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HomeMy WebLinkAboutC-1777 - Senior Citizens surveyC(*JNTY OF ORANGE GENERAL SERVICES AGENCY o` PURCHASE ORDER VENDOR rPURCHASE ORDER N0. � 4 ? >09 CONTROL NO. 24G81 SHIPTO CITY OF NEWPORT BEACH SENIOR CITIZENS PROGRAM OFFICE 3300 NEWPORT BOULEVARD 801 -C N. BROADWAY NEWPORT BEACH, CALIFOR14IA 92663 SANTA ANAL CALIFORNIA 92701 NOT TO EXCEED FUND B/U OBJECT SUB GREW RESP. CT0. CATEGORY JOB NUMBER GRHNT DATE MHILED COMMODITY TOTAL AMOUNT 0148 190 003 LH 1 -20 -76 19958 RED NO. PRI-CD FOB DEST PLUS FRT TERMS ORDER DATE DELIVERY WITHIN 2634 1 YES NO NET AS REQUIRED DAYSARO I,560I 00 ITEM NO. °" k UNIT DESCRIPTION UNIT PRICE AMOUNT 1 1 � I I AGREEMENT FOR IMPLEMENTATION OF SSI I ALERT PHASE II PER ATTACHED AGREEMENT WITH MONETARY LIMIT AND TIME PERIOD INDICATED. PER BOARD RESOLUTION 975 -1512. I I � 1 I I 1 I 1 I I „ � I I I I I Imo%. I I C� CL 1 Ally, �o S�- I p I � v4 ACKNOWLEDGED Receipt of Material AUTHORIZED _ THE ABOVE ITEPO$ WERE RECEIVED BY XXXXXX?CXXXx %l V j - I SIGNATURE OF COUNTY EMPLOYEE DATE NOTE: Report any damage or irregular itieS to the BUYER: ROBERT J. MERSHON Office of Procurement. IMMEDIATELY PHONE: (714) 834 -3400 ,. ' _ a AGREEMENT FOR SOCIAL SERVICES FOR ELDERLY PERSONS IN ORANGE COUNTY This AGREE14ENT is made and entered into this 23rd day of December, 1975, by and between the COUNTY OF ORANGE, hereinafter referred to as "County" and the CITY OF NEWPORT BEACH, 3300 Newport Blvd., .Newport Beach, CA 92663, hereinafter referred to as "Contractor ". WHEREAS, the Congress of the United States through the Administration on Aging of the Department of Health, Educa- tion and Welfare (hereinafter referred to as "HEW "), through j. the State of California Office on Aging (hereinafter referred to as "State•'), has made certain funds available under Title III of the Older Americans Act of 1965, as amended (hereinafter referred to as "Act "), Title 42, Section 3021 et seer. of the United States Code, for providing social services to elderly persons; WHEREAS, pursuant to the Burton Act for the Aging, California Welfare and Institutions Code Section 9000 et seq., the California Legislature has designated State as the single j' state agency for supervision of all programs under the Act; WHEREAS, pursuant to the provisions of the Act, State has designated County's Senior Citizens Program Office as the 'Area, Agency on Aging for Orange County, and County has adopted an Area Plan for Program on Aging to provide said services; WHEREAS, pursuant to the provisions of the Act, State has approved County's Area Plan for Programs on Aging; WHEREAS, State and County have entered into a written agreement, which incorporates by reference County's Area Plan for Programs. on Aging, whereby State is to provide County with i federal funds to implement County's Area Plan for Programs on Aging in accordance with the Act and all regulations and. directives relating thereto which are promulgated by HEW and by State; t WHEREAS, pursuant to the provisions of said written agreement, County has agreed to enter into written agreements with other. public and private agencies or organizations which shall provide certain of said services; WHEREAS, Contractor is equipped, staffed and pre- pared to provide certain of said services; j WHEREAS, pursuant to the provisions of California Government Code Section 53703, County may contract with other public and private agencies or organizations and do all acts necessary to participate in federal programs, such as this program under the Act, whereby federal funds are provided to County for purposes of public health, safety or welfare; and WHEREAS, the Administration on Aging has approved the use of certain Model Project funds, authorized under Title III, Section 308 of the Older Americans Act of 1965 as amended, to implement Phase II of SSI- Alert; WHEREAS, for purposes of this Agreement, the term "SSI" and the eligibility for SSI are explained as follows: On January 1, 1974, under Public Law 92 -603 enacted by Congress, a new income maintenance program for low- income per- sons went into effect nationwide. This new program, called Supplemental Security Income (SSI) , completely replaced Cali- fornia's previously existing federal - state- county public as- sistance programs for the aged (Old .Age Security) , blind (Aid to the Blind) , and disabled (Aid to the Totally Disabled).. Under. SSI, the federal government guarantees a minimum income level - -as of July, 1975, $157.70 per month for an el- igible individual, and $236.60 per month for an eligible couple. The federal government also sets eligibility requirements which are uniform throughout the country. Basically there are four separate requirements that each claimant for SSI benefits must meet. The first requirement is that he or she have certain "special characteristics" as defined by federal statutes and regulations. These characteristics are that the person is either aged (i.e., at least 65 years of age); or blind or disabled of any age. Second, he must have certain "common characteristics "; that is, he must be a U.S. and Cali - fornia resident, and be a U.S. citizen or have certain resident alien status. Third, his income must be within certain speci= Pied limits. Fourth, his resources (assets) must also be with- in certain.specified limits. SSI ELIGIBILITY: THE FOUR BASIC REQUIREMENTS An'applicant must have: 11 certain special characteristics: that is, he must be either: a) aged (65 or over); or b) blind. (any age); , or c) disIbled (any age).- and 2) certain common characteristics, such as U.S. and California residency, and citizenship or permanent alien status; and 3) limited income; - and 4) limited resources. NOW THEREFORE, the parties hereto mutually agree as follows: 1. Scope of Services. Contractor shall perform, in a manner satisfactory to the County, the duties as set forth in the following paragraphs hereof which state for such services: '(A). Statement of Goals (1) To develop a pilot program to locate i and identify senior citizens who may be eligible for the Supplemental Security Income Program (SSI). f (2) To conduct a needs assessment survey, i.e., "Action Survey" to determine the needs of the pilot area senior citizens. (B) Responsibilities i (1) Orange County Senior Citizens Program Office's responsibilities are: i. To secure cooperation and partici- pation from local cities, non - profit private agencies and volunteers. 3 - ii. To monitor the program and assist in i analyzing the collected data. To coordinate with Social Security Administration Office in analyzing and planning better services for seniors. i:v. To prepare questionnaire forms (see attachments) needed materials and training sessions. (2) Sub- contractor's responsibilities are: i. To provide or utilize a centrally accessible office with dependable voluntary or paid personnel and suf- ficient in -house equipment to be able to support SSI Suryey in their pilot areas. ii. To recruit volunteers from their areas to conduct the survey. To identify the location of the pilot area senior citizens. iv. To coordinate with SCPO, CRIS, SSA and other public and private agencies in developing a cooperative network of information and referral service to persons in their areas. V. To develop and maintain records of 'its transactions. The records should include the number of senior citizens contacted, method of contact, number' of SSI referrals and names of organi- zations or agencies where volunteers were recruited. The records should be kept in a confidential manner so that no individual will be identified by the public. vi To submit invoices for payment to the County of Orange for staff (if appli- cable) and volunteer expenses and to keep travel vouchers and time sheets _.. 8�g.: 1'�n_ka:vn.. .f�.r .a_ewv�i..n e. .. .. ...• -. , 2. Time of Performance. The term of this Agree- ment shall commence on any date but not to exceed 8 weeks from January 1, 1976 to March 31, 1976. This Agreement may be terminated by either party at any time as described in Paragraph 7 and 8 with written notice to the other party. County may also terminate this' Agreement immediately upon written notice to Contractor if County receives communica- tion from State that funds are not available for this Agreement or for any portion hereof. 3. Location of Performance. During the term of this Agreement, Contractor shall continuously manage and operate the service site(s) at the following location(s) to provide the services set forth in Paragraph l hereof: CITY OF NEWPORT BEACH, 3300 Newport Blvd., Newport Beach, CA 92663. The service site(s) listed hereinabove may be eliminated from and or other service site(s) may be added to this Agreement as mutually agreed upon by the parties hereto in accordance with Paragraph 9 hereof. The service area is within Orange County. 4. Compensation. (Budget, pay scale, allowable expense, and terms of payment) County agrees to pay Contractor. for the performance of the duties set forth herein as follows: A. Total Budget: $1,560.00 Total Staff Cost $ 560.00 Total Volunteer Cost $1,000.00 B. Allowable expenses are as follows: i. All volunteer transportation and parking expense related to the SSI -Alert "Action Survey ": traveling expenses reimbursable at 17 cents a mile for the first 150 miles and 15 cents for the remaining miles. i ii. One (1) staff member is an allowable cost at.$3.50 per hour, 20 hours per week, - 5 - to act as the project manager for the term of the SSI -Alert Action Program for each sponsor.. iii. Meals are allowable, but will be left to the discretion of the contractor who should receive meal reimbursement. •C. Terms of Payment - By Invoice The Contractor will submit staff time every two weeks and volunteer travel and meal expense once a month. 5. Contacts for Responsibility. The Director of the the Orange County Senior Citizens Program Office, or his desig- nee; is the County's representative for purposes of monitoring this Agreement. He or. his staff will provide technical assist- ance, training sessions and will analyze the collected data as indicated in paragraph 1 (A). Contractor shall make available to County a list of all persons by name, job title and duties, experience, and professional degrees, if any, who are to per - form services hereunder. All personnel shall be qualified in accordance with the Act and all federal, state and local laws, ordinances, regulations., and directives applicable thereto. 6. Audit and Inspection of Records. At any time during normal business hours and as often as County may deem necessary, Contractor shall make available to County, State and Federal officials for examination all of its records with re- spect to all matters covered by this Agreement and will permit County, State and Federal officials to audit, examine and make excerpts or transcripts from such records, and to make audits of all invoices, materials, payrolls, records of personnel and I other data relating to all matters covered by this Agreement. Contractor shall maintain all such records for a minimum of three years if audit has occurred, and five years if audit has not occurred, and. in the case of audit exception .until such exception has been cleared. Contractor fur- ther agrees to submit such reports of its activities and expenditures as may be required by the State and the County. Exclusion: Client matters identified or designated as confi- dential by Contractor. 7. Changes.. County may from time to time request changes in the scope of the services of Contractor to be per - formed hereunder. Such changes, including any increase or decrease in the amount of Contractor's compensation, which are mutually agreed upon by and between County and Contractor shall be effective when incorporated in written amendments to the Agreement. No oral understanding or agreement, not incor- porated herein, shall be binding on the parties hereto. 8. Assignability. Contractor shall not assign any interest in this Agreement and shall not transfer any interest in the same, whether by assignment or novation, without the prior written consent of County thereto; provided, however, that claims for money due or to become due to Contractor from County under this Agreement, may be assigned to a bank, trust company, or other financial institution without such approval. Notice of any such assignment or transfer shall be furnished promptly to .County. 9. Interest of Contractor. Contractor convenants that he presently has no interest and shall not acquire any interest, direct or indirect, which would conflict in any. manner or degree with the performance of services required to be performed under this Agreement. Contractor further covenants that in the performance. of this Agreement, no person having any such, interest shall be employed. 10. Indemnity. Contractor agrees to maintain and 'provide evidence of such insurance as will fully protect both Contractor and County from any and all claims under any Workers' Compensation Act or employer's liability laws, and from any and all other claims of whatsoever kind or nature for the damage to property or for personal injury, including death, made by anyone whomsoever which may arise from operations carried on under this Agreement, either by Contractor, any sub - contractor or by anyone. directly or indirectly engaged or employed by i either of them. It is necessary that the County of Orange be shown as an additional assured and that 30 days written notice of cancellation be provided. Contractor shall exonerate, indemnify and .hold harmless County from and against, and shall assume full responsibility for payment of all Federal, - 7 - State and local taxes or contributions imposed "or required under Unemployment Insurance, Social Security, and Income Tax Laws, with respect to Contractor and Contractor's employees engaged in performance of this Agreement. County, and its agents and employees, shall not be, nor be held liable for any liabilities, penalties, or forfeitures, or for any damage . to the goods, properties or effects of Contractor, or of any other persons whatsoever, not for personal injury to or death of them, whether caused by or resulting from any negligent act or omission of Contractor. Contractor further agrees to indemnify and hold harmless County and County's agents and• employees, against and from any and all of the foregoing liabilities, and any and all costs or expenses incurred by County foregoing obligations and liabilities, by which it is intended by both parties that Contractor shall indemnify and hold County harmless from all claims arising by reason of any act or omission of Contractor. It is understood that there will be consultants and volunteers involved in "this service. They should be liable for themselves. Neither the County nor the Contractor are responsible for their liabilities. 11. Confidentiality. Contractor agrees and shall insure that no information about or obtained from any elderly person receiving services hereunder shall be voluntarily dis- closed in any form identifiable with such elderly person without first obtaining the written consent of such elderly person. The provisions of this section shall not, however, restrict the Contractor's obligations to provide required information under this or its other County, State or Federal contracts. 12. Independent Contractor. It is agreed that Contractor shall perform as an independent contractor under this Agreement. Contractor is, for all purposes arising out of this-Agreement, an independent contractor and it shall not be deemed an employee of the County. It is expressly under- stood and agreed that Contractor shall in-no event be entitled to any benefits to which County employees are entitled, including+ but not limited to, overtime, any retirement benefits, Workmen's Compensation benefits, and injury leave or other leave benefits. 13. Affirmative-Action. Contractor performing under this Agreement, shall comply with the Affirmative Action and Equal Opportunity Regulations of the State of California. 14. Authority to Contract. Contractor shall have no authority to contract for or on behalf of, or incur obligations on behalf of, the State of California or the County of Orange. 15. Fair Employment. Contractor shall not discrimi- nate in the hiring of personnel to perform the services hereunder on the basis of race, color, religion, sex, age, .national origin or ancestry. In addition, Contractor, shall not discriminate in its delivery of services hereunder to elderly persons on the basis of race, color, religion, sex, national origin or ancestry. Contractor shall further comply with the Civil Rights Act of 1964, as amended, and all regulations applicable thereto and has executed the Assurance of Compliance with said Act which is attached herein by reference. 16. Notice. Any notice or notices required or per- mitted to be given pursuant to this Agreement may be personally served on the other party by the party giving such notice, or may be served by certified mail, return receipt requested, to i the following addresses: County: Contract Designee: Director CITY OF NEWPORT BEACH Senior Citizens Program Office 3300 Newport Blvd. 801 -C North Broadway Newport Beach, CA 92663 Santa Ana, CA 92701 17. Conflict or Disagreement. To the extent that there exists any conflict between the language of this Agree- ment and the exhibits attached hereto, the former shall govern and prevail. IN WITNESS WHEREOF, the Board of Supervisors of the County of Orange has caused this Agreement to be subscribed byx its Chairman and the seal of said Board to be hereto affixed, and attested by the County Clerk and ex- officio Clerk thereof, and Contractor has caused this Agreement to be subscribed in its behalf by its duly authorized officers, the day, month, and year first above written. i Contractor: CITY OF NEWPORT BEACH Mayor \. \�. /TTEST: ! City Clerk / =� APPR TED • LPLrchasing Agent for the County of Oranae i AGREEMENT FOR SOCIAL SERVICES FOR ELDERLY PERSONS IN ORANGE COUNTY This AGREEMENT is made.and entered into this 23rd day of December, 1975, by and between the COUNTY OF ORANGE, hereinafter referred to as "County" and the CITY OF NEIgPORT BEACH, 3300 Newport Blvd., Newuort Beach, CA 92663, hereinafter referred to as "Contractor ". WHEREAS, the Congress of the United States through the Administration on Aging of the Department of Health, Educa- tion and Welfare (hereinafter referred to as "HEW "), through the State of California Office on Aging (hereinafter referred to as "State "), has made certain funds available under Title III of the Older Americans Act of 1965, as amended (hereinafter referred to as "Act "), Title 42, Section 3021 et sec. of the United States Code, for providing social services to elderly persons; WHEREAS, pursuant to the Burton Act for the Aging, California Welfare and Institutions Code Section 9000 et seq., the California Legislature has designated State as the single state agency for supervision of all programs under the Act; WHEREAS, pursuant to the provisions of the Act, State .has designated County's Senior Citizens Program Office as the Area Agency on Aging for Orange County, and County has adopted an Area Plan for Program on Aging to provide said services; WHEREAS, pursuant to the provisions of the Act, State has approved County's Area Plan for Programs on Aging; WHEREAS, State and County have entered into a written agreement, which incorporates by reference County's Area Plan for Programs on Aging, whereby State is to provide County with federal funds to implement County's Area Plan for Programs on Aging in accordance with the Act and all regulations and directives relating thereto which are promulgated by HEW and by State; WHEREAS, pursuant to the provisions of said written agreement, County has agreed to enter into written agreements with other public and private agencies or organizations which shall provide certain of said services; WHEREAS, Contractor is equipped, staffed and pre- pared to provide certain of said services; WHEREAS, pursuant to the provisions of California Government Code Section 53703, County may contract with other public and private agencies or organizations and do all acts necessary to participate in federal programs, such as this program under the Act, whereby federal funds are provided to County for purposes of public health, safety or welfare; and WHEREAS, the Administration on Aging has approved the use of certain Model Project funds, authorized under Title III, Section 308 of the Older Americans Act of 1965 as amended, to implement Phase II of SSI- Alert; WHEREAS, for purposes of this Agreement, the term "SSI" and the eligibility for SSI are explained as follows: On January 1, 1974, under Public Law 92 -603 enacted by Congress, a new income maintenance program for low- income per- sons went into effect nationwide. This new program, called Supplemental Security Income (SSI) , completely replaced Cali- fornia's previously existing federal- state - county public as- sistance programs for the aged (Old Age Security) , blind (Aid to the Blind) , and disabled (Aid to the Totally Disabled) . Under SSI, the federal government guarantees a minimum income level - -as of July, 1975, $157.70 per month for an el- igible individual, and $236.60 per month for an eligible couple. The federal government also sets eligibility requirements which are uniform throughout the country. Basically there are four separate requirements that each claimant for SSI benefits must meet. The first requirement is that he or she have certain "special characteristics" as defined by federal statutes and regulations. These characteristics are that the person is either aged (i.e., at least 65 years of age); or blind or disabled of any age. Second, he must have certain r WHEREAS, pursuant to the provisions of said written agreement, County has agreed to enter into written agreements with other public and private agencies or organizations which shall provide certain of said services; WHEREAS, Contractor is equipped, staffed and pre- pared to provide certain of said services; WHEREAS, pursuant to the provisions of California Government Code Section 53703, County may contract with other public and private agencies or organizations and do all acts necessary to participate in federal programs, such as this program under the Act, whereby federal funds are provided to County for purposes of public health, safety or welfare; and WHEREAS, the Administration on Aging has approved the use of certain Model Project funds, authorized under Title III, Section 308 of the Older Americans Act of 1965 as amended, to implement Phase II of SSI- Alert; WHEREAS, for purposes of this Agreement, the term "SSI" and the eligibility for SSI are explained as follows: On January 1, 1974, under Public Law 92 -603 enacted by Congress, a new income maintenance program for low- income per- sons went into effect nationwide. This new program, called Supplemental Security Income (SSI) , completely replaced Cali- fornia's previously existing federal- state - county public as- sistance programs for the aged (Old Age Security) , blind (Aid to the Blind) , and disabled (Aid to the Totally Disabled) . Under SSI, the federal government guarantees a minimum income level - -as of July, 1975, $157.70 per month for an el- igible individual, and $236.60 per month for an eligible couple. The federal government also sets eligibility requirements which are uniform throughout the country. Basically there are four separate requirements that each claimant for SSI benefits must meet. The first requirement is that he or she have certain "special characteristics" as defined by federal statutes and regulations. These characteristics are that the person is either aged (i.e., at least 65 years of age); or blind or disabled of any age. Second, he must have certain I "common characteristics "; fornia resident, and be a alien status. Third, his fied limits. Fourth, his in certain specified limi that is, he must be a U.S. and Cali - U.S. citizen or have certain resident income must be within certain speci= resources (assets) must also be with - ts. SSI ELIGIBILITY: THE FOUR BASIC REQUIREMENTS An applicant must have: 1) certain special characteristics: that is, he must be either: a) aged (65 or over); or b) blind, (any age); or c) disabled (any age). and 2) certain common characteristics, such as U.S. and California residency, and citizenship or permanent alien status; and 3) limited income; and 4) limited resources. NOW THEREFORE, the parties hereto mutually agree as follows: 1. Scope of Services. Contractor shall perform, in a manner satisfactory to the County, the duties as set forth in the following paragraphs hereof which state for such services: (A) Statement of Goals (1) To develop a pilot program to locate and identify senior citizens who may be eligible for the Supplemental Security Income Program (SSI). (2) To conduct a needs assessment survey, i.e., "Action Survey" to determine the needs of the pilot area senior citizens. (B) Responsibilities (1) Orange County Senior Citizens Program Office's responsibilities are: i. To secure cooperation and partici- pation from local cities, non - profit private agencies and volunteers. -'3 - ii. To monitor the program and assist in analyzing the collected data. i iii. To coordinate with Social Security Administration Office in analyzing and planning better services for seniors. iv. To prepare questionnaire forms (see attachments), needed materials and training sessions. (2) Sub - contractor's responsibilities are: i. To provide or utilize a centrally accessible office with dependable voluntary or paid personnel and suf- ficient in -house equipment to be able to support SSI Survey in their pilot areas. ii. To recruit volunteers from their areas to conduct the survey. iii. To identify the location of the pilot area senior citizens. iv. To coordinate with SCPO, CRIS, SSA and other public and private agencies in developing a cooperative network of information and referral service to persons in their areas. V. To develop and maintain records of its transactions. The records should include the number of senior citizens contacted, method of contact, number of SSI referrals and names of organi- zations or agencies where volunteers were recruited. The records should be kept in a confidential manner so that no individual will be identified by the public. vi To submit invoices for payment to the County of Orange for staff (if appli- cable) and volunteer expenses and to keep travel vouchers and time sheets as backup for invoices. 2. Time of Performance. The term of this Agree- ment shall commence on any date but not to exceed 8 weeks from January 1, 1976 to March 31, 1976. This Agreement may be terminated by either party at any time as described in Paragraph 7 and 8 with written notice to the other party. County may also terminate this Agreement immediately upon written notice to Contractor if County receives communica- tion from State that funds are not available for this Agreement or for any portion hereof. 3. Location of Performance. During the term of. this Agreement, Contractor shall continuously manage and operate the service site(s) at the following location(s) to provide the services set forth in Paragraph 1 hereof: CITY OF NEWPORT BEACH, 3300 Newport Blvd., Newport Beach, CA 92663. The service site(s) listed hereinabove.may be eliminated from and or other service site(s) may be added to this Agreement as mutually agreed upon by the parties hereto in accordance with Paragraph 9 hereof. The service area is within Orange Coen *x. 4. Compensation.(Budget, pay scale, allowable expense, and terms of payment) County agrees to pay Contractor for the performance of the duties set forth herein as follows: A. Total Budget: $1,560.00 Total Staff Cost $ 560.00 Total Volunteer Cost $1,000.00 B. Allowable expenses are as follows: i. All volunteer transportation and parking expense related to the SSI -Alert "Action Survey ": traveling expenses reimbursable at 17 cents a mile for the first.150 miles and 15 cents for the remaining miles. ii. One (1) staff member is an allowable cost at $3.50 per hour, 20 hours per week, 5 - to act as the project manager for the term of the SSI -Alert Action Program for each sponsor.. Meals are allowable, but will be left to the discretion of the contractor who should receive meal reimbursement. C. Terms of Payment - By Invoice The Contractor will submit staff time every two weeks and volunteer travel and meal expense once a month. 5. Contacts for Responsibility. The Director of the the Orange County Senior Citizens Program Office, or his desig- nee; is the County's representative for purposes of monitoring this Agreement. He or.his staff will provide technical assist- ance, training sessions and will analyze the collected data as indicated in paragraph 1 (A). Contractor shall make available to County a list of all persons by name, job title and duties, experience, and professional degrees, if any, who are to per- form services hereunder. All personnel shall be qualified in accordance with the Act and all federal, state and local laws, ordinances, regulations, and directives applicable thereto. 6. Audit and Inspection of Records. At any time during normal business hours and as often as County may deem necessary, Contractor shall make available to County, State and Federal officials for examination all of its records with re- spect to all matters covered by this Agreement and will permit County, State and Federal officials to audit, examine and make excerpts or transcripts from such records, and to make audits of all invoices, materials, payrolls, records of personnel and other data relating to all matters covered by this Agreement. Contractor shall maintain all such records for a minimum of three years if audit has occurred, and five years if audit has not occurred, and.in the case of audit exception until such exception has been cleared. Contractor fur- ther agrees to submit such reports of its activities and expenditures as may be required by the State and the County. Exclusion: Client matters identified or designated as confi- dential by Contractor. 7. Changes. County may from time to time request changes in the scope of the services of Contractor to be per- formed hereunder. Such changes, including any increase or decrease in the amount of Contractor's compensation, which are mutually agreed upon by and between County and Contractor shall be effective when incorporated in written amendments to the Agreement. No oral understanding or agreement, not incor- porated herein, shall be binding on the parties hereto. 8. Assignability. Contractor shall not assign any interest in this Agreement and shall not transfer any interest in the same, whether by assignment or novation, without the prior written consent of County thereto; provided, however, that claims for money due or to become due to Contractor from County under this Agreement, may be assigned to a bank, trust company, or other financial institution without such approval. Notice of any such assignment or transfer shall be furnished promptly to.County. 9. Interest of Contractor. Contractor convenants that he presently has no interest and shall not acquire any h' interest, direct or indirect, which would conflict in any manner or degree with the performance of services required to be performed under this Agreement. Contractor further covenants that in the performance of this Agreement, no person having any such interest shall be employed. 10. Indemnity. Contractor agrees to maintain and 'provide evidence of such insurance as will fully protect both Contractor and County from any and all claims under any Workers' Compensation Act or employer's liability laws, and from any and all other claims of whatsoever kind or nature for the damage to property or for personal injury, including death, made by anyone whomsoever which may arise from operations carried on i under this Agreement, either by Contractor, any sub - contractor or by anyone directly or indirectly engaged or employed by either of them. It is necessary that the County of Orange be shown as an additional assured and that 30 days written notice of cancellation be provided. Contractor shall exonerate, indemnify and hold harmless County from and against, and shall assume full responsibility for payment of all Federal, 7 - State and local taxes or contributions imposed or required under Unemployment Insurance, Social Security, and Income Tax Laws, with respect to Contractor and Contractor's employees engaged in performance of this Agreement. County, and its agents and employees, shall not be, nor be held liable for any liabilities, penalties, or forfeitures, or for any damage to the goods, properties or effects of Contractor, or of any other persons whatsoever, not for personal injury to or death of them, whether caused by or resulting from any negligent act . or omission of Contractor. Contractor further agrees to indemnify and hold harmless County and County's agents and employees, against and from any and all of the foregoing liabilities, and any and all costs or expenses incurred by County foregoing obligations and liabilities, by which it is intended by both parties that Contractor shall indemnify and hold County harmless from all claims arising by reason of any act or omission of Contractor. It "is' understood that there will be consultants and volunteers involved in this service. They should be liable for themselves. Neither the County nor the Contractor are responsible for their liabilities. 11. Confidentiality. Contractor agrees and shall insure that no information about or obtained from any elderly person receiving services hereunder shall be voluntarily dis- closed in any form identifiable with such elderly person without first obtaining the written consent of such elderly person. The provisions of this section shall not, however, restrict the Contractor's obligations to provide required information under this or its other County, State or Federal contracts. 12. Independent Contractor. It is agreed that Contractor shall perform as an independent contractor under this Agreement. Contractor is, for all purposes arising out of this Agreement, an independent contractor and it shall not be deemed an employee of the County. It is expressly under- stood and agreed that Contractor shall in no event be entitled to any benefits to which County employees are entitled, including, but not limited to, overtime, any retirement benefits, Workmen's Compensation benefits, and injury leave or other leave benefits. _ g _ J I County of Orange, a political sub - division of the State of California By Chairman of the Board of Supervisors ATTEST: WILLIAM E. ST. JOHN County Clerk and ex- officio Clerk of the Board of Supervisors of Orange County, California By Deputy Approved as to Form: ADRIAN KUYPER, COUNTY COUNSEL Orange County, California By Contractor: CITY OF NEWPORT BEACH By: , Mayor ATTEST: ) /A'/i.a� I APPROVED: Nathan A. Cherry, Purchasing Agent for the Countv of Orange 13. Affirmative Action. Contractor performing under this Agreement, shall comply with the Affirmative Action and Equal Opportunity Regulations of the State of California. 14. Authority to Contract. Contractor shall have no authority to contract for or on behalf of, or incur obligations on behalf of, the State of California or the County of Orange. 15. Fair Employment. Contractor shall not discrimi- nate in the hiring of personnel to perform the services hereunder on the basis of race, color, religion, sex, age, national origin or ancestry. In addition, Contractor shall not discriminate in its delivery of services hereunder to elderly persons on the basis of race, color, religion, sex, national origin or ancestry. Contractor shall further comply with the Civil Rights Act of 1964, as amended, and all regulations applicable thereto and has executed the Assurance of Compliance with said Act which is attached herein by reference. 16. Notice. Any notice'or notices required or per- mitted to be given pursuant to this Agreement may be personally served on the other party by the party giving such notice, or may be served by certified mail, return receipt requested, to the following addresses: County: Contract Designee:, Director CITY OF NEWPORT BEACH Senior Citizens Program Office 3300 Newport Blvd. 801 -C North Broadway Newport Beach, CA 92663 Santa Ana, CA 92701 17. Conflict or Disagreement. To the extent that there exists any conflict between the language of this Agree- ment and the exhibits attached hereto, the former shall govern and prevail. IN WITNESS WHEREOF, the Board of Supervisors of the County of Orange has caused this Agreement to be subscribed by its Chairman and the seal of said Board to be hereto affixed, and attested by the County Clerk and ex- officio Clerk thereof, and Contractor has caused this Agreement to be subscribed in its behalf by its duly authorized officers, the day, month, and year first above written. - 9 - L PROJECT SSI ALERT -Name Social Security No. Address f Telephone Number Code No. 1. Do you or your spouse receive Gold- colored Supplemental Security Income checks? Yes No Declines 2. Have you applied for these checks? Yes No Declines 3. Are you 65 or older? Yes No Declines - Are you disabled? Yes No Declines ' Are you blind? Yes No Declines i If you are married, answer these questions: Is your spouse age 65 or older? Yes No Declines . Is your spouse disabled? Yes No Declines Is your spouse blind? Yes No Declines 4. Are you a U.S. citizen? Yes No Declines 5. What amount did you receive last month from Social Security, other pensions, or other kinds of payments? $ If other than English language, contact should be made by someone who speaks ' language I understand that this form will protect my right's to any Supplemental Security Income payments which may be due me from the Social Security Administration. Your Signature Date Volunteer's Name Date INTERVIEW /QUESTIONNAIRE PILOT PROJECT Social Organizations 1. Are you a member of any service club or social organization that have programs specifically for senior citizens in your community? la. If yes, how often do you attend these club functions? Often Very Often { ) Rarely ( ) Never ( ) lb. If no, would you join if such organizations were formed in your community? ic. Do you know of any programs for senior persons in your community? If yes, how frequently do you participate in these programs? Daily ( ) Weekly { ) Once a month ( ) Other Id. Would you participate in programs for senior persons if they were available? le. Do you feel there is a need for facilities for senior citizens in Newport Beach? lf. 4tould you use a public facility providing recreational programs? Ig. (or) service -type programs (counseling, healti:, or legal advice) for seniors if they were available? lh. 'v:ouid you use a central facility? li. (or) would you prefer smaller facilities dispersed roughp_it the City? li. .,;uld y o j use such a facility? i'ornings ( } Afterr.:;oos venin9s ( } Yes No Declines Yes No Declines Yes No Declines Yes No Declines Yes No Declines Yes No Declines Yes No Declines Yes No Declines: Yes No Declines Yes No Declines Ye No Declines Health 2. Do you have a health - insurance plan now? 2a. If yes, what kind? Nedi - cal ( ) Medicare ( ) Kaiser ( ) Other 2b. If no, have you applied for a public - health insurance plan? 2c. Have you experienced difficulty in obtaining medical or dental care? If yes, what type? 3. Where do you go for medical care? Private doctor ( } Community Health Clinic ( j County hospital ( ) Other - Location 3a. Do you have a twice- yearly health check? 3b. Have you experience any problem in obtaining prescription medicines? If yes, explain. 4. Have you experienced any problems in getting to medical facilities, due to transportation? Transportation 5. Do you drive a car? 6. Do you own a car? 7. Do you have a valid driver's license? 8. If no, do you have access to a car? 9. Whose? 10. Do you pay this person for the use of his car? 10a. If yes, what amount do you pay this person? 11. iuw often do you use this person's car? Very often ( ) Occasionally ( ) Rarely ( 1 72. there a bus route within walking distance of Ur meidE'n ce? -3- Yes No Decline Yes No Decline Yes No Decline Yes No Decline Yes No Decline! Yes No Decline! Yes No Declines Yes No Declines Yes No Declines Yes No Declines Yes No Declines. IYes No Declines; 12a. Do you know that free bus service for senior persons over 65 is now available? Yes No Declines I 13. If yes, how did you find out about this service? Newspaper (name) s _ A friend i Community Center (name) I _ Other i — 14_ 'fill you take advantage of this service? Yes No Decline: 15. If yes, hour often will you use this service? Very often ( ) Occasionally ( ) Hardly ever ( ) Never ( ) 16. Are you less active now due to problems with transportation? Yes No Decline Comments 16a. If you had a need for legal advice, were you able to obtain it? If not, why? Yes No Decline Job Opportunities 17. What type of work did you do at the time of your retirement? 18. Are you working now? Yes No Decline 18a. If no, are you seeking employment now? Yes No Decline. 18h. If yes, do you feel that you have been discriminated f against when seeking employment because of your age? Yes No Decline 19. Mould you be interested in doing volunteer work? I Yes No Decline i9a. Would you be interested in participating in the RSVP program? (Retired Senior Volunteers Program) Yes No Decline Info:-,.: — a ti or, i s 20. o:r d you receive you; information concerning pro - gram,s and activities that effect you and other senior i p :'. i'S C11 s? I - : C0 r.', a il y Ce ra tar D']11ci1:'1S f Otn�Pr i I r 20a. Do you read a newspaper regularly? 21. Would you like to receive a newsletter informing you about senior citizen activities, legislation and services? 21a. Would you like to receive a free newspaper that includes senior citizens information? Educational Opportunities 22. Several area colleges offer special programs for senior citizens. Have you taken any of these courses? 22a. If no, would you be interested in taking some of these courses? 22b. Has lack of transportation kept you from partici- pating in these classes? Nutritional 23. How many meals a day do you normally eat? 23a. Do you have access to cooking facilities? 23b. Would you be interested in receiving nutritional information? 23c. Would you participate in a lunch program if it were offered in a school close to your home? 24. Have you ever participated in the Transportation, Lunch, and Counseling Program (TLC)? 24a. Do you regularly participate in the TLC program? tab. If yes, how did you find out about TLC? Newspaper. (name) R friend ( ) Community Center bulletins ( ) Other Personal Data 25. 'hat is your age? 60 or below ( ) 61 - 63 ( ) 64 - 66 ( ) 67 - 69 ( ) - 5- Yes No Decline Yes No Decline Yes No Decline Yes No .Decline Yes No Decline Yes No Decline! Yes No Declin( Yes No Decli Yes No Deciin Yes No Decline Yes No Decline k 26. Are you: iii arried ( ) single ( ) divorced ( ) widowed ( ) 27 ldhat is your present liviny arrangements? living alone ( ) living with spouse ( } living with relatives ( } 29. Do you feel your neighborhood is safe? 28a. If no, why not? 29. Do you own your home? 30. What is your approximate monthly costs for: 31 32 3u Z =. Pent Utilities Tares Total Do you receive Social Security? Do you receive income from: Railroad Retirement ( ). Teacher's Retirement ( ) Civil Service Private Retirement Funds ( ) Stocks or bonds ( ) Interest from savings ( ) Insurance annuities ( ) InCorlle property ! ) Support roln, family eteran s pension ( ) Uther ( ) haf is your approximate monthly income fror.1 all sources? S ,;!iat do you feel is :ne ,Yost pressing prrjhlen(s) ,Id ;'Ou .JC abr) "i s0 v.n,l the pr0bi._i'i 6- Yes No Declines! Yes No Declines Yes No Declines Thank you ( ) Refused to answer questions. Name of Volunteer Date ASSURANCE Or COMPLIANCE 'WITH THE DEPARTMENT OF HEALTH, EDUCATION AND WPLFARE REGULATIONS UNDER TITLE VI OF THE CIVIL RIGHTS ACT or 1964 City of Newport $parh (hereinafter (Name of Grantee or Contractor) called the "Recipient of Award ") HEREBY AGREES THAT it will comply with Title VI of the Civil Rights Act- of 1969 (P.L. 88-352) and all requirements imposed by or pursuant to the Regulation of the Department- of Health, Educa- tion and Welfare (95 CFR Part 80) issued pursuant to that title, to the end that, in accordance with Title VI of that Act and the regulation, no person in the United States shal.l., on the ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be other- wise subjected to discrimination under any program or activity for which the Recipient of Ac•:ard receives Federal financial assistance from ^ Orange Count Senior Citizens Pr_ogr.jm Office_, a recipient of Federal financial assistance (Name of Area Agency) from th3 Department; and HEREBY GIVES ASSURANCE THAT it will immediately take any measures necessary to effectuate this agreement. If any real property or structure thereon is ,provided or improved with the aid of Federal financial assistance extended to the Recipient of Award by the Area F.gency, this assurance shcl.l obligate the recipient of Award or in die case of any transfer of such prroperty, any transferee, for the poriod during t: ?ii.ch the real property or structure is used for. a purpose for which the Federal financial assistance is extended or for another purpose involving thn pru,,ision of.sicilai Gervices or benefits. If any personal. property is so prnvrned, tlis assurance shall obligate the Recipiont of Award for the per.iol duri.n•g which the Federal financial assistance. is extended to it by the Psrea Agency. THIS ASS'UIn" CL is give:: in consideration of and for the purpose of obtain- ing any and all Federal grants, loans, contracts, pr:onerty, discounts or other FuGeral fin n.cial. assistance extended after: the date hereof to the Recipient of i..:ar by the Area Agency, inca.uci.i.nq instal.l::•ent payments after such date on a co.isrt of ape >lieati_ons for Federal fi.rre:nci.al ass.is.ancr. which .hare ap;,roved be,`.ore such date. The Recipient. of A•,.,ard reconni.zes and agrees ti:at such federal financial. assistance will be extended -in re- liance on, the re?::esentaT. ion acrd agrecnents made in this assurance, and that Ule Area Tqe: ?i:y or the United States or both .;hall have tj're right: to see}: judicial en:orce::.cnt of this assurance. This aF; %ur.n;ce. is binlinq on the Jecipient of Award, its successors, transferees: and assignees, and the person or persone whose signatures a;,pcar belowr are authorized to sign this assurance on behalf of the 1iecipicr.t of Award. Dated _ December 23_2 1975 CITY OF NE14PORT BEACH _ (Recipiclit- of Award) 3300 Newport Boulevard (President, Chairman of Boara, or comparable authorized official) Newport Beach, CA 92633 . Ti (Recipient's mailing adclress) ATI (Attn- Tim ,_. Agxeemant with ty for Senior Citizens Su funds d— 1777c; Enclosed are the original and one copy of subjaot agreement which have been duly aiyned by the City. Please tranaedt to the appropriate Cbmty agency for ftrther execution. t,ben the agreement has been fully eiTied by the Ot mty, Please return a copy to my office for inclusion in the official reooxds. I ? Ii 3I 4� S G, 7 8 9 t0 11 l2 13 14 j 15 16 17 '18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 15 3_ RESOLUTION OF THE BOARD OF SUPERVISORS Y" RECEIVED COmm�nity Devewpment Dept. NQV � 1976x► CITY or NEWPORT BEACH,� OF ORANGE COUNTY, CALIFORNIA T � is November 4, 1975 I On motion of Supervisor Schmit, duly seconded and carried, the fol- lowing Resolution was adopted: BE IT RESOLVED as follows: 1. The amendment to the SSI Alert Program Contract between the County of Orange and the California Office on Aging, extending the term of the agreement from October 14, 1974, to December 31, 1975, is hereby -- approved. 2. The Director of the Orange County Senior Citizens Program Offic( is authorized to negotiate subcontracts for this service, where applicable r AYES: SUPERVISORS LAURENCE J. SCHMIT, RALPH B. CLARY, ROBERT W. BATTIN, THOMAS F. RILEY, and RALPH A. DIEDRICH NOES: SUPERVISORS NONE ABSENT: SUPERVISORS NONE STATE OF CALIFORNIA ) ss. COUNTY OF ORA11GE ) I, WILLIAM E. ST JOHN, County Clerk and ex- officio Clerk of the Board of Supervisors of Orange County, California, hereby certify that the above and foregoing Resolution was duly and regularly adopted by the said Board at a regular meeting thereof held on ti.e 4th day of November 1975 , and passed by a ur,ani_r.:ons vote of said Boar IN WI'NESS WHEREOF, I have hereunto set my, harid`And seal this A +h day of A?rn,nmhn,- 19 .. Resolution No. 75 -1512 WILLIA:i E. ST JOHN r SSI Alert Cati, ?i_y. C3cx:: crl : er- o£zicio Clerk Extension n of tht Bo< -rd of Supervisors of Program Contract Orange County, California By • f _ Deputy - • 1 i Contractor: CITY OF NEUMORT BEACH p Y Mayor /TTEST: 2261 ,,- 0-C', ! City Clerk HquuL zor the County of oranae RESOLUTION NO. 8 6 5 R A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF NEWPORT BEACH AUTHORIZING THE EXECUTION OF AN AGREEMENT BETWEEN THE CITY OF NEWPORT BEACH AND THE COUNTY OF ORANGE FOR FUNDS TO BE USED IN CONNECTION WITH THE SENIOR CITIZENS SURVEY WHEREAS, there has been presented to the City Council of the City of Newport Beach a certain agreement between the City of Newport Beach and the County of Orange for funds to be used in connection with the Senior Citizens Survey; and WHEREAS, the City Council has considered the terms and conditions fo said agreement and found them to be fair and equitable, and in the best interests of the City; NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of Newport Beach that said agreement above - described is approved, and the Mayor and City Clerk are hereby authorized and directed to execute the same on behalf of the City of Newport Beach. ADOPTED this 22nd day of December ATTEST: City Clerk i, 1975. DDO /bc 12/19/75