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HomeMy WebLinkAbout2016-310 Aging - TJCOG Area Agency on Aging - Contract for Provision of Co. Based MIPPA Services --31 b October 1, 2015 Through September 30, 2016 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 Department on Aging (the "Subcontractor") (referred to collectively as the "Parties") The Subcontractor's federal tax identification number is - .., 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 10.1.2015 and shall terminate on 9.30.2016. 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, 2016. 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 Mary K. Warren, Director, Area Agency on Aging Triangle J Council of Governments Area Agency on Aging SAME 4307 Emperor Blvd., Suite 110 Durham, NC 27703 Telephone : 919 558-2707 Fax: 919 549-9390 Email: mwarren @tjcog.org For the Subcontractor: IF DELIVERED BY US POSTAL SERVICE IF DELIVERED BY ANY OTHER MEANS Oran a C�bCant De y ptnttn_09 S, ran G©� 13epartmencin Agrg evey Sl�ufar wrt`��h�f� _ .. 2x51 Hor est�c Road 25 Hnrn stead RbOd Chapel ill, C", G 2756.. Tel0phon 9'9.)24$4274 ��i�4„�bshu�or+�ic�ran��eco�r�tyhc Page 2 of 12 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 notice 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. Page 3 of 12 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 _ 7y Lee Worsley, Executive Director Date Attest Or Witness MaN K.Warren, Area Agency on Aging Date Director I G r'Y1a,M L. ujc.'y'�r-w ` Printed NAme Title Orange County Department on Aging A �igr�ature Date Bonielamr�er .l Qran�a dauntMarag Pr rated tame T t f Attest ' Wiitn�ss o ssa S C� s� co (� l Mel l� arl Ek tive�srs tr3, aunty lanag�e PrirteiINam� tl 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: u A Judy A. Weller Finance Director Triangle J Council of Governments Page 4 of 12 Attachment A GENERAL TERMS AND CONDITIONS State laws relating to equal employment Availability of Funds: The parties to this opportunity. contract agree and understand that the payment of the sums specified in this contract is dependent Health Insurance Portability and and contingent upon and subject to the Accountability Act(HIPAA): The appropriation, allocation, and availability of funds Subcontractor agrees that, if the Contractor for this purpose to the Contractor from federal, determines that some or all of the activities state and local sources. within the scope of this contract are subject to the Health Insurance Portability and Force Majeure: Neither party shall be deemed to Accountability Act of 1996, P.L. 104-91, as be in default of its obligations hereunder if and so amended ("HIPAA"), or its implementing long as it is prevented from performing such regulations, it will comply with the HIPAA obligations by any act of war, hostile foreign requirements and will execute such agreements action, nuclear explosion, riot, strikes, civil and practices as the Contractor may require to insurrection, earthquake, hurricane, tornado, or ensure compliance. other catastrophic natural event or act of God. Confidentiality Survival of Promises: All promises, requirements, terms, conditions, provisions, Confidentiality: Any information, data, representations, guarantees, and warranties instruments, documents, studies or reports given contained herein shall survive the contract to or prepared or assembled by the Subcontractor expiration or termination date unless specifically under this agreement shall be kept as confidential provided otherwise herein, or unless superseded and not divulged or made available to any by applicable Federal or State statutes of individual or organization without the prior written limitation. approval of the Contractor. The Subcontractor acknowledges that in receiving, storing, Intellectual Property Rights processing or otherwise dealing with any confidential information it will safeguard and not Copyrights and Ownership of Deliverables: All further disclose the information except as deliverable items produced pursuant to this otherwise provided in this contract. contract are the exclusive property of the Contractor. The subcontractor shall not assert a Oversight claim of copyright or other property interest in such deliverables. Access to Persons and Records: The Contractor, County, Area Agency on Aging, Federal Intellectual Property Bankruptcy Division of Aging and Adult Services, other Protection Act: The Parties agree that the authorized officials of the Contractor, funding Contractor shall be entitled to all rights and authorities, the North Carolina State Auditor, benefits of the Federal Intellectual Property and/or applicable federal agencies shall have Bankruptcy Protection Act, Public Law 100-506, access to persons and records as a result of all codified at 11 U.S.C. 365 (n) and any contracts or grants entered into by State agencies amendments thereto. or political subdivisions in accordance with General Statute 147-64.7. Additionally,as a State Compliance with Applicable Laws funding authority, the Department of Health and Human Services shall have access to persons and Compliance with Laws: The Subcontractor shall records as a result of all contracts or grants comply with all laws, ordinances, codes, rules, entered into by State agencies or political regulations, and licensing requirements that are subdivisions. applicable to the conduct of its business, including those of federal, state, and local agencies having Record Retention: Records shall not be jurisdiction and/or authority. destroyed, purged or disposed of without the express written consent of the Contractor. State Equal Employment Opportunity: The basic records retention policy requires all grant Subcontractor shall comply with all federal and records to be retained for a minimum of five years or until all audit exceptions have been resolved, Page 5 of 12 whichever is longer. If the contract is subject to requirement of this contract violates any federal policy and regulations, record retention applicable law, each such provision or may be longer than five years since records must requirement shall continue to be enforced to the be retained for a period of three years following extent it is not in violation of law or is not submission of the final Federal Financial Status otherwise unenforceable and all other provisions Report, if applicable, or three years following the and requirements of this contract shall remain in submission of a revised final Federal Financial full force and effect. Status Report. Also, if any litigation, claim, negotiation, audit, disallowance action, or other Headings: The Section and Paragraph headings action involving this Contract has been started in these General Terms and Conditions are not before expiration of the five-year retention period material parts of the agreement and should not be described above, the records must be retained used to construe the meaning thereof. until completion of the action and resolution of all issues which arise from it, or until the end of the Time of the Essence: Time is of the essence in regular five-year period described above, the performance of this contract. whichever is later. The record retention period for Temporary Assistance for Needy Families(TANF) Key Personnel: The Contractor shall not replace and MEDICAID and Medical Assistance grants any of the key personnel assigned to the and programs must be retained for a minimum of performance of this contract without the prior ten years. written notification of the Contractor. The term "key personnel" includes any and all persons Warranties and Certifications identified by as such in the contract documents and any other persons subsequently identified as Date and Time Warranty: The Subcontractor key personnel by the written agreement of the warrants that the product(s) and service(s) parties. furnished pursuant to this contract ("product' includes, without limitation, any piece of Care of Property: The Subcontractor agrees that equipment, hardware, firmware, middleware, it shall be responsible for the proper custody and custom or commercial software, or internal care of any property furnished to it for use in components, subroutines, and interfaces therein) connection with the performance of this contract that perform any date and/or time data recognition and will reimburse the Contractor for loss of, or function, calculation, or sequencing will support a damage to, such property. At the termination of four digit year format and will provide accurate this contract, the Subcontractor shall contact the date/time data and leap year calculations. This Area Agency on Aging for instructions as to the warranty shall survive the termination or expiration disposition of such property and shall comply with of this contract. these instructions. Certification Regarding Collection of Taxes: Travel Expenses: Reimbursement to the G.S. 143-59.1 bars the Secretary of Administration Subcontractor for travel mileage, meals, lodging from entering into contracts with vendors that and other travel expenses incurred in the meet one of the conditions of G.S. 105-164.8(b) performance of this contract shall not exceed the and yet refuse to collect use taxes on sales of rates published in the applicable State rules. tangible personal property to purchasers in North International travel shall not be reimbursed under Carolina. The conditions include:(a)maintenance this contract. of a retail establishment or office; (b) presence of representatives in the State that solicit sales or Sales/Use Tax Refunds: If eligible, the transact business on behalf of the vendor;and(c) Subcontractor and all subcontractors shall:(a)ask systematic exploitation of the market by media- the North Carolina Department of Revenue for a assisted, media-facilitated, or media-solicited refund of all sales and use taxes paid by them in means. The Contractor certifies that it and all of the performance of this contract, pursuant to its affiliates (if any)collect all required taxes. G.S. 105-164.14; and (b) exclude all refundable Miscellaneous sales and use taxes from all reportable expenditures before the expenses are entered in Amendment: This contract may not be amended their reimbursement reports. orally or by performance. Any amendment must be made in written form and executed by duly Advertising: The Contractor shall not use the authorized representatives of the Contractor. award of this contract as a part of any news release or commercial advertising. Severability: In the event that a court of competent jurisdiction holds that a provision or Page 6 of 12 Attachment B For the period 10.1.15 — 9.30.16 Statement of Work Subcontractor: Orange County Department on Aging 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 susan.reeda-wakegov.com. A final report of expenses incurred is due on or before November 10, 2016. The following Scope of Work should address the ways the Subcontractor will accomplish the above expectations and/or willingness to comply. S,GQPE QF,Y�O Page 7 of 12 (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) Will 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) Monthly reporting forms for contracted activities and expenses incurred will be submitted electronically by the 10th of each month for the month prior to Susan Reed at susa n.reed A-wa kegov.com. The final report of expenses incurred will be submitted by November 10, 2015. Page 8 of 12 Attachment C For the period 10.1.15—9.30.16 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 County Department on Aging Amount Requested: $ 3,500 Budget Category Amol Contractual Supplies Equipment Travel Personnel MOM Fringe Benefits Other itemize below TOTAL J13000ET NAROATIV PERSONNEL: $3,500 for temporary personnel to assist Orange County SHIP coordinator Page 9 of 12 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. Page 10 of 12 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; Page 11 of 12 (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. In it 1 D rtmn ©i c Sign; r ctt A&w- 'A"O" h' F ing Official Name and',Tltlb Qf Aufor)zc>[Gertifyng Official rartrte-Caunfv Northrolina k �4 , .. . ., ubconfracar N�}e '>»,» fe Su�m�ffed Page 12 of 12