Loading...
HomeMy WebLinkAboutCOM 0041.004 2008-2010 ~Mt l i' William P. Kenoi Alan R. Parker Mayor Executive on Aging County of Hawaii OFFICE OF AGING Aging and Disability Resource Center, 1055 Kino'ole Street, Suite 101, Hilo, Hawaii 96720-3872 Phone (808) 961-8600 • Fax (808) 961-8603 • Email: hcoa©hawaiimtel.net Hanama Place, 75-5706 Kuakini Highway, Suite 106, Kailua-Kona, Hawaii 96740-1751 Phone (808) 327-3597 • Fax (808) 327-3599 • Email: hcoakona@hawaiimtel.net rv DATE: July 8, 2009 0 i) e TO: J Yoshimoto, Council Chairman and c _ Council Members VIA: Kay O~shiro, ACting ntroller : L 'Vo FROM: Alan Parker, Exo6utive on Aging RE: NOTIFICATION OF GRANT AWARD = r ) N Compliance with Ordinance No. 09-64, Section 7(1) Name of Grant Program: Area Plan on Aging Grantor: Dept. of Health, Executive Office on Aging County Grantee Department or Agency: Hawaii County Office of Aging Grant No. (IF KNOWN): HA.2010.N Amount of Grant: $954,863.00 Amount of County Match: $120,000.00 County Rev. & Exp. Account Numbers: 43301.04 & 4101.411.5411.09 to .10 - $563,922.00 (HCOA) #3301.01 & #101.481.5483.01 to .03 - $315,191.00 (HCNP) #3301.15 & #010.481.5481.01 to .03 - $75,750000 (CSE) Grant Period (Commencement & Completion): July 1, 2009-June 30, 2010 Purpose of Grant: To provide the supportive social services, recreational and cultural programs, congregate and home delivered nutrition services, in-home services, and preventive health services described in the State approved Area Plan for the County of Hawaii. Is final report required by grantor? FX Yes 7 No Notification attached: © Yes 7 No, because pf Comm. No. tit. Ref. To, c: Parks and Recreation Ref. Date ^ I p4 Haivat 'i County is an equal opportunityprovider and employer. An Area Agency on Aging 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) July 1 2009 , between the (agency) Department of Health State of Hawai'i (the "STATE"), by its Director, Executive Office on Aging (the "DIRECTOR"), whose address is 250 South Hotel Street, Suite 406, Honolulu, Hawaii 96813, and County of Hawaii, Hawaii County Office of Aging (the "PROVIDER"), a (government entity/corporation/partnership/sole proprietorship/ other business form) government entity whose business address and taxpayer identification number are: Hawaii County Office of Agin2,1055 lUno'ole Street, Suite 101, Hilo, Hawaii 96720 Federal Tax I.D. #99-6000567 State Tax I.D. #W40893544-01 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), HAP., 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 beneficiaries, (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 HA.2010.N 1 Form AG3-Exempt(4/99) ? 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: (1) (identify state sources) Item , ACT , 2009 HSL , or (2) (identify federal sources) Older Americans Act as amended 2006 , or both, in the following amounts: State: $ -0- Federal: $ 954,863.00 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 of 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 HA.2010.N 2 Form AG3-Exempt(4/99) ? 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 PROVIDER has produced, and the STATE has inspected, a certificate of insurance in the amount of n/a DOLLARS ( n/a 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 Hawai'i, 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 2009 , to (date) June 30 , 2012 unless this Agreement is sooner terminated. 3. Compensation. The PROVIDER shall be compensated: ® in a total amount for all required services not to exceed NINE HUNDRED FIFTY-FOUR THOUSAND EIGHT HUNDRED SIXTY- THREE AND NO/100 DOLLARS ($954,863.00), 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 HA.2010.N 3 Form AG3-Exempt(4/99) 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 Requirements. In addition to whatever other reports may be required elsewhere in this Agreement, the PROVIDER shall also submit a Final Project Report, by (date) August 30 , 2012 . No amendment to the PROVIDER's Final Project Report shall be considered after (date) September 30 , 2012 . 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: Executive Office on Aging, 250 South Hotel Street, Suite 406, Honolulu, Hawaii 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 State Procurement Office, 1151 Punchbowl Street, Room 230A, Honolulu, Hawaii 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 HA.2010.N 4 Form AG3-Exempt(4/99) IN VIEW OF THE ABOVE, the parties execute this Agreement by their signatures, on the dates below, to be effective as of the date first above written. STATE EXEC OFF O T AG G By Print Name Noemi Pendleton Title Director Date June 26, 2009 PROVIDER CO 11 By Print Name WILLIAM P. KENOI Title MAYOR Date UUN 15 2009 RECOMMEND APPROVAL: Date JUN 0 3 2009 Hawaii County Office of Aging County Executive APPROVED AS TO FORM AND LEGALITY: Deputy rpor ton Counsel County of Hawaii PROVED AS TO FORM: De ty Attorney Ge r State of Hawaii EXEMPT TRANSACTIONS HA.2010.N Page 5 Form AW-Exempt (4/99)