HomeMy WebLinkAboutResolution - 2008-R0481 - Contract With SPAG To Provide AAA Services - 12_04_2008Resolution No. 2008-RO481
December 4, 2008
Item No. 5.1.3
RESOLUTION
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK:
THAT the Mayor of the City of Lubbock BE and is hereby authorized and
directed to execute for and on behalf of the City of Lubbock, a Contract with the South
Plains Association of Governments (SPAG) for pass through funds from the Texas
Department of Aging and Disability Services for an Area Agency on Aging Direct
Purchase of Services Program grant and any associated documents, a copy of which
Contract is attached hereto and which shall be spread upon the minutes of this Council
and as spread upon the minutes of this Council shall constitute and be a part hereof as if
fully copied herein in detail.
Passed by the City Council this 4th day of December 2008.
W-J,�'t
TOM MARTIN, MAYOR
ATTEST:
-CQ ,* , - -
Reber a Garza, City Secretary
APPROVED AS TO CONTENT:
Randy Trues 1, Community Services Director
APPROVED AS TO FORM:
G. Vandiver, City Attorney
DDres/SPAG 08-09 Res
November 17, 2008
Resolution No. 2008—RO481
SOUTH PLAINS ASSOCIATION OF GOVERNMENTS Area Agency
AREA AGENCY ON AGING
SPAG JZon
Aging
VENDOR AGREEMENT
Souih Plains Assxialion
Of 6oremmenls
City of Lubbock, hereinafter referred to as Vendor, and the
The South Plains Association of Governments Area Agency on Aging (AAA) do hereby agree to provide
services effective October 01, 2008 in accordance with the Older Americans Act of 1965 (OAA), as
amended, Texas Department of Aging and Disability Services (DADS), the AAA Direct Purchase of
Services program and the stated Scope of Services.
The AAA Direct Purchase of Services program is designed to promote the development of a comprehensive
and coordinated service delivery system to meet the needs of older individuals (age 60 and older). This agreement
agreement provides a mechanism for the creation of an individualized network of community resources
on a client -by -client basis through the Older Americans Act, as amended, and the Texas Department of
Department of Aging and Disability Services' AAA Access and Assistance guidelines.
The purpose of this system of Access and Assistance is to develop cooperative working relationships with
other service providers to build an integrated service delivery system that ensures broad access to and
information about community services, maximizes the use of existing resources, avoids duplication of effort,
gaps in services, and facilitates the ability of people who need services to easily find the most appropriate
Vendor.
SCOPE OF SERVICES
A. The Vendor agrees to provide the following service(s) to clients authorized by the AAA
staff as identified below in accordance with the vendor application, all required
assurances, licenses, certifications and rate setting documents, as applicable.
Service:
CONGREGATE MEALS
TRANSPORTATION
Service Definition:
CONGREGATE MEAL - A hot or other appropriate meal served to an eligible
client which meets 33'/3 percent of the dietary reference intakes established by the
Food and Nutrition Board of the Institute of Medicine of the National Academy of
Sciences and complies with the Dietary Guidelines for Americans, published by the
Secretary of Agriculture, and which is in a congregate setting. The objective is to reduce
food insecurity and promote socialization of older individuals. There are two types of
congregate meals:
• Standard meal - A regular meal from the standard menu that is served to the
majority or all of the participants.
• Therapeutic meal or liquid supplement - A special meal or liquid supplement that
has been prescribed by a physician and is planned specifically for the participant
by a dietician (e.g., diabetic diet, renal diet, pureed diet, tube feeding).
TRANSPORTATION - Taking an eligible client from one location to another but
does not include any other activity.
• Demand/Response - transportation designed to carry eligible clients from specific
origin to specific destination upon request. Clients request the transportation
advance of their need, usually twenty-four to forty-eight hours prior to the trip.
Form #;A 1 AA A_V A2.0 SPAG
Form Date: 10/22/2008 1 of 5 10/22/2008
II.
Unit Definition:
CONGREGATE MEALS: One Meal.
TRANSPORTATION: Demand/Response: One, One-way Trip
Service Area:
City of Lubbock
All Texas Administrative Code standards may be accessed at the Texas Secretary of
State website: www.sos.state.tx.us
All Older Americans Act and other required rules and regulations may be accessed at
www.aoa.dhhs.gov/about/lcgbudg/oaa/legbudg oaa.asp
Targeting: Services are designed to identify eligible clients, with an emphasis on high -risk
clients and serving older individuals with greatest economic and social need, low-income
minorities and those residing in rural areas, as identified in the Older Americans Act.
B. Services & Reimbursement Methodology:
Service
Fixed Rate
(include rate)
Variable Rate
(identify range)
Cost
Reimbursement
Congregate
$5.60
Transportation
$4.00
TERMS OF THE AGREEMENT
A. The Vendor agrees to and/or understands:
Forth N:AIAAA_VA2.0
Forth Date: IOi22,12008
1. Provide services in accordance with current or revised DADS policies and
standards and the OAA.
2. Target services to older individuals with greatest economic and social need,
including low-income minorities and older individuals residing in rural areas as
applicable.
3. Email roster(s) documentation along with paper documentation as required by
the AAA by close of business on the 2"d working day of each month
following the last day of the month in which services were provided. If the 2nd
working day falls on a SPAG holiday, the information shall be delivered by the
close of business on the preceding business day.
4.(a) The AAA cannot guarantee payment of a reimbursement request received
for more than 30 calendar days of service delivery. No reimbursement for
services provided will be made if vendor payment invoices are not submitted
to the AAA within the 30 days of service delivery.
4.(b) If a request for revised documentation is necessary these revisions will be due
by the 1 Oth working day of each month and funding will be delayed. A letter
to the director and the board president will be sent if the AAA is not receiving
required documentation. The letter will indicate the reason for the delay and a
corrective action plan will be required. These actions will further delay the
funding request.
SPAG
2 of 5 t 0/22/2008
5. Encourage client contributions (program income) on a voluntary and confidential
basis. Such contributions will be properly safeguarded and accurately accounted
for as receipts and expenditures on its financial reports if they are not required
to be forwarded to the AAA. Client contributions (program income) will be
reported fully, as required, to the AAA. Vendor agrees to expend all program
income to expand or enhance the program/service under which it earned.
6. Refer Medicaid eligible clients to the Health and Human Services Commission,
and/or the Medicaid participating suppliers/vendors for the purpose of securing
appropriate services, as applicable.
7. Notify the AAA Access and Assistance division immediately if, for any
reason, the Vendor becomes unable to provide the service(s).
8. Maintain communication and correspondence concerning clients' status.
9. Establish a method to guarantee the confidentiality of all information relating
to the client in accordance with applicable Federal and State laws, rules, and
regulations. This provision shall not be construed, as limiting AAA or any
Federal, or State authorized representative's right of access to client case
records or other information relating to clients served under this agreement.
10. Keep financial and program supporting documents, statistical records, and any
other records pertinent to the services for which a claim for reimbursement
was submitted to the AAA. The records and documents will be kept for a
minimum of five years after close of contract year.
11. Make available at reasonable times and for required periods those client
records, books, and supporting documents pertaining to services provided, under
this agreement, for purposes of inspection, monitoring, auditing, or evaluations
by AAA staff, the Comptroller General of the United States and the State of
Texas, through any authorized representative(s).
12. This agreement may be terminated for cause or without cause upon the
giving of 30 days advance written notice.
13. This agreement does not guarantee a total level of reimbursement other than
for individual units/services authorized; contingent upon receipt of funds.
14. It is an independent provider, NOT an agent of the AAA. Thus the Vendor
indemnifies, saves and holds harmless the South Plains Association of
Governments Area Agency on Aging against expense or liability of any kind
arising out of service delivery performed by the Vendor, and to immediately
notify the Area Agency on Aging if the Vendor becomes involved in or is
threatened with litigation related to Access Assistance participants.
15. Employees shall not solicit nor accept gifts or favors of monetary value by
or on behalf of clients as a gift, reward or payment.
B. Through the Direct Purchase of Service program, the South Plains Association of
Governments Area Agency on Aging agrees to:
1. Review original client intake and assessment forms completed by the Vendor,
as applicable, to determine client eligibility. Service authorization is based on
client need and the availability of funds. Original client intake and assessment
forms will be housed at the South Plains Association of Governments Area
Agency on Aging.
2. Provide timely written notification to Vendor of client's eligibility and
authorization to receive services.
3. :Maintain communication and correspondence concerning the clients' status.
Form 4:AIAAA_VA2.0 SPAG
Form Date: 10/22/2008 3 of 5 10/22/2008
4. Provide timely technical assistance to Vendor as requested and as available.
5. Conduct quality -assurance procedures, which may include on -site visits, to
ensure quality services are being provided.
6. Provide written policy, procedures and standard documents concerning client
authorization to release information (both a general and medical/health related
release), ability to contribute to the cost of services provided, complaints/
grievances and appeals to all clients.
7. Reimburse the Vendor based on the agreed reimbursement methodology,
approved rate(s), service(s) authorized, and Section II.A.(3) and (4) of this
document within 45 days of receipt of invoice.
8. Reimburse the Vendor upon receipt of a properly prepared vendor payment
invoice, identified in Section II.B.(7), contingent upon the AAA's receipt of
funds authorized for this purpose from DADS.
III. ASSURANCES
A. Americans with Disabilities Act of 1990 —
The VENDOR shall comply with the requirements established under the Americans
with Disabilities Act in meeting statutory deadlines established under the Act as they
pertain to operations for employment, public accommodations, transportation, state and
local government operations and telecommunications.
B. Section 504 of the Rehabilitation Act of 1973 —
The VENDOR shall provide that each program activity, when viewed in its entirety is
readily accessible to and usable by persons with disabilities in keeping with 45 CFR,
Part 84.11, et. seq., and as provided for in Section 504 of the Rehabilitation Act of 1974,
as amended. When structural changes are required, these changes shall be in keeping
with 45 CFR, Part 74.
C. Age Discrimination in Employment Act of 1967 —
The VENDOR shall comply with Age Discrimination in Employment Act of 1967
(29 USC 621, et. seq.).
D. Drug Free Workplace
The VENDOR shall comply with the Drug -Free Workplace Act of 1988, and Texas
Senate Bill 1 - 1991, as applicable.
E. Certification Regarding Debarment
45CFR §92.35 Sub awards to debarred and suspended parties; this document is
required annually as long as this agreement is in affect.
F. Independent Audit
VENDOR receiving more than $500,000 in federal or state funding from all sources
will provide an audit in accordance with the standards for financial and compliance
audits contained in the Standards for Audit of Governmental Organizations, Programs,
Activities and Functions, issued by the U.S. General Accounting Office; the Single
Audit Act of 1984, including all updates and revisions; the provisions of OMB Circular
A-133, Audits of States, Local Governments, and Nonprofit Organizations, as applicable,
and the Uniform Grant Management Standards.
IV. ATTACHMENTS
A. List of Focal Points in the South Plains Association of Governments AAA Region.
B. Vendor Application and all other applicable State and Federal license and/or Certifications
that regulate your business
C. Signed Certification Regarding Debarment
Form # AIAAA_VA2.0 SPAG
Form Date: 10/22/2008 4 of 5 10/22/2008
D. Signed Affirmative Action Plan indicating compliance with the Civil Rights Act of 1964
E. Rate Setting Documents, if applicable
F. Senior Center Operations contract, if applicable
G. Independent Audit Agreement, if applicable
IV. SIGNATURES
For the faithful performance of the terms of this agreement, the parties affix their signatures and bind
themselves effective October 01, 2008.
City of Lubbock South Plains Association of Governments
Legal Name of Contracted Provider Name of Area Agency on Aging
T � �
Signature Signature
Tom Martin
Printed/Typed Name of Signer
December 4, 2008
Date
ATTEST:
Re cca Garza
City Secretary
APPROVED TO ON T:
Randy Trhesd6ll .
Community Services Director
Tim C. Pierce
Printed/Typed Name of Signer
December 4, 2008
Date
•••• • 11410
S./An �� 1
City Attorney
Form #:A I AAA_VA2.0
Form Date: 10/22/2008
SPAG
5 of 5
I0/22/2008
Resolution No. 2008-RO481
BOA f
DATE October 1, 2008
TO South Plains Association of Government
FROM City of Lubbock — Senior Center Programs
SUBJECT FY 2008-2009 Operating Hours and Holidays for SPAG Grant
Number of Days and Hours
Name of Sites Serving Days of Operation
Lubbock Senior Center 251 M-F 8:00 am - 5:00 pm
Rawlings Community Center 251 M-F 8:30 am - 4:30 pm
Simmons Senior Center 251 M-F 8:30 am - 4:30 pm
Trejo Supercenter 251 M-F 8:30 am - 4:30 pm
Homestead Senior Program 251 M-F 9:00 am - 1:00 pm
Holidays Observed
Dates
Thanksgiving Day
November 27, 2008
Day After Thanksgiving
November 28, 2008
Christmas Eve
December 24, 2008
Christmas Day
December 25, 2008
New Year's Day
January 1, 2009
Martin Luther King, Jr. Day
January 19, 2009
Good Friday
April 10, 2009
Memorial Day
May 25, 2009
4th of July
July 3, 2009
Labor Day
September 7, 2009
jArea A en The South Plains Association of Governments Area Agency on Aging ! �
1�g � Direct Purchase of Service PAG
Aging Fiscal Year 2009 Vendor Application/Renewal Update S
s"dh main &WCWM
d Gowmmerh
Please type or clearly print application information.
City of Lubbock
Vendor Name/Legal Entity
DBA (if applicable)
Physical Address:
2001 19th Street (Lubbock Senior Center) Parks Administration 1010 9th Street, Lubbock, TX 79401
Mailing Address:
PO Box 2000, Lubbock, TX 79457
Tax Identification Number (SSN or Federal ID):
Fax Number (including area code):
17560005906
806-775-2686
Type of Provider:
MGovemmental Agency OPrivate Non -Profit OPrivate For Profit
City Government County Government Other:
Authorizing Official:
Title:
Tom Martin
Mayor
Email Address:
Telephone:
tmartin mvlubbock.us
806-775-2303
Billing Contact Person and billing address:
Title:
Nancy Neill
Indoor Recreation Coodinator
Email Address:
Telephone:
nneiII q)!n lubbock.us
806-775-2685
Number of Years Organization has been in business:
Is Organization Bonded
(Attach certificate of bonding ins.)
29 Years
0 Yes No
Has anyone involved in the direct provision of client services
If Yes, Explain:
been convicted of a felony (In -home Services only)?
Yes El No
Does Organization have liability insurance?
(Attach certificate of all insurances)
Attach a copy of all applicable State and Federal
0 Yes 1:1 No
licenses and /or certifications for your business.
Conflicts of Interest: Attach information of applicable names and relationship of any employee(s) or officers of
your organization that may have a conflict of interest with the South Plains Association of Governments
Area Agency on Aging staff person or Advisory Council member.
DPS Application
Page 1
Service and Bidding Information:
A. Proposed Service:
Congregate Meals
B. Service Area:
City of Lubbock
C. Proposed AAA cost per unit: Standard cost per Unit:
$5.60 $6.15
A. Proposed Service:
B. Service Area:
City of Lubbock
C. Proposed AAA cost per unit: Standard cost per Unit:
$ 4.00 $ 5.33
A. Proposed Service:
B. Service Area:
C. Proposed AAA cost per unit:
A. Proposed Service-
1 B. Service Area:
C. Proposed AAA cost per unit:
DPS Application
Page 2
Standard cost per Unit:
Standard cost per Unit:
Signature:
I, Nancy Neill , certify that the information provided in this application is true and
Printed Name
correct to the best of my knowledge.
LE:) 6--e — — , 8 1 (-0 1 0 �
Authoriz ignature D*o
DPS Application
Page 3
CERTIFICATE OF SELF-INSURANCE
The undersigned officer of the City of Lubbock, Texas, a Texas home rule
municipality, hereby certifies that the City of Lubbock has a $500,000.00 self -
insured retention for Automobile and General Liability in accordance with the laws
of the State of Texas. The City of Lubbock has a policy that covers Property/Bodily
Injury over $500,000.00 per occurrence with One Beacon America Insurance
Company under policy #791-0000-76 which expires on 10/01/09. The current net
asset balance of the self-insurance fund is $3,397,295. The existing cash asset
balance is $8,650,340 as of the date stated below.
By:
Leisa Hutcheson
Risk Management Coordinator
Date: September 30, 2008
Certification Regarding Debarment
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY
AND VOLUNTARY EXCLUSION FOR COVERED CONTRACTS AND GRANTS
Federal Executive Order 125.49 requires the Texas Department of Aging and Disability
Services (DADS)) to screen each covered potential vendor/grantee to determine whether each
has a right to obtain a contract/grant in accordance with federal regulations on debarment,
suspension, ineligibility, and voluntary exclusion. Each covered vendor/grantee must also
screen each of its covered sub vendors/providers.
In this certification "vendor/grantee" refers to both vendor/grantee and sub vendor/sub-
grantee: "contract/grant" refers to both contract/grant and subcontract/sub-grant.
By signing and submitting this certification the potential vendor/grantee accepts the
following terms:
1. The certification herein below is a material representation of fact upon which reliance
was placed when this contract/grant was entered into. It is later determined that the
potential vendor/grantee knowingly rendered an erroneous certification, in addition to
other remedies available to the federal government, the Department of Health and
Human Services. United States Department of Agriculture or other federal
department or agency, or the Texas Department of Aging and Disability Services
may pursue available remedies, including suspension and/or debarment.
2. The potential vendor/grantee shall provide immediate written notice to the person to
which this certification is submitted if at any time the potential vendor/grantee learns
that the certification was erroneous when submitted or has become erroneous by
reason of changed circumstances.
3. The words "covered contract," " debarred," "suspended," "ineligible," "participant,"
"person," "principal," "proposal," and "voluntarily excluded," as used in this
certification have meanings based upon materials in the Definitions and Coverage
sections of federal rules implementing Executive Order 12549. Usage is as defined in
the attachment.
4. The potential vendor/grantee agrees by submitting this certification that, should the
proposed covered contract/grant be entered into, it shall knowingly into any
subcontract with a person who is debarred, suspended, declared ineligible, or
voluntarily excluded from participation in this covered transaction, unless authorized
by the Department of Health and Human Services, United States Department of
CERTIFICATION REGARDING DEBARMENT
Page 2
Agriculture or other federal department or agency, and/or the Texas Department of
Aging and Disability Services, as applicable.
Do you have or do you anticipate having sub vendors/sub-grantees under this
proposed contract? X yes no
5. The potential vendor/grantee further agrees by submitting this certification that it will
include this certification titled "Certification Regarding Debarment, Suspension,
Ineligibility, and Voluntary Exclusion for Covered Contracts and Grants" without
modification, in all covered subcontracts and in solicitations for all covered
subcontracts.
6. A vendor/grantee may rely upon a certification of a potential sub vendor/sub-grantee
that is not debarred, suspended, ineligible, or voluntarily excluded from the covered
contract/grant, unless the vendor/grantee knows that the certification is erroneous. A
vendor/grantee must, at a minimum obtain certifications from its covered sub
vendors/sub-grantees upon each subcontract's/sub-grant's initiation and upon each
renewal.
7. Nothing contained in all the foregoing shall be construed to require establishment of a
system of records in order to render in good faith the certification by this certification
document. The knowledge and information of a vendor/grantee is not required to
exceed that which is normally possessed by a prudent person in the ordinary course of
business dealings.
8. Except for contracts/grants authorized under paragraph 4 of these terms, if a
vendor/grantee in a covered contract/grant knowingly enters into a covered
subcontract/subgrant with a person who is suspended, debarred, ineligible, or
voluntarily excluded from participation in the transaction, in addition to other
remedies available to the federal government, Department of Health and Human
Services, United States Department of Agriculture, or other federal department or
agency, as applicable, and/or the Texas Department of Aging and Disability Services
may pursue available remedies, including suspension and/or debarment.
CERTIFICATION REGARDING DEBARMENT
Page 3
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND
VOLUNTARY EXCLUSION FOR COVERED CONTRACTS AND GRANTS
Indicate which statement applies to the covered potential vendor/grantee:
The potential vendor/grantee certifies by submission of this certification that neither it
nor its principals are presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from participation in this contract/grant by any
federal department or agency or by the State of Texas.
The potential vendor/grantee is unable to certify one or more of the terms in this
certification. In this instance, the potential vendor/grantee must attach an explanation
for each of the above terms to which it is unable to make certification. Attach the
explanation(s) to this certification.
NAME OF POTENTIAL VENDOR/GRANTEE City of Lubbock
VENDOR ID NO./FEDERAL EMPLOYER'S ID NO. 1-75-6000590-6
Si re of Autho 'zed Representative
Donald G. Vandiver
Printed/Typed Name of Authorized Representative
City Attorney / ( /� ��L R
Title of Authorized Representative Date
THIS CERTIFICATION IS FOR FY 2008, PERIOD BEGINNING 10/1/2007 and ENDING
9/30/2008.
CERTIFICATION REGARDING DEBARMENT
Page 4
DEFINITIONS
Covered Contract/Grant and Subcontracts/Sub-grants.
(1) Any non -procurement transaction which involves federal funds (regardless of
amount and including such arrangements as sub -grants) and is between the
Texas Department of Aging and Disability Services or its agents/grantees and
another entity.
(2) Any procurement contract for goods or services between a participant and a
person, regardless of type, expected to equal or exceed the federal
procurement small purchase threshold fixed at 10 U.S.C. 2304(g) and 41
U.S.C. 253(g) (currently $25,000) under a grant or sub -grant.
(3) Any procurement contract for goods or services between a participant and a
person under a covered grant, sub -grant, contract or subcontract, regardless of
amount, under which that person will have a critical influence on or
substantive control over that covered transaction including:
a. Principal investigators.
b. Providers of audit services required by the Texas Department of Aging
and Disability Services or federal funding source.
C. Researchers.
DEBARMENT
An action taken by a debarring official in accordance with 45 CFR Part 76 (or
comparable federal regulations) to exclude a person from participating in covered
contracts/grants. A person so excluded is "debarred."
GRANT
An award of financial assistance, including cooperative agreements, in the form of
money, or property in lieu of money, by the federal government to an eligible grantee.
INELIGIBLE
Excluded from participation in federal non -procurement programs pursuant to a
determination of ineligibility under statutory, executive order, or regulatory authority,
other an Executive Order 12549 and its agency implementing regulations: for
example, excluded pursuant to the Davis -Bacon Act and its implementing regulations,
the equal employment opportunity acts and executive orders, or the environmental
protection acts and executive orders. A person is ineligible where the determination
of ineligibility affects such person's eligibility to participate in more than one covered
transaction.
CERTIFICATION REGARDING DEBARMENT
Page 5
PARTICIPANT
Any person who submits a proposal for, enters into, or reasonably may be expected to
enter into a covered contract. This term also includes any person who acts on behalf
of or is authorized to commit a participant in a covered contract/grant as an agent or
representative of another participant.
PERSON
Any individual, corporation, partnership, association, unit of government, or legal
entity, however organized, except: foreign governments or foreign governmental
entities, public international organizations, foreign government owned (in whole or
part) or controlled entities, and entities consisting wholly or partially of foreign
governments or foreign governmental entities.
PRINCIPAL
Officer, director, owner, partner, key employee, or other person within a participant
with primary management or supervisory responsibilities: or a person who has a
critical influence on or substantive control over a covered contract/grant whether or
not the person is employed by the participant. Persons who have a critical influence
on or substantive control over a covered transaction are:
(1) Principal investigators.
(2) Providers of audit services required by the Texas Department of Aging and
Disability Services or federal funding source.
(3) Researchers.
PROPOSAL
A solicited or unsolicited bid, application, request, invitation to consider or similar
communication by or on behalf of a person seeking to receive a covered
contract/grant.
SUSPENSION
An action taken by a suspending official in accordance with 45 CFR part 76 (or
comparable federal regulations) that immediately excludes a person from participating
in covered contracts/grants for a temporary period, pending completion of an
investigation and such legal, debarment, or Program Fraud Civil Remedies Act
proceedings as may ensue. A person so excluded is "suspended."
VOLUNTARY EXCLUSION OR VOLUNTARILY EXCLUDED
A status of nonparticipation or limited participation in covered transactions assumed
by a person pursuant to the terms of a settlement.
BUDGET WORKSHEET Resolution No. 2008-RO481
A B C D
E F G H
91-
AAA/Region Name: SPAG Contract Number: A-100
Provider Name: City of Lubbock _ Service: Congregate
Period covered in YTD:October 1, 2007 - Ma 31, 2008 New Contract Year: ' October 1 , 2008 -September 30, 2009
NOTE: You must identify the number of months the YTD actual expenses are based on in Column D,
under "Annualized Exp. Months YTO Based on." The worksheet is currently set at 9 months.
2
3
4
6
7
8
9
10
YTD Actual
Cost Area Expenses
Annualized Exp.
Months YTD Based on Budgeted Exp. for
8 New Contract Yr.
Percent Difference
(Budget to Annualized)
Reason for Difference/Explanation
(If Over Routine Inflation Percentage - 1.05%)
11
12
1. Personnel
13
14
lTotal
Salaries, PR Taxes 8
Benefits
Contract staff,
Compensation
88,106.70
_..
132,160.05
_ ...._ - . _-_ _ .
-
95,000.00
- ---
-28.12%
---____ ._- -.-
Minimum Wage increased; thereby generating increases i
for all City PT staff of $.70/hour as of 7/07 and an add'1
$.70 as of 7/08, with a 3rd $.70 increase in 7/09.
Additionally, staff Changes/deletions offset this increase.
15
16
L 88,106.70
1 132,160.05
95,000.00
-28.12%
2. Nutrition Education
r2n17
Salaries, PR Taxes 8
BenefitsContract staff,
Compensation
Materials
Conference
Total
-
-
21
22
23
-
-
-
24
...:.w. ,. _ _, ... -
Mil
3. Professional Development
25
26
Conference
Dues
Materials
Total
200.00
-
300.00
-
Staffing changes will require Food Handling Certification
27
400.00
33.33%
28
29
200.00
300.00
400.00
33.33%
30
4. Meals/Food
31
32
Raw Food
Nutrition Supplement
Freight
Storage
Consumables
Contracted Meals/Food
Other
4,000 00
92,884.23
_
_
_
6,000.00
139,326.35
_
__---------------___
_.....
67% increase in contracted cost per meal as of 5108 from 1
$3 to $5 per meal._ Offset by fewer meals projected.
- fi - ...._...
33
34
.
35
_ 6,000.00
206,978.00
_ _ 0.00%
48.56%
36
37
38
L391
Total
96 884.23
145 326.35
212 978.00
46.55%
BUDGET WORKSHEET
A B C D E F G H
2 AAA/Region Name: SPAG Contract Number: A-100
3 Provider Name: City of Lubbock Service: ICon r ate
4 Period covered in YTD: October 1, 2007 - Ma 31, 2008 New Contract Year: ! October 1 , 2008 - September 30, 2009
,.
5 ;
far
6 NOTE: You must identify the number of months the YTD actual expenses are based on in Column D,
7 under "Annualized Exo. Months YTD Based on." The worksheet is currently set at 9 months.
8
9 Annualized Exp.
10 YTD Actual Months YTD Based on Budgeted Exp. for Percent Di ference Reason for Difference/Explanation
11 Cost Area Expenses 8 New Contract Yr. (Budget to Annualized) (If Over Routine Inflation Percentage - 1.05%)
40
41 S. Equip ment
42 Depreciation -
43 Interest
44 Leasing
45 Maintenance -
46 Total
47
48
6.Occu n /Bulldin
49
Rent
-
50
Utilities
51
Depreciation
-
52
Mortgage Interest
53
Insurance
54
Security
---
- - -- -
-------- ---- _ _....
-- - _...
55
Janitorial
---------_______ -- _
------------
56
Repair
_._ _ .._..
57
Taxes
-
,9
ITotal----
-
-
60
7. Trans tion/Travel
61
Mileage Reimbursement
-
62
Delivery
-
63
Gas & Oil
_
64
Repairs
_
65
Insurance
_
------ - -- —
_
- - ------...
66
Depreciation/Lease __
-
67
Interest
_
68
Tags & Licenses
-
691
Total
-
-
-
70
71
8. Administrative & General
72
Advertising
2,400.00
3,600.00
3,600.00
0.00%
73
Printing
_
74
Copying
200.00
300.00
300.00
0.00%
-
75
Office supplies
-
BUDGET WORKSHEET
A B C D
E
F G H
2
AAA/Region Name: SPAG
Contract Number:,A-100
Service: Con ate
_ New Contract Year: October 1 , 2008 - September 30, 2009
are based on in Column D,
is currently set at 9 months.
3
Provider Name: City of Lubbock
4
Period covered in YTD: October 1, 2007 - Ma 31, 2008
NOTE: You must identify the number of months the YTD actual expenses
under "Annualized Exo. Months YTD Based on." The worksheet
6
7
Annualized Exp.
YTD Actual Months YTD Based on
Cost Area Expenses 8
Budgeted Exp. for
New Contract Yr.
Percent Difference
(Budget to Annualized)
Difference/Explanation
Reason far Of
(If Over Routine Inflation Percentage - 1.059/6)
9
10
11
12,
Contractual Agreements
Postage
Telecommunications
Liability Insurance
Interest-Wk . Capital_-
Legal Fees
Accounting Fees
Consulting Fees
Other Fees (Explain)_
Audit
Other Misc. (Explain)
Total
a
-
-
- --- - -
-
76
77
78
-
-
-
-
79
80
81
82
83
84
85
86
87
2,600.00
3,900.00
3,900.00
0.00%
88
89
90
Total of all Cost Areas 187 790.93 281,68
Total Number of Meals
Provided 27,597 41,395.50
Total Number of
Anticipated Meals
—f--
312 278.00 10.86%
50,73922.57%
91
92
j
Budgeted Cost perMeal $6A5
93
94
-- ---
-fi --------- - -'
Reason for Difference/Explanation
If Over Routine Inflation Percentage -1.05%
95
FY08 VS FY09
FY08
FY09
Difference
Percentage Difference
96
Whole Unit Rate
-
6.15
6.15
#DIV10!
97
Funding SourceProposed
DADS A&I AAA _
DADS - Title XX
DADS Title XIX (CBA and ICM� -
DADS -Title XIX Managed Care STAR+Plus
- --g (T - - 1 - -
Program Income
LocalFunds- Eligible Meals -
Meals
I _ _ 23 217�
�- _
- --- ---
9 500
- - 18,022
r -----
Calc_ulated_Rate - - - Revenue
}- -_^
_ 5 60 , _ __ 130,015
- _ 4 95� _ - 0
T— - -6.12 0
-
6.15 58,425
— - --6.15 --- -- — 110,835
r
Proposed Meals* Calculated Units
Proposed Meals Calculated Units
Proposed Meals `Calculated Units _... _
Proposed Meals_' Calculated Units
-
Proposed Meals' Calculated Units
Pr osed Meals ` Calculated Units
96_..-
100
101
102
103
N1,01
BUDGET WORKSHEET
A B C
D
E
F G H
2
AAAtRe ion Name:
SPAG
Contract Number: A-100
3
Provider Name: Cityof
Lubbock
Service:; Congregate
4
Period covered in YTD: October 1, 2007 - Ma 31, 2008
New Contract Year:: October 1 , 2008 - September 30, 2009
enses are based on in Column D,
is currently set at 9 months.
actual expenses NOTE: You must identify the number of months the YTD tual
_
under "Annualized Exp. Months YTD Based on." The worksheet
6
7
w
_
YTD Actual
Cost Area Expenses
Annualized Exp.
Months YTD Based on
8
Budgeted Exp. for
New Contract Yr.
Percent Difference Reason for Difference/Explanation
(Budget to Annualized) (If Over Routine Inflation Percentage - 1,05%)
9
10
11
12
107
Other Funds - Non -Eligible Meals
--�
; 6.15 I 0 Proposed Meals * Calculated Units
-
108
Local funds - Required Match
9
_ NA _
0-55
-- - -i-
-- - - 12,769 DADS Proposed Meals +Title XX Proposed Meats *Calculated Rate
109
Local Funds - Ca Limit Exceeded DADS &Title XX
NA
ut
O DADS Proposed Meals +Title XX Proposed Meals'Calculated Rate
Local Funds - Cap Limit Exceeded Title XIX & XIX
110
Managed Care
NA
0.03
0 DADS Title XIX Proposed Meals *Calculated Rate
111
50,739
Estimated Number of
_ _
312,045 <---This total does not Inlcude Title XIX Managed Care meals,
112
114
Nutrition Education
Calculated Cost per Nutrition Education
115
Units
Unit
#DIV701
Budget
116
Resolution No. 2008—RO481
BUDGET WORKSHEET CALCULATION OF THE PER MEAL UNIT RATE
1. Total Budgeted Expenses for Contract Year
2. Total Number of Anticipated Meals to be Provided
Title XWTitle XIX
CBA, ICM,
DADS A&1 AAA 23,217 Title XX 0 STAR+Plus 0
Program Income 9,500 Other Eligible 18,022 Nan -Eligible 0
3. Cost per meal (Line 1 divided by Line 2)
Reimbursement Calculation
DADS A&I AAA
Title XIX/Titte XIX
& Title XX
Managed Care
4. Projected NSIP per Meal Value
0.61
NIA
5. Rate Less NSIP per Meal Value
$ 5,54
NIA
6. Mandatory Local Match of 10% $ 0.55
" If Applicable, Match Reduction
From the In -kind Match
Certification form $ -
Required Match
$ 0.55
N/A
7. Proposed Meal Rate (Line 3 minus Line 6)
$ 5.60
$ 6.15
Rate Cap Applicable to DADS A&I AAA and XX
Common Providers Only
$ 4.95
$ 6.12
8. Excess of Cap Rate Reduction
$ (0.65)
$ (0.03)
DADS A&I AAA/Title XX/Title XIX/Title XIX Managed Care
$_ 4.95_
$ _ 6.12
(Line 7 minus Line 8)
If any portion of the required match is in -kind, you must complete an In -Kind Match Certification form.
1. $ 312.278.00
2. 50,739
3. $ 6.15
By signing below, you certify that all expenses and units related to services supported by the Texas Department
of Agriculture's State General Revenue funding are excluded from this rate setting process, and acknowledge that all related records
are subject to audit in accordance with contract requirements and all applicable
effe/d�eral�l and state laws.
City of Lubbock
Legal Name of Contracted Provider Tom Martin, Mayor
Signature
SPAG
Name of Area Agency on Aging
Tim C. Piexce
P ted/Ty d me Signer
Signatu e
December 4, 2008
Date
December 4, 2008
Date
Department of Aging and Disability Services
Title XIX, Title XIX Managed Care &Title XX
Printed/Typed Name of Signer
Signature
Date
Attest: Approved to ontent: Approved as to rm:
Rebe a Garza Rand. T esdel D ald G. b'a aver
City Secretary Community S vices City Attorney
Director
BUDGET WORKSHEET CERTIFICATION
October I , LUU8 - September 3U, zwo
AS SIGNER OF THIS BUDGET WORKSHEET, I HEREBY CERTIFY THAT:
• I have read the note below and the instructions applicable to this budget worksheet.
e I have reviewed this budget worksheet after its preparation.
• To the best of my knowledge and belief, this budget worksheet is true, correct and
complete, and was prepared in accordance with the instructions applicable to this
budget worksheet.
• This budget worksheet was prepared from the books and records of the contracted
provider.
• This budget worksheet excludes all expenses and units of service supported
by Texas Department of Agriculture State General Revenue funding.
• I acknowledge that all books and records related to this rate setting process are
subject to audit in accordance with contract requirements and all applicable federal
and state laws.
Note: The person legally responsible for the conduct of the contracted provider must
sign this Budget Worksheet Certification. If a sole proprietor, the owner
must sign the Budget Worksheet Certification. If a partnership, a partner must
sign the Budget Worksheet Certification. If a corporation, the person authorized by the
Board of Directors Resolution must sign the Budget Worksheet Certification.
Misrepresentation of information contained in the budget worksheet may result in
adverse action, up to and including contract termination. Furthermore, falsification of
information in the budget worksheet may result in a referral for prosecution.
City of Lubbock
,Name of Contracted Provider
December 4, 2008
Signer Authority:
(check one)
Date
f So(e Proprietor
f" Partner
r Corporate Officer
TOM MARTIN, MAYOR
Printed/Typed Name of Signer
< "00��
Signature
(J Association Officer
r Board Member
r Governmental Official
Attest: Approve s to me rna
d as to Fo
4eb cca ( R y T esd G. 'andiver
City Secretary Community, ervices City Attorney
Director
BUDGET WORKSHEET
A B C D E F G H
....... ---
2 AAA Name: SPAG Contract Number: A-100
3 Provider Name: City of Lubbock Service: Transportation
4 Period covered in YTD: October 1, 2007 - Max 31, 2008 New Contract Year: October 1 2008 - September 30, 2009
6 NOTE- You must Identity the number of months the YTD actual expenses are based an in Column D,
under "Annualized Exo. Months YTD Based on." The worksheet is currently set at 9 months.
AL
Annualized Exp. ---
I
-Difference I I
. ........
-Difference
YTD Actual Months YTD, Based on Budgeted
ted - Exp. for
Percent
Reason for
Cost Area Expenses New Contract Yr.
(Budget to Annualized)
(if Over Routine Inflation Percentage - 1 .05%)
- I_ .. . . I -
gmw �u�w
1. Personnel
mmm'�Ag� 71""�
Minimum Wage increased; thereby generating increases
for all City PT staff of $7011hour as of 7/07 and an addl
Salaries. PR Taxes &
$.70 as of 7/08, with a 3rd $70 increase in 7/09.
Benefits
27,122.00
40,68100
29,912.00
-26.48%
Additionally_, §Aaff_Chanjp.s%e1 offset this increase.
Contract staff,
Compensation
27,122.00
40,683.00 1
29,912.00
-26.48%1
ITotal
2. Professional Development
Conference
Dues
Materials
Total
4. Eq iprnent
Depreciation
Interest
Leasing
Maintenance
Total
5. Occu
uIlding
Rent
Utilities
Depreciation
Mortgage Interest
Insurance
Security
Janitorial
Repair
Taxes
Total
6. Trans RationfTravel
Mileage Reirnbursenvent
Delivery
Gas & Oil
6,191.00
9,286.66
9266.50
0.00%
Repairs
Insurance
I Interest
BUDGET WORKSHEET
A B
C D
E
F G
H
1 J
2
AAA Name:
SPAG
Contract Number. A-100
3
Provider Name:
City of Lubbock
Service: Transportation
4
Period covered in YTD:
October 1, 2007 - May 31, 2008
New Contract Year. October 1 , 2008 - Se tember 30 2009
6
NOTE: You must identiiv the number of months the YTD actual expenses are based on in Column D i
under "Annualized Exo. Months YTD Based on." The worksheet is currently set at 9 months.
-
7
9
Annualized Expr-
YTD Actual Months YTD Based on
Cost Area Expenses 8
Budgeted Exp. for
New Contract Yr.
Percent Difference
(Budget to Annualized)
77
Reason for Difference
(if Over Routine Inflation Percentage - 1.05%)
10
11
51
Tags 8 Licenses
Total 6,191.00 9286.50
52
9,286.50 0.00%
53
54
4>. .�. _,...�- ..
7. Administrative & General
55
Advertising
Printing
Copying
Office Supplies
Contractual Agreements
Postage
Telecommunications
Liability Insurance
Interest-Wkg. Capital
Legal Fees
Accounting Fees
Consulting Fees
Other Fees (Explain)
Audit
Other Misc. (Explain)
Total
200.00
80.00
80.60
300.00
120.00
120.00
-
-
-
-
-
-
-
300.00
120.00
— 126.00
-
0.00%
0.00%
0.00%
_
- - -
_
56
57
7a
59
60
61
-
- --
0.00%
62
63
64
65
66
67
68
69
70
360.00
540.00
540.00
71
72
73
74
Total of all Cost Areas 33 673.00
Total Number of Units
Provided 4,370.00
Total Number of
Anticipated Units
50 509.50
6,555.00
39,73$.50
7 459
-21.32%
13J9%
75
Budgeted Cost r Unit $5.33
76
77
Reason for Difference/1_xplanation
78 FY08 VS FY09 FY08 FY09 Difference Percentage Difference N Over Routine inflation Percentage 1.05%
whole Unit Rate
-
5.331
5.331 #DIV/0!
Enter the Total Number of Anticipated Units or the Pro po_ised
units bar Funding Source
___._
—
Funding Source _ ...
Proposed Units
(Calculated Rate i w Revenue
j
AAA/DADS -Match Required 3,133
4 00 ! -^ -- 12 532!Proposed
r - -
Units Calculated Units.
AAAIDADS - Full Unit Rate 4
5 i
33 - --- OlProposed
Units' Calculated Units
Source 3 1 400
Source 4
i 5 33 1 7 462
5.96T1Proposed
Proposed Units Calculated Units
Unts Calculated Umts
Source 5
_ 5.33 - 0
- --�
(Proposed Units Calculated Units
Source 6
5.33 61
Proposed Units Calculated Unts
Local Funds - Required Match NA
1.33 4 167
iTDoA/AAA Proposed Units "Calculated Rate
BUDGET WORKSHEET
A B C D E F G H I J
2 AAA Name: SPAG Contract Number: A-100
3 Provider Name: City of Lubbock Service: Transportation
4 Period covered in YTD: October 1, 2007 - Ma 31, 2008 New Contract Year: October 1 2008 - Se tember 30 2009
6 NOTE: You must identify the number of months the YTD actual expenses are based on in Column D,
7 under "Annualized Exo. Months YTD Based on. The worksheet is currently set at 9 months
9 Annualized Exp. - .. .
10 YTD Actual Months YTD Based on Budgeted Exp. for - Percent Difference - Reason for Difference
11 Cost Area Expenses 8 New Contract Yr. (Budget to Annualized) (If Over Routine Inflation Percentage - 1_05%)
12 t. N. _.,..... - -
91 1459 39,756 ,
92 ... 1--- --- -�— - --
93
-- -- -,_
Resolution No. 2008-R0481
Service: Transportation
BUDGET WORKSHEET CALCULATION OF THE UNIT RATE
1.Total Budgeted Expenses for Contract Year
27otal Number of Anticipated Units to be Provided
AAA/DADS - Match
Required
AAA/DADS - Full Unit
Rate
3,133 Source 3 1,400 Source 5 0
0 Source 4 2,926 Source 6 0
3. Cost per unit (Line 1 divided by Line 2) - Full Unit Rate
Reimbursement Calculation for Contracts Requiring Unit Rate Match Reduction
4. Mandatory Local Match of 25%
If Applicable, Match Reduction From the In -kind Match Certification form
Required Match
5.Full Unit Rate Less Required Match (Line 3 minus Line
$ 1.33
$
"If any portion of the required match is in -kind, you must complete an In -Kind Match Certification form.
1. $ 39,738.50
2, 7,459
3. $ 5.33
4. $ 1.33
5. $ 4.00
Contract Reimbursed at Full Cost Per Unit Rate. Match Requirements Nil Be Met Through Provision of Additional Units
$ 5.33
Contractor Initial AAA Initial
Contract Reimbursed at the Full Cost Per Unit Less Required Match.
$ 4.00
Contractor Initial AAA Initial
City of Lubbock
Legal Name of Contracted Provider
�� �,-� "
Signature
Tom Martin, Mayor
December 4, 2008
Date
Attest:
eb ca aria
City Secretary
Approved to onten .
Rand T esde
Community Services
Director
SPAG
N ofZArea-�genAging
Y_ I
Signature
Tim C. Pierce
Printed/Typed Name of Signer
December 4, 2008
Date
Approved as to Fo `
Do .Van tver
City Attorney
Resolution No. 2008—RO481
4 South Plains Association of Governments Area Agency
SPAG Area Agency on Aging Won
Aging
SvA Plans Association
of Gwrmo is
Independent Audit
A. VENDOR receiving more than $500,000 in federal or state funding from all sources will provide an
audit in accordance with the standards for financial and compliance audits contained in the Standards
for Audit of Governmental Organizations, Programs, Activities and Functions, issued by the U.S.
General Accounting Office; the Single Audit Act of 1984, including all updates and revisions; the
provisions of OMB Circular A-133, Audits of States, Local Governments, and Nonprofit
Organizations, as applicable, and the Uniform Grant Management Standards.
(1) The VENDOR shall provide and furnish the AAA an annual audit by an independent
certified public accounting firm in accordance with OMB Circular A-133 within 30 calendar
days following receipt of such audit, but in no case more than 9 months following the end of
the VENDOR's fiscal year end.
(2) The VENDOR shall ensure that the audit covers the entire organization and be conducted in
accordance with generally accepted auditing standards. Additionally, audits shall be
conducted in accordance with audit guidelines promulgated by the AAA, or the Single Audit
Manager's Forum (SAMF) or other authoritative source with prior written approval from the
AAA.
(3) The VENDOR, if a non -state entity, shall provide and furnish the AAA a state single audit
when the entity expends $500,000 or more in state awards in a fiscal year. If a single audit is
required, ensuring that the audit report:
i) be conducted by independent certified public accountant
ii) has a Single Audit section
iii) within the Single Audit section, has Schedule for Federal Financial Assistance that
includes property surplus property and its acquisition cost; and
iv) references the Catalog of Federal Domestic Assistance No. 30003.
The VENDOR understands and agrees that the VENDOR shall be liable to SPAG for any costs
disallowed as a result of unresolved costs revealed during the audit.
South Plains Association of Governments
The VENDOR acknowledges and understands the above information.
VE OR requires an Independent Audit
Yes No
TOM MARTIN, MAYOR
Vendor's Name Vendor's Signature
December 4, 2008
Date
Attest: Approve as to Conte Ap roved as to rm:
Re ecca Garza Ra y ruesdell Do ald G. andiver
City Secretary Conununity Services City Attorney
Director