities of daily living (ADL) without
substantial human assistance, including verbal reminding, physical cueing or supervision; or due to cognitive or
other mental impairment, requires substantial supervision because the individual behaves in a manner that poses a
serious health or safety hazard to the individual or to another indiyidual.
Grandparent: A grandparent or step-grandparent of a child, or a relative of a child by blood, marriage or
adoption and who lives with the child: is the primary caregiver "fthe child because the biological or adoptive
parep.ts are unable or um\'iHing to serve as the primary caregiver of the child; and has a legal relationship to the
child, such as Icgal custody or guardianship, or is raising the child informally,
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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.
1.2.1. Older Americans Act Program Mission Statement
The Older Americans Act (OAA) Program is a federal program that provides assistance to older persons and
caregivers and is the only federal supportive services program directed solely toward improving the lives of older
people. The program provides a framework for a partnership among the different levels of government and the
public and private sectors with a common objective, improving the quality of life for all older individuals by
helping them to remain independent and productive
1.3. GENERAL DESCRIPTION
1.3.1. General Statement
The primary purpose of the OAA program is to foster the development and implementation of comprehensive
and coordinated systems to serve older individuals. The OAA program uses these systems to assist older
individuals to attain and maintain maximum independence and dignity in a home environment and allows for the
capability of self.care with appropriate supportive services.
1.3,2 Authority
The relevant references authority governing the OAA program is:
(I) Older Americans Act of 2006, as amended;
(2) Rule 58A-1, florida Administrative Code; and
(3) Section 430.101, Florida Statutes,
1.3.3. Scope of Service
The recipient is responsible for the programmatic, fiscal, and operational management of the Title IlIB, IIIC1 and
2, and IIIE programs of the Older Americans Act within its designated Planning and Service Areas (PSAs). The
scope of service includes planning, coordinating and assessing the needs of older persons, and assuring the
availability and quality of services. The services shall be provided in a manner consistent with and described in
the current service provider's application and the current Department of Eldcr Affairs Programs and Services
llandbook.
1.3.4. Major Program Goals
The major goals of the OAA program are to improve the quality of life for older individuals, preserve their
independence and prevent or delay more costly institutional care. These goals are achieved through the
implementation of a comprehensive and coordinated service system that provides a continuum of service
alternatives that meet the diverse needs of elders and their caregivers.
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1.4. INDIVIDUALS TO BE SERVED
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1.4.1. Eligibility (Title III Programs)
1.4.1.1. OAA Title III, General
Consumers shali not be dualiy enrolied in an OAA program and a Medicaid capitated long-term care program
1.4.1.2. OAA Title IIIB, Supportive Services
(1) Individuals age 60 or older; and
1.4.1.3. OAA Title IIICl and C2, Nutrition Services, General
General factors that should be considered in establishing priority for Nutrition Services, both CI and C2, include
those older persons who:
(J) Cannot afford to eat adequately;
(2) Lack the skills or knowledge to select and prepare nourishing and well-balanced meal;
(3) Have limited mobility which may impair their capacity to shop and cook for themselves; or
(4) Have a disabling iliness or physical condition requiring nutritional support or have been screened at a high
nutritional risk.
1.4.1.3.1
OAA Title IIICI, Congregate Nutrition Services
In addition to meeting lhe general nutrition services eligibility requirements listed in A TT ACHMENT I,
Paragraph 1.4.1.3., individuals must be mobile, not homebound and physically, mentaliy and medically able to
attend a congregate nutrition program. Individuals eligible to receive congregate meals include:
(J) Individuals age 60 or older;
(2) Any spouse (regardless of age) who attends the dining center with his/her eligible spouse;
(3) Persons with a disability, regardless of age, who reside in housing facility occupied by older individuals
where congregate nutrition services are provided;
(4) Disabled persons who reside at home with and accompany an eligible person to the dining center; and;
(5) volunleers, regardless of age, who provide essential services on a regular basis during meal hours.
1.4.1.32
OAA Title IIIC2, Home Delivered Nutrition Services
In addition to meeting the general nutrition services eligibility requirements listed in ATTACHMENT I,
Paragraph 1.4.1.3., individuals must be homebound and physicaliy, mentaliy or medically unable to attend a
congregate nutrition program. Individuals cligiblc to receive home delivered meals include:
(1) Individuals age 60 or older who are also frail and homebound by reason of illncss, disability, or isolation;
(2) The spouse ofa homebound eligible individual, regardless of age, ifthc provision of the collateral meal
supports maintaining the person at home;
(3) Individuals with disabilities, regardless of age, who reside at home with eligible individuals and are
dependent on them for care; and
(4) Persons at nutritional risk who have physical, cmotional or bchavioral conditions, which would make their
presence at the congregate site inappropriate: and persons at nutritional risk who are sociaIJy or otherwise isolated
and unable to attend a congregate nutritional site.
1.4.1.4 OAA Title llIE, Caregiver Support Sen'iees
(1) Family caregivers of individuals age 60 or older;
(2) Grandparents (age 55 or older) or older individuals (age 55 or older) who are relative-caregivers;
(3) Priority \viii be given to family caregivers \\'no provide care ror individuais with Aizheimer's disease and
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related disorders with neurological and organic brain dysfunction and for grandparents or older individuals who
are relative caregivers who provide care for children with severe disabilities; and
(4) For respite and supplemental services, a family caregiver must be providing care for an older individual who
meets the definition of the term "frail" in OAA, Section 102, Paragraph 22,
\.4.2 Targeted Groups
Preference shall be given to those with the greatest economic and social needs, with particular attention to low-
income older individuals, including those that are low-income minorities, have limited English proficiency, and
older individuals residing in rural areas.
SECTION II - MANNER OF SERVICE PROVISION
2.] SERViCE TASKS
In order to achieve the goals of the OAA program, the contractor shall ensure the following tasks are performed:
(J) Client eligibility determination as listed in A TT ACHMENT I, Paragraph 1.4.1.1 and 1.4.1.2;
(2) Targeting and screening of service delivery for new clients;
(3) Delivery of services to eligible clients;
(4) Use of volunteers to expand the provision of available serviccs; and
2. 1.\ Targeting and Screening of Service Delivery for New Clients
The recipient shall develop and implement policies and procedures consistent with OAA targeting and screening
criteria. All new clients must access the scrvice delivery system through the ARC.
2.1.2. Delivery of Services to Eligible Clients
The recipient shall provide a continuum of services that meets the diverse needs of elders and their caregivers.
The recipient shall perform and report performance of the following scrvices in accordance with the Department
of Elder Affairs Programs & Services Handbook. The services funded pursuant to this contract are in accordance
with the OAA, Title Ill, sections 321, 33], 336, 361 and 373 as follows:
(1) Section 321, Title IIlB Supportive Services;
(2) Section 331, Title lIIC \ Congregate Nutrition Services;
(3) Section 336, Title IIlC2 Home Delivered Nutrition Services;
(4) Section 373, Title IIlE Caregiver Support Services
2.1.2.1 Supportive Services
Supportive services include a variety of community-based and home-delivered services that support the quality of
life for older individuals by helping them remain independent and productive, Services include the following:
(1) Adult Day Care/Adult Day Health Care;
(2) Caregiver Training/Support;
(3) Case Aide/Case Management;
(4) Chore Services;
(5) Companionship;
(6) Counseling (Gerontological and Mental Health);
(7) Education/Training
(8) Emergency Alert Response;
(9) Escort;
(10) Home Health Aid;
(J I) Homemaker;
(] 2) Housing Improvements;
(13) Information;
(14) Intake;
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(15) Legal Assistance;
(16) Material Aid;
(17) Outreach;
(1 8) Personal Care;
(] 9) Respite Services;
(20) Skilled Nursing;
(21) Specialized Medical Equipment, Services and Supplies;
(22) Transportation.
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2.1.2.2.1.
Congregate Nutrition Services
Nutrition services are provided in congregate settings and arc designed to reduce hunger and food insecurity,
piomote socialization and the heaith and well being of older individuals by assisting them to gain access to
nutrition and other disease prevcntion and health promotion services. Services include:
(1) Congregate meals,
(2) Congregate meals screening;
(3) Nutrition education and nutrition counseling; and
(4) Outreach.
2.1.2.2.2.
Home Delivered Nutrition Services
In-home nutrition services are provided to reduce hunger and food insecurity; promote socialization and the
health and well being of older individuals by assisting such individuals to gain access to nutrition and other
disease prevention and health promotion services, Services include:
(1) Home delivered meals;
(2) Nutrition education and counseling; and
(3) Outreach,
2.1.2.3. Caregiver Support Services Program
The Caregiver Support Services Program components are designated in the Client Information and Registration
Tracking System (CIRTS) as follows:
(1) Caregiver Support Services (I1IE Program);
(2) Caregiver Supplemental Services (I1IES Program);
(3) Grandparent Support Services (IIIEG Program),
2.1.2.4. Caregiver Support Services (I1IE Program)
The following services are intended to provide direct help to caregivers, assist in the areas of health, nutrition and
financial literacy and assist caregivers in making decisions and problem solving related to their caregiving roles
and responsibilities:
(1) Adult Day Care/Adult Day Health Care;
(2) Caregiver Training/Support;
(3) Counseling (Gcrontological and Mcntal Hcalth);
(4) Educ.ation/Training;
(5) Financial Risk Rcduction (Assessment and
Maintenance)
6) Information;
(7) Intake;
(8) Outreach;
(9) Referral! Assistance;
(10) Respite Ser.rice:;;
(11) Scrcening! Assessment; and
(12) Transportation,
2.1.2.5. Caregiver Support Supplemental Services (IIIES Program):
At least 10 percent, but no morc than 20 pcrcent, of the total Title HIE funds shall be used to provide
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supplemental support services. The following services are provided to complement the care provided by
caregJvers.
(I) Chore Services;
(2) Housing Improvement;
(3) Legal Assistance;
(4) Material Aid; and
(5) Specialized Medical Equipment, Services and Supplies.
2.1.2.7. Caregiver Support Grandparent Services (IJIEG Program):
A t least 5 percent, but no more than 10 percent, of the total Title IIIE funds shall be used to provide support
services to grandparents and older individuals who are relative caregivers, Services for grandparents or older
individuals who are relative caregivers designed to help meet their caregiving obligations include:
(I) Caregiver Training/Support;
(2) Child Day Care;
(3) Counseling (Gerontological and Mental Health);
(4) Education/Training
(5) Information;
(6) Legal Assistance;
(7) Outreach;
(8) Referral/Assistance;
(9) Screening/Assessment;
(J 0) Sitter; and
(II) Transportation.
2.2 SERVICE LOCATION AND EQUIPMENT
2.2,1 Service Times
The recipient shall ensure the provision of the services listed in the contract during normal business hours unless
other times are more appropriate to meet the performance requirements of the contract, and it shall monitor its
subcontractors to ensure they are available to provide services during hours responsive to client needs and during
those times which best meet the needs of the relevant service community.
2,3 Equipment
2,3.1. Equipment means: (a) an article of nonexpcndable, 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
organization for the financial statement purposes, or $5,000.00 [for federal funds], or (b); nonexpendable,
tangible 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 studeuts or the general
public, with a value or cost of $250,00 or more [for state funds].
2.3.2. Recipients and sub-contractors 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 Requircments (fOlmerly OMB Circular A-ll0) 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
oncc every two years. The property records must be maintained on file and shall be provided to the department
upon request.
2.3.3. 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.
18
(3) Source of the equipment, including the award number;
(4) Whether title vests in the recipient or the Federal Government;
(5) Acquisition dale (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 equi~ment
(not applicable to equipment furnished by the Federal Government);
(7) Location and condition of the equipment and the dale the information was reported;
(8) Unit acquisition cost; and
(9) Ultimate disposition data, including the 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.
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2.3.4. 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 requested and approved by the Agency is
part of the cost of carrying out the activities and functions ofihe grant awards and Title (ownership) will vest in
the agency, subject to the conditions of2 CFR Part 215 Administrative Requirements (formerly OMB Circular A-
I 10), 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 sub-contractors (not included in a cost
methodology), is subject to the conditions of section 273, F, S, and 60A-LOOI 7, F. A. C. or Title 45 CFR Part 74.
2.3,5, The recipient shall not dispose of any equipment or materials provided by the Agency, or purchased with funds
provided through this contract without first obtaining the approval of the Agency's Contract Manager. When
disposing of property or equipment the recipient must submit a 'Hitten 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.).
2.3.6, The Agency's Contract Manager will issue disposition instructions. If disposition instructions are not received
within 120 days of the written request for disposition, the recipient is auihorized to proceed as directed in 2 CFR
Part 215 Administrative Requircmcnts (fonncrly OMB Circular A-ll0),
2.3,7. Real property means land (including land improvements), buildings, structures and appurtenances thereto, but
excludes movable machinery and equipment. Real property may not be purchased wiih state or federal funds
through agreements covered under this contract. Real property purchases from Older Americans Act funds are
subject to the provisions of Title 42, Chapter 35, Subchapter III, Part A., Sec. 3OJOb United States Code (USC).
Real property purchases from state funds can only be made through a fixed capital outlay grants and aids
appropriation and therefore are subject to the provisions of s. 2] 6.348, F. S,
2.3.8, Any permanent storage devices (e,g.: hard drives, removable storage media) must be reformatted and tested prior
to disposal to ensure no confidential information remains.
2.3.9. The recipient must adhere to the Agency's procedures and standards when purchasing Information Technology
Resources (ITR) as part of any agreement(s) incorporating this contract by reference, An ITR worksheet is
required for any computer related item costing $1,000.00 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 rTR proeedures.
2.4. DELIVERABLES
"
2.4.1. Service Unit
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The contractor shall provide the services described in the contract in accordance with the Department of Elder
Affairs Programs & Services Handbook. The chart below lists the services that can be performed and the unit of
measurement.
Adult Date Care/Adult Day Health
Care
Caregiver Training/Support Homemaker
Case Aid/Case Management Housing Improvement
Child Day Care Intake
Chore Services Nutrition Counseling I
Companionship Personal Care
Congregate Meals Screening Respite Services
Counseling Services Screening/Assessment Hour
Escort Sitter
Home Health Aide Skilled Nursing Services
Emergencv Alert ReSDonse Dav
, Education/Training
Material Aid
Nutrition Education Episode
I Specialized Medical Equipment, Services and Supplies
,
I Outreach Person
Escort
Shopping Assistance One-Way Trip
TransDortation
Congregate and Home Delivered Meals Meal
Service
Unit of
Service
2.5. REPORTS
The recipient is responsible for responding in a timely fashion to additional routine and/or special requests for
information and reports required by the Agency. The recipient must establish due dates for any subcontractors
that permit the recipient to meet the Agency's reporting requirements,
2.5.1. Client Information and Registration Tracking System (CLT{TS) Reports
The recipient is required to use CIRTS reports in the web-based ClRTS database system to ensure data accuracy.
The report categories include:
The report categories include:
(1) Client Reports;
(2) Monitoring Reports;
(3) Services Reports;
20
(4)
(5)
(6)
Miscellaneous Reports;
Fiscal Reports
Outcome Measurement Reports
n:"::~?l '(:::!il :';:J. :~[)7
= """"1CV1 Q 2)['9
OAli'103,M8
2009
2.5.2. Service Costs Reports
The agency shall require recipients to submit to the recipient semi-annual service cost reports, which reflect actual
costs of providing each service by program. This report provides information for planning and negotiating unit
rates, These costs reports are due August 15,2009 (covering January - June) and February 15,20] 0 (covering
July - December),
2.5.3. Surplus Deficit Report
The recipient will submit a consolidated surplus/deficit report in a format provided by the Agency to the Agency's
Contract ?\1anager by the 18th of each month. This report is for all agreements and/or contracts between the
contractor and the Agency, The report shall include the following:
(]) A list of all subcontractors and their current status regarding surplus/deficit;
(2) The recipient detailed plan on how the surplus/deficit spending exceeding the threshold specified by the
Agency will be resolved;
(3) Recommendations to transfer funds to resolve surplus/deficit spending;
(4) Input from the recipient's Board of Directors on resolution of spending issues, if applicable
(5) Number of clients currently on Assessed Priority Consumer List (APCL) that receive a priority ranking
score of 4 or 5; and
(6) Number of clients currently on the APCL designated as Imminent Risk.
2.6. RECORDS AND DOCUMENTATION
The recipient will 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. Maintenance includes valid exports and backups
of all data and systems according to Agency standards.
2.6.1. Each recipient and subcontractor among other requirements, must anticipate and prepare for the loss of
information processing capabilities, 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
2.7 PERFORMANCE SPECIFJCATIONS
2.7.1. Outcomes
(l) The recipient shall timely submit to the Agency all reports described in A TT ACHMENT I, Paragraph
2.5 REPORTS;
(2) The recipient shall timely submit to tlle Agency all infonnation described in ATTACHMENT I,
paragraph 2.6, RECORDS AND DOCUMENTATION;
(3) The recipient shall ensure services in this contract are in accordance with the servicc provider's
application and the current Department of Elder Affairs Programs and Services Handbook.
2.7.2. The performance of the recipient in providing the services dcscribed in this contract shall be measured by the
current service provider's application and Arca Plan strategies for the following criteria:
(1) Percent of most frail elders who rcmain at home or in the community instead of going into a nursing
home;
(2) Percent of Adult Protective Services (APS) referrals who are in need of immediate services to prevent
further harm who are served within 72 hours,
(3) Average monthly savings per Cunsurner for home and community-based care versus nursing home care
for comparable client groups;
(4) Percent of eiders assessed \vith high or moderate risk environments who improved their environment
score;
21
(5)
(6)
(7)
(8)
(9)
/"Qenc:a it-2m ~Jo.l'~;D
" February ~iO, 200
Ciftl~"2B3 .'lJ94
Percent of new service recipients with high-risk nutrition scores whose nutritional status improved;
Percent of new service recipients whose ADL assessment score has been maintained or improved;
Percent or new service recipients whose IADL assessment score has been maintained or improved;
Percent of family and family-assistcd caregivers who self-report they are very likely to provide care;
Percent of caregivers whose ability to continue to provide care is maintained or improved after one year
of service intervention (as determined by the caregiver and the assessor); and
Percent of customers who are at imminent risk of nursing home placement who are serviced with
community based services.
2009
(10)
2,7,3. Monitoring and Evaluation Methodology
The Agency will review and evaluate the performance of the recipient under the terms ofthis 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. Tne recipient agrees to
cooperate with the Agency in monitoring the progress of completion of the service tasks and deliverables.
2.8 RECEPIENT'S FINANCIAL OBLIGATIONS
2.8.1. Matching, Level of Effort, and Earmarking Requirements
A recipient's match will be made in the form of cash and/or in-kind resources. Match must be reported by title
each month. At the end of the contract period, all OAA funds must be properly matched,
2.8.2. Consumer Contributions
(1) The recipient assures compliance with Section 315 of the older Americans Act as amended in 2006, in
regard to consumer contributions.
(2) Voluntary contributions are not to be used for cost sharing or matching;
(3) Accumulated voluntary contributions are to be used prior to requesting federal reimbursement; an
(4) Voluntary contributions are to be used only to expand services.
2.8.3. The recipient agrees to distribute funds as detailed in the Budget Summary, ATTACHMENT vn and the Rate
Summary, ATTACHMENT VIIl to this contract. Any changes in the amounts of federal or general revenue
funds identified on the Budget Summary form require a contract amendment
2.8.4. Title III Funds
The recipient assures compliance with Section 306 of the Older Americans Act as amended in 2006, that funds
received under Title III will not be used to pay any part of a cost (including an administrative cost) incurred by the
recipient to maintain a contractual or commercial relationship that is not carried out to implement Title Ill.
2.9. AGENCY'S RESPONSIBILITIES
2.9.1. 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
2.9.2. Contract Monitoring
The Agency shall, at its own discretion, conduct monitoring concerning any aspect of the recipient's performance
of this contract
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 on audited
historical costs in instances where an independent audit is required. The recipient shall consolidate all requests
for payment from subcuntractors and t:xpenditure n:ports that support requests for payment and shall submit to the
22
:l'2~' roo ~)C7
10 20U9
OAXCiD3Cog18
2009
Agency on fonns ] 06A (A TT ACHMENT X-C), ] 05AS A TT ACHMENT X-A) AND 105AE
(ATTACHMENT X-B).
3.1.1. The recipient agrees to implement the distribution of funds as detailed in ATTACHMENT VII, Budget
Summary. An amendment is required to change the total amount of the contract.
3.2. Advance Payments
3.2.1. The recipient may request up to two months of advances allhe start of the contract period, if available, to cover
program administrative and service costs, The payment of an advance will be contingent upon the sufficiency and
amount of flUlds released to the Agency by the State of Florida ("budget re]ease"). The recipient shall provide the
Agency's Contract Manage documentationjustirying the need for an advance and describing how the funds will
be distributed.
3.2.2. The recipient's requests for advance require the approval of the Agency's Contract Manager. If sufficient budget
is available, the Agency will issue approved advance payments after January 1,2009.
3.2.3. Requests for the third through the twelfth months shall be based on the submission of actual monthly expenditure
reports beginning with the first month of the contract. The schedule for submission of advance requests, if
available is shown on ATTACHMENT VIII of this contract.
3.2.4. All advance payments made to the recipient shall be recouped in accordance with the Invoice Schedule.
ATTACHMENT IV of this contract.
3.2.5. Interest earned on advances must be identified separately by source of funds, state or federal. Recipients shall
maintain advances of federal funds in interest bearing accounts unless otherwise excepted in accordance with 45
CPR 74.22(k).
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 106A (ATTACHMENT X-C), ]05AS ATTACHMENT X-A) AND 105AE (ATTACHMENT X-B).
Duplication or replication of both fonns via data processing equipment is pennissible, provided all data elements
are in the same fonnat 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 (when available) and invoices is
A TT ACHMENT IV to this contract.
3.3.2. Any payment due by the Agency under the tenns of this contract may be withheld pending the receipt and
approval of all financial and programmatic reports due from the recipient and any adjustments thereto, including
any disallowance not resolved as outlined in Paragraph 22 of this contract.
3.3.3. Payment may be authorized only for allowable expenditures. which are in accordance with the limits specified in
ATTACHMENT VII, Budget Summary. Any changes in the amounts of federal or general revenue funds
identified on the Budget Summary fonn require a contract amendment.
3.3.4. Date for Final Request for Payment
The final request for paymcnt will be due to the Agency no later than February 15,2010.
3.4. Documentation for Payment
The recipient shall maintain documentation to support payment requests that all be available to the Agency or
authorized individuals, such as, Department of Financial Services, upon request.
0'
~O
2009
3.4.1.
3.4.2.
Agenca item No, 607
FebrlJary 1 (] 2009
c5'ft:.~:ili3cM8
The recipient shall ensure subcontractors enter all required data per the Department of Elder Affairs CIR TS Policy
Guidelines for clients and services in the CIRTS database. Data must be entered into CIRTS before the
subcontractors submit tileir request for payment and expenditure reports to the contract. The recipient shall
establish time frames to assure compliance with due dates for the requests for payment and expenditure reports to
Agency.
The recipient will require subcontractors to run monthly CIRTS reports and verifY that client and service data in
CIRTS is accurate. This report must be submitted to the recipient with the monthly request for payment and
expenditure report and must be reviewed by the recipient before the subcontractors request can be approved by
the recipient.
24
:tsm I'b.! SD?
;:::- ~;~~UaiY 10, 2009
c5' AI\' 203 09' 8
2009
ATTACHMENT II
CERTIFICA TION REGARDING LOBBYING
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 tAl influence an of Ticer 0f elllployee uLlIIY statt ur leaeraJ agency, a member of
congress, an officer or employee of congress, an employee of a member of congress, or an officer or employee of
the state legislature, in connection with the awarding of any federal grant, the making of any federal loan, the
entering into of any cooperative agreement, and the extension, continuation, renev.'al, 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) Ifany 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, n in accordance with its instructions.
This certification is a material representation of fact upon which reliance \\'as placed when this transaction was made or
entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by
section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil
penalty of not less than $10,000,00 and not more than $100,000,00 for each such failure,
Signature
February 10.2009
Date
Donna Fiala. Chairman
Name of Authorized Individual
Application or Agreement Number
Collier County BCC
Naoles. FL 34112
Name and Address of Organization
C,~7vl/~
Assistant County Attorney
ATTEST:
DWIGHT E. BROCK. Clerk
0'
4)
By:
2009
,l".cenda Hem No. 1607
~ February 10. 2009
~,~- ~Q ",' 48
vA'A'2\J).u9
DOEA Form] 03
ATTACHMENT III
FINANCIAL AND COMPLIANCE AUDIT
The administration of resources awarded by the Area Agency on Aging of Southwest Florida, Inc. to the provider may be
subject to audits and/or monitoring by the Area Agency on Aging of Southwest Florida, Inc., as described in this section,
MONITORING
In addition to reviews of audits conducttd in accordance with OMB Circular A-133, as revised, and Section 215.97, F,S.,
(see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits by the Agency staff,
limited scope audits as defined by OMB Circular A-133, as revised, and/or other procedures. By entering into this
agreement, the provider agrees to comply and cooperate with any monitoring procedures/processes deemed appropriate by
the Area Agency on Aging of Southwest Florida, Inc. In the event the Area Agency on Aging of Southwest Florida, Inc.
determines that a limited scope audit of the provider is appropriate, the provider agrees to comply with any additional
instructions provided by the Area Agency on Aging of Southwest Florida, Inc. to the provider regarding such audit. The
provider further agrees to comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary
by the Director of Finance of the Area Agency on Aging of Southwtst Florida, Inc.
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 OMS
Circular A133, as revised.
In the event that the provider expends $500,000.00 or more in Federal awards during its fiscal year, the provider must
have a single or program-specific audit conducted in accordance with the provisions of OMS Circular A-\33, as revised.
EXHIBIT 1 to this agreement indicates Federal resources awarded through the Department of Elder Affairs by this
agrecment. In determining the Federal awards expendcd in its fiscal year, the provider shall consider all sources of
Federal awards, including Federal resources received from the Department of Elder Affairs. The determination of
amounts of Federal awards expended should be in accordance with the guidelines established by OMS Circular A-133, as
revised. An audit of the provider conducted by the Auditor General in accordance with the provisions of OMS Circular
A-133, as revised, will meet the requirements ofthis part.
In connection with the audit requircments addressed in Part I, paragraph 1, the provider shall fulfill the requirements
relative to auditee responsibilities as provided in Subpart C of OMS Circular A-133, as revised.
[fthe provider expends less than $500,000,00 in Federal awards in its fiscal year, an audit conducted in accordance with
the provisions of OMS Circular A-133, as rcvised, is not required. In the event that the provider expends less than
$500,000.00 in Federal awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of
OMS 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 cunducted in accunlance with Lhis part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Area Agency on Aging of Southwest Florida, [nc, shall be based on
the agreement's requirements, including any rules, regulations, or statutes referenced in the agreement. The financial
statements shall disclose whether or not the matching requirement was met for each applicable agreement All questioned
costs and liabilities due to the Area Agency on Aging of Southwest Florida, Inc. shall be fully disclosed in the audit report
vith reference to the Area Agency on Aging of Southwest Florida, Inc. agreement involved. Ifnot otherwise disclosed as
required by Scction .31 0(b)(2) of OMS Circular A-133, as revised, the schedule of expenditures of Federal awards shall
26
itciTI r~O.', \.~L)7
="-'br' '~~y ~ O. ~WI(j9
2009 . .. aJ,),;;"Z~~0~48
ide~tity ~xpen~itures by agreement number for each agreement with the Department of Elder Affairs in effect during the
audIt penod. Fm~ncl8l rcportmg packages required under this part must be submitted within the earlier of 30 days after
receIpt of the audit report or 9 months after the end of the provider's fiscal year end.
PART II: STATE FUNDED
This part is applicable if the provider is a nonstate entity as defined by Section 215.97(2), Florida Statutes,
In the event that the provider expends a total amount of state financial assistance equal to or in excess of $500,000.00 in
any fiscal year of such provider (for fiscal years ending September 30,2004 or thereafter), the provider must have a State
single or project-specific audit for such fiscal year in accordance with Section 215.97, Florida Statutes; applicable rules of
the Department of Financial Services; and Chapters 10,550 (local governmental entities) or ]0,650 (nonprofit and for-
profit organizations), Rules of the Auditor General. EXHIBIT I to this agreement indicates state financial assistance
awarded through the Department of Elder Affairs by this agreement. In determining the state financial assistance
expended in its fiscal year, the provider shall consider all sources of state financial assistance, including state financial
assistance received from the Department of Elder Affairs, other state agencies, and other nonstate entities. State financial
assistance does not include Federal direct or pass-through awards and resources received by a nonstate entity for Federal
program matching requirements,
In connection with the audit requirements addressed in Part 1/, paragraph I, the provider shall ensure that the audit
complies with the requirements of Section 215.97(8), Florida Statutes. This includes submission ofa financial reporting
package as defined by Section 215.97(2), Florida Statutes, and Chapter 10.550 (local governmental entities) or 10.650
(nonprofit and for-profit organizations), Rules of the Auditor General.
If the provider expends less than $500,000.00 in state financial assistance in its fiscal year (for fiscal years ending
September 30, 2004 or thereafter), an audit conducted in accordance with the provisions of Section 215.97, Florida
Statutes, is not required, In the event that the provider expends less than $500,000,00 in state financial assistance in its
fiscal year and clects 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 of Southwest Florida, Inc. shall be based on
the agreement's requirements, including any applicable rules, regulations, or statutes, The financial statements shall
disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and
liabilities due to the Area Agency on Aging of Southwest Florida, Inc. shall be fully disclosed in the audit report with
reference to the Area Agency on Aging of Southwest Florida, Inc. agreement involved, If not otherwise disclosed as
required by Rule 691-5.003, F1a, Admin. Code, the schedule of expenditures of state financial assistance shall identify
expenditures by agreement number for each agreement with the Area Agency on Aging of Southwest Florida, Inc. in
effect during the audit period. Financial reporting packages required under this part must be submitted within 45 days
after delivery of the audit report, but no later than 12 months after the provider's fiscal year end for local governmental
entities. Non-profit or for-profit organizations are required to be submitted within 45 days after delivery of the audit
report, but no later than 9 months after the provider's fiscal year end. Notwithstanding the applicability of this portion,
the A rea Agency on Aging of Southwest Florida, Inc. retains all right and obligation to monitor and oversee the
performance of this agreement as outlincd throughout this document and pursuant to law.
PART III: REPORT SUBMISSION
Copies ofreporting 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 requircd by Section .320 (d), OMB Circular A-133, as revised, by or
on behalf of the provider directlv to each of the following:
The Area Agency on Aging for Southwest Florida, Inc, at each of the following addresses:
27
2009
Aoem1a itern !'~o. 6D7
~, rc::bruary 'I;] 2009
O~W~ii3.~48
Leigh Wade-Schield, Executive Director
Area Agency on Aging for Southwest Florida, Inc.
2285 First Street
Fort Myers, Florida 33901
The Federal Audit Clearinghouse designated in OMB Circular A-133. as revised (the number of copies required by
Sections .320 (d)(I) and (2), OMB Circular A-133, as revised, should be submitted to the Federal Audit Clearinghouse), at
the following address:
Federal Audit Clearinghouse
Bureau ofthe Census
1201 East 10" Street
Jeffersou, IN 47132
Other Federal agencies and pass-through entities in accordance with Sections .320 (e) and (I), OMB Circular A-133, as
revised.
Pursuant to Sections .320(1), OMB Circular A-133, as revised, the provider shall submit a copy of the reporting package
descrihed in Section .320(c), OMB Circular A-133, as revised, and any management letter issued by the auditor, to The
Area Agency on Aging of Southwest Florida, Inc. at each of the following addresses:
Leigh Wade-Schield, Executive Director
Area Agency on Aging for Southwest Florida, Inc.
2285 First Street
Fort Myers, Florida 33901
Additionally, copies of financial reporting packages required by Part II of this agreement shall be submitted by or on
behalf ofthe provider directly to each of the following:
The Area Agency on Aging of Southwest Florida, Inc. at each of the following addresses:
Leigh Wade-Schield, Executive Director
Area Agency on Aging for Southwest Florida, Inc.
2285 First Street
Fort Myers, Florida 33901
The Auditor General's Office at the following address:
State of Florida Auditor General
Claude Peppcr Building, Room 574
III 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 accordancc with OMB Circular A-133,
Florida Statutes, and Chapters 10.550 (local governmental entities) or] 0.650 (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 (loca] governmental entities) or 10.650
(nonprofit and for-profit organizations), Rulcs of the Auditor General, should indicate the date that the reporting package
was delivered to the provider in correspondence accompanying the reporting package.
28
2009
1:8m t'j:j. 'iCj[;7
iO.20U9
CJA'}'!'2G3.()9"3
PART IV: RECORD RETENTJON
The provider shall retain sufficient records demonstrating its compliance with the tenus of this agreement for a period of
six years from the date the audit report is issued, and shall allow the Area Agency on Aging for Southwest Florida, Inc, or
its designee, the Director of Finance access to such records upon request. The provider shall ensure that audit working
papers are made available to the Area Agency on Aging for Southwest Florida, Inc. or its designee, Director of Finance
upon request for a period of six years from the date the audit report is issued, unless extended in writing by the Area
Agency on Aging for SOUtllWeSt Florida, Inc.
A TT ACHMENT III
EXHIBIT - 1
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONSIST
OF THE FOLLOWING:
.. Program Title. Year Funding Source CFDAJCSF A . Amount
, . '. .. .. .. .
Older Americans Act Title IlIB 2009 US Health and Human 93,044 $ 50,000.00
,
CN CM! SCAS/ INSC I I Services $ 75,000.00
Transportation $155,8] 6.00
Support Services
Title III C I Congregate Meals 2009 U.S. Health and Human 93,045 $202,354.00
Spending Authority Services
Title III C2 Home Delivered 2009 , U.S. Health and Human I 93.045 $228,705.00
Meals -Spending Authority I Services I
Older Americans Act Title IIIE 2009 I US Health and Human 93.052 $40,269.00
I Supplement Services I Services , $15,330.00
Grandparent Services i I $ 2,336.00
. TOTAL FEDERAL AWARD: $769,810.00
..... .
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT
TO THIS AGREEMENT ARE AS FOLLOWS:
29
2009
.Agenda 11em r'~o. 1607
February 10,2009
0"'11/'2610948
ATTACHMENT 111
EXHIBIT -2
PART I: AUDIT RELATIONSHIP DETERMINATION
Providers who receive state or federal resources mayor may not be subject to the audit requirements ofOMB Circular A-l33, as
revised, and!or Section 215,97, Fla. Stat. Providers who are determined to be recipients or suhrecipients 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 fmandaI assistance, must comply with applicable
programmatic and fiscal compliance requirements.
In accordance with Sec. 210 ofOMB Circular A-l33 and!or Rule 691-5.066, FAC, provider has been determined to be:
_Vendor or exempt entity and not subject to OMB Circular A-l33 and/or Section 215,97, F.S.
_X_Recipientlsubrecipient subject to OMB Circular A-133 and/or Section 25,97, F,S,
NOTE: If a provider is determined to a recipientlsubrecipient of federal and or state fmancial assistance and has been approved by the
Agency to subcontract, they must comply with SectIon 215,97(7), F,S., and Rule 691-,006(2), FAC [state financial assistance] and
Section _AOO 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-1 02 - 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 OMS Circular A-22-Cost Principles)*
2 CFR Part 215 Administrative Requirements (Fonnerly OMB Circular A-II 0 - Administrative Requirements)
OMB Circular A-l33 - Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations.
EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT)
MUST FOLLOW:
2 CFR Part 220 Cost Principles for Educational Institutions OMB (Formerly Circular A-21-Cost Principles)'
2 CFR 215Administrative Requirements (Formerly OMB Circular A-lI0-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
recipientfsubrecipient, must comply with the following fiscal laws, rules and regulations:
Section 215-97, Fla. Stat
Chapter 619-5, Fla, Admin, Code
State Projects Compliance Supplement
Reference Guide for State expenditures
Other tiscal requirements set forth in program laws, rules and regulations.
30
2009
item i'b. :bD7
FeNuary 10. 2009
OA'}\1'1&j.09~8
ATTACHMENT IV
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE
FOR AGREEMENTS, GRANTS, LAND AND
COOPERATIVE AGREEMENTS
The undersigned, an authorized representative of the recipient named in the contract or agreement to which this fonn is an
attachment, hereby certifies that:
(1) The recipient and any sub-contractors of services under this contract have financial management systems capable
of providing certain infonnation, including: (1) accurate, current, and complete disclosure of the financial results
of each grant-funded project or program in accordance with the prescribed reporting requirements; (2) the source
and application of funds for all agreement supported activities; and 93) the comparison of outlays with budgeted
amounts for each award. The inability to process infonnation in accordance with these requirements could result
in a return of grand funds that have not been accounted for properly.
(2) Management Infonnation Systems used by the recipient, sub-contractor(s) or any outside entity on which the
recipient is dependent for data that is to be reported, transmitted or calculated, have been assessed and verified to
be capable of processing data accurately, including year-date dependent data. For those systems identified to be
non-compliant, recipient(s) will take immediate action to assure data integrity.
(3) If this contract includes the provision of hardware, software, finnware, 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.
[n the event of any decrcase 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 offunctionality as warranted
herein, at no charge to the State, and without interruption to the ongoing business of the state, time being of the
essence.
(4) The recipient and any sub-contractor( s) of services under this contract warrant their policies and procedures
include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies
arising from data integrity compliance issues.
The recipient shall require that the language of this certification be included in all subagreements, subgrants, and other
agreements and that all sub-contractors shall certify compliance accordingly.
This certification is a material representation of fact upon which rcliance 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-I 02 and 2 CFR PaJ1 215 (formerly OMB Circular A-II 0).
Donna Fiala, Chairman, Collier County Board of County Commissioners
3301 Tamiami Trail E. Bldg, F. Naples FL 34112
Name and Address of Recipient
Chainnan
Title
Februarv 10.2009
Date
Signature
Donna Fiala. Chairman
Name of Authorized Signer
ATTEST:
DWIGHT E, BROCK. Clerk
c~ '{ill I!J/PAP
Assistant County Attorney
31
By'
2009
.'--.gend8 ilsm ~Jo. 16D7
February 10,2009
ctPe!i'1ii3'.0'9 4 8
ATTACHMENT V
CERTiFICATiON REGARDiNG DEBARMENT, SUSPENSION, lNELIGIDILITY AND
VOLUNTARY EXCLUSION FOR LOWER TiER COVERED TRANSACTiONS
(1) The prospective contractor certifies, by signing this ccrtification, neither it nor its principals are presently debated,
suspended, proposed for debannent, declared ineligible, or voluntarily excluded from participation in this
transaction by any federal department or agency.
(2) Where the prospective contractor is unable 10 certifY to any of the statements in this certification, such prospective
participant shall attach an explanation to this certification.
Signature
F ebruarv I O. 2009
Date
Donna Fiala. Chainnan
Title
Collier County BCC
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] 2549. (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,
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 detennines 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 Ticr Covercd Transaction" in all its lower ticr 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 witb a person who is
dcbarred, suspended, detennined ineligible or volunlllrily excluded from participation, unless otherwise
authorized by thc fedcral governmcnt.
6.
If the recipient knowingly enters into a lower tier covered transaction with a person who is suspended, debarred,
ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to
the federal government, the Agency may pursue available remedies, including suspension, and/or dcbannent.
].
The recipient may rely upon a certification of a prospective participant in a lower tier covered transaction, unless
it knows tllat the c.e'tiification is <<\Toneous.
Approved as to form & e981 sunlclency
C(f~I11~
/
Colleen Greene,
Assistant County Attorney
32
ATTEST:
DWIGHT E. BROCK. Clerk
By:
:t-':::!11 f\!o. "G=',]
1 0 2D'J9
dA~'-'203.v943
2009
ATTACHMENT VI
ASSURA.l'iCES-NON-CONSTRUCTlON PROGRAMS
Public reporting burden for this collection of infonnation 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 infonnation. Send comments regarding the burden estimate or any other s=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 MANAGEMEI'iT AND BUDGET,
SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to }'our project or program. If you have questions, please contact
the awarding agenc)'. Further, certain Federal awarding agencies ma)' require applicants to certif}' to additional
assurances. If such is the case, you will be notified.
1, Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including
funds sufficient to pay the non-Federal share of project cost) to ensure proper planning, management, and completion of the
project described in this applications.
2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any
authorized representative, access to and the right to examine all records, books, papers, or documents related to the award;
and will establish a proper accounting system in accordance with generally accepted accounting standards or agency
directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the
appearance of personal or organizational conflict of interest, or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency,
5, Will comply with the Intergovernmental Personnel Act of 1970 (42 U,S,c., 4728-4763) relating to prescribed standards for
merit systems for programs funded under one of the ] 9 statutes or regulations specified in Appendix A ofOPM's Standards
for a Merit System of Personnel Administration (5 CYR, 900, Subpart F),
6. Will comply with all Fcdeial statutes relating to nondiscrimination. These include but are not limited to; (a) Title VI of the
Civil Rights Act of 1964 (PL 88-352) which prohibits discrimination on Ihe basis of race, color or national origin; (b) Title
IX of the Education Amendments of 1972, as amended (20 U,S,e., 1681-1683 and ]685-1686). 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 (PL 92-
255)l as amended, relating to nondiscrimination on the basis of drug abuse; (t) the Comprehensive Alcohol Abuse and
Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (PL 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,e, 290 dd-3
and 290 ee 3), as amended, relating to confidentiality ofalcoho] and drug abuse patient records; (h) Title Vll1 of the Civil
Rights Act of 1968 (42 USe.. 3601 et seq) as amended, relating to nondiscrimination in the sale, remal or financing of
housing; (i) any other nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is
being made; and (j) the requirements of any other nondiscrimination statute(s) which may app]:y to the application.
7. Will comply. or has already complied, with the requirements of Titles II and III of the unjfonn Relocation Assistance and
Real Property Acquisition Policies Act of 1970 (PL 91-646) which provide lor 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 rea! propcliy acquired for project purposes regardless of Federal participation in purchases.
8, Will comply, as applicable, with the provisions of the Hatch Act (5 use, 150]-1508 and 7324-7328), which limit the
political activities of employees \vhose principal employment activities arc funded in whole or in part with Federal funds.
33
!~\genda 118m ~~o. i6D7
F2bruary 10, 2009
2009 @1'! ~O:p.M8
9. Will comply, as applicable, with the provisions of the Davis-Bacon Act (40 U.SC., 276a to 276a-7), the Copeland Act (40
U.S,c' 276c and 18 U,S,c" 874) and the Contract Work Hours and Safety Standards Act (40 U,S,C., 327-333), regarding
labor standards for federally assisted construction subagreements.
10, Will comply, if applicable, with flood insurance purchase requirements of section 102(a) of the Flood Disaster Projection Act
of 1973 (P.L 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase
flood insurance if the total cost of insurable construction and acquisition is $10,000,00 or more.
II, 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 1738 (c) protection of wetlands pursuant to EO
11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with
the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U_S,c, 1451 et
seq.); (I) conformity of Federal actions of State (Clear Air) Implementation Plans under Section I 76(c) or the Clear Air Act
of 1955, as amended (42 USC. 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 USc, 469a-l 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 oflead-
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. \Vill comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing
this program.
SIGNA TtJRE OF AUTHORIZED CERTIFYING OFFICIAL
TITLE
i Chairman
Donna Fiala
APPLICANT ORGANIZA nON
DATE SUBMITTED
I Fcbru", ro.2009
Collier County Boardof Cot1!1t)' Connnissioners
Housing and Human Services Department
Assistant County Attllimey
ATTEST:
DWIGHT E. BROCK. Clerk
34
By:
!Lc;:Ti no. ') 607
10. 2,]09
oJ\1,!!"2&3.0f)43
ATTACHMENT VII
2009
OAA BUDGET SUMMARY
RECIPIENT: Collier County Housing and Human Services
I. Title III B Support Services
$ 280,81600
2. Title III C 1 Congicgate Meals
$ 202,354.00
3. Title III C2 Home Delivered Meals $ 228,705.00
4. Title III E Services
$ 57,935,00
TOTAL
$769,810.00
35
2009
OAA RATE SUMMARY
,Agsnda item No. 16D7
February 10,2009
~'2(j~.g948
ATTACHMENT VIIl
Human Senrices
Reimbursement Rate
$25.00
$45,00
$25.00
$45.00
90% of Cost
$53.00
$10.00
$45,00
$8.87
$53.00
$1.62
$28,00
$4.3 2 per person
$8.88
$53,00
$1.62
$45,00
$4.3 2 per person
RECiPIENT: Collier County Housing and
Services
IIlB
Case Aide
Case Mana ement
Intake
Screen in I Assessment
Trans ortation
IIlE
C-t
Con re ate Meals
Nutrition Counsel in
Nutrition Education
Nutrition Screenin
Outreach
C-2
Home Delivered Meals
Nutrition Counsel in
Nutrition Education
__. Nutrition Scree~._.
Outreach
Total Cost
$27.78
$50.00
$27.78
$50.00
100% Cost
$58.89
$11. ]2
$50.00
$9.86
$58.89
$1.80
$31.12
$4.80 er erson
$9.87
$58.89
$1.80
$50.00
$4.80 er erson
36
2009
INVOICE SCHEDULE
:T~~:1, i'b. -1 ee7
::,:-;b~u3ry 10,2009
o5\~'26ie9:,3
ATTACHMENT IX
REPORT BASED ON SUBMIT TO THE AGENCY
ON THIS DATE
1 January Advance' I January 1
2 February Advance' January I
3 January Expenditure Report February] 0
4 February Expenditure Report March ] 0
5 March Expenditure Report April ]0
6 April Expenditure Report May 10
7 Mav Expenditure Report June 10
8 June Expenditure Report Julv 10
9 J ulv Expenditure Report August 10
10 August Expenditure Report Septem ber I 0
11 September Expenditure Rcport October 10
,
12 October Expenditure Report November 10
13 November Expenditure Report/Jan, Adv, Reconciliation" Decem ber 1 0
14 December Expenditure Report/Feb, Adv. Reconciliation" January 10
15 Final Expenditure and Request for P~ment Report February] 5
16 Closeout Report February 25
i
I
Legend 'Advance based on projected cash need,
"Submission of expenditure reports mayor may not generate a payment request If final
expenditure report reflects funds due back to the Agencv, payment is to accompany the report.
Note#1
Report # I for Advance Basis Agreements cannot be submitted to the Agency prior to January I or until
the agreement with the Agency has been executed and a copy sent to the Comptroller.
Actual submission of the vouchers to the Agency is dependent on the accuracy of the expenditure renort.
I Note #2
, The last two months of the recipient's fiscal reports covering actual expenditures shall reflect an adjustment
I repaying advances for the first two months of the agreement, if advances have not been recouped.
37
Aaenda Itern I'.~o. 16D7
~ February 10, 2009
Page 41 of 43
ATTACHMENT X-A
RECEIPTS AND EXPENDITURE REPORT
OLDER AMERICAN ACT
PROVIDER NAME, ADDRESS, PHQNE# AND FEID# Program Funding Source, THIS REPORT PERIOD
FROM TO:
IIIB mc,
CONTRACT
llIC2 PERIOD:
CONTRACT #
REPORT #
PSA#
CERTIFICATION: I certify to the best of my knowledge and belief that this report is complete and all outlays herein are for purposes set forth
in the contract
Prepared by Date. Approved by : Date.
PART A. BUDGETED INCOMEJ RECEIPTS 1 Approved 2. Actual Receipts 3, Total Receipts 4, Percent of
Budget For This Report Year to Date Approved Budget
1. Federal Funds $0,00 $0,00 $0.00 %
2. State Funds $0.00 $0,00 $0.00 %
3. Program Income $0.00 $0.00 so. 00 %
4. Local Cash Match (CCE, HCE and Other) $0.00 $0.00 $0,00 %
5. SUBTOTAL: CASH RECEIPTS $0.00 $0.00 $0,00 %
6. Localln.Kind Match $0.00 SO.OO $0.00 %
7, TOTAL RECEIPTS $000 $0,00 $0,00 %
PART B : EXPENDITURES 1 Approved 2 Expenditures 3. Expenditures 4. Percent of
Budget For This Report Year to Dale Approved Budget
1. Meals I Meal Agreements $0.00 $0.00 $0.00 %
2. Service Subcontractor $0.00 $000 SO,OO %
3. Other $0,00 $000 $0.00 %
4. Indirect Cost $0,00 $0,00 $0.00 %
5. TOTAL EXPENDITURES $000 $0,00 $0,00 %
PARTC OTHER EXPENDITURES
(For Tracking Purposes only)
1 Match
a, Other and In-Kind $0.00 $0.00 $0.00 %
b Local Match $0,00 $0,00 $0,00 %
2, USDA Cash Received $000 $0.00 $000 %
3. TOTAL OTHER $0,00 $0.00 $0.00 %
PART 0 . OTHER REVENUE AND EXPENDITURES 2 Addition Cost Alternative Program Income 3.1nlerest
1, Program Income (PI) a Approved Budget $ a. Earned on GR Advances $
a OM Unbudgeted PI Receipts YTD
b, Received YTD $ b. Return of GR Advance $
$
c. Expenditures $ c. Other Earned $
DOEA FORM 105as revised 10/08
38
ATTACHMENT X.B
RECEIPTS AND EXPENDITURE REPORT
OLDER AMERICAN ACT
:t::,rr, !'JO. -r'3[}7
,c e=:n..;' 3....y 10, 201'(:]
?cl;]9 J2 of J.B
PROVIDER NAME, ADDRESS, PHONE# AND FEID# Program Funding Source. THIS REPORT PERIOD
FROM: TO:
CONTRACT
Title IJI E - PERIOD:
CONTRACT #
REPORT #
PSA#
CERTIFICATION' I certify to the best of my knowledge a"d belief that this report is complete and all outlays herein are for purposes set fo.1h
in the contract
Prepared by . Date: Approved by . Date.
PART A . BUDGETED INCOME! RECEIPTS , Approved 2. Actual Receipts 3, Total Receipts 4. Percent of
Budget For ThiS Report Year to Dale Approved Budget
1. Federal Funds $000 $0.00 SO.OO %
2 Slate Funds $0,00 $0,00 $0.00 %
3. Program Income $000 $0.00 $0,00 %
4 Local Cash Match $0,00 $0,00 $000 %
5, SUBTOTAL: CASH RECEIPTS $0.00 $0,00 so. 00 %
6. local In-Kind Match $000 $0.00 $0,00 %
7, TOTAL RECEIPTS $0,00 $0,00 $0,00 %
PART B. EXPENDITURES " Approved 2. Expenditures 3 Expenditures 4. Percent of
Budget For This Report Year 10 Date Approved BUdget
A Direct Services
1, Personnel $0,00 $0.00 $0,00 %
2. Travel $000 $000 $0.00 %
3 Building Space $0,00 $(l.00 $0.00 %
4 Communication I Utilities $0,00 $0.00 $0.00 %
5 Printing I Supplies $O.OD $0.00 $0.00 %
6. Equipment $0.00 $0.00 $0,00 %
7, Other $0.00 $0.00 $000 %
B . Agreement Services
8 Services Subcontracled $0.00 $0.00 $0.00 %
9. TOTAL EXPENDITURES $0.0:) $000 $0.00 %
10, DEDUCTIONS I
a. Total Locai Match $0,00 $0,00 $0,00 %
b. Program Income Used $0.00 $0.00 $0,00 %
c. TOTAL DEDUCTIONS $0.00 $0,00 $000 %
11 NET EXPENDITURES $0,00 $0.00 $000 %
PART C . EXPENDITURES ANALYSIS 12
Units of Services Year to Dale 3. Number of People Served Year to Date
A Expenditures by Services Vear to Dale: $0.001
1 Information $0,00 aGO
2 Assistance.. $0,00 $0.00 000
3. Counseling.. $0.00 $0,00 0,00
, Respite.. $000 $0.00 000
5, Supplemental Services. $0,00 $0,00 0.00
6. TOTAL.. $000
Part B Line 11, column 3 should be equal to this total.
PART D : GRANDPARENT SERVICES (reported by Federal Fiscal Year)
FFY I FFY I FFY I
Match $ Match $ Match $
,
DOEA rORM 105AE rEvised 12/08
39
REQUEST FOR PAYMENT
OLDER AMERICANS ACT
,A.:).;~nda itern ~~o. 16D7
, February 10,2009
Page 43 of 48
ATTACHMENT x-c
PROVIDER NAME. ADDRESS. PHONE AND FED ID NUMBER TYPE OF REPORT: THIS REQUEST PERIOD:
Report #
Advance Reimbursement Agreement #:
Agreement Period:
PSA:
ICERTIFICATION I hereby certify to the best of my knowledge thai this request conforms with the terms and the purposes set forth in the above agreement
Dale Approved By: Dale.
Prepared By
PART A,: (2) {31 (4) (7) (6)
BUDGET SUMMARY III B 1I1C1 II1C2 Tille IIIE TOTAL
LApproved
Agreement Amount. 0.00 0.00 0,00 0.00 0,00
2. Previous Funds
RECEIVED for
Agreement period 000 0,00 0,00 0,00 0,00
3. Agreement Balance 0,00 0,00 000 0.00 ODD
4. Previous Funds
REQUESTED for
Agreement period. 0.00 0,00 0,00 0.00 0.00
I
G~4.greemenl I
lance 0.00 0.00 0.00 0,00 0,00
.~TB:
FUNDS REQUESTED
1 1st-2nd Months I
RequeslOnly 000 0,00 0,00 0.00 0,00
2. Net Expenditures 0001 I 0001
For Month 0.00 0.00 0.00
3. Additional I
I
Cash Needs (Attach Doc.) 0.00 0.001 0.00 0,00 0,00
'4. Total 0,00 0001 0,00 0.00 0.00
pA.RTe;
NET FUNDS REQUESTED:
1, Less: Over.Advance 0.00 0.00 0.00 0.00 0.00
2. Agreement Funds are
Hereby Requested For 000 000 0,00 000 0.00
DO~ FORM l06A re"';$ed 01107
40
3 DATE STAMP
Prograrn/Facility Name
STATE OF FI.ORIDA DEPARTME\iT OF ELDERAFFAlRS
CIVIL RIGHTS COMPLlA\iCE CI IECKLlST
County
,\T1'.;'~NilN in
:---etlr~i2fy i 0
8:...-'1
2CiC9
.8
j,\J\AJContractor
Address
Completed By
City, State. Zip Code
Date
Telephone
PART I. READ THE A TT ACHED INSTRUCTIONS FOR ILLUSTRA T1VE INFORMA T10N WHICH WILL HELP YOU IN THE
COMPLETION OF THIS FORM.
]. Briefly describe the geographic area served by the programlfacility and the type of service provided:
o
~.
Total#
% Vv'hite
~hBlack
I %Hjspanic
POPULATION OF AREA SERVED. Source of data:
%Other %Female
3,
STAFF CURRENTLY EMPLOYED, Effective Date:
Total# %White %Black %Hispanic
%Other )
I
Effective Date:
%Other I
%Female
%Disabled
4.
CLIENTS CURRENTL Y ENROLLED OR REGISTERED,
Total# %White %BJack %Hispanic
%Female
%Disabled
% Over 40
5.
ADVISORY OR GOVERNING BOARD, IF APPLICABLE,
Total# %\Vhite %Black %Hispanic %Other
%Female
PART II. USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE.
6. Is an Assurance of Compliance on file with DOEA? IfNA or No, explain, NA YES NO
ODD
7. Compare staff composition to the population. Are staff representative of the population?
IfNA or NO, explain.
NA YES NO
DO 0
8. Compare the client composition to the population. Are race and sex characteristics representative
of the population? IfNA or No, explain.
NA YES NO
ODD
9. Are eligibility requirements for services applied to clients and applicants without regard to race,
color, national origin, sex, age, religion or handicap? If NA or NO, explain.
NA YES NO
--- ODD
] O. Are all benefits, services and facilities available to applicants and participants in an equally effective
manner regardless of race, sex, color, age, national origin, religion or disability? IfNA or NO, explain. NA YES NO
ODD
II. For inpatient services, are room assignments made without regard to race, coior, national
origin or handicap? IfNA or NO, explain.
NA YES NO
---~----------------- 0 0 0
Revised May 2008 Page 1 of 2 .~ I
'M'r~EJH'M[!'mA 16D7
"ebruary ',0, 2009
?aOA8 ~~"Jl 4N80
12. Is the program/facility accessible to non-English speaking clients? If NA or NO, explain, N, r 1O~
13. Are employees, applicants and participants informed of their protection against discrimination?
If YES, how? Verbal D Written D Poster D IfNA or No, explain.
14. Give the number and current status of any discrimination complaints regarding services or
Employment filed against the program / facility.
15. Is the program/facility physically accessible to mobility, hearing and sight impaired Individuals?
IfNA or NO, explain.
000
NA YES NO
ODD
NA NUMBER
D
NA YES NO
ODD
PART Ill. THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES
16. Has a self-evaluation been conducted to identify any barriers to serving disabled individuals, and to
make any necessary modifications? [fNO, explain, YES NO
DD
17. Is there an established grievance procedure that incorporates due process into the resolution
of complaints? If NO, explain.
18, Has a person been designated to coordinate Section 504 compliance activities? [fNO, explain.
19. Do recruitment and notification materials advise applicants, employees and participants of
nondiscrimination on the basis of disability? If NO, explain.
20. Are auxiliary aids available to assure accessibility of services to hearing and sight
impaired individuals? If NO, explain.
YES NO
DD
YES NO
DO
YES NO
DO
YES NO
DO
-
PART IV FOR PROGRAMS OR FACILITIES WITH SO OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF
$50,000 OR MORE
21. Do you have a written affirmative action program? If NO, explain.
DOEA USE ONLY
Reviewed by D No.D 1
In Comoliance: YES
Program Office I
*Notice of Corrective Action Sent I ,- I
I Date I Telephone: ResDonse Due I I
I
On-Site 0 Desk Review D Response Received I 1
DOE^ Form IOI-A, Revised May2008~ Page 2 of2
42
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INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST "
1. Describe the geographic service area such as a district, county, city or other locality. Ifthe program/facility
serves a specific target population such as adolescents, describe the target population. Also define the type of
service provided,
2. Enter the percent of the population served by race and sex. The population served includes persons in the
geographical area for which services are provided such as a city, county or other regional area. Population
statistics can be obtained from local chambers of commerce, libraries, or any publication from the 1980 Census
containing Florida population statistics, Include the source of your population statistics. ("Other" races include
Asians/Pacific Islanders and American Indian/Alaskan Natives.)
3. Enter the total number of full-time staff and their percent by race, sex and disability. Include the effective date of
your summary.
4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and
list their percent by race, sex and disability. Include the date that enrollment was counted.
5. Enter the total number of advisory board members and their percent by race, sex and handicap. If there is no
advisory or governing board, leave this section blank.
6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in
compliance with all nondiscriminatory provisions as required in 45 CFR 80. This is usually a standard part of the
contract language for DOEA recipients and their subgrantees. 45 CFR 80.4(a)
7. Is the race, sex, national origin composition of the staff reflective of the general population? For example, if 10%
of the population is Hispanic, is there a comparable percentage of Hispanic staff?
8. Where there is significant variation between the race, sex or ethnic composition of the clients and their availability
in the population, the program/facility has the responsibility to determine the reasons for such variation and take
whatever action may be necessary to correct any discrimination. Some legitimate disparities may exist when
programs are sanctioned to serve target populations such as elderly or disabled persons. 45 CFR 80.3 (b) (6)
9. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or
employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also
through on-site record analysis of persons who applied but were denied services or employment 45 CFR 80.3 (a)
and 45 CFR 80.1 (b) (2)
10, Participants or clients must be provided services such as medical, nursing and dental care, laboratory services,
physical and recreational therapies, counseling and social services without regard to race, sex, color, national
origin, religion, age or handicap. Courtesy titles, appointment scheduling and accuracy of record keeping must be
applied uniformly and without regard to race, sex, color, national origin, religion, age or handicap, Entrances,
waiting rooms, reception areas, restrooms and other facilities must also be equally available to all clients. 45 CFR
80.3 (b)
11. For in-patient services, residents must be assigned to rooms, v.'ards, etc., without regard to race, color, national
origin or disability, Also, residents must not be asked whether they are willing to share accommodations with
persons of a different race, color, national origin, or disability. 45 CFR 80.3 (a)
12, The program facility and all services must be accessible to pal1icipants and applicants, including those persons
who may not speak English. In geographic areas where a significant population of non-English speaking people
live, prograrn accessibiiity may include the employment ofbiiillgual staff. In other areas, it is sufficient to have a
policy or plan for service, such as a current list of names and telephone numbers of bilingual individuals who will
assist in the provision of services, 45 CFR SO,3(a)
43
13.
Agenda Hem I~o. 1607
February -'10, 2009
Page 47 of 48
Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available of
their participants, beneficiaries or any other interested parties. This should include information on their right to
file a complaint of discrimination with either the Florida Department of Elder Affairs or the V.S. Department of
HHS. The information may be supplied verbally or in writing to every individual, or may be supplied through the
use of an equal opportunity policy poster displayed in a public area ofthe facility. 45 CFR 80.6Cd)
14.
Report number of discrimination complaints filed against the program/facility. Indicate the basis, e.g., race, color,
creed, sex, age, national origin, disability, retaliation; the issues involved, e.g., services or employment,
placement, termination, etc. Indicate the civil rights law or policy alleged to have been violated along with the
name and address ofthe local, state or federal agency with whom the complaint has been filed. Indicate the
current status, e.g., settled, no reasonable cause or reasonable cause found, failure to conciliate, failure to
cooperate, under review, etc.
15.
The program/facility must be physically accessible to disabled individuals. Physical accessibility includes
designated parking areas, curb cuts or level approaches, ramps and adequate widths to entrances. The lobby,
public telephone, restroom facilities, water fountains, information and admissions offices should be accessible.
Door widths and traffic areas of administrative offices, cafeterias, restrooms, recreation areas, counters and
serving lines should be observed for accessibility. Elevators should be observed for door width, and braille or
raised numbers. Switches and controls for light, heat, ventilation, fire alarms, and other essentials should be
installed at an appropriate height for mobility impaired individuals.
16.
Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a
self-evaluation to identifY any accessibility barriers. Self-evaluation is a four step process:
. With the assistance of a disabled individual/organization, evaluate current practices and policies to
identifY any practices or policies which do not comply with Section 504.
. ModifY policies and practices that do not meet Section 504 requirements.
. Take remedial steps to eliminate any discrimination that has been identified.
. Maintain self-evaluation on file. (This checklist may be used to satisfY this requirement if these four steps
have been followed.)45 CFR 84.6
17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate
appropriate due process standards and provide for the prompt and equitable resolution of complaints alleging any
action prohibited by Section 504.45 CFR 84,7 (b)
18. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to
comply with Section 504.45 CFR 84,7 Ca)
19. Continuing steps must be taken to notifY employees and the public of the program/facility's policy of
nondiscrimination on the basis of handicap. This includes recruitment material, notices for hearings, newspaper
ads, and other appropriate written communication. 45 CFR 84.8 (a)
20. Programs/facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with
impaired sensory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to,
interpreters for hearing impaired individuals, taped or braille materials, or any alternative resources that can be
used to provide equally effective services. 45 CFR 84.52 Cd)
21. Programs/facilities with 50 or more employees and $50,000 in federal contracts must develop, implement and
maintain a written affirmative action compliance program in accordance with Executive Order 11246. 41 CFR 60
and Title VI of the Civil Rights Act of 1964, as amended.
44
::em f'~CJ. ; ee?
Revised August 2007
10.2009
P2;e4B of,3
Attestation Statement
Agreement/Contract Number OAA 203.09
Amendment Number
I, Donna Fiala. Chairman
(Recipient/Contractor representative
, attest that no changes or revisions have been made to
content of the above referenced agreement/contract or amendment between the Department ofEJder Affairs
and
Collier County Board of CounN Commissioners
(Recipient/Contractor name)
The only exception to this statement would be for changes in page fOlmaning, due to the differences in
electronic data processing media, which has no affect on the agreement/contract content.
Signature of Recipient/Contractor representative
Date
(~l1'1~
Assistant County Attorney
ATTEST:
DWIGHT E. BROCK, Clerk
By:
DOEA Contract Manager to initial and date indicating signatureslinitials appropriate on all documents;
ready for DOEA Secretary/designee signature
Initial date
Revised August 2007