Agenda 04/28/2020 Item #16D 5 (After-the-Fact Contract Amendment - Area Agency on Aging)
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January — December 2020 OAA 203.20
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC.
STANDARD CONTRACT
OLDER AMERICANS ACT
THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc. (Agency) and Collier
County Board of County Commissioners (Contractor), collectively referred to as the "Parties." The term Contractor for
this purpose may designate a Vendor, Subgrantee, or Subrecipient.
WITNESSETH THAT:
WHEREAS, the Agency has determined that it is in need of certain services as described herein; and WHEREAS, the
Contractor has demonstrated that it has the requisite expertise and ability to faithfully perform 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
annual covenants and conditions set forth herein, the Parties agree as follows:
1. Purpose of Contract:
The purpose of this contract is to provide services in accordance with the terms and conditions specified in this contract
including all attachments, forms, and exhibits, which constitute the contract document.
2. Incomo•ation of Documents within the Contract:
The contract will incorporate attachments, proposal(s), state plan(s), grant agreements, relevant Department handbooks,
manuals and/or desk books, as an integral part of the contract, except to the extent that the contract explicitly provides
to the contrary. In the event of conflict in language among any of the documents referenced above, the specific
provisions and requirements of the contract doemnent(s) shall prevail over inconsistent provisions in the proposal(s)
or other general materials not specific to this contract document and identified attachments.
3. Term of Contract:
This contract shall begin at twelve (12:00) A.M., Eastern Standard Time January 1, 2020 or on the date the contract
has been signed by the last party required to sign it, whichever is later. It shall end at eleven fifty-nine (11:59) P.M.,
Eastern Standard Time December 31, 2020.
4. Contract Amount:
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount not
to exceed $1,230,714.99 subject to the availability of funds. Any costs or services paid for under any other contract or
front any other source are not eligible for payment under this contract.
5. Renewals:
By mutual agreement of the Parties, in accordance with Section 287.058(1)(g), Florida Statutes (F.S.), the Agency
may renew the contract for a period not to exceed three years, or the term of the original contract, whichever is longer.
The renewal price, or method for determining a renewal price, is set forth in the bid, proposal, or reply. No other costs
for the renewal may be charged. Any renewal is subject to the same terms and conditions as the original contract and
contingent upon satisfactory performance evaluations by the Agency and the availability of funds.
6. Compliance with Federal Law:
6.1 If this contract contains federal funds this section shall apply.
6.1.1 The Contractor shall comply with the provisions of 45 Code of Federal Regulations (CFR) 75 and/or 45
CFR Part 92, 2 CFR Part 200, and other applicable regulations.
6.1.2 If this contract contains federal funds and is over $100,000.00, the Contractor shall comply with all
applicable standards, orders, or regulations issued under Section 306 of the Clean Air Act as amended (42
United States Code (U.S.C.) §7401, et seq.), Section 508 of the Federal Water Pollution Control Act as
amended (33 U.S.C. § 1251, et seq.), Executive Order 11738, as amended, where applicable,
Environmental Protection Agency regulations 2 CFR Part 1500. The Contractor shall report anyviolations
of the above to the Agency.
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January — December 2020
OAA 203.20
6.1.3 Neither the Contractor nor any agent acting for the Contractor may not use any federal funds received in
connection with this contract to influence legislation or appropriations pending before Congress or any
state legislature. The Contractor must complete all disclosure forms as required, specifically the
Certification and Assurances Attachment, which must be completed and returned to the Contract Manager
prior to the execution of this contract.
6.1.4 In accordance with Appendix II to 2 CFR Part 200, the Contractor shall comply with Executive Order
11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as
supplemented in Department of Labor regulations 41 CFR Part 60 and in Department of Health and Human
Services regulations 45 CFR Part 92, if applicable.
6.1.5 A contract award with an amount expected to equal or exceed $25,000.00 and certain other contract awards
will not be made to parties listed on the government -wide Excluded Parties List System, in accordance with
the Office of Management and Budget (OMB) guidelines at 2 CFR 180 that implement Executive Orders
12549 and 12689, "Debarment and Suspension." The Excluded Parties List System contains the names of
parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared ineligible under
statutory or regulatory authority other than Executive Order 12549. The Contractor shall comply with
these provisions before doing business or entering into subcontracts receiving federal funds pursuant to
this contract. The Contractor shall complete and sign the Certifications and Assurances Attachment prior to
the execution of this contract.
6.2 The Contractor shall not employ an unauthorized alien. The Agency will consider the employment of
unauthorized aliens a violation of the Immigration and Nationality Act (8 U.S.C. § 1324a) and the Immigration
Reform and Control Act of 1986 (8 U.S.C. § 1101). Such violation will be cause for unilateral cancellation of
this contract by the Agency.
6.3 If the Contractor is a non-profit provider and is subject to Internal Revenue Service (IRS) tax exempt organization
reporting requirements (filing a Form 990 or Form 990-N), and has its tax exempt status revoked for failing to
comply with the filing requirements of the Pension Protection Act of 2006 or for any other reason, the Contractor
must notify the Agency in writing within thirty (30) days of receiving the IRS notice ofrevocation.
6.4 The Contractor shall comply with Title 2 CFR Pact 175 regarding Trafficking in Persons.
6.5 Unless exempt under 2 CFR § 170.110(b), the Contractor shall comply with the reporting requirements of the
Transparency Act as expressed in 2 CFR Part 170.
6.6 To comply with Presidential Executive Order 12989, as amended, and State of Florida Executive Order Number
11-116, Contractor agrees to utilize the U.S. Department of Homeland Security's E -verify system to verify the
employment of all new employees hired by Contractor during the contract term. Contractor shall include in
related subcontracts a requirement that Subcontractors performing work or providing services pursuant to the
state contract utilize the E -verify system to verify employment of all new employees hired by the Subcontractor
during the contract term. Contractors meeting the terms and conditions of the E -Verify System are deemed to be
in compliance with this provision.
7. Compliance with State Law:
7.1 This contract is executed and entered into in the State of Florida, and shall be construed, performed, and
enforced in all respects in accordance with Florida law, including Florida provisions for conflict oflaws.
7.2 If this contract contains state financial assistance funds, the Contractor shall comply with Section 215.97, F.S.,
and Section 215.971, F.S., and expenditures must be in compliance with laws, rules, and regulations including,
but not limited to, the Reference Guide for State Expenditures.
7.3 The Contractor shall comply with the requirements of Section 287.058, F.S., as amended.
7.3.1 The Contractor shall perform all tasks contained in Attachment I.
7.3.2 The Contractor shall provide units of deliverables, including repots, findings, and drafts, as specified in
Attachment 1, to be received and accepted by the Area Agency Contract Manager prior to payment.
7.3.3 The Conti -actor shall comply with the criteria and final date by which such criteria must be met for
completion of this contract as specified in Attachment 1, Section 111. Method of Payment.
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January — December 2020
OAA 203.20
7.3.4 The Contractor shall submit bills for fees or other compensation for services or expenses in sufficient detail
for a proper pre -audit and post -audit.
7.3.5 If itemized payment for travel expenses is permitted in this contract, the Contractor shall submit invoices
for any travel expenses in accordance with Section 112.061, F.S., or at such lower rates as may be
provided in this contract.
7.3.6 The Contractor shall allow public access to all documents, papers, letters, or other public records as defined
in Section 119.011(12), F.S., made or received by the Contractor in conjunction with this contract except
for those records which are made confidential or exempt by law. The Contractor's refusal to comply with
this provision will constitute an immediate breach of contract for which the Agency may unilaterally
terminate this contract.
7.4 If clients are to be transported under this contract, the Contractor shall comply with the provisions of Chapter
427, F.S., and Rule Chapter 41-2, Florida Administrative Code (F.A.C).
7.5 Subcontractors who are on the Discriminatory Vendor List may not transact business with any public entity, in
accordance with the provisions of Section 287.134, F.S.
7.6 The Contractor shall comply with the provisions of Section 11.062, F.S., and Section 216.347, F.S., which prohibit
the expenditure of contract funds for the purpose of lobbying the legislature, judicial branch or a state agency.
7.7 The Agency may, at its option, terminate the Contract if the Contractor is found to have submitted a false
certification as provided under Section 287.135(5), F.S., has been placed on the Scrutinized Companies with
Activities in the Iran Petroleum Energy Sector List, the Scrutinized Companies with Activities in Sudan List, or
the Scrutinized Companies that Boycott Israel List, or if the Contractor has been engaged in business operations
in Cuba or Syria or is engaged in a boycott of Israel.
LNEINTINIMOMI
The Contractor shall ensure that the requirements of Section 430.0402 and Chapter 435, F.S., as amended, are met
regarding background screening for all persons who meet the definition of a direct service provider and who are not
exempt from the Department's level 2 background screening pursuant to Sections 430.0402(2)-(3), F.S. The
Contractor must also comply with any applicable rules promulgated by the Agency and the Agency for Health Care
Administration regarding implementation of Section 430.0402 and Chapter 435, F.S. To demonstrate compliance with
this provision, Contractor shall submit the Background Screening Affidavit of Compliance (Screening Form) to the
Agency within thirty (30) days of execution of this contract. Should the Agency have a completed Screening Form on
file for the Contractor, a new Screening Form will be required every twelve (12) months.
8.1 Further information concerning the procedures for background screening may be found at
littp://eideraffairs.state.fl. us/doea/backgroundscreeningphp.
9. Grievance Procedures:
The Contractor shall develop, implement, and ensure that its Subcontractors have established grievance procedures to
process and resolve client dissatisfaction with, or denial of, service(s) and address complaints regarding the
termination, suspension or reduction of services, as required for receipt of funds. These procedures, at a minimum,
will provide for notice of the grievance procedure and an opportunity for review of the Subcontractor's
determination(s).
10.1 By execution of this contract, Contractor agrees to all provisions of Chapter 119, F.S., and any other applicable
law, and shall:
10.1.1 Keep and maintain public records required by the Agency to perform the contracted services.
10.1.2 Upon request from the Agency's custodian of public records, provide the Agency a copy of the requested
records or allow the records to be inspected or copied within a reasonable time at a cost that does not
exceed the cost provided in Chapter 119, F.S., or as otherwise provided by law.
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January — December 2020
OAA 203.20
10.1.3 Ensure that public records that are exempt, or confidential and exempt, from public records disclosure
requirements are not disclosed except as authorized by law for the duration of the contract term and
following completion of the contract if the Contractor does not transfer the records to the Agency.
10.1.4 Upon completion of the contract, the Contractor will either transfer, at no cost to the Agency, all public
records in possession of the Contractor to the Agency, or will keep and maintain public records required
by the Agency. If the Contractor transfers all public records to the Agency upon completion of the
contract, Contractor shall destroy any duplicate public records that are exempt, or confidential and exempt,
from public records disclosure requirements. If the Contractor keeps and maintains public records upon
completion of the contract, the Contractor shall meet all applicable requirements for retaining public
records. All records stored electronically must be provided to the Agency in a format that is compatible
with the information technology systems of the Agency.
10.2 The Agency may unilaterally cancel this contract, notwithstanding any other provisions of this contract, for
refusal by the Contractor to comply with Section 10 of this contract by not allowing public access to all documents,
papers, letters, or other material made or received by the Contractor in conjunction with this contract, unless the
records are exempt, or confidential and exempt, from Section 24(a) of Article I of the State Constitution and
Section 119.07(I),F.S.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION
OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY
TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT,
CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT:
Public Records Coordinator
Area Agency on Aging for Southwest Florida, Inc.
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
239-652-6900
10.3 Upon termination of this contract, whether for convenience or for cause as detailed in section 53 of this
contract, the Contractor and Subcontractors shall, at no cost to the Agency, transfer all public records in their
possession to the Agency and/or Department and destroy any duplicate public records that are exempt, or
confidential and exempt, from public records disclosure requirements. All records stored electronically shall
be provided to the Agency in a format that is compatible with the information technology systems of the
Department.
11. Audits. inspections. investigations:
11.1 The Contractor shall establish and maintain books, records and documents (including electronic storage media)
sufficient to reflect all assets, obligations, unobligated balances, income, interest and expenditures of funds
provided by the Agency under this contract. Contractor shall adequately safeguard all such assets and assure
they are used solely for the purposes authorized order this contract. Whenever appropriate, financial information
should be related to performance and unit cost data.
11.2 The Contractor shall retain and maintain all client records, financial records, supporting documents, statistical
records, and any other documents (including electronic storage media) pertinent to this contract for a period of
six (6) years after completion of the contract, or longer when required by law. in the event an audit is required
by this contract, records shall be retained for a minimum period of six (6) years after the audit repot is issued or
until resolution of any audit findings or litigation based on the terms of this contract, at no additional cost to the
Agency.
11.3 Upon demand, at no additional cost to the Agency, the Contractor shall facilitate the duplication and transfer of
any records or documents during the required retention period.
11.4 The Contractor shall ensue that the records described in this section will be subject at all reasonable times to
inspection, review, copying, or audit by federal, state, or other personnel duly authorized by the Agency.
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January — December 2020 OAA 203.20
11.5 At all reasonable times for as long as records are maintained, persons duly authorized by the Agency and
federal auditors, pursuant to 45 CFR Part 75, shall be allowed full access to and the right to examine any of the
Contractor's contracts and related records and documents pertinent to this specific contract, regardless of the
form in which kept.
11.6 The Contractor shall provide a Financial and Compliance Audit to the Agency as specified in this contract and
ensure that all related third -party transactions are disclosed to the auditor.
11.7 Contractor agrees to comply with the Inspector General in any investigation, audit, inspection, review, or hearing
performed pursuant to Section 20.055, F.S. Contractor further agrees that it shall include in related
subcontracts a requirement that subcontractors performing work or providing services pursuant to this contract
agree to cooperate with the Inspector General in any investigation, audit, inspection, review, or hearing pursuant
to Section 20.055(5), F.S. By execution of this contract the Contractor understands and will comply with this
subsection.
12.1 The Contractor shall execute Assurances as stated in the Assurances -Non -Construction Programs Attachment that
it will not discriminate against any person in the provision of services or benefits under this contract or in
employment because of age, race, religion, color, disability, national origin, marital status, or sex in compliance
with state and federal law and regulations. The Contractor further assures that all Contractors, Subcontractors,
Sub -grantees, or others with whom it arranges to provide services or benefits in connection with any of its
programs and activities are not discriminating against clients or employees because of age, race, religion, color,
disability, national origin, marital status, or sex.
12.2 During the term of this contract, the Contractor shall complete and retain on file a timely, complete, and
accurate Civil Rights Compliance Checklist, attached to this contract.
12.3 The Contractor shall establish procedures pursuant to federal law to handle complaints ofdiscrimination involving
services or benefits through this contract. These procedures shall include notifying clients, employees, and
participants of the right to file a complaint with the appropriate federal or state entity.
12.4 If this contract contains federal funds, these assurances are a condition of continued receipt of or benefit from
federal financial assistance, and are binding upon the Contractor, its successors, transferees, and assignees for the
period during which such assistance is provided. The Contractor further assures that all Subcontractors, Vendor,
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 Contractor
understands that the Agency may, at its discretion, seek a court order requiring compliance with the termsof this
assurance or seek other appropriate judicial or administrative relief including but not limited to, termination of
the contract and denial of further assistance.
The Contractor shall permit persons duly authorized by the Agency to inspect and copy any records, papers,
documents, facilities, goods, and services of the Contractor which are relevant to this contract, and to interview any
clients, employees, and Subcontractor employees of the Contractor to assure the Agency of the satisfactory
performance of the terms and conditions of this contract. Following such review, the Agency will provide a written
report of its findings to the Contractor and, where appropriate, the Contractor shall develop a Corrective Action Plan
(CAP). The Contractor hereby agrees to correct all deficiencies identified in the CAP in a timely manner as determined
by the Agency's Contract Manager,
14. Provision of Services:
Tine Contractor shall provide services in the manner described in Attachment I.
15. Indemnification:
The Contractor shall indemnify, save, defend, and hold harmless the Agency and its agents and employees from any
and all claims, demands, actions, and causes of action of whatever nature or character arising out of, or by reason of,
i >>
January — December 2020 OAA 203.20
the execution of this contract or performance of the services provided for herein. It is understood and agreed that
the Contractor is not required to indemnify the Agency for claims, demands, actions, or causes of action arising solely
out of the negligence of the Agency.
15.1 Except to the extent permitted by Section 768.28, F.S., or other Florida law, this Section 15 is not applicable to
contracts executed between the Area Agency and state agencies or subdivisions defined in Section 768.28(2),
F.S.
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16.1 The Contractor shall provide continuous adequate liability insurance coverage during the existence of this
contract and any renewal(s) and extension(s) of it. By execution of this contract, unless it is a state agency or
subdivision as defined by Section 768.28(2), F.S., the Contractor accepts full responsibility for identifying and
determining the type(s) and extent of liability insurance coverage necessary to provide reasonable financial
protections for the Contractor and the clients to be served under this contract. The limits of coverage under
each policy maintained by tine Contractor do not limit the Contractor's liability and obligations under this
contract. The Contractor shall ensure that the Agency has the most current written verification of insurance
coverage throughout the term of this contract. Such coverage may be provided by a self-insurance program
established and operating under the laws of the State of Florida. The Agency reserves the right to require
additional insurance as specified in this contract.
16.2 Throughout the term of this contract, the Contractor shall maintain an insurance bond from a responsible
commercial insurance company covering all officers, directors, employees, and agents of the Contractor
authorized to handle funds received or disbursed under all agreements and/or contracts incorporating this
contract by reference in an amount commensurate with the funds handled, the degree of risk as determined by
the insurance company, and consistent with good business practices.
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The Contractor shall not use or disclose any information concerning a recipient of services tinder 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.
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Where applicable, the Contractor shall comply with the Health Insurance Portability and Accountability Act (42 USC
§ 1320d.), as well as all regulations promulgated thereunder (45 CFR Parts 160, 162, and 164).
19. Incident Re ort tine:
19.1 The Contractor shall notify the Agency immediately but no later than forty-eight (48) hours front the
Contractor's awareness or discovery of conditions that may materially affect the Contractor's or
Subcontractor's ability to perform the services required to be performed under this contract. Such notice shall
be made orally to the Agency's Contract Manager (by telephone) with an email to immediately follow.
19.2 The Contractor shall immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of
a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone number
(1-800-96ABUSE). As required by Chapters 39 and 415, F.S., this provision is binding upon the Contractor, its
Subcontractors, and their employees.
The Contractor shall notify the Agency within ten (10) days of entering into a new contract with any of the remaining
four (4) state human service agencies. The notification shall include the following information: (1) contracting state
agency and the applicable office or program issuing the contract; (2) contract name and number; (3) contract start and
end dates; (4) contract amount; (5) contract description and commodity or service; (6) Contract Manager name and
contact information. In complying with this provision, and pursuant to Section 287.0575, F.S., as amended, the
Contractor shall complete the Contractor's State Contracts List (request copy front Area Agency).
21. Bankruptcy Notification:
Dining the term of this contract, the Contractor shall immediately notify the Area Agency on Aging for Southwest
Florida, Inc. if the Contractor, its assignees, Subcontractors, or affiliates file a claim for bankruptcy. Within ten (10) days
January — December 2020 OAA 203.20
after notification, the Contractor must also provide the following information to the Agency: (1) the date of filing of
the bankruptcy petition; (2) the case number; (3) the court name and the division in which the petition was filed (e.g.,
Middle District of Florida, Fort Myers Division); and (4) the name, address, and telephone number of the bankruptcy
attorney.
22. Sponsorship and Publicity:
22.1 As required by Section 286.25, F.S., if the Contractor is a non-governmental organization which sponsors a
program financed wholly or in pail by state funds, including any funds obtained through this contract, it shall,
in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by (Contractor's
name) and the Area Agency on Aging for Southwest Florida, Inc. and/or State of Florida, Department of Elder
Affairs." If the sponsorship reference is in written material, the words "Area Agency on Aging for Southwest
Florida, Inc. and/or State of Florida, Department of Elder Affairs" shall appear in at least the same size letters or
type as the name of the organization.
22.2 The Contractor shall not use the words "Area Agency on Aging for Southwest Florida, Inc. and/or State of Florida,
Department of Elder Affairs" to indicate sponsorship of a program otherwise financed, unless specific written
authorization has been obtained by the Agency prior to such use.
23. Assignments:
23.1 The Contractor shall not assign the rights and responsibilities under this contract without the prior written
approval of the Agency. Any sublicense, assignment, or transfer otherwise occurring without prior written
approval of the Agency shall constitute a material breach of the contract. In the event the Area Agency and/or
the State of Florida approves assignment of the Contractor's obligations, the Contractor remains responsible
for all work performed and all expenses incurred in connection with this contract.
23.2 The Area Agency and/or the State of Florida is, at all times, entitled to assign or transfer, in whole or part, its
rights, dirties, or obligations under this contract to another governmental agency in the State of Florida, upon
giving prior written notice to the Contractor
23.3 This contract shall remain binding upon the successors in interest of the Contractor and the Agency.
24. Subcontracts:
24.1 The Contractor is responsible for all work performed and for all commodities produced pursuant to this contract,
whether actually furnished by the Contractor or its Subcontractors. Any subcontracts shall be evidenced by a
written document and subject to any conditions of approval the Agency deems necessary. The Contractor
further agrees that the Agency will not be liable to the Subcontractor in any way or for any reason. The
Contractor, at its expense, shall defend the Agency against any such claims.
24.2 The Contractor shall promptly pay any Subcontractors upon receipt of payment from the Agency or other state
agency. Failure to make payments to any Subcontractor in accordance with Section 287.0585, F.S., unless
otherwise stated in the contract between the Contractor and Subcontractor, will result in a penalty as provided
by statute.
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It is the intent and understanding of the Parties that the Contractor and any of its Subcontractors are independent
Contractors and are not employees of the Agency, and that they shall not hold themselves out as employees or agents
of the Agency without prior specific authorization from the Agency. It is the further intent and understanding of the
Parties that the Agency does not control the employment practices of the Contractor and will not be liable for any
wage and hour, employment discrimination, or other labor and employment claims against the Contractor or its
Subcontractors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment
compensation funds, and all necessary insurance for the Contractor are the sole responsibility of the Contractor.
26. PaKment:
Payments shall be made to the Contractor for all completed and approved deliverables (units of service) as defined in
Attachment I. The Area Agency Contract Manager will have final approval of the Contractor's invoice submitted for
payment and will approve the invoice for payment only if the Contractor has met all terms and conditions of the
contract, unless the bid specifications, purchase order, or this contract specify otherwise. The approved invoice will be
January — December 2020 OAA 203.20
submitted to the Agency's finance section for budgetary approval and processing. Disputes arising over invoicing and
payments will be resolved in accordance with the provisions of Section 215.422, F.S. A Vendor Ombudsman has been
established within the Florida Department of Financial Services and may be contacted at 800-342-2762.
27. Return of hinds:
The Contractor shall return to the Agency any overpayments due to unearned funds or funds disallowed, and any
interest attributable to such funds pursuant to the terms and conditions of this contract, that were disbursed to the
Contractor by the Agency. in the event that the Contractor or its independent auditor discovers that an overpayment has
been made, the Contractor shall repay said overpayment immediately without prior notification from the Agency. In
the event that the Agency first discovers an overpayment has been made, the Area Agency Contract Manager will
notify the Contractor in writing of such findings. Should repayment not be made forthwith, the Contractor shall be
charged at the lawful rate of interest on the outstanding balance pursuant to Section 55.03, F.S., after Agency
notification or Contractor discovery.
28. Data Integrity. and Safeguarding Information:
The Contractor shall ensure an appropriate level of data security for the information the Contractor is collecting or using
in the performance of this contract. An appropriate level of security includes approving and tracking all Contractor
employees that request system or information access and ensuring that user access has been removed from all terminated
employees. The Contractor, among other requirements, must anticipate and prepare for the loss of information
processing capabilities. All data and software shall be routinely backed up to ensure recovery from losses or outages
of the computer system. The security over the backed -up data is to be as stringent as the protection required of the
primary systems. The Contractor shall ensure all Subcontractors maintain written procedures for computer system
backup and recovery. The Contractor shall complete and sign the Certification Regarding Data integrity Compliance
for Agreements, Grants, Loans, and Cooperative Agreements prior to the execution of this contract.
The Department has implemented a Social Media Policy, in addition to its Computer Use Policy, which applies to all
employees, contracted employees, consultants, Other Personal Services (OPS) employees and volunteers, including
all personnel affiliated with third parties, such as, but not limited to, contractus and subcontractors. Any entity that
uses the Department's computer resource systems must comply with the Department's policy regarding social media.
Social Media includes, but is not limited to, blogs, podcasts, discussion forums, Wikis, RSS feeds, video sharing,
social networks like MySpace, Facebook and Twitter, as well as content sharing networks such as flickr and
YouTube. This policy is available on the Department's website at: http://elderaffairs.state.fl.us/doea/financial.plip.
30. Conflict of Interest:
The Contactor shall establish safeguards to prohibit employees, board members, management, and Subcontractors
from using their positions for a purpose that constitutes or presents the appearance of personal or organizational
conflict of interest or personal gain. No employee, officer, or agent of the Contractor or Subcontractor shall participate
in the selection or in the award of a contract supported by state or federal funds if a conflict of interest, real or apparent,
would be involved. Such a conflict would arise when: (a) the employee, officer or agent; (b) any member of his/her
immediate family; (c) his or her partner; or (d) an organization which employs, or is about to employ, any of the
above individuals, has a financial or other interest in the firm being selected for award. The Contractor's or
Subcontractor's officers, employees, or agents will neither solicit nor accept gratuities, favors, or anything of
monetary value from Contractus, potential Contractors, or parties to Subcontracts. The Contractor's or
Subcontractor's board members and management must disclose to the Agency any relationship which may be, or may
be perceived to be, a conflict of interest within thirty (30) calendar days of an individual's original appointment or
placement in that position, or, if the individual is serving as an incumbent, within thirty (30) calendar days of the
commencement of this contract. The Contractor's employees and Subcontractors must make the same disclosures
described above to the Contractor's board of director. Compliance with this provision will be monitored.
31. Public Entity Crime:
Pursuant to Section 287.133, F.S., a person or affiliate who has been placed on the Convicted Vendor List following a
conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods or
services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the construction
or repair of a public building or public work; may not submit bids, proposals, or replies on leases of real property to a
January — December 2020
147:.W0911eD]
public entity; may not be awarded or perform work as a Contractor, Supplier, Subcontractor, or Consultant under a
contract with any public entity; and may not transact business with any public entity in excess of the threshold amount
provided in Section 287.017, F.S., for CATEGORY TWO for a period of thirty six (36) months following the date of
being placed on the Convicted Vendor List.
32.1 The Contractor may purchase articles which are the subject of, or are required to carry out, this contract from
Prison Rehabilitative Industries and Diversified Enterprises, Inc., (PRIDE) identified under Chapter 946, F.S.,
in the same manner and under the procedures set forth in Sections 946.515(2) and (4), F.S. For purposes of this
contract, the Contractor shall be deenned 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 at 800-643-8459.
32.2 The Contractor may procure any recycled products or materials which are the subject of or are required to carry
out this contract in accordance with the provisions of Section 403.7065, F.S.
32.3 The Contractor may purchase articles that are the subject of or are required to carry out this contract fi•otn a
nonprofit agency for the Blind or for the Severely Handicapped that is qualified pursuant to Chapter 413, F.S.,
in the same manner and under the same procedures set forth in Sections 413.036(1) and (2), F.S. For purposes
of this contract, the Contractor shall be deemed to be substituted for the Agency insofar as dealings with such
qualified nonprofit agency are concerned. Additional information about the designated nonprofit agency and
the products it offers is available atlnttp://www.respectofflorida.oig. This clause is not applicable to
Subcontractors unless otherwise required by law.
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If this contract is awarded state funding and if any discovery, invention, or copyrightable material is developed or
produced in the course of or as a result of work or services performed under this contract or in any way connected with
this contract, or if ownership of any discovery, invention, or copyrightable material was purchased in the course of or
as a result of work or services performed under this contract, the Contractor shall refer the discovery, invention, or
copyrightable material to the Agency to be referred to the Department of State. Any and all patent rights or copyrights
accruing under this contract are hereby reserved to the State of Florida in accordance with Chapter 286, F.S. Pursuant
to Section 287.0571(5)(k), F.S., the only exceptions to this provision shall be those that are clearly expressed and
reasonably valued in this contract.
33.1 If the primary purpose of this contract is the creation of intellectual property, the Agency and/or State of
Florida shall retain an unencumbered right to use such property, notwithstanding any agreement made pursuant
to this Section 34.
33.2 If this contract is awarded solely federal funding, the terms and conditions are governed by 2 CFR § 200.315
or 45 CFR § 75.322, as applicable.
33.3 Notwithstanding the foregoing provisions, if the Contractor or one of its Subcontractor is a university and a
member of the State University System of Florida, then Section 1004.23, F.S., shall apply, but the Agency
shall retain a perpetual, fully -paid, nonexclusive license for its use and the use of its Contractors,
Subcontractor, or Assignees of any resulting patented, copyrighted, or trademarked work products.
34.1 If the tasks to be performed pursuant to this contract include the physical care and control of clients, or the
administration and coordination of services necessary for client health, safety, or welfare, the Contractor shall,
within thirty (30) calendar days of the execution of this contract, submit to the Agency's Contract Manager,
verification of an Emergency Preparedness Plan. In the event of an emergency, the Contractor shall notify the
Agency of emergency provisions.
34.2 In the event a situation results in a cessation of services by a Subcontractor, the Contractor shall remain
responsible for performance under this contract and must follow procedures to ensure continuity of operations
without interruption.
January — December 2020
35. Rauimnent:
OAA 203.20
35.1 Equipment means: (a) tangible personal property (including information technology systems) having a useful life
of more than one year and a per-unit acquisition cost which equals or exceeds the lesser of the capitalization level
established by the organization for the financial statement purposes, or $5,000.00 [for federal funds - 2 CFR
§ 200.33 and 45 CFR § 75.2, as applicable], or (b); nonexpendable, tangible personal property of a non-
consumable nature with an acquisition cost of $1,000.00 or more per unit, and expected useful life of at least one
(1) year; and hardback bound books not circulated to students or the general public, with a value or cost of
$250.00 or more [for state funds].
35.2 Contractors and Subcontractors who are Institutions of Higher Education, Hospitals, and Other Non -Profit
Organizations shall have written property management standards in compliance with 2 CFR Part 200
Administrative Requirements (formerly OMB Circular A -I10) that include: (a) a property list with all the
elements identified in the circular; (b) a procedure for conducting a physical inventory of equipment at least once
every two (2) years; (c) a control system to insure adequate safeguards to prevent loss, damage, or theft of the
equipment; and (d) maintenance procedures to keep the equipment in good condition. The property records must
be maintained on file and shall be provided to the Agency upon request. The Contractor shall promptly
investigate, fully document, and notify the Agency's Contract Manager of any loss, damage, or theft of
equipment. The Contractor shall provide the results of the investigation to the Agency's Contract Manager.
35.3 The Contractor's property management standards for equipment (including replacement equipment), whether
acquired in whole or in part with federal funds and federally -owned equipment shall, at a minimum, meet the
following requirements and shall include accurately maintained equipment records with the following
information:
35.3.1 Property records must be maintained that include a description of the equipment;
35.3.2 Manufacturer's serial number, model number, federal stock number, national stock number, or other
identification number;
35.3.3 Source of funding for the equipment, including the federal award identification number;
35.3.4 Whether title vests in the Contractor or the federal government;
35.3.5 Acquisition date (or date received, if the equipment was furnished by the federal government);
35.3.6 Information fi om which one can calculate the percentage of federal participation in the cost of the
equipment (not applicable to equipment furnished by the federal government);
35.3.7 Location, use and condition of the equipment and the date the information was reported;
35.3.8 Unit acquisition cost; and
35.3.9 Ultimate disposition data, including date of disposal and sales price or the method used to determine
current fair market value where a Contractor compensates the federal awarding agency for its share.
35.3.10 A physical inventory must be taken and the results reconciled with the property records at leastonce
every two (2) years.
35.3.11 A control system must be developed to ensure adequate safeguards to prevent loss, damage, or theft of
the property. Any loss, damage, or theft must be investigated. 45 CFR § 75.320(d)(3).
35.3.12 Adequate maintenance procedures must be developed to keep the property in good condition.
35.3.13 If the Contractor is authorized or required to sell the equipment, proper sales procedures must be
established to ensure the highest possible return.
35.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased with
state funds with an acquisition cost over $1,000.00 is part of tine cost of carrying out the activities and functions
of the grant awards and title (ownership) will vest in the Contractor [for federal funds see 2 CFR § 200.313(a)
and 45 CFR § 75320(a), as applicable], subject to the conditions of 2 CFR Part 200 and/or 45 CFR Part 75.
Equipment purchased under these thresholds is considered supplies and is not subject to property standards.
10
January — December 2020
OAA 203.20
Equipment purchased with funds identified in the budget attachments to agreements covered by this contract or
identified in the sub -agreements with Subcontractors (not included in a cost methodology), is subject to the
conditions of Chapter 273, F.S., rule 60A-1.017, F. A. C., and 2 CFR Part 200 and/or 45 CFR Part 75.
35.5 The Contractor shall not dispose of any equipment or materials provided by the Agency or purchased with
fiords provided through this contract without first obtaining the approval of the Agency's Contract Manager.
When disposing of property or equipment the Contractor must submit a written request for disposition
instructions to the Agency's Contract Manager. The request should include a brief description of the property,
purchase price, funding source, and percentage of state or federal participation, acquisition date and condition
of the property. The request should also indicate the Contractor's proposed disposition of the property (i.e.,
transfer or donation to another agency that administers federal programs, offer of the items for sale, destroy the
items, etc.).
35.6 The Agency's Contract Manager will issue disposition instructions. If disposition instructions are not received
within one hundred twenty (120) days of the written request for disposition, the Contractor is authorized to
proceed as directed in 2 CFR § 200.313 or 45 CFR § 75.320, as applicable.
35.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto, but
excludes movable machinery and equipment. Real property may not be purchased with state or federal funds
through agreements covered under this contract without the prior approval of the Agency. Real property
purchases from Older Americans Act funds are subject to the provisions of Title 42, Chapter 35, Subchapter 111,
Part A., Section 3030b United States Code (U.S.C.). Real property purchases front state funds can only be
made through fixed capital outlay grants and aids appropriations and therefore are subject to the provisions of
Section 216.348, F.S.
35.8 Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted and tested prior
to disposal to ensure no confidential information remains.
35.9 The Contractor must adhere to the Agency's procedures and standards when purchasing Information
Technology Resources (ITR) as part of any agreement(s) incorporating this contract by reference. An ITR
worksheet is required for any computer related item costing $1,000.00 or more, including data processing
hardware, software, services, supplies, maintenance, training, personnel, and facilities. The completed ITR
worksheet shall be maintained in the LAN administrator's file and must be provided to the Agency upon
request. The Contractor has the responsibility to require any Subcontractors to comply with the Agency's ITR
procedures.
36. PUR 1000 Form:
The PUR 1000 Form is hereby incorporated by reference and available at
http://www.myflorida.com/apps/vbs/adoe/F7740 PUR1000.pddf
In the event of any conflict between the PUR 1000 Form and any terms or conditions of this contract, the terms or
conditions of this contract shall take precedence over the PUR 1000 Form. However, if the conflicting terms or
conditions in the PUR 1000 Form are required by any section of the Florida Statutes, the terms or conditions contained
in the PUR 1000 Form shall take precedence.
37. Use of State Funds to Purchase or Improve Real Pru en rty:
Any state funds provided for the purchase of or improvements to real property are contingent upon the Contractor or
political subdivision granting to the state a security interest in the property at least to the amount of state funds provided
for at least five (5) years from the date of purchase or the completion of the improvements or as further required by law.
Any dispute concerning performance of the contract shall be decided by the Agency's Contract Manager, who shall
reduce the decision to writing and serve a copy on the Contractor.
If the Contractor fails to meet the minimum level of service or performance identified in this contract, the Agency will
shall impose financial consequences as stated in Attachment 1.
January — December 2020
40. No Waiver of Sovereign Immunity:
OAA 203.20
Nothing contained in this contract is intended to serve as a waiver of sovereign immunity by any entity to which
sovereign immunity may be applicable.
41. Venue:
If any dispute arises out of this contract, the venue of such legal recourse shall be Lee County, Florida.
42. Entire Contract:
This contract contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations
shall be valid or binding upon the Agency or the Contractor unless expressly contained herein or by a written
amendment to this contract signed by both Parties.
43. Force Maieure:
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control,
provided the party experiencing the force Majeure condition provides immediate written notification to the other party
and takes all reasonable efforts to cure tine condition.
44. Severability Clause:
The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or unenforceable,
the other provisions are severable to that void provision and shall remain in full force and effect.
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The Parties agree that the Agency's performance and obligation to pay under this contract are contingent upon an
annual appropriation by the Legislature.
46. Addition/Deletion:
The Parties agree that the Agency reserves the right to add or to delete any of the services required tinder this contract
when deemed to be in the State of Florida's best interest and reduced to a written amendment signed by both Parties.
The Parties shall negotiate compensation for any additional services added.
47. Waiver:
The delay or failure by the Agency to exercise or enforce any of its rights under this contract will not constitute or be
deemed a waiver of the Agency's right thereafter to enforce those rights, nor will any single or partial exercise of any
such right preclude any other or further exercise thereof or tine exercise of any other right.
48. Compliance:
The Contractor shall abide by all applicable current federal statutes, laws, rules, and regulations as well as applicable
current state statutes, laws, rules and regulations. The Parties agree that failure of the Contractor to abide by these laws
shall be deemed an evert of default of the Contractor and subject the contract to immediate unilateral cancellation of
the contract at the discretion of the Agency.
49. Final Invoice:
The Contractor shall submit the final invoice for payment to the Agency no later than thirty (30) days after the
contract ending date unless otherwise specified in Attachment I. If the Contractor fails to do so, all right to payment is
forfeited and the Agency shall not honor any requests submitted after the aforesaid time period. Any payment due
under the terms of this contract shall be withheld until all required documentation and reports due from the Contractor
and necessary adjustments thereto have been approved by the Agency.
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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.
12
January — December 2020
51. Suspension of Work
OAA 203.20
The Agency may, in its sole discretion, suspend any or all activities under the contract or purchase order, at any time,
when in the best interest of the State to do so. The Agency shall provide the Contractor written notice outlining the
particulars of suspension. Examples of the reason for suspension include, but are not limited to, budgetary constraints,
declaration of emergency, or other such circumstances. After receiving a suspension notice, the Contractor shall
comply with the notice and shall not accept any purchase orders. Within ninety (90) days, or any longer period agreed
to by the Contractor, the Agency shall either: (1) issue a notice authorizing resumption of work, at which time activity
shall resume, or (2) terminate the contract or purchase order. Suspension of work shall not entitle the Contractor to
any additional compensation.
52. Termination:
52.1 Termination for Convenience. The Agency, by written notice to the Contractor, may terminate this contract in
whole or in part when the Agency determines in its sole discretion that it is in the State's interest to do so. The
Contractor shall not furnish any product after it receives the notice of termination, except as necessary to
complete the continued portion of this contract, if any. The Contractor shall not be entitled to recover any
cancellation charges or lost profits.
52.2 Termination for Cause. The Agency may terminate this contract if the Contractor fails to: (1) deliver the
product within the time specified in the contract or any extension, (2) maintain adequate progress, thus
endangering performance of the contract, (3) honor any term of the contract, or (a) abide by any statutory,
regulatory, or licensing requirement. Rule 60A-1.006(3), F.A.C., governs the procedure and consequences of
default. The Contractor shall continue work on any work not terminated. Except for defaults of Subcontractors
at any tier, the Contractor shall not be liable for any excess costs if the failure to perform the contract arises from
events completely beyond the control, and without the fault or negligence, of the Contractor. If the failure to
perform is caused by the default of a Subcontractor at any tier, and if the cause of the default is completely beyond
the control of both the Contractor and the Subcontractor, and without the fault or negligence of either, the
Contractor shall not be liable for any excess costs for failure to perform, unless the subcontracted products were
obtainable from other sources in sufficient time for the Contractor to meet the required delivery schedule. If, after
termination, it is determined that the Contractor was not in default, or that the default was excusable, the rights
and obligations of the Parties shall be the same as if the termination had been issued for the convenience of the
Agency. The rights and remedies of the Agency in this clause are in addition to any other rights and remedies
provided by law or under the contract.
DIMUMMt r i
The Agency authorizes, but does not require, the Contractor to create and retain electronic records and to use
electronic signatures to conduct transactions necessary to carry out the terms of this contract. A Contractor that creates
and retains electronic records and uses electronic signatures to conduct transactions shall comply with the requirennents
contained in the Uniform Electronic Transaction Act, Section 668.50, F.S. All electronic records must be fully
auditable; are subject to Florida's Public Records Law, Chapter 119, F.S.; must comply with contract Section 29, Data
Integrity and Safeguarding Information; must maintain all confidentiality, as applicable; and must be retained and
maintained by the Contractor to the same extent as non -electronic records are retained and maintained as required by
this contract.
53.1 The Agency's authorization pursuant to this section does not authorize electronic transactions between tine
Contractor and the Agency. The Contractor is authorized to conduct electronic transactions with the Agency
only upon further written consent by the Agency.
53.2 Upon request by the Agency, the Contractor shall provide the Agency with non -electronic (paper) copies of
records. Non -electronic (paper) copies provided to the Agency of any document that was originally in
electronic form with an electronic signature must identify the person and the person's capacity who electronically
signed the document on any non -electronic copy of the document.
13
January — December 2020
54. Contract Manager:
OAA 203.20
The Agency may substitute any Agency employee to serve as the Area Agency Contract Manager.
REMAINDER OF THE PAGE INTENTIONALLY LEFT 6LANIC
14
January — December 2020 OAA 203.20
55. Official Payee and Representatives (Names. Addresses. and Telephone Numbers),
56. All Terms and Conditions Included:
This contract and its Attachments, I — XVII including any exhibits referenced in said attachments, together with
any documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There
are no provisions, terms, conditions, or obligations other than those contained herein, and this contract shall
supersede all previous communications, representations, or agreements, either written or verbal, between the
Parties.
By signing this contract, the Parties agree that they have read and agree to the entire contract.
IN WITNESS WHEREOF, the Parties hereto have caused this contract to be executed by their undersigned
officials as duly authorized.
CONTRACTOR: COLLIER COUNTY BOARD OF
COUNTY CO SSI NERS
SIGNED BY: 1
NAME: STEPHEN Y CARNELL
TITLE: PUBLIC SERVICES DEPARTMENT HEAD
DATE: I' ' ac)
Federal Tax ID: 59-6000588
Fiscal Year Ending Date: 09/30
Duns: 188277693
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA,iINC.
SIGNED BY: / /l
NAME: MARIANNE G LORNI
TITLE: PRESIDENT/CEO
DATE: )I glabIo
Approved as to form and legality
15 9
Asbrbtanl County onay t
312020
The Contractor name, as shown on page 1 of this
Collier County Board of County Commissioners
3339 E Tamiami Trail, Building H
a.
contract, and mailing address of the official payee to
Naples, FL 34112
whom the payment shall be made is:
The name of the contact person and street address
Kristi Sonntag, Director
Collier County Board of County Commissioners
b.
where financial and administrative records are
%Community and Human Services
maintained is:
3339 E Tamiami Trail, Building H
Naples, FL 34112
Kristi Sountag, Director
The name, address, and telephone number of the
Collier County Board of County Commissioners
C.
representative of the Contractor responsible for
%Community and Human Services
administration of the program under this contract is:
3339 E Tamiami Trail, Building H
Naples, FL 34112
239 252-2273
Area Agency on Aging for Southwest Florida, Inc.
d
The section and location within the Agency where
15201 North Cleveland Avenue, Suite 1100
Requests for Payment and Receipt and Expenditure
North Fort Myers, FL 33903
forms are to be mailed is:
Linda Howard, Director of Program & Planning
e.
The name, address, and telephone number of the
Area Agency on Aging for Southwest Florida, Inc.
Contract Manager for this contract is:
15201 North Cleveland Avenue, Suite 1100
North Fort Myers, FL 33903
239 652-6900
Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided in
writing to the other party.
56. All Terms and Conditions Included:
This contract and its Attachments, I — XVII including any exhibits referenced in said attachments, together with
any documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There
are no provisions, terms, conditions, or obligations other than those contained herein, and this contract shall
supersede all previous communications, representations, or agreements, either written or verbal, between the
Parties.
By signing this contract, the Parties agree that they have read and agree to the entire contract.
IN WITNESS WHEREOF, the Parties hereto have caused this contract to be executed by their undersigned
officials as duly authorized.
CONTRACTOR: COLLIER COUNTY BOARD OF
COUNTY CO SSI NERS
SIGNED BY: 1
NAME: STEPHEN Y CARNELL
TITLE: PUBLIC SERVICES DEPARTMENT HEAD
DATE: I' ' ac)
Federal Tax ID: 59-6000588
Fiscal Year Ending Date: 09/30
Duns: 188277693
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA,iINC.
SIGNED BY: / /l
NAME: MARIANNE G LORNI
TITLE: PRESIDENT/CEO
DATE: )I glabIo
Approved as to form and legality
15 9
Asbrbtanl County onay t
312020
January – December 2020 OAA 203.20
INDEX OF ATTACHMENTS
ATTACHMENTI...............................................................................................................................................................
17
STATEMENT OF WORK
ATTACHMENTII.............................................................................................................................................................
35
FINANCIAL AND COMPLIANCE A UDIT
ATTACHMENTIII....................................................................................................................................................................42
61
CERTIFICATIONS AND ASSURANCES
ATTACHMENTIV....................................................................................................................................................................47
62
ASSURANCES—NON-CONSTRUCTION PROGRAMS
ATTACHMENTV.............................................................................................................................................................
49
FLORIDA DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST
ATTACHMENTVII..........................................................................................................................................................
53
BACKGROUND SCREENING
ATTACHMENTIX....................................................................................................................................................................54
65
BUDGF.TAND RATE SUDGbIARY
ATTACHMENTX.............................................................................................................................................................
58
INVOICE SCHEDULE
ATTACHMENTXI............................................................................................................................................................
59
REQUEST FOR PAI HENT
ATTACHMENT XII—Exhibit 1.......................................................................................................................................
60
RECEIPTS AND EXPENDITURE REPORT (IIIB)
ATTACHMENT XII—Exhibit 2.......................................................................................................................................
61
RECEIPTS AND EXPENDITURE REPORT (IIICI)
ATTACHMENTXII—Exhibit 3.......................................................................................................................................
62
RECEIPTS AND EXPENDITURE REPORT (HIC2)
ATTACHMENT XII—Exhibit 4.......................................................................................................................................
63
RECEIPTS AND EXPENDITURE REPORT (HIE)
ATTACHMENT XII—Exhibit 5.......................................................................................................................................
64
RECEIPTS AND EXPENDITURE REPORT (NSIP)
ATTACHMENTXVI.........................................................................................................................................................
65
OAA ANNUAL VOLUNTEER ACTIVITY REPORT SPECIFICATIONS
ATTACHMENTXVII.......................................................................................................................................................
67
OAA ANNUAL VOLUNTEER ACTIVITY REPORT
16
January — December 2020
ATTACHMENT
STATEMENT OF WORK
L SER DICES ALLOWED UNDER THE OAA CONTRACT:
OAA 203.20
Disclaimer. Allowed Services under this contract, may or may not be contracted with. For contracted services.for each
lead agency, please seethe ATTACHMENT regarding the BUDGET and RATE Summary.
A. Definitions of Terms
1. Contract Acronyms
Area Agency on Aging (AAA)
Activities of Daily Living (ADL)
Administration on Aging (AoA)
Administration on Community hiving (ACL)
Alliance of Information & Referral Systems (AIRS)
Assessed Priority Consumer List (APCL)
Adult Protective Services (APS)
Client Information and Registration Tracking System (CIRTS)
Chronic Disease Self -Management Education (CDSME)
Chronic Disease Self -Management Program (CDSMP)
Dietary Reference Intake (DRI)
Evidence -Based Disease Prevention and Health Promotion (EBDPHP)
Florida Department of Business and Professional Regulations (DBPR)
Florida Department of Elder Affairs (DOEA or Department)
Florida Department of Health (DOH)
Information and Referral (I&R)
Instrumental Activities of Daily Living (IADL)
National Council on Aging (NCOA)
Nutrition Services Incentive Program (NSIP)
Older Americans Act (OAA)
Planning and Service Area (PSA)
State of Florida (State)
Statewide Medicaid Managed Care Long -Term Care (SMMC LTC)
United States Department of Agriculture (USDA)
United States Department of Health and Human Services (USDHHS)
2. Program Specific Terms
Adult Child with a Disability: A child who is age 18 or older and is financially dependent on an older
individual who is a parent of the child and has a disability.
Area Plat: A plan developed by the AAA outlining a comprehensive and coordinated service delivery system
in its PSA in accordance with Section 306 of the OAA [42 United States Code (U.S.C.) § 3026] and Agency
instructions.
17
January — December 2020
OAA 203.20
Area Plan Update: A revision to the Area Plan wherein the AAA enters OAA specific data in CIRTS. An
Update may also include other revisions to the Area Plan as instructed by the Agency and/or Department.
Child: An individual who is not more than eighteen (18) years of age or an individual with a disability.
Criteria: A standard which the Administration on Aging(AoA)/Administration for Community Living(ACL)
set for the Title IIID Program. AoA/ACL's standard criterion consists of three tiers: Minimal Criteria,
Intermediate Criteria, and Highest- Level Criteria.
Family Caregiver: An adult family member, or another individual, who is an informal provider of in-home
and community care to an older individual.
Frail: When an older individual is (1) determined to be unable to perform at least two activities of daily living
without substantial human assistance, including verbal reminding, physical cueing, or supervision or (2)
unable to perform at least three such activities without such assistance; or, (3) due to a cognitive or other mental
impairment, requires substantial supervision because the individual behaves in a manner that poses a serious
health or safety hazard to the individual or to another individual.
Grandparent: A grandparent or step -grandparent of a child, or a relative of a child by blood, marriage or
adoption, who: (1) lives with the child, (2) is the primary caregiver of the child because the biological or
adoptive parents are unable or unwilling to serve as the primary caregiver of the child, and (3) has a legal
relationship to the child, such as legal custody or guardianship, or is raising tine child informally.
B. General Description
1. General Statement
The primary purpose of the OAA Program is to foster the development and implementation of comprehensive
and coordinated systems to serve older individuals. These systems assist older individuals to attain and maintain
maximum independence with supportive services.
The NSIP provides incentives for the effective delivery of nutritious meals to older individuals. NSIP allows
programs to increase the number and/or the quality of meals served. NSIP is a cash allotment or commodity
program that supplements funding or food used in meals served under the OAA. Florida has opted for cash
payments in lieu of donated foods.
2. Authority
All applicable federal laws, regulations, action transmittals, program instructions, review guides and similar
documentation related to the following:
a. Catalog of Federal Domestic Assistance Nos. 93.043, 93.044, 93.045, 93.052, and 93.053;
b. Older Americans Act of 1965, as amended 2016;
c. Section 311 of the Older Americans Act of 1965, as amended 2016 (42 U.S.C. § 3030a);
d. 42 U.S.C. § 303 and§ 604;
e. Rule 58A-1, Florida Administrative Code (F.A.C.);
f. Section 430.101, Florida Statutes (F.S.); and
g. DOEA Programs and Services Handbook, which is hereby incorporated by reference, to include any
subsequent revisions thereof.
3. Scope of Service
Tile Contractor is responsible for the programmatic, fiscal, and operational management of the OAA Title 11113,
Title IIIC1, Title IIIC2, and Title IIIE Programs and NSIP, within its designated service area. The program
services shall be provided in a manner consistent with the Agency's current Area Plan, as updated and hereby
incorporated by reference, and the current DOEA Programs and Services Handbook. The Contractor shall use
the NSIP funding to supplement funding for food used in meals served by OAA Nutrition Program Providers.
18
January — December 2020
4. Major Program Goals
OAA 203.20
The major goals of the OAA Program are to improve older individuals' quality of life, preserve their
independence, and prevent or delay their need for costlier institutional care. These goals are achieved through
the implementation of a comprehensive and coordinated service system that provides a continuum of service
alternatives and effective delivery of nutritious meals that meet the diverse needs of elders and their
caregivers.
C. Clients to be Served
1. General Description
The OAA Program gives preference to older individuals with greatest economic need and older individuals
with greatest social need (with particular attention to low-income older individuals, including low-income
minority older individuals, older individuals with limited English proficiency, and older individuals residing in
rural areas),
2. Client Eligibility
it. OAA Title III
Consumers shall not be dually enrolled in an OAA Program and a Medicaid capitated Loing-Term Care
Program, except consunners in need of OAA Legal Assistance services and OAA Congregate Nutrition
Services, including transportation to and from congregate meal sites.
b. NSIP
Meals served to an elderly individual, funded in whole or in part under the SMMC LTC, (Statewide
Medicaid Managed Care Long -Term Care). Home Care for the Elderly, Community Care for the Elderly
Programs, or other means tested programs may not be included in the NSIP count. OAA -funded congregate
meals provided to SMMC LTC clients may be included inthe NSIP count.
c. OAA Title IIIII, Supportive Services
i. Individuals must be age sixty (60) or older; and
ii. I&R(hnfornnation and Referral)/Assistance services are provided to individuals regardless of age.
d. OAA Titles IIIC1 and IIIC2, Nutrition Services, General
General factors that shall be considered in establishing priority for the receipt of nutrition services include
those older persons who:
i. Cannot afford to eat adequately;
ii. Lack the skills or knowledge to select and prepare nourishing and well-balanced meals;
iii. Have limited mobility which may impair their capacity to shop and cook forthemselves;
iv. Have a disabling illness or physical condition requiring nutritional support; or
v. Have been screened at a high nutritional risk.
e. OAA Title IIICI, Congregate Nutrition Services
In addition to meeting the general nutrition services eligibility requirements listed in Section I.C.2.d. above,
individuals must be mobile, not homebound, and physically, mentally, and medically able to attend a
congregate nutrition program. individuals eligible to receive congregate meals include the following:
I. Individuals age sixty (60) or older;
ii. Any spouse (regardless of age) who attends the dining center with his/her eligible spouse;
iii. Persons with a disability, regardless of age, who reside in a housing facility occupied primarily by older
individuals where congregate nutrition services are provided;
iv. Disabled persons who reside at home with and accompany an eligible person to the dining center; and
v. Volunteers, regardless of age, who provide essential services on a regular basis during meal hours.
19
January — December 2020 OAA 203.20
f. OAA Title IIIC2, Home Delivered Nutrition Services
In addition to meeting the general nutrition services eligibility requirements as listed in Section I.C.2.d.,
individuals most be homebound and physically, mentally, or medically unable to attend a congregate
nutrition program. htdividuals eligible to receive home delivered meals include the following:
I. Individuals age sixty (60) or older who are homebound because of illness, disability, or isolation;
ii. The spouse of a homebound eligible individual, regardless of age, if the provision of the collateral meal
supports maintaining the person at home;
iii. Individuals with disabilities, regardless of age, who reside at home with eligible individuals and are
dependent on them for care; and
iv. Persons at nutritional risk who have physical, emotional, or behavioral conditions which would make
their presence at congregate nutrition sites inappropriate; and
v. Persons at nutritional risk who are socially or otherwise isolated and unable to attend a congregate
nutrition site.
g. OAA Title IIIE, Caregiver Support Services
Eligibility for OAA Title IIIE, Caregiver Support Services, is as follows:
i. Eligible individuals include:
(1) Family caregivers of individuals age sixty (60) or older; and
(2) Grandparents [age fifty-five (55) or older] or older individuals [age fifty-five (55) or older] who
are relative caregivers.
ii. For respite and supplemental services, a fain ily caregiver must be providing care for an older individual
who meets the definition of the term "frail" as defined above.
iii. Priority will be given to family caregivers who provide care for individuals with Alzheimer's disease
and related disorders with neurological and organic brain dysfunction and to grandparents or older
individuals who are relative caregivers who provide care for children with severe disabilities.
II. MANNER OF SERVICE PROVISION
A. Service Tasks
To achieve the goals of the OAA Program, the Contractor shall ensure performance of the following tasks:
1. Client Eligibility Determination
The Contractor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a
client is based on meeting the requirements described in Section I.C.2.
2. Targeting and Screening New Clients for Service Delivery
The Contractor shall develop and implement policies and procedures consistent with OAA targeting and
screening criteria for new clients.
3. Program Services
The Contractor shall ensure the provision of program services is consistent with the Agency's current Area
Plan, as updated and approved by the Department, and the current DOEA Programs and Services Handbook.
4. Program Eligibility Requirements
a. Eligibility Criteria
To be eligible for program participation, an entity must:
Be an agency that has received a grant under OAA Title III [OAA section 311(42 U.S.C. § 3030a)]; and
P
January — December 2020
OAA 203.20
ii. Partner with a nutrition service provider that serves meals and is under thejurisdiction, control,
management, and audit authority of the Area Agency on Aging and the Florida Department of Elder
Affairs.
b. Provider's Nutrition Service Operations
The Contractor shall ensure that the nutrition service operations of the provider meet the requirements of
this contract, as well as any other applicable regulations and policies prescribed by the current DOEA
Programs and Services Handbook, USDHHS, USDA, DOH and local health departments, DBPR, or any
other agency designated to inspect meal quality for the State.
c. Prescribed Nutritional Requirements
The Contractor shall ensure that each meal provided under this contract meets the following criteria:
i. Complies with the current Dietary Guidelines for Americans, published by the Secretaries of the
USDHHS and USDA; and
ii. Provides a minimum of thirty-three and a third percent (33 1/3%) of the dietary reference
intakes/adequate intakes for a female age seventy (70) or older as established by the Food and Nutrition
Board of the National Academy of Sciences.
d. Food Origin and Commodities Requirements
Consistent with existing requirements of the NSIP, the Contractor and its service providers may use NSIP
cash to purchase foods of U.S. origin for their nutrition projects under Title Ill of the OAA. NSIP funds
must be used to expand meal services to older adults.
B. Use of Subcontractors
If this contract involves the use of a subcontractor or third party, then the Contractor shall not delay the
implementation of its agreement with the Subcontractor. If any circumstance occurs that may result in a delay for a
period of sixty (60) days or more of the initiation of the subcontract or the performance of the Subcontractor, the
Contractor shall notify the Area Agency Contract Manager and/or the Agency's Chief Financial Officer in writing
of such delay. The Contractor shall not permit a Subcontractor to perform services related to this contract without
having a binding Subcontractor agreement executed. The Agency will not be responsible or liable for any
obligations or claims resulting from such action.
1. Copies of Subcontracts
The Contractor shall submit copies of all subcontracts to the Agency Contract Manager within thirty (30) days
of execution of each subcontract agreement.
2. Monitoring the Performance of Subcontractors
The Contractor shall monitor, at least once per year, each of its subcontractors, sub -recipients, vendor, and/o'
consultants paid from funds provided under this contract. The Contractor shall perform fiscal, administrative,
and programmatic monitoring to ensure contractual compliance, fiscal accountability, programmatic
performance, and compliance with applicable state and federal laws and regulations. The Contractor shall
monitor its subcontractors to ensure that the budget and scope of work are accomplished within the specified
time periods, and that all performance goals stated in this contract are achieved.
a. The Contractor shall enter all required data per the Agency's and Department's CIRTS Policy Guidelines
for clients and services into the CIRTS database. The data must be entered into the CIRTS database
before the Contractor submits their Request for Payment and Receipts and Expenditure Repots to the
Agency. The Agency shall establish time frames to ensure compliance with due dates for the Requests for
Payment and Receipts Expenditure Repots to the Agency.
b. The Contractor shall run monthly CIRTS reports and to verify that the client and service data in the
CIRTS database is accurate. This report must be submitted to the Agency with the monthly Request for
Payment and Receipts and Expenditure Report.
IT
January — December 2020
OAA 203.20
c. The Agency shall require Contractors to report on outreach activities at least semi-annually using a
uniform reporting format established by the Agency. Contractor reports must include the total number of
outreach events or activities performed as well as the following information for each event or activity:
date, location, type of event or activity, total number of participants, individual service needs identified,
and referral sources or information provided to participants.
C. Staffing Requirements
1. Staffing Levels
The Contractor shall assign its own administrative and support staff as needed to perform the tasks,
responsibilities, and duties under this contract and ensure that subcontractors dedicate adequate staff
accordingly.
2. Professional Qualifications
The Contractor shall ensure that the staff responsible for performing any duties or functions within this contract
have the qualifications specified in the DOEA Programs and Services Handbook.
3. Service Times
The Contractor shall ensure the availability of services listed in this contract at tires appropriate to meet client
service needs, including, at a rininmun, during normal business hours. Normal business hours are defined as
Monday through Friday, 8:00 a.m. to 5:00 p.m. local time.
D. Deliverables
The following section provides the specific quantifiable units of deliverables and the source documentation required
to evidence the completion of tine tasks specified in this contract. The Contractor must submit all required
documentation in the time and manner specified for the minimum performance levels to be met. Each deliverable
must be accepted in writing by the Agency Contract Manager based on the requirements for each deliverable
before the Contractor submits an invoice requesting payment.
1. Delivery of Services to Eligible Clients
The Contractor shall ensue the provision of a continuum of services that nneets tine diverse needs of elders and
their caregivers. Documentation of service delivery must include a report consisting of the following: number
of clients served, number of service units provided by service, and rate per service unit with calculations that
equal the total invoice amount. The Contractor shall ensure the performance and reporting of the following
types of services, in accordance with the Agency's current Area Plan, the current DOEA Programs and
Services Handbook, and Section Ii.A. Disclaimer: Services that full under these categories may or may not
he contracted with each lend agency. For contracted services for each lead agency, please see the
BI/DGET and RATE Sm iatary ATTACHMENT.
a. Supportive Services (III11 Program)
Supportive services include a variety of community-based and home -delivered services that support older
individuals' quality of life by helping them remain independent and productive. Services include the
following:
`%
January – December 2020
OAA 203.20
i.
Adult Day Care/Adult Day Health Care;
xviii.
Material Aid;
ii.
Caregiver Training/Support;
six.
Occupational Therapy;
iii.
Case Aid/Case Management;
XX.
Outreach;
iv.
Chore and Chore (Enhanced);
xxi.
Personal Care;
V.
Companionship;
xxii.
Physical Therapy;
Vi.
Counseling (Gerontological and Mental
xxiii.
Recreation;
Health/Screening);
xxiv.
Referral/Assistance;
vii.
Education/Training;
xxv.
Respite Services (In -Home and Facility Based);
viii.
Emergency Alert Response;
xxvi.
Screening/Assessment;
ix.
Escort;
xxvii.
Shopping Assistance;
X.
Health Support;
xxviii.
Skilled Nursing;
A.
Home Health Aid;
xxix.
Specialized Medical Equipment, Services, and
xii.
Homemaker;
Supplies;
xiii.
Housing Improvement;
xxs.
Speech Therapy;
xiv.
Information;
xxxi.
Telephone Reassurance; and
xv.
Intake;
xxxii.
Transportation.
xvi.
Interpreter/Translating;
xvii.
Legal Assistance;
b. Congregate Nutrition Services (IIICI Program)
Nutrition services are provided in congregate settings and are designed to reduce hunger and food insecurity
and to promote socialization and the health and well-being of older individuals through access to nutrition
and other disease prevention and health promotion services. Services include the following:
i. Congregate meals;
ii. Congregate meals screening;
iii. Nutrition education and nutrition counseling; and
iv. Outreach.
c. Home Delivered Nutrition Services (IIIC2 Program)
hn-home nutrition services are provided to reduce hunger and food insecurity; promote socialization and
the health and well-being of older individuals by assisting such individuals to gain access to nutrition and
other disease prevention and health promotion services. Services include the following:
I. Home delivered meals;
ii. Nutrition education and counseling;
iii. Outreach; and
iv. Screening/Assessment.
d. Disease Prevention and Health Promotion Services (Title IIID Program)—AAA administers
Evidence -Based Disease Prevention and Health Promotion (EBDPHP) services have been demonstrated
through evaluation to be effective for improving health and wellbeing or reducing disease, disability, and/or
injury among older adults. The ACL defines EBDPHP services as meeting highest -level criteria. Only
services that meet the highest -level criteria are allowable under the IIID Program. EBDPHP services must
be delivered per the requirements of the program and ensure program fidelity. EBDPHP services include
the following:
i. A Matter of Balance; iv. Arthritis Foundation Tai Chi Program (Tai
ii. Active Living Every Day; Chi for Arthritis);
iii. Arthritis Foundation Exercise Program; V. Arthritis Self -Management Program;
23
January — December 2020 OAA 203.20
vi.
Brief Intervention & Treatment
XX.
Physical Fitness;
financial literacy, and to assist them with decision-making and problem -solving related to their caregiving
for Elders (BRITE);
xxi.
Powerful Tools for Caregivers;
vii.
Chronic Disease Self-
xxii.
Program to Encourage Active
Powerful Tools for Caregivers;
Management Program;
Referral/Assistance;
Rewarding Lives for Seniors
viii.
Chronic Pain Self-
Screening/Assessment; and
(PEARLS);
Transportation.
Management Program;
xxiii.
Programa de Manejo Personal de la
ix.
Diabetes Empowerment
Artritis;
Education Program (DEEP);
xxiv.
Programa de Manejo Personal de la
X.
Diabetes Self -Management Program;
Diabetes;
xi.
Disease Information;
xxv.
Stepping On;
xii.
Enhance Fitness;
xxvi.
Stay Active and Independent for Life
xiii.
Enhance Wellness;
(SAIL);
xiv.
Fit and Strong!;xxvii.
"
Tai Chi/Tai Ji Quan Moving for Better
Balance (F lighest-Level);
xv.
Healthy Eating Every Day;
xxviii.
Tomando Control de so Salud;
xvi.
Healthy Ideas;
xxii,
Un Asunto de Equilibrio; and
xvii.
Healthy Moves for Aging Well;
sxs.
Walk with Ease.
xviii.
Home Injury Control;
xix.
HomeMeds;
e. Caregiver Support Services (IIIE Program)
The following services are intended to provide direct aid to
caregivers in the areas of health, nutrition, and
financial literacy, and to assist them with decision-making and problem -solving related to their caregiving
roles and responsibilities, Services include the following:
I. Adult Day Care/Adult Day Health
Care; viii.
Outreach;
ii. Caregiver Training/Support; ix.
Powerful Tools for Caregivers;
iii. Counseling (Gerontological and X.
Referral/Assistance;
Mental Health/Screening); xi.
Respite Services (In -Home and Facility Based);
iv. Education/Training; xii.
Screening/Assessment; and
V. Financial Risk Reduction
x�°.
Transportation.
(Assessment and Maintenance);
vi. Information;
vii. Intake;
PZI!
January — December 2020 OAA 203.20
(1) Caregiver Support Supplemental Services (IIIES Program)
At least ten percent (10%), but no more than twenty percent (20%), of the total Title IIIE funds
shall be used to provide supplemental support services. The following services are provided to
complement the care provided by caregivers. Services include the following:
(a) Chore and Chore (Enhanced);
(b) Housing Improvement;
(c) Legal Assistance;
(d) Material Aid; and
(e) Specialized Medical Equipment, Services and Supplies.
(2) Caregiver Support Grandparent Services (IIIEG Program)
At least five percent (5%), but no more than ten percent (10%), of the total Title 111E funds shall be
used to provide support services to grandparents and older individuals who are relative caregivers.
Services for grandparents or older individuals who are relative caregivers that are designed to help
them meet their caregiving obligations include the following. Services include the following:
(a) Caregiver Training/Support;
(b) Child Day Care;
(c) Counseling (Gerontological and Mental Health/Screening);
(d) Education/Training;
(e) Legal Assistance;
(f) Outreach;
(g) Referral/Assistance;
(h) Screening/Assessment;
(i) Sitter; and
(j) Transportation.
f. Provision of Services
The Agency and/or Contractor shall ensure the provision of the services described in this contract are in
accordance with the current DOEA Programs and Services Handbook, the Agency's Department -
approved Area Plan, and the tasks described in Section II.A.
g. Complaint Procedures
The Agency and/or Contractor shall develop and implement complaint procedures and ensure that
subcontractors develop and implement complaint procedures to process and resolve client dissatisfaction
with services. Complaint procedures shall address the quality and timeliness of services, provider and
direct service worker complaints, and all other issues except the termination, suspension, or reduction of
services, which shall be addressed through the grievance process as described in Appendix D of the
DOEA Programs and Services Handbook. Complaint procedures shall include notification to all clients
of the complaint procedure and include tracking the date, nature, and disposition of each complaint.
E. Reports
The Contractor shall respond to additional, routine, or special requests for information and reports required by the
Agency in a timely manner as determined by the Agency Contract Manager. The Contractor shall establish
reporting deadlines and due dates for subcontractors that permit the Contractor to review and validate the data and
meet the Agency's reporting requirements.
25
January — December 2020
2. OAA Annual Volunteer Activity Repot
OAA 203.20
The Contractor shall submit an OAA Annual Volunteer Activity Repot electronically, to Area Agency
Programs Department at the following email address: Programs a a a a s w f l . o r g, per the report
specifications provided in Attachment XVI. The Annual Volunteer Activity Report must be completed and
submitted to the Agency by January 10, 2020. The form is Attachment XVII.
3. CIRTS Repots
a. Contractor shall input OAA -specific and NSIP-specific data into CIRTS. To ensure CIRTS data accuracy,
the Contractor shall use CIRTS-generated reports which include the following:
i. Client Reports;
ii. Monitoring Reports;
iii. Services Reports;
iv. Miscellaneous Reports;
v. Fiscal Repots; and
vi. Outcome Measurement Repots.
b. CIRTS Data Entries for Contractors
The Agency must require Contractors to enter all required data for clients and services in the CIRTS
database per the DOEA Programs and Services Handbook and the CIRTS User Manual — Aging Provider
Network users (located in Documents on the CIRTS Enterprise Application Services). Contractors must
enter this data into the CIRTS database prior to submitting their Requests for Payment and Receipts and
Expenditure Reports to the Agency. The Agency shall establish deadlines for completing CIRTS data entry
to ensure compliance with due dates for the Requests for Payment and Receipts and Expenditure Reports
that Contractor must submit to the Agency.
c. Contractor must run monthly CIRTS reports and verify that client and service data in the CIRTS database
is accurate. This report must be submitted to the Agency with the monthly Request for Payment and
Receipts and Expenditure Reports. The Agency will review and approve the Contractor's Request for
Payment and Receipts and Expenditure Reports.
4. Annual Service Cost Repots
The Agency shall require Contractors to annually submit to the Agency service cost reports, which reflect actual
costs of providing each service. This Annual Service Cost Report will be due by February 25, of each year. The
report will include actual costs for performing all services during the preceding calendar year. Supporting
documentation must accompany the report, which will include General Ledger, Trial Balance and/or Statement
of Revenue and Expenditures along with a narrative explanation and justification of rate differences.
Any multi-year contracts entered into with service providers on or after the effective date of this contract shall
contain a provision requiring the contract's parties to re-evaluate the contract's reimbursement rates on an
annual basis. The Contractor may annually renegotiate rates based on factors including but not limited to a
review of sustainability, the respective consumer price index, or current market conditions. However, it is the
intent of the Department and/or Agency that the quality of services provided to current program recipients not
be reduced. Unit Cost Methodology worksheets, along with supporting documentation and narrative
explanation, must be submitted by August I of each year, if a rate increase is being requested.
5. Surplus/Deficit Report
The Contractor shall submit a Consolidated Surplus/Deficit Report, Lead Spending Report, in a format
provided by the Agency, to the Agency's Contract Manager by the 18th of each month. This Consolidated
Surplus/Deficit Repot is for all agreements and/o' contracts between the Contractor and the Agency and must
include the following:
M
January — December 2020 OAA 203.20
a. A list of all Subcontractors and their status regarding surplus/deficit;
b. The Contractor's detailed plan on how the surplus/deficit spending which exceeds the threshold specified
by the Agency will be resolved;
c. Recommendations to transfer funds to resolve surplus/deficit spending;
d. Input from the Contractor's Board of Directors on resolution of spending issues, ifapplicable;
e. Number of clients currently on APCL that receive a priority ranking score of four (4) or five (5); and
E Number of clients currently on the APCL designated as Imminent Risk.
6. OAA National Aging Program Information System (NAPIS) Report
Data required for the OAA NAPIS Report that is not recorded in CIRTS will be provided to the Agency
Contract Manager in the format and on the date established by the Agency.
7. Program Highlight Narratives
The Contractor shall submit brief written narratives to the Agency for publication in the Program Highlight
sections of the Agency's Summary of Programs and Services, which is hereby incorporated by reference, to
include any subsequent revisions thereof. The narratives shall reference specific events that have occurred
since the last submission of Program Highlight narratives, including new success stories, quotes, testimonials,
or human -interest vignettes. The narratives shall be written for a general audience, with no acronyms or
technical terms. For all agencies or organizations that are referenced in the narratives, the Contractor shall
provide a brief description of their mission or role. The active tense shall be consistently used in the narratives
to identify the specific individuals or entities that performed the activities described in the narratives. The
Contractor shall review and edit narratives for clarity, readability, relevance, specificity, human interest, and
grammar prior to submitting them to the Agency.
S. Congregate Meal Site and Food Service Vendor Verification Report
The Agency shall conduct monthly reviews of the PSA's congregate meal site information to verify the
accuracy of the information of file. Congregate meal site information includes, but may not be limited to, the
address of the meal site, meal service time, name of caterer/vendor, and days of meal service. Any changes to
congregate meal site information must be submitted to the Agency Contract Manager. Any changes to this
information that the Contractor is made aware of prior to the Conti -actor's monthly repot submission shall be
coinmmnicated to the Agency Contract Manager within 48 hours of the change (or in advance as appropriate).
F. Records and Documentation
1. The Contractor agrees to make available to Agency staff and any party designated by the Agency all contract
related records and documentation. The Contractor shall ensure the collection and maintenance of all program
related information and documentation on any system designated by the Agency. Maintenance includes valid
exports and backups of all data and systems according to Agency standards. Data must be usable and must be
maintained in a format that is readable to the Agency.
2. CIRTS Data and Maintenance
The Contractor shall ensure monthly collection and maintenance of client and service information in CIRTS or
any other system designated by the Agency. Maintenance includes ensuring that all data is accurate and
current and performing valid exports and backups of all data and systems according to Agency standards.
3. Policies and Procedures for Records and Documentation
The Contractor shall maintain written policies and procedures for computer system backup and recovery and
shall have the same requirement of its subcontractors. These policies and procedures shall be made available to
the Agency upon request.
27
January — December 2020
4. CIRTS Address Validation
OAA 203.20
The Contractor shall work with the Agency to ensure that client addresses are correct in CIRTS for disaster
preparedness efforts. At least annually, and more fiequently as needed, the Agency will provide direction on
how to validate CIRTS addresses to ensure they can be mapped. The Contractor will receive a list of
unmatched addresses that cannot be mapped, and the Contractor will be responsible for working with the local
service providers to correct addresses and send a list to the Agency with confirmed addresses. The Agency
will use this information to update maps, client rosters, and unmatched addresses and disseminate this
information to the local service providers.
G. Performance Specifications
I. Outcomes and Outputs (Performance Measures)
At a minimum, the Contractor shall:
a. Ensure the provision of the services described in this contract are in accordance with the DOEA Programs
and Services Handbook, the current Agency's Department -approved Area Plan, and Section II.A.
b. Timely and accurately submit to the Agency all documentation and reports described in Attachment 1,
Section II.E.
c. Timely and accurately, per Attachment X, submit to the Agency Attachments XI -Exhibits 1-5 (whichever
reports pertain to the Contractor's specific contract).
d. Develop and document strategies to support the Agency's Area Plan to support the Agency's standard of
performance achievement, including increases in the following:
i. Percentage of most frail elders who remain at hone or in the community instead of going into a nursing
home;
it. Percentage ofAPS referrals who need immediate services to prevent further harm who are served within
seventy-two (72) hours;
iii. Percentage of active clients eating two or more meals per day;
iv. Percentage of new service recipients whose ADL assessment score has been maintained or improved;
v. Percentage of new service recipients whose IADL assessment score has been maintained orimproved;
vi. Percentage of caregivers who, after service intervention, self -repot being very confident about their
ability to continue to provide care; and
vii. Percentage of customers who are at imminent risk of nursing home placement who are served with
conmunity-based services.
2. The Contractor's performance of the measures in G1, above, will be reviewed and documented in the
Agency's Annual Programmatic Monitoring Reports.
3. Monitoring and Evaluation Methodology
The Agency will review and evaluate the performance of the Contractor under the terms of this contract.
Monitoring shall be conducted through direct contact with tine Contractor via telephone, in writing, or an on-
site visit. The primary, secondary, or signatory of the contract must be available for any on-site programmatic
monitoring visit. The Agency reserves the right to conduct an on-site visit unannounced by persons duly
authorized by the Agency. The Agency's determination of acceptable performance shall be conclusive. The
Contractor agrees to cooperate with the Agency in monitoring the progress of completion of the service tasks
and deliverables. The Agency may use, but is not limited to, one or more of the following methods for
monitoring:
a. Desk reviews and analytical reviews;
b. Scheduled, unscheduled, and follow-up on-site visits;
28
January — December 2020
c. Client visits;
d. Review of independent auditor's reports;
e. Review of third -party documents and/or evaluation;
L Review of progress reports;
g. Review of customer satisfaction surveys;
It. Agreed-upon procedures review by an external auditor or consultant;
i. Limited -scope reviews; and
j. Other procedures as deemed necessary by the Agency.
4. Performance Definitions
OAA 203.20
"Work day" shall mean a provider's staff member's eight (8) hour work period, unless specifically noted
otherwise. "Day" shall mean a calendar day, unless specifically noted otherwise.
H. Contractor Responsibilities
1. Contractor Unique Activities
All tasks listed above in Section 11. are solely and exclusively the responsibility of the Contractor and are tasks
for which, by execution of this contract, the Contractor agrees to be held accountable.
2. Coordination with Other Providers and/o• Entities
Notwithstanding that services for which the Contractor is held accountable involve coordination with other
entities in performing the requirements of this contract, the failure of other providers or entities does not
alleviate the Contractor from any accountability for tasks or services that the Contractor is obligated to perform
pursuant to this contract.
I. Agency Responsibilities
1. Agency Obligations
The Agency may, within its resources, provide technical support and/o' assistance to the Contractor to
assist the Contractor in meeting the requirements of this contract. The Agency's support and assistance, or
lack thereof, shall not relieve the Contractor from full performance of contract requirements.
2. Agency Determinations
The Agency reserves the exclusive right to make certain determinations in the tasks performed by the
Contractor and the approaches used by the Contractor to perform those tasks. The absence of the Agency
setting forth a specific reservation of rights does not mean that all other areas of the contract are subject to
mutual agreement.
III. METHOD OF PAYMENT
A. Payment Method Used
The method of payment for this contract is a combination of Fixed-Fee/Unit Rate, Cost Reimbursement, and
Advance Payments subject to the availability of funds and Contractor performance. The Agency will pay the
Contractor upon satisfactory completion of the Tasks/Deliverables, as specified in the attachment regarding the
budget and rate summary and in accordance with all other terms and conditions of this contract.
B. Unit of Service
1. Fixed Fee/Unit Rate
Contractor must meet the minimunh level of performance stated in the contract to receive payment. Payments
for Fixed Fee/Unit Rates shall not exceed amounts established in Attachment IX.
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January — December 2020
2. Fixed Rates for NSIP Program
OAA 203.20
Payments for NSIP Fixed rate shall not exceed the unit rate of service identified below:
Service to be Provided
Unit of Service
Unit Rate
Eligible Congregate and Home Delivered Meals
I unit = 1 meal
$.72
IService to be Provided
Unit of Service
Unit Rate
Maximum Units
Allocation
Eligible Congregate and
1 unit = 1 meal
$.72
64,912
$46,737.03
Flome Delivered Meals
3. Cost Reimbursement
Payment shall only be authorized for allowable expenditures, per the limits specified in the Budget Summary
(Attachment IX). All cost reimbursement Requests for Payment must include the actual Receipts and
Expenditure Reports, beginning with the first month of the contact. The Contractor must meet the minimum
level of performance stated in the contract to receive payment.
The Contractor agrees to distribute funds as detailed in the Agency's Area Plan Update and the Budget
Summary (Attachment IX). Any change in the total amounts of the funds identified on the Budget Summary
form requires a contract amendment.
C. Advance Payments
The Contractor may request up to two (2) months of advances at the start of the contract period to cover program
administration, outreach, and service costs. The payment of an advance will be contingent upon the sufficiency and
amount of funds released to the Agency by the State of Florida (budget release). The Contractor's requests for
advance payments require the written approval of the Agency's Contract Manager. For the first month's advance
request, the Contractor shall provide the Agency's Contract Manager documentation justifying the need for an
advance and describing how the fiords will be distributed. If the Contractor is requesting two (2) months of
advances, documentation must be provided reflecting the cash needs of the Contractor within the initial two (2)
months and should be supported through a cash-flow analysis or other information appropriate to demonstrate the
Contractor's financial need for the second month of advances. If sufficient budget is available, and the Agency's
Contract Manager, in his or her sole discretion, has determined that there is ajustifred need for an advance, the
Agency will issue approved advance payments after January Ist of the contract year. Advance payments will not
be issued forNSIP.
1. Any advance payments the Contractor requests for subcontractors must be distributed within seven (7) days of
receipt of payment from the Agency. The Contractor shall submit to the Agency documentation to support full
distribution of advanced fiords with Request for Payment, report number 5, due to the Agency
on April 09, 2020, in accordance with Invoice Schedule (Attachment X).
2. All advance payments retained by the Contractor must be fully expended no later than March 31, 2020. Any
portion of advanced payments not expended must be recouped on the Request for Payment, report number 5,
due to the Agency on April 09, 2020, in accordance with the Invoice Schedule (Attachment X).
3. All advance payments made to the Contractor shall be reimbursed to the Agency as follows: one—tenth of the
advance payment received shall be reported as an advance recoupment on each Request for Payment, starting
with report number 5, in accordance with the Invoice Schedule (Attachment X).
4. Interest earned on advances must be identified separately by source of funds (state or federal). Contractors shall
maintain advanced payments of federal funds in FDIC interest bearing accounts unless an exception is made in
accordance with 45 CFR § 75.305. Earned interest must be returned to the Agency at the end of each quarter of
the contract period.
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January — December 2020
D. Invoice Instructions
OAA 203.20
Payment shall be made upon the Contractor's presentation of an invoice subsequent to the acceptance by the
Agency of the deliverables shown on the invoice. The form and substance of each invoice submitted by the
Contractor shall be as follows:
1. The invoice shall include a "Remit to" address that corresponds exactly to the remittance address identified in
the MyFloridaMarketPlace (MFMP) registration.
2. The monthly invoice shall include the units of services established in the Agency's Department -approved
Area Plan, per the requirements in the DOEA Programs and Services Handbook, at the rates established in
Attachment IX, Service Rate Report. Documentation of service delivery shall include a report consisting of
the following: number of clients served, number of service units provided by service, and rate per service unit,
with calculations that equal the total invoice amount. Any change to the Agency's Department -approved
budget after the execution of this contract shall require approval from the Agency's Contract Manager prior to
being made. Any change to the total contract amount requires a contract amendment.
3. The Contractor shall consolidate requests for payment f4om subcontractors and receipts and expenditure reports
that support the requests for payment and shall submit to the Agency Requests for Payment (Attachment Xl),
and Receipt and Expenditure Reports (Attachment XII -Exhibits 1-5 according to Contractor's contract).
4. The Contractor shall include with the Fixed Fee/Unit Rate portion of its invoice the units of services provided
based on rates established in Attachment IX, number of clients, and the rates for the services provided per the
requirements described in the deliverables and service tasks. The Contractor shall clearly state the provider
name, the report month, and the invoice number on the invoice.
5. All Requests for Payment shall be based on the submission of actual monthly Receipts and Expenditure Reports
beginning with the first month of the contract. The schedule for submission of advanced payment requests
(when available) and invoices can be found in the Invoice Schedule (Attachment X).
6. Final contract invoices must be submitted to the Agency no later than February 15, 2021.
E. Payment Withholding
Any payment due by the Agency under the terms of this contract may be withheld pending receipt and approval by
the Agency of all financial and programmatic reports due from the Contractor and any adjustments thereto,
including any disallowance not resolved.
F. Corrective Action Plan
1. Contractor shall ensure 100% of the deliverables identified in Section II.D. are performed pursuant to contract
requirements.
2. If at any time the Contractor is notified by the Agency Contract Manager that it has failed to correctly,
completely, or adequately perform contract deliverables identified in Section ILD., the Contractor will have ten
(10) days to submit a Corrective Action Plan (CAP) to the Agency Contract Manager that addresses the
deficiencies and states how the deficiencies will be remedied within a time period approved by the Agency
Contract Manager. The Agency shall assess a financial consequence for non-compliance on the Contractor as
referenced in Section III.G, for each deficiency identified in the CAP which is not corrected pursuant to the
CAP. The Agency will also assess a financial consequence for failure to timely submit a CAP to the Agency.
3. If the Contractor fails to correct an identified deficiency within the Agency -approved period specified in the
CAP, the Agency shall deduct the percentage established in Section IILG. from the payment for the invoice of
the following month.
4. If the Contractor fails to timely submit a CAP to the Agency, the Agency shall deduct the percentage
established in Section IILG. for each day the CAP is overdue. The deduction will be made fi•om tine payment
for the invoice of the following month.
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January — December 2020
G. Financial Consequences
OAA 203.20
The Agency will withhold or reduce payment if the Contractor fails to perform the deliverables to the satisfaction
of the Agency according to the requirements referenced in Section ILD. The following financial consequences
will be imposed if the deliverables stated do not meet in part or in whole the performance criteria as outlined in
Section II.D.:
1. Delivery of services to eligible clients as referenced in Section ILA.2. and Section II.D. L of this contract —
Failure to comply with established assessment and prioritization criteria, as evidenced by CIRTS reports, will
result in a 2% reduction of payment per business day. The reduction of payment will begin on the first business
day following the Agency's notification to the Contractor that the identified deficiency was not cured or
satisfactorily addressed in accordance with the Agency -approved CAP.
2. Services and units of services as referenced in Section II.D.2. of this contract — Failure to provide services in
accordance with the current DOEA Programs and Services Handbook, the service tasks described in Section
II.A., and Attachment IX, or failure to submit required documentation will result in a 2% reduction of payment
per business day. The reduction of payment will begin the first business day following the Agency's
notification to the Contractor that the identified deficiency is not cured or satisfactorily addressed in accordance
with the Agency -approved CAP.
3. Administrative duties as referenced in Section II.D.3. of this contract — Failure to perform management and
oversight of program operations will result in a 2% reduction of payment per business day. The reduction of
payment will begin the first business day following the Agency's notification to the Contractor that the
identified deficiency was not cured or satisfactorily addressed in accordance with the Agency approved CAP.
4. Timely submission of a CAP — Failure to timely submit a CAP within ten (10) business days afternotification
of a deficiency by the Agency Contract Manager will result in a 2% reduction of payment per business day
the CAP is not received. The reduction of payment will begin with the subsequent invoice received from the
Contractor and shall be prorated for each day the CAP was late following the due date specified by the
Agency and shall remain in effect until the contractor complies with the submission requirement.
5. Exceptions may be granted solely, in writing, by the Agency Contract Manager.
IV. SPECIAL PROVISIONS
A. Final Budget and Funding Revision Requests
Final requests for budget revisions or adjustments to contract funds based on expenditures for provided services
must be submitted to the Agency Contract Manager in writing no later than December 31, 2020; email requests
are considered acceptable.
B. Contractor's Financial Obligations
1. Matching, Level of Effort, and Earmarking Requirements
The Contractor will assure, through a provision in subcontracts, a match requirement of at least ten percent
(10%) of the cost for services funded through this contract. The Contractor's and/or subcontractor's match
will be made in the form of cash and/or in-kind resources. The Contractor shall report match funds by title
each month. At the end of the contract period, the Contractor must properly match OAA funds that require a
match.
2. Consumer Contributions
Consumer contributions are to be used under the following terms:
a. The Contractor assures compliance with Section 315 of the OAA, as amended in 2016, regarding consumer
contributions;
b. Voluntary contributions are not to be used for cost sharing or matching;
c. Voluntary contributions are to be used only to expand services; and
d. Accumulated voluntary contributions are to be used prior to requesting federal reimbursement.
32
January — December 2020 OAA 203.20
3. Use of Service Dollars and Management of the Assessed Priority Consumer List
The Contractor is expected to spend all federal, state, and other funds provided by the Agency for the purpose
specified in this contract. For each program managed by the Contractor, the Contractor most manage the
service dollars in such a manner as to avoid having a wait list and a surplus of fiords at the end of the contract
period. If the Agency determines that the Contractor is not spending service funds accordingly, the Agency
may transfer funds to other Lead Agencies during the contract period and/or adjust subsequent finding
allocations as allowable under state and federal law.
4. Title III Funds
The Contractor assures compliance with Section 306 of the OAA, as amended in 2016, and will not use funds
received under Title IIi to pay any pail of a cost (including an administrative cost) incurred by the Contractor
to maintain a contractual or commercial relationship that is not carried out to implement Title III.
C. Remedies for Nonconforming Services
1. The Contractor shall ensure that all goods and/or services provided under this contract are delivered timely,
completely, and commensurate with required standards of quality. Such goods and/or services will only be
delivered to eligible program participants.
2. Ifthe Contractor fails to meet the prescribed quality standards for services, such services will not be reimbursed
under this contract. In addition, any nonconforming goods (including home delivered meals) and/or services
not meeting such standards will not be reimbursed under this contract. The Contractor's signature on the
Request for Payment Form certifies maintenance of supporting documentation and acknowledgement that the
Contractor shall solely bear the costs associated with preparing or providing nonconforming goods and/or
services. The Agency requires immediate notice of any significant and/or systemic infractions that
compromise the quality, security, or continuity of services to clients.
D. Incident Reporting
The Contractor shall notify the Agency immediately but no later than forty-eight (48) hours from the Contractors
awareness or discovery of changes that may materially affect the Contractor or any subcontractor's ability to
perform the services required to be performed under this contract. Such notice shall be made orally to the Agency
Contract Manager (by telephone) with an email to immediately follow, including the Contractor's plan for
provision of services required by contract. This plan must detail the Contractor's anticipated plan for ensuring a
continuity in services for each client impacted by and for the duration of the incident. Following submission of the
plan, the Contractor's is expected to provide the Agency updates in a frequency determined by the Agency as
appropriate until the incident is resolved.
E. Volunteers
The Contractor shall ensure the use of trained volunteers in providing direct care services delivered to older
individuals and those individuals with disabilities needing such services. If possible, the Contractor shall work in
coordination with organizations that have experience in providing training, placement, and stipends for volunteers
or participants (such as the Senior Community Service Employment Program or organizations carrying out federal
service programs administered by the Corporation for National and Community Service).
F. Enforcement
In accordance with Section 430.04, F.S., the Agency/and or Department shall rescind designation of a lead
agency or take intermediate measures against the Contractor, including corrective action, unannounced
special monitoring, temporary assumption of operation of one or more programs by the Agency, placement on
probationary status, imposing a moratorium on Contractor action, imposing financial penalties for
nonperformance, or other administrative action pursuant to Chapter 120, F.S., if the Agency and/o•
Department finds that any of the following have occurred:
a. An intentional or negligent act of the Contractor has materially affected the health, welfare, or safety of
clients, or substantially and negatively affected the operation of an aging services program.
33
January — December 2020
OAA 203.20
b. The Contractor lacks financial stability sufficient to meet contractual obligations or that contractual funds
have been misappropriated.
c. The Contractor has committed multiple or repeated violations of legal and regulatory requirements or
Agency and/or Department standards.
d. The Contractor has failed to continue the provision or expansion of services after the declaration of a state
of emergency.
e. The Contractor has exceeded its authority or otherwise failed to adhere to the terms of this contract with
the Agency and/or Department or has exceeded its authority or otherwise failed to adhere to the
provisions specifically provided by statute or rule adopted by the Agency.
f. The Contractor has failed to properly determine client eligibility as defined by the Agency or efficiently
manage program budgets.
g. The Contractor has failed to implement and maintain an Agency -approved client grievance resolution
procedure.
2. In making any determination under this provision the Agency may rely upon findings of another state or
federal agency, or other regulatory body. Any claims for damages for breach of contract are exempt 5tom
administrative proceedings and shall be brought before the appropriate entity in the venue of Lee County,
Florida. In the event the Agency initiates action to rescind a lead agemcu designation, the Agency shall follow
the procedures set forth in 42 U.S.C. § 3025(b).
G. Investigation of Criminal Allegations
Any report that implies criminal intent on the part of the Contractor or any subcontractor and referred to a
governmental or investigatory agency must be sent to the Agency. If the Contractor has reason to believe that the
allegations will be referred to the State Attorney, a law enforcement agency, the United States Attorney's office, or
governmental agency, the Contractor shall notify the Area Agency and/o' Inspector General at the Department
immediately. A copy of all documents, repots, notes, or other written material concerning the investigation,
whether in the possession of the Contractor or subcontractor, must be sent to the Area Agency's and/or
Department's Inspector General with a summary of the investigation and allegations.
REMAINDER OF PAGE INTENTIONALL P LEFT BLANK
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January — December 2020
ATTACHMENT II
FINANCIAL AND COMPLIANCE AUDIT
OAA 203.20
The administration of resources awarded by the Agency to the Contractor may be subject to audits and/or monitoring by
the Area Agency on Aging for Southwest Florida, Inc., as described in this section.
MONITORING
In addition to reviews of audits conducted in accordance with 2 CFR Part 200 (formerly OMB Circular A-133 as revised),
and Section 215.97, F.S., (see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits
by the Agency staff, limited scope audits as defined by OMB Circular A-133, as revised, and/or other procedures. By
entering into this contract, the Contractor agrees to comply and cooperate with any monitoring procedures/processes deemed
appropriate by the Agency. In the event the Agency determines that a limited scope audit of the Contractor is appropriate,
the Contractor agrees to comply with any additional instructions provided by the Agency to the Contractor regarding such
audit. The Contractor further agrees to comply and cooperate with any inspections, reviews, investigations, or audits
deemed necessary by the Chief Financial Officer (CFO) or Auditor General,
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the Contractor is a State or local government or a non-profit organization as defined in 2 CFR Part
200, Subpart A.
In the event that the Contractor expends $750,000.00 or more in federal awards during its fiscal year, the Contractor most
have a single or program -specific audit conducted in accordance with the provisions of 2 CFR Part 200. Financial and
Compliance Audit Attachment, Exhibit 2 indicates federal resources awarded through the Agency by this contract. In
determining the federal awards expended in its fiscal year, the Contractor shall consider all sources of Federal awards,
including federal resources received from the Agency. The determination of amounts of Federal awards expended should
be in accordance with 2 CFR Part 200. An audit of the Contractor conducted by the Auditor General in accordance with
the provisions of 2 CFR Part 200 will meet the requirements of this part.
In connection with the audit requirements addressed in Part 1, paragraph 1, the Contractor shall fulfill the requirements
relative to auditee responsibilities as provided in 2 CFR § 200.508.
If the Contractor expends less than $750,000.00 in federal awards in its fiscal year, an audit conducted in accordance with
the provisions of 2 CFR Part 200 is not required. hi the event that the Contractor expends less than $750,000.00 in federal
awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of 2 CFR Part 200, the
cost of the audit must be paid from non-federal resources (i.e., the cost of such audit most be paid from Contractor
resources obtained from other than federal entities.)
An audit conducted in accordance with this pail shall cover the entire organization for the organization's fiscal year.
Compliance findings related to contracts with the Agency shall be based on the contract's requirements, including any
rules, regulations, or statutes referenced in the contract. The financial statements shall disclose whether or not the matching
requirement was met for each applicable contract. All questioned costs and liabilities due to the Agency shall be fully
disclosed in the audit report with reference to the Area Agency on Aging for Southwest Florida, Inc. contract involved. If
not otherwise disclosed as required by 2 CFR § 200.510 the schedule of expenditures of federal awards shall identify
expenditures by contract number for each contract with the Agency in effect during the audit period. Financial reporting
packages required under this pail Must be submitted within the earlier of 30 days after receipt of the audit report or 9
Months after the end of the Contractor's fiscal year end.
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January — December 2020
PART II: STATE FUNDED
OAA 203.20
This part is applicable if the Contractor is a non -state entity as defined by Section 215.97(2), F.S.
hi the event that the Contractor expends a total amount of state financial assistance equal to or in excess of $750,000.00 in
any fiscal year of such Contractor, the Contractor must have a State single or project -specific audit for such fiscal year in
accordance with Section 215.97, F.S.; applicable rules of the Department of Financial Services; and Chapter 10.550 (local
governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General. Financial
Compliance Audit Attachment, Exhibit 2 indicates state financial assistance awarded through the Agency by this contract.
In determining the state financial assistance expended in its fiscal year, the Contractor shall consider all sources of state
financial assistance, including state financial assistance received from the Agency, other state agencies, and other non -
state entities. State financial assistance does not include Federal direct or pass-through awards and resources received by a
non -state entity for Federal program matching requirements.
In connection with the audit requirements addressed in Part 11, paragraph 1, the Contractor shall ensure that the audit
complies with the requirements of Section 215.97(8), F.S. This includes submission of a financial reporting package as
defined by Section 215.97(2), F.S., and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit
organizations), Rules of the Auditor General.
If the Contractor expends less than $750,000.00 in state financial assistance in its fiscal year, an audit conducted in
accordance with file provisions of Section 21597, F.S., is not required. In the event that the Contractor expends less than
$750,000.00 in state financial assistance in its fiscal year and elects to have an audit conducted in accordance with the
provisions of Section 215.97, F.S., the cost of the audit must be paid from the non -state entity's resources (i.e., the cost of
such an audit must be paid from the Contractor resources obtained from other than State entities).
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to contracts with the Agency shall be based on the contract's requirements, including any
applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching requirement
was met for each applicable contract. All questioned costs and liabilities due to the Agency shall be fully disclosed in the
audit report with reference to the Agency contract involved. If not otherwise disclosed as required by Rule 691- 5.003,
F.A.C., the schedule of expenditures of state financial assistance shall identify expenditures by contract number for each
contract with the Agency in effect during the audit period. For local governmental entities, financial reporting packages
required under this pail must be submitted within 45 days after delivery of the audit report, but no later than 12 months
after the Contractor's fiscal year end. For non-profit or for-profit organizations, financial reporting packages required
under this part must be submitted within 45 days after delivery of the audit report, but no later than 9 months after the
Contractor's fiscal year end. Notwithstanding the applicability of this portion, the Agency retains all right and obligation
to monitor and oversee the performance of this contract as outlined throughout this document and pursuant to law.
PART III: REPORT SUBMISSION
Copies of financial reporting packages for audits conducted in accordance with 2 CFR Part 200 and required by Part I of this
Financial Compliance Audit Attachment, shall be submitted, when required by 2 CFR § 200.512 by or on behalf of the
Contractor directly to each of the following:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10"' Street
Jeffersonville, IN 47132
Pursuant to 2 CFR § 200.512, all other Federal agencies, pass-through entities and others interested in a reporting package
and data collection form must obtain it by accessing the Federal Audit Clearinghouse.
W
January — December 2020
OAA 203.20
The Contractor shall submit a copy of any management letter issued by the auditor, to the Area Agency on Aging for
Southwest Florida, Inc. at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Ken Carr, CFO
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
Additionally, copies of financial reporting packages required by this contract's Financial Compliance Audit Attachment,
Part 11, shall be submitted by or on behalf of the Contractor directly to each of the following:
The Area Agency on Aging for Southwest Florida, Inc. at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Ken Carr, CFO
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
The Auditor General's Office at the following address:
State of Florida Auditor General
Claude Pepper Building, Room 574
111 West Madison Sheet
Tallahassee, Florida 32399-1450
Any reports, management letters, or other information required to be submitted to the Agency pursuant to this contract
shall be submitted timely in accordance with 2 CFR Part 200, F.S., and Chapter 10.550 (local governmental entities) or
10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, as applicable.
Contractors, when submitting financial reporting packages to the Agency for audits done in accordance with 2 CFR Part 200
or Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor
General, should indicate the date that the reporting package was delivered to the Contractor in correspondence
accompanying the reporting package.
PART IV: RECORD RETENTION
The Contractor shall retain sufficient records demonstrating its compliance with the terms of this contract for a period of
six (6) years from the date the audit report is issued, and shall allow the Agency or its designee, the CFO, or Auditor
General access to such records upon request. The Contractor shall ensure that audit working papers are made available to
the Agency or its designee, CFO, or Auditor General upon request for a period of six (6) years from the date the audit
report is issued, unless extended in writing by the Agency.
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January — December 2020
OAA 203.20
ATTACHMENT II -EXHIBIT 1
PART I: AUDIT RELATIONSHIP DETERMINATION
Contractors who receive state or federal resources may or may not be subject to the audit requirements of 2 CFR Pant 200
and/or Section 215.97, F.S. Contractors who are determined to be recipients or sub -recipients of federal awards and/or
state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I
and/or Part Il of Exhibit I are met. Contractors who have been determined to be vendors are not subject to the audit
requirements of 2 CFR § 200.38, and/or Section 215.97, F.S. Regardless of whether the audit requirements are met,
Contractors who have been determined to be recipients or sub -recipients of Federal awards and/or state financial
assistance must comply with applicable programmatic and fiscal compliance requirements.
In accordance with 2 CFR Part 200 and/or Rule 691-5.006, F.A.C., Contractor has been determined to be:
Vendor not subject to 2 CFR § 200.38 and/or Section 215.97, F.S.
X Recipient/sub-recipient subject to 2 CFR § 200.86 and § 200.93 and/or Section 215.97, F.S.
Exempt organization not subject to 2 CFR Part 200 and/or Section 215.97, F.S. For Federal awards, for-profit
organizations are exempt; for state financial assistance projects, public universities, community colleges, district
school boards, branches of state (Florida) government, and charter schools are exempt. Exempt organizations must
comply with all compliance requirements set forth within the contract or award document.
NOTE: If a Contractor is determined to be a recipient/sub-recipient of federal and/or state financial assistance, and has
been approved by the Agency to subcontract, they must comply with Section 21597(7), F.S., and Rule 691-5.006, F.A.C.
[state financial assistance] and/or 2 CFR § 200.330[federal awards].
PART II: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Contractors who receive Federal
awards, state maintenance of effort funds, or state matching funds on Federal awards and who are determined to be a sub -
recipient must comply with the following fiscal laws, rules, and regulations:
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR § 200.416 - § 200.417 — Special Considerations for States, Local Governments and Indian Tribes*
2 CFR § 200.201 — Administrative Requirements**
2 CFR § 200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
NON-PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR § 200.400 - §200.411 — Cost Principles*
2 CFR § 200.100 — Administrative Requirements
2 CFR § 200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT)
MUST FOLLOW:
2 CFR § 200.418 — § 200.419 — Special Considerations for Institutions of Higher Education*
2 CFR § 200.100 — Administrative Requirements
2 CFR § 200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
38
January — December 2020
OAA 203.20
*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in 2 CPR
§ 200.400(5)(c).
**For funding passed through U.S. Health and Human Services, 45 CFR Part 75; for funding passed through U.S.
Department of Education, 34 CFR Part 80.
STATE FINANCIAL ASSISTANCE. Contractors who receive state financial assistance and who are determined to be a
recipient/sub-recipient must comply with the following fiscal laws, rules and regulations:
Sections 215.97 & 215.971, F.S.
Chapter 691-5, F.A.C.
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rides, and regulations
39
January — December 2020
ATTACHMENT II -EXHIBIT 2
FUNDING SUMMARY
1147:1:V4Qt0A1
Note: Title 2 CFR §20033 l,as revised,and Section 215.97(5), F.S., require thattlie information about federal programs and State Projects be
p-ovided tothe Recipient and we stated inTlieFinaricial And Compliance Audit Attachment 11, Exhibit I provided tothe recipient,
information contained herein is a predictionoffmdings3urcesand related amounts based on the contract budget.
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT
CONSIST OF THE FOLLOWING:
COLLIER COUNTY
GRANT AWARD FAIN# : 2001FLOASS, 2001 FLOACM, 2001FLOAHD, 2001FLOAPH, 2001FLOAFC
DUNS NUMBER :076997790
FEDERAL AWARD DATE: OCTOBER 01, 2019
PROGRAM TITLE
FUNDING SOURCE
CFDA
AMOUNT
Older Americans Act Title IIIB —
Transportation
$ 9,863.90
Support Services
U.S. Health and Human Services
93.044
$ 375,156.79
$ 385,020.69
Total IIIB
OAA Title IHC 1 — Congregate Meals
U.S. Health and Human Services
93.045
$ 341,322.29
Total IIICI
OAA Title III C2—Home Delivered Meals
U.S. Health and Human Services
93.045
$ 301,442.67
Total I IIC2
Older Americans Act Title III E
Services (Title III E)
$ 136,240.61
Supplement Services (Title III ES)
U.S. Health and Human Services
93.052
$ 13,951.15
Grandparent Services (Title III EG)
$ 6,000.55
Total DIE
$ 156192.31
Nutrition Services Incentive Program (NSIP)
U.S. Health and Human Services
93.053
$ 46,737.03
TOTAL FEDERAL AWARD
$1,230,714.99
40
January — December 2020
OAA 203.20
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO
THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS:
2 CFR Part 2000niform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards/
OMB Circular A-133 — Audits of States, Local Governments, and Non -Profit Organizations
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF
THE FOLLOWING.
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS
CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE
Section 215.97 & 215.971, F.S., Chapter 691-5, F.A.C., State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
41
January — December 2020
ATTACHMENT III
CERTIFICATIONS AND ASSURANCES
OAA 203.20
Agency will not award this contract unless Contractor completes this CERTIFICATIONS AND ASSURANCES. In
performance of this contract, Contractor provides the following certifications and assurances:
G. Certification Regarding Data Integrity Compliance for Contracts. Agreements. Grants. Loans. and
Cooperative Agreements
�Za4lmffri7S[fSiiDIi oi7L19iiTsnimYiimem" t
A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY
MATTERS — PRIMARY COVERED TRANSACTION.
The undersigned Contractor certifies, to the best of its knowledge and belief, that it and its principals:
1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
covered transactions by a Federal department or agency;
2. Have not within a three-year period preceding this contract been convicted or had a civil judgment rendered against
thein for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing
a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State
antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records,
making false statements, or receiving stolen property;
3. Are not presently indicated or otherwise criminally or civilly charged by a government entity (Federal, State, or
local) with commission of any of the offenses enumerated in paragraph A.2. of this certification; and/or
4. Have not within a three-year period preceding this application/proposal had one or more public transactions
(Federal, State, or local) terminated for cause of default.
The undersigned shall require that language of this certification be included in the documents for all subcontracts atall
tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all
sub -recipients and contractors shall provide this certification accordingly.
B. CERTIFICATION REGARDING LOBBYING — CERTIFICATION FOR CONTRACTS, GRANTS, LOANS,
AND COOPERATIVE AGREEMENTS.
The undersigned Contractor certifies, to the best of its knowledge and belief, that:
No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of Congress or an employee of a Member of Congress in
42
January — December 2020
OAA 203.20
connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan,
the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification
of any Federal contract, grant, loan, or cooperative agreement.
if any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of
Congress, or employee of a Member of Congress in connection with a Federal contract, grant, loan, or cooperative
agreement, the undersigned shall also complete and submit Standard Form — LLL, "Disclosure Form to Report
Lobbying," in accordance with its instructions.
The undersigned shall require that language of this certification be included in the documents for all subcontracts atall
tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all
sub -recipients and contractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this contract was made or
entered into. Submission of this certification is a prerequisite for making or entering into this contract imposed by 31
U.S.C. § 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than
$10,000 and not more than $100,000 for each such failure.
C. NON- DISCRIMINATION & EQUAL OPPORTUNITY ASSURANCE (29 CFR PART 37 AND 45 CFR PART
80). - As a condition of the Contract, Contractor assures that it will comply fully with the nondiscrimination and equal
opportunity provisions of the fol lowing laws:
1. Section 188 of the Workforce Investment Act of 1998 (WIA), (Pub. L. 105-220), which prohibits discrimination
against all individuals in the United States on the basis of race, color, religion, sex, national origin, age, disability,
political affiliation, or belief, and against beneficiaries on the basis of either citizenship/status as a lawfully admitted
immigrant authorized to work in the United States or participation in any WIA Title I -financially assisted program
or activity.
2. Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352), as amended, and all requirements imposed by or pursuant
to the Regulation of the Department of Health and Human Services (45 CFR Part 80), to the end that, in accordance
with Title VI of that Act and the Regulation, no person in the United States shall, on the ground of race, color, or
national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to
discrimination under any program or activity for which the Applicant receives Federal financial assistance from the
Agency.
3. Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112), as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CPR Part 84), to the end that, in
accordance with Section 504 of that Act and the Regulation, no otherwise qualified handicapped individual in the
United States shall, solely by reason of his handicap, be excluded from participation in, be denied the benefits of,
or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial
assistance from the Agency.
4. The Age Discrimination Act of 1975 (Pub. L. 94-135), as amended, and all requirements imposed by or pursuant
to the Regulation of the Department of Health and Human Services (45 CFR Part 91), to the end that, in accordance
with the Act and the Regulation, no person in the United States shall, on the basis of age, be denied the benefits of,
be excluded from participation in, or be subjected to discrimination tinder any program or activity for which the
Applicant receives Federal financial assistance from the Agency.
5. Title IX of the Education Amendments of 1972 (Pub. L. 92-318), as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 86), to the end that, in
accordance with Title IX and the Regulation, no person in the United States shall, on the basis of sex, be excluded
from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any education
program or activity for which the Applicant receives Federal financial assistance from the Agency.
6. The American with Disabilities Act of 1990 (Pub. L. 101-336), which prohibits discrimination in all employment
practices including job application procedures, hiring, firing, advancement, compensation, training, and other
terms, conditions, and privileges of employment. It applies to recruitment, advertising, tenure, layoff, leave, fringe
benefits, and all other employment-related activities.
43
January — December 2020
OAA 203.20
7. Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws
listed above. This assurance applies to Contractor's operation of the WIA Title I — financially assisted program or
activity, and to all contracts Contractor makes to carry out the WIA Title I — financially assisted program or activity.
Contractor understands that the Agency and/or DOEA and the United States have the right to seek judicial
enforcement of the assurance.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all
sub -recipients and contractors shall provide this assurance accordingly.
D. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES, SECTION 287.133, F.S.
Contractor hereby certifies that neither it, nor any person or affiliate of Contractor, has been convicted of a Public Entity
Crime as defined in section 287.133, F.S., nor placed on the convicted vendor list.
Contractor understands and agrees that it is required to inform Agency immediately upon any change of
circumstances regarding this status.
E. ASSOCIATION OF COMMUNITY ORGANIZATIONS FOR REFORM NOW (ACORN) FUNDING
RESTRICTIONS ASSURANCE (Pub. L. 111-117).
As a condition of the Contract, Contractor assures that it will comply fully with tine federal funding restrictions
pertaining to ACORN and its subsidiaries per the Consolidated Appropriations Act, 2010, Division E, Section 511 (Pub.
L. 111-117). The Continuing Appropriations Act, 2011, Sections 101 and 103 (Pub. L. 111-242), provides that
appropriations made under Pub. L. 111-117 are available under the conditions provided by Pub. L. 111-117.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grant's and contracts under grants, loans and cooperative agreements) and that all sub -
recipients and contractors shall provide this assurance accordingly.
F. SCRUTINIZED COMPANIES LISTS AND NO BOYCOTT OF ISRAEL CERTIFICATION, SECTION
287.135, F.S.
In accordance with section 287.135, F.S., Contractor hereby certifies that it has not been placed on the Scrutinized
Companies that Boycott Israel List and that it is not engaged in a boycott of Israel.
If this contract is in the amount of $1 million or more, in accordance with the requirements of section 287.135, F.S.,
Contractor hereby certifies that it is not listed on either the Scrutinized Companies with Activities in Sudan List or the
Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List and that it is not engaged in business
operations in Cuba or Syria.
Contractor understands that pursuant to section 287.135, F.S., the submission of a false certification may result in the
Agency terminating this contract and the submission of a false certification may subject Contractor to civil penalties and
attorney fees and costs, including any costs for investigations that led to the finding of false certification.
If Contractor is unable to certify any of the statements in this certification, Contractor shall attach an explanation to
this contract.
G. CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR CONTRACTS, AGREEMENTS,
GRANTS, LOANS, AND COOPERATIVE AGREEMENTS
1. The Contractor and any Subcontractors of services under this contract have financial management systems
capable of providingcertain information, including: (1) accurate, current, and complete disclosure of the financial
results of each grant -funded project or program in accordance with the prescribed reporting requirements; (2) the
source and application of funds for all contract supported activities; and (3) the comparison of outlays with
44
January — December 2020
14I.T.f4IlI 41;
budgeted amounts for each award. The inability to process information in accordance with these requirements
could result in a return of grant funds that have not been accounted for property.
2. Management Information Systems used by the Contractor, Subcontractors, or any outside entity on which the
Contractor is dependent for data that is to be reported, transmitted, or calculated have been assessed and verified
to be capable of processing data accurately, including year -date dependent data. For those systems identified to be
non-compliant, Contractors will take immediate action to assure data integrity.
3. If this contract includes the provision of hardware, software, firmware, microcode, or imbedded chiptechnology,
the undersigned warrants that these products are capable of processing year -date dependent data accurately. All
versions of these products offered by the Contractor (represented by the undersigned) and purchased by the state
will be verified for accuracy and integrity of data prior to transfer.
4. In the event of any decrease in functionality related to time and date related codes and internal subroutines that
impede the hardware or software programs from operating properly, the Contractor agrees to immediatelymake
required corrections to restore hardware and software programs to the same level of functionality as warranted
herein, at no charge to the state, and without interruption to the ongoing business of the state, time being of the
essence.
5. The Contractor and any Subcontractors of services under this contract warrant that their policies and procedures
include a disaster plan to provide for service delivery to continue in case of an emergency, including emergencies
arising from data integrity compliance issues.
H. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION
As a condition of contracting with the Agency, Contractor certifies the use of the U.S. Department of Homeland
Security's E -verify system to verify the employment eligibility of all new employees hired by Contractor during the
contract term to perform employment duties pursuant to this contract, and that any subcontracts include an express
requirement that Subcontractors performing work or providing services pursuant to this contract utilize the E -verify
system to verify the employment eligibility of all new employees hired by the Subcontractor during the entire contract
term.
The Contractor shall require that the language of this certification be included in all sub -agreements, sub -grants, and
other agreements/contracts and that all Subcontractors shall certify compliance accordingly.
This certification is a material representation of fact upon which reliance was placed when this contract was made or
entered into. Submission of this certification is a prerequisite for making or entering into this contract imposed by
Circulars A-102 and 2 CFR Part 200 and 215 (formerly OMB Circular A -I 10).
I. RECORDS AND DOCUMENTATION
The Contractor agrees to make available to Agency staff and/or any party designated by the Agency any and all
contract related records and documentation. The Contractor shall ensure the collection and maintenance of all program
related information and documentation on any such system designated by the Agency. Maintenance includes valid
exports and backups of all data and systems according to Agency standards.
J. CERTIFICATION REGARDING INSPECTION OF PUBLIC RECORDS
I. In addition to the requirements of Section 10 of the Standard Contract, sections 119.0701(3) and (4) F.S., and any
other applicable law, if a civil action is commenced as contemplated by section 119.0701(4), F.S., and the Agency is
named in the civil action, Contractor agrees to indemnify and hold harmless the Agency for any costs incurred by the
Agency and any attorneys' fees assessed or awarded against the Agency from a Public Records Request made
pursuant to Chapter 119, F.S., concerning this contract or services performed thereunder.
a. Notwithstanding section 119.070 1, F.S., or other Florida law, this section is not applicable to contracts executed
between the Agency and state agencies or subdivisions defined in section 768.28(2), F.S.
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January — December 2020
OAA 203.20
2. Section 119.01(3), F.S., states if public funds are expended by an agency in payment of dues or membership
contributions for any person, corporation, foundation, trust, association, group, or other organization, all the financial,
business, and membership records of such an entity which pertain to the public agency (Area Agency on Aging
for Southwest Florida, Inc.) are public records. Section 119.07, F.S, states that every person who has custody of such
a public record shall permit the record to be inspected and copied by any person desiring to do so, under reasonable
circumstances.
Additionally, I certify this organization does _x_ does not provide for institutional memberships.
Contractor's signature below attests that records pertaining to the dues or membership application by the Agency are
available for inspection if applicable, as stated above.
By execution of this contract, Contractor must include these provisions (A -J) in all related subcontract agreements (if
applicable).
By signing below, Contractor certifies that the representations outlined in parts A through J above are true and correct.
IW -k �2, W
Signature and Title of Authorized Representative
STEPHEN Y CARNELL,
PUBLIC SERVICE DEPARTMENT HEAD
Street Address:
3339 TAMIAMI TRAIL E SUITE 211
COLLIER COUNTY BOARD OF COMMISSIONERS
NAPLES, FL 34112
Contractor I Date
City, State, Zip code
46
CAO
January — December 2029
OAA 203.20
ATTACHMENT IV
ASSURANCES--NON-CONSTRUCTION PROGRAMS
Public reporting burden for this collection of information is estimated to average forty-five (45) minutes per response, including time
for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing
the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348-0043),
Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND
BUDGET, SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY..
Note: Certain of these assurances may not be applicable to your project or program. If you have questions please
contact the awarding agency. Further, certain federal awarding agencies may require applicants to certify to
additional assurances. If such is the case, you will be notified.
1. Has the legal authority to apply for federal assistance, and the institutional, managerial and financial capability
(including funds sufficient to pay the non-federal share of project cost) to ensure proper planning, management, and
completion of the project described in this application.
2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the state, throughany
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 awa•dingagency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §§ 4728-4763) relating to prescribed
standards for merit systems for programs funded under one of the 19 statutes o• regulations specified in Appendix A
of OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).
6. Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of
the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin;
(b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§ 1681-1683 and §§ 1685-1686), which
prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C.
§ 794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended
(42 U.S.C. §§ 6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and
Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the
Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616),
as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) Sections 523 and 527 of the
Public Health Service Act of 1912 (42 U.S.C. §§ 290 dd-3 and 290 ee 3), as amended, relating to confidentiality of
alcohol and drug abuse patient records; (h) Title Vlll of the Civil Rights Act of 1968 (42 U.S.C. § 3601 et seq.), as
amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination
provisions in the specific statute(s) under which application for federal assistance is being made; and 0) the
requirements of any other nondiscrimination statate(s) which may apply to the application.
7. Will comply, or has already complied, with the requirements of Titles 11 and III of the uniform Relocation Assistance
and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of
persons displaced or whose property is acquired as a result of federal or federally assisted programs. These requirements
apply to all interests in real property acquired for project purposes regardless of federal participation in purchases.
47
January — December 2020
OAA 203.20
8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. §§ 1501-1508 and §§ 7324-7328), which
limit the political activities of employees whose principal employment activities are funded in whole or in pant with
federal funds.
9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C. §§ 276a to 276a-7), the Copeland
Act (40 U.S.C. § 276c and 18 U.S.C. § 874) and the Contract Work Homs and Safety Standards Act (40 U.S.C. §§
327-333), regarding labor standards for federally assisted construction sub -contracts.
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the
program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or
more.
11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and
Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of
project consistency with the approved State management program developed under the Coastal Zone Management Act
of 1972 (16 U.S.C. § 1451 et seq.); (f) conformity of federal actions to State (Clear Air) Implementation Plans under
Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. § 7401 et seq.); (g) protection of underground
sources of drinking water under the Safe Drinking Water Act of 1974, as amended (P.L. 93-523); and (h) protection of
endangered species wider the Endangered Species Act of 1973, as amended (P.L, 93-205).
12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. § 1721 et seq.) related to protecting components
or potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of
1966, as amended (16 U.S.C. § 470), EO 11593 (identification and protection of historic properties), and the
Archaeological and Historic Preservation Act of 1974 (16 U.S.C. § 469a-1 et seq.).
14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related
activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. § 2131 et seq.)
pertaining to the care, handling, and treatment of warm-blooded animals held for research, teaching, or other activities
supported by this award of assistance.
16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. § 4801 et seq.), which prohibits the use
of lead- based paint in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act
Amendments of 1996 and 2 CFR Part 200.
18. Will comply with all applicable requirements of all other federal laws, executive orders, regulations, and policies
governing this program.
SI TU OF AUT RIZED ERTIFYING OFFICIAL
TITLE
�91PUBLIC
SERVICE DEPARTMENT HEAD
STEP Y CARNELL
E
APPLICANT ORGANIZATION
DATE SUBMITTED
COLLIER COUNTY BOARD OF COMMISSIONERS
I
48 Approved as to form and legality
cAo
Ass' tantCounty Vmrcy t�31ao�0
January — December 2020
OAA 203.20
ATTACHMENT V
FLORIDA DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST
Program/Faci lity Name
County
AAA/Contractor
Address
Completed By
City, State, Zip Code
Date
Telephone
PART I: READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU COMPLETE
THIS FORM.
1. Briefly describe the geographic area served by the program/facility and the type of service provided:
For questions 2-5 please indicate the foil,
2. Population of area served
!3. Staff currently employed
'.4. Clients currently enrolle(Viegistered
5. Advisory/Governing Board ifapplicable
Total # % % %
)wing: White Black Hispanic
% % % %
Other Female Disabled Over 40
Source of data:
Effective date:
Effective date:
PART II: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING \MORE SPACE. IF N/A m• NO, EXPLAIN.
6. Is an Assurance of Compliance on file with DOER? N/A YES
❑ ❑
NO
❑
7. Compare the staff composition to the population. Is staff representative of the population?
N/A
❑
YES
❑
NO
❑
8. Are eligibility requirements for services applied to clients and applicants without regard to race, color, national
origin, sex, age, religion, or disability?
N/A
❑
YES
❑
NO
❑
9. 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?
N/A
❑
YES
❑
NO
❑
10. For in-patient services, are room assignments made without regard to race, color, national origin or disability?
N/A
YES
NO
❑
❑
❑
11. Is the program/facility accessible to non-English speaking clients?
N/A
YES
NO
❑
❑
❑
12. Are employees, applicants and participants informed of their protection against discrimination? If YES, how?
Verbal ❑ Written ❑ Poster ❑
N/A
❑
YES
❑
NO
❑
49
January — December 2020
OAA 203.20
50
11
Reviewed by
In Compliance: YES NO*
Program Office
*Notice of Corrective Action Sent—/—/—
13. Give the number and current status of any discrimination complaints regarding services or employment filed
against the program/facility.
N/A NUMBER
❑
On -Site Lj Desk Review
Response Received_/_/_
14. Is the program/facility physically accessible to mobility, hearing, and sight -impaired individuals?
N/A
❑
YES NO
❑ ❑
PART III: THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES. IF
EXPLAIN.
15. Has as a self-evaluation been conducted to identify any barriers to serving disabled individuals and to make any YES
necessary modifications? ❑
NO,
NO
❑
16. Is there an established grievance procedure that incorporates due process in the resolution ofcomplaints?
YES
NO
❑
❑
17. Has a person been designated to coordinate Section 504 compliance activities?
YES
NO
❑
❑
18. Do recruitment and notification materials advise applicants, employees, and participants of nondiscrimination
on the basis of disability?
YES
❑
NO
❑
19. Are auxiliary aids available to ensure accessibility of services to hearing and sight -impaired individuals?
YES
NO
❑
❑
PART IV: FOR PROGRAMS OR FACILITIES N4TH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF 550,000.00 OR MORE.
20. Do you have a written affirmative action plan? If NO, explain. YES
NO
❑
❑
50
11
Reviewed by
In Compliance: YES NO*
Program Office
*Notice of Corrective Action Sent—/—/—
Date
Tele hone Response Due
On -Site Lj Desk Review
Response Received_/_/_
50
January — December 2020
OAA 203.20
ATTACHMENT V
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST
1. Describe the geographic service area such as a district, county, city, or other locality. if the program/facility serves
a specific target population such as adolescents, describe the target population. Also, define the type of service
provided.
2. Enter the percent of the population served by race, sex, disability, and over the age of 40. The population served
includes persons in the geographical area for which services are provided such as a city, county or other regional
area. Population statistics can be obtained from local chambers of commerce, libraries, or any publication from
the 1980 Census containing Florida population statistics. Include the source of your population statistics. ("Other"
races include Asian/Pacific Islanders and American Indian/Alaskan Natives.)
3. Enter the total number of full-time staff and their percent by race, sex, disability, and over the age of 40. Include
the effective date of your summary.
4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and list
their percent by race, sex, disability, and over the age of 40. Include the date that enrollment was counted.
a. Where there is a significant variation between the race, sec, or ethnic composition of the clients and their availability
in the population, the program/facility has the responsibility to determine the reasons for such variation and take
whatever action may be necessary to correct any discrimination. Some legitimate disparities may exist when
programs are sanctioned to serve target populations such as elderly or disabled persons.
5. Enter the total number of advisory board members and their percent by race, sex, disability, and over the age of
40. If there is no advisory or governing board, leave this section blank.
6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in
compliance with all nondiscriminatory provisions as required in 45 CFR Part 80. This is usually a standard part of
the contract language for Area Agency and/or DOEA Recipients and their Sub -grantees. 45 CFR § 80.4 (a).
7. Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the
population is Hispanic, is there a comparable percentage of Hispanic staff?
8. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or
employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also
through on-site record analysis of persons who applied but were denied services or employment. 45 CFR § 80.3
(a) and 45 CFR § 80.1.
9. Participants or clients must be provided services such as medical, nursing, and dental care, laboratory services,
physical and recreational therapies, counseling, and social services without regard to race, sex, color, national origin,
religion, age, or disability. Courtesy titles, appointment scheduling, and accuracy of record keeping must be
applied uniformly and without regard to race, sex, color, national origin, religion, age, or disability. Entrances,
waiting rooms, reception areas, restrooms, and other facilities must also be equally available to all clients. 45 CFR
§ 80.3 (b).
10. For in-patient services, residents must be assigned to rooms, wards, etc., without regard to race, color, national
origin, or disability. Also, residents must not be asked whether they are willing to share accommodations with
persons of a different race, color, national origin, or disability. 45 CFR § 80.3 (a).
It. The program/facility and all services must be accessible to participants and applicants, including those persons who
may not speak English. In geographic areas where a significant population of non-English speaking people live,
program accessibility may include the employment of bilingual staff. In other areas, it is sufficient to have a policy
or plan for service, such as a current list of names and telephone numbers of bilingual individuals who will assist
in the provision of services. 45 CFR § 80.3 (a).
12. Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to their
participants, beneficiaries, or any other interested parties. 45 CFR § 80.6(d). This should include information on
51
January — December 2020
OAA 203.20
their right to file a complaint of discrimination with either the Area Agency on Aging for Southwest Florida, Inc.
and/or Florida Department of Elder Affairs or the U.S. Department of Health and Human Services. The
information may be supplied verbally or in writing to every individual or may be supplied through the use of an
equal opportunity policy poster displayed in a public area of the facility.
13. Report number of discrimination complaints filed against the program/facility. Indicate the basis (e.g. race, color,
creed, sex, age, national origin, disability, and/or retaliation) and the issues involved (e.g. services or employment,
placement, termination, etc.). Indicate the civil rights law or policy alleged to have been violated along with the
name and address of the local, state, or federal agency with whom the complaint has been filed. Indicate the
current status of the complaint (e.g. settled, no reasonable cause found, failure to conciliate, failure to cooperate,
under review, etc.).
14. The program/facility must be physically accessible to mobility, hearing, and sight -impaired individuals. Physical
accessibility includes designated parking areas, curb cuts or level approaches, ramps, and adequate widths to
entrances. The lobby, public telephone, restroom facilities, water fountains, and information and admissions
offices should be accessible. Door widths and traffic areas of administrative offices, cafeterias, restrooms,
recreation areas, counters, and serving lines should be observed for accessibility. Elevators should be observed for
door width and Braille or raised numbers. Switches and controls for light, heat, ventilation, fire alarms, and other
essentials should be installed at an appropriate height for mobility impaired individuals.
15. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self-
evaluation to identify any accessibility barriers. Self-evaluation is a four -step process:
a. Evaluate, with the assistance of disabled individual(s)/organization(s), current practices and policies that do
not comply with Section 504;
b. Modify policies and practices that do not meet Section 504 requirements;
c. Take remedial steps to eliminate the effects of any discrimination that resulted from adherence to these policies and
practices; and
d. Maintain self-evaluation on file, including a list of the interested persons consulted, a description of areas
examined, and any problems identified, and a description of any modifications made and of any remedial steps
taken 45 CFR § 84.6. (This checklist may be used to satisfy this requirement if these four steps have been
followed).
16. Programs or facilities that employ 15 or more persons shall adopt grievance procedures that incorporate appropriate
due process standards and that provide for the prompt and equitable resolution of complaints alleging any action
prohibited by Part 84 of Title 45, CFR § 84.7(b).
17. Programs or facilities that employ 15 or more persons shall designate at least one person to coordinate its efforts to
comply with Part 84 of Title 45, CFR. 45 CFR § 84.7(a).
18. Programs or facilities that employ 15 or more persons must provide appropriate initial and continuing steps to notify
participants, beneficiaries, applicants, and employees that the program/facility does not discriminate on the basis
of handicap in violation of Section 504 and part 84 of Title 45, CFR. Methods of initial and continuing
notification may include the posting of notices, publication in newspapers and magazines, placement of notices in
publications of the programs or facilities, and distribution of memoranda or other written communications.
45 CFR § 84.8(a).
19. Programs or facilities that employ 15 or more persons shall provide appropriate auxiliary aids to persons with
impaired sensory, manual, or speaking skills where necessary to afford such persons an equal opportunity to
benefit from the service in question. Auxiliary aids may include, but are not limited to, brailed and taped
materials, interpreters, and other aids for persons with impaired hearing or vision. 45 CFR § 84.52(d).
20. Programs/facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement, and
maintain a written affirmative action compliance program in accordance with Executive Order 11246, 41 CFR 60
and Title VI of the Civil Rights Act of 1964, as amended.
52
DEPARTMENToF
ELDER
AFFAIRS
STATE OF FLORIDA
BACKGROUND SCREENING
Affidavit of Compliance - Employer
AUTHORITY: This form is required annually of all employers to comply with the attestation
requirements set forth in section 435.05(3), Florida Statutes.
D The term "employer" means any person or entity required by law to conduct background screening,
including but not limited to, Area Agencies on Aging, Aging Resource Centers, Aging and Disability
Resource Centers, Lead Agencies, Long -Term Care Ombudsman Program, Serving Health Insurance Needs
of Elders Program, Service Providers, Diversion Providers, and any other person or entity which hires
employees or has volunteers in service who meet the definition of a direct service provider. See §§
435.02, 430.0402, Fla. Stat.
➢ A direct service provider is "a person 18 years of age or older who, pursuant to a program to provide
services to the elderly, has direct, face -to -fate contact with a client while providing services to the client
and has access to the client's living area, funds, personal property, or personal Identification information
as defined In s. 817.568. The term includes coordinators, managers, and supervisors of residential
facilities; and volunteers." § 430.0402(1)(b), Fla. Stat.
ATTESTATION:
As the duly authorized representative of COLLIER COUNTY BOARD OF COMMISSIONERS
Employer Nome
located at 3339 TAMIAMI TRAIL EAST #211 NAPLES FL 34112
Street Address City State ZIP code
I, STEPHEN Y CARNELL do hereby affirm under penalty of perjury
Name of Representative
that the above named employer is in compliance with the provisions of Chapter 435 and section
4 0.0402, Florida Sta►ttu-ttee^ess_,, regarding level 2 background screening.
igna r of Representative'i'7 Date (SCJ
STATE OF FLORIDA, COUNTY OF 1i wed (—
Sworn to (or affirmed) and subscribed before me this (A day of 202P by
��r1 CiaJdle- �� (Name of Representative) who isrsona
e^ Ily known
torMeoroduc d as proof of identification.
NOUry Pub11c Slate ar Fbritls
A Wendy Klopt
a91
Pri ,7 dL!6 Sta b o�ie R1 ef oa ublic Notary Public
DOEA Form 235, Affidavit of Compliance- Employer, Effective April 2012 Approved as to fornf%f EpItIlf ill h F.S.
Form available at: htto,//elderaffairs state fl us/english/backgroundscreening.oho
Assl unt County Altney
January — December 2020
OAA 203.20
ATTACHMENT IX
BUDGET AND RATE SUMMARY
OLDER AMERICANS ACT BUDGET SUMMARY
CONTRACTOR: COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY
1. Title III 6 Support Services $ 385,020.69
2. Title 111 Cl Congregate Meals $ 341,322.29
3. Title III C2 Home Delivered Meals $ 301,442.67
4. Title III E Services $ 156,192.31
5. NSIP $ 46,737.03
TOTAL $1,230,714.99
54
January — December 2020
ATTACHMENT IX
BUDGET AND RATE SUMMARY
COLLIER
IIIB
OAA 203.20
SERVICE
REIMBURSEMENT METHOD OF
UNIT RATE PAYMENT
UNIT
TYPE
CASE MANAGEMENT
$54.00 Fixed Fee/Unit Rate
HOURS
CHORE
$22.29 Fixed Fee/Unit Rate
HOURS
EMERGENCY ALERT RESPONSE
$ 1.35 Fixed Fee/Unit Rate
DAYS
HOMEMAKER
$22.55 Fixed Fee/Unit Rate
HOURS
HOUSING IMPROVEMENT
Cost Reimbursement 90% of Cost
EPISODE
MATERIAL AID
Cost Reimbursement 90% of Cost
EPISODE
PERSONAL CARE
$23.48 Fixed Fee/Unit Rate
HOURS
RESPITE IN - HOME
$23.27 Fixed Fee/Unit Rate
HOURS
SKILLED NURSING SERVICES
$38.06 Fixed Fee/Unit Rate
HOURS
SPECIALIZED MEDICAL
EQUIPMENT, SERVICES,
Cost Reimbursement 90% of Cost
EPISODE
TRANSPORTATION
Cost Reimbursement 100% of Cost
TRIPS
55
January — December 2020
ATTACHMENT IX
BUDGET AND RATE SUMMARY
COLLIER COUNTY
IIIE, IIIES, & IIIEG
OAA 203.20
SERVICE
REIMBURSEMENT
UNIT RATE
METHOD OF
PAYMENT
UNIT
TYPE
IIIE-- ADULT DAY CARE
$12.76
Fixed Fee/Unit Rate
HOURS
RESPITE IN-HOME
$23.27
Fixed Fee/Unit Rate
HOURS
RESPITE IN -FACILITY
$11.05
Fixed Fee/Unit Rate
HOURS
SCREENING & ASSESSMENT
$55.17
Fixed Fee/Unit Rate
HOURS
IIIES-- CHORE
$22.29
Fixed Fee/Unit Rate
HOURS
Specialized Medical Equipment,
Service & Supplies
Cost Reimbursement
90% of Cost
EPISODE
MATERIAL AID
Cost Reimbursement
90% of Cost
EPISODE
IIIEG--CHILD DAY CARE
$15.00
Fixed Fee/Unit Rate
HOURS
SCREENING AND ASSESSMENT
$55.17
Fixed Fee/Unit Rate
HOURS
56
January — December 2020
Ia7lWFXfJ I lu1PIC#8
BUDGET AND RATE SUMMARY
C-1 & C-2
COLLIER COUNTY
OAA 203.20
SERVICE
REIMBURSEMENT
UNIT RATE
UNIT TYPE
Cl -- CONGREGATE MEALS
$11.72
MEALS
NUTRITION EDUCATION
$ 1.59
PARTICIPANTS
CONGREGATE MEAL SCREENING
$28.00
14OUR
OUTREACH
$4.32 PER PERSON
EPISODE
SERVICE
REIMBURSEMENT
UNIT RATE
UNIT TYPE
C2 -- HOME DELIVERED MEALS
$ 8.07
MEALS
NUTRITION EDUCATION
$ 1.59
PARTICIPANTS
SCREENING & ASSESSMENT
$48.76
HOUR
OUTREACH
$4.32 PER PERSON
EPISODE
57
January — December 2020
ATTACHMENT X
INVOICE SCHEDULE
Report Number Based On
January Advance*
2 February Advance*
3 January Expenditure Report
4 February Expenditure Report
5 March Expenditure Report
6 April Expenditure Report
7 May Expenditure Report
8 June Expenditure Report
9 July Expenditure Report
10 August Expenditure Report
1 1 September Expenditure Report
12 October Expenditure Report
13 November Expenditure Report
14 December Expenditure Report
15 Final Expenditure and Request for Payment
OAA 203.20
Submit to Agency
On This Date
January 1
January I
February 9 *See Note #4*
March 9
April 9
May 9
June 9
July 9
August 9
September 9
October 9
November 9
December 9
January 9
February 15
Legend: * Advance based on projected cash need as supported by a cash-flow analysis or other information
appropriate to demonstrate the contractor's financial need for the advance.
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.
Note #2: Report numbers 5 through 14 shall reflect an adjustment of one-tenth of the total advance
amount, on each of the reports, repaying advances issued the first two months of the agree-
ment. The adjustment shall be recorded in Part C, 1 of the report (ATTACHMENT XI).
Note # 3: Submission of expenditure reports may or may not generate a payment request. If final
expenditure report reflects funds due back to the Agency, payment is to accompany the
report.
Note 44: ALL Expenditure Reports are due by 12:00 p.m. on the 91h of each month. IF the 9"' falls
on a Saturday, then the report will be due by the 8"' by 12:00 p.m. AND IF the 9" falls
on a Sunday, the report will be due by the 10°i by 12:00 p.m. Actual submission of the
vouchers to Dept. of Elder Affairs is dependent on the accuracy of the expenditure report,
which is verified and paid by CIRTS data only. ATTER Billing submitted, DO NOT ADD
any additional units (retro or next billing period) until after the 15`x' of the month.
58
January - December 2020
ATTACHMENT XI
REQUEST FOR PAYMENT
OAA 203.20
6111
TYPE OF REPORT:
PROVIDER NAME, ADDRESS. PHONE d FED ID NUMBER
CanhadY
Advance_,___
iCon0ad Reuel
Reimbursement
:Report Period
0.eDarlp
PSA
m.acee
CERTIFICATION I hereby ceNfy botM1e best of my lumMedOe Unit this requestconomms
-.m To term sad the putposes vetlrth
int -he ordercoV LTolhe
-
best of my olmy Mmovel d9e, all CIRTS Is accurate
and correct
Prepared By.
Dale:
Approved By:
Date:
PART A:
(I)
(2)
(3)
(4)
(5)
(6) i (i)
(8)
BUDGET SUMMARY
ADMIN.
IIIB
MCI
IIIC2
NO
IIIE NSIP
TOTAL
Contract Amount
000
000
0.00
0.00
0.00
OOO 000
0.00
2. Preetous Funds
RECEIVED for
Cunt racl pednd
000
0.00
0.00
0.00
0.00
O'00i MIS
000
B Como- an Belame
OM
000
0,00
000
0.00
0.001 o.DD
000
Fine I minus line 2)
4, Previous Funds
REQUESTED and
Not Rocelvad,
0.00
000
0.00
000
000
0.001 000
000
S. C. first Balantt
O.OD
0.00
0.00
0.00
0.00
O.00j 0.00
0.00
(Lms 0 minus Irne 4)
'.i
PART 8:
FUNDS REQUESTED
1. 1542mdllonths
ReyurM only
OSD
0.00
OOo
0.00
000
0ODI 0.00
0.00
2, Net ESDenddurm
For Mouth
OSD
0.00
0.00
0.00
0.00
0.00 0.00
0,00
1, Total
Oo0
000
CSO
0.00
0.00
O.00l 000
000
P RTC:
NET FUNDS REQUESTED:
LLsss: Over -Advance
000
000
0.00
000
0.00
0.001 000
000
2 Contract Funds are
Hereby Requested
0.00
0.00
0.00
0,001
0.00
0.00., 0,001
0.00
Dat of Services I Units I Rales provided- See attached report.
DOEAUse Oniy
FA FORM I(PA-led INIShe
6111
January - December 2020
ATTACHMENT XII
EXHIBIT 1
RECEIPTS AND EXPENDITURE REPORT
OAA 203.20
PROVIDER NAME, ADDRESS, PHONE# AND FEID#
PROGRAM FUNDING SOURCE:
Contract#
Title III
Contract Period:
IIIB
ReportPeriod
PSA
Report#
Invoice#
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.
To the best of my knowledge, all CIRTS is
accurate and correct.
Prepared by: Date:
Approved by:
Dale:
PART A: BUDGETED INCOME/ RECEIPTS
1. Approved Budget
2. Actual Receipts
3. Total Receipts
4. Percent of
For This Report
Year to Dale
Approved Budget
1. Federal Funds
$0.00
$0.00
$0.00
#DIV/0!
2. State Funds
$0.00
$0.00
$0.00
#DIV/01
3. Program Income - Non Match
$0.00
$0.00
$0.00
#DIV/01
4. Local Cash Match
$0.00
$0.00
$0.00
#DIV/01
5. SUBTOTAL: CASH RECEIPTS
$0.00
$0.00
$0.00
#DIV/01
6. Local In -Kind Match
$0.00
$0.00
$0.00
#DIV/01
7. TOTAL RECEIPTS
$0.00
$0.00
$0.00
#DIV/01
PART B: EXPENDITURES
1. Approved Budget
2. Expenditures
3. Expenditures
4. Percent of
For This Report
Year to Date
Approved Budget
1, AAA Direct Services
$0.00
$0.00
$0.00
#DIV/01
2. Subcontractor
$0.00
$0.00
$0.00
#DIV/0!
3. IIIB Set Aside
$0.00
$0.00
$0.00
#DIV/01
4. IIIB Set Aside DRR(Disaster Recovery Reserve)
$0.00
$0.00
$0.00
#DIV/01
5. TOTAL EXPENDITURES
$0.00
$0.00
$0.00
#DIV/01
PART C: OTHER EXPENDITURES
1. Approved Budget
2. Expenditures
3. Expenditures
A. Percent of
(For Tracking Purposes only)
For This Report
Year to Date
Approved Budget
1. Match
a. Otherand In -Kind
$0.00
$0.00
$0.00
#DIV/0!
b. Local Match
$0.00
$0.00
$0.00
#DIV/0!
2. Program Income
$0.00
$0.00
$0.00
#DIV/01
3. TOTAL OTHER
$0.00
$0.00
$0.00
#DIV/01
PART D: INTEREST
1. Earned on Advances $0.00
2. Return on Advances 50.00
3. Other Earned $0.00
DmF FORM 105as-III8mvised 10119/18
60
January - December 2020
OAA 203.20
ATTACHMENT XII
EXHIBIT 2
RECEIPTS AND EXPENDITURE REPORT
PROVIDER NAME, ADDRESS, PHONE# AND FEID#
PROGRAM FUNDING SOURCE:
Contract #
Title
III
Contract Period:
C1
Report Period
PSA
Report #
Invoice#
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 To the best of my knowledge, all CIRTS
is accurate and correct.
Prepared by : Date: -Approved
by :
Date
PART A: BUDGETED INCOME/ RECEIPTS
1. Approved Budget
2. Actual Receipts
3. Total Receipts
4. Percent of
For This Report
Year to Date
Approved Budget
1. Federal Funds
$0.00
$0.00
$0.00
#DIV/0!
2. State Funds
$0.00
50.00
$0.00
#DIV/0!
3. Program Income - Non Match
$0.00
$0.00
$0.00
#DIV/01
4. Local Cash Match
$0.00
$0.00
$0.00
#DIV/01
5. SUBTOTAL: CASH RECEIPTS
$0.00
$0.00
$0.00
#DIV/0!
6. Local In -Kind Match
$0.00
50.00
$0.00
#DIV/01
7. TOTAL RECEIPTS
$0.00
$0.00
$0.00
#DIV/01
PART B: EXPENDITURES
1. Approved Budget
2. Expenditures
3. Expenditures
4. Percent of
For This Report
Year to Date
Approved Budget
1. Subcontractor
$0.00
$0.00
$0.00
#DIV/0!
2. C1 Set Aside DRR (Disaster Recovery Reserve)
$0.00
$0.00
$0.00
#DIV/01
3. TOTAL EXPENDITURES
$0.00
$0.00
$0.00
4DIV/01
PART C: OTHER EXPENDITURES
1. Approved Budget
2. Expenditures
3. Expenditures
4. Percent of
(For Tracking Purposes only)
For This Report
Year to Date
Approved Budget
1. Match
a. Other and In -Kind
$0.00
$0.00
$0.00
#DIV/0!
b. Local Match
$0.00
$0.00
$0.00
#DIV/01
2. Program Income
$0.00
$0.00
$0.00
#DIV/0!
3. TOTAL OTHER
$0.00
$0.00
$0.00
#DIV/0!
PART D: INTEREST
1. Earned on Advances $0.00
2. Return on Advances $0.00
3. Other Earned $0.00
00F FORM 105as-CI revised 10119118
a
January - December 2020
OAA 203.20
ATTACHMENT XII
EXHIBIT 3
RECEIPTS AND EXPENDITURE REPORT
PROVIDER NAME, ADDRESS, PHONE#AND FEID#
PROGRAM FUNDING SOURCE:
Contract#
Title
III
Contract Period:
C2
ReportPeriod
PSA
Report#
Invoice#
CERTIFICATION: I certify to the best of my knoWedge and belief that this report is complete and all outlays herein are for purposes set
forth in the contract. To the best of my knowledge, all CIRTS is accurate and correct.
Prepared by: Dale:
Approvedby:
Date:
PART A: BUDGETED INCOME/ RECEIPTS
1. Approved Budget
2. Actual Receipts
3. Total Receipts
4. Percent of
For This Report
Year to Date
Approved Budget
1. Federal Funds
$0.00
$0.00
$0.00
#DIV/01
2. State Funds
$0.00
$0.00
$0.00
#DIV/0!
3. Program Income - Non Match
$0.00
$0.00
$0.00
#DIV/01
4. Local Cash Match
$0.00
$0.00
$0.00
#DIV/01
5. SUBTOTAL: CASH RECEIPTS
$0.00
$0.00
$0.00
#DIV/01
6. Local In -Kind Match
$0.00
$0.00
$0.00
#DIV/0!
7. TOTAL RECEIPTS
$0.00
$0.00
$0.00
#DIV/0!
PART B: EXPENDITURES
1. Approved Budget
2. Expenditures
3. Expenditures
4. Percent of
For This Report
Year to Date
Approved Budget
1. Subcontractor
$0.00
$0.00
$0.00
#DIV/01
2. C2 Set Aside DRR (Disaster Recovery Reserve)
$0.00
$0.00
$0.00
#DIV/01
3. TOTAL EXPENDITURES
$0.00
$0.00
$0.00
#DIV/01
PART C: OTHER EXPENDITURES
1. Approved Budget
2. Expenditures
3. Expenditures
A. Percent of
(For Tracking Purposes only)
For This Report
Year to Dale
Approved Budget
1. Match
a. Olherand In -Kind
$0.00
$0.00
$0.00
4DIV/0!
b. Local Match
$0.00
$0.00
$0.00
#DIV/O!
2. Program Income
$0.00
$0.00
$0.00
#DIV/0!
3. TOTAL OTHER
$0.00
$0.00
$0.00
#DIV/01
PART D: INTEREST
1. Earned on Advances $0.00
2. Return on Advances $0.00
3. Other Earned $0.00
OOEA FORM 105as-C2 rsNsed 10/19118
62
January - December 2020
OAA 203.20
I:Y W 1►•LN ilu DI►Y IEiii
EXHIBIT 4
RECEIPTS AND EXPENDITURE REPORT
PROVIDER NAME. ADDRESS. PHONEfI AND FEIGN
PROGRAM FUNDING SOURCE:
Contracts -
Title 111
Contract Period:
HIE
Report Period
PSA
Report#
levoicolf
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. To the best of my knowledge, all CIRTS Is accurate and correct.
Prepared by: Dal.:
Approved by:
Date:
PART A : BUDGETED INCOME/ RECEIPTS
1. Approved Budget
2. Actual Receipts
3. Total Receipts
4. Percent of
For This Report
Year to Dale
Approved Budget
1. Federal Funds
$0.00
$0.00
$0.00
#DIV/01
2. State Funds
$0.00
$0.00
$0.00
#DIV/01
3. Program Income - Non Match
$0.00
$0.00
$0.00
4DIV/01
4. Local Cash Match
$0.00
$0.00
$0.00
#DIV/01
5. SUBTOTAL: CASH RECEIPTS
$0.00
$0.00
$0.00
#DIV/01
6. Local In -Kind Match
$0.00
$0.00
$0.00
4DIV/01
]. TOTAL RECEIPTS
$0.00
$0.00
$0.00
#DIV/01
PART B : EXPENDITURES
1. Approved Budget
2. Expenditures
3. Expenditures
4. Percent of
For This Report
Year to Date
Approved Budget
1. AAA Direct Services
$0.00
SO.00
$0.00
#DIV/01
2. Sub -Contracted Services
$0.00
$0.00
$0.00
9DIV/01
3. TOTAL EXPENDITURES
$0.00
$0.00
$0.00
#DIV/01
PART C : OTHER EXPENDITURES
1. Approved Budget
2. Expenditures
3. Expenditures
4. Percent of
(For Tracking Purposes only)
For This Report
Year to Dale
Approved Budget
1. Match
a. Other and In -Kind
$0.00
$0.00
$0.00
#DIV/01
b. Local Match
$0.00
50.00
$0.00
#DIV/01
2. Program Income
$0.00
$0.00
$0.00
#DIV/01
3. TOTAL OTHER
$0.00
$0.00
$0.00
#DIV/OI
PART D : EXPENDITURES ANALYSIS
1. Expenditures by Services Year to Date:
2. Units of Services Year to Date
3. Number of People Served Year to Date
1, Information ...... ..... _.... .. 0.00
..._........ _.........0
..._ ................_..0
2. Assistance .................. _.. $0.00
........................
0
..........................0
3. Counseling ..................... 0.00
....................._.
0
......... _.._...........0
4. Respite ......................... $0.00
........................
0
..........................0
5. Supplemental Services...... Wind
........................0
...........................0
6. TOTAL .......................... 0.00
Pad B Line 3, column 3 should be equal to this total.
PART E : GRANDPARENT SERVICES (reported by Federal Fiscal Year)
FFV $ IFFY
$
FFY
$
Match $
Match S
Match $
PART F: INTEREST
1. Earned on Advances $000
2. Returned on Advances $0.00
3. Other Earned ___$0.00
OOEA F0n1,1105as-IIIE,BN90G 10/19/I8
63
January — December 2020
OAA 203.20
ATTACHMENT XII
EXHIBIT 5
RECEIPTS AND EXPENDITURE REPORT
PROVIDER NAME, ADDRESS, PHONE#AND FEID#
PROGRAM FUNDING SOURCE:
Contract#
Tltle III
Contract Period:
NSIP
Report Period
PSA
Repod#
Invoice#
CERTIFICATION: 1 certify to the bestof my knowledge and belief that this report is complete and all outlays herein are for purposes set
forth in the contract. To the best of my knowledge, all CIRTS is accurate and correct.
Prepared by: Date: Approved by: Date:--
ate:—PART
PARTA: EXPENDITURE COMPUTATION
YEARTODATE
CURRENT MONTH
CONGREGATE HOME DEEiV=
----- CDNGRE�TE
HOME DELIVERED -
0 0
0
0
1. Number of Meals Served
2. Line 1 Times $ .72 cents per Meal
$0.00 $0.00
$0.00
$0.00
Year To Date Total Meals 0
Current Month Total Meals 0
Year To Dale Total Expenditures $0.00
Total Current Expenditures $0.00
PART B: CONTRACT SUMMARY
1. Approved Contract Amount
$0.00
2. Actual Expenditures for this Report
$0.00
3. Total Expenditures Year to Date
$0.00
4. Contract Balance
$0.00
DOFA FORM 105asNeiP revised 10119110
64
January — December 2020 OAA 203.20
ATTACHMENT XVI
OAA ANNUAL VOLUNTEER ACTIVITY REPORT SPECIFICATIONS
L Categories & Definitions
Direct Volunteers: Volunteers who have person-to-person contact with clients (e.g. I&R specialists, SHINE
counselors, and individuals providing respite and companionship).
Indirect Volunteers: Volunteers who coordinate, manage, or participate in specific services, programs, or
activities that assist paid staff in planning, implementing, and evaluating the goals and objectives of an
organization (e.g. speaker's bureau volunteer, data entry, board members, etc.).
Episodic Volunteers: Volunteers who participate in a specific, one-time event for a limited time, regardless of
direct or indirect volunteers.
NOTE: A volunteer can only be counted once. Select the category (direct, indirect, or episodic) that best describes
the individual volunteer and his/her volunteer work.
Unduplicated direct or indirect volunteers: Number of volunteers who perform service activities.
IL Survey Questions
User input: Entail address
User input: Survey questions
1. Number of unduplicated direct service volunteers.
1. Number of unduplicated indirect service volunteers.
2. Number of episodic volunteers engaged during the contract year.
3. Total number of direct volunteer hours served.
4. Total number of indirect volunteer hours served.
5. Total number of episodic volunteer hours served.
6. Number of clients served by volunteers.
7, Number of volunteers age 60 or older.
8. Number of volunteers under age 60.
LII. Service Categories
Groupings for reporting the number of volunteers providing services during the data collection period
(January 1 — December 31). If there are no activities during the year, enter zero.
Adult Day Care: Non-residential facility specializing in providing activities for elderly individuals or
individuals with disabilities. Operates ten to twelve (10 — 12) hours per day and provides meals, social or
recreational outings, and general supervision.
Advisory Council/Board Membership: Group of experts and leaders in an industry who share knowledge,
contacts, and leadership skills to benefit an organization; comprised of people who have no material interests in
the organization other than their directorship and who are responsible for a fiduciary role within the organization.
AmeriCorps: Network of national service programs that engage members and comnumity volunteers in intensive
service to meet needs in education, public health, and the environment. This service produces volunteers who will
provide direct services to clients.
AmeriCorps Vista: VISTA members commit to serve full-time for a year at a nonprofit organization or local
government agency, working to fight illiteracy, improve health services, create businesses, strengthen community
groups, and much more. This service produces volunteers who will provide direct services to clients.
Clerical/Administration: Complex work tasks performed under direction in support of one or more persons
serving in an administrative or professional capacity; completion of routine administrative tasks directly related to
the work of supervisor(s).
Companionship Programs: Programs that help elders to help other elders with their daily lives. Tasks may
include grocery shopping, household chores, going out to lunch, or simply visiting the elders to keep them
company.
Congregate Meals: Meal service in a group setting to individuals who cannot prepare or obtain nutritionally
adequate meals themselves. Meals assist individuals to maintain a nutritious diet.
65
January — December 2020
OAA 203.20
Consumer Education/Counseling: Enhances the capacity of mature consumers to navigate the increasingly
complex marketplace. Consumer education programs provide significant benefits, including identification of
market information, compliant and consumer redress procedures, and understanding of a technology-based
consumer environment.
Disaster Preparation/Recovery: Services provided in coordination with American Red Cross, FEMA, and
local task forces in response or in preparation of a disaster.
Education: Community outreach program of an academic institution that offers educational and cultural programs
specifically designed to foster and support lifelong learning.
Foster Grandparents: Provides a way for volunteers age 55 and older to stay active by serving children and
youth in their communities, through tutoring and mentoring.
Fundraising: Any service directly related to the solicitation of contributions for a committee, program, or organization.
Health Promotion: Programs specifically for older adults in the areas of health education, physical activity,
coordinated screening, and mental health.
Horne Delivered Meals: Meal service delivered to the homes to individuals who cannot prepare or obtain
nutritionally adequate meals for themselves. Meals assist individuals to maintain a nutritious diet.
Homemaker Programs: Programs provide in-home services to elders at -risk of premature placement in a
nursing home. Clients must be 60 years of age or older.
Home Repair: Home improvement, remodeling, or handyman work, including small odd jobs, and routine tasks.
Information and Referral: One-to-one services directing elders to appropriate programs and resources based
on elders' needs and specialized knowledge of aging services within the community.
Intergenerational: Activities or programs that increase cooperation, interaction, or exchange between any two or more
generations.
Legal Assistance: Legal services to elders age 60 and older that deal with issues such as property taxes,
mobile home, and other landlord tenant issues, advance directives, Medicaid eligibility, Social Security
denial, and state and local welfare benefit denials.
RSVP: Retired Senior Volunteer Program includes a network for individuals age 55 and older who use their
skills and talents in volunteer activities such as home repairs, tutoring and mentoring, and assisting victims of
natural disasters.
Recreation: Programs for older adults including health education, physical activity, and coordinated
screening for physical and mental health.
RELIEF: Respite for Elders Living in Everyday Families offers respite services to caregivers of frail elders and
those with Alzheimer's disease and related dementia.
Respite: Service that provides a temporary break for a family member from daily caregiving responsibilities.
Safety Education Programs: Programs on home safety, driver's safety fall prevention, and other general safety
educational topics provided by a volunteer to the aging network.
Senior Companions: Volunteers provide services to elders at risk of institutionalization due to chronic illness,
disability, or isolation. Services may include transportation to medical appointments, shopping assistance, meal
preparation, companionship, and advocacy, as well as respite for caregivers.
Elder Abuse Prevention Programs: Prevention strategies for elder abuse neglect, and exploitation, fraud,
scams, identify theft, and programs on home safety. SHINE and Florida SHINE/SMP: The SHINE Program
provides free and unbiased counseling through a dedicated network of volunteers, empowering Florida seniors
to make informed decisions. Through the SHINE Program, SHINE volunteers help Medicare beneficiaries,
their families, and caregivers through education, counseling and assistance. Through the SHINE/SMP (Senior
Medicare patrol) Program, volunteers also educate beneficiaries to protect, detect and repot potential errors,
fraud, and abuse with their Medicare Coverage
Special Events: Tinto -limited events.
Speakers' Bureau: Service that provides the right professional speaker for every type of event.
Telephone Reassurance: Scheduled telephone calls to check on homebound elders, which may include a
friendly visit from law enforcement or volunteers.
Transportation: Service provided for older adults and individuals with disabilities including lift -equipped
vehicles for wheelchair transport and medical transportation for appointments, dialysis, and chemotherapy.
66
January — December 2020 OAA 203.20
Area Agency on Aging
• FOR SOUTHWEST FLORIDA
`:'Yddf ABlhB dpd pbsbllily P9Y0Y(L1 Conies j
ATTACHMENT XVII
LULU Annual volunteer Keport
Category 1st 2nd 3rd 4th
Quarter Quarter Quarter Quarter
Number of unduplicated direct service volunteers
Number of unduplicated indirect service volunteers
Number of episodic volunteers engaged this quarter
Total number of direct volunteer hours served
Total number of indirect volunteer hours served
Total number of episodic volunteer hours served
Number of clients served by volunteers
Number of volunteers 60 or older
Adult Daycare
A non-residential facility specializing in providing activities for
elderly and/or handicapped individuals. Operate 10 - 12 hours
per day and provide meals, social/recreational outings, and
general supervision.
Advisory Council/Board Membership
A group of assorted experts and leaders in a particular industry
that share knowledge, contacts, and leadership skills for the
betterment of a growing organization. Is comprised of people
who have no material interests in the organization other than
their directorship and are responsible for fiduciary role within
the organization.
AmeriCorps
A network of national service programs that engage members
and community volunteers in intensive service to meet critical
needs in education, public health, and the environment.
AmeriCorps Vista
VISTA members commit to serve full-time for a year at a
nonprofit organization or local government agency, working to
fight illiteracy, improve health services, create businesses,
strengthen community groups, and much more.
67
January — December 2020
OAA 203.20
Clerical/Administration
Under direction, performs complex clerical and administrative
work tasks in support of one or more persons serving in an
administrative or professional capacity,, completes routine
administrative tasks directly related to the work of their
supervisor(s); and performs other related work as required.
Companionship Programs
A program, that helps senior citizens find persons to help them
with their daily lives. Tasks may include grocery shopping,
household chores, going out to lunch, or simply visiting the
senior's house or ALF to keep them company.
Congregate Meals
An individually designed service which provides meals to waiver
participants who cannot prepare or obtain nutritionally
adequate meals for themselves, or when the provision of such
meals will decrease the need for more costly supports to
provide in-home meal preparation. These meals will assist the
waiver participant to maintain a nutritious diet.
Consumer Education/Counseling
Highlights the role of consumer education in enhancing the
capacity of mature consumers to navigate the increasingly
complex marketplace. Consumer education programs can
provide significant benefits, including identification of market
information, complaint and consumer redress procedures, and
understanding a more technology-based consumer
environment.
Disaster Preparation/Recovery
Services in coordination with American Red Cross, FEMA, &
local taskforces, in response or in preparation of a disaster.
Education
A community outreach program of an academic institution that
offers educational and cultural programs specifically designed
to foster and support lifelong learning.
Fundraising
Performs any service directly related to the solicitation of
contributions for a committee, program or organization.
68
January — December 2020
OAA 203.20
Health Promotion
Programs specifically for older adults in the areas of health
education, physical activity, coordinated screening and mental
health.
Home Delivered Meals
(e.g. Meals on Wheels); an individually designed service which
provides meals to waiver participants who cannot prepare or
obtain nutritionally adequate meals for themselves, or when
the provision of such meals will decrease the need for more
costlysupports to provide in-home meal preparation.
Homemaker Programs
The program provides in-home services to senior citizens.
Services are available to eligible clients who are at -risk of
premature placement in a nursing home due to a medical,
emotional or psychological impairment. Clients of the
homemaker program must be 60 years of age or older and
homebound.
Home Repair
Home improvement, remodeling or handyman work. Small
or odd jobs; and routine tasks.
Information & Referral
Provides in-depth information and referral services directing
seniors to appropriate programs and resources based on
specialized knowledge of aging services and seniors' needs
within their community.
Intergenerational
Activities or programs that increase cooperation, interaction or
exchange between any two or more generations.
January — December 2020
OAA 203.20
Legal Assistance
Offers free civil legal services to senior citizens age 60 and older
with no income eligibility requirements. The issues that are
dealt with may include: property tax problems, mobile home
and other landlord tenant issues, advance directives and
Medicaid eligibility, help with social security denial, and help
with state and local welfare benefit denials.
Recreation
Programs specifically for older adults in the areas of health
education, physical activity, coordinated screening and mental
health.
RELIEF
Respite for Elders Living in Everyday Families- Offers respite
services to caregivers of frail elders and those with Alzheimer's
disease and related dementia.
Respite
Provides a temporary break for o family member from daily
care -giving responsibilities.
Senior Companion
Volunteers provide services to elders at risk of
institutionalization due to chronic illness, disability or isolation.
Services include such things as transportation to medical
appointments, shopping assistance, meal preparation,
companionship and advocacy, as well as respite for caregivers
Senior Prevention/Fraud/Abuse Programs
Elder abuse prevention, Medicare fraud and abuse, identity
theft safety education and prevention strategies including
programs on home safety etc.
SHINE
Provides educational materials and free, unbiased insurance
counseling to Florida elders, caregivers and family members.
70
January — December 2020
OAA 203.20
Special Events/Time Limited
Speaker's Bureau (list topics below)
A service that provides the right professional speaker for every
type of event.
Telephone Reassurance
Scheduled telephone calls to check on homebound seniors who
may include a friendly visit via law enforcement or volunteers.
Transportation
Programs specifically for older adults in the areas of public
transportation and specialized transportation for disabled
individuals may include lift -equipped vehicles for wheelchair
transport and medical transportation for appointments,
dialysis, and chemotherapy.
71
Revised August 2007
Attestation Statement
Agreement/Contract Number OAA 203.20
Amendment Number na
I, STRPHAN Y CARNRLL , attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
Collier County Board of Commissioners
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting, due to the differences in
electronic data processing media, which has no affect on the agreement/contract content.
I
Signature of Recipient/Contractor representative
Approved as to form and legality
Assistant Count) Corney
Revised August 2007
VERIFICATION OF EMERGENCY PREPAREDNESS PLAN
Contract If OAA 203.20
I, STEPHEN Y CARNELL certify that.COLLIER COUNTY BOARD OF COMMISSIONERS
(Name of authorized contractor representative) (Name of contractor)
has a current and properly maintained Emergency Preparedness Plan. Assurance is given that
the plan will be made available to the Department of Elder Affairs (DOEA) upon request.
-�a* �2, (�;*
Signatureof authorized contractor representative
PUBLIC SERVICE DEPARTMENT HEAD
Tine
14
Date
DOEA Contract Manager's Review
October 2008
Approved as to form and legality
Asststnt County
July 2019 to June 2020
ADI 203.19
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC.
ALZHEIMER'S DISEASE INITIATIVE PROGRAM STANDARD CONTRACT
COLLIER COUNTY BOARD OF COUNTY
THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc. (Agency) and Collier
County Board of County Commissioners (Contractor), collectively referred to as the "Parties." The term Contractor for this
purpose may designate a Vendor, Subgrantee, or Subrecipient.
WITNESSETH THAT:
WHEREAS, the Agency has determined that it is in need of certain services as described herein; and WHEREAS,
the Contractor has demonstrated that it has the requisite expertise and ability to faithfully perform 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 set forth herein, the Parties agree as follows:
1. Purpose of Contract:
The purpose of this contract is to provide services in accordance with the terms and conditions specified in this contract
including all attachments, forms, and exhibits which constitute the contract document.
2. Incorporation of Documents within the Contract:
The contract will incorporate attachments, proposal(s), state plan(s), grant agreements, relevant Department handbooks,
manuals and/or desk books, as an integral part of the contract, except to the extent that the contract explicitly provides
to the contrary. In the event of conflict in language among any of the documents referenced above, the specific provisions
and requirements of the contract document(s) shall prevail over inconsistent provisions in the proposal(s) or other
general materials not specific to this contract document and identified attachments.
ERE Jj ' m
This contract shall begin at twelve (12:00) A.M., Eastern Standard Time July 1, 2019 or on the date the contract has
been signed by the last party required to sign it, whichever is later. It shall end at eleven fifty-nine (11:59) P.M., Eastern
Standard Time June 30, 2020.
4. Contract Amount:
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount not
to exceed $449,855.00 subject to the availability of funds. Any costs or services paid for under any other contract or from
any other source are not eligible for payment under this contract.
5. Renewals:
By mutual agreement of the Parties, in accordance with Section 287,058(1)(g), Florida Statutes (F.S.), the Agency may
renew the contract for a period not to exceed three years, or the term of the original contract, whichever is longer. The
renewal price, or method for determining a renewal price, is set forth in the bid, proposal, or reply. No other costs for
the renewal may be charged. Any renewal is subject to the same terms and conditions as the original contract and
contingent upon satisfactory performance evaluations by the Agency and the availability of funds.
6. Compliance with Federal Law:
6.1 If this contract contains federal funds this section shall apply.
6.1.1 The Contractor shall comply with the provisions of 45 Code of Federal Regulations (CFR) 75 and/or 45
CFR Part 92, 2 CFR Part 200, and other applicable regulations.
6.1.2 If this contract contains federal funds and is over $100,000.00, the Contractor shall comply with all
applicable standards, orders, or regulations issued under Section 306 of the Clean Air Act as amended (42
United States Code (U.S.C.) § 7401, et seq.), Section 508 of the Federal Water Pollution Control Act
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July 2019 to June 2020 ADI 203.19
as amended (33 U.S.C. § 1251, et seq.), Executive Order 11738, as amended, and, where applicable,
Environmental Protection Agency regulations 2 CFR Part 1500. The Contractor shall report any violations
of the above to the Agency.
6.1.3 Neither the Contractor nor agent acting on behalf of the Contractor may not use any federal funds received
in connection with this contract to influence legislation or appropriations pending before Congress or
any state legislature. The Contractor must complete all disclosure forms as required, specifically the
Certification and Assurances Attachment, which must be completed and returned to the Contract Manager
prior to the execution of this contract.
6.1.4 In accordance with Appendix R to 2 CFR Part 200, the Contractor shall comply with Executive Order
11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as
supplemented in Department of Labor regulations 41 CFR Part 60 and in Department of Health and Human
Services regulations 45 CFR Part 92, if applicable.
6.1.5 A contract award with an amount expected to equal or exceed $25,000.00 and certain other contract awards
will not be made to parties listed on the government -wide Excluded Parties List System, in accordance with
the Office of Management and Budget (OMB) guidelines at 2 CFR Part 180 that implement Executive
Orders 12549 and 12689, "Debarment and Suspension." The Excluded Parties List System contains the
names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared
ineligible under statutory or regulatory authority other than Executive Order 12549. The Contractor shall
comply with these provisions before doing business or entering into subcontracts receiving federal funds
pursuant to this contract. The Contractor shall complete and sign the Certifications and Assurances
Attachment prior to the execution of this contract.
6.2 The Contractor shall not employ an unauthorized alien. The Agency will consider the employment of
unauthorized aliens a violation of the Immigration and Nationality Act (8 U.S.C. § 1324a) and the Immigration
Reform and Control Act of 1986 (8 U.S.C. § 1101). Such violation will be cause for unilateral cancellation of this
contract by the Agency.
6.3 If the Contractor is a non-profit provider and is subject to Internal Revenue Service (IRS) tax exempt organization
reporting requirements (filing a Form 990 or Form 990-N), and has its tax exempt status revoked for failing to
comply with the filing requirements of the Pension Protection Act of 2006 or for any other reason, the Contractor
must notify the Agency in writing within thirty (30) days of receiving the IRS notice of revocation.
6.4 The Contractor shall comply with Title 2 CFR Part 175 regarding Trafficking in Persons
6.5 Unless exempt under 2 CFR § 170.110(b), the Contractor shall comply with the reporting requirements of the
Transparency Act as expressed in 2 CFR Part 170.
6.6 To comply with Presidential Executive Order 12989, as amended, and State of Florida Executive Order Number
11-116, Contractor agrees to utilize the U.S. Department of Homeland Security's E -verify system to verify the
employment of all new employees hired by Contractor during the contract term. Contractor shall include in
related subcontracts a requirement that Subcontractors performing work or providing services pursuant to the
state contract utilize the E -verify system to verify employment of all new employees hired by the Subcontractor
during the contract term, Contractors meeting the terms and conditions of the E -Verify System are deemed to be in
compliance with this provision.
dmLwiml
• ._
7.1 This contract is executed and entered into in the State of Florida, and shall be construed, performed, and enforced
in all respects in accordance with Florida law, including Florida provisions for conflict of laws.
7.2 If this contract contains state financial assistance funds, the Contractor shall comply with Section 215.97, F.S.,
and Section 215.971, F.S., and expenditures must be in compliance with laws, rules, and regulations including, but
not limited to, the Reference Guide for State Expenditures.
7.3 The Contractor shall comply with the requirements of Section 287.058, F.S., as amended.
7.3.1 The Contractor shall perform all tasks contained in Attachment I.
July 2019 to June 2020
ADI 203.19
7.3.2 The Contractor shall provide units of deliverables, including reports, findings, and drafts, as specified in
Attachment I, to be received and accepted by the Agency Contract Manager prior to payment.
7.3.3 The Contractor shall comply with the criteria and final date by which such criteria must be met for
completion of this contract as specified in Attachment I, Section III. Method of Payment.
7.3.4 The Contractor shall submit bills for fees or other compensation for services or expenses in sufficient detail
for a proper pre -audit and post -audit.
7.3.5 If itemized payment for travel expenses is permitted in this contract, the Contractor shall submit invoices
for any travel expenses in accordance with Section 112.061, F.S., or at such lower rates as may be provided
in this contract.
7.3.6 The Contractor shall allow public access to all documents, papers, letters, or other public records as defined
in Section 119.011(12), F.S., made or received by the Contractor in conjunction with this contract except for
those records which are made confidential or exempt by law. The Contractor's refusal to comply with this
provision will constitute an immediate breach of contract for which the Agency may unilaterally terminate
this contract.
7.4 If clients are to be transported under this contract, the Contractor shall comply with the provisions of Chapter
427, F.S., and Rule Chapter 41-2, Florida Administrative Code (F.A.C).
7.5 Subcontractors who are on the Discriminatory Vendor List may not transact business with any public entity, in
accordance with the provisions of Section 287.134, F.S.
7.6 The Contactor shall comply with the provisions of Section 11.062, F.S., and Section 216.347, F.S., which prohibit
the expenditure of contact funds for the purpose of lobbying the legislature, judicial branch or a state agency.
7.7 The Area Agency may, at its option, terminate the Contract if the Contractor is found to have submitted a false
certification as provided under section 287.135(5), F.S., has been placed on the Scrutinized companies with
Activities in the Iran Petroleum Energy Sector List, the Scrutinized Companies with Activities in Sudan List, or
the Scrutinized Companies that Boycott Israel List, or if the Contractor has been engaged in business operations
in Cuba or Syria or is engaged in a boycott of Israel.
8. Background Screeni=
The Contactor shall ensure that the requirements of Section 430.0402 and Chapter 435, F.S., as amended, are met
regarding background screening for all persons who meet the definition of a direct service provider and who are not
exempt from the Department's level 2 background screening pursuant to Sections 430.0402(2)-(3), F.S. The
Contractor must also comply with any applicable rules promulgated by the Agency and/or Department and the
Department for Health Care Administration regarding implementation of Section 430.0402 and Chapter 435, F.S.
To demonstrate compliance with this provision, Contractor shall submit the Background Screening Affidavit of
Compliance (Screening Form) to the Agency within thirty (30) days of execution of this contract. Should the
Agency have a completed Screening Form on file for the Contactor, a new Screening Form will be required every
twelve (12) months.
8.1 Further information concerning the procedures for background screening may be found at
http://elderaffairs.state.fl.us/docalbackwoundscreening.php.
9. Grievance Procedures:
The Contractor shall develop, implement, and ensure that its Subcontractors have established grievance procedures to
process and resolve client dissatisfaction with, or denial of, service(s) and to address complaints regarding the termination,
suspension or reduction of services, as required for receipt of funds. These procedures, at a minimum, will provide for
notice of the grievance procedure and an opportunity for review of the Subcontractor's determination(s).
10. Public Records and Retention:
10.1 By execution of this contract, Contactor agrees to all provisions of Chapter 119, F.S., and any other applicable
law, and shall:
10.1.1 Keep and maintain public records required by the Agency to perform the contacted services.
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July 2019 to June 2020
ADI 203.19
10.1.2 Upon request from the Agency's custodian of public records, provide the Agency a copy of the requested
records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed
the cost provided in Chapter 119, F.S., or as otherwise provided by law.
10.1.3 Ensure that public records that are exempt, or confidential and exempt, from public records disclosure
requirements are not disclosed except as authorized by law for the duration of the contract term and
following completion of the contract if the Contractor does not transfer the records to the Agency.
10.1.4 Upon completion of the contract, the Contractor will either transfer, at no cost to the Agency, all public
records in possession of the Contractor to the Agency or will keep and maintain public records required by
the Agency. If the Contractor transfers all public records to the Agency upon completion of the
contract, Contractor shall destroy any duplicate public records that are exempt, or confidential and exempt,
from public records disclosure requirements. If the Contractor keeps and maintains public records upon
completion of the contract, the Contractor shall meet all applicable requirements for retaining public
records. All records stored electronically must be provided to the Agency in a format that is compatible with
the information technology systems of the Agency.
10.2 The Agency may unilaterally cancel this contract, notwithstanding any other provisions of this contract, for refusal
by the Contractor to comply with Section 10 of this contract by not allowing public access to all documents, papers,
letters, or other material made or received by the Contractor in conjunction with this contract, unless the records
are exempt, or confidential and exempt, from Section 24(a) of Article I of the State Constitution and Section
119.07(1), F.S.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION
OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO
PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT
THE CUSTODIAN OF PUBLIC RECORDS AT:
Public Records Coordinator
Area Agency on Aging for Southwest Florida, Inc.
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
239-652-6900 or 866-413-5337
10.3 Upon termination of this contract, whether for convenience or for cause as detailed in Section 53 of this contract, the
Contractor and Subcontractors shall, at no cost to the Agency, transfer all public records in their possession to the
Agency and destroy any duplicate public records that are exempt, or confidential and exempt, from public records
disclosure requirements. All records stored electronically shall be provided to the Agency in a format that is
compatible with the information technology system of the Agency.
11. Audits. Inspections. Investigations:
11.1 The Contractor shall establish and maintain books, records, and documents (including electronic storage media)
sufficient to reflect all assets, obligations, unobligated balances, income, interest, and expenditures of funds
provided by the Agency raider this contract. Contractor shall adequately safeguard all such assets and ensure that
they are used solely for the purposes authorized under this contract. Whenever appropriate, financial information
should be related to performance and unit cost data.
11.2 The Contractor shall retain and maintain all client records, financial records, supporting documents, statistical
records, and any other documents (including electronic storage media) pertinent to this contract for a period of
six (6) years after completion of the contract, or longer when required by law. In the event an audit is required
by this contract, records shall be retained for a minimum period of six (6) years after the audit report is issued or
until resolution of any audit findings or litigation based on the terms of this contract, at no additional cost to the
Agency.
11.3 Upon demand, at no additional cost to the Agency, the Contractor shall facilitate the duplication and transfer of
any records or documents during the required retention period.
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July 2019 to June 2020
ADI 203.19
11.4 The Contractor shall ensure that the records described in this section will be subject at all reasonable times to
inspection, review, copying, or audit by federal, state, or other personnel duly authorized by the Agency.
11.5 At all reasonable times for as long as records are maintained, persons duly authorized by the Agency and
federal auditors, pursuant to 45 CFR Part 75, shall be allowed full access to and the right to examine any of the
Contractor's contracts and related records and documents pertinent to this specific contract, regardless of the
form in which kept.
11.6 The Contractor shall provide a Financial and Compliance Audit to the Agency as specified in this contract and
ensure that all related third -party transactions are disclosed to the auditor.
11.7 Contractor agrees to comply with the Inspector General in any investigation, audit, inspection, review, or hearing
performed pursuant to Section 20.055, F.S. Contractor further agrees that it shall include in related subcontracts
a requirement that subcontractors performing work or providing services pursuant to this contract agree to
cooperate with the Inspector General in any investigation, audit, inspection, review, or hearing pursuant to Section
20.055(5), F,S. By execution of this contact the Contractor understands and will comply with this subsection.
12. Nondiscrimination -Civil Rights Compliance:
12.1 The Contractor shall execute Assurances as stated in the Assurances -Non -Construction Programs Attachment that
it will not discriminate against any person in the provision of services or benefits under this contract or in
employment because of age, race, religion, color, disability, national origin, marital status or sex in compliance
with state and federal law and regulations. The Contactor further assures that all Contractors, Subcontractors,
Sub -grantees, or others with whom it arranges to provide services or benefits in connection with any of its
programs and activities are not discriminating against clients or employees because of age, race, religion, color,
disability, national origin, marital status, or sex.
12.2 During the term of this contract, the Contractor shall complete, and retain on file a timely, complete and accurate
Civil Rights Compliance Checklist, attached to this contract.
12.3 The Contactor shall establish procedures pursuant to federal law to handle complaints of discrimination involving
services or benefits through this contract. These procedures shall include notifying clients, employees, and
participants of the right to file a complaint with the appropriate federal or state entity.
12.4 If this contract contains federal funds, these assurances are a condition of continued receipt of or benefit from
federal financial assistance, and are binding upon the Contactor, its successors, transferees, and assignees for the
period during which such assistance is provided. The Contractor further assures that all Subcontractors, Vendors,
or others with whom it arranges to provide services or benefits to participants or employees in connection with
any of its programs and activities are not discriminating against those participants or employees in violation of
the any statutes, regulations, guidelines, and standards. In the event of failure to comply, the Contractor
understands that the Agency may, at its discretion, seek a court order requiring compliance with the terms of this
assurance or seek other appropriate judicial or administrative relief including, but not limited to, termination of
the contact and denial of further assistance.
13. Monitoring by the Agency:
The Contractor shall permit persons duly authorized by the Agency to inspect and copy any records, papers,
documents, facilities, goods, and services of the Contractor which are relevant to this contact, 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 provide a written report
of its findings to the Contractor and, where appropriate, the Contractor shall develop a Corrective Action Plan (CAP).
The Contractor hereby agrees to correct all deficiencies identified in the CAP in a timely manner as determined by the
Agency's Contract Manager.
14. Provision of Services:
The Contractor shall provide services in the manner described in Attachment I.
July 2019 to June 2020
�i VGIMMOMMIM11101r
ADI 203.19
If the Contractor receives funding from one or more State of Florida human service agencies, in addition to the
Agency, or Department of Elder Affairs, then ajoint monitoring visit including such other agencies may be scheduled.
For the purposes of this contract, and pursuant to Section 287.0575, F.S., as amended, Florida's human service agencies
shall include the Department of Elder Affairs, the Department of Children and Families, the Department of Health,
the Agency for Persons with Disabilities, and the Department of Veterans' Affairs. Upon notification and the
subsequent scheduling of such a visit by the designated agency's lead administrative coordinator, the Contractor shall
comply and cooperate with all monitors, inspectors, and/or investigators.
16. Indemnification:
The Contractor shall indemnify, save, defend, and hold harmless the Agency and its agents and employees from any
and all claims, demands, actions, and causes of action of whatever nature or character arising out of, or by reason of, the
execution of this contract or performance of the services provided for herein. It is understood and agreed that the
Contractor is not required to indemnify the Agency for claims, demands, actions, or causes of action arising solely out
of the negligence of the Agency.
16.1 Except to the extent permitted by Section 768.28, F.S., or other Florida law, this Section 16 is not applicable to
contracts executed between the Agency and state agencies or subdivisions defined in Section 768.28(2), F.S.
17. Insurance and Bonding:
17.1 The Contractor shall provide continuous adequate liability insurance coverage during the existence of this
contract and any renewal(s) and extension(s) of it. By execution of this contract, unless it is a state agency or
subdivision as defined by Section 768.28(2), F.S., the Contractor accepts full responsibility for identifying and
determining the type(s) and extent of liability insurance coverage necessary to provide reasonable financial
protections for the Contractor and the clients to be served under this contract. The limits of coverage under
each policy maintained by the Contractor do not limit the Contractor's liability and obligations under this
contract. The Contractor shall ensure that the Agency has the most current written verification of insurance
coverage throughout the term of this contract. Such coverage may be provided by a self-insurance program
established and operating under the laws of the State of Florida. The Agency reserves the right to require
additional insurance as specified in this contract.
17.2 Throughout the term of this contract, the Contractor shall maintain an insurance bond from a responsible
commercial insurance company covering all officers, directors, employees, and agents of the Contractor
authorized to handle funds received or disbursed under all agreements and/or contracts incorporating this
contract by reference in an amount commensurate with the funds handled, the degree of risk as determined by
the insurance company, and consistent with good business practices.
18. Confidentiality of Information:
The Contractor shall not use or disclose any information concerning a recipient of services under this contract for any
purpose prohibited by state or federal law or regulations except with the written consent of a person legally authorized
to give that consent or when authorized by law.
19. Health Insurance Portability and Accountability Act:
Where applicable, the Contractor shall comply with the Health Insurance Portability and Accountability Act (42 USC
§ 1320d.), as well as all regulations promulgated thereunder (45 CFR Parts 160, 162, and 164).
20. Incident Reporting:
20.1 The Contactor shall notify the Agency immediately but no later than forty-eight (48) hours from the
Contractor's awareness or discovery of conditions that may materially affect the Contractor's or Subcontractor's
ability to perform the services required to be performed under this contract. Such notice shall be made orally to
the Agency's Contract Manager (by telephone) with an email to immediately follow.
July 2019 to June 2020 ADI 203.19
20.2 The Contractor shall immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of
a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone number
(1-800-96ABUSE). As required by Chapters 39 and 415, FS., this provision is binding upon the Contractor,
its Subcontractors, and their employees.
21. Bankrupts Notification:
During the term of this contract, the Contractor shall immediately notify the Agency if the Contractor, its assignees,
Subcontractors, or affiliates file a claim for bankruptcy. Within ten (10) days after notification, the Contractor must also
provide the following information to the Agency: (1) the date of filing of the bankruptcy petition; (2) the case number;
(3) the coma name and the division in which the petition was filed (e.g., Middle District of Florida, Fort Myers, Florida);
and (4) the name, address, and telephone number of the bankruptcy attorney.
22.1 As required by Section 286.25, F.S., if the Contractor is a non-governmental organization which sponsors a
program financed wholly or in part by state funds, including any funds obtained through this contract, it shall, in
publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by (Contractor's name),
the Area Agency on Aging for Southwest Florida and/or the State of Florida, Department of Elder Affairs." If the
sponsorship reference is in written material, the words "Area Agency on Aging for Southwest Florida, Inc. and the
State of Florida, Department of Elder Affairs" shall appear in at least the same size letters or type as the name of
the organization.
22.2 The Contractor shall not use the words "Area Agency on Aging for Southwest Florida, Inc. and/or the State of
Florida, Department of Elder Affairs" to indicate sponsorship of a program otherwise financed, unless specific
written authorization has been obtained by the Agency and/or Department prior to such use.
23. Assignments:
23.1 The Contractor shall not assign the rights and responsibilities under this contract without the prior written
approval of the Agency. Any sublicense, assignment, or transfer otherwise occurring without prior written
approval of the Agency shall constitute a material breach of the contract. In the event the State of Florida
and/or the Area Agency on Aging for Southwest Florida, Inc. approves assignment of the Contractor's
obligations, the Contractor remains responsible for all work performed and all expenses incurred in connection
with this contract.
23.2 This contract shall remain binding upon the successors in interest of the Contractor and the Agency
24. Subcontracts:
24.1 The Contractor is responsible for all work performed and for all commodities produced pursuant to this contract,
whether actually furnished by the Contractor or its Subcontractors. Any subcontracts shall be evidenced by a
written document and subject to any conditions of approval the Agency deems necessary. The Contractor further
agrees that the Agency will not be liable to the Subcontractor in any way or for any reason. The Contractor,
at its expense, shall defend the Agency against any such claims.
24.2 The Contractor shall promptly pay any Subcontractors upon receipt of payment from the Agency or other state
agency. Failure to make payments to any Subcontractor in accordance with Section 287.0585, F.S., unless
otherwise stated in the contract between the Contractor and Subcontractor, will result in a penalty as provided
by statute.
!•1•J.., s Ir r
It is the intent and understanding of the Parties that the Contractor and any of its Subcontractors are independent
Contractors and are not employees of the Agency, and that they shall not hold themselves out as employees or agents
of the Agency without prior specific authorization from the Agency. It is the further intent and understanding of the
Parties that the Agency does not control the employment practices of the Contractor and will not be liable for any
wage and hour, employment discrimination, or other labor and employment claims against the Contractor or its
Subcontractors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment
compensation funds, and all necessary insurance for the Contractor are the sole responsibility of the Contractor.
ON
July 2019 to June 2020
26. Payment:
ADI 203.19
Payments shall be made to the Contractor for all completed and approved deliverables (units of service) as defined in
Attachment I. The Agency Contract Manager will have final approval of the Contractor's invoice submitted for payment
and will approve the invoice for payment only if the Contractor has met all terms and conditions of the contract, unless
the bid specifications, purchase order, or this contract specify otherwise. The approved invoice will be submitted to
the Agency's finance section for budgetary approval and processing. Disputes arising over invoicing and payments
will be resolved in accordance with the provisions of Section 215.422, F.S. A Vendor Ombudsman has been established
within the Florida Department of Financial Services and may be contacted at 800-342-2762.
A19RU f9S1 I ;l=1�
The Contractor shall return to the Agency any overpayments due to unearned funds or funds disallowed, and any
interest attributable to such funds pursuant to the terms and conditions of this contract, that were disbursed to the
Contractor by the Agency. In the event that the Contractor or its independent auditor discovers that an overpayment has
been made, the Contractor shall repay said overpayment immediately without prior notification from the Agency. In
the event that the Agency first discovers an overpayment has been made, the Agency Contract Manager will notify
the Contractor in writing of such findings. Should repayment not be made forthwith, the Contractor shall be charged at
the lawful rate of interest on the outstanding balance pursuant to Section 55.03, F.S., after Agency notification or
Contractor discovery.
28. Data Integrity and Safeguarding Information:
The Contractor shall ensure an appropriate Level of data security for the information the Contractor is collecting or using
in the performance of this contract. An appropriate level of security includes approving and tracking all Contractor
employees that request system or information access and ensuring that user access has been removed from all terminated
employees. The Contractor, among other requirements, must anticipate and prepare for the loss of information
processing capabilities. All data and software shall be routinely backed up to ensure recovery from losses or outages
of the computer system. The security over the backed -up data is to be as stringent as the protection required of the
primary systems. The Contractor shall ensure all Subcontractors maintain written procedures for computer system
backup and recovery. The Contractor shall complete and sign the Certification Regarding Data Integrity Compliance
for Agreements, Grants, Loans, and Cooperative Agreements prior to the execution of this contract.
29. ComRuter Use and Social Media Policy:
The Department has implemented a Social Media Policy, in addition to its Computer Use Policy, which applies to all
employees, contracted employees, consultants, Other Personal Services (OPS) employees and volunteers, including
all personnel affiliated with third parties, such as, but not limited to, contractors and subcontractors. Any entity
that uses the Department's computer resource systems must comply with the Department's policy regarding social
media. Social Media includes, but is not limited to, blogs, podcasts, discussion forums, Wikis, RSS feeds, video
sharing, social networks like MySpace, Facebook and Twitter, as well as content sharing networks such as flickr and
YouTube. This policy is available on the Department's website at: http://elderaffairs.state.fl.us/doea/financial.php.
30. Conflict of Interest:
The Contractor shall establish safeguards to prohibit employees, board members, management, and Subcontractors from
using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of
interest or personal gain. No employee, officer, or agent of the Contractor or Subcontractor shall participate in the
selection or in the award of a contract supported by state or federal funds if a conflict of interest, real or apparent, would
be involved. Such a conflict would arise when: (a) the employee, officer or agent; (b) any member of his/her immediate
family; (c) his or her partner; or (d) an organization which employs, or is about to employ, any of the above
individuals, has a financial or other interest in the firm being selected for award. The Contractor's or Subcontractor's
officers, employees, or agents will neither solicit nor accept gratuities, favors, or anything of monetary value from
Contractors, potential Contractors, or parties to Subcontracts. The Contractor's board members and management
must disclose to the Agency any relationship which may be, or may be perceived to be, a conflict of interest within
thirty (30) calendar days of an individual's original appointment or placement in that position, or, if the individual is
serving as an incumbent, within thirty (30) calendar days of the commencement of this contract. The Contractor's
employees and Subcontractors must make the same disclosures described above to the Agency's board of directors.
Compliance with this provision will be monitored.
July 2019 to June 2020
31. Public Entity Crime:
ADI 203.19
Pursuant to Section 287.133, F.S., a person or affiliate who has been placed on the Convicted Vendor List following a
conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods or
services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the construction
or repair of a public building or public work; may not submit bids, proposals, or replies on leases of real property to a
public entity; may not be awarded or perform work as a Contractor, Supplier, Subcontractor, or Consultant under a
contract with any public entity; and may not transact business with any public entity in excess of the threshold amount
provided in Section 287.017, F.S., for CATEGORY TWO for a period of thirty six (36) months following the date of
being placed on the Convicted Vendor List.
32. Purchasing:
32.1 The Contractor may purchase articles which are the subject of, or are required to carry out, this contract from
Prison Rehabilitative Industries and Diversified Enterprises, Inc., (PRIDE) identified under Chapter 946, F.S.,
in the same manner and under the procedures set forth in Sections 946.515(2) and (4), F.S. For purposes of this
contract, the Contractor 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 at (800) 643-8459.
32.2 The Contractor may procure any recycled products or materials which are the subject of or are required to carry
out this contact in accordance with the provisions of Section 403.7065, F.S.
32.3 The Contractor may purchase articles that are the subject of or are required to carry out this contract from
a nonprofit agency for the Blind or for the Severely Handicapped that is qualified pursuant to Chapter 413, F.S.,
in the same manner and under the same procedures set forth in Sections 413.036(1) and (2), F.S. For purposes of
this contract, the Contractor shall be deemed to be substituted for the Agency insofar as dealings with such
qualified nonprofit agency are concerned. Additional information about the designated nonprofit agency and
the products it offers is available at http://www.respectofflorida.org. This clause is not applicable to
Subcontractors unless otherwise required by law.
33. Patents. Copyrights, Royalties:
If this contract is awarded state funding and if any discovery, invention, or copyrightable material is developed or produced
in the course of or as a result of work or services performed under this contract or in any way connected with this contract,
or if ownership of any discovery, invention, or copyrightable material was purchased in the course of or as a result of
work or services performed under this contract, the Contractor shall refer the discovery, invention, or copyrightable
material to the Agency to be referred to the Agency and/or Department of State. Any and all patent rights or
copyrights accruing under this contact are hereby reserved to the State of Florida in accordance with Chapter 286, F.S.,
Pursuant to Section 287.0571(5)(lo, as amended, the only exceptions to this provision shall be those that are clearly
expressed and reasonably valued in this contact.
33.1 If the primary purpose of this contact is the creation of intellectual property, the State of Florida shall retain an
unencumbered right to use such property, notwithstanding any agreement made pursuant to this Section 34.
33.2 If this contract is awarded solely federal funding, the terms and conditions are governed by 2 CFR § 200.315 or
45 CFR § 75.322, as applicable.
33.3 Notwithstanding the foregoing provisions, if the Contactor or one of its Subcontractors is a university and a
member of the State University System of Florida, then Section 1004.23, F.S., shall apply, but the Agency shall
retain a perpetual, fully -paid, nonexclusive license for its use and the use of its Contractors, Subcontractors, or
Assignees of any resulting patented, copyrighted, or trademarked work products.
MR, • Into
• ��
34.1 If the tasks to be performed pursuant to this contact include the physical care and control of clients, or the
administration and coordination of services necessary for client health, safety, or welfare, the Contractor shall,
within thirty (30) calendar days of the execution of this contract, submit to the Agency Contract Manager,
verification of an Emergency Preparedness Plan. In the event of an emergency, the Contractor shall notify the
Agency of emergency provisions.
9
July 2019 to June 2020
ADI 203.19
34.2 In the event a situation results in a cessation of services by a Subcontractor, the Contractor shall remain
responsible for performance under this contract and must follow procedures to ensure continuity of operations
without interruption.
35. Enuinment:
35.1 Equipment means: (a) tangible personal property (including information technology systems) having a useful life of
more than one year and a per-unit acquisition cost which equals or exceeds the lesser of the capitalization level
established by the organization for the financial statement purposes, or $5,000.00 [for federal funds - 2 CFR
§ 200.33 and 45 CFR § 75.2, as applicable], or (b); nonexpendable, tangible personal property of a non-
consumable nature with an acquisition cost of $1,000.00 or more per unit, and expected useful life of at least one
(1) year; and hardback bound books not circulated to students or the general public, with a value or cost of
$250.00 or more [for state funds].
35.2 Contractors and Subcontractors who are Institutions of Higher Education, Hospitals, and Other Non -Profit
Organizations shall have written property management standards in compliance with 2 CFR Part 200
Administrative Requirements (formerly OMB Circular A-110) that include: (a) a property list with all the
elements identified in the circular; (b) a procedure for conducting a physical inventory of equipment at least once
every two (2) years; (c) a control system to insure adequate safeguards to prevent loss, damage, or theft of the
equipment; and (d) maintenance procedures to keep the equipment in good condition. The property records must
be maintained on file and shall be provided to the Agency upon request. The Contractor shall promptly
investigate, fully document, and notify the Agency Contract Manager of any loss, damage, or theft of
equipment. The Contractor shall provide the results of the investigation to the Agency Contract Manager.
35.3 The Contractor's property management standards for equipment (including replacement equipment), whether
acquired in whole or in part with federal funds and federally -owned equipment shall, at a minimum, meet the
following requirements and shall include accurately maintained equipment records with the following information:
35.3.1 Property records must be maintained that include a description of the equipment;
35.3.2 Manufacturer's serial number, model number, federal stock number, national stock number, or other
identification number;
35.3.3 Source of funding for the equipment, including the federal award identification number;
35.3.4 Whether title vests in the Contractor or the federal government;
35.3.5 Acquisition date (or date received, if the equipment was furnished by the federal government);
35.3.6 Information from which one can calculate the percentage of federal participation in the cost of the
equipment (not applicable to equipment furnished by the federal government);
35.3.7 Location, use and condition of the equipment and the date the information was reported;
35.3.8 Unit acquisition cost; and
35.3.9 Ultimate disposition data, including date of disposal and sales price or the method used to determine
current fair market value where a Contractor compensates the federal awarding agency for its share.
35.3.10 A physical inventory must be taken and the results reconciled with the property records at least once
every two (2) years.
35.3.11 A control system must be developed to ensure adequate safeguards to prevent loss, damage, or theft of
the property. Any loss, damage, or theft must be investigated. 45 CFR § 75.320(d)(3).
35.3.12 Adequate maintenance procedures must be developed to keep the property in good condition.
35.3.13 If the Contractor is authorized or required to sell the equipment, proper sales procedures must be
established to ensure the highest possible return.
35.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased with
state funds with an acquisition cost over $1,000.00 is part of the cost of carrying out the activities and functions of
the grant awards and title (ownership) will vest in the Contractor (for federal funds see 2 CFR § 200.313(a) and
10 GO
July 2019 to June 2020 ADI 203.19
45 CFR § 75.320(a), as applicable) subject to the conditions of 2 CFR Part 200 and/or 45 CFR Pant 75.
Equipment purchased under these thresholds is considered supplies and is not subject to property standards.
Equipment purchased with funds identified in the budget attachments to agreements covered by this contract or
identified in the sub -agreements with Subcontractors (not included in a cost methodology), is subject to the
conditions of Chapter 273, F.S., rule 60A-1.017, F. A. C., and 2 CFR Part 200 and/or 45 CFR Part 75.
35.5 The Contractor shall not dispose of any equipment or materials provided by the Agency, or purchased with funds
provided through this contract without first obtaining the approval of the Agency Contract Manager. When
disposing of property or equipment the Contractor must submit a written request for disposition instructions to
the Agency's Contract Manager. The request should include a brief description of the property, purchase
price, funding source, and percentage of state or federal participation, acquisition date and condition of the
property. The request should also indicate the Contractor's proposed disposition of the property (i.e., transfer or
donation to another agency that administers federal programs, offer of the items for sale, destroy the items, etc.).
35.6 The Agency Contract Manager will issue disposition instructions. If disposition instructions are not received
within one hundred twenty (120) days of the written request for disposition, the Contractor is authorized to proceed
as directed in 2 CFR § 200,313 or 45 CFR § 75.320, as applicable.
35.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto, but
excludes movable machinery and equipment. Real property may not be purchased with state or federal funds
through agreements covered under this contract without the prior approval of the Agency. Real property
purchases from Older Americans Act funds are subject to the provisions of Title 42, Chapter 35, Subchapter III,
Part A., Section 3030b United States Code (U.S.C.). Real property purchases from state funds can only be made
through fixed capital outlay grants and aids appropriations and therefore are subject to the provisions of Section
216.348, F.S.
35.8 Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted and tested prior to
disposal to ensure no confidential information remains.
35.9 The Contractor must adhere to the Agency's procedures and standards when purchasing Information Technology
Resources (ITR) as part of any agreement(s) incorporating this contract by reference. An ITR worksheet is
required for any computer related item costing $1,000.00 or more, including data processing hardware,
software, services, supplies, maintenance, training, personnel, and facilities. The completed ITR worksheet
shall be maintained in the LAN administrator's file and must be provided to the Agency upon request. The
Contractor has the responsibility to require any Subcontractors to comply with the Agency's ITR procedures.
36. PUR 1000 Form:
The PUR 1000 Form is hereby incorporated by reference and available at:
http://www.myflorida.com/apps/vbs/adoe/F7740 PUR1000.pdf
In the event of any conflict between the PUR 1000 Form and any terms or conditions of this contract, the terms or
conditions of this contract shall take precedence over the PUR 1000 Form. However, if the conflicting terns or
conditions in the PUR 1000 Form are required by any section of the Florida Statutes, the terms or conditions contained
in the PUR 1000 Form shall take precedence.
37. Use of State Funds to Purchase or Improve Real Property:
Any state funds provided for the purchase of or improvements to real property are contingent upon the Contractor or
political subdivision granting to the state a security interest in the property at least to the amount of state funds provided
for at least five (5) years from the date of purchase or the completion of the improvements or as further required by law.
38. Dispute Resolution:
Any dispute concerning performance of the contract shall be decided by the Agency Contract Manager, who shall reduce
the decision to writing and serve a copy on the Contractor.
39. Financial Consequences:
If the Contractor fails to meet the minimum level of service or performance identified in this contract, the Agency shall
impose financial consequences as stated in Attachment I.
11
July 2019 to June 2020
40. No Waiver of Sovereign Immunity:
ADI 203.19
Nothing contained in this contract is intended to serve as a waiver of sovereign immunity by any entity to which
sovereign immunity may be applicable.
41. Venue:
If any dispute arises out of this contract, the venue of such legal recourse shall be Lee County, Florida.
42. Entire Contract:
This contract contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations
shall be valid or binding upon the Agency or the Contractor unless expressly contained herein or by a written
amendment to this contract signed by both Parties.
43. Force Maieure:
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control,
provided the party experiencing the force majeure condition provides immediate written notification to the other party
and takes all reasonable efforts to cure the condition.
44. Severability Clause:
The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or unenforceable, the
other provisions are severable to that void provision and shall remain in full force and effect.
45. Condition Precedent to Contract ApUronriations:
The Parties agree that the Agency's performance and obligation to pay under this contract are contingent upon an
annual appropriation by the Legislature.
46. Addition/Deletion:
The Parties agree that the Agency reserves the right to add or to delete any of the services required under this
contract when deemed to be in the State of Florida's best interest and reduced to a written amendment signed by both
Parties. The Parties shall negotiate compensation for any additional services added.
47. Waiver:
The delay or failure by the Agency to exercise or enforce any of its rights under this contract will not constitute or be
deemed a waiver of the Agency's right thereafter to enforce those rights, nor will any single or partial exercise of any
such right preclude any other or further exercise thereof or the exercise of any other right.
48. Compliance:
The Contractor shall abide by all applicable current federal statutes, laws, rules, and regulations as well as applicable
current state statutes, laws, rules and regulations. The Parties agree that failure of the Contractor to abide by these laws
shall be deemed an event of default of the Contractor and subject the contract to immediate unilateral cancellation of
the contract at the discretion of the Agency.
49. Final Invoice:
The Contractor shall submit the final invoice for payment to the Agency no later than thirty (30) days upon the
contract ending date unless otherwise specified in Attachment I. If the Contractor fails to do so, all right to payment is
forfeited and the Agency shall not honor any requests submitted after the aforesaid time period. Any payment due
under the terms of this contract shall be withheld until all required documentation and reports due from the Contractor
and necessary adjustments thereto have been approved by the Agency.
50. Renegotiations of Modifications:
Modifications of the provisions of this contract shall be valid only when they have been reduced to writing and duly
signed by both parties. The rate of payment and the total dollar amount may be adjusted retroactively to reflect price
level increases and changes in the rate of payment when these have been established through the appropriations process
and subsequently identified in the Agency's operating budget.
12
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July 2019 to June 2020
51. Suspension of Work:
ADI 203.19
The Agency may, in its sole discretion, suspend any or all activities under the contract or purchase order, at any time,
when in the best interest of the State to do so. The Agency shall provide the Contractor written notice outlining the
particulars of suspension. Examples of the reason for suspension include, but are not limited to, budgetary
constraints, declaration of emergency, or other such circumstances. After receiving a suspension notice, the Contractor
shall comply with the notice and shall not accept any purchase orders. Within ninety (90) days, or any longer period
agreed to by the Contractor, the Agency shall either: (1) issue a notice authorizing resumption of work, at which time
activity shall resume, or (2) terminate the contract or purchase order. Suspension of work shall not entitle the
Contractor to any additional compensation.
52. Termination:
52.1 Termination for Convenience. The Agency, by written notice to the Contractor, may terminate this contact in
whole or in part when the Agency determines in its sole discretion that it is in the State's interest to do so. The
Contractor shall not furnish any product after it receives the notice of termination, except as necessary to
complete the continued portion of this contract, if any. The Contractor shall not be entitled to recover any
cancellation charges or lost profits.
52.2 Termination for Cause. The Agency may terminate this contract if the Contractor fails to: (1) deliver the
product within the time specified in the contract or any extension, (2) maintain adequate progress, thus
endangering performance of the contract, (3) honor any term of the contract, or (4) abide by any statutory,
regulatory, or licensing requirement. Rule 60A-1.006(3), F.A.C., governs the procedure and consequences of
default. The Contactor shall continue work on any work not terminated. Except for defaults of Subcontractors
at any tier, the Contractor shall not be liable for any excess costs if the failure to perform the contract arises from
events completely beyond the control, and without the fault or negligence, of the Contactor. If the failure to
perform is causedby the default of a Subcontractor at any tier, and if the cause of the default is completely beyond
the control of both the Contractor and the Subcontractor, and without the fault or negligence of either, the
Contractor shall not be liable for any excess costs for failure to perform, unless the subcontracted products were
obtainable from other sources in sufficient time for the Contractor to meet the required delivery schedule. If, after
termination, it is determined that the Contactor was not in default, or that the default was excusable, the rights
and obligations of the Parties shall be the same as if the termination had been issued for the convenience of the
Agency. The rights and remedies of the Agency in this clause are in addition to any other rights and remedies
provided by law or under the contract.
53. Electronic Records and Signature:
The Agency authorizes, but does not require, the Contractor to create and retain electronic records and to use
electronic signatures to conduct transactions necessary to. carry out the terms of this contract. A Contractor that creates
and retains electronic records and uses electronic signatures to conduct transactions shall comply with the requirements
contained in the Uniform Electronic Transaction Act, Section 668.50, F.S. All electronic records must be fully
auditable; are subject to Florida's Public Records Law, Chapter 119, F.S.; must comply with contract Section 29, Data
Integrity and Safeguarding Information; must maintain all confidentiality, as applicable; and must be retained and
maintained by the Contactor to the same extent as non -electronic records are retained and maintained as required by
this contact.
53.1 The Agency's authorization pursuant to this section does not authorize electronic transactions between the
Contractor and the Agency. The Contractor is authorized to conduct electronic transactions with the Agency
only upon further written consent by the Agency.
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July 2019 to June 2020
ADI 203.19
53.2 Upon request by the Agency, the Contractor shall provide the Agency with non -electronic (paper) copies of
records. Non -electronic (paper) copies provided to the Agency of any document that was originally in electronic
form with an electronic signature must identify the person and the person's capacity who electronically signed the
document on any non -electronic copy of the document.
ymortriMIMu ➢#
The Agency may substitute any Agency employee to serve as the Agency Contract Manager.
REMAINDER OF THE PAGE INTENTIONALLY LEFT BLANK
14
July 2019 to June 2020 ADI 203.19
55. Official Payee and Representatives (Names. Addresses. and Telephone Numbers):
56. All Terms and Conditions Included:
This contract and its Attachments, I — XV including any exhibits referenced in said attachments, together with any
documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There are no
provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all
previous communications, representations, or agreements, either written or verbal, between the Parties.
By signing this contract, the Parties agree that they have read and agree to the entire contract.
IN WITNESS WHEREOF, the Parties hereto have caused this contract to be executed by their undersigned officials
as duly authorized.
CONTRACTOR: COLLIER COUNTY BOARD
OF COUNTY COMMISSIONERS
SIGNED BY 's.:�i
NAME: Stephen Y Carnell
TITLE: Public Service Department Head
DATE: ` / � C,
Federal Tax ID: 59-6000588
Fiscal Year Ending Date: 09/30
Duns: 076997790
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA, INC.
SIGNED BY: OQ
NAME: MARIANNE G LORINI
TITLE: PRESIDENT/CEO
DATE: '71a 2 119
Approved as to form and legality
15 Assns nt County Atka' c
Q
The Contractor name, as shown on page 1 of this
Collier County Board of County Commissioners
contract, and mailing address of the official payee to
3339 E Tamiami Trail, Building H
a.
whom the payment shall be made is:
Naples, FL 34112
The name of the contact person and street address
ICr Sonntag, Director
Collier County Board of County Commissioners
b.
where financial and administrative records are
%Community and Human Services
maintained is:
3339 E Tamiami Trail, Building H
Naples, FL 34112
Kristi Sonntag, Director
The name, address, and telephone number of the
Collier County Board of County Commissioners
c'
representative of the Contractor responsible for
%Community and Human Services
administration of the program under this contract is:
3339 E Tamiami Trail, Building H
Naples, FL 34112
239 252-2273
Area Agency on Aging for Southwest Florida, Inc.
d
The section and location within the Agency where
15201 North Cleveland Avenue, Suite 1100
Requests for Payment and Receipt and Expenditure
North Fort Myers, FL 33903
forms are to be mailed is:
Becky MacKenzie, Director of Program & Planning
e.
The name, address, and telephone number of the
Area Agency on Aging for Southwest Florida, Inc.
Contract Manager for this contract is:
15201 North Cleveland Avenue, Suite 1100
North Fort Myers, FL 33903
239-652-6900
Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided in
writing to the other party.
56. All Terms and Conditions Included:
This contract and its Attachments, I — XV including any exhibits referenced in said attachments, together with any
documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There are no
provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all
previous communications, representations, or agreements, either written or verbal, between the Parties.
By signing this contract, the Parties agree that they have read and agree to the entire contract.
IN WITNESS WHEREOF, the Parties hereto have caused this contract to be executed by their undersigned officials
as duly authorized.
CONTRACTOR: COLLIER COUNTY BOARD
OF COUNTY COMMISSIONERS
SIGNED BY 's.:�i
NAME: Stephen Y Carnell
TITLE: Public Service Department Head
DATE: ` / � C,
Federal Tax ID: 59-6000588
Fiscal Year Ending Date: 09/30
Duns: 076997790
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA, INC.
SIGNED BY: OQ
NAME: MARIANNE G LORINI
TITLE: PRESIDENT/CEO
DATE: '71a 2 119
Approved as to form and legality
15 Assns nt County Atka' c
Q
July 2019 to June 2020
INDEX OF ATTACHMENTS
ATTACHMENT
ADI 203.19
STATEMENTOF WORK........................................................................................................................................17
ATTACHMENT II
FINANCIAL AND COMPLIANCE A UDIT.......................................................................................................
30
ATTACHMENT III
CERTIFICATIONS AND ASSURANCES.............. ............................................... .............................................
36
ATTACHMENT IV
ASS URANCES-NON-CONSTR UCTION PR OGRAMS................... ................................................................
41
ATTACHMENT V
FLORIDA DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST ..................
43
ATTACHMENT VII
BACKGROUNDSCREENING.........................................................................................................................
47
ATTACHMENT IX
INVOICEREPORT SCHEDULE......................................................................................................................
48
ATTACHMENT X
ANNUALBUDGET SUMMARY.......................................................................................................................
49
ATTACHMENT XI
REQUESTFOR PAYMENT..............................................................................................................................
50
ATTACHMENT XII
RECEIPT AND EXPENDITURE REPORT......................................................................................................
51
ATTACHMENT XV
SERVICERATE REPORT.................................................................................................................................
52
16
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July 2019 to June 2020
ADI 203.19
ATTACHMENT
STATEMENT OF WORK
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
I. SERVICES TO BE PROVIDED
A. Definitions of Terms
1. Acronyms
Alzheimer's Disease (AD)
Alzheimer's Disease Initiative (ADI)
Activities of Daily Living (ADL)
Area Agency on Aging (AAA)
Assessed Priority Consumer List (APCL)
Adult Protective Services (APS)
Client Information and Registration Tracking System (CIRTS)
Community Care for Disabled Adults (CODA)
Corrective Action Plan (CAP)
Dementia Care & Cure Initiative (DCCI)
Department of Elder Affairs (DOEA or Department)
Florida Administrative Code (F.A.C.)
Florida Statutes (F.S.)
Home Care for Disabled Adults (HCDA)
Instrumental Activities of Daily Living (IADL)
Memory Disorder Clinic (MDC)
Planning and Service Area (PSA)
Summary of Programs and Services (SOPS)
United States Code (U.S.C.)
2. Program -Specific Terms
Area Plan: A plan developed by the Agency outlining a comprehensive and coordinated service delivery
system in the respective Planning and Service Area, in accordance with Section 306 of the Older Americans
Act (42 U.S.C. § 3026), as amended, and Department instructions. The Area Plan includes performance
measures and unit rates per service offered per county.
Area Plan Update: A revision to the Area Plan wherein the Agency and/or contractor enters ADI -specific
data into the CIRTS. An update may also include other revisions to the Area Plan as instructed by the
Agency and/or Department.
Department of Elder Affairs Handbook: An official document of DOEA. The DOEA Handbook includes
program policies, procedures, and standards applicable to agencies which are recipients/providers of DOEA
funded programs. An annual update is provided through a Notice of Instruction (NOI).
Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to
remain independent and in the least restrictive living arrangement.
Memory Disorder Clinic (MDC): Research oriented programs created pursuant to Sections 430.502(1) and (2),
F.S., to provide diagnostic and referral services, conduct basic and service -related multidisciplinary research,
and develop training materials and educational opportunities for lay and professional caregivers of individuals
with AD.
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July 2019 to June 2020
ADI 203.19
Notice of Instruction (NOI): The Department's established method to communicate to the Agency, Contractor,
and subcontractor the requirement to perform a task or activity. NOIs are located on the Department's website
at http://elderaffairs.state.fl.us/doea/nois.php.
Provision: Language used in a general appropriations bill to qualify or restrict the way in which a specific
appropriation is to be expended.
Program Highlights: Success stories, quotes, testimonials, or human -interest vignettes that are used in the
Agency's Summary of Programs and Services (SOPS) to include information that helps tell the story of how
programs and services help elders, families, and caregivers.
Specialized Day Care: Licensed Specialized Alzheimer's Services Adult Day Care Centers, licensed, in
accordance with Section 429.918, F.S., that are considered models because they provide specialized Alzheimer's
services for AD clients. FloridaHealthFinder.gov provides an up to date listing of all Specialized Alzheimer's
Services Adult Day Care Centers.
Specialized Alzheimer's Services: Specialized Alzheimer's services, offered in day care centers include, but
are not limited to, those listed below:
i. Providing education and training on the specialized needs of persons with Alzheimer's disease or related
memory disorders and caregivers,
ii. Providing specialized activities that promote, maintain, or enhance the ADI client's physical, cognitive,
social, spiritual, or emotional health; and
iii. Providing therapeutic, behavioral, health, safety, and security interventions; clinical care, and support
services for the ADI client and caregiver.
Summary of Programs and Services (SOPS): A document produced by the Department and updated yearly
to provide the public and the Legislature with information about programs and services for Florida's elders.
B. GENERAL DESCRIPTION
1. General Statement
The purpose of the ADI is to address the special needs of individuals with AD, their families, and caregivers.
2. Alzheimer's Disease Initiative Program Mission Statement
The ADI program assists persons afflicted with AD and other forms of dementia to live as independently as
possible with support to family members and caregivers.
Authority
The relevant authority governing the ADI Program includes:
a. Rule Chapter 58D-1, F.A.C.;
b. Sections 430.501, 430.502, 430.503, and 430.504, F.S.; and
c. The Catalog of State Financial Assistance (CSFA) Numbers 65004 and 65002.
4. Scope of Service
The Contractor is responsible for the programmatic, fiscal, and operational management of the ADI Program.
The program services shall be provided in a manner consistent with the Agency's Area Plan, as updated, and
the current.DOEA Handbook, which are incorporated by reference. The Contractor agrees to be bound by all
subsequent amendments and revisions to the DOEA Handbook, and the Contractor agrees to accept all such
amendments and revisions via a NOI.
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July 2019 to June 2020
5. Major Program Goal
ADI 203.19
The major goal of the ADI Program is to provide services to meet the needs of caregivers and individuals with
AD or other related disorders.
C. Clients to be Served
1. General Description
The ADI program addresses the special needs of individuals with AD or other related disorders, and their
caregivers.
2. Client Eligibility
Clients eligible to receive services under this contract must:
a. Be 18 years of age or older and have a diagnosis of AD or a related disorder, or be suspected of having
AD or a related disorder; or
b. If enrolled in Specialized Alzheimer's Services Adult Day Care, be a participant who has a documented
diagnosis of Alzheimer's disease or a dementia -related disorder (ADRD) from a licensed physician,
licensed physician assistant, or a licensed advanced registered nurse practitioner; and
c. Not be enrolled in any Medicaid capitated long-term care program.
3. Targeted Groups
Priority for services under this contract will be given to those eligible persons assessed to be at risk of
placement in an institution.
4. Client Determination
The Agency shall have final authority for the determination of client eligibility.
S. Contract Limits
In no case shall the Contractor be required to incur costs in excess of the contract amount in providing services
to the clients.
6. Clients Served
This contract does not provide for direct services to clients other than intake, information and referral services,
and screening.
II. MANNER OF SERVICE PROVISION
A. Service Tasks
To achieve the goals of the ADI program, the Contactor shall perform, or ensure that its subcontractors perform,
the following tasks:
Client Eligibility Determination
The Contractor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a
client is based on meeting the requirements described in Section I.C.2.
2. Assessment and Prioritization of Service Delivery for New Clients
The Contactor shall ensure the following criteria are used to prioritize new clients in the sequence below for
service delivery. It is not the intent of the Agency to remove existing clients from services in order to serve new
clients being assessed and prioritized for service delivery.
19
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July 2019 to June 2020
raerzlxllE[:1
a. Imminent Risk individuals: Individuals in the community whose mental or physical health condition has
deteriorated to the degree that self-care is not possible, there is no capable caregiver, and nursing home
placement is likely within a month or very likely within three (3) months.
b. Service priority for individuals not included above, regardless of referral source, will be determined
through the Agency's functional assessment administered to each applicant, to the extent funding is
available. The Contractor shall ensure that first priority is given to applicants at the higher levels of frailty
and risk of nursing home placement.
3. Program Services
The Contractor shall ensure the provision of program services is consistent with the Agency's current Area Plan,
as updated and approved by the DOEA, and the current DOEA Handbook.
4. Task Limits
The Contractor shall not perform any tasks related to the project other than those described in this contract
without the express written consent of the Agency.
B. Use of Subcontractors
If this contract involves the use of a subcontractor or third party, then the Contractor shall not delay the
implementation of its agreement with the Subcontractor. If any circumstance occurs that may result in a delay for
a period of sixty (60) days or more of the initiation of the subcontract or the performance of the Subcontractor, the
Contractor shall notify the Agency's Contract Manager in writing of such delay. The Contractor shall not permit
a Subcontractor to perform set -vices related to this contract without having a binding Subcontractor agreement
executed. The Agency will not be responsible or liable for any obligations or claims resulting from such action.
Copies of Subcontracts
The Contractor shall submit a copy of all subcontracts to the Agency Contract Manager within thirty (30) days
of the subcontract being executed.
2. Monitoring the Performance of Subcontractors
The Contractor shall monitor, at least once per fiscal year, each of its subcontractors, subrecipients, vendors,
and/or consultants paid from funds provided under this contract. The Contractor shall perform fiscal,
administrative, and programmatic monitoring to ensure contractual compliance, fiscal accountability,
programmatic performance, and compliance with applicable state and federal laws and regulations. The
Contractor shall monitor to ensure that the budget is met, the scope of work is accomplished within the
specified time periods, and other performance goals stated in this contract are achieved.
3. Copies of Subcontractor Monitoring Reports
The Contractor shall forward a copy of all subcontractor Monitoring Reports to the Agency Contract
Manager within thirty (30) days of the report being issued to the Subcontractors, Subrecipients, Vendors,
and/or Consultants.
C. Staffing Requirements
1. Staffing Levels
The Contractor shall assign its own administrative and support staff as necessary to meet the obligations of
this contract and shall ensure that subcontractors dedicate adequate staff accordingly.
2. Professional Qualifications
The Contractor shall ensure that the staff responsible for performing any duties or functions within this contract
have the qualifications as specified in the current DOEA Handbook.
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July 2019 to June 2020
3. Service Times
ADI 203.19
The Contractor shall ensure the availability of the services listed in this contract at times appropriate to meet
client service needs including, at a minimum, during normal business hours, or as otherwise specified in
provision or the Subcontractor's approved service provider application. Normal business hours are defined as
Monday through Friday, 8:00 a.m. to 5:00 p.m. local time.
D. Service Location and Equipment
1. Service Delivery Location
Services will be provided as needed in locations determined by provider to best meets clients'
immediate needs.
2. Changes in Location
The Contractor shall notify the Agency in writing a minimum of one week prior to making changes in
location that will affect the Agency's ability to contact the Contractor by telephone or facsimile.
3. Equipment
Contractor shall be responsible for supplying, at its own expense, all equipment necessary for its performance
under the contract including, but not limited to, computers, telephones, copiers, fax machines, maintenance and
office supplies.
E. Deliverables
The following section provides the specific quantifiable units of deliverables and source documentation required
to evidence the completion of the tasks specified in this contract.
1. Delivery of Services to Eligible Clients
The Contractor shall ensure the provision of a continuum of services addressing the diverse needs of
individuals with AD and their caregivers. The Contractor shall ensure performance and reporting of the
following services in accordance with the Agency's current Department -approved Area Plan, the current
DOEA Handbook, which is.incorporated by reference, and Section H.A. of this contract. Documentation of
service delivery must include a report consisting of the following: number of clients served, number of
service units provided by service, and rate per service unit with calculations that equal the total invoice amount.
The continuum of services provided under this contract include those identified by the following service
categories:
a. Respite and Other Services
(1) Caregiver Training/Support;
(2) Case Aide;
(3) Case Management;
(4) Counseling (Gerontological);
(5) Counseling (Mental Health/Screening);
(6) Education/Training;
(7) Intake;
(8) Respite (Facility -Based);
(9) Respite (In -Home);
(10) Respite (In -Facility, Specialized Alzheimer's services);
(11) Specialized Medical Equipment, Services, and Supplies; and
(12) Transportation.
b. Memory Disorder Clinics (MDCs)
The Agency shall maintain coordination with the MDCs, the Alzheimer's Disease and Related Disorders
Research Brain Bank (Brain Bank), and all other components of the ADI, as well as Silver Alert, in the
designated PSA. MDCs are required to provide annual in-service training to all respite, in -facility respite,
and model day care center staff in their designated service areas, and to plan and develop service -related
21
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July 2019 to June 2020
ADI 203.19
research projects with model day care and respite providers. The Contractor shall respond to requests for
statistical data concerning its consumers, based on information requirements of the MDCs and the Brain
Bank, and assist the MDCs in carrying out Silver Alert protocol activities to include return of the Aging and
Disability Resource Center (ADAC) Silver Alert Services Referral Form to the referring MDC within
fourteen (14) days of receipt.
2. Services and Units of Service
The Contractor shall ensure that the provision of services described in this contract is in accordance with the
current DOEA Handbook and the service tasks described in Section II.A. The Service Rate Report lists the
services that can be performed, the highest reimbursement unit rate, the method of payment, and the service
unit type. Units of service will be paid pursuant to the rate established in the Area Plan as updated, as shown in
the Service Rate Report, and approved by the Agency.
F. Reports
The Contractor shall respond to additional routine or special requests for information and reports required by the
Agency in a timely manner, as determined by the Agency Contract Manager. The Contractor shall establish
reporting due dates for Subcontractors that permit the Contractor to meet the Agency's reporting requirements.
1. CIRTS Reports
The Contractor shall input ADI -specific data into CIRTS. To ensure CIRTS data accuracy, the Contactor shall
use CIRTS-generated reports which include the following:
a. Client Reports;
b. Monitoring Reports;
c. Services Reports;
it. Miscellaneous Repots;
e. Fiscal Reports;
f. Aging and Disability Resource Center Reports; and
g. Outcome Measurement Reports.
1. Annual Service Cost Reports
a. The Agency shall require Contractors to annually submit to the Agency service cost reports, which reflect
actual costs of providing each service. This Annual Service Cost Report will be due by February 25, of
each year. This report will include actual costs for performing all services during the preceding calendar
year. Supporting documentation must accompany the repot, which will include General Ledger, Trial
Balance and/or Statement of Revenue and Expenditures along with a narrative explanation and justification
of rate differences. This Annual Service Cost Report provides information for planning and negotiating unit
rates.
b. Any multi-year contracts entered into with service providers on or after the effective date of this contract
shall contain a provision requiring the contract's parties to re-evaluate the contract's reimbursement rates on
an annual basis. The Contractor may annually renegotiate rates based on factors including but not limited to
a review of sustainability, the respective consumer price index, or current market conditions. However, it is
the intent of the Department and/or Agency that the quality of services provided to current program recipients
not be reduced. Unit Cost Methodology worksheets, along with supporting documentation and narrative
explanation, must be submitted by April 15 of each year, if a rate increase is being requested for any service
in the next contact year.
3. Surplus/Deficit Report
The Contractor shall submit a Consolidated Surplus/Deficit Report, Lead Agency Spending Report, in a format
provided by the Agency, to the Agency Contract Manager by the 18th of each month. This Consolidated
Surplus/Deficit Report is for all agreements and contracts between the Contractor and the Agency and must
include the following:
a. A list of all contracts and their current status regarding surplus/deficit;
22
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July 2019 to June 2020
ADI 203.19
b. The Contractor's detailed plan on how the surplus/deficit spending exceeding the threshold specified by
the Agency will be resolved;
c. Recommendations to transfer funds within the PSA to resolve surplus/deficit spending; and
d. Input from the Agency's Board of Directors on resolution of spending issues, if applicable;
4. Program Highlights
The Contractor shall submit Program Highlights referencing specific events that occurred in SFY/FFY 2018-2019
by August 30, 2019. The Contractor shall provide a new success story, quote, testimonial, or human -interest
vignette. The highlights shall be written for a general audience, with no acronyms or technical terms. For all
agencies or organizations that are referenced in the highlight, the Contractor shall provide a brief description of
their mission or role. The active tense shall be consistently used in the highlight narrative, to identify the specific
individual or entity that performed the activity described in the highlight.
G. Records and Documentation
1. Requests for Payment
The Contractor shall maintain documentation to support Requests for Payment that shall be available to the
Agency or authorized individuals upon request.
2. CIRTS Data and Maintenance
The Contractor shall ensure, on a monthly basis, collection and maintenance of client and service information
in CIRTS or any such system designated by the Agency. Maintenance includes accurate and current data, and
valid exports and backups of all data and systems according to Agency standards.
2. CIRTS Address Validation
The Contractor shall work with the Area Agency on Aging for Southwest Florida, to ensure client addresses are
correct in CIRTS for disaster preparedness efforts. At least annually, and more frequently as needed, the Agency
will provide direction on how to validate CIRTS addresses to ensure these can be mapped. The Agency will
receive a list of unmatched addresses that cannot be mapped and the Agency will be responsible for working with
the Lead Agencies to correct addresses. The Area Agency will send a list to the Department of Elder Affairs with
confirmed addresses. The Department will use this information to update maps, client rosters, and unmatched
addresses to disseminate to the Lead Agencies.
4. Data Integrity and Back up Procedures
Each Contractor shall anticipate and prepare for the loss of information processing capabilities. The routine
backing up of all data and software is required to recover from losses or outages of the computer system. Data
and software essential to the continued operation of Contractor functions must be backed up. The security
controls over the backup resources shall be as stringent as the protection required of the primary resources. A
copy of the backed -up data shall be stored in a secure, offsite location.
5. Policies and Procedures for Records and Documentation
The Contractor shall maintain written policies and procedures for computer system backup and recovery and
shall have the same requirement of its subcontractors. These policies and procedures shall be made available
to the Agency upon request.
H. Performance Specifications
1. Outcomes and Outputs (Performance Measures)
The Contractor must:
a. Ensure the prioritization of clients and provision of services to clients in accordance with Section II.A. of
this contract.
23 k- o,
bD
July 2019 to June 2020
ADI 203.19
b. Ensure the provision of the services described in this contract are in accordance with the current DOEA
Handbook and Section II.D of this contract;
c. Timely and accurately submit to the Agency all required documentation and reports described in
Section ILE of this contract; and
d. Timely (i.e. in accordance with the Annual Budget Summary) and accurately submit the Request for
Payment, the Receipt and Expenditure Report, and supporting documentation such as CIRTS Reports
to the Agency.
2. Annual Programmatic Monitoring Report
The Contractor's performance of the measures in Section II.H.I., above, will be reviewed and documented in
the Agency's Annual Programmatic Monitoring Report.
3. Monitoring and Evaluation Methodology
The Agency will review and evaluate the performance of the Contractor under the terms of this contract.
Monitoring shall be conducted through direct contact with the Contractor via telephone, in writing, and/or on-
site visit(s). The primary, secondary, or signatory of the contract must be available for any on-site programmatic
monitoring visit. The Agency's determination of acceptable performance shall be conclusive. The Contractor
agrees to cooperate with the Agency in monitoring the progress of completion of the service tasks and
deliverables. The Agency may use, but is not limited to, one or more of the following methods for
monitoring:
a. Desk reviews and analytical reviews;
b. Scheduled, unscheduled, and follow-up on-site visits;
C. Client visits;
d. Review of independent auditor's reports;
e. Review of third -party documents and/or evaluation;
f. Review of progress reports;
g. Review of customer satisfaction surveys;
h. Agreed-upon procedures review by an external auditor or consultant;
i. Limited -scope reviews; and/or
j. Other procedures as deemed necessary.
I. Contractor Responsibilities
1. Contractor Accountability
All service tasks and deliverables pursuant to this contract are solely and exclusively the responsibility of the
Contractor and are tasks and deliverables for which, by execution of this contract, the Contractor agrees to be
held accountable.
2. Coordination with Other Providers and/or Entities
Notwithstanding that services for which the Contractor is held accountable involve coordination with other
entities in performing the requirements of this contract, the failure of other entities does not alleviate the
Contractor from any accountability for tasks or services that the Contractor is obligated to perform pursuant
to this contract.
I Agency Responsibilities
1. Agency Obligations
The Agency may, within its resources, provide technical support and assistance to the Contractor in meeting
the requirements of this contract. The Agency's support and assistance, or lack thereof, shall not relieve the
Contractor from full performance of contract requirements.
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ADI 203.19
2. Agency Determinations
The Agency reserves the exclusive right to make certain determinations in the tasks and approaches used to
perform tasks. The absence of the Agency setting forth a specific reservation of rights does not mean that all
other areas of the contract are subject to mutual agreement.
III. METHOD OF PAYMENT
A. Payment Methods Used
The method of payment for this contract is a combination of fixed-fee/unit rate, cost reimbursement, and advance
payments, subject to the availability of funds and Contractor performance. The Agency will pay the Contractor upon
satisfactory completion of the Tasks/Deliverables, as specified in Section II., Manner of Service Provision, and in
accordance with other terms and conditions of this contract.
1. Fixed Fee/Unit Rate
Payments for Fixed Fee/Unit Rate shall not exceed amounts established in the Service Rate Report.
2. Cost Reimbursement
Payment may be authorized only for allowable expenditures which are in accordance with the services specified
in the Service Rate Report. All Cost Reimbursement Requests for Payment must submit the Request for Payment
as well as the Receipt and Expenditure Report beginning with the first month of this contract.
3. Advance Payments
The Contractor may request up to two (2) months of advances at the start of the contract period to cover program
administrative and service costs. The payment of an advance will be contingent upon the sufficiency and amount
of funds released to the Agency by the State of Florida ("budget release"). The Contractor's requests for
advance payments require the written approval of the DOEA's Contract Manager. For the first month's advance
request, the Contractor shall provide to the Agency Contract Manager documentation justifying the need for an
advance and describing how the funds will be distributed. if the Contractor is requesting two (2) months of
advances, documentation must be provided reflecting the cash needs of the Contractor within the initial two (2)
months and should be supported through as cash-flow analysis or other information appropriate to demonstrate
the Contractor's financial need for the second month of advances. The Contractor must also describe how the
funds will be distributed for the first and second month. If sufficient budget is available, and the Agency Contract
Manger, in his or her sole discretion, has determined that there is justified need for an advance, the Agency will
issue approved advance payments after July I" of the contract year.
a. All advance payments retained by the Contractor must be fully expended no later than September 30, 2019.
Any portion of advance payments not expended must be recouped on the Request for Payment, Report
Number 5, due to the Agency on October 10, in accordance with the Invoice Report Schedule.
b. All advance payments made to the Contractor shall be reimbursed to the Agency as follows: At least one—
tenth of the advance payment received shall be reported as an advance recoupment on each Request for
Payment, starting with Report Number 5, in accordance with the Invoice Report Schedule.
B. Funding Distribution
The Contactor agrees to distribute funds as detailed in the Area Plan update and Invoice Report Schedule. Any
changes in the total amounts of the funds identified on the Annual Budget Summary form require a contract
amendment.
25 �tO
July 2019 to June 2020
C. Method of Invoice Payment
ADI 203.19
Payment shall be made upon the Contractor's presentation of an invoice subsequent to the acceptance and approval
by the Agency of the deliverables shown on the invoice. The form and substance of each invoice submitted by the
Contractor shall be as follows:
1. Have a Remittance Address that corresponds exactly to the "Remit To" address provided to
MyFloridaMarketPlace (MFMP) during registration;
2. Request payment on a monthly basis for the units of services established in the Agency's approved Area Plan,
provided in conformance with the requirements as described in the current DOEA Handbook, at the rates
established in the Service Rate Report of this contract. Documentation of service delivery must include a
report consisting of the following: number of clients served, number of service units provided by service, and
rate per service unit with calculations that equal the total invoice amount. Any requested changes to the
approved budget subsequent to the execution of this contract must be submitted to the Agency Contract
Manager for written approval. Any change to the total contract amount requires a contract amendment;
3. The Contractor shall consolidate all subcontractors' Requests for Payment and Receipt Expenditure Reports
that support Requests for Payment and shall submit to the Agency using the attached Request for Payment
form, Receipt and Expenditure Report for services, which must include itemized expenditure categories; and
4. All Requests for Payment shall be based on the submission of monthly Receipt and Expenditure Reports
beginning with the first month of this contract. The schedule for submission of advance requests (when
available) and invoices is listed in the Invoice Schedule.
D. Payment Withholding
Any payment due by the Agency under the terms of this contract may be withheld pending the receipt and
approval by the Agency of all financial and programmatic reports due from the Contractor and any adjustments
thereto, including any disallowances.
E. Final Invoice Instructions
The Contractor shall submit the final Request for Payment to the Agency no later than July 25, 2020.
F. CIRTS Data Entries for Subcontractors
The Contractor shall be required to enter all required data for clients and services in the CIRTS database per the
current DOEA Handbook and the CIRTS User Manual — Aging Provider Network users (located in Documents on
the CIRTS Enterprise Application Services). Contractors must enter this data into the CIRTS prior to
submitting their Requests for Payment and Receipt Expenditure Reports to the Contractor. The Agency shall
establish deadlines for completing CIRTS data entry and ensure compliance with due dates for the requests for the
Requests for Payment and Receipt and Expenditure Reports that Contractor must submit to the Agency.
G. Contractors' Mmrthly CIRTS Reports
The Agency must require Contractors to run monthly CIRTS reports and verify that client and service data in the
CIRTS is accurate. This report must be submitted to the Agency with the monthly Request for Payment and
Expenditure Report and must be reviewed by the Agency before the Contractor's Request for Payment and
Expenditure Reports can be approved by the Agency.
CIRTS Reports: (Listed under Services #3) Monthly & YTD Service Units with Unduplicated Client Counts; and
(Listed under Services #6) Monthly & YTD Services Repotted by Program and Service Summary Report
26 (bW\
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July 2019 to June 2020
H. Corrective Action Plan
ADI 203.19
Contractor shall ensure one -hundred percent (100%) of the deliverables identified in Section II.D.1-3 of this
contract are performed pursuant to contract requirements.
2. If at any time the Contractor is notified by the Agency Contract Manager that it has failed to correctly,
completely, or adequately perform contract deliverables identified in Section II.E.1-3 of this contract, the
Contractor will have ten (10) days to submit a Corrective Action Plan (CAP) to the Agency Contract Manager
that addresses the deficiencies and states how the deficiencies will be remedied within a time period approved
by the Agency Contract Manager. The Agency shall assess a Financial Consequence for Non -Compliance on
the Contractor as referenced below in Section I1I.I. of this contract for each deficiency identified in the CAP which
is not corrected pursuant to the CAP. The Agency will also assess a Financial Consequence for failure to timely
submit a CAP.
3. If the Contractor fails to correct an identified deficiency within the approved time period specified in the CAP,
the Agency shall deduct the percentage established below in Section III.I. of this contract from the payment
for the invoice of the following month.
4. If the Contractor fails to timely submit a CAP, the Agency shall deduct the percentage established below
in Section III.I. of this contract for each day the CAP is overdue. The deduction will be made from the payment
for the invoice of the following month.
I. Financial Consequences
The Agency will withhold or reduce payment if the Contractor fails to perform the deliverables to the satisfaction
of the Agency according to the requirements referenced in Section II.E. of this contract. The following financial
consequences will be imposed if the deliverables stated do not meet in part or in whole the performance criteria as
outlined in Section H.E. of this contract.
1. Delivery of services to eligible clients as referenced in Section ILA.1-3. and Section II.E.1. of this contract —
Failure to comply with established assessment and prioritization criteria, as evidenced by CIRTS reports, will
result in a 2% reduction of payment per business day. The reduction of payment will begin on the first business
day following the Agency's notification to the Contractor that the identified deficiency was not cured or
satisfactorily addressed in accordance with the Agency -approved CAP, referenced in Section III.H.
2. Timely submission of a CAP — Failure to timely submit a CAP within ten (10) business days after notification
of a deficiency by the Agency Contract Manager will result in a 2% reduction of payment per business day the
CAP is not received. The reduction of payment will begin the first business day following the Agency's
notification to the Contractor that the identified deficiency was not cured or satisfactorily addressed in
accordance with the Agency approved CAP, referenced in Section III.H.
3. Exceptions may be granted solely, in writing, by the Agency contract manager.
II. SPECIAL PROVISIONS
A. Final Budget and Funding Revision Requests
Final requests for budget revisions or adjustments to contract funds based on expenditures for provided services
must be submitted to the Agency Contract Manager in writing no later than June 30, 2020. Email requests are
considered acceptable.
27 (9
July 2019 to June 2020
B. Contractor's Financial Obligations
ADI 203.19
Use of Service Dollars and Management of the Assessed Priority Consumer List
The Contractor is expected to spend ail funds provided by the Agency for the purpose specified in this
contract. For each program managed by the Contractor, the Contractor must manage the service dollars in such
a manner so as to avoid having a wait list and a surplus of funds at the end of the contract period. If the
Agency determines that the Contractor is not spending service funds accordingly, the Agency may transfer
funds to other provider agencies during the contract period and/or adjust subsequent funding allocations
accordingly, as allowable under state and federal law.
2. Cost Sharing and Co -payments
Pursuant to Section 430.204(8), the dollar amount for co -payments associated with any Alzheimer's Disease
Initiative programs must be calculated by applying the current federal poverty guidelines published by the U.S.
Department of Health and Human Services.
a. No -co -payments will be assessed on a client whose income is at, or below, the federal poverty level (FPL)
as established each year by the U.S. Department of Health and Human Services.
b. No client may have their services terminated for inability to pay their assessed co -payment. The
Contractor, in conjunction with the Agency, must establish procedures to remedy financial hardships
associated with co -payments and ensure that there is no interruption in service(s) for inability to pay. If a
client's co -payment is reduced or waived entirely, a written explanation for the change must be placed in the
client file.
C. Remedies for Nonconforming Services
1. The Contractor shall ensure that all goods and/or services provided under this contract are delivered timely,
completely, and commensurate with required standards of quality. Such goods and/or services will only be
delivered to eligible program participants.
2. If the Contractor fails to meet the prescribed quality standards for services, such services will not be reimbursed
under this contract. In addition, any nonconforming goods and/or services not meeting such standards will not
be reimbursed under this contract. The Contractor's signature on the Request for Payment Form certifies
maintenance of supporting documentation and acknowledgement that the Contractor shall solely bear the costs
associated with preparing or providing nonconforming goods and/or services. The Agency requires
immediate notice of any significant and/or systemic infractions that compromise the quality, security or
continuity of services to clients.
D. Incident Reporting
The Contractor shall notify the Agency immediately but no later than forty-eight (48) hours from the Contractor's
awareness or discovery of changes that may materially affect the Contractor or any Subcontractor's ability to
perform the services required to be performed under this contract and in authorizing proviso. Such notice shall be
made orally to the Agency Contract Manager (by telephone) with an email to immediately follow, which shall
include the Contractor's plan for provision of services authorized in proviso.
F. Investigation of Criminal Allegations
Any report that implies criminal intent on the part of the Contractor or any Contractors and referred to a
governmental or investigatory agency must be sent to the Agency, If the Contractor has reason to believe that the
allegations will be referred to the State Attorney, a law enforcement agency, the United States Attorney's office, or
other governmental agency, the Contractor shall notify the Contract Manager at the Agency immediately. A copy
of all documents, reports, notes, or other written material concerning the investigation, whether in the
possession of the Contractor or Subcontractors, must be sent to the Agency's Contractor Manager with a summary of
the investigation and allegations.
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ADI 203.19
F. Volunteers
If applicable, the Contractor shall ensure the use of trained volunteers in providing direct services delivered to older
individuals and individuals with disabilities needing such services. If possible, the Contractor shall work in
coordination with organizations that have experience in providing training, placement, and stipends for volunteers
or participants (such as the Senior Community Service Employment Program or organizations carrying out federal
service programs administered by the Corporation for National and Community Service).
G. Enforcement
1. In accordance with Section 430.04, F.S., the Agency may, without taking any intermediate measures available
to it against the Contractor, rescind the Contractor's designation as an AAA, if the Agency finds that any of the
following have occurred:
a. An intentional or negligent act of the Contractor has materially affected the health, welfare, or safety of
clients, or substantially and negatively affected the operation of services covered pursuant to this contract;
b. The Contractor lacks financial stability sufficient to meet contractual obligations or that contractual funds
have been misappropriated;
c. The Contractor has committed multiple or repeated violations of legal and regulatory requirements,
regardless of whether such laws or regulations are enforced by the Agency, or the Contractor has
committed multiple or repeated violations of Agency standards;
d. The Contractor has failed to continue the provision or expansion of services after the declaration of a state
of emergency;
e. The Contractor has failed to adhere to the terms of this contact;
f. The Contractor has failed to properly determine client eligibility as defined by the Agency or efficiently
manage program budgets; or
g. The Contractor has failed to implement and maintain an Agency -approved client grievance resolution
procedure.
2. If the Agency finds that any acts listed in Section N.G.La.-g. above have occurred, in accordance with Section
430.04, F.S., the Agency may, its sole discretion, in accordance with Section 430.04, F.S., take intermediate
measures against the Contractor, including corrective action, unannounced special monitoring, temporary
assumption of the operation of one or more contractual services, placement of the Contractor on probationary
status, imposing a moratorium on Contractor action, imposing financial penalties for nonperformance, or other
administrative action pursuant to Chapter 120, F.S.
3. In making any determination under this provision, the Agency may rely upon findings of another state or
federal agency, or other regulatory body. Any claims for damages for breach of contract are exempt from
administrative proceedings and shall be brought before the appropriate entity in the venue of Lee County. In the
event the Agency initiates action to rescind a lead agency designation, the Agency shall follow the procedures
set forth in 42 U. S. C. § 3025(b).
H. Contract Modifications
The Agency's Contract Manager has the authority to modify and/or extend deliverable deadlines. All
deliverable extension requests must be made, in writing prior to the required deadline, to the Agency's
Contract Manager. All approvals for deliverable extensions must be communicated, in writing, by the Agency's
Contact Manager to Contractor and are subject to the discretion of the Agency's Contract Manager. The
requests and the approval must occur prior to the established deadline. An email writing (request and response) is
considered acceptable.
END OF A TTA CHMENT I
29 ���
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ATTACHMENT II
FINANCIAL AND COMPLIANCE AUDIT
ADI 203.19
The administration of resources awarded by the Agency to the Contractor may be subject to audits and/or monitoring by
the Agency as described in this section.
MONITORING
In addition to reviews of audits conducted in accordance with 2 CFR Part 200 (formerly OMB Circular A-133 as revised),
and Section 215.97, F.S., (see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits
by the Agency staff, limited scope audits and/or other procedures. By entering into this contract, the Contractor agrees to
comply and cooperate with any monitoring procedures/processes deemed appropriate by the Agency. In the event the
Agency determines that a limited scope audit of the Contractor is appropriate, the Contractor agrees to comply with any
additional instructions provided by the Agency to the Contractor regarding such audit. The Contractor further agrees to
comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Chief Financial
Officer (CFO) or Auditor General.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the Contractor is a State or local government or a non-profit organization as defined in 2 CFR Part
200, Subpart A.
In the event that the Contractor expends $750,000.00 or more in federal awards during its fiscal year, the Contractor must
have a single or program -specific audit conducted in accordance with the provisions of 2 CFR Part 200. Financial
and Compliance Audit Attachment, Exhibit 2 indicates federal resources awarded through the Agency by this contract. In
determining the federal awards expended in its fiscal year, the Contractor shall consider all sources of Federal awards,
including federal resources received from the Agency. The determination of amounts of Federal awards expended should
be in accordance with 2 CFR Part 200. An audit of the Contractor conducted by the Auditor General in accordance with the
provisions of 2 CFR Part 200 will meet the requirements of this part.
In connection with the audit requirements addressed in Part I, paragraph I, the Contactor shall fulfill the requirements
relative to auditee responsibilities as provided in 2 CFR § 200.508.
If the Contractor expends less than $750,000.00 in federal awards in its fiscal year, an audit conducted in accordance with
the provisions of 2 CFR Part 200 is not required. In the event that the Contactor expends less than $750,000.00 in federal
awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of 2 CFR Part 200, the cost
of the audit must be paid from non-federal resources (i.e., the cost of such audit must be paid from Contractor resources
obtained from other than federal entities.)
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to contacts with the Agency shall be based on the contract's requirements, including any rules,
regulations, or statutes referenced in the contact. The financial statements shall disclose whether or not the matching
requirement was met for each applicable contract. All questioned costs and liabilities due to the Agency shall be fully
disclosed in the audit report with reference to the Agency contact involved. If not otherwise disclosed as required by
2 CFR § 200.510 the schedule of expenditures of federal awards shall identify expenditures by contract number for each
contact with the Agency in effect during the audit period. Financial reporting packages required under this part must be
submitted within the earlier of 30 days after receipt of the audit report or 9 months after the end of the Contractor's fiscal
year end.
30 ON�
July 2019 to June 2020
PART II: STATE FUNDED
ADI 203.19
This part is applicable if the Contractor is a non -state entity as defined by Section 215.97(2), F.S.
In the event that the Contractor expends a total amount of state financial assistance equal to or in excess of $750,000.00 in
any fiscal year of such Contractor, the Contractor must have a State single or project -specific audit for such fiscal year in
accordance with Section 215.97, F.S.; applicable rules of the Department of Financial Services; and Chapter 10.550 (local
governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General. Financial
Compliance Audit Attachment, Exhibit 2 indicates state financial assistance awarded through the Agency by this
contract. In determining the state financial assistance expended in its fiscal year, the Contractor shall consider all sources
of state financial assistance, including state financial assistance received from the Agency, other state agencies, and other
non -state entities. State financial assistance does not include Federal direct or pass-through awards and resources received
by a non -state entity for Federal program matching requirements.
In connection with the audit requirements addressed in Part II, paragraph 1, the Contractor shall ensure that the audit
complies with the requirements of Section 215.97(8), F.S. This includes submission of a financial reporting package as
defined by Section 215.97(2), F.S., and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit
organizations), Rules of the Auditor General.
If the Contractor expends less than $750,000.00 in state financial assistance in its fiscal year, an audit conducted in
accordance with the provisions of Section 215.97, F.S., is not required. In the event that the Contractor expends less than
$750,000.00 in state financial assistance in its fiscal year and elects to have an audit conducted in accordance with the
provisions of Section 215.97, F.S., the cost of the audit must be paid from the non -state entity's resources (i.e., the cost of
such an audit must be paid from the Contractor resources obtained from other than State entities).
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to contracts with the Agency shall be based on the contract's requirements, including any
applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching requirement
was met for each applicable contract. All questioned costs and liabilities due to the Agency shall be fully disclosed in the
audit report with reference to the Agency contract involved. If not otherwise disclosed as required by Rule 69I- 5.003,
F.A.C., the schedule of expenditures of state financial assistance shall identify expenditures by contract number for each
contract with the Agency in effect during the audit period. For local governmental entities, financial reporting packages
required under this part must be submitted within 45 days after delivery of the audit report, but no later than 12 months after
the Contractor's fiscal year end. For non-profit or for-profit organizations, financial reporting packages required under this
part must be submitted within 45 days after delivery of the audit report, but no later than 9 months after the Contractor's
fiscal year end. Notwithstanding the applicability of this portion, the Agency retains all right and obligation to monitor and
oversee the performance of this contract as outlined throughout this document and pursuant to law.
PART III: REPORT SUBMISSION
Copies of financial reporting packages for audits conducted in accordance with 2 CFR Part 200 and required by Part I of this
Financial Compliance Audit Attachment, shall be submitted, when required by 2 CFR § 200.512 by or on behalf of the
Contractor directly to each of the following:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10th Street
Jeffersonville, IN 47132
.Pursuant to 2 CFR § 200.512, all other Federal agencies, pass-through entities and others interested in a reporting package
and data collection form must obtain it by accessing the Federal Audit Clearinghouse.
July 2019 to June 2020 ADI 203.19
The Contractor shall submit a copy of any management letter issued by the auditor to the Agency at the following address:
The Area Agency on Aging for Southwest Florida, Inc.at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Tammy Rhoades, CFO
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
Additionally, copies of financial repotting packages required by this contract's Financial Compliance Audit Attachment,
Part II, shall be submitted by or on behalf of the Contractor directly to each of the following:
The Area Agency on Aging for Southwest Florida, hrc.at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Tammy Rhoades, CFO
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
The Auditor General's Office at the following address:
State of Florida Auditor General
Claude Pepper Building, Room 574
111 West Madison Street
Tallahassee, Florida 32399-1450
Any reports, management letters, or other information required to be submitted to the Agency pursuant to this contract shall
be submitted timely in accordance with 2 CFR Part 200, F.S., and Chapter 10.550 (local governmental entities) or 10.650
(nonprofit and for-profit organizations), Rules of the Auditor General, as applicable.
Contractors, when submitting financial reporting packages to the Agency for audits done in accordance with 2 CFR Part 200
or Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor
General, should indicate the date that the reporting package was delivered to the Contractor in correspondence
accompanying the reporting package.
PART IV: RECORD RETENTION
The Contractor shall retain sufficient records demonstrating its compliance with the terms of this contract for a period of
six (6) years from the date the audit report is issued, and shall allow the Agency or its designee, the CFO, or Auditor
General access to such records upon request. The Contractor shall ensure that audit working papers are made available to
the Agency or its designee, Contract Manager, or Auditor General upon request for a period of six (6) years from the date
the audit report is issued, unless extended in writing by the Agency.
July 2019 to June 2020
ADI 203.19
ATTACHMENT II -EXHIBIT 1
PART L• AUDIT RELATIONSHIP DETERMINATION
Contractors who receive state or federal resources may or may not be subject to the audit requirements of 2 CFR Part 200
and/or Section 215.97, F.S. Contractors who are determined to be recipients or sub -recipients of federal awards and/or
state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I
and/or Part II of Exhibit 1 are met. Contractors who have been determined to be vendors are not subject to the audit
requirements of 2 CFR § 200.38, and/or Section 215.97, F.S. Regardless of whether the audit requirements are met,
Contractors who have been determined to be recipients or sub -recipients of Federal awards and/or state financial
assistance must comply with applicable programmatic and fiscal compliance requirements.
In accordance with 2 CFR Part 200 and/or Rule 69I-5.006, F.A.C., Contractor has been determined to be:
Vendor not subject to 2 CFR § 200.38 and/or Section 215.97, F.S.
X Recipient/sub-recipient subject to 2 CFR §§ 200.86 and 200.93 and/or Section 215.97, F.S.
Exempt organization not subject to 2 CFR Part 200 and/or Section 215.97, F.S. For Federal awards, for-profit
organizations are exempt; for state financial assistance projects, public universities, community colleges, district
school boards, branches of state (Florida) government, and charter schools are exempt. Exempt organizations must
comply with all compliance requirements set forth within the contract or award document.
NOTE: If a Contractor is determined to be a recipient/sub-recipient of federal and/or state financial assistance, and has been
approved by the Agency to subcontract, they must comply with Section 215.97(7), F.S., and Rule 691-5.006, F.A.C. [state
financial assistance] and/or 2 CFR § 200.330 [federal awards].
PART H: FISCAL COMPLIANCE R' QUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Contactors who receive Federal
awards, state maintenance of effort funds, or state matching funds on Federal awards and who are determined to be a sub -
recipient must comply with the following fiscal laws, rules, and regulations:
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR § 200.416 - § 200.417 — Special Considerations for States, Local Governments and Indian Tribes*
2 CFR § 200.201 —Administrative Requirements**
2 CFR § 200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
NON-PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR § 200.400 - § 200.411 — Cost Principles*
2 CFR § 200.100 — Administrative Requirements
2 CFR § 200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT)
MUST FOLLOW:
2 CFR § 200,418 — § 200.419 - Special Considerations for Institutions of Higher Education*
2 CFR § 200.100 — Administrative Requirements
2 CFR § 200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
33 19
July 2019 to June 2020
ADI 203.19
*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in 2 CFR
§ 200.400(5)(c).
**For funding passed through U.S. Health and Human Services, 45 CFR Part 75; for funding passed through U.S.
Department of Education, 34 CFR Part 80.
STATE KNANCIAL ASSISTANCE. Contractors who receive state financial assistance and who are determined to be a
recipient/sub-recipient must comply with the following fiscal laws, rules and regulations:
Sections 215.97 & 215.971, F.S.
Chapter 69I-5, F.A.C.
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
34 �p �
July 2019 to June 2020
ATTACHMENT H -EXHIBIT 2
FUNDING SUMMARY
ADI 203.19
Note: Title 2 CFR, as revised, and Section 215.97, F.S., require that the information about Federal Programs and State
Projects included in Attachment II, Exhibit 1, be provided to the recipient. Information contained herein is a prediction of
funding sources and related amounts based on the contract budget.
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT
CONSIST OF THE FOLLOWING:
GRANT AWARD (FAIN#): FEDERAL AWARD DATE:
DUNS NUMBER: 076997790
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT
TO THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS:
2 CFR Part 200 — Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards.
OMB Circular A-133 — Audits of States, Local Governments, and Non -Profit Organizations
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF
THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD
STATE FINANCIAL ASSISTANCE SUBJECT TO SECTION 215.97, F.S.
PROGRAM TITLE
FUNDING SOURCE
CSFA
AMOUNT
Alzheimer's Disease Initiative
General Revenue—TSTF
65.002
65.004
$ 449,855.00
TOTAL AWARD
$ 449,855.00
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS
CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE
Sections 215.97 & 215.971, F.S., Chapter 691-5, F.A.C., State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
35
�b
July 2019 to June 2020 ADI 203.19
ATTACHMENT III
CERTIFICATIONS AND ASSURANCES
The Agency will not award this contract unless Contractor completes this CERTIFICATIONS AND ASSURANCES. In
performance of this contract, Contractor provides the following certifications and assurances:
A. Debarment and . CFR Part 95 and 45 CFR Part 75)
B. Certification Regarding Lobbying (29 CFR Part 93 and 45 ` Part 93)
C. Nondiscrimination . • : 1
D. Regarding Public EntijX Crimes.
L. 111-1171
F. Scrutinized Companies Lists and No Boycott of Israel Certification. section 287.135. F.S.
G. Certification Regarding Data Integrity Compliance for Contracts. Agreements, Grants. Loans. and
Cooperative Agreements
H. Verification of Employment Status Certification
I. Records and Documentation
A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY
MATTERS — PRIMARY COVERED TRANSACTION.
The undersigned Contractor certifies, to the best of its knowledge and belief, that it and its principals:
1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
covered transactions by a Federal department or agency;
2. Have not within a three-year period preceding this contract been convicted or had a civil judgment rendered against
them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a
public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State
antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records,
making false statements, or receiving stolen property;
3. Are not presently indicted or otherwise criminally or civilly charged by a government entity (Federal, State, or local)
with commission of any of the offenses enumerated in paragraph A.2, of this certification; and/or
4. Have not within a three-year period preceding this application/proposal had one or more public transactions
(Federal, State, or local) terminated for cause of default.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -
recipients, and contractors shall provide this certification accordingly.
B. CERTIFICATION REGARDING LOBBYING — CERTIFICATION FOR CONTRACTS, GRANTS,
LOANS, AND COOPERATIVE AGREEMENTS.
The undersigned Contractor certifies, to the best of its knowledge and belief, that:
No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of Congress or an employee of a Member of Congress in
36 0y
July 2019 to June 2020 ADI 203.19
connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan,
the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification
of any Federal contract, grant, loan, or cooperative agreement.
If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of
Congress, or employee of a Member of Congress in connection with a Federal contract, grant, loan, or cooperative
agreement, the undersigned shall also complete and submit Standard Form — LLL, "Disclosure Form to Report
Lobbying," in accordance with its instructions.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -
recipients and contractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this contract was made or
entered into. Submission of this certification is a prerequisite for making or entering into this contract imposed by 31
U.S.C. 4 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than
$10,000 and not more than $100,000 for each such failure.
C. NON-DISCRIMINATION & EQUAL OPPORTUNITY ASSURANCE (29 CFR PART 37 AND 45 CFR PART
80). - As a condition of the Contract, Contactor assures that it will comply fully with the nondiscrimination and equal
opportunity provisions of the following laws:
1. Section 188 of the Workforce Investment Act of 1998 (WIA), (Pub. L. 105-220), which prohibits discrimination
against all individuals in the United States on the basis of race, color, religion, sex, national origin, age, disability,
political affiliation, or belief, and against beneficiaries on the basis of either citizenship/status as a lawfully admitted
immigrant authorized to work in the United States or participation in any WIA Title I -financially assisted program or
activity.
2. Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352), as amended, and all requirements imposed by or pursuant to
the Regulation of the Department of Health and Human Services (45 CFR Part 80), to the end that, in accordance with
Title VI of that Act and the Regulation, no person in the United States shall, on the ground of race, color, or national
origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination
under any program or activity for which the Applicant receives Federal financial assistance from the Department
and/or Agency.
3. Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112), as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 84), to the end that, in
accordance with Section 504 of that Act and the Regulation, no otherwise qualified handicapped individual in the
United States shall, solely by reason of his handicap, be excluded from participation in, be denied the benefits of, or
be subjected to discrimination under any program or activity for which the Applicant receives Federal financial
assistance from the Agency.
4. The Age Discrimination Act of 1975 (Pub. L. 94-135), as amended, and all requirements imposed by or pursuant to
the Regulation of the Department of Health and Human Services (45 CFR Part 91), to the end that, in accordance with
the Act and the Regulation, no person in the United States shall, on the basis of age, be denied the benefits of, be
excluded from participation in, or be subjected to discrimination under any program or activity for which the
Applicant receives Federal financial assistance from the Agency.
5. Title IX of the Education Amendments of 1972 (Pub. L. 92-318), as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 86), to the end that, in
accordance with Title IX and the Regulation, no person in the United States shall, on the basis of sex, be excluded
from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any education
program or activity for which the Applicant receives Federal financial assistance from the Agency.
6. The American with Disabilities Act of 1990 (Pub. L. 101-336), which prohibits discrimination in all employment
practices including, job application procedures, hiring, firing, advancement, compensation, training, and other
terms, conditions, and privileges of employment. It applies to recruitment, advertising, tenure, layoff, leave, fringe
benefits, and all other employment-related activities.
7. Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws listed
above. This assurance applies to Contractor's operation of the WIA Title I — financially assisted program or
37
July 2019 to June 2020
ADI 203.19
activity, and to all contracts Contractor makes to carry out the W IA Title I — financially assisted program or activity.
Contractor understands that the Agency and/or DOEA and the United States have the right to seek judicial enforcement
of the assurance.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -
recipients, and contractors shall provide this assurance accordingly.
D. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES, SECTION 287.133, F.S.
Contactor hereby certifies that neither it, nor any person or affiliate of Contractor, has been convicted of a Public Entity
Crime as defined in Section 287.133, F.S., nor placed on the convicted vendor list.
Contactor understands and agrees that it is required to inform Area Agency and DOEA immediately upon any change
of circumstances regarding this status.
E. ASSOCIATION OF COMMUNITY ORGANIZATIONS FOR REFORM NOW (ACORN) FUNDING
RESTRICTIONS ASSURANCE (Pub. L. 111-117).
As a condition of the Contract, Contactor assures that it will comply fully with the federal funding restrictions
pertaining to ACORN and its subsidiaries per the Consolidated Appropriations Act, 2010, Division E, Section 511 (Pub.
L. 111-117). The Continuing Appropriations Act, 2011, Sections 101 and 103 (Pub. L. 111-242), provides that
appropriations made under Pub. L. 111-117 are available under the conditions provided by Pub. L. 111-117.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -
recipients and contractors shall provide this assurance accordingly.
F. SCRUTINIZED COMPANIES LISTS AND NO BOYCOTT OF ISRAEL CERTIFICATION, SECTION
287.135, F.S.
In accordance with section 287.135, F.S., Contractor certifies that it has not been placed on the Scrutinized Companies that
Boycott Israel List and that it is not engaged in a boycott of Israel.
If this Contract is in the amount of $1 million or more, in accordance with the requirements of section 287.13 5,, F.S.,
Contactor hereby certifies that it is not listed on either the Scrutinized Companies with Activities in Sudan List or the
Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List and that it is not engaged in business
operations in Cuba or Syria.
Contractor understands that pursuant to Section 287.135, F.S., the submission of a false certification may result in
the Agency terminating this contract and the submission of a false certification may subject Contractor to civil penalties
and attorney fees and costs, including any costs for investigations that led to the finding of false certification.
If Contractor is unable to certify any of the statements in this certification, Contractor shall attach an explanation to
this contract.
G. CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR CONTRACTS,
AGREEMENTS, GRANTS, LOANS, AND COOPERATIVE AGREEMENTS
1. The Contractor and any Subcontractors of services under this contact have financial management systems capable
of providing certain information, including: (1) accurate, current, and complete disclosure of the financial results
of each grant -funded project or program in accordance with the prescribed reporting requirements; (2) the source
and application of funds for all contact supported activities; and (3) the comparison of outlays with budgeted
amounts for each award. The inability to process information in accordance with these requirements could result in
a return of grant funds that have not been accounted for properly.
2.
Management Information Systems used by the Contactor, Subcontractors, or any outside entity on which the
Contactor is dependent for data that is to be reported, transmitted, or calculated have been assessed and verified
be capable of processing data accurately, including year -date dependent data. For those systems identified to be
non-compliant, Contractors will take immediate action to assure data integrity.
If UN
.55i
W.
to
July 2019 to June 2020
ADI 203.19
3. If this contract includes the provision of hardware, software, firmware, microcode, or imbedded chip technology,
the undersigned warrants that these products are capable of processing year -date dependent data accurately. All
versions of these products offered by the Contractor (represented by the undersigned) and purchased by the state
will be verified for accuracy and integrity of data prior to transfer.
4. hi the event of any decrease in functionality related to time and date related codes and internal subroutines that
impede the hardware or software programs from operating properly, the Contractor agrees to immediately make
required corrections to restore hardware and software programs to the same level of functionality as warranted
herein, at no charge to the state, and without interruption to the ongoing business of the state, time being of the
essence.
5. The Contractor and any Subcontractors of services under this contract warrant that their policies and procedures
include a disaster plan to provide for service delivery to continue in case of an emergency, including emergencies
arising from data integrity compliance issues.
H. VITRIFICATION OF EMPLOYMENT STATUS CERTIFICATION
As a condition of contracting with the Agency, Contractor certifies the use of the U.S. Department of Homeland
Security's E -verify system to verify the employment eligibility of all new employees hired by Contactor during the
contract term to perform employment duties pursuant to this contract, and that any subcontracts include an express
requirement that Subcontractors performing work or providing services pursuant to this contract utilize the E -verify
system to verify the employment eligibility of all new employees hired by the Subcontractor during the entire
contract term.
The Contractor shall require that the language of this certification be included in all sub -agreements, sub -grants, and
other agreements/contracts and that all Subcontractors shall certify compliance accordingly.
This certification is a material representation of fact upon which reliance was placed when this contract was made or
entered into. Submission of this certification is a prerequisite for making or entering into this contract imposed by
Circulars A-102 and 2 CFR Part 200 and 215 (formerly OMB Circular A-110).
I. RECORDS AND DOCUMENTATION
The Contractor agrees to make available to Agency staff and/or any party designated by the Agency any and all
contract related records and documentation. The Contractor shall ensure the collection and maintenance of all
program related information and documentation on any such system designated by the Agency. Maintenance includes
valid exports and backups of all data and systems according to Agency standards.
J. CERTIFICATION REGARDING INSPECTION OF PUBLIC RECORDS
1. In addition to the requirements of Section 10 of the Standard Contact, and sections 119.0701(3) and (4) F.S., and any other
applicable law, if a civil action is commenced as contemplated by section 119.0701(4), F.S., and the Agency is named in the
civil action, Contractor agrees to indemnify and hold harmless the Agency for any costs incurred by the Agency and
any attorneys' fees assessed or awarded against the Agency from a Public Records Request made pursuant to Chapter
119, F.S., concerning this contract or services performed thereunder.
a. Notwithstanding section 119.0701, F.S., or other Florida law, this section is not applicable to contracts executed between
the Agency and state agencies or subdivisions defined in section 768.28(2), F.S.
2. Section 119.01(3), F.S., states if public funds are expended by an agency in payment of dues or membership contributions
for any person, corporation, foundation, trust, association, group, or other organization, all the financial, business, and
membership records of such an entity which pertain to the public agency (Area Agency on Aging for Southwest Florida,
Inc.) are public records. Section 119.07, F.S, states that every person who has custody of such a public record shall permit
the record to be inspected and copied by any person desiring to do so, under reasonable circumstances.
39 cPO
July 2019 to June 2020 ADI 203.19
Additionally, I certify this organization does X does not _provide for institutional memberships.
Contractor's signature below attests that records pertaining to the dues or membership application by the Agency are available
for inspection if applicable, as stated above.
By execution of this agreement, Contractor must include these provisions (A -J) in all related subcontract agreements (if
applicable).
By signing below, Contractor certifies that the representations outlined in parts A through J above are true and correct.
/ r
3339 Tamiami Trail E Suite 211
Stephen Y Carnell Public Service Department Head
Signature and Title of Authorized Representative
Street Address
Collier County Board of County Commissioners
Naples FL 34112
//r`c
V1
Contractor Date5�
City, State, Zicode
Approved as to form and legality
Assistant County Attorney L
40 0
July 2019 to June 2020 ADI 203.19
ATTACHMENT IV
ASSURANCES—NON-CONSTRUCTION PROGRAMS
Public reporting burden for this collection of information is estimated to average forty-five (45) minutes per response, including time
for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing
the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348-0043),
Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND
BUDGET, SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions, please
contact the awarding agency. Further, certain federal awarding agencies may require applicants to certify to
additional assurances. If such is the case, you will be notified.
1. Has the legal authority to apply for federal assistance, and the institutional, managerial and financial capability
(including funds sufficient to pay the non-federal share of project cost) to ensure proper planning, management, and
completion of the project described in this application.
2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the state, through any
authorized representative, access to and the right to examine all records, books, papers, or documents related to the
award; and will establish a proper accounting system in accordance with generally accepted accounting standards or
agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes, or presents the
appearance of, personal or organizational conflict of interest or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §§ 4728-4763) relating to prescribed standards
for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's
Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).
6. Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of
the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin;
(b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§ 1681-1683, and §§ 1685-1686),
which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29
U.S.C.
§7 94), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended
(42 U.S.C. §§ 6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment
Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive
Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended,
relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) Sections 523 and 527 of the Public Health
Service Act of 1912 (42 U.S.C. §§ 290 dd-3 and 290 ee 3), as amended, relating to confidentiality of alcohol and
drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. § 3601 et seq.), as amended,
relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in
the specific statute(s) under which application for federal assistance is being made; and 0) the requirements of any other
nondiscrimination statute(s) which may apply to the application.
7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance
and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of
persons displaced or whose property is acquired as a result of federal or federally assisted programs. These requirements
apply to all interests in real property acquired for project purposes regardless of federal participation in purchases.
41
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July 2019 to June 2020
ADI 203.19
8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. §§ 1501-1508 and §§ 7324-7328), which
limit the political activities of employees whose principal employment activities are funded in whole or in part with
federal funds.
9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C. §276a to 276a-7), the Copeland Act
(40 U.S.C. § 276c and 18 U.S.C. § 874) and the Contract Work Hours and Safety Standards Act (40 U.S.C. §§ 327-
333), regarding labor standards for federally assisted construction sub -contracts.
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the
program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or
more.
11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and
Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in floodplain in accordance with EO 11988; (e) assurance of
project consistency with the approved State management program developed under the Coastal Zone Management Act
of 1972 (16 U.S.C. § 1451 et seq.); (f) conformity of federal actions to State (Clear Air) Implementation Plans under
Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. § 7401 et seq.); (g) protection of underground
sources of drinking water under the Safe Drinking Water Act of 1974, as amended (P.L. 93-523); and (h) protection of
endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93-205).
12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §1 721 et seq.) related to protecting components
or potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of
1966, as amended (16 U.S.C. § 470), EO 11593 (identification and protection of historic properties), and the
Archaeological and Historic Preservation Act of 1974 (16 U.S.C. §4 69a-1 et seq.).
14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related
activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. § 2131 et seq.)
pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities
supported by this award of assistance.
16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. § 4801 et seq.), which prohibits the use of
lead- based paint in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act
Amendments of 1996 and 2 CFR Part 200.
18. Will comply with all applicable requirements of all other federal laws, executive orders, regulations, and policies
governing this program.
CERTIFYING OFFICIAL
APPLICANT ORGANIZATION
Collier County Board of County Commissioners
TITLE
Public Service Department Head
DATESUBMITTED
42
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July 2019 to June 2020
ADI 203.19
ATTACHMENT V
ITI.numA DF]PARTMENT OF FI.TIFR AFFAIRS CT". RIGHTS COMPT,TANCE CHECKLIST
Program/Facility Name
County
AAA/Conri'actor
Address
Completed By
City, State, Zip Code
Date
Telephone
PART I: READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU COMPLETE
THIS FORM.
1. Briefly describe the geographic area served by the program/facility and the type of service provided:
For questions 2-5 please indicate the foll
2. Population of area served
3. Staff currently employed
4. Clients currently emolled/registered
5. Advisory/Governing Board if applicable
_ Total # % %
owing: White Black Hispanic Other Female Disabled Over 40
Source of data:
Effective date:
Effective date:
PART 1I: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. IF N/A or NO, EXPLAIN.
6. Is an Assurance of Compliance on file with DOEA? N/A YES NO
❑ ❑ ❑
7. Compare the staff composition to the population. Is staff representative of the population?
S. Are eligibility requirements for services applied to clients and applicants without regard to race, color, national
origin, sex, age, religion, or disability?
9. 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?
10. For in-patient services, are room assignments made without regard to race, color, national origin or disability?
11. Is the program/facility accessible to non-English speaking clients?
12. Are employees, applicants and participants informed of their protection against discrimination? If YES, how?
Verbal ❑ Written ❑ Poster ❑
N/A YES NO
❑ ❑ ❑
N/A YES NO
❑ ❑ ❑
N/A YES NO
■ ■ ■
N/A YES NO
❑ ❑ ❑
N/A YES NO
❑ ❑ ❑
N/A YES NO
❑ ❑ ❑
July 2019 to June 2020 ADI 203.19
K'T @11 D10 W&
MI DF13MG
Reviewedby
In Compliance: YES NO*
Program Office
*Notice of Corrective Act ion Sent—/—
Date Telephone
Response Due / /_
13.
Give the number and current status of any discrimination complaints regarding services or employment filed
against the prograin/facility.
N/A
11
NUMBER
14.
Is the program/facility physically accessible to mobility, hearing, and sight -impaired individuals?
N/A
YES NO
❑
❑ ❑
PART IH: THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES.
EXPLAIN.
15. Has as a self-evaluation been conducted to identify any barriers to serving disabled individuals and to make any
necessary modifications?
IF NO,
YES NO
❑ ❑
16.
Is there an established grievance procedure that incorporates due process in the resolution of complaints?
YES
NO
❑
❑
17.
Hasa person been designated to coordinate Section 504 compliance activities?
YES
❑
NO
❑
18.
Do recruitment and notification materials advise applicants, employees, and participants of nondiscrimination on the
basis of disability?
YES
❑
NO
❑
19.
Are auxiliary aids available to ensue accessibility of services to hearing and sight -impaired individuals?
YES
❑
NO
❑
PART IV: FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $50,000.00 OR MORE.
20. Do you have a written affirmative action plan? If NO, explain.
YES
❑
NO
❑
K'T @11 D10 W&
MI DF13MG
Reviewedby
In Compliance: YES NO*
Program Office
*Notice of Corrective Act ion Sent—/—
Date Telephone
Response Due / /_
On -Site LJ Desk Review
Response Received—/ /
44
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July 2019 to June 2020
ADI 203.19
ATTACHMENT V
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST
1. Describe the geographic service area such as a district, county, city, or other locality. If the program/facility serves
a specific target population such as adolescents, describe the target population. Also, define the type of service
provided.
2. Enter the percent of the population served by race, sex, disability, and over the age of 40. The population served
includes persons in the geographical area for which services are provided such as a city, county or other regional
area. Population statistics can be obtained from local chambers of commerce, libraries, or any publication from the
1980 Census containing Florida population statistics. Include the source of your population statistics. ("Other"
races include Asian/Pacific Islanders and American Indian/Alaskan Natives.)
3. Enter the total number of full-time staff and their percent by race, sex, disability, and over the age of 40. Include
the effective date of your summary.
4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and list
their percent by race, sex, disability, and over the age of 40. Include the date that enrollment was counted.
a. Where there is a significant variation between the race, sex, or ethnic composition of the clients and their
availability in the population, the program/facility has the responsibility to determine the reasons for such
variation and take whatever action may be necessary to correct any discrimination. Some legitimate disparities
may exist when programs are sanctioned to serve target populations such as elderly or disabled persons.
5. Enter the total number of advisory board members and their percent by race, sex, disability, and over the age of
40. If there is no advisory or governing board, leave this section blank.
6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in
compliance with all nondiscriminatory provisions as required in 45 CFR Part 80. This is usually a standard part of
the contract language for DOEA Recipients and their Sub -grantees. 45 CFR § 80.4(a).
Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the
population is Hispanic, is there a comparable percentage of Hispanic staff?
8. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or
employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also
through on-site record analysis of persons who applied but were denied services or employment. 45 CFR § 80.3 (a)
and 45 CFR § 80.1.
Participants or clients must be provided services such as medical, nursing, and dental care, laboratory services,
physical and recreational therapies, counseling, and social services without regard to race, sex, color, national origin,
religion, age, or disability. Courtesy titles, appointment scheduling, and accuracy of record keeping must be applied
uniformly and without regard to race, sex, color, national origin, religion, age, or disability. Entrances, waiting
rooms, reception areas, restrooms, and other facilities must also be equally available to all clients. 45 CFR § 80.3(b).
10. For in-patient services, residents must be assigned to rooms, wards, etc., without regard to race, color, national
origin, or disability. Also, residents must not be asked whether they are willing to share accommodations with
persons of a different race, color, national origin, or disability. 45 CFR § 80.3(a).
11. The program/facility and all services must be accessible to participants and applicants, including those persons who
may not speak English. In geographic areas where a significant population of non-English speaking people live,
program accessibility may include the employment of bilingual staff. In other areas, it is sufficient to have a policy
or plan for service, such as a current list of names and telephone numbers of bilingual individuals who will assist
in the provision of services. 45 CFR § 80.3(a).
45
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July 2019 to June 2020
ADI 203.19
12. Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to their
participants, beneficiaries, or any other interested parties. 45 CFR § 80.6(d). This should include information on
their right to file a complaint of discrimination with either the Area Agency on Aging for Southwest Florida, Inc.
and/or the Florida Department of Elder Affair or the U.S. Department of Health and Human Services. The
information may be supplied verbally or in writing to every individual or may be supplied through the use of an equal
opportunity policy poster displayed in a public area of the facility.
13. Report number of discrimination complaints filed against the program/facility. Indicate the basis (e.g. race, color,
creed, sex, age, national origin, disability, and/or retaliation) 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 of the local, state, or federal agency with whom the complaint has been filed. Indicate the
current status of the complaint (e.g. settled, no reasonable cause found, failure to conciliate, failure to cooperate,
under review, etc.).
14. The program/facility must be physically accessible to mobility, hearing, and sight -impaired individuals. Physical
accessibility includes designated parking areas, curb cuts or level approaches, ramps, and adequate widths to
entrances. The lobby, public telephone, restroom facilities, water fountains, and information and admissions
offices should be accessible. Door widths and traffic areas of administrative offices, cafeterias, restrooms, recreation
areas, counters, and serving lines should be observed for accessibility. Elevators should be observed for door width
and Braille or raised numbers. Switches and controls for light, heat, ventilation, fire alarms, and other essentials
should be installed at an appropriate height for mobility impaired individuals.
15. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self-
evaluation to identify any accessibility barriers. Self-evaluation is a four -step process:
a. Evaluate, with the assistance of disabled individual(s)/organization(s), current practices and policies that do
not or may not comply with Section 504;
b. Modify policies and practices that do not meet Section 504 requirements;
c. Take remedial steps to eliminate the effects of any discrimination that resulted from adherence to these policies
and practices; and.
d. Maintain self-evaluation on file, including a list of the interested persons consulted, a description of areas
examined, and any problems identified, and a description of any modifications made and of any remedial steps
taken 45 CFRR §. 84.6. (This checklist may be used to satisfy this requirement if these four steps have been
followed.)
16. Programs or facilities that employ 15 or more persons shall adopt grievance procedures that incorporate appropriate
due process standards and that provide for the prompt and equitable resolution of complaints alleging any
action prohibited by Part 84 of Title 45, CFR § 84.7(b).
17. Programs or facilities that employ 15 or more persons shall designate at least one person to coordinate its efforts
to comply with Part 84 of Title 45, CFR § 84.7(a).
18. Programs or facilities that employ 15 or more persons shall take appropriate initial and continuing steps to notify
participants, beneficiaries, applicants, and employees that the program/facility does not discriminate on the basis of
handicap in violation of Section 504 and Part 84 of Title 45, CFR. Methods of initial and continuing notification may
include the posting of notices, publication in newspapers and magazines, placement of notices in publications of the
programs or facilities, and distribution of memoranda or other written communications. 45 CFR § 84.8(a).
19. Programs/facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with impaired
sensory, manual, or speaking skills where necessary to afford such persons an equal opportunity to benefit from the
service in question. Auxiliary aids may include, but are not limited to, brailed and taped materials, interpreters, and
other aids for persons with unpaired hearing or vision. 45 CFR § 84.52(d).
20. Programs/facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement, and
maintain a written affirmative action compliance program in accordance with Executive Order 11246, 41 CFR Part
60 and Title VI of the Civil Rights Act of 1964, as amended.
46
G
July 2019 to June 2020
DEPARTMENT OF
ELDER
AFFAIRS
STATE OF FLORIDA
ADI 203.19
ATTACHME, NT VII
BACKGROUND SCREENING
BACKGROUND SCREENING
Affidavit of Compliance - Employer
AUTHORITY: This form is required annually of all employers to comply with the attestation
requirements set forth in section 435:05(3), Florida Statutes.
➢ The term "employer' means any person or entity required by. law to, conduct background screening,
including but not limited to, Area Agencies on Aging, Aging Resource Centers, Aging and Disability
Resource Centers, Lead Agencies, Long -Term Care Ombudsman Program; Serving Health Insurance Needs
of Elders Program, Service Providers, Diversion Providers, and any other person or entity which hires
employees or has volunteers in service who meet the definition of :a direct service provider. See §§
435.02, 430.0402; Fla. Stat.
➢ A direct service provider is "a person 18 years of age or older who, pursuant to a -program to provide
services to the elderly,, has direct, face-to-face contact with a client while providing services to: the client
and has accessto the client's living area, funds, personal property, or personal identification information
as. defined In s. 817.568. The term Includes coordinators, managers, and supervisors of residential
facilities; and volunteers." §430.0402(1)(6); Fla. Stat.
ATTESTATION:
As the duly a uthorized representative of
Employer Name
located at
StreetAddress City State ZIP code
I, do hereby affirm under penalty of perjury
Name of Representative
that the above named employer is in compliance with the provisionsofChapter 435 and section
430.0402, Florida Statutes, regarding level background screening.
Signature of Representative
STATE OF FLORIDA, COUNTY OF
Date
Sworn to (or affirmed) and subscribed before me this day of
to me or produced
20by
of Representative) who is personally known
Pdnt,Typ% or Stamp Commissfoned Name of Notary Public Notary Public
as proofof identification.
DOEA Form 235, Aff1daW of Compliame -Employer, Effective ApHl 2012 Secdcn 435.0.5(3), FS,
Farm avallabla at: h[ts/Jelderaffalrsstzte.fl.us/erelishtbackaroundsaeenine.otn
47
a
July 2019 to June 2020
Report Number
10
11
12
13
14
15
Legend:
ATTACHMENT IX
INVOICE REPORT SCHEDULE
ALZHEIlViER'S DISEASE INITIATIVE
Based On
July Advance*
August Advance*
July Expenditure Report
August Expenditure Report
September Expenditure Report
October Expenditure Report
November Expenditure Report
December Expenditure Report
January Expenditure Report
February Expenditure Report
March Expenditure Report
April Expenditure Report
May Expenditure Report
June Expenditure Report
Final Request for Payment
* Advance based on projected cash need
ADI 203.19
Submit to Agency on This Date
July 1
July 1
August 10
September 10
October 10
November 10
December 10
January 10
February 10
March 10
April 10
May 10
June 10
July 10
July 25
Note # 1: Report #1 for Advance Basis Contracts cannot be submitted to the Area Agency
on Aging for Southwest Florida, Inc. prior to July 1 or until the contract with the
Agency has been executed and a copy sent to the Area Agency on Aging for
Southwest Florida, Inc. Actual submission of the vouchers to the Agency is
dependent on the accuracy of the expenditure report.
Note # 2: Report numbers 5 through 14 shall reflect an adjustment of at least one-tenth of
the total advance amounts, repaying advances issued the first two months of the
agreement. All advance payments made to the Contractor shall be returned to
the Agency and reported as an advance recoupment on each request for
payment. The adjustment shall be recorded in Part C, Line 1 of the report
(ATTACHMENT XI).
Note # 3: Submission of expenditure reports may or may not generate a payment request.
If final expenditure report reflects funds due back to the Agency, payment is to
accompany the report.
Note # 4: ALL Expenditure Reports are due by 12:00 p.m. on the 10th of each month. IF
the 10th falls on a Saturday, then the report will be due by the 9th by 12:00 p.m.
AND IF the 10th falls on a Sunday, the report will be due by the 1 lth by 12:00
p.m. Actual submission of the vouchers to Dept. of Elder Affairs is dependent
on the accuracy of the expenditure report, which is verified and paid by CIRTS
data only.
July 2019 to June 2020
ATTACHMENT X
ANNUAL BUDGET SUMMARY
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
for
Collier County Board of County Commissioners
Collier
ALLOCATION TOTAL $ 449,855.00
ADI 203.19
CAO
July 2019 to June 2020
ATTACHMENT XI
ADI 203.19
REQUEST FOR PAYMENT
ALZHEIMERS
DISEASE INITIATIVE PROGRAM
RECIPIENT NAME, ADDRESS, PHONE#and FEID#
TYPE OF REPORT:
Contract#
Contract Period
A. PAYMENT REQUEST:
Report Period
Regular
Report #
Invoice #
B. METHOD OF PAYMENT:
Advance
Reimbursement
PSA e
CERTIFICATION: I hereby certify to the best of my knowledge that this request is complete and correct and conforms with the terms and the purposes of the above
contract. To the best of my knowledge, all CIRTS
is accurate and correct.
Prepared by: Dale:
Approved by:
Date:
(1)
(2)
PARTA: BUDGETSUMMARY
Respite
Specialized Services
TOTAL
1. Approved ContractAmount
$0.00
$0.00
$0.00
2. Previous Funds Received for Contract Period
$0.00
$0.00
$0.00
3. Contract Balance (line 1 minus line 2)
$0.00
$0.00
$0.00
4. Previous Funds Requested and Not Received for Contract Period
$0.00
$0.00
$0.00
5. Contract Balance (line 3 minus line 4)
$0.00
$0.00
$0.00
PART B: CONTRACT FUNDS REQUEST
1. Anticipated Cash Needs (1 sl - 2nd month, Attach Justification)
$0.00
$0.00
$0.00
2. Net Expenditures For Month
$0.00
$0.00
$0.00
(DOEA Form 105Z Part B, Line 3)
3. TOTAL
$0.00
$0.00
$0.00
PART C: NET FUNDS REQUESTED
1. Less Advance Applied
$0.00
$0.00
$0.00
2. Contract Funds are Hereby Requested for (Part B, Line 3
$0.00
$0.00
$0.00
minus Part C, Line 1)
List of Services / Units / Rates provided - See attached report.
DOEA FORM 106Z
Revised 05/18
50 CAO
July 2019 to June 2020
ATTACBMENT XII
RECEIPT AND EXPENDITURE
ADI 203.19
ALZHEIMERS DISEASE INITIATIVE PROGRAM
PROVIDER ADDRESS, PHONE # and FEID#
TNAME,
CONTRACT#
PROGRAM FUNDING:
CONTRACT PERIOD
RESPITE
REPORT PERIOD
PROJECTS
REPORT#
SPECIALIZED DAY CARE
INVOICE #
PSA.8
CERTIFICATION: I certify to the best of my knowledge and belief that the report is complete and correct and all outlays
herein are for purposes set forth In the contract. To the best of my knowledge, all CIRTS is accurate and correct.
Prepared by: Date: Approved by: --Date:_
PART A: BUDGETED INCOME/ RECEIPTS
1. Approved
2. Actual Receipts
3. Total Receipts
4. Percent of
Budget
For This Report
Year to Date
Approved Budget
1. State Funds
$0.00
$0.00
$0.00
#DIV/01
2. Program Income
$0.00
$0.00
$0.00
#DIV/01
3. Local Cash Match
$0.00
$0.00
$0.00
#DIV/01
4. SUBTOTAL: CASH RECEIPTS
5. Local in -Kind Match
0. TOTAL RECEIPTS
$0.00
$0.00
$0.00
#DIV/01
PART B: EXPENDITURES
1. Approved
2. Expenditures
3. Expenditures
4. Percent of
Budget
For This Report
Year to Date
Approved Budget
$0.00
$0.00
$0.00
#DIV/01
1. Administrative Services
2. Service Subcontractor(s) -
$0.00
$0.00
$0.00
#DIV/01
3. Alzheimer's Association
4. Jewish Family & Community Services
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
#DIV/01
#DIV/01
5. TOTAL EXPENDITURES
$0.00
$0.00
$0.00
#DIV/01
PART C: OTHER REVENUE AND EXPENDITURES
11. Interest:
III. Advance Recouped
1. Program Income (PI)
1. Earned on GR Advance $
$0.00
1. ADI: PI Collected YTD $
2. Return of GR Advance $
(Includes co -payments collected)
3. Other Earned $
PART D: CO -PAYMENTS CURRENT MONTH YEAR-TO-DATE
1. Total of Co -payments assessed $0.00 $0.00
2. Total of Co -payments collected $0.00 $0.00
(For Tracking Purposes only)
DOEA FORM 105Z
Revised 05/18
51 \ AO
July 2019 to June 2020
ATTACHMENT XV
SERVICE RATE REPORT
Collier
Aide:
Management:
lte In -Facility:
lte In -Home:
Medical Equipment, Services and Supplies
HIGHEST
REIMBURSEMENT
UNIT RATE
52
EL!
FWAINWIMAK
METHOD OF
PAYMENTS
Fixed Fee / Unit Rate
Fixed Fee / Unit Rate
Fixed Fee / Unit Rate
Fixed Fee / Unit Rate
Cost Reimbursement
Cost Reimbursement
^)
Revised August 2007
Attestation Statement
Agreement/Contract Number ADI 203.19
Amendment Number NA
I, Stenehn Y Carnell , attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
Collier County Board of County Commissioners
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting, due to the differences in
electronic data processing media, which has no affect on the agreement/contract content.
Signature of Recipie't/Contractor representative Date
Approved as to forin and legality
As "•tint County Ath ra
Revised August 2007
8
July 2019 — June 2020
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC.
COMMUNITY CARE FOR THE ELDERLY
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
CCE 203.19
THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, hie., (Agency) and Collier
County Board of County Commissioners (Contractor), collectively referred to as the "Patties." The term Contractor for
this purpose may designate a Vendor, Subgrantee or Subrecipient.
WITNESSETH THAT:
WHEREAS, the Agency has determined that it is in need of certain services as described herein; and WHEREAS,
the Contractor has demonstrated that it has the requisite expertise and ability to faithfully perform such services as
an independent Contractor of the Agency.
NOW THEREFORE, in consideration of the services to be performed and payments to be made, together with the
mutual covenants and conditions set forth herein, the Parties agree as follows:
1. PurRose of Contract:
The purpose of this contract is to provide services in accordance with the terms and conditions specified in this contract
including all attachments, forms and exhibits, which constitute the contract document.
l, ,i�"I, T ,iMT.4I9,ifiiL�KiriT�Si1
The contract will incorporate attachments, proposal(s), state plan(s), grant agreements, relevant Department handbooks,
manuals and/or desk books, as an integral part of the contract, except to the extent that the contract explicitly
provides to the contrary. In the event of conflict in language among any of the documents referenced above, the
specific provisions and requirements of the contract document(s) shall prevail over inconsistent provisions in the
proposal(s) or other general materials not specific to this contract document and identified attachments.
3. Term of Contract:
This contract shall begin at twelve (12:00) A.M., Eastern Standard Time July 1, 2019 or on the date the contract has
been signed by the last party required to sign it, whichever is later. It shall end at eleven fifty-nine (11:59) P.M., Eastern
Standard Time June 30, 2020.
4. Contract Amount:
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount not
to exceed $916,057.00, subject to the availability of funds. Any costs or services paid for under any other contract or
fi•om any other source are not eligible for payment under this contract.
5. Renewals:
By mutual agreement of the Parties, in accordance with Section 287.058(1)(g), Florida Statutes (F.S.), the Agency
may renew the contract for a period not to exceed three years, or the term of the original contract, whichever is longer.
The renewal price, or method for determining a renewal price, is set forth in the bid, proposal, or reply. No other costs
for the renewal may be charged. Any renewal is subject to the same terms and conditions as the original contract and
contingent upon satisfactory performance evaluations by the Agency and the availability of funds.
6. Compliance with Federal Law:
6.1 If this contract contains federal funds this section shall apply.
6.1.1 The Contractor shall comply with the provisions of 45 Code of Federal Regulations (CFR) 75 and/or 45
CFR Part 92, 2 CFR Part 200, and other applicable regulations.
6.1.2 If this contract contains federal Rinds and is over $100,000.00, the Contractor shall comply with all
applicable standards, orders, or regulations issued under Section 306 of the Clean Air Act as amended (42
United States Code (U.S.C.) § 7401, et seq.), Section 508 of the Federal Water Pollution Control Act
July 2019 — June 2020 CCE 203.19
as amended (33 U.S.C. § 1251, et seq.), Executive Order 11738, as amended, and, where applicable,
Environmental Protection Agency regulations 2 CFR Part 1500. The Contractor shall report any violations
of the above to the Agency.
6.1.3 Neither the Contractor nor any agent acting on behalf of the Contractor may not use any federal funds
received in connection with this contract to influence legislation or appropriations pending before
Congress or any state legislature. The Contractor must complete all disclosure forms as required,
specifically the Certification and Assurances Attachment, which must be completed and returned to the
Contract Manager prior to the execution of this contract.
6.1.4 In accordance with Appendix B to 2 CFR Part 200, the Contractor shall comply with Executive Order
11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as
supplemented in Department of Labor regulations 41 CFR Part 60 and in Department of Health and Human
Services regulations 45 CPR Part 92, if applicable.
6.1.5 A contract award with an amount expected to equal or exceed $25,000.00 and certain other contract awards
will not be made to parties listed on the government -wide Excluded Patties List System, in accordance with
the Office of Management and Budget (OMB) guidelines at 2 CFR Part 180 that implement Executive
Orders 12549 and 12689, "Debarment and Suspension." The Excluded Parties List System contains the
names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared
ineligible under statutory or regulatory authority other than Executive Order 12549. The Contractor
shall comply with these provisions before doing business or entering into subcontracts receiving
federal funds pursuant to this contract. The Contractor shall complete and sign the Certifications and
Assurances Attachment prior to the execution of this contract.
6.2 The Contractor shall not employ an unauthorized alien. The Agency will consider the employment of
unauthorized aliens a violation of the Immigration and Nationality Act (8 U.S.C. § 1324a) and the
Immigration Reform and Control Act of 1986 (8 U.S.C. § 1101). Such violation will be cause for unilateral
cancellation of this contact by the Agency.
6.3 If the Contractor is a non-profit provider and is subject to Internal Revenue Service (IRS) tax exempt organization
reporting requirements (filing a Form 990 or Form 990-N) and has its tax-exempt status revoked for failing to
comply with the filing requirements of the Pension Protection Act of 2006 or for any other reason, the Contractor
must notify the Agency in writing within thirty (30) days of receiving the IRS notice of revocation.
6.4 The Contactor shall comply with Title 2 CFR Part 175 regarding Trafficking in Persons.
6.5 Unless exempt under 2 CFR § 170.110(b), the Contractor shall comply with the reporting requirements of the
Transparency Act as expressed in 2 CFR Part 170.
6.6 To comply with Presidential Executive Order 12989, as amended, and State of Florida Executive Order Number
I1-116, Contactor agrees to utilize the U.S. Department of Homeland Security's E -verify system to verify the
employment of all new employees hired by Contractor during the contact term. Contactor shall include in
related subcontracts a requirement that Subcontractors performing work or providing services pursuant to the
state contact utilize the E -verify system to verify employment of all new employees hired by the Subcontractor
during the contact term. Contractors meeting the terms and conditions of the E -Verify System are deemed to be
in compliance with this provision.
7. Compliance with State Law:
7.1 This contract is executed and entered into in the State of Florida, and shall be construed, performed, and enforced
in all respects in accordance with Florida law, including Florida provisions for conflict of laws.
7.2 If this contract contains state financial assistance funds, the Contractor shall comply with Section 215.97, F.S.,
and Section 215.971, F.S., and expenditures must be in compliance with laws, rules, and regulations including,
but not limited to, the Reference Guide for State Expenditures.
7.3 The Contactor shall comply with the requirements of Section 287.058, F.S, as amended.
7.3.1 The Contractor shall perform all tasks contained in Attachment I.
7.3.2 The Contractor shall provide units of deliverables, including reports, findings, and drafts, as specified in
July 2019 — June 2020 CCE 203.19
Attachment I, to be received and accepted by the Agency Contract Manager prior to payment.
7.3.3 The Contractor shall comply with the criteria and final date by which such criteria must be met for
completion of this contract as specified in Attachment I, Section III. Method of Payment.
7.3.4 The Contractor shall submit bills for fees or other compensation for services or expenses in sufficient detail
for a proper pre -audit and post -audit.
7.3.5 If itemized payment for travel expenses is permitted in this contract, the Contractor shall submit invoices
for any travel expenses in accordance with Section 112.061, F.S., or at such lower rates as may be
provided in this contract.
7.3.6 The Contractor shall allow public access to all documents, papers, letters, or other public records as defined
in Section 119.011(12), F.S., made or received by the Contractor in conjunction with this contract except
for those records, which are made confidential or exempt by law. The Contractor's refusal to comply with
this provision will constitute an immediate breach of contract for which the Agency may unilaterally
terminate this contract.
7.4 If clients are to be transported under this contract, the Contractor shall comply with the provisions of Chapter
427, F.S., and Rule Chapter 41-2, Florida Administrative Code (F.A.C).
7.5 Subcontractors who are on the Discriminatory Vendor List may not transact business with any public entity, in
accordance with the provisions of Section 287.134, F.S.
7.6 The Contractor shall comply with the provisions of Section 11.062, F.S., and Section 216.347, F.S., which prohibit
the expenditure of contract funds for the purpose of lobbying the legislature, judicial branch or a state agency.
7.7 The Area Agency may, at its option, terminate the Contract if the Contractor is found to have submitted a false
certification as provided under section 287.135(5),F.S., has been placed on the Scrutinized Companies with
Activities in the Iran Petroleum Energy Sector List, the Scrutinized Companies with Activities in Sudan List,
or the Scrutinized Companies that Boycott Israel List, or if the Contractor has been engaged in business
operations in Cuba or Syria or is engaged in a boycott of Israel.
8. Background Screening:
The Contractor shall ensure that the requirements of Section 430.0402 and Chapter 435, F.S., as amended, are met
regarding background screening for all persons who meet the definition of a direct service provider and who are not
exempt from the Department's level 2 background screening pursuant to Section 430.0402(2-)-(3), F.S. The Contractor
must also comply with any applicable rules promulgated by the Agency and the Agency for Health Care
Administration regarding implementation of Section 430.0402 and Chapter 435, F.S. To demonstrate compliance with
this provision, Contractor shall submit the Background Screening Affidavit of Compliance (Screening Form) to the
Agency within thirty (30) days of execution of this contract. Should the Agency have a completed Screening Form on
file for the Contractor, a new Screening Form will be required every twelve (12) months.
8.1 Further information concerning the procedures for background screening may be found at
http://elderaffairs state fl.us/doea/backgroundscreening.plip.
9. Grievance Procedures:
The Contractor shall develop, implement, and ensure that its Subcontractors have established grievance procedures to
process and resolve client dissatisfaction with, or denial of, service(s) and address complaints regarding the termination,
suspension or reduction of services, as required for receipt of funds. These procedures, at a minimum, will provide for
notice of the grievance procedure and an opportunity for review of the Subcontractor's determination(s).
10. Public Records and Retention:
10.1 By execution of this contract, Contractor agrees to all provisions of Chapter 119, F.S., and any other applicable
law, and shall:
10.1.1 Keep and maintain public records required by the Agency to perform the contracted services.
July 2019 — June 2020
CCE 203.19
10.1.2 Upon request from the Agency's custodian of public records, provide the Agency a copy of the
requested records or allow the records to be inspected or copied within a reasonable time at a cost that does
not exceed the cost provided in Chapter 119, F.S., or as otherwise provided by law.
10.1.3 Ensure that public records that are exempt, or confidential and exempt, from public records disclosure
requirements are not disclosed except as authorized by law for the duration of the contract term and
following completion of the contract if the Contractor does not transfer the records to the Agency.
10.1.4 Upon completion of the contract, the Contractor will either transfer, at no cost to the Agency, all public
records in possession of the Contactor to the Agency or will keep and maintain public records required by
the Agency. If the Contractor transfers all public records to the Agency upon completion of the
contact, Contractor shall destroy any duplicate public records that are exempt, or confidential and exempt,
from public records disclosure requirements. If the Contractor keeps and maintains public records upon
completion of the contact, the Contractor shall meet all applicable requirements for retaining public
records. All records stored electronically must be provided to the Agency in a format that is compatible
with the information technology systems of the Agency.
10.2 The Agency may unilaterally cancel this contact, notwithstanding any other provisions of this contract, for
refusal by the Contactor to comply with Section 10 of this contact by not allowing public access to all documents,
papers, letters, or other material made or received by the Contactor in conjunction with this contract, unless the
records are exempt, or confidential and exempt, from Section 24(a) of Article I of the State Constitution and
Section 119.07(1), F.S.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION
OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO
PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT
THE CUSTODIAN OF PUBLIC RECORDS AT:
Public Records Coordinator
Area Agency on Aging for Southwest Florida, Inc.
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
239-652-6900 or 866-413-5337
10.3 Upon termination of this contact, whether for convenience or for cause as detailed in Section 53 of this contract, the
Contactor and Subcontractors shall, at no cost to the Agency, transfer all public records in their possession to the
Agency and destroy any duplicate public records that are exempt, or confidential and exempt, from public records
disclosure requirements. All records stored electronically shall be provided to the Agency in a format that is
compatible with the information technology system of the Agency.
11. Audits. Inspections, Investigations:
11.1 The Contractor shall establish and maintain books, records and documents (including electronic storage media)
sufficient to reflect all assets, obligations, unobligated balances, income, interest, and expenditures of funds
provided by the Agency under this contact. Contactor shall adequately safeguard all such assets and ensure
they are used solely for the purposes authorized under this contract. Whenever appropriate, financial information
should be related to performance and unit cost data.
11.2 The Contractor shall retain and maintain all client records, financial records, supporting documents, statistical
records, and any other documents (including electronic storage media) pertinent to this contact for a period of
six (6) years after completion of the contact or longer when required by law. In the event an audit is required
by this contact, records shall be retained for a minimum period of six (6) years after the audit report is issued or
until resolution of any audit findings or litigation based on the terms of this contract, at no additional cost to the
Agency.
11.3 Upon demand, at no additional cost to the Agency, the Contractor shall facilitate the duplication and transfer of
any records or documents during the required retention period.
July 2019 — June 2020 CCE 203.19
11.4 The Contractor shall ensure that the records described in this section will be subject at all reasonable times to
inspection, review, copying, or audit by federal, state, or other personnel duly authorized by the Agency.
11.5 At all reasonable times for as long as records are maintained, persons duly authorized by the Agency and
federal auditors, pursuant to 45 CPR Part 75, shall be allowed full access to and the right to examine any of the
Contractor's contracts and related records and documents pertinent to this specific contact, regardless of the
form in which kept.
11.6 The Contractor shall provide a Financial and Compliance Audit to the Agency as specified in this contract
and ensure that all related third -party transactions are disclosed to the auditor.
11.7 Contractor agrees to comply with the Inspector General in any investigation, audit, inspection, review, or hearing
performed pursuant to Section 20.055, F,S, Florida Statutes. Contractor father agrees that it shall include in
related subcontracts a requirement that subcontractors performing work or providing services pursuant to this
contract agree to cooperate with the Inspector General in any investigation, audit, inspection, review, or hearing
pursuant to Section 20.055(5), F.S. By execution of this contract the Contractor understands and will comply
with this subsection.
12. Nondiscrimination -Civil I2ights Compliance:
12.1 The Contractor shall execute Assurances as stated in the Assurances -Non -Construction Programs Attachment that
it will not discriminate against any person in the provision of services or benefits under this contract or in
employment because of age, race, religion, color, disability, national origin, marital status, or sex in compliance
with state and federal law and regulations. The Contractor further assures that all Contractors, Subcontractors,
Sub -grantees, or others with whom it arranges to provide services or benefits in connection with any of its
programs and activities are not discriminating against clients or employees because of age, race, religion, color,
disability, national origin, marital status or sex.
12.2 During the term of this contract, the Contractor shall complete and retain on file a timely, complete, and accurate
Civil Rights Compliance Checklist, attached to this contract.
12.3 The Contractor shall establish procedures pursuant to federal law to handle complaints of discrimination involving
services or benefits through this contract. These procedures shall include notifying clients, employees, and
participants of the right to file a complaint with the appropriate federal or state entity.
12.4 If this contract contains federal funds, these assurances are a condition of continued receipt of or benefit from
federal financial assistance, and are binding upon the Contractor, its successors, transferees, and assignees for the
period during which such assistance is provided. The Contractor further assures that all Subcontractors,
Vendors, or others with whom it arranges to provide services or benefits to participants or employees in
connection with any of its programs and activities are not discriminating against those participants or
employees in violation of the any statutes, regulations, guidelines, and standards. hi the event of failure to
comply, the Contractor understands that the Agency may, at its discretion, seek a court order requiring
compliance with the terms of this assurance or seek other appropriate judicial or administrative relief, including
but not limited to, termination of and denial of further assistance.
13. Monitoring by the Agency;
The Contactor shall permit persons duly authorized by the Agency to inspect and copy any records, papers,
documents, facilities, goods, and services of the Contractor which are relevant to this contact, 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 provide a written
report of its findings to the Contractor, and where appropriate, the Contractor shall develop a Corrective Action Plan
(CAP). The Contractor hereby agrees to correct all deficiencies identified in the CAP in a timely manner as determined
by the Agency's Contract Manager.
14. Provision of Services:
The Contractor shall provide services in the manner described in Attachment I.
July 2019 — June 2020
15. Coordinated Monitoring with Other Agencies:
CCE 203.19
If the Contractor receives funding from one or more State of Florida human service agencies, in addition to the
Area Agency on Aging for Southwest Florida, Inc., then a joint monitoring visit including such other agencies may
be scheduled. For the proposes of this contract, and pursuant to Section 287.0575, F.S., as amended, Florida's
human service agencies shall include the Department of Children and Families, the Department of Health, the
Agency for Persons with Disabilities, the Department of Veterans' Affairs, and the Department of Elder Affairs.
Upon notification and the subsequent scheduling of such a visit by the designated agency's lead administrative
coordinator, the Contractor shall comply and cooperate with all monitors, inspectors, and/or investigators.
16. Indemnification:
The Contractor shall indemnify, save, defend, and hold harmless the Agency and its agents and employees from
any and all claims, demands, actions, and causes of action of whatever nature or character arising out of, or by reason
of the execution of this contract or performance of the services provided for herein. It is understood and agreed
that the Contractor is not required to indemnify the Agency for claims, demands, actions or causes of action arising
solely out of the negligence of the Agency.
16.1 Except to the extent permitted by Section 768.28, F.S., or other Florida law, this Section 17 is not applicable to
contracts executed between the Agency and state agencies or subdivisions defined in Section 768.28(2), F.S.
17. Insurance and Bonding:
17.1 The Contractor shall provide continuous adequate liability insurance coverage during the existence of this
contract and any renewal(s) and extension(s) of it. By execution of this contract, unless it is a state agency or
subdivision as defined by Section 768.28(2), F.S., the Contractor accepts full responsibility for identifying and
determining the type(s) and extent of liability insurance coverage necessary to provide reasonable financial
protections for the Contractor and the clients to be served under this contract. The limits of coverage under
each policy maintained by the Contractor do not limit the Contractor's liability and obligations under this
contract. The Contractor shall ensure that the Agency has the most current written verification of
insurance coverage throughout the term of this contract. Such coverage may be provided by a self-insurance
program established and operating under the laws of the State of Florida. The Agency reserves the right to
require additional insurance as specified in this contract.
17.2 Throughout the term of this contract, the Contractor shall maintain an insurance bond from a responsible
commercial insurance company covering all officers, directors, employees, and agents of the Contractor
authorized to handle funds received or disbursed under all agreements and/or contracts incorporating this
contract by reference in an amount commensurate with the funds handled, the degree of risk as determined by
the insurance company, and consistent with good business practices.
18. Confidentiality of Information:
The Contractor shall not use or disclose any information concerning a recipient of services under this contract for any
purpose prohibited by state or federal law or regulations except with the written consent of a person legally authorized
to give that consent or when authorized by law.
19. Health Insurance Portability and Accountability Act:
Where applicable, the Contractor shall comply with the Health Insurance Portability and Accountability Act (42 USC
§ 1320d.), as well as all regulations promulgated thereunder (45 CFR Parts 160, 162, and 164).
20. Incident ReRorting:
20.1 The Contractor shall notify the Agency immediately but no later than forty-eight (48) hours from the
Contractor's awareness or discovery of conditions that may materially affect the Contractors or Subcontractors
ability to perform the services required to be performed under this contract. Such notice shall be made orally to
the Agency's Contract Manager (by telephone) with an email to immediately follow.
20.2 The Contractor shall immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of
a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone number
July 2019 —June 2020
CCE 203.19
(1-800-96ABUSE). As required by Chapters 39 and 415, F.S., this provision is binding upon the Contractor,
its Subcontractors, and their employees.
21. Bankruptcy Notification:
During the term of this contract, the Contractor shall immediately notify the Agency if the Contractor, its assignees,
Subcontractors or affiliates file a claim for bankruptcy. Within ten (10) days after notification, the Contractor must
also provide the following information to the Area Agency on Aging for Southwest Florida, Inc.: (1) the date of filing
of the bankruptcy petition; (2) the case number; (3) the court name and the division in which the petition was filed (e.g.,
Middle District of Florida, Fort Myers, Florida); and (4) the name, address, and telephone number of the
bankruptcy attorney.
22. Sponsorship and Publicity:
22.1 As required by Section 286.25, F.S., if the Contractor is a non-governmental organization which sponsors a
program financed wholly or in part by state funds, including any funds obtained through this contract, it shall,
in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by (Contractor's
name) and the Area Agency on Aging for Southwest Florida, Inc. and/or State of Florida, Department of Elder
Affairs." If the sponsorship reference is in written material, the words "Area Agency on Aging for Southwest
Florida, Inc. and/or State of Florida, Department of Elder Affairs" shall appear in at least the same size letters or
type as the name of the organization.
22.2 The Contractor shall not use the words "Area Agency on Aging for Southwest Florida, Inc. and/or State of
Florida, Department of Elder Affairs" to indicate sponsorship of a program otherwise financed, unless specific
written authorization has been obtained by the Agency and/or Department prior to such use.
23. Assignments:
23.1 The Contractor shall not assign the rights and responsibilities under this contract without the prior written
approval of the Agency. Any sublicense, assignment, or transfer otherwise occurring without prior written
approval of the Agency shall constitute a material breach of the contract. In the event the State of Florida
and/or the Area Agency on Aging for Southwest Florida, hie. approves assignment of the Contractor's
obligations, the Contractor remains responsible for all work performed and all expenses incurred in connection
with this contract.
23.2 This contract shall remain binding upon the successors in interest of the Contractor and the Agency.
24. Subcontracts:
24.1 The Contractor is responsible for all work performed and for all commodities produced pursuant to this contract,
whether actually furnished by the Contractor or its Subcontractors. Any subcontracts shall be evidenced by a
written document and subject to any conditions of approval the Agency deems necessary. The Contractor
further agrees that the Agency will not be liable to the Subcontractor in any way or for any reason. The
Contractor, at its expense, shall defend the Agency against any such claims.
24.2 The Contractor shall promptly pay any Subcontractors upon receipt of payment from the Agency or other
state agency. Failure to make payments to any Subcontractor in accordance with Section 287.0585, F.S., unless
otherwise stated in the contract between the Contactor and Subcontractor, will result in a penalty as provided by
statute.
25. Independent CaUacily of Contractor:
It is the intent and understanding of the Parties that the Contractor and any of its subcontractors are independent
Contractors and are not employees of the Agency, and that they shall not hold themselves out as employees or
agents of the Agency without specific authorization from the Agency. It is the further intent and understanding of the
Parties that the Agency does not control the employment practices of the Contractor and will not be liable for any
wage and hour, employment discrimination, or other labor and employment claims against the Contractor or its
9
July 2019 — June 2020 CCE 203.19
Subcontractors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment
compensation funds, and all necessary insurance for the Contractor are the sole responsibility of the Contractor.
26. men
Payments shall be made to the Contractor for all completed and approved deliverables (units of service) as defined in
Attachment I. The Agency Contract Manager will have final approval of the Contractor's invoice submitted for
payment and will approve the invoice for payment only if the Contractor has met all terms and conditions of the
contract, unless the bid specifications, purchase order, or this contract specify otherwise. The approved invoice will
be submitted to the Agency's finance section for budgetary approval and processing. Disputes arising over
invoicing and payments will be resolved in accordance with the provisions of Section 215.422, F.S. A Vendor
Ombudsman has been established within the Florida Department of Financial Services and may be contacted at
800-342-2762.
27. Return of Funds:
The Contractor shall return to the Agency any overpayments due to unearned funds or funds disallowed, and any
interest attributable to such fiords pursuant to the terms and conditions of this contract, that were disbursed to the
Contractor by the Agency. In the event that the Contractor or its independent auditor discovers that an overpayment
has been made, the Contractor shall repay said overpayment immediately without prior notification from the
Agency. In the event that the Agency first discovers an overpayment has been made, the Agency Contact Manager
will notify the Contractor in writing of such findings. Should repayment not be made forthwith, the Contractor shall be
charged at the lawful rate of interest on the outstanding balance pursuant to Section 55.03, F.S., after Agency
notification or Contractor discovery.
28. Data Integrity and Safeguarding Information:
The Contractor shall ensure an appropriate level of data security for the information the Contractor is collecting or using
in the performance of this contract. An appropriate level of security includes approving and tracking all Contractor
employees that request system or information access and ensuring that user access has been removed from all terminated
employees. The Contractor, among other requirements, must anticipate and prepare for the loss of information
processing capabilities. All data and software shall be routinely backed up to ensure recovery from losses or outages
of the computer system. The security over the backed -up data is to be as stringent as the protection required of the
primary systems. The Contractor shall ensure all Subcontractors maintain written procedures for computer system
backup and recovery. The Contractor shall complete and sign the Certification Regarding Data Integrity Compliance
for Agreements, Grants, Loans, and Cooperative Agreements prior to the execution of this contract.
29. Computer Use and Social Media Policy:
The Department has implemented a Social Media Policy, in addition to its Computer Use Policy, which applies to all
employees, contracted employees, consultants, Other Personal Services (OPS) employees and volunteers, including
all personnel affiliated with third parties, such as, but not limited to, contractors and subcontractors. Any entity
that uses the Department's computer resource systems must comply with the Department's policy regarding social
media. Social Media includes, but is not limited to blogs, podcasts, discussion forums, Wikis, RSS feeds, video
sharing, social networks like MySpace, Facebook and Twitter, as well as content sharing networks such as flickr• and
YouTube. This policy is available on the Department's website at: http://eideraffairs.state.fl.us/doea/financial.php.
30. Conflict of Interest:
The Contractor shall establish safeguards to prohibit employees, board members, management, and Subcontractors
from using their positions for a purpose that constitutes or presents the appearance of personal or organizational
conflict of interest or personal gain. No employee, officer, or agent of the Contractor or Subcontractor shall
participate in the selection or in the award of a contract supported by state or federal fiords 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 Contractor's or
Subcontractor's officers, employees, or agents will neither solicit nor accept gratuities, favors, or anything of
KC A{)
July 2019 — June 2020
CCE 203.19
monetary value from Contractors, potential Contractors, or parties to Subcontracts. The Contractor's board
members and management must disclose to the Agency any relationship which may be, or may be perceived to be,
a conflict of interest within thirty (30) calendar days of an individual's original appointment or placement in that
position, or, if the individual is serving as an incumbent, within thirty (30) calendar days of the commencement of this
contract. The Contractor's employees and Subcontractors must make the same disclosures described above to the
Agency's board of directors. Compliance with this provision will be monitored.
31. Public Entity Crime:
Pursuant to Section 287.133, F.S., a person or affiliate who has been placed on the Convicted Vendor List following a
conviction for a public entity crime may not submit a bid, proposal, or reply on a contact 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 Contactor, Supplier, subcontractor, or Consultant under a
contact with any public entity; and may not transact business with any public entity in excess of the threshold amount
provided in Section 287.017, F.S., for CATEGORY TWO for a period of thirty six (36) months following the date of
being placed on the Convicted Vendor List.
32. Purchasing:
32.1 The Contractor may purchase articles which are the subject of, or are required to cavy 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 Sections 946.515(2) and (4), F.S. For purposes
of this contract, the Contractor 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 at 800-643-8459.
32.2 The Contactor may procure any recycled products or materials, which are the subject of or are required to carry
out this contact in accordance with the provisions of Section 403.7065, F.S.
32.3 The Contractor may purchase articles that are the subject of or required to carry out this contact from a
nonprofit agency for the Blind or for the Severely Handicapped that is qualified pursuant to Chapter 413, F.S.,
in the same manner and under the same procedures set forth in Sections 413.036(1) and (2), F.S. For purposes
of this contact, the Contractor shall be deemed to be substituted for the Agency insofar as dealings with such
qualified nonprofit agency are concerned. Additional information about the designated nonprofit agency and
the products it offers is available at httu'//www.respectofflorida.org. This clause is not applicable to
Subcontractors unless otherwise required by law.
33. Patents. Copyrights. Royalties:
If this contact is awarded state finding and if any discovery, invention, or copyrightable material is developed or
produced in the course of or as a result of work or services performed under this contact or any way connected with
this contract, or if ownership of any discovery, invention, or copyrightable material was purchased in the course of or
as a result of work or services performed under this contract, the Contractor shall refer the discovery, invention or
copyrightable material to the Agency to be referred to the Agency and/or Department of State. Any and all patent
rights or copyrights accruing under this contact are hereby reserved to the State of Florida in accordance with Chapter
286, F.S. Pursuant to Section 287.0571(5)(Ic), F.S., as amended, the only exceptions to this provision shall be those that
are clearly expressed and reasonably valued in this contract.
33.1 If the primary purpose of this contract is the creation of intellectual property, the State of Florida shall retain an
unencumbered right to use such property, notwithstanding any agreement made pursuant to this Section 34.
33.2 If this contract is awarded solely federal funding, the terms and conditions are governed by 2 CFR § 200.315
or 45 CFR § 75.322, as applicable.
33.3 Notwithstanding the foregoing provisions, if the Contactor or one of its Subcontractors is a university and a
member of the State University System of Florida, then Section 1004.23, F.S., shall apply, but the Agency
shall retain a perpetual, fully -paid, nonexclusive license for its use and the use of its Contractors, Subcontractors
or Assignees of any resulting patented, copyrighted, or trademarked work products.
July 2019 — June 2020
34. Emergeny Preparedness and Continuity of Operations:
CCE 203.19
34.1 If the tasks to be performed pursuant to this contract include the physical care and control of clients, or the
administration and coordination of services necessary for client health, safety, or welfare, the Contractor shall,
within thirty (30) calendar days of the execution of this contract, submit to the Agency Contract Manager,
verification of an Emergency Preparedness Plan. In the event of an emergency, the Contractor shall notify the
Agency of emergency provisions.
34.2 In the event a situation results in a cessation of services by a Subcontractor, the Contractor shall remain
responsible for performance under this contract and must follow procedures to ensure continuity of operations
without interruption.
35. Equipment:
35.1 Equipment means: (a) tangible personal property (including information technology systems) having a useful life
of more than one year and a per-unit acquisition cost which equals or exceeds the lesser of the capitalization level
established by the organization for the financial statement proposes, or $5,000.00 [for federal funds - 2 CFR
§ 200.33 and 45 CFR § 75.2, as applicable], or (b); nonexpendable, tangible personal property of a
non- consumable nature with an acquisition cost of $1,000.00 or more per unit, and expected useful life of at
least one
(1) year; and hardback bound books not circulated to students or the general public, with a value or cost of
$250.00 or more [for state funds].
35.2 Contractors and Subcontractors who are Institutions of Higher Education, Hospitals, and Other Non -Profit
Organizations shall have written property management standards in compliance with 2 CFR Part 200
Administrative Requirements (formerly OMB Circular A -I10) that include: (a) a property list with all the
elements identified in the circular; (b) a procedure for conducting a physical inventory of equipment at least once
every two (2) years; (c) a control system to insure adequate safeguards to prevent loss, damage, or theft of the
equipment; and (d) maintenance procedures to keep the equipment in good condition. The property records must
be maintained on file and shall be provided to the Agency upon request. The Contractor shall promptly
investigate, fully document, and notify the Agency Contract Manager of any loss, damage, or theft of
equipment. The Contractor shall provide the results of the investigation to the Agency Contract Manager.
35.3 The Contractor's property management standards for equipment (including replacement equipment), whether
acquired in whole or in part with federal funds and federally -owned equipment shall, at a minimum, meet the
following requirements and shall include accurately maintained equipment records with the following
information:
35.3.1 Property records must be maintained that include a description of the equipment;
35.3.2 Manufacturer's serial number, model number, federal stock number, national stock number, or other
identification number;
35.3.3 Source of funding for the equipment, including the federal award identification number;
35.3.4 Whether title vests in the Contractor or the federal government;
35.3.5 Acquisition date (or date received, if the equipment was furnished by the federal government);
35.3.6 Information from which one can calculate the percentage of federal participation in the cost of the
equipment (not applicable to equipment furnished by the federal government);
35.3.7 Location, use and condition of the equipment and the date the information was reported;
35.3.8 Unit acquisition cost; and
35.3.9 Ultimate disposition data, including date of disposal and sales price or the method used to determine
current fair market value where a Contractor compensates the federal awarding agency for its share.
35.3.10 A physical inventory must be taken and the results reconciled with the property records at least once
every two (2) years.
July 2019 — June 2020
CCE 203.19
35.3.11 A control system must be developed to ensure adequate safeguards to prevent loss, damage, or theft of
the property. Any loss, damage, or theft must be investigated, 45 CFR § 75.320(d)(3).
35.3.12 Adequate maintenance procedures must be developed to keep the property in good condition.
35.3.13 If the Contractor is authorized or required to sell the equipment, proper sales procedures must be
established to ensure the highest possible return.
35.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased with
state funds with an acquisition cost over $1,000.00 is part of the cost of carrying out the activities and functions
of the grant awards and title (ownership) will vest in the Contractor [for federal funds see 2 CFR § 200.313(a)
and 45 CFR § 75.320(a), as applicable], subject to the conditions of 2 CFR Part 200 and/or 45 CFR Part 75.
Equipment purchased under these thresholds is considered supplies and is not subject to property standards.
Equipment purchased with funds identified in the budget attachments to agreements covered by this contract or
identified in the sub -agreements with Subcontractors (not included in a cost methodology), is subject to the
conditions of Chapter 273, F. S., rule and 60A-1.017, F. A. C., and 2 CFR Part 200 and/or 45 CFR Part 75.
35.5 The Contractor shall not dispose of any equipment or materials provided by the Agency or purchased with
Rinds provided through this contract without first obtaining the approval of the Agency Contract Manager.
When disposing of property or equipment the Contractor must submit a written request for disposition
instructions to the Agency's Contract Manager. The request should include a brief description of the
property, purchase price, funding source, and percentage of state or federal participation, acquisition date and
condition of the property. The request should also indicate the Contractor's proposed disposition of the property
(i.e., transfer or donation to another agency that administers federal programs, offer of the items for sale, destroy
the items, etc.).
35.6 The Agency Contract Manager will issue disposition instructions. If disposition instructions are not
received within one hundred twenty (120) days of the written request for disposition, the Contractor is authorized
to proceed as directed in 2 CFR § 200.313 or 45 CFR § 75.320, as applicable.
35.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto, but
excludes movable machinery and equipment. Real property may not be purchased with state or federal funds
through agreements covered under this contract without the prior approval of the Agency. Real property
purchases from Older Americans Act funds are subject to the provisions of Title 42, Chapter 35, Subchapter III,
Part A., Section 3030b United States Code (U.S.C.). Real property purchases from state funds can only be
made through fixed capital outlay grants and aids appropriations and therefore are subject to the provisions of
Section 216.348, F.S.
35.8 Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted and tested prior
to disposal to ensure no confidential information remains.
35.9 The Contractor must adhere to the Agency's procedures and standards when purchasing Information
Technology Resources (ITR) as part of any agreement(s) incorporating this contact 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 Contactor has the responsibility to require any Subcontractors to comply with the Agency's ITR
procedures.
' r -
The PUR 1000 Form is hereby incorporated by reference and available at:
hftp•//www.myflorida.com/apps/vbs/adoc/F7740 PURIOOO.pdf
In the event of any conflict between the PUR 1000 Form and any terms or conditions of this contract, the terms or
conditions of this contract shall take precedence over the PUR 1000 Form. However, if the conflicting terms or
conditions in the PUR 1000 Form are required by any section of the Florida Statutes, the terms or conditions contained
in the PUR 1000 Form shall take precedence.
�t AC1
July 2019 — June 2020
37. Use of State Funds to Purchase or Improve Real property:
CCE 203.19
Any state funds provided for the purchase of or improvements to real property are contingent upon the Contractor or
political subdivision granting to the state a security interest in the property at least to the amount of state funds provided
for at least five (5) years from the date of purchase or the completion of the improvements or as further required by law.
38. Dispute Resolution:
Any dispute concerning performance of the contract shall be decided by the Agency Contract Manager, who shall
reduce the decision to writing and serve a copy on the Contractor.
39. Financial Conseau ne ces:
If the Contractor fails to meet the minimum level of service or performance identified in this contract, the Agency
shall impose financial consequences as stated in Attachment I.
40. No Waiver of Sovereign immunity:
Nothing contained in this contract is intended to serve as a waiver of sovereign immunity by any entity to which
sovereign immunity may be applicable.
41. Venue:
If any dispute arises out of this contract, the venue of such legal recourse shall be Lee County, Florida.
42. Entire Contract:
This contract contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations
shall be valid or binding upon the Agency or the Contractor unless expressly contained herein or by a written
amendment to this contract signed by both Patties.
43. Force Majeure:
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control,
provided the party experiencing the force majeure condition provides immediate written notification to the other patty
and takes all reasonable efforts to cure the condition.
44. Severability Clause:
The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or unenforceable, the
other provisions are severable to that void provision and shall remain in full force and effect.
45. Condition Precedent to Contract Aopronriations:
The Parties agree that the Agency's performance and obligation to pay under this contract are contingent upon an
annual appropriation by the Legislature.
46. Addition/Deletion:
The Parties agree that the Agency reserves the right to add or to delete any of the services required under this
contract when deemed to be in the State of Florida's best interest and reduced to a written amendment signed by both
Parties. The Parties shall negotiate compensation for any additional services added.
The delay or failure by the Agency to exercise or enforce any of its rights under this contract will not constitute or be
deemed a waiver of the Agency's right thereafter to enforce those rights, nor will any single or partial exercise of any
such right preclude any other or further exercise thereof or the exercise of any other right.
48. Com ho •ance:
The Contractor shall abide by all applicable current federal statutes, laws, rules, and regulations as well as applicable
current state statutes, laws, rules and regulations. The Parties agree that failure of the Contractor to abide by these laws
shall be deemed an event of default of the Contractor and subject the contract to immediate unilateral cancellation of
the contract at the discretion of the Agency.
12 ec;
July 2019 — June 2020
49. Final Invoice:
CCE 203.19
The Contractor shall submit the final invoice for payment to the Agency no later than thirty (30) days after the
contract ending date unless otherwise specified in Attachment I. If the Contractor fails to do so, all right to payment is
forfeited and the Agency shall not honor any requests submitted after the aforesaid time period. Any payment due
under the terms of this contact shall be withheld until all required documentation and reports due from the Contractor
and necessary adjustments thereto have been approved by the Agency.
50. Renegotiations of Modifications:
Modifications of the provisions of this contact shall be valid only when they have been reduced to writing and duly
signed by both parties. The rate of payment and the total dollar amount may be adjusted retroactively to reflect price
level increases and changes in the rate of payment when these have been established through the appropriations process
and subsequently identified in the Agency's operating budget.
51. Suspension of Work:
The Agency may in its sole discretion, suspend any or all activities under the contract or purchase order, at any time,
when in the best interest of the State to do so. The Agency shall provide the Contractor written notice outlining the
particulars of suspension. Examples of the reason for suspension include, but are not limited to, budgetary
constraints, declaration of emergency, or other such circumstances. After receiving a suspension notice, the Contractor
shall comply with the notice and shall not accept any purchase orders. Within ninety (90) days, or any longer period
agreed to by the Contractor, the Agency shall either: (1) issue a notice authorizing resumption of work, at which
time activity shall resume, or (2) terminate the contract or purchase order. Suspension of work shall not entitle the
Contractor to any additional compensation.
52. Termination:
52.1 Termination for Convenience. The Agency, by written notice to the Contractor, may terminate this contract in
whole or in part when the Agency determines in its sole discretion that it is in the State's interest to do so. The
Contractor shall not furnish any product after it receives the notice of termination, except as necessary to
complete the continued portion of this contract, if any. The Contractor shall not be entitled to recover any
cancellation charges or lost profits.
52.2 Termination for Cause. The Agency may terminate this contract if the Contractor fails to (1) deliver the
product within the time specified in the contract or any extension, (2) maintain adequate progress, thus
endangering performance of the contract, (3) honor any term of the contract, or (4) abide by any statutory,
regulatory, or licensing requirement. Rule 60A-1.006(3), F.A.C., governs the procedure and consequences of
default. The Contractor shall continue work on any work not terminated. Except for defaults of Subcontractors
at any tier, the Contractor shall not be liable for any excess costs if the failure to perform the contract arises from
events completely beyond the control, and without the fault or negligence, of the Contractor. If the failure to
perform is caused by the default of a Subcontractor at any tier, and if the cause of the default is completely beyond
the control of both the Contractor and the Subcontractor, and without the fault or negligence of either, the
Contractor shall not be liable for any excess costs for failure to perform, unless the subcontracted products were
obtainable fi-om other sources in sufficient time for the Contractor to meet the required delivery schedule. If, after
termination, it is determined that the Contractor was not in default, or that the default was excusable, the rights
and obligations of the Parties shall be the same as if the termination had been issued for the convenience of the
Agency. The rights and remedies of the Agency in this clause are in addition to any other rights and
remedies provided by law or under the contract.
13
Judy 2019 — June 2020
53. Electronic Records and Signature:
CCE 203.19
The Agency authorizes, but does not require, the Contractor to create and retain electronic records and to use
electronic signatures to conduct transactions necessary to carry out the terms of this contract. A Contractor that creates
and retains electronic records and uses electronic signatures to conduct transactions shall comply with the requirements
contained in the Uniform Electronic Transaction Act, Section 668.50, F.S. All electronic records must be fully
auditable; are subject to Florida's Public Records Law, Chapter 119, F.S.; must comply with contract Section 29, Data
Integrity and Safeguarding Information; must maintain all confidentiality, as applicable; and must be retained and
maintained by the Contractor to the same extent as non -electronic records are retained and maintained as required by
this contract.
53.1 The Agency's authorization pursuant to this section does not authorize electronic transactions between the
Contractor and the Agency. The Contractor is authorized to conduct electronic transactions with the
Agency only upon further written consent by the Agency.
53.2 Upon request by the Agency, the Contractor shall provide the Agency with non -electronic (paper) copies of
records. Non -electronic (paper) copies provided to the Agency of any document that was originally in
electronic form with an electronic signature must identify the person and the person's capacity who electronically
signed the document on any non -electronic copy of the document.
MWO �i MmIki.1.,
The Agency may substitute any Agency employee to serve as the Agency Contract Manager.
REMAINDER OF THE PAGE INTENTIONALL Y LEFT BLANK
14
C�,c�
July 2019 - June 2020
55. Official Payee and Representatives (Names. Addresses. and Telephone Numbers):
CCE 203.19
56. All Terms and Conditions Included:
This contract and its Attachments I - XB including any exhibits referenced in said attachments, together with any
documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There are no
provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all previous
communications, representations, or agreements, either written or verbal, between the Parties.
By signing this contract, the Parties agree that they have read and agree to the entire contract.
IN WITNESS WHEREOF, the Parties hereto have caused this contract to be executed by their undersigned officials
as duly authorized.
CONTRACTOR: COLLIER COUNTY BOARD AREA AGENCY ON AGING FOR
OF COUNTY COMMISSIONERS SOUTHWEST FLORIDA, INC.
SIGNED BY-.,/ •, . . (u t; - SIGNED BY:
t�
NAME: Steuhen Y Carnell NAME: MARIANNE G LORINI
TITLE: Public Service Department Head TITLE: PRESIDENT/CEO
DATE: %/ ` f 1 DATE:
Federal Tax ID: 59-6000588
Approved as to form and legality
Fiscal Year Ending Date: 09/30
DUNS: 076997790 }z \f n
15 ssislantCou t Allorucy -)�\ \Y
The Contactor name, as shown on page 1 of this
Collier County Board of County Commissioners
3339 E Tamiami Trail, Building H
a.
contract, and mailing address of the official payee to
Naples, FL 34112
whom the payment shall be made is:
The name of the contact person and street address
Kristi Sonntag, Director
Collier County Board of County Commissioners
b.
where financial and administrative records are
%Community and Human Services
maintained is:
3339 E Tamiami Trail, Building H
Naples, FL 34112
Kristi Sonntag, Director
The name, address, and telephone number of the
Collier County Board of County Commissioners
C.
representative of the Contractor responsible for
%Community and Hunan Services
administration of the program under this contract is:
3339 E Tamiami Trail, Building H
Naples, FL 34112
(239)252-2273
Area Agency on Aging for Southwest Florida, Inc.
d
The section and location within the Agency where
15201 North Cleveland Avenue, Suite 1100
Requests for Payment and Receipt and Expenditure
North Fort Myers, FL 33903
forms are to be mailed is:
Becky MacKenzie, Director of Program & Planning
e.
The name, address, and telephone number of the
Area Agency on Aging for Southwest Florida, Inc.
Contract Manager for this contract is:
15201 North Cleveland Avenue, Suite 1100
North Fort Myers, FL 33903
239-652-6900
Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided in
writing to the other party.
56. All Terms and Conditions Included:
This contract and its Attachments I - XB including any exhibits referenced in said attachments, together with any
documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There are no
provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all previous
communications, representations, or agreements, either written or verbal, between the Parties.
By signing this contract, the Parties agree that they have read and agree to the entire contract.
IN WITNESS WHEREOF, the Parties hereto have caused this contract to be executed by their undersigned officials
as duly authorized.
CONTRACTOR: COLLIER COUNTY BOARD AREA AGENCY ON AGING FOR
OF COUNTY COMMISSIONERS SOUTHWEST FLORIDA, INC.
SIGNED BY-.,/ •, . . (u t; - SIGNED BY:
t�
NAME: Steuhen Y Carnell NAME: MARIANNE G LORINI
TITLE: Public Service Department Head TITLE: PRESIDENT/CEO
DATE: %/ ` f 1 DATE:
Federal Tax ID: 59-6000588
Approved as to form and legality
Fiscal Year Ending Date: 09/30
DUNS: 076997790 }z \f n
15 ssislantCou t Allorucy -)�\ \Y
July 2019 — June 2020
INDEX OF ATTACHMENTS
CCE 203.19
ATTACHMENT
STATEMENTOF WORK................................................................................................................................ 17
ATTACHMENT II
I�1►/.7�[�JI�.\►f3K�751711/_\�C\1�1.��1�
ATTACHMENT III
CERTIFICATIONS AND ASSURANCES...................................................................................................... 37
ATTACHMENT IV
ASSURANCES—NON-CONSTRUCTION PROGRAMS............................................................................. 42
ATTACHMENT V
FLORIDA AGENCY OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST ...................... 44
ATTACHMENT VII
BACKGROUND SCREENING....................................................................................................................... 48
ATTACHMENT VIII
ANNUAL BUDGET SUMMARY................................................................................................................... 49
ATTACHMENT IX
INVOICE REPORT SCHEDULE.................................................................................................................... 50
ATTACHMENT X
REQUESTFOR PAYMENT............................................................................................................................ 51
ATTACHMENT XI
RECEIPT AND EXPENDITURE REPORT.................................................................................................... 53
ATTACHMENT XII
SERVICE RATE REPORT.............................................................................................................................. 54
16
July 2019 —June 2020
ATTACHMENTI
STATEMENT OF WORK
I. SERVICES TO BE PROVIDED
A. Definitions of Terms
1. Contract Acronyms
Activities of Daily Living (ADLs)
Area Agency on Aging (AAA)
Access Priority Consumer List (APCL)
Adult Protective Services (APS)
CCE 203.19
Adult Protective Services Referral Tracking Tool (ARTT) Code of Federal Regulations (CFR)
Corrective Action Plan (CAP)
Community Care for the Disabled Adult (CCDA)
Community Care for the Elderly (CCE)
Client Information and Registration Tracking System (CIRTS)
Department of Children and Families (DCF)
Florida Administrative Code (F.A.C.)
Florida Department of Elder Affairs (DOEA or Department)
Florida Statutes (F.S.)
Home Care for Disabled Adults (HCDA)
Instrumental Activities of Daily Living (IADLs)
Notice of Instruction (NOI)
Planning and Service Area (PSA)
Summary of Programs and Services (SOPS)
2. Program Specific Terms
Administrative Funding: Contract dollars that are allocated to support the Agency's expenses incurred in
the management and operation of the CCE Program, as stipulated in this contract.
Adult Protective Services Referral Tracking Tool (ARTT): A system designed to track DCF APS referrals
to AAAs and CCE Lead Agencies for victims of second party abuse, neglect, and exploitation who need
home and community-based services as identified by APS staff.
Aging Out: The condition of reaching sixty (60) years of age and being transitioned from DCF's CCDA or
HCDA set -vices to DOEA's community-based services.
Area Plan: A plan developed by the Agency outlining a comprehensive and coordinated service delivery
system in its PSA in accordance with Section 306 of the Older Americans Act (42 U.S.C. § 3026) and
Department instructions. The Area Plan includes performance measures and unit rates per service offered per
county.
Area Plan Update: A revision to the Area Plan wherein the Agency and/or contractor enters CCE -
specific data into the CIRTS. An update may also include other revisions to the Area Plan as instructed by
the Agency and/or Department.
17
July 2019 — June 2020
CCE 203.19
Department of Elder Affairs Programs and Services Handbook (DOEA Handbook): An official document
of the of DOEA. The DOEA Handbook includes program policies, procedures, and standards applicable to
agencies which are recipients of DOEA-funded programs, and providers of program -funded services. An
annual update is provided through a NOI.
Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to
remain living independently in the least restrictive living arrangement.
Lead Agency: An agency designated by the AAA at least every six (6) years through competitive
procurement, which provides case management to all CCE clients and ensures service integration and
coordination of service providers within the community care service system.
NOI: DOEA's established method to communicate to the Agency, Contractor and Subcontractor the
requirements to perform specific tasks or activities in a particular manner. NOIs are located on the DOEA
website at http://elderaffairs.state.fl.us/doea/nois.php.
Program Highlights: Success stories, quotes, testimonials, or human -interest vignettes that are used in the
Summary of Programs and Services, SOPS, to demonstrate how programs and services help elders,
families, and caregivers.
Summary of Programs and Services (SOPS): A document produced by DOEA and updated yearly to provide
the public and the Legislature with information about programs and services for Florida's elders.
Vulnerable Adult in Need of Services: A vulnerable adult who has been determined by a protection
investigator to be suffering from the ill effects of neglect not caused by a second party perpetrator and is in
need of protective services or other services to prevent further harm.
B. General Description
1. General Statement
The primary purpose of the CCE Program is to prevent, decrease, or delay premature or inappropriate and
expensive placement of elders in nursing homes and other institutions.
2. Community Care for the Elderly Mission Statement
The CCE Program assists functionally impaired elderly persons in living dignified and reasonably
independent lives in their own homes or in the homes of relatives or caregivers through the development,
expansion, reorganization, and coordination of various as possible, in the least restrictive environment
suitable to their needs. The program provides a continuum of care through the development, expansion,
reorganization, and coordination of multiple community-based services. The program provides a continuum
of care so that functionally impaired elderly persons age sixty (60) and older may be assured the least
restrictive environment suitable to their needs.
3. Authority
The relevant authority governing the CCE Program includes:
a. Sections 430.201 through 430.207, F.S.;
b. Rule 58C-1, F.A.C.; and
c. The Catalog of State Financial Assistance (CSFA) Number 65010.
4. Scope of Service
The Contactor is responsible for the programmatic, fiscal, and operational management of CCE Program. The
program services shall be provided in a manner consistent with the Agency's current Area Plan, as updated,
and the current DOEA Handbook, which are hereby incorporated by reference. The Contractor agrees to be
bound by all subsequent amendments and revisions to the DOEA Handbook, and the Contractor agrees to
accept all such amendments and revisions via a NOI.
18 ��
July 2019 — June 2020
5. Major Program Goals
CCE 203.19
The major goals of the CCE Program are to preserve the independence of elders and prevent or delay
costlier institutional care through a community care service system that provides case management and other
in-home and community services as needed under the direction of a lead agency, and to provide a continuum
of service alternatives that meets the diverse needs of functionally -impaired elders.
C. Clients to be Served
1. General Description
The CCE Program provides a continuum of services for functionally -impaired elders age sixty (60) and older
2. Client Eligibility
To receive services under this contract, an applicant must:
a. Be at least sixty (60) years of age and be functionally impaired pursuant to Section 430.203(7), F.s., as
determined through the functional assessment and at least an annual reassessment; or
b. Be aging out as defined in Section I.A.2. of this contract; and
e. Clients cannot be dually enrolled in the CCE Program and a Medicaid -capitated long-term care program.
3. Targeted Groups
Priority for services provided under this contract shall be given to those eligible persons assessed to be at risk
of placement in an institution or who are abused, neglected, or exploited.
4. Client Determination
The Agency shall have final authority for the determination of client eligibility.
U. MANNER OF SER VICE PR6VISION
A. Service Tasks
To achieve the goals of the CCE Program, the Contractor shall perform, or ensure that its subcontractors perform,
the following tasks:
1. Client Eligibility Determination
The Contractor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a
client is based on meeting the requirements described in Section I.C.2.
2. Assessment and Prioritization of Service Delivery for New Clients
The Contractor shall ensure the following criteria are used to prioritize new clients for service delivery in the
sequence below. It is not the intent of the Agency to remove existing clients from services to serve new
clients being assessed and prioritized for service delivery.
a. DCF APS High Risk individuals: The Contractor shall ensure that pursuant to Section 430.205(5)(a), F.S.,
those elderly persons who are determined by DCF APS to be vulnerable adults in need of services, pursuant
to Section 415.105(3)(b), or to be victims of abuse, neglect, or exploitation who need immediate services
to prevent further harm, and are referred by APS, shall be given primary consideration for receiving
CCE services. As used in this subsection, "primary consideration" means that an assessment and services
must commence within seventy-two (72) hours after referral to the Agency or as established in accordance
with local protocols developed between Agency service contractors and APS. The Contractor shall follow
guidelines for DCF APS High Risk referrals established in the APS Operations Manual, which is
incorporated by reference.
19 -0
OFO
July 2019 — June 2020
CCE 203.19
b. For DCF APS Low, Intermediate, and High -Risk Referrals for individuals enrolled in a Medicaid long-
term care program at the time of referral to the Contractor or subcontractor, the Contractor shall:
i. Ensure that the intake entity contacts and notifies the DCF APS protective investigator that the referral
was not accepted because the referred individual is enrolled in a Medicaid long-term care program; and
ii. Ensure that the intake entity notes that the referred individual is enrolled in a Medicaid long-term care
program in the ARTT as the reason for rejection.
e. Imminent Risk individuals: Individuals in the community whose mental or physical health condition has
deteriorated to the degree that self-care is not possible, there is no capable caregiver, and nursing home
placement is likely within one (1) month or very likely within three (3) months.
d. Aging Out individuals: Individuals receiving CCDA and HCDA services through DCF's Adult Services
transitioning to community-based services provided through the Agency when DCF's services are not
currently available.
e. Service priority for individuals not included in a., c., or d. above, regardless of referral source, will be
determined through the Agency's functional assessment administered to each applicant, to the extent
funding is available. The Contractor shall ensure that priority is given to applicants at the higher levels of
fiailty and risk of nursing home placement. For individuals assessed at the same priority and risk of nursing
home placement, priority will be given to applicants with the lesser ability to pay for services.
3. Referrals for Medicaid Waiver Services
a. The Contractor must, through the performance of the client assessment, identify potential Medicaid
eligible CCE clients and to refer these individuals for application for Medicaid Waiver services.
b. The Contractor must require individuals who have been identified as being potentially Medicaid Waiver
eligible to apply for Medicaid Waiver services to receive community-based services. These individuals may
only receive CCE services while the Medicaid Waiver eligibility determination is pending. If the
client is found ineligible for Medicaid Waiver services for any reason other than failure to provide required
documentation, then the individual may continue to receive CCE services.
c. The Contractor must advise individuals who have been identified as being potentially Medicaid Waiver
eligible of the responsibility to apply for Medicaid Waiver services as a condition of receiving CCE services
while the eligibility determination is being processed.
4. Program Services
The Contractor shall ensure the provision of program services is consistent with the Agency's current Area
Plan, as updated and approved by the DOEA, and the current DOEA Handbook.
B. Use of Subcontractors
If this contract involves the use of a Subcontractor or third party, then the Contractor shall not delay the
implementation of its agreement with the Subcontractor. If any circumstance occurs that may result in a delay for
a period of sixty (60) days or more of the initiation of the subcontract or the performance of the subcontractor,
the Contractor shall notify the Agency Contract Manager and the Agency Chief Financial Officer in writing of
such delay. The Contractor shall not permit a subcontractor to perform services related to this Contract without
having a binding subcontractor agreement executed prior to the Subcontractor's performance. The Agency will
not be responsible or liable for any obligations or claims resulting fiom such action.
1. Copies of Subcontracts
The Contractor shall submit a copy of all subcontracts to the Agency Contract Manager within thirty (30) days
of the subcontract being executed.
20^
July 2019 —June 2020 CCE 203.19
2. Monitoring the Performance of Subcontractors
The Contractor shall monitor, at least once per year, each of its Subcontractors, Subrecipients, Vendors,
and/or Consultants paid from funds provided under this contract. The Contractor shall perform fiscal,
administrative, and programmatic monitoring to ensure contractual compliance, fiscal accountability,
programmatic performance, and compliance with applicable state and federal laws and regulations. The
Contractor shall monitor to ensure that the budget is met, the scope of work is accomplished within the
specified time periods, and all other performance goals stated in this contract are achieved.
3. Copies of Subcontractor Monitoring Reports
The Contactor shall forward a copy of all subcontractor monitoring reports to the Agency's Contract
Manager within thirty (30) days of the report being issued to the subcontractors, subrecipients, vendors, and/or
consultants.
C. Staffing Requirements
1. Staffing Levels
The Contractor shall dedicate its own staff as necessary to meet the obligations of this contract and ensure that
subcontractors dedicate adequate staff accordingly.
2. Professional Qualifications
The Contractor shall ensure that the staff responsible for performing any duties or functions within this contact
have the qualifications as specified in the current DOEA Handbook.
3. Service Times
The Contactor shall ensure the availability of services listed in this contract at times appropriate to meet client
service needs including, at a minimum, during normal business hours. Normal business hours are defined
as Monday through Friday, 8:00 a.m. to 5:00 p.m. local time.
D. Deliverables
The following section provides the specific quantifiable units of deliverables and source documentation required to
evidence the completion of the tasks specified in this contract.
1. Delivery of Service to Eligible Clients
The Contactor shall ensure the provision of a continuum of services that meets the diverse, individual, and
assessed needs of each functionally -impaired elder. The Contractor shall ensure performance and reporting of
the following services are in accordance with the Agency's current approved Department -approved Area
Plan, the current DOEA Handbook, and Section H.A.1-4. of this contract. Documentation of service
delivery must include a report consisting of the following: number of clients served, number of service
units provided by service, and rate per service unit with calculations that equal the total invoice amount. The
services include the following categories:
21 (�
July 2019 — June 2020
CCE 203.19
a. Core Services for Programmatic Operation
The Contractor shall ensure that core services include a variety of home -delivered services, day care
services, and other basic services that are most needed to prevent unnecessary institutionalization. Core
services, to be provided at the unit rate identified in the Agency's Area Plan, as updated, include the
following:
(1) Adult Day Care; (8) Housing Improvement;
(2) Chore Services; (9) Legal Assistance;
(3) Companionship; (10) Pest Control Services;
(4) Escort; (11) Respite Services;
(5) Financial Risk Reduction; (12) Shopping Assistance; and
(6) Home Delivered Meals; (13) Transportation.
(7) Homemaker;
b. Health Maintenance Services
The Contractor shall ensure that health maintenance
services are made available as necessary to help
maintain the health of functionally -impaired
elders. These services are limited to medical therapeutic
services and non-medical prevention services.
Typical services to be provided at the unit rate identified in
the Agency's Area Plan, as updated, include the following:
(1) Adult Day Health Care;
(8) Nutrition Counseling;
(2) Emergency Alert Response;
(9) Occupational Therapy;
(3) Gerontological Counseling;
(10) Personal Care;
(4) Health Support;
(11) Physical Therapy;
(5) Home Health Aide;
(12) Skilled Nursing Services;
(6) Medication Management;
(13) Specialized Medical Equipment,
(7) Mental Health
Services, and Supplies; and
Counseling/Screening;
(14) Speech Therapy.
22
L``")
July 2019 — June 2020
c. Other Support Services
CCE 203.19
The Contractor shall ensure that support services expand the continuum of care options to assist
functionally -impaired elders and their caregivers. Support services to be provided at the unit rate identified
in the Agency's Area Plan, as updated, include the following:
(1) Caregiver Training/Support;
(2) Case Aid;
(3) Case Management
2. Service Units
(4) Intake;
(5) Material Aid; and
(6) Other services, as approved by the Agency.
The Contractor shall ensure that the provision of services described in this contract is in accordance with the
current DOEA Handbook and the service tasks described in Section II.A. The Service Rate Report lists the
services that can be performed, the highest reimbursement unit rate, the method of payment, and the service
unit type. Units of service will be paid pursuant to the rate established in the Agency's Area Plan as updated, as
shown in the Service Rate Report and approved by the Agency.
E. Reports
The Contractor shall respond within ten (10) business days, or within deadlines established by the Agency, to the
Agency's request for routine and/or special requests for information and ad hoc reports. The Contractor must
establish due dates for any subcontractors that permit the Contractor to meet the Agency's reporting
requirements.
1. CIRTS Reports
The Contractor shall ensure timely input of CCE -specific data into CIRTS. To ensure CIRTS data accuracy,
the Contractor shall use CIRTS-generated reports which include the following:
a. Client Reports;
b. Monitoring Reports;
c. Services Reports;
d. Miscellaneous Reports;
e. Fiscal Reports;
f. Aging and Disability Resource Center Reports; and
g. Outcome Measurement Reports.
2. Annual Service Cost Reports
a. The Agency shall require Contractors to annually submit to the Agency Contract Manager Service Cost
Reports, which reflect the actual costs of providing each service by program. This Annual Service Cost
Report will be due by February 25, of each year. This report will include actual costs for performing all
services during the preceding calendar year. Supporting documentation must accompany the report, which
will include General Ledger, Trial Balance and/or Statement of Revenue and Expenditures along with a
narrative explanation and justification of rate differences. This Annual Service Cost Report provides
information for planning and negotiating unit rates.
b. Any multi-year contracts entered into with service providers on or after the effective date of this contract
shall contain a provision requiring the contract's parties to re-evaluate the contract's reimbursement rates
on an annual basis. The Contractor may annually renegotiate rates based on factors including but not
limited to a review of sustainability, the respective consumer price index, or current market conditions.
However, it is the intent of the Department and/or Agency that the quality of services provided to current
program recipients not be reduced. Unit Cost Methodology worksheets, along with supporting
documentation and narrative explanation, must be submitted by April 15 of each year, if a rate increase is
being requested for any service in the next contract year.
23
;t,�3
July 2019 —June 2020 CCE 203.19
3. Surpins/Defiicit Report
The Contractor shall submit a Consolidated Surplus/Deficit Report, Lead Agency Spending Report, in a
format provided by the Agency, to the Agency Contract Manager by the 18th of each month. This
Consolidated Surplus/Deficit Report is for all agreements and contracts between the Contractor and the
Agency and must include the following:
a. A list of all contracts and their current status regarding surplus/deficit;
b. The Contractor's detailed plan on how the surplus/deficit spending exceeding the threshold specified by the
Agency will be resolved;
c. Recommendations to transfer finds within the PSA to resolve surplus/deficit spending;
d. Input from the Agency's Board of Directors on resolution of spending issues, if applicable;
4. Co -Pay Collections Report
The Contractor shall submit an annual co -payment collections report to the Agency's Contract Manager by
July 25, using Attachment 5, located in Appendix B of the current DOEA Handbook.
5. Program Highlights
The Contractor shall submit Program Highlights referencing specific events that occurred in SFY/FFY 2018-
2019 by August 30, 2019. The Contractor shall provide a new success story, quote, testimonial, or human -
interest vignette. The highlights shall be written for a general audience, with no acronyms or technical terms.
For all agencies or organizations that are referenced in the highlight, the Contractor shall provide a brief
description of their mission or role. The active tense shall be consistently used in the highlight narrative, to
identify the specific individual or entity that performed the activity described in the highlight.
F. Records and Documentation
1. Requests for Payment
The Contractor shall maintain documentation to support Requests for Payment that shall be available to the
Agency or authorized individuals upon request.
2. CIRTS Data and Maintenance
The Contractor shall ensure monthly collection and maintenance of client and service information in CIRTS or
any such system designated by the Agency.
3. CIRTS Address Validation
The Contractor shall work with the Area Agency on Aging for Southwest Florida, to ensure client addresses are
correct in CIRTS for disaster preparedness efforts. At least annually, and more frequently as needed, the
Agency will provide direction on how to validate CIRTS addresses to ensure these can be mapped. The Agency
will receive a list of unmatched addresses that cannot be mapped and the Agency will be responsible for
working with the Lead Agencies to correct addresses. The Area Agency will send a list to the Department of
Elder Affairs with confirmed addresses. The Department will use this information to update maps, client rosters,
and unmatched addresses to disseminate to the Lead Agencies.
4. Data Integrity and Back up Procedures
Each Contractor shall anticipate and prepare for the loss of information processing capabilities. The routine
backing up of all data and software is required to recover from losses or outages of the computer system. Data
and software essential to the continued operation of Contractor functions must be backed up. The security
controls over the backup resources shall be as stringent as the protection required of the primary resources. A
copy of the backed -up data shall be stored in a secure, offsite location.
24
July 2019 — June 2020 CCE 203.19
5. Policies and Procedures for Records and Documentation
The Contractor shall maintain written policies and procedures for computer system backup and recovery and
shall have the same requirement of its subcontractors. These policies and procedures shall be made available
to the Agency upon request.
G. Performance Specifications
1. Outcomes and Outputs (Performance Measures)
The Contractor must:
a. Ensure the prioritization of clients and provision of services to clients in accordance with Section II.A.2. of
this contract;
b. Ensure the provision of the services described in this contract are in accordance with the current DOEA
Handbook and Section II.A.1.-4 and Section ILD. L-3. of this contract;
c. Timely and accurately submit to the Agency all required documentation and reports described in
Section II.E.;
d. Timely (in accordance with the Invoice Report Schedule) and accurately submit the Request for Payment,
the Receipt and Expenditure report, and supporting documentation such as CIRTS Reports.
2. Annual Programmatic Monitoring Report
The Contractor's performance of the measures in II.G.I., above, will be reviewed and documented in the
Agency's Annual Programmatic Monitoring Report.
3. Monitoring and Evaluation Methodology
The Agency will review and evaluate the performance of the Contractor under the terms of this contract.
Monitoring shall be conducted through direct contact with the Contractor through telephone, in writing, and/or
on-site visit(s). The primary, secondary, or signatory of the contract must be available for any on-site
programmatic monitoring visit. The Agency's determination of acceptable performance shall be conclusive.
The Contractor agrees to cooperate with the Agency in monitoring the progress of completion of the
service tasks and deliverables. The Agency may use, but is not limited to, one or more of the following
methods for monitoring:
a. Desk reviews and analytical reviews;
b. Scheduled, unscheduled, and follow-up on-site visits;
c. Client visits;
d. Review of independent auditor's reports;
e. Review of third -party documents and/or evaluation;
f. Review of progress reports;
g. Review of customer satisfaction surveys;
It. Agreed-upon procedures review by an external auditor or consultant;
i. Limited -scope reviews; and
j. Other procedures as deemed necessary by the Agency.
H. Contractor Responsibilities
1. Contractor Accountability
All service tasks and deliverables pursuant to this contract are solely and exclusively the responsibility of the
Contractor and all tasks deliverables for which, by execution of this contract, the Contractor agrees to be held
accountable.
25
July 2019 — June 2020
2. Coordination with Other Providers and/or Entities
CCE 203.19
Notwithstanding that services for which the Contractor is held accountable involve coordination with other
entities in performing the requirements of this contract, the failure of other entities does not alleviate the
Contractor from any accountability for tasks or services that the Contractor is obligated to perform pursuant to
this contract.
I. Agency Responsibilities
1. Agency Obligations
The Agency may, within its resources, provide technical support and/or assistance to the Contractor to assist
the Contractor in meeting the requirements of this contract. The Agency's technical support and/or assistance,
or lack thereof, shall not relieve the Contractor from full performance of contract requirements.
2. Agency Determinations
The Agency reserves the exclusive right to make certain determinations in the tasks and approaches used to
perform tasks required by this contract. The absence of the Agency setting forth a specific reservation of rights
does not mean that all other areas of the contract are subject to mutual agreement.
M. METHOD OF PAYMENT
A. Payment Methods Used
The method of payment for this contract is a combination of fixed-fee/unit rate, cost reimbursement, and advance
payments, subject to the availability of funds and Contractor performance. The Agency will pay the Contractor
upon satisfactory completion of the Tasks/Deliverables, as specified in Section II.D., and in accordance with other
terms and conditions of this contract.
1. Fixed Fee/Unit Rate
Payment for Fixed Fee/Unit Rates shall not exceed amounts established in the Service Rate Report.
2. Cost Reimbursement
Payment may be authorized only for allowable expenditures which are in accordance with the services specified
in the Service Rate Report. All Cost Reimbursement Requests for Payment must submit the Request for
Payment as well as the Receipt and Expenditure Report beginning with the first month of this contract. The
Agency reserves the right to review supporting documentation for any cost reimbursement requests.
3. Advance Payments
The Contractor may request up to two (2) months of advances at the start of the contract period to cover program
administrative and service costs. The payment of an advance will be contingent upon the sufficiency and amount
of finds released to the Agency by the State of Florida ("budget release"). The Contractor's requests for
advance payments require the written approval of the DOEA's Contract Manager. For the first month's
advance request, the Contractor shall provide to the Agency Contract Manager documentation justifying the
need for an advance and describing how the funds will be distributed. If the Contractor is requesting two (2)
months of advances, documentation must be provided reflecting the cash needs of the Contractor within the
initial two (2) months and should be supported through as cash-flow analysis or other information appropriate
to demonstrate the Contractor's financial need for the second month of advances. The Contractor must also
describe how the finds will be distributed for the first and second month. If sufficient budget is available, and
the Agency Contract Manger, in his or her sole discretion, has determined that there is justified need for an
advance, the Agency will issue approved advance payments after July I` of the contract year.
a. All advance payments retained by the Contractor must be fully expended no later than September 30, 2019.
Any portion of advance payments not expended must be recouped on the Invoice Report Schedule, report
number 5, due to the Agency on October 11, 2019, in accordance with the Invoice Report Schedule.
b. All advance payments made to the Contractor shall be reimbursed to the Agency as follows: At least
one—tenth of the advance payment received shall be reported as an advance recoupment on each Request
for Payment, starting with Report Number five (5), in accordance with the Invoice Report Schedule.
26
July 2019 — June 2020
B. Funding Distribution
CCE 203.19
The Contractor agrees to distribute funds as detailed in the Area Plan update and Invoice Report Schedule. Any
changes in the total amounts of the funds identified on the Annual Budget Summary form require a contract
amendment.
C. Method of Invoice Payment
Payment shall be made upon the Contractor's presentation of an invoice subsequent to the acceptance and approval
by the Agency of the deliverables shown on the invoice. The form and substance of each invoice submitted by the
Contractor shall be as follows:
1. Have a Remittance Address that corresponds exactly to the "Remit To" address provided to
MyFloridaMarketPlaee (IvJF'MP) during registration;
2. Request payment monthly for the units of services established in the Agency's approved Area Plan, provided in
conformance with the requirements as described in the current DOEA Handbook, at the rates established in
the Service Rate Report of the contract. Documentation of service delivery must include a report consisting
of the following: number of clients served, number of service units provided by service, and rate per service
unit with calculations that equal the total invoice amount. Any requested changes to the approved budget
subsequent to the execution of this contract must be submitted to the Agency Contract Manager for written
approval. Any change to the total contract amount requires a formal contract amendment;
3. The Contractor shall consolidate all Subcontractors' Requests for Payment and Receipt Expenditure
Reports that support Requests for Payment and shall submit the consolidated information to the Agency
using the Request for Payment form, and Receipt and Expenditure Report form for services, which must
include itemized expenditure categories, and signed CIRTS reports; and
4. All Requests for Payment shall be based on the submission of monthly Receipt and Expenditure Reports
beginning with the fast month of this contract. The schedule for submission of advance requests (when
available) and invoices is set forth in the Invoice Report Schedule.
D. Payment Withholding
Any payment due by the Agency under the terms of this contract may be withheld pending the receipt and
approval by the Agency of all financial and programmatic reports due from the Contractor and any adjustments
thereto, including any disallowance not resolved.
E. Final Invoice Instructions
The Contractor shall submit the final Request for Payment to the Agency no later than July 25, 2020.
F. CIRTS Data Entries for Contractors
The Agency shall require Contractors to enter all required data for clients and services in the CIRTS database in
accordance with the current DOEA Handbook and the CIRTS User Manual — Aging Provider Network
users (located in Documents on the CIRTS Enterprise Application Services). Contractors must enter this data
into the CMTS prior to submitting their Requests for Payment Expenditure Reports to the Agency. The
Agency shall establish deadlines for completing CIRTS data enhy and ensure compliance with due dates for
the Requests for Payment and Expenditure Reports that Contractor must submit to the Agency as well as the
specific CIRTS reports.
G. Contractors' Monthly CIRTS Reports
The Contractor shall be required to run monthly CIRTS reports and to verify that client and service data in the
CIRTS is accurate. This report must be submitted to the Agency with the monthly Request for Payment and
Expenditure Reports and must be reviewed by the Agency before the Contractor's Request for Payment and
Expenditure Reports can be approved by the Agency. The Contractor shall establish deadlines for completing
CIRTS data entry and ensure compliance with due dates for the Requests for Payment and Receipt and Expenditure
reports that Contractor must submit to the Agency.
CIRTS Reports: (Listed under Services #3) Monthly & YTD Service Units with Unduplicated Client Counts; and
(Listed under Services #6) Monthly & YTD Services Reported by Program and Service Summary Report
27 Ov;
July 2019 —June 2020
H. Corrective Action Plan
CCE 203.19
1. Contractor shall ensure one hundred percent (100%) of the deliverables identified in Section H.D. L-3 of this
contact are performed pursuant to contract requirements.
2. If at any time the Contractor is notified by the Agency's Contract Manager that it has failed to correctly,
completely, and/or adequately perform contract deliverables identified in Section II.D.1-3 of this contract, the
Contractor will have ten (10) days to submit a CAP to the Agency's Contract Manager that addresses the
deficiencies and states how the deficiencies will be remedied within the time approved by the Agency's
Contract Manager. The Agency shall assess a Financial Consequence for Non -Compliance on the Contractor
as referenced in Section HLI. of this contract for each deficiency identified in the CAP which is not corrected
pursuant to the CAP. The Agency will also assess a financial consequence for failure to timely submit a CAP.
3. If the Contractor fails to correct an identified deficiency within the approved time specified in the CAP, the
Agency shall deduct the percentage established in Section I11.1. of this contract from the payment for the
invoice of the following month.
4. If the Contractor fails to timely submit a CAP, the Agency shall deduct the percentage established in Section
HI.I. of this contract for each day the CAP is overdue. The deduction will be made from the payment for the
invoice of the following month.
I. Financial Consequences
The Agency will withhold or reduce payment if the Contractor fails to perform the deliverables to the
satisfaction of the Agency according to the requirements referenced in Section II.D. of this contract. The
following financial consequences will be imposed if the deliverables stated do not meet in part or in whole the
performance criteria as outlined in Section II.D. of this contract:
1. Delivery of services to eligible clients as referenced in Section II.A.I.-2 and Section H.D.1 of this contract
— Failure to comply with established assessment and prioritization criteria, as evidenced by CIRTS reports,
will result in a two percent (2%) reduction of payment per business day. The reduction of payment will begin
on the first business day following the Agency's notification to the Contractor that the identified deficiency
was not cured or satisfactorily addressed in accordance with the Agency -approved CAP, referenced in Section
III.H.;
2. Services and units of services as referenced in Section II.D.2. of this contract — Failure to provide services in
accordance with the current DOEA Handbook, the service tasks described in Section H.A, and the Service
Rate Report, and/or failure to submit documentation will result in a two percent in a two percent (2%) reduction
of payment per business day. The reduction of payment will begin the first business day following the
Agency's notification to the Contactor that the identified deficiency is not cured or satisfactorily
addressed in accordance with the Agency approved CAP, referenced in Section IH.H.;
3. Timely submission of a CAP — Failure to timely submit a CAP within ten (10) business days after notification
of a deficiency by the Agency's Contract Manage will result in a two percent (2%) reduction of payment
per business day the CAP is not received. The reduction of payment will begin the first business day
following the Agency's notification to the Contactor that the identified deficiency was not cured or
satisfactorily addressed in accordance with the Agency -approved CAP, referenced in Section IH.H.; and
4. Exceptions may be granted solely, in writing, by the Agency's Contract Manager.
W. SPECIAL PROVISIONS
A. Final Budget and Funding Revision Requests
Final requests for budget revisions or adjustments to contact fiords based on expenditures for provided services
must be submitted to the Agency's Contact Manager in writing no later than June 25, 2020; email requests are
considered acceptable.
B. Contractor's Financial Obligations
1. Matching, Level of Effort, and Earmarking Requirement
28t%
July 2019 — June 2020 CCE 203.19
The Contractor must provide a match of at least ten percent (10%) percent of the cost for all CCE services.
The match must be made in the form of cash and/or in-kind resources. At the end of the contact period, all
CCE fiords expended must be properly matched. State funds shall not be used to match another state -funded
program.
2. Cost Sharing and Co -Payments
Pursuant to Section 430.204(8), F.S., and Rule 58c-1.0007, F.A.C., the dollar amount for co -payments
associated with CCE must be calculated by applying the current federal poverty guidelines published by the U.S.
Department of Health and Human Services.
a. No -co -payments will be assessed on a client whose income is at, or below, the federal poverty level (FPL) as
established each year by the U.S. Department of Health and Human Services.
b. No client may have their services terminated for inability to pay their assessed co -payment. The Contractor,
in conjunction with the Agency, must establish procedures to remedy financial hardships associated with co-
payments and ensure that there is no interruption in service(s) for inability to pay. If a client's co -payment is
reduced or waived entirely, a written explanation for the change must be placed in the client file.
c. Co -payments include only the amounts assessed to consumers by Contractors or the amounts
consumers opt to contribute in lieu of an assessed co -payment. The consumer's contribution must
be equal to or greater than the assessed co -payment. Co -payments collected in the CCE Program
can be used as part of the local match, as detailed above in Section IV.B.1.
3. Use of Service Dollars and Management of the Assessed Priority Consumer List
The Contactor is expected to spend all funds provided by the Agency for the purpose specified in this
contact. The Contractor must manage the service dollars in such a manner so to avoid having a wait list and a
surplus of fiords at the end of the contract period. If the Agency determines that the Contactor is not
spending service funds accordingly, the Agency may transfer funds to other provider agencies during the
contract period and/or adjust subsequent funding allocations accordingly, as allowable under state and federal
law.
4. Contract Limits
In no case shall the Contractor be required to incur costs in excess of the contract amount in providing
services to clients.
C. Remedies for Nonconforming Services
1. The Contractor shall ensure that all goods and/or services provided under this contact are delivered timely,
completely, and cormnensurate with required standards of quality. Such goods and/or services will only be
delivered to eligible program participants.
2. If the Contactor fails to meet the prescribed quality standards for services, such services will not be reimbursed
under this contract. In addition, any nonconforming goods (including home delivered meals) and/or services
not meeting such standards will not be reimbursed under this contract. The Contractor's signature on the
Request for Payment form certifies maintenance of supporting documentation and acknowledgement that the
Contractor shall solely bear the costs associated with preparing or providing nonconforming goods and/or
services. The Agency requires immediate notice of any significant and/or systemic infractions that
compromise the quality, security, or continuity of services to clients.
D. Incident Reporting
The Contactor shall notify the Agency immediately but no later than forty-eight (48) hours from the
Contractor's awareness or discovery of changes that may materially affect the Contractor or any subcontractor's
ability to perform the services required to be performed under this contract and in authorizing proviso. Such notice
shall be made orally to the Agency's Contract Manager (by telephone) with an email to immediately
29 �ON7
July 2019 — June 2020 CCE 203.19
follow, including the Contractor's plan for provision of services authorized in proviso.
E. Investigation of Criminal Allegations
Any report that implies criminal intent on the part of the Contractor or any subcontractors and referred to a
governmental or investigatory agency must be sent to the Agency. If the Contractor has reason to believe that the
allegations will be referred to the State Attorney, a law enforcement agency, the United States Attorney's office, or
other governmental agency, the Contractor shall notify the Contract Manager at the Agency immediately. A copy
of all documents, reports, notes, or other written material concerning the investigation, whether in the
possession of the Contractor or subcontractors, must be sent to the Agency's Contract Manager with a summary of
the investigation and allegations.
F. Volunteers
The Contractor shall ensure the use of trained volunteers in providing direct services delivered to older individuals
and individuals with disabilities needing such services. If possible, the Contractor shall work in coordination with
organizations that have experience in providing training, placement, and stipends for volunteers or participants
(such as the Senior Community Service Employment Program or organizations carrying out federal service
programs administered by the Corporation for National and Community Service).
G. Enforcement
1. In accordance with Section 430.04, F.S., the Agency shall rescind designation of lead agency or take
intermediate measures against the Contactor, including corrective action, unannounced special monitoring,
temporary assumption of operation of one or more programs by the Agency, placement on probationary
status, imposing a moratorium on Contractor action, imposing financial penalties for nonperformance, or
other administrative action pursuant to Chapter 120, F.S., if the Agency finds that any of the following have
occurred:
a. An intentional or negligent act of the Contactor has materially affected the health, welfare, or safety of
clients, or substantially and negatively affected the operation of an aging services program;
b. The Contractor lacks financial stability sufficient to meet contactual obligations or that contractual funds
have been misappropriated;
c. The Contractor has committed multiple or repeated violations of legal and regulatory requirements or
Agency standards;
d. The Contactor has failed to continue the provision or expansion of services after the declaration of a state
of emergency;
e. The Contractor has exceeded its authority or otherwise failed to adhere to the terms of this contract with
the Agency or has exceeded its authority or otherwise failed to adhere to the provisions specifically
provided by statute or rule adopted by the Agency;
f. The Contractor has failed to properly determine client eligibility as defined by the Agency or efficiently
manage program budgets; or
g. The Contractor has failed to implement and maintain a Agency -approved client grievance resolution
procedure.
2. In making any determination under this provision, the Agency may rely upon findings of another state or
federal agency or other regulatory body. Any claims for damages for breach of contract are exempt from
administrative proceedings and shall be brought before the appropriate entity in the venue of Lee County,
Florida. In the event the Agency initiates action to rescind a lead agency designation, the Agency shall
follow the procedures set forth in 42 U.S.C. § 3025(b).
H. Contact Modifications
The Agency's Contract Manager has the authority to modify and/or extend deliverable deadlines. All
30
July 2019 — June 2020 CCE 203.19
deliverable extension requests must be made to the Agency's Contract Manager, in writing, prior to the
required deadline. All approvals for deliverable extensions must be communicated, in writing, by the Agency's
Contract Manager to the Contractor and are subject to the discretion of the Agency's Contract Manager. The
requests and the approval must occur prior to the established deadline. An e-mail writing (request and response)
is considered acceptable.
END OF ATTACHMENT
31
July 2019 — June 2020
ATTACHMENT II
FINANCIAL AND COMPLIANCE AUDIT
CCE 203.19
The administration of resources awarded by the Agency to the Contractor may be subject to audits and/or monitoring by
the Area Agency on Aging for Southwest Florida, Inc., as described in this section.
MONITORING
In addition to reviews of audits conducted in accordance with 2 CFR Part 200 (formerly OMB Circular A-133 as revised),
and Section 215.97, F.S., (see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits
by the Agency staff, limited scope audits and/or other procedures. By entering into this contract, the Contractor agrees to
comply and cooperate with any monitoring procedures/processes deemed appropriate by the Agency. In the event the
Agency determines that a limited scope audit of the Contractor is appropriate, the Contactor agrees to comply with any
additional instructions provided by the Agency to the Contactor regarding such audit. The Contractor further agrees to
comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Vice President of
Finance or Auditor General.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the Contractor is a State or local government or a non-profit organization as defined in 2 CFR Part
200, Subpart A.
In the event that the Contractor expends $750,000.00 or more in federal awards during its fiscal year, the Contractor must
have a single or program -specific audit conducted in accordance with the provisions of 2 CFR Part 200. Financial
Compliance Audit Attachment, Exhibit 2 indicates federal resources awarded through the Agency by this contract. In
determining the federal awards expended in its fiscal year, the Contractor shall consider all sources of Federal awards,
including federal resources received from the Agency. The determination of amounts of Federal awards expended
should be in accordance with 2 CFR Part 200. An audit of the Contactor conducted by the Auditor General in
accordance with the provisions of 2 CFR Part 200 will meet the requirements of this part.
In connection with the audit requirements addressed in Part I, paragraph 1, the Contractor shall fulfill the requirements
relative to auditee responsibilities as provided in 2 CFR § 200.508.
If the Contractor expends less than $750,000.00 in federal awards in its fiscal year, an audit conducted in accordance with
the provisions of 2 CFR Part 200 is not required. In the event that the Contractor expends less than $750,000.00 in federal
awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of 2 CPR Part 200, the
cost of the audit must be paid from non-federal resources (i.e., the cost of such audit must be paid from Contactor
resources obtained from other than federal entities.)
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to contacts with the Agency shall be based on the contact's requirements, including any
rules, regulations, or statutes referenced in the contact. The financial statements shall disclose whether or not the matching
requirement was met for each applicable contract. All questioned costs and liabilities due to the Agency shall be fully
disclosed in the audit report with reference to the Agency contact involved. If not otherwise disclosed as required by 2
CFR § 200.510, the schedule of expenditures of federal awards shall identify expenditures by contract number for each
contact with the Agency in effect during the audit period. Financial reporting packages required under this part must
be submitted within the earlier of 30 days after receipt of the audit report or 9 months after the end of the Contractor's
fiscal year end.
32
July 2019—June 2020 CCE 203.19
PART II: STATE FUNDED
This part is applicable if the Contractor is a non -state entity as defined by Section 215.97(2), F.S.
In the event that the Contractor expends a total amount of state financial assistance equal to or in excess of $750,000.00 in
any fiscal year of such Contractor, the Contractor must have a State single or project -specific audit for such fiscal year in
accordance with Section 215.97, F.S.; applicable rules of the Department of Financial Services; and Chapter 10.550
(local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General.
Financial Compliance Audit Attachment, Exhibit 2 indicates state financial assistance awarded through the Agency by this
contract. In determining the state financial assistance expended in its fiscal year, the Contractor shall consider all sources of
state financial assistance, including state financial assistance received from the Agency, other state agencies, and other
non -state entities. State financial assistance does not include Federal direct or pass-through awards and resources received
by a non -state entity for Federal program matching requirements.
In connection with the audit requirements addressed in Part II, paragraph 1, the Contractor shall ensure that the audit
complies with the requirements of Section 215.97(8), F.S. This includes submission of a financial reporting package as
defined by Section 215.97(2), F.S., and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit
organizations), Rules of the Auditor General.
If the Contractor expends less than $750,000.00 in state financial assistance in its fiscal year, an audit conducted in
accordance with the provisions of Section 215.97, F.S., is not required. In the event that the Contractor expends less than
$750,000.00 in state financial assistance in its fiscal year and elects to have an audit conducted in accordance with the
provisions of Section 215.97, F.S., the cost of the audit must be paid from the non -state entity's resources (i.e., the cost of
such an audit must be paid from the Contractor resources obtained from other than State entities).
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to contracts with the Agency shall be based on the contract's requirements, including any
applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching requirement
was met for each applicable contract. All questioned costs and liabilities due to the Agency shall be fully disclosed in the
audit report with reference to the Agency contract involved. If not otherwise disclosed as required by Rule 691- 5.003,
F.A.C., the schedule of expenditures of state financial assistance shall identify expenditures by contract number for each
contract with the Agency in effect during the audit period. For local governmental entities, financial reporting
packages required under this part must be submitted within 45 days after delivery of the audit report, but no later than 12
months after the Contractor's fiscal year end. For non-profit or for-profit organizations, financial reporting packages
required under this part must be submitted within 45 days after delivery of the audit report, but no later than 9 months after
the Contractor's fiscal year end. Notwithstanding the applicability of this portion, the Agency retains all right and
obligation to monitor and oversee the performance of this contract as outlined throughout this document and pursuant to
law.
PART III: REPORT SUBNIISSION
Copies of financial reporting packages for audits conducted in accordance with 2 CFR Part 200 and required by Part I of this
Financial Compliance Audit Attachment, shall be submitted, when required by 2 CFR § 200.512 by or on behalf of the
Contractor directly to each of the following:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10" Street
Jeffersonville, IN 47132
Pursuant to 2 CFR § 200.512, all other Federal agencies, pass-through entities and others interested in a reporting package
and data collection form must obtain it by accessing the Federal Audit Clearinghouse.
July 2019 — June 2020
CCE 203.19
The Contractor shall submit a copy of any management letter issued by the auditor, to the Area Agency on Aging for
Southwest Florida, Inc. at the following address:
The Area Agency on Aging for Southwest Florida, Inc.at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Tammy Rhoades, CFO
15201 N Cleveland Ave., Suite 1100
Nath Fort Myers, FL 33903
Additionally, copies of financial reporting packages required by this contract's Financial Compliance Audit Attachment,
Part H, shall be submitted by or on behalf of the Contractor directly to each of the following:
The Area Agency on Aging for Southwest Florida, Ine.at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Tammy Rhoades, CFO
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
The Auditor General's Office at the following address:
State of Florida Auditor General
Claude Pepper Building, Room 574
111 West Madison Street
Tallahassee, Florida 32399-1450
Any reports, management letters, or other information required to be submitted to the Agency pursuant to this contract
shall be submitted timely in accordance with 2 CFR Part 200, F.S., and Chapter 10.550 (local governmental entities) or
10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, as applicable.
Contractors, when submitting financial reporting packages to the Agency for audits done in accordance with 2 CFR Part 200
or Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor
General, should indicate the date that the reporting package was delivered to the Contractor in correspondence
accompanying the reporting package.
PART IV: RECORD RETENTION
The Contractor shall retain sufficient records demonstrating its compliance with the terms of this contract for a period of
six (6) years from the date the audit report is issued, and shall allow the Agency or its designee, the CFO, or Auditor
General access to such records upon request. The Contactor shall ensure that audit working papers are made available to
the Agency or its designee, CFO, or Auditor General upon request for a period of six (6) years from the date the audit
report is issued, unless extended in writing by the Agency.
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July 2019 — June 2020
ATTACHMENT H -EXHIBIT I
PART I: AUDIT RELATIONSHIP DETERMINATION
CCE 203.19
Contractors who receive state or federal resources may or may not be subject to the audit requirements of 2 CFR Part 200
and/or Section 215.97, F.S. Contractors who are determined to be recipients or sub -recipients of federal awards and/or
state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I
and/or Part II of Exhibit 1 are met. Contractors who have been determined to be vendors are not subject to the audit
requirements of 2 CPR § 200.38, and/or Section 215.97, F.S. Regardless of whether the audit requirements are met,
Contractors who have been determined to be recipients or sub -recipients of Federal awards and/or state financial
assistance must comply with applicable programmatic and fiscal compliance requirements.
In accordance with 2 CFR Part 200 and/or Rule 69I-5.006, F.A.C., Contractor has been determined to be:
Vendor not subject to 2 CPR § 200.38 and/or Section 215.97, F.S.
X Recipient/sub-recipient subject to 2 CFR §§ 200.86 and 200.93 and/or Section 215.97, F.S.
Exempt organization not subject to 2 CFR Part 200 and/or Section 215.97, F.S. For Federal awards, for-profit
organizations are exempt; for state financial assistance projects, public universities, cormmunity colleges, district
school boards, branches of state (Florida) government, and charter schools are exempt. Exempt organizations must
comply with all compliance requirements set forth within the contract or award document.
NOTE: If a Contractor is determined to be a recipient/sub-recipient of federal and/or state financial assistance, and has been
approved by the Agency to subcontract, they must comply with Section 215.97(7), F.S., and Rule 69I-5.006, F.A.C.
[state financial assistance] and/or 2 CFR § 200.330 [federal awards].
PART H: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Contractors who receive Federal
awards, state maintenance of effort funds, or state matching funds on Federal awards and who are determined to be a sub -
recipient must comply with the following fiscal laws, rules, and regulations:
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR § 200.416 - § 200.417 — Special Considerations for States, Local Governments, and Indian
Tribes* 2 CFR § 200.201 — Administrative Requirements**
2 CFR § 200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
NON-PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR § 200.400 - § 200.411 — Cost Principles*
2 CFR § 200.100 — Administrative Requirements
2 CFR § 200 Subpart F —Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT)
MUST FOLLOW:
2 CFR § 200.418 — § 200.419 — Special Considerations for Institutions of Higher Education*
2 CFR § 200.100 — Administrative Requirements
2 CFR § 200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
35
July 2019 — June 2020
CCE 203.19
*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in 2 CFR
§ 200.400(5)(c).
**For funding passed through U.S. Health and Human Services, 45 CFR Part 75; for funding passed through U.S.
Department of Education, 34 CFR Part 80.
STATE FINANCIAL ASSISTANCE. Contractors who receive state financial assistance and who are determined to be a
recipient/sub-recipient must comply with the following fiscal laws, rules, and regulations:
Sections 215.97 & 215.971, F.S.
Chapter 69I-5, F.A.C.
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
36
July 2019 — June 2020
ATTACHMENT H -EXHIBIT 2
FUNDING SUMMARY
CCE 203.19
Note: Title 2 CFR & 2 CFR Part 200, as revised, and Section 215.97(5), F.S., require that the information about Federal
Programs and State Projects included in Exhibit 1, be provided to the recipient. Information contained herein is a
prediction of funding sources and related amounts based on the contract budget.
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT
CONSIST OF THE FOLLOWING:
GRANT AWARD (FAIN#): FEDERAL AWARD DATE:
DUNS NUMBER: 076997790
PROGRAM TITLE
FUNDING SOURCE
CFDA AMOUNT
General Revenue
65.010
$916,057.00
TOTAL AWARD
$916,057.00
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT
TO THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS:
2 CFR Part 200 — Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards.
OMB Circular A-133 — Audits of States, Local Governments, and Non -Profit Organizations
2. STATE RESOURCES AWARDED TO TILE RECIPIENT PURSUANT TO TINS CONTRACT CONSIST OF
THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD
STATE FINANCIAL ASSISTANCE SUBJECT TO See. 215.97, F.S.
PROGRAM TITLE
FUNDING SOURCE
CSFA
AMOUNT
Community Care for the Elderly
General Revenue
65.010
$916,057.00
TOTAL AWARD
$916,057.00
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS
CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE
Section 215.97, F.S., Chapter 69I-5, F.A.C., State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
37 00
July 2019 — June 2020
ATTACHMENT III
CERTIFICATIONS AND ASSURANCES
CCE 203.19
The Agency will not award this contract unless Contractor completes this CERTIFICATIONS AND ASSURANCES. In
performance of this contract, Contractor provides the following certifications and assurances:
A.
Debarment and
Suspension Certification (29 CFR
Part 95 and 45 CFR Pant 75)
B.
Certification Regarding
Lobbying (29 CFR Part
93 and 45 CFR Part 93)
C.
Nondiscrimination
& Egual 011Uortunity Assurance
(29 CFR Part 37 and 45 CFR Part 80)
D.
Certification Regarding
Public Entity Crimes. section
287.133. F.S.
E.
Association of Community
Organizations for Reform
Now (ACORN) Funding Restrictions Assurance (Pub.
L. 111-117)
F. Scrutinized Companies Lists and No Boycott of Israel Certification. section 287.135. F.S.
G. Certification Regarding Data Lrtegrity Compliance for Contracts. Agreements. Grants. Loans. and
Cooperative Agreements
H. Verification of Employment Status Certification
I. Records and Documentation
J. Certification Regarding Inspection of Public Records
A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY
MATTERS — PRIMARY COVERED TRANSACTION.
The undersigned Contractor certifies, to the best of its knowledge and belief, that it and its principals:
1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
covered transactions by a Federal department or agency;
2. Have not within a three-year period preceding this contract been convicted or had a civil judgment rendered against
them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing
a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State
antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records,
malting false statements, or receiving stolen property;
3. Are not presently indicted or otherwise criminally or civilly charged by a government entity (Federal, State, or local)
with commission of any of the offenses enumerated in paragraph A.2. of this certification; and/or
4. Have not within a three-year period preceding this application/proposal had one or more public transactions
(Federal, State, or local) terminated for cause of default.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants, and contacts under grants, loans, and cooperative agreements) and that all
sub -recipients and contractors shall provide this certification accordingly.
B. CERTIFICATION REGARDING LOBBYING — CERTIFICATION FOR CONTRACTS, GRANTS,
LOANS, AND COOPERATIVE AGREEMENTS.
The undersigned Contractor certifies, to the best of its knowledge and belief, that:
No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of Congress or an employee of a Member of Congress in
IN
r
Q1
July 2019 — June 2020
CCE 203.19
connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan,
the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification
of any Federal contract, grant, loan, or cooperative agreement.
If any funds other than Federal appropriated fiords have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of
Congress, or employee of a Member of Congress in connection with a Federal contract, grant, loan, or cooperative
agreement, the undersigned shall also complete and submit Standard Form — LLL, "Disclosure Form to Report
Lobbying," in accordance with its instructions.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -
recipients and contractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this contract was made or
entered into. Submission of this certification is a prerequisite for making or entering into this contract imposed by 31
U.S.C. § 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than
$10,000 and not more than $100,000 for each such failure.
C. NON DISCRDUNATION & EQUAL OPPORTUNITY ASSURANCE (29 CFR PART 37 AND 45 CFR PART
80). - As a condition of the Contract, Contractor assures that it will comply fully with the nondiscrimination and equal
opportunity provisions of the following laws:
1. Section 188 of the Workforce Investment Act of 1998 (WIA), (Pub. L. 105-220), which prohibits discrimination
against all individuals in the United States on the basis of race, color, religion, sex, national origin, age, disability,
political affiliation, or belief, and against beneficiaries on the basis of either citizenship/stahis as a lawfully admitted
immigrant authorized to work in the United States or participation in any WIA Title I -financially assisted program
or activity.
2. Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352), as amended, and all requirements imposed by or pursuant
to the Regulation of the Department of Health and Human Services (45 CFR Part 80), to the end that, in accordance
with Title VI of that Act and the Regulation, no person in the United States shall, on the ground of race, color, or
national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to
discrimination under any program or activity for which the Applicant receives Federal financial assistance from the
Department and/or Agency.
3. Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112), as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 84), to the end that, in
accordance with Section 504 of that Act and the Regulation, no otherwise qualified handicapped individual in the
United States shall, solely by reason of his handicap, be excluded from participation in, be denied the benefits of,
or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial
assistance fi•om the Agency.
4. The Age Discrimination Act of 1975 (Pub. L. 94-135), as amended, and all requirements imposed by or pursuant
to the Regulation of the Department of Health and Human Services (45 CFR Part 91), to the end that, in accordance
with the Act and the Regulation, no person in the United States shall, on the basis of age, be denied the benefits of,
be excluded from participation in, or be subjected to discrimination under any program or activity for which the
Applicant receives Federal financial assistance from the Agency.
5. Title IX of the Education Amendments of 1972 (Pub. L. 92-318), as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 86), to the end that, in
accordance with Title IX and the Regulation, no person in the United States shall, on the basis of sex, be excluded
from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any education
program or activity for which the Applicant receives Federal financial assistance from the Agency.
6. The American with Disabilities Act of 1990 (Pub. L. 101-336), which prohibits discrimination in all employment
practices including job application procedures, hiring, firing, advancement, compensation, training, and other
terms, conditions, and privileges of employment. It applies to recruitment, advertising, tenure, layoff, leave, fringe
benefits, and all other employment-related activities.
39 � f�
July 2019 — June 2020
CCE 203.19
Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws
listed above. This assurance applies to Contractor's operation of the WIA Title I — financially assisted program
or activity, and to all contracts Contractor makes to carry out the WIA Title I — financially assisted program or
activity. Contractor understands that the Agency and/or the DOEA and the United States have the right to seek
judicial enforcement of the assurance.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -
recipients and contractors shall provide this assurance accordingly.
D. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES, SECTION 287.133, F.S.
Contractor hereby certifies that neither it, nor any person or affiliate of Contractor, has been convicted of a Public Entity
Crime as defined in Section 287.133, F.S., nor placed on the convicted vendor list.
Contractor understands and agrees that it is required to inform Area Agency and DOEA immediately upon any change
of circumstances regarding this status.
E. ASSOCIATION OF COMMUNITY ORGANIZATIONS FOR REFORM NOW (ACORN) FUNDING
RESTRICTIONS ASSURANCE (Pub. L. 111-117).
As a condition of the Contract, Contractor assures that it will comply fully with the federal funding restrictions
pertaining to ACORN and its subsidiaries per the Consolidated Appropriations Act, 2010, Division E, Section 511 (Pub.
L. 111-117). The Continuing Appropriations Act, 2011, Sections 101 and 103 (Pub. L. 111-242), provides that
appropriations made under Pub. L. 111-117 are available under the conditions provided by Pub. L. 111-117.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants and contracts under grants, loans and cooperative agreements) and that all sub -
recipients and contractors shall provide this assurance accordingly.
F. SCRUTINIZED COMPANIES AND NO BOYCOTT OF ISRAEL CERTIFICATION, SECTION 287.135, F.S.
In accordance with section 287.135, F.S., Contractor certifies that it has not been placed on the Scrutinized Companies
that Boycott Israel list and that it is not engaged in a boycott of Israel.
If this Contract is in the amount of $1 million or more, in accordance with the requirements of Section 287.135, F.S.,
Contractor hereby certifies that it is not listed on either the Scrutinized Companies with Activities in Sudan List or the
Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List and that it is not engaged in business
operations in Cuba or Syria.
Contractor understands that pursuant to Section 287.135, F.S., the submission of a false certification may result in
the Agency terminating this contract and the submission of a false certification may subject Contractor to civil penalties
and attorney fees and costs, including any costs for investigations that lead to the finding of false certification.
If Contractor is unable to certify any of the statements in this certification, Contractor shall attach an explanation to
this Contract.
G. CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR CONTRACTS,
AGREEMENTS, GRANTS, LOANS, AND COOPERATIVE AGREEMENTS
1. The Contractor and any Subcontractors of services under this contract have financial management systems
capable of providing certain information, including: (1) accurate, current, and complete disclosure of the 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 contract supported activities; and (3) the comparison of outlays with
budgeted amounts for each award. The inability to process information in accordance with these requirements
could result in a return of grant funds that have not been accounted for properly.
40
July 2019 — June 2020
CCE 203.19
2. Management Information Systems used by the Contractor, Subcontractors, or any outside entity on which the
Contractor is dependent for data that is to be reported, transmitted, or calculated, have been assessed and verified
to be capable of processing data accurately, including year -date dependent data. For those systems identified to be
non-compliant, Contractors will take immediate action to assure data integrity.
3. If this contract includes the provision of hardware, software, firmware, microcode, or imbedded chip technology,
the undersigned warrants that these products are capable of processing year -date dependent data accurately. All
versions of these products offered by the Contractor (represented by the undersigned) and purchased by the state
will be verified for accuracy and integrity of data prior to transfer.
4. In the event of any decrease in functionality related to time and date related codes and internal subroutines that
impede the hardware or software programs from operating properly, the Contractor agrees to immediately make
required corrections to restore hardware and software programs to the same level of functionality as warranted
herein, at no charge to the state, and without interruption to the ongoing business of the state, time being of the
essence.
5. The Contractor and any Subcontractors of services under this contract warrant that their policies and procedures
include a disaster plan to provide for service delivery to continue in case of an emergency, including emergencies
arising fi•om data integrity compliance issues.
H. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION
As a condition of contracting with the Agency, Contractor certifies the use of the U.S. Department of Homeland
Security's E -verify system to verify the employment eligibility of all new employees hired by Contractor during the
contract term to perform employment duties pursuant to this contract, and that any subcontracts include an express
requirement that Subcontractors performing work or providing services pursuant to this contract utilize the E -verify
system to verify the employment eligibility of all new employees hired by the Subcontractor during the entire
contract term.
The Contractor shall require that the language of this certification be included in all sub -agreements, sub -grants, and
other agreements/contracts and that all Subcontractors shall certify compliance accordingly.
This certification is a material representation of fact upon which reliance was placed when this contract was made or
entered into. Submission of this certification is a prerequisite for making or entering into this contract imposed by
Circulars A-102 and 2 CFR Part 200 and 215 (formerly OMB Circular A-110).
I. RECORDS AND DOCUMENTATION
The Contractor agrees to make available to Agency staff and/or any party designated by the Agency any and all
contract related records and documentation. The Contractor shall ensure the collection and maintenance of all
program related information and documentation on any such system designated by the Agency. Maintenance includes
valid exports and backups of all data and systems according to Agency standards.
J. CERTIFICATION REGARDING INSPECTION OF PUBLIC RECORDS
1. In addition to the requirements of Section 10 of the Standard Contract, sections 119.0701(3) and (4) F.S., and any other
applicable law, if a civil action is commenced as contemplated by section 119.0701(4), F.S., and the Agency is named
in the civil action, Contractor agrees to indemnify and hold harmless the Agency for any costs incurred by the
Agency and any attorneys' fees assessed or awarded against the Agency from a Public Records Request made
pursuant to Chapter 119, F.S., concerning this contract or services performed thereunder.
a. Notwithstanding section 119.0701, F.S., or other Florida law, this section is not applicable to contracts executed
between the Agency and state agencies or subdivisions defined in section 768.28(2), F.S.
41
July 2019 — June 2020
CCE 203.19
2. Section 119.01(3), F.S., states if public funds are expended by an agency in payment of dues or membership contributions
for any person, corporation, foundation, bust, association, group, or other organization, all the financial, business, and
membership records of such an entity which pertain to the public agency (Area Agency on Aging for Southwest
Florida, Inc.) are public records. Section 119.07, F.S, states that every person who has custody of such a public record
shall pennit the record to be inspected and copied by any person desiring to do so, under reasonable circumstances.
Additionally, I certify this organization does X does not _ provide for institutional memberships.
Contractor's signature below attests that records pertaining to the dues or membership application by the Agency are
available for inspection if applicable, as stated above.
By execution of this contract, Contractor must include these provisions in all related subcontract agreements (if applicable).
By execution of this agreement, Contractor must include these provisions (A -J) in all related subcontract agreements (if
applicable).
By signing below, Contractor certifies that the representations outlined in parts A through J above are true and correct.
1 J
3339 Tamiami Trail E Suite 211
Stephen Y Carvell -Public Service Department Head
(Signature and Title of Authorized Representative
Street Address
Collier County Board of County Commissioners
Naples, FL 34112
Contractor Date
City, State, Zip code
Approved as to form and legality
sista oun llurncy
42
�f.
July 2019 — June 2020
ATTACHMENT IV
ASSURANCES—NON-CONSTRUCTION PROGRAMS
CCE 203.19
Public reporting burden for this collection of information is estimated to average forty-five (45) minutes per response, including time
for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing
the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348-0043),
Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND
BUDGET, SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions please
contact the awarding agency. Further, certain federal awarding agencies may require applicants to certify to
additional assurances. If such is the case, you will be notified.
1. Has the legal authority to apply for federal assistance, and the institutional, managerial and financial capability
(including funds sufficient to pay the non-federal share of project cost) to ensure proper plamring, management, and
completion of the project described in this application.
2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the state, through any
authorized representative, access to and the right to examine all records, books, papers, or documents related to the
award; and will establish a proper accounting system in accordance with generally accepted accounting standards or
agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes, or presents the
appearance of, personal or organizational conflict of interest or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §§ 4728-4763) relating to prescribed
standards for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A
of OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).
6. Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of
the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin;
(b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§ 1681-1683, and §§ 1685-1686),
which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29
U.S.C.
§ 794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended
(42 U.S.C. §§ 6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and
Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the
Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-
616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) Sections 523 and 527
of the Public Health Service Act of 1912 (42 U.S.C. §§ 290 dd-3 and 290 ee 3), as amended, relating to
confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42
U.S.C. § 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any
other nondiscrimination provisions in the specific statute(s) under which application for federal assistance is being
made; and 0) the requirements of any other nondiscrimination statute(s) which may apply to the application.
7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance
and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of
persons displaced or whose property is acquired as a result of federal or federally assisted programs. These requirements
apply to all interests in real property acquired for project purposes regardless of federal participation in purchases.
43 �
t`'
July 2019 — June 2020
CCE 203.19
Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. §§ 1501-1508 and §§ 7324-7328), which
limit the political activities of employees whose principal employment activities are funded in whole or in part with
federal funds.
9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C. §§ 276a to 276a-7), the Copeland
Act (40 U.S.C. § 276c and 18 U.S.C. § 874) and the Contract Work Hours and Safety Standards Act (40 U.S.C. §§
327-333), regarding labor standards for federally assisted construction sub -agreements.
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the
program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or
more.
11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and
Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of
project consistency with the approved State management program developed under the Coastal Zone Management Act
of 1972 (16 U.S.C. § 1451 et seq.); (f) conformity of federal actions to State (Clear Air) Implementation Plans under
Section 176(e) of the Clear Air Act of 1955, as amended (42 U.S.C. § 7401 et seq.); (g) protection of underground
sources of drinking water under the Safe Drinking Water Act of 1974, as amended (P.L. 93-523); and (h) protection
of endangered species under the Endangered Species Act of 1973, as amended (P.L. 93-205).
12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. § 1721 et seq.) related to protecting components
or potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of
1966, as amended (16 U.S.C. § 470), EO 11593 (identification and protection of historic properties), and the
Archaeological and Historic Preservation Act of 1974 (16 U.S.C. § 469a-1 et seq.).
14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related
activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. § 2131 et seq.)
pertaining to the care, handling, and treatment of warm-blooded animals held for research, teaching, or other activities
supported by this award of assistance.
16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. § 4801 et seq.), which prohibits the use of
lead- based paint in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act
Amendments of 1996 and 2 CFR Part 200.
18. Will comply with all applicable requirements of all other federal laws, executive orders, regulations, and policies
governing this program.
OF AUTHORIZED CERTIFYING OFFICIAL I TITLE
Stephen Y Carrell i`) Public Service Department Head
APPLICANT ORGANIZATION DATE SUBMITTED
Collier
%
Collier County Board of County Commissioners 7 / (� // --/
44
Assistant Count ')%uorncy a
July 2019 — June 2020
CCE 203.19
ATTACHMENT V
FLORH)A DEPARTMENT OF ELDER AFFAIRS C". RIGHTS COMPTJANCE CHECKLIST
Program/Facility Name
County
AAA/Contractor
Address
Completed By
City, State, Zip Code
Date
Telephone
PART I: READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU COMPLETE
THIS FORM.
1. Briefly describe the geographic area served by the program/facility and the type of service provided:
For questions 2-5 please indicate the foil
2.. Population of area served
13. Staff currently employed
4. Clients currently enrolled/registered
5. Advisory/Governing Board if applicable
% % % % % % %
owing: Total # White Black Hispanic Other Female Disabled Over 40
Source of data:
Effective date:
Effective date:
PART II: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. IF N/A or NO, EXPLAIN.
6. Is an Assurance of Compliance on file with DOEA? N/A YES NO
❑ ❑ ❑
7. Compare the staff composition to the population. Is staff representative of the population?
N/A
❑
YES
❑
NO
❑
S. Are eligibility requirements for services applied to clients and applicants without regard to race, color, national
origin, sex, age, religion, or disability?
N/A
❑
YES
❑
NO
❑
9. 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?
N/A
El
YES
n
NO
El
10. For in-patient services, are room assignments made without regard to race, color, national origin or disability?
N/A
YES
NO
❑
❑
❑
11. Is the program/facility accessible to non-English speaking clients?
N/A
YES
NO
12. Are employees, applicants and participants informed of their protection against discrimination? If YES, how?
Verbal ❑ Written ❑ Poster ❑
❑
N/A
❑
❑
YES
❑
❑
NO
❑
M
Is
July 2019 — June 2020 CCE 203.19
Reviewed by
1
In Compliance: YES NO*
Program Office
*Notice of Corrective Action Sent/—
Date
Telephone Response Due _ /
13. Give the number and current status of any discrimination complaints regarding services or employment filed
against the program/facility.
N/A
NUMBER
14. Is the program/facility physically accessible to mobility, hearing, and sight -impaired individuals?
N/A
YES NO
❑
❑ ❑
PART IH: THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES. IF NO,
EXPLAIN.
15. Has as a self-evaluation been conducted to identify any barriers to serving disabled individuals and to make any YES NO
necessary modifications?
16. Is there an established grievance procedure that incorporates due process in the resolution of complaints?
YES
❑
NO
❑
17. Has a person been designated to coordinate Section 504 compliance activities?
YES
❑
NO
❑
18. Do recruitment and notification materials advise applicants, employees, and participants of nondiscrimination on
the basis of disability?
YES
❑
NO
19. Are auxiliary aids available to ensure accessibility of services to hearing and sight -impaired individuals?
YES
NO
❑
❑
PART IV: FOR PROGRAMS OR FACILITIES WITH 50 OR MORE ENIPLOYEES AND FEDERAL CONTRACTS OF $50,000.00 OR MORE.
20. Do you have a written affirmative action plan? If NO, explain. LYES
N
Reviewed by
1
In Compliance: YES NO*
Program Office
*Notice of Corrective Action Sent/—
Date
Telephone Response Due _ /
On -Site ❑ Desk Review
Response Received_/
46
July 2019 — June 2020 CCE 203.19
ATTACHMENT V
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST
1. Describe the geographic service area such as a district, county, city, or other locality. If the program/facility serves
a specific target population such as adolescents, describe the target population. Also, define the type of service
provided.
2. Enter the percent of the population served by race, sex, disability, and over the age of 40. The population
served includes persons in the geographical area for which services are provided such as a city, county or other
regional area. Population statistics can be obtained from local chambers of commerce, libraries, or any
publication from the 1980 Census containing Florida population statistics. Include the source of your population
statistics. ("Other" races include Asian/Pacific Islanders and American Indian/Alaskan Natives.)
3. Enter the total number of full-time staff and their percent by race, sex, disability, and over the age of 40. Include
the effective date of your summary.
4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and list
their percent by race, sex, disability, and over the age of 40. Include the date that enrollment was counted.
a. Where there is a significant variation between the race, sex, or ethnic composition of the clients and their
availability in the population, the program/facility has the responsibility to determine the reasons for such
variation and take whatever action may be necessary to correct any discrimination. Some legitimate disparities
may exist when programs are sanctioned to serve target populations such as elderly or disabled persons.
5. Enter the total number of advisory board members and their percent by race, sex, disability, and over the age of
40. If there is no advisory or governing board, leave this section blank.
6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in
compliance with all nondiscriminatory provisions as required in 45 CFR Part 80. This is usually a standard part of
the contract language for DOEA Recipients and their Sub -grantees. 45 CFR § 80.4 (a).
7. Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the
population is Hispanic, is there a comparable percentage of Hispanic staff.
8. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or
employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and through
on-site record analysis of persons who applied but were denied services or employment. 45 CFR § 80.3(a) and 45
CFR § 80.1.
9. Participants or clients must be provided services such as medical, nursing, and dental care, laboratory services,
physical and recreational therapies, counseling, and social services without regard to race, sex, color, national origin,
religion, age, or disability. Courtesy titles, appointment scheduling, and accuracy of record keeping must be applied
uniformly and without regard to race, sex, color, national origin, religion, age, or disability. Entrances, waiting
rooms, reception areas, restrooms, and other facilities must also be equally available to all clients.
45 CFR § 80.3 (b).
10. For in-patient services, residents must be assigned to rooms, wards, etc., without regard to race, color, national
origin or disability. Also, residents must not be asked whether they are willing to share accommodations with
persons of a different race, color, national origin, or disability, 45 CFR 80.3 (a).
11. The program/facility and all services must be accessible to participants and applicants, including those persons who
may not speak English. In geographic areas where a significant population of non-English speaking people live,
program accessibility may include the employment of bilingual staff In other areas, it is sufficient to have a policy
or plan for service, such as a current list of names and telephone numbers of bilingual individuals who will assist
in the provision of services. 45 CFR § 80.3 (a).
12. Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to their
participants, beneficiaries, or any other interested parties. 45 CFR § 80.6(d). This should include information on
47
00
July 2019 — June 2020
CCE 203.19
their right to file a complaint of discrimination with either the Agency and/or Department or the U.S. Department
of Health and Human Services. The information may be supplied verbally or in writing to every individual or may
be supplied through the use of an equal opportunity policy poster displayed in a public area of the facility.
13. Report number of discrimination complaints filed against the program/facility. Indicate the basis (e.g. race, color,
creed, sex, age, national origin, disability, and/or retaliation) and the issues involved (e.g. services or employment,
placement, termination, etc.). Indicate the civil rights law or policy alleged to have been violated along with
the name and address of the local, state or federal agency with whom the complaint has been filed. Indicate the
current status of the complaint (e.g. settled, no reasonable cause found, failure to conciliate, failure to cooperate,
tinder review, etc.).
14. The program/facility must be physically accessible to mobility, hearing, and sight -impaired individuals. Physical
accessibility includes designated parking areas, curb cuts or level approaches, ramps, and adequate widths to
entrances. The lobby, public telephone, restroom facilities, water fountains, and information and admissions offices
should be accessible. Door widths and traffic areas of administrative offices, cafeterias, restrooms, recreation areas,
counters, and serving lines should be observed for accessibility. Elevators should be observed for door width and
Braille or raised numbers. Switches and controls for light, heat, ventilation, fire alarms, and other essentials should
be installed at an appropriate height for mobility impaired individuals.
15. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self-
evaluation to identify any accessibility barriers. Self-evaluation is a four -step process:
a. Evaluate, with the assistance of disabled individual(s)/organization(s), current practices and policies that do
not or may not comply with Section 504;
b. Modify policies and practices that do not meet Section 504 requirements.;
c. Take remedial steps to eliminate the effects of any discrimination that resulted from adherence to these polocies
and practices; and
d. Maintain self-evaluation on file, including a list of the interested persons consulted, a description of areas
examined, any any problems identified, and a description of any modifications made and of any remedial steps
taken 34 CFR § 84.6. (This checklist may be used to satisfy this requirement if these four steps have been
followed).
16. Programs or facilities that employ 15 or more persons shall adopt grievance procedures that incorporate appropriate
due process standards and provide for the prompt and equitable resolution of complaints alleging any action
prohibited by Part 84 of Title 45, CFR45 CFR § 84.7(b).
17. Programs or facilities that employ 15 or more persons shall designate at least one person to coordinate its efforts
to comply with Part 84 of Title 45, CFR. 45 CFR § 84.7(a).
18. Programs or facilities that employ 15 or more persons shall take appropriate initial and continuing steps to notify
participants, beneficiaries, applicants, and employees that the program/facility does not discriminate on the basis of
handicap in violation of Section 504 and Part 84 of Title 45, CFR. Methods of initial and continuing notification
may include the posting of notices, publication in newspapers and magazines, placement of notices in publications
of the programs or facilities, and distribution of memoranda or other written communications. 45 CFR § 84.8(a).
19. Programs/facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with
impaired sensory, manual or speaking skills where necessary to afford such persons an equal opportunity to benefit
from the service in question. Auxiliary aids may include, but are not limited to, brailed and taped materials,
interpreters, and other aids for persons with impaired hearing or vision. 45 CFR § 84.52(d).
20. Programs/facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement and
maintain a written affirmative action compliance program in accordance with Executive Order 11246, 41 CFR 60
and Title VI of the Civil Rights Act of 1964, as amended.
Edi
My 2019 — June 2020
DEPARTMENT OF
ELDER
AFFAIRS
STATE OF FLORIDA
CCE 203.19
ATTACHMENT VII
BACKGROUND SCRE ED
BACKGROUND SCREENING
Affidavit of Compliance - Employer
AUTHORITY: This form is required annually of all employers to comply with the attestation
requirements set forth in section 435.05(3), Florida Statutes.
➢ The term "employer" means any person or entity required by law to conduct background screening,
Including but not limited to, Area Agencies on Aging, Aging Resource Centers, Aging and Disability
Resource Centers, Lead Agencies, Long -Term Care Ombudsman Program, Serving Health Insurance Needs
of Elders Program, Service Providers, Diversion Providers, and any other person or entity which hires
employees or has volunteers in service who meet the definition of a direct service provider. See §§
435.02, 430.0402, Fla. Stat.
➢ A direct service provider is "a person 18 years of age or older who, pursuant to a program to provide
services to the elderly, has direct, face-to-face contact with a client while providing services to the client
and has access to the client's living area, funds, personal property, or personal identification Information
as defined in s. 817.568. The term includes coordinators, managers, and supervisors of residential
facilities; and volunteers." § 430.0402(1)(b), Fla. Stat.
ATTESTATION:
As the duly a uthorized representative of
Employer Name
located at
StreetAddress City State ZIP rode
I, do hereby affirm under penalty of perjury
Name of Representative
that the above named employer is in compliance with the provisions of Chapter 435 and section
430.0402, Florida Statutes, regarding level 2 background screening.
Signature of Representative Date
STATE OF FLORIDA, COUNTY OF
Sworn to (or affirmed) and subscribed before me this _ day of
to me or produced
Pdnq Type, or Stamp Commfsslomd Name of NotaryPublfc
20.1 by
(Name of Representative) who is personally known
Notary Public
DOEA Form 235, Afffdaett of Complfance -Employer, Effective Apol 2012
Form available at: htto://elderaffafrss[ate.fl.us/erelfsh/backeroundscreenine.oln
49
as proof of identification.
Section 435.05(3), F.S
July 2019 — June 2020
ATTACHMENT VIII
ANNUAL BUDGET SUMMARY
COMMUNITY CARE FOR THE ELDERLY PROGRAM
for
Collier County Board of County Commissioners
Collier
CCE Services Allocations $ 916,057.00
50
CCE 203.19
N
July 2019 — June 2020
Report Number
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
ATTACHMENT IX
INVOICE REPORT SCHEDULE
COMMUNITY CARE FOR THE ELDERLY
Based On
July Advance*
August Advance*
July Expenditure Report
August Expenditure Report
September Expenditure Report
October Expenditure Report
November Expenditure Report
December Expenditure Report
January Expenditure Report
February Expenditure Report
March Expenditure Report
April Expenditure Report
May Expenditure Report
June Expenditure Report
Final Request for Payment
CCE 203.19
Submit to Agency on This Date
July 1
July I
August 11
September 11
October 11
November 11
December 11
January 11
February 11
March 11
April 11
May 11
June 11
July 11
July 25
Legend: * Advance based on projected cash need
Note # l: Report 41 for Advance Basis Contracts cannot be submitted to the Area Agency
Aging for Southwest Florida, Inc. prior to July 1 or until the contract with the
Agency has been executed and a copy sent to the Area Agency on Aging for
Southwest Florida, Inc. Actual submission of the vouchers to the Agency is
dependent on the accuracy of the expenditure report.
Note # 2: Report numbers 5 through 14 shall reflect an adjustment of at least one-tenth of the
total advance amount, on each of the reports, repaying advances issued the first two
months of the agreement. All advance payments made to the Contractor shall be
returned to the Agency and reported as an advance recoupment on each
request for payment. The adjustment shall be recorded in Part C, Line 1 of the
report (ATTACHMENT X).
Note # 3: Submission of expenditure reports may or may not generate a payment request. If
frtal expenditure report reflects funds due back to the Agency, payment is to
accompany the report.
Note # 4: ALL Expenditure Reports are due by 12:00 p.m. on the 11th of each month. IF the
11th falls on a Saturday, then the report will be due by the 10" by 12:00 p.m.
AND IF the 1 Ith falls on a Sunday, the report will be due by the 12t11 by 12:00 p.m.
Actual submission of the vouchers to Dept. of Elder Affairs is dependent on the
accuracy of the expenditure report, which is verified and paid by CIRTS data only.
51
July 2019 - June 2020
ATTACHATFNT X
REQUEST FOR PAYMENT
COMMUNITY CARE FOR THE ELDERLY
CCE 203.19
RECIPIENT NAME, ADDRESS, PHONE#and FEID#
TYPE OF PAYMENT:
Regular
Advance
This Request Period: From,-- To: _
Contract Period _
Contract #
Report#___ _
PSA #
CERTIFICATION: I hereby eerfifyto the best of my knowledge that this request or refund conforms with the terms and the purposes of the above contract.
To the best of my knowledge, nil CIRTS is accurate and correct.
Prepared by: Date:_ Approved by. Date:
PARTA: BUDGETSUMMARY
1. Approved Contract Amount
2. Previous Funds Received fir Contract Pedatl
3. Contract Balance the 1 minus line 21
4. Previous Funds Requested and Not Received for Contract Period
5. CONTRACT BALANCE (line 3 minus line 4)
CCE Admin.
$ 0.00
CCE Services
$ 0.00
TOTAL
$ 0.00
S 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
S 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
PART B: CONTRACT FUNDS REQUEST
1. Anticipated Cash Need (1st- 2nd months)
2. Net Expenditures For Month
(DOEA Farm 1050, Part 8, Line 4)
3. TOTAL
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
PART C: NET FUNDS REQUESTED
1. Less Advance Applied
2. TOTAL FUNDS REQUESTED (Part 8 Line 3, minus PartC Line 1)
§ 0.00
$ 0.00
$ 0.00
$ am
$ 0.00
$ 0.00
List of Services I Units / Rates provided -See attached report.
DOEA FORM t OBC
Revised 51/12
52
July 2019 - June 2020
ATTACEMENT XI
RECEIPT AND EXPENDITURE REPORT
CCE 203.19
PROVIDER NAME, ADDRESS, PHONE # and FEID#
Program Funding :
THIS REPORT PERIOD:
From To
CCE Admin.
CONTRACT PERIOD:
CCE Services
CONTRACT #
REPORT #
PSA#
CERTIFICATION : I certify to the best of my knowledge and belief that the report is complete and correct and all outlays
herein are for purposes set forth In the contract. To the best of my knowledge, all CIRTS is accurate and correct.
Prepared by: Date: Approved by: Data:
PART A: BUDGETED INCOME/ RECEIPTS
1. Approved
2. Actual Receipts
3. Total Receipts
4. Percent of
Budget
For This Report
Year to Date
Approved Budget
$0.00
$0.00
$0.00
#DIV/01
1. State Funds
2. Program Income
$0.00
$0.00
$0.00
#DIV/0!
3. Local Cash Match
$0.00
$0.00
$0.00
#DIV/01
4. SUBTOTAL: CASH RECEIPTS
5. Local In -Kind Match
6. TOTAL RECEIPTS
$0.00
$0.00
$0.00
#DIV/0!
PART B: EXPENDITURES
1. Approved
2. Expenditures
3. Expenditures
4. Percent of
Budget
For This Report
Year to Date
Approved Budget
1. Administrative Services
$0.00
$0.00
$0.00
#DIV/O!
2. Service Subcontractor(s)
$0.00
$0.00
$0.00
#DIV/01
3. Adult Protective Services
$0.00
$0.00
$0.00
#DIV/01
4. TOTAL EXPENDITURES
$0.00
':$0.00
$0.00
#DIV/0!
PART C: OTHER REVENUE AND EXPENDITURES
It. Interest:
III. Advance Recouped
I. Program Income (PI)
1. Earned on GR Advance $
$
1. CCE: PI Collected YTD $
2. Return of GR Advance $
(Includes fees collected)
3. Other Earned $
PART D: CO -PAYMENTS CURRENT MONTH YEAR-TO-DATE
1. Total of Co -payments assessed $ $
2. Total of Co -payments collected $ $
(For Tracking Purposes only)
DOER FORM 105C
RoNsed 5/2 512 01 0
53
July 2019 — June 2020
ATTACHMENT XII
SERVICE RATE REPORT
Collier County Board of County Commissioners
CCE 203.19
SERVICE
SFY 19/20
REIMBURSEMENT
UNIT RATE
METHOD OF
PAYMENT
UNIT
TYPE
ADULT DAYCARE
$14.09
Fixed Fee/Unit Rate
HOURS
CASE AIDE
$30.50
Fixed Fee/Unit Rate
HOURS
CASE MANAGEMENT
$54.00
Fixed Fee/Unit Rate
HOURS
CHORE
$21.77
Fixed Fee/Unit Rate
HOURS
CHORE (ENHANCED)
36.00
Fixed Fee/Unit Rate
HOURS
COMPANIONSHIP
$21.00
Fixed Fee/Unit Rate
HOURS
EMERGENCY ALERT RESPONSE
$ 1.35
Fixed Fee/Unit Rate
DAYS
ESCORT
$19.50
Fixed Fee/Unit Rate
TRIPS
HOME DELIVERED MEALS
$ 7.00
Fixed Fee/Unit Rate
MEALS
HOMEMAKER
$24.28
Fixed Fee/Unit Rate
HOURS
HOUSING IMPROVEMENT
Cost Reimbursement
Cost Reimbursement
EPISODE
MATERIAL AID
Cost Reimbursement
Cost Reimbursement
EPISODE
OTHER SERVICES
Cost Reimbursement
Cost Reimbursement
EPISODE
PERSONAL CARE
$25.16
Fixed Fee/Unit Rate
HOURS
PEST CONTROL Maintenance
$50.00
Fixed Fee/Unit Rate
EPISODE
PEST CONTROL (Initiation)
$150.00
Fixed Fee/Unit Rate
EPISODE
RESPITE IN - FACILITY
$10.29
Fixed Fee/Unit Rate
HOURS
REPITE IN - HOME
$22.51
Fixed Fee/Umt Rate
HOURS
SKILLED NURSING SERVICES
$40.26
Fixed Fee/Unit Rate
HOURS
SPECIALIZED MEDICAL EQUIPMENT,
SERVICES, AND SUPPLIES
Cost Reimbursement
Cost Reimbursement
EPISODE
TRANSPORTATION
Cost Reimbursement
Cost Reimbursement
TRIPS
54
Revised August 2007
Attestation Statement
Agreement/Contract Number CCE 203.19
Amendment Number NA
1, Stenehn Y Carnell , attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
Collier County Board of County Commissioners
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting, due to the differences in
electronic data processing media, which has no affect on the agreement/contract content.
Signature of Reci0ent/Contractor representative Date
Approved as to ffonin and legality
• istant County A }tu tey
Revised August 2007
July 2019 —June 2020 HCE 203.19
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC.
HOME CARE FOR THE ELDERLY
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc. and Collier County Board
of County Commissioners (Contractor), collectively referred to as the "Parties." The tern Contractor for this purpose may
designate a Vendor, Subgrantee, or Subrecipient.
WITNESSETH THAT:
WHEREAS, the Agency has determined that it is in need of certain services as described herein; and WHEREAS,
the Contractor has demonstrated that it has the requisite expertise and ability to faithfully perform such services as
an independent Contractor of the Agency.
NOW THEREFORE, in consideration of the services to be performed and payments to be made, together with the
mutual covenants and conditions set forth herein, the Parties agree as follows:
1. Purpose of Contract:
The purpose of this contract is to provide services in accordance with the terms and conditions specified in this contract
including all attachments, forms, and exhibits, which constitute the contract document.
2. Incorporation of Documents within the Contract:
The contract will incorporate attachments, proposal(s), state plan(s), grant agreements, relevant Department handbooks,
manuals and/or desk books, as an integral part of the contract, except to the extent that the contract explicitly
provides to the contrary. In the event of conflict in language among any of the documents referenced above, the
specific provisions and requirements of the contract document(s) shall prevail over inconsistent provisions in the
proposal(s) or other general materials not specific to this contract document and identified attachments.
3. Term of Contract:
This contract shall begin at twelve (12:00) A.M., Eastern Standard Time July 1, 2019 or on the date the contract has
been signed by the last party required to sign it, whichever is later. It shall end at eleven fifty-nine (11:59) P.M., Eastern
Standard Time June 30, 2020.
4. Contract Amount:
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount not
to exceed $54,450.00, subject to the availability of funds. Any costs or services paid for under any other contract or
from any other source are not eligible for payment under this contract.
5. Renewals:
By mutual agreement of the Parties, in accordance with Section 287.058(1)(g), Florida Statutes (F.S.), the Agency
may renew the contract for a period not to exceed three years, or the term of the original contract, whichever is longer.
The renewal price, or method for determining a renewal price, is set forth in the bid, proposal, or reply. No other costs
for the renewal may be charged. Any renewal is subject to the same terms and conditions as the original contract and
contingent upon satisfactory performance evaluations by the Agency and the availability of funds.
6. Compliance with Federal Law:
6.1 If this contract contains federal funds this section shall apply.
6.1.1 The Contractor shall comply with the provisions of 45 Code of Federal Regulations (CFR) 75 and/or 45
CFR Part 92, 2 CFR Part 200, and other applicable regulations.
6.1.2 If this contract contains federal funds and is over $100,000.00, the Contractor shall comply with all
applicable standards, orders, or regulations issued under Section 306 of the Clean Air Act as amended (42
United States Code (U.S.C.) § 7401, et seq.), Section 508 of the Federal Water Pollution Control Act
as amended (33 U.S.C. § 1251, et seq.), Executive Order 11738, as amended, where applicable,and
where applicable Environmental Protection Agency regulations 2 CFR Part 1500. The Contactor shall
report any violations of the above to the Agency.
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July 2019 — June 2020
HCE 203.19
6.1.3 Neither the Contractor nor any agent acting on behalf of the Contractor, may not use any federal funds
received in connection with this contract to influence legislation or appropriations pending before
Congress or any state legislature. The Contactor must complete all disclosure forms as required,
specifically the Certification and Assurances Attachment, which must be completed and returned to the
Contract Manager prior to the execution of this contract.
6.1.4 In accordance with Appendix II to 2 CFR Part 200, the Contractor shall comply with Executive Order
11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as
supplemented in Department of Labor regulations 41 CFR Part 60 and in Department of Health and Human
Services regulations 45 CFR Part 92, if applicable.
6.1.5 A contract award with an amount expected to equal or exceed $25,000.00 and certain other contract awards
will not be made to parties listed on the government -wide Excluded Parties List System, in accordance with
the Office of Management and Budget (OMB) guidelines at 2 CFR Part 180 that implement Executive
Orders 12549 and 12689, "Debarment and Suspension." The Excluded Parties List System contains
the names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared
ineligible under statutory or regulatory authority other than Executive Order 12549. The Contractor
shall comply with these provisions before doing business or entering into subcontracts receiving
federal funds pursuant to this contract. The Contractor shall complete and sign the Certifications and
Assurances Attachment prior to the execution of this contract.
6.2 The Contractor shall not employ an unauthorized alien. The Agency will consider the employment of
unauthorized aliens a violation of the Immigration and Nationality Act (8 U.S.C. § 1324a) and the
Immigration Reform and Control Act of 1986 (8 U.S.C. § 1101). Such violation will be cause for unilateral
cancellation of this contract by the Agency.
6.3 If the Contractor is a non-profit provider and is subject to Internal Revenue Service (IRS) tax exempt organization
reporting requirements (filing a Form 990 or Form 990-N), and has its tax exempt status revoked for failing to
comply with the filing requirements of the Pension Protection Act of 2006 or for any other reason, the Contractor
must notify the Agency in writing within thirty (30) days of receiving the IRS notice of revocation.
6.4 The Contractor shall comply with Title 2 CFR Part 175 regarding Trafficking in Persons.
6.5 Unless exempt under 2 CFR § 170.110(b), the Contractor shall comply with the reporting requirements of the
Transparency Act as expressed in 2 CFR Part 170.
6.6 To comply with Presidential Executive Order 12989, as amended, and State of Florida Executive Order Number
11-116, Contractor agrees to utilize the U.S. Department of Homeland Security's E -verify system to verify the
employment of all new employees hired by Contractor during the contract term. Contractor shall include in
related subcontracts a requirement that Subcontractors performing work or providing services pursuant to the
state contract utilize the E -verify system to verify employment of all new employees hired by the Subcontractor
during the contract term. Contractors meeting the terms and conditions of the E -Verify System are deemed to be
in compliance with this provision.
7. Compliance with State Law:
7.1 This contract is executed and entered into in the State of Florida, and shall be construed, performed, and enforced
in all respects in accordance with Florida law, including Florida provisions for conflict of laws.
7.2 If this contract contains state financial assistance funds, the Contractor shall comply with Section 215.97, F.S.,
and Section 215.971, F.S., and expenditures must be in compliance with laws, rules, and regulations including,
but not limited to, the Reference Guide for State Expenditures.
7.3 The Contractor shall comply with the requirements of Section 287.058, F.S., as amended.
7.3.1 The Contractor shall perform all tasks contained in Attachment I.
7.3.2 The Contractor shall provide units of deliverables, including reports, findings, and drafts, as specified in
Attachment I, to be received and accepted by the Agency Contract Manager prior to payment.
7.3.3 The Contractor shall comply with the 'criteria and final date by which such criteria must be met for
completion of this contract as specified in Attachment I, Section III. Method of Payment.
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July 2019 — June 2020
HCE 203.19
7.3.4 The Contractor shall submit bills for fees or other compensation for services or expenses in sufficient detail
for a proper pre -audit and post -audit.
7.3.5 If itemized payment for travel expenses is permitted in this contract, the Contractor shall submit invoices
for any travel expenses in accordance with Section 112.061, F.S., or at such lower rates as may be
provided in this contract.
7.3.6 The Contractor shall allow public access to all documents, papers, letters, or other public records as defined
in Section 119.011(12), F.S., made or received by the Contractor in conjunction with this contract except
for those records which are made confidential or exempt by law. The Contractor's refusal to comply with
this provision will constitute an immediate breach of contract for which the Agency may unilaterally
terminate this contract.
7.4 If clients are to be transported under this contract, the Contractor shall comply with the provisions of Chapter
427, F.S., and Rule Chapter 41-2, Florida Administrative Code (F.A.C).
7.5 Subcontractors who are on the Discriminatory Vendor List may not transact business with any public entity, in
accordance with the provisions of Section 287.134, F.S.
7.6 The Contractor shall comply with the provisions of Section 11.062, F.S., and Section 216.347, F.S., which prohibit
the expenditure of contract funds for the purpose of lobbying the legislature, judicial branch or a state agency.
7.7 The Area Agency may, at its option, terminate the Contract if the Contractor is found to have submitted a false
certification as provided under section 287.135(5),F.S., has been placed on the Scrutinized Companies with
Activities in the Iran Petroleum Energy Sector List, the Scrutinized Companies with Activities in Sudan List,
or the Scrutinized Companies that Boycott Israel List, or if the Contractor has been engaged in business
operations in Cuba or Syria or is engaged in a boycott of Israel.
8. Background Screening:
The Contractor shall ensure that the requirements of Section 430.0402 and Chapter 435, F.S., as amended, are met
regarding background screening for all persons who meet the definition of a direct service provider and who are not
exempt from the Department's level 2 background screening pursuant to Sections 430.0402(2)-(3), F.S. The Contractor
must also comply with any applicable rules promulgated by the Agency and/or Department and the Agency for Health
Care Administration regarding implementation of Section 430.0402 and Chapter 435, F.S. To demonstrate
compliance with this provision, Contractor shall submit the Background Screening Affidavit of Compliance
(Screening Form) to the Agency within thirty (30) days of execution of this contract. Should the Agency have a
completed Screening Form on file for the Contractor, a new Screening Form will be required every twelve (12)
months.
8.1 Further information concerning the procedures for background screening may be found at
http•//elderaffairs state fl us/doea/backuoundscreening php.
9. Grievance Procedures:
The Contractor shall develop, implement, and ensure that its Subcontractors have established grievance procedures to
process and resolve client dissatisfaction with, or denial of, service(s), and to address complaints regarding the
termination, suspension or reduction of services, as required for receipt of funds. These procedures, at a minimum,
will provide for notice of the grievance procedure and an opportunity for review of the Subcontractor's
determination(s).
10. Public Records and Retention:
10.1 By execution of this contract, Contractor agrees to all provisions of Chapter 119, F.S., and any other applicable
law, and shall:
10.1.1 Keep and maintain public records required by the Agency to perform the contracted services.
July 2019 — June 2020
HCE 203.19
10.1.2 Upon request from the Agency's custodian of public records, provide the Agency a copy of the
requested records or allow the records to be inspected or copied within a reasonable time at a cost that does
not exceed the cost provided in Chapter 119, F.S., or as otherwise provided by law.
10.1.3 Ensure that public records that are exempt, or confidential and exempt, from public records disclosure
requirements are not disclosed except as authorized by law for the duration of the contract term and
following completion of the contract if the Contractor does not transfer the records to the Agency.
10.1.4 Upon completion of the contract, the Contractor will either transfer, at no cost to the Agency, all public
records in possession of the Contractor to the Agency or will keep and maintain public records required by
the Agency. If the Contractor transfers all public records to the Agency upon completion of the
contract, Contractor shall destroy any duplicate public records that are exempt, or confidential and exempt,
from public records disclosure requirements. If the Contractor keeps and maintains public records upon
completion of the contract, the Contractor shall meet all applicable requirements for retaining public
records. All records stored electronically must be provided to the Agency in a format that is compatible
with the information technology systems of the Agency.
10.2 The Agency may unilaterally cancel this contact, notwithstanding any other provisions of this contract, for
refusal by the Contractor to comply with Section 10 of this contact by not allowing public access to all documents,
papers, letters, or other material made or received by the Contractor in conjunction with this contact, unless the
records are exempt, or confidential and exempt, from Section 24(a) of Article I of the State Constitution and
Section 119.07(1), F.S.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION
OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO
PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT
THE CUSTODIAN OF PUBLIC RECORDS AT:
Public Records Coordinator
Area Agency on Aging for Southwest Florida, Inc.
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
239-652-6900 or 866-413-5337
10.3 Upon termination of this contract, whether for convenience or for cause as detailed in Section 53 of this contract,
the Contractor and Subcontractors shall, at no cost to the Agency, transfer all public records in their possession
to the Agency and destroy any duplicate public records that are exempt, or confidential and exempt, from public
records disclosure requirements. All records stored electronically shall be provided to the Agency in a format
that is compatible with the information technology system of the Agency.
11. Audits. Inspections. Investigations:
11.1 The Contractor shall establish and maintain books, records and documents (including electronic storage media)
sufficient to reflect all assets, obligations, unobligated balances, income, interest and expenditures of funds
provided by the Agency under this contract. Contactor shall adequately safeguard all such assets and ensure
they are used solely for the purposes authorized under this contract. Whenever appropriate, financial information
should be related to performance and unit cost data.
11.2 The Contactor shall retain and maintain all client records, financial records, supporting documents, statistical
records, and any other documents (including electronic storage media) pertinent to this contract for a period of
six (6) years after completion of the contact, or longer when required by law. In the event an audit is required
by this contract, records shall be retained for a minimum period of six (6) years after the audit report is issued or
until resolution of any audit findings or litigation based on the terms of this contract, at no additional cost to the
Agency.
11.3 Upon demand, at no additional cost to the Agency, the Contractor shall facilitate the duplication and transfer of
any records or documents during the required retention period.
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O
July 2019 — June 2020 HCE 203.19
11.4 The Contractor shall ensure that the records described in this section will be subject at all reasonable times to
inspection, review, copying, or audit by federal, state, or other personnel duly authorized by the Agency.
11.5 At all reasonable times for as long as records are maintained, persons duly authorized by the Agency and
federal auditors, pursuant to 45 CFR Part 75, shall be allowed full access to and the right to examine any of
the Contractor's contracts and related records and documents pertinent to this specific contract, regardless of
the form in which kept.
11.6 The Contractor shall provide a Financial and Compliance Audit to the Agency as specified in this contract
and ensure that all related third -party transactions are disclosed to the auditor.
11.7 Contractor agrees to comply with the Inspector General in any investigation, audit, inspection, review, or hearing
performed pursuant to Section 20.055, F.S. Contractor further agrees that it shall include in related
subcontracts a requirement that subcontractors performing work or providing services pursuant to this contract
agree to cooperate with the Inspector General in any investigation, audit, inspection, review, or hearing pursuant
to Section 20.055(5), F.S. By execution of this contract the Contractor understands and will comply with this
subsection.
12. Nondiscrimination -Civil Rights Compliance:
12.1 The Contractor shall execute Assurances as stated in the Assurances -Non -Construction Programs Attachment that
it will not discriminate against any person in the provision of services or benefits under this contract or in
employment because of age, race, religion, color, disability, national origin, marital status or sex in compliance
with state and federal law and regulations. The Contractor further assures that all Contractors, subcontractors,
Sub -grantees, or others with whom it arranges to provide services or benefits in connection with any of its
programs and activities are not discriminating against clients or employees because of age, race, religion, color,
disability, national origin, marital status, or sex.
12.2 During the term of this contract, the Contractor shall complete and retain on file a timely, complete, and accurate
Civil Rights Compliance Checklist, attached to this contract.
12.3 The Contractor shall establish procedures pursuant to federal law to handle complaints of discrimination involving
services or benefits through this contract. These procedures shall include notifying clients, employees, and
participants of the right to file a complaint with the appropriate federal or state entity.
12.4 If this contract contains federal funds, these assurances are a condition of continued receipt of or benefit from
federal financial assistance, and are binding upon the Contractor, its successors, transferees, and assignees for the
period during which such assistance is provided. The Contractor further assures that all Subcontractors,
Vendors, or others with whom it arranges to provide services or benefits to participants or employees in
connection with any of its programs and activities are not discriminating against those participants or
employees in violation of the any statutes, regulations, guidelines, and standards. In the event of failure to
comply, the Contractor understands that the Agency may, at its discretion, seek a court order requiring
compliance with the terms of this assurance or seek other appropriate judicial or administrative relief including
but not limited to, termination of the contract and denial of further assistance.
13. Monitoringby the Agency:
The Contractor shall permit persons duly authorized by the Agency to inspect and copy any records, papers,
documents, facilities, goods, and services of the Contractor which are relevant to this contract, and to interview any
clients, employees, and Subcontractor employees of the Contractor to assure the Agency of the satisfactory
performance of the terms and conditions of this contract. Following such review, the Agency will provide a written
report of its findings to the Contractor and, where appropriate, the Contractor shall develop a Corrective Action Plan
(CAP). The Contactor hereby agrees to correct all deficiencies identified in the CAP in a timely manner as determined
by the Agency's Contract Manager.
14. Provision of Services:
The Contractor shall provide services in the manner described in Attachment I.
July 2019 — June 2020 HCE 203.19
15. Coordinated Monitoring with Other Agencies:
If the Contractor receives funding from one or more State of Florida human service agencies, in addition to the
Agency, then a joint monitoring visit including such other agencies may be scheduled. For the purposes of this
contract, and pursuant to Section 287.0575, F.S., as amended, Florida's human service agencies shall include the
Department of Children and Families, the Department of Health, the Agency for Persons with Disabilities, the
Department of Veterans Affairs, and the Department of Elder Affairs. Upon notification and the subsequent
scheduling of such a visit by the designated agency's lead administrative coordinator, the Contractor shall comply and
cooperate with all monitors, inspectors, and/or investigators.
16. Indemnification:
The Contractor shall indemnify, save, defend, and hold harmless the Agency and its agents and employees from
any and all claims, demands, actions, and causes of action of whatever nature or character arising out of, or by reason
of, the execution of this contract or performance of the services provided for herein. It is understood and agreed
that the Contactor is not required to indemnify the Agency for claims, demands, actions, or causes of action arising
solely out of the negligence of the Agency.
16.1 Except to the extent permitted by Section 768.28, F.S., or other Florida law, this section 16 is not applicable to
contacts executed between the Agency and state agencies or subdivisions defined in Section 768.28(2), F.S.
17. Insurance and Bonding:
17.1 The Contractor shall provide continuous adequate liability insurance coverage during the existence of this
contract and any renewal(s) and extension(s) of it. By execution of this contact, unless it is a state agency or
subdivision as defined by Section 768.28(2), F.S., the Contactor accepts full responsibility for identifying and
determining the type(s) and extent of liability insurance necessary to provide reasonable financial protections
for the Contactor and the clients to be served under this contact. The limits of coverage under each policy
maintained by the Contactor do not limit the Contractor's liability and obligations under this contact. The
Contractor shall ensure that the Agency has the most current written verification of insurance coverage
throughout the term of this contact. 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 contact.
17.2 Throughout the term of this contact, the Contractor shall maintain an insurance bond from a responsible
commercial insurance company covering all officers, directors, employees and agents of the Contractor
authorized to handle funds received or disbursed under all agreements and/or contracts incorporating this
contract by reference in an amount commensurate with the funds handled, the degree of risk as determined by
the insurance company and consistent with good business practices.
18. Confidentiality of Information:
The Contractor shall not use or disclose any information concerning a recipient of services under this contact 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.
19. Health Insurance Porlabilityand Accountability Act:
Where applicable, the Contactor shall comply with the Health Insurance Portability and Accountability Act (42 USC
1320d.), as well as all regulations promulgated thereunder (45 CFR Parts 160, 162, and 164).
20. Incident Reporting:
20.1 The Contactor shall notify the Agency immediately but no later than forty-eight (48) hours from the
Contractor's awareness or discovery of conditions that may materially affect the Contactors or subcontractors
ability to perform the services required to be performed under this contact. Such notice shall be made orally to
the Agency's Contact Manager (by telephone) with an email to immediately follow.
9�6 0
July 2019 —June 2020 HCE 203.19
20.2 The Contractor shall immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of
a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone number
(1-800-96ABUSE). As required by Chapters 39 and 415, F.S., this provision is binding upon the Contractor,
subcontractors, and their employees.
21. Banhrujily Notification:
During the term of this contract, the Contractor shall immediately notify the Area Agency on Aging for Southwest
Florida, Inc. if the Contractor, its assignees, subcontractors or affiliates file a claim for bankruptcy. Within ten (10)
days after notification, the Contractor must also provide the following information to the Area Agency on Aging for
Southwest Florida, Inc.: (1) the date of filing of the bankruptcy petition; (2) the case number; (3) the court name and
the division in which the petition was filed (e.g., Middle District of Florida, Fort Myers, Florida); and (4) the name,
address, and telephone number of the bankruptcy attorney.
22. Snonsorshill and Publicity:
22.1 As required by Section 286.25, F.S., if the Contractor is a non-governmental organization which sponsors a
program financed wholly or in part by state funds, including any funds obtained through this contract, it shall,
in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by (Contractor's
name) and the Area Agency on Aging for Southwest Florida, Inc. and/or State of Florida, Department of Elder
Affairs." If the sponsorship reference is in written material, the words "Area Agency on Aging for Southwest
Florida, Inc. and/or State of Florida, Department of Elder Affairs" shall appear in at least the same size letters or
type as the name of the organization.
22.2 The Contractor shall not use the words "Area Agency on Aging for Southwest Florida, Inc. and/or State of
Florida, Department of Elder Affairs" to indicate sponsorship of a program otherwise financed, unless specific
authorization has been obtained by the Agency and/or Department prior to use.
23. Assignments:
23.1 The Contractor shall not assign the rights and responsibilities under this contract without the prior written
approval of the Agency. Any sublicense, assignment, or transfer otherwise occurring without prior written
approval of the Agency shall constitute a material breach of the contract. In the event the State of Florida
and/or the Area Agency on Aging for Southwest Florida, Inc. approves assignment of the Contractor's
obligations, the Contractor remains responsible for all work performed and all expenses incurred in connection
with this contract.
23.2 This contract shall remain binding upon the successors in interest of either the Contractor or the Agency
24. Subcontracts:
24.1 The Contractor is responsible for all work performed and for all commodities produced pursuant to this contract,
whether actually furnished by the Contractor or its Subcontractors. Any subcontracts shall be evidenced by a
written document and subject to any conditions of approval the Agency deems necessary. The Contractor
further agrees that the Agency will not be liable to the Subcontractor in any way or for any reason. The
Contractor, at its expense, shall defend the Agency against any such claims.
24.2 The Contractor shall promptly pay any Subcontractors upon receipt of payment from the Agency or other
state agency. Failure to make payments to any Subcontractor in accordance with Section 287.0585, F.S., unless
otherwise stated in the contract between the Contractor and Subcontractor, will result in a penalty as provided by
statute.
25. Independent Callacity of Contractor:
It is the intent and understanding of the Parties that the Contractor, and any of its Subcontractors, are independent
Contractors and are not employees of the Agency, and that they shall not hold themselves out as employees or agents
of the Agency without prior specific authorization from the Agency. It is the further intent and understanding of the
Parties that the Agency does not control the employment practices of the Contractor and will not be liable for any
wage and hour, employment discrimination, or other labor and employment claims against the Contractor or its
Subcontractors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment
compensation funds, and all necessary insurance for the Contractor are the sole responsibility of the Contractor.
July 2019 — June 2020
26. Payment:
HCE 203.19
Payments shall be made to the Contractor for all completed and approved deliverables (units of service) as defined in
Attachment I. The Agency Contract Manager will have final approval of the Contractor's invoice submitted for
payment and will approve the invoice for payment only if the Contractor has met all terms and conditions of the
contract, unless the bid specifications, purchase order, or this contract specify otherwise. The approved invoice will
be submitted to the Agency's finance section for budgetary approval and processing. Disputes arising over
invoicing and payments will be resolved in accordance with the provisions of Section 215.422, F.S. A Vendor
Ombudsman has been established within the Florida Department of Financial Services and may be contacted at 800-
342-2762.
27. Return of Funds:
The Contractor shall return to the Agency any overpayments due to unearned funds or funds disallowed, and any
interest attributable to such funds pursuant to the terms and conditions of this contract, that were disbursed to the
Contractor by the Agency. In the event that the Contractor or its independent auditor discovers that an overpayment
has been made, the Contractor shall repay said overpayment immediately without prior notification from the
Agency. In the event that the Agency first discovers an overpayment has been made, the Agency Contract
Manager will notify the Contractor in writing of such findings. Should repayment not be made forthwith, the
Contractor shall be charged at the lawful rate of interest on the outstanding balance pursuant to Section 55.03,
F.S., after Agency notification or Contractor discovery.
28. Data Integrity and Safeguarding Information:
The Contractor shall ensure an appropriate level of data security for the information the Contractor is collecting or using
in the performance of this contract. An appropriate level of security includes approving and tracking all Contractor
employees that request system or information access and ensuring that user access has been removed from all terminated
employees. The Contractor, among other requirements, must anticipate and prepare for the loss of information
processing capabilities. All data and software shall be routinely backed up to ensure recovery from losses or outages
of the computer system. The security over the backed -up data is to be as stringent as the protection required of the
primary systems. The Contractor shall ensure all Subcontractors maintain written procedures for computer system
backup and recovery. The Contractor shall complete and sign the Certification Regarding Data Integrity Compliance
for Agreements, Grants, Loans, and Cooperative Agreements prior to the execution of this contract.
29. Computer Use and Social Media Policy:
The Department has implemented a Social Media Policy, in addition to its Computer Use Policy, which applies to all
employees, contracted employees, consultants, Other Personal Services (OPS) employees and volunteers, including
all personnel affiliated with third parties, such as, but not limited to, contractors and subcontractors. Any entity
that uses the Department's computer resource systems must comply with the Department's policy regarding social
media. Social Media includes, but is not limited to, blogs, podcasts, discussion forums, Wikis, RSS feeds, video
sharing, social networks like MySpace, Facebook and Twitter, as well as content sharing networks such as flickr and
YouTube. This policy is available on the Department's website at: littp://elderaffairs.state.R.us/doca/fitiancial.plip.
30. Conflict of Interest:
The Contractor shall establish safeguards to prohibit employees, board members, management, and Subcontractors
from using their positions for a purpose that constitutes or presents the appearance of personal or organizational
conflict of interest or personal gain. No employee, officer, or agent of the Contractor or Subcontractor shall
participate in the selection or in the award of a contract supported by state or federal funds if a conflict of interest, real
or apparent, would be involved. Such a conflict would arise when: (a) the employee, officer or agent; (b) any member
of his/her immediate family; (c) his or her partner; or (d) an organization which employs, or is about to employ,
any of the above individuals, has a financial or other interest in the firm being selected for award. The
Contractor's or Subcontractor's officers, employees, or agents will neither solicit nor accept gratuities, favors, or
anything of monetary value from Contractors, potential Contractors, or parties to Subcontracts. The Contractor's
8 C
July 2019 — June 2020 HCE 203.19
board members and management must disclose to the Agency any relationship which may be, or may be perceived
to be, a conflict of interest within thirty (30) calendar days of an individual's original appointment or placement in that
position, or, if the individual is serving as an incumbent, within thirty (30) calendar days of the commencement of this
contract. The Contractor's employees and Subcontractors must make the same disclosures described above to the
Contractor's board of directors. Compliance with this provision will be monitored.
31. Public Entity Crime:
Pursuant to Section 287.133, F.S., a person or affiliate who has been placed on the Convicted Vendor List following a
conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods or
services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the construction
or repair of a public building or public work; may not submit bids, proposals, or replies on leases of real property to a
public entity; may not be awarded or perform work as a Contractor, Supplier, Subcontractor, or Consultant under a
contract with any public entity; and may not transact business with any public entity in excess of the threshold amount
provided in Section 287.017, F.S., for CATEGORY TWO for a period of thirty six (36) months following the date of
being placed on the Convicted Vendor List.
32. Purchasing:
32.1 The Contractor may purchase articles which are the subject of, or are required to cavy 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 Sections 946.515(2) and (4), F.S. For purposes
of this contract, the Contactor 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 at 800-643-8459.
32.2 The Contractor may procure any recycled products or materials which are the subject of or are required to carry
out this contact in accordance with the provisions of Section 403.7065, F.S.
32.3 The Contractor may purchase articles that are the subject of or are required to carry out this contract
from a nonprofit agency for the Blind or for the Severely Handicapped that is qualified pursuant to Chapter
413, F.S., in the same manner and under the same procedures set forth in Sections 413.036(1) and (2), F.S. For
purposes of this contract, the Contactor shall be deemed to be substituted for the Agency insofar as dealings
with such qualified nonprofit agency are concerned. Additional information about the designated nonprofit
agency and the products it offers is available at http://www.respectofflorida.org. This clause is not
applicable to Subcontractors unless otherwise required by law.
33. Patents, Copyrights, Royalties:
If this contact is awarded state funding and if any discovery, invention, or copyrightable material is developed or
produced in the course of or as a result of work or services performed under this contact or in any way connected with
this contact, or if ownership of any discovery, invention, or copyrightable material was purchased in the course of or as
a result of work or services performed under this contact, the Contractor shall refer the discovery, invention, or
copyrightable material to the Agency to be referred to the Agency and/or Department of State. Any and all patent rights
or copyrights accruing under this contact are hereby reserved to the State of Florida in accordance with Chapter 286,
F.S. Pursuant to Section 287.0571(5)(k), F.S., as amended, the only exceptions to this provision shall be those that are
clearly expressed and reasonably valued in this contact.
33.1 If the primary purpose of this contact is the creation of intellectual property, the State of Florida shall retain an
unencumbered right to use such property, notwithstanding any agreement made pursuant to this Section 34.
33.2 If this contract is awarded solely federal funding, the terms and conditions are governed by 2 CFR § 200.315
or 45 CFR § 75.322, as applicable.
33.3 Notwithstanding the foregoing provisions, if the Contractor or one of its Subcontractors is a university and a
member of the State University System of Florida, then Section 1004.23, F.S., shall apply, but the Agency
shall retain a perpetual, fully -paid, nonexclusive license for its use and the use of its Contractors, Subcontractors
or Assignees of any resulting patented, copyrighted, or trademarked work products.
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July 2019 — June 2020
34. Emergency Preparedness and Continuity of Operations:
HCE 203.19
34.1 If the tasks to be performed pursuant to this contract include the physical care and control of clients, or the
administration and coordination of services necessary for client health, safety, or welfare, the Contractor shall,
within thirty (30) calendar days of the execution of this contract, submit to the Agency Contract Manager,
verification of an Emergency Preparedness Plan. In the event of an emergency, the Contractor shall notify the
Agency of emergency provisions.
34.2 In the event a situation results in a cessation of services by a Subcontractor, the Contractor shall remain
responsible for performance under this contract and must follow procedures to ensure continuity of operations
without interruption.
35. Equipment:
35.1 Equipment means: (a) tangible personal property (including information technology systems) having a useful life
of more than one year and a per-unit acquisition cost which equals or exceeds the lesser of the capitalization level
established by the organization for the financial statement purposes, or $5,000.00 [for federal fimds - 2 CFR
§ 200.33 and 45 CFR § 75.2, as applicable], or (b); nonexpendable, tangible personal property of a
non- consumable nature with an acquisition cost of $1,000.00 or more per unit, and expected useful life of at
least one
(1) year; and hardback bound books not circulated to students or the general public, with a value or cost of
$250.00 or more [for state funds].
35.2 Contractors and Subcontractors who are Institutions of Higher Education, Hospitals, and Other Non -Profit
Organizations shall have written property management standards in compliance with 2 CFR Part 200
Administrative Requirements (formerly OMB Circular A-110) that include: (a) a property list with all the
elements identified in the circular; (b) a procedure for conducting a physical inventory of equipment at least once
every two (2) years; (c) a control system to insure adequate safeguards to prevent loss, damage, or theft of the
equipment; and (d) maintenance procedures to keep the equipment in good condition. The property records must
be maintained on file and shall be provided to the Agency upon request. The Contractor shall promptly
investigate, fully document, and notify the Agency Contract Manager of any loss, damage, or theft of
equipment. The Contractor shall provide the results of the investigation to the Agency Contract Manager.
35.3 The Contractor's property management standards for equipment (including replacement equipment), whether
acquired in whole or in part with federal funds and federally -owned equipment shall, at a minimum, meet the
following requirements and shall include accurately maintained equipment records with the following
information:
35.3.1 Property records must be maintained that include a description of the equipment;
35.3.2 Manufacturer's serial number, model number, federal stock number, national stock number, or other
identification number;
35.3.3 Source of funding for the equipment, including the federal award identification number;
35.3.4 Whether title vests in the Contractor or the federal government;
35.3.5 Acquisition date (or date received, if the equipment was furnished by the federal government);
35.3.6 Information from which one can calculate the percentage of federal participation in the cost of the
equipment (not applicable to equipment furnished by the federal government);
35.3.7 Location, use and condition of the equipment and the date the information was reported;
35.3.8 Unit acquisition cost; and
35.3.9 Ultimate disposition data, including date of disposal and sales price or the method used to determine
current fair market value where a Contactor compensates the federal awarding agency for its share.
35.3.10 A physical inventory must be taken and the results reconciled with the property records at least once
every two (2) years.
35.3.11 A control system must be developed to ensure adequate safeguards to prevent loss, damage, or theft of
the property. Any loss, damage, or theft must be investigated. 45 CFR § 75.320(d)(3).
10 0
July 2019 — June 2020
HCE 203.19
35.3.12 Adequate maintenance procedures must be developed to keep the property in good condition.
35.3.13 If the Contractor is authorized or required to sell the equipment, proper sales procedures must be
established to ensure the highest possible return.
35.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased with
state funds with an acquisition cost over $1,000.00 is part of the cost of canynng out the activities and functions
of the grant awards and title (ownership) will vest in the Contractor [for federal funds see 2 CFR § 200.313(a)
and 45 CFR § 75.320(a), as applicable], subject to the conditions of 2 CFR Part 200 and/or 45 CFR Part 75.
Equipment purchased under these thresholds is considered supplies and is not subject to property standards.
Equipment purchased with funds identified in the budget attachments to agreements covered by this contract or
identified in the sub -agreements with Subcontractors (not included in a cost methodology), is subject to the
conditions of Chapter 273, F. S., and 60A-1.017, F. A. C., and 2 CFR Part 200 and/or 45 CFR Part 75.
35.5 The Contractor shall not dispose of any equipment or materials provided by the Agency or purchased with
funds provided through this contract without fust obtaining the approval of the Agency Contract Manager.
When disposing of property or equipment the Contractor must submit a written request for disposition
instructions to the Agency's Contract Manager. The request should include a brief description of the
property, purchase price, funding source, and percentage of state or federal participation, acquisition date and
condition of the property. The request should also indicate the Contractor's proposed disposition of the
property (i.e., transfer or donation to another agency that administers federal programs, offer of the items for
sale, destroy the items, etc.).
35.6 The Agency Contract Manager will issue disposition instructions. If disposition instructions are not
received within one hundred twenty (120) days of the written request for disposition, the Contractor is authorized
to proceed as directed in 2 CFR § 200.313 or 45 CFR § 75.320, as applicable.
35.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto, but
excludes movable machinery and equipment. Real property may not be purchased with state or federal funds
through agreements covered under this contract without the prior approval of the Agency. Real property
purchases from Older Americans Act funds are subject to the provisions of Title 42, Chapter 35, Subchapter III,
Part A., Section 3030b United States Code (U.S.C.). Real property purchases from state funds can only be
made through fixed capital outlay grants and aids appropriations and therefore are subject to the provisions of
Section 216.348, F.S.
35.8 Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted and tested prior
to disposal to ensure no confidential information remains.
35.9 The Contractor must adhere to the Agency's procedures and standards when purchasing Information
Technology Resources (ITR) as part of any agreement(s) incorporating this contract by reference. An ITR
worksheet is required for any computer related item costing $1,000.00 or more, including data processing
hardware, software, services, supplies, maintenance, training, personnel, and facilities. The completed ITR
worksheet shall be maintained in the LAN administrator's file and must be provided to the Agency upon
request. The Contractor has the responsibility to require any Subcontractors to comply with the Agency's ITR
procedures.
36. PUR 1000 Form:
The PUR 1000 Form is hereby incorporated by reference and available at:
littp://www.myflorida.com/apps/vbs/adoc/F7740 PUR1000 pdf
In the event of any conflict between the PUR 1000 Form and any terms or conditions of this contract, the terms or
conditions of this contract shall take precedence over the PUR 1000 Form. However, if the conflicting terms or
conditions in the PUR 1000 Form are required by any section of the Florida Statutes, the terms or conditions contained
in the PUR 1000 Form shall take precedence.
37. Use of State Funds to Purehase or Improve Real Property:
11 6'D
July 2019 — June 2020 HCE 203.19
Any state funds provided for the purchase of or improvements to real property are contingent upon the Contractor or
political subdivision granting to the state a security interest in the property at least to the amount of state funds provided
for at least five (5) years from the date of purchase or the completion of the improvements or as farther required by law.
38. Dispute Resolution:
Any dispute concerning performance of the contract shall be decided by the Agency Contract Manager, who shall
reduce the decision to writing and serve a copy on the Contractor.
39. Financial Consequences:
If the Contractor fails to meet the minimum level of service or performance identified in this contract, the Agency
shall impose financial consequences as stated in Attachment I.
40. No Waiver of Sovereign Immunity:
Nothing contained in this contract is intended to serve as a waiver of sovereign immunity by any entity to which
sovereign immunity may be applicable.
41. Venue:
If any dispute arises out of this contract, the venue of such legal recourse shall be Lee County, Florida.
42. Entire Contract:
This contract contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations
shall be valid or binding upon the Agency or the Contractor unless expressly contained herein or by a written
amendment to this contract signed by both Parties.
43. Force Majeure:
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control,
provided the party experiencing the force majeure condition provides immediate written notification to the other party
and takes all reasonable efforts to cure the condition.
44. Severability Clause:
The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or unenforceable, the
other provisions are severable to that void provision and shall remain in full force and effect.
45. Condition Precedent to Contract Appropriations:
The Parties agree that the Agency's performance and obligation to pay under this contract are contingent upon an
annual appropriation by the Legislature.
46. Addition/Deletion:
The Parties agree that the Agency reserves the right to add or to delete any of the services required under this
contract when deemed to be in the State of Florida's best interest and reduced to a written amendment signed by both
Parties. The Parties shall negotiate compensation for any additional services added.
47. Waiver:
The delay or failure by the Agency to exercise or enforce any of its rights under this contract will not constitute or be
deemed a waiver of the Agency's right thereafter to enforce those rights, nor will any single or partial exercise of any
such right preclude any other or further exercise thereof or the exercise of any other right.
48. Compliance:
The Contractor shall abide by all applicable current federal statutes, laws, rules, and regulations as well as applicable
current state statutes, laws, rules and regulations. The Parties agree that failure of the Contractor to abide by these laws
shall be deemed an event of default of the Contractor and subject the contract to immediate unilateral cancellation of
the contract at the discretion of the Agency.
12 O
July 2019 — June 2020
49. Final Invoice:
HCE 203.19
The Contractor shall submit the final invoice for payment to the Agency no later than thirty (30) days after the
contract ending date unless otherwise specified in Attachment I. If the Contractor fails to do so, all right to payment is
forfeited and the Agency shall not honor any requests submitted after the aforesaid time period. Any payment due
under the terms of this contract shall be withheld until all required documentation and reports due from the Contractor
and necessary adjustments thereto have been approved by the Agency.
50. Renegotiations of Modifications:
Modifications of the provisions of this contract shall be valid only when they have been reduced to writing and duly
signed by both parties. The rate of payment and the total dollar amount may be adjusted retroactively to reflect price
level increases and changes in the rate of payment when these have been established through the appropriations process
and subsequently identified in the Agency's operating budget.
51. Suspension of Work:
The Agency may, in its sole discretion, suspend any or all activities under the contract or purchase order, at any time,
when in the best interest of the State to do so. The Agency shall provide the Contractor written notice outlining the
particulars of suspension. Examples of the reason for suspension include, but are not limited to, budgetary
constraints, declaration of emergency, or other such circumstances. After receiving a suspension notice, the Contractor
shall comply with the notice and shall not accept any purchase orders. Within ninety (90) days, or any longer period
agreed to by the Contractor, the Agency shall either: (1) issue a notice authorizing resumption of work, at which
time activity shall resume, or (2) terminate the contract or purchase order. Suspension of work shall not entitle the
Contractor to any additional compensation.
52. Termination:
52.1 Termination for Convenience. The Agency, by written notice to the Contractor, may terminate this contract in
whole or in part when the Agency determines in its sole discretion that it is in the State's interest to do so. The
Contractor shall not furnish any product after it receives the notice of termination, except as necessary to
complete the continued portion of this contract, if any. The Contractor shall not be entitled to recover any
cancellation charges or lost profits.
52.2 Termination for Cause. The Agency may terminate this contract if the Contractor fails to (1) deliver the
product within the time specified in the contract or any extension, (2) maintain adequate progress, thus
endangering performance of the contract, (3) honor any term of the contract, or (4) abide by any statutory,
regulatory, or licensing requirement. Rule 60A-1.006(3), F.A.C., governs the procedure and consequences of
default. The Contractor shall continue work on any work not terminated. Except for defaults of Subcontractors
at any tier, the Contractor shall not be liable for any excess costs if the failure to perform the contract arises fi-om
events completely beyond the control, and without the fault or negligence, of the Contractor. If the failure to
perform is caused by the default of a Subcontractor at any tier, and if the cause of the default is completely beyond
the control of both the Contractor and the Subcontractor, and without the fault or negligence of either, the
Contractor shall not be liable for any excess costs for failure to perform, unless the subcontracted products were
obtainable from other sources in sufficient time for the Contractor to meet the required delivery schedule. If, after
termination, it is determined that the Contractor was not in default, or that the default was excusable, the rights
and obligations of the Parties shall be the same as if the termination had been issued for the convenience of the
Agency. The rights and remedies of the Agency in this clause are in addition to any other rights and
remedies provided by law or under the contract.
53. Electronic Records and Signature:
The Agency authorizes, but does not require, the Contractor to create and retain electronic records and to use
electronic signatures to conduct transactions necessary to carry out the terms of this contract. A Contractor that creates
and retains electronic records and uses electronic signatures to conduct transactions shall comply with the requirements
contained in the'Uniform Electronic Transaction Act, Section 668.50, F.S. All electronic records must be fully
auditable; are subject to Florida's Public Records Law, Chapter 119, F.S.; must comply with contract Section 29, Data
Integrity and Safeguarding Information; must maintain all confidentiality, as applicable; and must be retained and
13
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July 2019 —June 2020
ACE 203.19
maintained by the Contractor to the same extent as non -electronic records are retained and maintained as required by
this contract.
53.1 The Agency's authorization pursuant to this section does not authorize electronic transactions between the
Contractor and the Agency. The Contractor is authorized to conduct electronic transactions with the
Agency only upon further written consent by the Agency.
53.2 Upon request by the Agency, the Contractor shall provide the Agency with non -electronic (paper) copies of
records. Non -electronic (paper) copies provided to the Agency of any document that was originally in
electronic form with an electronic signature must identify the person and the person's capacity who electronically
signed the document on any non -electronic copy of the document.
54. Contract Manager:
The Agency may substitute any Agency employee to serve as the Agency Contract Manager.
REMAINDER OF THE PAGE INTENTIONALL Y LEFT BLANK
14
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July 2019 — June 2020 HCE 203.19
55. Official Payee and Representatives (Names. Addresses. and Telephone Numhersl:
56. All Terms and Conditions Included:
This contract and its Attachments, I — XIV including any exhibits referenced in said attachments, together with any
documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There are no
provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all previous
communications, representations, or agreements, either written or verbal, between the Parties.
By signing this contract, the Parties agree that they have read and agree to the entire contract.
IN WITNESS WHEREOF, the Parties hereto have caused this contract to be executed by their undersigned
officials as duly authorized.
CONTRACTOR: COLLIER COUNTY BOARD AREA AGENCY ON AGING FOR
OF COUNTY COMMISSIONERS SOUTHWEST FLORIDA, INC. �3
SIGNED BY: t s t�t i Jam,_ SIGNED BY:
NAME: Stephen Y Carnell NAME: MARIANNE G LORINI
TITLE: Public Service Deoartnent Head TITLE: PRESIDENT/CEO
DATE:! 6 % 1 DATE:
Federal Tax ID: 59-6000588 Approved as to form Pq legality
Fiscal Year Ending Date: 09/30 4Asfiistant
DUNS: 07699779015 Cou ty At or 'y n,t Ct Y
0
The Contractor name, as shown on page 1 of this
Collier County Board of County Commissioners
3339 E Tamiami Trail, Building H
a.
contract, and mailing address of the official payee to
Naples, FL 34112
whom the payment shall be made is:
The name of the contact person and street address
Kristi Sonntag, Director
Collier County Board of County Commissioners
b.
where financial and administrative records are
%Community and Human Services
maintained is:
3339 E Tamiami Trail, Building H
Naples, FL 34112
Kristi Sonntag, Director
The name, address, and telephone number of the
Collier County Board of County Commissioners
c'
representative of the Contractor responsible for
%Community and Human Services
administration of the program under this contract is:
3339 E Tamiami Trail, Building H
Naples, FL 34112
(239)252-2273
Area Agency on Aging for Southwest Florida, Inc.
d
The section and location within the Agency where
15201North Cleveland Avenue, Suite 1100
Requests for Payment and Receipt and Expenditure
North Fort Myers, FL 33903
forms are to be mailed is:
Becky MacKenzie, Director of Program & Planning
e.
The name, address, and telephone number of the
Area Agency on Aging for Southwest Florida, Inc.
Contract Manager for this contract is:
15201 North Cleveland Avenue, Suite 1100 North
Fort Myers, FL 33903
239-652-6900
Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided in writing
to the other party.
56. All Terms and Conditions Included:
This contract and its Attachments, I — XIV including any exhibits referenced in said attachments, together with any
documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There are no
provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all previous
communications, representations, or agreements, either written or verbal, between the Parties.
By signing this contract, the Parties agree that they have read and agree to the entire contract.
IN WITNESS WHEREOF, the Parties hereto have caused this contract to be executed by their undersigned
officials as duly authorized.
CONTRACTOR: COLLIER COUNTY BOARD AREA AGENCY ON AGING FOR
OF COUNTY COMMISSIONERS SOUTHWEST FLORIDA, INC. �3
SIGNED BY: t s t�t i Jam,_ SIGNED BY:
NAME: Stephen Y Carnell NAME: MARIANNE G LORINI
TITLE: Public Service Deoartnent Head TITLE: PRESIDENT/CEO
DATE:! 6 % 1 DATE:
Federal Tax ID: 59-6000588 Approved as to form Pq legality
Fiscal Year Ending Date: 09/30 4Asfiistant
DUNS: 07699779015 Cou ty At or 'y n,t Ct Y
0
July 2019 — June 2020
INDEX OF ATTACHMENTS
F.'"MiUNWIk atel
HCE 203.19
STATEMENTOF WORK................................................................................................................................ 17
FAWY:CNSirfogolll
FINANCIAL AND COMPLIANCE AUDIT...................................................................................................
31
ATTACHMENT III
CERTIFICATIONS AND ASSURANCES......................................................................................................
37
ATTACHMENT IV
ASSURANCES—NON-CONSTRUCTION PROGRAMS.............................................................................
42
ATTACHMENT V
FLORIDA DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST ............
44
ATTACHMENT VII
BACKGROUND SCREENING.......................................................................................................................48
ATTACHMENT IX
ANNUALBUDGET SUMMARY...................................................................................................................
49
ATTACHMENT X
INVOICEREPORT SCHEDULE....................................................................................................................
50
ATTACHMENT XI
REQUESTFOR PAYMENT............................................................................................................................
51
ATTACHMENT XII
RECEIPT AND EXPENDITURE REPORT....................................................................................................
52
ATTACHMENT XIV
SERVICERATE REPORT..............................................................................................................................
53
16
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July 2019 — June 2020
ATTACHMENT
STATEMENT OF WORK-
i.
ORD
i. SERVICES TO BE PROVIDED
A. Definitions of Terms
1. Acronyms
Activities of Daily Living (ADLs)
Area Agency on Aging (AAA)
Access Priority Consumer List (APCL)
Adult Protective Services (APS)
Code of Federal Regulations (CFR)
Corrective Action Plan (CAP)
Community Care for Disabled Adults (CCDA)
Community Care for the Elderly (CCE)
Client Information and Registration Tracking System (CIRTS)
Department of Children and Families (DCF)
Florida Administrative Code (F.A.C.)
Florida Department of Elder Affairs (DOEA or Department)
Florida Statutes (F.S.)
Home Care for Disabled Adults (HCDA)
Home Care for the Elderly (HCE)
Institutional Care Program (ICP)
Instrumental Activities of Daily Living (IADLs)
Notice of Instruction (NOI)
Planning and Service Area (PSA)
Summary of Programs and Services (SOPS)
United States Code (U.S.C.)
2. Program -Specific Terms
HCE 203.19
Aging Out: The condition of reaching sixty (60) years of age and being transitioned from DCF's CCDA
or HCDA services to the Agency's community-based services.
Area Plan: A plan developed by the Agency outlining a comprehensive and coordinated service delivery
system in its PSA in accordance with the Section 306 of the Older Americans Act (42 U.S.C. § 3026) and
Department instructions. The Area Plan includes performance measures and unit rates per service offered per
county.
Area Plan Update: A revision to the Area Plan wherein the Agency enters HCE-specific data in CIRTS.
An update may also include other revisions to the Area Plan as instructed by the Agency and/or Department.
Department of Elder Affairs Programs and Services Handbook (DOER Handbook): An official document
of DOEA. The DOEA Handbook includes program policies, procedures, and standards applicable to
agencies which are recipients/providers of DOEA-funded programs. An annual update is provided through a
NOI. c
17 Qo )
July 2019 — June 2020
HCE 203.19
Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to
remain independent and in the least restrictive living arrangement.
NOI: The Department's established method to communicate to the Agency, Contractor, and Subcontractor
the requirement to perform a specific task or activity in a particular manner. NOIs are located on the
Department's website at littp:Helderaffairs.state.fl.us/doea/nois.plip.
Program Highlights: Success stories, quotes, testimonials, or human -interest vignettes that are used in the
SOPS to demonstrate how programs and services help elders, families, and caregivers.
Summary of Programs and Services (SOPS): A document produced by the Department and updated yearly
to provide the public and the Legislature with information about programs and services for Florida's elders.
B. GENERAL DESCRIPTION
1. General Statement
The purpose of the HCE Program is to encourage the provision of care for elders in family -type living
arrangements in private homes as an alternative to nursing homes or other institutional care settings.
2. Home Care for the Elderly Program Mission Statement
The HCE Program assists caregivers of three (3) or fewer elders, living in private homes, through the provision
of a basic subsidy for maintenance and supervision, as well as other necessary specialized services.
3. Authority
The relevant authority governing the HCE Program includes:
a. Sections 430.601-430.606 and 430.608, F.S.;
b. Rule Chapter 58H-1, F.A.C.;
c. The Catalog of State Financial Assistance (CSFA) Number 65001.
4. Scope of Service
The Contractor is responsible for the programmatic, fiscal, and operational management of the HCE Program.
The program services shall be provided in a manner consistent with the Agency's current Area Plan, as
updated, and the current DOEA Handbook, which are incorporated by reference. The Contactor agrees to be
bound by all subsequent amendments and revisions to the DOEA Handbook, and the Contractor agrees to accept
all such amendments and revisions via a NOI.
5. Major Program Goals
The major goals of the HCE Program are to ensure that:
a. A basic subsidy is provided to the caregiver of each client; and
b. A special subsidy is provided when essential to the well-being of the client.
C. Clients to be Served
1. General Description
The HCE Program serves elders age sixty (60) and older at risk of placement in a nursing home or other
institutional setting who can remain in a family -style setting with a caregiver through the provision of subsidies.
18
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July 2019 — June 2020
2. Client Eligibility
HCE 203.19
Clients eligible to receive services under this contract must meet the following requirements in accordance with
Rule 5811-1.005, F.A.C.:
a. Be sixty (60) years of age or older;
It. Be a current resident of the State of Florida with the intent to remain in the state; and
c. Meet the criteria for functional and financial eligibility set forth below:
i. Be at risk of nursing home placement; based on DOEA 70113 assessment;
ii. Have self -declared income and assets which do not exceed the ICP limits established by Medicaid and
DCF, or;
iii. Receive Supplemental Security Income (SSI), or;
iv. Receive benefits as a Qualified Medicare Beneficiary (OMB) or as a Special Low -Income Medicare
Beneficiary (SLMB); and
v. Have an approved caregiver who meets the caregiver requirements pursuant to Rule 58H-1.006, F.A.C.,
and the dwelling requirements pursuant to Rule 58-H-1.007, F.A.C.
3. Caregiver Eligibility
Caregivers eligible to receive services under this contract must:
a. Be at least eighteen (18) years of age;
It. Be capable of providing a family -type living environment for the home care client/recipient;
c. Be a relative, or a friend who has been accepted by the client as surrogate family, or a responsible adult .
with whom the client has made an arrangement to provide home care services;
d. Be willing to accept responsibility for the social, physical, and emotional needs of the home care client/
recipient;
e. Be physically present and live in the home to provide supervision and to assist in arrangement of services
for the client;
f. Maintain the residential dwelling free of conditions that pose an immediate threat to the life, safety, health
and well-being of the home care client in accordance with Rule 58H-1.007, F.A.C.; and
g. Be without record of conviction of abuse, neglect, or exploitation of another person.
4. Targeted Groups
Priority for services provided under this contract shall be given to those eligible persons assessed to be at risk
of placement in an institution.
11. MANNER OF SERVICE PROVISION
A. Service Taslo
To achieve the goals of the HCE Program, the Contractor shall perform, or ensure that its subcontractors perforin,
the following tasks:
1. Client Eligibility Determination
The Contractor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a
client is based on meeting the requirements described in Section I.C.2. and I.C.3.
2. Assessment and Prioritization of Set -vice Delivery for New Clients
The Contractor shall ensure the following criteria are used to prioritize new clients in the sequence below for
service delivery. It is not the intent of the Agency to remove existing clients from services to serve new
clients being assessed and prioritized for service delivery.
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July 2019 — June 2020 HCE 203.19
a. Imminent Risk individuals: Individuals in the community whose mental or physical health condition has
deteriorated to the degree that self-care is not possible, there is no capable caregiver, and nursing home
placement is likely within one (1) month or very likely within three (3) months.
b. Aging Out individuals: Individuals receiving CCDA and HCDA services through DCF's Adult
Services transitioning to community-based services provided through the Agency when DCF's services
are not currently available.
c. Service priority for individuals not included in a., c., and d. above, regardless of referral source, will be
determined through the Agency's functional assessment administered to each applicant, to the extent
funding is available. The Contractor shall ensure that priority is given to applicants at the higher levels of
frailty and risk of nursing home placement. For individuals assessed at the same priority and risk of nursing
home placement, priority will be given to applicants with the lesser ability to pay for services.
3. Program Services
The Contractor shall ensure the provision of program services is consistent with the Agency's current Area
Plan, as updated and approved by the DOEA, and the current DOEA Handbook.
B. Staffing Requirements
1. Staffing Levels
The Contractor shall assign its own administrative and support staff as needed to perform the tasks,
responsibilities, and duties under this contact and ensure that subcontractors dedicate adequate staff
accordingly.
2. Professional Qualifications
The Contactor shall ensure that the staff responsible for performing any duties or functions within this contact
have the qualifications as specified in the current DOEA Handbook.
3. Service Times
The Contactor shall ensure the availability of services listed in this contract at times appropriate to meet client
service needs including, at a minimum during normal business hours. Normal business hours are defined as
Monday through Friday, 8:00 a.m. to 5:00 p.m. local time.
4. Use of Subcontractors
If this contact involves the use of a Subcontractor or third party, then the Contactor shall not delay the
implementation of its agreement with the Subcontractor. If any circumstance occurs that may result in a delay
for a period of sixty (60) days or more of the initiation of the subcontract or the performance of the
subcontractor, the Contractor shall notify the Agency Contract Manager and the Agency Chief Financial
Officer in writing of such delay. The Contractor shall not permit a Subcontractor to perform services
related to this agreement without having a binding Subcontractor agreement executed prior to the
Subcontractor's performance. The Agency will not be responsible or liable for any obligations or claims
resulting from such action.
a. Copies of Subcontract
The Contactor shall submit a copy of all subcontracts to the Agency's Contract Manager within thirty
(3 0) days of the subcontract being executed.
b. Monitoring the Performance of Subcontractors
The Contractor shall monitor, at least once per year, each of its Subcontractors, Subrecipients,
Vendors, and/or Consultants paid from funds provided under this contract. The Contactor shall
perform fiscal, administrative, and programmatic monitoring to ensure contractual compliance, fiscal
accountability, .programmatic performance, and compliance with applicable state and federal laws and
regulations. The Contractor shall monitor to ensure that the budget is met, the scope of work is
accomplished within the specified time periods, and all other performance goals stated in this contact are
achieved.
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July 2019 — June 2020 HCE 203.19
c. Copies of Subcontractor Monitoring Reports
The Contractor shall forward a copy of all subcontractor monitoring reports to the Agency's Contract
Manager within thirty (30) days of the report being issued to the subcontractors, subrecipients, vendors,
and/or consultants.
C. Deliverables
The following section provides the specific quantifiable units of deliverables and source documentation required to
evidence the completion of the tasks specified in this contract.
1. Delivery of Services to Eligible Clients
The Contractor shall ensure the provision of a continuum of services that meets the diverse needs of the
functionally impaired elders and their caregivers. The Contractor shall ensure that performance and
reporting of the following services are in accordance with the Agency's current Department -approved Area
Plan, the current DOEA Handbook, and Section II.A.1-3. of this contract. Documentation of service delivery
must include a report consisting of the following: number of clients served, number of service units provided
by service, and rate per service unit with calculations that equal the total invoice amount. The services
include the following categories:
a. Basic Subsidy
The Contractor shall ensure that the Basic Subsidy is a cash payment of at least $160.00 made to an
approved caregiver each month to reimburse expenses incurred in caring for the client, as detailed herein
and in the current DOEA Handbook. The Contractor shall further ensure that existing clients receiving a
subsidy greater than $160.00 as of October 24, 2018, continue to receive the higher subsidy as specified in
the SWCBS, issued February 22, 2019, and incorporated herein by reference. The Basic Subsidy is
provided for support and maintenance of the care client/recipient, including housing, food, clothing, and
medical costs not covered by Medicaid, Medicare or any other insurance. A Basic Subsidy shall be paid to
authorized caregivers when the client is in the home for any part of the month. Calculating the Basic
Subsidy
b. Special Subsidy Services
The Contractor shall ensure that the Special Subsidy payments are pre -authorized and are based on
additional specialized medical or health care services, supplies, or equipment needed to maintain the health
and well-being of the individual elder. The Special Subsidy for additional medical support and special
services is a cash payment to reimburse the costs of any other service or special care not covered by
Medicaid, Medicare, or private insurance when these services are determined to be essential to maintain
the well-being of the home care recipient. A Special Subsidy shall be paid to the authorized caregivers
when the client/recipient is in the home for any part of the month. Special Subsidy services may be
authorized through a subcontractor agreement. All Special Subsidy services must be performed in
accordance with the current DOEA Handbook. Special Subsidy services include the following:
1) Adult Day Care
2) Adult Day Health Care
3) Caregiver Training/Support
4) Chore
5) Chore (Enhanced)
6) Counseling (Gerontological)
7) Counseling (Mental Health/Screening)
8) Home Health Aide Service
9) Homemaker
10) Home Delivered Meals
11) Housing Improvement
12) Material Aid
13) Occupational Therapy
14) Other
15) Personal Care
16) Physical Therapy
17) Respite (Facility Based or In -Home)
18) Skilled Nursing Services
19) Specialized Medical Equipment, Services and
Supplies
20) Speech Therapy
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c. Access to, and Coordination of, Services
The Contractor shall ensure, through case management and case aide services, that the HCE client's needs
are documented, and needed services are planned, arranged, and coordinated for the client and caregiver.
2. Service Units
The Contractor shall ensure that the provision of services described in this contract is in accordance with the
current DOEA Handbook and the service tasks described in Section H.A. The Service Rate Report, lists the
services that can be performed, the highest reimbursement unit rate, the method of payment, and the service
unit type. Units of service will be paid pursuant to the rate established in the Agency's Area Plan as updated, as
shown in Service Rate Report, and approved by the Agency.
D. Reports
The Contractor shall respond within ten (10) business days, or within deadlines established by the Agency, to the
Agency's request for routine and/or special requests for information and ad hoc reports. The Contractor must
establish due dates for any subcontractors that permit the Contractor to meet the Agency's reporting
requirements.
1. CIRTS Reports
The Contractor shall input HCE-specific data into CIRTS. To ensure CIRTS data accuracy, the Contractor shall
use CIRTS-generated reports which include the following:
a. Client Reports;
b. Monitoring Reports;
c. Services Reports;
d. Miscellaneous Reports;
e. Fiscal Reports;
f. Aging and Disability Resource Center Reports; and
g. Outcome Measurement Reports.
2. Annual Service Cost Reports
a. The Agency shall require Contractors to submit to the Agency Contract Manager Service Cost Reports,
which reflect the actual costs of providing each service by program. This Annual Service Cost Report
will be due by February 25, of each year. This report will include actual costs for performing all services
during the preceding calendar year. Supporting documentation must accompany the report, which will
include General Ledger, Trial Balance and/or Statement of Revenue and Expenditures along with a
narrative explanation and justification of rate differences. This Annual Service Cost Report provides
information for planning and negotiating unit rates.
b. Any multi-year contracts entered into with service providers on or after the effective date of this contract
shall contain a provision requiring the contract's parties to re-evaluate the contract's reimbursement rates
on an annual basis. The Contractor may annually renegotiate rates based on factors including but not
limited to a review of sustainability, the respective consumer price index, or current market conditions.
However, it is the intent of the Department and/or Agency that the quality of services provided to current
program recipients not be reduced. Unit Cost Methodology worksheets along with supporting
documentation and narrative explanation, must be submitted by April 15 of each year, if a rate increase is
being requested for any service in the next contact year.
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HCE 203.19
3. Surplus/DeficitReport
The Contractor shall submit a Consolidated Surplus/Deficit Report, Lead Agency Spending Report, in a
format provided by the Agency, to the Agency Contract Manager by the 18th of each month. This
Consolidated Surplus/Deficit Report is for all agreements and contracts between the Contractor and the
Agency and must include the following:
a. A list of all contracts and then current status regarding surplus/deficit;
b. The Contractor's detailed plan on how the surplus/deficit spending exceeding the threshold specified by
the Agency will be resolved;
c. Reconnnendations to transfer funds within the PSA to resolve surplus/deficit spending;
d. Input from the Agency's Board of Directors on resolution of spending issues, if applicable;
4. Program Highlights
The Contractor shall submit Program Highlights referencing specific events that occurred in SFY/FFY 2018-
2019 by August 30, 2019. The Contactor shall provide a new success story, quote, testimonial, or human -
interest vignette. The highlights shall be written for a general audience, with no acronyms or technical terms.
For all agencies or organizations that are referenced in the highlight, the Contactor shall provide a brief
description of then mission or role. The active tense shall be consistently used in the highlight narrative, to
identify the specific individual or entity that performed the activity described in the highlight.
E. Records and Documentation
1. Requests for Payment
The Contactor shall maintain documentation to support Requests for Payment that shall be available to the
Agency or authorized individuals, such as Florida Department of Financial Services (DPS), upon request.
2. CIRTS Data and Maintenance
The Contactor shall ensure monthly collection and maintenance of client and service information in CIRTS or
any such system designated by the Agency.
3. CIRTS Address Validation
The Contactor shall work with the Area Agency on Aging for Southwest Florida, to ensure client addresses are
correct in CIRTS for disaster preparedness efforts. At least annually, and more frequently as needed, the
Agency will provide direction on how to validate CIRTS addresses to ensure these can be mapped. The Agency
will receive a list of unmatched addresses that cannot be mapped and the Agency will be responsible for
working with the Lead Agencies to correct addresses. The Area Agency will send a list to the Department of
Elder Affairs with confirmed addresses. The Department will use this information to update maps, client rosters,
and unmatched addresses to disseminate to the Lead Agencies.
4. Data Integrity and Back up Procedures
Each Contactor shall anticipate and prepare for the loss of information processing capabilities. The routine
backing up of all data and software is required to recover from losses or outages of the computer system. Data
and software essential to the continued operation of Contactor functions must be backed up. The security
controls over the backup resources shall be as stringent as the protection required of the primary resources. A
copy of the backed -up data shall be stored in a secure, offsite location.
5. Policies and Procedures for Records and Documentation
The Contactor shall maintain written policies and procedures for computer system backup and recovery and
shall have the same requirement of its subcontractors. These policies and procedures shall be made available
to the Agency upon request.
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July 2019 — June 2020 HCE 203.19
F. Performance Specifications
1. Outcomes and Outputs (Performance Measures)
The Contractor must:
a. Ensure the prioritization of clients and provision of service to clients in accordance with Section H.A. 1-2.
of this contract;
b. Ensure the provision of the services described in this contract are in accordance with the current DOEA
Handbook and Sections H.A. L-3 and ILC.1. of this contract;
c. Timely and accurately submit to the Agency all required documentation and reports described in
Section II.E.;
d. Timely (in accordance with Attachment X) and accurately submit Attachments XI, XII and
supporting documentation such as CIRTS Reports; and
e. Develop and document strategies in the Area Plan to support the Agency's standard of performance
achievement, including increases for the following:
i. Percentage of most frail elders who remain at home or in the community instead of going into a
nursing home;
ii. Percentage of active clients eating two or more meals per day;
iii. Percentage of new service recipients whose ADL assessment score has been maintained or improved;
iv. Percentage of new service recipients whose IADL assessment score has been maintained or improved;
v. After service intervention, the percentage of caregivers who self-report being very confident about their
ability to continue to provide care;
vi. Percentage of clients who are at imminent risk of nursing home placement who are served
with community-based services; and
vii. Percentage of elders assessed with high or moderate risk environments who improved their
environment score.
2. The Contractor's performance of the measures in II.F.1., above, will be reviewed and documented in the
Agency's Annual Programmatic Monitoring Report.
3. Monitoring and Evaluation Methodology
The Agency will review and evaluate the performance of the Contractor under the terms of this contract.
Monitoring shall be conducted through direct contact with the Contractor through telephone, in writing, and/or
on-site visit(s). The primary, secondary, or signatory of the contract must be available for any on-site
programmatic monitoring visit. The Agency's determination of acceptable performance shall be conclusive.
The Contractor agrees to cooperate with the Agency in monitoring the progress of completion of the
service tasks and deliverables. The Agency may use, but is not limited to, one or more of the following
methods for monitoring:
a. Desk reviews and analytical reviews;
b. Scheduled, unscheduled, and follow-up on-site visits;
C. Clientvisits;
d. Review of independent auditor's reports;
e. Review of third -party documents and/or evaluation;
f. Review of progress reports;
g. Review of customer satisfaction surveys;
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July 2019 — June 2020 HCE 203.19
h. Agreed-upon procedures review by an external auditor or consultant;
i. Limited -scope reviews; and
j. Other procedures as deemed necessary by the Agency.
G. Contractor Responsibilities
1. Contractor Accountability
All service tasks and deliverables pursuant to this contract are solely and exclusively the responsibility of the
Contractor and are tasks and deliverables for which, by execution of this contract, the Contractor agrees to be
held accountable.
2. Coordination with Other Providers and/or Entities
Notwithstanding that services for which the Contractor is held accountable involve coordination with other
entities in performing the requirements of the contact, the failure of other entities does not alleviate the
Contractor from any accountability for tasks or services that the Contractor is obligated to perform pursuant to
this contract.
H. Agency Responsibilities
1. Agency Obligations
The Agency may, within its resources, provide technical support and/or assistance to the Contractor to assist
the Contractor in meeting the requirements of this contract. The Agency's technical support and/ or
assistance, or lack thereof, shall not relieve the Contractor from full performance of contact requirements.
2. Agency Determinations
The Agency reserves the exclusive right to make certain determinations in the tasks and approaches used to
perform tasks required by this contract. The absence of the Agency setting forth a specific reservation of rights
does not mean that all other areas of the contract are subject to mutual agreement.
III. METHOD OF PAYMENT
A. Payment Methods Used
The method of payment for this contract is a combination of fixed-fee/unit rate, cost reimbursement, and advance
payments, subject to the availability of funds and Contractor performance. The Agency will pay the Contactor
upon satisfactory completion of the Tasks/Deliverables, as specified in Section It, Manner of Service Provision,
and in accordance with other terms and conditions of this contract.
1. Fixed Fee/Unit Rate
Payments for Fixed Fee/Unit Rate shall not exceed amounts established in Service Rate Report.
2. Cost Reimbursement
Payment may be authorized only for allowable expenditures which are in accordance with the services specified
in the Service Rate Report. All Cost Reimbursement Requests for Payment must submit the Request for
Payment as well as the Receipt and Expenditure Report begriming with the fust month of this contract. The
Agency reserves the right to review supporting documentation for any cost reimbursement requests.
3. Advance Payments
The Contactor may request up to two (2) months of advances at the start of the contact period to cover program
administrative and service costs. The payment of an advance will be contingent upon the sufficiency and amount
of funds released to the Agency by the State of Florida ("budget release"). The Contractor's requests for
advance payments require the written approval of the DOEA's Contact Manager. For the first month's
advance request, the Contractor shall provide to the Agency Contact Manager documentation justifying the
need for an advance and describing how the funds will be distributed. If the Contractor is requesting two (2)
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HCE 203.19
months of advances, documentation must be provided reflecting the cash needs of the Contractor within the
initial two (2) months and should be supported through as cash-flow analysis or other information appropriate
to demonstrate the Contractor's financial need for the second month of advances. The Contractor must also
describe how the funds will be distributed for the first and second month. If sufficient budget is available, and
the Agency Contract Manger, in his or her sole discretion, has determined that there is justified need for an
advance, the Agency will issue approved advance payments after July P" of the contract year.
a. All advance payments retained by the Contractor must be fully expended no later than September 30, 2019.
Any portion of advance payments not expended must be recouped on the Invoice Report Schedule, report
number 5, due to the Agency on October 11, in accordance with the Invoice Report Schedule.
b. All advance payments made to the Contractor shall be reimbursed to the Agency as follows: At least
one—tenth of the advance payment received shall be reported as an advance recoupment on each Request
for Payment, starting with report number 5, in accordance with the Invoice Report Schedule.
B. Funding Distribution
The Contractor agrees to distribute funds as detailed in the Area Plan update and Invoice Report Schedule. Any
changes in the total amounts of the funds identified on the Annual Budget Summary form require a contract
amendment.
C. Method of Invoice Payment
Payment shall be made upon the Contractor's presentation of an invoice subsequent to the acceptance and approval
by the Agency of the deliverables shown on the invoice. The form and substance of each invoice submitted by the
Contractor shall be as follows:
1. Have a Remittance Address that corresponds exactly to the "Remit To" address provided to
MyFloridaMarketPlace (MFMP) during registration;
2. Request payment monthly for the units of services established in the Agency's approved Area Plan, provided in
conformance with the requirements as described in the current DOEA Handbook, at the rates established in
the Service Rate Report of the contract. Documentation of service delivery must include a report consisting
of the following: number of clients served, number of service units provided by service, and rate per service
unit with calculations that equal the total invoice amount. Any requested changes to the approved budget
subsequent to the execution of this contract must be submitted to the Agency Contract Manager for written
approval. Any change to the total contract amount requires a formal contract amendment;
3. The Contractor shall consolidate all Subcontractors' Requests for Payment and Receipt Expenditure
Reports that support Requests for Payment and shall submit the consolidated information to the Agency
using the Request for Payment form, and Receipt and Expenditure Report form for services, which must
include itemized expenditure categories, and signed CIRTS reports; and
4. All Requests for Payment shall be based on the submission of monthly Receipt and Expenditure Reports
beginning with the first month of this contract. The schedule for submission of advance requests (when
available) and invoices is set forth in the Invoice Report Schedule.
D. Payment Withholding
Any payment due by the Agency under the terms of this contract may be withheld pending the receipt and
approval by the Agency of all financial and programmatic reports due from the Contractor and any adjustments
thereto, including any disallowance not resolved.
F. Final Invoice Instructions
The Contractor shall submit the final Request for Payment to the Agency no later than July 25, 2020,
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HCE 203.19
F. HCE Subsidy Data Entries Schedule
The Contractor must ensure all data for HCE subsidies are entered into the CIRTS by the 15th of each month.
HCE subsidy data entered into the CIRTS by the 15th of the month will be for payments incurred between the
16th of the previous month and including billing up to the 15th of the current month. The Contractor shall ensure
data entry for HCE subsidies will cease on the 15th of the month and that the CIRTS Monthly Service Utilization
Report by client name and by worker is generated. The Contractor shall ensure the Monthly Utilization Report by
client name and by worker is verified, corrected, and certified with a signature no later than the 20th of the month
in which the Report is generated and due to the Agency. (Case management data entered into the CIRTS, which
MUST be entered into CIRTS prior to the 9" of each month, shall be for units of service provided during the
previous billing month from the Is' of the month and up to and including the last day of the previous month and
also entered before submitting billing reports which are due by the 9' of each month)
G. CHITS Data Entries for Contractors
The Contractor shall be required to enter all required data for clients and services in the CIRTS database in
accordance with the current DOEA Handbook and the CIRTS User Manual — Aging Provider Network users
(located in Documents on the CIRTS Enterprise Application Services). Contractors must enter this data into the
CIRTS prior to submitting their Requests for Payment Expenditure Reports to the Agency. The Agency shall
establish deadlines for completing CIRTS data entry and ensure compliance with due dates for the Requests for
Payment and Expenditure Reports that Contractor must submit to the Agency as well as the specific CIRTS
reports. When the Area Agency requests backup documentation, the Contractor must submit billing receipts over
$150 (total for the month).
H. Time Limits
The caregiver must submit the receipts to the case manager within 30 days. Caregivers will be reimbursed within
60 days of submitting the original receipt to the Contractor.
I. Contractors' Monthly CIRTS Reports
The Agency must require Contractors to run monthly CIRTS reports and to verify that client and service data in the
CIRTS is accurate. This report must be submitted to the Agency with the monthly Request for Payment and
Receipts and Expenditure Report and must be reviewed by the Agency before the Contractor's Request for
Payment and Receipt and Expenditure Reports can be approved by the Agency.
CIRTS Reports: (Listed under Services #3) Monthly & YTD Service Units with Unduplicated Client Counts; and
(Listed under Services #6) Monthly & YTD Services Reported by Program and Service Summary Report
And the HCE Utilization Report (needs signature)
I Corrective Action Plan
1. Contractor shall ensure that one hundred percent (100%) of the deliverables identified in Section II.C.1-3
of this contract are performed pursuant to contract requirements.
2. If at any time the Contractor is notified by the Agency's Contract Manager that it has failed to
correctly, completely, and/or adequately perform contact deliverables identified in Section II.C.1-3. of this
contract, the Contractor will have ten (10) days to submit a CAP to the Agency's Contract Manager
that addresses the deficiencies and states how the deficiencies will be remedied within the time approved by
the Agency's Contract Manager. The Agency shall assess a Financial Consequence for Non -Compliance
on the Contractor as referenced in Section III.J. of this contract for each deficiency identified in the CAP
which is not corrected pursuant to the CAP. The Agency will also assess a financial consequence for failure
to timely submit a CAP.
3. If the Contractor fails to correct an identified deficiency within the approved time specified in the CAP, the
Agency shall deduct the percentage established in Section III.J. of this contract fiom the payment for the
invoice of the following month.
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July 2019 — June 2020
HCE 203.19
4. If the Contractor fails to timely submit a CAP, the Agency shall deduct the percentage established in Section
III.J. of this contract for each day the CAP is overdue. The deduction will be made from the payment for the
invoice of the following month.
K. Financial Consequences
1. The Agency will withhold or reduce payment if the Contactor fails to perform the deliverables to the
satisfaction of the Agency according to the requirements referenced in Section II.C. of this contract. The
following financial consequences will be imposed if the deliverables stated do not meet in part or in whole the
performance criteria as outlined in Section H.C. or Section II.F. of this contract:
a. Delivery of services to eligible clients as referenced in Section II.A.1-3 and Section II.E.l of this
contract — Failure to comply with established assessment and prioritization criteria, as evidenced by
CIRTS reports, will result in a two percent (2%) reduction of payment per business day. The reduction of
payment will begin on the first business day following the Agency's notification to the Contactor that
the identified deficiency was not cured or satisfactorily addressed in accordance, with the Agency -
approved CAP, referenced in Section III.J.
b. Timely submission of a CAP — Failure to timely submit a CAP within ten (10) business days after
notification of a deficiency by the Agency's Contract Manager will result in a two percent (2%) reduction
of payment per business day the CAP is not received. The reduction of payment will begin the first
business day following the Agency's notification to the Contractor that the identified deficiency was
not cured or satisfactorily addressed in accordance with the Agency -approved CAP, referenced in
Section 1111
2. Exceptions may be granted solely, in writing, by the Agency's Contract Manager.
H. SPECIAL PROVISIONS
A. Final Budget and Funding Revision Requests
Final requests for budget revisions or adjustments to contract funds based on expenditures for provided services
must be submitted to the Agency Contract Manager in writing no later than June 30, 2020. Email requests are
considered acceptable.
B. Use of Service Dollars and Management of the Assessed Priority Consumer List
The Contractor is expected to spend all funds provided by the Agency for the purpose specified in this contract.
The Contractor must manage the service dollars in such a manner is to avoid having a wait list and a surplus of
funds at the end of the contract period. If the Agency determines that the Contractor is not spending service
funds accordingly, the Agency may transfer funds to other provider agencies during the contract period and/or
adjust subsequent funding allocations accordingly, as allowable under state and federal law
C. Contract Limits
In no case shall the Contactor be required to incur costs in excess of the contract amount in providing services to the
clients.
D. Remedies for Nonconforming Services
1. The Contractor shall ensure that all goods and/or services provided under this contact are delivered timely,
completely, and commensurate with required standards of quality. Such goods and/or services will only be
delivered to eligible program participants.
2. If the Contactor fails to meet the prescribed quality standards for services, such services will not be reimbursed
under this contact. In addition, any nonconforming goods (including home delivered meals) and/or services
not meeting such standards will not be reimbursed under this contact. The Contractor's signature on the
Request for Payment form certifies maintenance of supporting documentation and acknowledgement that the
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July 2019 —June 2020
HCE 203.19
Contractor shall solely bear the costs associated with preparing or providing nonconforming goods and/or
compromise the quality, security, or continuity of services to clients. The Agency requires immediate notice of
any significant and/or systemic infractions.
E. Incident Reporting
The Contractor shall notify the Agency immediately but no later than forty-eight (48) hours from the
Contractor's awareness or discovery of changes that may materially affect the Contractor or any subcontractor's
ability to perform the services required to be performed under this contract and in authorizing proviso. Such notice
shall be made orally to the Agency's Contract Manager (by telephone) with an email to immediately
follow, including the Contractor's plan for provision of services authorized in proviso.
F. Investigation of Criminal Allegations
Any report that implies criminal intent on the part of the Contractor or any subcontractors and referred to a
governmental or investigatory agency must be sent to the Agency. If the Contractor has reason to believe that the
allegations will be referred to the State Attorney, a law enforcement agency, the United States Attorney's office, or
other governmental agency, the Contractor shall notify the Contract Manager at the Agency immediately. A copy
of all documents, reports, notes, or other written material concerning the investigation, whether in the
possession of the Contractor or subcontractors, must be sent to the Agency's Contract Manager with a summary of
the investigation and allegations.
G. Volunteers
The Contractor shall ensure the use of trained volunteers in providing direct services delivered to older individuals
and individuals with disabilities needing such services. If possible, the Contractor shall work in coordination with
organizations that have experience in providing training, placement, and stipends for volunteers or participants
(such as the Senior Community Service Employment Program or organizations carrying out federal service
programs administered by the Corporation for National and Community Service).
H. Enforcement
In accordance with Section 430.04, F.S., the Agency shall rescind designation of a lead agency or take
intermediate measures against the Contractor, including corrective action, unannounced special monitoring,
temporary assumption of operation of one or more programs by the Agency, placement on probationary
status, imposing a moratorium on Contactor action, imposing financial penalties for nonperformance, or
other administrative action pursuant to Chapter 120, F.S., if the Agency finds that any of the following have
occurred:
a. An intentional or negligent act of the Contractor has materially affected the health, welfare, or safety of
clients, or substantially and negatively affected the operation of an aging services program;
b. The Contractor lacks financial stability sufficient to meet contractual obligations or that contractual funds
have been misappropriated;
c. Contractor has committed multiple or repeated violations of legal and regulatory requirements or Agency
standards;
d. The Contactor has failed to continue the provision or expansion of services after the declaration of a state
of emergency;
e. The Contractor has exceeded its authority or otherwise failed to adhere to the terms of this contract with
the Agency or has exceeded its authority or otherwise failed to adhere to the provisions specifically
provided by statute or rule adopted by the Agency;
L The Contractor has failed to properly determine client eligibility as defined by the Agency or efficiently
manage program budgets; or
g. The Contactor has failed to implement and maintain an Agency -approved client grievance resolution
procedure.
29 T
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July 2019 — June 2020
HCE 203.19
2. In making any determination under this provision, the Agency may rely upon findings of another state or
federal agency or other regulatory body. Any claims for damages for breach of contract are exempt from
administrative proceedings and shall be brought before the appropriate entity in the venue of Lee County. In
the event the Agency initiates action to rescind a lead agency designation, the Agency shall follow the
procedures set forth in 42 U. S. C. § 3025(b).
I. Contract Modifications
The Agency's Contract Manager has the authority to modify and/or extend deliverable deadlines. All
deliverable extension requests must be made to the Agency's Contract Manager, in writing prior to the
required deadline. All approvals for deliverable extensions must be communicated, in writing, by the Agency's
Contract Manager to the Contractor and are subject to the discretion of the Agency's Contract Manager.
The requests and the approval must occur prior to the established deadline. An e-mail writing (request and
response)is considered acceptable.
END OF ATTACHMENT
30
RE
July 2019 — June 2020
ATTACHMENT II
FINANCIAL AND COMPLIANCE AUDIT
HCE 203.19
The administration of resources awarded by the Agency to the Contractor may be subject to audits and/or monitoring by
the Agency as described in this section.
MONITORING
In addition to reviews of audits conducted in accordance with 2 CFR Part 200 (formerly OMB Circular A-133 as revised),
and Section 215.97, F.S., (see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits
by the Agency staff, limited scope audits and/or other procedures. By entering into this contract, the Contractor agrees to
comply and cooperate with any monitoring procedures/processes deemed appropriate by the Agency. In the event the
Agency determines that a limited scope audit of the Contactor is appropriate, the Contractor agrees to comply with any
additional instructions provided by the Agency to the Contactor regarding such audit. The Contactor further agrees to
comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Vice President of
Finance or Auditor General.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the Contactor is a State or local government or a non-profit organization as defined in 2 CFR Part
200, Subpart A.
If the event that the Contactor expends $750,000.00 or more in federal awards during its fiscal year, the Contactor must
have a single or program -specific audit conducted in accordance with the provisions of 2 CFR Part 200. Financial
Compliance Audit Attachment, Exhibit 2 indicates federal resources awarded through the Agency by this contact. In
determining the federal awards expended in its fiscal year, the Contactor shall consider all sources of Federal awards,
including federal resources received from the Agency. The determination of amounts of Federal awards expended
should be in accordance with 2 CFR Part 200. An audit of the Contactor conducted by the Auditor General in
accordance with the provisions of 2 CFR Part 200 will meet the requirements of this part.
In connection with the audit requirements addressed in Part I, paragraph 1, the Contactor shall fulfill the requirements
relative to auditee responsibilities as provided in 2 CFR § 200.508.
If the Contactor expends less than $750,000.00 in federal awards in its fiscal year, an audit conducted in accordance with
the provisions of 2 CFR Part 200 is not required. In the event that the Contactor expends less than $750,000.00 in federal
awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of 2 CFR Part 200, the
cost of the audit must be paid from non-federal resources (i.e., the cost of such audit must be paid from Contactor
resources obtained from other than federal entities.)
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to contacts with the Agency shall be based on the contact's requirements, including any
rules, regulations, or statutes referenced in the contact. The financial statements shall disclose whether or not the matching
requirement was met for each applicable contact. All questioned costs and liabilities due to the Agency shall be fully
disclosed in the audit report with reference to the Agency contact involved. If not otherwise disclosed as required by 2
CFR § 200.510 the schedule of expenditures of federal awards shall identify expenditures by contract number for each
contact with the Agency in effect during the audit period. Financial reporting packages required under this part must
be submitted within the earlier of 30 days after receipt of the audit report or 9 months after the end of the Contractor's
fiscal year end.
n
31
,p
July 2019 — June 2020 HCE 203.19
PART H: STATE FUNDED
This part is applicable if the Contractor is a non -state entity as defined by Section 215.97(2), F.S.
In the event that the Contractor expends a total amount of state financial assistance equal to or in excess of $750,000.00 in
any fiscal year of such Contractor, the Contractor must have a State single or project -specific audit for such fiscal year in
accordance with Section 215.97, F.S.; applicable rules of the Department of Financial Services; and Chapter 10.550
(local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General.
Financial Compliance Audit Attachment, Exhibit 2 indicates state financial assistance awarded through the Agency by this
contract. In determining the state financial assistance expended in its fiscal year, the Contractor shall consider all sources of
state financial assistance, including state financial assistance received from the Agency, other state agencies, and other
non -state entities. State financial assistance does not include Federal direct or pass-through awards and resources received
by a non -state entity for Federal program matching requirements.
In connection with the audit requirements addressed in Part 11, paragraph 1, the Contractor shall ensure that the audit
complies with the requirements of Section 215.97(8), F.S. This includes submission of a financial reporting package as
defined by Section 215.97(2), F.S., and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit
organizations), Rules of the Auditor General.
If the Contractor expends less than $750,000.00 in state financial assistance in its fiscal year, an audit conducted in
accordance with the provisions of Section 215.97, F.S., is not required. In the event that the Contractor expends less than
$750,000.00 in state financial assistance in its fiscal year and elects to have an audit conducted in accordance with the
provisions of Section 215.97, F.S., the cost of the audit must be paid from the non -state entity's resources (i.e., the cost of
such an audit must be paid from the Contractor resources obtained from other than State entities).
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to contracts with the Agency shall be based on the contract's requirements, including any
applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching requirement
was met for each applicable contract. All questioned costs and liabilities due to the Agency shall be fully disclosed in the
audit report with reference to the Agency contract involved. If not otherwise disclosed as required by Rule 69I-5.003,
F.A.C., the schedule of expenditures of state financial assistance shall identify expenditures by contract number for each
contract with the Agency in effect during the audit period. For local governmental entities, financial reporting
packages required under this part must be submitted within 45 days after delivery of the audit report, but no later than 12
months after the Contractor's fiscal year end. Non-profit or for-profit organizations, financial reporting packages required
under this part must be submitted within 45 days after delivery of the audit report, but no later than 9 months after the
Contractor's fiscal year end. Notwithstanding the applicability of this portion, the Agency retains all right and obligation
to monitor and oversee the performance of this contract as outlined throughout this document and pursuant to law.
PART III: REPORT
Copies of reporting packages for audits conducted in accordance with 2 CFR Part 200 and required by Part I of this Financial
Compliance Audit Attachment, shall be submitted, when required by 2 CFR § 200.512 by or on behalf of the Contractor
directly to each of the following:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10`h Street
Jeffersonville, IN 47132
Pursuant to 2 CFR § 200.512, all other Federal agencies, pass-through entities and others interested in a reporting package
and data collection form must obtain it by accessing the Federal Audit Clearinghouse.
32 �'\`
July 2019 — June 2020
HCE 203.19
The Contractor shall submit a copy of any management letter issued by the auditor to the Area Agency on Aging for
Southwest Florida, Inc. at the following address:
The Area Agency on Aging for Southwest Florida, Inc.at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Tammy Rhoades, CFO
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
Additionally, copies of financial reporting packages required by this contract's Financial Compliance Audit Attachment
Part II, shall be submitted by or on behalf of the Contractor directly to each of the following:
The Area Agency on Aging for Southwest Florida, hic.at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Tammy Rhoades, CFO
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
The Auditor General's Office at the following address:
State of Florida Auditor General
Claude Pepper Building, Room 574
111 West Madison Street
Tallahassee, Florida 32399-1450
Any reports, management letters, or other information required to be submitted to the Agency pursuant to this contract
shall be submitted timely in accordance with 2 CFR Part 200, F.S., and Chapter 10.550 (local governmental entities) or
10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, as applicable.
Contractors, when submitting financial reporting packages to the Agency for audits done in accordance with 2 CFR Part 200
or Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor
General, should indicate the date that the reporting package was delivered to the Contractor in correspondence
accompanying the reporting package.
PART FV: RECORD RETENTION
The Contractor shall retain sufficient records demonstrating its compliance with the terms of this contract for a period of
six (6) years from the date the audit report is issued, and shall allow the Agency or its designee, the Contract Manager or
Auditor General access to such records upon request. The Contractor shall ensure that audit working papers are made
available to the Agency or its designee, Contract Manager, or Auditor General upon request for a period of six (6) years
from the date the audit report is issued, unless extended in writing by the Agency.
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33 0�
July 2019 — June 2020
ATTACHMENT II -EXHIBIT 1
PART I: AUDIT RELATIONSHIP DETERMINATION
HCE 203.19
Contractors who receive state or federal resources may or may not be subject to the audit requirements of 2 CFR Part 200
and/or Section 215.97, F.S. Contractors who are determined to be recipients or sub -recipients of federal awards and/or
state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I
and/or Part H of Exhibit 1 are met. Contractors who have been determined to be vendors are not subject to the audit
requirements of 2 CFR § 200.3 8, and/or Section 215.97, F.S. Regardless of whether the audit requirements are met,
Contractors who have been determined to be recipients or sub -recipients of Federal awards and/or state financial
assistance must comply with applicable programmatic and fiscal compliance requirements.
In accordance with 2 CFR Part 200 and/or Rule 69I-5.006, F.A.C., Contractor has been determined to be:
Vendor not subject to 2 CFR § 200.38 and/or Section 215.97, F.S.
—X—Recipient/sub-recipient subject to 2 CFR § § 200.86 and 200.93 and/or Section 215.97, F.S.
Exempt organization not subject to 2 CFR Part 200 and/or Section 215.97, F.S. For Federal awards, for-profit
organizations are exempt; for state financial assistance projects, public universities, community colleges, district
school boards, branches of state (Florida) government, and charter schools are exempt. Exempt organizations must
comply with all compliance requirements set forth within the contract or award document.
NOTE: If a Contractor is determined to be a recipient/sub-recipient of federal and/or state financial assistance, and has been
approved by the Agency to subcontract, they must comply with Section 215.97(7), F.S., and Rule 69I-5.006, F.A.C.
[state financial assistance] and/or 2 CFR § 200.330[federal awards].
PART H: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Contractors who receive Federal
awards, state maintenance of effort funds, or state matching funds on Federal awards and who are determined to be a sub -
recipient must comply with the following fiscal laws, rules, and regulations:
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR § 200.416 - § 200.417 — Special Considerations for States, Local Governments and Indian Tribes*
2 CFR § 200.201 —Administrative Requirements**
2 CFR § 200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
NON-PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR § 200.400 - § 200.411 — Cost Principles*
2 CFR § 200.100 — Administrative Requirements
2 CFR § 200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT)
MUST FOLLOW:
2 CFR § 200.418 — § 200.419 — Special Considerations for Institutions of Higher Education*
2 CFR § 200.100 — Administrative Requirements
2 CFR § 200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
34 c
July 2019 — June 2020
HCE 203.19
*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in 2 CFR
§ 200.400(5) (c).
**For funding passed through U.S. Health and Human Services, 45 CFR Part 75; for funding passed through U.S.
Department of Education, 34 CFR Part 80.
STATE FINANCIAL ASSISTANCE. Contractors who receive state financial assistance and who are determined to be a
recipient/sub-recipient must comply with the following fiscal laws, rules and regulations:
Sections 215.97 & 215.971, F.S.
Chapter 69I-5, F.A.C.
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
r�
35
July 2019 — June 2020
FUNDING SUMMARY
HCE 203.19
DjUkLTitle 2 CFR, as revised, and Section 215.97, F.S., require that the information about Federal Programs and State
Projects included in Attachment II, Exhibit 1, be provided to the recipient. Information contained herein is a prediction of
funding sources and related amounts based on the contract budget.
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT
CONSIST OF THE FOLLOWING:
GRANT AWARD (FAIN#): FEDERAL AWARD DATE:
DUNS NUMBER: 076997790
PROGRAM TITLE FUNDING SOURCE
CFDA AMOUNT
Home Care for the Elderly
General Revenue
65.001
$54,450.00
TOTAL AWARD
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL
TO THIS CONTRACT ARE AS FOLLOWS:
AWARDED PURSUANT
FEDERAL FUNDS:
2 CFR Part 200 — Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards.
OMB Circular A-133 — Audits of States, Local Governments, and Non -Profit Organizations
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF
THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL. PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD
STATE FINANCIAL ASSISTANCE SUBJECT TO SECTION 215.97, F.S.
PROGRAM TITLE
FUNDING SOURCE A=CSFA
AMOUNT
Home Care for the Elderly
General Revenue
65.001
$54,450.00
TOTAL AWARD
$54,450.00
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE
CONTRACT ARE AS FOLLOWS:
AWARDED PURSUANT TO THIS
STATE. FINANCIAL ASSISTANCE
Sections 215.97 & 215.971, F.S., Chapter 69I-5, F.A.C., State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
36
C ��
July 2019 —June 2020
ATTACHMENT III
CERTIFICATIONS AND ASSURANCES
IICE 203.19
The Agency will not award this contract unless Contractor completes this CERTIFICATIONS AND ASSURANCES. In
performance of this contract, Contractor provides the following certifications and assurances:
A.
Debarment and
Suspension Certification
(29
CFR Part 95 and 45 CFR Part 751
B.
Certification Regarding
Lobbying (29
CFR Part
93 and 45 CFR Part 93)
C.
Nondiscrimination
& Equal Opportunity
Assurance
(29 CFR Part 37 and 45 CFR Part 80)
D.
Certification Regarding
Public Entity
Crimes,
section 287.133. F.S.
E.
Association of Community
Organizations
for
Reform Now (ACORN) Funding Restrictions Assurance
(Pub. L. 111-117
F. Scrutinized Companies Lists and No Boycott of Israel Certification section 287.135, F'S.
G. Certification Regarding Data Integrity Compliance for Contracts Agreements Grants Loans And
Cooperative Agreements
H. Verification of Employment Status Certification
1. Records and Documentation
J. Certification Regarding Inspection of Public Records
A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY
MATTERS — PRIMARY COVERED TRANSACTION.
The undersigned Contractor certifies, to the best of its knowledge and belief, that it and its principals:
1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
covered transactions by a Federal department or agency;
2. Have not within a three-year period preceding this contract been convicted or had a civil judgment rendered against
them for commission of fi•aud or a criminal offense in connection with obtaining, attempting to obtain, or performing
a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State
antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records,
making false statements, or receiving stolen property;
3. Are not presently indicted or otherwise criminally or civilly charged by a government entity (Federal, State, or local)
with commission of any of the offenses enumerated in paragraph A.2, of this certification; and/or
4. Have not within a three-year period preceding this application/proposal had one or more public transactions
(Federal, State, or local) terminated for cause of default.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants, and contacts under grants, loans, and cooperative agreements) and that all
sub -recipients and contactors shall provide this certification accordingly.
B. CERTIFICATION REGARDING LOBBYING — CERTIFICATION FOR CONTRACTS, GRANTS,
LOANS, AND COOPERATIVE AGREEMENTS.
The undersigned Contactor certifies, to the best of its knowledge and belief, that:
No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of Congress or an employee of a Member of Congress in
connection with the awarding of any Federal contact, the malting of any Federal grant, the making of any Federal loan,
the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification
of any Federal contact, grant, loan, or cooperative agreement.
37 n`
July 2019 — June 2020 HCE 203.19
If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of
Congress, or employee of a Member of Congress in connection with a Federal contract, grant, loan, or cooperative
agreement, the undersigned shall also complete and submit Standard Form — LLL, "Disclosure Form to Report
Lobbying," in accordance with its instructions.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -
recipients and contractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this contract was made or
entered into. Submission of this certification is a prerequisite for malting or entering into this contract imposed by 31
U.S.C. § 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than
$10,000 and not more than $100,000 for each such failure.
C. NON DISCREUINATION & EQUAL OPPORTUNITY ASSURANCE (29 CFR PART 37 AND 45 CFR PART
80). - As a condition of the Contract, Contractor assures that it will comply fully with the nondiscrimination and equal
opportunity provisions of the following laws:
1. Section 188 of the Workforce Investment Act of 1998 (WIA), (Pub. L. 105-220), which prohibits discrimination
against all individuals in the United States on the basis of race, color, religion, sex, national origin, age, disability,
political affiliation, or belief, and against beneficiaries on the basis of either citizenship/status as a lawfully admitted
immigrant authorized to work in the United States or participation in any WIA Title I -financially assisted program
or activity.
2. Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352), as amended, and all requirements imposed by or pursuant
to the Regulation of the Department of Health and Human Services (45 CFR Part 80), to the end that, in accordance
with Title VI of that Act and the Regulation, no person in the United States shall, on the ground of race, color, or
national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to
discrimination under any program or activity for which the Applicant receives Federal financial assistance from the
Department and/or Agency.
3. Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112), as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 84), to the end that, in
accordance with Section 504 of that Act and the Regulation, no otherwise qualified handicapped individual in the
United States shall, solely by reason of his handicap, be excluded from participation in, be denied the benefits of,
or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial
assistance from the Agency.
4. The Age Discrimination Act of 1975 (Pub. L. 94-135), as amended, and all requirements imposed by or pursuant
to the Regulation of the Department of Health and Human Services (45 CFR Part 91), to the end that, in accordance
with the Act and the Regulation, no person in the United States shall, on the basis of age, be denied the benefits of,
be excluded from participation in, or be subjected to discrimination under any program or activity for which the
Applicant receives Federal financial assistance from the Agency.
5. Title IX of the Education Amendments of 1972 (Pub. L. 92-318), as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 86), to the end that, in
accordance with Title IX and the Regulation, no person in the United States shall, on the basis of sex, be excluded
from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any education
program or activity for which the Applicant receives Federal financial assistance from the Agency.
6. The American with Disabilities Act of 1990 (Pub. L. 101-336), which prohibits discrimination in all employment
practices including job application procedures, hiring, firing, advancement, compensation, training, and other
terms, conditions, and privileges of employment. It applies to recruitment, advertising, tenure, layoff, leave, fringe
benefits, and all other employment-related activities.
7. Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws
listed above. This assurance applies to Contractor's operation of the WIA Title I — financially assisted program
or activity, and to all contracts Contractor makes to carry out the WAI Title I —financially assisted program or
activity. Contractor understands that the Agency and/or DOEA and the United States have the right to seek
judicial enforcement of the assurance.
38 )
Com.
July 2019 — June 2020
HCE 203.19
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all
sub -recipients and contractors shall provide this assurance accordingly.
D. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES, SECTION 287.133, F.S.
Contractor hereby certifies that neither it, nor any person or affiliate of Contractor, has been convicted of a Public Entity
Crime as defined in Section 287.133, F.S., nor placed on the convicted vendor list.
Contractor understands and agrees that it is required to inform Area Agency and DOEA immediately upon any change
of circumstances regarding this status.
E. ASSOCIATION OF COMMUNITY ORGANIZATIONS FOR REFORM NOW (ACORN) FUNDING
RESTRICTIONS ASSURANCE (Pub. L. 111-117).
As a condition of the Contract, Contractor assures that it will comply fully with the federal funding restrictions
pertaining to ACORN and its subsidiaries per the Consolidated Appropriations Act, 2010, Division E, Section 511 (Pub.
L. 111-117). The Continuing Appropriations Act, 2011, Sections 101 and 103 (Pub. L. 111-242), provides that
appropriations made under Pub. L. 111-117 are available under the conditions provided by Pub. L. 111-117.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants and contracts under grants, loans and cooperative agreements) and that all sub -
recipients and contractors shall provide this assurance accordingly.
F. SCRUTINIZED COMPANIES LISTS AND NO BOYCOTT OF ISRAEL CERTIFICATION, SECTION
287.135, F.S.
In accordance with section 287.135,F.S, Contractor certifies that it is has not been placed on the Scrutinized Companies
that Boycott Israel List and that it is not engaged in a boycott of Israel.
If this Contract is in the amount of $1 million or more, in accordance with the requirements of section 287.135, F.S.,
Contractor hereby certifies that it is not listed on either the Scrutinized Companies with Activities in Sudan List or the
Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List and that it is not engaged in business
operations in Cuba or Syria.
Contractor understands that pursuant to section 287.135, F.S., the submission of a false certification may result in
the Agency terminating this contract and the submission of a false certification may subject Contractor to civil penalties
and attorney fees and costs, including any costs for investigations that lead to the finding of false certification.
If Contractor is unable to certify any of the statements in this certification, Contactor shall attach an explanation to
this contract.
G. CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR CONTRACTS,
AGREEMENTS, GRANTS, LOANS AND COOPERATIVE AGREEMENTS
1. The Contractor and any Subcontractors of services under this contract have financial management systems
capable of providing certain information, including: (1) accurate, current, and complete disclosure of the 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 contract supported activities; and (3) the comparison of outlays with
budgeted amounts for each award. The inability to process information in accordance with these requirements
could result in a return of grant funds that have not been accounted for properly.
2. Management Information Systems used by the Contactor, Subcontractors, or any outside entity on which the
Contactor 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, Contactors will take immediate action to assure data integrity.
3. If this contact includes the provision of hardware, software, firmware, microcode, or imbedded chip technology,
the undersigned warrants that these products are capable of processing year -date dependent data accurately. All
39 7
July 2019 — June 2020
HCE 203.19
versions of these products offered by the Contractor (represented by the undersigned) and purchased by the state
will be verified for accuracy and integrity of data prior to transfer.
4. In the event of any decrease in functionality related to time and date related codes and internal subroutines that
impede the hardware or software programs from operating properly, the Contractor agrees to immediately make
required corrections to restore hardware and software programs to the same level of functionality as warranted
herein, at no charge to the state, and without interruption to the ongoing business of the state, time being of the
essence.
5. The Contractor and any Subcontractors of services under this contract warrant that their policies and procedures
include a disaster plan to provide for service delivery to continue in case of an emergency, including emergencies
arising from data integrity compliance issues.
H. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION
As a condition of contracting with the Agency, Contractor certifies the use of the U.S. Department of Homeland
Security's E -verify system to verify the employment eligibility of all new employees hired by Contractor during the
contact term to perform employment duties pursuant to this contract, and that any subcontracts include an express
requirement that Subcontractors performing work or providing services pursuant to this Agreement utilize the E -
verify system to verify the employment eligibility of all new employees hired by the Subcontractor during the entire
contact term.
The Contractor shall require that the language of this certification be included in all sub -agreements, sub -grants, and
other agreements/contacts and that all Subcontractors shall certify compliance accordingly.
This certification is a material representation of fact upon which reliance was placed when this contact was made or
entered into. Submission of this certification is a prerequisite for making or entering into this contact imposed by
Circulars A-102 and 2 CFR Part 200 and 215 (formerly 0Iv0 Circular A-110).
I. RECORDS AND DOCUMENTATION
The Contractor agrees to make available to Agency staff and/or any party designated by the Agency any and all
contact related records and documentation. The Contactor shall ensure the collection and maintenance of all
program related information and documentation on any such system designated by the Agency. Maintenance includes
valid exports and backups of all data and systems according to Agency standards.
J. CERTIFICATION REGARDING INSPECTION OF PUBLIC RECORDS
1. In addition to the requirements of Section 10 of the Standard Contact, sections 119.0701(3) and (4) F.S., and any other
applicable law, if a civil action is commenced as contemplated by section 119.0701(4), F.S., and the Agency is named in
the civil action, Contactor agrees to indemnify and hold harmless the Agency for any costs incurred by the
Agency and any attorneys' fees assessed or awarded against the Agency from a Public Records Request made
pursuant to Chapter 119, F.S., concerning this contact or services performed thereunder.
a. Notwithstanding section 119.0701, F.S., or other Florida law, this section is not applicable to contracts executed
between the Agency and state agencies or subdivisions defined in section 768.28(2), F.S.
2. Section 119.01(3), F.S., states if public funds are expended by an agency in payment of dues or membership contributions
for any person, corporation, foundation, trust, association, group, or other organization, all the financial, business, and
membership records of such an entity which pertain to the public agency (Area Agency on Aging for Southwest
Florida, Inc.) are public records. Section 119.07, F.S, states that every person who has custody of such a public record
shall permit the record to be inspected and copied by any person desiring to do so, under reasonable circumstances.
40 `�:�i
July 2019 — June 2020
HCE 203.19
Additionally, I certify this organization does X does not provide for institutional memberships.
Contractor's signature below attests that records pertaining to the dues or membership application by the Agency are
available for inspection if applicable, as stated above.
By execution of this contract, Contractor must include these provisions (A -J) in all related subcontract agreements (if applicable).
By signing below, Contractor certifies that the representations outlined in parts A through J above are true and correct.
�pprovcd as to form and legality
A:. -slant Count"A orncy \\ cil
11ia
41 a
3339 Tamiami Trail E Suite 211
Stephen Y Carrell- ublic Service Department Head
(Signature and Title of Authorized Representative
Street Address
Collier county Board of County Commissioners r cY jC
Naples, FL 34112
Contractor Date
City, State, Zip code
�pprovcd as to form and legality
A:. -slant Count"A orncy \\ cil
11ia
41 a
July 2019 – June 2020
ATTACHMENT IV
ASSURANCES—NON-CONSTRUCTION PROGRAMS
HCE 203.19
Public reporting burden for this collection of information is estimated to average forty-five (45) minutes per response, including time
for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing
the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348-0043),
Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND
BUDGET, SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions please
contact the awarding agency. Further, certain federal awarding agencies may require applicants to certify to
additional assurances. If such is the case, you will be notified.
1. Has the legal authority to apply for federal assistance, and the institutional, managerial and financial capability
(including funds sufficient to pay the non-federal share of project cost) to ensure proper planning, management, and
completion of the project described in this application.
2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the state, through any
authorized representative, access to and the right to examine all records, books, papers, or documents related to the
award; and will establish a proper accounting system in accordance with generally accepted accounting standards or
agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes, or presents the
appearance of, personal or organizational conflict of interest or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. § 4728-4763) relating to prescribed standards
for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's
Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).
6. Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of
the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin;
(b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§ 1681-1683, and §§ 1685-1686),
which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29
U.S.C. § 794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as
amended (42 U.S.C. §§ 6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and
Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the
Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-
616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) Sections 523 and 527
of the Public Health Service Act of 1912 (42 U.S.C. §§ 290 dd-3 and 290 ee 3), as amended, relating to
confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42
U.S.C. § 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any
other nondiscrimination provisions in the specific statute(s) under which application for federal assistance is being
made; and 0) the requirements of any other nondiscrimination statute(s) which may apply to the application.
7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance
and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of
persons displaced or whose property is acquired as a result of federal or federally assisted programs. These requirements
apply to all interests in real property acquired for project proposes regardless of federal participation in purchases.
42 GfcY
July 2019 — June 2020
HCE 203.19
Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. §§ 1501-1508 and §§ 7324-7328), which
limit the political activities of employees whose principal employment activities are funded in whole or in part with
federal funds.
Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C. §§ 276a to 276a-7), the Copeland
Act (40 U.S.C. § 276c and 18 U.S.C. § 874) and the Contract Work Hours and Safety Standards Act (40 U.S.C. §§
327-333), regarding labor standards for federally assisted construction sub -contracts.
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the
program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or
more.
11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and
Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in floodplain in accordance with EO 11988; (e) assurance of
project consistency with the approved State management program developed under the Coastal Zone Management Act
of 1972 (16 U.S.C. § 1451 et seq.); (f) conformity of federal actions to State (Clear Air) Implementation Plans under
Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. § 7401 et seq.); (g) protection of underground
sources of drinking water under the Safe Drinking Water Act of 1974, as amended (P.L. 93-523); and (h) protection
of endangered species under the Endangered Species Act of 1973, as amended (P.L. 93-205).
12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. § 1721 et seq.) related to protecting components
or potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of
1966, as amended (16 U.S.C. § 470), EO 11593 (identification and protection of historic properties), and the
Archaeological and Historic Preservation Act of 1974 (16 U.S.C. § 469a-1 et seq.).
14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related
activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. § 2131 et seq.)
pertaining to the care, handling, and treatment of warm-blooded animals held for research, teaching, or other activities
supported by this award of assistance.
16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. § 4801 et seq.), which prohibits the use of
lead- based paint in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act
Amendments of 1996 and 2 CFR Part 200.
18. Will comply with all applicable requirements of all other federal laws, executive orders, regulations, and policies
governing this program.
SIGNATUIjE O AUTH RLZF�I? CERTIFYING OFFICIAL
t Y.
TITLE
Public Service Department Head
Stephen Y Carvell
APPLICANT ORGANIZATION
ATE SUBMITTED
Collier County Board of County Commissioners
V
Approves as ro toms alm h...•.,
43 O
v
assistant County A xnay -)\p_\0 J.\0 o
July 2019 — June 2020
HCE 203.19
ATTACHMENT V
FLORIDA DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST
Program/Facility Name
County
AAA/Contraetor
Address
Completed By
City, State, Zip Code
Date
Telephone
PART I: READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU COMPLETE
THIS FORM.
1. Briefly describe the geographic area served by the program/facility and the type of service provided:
For questions 2-5 please indicate the foll
2. Population of area served
13. Staff currently employed
4. Clients currently enrolled/registered
5. Advisory/Governing Bond if applicable
owing:
Total #
White Black Hispanic Other Female Disabled Over 40
Source of data:
Effective date:
Effective date:
PART H: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. IF N/A or NO, EXPLAIN.
6. Is an Assurance of Compliance on file with DOEA? N/A YES
❑ ❑
NO
❑
7.
Compare the staff composition to the population. Is staff representative of the population?
N/A
YES
NO
8.
Are eligibility requirements for services applied to clients and applicants without regard to race, color, national
origin, sex, age, religion, or disability?
N/A
❑
YES
n
NO
❑
9.
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?
N/A
❑
YES
NO
10.
For in-patient services, are room assignments made without regard to race, color, national origin or disability?
N/A
YES
NO
❑
❑
❑
11.
Is the program/facility accessible to non-English speaking clients?
N/A
YES
NO
❑
❑
❑
12.
Are employees, applicants and participants informed of their protection against discrimination? If YES, how?
Verbal ❑ Written ❑ Poster ❑
N/A
❑
YES
❑
NO
❑
44
01
July 2019 —June 2020 HCE 203.19
Reviewed
Date
On -Site ❑ Desk Review
45
In Compliance: YES NO*
*Notice of Corrective Action Sent_/_ /
ReSDonse Due
CAO
13. Give the number and current status of any discrimination complaints regarding services or employment filed
against the program/facility.
N/A
❑
NUNMER
14. Is the program/facility physically accessible to mobility, hearing, and sight -impaired individuals?
N/A
YES NO
❑
❑ ❑
PART III: THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 1S OR MORE EMPLOYEES.
EXPLAIN.
15. Has as a self-evaluation been conducted to identify any barriers to serving disabled individuals, and to make any
necessarymodifications?
IF NO,
YES NO
❑
16. Is there an established grievance procedure that incorporates due process in the resolution of complaints?
YES
NO
❑
❑
17. Has a person been designated to coordinate Section 504 compliance activities?
YES
NO
❑
❑
18. Do recruitment and notification materials advise applicants, employees, and participants of nondiscrimination on
the basis of disability?
YES
❑
NO
19. Are auxiliary aids available to assure accessibility of services to hearing and sight -impaired individuals?
YES
NO
❑
❑
PART IV: FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $50,000.00 OR MORE.
20. Do you have a written affirmative action plan? If NO, explain. YES
N
Reviewed
Date
On -Site ❑ Desk Review
45
In Compliance: YES NO*
*Notice of Corrective Action Sent_/_ /
ReSDonse Due
CAO
July 2019 — June 2020 HCE 203.19
ATTACHMENT V
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECI{LIST
1. Describe the geographic service area such as a district, county, city, or other locality. If the program/facility serves
a specific target population such as adolescents, describe the target population. Also, define the type of service
provided.
2. Enter the percent of the population served by race, sex, disability, and over the age of 40. The population
served includes persons in the geographical area for which services are provided such as a city, county or other
regional area. Population statistics can be obtained from local chambers of commerce, libraries, or any
publication from the 1980 Census containing Florida population statistics. Include the source of your population
statistics. ("Other" races include Asian/Pacific Islanders and American Indian/Alaskan Natives.)
3. Enter the total number of full-time staff and their percent by race, sex, disability, and over the age of 40. Include
the effective date of your summary.
4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and list
their percent by race, sex, disability, and over the age of 40. Include the date that enrollment was counted.
a. Where there is a significant variation between the race, sec, 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.
S. Enter the total number of advisory board members and their percent by race, sex, disability, and over the age of
40. If there is no advisory or governing board, leave this section blank.
6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in
compliance with all nondiscriminatory provisions as required in 45 CFR Part 80. This is usually a standard part of
the contract language for Agency Recipients and their Sub -grantees. 45 CFR § 80.4(a).
7. Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the
population is Hispanic, is there a comparable percentage of Hispanic staff?
8. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or
employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and through
on-site record analysis of persons who applied but were denied services or employment. 45 CFR § 80.3(a) and
45 CFR § 80.1.
9. Participants or clients must be provided services such as medical, nursing, and dental care, laboratory services,
physical and recreational therapies, counseling, and social services without regard to race, sex, color, national origin,
religion, age or disability. Courtesy titles, appointment scheduling, and accuracy of record keeping must be applied
uniformly and without regard to race, sex, color, national origin, religion, age or disability. Enhances, waiting
rooms, reception areas, restrooms, and other facilities must also be equally available to all clients.
45 CFR § 80.3(b).
10. For in-patient services, residents must be assigned to rooms, wards, etc., without regard to race, color, national
origin or disability. Also, residents must not be asked whether they are willing to share accommodations with
persons of a different race, color, national origin, or disability. 45 CFR § 80.3(a).
11. The program/facility and all services must be accessible to participants and applicants, including those persons who
may not speak English. In geographic areas where a significant population of non-English speaking people live,
program accessibility may include the employment of bilingual staff. In other areas, it is sufficient to have a policy
or plan for service, such as a current list of names and telephone numbers of bilingual individuals who will assist
in the provision of services. 45 CFR § 80.3(a).
12. Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to their
participants, beneficiaries, or any other interested parties. 45 CFR § 80.6(d). This should include information on
their right to file a complaint of discrimination with either the Agency or the U.S. Department of Health and
46
Gw
July 2019 — June 2020 HCE 203.19
Human Services. 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 of the facility.
13. Report number of discrimination complaints filed against the program/facility. Indicate the basis (e.g. race, color,
creed, sex, age, national origin, disability, and/or retaliation) and the issues involved (e.g. services or employment,
placement, termination, etc.). Indicate the civil rights law or policy alleged to have been violated along with
the name and address of the local, state, or federal agency with whom the complaint has been filed. Indicate the
current status of the complaint (e.g. settled, no reasonable cause found, failure to conciliate, failure to cooperate,
under review, etc.).
14. The program/facility must be physically accessible to mobility, hearing, and sight -impaired 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, and information and admissions
offices should be accessible. Door widths and traffic areas of administrative offices, cafeterias, restrooms,
recreation areas, counters, and serving lines should be observed for accessibility. Elevators should be observed for
door width and Braille or raised numbers. Switches and controls for light, heat, ventilation, fire alarms, and
other essentials should be installed at an appropriate height for mobility impaired individuals.
15. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self-
evaluation to identify any accessibility barriers. Self-evaluation is a four -step process:
a. Evaluate, with the assistance of a disabled individual(s)/organization(s), current practices and policies that do
not or may not comply with Section 504;
b. Modify policies and practices that do not meet Section 504 requirements.;
c. Take remedial steps to eliminate the effects of any discrimination that resulted from adherence to these policies
and practices; and
d. Maintain self-evaluation on file, including a list of the interested persons consulted, a description of areas
examined, and any problems identified, and a description of any modifications made and of any remedial steps
taken 45 CFR § 84.6. (This checklist may be used to satisfy this requirement if these four steps have been
followed).
16. Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate appropriate
due process standards that provide for the prompt and equitable resolution of complaints alleging any action
prohibited by Part 84 of Title 45, CFR 45 CFR § 84.7(b).
17. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to
comply with Part 84 of Title 45, CFR 45 CFR § 84.7(a).
18. Programs or facilities that employ 15 or more persons shall take appropriate initial and continuing steps to notify
participants, beneficiaries, applicants, and employees that the program/facility does not discriminate on the basis of
handicap in violation of Section 504 and Part 84 of Title 45, CFR. Methods of initial and continuing notification
may include the posting of notices, publication in newspaper and magazines, placement of notices in publications
of the programs or facilities, and distribution of memoranda or other written communication, 45 CFR § 84.8(a).
19. Programs/facilities that employ 15 or more persons shall provide appropriate auxiliary aids to persons with impaired
sensory, manual, or speaking skills where necessary to afford such persons an equal opportunity to benefit from the
service in question. Auxiliary aids may include, but are not limited to, brailed and taped materials, interpreters, and
other aids for persons with impaired hearing or vision. 45 CFR § 84.52(d).
20. Programs/facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement, and
maintain a written affirmative action compliance program in accordance with Executive Order 11246, 41 CFR
Part 60 and Title VI of the Civil Rights Act of 1964, as amended.
47
C10
July 2019 — June 2020
DEPARTMENT OF
ELDER
AFFAIRS
STATE OF FLORIDA
HCE 203.19
ATTACHMENT VII
BACKGROUND SCREENING
BACKGROUND SCREENING
Affidavit of Compliance - Employer
AUTHORITY: This form is required annually of all employers to comply with the attestation
requirements set forth in section 435.05(3), Florida Statutes.
➢ The term "employer' means any person or entity required by law to conduct background .screening,
including but not limited to, Area Agencies on Aging, Aging Resource Centers, Aping and Disability
Resource Centers, Lead Agencies, Long -Term Care Ombudsman Program; Serving Health Insurance Needs
of Elders Program, Service Providers; Diversion Providers, and any other person or entity which hires
employees or has volunteers in service who meet the definition of a direct service provider. See §§
435.02; 430.0402, Fla. Stat.
➢ A direct service provider is "a person 18 years of age or older who, pursuant to a program to provide
services to the elderly, has direct, face-to-face contact with a client while providing services to the client
and has accessto the cl'ient's living area, funds, personal property, or personal identification information
as defined in s. 817.568. The term includes coordinators, managers; and supervisors of residential
facilities; and volunteers." §430.0402(1)(b), Fla. Stat.
ATTESTATION:
As the duly a uthorized representative of
EmployerNome
located at
Streek.Address City State ZIP code
I, do hereby,affirm under penalty of perjury
Name of Representative
that the above named employer Is In compliance with the provisions of Chapter 435 and section
430.0402, Florida Statutes, regardinglevel 2 background screening.
.Signature of Representative
STATE OF FLORIDA, COUNTY OF
Sworn to (or affirmed) and subscribed before me this _ day of
to me or produced
20by
(Name of Representative) who is personally known
Print,Type, or Stamp Commtssloned Name of Notary Public Notary Public
DOEA Form 235, AffldaMt of Compl lance -Employer, Effective Apol 2012
Form evallable at: httoa/elderatfairssbtafi.us/ereilsh/backeroundsveentne.ofw
as proof of identification.
Section 435.05(3), F.S
48 00
Jilly 2019 — June 2020
ATTACHMENT IX
ANNUAL BUDGET SUMMARY
1. HCE Services (Subsidies &
Case Management)
Total
49
Collier
HCE 203.19
$ 54,450.00
$54,450.00
July 2019 — June 2020
ATTACHMENT X
HOME CARE FOR THE ELDERLY
INVOICE REPORT SCHEDULE
Report Number
Based On
1&2
July* AND August* Advance
3
Monthly Utilization Report (7/1-7/15)
July Expenditure Reports (105 & 106)
4
Monthly Utilization Report (7/16-8/15)
August Expenditure Report (105 & 106)
5
Monthly Utilization Report (8/16-9/15)
September Expenditure Report (105 & 106)
6
Monthly Utilization Report (9/16-10/15)
October Expenditure Report (105 & 106)
7
Monthly Utilization Report (10/16-11/15)
November Expenditure Report (105 & 106)
8
Monthly Utilization Report (11/16-12/15
December Expenditure Report (105 & 106)
9
Monthly Utilization Report (12/16-1/15)
January Expenditure Report (105 & 106)
10
Monthly Utilization Report (1/16-2/15)
February Expenditure Report (105 & 106)
11
Monthly Utilization Report (2/16-3/15)
March Expenditure Report (105 & 106)
Monthly Utilization Report (3/16-4/15)
11
April Expenditure Report (105 & 106)
Monthly Utilization Report (4/16-5/15)
12
May Expenditure Report (105 & 106)
Monthly Utilization Report (5/16-6/15)
13
June Expenditure Report (105 & 106)
Monthly Utilization Report (6/15-6/30)
15
Final Expenditure Report (105 & 106)
Legend: * Advance based on projected cash need.
HCE 203.19
Submit to Agency on this Date
July 1
July 20
August 11
August 20
September 11
September 20
October 11
October 20
November 11
November 20
December 11
December 20
January 11
January 20
February 11
February 20
March 11
March 20
April 11
April 20
May l l
May 20
June 11
June 20
July 11
July 20
July 25
Note # 1: Report #I for Advance Basis Contracts cannot be submitted to the Area Agency on Aging for
Southwest Florida, Inc. prior to July 1 or until the contract with the Agency has been executed and a
copy sent to the Agency on Aging for Southwest Florida, Inc. Actual submission of the vouchers to the
Agency is dependent on the of the expenditure report.
Note # 2: Report numbers 5 through 14 shall reflect an adjustment of at least one-tenth of the total advance
amounts, repaying advances issued the first two months of the agreement. All advance payments
made to the Contractor shall be returned to the Agency and reported as an advance recoupment on
each request for payment. The adjustment shall be recorded in Part C, Line 1 of the report
(ATTACHMENT IX).
Note #3: Submission of expenditure reports may or may not generate a payment request. If final expenditure
report reflects funds due back to the Agency, payment is to accompany the report.
Note:#4: ALL Expenditure Reports are due by 12:00 p.m. on the l lth of each month. IF the l lth falls on a
Saturday, then the report will be due by the 10th by 12:00 p.m. AND if the l lth falls on a Sunday, the
report will be due by the 12th by 12:00 p.m. Actual submission of the vouchers to Dept. of Elder Affairs
is dependent on the accuracy of the expenditure report, which is verified and paid by CIRTS data only.
50
Jgly 2019 — June 2020
ATTACHMENT X1
REQUEST FOR PAYMENT
HOME CARE FOR THE ELDERLY PROGRAM
HCE 203.19
RECIPIENT NAM
E, ADDRESS
PHONE#and FEID# Contract#
— TYPE OF PAYMENT_
Contract Period
Report Period
Advance—
Report#
----
(r—�
.____
Invoice#
_
-----------
CERTIFICATION: 1 herebycerti to fhe best of m knowledge that this request is cam tete and correct and conforms with the terms and the Durposes of the above
—ec—
contract.
o-the-hist-of-my-knowledg,all-GIRTSds seconds a d correct.
—t
Prepared y: _-_._-_..__-_.__.Dale:___ Ap—proved y:
PARER: BTJOGET`SUIvvfkAN
ti m
ervces
TOTAr
T.-TraTAmoun
$b.oa
Too$Tob
tete
rev ous un(s ve( orContract Period-O.Oi---
WOO—
b-60
. on ra -Balance line i minus I nnee 2
5b-06
$O:bO
$CFO—
. Pmv ousun(s eques a a -n WoT ece ve or onra enoT—
$b-00
$Too
6 -COR( CT"gA&IRC ne 3 minus ne
o -OD
--$b.00
C-OFITRXCT
IPARTB: FUNDSS REQUES
. nLcipaeCC-aiii""eer s -qhs
$0130
$U.-CF
—$O-.OT-
O:OO2.W.TapLid
2ores or Mem
V..�0-00
�031TPaTr �3
3. TO
$O.W
—$h 079—
$0150
PART-C-I
-SREQUESTED
ess
Vance pplied
--------------
QOM
$0150—$0-00
2T07 Uaos4EQUEST
EO (Pa�Er BTlihe3, minus Pa me 1)
$O.0
Who--
ho
List of Services / Units / Rates provided - See attached report.
List
Rev�e372377E—
-- — ---
51 \/C,
July 2019 - June 2020
ATTACIIMENT XII
RECEIPT AND EXPENDITURE REPORT
HOME CARE FOR THE ELDERLY PROGRAM
HCE 203.19
PROVIDER NAME, ADDRESS, PHONE # and FEID#
Program Funding:
Contract#
Contract Period
AAA Admin.
Report Period
Report#
Services
Invoice #
PSA#
CERTIFICATION : I certify to the best of my knowledge and belief that the report is complete and correct and all outlays herein
are for purposes set forth in the contract. To the best of my knowledge, all CIRTS is accurate and correct.
Prepared by : Date: Approved by : Date:
PART A: BUDGETED INCOME/RECEIPTS
1. Approved
2. Actual Receipts
3. Total Receipts
4. Percent of
Budget
For This Report
Year to Date
Approved Budget
1. State Funds
$0.00
$0.00
$0.00
#DIV/01
2. TOTAL RECEIPTS
$0.00
$0.00
$0.00
#DIV/01
PART B: EXPENDITURES
1. Approved
2. Expenditures
3. Expenditures
4. Percent of
Budget
For This Report
Year to Date
Approved Budget
1. AAA Program Administration
$0.00
$0.00
$0.00
#DIV/01
2. Services
$0.00
$0.00
$0.00
#DIV/01
3. TOTAL EXPENDITURES
$0.00
$0.00
$0.00
#DIV/01
PART 0: OTHER REVENUE AND EXPENDITURES
I. Interest:
II. Advance Recoupment
1. Earned on GR Advance $
2. Return of GR Advance $
1. Advance Recouped $
3, Other Earned $
DOEA FORM 105H
Reels d 03/23/18
52 C_�>
July 2019 — June 2020
ATTACHMENT XIV
SERVICE RATE REPORT
Collier
HCE 203.19
SERVICE
SFY 19/20
REIMBURSEMENT
UNIT RATE
METHOD OF
PAYMENT
UNIT
TYPE
BASIC SUBSIDY
Cost Reimbursement
Cost Reimbursement
EPISODE
CASE AIDE VENDOR
$33.88
Fixed Fee/Unit Rate
HOURS
CASE MANAGEMENT - VENDOR PAYMENT
$60.00
Fixed Fee/Unit Rate
HOURS
HOMEMAKING —VENDOR PAYMENT
$21.50
HOUSING IMPROVEMENT - HCE
Cost Reimbursement
Cost Reimbursement
EPISODE
HOUSING IMPROVEMENT - VENDOR PAYMENT
Cost Reimbursement
Cost Reimbursement
EPISODE
MATERIAL AID
Cost Reimbursement
Cost Reimbursement
EPISODE
OTHER -BACKGROUND SCREEN —VENDOR
$41.25
Fixed FeelUnit Rate
HOURS
PERSONAL CARE —VENDOR
$25.67
Fixed Fee/Unit Rate
HOURS
RESPITE - VENDOR PAYMENT
$25.02
Fixed Fee/Unit Rate
HOURS
SPECIALIZED MEDICAL EQUIPMENT, SERVICES,
AND SUPPLIES
Cost Reimbursement
Cost Reimbursement
EPISODE
SPECIALIZED MEDICAL EQUIPMENT, SERVICES,
AND SUPPLIES - VENDOR PAYMENT
Cost Reimbursement
Cost Reimbursement
EPISODE
TRANSPORTATION
Cost Reimbursement
Cost Reimbursement
TRIPS
s5
53
Revised August 2007
Attestation Statement
Agreement/Contract Number HCE 203.19
Amendment Number NA
I, Steuehn Y Cornell , attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
Collier County Board of County Commissioners
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting, due to the differences in
electronic data processing media, which has no affect on the agreement/contract content.
Signature of Recipiept/Contra
Revised August 2007
representative
Approved as to form and legality
Assi Tant County Attur m
October 2019 — September 2020
EHEAP 203.19
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC.
EMERGENCY HOME ENERGY ASSISTANCE PROGRAM
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Joe. (Agency)
and Collier County Board of County Commissioners (Contractor), collectively referred to as the 'Parties."
The term Contractor for this purpose may designate a Vendor, Subgrantee or Subrecipient.
WITNF..SSETH THAT:
WHEREAS, the Agency has determined that it is in need of certain services as described herein; and
WHEREAS, the Contractor has demonstrated that it has the requisite expertise and ability to faithfully
perform such set -vices as an independent Contractor of the Agency.
NOW THEREFORE, in consideration of the services to be performed and payments to be made, together
with the mutual covenants and conditions set forth herein, the Parties agree as follows:
1. Purpose of Contract:
The purpose of this contract is to provide services in accordance with the terms and conditions
specified in this contract including all attachments, forms and exhibits, which constitute the contract
document.
2 Incorporation of Documents within the Contract:
The contract will incorporate attachments, proposal(s), state plan(s), grant agreements, relevant
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 at twelve (12:00) AM., Eastern Standard Time October 1, 2019 or on the
date the contract has been signed by the last party required to sign it, whichever is later. It shall end
at eleven fifty-nine (11:59) P.M., Eastern Standard Time September 30, 2020.
4 Contract Amount:
The Agency agrees to pay for contracted services according to the terms and conditions of this contract
in an amount not to exceed $73,218.87 subject to the availability of funds. Any costs or services paid
for under any other contract or from any other source are not eligible for payment under this contract.
5. Renewals:
By mutual agreement of the Parties, in accordance with Section 287.058(1)(g), Florida Statutes (F.S.),
the Agency may renew the contract for a period not to exceed three years, or the term of the original
contract, whichever is longer. The renewal price, or method for determining a renewal price, is set
price, is set forth in the bid, proposal, or reply. No other costs for the renewal may be charged. Any
1
GAO
October 2019 — September 2020 EHEAP 203.19
renewal is subject to the same terms and conditions as the original contract and contingent upon
satisfactory performance evaluations by the Agency and the availability of funds.
6. Compliance with Federal Law:
6.1 If this contract contains federal funds this section shall apply.
6.1.1 The Contractor shall comply with the provisions of 45 Code of Federal Regulations (CFR) 75
and/or 45 CFR Part 92, 2 CFR Part 200 and other applicable regulations.
6.1.2 If this contract contains federal funds and is over $100,000.00, the Contractor shall comply
with all applicable standards, orders, or regulations issued under Section 306 of the Clean Air
Act as amended (42 United States Code (U.S.C.) 7401, et seq.), Section 508 of the Federal
Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order t 1738,
as amended, and where applicable Environmental Protection Agency regulations 2 CFR Part
1500, The Contractor shall report any violations of the above to the Agency.
6.13 Neither the Contractor nor any agent acting on behalf of the Contractor, may not use any
federal finds received in connection with this contract to influence legislation or
appropriations pending before Congress or any state legislature. The Contractor must complete
all disclosure forms as required, specifically the Certification and Assurances Attachment,
which must be completed and returned to the Contract Manager prior to the execution of this
contract.
6.1.4 In accordance with Appendix 1I to 2 CFR Part 200, the Contractor shall comply with Executive
Order 11246, Equal Employment Opportunity, as amended by Executive Order 11375 and
others, and as supplemented in Department of Labor regulations 41 CFR Part 60 and in
Department of Health and Human Services regulations 45 CFR Part 92, if applicable.
6.1.5 A contract award with an amount expected to equal or exceed $25,000.00 and certain other
contract awards will not be made to parties listed on the government -wide Excluded Parties
List System, in accordance with the Office of Management and Budget (OMB) guidelines at
2 CFR Part 180 that implement Executive Orders 12549 and 12689, 'Debarment and
Suspension." The Excluded Parties List System contains the names of parties debarred,
suspended, or otherwise excluded by agencies, as well as parties declared ineligible under
statutory or regulatory, authority other than Executive Order 12549. The Contractor shall
comply with these provisions before doing business or entering into subcontracts receiving
federal funds pursuant to this contract. The Contractor shall complete and sign the
Certifications and Assurances Attachment prior to the execution of this contract.
62 The Contractor shall not employ an unauthorized alien. The Agency will consider the employment
of unauthorized aliens a violation of the Immigration and Nationality Act (8 U.S.C. 1324a) and the
Immigration Reform and Control Act of 1986 (8 U.S.C. 1101). Such violation will be cause for
unilateral cancellation of this contract by the Agency.
63 If the Contractor is a non-profit provider and is subject to Internal Revenue Service (IRS) tax exempt
organization reporting requirements (filing a Form 990 or Form 990-N) and has its tax-exempt
status revolted for failing to comply with the filing requirements of the Pension Protection Act of
2006 or for any other reason, the Contractor must notify the Agency in writing within thirty (30)
days of receiving the IRS notice of revocation.
2
October 2019 — September 2020
EHEAP 203.19
6.4 Tire Contractor shall comply with Title 2 CFR Pail 175 regarding Trafficking in Persons.
65 Unless exempt under 2 CFR Part 170.110(b), the Contractor shall comply with the reporting
requirements of the Transparency Act as expressed in 2 CPR Part 170.
6.6 To comply with Presidential Executive Order 12989, as amended, and State of Florida Executive
Order Number 11-116, Contractor agrees to utilize the U.S. Department of Homeland Security's E -
verify system to verify the employment of all new employees hired by Contractor during the
contract term. Contractor shall include in related subcontracts a requirement that Subcontractors
performing work or providing services pursuant to the state contract utilize the E -verify system to
verify employment of all new employees hired by the Subcontractor daring the contract term.
Contractors meeting the terms and conditions of the E -Verify System are deemed to be in
compliance with this provision.
7. Coin Ill ianccwithState Law:
7.1 This contract is executed and entered into in the State of Florida, and shall be construed, performed,
and enforced in all respects in accordance with Florida law, including Florida provisions for conflict
of laws,
7.2 If this contract contains state financial assistance funds, the Contractor shall comply with Section
21597, F.S., and Section 215.971, F.S., and expenditures must be in compliance with laws, rules,
and regulations including, but not limited to, the Reference Guide for State Expenditures.
7.3 The Contractor shall comply with the requirements of Section 287.058, F.S., as amended.
7.3.1 The Contractor shall perform all tasks contained in ATTACHMENT I.
73.2 The Contractor shall provide units of deliverables, including reports, findings, and drafts, as
specified in ATTACHMENT I to be received and accepted by the Area Agency contract
manager prior to payment.
7.33 The Contractor shall comply with the criteria and final date by which such criteria must be met
for completion of this contract as specified in ATTACHMENT I, Section III. Method of
Payment,
73.4 The Contractor shall submit bills for fees or other compensation for services or expenses in
sufficient detail for a proper pre -audit and post -audit.
7.3.5 If itemized payment for travel expenses is permitted in this contract, the Contractor shall
submit bills for any travel expenses in accordance with Section 112.06 1, F.S., or at such lower
rates as may be provided in this contract.
7.3.6 The Contractor shall allow public access to all documents, papers, tetters, or other public
records as defined in Section 119.011(72), F.S., made or received by the Contractor in
conjunction with this contract except for those records which are made confidential or exempt
by law. The Contractor's refusal to comply with this provision will constitute an immediate
breach of contract for which the Agency may unilaterally terminate this contract.
7.4 If clients are to be transported under this contract, the Contractor shall comply with the provisions
of Chapter 427, F.S., and Rule Chapter 41-2, Florida Administrative Code (F.A.C).
7.5 Subcontractors who are on the Discriminatory Vendor List may not transact business with any
public entity, in accordance with the provisions of Section.287.134, F.S.
IN
October 2019 — September 2020 EHEAP 203.19
7.6 The Contractor shall comply with the provisions of Section 11.062, F.S., and Section 216.347, F.S.,
which prohibit the expenditure of contract finds for the purpose of lobbying the legislature, judicial
branch or a state agency.
7.7 The Agency may, at its option, terminate the Contract if the Contractor is found to have submitted
a false certification as provided under Section 287.135(5), F.S., has been placed on the Scrutinized
Companies with Activities in the ban Petroleum Energy Section List, the Scrutinized Companies
with Activities in Sudan .List, or the Scrutinized Companies that Boycott Israel list, or if the
contractor had been engaged in business operations in Cuba or Syria or is engaged in a boycott of
Israel.
8. Backeround Screening:
The Contractor shall ensure that the requirements of Section 430.0402 and Chapter 435, F.S, as
amended, are met regarding background screening for all persons who meet the definition of a direct
service provider and who are not exempt from the Agency's level 2 background screening pursuant
to Sections 430.0402(2)-(3), F.S. The Contractor must also comply with any applicable rules
promulgated by the Agency and the Department for Health Care Administration regarding
implementation of Section 430.0402 and Chapter 435, F.S. To demonstrate compliance with this
provision, Contractor shall submit the Background Screening Affidavit of Compliance (Screening
Form) to the Agency within thirty (30) days of execution of this contract. Should the Agency have
a completed Screening Form on file for the Contractor, a new Screening Form will be required every
twelve (12) months.
8.1 Further information concerning the procedures for background screening may be found at
lithr//clderaffairs.state fl us/doca/backgroundscreenina.Iprn•
9. Grievance Procedures:
The Contactor shall develop, implement, and ensure that its Subcontractors have established
grievance procedures to process and resolve client dissatisfaction with, or denial of, service(s) and
address complaints regarding the termination, suspension or reduction of services, as required for
receipt of funds. These procedures, at a minimum, will provide for notice of the grievance procedure
and an opportunity for review of the Subcontractor's determination(s).
10. Publie Records and Retention:
1.0.1By execution of this contract, Contractor agrees to all provisions of Chapter 119, F.S., and any
other applicable law, and shall:
1O.1.11(eep and maintain public records required by the Agency to perform the contracted services.
1O.1.2tJpon request from the Agency's custodian of public records, provide the Agency a copy of
the requested records or allow the records to be inspected or copied within a reasonable time
at a cost that does not exceed the cost provided in Chapter 119, F.S., or as otherwise provided
by law.
1O.1.3Ensure that public records that are exempt or confidential and exempt from public records
disclosure requirements are not disclosed except as authorized by law for the duration of the
contract term and following completion of the contract if the Contractor does not transfer the
records to the Agency.
1OJAUpon completion of the contract, the Contractor will either transfer, at no cost to the Agency,
all public records in possession of the Contractor to the Agency, or will keep and maintain
public records required by the Agency. If the Contractor transfers all public records to the
0
October 2019 — September 2020
EHEAP 203.19
Agency upon completion of the contract, Contractor shall destroy any duplicate public records
that are exempt or confidential and exempt from public records disclosure requirements. If the
Contractor keeps and maintains public records upon completion of the contract, the Contractor
shall meet all applicable requirements for retaining public records. All records stored
electronically must be provided to the Agency in a format that is compatible with the
information technology systems of the Agency.
10.2 The Agency may unilaterally cancel this contract, notwithstanding any other provisions of this
contract, for refusal by the Contractor to comply with Section 10 of this contract by not allowing
public access to all documents, papers, letters, or other material made or received by the Contractor
in conjunction with this contract, unless the records are exempt or confidential and exempt from
Section 24(a) of Article I of the State Constitution and Section 119.07(1 ), F.S.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF
CHAPTER 11.9, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE
PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF
PUBLIC RECORDS AT:
Public Records Coordinator
Area Agency on Aging for Southwest Florida, Inc.
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
239-652-6900 or 866-413-5337
10.3 Upon termination of this contract, whether for convenience or for cause as detailed in section 53 of
this contract, the Contractor and Subcontractors shall, at no cost to the Agency, transfer all public
records in their possession to the Agency and destroy any duplicate public records that are exempt,
or confidential and exempt, from public records disclosure requirements. All records stored
electronically shall be provided to the Agency in a format that is compatible with the information
technology systems of the Agency.
1LAudits, Inspections, Investil?ations:
11.1 The Contractor shall establish and maintain books, records and documents (including electronic
storage media) sufficient to reflect all assets, obligations, unobligated balances, income, interest
and expenditures of funds provided by the Agency under this contract. Contractor shall adequately
safeguard all such assets and assure that they are used solely for the purposes authorized under this
contract. Whenever appropriate, financial information should be related to performance and unit
cost data.
11.2 The Contractor shall retain and maintain all client records, financial records, supporting
documents, statistical records, and any other documents (including electronic storage media)
pertinent to this contract for a period of six (6) years after completion of the contract, or longer
when required by law. In the event an audit is required by this contract, records shall be retained
for a minimum period of six (6) years after the audit report is issued or until resolution of any audit
findings or litigation based on the terms of this contract, at no additional cost to the Agency.
IL3Upon demand, at no additional cost to the Agency, the Contractor shall facilitate the duplication
and transfer of any records or documents during the required retention period.
IIAThe Contractor shall ensure that the records described in this section will be subject at all
October 2019 — September 2020 EHEAP 203.19
reasonable times to inspection, review, copying, or audit by federal, state, or other personnel duly
authorized by the Agency.
11.5 At all reasonable times f'o• as long as records are maintained, persons duly authorized by the
Agency and federal auditors, pursuant to 45 CFR Part 75, shall be allowed full access to and the
right to examine any of the Contractor's contracts and related records and documents pertinent to
this specific contract, regardless of the form in which kept.
11.6 The Contractor shall provide a Financial and Compliance Audit to the Agency as specified in this
contract and ensure that all related third -party transactions are disclosed to the auditor.
11,7Contractor agrees to comply with the Inspector General in any investigation, audit, inspection,
review, or hearing performed pursuant to Section 20.055, Florida Statutes. Contractor further agrees
that it shall include in related subcontracts a requirement that subcontractors performing work or
providing services pursuant to this contract agree to cooperate with the Inspector General in any
investigation, audit, inspection, review, or hearing pursuant to Section 20.055(5), F.S. By execution
of this contract, the Contractor understands and will comply with this subsection.
12.Nondiscrimination-Civil Rieirts Compliance:
12.1 The Contractor shall execute Assurances as stated in the Assurances -Non -Construction Programs
Attachment that it will not discriminate against any person in the provision of services or benefits
under this contract or in employment because of age, race, religion, color, disability, national origin,
marital status, or sex in compliance with state and federal law and regulations. The Contractor
further assures that all Contractors, Subcontractors, Sub -grantees, or others with whom it arranges
to provide services or benefits in connection with any of its programs and activities are not
discriminating against clients or employees because of age, race, religion, color, disability, national
origin, marital status, or sex.
12.2 During the term of this contract, the Contractor shall complete and retain on file a timely, complete,
and accurate Civil Rights Compliance Checklist, attached to this contact.
12.3The Contactor shall establish procedures pursuant to federal law to handle complaints of
discrimination involving services or benefits through this contract, These procedures shall include
notifying clients, employees, and participants of the right to file a complaint with the appropriate
federal or state entity.
12.4 If this contact contains federal finds, these assurances are a condition of continued receipt of or
benefit from federal financial assistance, and are binding upon the Contractor, its successors,
transferees, and assignees for the period during which such assistance is provided. The Contractor
further assures that all Subcontractors, Vendors, or others with whom it arranges to provide services
or benefits to participants or employees in connection with any of its programs and activities are
not discriminating against those participants or employees in violation of any statutes, regulations,
guidelines, and standards. In the event of failure to comply, the Contractor understands that the
Agency may, at its discretion, seek a court order requiring compliance with the terms of this
assurance or seek other appropriate judicial or administrative relief including, but not limited to,
termination of the contact and denial of further assistance.
13.Monitoring by the Agency:
The Contractor shall permit persons duly authorized by the Agency to inspect and copy any records,
papers, documents, facilities, goods, and services of the Contactor, which are relevant to this contract,
and to interview any clients, employees, and Subcontractor employees of the Contractor to assure the
MA
October 2019 — September 2020 EHEAP 203.19
Agency of the satisfactory performance of the terms and conditions of this contract. Following such
review, the Agency will provide a written report of its findings to (lie Contractor and, where appropriate,
the Contractor shall develop a Corrective Action Plan (CAP). The Contractor hereby agrees to correct all
deficiencies identified in the CAP in a timely manner as determined by the Contract Manager.
14. Provision of Services:
The Contractor shall provide services in the manner described in ATTACHMENT I.
15. Coordinated Monitoring with Other Agencies:
If the Cont actor receives funding from one or more State of Florida human service agencies, in addition
to the Agency, then a joint monitoring visit including such other agencies may be scheduled. For the
purposes of this contract, and pursuant to Section 287.0575, F.S., as amended, Florida's human service
agencies shall include the Agency, the Department of Children and Families, the Department of Health,
the Agency for Persons with Disabilities, and the Department of Veterans' Affairs. Upon notification and
the subsequent scheduling of such a visit by the designated agency's lead administrative coordinator, the
Contractor shall comply and cooperate with all monitors, inspectors, and/or investigators.
16. New Contract(s) Reporting:
The Contractor shall notify the Agency within lien (10) days of entering into a new contract with any of
the remaining four (4) state human service agencies. The notification shall include the following
information: (1) contracting state agency and the applicable office or program issuing the contract; (2)
contract name and number; (3) contract start and end dates; (4) contract amount; (5) contract description
and commodity or service; and (6) Contract Manager name and contact information. In complying with
this provision, and pursuant to Section 287.0575, F.S., as amended, the Contractor shall complete the
Contractor's State Contracts List attached to this contract.
17. Indemnification:
The Contractor shall indemnify, save, defend, and hold harmless the Agency and its agents and employees
from any and all claims, demands, actions, and causes of action of whatever nature or character arising
out of, or by reason of the execution of this agreement or performance of the services provided for herein.
It is understood and agreed that the Contractor is not required to indemnify the Agency for claims,
demands, actions, or causes of action arising solely out of the negligence o f the Agency.
17.1 ,Except to the extent permitted by Section 768.28, F.S., or other Florida law, this Section 17 is not
applicable to contracts executed between the Agency and state agencies or subdivisions defined in
Section 768.28(2), F.S.
18 Insurance and Bonding:
181 The Contractor shall provide continuous adequate liability insurance coverage during the existence
of this contract and any renewal(s) and extension(s) of it. By execution of this contract, unless it
is a state agency or subdivision as defined by Section 768.28(2), F.S., the Contractor accepts fall
responsibility for identifying and determining the type(s) and extent of liability insurance coverage
necessary to provide reasonable financial protections for the Contractor and the clients to be served
under this contract. The limits of coverage under each policy maintained by the Contractor do not
limit the Contractor's liability and obligations under this contract. The Contractor shall ensure that
the Agency has the most current written verification of insurance coverage throughout the term of
this contract. Such coverage may be provided by a self-insurance program established and
operating under the laws of the State of Florida. The Agency reserves the right to require additional
insurance as specified in this contract.
October 2019 — September 2020
EHEAP 203,19
182 Throughout the term of this contract, the Contractor shall maintain an insurance bond from a
responsible commercial insurance company covering all officers, directors, employees, and agents
of the Contractor authorized to handle funds received or disbursed under all agreements and/or
.contracts incorporating this contract by reference in an amount commensurate with the funds
handled, the degree of risk as determined by the insurance company, and consistent with good
business practices.
19 Confidentiality of Information:
The Contractor shall not use or disclose any information concerning a recipient of services under this
contract for any purpose prohibited by state or federal law or regulations except with the written consent
of a person legally authorized to give that consent or when authorized by law.
2R Health insurance Portability and Accountability Act:
Where applicable, the Contractor shall comply with the Health Insurance Portability and Accountability
Act (42 USC § 1320d.), as well as all regulations promulgated thereunder (45 CFR Parts 160, 162, and
164).
21. Incident Reporting:
21J The Contractor shall notify the Agency immediately but no later than forty-eight (48) hours from
the Contractor's awareness or discovery of conditions that may materially affect the Contractor's
or Subcontractor's ability to perform the services required to be performed under this contract.
Such notice shall be made orally to the Agency's Contract Manager (by telephone) with an email
to immediately follow,
212 The Contractor shall immediately report knowledge or reasonable suspicion of abuse, neglect, or
exploitation of it child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide
toll-free telephone number (1-800-96ABUSE). As required by Chapters 39 and 415, F.S., this
provision is binding upon the Contractor, its Subcontractors, and their employees.
22. Bankruptcy Notification:
During the term of this contract, the Contractor shall immediately notify the Area Agency on Aging for
Southwest Florida, Inc. if the Contractor, its assignees, Subcontractors, or affiliates file a claim for
bankruptcy. Within ten (10) days after notification, the Contractor must also provide the following
information to the Area Agency on Aging for Southwest Florida, Inc.: (1) the date of filing of the
bankruptcy petition; (2) the case number; (3) the court name and the division in which the petition was
filed (e.g., M District of Florida,'fallahassee Division); and (4) the name, address, and telephone number
of the bankruptcy attorney.
23. Snonsorsbip and Publiei
231 As required by Section 286.25, F.S., if the Contractor is a non-governmental organization which
sponsors a program financed wholly or in part by state funds, including any funds obtained through
this contract, it shall, in publicizing, advertising, or describing the sponsorship of the program,
state: "Sponsored by (Contractors name) and the State of Florida, Department of Elder Affairs
and/or the Area Agency on Aging for Southwest Florida, Inc.." If the sponsorship reference is in
written material, the words "State of Florida, Department of Elder Affairs and/or the Area Agency
on Aging for Southwest Florida, inc." shall appear in at least the same size letters or type as the
name of the organization.
October 2019 — September 2020
EHEAP 203.19
232 The Contractor shall not use the words "State of Florida, Department of Elder Affairs and the Area
Agency on Aging for Southwest Florida, Inc." to indicate sponsorship of a program otherwise
financed, unless specific authorization has been obtained by the Agency prior to such use.
24 Assignments:
241 The Contractor shall not assign the rights and responsibilities under this contract without the prior
written approval of the Agency. Any sublicense, assignment, or transfer otherwise occurring
without prior written approval of the Agency shall constitute a material breach of the contract. In
the event the State of Florida approves transfer of the Contractor's obligations, the Contractor
remains responsible for all work performed and all expenses incurred in connection with this
contract.
242 This contract shall remain binding upon the successors in interest of the Contractor and the
Agency.
25. Subcontracts:
251 The Contractor is responsible for all work performed and for all commodities produced pursuant
to this contract, whether actually furnished by the Contractor or its Subcontractors. Any
subcontracts shall be evidenced by a written document and subject to any conditions of approval
the Agency deems necessary. The Contractor further agrees that the Agency will not be liable to
the Subcontractor in any way or for any reason. The Contractor, at its expense, shall defend the
Agency against any such claims.
252 The Contractor shall promptly pay any Subcontractors upon receipt of payment from the Agency
or other state agency. Failure to male payments to any Subcontractor in accordance with Section
287.0585, F.S., unless otherwise stated in the contract between the Contractor and Subcontractor,
will result in a penalty as provided by statute.
26. Independent Capacity of Contractor:
It is the intent and understanding of the Parties that the Contractor and any of its Subcontractors are
independent Contractors and are not employees of the Agency, and that they shall not hold themselves
out as employees or agents of the Agency without prior specific authorization from the Agency. It is the
further intent and understanding of the Parties that the Agency does not control the employment
practices of the Contractor and will not be liable for any wage and hour, employment discrimination, or
other labor and employment claims against the Contractor or its Subcontractors. All deductions for
social security,, withholding taxes, income taxes, contributions to unemployment compensation funds,
and all necessary insurance for the Contractor are the sole responsibility of the Contractor.
V. Payment:
Payments shall be made to the Contractor for all completed and approved deliverables (units of service)
as defined in ATTACHMENT 1. The Area Agency Contract Manager will have final approval of the
Contractor's invoice submitted for payment and will approve the invoice for payment only if the
Contractor has met all terms and conditions of the contract, unless the bid specifications, purchase order,
or this contact specify otlierwise. The approved invoice will be submitted to the Agency's finance
section for budgetary approval and processing. Disputes arising over invoicing and payments will be
resolved in accordance with the provisions of Section 215.422, F.S. A Vendor Ombudsman has been
established within the Florida Department of Financial Services and may be contacted at 800-342-2762.
9
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October 2019 — September 2020 EHEAP 203.19
28 Return of Funds:
The Contractor shall return to the Agency any overpayments due to unearned funds or funds disallowed,
and any interest attributable to such fiords pursuant to the terms and conditions of this contract, that were
disbursed to the Contractor by the Agency. In the event that the Contractor or its independent auditor
discovers that an overpayment has been made, the Contractor shall repay said overpayment immediately
without prior notification from the Agency. In the event that the Agency first discovers an overpayment
has been made, the Area Agency Contract Manager will notify the Contractor in writing of such findings.
Should repayment not be made forthwith, the Contractor shall be charged at the lawful rate of interest
on the outstanding balance pursuant to Section 55.03, F.S., after Agency notification or Contractor
discovery.
29 Data Integrity and Safeguarding Information:
The Contractor shall ensure an appropriate level of data security for the information the Contractor is
collecting or using in the performance of this contract. An appropriate level of security includes
approving and tracking all Contractor employees that request system or information access and ensuring
that user access has been removed from all terminated employees. The Contractor, among other
requirements, must anticipate and prepare for the loss of information processing capabilities. All data
and software shall be routinely backed up to ensure recovery from losses or outages of the computer
system. The security over the backed -up data is to be as stringent as the protection required of the
primary systems. The Contractor shall ensure all Subcontractors maintain written procedures for
computer system backup and recovery. The Contractor shall complete and sign the Certification
Regarding Data Integrity Compliance for Agreements, Grants, Loans, and Cooperative Agreements
prior to the execution of this contract.
AA Computer Use and Social Media Policy:
The Department has implemented a Social Media Policy, in addition to its Computer Use Policy, which
applies to all employees, contracted employees, consultants, Other Personal Services (OPS) employees
and volunteers, including all personnel affiliated with third parties, such as, but not limited to, contractors
and subcontractors. Any entity that uses the Department's computer resource systems must comply with
the Department's policy regarding social media. Social Media includes, but is not limited to, blogs,
podcasts, discussion forums, Wikis, RSS feeds, video sharing, social networks like MySpace, Facebook
and Twitter, as well as content sharing networks such as flicla• and YouTube. This policy is available on
the Department's website at: http://eidei-affairs state.fl.us/doea/financial.plip.
31. Conflict of Interest:
The Contractor shall establish safeguards to prohibit employees, board members, management, and
Subcontractors from using their positions for a purpose that constitutes or presents the appearance of
personal or organizational conflict of interest or personal gain. No employee, officer, or agent of the
Contractor or Subcontractor shall participate in the selection, or in the award of a contract supported by
state or federal funds if a conflict of interest, real or apparent, would be involved. Such a conflict would
arise when: (a) the employee, officer or agent; (b) any member of his/her immediate family; (c) his or
her partner; or (d) an organization which employs, or is about to employ, any of the above individuals,
has a financial or other interest in the firm being selected for award. The Contractor's or Subcontractor's
officers, employees, or agents will neither solicit not, accept gratuities, favors, or anything of monetary
value from Contractors, potential Contractors, or parties to Subcontracts. The Contractors 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
10
October 2019 — September 2020 EHEAP 203.19
appointment, or, placement in that position,, or if the individual is serving as an incumbent, within thirty
(30) calendar days or the commencement of this contract. The Contractor's employees and
Subcontractors must make the same disclosures described above to the Contractor's board of directors.
Compliance with this provision will be monitored.
32. Public Entity Crime:
Pursuant to Section 287.133, F.S., a person or affiliate who has been placed on the Convicted Vendor
List following a conviction for a public entity crime may not submit a bid, proposal, or reply on a
contract to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on
a contract with a public entity for the construction or repair of a public building or public work; may not
submit bids, proposals, or replies on leases of real property to a public entity; may not be awarded or
perform work as a Contractor, Supplier, Subcontractor, or Consultant wider a contract with any public
entity; and may not transact business with any public entity in excess of the threshold amount provided
in Section 287.017, F.S., for CATEGORY TWO for a period of thirty six (36) months following the
date of being placed on the Convicted Vendor List.
33 Purchasing:
Alt The Contractor may purchase articles which are the subject of or are required to carry out, this
contract from Prison Rehabilitative Industries and Diversified Enterprises, Inc., (PRIDE)
identified under Chapter 946, F.S., in the same manner and under the procedures set forth in
Sections 946.515(2) and (4), F.S. For purposes of this contract, the Contractor 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.
332 The Contractor may procure any recycled products or materials which are the subject of or are
required to carry out this contract in accordance with the provisions of Section 403.7065, F.S.
333 The Contractor may purchase articles that are the subject of, or required to carry out, this contract
from a nonprofit agency for the Blind or for the Severely Handicapped that is qualified pursuant
to Chapter 413, F.S., in the same manner and under the same procedures set forth in Sections
413.036(1) and (2), F.S. For purposes of this contract, the Contractor shall be deemed to be
substituted for the Agency insofar as dealings with such qualified nonprofit agency are concerned.
Additional information about the designated nonprofit agency and the products it offers is
available at h�,./wwwsespactoffioridaLoi� This clause is not applicable to Subcontractors unless
otherwise required by law.
3'6 Patents, Copyrights, Royalties:
ffthis contact is awarded state 'funding and if any discovery, invention, or copyrightable material is
developed or produced in the course of or as a result of work or services performed raider this contract
or in any way connected with this contract, or if ownership of any discovery, invention, or
copyrightable material to the Agency to be referred to the Department of State. Any and all patent
rights or copyrights accruing under this contract are hereby reserved to the State of Florida in
accordance with Chapter 286, F.S. Pursuant to Section 287.057l(5)(k), F.S., the only exceptions to
this provision shall be those that are clearly expressed and reasonably valued in this contract.
311 If the primary purpose of this contract is the creation of intellectual property, the State ofFlorida
shall retain an unencumbered right to use such property, notwithstanding any agreement made
Pursuant to this Section 34.
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October 2019 — September 2020 EHEAP 203.19
342 If this contract is awarded solely federal funding, the terms and conditions are governed by 2 CFR
200.315 or 45 CFR 75.322, as applicable.
343 Notwithstanding the foregoing provisions, if the Contractor or one of its Subcontractors is a
university and a member of the State University System of Florida, then Section 1004.23, F.S.,
shall apply, but the Agency shall retain a perpetual, fhlly-paid, nonexclusive license for its use
and the use of its Contractors, Subcontractors, or Assignees of any resulting patented,
copyrighted, or trademarked work products.
35 Emergency Preparedness and Continuity of Operations:
M1 If the tasks to be performed pursuant to this contract include the physical care and control of
clients, or the administration and coordination of services necessary for client health, safety, or
welfare, the Contractor shall, within thirty (30) calendar days of the execution of this contract,
submit to the Agency's Contract Manager verification of an Emergency Preparedness Plan. In the
event of an emergency, the Contractor shall notify the Agency of emergency provisions.
352 In the event a situation results in a cessation of services by a Subcontractor, the Contractor shall
remain responsible for performance under this contract and must follow procedures to ensure
continuity of operations without interruption.
36 Equipment
361 Equipment means: (a) tangible personal property (including information technology systems)
having a useful life of more than one year and a per-unit acquisition cost which equals or exceeds
the lesser of the capitalization level established by the organization for the financial statement
purposes, or $5,000.00 [for federal funds -2 CFR 200.33 and 45 CFR 75.2, as applicable], or (b);
nonexpendable, tangible personal property of a non -consumable nature with an acquisition cost of
$1,000.00 or more per unit, and expected useful life of at least one (1) year; and hardback bound
books not circulated to students or the general public, with a value or cost of $250.00 or more [for
state funds].
362 Contractus and Subcontractors who are Institutions of Higher Education, Hospitals, and Other
Non -Profit Organizations shall have written property management standards in compliance with 2
CFR Part 200 Administrative Requirements (formerly OMB Circular A-1 10) that include: (a) a
property list with all the elements identified in the circular; (b) a procedure for conducting a
physical inventory of equipment at least once every two (2) years; (c) a control system to insure
adequate safeguards to prevent loss, damage, or theft of the equipment; and (d) maintenance
procedures to keep the equipment in good condition. The property records must be maintained on
file and shall be provided to the Agency upon request. The Contactor shall promptly investigate,
fully document, and notify the Agency's Contract Manager of any loss, damage, or theft of'
equipment. The Contractor shall provide the results of the investigation to the Agency's Contact
Manager.
353 The Contractor's property management standards for equipment (including replacement
equipment), whether acquired in whole or part with federal funds and federally -owned equipment
shall, at a minimum, meet the following requirements and shall include accurately maintained
equipment records with the following information:
36.3.1 Property records must be mairrtained that include a desceiption of the equipment;
36.3.2 Manufacturer's serial number, model number, federal stock number, national stock
number, or other identification number;
12
October 2019 — September 2020 EHEAP 203.19
36.3.3 Source of funding for the equipment, including the federal award number identification
number;
36.3.4 Whether title vests in the Contractor or the federal government;
36.3.5 Acquisition date (or date received, if the equipment was furnished by the federal
government);
36.3.6 Information from which one can calculate the percentage of federal participation in the
cost of the equipment (not applicable to equipment furnished by the federal
government);
36.3.7 Location, use and condition of the equipment and the date the information was
reported;
36.3.8 Unit acquisition cost; and
36.3.9 Ultimate disposition data, including date of disposal and sales price or the method
used to determine current fair market value where a Contractor compensates the
federal awarding agency for its share.
36.3.10 A physical inventory must be taken, and the results reconciled with the property
records at least once every two (2) years.
36.3.11 A control system must be developed to ensure adequate safeguards to prevent loss,
damage, or theft of the property. Any loss, damage, or theft must be investigated.
45 CFR § 75.320(d)(3).
36.3.12 Adequate maintenance procedures must be developed to keep the property in good
condition.
36.3.13 If the Contractor is authorized or required to sell the equipment, proper sales
procedures must be established to ensure the highest possible return.
36.4 Equipment purchased with federal fiords with an acquisition cost over $5,000.00 and equipment
purchased with state funds with an acquisition cost over $1,000.00 is part of the cost of carrying
out the activities and functions of the grant awards and title (ownership) will vest in the Contractor
[for federal funds see 2 CFR § 200.313(a) and 45 § CFR 75.320(x), as applicable], subject to the
conditions of 2 CPR Part 200 and/or 45 CFR part 75. Equipment purchased under these thresholds
is considered supplies and is not subject to property standards. Equipment purchased with funds
identified in the budget attachments to agreements covered by this contract or identified in the sub -
agreements with Subcontractors (not included in a cost methodology), is subject to the conditions
of Chapter 273, F.S., rule 60A-1.001 7, F. A. C., and 2 CFR Part 200 and/or 45 CFR Part 75.
36.5 The Contractor shall not dispose of any equipment or materials provided by the Agency, or
purchased with funds provided through this contract without first obtaining the approval of the
Agency's Contract Manager. When disposing of property or equipment the Contractor must submit
it written request for disposition instructions to the Agency's Contract Manager. The request should
include a brief description of the property, purchase price, funding source, and percentage of state
or federal participation, acquisition date and condition of the property. The request should also
indicate the Contractor's proposed disposition of the property (i.e., transfer or donation to another
agency that administers federal programs, offer of the items for sale, destroy the items, etc.).
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October 2019 — September 2020
EHEAP 203.19
36.6 The Agency's Contract Manager will issue disposition instructions. If disposition instructions are
not received within one hundred twenty (1.20) days of the written request for disposition, the
Contractor is authorized to proceed as directed in 2 CFR § 200.313 or 45 CFR § 75.320, as
applicable.
36.7 Real property means land (including land improvements), buildings, structures and appurtenances
thereto, but excludes movable machinery and equipment. Real property may not be purchased with
state or federal funds thorough agreements covered under this contract without the prior approval of
the Agency. Real property purchases from Older Americans Act funds are subject to the provisions
of Title 42, Chapter 35, Subchapter III, Part A., Section 3030b United States Code (USC). Real
property purchases from state funds can only be made through fixed capital outlay grants and aids
appropriations and therefore are subject to the provisions of Section 216.348, F.S.
36.8 Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted
and tested prior to disposal to ensure no confidential information remains.
36.9 The Contractor must adhere to the Agency's procedures and standards when purchasing Information
Technology Resources (ITR) as part of any agreement(s) incorporating this contract by reference.
An ITR worksheet is required for any computer related item costing $1,000.00 or more, including
data processing hardware, software, services, supplies, maintenance, training, personnel, and
facilities. The completed fFR worksheet shall be maintained in the LAN administrator's file and
must be provided to the Agency upon request. The Contractor has the responsibility to require any
Subcontractors to comply with the Agency's ITR procedures.
37.PUR 1000 Form:
The PUR 1000 Foran is hereby incorporated by reference and available at:
http_!/w_yw_.mvflorida cpm/;ap lsh bsladoc,T-7740 PUR I000.pdf
In the event of any conflict between the PUR 1000 Form and any terms or conditions of this contract, the
terms or conditions of this contract shall take precedence over the PUR1000 Form. However, if the
conflicting terms or conditions in the PUR1000 Form are required by any section of the Florida Statutes,
the terms or conditions contained in the PUR1000 Form shall take precedence.
38. Use of State Funds to Purchase or Improve Real Property:
Any state fiords provided for the purchase of or improvements to real property are contingent upon the
Contractor or political subdivision granting to the state a security interest in the property at least to the
amount of state funds provided for at least five (5) years from the date of purchase or the completion of
the improvements or as further required by law.
39. Dispute Resolution:
Any dispute concerning performance of the contract shall be decided by the Agency's Contract Manager,
who shall reduce the decision to writing and serve a copy on the Contractor.
40. Financial Consenuences:
If the Contractor faits to meet the minimum level of service or performance identified in this contract, the
Agency will impose financial consequences as stated in ATTACHMENT I.
14
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41. No Waiver of Sovereign Immunity:
EHEAP 203.19
Nothing contained in this contract is intended to serve as a waiver of sovereign immunity by any entity
to which sovereign immunity may be applicable.
42. Venuc:
If any dispute arises out of this contract, the venue of such legal recourse shall be Lee County, Florida.
43.Entire Contract:
This contract contains all the terms and conditions agreed upon by the Parties. No oral agreements or
representations shall be valid or binding upon the Agency or the Contractor unless expressly contained
herein or by a written amendment to this contract signed by both Parties.
44. Force Maieure:
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their
control, provided the party experiencing the force majeure condition provides immediate written
notification to the other party and takes all reasonable efforts to cure the condition.
45. Severability Clause:
The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or
unenforceable, the other provisions are severable to that void provision and shall remain in full force
and effect.
46. Condition Precedent to Contract Appropriations:
The Parties agree that the Agency's performance and obligation to pay under this contract are contingent
upon an annual appropriation by the Legislature.
47. Addition/Deletion:
The Parties agree that the Agency reserves the right to add or to delete any of the services required under
this contract when deemed to be in the State of Florida's best interest and reduced to a written amendment
signed by both Parties. The Parties shall negotiate compensation for any additional services added.
48. Waiver:
The delay or failure by the Agency to exercise or enforce any of its rights under this contract will not
constitute or be deemed a waiver of the Agency's right thereafter to enforce those rights, nor will any
single or partial exercise of any such right preclude any other or further exercise thereof or the exercise
of any other right.
49. Compliance:
The Contractor shall abide by all applicable current federal statutes, laws, rules, and regulations as well
as applicable current state statutes, laws, rules and regulations. The Parties agree that failure of the
Contractor to abide by these laws shall be deemed an event of default of the Contactor and subject the
contract to immediate unilateral cancellation of the contract at the discretion of the Agency.
SII. Final Invoice:
The Contractor shall submit the final invoice for payment to the Agency no later than thirty (30) days
after the contract ending date unless otherwise specified in ATTACHMENT L If the Contractor fails to
do so, all right to payment is forfeited and the Agency shall not honor any requests submitted after the
aforesaid time period. Any payment due under the terms of this contract shall be withheld until all
15
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EHEAP 203.19
required documentation and reports due from the Contractor and necessary adjustments thereto have been
approved by the Agency.
51. Renegotiations of Modifications:
Modifications of the provisions of this contract shall be valid only when they have been reduced to writing
and duly signed by both parties.
52.Susuension of Worts;:
The Agency may in its sole discretion, suspend any or all activities tinder the contract or purchase order,
at any time, when in the interest of the State to do so. The Agency shall provide the Contractor written
notice outlining the particulars of suspension. Examples of the reason for suspension include, but are not
limited to, budgetary constraints, declaration of emergency, or other such circumstances. After receiving
a suspension notice, the Contractor shall comply with the notice and shall not accept any purchase orders.
Within ninety (90) clays,, or any longer period agreed to by the Contractor, the Agency shall either (I)
issue a notice authorizing resumption of work, at which time activity shall resume, or (2) terminate the
contract or purchase order. Suspension of work shall not entitle the Contractor to any additional
compensation.
53. Termin ation:
53.1 Termination for Convenience. The Agency, by written notice to the Contractor, may terminate this
contract in whole or in part when the Agency determines in its sole discretion that it is in the State's
interest to do so. The Contractor shall not furnish any product after it receives the notice of
termination, except as necessary to complete the continued portion of this contract, if any. The
Contractor shall not be entitled to recover any cancellation charges or lost profits.
53.2 Termination for Cause. The Agency may terminate this contract ifthe Contractor fails to: (1) deliver
the product within the time specified in the contract or any extension, (2) maintain adequate
progress, thus endangering performance of the contract, (3) honor any term of the contract, or (4)
abide by any statutory, regulatory, or licensing requirement. Rule 60A-1.006(3), P.A.C., governs the
procedure and consequences of default. The Contractor shall continue work on any work not
terminated. Except for defaults of Subcontractors at any tier, the Contractor shall not be liable for
any excess costs if the failure to perform the contract arises from events completely beyond the
control, and without the fault or negligence, of the Contractor. If the failure to perform is caused by
the default of a Subcontractor at any tier, and if the cause of the default is completely beyond the
control of both the Contractor and the Subcontractor, and without the fault or negligence of either,
the Contractor shall not be liable for any excess costs for failure to perform, unless the subcontracted
products were obtainable from other sources in sufficient time for the Contractor to meet the
required delivery schedule. If, atter termination, it is determined that the Contractor was not in
default, or that the default was excusable, the rights and obligations of the Parties shall be the same
as if the termination had been issued for the convenience of the Agency. The rights and remedies
of the Agency in this clause are in addition to any other rights and remedies provided by law or
under the contract.
54.Electronic Records and Signature:
The Agency authorizes, but does not require, the Contractor to create and retain electronic records and
to use electronic signatures to conduct transactions necessary to carry out the terms of this contract. A
Contractor that creates and retains electronic records and uses electronic signatures to conduct
16
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October 2019 — September 2020 EHEAP 203.19
transactions shall comply with the requirements contained in the Uniform Electronic Transaction Act,
Section 668.50, F.S, All electronic records must be fully auditable; are subject to Florida's Public Records
Law, Chapter 119, F.S.; must comply with contract Section 29, Data Integrity and Safeguarding
Information; must maintain all confidentiality, as applicable; and must be retained and maintained by the
Contractor to the same extent as non -electronic records are retained and maintained as required by this
contract.
541 The Agency's authorization pursuant to this section does not authorize electronic transactions
between the Contractor and the Agency. The Contractor is authorized to conduct electronic
transactions with the Agency only upon further written consent by the Agency.
54.2 Upon request by the Agency, the Contractor shall provide the Agency with non -electronic (paper)
copies of records. Nonelectronic (paper) copies provided to the Agency of any document that
was originally in electronic form with an electronic signature must identify the person and the
person's capacity who electronically signed the document on any non -electronic copy of the
document.
55. Contract Manager:
The Agency may substitute any Agency employee to serve as the Area Agency's Contract Manager
REMAINDER OF THEPAGE INTENTIONALLY LEFT BLANK
17
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October 2019 — September 2020
EHEAP 203.19
56. Official Payee and Representatives(Names, Addresses, and Telephone Numbers):
57. All Terms and Conditions Included:
This contract and its ATTACHMENTS I -XXIII including any exhibits referenced in said attachments, together
with any documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties.
There are no provisions, terms, conditions, or obligations other than those contained herein, and this contract shall
supersede all previous communications, representations or agreements, either written or verbal between the Parties.
By signing this contract, the Parties agree that they have read and agree to the entire contract.
IN WITNESS, THEREOF, the Parties hereto have caused this contract to be executed by their undersigned
officials as duly authorized.
CONTRACTOR: COLLIER COUNTY BOARD
OF COUNTY C M SIONER
SIGNED BY: V, �IZI
NAME: STEPHEN Y CARNELL
TITLE: Public Services -Department Head
DATE: "1
Federal Tax ID: 59-6000588
Fiscal Year Ending Date: 09/30
DUNS: 076997790
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA,
SIGNED BY: Tu -
NAME: MARIANNE G LORINI
TITLE: PRESIDENT/CEO
DATE: /a I P bf
Approved as to form and legality
18
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The Contractor name, as shown on page I of
Collier County Board of County Commissioners
a.
this contract, and mailing address of the
3339 E Tamiami Trail, Building H
Naples, FL 34112
official payee to whom the payment shall be
made is:
The name of the contact person and street
Kristi Sonntag, Director
Collier County Board of County Commissioners
b.
address where financial and administrative
%Community and Human Services
records are maintained is:
3339 E Tamiami Trail, Building H
Naples, FL 34112
The natne, address, and telephone number of
Kristi Sonmag, Director
C.
the representative of the Contractor
CollierCountyBoard of County Commissioners
/oCommunity and Human Services
responsible for administration of the ro am
P p gr
3339 E Tamiami Trail, Building H
under this contract is:
Naples, FL 34112
(239)252-2273
The section and location within the Agency
Area Agency on Aging for Southwest Florida, Inc.
d.
where Requests for Payment and Receipt and
Fiscal Department
Expenditure forms are to be mailed is:
15201 North Cleveland Avenue, Suite 1100
North Fort Myers, FL 33903
The name, address, and telephone number
Vacant, Director of Program & Planning
e.
of the Contract Manager for this contract
Area Agency on Aging for Southwest Florida, Inc.
15201 North Cleveland Avenue, Suite 1100 North
is:
Fort Myers, FL 33903
239-652-6900
Upon change of representatives (names, addresses, and telephone numbers) by either party, notice shall be
provided in writing to the other party.
57. All Terms and Conditions Included:
This contract and its ATTACHMENTS I -XXIII including any exhibits referenced in said attachments, together
with any documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties.
There are no provisions, terms, conditions, or obligations other than those contained herein, and this contract shall
supersede all previous communications, representations or agreements, either written or verbal between the Parties.
By signing this contract, the Parties agree that they have read and agree to the entire contract.
IN WITNESS, THEREOF, the Parties hereto have caused this contract to be executed by their undersigned
officials as duly authorized.
CONTRACTOR: COLLIER COUNTY BOARD
OF COUNTY C M SIONER
SIGNED BY: V, �IZI
NAME: STEPHEN Y CARNELL
TITLE: Public Services -Department Head
DATE: "1
Federal Tax ID: 59-6000588
Fiscal Year Ending Date: 09/30
DUNS: 076997790
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA,
SIGNED BY: Tu -
NAME: MARIANNE G LORINI
TITLE: PRESIDENT/CEO
DATE: /a I P bf
Approved as to form and legality
18
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October 2019 — September 2020
INDEX OF ATTACHMENTS
EHEAP 203.19
ATTACHMENT
.........
STATEMENTOF WORK........................................................................................................................
20
A'17TACHMENT 11
FINANCIAL AND COMPLIANCE AUDIT............................................................................................45
ATTACHMENTIII
CERTIFICATIONSAND ASSURANCES..............................................................................................51
ATTACHMENT IV
ASSURANCES -NON -CONSTRUCTION PROGRAMS......................................................................56
ATTACHMENT V
FLORIDA DEPARTMENT" OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE CHECKLIST....
58
ATTACHMENT VII
BACKGROUNDSCREENING................................................................................................................62
ATTACHMENT IX
BUDGETSUMMARY .................................... ............ ....... .......................................... ................. ............
63
ATTACHMF.,NT X
EHEAP ADMINISTRATIVE.; AND OUTREACH EXPENSE BUDGET DETAIL................................64
ATTACHMENT XI
RECEIPTS AND EXPENDITURE REPORT...........................................................................................65
ATTACHMENT XII
REQUESTFOR PAYMF,N`I'.....................................................................................................................66
ATTACHMENT XIII
INVOICEREPORT SCHEDULE .............................................................................................................67
ATTACHMENT XIV
POVERTYINCOME GUIDELINES.. ................................ .....................................................................
68
ATTACHMENT XV
LTHEAP PAYMENT MATRIX....................................................69
........................................ .
ATTACHMENT XVI
SOURCESOF INCOME...................................................................................................
ATTACHMENT XVII
OUTREACHPLAN SURVEY..........................................................:...............................
ATTACHMENT XVIII
EHEAP APPLICATION AND ELIGIBILITY WORKSHEET.. ......................................
ATTACHMENT XIX
EHEAP APPLICATION AND ELIGIBILITY INSTRUCTIONS ...................................
ATTACHMENT XX
EHEAP CLIENT FILE CONTENT CHECKLIST .......................................................1111
ATTACHMENT XXT
EHEAP COST REIMBURSEMENT' SUMMARY ............. ............... ............... ................. ..............
1111
ATTACHMENT XXII
COSTALLOCATION PLAN......................................................................................11..................11..
ATTACHMENT XXIII
SERVICERATE REPOR'I'......................................................................................11...11.....................
10
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October 2019 — September 2020
ATTACHMENT
STATEMENT OF WORK
I. SERVICES TO BE PROVIDED
A. DEFINITION OF TERMS
EHEAP 203.19
1. 18 hours — The timeframe within which all applications for crisis assistance shall be acted upon,
with an eligible action to mediate the crisis within eighteen (18) hours of the application date
stamp and documenting in the client file the eligible action taken.
2. Caseworker —,Person who is responsible for determining program eligibility by completing the
Emergency Home Energy Assistance for the Elderly Program (EIIEAP) Eligibility Worksheet
(ATTACHMENT XVIII) and awarding crisis benefits,
3. Caseworker Signature Date — The date that the client's completed application is processed,
eligibility determined, and the crisis resolved. This date shall not be changed. Signatures must be
in ink. Rubber-stamped signatures will not be accepted.
4. Client Application Date — The date that the client's completed application is completed (whether
by self or with assistance) and signed by the elder. This date shall not be changed. Signatures
must be in ink. Rubber-stamped signatures will not be accepted. If an elder cannot write their
signature on the application, or any other required document, and must sign with an "X." two
witnesses are required.
5. Crisis — A home cooling or heating crisis exists when an elder has no access to, or is in immediate
danger of losing access to, needed home energy.
6. Crisis Assistance — Assistance provided to an elder who has no access to, or is in danger of losing
access to, needed home energy.
7. Date of Resolution — The date that a documented commitment to pay was made to the utility
vendor to resolve the energy crisis. This date is used as the F,HEAP Client Enrollment date in the
Department's Client Information and Registration Tracking System (CIRTS). This date shall not
be changed.
a. The amount of time elapsed between the Date Stamp and the Date of Resolution shall
determine whether or not the eighteen (18) hour rule was met.
b. Vendors must be paid within forty-five (45) days of the date of resolution.
S. Date Stamp — The date the application and all required documentation is presented in acceptable
form to intake staff. An inked stamp must be used, and the date shall not be changed. The 18 -hour
hour rule for crisis resolution begins when the application is date stamped.
9. Disability — A disabling condition that causes an elder to be determined eligible to receive
Supplement Security Income (SSI) or Social Security Disability Income (SSDT) from the Social
Security Administration.
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October 2019 — September 2020 EHEAP 203.19
10.Elder—An individual aged sixty (60) years or older.
11. Eligible Action —An action taken by the caseworker to mediate an elder's energy crisis. Eligible
actions include:
a. Approval of an elder's application;
b. Denial of an elder's application pending further information;
c. Denial of an elder's application because the elder is deemed ineligible;
d. Contact with a utility vendor to halt utility disconnection or interruption in services; or
e. Written referral to and providing the elder with assistance contacting another agency if
EHEAP funding is not available or the elder is ineligible.
12. Energy Subsidy — Utility costs paid directly or indirectly to the elder who lives in government -
subsidized housing.
13.Houseltold —Any individual or group of individuals who are living together as one economic unit
for whom residential energy is customarily purchased in common or who make undesignated
payments for energy in the form of rent.
14.Houschold Member—Persons in a household who share a common kitchen or bath and purchase
residential energy in common.
15.Intake Worker — Person who accepts the ENEAP application and required documentation and
may have the responsibility to determine eligibility or award crisis benefits.
16.Mininrum Level of Service — Service to a minimum of one household per month.
17.0-isis Assistance Benefit — Payment of a heating/cooling energy bill, the purchase of
heating/cooling device; and/or the repair of a heating/cooling device.
1S.Priority for Assistance — Households with the highest home energy needs and lowest household
income, which will be determined by taking into account both the energy burden and the unique
situation of such households with members of vulnerable populations, including very young
children, individuals with disabilities, and fi•ail elder individuals.
1.9.Provider — The entity that has entered into a contract, subcontract, or Memorandum of
Understanding (MOU) to provide services under EHEAP. For the purposes of this contract, the
terms "Provider" and "Contractor" may be used interchangeably.
20.Reasonable Promptness —Within fifteen (15) working days of receiving the client's completed
application.
21.Request for Payment — Submission of actual monthly expenditures for reimbursement.
22.Service Unit — One individual (elder) served.
23. Social Security Number —The number on an elder's Social Security card or the number provided
by an award or determination letter from an entity, such as a government agency, that has already
verified the social security number.
24.Supervisory/Peer Review Date—The date that a supervisor or peer reviewed the application and
documentation and signed the application indicating vendor payment can be made. The intent of
the supervisor/peer review is to avoid errors in eligibility determination and payment amounts and
21
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October 2019 — September 2020
EHEAP 203.19
to alleviate the possibility of fraud. This date shall not be changed. Signatures must be in ink.
Rubber-stamped signatures will not be accepted.
25. Verification Date - The date the caseworker verified previous Low -Income Home Energy
Assistance Program (LIHEAP) crisis benefits with the LIHEAP provider or the minimum amount
necessary to resolve the crisis with the utility company. This date shall not be changed.
B. GENERAL DESCRIPTION
1. General Statement
The Emergency Home Energy Assistance for the Elderly Program (EHEAP) serves the mission
of the Agency by providing home energy assistance aid to elders in the event of a home energy
heating or cooling emergency. EHEAP is designed to assist low-income households with at least
one member aged sixty (60) or older experiencing a heating or cooling emergency
2. Authority
The relevant federal and state authorities governing EIIEAP are:
a. Low Income Home Energy Assistance Act of 1981; (Title XXVI of the Omnibus Budget
Reconciliation Act off.981, P.L. 97-35), as amended.;
b. 42 United States Code (U. S. C.) § 8621 et seq.;
c. 45 Code of Federal Regulations (CFR) Part 96, Subpart I -I (§§ 96.80-96.89);
d. Section 409.508, Florida Statutes (F.S.) and Rule 73C-26.021 (3), Florida Administrative Code
(F. A. C.);
e. Rule Chapter 73C-26, F. A. C.;
L State of Florida LIHEAP Policies and Procedures Manual; and
g. LIHEAP State Plan.
3. Scope of Service
The Contractor is responsible for the programmatic, fiscal, and operational management of
EHEAP. Eligible elders may receive one crisis assistance benefit per heating or cooling season,
not to exceed $600.00 each. If eligible, elders may receive one summer crisis assistance benefit
during the period from April 1 to September 30, and one winter crisis assistance benefit during the
period of October I to March 31, each year. An elder's eligibility for crisis benefits is not related
to EHEAP contract periods.
Weather-Related/Supply Shortage funds can be provided in addition to crisis benefits when
authorized by (lie Florida Department of Economic Opportunity (DEO). In the event of a weather-
related event or supply shortage, the President of the United States, Governor of the State of
Florida, or Executive Director of DEO may declare a weather- related crisis and release additional
funds to assist affected households. When benefits are distributed for a weather-related/supply
shortage emergency, the Contractor shall comply with directives provided by the DOEA as to the
allowable expenditures of these funds.
a. The services provided under this contract shall be in a manner consistent with and described
in ATTACHMENT I, Section II: Manner of Service Provision. Contractor, in
collaboration with its EHEAP program partners, shall ensure the following service tasks are
completed:
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October 2019 — September 2020 EHEAP 203.19
(I) Consumer Outreach;
(2) Program Partners and Stakeholders Coordination;
(3) Elder's Benefit Eligibility Determination; and
(4) Benefit Disbursement.
4. Major Program Goals
EHEAP is designed to provide crisis assistance to eligible low-income households with at least
one individual aged sixty (60) or older experiencing a heating or cooling emergency. The program
allows for payments to utility companies and/or fuel suppliers; for the purchase of blankets,
portable heaters, fans, and/or air conditioners; for the repair or replacement of existing heating or
cooling equipment; for the payment of deposits, late fees, disconnect and reconnection fees; for
the provision of temporary emergency shelter; or to resolve other heating and cooling
emergencies. The program also provides eligible elders with weather-related/supply shortage
emergency benefits when authorized by DEO.
a. Crisis Assistance
A standard ]ionic cooling or heating crisis exists when an elder has no access to, or is in danger
of losing access to, needed home energy because one or more of the following conditions is
present:
(1) The elder's home cooling or heating energy source has been cut off;
(2) The elder has been notified that the elder's home cooling or heating energy source will
soon be cut off;
(3) Tile elder has an energy bill or notice for which the due date has lapsed;
(4) The elder has received a notice indicating the household's energy bill is delinquent or past
due;
(5) The elder is unable to get delivery of heating fuel, is out of heating fuel, or is in danger of
being out of heating Eitel; or
(6) The elder has other problems with lack of cooling or heating in the home, such as needing
to pay a deposit, needing a repair or purchase of heating or cooling equipment, or needing
interim emergency measures to avoid 'further crisis.
b. Allowable Categories for Crisis Assistance are:
(1) Electric;
(2) Gas;
(3)Propane;
(4) Wood/coal;
(5) Refillable fuels; and
(6)Pre-Pay home energy usage.
(i) The elder is within seven days of using the remaining balance of the pre -purchased
energy source, the elder's power is currently disconnected/shut off, or the elder
needs a deposit.
23
October 2019 — September 2020 EHEAP 203.19
(ii) The LIHEAP Payment (ATTACHMENT XV) shall be used to determine the
benefit amount.
C. CLIENTS TO BE SERVED
I. General Description
EHEAP provides for direct client services to elders in low-income households experiencing a
home energy heating or cooling emergency. A household receiving EHEAP services may not have
an income above one hundred fifty percent (150%) of the poverty level, as published by the United
States Department of Health and Human Services.
2. Client Eligibility
To be eligible for services under this contract, and to receive assistance, an elder must:
a. Be aged sixty (60) or older;
b. Reside in the EHEAP service area (Planning and Service Area) at the time the home energy
costs were incurred;
c. Complete and return an EHEAP application with all required information and verification to
contractor, while funds remain available;
d. Provide a fuel bill or other docmnentation evidencing an energy emergency and an
obligation to pay for home energy costs for the home in which they live;
e. Possess a total gross household income of not more than one hundred fifty percent (150%) of
the Office of Management and Budget (OMB) federal poverty level for the size of the
household. In accordance with Section I.C3.d. of this contract;
I. Be experiencing one or more verifiable home cooling or heating crises.
g. Not be a resident of a group living facility or a home where the cost of residency is at least
partially paid (or subsidized) through a foster care or residential program administered by the
state;
Ii. Not be a student living in a dormitory; and
i. Legally reside in the State of Florida.
3. ClientDeterminatimt
Contractor shall begin taking applications for EHEAP services upon execution of this contract
and continue taking applications until the contract expires or finds are exhausted. Contractor shall
not accept applications when funds are exhausted for a particular time period. Contractor shall:
a. Provide assistance to elders in completing Agency -provided applications for assistance and
determining eligibility;
b. Ensure that no one is excluded from program participation on the grounds of race, color,
national origin, sex, or age, and ensure that such persons shall not be subjected to
discrimination under any activity funded in whole or in part with these finds;
c. Treat homeowners and those who rent equitably under this contract;
it. Calculate the income eligibility of the elder by using the past thirty (30) days earnings for all
occupants of the household annualized or the elder's current economic situation and reference
24
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October 2019 — September 2020 EHEAP 203.19
the current Sources of income (ATTACHMENT XVI) to determine what is considered
allowable income. Contractor shall proceed as follows;
(1)Total household income cannot exceed one hundred fifty percent (1.50%) of the current
federal Poverty Income Guidelines (ATTACHMENT XIV); and
(2) Obtain a written self -declaration from household members aged eighteen (18) years of-
older
rolder claiming zero income. Self'declarations must be completed and signed by the
household member who is claiming zero income.
e. Determine if all or part of the elder's utility costs are paid directly (utility reimbursement) or
indirectly (utility allowance) by the government if the elder lives in government -subsidized
housing. Contractor shall proceed as follows:
(I)If total home heating or cooling costs are included in the rent and the elder has no
obligation to pay any portion of the costs, then the elder is not eligible for assistance; and
(2)If there is a Florida Section 8 (Housing Choice Voucher Program) or a Public Housing
Authority (PHA) Program energy subsidy available to the elder during the period covered
by the utility bill, then the elder is only eligible for partial assistance. The energy subsidy
for the period covered by (lie utility bill must be subtracted from the allowable EHEAP
benefit calculated for the household,
f. Use program qualification approvals or notifications to document household size and income
of elders receiving Supplemental Nutrition Assistance Program (SNAP) or SSI. Elders shall
meet program income eligibility guidelines and possess a total gross household intone of not
more than 150% of the OMB federal poverty level for the size of the household. The benefit
level to be provided to elders receiving SNAP o• SSI, shall be the same as that provided to
other qualified elders;
g. Obtain a signed statement of maintenance from the elder explaining how basic living expenses,
(i.e., food, shelter, and transportation are being provided) if the total household income is less
than fifty percent (50%) of the current federal poverty guidelines and no one in the household
is receiving SNAP;
h. Ensure elders receive no more than one approved crisis assistance benefit during the cooling
season, April I — September 30, and one approved crisis assistance benefit during the heating
season, October I — March 31. The Contractor shall proceed as follows:
(1) Crisis assistance benefit may consist of payment of more than one energy obligation, per
heating and cooling season, for a household to resolve a single crisis, thus allowing for:
(i) The purchase or repair of fans, blankets, air conditioners, and/or portable heaters in
addition to heating/cooling bill assistance, that combined does not exceed the
maximum crisis benefit of $600; and
(H)Crisis situations which may involve a heater or air conditioner that is powered by both
gas and electricity, in which case both energy obligations are eligible for a crisis
benefit payment that combined does not exceed the maxinnun crisis benefit of $600.
(2) Water, sewer, and garbage, and fire, etc, charges may not be paid.
(3)Repair or replacement of a heating/cooling unit is allowable within the maximum limit of
25
N)
October 2019 — September 2020 EHEAP 203.19
$600, provided any required installation or repair work is completed by a licensed
contractor;
(4) Deposits to connect or restore energy are allowable, not to exceed the maximum limit of
$600;
(5) Late fees, disconnect fees, and reconnect fees are allowable, not to exceed the maximum
limit of $600;
(6) Charges 'from a previous account held by the elder that is now closed are allowable, not
to exceed the maximum limit of $600;
(7) Payment to landlord when utility costs are included in the elder's rent is allowable, not to
exceed the maximum limit of $600; and
(8) Payment for temporary emergency shelter is allowable, if due to energy-related crisis,
not to exceed the maximum limit of $600.
i. In no case shall the Contractor be required to incur costs in excess of the full contract
amount to provide services to the clients.
II. MANNER OF SERVICE PROVISION
A. SERVICE TASKS
In order to achieve the goals of EHEAP, Contractor shall ensure the following tasks are performed:
1. Ensure that all eligible elders meet the requirements of Section I.C.2. of this contract;
2 Ensure that all energy assistance payments made to home energy vendors comply with the
requirements of Section 11.A.14.d. of this contract;
3. Implement appropriate program management and operational controls to ensure all applications
for crisis assistance are acted upon with an eligible action to mediate the crisis within eighteen
(18) hours of the application date stamp, and document in the client file that the crisis was resolved
within eighteen (18) hours.
4. Provide all elders approved for EHEAP funding with a written Notice of Approval and Appeal
within fifteen (15) working days of crisis resolution. The written Notice of Approval and Appeal
shall include:
a. Type and amount of assistance;
b. Name of the home energy vendor to be paid on elder's behalf;
e. The next date when the elder will be eligible to apply for further assistance; and
d. Contractor's appeal process.
5. Provide all elders whose EHEAP applications were denied with a written Notice of Denial and
Appeal within fifteen (15) working days of receiving the elder's application. The written Notice
of Denial and Appeal shall contain:
a. Name of the elder;
b. Date of application;
c. Type of benefit sought;
d. Reason(s) for denial;
26
October 2019 — September 2020 EHEAP 203.19
e. Statement on Contractor's benefit limits, if applicable;
f. Contractor's appeal process;
g. Explanation of circumstances under which the elder may reapply;
h. Information or documentation needed for the elder to reapply;
i. The name, address, and phone number applicable to the appeal process; and
j. Number of days the elder has to file the appeal.
6. Maintain consumer appeal procedures that provide an opportunity for a fair administrative hearing
to elders whose applications for assistance are denied or whose applications are not acted upon
with reasonable promptness;
7. Provide an opportunity for elders to file a written appeal or complaint with the Contractor's
Program Supervisor within ten (10) working days of receipt of the written Notice of Denial and
Appeal.
a. Upon receipt of a validly filed appeal or complaint, Contractor must respond in writing
within ten (10) working days;
b. Elders may appeal Contractor's first response by filing its objections to the response with
Contractor's Director, 'Executive Director, or Board Chair, as applicable, within five (5)
working days of receipt of the first response; and
c. Upon receipt of a validly filed objection to the first response, Contractor must respond in
writing within ten (10) working days, and the response must clearly state the final outcome
of the appeal, that the decision is final, and if applicable, the circumstances under which the
elder may reapply for services,
S. Post appeal provisions in a prominent place and in plain view at all locations where EFIEAP are
received;
9. 9. Ensure all ineligible applicants and applicants denied crisis assistance, when EHEAP funds are
not available or are insufficient to meet their emergency home energy needs, are referred to and
assisted in securing help through other community resources;
10. Ensure no consumer fees are charged to, nor donations accepted from, an elder as a prerequisite
for receiving EHEAP benefits. Post in a conspicuous place at all locations where EHEAP
applications are received the following notice: "No money, cash, or checks will be requested or
received from customers in the EHEAP office. If an employee asks for money, report this to the
agency executive director or Agency head."
.It. Compare LIHEAP records and EHEAP records for households with elderly members to avoid
duplicate crisis assistance payment during the same eligibility period and maintain documentation
sufficient to ensure compliance with this requirement;
12. Maintain a written policy and implement procedures to protect and secure elder applicants'
information and social security numbers in order to protect their identities from theft or fraud.
This policy shall address the handling of both paper and electronic records and files. Contractor
shall, in collecting elders' social security numbers, use the Notice Regarding Collection of Social
Security Numbers, which is incorporated into this contract by reference, (Notice of
Instruction#071 1 13-1-I-SWCB S,
http://el(lerafrairs state f7 us/doea/noticess/Jtih,l3/LIHEAI'%2ONotice%20re%20Social%20Seeurit
y%20Numbcrs%20PinaLpd[). The Notice Regarding Collection of Social Security Numbers shall
be signed by the elder and retained in the client file;
27
October 2019 — September 2020
13. Consumer Outreach
EHEAP 203.19
Ensure that households in all counties within the service area wishing to benefit from the program
have the opportunity to do so. Contractor shall undertake consumer outreach initiatives in all
counties within the service area designed to inform potentially eligible households about EHEAP.
Outreach efforts must focus on elderly households with disabled individuals, young children, and
where the highest percentage of the household income is required to pay for their home energy.
Specific outreach initiatives shall include, but are not limited to:
a. Informing all service area local agencies, non -profits, and similar organizations that are in
regular contact with the low-income population about the EHEAP program, especially those
serving seniors;
b. Encouraging EHEAP program participation through local television and radio programs, and
placing announcements of the EHEAP program in media community calendars;
c. Developing and implementing a written procedure for making home visits to households with
homebound elderly persons in order to assist with the completion of the program application
when other assistance is not available;
d. Making visits to provide information, and/or malting presentations about EHEAP in response
to requests by local congregational centers serving elderly or disabled persons;
e. Providing information concerning the local weatherization program to all persons who request
it (including organizations that provide outreach activities); and
f. Completing the EHEAP Outreach Plan Survey (ATTACHMENT XVII) to demonstrate to the
Agency that outreach efforts to inform potentially eligible households about EHEAP shall be
rnade to target households in all counties. The EHEAP Outreach Plan Survey is required to
be submitted by Contractor to the Contract manager within thirty (30) days of the contract
execution date.
14. Program Partners and Stakeholder Coordination
Coordinate shall coordinate services with other program partners and stakeholders to prevent the
duplication of services, facilitate referrals, and improve the efficiency of services for
consumers. Coordination activities shall include, but not be limited to:
a. Communicating with the DEO LIIIEAP contractors in their respective service areas to prevent
the duplication of benefits to elders. Additionally, Contractor shall review LIHEAP and
EHEAP records for households with elderly members to ensure duplicate crisis assistance
payments are not received during the same heating or cooling season;
b. Developing a new, or continuing an existing, MOU with the Weatherization Assistance
Program (WAP) in the service area. The MOU shall detail cooperative efforts and describe
the actions that will be taken by both parties to ensure coordination and referrals. The MOU
shall be reviewed and renewed at least every five years. Contractor, in coordination with the
local WAP agency, shall develop a system by which elders who have received more than three
EI-IEAP and LIHEAP benefits in the last eighteen (18) months and who are homeowners are
referred to a WAP provider. Contractor shall maintain copies,of all MOUS;
c. Establishing a new, or continuing an existing, MOU with service area LIIIEAP contractors.
Each MOU shall ensure coordination of services, to avoid duplication of assistance, and
increase the quality of services provided to elders. The MOU shall direct LIHEAP providers
to refer elders aged sixty (60) or older to EHEAP providers for energy assistance. The MOU
shall be reviewed and renewed at least every five (5) years. Contractor shall maintain copies
28
October 2019 — September 2020 EHEAP 203.19
of all MOUS. MOUS with local LIHEAP agencies shall be updated if the contracting parties
change. The MOUS must be applicable to Contractor's current EIIEAP program requirements
and guidelines;
d. Developing agreements with home energy vendors that benefit elders. Contractor shall
maintain copies of all vendor agreements. All agreements between Contractor and home
energy vendors shall contain the following conditions:
(1)The beginning and ending date of the Vendor Agreement;
(2)The Contractor's representative(s) authorized to resolve a crisis situation and make a
payment commitment on behalf of an elder;
(3)The home energy vendor's representative(s) authorized to resolve a crisis;
(4)A description of how energy payments will be made directly to the home energy vendor
on behalf of the EHEAP eligible customer;
(5)Assurance from the home energy vendor that no household receiving EHEAP assistance
will be treated adversely because of such assistance under applicable provisions of state
law or public regulatory requirements;
(6)Assurance that the home energy vendor will not discriminate, either in the cost of goods
supplied or the services provided, against the eligible household on whose behalf payments
are made;
(7)A statement that only energy-related elements of a utility bill are to be paid. Water, sewer,
garbage, and fire, etc. charges are not covered as part of the utility bill of the household.
However, EHEAP does allow an exception with water that is used for air conditioning, i.e.
an evaporated cooler;
(8)A statement that Contractor may not pay for charges that result from illegal activities such
as a worthless check or meter tampering, and that the home energy vendor is aware that
those charges are the responsibility of the elder;
(9)Assurance from the home energy vendor that when the benefit amount to the elder does
not pay for the complete charges owed by an elder, the elder is responsible for the
remaining amount owed;
(10) Details on how the home energy vendor will assist Contractor in verifying the elder's
account information and, in the case of crisis assistance, make timely commitments to
resolve the crisis. A process should be in place to verify the current amount owed and the
minimum annount necessary to resolve the crisis situation;
(11) Contractor's commitment to make payment to the home energy vendor• within forty-
five (45) days of the date of crisis resolution;
(12) Assurance from the home energy vendor that when EHEAP payments made to the
vendor cannot be applied to the elder's account, the funds will be returned to Contractor
or, with Contractor's approval, applied to another eligible customer's account,;
(13) Assurance that the Contractor shall collect a signed Authorization for Release of
General and/or Confidential Information for EHEAP Data from each eligible elder and
ensure the signed releases are available for inspection by the home energy vendor;
(14) Assurance that home energy vendors is aware that as long as signed Authorization for
Release of General and/or Confidential Information for EHEAP Data are collected and
available, the home energy vendor will provide the requested customer date to DEO;
29
October 2019 — September 2020 EHEAP 203.19
(15) The agreement will be reviewed by both parties at least every five (5) years;
(16) The agreement must be signed by a representative of both Contractor and the vendor
who has authority to bind the entity and enter into such commitments; and
(.17) The home energy vendor, with the exception of municipal providers, must be in
"active" status with the State of Florida: (http://sunbiz.org/search.html) and the vendor's
name must be checked on Excluded Parties List System (EPLS) (haps://vvww.epls.eov .
The business name on the vendor agreement must match the legal business name on the
State of Florida website.
15. Comply with the Federal Financial Accountability and Transparency Act (FFATA) by securing a
Dun and Bradstreet. Numbering System (DUNS) number (www.dnb.com) and maintaining an
active and current profile in the System for Award Management (SAM) (www.sam.gov); and
166 Based on local need for EHEAP services and other non-EHEAP energy assistance resources in
the service area, Contractor may limit crisis benefits to less than those stated in Section I.C.3.h.
Policy changes concerning the amount of crisis benefits available to elders require Agency
approval and require notification of the change be sent to current and potential elders.
B. STAFFING REQUIREMENTS
1. Use of Subcontractors
If an entity other than the Contractor provides any service required under this contract, the
Contractor shall ensure the following requirements are met:
a. Eligible entities that provide outreach, perform intake, make eligibility determinations, or
process benefit payments must be one of the following:
(1) A Local City Government;
(2) A Local County Government;
(3) A Community -Based Organization;
(4) A Faith -Based Organization; or
(5) A State -Community Services Agency.
b. Entities providing any administrative function under this contract shall provide to Contractor
a list of all individuals performing administrative functions for the EHEAP. The list must
include Subcontractor's employees, agents and representatives serving EHEAP
administratively. For each individual on the list, Subcontractor must also provide the
individual's EHEAP administrative duties and fimction(s). Additionally, Subcontractor must
provide total salary and benefit amounts for each individual on the list, specifying all funding
sources from which that person is paid and the corresponding amounts of that pay charged to
each funding source.
c. For the term of this contract, each month Subcontractor shall provide to Contractor the
following information:
(1) The total number of individuals served with crisis assistance for the reporting month;
(2) The total number of individuals ineligible or denied assistance during the reporting month;
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October 2019 — September 2020 EHEAP 203.19
(3) The total number of individuals served by referral to other community resources for energy
assistance during the reporting month;
(4) The total amount of funding expended for crisis assistance per county for the reporting
month; and
(5) An EHEAP Outreach Activity Report to demonstrate that outreach efforts to inform
potentially eligible households about EHEAP are conducted to target households in all
counties,
d. Entities providing any service required under this contract must comply with the FFATA. This
includes securing a DUNS number (www.dnb.com) and maintaining an active and current
profile in the System for Award Management (SAM) (www.sam.tToy).
e. Entities must maintain current written agreements in the following formats with service
providers:
(I)A MOU shall be executed by both parties if a service provider performs any service
required under this contract and is paid for providing specific services without a direct
pass-through of federal funds. The MOU shall clearly state program expectations and the
role and responsibilities of each entity. The Contractor shall submit a copy of all MOUS
to the Agency's Contract Manager within thirty (30) days of the contract execution date;
and
(2) An EHEAP subcontract shall be executed by both parties if a service provider performs
any service required under this contract and is awarded a direct pass-through of federal
funds to operate the program and provide program services. Contractor shall submit a copy
of all subcontracts to the Agency's ContraetManager within thirty (30) days of the contract
execution date.
f. 'Eligible entities must provide the service provider commensurate compensation for the delivery
of administrative and outreach activities and for the delivery of crisis benefits. Commensurate
compensation of administration and outreach activities shall include cost -reimbursement of
actual expenses or a negotiated rate for specific activities.
g. If any of the work required under this contract is subcontracted, Contractor shall include in the
subcontract that the subcontractor is bound by the terms of this contract, is bound by all
applicable state and federal laws and regulations, and shall hold the Agency and Contractor
harmless against all claims of any nature arising out of the subcontractor's performance of
work under this contract to the extent allowed and required by law.
It. Subcontractor shall not be permitted to perform services related to this contract without an
executed subcontract and an approved Provider Cost Analysis or MOU verifying that
subcontractor's staff is paid from non-federal resources or is compensated for such activities
by EHEAP. In accordance with Sections 25-26 of the Standard Contract, the Agency shall not
be responsible or liable for any obligations or claims resulting from any subcontract.
i. Contractor shall document the subcontractor's progress in performing its work under this
contract in the quarterly report.
j. For each subcontractor, Contactor shall provide a written statement to the Agency regarding
whether that subcontractor is a minority vendor, as defined in Section 288.703, F.S.,
k. If this contact involves the use of a subcontractor or third party, then Contractor shall not
delay the implementation of its agreement with the subcontractor. If any circumstances occur
that may result in a delay of the initiation of the subcontract or in the performance of the
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6Io
October 2019 — September 2020 EHEAP 203.19
subcontractor for a period of sixty (60) days or more, Contractor shall notify the Agency's
Contract Manager and the Agency's Chief Financial Officer in writing of such delay.
C. SERVICE DELIVERY
1. Service Delivery Location
Contractor shall ensure that the services provided under this contract are available to residents
within each county in the Service Area (PSA) by in-person service, telephone, and/or other
electronic means.
2. Service Times
Contractor shall provide the services listed in this contract during normal business hours. Normal
business hours are defined as Monday through Friday, 8:00 a.m. to 5:00 p,m, local time, excluding
holidays, and force maleure.
3. Contractor shall publish its service delivery location, toll-free telephone number, and normal
business homy in available forms of media (i.e, newspapers, radio, television, website, publications,
etc.)
D. DELIVERABLES
1. Deliverables
a. Certification that Contractor must operate during its regular business homy, as identified in
Section II.C.2 of this contract.
b. Contractor shall provide the minimum level of service per month in each county served, as
defined in :Section I.A.16.
2. Source Documentation
The deliverables shall be reported monthly on Contractor's monthly financial status reports.
Successful completion of the deliverables shall be determined by the Agency's receipt of
Contractor's Receipts and Expenditure Report (ATTACHMENT XI) and Request for Payment
(ATTACHMENT XII) containing the number of individuals served with crisis assistance;
number of individuals ineligible or denied assistance; number of applicants served by referral to
other community resources for energy assistance; a summary of fiords expended per county for
the reporting month using the EHEAP Cost Reimbursement Summary form (ATTACHMENT
XXT); and the certification required in Section II, W.
3. Records and Documentation
Contractor will maintain a separate record (paper and CIRTS) for each EHEAP applicant that
includes the following as applicable:
a. The EHEAP Application and Eligibility Worksheet, (ATTACHMENT XVIII), completed
and signed by Contractor and the elder. The application must be approved by a supervisor or
peer prior to payment remittance. Contractor is responsible for using the most recent
application, eligibility worksheet, and EHEAP Application and Eligibility Worksheet
Instructions (ATTACHMENT XIX), issued by the Agency.
(1)If Contractor approves an application, one elderly member of the household must be
registered in CARTS using the EHEAP Application and Eligibility Worksheet
(ATTACHMENT XVIII); or
(2) If Contractor denies an application, the elder must be registered in CIRTS using the
EHEAP Application and Eligibility Worksheet (ATTACHMENT XVIII).
b. The elder' s name, address, sex, and age;
32
October 2019 — September 2020 EHEAP 203.19
c. Names, ages and current identification documentation (no more than one year expired) of all
household members;
d. Social Security numbers and documentation of those numbers for all household members or
the citation to the applicable exemption;
e. Signed notice regarding the collection of Social Security numbers (Notice of Instruction
#07 1 1 1 3-1-1-S W CBS,
f. Income amount and method of verification for all household members;
g. ,Income documentation to support eligibility that is representative of the elder's current
economic situation;
h. Statement of self -declaration of income, if applicable;
i. A signed statement of how basic living expenses (i.e., food, shelter, and transportation) are
being provided if the total household income is less than fitly percent (50%) of the current
Federal Poverty Guidelines and no one in the household is receiving SNAP assistance;
j. Documentation of the elder's obligation(s) to pay an energy bill for the residence in which
they live;
(1) The elder's utility bill must include detail to identify unallowable categories of
assistance resulting from charges for water, sewer, garbage, and fire, etc.; charges
resulting from meter -tampering and returned checks; and other charges that are not
energy-related and are not required for cooling/heating the household,
(2) Use of the most current utility bill(s) which provides the vendor's name and address,
account holder's name and physical address, account number, and amourt(s) due is
required. If an elder's utility bill, cutoff notice, or door -hanger notice or similar
documentation does not include all of this information, Contractor must document the
verified missing information by writing the information on the utility bill and on the
EHEAP Application and Eligibility Worksheet (ATTACHMENT VIII).
k. Signed Authorization for Release of General and/or Confidential Information for LIHEAP/
EFIEAP Federal Reporting or a statement on the application which states that the elder
refused to sign the waiver;
1. Copies of approval or denial letters, including those related to the initial application and all
appeals, which are provided to the elder;
m. If preference is given due to a disability, documentation of such disability that includes
disability income or a physician's statement;
n. Documentation of referrals to LIHEAP and WAP;
o. Notation if EIIEAP prevented a disconnection or restored an energy disruption;
p. Documentation of coordination with IAHEAP providers to avoid duplication of crisis
services for households with elderly residents;
q. Proof of payment made to vendors;
r. Documented of calculation of crisis benefits for elders living in subsidized housing; and
s. Completed EHEAP Client File Content Checklist, (ATTACHMENT XX).
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October 2019 — September 2020
E. PERFORMANCE SPECIFICATIONS
EHEAP 203.19
1. Reports
Contractor is responsible for responding in a timely fashion to additional routine and/or special
requests for information and reports required by the Agency. Contractor must establish due dates
for any subcontractor's report that permits Contractor to meet the Agency's reporting requirements.
a. Contractor shall report monthly on Contractor's Request for Payment, (ATTACHMENT
XII) as delineated in Section II.B.I.i, of this contract.
b. Administrative and Outreach Expense Budget Detail
Contractor shall submit by the 9th of the month to the Agency's EHEAP Contract Manager
the EHEAP Administrative and Outreach Expense Budget Detail (ATTACHMENT X). The
Administrative and Outreach Expense Budget Detail shall clearly delineate planned
expenditures for funds retained by the Contractor and funds subcontracted. The
Administrative and Outreach Expense Budget Detail shall include all Contractor positions,
by title, to be paid with these fiords and shall detail the estimated number of hours, the hourly
wage, and the estimated salary to be paid by EHEAP. Funding sources, estimated hours, and
hourly wage shall be identified for the balance of salary where EHEAP funds are used to pay
less than one hundred percent (100%) of the salary. Percentages must be supported by the
submitted cost allocation plan.
c. Cost Allocation Plan
The Contractor shall submit to the Agency's EHEAP Contract Manager the EHEAP Cost
Allocation Plan (ATTACHMENT XXII). The Cost Allocation Plan shall provide budgeting
methodology, allocation distribution, and the data source(s) used.
d. Provider Cost Analysis
State of Florida Chief Financial Officer Memorandum No. 02 (released October 3, 2012),
requires Contractor to provide assistance to the Agency's Contract Manager in completing the
DOEA Cost Analysis for Non -Competitively Procured Contracts in Excess of Category II -
Addendum to the EHEAP Cost Allocation Plan (ATTACHMENT XXII).
('1) The Contractor shall submit a completed Cost Analysis, which shall reflect
Administrative, Outreach, and Crisis Service allocations as delineated on the Budget
Summary (ATTACHMENT IX) and must be sufficient to explain the expenditures'
allowability, allocability, and reasonableness. The Cost Analysis shall be submitted and
approved by the Agency prior to execution of this contract. All subsequent amendments
that affect the budget shall also be submitted to and approved by the Agency prior to any
change.
e. .Monthly Reports
(I) EHEAP Outreach Activity Report
The Contractor shall ensure the use of outreach efforts that will inform potentially
eligible households about EHEAP to the Agency Contract Manager or its designee by
the 9°' of each month along with the county's monthly billing. The EHF.,AP Outreach
Activity Report shall consist of the following:
(i) Date;
(ii) County:
34
October 2019 — September 2020 EHEAP 203.19
(iii) Location Address
(iv) Description of Activity; and
(v) Name and Position of Staff
(2) Surplus/Deficit Report—Lead Agency Spending Report
The Contractor shall submit a Consolidated Surplus/Deficit Report, Lead Agency
Spending Report, in a format provided by the Agency, to the Agency Contract Manager
by the 18th of each month. This Consolidated Surplus/Deficit Report is for all
agreements and contracts between the Contractor and the Agency and must include the
following:
(i) A list of all contracts and their current status regarding surplus/deficit;
(ii) The Contractor's detailed plan on how the surplus/deficit spending exceeding the
threshold specified by the Agency will be resolved;
(iii) Recommendations to transfer funds within the PSA to resolve surplus/deficit
spending; and
(iv) Input from the Agency's Board of Directors on resolution of spending issues, if
applicable;
f. Quarterly Reports
EHEAP Summary Report
Contractor shall ensure timely and accurate CIRTS data entry of EHEAP activity and submit
to the Agency's EHEAP Contract Manager or designee the service report entitled, "EHEAP
SUMMARY," from CIRTS. The report shall reflect the use of EHEAP in your county(s) in
the PSA and shall be inclusive of all elders applying for crisis energy assistance during the
reporting quarter.
The CIRTS EHEAP Summary Report shall be submitted based on the following schedule:
REPORT
REPORTING PERIOD
SEASON
DATE DUE TO
AGENCY
1
10/01/19 — t2/31/19
Heating Season
January 09, 2020
2
01/01/20 — 03/31/20
Heating Season
April 09, 2020
3
04/01/20-06/30/20
Cooling Season
July 09, 2020
4
07/01/20 — 09/30/20
Cooling Season
October 09, 2020
The EHEAP Summary Report parameters for the program year shall be:
(i) PSA;
(ii) All Providers;
(iii) Your Location;
(iv) EHEAP;
(v) All Cities;
35
October 2019 — September 2020
EHEAP 203.19
(vi) Poverty Line $12,140;
(vii) Each Additional Household Members $4,320; and
(viii) Current Reporting Period.
g. Program Effectiveness Reports
The Contractor agrees to provide the Agency any additional service reports requested by the
Agency concerning the effectiveness of the program and shall include any statistics and
information that the Agency may require. The reporting period shall begin with the effective
date of this contract in a format and according to a schedule provided by the Agency for each
report.
2. Monitoring and Evaluation Methodology
Contractor shall monitor its performance under this contract as swell as that of its subcontractors,
subrecipients and consultants who are paid from funds provided under this contract to ensure that
the scope of work is accomplished within specified time periods and budgets set and that other
performance goals stated in this contract are achieved. Such review shall be made for each function
or activity set forth in this contract and reported in the quarterly report.
a. Contractor shall review completed EHEAP applications in accordance with the EHEAP Client
File Content Checklist (ATTACHMENT XX).
b. The Agency shall, at its own discretion, conduct investigations concerning any aspect of
Contractor's performance of this contract.
c. The Agency shall conduct a full onsite review of Contractor at least once during each three-year
period. Contractor shall allow the Agency to carry out monitoring, evaluation, and technical
assistance, and shall ensure the cooperation of its employees, and of any subcontractors with
whom Contractor contracts to carry out program activities.
d. The Agency shall conduct desk review activities throughout the year to monitor contractual
program requirements.
e. The Agency shall conduct EHEAP intake site visits.
f. In conjunction with onsite monitoring visits and desk review activities, the Agency shall review
a sample of completed EHEAP client files in accordance with the EHEAP Client File Content
Checklist, (ATTACHMENT XX).
g. The Agency shall conduct follow-up reviews including prompt return visits to Contractors that
fail to meet the goals, standards, and requirements established by the state and federal funding
agency.
3. Program Highlights
The Contractor shall submit Program Highlights referencing specific events that occurred in
SFY/FFY 2018-2019 by August 30, 2019. The Contractor shall provide a new success story, quote,
testimonial, or human -interest vignette, The highlights shall be written for a general audience, with
no acronyms or technical terms. For all agencies or organizations that are referenced in the
highlight, the Contractor shall provide a brief description of their mission or role. The active tense
shall be consistently used in the highlight narrative, to identify the specific individual or entity that
performed the activity described in the highlight.
36
October 2019 — September 2020
4. Outreach Plan Survey
EIIEAP 203.19
Contractor shall submit to the EHEAP Contract Manager the EHEAP Outreach Plan Survey
(ATTACHMENT XVII). The purpose of the Outreach Plan Survey is to delineate all activities
and efforts for the program year. The EHEAP Outreach Plan Survey is due within thirty (30) days
of the contract execution date.
5. Within three months of execution of this contract, Contractor shall provide the Agency a list of
all individuals performing any administrative functions for the EHEAP. The list must include
Contractor's employees, agents, and representatives, as well as all employees, agents, or
representatives of subcontractor(s) or sub-subcontractor(s) serving EHEAP administratively. For
each individual on the list, Contractor must also provide the individual's EHEAP administrative
duties and function(s). Additionally, Subrecipient must provide total salary and benefit amounts
for each individual on the list, specifying all funding sources from which that person is paid and
the corresponding amounts of that pay charged to each funding source.
6. For the term of this contract, each month Contractor shall provide to the Agency, by the 901 of each
month for the preceding month, the following information will be entered on ATTACHMENT
XII, Request for Payment, under Part D: Service Information
(i) The total number of individuals served with crisis assistance for the reporting month;
(ii) The total number of individuals ineligible or denied assistance during the reporting
month;
(iii) The total number of individuals served by referral to other community
resources for energy assistance during the reporting month; and
(iv) The total amount of funding expended for crisis assistance per county for the
reporting month.
F. CONTRACTOR RESPONSIBILITES
I. Make vends» • payments directly to fuel and/or home energy providers on behalf of eligible elders.
2. Determine the correct amount of each crisis benefit based on the minimum necessary amount
needed to resolve the crisis, but not more than the item limits or total limit set by the Agency. The
maximum crisis benefit for this contract period is $600.00 per household per season.
3. Encourage households to seek assistance prior to incurring non -energy penalties such as
disconnect/reconnect fees, additional deposits, interest or late payments.
4. Provide EHEAP crisis services to households with elders in every city within the service area.
a. Contractor shall ensure that each city within their service area receives a minimum level of
crisis services monthly, as delineated in Section T.A.16.;
b. EI3EAP funded staff shall make themselves available in all underserved counties as needed,
to ensure that the minimum level of servicers met; and
c. Contractor shall provide oversight to ensure that the minimum level of service is provided
monthly in each city in Contractor's service area.
5. Make crisis benefit payments to vendors on behalf of approved elders within forty-five (45) days
of the date of crisis resolution.
6. Make payments on behalf of those elders with the highest home energy needs and the lowest
household income, which will be determined by taking into account both the energy burden and
37
October 2019 — September 2020 EHEAP 203.19
the unique situation of households that result from having members of a vulnerable population,
including very young children, the disabled, and frail elders.
7. Refund to the Agency, with non-federal Rinds, all funds incorrectly paid on behalf of elders that
cannot be collected from the elder.
8. Develop adequate procedures to ensure EIIEAP funds are appropriately budgeted and expended
to permit payment of energy assistance benefits in both the heating and cooling seasons, ensure
that this is a twelve- month program, and ensure that funding is available to and expended in, all
counties within Contractor's service area. Procedures should include referral to other community
agencies when funds budgeted for a particular time period are exhausted and elders are
subsequently denied.
9. Develop monitoring and oversight procedures to ensure that administrative costs that exceed the
contracted EHEAP administrative award to Contractor or Subcontractor are paid from non-federal
sources.
IO.Develop adequate procedures to address the use of EILEAP finds for elders who are on oxygen
support or a "Lifeline Program" and must have power.
11. Develop a written policy regarding the use of funds for repairing or replacing heating or cooling
equipment. The procedures must address the conditions under which an elder is eligible for such
funds and what constitutes an emergency related to lack of heating or cooling.
12. Ensure providers and appropriate staff participate in training opportunities scheduled by the
Agency to cover EHEAP policies and procedures.
13 Ensure the provision of training for all providers and staff members assigned responsibilities
within the program.
14 Maintain an EHEAP Policies and Procedures Manual to serve as a local resource for program
administration, training, and reference. The EHEAP Policies and Procedures Manual shall be
distributed to all subcontractors that provide any service under EHEAP. The EHEAP Policies and
Procedures Manual shall be reviewed during, and in accordance with, the Agency's EHEAP
contract monitoring schedule, and shall include the following:
a. The State of Florida LIIIEAP Policies and Procedures Manual;
b. An MOU or Subcontract with EIIEAP providers;
c. An MOU with all service area L IHEAP providers;
d. An MOU with all service area WAP providers;
e. Contractor's cost allocation methodology;
f. Written policies and procedures to ensure that all energy assistance payments made to home
energy vendors comply with the requirements of the Vendor Agreement;
g. Adequate procedures to ensure that EHEAP funds are appropriately budgeted and expended
to sufficiently allow for energy assistance benefits in both the heating and cooling seasons,
ensure that this is a twelve- month program, and to ensure that funding is available to, and
expended in, all counties within Contractor's service area;
Ii. Policies regarding the detection and prevention of fraud and abuse of program funds;
i. Policies that address serving family members and employees;
38
October 2019 — September 2020 EHEAP 203.19
j. Policies and procedures to secure applicant Social Security Numbers, in order to protect
applicants' identities;
k. Procedures for computer system backup and recovery;
1. Procedures for referral or access assistance to the "Lifeline Program';
in, A policy outlining the criteria to determine if a household has a "home energy crisis" and the
information and/or documentation required to verify the crisis;
n. Policies and procedures for determining the eligibility of elders applying for F.,HEAP;
o. Policies which encourage households to seek assistance prior to incurring non -energy
penalties such as disconnect/reconnect fees, additional deposits, interest, or late payments;
p. Procedures referring elderly homeowners who have received more than three energy benefits
(EHEAP or LIHEAP) in the last eighteen (18) months to the WAP provider;
q. A policy concerning the use of fonds for the purchase or repair of heating or cooling
equipment;
r. Policies and procedures which detail allowable timeframes for elders to submit required
documentation, if missing at the time of application;
s. A resource guide, or the utilization of the Information and Referral database (ReferNET), to
access other energy assistance resources available at the local level to provide referrals to
elders when EHEAP Funding is not available or they do not qualify; or contacting the Area
Agency's Elder Help Line for resources.
t. Consumer appeal procedures that provide an opportunity for a fair administrative hearing at
the provider level to elders whose applications for assistance are denied, or whose applications
are not acted upon with reasonable promptness; and
u. Policies and procedures for conducting home visits to home -bound elders for completion of
the program application or eligibility determination when other assistance is not available.
15 Notwithstanding that tasks for which the Contractor is held accountable involve coordination with
other entities in performing this contract, the failure of other entities does not alleviate the
Contractor from any accountability for tasks or services that the Contractor is obligated to perform
pursuant to this contract.
G. AGENCY RESPONSIBILITIES
1. The Agency may provide technical support and assistance to Contractor within the resources of
the Agency to assist the Contractor in meeting the requirements of this contract. The support and
assistance, or lack thereof, shall not relieve Contractor from full performance of contract
requirements.
2 The Agency will provide to Contractor the State of Florida LIHEAP Policies and Procedures
Manual. The State of Florida LIHEAP Policies and Procedures Manual will provide information
and procedures needed to administer EHEAP in Florida.
a. This contact excludes all provisions of the State of Florida LIHEAP Policies and Procedures
Manual in reference to LIHEAP Regular Home Energy Annual Benefits.
b. To the extent any conflict arises between this contact and any incorporated reference
contained herein, this contract shall have precedence.
39
October 2019 — September 2020
III. METHOD OF PAYMENT
A. PAYMENT METHOD USED
EHEAP 203.19
The Method of Payment for this contract is a combination of cost reimbursement and advance
payments, subject to the availability of funds and Contractor performance. The Agency will pay the
Contractor upon satisfactory completion of the Tasks/Deliverables, as specified in Section II, Manner
of Service Provision, and in accordance with other terms and conditions of this contract.
L Cost Reimbursement
The Contractor agrees to distribute funds as detailed in the Budget Summary (ATTACHMENT
IX), attached to this contract. Any change in allocation of categorical or total amounts of funds
identified on the Budget Summary form require a contract amendment. ,Payment may be
authorized only for allowable expenditures, which are in accordance with the limits specified in
ATTACHMENT IX. All Cost Reimbursement Requests for ,Payment must include the actual
Receipts and Expenditure Reports beginning with the first month of this contract.
a. Budget Summary
Contractor agrees to implement the distribution of funds as detailed in the Budget Summary
(ATTACHMENT IX). An amendment is required to change category allocations or the total
amount of this contract.
(1) Administrative Expense
Administrative expenses include costs for general administration and coordination of the
program, including direct and indirect costs. This includes the salaries, fringe benefits (i.e.
insurance, retirement, etc.), rent, utilities, travel, etc, associated with financial and
administrative management of the program. The use of other federal funds to supplement
the administrative operations of EHEAP, above and beyond the budgeted amount, is
prohibited. Administrative costs that exceed the contracted EHEAP administrative award
to Contractor or subcontractor must be paid from non-federal sources. Contractors must
have adequate procedures for monitoring and oversight to ensure compliance.
(2) Outreach Expense
Outreach expenses are those costs incurred in delivering EHEAP services that are not
purely administrative in nature. This may include staff and subcontractor expenses such as
salaries, fringe benefits (i.e. insurance, retirement, etc.), rent, utilities, travel, etc. for those
employees performing outreach and intake, and any subcontractor expenses. Outreach
expense shall not include senior management expense, unless outreach and intake involving
direct contact with elders occurs. Documentation to support this exception shall be
maintained by Contractor and available upon request.
b. Weather/Related Supply Shortage
Weather Related/Supply Shortage funds are a set-aside for emergency assistance. These funds
must be held in this budget line item category until December 15°i of the program year, for use
in response to a possible disaster. These funds shall only be used during state or federal
emergencies declared officially by the President of the United States, the Governor of the State
of Florida, or the Executive Director of DEO. In the event of an emergency being officially
declared, if Contractor or the Agency finds that the budgeted amount of Weather
40
October 2019 — September 2020 EHEAP 203.19
Related/Supply Shortage emergency assistance funds is not sufficient to meet the emergency,
Contractor may, with the Agency's written authorization, draw on other contract categories up
to fifty percent (50%) of the total contract budget. When funds are distributed for a weather-
related/supply shortage emergency, the Agency will provide binding directives as to the
allowable expenditures of the funds. After December T5, if no emergency has been declared,
the Agency will release the funds and Contractor shall allocate these finds to the crisis category
of the program.
e. Indirect Cost Rate
Per 2 C.F.R.§ 200.331(a)(4), Subrecipients of federal awards are required to have an approved,
federally recognized indirect cost rate, negotiated between the Subrecipient and the Federal
Government. If no such rate exists, then the Subrecipient shall have either a rate negotiated
with DOEA (in compliance with 2 C.F.R.Tart 200), or a de minimal indirect cost rate as
defined in 2 C.F.R. § 200.4140. Subrecipient shall maintain its current Indirect Cost Rate
Proposal and make the proposal available upon request. If Subrecipient chooses to use the de
minimal rate, Subrecipient shall make sure it is entitled to use that rate and include a statement
to that effect. Subrecipient is not obligated to establish an indirect cost rate if Subrecipient
does not charge an indirect cost rate.
2 Advance Payments
Contractor may request up to two (2) months of advances at the start of the contract period to
cover program administration, outreach, and service costs. The payment of an advance will be
contingent upon the sufficiency and amount of funds released to the Agency by the State ofFlorida
("budget release"). Contractor's requests for advance payments require the written approval of the
Agency's Contract Manager. For the first month's advance request, Contractor shall provide the
Agency's Contract Manager documentation justifying the need for an advance and describing how
the funds will be distributed. If sufficient budget is available, and the Agency's ContaetManager,
in his or her sole discretion, has determined that there is a justified need for an advance, the
Agency will issue approved advance payments after October 1, 2019.
a. Any advance payment the Contractor requests for subcontractors must be distributed within
seven days of receipt of payment from the Agency. The Contractor shall submit to the Agency
documentation to support full distribution of advance funds with report number 5, due to the
Agency on January 9, 2020, in accordance with the Invoice Report Schedule,
(ATTACHMENT XIII), to this contract.
b. All advance fluids requested for the Contractor must be fully expended no later than December
15, 2019. Any amount of advance payments not fully recouped on the Request for Payment
starting with Receipts and Expenditure Report number 5, due to the Agency on January 9,
2020, in accordance with the Invoice Report Schedule, (ATTACHMENT XHI), attached to
this contract.
e. All advance payments made to the Contractor shall be reimbursed to the Agency as follows:
one -tenth of the advance payment received shall be reported as an advance recoupment on
each Request for Payment, starting with Receipts and Expenditure Repoli number 5, in
accordance with the Invoice Report Schedule, (ATTACHMENT XIII), attached to this
contract.
d. Interest earned on advances must be identified separately by source of fluids, state or federal.
Contractor shall maintain advances of federal fluids in FDIC interest bearing accounts, unless
an exception is made in accordance with 45 CFR Part 75. Interest earned in excess of
41
October 2019 — September 2020
EHEAP 203.19
$250 per year on Federal cash balances shall be returned to the Agency at the end of each
quarter of the contract period.
B. All payment requests shall be based oil actual monthly expenditures beginning with the first month
of this contract. The schedule for submission of advance requests and requests for payment is in
ATTACHMENT XIII to this contract.
C. The final request for payment is due to the Agency no later than October 15, 2020.
D. METHOD OF INVOICE PAYMENT
Payment shall be made upon Contractor's presentation of an invoice subsequent to the acceptance and
approval by the Agency of the deliverables on the invoice. The form and substance of each invoice
submitted by Contractor shall be as follows:
I. Have Remittance Address that corresponds exactly to the "Remit To" address provided to My
Florida Marketplace (MFMP) during registration;
2 Request payment for services as established in the Service Rate Report (ATTACHMENT
XXIII);
3 Contractor shall consolidate all Requests for Payment from subcontractors and Receipts and
Expenditure Reports that support requests for payment and shall submit them to the Agency using
Receipts and Expenditure Report (ATTACHMENT XI), Request for Payment
(ATTACHMENT XII), and Cost Reimbursement Summary (ATTACHMENT XXI);
4. Contractor shall include requiring supporting documentation as delineated in Section III. F. with
the cost reimbursement portion of the invoice.
E. PAYMENT WITHHOLDING
Any payment due by the Agency under the terms of this contract may be withheld pending the receipt
and approval by the Department of all financial and programmatic reports due from the Contractor
and any adjustments thereto, including any disallowance not resolved.
F. SUPPORTING DOCUMENTATION REQUIREMENTS
For the reporting month, Contractor shall include the following with Request for Payment:
L 'file number of individuals served, that include:
a. The number of individuals served with crisis assistance during the reporting month;
Ii. The number of individuals ineligible or denied assistance during the reporting month;
e. The number of individuals referred to other community resources for energy assistance
during the reporting month;
2 Certification that Contractor operated during its normal business hours during the reporting month;
and
a The total amount of funding expended for crisis assistance per county for the reporting period;
G. FINANCIAL CONSEQUENCES
Failure to meet the deliverables described in this contract may result in a financial consequence and
may result in the redistribution of fimding. Contractor shall ensure the provision of services and the
successibl completion of deliverables as set forth in this contract.
42
October 2019 — September 2020 EHEAP 203.19
1 The Agency shall not reimburse any expenditures associated with Deliverables not accepted by
the Agency as successfully completed; however, this does not preclude Contractor :from receiving
payment for such expenditures upon successful completion of the deliverable.
2 If Contractor fails to be open and available for services according to its regular business hours as
identified in Section II.C.2 of this contract, excluding weekends or state and federal holidays,
Contractor shall pay to the Agency financial consequences for such failure, unless the Agency
waives such failure in writing based upon its determination that the failure was due to factors
beyond the control of Contractor.
* Contractor's failure to operate according to its regular business hours shall result in an assessment
of a financial consequence in the amount of $10.00 per day.
4 Any amounts due from financial consequences shall be paid by Contractor out of nonfederal funds.
H. REMEDIES -NONCONFORMING SERVICES
Contractor shall ensure that all participants served under this contract are eligible for the program and
that all monthly and/or quarterly performance reports and financial records are maintained for each
reporting period and submitted as stipulated in this contract.
1 Any nonconforming program service, performance report, or financial record not meeting the
aforementioned requirements is not eligible for reimbursement under this program. Contractor
shall solely bear the costs associated with enrolling, training, reporting and/or managing the
program. Contractor shall give immediate notice to the Agency of any significant and/or systemic
infraction that compromises Contractor's ability to provide participant services, to achieve
programmatic performance, or to provide sound financial management of the program.
1, CONSEQUENCES FOR NON-COMPLIANCE
Contractor shall ensure one hundred percent (100%) of the deliverables identified in this contract
are performed pursuant to contract requirements, and as described in Section II.D. are identified as
major deliverables in this contract.
1. If at any time the Contractor is notified by the Agency's Contract Manager that it has failed to
correctly, completely, or adequately perform these major deliverables, the Contractor will have
ten (10) days to submit a Corrective Action Plan (CAP) to the Contract Manager that addresses
the deficiencies and states how the deficiencies will be remedied within a time period approved
by the Contract Manager. The Agency shall assess aFinancial Consequence forNon-Compliance
on the Contractor for each deficiency identified in the CAP which is not corrected pursuant to
the CAP. The Agency will also assess a Financial Consequence for failure to timely submit a
CAP. if Contactor fails to timely submit a CAP, the Agency shall deduct 1% of the monthly
value of the administrative funds in the contract for each day the CAP is overdue, beginning the
I I" day after notification by the Contract Manager of the deficiency. The deduction will be made
from the payment for the invoice of the following month.
2 In the eventthat Contractor fails to correct an identified deficiency within the approved time period
specified in the CAP, the Agency shall deduct, from the payment for the invoice of the following
month, 1% of the monthly value of the administrative finds in the contract for each day the
deficiency is not corrected. The Agency may also deduct, from the payment for the invoice of
the following month, t% of the monthly value of the administrative funds in the contract for
each day the Contractor fails to timely submit a CAP.
43
October 2019 — September 2020 EIIEAP 203.19
IV. SPECIAL PROVISIONS
A. The following is incorporated by reference:
1. State of Florida LIHEAP Policies and Procedures Manual,
B. Modifications
The Agency shall not be obligated to reimburse Contractor for expenditures in excess of the funded
amount of this contract unless and until the Agency officially approves such expenditures by
executing a written modification to the original contract. signed by both parties.
1. Contractor must use an Agency approved budget modification process.
2 For the purpose of transferring funds, the following are considered budget categories
(1) Administrative, (2) Outreach, and (3) Crisis Assistance.
END OF ATTACHMENT
44
October 2019 — September 2020
FINANCIAL AND COMPLIANCE AUDIT
EHEAP 203.19
ATTACHMENT II
The administration of resources awarded by the Agency to the Contractor may be subject to audits and/or monitoring by the
Area Agency on Aging for Southwest Florida as described in this section.
MONITORING
In addition to reviews of audits conducted in accordance with 2 CFR Pail 200 (formerly OMB Circular A-133 as revised),
and Section 215.97, KS., (see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits
by the Agency and/or Department staff, limited scope audits and/or other procedures. By entering into this contract, the
Contractor agrees to comply and cooperate with any monitoring procedures/processes deemed appropriate by the Agency
and/or Department. In the event the Agency and/or Department determines that a limited scope audit of the
Contractor is appropriate, the Contractor agrees to comply with any additional instructions provided by the Agency
and/or Department to the Contractor regarding such audit. The Contractor further agrees to comply and cooperate with any
inspections, reviews, investigations, or audits deemed necessary by the Agency's Director of Program and Planning.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the Contractor is a State or local government or a non-profit organization as defined in 2 CFR Part
200, Subpart A.
In the event that the Contractor expends $750,000.00 or more in federal awards during its fiscal year, the Contractor must
have a single or program -specific audit conducted in accordance with the provisions of 2 CFR Part 200. Financial
a n d C o m p l i a n c e A u d i t A T T A C H M E N T 11, EXHIBIT 2 to this agreement indicates federal resources
awarded through the Agency by this contract. In determining the federal awards expended in its fiscal year, the Contractor
shall consider all sources of Federal awards, including federal resources received from the Agency. The determination of
amounts of Federal awards expended should be in accordance with 2 CFR Part. An audit of the Contractor conducted by the
Auditor General in accordance with the provisions of 2 CFR Part 200 will meet the requirements of this part.
In connection with the audit requirements addressed in Part I, paragraph 1, the Contractor shall fulfill the requirements relative
to auditee responsibilities as provided in 2 CFR §200.508.
If the Contractor expends less than $750,000.00 in federal awards in its fiscal year, an audit conducted in accordance with the
provisions of 2 CFR Part 200 is not required. In the event that the Contractor expends less than $750,000.00 in federal awards
in its fiscal year and elects to have an audit conducted in accordance with the provisions of 2 CFR Part 200, the cost of the
audit must be paid from non-federal resources (i.e, the cost of such audit must be paid from Contractor resources obtained
from other than federal entities.)
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to contracts with the Agency shall be based on the contract's requirements, including any rules,
regulations, or statutes referenced in the contract. The financial statements shall disclose whether or not the matching
requirement was met for each applicable contract. All questioned costs and liabilities due to the Agency shall be fully
disclosed in the audit report with reference to the Area Agency on Aging for Southwest Florida, Inc. contract involved. If
not otherwise disclosed as required by 2 CFR § 200.510, the schedule of expenditures of federal awards shall identify
expenditures by contract number for each agreement with the Agency in effect daring the audit period. Financial reporting
packages required under this part must be submitted within the earlier of 30 days after receipt of the audit report or 9 months
after the end of the Contractor's fiscal year end.
45
PART IIe STATE F1�DED 2020
EHEAP 203.19
This part is applicable if the Contractor is a non -state entity as defined by Section 215.97(2), F.S.
In the event that the Contractor expends a total amount of state financial assistance equal to or in excess of $750,000.00
in any fiscal year of such Contractor, the Contractor must have a State single or project -specific audit for such fiscal
year in accordance with Section 215.97, F.S.; applicable rules of the Department of Financial Services; and Chapter 10.550
(local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General.
ATTACHMENT 11, EXHIBIT 2 to this agreement indicates state financial assistance awarded through the Agency
by this contract. In determining the state financial assistance expended in its fiscal year, the Contractor shall consider all
sources of state financial assistance, including state financial assistance received from the Agency, other state agencies,
and other nonstate entities. State financial assistance does not include Federal direct or pass-through awards and resources
received by a non -state entity for Federal program matching requirements.
In connection with the audit requirements addressed in Part I1, paragraph 1, the Contractor shall ensure that the audit complies
with the requirements of Section 215.97(8), F.S. This includes submission of a financial reporting package as defined by
Section 215.97(2), F.S., and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations),
Rules of the Auditor General.
If the Contractor expends less than $750,000.00 in state financial assistance in its fiscal year, an audit conducted in accordance
with the provisions of Section 215.97, F.S., is not required. In the event that the Contractor expends less than $750,000.00
in state financial assistance in its fiscal year and elects to have an audit conducted in accordance with the provisions of Section
215.97, F.S„ the cost of the audit must be paid from the non -state entity's resources (i.e., the cost of such an audit must be
paid fiom the Contractor resources obtained from other than State entities).
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to contracts with the Agency shall be based on the contract's requirements, including any
applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching
requirement was met for each applicable contract. All questioned costs and liabilities due to the Agency shall be fully
disclosed in the audit report with reference to the Agency contract involved. If not otherwise disclosed as required by Rule
69I-5.003, F.A.C., the schedule of expenditures of state financial assistance shall identify expenditures by contract
number for each contract with the Agency in effect during the audit period. For local governmental entities, financial
reporting packages required under this part must be submitted within 45 days after delivery of the audit report, but no later
than 12 months after the Contractor's fiscal year end. For non-profit or for-profit organizations, financial reporting
packages required under this part must be submitted within 45 days after delivery of the audit report, but no later
than 9 months after the Contractor's fiscal year end. Notwithstanding the applicability of this portion, the Agency retains
all right and obligation to monitor and oversee the performance of this contract as outlined throughout this document and
pursuant to law.
PART III: REPORT SUBMISSION
Copies of financial reporting packages for audits conducted in accordance with 2 CFR Part 200 and required by Part
I of this Financial Compliance Audit Attachment, shall be submitted, when required by 2 CFR § 200.512 by or on behalf
of the Contractor directIV to each of the following:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 101i Street
Jeffersonville, IN 47132
Pursuant to 2 CFR §200.512, all other Federal agencies, pass-through entities and others interested in a reporting package
and data collection form must obtain it by accessing the Federal Audit Clearinghouse.
46
r::
October 2019 — September 2020 EHEAP 203.19
The Contractor shall submit a copy of any management letter issued by the auditor, to the Area Agency on Aging for
Southwest Florida, Inc.at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Ken Carr, CFO
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
Additionally, copies of financial reporting packages required by PART II of this contract's Financial and Compliance
Audit Attachment shall be submitted by or on behalf of the Contractor directlyto each of the following:
The Area Agency on Aging for Southwest Florida, Inc.at the following address:
Area Agency on Aging for Southwest Florida, Inc.
Attn: Ken Carr, CFO
15201 N Cleveland Ave., Suite 1100
North Fort Myers, FL 33903
The Auditor General's Office at the following address:
State of Florida Auditor General
Claude Pepper Building, Room 574
111 West Madison Sheet
Tallahassee, Florida 32399-1450
Any reports, management letters, or other information required to be submitted to the Agency pursuant to this agreement shall
be submitted timely in accordance with 2 CFR Part 200, F.S., and Chapter 10.550 (local governmental entities) or 10.650
(nonprofit and for-profit organizations), Rules of the Auditor General, as applicable.
Contractors, when submitting financial reporting packages to the Agency for audits done in accordance with 2 CFR Part
200 or Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor
General, should indicate the date that the reporting package was delivered to the Contractor in correspondence accompanying
the reporting package.
PART IV: RECORD RETENTION
The Contractor shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of
six (6) years from the date the audit report is issued, and shall allow the Agency or its designee, the CFO or Auditor
General Access to such records upon request. The Contractor shall ensure that audit working papers are made available to
the Agency or its designee, CFO, or Auditor General upon request for a period of six (6) years from the date the audit report
is issued, unless extended in writing by the Agency.
47
October 2019 — September 2020
EHEAP 203.19
ATTACHMENT H -EXHIBIT 1
PART I: AUDIT RELATIONSHIP DETERMINATION
Contractors who receive state or federal resources may or may not be subject to the audit requirements of 2 CFR Part 200
and/or Section 215.97, F.S. Contractors who are determined to be recipients or sub -recipients of federal awards and/or
state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I
and/or Part II of Exhibit I are met. Contactors who have been determined to be vendors are not subject to the audit
requirements of 2 CFR § 200.38, and/or Section 215.97, F.S. Regardless of whether the audit requirements are met,
Contractors who have been determined to be recipients or sub -recipients of Federal awards and/or state financial
assistance must comply with applicable programmatic and fiscal compliance requirements.
In accordance with 2 CFR Part 200 and/or Rule 69I-5.006, F.A.C., Contractor has been determined to be:
Vendor not subject to 2 CFR § 200.38 and/or Section 215.97, F.S.
X Recipient/sub-recipient subject to 2 CFR §§ 200.86 and 200.93 and/or Section 215.97, F.S.
_Exempt organization not subject to 2 CFR Part 200 and/or Section 215.97, F.S. For Federal awards, for-profit
organizations are exempt; for state financial assistance projects, public universities, community colleges, district
school boards, branches of state (Florida) government, and charter schools are exempt. Exempt organizations must
comply with all compliance requirements set forth within the contract or award document.
NOTE: If a Contractor is determined to be a recipient/sub-recipient of federal and /or state financial assistance, and has been
approved by the Agency to subcontract, they must comply with Section 215.97(7), F.S., and Rule 69I-5006, F.A.C. [state
financial assistance] and/or 2 CFR § 200.330[federal awards].
PART II: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Contractors who receive Federal
awards, state maintenance of effort funds, or state matching funds on Federal awards and who are determined to be a sub -
recipient must comply with the following fiscal laws, rules, and regulations:
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR § 200.416 - §200.417 — Special Considerations for States, Local Governments, and Indian Tribes*
2 CFR § 200.201 — Administrative Requirements**
2 CFR § 200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
NON-PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR § 200.400 - §200.411 — Cost Principles*
2 CFR § 200.100 — Administrative Requirements
2 CFR § 200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT)
MUST FOLLOW:
2 CFR § 200.418 — §200.419 — Special Considerations for Institutions of Higher Education*
2 CFR § 200.100—Administrative Requirements
2 CFR § 200 Subpart F — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
48
October 2019 — September 2020
EHEAP 203.19
*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in 2 CFR
§ 200.400(5)(c).
**For funding passed through U.S. Health and Human Services, 45 CFR Part 75; for funding passed
through U.S. Department of Education, 34 CFR Part 80.
STATE FINANCIAL ASSISTANCE. Contractors who receive state financial assistance and who are determined to be
a recipienUsub-recipient must comply with the following fiscal laws, rules, and regulations:
Section 215.97 & 215.971, F.S.
Chapter 69I-5, F.A.C.
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
49
October 2019 — September 2020
FUNDING SUMMARY
EHEAP 203.19
ATTACHMENT II—EXHIBIT 2
Note: Title 2 CFR, as revised, and Section 215.97, F.S., require that the information about Federal Programs
and State Projects included in ATTACHMENT II—EXHIBIT I, be provided to the recipient. Information
contained herein is a prediction of funding sources and related amounts based on the contract budget.
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS
CO NTR A ('T (-nNSiST (1F THE F(N.i.OWING-
GRANT AWARD (FAIN#): 17EA-OF-13-00-16-003 FEDERAL AWARD DATE: April 1, 2019
DUNS NUMBER: 076997790
PROGRAM TITLE
FUNDING SOURCE
CFDA
AMOUNT
Emergency Home Energy Assistance
for the Elderly Program
United States Department of Health
and Human Services
93.568
EHEAP
Collier
93.568
$ 73 218.87
TOTAL FEDERAL AWARD
$ 73 218.87
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED
PURSUANT TO THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS:
2 CFR Pail 200 — Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal
Awards. OMB Circular A-133 — Audits of States, Local Governments, and Non -Profit Organizations
2 STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT
CONSIST OF THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD
ANN1N 1 A1NCL
JISl,11V 1N Z13.7/. P.J.
I PROGRAM TITLE I FUNDING SOURCE I CSFA I AMOUNT
AL A
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT
TO THIS CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE.
Sections 215.97 & 215.971, F.S., Chapter 69I-5, F.A.C, State Projects Compliance
Supplement Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules, and regulations
50
October 2019 — September 2020
CERTIFICATIONS AND ASSURANCES
EHEAP 203.19
ATTACHMENT III
DOEA will not award this contract unless Contractor completes this CERTIFICATIONS AND ASSURANCES. In
performance of this contract, Contactor provides the following certifications and assurances:
a. Debarment and Susnension Certification R Part 95 andL Part 75)
1 1 I Regarding1 I ' CFR Part ' 45 [ Part '
c. Nondiscriminaflon & Filual1 1 1 9 CFR Part 37 and 45 CFR' : 1
/. Certification Regarding"llic EntJU Crimes. Section
e. Assoceation of Coin m u njL� Organizations for Reform Now (ACORN) Fundi n i! Restrictions Assu ran ce (Pub.
L Scrutinized Companies Lists and No Boycott of Israel Certification Section 287.135. F.S.
OFIR11 M, 11 k"+ !In=P711111 \ 1111 rMlITO r1WQ 11 F MIMN =1IT = 1 110•
1
111 I 1 1'1 1
' 1 1 IT11,11111K411, 1011
A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY
MATTERS —PRIMARY COVERED TRANSACTION.
The undersigned Contractor certifies, to the best of its knowledge and belief, that it and its principals:
1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
covered transactions by a Federal department or agency;
2. Have not within a three-year period preceding this contact been convicted or had a civil judgment rendered against
them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing
a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State
antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records,
making false statements, or receiving stolen property;
3. Are not presently indicted or otherwise criminally or civilly charged by a government entity (Federal, State, or local)
with commission of any of the offenses enumerated in paragraph A.2, of this certification; and/or
4. Have not within a three-year period preceding this application/proposal had one or more public transactions
(Federal, State, or local) terminated for cause of default.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -
recipients and contractors shall provide this certification accordingly.
51
October 2019 — September 2020
EHEAP 203.19
B. CERTIFICATION REGARDING LOBBYING —CERTIFICATION FOR CONTRACTS, GRANTS,
LOANS, AND COOPERATIVE AGREEMENTS
The undersigned Contractor certifies, to the best of its knowledge and belief, that:
No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of Congress or an employee of a Member of Congress in
connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan,
the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification
of any Federal contract, grant, loan, or cooperative agreement.
If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of
Congress, or employee of a Member of Congress in connection with a Federal contract, grant, loan, or cooperative
agreement, the undersigned shall also complete and submit Standard Form — LLL, "Disclosure Form to Report
Lobbying," in accordance with its instructions.
The undersigned shall require that language of this certification be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -
recipients and contractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this contract was made or
entered into. Submission of this certification is a prerequisite for making or entering into this contract imposed by 31
U,S.C. § 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than
$10,000 and not more than $100,000 for each such failure.
C. NON-DISCRIMINATION & EQUAL OPPORTUNITY ASSURANCE (29 CFR PART 37 AND 45 CFR PART
80). - As a condition of the Contract, Contractor assures that it will comply fully with the nondiscrimination and equal
opportunity provisions of the following laws:
1. Section 188 of the Workforce Investment Act of 1998 (WIA), (Pub. L. 105-220), which prohibits discrimination
against all individuals in the United States on the basis of race, color, religion, sex, national origin, age, disability,
political affiliation, or belief, and against beneficiaries on the basis of either citizenship/status as a lawfully admitted
immigrant authorized to work in the United States or participation in any WIA Title I -financially assisted program
or activity.
2. Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352), as amended, and all requirements imposed by or pursuant
to the Regulation of the Department of Health and Human Services (45 CFR Part 80), to the end that, in accordance
with Title VI of that Act and the Regulation, no person in the United States shall, on the ground of race, color, or
national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to
discrimination under any program or activity for which the Applicant receives Federal financial assistance from the
Department and/or Agency.
3. Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112), as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 84), to the end that, in
accordance with Section 504 of that Act, and the Regulation, no otherwise qualified handicapped individual in the
United States shall, solely by reason of Ns handicap, be excluded from participation in, be denied the benefits of,
or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial
assistance from the Agency.
4. The Age Discrimination Act of 1975 (Pub. L. 94-135), as amended, and all requirements imposed by or pursuant
to the Regulation of the Agency of Health and Human Services (45 CFR Part 91), to the end that, in accordance with
the Act and the Regulation, no person in the United States shall, on the basis of age, be denied the benefits of, be
excluded from participation in, or be subjected to discrimination under any program or activity for which the
Applicant receives Federal financial assistance from the Agency.
5. Title IX of the Education Amendments of 1972 (Pub. L. 92-318), as amended, and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 86), to the end that, in
accordance with Title IX and the Regulation, no person in the United States shall, on the basis of sex, be excluded
52
October 2019 — September 2020
EHEAP 203.19
from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any education
program or activity for which the Applicant receives Federal financial assistance from the Agency.
6. The American with Disabilities Act of 1990 (Pub. L. 101-336), which prohibits discrimination in all employment
practices including job application procedures, hiring, firing, advancement, compensation, training, and other
terms, conditions, and privileges of employment. It applies to recruitment, advertising, tenure, layoff, leave, fringe
benefits and all other employment-related activities.
7. Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws
listed above. This assurance applies to Contractor's operation of the WIA Title I — financially assisted program or
activity; and to all contracts, Contractor makes to cant' out the WIA Title I — financially assisted program or
activity. Contractor understands that the Agency and/or DOEA and the United States have the right to seek judicial
enforcement of the assurance.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -
recipients and contractors shall provide this assurance accordingly.
D. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES, SECTION 287.133, F.S.
Contractor hereby certifies that neither it, nor any person or affiliate of Contractor, has been convicted of a Public Entity
Crime as defined in Section 287.133, F.S., nor placed on the Convicted Vendor List.
Contractor understands and agrees that it is required to inform Area Agency and DOEA immediately upon any change
of circumstances regarding this status.
E. ASSOCIATION OF C O M M U N I T Y ORGANIZATIONS FOR REFORM NOW (ACORN) FUNDING
RESTRICTIONS ASSURANCE (Pub. L. 111-117).
As a condition of the Contract, Contractor assures that it will comply fully with the federal funding restrictions
pertaining to ACORN and its subsidiaries per the Consolidated Appropriations Act, 2010, Division E, Section 511 (Pub.
L. 111-117). The Continuing Appropriations Act, 2011, Sections 101 and 103 (Pub. L. 111-242), provides that
appropriations made under Pub. L. 111-117 are available under the conditions provided by Pub. L. 111-117.
The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all
tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub
recipients and contractors shall provide this assurance accordingly.
F. SCRUTINIZED COMPANIES LISTS AND NO BOYCOTT OF ISRAEL CERTIFICATION,
SECTION 287.135, F.S.
In accordance with section 287.135, F.S., Contractor hereby certifies that it has not been placed on the Scrutinized
Companies that Boycott Israel List and that it is not engaged in a boycott of Israel.
If this contract is in the amount of $1 million or more, in accordance with the requirements of section 287.135,
F.S., Contractor hereby certifies that it is not listed on either the Scrutinized Companies with Activities in Sudan
List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List and that it is not
engaged in business operations in Cuba or Syria.
Contractor understands that pursuant to section 287.135, F.S., the submission of a false certification may result in
the Agency terminating this contract and the submission of a false certification may subject Contractor to civil
penalties and attorney fees and costs, including any costs for investigations that led to the finding of false
certification.
If Contractor is unable to certify any of the statements in this certification, Contractor shall attach an
explanation to this contract.
53
October 2019 — September 2020 EHEAP 203.19
G. CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR CONTRACTS, AGREEMENTS,
GRANTS, LOANS, AND COOPERATIVE AGREEMENTS
1. The Contractor and any Subcontractors of set -vices under this contract have financial management systems
capable of providing certain information, including: (1) accurate, current, and complete disclosure of the financial
results of each grant -funded project or program in accordance with the prescribed reporting requirements; (2) the
source and application of funds for all contract supported activities; and (3) the comparison of outlays with
budgeted amounts for each award. The inability to process information in accordance with these requirements
could result in a return of grant funds that have not been accounted for properly.
2. Management Information Systems used by the Contractor, Subcontractors, or any outside entity on which the
Contractor is dependent for data that is to be reported, transmitted, or calculated have been assessed and verified
to be capable of processing data accurately, including year -date dependent data. For those systems identified to be
non-compliant, Contractors will take immediate action to assure data integrity.
3. If this contract includes the provision of hardware, software, firmware, microcode, or imbedded clup technology,
the undersigned warrants that these products are capable of processing year -date dependent data accurately. All
versions of these products offered by the Contractor (represented by the undersigned) and purchased by the state
will be verified for accuracy and integrity of data prior to transfer.
4. In the event of any decrease in functionality related to time and date related codes and internal subroutines that
impede the hardware or software programs from operating properly, the Contractor agrees to immediately make
required corrections to restore hardware and software programs to the same level of functionality as warranted
herein, at no charge to the state, and without interruption to the ongoing business of the state, time being of the
essence.
5. The Contractor and any Subcontractors of services under this contract warrant that their policies and procedures
include a disaster plan to provide for set -vice delivery to continue in case of an emergency, including emergencies
arising from data integrity compliance issues.
H. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION
As a condition of contracting with the Agency, Contractor certifies the use of the U.S. Department of Homeland
Security's E -verify system to verify the employment eligibility of all new employees hired by Contractor during the
contract term to perform employment duties pursuant to this contract, and that any subcontracts include an express
requirement that Subcontractors performing work or providing set -vices pursuant to this contract utilize the E -verify
system to verify the employment eligibility of all new employees hired by the Subcontractor during the entire
contract term.
The Contractor shall require that the language of this certification be included in all sub -agreements, sub -grants, and
other agreements/contracts and that all Subcontractors shall certify compliance accordingly.
This certification is a material representation of fact upon which reliance was placed when this contract was made or
entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by
Circulars A-102 and 2 CFR Part 200 and 215 (formerly OMB Circular A -I 10).
I. RECORDS AND DOCUMENTATION
The Contractor agrees to make available to Agency staff and/or any party designated by the Agency any and all
contract related records and documentation. The Contractor shall ensure the collection and maintenance of all
program related information and documentation on any such system designated by the Agency. Maintenance includes
valid exports and backups of all data and systems according to Agency standards.
54
October 2019 — September 2020 EHEAP 203.19
J. CERTIFICATION REGARDING INSPECTION OF PUBLIC RECORDS
1. In addition to the requirements of Sections 10 of the Standard Contract sections 119.0701(3) and (4) F.S., and any other
applicable law, if a civil action is commenced as contemplated by section 119.0701(4), F.S., and the Agency is named in
the civil action, Contractor agrees to indemnify and hold harmless the Agency for any costs incurred by the Agency,
and any attorneys' fees assessed or awarded against the Agency from a Public Records Request made pursuant to Chapter
119, F.S., concerning this contract or services performed thereunder.
a. Notwithstanding Section 119.0701, F.S., or other Florida law, this section is not applicable to contracts executed
between the Department and state agencies or sub divisions defined in section 768.28(2), F.S.
2. Section 119.0 1(3), F.S., states if public funds are expended by an agency in payment of dues or membership contributions
for any person, corporation, foundation, trust, association, group, or other organization, all the financial, business, and
membership records of such an entitywhich pertain to the public agency (Area Agency on Aging for Southwest Florida,
Inc.) are public records. Section 119.07, F.S, states that every person who has custody of such a public record shall permit
the record to be inspected and copied by any person desiring to do so, under reasonable circumstances.
Additionally, I certify this organization does X does not _ provide for institutional memberships.
Contractor's signature below attests that records pertaining to the dues or membership application by the Agency are
available for inspection if applicable, as stated above.
By execution of this contract, Contractor must include these provisions (A -J) in all related subcontract agreements (if applicable).
By signinygg below, Contractor certifies the epresentations outlined in parts A through J above are true and correct.
STEPHEN Y'CARNELL 3339 TAMIAMI TRAIL E. SUITE 212
(Signature and Title of Authorized Representative)
COLLIER COUNTY BOARD OF COMMISSIONERS
(Contractor) 1 O I 5-1 A (Date)
55
(Street Address)
NAPLES FL 34112
(City, State, ZIP code)
0�1
October 2019 — September 2020 EHEAP 203.19
ATTACHMENT IV
ASSURANCES—NON-CONSTRUCTION PROGRAMS
Public reporting burden for this collection of information is estimated to average forty-five (45) minutes per response, including time
for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing
the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348-0043),
Washington DC 20503.
PIN ARF. nn NOT RFTYMN VOIiR C'OMPI NTFn FORM TO TAF. OFFiC'F, OF MANAGEMENT AND
BUDGET, SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions, please
contact the awarding agency. Further, certain federal awarding agencies may require applicants to certify to
additional assurances. If such is the case, you will be notified.
1. Has the legal authority to apply for federal assistance, and the institutional, managerial and financial capability
(including funds sufficient to pay the non-federal share of project cost) to ensure proper planning, management, and
completion of the project described in this application.
2 Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the state, through any
authorized representative, access to and the right to examine all records, books, papers, or documents related to the
award; and will establish a proper accounting system in accordance with generally accepted accounting standards or
agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the
appearance of, personal or organizational conflict of interest or personal gain.
4 Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §§ 4728-4763) relating to prescribed standards
for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's
Standards for a Merit System of Personnel Administration (5 CY R. 900, Subpart F).
6 Will comply with all federal statues relating to nondiscrimination. These include but are not limited to: (a) Title VI of
the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin;
(b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§ 1681-1683, and §§ 1685-1686),
which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29
U.S.C.§ 794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as
amended (42 U.S.C. §§ 6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and
Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the
Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-
616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) Sections 523 and 527
of the Public Health Service Act of 1912 (42 U.S.C. §§ 290 dd-3 and 290 ee 3), as amended, relating to confidentiality
of alcohol and drug abuse patient records; (h) Titte VIII of the Civil Rights Act of 1968 (42 U.S.C. § 3601 et seq.),
as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination
provisions in the specific statute(s) under which application for federal assistance is being made; and 0) the requirements
of any other nondiscrimination statute(s) which may apply to the application.
7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance
and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of
persons displaced or whose property is acquired as a result of federal or federally assisted programs. These requirements
apply to all interests in real property acquired for project purposes regardless of federal participation in purchases.
56
October 2019 — September 2020 EHEAP 203.19
8 Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. §§ 1501-1508 and §§ 7324-7328), which
limit the political activities of employees whose principal employment activities are funded in whole or in part with
federal funds.
9 Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C. §§ 276a to 276a-7), the Copeland Act
(40 U.S.C. § 276c and 18 U.S.C. § 874) and the Contract Work Hours and Safety Standards Act (40 U.S.C. §§ 327-
333), regarding labor standards for federally assisted construction sub -contracts.
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the
program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or
more.
11. Will comply with environmental standards which may be prescribed pursuant to the following; (a) institution of
environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and
Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of
project consistency with the approved State management program developed under the Coastal Zone Management Act of
1972 (16 U.S.C. § 1451 et seq.); (f) conformity of federal actions to State (Clear Air) Implementation Plans under
Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. § 7401 et seq.); (g) protection of underground
sources of drinking water under the Safe Drinking Water Act of 1974, as amended (P.L. 93-523); and (h) protection of
endangered species under the Endangered Species Act of 1973, as amended (P.L. 93-205).
12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. § 1721 et seq.) related to protecting components
or potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of
1966, as amended (16 U.S.C. § 470), EO 11593 (identification and protection of historic properties), and the
Archaeological and Historic Preservation Act of 1974 (16 U.S.C. § 469a-1 et seq.).
14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related
activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. § 2131 et seq.)
pertaining to the care, handling, and treatment of warm-blooded animals held for research, teaching, or other activities
supported by this award of assistance.
16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. § 4801 et seq.), which prohibits the use of
lead- based paint in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act
Amendments of 1996 and 2 CFR Part 200.
18. Will comply with all applicable requirements of all other federal laws, executive orders, regulations, and policies
governing this program.
SIF AUTHORIZED TIFYING OFFICIAL TITLE
n �
STEPHEN Y CAJ&ELL UBLIC SERVICES -DEPARTMENT HEAD
APPLICANT ORGANIZATION DATESUBMITTED
COLLIER COUNTY BOARD OF COMMISSIONERS I C' I "�-I Iq
Approved as to form and legality
q `x.40
As ' Stant County Attu a q '\ N
�,O
October 2019 — September 2020 X"i1'APC9WNT V
Ri "DTnA IIRPADTMRNT (ITi RI ]IRR AFFAIR. ("MI. RT(_FIT.0 (YIMPI.IANCF. CHF.CK1JST
Program/Facility Name
County
AAA/Contractor
Address
Completed By
City, State, Zip Code
Date
Telephone
PART I: READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU COMPLETE THIS FORM.
1. Briefly describe the geographic area served by the program/facility and the type of set -vice provided:
For questions 2-5 please indicate the foll
2. Population of area served
Total %
owing: White Black Hispanic I Other
Female Disabled Over 40
Source of data:
NO
❑
3. Staff currently employed
4. Clients currently enrolled/registered
Effective date:
5. Advisory/Governing Board if applicable
PART II: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. IF N/A or NO, EXPLAIN.
6. Is an Assurance of Compliance on file with DOER?
N/A
El
YES
NO
❑
7. Compare the staff composition to the population. Is staff representative of the population?
N/A
El
YES
NO
❑
8. Are eligibility requirements for services applied to clients and applicants without regard to race, color, national
origin, sex, age, religion or disability?
N/A
El
YES
El
NO
1:19.
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?
N/A
E]❑
YES
NO
E]10.
For in-patient services, are room assignments made without regard to race, color, national origin or disability?
N/A
11
YES
NO
❑
11. Is the program/facility accessible to non-English speaking clients?
N/A
1:1❑
YES
NO
❑
12 Are emplo ees, applicants and participants informed of their protection against discrimination? If YES, how?
Verbal Written❑ Poster❑
N/A
El
YES
El
NO
El
58
n
C��
October 2019 — September 2020 EHEAP 203.19
59
1
Reviewed by
13. Give the number and current status of any discrimination complaints regarding services or employment filed
against the program/facility.
N/A
❑
NUMBER
Date
Telephone Response Due
On-Sit,0 Desk Review
Response Received
14. Is the program/facility physically accessible to mobility, hearing, and sight -impaired individuals?
N/A
❑
YES NO
❑ ❑
PART III: THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES. IF
EXPLAIN.
15, Has as a self-evaluation been conducted to identify any barriers to serving disabled individuals and to make any YES
necessary modifications? ❑
NO,
NO
❑
16. Is there an established grievance procedure that incorporates due process in the resolution of complaints?
YES
❑
NO
❑
17. Has a person been designated to coordinate Section 504 compliance activities?
YES
❑
NO
❑
18. Do recruitment and notification materials advise applicants, employees, and participants of nondiscrimination on
the basis of disability?
YES
❑
NO
❑
19. Are auxiliary aids available to ensure accessibility of services to hearing and sight -impaired individuals?
YES
❑
NO
❑
PART IV: FOR PROGRAMS OR FACILITIES WITII 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $5D,000.00 OR MORE.
20. Do you have a written affirmative action plan? HNO, explain. YES
❑
NO
❑
59
1
Reviewed by
In Compliance: YES LJ NO* LJ
Program Office
*Notice of Corrective Action Sent
Date
Telephone Response Due
On-Sit,0 Desk Review
Response Received
59
October 2019 — September 2020 EHEAP 203.19
ATTACHMENT V
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST
1. Describe the geographic service area such as a district, county, city, or other locality. If the program/facility serves
a specific target population such as adolescents, describe the target population. Also, define the type of service
provided.
2. Enter the percent of the population served by race, sex, disability, and over the age of 40. The population served
includes persons in the geographical area for which services are provided such as a city, county or other regional
area. Population statistics can be obtained from local chambers of commerce, libraries, or any publication from the
1980 Census containing Florida population statistics, Include the source of your population statistics. ("Other"
races include Asian/Pacific Islanders and American IndiardAlaskan Natives.)
3. Enter the total number of full-time staff and their percent by race, sex, disability, and over the age of 40. Include
the effective date of your summary.
4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and list
their percent by race, sex, disability, and over the age of 40. Include the date that enrollment was counted.
a, Where there is a significant variation between the race, sex, or ethnic composition of the clients and their
availability in the population, the program/facility has the responsibility to determine the reasons for such
variation and take whatever action may be necessary to correct any discrimination. Some legitimate
disparities may exist when programs are sanctioned to serve target populations such as elderly or disabled
persons.
S. Enter the total number of advisory board members and their percent by race, sex, disability, and over the age of
40. If there is no advisory or governing board, leave this section blank.
6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in
compliance with all nondiscriminatory provisions as required in 45 CFR Part 80. This is usually a standard part of
the contract language for DOEA Recipients and their Sub -grantees. 45 CFR § 80.4(a).
7. Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the
population is Hispanic, is there a comparable percentage of Hispanic staff.
8. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or
employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also
through on-site record analysis of persons who applied but were denied set -vices or employment. 45 CFR § 80.3 (a)
and 45 CFR § 80.1.
9. Participants or clients must be provided services such as medical, nursing, and dental care, laboratory services,
physical and recreational therapies, counseling, and social services without regard to race, sex, color, national origin,
religion, age, or disability. Courtesy titles, appointment scheduling, and accuracy of record keeping must be applied
uniformly and without regard to race, sex, color, national origin, religion, age, or disability. Entrances, waiting
rooms, reception areas, restrooms, and other facilities must also be equally available to all clients. 45 CFR § 80.3(b).
10. For in-patient services, residents must be assigned to rooms, wards, etc., without regard to race, color, national
origin, or disability. Also, residents must not be asked whether they are willing to share accommodations with
persons of a different race, color, national origin, or disability. 45 CFR § 80.3(a).
11. The program/facility, and all services must be accessible to participants and applicants, including those persons who
may not speak English. In geographic areas where a significant population of non-English speaking people live,
program accessibility may include the employment of bilingual staff. In other areas, it is sufficient to have a policy
or plan for service, such as a current list of names and telephone numbers of bilingual individuals who will assist
in the provision of services. 45 CFR § 80.3(a).
60
October 2019 — September 2020 EHEAP 203.19
12. Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to their
participants, beneficiaries, or any other interested parties. 45 CFR § 80.6(d)This should include information on
their right to file a complaint of discrimination with either the Area Agency on Aging for Southwest Florida,
Inc. and/or the Florida Department of Elder Affairs or the U.S. Department of Health and Human Services. The
information may be supplied verbally or in writing to every individual or may be supplied through the use of an
equal opportunity policy poster displayed in a public area of the facility.
13. Report number of discrimination complaints filed against the program/facility. Indicate the basis, (e.g,, race, color,
creed, sex, age, national origin, disability, and/or retaliation) and the issues involved, (e.g., services or employment,
placement, termination, etc.). Indicate the civil rights law or policy alleged to have been violated along with the
name and address of the local, state, or federal agency with whom the complaint has been filed. Indicate the
current status of the complaint ( e.g., settled, no reasonable cause found, failure to conciliate, failure to cooperate,
under review, etc.).
14. The program/facility must be physically accessible to mobility, hearing, and sight -impaired individuals. Physical
accessibility includes designated parking areas, curb cuts or level approaches, ramps, and adequate widths to
entrances. The lobby, public telephone, restroom facilities, water fountains, and information and admissions
offices should be accessible. Door widths and traffic areas of adnimishative offices, cafeterias, restrooms, recreation
areas, counters, and serving lines should be observed for accessibility. Elevators should be observed for door width
and Braille or raised numbers. Switches and controls for light, heat, ventilation, fire alarms, and other essentials
should be installed at an appropriate height for mobility impaired individuals.
15. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self-
evaluation to identify any accessibility barriers. Self-evaluation is a four -step process:
a. Evaluate, with the assistance of disabled individuals(s)/organization(s), current policies and practices that do not
or may not comply with Section 504;
b. Modify policies and practices that do not meet Section 504 requirements.
c. Take remedial steps to eliminate the effects of any discrimination that resulted from adherence to these policies
and practices; and
d. Maintain self-evaluation on file, including a list of the interested persons consulted, a description of areas
examined, and any problems identified, and a description of any modifications made and of any remedial steps
taken 45 CFR § 84.6. (This checklist may be used to satisfy this requirement if these four steps have been
followed.).
16. Programs or facilities that employ 15 or more persons shall adopt grievance procedures that incorporate appropriate
due process standards that provide for the prompt and equitable resolution of complaints alleging any action
prohibited by Part 84 of Title 45, CFR § 84.7(b).
17. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to
comply with Part 84 of Title 45 CFR § 84.7(a).
18. Programs or facilities that employ 15 or more persons shall take appropriate initial and continuing steps to notify
participants, beneficiaries, applicants, and employees that the program/facility does not discriminate on the basis of
handicap in violation of Section 504 and Part 84 of Title 45, CFR. Methods of initial and continuing notification
may include the posting of notices, publication in newspapers and magazines, placement of notices in publications
of the programs or facilities, and distribution of memoranda or other written communications. 45 CFR § 84.8(a).
19. Programs/facilities that employ 15 or more persons shall provide appropriate auxiliary aids to persons with impaired
sensory, manual or speaking skills where necessary to afford such persons an equal opportunity to benefit from the
service question. Auxiliary aids may include, but are not limited to, brailed and taped materials, interpreters and other
aids for persons with impaired hearing or vision. 45 CFR § 84.52(d).
20. Programs/facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement, and
maintain a written affirmative action compliance program in accordance with Executive Order 11246, 41 CFR Part
60 and Title VI of the Civil Rights Act of 1964, as amended.
61
October 2019 — September 2020
utas —rat->ni cit 1
l
I
`ELDER;
AFFSTATE AIRS
EHEAP 203.19
ATTACHMENT VII
BACKGROUND SCREENING
BACKGROUND SCREENING
Affidavit of Compliance - Employer
AUTHORITY: This form is required annually of all employers to comply with the attestation
requirements set forth in section 435.05(3), Florida Statutes.
➢ The term "employer" means any person or entity required by law to conduct background screening,
including but not limited to, Area Agencies on Aging, Aging Resource .Centers, Aging and Disability
Resource Centers, Lead Agencies, Long -Term Care Ombudsman Program, Serving Health Insurance Needs
of Elders Program, Service Providers, Diversion Providers, and any other .person or entity which hires
employees or has volunteers in service who meet the definition of a direct service provider, See §4
435.02, 430.0402, Fla. Stat.
➢ A direct service provider is "a person 18 years of age or older who, pursuant to a program to provide
services to the elderly, has direct, face-to-face contact with a client while providing services to the client
and has access to the client's living area, funds, personal property, or personal identification information
as defined in s. 817.568. The term includes coordinators, managers, and Supervisors of residential
facilities; and volunteers." § 430.0402(1)(b), Fla Stat.
ATTESTATION:
As the duly authorized representative of
Employer Name
located at
SVeetAddress City. State ZIP code
I, do Hereby affirm under penalty of perjury
Name of Representative
that the above named employer is in compliance with the provisions of Chapter 435 and section
430.0402, Florida Statutes, regarding level background screening.
Signature of Representative
STATE OF FLORIDA, COUNTY OF
Sworn to (or affirmed) and subscribed before me this _ day of
to me or produced
Pdnq Type or Stamp ('nmmisslPned Namn.ol Notary Public
20_, by
(Name of Representative) who is personally known
Notary Public
as proof of identification.
DOEA Form 235, ArfidaNt of Compllaxe - Employor. Eff cU a April 2012 Section 435.05(3), RS
Form available at: btb9rmlde,,Ha,L�t" fl =/e,erfILb�' imndw'ee111rs{ l
62
October 2019 — September 2020 EHEAP 203.19
ATTACHMENT IX
ANNUAL BUDGET SUMMARY AND DETAIL
EMERGENCY HOME ENERGY ASSISTANCE PROGRAM
for
Collier County Board of County Commissioners
Collier
EHEAP ADMINISTRATION BUDGET $ 6,110.19
EHEAP OUTREACH BUDGET
$ 10,295.01
EHEAP CRISIS ASSISTANCE
$ 56,813.67
TOTAL
$ 73,218.87
Projected minimum number of individuals to be sewed
Energy Assistance*
204
*Eligible households may be provided with one benefit per season up to six hundred dollars per benefit. The
minimum number of consumers may reflect duplicated consumers if a consumer receives a benefit in both
seasons.
63
October 2019 — September 2020
EREAP 203.19
ATTACHMENT X
EHEAP ADMINISTRATIVE AND OUTREACH EXPENSE BUDGET DETAIL
PSA CONTRACT #
Emerqency Home Enerqy Assistance Program
Administrative & Outreach Expense Budget Detai
WIN
MENMUE
50.00
$0.00
SO.00
50.00
S(to()
S0.00
50.00
50.00
S0.00
50.00
50.00
S().00
$(),00
r ----------
SO.00
50.00
SO.00
S0,00
SO.00
5t 00
sT) (TO
S0.00
S0,00
$0,00
Administration Subtotal $
-
Outreach Subtotal $
Totul $ -
64
October 2019 - September 2020
EHEAP 203.19
ATTACHMENT X1
RECEIPTS AND EXPENDITURE REPORT
EMERGENCY HOME ENERGY ASSISTANCE PROGRAM
PROVIDER NAME, ADDRESS, PHONE# AND FEID#
Program Funding Source:
THIS REPORT PERIOD
FROM:
EHEAP
CONTRACT
(Emergency Home Energy
PERIOD: 10/01119.09130/20
Assistance for the Elderly Program)
CONTRACT # HP019
REPORT#
PSA# 8
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
To the best of my knowledge, all CIRTS is acccurate and correct.
Prepared by : Date : Approved by : Date:
PART A: BUDGETED INCOMEI RECEIPTS
I. Approved
2. Actual Receipts
3. Total Receipts
4. Percent of
Budget
For This Report
Year to Date
Approved Budget
1. Agreement Amount
$0.00
$0.00
$0.00
#DIV/01
2. Interest on Agreement Funds
$0.00
$0.00
$0.00
0.00%
3. TOTAL AGREEMENT AMOUNT
$0.00
$0.00
$0.00
#DIV/0i
PART B : EXPENDITURES
1. Approved
2. Expenditures
3. Expenditures
4. Percent of
Budget
For This Report
Year to Date
Approved Budget
1. Administration
$ -
$0.00
$0.00
#DIV/01
2. Outreach
$ -
$0.00
$0.00
#DIV/01
3. Crisis Services
$ -
$0.00
$0.00
#DIV101
4. Weather Related Services
$ -
$0,00
$0.00
#DIV/01
5. Weather Related Administration
$ -
$0.00
$0.00
0.00%
6. TOTAL EXPENDITURES
$0.00
$0.00
$0.00
#DIV/01
DOEA FORM 105p revised 12/08
65 a'
C�_
October 2019 - September 2020
EHEAP 203.19
ATTACHMENT XII
REQUEST FOR PAYMENT
REQUEST FOR PAYMENT
EMERGENCY HOME ENERGY ASSISTANCE PROGRAM
Contract# HP019
CONTRACTOR NAME, ADDRESS, PHONE# and FEIO#
TYPE OF REPORT :
Request Period
_
PSA# a _.. _...
Advance Request
Report#
Contract #_HP019
Reimbursement Request X
Contract Period _ 10101119-05130120
CERTIFICATION: I hereby certify thattrus request to the best of my knowledge to be complete and correct and conforms with the terms of the above contract. .
To the best of my knowledge, all CIRTS Is accurate and correct
Prepared by: Date: Approved by: Date;
ADMINISTRATION
PART A: BUDGET SUMMARY
ADMINISTRATION
OUTREACH
CRISIS
WEATHER
WEATHER
TOTAL,,,,
'
SERVICES
CERVICES
SERVICES
RELATED
RELATED
$D.06
$0.00
_ $0.00
$0.00
$0.00
$0.00
1. Approved Contract Amount
2. Previous Funds Received for
$0.00
$0.00
$0.00
$0.00
$0.00.
$0.00
Contract Period
3. Contract Balance pine t minus line 2)
$0.00
$0.00
_ $0.00
E0.00
$D o0 _
moo
4. Previous Funds Requested and Not
$D.00
$0,00
$0.00
$0.00
$0.00
$0.00
Received for Contract Perlotl
5 Contract Balance (Ilne 3 minus line 4)
$0.00,
$0.00
_ $0.00
$0.00
$0.00_ _
$0.00
PART S: CONTRACT FUNDS REQUEST
1. Anticipated Cash Needs
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
(1st- 2nd month, Attach Justification)
2, Net Expenditures For Month
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00,
(DOEA Form 106P, Part B, Line 6)
3. TOTAL _
_. $0.00
$0.00
$0.00
$0.00
$0.00..
$0.00
PART C: NET FUNDS REQUESTED
1. Less Advance Applied
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
2, TOTAL FUNDS REQUESTED
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
(Part B, Line 3 minus Pad C, Line 1)
PART D: SERVICE INFORMATION
Number of Individuals Junks) sewed with crisis energy assistance during the report month _ 0 _
Number of Individuals ineligible or denied assistance during the report month. 0
Number of Individuals served by referral to other community resources for energy during the report month. 0 _
Certification statement: Contractor hereby certifies that It has been open and operating during els normal business hours for the reporting month, as _.
described in the Statement of Work section, of the SHEAF contract. _
DOEA FORM 106P _..._ _..- .... _.....
-
redsed 410117 -
66
October 2019 — September 2020
INVOICE REPORT SCHEDULE
Report Number Based Upon
I October Advance*
2 November Advance*
3
October Invoice
4
November Invoice
5
December Invoice
6
January Invoice
7
February Invoice
8
March Invoice
9
April Invoice
10
May Invoice
11
June Invoice
12
July Invoice
13
August Invoice
14
September Invoice
15
Final Request for Payment
* Advance based on projected cash need.
EIIEAP 203.19
ATTACHMENT XIII
Date Due to the Department
Upon receipt of executed contract.
Upon receipt of executed contract.
November 09, 2019
December 09, 2019
January 09, 2020
February 09, 2020
March 09, 2020
April 09, 2020
May 09, 2020
June 09, 2020
July 09, 2020
August 09, 2020
September 09, 2020
October 09, 2020
October 15, 2020
Note # 1: Report 41 and #2 for advance basis invoices, cannot be submitted to the Agency prior to
October I or until the agreement with the Agency has been executed and a copy sent to the
Agency. Actual submission of the vouchers to the Agency is dependent on the accuracy of
the Receipts and Expenditure Report.
Note #2: Report numbers 5 through 14 shall reflect an adjustment of one-tenth of the total advance
amount, on each of the reports, repaying advances issued the first one or two months of the
agreement. The adjustment shall be recorded in Part C. I of the report (ATTACHMENT XII).
Note # 3: Submission of expenditure reports may or may not generate a payment request. If final
expenditure report reflects funds due back to the Agency, payment is to accompany the
report.
Note #4: ALL Expenditure Reports are due by 12:00 p.m. on the 9" of each month. IF the 9t' falls on
a Saturday, then the report will be due by the 8" by 12:00 p.m. AND IF the 9"' falls on a
Sunday, the report will be due by the 10t" by 12:00 p.m. Actual submission of the vouchers
to Dept. of Elder Affairs is dependent on the accuracy of the expenditure report which is
verified and paid by CIRTS data only.
Q67 c>
October 2019 — September 2020
DE'4)
FLORIDA DEPARTMENTof
ECONOMIC OPPORTUNITY
EHEAP 203.19
ATTACHMENT XIV
LOW INCOME HOME ENERGY ASSISTANCE PROGRAM (LIHEAP)
POVERTY INCOME GUIDELINES*
EFFECTIVE OCTOBER 1, 2019
PEOPLE IN THE HOUSEHOLD
150%
1
$18,735
2
$25,365
3
$31,995
4
$38,625
5
$45,255
6
$51,885
7
$58,515
8
$65,145
For each additional person in the household
with more than 8 people, add:
$ 6,630
*These figures are based on the 2019 U.S. Department of Health and Human Services (HHS) poverty
guidelines published in the Federal Register on February 1, 2019.
68
October 2019 - September 2020
LIHEAP PAYMENT MATRIX
EHEAP 203.19
ATTACHMENT XV
LOW-INCOME HOME ENERGY ASSISTANCE PROGRAM PAYMENT MATRIX - FY 2019/2020
1) Elderly
$50
1) Disabled
HHS
POVERTY LEVELS
$75
BY
HOUSEHOLD SIZE AND INCOME
HOUSEHOLD INCOME IN DOLLARS PER YEAR
NUMBER OF
50% of
Over 50%
of Poverty
At least
75% but no
Over 100% but
no more
Ovex 125%
but no
150%
PEOPLE IN
Poverty or
but Less
than 75%
more than 100%
than 125%
Poverty
more than
Less
PovertyPovex
HOUSEHOLD
At or Below
Annual Income at Least but No Greater Than
1
$ 6,245
$ 6,246
$ 9,367
$ 9,368
$12,490
$12,491
$15,613
$15,614
$18,735
2
$ 8,455
$ 8,456
$12,682
$12,683
$16,910
$16,911
$21,138
$21,139
$25,365
3
$10,665
$10,666
$15,997
$15,998
$21,330
$21,331
$26,663
$26,664
$31,995
4
$12,875
$12,876
$19,312
$19,313
$25,750
$25,751
$32,188
$32,189
$38,625
5
$15,085
$15,086
$22,627
$22,628
$30,170
$30,171
$37,713
$37,714
$45,255
6
$17,295
$17,296
$25,942
$25,943
$34,590
$34,591
$43,238
$43,239
$51,885
7
$19,505
$19,506
$29,257
$29,258
$39,010
$39,011
$48,763
$48,764
$58,515
8
$21,715
$21,716
$32,572
$32,572
$43,430
$43,431
$54,288
$54,289
$65,145
9
$23,925
$23,926
$35,887
$35,888
$47,850
$47,851
$59,813
$59,814
$71,775
10
$26,135
$26,136
$39,202
$39,203
$52,270
$52,271
$65,338
$65,339
$78,405
11
$28,345
$28,346
$42,517
$42,518
$56,690
$56,691
$70,863
$70,864
$85,035
12
$30,555
$30,556
$45,832
$45,833
$61,110
$61,111
$76,388
$76,389
$91,665
13
$32,765
$32,766
$49,147
$49,148
$65,530
$65,531
$81,913
$81,914
$98,295
14
$34,975
$34,976
$52,462
$52,463
$69,950
$69,951
$87,438
$87,439
$104,925
15
$37,185
$37,186
$55,777
$55,778
$74,370
$74,371
$92,963
$92,964
$111,555
16
$39,395
$39,396
$59,092
$59,093
$78,790
$78,791
$98,488
$98,489
$118,185
17
$41,605
$41,606
$62,407
$62,408
$83,210
$83,211
$104,013
$104,014
$124,815
18
$43,815
$43,816
$65,722
$65,723
$87,630
$87,631
$109,538
$109,539
$131,445
19
$46,025
$46,026
$69,037
$69,038
$92,050
$92,051
$115,063
$115,064
$138,075
20
$48,235
$48,236
$72,352
$72,353
$96,470
1 $96,471
$120,588
$120,589
$144,705
FLIHEAP HOME
ENERGY BENEFIT' $300 to $475** $250 to $425** $200 to $375**
"-Additional Assistance if applicant household includes:
1) Elderly
$50
1) Disabled
$50
3) Applicant with child age 5 or younger:
$75
69
These benefit levels are effective October 1, 2019
These figures are based upon the 2019 U.S, Department
of Health and Human Services I HHS) Poverty Guidelines
published in the Federal Register on
February 1, 2019
October 2019 — September 2020
SOURCES OF LN,CO h,IE
EHEAP 203.19
ATTACHMENT XVI
70 ->'\
LOW II'CO,SLE HOME ENE:R'GV ASSISTANCZ PROGRAM (LSHE.AP)
FY 2D'19 j'?t72fl- SOURCES OF Rti COME
EFFECTI: TE OCTOBER 1, 21719
ING111LINED
=LUDED
SOT MCEI OF INCOME,
SOURCES OF INCONCE
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70 ->'\
October 2019 — September 2020
OUTREACH PLAN SURVEY
PSA Click here to enter text.
COUNTY(IES) Click here to enter tent.
AGENCY'S EHEAP COORDINATOR Click here to enfct text.
PHONE W/EXT. Click here to enter taxi.
EMAIL Cllclr here to entzr text.
EHEAP 203.19
ATTACHMENT XVII
1. ELDERLY OUTREACH
Describe the efforts to increase the number and percentage of elderly households served.
Click here to enter text.
2. INTEGRATION OF OTHER LOCAL AGENCIES IN OUTREACH
Describe what local coordination efforts support outreach activities. Identify agencies, utilities, charities, and
others incorporated in these efforts and the activities included.
Click h" re to entertett.
3. ADVERTISING, PROMOTIONAL, MEDIA, AND OTHER PRINT OUTREACH EFFORTS
a. Brochures — please select all of the options you currently use in your program from the list below:
❑ Use a locally developed brochure (send an electronic copy with your survey)
❑ Other, please describe Click here to enter tent.
How will the brochures be distributed/used (check all that apply):
❑ Display at County courthouse/office building
❑ Provide to Senior Citizen Centers in county
❑ Provide to meal sites in county
❑ Provide to "Meals on Wheels" for distribution
❑ Provide to local utility companies and heating fuel providers
❑ To cooperating local agencies (such as Salvation Army)
❑ Grocery stores or similar businesses
❑ Provide to churches
❑ Provide to hospitals
❑ Provide to day care facilities
❑ Provide to local libraries
❑ Laundrornats
❑ Provide to banks
❑ Provide to clinics
71
October 2019 — September 2020 EHEAP 203.19
❑ Provide to Head Start Programs
❑ Other: Click hers to enter text.
b. POSTERS
Please select all of the options you currently use in your program from the list below:
❑ Use locally developed poster (send a copy with your survey)
❑ Don't use posters
How does your agency distribute or use program posters (check all that apply):
❑ Display at County courthouse/office building
❑ Provide to Senior Citizen Centers in county
❑ Provide to meal sites in county
❑ Provide to grocery stores
❑ Provide to laundromats
❑ Provide to churches
❑ Provide to hospitals
❑ Provide to day care facilities
❑ Provide to local libraries
❑ Provide to other businesses
❑ Provide to clinics
❑ Provide to Head Start Programs
❑ Provide to banks
❑ Other: Click here to enter text.
c. PAIDADVERTISING
Does your agency use paid advertising to promote the program?
❑ Yes
❑ No (if you answered No — go to Section D)
Total Budget for advertising (per fiscal year) $ Click here to enter text.
Does you agency advertise in NEWSPAPERS? ❑ Yes ❑ No
Name of Paper Click here to enter text. City/Location Click hereto enter text,
Name of Paper Click here, to enter text. City/Location Click here to enter text.
Name of Paper Click here to enter text City/Location Click here to enter text.
Frequency or # of times ads are placed per cooling season: Click here to enter text.
Frequency or # of times ads are placed per heating season: Click here to enter text.
When do you advertise (check all that apply)?
72
October 2019 — September 2020
EHEAP 203,19
❑ April
❑ October
❑ May
❑ November
❑ June
❑ December
❑ July
❑ January
❑ August
❑ February
❑ September
❑ March
Do you use the same ad for all newspaper advertising? ❑ Yes ❑ No
If not, how many different ads do you place? Crich hereto enter_ r text.
In which language(s) are your ads place? (check all that apply)
❑ English
❑ Spanish
❑ Other (please list) Crick here to ante+text,
Does your agency advertise in SHOPPERS? ❑ Yes ❑ No
Name of Shopper Cl Ick here to c nte.r te::t. City/Location Click hare to enter text,
Name of Shopper Clicic hare eo enter text. City/Location Click here to entar text,
Frequency or # of times ads are placed per cooling season: Glick here to enter text.
Frequency or # of times ads are placed per heating season: Click hereto enter text,
When do you advertise (check all that apply)
❑ April ❑ October
❑ May ❑ November
❑ June ❑ December
❑ July ❑ January
❑ August ❑ February
❑ September ❑ March
Do you use the same ad for all shopper advertising? ❑ Yes ❑ No
If not, how many different ads do you place? Clk1, here to enter text.
In which language(s) are your ads place? (check all that apply)
❑ English
❑ Spanish
❑ Other (please list) Click here eo enter text.
Does your agency advertise on RADIO? ❑ Yes ❑ No
Station Call Letters Click Isere to enter text. City/Location Click here to enter text,
Station Call Letters Click hereto enter text. City/Location Click here to enter-Cext.
73
October 2019 — September 2020
EHEAP 203.19
Frequency or # of times ads are placed per cooling season: Click here to enter text.
Frequency or # of times ads are placed per heating season: Click here to er�te.r text.
When do you advertise (check all that apply)
❑ April ❑ October
❑ May ❑ November
❑ June ❑ December
❑ July ❑ January
❑ August ❑ February
❑ September ❑ March
Do you use the same ad for all radio advertising? ❑ Yes ❑ No
If not, how many different ads do you place? Click here to enter text.
In which language(s) are your ads place? (check all that apply)
❑ English
❑ Spanish
❑ Other (please list) Click here to enter text.
Does your agency advertise on TELEVISION? ❑ Yes ❑ No
Station Call Letters Clld< Dere to enter faxt. City/Location Click hereto enter text.
Cable Operator Click hers to enter text, City/Location Click here to entertext.
Frequency or # of times ads are placed per cooling season: Click here to enter text.
Frequency or # of times ads are placed per heating season: Click here to enter text.
When do you advertise (check all that apply)
❑ April
❑
October
❑ May
❑
November
❑ June
❑
December
❑ July
❑
January
❑ August
❑
February
❑ September
❑
March
Do you use the same ad for all television advertising? ❑ Yes ❑ No
If not, how many different ads do you place? Click herd to enter text.
In which language(s) are your ads place? (check all that apply)
❑ English
❑ Spanish
❑ Other (please list) C,liei� hire t� anter text.
OTHER PAID AVERTISING (Please Describe): Click hers to entar tcmt,
74
October 2019 — September 2020
FHEAP 203.19
d. FREE MEDIA PROMOTION/COVERAGE
Please check all the appropriate selections related to how your agency utilizes free media
promotion/coverage:
❑ Issue Press Releases to local/area media
Are press releases sent out more than one time per year? ❑ Yes ❑ No
If yes, how often? Click lie re to enter text.
Do you use the same press release each time? ❑ Yes ❑ No ❑ N/A
❑ Prepare announcements for public access television (cable)
❑ Prepare public service announcements (PSAs)
❑ Arrange for on air radio or television interviews
❑ Post information on a County or Agency website
❑ Post information or link to other local websites
❑ Our agency does not take part in any Free Media Promotion
Are any of these materials translated? ❑ Yes ❑ No
❑ Spanish ❑ Other non-English languages
Web activities:
❑ Post information on a County or Agency website
❑ Post information or link to other local websites
e. DIRECT PROMOTIONAL ACTIVITIES
Please select all of the appropriate selections related to how your agency completes Direct Promotional
Activities:
❑ Direct mail — Anticipated size of mailings) Click hexa to enter text. (number of pieces sent)
❑ Telephone promotion (not application taking)
❑ Displays/at stores, malls, etc.
❑ Displays/booths at events (check all that apply):
❑ Home Show
❑ lob Fair
❑ Meal Sites
❑ Health Fairs
❑ Other (please list): Click hereto enter text,
Who will you target with your direct promotional activities (check all that apply)?
❑ Aging/Seniors/Elderly
❑ Disabled
❑ High Energy Users
❑ Families with children
❑ Last year's applicants
❑ Homebound
❑ Last year's home visit applicants
75 (`0
October 2019 — September 2020 EHEAP 203.19
❑ Churches
❑ Head Start
❑ Specific Vendors
❑ Subsidized -housing residents
❑ Other (List)
f, HOME VISITS
Does your agency perform home visits? ❑ Yes ❑ No (if no, skip to Section 6, Special Outreach
Efforts)
Number of home visits conducted last year Click hc-re to enter text,
Number of home visits expected this year Click here to cntertext ,
Do early applications reduce the number of home visits? ❑ Yes ❑ No
Check the criteria used to determine when home visits will be done (check all that apply):
❑ Age
❑ Disability
❑ Transportation difficulties (no car, can't drive, etc.)
❑ Applicant's work schedule
❑ Small children in household
❑ Language barrier/availability of translator
❑ Other (please list): Click hereto enter texi.
4, SPECIAL OUTREACH EFFORTS
Please check each of the Target/Special Needs populations you are carrying out special efforts to reach from the
list below:
❑ The working poor (check all activities that apply):
❑ Evening office hours
❑ Saturday morning office hours
❑ Saturday afternoon office hours
❑ Promote at churches
❑ Special phone/mail application efforts
❑ After hours home visits
❑ Promote at specific employers
❑ Other (please list):
❑ Households with young children:
❑ Provide materials to day care facilities
❑ Take applications at day care facilities
❑ Promote at churches
❑ Handouts to school children
❑ Materials for Pediatricians and clinics
❑ Other (please list):
76
October 2019 — September 2020 EIiEAP 203.19
❑ Non-English speaking population, etc.:
❑ Promote through Hispanic groups
❑ Provide brochures/posters in other languages to hospitals and clinics
❑ Promote through religious organizations
❑ Identify local interpreters to use
❑ Have signage at office in multiple languages
❑ Use pre-recorded messages in different languages
❑ Set application site at gatherings and events where minority groups congregate and interpreters
are available
5. INTAKE SITES AND TIMES
Please select the statement that best fits your application process:
❑ Take applications primarily through appointments
❑ Take applications by appointment and work in walk-ins
❑ Take applications by appointment and have day(s) for doing walk-ins
❑ Take applications primarily through walk-ins and reserve appointments for special needs or problem
cases,
❑ Take applications from walk-ins only
IA.+Ih,+I,. int.4. aitac to IN. umd daily IMnndav thrnunh Fridav)
Name of Site
Area/County(s) Served
Hours
Also LIHEAP provider?
Click here to eater text.
Click here to entertextt.
Click: here to enter text.
❑Yes ❑No
Click here to entertext,
Click: hereto enter text.
Click here to enter text,
❑Yes ❑No
Click here to enter text.
Click here to enter text,
Click here to enter text.
Dyes ❑No
Click here to enter text.
Click here to enter teNt.
Click: here to enter text.
Dyes ❑No
Ciick here to enter text.
Click( here to enter text.
Ohck here to enter text.
Dyes ❑ No
Click here to entertext,
Click hero to enter text.
Click here to enter text.
Dyes ❑No
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h. Identifv the intake sites to be used reeulariv, as In once a week, twice a month, etc.
Name of Site
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Hours
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(time/??)
provider?
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77 C�
\fix
October 2019 — September 2020
EHEAP 203.19
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d. Planned extended or flexible application times.
78
Area/County(s) Served
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78
October 2019 — September 2020
EHEAP 203.19
Evening Hours
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e. Days Offices are Closed
Check all holidays the agency is closed:
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❑
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6, SENIOR STAFF WORK SCHEDULES
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Title
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Executive Director
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79
October 2019 — September 2020
EHEAP 203.19
7. OUTREACH ASSESSMENT/EVALUATION
Do you survey your applicants to assess the effectiveness of outreach efforts? ❑ Yes ❑ No
Surveys are targeted at
❑ Elderly
❑ Handicapped/disabled
❑ Households with young children
❑ Non-English speaking households
Surveys are not targeted ❑ Yes ❑ No
Do you track numbers of applicants at each outreach site? ❑ Yes ❑ No
Each time the site is used? ❑ For all visits combined? ❑
Do you compare types of outreach sites? ❑ Yes ❑ No
What is the most effective type of outreach site? (For example: senior center, library, town hall, fire
station, housing facility, etc.) Click hereto eniertext,
Do you track the number of home visits? ❑ Yes ❑ No
Do you track the reason for doing each home visit? ❑ Yes ❑ No
What other way do you assess the effectiveness and success of your outreach efforts? Click here to ester text.
80 >'`
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7. OUTREACH ASSESSMENT/EVALUATION
Do you survey your applicants to assess the effectiveness of outreach efforts? ❑ Yes ❑ No
Surveys are targeted at
❑ Elderly
❑ Handicapped/disabled
❑ Households with young children
❑ Non-English speaking households
Surveys are not targeted ❑ Yes ❑ No
Do you track numbers of applicants at each outreach site? ❑ Yes ❑ No
Each time the site is used? ❑ For all visits combined? ❑
Do you compare types of outreach sites? ❑ Yes ❑ No
What is the most effective type of outreach site? (For example: senior center, library, town hall, fire
station, housing facility, etc.) Click hereto eniertext,
Do you track the number of home visits? ❑ Yes ❑ No
Do you track the reason for doing each home visit? ❑ Yes ❑ No
What other way do you assess the effectiveness and success of your outreach efforts? Click here to ester text.
80 >'`
October 2019 — Se p tem'P &lN �OZ� EHEAP 203.19
APPLICATION AND ELIGIBILITY WORKSHEET ATTACHMENT XVIII
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October 2019 — September 2020
FHFAP 203.19
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82
October 2019 — September 2020
EHEAP 203.19
ATTACHMENT XIX
EHEAP APPLICATION AND ELIGIBILITY INSTRUCTIONS
Department of Elder Affairs
Emergency Home Energy Assistance for the Elderly Program (EHEAP)
EHEAP Application Instructions
Section One: Applicant (Age 60 and older) Information
Complete Section One in its entirety.
Special notes:
✓ The Date Stamp is the official application date;
✓ The Intake Worker (with name and phone number recorded) is the person who accepts the
application and required documentation;
✓ The applicant's income type(s) and monthly income amount is recorded in this section, and
✓ If any field is determined to be not applicable, complete the field by entering N/A.
Section Two: Additional Household Members Information
Complete Section Two by listing additional household members and providing the information requested.
Special notes:
✓ At a minimum, the name(s), age(s), and Social Security number(s) of each additional household
member is required;
✓ You will be attaching a calculator tape of the household's income calculations in the section
provided on the EHEAP Eligibility Worksheet; and
✓ If any field is determined to be not applicable, complete the field by entering N/A.
Section Three: Household Characteristics
Complete Section Three by answering each "Yes" or "No" question and providing additional information if applicable.
Special note:
✓ If any field is determined to be not applicable, complete the field by entering N/A.
Section Four• Heatina and Cooling Information
Complete Section Four by answering each question.
Special note:
✓ If any field is determined to be not applicable, complete the field by entering N/A.
Section Five: Enerav Crisis Explanation
Section Five is completed by choosing the best possible explanation for the applicant's crisis and obtaining their
signature and date of signature.
Special notes:
✓ All life-threatening crisis explanations must be acted upon, with an eligible action to mediate the
crisis within eighteen (18) hours of the application date stamp.
✓ All standard crisis explanations must be acted upon, with an eligible action to mediate the crisis
within forty-eight (48) hours of the application date stamp.
✓ If any field is determined to be not applicable, complete the field by entering N/A.
83 �:`^
October 2019— September 2020
EHEAP 203.19
Client Attestation and Signature
The applicant should read the attestation statement. If the applicant is unable to read the attestation
statement, the intake worker should read it to them before they sign and date the application.
At this point, the intake worker should have the applicant sign the waiver authorizing the release of general
and/or confidential information for LIHEAP/EHEAP federal reporting. CIRTS will require you to verify that either
the waiver has been signed or that the client has refused to sign.
EHEAP Eliaibility Worksheet Instructions
Section Six: Income Eligibility Determination
Complete Section Six by stapling the calculator tape in the space provided, entering the annual income, and
checking the appropriate number of individuals in the household to determine the household annual income limit.
Special notes:
✓ Adjacent to the annual income limit by household size is the fifty percent (50%) of poverty
amount by household size. If the annual household income is below the amount for the
household size, AND the household does not receive SNAP, the applicant must provide a
written statement of how basic living expenses are provided for the household.
✓ If any field is determined to be not applicable, complete the field by entering N/A.
Section Seven: Vendor Benefit and Verification Information
Complete Section Seven by completing in its entirety.
Special notes:
✓ The minimum amount due is the amount provided to you during the verification process with the
home energy vendor.
✓ For those applicants receiving an energy subsidy, the minimum amount due will be reduced by
the energy subsidy amount listed on the applicant's public housing lease to determine the total
EHEAP benefit. The energy subsidy is deducted from home energy vendor payments only.
✓ Water, sewer, garbage, and fire, etc. MAY NOT be paid with EHEAP funds. Utility bills that
include charges that are not directly related to cooling and heating will be reduced by the
amounts for these charges.
✓ It is allowable to make several crisis benefit payments for a household to resolve a single crisis.
This may include the purchase of blankets, portable fans, space heaters, and/or repair of
existing heating/cooling equipment, in addition to energy bill assistance, that combined does not
exceed the maximum crisis benefit of $600.
✓ Crisis situations that involve a heater or air conditioner that is powered by both gas and
electricity are eligible for a crisis benefit payment to both home energy vendors, that combined
does not exceed the maximum crisis benefit of $600.
✓ Allowable utility categories for heating/cooling bill assistance include the following:
a. Utility payments for heating/cooling bill assistance for electric, gas, propane, wood, coal,
or refillable fuels;
b. Temporary emergency shelter (if needed due to energy-related crisis);
c. Payment to landlords (when utility costs are included in rent);
d. Repairs or replacements to heating/cooling units (as long as the amount is within the
benefit limits and work is done by a licensed contractor);
84 �t
October 2019 — Sept ber 2 2 EHEAP 203.19
e. repos s4o connect or restore energy;
f. Late fees, disconnect fees, and reconnect fees;
g. Charges from a previous account held by the applicant that is now closed;
i,. Blankets and fans,
1. Taxes and fees associated with the client's utility bill towards the energy portion. In some
cases, where the utility vendor combines all the other fees and taxes, which also includes
non -home energy services, such taxes and fees can be paid with EHEAP funding.
Example: In a case where heating and cooling taxes are commingled with other service
taxes, proceed with paying the taxes portion of the bill.
j. Other allowable payments are those related to the start-up of services, including
reasonable connection or reconnection fees, delivery fees, deposits, and other fees
related to the start-up of service.
✓ If any field is determined to be not applicable, complete the field by entering N/A.
ii.F=11,12211
Complete Section Eight in its entirety.
Special notes:
✓ When determining the number of LIHEAP or EHEAP crisis benefits the applicant has had, you
will include the current application in the count, provided the application is approved. Refer back
to Section Seven, to the information obtained from the LIHEAP provider.
✓ If any field is determined to be not applicable, complete the field by entering N/A.
Section Nine: Resolution of Crisis
Complete Section Nine by selecting all that applies to this applicant and application for services.
Special notes:
✓ The left-hand selections indicate that the application has been acted upon within the
eighteen (18) hour/ forty-eight (48) hour requirement.
✓ If the selection is made to deny the application pending additional information from the client,
the 18/48 hours has been met and does not repeat itself when the client returns with the
pending information. You have already met the requirement.
✓ If any field is determined to be not applicable, complete the field by entering N/A.
Case Worker Signature
To complete this section, the individual who completes the EHEAP Eligibility Worksheet, determines income
eligibility, and provides the commitment to the utility vendor must sign and complete the requested information.
Special note:
✓ If you are the applicant, or a friend, relative, or employee of the applicant, you cannot determine
the eligibility or award EHEAP benefits. This application must be processed by someone who is
not the applicant or a friend, relative, or employee of the applicant.
To complete this section, the signer is attesting that he/she has reviewed the application for completeness,
determined that all required documentation is included, and verified that the annual household income
calculation and EHEAP benefit awarded are correct.
Instructions for DOEA Form 114-10/1/2019
85
October 2019 — September 2020
EMERC-_1:NCY HOMF FNrrRf-v
EHEAP 203.19
ATTACHMENT XX
A B.cLCTAN CR FOR TAF F.i.PIERLY CLIENT FILE CONTENT CHECKLIST
ELDER'S NAMEv
PSA#
AGENCY
APPROVAL_.
DENIAL_
NAME OF WORKER '-
APPLICATION DATE :
CRISIS RESOLUTION DATE
CHECK DATE
PROGRAM REQUIREMENTS MONITORED
Yes
No
N/A
COMMENTS
1. Individual client file for the elder includes consumer's name, address, sex, and age.
2. Household contains a member 60 or older.
3. The household is in the Florida county covered by the contract.
4. All household members are listed and their name, age, DOB, and income(s) are included.
Client file contains documentation of Social Security numbers for all household members, or citation
5
to the applicable exemption.
6. Client file contains signed notice regarding collection of social security number(s).
7. The client file contains official income documents for all household members.
If income is self -declared, is there a self -declaration form signed by each individual household
8
member (18 years of age or older) lacking income verification or claiming zero income?
The household's total gross income is calculated correctly and is at or below 150% of die OMB
9
Federal Poverty Level for the household size.
Statement of how basic living expenses (i.e., food, shelter and transportation) are being provided if
10. total household income is less than 50% of the current Federal Poverty Guidelines and no one in the
household is receiving SNAP assistance.
Checked that elder does not live in student dormitory, adult family care home, or any kind of group
11
living facility.
Verified and documented household has not received LIFIEAP Crisis Assistance during the same
12
heating or cooling season.
13. Documentation of Weatherization Assistance Program (WAP) referral, if applicable.
Copies of fuel bills, or other supporting documentation as proof of energy crisis, for the residence in
14
which they reside.
15. Signed copy of Authorization for Release of General and/or Confidential Information.
16. Only eligible components of the utility bill are paid to resolve the crisis.
Only the minimum necessary to resolve the crisis is paid. If a different amount is required by the
17
utility company, provide additional information on the Eligibility Worksheet.
Crisis energy bereft was reduced by unallowable charges, such as: water, sewer, garbage, fire, etc., if
18
applicable.
19. Crisis energy benefit was reduced by energy subsidy, if applicable.
20. Energy crisis resolved within 18 hours by an eligible action.
Written notice of approval or denial for services that includes appeal procedures is issued within 15
21
working days of eligibility determination.
22, Appropriate benefit provided, at or below $600.00.
All required sections of the application are signed and dated by the elder, staff, and supervisory/peer
23
PRIOR to payment.
24. Proof of payment to vendor.
25. Place completed COLA Form 211 (10/01/2019) in client file.
INSTRUCTIONS: A check mark in the Yes eolonn indicates the requirement has been met. A check non it the No column Indicates the requil mucw has
not been met oris questionable. Each "No" stark must be explained under "COMMENTS".
Supervisor/Peer Signature Consumer File Monitoring Date
DOEA FORM 21110RA/2619 <
86
October 2019— September 2020
EHEAP COST REIMBURSEMENT SUMMARY
Contract #
Report Period:
EHEAP 203.19
ATTACHMENT XXI
TOTAL ADMINISTRATION $0.00
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October 2019 — September 2020
SERVICE RATE REPORT
EHEAP 203.19
ATTACHMENT XXIII
PROGRAM: EMERGENCY HOME ENERGY ASSISTANCE FOR THE ELDERLY PRORAM (EHEAP)
Federally Funded
From 10/01/2019 to 09/30/2020
HIGH
Category
SERVICE
METHOD OF
REIMBURSEMEN
UNIT
PAYMENT
T RATE
TYPE
Administration
ADMINISTRATIVE
Cost Reimbursement
Cost Reimbursement
EPISODE
COSTS*
Outreach
OUTREACH COSTS*
Cost Reimbursement
Cost Reimbursement
EPISODE
Crisis
CRISIS ENERGY
Cost Reimbursement
Cost Reimbursement
EPISODE
Assistance
ASSISTANCE BENEFITS*
*As stipulated in contract, these services are provided on a cost reimbursement basis.
91
Revised August 2007
Attestation Statement
Agreement/Contract Number: EHEAP 203.19
Amendment Number
I, Stephen Y Carnell , attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
Collier County Board of Commissioners
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting, due to the differences in
electronic data processing media, which has no affect on the agreement/contract content.
Approved as to fomi an Iegulity
01
A"IstlantCountyAliot c \�
01
Revised August 2007