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HomeMy WebLinkAboutFY16 SRC Title III-D Health Promotion grant contractORIGINAL CONTRACT SF15116 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 201h day of October, 2015 between the Cape Fear Council of Governments, hereinafter referred to as the "Council of Governments," and New Hanover County Senior Resource Center, hereinafter referred to as the "Grantee." II. EFFECTIVE PERIOD OF CONTRACT This contract shall be effective July 1, 2015 and shall terminate on June 30, 2016. III. 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 $8,793.00 for disease prevention and health promotion. The Grantee is accountable for insuring the local cash matching requirement for $977.00 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, 2016 Any invoices received after that time will not be considered for payment. Payment of funds will be based upon the Aging Resources Management System (ARMS) Provider Reimbursement Report (ZGA370 -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 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 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/nonprofitsite. 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 Certification form and Schedule of and less that $500,000 Grantee Receipts >$25,000 and in State or Federal Funds Schedule of Receipts and Expendi- tures OR • $500,00+ in State funds but and Federal pass through in an amount less than $500,00 $500,000+ in State funds Federal and $500,000+ in Federal pass through funds (i.e. at least $1,000,000) Less than $500,000 in State funds, funds and $500,000+ in Federal pass through funds 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 compliance with OMB Circular A -133 (i.e. Single Audit) Audited Financial Statement in compliance with OMB Circular 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. 4 X111. 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. CAPE FEAR COUNCIL OF GOVERNMENTS: it Executive Director e THIS INSTRUMENT HAS BEEN PREAUDITED IN THE MANNER REQUIRED BY THE LOCAL GOVERNMENT BUDGET A FISCAL OL ACT. Finance Officer Date GRANTEE: Name of Organization By: Aulffir'zed Lead Agency Official By:�� �V Authorized Official (County or Organization Providing Matching Funds) U'--4ck U—Vc-kZ\ ak-er, C'S,%t--Q rinarc%gl Outer 1 1 l _ +1Lr ate Grantee: SSAN and /or Federal Tax ID No. 15�0- kaooj-�)aq- 6 Y a.. North Carolina Department of Health and Human Services Division of Aging and Adult Services 2101 Mail Service Center • Raleigh, North Carolina 27699 -2101 Tel 919 733 -3983 • Fax No. 919 733 -0443 Beverly Eaves Perdue, Governor Dennis W. Streets, Director Albert A. Delia, Acting Secretary 919 -855 -3400 April 24, 2012 Administrative Letter No. DAAS -12 -05 To: Area Agencies on Aging Administrators 11 , From: Dennis Streets, Division Director 1 J2A Q NC Division of Aging and Adult Services Subject: Title III -D Health Promotion and Disease Prevention Revision Date: April 24, 2012 Effective July 1, 2012, Title III Part D Section 361 of the Older Americans Act, which pertains to Disease Prevention and Health Promotion, may only be used for programs and activities that have been demonstrated through rigorous evaluation to be 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 to these types of programs. In February 2012, Congressional appropriations mandated that Older Americans Act Title III -D funding for Fiscal Year 2012 be used only for programs and activities that have been demonstrated to be evidence - based. The U.S. Administration on Aging (AoA) uses graduated criteria known as "tiers" to define evidence -based interventions. Health promotion programs can fall within any of the tiers. Based on the history of the Title III -D program, and the degree of change needed to transition to the optimal level of evidence -based implementation, each program will be assessed based on the following criteria. While the goal is for all Title III -D activities to move toward the highest level criteria, programs meeting the minimal or intermediate criteria will satisfy current requirements. The three tiers include: 1. Minimal Criteria • Demonstrated through evaluation to be effective for improving the health and well -being or reducing disease, disability and /or injury among older adults; AND • Are ready for translation, implementation and /or broad dissemination by community -based organizations using appropriately credentialed practitioners. Location: 693 Palmer Drive, Raleigh, NC 27603 - State Courier No. 56 -20 -02 An Equal Opportunity / Affirmative Action Employer a 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 IIID 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 - reviewjoumal; 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 Artritis (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: //www.aoa.gov /AoARooVAoA Programs /HPW/Title IIID /index.aspx. Title III -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 in North Carolina, over 50% of III -D funds support AoA recognized evidence -based programs. The remaining funding supports Senior Games, exercise program instructors at senior centers, health fairs and medication management activities. Since July 2009, each AAA has been expected to allocate at least 23.6% of III -D funds for medication management and at least 35% of III -D funds for implementing evidence-based disease prevention and health promotion programs. This will no longer be a 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 critieria). With reference to program instructors at senior centers, only those providing approved evidence -based programming can now be supported with III -D funding. Aging service providers can use Title III -B funds in lieu of Title III -D funds for those programs and activities that do not meet the evidence -based criteria. These Title III -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 to go 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, 2012, please use Service Code 401 to report Title III -D funding in the Division of Aging and Adult Services (DAAS) Aging Resources Management System (ARMS). AAAs and local providers will be monitored on these new criteria. For FY2012 -13, AAAs are required to submit a proposed Title III -D Plan with designated criteria tiers to DAAS by May 18. 2012 using the attached report. 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 to demonstrate compliance with the new Title III -D requirements. In following years, proposed AAA plans will be included in the AAA's annual Area Plan. Please contact Audrey Edmisten, audrey.edmistenQdhhs.nc.gov or 919- 855 -3418, if you have questions or concerns. Location: 693 Palmer Drive, Raleigh, NC 27603 • State Courier No. 56 -20 -02 An Equal Opportunity / Affirmative Action Employer FY2012 -13 Title III -D Health Promotion and Disease Prevention Plan Service Code 401: Evidence -based Health Promotion /Disease Prevention Area Agency on Aging (AAA) __ AAA person submitting this Plan Date: 1. EXPLAIN briefly how the AAA will allocate III -D funding in FY2012 -13. Will the AAA keep this funding and /or allocate the funding to local providers? Include which tier or tiers your evidence -based programs meet (e.g., CDSMP = Highest level Criteria, Senior Games = Minimal Criteria). 2. a. BUDGET Federal /State Title III -D Regional Allocation Amount: AAA Salary/Fringe* AAA Staff Travel/Training /Other Expenses ** Evidence -based Program Expenses *''* Other Expenses "** b. BUDGET Justification *Explain what AAA staff will be supporting evidence -based programs and the percentage of time that will be allocated using Title III -D funding. "Explain AAA staff expenses. ** *Explain which programs and how many programs you plan to implement. ** **Explain other expenses (e.g., local provider staff salary; cost of blood pressure monitor machine for senior center) Additional Comments (may attach): DAAS: Approved _____ Not Approved _____ Date Comments: Submit this plan to Audrey Edmisten at DAAS by May 18, 2012. Audrey.edmisten(cbdhhs.nc.gov 1 Pat McCrory Governor North Carolina Department of Health and Human Services Division of Aging and Adult Services 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 1, 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.ncdhhs.gov • www.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 (hgp: / /www.aoa.gov /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 ( http:// www. ncoa.org/improve- health/center- for - healthy- aging/ content- librarry/Title -ITTD- Highest- Tier - Evidence- FINAL.pdfl. 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 HID 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 HID funds. These include information on partnerships, business plans, and using other sources of funding (such as Title HIB). • 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 credentialed/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.miller(@dhhs.nc.gov or Audrey Edmisten, audrey.edmistenaa,dhhs.nc.gov with any questions or concerns regarding the Health Promotion and Disease Prevention Standards and practice guidelines. ORIGINAL CONTRACT SF15 116 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 20th day of October, 2015 between the Cape Fear Council of Governments, hereinafter referred to as the "Council of Governments," and New Hanover County Senior Resource Center, hereinafter referred to as the "Grantee." II. EFFECTIVE PERIOD OF CONTRACT This contract shall be effective July 1, 2015 and shall terminate on June 30, 2016. III. 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 $8,793.00 for disease prevention and health promotion. The Grantee is accountable for insuring the local cash matching requirement for $977.00 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, 2016 Any invoices received after that time will not be considered for payment. Payment of funds will be based upon the Aging Resources Management System (ARMS) Provider Reimbursement Report (ZGA370 -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 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 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/nonprofitsite. 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 Certification form and Schedule of and less that $500,000 Grantee Receipts >$25,000 and in State or Federal Funds Schedule of Receipts and Expendi- tures • $500,00+ in State funds but and Federal pass through in an amount less than $500,00 • $500,000+ in State funds Federal and $500,000+ in Federal pass through funds (i.e. at least $1,000,000) 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 compliance with OMB Circular A -133 (i.e. Single Audit) 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 fsP 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. 4 XIIL 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. CAPE FEAR COUNCIL OF GOVERNMENTS: Executive Director Area Agency on Aging Administrator THIS INSTRUMENT HAS BEEN PREAUDITED IN THE MANNER REQUIRED BY THE LOCAL GOVERNMENT BUDGET AND FISCAL CONTROL ACT. Finance Officer GRANTEE: Name of Organization By: By: A'uV%ried Lead Agency Official Authorized Official (County or Organization Providing Matching Funds) lam i'S m t-V �i nmov-%g1 00Ace r Date Date Date II113/ /-� Grantee: SSAN and /or Federal Tax ID No. 15 0 - �iwo-�) a 4 6 �t` n J J� T North Carolina Department of Health and Human Services Division of Aging and Adult Services 2101 Mail Service Center • Raleigh, North Carolina 27699 -2101 Tel 919 733 -3983 • Fax No. 919 733 -0443 Beverly Eaves Perdue, Governor Dennis W. Streets, Director Albert A. Delia, Acting Secretary 919 - 855 -3400 April 24, 2012 Administrative Letter No. DAAS -12 -05 To: Area Agencies on Aging Administrators From: Dennis Streets, Division Director NC Division of Aging and Adult Services Subject: Title III -D Health Promotion and Disease Prevention Revision Date: April 24, 2012 Effective July 1, 2012, Title III Part D Section 361 of the Older Americans Act, which pertains to Disease Prevention and Health Promotion, may only be used for programs and activities that have been demonstrated through rigorous evaluation to be 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 to these types of programs. In February 2012, Congressional appropriations mandated that Older Americans Act Title III -D funding for Fiscal Year 2012 be used only for programs and activities that have been demonstrated to be evidence - based. The U.S. Administration on Aging (AoA) uses graduated criteria known as "tiers" to define evidence -based interventions. Health promotion programs can fall within any of the tiers. Based on the history of the Title III -D program, and the degree of change needed to transition to the optimal level of evidence -based implementation, each program will be assessed based on the following criteria. While the goal is for all Title III -D activities to move toward the highest level criteria, programs meeting the minimal or intermediate criteria will satisfy current requirements. The three tiers include: 1. Minimal Criteria • Demonstrated through evaluation to be effective for improving the health and well -being or reducing disease, disability and /or injury among older adults; AND • Are ready for translation, implementation and /or broad dissemination by community -based organizations using appropriately credentialed practitioners. Location: 693 Palmer Drive, Raleigh, NC 27603 • State Courier No. 56 -20 -02 An Equal Opportunity / Affirmative Action Employer f 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 111D evidence -based services. Contact DAAS if you have questions. Title 111D 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 Artritis (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: //www.aoa.gov /AoARooVAoA Programs /HPWfritle IIID /index.asox. Title III -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 in North Carolina, over 50% of III -D funds support AoA recognized evidence -based programs. The remaining funding supports Senior Games, exercise program instructors at senior centers, health fairs and medication management activities. Since July 2009, each AAA has been expected to allocate at least 23.6% of III -D funds for medication management and at least 35% of III -D funds for implementing evidence -based disease prevention and health promotion programs. This will no longer be a 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 critieria). With reference to program instructors at senior centers, only those providing approved evidence -based programming can now be supported with III -D funding. Aging service providers can use Title III -B funds in lieu of Title III -D funds for those programs and activities that do not meet the evidence -based criteria. These Title III -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 to go 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, 2012, please use Service Code 401 to report Title III -D funding in the Division of Aging and Adult Services (DAAS) Aging Resources Management System (ARMS). AAAs and local providers will be monitored on these new criteria. For FY2012 -13 AAAs are required to submit a proposed Title III -D Plan with designated criteria tiers to DAAS by May 18, 2012 using the attached report. 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 to demonstrate compliance with the new Title III -D requirements. In following years, proposed AAA plans will be included in the AAA's annual Area Plan. Please contact Audrey Edmisten, audrey.edmistena-dhhs.nc.gov or 919 - 855 -3418, if you have questions or concerns. Location: 693 Palmer Drive, Raleigh, NC 27603 • State Courier No. 56 -20 -02 An Equal Opportunity / Affirmative Action Employer FY2012 -13 Title III -D Health Promotion and Disease Prevention Plan Service Code 401: Evidence -based Health Promotion /Disease Prevention Area Agency on Aging (AAA) __ AAA person submitting this Plan Date: 1. EXPLAIN briefly how the AAA will allocate III -D funding in FY2012 -13. Will the AAA keep this funding and /or allocate the funding to local providers? Include which tier or tiers your evidence -based programs meet (e.g., CDSMP = Highest level Criteria, Senior Games = Minimal Criteria). 2. a. BUDGET Federal /State Title III -D Regional Allocation Amount: AAA Salary/Fringe* AAA Staff Travel/Training /Other Expenses ** Evidence -based Program Expenses * ** $_ _______ Other Expenses * * ** $______________ b. BUDGET Justification *Explain what AAA staff will be supporting evidence -based programs and the percentage of time that will be allocated using Title III -D funding. * *Explain AAA staff expenses. ** *Explain which programs and how many programs you plan to implement. * ** *Explain other expenses (e.g., local provider staff salary; cost of blood pressure monitor machine for senior center) Additional Comments (may attach): DAAS: Approved _____ Not Approved _____ Date Comments: Submit this plan to Audrey Edmisten at DAAS by May 18, 2012. Audrey.edmisten ddhhs.nc._gov �4 51A4 r 1tZ 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 1, 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.ncdhhs.gov • www.ncdhhs.gov /aging Tel 919- 855 -3400 • Fax 919 - 733 -0443 J Location: Taylor Hall, 693 Palmer Drive • Raleigh, NC 27603 q 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 (hqp: / /www.aoa.gov /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 (htto: / /www.ncoa.or /g/i=rove-health/center- for- healthy- aging/ content- library/Title -IIID- Highest- Tier - Evidence- FINAL.pdfl. 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 credentialed/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.miller@dhhs.nc.gov or Audrey Edmisten, audrey.edmistenAdhhs.nc.gov with any questions or concerns regarding the Health Promotion and Disease Prevention Standards and practice guidelines.