FY16 SRC UNITED WAY HOST AGENCY AGREEMENTI am submitting to you (hard copy) original of the United Way of the Cape Fear
Area Senior Service America, (SSAI), Senior Community Service Employment
Program (Title V of the Older Americans Act) Host Agency Agreement from Phillip
Hedgepeth, Director, SCSEP Director.
This Host Agency Agreement covers July 1, 2015 through June 30, 2015 and
supports Mary Hollis & Steve Moore who provide part-time SRC switchboari
coverage through the CFAUW/SCSEP program at no cost to the County.
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This Agreement is in effect from July 1, 2015 - June 30, 2016
Signed — Host Agency
Host Agency: IV F1 C .5 )e
Representative's Name: qVRiL Pj- 1,J
Representative's Signature
Host Agency Title:
Host Agency Supervisor: e
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Date:
SCSEP Sponsor: United Way of the Cape Fear Area SCSEP
Representative's Name: Phillip Hedge
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Representative's Signatu
Title: SCSEP Director
Address- 5919 Oleander Drive Suite 115, Wilmington,.,.N,C,-28403
Email: Vhillip•hedgepethq@uwcfa.or Date:
Definition of Host Agency Status
(Check one)
a--�This host agency is a government agency
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FEIN (Required by USDOL).
❑ This host agency is a certified non-proflt agency under Section 501(c) (3) of the United
States Internal Revenue Code. FEIN (Required by USDOL).
501(c) (3) documentation is attached.
501(c) (3) documentation is already on file with the sponsor.
Host Agency Agreement — revised May 4, 2015 Page 3
To comply with the requirements of the Senior Service America, Inc. (SSAI), Senior
Community Service Employment Program (SCSEP), operated under Title V of the Older
Americans Act, this Agreement is voluntarily entered into by
hereinafter referred to as the Host Agency, and UNITED WAY QF THE CAPE FEAR AREA,
hereinafter referred to as the Sponsor Agency.
The Host Agency agrees to provide a safe and healthful work site for each participant, to
provide the orientation and training necessary to perform assigned duties in accordance
with a written community service assignment description, to provide additional training as
opportunities occur, and, to the extent possible, treat each participant as a regular member
of the Host Agency staff.
The Host Agency agrees to consider each participant for regular employment, either full-
time or part-time, when vacancies occur in the Host Agency staff or when new positions are
created. The Host Agency will also recommend suitable training for unsubsidized
placement of the participant. A detailed training plan, which includes skills to be attained
and timelines for achieving the goal, will be documented in the participant's Individual
Employment Plan (IEP) and Community Service Assignment Description. The Community
Service Assignment Description must specify the nature of the assignment, the hours each
participant will train, specific duties and tasks to be performed.
The Host Agency understands that the length of time that a participant may remain in the
same assignment will be determined in their IEP. The Host Agency understands that the
Sponsor Agency may reassign any participant when that reassignment will increase the
participant's opportunities for training or unsubsidized employment, or will otherwise
serve the best interests of the participant.
While this agreement is in effect, the Host Agency agrees to not provide community service
assignments for participants serving through another national Title V project sponsor.
The Host Agency agrees to abide by the hours and work schedules mutually agreed to for
each participant and to provide: properly prepared time sheets ( the supervisor will
confirm that the participant worked the hours claimed on their time sheet, and will assure
that both they and the participant sign the time sheet); periodic performance evaluations;
and other required documents. The Host Agency agrees and understands that each
Host Agency Agreement — revised May 4, 201 5 Page 1
participant will be required to attend periodic SCSEP meetings during regular working
hours.
The Host Agency agrees that the community service assignments for any participant are to
be similar to "in demand" or "growth industries" private sector jobs, such as health care;
child day care; education; or green jobs. However, these assignments will not result in the
displacement of currently employed workers; or in a reduction in non - overtime hours of
work, wages, or benefits; will not impair any existing contract for service or result in the
substitution of the wages of the participant for other funds in connection with work which
otherwise would be performed; will not be a substitution for any existing federally- assisted
job; and will not be a position which is the same as or substantially the same as that
occupied by any other person who is on lay -off or absent due to labor disputes. Further,
the Host Agency agrees that it will not discriminate against a participant on the grounds of
race, color, age, religion, sex, national origin, age, or disability.
The Host Agency agrees to send a representative to a Host Agency supervisors' meeting.
Host Agency supervisors' meetings will be held annually to acquaint all concerned with the
SCSEP goals and objectives. The Host Agency agrees to participate in the DOL Customer
Satisfaction Survey if solicited.
The Host Agency agrees to provide documentation of in -kind contributions. Further, it is
understood by the Host Agency and the Sponsor Agency that any contribution, whether
cash or in -kind, by the Host Agency is purely voluntary and is not a condition for the
assignment of any participant.
The Host Agency certifies by this Agreement that it is a governmental agency or is a non-
profit agency which is currently certified as a Section 501(c) (3) organization under the
Internal Revenue Code. In addition, the Host Agency will provide its Federal Employer
Identification Number (FEIN). Further, if the Host Agency is certified as a Section 501(c)
(3) agency, a copy of that certification is attached or is on file with the Sponsor Agency and
is still in effect. The Host Agency agrees to inform the Sponsor Agency immediately if the
Section 501(c) (3) certification is revoked.
The Sponsor Agency agrees to recruit, enroll, and assign a participant to the Host Agency
for the purpose of engaging in productive community service employment.
The Sponsor Agency agrees to be responsible for all administrative and fiscal controls of
the SCSEP and for paying wages and providing fringe benefits to each participant. The Host
Agency does not provide Workers' Compensation insurance for participants; the Sponsor
Agency will provide Workers' Compensation insurance for SCSEP Participants.
This Agreement may not be amended except upon written agreement between the parties.
Host Agency Agreement — revised May 4, 2015 Page 2