Request for Proposal (RFP) · 2019. 5. 21. · Appeal Process 51 o. Contract Terms and Conditions...

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ALLIANCE FOR AGING, INC. THE AREA AGENCY ON AGING FOR

MIAMI-DADE AND MONROE COUNTIES

Community Care for the Elderly Program

Request for Proposal (RFP) For Lead Agency Designation October 26, 2016

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TABLE OF CONTENTS

TITLE

DESCRIPTION PAGE SECTION A

INTRODUCTION

6

1.

Legislatively Mandated Requirements 6

2.

Statement of Need 8

3.

Statement of Purpose 9

SECTION B

RFP SPECIFICATIONS: MINIMUM REQUIREMENTS TO MEET

15

1.a.

Program Requirements: Service Delivery Methodology

15

1.

Program Coordination 15

2.

Case Management and Core Services 16

3.

Community Care Service System 17

1.b.

Program Requirements: Lead Agency Requirements 17

1.

Coordination 17

2.

Confidentiality 19

3.

Consumer Identification 19

4.

Comprehensive Assessment of Eligible Consumers 23

5.

Provision of Services to Adult Protective Services (APS) Referrals 24

6.

Service Care Plan 25

7.

Resource Management and Development 26

8.

Quality Assurance 27

9.

Co-Payment 27

10.

Disaster Preparedness and Emergency Related Service Provision 28

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TITLE

DESCRIPTION PAGE

11. Social Security Number Disclosure 29

12. Consumer Grievance and Appeals Procedures 30

13. Voter Registration 30 14. Personnel Standards and Employee Benefits 30 15. Organization Chart 31

16. Reporting 32

17. Staffing and Facility Requirements 33

18. Training 34

19. Volunteers 35 1.c.

Coordination of Case Management & Consumers to be Case Managed

36

1.d.

Services to be Coordinated 38

1.e.

Special Conditions 39

1.f.

Planning Goals and Outcome / Output Measures 39

2.

General Information

41

a.

Contact Person 41

b.

Inquiries / Cone of Silence 41

c.

Funding Levels 42

d.

Matching Requirement 43

e.

Type of Contract and Method of Payment 43

f.

Allowable Costs and Method of Cost Presentation 45

g.

Trade Secrets 46

h.

Cost of Preparation of Proposal 46

i.

Proposal Deadlines 47

j.

Notice of Intent to Submit a Proposal 48

k. Acceptance of Proposal 48

l. Number of Copies Required and Submission Procedure 49

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TITLE

DESCRIPTION PAGE

m.

Notice of Intent to Award 50

n.

Appeal Process 51

o.

Contract Terms and Conditions 53

SECTION C.

INSTRUCTIONS TO BIDDERS

54

1. Bidders Certification 54 2. Service Provider Application Formats 55

2.a. Service Provider Summary Information Page 55 2.b.

Program Module – General Instructions 55

2.c.

Contract Module – General Instructions 55

3. Organizational Capability Package 56

SECTION D.

PROPOSAL EVALUATION

58

1.

Description of Evaluation Process 58

APPENDIX Ia

Master Contract

Ia

APPENDIX Ib

CCE Contract

Ib

APPENDIX Ic HCE Contract Ic APPENDIX II

Notice of Intent to Submit Proposal

II

APPENDIX III

Contract Terms and Conditions Statement

III

APPENDIX IV

Statement of No Involvement Form

IV

APPENDIX V Contract Module Worksheets Instructions V

APPENDIX VIa Service Provider Application Formats (Program & Contract Modules)

VIa

APPENDIX VIb Organizational Capability Package VIb APPENDIX VIc Review Checklist VIc APPENDIX VII Administrative Assessment Checklist VII APPENDIX VIII Fatal Criteria VIII APPENDIX IX Proposal Evaluation Instrument IX APPENDIX X Appeal Procedures X APPENDIX XI Bidder Checklist XI

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TITLE

DESCRIPTION PAGE

APPENDIX XII CCE Historical Information XII APPENDIX XIII CCE Contract Rates XIII

APPENDIX XIV Statement Assuring No CCE Funds Used to Develop RFP XIV

APPENDIX XV Rate Review Policy XV

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SECTION A - INTRODUCTION 1. Legislatively Mandated Requirements

The Community Care for the Elderly (CCE) Act (ss. 430.201-430.207, Florida

Statutes (F.S.)) was created by the Florida Legislature to assist functionally impaired

elderly persons to live dignified and reasonably independent lives in their own homes,

or in the homes of relatives or caregivers. The CCE program provides a continuum

of care through the development, expansion, reorganization and coordination of

multiple community-based services to assist elders to reside in the least restrictive

environment suitable to their needs.

Pursuant to ss. 430.203 and 430.204, F.S., a Lead Agency must be designated for

each community care service system. A community care service system is defined

as a service network comprised of a variety of home-delivered services, day care

services, and other basic services (referred to as core services). The primary goal of

the community care service system is to prevent unnecessary institutionalization of

functionally impaired elderly persons by providing community-based services.

In accordance with s. 430.203(9)(c), F. S., …the Lead Agency must be given the

authority and responsibility to coordinate some or all of the services, either directly or

through subcontracts, for functionally impaired elderly persons. These services

include, but are not limited to: case management, homemaker and chore services,

respite care, adult day care, personal care services, home-delivered meals,

counseling, and emergency home repair services. The Lead Agency must compile

CCE statistics and monitor, when applicable, subcontracts with agencies providing

services. Pursuant to s. 430.203(9), F.S., agencies must be designated at least once

every six years as a result of a competitive procurement conducted through a

Request for Proposal (RFP) process.

The goal of this Request for Proposal (RFP) is to define the scope of work to be

accomplished, and convey the requirements and expectations for Lead Agency

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designation, and describe the process pursuant to which the Alliance for Aging, Inc.

(Alliance) will designate Lead Agencies under the CCE Act for the period beginning

with Fiscal Year 2017-2018. Pursuant to s. 430.203(9)(a), F.S., this RFP includes

requirements for the “assurance of quality and cost efficiency of services, minimum

personnel standards, and employee benefits.”

The Alliance has been designated by the State of Florida Department of Elder Affairs

(DOEA) as the Area Agency on Aging (AAA) for Planning and Service Area (PSA) 11

which covers Miami-Dade and Monroe Counties. As such, it is identified by the State

as the contracting agency of choice for the coordination and administration of the

Community Care for the Elderly Program in PSA 11. The Alliance intends to fulfill

the legislatively mandated requirements referenced above by issuing this RFP for

designation of CCE Lead Agencies for the six year period beginning Fiscal Year

2017-2018 and ending Fiscal Year 2022-2023.

Section 430.602(3), Florida Statutes, defines “Home Care for the Elderly” (HCE) as “a

full-time family-type living arrangement, in a private home, under which a person or

group of persons provides, on a nonprofit basis, basic services of maintenance and

supervision, and any necessary specialized services as may be needed, for three or

fewer elderly persons.” Pursuant to Rule 58H-1.002(6), Florida Administrative Code,

a service provider under the HCE program is a CCE lead agency that is awarded a

contract to provide case management and other services under the HCE program.

Accordingly, both CCE and HCE services will be procured from CCE Lead Agencies

designated pursuant to this RFP.

The CCE and HCE contracts procured through this RFP will be for a term of one year

each beginning with Fiscal Year 2017-2018. Each contract may be renewed for up to

five additional one year periods with each succeeding fiscal year , contingent upon

satisfactory performance and availability of funds. Community-based

agencies/organizations interested in obtaining a CCE Lead Agency designation are

required to submit written proposals detailing their qualifications and plans for

providing case management services, coordination of home and community based

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services and other Lead Agency required functions of the CCE program as set forth

in this RFP.

2. Statement of Need

Demographic data of the 60 years of age and over population for PSA 11 comprising

the counties of Miami-Dade and Monroe, obtained from DOEA, indicates the 2

counties have approximately 558,220 residents aged 60 and older representing 20.6

percent of the PSA’s total population and 11.2 percent of the State of Florida’s age 60

and older population. It is anticipated that over the next 10 years, a considerable

number of residents will become elders as a result of net migration and the cohort of

“baby boomers” continuing to age into retirement. It is estimated that between the

years 2010 and 2030, the number of Floridians age 60 and older is expected to rise

faster than the rest of the country, to an estimated 30 percent of the state’s

population by 2030.

In addition to the number and percent of elders projected to increase in the coming

years, people are also living longer. An expected consequence is the continued rise

in the need for long-term care services. The data indicates the needs of elders will

continue to grow as more elders live alone (31%), 26% report they are not receiving

adequate nutrition, and as seniors and caregivers experience more problems with

their homes (21%) (Assessing the Needs of Elder Floridians, 2012).

Along with these rising trends, there are challenges in addressing the increasing size

of the age 60 and older population. It is reasonable to expect as these individuals

age in place and begin to cope with infirmities of old age, their reliance on a caregiver

to help with their activities of daily living will also grow.

Queries of the Client Information & Registration Tracking System (CIRTS) on

services most often provided under the CCE program indicate the need to support

functionally impaired elders with ongoing assistance and caregiving whether provided

through formal or informal means.

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The core services most often provided in PSA 11 to frail consumers under the CCE

program are:

Case Management / Case Aide

Personal Care

Adult Day Care

Homemaker

Housing Improvement/Material Aide

Respite

Specialized Medical Equipment, Services and Supplies

Home Delivered Meals

Emergency Alert Response

Chore

The gap between people served and people awaiting services, as well as the

disparity between client needs and depth of services actually provided, poses a

serious concern. As the contracting agency for development, coordination and

administration of the CCE program in PSA 11, the Alliance intends to address these

concerns through issuance of this RFP, which seeks innovative approaches to

service delivery and program management, while emphasizing improved quality and

customer satisfaction, all at a reasonable cost.

3. Statement of Purpose

The purpose of this RFP is to solicit applications from qualified

agencies/organizations interested in providing case management, core service(s)

coordination, and other functions required by law for a designated CCE Lead Agency.

Through this RFP, the Alliance intends to designate Lead Agencies pursuant to

Section 430.203(9), F.S., and to award contracts funded under the CCE and HCE

programs to those CCE Lead Agencies Through this RFP the Alliance intends to

select up to three Lead Agencies for Miami-Dade County and one Lead Agency for

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Monroe County.

The purpose of a designated Lead Agency is to provide case management to CCE

and HCE clients and ensure service integration and coordination of service providers.

The responsibilities of a designated Lead Agency are to:

1. Ensure all other funding sources available have been exhausted before

using CCE and HCE.

2. Establish coordination with all community-based health and social services

for functionally impaired older persons funded wholly, or in part, by federal,

state and local funds to provide a continuum of care.

3. Deliver directly, or through subcontracts, core and other necessary

contracted services.

4. Provide case management directly to applicants and ongoing recipients of

core and other contracted services.

5. Assess and collect co-payments for core and other contracted services.

6. Train and use volunteers to the fullest extent possible to provide services to

clients and assist with other Lead Agency activities.

7. Compile accurate reports.

8. Monitor subcontract / vendor agreements to ensure quality services and

efficient use of funds. Make payments to subcontractors for core and other

contracted services.

9. Initiate and maintain coordination among agencies.

10. Arrange in-service training annually for staff, volunteers, and

subcontractors, in compliance with the DOEA Programs and Services

Handbook and any applicable contract with the Alliance.

11. Accept voluntary contributions, gifts and grants to carry out a community

care service system.

12. Demonstrate innovative approaches to program management, staff

training and service delivery that impact on cost avoidance, cost

effectiveness and program efficiency.

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13. Establish and follow procedures for handling recipient complaints

concerning adverse actions such as service termination, suspension or

service reduction.

14. Conduct client satisfaction surveys to evaluate and improve service

delivery.

15. Implement measureable client outcomes directed at:

a. Maintaining clients in the least restrictive settings

b. Targeting high risk clients

c. Improving quality of life

d. Maintaining or improving functional status

16. Improve operations and accessibility by:

a. Assuring case management services are available on-call, including

evenings, weekends and emergencies for Adult Protective Services

(APS) cases.

b. Providing services, other than case management, within 72-hours to

APS referrals classified as high risk and in need of services to

prevent further harm.

c. Responding to referrals for persons at imminent risk of institutional

placement.

17. Ensure CIRTS data is timely and accurate.

18. Develop and implement complaint procedures and ensure subcontractors

develop and implement complaint procedures to process and resolve client

dissatisfaction with services.

In addition, the Lead Agency must also ensure that procedures include a process for

complaints or grievances involving alleged abuse, neglect, or exploitation to be

reported to the Florida Department of Children and Families Adult Protective Services

– Abuse Hotline, as required by contract and Florida Statute. The Lead Agency must

also ensure that conditions that may endanger the health, safety, or welfare of a

recipient will be reported to the Alliance within 48 hours of the Lead Agency or a

subcontractor having knowledge of such conditions.

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In performing these responsibilities, the Lead Agency must itself conform, and ensure

that its subcontractors conform, to all applicable regulations and standards in the

DOEAs Programs and Services Handbook as updated by DOEA from time to time

(http://www.allianceforaging.org/providers/program-documents/2012-doea-programs-

services-handbook), Adult Protective Services Referrals Operational Manual as may

be updated from time to time (http://www.allianceforaging.org/providers/program-

documents), and Master Contract (Appendix Ia) as well as any CCE and/or HCE

contract executed by the Lead Agency with the Alliance. The CCE Lead Agency is a key component of the publicly funded long term care

system and its performance has a highly significant impact on the lives of the

individuals it serves and the local, regional and statewide fiscal sustainability of the

long term care system. It is highly desirable for the Lead Agency designation to be

conferred only to case management agencies with a proven record of performance

under conditions typically found in the everyday course of business of a lead agency

designated pursuant to Ch. 430, F.S.

Agencies applying to be designated by the Alliance as a CCE Lead Agency under the

provisions of Ch. 430, F.S. and this RFP, must have the following qualifications:

1. Ability to provide case management services to functionally impaired, elderly

persons; coordinating community-based health and social services funded

wholly, or in part, by federal, state and local funds to provide a continuum of

care.

2. Ability to provide in-home services directly, or by managing a community

service system of providers through subcontracts.

3. Ability to provide emergency services to at-risk individuals, such as elders at

imminent risk of abuse or institutionalization.

4. Ability to monitor subcontracts / vendors to ensure high quality services and

efficient use of funds.

5. Ability to coordinate service delivery using multiple funding sources and

subcontractors / vendors.

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6. Ability to financially match CCE contract dollars at the rate of 10%.

Designated Lead Agencies will be expected to:

Promote Quality Services by Assuring:

Case managers develop care plans to meet the individual needs of

consumers.

Case managers act as consumer advocates by seeking services from all

community resources, not just from traditional service providers.

Case managers monitor the quality, appropriateness and cost of services

delivered to consumers.

All staff are appropriately trained and assigned.

Implement Measurable Consumer Outcomes to:

Maintain consumers in the least restrictive setting.

Target high-risk consumers.

Improve quality of life.

Improve or maintain functional status.

Improve Operations and Accessibility by:

Assuring case management services are available on call, including evenings,

weekends, and emergencies.

Providing needed assessment and services within 72 hours to Adult Protective

Services referrals classified as high risk and in need of services to prevent

further harm, pursuant to Chapter 415, Florida Statutes.

Serving targeted groups as established in the Area Plan.

Ensure Maximum Efficiency by:

Minimizing administrative costs.

Increasing funds available for core services.

Actively seeking all community resources available for client services.

Clearly identifying in the client care plan funding alternatives used prior to

using CCE funds.

Seeking competitive bids or proposals or competitively negotiating vendor

agreements for provision of quality, cost-competitive services not directly

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provided by the designated Lead Agency.

Thoroughly and timely billing and collecting of all co-payments.

All CCE Lead Agency designations by the Alliance beginning with the 2017-2018

fiscal year shall be made through this RFP. Those organizations currently holding

the Lead Agency designation from the Alliance will not be designated by the Alliance

as a CCE Lead Agency as of the start of the 2017-2018 fiscal year unless they are

designated by the Alliance as a Lead Agency and awarded a contract as a result of

this RFP process.

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SECTION B - RFP SPECIFICATIONS

1. Program Requirements:

1.a. Service Delivery Methodology

1) Program Coordination

The Alliance is designated as an Aging and Disability Resource Center,

hereinafter referred to as the “ADRC”, under the provisions of Section 430.2053,

Florida Statutes. The primary functions of an ADRC are to facilitate consumer

friendly access to long term care services and benefits for elders and caregivers

through a coordinated, multi-access “one stop” system that integrates information,

referral and eligibility determination functions.

The ADRC functions are supported by designated Access Points. Lead Agencies

are one type of ADRC Access Point. An Access Point operates as a local point of

contact for elders and caregivers seeking to access long term care services and

benefits.

An Access Point agrees to:

Refer to the ADRC all individuals seeking long term care services and

benefits, including, but not limited to information, referral, intake,

screening and eligibility determinations.

Implement referral protocols and procedures established by the ADRC.

Provide the ADRC with the most current information on elder resources

available in the contractor’s county or local community.

Report the number of contacts (calls, walk-ins, emails, or faxes) of

individuals seeking information, referrals or assistance for themselves or

others.

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As the ADRC, the agency agrees to: Provide timely and helpful long term care options to elders and caregivers

referred by the Access Point.

Provide the Access Point with written policies and procedures concerning

the Access Point referral process.

Provide technical assistance and training for Access Point staff, as

needed.

Provide an opportunity for consumers to choose their Lead Agency in

Miami-Dade County.

The ADRC and Access Point mutually agree to:

Cooperate on efforts to enhance consumer choice, support informed

decision-making, minimize service fragmentation and confusion, reduce

duplication of administrative paperwork and procedures, and increase

cost-effectiveness of long term care support and delivery systems.

Participate in public education programs to increase awareness of ADRC

services.

Additional coordination and program management responsibilities of the Lead

Agency are listed throughout Section B of this document.

2) Case Management and Core Services

Respondents to this RFP are required to submit a proposal detailing the cost for

case management services and CCE services most often provided. Case

Management must be provided directly by a Lead Agency and by that agency

only. Case aides support case management and if charged to this contract, must

be reflected as a separate service under case management. A schedule of CCE

contracted rates per unit of service for the previous two years are included as

Appendix XIII. CCE services may be offered directly by each Lead Agency, or

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through qualified provider agencies under subcontract with each Lead Agency.

The Alliance reserves the right to review and approve or disapprove any

subcontracted entities and reimbursement rates for core services.

Information regarding funding levels for CCE services under this RFP is included

in Section B.2.c. Additional information on core services to be coordinated by the

Lead Agency is included in Section B.1.d. of this RFP.

3) Community Care Service System

The Lead Agency designation is contingent upon the bidder’s ability to accept

referrals and provide case management and coordination of core services

countywide for all eligible consumers residing in the specific county being bid.

Interested bidders must demonstrate the ability to accept referrals and provide

case management services and core service coordination countywide. Failure of

a designated Lead Agency to provide services on a countywide basis may result

in termination by the Alliance of its contracts with the Lead Agency or other

enforcement actions authorized under the contracts between the Lead Agency

and the Alliance.

1. b. Lead Agency Requirements

1) Coordination

Bidders must have two-years of case management experience.

Bidders who do not meet the two years minimum required experience will

not be considered eligible for Lead Agency designation under this RFP.

Lead Agency case managers will coordinate all community resources for

functionally impaired elderly persons in a community care service system,

which is designed to provide a continuum of care as the consumers’ needs

change. This includes administering and managing the CCE program and

the HCE program. Each program is funded separately and carries distinct

program responsibilities. Alternative funding (City, County, Local, etc.)

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must be used to fund client services prior to using the CCE or HCE

contracted funds.

Priority Groups have been established for receipt of CCE services, and are as

follows in order of highest priority:

a. CCE emergency services are specifically provided within 72-hours to

alleged or actual victims of abuse, neglect or exploitation who have

been referred and designated as high risk by the Department of

Children and Families (DCF) Adult Protective Services. Services must

be carefully coordinated by the CCE Lead Agency with the Adult

Protective Services case worker / investigator and service provider

agencies. Actual or alleged victims of abuse, neglect or exploitation, or

those at risk for same, are afforded the highest priority access to CCE

services.

b. Referrals for consumers deemed at imminent risk of nursing home

placement because their mental or physical health condition has

deteriorated to the degree that self-care is not possible, there is no

caregiver, and nursing home placement is likely within a month or very

likely within 3 months shall receive the next highest priority for CCE

services.

Detailed information on services, program requirements and case management

coordination is contained in the DOEA Programs and Services Handbook.

Chapter 2 of the DOEA Handbook contains information on all aspects of Case

Management, including case manager qualifications, job descriptions, duties and

responsibilities, etc. Chapter 5 provides a detailed description of CCE program

administration, Chapter 7 provides a detailed description of HCE program

administration, Appendix B contains Co-Pay standards, and Appendix D contains

grievance standards. Bidders submitting applications in response to this RFP

must agree to comply with all applicable requirements set forth in the DOEA

Programs and Services Handbook.

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2) Confidentiality

Information about functionally impaired elderly persons who receive services

under the CCE or HCE program or through an ADRC that is received through

files, reports, inspections, or otherwise by DOEA authorized employees,

volunteers, or by persons who provide services through DOEA contracts,

including contracts procured by the Alliance pursuant to this RFP, is confidential

and exempt from the provisions of Section 119.07(1), F.S., Florida's Public

Records Act. This information may not be disclosed publicly in such a manner as

to identify a functionally impaired elderly person, unless that person or their legal

guardian provides written consent.

The Lead Agency must ensure confidentiality of consumer information by all

employees, service providers and volunteers as required by all applicable laws. It

is essential that training be established and provided for Lead Agency staff,

subcontractors, and volunteers, and that necessary policies and procedures be

implemented to promote security of information, including protection from loss,

damage, defacement or unauthorized access.

The designated Lead Agency must comply with all confidentiality requirements in

its contracts with the Alliance.

3) Consumer Identification

a. Outreach

The Lead Agency is responsible for outreach to identify and inform frail

elders and their caregivers of the range and availability of services. This

may be done in cooperation with church, civic, social and medical

organizations. The target audience is those individuals most likely to fall

into the high-need categories, which are priority levels 4 and 5 when

assessed. Lead Agency staff should participate in local networks and

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consortiums where hospital, home health, social and medical providers are

represented as these are often referral sources for high-need individuals.

b. Intake

The intake process begins when an individual or caregiver seeking

assistance contacts the ADRC or other access point. The ADRC performs

the intake and screening service functions using the 701-S form. Service

provider agencies seeking assistance on behalf of an elderly person may

make referrals to the ADRC.

During intake, essential information is gathered about the person’s

physical, mental and functional abilities; concerns, limitations, problems,

and general background are also obtained to assist in eligibility screening

for appropriate service referrals.

If during preliminary intake, the elderly person appears eligible for CCE or

HCE services, the intake worker shall conduct a more thorough discussion

of the person’s situation and service needs, called a screening. Screening

is required to determine if the consumer may meet eligibility requirements

under the CCE and HCE programs.

If a person does not meet eligibility requirements for any program

administered by the ADRC, the ADRC shall explain the eligibility criteria

and reason for determination. Referral to other community-based service

agencies should be made, if appropriate.

c. Initial Screening

The screening process begins with determining the urgency of a person’s

need, and type of assistance required. The purpose of the 701-S

Telephone Screening is to assess severity of the person’s situation and

place them on the Assessed Consumer Priority List (ACPL). The 701-S

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Telephone Screening does not take the place of a comprehensive 701-B

in-home assessment which is required before care plan development and

delivery of service(s). The comprehensive in-home screening (701B) is

completed by the Lead Agency once the client is released from the APCL.

The initial 701-S screening is handled through the ADRC by ADRC staff

who have received their certification on Uniform Client Assessment

Training per the DOEA Programs and Services Handbook requirement.

The Prioritization Assessment Instrument DOEA Form 701-S is used to

collect common information about applicants applying for services funded

by the DOEA. Other items related to this process are:

It is also used to prioritize persons so those in greatest need and with

the least assistance available receive services first.

It is completed over the phone.

If an applicant can be served, and is authorized by the ADRC for

enrollment, the Assessment Instrument (DOEA Form 701B) must be

completed by the Lead Agency within 14 business days after receiving

authorization to enroll.

d. Eligibility Determination

All clients served by the CCE program must be functionally impaired. As

defined under Section 430.203(7), F.S. , a ...functionally impaired elderly

person means “any person, 60 years of age or older, having physical or

mental limitations that restrict individual ability to perform the normal

activities of daily living and impede individual capacity to live independently

without the provision of core services.” As set forth in Rule 58C-1.002(2),

F.A.C., functional impairment pursuant to Section 430.203(7) shall be as

determined by an initial comprehensive assessment and at least an annual

reassessment using the form incorporated by reference in paragraph 58A-

1.010(1) (b), F.A.C.

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Final determination of eligibility is the responsibility of the CCE Lead

Agency. A potential consumer will be determined eligible only after a

DOEA Form 701B Assessment is completed to establish age, need and

risk of institutional placement without services.

e. Prioritization

Individuals seeking services may enter the community care service system

by direct contact with an access point. Consumer enrollment into CCE and

HCE is based on available funding and prioritization as referenced in

Chapter 2 of the DOEA Programs and Services Handbook.

The Uniform Client Assessment Instrument (Form 701B) developed by the

DOEA must be used by the CCE Lead Agency case manager to determine

an individual’s level of need.

f. Referral

Services not available through the agencies under subcontract or vendor

agreement with a CCE Lead Agency should be obtained and / or arranged

through referrals to other community resources. Referrals should be made

to volunteer agencies, informal networks and proprietary agencies that

charge fees a consumer may be able to pay. Services provided under the

CCE program should be considered as a “last resort” to meet the needs of

any given consumer.

To ensure services have begun as authorized, the CCE Lead Agency case

manager must conduct follow-up contacts within fourteen business days of

service authorization.

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g. Enrollment Management

The APCL, also known as the wait list, must be maintained by the Alliance

when funding for CCE and HCE is not available. Following the screening

and assessment process, the client is placed on the APCL, informed about

the enrollment management process and provided alternative sources for

assistance that may be available. Further information on APCL or wait list

requirements can be found in the DOEA Programs and Services

Handbook, Chapter 2.

4) Comprehensive Assessment of Eligible Consumers

The Lead Agency's case manager is responsible for completing the DOEA

Uniform Client Assessment Instrument, Form 701B. The assessment determines

the person’s functional status, existing resources and service needs. Further

information on DOEA Form 701B requirements can be found in the DOEA

Programs and Services Handbook.

a. Determination of Functional Status

A consumer’s functional status is determined by the scores received on) on

all sections of the DOEA Form 701B Assessment instrument including the

Activities of Daily Living (ADL) and the Instrumental Activities of Daily

Living (IADL) .

b. Establishing Service Needs

The result of the comprehensive assessment process is establishment of a

consumer care plan, which must thoroughly address all service needs of

the functionally impaired elderly person.

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5) Provision of Services to Adult Protective Services (APS) Referrals

DOEA and DCF signed a memorandum of agreement to ensure delivery of timely

services to vulnerable elders in need of services or victims of abuse, neglect, or

exploitation. The agreement calls for development of joint local written procedures

through a Memorandum of Understanding for serving adult protective services

referrals. Every AAA, DCF region and Lead Agency is responsible for jointly

creating and signing a Memorandum of Understanding to define:

The APS referral process

Method to track referrals in CIRTS and APS Referral Tracking Tool (ARTT)

Service delivery guidelines according to “APS Referrals Operations

Manual”

The Lead Agency shall ensure, pursuant to Section 430.205(5), F.S., those

elderly persons determined by APS to be victims of abuse, neglect, or

exploitation, and who are in need of immediate services to prevent further harm,

and are referred by APS as “high risk”, will be given primary consideration to

receive CCE services.

Case coordination by a Lead Agency case manager must be available 24 hours

per day, seven days a week for elderly victims of abuse, neglect or exploitation

who are referred by an APS investigator. Emergency services may be provided,

or continued, for up to 31 days for APS referrals by contracted emergency

services providers. A DOEA Form 701B Assessment must be conducted within

72 hours to determine eligibility for ongoing CCE services.

Any person, including but not limited to a Lead Agency case manager, who knows

or has reasonable cause to suspect that a vulnerable adult has been or is being

abused, neglected, or exploited must immediately report such knowledge to 1-

800-96-Abuse Registry as required by Section 415.1034, F.S.

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Lead Agency case managers must coordinate closely with APS workers,

investigators and / or case workers to:

Assure immediate need for services is met within 72 hours of an initial

high-risk referral from the APS worker.

Share client or case specific information to assure the best and most

expeditious care for the person and eliminate or reduce factors placing the

person at risk of abuse, neglect or exploitation.

Until released by APS, the Lead Agency must coordinate case

management with APS, and may bill for case management units.

Adhere stringently to the applicable guidelines in the DCF APS Operations

Manual and DOEA Programs and Services Handbook.

6) Service Care Plan

Lead Agency case managers must prepare a care plan for each eligible consumer

using the format prescribed by the DOEA Programs and Services Handbook,

Chapter 2. The care plan is developed in coordination with the consumer and / or

caregiver, and must address all consumer needs. It is the responsibility of the

case manager to consider the most appropriate resources to provide the services

needed, as indicated in the care plan. Consumers or caregivers may accept or

decline services or providers of services. The option of the consumer to choose

from multiple service provider agencies must be observed at all times.

Case managers must manage consumer care plans by arranging for the services

accepted, and monitoring the quality of service delivered to their clients. Periodic

review of continued appropriateness of the care plan should occur at least twice

annually. Specific frequency requirements for each program are prescribed in the

DOEA Programs and Services Handbook, Chapter 2.

All consumers must be reassessed at least annually, and care plans must reflect

changing or ongoing consumer needs.

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7) Resource Management and Development

Funds appropriated by the Florida Legislature for the CCE program must be used

only to provide CCE services, case management and directly related

expenditures. The Lead Agency must ensure all other funding sources available

have been exhausted before using CCE funds. Additionally, the designated Lead

Agency must prepare CCE and HCE surplus / deficit reports and forward the

reports to the Alliance as required in the contracts between the Lead Agency and

the Alliance.

To provide an effective continuum of care, the Lead Agency must ensure

coordination with all community-based health and social services programs for

functionally impaired older persons funded wholly or in part by federal, state and

local funds. Voluntary contributions, gifts and grants must be encouraged and

used to expand CCE services to support a comprehensive service array.

Collecting co-payments from clients is an important responsibility for providers of

CCE services. Appendix B of the DOEA Program and Services Handbook

provides detailed information about co-payment requirements. State General

Revenue resources to support services for the elderly cannot meet the growing

needs of this population. Therefore, every eligible client must be given an

opportunity to participate in the co-pay for services program. It is critical that the

Lead Agency's case managers assess potential clients for their ability to

participate in the cost of their care.

It is equally important to identify potential Medicaid-eligible clients and refer them

to the ADRC for assistance in obtaining their Medicaid benefits through DCF, and

potential eligibility and enrollment in the Medicaid Managed Long-Term Care

Program. State General Revenue resources should not be used for clients who

meet Medicaid functional impairment criteria and who are Medicaid eligible.

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The ADRC provides long-term care options counseling. ADRC Helpline staff

conducts long-term care options counseling to assist clients in determining the

best and most appropriate selection of services and programs for themselves.

For Medicaid-eligible consumers, the ADRC coordinates eligibility determination

for publicly funded program services. When it is determined a client may be

eligible for Medicaid funded programs, ADRC staff assist with eligibility

determinations through coordination with CARES and DCF staff.

8) Quality Assurance

To assure effective and efficient client care through delivery of quality services,

Lead Agencies must participate in pre-service and in-service training developed

according to standards and requirements specified in rules adopted by DOEA and

the DOEA Programs and Services Handbook.

The Lead Agency will self-monitor and self-evaluate the quality of service delivery

by its own staff. Additionally, the Alliance will conduct independent quality

assurance monitoring and performance evaluations of all CCE Lead Agencies.

The degree of client satisfaction with service quality and staff effectiveness must

be evaluated periodically during the contract period. A consumer survey must be

conducted, compiled and results evaluated and reported to the Alliance.

Consumer surveys must be conducted annually. Survey results are expected to

be analyzed by the Lead Agency and used to develop continuous quality

assurance initiatives to ensure improvements to service delivery.

9) Co-Payment

Pursuant to Section 430.204(8), F.S., provider agencies are responsible for

collection of fees for services in accordance with rules adopted by DOEA. DOEA

has adopted Rule 58C-1.007 governing co-payments and contributions. Provider

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agencies shall assess fees for services rendered according to Rule 58C-1.007.

To help pay for services, a functionally-impaired elderly person shall be assessed

a fee based on an overall ability to pay. The fee assessed shall be fixed according

to an established DOEA Co-pay schedule. Co-pay Guidelines can be found in

Appendix B of the DOEA Programs and Services Handbook.

The Lead Agency is responsible for timely billing and collecting assessed co-

payments for all services provided under the CCE program. This includes

coordinating with other service provider agencies with which CCE consumers are

shared. Case managers must exercise particular attention to the procedures

established for termination of services to consumers due to non-payment, and

requirements for consumer notification of right to appeal and approval of waiver of

termination for non-payment. The collected funds must be retained in an interest

bearing account and reported to the Alliance monthly. All collected co-payment

funds must be used to expand consumer services under the CCE program and

may be used to count toward the 10% contract match requirement. The

designated Lead Agency’s annual co-payment goals will be established in

conjunction with the Alliance.

10) Disaster Preparedness and Emergency Related Service Provision

The Lead Agency is required to enter disaster preparedness data into CIRTS for

all consumers. In addition to basic identification, location, emergency contact and

handicap information, this data includes fields to indicate if a consumer needs

help for emergency evacuation, and if they need a specially equipped shelter and

special disaster registry listing. The Lead Agency must be prepared to use CIRTS

reports to routinely provide registry information to the local emergency

management team and identify, locate and assist with evacuation and other

needs of endangered elderly in the event of disaster, as directed by the Alliance

and/or DOEA.

To prepare for an emergency / disaster event, the Lead Agency will cooperate,

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coordinate and train with the local emergency management agency to the fullest

extent possible. The Lead Agency must maintain a current DOEA required

Disaster Plan to be implemented, at the direction of the Alliance and/or the DOEA,

in the event a disaster is declared by federal, state or local officials. For more

detailed information refer to Chapter 8 of the DOEA Programs and Services

Handbook. The plan minimally calls for the following measures and procedures:

Designation of a Disaster Coordinator and alternate.

Plans for contacting all at-risk consumers, on a priority basis, prior to and

immediately following a disaster.

Plans to receive referrals, conduct outreach, and deliver services, before and

after a disaster, to elderly persons who may or may not be current consumers.

Plans for after-hours coverage of network services, as necessary.

Plans to dispatch to shelters outside the disaster area to assist elderly

evacuees with special needs, if necessary.

Plans to help at-risk consumers register with the Special Needs Registry of the

local emergency management agency.

Plans to deliver meals to consumers prior to and following a disaster.

Continuity of Operations (COOP).

11) Social Security Number Disclosure Assessors/Case Managers are authorized to collect a client's Social

Security Number (SSN) pursuant to 42 Code of Federal Regulations, Section

435.910, to be used for screening and referral to programs or services that may

be appropriate for the client. All clients, however, shall be provided a written

statement that explains their SSN is confidential under law and that disclosure of

their SSN is voluntary. This notice is currently included as part of DOEA Form

701B, Comprehensive Assessment. Whenever possible, the Lead Agency should

submit reports to the Alliance with client identifying information using the assigned

client CIRTS identification, in lieu of an individual’s social security number.

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12) Consumer Grievance and Appeals Procedures

The Lead Agency must develop and maintain procedures to provide for handling

consumer complaints and process appeals regarding denial, reduction or

termination of core services. These procedures must provide for informing all

consumers of the grievance and appeal process, including prior written notification

to the consumer of activities related to the grievance / appeal, and providing

assistance to consumers desiring to file a grievance / appeal. Information

concerning consumer grievance and appeals procedures can be found in

Appendix Ia, Master Contract, and Appendix D of the DOEA Programs and

Services Handbook.

13) Voter Registration

In accordance with The National Voter Registration Act of 1993 (52 U.S.C. §§

20501-20511 and Sections 97.021 and 97.058, Florida Statutes, Lead Agency

case managers and staff are required to offer voter registration assistance to

individuals applying for Medicaid services. Time spent on voter registration

assistance is not a billable case management activity. The case manager must

complete a Voter Registration Preference Form to be filed in the client record and

assist, if the consumer desires, with completion of the Voter Registration

Application Form, forward the application form to the Supervisor of Elections

within five days, and complete the CIRTS client voter registration data fields.

Voter Registration Preference Forms and Voter Registration Application Forms (in

English and Spanish) may be obtained from the Supervisor of Elections.

14) Personnel Standards and Employee Benefits

Personnel policies incorporated into Lead Agency operating procedures must be

developed to address at a minimum, the following:

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a. Employee recruitment and hiring

b. Lines of authority and supervision

c. Working schedules and hours of operation

d. Employee compensation

e. Employee fringe benefits

f. Employee evaluation and promotion

g. Leave

h. Confidentiality and privacy, including HIPAA

i. Employee discipline and termination

j. Employee grievance procedures

k. Accidents, safety, and unusual incidents

l. Travel and transportation policies

m. Employee conduct

n. Employee pre-and in-service training and staff development

o. Background screening

p. Assurance of agency compliance with all applicable federal and state laws and

regulations

Job descriptions must be established for each funded and any associated unpaid

position. Job descriptions for funded positions must include reference to salary

ranges and must meet all applicable requirements and standards per Chapter 2 of

the DOEA Programs and Services Handbook. Personnel policies, job

descriptions, and salary ranges must be made available by the Lead Agency upon

request by the Alliance.

A salary range for each paid position must be established by the governing body

of the Lead Agency.

15) Organization Chart

An organizational chart illustrating the structure and relationship of positions,

units, supervision and functions must be developed and approved by the

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governing body of the Lead Agency, and submitted by the bidder as part of the

proposal response.

16) Reporting

The Lead Agency is required to compile CCE and HCE, service delivery statistics

and other data and report to the Alliance according to reporting requirements set

forth in this RFP, the DOEA Programs and Services Handbook, and the contracts

between the Lead Agency and the Alliance.

The Alliance monthly reporting requirements for CIRTS require all client and

service data to be entered into CIRTS by the 7th day of the month following the

month during which services were performed. Information is reported in the

following categories:

Consumer Demographics

Consumer Program Enrollment

Consumer Assessment Information

Consumer Care Plan Information

Consumer Services

Case management, case aide and any CCE service provided by the Lead Agency

must be reported monthly in CIRTS by the Lead Agency. All requests for payment

reporting requirements must be submitted within the time frame established by the

Alliance. Other required reports are identified in the CCE contract.

In addition to proper storage, security and preservation of source documentation

must be protected. Maintenance will include valid backup and retention of

electronic data on a regular basis.

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17) Staffing and Facility Requirements

Each Lead Agency’s governing body must designate a local representative or

employee with the authority to act on behalf of the Lead Agency for purposes of

the CCE program. This individual must devote sufficient time to ensure the CCE

program is administered and managed pursuant to all applicable DOEA

requirements and the Lead Agency's contract with the Alliance.

All CCE services (including case management) must be delivered by qualified

staff according to service standards included in the DOEA Programs and Services

Handbook. The number of staff employed should follow the DOEA Programs and

Services Handbook and be sufficient to ensure timely and quality service delivery

to all Lead Agency consumers.

All CCE Lead Agencies must be open and accessible to the public a minimum of

40 hours per week, Monday through Friday between the hours of 8:00 AM and

5:00 PM. During all other hours, telephone coverage via answering service must

be provided. The office should be reasonably accessible to persons seeking

assistance and/or information; it is preferable the Lead Agency be centrally

located within the Community Care Service Area. The Lead Agency's office

should also be handicap accessible.

Lead Agencies must demonstrate they have sufficient resources, in terms of both

trained staff and equipment, to complete timely CIRTS data entry, data

management requirements. They must also be able to communicate with the

DOEA and the Alliance via electronic mail.

A successful bidder for Lead Agency designation must be prepared to assume

program responsibilities and service provision, either directly or through

subcontractors, at 12:01 AM on the first day covered by the contract period,

without interruption to existing consumers. Additionally, beginning at the start of

the contract period, case coordination by a Lead Agency case manager must be

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available 24 hours per day/seven days per week for elderly victims of abuse,

neglect or exploitation who are referred by an APS investigator. Bidders for Lead

Agency designation that are awarded contracts must provide detailed plans for

the timely transfer of files and service care plans to assure a seamless transition

with no interruption of service to consumers in the event of loss of designation as

a Lead Agency as described in Section C.3. of this RFP below.

18) Training

All staff providing services require a general pre-service orientation and training

specific to the service being provided. Lead Agencies shall be responsible for

provision of the pre-service and in-service training for all paid and volunteer staff

as referenced in the DOEA Programs and Services Handbook.

Each provider agency shall describe and allocate funds for training in the provider

application included in this RFP.

Pre-service orientation for staff and volunteers shall include:

Overview of the aging process

Overview of the aging network (AAA, DCF, Agency for Health Care

Administration (AHCA), DOEA and other agencies), and the agency’s

relationship to the community care service system

Overview of community care services

Review of the relationship of case management to the community care

services system

Communication techniques with the elderly

Observation of abuse, neglect, exploitation and incident reporting

Local agency service procedures and protocol

Client confidentiality

Use and completion of assessment instruments and care plans

Interviewing skills and techniques

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Record keeping procedures

CIRTS procedures

Caregiver training regarding responsibilities and resource development

techniques

Interagency coordination and informal network development training

DOEA’s on-line 701B assessment training

In-service training hours and topics shall be provided at the discretion of the Lead

Agencies. Staff must have six hours of in-service training per year and document

the duration and content in case management staff records. Topics such as

Alzheimer’s disease, Cultural Sensitivity, Caregivers Needs, Dealing with Difficult

Clients, Mental Health and the Elderly, and continuing Handbook and Policy

Reviews are appropriate. Attendance at all trainings sponsored by the Alliance or

DOEA is required.

Case managers must successfully complete DOEA's on-line training on the

Uniform Client Assessment Form and pass the certification test as well as attend

Care Plan training and receive an acceptable score on the post-test provided by

the Alliance.

It is essential that Lead Agencies meet with CCE subcontractors to establish

necessary protocol and procedures for authorization of services, paperwork and

reporting, unusual incident reports and general expectations for service

coordination. Service provider agencies under subcontract with a Lead Agency

must recognize a case manager’s responsibility for coordinating and authorizing

services.

19) Volunteers

Pursuant to section 430.204(3), Florida Statutes, concerning the CCE program,

“The use of volunteers shall be maximized to provide a range of services for the

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functionally impaired elderly person. The department shall provide or arrange for

the provision of training and supervision of volunteers to ensure the delivery of

quality services. The department or contracting agency may provide appropriate

insurance coverage to protect volunteers from personal liability while acting within

the scope of their volunteer assignments under a community care service area.

The coverage may also include excess automobile liability protection.”

Bidders must provide assurance and demonstrate staffing capability to train and

supervise volunteer staff and volunteer supervisors. All bidders must submit a

written plan to address recruitment, training, utilization and retention of volunteers

to assist the CCE Lead Agency.

Reporting on the number of volunteers and volunteer hours must be submitted to

the Alliance annually.

Lead Agencies may use CCE funds and staff for securing, training and using

volunteers. CCE funds may also be used to provide insurance and personal

liability coverage, excess automobile liability protection and automobile mileage

reimbursement. Per Section.112.061(7),(d)1.,a., F.S., the current State of Florida

approved mileage reimbursement rate is $0.445 per mile.

1.c. Coordination of Case Management and Consumers to be Case Managed

When a consumer is enrolled in one or more programs which fund case

management, the following applies: HCE will pay case management for HCE

program participants who are also enrolled in another General Revenue (GR)

program. If a consumer is not enrolled in HCE, the CCE provider will provide and

fund case management. Additional information about each program for which

case management services are to be provided is available in the DOEA Programs

and Services Handbook.

Multiple assessments will not be conducted unless a significant change in

consumer status occurs to warrant such action. Providers will check CIRTS to

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determine if a current assessment has been completed prior to conducting an

assessment.

The case manager is the gatekeeper in the community care service system with

the knowledge and responsibility to link consumers to the most beneficial and

least restrictive array of community services and resources, irrespective of funding

source or program. Case managers serve as a contact between health care and

social service delivery systems, particularly physicians, hospitals, health

maintenance organizations, nursing homes and home health agencies.

Consumer choice is the primary consideration in determining service referrals. In

those instances where more than one CCE subcontractor is available for a given

service, and the consumer expresses no preference, the Lead Agency should

make the referral based on geographical and cost efficiency considerations. The

procedures and referral formats used are to be developed by the Case

Management/Lead Agency.

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1. d. Services to be Coordinated

The following is a list of the services, which may be funded under the CCE

program in PSA 11

Adult Day Care Health Support Pest Control Initial /

Maintenance

Adult Day Health Care Home Delivered Meals Physical Therapy

Chore / Enhanced

Chore

Housing Improvement Respite

Caregiver Training /

Support

Home Health Aide Shopping Assistance

Case Aide Homemaker Skilled Nursing Services

Case Management Legal Assistance Speech Therapy

Companionship Material Aid Specialized Medical Equip

Services & Supplies

Counseling

(Gerontological or

Mental Health)

Medication

Management

Transportation

Emergency Alert

Response

Nutrition Counseling

Escort Occupational Therapy

Financial Risk

Reduction

Personal Care

A complete list of the services funded by DOEA and descriptions for each may be

found in Appendix A of the DOEA Programs and Services Handbook.

Information about funding available for case management and other services

being procured through this RFP is included in Section B.2.c. (Funding Levels).

Additionally, county specific historical service funding levels and unduplicated

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client information for the 2014-2015 and 2015-2016 CCE contract periods are

included as Appendix XII.

1.e. Special Conditions

a. Each Lead Agency will provide case mManagement services for the caseload

stipulated in their CCE and HCE contracts.

b. Any request for unit rate increases for CCE and/or HCE services for any fiscal

year beyond Fiscal Year 2017-2018 must be initiated by the Lead Agency

following submission of their Annual Service Cost Report per the Alliance’s

Reimbursement Rate Review Policy (Appendix XV). All unit rate increase

negotiations shall be governed by the Alliance's Reimbursement Rate Review

Policy and the DOEA Notice of Instruction NOTICE #: 092815-1-PC-SCBS, dated September 28, 2015.

1. f. Planning Goals and Outcome / Output Measures

In keeping with the legislatively mandated requirements for performance-based

budgeting, DOEA has identified six (6) key goals for which AAAs and provider agencies

are required to develop implementation strategies in order to assist DOEA in achieving

the statewide outcome and output measures it has identified for the aging network.

The identified goals are:

To Age in Place To Age with Purpose To Age with Security To Age in an Elder Friendly Environment To Age with Dignity

Each proposal submitted in response to this RFP must include a Service Provider

Application (SPA). All bidders are required to describe in their SPA the strategies and

actions they will use to implement and follow to meet and/or exceed the outcome

measures as specified by DOEA as delineated below.

1. 97% of Adult Protective Services (APS) referrals who are in need of immediate

services to prevent further harm will be served within 72 hours.

2. 79.3% of elders assessed with high or moderate risk environments will improve

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their environment score.

3. 66% of new service recipients with high-risk nutrition scores will improve their

nutritional status.

4. 65% of new service recipients will maintain or improve their ADL assessment

score.

5. 62.3% of new service recipients will maintain or improve their IADL assessment

score.

6. 89% of family and family-assisted caregivers will self-report they are very likely

to provide care.

7. 90% of caregivers will maintain or improve their ability to provide care after one

year of service intervention (as determined by the caregiver and the assessor).

All Objectives, Performance Measures and/or Standards are subject to revision

by DOEA or the Alliance at any time in any given contract year.

Each designated Lead Agency is required to adhere to the action steps and

implementation strategies in their SPA to meet and/or exceed the planning goals

and outcome/output measures as specified by the DOEA and the Alliance.

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SECTION B - RFP SPECIFICATIONS 2. General Information

a. Contact Person

The contacts for this Request for Proposal process are:

Stan McNeese, CFO

Alliance for Aging, Inc.

760 NW 107th Avenue, Suite 214

Miami, FL 33172

[email protected]

305-670-6500

b. Inquiries/Cone of Silence

Inquiries: Verbal inquires or other verbal questions relating to the RFP will not be

accepted. All questions must be submitted in writing only and must be submitted

by the deadline in the RFP timeline. The written inquires received by the Alliance

and the Alliance's answers to such questions will be posted on the Alliance’s

website as an addenda to this RFP. The address for the Alliance's website is:

www.allianceforaging.org

Cone of Silence: Bidders responding to this RFP, or persons acting on their

behalf, may not contact, between the release of this RFP and deadline for

submission of written appeals, any employee or officer of the Alliance, any

individual involved in evaluating proposals submitted in response to the RFP, or

any employee or officer of the State of Florida concerning any aspect of this

solicitation, except in writing to the contact person identified below. Violation of

this provision may be grounds for rejecting a proposal.

mailto:[email protected]

http://www.allianceforaging.org/

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No interpretation of the meaning of the RFP documents will be made to any

proposer orally. Failure of a bidder to receive any addendum shall not relieve said

bidder from complying with the RFP documents as clarified or revised in writing.

All addenda shall become part of the RFP documents.

Written inquiries may be emailed, hand delivered or mailed to the contact person

in charge of this solicitation process. The Alliance may at times experience

technical difficulties receiving email correspondence. For this reason, bidders

may call the contact person to confirm that the bidder's questions have been

received by the Alliance. Further, the Alliance has no obligation to respond to any

written inquiries that have not been received by the Alliance within the established

deadline and timely submitted to:

Stan McNeese, CFO

Alliance for Aging


Miami, FL 33172

305-670-6500

c. Funding Levels

Funding for the CCE program is contingent upon an annual appropriation from the

Legislature and, therefore, is subject to the availability of funds which can be

reduced or eliminated from the state budget. The total current Legislative

appropriation for CCE case management and coordination of services for PSA 11

for Fiscal Year 2016-2017 is $6,750,564.00. There is no guarantee that this

amount will be appropriated during the Fiscal Years for which contracts will be

awarded under this RFP.

Lead Agency designations and contracts awarded pursuant to this RFP will be on

a county basis with separate awards for Miami-Dade and Monroe County. Each

bidder must ensure the respective services will be accessible throughout the

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entire county for which they submit a proposal. If a bidder chooses to bid on

services in both Miami-Dade and Monroe counties, a separate proposal must be

submitted for each county. Proposals submitted for Miami-Dade County will only

be considered for Miami-Dade County. Proposals submitted for Monroe County

will only be considered for Monroe County.

In the event that an existing Miami-Dade County Lead Agency loses its

designation, its case load will be equally divided among all designated Lead

Agencies in Miami-Dade County as of the 2017-2018 Fiscal Year. In the event

that the existing Monroe County Lead Agency loses its designation, its case load

will be assigned to the designated Lead Agency as of the 2017-2018 Fiscal Year.

The county specific funding levels and required average caseload count

information is noted below.

2016-2017 CCE Service Miami-Dade Provider A

Miami-Dade Provider B

Miami-Dade Provider C Monroe

Case Management & Case Aide $ 735,376 $ 196,299 $ 195,693 $ 46,290 Core Services $ 3,661,612 $ 631,376 $ 916,507 $ 367,410 Total CCE Funds $ 4,396,989 $ 827,675 $ 1,112,200 $ 413,700

Average Annual Caseload

700 132 177 65

d. Matching Requirement

Bidders awarded funds through this RFP will be required to provide a match equal

to or greater than, 10% of the total funds provided. The match requirement may

be satisfied through a commitment of cash or in-kind resources, or a combination.

State General Revenue dollars from other contracts or grants may not be used as

match. Allowable matching funds based on the Lead Agency’s year to date

contract achievement levels must be reported to the Alliance on a monthly basis.

e. Type of Contract and Method of Payment

Contracts will be paid based on fixed unit rates, except for any services for which

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the contract between the Alliance and the Lead Agency expressly provides for

payment on a cost reimbursement basis. Bidders awarded funds will be

reimbursed monthly for the units of service provided, at the contracted unit rate (or

on a cost reimbursement basis when such payment is expressly specified in the

contracts), up to the total amount of the contract. The Lead Agency is expected to

manage its budgets such that the lead agency is able to provide services to

enrolled clients for the entire contract period without interruption. Lead Agencies

shall monitor overall contract expenditure rates during the contract period.

Monthly invoices submitted by the Lead Agency are consolidated and submitted

to DOEA for payment. Payments will be submitted by the Alliance to the Lead

Agencies within 7 calendar days of the date the Alliance receives payment from

DOEA.

Service and client information must be maintained in CIRTS. Case management

and service units must be entered in CIRTS monthly for Lead Agencies to be

reimbursed.

Bidders awarded funds through this RFP agree to maintain and provide, upon

request, all programmatic, financial, and CIRTS reports as required in the Master

Contract, CCE Contract, and HCE Contract. Copies of the sample form of all

contracts are attached to this Request for Proposals document as Appendices Ia, Ib, and Ic. Failure to abide by the terms and conditions in any contract between

the Lead Agency and the Alliance may result in suspension of payment, financial

consequences, and/or termination of one or all of the contracts. The sample

contracts are provided for general information only. The sample contracts in

Appendices Ia., Ib. and Ic. are subject to change prior to contract execution.

The method of payment for awarded contracts under this RFP may include

payment advances. Per applicable Florida law, advance payments may be made

only to not-for-profit corporations and governmental agencies.

The Bidder must ensure fixed unit rates include only those costs allowable under

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all applicable state and federal statutes and regulations. All fixed unit rates must

also be based on audited historical costs in instances where an independent

audit is required. All requests for payment will be processed using CIRTS and

DOEA required forms. Additional information on method of payment and the

schedule of reporting is included in the Master Contract, Appendix Ia, the CCE

Contract, Appendix Ib, and the HCE Contract, Appendix Ic.

f. Allowable Costs, Method of Cost Presentation, and Method of Payment

Allowable Costs

All CCE program costs must be reasonable and necessary. Lead Agencies must

comply with the provisions of the Florida Single Audit Act as contained in section

215.97, Florida Statutes, if applicable.

Method of Cost Presentation

All fixed unit rates and other contract costs must be developed using the DOEA

Unit Cost Methodology formats as described in the Service Provider Application

(Appendix VIa) and Contract Module Worksheets Instructions (Appendix V).

Please visit the Alliance website to obtain related documents for completing the

RFP application package needed to submit a proposal in response to this RFP.

Bidders must follow the Unit Cost Methodology closely and provide the Alliance

with information in sufficient detail to allow the proposal review team to determine

the appropriateness and accuracy of all identified costs and rates. The review

team must be able to establish through review of information submitted by each

bidder that costs are allowable, reasonable and necessary. Budget notes and any

additional narrative that will give the review team a clear picture of the allocation

methodology followed by the bidder are recommended and bidders are

encouraged to include any and all such information in their proposals.

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g. Trade Secrets

The Alliance is unable to assure confidentiality of information that a bidder claims

to meet the definition of trade secrets pursuant to Section 812.081, Florida

Statutes. The Alliance assumes no liability for disclosure of or use of unmarked

material containing trade secrets or other confidential material and may use or

disclose the data for any purpose, and may assume the proposal was not

submitted in confidence and therefore is a public record pursuant to Chapter 119,

Florida Statutes. The Alliance is not obligated to agree with a bidder’s claim of

trade secret for marked materials and, by submitting a proposal, the bidder

agrees to be responsible for defending its claim that each and every portion of

marked as trade secret is exempt from inspection and copying under Florida’s

Public Records Law. Each bidder r agrees that it shall protect, defend, and

indemnify, including attorney fees and costs, including any appellate costs and

attorney fees, the Alliance, its officers, employees, agents, and legal counsel from

any and all claims and litigation arising from or relating to proposer’s claim that the

marked portions of its proposal are confidential, proprietary, trade secret, or

otherwise not subject to disclosure.

h. Costs of Preparation of Proposal

Any and all expenses involved in the preparation and submission of proposals in

connection with this solicitation process shall be borne by the bidder(s). The

Alliance assumes no liability for any cost incurred by a bidder in responding to this

RFP nor for any costs incurred by any bidder prior to the effective date of any

contract between the bidder and the Alliance awarded pursuant to this RFP. Each

bidder must certify they have not used CCE program funds in preparing their

proposals submitted in response to this RFP by completing Appendix XIV.

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i. RFP Timeline

ACTIVITIES DATE

TIME

1. Request for Proposal released October 26, 2016 5:00 PM

2. RFP documents available on the Alliance for Aging, Inc. website

(http://www.allianceforaging.org/)

October 26, 2016 5:00 PM

4. Last day for written inquiries to be submitted November 9, 2016 5:00 PM

5. Intent to submit a proposal forms due (optional) November 15, 2016

5:00 PM

6. Alliance response to timely received written inquiries a posted on Alliance

website as an addendum to the RFP.

November 18, 2016

5:00 PM

7. Last day for proposal submission at:



Miami, FL 33172

December 12, 2016

11:00 AM

8. Proposals opened and reviewed for fatal criteria December 12, 2016

1:00 PM

9. Public Meeting to open/tally reviewers' scores at:



Miami, FL 33172

January 17, 2017 11:00 AM

10. Presentation to Alliance Board of Directors and recommendations for

contract awards – Public Meeting

January 19, 2017 4:00 PM

11. Intent to Award Contracts posted on Alliance website January 23, 2017 5:00 PM

16. Anticipated Contract Effective Date July 1, 2017 12:01 AM

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j. Notice of Intent to Submit a Proposal

All addenda to the RFP (including the timely received written inquiries and the

Alliance's responses) will be posted to the Alliance's website. All addenda will

also be sent via e-mail to those prospective bidders that submit a written Notice of

Intent to Submit a Proposal (Appendix II) by November 18, 2016 by 5:00 p.m. to:

Stan McNeese, CFO



Miami, FL 33172

The Alliance will not e-mail addenda to any person or entity other than those

prospective bidders that timely submit a Notice of Intent to Submit a Proposal form

as described above.

k. Acceptance of Proposal

Proposals must be received by December 12, 2016 at 11:00 AM and submitted to:

Stan McNeese, CFO



Miami, FL 33172

No changes, modifications or additions to the proposals submitted will be

accepted after the submission deadline.

Proposals not received by the Alliance at the specified place by the specified date

and time will be rejected and returned unopened. All times specified in this RFP

are based on the clock maintained at the reception desk in Suite 214 at the

Alliance.

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l. Number of Copies Required and Submission Procedure

Bidders must submit a proposal including a complete SPA (both Program Module

and Contract Module) in a clearly marked and sealed container. The container

must be clearly marked on the outside to read:

Proposal for CCE Lead Agency Designation Submitted by: [name of Bidder]

Failure to timely submit a SPA consisting of both the Program Module and the Contract Module in a clearly marked and sealed container will be considered a Fatal Flaw.

Within the sealed container in which the proposal is submitted, the Program

Module and Contract Module must be in separate sealed packages. Please note

that The Organizational Capability Package (Appendix VIb) which is part of the

Contract Module (and shall be included in the separate sealed package

containing the Contract Module) must be submitted in such a way that it may be

pulled out of the RFP proposal packet.

The outside cover of the separate sealed package containing copies of the

Program Module shall be marked: Program Module

Proposal for CCE Lead Agency Designation Submitted by: [name of Bidder]

The outside cover of the separate sealed package containing copies of the

Contract Module shall be marked:

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Contract Module Proposal for CCE Lead Agency Designation

Submitted by: [name of Bidder]

Bidders are required to submit an original and four hard copies of their proposal

for both modules. At least one copy must contain the original signature of an

official of the bidder authorized to bind the bidder to the agency’s proposal. In

addition to the original and hard copies of the proposals, each bidder must submit

one electronic copy of its completed Program Module in the Program Module

package and one electronic copy of its completed Contract Module in the Contract

Module package. All electronic copies must be submitted on a flash drive.

The original of the proposal must contain, where required, the signature of an

agency official authorized to do so on behalf of the bidder.

Proposals may be mailed or hand delivered to:

Stan McNeese, CFO



Miami, FL 33172

Proposals cannot be faxed or e-mailed.

Proposals will be date and time stamped immediately upon receipt. Alliance staff

will open the first proposal at 1:00 p.m. on December 12, 2016 at which time no

further proposals will be accepted under this RFP.

m. Notice of Intent to Award

The Alliance's Notice of Intent to Award contracts arising from this RFP shall be

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published in the same manner as this RFP by posting on the Alliance website

(www.allianceforaging.org). The posting of the Notice of Intent to Award is

anticipated to occur at the date and time specified in the RFP Timeline. In

addition, a copy of the Notice of Intent to Award will be sent via e-mail to all

bidders that timely submitted a proposal in response to the RFP.

The Alliance will designate as Lead Agencies and award contracts to the

proposals ranked highest using the evaluation methodology and criteria in this

RFP, subject to the thresholds and procedures described in more detail below.

The Alliance reserves the right to reject any and all proposals. If any award under this RFP is made, the Alliance will designate as Lead

Agencies the most responsive, responsible, and best proposals in compliance

with this RFP based on the quantitative and qualitative evaluation process

followed in the review of all proposals to be submitted in accordance with this

RFP. The Alliance reserves the right to waive any minor irregularity in any

proposal. Regardless of any other statements in this RFP, the Alliance reserves

the right to reject any one or all proposals; to re-advertise this Request for

Proposal; to postpone or cancel the solicitation process; to waive any informality

in any proposal; and to award the contract in the best interest of the Alliance

based on the requirements of the RFP. The Alliance, likewise, reserves the right

to reject the proposal of any bidder who has previously failed to perform properly

or to complete on time, contracts of a similar nature; or which is not in a position

to perform the contract.

n. Appeal Process

In accordance with 430.203(9)(a), F.S., and 58C-1.0031 F.A.C. “Lead Agency

Dispute Resolution”, any party who is substantially affected by the Alliance’s

intended decision to award a contract for a Lead Agency must file a written notice

of protest with the Alliance within 72-hours after posting of the Notice of Intent to

Award, excluding weekends and state holidays. Only hard copies of a notice of

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intent to protest will be accepted. A notice of intent to protest will not be accepted

if sent electronically whether via e-mail or fax. A substantially affected party is

any party who bid on the RFP for designation as a Lead Agency.

A formal written protest must be filed within 10 calendar days after date the notice

of protest is filed, unless the 10th day falls on a weekend or state holiday, in which

case the deadline shall be the next business day. The formal written protest must

be timely filed with:

Max B. Rothman, J.D., LL.C

CEO


C/O RFP Appeal

760 NW 107 Avenue

Suite 214

Miami, FL 33172

The formal written protest must state, with particularity, the facts and law upon

which the protest is based.

“Failure to file a Notice of Protest as described in subsection (4) of Rule 58C-1.0031, Florida Administrative Code (F.A.C.), shall constitute a waiver of proceedings under Rule 58C-1.0031, F.A.C.”

As set forth in Appendix X any disputes arising out of this RFP will be resolved

pursuant to the Lead Agency Dispute Resolution procedures in Rule 58C-1.0031,

F.A.C.

In accordance with Rule 58C-1.0031(5), upon receipt of a timely filed notice of

protest, the Alliance will stop the contract award process until the subject of the

protest is resolved by final action. However, in the event any pending protest will

result in a disruption in service delivery to elderly clients, the Alliance reserves the

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right to contract on an emergency and interim basis, to maintain the delivery of

services in place until such time when the protest is resolved.

o. Contract Terms and Conditions

Contracts procured through this RFP are for a term of one year, Fiscal Year 2017-

2018. Each contract may be renewed for up to five additional one year periods

subject to continued legislative appropriations and satisfactory performance.

Sample contracts and associated attachments may be found in Appendices Ia.,

Ib., and Ic. of this RFP. All bidders are instructed to read the sample contracts

carefully to determine their agency’s ability to meet the requirements in all of the

sample contract documents. Proposals must include a signed and dated Contract

Terms and Conditions Statement (Appendix III) that certifies each bidder’s

intention to abide by all terms and conditions of the contracts as set forth in the

sample contracts included in the appendices to this RFP.

FAILURE TO SUBMIT A FULLY COMPLETED CONTRACT TERMS AND CONDITIONS STATEMENT CONSTITUTES A FATAL FLAW AND WILL AUTOMATICALLY DISQUALIFY A PROPOSAL FROM FURTHER REVIEW AND CONSIDERATION.

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SECTION C: INSTRUCTIONS TO BIDDERS

The following pages contain general conditions a bidder must follow to submit their

proposal. The RFP package must include a Table of Contents, and all pages must be

numbered. The bidder should use the Bidder Checklist, Appendix XI, to help confirm

that it has submitted the required information as part of its proposal. The Table of

Contents must note the corresponding page number(s) associated with each item.

1. BIDDER CERTIFICATION

The following forms are REQUIRED and must be included in the proposal:

a.. Administrative Assessment Checklist: Each bidder is required to fill out

this standard checklist to indicate the agency’s adherence to commonly

accepted fiscal and administrative policies and procedures. The checklist is

Appendix VII to the RFP.

b. Contract Terms and Conditions: A signed statement indicating the bidder’s

acceptance of all terms and conditions of the sample Master Contract, CCE

Contract and HCE Contract attached as Appendices Ia., Ib., and Ic. is

required. The Contract Terms and Conditions Statement is included as Appendix III to the RFP.

c. Statement of No Involvement: A signed statement indicating neither the

bidder, nor any person with an interest in the bidder's firm had a

noncompetitive contract with the Alliance that involved any preliminary work

(e.g., feasibility study or actual preparation of the RFP) prior to release of the

solicitation document. This form is Appendix IV to the RFP.

FAILURE TO SUBMIT the Administrative Assessment Checklist - APPENDIX VII, Contract Terms and Conditions Statement - APPENDIX III, AND Statement of No Involvement - APPENDIX IV CONSTITUTES A FATAL

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FLAW, WHICH WILL AUTOMATICALLY DISQUALIFY ANY PROPOSAL FROM FURTHER REVIEW AND CONSIDERATION.

2. SERVICE PROVIDER APPLICATION (APPENDIX VIa)

a. Service Provider Summary Information Page Section I.A. of the Service Provider Application (SPA) (Appendix Via) must be

completed in its entirety, and must be signed and dated by an authorized

agency official.

FAILURE TO SUBMIT at least one copy of the signed Service Provider Summary Information Page signed by the person authorized to bind the agency to all contractual obligations CONSTITUTES A FATAL FLAW, WHICH WILL AUTOMATICALLY DISQUALIFY ANY PROPOSAL FROM FURTHER REVIEW AND CONSIDERATION

b. Program Module – General Requirements Section II.A. (Items 1-15) of the SPA (Appendix VIa) must be completed by

each bidder in its entirety. Detailed instructions are included for each item (1-

15) on the SPA form. Bidders will be expected to provide, in narrative form,

information that indicates an understanding of the need for, and purpose for

the project, as presented in the RFP.

The proposal should include a detailed description of the program objectives

pursued by the bidder, as well as an explanation of how each funded service

will be provided to achieve the output and outcome measures set forth in the

SPA and intended by the bidder.

c. Contract Module – General Requirements Section II.B. Items 1-3 of the SPA (Appendix VIa) must be completed by

each bidder in its entirety. Bidders must closely follow the Unit Cost

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Methodology and provide the Alliance with sufficient detail to allow the

proposal review team members to determine the appropriateness and

accuracy of all identified costs and rates. The proposal review team must be

able to establish, through review of factual information submitted by each

bidder, that costs are allowable, reasonable and necessary. It is

recommended that a bidder include in its proposal budget notes and any

additional narrative to give the proposal review team a clear picture of the

bidder’s allocation methodology.

Section II.B., items 4-9: depending upon the method of match (cash or in-

kind) to be provided by bidder, the appropriate “Commitment of Cash or In-

Kind” forms (items 4-9) must be completed. Please note the required match

may be satisfied through cash or in-kind resources or a combination of both. It

is helpful to use the Contact Module Worksheets Instructions (Appendix V) to

complete each item.

Bidders who do not submit the Match Commitment Forms to demonstrate their

ability to meet the match requirements will not be considered eligible for Lead

Agency designation under this RFP.

Section II.B., item 10: the “Availability of Documents” form identifies required

documentation that must be maintained and available at the bidder’s

administrative office. The form must be signed and dated by the bidder’s

authorized agency official.

3. ORGANIZATIONAL CAPABILITY PACKAGE (APPENDIX #VIb)

The Organizational Capability Package (Appendix VIb) details 10 items

requested from all bidders. These items are intended to assist the proposal review

team in measuring the bidder’s management capabilities, financial position and

experience. Bidders are urged to pay close attention to the specific requirements

in Appendix VIb and address each item in detail.

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Transition Plan: In the event a Lead Agency designated pursuant to this RFP is

not a current Lead Agency, or a current Lead Agency is not designated to

continue in a Lead Agency role as of the start of Fiscal Year 2017-2018, a

Transition Plan must be submitted within 20 days of bid award in order to address

the transfer of clients and client files to the successful bidder. Therefore, bidders

must include a statement as part of their bidder’s RFP package agreeing to

submit their Transition Plan within 20 days of contract award. Failure to timely

submit the Transition Plan may result in forfeiture of Lead Agency designation.

The Alliance must approve any Transition Plan in advance of implementation.

The Transition Plan must include an implementation schedule to ensure

uninterrupted service delivery.

Transition Plans for all bidders must take into consideration the transfer of current

client files. The plan from any newly designated Lead Agency which is not

currently designated as a Lead Agency must include staffing and training plans,

start-up activities, time frames for completion, any modification of service delivery

schedules and sites, and notification to clients of the new Lead Agencies.

If there is insufficient time for the current and new service providers to transition

services so there is no disruption in service delivery, the Alliance may choose to

continue services under an emergency contract with a provider of the Alliance's

choice until such time as transition can be accomplished without disruption in

service delivery.

Failure for an existing agency that loses its designation as a Lead Agency to

comply with the contractual stipulation on the transfer of files as part of the

transition of cases will forfeit its opportunity to bid on any and all future

procurements issued by the Alliance.

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SECTION D: PROPOSAL EVALUATION

1. Description of Evaluation Process

Each proposal will be evaluated according to the standards contained in

Appendices: VIII (Proposal Fatal Criteria) and IX (Proposal Evaluation). Fatal

Criteria are items that require the same response from all bidders. Non-fatal

criteria are items that can be responded to differently by bidders.

"Fatal" criteria require only a YES or NO response. Proposals which receive a

negative answer to any of the "Fatal Criteria" on Appendix VIII will be eliminated

from further consideration. Whether or not each proposal satisfies the Fatal Criteria

requirements of Appendix will be determined during a public meeting.

A proposal review team of three persons appointed by the Alliance’s President and

CEO will individually and independently review and score the Program Modules of

all timely proposals submitted that pass the Fatal Criteria review. The Contract

Module of all such proposals will be reviewed and scored by the Alliance’s CFO or

an alternate person selected by the Alliance’s President and CEO. The Alliance

will ensure that no person reviewing the proposals has a conflict of interest which

could interfere in Lead Agency designation.

The proposals will be evaluated using the Proposal Evaluation Instrument

(Appendix IX).

After the proposals are reviewed and scored on an independent and individual

basis by the proposal review team members and the CFO or other individual

designated to review and score the Contract Module, a public meeting will be held

at which the scores from the Program Module and the Contract Module will be

tallied. A total overall average score will be determined for each proposal.

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Proposals scoring less than a final weighted minimum rating of 2.0 will be

eliminated from further consideration.

In addition to the Proposal Evaluation Instrument (Appendix IX), a Program

Module Review Checklist and Contract Module Review Checklist (Appendix VIc) has been provided to assist bidders in determining if their proposal contains all

required items. The Program Module Review Checklist and Contract Module

Review Checklist (Appendix Vic) must be completed and included with the RFP

package. All items should be initialed noting these items are in the bidder’s RFP

package. The Program Module Review Checklist should be included in the

separately sealed package containing the bidder's Program Module. The

Contract Module Review Checklist should be included in the separately sealed

package containing the bidder's Contract Module.

The scores and rankings of the proposals will be presented to the Alliance

President and CEO who, in turn, will make a recommendation to the Alliance

Board of Directors which has ultimate authority to approve Lead Agency

designation.

For Miami-Dade County, the Alliance intends to award the Lead Agency

designations to three agencies unless there are fewer than three qualified

bidders. Qualifications are ascertained by a total weighted score of 2.0 or higher.

If there are three or more bidders with a total weighted score of 2.0 or more, the

Alliance will award Lead Agency designations in Miami-Dade County to the three

bidders with the highest total weighted scores. Ties will be decided, first on the

basis of the lower case management rate and second on the years of experience

as a case management agency providing services for persons age 60 and over.

If there are less than three bidders for Miami-Dade County with a total weighted

score of less than 2.0, the two bidders with the highest total weighted scores will

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be awarded the Lead Agency designations.

For Monroe County, the Alliance intends to award the Lead Agency designation

to one agency. Qualifications are ascertained by a total weighted score of 2.0 or

higher.

If there is more than one bidder with a total weighted score of 2.0 or more, the

Alliance will award Lead Agency designation in Monroe County to the one bidder

with the highest total weighted score. Ties will be decided, first on the basis of

the lower case management rate and second on the years of experience as a

case management agency providing services for persons age 60 and over.

If there are no bidders for Monroe County with a total weighted score of 2.0 or

higher, the bidder with the highest total weighted score will be awarded the Lead

Agency designation.

The Alliance reserves the right to reject any and all proposals if in the best

interest of the Alliance, the State of Florida, or the current or potential CCE

program participants in PSA 11.

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ALLIANCE FOR AGING, INC.

MASTER CONTRACT FOR FEDERAL AND STATE PROGRAMS

THIS MASTER CONTRACT is entered into between the Alliance for Aging, Inc. (Alliance) and [CONTRACTOR NAME] (Contractor), and collectively referred to as the "Parties".

1. Purpose of Contract:

The purpose of this Master Contract is to establish the Department of Elder Affairs (Department) and the Alliance's standard terms and conditions for services provided in any contract or agreement incorporating this Master Contract by reference including all attachments, forms and exhibits, which constitute the contract document.

The Contractor agrees to provide the services specified in the CCE, HCE, LSP, and ADI contracts or agreements incorporating this Master Contract during the period this contract is in effect.

The Contractor agrees that this Master Contract covers all services provided by the Contractor under contracts or agreements with the Alliance which incorporate this Master Contract by reference.

2. Incorporation of Documents within the Contract or Agreement:

All contracts or agreements including attachments, proposal(s), solicitation(s), state plan(s), grant agreements, relevant Department of Elder Affairs handbooks, manuals or desk books executed between the Contractor and the Alliance shall incorporate this Master Contract by reference and be subject to the conditions set forth in this Master Contract for the duration of the contract period(s). Any and all contracts or agreements executed between the Contractor and the Alliance during the effective period of this Master Contract will incorporate this Master Contract by reference and shall be governed in accordance with the applicable laws, statutes, and other conditions set for in this Master Contract.

Incorporation of Reference Memoranda: In accordance with Chapter 287 F.S., amended, and Department of Financial Services' Chief Financial Officer Memoranda, the following memoranda are hereby incorporated by reference:

(1) CFO Memo No. 02: Release date, October 3, 2012; (2) CFO Memo No. 06: Release date, June 27, 2012; (3) CFO Memo No. 01: Release date, July 26, 2012; and (4) CFO Memo No. 04: Release date, June 30, 2006

3. Term of Master Contract:

This Master Contract will become binding at twelve (12:00) A.M., Eastern Standard Time on July 1, 2017 or on the date the Master 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, 2023.

4. Compliance with Federal Law:

4.1 If any contract and agreement contains federal funds this section shall apply.

4.1.1 The Contractor shall comply with the provisions of 2 CFR Part 200 and/or 45 CFR Part 92, and other applicable regulations.

4.1.2 If the contract and agreement contains federal funds and is over $100,000.00, the Contractor shall comply with all applicable standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s. 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable Environmental Protection Agency regulations 40 CFR Subchapter B. The Contractor shall report any violations of the above to the Alliance.

4.1.3 The Contractor, or agent acting for the Contractor, may not use any federal funds received in connection with any contract

and agreement to influence legislation or appropriations pending before the Congress or any State Legislature. If any contract or agreement contains federal funding in excess of $100,000.00, the Contractor must, prior to contract execution, complete the Certification Regarding Lobbying form, ATTACHMENT I. All disclosure forms as required by the Certification Regarding Lobbying form must be completed and returned to the Contract Manager prior to payment under any contract or agreement.

4.1.4 In accordance with Appendix A 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 regulation 41 CFR Part 60 and 45 CFR Part 92, if applicable.

APPENDIX Ia

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4.1.5 A contract or agreement award with an amount expected to equal or exceed $25,000.00 and certain other contract or

agreement awards will not be made to parties listed on the government-wide Excluded Parties List System, in accordance with the OMB guidelines at 2 CFR 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 any contract or agreement. The Contractor shall complete and sign ATTACHMENT IV prior to the execution of this Master Contract.

4.2 The Contractor shall not employ an unauthorized alien. The Alliance 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 violations will be cause for unilateral cancellation of this Master Contract and any/all contracts or agreements by the Alliance.

4.3 If the Contractor is a non-profit contractor 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 Alliance in writing within thirty (30) days of receiving the IRS notice of revocation.

4.4 The Contractor shall comply with Title 2 CFR Part 175 regarding Trafficking in Persons.

4.5 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.

4.6 To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number 11-116, the 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 or agreement term. The 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 any contract or agreement term. Contractors meeting the terms and conditions of the E-Verify System are deemed to be in compliance with this provision. The Contractor shall complete and sign ATTACHMENT J prior to the execution of this Master Contract.

5. Compliance with State Law:

5.1 This Master Contract and all contracts or agreements incorporating this Master Contract by reference is executed and entered into in the State of Florida, and shall be construed, performed and enforced in all respects in accordance with the Florida law, including Florida provisions for conflict of laws.

5.2 The Contractor shall comply with requirements of s. 287.058, F.S. as amended.

5.2.1 The Contractor shall provide units of deliverables, including various client services, and in some instances may include

reports, findings, and drafts, as specified in this Master Contract and all contracts or agreement incorporating this Master Contract, which the Contract Manager must receive and accept in writing prior to payment in accordance with s. 215.971, F.S. (1) and (2).

5.2.2 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.

5.2.3 If itemized payment for travel expenses is permitted in any contract or agreement incorporating this Master Agreement by reference, the Contractor shall submit bills for any travel expenses in accordance with s. 112.061, F.S., or at such lower rates as may be provided in this Master Contract and any contract or agreement incorporating this Master Contract by reference.

5.2.4 The Contractor shall allow public access to all documents, papers, letters, or other public records as defined in subsection

119.011(12), F.S., made or received by the Contractor in conjunction with any contract or agreement incorporating this Master 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 or agreement for which the Alliance may unilaterally terminate the Master Contract and any contract or agreement incorporating the Master Contract.

5.3 If clients are to be transported under any contract or agreement incorporating this Master Contract by reference, the Contractor

shall comply with the provisions of Chapter 427, F.S., and Rule Chapter 41-2, F.A.C.

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5.4 Subcontractors who are on the discriminatory vendor list may not transact business with any public entity, in accordance with the provisions of s. 287.134, F.S.

5.5 The Contractor shall comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the expenditure of

contract funds for the purpose of lobbying the legislature, judicial branch or a state agency.

5.6 In accordance with s. 287.135 F.S., any Contractor on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List (Lists), created pursuant to s. 215.473 F.S., is ineligible to enter into or renew a contract or agreement with the Alliance for goods or services of $1 million or more. Pursuant to s. 287.135 F.S., the Alliance may terminate this Master Contract and any contract or agreement incorporating this Master Contract by reference if the Contractor is found to have submitted a false certification of its status on the Lists or has been placed on the Lists. Further, the Contractor is subject to civil penalties, attorney's fees and costs and any costs for investigations that led to the finding of false certification. If any contract or agreement incorporating this Master Contract contains $1 million or more, the Contractor shall complete and sign ATTACHMENT H, Certification Regarding Scrutinized Companies Lists, prior to the execution of this Master Contract.

6. Background Screening:

6.1 The Contractor shall ensure that the requirements of s. 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 s. 430.0402(2)-(3), F.S. The Contractor must also comply with any applicable rules promulgated by the Department and the Agency for Health Care Administration regarding implementation of s. 430.0402 and Chapter 435, F.S.

6.2 Further information concerning the procedures for background screening is found at

http://elderaffairs.state.fl.us/doea/backgrotmdscreening.php.

6.3 Background Screening Affidavit of Compliance - To demonstrate compliance with section 6 of this Master Contract, the Contractor shall submit ATTACHMENT G, Background Screening Affidavit of Compliance annually, by January 15th.

7. Grievance and Complaint Procedures:

7.1 Grievance Procedures: The Contractor shall comply with and ensure subcontractor compliance with the Minimum Guideline for Recipient Grievance Procedures, Appendix D of the Department of Elder Affairs Programs and Services Handbook, to address complaints regarding the termination, suspension or reduction of services, as required for receipt of funds.

7.2 Complaint Procedures:

The Contractor shall develop and implement complaint procedures and ensure that Subcontractors develop and implement complaint procedures to process and resolve client dissatisfaction with services. Complaint procedures shall address the quality and timeliness of services, provider and direct service worker complaints, or any other advice related to complaints other than termination, suspension or reduction in services that require the grievance process as described in Appendix D of the Department of Elder Affairs Programs and Services Handbook. The complaint procedures shall include notification to all clients of the complaint procedure and include tracking the date, nature of the complaint and the determination of the complaint.

8. Public Records and Retention:

8.1 If, under any contract or agreement incorporating this Master Contract by reference, the Contractor is providing services and is acting on behalf of the Alliance and the Department as provided under section 119.011(2), Florida Statutes, the Contractor, subject to the terms of section 287.058(l)(c), Florida Statutes, and any other applicable legal and equitable remedies, shall:

a) Keep and maintain public records that ordinarily and necessarily would be required by the public agency in order to

perform the services. b) Provide the public with access to public records on the same terms and conditions that the

Alliance would provide the records and at a cost that does not exceed the cost provided in Chapter 119, Florida Statutes, or as otherwise provided by law.

c) Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law.

d) Meet all requirements for retaining public records and transfer, at no cost, to the Alliance all public records in possession of the Contractor upon termination or expiration of any contract or agreement incorporating this Master Contract by reference and destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. All records stored electronically must be provided to the Alliance in a format that is compatible with the information technology systems of the Alliance.

8.2 The Alliance may unilaterally cancel this Master Contract, and any contract or agreement incorporating this Master Contract

http://elderaffairs.state.fl.us/doea/backgrotmdscreening.php.

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by reference, notwithstanding any other provisions of this Master Contract, for refusal by the Contractor to comply with Section 8 of this Master Contract by not allowing public access to all documents, papers, letters, or other material made or received by the Contractor in conjunction with the contract or agreement incorporating this Master Contract by reference, unless the records are exempt from Section 24(a) of Article I of the State Constitution and Section 119.07(1), Florida Statutes.

9. Audits, Inspections, Investigations:

9.1 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 Alliance under any contract or agreement incorporating this Master Contract by reference. Contractor(s) shall adequately safeguard all such assets and assure they are used solely for the purposes authorized under any contract or agreement which incorporates this Master Contract by reference. Whenever appropriate, financial information should be related to performance and unit cost data.

9.2 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 any contract or agreement which incorporates this Master Contract by reference for a period of six (6) years after completion of the contract or agreement incorporating this Master Contract by reference or longer when required by law. In the event an audit is required for any contract or agreement incorporating this Master Contract by reference, 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 any contract or agreement incorporating this Master Contract by reference, at no additional cost to the Alliance.

9.3 Upon demand, at no additional cost to the Alliance, the Contractor shall facilitate the duplication and transfer of any records or

documents during the required retention period.

9.4 The Contractor shall assure 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 Alliance.

9.5 At all reasonable times for as long as records are maintained, persons duly authorized by the Alliance, the Department and

Federal Auditors, pursuant to 2 CFR 200.336, will be allowed full access to and the right to examine any of the Contractor's contracts or agreements, related records and documents pertinent to any contract or agreement, regardless of the form in which it is kept.

9.6 The Contractor shall provide a financial and compliance audit to the Alliance as specified in this Master Contract and in

ATTACHMENT II and ensure that all related third-party transactions are disclosed to the auditor.

9.7 The Contractor shall comply and cooperate immediately with any inspections, reviews, investigations, or audits deemed necessary by the office of the Inspector General pursuant to s. 20.055, F.S.

10. Nondiscrimination-Civil Rights Compliance:

10.1 The Contractor shall execute assurances in ATTACHMENT V that it will not discriminate against any person in the provision of services or benefits under any contract or agreement incorporating this Master Contract by reference 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, Subgrantees, or others with whom it arranges to provide services or benefits in connection with any of its programs and activities are not discriminating against clients or employees because of age, race, religion, color, disability, national origin, marital status or sex. The Contractor shall complete and sign ATTACHMENT V prior to the execution of the Master Contract.

10.2 During the term of any contract or agreement incorporating this Master Contract by reference, the Contractor shall

complete and retain on file a timely, complete and accurate Civil Rights Compliance Checklist (ATTACHMENT B).

10.3 The Contractor shall establish procedures pursuant to federal law to handle complaints of discrimination involving services or benefits through any contract or agreement incorporating this Master Contract by reference. These procedures will include notifying clients, employees, and participants of the right to file a complaint with the appropriate federal or state entity.

10.4 If any contract or agreement incorporating this Master Contract by reference 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 above statutes, regulations, guidelines, and standards. In the event of failure to comply, the Contractor understands that the Alliance 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.

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11. Monitoring by the Alliance:

11.1 The Contractor shall permit persons duly authorized by the Alliance to inspect and copy any records, papers, documents, facilities, goods and services of the Contractor which are relevant to any contract or agreement which incorporate this Master Contract by reference, and to interview any clients, employees and Subcontractor employees of the Contractor to assure the Alliance of the satisfactory performance of the terms and conditions of any contract or agreement which incorporate this Master Contract by reference. Following such review, the Alliance 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 Contract Manager.

11.2 The Alliance will perform administrative, fiscal, and programmatic monitoring of the provider to ensure contractual compliance,

fiscal accountability, programmatic performance, and compliance with applicable state and federal laws and regulations. The contractor will supply progress reports, including data reporting requirements as specified by the Alliance or the Department to be used for monitoring progress or performance of the contractual services. Examples of review criteria are surplus/deficit reports, independent audits, internal controls, reimbursement requests, subcontractor monitoring, targeting, program eligibility, outcome measures, service provision to clients, data integrity, client satisfaction, and client file reviews.

11.3 Service Cost Reports –The Contractor shall submit Service Cost Reports to the Alliance annually, but no later than ninety (90)

calendar days after the contract year ends. The Service Cost Reports shall reflect actual costs of providing each service by program for the preceding contract year. If the Contractor desires to renegotiate its reimbursement rates, the Contractor shall make a request in writing to the Alliance in accordance with the Alliance’s approved Reimbursement Rate Review Policy, which is incorporated by reference.

12. Provision of Services:

The Contractor shall provide services in the manner to be described in subsequent contracts or agreements incorporating this Master Contract by reference.

13. Coordinated Monitoring with Other Agencies:

If the Contractor receives funding from one or more of the State of Florida other human service agencies, in addition to the Department of Elder Affairs, then a joint monitoring visit including such other agencies may be scheduled. For the purposes of any contract or agreement incorporating this Master Contract by reference, and pursuant to s. 287.0575, F.S. as amended, Florida's human service agencies shall include the Department of Children and Families, the Department of Health, the Agency for Persons with Disabilities, the Department of Veterans Affairs, and the Department of Elder Affairs. Upon notification and the subsequent scheduling of such a visit by the designated agency's lead administrative coordinator, the Contractor shall comply and cooperate with all monitors, inspectors, or investigators.

14. Indemnification:

The Contractor shall indemnify, save, defend, and hold harmless the Department, the Alliance and its officers, agents and employees from any and all claims, demands, actions, causes of action of whatever nature or character, arising out of or by reason of the execution of this Master Contract and any contract or agreement incorporating this Master Contract by reference, or performance of the services provided for herein. It is understood and agreed that the Contractor is not required to indemnify the Department or the Alliance for claims, demands, actions or causes of action arising solely out of the Department’s or Alliance's negligence.

15. Insurance and Bonding:

15.1 Contractor must provide continuous adequate liability insurance and worker’s compensation insurance coverage, during the existence of any contract or agreement incorporating this Master Contract by reference, and during any renewal(s) or extension(s) of it. The Alliance shall be included as an additional insured on the provider’s liability insurance policy or policies and a copy of the Certificate of Insurance shall be provided annually or when any changes occur. The Contractor accepts full responsibility for identifying and determining the type(s) and extent of liability insurance necessary to provide reasonable financial protections for the Contractor and the clients to be served under any contract or agreement incorporating this Master Contract. Upon execution of this Master Contract, the Contractor shall furnish the Alliance written verification supporting both the determination and existence of such insurance coverage. The limits of coverage under each policy maintained by the Contractor do not limit the Contractor's liability and obligations under this contract or agreement incorporating this Master Contract by reference. The Contractor shall ensure that the Alliance has the most current written verification of insurance coverage throughout the term of any contract or agreement incorporating this Master Contract by reference. Such coverage may be provided by a self-insurance program established and operating under the laws of the State of Florida. The Department and the Alliance reserve the right to require additional insurance as specified by any contract or agreement incorporating this Master Contract by reference.

15.2 Throughout the term of any contract or agreement incorporating this Master Contract by reference , the Contractor must 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 contracts or agreements

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incorporating this Master 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.

16. Confidentiality of lnformation: The Contractor shall not use or disclose any information concerning a recipient of services under any contract or agreement 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.

17. 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).

18. Incident Reporting:

18.1 The Contractor shall notify the Alliance immediately but no later than forty-eight (48) hours from the Contractor's awareness or discovery of conditions that may materially affect the Contractor or Subcontractor's ability to perform the services required to be performed under any contract or agreement which incorporate this Master Contract by reference. Such notice shall be made orally to the Contract Manager (by telephone) with an email to immediately follow.

18.2 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.

19. New Contract(s) Reporting:

The Contractor shall notify the Alliance within ten (10) days of entering into a new contract or agreement with any of the five (5) state human service agencies. The notification shall include the following information: (I) contracting state agency; (2) contract name and number; (3) contract or agreement start and end dates; (4) contract or agreement amount; (5) contract or agreement description and commodity or service; and (6) Contract Manager Name and Number. In complying with this provision, and pursuant to s. 287.0575, F.S. as amended, the Contractor shall complete and provide the information in ATTACHMENT D.

20. Bankruptcy Notification: During the term of any contract or agreement incorporating this Master Contract by reference, the Contractor shall immediately notify the Alliance if the Contractor, its Assignees, Subcontractor's or Affiliates files a claim for bankruptcy. Within ten (I0) days after notification, the Contractor must also provide the following information to the Alliance: (I) 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., Northern District of Florida, Tallahassee Division); and (4) the name, address, and telephone number of the bankruptcy attorney.

21. Sponsorship and Publicity:

21.1 As required by s. 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 any contract or agreement incorporating this Master Contract by reference, it shall, in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by [Contractor's name], The Alliance for Aging, Inc., and the State of Florida, Department of Elder Affairs." If the sponsorship reference is in written material, the words “Alliance for Aging, Inc.” and "State of Florida, Department of Elder Affairs" shall appear in at least the same size letters or type as the name of the organization.

21.2 The Contractor shall not use the words “Alliance for Aging, Inc.” or "The State of Florida, Department of Elder Affairs" to

indicate sponsorship of a program otherwise financed, unless specific authorization has been obtained by the Alliance prior to use.

22. Assignments:

22.1 The Contractor shall not assign the rights and responsibilities under any contract or agreement incorporating this Master Contract by reference without the prior written approval of the Alliance, which shall not be unreasonably withheld. Any sublicense, assignment, or transfer otherwise occurring without prior written approval of the Alliance will constitute a material breach of the contract or agreement.

22.2 All contracts or agreements incorporating this Master Contract by reference shall remain binding upon the successors in

interest of either the Contractor or the Alliance.

23. Subcontracts: 23.1 The Contractor is responsible for all work performed and for all commodities produced pursuant to any contract or agreement

incorporating this Master Contract by reference, 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 Alliance deems necessary. The Contractor further agrees that the Alliance will not be liable to the Subcontractor in any way or for any reason.

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The Contractor, at its expense, shall defend the Alliance against any such claims.

23.2 The Contractor shall promptly pay any Subcontractors upon receipt of payment from the Alliance or other state agency. Failure to make payments to any Subcontractor in accordance with s. 287.0585, F.S., unless otherwise stated in the contract or agreement incorporating this Master Contract by reference between the Contractor and Subcontractor, will result in a penalty as provided by statute.

23.3 The Contractor shall programmatically monitor, at least once per year, each of its Subcontractors, Subrecipients, Vendors,

and/or Consultants. The Contractor shall perform programmatic monitoring to ensure contractual compliance, and programmatic performance and compliance with applicable state and federal laws and regulations. The Contractor shall monitor to ensure that time schedules are met; the budget and scope of work are accomplished within the specified time periods, and other performance goals. The Contractor shall also perform fiscal and administrative monitoring for all subcontractors to ensure fiscal accountability.

23.4 The Contractor shall have a procurement policy that assures maximum free and open competition. Such procurement policy

must conform, as applicable, with Federal and State contracting and procurement regulations, as set forth in Title 2 Code of Federal Regulations (CFR) Part 200, Ch. 287.057 Florida Statutes (F.S.), U.S. Office of Management and Budget (OMB) Circular 110, Florida Department of Management Services (DMS) Rule 60A-1, Florida Administrative Code, and with the Department’s Program and Services Handbook.

23.5 The Contractor shall dedicate the staff necessary to meet the obligations of this contract and ensure that subcontractors dedicate adequate staff, accordingly. The provider shall ensure that staff responsible for performing any duties or functions within this contract has the qualifications as specified in the Department’s Programs and Services Handbook.

24. Funding Obligations:

24.1 The Alliance acknowledges its obligation to pay the Contractor for the performance of the Contractor's duties and responsibilities set forth in any contract or agreement incorporating this Master Contract by reference.

24.2 The Alliance shall not be liable to the Contractor for costs incurred or performance rendered unless such costs and

performances are in accordance with the terms and conditions of any contract or agreement executed between the parties, which incorporates this Master Contract by reference, including but not limited to terms, governing the Contractor's promised performance and unit rates and/or reimbursement capitations specified.

24.3 The Alliance shall not be liable to the Contractor for any expenditures which are not allowable costs as defined in 2 CFR Part

200 and 45 CFR Part 92, as amended, or which expenditures have not been made in accordance with all applicable state and federal rules.

24.4 The Alliance shall not be liable to the Contractor for expenditures made in violation of regulations promulgated under the

Older Americans Act, as amended, or in violation of applicable state and federal laws, rules, m· provisions of any contract or agreement incorporating this Master Contract by reference.

25. Independent Capacity of Contractor:

It is the intent and understanding of the Parties that the Contractor, or any of its Subcontractors, are independent Contractor's and are not employees of the Alliance and shall not hold themselves out as employees or agents of the Alliance without specific authorization from the Alliance. It is the further intent and understanding of the Parties that the Alliance 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 clain1s 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. Payment:

26.1 Payments shall be made to the Contractor as services are rendered and invoiced by the Contractor. The Alliance will have final approval of the invoice for payment, and will approve the invoice for payment only if the Provider has met all terms and conditions of the contract, incorporating this Master Contract by reference, unless the bid specifications, purchase order, or the contract specify otherwise. The approved invoice will be submitted to the Alliance’s fiscal department for budgetary approval and processing.

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The Contractor shall maintain detailed documentation to support each item on the itemized invoice or payment request for cost reimbursed expenses, fixed rate or deliverables, for contracts incorporating this Master Contract by reference, including paid sub-contractor invoices, and will be produced upon request by the Alliance. The Contractor shall only request reimbursement for allowable expenses as defined in the laws and guiding circulars cited in this Master Contract sections 4 and 5, in the Reference Guide for State Expenditures, and any other laws or regulations, as applicable.

26.3 The Contractor and Subcontractors shall provide units of deliverables, including reports, findings, and drafts as specified in

the contracts and attachments which incorporate this Master Contract by reference to be received and accepted by the Alliance prior to payment.

27. Return of Funds:

The Contractor shall return to the Alliance any overpayments due to unearned funds or funds disallowed and any interest attributable to such funds pursuant to the terms and conditions of any contract or agreement incorporating this Master Contract by reference that were disbursed to the Contractor by the Alliance. 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 Alliance. In the event that the Alliance first discovers an overpayment has been made, the 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 s. 55.03, F.S., after Alliance 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 any contract or agreement incorporating this Master Contract by reference. 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 ATTACHMENT III prior to the execution of the Master Contract.

29. Computer Use and Social Media Policy:.

The Department of Elder Affairs has implemented a new Social Media Policy, in addition to its Computer Use Policy, which applies to all employees, contracted employees, consultants, OPS and volunteers, including all personnel affiliated with third parties, such as, but not limited to, the Alliance and vendors. Any entity that uses the Department’s computer resource systems must comply with the Department's policy regarding social media. Social Media includes, but is not limited to blogs, podcasts, discussion forums, Wikis, RSS feeds, video sharing, social networks like MySpace, Facebook and Twitter, as well as content sharing networks such as flickr and YouTube. This policy is available on the Department's website at: http://elderaffairs.state.fl.us/doea/financial.php

30. Conflict of lnterest:

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 selection, or in the award of an agreement supported by state or federal funds if a conflict of interest, real or apparent, would be involved. Such a conflict would arise when: (a) the employee, officer or agent; (b) any member of his/her immediate family; (c) his or her partner; or (d) an organization which employs, or is about to employ, any of the above, has a financial or other interest in the firm selected for award. The Contractor or Subcontractors 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 Contractors board members and management must disclose to the Alliance 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 any contract incorporating this Master Contract by reference. The Contractors employees and Subcontractors must make the same disclosures described above to the Contractors Board of Directors. Compliance with this provision will be monitored.

31. Public Entity Crime:

Pursuant to s. 287.133, F.S., a person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a bid, proposal, or reply on a contract or agreement to provide any goods or services to a public entity; may

26.2 The Contractor shall maintain documentation to support payment requests which shall be available to the Department of Financial Services, the Department, or the Alliance upon request. Invoices must be submitted in sufficient detail for a proper pre audit and post audit thereof. The Contractor shall comply with all state and federal laws governing payments to be made that are applicable to the contracts incorporating this Master Contract by reference. including, but not limited to the following: section 216.181(16)(a) & (b), F. S., regarding advances; (b) Rule 69I-40.103 F.A.C. pertaining to Restriction of Expenditures from state funds; and (c) the Invoice Requirements of the Reference Guide for State Expenditures from the Department of Financial Services at _http://www.myfloridacfo.com/aadir/reference_guide/reference_guide_for_state_expenditures.pdf.

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not submit a bid, proposal, or reply on a contract or agreement 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 or agreement with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in s. 287.017(2), F.S., for Category Two for a period of 36 months following the date of being placed on the convicted vendor list. If the Contractor or any of its officers or directors is convicted of a public entity crime during the period of this agreement, the provider shall notify the Alliance immediately. Non-compliance with this statute shall constitute a breach of this agreement.

32. Purchasing:

32.1 The Contractor may purchase articles which are the subject of or are required to carry out any contract or agreement from Prison Rehabilitative Industries and Diversified Enterprises, Inc., (PRIDE) identified under Chapter 946, F.S., in the same manner and under the procedures set forth in subsections 946.515(2) and (4), F.S. For purposes of any contract or agreement incorporating this Master Contract by reference, the Contractor shall be deemed to be substituted for the Alliance 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.

32.2 The Contractor may procure any recycled products or materials, which are the subject of or are required to carry any contract

or agreement incorporating this Master Contract by reference, in accordance with the provisions of s. 403.7065, F.S.

32.3 The Contractor may purchase articles that are the subject of, or required to carry out, any contract or agreement from a nonprofit agency for the Blind or for the Severely Handicapped that is qualified pursuant to Chapter 413, F.S., in the same manner and under the same procedures set forth in s. 413.036(1) and (2), F .S. For purposes of any contract or agreement incorporating this Master Contract by reference, the Contractor shall be deemed to be substituted for the Alliance 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:

33.1 If any contract or agreement incorporating this Master Contract by reference is awarded state funding and if any discovery, invention or copyrightable material is developed, produced or for which ownership was purchased in the course of or as a result of work or services performed under any contract or agreement incorporating this Master Contract by reference, the Contractor shall refer the discovery, invention or material to the Alliance to be referred to the Department. Any and all patent rights or copyrights accruing under any contract or agreement incorporating this Master Contract by reference are hereby reserved to the State of Florida in accordance with Chapter 286, F.S. Pursuant to s. 287.0571 (5)(k)1 and 2 as amended, the only exceptions to this provision shall be those that are clearly expressed and reasonably valued in any contract or agreement incorporating this Master Contract by reference.

33.2 If the primary purpose of any contract or agreement incorporating this Master Contract by reference 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 33.

33.3 If any contract or agreement incorporating this Master Contract by reference is awarded solely federal funding, the terms and

conditions are governed by 2 CFR Part 200.

34. Emergency Preparedness and Continuity of Operations: The Contractor shall, within thirty (30) calendar days of the execution of this contract, submit to the Contract Manager verification of an emergency preparedness plan. In the event of an emergency, the Contractor shall notify the Alliance of emergency provisions.

In the event a situation results in a cessation of services by a sub-contractor, the Contractor shall retain responsibility for performance under any contract incorporating this Master Contract by reference and must follow procedures to ensure continuity of operations without interruption.

35. Equipment: 35.1 Equipment means: (a) an article of nonexpendable, tangible personal property having a useful life of more than one year and an

acquisition cost which equals or exceeds the lesser of the capitalization level established by the organization for the financial statement purposes, or $5,000.00 [for federal funds], 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 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; and, (b) a procedure for

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conducting a physical inventory of equipment at least once every two years. (c) a control system to insure adequate safeguards to prevent loss, damage, or theft of the equipment; and (d) maintenance procedures to keep the equipment in good condition. The property records must be maintained on file and shall be provided to the Alliance upon request. The Contractor shall promptly· investigate, fully document and notify the Contract Manager of any loss, damage, or theft of equipment. The Contractor shall provide the results of the investigation to the Contract Manager.

35.3 The Contractor's property management standards for equipment acquired with Federal funds and federally- owned equipment

shall include accurately maintained equipment records with the following information:

(1) A description of the equipment; (2) Manufacturer's serial number, model number, federal stock number, national stock number, or other identification number; (3) Source of the equipment, including the award number; (4) Whether title vests in the Contractor or the federal government; (5) Acquisition date (or date received, if the equipment was furnished by the federal government) and cost; (6) Information from which one can calculate the percentage of federal participation in the cost of the equipment (not

applicable to equipment furnished by the federal government); (7) Location and condition of the equipment and the date the information was reported; (8) Unit acquisition cost; and (9) Ultimate disposition data, including date of disposal and sales price or the method used to determine current fair market

value where a Contractor compensates the federal awarding agency for its share.

35.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased with state funds with an acquisition cost over $1,000.00 must be prior approved by the Alliance in writing and is part of the cost of carrying out the activities and functions of the grant awards and Title (ownership) will vest in the Contractor, subject to the conditions of 2 CFR Part 200 Administrative Requirements (formerly OMB Circular A-110), Subpart C, paragraph 34. Equipment purchased under these thresholds is considered supplies and is not subject to property standards. Equipment purchased with funds identified in the budget attachments to agreements covered by any contract or agreement incorporating this Master Contract by reference, 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-1.0017, F. A. C. or Title 2 CFR Part 200.

35.5 The Contractor shall not dispose of any equipment or materials provided by the Alliance, or purchased with funds provided

through any contract or agreement incorporating this Master Contract without first obtaining the approval of the Contract Manager. When disposing of property or equipment the Contractor must submit a written request for disposition instructions to the respective Contract Manager. The request should include a brief description of the property, purchase price, funding source, percentage of state or federal participation, acquisition date and condition of the property. The request should also indicate the Contractors proposed disposition (i.e., transfer or donation to another agency that administers federal programs, offer the items for sale, destroy the items, etc.).

35.6 The Contract Manager will issue disposition instructions. If disposition instructions are not received within 120 days of the

written request for disposition, the Contractor is authorized to proceed as directed in 2 CFR Part 200 Administrative Requirements (formerly OMB Circular A-110).

35.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto, but excludes movable

machinery and equipment. Real property may not be purchased with state or federal funds through agreements covered under any contract or agreement incorporating this Master Contract without the prior approval of the Alliance. Real property purchases from Older Americans Act funds are subject to the provisions of Title 42, Chapter 35, Subchapter III, Part A., Sec. 3030b United States Code (USC). Real property purchases from state 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 Alliance's procedures and standards when purchasing Information Technology Resources (ITR) as part of any contract or agreement incorporating this Master 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, maintenm1ce, training, personnel and facilities. The completed ITR worksheet shall be maintained in the LAN administrator's file and must be provided to the Alliance upon request. The Contractor has the responsibility to require any Subcontractors to comply with the Alliance'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/adoc/F7740_PUR1000.pdf

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In the event of any conflict between the PUR 1000 Form and any terms or conditions of any contract or agreement terms or conditions the 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 I 000 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 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 any contract or agreement incorporating this Master Contract by reference shall be decided by the Alliance, who shall reduce the decision to writing and serve a copy on the Contractor.

39. Financial Consequences of Non-Performance:

39.1 If the Contractor fails to meet the minimum level of service or performance identified in any contract incorporating this Master Contract by reference, or that is customary for the industry, then the Alliance must apply financial consequences commensurate with the deficiency. Financial consequences may include, but are not limited to, contract or agreement suspension, refusing payment, withholding payments until the deficiency is cured, tendering only partial payments, and/or cancellation of any contract or agreement and reacquiring services from an alternate source.

39.2 The Contractor will not be charged with financial consequences, when a failure to perform arises out of causes that were the

responsibility of the Alliance.

40. No Waiver of Sovereign Immunity: Nothing contained in any contract incorporating this Master Contract by reference 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 any contract incorporating this Master Contract by reference, the venue of such legal recourse will be Miami-Dade County, Florida.

42. Entire Contract:

This Master Contract and/or any contract incorporating this Master Contract by reference, contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations shall be valid or binding upon the Alliance or the Contractor unless expressly contained herein or by a written subsequent contract and/or amendment to this Master 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 Alliance’s performance and obligation to pay under this contract is contingent upon an annual appropriation by the Legislature to the Department and a corresponding allocation under contract from the Department to the Alliance.

46. Addition/Deletion: The Parties agree that the Alliance reserves the right to add or to delete any of the services required under any contract incorporating this Master Contract by reference when deemed to be in the Alliance and/or 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 Alliance to exercise or enforce any of its rights under this Master Contract and any contract incorporating this Master Contract by reference will not constitute or be deemed a waiver of the Alliance'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

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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 any contract incorporating this Master Contract by reference, to immediate, unilateral cancellation at the discretion of the Alliance.

49. Final Invoice:

The Contractor shall submit the final invoice for payment to the Alliance as specified in any contract incorporating this Master Contract by reference. If the Contractor fails to submit final request for payment as specified in any contract, then all rights to payment may be forfeited and the Alliance may not honor any requests submitted. Any payment due under the terms of any contract incorporating this Master Contract by reference may be withheld until all reports due from the Contractor and necessary adjustments thereto have been approved by the Alliance.

50. Modification:

Modifications of the provisions of any contract and this Master Contract shall be valid only when they have been reduced to writing and duly signed by both parties.

51. Suspension of Work:

The Alliance may suspend any or all activities under this Master Contract and any Contract incorporating this Master Contract by reference, at any time, when it is in the best interests of the Alliance or the Department to do so. The Alliance 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. Within ninety days, or any longer period agreed to by the Contractor, the Alliance shall either (I) issue a notice authorizing resumption of work, at which time activity shall resume, or (2) terminate the Contract. Suspension of work shall not entitle the Contractor to any additional compensation.

52. Termination:

52.1 Termination for Convenience. This contract may be terminated by either party without cause upon no less than thirty (30) calendar days’ notice in writing to the other party unless a sooner time is mutually agreed upon in writing. Said notice shall be delivered by U.S. Postal Service with verification of delivery or any expedited delivery service that provides verification of delivery or by hand delivery to the Contract Manager or the representative of the Contractor responsible for administration of the contract. The Contractor shall not furnish any product after it receives the notice of termination, except as necessary to complete the continued portion of the contract, if any. The Contractor shall not be entitled to recover any cancellation charges or lost profits.

52.2 Termination for Cause. The Alliance may terminate the Master Contract and any contract incorporating this Master Contract if

the Contractor fails to (I) 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 Master Contract and any contract incorporating this Master Contract by reference, (4) abide by any statutory, regulatory, or licensing requirement, or (5) in the event funds for payment become unavailable for any contract incorporating this Master Contract by reference. The Alliance will be the final authority as to the availability and adequacy of funds. In the event of termination of any contract incorporating this Master Contract by reference, the Provider will be compensated for any work satisfactorily completed prior to the date of termination. 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 or services 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 Alliance. The rights and remedies of the Alliance in this clause are in addition to any other rights and remedies provided by law or under the Contract.

52.3 Upon expiration or termination of this Master Contract and any contract or agreement incorporating this Master Contract by

reference the Contractor and Subcontractors shall transfer all public records in its possession to the Alliance and destroy any duplicate public records that are exempt or confidential and exempt from public records, disclosure requirements at no cost to the Alliance. All electronically stored records shall be provided to the Alliance in a format that is compatible with the Alliance's information technology system(s).

53. Successors

This contract shall remain binding upon the successors in interest of either the Alliance or the provider, subject to the assignment provisions in Section 22 above.

54. Electronic Records and Signature:

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54.1 The Alliance 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 Master Contract and any contract(s) or agreement(s) which incorporate this Master Contract by reference. 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, s. 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 section 28, 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 any contract or agreement incorporating this Master Contract by reference.

54.2 The Alliance's authorization pursuant to this section does not authorize electronic transactions between the Contractor and the

Alliance. The Contractor is authorized to conduct electronic transactions with the Alliance only upon further written consent by the Alliance.

54.3 Upon request by the Alliance and/or the Department, the Contractor shall provide the Alliance and/or the Department with

non-electronic (paper) copies of records. Non-electronic (paper) copies provided to the Alliance and/or the Department of any document that was originally in electronic form with an electronic signature must indicate the person and the person's capacity who electronically signed the document on any non-electronic copy of the document.

55. Special Provisions:

The Contractor agrees to the following provisions:

55.1 Investigation of Criminal Allegations: Any report that implies criminal intent on the part of the Contractor or any Sub-Contractors and referred to a governmental or investigatory agency must be sent to the Alliance. 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 Alliance. A copy of all documents, reports, notes or other written material concerning the investigation, whether in the possession of the Contractor or Sub-Contractors, must be sent to the Alliance’s contract manager with a summary of the investigation and allegations.

55.2 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 organizations carrying out federal service programs administered by the Corporation for National and Community Service), in community service settings.

55.3 Enforcement:

55.3.1 The Alliance may, without taking any intermediate measures available to it against the Contractor, rescind the contract, if the Alliance finds that:

55.3.2 An intentional or negligent act of the Contractor has materially affected the health, welfare, or safety of clients

served pursuant to any contract or agreement incorporating this Master Contract by reference, or substantially and negatively affected the operation of services covered under any contract or agreement;

55.3.3 The Contractor lacks financial stability sufficient to meet contractual obligations or that contractual funds have been

misappropriated;

55.3.4 The Contractor has committed multiple or repeated violations of legal and regulatory standards, regardless of whether such laws or regulations are enforced by the Alliance, or the Contractor has committed or repeated violations of the Alliance or the Department standards;

55.3.5 The Contractor has failed to continue the provision or expansion of services after the declaration of a state of

emergency; and/or

54.3.6 The Contractor has failed to adhere to the terms of any contract or agreement incorporating this Master Contract by reference.

54.3.7 In the alternative, the Alliance may, at its sole discretion, take immediate 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.

54.4 In making any determination under this provision the Alliance may rely upon the findings of another state or federal agency,

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or other regulatory body. Any claims for damages for breach of any contract incorporating this Master Contract by reference are exempt from administrative proceedings and shall be brought before the appropriate entity in the venue of Miami-Dade County.

54.5 Use of Service Dollars: The Contractor will optimize the use of contract funds by serving the maximum possible number of individuals with the services allowed by each contract incorporating this Master Contract by reference. The Contractor will spend all funds provided by this contract to provide such services.

54.6 Surplus/Deficit Report: The Contractor will submit a consolidated surplus/deficit report in a format provided by the Alliance to the Alliance's Contract

Manager in conjunction with the required monthly billing submission. This report is for all contracts or agreements incorporating this Master Contract by reference between the Contractor and the Alliance. The report will include the following: 54.6.1 The Contractor's detailed plan on how the surplus or deficit spending exceeding the 1% threshold will be resolved;

54.6.2 Number of clients currently on the APCL, that receive a priority ranking score of four (4) or five (5);

54.6.3 Number of clients currently on the APCL designated as Imminent Risk.

54.6.4 Number of clients served and ADRC client contacts,

In accordance with its surplus/deficit management policies, in order to maximize available funding and minimize the time that potential clients must wait for services, the Alliance in its sole discretion can reduce funding awards if the Contractor is not spending according to monthly plans and is projected to incur a surplus at the end of the year.

54.7 Training: The Contractor will attend all required trainings and meetings schedule by the Alliance.

56. All Terms and Conditions Included: This Master Contract and its Attachments, I - V, A, B, C, D, G, H and J and any exhibits referenced in said attachments, together with any documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There are no provisions, terms, conditions, or obligations other than those contained herein, and this Master 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 Master Contract to be executed by their undersigned officials as duly authorized.

ALLIANCE FOR AGING, INC. [CONTRACTOR NAME SIGNED BY: __________________________________ SIGNED BY: _______________________________ NAME: Max B. Rothman, JD, LL.M. NAME: ____________________________________ TITLE: President & CEO TITLE: ____________________________________ DATE: _______________________________________ DATE: ____________________________________

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ATTACHEMENT I CERTIFICATION REGARDING LOBBYING

CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND AGREEMENTS

The undersigned certifies, to the best of his or her knowledge and belief, that:

(1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any state or federal agency, a member of congress, an officer or employee of congress, an employee of a member of congress, or an officer or employee of the state legislator, in connection with the awarding of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement.

(2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence

an officer or employee of any agency, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.

(3) The undersigned shall require that the language of this certification be included in the award documents for all sub- awards at all tiers

(including subcontracts, sub-grants, and contracts under grants, loans and cooperative agreements) and that all Subcontractors shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000.00 and not more than $100,000.00 for each such failure.

______________________________________ ___________________________________ Signature Date ______________________________________ ___________________________________ Name if Authorized Individual Contract Number _______________________________________ Title _______________________________________ Name of Agency/Corporation

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ATTACHMENT II

ATTACHMENT II FINANCIAL AND COMPLIANCE AUDIT

The administration of resources awarded by the Alliance to the provider may be subject to audits and/or monitoring by the Alliance and/or the Department as described in this section. I. MONITORING In addition to reviews of audits conducted in accordance with OMB Circular A-133, as revised, and Section 215.97, F.S., (see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits by the Alliance and/or the Department staff, limited scope audits as defined by OMB Circular A-133, as revised, and/or other procedures. By entering into this agreement, the Contractor agrees to comply and cooperate with any monitoring procedures/processes deemed appropriate by the Alliance. In the event the Alliance and/or the Department determines that a limited scope audit of the Contractor is appropriate, the Contractor agrees to comply with any additional instructions provided by the A l l i a n c e a n d / o r t h e 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 All iance and/or the Department . AUDITS PART I: FEDERALLY FUNDED This part is applicable if the provider is a State or local government or a non-profit organization as defined in OMB Circular A-133, as revised. In the event that the 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 OMB Circular A-133, as revised. EXHIBIT 2 to th is agreement indicates federal resources awarded through the Alliance by this agreement. In determining the federal awards expended in its fiscal year, the C o n t r a c t o r shall consider all sources of Federal awards, including federal resources received from the A l l i a n c e . The determination of amounts of Federal awards expended should be in accordance with the guidelines established by OMB Circular A-133, as revised. An audit of the C o n t r a c t o r conducted by the Auditor General in accordance with the provisions of OMB Circular A-133, as revised, will meet the requirements of this part. In connection with the audit requirements addressed in Part I, paragraph I, the Contractor shall fulfill the requirements relative to auditee responsibilities as provided in Subpart C of OMB Circular A-133, as revised. 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 OMB Circular A-133, as revised, 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 OMB Circular A-133, as revised, the cost of the audit must be paid from non-federal resources (i.e., the cost of such audit must be paid from 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 agreements with the Alliance shall be based on the agreement's requirements, including any rules, regulations, or statutes referenced in the agreement. The financial statements shall disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the Alliance and/or the Department shall be fully disclosed in the audit report with reference to the Alliance agreement involved. If not otherwise disclosed as required by Section .310(b)(2) of OMB Circular A-133, as revised, the schedule of expenditures of federal awards shall identify expenditures by agreement number for each agreement with the Alliance in effect during the audit period. Financial reporting packages required under this part must be submitted within the earlier of 30 days after receipt of the audit report or 9 months after the end of the Contractor's fiscal year end. PART II: STATE FUNDED This part is applicable if the Contractor is a non-state entity as defined by Section 215.97(2), F.S. In the event that the con t ra c tor expends a total amount of state financial assistance equal to or in excess of $750,000.00 in any fiscal year of such Contractor (for fiscal years ending September 30, 2004 or thereafter), 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 Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General. EXHIBIT 2 to this agreement indicates state financial assistance awarded through the A l l i a n c e by this agreement. 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 Alliance, other state agencies,

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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 I, 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 (for fiscal years ending September 30, 2004 or thereafter), an audit conducted in accordance with the provisions of Section 215.97, F.S., is not required. In the event that the 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 agreements with the Alliance shall be based on the agreement's requirements, including any applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the Alliance shall be fully disclosed in the audit report with reference to the Alliance agreement involved. If not otherwise disclosed as required by Rule 69I-5.003, Fla. Admin. Code, the schedule of expenditures of state financial assistance shall identify expenditures by agreement number for each agreement with the Al l iance in effect during the audit period. Financial reporting packages required under this part must be submitted within 45 days after delivery of the audit report, but-no later than 12 months after the Contractor 's fiscal year end for local governmental entities. Non-profit or for-profit organizations are required to be submitted within 45 days after delivery of the audit report, but no later than 9 months after the Contractor 's fiscal year end. Notwithstanding the applicability of this portion, the Alliance retains all right and obligation to monitor and oversee the performance of this agreement as outlined throughout this document and pursuant to law. II. PART III: REPORT SUBMISSION Copies of reporting packages for audits conducted in accordance with OMB Circular A-133, as revised, and required by PART I of this agreement shall be submitted, when required by Section .320 (d), OMB Circular A-133, as revised, by or on behalf of the Contractor directly to each of the following: The Alliance at each of the following addresses:

Alliance for Aging, Inc. Attn: F i s c a l D e p a r t m e n t

760 NW 107th Avenue Suite 214

Miami, FL 33172

The Federal Audit Clearinghouse designated in OMB Circular A-133, as revised (the number of copies required by Sections .320 (d), OMB Circular A-133, as revised, should be submitted to the Federal Audit Clearinghouse), at the following address:

Federal Audit Clearinghouse Bureau of the Census 1201 East 10'" Street

Jeffersonville, IN 47132 Other Federal agencies and pass-through entities in accordance with Sections .320 (e) and (f), OMB Circular A-133, as revised. Pursuant to Sections .320(f), OMB Circular A-133, as revised, the provider shall submit a copy of the reporting package described in Section .320(c), OMB Circular A-133, as revised, and any management letter issued by the auditor, to the Alliance at each of the following addresses:



Miami, FL 33172

Additionally, copies of financial reporting packages required by Part II of this agreement shall be submitted by or on behalf of the Contractor directly to each of the following: The Alliance at the following address:

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Miami, FL 33172 Any reports, management letter, or other information required to be submitted to the Alliance pursuant to this agreement shall be submitted timely in accordance with OMB Circular A-133, F.S., and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, as applicable. Contractors, when submitting financial reporting packages to the A l l i a n c e for audits done in accordance with OMB Circular A-133 or Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, should indicate the date that the reporting package was delivered to the Contractor in correspondence accompanying the reporting package. III. 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 Al l ian ce and the Department 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 Alliance and the Department, 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 Al l i an c e .

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ATTACHMENT II FINANCIAL, AND COMPLIANCE AUDIT ATTACHMENT

EXHIBIT 1

PART 1: AUDIT RELATIONSHIP DETERMINATION Contractors who receive state or federal resources may or may not be subject to the audit requirements of 2 CFR Part §200.500, and/or Section 215.97, Fla. Stat. C o n t r a c t o r s who are determined to be recipients or subrecipients of federal awards and/or state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I and/or Part II of Exhibit I is met. C o n t r a c t o r s who have been determined to be vendors are not subject to the and it requirements of 2 CFR Part §200.38, and/or Section 215.97, Fla. Stat. Regardless of whether the audit requirements are met, C o n t r a c t o r s who have been determined to be recipients or subrecipients of Federal awards and/or state financial assistance must comply with applicable programmatic and fiscal compliance requirements. In accordance with 2 CFR Part §200 and/or Rule 691-5.006, FAC, C o n t r a c t o r has been determined to be: ____ Vendor not subject to 2 CFR Part §200.38 and/or Section 215.97, F.S. ____ Recipient/subrecipient subject to 2 CFR Part §200.86 and §200.93 and/or Section 215.97, F.S. ____ Exempt organization not subject to 2 CFR Part §200 and/or Section 215.97, F.S. For Federal awards, for-profit organizations are

exempt; for state financial assistance projects, public universities, community colleges, district school boards, branches of state (Florida) government, and charter schools are exempt. Exempt organizations must comply with all compliance requirements set forth within the contract or award document.

NOTE: If a C o n t r a c t o r is determined to be a recipient/subrecipient of federal and or state financial assistance and has been approved by the Alliance to subcontract, they must comply with Section 215.97(7), F.S., and Rule 69I-5.006, FAC [state financial assistance] and 2 CFR Part §200.330 [federal awards]. PART II: FISCAL COMPLIANCE REQUIREMENTS FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. C o n t r a c t o r s who receive Federal awards, state maintenance of effort funds, or state matching funds on Federal awards and who are determined to be a subrecipient must comply with the following fiscal laws, rules and regulations:

STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW: 2 CFR Part §200.416- Cost Principles* 2 CFR Part §200.201- Administrative Requirements** 2 CFR Part §200.500- Audit Requirements Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations

NON-PROFIT ORGANIZATIONS MUST FOLLOW:

2 CFR Part §200.400-.411- Cost Principles* 2 CFR Part §200.100 -Administrative Requirements 2 CFR Part §200.500- Audit Requirements Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations

EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT) MUST FOLLOW:

2 CFR Part §200.418- Cost Principles* 2 CFR Part §200.100- Administrative Requirements 2 CFR Part §200.500 -Audit Requirements Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations

*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in the 2 CFR Part §200.401(5) (c). **For funding passed through U.S. Health and Human Services, 45 CFR P a r t 92; for funding passed through U.S. Department of Education, 34 CFR 100. STATE FINANCIAL ASSISTANCE. C o n t r a c t o r s who receive state financial assistance and who are determined to be a recipient/subrecipient must comply with the following fiscal laws, rules and regulations:

Section 215.97, Fla. Stat. Chapter 691-5, Fla. Admin. Code State Projects Compliance Supplement Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations

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ATTACHMENT II FINANCIAL, AND COMPLIANCE AUDIT ATTACHMENT

EXHIBIT 2-FUNDING SUMMARY Note: Title 2 CFR § 200.331, As Revised, and Section 215.97(5), Florida Statutes, Require That Information About Federal Programs and State Projects Be Provided to the Recipient and Are Stated in the Financial and Compliance Audit Attachment and Exhibit 1. Financial and Compliance Audit Attachment, Exhibit 2-Funding Summary Provides Information Regarding the Funding Sources Applicable to This Contract, Contained Herein, Is A Prediction of Funding Sources and Related Amounts Based on the Contract Budget. 1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF THE FOLLOWING:

GRANT AWARD (FAIN#): N/A FEDERAL AWARD DATE: DUNS NUMBER: 785359126 PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT

TOTAL FEDERAL AWARD COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: FEDERAL FUNDS: 2 CFR Part 200- Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. OMB Circular A-133, As amended- Audits of States, Local Governments, and Non-Profit Organizations 2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF THE FOLLOWING:

MATCHING RESOUCES FOR FEDERAL PROGRAMS PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT

TOTAL STATE AWARD

STATE FINANCIAL ASSITANCE SUBJECT TO sec. 215.97, F.S. PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT

TOTAL AWARD 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, FL Admin Code, Reference Guide for State Expenditures, Other fiscal requirements set forth in program laws, rules and regulations.

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ATTACHMENT III

CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS, LOANS AND COOPERATIVE AGREEMENTS

The undersigned, an authorized representative of the Contractor named in the contract or agreement to which this form is an attachment, hereby certifies that:

(1) The Contractor and any Subcontractors of services under this contract have financial management systems capable of

providing certain information, including: (1) accurate, current, and complete disclosure of the financial results of each grant-funded project or program in accordance with the prescribed reporting requirements; (2) the source and application of funds for all agreement supported activities; and (3) the comparison of outlays with budgeted amounts for each award. The inability to process information in accordance with these requirements could result in a return of grant funds that have not been accounted for properly.

(2) Management Information Systems used by the Contractor, Subcontractors, or any outside entity on which the Contractor is

dependent for data that is to be reported, transmitted or calculated, have been assessed and verified to be capable of processing data accurately, including year-date dependent data. For those systems identified to be non-compliant, Contractors will take immediate action to assure data integrity.

(3) 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.

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.

(4) The Contractor and any Subcontractors of services under this contract warrant their policies and procedures include a

disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data integrity compliance issues.

The Contractor shall require that the language of this certification be included in all subagreements, subgrants, and other agreements and that all Subcontractors shall certify compliance accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB Circulars A-1 02 and 2 CFR Part 200 (formerly OMB Circular A-110).

_________________________________________ __________________________ _______________ Signature Title Date _________________________________________ Name of Authorized Signer _________________________________________ Name of Agency/Corporation

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ATTACHMENT IV

CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS

(1) 'The Contractor certifies, by signing this certification, neither it nor its principals are presently debarred, suspended,

proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency.

(2) Where the Contractor is unable to certify to any of the statements in this certification, such prospective participant

shall attach an explanation to this certification.

____________________________________________ ____________________________________ Signature Date ____________________________________________ ____________________________________ Title Agency/Corporation (Signature should be the same as Contract Signature)

Instructions for Certification

1. The terms “covered transaction,” “debarred,” “suspended,” “'ineligible,” “lower tier covered transaction,” “'person,” “primary covered transaction,” and “voluntarily excluded,” as used herein, have the meanings set out in the sections of rules implementing Executive Order 12549. (2 CFR 180.5-180.1020, as supplemented by 2 CFR 376.10-376.995). You may contact the Contract Manager for assistance in obtaining a copy of those regulations.

2. This certification is a material representation of facts upon which reliance was placed when the parties entered into

this transaction. If it is later determined that the Contractor knowingly rendered an erroneous certification, in addition to other remedies available to the federal government, the Department may pursue available remedies, including suspension and/or debarment.

3. The Contractor will provide immediate written notice to the Contract Manager if at any time the Contractor learns

that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The Contractor may decide the method and frequency by which it determines the eligibility of its principals. Each participant to a lower tier covered transaction may, but is not required to, check the Excluded Parties List System (EPLS).

4. The Contractor will include a "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transaction" in all its lower tier covered transactions and in all solicitations for lower tier covered transactions.

5. The Contractor agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is

debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise authorized by the federal government.

6. If the Contractor knowingly enters into a lower tier covered transaction with a person who is suspended, debarred,

ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the Department may pursue available remedies, including suspension, and/or debarment.

7. The Contractor may rely upon a certification of a prospective participant in a lower tier covered transaction that it is

not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous.

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ATTACHMENT V ASSURANCES-NON-CONSTRUCTION PROGRAMS

Public reporting burden for this collection of information is estimated to average 45 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of 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.

I. Has the legal authority to apply for federal assistance, and the institutional, managerial and financial capability (including

funds sufficient to pay the non-federal share of project cost) to ensure proper planning, management, and completion of the project described in this application.

2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the state, through any

authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives.

3, Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the

appearance of personal or organizational conflict of interest, or personal gain.

4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.

5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. 4728-4763) relating to prescribed standards for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of 0PM’s Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).

6. Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the

Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. 6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) 523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. 290dd-3 and 290ee 3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s) under which application for federal assistance is being made; and (j) the requirements of any other nondiscrimination statute(s) which may apply to the application.

7. Will comply, or has already complied, with the requirements of Titles II and ill of the uniform Relocation Assistance and Real

Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of federal or federally assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of federal participation in purchases.

8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. 1501-1508 and 7324-7328), which limit the

political activities of employees whose principal employment activities arc 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 Safely Standards Act (40 U.S.C. 327-333), regarding labor standards for federally assisted construction subagreements.

10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster 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.

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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 (54 U.S.C. 300101), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974, as amended (54 U.S.C. 312501 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. 4821 et seq.), which prohibits the use of lead-

based paint in construction or rehabilitation of residence structures.

17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 1996 and OMB Circular No. A-133, Audits of States, Local Governments, and Non-Profit Organizations.

18. Will comply with all applicable requirements of all other federal laws, executive orders, regulations and policies governing

this program. ________________________________________________ ______________________________________________ Signature of Authorized Certifying Official Title ________________________________________________ ______________________________________________ Applicant Agency/Organization Date Submitted

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ATTACHMENT A

DEPARTMENT OF ELDER AFFAIRS PROGRAMS & SERVICES HANDBOOK

Department of Elder Affairs Programs & Services Handbook available at: http://www.allianceforaging.org/providers/program-documents/2012-doea-programs-services-handbook

http://www.allianceforaging.org/providers/program-documents/2012-doea-programs-services-handbook


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ATTACHMENT B STATE OF FLORIDA DEPARTMENT OF ELDER AFFAIRS

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: _________________________________________________________________________________________________ _________________________________________________________________________________________________

2. POPULATION OF AREA SERVED. Source of data: Total #

% White % Black % Hispanic % Other % Female

3. STAFF CURRENTLY EMPLOYED. Effective date: Total #

% White % Black % Hispanic % Other % Female % Disabled

4. CLIENTS CURRENTLY ENROLLED OR REGISTERED. Effective date: Total #

% White % Black % Hispanic % Other % Female % Disabled % Over 40

5. ADVISORY OR GOVERNING BOARD, IF APPLICABLE. Total #

% White % Black % Hispanic % Other % Female

% Disabled

PART II: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. 6. Is an Assurance of Compliance on file with DOEA? If N/A or NO, explain. N/A YES NO

7. Compare the staff composition to the population. Is staff representative of the population? If N/A or NO, explain. N/A YES NO

8. Compare the client composition to the population. Are race and sex characteristics representative of the population? If N/A or NO, explain. N/A YES NO

9. Are eligibility requirements for services applied to clients and applicants without regard to race, color, national origin, sex, age, religion or disability? If N/A or NO, explain. N/A YES NO

10. 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? If N/A or NO, explain. N/A YES NO

11. For in-patient services, are room assignments made without regard to race, color, national origin or disability? If N/A or NO, explain. N/A YES NO

Revised August 2010, Page 1of 2

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12. Is the program/facility accessible to non-English speaking clients? If N/A or NO, explain. N/A YES NO

13. Are employees, applicants and participants informed of their protection against discrimination? If YES, how? Verbal Written Poster If N/A or NO, explain. N/A YES NO

14. Give the number and current status of any discrimination complaints regarding services or employment filed against the program/facility. N/A NUMBER

_______

15. Is the program/facility physically accessible to mobility, hearing, and sight-impaired individuals? If N/A or NO, explain. N/A YES NO

PART III: THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES.

16. Has a self-evaluation been conducted to identify any barriers to serving disabled individuals, and to make any necessary modifications? If NO, explain. YES NO

17. Is there an established grievance procedure that incorporates due process in the resolution of complaints? If NO, explain. YES NO

18. Has a person been designated to coordinate Section 504 compliance activities? If NO, explain. YES NO

19. Do recruitment and notification materials advise applicants, employees and participants of nondiscrimination on the basis of disability? If NO, explain. YES NO

20. Are auxiliary aids available to assure accessibility of services to hearing and sight-impaired individuals? If NO, explain. YES NO

PART IV: FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $50,000.00 OR MORE.

21. Do you have a written affirmative action plan? If NO, explain. YES NO

ALLIANCE USE ONLY

Reviewed By In Compliance: YES NO*

Program Office *Notice of Corrective Action Sent ___/___/___

Date Telephone Response Due ___/___/___

On-Site Desk Review Response Received ___/___/___

Revised August 2010, Page 2 of 2

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INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST

1. Describe the geographic service area such as a district, county, city or other locality. 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 and sex. The population served includes persons in the geographical

area for which services are provided such as a city, county or other regional area. Population statistics can be obtained from local chambers of commerce, libraries, or any publication from the 1980 Census containing Florida population statistics. Include the source of your population statistics. ("Other" races include Asian/Pacific Islanders and American Indian/Alaskan Natives.)

3. Enter the total number of full-time staff and their percent by race, sex and disability. Include the effective date of your

summary.

4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and list their percent by race, sex and disability. Include the date that enrollment was counted.

5. Enter the total number of advisory board members and their percent by race, sex, and disability. 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. 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, 45 CFR 80.3(b)(6).

9. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or

employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also through on-site record analysis of persons who applied but were denied services or employment, 45 CFR 80.3(a) and 45 CFR 80.3(b)(2).

10. Participants or clients must be provided services such as medical, nursing and dental care, laboratory services, physical

and recreational therapies, counseling and social services without regard to race, sex, color, national origin, religion, age or 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).

11. 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).

12. 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).

13. Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to their

participants, beneficiaries or any other interested parties. This should include information on their right to file a complaint of discrimination with either the Florida Department of Elder Affairs or the U.S. Department of HHS. The information may be supplied verbally or in writing to every individual, or may be supplied through the use of an equal opportunity policy poster displayed in a public area of the facility, 45 CFR 80.6(d).

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14. Report number of discrimination complaints filed against the program/facility. Indicate the basis, e.g., race, color, creed,

sex, age, national origin, disability, retaliation; the issues involved, e.g., services or employment, placement, termination, etc. Indicate the civil rights law or policy alleged to have been violated along with the name and address of the local, state or federal agency with whom the complaint has been filed. Indicate the current status, e.g., settled, no reasonable cause found, failure to conciliate, failure to cooperate, under review, etc.

15. The program/facility must be physically accessible to disabled individuals. Physical accessibility includes designated

parking areas, curb cuts or level approaches, ramps and adequate widths to entrances. The lobby, public telephone, restroom facilities, water fountains, information and admissions offices should be accessible. Door widths and traffic areas of administrative offices, cafeterias, restrooms, recreation areas, counters and serving lines should be observed for accessibility. Elevators should be observed for door widths and Braille or raised numbers. Switches and controls for light, heat, ventilation, fire alarms, and other essentials should be installed at an appropriate height for mobility impaired individuals.

16. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self-

evaluation to identify any accessibility barriers. Self-evaluation is a four step process:

a. With the assistance of a disabled individual/organization, evaluate current practices and policies which do not comply with Section 504.

b. Modify policies and practices that do not meet Section 504 requirements. c. Take remedial steps to eliminate any discrimination that has been identified. d. Maintain self-evaluation on file. (This checklist may be used to satisfy this requirement if these four steps have

been followed.), 45 CFR 84.6.

17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate appropriate due process standards and provide for the prompt and equitable resolution of complaints alleging any action prohibited by Section 504.45 CFR 84.7 (b).

18. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to comply

with Section 504.45 CFR 84.7 (a).

19. Continuing steps must be taken to notify employees and the public of the program/facility's policy of nondiscrimination on tl1e basis of disability. This includes recruitment material, notices for hearings, newspaper ads, and other appropriate written communication, 45 CFR 84.8 (a).

20. Programs/facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with impaired

sensory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to, interpreters for hearing impaired individuals, taped or Braille materials, or any alternative resources that can be used to provide equally effective services, 45 CFR 84.52 (d}.

21. 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.

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ATTACHMENT C Alliance for Aging, Inc.

Business Associate Agreement This Business Associate Agreement is dated _____________________, by the Alliance for Aging, Inc. (“Covered Entity”) and United Home Care Services, (“Business Associate”), a not-for-profit Florida corporation.

1.0 Background. 1.1 Covered Entity has entered into one or more contracts or agreements with Business Associate that involves the use of

Protected Health Information (PHI). 1.2 Covered Entity, recognizes the requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)

and has indicated its intent to comply in the County’s Policies and Procedures. 1.3 HIPAA regulations establish specific conditions on when and how covered entities may share information with contractors

who perform functions for the Covered Entity. 1.4 HIPAA requires the Covered Entity and the Business Associate to enter into a contract or agreement containing specific

requirements to protect the confidentiality and security of patients’ PHI, as set forth in, but not limited to the Code of Federal Regulations (C.F.R.), specifically 45 C.F.R. §§ 164.502(e), 164.504(e), 164.308(b), and 164.314(a-b) (as may apply) and contained in this agreement.

1.5 The Health Information Technology for Economic and Clinical Health Act (2009), the American Recovery and

Reinvestment Act (2009) and Part I – Improved Privacy Provisions and Security provisions located at 42 United States Code (U.S.C.) §§ 17931 and 17934 (2010) require business associates of covered entities to comply with the HIPAA Security Rule, as set forth in, but not limited to 45 C.F.R. Subpart C and such sections shall apply to a business associate of a covered entity in the same manner that such sections apply to the covered entity.

The parties therefore agree as follows: 2.0 Definitions. For purposes of this agreement, the following definitions apply: 2.1 Catch-all definition. The following terms used in this Agreement shall have the same meaning as those terms in the

HIPAA Rules: Access, Administrative Safeguards, Authentication, Availability, Breach, Confidentiality, Data Aggregation, Designated Record Set, Disclosure, Electronic Protected Health Information (ePHI), Health Care Operations, Individual, Information System, Integrity, Malicious Software, Minimum Necessary, Notice of Privacy Practices, Password, Physical Safeguards, Protected Health Information (PHI), Required By Law, Secretary, Security Incident, Subcontractor, Technical Safeguards, Unsecured Protected Health Information, and Use.

2.2 ARRA. The American Recovery and Reinvestment Act (2009) 2.3 Business Associate. “Business Associate” shall generally have the same meaning as the term “business associate” at 45

CFR 160.103, and in reference to the party to this Agreement, United Home Care Services. 2.4 Covered Entity. “Covered Entity” shall generally have the same meaning as the term “covered entity” at 45 CFR

160.103, and in reference to the party to this Agreement, shall mean Alliance for Aging, Inc. 2.5 HIPAA Rules. “HIPAA Rules” shall mean the Privacy, Security, Breach Notification, and Enforcement Rules at 45 CFR

Parts 160 and 164. 2.6 HITECH. The Health Information Technology for Economic and Clinical Health Act (2009) 2.7 All other terms used, but not otherwise defined, in this Agreement shall have the same meaning as those terms in the

HIPAA Rules. 3.0. Obligations and Activities of Business Associate. 3.1 Business Associate agrees to not use or disclose PHI other than as permitted or required by this agreement or as Required

by Law. 3.2 Business Associate agrees to:

(a) Implement policies and procedures to prevent, detect, contain and correct Security violations in accordance with 45 CFR § 164.306;

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(b) Prevent use or disclosure of the PHI other than as provided for by this Agreement or as required by law; (c) Reasonably and appropriately protect the confidentiality, integrity, and availability of the ePHI that the Business

Associate creates, receives, maintains, or transmits on behalf of the Covered Entity; and (d) Comply with the Security Rule requirements under Subpart C of 45 CFR Part 164, including the Administrative

Safeguards, Physical Safeguards, Technical Safeguards, and policies and procedures and documentation requirements set forth in 45 CFR §§ 164.308, 164.310, 164.312, and 164.316.

3.3 Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is known to Business Associate of

a use or disclosure of PHI by Business Associate in violation of the requirements of this Agreement. 3.4 Business Associate agrees to promptly report to Covered Entity any use or disclosure of the PHI not provided for by this

Agreement of which it becomes aware. This includes any requests for inspection, copying or amendment of such information and including any security incident involving PHI.

3.5 Business Associate agrees to notify Covered Entity without unreasonable delay, but not later than ten (10) days following

the discovery, of any security breach pertaining to:

(a) Identification of any individual whose unsecured PHI has been, or is reasonably believed by the Business Associate to have been, accessed, acquired, or disclosed during such security breach; and

(b) All information required for the Notice to the Secretary of HHS of Breach of Unsecured Protected Health Information.

3.6 Business Associate agrees to ensure that any agent, including a subcontractor, to whom it provides PHI received from, or

created or received by Business Associate on behalf of Covered Entity, agrees to the same restrictions and conditions that apply through this Agreement to Business Associate with respect to such information.

3.7 If Business Associate has PHI in a Designated Record Set:

(a) Business Associate agrees to provide access, at the request of Covered Entity during regular business hours, to PHI in a Designated Record Set, to Covered Entity or, as directed by Covered Entity, to an individual in order to meet the requirements under 45 CFR §164.524; and

(b) Business Associate agrees to make any amendment(s) to PHI in a Designated Record Set that the Covered Entity

directs or agrees to pursuant to 45 CFR § 164.526 at the request of Covered Entity or an Individual within 10 business days of receiving the request.

3.8 Business Associate agrees to make internal practices, books, and records, including policies and procedures and PHI,

relating to the use and disclosure of PHI received from, or created or received by Business Associate on behalf of Covered Entity, available to the Covered Entity or to the Secretary upon request of either for purposes of determining Covered Entity’s compliance with the Privacy Rule.

3.9 Business Associate agrees to document such disclosures of PHI and information related to such disclosures as would be

required for Covered Entity to respond to a request by an individual for an accounting of disclosures of PHI in accordance with 45 CFR § 164.528.

3.10 Business Associate agrees to provide to Covered Entity or an individual, upon request, information collected to permit

Covered Entity to respond to a request by an Individual for an accounting of disclosures of PHI in accordance with 45 CFR § 164.528 and ARRA § 13404.

3.11 Business Associate specifically agrees to use security measures that reasonably and appropriately protect the

confidentiality, integrity, and availability of PHI in electronic or any other form, that it creates, receives, maintains, or transmits on behalf of the Covered Entity.

3.12 Business Associate agrees to implement security measures to secure passwords used to access ePHI that it accesses,

maintains, or transmits as part of this Agreement from malicious software and other man-made and natural vulnerabilities to assure the availability, integrity, and confidentiality of such information.

3.13 Business Associate agrees to implement security measures to safeguard ePHI that it accesses, maintains, or transmits as

part of this agreement from malicious software and other man-made and natural vulnerabilities to assure the availability, integrity, and confidentiality of such information.

3.14 Business Associate agrees to comply with:

(a) ARRA § 13404 (Application of Knowledge Elements Associated with Contracts);

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(b) ARRA § 13405 (Restrictions on Certain Disclosures and Sales of Health Information); and (c) ARRA § 13406 (Conditions on Certain Contacts as Part of Health Care Operations).

3.15 To the extent Business Associate is to carry out one or more of Covered Entity’s obligation(s) under the Privacy Rule,

Business Associate agrees to comply with the requirements of the Privacy Rule that apply to Covered Entity in the performance of such obligation(s).

4.0 Permitted Uses and Disclosures by Business Associate. Except as otherwise limited in this Agreement or any related

agreement, Business Associate may use or disclose PHI as Required By Law, as well as to perform functions, activities, or services for, or on behalf of, Covered Entity as specified in any and all contracts with Covered Entity provided that such use or disclosure would not violate the Privacy Rule if done by Covered Entity or the minimum necessary policies and procedures of the Covered Entity.

5.0 Specific Use and Disclosure Provisions. 5.1 Except as otherwise limited in this agreement or any related agreement, Business Associate may use PHI for the proper

management and administration of the Business Associate or to carry out the legal responsibilities of the Business Associate.

5.2 Except as otherwise limited in this agreement or any related agreement, Business Associate may disclose PHI for the

proper management and administration of the Business Associate, provided that disclosures are Required By Law, or Business Associate obtains reasonable assurances from the person to whom the information is disclosed that it will remain confidential and used or further disclosed only as Required By Law or for the purpose for which it was disclosed to the person, and the person notifies the Business Associate of any instances of which it is aware in which the confidentiality of the information has been breached.

5.3 Business Associate may use PHI to provide data aggregation services to Covered Entity as permitted by 45 CFR

§164.504(e)(2)(i)(B), only when specifically authorized by Covered Entity. 5.4 Business Associate may use PHI to report violations of law to appropriate Federal and State authorities, consistent with 45

CFR §164.502(j)(1). 6.0 Obligations of Covered Entity. 6.1 Covered Entity shall notify Business Associate of any limitation(s) in its notice of privacy practices of Covered Entity in

accordance with 45 CFR § 164.520, to the extent that such limitation may affect Business Associate’s use or disclosure of PHI, by providing a copy of the most current Notice of Privacy Practices (NPP) to Business Associate as Attachment XI to this Agreement. Future Notices and/or modifications to the NPP shall be posted on Covered Entity’s website at www.allianceforaging.org.

6.2 Covered Entity shall notify Business Associate of any restriction to the use or disclosure of PHI that Covered Entity has

agreed to in accordance with 45 CFR § 164.522, to the extent that such restriction may affect Business Associate’s use or disclosure of PHI.

7.0 Permissible Requests by Covered Entity. Except for data aggregation or management and administrative activities of

Business Associate, Covered Entity shall not request Business Associate to use or disclose PHI in any manner that would not be permissible under the Privacy Rule if done by Covered Entity.

8.0 Effective Date and Termination. 8.1 The Parties hereby agree that this agreement amends, restates and replaces any other Business Associate Agreement

currently in effect between Covered Entity and Business Associate and that the provisions of this agreement shall be effective as follows:

(a) These Business Associate Agreement provisions, with the exception of the electronic security provisions and the provisions mandated by ARRA and HITECH shall be effective upon the later of April 14, 2003, or the effective date of the earliest contract entered into between Business Associate and Covered Entity that involves the use of PHI;

(b) The electronic security provisions hereof shall be effective the later of April 21, 2005 or the effective date of the

earliest contract entered into between Business Associate and Covered Entity that involves the use of PHI; and (c) Provisions hereof mandated by ARRA and HITECH shall be effective the later of February 17, 2010 or the effective

date of the earliest contract entered into between covered entity and business associate that involves the use of PHI or ePHI.

http://www.allianceforaging.org/

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8.2 Termination for Cause. Upon Covered Entity’s knowledge of a material breach by Business Associate, Covered Entity

shall either: (a) Provide an opportunity for Business Associate to cure the breach or end the violation and terminate this agreement

if Business Associate does not cure the breach or end the violation within the time specified by Covered Entity; (b) Immediately terminate this agreement if Business Associate has breached a material term of this Agreement and

cure is not possible; or (c) If neither termination nor cure is feasible, Covered Entity shall report the violation to the Secretary. 8.3 Effect of Termination. Except as provided in subparagraph (b) of this section, upon termination of this agreement, for

any reason, Business Associate shall return all PHI and ePHI received from Covered Entity, or created or received by Business Associate on behalf of Covered Entity.

(a) This provision shall apply to PHI and ePHI that is in the possession of subcontractors or agents of Business

Associate. Business Associate shall retain no copies of the PHI and ePHI. (b) In the event that Business Associate or Covered Entity determines that returning the PHI or ePHI is infeasible,

notification of the conditions that make return of PHI or ePHI infeasible shall be provided to the other party. Business Associate shall:

1. Retain only that PHI which is necessary for Business Associate to continue its proper management and

administration or to carry out its legal responsibilities; 2. Return to Covered Entity (or, if agreed to by Covered Entity, destroy) the remaining PHI that the Business

Associate still maintains in any form; 3. Continue to use appropriate safeguards and comply with Subpart C of 45 CFR Part 164 with respect to the

ePHI to prevent use or disclosure of the PHI, other than as provided for in this Section, for as long as Business Associate retains the PHI;

4. Not use or disclose the PHI retained by Business Associate other than for the purposes for which such PHI was retained and subject to the same conditions set out at Section 5.0 “Specific Use and Disclosure Provisions” which applied prior to the termination; and

5. Return to Covered Entity (or, if agreed to by Covered Entity, destroy) the PHI retained by Business Associate when it is no longer needed by Business Associate for its proper management and administration or to carry out its legal responsibilities.

The obligations of Business Associate under this Section shall survive the termination of this Agreement. 9.0 Regulatory References. A reference in this agreement to a section in the Privacy Rule or Security Rule means the section

then in effect or as may be amended in the future. 10.0 Amendment. The Parties agree to take such action as is necessary to amend this agreement from time to time as is

necessary for Covered Entity to comply with the requirements of the Privacy Rule, the Security Rule and the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191.

11.0 Survival. Any term, condition, covenant or obligation which requires performance by either party hereto subsequent to

the termination of this agreement shall remain enforceable against such party subsequent to such termination. 12.0 Interpretation. Any ambiguity in this agreement shall be resolved to permit Covered Entity to comply with the Privacy

Rule and Security Rule. 13.0 Incorporation by reference. Any future new requirement(s), changes or deletion(s) enacted in federal law which create

new or different obligations with respect to HIPAA privacy and/or security, shall be automatically incorporated by reference to this Business Associate Agreement on the respective effective date(s).

14.0 Notices. All notices and communications required, necessary or desired to be given pursuant to this agreement, including

a change of address for purposes of such notices and communications, shall be in writing and delivered personally to the other party or sent by express 24-hour guaranteed courier or delivery service, or by certified mail of the United States Postal Service, postage prepaid and return receipt requested, addressed to the other party as follows (or to such other place as any party may by notice to the others specify):

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To Covered Entity: Alliance for Aging, Inc. Attention: Max Rothman 760 NW 107 Avenue Miami, Florida 33172 To Business Associate: [Provider Name & Address]

Any such notice shall be deemed delivered upon actual receipt. If any notice cannot be delivered or delivery thereof is refused, delivery will be deemed to have occurred on the date such delivery was attempted.

15.0 Governing Law. The laws of the State of Florida, without giving effect to principles of conflict of laws, govern all

matters arising under this agreement. 16.0 Severability. If any provision in this agreement is unenforceable to any extent, the remainder of this agreement, or

application of that provision to any persons or circumstances other than those as to which it is held unenforceable, will not be affected by that unenforceability and will be enforceable to the fullest extent permitted by law.

17.0 Successors. Any successor to Business Associate (whether by direct or indirect or by purchase, merger, consolidation, or

otherwise) is required to assume Business Associate’s obligations under this agreement and agree to perform them in the same manner and to the same extent that Business Associate would have been required to if that succession had not taken place. This assumption by the successor of the Business Associate’s obligations shall be by written agreement satisfactory to Covered Entity.

18.0 Entire Agreement. This agreement constitutes the entire agreement of the parties relating to the subject matter of this

agreement and supersedes all other oral or written agreements or policies relating thereto, except that this agreement does not limit the amendment of this agreement in accordance with section 10.0 of this agreement.

Covered Entity: Alliance for Aging, Inc. By: ______________________________________ Date: _____________ (signature) Business Associate: [Provider Name] By: ______________________________________ Date: _____________ (signature)

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ATTACHMENT D

CONTRACTOR'S STATE CONTRACTS LIST Contractors State Contracts List

Report Period: From: ___________ CONTRACTOR INFORMATION: To: _____________

Name: ____________________________________ Phone: _______________________________________ Address: ____________________________________ Email: _______________________________________ FEID: ____________________________________ Contract: _______________________________________

Signature: _________________________________________ Date: _______________________________ Title: _________________________________________

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THIS PAGE LEFT INTENTIALLY BLANK

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ATTACHMENT H

CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS

The undersigned, an authorized representative of the Contractor named in the contract or agreement to which this form is an attachment, hereby ce1iifies that:

(I) The Contractor understands that pursuant to s. 287.135 F.S., any company at the time of bidding or submitting a proposal for a new contract or renewal of an existing contract, that is on the "Scrutinized Companies with Activities in Sudan List" or the "Scrutinized Companies with Activities in the Iran Petroleum Sector List (collectively, "the Lists") is ineligible for, and may not bid on, submit a proposal for, or enter into or renew a contract with the Alliance for goods or services of $1 million or more.

(2) The Contractor understands that, pursuant to s. 287.135 F .S., any company that submits a false certification to the Depa1iment is subject to civil penalties, attorney's fees and costs and any costs for investigations that led to the finding of false certification.

(3) The Contractor understands that the contract to which this form is an attachment may be terminated by the Alliance if the Contractor submits a false certification or has been placed on the Lists.

This certification, required by Florida law, is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction. __________________________________________________ _____________________________________ Signature Date __________________________________________________ Title __________________________________________________ Agency/Corporation

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ATTACHMENT J

VEREIFICATION OF EMPLOYMENT STATUS CERTIFICATION As a condition of contracting with the Alliance for Aging, Inc., ______________________, hereby referred to as 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 Agreement and that any subcontracts include an express requirement that Subcontractors performing work or providing services pursuant to this Agreement utilize the E-verify system to verify the employment eligibility of all new employees hired by the Subcontractor during the contract term.

___________________________________________ _______________________________________ Signature Date ___________________________________________ Title ___________________________________________ Agency/Corporation

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COMMUNITY CARE FOR THE ELDERLY LEAD AGENCY CONTRACT 2017-2018 Fiscal Year

THIS CONTRACT is entered into between the Alliance for Aging Inc., hereinafter referred to as the “Alliance” and [PROVIDER NAME], hereinafter referred to as the “Contractor,” and collectively referred to as the "parties." WHEREAS, the Alliance has been designated as the Area Agency on Aging for Planning and Service Area 11 encompassing Miami-Dade and Monroe Counties; and WHEREAS, the Florida Department of Elder Affairs (the "Department") has entered into a Contract with the Alliance to fund community care service systems in Miami-Dade and Monroe Counties; and WHEREAS, in accordance with Section 430.203, Florida Statutes, the Alliance has designated the Contractor as a Lead agency for the Community Care for the Elderly (CCE) program; NOW THEREFORE, in consideration of the services to be performed and payments to be made, together with the mutual covenants and conditions hereinafter set forth, the Parties agree as follows:

1. Purpose of Contract The purpose of this contract is to provide services in accordance with the terms and conditions specified in this contract including all attachments, forms, exhibits, and references incorporated which constitute the contract document.

2. Services to be Provided

The Contractor agrees to plan, develop, and accomplish the services delineated, or otherwise cause the planning, development, and accomplishment of such services and activities, on a countywide basis, under the conditions specified and in the manner prescribed in ATTACHMENT I of this contract.

3. Incorporation of Documents within the Contract The contract will incorporate attachments, proposal(s), grant agreements, relevant Department handbooks, manuals, or desk books and the Master Contract 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 documents(s) shall prevail over inconsistent provisions in the proposals(s) or other general materials not specific to this contract document and identified attachments.

4. Term of Contract Effective Date: This contract shall begin at twelve (12:00) A.M., Eastern Standard Time on July 1, 2017 or on the date the contract has been signed by both parties, whichever is later.

Delivery of services shall end at 11:59 P.M., Eastern Standard Time on June 30, 2018. The Alliance will not reimburse the provider for services provided after this date. However, the parties recognize that they will need to perform continued activities relating to reporting, invoicing and payment in July of 2018 to facilitate payment for services rendered by the provider under this contract.

5. Contract Amount The Alliance agrees to pay for contracted services according to the terms and conditions of this contract in an amount not to exceed $X,XXX.XX for an average monthly caseload of XXX clients , 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.

APPENDIX Ib

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6. Obligation to Pay

The Alliance’s performance and obligation to pay under this contract is contingent upon an annual appropriation by the Legislature to the Department and funding received by the Alliance under its contract with the Department.

7. Source of Funds

The costs of services paid under any other contract or from any other source are not eligible for reimbursement under this contract. The funds awarded to the provider pursuant to this contract are in the state grants and aids appropriations and consists of the following:

Program Title Funding Source CSFA # Funds Amount

Community Care for the Elderly General Funds 65010 $X,XXX.XX

TOTAL FUNDS CONTAINED IN THIS CONTRACT $X,XXX.XX 8. Renewals

The contract may be renewed on a yearly basis for no more than five additional years. Such renewals shall be contingent upon satisfactory performance evaluations as determined by the Alliance and the availability of funds. Any renewal of a contract shall be subject to mutual agreement, confirmed in writing, and subject to the same terms and conditions set forth in the initial contract. The renewal price, or method for determining a renewal price, is set forth in the bid, proposal, or reply. Requests to renegotiate the original contractual established rates are provided for in the Alliance’s approved Reimbursement Rate Review Policy, which is incorporated by reference.

The parties shall re-evaluate the contract’s reimbursement rates on an annual basis pursuant to DOEA’s Notice of Policy Clarification: Service Cost Reports Notice #092815-1-PC-SCBS dated September 28th, 2015 and the approved Alliance’s Reimbursement Rate Review Policy.

In the event that contracts cannot be executed prior to the July 1st start date, the Alliance may, at its discretion, extend this Agreement upon written notice for up to 120 days to ensure continuity of service. Services provided under this extension will be paid for out of the succeeding agreement amount

9. Modifications

Modifications of provisions of this contract shall only be valid when they have been reduced to writing and duly signed by both parties. The parties agree to renegotiate this contract if revisions of any applicable laws or regulations make changes in this contract necessary.

10. TERMINATION, SUSPENSION, AND ENFORECMENT

The causes and remedies for suspension or termination of this contract shall follow the same procedures as outlines in the Master Contract.

11. Official Payee and Representatives (Name, Address, and Telephone Numbers) The name, address, and telephone number of the representative for the Alliance for this contract is:

Max B. Rothman, JD, LL.M. President and CEO 760 NW 107th Ave, Suite 214

Miami, Florida 33172 (305) 670-6500, Ext. 224

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The name, address, and telephone number of the representative of the Contractor responsible for administration of the program under this contract is:

a The Contractor name, as shown on page 1 of this contract, and mailing address of the official payee to whom the payment shall be made is:

[Contractor Name, Address, Phone Number]

b The name of the contact person of the Contractor and street address where financial and administrative records are maintained is:

[Contractor Administrator Contact Name, Contractor

Name, Address, Phone Number]

c

The name, address, and telephone number of the representative of the Provider responsible for administration of the program under this contract is:

[Contractor CEO Contact Name, Contractor Name, Address, Phone Number]

d

The section and location within the AAA where Requests for Payment and Receipt and Expenditure forms are to be mailed is:


Fiscal Department 760 NW 107th Avenue, Suite 214

Miami, Florida 33172-3155 305-670-6500

e

The name, address, and telephone number of the Contract Manager for the AAA for this contract is:

Contract Monitor

Alliance for Aging, Inc. 760 NW 107th Avenue, Suite 214

Miami, Florida 33172-3155 605-670-6500

Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided in writing to the other party and the notification attached to the originals of this contract. 12. All Terms and Conditions Included

This contract and its ATTACHMENTS I, II, III, VII, IX, X, A, C, G, and K and any exhibits referenced in said attachments, together with any documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There are no provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all previous communications, representations or agreements, either written or verbal between the Parties.

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By signing this contract, the Parties agree that they have read and agree to the entire contract. IN WITNESS THEREOF, the Parties hereto have caused this contract, to be executed by their undersigned officials as duly authorized.

Provider : [PROVIDER NAME]


SIGNED BY:_________________________ SIGNED BY:___________________________

NAME:_____________________________ NAME: MAX B. ROTHMAN, JD, LL.M.

TITLE:______________________________ TITLE: PRESIDENT AND CEO DATE:______________________________ DATE:________________________________

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INDEX TO ATTACHMENTS

Attachment I STATEMENT OF WORK

Attachment II CERTIFICATIONS AND ASSURANCES

Attachment III FINANCIAL AND COMPLIANCE AUDIT

Attachment VII BUDGET SUMMARY

Attachment VIII INVOICE REPORT SCHEDULE

Attachment IX REQUEST FOR PAYMENT FORM

Attachment X RECEIPT AND EXPENDITURE REPORT

Attachment A DOEA HANDBOOK

Attachment C REFERRAL PROTOCOL AGING AND DISABILITY RESOURCE CENTER (ADRC) – OUTSOURCED FUNCTIONS

Attachment G BACKGROUND SCREENING AFFADAVIT OF COMPLIANCE

Attachment K INCONTINENCE SUPPLIES/NUTRITIONAL PRODUCT LIST

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ATTACHMENT I COMMUNITY CARE FOR THE ELDERLY PROGRAM

STATEMENT OF WORK

SECTION I. SERVICES TO BE PROVIDED 1.1. DEFINITIONS OF TERMS AND ACRONYMS

1.1.1 CONTRACT ACRONYMS Area Agency on Aging (AAA) Activities of Daily Living (ADL) Adult Protective Services (APS) Adult Protective Services Referral Tracking Tool (ARTT) Assessed Priority Consumer List (APCL) Comprehensive Assessment and Review for Long-Term Care Services (CARES) Community Care for the Disabled Adult (CCDA) Community Care for the Elderly (CCE) Client Information and Registration Tracking System (CIRTS) Department of Children and Families (DCF) Florida Department of Elder Affairs (DOEA or the “Department”) Home Care for Disabled Adults (HCDA) Instrumental Activities of Daily Living (IADL) Notice of Instruction (NOI) Planning and Service Area (PSA) Service Provider Application (SPA)

1.1.2 PROGRAM SPECIFIC TERMS

Adult Protective Services Referral Tracking Tool: A system designed to track DCF APS referrals to AAAs and CCE Lead Agencies for victims of second party abuse, neglect, and exploitation who need home and community-based services as identified by APS staff.

Aging Out: The condition of reaching 60 years of age and being transitioned from the Department of Children and Families (DCF) Services, Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults (HCDA) services to the Department’s community-based services.

Area Plan: A plan developed by the AAA outlining a comprehensive and coordinated service delivery system in its planning and service area in accordance with the Section 306 (42 U.S.C. 3026) of the Older Americans Act and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county.

Area Plan Update: A revision to the Area Plan wherein the AAA enters CCE specific data in the CIRTS. An update may also include other revisions to the Area Plan as instructed by the Department.

Department of Elder Affairs Programs and Services Handbook: An official document of the State of Florida, Department of Elder Affairs. The Handbook includes program policies, procedures, and standards applicable to agencies which are recipients of DOEA–funded programs and providers of program-funded services. An annual update is provided through a Notice of Instruction.

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Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment.

Notice of Instruction (NOI): DOEA’s established method to communicate to the Contractor and Subcontractor the requirements to perform particular tasks or activities. NOIs are located on the DOEA website.

Program Highlights: Success stories, quotes, testimonials, or human-interest vignettes that are used in the Summary of Programs and Services, to demonstrate how programs and services help elders, families, and caregivers.

Service Provider Application (SPA): The plan developed by the Contractor and any revisions thereto, approved by the AAA which outlines the services and service delivery system to be used to fulfill the program requirements of the agency, the Department, and the CCE program.

1.2 GENERAL DESCRIPTION

1.2.1 General Statement

The primary purpose of the CCE program is to prevent, decrease or delay premature or inappropriate and expensive placement of older persons in nursing homes and other institutions.

1.2.2 Community Care for the Elderly Mission Statement

The CCE Program assists functionally-impaired elderly persons in living as independently as possible in 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.

1.2.3 Authority

The relevant authorities governing the CCE program are:

(1) Rule 58C-1, Florida Administrative Code; (2) Sections 430.201 through 430.207, F.S.; and (3) The Catalog of State Financial Assistance (CSFA) Number 65.010

1.2.4 Scope of Service

The Contractor is responsible for the programmatic, fiscal and operational management of CCE. The services shall be provided in a manner consistent with and described in the Contractors SPA, and any revisions thereto approved by the AAA, and the current DOEA Programs and Services Handbook, which are hereby incorporated by reference. The Contractor’s application submitted in response to the 2016 CCE RFP, as well as the RFP itself is incorporated by reference in this contract between the Alliance and the Contractor and made a part of this contract. In case of conflict between the SPA and the Handbook, the Handbook prevails.

1.2.5 Major Program Goals

The major goals of the Community Care for the Elderly program are to preserve the independence of elders and prevent or delay more costly institutional care through a community care service system that provides case management and other in-home and community services as needed under the direction of a lead agency and provide a continuum of service alternatives that meet the diverse needs of functionally-impaired elders.

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1.3 CLIENTS TO BE SERVED

1.3.1 General Description The CCE program provides a continuum of services for functional impaired elders.

1.3.2 Client Eligibility

In order to receive services under this contract, an applicant must:

(1) Be at least 60 years of age; (2) Be functionally impaired as determined through the initial comprehensive assessment; (3) Not be dually enrolled in the CCE program and a Medicaid capitated long-term care program; and (4) Be aging out as defined in ATTACHMENT I, Sec 1.1.2.

1.3.3 Targeted Groups Priority for services provided under this contract shall be given to those eligible persons assessed to be at risk of placement in an institution or who are abused, neglected or exploited.

SECTION II. MANNER OF SERVICE PROVISION

A. Service Tasks To achieve the goals of the CCE Program, the Contractor shall perform, or ensure that its Subcontractors perform, the following tasks:

1. Client Eligibility Determination

The Contractor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described in section I.C.2.

2. Assessment and Prioritization of Service Delivery for New Clients

The Contractor shall ensure the following criteria are used to prioritize new clients for service delivery in the sequence below. It is not the intent of the Alliance to remove existing clients from services in order to serve new clients being assessed and prioritized for service delivery. a. DCF APS High Risk individuals: The Contractor shall ensure that pursuant to Section 430.205(5) (a), Florida

Statutes, those elderly persons who are determined by DCF APS to be victims of abuse, neglect, or exploitation who are in need of immediate services to prevent further harm, and are referred by APS, will be given primary consideration for receiving CCE services. As used in this subsection, "primary consideration" means that an assessment and services must commence within 72 hours after referral to the Department or as established in accordance with local protocols developed between Department service contractors and APS. The Contractor shall follow guidelines for DCF APS High Risk referrals established in the APS Operations Manual, which is incorporated by reference.

b. Imminent Risk individuals: Individuals in the community whose mental or physical health condition has

deteriorated to the degree that self-care is not possible, there is no capable caregiver, and nursing home placement is likely within a month or very likely within 3 months.

c. Aging Out individuals: Individuals receiving CCDA and HCDA services through the Department of

Children and Families' Adult Services transitioning to community-based services provided through the Department when services are not currently available. All Aging Out individuals will be referred by DCF to the ADRC for enrollment into the corresponding aged program.

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d. Service priority for individuals not included in a., c., and d. above, regardless of referral source, will be determined through the Department'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. 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 require Subcontractors, through the performance of the client assessment, to identify potential Medicaid eligible CCE clients and to refer these individuals for application for Medicaid Waiver services.

b. The Contractor must require individuals who have been identified as being potentially Medicaid Waiver

eligible to apply for Medicaid Waiver services in order to receive CCE services. These individuals may only receive CCE services while the Medicaid Waiver eligibility determination is pending. If the client is found ineligible for Medicaid Waiver services for any reason other than failure to provide required documentation, then the individual may continue to receive CCE services.

c. The Contractor must advise individuals who have been identified as being potentially Medicaid Waiver

eligible of the responsibility to apply for Medicaid Waiver services as a condition of receiving CCE services while the eligibility determination is being processed.

4. Program Services

The Contractor shall ensure the provision of program services is consistent with the Alliance’s current area plan, as updated and approved by the Department, and the current DOEA Programs and Services Handbook. The assessment and provision of services should always consider the most cost effective means of service delivery.

B. Use of Subcontractors

If this contract involves the use of a Subcontractor or third party, then the Contractor shall not delay the implementation of its agreement with the Subcontractor. If any circumstance occurs that may result in a delay for a period of 60 days or more the initiation of the subcontract or the performance of the Subcontractor, the Contractor shall notify the Alliance’s Contract Manager in writing of such delay. The Contractor shall not permit a Subcontractor to perform services related to this agreement without having a binding Subcontractor agreement executed. In accordance with Section 23.1 of Master Contract, the Alliance will not be responsible or liable for any obligations or claims resulting from such action.

1. List of Subcontracts:

The Contractor shall submit a list of all subcontracts to the Alliance Contract Manager within thirty days of the subcontract being executed.

2. Monitoring the Performance of Subcontractors:

The Contractor shall programmatically monitor, at least once per year, each of its Subcontractors, Subrecipients, Vendors, and/or Consultants. The Contractor shall perform programmatic monitoring to ensure contractual compliance, and programmatic performance and compliance with applicable state and federal laws and regulations. The Contractor shall monitor to ensure that time schedules are met; the budget and scope of work are accomplished within the specified time periods, and other performance goals. The Contractor shall also perform fiscal and administrative monitoring for all subcontractors to ensure fiscal accountability.

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C. Staffing Requirements

1. Staffing Levels The Contractor shall dedicate the staff 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 contract has the qualifications as specified in the DOEA Programs and Services Handbook.

3. Service Times

The Contractor shall ensure the availability of services listed in this contract at times appropriate to meet client service needs, at a minimum during normal business hours. Normal business hours are defined as Monday through Friday, 8:00a.m. to 5:00p.m.

D. Deliverables

The following section provides the specific quantifiable units of deliverables and source documentation required to evidence the completion of the tasks specified in this contract.

1. Delivery of Service to Eligible Clients:

The Contractor shall ensure the provision of a continuum of services that meets the diverse, individual, and assessed needs of each functionally-impaired elder. The Contractor shall ensure performance and reporting of the following services in accordance with the current DOEA Programs and Services Handbook, which is incorporated by reference, and ATTACHMENT I, Sec. II.A.l-4 of this contract. Documentation of service delivery must include a report consisting of the following: number of clients served, number of service units provided by service, and rate per service unit with calculations that equal the total invoice amount. The services include the following categories:

a. Core Services for Programmatic Operation

The Contractor shall ensure that core services include a variety of in-home services, day care services, and other basic services that are most needed to prevent unnecessary institutionalization. Core services to be provided must be described on the Service Provider Application and are referenced on ATTACHMENT VII of this contract. Core services may include the following:

(1) Adult Day Care; (8) Housing Improvement; (2) Chore/Enhanced Chore Services; (9) Legal Assistance; (3) Companionship; (10) Pest Control Services; (4) Escort; (11) Respite Services; (5) Financial Risk Reduction; (12) Shopping Assistance; and (6) Home Delivered Meals; (13) Transportation. (7) Homemaker;

b. Health Maintenance Services

The Contractor shall ensure that health maintenance services are made available as necessary to maintain the health of functionally impaired elders. The services are limited to medical therapeutic services and non-medical prevention services. Health Maintenance services to be provided must be described on the Service Provider Application and are referenced on ATTACHMENT VII of this contract. Health Maintenance Services may include the following:

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(1) Adult Day Health Care; (2) Emergency Alert Response; (3) Gerontological Counseling; (4) Health Support; (5) Home Health Aide; (6) Nutrition Counseling; (7) Occupational Therapy; (8) Personal Care; (9) Physical Therapy; (10) Skilled Nursing Services; (11) Medication Management; (12) Mental Health Counseling/Screening; (13) Specialized Medical Equipment, Services and Supplies; and (14) Speech Therapy.

c. Other Support Services The Contractor shall ensure that support services expand the continuum of care options to assist

functionally impaired elders and their caregivers. Other Support services to be provided must be described on the Service Provider Application and are referenced on ATTACHMENT VII of this contract. Other Support Services may include the following:

(1) Caregiver Training/Support; (2) Case Aid; (3) Case Management; (4) Material Aid; and (5) Other services, as approved by the Department.

E. Administrative Responsibilities

The Contractor shall provide management and oversight of CCE Program operations in accordance with the current DOEA Programs and Services Handbook including:

1. Prepare and submit an annual Service Provider Application (SPA). 2. Establish contractual agreements with appropriate and capable subcontractor and vendor agreements, when

applicable. 3. Provide technical assistance to subcontractors and vendors to ensure provision of quality services. 4. Monitor and evaluate subcontractors and vendors for appropriate programmatic and fiscal compliance. 5. Appropriately submit payments to subcontractors. 6. Establish procedures for handling recipient complaints concerning such adverse actions as service

termination, suspension or reduction in services. 7. Ensure compliance with Client Information and Registration Tracking System (CIRTS) regulations. 8. Monitor outcome measures in accordance with targets set by the Department. 9. Conduct client satisfaction surveys to evaluate and improve service delivery.

F. Reports

The Contractor is responsible for responding in a timely manner as determined by the agency to additional routine and/or special requests for information and reports required by the Alliance. The Contractor must establish due dates for subcontractors that permit the Contractor to meet the Alliance’s reporting requirements.

1. Service Cost Reports:

The Provider shall submit Service Cost Reports to the Alliance annually, but no later than ninety (90) calendar days after the contract year ends. The Service Cost Reports shall reflect actual costs of providing each service by program for the preceding contract year. If the Provider desires to renegotiate its reimbursement rates, the Provider shall make a request in writing to the Alliance in accordance with the Alliance’s approved Reimbursement Rate Review Policy, which is incorporated by reference.

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2. CIRTS Reports: The Contractor shall ensure timely input of CCE specific data into CIRTS. The contractor must run monthly CIRTS reports to validate the client and service data in CIRTS is accurate prior to submitting a request for payment invoice. To ensure CIRTS data accuracy, the Provider shall adhere to the Alliance’s CIRTS Data Integrity Policy and use CIRTS-generated reports which include the following:

• Client Reports; • Monitoring Reports; • Service Reports; • Miscellaneous Reports; • Fiscal Reports; and • Outcome Measures Reports.

3. Surplus/Deficit Report: The Contractor will submit a consolidated surplus/deficit report in a format provided by the Alliance to the

Alliance's Contract Manager in conjunction with the required monthly billing submission. The report will include the following:

The Contractor's detailed plan on how the surplus or deficit spending exceeding the 1% threshold will be resolved;

Number of clients currently on the APCL, that receive a priority ranking score of four (4) or five (5); Number of clients currently on the APCL designated as Imminent Risk. Number of clients served and ADRC client contacts,

In accordance with Alliance surplus/deficit management policies, in order to maximize available funding and minimize the time that potential clients must wait for services, the Alliance in its sole discretion can reduce funding awards if the Contractor is not spending according to monthly plans and is projected to incur a surplus at the end of the year.

4. Program Highlights The Contractor shall submit Program Highlights referencing specific events that occurred in the previous fiscal

year by September 15th of the current contract year. 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, in order to identify the specific individual or entity that performed the activity described in the highlight. The Contractor shall review and edit Program Highlights for clarity, readability, relevance, specificity, human interest, and grammar, prior to submitting them to the Alliance.

5. Performance Outcome Measurements

a. Service Providers Applications (SPA) must be updated and submitted annually within 30 days of the

execution of the current contract. b. The performance of the Contractor in providing the services described in this contract shall be measured by

the current SPA strategies for the following criteria: i. Percentage of APS referrals who are in need of immediate services to prevent further harm who are

served within 72 hours. ii. Percent of elders assessed with high to moderate risk environments who improved their environment

score.

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iii. Percent of new service recipients with high-risk nutrition scores whose nutritional status improved. iv. Percent of new service recipients whose ADL assessment score has been maintained or improved. v. Percent of new service recipients whose IADL assessment score has been maintained or improved. vi. Percent of family and family assisted caregivers who self-report they are likely to provide care. vii. Percent of caregivers whose ability to provide care is maintained or improved after one year of

service intervention (as determined by the caregiver and the assessor).

G. Records and Documentation

1. The Contractor shall maintain documentation to support Requests for Payment that shall be available to the Alliance or authorized individuals, such as the Department or the Department of Financial Services, 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 Alliance. Maintenance includes accurate and current data, and valid exports and backups of all data and systems according to the Alliance and Department standards.

3. Data Integrity and Back up Procedures:

The Contractor shall anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of contractor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location.

4. Policies and Procedures for Records and Documentation:

The Contractor shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement of its subcontractors. These policies and procedures shall be made available to the Alliance upon request.

H. Performance Specifications

1. Outcomes a. The Contractor shall timely submit to the Alliance all reports described in ATTACHMENT I, Sec. II.F.:

REPORTS; b. The Contractor shall maintain all information described in ATTACHMENT I, Sec II.G.: ELECTRONIC

RECORDS AND DOCUMENTATION; c. The Contractor shall ensure the provision of services described in this contract are in accordance with the

current DOEA Programs and Services Handbook. d. The Contractor shall ensure the prioritization and service provision of clients in accordance with

ATTACHMENT I, Sec. II.A.2 of this contract. e. The Contractor shall endure timely (in accordance with Attachment VIII) and accurately submit to the

Alliance Attachments IX, X and supporting documentation. 2. The performance of the Contractor in providing the services described in this contract shall be measured by the

current SPA strategies for the following criteria:

a. Percent of APS referrals who are in need of immediate services to prevent further harm who are served within 72 hours;

b. Percent of elders assessed with high or moderate risk environments who improved their environment score;

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c. Percent of new service recipients with high-risk nutrition scores whose nutritional status improved; d. Percent of new service recipients whose ADL assessment score has been maintained or improved; e. Percent of new service recipients whose IADL assessment score has been maintained or improved; f. Percent of family and family-assisted caregivers who self-report they are likely to provide care; g. Percent of caregivers whose ability to provide care is maintained or improved after one year of service

intervention (as determined by the caregiver and the assessor);

I. Monitoring and Evaluation The Alliance 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 Alliance's determination of acceptable performance shall be conclusive. The Contractor agrees to cooperate with the Alliance in monitoring the progress of completion of the service tasks and deliverables. The Alliance may use, but is not limited to, one or more of the following methods for monitoring:

1. Desk reviews and analytical reviews; 2. Scheduled, unscheduled, and follow-up on-site visits; 3. Client visits; 4. Review of independent auditor's reports; 5. Review of customer satisfaction surveys; 6. Limited-scope reviews; and 7. Other procedures as deemed necessary.

J. Contractor Responsibilities

1. Contractor Accountability: All service tasks and deliverables pursuant to this contract are solely and exclusively the responsibility of the Contractor, and for which, by execution of the contract, the Contractor agrees to be held accountable.

2. Coordination with Other Providers and/or Entities:

Notwithstanding that services for which the Contractor is held accountable involve coordination with other entities in performing the requirements of the contract; the failure of other entities does not alleviate the Contractor from any accountability for tasks or services that the Contractor is obligated to perform pursuant to this contract.

K. Alliance Responsibilities

1. Alliance Obligations: The Alliance will provide technical support to assist the Contractor in meeting the requirements of this contract.

2. Alliance Determinations:

The Alliance reserves the exclusive right to make certain determinations in the tasks and approaches. The absence of the Alliance setting forth a specific reservation of rights does not mean that all other areas of the contract are subject to mutual agreement.

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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 Alliance will pay the Contractor upon satisfactory completion of the Tasks/Deliverables, as specified in Section II and in accordance with other terms and conditions of the contract.

1. Fixed Fee/Unit Rate

Payment for Fixed Fee/Unit Rates shall not exceed amounts established in ATTACHMENT VII, per unit of service.

2. Cost Reimbursement

Payment may be authorized only for allowable expenditures, which are in accordance with the services specified in ATTACHMENT VII and ATTACHMENT K. All Cost Reimbursement Requests for Payment must include the Receipt and Expenditure Report (ATTACMENT X) beginning with the first month of the contract.

3. Advance Payments

Contractors may request a monthly advance for service costs for each of the first two months of the contract period, based on anticipated cash needs. Detailed documentation justifying cash needs for advances must be submitted with the signed contract, approved by the Alliance, and maintained in the contract manager’s file. All advance payments will be reconciled and recouped from the third through the twelfth month. Reconciliation and recouping of advances made under this contract are to be completed in accordance with ATTACHEMNT VIII. All advance payments are subject to the availability of funds.

B. Method of Invoice Payment

Payment shall be made upon the Contractor's presentation of an invoice subsequent to the acceptance and approval by the Alliance of the deliverables shown on the invoice and payment has been received from DOEA. The form and substance of each invoice submitted by the Contractor shall be as follows:

1. Request payment on a monthly basis for the units of services established in this contract, provided in

conformance with the requirements as described in the DOEA Programs and Services Handbook, and at the rates established in ATTACHMENT VII and ATTACHMENT K 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 change to the total contract amount requires a formal amendment;

2. The Contractor shall consolidate all subcontractors' Requests for Payment and Expenditure Reports that support

Requests for Payment and shall submit to the Alliance using forms Request for Payment (ATTACHMENT IX), Receipt and Expenditure Reports (ATTACHMENT X) for services;

3. All Requests for Payment shall be based on the submission of monthly Expenditure Reports beginning with the

first month of the contract. The schedule for submission of advance requests and invoices is Invoice Schedule, ATTACHMENT VIII;

4. In the event that services were not billed during the regular billing cycle, the Contractor may request payment for

services no later than 90 days after the month in which the expense was incurred, except that requests cannot be made after the contract closeout date. Request for payment of services rendered 90 days after the month in which the expense was incurred will require approval of the contract manager prior to the billing of such incurred expenses. Late service billing requests will not be paid unless justification is submitted and approved by the contract manager;

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5. The Contractor shall maintain documentation to support payment requests which shall be available to the

Alliance, the Department, and the Department of Financial Services, or other authorized state and federal personnel upon request; and

6. All payments under the terms of this contract are contingent upon an annual appropriation by the Legislature, and

subject to the availability of funds.

D. Payment Withholding Any payment due by the Alliance under the terms of this contract may be withheld pending the receipt and approval by the Alliance of all financial and programmatic reports due from the Contractor and any adjustments thereto, including any disallowance not resolved as outlined in Section 26 of the Master Contract.

E. Final Invoice Instructions

The Contractor shall submit the final Request for Payment to the Department no later than 45 days after the contract period ends and as referenced in ATTACHMENT VIII. If the contract is terminated prior to the end date of the contract, then the Contractor must submit the final request for payment to the Alliance no more than 45 days after the contract is terminated. If the provider fails to do so, all right to payment is forfeited, and the Alliance will not honor any requests submitted after the aforesaid time period.

F. Contractors' Monthly CIRTS Reports

The Contractor must run monthly CIRTS reports and verify client and service data in the CIRTS is accurate. This report must be submitted to the Alliance with the monthly request for payment and expenditure report and must be reviewed by the Alliance before the Contractor's request for payment and expenditure reports can be approved by the Alliance.

G. CIRTS Data Entries for Subcontractors

The Contractor must require Subcontractors 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). Subcontractors must enter this data into the CIRTS prior to submitting their requests for payment and expenditure reports to the Contractor. The Contractor shall establish deadlines for completing CIRTS data entry and to assure compliance with due dates for the requests for payment and expenditure reports that Contractor must submit to the Alliance.

H. Corrective Action Plan

1. Contractor shall ensure 100% of the deliverables identified in ATTACHMENT 1, Section II (Manner of Service Provision) of this contract, are performed pursuant to contract requirements.

2. If at any time the Contractor is notified by the Alliance Contract Manager that it has failed to correctly,

completely, or adequately perform contract deliverables identified in ATTACHMENT I, Sec. II, the Contractor will have 10 days to submit a Corrective Action Plan (“CAP”) to the Alliance Contract Manager that addresses the deficiencies and states how the deficiencies will be remedied within a time period approved by the Alliance Contract Manager. The Alliance shall assess a Financial Consequence for Non-Compliance on the Contractor as referenced in ATTACHMENT I, Sec. II.I. of this contract for each deficiency identified in the CAP which is not corrected pursuant to the CAP. The Alliance 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 Alliance shall deduct the percentage established in ATTACHMENT I, Sec. II.I. of this contract, from the payment for the invoice of the following month.

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4. If the Contractor fails to timely submit a CAP, the Alliance shall deduct the percentage established in

ATTACHMENT I, Sec. II.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. If, or to the extent, there is any conflict between ATTACHMENT I, Sec. II.I. above and paragraphs 39.1 and 39.2 of the Master Contract, this section shall take precedence.

I. Financial Consequences of Non-Performance

The Alliance will withhold or reduce payment if the Contractor fails to perform the deliverables to the satisfaction of the Contract according to the requirements referenced in ATTACHMENT I, Sec. I and Sec. II 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 ATTACHMENT I, Sec. II of this contract.

1. Delivery of services to eligible clients as referenced in ATTACHMENT I, Sec. I.1.3 Sec. II.A.2 of this contract –

Failure to comply with established assessment and prioritization criteria as evidenced in 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 Alliance’s notification to the contractor that the identified deficiency was not cured or satisfactorily addressed in accordance with the Alliance approved CAP, referenced in ATTACHMENT I, Sec. II.H.

2. Services and units of services as referenced in ATTACHMENT I, Sec. II.D. of this contract – Failure to provide

services in accordance with the current DOEA Programs and Services Handbook, the service tasks described in section ATTACHMENTS VII and K, and submission of required documentation will result in a 2% reduction of payment per business day. The reduction of payment will begin the first business day following the Alliance’s notification to the contractor that the identified deficiency was not cured or satisfactorily addressed in accordance with the Alliance approved CAP, referenced in ATTACHMENT I, Sec. II.H.

3. Administrative duties as referenced in ATTACHMENT I, Sec. II.E. of this contract – Failure to perform the

performance specifications and oversight of CCE 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 Alliance’s notification to the contractor that the identified deficiency was not cured or satisfactorily addressed in accordance with the Alliance approved CAP, referenced in ATTACHMENT I, Sec. II.H.

4. Timely submission of a CAP – Failure to timely submit a CAP within 10 business days after notification of the

deficiency by the Alliance 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 Alliance’s notification to the contractor that the identified deficiency was not cured or satisfactorily addressed in accordance with the Alliance approved CAP, referenced in ATTACHMENT I, Sec. II.H.

5. Exceptions may be granted solely, in writing, by the Alliance contract manager.

IV. SPECIAL PROVISIONS

A. Contractor’s Financial Obligations

1. Matching, Level of Effort, and Earmarking Requirement: The Contractor must provide a match of at least 10 percent of the cost for all CCE services. The match will be made in the form of cash and/or in-kind resources. At the end of the contract period, all CCE funds expended must be properly matched. State funds cannot be used to match another state-funded program.

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2. Cost Sharing and Co-payments: The Contractor in conjunction with the Alliance shall establish an annual co-payment goal (amount to be collected from clients). Using the method prescribed in Appendix B of the current Department of Elder Affairs Program and Services Handbook, the provider shall project the annual co-payments to be collected from each active client in all income ranges prior to the start of each fiscal year. The provider is required to meet the established goal. Co-payments collected in the CCE program can be used as part of the local match. The Alliance will hold back 5% of the Contractor’s contract amount. The amount held back shall be released to the provider after 50% of the adjusted annual goal is collected, but no later than February 15th of the fiscal year. Hold back amounts not earned by providers as of February 15th will be reallocated to other Contractors meeting or exceeding 50% of their annual goal, except when no Contractor is meeting or exceeding its annual goal, or when a Contractor that is meeting or exceeding such goal affirms that it lacks the capacity to receive additional funds.

3. Management and Use of Service Dollars and Continuity of Service:

a. The Contractor is expected to spend all funds provided by the Alliance for the purpose specified in this

contract. The Contractor must manage the service dollars in such a manner so as to avoid having a surplus of funds at the end of the contract period. If the Alliance determines that the Contractor is not maximizing available funding, the Alliance, in accordance with its CCE/HCE Surplus/Deficit Fiscal policies, may transfer funds to other Contractors and/or adjust subsequent funding allocations accordingly.

b. The Contractor shall ensure that contract services will be provided until the end of the contract period. In

order to enable the Contractor to better manage the services under this contract and to maximize the use of available resources, the Alliance has established a spending authority as identified in Budget Summary, ATTACHMENT VII. The Contractor is responsible for managing the spending authority so that a continuity of service can be maintained for the maximum number of consumers. The Contractor agrees to assume responsibility for any contractual deficit that may be incurred.

4. Budget Summary:

The Alliance has established a spending authority based on services and rate detailed in the SPA and the Budget Summary, ATTACHMENT VII and any revisions thereto approved by the Alliance. Any changes in the total amounts of the funds identified on the Budget Summary require a contract amendment.

B. Remedies for Nonconforming Services

1. The Contractor shall ensure that all goods and/or services provided under this contract are delivered timely,

completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants.

2. If the Contractor fails to meet the prescribed quality standards for services, such services will not be reimbursed

under this contract. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be reimbursed under this contract. The Contractor’s signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the Contractor shall solely bear the costs associated with preparing or providing nonconforming goods and/or services. The Alliance requires immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients.

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ATTACHMENT II CERTIFICATIONS AND ASSURANCES The Alliance will not award this contract unless Contractor completes the CERTIFICATIONS AND ASSURANCES contained in this Attachment. In performance of this contract, Contractor provides the following certifications and assurances:

A. Debarment and Suspension Certification (29 CFR Part 95 and 2 CFR Part 200)

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. Certification Regarding Scrutinized Companies Lists, section 287.135, F.S.

G. Certification Regarding Data Integrity Compliance for Agreements. Grants, Loans And Cooperative

Agreements

H. Verification of Employment Status Certification A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY

MATTERS - PRIMARY COVERED TRANSACTION.

The undersigned Contractor certifies to the best of its knowledge and belief, that it and its principals: I. 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.

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B. CERTIFICATION REGARDING LOBBYING - Certification for Contracts, Grants, Loans, and Cooperative Agreements.

The undersigned Contractor certifies, to the best of its knowledge and belief, that: No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan or cooperative agreement. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employees of 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 tl1e benefits of, or be otherwise subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Alliance.

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 Alliance.

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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 Alliance.

5. Title IX of the Educational Amendments of 1972 (Pub. L. 92-318), as amended, and all requirements imposed by

or pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 86), to the end that, in accordance with Title IX and the Regulation, no person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any education program or activity for which the Applicant receives Federal financial assistance from the Alliance.

6. The American with Disabilities Act of 1990 (Pub. L. 101-336), prohibits discrimination in all employment

practices, including, job application procedures, hiring, firing, advancement, compensation, training, and other terms, conditions, and privileges of employment. It applies to recruitment, advertising, tenure, layoff, leave, fringe benefits, and all other employment-related activities, and;

Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws listed above. This assurance applies to Contractor's operation of the WIA Title I- financially assisted program or activity, and to all agreements Contractor makes to carry out the WIA Title I- financially assisted program or activity. Contractor understands that the Alliance, Department, and the United States have the right to seek judicial enforcement of the assurance.

D. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES, SECTION 287.133, F.S.

Contractor hereby certifies that neither it, nor any person or affiliate of Contractor, has been convicted of a Public Entity Crime as defined in section 287.133, F.S., nor placed on the convicted vendor list. Contractor understands and agrees that it is required to inform 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, 20 I 0, Division E, Section 511 (Pub. L. 111-117). The Continuing Appropriations Act, 2011, Sections 101 and 103 (Pub. L. 111-242), provides that appropriations made under Pub. L. 111-117 are available under the conditions provided by Pub. L. 111-117. The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all tiers (including subcontracts, sub-grants and contracts under grants, loans and cooperative agreements) and that all sub recipients and contractors shall provide this assurance accordingly.

F. SCRUTINIZED COMPANIES LISTS CERTIFICATION, SECTION 287.135, F.S.

If this Contract is in the an1ount of $1 million or more, in accordance with the requirements of section 287.135, F.S., Contractor hereby certifies that it is not listed on either the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List. Both lists are created pursuant to section 215.473, F.S.

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Contractor understands that pursuant to section 287.135, F.S., the submission of a false certification may subject Contractor to civil penalties, attorney's fees, and/or costs. If Contractor is unable to certify to any of the statements in this certification, Contractor shall attach an explanation to this Contract.

G. CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS,

GRANTS, LOANS AND COOPERATIVE AGREEMENTS

1. The Contractor and any Subcontractors of services under this contract have financial management systems capable of providing certain information, including: (I) accurate, current, and complete disclosure of the financial results of each grant-funded project or program in accordance with the prescribed reporting requirements; (2) the source and application of funds for all agreement supported activities; and (3) the comparison of outlays with budgeted amounts for each award. The inability to process information in accordance with these requirements could result in a return of grant funds that have not been accounted for properly.

2. Management Information Systems used by the Contractor, Subcontractors, or any outside entity on which the

Contractor is dependent for data that is to be reported, transmitted or calculated, have been assessed and verified to be capable of processing data accurately, including year-date dependent data. For those systems identified to be non-compliant, Contractors will take immediate action to assure data integrity.

3. 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.

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. 4. The Contractor and any Subcontractors of services under this contract warrant their policies and procedures

include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data integrity compliance issues.

H. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION

As a condition of contracting with the Alliance, Contractor certifies the use of the U.S. Department of Homeland Security's E-verify system to verify the employment eligibility of all new employees hired by Contractor during the contract term to perform employment duties pursuant to this contract and that any subcontracts include an express requirement that Subcontractors performing work or providing services pursuant to this Agreement utilize the E-verify system to verify the employment eligibility of all new employees hired by the Subcontractor during the entire contract term. The Contractor shall require that the language of this certification be included in all subagreements, subgrants, and other agreements and that all Subcontractors shall certify compliance accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB Circulars A-102 and 2 CFR Part 200 (formerly OMB Circular A-110).

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By signing below, Contractor certifies the representations outlined in parts A through H above are true and correct. _______________________________________________ (Signature and Title of Authorized Representative) _______________________________________________ Contractor Date _______________________________________________ (Street Address) _______________________________________________ (City, State, Zip code)

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ATTACHMENT III ATTACHMENT III

FINANCIAL AND COMPLIANCE AUDIT

The administration of resources awarded by the Alliance to the provider may be subject to audits and/or monitoring by the Alliance and/or the Department as described in this section. I. MONITORING In addition to reviews of audits conducted in accordance with OMB Circular A-133, as revised, and Section 215.97, F.S., (see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits by the Alliance and/or the Department staff, limited scope audits as defined by OMB Circular A-133, as revised, and/or other procedures. By entering into this agreement, the Contractor agrees to comply and cooperate with any monitoring procedures/processes deemed appropriate by the Alliance. In the event the Alliance and/or the Department determines that a limited scope audit of the Contractor is appropriate, the Contractor agrees to comply with any additional instructions provided by the A l l i a n c e a n d / o r t h e 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 Alliance and/or the Department . AUDITS PART I: FEDERALLY FUNDED This part is applicable if the provider is a State or local government or a non-profit organization as defined in OMB Circular A-133, as revised. In the event that the 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 OMB Circular A-133, as revised. EXHIBIT 2 to this agreement indicates federal resources awarded through the Alliance by this agreement. In determining the federal awards expended in its fiscal year, the C o n t r a c t o r shall consider all sources of Federal awards, including federal resources received from the A l l i a n c e . The determination of amounts of Federal awards expended should be in accordance with the guidelines established by OMB Circular A-133, as revised. An audit of the C o n t r a c t o r conducted by the Auditor General in accordance with the provisions of OMB Circular A-133, as revised, will meet the requirements of this part. In connection with the audit requirements addressed in Part I, paragraph I, the Contractor shall fulfill the requirements relative to auditee responsibilities as provided in Subpart C of OMB Circular A-133, as revised. 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 OMB Circular A-133, as revised, 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 OMB Circular A-133, as revised, the cost of the audit must be paid from non-federal resources (i.e., the cost of such audit must be paid from 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 agreements with the Alliance shall be based on the agreement's requirements, including any rules, regulations, or statutes referenced in the agreement. The financial statements shall disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the Alliance and/or the Department shall be fully disclosed in the audit report with reference to the Alliance agreement involved. If not otherwise disclosed as required by Section .310(b)(2) of OMB Circular A-133, as revised, the schedule of expenditures of federal awards shall identify expenditures by agreement number for each agreement with the Alliance in effect during the audit period. Financial reporting packages required under this part must be submitted within the earlier of 30 days after receipt of the audit report or 9 months after the end of the Contractor's fiscal year end. PART II: STATE FUNDED This part is applicable if the Contractor is a non-state entity as defined by Section 215.97(2), F.S.

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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 (for fiscal years ending September 30, 2004 or thereafter), 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 Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General. EXHIBIT 2 to this agreement indicates state financial assistance awarded through the A l l i a n c e by this agreement. 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 Alliance, 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 I, 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 (for fiscal years ending September 30, 2004 or thereafter), an audit conducted in accordance with the provisions of Section 215.97, F.S., is not required. In the event that the 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 agreements with the Alliance shall be based on the agreement's requirements, including any applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the Alliance shall be fully disclosed in the audit report with reference to the Alliance agreement involved. If not otherwise disclosed as required by Rule 69I-5.003, Fla. Admin. Code, the schedule of expenditures of state financial assistance shall identify expenditures by agreement number for each agreement with the All iance in effect during the audit period. Financial reporting packages required under this part must be submitted within 45 days after delivery of the audit report, but-no later than 12 months after the Contractor 's fiscal year end for local governmental entities. Non-profit or for-profit organizations are required to be submitted within 45 days after delivery of the audit report, but no later than 9 months after the Contractor 's fiscal year end. Notwithstanding the applicability of this portion, the Alliance retains all right and obligation to monitor and oversee the performance of this agreement as outlined throughout this document and pursuant to law. II. PART III: REPORT SUBMISSION Copies of reporting packages for audits conducted in accordance with OMB Circular A-133, as revised, and required by PART I of this agreement shall be submitted, when required by Section .320 (d), OMB Circular A-133, as revised, by or on behalf of the Contractor directly to each of the following: The Alliance at each of the following addresses:



Miami, FL 33172

The Federal Audit Clearinghouse designated in OMB Circular A-133, as revised (the number of copies required by Sections .320 (d), OMB Circular A-133, as revised, should be submitted to the Federal Audit Clearinghouse), at the following address:


Jeffersonville, IN 47132

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Other Federal agencies and pass-through entities in accordance with Sections .320 (e) and (f), OMB Circular A-133, as revised. Pursuant to Sections .320(f), OMB Circular A-133, as revised, the provider shall submit a copy of the reporting package described in Section .320(c), OMB Circular A-133, as revised, and any management letter issued by the auditor, to the Alliance at each of the following addresses:



Miami, FL 33172




Miami, FL 33172 Any reports, management letter, or other information required to be submitted to the Alliance pursuant to this agreement shall be submitted timely in accordance with OMB Circular A-133, F.S., and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, as applicable. Contractors, when submitting financial reporting packages to the A l l i a n c e for audits done in accordance with OMB Circular A-133 or Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, should indicate the date that the reporting package was delivered to the Contractor in correspondence accompanying the reporting package. III. 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 All iance and the Department 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 Alliance and the Department, 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 Al l i ance .

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ATTACHMENT III

FINANCIAL, AND COMPLIANCE AUDIT ATTACHMENT EXHIBIT 1

PART 1: AUDIT RELATIONSHIP DETERMINATION Contractors who receive state or federal resources may or may not be subject to the audit requirements of 2 CFR Part §200.500, and/or Section 215.97, Fla. Stat. C o n t r a c t o r s who are determined to be recipients or subrecipients of federal awards and/or state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I and/or Part II of Exhibit I is met. C o n t r a c t o r s who have been determined to be vendors are not subject to the and it requirements of 2 CFR Part §200.38, and/or Section 215.97, Fla. Stat. Regardless of whether the audit requirements are met, C o n t r a c t o r s who have been determined to be recipients or subrecipients of Federal awards and/or state financial assistance must comply with applicable programmatic and fiscal compliance requirements. In accordance with 2 CFR Part §200 and/or Rule 691-5.006, FAC, C o n t r a c t o r has been determined to be: ____ Vendor not subject to 2 CFR Part §200.38 and/or Section 215.97, F.S. ____ Recipient/subrecipient subject to 2 CFR Part §200.86 and §200.93 and/or Section 215.97, F.S. ____ Exempt organization not subject to 2 CFR Part §200 and/or Section 215.97, F.S. For Federal awards, for-profit

organizations are exempt; for state financial assistance projects, public universities, community colleges, district school boards, branches of state (Florida) government, and charter schools are exempt. Exempt organizations must comply with all compliance requirements set forth within the contract or award document.

NOTE: If a C o n t r a c t o r is determined to be a recipient/subrecipient of federal and or state financial assistance and has been approved by the Alliance to subcontract, they must comply with Section 215.97(7), F.S., and Rule 69I-5.006, FAC [state financial assistance] and 2 CFR Part §200.330 [federal awards]. PART II: FISCAL COMPLIANCE REQUIREMENTS FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. C o nt ra c t o r s who receive Federal awards, state maintenance of effort funds, or state matching funds on Federal awards and who are determined to be a subrecipient must comply with the following fiscal laws, rules and regulations:






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*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in the 2 CFR Part §200.401(5) (c). **For funding passed through U.S. Health and Human Services, 45 CFR 92; for funding passed through U.S. Department of Education, 34 CFR 100. STATE FINANCIAL ASSISTANCE. C o nt ra c t o r s who receive state financial assistance and who are determined to be a recipient/subrecipient must comply with the following fiscal laws, rules and regulations:

Section 215.97, Fla. Stat. Chapter 691-5, Fla. Admin. Code State Projects Compliance Supplement Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations

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ATTACHMENT III FINANCIAL, AND COMPLIANCE AUDIT ATTACHMENT

EXHIBIT 2-FUNDING SUMMARY Note: Title 2 CFR § 200.331, As Revised, and Section 215.97(5), Florida Statutes, Require That Information About Federal Programs and State Projects Be Provided to the Recipient and Are Stated in the Financial and Compliance Audit Attachment and Exhibit 1. Financial and Compliance Audit Attachment, Exhibit 2-Funding Summary Provides Information Regarding the Funding Sources Applicable to This Contract, Contained Herein, Is A Prediction of Funding Sources and Related Amounts Based on the Contract Budget. 1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF THE FOLLOWING: GRANT AWARD (FAIN#): N/A FEDERAL AWARD DATE: DUNS NUMBER: 785359126

PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT

TOTAL FEDERAL AWARD

COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: FEDERAL FUNDS: 2 CFR Part 200- Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. OMB Circular A-133, as amended- Audits of States, Local Governments, and Non-Profit Organizations 2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF THE FOLLOWING: MATCHING RESOUCES FOR FEDERAL PROGRAMS

PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT TOTAL STATE AWARD


TOTAL AWARD

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, FL Admin Code, Reference Guide for State Expenditures, Other fiscal requirements set forth in program laws, rules and regulations.

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ATTACHMENT VII COMMUNITY CARE FOR THE ELDERLY PROGRAM

BUDGET SUMMARY The Alliance shall make payment to the provider for provision of services up to a maximum number of units of service and at the rate(s) stated below:

Service to be Provided Service Unit Rate Maximum Units of Service

Maximum Dollars

Adult Day Care

Case Management

Chore

Chore (Enhanced)

Companionship

Counseling (Gerontological)

EAR Installation

EAR Maintenance

Escort

Home Delivery Meals

Homemaker

Nutrition Counseling

Personal Care

Pest Control Initial

Pest Control Maintenance

Respite (In Home)

Specialized Medical Equipment & Supplies

TOTAL

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ATTACHMENT VIII

COMMUNITY CARE FOR THE ELDERLY INVOICE REPORT SCHEDULE

Report Number Based On Submit to Alliance on

this Date 1 July Advance* July 1 2 August Advance* July 1 3 July Expenditure Report August 7 4 August Expenditure Report September 7 5 September Expenditure Report + 1/10 advance reconciliation October 7 6 October Expenditure Report + 1/10 advance reconciliation November 7 7 November Expenditure Report + 1/10 advance reconciliation December 7 8 December Expenditure Report + 1/10 advance reconciliation January 7 9 January Expenditure Report + 1/10 advance reconciliation February 7

10 February Expenditure Report + 1/10 advance reconciliation March 7 11 March Expenditure Report + 1/10 advance reconciliation April 7 12 April Expenditure Report + 1/10 advance reconciliation May 7 13 May Expenditure Report + 1/10 advance reconciliation June 7 14 June Expenditure Report+ 1/10 advance reconciliation July 7 15 Final Expenditure and closeout August 15

Legend: * Advance based on projected cash need. Note 1: All advance payments made to the Provider shall be returned to the Alliance as

follows: One-tenth of the advance payment received shall be reported as an advance recoupment on each Request for Payment, starting with report #5. The adjustment shall be recorded in Part C, Line 1 of the report (Attachment IX). Note 2: Submission of expenditure reports may or may not generate a payment request. If final expenditure report reflects funds due back to the Alliance, payment is to accompany the report.

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ATTACHMENT IX

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PROVIDER NAME, ADDRESS, PHONE # and FEID# Program Funding : THIS REPORT PERIOD: From ____________ To ____________CCE Admin. _________ CONTRACT PERIOD: CCE Services __________ CONTRACT #

REPORT #

PSA#

CERTIFICATION : I certify to the best of my knowledge and belief that the report is complete and correct and all outlays herein are for purposes set forth in the contract.

Prepared by : ______________________________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/0! 2. Program Income $0.00 $0.00 $0.00 #DIV/0! 3. Local Cash Match $0.00 $0.00 $0.00 #DIV/0! 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/0! 2. Service Subcontractor(s) $0.00 $0.00 $0.00 #DIV/0! 3. Adult Protective Services $0.00 $0.00 $0.00 #DIV/0!

4. TOTAL EXPENDITURES $0.00 $0.00 $0.00 #DIV/0!

PART C : OTHER REVENUE AND EXPENDITURES II. Interest: III. Advance Recouped

I. Program Income (PI) 1. Earned on GR Advance $____________ $ ________________ 1. CCE: PI Collected YTD $_____________ 2. Return of GR Advance $____________

3. Other Earned $______________

PART D : CO-PAYMENTS CURRENT MONTH YEAR-TO-DATE

1. Total of Co-payments assessed $_______________ $_______________

2. Total of Co-payments collected $_______________ $_______________

DOEA FORM 105CRevised 5/25/2010

COMMUNITY CARE FOR THE ELDERLYRECEIPT AND EXPENDITURE REPORT

(Includes fees collected)

(For Tracking Purposes only)

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ATTACHMENT A

Title: Department of Elder Affairs Programs & Services Handbook



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ATTACHMENT C REFERRAL PROTOCOL

Issue: Screening, Triage, and Referral for Activation under the Community Care for the Elderly/Home

Care for the Elderly Programs. Policy: Referrals will be made based on availability of funds, in accordance with prioritization

requirements. Purpose: To ensure funding is spent expeditiously and consumers are given a choice of case management

agencies, to the extent possible. Procedure for Miami-Dade County: I. Roles and Responsibilities

A. Alliance for Aging / Aging and Disability Resource Center

Reconciles overall program and Lead Agency specific spending levels on a monthly basis to ensure the Lead Agencies are operating within the funding allocations.

Reviews the number of cases for activation based on projected funding available by Lead Agency.

Screens consumers to link with appropriate resources and prioritize for DOEA-funded programs and services.

Recommends potential cases for activation based upon projected funding available by Lead Agency.

Selects consumers from the waiting list based on their prioritization score. Monitors compliance with service standards and outcome measures. Reviews files per the File Review Policies and Procedures. Reviews data in CIRTS.

B. Case Management Agency

Requests and accepts referrals from the Aging and Disability Resource Center, to serve an

optimal caseload and to avoid surpluses or deficits in accordance with the Alliance CCE/HCE Surplus/Deficit Analysis policy.

Refers inquiries from consumers interested in services to the ADRC for Information and Referral to community resources, Screening, Triage, and Long-Term Care Options Counseling, as appropriate.

Completes comprehensive assessments on new consumers and annual reassessment on existing consumers and develops care plans and reviews care plans semi-annually.

Authorizes service delivery and enters data into CIRTS. Identifies consumers for placement onto the Statewide Medicaid Managed Care Long

Term Care Program waiting list. Bills in CIRTS as appropriate. Monitors care plans in an effort to keep costs down while sustaining the individuals in the

community.

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II. Management of the Assessed Prioritized Consumer List (APCL).

A. Referrals to the ADRC are routed to the Information and Referral Specialists or Intake Unit staff depending on the type of referral. Clients are provided information on community resources and programs available including private pay options. Persons are directed to those resources most capable of meeting the need they have expressed to ADRC staff. Cases presenting strong identifiers that indicate the consumer might benefit from publicly funded long term care services are screened, entered into CIRTS, triaged and provided options counseling. DOEA prioritization requirements will be adhered to as follows:

1. APS High Risk referrals (See Section B).

2. Imminent Risk cases will be prioritized for activation after APS High Risk Referrals have

been served. If budgetary constraints prevent opening new cases, clients will be placed on the APCL. ADRC staff will contact the client on a monthly basis to determine if there has been a change in the client’s situation.

3. Aging Out consumers will be referred by DCF to the ADRC Intake Unit for prioritization

and/or activation in the corresponding aged program managed by the Alliance, as appropriate (See section V).

4. Consumers applying for the Community Care for the Elderly (CCE) and/or Home Care for

the Elderly (HCE) programs will be contacted by Intake Unit staff and screened using the statewide assessment form developed by the Department of Elder Affairs for this purpose (Form 701S). If a consumer is being served through a DOEA-funded agency which enters their annual assessment into CIRTS, the Priority Score generated by that assessment will determine their ranking on the APCL.

5. Consumers referred to the ADRC for inclusion under the Statewide Medicaid Managed

Care Long Term Care Program APCL will be contacted and screened by an ADRC staff person following the same procedure as the one described under Section 5. Individuals who appear as potentially eligible for other types of public assistance will be referred to the Economic Self-Sufficiency Unit at the Department of Children and Families.

6. All other referrals will be screened and prioritized, during which time the ADRC/Elder Helpline will research other community resources, including private pay/fee for services providers. The ADRC will reassess consumers on the waiting lists according to the 2015 Department of Elder Affairs Programs and Services Handbook, or any revisions made thereafter.

B. HIPAA forms will be sent to the consumer as appropriate.

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III. Opening New Cases

A. CCE/HCE Clients

1. The Fiscal Department will monitor Lead Agency specific spending levels on a monthly basis to ensure each Lead Agency is operating within its spending authority. In addition, the department will analyze surplus/deficit projections, and share the information with the Lead Agency to assist in their determination of slot availability. The Lead Agency will request referrals directly from the ADRC. The Fiscal Department will be notified of the number of new cases being referred to the Lead Agency for activation.

2. Upon receipt of the request for referrals from the Lead Agency, the ADRC Intake Unit

Supervisor will run the Prioritized Risk Report to identify the consumers on the APCL to be opened.

3. In response to the request for referrals, the ADRC Intake Unit Supervisor will refer wait listed clients to the Lead Agency for activation, in accordance with prioritization requirements. The Intake Unit will update the wait list enrollment using the appropriate code to terminate from the APCL, for release to the Lead Agency (TAEL).

4. The Intake Unit will notify clients in writing of the Lead Agency and of the program to which

they have been referred for enrollment.

5. Upon receipt of list of clients released from the waiting list, the Lead Agency will enter the APPL enrollment, will contact clients to offer program enrollment, and will proceed with activation. The Lead Agency will enter subsequent enrollments into CIRTS to reflect client status.

6. The ADRC will oversee the enrollment process to ensure referrals have timely outcomes in

CIRTS.

7. Choice: In the event that unallocated funds become available at the Alliance to allow for new client enrollments into CCE or HCE, the ADRC will contact consumers from the waiting list to offer choice of Lead Agency. The client may be provided fact sheets on the available Lead Agencies as needed. If the client is no longer interested in receiving services, the next client on the list will be contacted.

a. Intake Unit Specialists will contact the client to obtain a verbal choice. The verbal

choice will be documented in the REFER database as well as in the Client Referral Tracking Tool and the client’s CIRTS status will be changed from APCL to TAEL. The client referral will then be sent to the Lead Agency selected by the client.

b. Upon receipt of referral, the Lead Agency will enter the APPL enrollment, and subsequent enrollments to reflect client status.

c. The ADRC will mail confirmation of the program referral based on the verbal choice and informed that they may change agencies on a monthly basis, if they so choose.

d. If after two attempts by phone the Intake Unit staff is unable to reach the consumer, a contact letter will be sent.

e. If there is still no contact made with the consumer after these attempts, the Intake Unit will close CIRTS enrollments (TALO).

f. If the consumer later contacts the Elder Helpline, the consumer can be placed back on the APCL if they so desire.

g. On an as needed basis, the ADRC may mail wait-listed consumers for whom funding

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is available a letter for selection of Lead Agency. h. Upon receipt of referral, the Lead Agency will enter the APPL enrollment, and

subsequent enrollments to reflect client status. Contract amendments will follow in accordance with the number of clients referred for activation.

B. Statewide Medicaid Managed Care Long Term Care Program Clients

1. The Department of Elder Affairs will run the statewide APCL (Assessed Priority

Consumer List) report to review clients wait listed for the SMMCLTCP program. DOEA will provide the ADRC with a list of individuals authorized for release from the APCL.

2. For clients identified as active in CCE or HCE and authorized for release from the SMMCLTCP waiting list, the ADRC will be responsible for the SMMCLTCP application process. For CCE active clients, the ADRC will notify the Lead Agency in order to waive the CCE co-pay.

C. APS Referrals

1. APS Low and Intermediate Risk referrals will be screened and prioritized for services by

the ADRC as per the DOEA/APS Memorandum of Understanding. Low and Intermediate Risk referrals are also offered information and referral to additional community resources, including private pay as appropriate.

2. APS High Risk Referrals are not waitlisted. They are immediately referred for service to a

Lead Agency on a rotation basis. APS cases are to be served for a maximum of 31 calendar days or less. If additional time is justified, the case management agency will staff the case with the Alliance to obtain the extension needed.

3. During work hours, the Intake Unit will check in CIRTS by Social Security Number,

client name and then other identifying information as needed, to determine if the person is in CIRTS.

a. If the person is already in CIRTS being served by a Lead Agency, the referral will be made to that Lead Agency.

b. If the CIRTS query shows the person is not being served by a specific Lead Agency, the referral will be made to the Lead Agency slated to receive a referral on a rotation basis.

c. ARTT referrals will be forwarded to the appropriate Lead Agency. If the ARTT

system is down at the time of the referral, Intake will inform DCF of the case management agency assigned to serve the consumer.

4. DCF should notify the ADRC if there is someone else in the home who may be receiving

services. This person will also be checked in CIRTS and if that person is receiving services from a Lead Agency, then the new referral will be made to that Lead Agency to avoid having more than one Lead Agency in the home.

5. APS referrals after regular business hours will be sent from DCF to the Lead Agency. Lead Agencies may receive after hours referrals from DCF according to the following schedule:

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July 1 – October 31 – TBD November 1 – February 28 – TBD March 1 – June 30 – TBD

6. Upon receipt of the APS High Risk referral, the Lead Agency will coordinate services to

begin within the 72 hour period mandated by statute. A comprehensive assessment will be done within 72 hours of the referral. Services required under the care plan will remain in place for a maximum of 31 days, unless an extension has been granted.

7. The Lead Agency will enter ACTV enrollment under their provider number in CIRTS. In

addition, service codes will be entered by service date for all services provided. If a service(s) is not provided as required under the care plan, an NDP code will need to be entered in CIRTS and the case notes under the client file should document the reason for non-delivery of such service(s).

IV. Clients Changing Case Management Agencies A. Frequency of Changes

1. Consumers may change case management agencies on a monthly basis if they so choose.

2. Consumers will need to request a change of case management agency by the first (1st) of

the month in order for the change to be in effect by the 16th of that same month.

3. If the request is made after the first of the month, the change will take effect by the 16th of the following month.

B. Process for Changing

1. Requests to change case management agency must come from the client or their personal representative to the ADRC/Elder Helpline. Requests made by a case management agency will not be honored.

2. When requesting a change, the consumer will be asked by the ADRC staff person to share

his/her reasons for doing so; if they spoke with their case management agency about their concerns; and if they would like to speak with someone else at that agency.

3. If the consumer chooses to call the agency, nothing will be done until the consumer calls

the ADRC back requesting a change.

4. If the consumer does not want to speak with the case management agency and wants to change, the ADRC will initiate the transfer process. A verbal choice will be accepted and documented in the REFER database.

5. The ADRC/ Intake Unit will send a Transfer Form to the selected Lead Agency and to the

current Lead Agency. Both Lead Agencies will work closely with the ADRC to ensure the transfer process is completed by the 15th of the month, as long as the transfer request was received at the ADRC by the first of that same month.

6. The ADRC Intake Unit will change the owner provider record in CIRTS to the new Lead

Agency.

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7. The current Lead Agency will terminate enrollment in CIRTS as of the 15th of the month

when the transfer is to take place. The new Lead Agency will activate enrollment in CIRTS as of the 16th of the month when the transfer is to take place.

8. Each Lead Agency will notify its respective vendors of the termination and/or activation

of services for the transferred client as appropriate. 9. Services will start on the 16th of the month when the change becomes effective.

V. Aging Out Consumers:

A. All “Aging Out” consumers will be referred by DCF to the ADRC Intake Unit for activation in the corresponding aged program managed by the Alliance.

B. Consumers active in the CCDA and HCDA programs that are turning 60 and are eligible for CCE

and/or HCE will be opened in the corresponding aged program managed by the Alliance if funding is available. If funding is available, these consumers will be made active. If funding is not available, they will be waitlisted for these programs but will be given priority for activation once funding is available.

C. Consumers will be offered choice of enrolled Lead Agencies as available. If the consumer is

already being served by a Lead Agency, they will continue with that Lead Agency unless he/she requests a change.

Note: These ADRC policies and procedures are subject to change. Any modifications will be done through a

contract amendment.

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ATTACHMENT K

Incontinence Supplies/Nutritional Products List

CATEGORY

BILLING

CODE

MODIFIER RATE/UNIT

Adult Diapers Regular Absorbency Adult Size Brief/Diaper - Medium T4522 $0.69 Adult Size Brief/Diaper - Large T4523 $0.80 Adult Size Brief/Diaper - X Large T4524 $0.90 Adult Diapers Moderate Absorbency Adult Size Brief/Diaper - Small T4521 U2 $0.63 Adult Size Brief/Diaper - Medium T4522 U2 $0.69 Adult Size Brief/Diaper - Large T4523 U2 $0.80 Adult Size Brief/Diaper - X Large T4524 U2 $0.90 Adult Size Brief/Diaper - XX Large T4543 U2 $1.52 Adult Size Brief/Diaper - XXX Large Bariatric T4543 U2 $1.52 Adult Diapers Extra Absorbency Adult Size Brief/Diaper - Small T4521 U3 $0.63 Adult Size Brief/Diaper - Medium T4522 U3 $0.69 Adult Size Brief/Diaper - Large T4523 U3 $0.80 Adult Size Brief/Diaper - X Large T4524 U3 $0.90 Adult Size Brief/Diaper - XX Large T4543 U3 $1.52 Adult Size Brief/Diaper - XXX Large Bariatric T4543 U3 $1.52 Pull Ups Regular Absorbency Adult Size Pull -up - Small T4525 $0.78 Adult Size Pull -up - Medium T4526 $0.85 Adult Size Pull -up - Large T4527 $0.94 Adult Size Pull -up - X Large T4528 $1.02 Pull Ups Moderate Absorbency Adult Size Pull -up - Small T4525 U2 $0.78 Adult Size Pull -up - Medium T4526 U2 $0.85 Adult Size Pull -up - Large T4527 U2 $0.94 Adult Size Pull -up - X Large T4528 U2 $1.02 Pull Ups Extra Absorbency Adult Size Ex- Absorb Pull -up - Small T4525 U3 $0.78 Adult Size Ex- Absorb Pull -up - Medium T4526 U3 $0.85 Adult Size Ex- Absorb Pull -up - Large T4527 U3 $0.94 Adult Size Ex- Absorb Pull -up - X Large T4528 U3 $1.02 Adult Size Ex- Absorb Pull -up - XX Large T4528 U3 $1.02

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*Services must be provided in accordance to the DEOA Programs and Services Handbook. This service shall only be provided, if it cannot be purchased through Medicare, Medicaid or other third parties. All items shall have direct medical or remedial benefit to the client and be related to the client’s medical condition.

CATEGORY

BILLING

CODE

MODIFIER

RATE/UNIT

UNITS* Additional Disposable Incontinence Products Disposable Liner/Shield/Pad Small T4535 $0.44 Disposable Liner/Shield/Pad Medium T4535 U1 $0.44 Disposable Liner/Shield/Pad Large T4535 U2 $0.44 Disposable Underpads Extra Absorb 23X36 A4554 U2 $0.34 Disposable Underpads 23X36 A4554 U2 $0.34 Disposable Underpads 30x30 A4554 U2 $0.34 Incontinence Wipes A5120 $0.17 Gloves non sterile (vinyl) powder free-box A4927 $4.00 Skin Sealants, Zinc Oxide (Tub) S5199 $16.66 Nutritional Products Ensure (24/cs) B4150 SC $0.62 60 Boost (27/cs) B4150 SC $0.62 65 Ensure High Protein (24/cs) B4150 SC $0.62 50 Boost High Protein (27/cs) B4150 SC $0.62 65 Jevity 1.2 (24/cs) B4150 SC $0.62 68 Ensure Plus (24/cs) B4152 SC $0.50 84 Boost Plus (27/cs) B4152 SC $0.50 97 Jevity 1.5 (24/cs) B4152 SC $0.50 85 Boost Glucose (27/cs) B4154 SC $0.90 68 Glucerna (24/cs) B4154 SC $0.90 48 Nepro (24/cs) B4154 SC $0.90 102 Bath Accessories 3 in 1 Bedside Commode E0163 $71.78 Raised Toilet Seat with Arms E0244 $29.10 Tub, Stool / Chair with Back E0245 $38.00 Transfer Bench E0247 $65.00

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HOME CARE FOR THE ELDERLY PROGRAM LEAD AGENCY CONTRACT 2017-2018 Fiscal Year

THIS CONTRACT is entered into between the Alliance for Aging Inc., hereinafter referred to as the “Alliance” and [PROVIDER NAME], hereinafter referred to as the “Contractor,” and collectively referred to as the "parties." WHEREAS, the Alliance has been designated as the Area Agency on Aging for Planning and Service Area 11 encompassing Miami-Dade and Monroe Counties; and WHEREAS, the Florida Department of Elder Affairs (the "Department") has entered into a Contract with the Alliance to fund community care service systems in Miami-Dade and Monroe Counties; and WHEREAS, in accordance with Section 430.203, Florida Statutes, the Alliance has designated the Contractor as a Lead agency for the Home Care for the Elderly (HCE) program; NOW THEREFORE, in consideration of the services to be performed and payments to be made, together with the mutual covenants and conditions hereinafter set forth, the Parties agree as follows:

1. Purpose of Contract The purpose of this contract is to provide services in accordance with the terms and conditions specified in this contract including all attachments, forms, exhibits and references incorporated, which constitute the contract document.

2. Services to be Provided

The Contractor agrees to plan, develop, and accomplish the services delineated, or otherwise cause the planning, development, and accomplishment of such services and activities, on a countywide basis, under the conditions specified and in the manner prescribed in ATTACHMENT I of this contract.

3. Incorporation of Documents within the Contract

The contract will incorporate attachments, proposal(s), state plan(s), grant agreements, relevant Alliance handbooks, manuals or desk books and the Master Contract 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.

4. Term of Contract

Effective Date: This contract shall begin at twelve (12:00) A.M., Eastern Standard Time on July 1, 2017 or on the date the contract has been signed by both parties, whichever is later.

Delivery of services shall end at 11:59 P.M., Eastern Standard Time on June 30, 2018. The Alliance will not reimburse the provider for services provided after this date. However, the parties recognize that they will need to perform continued activities relating to reporting, invoicing and payment in July of 2018 to facilitate payment for services rendered by the provider under this contract.

APPENDIX Ic

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5. Contract Amount The Alliance agrees to pay for contracted services according to the terms and conditions of this contract in an amount not to exceed $X,XXX.XX for an average monthly caseload of XXX clients , 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.

6. Obligation to Pay

The Alliance’s performance and obligation to pay under this contract is contingent upon an annual appropriation by the Legislature to the Department and funding received by the Alliance under its contract with the Department.

7. Source of Funds

The costs of services paid under any other contract or from any other source are not eligible for reimbursement under this contract. The funds awarded to the provider pursuant to this contract are in the state grants and aids appropriations and consists of the following:

Program Title Funding Source CSFA # Funds Amount

Home Care for the Elderly General Funds 65010 $X,XXX.XX

TOTAL FUNDS CONTAINED IN THIS CONTRACT $X,XXX.XX

8. Renewals

The contract may be renewed on a yearly basis for no more than five additional years. Such renewals shall be contingent upon satisfactory performance evaluations as determined by the Alliance and the availability of funds. Any renewal of a contract shall be subject to mutual agreement, confirmed in writing, and subject to the same terms and conditions set forth in the initial contract. The renewal price, or method for determining a renewal price, is set forth in the bid, proposal, or reply. Requests to renegotiate the original contractual established rates are provided for in the Alliance’s approved Reimbursement Rate Review Policy, which is incorporated by reference.

The parties shall re-evaluate the contract’s reimbursement rates on an annual basis pursuant to DOEA’s Notice of Policy Clarification: Service Cost Reports Notice #092815-1-PC-SCBS dated September 28th, 2015 and the approved Alliance’s Reimbursement Rate Review Policy.

In the event that contracts cannot be executed prior to the July 1st start date, the Alliance may, at its discretion, extend this Agreement upon written notice for up to 120 days to ensure continuity of service. Services provided under this extension will be paid for out of the succeeding agreement amount

9. Modifications

Modifications of provisions of this contract shall only be valid when they have been reduced to writing and duly signed by both parties. The parties agree to renegotiate this contract if revisions of any applicable laws or regulations make changes in this contract necessary.

10. Termination, Suspension, and Enforcement

The causes and remedies for suspension or termination of this contract shall follow the same procedures as outlines in the Master Contract.

11. Official Payee and Representatives (Name, Address, and Telephone Numbers) The name, address, and telephone number of the representative for the Alliance for this contract is:

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Max B. Rothman, JD, LL.M. President and CEO 760 NW 107th Ave, Suite 214

Miami, Florida 33172 (305) 670-6500, Ext. 224

The name, address, and telephone number of the representative of the Contractor responsible for administration of the program under this contract is:

a The Contractor name, as shown on page 1 of this contract, and mailing address of the official payee to whom the payment shall be made is:

[Contractor Name, Address, Phone Number]

b The name of the contact person of the Contractor and street address where financial and administrative records are maintained is:

[Contractor Administrator Contact Name, Contractor

Name, Address, Phone Number]

c

The name, address, and telephone number of the representative of the Provider responsible for administration of the program under this contract is:

[Contractor CEO Contact Name, Contractor Name, Address, Phone Number]

d

The section and location within the AAA where Requests for Payment and Receipt and Expenditure forms are to be mailed is:


Fiscal Department 760 NW 107th Avenue, Suite 214

Miami, Florida 33172-3155 305-670-6500

e

The name, address, and telephone number of the Contract Manager for the AAA for this contract is:

Contract Monitor

Alliance for Aging, Inc. 760 NW 107th Avenue, Suite 214

Miami, Florida 33172-3155 605-670-6500

Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided in writing to the other party and the notification attached to the originals of this contract.

12. All Terms and Conditions Included

This contract and its ATTACHMENTS I, II, III, VII, VIII, IX, X, A, C, G, and K and any exhibits referenced in said attachments, together with any documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There are no provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all previous communications, representations or agreements, either written or verbal between the Parties.

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By signing this contract, the Parties agree that they have read and agree to the entire contract. IN WITNESS THEREOF, the Parties hereto have caused this contract, to be executed by their

undersigned officials as duly authorized.

Provider : [PROVIDER NAME]


SIGNED BY:_________________________ SIGNED BY:___________________________

NAME:_____________________________ NAME: MAX B. ROTHMAN, JD, LL.M.

TITLE:______________________________ TITLE: PRESIDENT AND CEO DATE:______________________________ DATE:________________________________

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INDEX TO ATTACHMENTS

Attachment I STATEMENT OF WORK

Attachment II CERTIFICATIONS AND ASSURANCES

Attachment III FINANCIAL AND COMPLIANCE AUDIT

Attachment VII BUDGET SUMMARY

Attachment VIII INVOICE REPORT SCHEDULE

Attachment IX REQUEST FOR PAYMENT FORM

Attachment X RECEIPT AND EXPENDITURE REPORT

Attachment A DOEA HANDBOOK

Attachment C REFERRAL PROTOCOL AGING AND DISABILITY RESOURCE CENTER (ADRC) – OUTSOURCED FUNCTIONS

Attachment G BACKGROUND SCREENING AFFADAVIT OF COMPLIANCE

Attachment K INCONTINENCE SUPPLIES/NUTRITIONAL PRODUCT LIST

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ATTACHMENT I

STATEMENT OF WORK

HOME CARE FOR THE ELDERLY PROGRAM

I. SERVICES TO BE PROVIDED

A. Definitions of Terms

1. Acronyms

CONTRACT ACRONYMS Area Agency on Aging (AAA) Activities of Daily Living (ADL) Adult Protective Services (APS) Adult Protective Services Referral Tracking Tool (ARTT) Assessed Priority Consumer List (APCL) Comprehensive Assessment and Review for Long-Term Care Services (CARES) Community Care for the Disabled Adult (CCDA) Community Care for the Elderly (CCE) Client Information and Registration Tracking System (CIRTS) Department of Children and Families (DCF) Florida Department of Elder Affairs (DOEA or the “Department”) Florida Statutes (F.S.) Home Care for Disabled Adults (HCDA) Home Care for the Elderly (HCE) Instrumental Activities of Daily Living (IADL) Notice of Instruction (NOI) Planning and Service Area (PSA) Service Provider Application (SPA)

2. Program-Specific Terms

Adult Protective Services Referral Tracking Tool: A system designed to track DCF APS referrals to AAAs and CCE Lead Agencies for victims of second party abuse, neglect, and exploitation who need home and community-based services as identified by APS staff.

Aging Out: The condition of reaching 60 years of age and being transitioned from the Department of Children and Families (DCF) Services, Community Care for Disabled Adults (CCDA) or Home Care for Disabled Adults (HCDA) services to the Department’s community-based services.

Area Plan: A plan developed by the AAA outlining a comprehensive and coordinated service delivery system in its planning and service area in accordance with the Section 306 (42 U.S.C. 3026) of the Older Americans Act and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county.

Area Plan Update: A revision to the Area Plan wherein the AAA enters CCE specific data in the CIRTS. An update may also include other revisions to the Area Plan as instructed by the Department.

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Department of Elder Affairs Programs and Services Handbook: An official document of the State of Florida, Department of Elder Affairs. The Handbook includes program policies, procedures, and standards applicable to agencies which are recipients of DOEA–funded programs and providers of program-funded services. An annual update is provided through a Notice of Instruction.

Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. Notice of Instruction (NOI): DOEA’s established method to communicate to the Contractor and Subcontractor the requirements to perform particular tasks or activities. NOIs are located on the DOEA website.

Program Highlights: Success stories, quotes, testimonials, or human-interest vignettes that are used in the Summary of Programs and Services, to demonstrate how programs and services help elders, families, and caregivers.

Service Provider Application (SPA): The plan developed by the Contractor and any revisions thereto, approved by the AAA which outlines the services and service delivery system to be used to fulfill the program requirements of the agency, the Department, and the CCE program.

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. Rule Chapter 58H-1, Florida Administrative Code; b. Sections 430.601, 430.602, 430.603, 430.604, 430.605, 430.606, 430.608, F.S.; and 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 HCE. The services shall be provided in a manner consistent with and described in the Contractors SPA, and any revisions thereto approved by the Alliance and the current DOEA Programs and Services Handbook, which are hereby incorporated by reference. The Contractor’s application submitted in response to the 2016 CCE RFP, as well as the RFP itself is incorporated by reference in this contract between the Alliance and the Contractor and made a part of this contract. In case of conflict between the SPA and the Handbook, the Handbook prevails.

Client access to services assessment and eligibility determination must conform to the protocols listed in ATTACHMENT C, the provider will offer services based on clients’ service plans.

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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 60 and older at risk of placement in a nursing home or other institutional setting who are able to remain in a family-style setting with a caregiver through the provision of subsidies.

2. Client Eligibility

Clients eligible to receive services under this contract must:

a. Be 60 years of age or older; b. Have income no greater than the Medicaid Institutional Care Program (ICP) limits ; c. Meet the ICP asset limitation; d. Be at risk of nursing home placement; e. Have an adult caregiver living in the home with them who is willing and able to provide care and/or

assist in arranging for care; f. Eligible applicants must be screened, prioritized and referred to the provider by the Aging and Disability

Resource Center (ADRC); and g. Not be enrolled in a Medicaid capitated long-term care program.

3. Caregiver Eligibility

Caregivers eligible to receive services under this contract must: a. Be at least 18 years of age; b. Be capable of providing a family-type living environment; c. Be a relative or a friend who has been accepted by the client as a surrogate family, or is a responsible

adult with whom the client has made an arrangement to provide home care services; d. Be willing to accept responsibility for the social, physical, and emotional needs of the care 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; 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.

II. MANNER OF SERVICE PROVISION

A. Service Tasks To achieve the goals of the HCE Program, the Contractor shall perform or ensure the following tasks:

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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 3.

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 Alliance to remove existing clients from services in order to serve new clients being assessed and prioritized for service delivery.

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 3 months.

b. Aging Out individuals: Individuals receiving CCDA and HCDA services through the Department of

Children and Families' Adult Services transitioning to community-based services provided through the Department when services are not currently available. All Aging Out individuals will be referred by DCF to the ADRC for enrollment into the corresponding aged program.

c. Service priority for individuals not included in a., c., and d. above, regardless of referral source, will be

determined through the Department'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. 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 Alliance’s current area plan, as updated and approved by the Department, and the current DOEA Programs and Services Handbook. The assessment and provision of services should always consider the most cost effective means of service delivery.

B. Use of Subcontractors

If this contract involves the use of a Subcontractor or third party, then the Contractor shall not delay the implementation of its agreement with the Subcontractor. If any circumstance occurs that may result in a delay for a period of 60 days or more the initiation of the subcontract or the performance of the Subcontractor, the Contractor shall notify the Alliance’s Contract Manager in writing of such delay. The Contractor shall not permit a Subcontractor to perform services related to this agreement without having a binding Subcontractor agreement executed. In accordance with Section 23.1 of Master Contract, the Alliance will not be responsible or liable for any obligations or claims resulting from such action. 1. List of Subcontracts:

The Contractor shall submit a list of all subcontracts to the Alliance Contract Manager within thirty days of the subcontract being executed.

2. Monitoring the Performance of Subcontractors:

The Contractor shall programmatically monitor, at least once per year, each of its Subcontractors, Subrecipients, Vendors, and/or Consultants. The Contractor shall perform programmatic monitoring to ensure contractual compliance, and programmatic performance and compliance with applicable state and federal laws and regulations. The Contractor shall monitor to ensure that time schedules are met; the budget and scope of work are accomplished within the specified time periods, and other performance goals. The

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Contractor shall also perform fiscal and administrative monitoring for all subcontractors to ensure fiscal accountability.

C. Staffing Requirements

1. Staffing Levels

The Contractor shall dedicate the staff 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 contract has the qualifications as specified in the DOEA Programs and Services Handbook.

3. Service Times

The Contractor shall ensure the availability of services listed in this contract at times appropriate to meet client service needs, at a minimum during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 A.M. to 5:00 P.M EST.

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 Services to Eligible Clients The Contractor shall ensure the provision of a continuum of services that meets the diverse, individual, and assessed needs of each functionally-impaired elder. The Contractor shall ensure performance and reporting of the following services in accordance with the current DOEA Programs and Services Handbook, which is incorporated by reference, and ATTACHMENT I, Sec. II.A.l-4 of this contract. Documentation of service delivery must include a report consisting of the following: number of clients served, number of service units provided by service, and rate per service unit with calculations that equal the total invoice amount. The services include the following categories:

a. 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.

b. Basic Subsidy The Contractor shall ensure that the client is eligible to receive the Basic Subsidy. The Contractor must ensure all data for HCE Basic subsidies are entered in the CIRTS by the 15th of each month. HCE Basic subsidy data entered into the CIRTS by the 15th of the month will be for payments incurred between the 16th of the previous month and the 15th of the current month. The Contractor shall then submit the Monthly Service Utilization Report based on the data entered in CIRTS to the Alliance by the 20th of each month. This report is used to generate the cash payment made to the caregiver. The Basic Subsidy is provided for support and maintenance of the care recipient, including housing, food, clothing, and medical costs not covered by Medicaid, Medicare or any other insurance. A Basic Subsidy shall be paid to approve caregivers when the client is in the home for any part of the month. If the client is hospitalized or in any other temporary institution for 30 days or less, the full Basic Subsidy shall be provided to the caregiver as if the client were in the home.

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c. Calculating the Basic Subsidy The Basic Subsidy shall be based on the financial status of the client receiving care. In the event that both a husband and wife are clients, their combined financial status shall be used to determine the amount of the Basic Subsidy. The Contractor shall ensure the Basic Subsidy is calculated in accordance with the current DOEA Programs and Services Handbook.

d. 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 approved caregivers when the client is in the home for any part of the month. Special Subsidy Services may be authorized through a vendor agreement. All Special Subsidy services must be performed in accordance with the DOEA Programs and Services 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) Personal Care 15) Physical Therapy 16) Respite (Facility Based or In-

Home) 17) Skilled Nursing Services 18) Specialized Medical

Equipment, Services and Supplies

19) Speech Therapy 20) Transportation

E. Administrative Responsibilities The Contractor shall provide management and oversight of HCE Program operations in accordance with the current DOEA Programs and Services Handbook including: 1. Prepare and submit an annual Service Provider Application (SPA). 2. Establish contractual agreements with appropriate and capable subcontractor and vendor agreements, when

applicable. 3. Provide technical assistance to subcontractors and vendors to ensure provision of quality services. 4. Monitor and evaluate subcontractors and vendors for appropriate programmatic and fiscal compliance. 5. Appropriately submit payments to subcontractors. 6. Establish procedures for handling recipient complaints concerning such adverse actions as service

termination, suspension or reduction in services. 7. Ensure compliance with Client Information and Registration Tracking System (CIRTS) regulations.

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8. Monitor outcome measures in accordance with targets set by the Department. 9. Conduct client satisfaction surveys to evaluate and improve service delivery.

F. Reports The Contractor is responsible for responding in a timely manner as determined by the agency to additional routine and/or special requests for information and reports required by the Alliance. The Contractor must establish due dates for subcontractors that permit the Contractor to meet the Alliance’s reporting requirements. 1. Service Cost Reports:

The Provider shall submit Service Cost Reports to the Alliance annually, but no later than ninety (90) calendar days after the contract year ends. The Service Cost Reports shall reflect actual costs of providing each service by program for the preceding contract year. If the Provider desires to renegotiate its reimbursement rates, the Provider shall make a request in writing to the Alliance in accordance with the Alliance’s approved Reimbursement Rate Review Policy, which is incorporated by reference.

2. CIRTS Reports:

The Contractor shall ensure timely input of HCE specific data into CIRTS. The contractor must run monthly CIRTS reports to validate the client and service data in CIRTS is accurate prior to submitting a request for payment invoice. To ensure CIRTS data accuracy, the Provider shall adhere to the Alliance’s CIRTS Data Integrity Policy and use CIRTS-generated reports which include the following: • Client Reports; • Monitoring Reports; • Service Reports; • Miscellaneous Reports; • Fiscal Reports; and • Outcome Measures Reports.

3. Surplus/Deficit Report: The Contractor will submit a consolidated surplus/deficit report in a format provided by the Alliance to the

Alliance's Contract Manager in conjunction with the required monthly billing submission. The report will include the following:

The Contractor's detailed plan on how the surplus or deficit spending exceeding the 1% threshold will be

resolved; Number of clients currently on the APCL, that receive a priority ranking score of four (4) or five (5); Number of clients currently on the APCL designated as Imminent Risk. Number of clients served and ADRC client contacts,

In accordance with Alliance surplus/deficit management policies, in order to maximize available funding and minimize the time that potential clients must wait for services, the Alliance in its sole discretion can reduce funding awards if the Contractor is not spending according to monthly plans and is projected to incur a surplus at the end of the year.

4. Program Highlights The Contractor shall submit Program Highlights referencing specific events that occurred in the previous

fiscal year by September 15th of the current contract year. 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

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used in the highlight narrative, in order to identify the specific individual or entity that performed the activity described in the highlight. The Contractor shall review and edit Program Highlights for clarity, readability, relevance, specificity, human interest, and grammar, prior to submitting them to the Alliance.

5. Performance Outcome Measurements

a. Service Providers Applications (SPA) must be updated and submitted annually within 30 days of the execution of the current contract.

b. The performance of the Contractor in providing the services described in this contract shall be measured by the current SPA strategies for the following criteria: i. Percent of elders assessed with high to moderate risk environments who improved their environment

score. ii. Percent of new service recipients with high-risk nutrition scores whose nutritional status improved. iii. Percent of new service recipients whose ADL assessment score has been maintained or improved. iv. Percent of new service recipients whose IADL assessment score has been maintained or improved. v. Percent of family and family assisted caregivers who self-report they are likely to provide care. vi. Percent of caregivers whose ability to provide care is maintained or improved after one year of

service intervention (as determined by the caregiver and the assessor).

G. Records and Documentation

1. The Contractor shall maintain documentation to support Requests for Payment that shall be available to the Alliance or authorized individuals, such as the Department or the Department of Financial Services, 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 Alliance. Maintenance includes accurate and current data, and valid exports and backups of all data and systems according to the Alliance and Department standards.

3. Data Integrity and Back up Procedures:

The Contractor shall anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of contractor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location.

4. Policies and Procedures for Records and Documentation:

The Contractor shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement of its subcontractors. These policies and procedures shall be made available to the Alliance upon request.

H. Performance Specifications

1. Outcomes and Outputs (Performance Measures) The Contractor must:

a. Ensure the prioritization and service provision of clients in accordance with ATTACHMENT I Sec.

II.A.1-2. of this contract;

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b. Ensure the provision of the services described in this contract are in accordance with the current DOEA Programs and Services Handbook and ATTACHMENT I, Sec. II.D of this contract;

c. Timely submit to the Alliance all required documentation and reports described in Section II.E; and d. Timely (in accordance with Attachment VIII) and accurately submit Attachments IX, X, and

supporting documentation.

I. Monitoring and Evaluation The Alliance 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 Alliance's determination of acceptable performance shall be conclusive. The Contractor agrees to cooperate with the Alliance in monitoring the progress of completion of the service tasks and deliverables. The Alliance may use, but is not limited to, one or more of the following methods for monitoring:

1. Desk reviews and analytical reviews; 2. Scheduled, unscheduled, and follow-up on-site visits; 3. Client visits; 4. Review of independent auditor's reports; 5. Review of customer satisfaction surveys; 6. Limited-scope reviews; and 7. Other procedures as deemed necessary.

J. Contractor Responsibilities

1. Contractor Accountability

All service tasks and deliverables pursuant to this contract are solely and exclusively the responsibility of the Contractor, and for which, by execution of the contract, the Contractor agrees to be held accountable.

2. Coordination with Other Providers and/or Entities

Notwithstanding that services for which the Contractor is held accountable involve coordination with other entities in performing the requirements of the contract; the failure of other entities does not alleviate the Contractor from any accountability for tasks or services that the Contractor is obligated to perform pursuant to this contract.

K. Alliance Responsibilities

1. Alliance Obligations

The Alliance will provide technical support to assist the Contractor in meeting the requirements of this contract.

2. Alliance Determinations The Alliance reserves the exclusive right to make certain determinations in the tasks and approaches. The absence of the Alliance setting forth a specific reservation of rights does not mean that all other areas of the contract are subject to mutual agreement.

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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 Alliance will pay the Contractor upon satisfactory completion of the Tasks/Deliverables, as specified in Section II and in accordance with other terms and conditions of the contract.

1. Fixed Fee/Unit Rate

Payment for Fixed Fee/Unit Rates shall not exceed amounts established in ATTACHMENT VII, per unit of service.

2. Cost Reimbursement

Payment may be authorized only for allowable expenditures, which are in accordance with the services specified in ATTACHMENT VII and ATTACHMENT K. All Cost Reimbursement Requests for Payment must include the Receipt and Expenditure Report (ATTACMENT X) beginning with the first month of the contract.

3. Advance Payments

Contractors may request a monthly advance for service costs for each of the first two months of the contract period, based on anticipated cash needs. Detailed documentation justifying cash needs for advances must be submitted with the signed contract, approved by the Alliance, and maintained in the contract manager’s file. All advance payments will be reconciled and recouped from the third through the twelfth month. Reconciliation and recouping of advances made under this contract are to be completed in accordance with ATTACHEMNT VIII. All advance payments are subject to the availability of funds.

B. Method of Invoice Payment

Payment shall be made upon the Contractor's presentation of an invoice subsequent to the acceptance and approval by the Alliance of the deliverables shown on the invoice and payment has been received from DOEA. The form and substance of each invoice submitted by the Contractor shall be as follows:

1. Request payment on a monthly basis for the units of services established in this contract, provided in

conformance with the requirements as described in the DOEA Programs and Services Handbook, and at the rates established in ATTACHMENT VII and ATTACHMENT K 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 change to the total contract amount requires a formal amendment;

2. The Contractor shall consolidate all subcontractors' Requests for Payment and Expenditure Reports that

support Requests for Payment and shall submit to the Alliance using forms Request for Payment (ATTACHMENT IX), Receipt and Expenditure Reports (ATTACHMENT X) for services;

3. All Requests for Payment shall be based on the submission of monthly Expenditure Reports beginning with

the first month of the contract. The schedule for submission of advance requests and invoices is Invoice Schedule, ATTACHMENT VIII;

4. In the event that services were not billed during the regular billing cycle, the Contractor may request

payment for services no later than 90 days after the month in which the expense was incurred, except that requests cannot be made after the contract closeout date. Request for payment of services rendered 90 days after the month in which the expense was incurred will require approval of the contract manager prior to the

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billing of such incurred expenses. Late service billing requests will not be paid unless justification is submitted and approved by the contract manager;

5. The Contractor shall maintain documentation to support payment requests which shall be available to the

Alliance, the Department, and the Department of Financial Services, or other authorized state and federal personnel upon request; and

6. All payments under the terms of this contract are contingent upon an annual appropriation by the Legislature,

and subject to the availability of funds.

C. Payment Withholding Any payment due by the Alliance under the terms of this contract may be withheld pending the receipt and approval by the Alliance of all financial and programmatic reports due from the Contractor and any adjustments thereto, including any disallowance not resolved as outlined in Section 26 of the Master Contract.

D. Final Invoice Instructions

The Contractor shall submit the final Request for Payment to the Department no later than 45 days after the contract period ends and as referenced in ATTACHMENT VIII. If the contract is terminated prior to the end date of the contract, then the Contractor must submit the final request for payment to the Alliance no more than 45 days after the contract is terminated. If the provider fails to do so, all right to payment is forfeited, and the Alliance will not honor any requests submitted after the aforesaid time period.

E. CIRTS Data Entries for Subcontractors

The Contractor must require Subcontractors 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). Subcontractors must enter this data into the CIRTS prior to submitting their requests for payment and expenditure reports to the Contractor. The Contractor shall establish deadlines for completing CIRTS data entry and to assure compliance with due dates for the requests for payment and expenditure reports that Contractor must submit to the Alliance.

F. Contractors’ Monthly CIRTS Reports

The Contractor must run monthly CIRTS reports and verify client and service data in the CIRTS is accurate. This report must be submitted to the Alliance with the monthly request for payment and expenditure report and must be reviewed by the Alliance before the Contractor's request for payment and expenditure reports can be approved by the Alliance.

G. Corrective Action Plan

1) Contractor shall ensure 100% of the deliverables identified in ATTACHMENT 1, Section II (Manner of

Service Provision) of this contract, are performed pursuant to contract requirements. 2) If at any time the Contractor is notified by the Alliance Contract Manager that it has failed to correctly,

completely, or adequately perform contract deliverables identified in ATTACHMENT I, Sec. II, the Contractor will have 10 days to submit a Corrective Action Plan (“CAP”) to the Alliance Contract Manager that addresses the deficiencies and states how the deficiencies will be remedied within a time period approved by the Alliance Contract Manager. The Alliance shall assess a Financial Consequence for Non-Compliance on the Contractor as referenced in ATTACHMENT I, Sec. II.I. of this contract for each deficiency identified in the CAP which is not corrected pursuant to the CAP. The Alliance will also assess a Financial Consequence for failure to timely submit a CAP.

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3) If the Contractor fails to correct an identified deficiency within the approved time period specified in the CAP, the Alliance shall deduct the percentage established in ATTACHMENT I, Sec. II.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 Alliance shall deduct the percentage established in

ATTACHMENT I, Sec. II.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. If, or to the extent, there is any conflict between ATTACHMENT I, Sec. II.I. above and paragraphs 39.1 and 39.2 of the Master Contract, this section shall take precedence.

H. Financial Consequences

1. The Alliance will withhold or reduce payment if the Contractor fails to perform the deliverables to the

satisfaction of the Contract according to the requirements referenced in ATTACHMENT I, Sec. I and Sec. II 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 ATTACHMENT I, Sec. II of this contract.

2. Delivery of services to eligible clients as referenced in ATTACHMENT I, Sec. I.1.3 Sec. II.A.2 of this contract – Failure to comply with established assessment and prioritization criteria as evidenced in 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 Alliance’s notification to the contractor that the identified deficiency was not cured or satisfactorily addressed in accordance with the Alliance approved CAP, referenced in ATTACHMENT I, Sec. II.H.

3. Services and units of services as referenced in ATTACHMENT I, Sec. II.D. of this contract – Failure to provide services in accordance with the current DOEA Programs and Services Handbook, the service tasks described in section ATTACHMENTS VII and K, and submission of required documentation will result in a 2% reduction of payment per business day. The reduction of payment will begin the first business day following the Alliance’s notification to the contractor that the identified deficiency was not cured or satisfactorily addressed in accordance with the Alliance approved CAP, referenced in ATTACHMENT I, Sec. II.H.

4. Administrative duties as referenced in ATTACHMENT I, Sec. II.E. of this contract – Failure to perform the performance specifications and oversight of CCE 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 Alliance’s notification to the contractor that the identified deficiency was not cured or satisfactorily addressed in accordance with the Alliance approved CAP, referenced in ATTACHMENT I, Sec. II.H.

5. Timely submission of a CAP – Failure to timely submit a CAP within 10 business days after notification of the deficiency by the Alliance 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 Alliance’s notification to the contractor that the identified deficiency was not cured or satisfactorily addressed in accordance with the Alliance approved CAP, referenced in ATTACHMENT I, Sec. II.H.

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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 DOEA Contract Manager in writing no later than June 30, 2017; email requests are considered acceptable.

B. Contractor’s Financial Obligations

1. Management and Use of Service Dollars and Continuity of Service:

a. The Contractor is expected to spend all funds provided by the Alliance for the purpose specified in this contract. The Contractor must manage the service dollars in such a manner so as to avoid having a surplus of funds at the end of the contract period. If the Alliance determines that the Contractor is not maximizing available funding, the Alliance, in accordance with its CCE/HCE Surplus/Deficit Fiscal policies, may transfer funds to other Contractors and/or adjust subsequent funding allocations accordingly.

b. The Contractor shall ensure that contract services will be provided until the end of the contract period.

In order to enable the Contractor to better manage the services under this contract and to maximize the use of available resources, the Alliance has established a spending authority as identified in Budget Summary, ATTACHMENT VII. The Contractor is responsible for managing the spending authority so that a continuity of service can be maintained for the maximum number of consumers. The Contractor agrees to assume responsibility for any contractual deficit that may be incurred.

2. Budget Summary:

The Alliance has established a spending authority based on services and rate detailed in the SPA and the Budget Summary, ATTACHMENT VII and any revisions thereto approved by the Alliance. Any changes in the total amounts of the funds identified on the Budget Summary require a contract amendment.

C. Remedies for Nonconforming Services

1. The Contractor shall ensure that all goods and/or services provided under this contract are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program participants.

2. If the Contractor fails to meet the prescribed quality standards for services, such services will not be

reimbursed under this contract. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be reimbursed under this contract. The Contractor’s signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the Contractor shall solely bear the costs associated with preparing or providing nonconforming goods and/or services. The Alliance requires immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients.

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ATTACHMENT II

CERTIFICATIONS AND ASSURANCES

DOEA will not award this contract unless Contractor completes the CERTIFICATIONS AND ASSURANCES contained in this Attachment. In performance of this contract, Contractor provides the following certifications and assurances:

A. Debarment and Suspension Certification (29 CFR Part 95 and 2 CFR Part 200)

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. Certification Regarding Scrutinized Companies Lists, section 287.135, F.S.

G. Certification Regarding Data Integrity Compliance for Agreements, Grants, Loans And Cooperative Agreements

H. Verification of Employment Status Certification

A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS – PRIMARY COVERED TRANSACTION.

The undersigned Contractor certifies to the best of its knowledge and belief, that it and its principals:

1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by a Federal Alliance or agency;

2. Have not within a three-year period preceding this Contract been convicted or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;

3. Are not presently indicted or otherwise criminally or civilly charged by a government entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph A.2. of this certification; and/or

4. Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State, or local) terminated for cause of default.

B. CERTIFICATION REGARDING LOBBYING – Certification for Contracts, Grants, Loans, and Cooperative Agreements.

The undersigned Contractor certifies, to the best of its knowledge and belief, that:

No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making

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of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan or cooperative agreement.

If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employees of 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 Alliance 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 Alliance.

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 Alliance 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 Alliance.

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 Alliance 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 Alliance.

5. Title IX of the Educational Amendments of 1972 (Pub. L. 92-318), as amended, and all requirements imposed by or pursuant to the Regulation of the Alliance 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 Alliance.

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6. The American with Disabilities Act of 1990 (Pub. L. 101-336), prohibits discrimination in all employment practices, including, job application procedures, hiring, firing, advancement, compensation, training, and other terms, conditions, and privileges of employment. It applies to recruitment, advertising, tenure, layoff, leave, fringe benefits, and all other employment-related activities, and;

Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws listed above. This assurance applies to Contractor’s operation of the WIA Title I – financially assisted program or activity, and to all agreements Contractor makes to carry out the WIA Title I – financially assisted program or activity. Contractor understands that DOEA and the United States have the right to seek judicial enforcement of the assurance.

D. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES, SECTION 287.133, F.S.

Contractor hereby certifies that neither it, nor any person or affiliate of Contractor, has been convicted of a Public Entity Crime as defined in section 287.133, F.S., nor placed on the convicted vendor list.

Contractor understands and agrees that it is required to inform DOEA immediately upon any change of circumstances regarding this status.

E. ASSOCIATION OF COMMUNITY ORGANIZATIONS FOR REFORM NOW (ACORN) FUNDING RESTRICTIONS ASSURANCE (Pub. L. 111-117). As a condition of the Contract, Contractor assures that it will comply fully with the federal funding restrictions pertaining to ACORN and its subsidiaries per the Consolidated Appropriations Act, 2010, Division E, Section 511 (Pub. L. 111-117). The Continuing Appropriations Act, 2011, Sections 101 and 103 (Pub. L. 111-242), provides that appropriations made under Pub. L. 111-117 are available under the conditions provided by Pub. L. 111-117.

The undersigned shall require that language of this assurance be included in the documents for all subcontracts at all tiers (including subcontracts, sub-grants and contracts under grants, loans and cooperative agreements) and that all sub recipients and contractors shall provide this assurance accordingly.

F. SCRUTINIZED COMPANIES LISTS CERTIFICATION, SECTION 287.135, F.S. If this Contract is in the amount of $1 million or more, in accordance with the requirements of section 287.135, F.S.,

Contractor hereby certifies that it is not listed on either the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List. Both lists are created pursuant to section 215.473, F.S.

Contractor understands that pursuant to section 287.135, F.S., the submission of a false certification may subject Contractor to civil penalties, attorney’s fees, and/or costs. If Contractor is unable to certify to any of the statements in this certification, Contractor shall attach an explanation to this Contract.

G. CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS, LOANS AND COOPERATIVE AGREEMENTS 1. The Contractor and any Subcontractors of services under this contract have financial management systems

capable of providing certain information, including: (1) accurate, current, and complete disclosure of the financial results of each grant-funded project or program in accordance with the prescribed reporting requirements; (2) the source and application of funds for all agreement supported activities; and (3) the comparison of outlays with budgeted amounts for each award. The inability to process information in accordance with these requirements could result in a return of grant funds that have not been accounted for properly.

2. Management Information Systems used by the Contractor, Subcontractors, or any outside entity on which the Contractor is dependent for data that is to be reported, transmitted or calculated, have been assessed and verified

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to be capable of processing data accurately, including year-date dependent data. For those systems identified to be noncompliant, 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.

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.

4. The Contractor and any Subcontractors of services under this contract warrant their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data integrity compliance issues.

H. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION As a condition of contracting with the Alliance of Elder Affairs, Contractor certifies the use of the U.S. Alliance of Homeland Security's E-verify system to verify the employment eligibility of all new employees hired by Contractor during the contract term to perform employment duties pursuant to this contract and that any subcontracts include an express requirement that Subcontractors performing work or providing services pursuant to this Agreement utilize the E-verify system to verify the employment eligibility of all new employees hired by the Subcontractor during the entire contract term.

The Contractor shall require that the language of this certification be included in all subagreements, subgrants, and other agreements and that all Subcontractors shall certify compliance accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB Circulars A-102 and 2 CFR Part 200 (formerly OMB Circular A-110).

By signing below, Contractor certifies the representations outlined in parts A through H above are true and correct.

________________________________________

(Signature and Title of Authorized Representative)

________________________________________

Contractor Date

________________________________________

(Street)

________________________________________

(City, State, ZIP Code)

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ATTACHMENT III ATTACHMENT III

FINANCIAL AND COMPLIANCE AUDIT

The administration of resources awarded by the Alliance to the provider may be subject to audits and/or monitoring by the Alliance and/or the Department as described in this section. I. MONITORING In addition to reviews of audits conducted in accordance with OMB Circular A-133, as revised, and Section 215.97, F.S., (see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits by the Alliance and/or the Department staff, limited scope audits as defined by OMB Circular A-133, as revised, and/or other procedures. By entering into this agreement, the Contractor agrees to comply and cooperate with any monitoring procedures/processes deemed appropriate by the Alliance. In the event the Alliance and/or the Department determines that a limited scope audit of the Contractor is appropriate, the Contractor agrees to comply with any additional instructions provided by the A l l i a n c e a n d / o r t h e 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 Alliance and/or the Department . AUDITS PART I: FEDERALLY FUNDED This part is applicable if the provider is a State or local government or a non-profit organization as defined in OMB Circular A-133, as revised. In the event that the 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 OMB Circular A-133, as revised. EXHIBIT 2 to this agreement indicates federal resources awarded through the Alliance by this agreement. In determining the federal awards expended in its fiscal year, the C o n t r a c t o r shall consider all sources of Federal awards, including federal resources received from the A l l i a n c e . The determination of amounts of Federal awards expended should be in accordance with the guidelines established by OMB Circular A-133, as revised. An audit of the C o n t r a c t o r conducted by the Auditor General in accordance with the provisions of OMB Circular A-133, as revised, will meet the requirements of this part. In connection with the audit requirements addressed in Part I, paragraph I, the Contractor shall fulfill the requirements relative to auditee responsibilities as provided in Subpart C of OMB Circular A-133, as revised. 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 OMB Circular A-133, as revised, 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 OMB Circular A-133, as revised, the cost of the audit must be paid from non-federal resources (i.e., the cost of such audit must be paid from 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 agreements with the Alliance shall be based on the agreement's requirements, including any rules, regulations, or statutes referenced in the agreement. The financial statements shall disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the Alliance and/or the Department shall be fully disclosed in the audit report with reference to the Alliance agreement involved. If not otherwise disclosed as required by Section .310(b)(2) of OMB Circular A-133, as revised, the schedule of expenditures of federal awards shall identify expenditures by agreement number for each agreement with the Alliance in effect during the audit period. Financial reporting packages required under this part must be submitted within the earlier of 30 days after receipt of the audit report or 9 months after the end of the Contractor's fiscal year end. PART II: STATE FUNDED This part is applicable if the Contractor is a non-state entity as defined by Section 215.97(2), F.S.

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In the event that the contrac tor expends a total amount of state financial assistance equal to or in excess of $750,000.00 in any fiscal year of such Contractor (for fiscal years ending September 30, 2004 or thereafter), 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 Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General. EXHIBIT 2 to this agreement indicates state financial assistance awarded through the A l l i a n c e by this agreement. 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 Alliance, 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 I, 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 (for fiscal years ending September 30, 2004 or thereafter), an audit conducted in accordance with the provisions of Section 215.97, F.S., is not required. In the event that the 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 agreements with the Alliance shall be based on the agreement's requirements, including any applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the Alliance shall be fully disclosed in the audit report with reference to the Alliance agreement involved. If not otherwise disclosed as required by Rule 69I-5.003, Fla. Admin. Code, the schedule of expenditures of state financial assistance shall identify expenditures by agreement number for each agreement with the All iance in effect during the audit period. Financial reporting packages required under this part must be submitted within 45 days after delivery of the audit report, but-no later than 12 months after the Contractor 's fiscal year end for local governmental entities. Non-profit or for-profit organizations are required to be submitted within 45 days after delivery of the audit report, but no later than 9 months after the Contractor 's fiscal year end. Notwithstanding the applicability of this portion, the Alliance retains all right and obligation to monitor and oversee the performance of this agreement as outlined throughout this document and pursuant to law. II. PART III: REPORT SUBMISSION Copies of reporting packages for audits conducted in accordance with OMB Circular A-133, as revised, and required by PART I of this agreement shall be submitted, when required by Section .320 (d), OMB Circular A-133, as revised, by or on behalf of the Contractor directly to each of the following: The Alliance at each of the following addresses: Alliance for Aging, Inc.

Attn: F i s c a l D e p a r t m e n t 760 NW 107th Avenue

Suite 214 Miami, FL 33172

The Federal Audit Clearinghouse designated in OMB Circular A-133, as revised (the number of copies required by Sections .320, OMB Circular A-133, as revised, should be submitted to the Federal Audit Clearinghouse), at the following address:


Jeffersonville, IN 47132

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Other Federal agencies and pass-through entities in accordance with Sections .320 (e) and (f), OMB Circular A-133, as revised. Pursuant to Sections .320(f), OMB Circular A-133, as revised, the provider shall submit a copy of the reporting package described in Section .320(c), OMB Circular A-133, as revised, and any management letter issued by the auditor, to the Alliance at each of the following addresses:



Miami, FL 33172




Miami, FL 33172 Any reports, management letter, or other information required to be submitted to the Alliance pursuant to this agreement shall be submitted timely in accordance with OMB Circular A-133, F.S., and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, as applicable. Contractors, when submitting financial reporting packages to the A l l i a n c e for audits done in accordance with OMB Circular A-133 or Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, should indicate the date that the reporting package was delivered to the Contractor in correspondence accompanying the reporting package.

III. 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 All iance and the Department 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 Alliance and the Department, 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 Al l i ance .

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ATTACHMENT III

FINANCIAL, AND COMPLIANCE AUDIT ATTACHMENT EXHIBIT 1

PART 1: AUDIT RELATIONSHIP DETERMINATION Contractors who receive state or federal resources may or may not be subject to the audit requirements of 2 CFR Part §200.500, and/or Section 215.97, Fla. Stat. C o n t r a c t o r s who are determined to be recipients or subrecipients of federal awards and/or state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I and/or Part II of Exhibit I is met. C o n t r a c t o r s who have been determined to be vendors are not subject to the and it requirements of2 CFR Part §200.38, and/or Section 215.97, Fla. Stat. Regardless of whether the audit requirements are met, C o n t r a c t o r s who have been determined to be recipients or subrecipients of Federal awards and/or state financial assistance must comply with applicable programmatic and fiscal compliance requirements. In accordance with 2 CFR Part §200 and/or Rule 691-5.006, FAC, C o n t r a c t o r has been determined to be:

____ Vendor not subject to 2 CFR Part §200.38 and/or Section 215.97, F.S. ____ Recipient/subrecipient subject to 2 CFR Part §200.86 and §200.93 and/or Section 215.97, F.S. ____ Exempt organization not subject to 2 CFR Part §200 and/or Section 215.97, F.S. For Federal awards, for-profit

organizations are exempt; for state financial assistance projects, public universities, community colleges, district school boards, branches of state (Florida) government, and charter schools are exempt. Exempt organizations must comply with all compliance requirements set forth within the contract or award document.

NOTE: If a C o n t r a c t o r is determined to be a recipient/subrecipient of federal and or state financial assistance and has been approved by the Alliance to subcontract, they must comply with Section 215.97(7), F.S., and Rule 69I-5.006, FAC [state financial assistance] and 2 CFR Part §200.330 [federal awards]. PART II: FISCAL COMPLIANCE REQUIREMENTS FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. C o nt ra c t o r s who receive Federal awards, state maintenance of effort funds, or state matching funds on Federal awards and who are determined to be a subrecipient must comply with the following fiscal laws, rules and regulations:






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*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in the 2 CFR Part §200.401(5) (c). **For funding passed through U.S. Health and Human Services, 45 CFR 92; for funding passed through U.S. Department of Education, 34 CFR 100. STATE FINANCIAL ASSISTANCE. C o nt ra c t o r s who receive state financial assistance and who are determined to be a recipient/subrecipient must comply with the following fiscal laws, rules and regulations:

Section 215.97, Fla. Stat. Chapter 691-5, Fla. Admin. Code

State Projects Compliance Supplement Reference Guide for State Expenditures

Other fiscal requirements set forth in program laws, rules and regulations

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ATTACHMENT III FINANCIAL, AND COMPLIANCE AUDIT ATTACHMENT

EXHIBIT 2-FUNDING SUMMARY Note: Title 2 CFR § 200.331, As Revised, and Section 215.97(5), Florida Statutes, Require That Information About Federal Programs and State Projects Be Provided to the Recipient and Are Stated in the Financial and Compliance Audit Attachment and Exhibit 1. Financial and Compliance Audit Attachment, Exhibit 2-Funding Summary Provides Information Regarding the Funding Sources Applicable to This Contract, Contained Herein, Is A Prediction of Funding Sources and Related Amounts Based on the Contract Budget.

1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF THE FOLLOWING: GRANT AWARD (FAIN#): N/A FEDERAL AWARD DATE: DUNS NUMBER: 785359126

PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT

TOTAL FEDERAL AWARD

COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: FEDERAL FUNDS: 2 CFR Part 200- Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. OMB Circular A-133, as amended- Audits of States, Local Governments, and Non-Profit Organizations

2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF THE FOLLOWING: MATCHING RESOUCES FOR FEDERAL PROGRAMS

PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT TOTAL STATE AWARD


TOTAL AWARD

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, FL Admin Code, Reference Guide for State Expenditures, Other fiscal requirements set forth in program laws, rules and regulations.

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ATTACHMENT VII

HOME CARE FOR THE ELDERLY PROGRAM BUDGET SUMMARY

The Alliance shall make payment to the provider for provision of services up to a maximum number of units of service and at the rate(s) stated below:

Service to be Provided Service Unit Rate

Maximum Units of Service

Maximum Dollars

Case Management $XX.XX X,XXX $XX,XXX.XX

Case Aide $XX.XX XXX $XX,XXX.XX Total $XXX,XXX.XX

NOTE: The Provider will receive Special Subsidy “set aside” funds, as determined and communicated by the Alliance. The Provider is authorized to use these funds to provide services in accordance with DOEA Programs and Services Handbook Chapter 7 and including Specialized Medical Equipment and Supplies, as per ATTACHMENT K.

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ATTACHMENT VIII

HOME CARE FOR THE ELDERLY INVOICE REPORT SCHEDULE

Report Number Based On Submit to Alliance on this Date

1 July Advance* July 1 2 August Advance* July 1 3 July Expenditure Report August 7 4 August Expenditure Report September 7 5 September Expenditure Report + 1/10 advance reconciliation October 7 6 October Expenditure Report + 1/10 advance reconciliation November 7 7 November Expenditure Report + 1/10 advance reconciliation December 7 8 December Expenditure Report + 1/10 advance reconciliation January 7 9 January Expenditure Report + 1/10 advance reconciliation February 7 10 February Expenditure Report + 1/10 advance reconciliation March 7 11 March Expenditure Report + 1/10 advance reconciliation April 7 12 April Expenditure Report + 1/10 advance reconciliation May 7 13 May Expenditure Report + 1/10 advance reconciliation June 7 14 June Expenditure Report+ 1/10 advance reconciliation July 7 15 Final Expenditure and closeout August 15

Legend: * Advance based on projected cash need. Note 1: All advance payments made to the Provider shall be returned to the Alliance as follows:

One-tenth of the advance payment received shall be reported as an advance recoupment on each Request for Payment, starting with report #5. The adjustment shall be recorded in Part C, Line 1 of the report (Attachment IX). Note 2: Submission of expenditure reports may or may not generate a payment request. If final expenditure report reflects funds due back to the Alliance, payment is to accompany the report.

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ATTACHMENT IX

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ATTACHMENT X

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ATTACHMENT A

Title: Department of Elder Affairs Programs & Services Handbook



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ATTACHMENT C REFERRAL PROTOCOL

Issue: Screening, Triage, and Referral for Activation under the Community Care for the Elderly/Home Care for

the Elderly Programs. Policy: Referrals will be made based on availability of funds, in accordance with prioritization requirements.

Purpose: To ensure funding is spent expeditiously and consumers are given a choice of case management agencies, to the extent possible.

Procedure for Miami-Dade County:

I. Roles and Responsibilities

A. Alliance for Aging / Aging and Disability Resource Center

Reconciles overall program and Lead Agency specific spending levels on a monthly basis to ensure the Lead Agencies are operating within the funding allocations.

Reviews the number of cases for activation based on projected funding available by Lead Agency. Screens consumers to link with appropriate resources and prioritize for DOEA-funded programs

and services. Recommends potential cases for activation based upon projected funding available by Lead

Agency. Selects consumers from the waiting list based on their prioritization score. Monitors compliance with service standards and outcome measures. Reviews files per the File Review Policies and Procedures. Reviews data in CIRTS.

B. Case Management Agency

Requests and accepts referrals from the Aging and Disability Resource Center, to serve an optimal

caseload and to avoid surpluses or deficits in accordance with the AAA CCE/HCE Surplus/Deficit Analysis policy.

Refers inquiries from consumers interested in services to the ADRC for Information and Referral to community resources, Screening, Triage, and Long-Term Care Options Counseling, as appropriate.

Completes comprehensive assessments on new consumers and annual reassessment on existing consumers and develops care plans and reviews care plans semi-annually.

Authorizes service delivery and enters data into CIRTS. Identifies consumers for placement onto the Statewide Medicaid Managed Care Long Term Care

Program waiting list. Bills in CIRTS as appropriate. Monitors care plans in an effort to keep costs down while sustaining the individuals in the

community.

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II. Management of the Assessed Prioritized Consumer List (APCL).

A. Referrals to the ADRC are routed to the Information and Referral Specialists or Intake Unit staff depending on the type of referral. Clients are provided information on community resources and programs available including private pay options. Persons are directed to those resources most capable of meeting the need they have expressed to ADRC staff. Cases presenting strong identifiers that indicate the consumer might benefit from publicly funded long term care services are screened, entered into CIRTS, triaged and provided options counseling. DOEA prioritization requirements will be adhered to as follows:

1. APS High Risk referrals (See Section B).

2. Imminent Risk cases will be prioritized for activation after APS High Risk Referrals have been

served. If budgetary constraints prevent opening new cases, clients will be placed on the APCL. ADRC staff will contact the client on a monthly basis to determine if there has been a change in the client’s situation.

3. Aging Out consumers will be referred by DCF to the ADRC Intake Unit for prioritization and/or

activation in the corresponding aged program managed by the Alliance, as appropriate (See section V).

4. Consumers applying for the Community Care for the Elderly (CCE) and/or Home Care for the

Elderly (HCE) programs will be contacted by Intake Unit staff and screened using the statewide assessment form developed by the Department of Elder Affairs for this purpose (Form 701S). If a consumer is being served through a DOEA-funded agency which enters their annual assessment into CIRTS, the Priority Score generated by that assessment will determine their ranking on the APCL.

5. Consumers referred to the ADRC for inclusion under the Statewide Medicaid Managed Care Long

Term Care Program APCL will be contacted and screened by an ADRC staff person following the same procedure as the one described under Section 5. Individuals who appear as potentially eligible for other types of public assistance will be referred to the Economic Self-Sufficiency Unit at the Department of Children and Families.

6. All other referrals will be screened and prioritized, during which time the ADRC/Elder Helpline will research other community resources, including private pay/fee for services providers. The ADRC will reassess consumers on the waiting lists according to the 2015 Department of Elder Affairs Programs and Services Handbook, or any revisions made thereafter.

B. HIPAA forms will be sent to the consumer as appropriate.

III. Opening New Cases

A. CCE/HCE Clients

1. The Fiscal Department will monitor Lead Agency specific spending levels on a monthly basis to ensure each Lead Agency is operating within its spending authority. In addition, the department will analyze surplus/deficit projections, and share the information with the Lead Agency to assist in their determination of slot availability. The Lead Agency will request referrals directly from the ADRC. The Fiscal Department will be notified of the number of new cases being referred to the Lead Agency for activation.

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2. Upon receipt of the request for referrals from the Lead Agency, the ADRC Intake Unit Supervisor will

run the Prioritized Risk Report to identify the consumers on the APCL to be opened.

3. In response to the request for referrals, the ADRC Intake Unit Supervisor will refer wait listed clients to the Lead Agency for activation, in accordance with prioritization requirements. The Intake Unit will update the wait list enrollment using the appropriate code to terminate from the APCL, for release to the Lead Agency (TAEL).

4. The Intake Unit will notify clients in writing of the Lead Agency and of the program to which they

have been referred for enrollment.

5. Upon receipt of list of clients released from the waiting list, the Lead Agency will enter the APPL enrollment, will contact clients to offer program enrollment, and will proceed with activation. The Lead Agency will enter subsequent enrollments into CIRTS to reflect client status.

6. The ADRC will oversee the enrollment process to ensure referrals have timely outcomes in CIRTS.

7. Choice: In the event that unallocated funds become available at the Alliance to allow for new client

enrollments into CCE or HCE, the ADRC will contact consumers from the waiting list to offer choice of Lead Agency. The client may be provided fact sheets on the available Lead Agencies as needed. If the client is no longer interested in receiving services, the next client on the list will be contacted.

a. Intake Unit Specialists will contact the client to obtain a verbal choice. The verbal choice will

be documented in the REFER database as well as in the Client Referral Tracking Tool and the client’s CIRTS status will be changed from APCL to TAEL. The client referral will then be sent to the Lead Agency selected by the client.

b. Upon receipt of referral, the Lead Agency will enter the APPL enrollment, and subsequent enrollments to reflect client status.

c. The ADRC will mail confirmation of the program referral based on the verbal choice and informed that they may change agencies on a monthly basis, if they so choose.

d. If after two attempts by phone the Intake Unit staff is unable to reach the consumer, a contact letter will be sent.

e. If there is still no contact made with the consumer after these attempts, the Intake Unit will close CIRTS enrollments (TALO).

f. If the consumer later contacts the Elder Helpline, the consumer can be placed back on the APCL if they so desire.

g. On an as needed basis, the ADRC may mail wait-listed consumers for whom funding is available a letter for selection of Lead Agency.

h. Upon receipt of referral, the Lead Agency will enter the APPL enrollment, and subsequent enrollments to reflect client status. Contract amendments will follow in accordance with the number of clients referred for activation.

B. Statewide Medicaid Managed Care Long Term Care Program Clients

1. The Department of Elder Affairs will run the statewide APCL (Assessed Priority Consumer List)

report to review clients wait listed for the SMMCLTCP program. DOEA will provide the ADRC with a list of individuals authorized for release from the APCL.

2. For clients identified as active in CCE or HCE and authorized for release from the SMMCLTCP waiting list, the ADRC will be responsible for the SMMCLTCP application process. For CCE active clients, the ADRC will notify the Lead Agency in order to waive the CCE co-pay.

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C. APS Referrals

1. APS Low and Intermediate Risk referrals will be screened and prioritized for services by the

ADRC as per the DOEA/APS Memorandum of Understanding. Low and Intermediate Risk referrals are also offered information and referral to additional community resources, including private pay as appropriate.

2. APS High Risk Referrals are not waitlisted. They are immediately referred for service to a Lead

Agency on a rotation basis. APS cases are to be served for a maximum of 31 calendar days or less. If additional time is justified, the case management agency will staff the case with the Alliance to obtain the extension needed.

3. During work hours, the Intake Unit will check in CIRTS by Social Security Number, client name

and then other identifying information as needed, to determine if the person is in CIRTS. a. If the person is already in CIRTS being served by a Lead Agency, the referral will be made to that Lead Agency.

b. If the CIRTS query shows the person is not being served by a specific Lead Agency, the referral will be made to the Lead Agency slated to receive a referral on a rotation basis.

c. ARTT referrals will be forwarded to the appropriate Lead Agency. If the ARTT system is

down at the time of the referral, Intake will inform DCF of the case management agency assigned to serve the consumer.

4. DCF should notify the ADRC if there is someone else in the home who may be receiving services.

This person will also be checked in CIRTS and if that person is receiving services from a Lead Agency, then the new referral will be made to that Lead Agency to avoid having more than one Lead Agency in the home.

5. APS referrals after regular business hours will be sent from DCF to the Lead Agency. Lead Agencies may receive after hours referrals from DCF according to the following schedule: July 1 – October 31 – TBD November 1 – February 28 – TBD March 1 – June 30 – TBD

6. Upon receipt of the APS High Risk referral, the Lead Agency will coordinate services to begin

within the 72 hour period mandated by statute. A comprehensive assessment will be done within 72 hours of the referral. Services required under the care plan will remain in place for a maximum of 31 days, unless an extension has been granted.

7. The Lead Agency will enter ACTV enrollment under their provider number in CIRTS. In

addition, service codes will be entered by service date for all services provided. If a service(s) is not provided as required under the care plan, an NDP code will need to be entered in CIRTS and the case notes under the client file should document the reason for non-delivery of such service(s).

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IV. Clients Changing Case Management Agencies

A. Frequency of Changes

1. Consumers may change case management agencies on a monthly basis if they so choose.

2. Consumers will need to request a change of case management agency by the first (1st) of the month in order for the change to be in effect by the 16th of that same month.

3. If the request is made after the first of the month, the change will take effect by the 16th of the

following month.

B. Process for Changing

1. Requests to change case management agency must come from the client or their personal representative to the ADRC/Elder Helpline. Requests made by a case management agency will not be honored.

2. When requesting a change, the consumer will be asked by the ADRC staff person to share his/her

reasons for doing so; if they spoke with their case management agency about their concerns; and if they would like to speak with someone else at that agency.

3. If the consumer chooses to call the agency, nothing will be done until the consumer calls the

ADRC back requesting a change.

4. If the consumer does not want to speak with the case management agency and wants to change, the ADRC will initiate the transfer process. A verbal choice will be accepted and documented in the REFER database.

5. The ADRC/ Intake Unit will send a Transfer Form to the selected Lead Agency and to the current

Lead Agency. Both Lead Agencies will work closely with the ADRC to ensure the transfer process is completed by the 15th of the month, as long as the transfer request was received at the ADRC by the first of that same month.

6. The ADRC Intake Unit will change the owner provider record in CIRTS to the new Lead Agency.

7. The current Lead Agency will terminate enrollment in CIRTS as of the 15th of the month when the

transfer is to take place. The new Lead Agency will activate enrollment in CIRTS as of the 16th of the month when the transfer is to take place.

8. Each Lead Agency will notify its respective vendors of the termination and/or activation of

services for the transferred client as appropriate. 9. Services will start on the 16th of the month when the change becomes effective.

V. Aging Out Consumers:

A. All “Aging Out” consumers will be referred by DCF to the ADRC Intake Unit for activation in the corresponding aged program managed by the Alliance.

B. Consumers active in the CCDA and HCDA programs that are turning 60 and are eligible for CCE and/or

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HCE will be opened in the corresponding aged program managed by the Alliance if funding is available. If funding is available, these consumers will be made active. If funding is not available, they will be waitlisted for these programs but will be given priority for activation once funding is available.

C. Consumers will be offered choice of enrolled Lead Agencies as available. If the consumer is already

being served by a Lead Agency, they will continue with that Lead Agency unless he/she requests a change.

Note: These ADRC policies and procedures are subject to change. Any modifications will be done through a contract amendment.

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ATTACHMENT G BACKGROUND SCREENING

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ATTACHMENT K


CATEGORY

BILLING

CODE MODIFIER

RATE/UNIT

Adult Diapers Regular Absorbency Adult Size Brief/Diaper - Medium T4522 $0.69 Adult Size Brief/Diaper - Large T4523 $0.80 Adult Size Brief/Diaper - X Large T4524 $0.90

Adult Diapers Moderate Absorbency Adult Size Brief/Diaper - Small T4521 U2 $0.63 Adult Size Brief/Diaper - Medium T4522 U2 $0.69 Adult Size Brief/Diaper - Large T4523 U2 $0.80 Adult Size Brief/Diaper - X Large T4524 U2 $0.90 Adult Size Brief/Diaper - XX Large T4543 U2 $1.52 Adult Size Brief/Diaper - XXX Large Bariatric T4543 U2 $1.52

Adult Diapers Extra Absorbency Adult Size Brief/Diaper - Small T4521 U3 $0.63 Adult Size Brief/Diaper - Medium T4522 U3 $0.69 Adult Size Brief/Diaper - Large T4523 U3 $0.80 Adult Size Brief/Diaper - X Large T4524 U3 $0.90 Adult Size Brief/Diaper - XX Large T4543 U3 $1.52 Adult Size Brief/Diaper - XXX Large Bariatric T4543 U3 $1.52

Pull Ups Regular Absorbency Adult Size Pull -up - Small T4525 $0.78 Adult Size Pull -up - Medium T4526 $0.85 Adult Size Pull -up - Large T4527 $0.94 Adult Size Pull -up - X Large T4528 $1.02

Pull Ups Moderate Absorbency Adult Size Pull -up - Small T4525 U2 $0.78 Adult Size Pull -up - Medium T4526 U2 $0.85 Adult Size Pull -up - Large T4527 U2 $0.94 Adult Size Pull -up - X Large T4528 U2 $1.02

Pull Ups Extra Absorbency Adult Size Ex- Absorb Pull -up - Small T4525 U3 $0.78 Adult Size Ex- Absorb Pull -up - Medium T4526 U3 $0.85 Adult Size Ex- Absorb Pull -up - Large T4527 U3 $0.94 Adult Size Ex- Absorb Pull -up - X Large T4528 U3 $1.02 Adult Size Ex- Absorb Pull -up - XX Large T4528 U3 $1.02

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*Services must be provided in accordance to the DEOA Programs and Services Handbook. This service shall only be provided, if it cannot be purchased through Medicare, Medicaid or other third parties. All items shall have direct medical or remedial benefit to the client and be related to the client’s medical condition.

CATEGORY

BILLING

CODE MODIFIER

RATE/UNIT

UNITS*

Additional Disposable Incontinence Products Disposable Liner/Shield/Pad Small T4535 $0.44 Disposable Liner/Shield/Pad Medium T4535 U1 $0.44 Disposable Liner/Shield/Pad Large T4535 U2 $0.44 Disposable Underpads Extra Absorb 23X36 A4554 U2 $0.34 Disposable Underpads 23X36 A4554 U2 $0.34 Disposable Underpads 30x30 A4554 U2 $0.34 Incontinence Wipes A5120 $0.17 Gloves non sterile (vinyl) powder free-box A4927 $4.00 Skin Sealants, Zinc Oxide (Tub) S5199 $16.66

Nutritional Products Ensure (24/cs) B4150 SC $0.62 60 Boost (27/cs) B4150 SC $0.62 65 Ensure High Protein (24/cs) B4150 SC $0.62 50 Boost High Protein (27/cs) B4150 SC $0.62 65 Jevity 1.2 (24/cs) B4150 SC $0.62 68 Ensure Plus (24/cs) B4152 SC $0.50 84 Boost Plus (27/cs) B4152 SC $0.50 97 Jevity 1.5 (24/cs) B4152 SC $0.50 85 Boost Glucose (27/cs) B4154 SC $0.90 68 Glucerna (24/cs) B4154 SC $0.90 48 Nepro (24/cs) B4154 SC $0.90 102

Bath Accessories 3 in 1 Bedside Commode E0163 $71.78 Raised Toilet Seat with Arms E0244 $29.10 Tub, Stool / Chair with Back E0245 $38.00 Transfer Bench E0247 $65.00

APPENDIX II

Notice of Intent to Submit a Proposal

for 2017/2018

Community Care for the Elderly Lead Agency Designation Date Agency Name Address City, State, Zip Telephone Number Fax Number Email Address Contact Person Contract Person’s Telephone Number SENIOR CONNECTION CENTER, INC. USE ONLY: DATE RECEIVED: TIME RECEIVED: RECEIVED BY:

APPENDIX III

Contract Terms and Conditions Statement In the event , (Name of Agency) is designated a Lead Agency and awarded contracts for the provision of services based on this Request for Proposal for Community Care for the Elderly Lead Agency Designation,

, (Name of Agency)

agrees to abide by and comply with all the terms and conditions of the sample Master Contract, CCE Contract, and HCE Contract included as Appendices Ia., Ib., and Ic. to the RFP.

_____________________________

Signature of Authorized Representative

______________________ Date

APPENDIX IV

Statement of No Involvement

I, , as the authorized representative of , certify that this agency, no member of this agency, or no person having an interest in this agency, has been awarded a contract by the Alliance, on a noncompetitive basis to:

(1) participate in drafting of any aspect of this RFP;

(2) perform a feasibility study concerning the scope of work contained in this RFP; or

(3) develop a program for future implementation that covers the services

being procured through this RFP. Signature of Authorized Representative Date

APPENDIX V


Unit Cost Methodology Worksheet Instructions

CONTRACT MODULE INSTRUCTIONS General Requirements: The Contract Module is comprised of the Department of Elder Affairs’ Unit Cost Development Worksheets, the Match Commitment, the Availability of Documents, the Organizational Capability Package, and the SPA Contract Module Checklist. The Unit Cost Development Worksheets (consisting of the Personnel Allocations Worksheet, Unit Cost Worksheet, and Supporting Budget by Program Activity) are included with the Excel workbook entitled “2017-2018 SGR Contract Module Worksheets.xls.” All Contract Module documentation (with the exception of documents in the Organizational Capability Package) must be completed using the required Word documents and Excel worksheets. The Excel worksheets include formulas and links intended to assist the bidder. These formulas and links should not be overwritten or altered. It is important that the bidder review the detailed instructions and worksheets before beginning the unit cost development process. The Alliance reserves the right to request additional documentation, if any of the information presented in the Contract Module is incomplete or inadequate. The bidder should include additional documentation wherever clarification is needed. Section II.B.1 – Personnel Allocations Worksheet: The Personnel Allocations Worksheet is located in the Excel workbook entitled “2017-2018 SGR Contract Module Worksheets.xls.” This spreadsheet is the first of the three Unit Cost Development Worksheets to be completed by the bidder. The Personnel Allocations Worksheet develops the staff time allocations for each DOEA funded service. It is intended to include all staff positions within the bidder’s agency. The allocation of staff time must be based on recent time studies or other accurate and verifiable documentation.

Before beginning the Worksheet:

1) Hide the Service Columns that are not applicable to your agency or the Service Provider

Application as this will make the worksheet much more manageable.

2) Complete the “Freeze Panes” option by completing the following steps: select the cell within the spreadsheet to freeze (on this spreadsheet it is often cell L10), click View, click Freeze Panes, and then, click Freeze Panes within that option. This will make working with the spreadsheet much more manageable. As you will notice there are other “Freeze Panes” options available. Also, when you no longer want the worksheet Freeze Pane on, complete the following: click View, click Freeze Panes, and then click “Unfreeze Panes” within that option.

Note: The Freeze Panes option freezes all cells above and to the left of the cell selected to freeze.

Start by inserting the personnel information on the first line (cell A10). Use one line for each employee. Include all agency personnel. Add rows as necessary to include all personnel. Include the proposed gross wages and net available hours calculations for each employee. Volunteers can be shown with "0" wages and net available hours. For each position, manually insert the percentage of time allocated to one or more of the services (the allocations must be based on recent time studies or other accurate and verifiable documentation). The worksheet will calculate the amount of time and wages allocated to each service.

Priority Items

All positions must be shown individually and all personnel allocations must equal 100%. It is important to ensure proper personnel allocations per employee.

Management and General (M&G) Cost Pool Personnel Positions normally associated with M&G Cost Pool are Executive Director and Assistant Director(s), fiscal staff, human resource staff, data processing office staff, and all related supporting personnel for those offices. Exceptions to this rule are if any of these positions are participate in lobbying, fundraising or other activities unallowable under state and federal grants, if this is the case an appropriate proportion of time should be allocated to these unallowable activities.

If your agency uses Paid Time Off (PTO), instead of the individual categories of Holidays, Sick, and Annual Leave, include the total PTO per employee under the Annual Leave category.

Importance of Other Non-Billable Time and the Net Available Hours Categories These categories are essential in assessing the time available for Direct Service Workers unit achievement by service. The total “HR/UNIT” information will be carried over to the Unit Cost Worksheet to develop the “Number of Billing Units” for all services which equate a staff hour with a unit of service.

Example: The CM Supervisor’s Other Non-Billable Time should reflect all the time that is Non-Billable and the Net Available Hours may possibly be -0-. Otherwise, if this is not backed out appropriately the Net Available Hours will artificially be inflated.

Note: Having the correct Net Available Hours for all Direct Services is a key component to the “Number of Billing Units” on the Unit Cost Worksheet.

There are multiple percentage and total “Check Points” located in the far right column on the Personnel Allocation Worksheet. Allow these check points to work for you and assist you in locating areas of concern within the spreadsheet.

Section II.B.2 – Unit Cost Worksheet: The Unit Cost Worksheet is located in the Excel workbook entitled “2017-2018 SGR Contract Module Worksheets.xls.” This spreadsheet is the second of the three Unit Cost Development Worksheets to be completed by the bidder. The Unit Cost Worksheet develops an “agency-wide” unit rate for each DOEA funded service. It is intended to include all of the agency’s budgeted units and costs for the proposed annual period no matter what the funding source. Personnel wages for each service are linked to the Personnel Allocations Worksheet. Personnel benefits are calculated by formula, unless more accurate manual allocations are documented and made. Specific cost categories for other budgeted costs are identified. Budgeted costs that can be directly charged to a service should be manually included. Budgeted costs that apply to all services can be included and allocated by formula using the “Management & General Cost Pool” and the “Facilities & Maintenance Cost Pool.” Considerations and allowances are given to bidders who may include service subcontractors or in-kind costs in their budgets. The Unit Cost Worksheet develops an “agency-wide” or “total” unit rate by taking the total budgeted cost for each service, and dividing this cost by the proposed “agency-wide” or “total” units to be achieved during the

contract period. This total unit rate becomes the basis for the bidder’s proposed unit rate for the services funded by the Alliance. There are multiple “Check Points” located in the far right column (Row BT) on the Unit Cost Worksheet. Allow these check points to work for you and assist you in locating areas of concern within the spreadsheet.

1. Line Item Expenses (rows 8 – 32)

A. Wages (row 8): will be carried over from Personnel Allocation Worksheet calculated via FORMULA B. Fringe (row 9): the total fringe expense must be MANUALLY INPUT into cell B9, and then the total fringe will be automatically spread based on the Personnel Allocation percentages. Note: if you choose not to use the total Personnel Allocations as your Fringe allocation – a separate worksheet is required, noting by position each Fringe Allocation.

All Line Item Expenses other than the two noted above (Wages and Fringe) must be MANUALLY INPUT and spread appropriately to all service categories.

C. Subcontractors: 1) multiple subcontracts for services having the same unit costs can be grouped (consolidated) and should be spread appropriately (i.e. In-Home Service subcontract could be spread to Homemaker, Personal, Care, and In-Home Respite). If subcontractors with the same unit costs are grouped, the subcontractor names must be indicated on the worksheet, 2) subcontracts cannot be grouped or consolidated unless they have the same cost per unit.

2. Service Subcontract Allowance and Service Subcontract Adjustment (rows 32 and 33)

Service Subcontract Allowance (row 32) – MANUAL INPUT

The narrative on this item was revised for clarification. The agency should input the amount of the subcontract if it is under $25,000 and input a maximum of $25,000 per subcontract for all subcontracts that are over $25,000.

Example: if the following Homemaker subcontracts are noted as subcontracts:

ABC HMKR $150,000

EZ HMKR $ 16,000

Premier HMKR $ 22,000

The Service Subcontractor Allowance amount would be $63,000 ($25,000 for ABC, $16,000 for EZ, and $22,000 for Premier – for a total of $63,000.

Service Subcontract Adjustment (row 33) – calculated via FORMULA

The Subcontract Adjustment will automatically calculate based on the information input for the Service Subcontract Allowance (SSA). The SSA will then be deducted from the Agency’s Total Allowable Costs (row 30) to create the Total Modified Direct Costs (row 36), which is the basis for the Reallocation of Management & General Costs (row 35).

3. Reallocate Management & General Costs (row 35) – calculated via FORMULA

As stated above, the M & G Cost Pool is reallocated based on the percent of funding in the Total Modified Direct Costs (row 36).

4. Reallocate Facilities & Maintenance (Space) Costs (row 38) – calculated via FORMULA based on the

Square Footage which must be MANUALLY INPUT into row 39.

5. Total Cost By Service (row 41) - calculated via FORMULA

This item is formula driven and adds the Total Allowable Cost (row 30), the Allocation of M & G

(row 35), and the Allocation of F & M (row 38) to provide the Total Cost By Service (row 41).

6. Number of Billing Units (estimated) (row 43) – MANUAL INPUT – COMPLETE THIS ITEM LAST.

Move on to the “new” Additional Subcontract Information (rows 49-53) which was added to the UCM. The Subcontractor Information (item 9 below) along with the Total Unit Analysis Information (item 10 below) will assist you in appropriately estimating units for many of the services provided.

7. Additional Subcontract Information (rows 49-53)

MANUALLY INPUT the number of units affiliated with each Subcontract (column D, rows 49-53)

Column B rows 49-53 will automatically calculate based on the subcontract information input in the subcontract Line Item Expenses.

Column C rows 49-53 will automatically calculate upon input of units in column D, rows 49-53.

Columns G – BO (service categories) will automatically calculate the affiliated subcontract information. The formula is based on the subcontractor funding that was input in subcontractor line item expenses divided by the units input manually in column D, rows 49-53.

10. Total Unit Analysis Information (rows 56-60) – calculated via FORMULA

This complete section is formula driven based on the HR/UNIT information from the Personnel

Allocations Worksheet and the Subcontract information on the Unit Cost Worksheet.

Row 56: Units from Personnel Alloc. Worksheet (Direct Service Staff)

Row 57: Subcontract Units

Row 58: Direct Staff plus Subcontract Units

Row 59: Checkpoint for Estimated Billing Units

Row 60: DIF %

Review and analyze the totals on Row 60 for all services. As you will notice some services are noted as not applicable (N/A) and cannot be computed in this manner. Calculations are included for the services which do calculate appropriately which are hourly unit based and/or subcontracted.

N/A services include: Adult Day Care, Caregiver Training/Support, Material Aid, Nutrition Education, Outreach, and Transportation.

After a thorough review of line 60 and if necessary, changes and review of the Subcontract Information and/or Personnel Allocations Worksheet, input the Estimated Billing Units as shown on row 60 to the appropriate services on row 43 (Number of Billing Units). Additionally, units of service for services which were not applicable (N/A) must be calculated and entered on row 43 based on historical and other Agency program information.

Review and analyze the multiple “Check Points” located in the far right column on the Unit Cost Worksheet (column BT). All “Line Item Expenses” (rows 8-29) should equate to zero in column BT.

Additionally, notes are included on the right of “column BT” for all other allocations to assist you in checking the spreadsheet for accuracy.

Section II.B.3 – Supporting Budget By Program Activity: The Supporting Budget By Program Activity Worksheet is located in the Excel workbook entitled “2017-2018 SGR Contract Module Worksheets.xls.” This spreadsheet is the Third of the three Unit Cost Development Worksheets to be completed by the bidder. The Supporting Budget By Program Activity Worksheet develops the “adjusted cost per unit of service” for each service funded by the Alliance. It is intended to include any required match and other resources that may affect the proposed unit rate. Unlike the first two worksheets, the Supporting Budget By Program Activity Worksheet reflects only the proposed units and funding available for the specific program and services funded by the Alliance. It is not an “agency-wide” spreadsheet. The unit rate developed on the Unit Cost Worksheet is linked to the Supporting Budget By Program Activity Worksheet for each funded service. This rate is then “adjusted” for match (CCE only, 10% required), client co-payments, program income, or other resources contributed by the bidder. These factors and the allocation determined by the Alliance will result in the proposed units to be achieved and the proposed unit rate.

You are now ready to begin the Worksheet.

As you will notice, well over half, actually 9 of the 16 items on the worksheet calculate automatically. The auto calculated items are highlighted.

Line 1: Total Budgeted Costs: will automatically calculate when the Total Budgeted Units are input to item 2.

Line 2: Total Budgeted Units: must be input manually based on how many units can be provided with the Federal/State allocation. There are many ways to begin calculating the units you will provide with the Contract funding:

1) Historical unit information.

2) Divide the Federal/State funding by the Agency’s historical Federal/State unit cost.

3) ADD the following: Federal/State allocation, historical Program Income, historical NSIP (if applicable), and Match (if not matched w/ in-kind), and historical Other Resources (if applicable) then DIVIDE this total by the Cash Cost per unit.

Line 2a: Total Cost Per Unit of Service: automatically calculates from the Unit Cost Worksheet (Unit Cost – Actual Cost, row 47)

Line 3: Less NSIP: The amount of NSIP must be manually added to this line.

Line 4: Less Cash Match: Only cash match should be shown in this line and should tie to the Commitment of Cash Donation Page

Line 5: Less In-Kind Match: The In-Kind Match should be shown on this this line and should tie to the In-Kind Commitment and Donations Pages.

Line 6: Less Co-Pay Used as Match: this applies only to CCE and is normally based on historical data.

Line 7: Total Match Commitment this line automatically calculates and adds all Matching components (lines 4 – 6). The total of this line must be at least 10% of the Federal/State contract allocation. To calculate the 10% matching requirement divide the Federal/State dollars by 9.

Line 8: Less Program Income: enter the amount of program income received by the Agency, this is normally based on historical data.

Line 9: Less Co-Pay Used as Program Income: this only applies to CCE and should include any additional Co-Pay budgeted that is not shown in Line 6 (Co-Pay Used as Match). Normally, all Co-Pay is used as match and shown on Line 6.

Line 10: Less Other Non-Matching Cash: This line is often times used to balance the budget to the Adjusted Budgeted Cost or to further buy-down the cost being charged to the Federal or State contract.

Line 11: Adjusted Budgeted Cost: This line must match the agency’s Federal/State allocation. This line is automatically calculated starting with the Total Budgeted Costs and backing out the following: NSIP, Sub-Total Match, Program Income, Co-Pay Not Used as Match, and Less Other Non-Matching Cash, to get the resulting Adjusted Budgeted Cost (Federal/State Funds).

Line 12: Adjusted Cost Per Unit of Service: This line is automatically calculated by dividing the Adjusted Budgeted Costs (line 11) by the Total Budgeted Units (line 2).

Line 11: Estimated Number of UNDUPLICATED Clients: input the unduplicated clients per service. This is normally based on historical CIRTS data.

Section II.B.4-9 - Match Commitments: The Match Commitment pages are located in the Service Provider Application as Word.doc. These pages are provided to assist the bidder in documenting the required match. The required match (CCE only) is 10% of the total funds provided (calculated by taking the Alliance allocation and dividing by 90%). The required match can be cash or in-kind. Section II.B.10 – Availability of Docuemnts The Availability of Documents is located in the SPA (RFP Appendix VIa) Section II.B.10. The form must be signed and attached to the RFP response. Section II.B.11 – Organizational Capability Package: Information regarding the Organizational Capability Package is located in the RFP Appendix VIb. The Organizational Capability Package identifies other required documentation that must be submitted.

October 2016 Page 1 of 39

APPENDIX VIa

Alliance for Aging, Inc. State General Revenue Programs

Service Provider Application 2017 CCE RFP

This packet contains the application formats to be used by bidders seeking to be designated by the Alliance as CCE Lead Agencies and to be awarded contracts pursuant to which they would receive funding under the following DOEA State General Revenue funded programs:

Community Care for the Elderly

Home Care for the Elderly


Service Provider Application Update Table of Contents

PAGE

I. A. Service Provider Summary Information 3 II. A. Program Module - General Requirements 4

1. Demographics and Community Care Service System 5 2. Consumer Identification 6 3. Case Management Functions 8 4. Services 10 4a. Subcontract Monitoring Schedule 11 5. Quality Assurance 12 6. Process for Reporting Adverse Incidents, Consumer

Complaints and Reducing or Terminating Services 14 7. Reporting 15 8. Client Confidentiality & Security 16 9. Disaster Preparedness 18 10. Volunteer Plan 18 11. Organizational Chart 19 12. Description of Service Delivery (by Service) 20 13. Objectives and Performance Measures 21 14. SPA Appendix 30 15. Program Module Review Checklist 30

II. B. Contract Module – General Requirements 31

1. Personnel Allocations Worksheet 32

2. Unit Cost Worksheet 32

3. Supporting Budget Schedule by Program Activity 32

4. Organizational Capability Package 32

5. Contract Module Review Checklist 32

6. Commitment of Cash Donation 33

7. Commitment for Donation of Building Space 34

8. Commitment of In-Kind Contribution of Supplies 35

9. Commitment of In-Kind Contribution of Equipment 36 10. Commitment of In-Kind Contribution of Services 37 11. Commitment of in-Kind Volunteer Personnel and Travel 38 12. Availability of Documents 39


I.A. SERVICE PROVIDER SUMMARY INFORMATION PAGE

PSA: 11 ORIGINAL [ ] 1. PROVIDER INFORMATION: Executive Director: [Name/Address/Phone] Legal Name of Agency: Mailing Address: Telephone Number:

2. GOVERNING BOARD CHAIR: [Name/Address/Phone] Name of Grantee Agency: 3. ADVISORY COUNCIL CHAIR: (if applicable) [Name/Address/Phone]

4. TYPE OF AGENCY/ORGANIZATION: NOT FOR PROFIT: ___ PRIVATE ___ PUBLIC PRIVATE FOR PROFIT: ___

5. PROPOSED FUNDING PERIOD: 07/01/2017 – 06/30/2018

6. FUNDS REQUESTED: [ ] CCE [ ] HCE

7. SERVICE AREA: [ ] Selected County: Specify

[ ] Miami-Dade [ ] Monroe 8. ADDRESS FOR PAYMENT OF CHECKS ITEM #: [ ] #1 [ ] #2 9. CERTIFICATION BY AUTHORIZED AGENCY OFFICER: I hereby certify that the contents of the proposal submitted by the bidder identified above is true, accurate and complete. I acknowledge that any intentional misrepresentations or false statements in the proposal may result in disqualification of the proposal or the termination of any contract between the bidder and the Alliance arising out of this RFP. Name: Signature: ______________________________ Title: _________________________________ Date:___________________


Alliance for Aging, Inc. State General Revenue Programs (CCE and HCE)

Service Provider Application 7/1/2017 – 6/30/2018 Contract Period

Section II. A.

Program Module – General Requirements


II.A.1. DEMOGRAPHICS AND COMMUNITY CARE SERVICE SYSTEM

Lead Agencies must accept Aging and Disability Resource Center (ADRC) referrals and provide case management and services on a countywide basis for all eligible consumers residing in the specific county. The CCE Lead Agencies for each county in PSA 11 must coordinate the system of community based services to meet the needs of newly referred and existing clients who are functionally impaired, persons assessed for services, and targeted elderly persons identified through outreach and referral activities during the program year.

a. Describe your agency’s ability to accept referrals and provide services on

a countywide basis.

b. Describe how your agency will coordinate, administer, and manage the system of community based services to meet the needs of newly referred and existing clients of the Community Care for the Elderly program (CCE) and the Home Care for the Elderly program (HCE).


II.A.2. Consumer Identification

The ADRC and Lead Agencies are charged with the responsibility to identify and inform frail elders and their caregivers of the range and availability of services. This may be carried out in cooperation with church, civic, social, and medical organizations. The target group consists of those individuals most likely to fall into the high-risk category (priority levels 4 and 5) when assessed. Lead Agency staff should participate in local networks and consortiums where hospital, home health, social and medical providers are represented, since these may be sources of referrals on such high-risk individuals.

a. Describe the anticipated activities your agency will conduct for the 2017-

2018 fiscal year to identify and inform frail elders and their caregivers of the range and availability of services.

Case managers serve as a contact between health care and social service delivery systems, particularly physicians, hospitals, health maintenance organizations, nursing homes and home health agencies.

b. Describe your agency’s efforts to participate in local networks and

consortiums where hospitals, home health, social and medical providers are represented in order to target high-risk individuals in need of services.

The case manager is the gatekeeper in the community care service system with the knowledge and responsibility to link consumers to the most beneficial and least restrictive array of community services and resources irrespective of funding source or program. Each consumer will be assigned one, and only one, case manager, even if the consumer is enrolled in more than one program. Consumer choice is the primary consideration in determining service referrals. In those instances when there is more than one subcontractor available for a given service, and the consumer expresses no preference, the Lead Agency should make the referral based on geographical and cost efficiency considerations. The referral procedures and referral formats used are to be developed by the Lead Agency. c. Describe your agency’s process of coordinating all formal and informal

resources to meet client need (ADRC, EHEAP, Food stamps, etc.). Include in your response how your agency will incorporate consumer choice in determining service referrals.


The intake process begins when an older person, caregiver, or family member makes contact with, or is referred t,o the ADRC. Lead Agencies must refer all potential consumers in need of service to the ADRC for preliminary screening and intake. Essential information about the nature of the person’s problem, as well as general background information, is obtained to assist in screening for eligibility and appropriate service referrals. d. Describe your agency’s process for referral to the ADRC. Include in your

description your agency’s procedures that will be, or are, in place to interface with the ADRC’s Information and Referral function. Describe the steps and criteria your agency will use to determine if a consumer should be referred to the ADRC’s Helpline.

e. Describe your agency’s procedures to request enrollment of wait listed

clients through communication with the ADRC.

f. Describe how your agency will process referrals from the ADRC for new client enrollments. The procedure should include each step from the initial receipt of the referral through all required and documented actions.

Adult Protective Services (APS) emergency services must be provided within 72 hours to alleged or actual victims of abuse, neglect or exploitation. Under this provision, services must be carefully coordinated by the CCE Lead Agency with the APS case worker/investigator and service provider agencies. Actual or alleged victims of abuse, neglect or exploitation, or those at risk for the same, are afforded the highest priority access to CCE services. g. Describe your Agency’s internal procedures that ensure priority service

delivery to APS high risk clients.

h. Describe your agency’s procedures to ensure client data entry into the

APS Referral Tracking Tool (ARTT) and Client Information and Registration Tracking System (CIRTS) occurs as required. Provide assurances that all required case managers have received, or will receive, the necessary ARTT Training Tutorial and certifications. Note: Copies of the APS and ARTT procedures must be maintained and available upon request by the Alliance.


II.A.3. Case Management Functions

The CCE program provides a continuum of care through the development, expansion, reorganization and coordination of multiple community-based services to assist elders to reside in the least restrictive environment suitable to their needs. The HCE Program provides care for elders in family-type living arrangements or in private homes, as an alternative to nursing home or other types of institutional care. Case Management and case aide must be provided directly by a Lead Agency and by the Lead Agency only. Lead Agency case managers will coordinate all community resources for functionally impaired elderly persons in a community care service system which is designed to provide a continuum of care as the needs of consumers change.

a. Describe how, and the extent to which, the agency has provided a minimum of two years of case management services. Note: Per Section 1.b.1. of the RFP, b\Bidders who do not meet the two years minimum required case management experience will not be considered eligible for Lead Agency designation under this RFP. Bidders must submit all monitoring reports, if applicable, for the most recent three years reflecting reviews of services as a CCE Lead Agency, or most similar to that of a CCE Lead Agency, as an attachment in Section II.A.14. (SPA Appendix).

Functional impairment shall be determined through a functional assessment developed by the DOEA and administered to each applicant for CCE services. Final determination of eligibility is the responsibility of the Lead Agency. A potential consumer will be determined eligible only after a comprehensive assessment has been completed to establish age, need and risk of institutional placement without services. Case managers must prepare a plan of care for each eligible consumer, utilizing the format prescribed by the DOEA. The plan of care is developed in coordination with the consumer and/or caregiver, if applicable, and must address all of the consumer’s needs.

b. Describe the action steps, number of staff involved, consumer to

case manager ratio and average timelines for consumer assessments, care plan development, and service initiation. Specifically address the timeline procedures from the ADRC wait list release date through service initiation. The timeline should correlate with the requirements of Chapter 2 of the DEOA Programs and Services Handbook.


c. Explain how overall coordination will be provided to inform

consumers of all programs and services accessible through the Lead Agency.

d. Explain your agency’s process for reviewing general revenue funded clients for potential services in other DOEA funded and non-funded programs, including steps staff will utilize when wait listing clients.

Please note – The Lead Agency’s process must include a mechanism for notifying the ADRC when an individual appears to be eligible for State Medicaid Managed Care Long Term Care (SMMC LTC) services; however, it is the ADRC’s responsibility to enroll the individual on the Assessed Prioritized Client List (i.e. APCL for LTCC) for Medicaid Waiver services.

The Lead Agency must ensure that all other funding sources available have been exhausted before requesting use of the grant funding.

e. Describe how all other available alternative resources for consumer

services will be explored, utilized, and documented prior to using general revenue funded services.

In accordance with rules and guidelines adopted by the DOEA, case managers must assess all non-exempt CCE and ADI consumers for services rendered based on ability to pay. Co-pay Guidelines are included in Appendix B of the DOEA’s Programs and Services Handbook and may also be included in DOEA policy memoranda on this subject, issued subsequently. The Lead Agency is responsible for billing and collecting assessed co-payments for all services provided under the CCE programs. This includes coordinating with other service provider agencies with which CCE consumers are shared in common. Case managers must exercise particular attention to the procedures established for termination of consumers due to non-payment, and the requirements for consumer notification of right to appeal and approval of waiver of termination for non-payment. f. Explain your agency’s internal procedure for assessing, billing, and

collecting co-payments in a timely manner.


II.A.4. Services

It is important that Lead Agencies ensure a variety of services to include home-delivered meals, day care services, and other basic services needed to prevent institutionalization that are available within the service area. When planning your agency’s service array, please take into account the recent Area Plan indicating priority service needs and the most often provided services referenced in Section 2, Statement of Need, in the RFP. A complete listing of the services funded under all programs managed by the Department of Elder Affairs and descriptions for each of these services may be found in Appendix A of the Programs and Services Handbook.

a. List the services your agency will offer including Case Management.

Note: A detailed explanation of each service must be provided in section “II.A.12. “Description of Service Delivery”.

b. List the services your agency plans to offer directly.

c. List the services your agency intends to subcontract.

d. Describe the subcontractor bid and selection process (include timeframes) that your agency had used to select the proposed subcontractors identified in this proposal and that will be used in the future in accordance with procurement regulations set forth in Chapter 287.057 F.S. or when and if a subcontract needs to be replaced or added.

e. Outline the process for ensuring all required subcontractor employees/volunteers have successfully completed a level 2 background screening.

f. Describe your plan for the programmatic and fiscal monitoring of subcontractors. Note: A copy of the subcontract monitoring tool(s) utilized by your agency must be submitted as an attachment in Section II.A.14. (SPA Appendix).

g. Complete the attached “Subcontract Monitoring Schedule” (II.A.4.a) on the following page. Include information on all proposed subcontractors who will provide services with CCE and HCE funding if your agency is designated a CCE Lead Agency pursuant to this RFO. Note: Copies of all CCE and HCE subcontracts must be maintained and available upon request by the Alliance. The Alliance also reserves the right to approve or disapprove any CCE or HCE subcontractors.


County: Date:

II.A.4.a SUBCONTRACT MONITORING SCHEDULE

Include all CCE and HCE Funded

Subcontractors and Vendors

Subcontractor or Vendor

Date of Visit Program Service [F]iscal/Admin.

[P]rogrammatic

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.


II.A.5. Quality Assurance

The Lead Agency will self-monitor and self- evaluate the quality of service, subject to further monitoring by the Alliance and/or DOEA. The degree of client satisfaction with service quality and staff effectiveness must be evaluated annually by the Lead Agency during the contract period. Survey results must be used to develop continuous quality assurance initiatives to ensure improvement of case management and other service delivery.

a. Describe your agency’s procedures including the

process/frequency to assure the delivery of quality services by Lead Agency staff. Note: Copies of all Quality Assurance/Quality Initiative procedures must be maintained and available upon request by the Alliance.

b. Describe your agency’s procedures including the process/frequency to assure the delivery of quality services by subcontractors, if applicable. Note: Copies of all Quality Assurance/Quality Initiative procedures must be maintained and available upon request by the Alliance.

c. Explain how the results of your quality assurance process will be used to improve services. Provide a narrative of quality improvement initiatives undertaken by your agency as a result of your quality assurance process.

d. Pre-Service and In-Service Case Management Staff Training

Lead Agencies shall be responsible for provision of the pre-service and in-service training for all paid and volunteer staff.

1. Describe your plan to provide the required pre-service staff training. Your plan should include the minimum standards/topics as outlined in Appendix A of the DOEA Programs and Services Handbook.

2. Describe your plan to provide required six (6) hours of in-service training to case management staff. Your plan should include the minimum standards/topics as outlined in Chapter 2 of the DOEA Programs and Services Handbook.


e. Describe the procedures your agency uses to evaluate consumer satisfaction. The description should include: 1) the proposed survey schedule, 2) proposed sample size, 3) tabulation information, 4) analysis and follow up process, 5) information on how the results are utilized to make improvements to services, and 6) timeframe for forwarding the results of the survey to the Alliance. Note: Copies of your consumer satisfaction policies must be maintained and available upon request by the Alliance.

Note: A copy of the bidder’s customer satisfaction survey and the results, analysis, and follow-up from the most recent survey must be submitted as an attachment in Section II.A.14. (SPA Appendix).


II.A.6. Process for Handling and Reporting Adverse Incidents, Consumer Complaints and Grievances

The Lead Agency must develop and maintain procedures that provide for handling consumer adverse incidents, complaints and for processing grievance appeals regarding denial, reduction or termination of core services. These procedures must include the process for receiving, reporting and remediating adverse incidents, complaints and grievances. In addition, the grievance process is required to inform consumers of the appeal process and must include prior written notification to the consumer of activities related to filing a grievance/appeal and assistance to consumers when they desire to file a grievance/appeal. Detailed information regarding grievance and appeal requirements may be found in Appendix D of the Programs and Services Handbook. a. Describe your agency’s procedures for ensuring compliance with

the required reporting of adverse incidents as outlined in and consistent with Section 18 of the Master Contract (Appendix Ia) Note: Copies of your agency’s Adverse Incident Procedure and log must be maintained and available upon request by the Alliance.

b. Describe your agency’s process for receiving, reporting and

remediating consumer complaints. Note: Copies of your agency’s Consumer Complaint Procedure and log must be maintained and available upon request by the Alliance.

c. Describe your agency’s process for handling consumer grievances;

along with the process for appeals regarding denial, reduction, or termination of services. Note: Copies of your agency’s Consumer Grievance Procedure and log must be maintained and available upon request by the Alliance.

The applicant’s Grievance Procedure must comply with the Master Contract and Appendix D of the DOEA Programs and Services Handbook.


II.A.7. Reporting

The Lead Agency is required to compile CCE and HCE service delivery statistics and other data and report to the Alliance and DOEA as required by any contract between the Lead Agency and the Alliance, or if otherwise requested. Monthly reporting requirements for CIRTS require all client and service data for the previous month to be entered into CIRTS by the 7th day of the month. Information is to be reported in the following categories:

Consumer Demographics Consumer Program Enrollment Consumer Assessment Information Consumer Care Plan Information Consumer Services Units of Service

Case management, case aide and any CCE and HCE service provided by the Lead Agency must be reported on a monthly basis in CIRTS by the Lead Agency. Additionally all requests for payment reporting requirements must be submitted within the time frame established by the Alliance.

a. Describe the steps your agency will follow in order to provide for accurate and timely entry of all service and consumer specific information in the CCIRTS database. Note: Copies of your agency’s CIRTS Policy and Procedure must be maintained and available upon request by the Alliance.

b. Explain your agency’s procedures for utilizing available CIRTS reports. Include how your agency uses these reports to improve data integrity in the CIRTS database.


II.A.8 Client Confidentiality and Security

Information about functionally impaired elderly persons who receive services under the CCE or HCE program or through an ADRC that is received through files, reports, inspections, or otherwise by DOEA authorized employees, volunteers, or by persons who provide services through DOEA contracts, including contracts procured by the Alliance pursuant to this RFP, is confidential and exempt from the provisions of Section 119.07(1), F.S., Florida's Public Records Act. Such information may not be disclosed publicly in a manner as to identify a functionally impaired elderly person, unless that person or their legal guardian provides written consent. The Lead Agency must ensure confidentiality of consumer information by all employees, service providers and volunteers as required by all applicable state and federal laws. It is essential that training be established to promote security of information, including protection from loss, damage, defacement, or unauthorized access. The Alliance requires the proper storage, protection, security, and preservation of source documentation, including case files, vendor invoices, case management time, and client log sheet information. CIRTS data must also be protected. Maintenance will include valid backup and retention of electronic data on a regular basis.

The Lead Agency must ensure the confidentiality of consumer information by all employees, service providers and volunteers as required by state and federal laws.

a. Describe what security measures are in place to address confidentiality

and consumer-specific information including client notification as it relates to state and federal (including, to the extent applicable, HIPAA) requirements. Note: A copy of your agency’s Privacy Notice issued to clients must be maintained and available upon request by the Alliance.

The Lead Agency must ensure consumers are notified of the purpose for collecting an individual’s social security number in compliance with section 119.071(5), F.S. b. Describe your agency’s current consumer notification which discloses the

purpose for which the client’s social security number (SSN) is being collected. Note: A copy of your agency’s SSN disclosure notification must be maintained and available upon request by the Alliance.


The Lead Agency is responsible for complying with Presidential Executive Order 12989 and State of Florida Executive Order Number 11-116 and all applicable requirements to utilize the U.S. Department of Homeland Security’s E-verify system to verify the employment of all new employees hired by the agency. c. Describe the procedures implemented by your agency to be certain that all

required employees are properly verified and determined eligible for hire through the U.S. Department of Homeland Security’s E-verify system. Provider is required to maintain documentation to assure new employees hired by the agency within the contract period is eligible for employment. Verification of eligibility must be maintained for monitoring purposes by the Alliance.

The Lead Agency must ensure that all employees, volunteers and contractors have successfully completed the background screening process pursuant to Sections 430.0402 and Chapter 435, Florida Statutes and all applicable SCC Notices of Instruction.

d. Describe the procedures implemented by your agency to be certain that all

applicable parties are properly screened and determined to have no disqualifying offenses prior to employment. Be sure to include your agency’s process for notifying the Department of Elder Affairs when staff/volunteers are no longer employed by your organization. Provider is required to maintain documentation to assure required direct service providers utilized by the agency have successfully completed the level 2 background screen through the Department of Elder Affairs. Verification assuring compliance must be maintained for monitoring purposes by the Alliance.

e. Describe your agency's procedures for the proper storage, protection,

security, and preservation of source documentation, including case files, vendor invoices, case management time, and client log sheet information. Note: A copy of your agency’s Electronic Backup procedures must be maintained and available upon request by the Alliance.


II.A.9. Disaster Preparedness

The Lead Agency will maintain a current Disaster Plan to be implemented, at the direction of the DOEA or Alliance, in the event that a disaster is declared by federal, state or local officials. Lead Agencies are also required to enter disaster preparedness data for all active consumers in CIRTS. Lead Agencies must be prepared to use CIRTS reports to routinely provide registry information to the local emergency management team and to identify, locate, and assist with the evacuation and other needs of endangered elderly in the event of a disaster.

a. Provide a summary of your agency’s disaster plan which should include

the following key elements: (Refer to Chapter 8 of the DOEA Programs and Services Handbook for further information):

Designation of a Disaster Coordinator. Plans for contacting all at-risk consumers, on a priority basis, prior to and

immediately following a disaster. Plans for receiving referrals and conducting outreach and delivering

services, before and after a disaster, to elderly persons in need who are not current consumers.

Plans for after-hours coverage of network services, as necessary. Plans for dispatching the Disaster Coordinator or other staff to shelters

outside the disaster area to assists elderly evacuees with special needs. Plans for helping at-risk consumers register with the Special Needs

Registry of the local emergency management agency. Plans for delivering meals to consumers prior to and following a disaster. Plans for assigning staff to Emergency Operation Centers and/or declared

assistance centers to ensure that elderly victims in the disaster area receive help.

Note: A copy of your agency’s Disaster Preparedness Plan must be maintained and available upon request by the Alliance.

II.A.10. Volunteer Plan

Lead Agencies must provide assurance and demonstrate staffing capable to train and supervise volunteer staff and volunteer supervisors. a. Provide a written plan of action to assure that your agency maintains

procedures on recruitment, training, utilization, and retention of volunteers to assist with your agency’s functions.


II.A.11. Organizational Chart

Each Lead Agency must have an approved organizational chart illustrating the structure and relationship of positions, units, supervision, and functions. The Lead Agency's governing body must designate a local representative or employee with legal authority to act on behalf of the agency with respect to the CCE program. This individual must devote sufficient time to ensure the CCE program is administered and managed in accordance with DOEA requirements.

All services (including case management) must be delivered by qualified staff in accordance with service standards and program requirements included in the DOEA Programs and Services Handbook. The number of staff should be sufficient to ensure the delivery of service to all agency consumers in a timely manner. Lead Agencies must demonstrate they have sufficient resources, in terms of both trained staff and equipment, in order to complete timely CIRTS data entry and access electronic mail from the Alliance. Lead Agencies must present evidence of an adequate number of trained staff to meet the case management, data entry, and data maintenance requirements of the programs in a timely fashion. Case coordination by a Lead Agency case manager must be available on a 24 hour/seven days per week basis for elderly victims of abuse, neglect or exploitation who are referred by an Adult Protective Services investigator.

a. Describe how your agency organizational structure is sufficient to support

the functional requirements of the CCE program including case management functions and CIRTS data entry and maintenance. Note: A copy of your current organizational chart which illustrates the structure and relationship of positions, units, supervision, and functions of your agency must be submitted as part of the Organizational Capability Package (Appendix VIb.).


II.A.12. Description of Service Delivery (by Service) (This page must be completed for each service including case management) Service: ___ Program(s): ______________ a. Subcontractor:

Will your Agency provide this service directly? ____ Yes ____ No If your Agency will subcontract this service then list all subcontractors below: Subcontractor(s) Business Name: Address: Phone Number: License Number (if applicable): Contract Start/End Date: Anticipated Monitoring Date:

b. Site Location: (Bidder may attach a list of site locations.) c. Days and Hours Of Operation: d. Activities: Describe the specific activities your agency will provide under this service

in accordance with the service description, delivery standards, and provider qualifications found in Appendix A of the DOEA Programs and Services Handbook.

e. Training Requirements: Describe the pre-service and in-service training required of

direct service staff providing this service. f. Unit Tracking Methodology: Describe the method for validating service units from

referral, to service delivery, to billing the Alliance.


II.A.13. 2017-2018 OBJECTIVES AND PERFORMANCE MEASURES

Outcome / Output Measures In keeping with the legislatively mandated requirements for performance-based budgeting, the State of Florida Department of Elder Affairs has identified six (6) key goals for which area agencies on aging and provider agencies are required to develop implementation strategies in order to assist the Department in achieving the statewide outcome and output measures it has identified for the aging network. The identified goals are:

To Age in Place To Age with Purpose To Age with Security To Age in an Elder Friendly Environment To Age with Dignity

All Lead Case Management agencies are required to describe the strategies and actions they will use to implement and follow to meet and/or exceed the outcome/output measures as specified by DOEA as delineated in the table below.


Objectives and Performance Measures

Objectives Performance Measures Standards*

1: To provide prompt and appropriate services to elders referred from Adult Protective Services who meet the frailty level criteria.

Outcome Measure: Percent of Adult Protective Services (APS) referrals who are in need of immediate services to prevent further harm who are served within 72 hours.

97%

2: To help elders to have home environments that are as safe as possible.

Outcome Measure: Percent of elders assessed with high or moderate risk environments who improved their environment score

79.3%

3: To improve the nutritional status of elders.

Outcome Measure: Percent of new service recipients with high-risk nutrition scores whose nutritional status improved Output Measure: Number of congregate meals provided

66%

4: To assist elders to maintain their independence and choices in their homes as long as possible.

Outcome Measure: Percent of new service recipients whose ADL assessment score has been maintained or improved 65%

5: To assist elders to maintain their independence and choices in their communities as long as possible.

Outcome Measure: Percent of new service recipients whose IADL assessment score has been maintained or improved 62.3%

6: To provide caregivers with assistance/respite to help them to be able to continue providing care.

Outcome Measure: Percent of family and family-assisted caregivers who self-report they are very likely to provide care

89%

Outcome Measure: Percent of caregivers whose ability to provide care is maintained or improved after one year of service intervention (as determined by the caregiver and the assessor)

90%


OUTCOME /OUTPUT MEASURES Use the format below as needed to describe in sufficient detail the implementation strategies, action steps and/or process measures you will follow to meet the goals, objectives and performance measures identified in the Objectives and Performance Measures Grid above. Use additional pages following the same format, if more space is needed.

GOAL (Indicate which of the 5 statewide priorities identified by the DOEA is being addressed): To provide prompt and appropriate services to elders referred from Adult Protective Services who meet the frailty level criteria.

OBJECTIVE (Point out which of the objectives identified by the DOEA under each goal is being

addressed): Percent of Adult Protective Services (APS) referrals who are in need of immediate services to prevent further harm who are served within 72 hours. ________________________________________________________________ STRATEGIES/ACTION STEPS OUTCOME (Select the appropriate outcome measure): 97% of Adult Protective Services (APS) referrals who are in need of immediate services to prevent further harm will be served within 72 hours. OUTPUT (Submit your projection for achievement of the stated performance standard):


GOAL (Indicate which of the 5 statewide priorities identified by the DOEA is being addressed): To help elders to have home environments that are as safe as possible. OBJECTIVE (Point out which of the objectives identified by the DOEA under each goal is being

addressed): Percent of elders assessed with high or moderate risk environments who improved their environment score ________________________________________________________________ STRATEGIES/ACTION STEPS OUTCOME (Select the appropriate outcome measure): 79.3% of elders assessed with high or moderate risk environments will improve their environment score OUTPUT (Submit your projection for achievement of the stated performance standard):


GOAL (Indicate which of the 5 statewide priorities identified by the DOEA is being addressed): To improve the nutritional status of elders. OBJECTIVE (Point out which of the objectives identified by the DOEA under each goal is being

addressed): Percent of new service recipients with high-risk nutrition scores whose nutritional status improved. ________________________________________________________________ STRATEGIES/ACTION STEPS OUTCOME (Select the appropriate outcome measure): 66% of new service recipients with high-risk nutrition scores will improve their nutritional status. OUTPUT (Submit your projection for achievement of the stated performance standard): _____ Number of congregate meals will be provided _____Number of home-delivered meals will be provided


GOAL (Indicate which of the 5 statewide priorities identified by the DOEA is being addressed): To assist elders to maintain their independence and choices in their homes as long as possible. OBJECTIVE (Point out which of the objectives identified by the DOEA under each goal is being

addressed): Percent of new service recipients whose ADL assessment score has been maintained or improved ________________________________________________________________ STRATEGIES/ACTION STEPS OUTCOME (Select the appropriate outcome measure): 65% of new service recipients will maintain or improve their ADL assessment score OUTPUT (Submit your projection for achievement of the stated performance standard):


GOAL (Indicate which of the 5 statewide priorities identified by the DOEA is being addressed): To assist elders to maintain their independence and choices in their communities as long as possible. OBJECTIVE (Point out which of the objectives identified by the DOEA under each goal is being

addressed): Percent of new service recipients whose IADL assessment score has been maintained or improved ________________________________________________________________ STRATEGIES/ACTION STEPS OUTCOME (Select the appropriate outcome measure): 62.3% of new service recipients will maintain or improve their IADL assessment score. OUTPUT (Submit your projection for achievement of the stated performance standard):


GOAL (Indicate which of the 5 statewide priorities identified by the DOEA is being addressed): To provide caregivers with assistance/respite to help them to be able to continue providing care. OBJECTIVE (Point out which of the objectives identified by the DOEA under each goal is being

addressed): Percent of family and family-assisted caregivers who self-report they are very likely to provide care. ________________________________________________________________ STRATEGIES/ACTION STEPS OUTCOME (Select the appropriate outcome measure): 89% of family and family-assisted caregivers will self-report they are very likely to provide care. OUTPUT (Submit your projection for achievement of the stated performance standard):


GOAL (Indicate which of the 5 statewide priorities identified by the DOEA is being addressed): To provide caregivers with assistance/respite to help them to be able to continue providing care. OBJECTIVE (Point out which of the objectives identified by the DOEA under each goal is being

addressed): Percent of caregivers whose ability to provide care is maintained or improved after one year of service intervention (as determined by the caregiver and the assessor). ________________________________________________________________ STRATEGIES/ACTION STEPS OUTCOME (Select the appropriate outcome measure): 90% of caregivers will maintain or improve their ability to provide care after one year of service intervention (as determined by the caregiver and the assessor) OUTPUT (Submit your projection for achievement of the stated performance standard):


II.A.14. SPA Appendix

Submit the following requested documentation.

Program and Fiscal Subcontractor Monitoring Tool Samples Most recent Customer Satisfaction Survey Report, including results, analysis and

necessary follow-up Consumer Satisfaction Sample Survey All monitoring reports, if applicable, for the most recent three years

II.A.15. SPA Program Module Checklist

Submit a completed Program Module Checklist indicating each item has been addressed and the page location for each item (Appendix VIc).


Alliance for Aging, Inc. State General Revenue Programs (CCE and HCE)

Service Provider Application

Section II. B.

Contract Module – General Requirements


The Contract Module must be submitted in a separately sealed package from the Program Module. Complete and attach the following documents: INSTRUCTIONS for the contract module are found together with the required worksheets at www.allianceforaging.org/whats-happening/funding-opportunities/procurement II. B. 1. Personnel Allocations Worksheet

Worksheet template is found at www.allianceforaging.org/whats-happening/funding-opportunities/procurement

II. B. 2. Unit Cost Worksheet Worksheet template is found at www.allianceforaging.org/whats-happening/funding-opportunities/procurement

II. B. 3. Supporting Budget by Program Activity Worksheet template is found at www. www.allianceforaging.org/whats-happening/funding-opportunities/procurement

II. B. 4. Commitment of Cash Donation (form attached) II. B. 5. Commitment for Donation of Building Space (form attached) II. B. 6. Commitment of In-Kind Contribution of Supplies (form attached) II. B. 7. Commitment of In-Kind Contribution of Equipment (form attached) II. B. 8. Commitment of In-Kind Contribution of Services (form attached) II. B. 9. Commitment of In-Kind Volunteer Personnel and Travel (form attached)

Note: Bidders who do not submit the Match Commitment Forms to

demonstrate their ability to meet the match requirements will not be

considered eligible for Lead Agency designation under this RFP.

II. B. 10. Availability of Documents (form attached) II. B. 11. Organizational Capability Package (Appendix VIb) II.B.12. SPA Contract Module Checklist (Appendix VIc)

Submit a completed Contract Module Checklist indicating each item has been addressed and the page location for each item.

http://www.allianceforaging.org/whats-happening/funding-opportunities/procurement









II. B. 4. Match Commitment of Cash Donation Agency Name: Donor Identification:

Name: Street:

City: State: Zip: Phone:

Authorized Representative:

Total Amount $

# Payments Amount/Payment $ Contribution Period Special Conditions: Donor Certification: I hereby certify intent to make the cash donation set forth above for use in the specified program during the program's upcoming funding period. This cash is not included as match for any other State or Federally assisted program or contract and is not borne by the federal government directly under any federal grant or contract. Signature of Donor or Representative: Date:_______


II. B. 5. Match Commitment for Donation of Building Space Agency Name: Donor Identification:

Name: Street:



Description of Space: [ ] Office [ ] Site [ ] Other Provider Owned Space: 1. Number of square footage used by

project: sq/ft 2. Appraised rental value per square

foot: $ 3. Total value of space used by project

(1x2): $ Donor Owned Space: 1. Established monthly rental value:

$ 2. Number of months rent to be paid by

donor: mos. 3. Value of donated space (1x2):

$ Special Conditions: Donor Certification: I hereby certify intent to donate use of the space set forth above for the program specified above during the program's upcoming funding period. This space is not being used as match for any other State or Federal program or contract. Signature of Donor or Representative: Date:__


II. B. 6. Match Commitment of Supplies Agency Name: Donor Identification:

Name: Street:



The below described supplies are committed for use by the project for the period of: Description of Supplies: Computation of value method: Value to be claimed by project: $ Donor Certification: These supplies are not included as contributions for any other State or Federally assisted program or contract and are not borne by the Federal Government directly or indirectly under any Federal grant or contract except as provided for under (cite the authorizing Federal regulation or law if applicable). Signature of Donor or Representative: Date:_______


II. B. 7. Match Commitment of Equipment Agency Name: Donor Identification:

Name: Street:



The below described equipment is committed for use by the project for the period of: Item Description Number Acquisition Cost Value to Project* 1. 2. 3. 4. TOTAL VALUE CLAIMED: $ * Items that are currently owned by the Grantee or are loaned or donated to the project

are valued at an annual rate of 6-2/3 percent of the acquisition value. Donor Certification: This equipment is not included as match for any other State or Federally assisted program or contract and are not borne by the Federal Government directly or indirectly under any Federal grant or contract except as provided for under (cite the authorizing Federal regulation or law if applicable). Signature of Donor or Representative: Date:_______


II. B. 8. Match Commitment of In-Kind Contribution of Services by Staff of Service Provider or Staff of Other Organizations

Agency Name: Donor Identification:

Name: Street: City: State: Zip: Phone:


The personal services described below are committed for use by the project for the period of: Description of Positions: Position/Title Service Hourly Rate or #Hours Value Annual Salary Worked to Project 1. 2. 3. 4.

TOTAL - $

* Value to project = (# of hours provided) x (hourly rate of annual salary). Donor Certification: It is certified that the time devoted to the project will be performed during normal working hours. These services are not included as match for any other State or Federally assisted program or contract and are not borne by the Federal Government directly or indirectly under any Federal grant or contract except as provided for under (cite the authorizing Federal regulation or law if applicable). Signature of Donor or Representative: Date:_______


II. B. 9. Match Commitment of In-Kind Volunteer Personnel And Travel Agency Name: Donor Identification: The volunteer staff positions identified below will be filled by local volunteers who will be recruited, trained and supervised as an ongoing activity of our agency. We will maintain volunteer records to document individual volunteer activity. Describe Volunteer Effort: Position Title Equivalent # of Value to Hourly Rate Hours

Project 1.

$ 2.

$ 3.

$ 4.

$ 5.

$ TOTAL VALUE TO AGENCY $ Equivalent Hourly Rates were determined by:

[ ] Rates for comparable positions within own agency. [ ] State Employment Service estimate of rates for type of work. [ ] Rates for comparable positions within other local agencies.

Estimated Mileage X Rate per mile = Value Donor Certification: I certify that commitments have been received from individual volunteers or groups sufficient to provide the volunteer hours and travel as identified above. Signature of Agency Official: Date:_______


II. B. 10. AVAILABILITY OF DOCUMENTS The undersigned hereby gives assurance that the following documents are maintained in the administrative office of the bidder and are accessible for review by the Alliance. a. Current Board Roster b. Articles of Incorporation and Corporate By-Laws c. Advisory Council By-Laws and Membership d. Staffing Plan (i.e. Position Descriptions, Salary Ranges, Organizational Chart with staff

names) e. Personnel Policies Manual f. Financial and Purchasing Procedures Manual g. Operational Procedures Manual h. Affirmative Action Plan i. Targeting Plan and documentation of activities j. Americans With Disabilities Act Assurances and Policies k. Staff Development and Training Plan (i.e. schedule, agendas, handouts, sign in sheets) l. Unusual Incident File m. Subcontracts and subcontractor monitoring reports n. Adult Protective Service and ARTT Procedures, including training tutorial log o. All Quality Assurance and Quality Improvement Initiative Procedures p. Consumer Satisfaction Policies q. CIRTS Reporting Procedures r. Sample of Privacy Notice Issued to Clients (HIPAA) s. Sample of Notification to Clients Regarding Collection of Social Security Number t. Co Payment System (i.e. Policies and Procedures for CCE and ADI) u. Civil Rights Compliance documentation v. Confirmation of successful completion of the Level II background checks of required staff w. E-Verify procedures x. Volunteer policies and procedures y. Safety/Licensure compliance (annual fire inspection reports of administrative offices and

agency buildings with SGR funded services and licensure documentation if applicable.) z. Conflict of Interest Policy aa. Current equipment inventory ab. Documentation of match commitments ac. Detailed documentation supporting contract expenditures and units of service ad. Client files

CERTIFICATION BY AUTHORIZED AGENCY OFFICIAL:

I hereby certify that the documents identified above currently exist and are available for review upon request. _______________________ _______ _______________________________________ Signature Date Name and Title of Authorized Individual

APPENDIX VIb

ORGANIZATIONAL CAPABILITY PACKAGE

The documents listed below are to be submitted with the Contract Module in such a way that they may be pulled out of the RFP proposal packet and reviewed separately. Please provide the listed items in the order specified below: 1. A copy of the most recent, board approved, organizational chart illustrating the

structure and relationship of all paid staff positions related to the CCE program. 2. A copy of the most recent audited financial statements and compliance reporting

package. Include any letters to management submitted by the independent auditor under separate cover as well as any response stating management’s position and plan of action.

3. A copy of the IRS determination letter granting you tax exempt status as a 501 (c)

(3). This item is applicable to non-profit agencies only. 4. A copy of most recent tax return for the most recent fiscal year. 5. A certificate of insurance from your agent detailing the types of coverage you

currently hold, the maximum dollar amount for each, and the dates when coverage became effective and is scheduled to terminate.

6. A copy of the Administrative Assessment Checklist required by this RFP (Refer to

Appendix VII) 7. Certification of availability of 30 days operating funds must be provided in a signed

statement by a corporate officer. 8. At least one letter of reference from another major funding source, besides the

Alliance, must be provided addressing the agency’s management capabilities, accountability of funds and service provision.

9. A signed copy of the statement assuring that no CCE funds were used in the

development of the RFP. (Appendix XIV)

10. A statement agreeing to forward a transition plan within 20 days of contract award.

APPENDIX VIc

Bidders are required to use this checklist to assure all required proposalitems have been addressed. No representation is made that the following checklist is a complete guide to every submission requirement in the RFP documents. Initial appropriate and applicable box.

Item # PROGRAM MODULE ITEM YES NO N/A PAGE COMMENTS

Table of Contents The location of each section of the Program Module of the Service Provider Application is accurately reflected on the Table of Contents.

I. A Service Provider Summary Information Page

The Service Provider Summary Information Page is properly completed and signed by the Board President (or or other authorized agency officer) and dated.

II. A Program Module - General Requirements 1 Demographics and Community Care Service

System

a.) The Provider has the ability to accept referrals and provide services for both CCE & HCE on a countywide basis.b.)The Provider's plan for coordinating, administering and managing both CCE & HCE is presented in a clear, concise, and thorough manner.

2 Consumer Identification a.) Provider described their anticipated activities for the 2017-18 contract year to identify and inform frail elders and their caregivers of the range and availability of services.

b.) The Provider described their efforts to participate in local networks and consortiums where hospitals, home health, social and medical providers are represented in order to target high-risk individuals in need of services.c.) Provider described its process of coordinationing of all formal and informal resources to meet client need (ADRC, EHEAP, Food stamps, etc.) including how it will incorporate consumer choice in determining service referrals. d.) Provider described the process for referral to the Aging and Disability Resource Center (ADRC). The description includes procedures that will be or are in place to interface with the ADRC’s Information and Referral function. The Provider described the steps and criteria used to determine if a consumer should be referred to the ADRC’s Helpline.e.) Provider described their procedures to request enrollment of their waitlist through communication with the ADRC following the waitlist enrollment protocols.

Program Module Review Checklist

Page 1 of 5

APPENDIX VIc




f.) Provider described how it will process referrals from the ADRC for new client enrollments. The procedure included each step from the initial receipt of the referral through all required and documented actions.

g.) The Provider included internal priortitization policies and procedures that ensure first priority service delivery to APS High Risk clients.h.) The Provider included policies and procedures for prompt data entry into ARTT and CIRTS occurs as required. Assurances that all required case managers have received or will receive the necessary ARTT Training Tutorial and certifications were included.

3 Case Management Functions a.) Two years of case management experience has been explained and monitoring reports submitted.b.) Case management functions for consumer assessments and care plan development includes action steps; number of staff involved; consumer to case manager ratios and average timelines. The Provider addresses timeline procedures from the ADRC waitlist release date to service initiation. The Provider's procedures follow the established guidelines.c.) Includes information on the provision for overall coordination of the proposed method of informing consumers of all the programs and services accessible through the Provider .d.) Explains process for reviewing general revenue funded clients for potential services in other DOEA funded and non-funded programs, including steps staff will utilize when wait listing clients.e.) Describes how all other available alternative resources for consumer services will be explored, utilized and documented prior to using state general revenue funding to provide services.f.) Includes Provider's internal procedures for assessing, billing, and collecting co-payments in a timely manner.

4 Services a.) The Provider lists the services to be offered including Case Management. A detailed explanation of each service is provided.b.) The Provider has indicated which services will be provided directly.

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APPENDIX VIc




c.) The Provider has indicated which services will be provided by subcontractors.d.) The Provider included the procedure(s) used for selection of qualified subcontractors. e.) Process included for ensuring that subcontracted employees and volunteers will obtain a level 2 background screening prior to receipt of state/federal funds.f.) The Provider has included a plan for the programmatic and fiscal monitoring of subcontractors. A copy of the subcontract monitoring tool(s) is included. g.) Provider has completed the "Subcontract Monitoring Schedule," which includes information on all applicable subcontractors providing services with CCE & HCE funding.

5 Quality Assurance a.) Provider included a description of the methods and procedures that will be utilized to assure the delivery of quality service(s) by its staff. The description included process and frequency. b.) Provider included a description of the methods and procedures used to assure the delivery of quality service(s) by its subcontractors. The description included process and frequency.

c.) Provider explained how the results of your quality assurance process will be used to improve services. Provided a narrative of quality improvement initiatives undertaken as a result of the quality assurance processd.) Pre-Service and In-Service Case Management Training - The Provider included: 1. Plan to provide the required pre-service staff training. and 2. Plan to provide required six (6) hours of in-service training to case management staff.

e.) The Provider included their policies and procedures to evaluate consumer satisfaction. The policies should include: 1) the proposed survey schedule, 2) proposed sample size, 3) tabulation information, 4) analysis and follow-up process, 5) information on how the results will be utilized to make improvements to services, and 6) timeframe the results of the survey will be forwarded to the Alliance. Additionally, consumer satisfaction survey and the results, analysis, and follow-up from the most recent survey are included.

Page 3 of 5

APPENDIX VIc




6 Process for Adverse Incident, Consumer Complaints, Grievances

a.) Provider described procedures for ensuring compliance with the required reporting of adverse incidents b.) Provider described its process for receiving, reporting and remediating consumer complaints.c.) Provider described its process for handling consumer grievances; along with the process for appeals regarding denial, reduction, or termination of services.

7 Reporting a.) The Provider outlined the procedures for accurate and timely entry of all service and consumer specific information and care plan data into the CIRTS database.b.) Provider explained its procedures for utilizing available CIRTS reports including how it uses these reports to improve data integrity in the CIRTS database.

8 Client Confidentiality & Security a.) Provider described what security measures are in place to address confidentiality and consumer-specific information including client notification as it relates to state and federal (HIPAA) requirementsb.) Provider described its current consumer notification which discloses the purpose for which the client’s social security number (SSN) is being collected.

c.) Provider described its procedures implemented to be certain that all required employees are properly verified and determined eligible for hire through the U.S. Department of Homeland Security’s E-verify systemd.) Provider described the procedures implemented to be certain that all applicable parties are properly screened and determined to have no disqualifying offenses prior to employment. Provider included its process for notifying DOEA when staff/volunteers are no longer employed by your organization. e.) Provider described its procedures for the proper storage, protection, security, and preservation of source documentation, including case files, vendor invoices, case management time, and client log sheet information.

9 Disaster Preparedness

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APPENDIX VIc




a.) Provider submitted a summary of its disaster plan which includes the key elements referenced in the SPA Section II.A.9.a.

10 Volunteer Plan

a.) The Provider included a written plan of action to assure that it maintains procedures on recruitment, training, utilization and retention of volunteers to assist with agency functions.

11 Organizational Chart a.) Provider described how its organizational structure is sufficient to support the functional requirements of the CCE program including Case Management functions and CIRTS data entry and maintenance. A copy of the organizational chart is included.

12 Description of Service Delivery (by Service) a.) Provider fully completed Section II.A.12. Description of Service Delivery for each service including case management.

13 Objectives and Performance Measures Provider included implementation strategies and action steps to be taken to ensure achievement of the six (6) Objectives and Performance Measures.

14 SPA AppendixProvider included the attachments as referenced in Section II.14.A (SPA Appendix)

Page 5 of 5


Item # CONTRACT MODULE ITEM YES NO N/A PAGEII.B.1. Personnel Allocations Worksheet

Complete and attach the Personnel Allocations Worksheet II.B.2. Unit Cost Worksheet

Complete and attach the Unit Cost WorksheetIII.B.3. Supporting Budget Worksheet

Complete and attach the Supporting Budget by Program Activity II.B.4-9. Match Commitment Forms

Complete and attach all applicable the Match Commitment formsII.B.10. Availability of Documents

The form must be signed and dated by the appropriate Agency representative.

II.B.11. Organizational Capability Package Appendix VIbAll documents referenced in Appendix VIb are attached and submitted in such a way that they may be pulled out of the RFP proposal packet and reviewed separately

APPENDIX VIcContract Module Review Checklist

Page 1 of 1

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Appendix VII

Administrative Assessment Checklist Agency: Date: Address: No. of Employees: No. of Business

Locations: Director's Name:

Administrative Assessment: An assessment of your organization's managerial, financial, and administrative capabilities will be made based on information in your proposal including your response to the following questions. If response is "no", please give your explanation below the applicable question. This information must be completed and returned with your response to the RFP. Failure to submit this checklist constitutes a fatal flaw, which will automatically disqualify your proposal from further review and consideration.

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VII-2

YES NO 1. Property Management

a. Are property records on file which describe the equipment, including the item number, the manufacturer's model number, equipment identification number, grant or contract identification number, acquisition date, location and condition of equipment maintained? _ _ 2. Procurement

a. Are written purchasing policies for procurement of supplies, equipment, construction, and other services on file? _____ ____ b. Is a code of conduct in writing maintained which governs performance of the officers, employees or agents engaged in procurement which states that they will avoid any conflict of interest? _ _ 3. Accounting a. Are financial reports prepared monthly for internal management purposes? _ _ b. Does an independent auditor perform a certified audit annually? _ _ c. Are basic books of accounting maintained? (General Ledger, Sub Ledgers Accounts Rceivable/Cash Receivables, Accounts Payable/Cash Disbursements) _ _

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VII-3 YES NO

d. Is there adequate segregation of duties among personnel in accounting functions listed below?

(1) Is payroll prepared by someone other than the timekeepers and persons who deliver paychecks

to employees? _ _

(2) Are duties of the bookkeeper separate from cash-related functions? _ _

(3) Is the signing of checks limited to those authorized to make disbursements and whose duties exclude posting and recording of cash received? _ _ (4) Are personnel performing disburse- ment functions excluded from the purchasing, receiving, inventory, and general ledger services? _ _ 4. Revenue a. Are receipts recorded in a cash receipt journal by individual cost centers? _ _ b. Is an equitable system of allocating fees and other third party payments to funding sources used when two or more sources are involved? _ _ c. Do controls exist to ensure that all appropriate costs for eligible service provisions are billed to third party payers in a timely manner? _ _ d. Are there guidelines for assessing fees? _ _

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VII-4 YES NO g. Are uncollectible write-offs approved by a responsible official? _ _

h. Are all checks marked "For Deposit Only" immediately upon receipt? _ _ i. Are receipts deposited on a regular basis? _ _ 5. Expenditures a. Are expenditure entries posted by cost centers? _ _ b. Is there a system for allocating direct cost when the project is funded by two or more sources? _ _ c. Are there written procedures for making refunds to clients, third party payers and others? _ _ e. Are written travel policies maintained? _ _ f. Are time and attendance records kept for all employees by program, by funding source? _ _ g. Are Federal quarterly payroll tax forms (U.S. 941) submitted in a timely manner? _ _ h. Are payroll records maintained? _ _

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VII-5 YES NO 6. Disbursements a. Are banks notified in writing when authorized check signers terminate employment with the provider? _ _

b. When not in use, are checks locked in a secure cabinet? _ _ f. Are cash receipts from accounts receivable or other sources segregated from petty cash funds? _ _ g. Are disbursements from petty cash documented by approved supporting invoices? _ _ 7. Personnel a. Are personnel policies in writing and approved by appropriate authority? _ _ b. Are job descriptions provided to all employees at time of initial employment? _ _ c. Are job descriptions on file for all positions? _ _ d. Is each staff member evaluated on performance, at least annually? _ _

APPENDIX VIII

PROPOSAL FATAL CRITERIA

Bidder: _____________________________________________________ Reviewer: __________________________________ Date: _____________ The “fatal” criteria listed below must be fully met in order for the proposal to be considered for further evaluation. Failure to receive a “YES” response on any item will result in an automatic rejection of the proposal. ITEM YES NO 1. Was the proposal received by the time and date

specified in the RFP? (as per RFP section B.2.i) _____ _____ 2. Were all copies of the proposal delivered in an envelope or box that was securely sealed and clearly marked on the outside with the RFP title and the name of the bidder? (as per RFP section B.2.l.) _____ _____ 3. Did the applicant submit both the

Program Module and the Contract Module of the proposal? _____ _____

4. Does the proposal include a signed Statementof No Involvement ?

(Appendix IV) _____ _____ 5. Does the proposal contain a signed Contract Terms and

Conditions Statement? (Appendix III) _____ _____

6. Does at least one copy of the Service Provider Summary

Information page contain the required original signature of the person authorized to bind the agency to all contractual obligations? (as per RFP section C.2.a) _____ _____

7. Does the proposal contain a completed Administrative Assessment Checklist? (Appendix VII) ______ _____


Applicant:

Reviewer:

Date:

Point Value Description4 Significantly exceeds expectations: The response is superior in its detail,

responsiveness, quality, clarity and organization. 3 Exceeds expectations. The response is good and is presented in a consistent, clear,

understandable, and concise manner.2 Meets minimum expectations. The response meets minimum requirements.1 Fails to meet minimum expectations. The response is insufficient, unclear, and

inconsistent in some areas.0 Response is incomplete. Required item(s) not included and/or inadequate.

The full proposal evaluation instrument includes this page and the following components:

1) Program Evaluation Instrument2) Contract Evaluation Instrument3) Organization Capabilities Evaluation Instrument4) Rating Summary Sheet

This document is a public record.

APPENDIX IX

PROPOSAL EVALUATION INSTRUMENT2017-2018

Page 1 of 1

Item # PROGRAM MODULE ITEM RATING COMMENTS

II. A Program Module - General Requirements

1 Demographic and Community Care Service System MAXIMUM POINT VALUE = 4a.) The bidder described its ability to accept referrals and provide services on a countywide basis for Community Care for the Elderly (CCE) and Home Care for the Elderly (HCE) . b.) The bidder described how it will coordinate, administer, and manage the system of community based services to meet the needs of the newly referred and existing clients of the Community Care for the Elderly program (CCE) and the Home Care for the Elderly program (HCE)

2 Consumer Identification MAXIMUM POINT VALUE = 4a.) The bidder described the anticipated activities it will conduct for the 2017-2018 fiscal year to identify and inform frail elders and their caregivers of the range and availability of servicesb.) The Bidder described its efforts to participate in local networks and consortiums where hospitals, home health, social and medical providers are represented in order to target high-risk individuals in need of services. c.) The bidder described its process of coordinationing of all formal and informal resources to meet client need (ADRC, EHEAP, Food stamps, etc.) including how it will incorporate consumer choice in determining service referrals. d.) The Bidder described its process for referral to the Aging and Disability Resource Center (ADRC). It included the description of its procedures that will be or are in place to interface with the ADRC’s Information and Referral function. THe Bidder also describe the steps and criteria it will use to determine if a consumer should be referred to the ADRC’s Helpline.e.) The Bidder described its procedures to request enrollment of wait listed clients through communication with the ADRC. f.) The Bidder described how it will process referrals from the ADRC for new client enrollments. The procedure included each step from the initial receipt of the referral through all required and documented actions.g.) The Bidder described its internal procedures that ensure priority service delivery to APS High Risk clients.

h.) The Bidder described its procedures to ensure client data entry into the APS Referral Tracking Tool (ARTT) and Client Information and Registration Tracking System (CIRTS) occurs as required. The Bidder provided assurances that all required case managers have received or will receive the necessary ARTT Training Tutorial and certifications.

3 Case Management Functions MAXIMUM POINT VALUE = 4a.) The Bidder described how and the extent to which it has provided a minimum of two years of case management services. Note: Per Section 1.b.1. of the RFP, Bidders who do not meet the two years minimum required case management experience will not be considered eligible for Lead Agency designation under this RFP. Bidders should submit all monitoring reports for the most recent three years reflecting reviews of services most similar to that of a Lead Agency. Bidder met the minimum 2 year requirement Yes/No

Program Module Evaluation InstrumentALLIANCE FOR AGING, INC.


Page 1 of 4




Case Management Functions Continued MAXIMUM POINT VALUE = 4b.) The Bidder described the action steps, number of staff involved, consumer to case manager ratio and average timelines for consumer assessments, care plan development, and service initiation. The bidder specifically addressed the timeline procedures from the ADRC wait list release date through service initiation. The timeline correlated with the requirements of Chapter 2 of the DEOA Programs and Services Handbook. c.) The Bidder explained how overall coordination will be provided to inform consumers of all programs and services accessible through the Lead Agency.

d.) The Bidder explained its process for reviewing general revenue funded clients for potential services in other DOEA funded and non-funded programs, including steps staff will utilize when wait listing clients. e.) The Bidder described how all other available alternative resources for consumer services will be explored, utilized, and documented prior to using general revenue funded services.

f.) The Bidder explained its internal procedure for assessing, billing, and collecting co-payments in a timely manner.

4 Services MAXIMUM POINT VALUE = 4Bidder presented material in a clear, concise and thorough manner. It is important that Bidder ensured that a variety of services were considered that include home-delivered meals, day care services, and other basic services needed to prevent institutionalization that are available within the service area. The Bidder took into account the most often provided services referenced in Section 2, Statement of Need, in the RFP. A complete listing of the services funded under all programs managed by the Department of Elder Affairs and descriptions for each of these services may be found in Appendix A of the Programs and Services Handbook.

a.) The Bidder listed the services it will offer other than Case Management. Note: A detailed explanation of each service must be provided in section “II.A.12. “Description of Service Delivery”.

b.) The bidder has indicated which services will be provided directly.c.) The bidder has indicated which services they intend to subcontract.

d.) The Bidder described the subcontractor bid and selection process and included timeframes. e.) The Bidder outlined their process for ensuring all required subcontractor employees/volunteers have successfully completed a level 2 background screening.

f.) The Bidder described its plan for the programmatic and fiscal monitoring of subcontractors. A copy of the subcontract monitoring tool(s) utilized by the Bidder is included in the SPA Appendix.

g.) The “Subcontract Monitoring Schedule” (II.A.4.a) was completed. It include information on all subcontractors who will provide services with CCE & HCE funding.

5 Quality Assurance MAXIMUM POINT VALUE = 4a.) The Bidder described its procedures including the process/frequency to assure the delivery of quality services by Lead Agency staff. b.) The Bidder described its procedures including the process/frequency to assure the delivery of quality services by subcontractors, if applicable. c.) The Bidder explained how the results of its quality assurance process will be used to improve services. The Bidder provided a narrative of quality improvement initiatives undertaken as a result of its quality assurance process. d.1.) The Bidder described its plan to provide the required pre-service staff training and included the minimum standards/topics as outlined in Appendix A of the DOEA Programs and Services Handbook.

Page 2 of 4




d.2.) The Bidder described its plan to provide required six (6) hours of in-service training to case management staff and included the minimum standards/topics as outlined in Chapter 2 of the DOEA Programs and Services Handbook.e.) The Bidder described the procedures it uses to evaluate consumer satisfaction. The description include:d 1) the proposed survey schedule, 2) proposed sample size, 3) tabulation information, 4) analysis and follow up process, 5) information on how the results are utilized to make improvements to services, and 6) timeframe for forwarding the results of the survey to the Alliance. A copy of the Bidder's most recent Consumer Satisfaction Survey, results, analysis, and follow-up is attached to the SPA Appendix.

6 Process for Consumer Complaints/Reducing/Term. Svcs. MAXIMUM POINT VALUE = 4The bidder provided a description of the process for dealing with complaints and processing appeals for denial, reduction or termination of services.a.) The Bidder described its policies and procedures for ensuring compliance with the required reporting of adverse incidents as outlined in Section 18 of the Master Contract (Appendix Ia). b.) The Bidder described its process for receiving, reporting and remediating consumer complaints.c.) The Bidder described its process for handling consumer grievances; along with the process for appeals regarding denial, reduction, or termination of services. The grievance procedures must provide for informing all consumers of the grievance/appeal process and providing assistance to consumers desiring to file a grievance/appeal.

7 Reporting MAXIMUM POINT VALUE = 4a.) The Bidder described the steps it will follow in order to provide for accurate and timely entry of all service and consumer specific information in the CIRTS database.b.) The Bidder described its procedures for utilizing available CIRTS reports including a discussion of how the Bidder uses such reports to improve data integrity in the CIRTS database.

8 Client Confidentiality MAXIMUM POINT VALUE = 4a.) The Bidder described what security measures are in place to address confidentiality and consumer-specific information including client notification as it relates to state and federal (HIPAA) requirements.b.) The Bidder described its current consumer notification which discloses the purpose for which the client’s social security number (SSN) is being collected.c.) The Bidder described the procedures implemented to be certain that all required employees are properly verified and determined eligible for hire through the U.S. Department of Homeland Security’s E-verify system. d.) The Bidder described the procedures implemented to be certain that all applicable parties are properly screened and determined to have no disqualifying offenses prior to employment. Included is the Bidder's process for notifying the DOEA when staff/volunteers are no longer employed by your organization. e.) The Bidder described its procedures for the proper storage, protection, security, and preservation of source documentation, including case files, vendor invoices, case management time, and client log sheet information.

Page 3 of 4




9 Disaster Preparedness MAXIMUM POINT VALUE = 4Bidder presented material in a clear, concise and thorough manner. Material included:a.) The Bidder provideds a summary of its disaster plan which should included the following key elements: (Refer to Chapter 8 of the DOEA Programs and Services Handbook for further information): • Designation of a Disaster Coordinator.• Plans for contacting all at-risk consumers, on a priority basis, prior to and immediately following a disaster.• Plans for receiving referrals and conducting outreach and delivering services, before and after a disaster, to elderly persons in need who are not current consumers.• Plans for after-hours coverage of network services, as necessary.• Plans for dispatching the Disaster Coordinator or other staff to shelters outside the disaster area to assists elderly evacuees with special needs.• Plans for helping at-risk consumers register with the Special Needs Registry of the local emergency management agency.• Plans for delivering meals to consumers prior to and following a disaster.• Plans for assigning staff to Emergency Operation Centers and/or declared assistance centers to ensure that elderly victims in the disaster area receive help.

10 Volunteer Plan MAXIMUM POINT VALUE = 4a.) The Bidder provided a written plan of action to assure that it maintains procedures on recruitment, training, utilization, and retention of volunteers to assist with your agency’s functions.

11 Organizational Chart MAXIMUM POINT VALUE = 4a.) The Bidder included an approved organizational chart illustrating the structure and relationship of positions, units, supervision and functions of the agency.b.) The Bidder described how its organizational structure is sufficient to support the functional requirements of the CCE program including Case Management functions and CIRTS data entry and maintenance.

12 Description of Service Delivery (by Service) MAXIMUM POINT VALUE = 4a.) The bidder fully completed Section II.A.12. Description of Service Delivery for each service including case management.

13 Performance and Outcome Measure Objectives MAXIMUM POINT VALUE = 4In keeping with the legislatively mandated requirements for performance-based budgeting, the Bidder provided implementation strategies to be used in keeping with the six key goals outlined by the DOEA for the Aging Network. The Bidder provided implementation strategies and action steps designed to ensure achievement of all outcome measures.

14 SPA Appendix MAXIMUM POINT VALUE = 4The Bidder submitted the Subcontractor Monitoring Tool SampleThe Bidder submitted the most recent Customer Satisfaction Survey Report, including results, analysis, and necessary follow-upThe Bidder submitted the Consumer Satisfaction Survey Sample

Total Rating: 0

Divided by Number of Questions: 14

Section Total: 0.00

Weight 60%

Page 4 of 4

Contract Module - Part AItem

# CONTRACT MODULE A ITEM Rating Comments1 Personnel Allocations Worksheet MAXIMUM POINT VALUE = 4

The Personnel Allocation Worksheet submitted lists all agency staff and available hours for each staff member. The required information provided is in sufficient detail, accurate, complete, and allocated.

Please note: Meeting the full requirements of this section will be assigned the maximum point value of four. Failure to meet the full requirements of this section will result in a point valuue of zero.

2 Unit Cost Worksheet MAXIMUM POINT VALUE = 4 Appropriate wages and salary information is linked from the

Personnel Allocation Worksheet. The Unit Cost Worksheet submitted reflects all services provided by bidder and includes all costs associated with those services regardless of funding source. Costs appear to be allowable, reasonable and necessary.


3 Supporting Budget by Program MAXIMUM POINT VALUE = 4 The Supporting Budget by Program tracks to the units of service

and total cost calculated on the Unit Cost Worksheet. All calculations are complete and correct.


4 Match Commitment Forms MAXIMUM POINT VALUE = 4 The matching funds categories (cash and in-kind) are at least 10%

of the "Adjusted Budgeted Costs" and are consistent with the match amounts included in the Supporting Budget. All required forms to document the bidder's commitment to match the state funds are properly completed, signed by the person authorized to bind the bidder to contractual agreements and dated.


Bidder Submitted applicable Match Commitment Forms Yes/No5 Availability of Documents MAXIMUM POINT VALUE = 4

The Availability of Documents is included, the certification is signed and dated.


Total Rating: 0

Divided by Number of Questions: 5

Section Total: 0Weight 10%

Contract Module Evaluation InstrumentALLIANCE FOR AGING, INC.


Page 1 of 1

Item # ORGANIZATIONAL CAPABILITY ITEM RATING COMMENTS

1 Organizational Chart & Job Descriptions MAXIMUM POINT VALUE = 4 Bidder submitted copies of its organizational chart. It is clear from

these documents that proper lines of supervision and adequate staffing are in place.


2 Audit MAXIMUM POINT VALUE = 4 A copy of the most recent audited financial statements and

compliance reports package was submitted. There were no significant findings or questioned costs and all recommendations made by the independent auditor to improve internal controls were implemented. Overall financial condition is strong.


3 IRS Determination MAXIMUM POINT VALUE = 4 A copy of the IRS determination letter granting tax exempt status (if

applicable) was submitted.Please note: Meeting the full requirements of this section will be assigned the maximum point value of four. Failure to meet the full requirements of this section will result in a point valuue of zero.

4 Tax Return MAXIMUM POINT VALUE = 4 A copy of the most recent was submitted. Overall financial condition

is strong.Please note: Meeting the full requirements of this section will be assigned the maximum point value of four. Failure to meet the full requirements of this section will result in a point valuue of zero.

5 Certificate of Insurance(s) MAXIMUM POINT VALUE = 4 A certificate of insurance was submitted detailing the types of

coverage held, the maximum dollar amount for each, and the dates when coverage became effective and is scheduled to terminate. Coverage at a minimum is as follows: $1M/$2M General Liability; $1M/$3M Professional Liability; $500K Auto Liability.


6 Administrative Assessment Checklist MAXIMUM POINT VALUE = 4 The Administrative Assessment Checklist was submitted. All items

were answered. Indication is given the agency adheres to sound fiscal and administrative standards for its operations.


7 Certification of 30 days operating funds MAXIMUM POINT VALUE = 4 Certification of the availability of 30 days operating funds was

provided in a signed statement.Please note: Meeting the full requirements of this section will be assigned the maximum point value of four. Failure to meet the full requirements of this section will result in a point valuue of zero.

8 Reference Letters MAXIMUM POINT VALUE = 4 The Bidder submitted at least one letter of reference from a major

funder addressing the agency's management capabilities, accountability of funds and service provision.


9 Statement of No CCE Funding Used MAXIMUM POINT VALUE = 49. A signed copy of the statement assuring that no CCE funds were used in the development of the RFP. (Appendix XIV)


10 Transition Plan Statement MAXIMUM POINT VALUE = 4 The Bidder provided a statement agreeing to forward a transition plan

within 20 days of contract award.Please note: Meeting the full requirements of this section will be assigned the maximum point value of four. Failure to meet the full requirements of this section will result in a point valuue of zero.

Total Rating: 0Divided by Number of Questions: 10

Section Total: 0Weight 10%

CCE Organizational Capability Evaluation InstrumentALLIANCE FOR AGING, INC.


Page 1 of 1

This document is a public record

RATING SUMMARY SHEET

Program Module Total Rating: 0 Divided by Number of Questions: 14 Section Total: 0.0000 Weight 60%

Contract Module - ATotal Rating: 0

Divided by Number of Questions: 5Section Total: 0.0000

Weight 10%

Contract Module - BTotal Rating: 0

Divided by Number of Questions: 1Section Total: 0.0000

Weight 20%

Organizational Capability (See note below) Total Rating: 0

Divided by Number of Applicable Questions: 10Section Total: 0.0000

Weight 10%

TOTAL WEIGHTED SCORE (by component)Program Module (60%) 0.00

Contract Module Part A (10%) 0.00Contract Module Part B (20%) 0.00

Organizational Capability (10%) 0.00

TOTAL WEIGHTED SCORE: 0.00

Bidder met the minimum 2 year requirement 0Bidder Submitted applicable Match Commitment Forms 0

APPENDIX IX


APPENDIX X

Lead Agency Dispute Resolution Procedures

Any dispute relating to the Allianceʼs intended contract awards for CCE Lead Agency designation as a result of the RFP will be resolved pursuant to the Lead Agency Dispute Resolution Procedure in Rule 58C-1.0031, Florida Administrative Code.

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APPENDIX XI

BIDDER CHECKLIST Bidders are encouraged to use this checklist to assure all required proposal items/time lines have been met. The bidder is cautioned to read and become familiar with all sections of the Alliance's RFP including all appendices. Failure to do so may result in the submission of an irregular proposal resulting in its possible rejection by the Alliance. Bidders should carefully review the items specified for submission of all of the required proposal documents. No representation is made that the following checklist is a complete guide to every submission requirement in the RFP. Minimum Requirements For A Proposal To Be Considered: 1. Delivered by December 12, 2016 at 11:00 AM 2. All copies of the proposal must be delivered in an envelope or box that is

securely sealed and clearly marked on the outside with RFP title and the name of the bidder.

___3. The proposal must include both the Program Module and the Contract Module. 4. Signed Statement of No Involvement (Appendix IV) 5. Signed Contract Terms and Conditions Statement (Appendix III) 6. Summary Information Page signed by a person authorized to bind the agency to

all contractual obligations (Title Page of Service Provider Application, Section I.A.)

Verify the following sections of the Service Provider Application have been properly submitted: Initial if submitted I.A. Service Provider Summary Information ________ II.A. Program Module Documents:

1. Demographics and Community Care Service System ________ 2. Consumer Identification ________ 3. Case Management Functions ________ 4. Services ________

a. Subcontract Monitoring Schedule 5. Quality Assurance ________ 6. Process for Handling and Reporting Adverse Incidents,

Consumer Complaints and Grievances ________ 7. Reporting ________ 8. Client Confidentiality & Security ________ 9. Disaster Preparedness ________

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Initial if submitted

10. Volunteer Plan ________ 11. Organizational Chart ________ 12. Description of Service Delivery (by Service) ________ 13. Objectives and Performance Measures ________ 14. SPA Appendix

a. Program and Fiscal Subcontractor Monitoring Tool Sample ________ b. Consumer Satisfaction Sample Survey ________ c. All monitoring reports, if applicable, for the most recent three years ________

15. Program Module Review Checklist ________ II.B. Contract Module Documents: Initial if submitted 1. Personnel Allocations Worksheet ________

2. Unit Cost Worksheet ________ 3. Supporting Budget Schedule by Program Activity ________ 4. Commitment of Cash Donation ________ 5. Commitment of In-kind Contribution of Space ________ 6. Commitment of In-Kind Contribution of Supplies ________ 7. Commitment of In-Kind Contribution of Equipment ________ 8. Commitment of In-Kind Contribution of Services ________ 9. Commitment of In-Kind Volunteer Personnel and Travel ________ 10. Availability of Documents ________ 11. Contract Module Review Checklist ________

Verify that the following sections of the Organizational Capability Package have been properly submitted: Initial if submitted

1. Approved Organization Chart ________ 2. Most Recent Audited Financial Statements ________ 3. IRS Determination Letter on Tax Exempt Status ________ 4. Most Recent Tax Return ________ 5. Certificate of Insurance ________ 6. Administrative Assessment Checklist (Appendix VII) ________ 7. Certification of 30 days operating funds ________ 8. Reference Letter ________ 9. Statement Assuring No CCE

Funds Used in Development of RFP ________ 10. Statement that Transition Plan Will Be Provided Within 20 Days of Contract Award ________

APPENDIX XII


CCE Historical information

2016/2017 Miami-Dade Monroe

CCE Award County County

Case Management (ESTIMATED) 633,686$ 33,096$

Core Services (ESTIMATED) 5,703,178$ 380,604$

TOTAL CCE Funds 6,336,864$ 413,700$

Average Annual Client Count 1,009 65

2015/2016 Miami-Dade Monroe 2014/2015 Miami-Dade Monroe

CCE Award County County CCE Award County County

Case Management 640,748$ 31,159$ Case Management 556,817$ 24,319$

Case Aid -$ 1,868$ Case Aid -$ -$

Adult Day Care 54,155$ -$ Adult Day Care 88,114$ -$

Chore 20,113$ 5,794$ Chore 18,463$ 2,220$

Chore Enhanced 52,869$ 580$ Chore Enhanced 80,354$ -$

Companionship 69,307$ 2,215$ Companionship 77,999$ 2,794$

Consumable Medical Supplies -$ -$ Consumable Medical Supplies 134,612$ -$

Counseling 1,539$ -$ Counseling 175$ -$

EAR Installation 1,272$ -$ EAR Installation 56$ -$

EAR Maintenance 22,591$ -$ EAR Maintenance 22,041$ -$

Escort 90$ -$ Escort 209$ -$

Home Delivered Meals 414,944$ -$ Home Delivered Meals 418,879$ -$

Homemaker 1,560,558$ 143,953$ Homemaker 1,651,124$ 123,624$

Home Improvement 9,254$ 2,833$ Home Improvement 16,643$ -$

Material Aid 2,812$ -$ Material Aid 2,145$ -$

Nutrition Counseling 3,020$ -$ Nutrition Counseling 3,957$ -$

Personal Care 1,797,336$ 168,716$ Personal Care 1,710,535$ 117,762$

Pest Control Initial 1,222$ -$ Pest Control Initial 1,675$ -$

Pest Control Maintenance 1,629$ -$ Pest Control Maintenance 2,651$ -$

Respite Facility -$ 15,193$ Respite Facility -$ 15,003$

Respite In-Home 510,319$ 40,846$ Respite In-Home 559,119$ 16,801$

Specialized Medical Equipment 712,657$ 544$ Specialized Medical Equipment 544,100$ -$

TOTAL CCE Funds 5,876,435$ 413,700$ TOTAL CCE Funds 5,889,668$ 302,523$

Average Annual Client Count 900 61 Average Annual Client Count 900 45$

APPENDIX XIII


CCE CONTRACT RATES PER UNITS OF SERVICE

2015/2016 CCE Service

Miami-Dade Provider

A

Miami-Dade

Provider B

Miami-Dade Provider

C Monroe

Adult Day Care 10.72 10.38 9.43

Case Aide 31.09 - 21.00 21.98

Case Management 48.41 39.88 37.83 50.48

Chore - - - -

Chore (Enhanced) - - - -

Companionship 15.36 14.62 15.00 15.33

Counseling (Gerontological-

Individual) 69.96 35.89 - -

Emergency Alert Response -

Installation 55.54 50.00 47.09 -

Emergency Alert Response 1.24 1.06 1.26 -

Escort 14.93 14.40 13.99 -

Home Delivered Meals 5.81 5.22 5.00 -

Homemaker 15.44 14.43 15.00 22.06

Housing Improvement Cost Reimbursement Cost Reimbursement Cost Reimbursement Cost Reimbursement

Nutrition Counseling - Individual 38.23 - 38.30 -

Personal Care 15.44 14.49 15.00 28.67

Pest Control - Initiation 59.67 55.87 55.41 -

Pest Control - Maintenance 41.80 36.54 33.44 -

Respite In-Facility - - 9.98 10.00

Respite In-Home 15.43 14.62 15.00 23.08

Specialized Medical Equipment Cost Reimbursement Cost Reimbursement Cost Reimbursement Cost Reimbursement

2014/2015 CCE Service

Miami-Dade Provider

A

Miami-Dade

Provider A

Miami-Dade Provider

A Monroe

Adult Day Care 10.72 10.38 9.43

Case Aide - - 21.00 21.98

Case Management 48.41 39.88 37.38 50.48

Chore 15.44 14.61 15.49 29.41

Chore (Enhanced) 25.09 24.94 25.00 32.19

Companionship 15.36 14.62 15.00 15.33

Counseling (Gerontological-

Individual) 69.96 - - -

Emergency Alert Response -

Installation 55.54 50.00 47.09 -

Emergency Alert Response 1.24 1.06 1.26 -

Escort 14.93 14.40 13.99 -

Home Delivered Meals 5.81 5.22 5.00 -

Homemaker 15.44 14.43 15.00 22.06

Housing Improvement Cost Reimbursement Cost Reimbursement Cost Reimbursement Cost Reimbursement

Nutrition Counseling - Individual 38.23 - 38.30 -

Personal Care 15.44 14.49 15.00 28.67

Pest Control - Initiation 59.67 55.87 55.41 -

Pest Control - Maintenance 41.80 36.54 33.44 -

Respite In-Facility - - 9.98 10.00

Respite In-Home 15.43 14.62 15.00 23.08

Specialized Medical Equipment Cost Reimbursement Cost Reimbursement Cost Reimbursement Cost Reimbursement

APPENDIX XIV

Statement Assuring No CCE Funds Were Used in Developing Proposal in Response to the RFP

I, , as an authorized representative

of , certify that no funding received from

an Area Agency on Aging for Community Care for the Elderly program services or other

services funded with Florida State General Revenue funds was used in preparing this

proposal.

Signature of Authorized Representative Date

APPENDIX XV

Alliance for Aging, Inc. March, 2016

REIMBURSEMENT RATE REVIEW POLICY POLICY: The Alliance and a service provider shall re-evaluate contract reimbursement rates on an annual basis pursuant to the Florida Department of Elder Affairs (DOEA) Notice of Policy Clarification #: 092815-1-PC-SCBS. Each provider's rates will be reviewed and approved by the Alliance as required by the Alliance's contract with the Florida Department of Elder Affairs (“DOEA”) and in accordance with the policy adopted by the Alliance's Board. An adjustment to a provider's reimbursement rates pursuant to this policy will not necessarily result in a change in contracted funds allocated to the provider. SERVICE COST REPORTS: The Alliance shall require service providers to annually submit to the Alliance service cost reports, due no later than ninety (90) calendar days after the contract year ends. The service cost reports shall reflect actual costs of providing each service by program for the preceding contract year. REQUESTING A CHANGE IN REIMBURSEMENT RATES: If a service provider desires to request a change in its reimbursement rates for a new contract year, the service provider shall make a request in writing to the Alliance no later than March 15 for General Revenue contracts and September 15 for Older Americans Act contracts of each year identifying the specific unit rates the service provider seeks to change and the proposed adjustment to such rates. The request must be accompanied by:

(a) a unit cost methodology report with line item budget projections for the new contract year showing any anticipated changes to the costs incurred as reflected in the most recent service cost report; and

(b) any other information the service provider believes should be considered in renegotiating rates

including supporting documents for line item increases, information relating to sustainability of services and current market conditions.

The service provider's written request for rate adjustment and all supporting information shall be submitted to the Alliance no later than the due date specified in the paragraph above. The service provider's written request for rate adjustment shall also include specific information regarding the extent to which the requested rate adjustment, if approved, will affect the availability of client services (positively or negatively), e.g. accommodating the increase through attrition by reducing the number of clients served during the contract year. This plan will provide the Alliance with the information needed to respond to any questions from clients, family members, DOEA or other interested person should the requested rate adjustment be approved and implemented pursuant to this policy. The Alliance shall use the last service cost report, the last and new unit cost methodology reports, and other information submitted with a request for rate adjustment to re-evaluate the service provider's reimbursement rates based on relevant factors, including, but not limited to, sustainability, the respective consumer price index, and/or current market conditions. In evaluating any request for a rate adjustment, it is the intent of DOEA, as stated in its’ NOTICE #: 092815-1-PC-SCBS and the Alliance that the quality of services provided to current program recipients will not be reduced.

After review of the service provider’s written request for rate adjustment and supporting documentation, the Alliance may determine a need for dialogue with the service provider which, if needed, will take place within 30 calendar days following each submission deadline. The Alliance's President/CEO shall provide written notice to each service provider, who requested a rate adjustment, of the Alliance's determination within 30 calendar days following each submission deadline. No adjustments shall be made to the rates of, and no notice shall be given to, any service provider who has not timely submitted to the Alliance a written request for a rate adjustment. A service provider may appeal to the Alliance Board's Executive Committee the Alliance's decision as communicated by the Alliance's President/CEO by submitting a written appeal to the President/CEO within five (5) business days of receipt of the Alliance's determination on the service provider's request for rate adjustment. The Executive Committee shall meet to hear any timely submitted appeal and render a decision on the appeal within forty-five (45) calendar days of the receipt of an appeal. The information to be considered by the Executive Committee in any appeal shall be limited to that information timely submitted by the service provider to the Alliance with the service provider's request for a rate adjustment. The President/CEO's decision shall be final with respect to any determination on a requested rate adjustment that is not timely appealed. The Executive Committee's decision shall be final with respect to any determination that is timely appealed. A one-time exception for the requirements of the March 15 deadline date for General Revenue contracts provides for an extension during the first year of this policy only to April 18, 2016. This onetime exception will reduce the time for which the Alliance’s President/CEO shall provide written notice to each service provider who requested a rate adjustment. The one-time exception adjusts the Alliance's determination to within twenty-one (21) calendar days following the submission deadline. The one-time exception will also reduce the Executive Committee’s time to review each appeal and render a decision on each appeal within thirty (30) calendar days of the receipt of an appeal. Any rate adjustment made pursuant to this policy shall be effective on July 1 for General Revenue contracts or January 1 for Older Americans Act contracts or the date of execution of a new contract, whichever is later. To the extent that the last day within a time frame for providing written notice or performing a task pursuant to this policy falls on a Saturday, Sunday or legal holiday during which the Alliance's offices are closed, the last day to provide written notice or perform such task shall be extended to the next business day during which the Alliance's offices are open.

Request for Proposal (RFP) · 2019. 5. 21. · Appeal Process 51 o. Contract Terms and Conditions...

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Transcript of Request for Proposal (RFP) · 2019. 5. 21. · Appeal Process 51 o. Contract Terms and Conditions...