SC_P2 - DCF RFP 2324 105.pdf

CONTRACT NO. [Enter Contract No.]

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EXHIBIT A – SPECIAL PROVISIONS

The following provisions supplement or modify the provisions of Items 1 through 11 of the Standard Contract, as provided herein:

A.1. ENGAGEMENT, TERM AND CONTRACT DOCUMENT

A.1.1. Program of Service Specific Terms

A.1.1.1. Caregiver – The parent, legal custodian, permanent guardian, adult household member, or other person responsible for a child's welfare, as defined in Chapter 39, Florida Statutes (F.S.).

A.1.1.2. Certified Unaccompanied Homeless Youth (CUHY) Population - Youth who meet the eligibility requirements, in §743.067, F.S.

A.1.1.3. Community Based-Care Lead Agency (CBC/Lead Agency) – A not-for-profit or government agency with which the Department contracts for the delivery of foster care and related services.

A.1.1.4. Full Time Equivalent (FTE) – A position whose total time worked in a week equals forty hours.

A.1.1.5. Group Home - A residential child-care setting that provides 24-hour-supervision in a home-like environment.

A.1.1.6. Information Technology Resources (ITR) - Equipment, data or word processing hardware, software, programs, services, supplies, contracted personnel, facilities, network, infrastructure, maintenance, or technology-related training.

A.1.1.7. Out-of-Home Care – A placement outside of home of the parent(s) to include foster family home, group care facility licensed by the Department, and/or relative and non-relative Caregivers.

A.1.1.8. Permanency Status (Permanency) – The status by which the youth reach their permanency goal as defined in §39.01(53), F.S.

A.1.1.9. Post Secondary Education Services and Support (PESS) Population - Young Adults who meet the eligibility requirements in §409.1451(2), F.S. and for post-secondary education services and support (PESS, as defined in §65C-42.001(8), F.A.C.).

A.1.1.10. Region/Circuit – A territorial division pertaining to a geographical service area of the department. There are six (6) Regions that are divided into twenty (20) Circuits.

A.1.1.11. Residential Program - A licensed residential care setting that provides 24-hour care for children in facilities maintained for that purpose. They include but are not limited to, maternity homes, runaway shelters, Group Homes that are administered by an agency, emergency shelters that are not in private residences, and wilderness camps.

A.1.1.12. Youth – Anyone aged 15 to 17 years, who is in Out-of-Home Care or certified under §743.067, F.S. as an unaccompanied homeless youth and who is a citizen of the United States or a legal resident of this state.

A.1.1.13. Young Adults – anyone ages 18 through 23rd birthday and continuing in care under s.

39.6251, F.S., receiving Post Secondary Education Services and Support under § 409.1451(2), F.S., or an unaccompanied homeless youth certified under § 743.067, F.S., who is a citizen of the United States or legal resident of this state.

A.2. STATEMENT OF WORK

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A.2.1. There are no additional provisions to this section of the Standard Contract.

A.3. PAYMENT, INVOICE AND RELATED TERMS

A.3.1. There are no additional provisions to this section of the Standard Contract.

A.4. GENERAL TERMS AND CONDITIONS GOVERNING PERFORMANCE

A.4.1. There are no additional provisions to this section of the Standard Contract.

A.5. RECORDS, AUDITS AND DATA SECURITY

A.5.1. There are no additional provisions to this section of the Standard Contract.

A.6. PENALTIES, TERMINATION AND DISPUTE RESOLUTION

A.6.1. There are no additional provisions to this section of the Standard Contract.

A.7. OTHER TERMS

A.7.1. There are no additional provisions to this section of the Standard Contract.

A.8. FEDERAL FUNDS APPLICABILITY

A.8.1. There are no additional provisions to this section of the Standard Contract.

A.9. CLIENT SERVICES APPLICABILITY

A.9.1. There are no additional provisions to this section of the Standard Contract.

A.10. PROPERTY

A.10.1. If any property is purchased by the Provider with funds provided by this Contract, the Provider shall inventory all non-expendable property, including all computers. A copy of which shall be submitted to the Department along with the expenditure report for the period in which ii was purchased, By June 30•, of each State Fiscal Year (SFY) of the Contract the Provider shall submit a complete inventory of all such property to the Department whether new purchases have been made or not.

A.10.2. The inventory shall include, at a minimum, the identification number; year and/or model,: a description of the property, its use and condition; current location; the name of the property custodian;

class code (use state standard codes for capital assets); if a group, record the number and description of the components making up the group, name, make, or manufacturer; serial number(s), if any, and if an automobile, the VIN and certificate number, acquisition date; original acquisition cost; funding source;

and, information needed to calculate the federal and/or state share of Its cost. The Contract Manager shall provide disposition instructions to the Provider prior to the end of the Contract period. The Provider cannot dispose of any property that reverts to the Department without the Contract Manager's approval.

The Provider shall furnish a closeout inventory by June 30 of each SFY of the Contract before the completion or termination of this Contract. The closeout inventory shall include all nonexpendable property including all computers purchased by the Provider. The closeout inventory shall contain, at a minimum, the same information required by the annual inventory.

A.10.3. The Provider hereby agrees that all inventories required by this Contract shall be current and accurate and reflect the date of the inventory. If the original acquisition cost of a property item is not available at the time of Inventory, an estimated value shall be agreed upon by both the Provider and the Department and shall be used in place of the original acquisition cost.

A.10.4. Title (ownership) to and possession of all property purchased by the Provider pursuant to this Contract shall be vested in the Department upon completion or termination of this Contract. During the term of this Contract, the Provider is responsible for insuring all property purchased by or transferred to the Provider is in good working order.

A.11. AMENDMENT IMPACT

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A.11.1. There are no additional provisions to this section of the Standard Contract.

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EXHIBIT B - SCOPE OF WORK

B.1. SCOPE OF SERVICE

The Provider will operate a Keys to Independence Program (Program) to assist in overcoming Financial obstacles associated with costs of licensure and costs incidental to licensure that prevent a Youth and Young Adults from obtaining or continuing employment or educational goals by paying the cost of driver’s education, licensure and other costs and services related to licensure, and motor vehicle insurance for eligible Youth and Young Adults, per §409.1454, F.S.

B.2. MAJOR CONTRACT GOALS

B.2.1. To provide eligible Youth and Young Adults, per §409.1454, F.S., the following:

B.2.1.1. Access to the completion of driver’s education courses;

B.2.1.2. Access to funds to pay the cost of driver’s education, including licensure and incidentals to licensure; and B.2.1.3. Access to any available subsidies for motor vehicle insurance.

B.3. SERVICE AREA/LOCATIONS/TIMES

B.3.1. Services will be rendered statewide.

B.3.2. The Provider’s administrative offices shall be located at the address specified in 1.3.3.

B.3.3. The Provider’s administrative offices shall be open from 9:00 A.M. to 5:00 P.M., Eastern Standard Time, Monday through Friday, with the exception of state holidays.

B.3.4. The Provider shall notify the Contract Manager, in writing, thirty (30) calendar days in advance of any changes in the street or mailing address, telephone number, electronic mail address, or facsimile number that affects the Department’s ability to contact the Provider.

B.4. CLIENT ELIGIBILITY

B.4.1. Per § 409.1454(4), F.S., eligible Youth and Young Adults include:

B.4.1.1. Youth in Out-of-Home Care;

B.4.1.2. Youth who have reached Permanency, which may receive services up to 6 months after the date they reach Permanency;

B.4.1.3. Youth in Out-of-Home Care who turn 18 years of age, which may receive services up to 6 months after the date they turn 18 years;

B.4.1.4. Young Adults continuing in care under §39.6251, F.S. These Young Adults must demonstrate that such costs are creating barriers for obtaining employment or completing educational goals.

B.4.2. Youth and Young Adults must also be eligible to obtain licensure pursuant to Chapter 322, F.S.

B.4.3. The PESS Population are those who on or after October 1, 2021:

B.4.3.1. Are living in licensed care on his or her 18th birthday;

B.4.3.2. Spent at least 6 months in licensed care before reaching his or her 18th birthday;

B.4.3.3. Earned a standard high school diploma pursuant to §§1002.3105(5), 1003.4281, or

1003.4282, F.S., or its equivalent pursuant to §1003.435;

B.4.3.4. Have been admitted for enrollment as a full-time student or its equivalent in an eligible postsecondary educational institution as provided in §1009.533, F.S. The term “full-time” means 9 credit hours or the vocational school equivalent. A student may enroll part-time if

PCMT-03 27 v.24.1 he or she has a recognized disability or is faced with another challenge or circumstance that would prevent full-time attendance. A student needing to enroll part-time for any reason other than having a recognized disability must get approval from his or her academic advisor;

B.4.3.5. Have reached 18 years of age but are not yet 23 years of age;

B.4.3.6. Have applied, with assistance from the Young Adult’s Caregiver and the CBC Lead

Agency, for any other grants and scholarships for which he or she may qualify;

B.4.3.7. Submitted a Free Application for Federal Student Aid which is complete and error free;

and B.4.3.8. Signed an agreement to allow the Department and the CBC Lead Agency access to school records.

B.4.4. The Certified Unaccompanied Homeless Youth are individuals who on or after July 1, 2022, are:

B.4.4.1. 16 years of age or older and:

B.4.4.2. Found by a school district’s liaison for homeless children and youths to be an unaccompanied homeless youth eligible for services pursuant to the McKinney-Vento Homeless Assistance Act, 42 U.S.C. ss. 11431-11435; or

B.4.4.3. Believed to qualify as an Unaccompanied Homeless Youth, as defined in the McKinney- Vento Homeless Assistance Act.

B.5. CLIENT DETERMINATION

The Provider will make the initial determination of eligibility for each Youth or Young Adult and the Department will make the final determination in the event of a dispute. The Department reserves the right to determine limits on the amount each Youth or Young Adult will be reimbursed each SFY and how much each Youth or Young Adult will be reimbursed over the lifetime of the Program. The Department will provide this in writing to the Provider.

B.6. EQUIPMENT

Equipment, property, and Information Technology Resources may be purchased in accordance with Section 10 and F.12. All property purchased under this Contract between the Provider and the Department shall be listed on a property inventory list as described in C.2.4 and Section 10. The Provider shall list all property/equipment purchased under this Contract on a property/equipment inventory list. Said listing shall include description and location of the property. A copy of the inventory list is to be maintained in the Contract Manager’s file.

B.7. CONTRACT LIMITS

Services in addition to those required by the express provisions of this Contract shall be deemed gratuitous and without charge to the Department.

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EXHIBIT C - TASK LIST

The Provider shall perform all functions necessary for the proper delivery of services including, but not limited to, the following:

C.1 SERVICE TASKS

C.1.1. Development and Submission of Program Plan (Plan). The Provider will develop and submit for Department review and approval by June 30th each year. The Plan shall include the following components for operating and administering the Program:

C.1.1.1. Management Activities. The Provider is required to have effective management and oversight of the Program from a statewide perspective. The Provider shall:

C.1.1.1.1. Develop procedures for taking applications and determining eligibility, including responsibilities for the Youth, Young Adults, and Caregivers;

C.1.1.1.2. Review and approve applications for potential eligible Youth and Young Adults.

The Provider shall have no more than 30 days to review each application once received and contact the applicant to provide the eligibility determination;

C.1.1.1.3. Propose application and payment forms and procedures for processing payments for driver’s education, learner’s expenses, license expenses, driver’s insurance expenses and related materials, deductibles paid for or by foster parents for incidentals by Youth and Young Adults, and Client Flex Funds. Client Flex Funds include Birth Certificates, transportation, and other costs to achieve license on a need basis per Youth and Young Adult. The Provider can either pay the cost upfront or reimburse the foster parents; and

C.1.1.1.4. Use either, or all, of the following approaches to make driving courses and licensure available:

C.1.1.1.4.1. Contract with a commercial driving school licensed under Chapter 488, Florida Statutes;

C.1.1.1.4.2. Contract with an instructor certified under the provisions of Chapter 488, Florida Statutes;

C.1.1.1.4.3. Reimburse for expenses paid by Caregiver or Youth and Young Adults for driver’s education; or

C.1.1.1.4.4. Reimburse for expenses related to public or private high school driver’s education courses.

C.1.2. Subcontracting and Coordination. The Provider shall initiate a statewide service, with effective subcontracting and coordination with all CBC Lead Agencies, service providers, and local partners. The Provider shall:

C.1.2.1. Assign a dedicated Point of Contact (POC) to each CBC Lead Agency to develop procedures for providing technical assistance to CBC Lead Agencies, service providers, Group Homes, external stakeholders, and Residential Programs to support removing obstacles that prevent eligible Youth and Young Adults from driving. The POC shall:

C.1.2.1.1. Offer timely and comprehensive support to the CBC Lead Agencies through telephonic and email channels. This includes addressing inquiries, providing clarification on Program-related matters, and offering guidance on the implementation of contracted services.

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C.1.2.1.2. Assist the CBC Lead Agencies in confirming and verifying the accuracy and completeness of applications submitted by Program participants. This includes reviewing documentation, ensuring compliance with Program requirements, and resolving any discrepancies that may arise.

C.1.2.1.3. Facilitate the enrollment of Program participants in driving school, offering guidance on the process, requirements, and available options. This may involve coordinating with driving schools and providing support to participants throughout the enrollment period.

C.1.2.1.4. Provide guidance and support to Program participants in successfully completing the required driving course. This may involve answering questions, offering resources, and ensuring Clients have access to the necessary tools for successful course completion.

C.1.2.1.5. Verify the acceptance of Program Clients into the designated Programs, ensuring compliance with eligibility criteria and notifying the CBC Lead Agencies promptly of any issues or concerns.

C.1.2.1.6. Provide technical assistance promptly upon request from the CBC Lead Agencies, maintaining a high level of responsiveness to ensure the efficient and effective delivery of services.

C.1.2.1.7. Provide regular reports to the CBC Lead Agencies detailing the status of technical assistance activities, including the number of inquiries handled, issues resolved, and any trends or patterns observed.

C.1.2.2. Create a detailed plan to develop and maintain community collaborative partnerships to link support services to eligible Youth and Young Adults; and

C.1.2.3. Develop a plan for receiving community support for resources tailored for the Program, such as driver’s education and insurance products.

C.1.2.4. Develop a subcontracting plan describing the scope, approach, and method of recruiting subcontractors, processes obtaining the Contract, and methods of ensuring subcontract performance in accordance with this Contract.

C.1.3. Marketing and Outreach. To raise awareness of existing services to the state, the Provider will publicize the Program and engage in outreach. The Provider shall develop:

C.1.3.1. An effective marketing strategy designed to reach Youth and Young Adults, Caregivers, service providers, and CBC Lead Agencies, with an emphasis on how a driver’s license can improve the ability to become self-sufficient and achieve independence;

C.1.3.2. Procedures for notifying eligible Youth and Young Adults, Caregivers, Group Homes, and Residential Programs of the availability and characteristics of the Program; and

C.1.3.3. A detailed plan for recruiting.

C.1.4. Incentives to Youth and Young Adults in Program. The Provider shall provide incentives for Youth and Young Adults in the Program to encourage the greatest number of eligible Youth and Young Adults to obtain driver’s licenses. The incentives must be reviewed and approved by the Department. The maximum dollar amount for each incentive cannot exceed $50.00, and a Youth and Young Adults may not receive more than a total of $200.00 worth of incentives during the time of Program eligibility.

C.1.5. Administrative Components. The Provider shall adopt effective administrative procedures to effectively attain the Contract goals. The Provider shall develop:

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C.1.5.1. A staffing plan for each SFY of the Contract due by July 31st, describing the number of FTE and part time staff, qualifications, and duties of the Provider’s staff under this Contract.

C.1.5.2. A list and description of the various records and documentation the Provider and its subcontractors will maintain.

C.1.5.3. The Provider shall keep record of the CBC Lead Agency by which the eligible Youth and Young Adults is being served and the Youth and Young Adult’s eligibility category.

C.1.5.4. The Provider shall keep documentation of the milestones that each participating Youth and Young Adult has achieved while in the Program. The participating Youth and Young Adult may self-report their milestones to the Provider. These milestones include:

C.1.5.4.1. Starting the 4-hour Traffic Law & Substance Abuse Course;

C.1.5.4.2. Completing the 4-hour Traffic Law & Substance Abuse Course;

C.1.5.4.3. Becoming eligible to take the learner’s license exam and apply for learner’s license;

C.1.5.4.4. Receiving learner’s license;

C.1.5.4.5. Becoming eligible to take a comprehensive driver’s education course;

C.1.5.4.6. Has completed a driver’s education course, when eligible;

C.1.5.4.7. Is eligible to apply for a driver’s license;

C.1.5.4.8. Has received a driver’s license;

C.1.5.4.9. Has been reimbursed for car insurance;

C.1.5.5. The Provider shall keep documentation of the:

C.1.5.5.1. Number of Youth and Young Adults, who receive services from a CBC Lead

Agency, and who’s birthdays occur during the reporting period;

C.1.5.5.2. Number of Youth and Young Adults, who receive services from a CBC Lead

Agency, and who’s applied for the Program during the reporting period.

C.1.6. Penetration Report. The Provider will be given access to and utilize Comprehensive Child Welfare Information System (CCWIS) Data and Florida Safe Families Network (FSFN) report on the:

C.1.6.1. Total number of potentially eligible Youth and Young Adults by CBC/Region/Circuit/County;

C.1.6.2. Number of enrolled Program applications by CBC/Region/Circuit/County;

C.1.6.3. Youth and Young Adults eligibility status, B.4;

C.1.6.4. Percentage enrolled of the total potentially eligible Youth and Young Adults;

C.1.6.5. Number of learner’s licenses received;

C.1.6.6. Percentage of learner’s licenses received;

C.1.6.7. Number of driver’s licenses received;

C.1.6.8. Percentage of driver’s licenses received;

C.1.6.9. Number of Youth and Young Adults who receive services from a CBC, and who’s birthdays occur during the reporting period;

C.1.6.10. Number of Youth and Young Adults who receive services from a CBC, and who have applied for the Program during the reporting period.

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This report will highlight the Regions experiencing a low participation rate. The Provider will use this data to develop its marketing strategy and its procedures for technical assistance. The Provider shall submit this report in the Annual Keys to Independence Program Report, see C.1.8.

C.1.7. Implementation of the Plan. Upon Department approval, the Plan is incorporated into this Contract by reference, as if fully set forth herein. The Provider will thereafter implement the approved Plan and perform all tasks set forth in the approved Plan, according to the terms thereof.

C.1.7.1. The Provider shall update the Plan each SFY by June 30th, describing updates and modifications to the Service Tasks listed in C.1, above.

C.1.8. Annual Keys to Independence Program Report. The Provider shall submit the Annual Program Report each SFY due July 15th to the Department. The report will describe what activities the Provider performed under the Contract during that year; evaluate the success of the Program’s outcomes and achievements; provide recommendations and strategies the Program will implement in the coming SFY; and identify if applicable forecast any barriers or challenges for the coming SFY. Additionally, the report shall also include the Penetration Report to highlight the Region’s participation rates each year, including the total number of Youth and Young Adults who participated in the Program including the PESS and CUHY population.

C.2. ADMINISTRATIVE TASKS

C.2.1. Staffing

C.2.1.1. Staffing Levels.

C.2.1.1.1. The Provider shall maintain sufficient FTE positions to provide the required services consistently and reliably.

C.2.1.1.2. Provider Representative Position: At all times the Provider shall have a representative, as identified in 1.3.3, assigned to administer all aspects of the Contract.

C.2.1.2. Professional Qualifications C.2.1.2.1. The minimum qualifications of staff described in C.2.1, are established in the

Provider’s position description narratives, which are hereby incorporated by reference, and maintained in the Department’s Contract file. The Provider’s position description narratives shall be updated upon new employee hire and annually July 31st of each SFY of the Contract. The Provider is required to employ staff meeting the above described position description requirements to perform the tasks set out herein.

C.2.1.2.2. Volunteer/Intern Screening. The Provider shall ensure volunteers and interns be screened under the statutes set forth in this paragraph, be of good moral character, and meet the Level 2 Employment Screening standards specified in §§435.04, 110.1127, and 39.001(2), F.S., as a condition of initial and continued employment including:

C.2.1.2.2.1. Employment history checks;

C.2.1.2.2.2. Fingerprinting for all criminal record checks;

C.2.1.2.2.3. Statewide criminal and juvenile delinquency records checks through the Florida

Department of Law Enforcement (FDLE);

C.2.1.2.2.4. Five-year FDLE re-screening;

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C.2.1.2.2.5. Federal criminal record checks from the Federal Bureau of Investigation via the FDLE; and

C.2.1.2.2.6. Security background investigation, which may include local criminal record checks through local law enforcement agencies.

C.2.1.2.3. The Provider shall sign an affidavit each SFY for the term of the Contract stating all volunteers and interns have been screened or the Provider is awaiting the results of screening.

C.2.1.2.4. All interns working with the Departments’ Child Welfare Program shall adhere to the same standards of confidentiality and information security especially involving the access, transport or storing of sensitive and confidential information.

C.2.1.2.5. Prior to authorizing an intern’s access to FSFN, verification must be obtained that the intern has completed all required security and confidentiality training and has reviewed all relevant operating procedures and policy, including, but not limited to, Security Awareness Training, HIPPA Training, and the Department’s Security Agreement Form (CF 1114). Documentation of these requirements will be maintained in the intern’s personnel file. Department policies on Security of Data and Information Technology Resources, Confidentiality of Client Records and Security (CFOP 50-2) shall apply to all interns with access to FSFN.

C.2.1.2.6. Violation of security requirements may result in an intern’s dismissal from the internship Program.

C.2.1.3. Staffing Changes.

C.2.1.3.1. The Provider shall notify the Department’s Contract Manager in writing within five calendar days of any key staffing changes. Notification of a staff vacancy shall include information identifying the person(s) assuming the responsibilities of the vacant position. When the vacant position is filled, the Provider shall notify the Department’s Contract Manager in writing of the identity of the new staff person.

C.2.1.3.2. The Provider shall staff the Program with key personnel (leadership and professional), which are considered by the Department to be essential to this Contract. Prior to diverting any of the key personnel from the project, the Provider shall notify and obtain written approval from the Department’s Contract Manager of any proposed substitution(s). Written justification shall include documentation of the circumstances requiring change and a list of the proposed substitutions in sufficient detail to permit evaluation of the impact on the services.

C.2.1.3.3. The Department, at its option, may agree to accept personnel of equal or superior qualifications in the event that circumstances necessitate the replacement of previously assigned personnel. Any such substitution shall be made only after consultation with the Contract Manager.

C.2.1.3.4. The Provider shall replace any employee on the project whose continued presence would be detrimental to the success of the project, as determined by the Department, with an employee of equal or superior qualifications. The Department shall exercise exclusive judgment in this matter.

C.2.1.3.5. Any change in the Provider Representative identified in 1.3.3, shall be provided by the Provider to the Contract Manager immediately, in writing.

C.2.1.4. Subcontracting.

C.2.1.4.1. This Contract allows the Provider to subcontract for the provision of services under this Contract, subject to the provisions of 4.6. The subcontractor at any tier level

PCMT-03 33 v.24.1 must comply with the E-Verify clause as subject to the same requirements as the Provider. Written requests by the Provider to subcontract for the provision of services under this Contract shall be routed through the Contract Manager for Department approval.

C.2.1.4.2. The request to subcontract shall be reviewed and, if approved, approval shall be in writing by the Contract Manager prior to procurement of the subcontract. Payment to the Provider shall not be authorized until Contract Manager approval is obtained.

C.2.1.4.3. A copy of each executed subcontract shall be provided to the Contract Manager within 10 calendar days of the execution date of the subcontract. Payment to the Provider shall not be authorized until Contract Manager is in receipt of each executed subcontract.

C.2.1.4.4. The Contract Manager shall review any request to amend any subcontract prior to the execution of the amendment and, if approved, approval shall be in writing.

C.2.1.4.5. A copy of each subcontract amendment shall be provided to the Contract Manager within ten (10) calendar days of the execution date of the subcontract amendment.

C.2.2. Records and Documentation.

The Provider shall maintain the following records and documentation:

ADMINISTRATIVE DOCUMENTS

Title Due Date # Copies Contents

1.

Civil Rights Compliance Checklist

Due on or prior to Contract begin date 1 electronic Form CF-0946

2.

Authorized Signature Authority for the Provider’s Representative to Sign Contract

Due on or prior to Contract begin date and updated as needed

1 electronic Authorized Signature Authority for the Provider’s Representative to sign Contract

3.

Authorized Signature Authority for the Provider’s Representative to Sign Invoices

Due on or prior to Contract begin date and updated as needed

1 electronic Authorized Signature Authority for the Provider’s Representative to

Sign Invoices

4. General Liability Insurance

Due on or prior to Contract begin date and annually thereafter

1 electronic Certificate of Insurance

5. Coordinated Contracted Services

Due on or prior to Contract begin date and annually thereafter

1 electronic CDA 11-07 Provider’s Contracts List Form

FEDERAL DOCUMENTS

C.2.2.1. All source documents or supporting documentation used to determine compliance with performance measures and deliverables.

C.2.2.2. Copies of time documentation, for each staff paid in whole or in part with these Contract funds, to support staff effort.

C.2.2.3. Copies of travel logs and requests for reimbursement for staff travel. Authorization to Incur Travel DFS-AA-13 Voucher for Reimbursement of Traveling Expenses DFS-AA-15.

C.2.2.4. For each staff paid in part or in whole with these Contract funds:

C.2.2.4.1. Annual original signed and dated Security Agreement Form CF1114.

C.2.2.4.2. Copies of employment screening results for each staff who meets the requirements to be screened for employment.

C.2.3. Reports (programmatic and to support payment).

6.

Executive Compensation Report

Due on or prior to Contract begin date and annually before May 1st

1 electronic PCMT-08

7.

HHS On-Line Monthly Summary Report

Due on the 5th of every month

1 electronic copy

Single Point of Contact ( SPOC) will enter the Monthly Summary Report directly into the database and forward confirmation of submission to the Contract Manager. OCR HHS Monthly Summary Report (formsite.com)

8.

Maintain a Single Point of Contact (SPOC) for Support to the Deaf or Hard of Hearing - List

By the 5th day of each month for the previous month from each Grantee and their sub- Grantees to include any change in the

SPOC

1 electronic copy

SPOC list for the Provider and each subcontractor to include:

1. Name

2. Position/Title

3. Agency

4. Street Address

5. Mailing Address

6. Telephone Number

7. Email address

FISCAL DOCUMENTS

9. Financial and Compliance Audit

Due 180’s days after the end of the previous SFY.

Attachment 5 Attachment 5 https://fs16.formsite.com/DCFTraining/Monthly-Summary-Report/form_login.html https://fs16.formsite.com/DCFTraining/Monthly-Summary-Report/form_login.html

The Provider shall deliver the following reports to the Contract Manager to document the completion of deliverables as specified in EXHIBIT D that shall be received by the Contract Manager prior to the Request for Payment and Monthly Expenditure Report and Request for Reimbursement and approved by the Contract Manager prior to authorizing payment for each SFY in accordance with the listed schedule. If the due date for the report falls on a state holiday or weekend, the report will be due the next business day.

REPORTS FOR FISCAL YEAR

# Title Due Date # Copies Contents

1. Performance Measure Compliance Report

Prior to or concurrent with the Request for Payment and with the Monthly Expenditure Report and Request for Reimbursement.

One electronic to the Contract Manager

See Attachment 1

2. Quarterly Cost Reconciliation Report

Within 20 days after the end of each state fiscal quarter

One electronic to the Contract Manager

Actual operations expenditures for each quarter of the SFY

3.

Monthly Expenditure Report and Request for Reimbursement

By the 20th day of each Month for the previous month of which reimbursement is being requested

One electronic to the Contract Manager

See Attachment 2

4. Request for Payment

By the 20th day of each Month for the previous month of which the Request for Payment is being requested

One electronic to the Contract Manager

See Attachment 3

5.

Annual Keys to Independence Program Report

Annually July 31st of

One electronic to the Contract Manager

A report evaluating the success of and outcomes achieved by the Program. A report highlighting the Regions’ participation rates (penetration report).

6.

15-21 Year Old (y/o) Youth or Young Adult Monthly Activity Report

Prior to or concurrent with the Request for Payment and with the Monthly Expenditure Report and Request for Reimbursement.

One electronic to the Contract Manager

See Attachment 4

7. Inventory Report Annually on June 30th and 30 days prior to completion of Contract

One electronic to the Contract Manager

See A-7.1,.

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8.

Monthly Outreach Activities for PESS Population and homeless population.

By the 20th day of each Month for the previous month of which payment is being requested.

One electronic to the Contract Manager

The Provider shall submit a monthly outreach roll-up that includes the following for each population:

1. Number of Outreach Activities;

2. Method of Outreach Activities; and

3. Dates of Outreach Activities.

9.

PESS Monthly Activity Report

By the 20th day of each Month for the previous month of which payment is being requested.

One electronic to the Contract Manager

The Provider shall use Attachment 4-2 to report on activities related to the PESS Population participants.

10. CUHY Monthly Activity Report

By the 20th day of each month for the previous month of which payment is being requested.

One electronic to the Contract Manager

The Provider shall use Attachment 4-3 to report on activities related to the CUHY Population participants.

11. Executive Compensation Annual Report

Due Annually by May 1st of each year.

One electronic to the Contract Manager

The Provider shall submit completed form annually by May 1 of each year.

C.3. Provider Responsibilities.

C.3.1. Provider Unique Activities.

Per 4.6.5.2., the Provider is solely and uniquely responsible for the satisfactory performance of the tasks, activities, and deliverables as described in this Contract. By execution of this Contract the Provider recognizes its singular responsibility for the tasks, activities, and deliverables described herein and warrants it has fully informed itself of all relevant factors affecting accomplishment of the tasks, activities, and deliverables and shall be fully accountable for the performance thereof.

C.3.1.1. Fiscal Control and Program Compliance: The Provider shall be knowledgeable of and fully comply with all applicable Federal and State laws, rules, regulations and Program instructions that do or may affect the subject areas of this Contract. Authorities and requirements include, but are not limited to, the citations identified in the Department’s Standard Contract.

C.3.2. Coordination with Other Providers/Entities.

Coordination with other providers, entities, or subcontractors does not relieve the Provider of any accountability for tasks, activities, deliverables, or services the Provider is obligated to perform pursuant to this Contract.

C.4. Department Responsibilities.

C.4.1. Department Obligations.

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C.4.1.1. Upon written request to the Contract Manager and when deemed necessary by the Department, the Department agrees to provide technical assistance concerning the terms and conditions of this Contract.

C.4.1.2. The Department’s failure to provide such technical assistance does not relieve the Provider of its responsibilities to ensure compliance with all state and federal laws, rules, and regulations or performance under the terms of this Contract.

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EXHIBIT D – DELIVERABLES

D.1. Deliverables.

DELIVERABLES – STATE FISCAL YEAR

# Title Due Date

# of Copies Contents and Criteria for Acceptance

1.

Notification Determination Sent to Youth and Young Adults Applicants C.1.1.1.2

Monthly on the 20th one electronic copy

The number of Program applications received and approved by the Provider. The Provider shall have no more than 30 days to review each application, determine eligibility, and notify the applicant of their eligibility determination. The number of applications received and approved, each month, shall be recorded in Attachments 4 through 4-2.

2.

Participant Eligibility Status

C.1.1.1.2

Monthly on the 20th one copy

The Provider shall identify and categorize the Youth and Young Adults eligibility status of participant. These categories include:

1. Foster Homes;

2. Group Homes;

3. Relative care;

4. Non-relative care;

5. Reached Permanency;

6. 18 years of age;

7. Extended Care; or

8. PESS Population Participant.

The Provider shall record the number of participants served, each month, under the correlating eligibility status in Attachment 4 through 4-2.

3.

Targeted Marketing and Technical Assistance to CBC Lead Agencies and External Stakeholders C.1.2.1.

C.1.2.1.6.

C.1.3.

C.1.6.10.

copy

The number of Targeting Marketing and Technical Assistance to CBC Lead Agencies and External Stakeholders provided, each month, shall be recorded in Attachments 4 through 4-2.

4.

Incentives to Youth and Young Adult C.1.4.

Monthly on the 20th one electronic copy

The Provider shall report the number of incentives given to participants, each month, in Attachment 4 through 4- 2.

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5.

Documentation of the Milestones that Participants Achieve while in the Program.

C.1.5.4.

copy

The Provider shall record the milestones that each participant achieves, each month, in Attachments 4 through 4-2. The milestones include a Youth and Young Adults who:

1. Has started taking the 4-hour Traffic Law &

Substance Abuse Course;

2. Has completed the 4-hour Traffic Law &

Substance Abuse Course;

3. Is eligible for taking the learner’s license exam and apply for learner’s license;

4. Has received their learner’s license;

5. Is eligible to take a comprehensive driver’s education course;

6. Has completed a driver’s education course, when eligible;

7. Is eligible to apply for a driver’s license;

8. Has received their driver’s license; and

9. Has been reimbursed for car insurance.

D.1.1. Each deliverable shall be performed in the manner acceptable to the Department and delivered by the dates set out in D.1.

D.1.2. The minimum level of service for each deliverable shall be:

D.1.2.1. Development and Submission of the Plan and annual updates thereafter.

D.1.2.2. Satisfaction of the standards, without financial consequence, in the Monthly Performance Measure Compliance Report, Attachment 1.

D.1.2.3. Timely delivery of Monthly Activity Reports, Attachments 4 through 4-2.

D.1.3. The Department reserves the right to reject the report, its updates, or any portions thereof, that the Department determines deficient for any reason. The Provider shall be notified in writing by the Contract Manager of any deficiencies. The Provider shall have five working days to correct the deficiencies and resubmit to the Contract Manager. If the Department is satisfied with the report, the Contract Manager will notify the Provider in writing of the acceptance of the report.

D.1.4. Merely the receipt of the reports shall not be construed to mean acceptance. The Department reserves the right to reject reports as being incomplete, inadequate, or unacceptable. The Department will notify the Provider in writing, within five working days of the disapproval of the required reports.

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EXHIBIT E – MINIMUM PERFORMANCE MEASURES

E.1. MINIMUM PERFORMANCE MEASURES

For minimum performance measures, see Attachment 1, Monthly Performance Measure Compliance Report.

E.1.1. Performance Evaluation Methodology.

E.1.1.1. Performance Standards Statement: By execution of this Contract the provider hereby acknowledges and agrees that its performance under the Contract must meet the standards set forth above and will be bound by the conditions set forth in this Contract. If the provider fails to meet these standards, the department, at its exclusive option, may allow a reasonable period, not to exceed 6 months, for the provider to correct performance deficiencies. If performance deficiencies are not resolved to the satisfaction of the department within the prescribed time, and if no extenuating circumstances can be documented by the provider to the department’s satisfaction, the department must terminate the Contract. The department has the sole authority to determine whether there are extenuating or mitigating circumstances.

E.1.1.2. For Collection Methodology, see Attachment 1.

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EXHIBIT F - METHOD OF PAYMENT

F.1. This is a combination fixed price (unit cost) and cost reimbursement multi-year Contract. The fixed fee is subject to reconciliation to actual expenditures. The Department agrees to pay the Provider a fixed fee of $TBD, based on budgeted expenditures for its operations. The Provider shall be reimbursed for allowable expenditures for the delivery of services pursuant to the terms of the Contract not to exceed $TBD for cost reimbursement, for a combined Contract amount of $TBD, subject to the availability of funding.

F.1.1. The Department will pay the Provider for the delivery of One Month of Program Operations as documented in Attachment 1, Performance Measure Compliance Report, and Attachment 4, Monthly Activity Report, in accordance with the terms and conditions of this Contract for a total dollar amount not to exceed the following:

F.1.1.1. Fixed Price in the amount of $TBD; Cost Reimbursement in the amount of $TBD for a combination total of $TBD for SFY 2024-2025.

F.1.1.2. Fixed Price in the amount of $TBD; Cost Reimbursement in the amount of $TBD for a combination total of $TBD for SFY 2025-2026.

F.1.1.3. Fixed Price in the amount of $TBD; Cost Reimbursement in the amount of $TBD for a combination total of $TBD for SFY 2026-2027.

F.1.1.4. Fixed Price in the amount of $TBD; Cost Reimbursement in the amount of $TBD for a combination total of $TBD for SFY 2027-2028.

F.2. State Fiscal Year 2024-2025

# Service Units Unit Price Maximum # of Units

Total

1. One Month of Program Operations, for the months of April through June, as documented in Attachment 1, Performance Measure Compliance Report.

$TBD 3 months $TBD

Total Fixed for State Fiscal Year 2024-2025: $TBD Total Available for Cost Reimbursement for State Fiscal Year 2024-2025: $TBD

Total State Fiscal Year Contract Amount: $TBD

F.3. State Fiscal Year 2025-2026

# Service Units Unit Price Maximum # of Units

Total

1. One Month of Program Operations, for the months of July through June, as documented in Attachment 1, Performance Measure Compliance Report.

$TBD 12 months $TBD

Total Fixed for State Fiscal Year 2025-2026: $TBD Total Available for Cost Reimbursement for State Fiscal Year 2025-2026: $TBD

Total State Fiscal Year Contract Amount: $TBD

F.4. State Fiscal Year 2026-2027

# Service Units Unit Price Maximum # of Units

Total

1. One Month of Program Operations, for the months of July through June, as documented in Attachment 1, Performance Measure Compliance Report.

$TBD 12 months $TBD

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Total Fixed for State Fiscal Year 2026-2027: $TBD Total Available for Cost Reimbursement for State Fiscal Year 2026-2027: $TBD

Total State Fiscal Year Contract Amount: $TBD

F.5. State Fiscal Year 2027-2028

# Service Units Unit Price Maximum # of Units

Total

1. One Month of Program Operations, for the months of July through June, as documented in Attachment 1, Performance Measure Compliance Report.

$TBD 9 months $TBD

Total Fixed for State Fiscal Year 2027-2028: $TBD Total Available for Cost Reimbursement for State Fiscal Year 2027-2028: $TBD

Total State Fiscal Year Contract Amount: $TBD

F.6. Invoice Requirements.

The Provider shall submit its invoice for expenditures for reimbursement on a monthly basis through submission of a properly completed Monthly Expenditure Report and Request for Reimbursement (Attachment 2), by the 20th day of each month for the previous month of which reimbursement is being requested. Charges on the invoice must be accompanied by supporting documentation. The Provider shall submit its invoice for fixed fee payment on a monthly basis through submission of a properly completed invoice Request for Payment (Attachment 3), within 20 calendar days following the end of the month for which payment is being requested.

F.6.1. Fixed fee payments may be authorized only for service units on the invoice, which are in accord with the above list, and other terms and conditions of this Contract. The service units for which payment is requested may not either by themselves, or cumulatively by totaling service units on previous invoices, exceed the total number of service units authorized by this Contract.

F.6.2. Budget Revisions. The Provider may make changes in or between line items of the Fixed Price Approved Line-Item Budget that are cumulatively less than 10% if the total SFY original budget or amended Fixed Price Approved Line Item Budget only if the following conditions are met.

F.6.2.1. The change does not decrease or increase the original dollar amount of each SFY’s Contract budget;

F.6.2.2. There is another line item in the budget from which funds can be shifted without affecting the scope of work;

F.6.2.3. The change does not involve establishing a new line item;

F.6.2.4. Written notification shall be submitted to the Contract Manager prior to the submission of the

Request for Payment in which the change to the Fixed Price Approved Line-Item Budget was made;

F.6.2.5. Budget modifications that do not meet the above conditions shall require a Contract amendment, signed by the Provider and the Department prior to implementation of the specific modification;

and

F.6.2.6. Cost reimbursement payments may be authorized only for allowable expenditures on the invoice which are in accord with the limits specified on the approved line-item budget.

F.7. The Provider shall submit quarterly Cost Reconciliation, documenting its actual operations expenditures through a properly completed Quarterly Cost Reconciliation Report within 20 days after the end of each state fiscal quarter. If the Final Quarterly Cost Reconciliation report submitted at the end of each Contract budget year identifies any unearned income, the Provider may be directed to return funds to the Department.

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F.8. Quarterly Cost Reconciliation Report.

Should the Provider’s Quarterly Cost Reconciliation Report indicate that payments were made to the Provider in excess of the actual costs of providing contracted services for that SFY; the Provider shall refund the difference to the Department in accordance with 3.5. During the final SFY of the Contract, the Department reserves the right to request monthly cost reconciliation reports to monitor the relationship of fixed fee payments to actual costs. If, in the Department’s sole determination, it appears that payments made, or to be made, to the Provider could be in excess of the actual cost of providing contracted services for the final quarter, the Department may require refunds of such excess as frequently as monthly.

F.9. Service Delivery Documentation Requirements.

The Provider shall maintain records documenting the total number of recipients and names (or unique identifiers) of recipients to whom services were provided and the dates(s) that the services were provided so that an audit train documenting services provision can be maintained.

F.10. Restriction of Expenditures.

Items expressly prohibited from purchase with these Contract funds include, but not limited to, flowers, awards or plaques, meals (excluding meals associated with travel per Chapter 112 F.S., including bottled water, snacks, refreshments, entertainment, and promotional items that do not have a specific statutory authority including but not limited to ribbons and wrists bands.

F.11. Expenditures shall meet the minimum requirements established by the Department of Financial Services, Division of Accounting and Auditing, Bureau of Auditing, Reference Guide for State Expenditures, which is available at the Department of Financial Services web site.

F.12. Information and Technology Resources.

The Provider must receive written approval from the Department prior to purchasing any ITR with Contract funds. The Provider agrees to secure prior written approval by means of an Information Resource Request (IRR) form before the purchase of any ITR. The Contract Manager is responsible for reviewing and approving the IRR.

The Provider will not be paid or reimbursed for any ITR purchase made prior to obtaining the Department’s written approval.

F.13 Funding Details There are three different categories of funding. PESS and homeless population come from the same funding source, while the 15-21 Youth or Young Adults are funded from a different funding source. Additionally, funded from a third source is 15-21, PESS population, and the homeless population. The Provider should be aware this impacts reporting requirements, as there are three different reporting forms based on the age requirements.

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EXHIBIT F1 –ADDITIONAL FINANCIAL CONSEQUENCES

The following financial consequences apply in addition to the Financial Consequences provided in 6.1.

F1.1. Financial Consequences.

F1.1.1. In addition to the financial penalties set out in Rule 65-29.001, F.A.C., for failure to comply with a requirement for corrective action, the Department shall assess financial consequences for failure to meet the performance measures outlined in Attachment 1, Performance Measure Compliance Report. Financial consequences shall be equally applied based upon remedies identified in Attachment 1, Performance Measure Compliance Report.

F1.1.2. Upon the Department’s decision to impose financial consequences, written notification will be sent to the Provider.