PROVIDE SERVICES TO ELDERLY CITIZENS IN NEED
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AGREEMENT
This Funds Agreement is made and entered into this L day of ~~~/~j>etween
the City of Clearwater, hereinafter referred to as the City, and ""NEiGHBO Y SENIOR
SERVICES, INC. hereinafter referred to as the Agency.
WHEREAS, it has been determined to be highly desirable and socially responsible to provide
services to elderly citizens to those who would not otherwise have such services; and
WHEREAS, the City desires to help those elderly citizens in need of services by providing
funding for such services; and
WHEREAS, the Agency provides services to elderly citizens and operates in the City;
NOW, THEREFORE, the parties agree as follows:
ARTICLE I. TERM
The term of this agreement shall be for a period of 12 months commencing on the 1st day
of October, 1997, and continuing through the 30th day of September, 1998, (the
TermilUltion Date), unless earlier terminated under the terms of this agreement.
ARTICLE II. RESPONSmILITIF.S OF THE AGENCY
1. Services to be Provided. The Agency shall provide services to elderly citizens in
accordance with the proposal submitted by the Agency and approved by the City, which is
incorporated herein by reference.
2. Area to be Served. Services rendered through this agreement shall be provided within
the corporate limits of the City as it now exists and as its boundaries may be changed during
the term of this agreement.
3. Scheduled Reports of Agency Activities. The Agency shall furnish the City Human
Relations Department, Grants Coordinator, with an annual report of activities conducted
under the provisions of this agreement within sixty days of the end of the Agency's fiscal
year. Each report is to identify the number of clients served, the costs of such service, and
commentary on the viability, effectiveness, and trends affecting the program.
4. Use and Disposition of Funds Received. Funds received by the Agency from the City
shall be used to pay for services to elderly citizens. Funds existing and not used for this
purpose at the end of the term of this agreement term shall be deemed excess to the intended
purpose and shall be returned to the City.
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5. Creation, Use and Maintenance of Financial Records.
a. Creation of Records. Agency shall create, maintain and make accessible to
authorized City representatives such financial and accounting records, books,
documents, policies, practices, and procedures necessary to reflect fully the financial
activities of the Agency. Such records shall be available and accessible at all times
for inspection, review, or audit by authorized City personnel.
b. Use of Records. Agency shall produce such reports and analyses that may be
required by the City and other duly authorized agencies to document the proper and
prudent stewardship and use of the monies received through this agreement.
c. Maintenance of Records. All records created hereby are to be retained and
maintained for a period not less than five (5) years from the termination of this
agreement.
6. Non-discrimination. Notwithstanding any other provision of this agreement, during the
term of this agreement, the Agency for itself, agents and representatives, as part of the
consideration for this agreement, does covenant and agree that:
a. No Exclusion from Use. No person shall be excluded from participation in,
denied the benefits of, or otherwise be subjected to discrimination in the operation
of this program on the grounds of race, color, religion, sex, handicap, age, or
national origin.
b. No Exclusion from Hire. In the management, operation, or provision of the
program activities authorized and enabled by this agreement, no person shall be
excluded from participation in or denied the benefits of or otherwise be subject to
discrimination on the grounds of, or otherwise be subjected to discrimination on the
grounds of race, color, religion, sex, handicap,age, or national origin.
c. Inclusion in Subcontracts. The Agency agrees to include the requirement to
adhere to Title VI and Title vn of the Civil Rights Act of 1964 in all approved sub-
contracts.
d. Breach of Nondiscrimination Covenants. In the event of conclusive evidence
of a breach of any of the above non-discrimination covenants, the City shall have
the right to terminate this agreement.
7. Liability and Indemnification. The Agency shall act as an independent contractor and
agrees to assume all risks of providing the program activities and services herein agreed and
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all liability therefore, and shall defend, indemnify, and hold harmless the City, its officers,
agents, and employees.from and against any and all claims of loss, liability, and damages of
whatever nature, to persons and property, including, without limiting the generality of the
foregoing, death of any person and loss of the use of any property, except claims arising
from the negligence or willful misconduct of the City or City's agents or employees. This
includes, but is not limited to, matters arising out of or claimed to have been caused by or
in any manner related to the Agency's activities or those of any approved or unapproved
invitee, contractor, subcontractor, or other person approved, authorized, or permitted by the
Agency in or about its premises whether or not based on negligence.
ARTICLE ill. RESPONSffiILITIES OF THE CITY
1. Grant of Funds. The City agrees to provide a total grant of $4,988.00 to fund the
program in accordance with this agreement.
2. Payments. The total amount requested will be paid by the City to the Agency within 30
days after execution of this agreement by the City and the Agency but no earlier than
October 1 of the budget year for which the funds are authorized.
ARTICLE IV. DISCLAIMER OF W ARRANTIFS
This Agreement constitutes the entire Agreement of the parties on the subject hereof and
may not be changed, modified or discharged except by written Amendment duly executed
by both parties. No representations or warranties by either party shall be binding unless
expressed herein or in a duly executed Amendment hereof.
ARTICLE V. TERMINATION
1. For Cause. Failure to adhere to any of the provisions of this agreement in material
respect shall constitute cause for termination. This agreement may be terminated with 30
day notice.
2. Disposition of Fund Monies. In the event of termination for any reason, monies made
available to the Agency but not expended in accordance with this agreement shall be
returned to the City.
ARTICLE VI. NOTICE
Any notice required or permitted to be given by the provisions of this agreement shall be
conclusively deemed to have been received by a party hereto on the date it is hand-delivered
to such party at the address indicated below (or at such other address as such party shall
specify to the other party in writing), or if sent by registered or certified mail (postage
prepaid), on the fifth (5th) business day after the day on which such notice is mailed and
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properly addressed.
1. If to Agency, addressed to: Administrative Coordinator
Neighborly Senior Services
13650 Stoneybrook Drive
Clearwater, Fl. 33762
2. If to City, addressed to:
Grants Coordinator
Human Relations Department
P.O. Box 4748
Clearwater, FL 34618-4748
ARTICLE VU. EFFECfIVE DATE
The effective date of this agreement shall be as of the first day of October, 1997.
~ IN WITNESS WHEREOF, the parties hereto have set their hands and. seals this
(q day of ~~ , 1997. .
CITY OF CLEARWATER, FLORIDA
By: 1--- '
City Manager
Approved as to form and legal sufficiency: Attest:
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John Carassas, Assistant City Attorney
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Witnesses as to Agency:
L~K .;Ju~
ISusan Tucker
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By: $:;~&+
Prefident / CEO
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..... Phone: (813) 562-4060 for assistance
Application Information
Applicant:
(Sponsor/Developer)
Organization Name:
(If different)
Address:
City~ State~ Zip:
Telephone Number:
Contact Person:
Title:
Telephone Number
Period for which funds
are being requested:
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City of Clearwater
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Social Services Grant
Project Application Form
redric Buchholtz, President/CEO
c
5/28/97
Due: May 29, 1997
Neighborly Senior Services, Inc.
Same as Above
13650 Stoneybrook Drive
Clearwater, Florida 34762
(813)573-9444
Lynn M.. Dunn
Administrative Coordinator
Same as Above
Project Period .1997-98
(See attached Board motion)
Board of Directors Chairperson
e City of Clearwater reserves the right to fund applicants at a level lower than requested.
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:Amount of Funding Currently Requested:
; (Not to exceed $10,000)
<$4,988 to be used as matching funds. $1.00 of match generates $9.00 in services.
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Specifically for what will this money be used.
, (Line item budget for this amount)
" Please see attached Total Agency Budget.
(Neighborly Senior Services' (NSS) Title Ill, Older Americans Act and Florida Community Care for the
, Elderly programs require that NSS provide local matching funds on a 90%/10% basis, i.e., for every nine
~. dollars of federal or state funds received, NSS must raise one dollar oflocal matching funds. NSS
'>requests funds from each municipality according to the municipality's fair share based on the number of
} clients served in each municipality through Adult Day Care; Community Care for the Elderly, Meals on
i','Wheels, Group Dining and Transportation. Clearwater's Fait Share is $136,273 or 15.56% ofthe
$875,451 in match required for these programs to serve 2,179 Clearwater elderly in these programs.
NSS is cognizant ofthe fact that cities have limited resources, so only 3.66% or $4,988 of Clearwater's
fair share is being requested.
(1) (2) (3) (4) (5)
Total Number of
Number of Unduplicated Total "Fair Share"
Unduplicated Clients in Percent of Amount of of
NSS Program Clients Clearwater Total Match Match
Adult Day Care 602 81 13.46% $35,136 $4,728
Community Care
for the Elderlv 2,125 346 16.28% $424,812 $69,169
Meals on Wheels 3.494 531 15.20% $82 570 $12549
Group Dinino 3133 385 12.29% $149,161 $18,330
Neighborly
Transportation 3,880 665 17.14% $183772 $31,497
Palm Harbor Multi-
purpose Senior Center* 1,300 11 0.85% $0 $0
Telephone Reassurancel
Companionship 319 29 9.09% $0 $0
Significant Others
Support 347 97 27.95% $0 $0
Alzheimer's Disease
Initiative Respite Care 132 34 25.76% $0 $0
Total
-Fair Share" $136,273
3.66% of total=
Total Match $875,451 Total Requested $4,988
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E. Brief description of project you wish to fund utilizing this grant.
Services provided include Adult Day Care, Meals on Wheels, Group Dining, Transportation, and
Community Care for the Elderly composed of 16 in-home services including; Homemaker, Personal Care,
Caregiver Relief, Home Health Aide, Occupational/Physical and Speech, Therapy, Mental Health
Counseling, Horne Nursing, Emergency Alert Response and Chore Services.
F. Brief description of your overall organization.
Neighborly Senior Services is a not-for-profit agency of dedicated staff and volunteers providing people
with quality long term care services to maximize their independence, quality of life, and dignity.
NSS is a private not-for-profit agency chartered in 1966 under the laws of the State of Florida and is tax
exempt under Section 501 (c)(3) of the Internal Revenue Code. NSS currently has 15 separate programs
and provides more than 37 services through its service delivery system consisting primarily of 22 group
dining sites, 126 meals on wheels routes, five adult day care centers, 45 vehicles providing transportation
services daily, and 16 in-home services in the Community Care for the Elderly Program. These programs
and 403 dedicated staff are augmented by 3,200 volunteers, most notably the 1,900 volunteers in the
Meals on Wheels Program. NSS Currently serves approximately 11,131 unduplicated or 15,322 low
income seniors per year. NSS is the only agency that provides these services to this target population.
NSS has written coordination agreements with 131 other agencies to which referrals are routinely made,
and a number of agencies provide services at sites.
NSS programs in this application address the following 1992 I-COPE need areas.
Community Care for the Elderly
Priority I - Frail and Impaired elderly
Priority I - Hunger and Poor Nutrition
Priority I - Physical Illness
Priority II - Abuse of the elderly and disabled
Priority II - Depression/Suicide in the elderly
PrioritY II - Disabilities
Priority II - Emotionally Impaired Adults
1lransportation
Priority I - Frail and Impaired elderly
Priority I - Hunger and Poor Nutrition
Priority I - Physical Illness
Adult Day Care
Priority I - Frail and Impaired elderly
Priority I - H:unger and Poor Nutrition
Priority I - Physical Illness
Priority I - Substance Abuse
Priority II - Abuse of the elderly and disabled
Priority II - Adult Illiteracy
Priority II - Depression/Suicide in the elderly
Priority II - Disabilities
Priority II - Domestic Violence
Priority n - Emotionally Impaired Adults
Priority II - Family conflict and separation
Priority ill - Accidental injury and death
Meals and More
Priority I - Frail and Impaired elderly
Priority I - Hunger and Poor Nutrition
Priority I - Poverty
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Number of clients served by this program.
15,322
/ Percentage of these clients who are citizens of Clearwater.
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t4%
Current overall organization budget (Please attach).
See attached.
If this is start up or ma,tching money, specify the details, i.e. which agency or organization will
provide the match, the requirements and the amount of the match.
This is match money on a 1:9 basis for Older Americans Act Programs: Adult Day Care, Meats on
. Wheels, Group Dining, and Transportation. It also matches Florida State Community Care for the
Elderly Program on a 1:9 basis. Clearwater's fair share of match is $136,273 however NSS is requesting
only 3.66% or $4,988. This amount generates $49,880 in revenue.
.; Is your agency a registered 501(c)(3) non-profit agency or in the process of becoming one?
Yes, Neighborly Senior Services is a registered 501(c)(3) non-profit agency.
Does your facility have or is it in the process of acquiring the appropriate licensure for the delivery
of the services described in this application.
Yes, all Neighborly Senior Services' facilities have the required licensure.
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(This is an excerpt from the Board of Director Minutes for March 31, 1997)
Annual General Revenue Funding Requests 1997-98
NSS is in the process of preparing annual General Revenue requests for Pinellas
County municipalities and the Jewish Federation. Revenue received from
municipalities is used as matching funds for grant programs on a 90110 basis.
It was moved by Gordon French and seconded by Owen Schlaug to authorize the
President/CEO to submit the funding requests and to negotiate and sign the
resultant contracts. Motion carried.
, "N~'GHBORLY SENIOR SERVICEs,I'Nc. Nl::IGHJORLY IN-HOME CARE
TOTAL AGENCY BUDGET COMMUNITY CASE CASE
1/1/97 TO I 2/3 1/97 CARE FOR MANAGEMENT MANAGEMENT
THE ELDERLY MEDICAID HCE
REVENUE:
FEDERAL FUNDS $352,900
STATE OF FLORIDA $3,823,3 I 3 $93,229
LOCAL CASH MATCH $90,723
LOCAL IN-KIND MATCH $334.089
USDA COMMODITY CASH
PROGRAM INCOME
SERVICES FOR A FEE
INTEREST INCOME
WORK FAMILY ELDER
DONA1l0NS
FUND RAISING
OTHER GRANTS
PINELLAS COUNTY
LOCAL MUNICIPALmES
JEWISH FEDERA1l0N
UNITED WAY
INDIRECT COST REIMBURSEMENT
CARRYOVER FUNDS
COST RECOVERY
MISCELLANEOUS
TOTAL REVENUE $4.248. 1 25 $352.900 $93.229
EXPENDITURES:
PERSONNEL $872.916 $257.00 I $69.795
lRAVEL $17.753 '$5.768 $1.555
BUILDING SPAC~ $20.508 $6.663 $1.796
COMMUNICAll0NS & UTILmES $31.759 $10.318 $2.780
PRINTING & SUPPLIES $ 1 4.979 $3.568 $961
EQUIPMENT $0 $0 $0
c $0
MEALS $0 $0
SERVICES SUB CONTRACTS $2.447.487 $0 $0
OTl-IERCOSTS $59;759 $27.634 $5.253
INDIRECT COSTS $448.875 $4 I .948 $11.089
IN-KIND COSTS $334.089 $0 $0
LOCAL MATCH EXPENSE $0
TOTAL EXPENDITURES $4.248. I 25 $352.900 $93.229
EXCESS REVENUE OVER EXPENDITURES $0 $0 <$0)
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:' NEIGHBORLY SENIOR SERv,cls. INC: NEIGHBORl MEALS 0. MORE
TOTAL AGENCY BUDGET GROUP HOME PINELLAS
1/ I /97 To' I 2/3 1/97 DINING DELIVERED COUNTY
MEALS MEALS MOW.
REVENUE:
FEDERAL FUNDS $950.783 $495.787
STATE OF FLORIDA $3 17,450 $73.79 I
LOCAL CASH MATCH $149.161 $82.570
LOCAL IN-KIND MATCH .$0 $0
USDA COMMODITY CASH $ 130.862 $187,837
PROGRAM INCOME $90.714 $ 5 24,999
SERVICES FOR A FEE
INTEREST INCOME
WORK FAMILY ELDER
DONA1l0NS
FUND RAISING
OTHER GRANTS
PINELLAS COUNTY $ I 2.000
LOCAL MUNICIPALmES
JEWISH FEDERA1l0N
UNITED WAY
INDIRECT COST REIMBURSEMENT
CARRYOVER FUNDS
COST RECOVERY
MISCELLANEOUS
TOTAL REVENUE $1,638,970 $ I .364,984 $ I 2,000
EXPENDITURES:
PERSONNEL $691 ,352 $459,533
TRAVEL $8.738 $7,399
BUILDING SPACE $6.304 $7.784
COMMUNICA1l0NS & ununES $100.562 $6,380
PRINllNG & SUPPUES $30,927 $4,265
EQUIPMENT $0 $20,000
MEALS C $493.127 $6 I 4,609 $10.762
SERVICES SUB COI'fTRACTS $0 $0
OTHER COSTS . $138.919 $104,230
INDIRECT COSTS $169.041 $140.784 $1.238
IN-KIND COSTS $0 $0
LOCAL MATCH EXPENSE
TOTAL EXPENDrTURES $ 1 ,638,970 $ 1 ,364,984 $ 1 2,000
EXCESS REVENUE OVER EXPENDITURES $0 $0 $0
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:~E:IGH~ORLY SENIOR SERVICES. INC.I
toTAL AGENCY BUD.GET
1/1/97 TO 12/31/97
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NEIGHBORLY mANSPORTAllON
FTA
GRANT
COMBINED
PROGRAM
VEHICLES
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NEfGHBORLY SENIOR SERVICES. INt. PALM I
tOTAL AGENCY BUDGET HARBOR
I / I /9 7 TO I 2/3 I /97 SENIOR
CENITR CORPORATION MARKETING
REVENUE:
FEDERAL FUNDS
STAll:: OF FLORIDA
LOCAL CASH MATCH
LOCAL IN-KIND MATCH
USDA COMMODITY CASH
PROGRAM INCOME
SERVICES FOR A FEE
INTEREST INCOME $99,600
WORK FAMILY ELDER
DONATIONS $44. 152
F1JND RAISING
OlHER GRANTS
PINELLAS COUNlY $15.506
LOCAL MUNICIPALmES $75.033
JEWISH FEDERATION $400
UNITED WAY $347.460
INDIRECT COST REIMBURSEMENT
CARRYOVER FUNDS
I COST RECOVERY
I, MISCELLANEOUS
, TOTAL REVENUE $44. 152 $537.999 $0
$32.528 $5.000
$882 $5.000
$3.582 $2.600
$1.400 $ 10.000 $8.500
$1.207 $62.333 $29.600
$4.554 $9.468
$431.589
$44. I 52 $523.391 $40.700
N
EsS REVENUE OVER EXPENDrTURES $0 $ 14.608 ($40.700> 0
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~~EIGHBORLY SENIOR SERVICEslINC. I
TOTAL AGENCY BUDGET
1/1/97 TO I 2/3 1/97 ELIMINATION
ENTRIES TOTAL
REVENUE:
FEDERAL FUNDS <$ I .638.688) $2.265.593
STATE OF FLORIDA <$43 I .589) $6.699.9 I 4
LOCAL CASH MATCH <$1 15.260) $373.651
LOCAL IN-KIND MATCH $626.907
USDA COMMODITY CASH $318.699
PROGRAM INCOME $961.248
SERVICES FOR A FEE $312.207
INTEREST INCOME $ 100.8 I 8
WORK FAMILY ELDER $2 I .600
DONAl10NS $68.357
FUND RAISING $27.513
OTHER GRANTS $81.381
PINELLAS COUt-rTY $27.506
LOCAL MUNICIPALmES $75.033
JEWISH FEDERAl10N $400
UNITED WAY $479.150
INDIRECf COST REIMBURSEMENT <$1.146.293) $0
CARRYOVER FUNDS $75.812
COST RECOVERY <$4 I ,043) $0
MISCELLANEOUS $7.327
TOTAL REVENUE <$3.372,873) $ I 2,523, I 16
EXPENDrTURES:
PERSONNEL $7,208,678
lRAVEL $ I 84,908
BUILDING SPACE $ 139,632
COMMUNICAl10NS & lffiLmES $218,301 -
PRIN'TING & SUPPUES $114,794
EQUIPMENT $223,900
MEALSt $1,185,762
SERVICES SUB CONlRACTS <$ I ,638,688) $ I , 169,993
OTHER COSTS <$4 I .043) $ I ,475,707
INDIRECf COSTS ($1,146,293) $107,835
IN-KIND COSTS ($ I 15,260) $49 I ,949
LOCAL MATCH EXPENSE <$43 I ,589) $0
$0
lUTAL EXPENOrTURES <$3.372.873) $ I 2.52 I ,458
EXCESS REVENUE OVER EXPENOrTURES $0 $1.657
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