HomeMy WebLinkAboutCOM 0140.031 2002-2004 qtr or y
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S`" r- ~ ~ Alan R. Parker
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OFFICE OF AGING
I Ido I nenon Centre. 101 Aupuni S(rea~t. Sulk i¢?. I liln. I Iawal'i Ob720-a'_62
Phon<(ROR)9G 1-8600 Pue (ROR)061-R(fl3
Hanumu Plan. 7~-?70G RuaAini Ilighwll)', tiulic IOG, Kailua-Kunll.IlNO aII on'730-I "1~1
Phone (ROR)327-1597 • Pue (NORI :?7-~>'79
DATE: August 27, 2003
TO: James Y Arakaki Council Chair and
Council Members
VIA: Deanna .~Sakg,'Controller l~(ta.,.r
~~~ZL -L,
FROM: "Alan Parkef, Executive on Aging
RE: NOTIFICATION OF GRANT AWARD
Compliance with Ordinance No. 02-6 Section 7(1)
03-~,~
Name of Grant Program- Kupuna Care Services
Grantor: Department of Health, Executive Office on Aging
County Grantee Department or Agency: Hawaii County Office of Aging
Grant No. (IF KNOWN): HA-2004/2005-2 (A)
Amount of Grant: $1,293,156 = $646,578 for FY 2004 + $646.578 for FY 2005
Amount of County Match: $96fJ00.00
County Revenue Account Numbers: #3302.06
County Rev. & Exp. Account Numbers: #3304.06 & #010-411-5411.09 to 10 - $554,419 (HCOA)
(For 7/1/03-6/30/04) #3304.04 & #010-481-5483.01 to 03 - $92,159 (HCNP)County
Grant Period (Commence. 8 Completion): July 1, 2003 to June 30, 2004
Purpose of Grant: To enable Hawaii's "Na Kupuna" to have access to affordable and quality
home-and -community based services that are client-centered and
family-supportive, allowing them to live with independence and dignity.
Services are Adult Day Care, Attendant Care, Case Management,
Chore. Homemaker/Housekeeper, Personal Care. Assisted
Transportation, and Home Delivered Meals.
Is final report required by grantor? [X] Yes No
Notification attached: Yes No, because dependent on prior year's meal count.
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Comm. No. '~W•3I
Ref. To:
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CHIYOME L FUKINO, M.D. el phone
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STATE OF HAWAII FILE leoel as-0I~s
EXECUTIVE OFFICE ON AG
NO. 1 CAPITOL DISTRICT
25(I SOUTH HOTEL STREET, SUITE 406
HONOLULU, HAWAII 96813-2831
August 4, 2003
TO: Alan Parker
County Executive
Hawaii County Office of Ag
FROM: Pat Sasaki~~'~'~
Executiv rector
Executive Office on Aging
SUBJECT: HA-2004/2005-2(A)
Enclosed for your files is the consummated contract #HA-2004/2005-2(A) between the
Executive Office on Aging and the Hawaii County Office of Aging. The contract is for the
provision of KUPUNA CARE Services FB 2003-2005 (July 1, 2003- June 30, 2005).
If you have any questions, please contact Caroline Cadirao at 586-7267. Mahalo.
CTC/ta
Encl.
STATE OF HAWAII
AGREEMENT FOR HEALTH AND HUMAN SERVICES:
TRANSACTIONS EXEMPT FROM CHAPTER 103F, HRS
This Agreement, executed on the respective dates of the signatures of the
parties shown hereafter, is effective as of (date) Jul~l 2003 ,
between the (agency) Department of Health
State of Hawaii (the "STATE"), by its Executive Director. Executive Office on AEina
(the "DIRECTOR"),whose address is 250 South Hotel Street. Suite 406. Honolulu, HI ,
ACTING
and County of Hawaii, by and through its County Council and its Mayor
(the "PROVIDER"), a (government entity/corporation/partnership/sole proprietorship/other
business form) local Qovernment entity
whose business address and taxpayer identification number are: Hawaii County
Office of Agine. ] Ol Aupuni Street. Room 342. Hilo, Hawaii 96720 TIN 99-6000567
RECITALS
A. This Agreement is for a purchase of health and human services that is exempt
from the requirements of Chapter 103F, HRS, because:
® this Agreement is between or among government agencies as provided
in Section 103F-101(a)(2), HRS;
~ this Agreement is to award grants or subsidies of state funds
appropriated by the legislature to a specific organization as provided
in Section 103F-101(a)(1), HRS, and Section 3-141-503(a)(2), HAR,
or to award subawards and subgrants to specific organizations directed
by the funding source as provided in Section 3-141-503(a)(1);
~ this Agreement is wholly or partly funded from federal sources that
conflict with the procedures and requirements established by Chapter
103F, HRS, and its implementing regulations;
~ this Agreement is wholly or partly funded from federal sources that (1)
identifies a target class of beneTiciaries, (2) defines the requirements
for a provider to be qualified to participate in the federal program, and
(3) has the price of the provided health and human services dictated
by federal law;
EXEMPT TRANSACTIONS
Page 1 Form AG3-Exem(4/99)
HA-2004-2005-2(A)
~ this Agreement is for an affiliation agreement with hospitals and other
health care providers required for University of Hawaii clinical
programs;
~ this Agreement is for the services of psychiatrist, or psychologists in
criminal or civil proceedings as required by a court order or by the
rules of the court;
~ this Agreement is for a transaction covered by a written exemption
from the Chief Procurement Officer for the STATE dated
B. The STATE is in need of the health and human services described in this
Agreement and its exhibits (the "Required Services"). The PROVIDER is agreeable to
providing the Required Services.
C. Money has been appropriated for the purchase of the Required Services by:
(I) (identify state sources) General Appropriations Act of 2003. HB 200. C.D. 1 , or
(2) (identify federal sources) _ ,or both,
in the following amounts:
State: $1,293,156
Federal: $
D. Pursuant to (legal authority for Agreement) Section 349 - 3. HRS ,
the STATE is authorized to enter into this Agreement.
E. The undersigned representative of the PROVIDER represents, and the
STATE relies upon such representation, that he or she has authority to sign this Agreement
by virtue of (check any or all that apply):
~ corporate resolutions of the PROVIDER or other authorizing
documents such as partnership resolutions;
~ corporate by-laws of the PROVIDER, or other similar operating
documents of the PROVIDER, such as a partnership agreement, or an
limited liability company operating agreement;
EXEMPT TRANSACTIONS
Page 2 Form AG3-Exem(4/99)
HA-2004-2005-2(A)
? the PROVIDER is a sole proprietor and as such does not require any
authorizing documents to sign this Agreement;
® the PROVIDER is a government entity, and the undersigned
representative of the PROVIDER is duly-authorized to execute
contracts on behalf such government entity;
? other evidence of signing authority:
F. The PROV[DER has produced, and the STATE has inspected, a certificate
of insurance in the amount of N/A DOLLARS
for bodily injury and property damage liability arising in connection with
the PROVIDER's performance under this Agreement.
G. The PROVIDER has produced, and the STATE has inspected, a tax clearance
certificate with approval from the State of Hawaii, Department of Taxation, dated
N/A _
NOW, THEREFORE, in consideration of the promises contained in this Agreement,
the STATE and the PROVIDER agree as follows:
1. Scope of Services. The PROVIDER shall, in a proper and satisfactory manner
as determined by the STATE, provide the Required Services as set forth in Exhibit "A" to
this Agreement, which is attached, and made a part of this Agreement.
2. Term of Agreement. The PROVIDER shall provide the Required Services
from (date) July 1 2003 to (date) June 30 ,
2005 ,unless this Agreement is sooner terminated.
3. Compensation. The PROVIDER shall be compensated
® in a total amount for all required services not to exceed One Million
Two Hundred Ninety-Three Thousand One Hundred Fifty-Six
DOLLARS 1,293,156 including taxes, at the time and in the manner set
forth in Exhibit "B" to this Agreement, which is attached, and made a part of
this Agreement.
? based upon referrals to the PROVIDER from the STATE, payment
EXEMPT TRANSACTIONS
Page 3 Form AG3-Exem(4/99)
HA-2004-2005-2(A)
for each such referral shall be made according to Exhibit "B" to this
Agreement, which is attached, and made a part of this Agreement.
The STATE shall provide a minimum of n/a referrals to
the PROVIDER.
4. Reporting Reyuirements. In addition to whatever other reports may be
required elsewhere in this Agreement, the PROVIDER sha? also submit a Final Project
Report, by (date) August 30, 2005 No amendment to the
PROVIDER'S Final Project Report shall be considered after (date) September 30,
2005
5. Standards of Conduct Declaration. The Standards of Conduct Declaration of
the PROVIDER is attached as Exhibit "C", and is made a part of this Agreement.
6. Other Terms and Conditions. The General Conditions for Health and Human
Services Contracts (the "General Conditions") are attached as Exhibit "D," and are made a
part of this Agreement. If applicable, any Special Conditions are attached as Exhibit "E,"
and are made a part of this Agreement. In the event of a conflict between the General
Conditions and the Special Conditions, the Special Conditions shall control.
7. Notices. Any notice, communication, or information required to be given by
any party to this Agreement shall be made in writing, and shall be (a) delivered personally,
or (b) sent by United States first class mail, postage prepaid. Notice required to be given
to the DIRECTOR shall be sent to the DIRECTOR'S office in Honolulu, Hawaii. Notice
to the Agency Procurement Officer shall be sent to:
250 South Hotel Street- Suite 406 Honolulu HI 96813 Notice to the
PROVIDER shall be sent to the PROVIDER at the PROVIDER'S address as indicated in
this Agreement. Notice to the STATE'S Chief Procurement Officer shall be sent to 1151
Punchbowl Street Rm. 230A Hon, HI 96813. A notice shall be deemed to have been received
three (3) days after mailing or at the time of actual receipt, whichever is earlier. The
PROVIDER is responsible for notifying the STATE in writing of any change of address.
EXEMPT TRANSACTIONS
Page 4 Form AG3-Exem(4/99)
HA-2004-2005-2(A)
IN WITNESS WHEREOF, the STATE and the PROVIDER have executed this
Agreement effective as of the date first above written.
STATE
EXECUTIVE OFFICE ON AGING
sy 1~~~_'
Executive Director
PROVIDER
COUNTY OF HAWAII
13y
Its ayor, County of Hawaii
RECOMMEND APPROVAL:
Hawaii County Office of Bing
County Executive
APP~ROVED`AS TO FORM AND LEGALITY:
V
-Bepnt~Corporation Counsel
County of Hawaii
APPROVED AS TO FORM:
Deputy Attorney General
State of Hawaii
* Evidence of authority of the PROVIDER'S representative to sign this agreement for the
PROVIDER must be attached.
Page 5
HA-2004-2005-2(A)
STATE OF HAWAII )
SS.
COUNTY OF HAWAII )
On this /5'~ day of , 2003, before me
personally appeared DIXIE KAETSU, to me personally known, who, being by me duly
sworn, did say that she is the Acting Mayor of the County of Hawaii, a municipal
corporation of the State of Hawaii; that the seal affixed to the foregoing instrument is
the corporate seal of the said County of Hawaii; that the foregoing instrument was
signed and sealed in behalf of the County of Hawaii by authority given to said Acting
Mayor of the County of Hawaii by Section 5-1.5 of the County Charter, County of
Hawaii (1991), as amended; and said DIXIE KAETSU acknowledged said instrument
to be the free act and deed of said County of Hawaii.
,E~. Gu-u-~-~
CATHY . CORREIA
Notary Public, State of Hawaii
My commission expires: 10/13/06
F,
~pTgp~s
i S
B
OF HP
PROVIDER'S ACKNOWLEDGMENT
State of
SS.
County o )
On this da of ,before me personally
appeared , to me personally known, who being by me
duly sworn, did say that he/she is t ~ e of
the PR VIDER named in the foregoing instrument, and that
he/she is authorized to sign said instru ent on behalf of the PROVIDER, as provided in
Recital E of the foregoing Agreement, d acknowledges that be/she executed said
instrument as the free act and deed of the PR IDER.
Notary Public,
My commission expi
EXEMPT TRANSACTIONS
Page 6 Form AG3-Exempt
HA-2004-2005-2(A)
SCOPE OF SERVICES
(State Funded Programs)
] PROVIDER shall, in a satisfactory and proper manner as determined by the STATE, and in
accordance with the terms and conditions of this Agreement, use the funds received under
this Agreement to provide KUPUNA CARE services as described in the 1999 - 2003 State
approved Area Plan for the County of Hawaii and FB 2003 --2005 Request For Proposal
#HTH-904-KC for KUPUI~A CARE Services for Hawaii County not physically attached
hereto but incorporated by reference as part of this Agreement. When a service listed is also
funded with federal funds, PROVIDER shall comply with all regulations and requirements
of the expending Federal agency and implement the Older Americans Act of 1965, as
amended. Federal guidelines supersede all local policies including, but not limited to,
targeting.
2 The Area Agencies on Aging Administration fund shall be used by the PROVIDER to carry
out the PROVIDER'S functions and responsibilities.
3 The KUPUNA CARE Administration fund shall be used by the PROVIDER for the
implementation of the KUPUNA CARE services.
4 The KUPUNA CARE Vendor Service fund shall be used only for the implementation of one
or more of the KUPUNA CARE services.
5 The PROVIDER shall implement and execute the coordination of the following core
services of KUPUNA CARE with the PROVIDER'S subcontractors:
HA-2004-2005-2(A)
EXHIBIT A
Page 1
5.1 Adult Day Care provides supportive services for functionally impaired adults in a
supervised, protective, and congregate setting during any part of a day, but less than
twenty-four (24) hours. Services may include social and recreational activities, training,
counseling, meals, and personal care services.
5.2 Assisted Transportation provides door-to-door transit service with assistance, including
escort, to older persons who have physical and or cognitive difftculties that prevent them
from using regular vehicular transportation services.
5.3 Case Management provides assistance either in the form of access or care coordination
in circumstances where the older person and/or their caregivers are experiencing
diminished functioning capacities, personal conditions or other characteristics which
require the provision of services by formal service providers.
5.4 Chore service provides assistance to persons having difficulty with one or more of the
following instrumental activities of daily living (IADL): heavy housework, yard work,
and or sidewalk maintenance.
5.5 Homemaker/Housekeeping services provides assistance to persons with the inability to
perform one or more of the following IADL: preparing meals, shopping for food and
other personal items, managing money, using the telephone, and doing light housework.
5.6 Nutrition/Home Delivered Meals provides nourishing home-delivered meals to eligible
persons whose activities of daily living (ADL) are restricted. The meal must meet the
minimum Administration on Aging's standards for a meal. Ahome-delivered meal must
be in compliance with the Dietary Guidelines for Americans and meet thirty-three and
one-third percent (33 1/;`%) of the Recommended Dietary Allowance (RDA), as
established by the Food and Nutrition Board of the National Research Council of the
National Academy of Sciences.
HA-2004-2005-2(A)
EXHIBIT A
Page 2
5.7 Personal Care service provides personal assistance, stand-by assistance, supervision or
cues for persons with the inability to perform one or more of the following ADLs:
eating, dressing, bathing. toileting, transferring in and out ofbed/chair, or walking.
5.8 The Provider and PROVIDER'S subcontractors shall comply with the KUPUNA CARE
Guidelines, Caring for Hawaii's Elderly, dated April 29, 1999, not physically attached
hereto but incorporated by reference as part of this Agreement.
5.9 The PROVIDER shall implement the following selected KLTPUNA CARE services with
the PROVIDER's subcontractors awarded through the 103F Competitive Purchase of
Service:
RFP# Scope of Service Awarded Provider
HTH-904-KC-CM-4 Case Management Vocational Rehabilitation, dba
Services for Seniors
HTH-904-KC-NHD-4 Nutrition Home-Delivered Hawaii County Nutrition Program
Meals
Assisted Transportation, Chore, Homemaker, Personal Care, Attendant Care, and Adult Day
Care services are vendored through the County of Hawaii.
HA-2004-2005-2(A)
EXHIBIT A
Page 3
COMPENSATION AND PAYMENT SCHEDULE
1 COMPENSATION: Subject to continuing availability of funds, the STATE agrees to
pay PROVIDER, for services satisfactorily performed under this A~eement, a sum
not to exceed ONE M[LLION TWO HUNDRED NINETY-THREE THOLJSAND
ONE HUNDRED FIFTY-SIX Dollars ($1,293,156), provided that PROVIDER shall
apportion said sum among the programs/activities set forth in Exhibit "A." Payment
of this sum shall constitute toll and complete compensation for all services, materials,
supplies, equipment, overhead, taxes, other incidentals, and operating expenses that
PROVIDER incurs in the performance of this Agreement. PROVIDER understands
and fully agrees that the sum payable under this Agreement shall be paid only upon
receipt by the STATE of those state general funds described and provided pursuant to
the STATE's Plan on Aging. The STATE shall not pay said amount to PROVIDER
out of any funds other than those received from DHHS or the state legislature.
2 METHOD OF PAYMENT
2.1 The funds awarded to the STATE by the DHHS and appropriated by the state
legislature for purposes of this Agreement shall be subject to the allotment
system as provided in Chapter 37, Hawaii Revised Statutes.
2.2 Subject to the availability of funds, payments to PROVIDER under this
Agreement shall he made iu accordance with and are subject to the provisions
of Chapter Request for Payments (Area Agency on Aging Reporting
Handbook), and the following appropriate State provisions:
2.3 State Funds
I3A-2004-2005-2(A)
EXHIBIT B
Page 1
2.3.1 If State funds aze awarded, the STATE shall use the allocation plan
contained in Exhibit B-1, as a basis of paying PROVIDER, upon
submission by PROVIDER of written request for payment.
2.3.2 Payment shall be made in advance quarterly installments upon submission
by PROVIDER of written request for payment.
2.3.3 The quarterly financial status reports and performance progress reports shall
be reviewed by the STATE for appropriateness and allowability of the
reported expenditures.
2.3.4 If an amount of reported expenditures is determined by the STATE to be
inappropriate and unallowable, the STATE may deduct an equivalent
amount from the next payable installment. If, after payment of the last
installment, investigation and examination reveal additional expenditures
that aze determined by the STATE to be inappropriate and unallowable, the
STATE may require that an equivalent amount of monies be refunded to the
STATE notwithstanding the STATE's preliminary determination of
appropriateness and allowability.
2.3.5 All payments shall be made in accordance with and subject to Chapter 40,
Hawaii Revised Statutes, which specifies the accounting procedures and
controls applicable to payments out of the Treasury of the State of Hawaii.
Such payments are subject to availability of funds and allotment by the
Director of Finance in Accordance with Chapter 37, Hawaii Revised
Statutes. Final payment under this Agreement shall be subject to sections
103-53 and 237-45, Hawaii Revised Statutes, which require a tax clearance
from the Director of Taxation, State of Hawaii, showing that all delinquent
HA-2004-2005-2(A)
EXHIBIT B
Page 2
taxes, levied or accrued under State law against the private subcontractors if
any, have been paid.
3 PROVIDER shall include appropriate provisions for its subcontractors to ensure that
the provisions of this Part maybe effectuated.
HA-2004-2005-2(A)
EXHIBIT B
Page 3
Compensation and Payment Schedule
HTH 904 - KC, KC HOME AND COMMUNITY BASED SERVICES
Period of Agreement: July 1, 2003 -June 30, 2005
Contractor: Hawaii County Office of Aging
Effective Date: July 1, 2003
Service Provider RFP I.D.# Scope of Service FY 2004 FY 2005 Total
Services for Seniors HTH-904- Case Mana ement short-term 319,928 319,928 639,856
KC-CM-4
Hawaii Count Nutrition Pro ram HTH-904- Home Delivered Meals 92,159 92,159 184,318
KC-N H D-4
Ku una Care Vendor Services Adult Da Care, Assisted Trans ortation, 190,585 190,585 381,170
Chore-Heav ,Homemaker,
Personal Care
Total Service Funds 602,672 602,672 1,205,344
HA-2004/2005-2(A) EXHIBIT B-1
Page t
Compensation and Payment Schedule
OTHER FUNDS
Period of Agreement: July 1, 2003 -June 30, 2005
Contractor: Hawaii County Office of Aging
Effective Date: July 1, 2003
FUNDS Account Code FY 2004 FY 2005 Total
AAA Administration 2,983 2,983 5,966
Ku una Care Administration 40,923 40,923 81,846
Total Administrative Funds 43,906 43,906 87,812
Total Non-KC Services - - -
HA-2004/2005-2(A) EXHIBIT B-1
Page 2
Compensation and Payment Schedule
SUMMARY OF FUNDS
Period of Agreement: July 1, 2003 -June 30, 2005
Contractor: Hawaii County Office of Aging
Effective Date: July 1, 2003
FUNDS Account Code FY 2004 FY 2005 Total
KC Services: Case M mt, Nutrition-Home Delivered Meals 412,087 412,087 824,174
B, Su ortive Services, Nutrition and Senior Centers _ _ _
KC Vendor Services 190,585 190,585 381,170
AAA Administration 2,983 2,983 5,966
Ku una Care Administration 40,923 40,923 81,846
Non-KC Services _
TOTAL 646,578 646,578 1,293,156
HA-2004/2005-2(A) EXHIBIT B-1
Page 3