HomeMy WebLinkAbout2003 S Social Services - Orange County Schools Contracts for Adolescent Parenting ServicesSTATE OF NORTH CAROLINA
DIVISION OF SOCIAL SERVICES
PURCHASE CONTRACT
ID # 68E21
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This Contract is entered into between the Department of Social Services and Orange
County Schools (referred to as Provider) identified on Attachment A. This contract shall
consist of form DSS-2497, Attachment A(DSS-1292) and Budget (DS5-6844).
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
5. 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
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3. Comply with all State licensing standazds, all applicable accrediting standazds 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 Cazolina'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 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.
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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 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 pirocedures 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.
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SECTION VIII: AMENDING THE CONTRACT
This contract in whole or in any part maybe 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, maybe canceled at any time:
1. By any party, with cause, upon at least 3Q 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 maybe 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
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.
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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 renegotiations or revision to
meet any new or revised rules, regulations, or policies that maybe 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
Oran~a County Schools
By: ~' -
Title: Superintendent
Date: ~ r, - ~. ~ ~ ~ 3
DEPARTMENT
Orange County Department of Social Services
By:
Title: Director
Date: ~~/ ~3
This Agreement has been preaudited in the manner required by the local Government Budget
and Fiscal Control Act.
ATTEST:
Orange County Finance Officer
Signature: ~.~~~
Date: ~`><~.3
Signature: W ~
Date: ~ /2 ~ /
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SECTION XI: CERTIFICATON
The Orange County Board of Social Services supports this performance based contract with
the Orange County Schools System to provide expanded case management services to
pregnant and parenting teens.
~ , 2~0~
Dorothy'Gamble, L it
Orange County Boa d of Social Services
ATTACHMENT A
State of North Carolina
Division of Social Services
Contract Application Page 1 of ~_
I. Contract Summary
A. This agreement is between the Orange County Department of Social Services (hereinafter
referred to as the "Department") and the Orange County Schools (heretofore and hereinafter
referred to as the "Provider").
B. This agreement shall be in effect from 7/01/03 to 6/30/04
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
Case Mana ement 522 16 16 1 teen anent
Information/
Referral
520
Education/Training 527
Any additional services should be listed in III. -Service Program Description
D. Area to be Served: Orange County School District
State of North Carolina
Division of Social Services
Contract Application
Page 2 of 7
E. Contract Identification:
1. Provider
a. Name of Contract Administrator Dr Shirley Carraway
Tel. # : (919) 732-8126
b. Name of Program Contact Person:
Tel. #: (919) 732-6271
Donna Williams
c. Program Name, Location and Mailing Address
Orange County Schools
Hillsborough NC 27278
d. Additional Service Delivery Sites:
e. Status : (X) Public ()Private, non-profit
()Private, for Profit ( )Individual
f. Provider Contract ID #:
2. County Department of Social Services
a. Name of Contract Administrator: Nancy Coston
Tel. # : (919) 732-8181
b. Name of Services Program Contact Person: Gwen Price or Valerie Collins-Russell
Tel. #: (919) 732-8181
c. Address of County Department of Social Services:
300 W Tryon St -
Hillsborough, NC 27278
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
$ 39,682.01 TOTAL = $ SSBG + $ IV-B + $ RAP +
$ State + $ County + $ Other (identify) :TANF Block
Grant
(Optional : County funds consist of $ for and $
for
(funding source)
B. Method of Reimbursement:
1. For Purchase Contract (DSS-2497) Total and Unit Cost:
(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 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 are to be reported on the DSS Administrative Cost Report (Form DSS-
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. 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 maybe 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 chugged 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)
(NA) 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.
(NA) 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
Division of Social Services
Contract Application
Page 7 of 7
III Service Program Description
The contract between Orange County Department of Social Services and Orange County
Schools was a result of a response to a request for proposals. The Welfare Reform Task
Force identified the need for services expanded services to teen parents.
The Intensive Teen Support Project was designed to expand case management services to
pregnant and parenting teens. Research studies support that intervention and preventive
services to teen significantly impact their ability to successfully care for their children and to
be self-sufficient.
The goals of the project are:
• Keep teen parents in school
• Help teens avoid a second pregnancy
• Improve health care for the teen parent and the child
• Assist teens further their education
• Prepare teens for employment and self-sufficiency by strengthening the employability
skills of teen parents
• Enhance parenting skills
Orange County Schools will hire afull-time social worker to provide case management
services to eligible teens, serve on the Adolescent Parenting Community Advisory
Committee, coordinate teen support group meetings, recruit and train volunteers, complete
required documentation, and submit monthly reports. The social worker will facilitate a
school based support group for teen parents focusing on health, academic, and career planning
issues. In an effort to ensure collaboration within the schools, monthly team meetings to
coordinate health care, education, child care issues and family dynamics will continue.
Reimbursement
Orange County Schools will be reimbursed based for expenditures as outlined in this contract
in the Purchase Contract Budget. Verification of expenditures must be submitted to the
Department of Social Services on a monthly basis and no later than the Sa' of the month
following the month of expenditure. Reimbursement will be processed within 15 days of
receipt.
Performance Measures
• Maintain a caseload of 12-16 teen parents
• Develop a case plan with each teen parent outlining specific goals
• Participate in bi-monthly CAC meetings
• Submit a monthly status report by the 2°d workday of the month
• Recruit, train and match volunteers with teens
• Maintain data on number of teen parents within school system
Outcomes
• 85 percent of teen mothers active in the program will avoid a second pregnancy
• 85 percent of teen mothers will continue their education
STATE OF NORTH CAROLINA
DIVISION OF SOCIAL SERVICES
PURCHASE CONTRACT BUDGET
SUMMARY Effective
Provider ~ana,e Crnw+._; SchcLls ID# period 7/1 /n~ throug116/3~1~4
Part I -Estimated Expenditures
Object of Expenditure Total Non- Matchable Total Matchable
Program Costs Costs Costs
(1 (2) 3
A. Salaries 29,361.62
B. Fringe Benefits 7,320.39
C. Staff Development-Services 1,000.00
D. Travel 1,000.00
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 1000.00
L. Indirect Costs
M. Totals 39,682.01
Yart 11 -Computation of Unit Cost or Individual Fixed Rate
A. 1. Total Matchable Costs
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) ro)
A. Estimated Eligible and Matchable Costs Number Ratio
1. Estimated Eligible Clients 16
2. Estimated ineligible Clients
3. Total Clients
16
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 Eligible Participation
col. (3) [B. (1) Less (2) [A. 1. (b B. (3) x (4)]
$ $ $ $ $
A. Program Costs
1. FederaUState Funds
2. Local Matching Share
3. Other Budgeted Funds
4. TOTAL REVENUE
Amount Source of Funds
$ 39.682.01 Work First Proms
$ 39.682.01
7. 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
Projection October-June
Projection
A. $ B. $ C. $
Signed:
Provi / uthorized fficial
o ty ector or Designee
Date: ~P - ~ ~ '~ 3
Date: ~/' ~~
Purchase Contract Budget
Supporting Budget Schedules
A. Sal Sc hedule
(1) (2) (3) (4) (5) (6) ~~)
Number Pay % of No. of Annual Total
of Persons Position or Title Grade Time Months Salary Cost
Em Toyed
1 Social Worker 100% 11 29,361.62 29361.62
Total - Sa laries 29,361.62
B. Fringe Benefits
(1) (2) (3)
Total
T e Method of Com utation Cost
Social Security 29361.62 X 7.65 % 2,246.16
Retirement 29361.62 X 8.83% 2,592.63
Hospital Insurance 226 X 11 2,481.60
Total -Fringe Benefits 7,320.39
.C. Staff Develo ment -Service Funds Schedule
(1)
Item (2)
Total
Cost
Conference and training workshops 1000
Total Staff Development -Service Funds 1000
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 (6)
Rate (7)
Days Total
Cost
1 Social Worker 2,740 @.365 mile 1000
Total -Travel 1000.00
E. E ui ment -Tan 'ble Pro erty Schedule
(1)
No. of
Units (2)
Item (3)
Cost er Unit (4)
Total Cost
Total Equipment -Tangible Property
F. Reci ient Trans ort ation Schedule
~1)
Item ~2~
Method of Computation ~3~
Total
Cost
1 a. Salaries
# of
Persons Position or Title Pay
Grade % of
Time # of Months
Employed Annual
Salary
lb. Frin e Benefits
Type Method of Computation
Total Recipient Transportation
G. Medical Su lies and Ex enses Schedule
(1)
Item (2)
Total
Cost
Total -Medical Su plies and Ex ense
H. Cost of S ace -Non-Residential Schedule
(1)
Item (2)
Total
Cost
Total Cost of S ace -Non-Residential
I. Room and Board Costs -Residential Treatment
~l)
Item ~2)
Method of Computation f3)
Total
Cost
Total Room and Board Costs - Residential Treatment
J. Service Payment Schedule
(1)
No. of
Units (2)
Item (3)
Cost er Unit (4)
Total
Total -Service Pa ent
K. Other Ex ense Schedule
(1)
Item (2)
Total
Cost
Instructional Materials 1000.00
Total -Other Ex ense 1000.00
L. Indirect Cost Schedule
(1)
Rate (2)
Rate Ap lied To: (3)
Amount Rate Applied To: (q)
Total
Total -Indirect Cost