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HomeMy WebLinkAbout2014-211 Aging - TJCOG Area Agency on Aging for Medicare Improvements for Patients and Providers Act (MIPPA) —Please return this copy to the Clerk to the Board's — office for permanent agenda file. Z jj November 1, 2013 Through September 29, 2014 Medicare Improvements for Patients and Providers Act (MIPPA) Contract for the Provision of County Based MIPPA Services This contract is hereby entered into by and between Triangle J Council of Governments Area Agency on Aging (TJAAA), (the "Provider") and Orange County -= "(the "Subcontractor") (referred to collectively as the "Parties"). The Subcontractor's federal tax identification number 1. Contract Documents: This contract consists of the following documents, which are incorporated herein by reference: a. This contract b. General Terms and Conditions for Public Sector Contracts (Attachment A) c. Statement of Work (Attachment B) d. Line Item Budget and Budget Narrative (Attachment C) e. Certifications Regarding Drug-Free Work-Place, Lobbying: and Debarment, Suspension and Other Responsibility Matters (Attachment D) These documents constitute the entire agreement between the Parties and supersede all prior oral or written statements or agreements. 2. Precedence Among Contract Documents: In the event of a conflict between or among the terms of the Contract Documents, the terms in the Contract Document with the highest relative precedence shall prevail. The order of precedence shall be the order of documents as listed in the contract document section, with the first-listed document having the highest precedence and the last-listed document having the lowest precedence. If there are multiple contract amendments, the most recent amendment shall have the highest precedence and the oldest amendment shall have the lowest precedence. 3. Effective Period: This contract shall be effective 11.1.2013 and shall terminate on 9.29.2014. 4. Subcontractor's Duties: The Subcontractor shall provide the services as described in the Statement of Work (Attachment B) and in accordance with the approved Line Item Budget and Budget Narrative (Attachment C). 5. Provider's Duties: The Provider shall pay the Subcontractor in the manner and in the amounts specified in the contract documents. The total amount paid by the Provider to the Subcontractor under this contract shall not exceed $ 3.500. (CFDA#93.071) There are no matching requirements. 6. Conflict of Interest Policy/Statement: The Provider has determined that this Contract is not subject to NCGS 14-C-6- 22 & 23. 7. Reversion of Unexpended Funds: Any unexpended grant funds shall revert to the Provider upon termination of this contract. 8. Grants: The Subcontractor has the responsibility to ensure that all sub-grantees, if any, provide all information necessary to permit the Subcontractor to comply with the standards set forth in this contract. 9. Payment Provisions: Payment provisions of this contract are as follows: a. An amount equal to one-half the total amount will be made upon final execution of contract; and, b. Pending compliance with monthly reporting requirements outlined in the Statement of Work(Attachment B), the final one-half allotment will be processed and paid upon receipt of the monthly compliance and budget report due on July 10, 2014. 10. Contract Administrators: All notices permitted or required to be given by one Party to the other and all questions about the contract from one Party to the other shall be addressed and delivered to the other Party's contract administrator. The name, post office address, street address, telephone number, fax number, and email address of the Parties' respective initial contract administrators are set out below. Either Party may change the name, post office address, street address, telephone number, fax number, or email address of its contract administrator by giving a written 30 day notice to the other Party. For the Provider: IF DELIVERED BY US POSTAL SERVICE IF DELIVERED BY ANY OTHER MEANS Joan M. Pellettier, Director, Area Agency on Aging Triangle J Council of Governments Area Agency on Aging SAME 4307 Emperor Blvd., Suite 110 Durham, NC 27703 Telephone : 919 558-9398 Fax: 919 549-9390Main_Fax Email:jpellettier @tjcog.org For the Subcontractor: IF DELIVERED BY US POSTAL SERVICE IF DELIVERED BY ANY OTHER MEANS Janice Tyler, Orange County Dept. on Aging Director Orange County SAME 2551 Homestead Road Chapel Hill, NC 27516 Telephone: 919-245-4255 Fax: 919-968-2093 Email: jtyler @orangecountync.gov 11. Supplementation of Expenditure of Public Funds: The Subcontractor assures that funds received pursuant to this contract shall be used only to supplement, not to supplant, the total amount of federal, state and local public funds that the Subcontractor otherwise expends for contract services and related programs. Funds received under this contract shall be used to provide additional public funding for such services; the funds shall not be used to reduce the Subcontractor's total expenditure of other public funds for such services. 12. Disbursements: As a condition of this contract, the Subcontractor acknowledges and agrees to make disbursements in accordance with the following requirements: a. Implement adequate internal controls over disbursements; b. Pre-audit all vouchers presented for payment to determine: • Validity and accuracy of payment • Payment due date • Adequacy of documentation supporting payment • Legality of disbursement c. Assure adequate control of signature stamps/plates; d. Assure adequate control of negotiable instruments; and e. Implement procedures to insure that account balance is solvent and reconcile the account monthly. 13. Outsourcing: The subcontractor agrees that it will not outsource any jobs related to this contract without providing notive to the Provider. 14. Signature Warranty: The undersigned represent and warrant that they are authorized to bind their principals to the terms of this agreement. 15. Federal Certifications: Individuals and Organizations receiving federal funds must ensure compliance with certain certifications required by federal laws and regulations. The Subcontractor is hereby complying with Certifications regarding Nondiscrimination, Drug-Free Workplace Requirements, Environmental Tobacco Smoke, Debarment, Suspension, and Lobbying. These assurances and certifications are Attachment D. The signature page is to be signed by the Subcontractor's authorized representative. In Witness Whereof, the Subcontractor and the Provider have executed this contract in duplicate originals, with one original being retained by each party. Triangle J Council of Governments Area Agency on Aging (TJAAA) n . Pellettier, Director AAA Date Attest Or Witness Sign ure U Date A,­:�h 1,-. � Pry Pr cam Printed Name- Title ORANGE CO N Sig ature Date 01C_ cIa I S, Coy Printed Name Title Attest Or Witness Signature Date S . Printed Name Title This instrument ha een approved as to technical content. Janie yler, DepaAment Director This instrument has been pre-audited in the manner required by the Local Government Budget ancl§cal Control Offic of the Finance Director Thi I i has been approved as to form and legal sufficiency. Office of the ou y Attorney Provision for payment of the monies to fall due under this Agreement within the current federal fiscal year have been made by appropriation duly authorized as required by the Local Government Budget and Fiscal Control Act BY: A- Ixa L== Judy A. Weller Finance Director Triangle J Council of Governments Attachment A GENERAL TERMS AND CONDITIONS Availability of Funds: The parties to this contract agree Confidentiality and understand that the payment of the sums specified in this contract is dependent and contingent upon and subject Confidentiality: Any information, data, instruments, to the appropriation,allocation, and availability of funds for documents, studies or reports given to or prepared or this purpose to the Contractor from federal,state and local assembled by the Subcontractor under this agreement sources. shall be kept as confidential and not divulged or made available to any individual or organization without the prior Force Majeure: Neither party shall be deemed to be in written approval of the Contractor. The Subcontractor default of its obligations hereunder if and so long as it is acknowledges that in receiving, storing, processing or prevented from performing such obligations by any act of otherwise dealing with any confidential information it will war, hostile foreign action, nuclear explosion, riot, strikes, safeguard and not further disclose the information except civil insurrection, earthquake, hurricane, tornado, or other as otherwise provided in this contract. catastrophic natural event or act of God. Oversight Survival of Promises: All promises,requirements,terms, conditions, provisions, representations, guarantees, and Access to Persons and Records: The Contractor, warranties contained herein shall survive the contract County,Area Agency on Aging, Division of Aging and Adult expiration or termination date unless specifically provided Services, other authorized officials of the Contractor, otherwise herein, or unless superseded by applicable funding authorities, the North Carolina State Auditor, Federal or State statutes of limitation. and/or applicable federal agencies shall have access to persons and records as a result of all contracts or grants Intellectual Property Rights entered into by State agencies or political subdivisions in accordance with General Statute 147-64.7. Additionally, Copyrights and Ownership of Deliverables: All as a State funding authority,the Department of Health and deliverable items produced pursuant to this contract are Human Services shall have access to persons and records the exclusive property of the Contractor. The as a result of all contracts or grants entered into by State subcontractor shall not assert a claim of copyright or other agencies or political subdivisions. property interest in such deliverables. Record Retention: Records shall not be destroyed, Federal Intellectual Property Bankruptcy Protection purged or disposed of without the express written consent Act:The Parties agree that the Contractor shall be entitled of the Contractor. State basic records retention policy to all rights and benefits of the Federal Intellectual Property requires all grant records to be retained for a minimum of Bankruptcy Protection Act, Public Law 100-506,codified at five years or until all audit exceptions have been resolved, 11 U.S.C. 365 (n) and any amendments thereto. whichever is longer. If the contract is subject to federal policy and regulations, record retention may be longer than Compliance with Applicable Laws five years since records must be retained for a period of three years following submission of the final Federal Compliance with Laws: The Subcontractor shall comply Financial Status Report, if applicable, or three years with all laws, ordinances, codes, rules, regulations, and following the submission of a revised final Federal licensing requirements that are applicable to the conduct of Financial Status Report. Also, if any litigation, claim, its business, including those of federal, state, and local negotiation, audit, disallowance action, or other action agencies having jurisdiction and/or authority. involving this Contract has been started before expiration of the five-year retention period described above, the Equal Employment Opportunity: The Subcontractor records must be retained until completion of the action and shall comply with all federal and State laws relating to resolution of all issues which arise from it, or until the end equal employment opportunity. of the regular five-year period described above,whichever is later. The record retention period for Temporary Health Insurance Portability and Accountability Act Assistance for Needy Families(TANF)and MEDICAID and (HIPAA): The Subcontractor agrees that, if the Medical Assistance grants and programs must be retained Contractor determines that some or all of the activities for a minimum of ten years. within the scope of this contract are subject to the Health Insurance Portability and Accountability Act of 1996, P.L. Warranties and Certifications 104-91, as amended ("HIPAA"), or its implementing regulations, it will comply with the HIPAA requirements Date and Time Warranty: The Subcontractor warrants and will execute such agreements and practices as the that the product(s)and service(s)furnished pursuant to this Contractor may require to ensure compliance. contract("product"includes,without limitation,any piece of equipment, hardware, firmware, middleware, custom or Time of the Essence: Time is of the essence in the commercial software,or internal components,subroutines, performance of this contract. and interfaces therein) that perform any date and/or time data recognition function, calculation, or sequencing will Key Personnel: The Contractor shall not replace any of support a four digit year format and will provide accurate the key personnel assigned to the performance of this date/time data and leap year calculations. This warranty contract without the prior written notification of the shall survive the termination or expiration of this contract. Contractor. The term"key personnel'includes any and all persons identified by as such in the contract documents Certification Regarding Collection of Taxes: G.S. 143- and any other persons subsequently identified as key 59.1 bars the Secretary of Administration from entering into personnel by the written agreement of the parties. contracts with vendors that meet one of the conditions of G.S. 105-164.8(b) and yet refuse to collect use taxes on Care of Property: The Subcontractor agrees that it shall sales of tangible personal property to purchasers in North be responsible for the proper custody and care of any Carolina. The conditions include: (a) maintenance of a property furnished to it for use in connection with the retail establishment or office; (b) presence of performance of this contract and will reimburse the representatives in the State that solicit sales or transact Contractor for loss of, or damage to, such property.At the business on behalf of the vendor; and (c) systematic termination of this contract, the Subcontractor shall contact exploitation of the market by media-assisted, media- the Area Agency on Aging for instructions as to the facilitated, or media-solicited means. The Contractor disposition of such property and shall comply with these certifies that it and all of its affiliates (if any) collect all instructions. required taxes. Miscellaneous Travel Expenses: Reimbursement to the Subcontractor for travel mileage, meals, lodging and other travel Amendment: This contract may not be amended orally or expenses incurred in the performance of this contract shall by performance. Any amendment must be made in written not exceed the rates published in the applicable State form and executed by duly authorized representatives of rules. International travel shall not be reimbursed under the Contractor. this contract. Severability: In the event that a court of competent Sales/Use Tax Refunds: If eligible, the Subcontractor jurisdiction holds that a provision or requirement of this and all subcontractors shall: (a) ask the North Carolina contract violates any applicable law, each such provision Department of Revenue for a refund of all sales and use or requirement shall continue to be enforced to the extent it taxes paid by them in the performance of this contract, is not in violation of law or is not otherwise unenforceable pursuant to G.S. 105-164.14; and (b) exclude all and all other provisions and requirements of this contract refundable sales and use taxes from all reportable shall remain in full force and effect. expenditures before the expenses are entered in their reimbursement reports. Headings: The Section and Paragraph headings in these General Terms and Conditions are not material parts of the Advertising: The Contractor shall not use the award of agreement and should not be used to construe the this contract as a part of any news release or commercial meaning thereof. advertising. Attachment B For the period 11.1.13 — 9.29.14 Statement of Work Subcontractor: Oranne County This statement should be short summary describing what the Subcontractor does and how the Subcontractor will use these funds. The terms of the contract between TJAAAA and the Subcontractor requires that these goals are met for the stated period. The uses of these funds are not limited to but MUST include the following activities. 1) Conduct a minimum of two outreach activities in each county. A minimum of one outreach activity must be planned in collaboration with a community partner(s) that serves individuals with mental illness, and a minimum of one outreach activity must be held that focuses on people who are aging and/or have disabilities other than mental illness. 2) All outreach activities must include Relay for Extra Help materials provided by the Senor Health Insurance Information (SHIIP) office. 3) Coordinate with local SHIIP sites and refer individuals who are likely eligible for LIS and MSP. 4) Submit Client Counseling Contact forms for individual counseling and Public& Media Outreach forms fro outreach events monthly to the TJAAA office for entering in the national SHIPtalk reporting system. 5) Develop new partnerships for planning and conducting successful outreach events. 6) Encourage Medicare beneficiaries to participate in local disease prevention and wellness activities. 7) Monthly reporting forms for contracted activities and expenses incurred are to be submitted to electronically by the 10th of each month for the month prior to Susan Reed at susa n.reed(W-wakegov.com. A final report of expenses incurred is due on or before November 10, 2014. The following Scope of Work should address the ways the Subcontractor will accomplish the above expectations and/or willingness to comply. SCORE OF WORK: (maximum 2 pages) 1) Orange County SHIIP (OC SHIIP) will conduct a minimum of two outreach activities including collaborating with at least one community partner that serves individuals with mental illness to conduct an outreach event, and at least one outreach event that focuses on people who are aging and/or had disabilities other than mental illness. 2) Relay for Extra Help materials will be used at all outreach events. 3) Coordinate with both Orange County SHIIP sites and NC SHIIP to refer individuals who are likely eligible for LIS and MSP. 4) Enter Client Counseling Contact forms for individual counseling and Public & Media Outreach forms for outreach events monthly in the national SHIPtalk reporting system and provide TJAAA with reports. 5) Continue to develop new partnerships for planning and conducting successful outreach events with OC SHIIP counselors and community organizations. 6) OC SHIIP counselors will encourage Medicare beneficiaries to participate in local disease prevention and wellness activities. 7) Submit reporting forms for contracted activities and expenses incurred electronically by the 10th of each month for the month prior to Susan Reed at susan.reed CcD-wakegov.com. The final report of expenses incurred will be submitted by November 10, 2014. Attachment C For the period 11.1.13-9.29.14 Line Item Budget and Budget Narrative Using the budget line items listed below, please provide a budget and a short narrative on how you plan to spend the funding amount reflected in the agreement. Allowable expenses include telephone, postage, salary/stipends, equipment purchases, internet services, etc. New CMS regulations stipulate that federal dollars cannot be used to purchase food. If any of your outreach events include food, it must be paid for from other funds. Additionally, please note that indirect charges will not be allowed under this agreement. Subcontractor Name: Orange Count Amount Requested: 31500, Budget Category Amount Contractual Supplies Equipment Travel Personnel Fringe Benefits Other(itemize below) $3,500 TOTAL BUDGET NARRATIVE: Publicize Relay for Extra Help in Orange County Senior Times, a quarterly newspaper distributed to an estimated 7,000 households and available at numerous locations throughout Orange County. Attachment D Certifications Regarding Drug-Free Work-Place; Lobbying; and Debarment, Suspension and Other Responsibility Matters 1. Drug-Free Work-Place The undersigned (authorized official) certifies that it will provide a drug-free workplace in accordance with the Drug-Free Work-Place Act of 1988, 45 CFR Part 76, subpart F. The certification set out below is a material representation of fact upon which reliance will be placed when awarding the grant. False certification or violation of the certification shall be grounds for suspension of payments, suspensions or termination of grants or government wide suspension or debarment. The grantee certifies that it will or will continue to provide a drug-free workplace by: (a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the grantee's workplace and specifying the actions that will be taken against employees for violation of such prohibition; (b) Establishing an on-going drug-free awareness program to inform employees about— (1)The dangers of drug abuse in the workplace; (2)The grantee's policy of maintaining a drug-free workplace; (3)Any available drug counseling, rehabilitation, and employee assistance programs; and (4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; (c) Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement required by paragraph (a); above; (d) Notifying the employee in the statement required by paragraph (a)that, as a condition of employment under the grant, the employee will— (1)Abide by the terms of the statement; and (2) Notify the employer in writing of his or her conviction for a violation of a criminal drug statute occurring in the workplace no later than five calendar days after such conviction; (e) Notifying the agency, in writing, within 10 calendar days after receiving notice under subparagraph (d)(2), above, from an employee or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide notice, including position title, to Agency on whose grant activity the convicted employee was working. Notices shall include the identification number(s)of each affected grant; (f)Taking one of the following actions, within 30 days of receiving notice under subparagraph (d)(2), above, with respect to any employee who is so convicted— (1)Taking appropriate personnel action against such an employee, up to and including termination, consistent with the requirements of the Rehabilitation Act of 1973, as amended; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; (g) Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs(a), (b), (c), (d), (e), and (f). The grantee certifies that, as a condition of the grant, it will not engage in the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance in conducting any activity with the grant. 2. Lobbying Title 31 of the United States Code, Section 1352, entitled "Limitation on use of appropriated funds to influence certain Federal contracting and financial transactions," generally prohibits recipients of Federal grants and cooperative agreements from using Federal (appropriated)funds for lobbying the Executive or Legislative Branches of the Federal Government in connection with a SPECIFIC grant or cooperative agreement. Section 1352 also requires that each person who request or received a Federal grants or cooperative agreement must disclose lobbying undertaking with non-Federal (non-appropriated)funds. These requirements apply to grants and cooperative agreements EXCEEDING$100,000 in total costs (45 CFR Part93). The undersigned (authorized official)certifies, to the best of his or her knowledge and belief, that: (a) 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, any officer or employee of Congress, or an employee of 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 grant, loan or cooperative agreement; (b) If any funds other than Federal appropriated funds have been paid or 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 Federal contract, grant, loan or cooperative agreement, the undersigned shall complete and submit Standard Form -LLL, "Disclosure of Lobbying Activities," in accordance with its instructions; (c)The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers(including subcontracts, subgrants, contracts and contracts under grants, loans and cooperative agreements)and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. 3. Debarment, Suspension and Other Responsibility Matters NOTE: In accordance with 45 CFR Part 76, amended June 26, 1995, any debarment, suspension, proposed debarment or other government wide exclusion initiated under the Federal Acquisition Regulation (FAR)on or after August 25, 1995, shall be recognized by and effective for Executive Branch agencies and participants as an exclusion under 45 CFR Part 76. (a) Primary Covered Transactions The undersigned (authorized official)certifies to the best of his or her knowledge and belief, that the applicant, defined as the primary participant in accordance with 45 CFR Part 76, and its principals: (1)are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal department or agency; (2) have not within a 3-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public(Federal, State or local)transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (3)are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or local)with commission of any of the offenses enumerated in paragraph (a)(2) of this certification; and (4) have not within a 3-year period preceding this application/proposal had one or more public transactions (Federal, State, or local)terminated for cause or default. Should the applicant not be able to provide this certification, an explanation as to why should be placed under the assurances page in the application package. (b) Lower Tier Covered Transactions The applicant agrees by submitting this proposal that it will include, without modification, the following clause titled "Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion --Lower Tier Covered Transaction" (Appendix B to 45 CFR Part 76) in all lower tier covered transactions(i.e., transactions with subgrantees and/or contractors)and in all solicitations for lower tier covered transactions: Certification Regarding Debarment,Suspension, Ineligibility, and Voluntary Exclusion -- Lower Tier Covered Transactions (1) The prospective lower tier participant certifies by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. (2) Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Janice Tyler, Department on Aging Director Sig ur of Auth6inizild Certifying Official Name and Title of Authorized Certifying Official Orange County Subcontractor Name Date Submitted