Cape Fear Council of Governments Family Caregiver FY14Cape Fear Council of Governments
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2222 S. College Road
Wiln�n, NC 28401
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policy and procedures as they relate to the progimm.
if you have any questions, do no-LI hesitate to call. I appreciate you and your staff's
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Serving Brunswick Columbus, Now Honover and Pender Counties
1480 Harbour Drive - Wilmington, NC 28401 • (910) 395-4553 • (800) 218-6575 • Fmc (910) 395-2684
www.capeteareog.org
An Equal OpportunHy/Affirmailve Action/ADA Emproyer/Program
CAPE FEAR COUNCIL OF GOVERNMENTS
AREA AGENCY ON AGING
GRANT AGREEMENT FOR
FAMILY CAREGIVER SUPPORT GRANTS
July 1, 2013 - Jane 30, 2014
I. PARTIES TO THE CGNTRACT
This agreement is made and entered into this 2°d day of August between the Cape Fear Council
of Gov+ernmens (1480 Harbour Drim, islmington, NC28401), hereinafter referred to as the
"Council of Governments," and New Hanover County Senior Resource Center (2222 South!
College Rd, l Hminglon, NC 28403), hereinafter referred to as the "'Grantee."
EFFECTIVE PERIOD OF CONTRACT
This contract shall be effective July 1, 2013 and shall temiinate on June 30, 201A.
M. GENERAL, PROVISION'S
Subject to the terms and conditions hereinafter set forth, the Council of Governments agrees to grant
Family Caregiver Support Program fiords 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 M, 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 8t Support Groups
Category 4 Respite Care, or Category 5 Supplemental Services. The olr ective is to give caregivers
relief and provide assistance in finding services allowing them to keep their 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 recoming
any other assistance.
categoly
semcm
I Grant
Unit Cost
I Praj
Projected
(2, 3, 4
To be
Amount
If applicable
NWnber of UW&
8 o be
or 5)
provided
If Applicable
3 (833)
Support Groups
$1,500
N/A
n/a
n/a
4 (842)
In- home/non- medical
$14,000
$17.OD
824
22
Respite varies
4 (843)
Adult Day Care
$5,200
$50 /day
104
3
Day Health
S (857)
Incontinence Supplies
$1800
5 (859)
Liquid Nutritional
$ Soo
Supplemental
$23,000
Note; The Cape Fear Council of Governments Area Agency on Aging must approve any changes to the
budget.
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 $1504 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 caringfor an older adult 60+ with at least two ADL (Activities ofDwly
Living i.e. eating, dressing, bathing) impairments or individuals with Alzheimer's disease and related
disorders with neurolo 'cal and or anic brain &sfunction No more than $1500.00 may be used per
eligihle client during grant period
The grantee has allocated $5,200 for Adult Day Care/Day Health and $14,400 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
careinursing facility. Referral for these services will be made after assessments (including reviewing
current services that are being provided to care recipient by cornplefft a comprehensive intake form) are
completed and an appropriate care plan has been developed by the Grm tec.
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
dian $500. 00 may be used per eligr7rle clam during grant period
The Grantee has allocated $1800 to help with Incontinence Supplies (857) and $500 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 Some and CommuW& Care Block Gram
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
agreementfor payment are contingent upon ilxty offunding.
2
IV. GRANT AMOUNT
The tots payment under this contract shall not exceed $23,000. 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.
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 Ameriems with
Disabilities Act of 1910, and the Department of Health and Hmnan 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 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/ ton of funding. Grantees are
required to participate in the ARMS user's fee�T. e 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:
# of records reimbursement is _ X $.15 Maintenance cost per service record -
Requested for each service
The Service Code Cart for the Family Caregiver Support Program Is as follows:
Non -Unit Services Code
Informatio Asslstance
822
Care Mann ent
823
Support Groups
833
Training/Education
835
In -home Respite Care
842
Community Respite Adult DaY Care
843
Institutional Respite
846
Medical Equipment and As6i5tive Technology
B54
Home Modlflcatlon Accesslbll (grab bars etc
855
Personal Emergency Response Systems
855
Incontinence Supplies
857
V uid nutritional supplements ensure boost
859
The whole service code chart for the Aging Resource Management System (ARMS) is available
on -line at h :Nwww.dhhs. state .nc.usjaoinglarmslsvcode.pdf
• Compensation: Grantees must meet the reporting requirements of the NC Division of
3
Payment of funds will be based upon the Aging Resource I Sy (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.
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.
4
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 amounts) 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.
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 Crrantee 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
12/31/2004) 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 fiords that may be part of an audit exception.
5
R Xesentatives 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 corrects 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 W +& VIII OF CIVIL RIGH'T'S ACT, SECTION 504
OF THE REIIABI:LITATION ACT, AND AMERICANS WffH DISABILITIES ACT
The Grantee shall comply with Title VI and VIII of the Civil Rights Act of 1954, 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.
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.
n WO � 111 M CM V 110
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.
r +�t I A
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 willfW act of ornission of the, Grantee, his agents,
employees, and subcontractors.
C
The Crrantee, 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.
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 germination 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 Govemments, become its property.
The Grantee shall be entitled to receive just and equitable compensation for any work
satisfactorily performed under this Agreement
f 514 161
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 Governaients. 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.
If grantee has tax exempt status they must submit a copy of the tax exempt declaration letter with
contract.
7
HAVE ■ I H DATE =WRffTTEN
Executive Director
M- I 1. =- 11 "7 M I i
N
This instrument has been preaudited in the manner required by the Local government
budget and fiscal control act.
9
Officer or Date
GRANTEE:
Name Organintion
2WRzed Lead Agency Official
S
Attachment A
CONFLICT OF INTEREST POLICY
In accordance with G.S. 143 -6.1 and related legislation, we, the undersigned entity, have
adopted the following policy regarding conflicts of interest:
The undersigned entity is aware that in the process of fund allocation by its
management, employees, members of the board of directors or other governing
body, instances may arise which have the appearance of a conflict of interest or
appearance of impropriety.
in order to avoid conflicts of interest or the appearance of impropriety, should
instances arise where a conflict may be perceived, any individual who may
benefit, directly or indirectly, from the entity's disbursement of funds shall abstain
from participating in any decisions or deliberation by the entity regarding the
disbursement of funds.
The undersigned entity recognizes the possibility that it may be the recipient of
funds which are allocated consistent with the purpose and goals of its programs.
If such allocations are made, the undersigned entity will strive to ensure that funds
are expended in such a manner that no individual will benefit; directly or
indirectly, from the expenditure of such funds in a mamw inconsistent with its
WW2X1-M
_ New Hanover Connty — Senior Resource Center
Name of Agency
Executive Director, or
other Authorized Official
Sworn to and subscribed before me,
This the �13;" day of .
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A M11A d4 t 14 ' kg�k
Notary Pd6lic
My Commission expires • $ MA`�
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