HomeMy WebLinkAboutAgenda - 06-01-1999 - 8sOrange County Board of Commissioners
Agenda Item Abstract
Meeting Date: June 1,1999
Action Agenda
Item # g-S
SUBJECT: Work First Job Development and Placement Contract with Employment
Security Commission
Department: Social Services
Public Hearing: Yes No X
ATTACHMENT (S): INFORMATION CONTACT:
1. Contract
Marti Pryor-Cook, Extension 2802
TELEPHONE NUMBERS:
Hillsborough - 732-8181
Durham - 688-7331
Mebane - 227-2031
Chapel Hill - 967-9251/968-4501
Purpose: To renew a Contract for Job Development and Placement Services with the
local Employment Security Commission Office for Fiscal Year 1999/2000.
Background: Orange County entered into a Purchase of Service Contract with the local
Employment Security Commission (ESC) Office in August 1998. ~ The Contract provides
an ESC Counselor full-time at the DSS Hillsborough office. Services offered by the
ESC Counselor include Vocational Assessment, Job Readiness Training, Job
Development and Placement, Employment Registration, and Unemployment Insurance
Claims Registration. One requirement of the Work First program is for applicants to
register for employment prior to application approval. This Contract facilitates that
requirement and assists Work First applicants and participants to obtain employment.
During the first seven months of the Contract period, the ESC Counselor registered 77
Work First applicants, conducted 45 Vocational Assessments, placed 29 participants in
jobs, and visited 15 employers to discuss the Work First program. In addition to Work
First applicants and participants, the Counselor serves other program applicants.
Fiscal Impact Statement: The total Contract cost of $38,962 is reimbursed at 100% by
the Federal Work First Block Grant.
Recommendation: The Manager recommends approval of the Purchase of Service
Contract with ESC and authorization for the Chair to sign.
STATE OF NORTH CAROLI
DIVISION OF SOCIAL SERVI
PURCHASE CONTRACT
ID # 68E01
This Contract is entered into between the Department
Employment Security Commission (referred to as Provider) i
This contract shall consist of form DS5-2497, Attachment A
6844).
The Department will purchase specific services from t
Contract in order to make optimal use of the facilities, staff az
This Contract is subject to the provisions of all applicable Fed
policies.
Subject to its other provisions, the terms of this contra
the dates specified on Attachment A.
SECTION I: RESPONSIBILITIES
A. The Department will:
1. Determine client eligibility for service(s) in accord
State regulations; and
2. Inform the Provider on Form DSS-1360 concenun€
individual for the service, the period of time for wh
and any changes in the individual's eligibility status;
3. Reimburse the Provider for service(s) purchased as de
of this Contract for eligible clients; and
4. Keep the Provider informed of any alterations in an
governing the service program; and
5. Accept fiscal responsibility for deviations from the
result of acts of the Department or any of its officer
representatives.
B. The Provider will:
Provide service(s) as specified in Attachment A of t
with applicable standazds for the service(s); and
2. Furnish information to the Department as required t
service(s) provided pursuant to this Contract; and
3
3. Comply with all State licensing standards, all applicable accrediting standards and
any other standazds or criteria established by the Division of Social Services to
assure quality of services; and
4. Restrict the use or disclosure of information obtained in connection with the
administration of North Carolina's programs for the provision of services
concerning applicants for and recipients of those services to purpose directly
connected with the administration of the service program; and
5. Comply with the terms of Section 504 of the Rehabilitation Act of 1973 and all
requirements imposed by or pursuant to the regulations of the Department of
Health and Human Services issued pursuant to that Section, which prohibit
discrimination against handicapped persons in employment and in the operation
of programs and activities receiving Federal funds; and
6. Comply with Title VI and VII of the Civil Rights Act of 1964 and all requirements
imposed by or pursuant to the regulations of the Department of Health and Human
Services issued pursuant to that Title; and
7. Accept fiscal responsibility for deviations from the terms of this Contract as a result
of acts of the Provider or any of its officers, employees, agents or representatives.
SECTION II: RESPONSIBILITY FOR LIABILITIES
Each party hereto agrees to be responsible for its own liabilities and that of its officers,
employees, agents, or representative arising out of this Contract.
SECTION III: TREATMENT OF ASSETS
Treatment of assets acquired under this Contract shall be sub}ect to the following:
A. Ownership of property purchased by the Provider under the terms of this Contract or
which reimbursement by the Department is based upon the actual purchase cost of the
property shall immediately vest with the Department of Human Resources upon such
reimbursement.
B. The North Cazolina Department of Human Resources shall have no claim to property
purchased by the Provider under the terms of this Contract for which reimbursement by
the Department is based upon approved depreciation schedule or use allowance.
C. The Provider shall maintain and administer in accordance with sound business practice a
program for the maintenance, repair, protection and preservation of property purchased
under the terms of this Contract to assure its continued availability.
D. Property purchase under the terms of this Contract shall be used only for the performance
of this Contract.
4
SECTION IV: RECORDS AND REPORTS
A. The Provider agrees to maintain client records which date and document, in accordance
with established policy, the service delivered for the individual, a valid authorization for
service, programs records, documents and other evidence which reflect program- -
operations.
B. The Provider agrees to fiunish information to the Department, as requested, to support
provision of service(s) pursuant to this Contract and the full cost of the service; and
submit changes, as needed or required, in this Contract, Attachment A or approved
supporting information for review and approval by the Department.
C. The Provider agrees to maintain books, records, documents and other evidence and
accounting procedures which reflect all direct and induect costs expended under this
Contract. A current, complete inventory of all equipment purchased under the terms of
this Contract must be kept.
D: The Provider agrees to retain all books, records and other documents relevant to this
Contract for three years after final payment or until all audits continued beyond this period
are completed. Federal auditors and any persons authorized by the Division of Social
Services or the Department shall have the right to examine any of these materials. In
records produced under this Contract will be turned over to the Department.
SECTION V: SUBCONTRACTING
The Provider shall not subcontract any of the work contemplated under this Contract without
obtaining prior written approval from the Department. Any approved subcontract shall be
subject to all conditions of this Contract. The Provider shall be responsible for the
performance of any subcontractor.
SECTION VI: MAINTENANCE OF EFFORT
The Provider certifies that the funds to be used under this Contract do not replace or supplant,
in any way, Federal, State or local funds for already existing services..
SECTION ~: MONITORING AND EVALUATION
A. The Provider agrees to participate in program, fiscal and administrative monitoring or
audits, making records an staff time available to Federal, State and county staff.
B. The Provider agrees to take necessary steps for corrective action, as negotiated within a
corrective action plan, for any items found to be out of compliance with Federal and State
laws, regulations, standards and/or terms of this Contract.
SECTION VIII: AMENDING THE CONTRACT
This contract in whole or in any part may be amended at any time:
A. By the Department in the event that such amendment is necessary to comply with
applicable laws, regulations, policies and standards; and by mutual consent of both parties.
B. Each party to this contract will notify the other immediately in writing if an amendment
becomes necessary due to alterations in the activities described in Attachment A or for any
other reason.
SECTION IX: TERMINATION
A. This contract, in whole or in any part, may be cancelled at any time:
By any parry, with cause, upon at least 30 days notice, in writing, and delivered by
registered mail with return receipt requested or in person, or
2. By the Department in the event reimbursement to the Department is not available
and/or continued at an aggregate level sufficient to allow for the purchase of the
indicated quantity of service. The obligations of each party shall be terminated to the
extent specified in the notice of termination, immediately upon receipt of the notice of
termination from the Department, or
3. By the Department in the event that the Division of Social Services/Department
determines that the Provider is in violation of any or all of the terms of this Contract.
The obligations of each party shall be terminated to the extent specified in the notice
of termination immediately upon receipt of the notice from the Department, or
.w
4. By mutual consent of all parties.
B. In the event of termination in part, all parties shall continue the performance of this
Contract to the extent not terminated
C. If this Contract is terminated, in whole or in part, the Provider may be required to deliver
and transfer Title or assignment of interest to the Division of Social Services or dispose of
any property specifically produced or acquired for the performance of such part of this
Contract as has been terminated, and the Provider shall, upon the direction of the Division
of Social Services, protect and preserve property in the possession of the Provider in
which the Division of Social Services has an interest.
D. After receipt of a notice of termination, and except as otherwise directed by the
Department, the Provider shat! cease work under the Contract on the date, an to the
extent specified, in the notice of termination. The Department shall pay the Provider the
agreed upon amount for the delivery of services under the terms of this Contract up to the
effective date of termination. Reimbursement shall not be made for equipment or supplies
purchased after the notice of termination is received except as approved by the
Department.
E. Waiver of any default shall not be deemed to be a waiver of any subsequent default.
Waiver of breach of any provision of the Contract shall not be deemed to be a waiver of
any other subsequent breach and shall not be construed to be a modification of the terms
of this Contract unless stated to be such in writing, signed by an authorized representative
of the Department and attached to the Contract.
SECTION X: CONCLUSION
It is expressly understood an agreed that the services provided to eligible clients pursuant to
this Contract shall consist exclusively of those services specified in the attached program
description incorporated into this Contract as Attachment A.
It is further understood and agreed that the provision of services pursuant to this Contract
shall be subject to the limitations and conditions contained in the laws. regulations,
guidelines and plans cited in this Contact, and that this Contract is subject to renegotiation or
revision to meet any new or revised rules, regulations, or policies that may be issued by the
Department of Health and Human Services, or the North Carolina Social Services
Commission, or the Department of Human Resources and that are communicated to the
Provider.
PROVIDER DEPARTMENT
Employment Security Commission Orange County Department of Social Services
By:
Title: Manager
By:
Title: Director
Date: ~~ ~~~Q
r~
Date:
This Agreement has been preaudited in the manner required by the local Crovernment Budget
and Fiscal Control Act.
ATTEST:
County: Orange
Title: Finance Director
Signature: .%~~~~
Date: _T~ ~l~
SECTION XI: CERTIFICATION
The Orange County Boazd of Social Services supports the need for this performance-
based contract with the Employment Security Commission to provide job search, and job
development for Work First Participants.
Rosette Moore, Clair ~
Orange County Board of Social Services
Assisting families make the transition from welfaze to work is a priority in Orange
County. The Orange County Board of County Commissioners, in response to the needs
of the Work First population, supports approves the contracts for job search and job
development and placement services from the Employment Security Commission.
Alice Gordon, Chairperson
Orange County Board of County Commissioners'
8
STATE OF NORTH CAROLINA
DIVISION OF SOCIAL SERVICES
PURCHASE CONTRACT BUDGET
SUMMARY .Effective
Provider Employment Security Commission ID# 68E01 Period 7!1/1999 through 6/30/2000
Part I -Estim ated Expenditures
Object of Expenditure Total Non- Matchable Total Matchable
Program Costs Costs
Costs (2) (3)
(1)
A. Salaries $27,678
B. Fringe Benefits 6 694
C. Staff Development-Services 1,004
D. Travel '
E. Equipment Purchase-Tangible Property
F. Transportation-Recipient
G. Medical Supplies and Expense .
H. Cost of Space-Non-Residential
I. Room 8c Board-Residential Treatment
J. Service Payments
K. Other
L. Indirect Costs
$ 3,590
M. Totals $38,962
tart li - t;omputatlon of Unit Lost or Individual Fixed Rate
A. 1. Total Matchable Costs $ N/A
2. Less: Earned Income for Unit Cost Method
3. Net Matchable Costs
B. 1. Total Service Unit Capacity, or
2. Total Anticipated Utilization Capacity
Method of Computation or Source of Data
D. Estimated Unit Cost or Individual Fixed Rate: $ per
Part III -Distribution of Estimated Revenue for Total Cost Reimbursement Method
(a) (b)
A. Estimated Eligible and Matchable Costs Number Ratio
1. Estimated Eligible Clients 250 100%
2. Estimated ineligible Clients 0 0%
3. Total Clients 250 100%
B. Eligible Costs
(1) Matchable (2) Less (3) Net (4) (5) Costs Eligible
Costs Earned Matchable Estimated % for Financial
[Part.l, Line M, Income Costs of Eligibles Participation
col. (3) [B. (1) Less (2)}] [A. 1. (b)] [B. (3) x (4)]
$ $ $ $ $
A. Program Costs ~ Amount Source of Funds
1. FederaVState Funds $ Work First
2. Local Matching Share $ Counri
3. Other Budgeted Funds $
4. TOTAL REVENUE $ 38,962
B. Fees (If Applicable) :~~~
1. Administrative Fce $
2. Certification Fee $
3. TOTAL FEES $
Part V-Reimbursement Projections (For Title XX Providers Only)
Annual Projection July- September
Projection October-June
Projection
A.$ B.$ C.$
Signed:
Provider/ uthorized Official
County Director or Designee
Date: ..~~ ~a
Date:
10
Purchase Contract Budget
Supporting Budget Schedules
A. Salary Schedule
{1) (2) (3) (4) (5) (6) (7)
Number Pay % of No. of Annual Total
of Persons Position or Title Grade Time Months Salary Cost
Employed
1 Job Development Specialist N/A 100 % 12 $27,678 $27,678
Total - Sa laries
B. Fringe Benefits
(1) (2) (3)
Total
• Type Method of Computation Cost
FICA
Health Ins.
Retirement
Worker's Compensation
Unemployment Insurance
Total -Fringe Benefits $6,694
11
C. Staff Development -Service Funds Schedule
(1)
Item (2)
Total
Cost
Total Staff Development -Service Funds
D. Travel Schedule
(1) (2) (3) (4) (5) Dail Subsistence (8}
No. of
Persons
Position or Title No. of
Miles/Days Rate per
Mile No. of
Days (~
Rate ('n
Days Total
Cost
1 Job
Development
Specialist
.~ 12
Months $1000
Total -Travel $1000
E. Equipm ent -Tangible Property Schedule
(1)
No. of
Units (2)
Item (3)
Cost per Unit (4)
Total Cost
N/A
Total Equipment -Tangible Property
12
F. Recipient Transport ation Schedule
~l)
Item (Z)
Method of Computation (3)
Total
Cost
N/A
1 a. Salaries
# of
Persons Position or Title Pay
Grade % of
Time # of Months
Employed Annual
Salary
N/A
1 b. Fringe Benefits ~~
Type Method of Computation
N/A
Total Recipient Transportation
13
G. Medical Supplies and Expenses Schedule
(1)
Item (2)
Total
Cost
N/A
Total -Medical Supplies and Expense
H. Cost of Space -Non-Residential Schedule
(1)
Item (2)
Total
Cost
N/A
Total Cost of Space -Non-Residential
I. Room and Board Costs -R esidential Treatment
(1)
Item (2)
Method of Computation (3)
Total
Cost
N1A
Total Room and Board Costs - Residential Treatment
14
J. Service Payment Schedule
(1)
No. of
Units (2)
Item (3)
Cost per Unit (4)
Total
N!A
Total -Service Payment
K. Other Expense Schedule
(1)
Item (2)
Total
Cost
N!A
Total -Other Expense
L. Indirec t Cost Schedule
(1)
Rate (2)
Rate Applied To: (3)
Amount Rate Applied To: (4)
Total
12.97% Salary $27,678 $3,590
Total -Indirect Cost $3,590
15
ATTACHMENT A
State of North Carolina
Division of Social Services
Contract Application
I. Contract Summary
A. This agreement is between the Orange County Department of Social
Services (hereinafter referred to as the "Department")and the Employment Security
Commission (heretofore and hereinafter referred to as the "Provider'.
B. This agreement shall be in effect from 7/1/1999 to 6/30/2000
C. Services to be Provided:
(1)
Service (2)
Service Code (3)
Number of
Persons Served (4)
Number of Units
of Service (5)
Definition of
Unit of Service
Job Development
and Placement 546 125 125 One Participant
Job Readiness/
Job Search - 547 250 250 One Participant
Any additional services should be listed in III. -Service Program Description
D. Area to be Served: Orange County
16
State of North Carolina ..
Division of Social Services
Contract Application
E. Contract Identification:
1. Provider
a. Name of Contract Administrator
Tel. # : (919) 967-0177
Pennell
b. Name of Program Contact Person: Same
Tel. #:
c. Program Name, Location and Mailing Address: Employment Security Commission
110 W. Main St.
Carrboro~, NC 27510
d. Additional Service Delivery Sites:
e. Status : (X )Public ()Private, non-profit
( )Private, for Profit ()Individual
f. Provider Contract ID #: 68E01
2. County.Department of Social Services
a. Name of Contract Administrator: Marti Pryor-Cook
Tel. # : (919) 732-8181
b. Name Services Program Contact Person: Gwendolyn Price
Tel. #: (919) 732-8181
c. Address of County Department of Social Services:
P.O. Box 8181
304 W. Tryon St.
Hillsborough, NC 27278
State of North Carolina
17
Division of Social Services
Contract Application
II. Fiscal Provisions
A. Amount of Reimbursement:
Reimbursement under the terms of this agreement will be limited to a maximum of
$ 32,916 TOTAL = $ SSBG + $ IV-B + $ RA,P +
$ State + $ County + $ Other (identify) : Federal, State
and Local TANF Dollars
(Optional : County funds consist of $ for and $
(funding source)
for .}
B. Method of Reimbursement:
1. For Purchase Contract (DSS-249 Total and Unit Cost:
(~ a. Reimbursement will be made in accordance with the current budget approved by
the Department and on file with both parties. The amount of reimbursement will be
based on allowable expenditures made in behalf of eligible clients, determined in a
accordance with acceptable cost allocation methods. The Provider will report all
expenditures made under the terms of the contract.
() b. Reimbursement will be made at a unit cost rate of $ per unit of
reimbursement delivered to eligible clients for an estimated number of
units. The Provider will document total expenditures made under the terms of the
contract to the Department within thirty days after the termination of this contract,
or as instructed by the Department. Reimbursement which exceeds actual allowable
cost will be adjusted to actual allowable cost.
2. For Vendor Agreements (DSS-2252) Fixed Rate
Reimbursement will be based on:
() a. a standard fixed rate or
() b. an individual fixed rate.
c. Reimbursement will be made at a fixed rate of $ per unit of
(define) for as estimated number of units.
Reimbursement will be based on the actual number of units delivered whether over
or under the estimated number. If multiple components are being purchased,
additional rates and units can be identified as follows:
State of North Cazolina
Division of Social Services
18
Contract Application
C. Reimbursement Reporting:
1. Expenditures
The Provider will report expenditures monthly in accordance with policy set forth by
the Controller's Offices, Division of Social Services, issued via the Fiscal Manual.
Expenditures aze to be reported on the DSS Administrative Cost Report (Form DDSs-
1571,Part III). Reports are to be submitted to the Department by the fifth working
day of the month following the month in which services were delivered. The
Department will reimburse the Provider monthly, usually by check, upon receipt of a
completed and correctly filed report.
2. Reporting for the Statewide Services Information System (SIS)
In addition to the Administrative Cost Report (DSS-1571, Part III), the Provider will
submit to the Department the Monthly Report of Service Delivery (DSS Form 1571,
Part IV). This should be submitted along with the Administrativc Cost Report by the
fifth working day of the month following the month in which services were delivered.
The utits reported in Column 12 of the 1571 Part IV are the units of service defined in
Column 5 of I.C. of this Attachment. Service definition and reporting instructions are
found in Family Services Manual, Volume VI, Chapter IV.
D. Audit Requirements
The Provider shall be responsible for compliance with the audit requirements of
Department of Health and Human Services federal regulation 45 CFR Part 74,
Administration of Grants, or State Administrative;Procedures Manual for Federal Block
Grant Funds, whichever is applicable. These regulations stipulate that an annual audit be
performed for the fiscal year in which contract funds were received.
() 1. NA
Private, non-profit if amount of reimbursement received is under $ 1,000; private,
for profit or individual .
() 2. (Applicable to Private, Non-Profit Providers if reimb. 51,000 or over)
An annual audit is to be performed in accordance with OMB Circular A-110 by an
"independent auditor." Independent auditor" means either: (a) a state goven~unent
auditor from the Department of Human Resources or the Department of
Administration, Office to the State Auditor; or (b) a certified public accountant.
Upon completion of the audit, a copy of the audit report must be forwarded to the
county department of social services.
State of North Carolina
Division of Social Services
19
Contract Application
() 3. (Applicable to Public Hospitals, Colleges, and Universities)
The annual audit must be performed in accordance with OMB Circular A-110.
It is not necessary for the institution to program audits performed separately
from anall-inclusive single audit which entails all revenues and expenditures
of the public agency. However, it is the responsibility of the contractor to
insure that the contract program is included in the institution's single annual
audit.
A copy of the audit report must be provided to the County department of
Social Services upon completion of the annual audit.
(~ 4. (Applicable to State or Local Government Agencies)
An annual audit is to be performed in accordance with OMB Circular A-128 by
an independent auditor. Upon completion of the audit, a copy of the audit
report must be forwarded to the county Department of Social Services.
E. Client Fees for Service
(~ 1. No fees will be charged to individuals determined to be eligible for services
by the department of social services.
() 2. The service(s) under contract with the Provider are services for which a client
fee may be assessed. Policy regazding the assessment and collection of fees is
contained in Family Services Manual, Volume VI, Chapter III. If a client is to
to be chazged a fee, the department will inform the Provider of the amount of
fee to be charged and of any subsequent changes by way of the Purchase of
Service Referral and Authorization (DSS Form 13b0). The Provider will
establish a plan with the client for collecting the fee on at least a monthly basis;
and when fees aze not paid within ten days of the due date, will bill the client in
writing and send a copy of the bill to the Department. NO OTHER FEES FOR
SERVICES MAY BE CHARGED TO THE CLIENT. Client fees aze to be
reported on the Monthly Report of Service Delivery (DSS Form 1571, Part
IV).
F. Management of the Funding/Matching Shaze Requirement
() 1. A cash transfer of the matching shaze will be made to the county department of
social services in accordance with the terms specified in the Donation
Agreement (DSS-1319).
State of North Carolina
Division of Social Services
20
Contract Application
() 2. The provider certifies through the contract budget attached to this contract that
the matching share in available. Further, it is agreed that the provider will
report all program costs incurred each month relating to this contract on the
DSS-1571. However, reimbursement will be limited to the federaUstate
financial participation rate.
(~ 3. The county department of social services is providing the match.
G. Provider Fees (For Purchase Contracts Only)
() 1. The Provider agrees to pay the Department/Division up to $
Administrative Fee as payment in full for the administration of the contract.
The amount of the fee is five percent of the matching share contributed by the
Provider.
() 2. The Provider agrees to pay the Department up to $ Certification Fee
as payment in full for the determination and certification of client eligibility.
The amount of the fee is five percent of the matching share contributed by the
Provider.
Monitoring and Certification Fees, when applicable, will be deducted from the
amount to be reimbursed.
21
State of North Cazolina
Division of Social Services
Contract Application
III. Service Program Description
Orange County Department of Social Services (DSS) is purchasing the services of a Job
Development Specialist from the Employment Security Commission of North Carolina.
The General Assembly considers the Employment Security Commission the state's
primary job placement authority. The Job Development Specialist will be stationed at the
DSS and will be providing services to Work First participants. The following services
aze included in this contracK:
• Vocational Assessment and Employment Counseling,
• Job Readiness Training and Job Club,
• First Stop Registration,
• Process Unemployment Insurance Claims
• Job Development and Placement (placements include direct placements and
entered employments), ,
• Follow-up Services
Job Development Specialist Duties
The Job Development Specialist will assess and counsel Work First participants who are
referred with an objective of locating employment. Job readiness and job club activities
will include but are not limited to information about employer expectations, appropriate
dress and grooming, resume preparation, goal setting, and networking.
Other duties of the Job Development Specialist are as follows:
• Interview applicants/participants to determine work history, education, training, and
skills,
• Conduct file searches of suitable job openings, ,,,-
• Refer applicant to employers, .
• Perform job development contacts with employers to obtain job orders,
• Provide labor market information to employers, applicants, and other agencies, .
• Determine eligibility for unemployment insurance, and
• Follow up with applicants and employers in an effort to impact job retention.
Performance Measures
North Camlina's Work First Program, implemented in July 1995, is one of the most
comprehensive welfare reform efforts in the nation. The guiding principles of Work First
requires parents to take personal responsibility for their. children; limits the receipt of
Work First Cash Assistance (temporary and short-term), and requires parents to work.
The Orange County Department of Social Services, in conjunction with the Employment
Security Commission have identified the following performance measures.
• Locate full-time employment for 125 Work First participants.
• Perform 45 employer visits to develop job openings for Work First participants.
• Conduct monthly job readiness workshops.
• Maintain contact with participants and employers for three months after placement.
z2
STATE OF NORTH CAROLINA
COUNTY OF ORANGE
AGREEMENT BETWEEN
THE UNIVERSITY OF NORTH CAROLINA HOSPITALS
AND
ORANGE COUNTY, NORTH CAROLINA
THIS AGREEMENT, made and entered into this the 1st day of July, 1999 by and between
ORANGE COUNTY (hereinafter referred to as the COUNTY) and THE UNIVERSITY OF NORTH
CAROLINA HOSPITALS, (hereinafter referred to as UNCH) Orange County, North Carolina.
WITNESSETH:
WHEREAS, the parties have agreed with each other that the County will provide certain
services for The University of North Carolina Hospitals in connection with the Orange County
Department of Social Services (hereinafter referred to as OCDSS), Medicaid Program; and
WHEREAS, the UNCH has agreed to pay certain compensation for said service and the
parties desire to execute this contract to delineate their understanding of this agreement;
NOW, THEREFORE, the parties hereby agree as follows:
1. Orange County agrees to make available to UNCH the services of three full time
Income Maintenance Caseworkers.
2. UNCH agrees to reimburse the County within 15 days of receipt of monthly billings for
the county share of the salary, benefits, and the indirect costs to which the parties have agreed
involved in maintaining three Social Services Income Maintenance Caseworkers at UNCH. The
county share of these positions is approximately 50 percent UNCH also agrees to reimburse the
county for 15 percent of the salary and benefits of a full time supervisor. Salary and benefits for
the Income Maintenance Caseworkers and the supervisor include: base salary according to the
Orange County pay plan; FICA taxes; Local government retirement; vacation, sick, petty, or other
Leave under approved county plan; paid holidays as observed by county; necessary travel and per
23
diem for job related activities; county paid insurance (health, dental, and life). Indirect costs for
each of the three Caseworkers at UNCH for fiscal year 1999/2000 will be $2098.00, which is the
proportionate share of the OCDSS's costs for liability insurance and services provided by the
Orange County Personnel and Finance Departments. UNCH further agrees to pay the county
share of any expense resulting from other requirements mutually agreed upon by OCDSS and
UNCH.
3. Other supportive services provided by OCDSS without additi3nal charge to UNCH
include continuing program training of Income Maintenance Caseworkers and consultation with
other counties in the catchment area about applications for pre-and post-discharge patients.
4. Other supportive services provided by UNCH without charge to OCDSS include:
office space; parking space; office equipment; clerical support; and telephone service.
5. The Income Maintenance Caseworkers shalt receive all potential medical assistance
applications originating at UNCH. Specifically, the Income Maintenance Caseworker shall
perform intake functions only, consisting of the following: conducting interviews that initiate an
application; obtaining signatures; obtaining documentation available at the time of interview; and
forwarding applications to the appropriate county for processing.
6. The Income Maintenance Caseworkers shall be assisted by UNCH staff in obtaining
information and documentation required to complete the application process.
7. The Social Services Income Maintenance Caseworkers shall work cooperatively with
UNCH staff and the staff of any Department of Social Services to make appropriate referrals of
patients and family members with problems not related to eligibility determination.
8. As empbyees of the County, the Income Maintenance Caseworkers shall be directly
supervised by and accountable to OCDSS. Due to the nature of this agreement and the working
relationship with UNCH, it is necessary that close contact be kept with UNCH administratlon and
certain members of the hosp'itai medical staff. In recognition of this factor, UNCH will name a staff
member to act as liaison between the OCDSS, the Income Maintenance Caseworkers, the
departments of UNCH and the other staff personnel. Assignment of work to the Income
24
Maintenance Caseworkers and coordination of sick, vacation, and other leave will be the joint
responsibility of this UNCH staff member and the OCDSS supervisor.
9. UNCH shall participate in the interviewing and selection process utilized by OCDSS for
the hiring of Income Maintenance Caseworkers covered by this agreement, in accordance with
County policy and procedures.
10. Both the County and UNCH agree and understand that if at any time UNCH
determines that an Income Maintenance Caseworker's performance or professional interactions
are inadequate or inappropriate. UNCH may request that OCDSS initiate appropriate action to
correct that employee's deficiencies, or to dismiss that employee if indicated. Any disciplinary
action shall be pursued in compliance with the Orange County Personnel ordinance and UNCH
shall provide sufficient documentatlon to support that action.
11. This Agreement shall be effective from July 01, 1999 to June 30, 2000.
12. This Agreement shall be reviewed at least annually, prior to July 1st and may be
terminated by either party upon 60 days written notice.
13. The Agreement contains the entire understanding of the parties and shall not be
altered, amended or modified, except by an agreement in writing executed by the duly authorized
officials of both parties.
IN WITNESS WHEREOF, the parties hereto have caused this contract to be signed by
its duly authorized officials.
is
FOR AND ON BEHALF OF:
ORANGE COUNTY, NORTH CAROLINA
Chair, Orange County Board of
Commissioners
DATE:
Attest:
Clerk of the Orange County
Board of Commissioners
FOR ANO ON BEHALF OF:
THE UNIVERSITY OF NORTH CAROLINA
HOSPITALS
r, The University
Hospitals
DATE: ~~~~ f
This instrument has been preaudited in the manner required by the Local Government
Budget and Fiscal Control Act
Ken Chavious, Orange County Finance
Officer
~-/-99
,~~~
Page 1 of 5
STATE OF NORTH CAROLINA
DIVISION OF SOCIAL SERVICES
PURCHASE CONTRACT
ID # 68E01
This Contract is entered into between the Department of Social Services and The
Employment Security Commission (referred to as Provider) identified on Attachment A.
This .contract shall consist of form DSS-2497, Attachment A (DSS-1292) and Budget (DSS-
6844).
The Department will purchase specific services from the Provider as set forth in the
Contract in order to make optimal use of the facilities, staff and programs of the Provider.
This Contract is subject to the provisions of all applicable Federal regulations and State
policies.
Subject to its other provisions, the terms of this contract shall be in effect to and from
the dates specified on Attachment A.
SECTION I: RESPONSIBILITIES
A. The Department will:
1. Determine client eligibility for service(s) in accordance with Federal and
State regulations; and
2. Inform the Provider on Form DSS-1360 concerning the eligibility of each
individual for the service, the period of time for which services are authorized,
and any changes in the individual's eligibility status; and
3. Reimburse the Provider for service(s) purchased as described in Attachment A
of this Contract for eligible clients; and
4. Keep the Provider informed of any alterations in and/or to the regulations
governing the service program; and
Accept fiscal' responsibility for deviations from the terms of this Contract as a
result of acts of the Department or any of its officers, employees, agents or
representatives.
B. The Provider will:
1. Provide service(s) as specified in Attachment A of this Contract in accordance
with applicable standards for the service(s); and
2. Furnish information to the Department as required to support the full cost of
service(s) provided pursuant to this Contract; and
Page 2 of 5
3. Comply with all State licensing standards, all applicable accrediting standards and
any other standards or criteria established by the Division of Social Services to
assure quality of services; and
4. Restrict the use or disclosure of information obtained in connection with the
administration of North Carolina's programs for the provision of services
concerning applicants for and recipients of those services to purpose directly
connected with the administration of the service program; and
5. Comply with the terms of Section 504 of the Rehabilitation Act of 1973 and all
requirements imposed by or pursuant to the regulations of the Department of
Health and Human Services issued pursuant to that Section, which prohibit
discrimination against handicapped persons in employment and in the operation
of programs and activities receiving Federal funds; and
6. Comply with Title VI and VII of the Civil Rights Act of 1964 and all requirements
imposed by or pursuant to the regulations of the Department of Health and Human
Services issued pursuant to that Title; and
7. Accept fiscal responsibility for deviations from the terms of this Contract as a result
of acts of the Provider or any of its officers, employees, agents or representatives.
SECTION II: RESPONSIBILITY FOR LIABILITIES
Each party hereto agrees to be responsible for its own liabilities and that of its officers,
employees, agents, or representative arising out of this Contract.
SECTION III: TREATMENT OF ASSETS
Treatment of assets acquired under this Contract shall be subject to the following:
A. Ownership of property purchased by the Provider under the terms of this Contract or
which reimbursement by the Department is based upon the actual purchase cost of the
property shall immediately vest with the Department of Human Resources upon such
reimbursement.
B. The North Carolina Department of Human Resources shall have no claim to property
purchased by the Provider under the terms of this Contract for which reimbursement by
the Department is based upon approved depreciation schedule or use allowance.
C. The Provider shall maintain and administer in accordance with sound business practice a
program for the maintenance, repair, protection and preservation of property purchased
under the terms of this Contract to assure its continued availability.
D. Property purchase under the terms of this Contract shall be used only for the performance
of this Contract.
SECTION IV: RECORDS AND REPORTS
Page 3 of 5
A. The Provider agrees to maintain client records which date and document, in accordance
with established policy, the service delivered for the individual, a valid authorization for
service, programs records, documents and other evidence which reflect program
operations.
B. The Provider agrees to furnish information to the Department, as requested, to support
provision of service(s) pursuant to this Contract and the full cost of the service; and
submit changes, as needed or required, in this Contract, Attachment A or approved
supporting information for review and approval by the Department.
C. The Provider agrees to maintain books, records, documents and other evidence and
accounting procedures which reflect all direct and indirect costs expended under this
Contract. A current, complete inventory of all equipment purchased under the terms of
this Contract must be kept.
D: The Provider agrees to retain all books, records and other documents relevant to this
Contract for three years after final payment or until all audits continued beyond this period
are completed. Federal auditors and any persons authorized by the Division of Social
Services or the Department shall have the right to examine any of these materials. In
records produced under this Contract will be turned over to the Department.
SECTION V: SUBCONTRACTING
The Provider shall not subcontract any of the work contemplated under this Contract without
obtaining prior written approval from the Department. Any approved subcontract shall be
subject to all conditions of this Contract. The Provider shall be responsible for the
performance of any subcontractor.
SECTION VI: MAINTENANCE OF EFFORT
The Provider certifies that the funds to be used under this Contract do not replace or supplant,
in any way, Federal, State or local funds for already existing services..
SECTION VII: MONITORING AND EVALUATION
A. The Provider agrees to participate in program, fiscal and administrative monitoring or
audits, making records an staff time available to Federal, State and county staff.
B. The Provider agrees to take necessary steps for corrective action, as negotiated within a
corrective action plan, for any items found to be out of compliance with Federal and State
laws, regulations, standards and/or terms of this Contract.
- Page 4 of 5
SECTION VIII: AMENDING THE CONTRACT
This contract in whole or in any part may be amended at any time:
A. By the Department in the event that such amendment is necessary to comply with
applicable laws, regulations, policies and standards; and by mutual consent of both parties.
B. Each party to this contract will notify the other immediately in writing if an amendment
becomes necessary due to alterations in the activities described in Attachment A or for any
other reason.
SECTION IX: TERMINATION
A. This contract, in whole or in any part, may be cancelled at any time:
1. By any party, with cause, upon at least 30 days notice, in writing, and delivered by
registered mail with return receipt requested or in person, or
2. By the Department in the event reimbursement to the Department is not available
and/or continued at an aggregate level sufficient to allow for the purchase of the
indicated quantity of service. The obligations of each party shall be terminated to the
extent specified in the notice of termination, immediately upon receipt of the notice of
termination from the Department, or
3. By the Department in the event that the Division of Social Services/Department
determines that the Provider is in violation of any or all of the terms of this Contract.
The obligations of each party shall be terminated to the extent specified in the notice
of termination immediately upon receipt of the notice from the Department, or
4. By mutual consent of all parties.
B. In the event of termination in part, all parties shall continue the performance of this
Contract to the extent not terminated.
C. If this Contract is terminated, in whole or in part, the Provider may be required to deliver
and transfer Title or assignment of interest to the Division of Social Services or dispose of
any property specifically produced or acquired for the performance of such part of this
Contract as has been terminated, and the Provider shall, upon the direction of the Division
of Social Services, protect and preserve property in the possession of the Provider in
which the Division of Social Services has an interest.
D. After receipt of a notice of termination, and except as otherwise directed by the
Department, the Provider shall cease work under the Contract on the date, an to the
extent specified, in the notice of termination. The Department shall pay the Provider the
agreed upon amount for the delivery of services under the terms of this Contract up to the
Page 5 of 5
effective date of termination. Reimbursement shall not be made for equipment or supplies
purchased after the notice of termination is received except as approved by the
Department.
E. Waiver of any default shall not be deemed to be a waiver of any subsequent default.
Waiver of breach of any provision of the Contract shall not be deemed to be a waiver of
any other subsequent breach and shall not be construed to be a modification of the terms
of this Contract unless stated to be such in writing, signed by an authorized representative
of the Department and attached to the Contract.
SECTION X: CONCLUSION
It is expressly understood an agreed that the services provided to eligible clients pursuant to
this Contract shall consist exclusively of those services specified in the attached program
description incorporated into this Contract as Attachment A.
It is further understood and agreed that the provision of services pursuant to this Contract
shall be subject to the limitations and conditions contained in the laws. regulations,
guidelines and plans cited in this Contact, and that this Contract is subject to renegotiation or
revision to meet any new or revised rules, regulations, or policies that may be issued by the
Department of Health and Human Services, or the North Carolina Social Services
Commission, or the Department of Human Resources and that are communicated to the
Provider.
PROVIDER
DEPARTMENT
Employment Security Commission Orange County Department of Social Services
By: - By;
Title: Manager Title: Director
Date: ~ f7 ~l ~` g Date:
This Agreement has been preaudited in the manner required by the local Government Budget
and Fiscal Control Act.
ATTEST:
County: Orange
Title: Finance Director
Signature: ~%~.-~ ~- ~~
Date: s~a-~~%~
SECTION XI: CERTIFICATION
The Orange County Board of Social Services supports the need for this performance-
based contract with the Employment Security Commission to provide job search, and job
development for Work First Participants.
_~~
Rosette Moore, Chair ~
Orange County Board of Social Services
Assisting families make the transition from welfare to work is a priority in Orange
County. The Orange County Board of County Commissioners, in response to the needs
of the Work First population, supports approves the contracts for job search and job
development and placement services from the Employment Security Commission.
`'Y~
Alice Gordon, Chairperson
Orange County Board of County Commissioners
STATE OF NORTH CAROLINA
DIVISION OF SOCIAL SERVICES
.PURCHASE CONTRACT BUDGET
SUMMARY Effective
Provider Employment Security Commission ID# 68EOI Period 7/1/1999 through 6/30/2000
Part I -Estimated Expenditures
Object of Expenditure Total Non- Matchable Total Matchable
Program Costs Costs
Costs (2) (3)
(I)
A. Salaries $27,678
B. Fringe Benefits 6,694
C. Staff Development-Services 1,000
D. Travel '
E. Equipment Purchase-Tangible Property
F. Transportation-Recipient
G. Medical Supplies and Expense
H. Cost of Space-Non-Residential
I. Room &Board-Residential Treatment
J. Service Payments
K. Other
L. Indirect Costs
$ 3,590
M. Totals $38,962
Part li -Computation of Unit Cost or lndividual mixed Kate
A. 1. Total Matchable Costs $ N/A
2. Less: Eamed Income for Unit Cost Method $
3. Net Matchable Costs ~ $
B. 1. Total Service Unit Capacity, or
2. Total Anticipated Utilization Capacity
Method of Computation or Source of Data
D. Estimated Unit Cost or Individual Fixed Rate: $ per
Part III -Distribution of Estimated Revenue for Total Cost Reimbursement Method
(a) (b)
A. Estimated Eligible and Matchable Costs Number Ratio
1. Estimated Eligible Clients 250 100%
2. Estimated ineligible Clients 0 0%
3. Total Clients 250 100%
B. Eligible Costs
(1) Matchable (2) Less (3) Net (4) (5) Costs Eligible
Costs Earned Matchable Estimated % for Financial
[Part 1, Line M, Income Costs of Eligibles Participation
col. (3) [B. (1) Less (2)}] [A. 1. (b)] [B. (3) x (4}]
$ $ $ $ $
A. Program Costs ~ Amount Source of Funds
1. Federal/State Funds $ Work First
2. Local Matching Share $ County
3. Other Budgeted Funds $
4. TOTAL REVENUE $ 38.962
B. Fees (If Applicable)
1. Administrative Fee $
2. Certification Fee $
3. TOTAL FEES $
Part V-Reimbursement Projections (For Title XX Providers Only)
Annual Projection July- September October-June
Projection Projection
A.$ B.$ C.$
Signed: Date: ~~ ~~
Provider/ uthorized Official
Date:
County Director or Designee
Purchase Contract Budget
Supporting Budget Schedules
A. Salary Sc hedule
(1) (2) (3) (4) (5) (6) (7)
Number Pay % of No. of Annual Total
of Persons Position or Title Grade Time Months Salary Cost
Employed
1 Job Development Specialist N/A 100 % 12 $27,678 $27,678
Total - Sa laries
B. Fringe Benefits
(1) (2) (3)
Total
Type Method of Computation Cost
FICA
Health Ins.
Retirement
Worker's Compensation
Unemployment Insurance
Total -Fringe Benefits $6,694
C. Staff Development -Service Funds Schedule
(1)
Item (2)
Total
Cost
Total Staff Development -Service Funds
D. Travel Schedule
(1) (2) (3) (4) (5) Daily Subsistence (8)
No. of
Persons
Position or Title No. of
Miles/Days Rate per
Mile No. of
Days (6)
Rate (7)
Days Total
Cost
1 Job
Development
Specialist 12
Months $1000.
Total -Travel $1000
E. Equipment -Tangible Property Schedule
(1}
No. of
Units (2)
Item (3)
Cost per Unit (4)
Total Cost
N/A
Total Equipment -Tangible Property
F. Recipient Transport ation Schedule
(1)
Item (2)
Method of Computation (3)
Total
Cost
N/A
1 a. Salaries
# of
Persons Position or Title Pay
Grade % of
Time # of Months
Employed Annual
Salary
N/A
lb. Fringe Be nefits
Type Method of Computation
NIA
Total Recipient Transportation
v. nneaica~ ~upphes and h;xpenses Schedule
(1)
Item (2)
Total
Cost
N/A
Total -Medical Supplies and Expense
H. Cost of Space -Non-Residential Schedule
(I)
Item (2)
Total
Cost
N/A
Total Cost of Space -Non-Residential
I. Room and Board Costs -Residential Treatment
(1)
Item (2)
Method of Computation (3)
Total
Cost
N/A
Total Room and Board Costs - Residential Treatment
J. Service Payment Schedule
(1)
No. of
Units (2)
Item (3)
Cost per Unit (4)
Total
N/A
Total -Service Payment
K. Other Expense Schedule
(1)
Item (2)
Total
Cost
N/A
Total -Other Expense
L. Indirec t Cost Schedule
(1)
Rate (2)
Rate Applied To: (3)
Amount Rate Applied To: (4)
Total
12.97% Salary $27,678 $3,590
Total -Indirect Cost $3,590
ATTACHMENT A
State of North Carolina
Division of Social Services
Contract Application
Page 1 of 7
I. Contract Summary
A. This agreement is between the Orange County Department of Social
Services (hereinafter referred to as the "Department")and the Employment Security
.Commission (heretofore and hereinafter referred to as the "Provider").
B. This agreement shall be in effect from 7/1/1999 to 6!30/2000
C. Services to be Provided:
(1)
Service (2)
Service Code (3)
Number of
Persons Served (4)
Number of Units
of Service (5)
Definition of
Unit of Service
Job Development
and Placement 546 125 125 One Participant
Job Readiness/
Job Search ~ 547 250 250 One Participant
Any additional services should be listed in III. -Service Program Description
D. Area to be Served: Orange. County
State of North Carolina
Division of Social Services
Contract Application
E. Contract Identification:
1. Provider
a. Name of Contract Administrator
Tel. # : (919) 967-0177
b. Name of Program Contact Person:
Tel. #:
Same
c. Program Name, Location and Mailing Address: Employment Security Commission
110 W. Main St.
Carrboro~, NC 27510
d. Additional Service Delivery Sites:
e. Status : (X )Public ()Private, non-profit
( )Private, for Profit ()Individual
f. Provider Contract ID #: 68E01
2. County Department of Social Services
a. Name of Contract Administrator: Marti Pryor-Cook
Tel. # : (919) 732-8181
b. Name Services Program Contact Person: Gwendolyn Price
Tel. #: (919) 732-8181
c. Address of County Department of Social Services:
P.O. Box 8181
300 W. Tryon St.
Hillsborough, NC 27278
Page 2 of 7
Pennell
State of North Carolina
Division of Social Services
Contract Application
Page 3 of 7
II. Fiscal Provisions
A. Amount of Reimbursement:
Reimbursement under the terms of this agreement will be limited to a maximum of
$ 32,916 TOTAL = $ SSBG + $ IV-B + $ RAP +
$ State + $ County + $ Other (identify) : Federal, State
and Local TANF Dollars
(Optional : County funds consist of $ for
for
.)
(funding source)
B. Method of Reimbursement:
1. For Purchase Contract (DSS-2497) Total and Unit Cost:
and$
(X) a. Reimbursement will be made in accordance with the current budget approved by
the Department and on file with both parties. The amount of reimbursement. will be
based on allowable expenditures made in behalf of eligible clients, determined in a
accordance with acceptable cost allocation methods. The Provider will report all
expenditures made under the terms of the contract.
() b. Reimbursement will be made at a unit cost rate of $ per unit of
reimbursement delivered to eligible clients for an estimated number of
units. The Provider will document total expenditures made under the terms of the
contract to the Department within thirty days after the termination of this contract,
or as instructed by the Department. Reimbursement which exceeds actual allowable
cost will be adjusted to actual allowable cost.
2. For Vendor Agreements (DSS-2252) Fixed Rate
Reimbursement will be based on:
() a. a standard fixed rate or
() b. an individual fixed rate.
c. Reimbursement will be made at a fixed rate of $ per unit of
(define) for as estimated number of units.
Reimbursement will be based on the actual number of units delivered whether over
or under the estimated number. If multiple components are being purchased,
additional rates and units can be identified as follows:
State of North Carolina
Division of Social Services
Contract Application
Page 4 of 7
C. Reimbursement Reparting:
1. Expenditures
The Provider will report expenditures monthly in accordance with policy set forth by
the Controller's Offices, Division of Social Services, issued via the Fiscal Manual.
Expenditures are to be reported on the DSS Administrative Cost Report (Form DDSs-
1571,Part III). Reports are to be submitted to the Department by the fifth working
day of the month following the month in which services were delivered. The
Department will reimburse the Provider monthly, usually by check, upon receipt of a
completed and correctly filed report.
2. Reporting for the Statewide Services Information System (SIS)
In addition to the Administrative Cost Report (DSS-1571, Part III), the Provider will
submit to the Department the Monthly Report of Service Delivery (DSS Form 1571,
Part IV). This should be submitted along with the Administrative Cost Report by the
fifth working day of the month following the month in which services were delivered.
The units reported in Column 12 of the 1571 Part IV are the units of service defined in
Column 5 of I.C. of this Attachment. Service definition and reporting instructions are
found in Family Services Manual, Volume VI, Chapter IV.
D. Audit Requirements
The Provider shall be responsible for compliance with the audit requirements of
Department of Health and Human Services federal regulation 45 CFR Part 74,
Administration of Grants, or State Administrative Procedures Manual for Federal Block
Grant Funds, whichever is applicable. These regulations stipulate that an annual audit be
performed for the fiscal year in which contract funds were received.
() 1. NA
Private, non-profit if amount of reimbursement received is under $ 1,000; private,
for profit or individual
() 2. (Applicable to Private, Non-Profit Providers if reimb. $1,000 or over)
An annual audit is to be performed in accordance with OMB Circular A-110 by an
"independent auditor." Independent auditor" means either: (a) a state government
auditor from the Department of Human Resources or the Department of
Administration, Office to the State Auditor; or (b) a certified public accountant.
Upon completion of the audit, a copy of the audit report must be forwarded to the
county department of social services.
State of North Carolina
Division of Social Services
Contract Application
Page 5 of 7
() 3. (Applicable to Public Hospitals, Colleges, and Universities)
The annual audit must be performed in accordance with OMB Circular A-110.
It is not necessary for the institution to program audits performed separately
from anall-inclusive single audit which entails all revenues and expenditures
of the public agency. However, it is the responsibility of the contractor to
insure that the contract program is included in the institution's single annual
audit.
A copy of the audit report must be provided to the County department of
Social Services upon completion of the annual audit.
(X) 4. (Applicable to State or Local Government Agencies)
An annual audit is to be performed in accordance with OMB Circular A-128 by
an independent auditor. Upon completion of the audit, a copy of the audit
report must be forwarded to the county Department of Social Services.
E. Client Fees for Service
(X) 1. No fees will be -charged to individuals determined to be eligible for services
by the department of social services.
() 2. The service(s) under contract with the Provider are services for which a client
fee may be assessed. Policy regarding the assessment and collection of fees is
contained in Family Services Manual, Volume VI, Chapter III. If a client is to
to be charged a fee, the department will inform the Provider of the amount of
fee to be charged and of any subsequent changes by way of the Purchase of
Service Referral and Authorization (DSS Form 1360). The Provider will
establish a plan with the client for collecting the fee on at least a monthly basis;
and when fees are not paid within ten days of the due date, will bill the client in
writing and send a copy of the bill to the Department. NO OTHER FEES FOR
SERVICES MAY BE CHARGED TO THE CLIENT. Client fees are to be
reported on the Monthly Report of Service Delivery (DSS Form 1571, Part
IV).
F. Management of the Funding/Matching Share Requirement
() 1. A cash transfer of the matching share will be made to the county department of
social services in accordance with the terms specified in the Donation
Agreement (DSS-1319).
State of North Carolina
Division of Social Services
Contract Application
Page 6 of 7
() 2. The provider certifies through the contract budget attached to this contract that
the matching share in available. Further, it is agreed that the provider will
report all program costs incurred each month relating to this contract on the
DSS-1571. However, reimbursement will be limited to the federaUstate
financial participation rate.
(X) 3. The county department of social services is providing the match.
G. Provider Fees (For Purchase Contracts Only)
() 1. The Provider agrees to pay the Department/Division up to $
Administrative Fee as payment in full for the administration of the contract.
The amount of the fee is five percent of the matching share contributed by the
Provider.
() 2. The Provider agrees to pay the Department up to $ Certification Fee
as payment in full for the determination and certification of client eligibility.
The amount of the fee is five percent of the matching share contributed by the
Provider.
Monitoring and Certification Fees, when applicable, will be deducted from the
amount to be reimbursed.
State of North Carolina Page 7 of 7
Division of Social Services
Contract Application
III. Service Program Description
Orange County Department of Social Services (DSS) is purchasing the services of a Job
Development Specialist from the Employment Security Commission of North Carolina.
The General Assembly considers the Employment Security Commission the state's
primary job placement authority. The Job Development Specialist will be stationed at the
DSS and will be providing services to Work First participants. The following services
are included in this contract:
• Vocational Assessment and Employment Counseling,
• Job Readiness Training and Job Club,
• First Stop Registration,
• Process Unemployment Insurance Claims
• Job Development and Placement (placements include direct placements and
entered employments),
• Follow-up Services
Job Development Specialist Duties
The Job Development Specialist will assess and counsel Work First participants who are
referred with an objective of locating employment. Job readiness and job club activities
will include but are not limited to information about employer expectations, appropriate
dress and grooming, resume preparation, goal setting, and networking.
Other duties of the Job Development Specialist are as follows:
• Interview applicants/participants to determine work history, education, training, and
skills,
• Conduct file searches of suitable job openings,
• Refer applicant to employers, .
• Perform job development contacts with employers to obtain job orders,
• Provide labor market information to employers, applicants, and other agencies, .
• Determine eligibility for unemployment insurance, and
• Follow-up with applicants and employers in an effort to impact job retention.
Performance Measures
North Carolina's Work First Program, implemented in July 1995, is one of the most.
comprehensive welfare reform efforts in the nation. The guiding principles of Work First
requires parents to take personal responsibility for their children, limits the receipt of
Work First Cash Assistance (temporary and short-term), and requires parents to work.
The Orange County Department of Social Services, in conjunction with the Employment
Security Commission have identified the following performance measures.
• Locate full-time employment for 125 Work First participants.
• Perform 45 employer visits to develop job openings for Work First participants.
• Conduct monthly job readiness workshops.
• Maintain contact with participants and employers for three months after placement.