HomeMy WebLinkAbout16-Parks and Rec
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CltC)OF SAN BERNARDIIO - REQUEO FOR COUNCIL ACON
From: ANNIE F. RAMOS, DIRECTOR Subject:
RESOLUTION AUTHORIZING AN AGREEMENT
WITH THE EAST VALLEY REGIONAL COUNCIL
ON AGING FOR PROVIDING COMPANIONSHIP
AND PERSONAL SERVICES TO CLIENTS IN
THE EAST VALLEY BY THE CITY OF SAN
BERNARDINO SENIOR COMPANION PROGRAM.
Dept: Parks, Recreation and Community Services
Date: December 20, 1990
Synopsis of Previous Council action:
July 5, 1989 - Adopted Resolution 89-244 authorizing Companion Services for the East
Valley Area for 1989
Recommended motion:
Adopt Resolution.
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Signature
Contect person: Tnm Rnllll~ Phone:
Supporting data attached: Staff Report, Reso 1 uti on & Agreement Ward:
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N/A
FUNDING REOUIREMENTS:
Amount:
N/A
Source: (ACCT. NO.) No cost to City - City will be reimbursed
for services.
(ACCT. DESCRIPTION)
Finance:
t:ouncll Notel:
n.G262
Agenda Item No.
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CI'tO)F SAN BERNARDI to - REQUEO FOR COUNCIL ACTON
RESOLUTION AUTHORIZING AN
AGREEMENT WITH THE EAST
VALLEY REGIONAL COUNCIL ON
AGING FOR PROVIDING COMPAN-
IONSHIP AND PERSONAL SERVICES
TO CLIENTS IN THE EAST VALLEY
BY THE CITY OF SAN BERNARD1NO
SENIOR COMPANION PROGRAM.
STAFF REPORT
,
The City of San Bernardino has the only SCP Program in this
region: consequently, other governmental agencies seek assistance
through our program to provide companions for their areas. The
East Valley Regional Council on Aging is one such organization
which has requested services of companions for which they totally
reimburse the city. There is no additional cost to the City for
recruiting and assigning the companion to serve the Senior home
and Health Care Clients.
Recommend adoption of the Resolution.
December 20, 1991
75-0264
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RESOLUTION NO.
RESOLUTION OF THE CITY OF SAN BERNARDINO AUTHORIZING THE
DIRECTOR OF PARKS, RECREATION AND COMMUNITY SERVICES
DEPARTMENT TO EXECUTE AN AGREEMENT BETWEEN THE CITY OF SAN
BERNARDINO AND THE EAST VALLEY REGIONAL COUNCIL ON AGING, SAN
BERNARDINO COUNTY, FOR THE PURPOSE OF PROVIDING COMPANIONSHIP
AND PERSONAL SERVICES TO CLIENTS IN THE EAST VALLEY SERVICE
AREA BY THE CITY OF SAN BERNARDINO SENIOR COMPANION PROGRAM.
BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE
CITY OF SAN BERNARDINO AS FOLLOWS:
SECTION 1.
The Director of Parks, Recreation and
Community Services Department of the City of San Bernardino
is hereby authorized and directed to execute for and on
behalf of said City an Agreement with the East Valley
Regional Council on Aging, San Bernardino County for the
purpose of providing companionship and personal services to
clients in the East Valley Service Area by the City of San
Bernardino Senior Companion Program; a copy of said agreement
is attached hereto as Exhibit "A" and incorporated herein by
reference as though fully set forth at length.
I HEREBY CERTIFY that the foregoing resolution was duly
adopted by the Mayor and Common Council of the City of San
Bernardino at a
meeting thereof,
held on the
day of
1991, by the following vote, to wit:
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RESOLUTION OF THE CITY OF SAN BERNARDINO AUTHORIZING THE
DIRECTOR OF PARKS, RECREATION AND COMMUNITY SERVICES
DEPARTMENT TO EXECUTE AN AGREEMENT BETWEEN THE CITY OF SAN
BERNARDINO AND THE EAST VALLEY REGIONAL COUNCIL ON AGING, SAN
BERNARDINO COUNTY, FOR THE PURPOSE OF PROVIDING COMPANIONSHIP
AND PERSONAL SERVICES TO CLIENTS IN THE EAST VALLEY SERVICE
AREA BY THE CITY OF SAN BERNARDINO SENIOR COMPANION PROGRAM.
COUNCIL MEMBERS
AYES
NAYS
ABSTAIN
ESTRADA
REILLY
FLORES
MAUDSLEY
MINOR
POPE-LUDLAM
MILLER
City Clerk
The foregoing resolution is hereby approved this
day of
, 1991.
W.R. Holcomb, Mayor
City of San Bernardino
Approved as to form
a~ legal content:
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ty Attorney
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AFR:jf
(RESOLUTION12/20)
12/20/90
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NOTIFICATION OF CONTRACT AWARD
CONTRACT NUMBER
TO:
SENIOR COMPANION PROGRAM
BY:
EAST VALLEY
REGIONAL COUNCIL ON AGING
THIS AGREEMENT, is made en the 1st day ef
January 19---1.1., by and between the Regienal
Ceuncil en Aging, hereinafter called the RCA and
SENIOR COHPANION PROGRAM direct service previder,
hereinafter called "Centracter."
The Older Americans Act ef 1965,
fer assistance to. state and lecal
secial suppertive services to. meet
as Amended, prevides
agencies to. develep
the needs ef elder
persens.
The Califernia Department ef Aging has allotted funds
to. the Ceunty ef San Bernardino. Office en Aging acting
as the Area Agency en Aging, hereinafter called the Office
en Aging er "OeA", fer the purpese ef administering a
certain pertien ef said funds pursuant to. said act; and
fer the purpese ef planning service pregrams and activities
fer elder persens.
WHEREAS, the RCA desires to. use Office en Aging menies
to. fund, and the Centracter desires to. eperate and execute
a Regienal Pregram, this centract is executed to. reduce
to. writing, the specific terms and cenditiens cevering
the funding, executien and eperatien ef the pregram previded
by this centract.
THEREFORE, in censideratien ef the mutual premises
and cevenants centained herein, the RCA and the Centracter
agree as fellews:
1. DEFINITIONS: CDA PM means "Title III pregram Manual
fer Area Agencies en Aging." This manual is based
en Federal regulatiens fer Title III published folarch
31, 1980 ICFR, Chapter 8, Subchapter C, Par. 1321).
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1 Pertinent parts of 45 CFR, Sub-title A, Part 74,
2 published June 3, 1980, have also been used. A copy
3 of the manual is available at the San Bernardino County
I;
4 . Office on Aging during regular office hours.
5 I 2. WORK TO BE PERFORMED: The Contractor shall, in a
6 ! satisfactory manner as determined by the RCA and OoA,
7 Ii conduct, administer and provide Regional services
8 I for the elderly as defined in the attached WORK PROGRAM
(Exhibit A) and PROGRAM BUDGET (Exhibit B). The
aforementioned and all other exhibits are, by this
reference, made a part of this contract as if fully
set forth herein.
3. PERFORMANCE STANDARDS AND REMEDIES: If for any reason
the Contractor's service falls below 5% or exceeds
25% of the contracted level during any calendar quarter,
the Contractor will submit to the RCA within thirty
(30) calendar days an analysis of the problem and
the actions being taken to correct the problem. If
the problem persists, the RCA, and the Contractor
will jointly prepare a written corrective plan with
time lines for completion. If the Contractor fails
to carry out the corrective action in the required
time frame, sanctions will be invoked as described
in the OoA Sanction Policy. Continued lack of
corrective action. will be cause for termination of
contract. If, after all appropriate actions have
been taken, the service level still falls below 5%
or exceeds 25% of the contracted level, the RCA may
in its sole discretion revise the contracted level
of service and the budget, as appropriate.
4. TERM: The term of this agreement will begin on the
1st day of ,janllary , 19.JtL, and terminate
on the 30th day of June 19.1l-,
subject, however, to early termination as herein
provided.
5. COMPENSATION/SCHEDULE OF PAYMENTS: The maximum amount
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of
funds
awarded
this
shall
be
under
contract
, and shall
from the California
be subject to receipt
Department of Aging and
$3,000.00
of funds
the OoA.
Contractor shall provide assurance that all funds
received by the Contractor from the RCA shall be
accounted for separately in the Contractor's accounting
system and segregated from all other funds under the
Contractor's control. Any funds received by the
Contractor from the RCA which have not been obligated
prior to the termination of this agreement shall be
returned to the RCA immediately thereafter.
The initial advance payment to the Contractor shall
be $1,000.00 after which payments shall be based
upon the units of service delivered during the previous
sixty (60) day period and cash balance on hand and
shall not exceed $1,000.00 per sixty (60) day
period unless approved in writing by the Rc;A and the
OoA Director. Contractor must be bonded in order
20 to receive an advance.
21 The initial payment to the Contractor shall be made
22 wi thin sixty (60) days of the commencement of service
23 and thereafter payment for each sixty (60) day period
24 of services will be made no later than the 30th day
25 of the following month subject to the availability
26 of funds from the OoA.
27 6. MATCHING SHARE: The Contractor will contribute a
28 cash match of $ -0- and/or an inkind match of
29 $ 333.00 for a total match of ten (10) percent
30 of all expended RCA/OoA and matching funds. Allowable
31 match shall be in accordance with CDA Program Manual,
32 Part I, Section 200, Non-Federal resources.
33 7. FISCAL RESPONSIBILITY: The Contractor agrees to
34 strictly adhere to the approved budget, listed in
35 Exhibit B. Contractor will ensure that all expenditures
36 are supported by properly executed payroll, time
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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 the
RCA Board and the OoA staff, as may be required.
8. AUDIT: Within 90 days after the termination of this
contract, Contractor shall perform an audit and submit
information as required in the OoA Final Program Report.
Requirements of the Final Program Report will be in
accordance with instructions found in the OoA
Contractor's Manual. In the event of an audit
exception, all documents referred to in Paragraph
7, FISCAL RESPONSIBILITY, shall be maintained and
kept available until every exception has been cleared
to the satisfaction of RCA and OoA.
9. INSURANCE: The Contractor agrees to indemnify, defend
and hold harmless the RCA, the OoA, the County and
their authorized agents, officers, volunteers and
employees against any and all claims or actions arising
from Contractor's acts or omissions and for any costs
or expenses incurred by the RCA, OoA, County or
Contractor on account of any claim therefore.
In order to accomplish the indemnification herein
provided for, but without limiting the indemnification,
the Contractor shall secure and maintain throughout
the term of the contract the following types of
insurance with limits as shown:
a. Workers' Compensation A program of Workers'
Compensation Insurance or a State-approved Self
Insurance Program in an amount and 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 the Contractor
and all risks to such persons under this Agreement.
b. Comprehensive General and Automobile Liability
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lO-15n4lA.S77
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Insurance - This coverage to include contractual
coverage and automobile liability coverage for
owned, hired, and non-owned vehicles. The policy
shall have combined single limits for bodily injury
and property damage of not less than three hundred
thousand dollars ($300,000).
Blanket Fidelity Bond Prior to entering upon
performance of this contract, the Contractor agrees
to submit to the County proof of a blanket fidelity
bond in an amount equal to one month of the contract
- ,
payroll of the contract period, covering all
officials, employees an agents handling or having
access to funds received or disbursed by the
Contractor under this contract, or who are
authorized to sign, or countersign checks. Said
bond shall constitute primary protection for the
County, and the Office on Aging, and their,officers,
agents, and employees. The bond policy shall
provide at least thirty (3D) days prior, written
notice to the County of cancellation or material
change. Said bond is required in order to receive
an advance.
All policies, with respect to the insurance coverage
above required, except for the Workers' Compensation
insurance coverage and professional liability
coverage, if applicable, shall obtain addi~ional
endorsements naming the Department and the County,
their employees, agents, volunteers and officers
as additional named insured with respect to
liabilities arising out of the performance of
services hereunder.
All policies required above
and non-contributing with any
insurance programs carried
are to be primary
insurance or self:-
or administered by
the County.
Contractor shall immediately furnish certificates
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of insurance and within 60 days provide certified
copies of all policies and endorsements to the
RCA evidencing the insurance coverage above required
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
RCA, and shall maintain such insurance from the
time Contractor commences performance of services
hereunder until the completion of such services.
The Contractor shall require the carriers of the
above required coverages to waive all rights of
subrogation against the RCA, the OoA and the County,
their officers, volunteers, employees, contractors
and subcontractors.
10. LICENSURE: Where the State or local public jurisdiction
wi thin the State requires licensure for the provision
of services, the Contractor will, in performing the
services stipulated in this contract, obtain all
necessary licenses, and maintain such licenses
throughout the term of this contract.
11. REPORTS: Contractor, at such times and in such forms
as the RCA and OoA may require, shall furnish RCA
and OoA statements, records, reports, data and
information as RCA and OoA may request pertaining
to Contractor performance of services hereunder and
other matters covered by this agreement.
12. INSPECTIONS: Contractor shall make available to RCA,
OoA, State or Federal officials, its records and data
with respect to all matters covered by this agreement
for inspection and .audit. Said inspection and audit
may be made at any time during normal business hours
after reasonable notice (CDA PM, Part G, Section 93.21
N 8).
13. MONITORING AND ASSESSMENT: Contractor shall permit
RCA, OoA, State or Federal officials to monitor, assess
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or evaluate Contractor's performance under this
agreement. Said monitoring, assessment or evaluation
shall include, but not be limited to, project site
visi ts and interviews with Contractor's employees
and agents providing the service under this agreement
and recipients thereof. Contractor will ensure
cooperation and shall attend all meetings mandated
by the RCA and OoA.
PROPERTY MANAGEMENT SYSTEM: All equipment, materials,
supplies or property of any kind purchased with OoA
funds provided herein shall be in accordance with
CDA PM, Part G, Section 93.19, and if not fully expended
or consumed prior to termination of this contract
shall be the property of the RCA, unless otherwise
directed by the OoA Director. The Contractor shall
be held liable for all losses of or damage to non-
expendable equipment or material resulting from
negligence or improper implementation of safeguards.
The disposal, loss and/or destruction of property
or equipment shall be fully documented by the Contractor
with copies thereof provided to the OoA with the monthly
report for the month in which occurred. Loss by
vandalism or theft must be immediately reported to
the police. The OoA Director shall be notified of
the loss wi thin seventy-two (72) hours of discovery
of the loss. Equipment that is worn beyond economical
repair may be turned in to the OoA for accountability
purposes. Replacement of the item shall require OoA
authorization. Any equipment purchased will be subject
to review over the life of the equipment, and if not
used, underused or misused, may be claimed by the
OoA for redistribution to other OoA projects.
AMENDMENTS TO THE CONTRACT: This Agreement constitutes
the entire agreement between the Contractor and the
RCA with respect to the subject matter of this
agreement. There are no other or further written
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.]5041A.577 I
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or oral understandings or agreements with respect
to this agreement. No variation or modification of
this agreement and no waivers of its provisions shall
be valid unless in writing and signed by the parties.
CONDITIONS FOR TERMINATION:
a) The RCA may terminate this agreement 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 the event of such termination,
the RCA and the DoA may proceed with the work
in any manner deemed proper by the RCA and/or
the OoA. The cost to the RCA and the OoA shall
be deducted from any sum due the Contractor under
this agreement, and the balance, if any, shall
be paid the Contractor upon demand.
b) Without the prior written consent of the RCA and
the OoA, this agreement is not assignable by
Contractor either in whole or in part.
c) The consideration to be paid to Contractor, as
provided herein, shall be in full payment for
all Contractor's services and expenses incurred
in the performance hereof.
d) If the grant or other funding under which this
contract is made is terminated, the RCA and the
OoA shall have cause to immediately terminate
this contract. Notice of the termination shall
be in writing to the Contractor.
e) Rec~amation and Closure: In the event of
termination, all funds, property, finished or
unfinished documents, data, supplies, and reports
obtained or prepared by the Contractor under this
contract shall, remain the property of the RCA,
unless otherwise directed by the OoA Director.
f) The Contractor shall be entitled compensation
for satisfactory performance or allowable expenses
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necessarily incurred under this contract.
g) RCA and/or OoA and/or Contractor may terminate
this contract upon thirty (30) days written notice
to the other party.
TRAINING AND MANPOWER DEVELOPMENT: The Contractor
agrees to participate in appropriate staff training
and development provided by the RCA, OoA, the California
Department of Aging and the Administration on Aging.
CONFIDENTIALITY: The Contractor will take steps to
ensure that no information about, or obtained from
an individual, and in the possession of the Contractor,
will be discussed in a form identifiable with the
individual, without the individual's informed consent.
PUBLICATIONS: Any books, reports, pamphlets, papers,
or articles based on activities funded by this contract
must be approved by OoA prior to publication and must
contain an acknowledgment of funding by the San
Bernardino County Office on Aging, and the Regional
Council on Aging.
COPYRIGHTS: If the contract results in a book or
other copyrightable materials, the author is free
to copyright the work, but the RCA and the OoA reserve
a royalty-free, non-exclusive and irrevocable license
to reproduce, publish, or otherwise use, and to
authorize others to use, all copyrighted material
and all material which can be copyrighted resulting
from the contract (CDA PM, Part G, Section 93.19).
CONTRACTOR INDEPENDENCE: The Contractor and the agents
and employees of the Contractor in the performance
of this agreement shall act in an independent capacity
and not as officers, or employees or agents of the
State of California, County of San Bernardino, the
OoA or the RCA.
UNAUTHORIZED ACTIVITIES: All activities not expressly
authorized by this agreement shall be prohibited without
the express written permission of the RCA and the
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OoA Director or his authorized agent.
BINDING CONTRACT: In the event any portion of the
contract is found to be invalid, the remaining portions
shall continue to constitute a valid and binding
contract.
PLANNING EFFORT: The Contractor agrees to cooperate
with the RCA and the OoA in their efforts toward
developing a comprehensive and coordinated system
of services for the elderly by participating in joint
planning efforts and other activities mutually agreed
upon to meet this goal (CDA PM, Part H, Section 107.5).
CONTRIBUTION FOR SOCIAL SERVICES: The Contractor
will provide older persons receiving such services
the opportunity to contribute to all or part of the
social services provided. Each individual recipient
will determine what he is able to contribute toward
the cost of the social service. No older person will
be denied a social service because of hi& failure
19 to contribute. No fee shall be required of the
20 recipient. Methods of receiving contributions from
21 recipients shall be handled in such a manner so as
22 not to differentiate among the individuals contributions
23 publicly. (California Department of Aging, Program
24 Manual, Part R., Section 111.1).
25 26. GREATEST ECONOMIC OR SOCIAL NEED: The Cont~actor
26 understands that one of its responsibilities under
27 this contract is to insure that "preference will be
28 given to providing services to older individuals with
29 the greatest economic or social needs [Older Americans
30 Act of 1965 as Amended, Amendments of 1987, Public
31 Law 98-459, 306 (5) (a) J." "The term 'greatest
32 economic need I means the need resulting from an income
33 level at or below the poverty threshold established
34 by the Bureau of the Census, and the term I greatest
35 social need' means the need caused by non-economic
36 factors which include physical and mental disabilities,
O.1~041A.577
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language barriers, and cpltural or social isolation
including that caused by racial or ethnic status which
restricts an individual's ability to perform normal
daily tasks or which threatens his or her capacity
to live independently. [Older Americans Act of 1965
as Amended, Amendments of 1984, Public Law 98-459,
306 (6)]. Minimum program goals relating to minorities
is determined for the census tracts served by this
contract by computing the percentage of minority
individuals sixty (60) years of age and older within
the total population sixty (60) years of age and older.
27. RELIGIOUS ACTIVITY PROHIBITED: There shall be no
religious worship, instruction, or proselytization
as part of, or in connection with, the performance
of this contract.
28. OTHER STATUTORY PROVISIONS: Contractor agrees to
fully comply with the laws and programs (including
regulations issued pursuant thereto) which are listed
following this paragraph. Such compliance is required
to the extent that such laws, programs and their
regulation are, by their own terms, applicable to
this contract. Contractor warrants that he will make
himself thoroughly familiar with the applicable
provisions of said laws, programs and regulations
prior to commencing performance of the contract.
Copies of said laws, programs, and regulations are
available upon request from the San Bernardino County
Contract Compliance Officer, 686 East Mill Street,
San Bernardino, California 92415-0640. To the extent
applicable the provisions of said laws, programs and
regulations are deemed to be a part of this contract
as if fully set forth herein.
A. The San Bernardino County Affirmative Action
Compliance Program (See Exhibit C).
B. Vietnam Era Veterans' Readjustment Assistance
Acts of 1972 and 1974, as amended. Pub. L.
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92-540, Title V Section 503 (a),
Title IV, as amended, Section 402.
Pub. L-93-508,
(38 USCA 2011-
2013) .
Rehabilitation Act of 1973, as amended (handicapped)
Pub. L. 93-112, amended.
California Fair Employment and Housing Act,
(Government Code Section 12900 et. seq.l.
Civil Rights Act of 1964, as amended (42 USCA
2000a to 2000h-6) and Executive Order No. 11246,
September 24, 1965, as amended by Executive Order
11375 and as supplemented in Department of Labor
regulations (41 CFR, Part 60).
F. Clean Air Act of 1970, [42 USC 1858 Section 306(h),
et. seq.] and the Federal Water Pollution Control
Act, (33 USC Section 508, et. seq.) as amended,
and Executive Orders 1368, 11738, and U.S.
Environment Protection Agency regulations (40
CFR Part 15).
C.
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D.
E.
G. Provisions against lobbying are as follows: Part
of Sec. 407 of Pub. L. 95-480, 92 Stat. 1589)
which states:
"No part of any appropriation contained in this
Act shall be used to pay the salary or" expenses
of any grant or contract or contract recipient
or agent acting for such recipient to engage in
any activity designed to influence legislation
or appropriation pending before Congress."
This means that the costs of attempting to influence
legislation pending before Congress may not be
charged either as direct or indirect costs to
any HHS grant awarded from funds subject to the
provision. Attempting to influence legislation
is commonly called lobbying.
This notice concerns only the charging of certain
costs to Older Americans Act grants including
the matching share. Nothing in this notice is
Page 12 of 14
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intended in any way to inhibitor discourage any
party from exercising its lawful rights to attempt
to influence legislation pending before Congress
as long as the costs are not charged to the grant.
This agreement constitutes the entire agreement between
the Contractor and the RCA with respect to the subject
matter of this agreement. There are no other or further
written or oral understandings or agreements with
respect to this agreement. No variation or modification
of this agreement and no waivers of its provisions
shall be valid unless in writing and signed by the
parties.
FOR THE REGIONAL COUNCIL ON AGING
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FOR THE CONTRACTOR
DATE
DATE
. Approved as to form and legal content:
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Y ATTORNEY
Page 13 of 14
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4 ndividual
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6 nvolved.
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CERTIFICATION SHEET
#1 ~ be a member of the governing board.
as such. Two separate individuals are to be
One individual is to sign the contract itself,
7 nd a second individual is to sign this certificate.
8
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certify
that
am
of
the
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17 ~aid Contract on behalf of the
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the foregoing Contract;
who signed
Contractor was/were then
of said Corporation;
22
23 l:Jy author i ty of its governing body and is wi thin the scope
24
25 pf its corporate powers.
26
27 ~ontained in the minutes of the Board meeting held on
Approval of this Contract is
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SENIOR COMPANION PROGRAM
EXHIBIT A
VWRK PROGRAM
TITLE III-D ALLOCATION
IN-HOME SERVICES FOR FRAIL OLDER INDIVIDUALS
FY 1990/91
In order to assist frail older individuals who have physical or
mental disabilities that restrict the ability of an individual
to perform daily tasks or which threatens the capacity of an
individual to live independently, including those with Alzheimers
Disease or a related disorder with neurological or organic
dysfunctions, Senior Companion Program shall expend funds to
provide respite services.
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CALIFORNIA DEPARTMENT OF AGING
TITLE III MANAGEMENT INFORMATION SYSTEMS
DIVISION ~OOO -- UNIT OF SERVICE MEASUREMENTS
PROGRAM NO. 19 - TITLE III D: IN-HOME SERVICES FOR FRAIL ~419
OLDER INDIVIDUALS (N.w 7/88)
Goal: To coo~dinat. with oth.~ community ag.nci.. and voluntary
o~ganization. p~oviding coun..ling and tr,ining fo~ fam,ly
ca~.giv.~. and .uppo~t ..~vic.. p.~.onn.l in m.n.g.m.nt of
ca~., functional and n..ds ......m.nt ..~vic.., assistance
with locating, a~~.nging, and coo~dinating ..~vic.., case
manag.ment, and coun..ling p~io~ to admi.sion to nu~s'n9
home to p~event p~.matu~e institutionalization.
Definition: In acco~dance with ..tablish.d .lig,bility c~ite~ia,
and S.ctions 7~709 and 74745, Califo~nia
Admini.t~ative Cod. A~ticl. 5, to a..ist frail older
individual. who have phy.ical o~ mental disabilit,es
that ~e.t~ict the ability of an individual 'to
p.~fo~m no~mal daily ta.k. o~ which th~.at.ns the
capacity of an individual to live ind.p.nd.ntly,
including tho.. with Alzh.ime~'. Di..... o~ a
~.l.t.d di.o~d.~ with n.u~ological o~ o~ganic brain
dy.functions.
Units of Se~vice:
REQUIRED
(at l.ast one)
(01) Minor Hom. Modification.
(03) Home Health Aide.
(05) Cho~.
(14) Hou..k..ping/Homemaking
(28) T.l.phoning
(31) Visiting
(~5) R..pit. (including Adult D.y Ca~.)
.
-----------------------------------------------------------------
(MIS Unit No.)
D.finition
(01) Mino~ Hom. Modification.: Mino~ modification of homes that
i. n.c....~y to f.cilit.t. the ability of old.~ individuals
to ~emain at home and that i. not available unde~ othe~
p~og~.ms, except that not more than $150 p.~ client may be
exp.nd.d for .uch modifications.
UNIT: on. client ..~v.d
-----------------------------------------------------------------
TL MIS' 12
DIVISION ~OOO PAGE 36
ISSUED: OCT. 1989
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CALIFORNIA DEPARTMENT OF AGING
TITLE III MANAGEMENT INFORMATION SYSTEMS
DIVISION 4000 -- UNIT OF SERVICE MEASUREMENTS
PROGRAM NO. 19 - TITLE III D: IN-HOME SERVICES FOR FRAIL 4419
OLDER INDIVIDUALS (Continued)
(MIS Unit NO.) Definition
(45) ReeDite (includina Adult Day ~are): To arrange relief for
the relative. or other caregivers of the frail elderly
living at home by providing .upportive .ervice. to the older
person(sl while the primary caregiver i. temporarily absent
(includes Adult Day Care as a respite service for families).
UNIT: one client .erved
-----------------------------------------------------------------
TL MIS. 12
-----------------------------------------------------------------
DIVISION 4000 PAGE 38
IssuED: OCT. 1989
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ASSURANCE OF COMPLIANCE WITH THE DEPARTMENT OF
HEALTH AND BOMAN SERVICES REGULATIONS UNDER
TITLE VI OF THE CIVIL RIGHTS ACT OF 1964
SENIOR COMPANION PROGRAM
(Name of Grantee or Contractor)
(herein after called the "Recipient of Award"), HEREBY AGREES that
it will comply with Title VI of the Civil Rights Act of 1964 (P.L.
33-352) and all requirements imposed by or pursuant to the Regulations
of the Department of Health and Human Services (45CFR, Part 80) issued
pursuant to that title, to the end that, in accordance with Title
VI of that Act and the regulation, no person in the United states
shall, on the ground of race, color, sex, age, or national origin,
be excluded from participation in, be denied the. benefits of or be
otherwise subjected to discrimination under any program or activity
for which the Recipient of Award received federal financial assistance
from the San Bernardino County Office on Aging: a recipient of federal
financial assistance from the Department: and HEREBY GIVES ASSURANCE
that it will immediately take any measures necessary to effectuate
this agreement.
If any real property or structure thereon is provided or improved
with the aid of federal financial assistance extended to the Recipient
of Award by the Area Agency on Aging, this assurance shall obligate
the Recipient of Award or in the case of any transfer of such property,
any transferree, for the period during which the real property or
structure is used for a purpose for which the federal financial
assistance is extended or for another purpose involved in the provision
of similar services or benefits. If any personal property is so
provided, this assurance shall obligate the Recipient of Award for
the period during which the federal financial assistance is extended
to it by the Area Agency on Aging.
THIS ASSURANCE is given in consideration of and for the purpose of
obtaining all federal grants, loans, contracts, property, discounts
or other federal financial assistance extended after the date hereof
to the Recipient of Award by the Area Agency on Aging, including
installment payments after such data on account of applications for
federal financial assistance which were approved before such date.
The Recipient of Award recognizes and agrees that such federal financial
assistance will be extended in reliance on the' representations and
agreements made in this assurance. This assurance is binding on the
Recipient of Award, its successors, transferrees and assignees, and
the person or persons whose signature appear below are authorized
to sign this assurance on behalf of the Recipient of Award.
BY:
(Recipient of Award)
TITLE:
Address
DATED:
San ~ernardino County
OoA - Form 09
6/88