FY15 TITLE III-D HLTH PROMOTION DISEASE PREVENTIONDATE: December 1 7, 2014
t) EC I
TO Teresa Hewett, Grants and Project Analyst, New Hanover County
FROM: Ginny Brinson, Aging Program Specialist,b
SUBJECT: Title 111-1) Health Promotion/Disease Prevention Contract FY 14115
Per your request, enclosed is the fully-executed Evidence Based Health Promotion Contract for
FY 14/15. A copy has been provided to Ben Brow at New Hanover County Senior Resource
Center.
If you have any questions, please give me a call.
Thank You
Enclosure
cc: Jane Jones
Serving Brunswick, Columbus, New Hanover and Fender Counties
1480 Harbour Drive - Wilmingfon, NC 28401 - (910) 395-4553 - (800) 218 6575 - Fax: (910) 395-2684
www.copetearcog.org
An Equal OpportunItyJAffirmotIve ActionfADA Employer /Program
ORIGINAL CONTRACT SF1411 S
CAPE FEAR COUNCIL OF GOVERNMENTS
GRANT AGREEMENT FOR
TITLE III -D HEALTH PROMOTION/DISEASE PREVENTION
EVIDENCE BASED HEALTH PROMOTION
I. PARTIES TO THE CONTRACT
This agreement is made and entered into this 12th day of November, 2014 between the Cape
Fear Council of Governments, hereinafter referred to as the "Council of Governments," and
New Hanover Senior Resource Center, hereinafter referred to as the "Grantee."
II. EFFECTIVE PERIOD OF CONTRACT
This contract shall be effective July 1, 2014 and shall terminate on June 30, 2015.
Ill. GENERAL PROVISIONS
Subject to the terms and conditions hereinafter set forth, the Council of Governments agrees to
grant Title III -D Health Promotion/Disease Prevention funds per the NC Division of Aging and
Adult Services intrastate funding formula to the Grantee for the purpose of providing Evidence
Based Health Promotion activities for senior adults described herein and in accordance with the
NC Division of Aging and Adult Services Title III -D Aging Service Standards as well as Title
III -D Health Promotion and Disease Prevention Revisions: Administrative Letter No. DAAS -12-
05, dated April 24, 2012, and Administrative Letter No. DAAS- 14 -05, dated June 1, 2014, both
of which are attached. 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 S2,000.00 for disease prevention and
health promotion. The Grantee is accountable for insuring the local cash matching
requirement for 222.00 is provided
V. DOCUMENTATION OF EXPENSES
The Grantee shall maintain full and complete documentation of all expenses associated with
performing Title III -D activities. Documentation in the form of paid invoices and canceled
checks shall be submitted to the Council of Governments at the time of the reimbursement
request. Grantee shall maintain all financial and program records for a period of three (3) years
from the date of final payment under this agreement.
VI. COMPENSATION AND PAYMENTS TO GRANTEE
The Grantee shall be compensated for the services and /or activities actually performed under this
contract by a line item accounting showing how these grant funds were expended. Payments will
be made monthly upon request for reimbursement by Grantee. Reimbursement requests, along
with paid invoices, must be submitted to the Council of Governments no later than the fifth
working day of the month in order to be considered for payment at the end of that month. Final
invoices must be at the Council of'Governments offices no later than 5 p.m. on June 30, 2015.
Any invoices received after that time ivill not be considered for payment.
Payment of funds will be based upon the Aging Resources Management System (ARMS)
Provider Reimbursement Report (LGA370 -7). The Council of Governments will forward
payment of the approved budget expenditure at the end of each month.
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 oil-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 may decrease the total compensation to be paid hereunder in order to reallocate funds to
other Grantees.
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 have an annual independent audit in accordance with North Carolina
General Statutes, North Carolina Local Government Commission requirements, Division of
Aging and Adult Services Program Audit Guide for Aging Services and Federal Office of
Budget and Management (OMB) Circular A -133.
Community service providers must provide a copy of their year end financial statements,
and any required audit, the Area Agency on Aging. Community service providers, as
specified in paragraph one (1) are subject to audit and fiscal reporting requirements as
stated in NC General Statute 143 -6.2 and OMB Circular a -133, where applicable. Home
and Community Care Block Grant providers are not required to submit Activities and
Accomplishments Reports. For - profit corporations are not subject to the requirements of
OMB Circular A -133, but are subject to NC General Statute 143 -6.2 and Yellow Book
audit requirements, where applicable. Federal funds may not be used to pay for a Single
or Yellow Book audit unless it a federal requirement. State funds will not be used to
pay for a Single or Yellow Book audit if the provider receives less than $500,000 in state
funds. The Department of Health and Human Services will provide confirmation of
federal and state expenditures at the close of the state fiscal year. Information on audit
and fiscal reporting requirements can be found at http:// www .ncauditor.net /non-orofitsite.
The following provides a summary of reporting requirements under NCGS 143 -6.2 and OMB
Circular A -133 based upon funding received and expended during the service provider's fiscal
year.
2
Annual Expenditures Report Required to AAA Allowable Cost for Reporting
• Less than $25,000 in Certification form and State N/A
State or Federal funds Grants Compliance Re-
porting <$25,000 (item # 11,
Activities and Accomplishments
does not have to be completed)
OR
Audited Financial Statements in
compliance with GAO /GAS (i.e.
Yellow Book)
Greater than $25,000
and less that $500,000
in State or Federal Funds
• $500,00+ in State funds
but
and Federal pass through
in an amount less than
$500,00
• $500,000+ in State funds
Federal
Certification form and Schedule of
Grantee Receipts >$25,000 and
Schedule of Receipts and Expendi-
tures
OR
Audited Financial Statements in
compliance with GAO /GAS (i.e.
Yellow Book)
Audited Financial Statement in
compliance with GAO /GAS (i.e.
Yellow Book)
Audited Financial Statement in
and $500,000+ in Federal compliance with OMB Circular
pass through funds (i.e. A -133 (i.e. Single Audit)
at least $1,000,000)
Less than $500,000 in State Audited Financial Statement in
funds,
funds and $500,000+ in compliance with OMB Circular
Federal pass through funds A -133 (i.e. Single Audit)
N/A
May use State funds,
not Federal Funds
May use State and
funds
May use Federal
but not State funds.
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 and Adult Services 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.
It is further understood that the community service providers are responsible to the Area Agency
for clarifying any audit exceptions that may arise from any Area Agency assessment, county or
community service provider single or financial audit, or audits conducted by the State or Federal
Governments. In the event that the Area Agency or the Department of Health and Human
Services disallows any expenditure made by the community service provider for any reason, the
Grantee shall promptly repay such funds to the Area Agency once any final appeal is exhausted
in accordance with paragraph nine (9). The only exceptions are if the Area Agency on Aging is
designated as a community service provider through the County Funding Plan or, if as a part of a
procurement process, the Area Agency on Aging enters into a contractual agreement for service
provision with a provider which is in addition to the required County Funding Plan formats. In
these exceptions, the Area Agency is responsible for any disallowed costs. The Grantee or Area
Agency on Aging can recoup any required payback from the community service provider in the
event that payback is due to a community service provider's failure to meet OMB Circular A -122
requirements, requirements of A -110, requirements of 45CFR, Part 1321, and 45CFR, Part 92, or
state eligibility requirements as specified in policy.
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. Grantee agrees to submit to the Council of Governments,
Area Agency on Aging, each quarter, a list of those EBHP required programs that have
been provided and what outreach activities (for example: media efforts) have been
expended in order to increase capacity to serve the county with EBHP.
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.
XI. CONFLICT OF INTEREST
The Grantee expressly states that he presently has not 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.
XII. 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.
XIII. INDEMNITY
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.
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.
IN WITNESS THEREOF, THE COUNCIL OF GOVERNMENTS AND THE GRANTEE
HAVE EXECUTED THIS AGREEMENT AS OF THE DATE FIRST WRITTEN
ABOVE.
CAP l`, i" EAR Co tT NCIL ii 'iy :
Executive Director
Area Ancy on Aging/Administrator
THIS INSTRUMENT HAS BEEN PREAUDITED IN THE
MANNER REQUIRED BY THE LOCAL GOVERNMENT
BUDGET AND FISCAL CONTROL ACT.
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Name of Organization
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Authorized Official Date
(County or Organization Providing Matching Funds)
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North Carolina Department of Health and Human Services
Division of Aging and Adult Services
Pat McCrory
Governor
June 1, 2014
Administrative Letter No. DAAS -14 -05
To: Area Agencies on Aging Administrators
From: Suzanne Merrill, Acting Division Director
NC Division of Aging and Adult Services
Subject: North Carolina Title IIID Health Promotion and Disease Prevention Standards Revision
Date: June I, 2014
Aldona Z. Wos, M.D.
Ambassador (Ret.)
Secretary DHHS
Suzanne P. Merrill
Acting Division Director
The Division of Aging and Adult Services (DAAS), in collaboration with the Area Agencies on Aging, updated the North Carolina
Division of Aging and Adult Services Health Promotion and Disease Prevention Standards. The revised Standards are based on the
Older Americans Act (OAA) Title III Part D (Title IIID) and reflect the federal changes implemented during the 2013 Fiscal Year
(FY) and updated language and definitions of the 2006 Reauthorization of the OAA. The Standards are effective immediately and also
provide guidance on interpreting the definitions and provide best practices for utilization of funds.
Revisions were made in all sections of the Title IIID Standards, with significant additions to the "Service Provision" section.
The following information addresses the specific revisions made to each section.
Format and Cover Page
In the Table of Contents, section heading names were changed to be consistent with other DAAS Standards and all
Appendices were removed.
I. Statement of Philosophy and Purpose
• The language in this entire section was changed to provide a general overview of Title IIID programs and chronic disease
statistics.
II. Legal Base
• Changes were made in this section to be consistent with revisions made to the Older Americans Act in 2006. The following
items that related to Health Promotion and Disease Prevention were changed: Section 303(d); Section 321(a); and Part D,
361.
o Mental health language was added to the 2006 revision of the OAA and is reflected in Section 321(a), items 1, 8,
and 23.
III. Definition of Health Promotion and Disease Prevention Services
• Title III Part D of the OAA Section 102(a) (14) now specifies that health promotion and disease prevention programs must be
evidence - based. Language was changed to be consistent with the OAA. More information regarding evidence -based health
promotion and disease prevention programs is found in the "Service Provision" section of the Standards.
www.nedhbs.gov • uww.ncdhhs.gov /aging
Tel 919- 855 -3400 • Fax 919- 733 -0443
Location: Taylor Hall, 693 Palmer Drive • Raleigh, NC 27603
Mailing Address: 2101 Mail Service Center • Raleigh, NC 27699 -2101
�" An Equal Opportunity / Affirmative Action Employer
IV. Client Eligibility
• No significant changes were made to client eligibility.
V. Service Provision
• Information related to the evidence -based requirement for health promotion and disease prevention programs was added to
this section. The new language derives from the Administration of Community Living (ACL) website
(http: / /www.aoa.2ov /AoARoot /AoA Programs /HPW /Title IIID). Examples of the three levels of programs were posted on
ACL's website at one point, but now only provide information on some of the highest -tier criteria programs by linking to a
cost chart on the National Council on Aging's (NCOA) website (littt)://www.ncoa.orglimprove- health /center- for- liealthy-
agina /content- ]ibrary/Title -IIID- Highest- Tier - Evidence- FINAL.pdf). States have been given the authority to determine if
programs meet evidence -based criteria and at what level.
• The examples of evidence -based health promotion and disease prevention programs listed in the Standards are subject to
change. Over time, programs may move from a lower criteria to a higher criteria as more evaluation is conducted.
Additionally, programs may be added to the list as interest in North Carolina grows and evaluation data is compiled.
• Language was added to clarify the leveraging role Title IIID funds may have in addition to solely supporting program
implementation. These include interventions and services that may be offered in a location such as a health fair.
• Based on guidance from the Administration of Community Living, language was added that food is not allowed with Title
IIID funds.
• Practice guidelines were added to this section to help guide administrators in utilizing Title IIID funds. These include
information on partnerships, business plans, and using other sources of funding (such as Title IIIB).
• Examples of prohibited activities at health fairs and in general were added to this section.
VI. Staffing Requirements and Training
• Because evidence -based health promotion and disease prevention programs require trained leaders, language was changed in
this section to reflect that requirement.
• An example of using an appropriately eredentialed/trained professional to provide a service was added.
• Practice guidelines were added to this section based on best - practices learned by offering evidence -based health promotion
and disease prevention programs in North Carolina. These include: support and establishing relationships with staff
(leaders); and ensuring fidelity of programs.
VII. Documentation and Reporting
• The heading for this section was changed to be consistent with other program Standards at DAAS.
• Language was added under Part A, "Documentation" to provide examples of supportive documents that would be appropriate
for health promotion and disease prevention activities.
• A link to the DAAS Home and Community Block Grant Procedure Manual was added under Part B, "Voluntary
Contributions." Additionally, a paragraph was added provide some guidelines for documenting, depositing, and reporting
contributions.
• In Part C, "Reporting," language was added to requesting the submission of evidence -based program data to collecting
agencies on a quarterly basis.
Service Code 401 must be used to report Title IIID activities in the DAAS Aging Resources Management System (ARMS).
Please contact Nicolle Miller, nicolle.ip,illcr,c dhlls.n , or Audrey Edmisten, audrey.edniistenL(i�dlnlns,.Li goy with any questions or
concerns regarding the Health Promotion and Disease Prevention Standards and practice guidelines.
North Carolina Department of Health and Human Services
Division of Aging and Adult Services
2l0] Mail 3eriue Center -Dueig\ North Carolina 17699-2}0U
Tel 9l9733-3983^ Fax No. 9l9733-V443
Beverly Eaves Perdue, Governor Dennis W. Streets, Director
Albert A. Delia, Acting Secretary 919-855-3400
April 24.2O12
Administrative Letter No. DAAS-13-05
To: Area Agencies onAging Administrators
.1
From: Dennis Streets, Division Director
NC Division ofAging and Adult Services
Subject: Title lU|-D Health Promotion and Disease Prevention Revision
Date: April 24.2O12
Effective July 1°2812, Title III Part D Section 361 of the Older Americans Act, which pertains to
Disease Prevention and Health Promotion, may only beused for programs and activities that
have been demonstrated through rigorous evaluation tobe evidence-based and effective.
Evidence-based disease prevention and health promotion programs have become an aging network
priority within North Carolina for several years, and the new requirement demonstrates a national
commitment tn these types ofprograms. [n February 2O12. Congressional appropriations mandated that
Older Americans Act Title III-D funding for Fiscal Year 2012 be used pnly for programs and activities that
have been demonstrated tobeevidemce-based. The U.S. Administration on Aging (AoA) uses
graduated criteria known as "tiern^todefine evidence-based interventions. Health promotion programs
can fall within any of the tiers. Based on the history of the Title |||-D program, and the degree ofchange
needed - transition implementation, e
asseo�dbased on the following criteria. While the ooa is for all Title }[|-D activities tn move toward the
highest level criteria, programs meeting the minimal or intermediate criteria will satisfy current
requirements.
The three tiers include:
?' Minimal Criteria
*
Demonstrated through evaluation to be effective for improving the health and well-being or
reducing disease, disability and/or injury anmomgo|deradO|bs;,48/D
m
Are ready for translation, implementation and/or broad dissemination bycommunity-based
organizations using appropriately credentialed practitioners.
L*cadou6y3PalmerDrive,KaleigbyJC276O3~StateCmurier No. 56-20-02
An Equal Opportunity /Affioomtivc Action Employer
Examples include: programs related to the prevention and mitigation of the effects of chronic disease (including
osteoporosis, hypertension, obesity, diabetes, and cardiovascular disease), alcohol and substance abuse
reduction, smoking cessation, weight loss and control, stress management, falls prevention, physical activity and
improved nutrition; most health screenings would also qualify at this level. Note: Not all programs of the types listed
above meet the minimal criteria for Title IIID evidence-based services. Contact DAAS if you have questions. Title
HID funding is not appropriate for purchasing pill boxes, night lights, line dancing, exercise videos, or Health Fairs,
but it is appropriate for Health Screening if it meets the minimal criteria provided. NC Senior Games meets this
criterion. If used for to support Senior Games' events, it must be used to support the events themselves (e.g.,
equipment); it should not be used for tee shirts, food, or other such items.
2. Intermediate Criteria
• Published in a peer-review journal; AND
• Proven effective with the older adult population, using some form of a control condition (e.g. pre-
post study, case control design, etc.); AND
• Some basis in translation for implementation by community level organization.
An example includes: Eat Better Move More
3. Highest-level Criteria
• Undergone experimental or quasi - experimental design; AND
• Level at which full translation has occurred in a community site; AND
• Level at which dissemination products have been developed and are available to the public.
Examples include, but not limited to:
• A Matter of Balance;
• Chronic Disease Self-Management Program
(CDSMP/Living Healthy);
• Diabetes Self-Management Program
(DSMP/Living Healthy with Diabetes);
• Tomando Control de su Salud (Spanish
Chronic Disease Self-Management
Program);
• Healthy IDEAS (identifying Depression,
Empowering Activities for Seniors);
• Fit and Strong!;
• Walk with Ease;
• Arthritis Foundation Life Programs (Exercise
Tai Chi, Aquatics Programs)
• Healthy Moves for Aging Well;
• Medication Management Improvement
System;
• Prevention and Management of Alcohol
Problems in Older Adults;
• Program to Encourage Active, Rewarding
Lives for Seniors (PEARLS);
• Active Living Every Day;
• Healthy Eating for Successful Living among
Older Adults,
• Stepping On;
• Enhance Fitness;
• Strong for Life;
• Tai Chi: Moving for Better Balance;
• Active Choices;
• Enhanced Wellness;
• Positive Self-Management Program for HIV;
• Arthritis Self-Management (Self-Help) Program;
• Chronic Pain Self-Management Program;
• Online Chronic Disease Self-Management
Program;
• Better Choice, Better Health—Diabetes;
• Healthier Living with Arthritis (Internet Arthritis
Self-Management Program;
• Programa de Manejo Personal de la Artrifis
(Spanish Arthritis Self-Management Program);
• Programa de Manejo Personal de la Diabetes
(Spanish Diabetes Self-Management Program).
Further guidance may be found at AoA's website:
http://wv,fw,aoa.gov/AoARooUAoA pro 9Lams/HP\AC/Fi1te IIQ/ x.a .
indgspx
_L_ _
Title lll-D funds may be used to support Area Agency on Aging (AAA) staff who coordinate and support
the implementation of evidence-based programs such as CDSMP and A Matter of Balance in their
region.
Location: 693 Palmer Drive, Raleigh, NC 27603 • State Courier No. 56-20-02
An Equal Opportunity / Affirmative Action Employer
Currently hn North Carolina, over 5U%of|||-D funds support AnArecognized programs.
The remaining funding supports Senior Games, exercise program instructors at senior centers, health
fairs and medication management activities. Since July 2O0A. each AAA has been expected hmallocate
at least 23.6Y6of|||^Dfunds for medication management and at least 35% of III-D funds for implementing
evidence-based disease prevention and health promotion programs. This will nu longer ban
requirement. Medication management education programs that are accompanied by appropriately
credentialed practitioners could possibly meet the minimal criteria tier (Medication Management
Information System is the only program that meets the highest level chUeha). With reference to program
instructors at senior centers, only those providing approved evidence-based programming can now be
supported with |||-Qfunding.
Aging service providers cmnuseTitleUUABfumdsinYieuofT0eU{-]fundsforthomeprogramoaod
activities that dn not meet the evidence-based criteria. These Title U|-B funds would fall under "Health
Promotion and Disease Prevention," the provision of allowable services that promote the health and
wellness of eligible older adults. For use of these funds, providers are required hugu through the county
planning process for the Home and Community Care Block Grant and become part of the approved
County Funding Plan.
Effective July 1,2812, please use Service Code 401toreport Title |H-D funding in the Division ofAging
and Adult Services (DAAS) Aging Resources Management System (ARyWS). /AAn and local providers
will be monitored on these new criteria.
For FY2012-13, AAAs are required to submit a proposed Title 1111-11) Plan with designated criteria
tiers to DAAS by May 18, 2012 using the attached repo . The Plan must at least meet the minimal
criteria for DAAS to approve by June 1, 2012. DAAS will use this justification as documentation for AoA
h} demonstrate compliance with the new Title O|-Drequirements. |n following years, proposed AAA
plans will be included in the AAA's annual Area Plan. Please contact Audrey Edrnishen,
gu
A��. edmisten dhhs.nc,aov or 919-855-3418, if you have questions or concerns.
Location: 693 Palmer Ddro Raleigh, NC27603° State Courier No. 56-20-02
An Equal Opportunity /Affiouative Action Employer