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COG AAA Family Caregiver budget amend contractBudget Amendment 05 -14 -13 ORIGINAL CONTRACT CAPE FEAR COUNCIL OF GOVERNMENTS AREA AGENCY ON AGING GRANT AGREEMENT FOR FAMILY CAREGIVER SUPPORT GRANTS Judy 1, 2012 - June 30, 2013 I. PARTIES TO THE CONTRACT This agreement is made and entered into this 3`d day of July 2012 between the Cape Fear Council of Governments (1480 Harbour Drive, Wilmington, NC 28401), hereinafter referred to as the "Council of Governments," and New Hanover County Senior Resource Center (2222 South College Rd, Wilmington, NC 28403), hereinafter referred to as the "Grantee." II. EFFECTIVE PERIOD OF CONTRACT This contract shall be effective July 1, 2012 and shall terminate on June 30, 2013. 111. GENERAL PROVISIONS Subject to the terms and conditions hereinafter set forth, the Council of Governments agrees to grant Family Caregiver Support Program funds per the NC Division of Aging and Adult Services authorized through the National Family Caregiver Support Act, (The Older Americans Act, as amended in 2000, Title III, Part E). This grant is intended to sustain the efforts of families and other informal caregivers of older adults by providing supportive services (as defined below) under the following Category 2 Access to Services, Category 3 Training, Counseling & Support Groups Category 4 Respite Care, or Category 5 Supplemental Services. The objective is to give caregivers relief and provide assistance in finding services allowing them to their keep older adult in the community for as long as possible and/or help support older adult relatives raising children 18 years of age or below. The services covered under the grant are intended for caregiver not receiving any other assistance. Category Services Grant Unit Cost Projected Projected (2, 3, 4 To be Amount If applicable Number of Units # to be or 5) provided If Applicable Served 3 (833) Support Groups $525 N/A n/a n/a 1275 4 (842) In- home/non- medical $18,000 $16.40 1125 32 Res ite varies 4 (843) Adult Day Care $10,000 $50day 200 15 Day Health 5 (857) Incontinence Supplies $4225 $ 1975 5 (859) Liquid Nutritional $250 Supplemental $31,500 Note: The Cape Fear Council of Governments Area Agency on Aging must approve any changes to the budget. IN WITNESS THEREOF, THE COUNCIL OF GOVERNMENTS AND THE GRANTEE HAVE EXECUTED THIS AGREEMENT AS OF THE DATE FIRST WRITTEN ABOVE. CAPE FEAR COUNCIL OF GOVERNMENTS: Executive Director Date Area Agency on Aging Administrator Date This instrument has been preaudited in the manner required by the local government budget and fiscal control act. Finance Officer Date GRANTEE. �Nlo� PSou�C� CIO Name of Organization By: '51►-1 Authorized Lead Agency Official Date ra ORIGINAL CONTRACT CAPE FEAR COUNCIL OF GOVERNMENTS AREA AGENCY ON AGING GRANT AGREEMENT FOR FAMILY CAREGIVER SUPPORT GRANTS July 1, 2012 - June 30, 2013 I. PARTIES TO THE CONTRACT This agreement is made and entered into this 3rd day of July 2012 between the Cape Fear Council of Governments (1480 Harbour Drive, Wilmington, NC 2840-1), hereinafter referred to as the "Council of Governments," and New Hanover County Senior Resource Center (2222 South College Rd, Wilmington, NC 28403), hereinafter referred to as the "Grantee." II. EFFECTIVE PERIOD OF CONTRACT This contract shall be effective July 1, 2012 and shall terminate on June 30, 2013. III. GENERAL PROVISIONS Subject to the terms and conditions hereinafter set forth, the Council of Governments agrees to grant Family Caregiver Support Program funds per the NC Division of Aging and Adult Services authorized through the National Family Caregiver Support Act, (The Older Americans Act, as amended in 2000, Title III, Part E). This grant is intended to sustain the efforts of families and other informal caregivers of older adults by providing supportive services (as defined below) under the following Category 2 Access to Services, Category 3 Training, Counseling & Support Groups Category 4 Respite Care, or Category 5 Supplemental Services. The objective is to give caregivers relief and provide assistance in finding services allowing them to their keep older adult in the community for as long as possible and/or help support older adult relatives raising children 18 years of age or below. The services covered under the grant are intended for caregiver not receiving any other assistance. Category Services Grant Unit Cost Projected Projected (2, 3, 4 To be Amount If applicable Number of Units # to be or S) provided If Applicable Served 3 (833) Support Groups $525 N/A n/a n/a 4 (842) In- home/non- medical $18,000 $16.00 1125 32 Respite varies 4 (843) Adult Day Care $10,000 $50day 200 15 Day Health 5 (857) Incontinence Supplies $1225 5 (859) Liquid Nutritional $250 Supplemental $30,000 Note: The Cape Fear Council of Governments Area Agency on Aging must approve any changes to the budget. V Category 2 Assistance in Gaining Access to Services (individual, one on one contact to assist caregivers in gaining access to services) The Grantee did not allocate any funds to this category. Category 3 Training, Counseling and Support Groups The Grantee has allocated $525 of funds to this category to help with monthly caregiver support group meetings. Category 4 Respite Services (Considered temporary, substitute supports or living arrangements to provide a brief period of relief to caregivers on an intermittent, occasional or emergency basis) *Eligible caregivers must be caring for an older adult 60+ with at least two ADL (Activities of Daily Living i.e. eating, dressing, bathing) impairments or individuals with Alzheimer's disease and related disorders with neurological and organic brain 42sfunction. No more than $1 500.00 may be used per eligible client during grant period The grantee has allocated $10,000 for Adult Day Care/Day Health and $18,000 for in -home respite to Category 4 Respite Care will be used to temporarily provide one of the following; in -home aide, adult day care, adult day health, respite care stay in nursing homes or adult care home, hospice and transportation to provide caregiver respite. These services will be provided for functionally impaired individuals whose primary caregivers need relief from everyday caregiving responsibilities in order for impaired individuals to remain at home for as long as possible. The Grantee will give the caregivers as much choice and flexibility as possible by offering temporary respite through in -home aide (medical and non- medical), adult day care /day health, group respite, and institutional respite in a licensed adult care /nursing facility. Referral for these services will be made after assessments (including reviewing current services that are being provided to care recipient by completing a comprehensive intake form) are completed and an appropriate care plan has been developed by the Grantee. Category 5 Supplemental Services (Services intended as a one -time assistance to caregivers that compliments the care they are providing. Examples include: purchasing incontinence supplies, home modifications, home safety interventions) *Eligible caregivers must be caring for an older adult 60+ with at least two ADL (Activities of Daily Living i.e. eating, dressing, bathing) impairments. No more than $500.00 may be used per eligible client during grant period The Grantee has allocated $1225 to help with Incontinence Supplies (857) and $250 for Liquid Nutritional Supplements (859). These services are to provide temporary relief and will be a bridging mechanism until consistent services are available. The NC Division of Aging and Adult Services Home and Community Care Block Grant Service Standards will be used for provided services. The Family Caregiver Resource Specialist and other AAA staff willprovide technical assistance for duration of the grant. The terms set forth in this agreement for payment are contingent upon availability of funding. IV. GRANT AMOUNT The total payment under this contract shall not exceed $30,000. The North Carolina Division of Aging and Adult Services is providing the match for the Family Caregiver Support Program; therefore no local match is required. V. DOCUMENTATION AND COMPENSATION In order to qualify for funding, applicants must agree to comply with the following: • All required assurances (which state the organization must comply with Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 794), the Americans with Disabilities Act of 1990, and the Department of Health and Human Services Regulation under Title VI of the Civil Rights Act of 1964) must be signed prior to receipt of funding under the FCSP. Aging Resource Management System (ARMS) Requirements: All program performance and financial reports must conform to the requirements of the Division of Aging and Adult Services' automated Aging Resource Management System (ARMS). The Grantee will be required to participate in the automated ARMS by supplying the necessary and required input data. The Grantee will also be required to participate in appropriate training workshops by the Division of Aging and Adult Services and or Area Agency on Aging. Failure to comply with the reporting requirements may result in either withholding of funds or possible suspension/termination of funding. Grantees are required to participate in the ARMS user's fee. The fee shall apply to each of the categories as the reimbursements are requested through the ARMS system. It shall be based on the following formula: ff of records reimbursement is X $.15 Maintenance cost per service record - Requested for each service The Service Code Chart for the Family Caregiver Support Program is as follows: Non -Unit Services Code Information /Assistance 822 Care Management 823 Support Groups 833 Training/Education 835 In -home Respite Care 842 Community Res pi Adult Day Care 843 Institutional Respite 846 Medical Equipment and Assistive Technology 854 Home Modifications Accessibili (grab bars etc 855 Personal Emergency Response 5 stems 856 Incontinence Supplies 857 Liquid nutritional supplements ensure boost 859 The whole service code chart for the Aging Resource Management System (ARMS) is available on -line at http://www.dhhs.state.nc.us/agincitarmsLsvcode.pdf • Compensation: Grantees must meet the reporting requirements of the NC Division of Aging and Adult Services and the Cape Fear Area Agency on Aging Family Caregiver Support Program. Payments will be made monthly upon request for reimbursement through ARMS by Grantee. Reimbursement forms will be due monthly to the Area Agency on Aging and must be received no later than the 71h of each month in order to be considered far payment at the end of that month. These forms should reflect the amount of funds requested through the ARMS system each month. Payment of funds will be based upon the Aging Resource Management System (ARMS) Provider Reimbursement Report (ZGA370 -12). The Cape Fear Council of Governments will forward payment of the approved budget expenditure at the end of each month. Documentation of Expenses: Grantee shall maintain full and complete documentation of all expenses associated with performing the scope of work under this contract. Documentation in the form of time sheets or other verification (prior approval required) that services were rendered shall be kept in each client file. Grantee shall maintain all financial and program records for a period of three (3) years from the date of final payment under this agreement. Grantee shall maintain records on each caregiver served including: Family Caregiver In -take Form, Service Cost Sharing form (signed and dated) and Client/Patient Rights form (signed and dated). The grantee should include their individual privacy /confidentiality form and a comprehensive intake on the care recipient (see page 2) in addition to above listed items. • Data Reporting: Grant recipients will keep client information updated in the ARMS system so we can submit a bi- annual report that will capture required data on caregivers The ARMS system will capture client information and report fund usage monthly. The NC Division of Aging and Adult Services and the Cape Fear Area Agency on Aging will provide training and technical assistance as needed. Grantees must allow for "consumer contributions" (caregiver must be given opportunity to contribute to defray the cost of the service, but may not be denied service should he /she fail to or choose not to contribute). The NC Division of Aging and Adult Services Home and Community Care Block Grant Service Standards for Consumer Contributions will be followed. The Consumer Contributions Policy and Procedures can be found on the web at: httW:/ /www.dhhs.state.nc.us/ aging /manual/consumercontributions pdf VII. REALLOCATION OF GRANT FUNDS It is understood and agreed, that in the event that the Grantee's rate of progress on this contract is leading to underutilization of the funds allocated, and if the Grantee cannot demonstrate how funds will be fully utilized during the contract period, then, upon notice to the Grantee, the Council of Governments may decrease the total compensation to be paid hereunder in order to reallocate funds to other Grantees. Family Caregiver Support Grant expenditures will be reviewed after six months to ensure it is on target. If results find that utilization of funds is less than 50% the AAA reserves the right to reduce the original grant amount. 4 VIII. AMENDMENTS AND REPROGRAMMING OF FUNDS This contract may be modified by written amendment at any time. It is understood and agreed that, in the event that the amount of funds received from the NC Division of Aging and Adult Services is reduced or increased from the amount(s) quoted, the Council of Governments may, in turn, decrease or increase the total compensation and reimbursement to be paid. Such changes, including any increase or decrease in the amount of the Grantee's compensation shall be incorporated in written amendments to this contract and signed by both parties. IX. MONITORING, AUDITING, AND REPORTING The Grantee agrees to submit to an audit by an independent Certified Public Accountant, the Council of Governments, the State of North Carolina or the federal government for a three -year period following the final payment under the terms of this Agreement. The Grantee agrees to permit monitoring by the Council of Governments, its staff, and appropriate representatives, and to comply with such reporting procedures as may be established by the Council of Governments. The Grantee further agrees that all pertinent financial records shall be made available for copying upon request by Council of Governments, the state or federal government, or their agent. It is expressly understood and agreed that the report procedures established by the Council of Governments may include, but not be limited to, the names, addresses and social security numbers of individuals receiving services under the terms of this contract, with the understanding that no personal information obtained from any individual will be disclosed by the Council of Governments in a form which allows identification of the individual, without the written consent of the individual. If the Grantee is receiving, using, or expending $500,000 (Effective for fiscal year ending 12131/2004) or more in combined state and federal funds through this contractual agreement or in combination with other state agencies and/or state universities a single audit or program specific audit is required. Entities receiving less than a total of $500,000 are required to have an audit of its fiscal year basic financial statements. Said audit must be prepared in conformity with generally accepted auditing standards, standards for financial audits contained in "Government Auditing Standards" issued by the Comptroller General of the United States, and the requirements of the appropriate Office of Management and Budget (OMB) Circular. Audits of non - governmental entities, both for -profit and not - for - profit, must meet requirements of OMB Circular A -133. The audit is to be submitted within six months after end of the Grantee's fiscal year. If the Grantee is a non - governmental entity, a copy of the audit report should be sent to the Office of the State Auditor in compliance with General Statute 143.1. A corrective action plan for any audit finding should be submitted with the audit report. It is further understood that the Grantee is responsible to the Council of Governments for clarifying any audit exceptions that may arise from an independent audit, the Department of Human Resources audit, or any federally conducted audit. In addition, the Grantee is responsible for repaying any federal and/or state funds that may be part of an audit exception. Representatives of the Council of Governments and the NC Division of Aging and Adult Services may at any reasonable times review and inspect the service activities and data collected pursuant to this Agreement. All reports and computations prepared by or for the Grantee shall be made available to authorized representatives of the Council of Governments, and the NC Division of Aging for inspection and review at any reasonable time in the Grantee's office. Approval and acceptance of such material shall not relieve the Grantee of its professional obligation to discover and correct, at its expense, any errors found in the work. To ensure adequate review and evaluation of the work and proper coordination among interested parties, the Council of Governments shall be kept fully informed concerning the progress of the work and services to be performed. Council of Governments staff will conduct on -site assessments and may also make unannounced visits for the purpose of evaluating the Grantee's work. X. COMPLIANCE WITH TITLE VI & VIII OF CIVIL RIGHTS ACT, SECTION 504 OF THE REHABILITATION ACT, AND AMERICANS WITH DISABILITIES ACT The Grantee shall comply with Title VI and VIII of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, and the Americans with Disabilities Act of 1990 (ADA) and all requirements imposed by Federal regulations, rules and guidelines issued pursuant to these Titles and the ADA for both personnel employed and clients served. M. CONFLICT OF INTEREST The Grantee expressly states that presently he has no interest and shall not acquire any interest, direct or indirect, which would conflict in any manner or degree with the performance of services required to be performed under this contract. The Grantee shall not employ any person having such interest during the performance of this contract. The Grantee further agrees to notify the AAA in writing of any instance that might have the appearance of a conflict of interest. See Attachment A for signature. MI. CONFIDENTIALITY Any reports, recipient information, data, or other materials given to or prepared or assembled by the Grantee under this Agreement which the Council of Governments requests to be kept confidential shall not be made available to any individual or organization by the Grantee without prior written approval of the Council of Governments. K14I_I.W10I1 X10 M FA'J Grantee shall indemnify and hold the Cape Fear Council of Governments, its agents and employees, harmless against any and all claims, demands, causes of action, or other liability, including attorney fees, on account of personal injuries or death or an account of property damages arising out of or relating to the work to be performed by the Grantee hereunder, resulting from the negligence of or the willful act of omission of the Grantee, his agents, employees, and subcontractors. XIV. ATTENDANCE AT REGION O AREA AGENCY ON AGING MEETINGS The Grantee, upon request of the AAA Administrator/Designee, will make efforts to attend any committee or special meeting relating to the project. The Grantee will attend any scheduled regional Family Caregiver Support Program meetings. XV. TERMINATION OF AGREEMENT FOR CAUSE If through any cause, the Grantee shall fail to fulfill in timely and proper manner its obligations under this Agreement or if the Grantee shall violate any of the covenant, agreements or stipulations of this Agreement, the Council of Governments shall thereupon have the right to terminate this Agreement by giving written notice to the Grantee of such termination and specifying the effective date thereof. The date of notice shall be at least fifteen (15) days before the effective date of such termination. The Grantee shall have the right to terminate this Agreement by giving the Council of Governments written notice of such termination at least 15 days prior to the effective date of the termination. In such event, all finished documents and other materials collected or produced under this Agreement shall, at the option of the Council of Governments, become its property. The Grantee shall be entitled to receive just and equitable compensation for any work satisfactorily performed under this Agreement. XVI. APPROVAL OF SUBCONRACTOR OR ASSIGNABILITY The grantee shall not assign all or any portion of its interests in this contract, nor shall any of the work or services to be performed under this contract by the Grantee be subcontracted, without the prior written approval of the Council of Governments. Any purchase of services with Family Caregiver Support Grant funding shall be carried out in accordance with the procurement and contracting policy of the community services provider or, where applicable, the Council of Governments, which does not conflict with Procurement and contracting requirements contained in 45 CFR 92.36. If services are subcontracted, the Grantee remains liable not withstanding such procedure. XVII. TAX EXEMPT STATUS If grantee has tax exempt status they must submit a copy of the tax exempt declaration letter with contract. IN WITNESS THEREOF, THE COUNCIL OF GOVERNMENTS AND THE GRANTEE HAVE EXECUTED THIS AGREEMENT AS OF THE DATE FIRST WRITTEN ABOVE. CAPE FEAR COUNCIL OF GOVERNMENTS: Executive Director Date Area Agency on Aging Administrator Date This instrument has been preaudited in the manner required by the local government budget and fiscal control act. Finance Officer Date GRANTEE. Name of Organization By: Authorized Lead Agency Official Date IN WITNESS THEREOF, THE COUNCIL OF GOVERNMENTS AND THE GRANTEE HAVE EXECUTED THIS AGREEMENT AS OF THE DATE FIRST WRITTEN ABOVE. CAPE FEAR COUNCIL OF G0VERNjWEN7S: Executive Director Date This instrument has been preaudited in the manner required by the local government budget and fiscal control act. -9 30, 6ov ®� Officer GRANTEE: Named By: U -' --j�; 1 Date Lead Agency Official Date 8 £IZ ZLOZ -90 -LO 9£:05:9L £90999ZOL6