FY24 SRC HCCBG funding plansDAAS-735-0
(updated 4-4-22)
July 1, 2023 through June 30, 2024
Home and Community Care Block Grant for Older Adults
Agreement for the Provision of County -Based Aging Services
This Agreement, entered into as of this - — day of2023, by and between the County of
New Hanover (hereinafter referred to as the "County") an the Cape Fear Council of Governments,
Lead Regional Organization for the Area Agency on Aging (hereinafter referred to as the "Area
Agency").
Witnesseth That:
WHEREAS, the Area Agency and the County agree to the terms and conditions for provision of aging
services in connection with activities financed in part by Older Americans Act grant funds, provided
to the Area Agency from the United States Department of Health and Human Services through the
North Carolina Division of Aging and Adult Services (DAAS) and state appropriations made available
to the Area Agency through the North Carolina Division of Aging and Adult Services, as set forth in
a) this document, b) the County Funding Plan, as reviewed by the Area Agency and the Division of
Aging and Adult Services, c) the Division of Aging and Adult Services Home and Community Care
Block Grant Procedures Manual for Community Service Providers, d) the Division of Aging and Adult
Services Service Standards, and, e) the Division of Aging and Adult Services Community Service
Providers Monitoring Guidelines.
NOW THEREFORE, in consideration of these premises, and mutual covenants and agreements
hereinafter contained, the parties hereto agree as follows:
As provided in the Area Plan, community service providers specified by the County to
encourage maximum collocation and coordination of services for older persons are as follows:
New Hanover Co. Senior Resource Center
The Community Service Provider(s) shall be those specified in Attachment A on the County
Funding Plan Provider Services Summary format(s) (DAAS-732) for the period ending June
30 for the year stated above.
2. Availability of Funds. The terms set forth in this Agreement for payment are contingent upon
the receipt of Home and Community Care Block Grant funding by the Area Agency.
Grant Administration.
The grant administrator for the Area Agency shall be: Holly Pilson, Area Agency on Aging
Director, Cape Fear Council of Governments. The grant administrator for the County shall be:
Amber Smith, New Hanover County Senior Resource Center Director.
DAAS-735-0
(updated 4-4-22)
It is understood and agreed that the grant administrator for the County shall represent the
County in the performance of this Agreement. The County shall notify the Area Agency in
writing if the administrator changes during the grant period. Specific responsibilities of the
grant administrator for the County are provided in paragraph seven (7) of this Agreement.
4. Services authorized through the County Funding Plan, as specified on the Provider Services
Summary format(s) (DAAS-732) in Attachment A, are to commence no later than July 1 of the
state fiscal year and shall be undertaken and pursued in such sequence as to assure their
expeditious completion. All services required hereunder shall be completed on or before the
end of the Agreement period, June 30 of the state fiscal year.
5. Assionability and Contracting. The County shall not assign all or any portion of its interest in
this Agreement. Any purchase of services with Home and Community Care Block Grant for
Older Adults funding shall be carried out in accordance with the procurement and contracting
policy of the community services provider or, where applicable, the Area Agency, which does
not conflict with procurement acrd contracting requirements contained in 45 CFR Part 75,
Subpart D -Post Federal Award Requirements, Procurement Standards. Federal funds shall not
be awarded to any subrecipients who have been suspended or debarred by the Federal
government. In addition, Federal funds may not be used to purchase goods or services costing
over $100,000 from a vendor that has been suspended or debarred from Federal grant
programs.
6. Com€7ensation and tavments to the Count;. The County shall be compensated for the work and
services actually performed under this Agreement by payments to be made monthly by the
Area Agency. Total reimbursement to the community service providers under this Agreement
may not exceed $1,250,197 the grand total of Block Grant funding, as specified on the Provider
Services Summary format (DAAS-732) in Attachment A.
a. Interim Payments to the Count'
Upon receipt of a written request from the County, the Division of Aging and Adult
Services, through the Area Agency, will provide the County Finance Officer with an
interim payment equivalent to seventy percent (70%) of one -twelfth (1112) of the County's
Home and Community Care Block Grant allocation by the 22nd of each month.
b. Reimbursement o f Service Costs
Reimbursement of service costs are carried out as provided in Section 3 of the N.C.
Division of Aging and Adult Services Home and Community Care Block Grant Procedures
Manual for Community Service Providers, revised February 17, 1997.
c. Role of the Count, Finance Director
The County Finance Director shall be responsible for disbursing Home and Community
Care Block Grant Funding to Community Service Providers in accordance with procedures
specified in the N.C. Division of Aging and Adult Services Home and Community Care
Block Grant Manual for Community Service Providers, revised February 17, 1997.
DAAS-735-0
(updated 44-22)
d. Pa, ment of Administration on A2ina Nutrition Services Ineentive,Pro ram t SIP E Subsld4
NSIP subsidy for congregate and home delivered meals will be disbursed by the Division of
Aging and Adult Services through the Area Agency to the County on a monthly basis,
subject to the availability of funds as specified in Section 3 of the N.C. Division of Aging
and Adult Services Home and Community Care Block Grant Procedures Manual for
Community Services Providers.
If through the U.S. Department of Agriculture Area Agency on Aging Elections Project, the
County elects to receive a portion of its USDA entitlement in the form of surplus
commodity foods in lieu of cash, the Area Agency will notify the County in writing of its
community valuation upon notification from the Division of Aging and Adult Services.
The delivery of commodity and bonus foods is subject to availability. The County will not
receive cash entitlement in lieu of commodities that are unavailable or undelivered during
the Agreement period.
7. Reallocation of FundsAnl Buda I Revisions. Any reallocation of Block Grant funding
between counties shall be voluntary on the part of the County and shall be effective only for the
period of the Agreement. The reallocation of Block Grant funds between counties will not
affect the allocation of future funding to the County, If during the performance period of the
Agreement, the Area Agency determines that a portion of the Block Grant will not be
expended, the grant administrator for the County shall be notified in writing by the Area
Agency and given the opportunity to make funds available for reallocation to other counties in
the Planning and Service Area or elsewhere in the state.
The County may authorize community service providers to implement budget revisions which
do not cause the County to fall below minimum budgeting requirements for access, in-home,
congregate, and home delivered meals services, as specified in Division of Aging and Adult
Services budget instructions issued to the County. If a budget revision will cause the County to
fall below minimum budgeting requirements for any of the aforementioned services, as
specified in Division of Aging and Adult Services budgeting instructions issued to the County,
the grants administrator for the County shall obtain written approval for the revision from the
Area Agency prior to implementation by the community service provider, so as to assure that
regional minimum budgeting requirements for the aforementioned services will be met.
Unless community services providers have been given the capacity to enter data into the Aging
Resources Management System (ARMS), Area Agencies on Aging are responsible for entering
amended service data into the Division of Aging and Adult Services Management Information
System, as specified in the N.C. Division of Aging and Adult Services Home and Community
Care Block Grant Procedures Manual for Community Service Providers.
8. Monitoring. This Agreement will be monitored to assure that services are being provided as
stated in the Division of Aging and Adult Service Monitoring Policies and Procedures at
The monitoring of services provided under this Agreement shall be carried out by the Area
Agency on Aging in accordance with its Assessment Plan and as specified in Sec. 308 of the
AAA Policies and Procedures Manual. Counties and community service providers will receive
DAAS-735-0
(updated 4.4-22)
a written report of monitoring findings in accordance with procedures established in Section
308.4. Any areas of non-compliance will be addressed in a written corrective action plan with
the community service provider.
Consumer Contributions: Grantees must allow for "consumer contributions" (caregiver must be
given opportunity to contribute to defray the cost of the service but may not be denied service
should he/she fail to or choose not to contribute). The NC Division of Aging and Adult
Services Home and Community Care Block Grant Service Standards for Consumer
Contributions will be followed, and a signed/dated provider assurance form must be present in
each client file. Please review the Consumer Contributions Policy and Procedures at:
r"'thit !J?w oa itt,'C f+ (3,.,1 ,t<t tuts C>":,`3_f 1G id
9. Disputes and Appeals. Any dispute concerning a question of fact arising under this Agreement
shall be identified to the designated grants administrator for the Area Agency. In accordance
with Lead Regional Organization (LRO) policy, a written decision shall be promptly furnished
to the designated grants administrator for the County.
The decision of the LRO is final unless within twenty (20) days of receipt of such decision the
Chairman of the Board of Commissioners furnishes a written request for appeal to the Director
of the North Carolina Division of Aging and Adult Services, with a copy sent to the Area
Agency. The request for appeal shall state the exact nature of the complaint. The Division of
Aging and Adult Services will inform the Chairman of the Board of Commissioners of its
appeal procedures and will inform the Area Agency that an appeal has been filed. Procedures
thereafter will be determined by the appeals process of the Division of Aging and Adult
Services. The state agency address is as follows:
Director
North Carolina Division of Aging and Adult Services
693 Palmer Drive
2101 Mail Service Center
Raleigh, North Carolina 27699-2101
10. Termination for Cause. If through any cause, the County shall fail to fulfill in a timely and proper
manner its obligations under this Agreement, or the County has or shall violate any of the
covenants, agreements, representations or stipulations of this Agreement, the Area Agency shall
have the right to terminate this Agreement by giving the Chairman of the Board of
Commissioners written notice of such termination no fewer than fifteen (15) days prior to the
effective date of termination. In such event, al I finished documents and other materials collected
or produced under this Agreement shall at the option of the Area Agency, become its property.
The County shall be entitled to receive just and equitable compensation for any work
satisfactorily performed under this Agreement.
11. Audit. The County 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) Uniform Guidance 2 CFR Part 200.
DAAS-735-0
(updated 4.4-22)
Community service providers, as specified in paragraph one (1), who are not units of local
government or otherwise subject to the audit and other reporting requirements of the Local
Government Commission are subject to audit and fiscal reporting requirements, as stated in NC
General Statute 143C-6.22 and 23 and OMB Uniform Guidance CFR 2 Part 200, where
applicable. Applicable community service providers must send a copy of their year-end
financial statements, and any required audit, to the Area Agency on Aging. 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
Uniform Guidance 2 CFR Part 200, but are subject to NC General Statute 143C-6-22 and 23
and Yellow Book audit requirements, where applicable.
Federal funds may not be used to pay for a Single or Yellow Book audit unless it is 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 in accordance with
Administrative Code 09 NCAC 03M can be found
The following chart provides a summary of reporting requirements under NCGS 143C-6-22
and 23 and OMB Uniform Guidance 2 CFR Part 200 based upon funding received and
expended during the service provider's fiscal year.
Annual Expenditures
Report Required to AAA
Allowable cost
for reporting
• Les —than $25,000 in
Certification form and Stale Grants
N.A.
state or federal funds
Compliance Reporting <$251000
(Item #11, Activities and Accomplishments)
j
does not have to be completed)
OR
Audited Financial Statements in compliance
with GAO/GAS ti.e., Yellow Book).
• Greater than $25,000
Certification form and Schedule of Grantee
N.A.
and less than
i Receipts >$25,000 and Schedule of Receipts
$500,000 in state
and Expenditures
funds or $750,000 in
I OR
federal funds.
Audited Financial Statements in compliance
with GAO/GAS (i.e., Yellow Book)
�_ — -
• $500,000+ in state I
Audited Financial Statement in compliance
May use state
{funds, but
funds but federal
with GAO/GAS (i.e., Yellow Book)
not
pass through in an
federal funds.
amount less than
__1750,000,. _
• $500,000+ in state
$750,000+
Audited Financial Statement in compliance
with OMB Uniform Guidance 2 CFR Part
May use state
i and federal
funds and
200 (i.e., Single Audit)
funds.
DAAS-735-0
(updated 4.4-22)
Annual Expend11 itures ! Report Required to AAA Allowable cost
for reporting
I in federal pass
through funds. --
• Less than $500,000 Audited Financial Statement in compliance May use federal
in state funds and with OMB Uniform Guidance 2 CFR Part funds, but not
$750,000+ in federal 200 (i.e., Single Audit) state funds.
12. Aiidit!A esessment Resolutions and DisallowO Cost. 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 County 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 County 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 Uniform Guidance CFR
2 Part 200, 45 CFR Part 1321 or state eligibility requirements as specified in policy.
13. Indemnitv, The County agrees to indemnify and save harmless the Area Agency, its agents,
and employees from and against any and all loss, cost, damages, expenses, and liability arising
out of performance under this Agreement to the extent of errors or omissions of the County.
14. Euual,Em-PION ent Oy€sortunit� and Americans With_ Disabilities Act Coin , iance. Both the
County and community service providers, as identified in paragraph one (1), shall comply with
all federal and state laws relating to equal employment opportunity and accommodation for
disability.
15. Data to be Furnished to the County. All information which is existing, readily available to the
Area Agency without cost and reasonably necessary, as determined by the Area Agency's staff,
for the performance of this Agreement by the County shall be furnished to the County and
community service providers without charge by the Area Agency. The Area Agency, its agents
and employees, shall fully cooperate with the County in the performance of the County's duties
under this Agreement.
16. RLhts in Documents. Materials and Data Produced. The County and community service
providers agree that at the discretion of the Area Agency, all reports and other data prepared by
or for it under the terms of this Agreement shall be delivered to, become and remain, the
DAAS-735-0
(updated 4-4-22)
property of the Area Agency upon termination or completion of the work. Both the Area
Agency and the County shall have the right to use same without restriction or limitation and
without compensation to the other. For the purposes of this Agreement, "data" includes
writings, sound recordings, or other graphic representations, and works of similar nature. No
reports or other documents produced in whole or in part under this Agreement shall be the
subject of an application for copyright by or on behalf of the County.
17. Interest of flic_pqqi,(J of Commissioners. The Board of Commissioners covenants that neither
the Board of Commissioners nor its agents or employees presently has an interest, nor shall
acquire an interest, direct or indirect, which conflicts in any manner or degree with the
performance of its service hereunder, or which would prevent, or tend to prevent, the
satisfactory performance of the service hereunder in an impartial and unbiased manner.
18.
Interest of Members of the Area Aencr. bead Regional Or anizat*on
.vand Others. No officee,
member or employee of the Area Agency or Lead Regional Organization, and no public official
of any local government which is affected in any way by the Project, who exercises any
function or responsibilities in the review or approval of the Project ar any component part
thereof, shall participate in any decisions relating to this Agreement which affects his personal
interest or the interest of any corporation, partnership or association in which he is, directly or
indirectly, interested; nor shall any such persons have any interest, direct or indirect, in this
Agreement or the proceeds arising there from.
19. Officials not to Benefit. No member of or delegate to the Congress o£the United States of
America, resident Commissioner or employee of the United States Government, shall be
entitled to any share or part of this Agreement or any benefits to arise here from.
20. ProbibitionAgainst Use of Funds to Influence Legislation. No part of any funds under this
Agreement shall be used to pay the salary or expenses of any employee or agent acting on
behalf of the County to engage in any activity designed to influence legislation or
appropriations pending before Congress.
21. Confidentiality and Securita. Any client information received in connection with the
performance of any function of a community service provider or its subcontractors under this
Agreement shall be kept confidential. The community service provider acknowledges that in
receiving, storing, processing, or otherwise handling any confidential information, the agency
and any subcontractors will safeguard and not further disclose the information except as
provided'in this Agreement and accompanying documents.
22. Record Retention and Dis7wsition. All state and local government agencies, nongovernmental
entities, and their subrecipients, including applicable vendors, that administer programs funded
by federal sources passed through the NC DHHS and its divisions and offices are expected to
main
tam compliance with the NC DHHS record retention and dtsposttton schedule
1 "i�. In
addition, the NC Department of Natural and Caltuml Resources has developed a General
DAAS-735-0
(updated 44-22)
Records Schedule for Local Government Agencies as well as individual retention and
disposition schedules for local government agencies like county social service agencies and
local health departments. Those schedules are posted at
Retention requirements apply to the community service providers funded under this Agreement
to provide Home and Community Care Block Grant services. By funding source and state
fiscal year, the NC DHHS record retention schedule lists the earliest date that grant records in
any format may be destroyed. The State Archives provides information about destroying
confidential data and authorized methods of record destruction (paper and electronic) at
)ITI,.I ': t L.: lr,s s.....`r'� .( t5.. '1 {; a :P��°*SL' ✓ L Ks-. � J__
ecordS.
The NC DHHS record retention schedule is based on federal and state regulations and pertains
to the retention of all financial and programmatic records, supporting documents, statistical
records, and all other records supporting the expenditure of a federal grant award. Records
legally required for ongoing official proceedings, such as outstanding litigation, claims, audits,
or other official actions, must be maintained for the duration of that action, notwithstanding the
instructions of the NC DHHS record retention and disposition schedule.
In addition to record retention requirements for records in any format, the long-term and/or
permanent preservation of electronic records require additional commitment and active
management by agencies. The community service provider will comply with all policies,
standards, and best practices published by the Division of Aging and Adult Services regarding
the creation and management of electronic.records.
23. Additional rmrovisions.
a. County and any subrecipients are required to follow policies and procedures for
procurement that are at least as stringent as those of the State. For federal funds this
requirement pertains to verifying that federal funds are not used to award funds to any
subrecipients who have been suspended or debarred by the federal government. In
addition, federal funds may not be used to purchase goods or services costing over
$100,000 for a vendor that has been suspended or disbarred from Federal grant
programs. Contractors and subcontractors of Older Americans Act funds are prohibited
from discharging, demoting, or otherwise discriminating against and employee for
whistle blowing as codified in 48 CFR Ch. 13.908.
b. Any capital purchases of $5,000 or more must be pre -approved by the Area Agency and
the Division of Aging and Adult Services.
c. Hany copyrightable material is developed in the course of or under this agreement and
any subaward, a copy will be furnished to the Department of Health and Human
Services and the Department shall have a royalty fee, non-exclusive, and irrevocable
right to reproduce, publish or otherwise use the work for Department purposes.
DAAS-735-0
(updated 4-4-22)
d. In accepting this award, the County agrees not to replace local program support with
Total Federal/State Reimbursement and will contract for any aging services as
identified through the county funding plan in accordance with policies and procedures
established in the Division of Aging and Adult Services Manual of Policies and
Procedures „Ji Jr S• i t .y;F ! i+ t0±li a ,t -ar? 1. ltl
e. County and any subrecipients shall comply with the Federal Funding Accountability
and Transparency Act (FFATA) by enrolling as a subrecipient in System for Award
Management (SAM) Registration on an annual basis and providing required award
information in the FFATA Subaward Reporting System per 2 CFR part 170.
f. In accepting this award, County and any subrecipients agree to maintain compliance
with Section 306(a), (13), (14), and (15), of the Older Americans Act, as amended in
2006 with regards to contractual and commercial relationships.
g. By signatures on Attachment B, Federal Certifications, the County certifies its
compliance and compliance of any subrecipients with federal requirements regarding
nondiscrimination; drug-free workplace; environmental tobacco smoke; debarment,
suspension, ineligibility, and voluntary exclusion lower tier covered transactions; and
lobbying.
h. E-Verife Compliance. Pursuant to Session Law 2013-418, Contractor shall fully comply
with the U.S. Department of Homeland Security employee legal status E -Verify
requirements for itself and all its subcontractors, if applicable. requires an affidavit
attesting to Contractor's compliance. Violation of the provision, unless timely cured,
shall constitute a breach of contract.
24. Applicable Law. This Agreement is executed and is to be performed in the State of North
Carolina, and all questions of interpretation and construction shall be construed by the laws of
such State.
Subrecipient name:
New Hanover County Senior Resource Center
Subrecipient's uni ue entity identifier:
SAM UEI: F7TLT2GMEJEl
TITLE HI -B TITLES III -Cl
TITLE III -C2_€
Federal Award Identification Number (FAIN):
AANCT38S tANCT3CM
%ANCT3HD
Federal Award Date:
07-01-2023
Subaward and Budget Period of Performance
07-01-2023
Start Date:
Subaward and Budget Period of Performance
06-30-2024
End Date:
-TITLE
TITLE III -B TYTLES III -CI
T 111-C2
Amount of Federal Funds Obligated to the
$ 772,632 125,000
352,565
subrecipient by this action:
(
Total Amount of Federal Funds Obligated to
$ 1,250,197
the subrecipient by CFCOG:
DAAS-735-0
(updated 4-4-22)
Total Amount of the Federal Award
Committed to the subreci fent by CFCOG:
$1,294,197
TITLE III -B
TITLES III -CI
TITLE III -C2
Federal award project description :
Supportive
Services
'ongregate Meals
Tome -Delivered
Meals
Federal awarding agency:
Federal recipient:
Administration for Community Living
North Carolina Department of Health and Human Services
Division of Aging and Adult Services
Subawardin agency:
Cave Fear Council of Governments
Subawarding agency contact information:
Holly Pilson, Area Agency on Aging Director
910-274-0339
TITLE_ III -B I TITLES III -CI
TITLE IH -C2
Assistance listings number and title:
93.044 ±3.045
)3.045
Research and development:
No _ _
In witness whereof, the Area Agency and the County have executed this Agreement as of the day first
written above.
New Hanover County
AWntnty
ager
9Agc n Aging Director
By: -
Chairman, Board of Commissioners
Area Acencp
Um
Executive Director
This instrument has been preaudited in the manner required by the Local Government Budget and Fiscal
Control Ac
By: -
Finance Director, Cape Fear Council of Governments
10
Ana�mmtA
Abd mamn
Attachment A
DAAS-733
(Rev. 2/19)
Home and Community Care Block Grant for Older Adults
Outreach Methodology
July 2023 through June 2024
Outreach Methodology to Address the Service Needs of Target Population
Community Service Provider: SenioriResource Center
County: NEW HANOVER
While all older adults age 60 and over are eligible for services, sec. 305(a)(2)(E) of the Older Americans Act
requires programs to target services to older individuals with the greatest economic and social need, (with
particular attention to low-income older adults, including low-income minority older adults, older adults with
limited English proficiency, and older adults residing in rural areas). The community service provider shall
specify how these service needs will be met through the services identified on the Provider Services Summary
(DAAS-732). This narrative shall address outreach and service delivery methodologies that will ensure that
this target population is adequately served and conform with specific objectives established by the Area
Agency on Aging, for providing services to low income minority individuals. Additional pages may be used as
necessary.
Attachment A
DAAS-734
AIN 111auh iMgAU..
Home and Community Care Block Grant for Older Adults
Community Service Provider
Standard Assurances
:Senior Resource Cents agrees to provide services through the Home and
Community Care Block Gran; as specified on the Provider Services S o m#n� (DAAS-732)
in nocordance with the following:
L Services shag be provided in accordance with requirements set forth in:
a) Tire 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 Standords at
o // II 1 v, /,yi-' / /-nopiawinB
Community service providers shag monitor any subcontracts with providers of Block Grant services and take appropriate
measures to ensure that services aro provided in accordance with the aforementioned documents.
2. 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 mourner specked on the Outreach Methodoloya ko Address
Service Needs of Tprwt Population (DAAS-733).
3. The following service authorization activities will be copied out in conjunction with all services provided through the Block
Gmm
a) Eligibility determination;
b) Client intoWnugislration;
c) Client assessmentheessessments and quarterly visits, as appropriate;
d) Determining the amount of services to be received by the client; and
e) Reviewing consumer contributions policies with eligible clients.
4. All licenscv, permits, bonds, and insurance necessary for carrying out Block Grant Services will be maintained by the
community service provider and any subcontracted providers.
S 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 urisiag out of procurement of services
through the Block Gant. Community service providers shall haveprocedures 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.
5. ApplicautrClient 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.
7. Community service providers are responsible for providing or arranging for the provision of required meal match, as
specified on the Provider Services Summary, (DAAS-732), loop] match shall be expended simultaneously with Block
Grant funding.
g. 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 Emptoymern Opportunity and Americans with Disabilities Act requiremenrs, 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 hnpro vement, 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 (DAAS-734
Standard Assurances Regarding In -Home Client Rights).
Attachment A
11. Subcontracting— All HCCHG community service providers must assure that subcontractors (for-profit and non-profit
entities only) meet the following requirements:
a. The subcontractor has not been suspertded or debarred. (N.C.G.S. §143C-6-23, 04NCAC 03M)
b. The subcontractor has not been barred from doing business at the federal level.
c. The subcontractor is able to produce a notarird lata.@ Grand; rific�tr�c rr '., Ceerru (a\D=pts."
d. Ali licenses, permits, bonds and insurance necessary for carrying out Home and Community Cue Block Grant services
will be maintained by both the community sctvice provider and any subcontractors.
e. The subcontractor is registered as a charitable, tax-exempt (501c3) organization with the Internal Revenue Service (non-
profit subcontractors only).
12• Confidentiality and Security. Per the requirements in I OA NCAC 051 and Section 6 of dre Home and Community Care
Black Grant Procedures Manual, client information in my format and whether recorded or not shell 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 them information including but not limited to
appropriately restricting access, establishing procedures to reduce the risk ofaecidental 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 end 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; mus[ adhere to the word ord retention and disposition schedule posted at
by the NC Department of Heakh and Human Services Controller's Dffice, as well as the local government schedules
pasted by the NC Department of Natural and Culltuml Resources at
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
bared on a schedule by funding source and fiscal year. The agency agrees to comply with 07 NCAC 04M .0510 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.
Attachment A
Standard Assurance To Comply with Older Americans Act
Requirements Regarding Clients Rights
For
Agencies Providing In -Home Services through the
Home and Community Care Block Grant for Older Adults
As a provider of one or more of the services listed below, our agency agrees to notify all Home and Community
Care Block Grant clients receiving any of the below listed services provided by this agency of their rights as a
service recipient. Services in this assurance include:
• In -Home Aide
• Home Care (home health)
• Housing and Home Improvement
• AduR Day Care or Adult Day Health Care
Notification will include, at a minimum, an oral review of the information outlined below as well as providing
each service recipient with a copy of the information In written form. In addition, providers of In-home
services will establish a procedure to document that client rights information has been discussed with in-home
services clients (e.g. copy of signed Client Bill of Rights statement).
Clients Rights information to be communicated to service recipients will include, at a minimum, the right to:
• be fully informed, in advance, about each in-home service to be provided and any change
in service(s) that may affect the wellbeing of the participant;
• participate in planning and changing any in-home service provided unless the client is
adjudicated incompetent;
• voice a grievance with respect to service that is or fails to be provided, without
discrimination or reprisal as a result of voicing a grievance;
• confidentiality of records relating to the individual;
• have property treated with respect; and
• be fully informed both orally and in writing, in advance of receiving an in-home service, of
the individual's rights and obligations.
Client Rights will be distributed to, and discussed with, each new client receiving one or more of the above
listed services prior to the onset of service. For all existing clients, the above information will be provided no
later than the next regularly scheduled service reassessment.
Agency Name: Senior Resource Center
Name of Agency Administrator: Amber K. Smith
Signature:
Attachment A
DAAS -730
(Rev. 4/2019)
Home and Community Care Block Grant for Older Adults
County Funding Plan
of Agency or Office with Lead Responsibility for County Funding Plan
New Hanover July 1, 2023 through June 30.2024
The agency or office with lead responsibility for planning and coordinating the County
Funding Plan recommends this funding plan to the Board of Commissioners as a
coordinated means to utilize community-based resources in the delivery of
comprehensive aging services to older adults and their families.
New Hanover County $_enior Resource Center
(Name of agency/office with lead responsibility
signature
Assistant
U.S. DEPARTMENT OF COMMERCE
WTI CERTIFICATION REGARDING LOBBYING
Applicants should also review the instructions for certification included in the regulations before completing this fano. Signature on this form provides for
compliance with cedifloation requirements under 15 CFR Pan 28, Wow Restrictions on Lobbying.' The certifications shall be treated as a material representation
or fact upon which reliance will be placed when the Department of Commerce determines to award the covered transaction, grant, or cooperative agreement.
LOBBYING
As required by Section 1352, TWO 31 of the U.S. Code, and Implemented
at 15 CFR Pad 28, for persons entering Into a grant, cooperative
agreement or contract over $100,000 or a loan or loan guarantee over
$160,000 as defined at 15 GFR Part 28, Sections 28.105 and 28.110, the
applicant certifies that to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid, by or on
behalf of the undersigned, to any person for influencing or attempting to
Influence an officer or employee of any agency, a Member of Congress in
connection with the awarding of any Federal contract, the making of any
Federal grant, the making of any Federal loan, the entering into of any
cooperative agreement, and the extension, continuation, renewal,
amendment, or modification of any Federal contract, grant, ban, or
cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will
be paid to any person for influencing or attempting to fnflusnco an officer or
employee of any agency, a Member of Congress, an officer or employee of
Congress, or an employee of a member of Congress In connection with
this Federal contract, grant, loan, or cooperative agreement the
undersigned shell complete and submit Standard Form-LLL,'Disclosure
Form to Repot lobbying.' in accordance with Us instructions.
(3) The undersigned shall require that the language of this cehrrcation be
included in the award documents for all subawards at all tiers (including
subcontracts, subgrerds, and contracts under grants, loans, and
cooperative agreements) and that all subrecipiems shall certify and
disclose accordingly.
This cartification Is a materiel representation of fact upon which reliance
was placed when this transaction was made or entered Into. Submission of
this cerdOcation is a prerequisite for making or entering Into this
transection Imposed by section 1352, title 31, U.S. Code. Any person who
falls to Ob the required conlflca0on shall be subject to a civil penalty of not
less than $10,000 and not more than $100,000 for each such failure
occurring on or before October 23, 1996, and of not loss than $11,000 and
not more then $110,000 for each such failure occurring after October 23,
1996.
Statement for Loan Guarantees and Loan Insurance
The undersigned states, to the best of his or her knowledge and belief,
that:
In any funds have been paid a will be paid to any person for influencing or
attempting to Influence an officer or employee of any agency, a Member of
Congress, an officer or employee of Congress, or an employee of a
Member of Congress In connection with this commitment providing for the
United States to Insure of guarantee a loan, the undersigned shall
complete and submit Standard Form-LU.,'Olsclosure Form to Report
Lobbying,' in accordance with Its Instructions.
Submission of this statement Is a prerequisite for making or entering into
this transection imposed by section 1352, title 31, U.S. Code. Any person
who fails to file the required statement shall be subject to a civil penaby of
not lass then $10,000 and not more than $100,000 for each such failure
occurring on or before October 23, 1996, and of not less than $11,000 and
not more then $110,000 for each such failure occurring after October 23,
1996.
As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above applicable certification.
NAME OF APPLICANT
DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB
Complete this form to disclose lobbying activitles pursuant to 31 U.S.C. 1352 0346-0D46
iSee reverse for public burden disclosure. L
1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type:
Qa. contract Da. bidiofferiapplication a. initial filing
b. grant b. initial award b, material change
c. cooperative agreement c. post -award For Material Change Only:
d. loan I{ year, quarter
e. loan guarantee date of last report
Number, ifknown:
0. a. Name and Address of Lobbying
bdarmYlon requaelad through INS ram u aulhodad by M Si U.S.C. wlt0
1352. TNs dndolare dl lobbylre ectivNes le a mstedm rap,eeanlay" of fact
upon which reliade was placed by the liar ab W when alto tremacdoo was made
or erolarld bdn. Toa disclosure to re(fiNrad Paaaenl to 31 U.S.C. 1352 TNe
Irdaaaoao Will ba fopoltedtu Uo collaress mrol-nnmlly and will ba avdlabla kr
public InapeNon, aay Person who 18Ifs to gra 00 requlrad dsdusom 081 bo
subjo4 to a d K penalty of not less bud $10,000 aryl rad am than $100.000 for
aed,alahfallm-
If Reporting Entity in No. 4 is a Subawardes, Enter
and Address of Prime:
Program
CFDA Number, if applicable:
Award Amount, if known:
Individuals Performing S
different from No, 10a)
Name:
hone No.: Date: _
Authof@ed for Local ReprodUldiOn
Standard Farm LLL (Rev. 7.97)