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FY19 SRC Title IIID Evidence Based Health Promotion ApplicationCape Fear Area Agency on Aging FY 2019 FUNDING APPLICATION PACKAGE TITLE IIID EVIDENCE BASED HEALTH PROMOTION A Matter of Balance NC Division of Aging and Adult Services Health Promotion Disease Prevention (IIID) Service Standards are located on the website: https: / /files.nc.aov /ncdhhs /documents /filesihealth services standards.pdf FUNDING NARRATIVE EVIDENCE BASED HEALTH PROMOTION (EBHP) Statement of Philosophy and Purpose Title IIID of the Older Americans Act (OAA) was established in 1987. It provides grants for education and activities that support healthy lifestyles and behaviors for those 60 and older. In 2012, Congress mandated that Title IIID funding be used only for programs and activities that have been demonstrated to be evidence - based. Evidence - based Health Programs are those which have been developed, researched, and rigorously tested in order to yield consistent, desired results. They help reduce the need for costly medical interventions and enable older adults to live independently longer. Funding support is provided to states under Health Promotion and Disease Prevention Services (Title IIID), to empower older adults to take control of their health. Through these programs, seniors learn to maintain a healthy lifestyle through increased self - efficiency and self- management behaviors. Classes are provided to older adults in their own communities, in familiar non - clinical settings, such as senior centers, community partners centers (such as the Family Y), and in peer learning groups which provide support, socialization and reinforcement of positive behavior changes. In keeping with the directive to promote and implement Evidence Based Health Promotion (EBHP) Programs in the North Carolina aging network, the following funding will be distributed per the intrastate funding formula to Lead - agencies within Region O. Title IIID standards beginning in SFY 2016/2017 changed to meet the federal requirements that only evidence -based programs meeting the highest tier criteria shall be offered and supported with Title IIID funds. FY 18/19 Evidence Based Health Promotion Allocation County Health Promotion Funds Required County Match Grand Total Brunswick 14,138 1,571 15,709 Columbus 6.795 755 7,550 New Hanover 14,904 1,656 16,560 Pender 5,747 639 6,386 Page 2 of 6 Application Requirements 1. Complete EBHP Proposal Spreadsheet found on page 5. 2. Consumer Contributions Requirement a) Describe how your agency will notify participants and solicit consumer contributions for participants of EBHP. b) Provide a copy of your Agency Policy and Procedures governing the collection of voluntary contributions. The NC DAAS Health Promotion and Disease Prevention Program Standards, (Section VII. B. Records, Reports and Reimbursement, page 8) states: "Voluntary Contributions: In accordance with the requirements of the Older Americans Act, agencies must provide individuals receiving service the opportunity to contribute to the cost of the service. Eligible persons receiving Health Promotion and Disease Prevention services are subject to these requirements. Agencies must establish written policies and procedures governing the collection of voluntary contributions." ➢ Agencies providing EBHP services with Title IIID funding cannot charge participants 60 and older for classes or services. 3. Sign the Standard Assurances — Attachment A 4. Sign the Conflict of Interest Policy (for non - profits only) — Attachment B 5. Reporting — Providers shall submit to the AAA each quarter the number of persons served for each program or activity offered with Title IIID funds. Additionally, Falls Prevention Programs data (such as A Matter of Balance), Living Health Programs data, and Tia Chi for Arthritis data must be reported to the N.C. Center for Health and Wellness at UNC Ashville https: / /ncchw.unca.edu/ Program data may be submitted to the AAA to be forwarded to UNC Ashville. Use of grant funds Title IIID funds cannot be used for: • Indirect costs or administrative salaries • Any program other than highest -tier criteria Title IIID funds can be used to • Support staff salary when they conduct training or attend meetings where they are sharing information about Evidence Based Programs • Any highest -tier program Page 3 of 6 Reimbursement Methodology Agency will submit expense records, including invoices, purchase orders, employee /instructor time records, stipend, travel, etc to the AAA. • Receipts will show allowable expenditures and request for reimbursement for non -unit services. • Service Code 401 must be used to report Title IIID activities in the DAAS Aging Resource Management System (ARMS). Helpful References Administration for Community Living — EBHP background information, frequently asked questions and more: https://www.acl.gov/programs/health-wellness/disease-prevention Federally- approved list of highest tier programs: https://www.ncoa.org/resources/ebpcha Page 4 of 6 EBHP Proposal Spreadsheet Name of Program, Event or Projected Number of Instructor/ Method for Method for Purpose of Budget Line Items Activity You Plan to Activities /Classes/ Credentialed Recruiting Tracking Funds for Attend /Conduct Seniors Served Practitioner, Participants Attendance Activity if known One class per wk. x 8 Mary Flyer, SRC Sign in Instructor $2,880 Instructor fees A Matter of Balance weeks. 4 full sessions Konicki, newsletter, social sheet and fees, will be completed. 12- Tina Woods media, NHC servtracker healthy $260 Healthy 15 seniors per session Annette communications, snacks, snacks Crumpton, newspaper supplies $120 Gayla (printing supplies MacMillan 5 classes per week at Annette Flyer, SRC Sign in Instructor $10560 Instructor fees Geri -Fit the SRC and 2 at the Y- Crumpton, newsletter, social sheet and fees, license Express. Total of 264 Gayla media, NHC servtracker renewal, $590 Supplies /replace classes covered by MacMillan, communications, equipment -ment EBHP (11 workshops) Shantel newspaper replacement equipment *3rd location after Davis, Mary i ays, ,supplies (printing $450 License 1/1/19 Two classes a week/ 40 Gayla Flyer, SRC Sign in Instructor $1600 Instructor fees Tai Chi for Arthritis classes (2 sessions). 10- MacMillan newsletter, social sheet and fees 18 seniors per session. media, NHC servtracker $100 supplies communications, newspaper Page 5 of 6 Iz w O a Attachment B For Non - Profits ONLY CONFLICT OF INTEREST POLICY In accordance with G.S. 143 -6.1 and related legislation, we, the undersigned entity, have adopted the following policy regarding conflicts of interest: The undersigned entity is aware that in the process of fund allocation by its management, employees, members of the board of directors or other governing body, instances may arise which have the appearance of a conflict of interest or appearance of impropriety. In order to avoid conflicts of interest or the appearance of impropriety, should instances arise where a conflict may be perceived, any individual who may benefit, directly or indirectly, from the entity's disbursement of funds shall abstain from participating in any decisions or deliberation by the entity regarding the disbursement of funds. The undersigned entity recognizes the possibility that it may be the recipient of funds which are allocated consistent with the purpose and goals of its programs. If such allocations are made, the undersigned entity will strive to ensure that funds are expended in such a manner that no individual will benefit, directly or indirectly, from the expenditure of such funds in a manner inconsistent with its programs. New Hanover County Senior Resource Center Name of Agency Avril M. Pinder, Deputy County Manager Sworn to and subscribed before me, This the _day of -r �. Notary Public n My Commission expires: Dahria Kianpour Notary Public New Hanover Count , NC My Commission Expires Is DAAS -734 (revised 2/16) Attachment A July 1, 2018 through June 30, 2019 Home and Community Care Block Grant for Older Adults Community Service Provider Standard Assurances NHC Senior Resource Center agrees to provide services through the Home and Community Care Block Grant, as specified on the Provider Services Summary (DAAS -732) in accordance with the following: Services shall be provided in accordance with requirements set forth in: a) The County Funding Plan; b) The Division of Aging and Adult Services Home and Community Care Block Grant Procedures Manual for Community Service Providers; and c) The Division of Aging and Adult Services Standards Manual, Volumes I through IV or at htti): / /www.ncdhhs.gov /aging /monitor /mpolicy.htm . Community service providers shall monitor any subcontracts with providers of Block Grant services and take appropriate measures to ensure that services are provided in accordance with the aforementioned documents. Priority shall be given to providing services to those older persons with the greatest economic or social needs. The service needs of low- income minority elderly will be addressed in the manner specified on the Methodology to Address Service Needs of Low- Income (Including Low Income Minority Elderly), Rural Elderly and Elderly with Limited English Proficiency format, (DAAS -733). The following service authorization activities will be carried out in conjunction with all services provided through the Block Grant: Eligibility determination; Client intake/registration; Client assessment/reassessments and quarterly visits, as appropriate; Determining the amount of services to be received by the client; and Reviewing consumer contributions policies with eligible clients. All licenses, permits, bonds, and insurance necessary for carrying out Block Grant DAAS -734 (revised 2/16) Services will be maintained by the community service provider and any contracted providers. 5. As specified in 45 CFR 75, Subpart D -Post Federal Award Requirements, Procurement Standards, community service providers shall have procedures for settling all contractual and administrative issues arising out of procurement of services through the Block Grant. Community service providers shall have procedures governing the evaluation of bids for services and procedures through which bidders and contracted providers may appeal or dispute a decision made by the community service provider. 6. Applicant/Client appeals shall be addressed as specified in Section 7 of the Division of Aging and Adult Services Home and Community Care Block Grant Manual for Community Service Providers, dated February 17, 1997. 7. Community service providers are responsible for providing or arranging for the provision of required local match, as specified on the Provider Services Summary, (DAAS -732). Local match shall be expended simultaneously with Block Grant funding. 8. Community service providers agree to comply with audit and fiscal reporting requirements as specified in the Agreement for the Provision of County -Based Aging Services (DAAS -735). 9. Compliance with Equal Employment Opportunity and Americans with Disabilities Act requirements, as specified in paragraph fourteen (14) of the Agreement for the Provision of County -Based Aging Services (DAAS -735) shall be maintained. 10. Providers of In -Home Aide, Home Health, Housing and Home Improvement, and Adult Day Care or Adult Day Health Care shall sign and return the attached assurance to the area agency on aging indicating that recipients of these services have been informed of their client rights, as required in Section 314 of the 2006 Amendments to the Older Americans Act. 11. Subcontracting — All HCCBG community service providers must assure that subcontractors (for -profit and non -profit entities only) meet the following requirements: a. The subcontractor has not been suspended or debarred. (N.C.G.S. 6143C -6 -23, 09 NCAC 03M) b. The subcontractor has not been barred from doing business at the federal level. c. The subcontractor is able to produce a notarized "State Grant Certification of No Overdue Tax Debts." DAAS -734 (revised 2/16) d. All licenses, permits, bonds and insurance necessary for carrying out Home and Community Care Block Grant services will be maintained by both the community service provider and any subcontractors. e. The subcontractor is registered as a charitable, tax - exempt (5010) organization with the Internal Revenue Service (non -profit subcontractors only). 12. Confidentiality and Securi ty. Per the requirements in l0A NCAC 05J and Section 6 of the Home and Community Care Block Grant Procedures Manual, client information in any format and whether recorded or not shall be kept confidential and not disclosed in a form that identifies the person without the informed consent of the person or legal representative. Community service providers, including subcontractors and vendors, must adhere to all applicable federal, state and departmental requirements for protecting the security and confidentiality of client information including but not limited to appropriately restricting access, establishing procedures to reduce the risk of accidental disclosures from data processing systems, and developing a process by which the Division of Adult Aging Services is notified of suspected or confirmed security incidents and data breaches. 13. Record Retention and Disposition. All community service providers are responsible for maintaining custody of records and documentation to support the allowable expenditure of funds, service provision, and the reimbursement of services. Service providers must adhere to the approved record retention and disposition schedule posted semiannually on the website of the NC Department of Health and Human Services Controller at http: / /www.ncdhhs.gov/ control /retention/retention.htm. Service providers are not authorized to destroy records related to the provision of services under this Agreement except in compliance with the approved DHHS retention and disposition schedule, which allows for the proper destruction of records based on a schedule by funding source and fiscal year. The agency agrees to comply with 07 NCAC 04M . 05 10 when deciding on a method of record destruction. Confidential records will be destroyed in such a manner that the records cannot be practically read or reconstructed. (Authorized Signature) (Date) �;� JA P (AACC , Co.-Li-Lt Aa Grant Document Routing Start date: 8/13/18 From: Teresa Hewett, Finance Department (7408) Signatures required: 1/ Avril Pinder, Deputy County Manager Notary vrs for Ail' signature g Return to Teresa Hewett, Finance Department (7408) Type(s) of document(s) attached: 1 original — Senior Resource Center Title IIID Evidence Based Health Promotion grant application Explanation of document(s): This is a recurring grant that was included in the adopted budget. There is an increase of $4,631 in funding, however no BA is needed, due to the contribution by VOCAL. Please let me know if you have any questions. Thank you. --------- or finance department use-------------------------------------------- - - - - -- DATE ADDED TO LASERFICHE PICKED UP BY: Print Name & Date Signature Project G0015 G0015 G0015 G0015 G0015 G0015 G0015 G0015 G0015 G0015 ".teru ♦ Org Object 11068050 700000 11068050 780580 11068053 301510 11068710 700000 11068710 780580 11068713 301510 11068713 302645 11073200 700000 11073200 780580 11073203 301510 Project G0015 G0015 G0015 G0015 G0015 G0015 G0015 G0015 G0015 G0015 Toc u ".teru Office Description 2019 Revised Budg... CONTR SERVS kan, Ira 0.00 TITLE 3 HEALTH GRANT{— 000...... 0.00 GRANT -STATE 0.00 000 CONTR SERVS 000 0.00 TITLE 3 HEALTH GRANT (p�rj(4 © 20,414.00 GRANT -STATE ti�ilac��{ - 10,273.00 CONTRIBUTIONS FROM VOCAL - 9,000.00 CONTR SERVS 000 0.00 TITLE 3 HEALTH GRANT 0.00 0.00 GRANT -STATE 000 0.00 Toc u ".teru 2019 Actual] 2019 Encumbrances 2019 Available I�.... 0.00 0.00 0.00 000 _. _.. 000...... 000.._ 0.00 0.00 0.00 000 000 0.00 1,887.08 0.00 18.526.92 - 1,231.00 000 - 9,042.00 _9,0G0 00 0.00 0.00 000 0.00 0.00 0.00 0.00 0.00 000 0.00 0.00 Hewett, Teresa From: Smith, Amber Sent: Thursday, August 09, 2018 6:09 PM To: Akin, Amy, Hewett, Teresa; Kennedy, Greg; Hurley, Karen Subject: FW: Senior Center General Purpose funding Attachments: EBHP FUNDING proposal FY19CFAAA (002).doc; Attachment B Conflict of Interest EBHP FY19.rtf; Attachment A 734 Standard Assurances FY 2019 for EBHP.doc Amy and Teresa, Attached is the EBHP grant allocation and proposal. We received a grant increase of $4,631. The new revenue allocation is $14,904 (11068713 301510 G0015). This grant requires a match, but b/c VOCAL contributes we will not need additional match from NHC. The expense budget will remain the same. Attachment A and B will need to be routing for signatures. Thank you. -Amber Amber Smith I Director Senior Resource Center New Hanover County 2222 South College Road Wilmington, NC 28403 (910) 798 -6410 p 1 (910) 798 -6411 f www.nhegov.com From: Smith, Amber Sent: Thursday, August 09, 2018 6:03 PM To: 'Ginny Brinson' <gbrinson @capefearcog.org> Subject: RE: Senior Center General Purpose funding Ginny, Attached is the NHC EBHP FY 19 proposal. This will go on the BOCC agenda and will be routed for signatures. Thank you! -Amber From: Ginny Brinson <ebrinson @capefearcoe.org> Sent: Friday, August 03, 2018 4:53 PM To: Smith, Amber <ASmith @nhcaov.com> Cc: Jane Jones <iiones @caoefearcoe.org> Subject: Senior Center General Purpose funding Importance: High Amber: Please find attached: 1. Allocation Letter that details the allocation of Senior Center General Purpose Funding to New Hanover County Senior Resources 2. Administrative Letter 18 -06 which details the allocation and distribution of Senior Center General Purpose Funding for 2018/19 3. General Purpose Proposal Packet for completion Please complete the General Purpose Proposal Packets by Friday, August 24, 2018. Money cannot be appropriated in ARMS until your Proposal Packet is received and approved. Thank you, YiK7� [��iason Aging Program Specialist Area Agency on Aging Cape Fear Council of Governments 1480 Harbour Drive Wilmington, NC 28401 PH: 910 274 -0345 FAX: 910 395 -2684