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ORIGINAL
CITY OF SAN BERNARDINO - REQUEST FOR COUNCIL ACTION
From: Lemuel P. Randolph, Director
Subject: RESOLUTION OF THE MAYOR
AND COMMON COUNCIL OF THE CITY OF
SAN BERNARDINO AUTHORIZING THE
MAYOR OR HER DESIGNEE TO EXECUTE
AMENDMENT NO. 1 FOR TITLE III-B
CONTRACT THROUGH THE COUNTY OF
SAN BERNARDINO DEPARTMENT OF
ADULT AND AGING SERVICES (DAAS) FOR
ASSISTED TRANSPORTATION FOR A
PERIOD OF JULY 1, 2005 THROUGH JUNE 30,
2006.
MICC Meeting Date: July 18, 2005
Dept: Parks, Recreation &
Community Services Dept.
Date: June 22, 2005
Synopsis of Previous Council Action:
May 3, 2004 - Mayor and Council approved Resolution No. 2004-122 authorizing the execution
of a contract with the County of San Bernardino to administer an outreach program for seniors.
Recommended Motion:
Adopt resolution.
Contact person: Aaliyah Harkley
Phone: 5231
Supporting data attached: Ward:
FUNDING REQUIREMENTS: Amount: $20,320
Source: (Acct. No.) 123-xxx-xxxx
(Acct {"'IE-scription) GJoallt
Finance:
Council Notes:
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CITY OF SAN BERNARDINO - "QUEST FOR COUNCIL ACTION
Staff Report
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Subject:
Resolution of the Mayor and Common Council of the City of San Bernardino authorizing the
Mayor or her designee to execute Amendment No. 1 for Title ill-B Contract through the County
of San Bernardino Department of Adult and Aging Services (DAAS) for Assisted Transportation
for a period of July 1, 2005 through June 30, 2006.
Background:
The Senior Companion Program (SCP) has existed since 1974. The SCP has received Title ill-B
funds for over 13 years. The funds assist the companions in providing services to low-income,
frail elderly clients in areas that are rural and sparsely populated. The Companions assist the
clients with grocery shopping, meal preparation, transportation to medical appointments,
pharmacies, banks, post offices, etc. These clients have no means of transportation and are at
risk of early institutionalization without this assistance.
On June 6, 2005, Mayor and Common Council approved Resolution 2005-148 authorizing the
department to apply for and adtn4llster a grant for SCP through the Corporation of National and
Community Services in the amount of $295,983. This SCP grant covers the stipends and meal
reimbursement costs of companions, but only pays mileage to and from the client's home. These
Title ill-B grant funds will cover the Companion's transportation costs of taking their clients to
medical appointments, pharmacies, grocery stores, banks, etc.
The Title ill-B grant funds will supplement transportation costs for all of our clients. The City
operates the only SCP in the San Bernardino County; therefore, we are required to serve outlying
areas to receive the federal grant. Clients living in the Morongo Basin and Victor Valley areas
will benefit the most from this grant because their travel cost are higher. This grant is in the
amount of $20,320 and will fund the transportation costs of 15 Companions who serve 55 clients
per week.
The attached Amendment No.1 was received from the County on June 21, 2005; therefore, there
was not sufficient time to complete a Request for Council Action before the start date of July 1,
2005. Upon approval of this Request for Council Action Amendment No.1 will be retroactive to
July 1, 2005. The county PO that supports this request is attached as "Attachment C" listed after
page 5 of Exhibit "A".
Financial Impact:
The in-kind service listed on the Budget Display sheet in the amount of $2,257 pays a portion of
the SCP Manager's salary. This position would exist with or without this contract; therefore,
there is no financial impact to the City.
Recommendation:
Adopt Resolution.
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RESOLUTION NO. t l6>> IPY
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RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY
OF SAN BERNARDINO AUTHORIZING THE MAYOR OR HER DESIGNEE TO
EXECUTE AMENDMENT NO. 1 FOR TITLE III-B CONTRACT THROUGH THE
COUNTY OF SAN BERNARDINO DEPARTMENT OF ADULT AND AGING
SERVICES (DAAS) FOR ASSISTED TRANSPORTATION FOR A PERIOD OF JULY
1,2005 THROUGH JUNE 30, 2006.
6 I BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE
i I CITY OF SAN BERNARDINO AS FOLLOWS:
8 SECTION 1. The Mayor and Common Council of the City of San Bernardino hereby
authorizes the execution of Amendment No. 1 for the Title III-B Contract by the Director of
Parks, Recreation and Community Services Department through the Department of Adult and
Aging Services (DAAS) in the amount $20,320 for assisted transportation for the Senior
Companion Program, a copy of which is attached hereto, marked Exhibit "A" and incorporated
herein by reference as fully as though set forth at length.
SECTION 2. The authorization to execute the above referenced agreement is
resci!lded if the parties to the agreement fail to execute it within 120 days 'of the passage of this
resolution.
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RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY I
OF SAN BERNARDINO AUTHORIZING THE MAYOR OR HER DESIGNEE TO !
i
EXECUTE AMENDMENT NO.1 FOR TITLE III-B CONTRACT THROUGH THE I
COUNTY OF SAN BERNARDINO DEPARTMENT OF ADULT AND AGING I
SERVICES (DAAS) FOR ASSISTED TRANSPORT A nON FOR A PERIOD OF JULY !
1,2005 THROUGH JUNE 30, 2006. i
i
I HEREBY CERTIFY that the foregoing Resolution was duly adopted by the Mayor ,
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G and Common Council of the City of San Bernardino at a
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, 2005, by the following
day of
meeting thereof, held on the
vote, to wit:
Council Members:
AYES
NAYS
ABSTAIN ABSENT
ESTRADA
LONGVILLE
MCGINNIS
DERRY
KELLEY
JOHNSON
17
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Jo
Rachel G, Clark, City Clerk
The foregoing resolution is hereby approved this
day of
2005.
Judith Valles, Mayor
City of San Bernardino
Approved as to
Form and legal content:
JAMES F. PENMAN,
City Attorney
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Exhibit "A"
Attachment A-1
Additional Terms and Conditions to Title IIIB Programs Purchase Order
Amendment 1 - Effective July 1, 2005
'-
THIS CONTRACT is entered into in the State of California by and between the County of San Bernardino,
Department of Aging and Adult Services, hereinafter called the County, and
Name
City of San Bernardino, Senior Companion Program
Address .
hereinafter called
"Contractor"
600 West Fifth Street
San Bernardino, CA 92410
Phone
(909) 384-5413
Federal 10 Noc or Social Security No.
95-6000772
IT IS HEREBY AGREED AS FOLLOWS:
AMENDMENT NO.1
It is hereby agreed to amend this Contract as follows:
Section VIII. TERM (A) is amended to read:
This Contract is effective as of July 1, 2005 and expires June 30, 2006, but may be terminated earlier in
accordance with provisions of Article IX of the Contract.
All other terms and conditions of this Contract shall remain the same and are incorporated herein by this
reference.
This amendment shall become effective upon execution by both parties.
COUNTY OF SAN BERNARDINO
PURCHASING DEPARTMENT
CONTRACTOR
By:
By:
LEO GOMEZ
Deputy Purchasing Agent
Dated:
Dated:
Page 1 of 1
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Attachment B
City of San Bernardino (Senior Companion Program)
WORK PLAN
',-
FY 2005 - 2006
This work plan contains the measurableobj~ctives mandated by OMS of the service provider. The
work plan specifies and establishes time frames either on an annual basis or, where required by state
regulations, on a quarterly basis. The work plan constitutes the primary document for ongoing
monitoring, Annual Program Performance Review/Fiscal Audit and will be used to measure the
provider's efforts toward providing quality Assisted Transportation.
I. Scope of Work
A. Geographic Area/Clientele and Eligibility Criteria
1. The geographic area served by this provider covers the Morongo Basin
and Victor Valley regions, including Joshua Tree, Twentynine Palms,
Yucca Valley; Adelanto, Apple Valley, Hesperia, and Victorville.
2. The clientele served by this agreement consists of seniors 60 and over.
B. Program Description
1. Purpose: Assisted Transportation is provided to improve the socialization
and increase independence for people who cannot drive or use regular
vehicular transportation.
2. Definition: Provide assistance, including escort to a person who has
difficulties (physical or cognitive) using, regular vehicular transportation.
C. Intended Outcomes
1. Assisted Transportation
a. Provide 3,251 one-way trips annually for seniors who are not eligible
for this program from any other resource and who cannot pay for this
program.
b. Staff and/or volunteers providing Assisted Transportation services
must be trained and qualified in the safe provision _ of Assisted
Transportation services. Assisted Transportation must be provided to
at least 55 unduplicated seniors of which 5 are to be minority low-
income seniors.
2. Develop and have on hand, for review by OMS, a cost allocation plan
which explains the methods used to allocate costs between programs with
funds received from OMS.
L:\Aging\ProgramslScopcs of Work and Provider Budgets\05-06 WPs & Budgets
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3.
Conduct a ,client or participant satisfaction survey at least once ,a ,year,
The survey form must be approved by designated OMS staff prior to its
use and all findings from the survey must be used to improve services.
The returned surveys and tabulated results must be kept on file for review
by DAAS staff.
II. Service Delivery Activities
A. Staffing
Sufficient personnel shall be available to carry out the needs of the program, This
includes a Director and additional personnel as determined by the size of the service
area and the method and level of service provision needed to fully comply with the
terms of this work plan and agreement.
B. Volunteer Staff
1. Volunteers are individuals who work without pay in the perfonnance of essential
duties to conduct the program. In some cases, the Director may be a volunteer.
2. ,Volunteers shall not replace paid personnel.
C. Clients will be given priority for services who are socially and/or economically needy and
who are not eligible for services from any other source.
Further, individuals referred by DAAS staff shall be given first priority for services under
this agreement.
Definitions: Economically Needy: Seniors whose income is at or below the SSIISSP
level.
, .
Socially Needy: Seniors who have at least two of the following characteristics:
Disabled, Language/Communication Barrier, Lives Alone, Age 75+.
D. Training Activities
1. Provide training both on the job and in formal training sessions, as appropriate, to
improve the understanding of paid staff about the service(s) being provided.
Wherever required by law and/or ordinance, licensed staff must be trained to
carry out assigned duties. In addition, annually evaluate paid staff performance
to determine his/her effectiveness, skill development and understanding of tasks
they are assigned. Documentation of training shall be kept on tile at the
provider's main office for review by DAAS during program monitoring to be
scheduled and conducted by OMS.
2. Volunteers should be provided on-the-job training and opportunities for formal
training to improve skills and understanding of the service being provided.
Wherever required by law or ordinance volunteers must be trained and/or
licensed to carry out assigned duties, Documentation of training shall be kept on
L:lAginglProgramslScopes of Work and Provider Budgets\05-06 WPs & Budgets
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file at the provider's main office for review by DAAS during program monitoring to
be scheduled and conducted by OAAS staff. .
III. Other Service Requirements
A. Physical Set-Up
1. Where services are provided in a care center, office or any setting outside the
client's home, the environment must be attractive, clean and free from obstacles
which could cause injury.
2. Post floor plans identifying emergency exits, assembly areas, etc. and conduct -
evacuation drills at least twice a year. Proof of evacuation drills will be kept on
file duly signed by the Fire . Marshal or other authorized agency within the
community where the service site is located.
B. Donations and Confidentiality
1. Encourage seniors to donate by notifying them verbally that donations are
accepted and are important to maintaining the service(s) provided. Post signs
where appropriate stating that donations are accepted. The provider shall not in
any way employ tactics which could be viewed as coercion, embarrassing, and/or
obligatory to the service being provided.
2. All contributions shall be used to increase the amount of service being provided
in the program(s) funded byDAAS.
C. Coordination Activities
1. Provider shall participate within appropriate coordination bodies established by
state law and/or county ordinance.
2. Provider shall include the following statement on all advertising, posters and
brochures, etc.:
"Funding for this service has been provided by the San Bernardino County
Department of Aging and Adult Services through a grant award from the
California Department of Aging."
3. Provider shall coordinate service with other County departments and local
agencies by providing time within the facility during participant meetings, staff
meetings and volunteer meetings, etc., for presentations on special activities that
promote a Community Based System of Care for elderly clients. All coordination
activities must be documented and kept on file for review by DAAS.
4. Provider shall coordinate service with other County departments and local
agencies by. providing time for presentations or special activities that promote a
Community Based System of. Care for the elderly participants attending their
sites. All such activities must be documented and kept on file for review by
DAAS.
L:\Aging\PrQgramslScopes of Work and Provider Budgets\o5-06 WPs & Budgets
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D. Reporting Requirements
Contractor, at such times and in such forms as OMS may require, shall furnish
statements, records, reports, data and information requested by DAAS
pertaining to Contractor's performance of services hereunder and other matte-rs
covered by this Contract. The forms shall be reviewed for timeliness,
completeness, and correctness of the information submitted, by the Program
Director or his/her designee, prior to submission to DAAS. Incomplete forms
shall be returned to the Contractor for completion. (In the event of changes in
these forms, DAAS shall advise the Contractor via written notice.) The Contractor
shall develop and implement a process for ensuring quality control.
a. Contractor shall meet the following standard for its financial management
systems, as provided in the CDA PM Title III Program Manual:
I. Financial Reporting (COA PM, Section G, Paragraph 93.5a)
Accurate, current and complete disclosure of the financial
results of the Supportive Services Program shall be made in
accordance with the financial reporting requirements of this
Contract. The following reports are to be submitted to OAAS
when indicated:
1) Monthly (Due by 5th working day of each month)
a. Monthly Expenditure Report/Request for
Reimbursement
2) Semi-Annually
a. Budget Revision #1 (Due November 1)
b. Budget Revision # 2 (Due May 15)
3) Annually ,
a. Financial Close-Out Report (Due August 1)
b. Periodic Inventory (DUe August 1 with Close-out)
c. Audit Report (Due October 31)
d. Revised Financial Close-out Report (Due October 31 )
with Audit Report.
II. Program Reporting
The following reports are to be submitted to DAAS when indicated:
1) Monthly (Due by the 5th working day of each month)
a. IIIB Monthly Service Unit Report
2) Quarterly
a. Program modification request in writing to OAAS,
Contractor shall describe, in detail, necessary program
changes and the reasons for the requested
modification.
L:\AgingIProgramslScopes of Work and Provider Budgets\05-06 WPs & Budgets
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3) Upon request
a. Completion of Client Intake Sheets provided by OAAS.
4) OAAS may require financial reports more frequently than
indicated above or with more d~tail (or both), upon written notice
to the Contractor, until such time as OAAS determines that the
financial management standards are met.
III. Report service and client data by the 5th working day of the month
on OAAS Monthly Service Report which will be verified by OAAS
during the annual program audit. Additionally, establish audit files
which include but are not limited to a copy of the Monthly
Service Report
IV. Report monthly expenditures to OAAS by the 5th working day of the
month. Maintain support files including but not limited to invoices,
payroll, and other supporting documents, all of which will be
attached to a copy of the expenditures report and kept on file by
month for review during the Annual Audit.
V. Maintain records, by month, that support claimed in-kind
expenditures.
In the event additional funds become available, the provider will use the funds to increase their
Assisted Transportation services provided to elderly clients by either increasing the number of
individuals served or by increasing the units of service provided or both. Exceptions to this
requirement, for instance the use of additional funds to purchase equipment, must be fully
documented in writing and submitted to the department for prior approval. Failure to abide by this
work plan will constitute just cause for sanctions being imposed.
L:\AgingIProgramslScopes of Work and Provider Budgets\OS-06 WPs & Budgets
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VENDOR C
Attachment 0
arellno
,I dult Services
AINT FORM
Date:
Program:
Name of person completing form: Phone #
Address: Phone #
Staff name (if it applies) Phone #
Office Location
ContractorNendor:
Has issue been brought to the attention of vendor? (Circle one)
Do you wish to remain anonymous? (Circle one) YES
YES
NO
NO
Issue:
.
.
.
FACTS:
.
Resolution:
Admin Staff Assigned Date Assigned Date Resolved
OAAS VEND 1 (11/02)
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Attachment E
INFORMATION SHEET
CONTRACTOR SHALL COMPLETE SECTION I OF THIS FORM AND RETURN TO:
SAN BERNARDINO COUNTY
Department of Aging and Adult Services
Attn: CONTRACTS
"I( II()'\ I (()'\IH\( IURI'\IOR\I\IIO'\
Phone:
7 North Sierra Wa , San Bernardino, CA 92410-4816
Web Site: Email:
(909) 384-5233
Fax:
w .ci.san-bemardino.ca. US
Site Name for Services(lf DiJftrtm from Con/Mc/or):
(909) 384-5160
Ib Street Senior Center and Perris Hill Senior Center
Address (inc/JJJ;/jng City. Slale and Zip Code):
Phone:
West 51b Street, San Bernardino, CA 92410 and 780 East 21' Street
Web Sile: Email:
(909) 384-5430
Fax:
(909) 384-5160
Senior Recreation Su rvisor
Name:
Title:
Signature:
Claim Si
Phone #:
Name:
San Bernardino County
Department of Aging and Adult Services
, Contracts Unit
686 E. Mill Street
San Bernardino, CA 92415-0920
Contracts Unit:
Leslie Dunn. Contracts Management
909-891-3930
E-Mail: Ldunn@hss.sbcounty.~ov
Unit Fax #: 909-891-3919
Page 1 of 1
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. OAAS AOMIN
Additional Terms and Conditions to Titl~ 1118 Programs Purchase OfmHn.
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Attachment A
rHIS CONTRACT is entered into in the State of California by and between the County of San Bernardino,
)epartment of Aging and Adult Services, hereinafter called the County, and
lame
~ity of San Bemardino, Senior Companion Program
. .ddress
hereinafter called
"Contractor"
iOO West Fifth Street
;an Bemardino, CA 92410
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909) 384-5413
.derallO No. or Social Security No.
'5-6000772
r IS HEREBY AGREED AS FOllOWS:
IfHEREAS, The County, acting as the Area Agency on Aging, through its representative, the Department of Aging
nd Adult Services, desires to provide services to seniors to improve or maintain choice, independence, and quality
f life: and
l
IfHEREAS, County has been allocated state and/or federal funds by the California Department of Aging to provide
ervices to seniors; and
IHEREAS, County finds Contractor qualified to provide services to seniors; and
IHEREAS, County desires that such services be provided by Contractor and Contractor agrees to perform these
3rvices as set forth below;
OW THEREFORE, County and Contractor mutually agree to the following terms and conditions:
CONTRACTOR SERVICE RESPONSIBILITIES
A. Contractor shall provide, in a satisfactory and proper manner, as determined by the County, the
services defined and set forth in Attachment B attached hereto and incorporated by these
, references into this Contract, based upon the services ordered by County staff.
B. Contractor shall provide all necessary qualified personnel for performance of services under this
Contract.
C. Contractor shall record services and submit reports as required by the State of California and
County, enumerating all services authorized and delivered to clients. Contractor shall make
available to the County all records as necessary to conduct thorough i'lnd comprehensive contract
monitoring and auditing, and to conduct evaluation concerning the Contractor and program as
appropriate under terms of this Contract.
D. Contractor is expected to maintain an ongoing cooperation between a client's other service
providers, if any, and the County staff; and to supply information to and utilize information received
from the County staff regarding referred clients.
E. Contractor agrees to participate in appropriate employee and vendor training and development
provided by the Department of Aging and Adult Services ("DAAS") and the California Department of
Aging ("CDA").
Page 1 of 11
Attachment A
I.
CONTRACTOR GENERAL RESPONSIBILITIES
A. In the performance of this Contract, Contractor, its agents and employees, shall act in an independent
capacity and not as officers, employees, or agents of the County of San Bemardino.
B. Contractor agrees to provide or has already provided information on former County of San Bemardino
administrative officials (as defined below) who are employed by or represent Contractor. The
information provided includes a list of form~r County administrative officials who terminated County
employment within the last five years and who are now officers, principals, partners, associates or
members of the business. The information also includ~s the employment with or representation of
Contractor. For purposes of this provision, "County administrative official" is defined as a member of
the Board of Supervisors or such officer's staff, County Administrative Officer or member of such
officers staff, County department or group head, assistant department or group head, or any
employee in the ~xempt Group, Management Unit or Safety Management Unit.
C. If during the course of the administration of this Contract, the County determines that the Contractor
has made a material misstatement or misrepresentation or that materially.inaccurate information has
been provided to the County, this Contract may be immediately terminated. If this Contract is
terminated according to this provision, the County is entitled to pursue any available legal remedies.
D. Without the prior written consent of County, this Contract is not assignable by Contractor either in
whole or in part.
E. Contractor agrees to obtain the written approval from the Director of DAAS prior to entering into any
subcontract for work contemplated under this Contract. Contractor shall be fully responsible for the
performance of any subcontractor, including but not limited to insuring the availability and retention of
records, alid subcontractor shall be subject to the provisions of this Contract. A copy of any executed
subcontract must be forwarded to DAAS within thirty (30) days before the start date of the
subcontract.
F. Contractor will maintain all records and books pertaining to the delivery of services under this Contract
and demonstrate accountability for contract performance. County, or its designee, shall have the right
upon reasonable notice and at reasonable hours of business to examine and inspect such records
and books. Records, should include, but are not limited to monthly summary sheets, sign-in sheets,
and other primary source documents. Fiscal records shall be kept in accordance with Generally
Accepted Accounting Principles and must account for all funds, tangible assets, revenue and
expenditures. Fiscal records must also comply with the appropriate Office of Management and
Budget (OMB) Circulars, which state the administrative requirements, cost principles and other
standards for accountancy.
G. ,All records shall be complete and current and comply with all Contract requirements. Failure to
maintain acceptable records per the preceding requirements shall be considered grounds for
withholding of payments for billings submitted and for termination of the Contract.
H. All budget changes within major categories, such as Salaries and Benefits, Equipment, Modes of
Service or Other Costs exceeding 10% of the approved budget, for that major category, represents a
departure from the approved project plans and require DAAS' approval. Budget modification requests
will be made to DAAS in the form of a written justification outlining specific shifts of funds that will be
made.
I. Contractor shall notify County of any continuing vacancies and any positions that become vacant
during the term of this Contract that will result in reduction of services to be provided under this
Contract. Upon notice of vacancies, the Contractor will apprise County of the steps being taken to
provide the services and to fill the position as expeditiously as possible.. Vacancies and associated
problems shall be reported to County on each periodically required report for the duration of said
vacancies and/or problems.
Page 2 of 11
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Attachment A
J.
Contractor shall protect from unauthorized use or disclosure names and other identifying information
conceming persons receiving services pursuant to this Contract, except for statistical information not
identifying any participant. The Contractor shall not use or disclose any identifying information for any
other purpose other than carrying out the Contractor's obligations under this Contract. This provision
will remain in force even after the termination of the Contract. .
K. Contractor shall obtain from the Department of Justice records of all convictions involving any sex
crimes, drug crimes, or crimes of violence of a person who is offered employment or volunteers,for
all positions in which he or she would have contact with a minor, the aged, the blind, the disabled or
a domestic violence client, as provided for in Penal Code section 11105.3. This includes licensed
personnel who are not able to provide documentation ,.of prior Department of Justice clearance. A
copy of a license from the State of California is sufficient proof.
,
L. Contractor shall notify County of any staff member, paid, intern, or volunteer, who is knowingly or
negligently employed who has been convicted of any crime of violence or of any sexual crime.
Contractor shall investigate all incidents where an applicant, employee, intern or volunteer has
been arrested and/or convicted for any crime listed in Penal Code Section 11105.3 and shall notify
the County. At the County's discretion, the County may instruct Contractor to take action to either
deny/terminate employment or deny/terminate internship and/or volunteer services where the
investigation shows that the underlying conduct renders the person unsuitable for employment,
internship, or volunteer services.
Contractor shall immediately notify Human Services System (HSS) concerning the arrest and/or
conviction, for other than minor traffic offenses, of any paid employee, agent, consultant, intern or
volunteer staff, when Contractor knows such information.
M. Contractor shall make every reasonable effort to prevent employees, consultants or members of its
governing bodies from using their positions for purposes that are, or give the appearance of being
motivated by a desire for private gain for themselves or others, such as those with whom they have
family, business, or other ties. In the event County determines a conflict of interest exists, County
may disallow any increase in costs associated with the conflict of interest and such conflict may
constitute grounds for termination of the Contract. This provision shall not be construed to prohibit
employment of persons with whom Contractor's officers, agents, or employees have family,
business or other ties so long as the employment of such persons does not result in increased
costs over those associated with the employment of any other equally qualified applicants and such
persons have successfully competed for employment with other applicants on a merit basis.
N. Contractor agrees to and shall comply with the following indemnification and insurance
requirements:
,
1. Indemnification - The Contractor agrees to indemnify, defend, and hold harmless the County
and its authorized officers, employees, agents and volunteers from any and all claims, actions,
losses, damages, and/or liability arising out of this Contract from any cause whatsoever,
including the acts, errors or omissions of any person and for any costs or expenses incurred
by the County on account of any claim therefore, except where such indemnification is
prohibited by law.
2. Insurance - Without in anyway affecting the indemnity herein provided and in addition thereto,
the Contractor shall secure and maintain throughout the term of the Contract the following
types of insurance with minimum limits as shown:
a. Worker's Compensation - A program of Workers' Compensation insurance or a State-
approved Self Insurance Program in amount or form to meet all applicable
requirements of the Labor Code of the State of California, including Employer's
Liability with $250,000 limits, covering all persons providing services on behalf of
Contractor and all risks to such persons under this Contract.
b. Comprehensive General and Automobile Liability Insurance - This coverage to include
contractual coverage and automobile liability coverage of owned, hired and non-
to
Page 3 of 11
"
Attachment A
owned vehicles. The policy shall have combined single limits for bodily injury and
property damage of not less than one million dollars ($1,000,000). If Contractor
provides transportation to one or more client at any time, the automobile liability .
insurance policy shall have combined single limits for bodily injury and property
- damage of not less than two million dollars ($2,000,000.00).
c. Errors and Omissions Liability Insurance - Combined single limits of $1,000,000 for
bodily injury and property damage and $3,000,000 in the aggregate or
d. Professional Liability - Professional liability insurance with limits of at least $1,000,000
per claim or occurrence.
3. Additional Named Insured - All policies, except for Workers' Compensation, Errors and
Omissions and Professional Liability policies, . shall contain additional endorsements naming
the County and its officers, employees, agents and volunteers as additional mimed insured
with respect to liabilities arising out of the performance of services hereunder.
4. Waiver of Subrogation Rights - Except for Errors and Omissions Liability and Professional
Liability, Contractor shall require the carriers of the above-required coverage to waive all rights
of subrogation against the County, its officers, employees, agents, volunteers, contractors and
subcontractors.
5. Policies Primary and Non-Contributory - All policies required above are to be primary and non-
contributory with any insurance or self-insurance programs carried or administered by the
County.
6. Proof of Coverage - Contractor shall immediately fumish certificates of insurance evidencing
the insurance coverage, including endorsements to:
County of San Bemardino
clo Insurance Compliance
686 East Mill Street
San Bemardino, CA 92415-0640
prior to the commencement of performance of services hereunder, which certificates shall
provide that such insurance shall not be terminated or expire without thirty (30) days written
notice to the County, and Contractor shall maintain such insurance from the time Contractor
commences performance of services hereunder until the completion of such services. Within
sixty (60) days of the commencement of this Contract, the Contractor shall fumish certified
copies of the policies and all endorsements.
O. Contractor agrees to and shall comply with the Elder and Dependent Adult Abuse Reporting laws:
1. Contractor will ensure that all known or 'suspected instances of elder or dependent adult
abuse are reported to DAAS Adult Protective Services.
2. In accordance with W &1 Code section 15630, employees of the Contractor and its
subcontractors may be mandated reporters of elder and dependent adult abuse. Contractor
assures all employees, agents, consultants or volunteers whb perform 'services under this
Contract and are mandated to report elder and dependent adult abuse will sign a statement,
upon the. commencement of their employment, acknowledging their reporting requirements
and their compliance with them.
3. Mandated reporters are required to report all instances of known or suspected abuse of the
elderly and dependent adults by telephone immediately or as soon as practically possible,
under the following circumstances:
a. When the mandated reporter has observed or has knowledge of an incident that
reasonably appears to be physical abuse, abandonment, isolation, financial abuse, or
neglect; or
Page 4 of 11
'~-""~'Cb"""_-.o._"""
Attachment A
b. When the mandated reporter is told by an elder or dependent adult that he or she has
experienced behavior constituting physical abuse, abandonment, isolation, financial
abuse, or neglect;
c. A written "Reportef Suspected Dependent Adult/Elder Abuse" (SeC 341) must be
submitted within two (2) working days of making' the telephone report to the
responsible agency, as defined below in paragraph 4.
4. Incidents of elder and dependent adult abuse must be reported to the correct agency as
follows:
a. If the abuse has occurred in a long term care facility, except a state mental hospital
or state developmental center, the report shall be made to the local Long term Care
Ombudsman or local law enforcement; .
b. If the abuse has occurred in a state mental hospital or state developmental center,
the report shall be made to the designated investigators of the State Department of
Mental Health or the State Department of Developmental services or to the local law
enforcement;
c. If the abuse occurred anywhere other than a long-term care facility or state mental
hospital or state developmental center, the report shall be made to Adult Protective
Services or local law enforcement.
5. Under the terms of this Contract, as changes in the Elder and Dependent Adult Reporting
Laws are enacted, the Contractor is bound to comply with the most current regulations.
P. Contractor shall comply with all applicable laws, statutes, ordinances, administrative orders, rules or
regulations relating to its duties, obligations ana performance under the terms of the Contract and
shall procure all licenses and pay ~II fees and other charges required thereby. Contractor shall
maintain all required licenses during the term of this Contract. Failure to comply with the provisions of
this section may result in immediate termination of this Contract.
Q. Contractor shall comply with all applicable local health and safety clearances, including fire
clearances, for each site where services are provided under the terms of this Contract.
R. Contractor agrees to and shall comply with the County's Equal Employment Opportunity Program
and Civil Rights Compliance requirements:
1. Equal Employment Opportunity Program: The Contractor agrees to Gomply with the
provisions of the Equal Employment Opportunity Program of the County of San Bernardino
and rules and regulations adopted pursuant thereto: Executive Order 11246, as amended
by Executive Order 11375, 11625, 12138, 12432, 12250, Title VII of the Civil Rights Act of
1964 (and Division 21 of the California Department of Social Services Manual of Polices
and Procedures and California Welfare and Institutions Code,Section 10000), the California
Fair Employment and Housing Act, and other applicable Federal, State, and County laws,
regulations and policies relating to equal employment or social services to welfare
recipients, including laws and regulations hereafter enacted.
The Contractor shall not unlawfully discriminate against any employee, applicant for
employment, or service recipient on the basis of race, color, national origin or ancestry,
religion, sex, marital status, age, political affiliation or disability. Information on the above
rules and regulations may be obtained from County HSS Contract Administration.
2. Civil Rights Compliance: The Contractor shall develop and maintain internal policies and
procedures to assure compliance with each factor outlined by state regulation. These
policies must be developed into a Civil Rights Plan, which is to be on file with County HSS
Contract Administration within 30 days of awarding of the contract. The Plan must address
prohibition of discriminatory practices, accessibility, language services, staff development
and training, dissemination of information, complaints of discrimination, compliance review,
and duties of the Civil Rights Liaison. Upon request, HSS shall supply a sample of the Plan
Page 5 of 11
=.,,, ~
.'
Attachment A
format. The Contractor shall be monitOred by HSS for compliance with provisions of its Civil
Rights Plan.
S. Contractor shall not offer (either directly or through an intermediary) any improper consideration
such as, but not limited to, cash, discounts, service, the "provision of travel or entertainment,or any
items of value to any office, employee or agent of the County in an attempt to secure favorable
treatment regarding this Contract. r-
The County, by written notice, may immediately terminate any contract if it determines that any
improper consideration as described in the preceding paragraph was offered to any officer,
employee or agent of the County with respect to the proposal and award process. This prohibition
shall apply to any agreement, extension or evaluation process once a Contract has been awarded.
Contractor shall immediately report any attempt by a County officer, employee or agent to solicit
(either directly or through an intermediary) improper consideration from Contractor. The report shall
be made to the supervisor or manager charged with supervision of the employee or to the County
Administrative Office. In the event of a termination of the Contract under this provision, the County
is entitled to pursue any available legal remedies.
T. Contractor agrees to comply with all applicable provisions of the Americans with Disabilities Act
(ADA).
u.
Contractor will observe the mandatory standards and policies relating to energy efficiency in the State
Energy Conservation Plan (Title 20, Chapter 4, Califomia Code of Regulations).
Contractor shall use recycled and recyclable products, whenever practicable, in fulfilling the terms of
this Contract. Recycled printed products shall include a symbol identifying the recycled material.
Contractor understands and agrees that any and all legal fees or costs associated with lawsuits
concerning this Contract against the County shall be the Contractor's sole expense and shall not be
charged as a cos~ under this Contract. In the event of any contract dispute hereunder, each party to
this Contract shall bear its own attorney's fees and costs regardless of who prevails in the outcome
of the dispute.
PAYMENT SCHEDULE AND METHOD
v.
w.
(.
IV.
A. The maximum amount of payment under this Contract shall not exceed the total contract -amount set
forth on the attached Purchase Order as authorized by the County's Purchasing Department, and
shall be subject to the availability of funds to the County. The County is under no obligation to make
any referrals for the purpose of services during the lifetime of this Contract.
B. Upon receipt of an approved invoice, the County shall pay the Contractor for services authorized the
previous month. The completed invoice is to be received by the 5th working day of the month. Under
normal conditions, Contractor should expect payment approximately twenty-one (21) days after
submission of a correctly prepared invoice. Monthly invoices shall not be greater than one-twelfth
(1/12) of the total annual contract amount.
C. DMS representative shall not approve any request for payment of funds until Contractor has filed
properly completed reports required under this Contract. Contractor shall ensure that all
expenditures are supported by properly executed payroll time records, invoices, contracts,
vouchers, orders and any other accounting documents pertaining in whole or in part to this
Contract. Such documents shall be clearly identified and readily accessible to DMS staff, as may
be required.
D. Contractor must return any unspent funds with submittal of revised year-end Financial Closeout
Report, or based on the results of an independent audit.
E. DMS reserves the right to refuse payment to Contractor or later disallow costs for any expenditure
determined by OMS to be non-compliant with any provision of this Contract, or inappropriate to
Page 6 of 11
. .
Attachment A
such activities, or for which there is inadequat~ supporting documentation presented, or for which
prior approval is required by not granted
F. OAAS shall pay Contractor only for services ordered by authorized OMS staff. The Contractor
agrees that reimbursement for each service furnished under this Contract made irl>.accordance with
the rates stipulated herein, represents payment in full for said service. The Contractor shall not
seek reimbursement from OAAS for any services reimbursed in whole or in part by any other payor.
Whenever Contractor is not in compliance with any provision of this Contract, OMS may withhold
payment of any invoice submitted to OMS by Contractor until such time as suitable documentation
is submitted to OAAS.
G. Contractor is to provide the requested services in accordance with the timelines set by OAAS.
Where the Contractor does not provide a definite date to commence providing the ordered services
within five (5) working days of service start-up as specified by OMS, the request for service
becomes automatically void and OMS will have no obligation to pay for any services provided
under such request for services.
H. If Contractor cannot provide authorized services to a specific client, or feels the authorized services
are not appropriate, Contractor shall notify OMS staff within three (3) working days of receipt of
request for services.
I. When Contractor fails to provide an authorized service to a client and the client incurs costs (e.g.
fees for a doctor appointment) Contractor will be responsible for said costs.
J. Costs for services under the terms of this Contract will be incurred during the term of the Contract
except as approved by County. County "will not use current year funds to pay prior or future year
obligations. .
K. Upon written demonstration of need by Contractor and at the option of the County, 10% of the total
annual Contract funds may be advanced to Contractor by County upon approval of the Director of
the Department of Aging & Adult Services. Any such advance will cause the amounts payable to
Contractor to be reduced to the amount determined by dividing the balance left by the number of
months remaining in the Contract term. The amount of the advance is limited to one-twelfth of the
maximum amount of payment under this Contract.
L. Funds made available under this Contract shall not supplant any federal, state or any governmental
funds intended for services of the same nature as this Contract. Contractor shall not claim
reimbursement or payment from County for, or apply sums received from County with respect to
that portion of its obligations that have been paid by another source of revenue. Contractor agrees
that it will not use funds received pursuant to this Contract, either directly or indirectly, as a
contribution or compensation for purposes of obtaining funds from another revenue source without
prior written approval of the County.
M. For any Contract where OAAS is the case manager, it is understood that the implementation of
services is dependent upon care plans developed by OAAS for DMS clients, and ordered from the
Contractor.
N. In the event the Contract utilizes Community Oevelopment Block Grants ("COBG") funds: "Cash
Match" refers to cash, other than program income, contributed to the project from local or state
. funds. With the exception of COBG, federal funds cannot be used as cash match.
O. County is not liable for the payment of any taxes, other than applicable sales or use tax, resulting
from this Contract however designated, .Ievied or imposed, unless County would otherwise be liable
for the payment of such taxes in the course of its normal business operations.
P. The Contractor, by signing this Contract, hereby certifies to the best of his or her knowledge and
belief, that:
1. No federal appropriated funds have been paid. or will be paid, by or on behalf of the
Contractor, to any person for influencing or attempting to influence an officer or employee of
Page 7 of 11
c-~_
'.
Attachment A
any agency, a Member of Congress, an 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 contract, grant, loan, or cooperative agreement.
2, If any funds other than federal appropriated funds have been paid or will be paid to any
person for influencing or attempting to 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
Contractor shall complete and submit Standard Form-LLL, "Disclosure Form to Report
Lobbying," in accordance with its instructions.
II. RIGHT TO MONITOR AND AUDIT
A. County shall have the absolute right to monitor the performance of Contractor in the delivery of
services provided under this Contract.
B. County or any subdivision or appointee thereof, and the State of Califomia or any subdivision or
appointee thereof, including the Auditor General, shall have absolute right to review and audit all
records, books, papers, documents, corporate minutes, and other pertinent items as requested, and
shall have absolute right to monitor the performance of Contractor in the delivery of services provided
under this Contract. Contractor shall give full cooperation in any auditing or monitoring conducted.
C. Contractor shall cooperate with County in the implementation, monitoring and evaluation of this
Contract and comply with any and all reporting requirements established by this Contract.
D. All records pertaining to service delivery and all fiscal, statistical and management books and records
shall be available for examination and audit by County, Federal and State representatives for a period
of three years after final payment under the Contract or until all pending County, State and Federal
audits are completed, whichever is. later. Records of the Contractor, which do not pertain to the
services under this Contract, shall not be subject to review or audit unless provided in this or another
Contract. Technical. program data shall be retained locally and made available upon the County's
reasonable advance written notice or turned over to County. If said records are not made available at
the scheduled monitoring visit Contractor may, at County's option, be required to reimburse County
for expenses incurred due to required rescheduling of monitoring visit(s). Such reimbursement will not
exceed $50 per hour (including travel time) and be deducted from the following month's claim for
reimbursement.
E. Contractor shall provide all reasonable facilities and assistance for the safety and convenience of
County's representative in the performance of their duties. All inspections and evaluations shall be
performed in such a manner as will not unduly delay the work of the Contractor.
'II. CORRECTION OF PERFORMANCE DEFICIENCIES AND APPEAL PROCEDURES
A. Correction of Performance Deficiencies
1. Failure by Contractor to comply with any of the provisions, covenants, requirements or
conditions of this Contract shall be a material breach of this Contract.
2. In the event of a non-cured breach, County may, at its sole discretion and in addition to
immediate termination and any other remedies available at law, in equity, or otherwise
specified in this Contract
a. Afford Contractor thereafter a time period within which to cure the breach, which period
shall be established at sole discretion of County; and/or
b. Discontinue reimbursement to Contractor for and during the period in which
Contractor is in breach, which reimbursement shall not be entitled to later recovery;
and/or
c. Withhold funds pending duration of the breach; and/or
Page 8 of 11
, .
fill.
~ 'F~
B.
Attachment A
d. Offset against any monies billed by Contractor but yet unpaid by County those monies
disallowed pursuant to Item "2" of this paragraph; and/or
e. Impose liquidated damages that will reduce the total reimbursable amount of the
Contract by the amount(s) levied and not claimable by Contractor. This remedy shall
only be used when reasonable efforts to correct a performance or violation deficiency
have failed to correct the problem, or in circumstances of unacceptable or negligent
performance of Contractor as determined by County. There is no limit to the number of
adjustments County may levy per each instance.
f. Terminate this Contract and be relieved of the payment of any consideration to
Contractor should Contractor fail to perform the covenants herein contained at the time
and in the manner herein provided. In event of such termination, the County may
proceed with the work in any manner deemed proper by the County. The cost to the
County shall be deducted from any sum due to the Contractor under this Contract and
the Contractor upon demand, if any, shall pay the balance.
Appeal Procedures
If Contractor disagrees with any decision or action taken by the County or DAAS related to this
Contract, Contractor may choose to file a formal grievance by following the procedures below:
1. The Contractor shall file a formal written grievance with the Director of DMS within fifteen
(15) business days after the Contractor is aware of the factors or conditions precipitating the
contract dispute. The written grievance shall set forth the subject of the grievance, identify the
specific clause in dispute and shall provide a detailed statement of the grievance, including
dates, names, places, and the specific remedy or action requested. The filing address is 686
East Mill Street, San Bernardino, Califomia, 92415-0640. The Director of DAAS shall provide a
written response to Contractor within fifteen (15) business days of receipt of the grievance.
2. If Contractor is not satisfied with the Director of DAAS' response, Contractor may file a written
grievance appeal, which shall include a statement by the Contractor as to why the Director of
DMS' response is not satisfactory, to the Assistant County Administrator of the Human
Services System ("Assistant County Administrator") within fifteen (15)business days of receipt
of the Director of DMS' response. The filing address is 385 North Arrowhead Avenue, Fifth
Floor, San Bernardino, California, 92415-0128. The Assistant County Administrator shall
provide a written response to Contractor within fifteen (15) business days. The Assistant
County Administrator shall have final authority for the decision on the grievance except as
provided in the paragraph below.
3. For those appeals that involve CDA programmatic policies and directives issued to the County
and contained within this Contract, this paragraph shall apply. If Contractor is not satisfied with
the Assistant County Administrator's decision, the written grievance may be registered in
writing with the CDA, Case Management Branch, 1600 "K" Street, Sacramento, California,
95814, within fifteen (15) business days following receipt of the Assistant County
Administrator's decision. Contractor shall submit to CDA the original written grievance along
with a copy of the Director of DMS' written response, the Contractor's appeal to the Assistant
County Administrator, and the Assistant County Administrators' decision. CDA shall have final
authority for the decision on the grievance.
TERM
A.
This Contract is effective as of July 1, 2004 and expires June 30, 2005, but may be terminated earlier
in accordance with provisions of Article IX of the Contract.
This Contract is of no force or effect until signed by both parties hereto. The Contractor shall not
commence performance until such approval has been obtained; failure to obtain such approval may
result in non-payment for the performance of those services.
B.
Page 9 of 11
,,-- --,-,...
...~ ._~..
--~~~
, r
Attachment A
x. EARLY TERMINATION
A. The County may terminate the Contract immediately under the provisions of Section VII of the
Contract. In addition, the County may terminate the Contract without cause by serving a written
notice to the Contractor thirty (30) days in advance of termination. The Assistant County Administrator
- Human Services System is authorized to exercise the County's rights with respect to any
termination of this Contract.
B. Contractor will only be reimbursed forcosts and uncancelable obligations incurred prior to the date of
termination. Contractor will not be reimbursed for costs incurred after the date of termination.
<. GENERAL PROVISIONS
A. When notices are required to be given pursuant to this Contract, the notices shall be in writing and
mailed to the following respective addresses listed below.
Contractor: City of San Bemardino .
Senior Companion Program
600 West Fifth Street
San Befnardino, CA 92410
County:
County of San Bemardino - Human Services System
Attn: Mary L. Sawicki
686 East Mill Street
San Bernardino, CA 92415-0515
B. Nothing contained in this Contract shall be construed as creating a joint venture, partnership or
employment arrangement between the parties hereto, nor shall either party have the right, power or
authority to create an obligation or duty, expressed or implied, on behalf of the party hereto.
C. County shall have Power of Attorney to pay delinquent debts and unpaid wages. for work provided
under this Contract from accounts payable to Contractor in the event debts and wages have not been
paid on a current basis. .
D. No waiver of any of the provisions of the Contract shall be effective unless it is made in writing, and
refers to' the provisions so waived and is executed by the parties. No course of dealing and no
delay or failure of a party in exercising any right under the Contract shall affect any other or future
exercise of that right or any exercise of any other right. A party shall not be precluded from
exercising a right by its having partially exercised that right or its having previously abandoned or
discontinued steps to enforce that right.
E. Any alterations, variations, modifications, or waivers of provisions of the Contract, unless
specifically allowed in the Contract, shall be valid only when they have been reduced to writing, duly
signed and approved by the Authorized Representatives of both parties as an amendment to this
Contract. No oral understanding or agreement not incorporated herein shall be binding on any of
the Parties hereto.
F. If any provision of the Contract is held by a court of competent jurisdiction to be unenforceable or
contrary to law, it shall be modified where practicable to the extent necessary so as to be enforceable
(giving effect to the intention of the parties) and the remaining provisions of the Contract shall not be
affected.
G. This Contract shall be governed by and construed in all aspects in accordance with the laws of the
State of California without regard to principles of conflicts of laws. The parties agree to the exclusive
jurisdiction of the federal and state courts located in the County of San Bemardino. for' any and all
disputes arising under this Contract, to the exclusion of all other federal and state courts.
Page 10 of 11
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Attachment A
KI. Conclusion
A. This Contract, consisting of 11 pages, which includes the Purchase Order, Attachment A _
Additional Terms and Conditions to f?urchase Order, Attachment B - Scope of Work, Attachment C
- BudgetDisplay, Attachment D - Vendor Complaint Form and Attachment E - Information Sheet,
is the full and complete document describing services to be rendered by Contractor to County
. including all covenants, conditions and benefits.
B. The signatures of the parties affixed to this Contract affirm that they are duly authorized to commit
and bind their respective institutions to the terms and c~nditions set forth in this document.
C. This Contract shall become effective upon execution by both parties.
D. This Contract may be executed in counterparts. When executed, each counterpart shall be
deemed an original irrespective of date of execution. Said counterparts shall together constitute
one and the same Contract.
IN WITNESS WHEREOF, the parties have caused this Contract to be executed as of the day and year
writte.n below by the County of San Bernardino Purchasing Department.
;OUNTY OF SAN BERNARDINO
)URCHASING DEPARTMENT
CONTRACTOR
kg
"
~y' ~ '~,.., By'
. MIO'lAE:L LOLLER rl I V\.. V .
Deputy Purchasing Agent
)ated: --.J/~ ~()4'-
Dated:
6/2faiy
Page 11 of 11
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ORIGI^A~
Attachment A-1
o
Additional Terms and Conditions to Title IIIB Programs Purchase Order
Amendment 1 - Effective July 1. 2005
TH IS CONTRACT is entered into in the State of California by and between the County of San Bernardino,
Department of Aging and Adult Services, hereinafter called the County, and
Name
City of San Bernardino, Senior Companion Program
Address
hereinafter called
"Contractor"
600 West Fifth Street
San Bernardino, CA 92410
Phone
(909) 384-5413
Federal 10 No. or Social Security No
95-6000772
IT IS HEREBY AGREED AS FOLLOWS:
AMENDMENT NO.1
It is hereby agreed to amend this Contract as follows:
Section VIII. TERM (A) is amended to read:
This Contract is effective as of July 1, 2005 and expires June 30, 2006, but may be terminated earlier in
o accordance with provisions of Article IX of the Contract.
All other terms and conditions of this Contract shall remain the same and are incorporated herein by this
reference.
This amendment shall become effective upon execution by both parties.
COUNTY OF SAN BERNARDINO
PURCHASING DEPARTMENT
CONTRACTOR
By:
By:
LEO GOMEZ
Deputy Purchasing Agent
Dated:
Dated:
Approved as to Form
and Legal Content:
JAMES F. PENMAN,
Cl:) ~ttorney
(}
./~
Page 1 of 1
C~".
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Attachment B
City of San Bernardino (Senior Companion Program)
o.
WORK PLAN
FY 2005 - 2006
This work plan contains the measurable objectives mandated by DAAS of the service provider. The
work plan specifies and establishes time frames either on an annual basis or, where required by state
regulations, on a quarterly basis. The work plan constitutes the primary document for ongoing
monitoring, Annual Program Performance Review/Fiscal Audit and will be used to measure the
provider's efforts toward providing quality Assisted Transportation.
I. Scope of Work
A. Geographic Area/Clientele and Eligibility Criteria
1. The geographic area served by this provider covers the Morongo Basin
and Victor Valley regions, including Joshua Tree, Twentynine Palms,
Yucca Valley, Adelanto, Apple Valley, Hesperia, and Victorville.
2. The clientele served by this agreement consists of seniors 60 and over.
B. Program Description
o
1.
Purpose: Assisted Transportation is provided to improve the socialization
and increase independence for people who cannot drive or use regular
vehicular transportation.
2. Definition: Provide assistance, including escort to a person who has
difficulties (physical or cognitive) using regular vehicular transportation.
C. Intended Outcomes
1. Assisted Transportation
a. Provide 3,251 one-way trips annually for seniors who are not eligible
for this program from any other resource and who cannot pay for this
program.
b. Staff and/or volunteers providing Assisted Transportation services
must be trained and qualified in the safe provision of Assisted
Transportation services. Assisted Transportation must be provided to
at least 55 unduplicated seniors of which 5 are to be minority low-
income seniors.
2.
Develop and have on hand, for review by DAAS, a cost allocation plan
which explains the methods used to allocate costs between programs with
funds received from DAAS.
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3.
Conduct a client or participant satisfaction survey at least once a year.
The survey form must be approved by designated DAAS staff prior to its
use and all findings from the survey must be used to improve services.
The returned surveys and tabulated results must be kept on file for review
by DMS staff.
II. Service Deliver'yActivities
A. Staffing
Sufficient personnel shall be available to carry out the needs of the program. This
includes a Director and additional personnel as determined by the size of the service
area and the method and level of service provision needed to fully comply with the
terms of this work plan and agreement.
B. Volunteer Staff
1. Volunteers are individuals who work without pay in the performance of essential
duties to conduct the program. In some cases, the Director may be a volunteer.
2. Volunteers shall not replace paid personnel.
C.
Clients will be given priority for services who are socially and/or economically needy and
who are not eligible for services from any other source.
Further, individuals referred by DAAS staff shall be'given first priority for services under
this agreement.
Definitions: Economically Needy: Seniors whose income is at or below the SSI/SSP
level.
Socially Needy: Seniors who have at least two of the following characteristics:
Disabled, Language/Communication Barrier, Lives Alone, Age 75+.
D. Training Activities
1. Provide training both on the job and in formal training sessions, as appropriate, to
improve the understanding of paid staff about the service(s) being provided.
Wherever required by law and/or ordinance, licensed staff must be trained to
carry out assigned duties. In addition, annually evaluate paid staff performance
to determine his/her effectiveness, skill development and understanding of tasks
they are assigned. Documentation of training shall be kept on file at the
provider's main office for review by DMS during program monitoring to be
scheduled and conducted by DAAS.
2.
Volunteers should be provided on-the-job training and opportunities for formal
training to improve skills and understanding of the service being provided.
Wherever required by law or ordinance volunteers must be trained and/or
licensed to carry out assigned duties. Documentation of training shall be kept on
LAging\I'rograms\Scopes of Work and Provider Budgels\05-06 WI's & Budgets
2
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file at the provider's main office for review by DAAS during program monitoring to
be scheduled and conducted by DAAS staff.
O. Other Service Requirements
A. Physical Set-Up
1. Where services are provided in a care center, office or any setting outside the
client's home, the environment must be attractive, clean and free from obstacles
which could cause injury.
2. Post floor plans identifying emergency exits, assembly areas, etc. and conduct
evacuation drills at least twice a year. Proof of evacuation drills will be kept on
file duly signed by the Fire Marshal or other authorized agency within the
community where the service site is located.
B. Donations and Confidentiality
1. Encourage seniors to donate by notifying them verbally that donations are
accepted and are important to maintaining the service(s) provided. Post signs
where appropriate stating that donations are accepted. The provider shall not in
any way employ tactics which could be viewed as coercion, embarrassing, and/or
obligatory to the service being provided.
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2.
All contributions shall be used to increase the amount of service being provided
in the program(s) funded by DAAS.
C. Coordination Activities
1 . Provider shall participate within appropriate coordination bodies established by
state law and/or county ordinance.
2. Provider shall include the following statement on all advertising, posters and
brochures, etc.:
"Funding for this service has been provided by the San Bernardino County
Department of Aging and Adult Services through a grant award from the
California Department of Aging."
3. Provider shall coordinate service with other County departments and local
agencies by providing time within the facility during participant meetings, staff
meetings and volunteer meetings, etc., for presentations on special activities that
promote a Community Based System of Care for elderly clients. All coordination
activities must be documented and kept on file for review by DAAS.
4.
Provider shall coordinate service with other County departments and local
agencies by providing time for presentations or special activities that promote a
Community Based System of Care for the elderly participants attending their
sites. All such activities must be documented and kept on file for review by
DAAS.
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D.
Reporting Requirements
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Contractor, at such times and in such forms as DAAS may require, shall furnish
statements, records, reports, data and information requested by DAAS
pertainiflg to Contractor's performance of services hereUnder and other matters
covered by this Contract. The forms shall be reviewed for timeliness,
completeness, and correctness of the information submitted, by the Program
Director or his/her designee, prior to submission to DAAS. Incomplete forms
shall be returned to the Contractor for completion. (In the event of changes in
these forms, DAAS shall advise the Contractor via written notice.) The Contractor
shall develop and implement a process for ensuring quality control.
a. Contractor shall meet the following standard for its financial management
systems, as provided in the CDA PM Title III Program Manual:
I. Financial Reporting (CDA PM, Section G, Paragraph 93.5a)
Accurate, current and complete disclosure of the financial
results of the Supportive Services Program shall be made in
accordance with the financial reporting requirements of this
Contract. The following reports are to be submitted to OMS
when indicated:
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1) Monthly (Due by 5th working day of each month)
a. Monthly Expenditure Report/Request for
Reimbursement
2) Semi-Annually
a. Budget Revision #1 (Due November 1 )
b. Budget Revision # 2 (Due May 15)
3) Annually
a. Financial Close-Out Report (Due August 1)
b. Periodic Inventory (Due August 1 with Close-out)
c. Audit Report (Due October 31)
d. Revised Financial Close-out Report (Due October 31 )
with Audit Report.
II. Program Reporting
The following reports are to be submitted to OMS when indicated:
1) Monthly (Due by the 5th working day of each month)
a. IIIB Monthly Service Unit Report
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2) Quarterly
a. Program modification request in writing to OMS.
Contractor shall describe, in detail, necessary program
changes and the reasons for the requested
modification.
L Aging"Programs'Scopes of Work and Provider Budgets\05-06 WPs & Budgets
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3) Upon request
a. Completion of Client Intake Sheets provided by DAAS.
4) DAAS may require financial reports more frequently than
indicated"above or with more detail (or both), upon written notice
to the Contractor, until such time as DAAS determines that the
financial management standards are met.
III.
Report service and client data by the 5th working day of the month
on DAAS Monthly Service Report which will be verified by DAAS
during the annual program audit. Additionally, establish audit files
which include but are not limited to a copy of the Monthly
Service Report
Report monthly expenditures to DAAS by the 5th working day of the
month. Maintain support files including but not limited to invoices,
payroll, and other supporting documents, all of which will be
attached to a copy of the expenditures report and kept on file by
month for review during the Annual Audit.
IV.
Maintain records, by month, that support claimed in-kind
expenditures.
.'n the event additional funds become available, the provider will use the funds to increase their
ssisted Transportation services provided to elderly clients by either increasing the number of
individuals served or by increasing the units of service provided or both. Exceptions to this
requirement, for instance the use of additional funds to purchase equipment, must be fully
documented in writing and submitted to the department for prior approval. Failure to abide by this
work plan will constitute just cause for sanctions being imposed.
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Attachment D
County of,San'Bernardino
Department of As;jing& Adult Services
VENDOR COMPLAINT FORM
Date:
Program:
Name of person completing form: Phone #
Address: Phone #
Staff name (if it applies) Phone #
Office Location
ContractorNendor:
Has issue been brought to the attention of vendor? (Circle one)
Do you wish to remain anonymous? (Circle one) YES
YES
NO
NO
Issue:
FACTS:
Resolution:
Admin Staff Assigned Date Assigned Date Resolved
DAAS VEND 1 (11/02)
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Attachment E
INFORMATION SHEET
CONTRACTOR SHALL COMPLETE SECTION I OF THIS FORM AND RETURN TO:
SAN BERNARDINO COUNTY
Department of Aging and Adult Services
Attn: CONTRACTS
Sf ( 110', I: (,O\TJ{ \("1 OJ{ I\H>R\I \ no"
Contractor Name:
it . of San Bernardino Parks, Recreation & Communit
Address (IIlrlUdlllg CIty, 5lau and ZIp Code)
Phone:
47 North Sierra Wa , San Bernardino, CA 9241O~4816
Web Site: Em~il:
(909) 384-5233
Fax:
VWW. ci. san-bernardino .ca. US
Sile Name for Services(1f Different from Contractor):
(909) 384-5160
Pbone:
00 West 51h Street, San Bernardino, CA 92410
Web SIle:
(909) 384-5413
EmaJl:
Fax:
Randol h le@shcitv.or
Tille:
(909) 889-9801
~ame.
Name
Lemuel P. Randol h
Title:
Director
SlgnalUre:
Tille
Pholle #: E-~lail'
( 909) 384-5030 andol h le@sbcitv.or
Claim Si nature Authorit
Phone #:
E-Mail:
Name:
J\jame"
mue1 P. Randol h
Tille:
Director
Bettv Deal
Tille:
Signature:
Phone #;
San Bernardino County
Department of Aging and Adult Services
Contracts Unit
686 E. Mill Street
San Bernardino, CA 92415-0920
Contracts Unit:
Leslie Dunn, Contracts Management
909-891-3930
E-Mail: Ldunn@hss.sbcounty.l!;ov
Unit Fax #: 909-891-3919
Pal!:e 1 of 1