[RECEIVED SEP 20 2012 HOUSINGDIVISION CONTRACT SUMMARY SHEETCITYATTORNEY'SOFFICE TO: THE OFFICE OF THE CITY CLERK, COUNCIL/PUBLIC SERVICES DIVISION ROOM 395, CITY HALL DATE: September;lo, 2011 FROM (DEPARTMENT): Los Angeles Housing Department CONTACT PERSON: Cecilia Rosales PHONE: 213-922-9661 CONTRACT NO.: C-120332 COUNCIL FILE NO.: 11-1593 DATE D NEW CONTRACT o AMENDMENT NO. 1 D ADDENDUM NO. - D SUPPLEMENTAL NO. D CHANGE ORDER NO. ADOPTED BY COUNCIL: 3/7/12 APPROVED BY BPW: _ DATE CONTRACTOR NAME: Project Angel Food -------------------------------------------- TERM OF CONTRACT: 12 months THROUGH: March 31,2013 --------------- TOTAL AMOUNT: $100,000 ------------------------------------------------ PURPOSE OF CONTRACT: This Amendment extends the time of performance of the contract an additional 12 months, from April 1,2012 to March 31,2013, and increases the compensation an additional $100,000 for a new total contract of $150,000. NOTE: CONTRACTS ARE PUBLIC RECORDS - SCANNED AND UPLOADED TO THE INTERNET
Transcript
[RECEIVED
SEP 20 2012HOUSINGDIVISION
CONTRACT SUMMARY SHEETCITYATTORNEY'SOFFICE
TO: THE OFFICE OF THE CITY CLERK,COUNCIL/PUBLIC SERVICES DIVISIONROOM 395, CITY HALL
D NEW CONTRACTo AMENDMENT NO. 1DADDENDUM NO. -D SUPPLEMENTAL NO.D CHANGE ORDER NO.
ADOPTED BY COUNCIL: 3/7/12
APPROVED BY BPW: _DATE
CONTRACTOR NAME: Project Angel Food--------------------------------------------TERM OF CONTRACT: 12 months THROUGH: March 31,2013---------------
TOTAL AMOUNT: $100,000------------------------------------------------
PURPOSE OF CONTRACT:
This Amendment extends the time of performance of the contract an additional 12 months, fromApril 1,2012 to March 31,2013, and increases the compensation an additional $100,000 for anew total contract of $150,000.
NOTE: CONTRACTS ARE PUBLIC RECORDS - SCANNED AND UPLOADED TO THE INTERNET
FIRST AMENDMENTTO AGREEMENT NO. C-120332 OF CITY OF LOS ANGELES CONTRACTS
BETWEENTHE CITY OF LOS ANGELES
ANDPROJECT ANGEL FOOD INC.
RELATING TO THEHOUSING OPPORTUNITIES FOR PERSONS WITH AIDS (HOPWA) PROGRAM
OTHER SUPPORTIVE SERVICES - FOOD
THIS FIRST AMENDMENT to Agreement Number C-120332 of City of LosAngeles Contracts ("Amendment") is made and entered into by and between the City ofLos Angeles, hereinafter referred to as the City and Project Angel Food Inc., hereinafterreferred to as the Contractor.
WITNESSETH
WHEREAS, the City of Los Angeles has contracted with Project Angel Food Inc.wherein the Contractor shall provide Other Supportive Services - Food under theHOPWA Program to persons living with HIV/AIDS and their families, said Agreement isC-120332 of City Contract, executed on April 16, 2012 which together with allamendments thereto shall hereinafter be referred to as the Agreement; and
WHEREAS, Section 707 of the Agreement provides for amendments to theAgreement; and
WHEREAS, this Amendment is necessary and proper to continue this Programand to ensure uninterrupted services; and
WHEREAS, the City and the Contractor are desirous of amending the Agreementas authorized by the action of the Los Angeles City Council and Mayor (refer to CouncilFile Number 11-1593, authorized by City Council on March 7, 2012 and approved bythe Mayor on March 9, 2012), which authorized the General Manager of the LosAngeles Housing Department to prepare and execute an amendment to the Agreementfor the purpose of: a) extending the term of the Agreement for an additional twelve (12)months for a new ending date of March 31, 2013; b) adding additional funds in theamount of One Hundred Thousand Dollars ($100,000.00) based on the 38th ProgramYear Housing and Community Budget Consolidated Plan for the period April 1, 2012through March 31, 2013 for a new total amount of One Hundred Fifty Thousand Dollarsand ($150,000.00); and c) making other changes as are required in connection with theforegoing, all as detailed elsewhere in this Amendment.
NOW THEREFORE, the City and Contractor agree that the Agreement beamended effective April 1, 2012 as follows:
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AMENDMENT
§1. Amend Section 102, Representative of the Parties and Service NoticesSubsection 1, by replacing Rushmore Cervantes with the following:
Mercedes M. Marquez, Interim General ManagerLos Angeles Housing Department1200 West ih Street, Ninth FloorLos Angeles, CA 90017
§2. Amend Section 201, Time of Performance, to delete October 01,2011 and endMarch 31,2012 and replace it with April 01, 2012 and end March 31, 2013.
§3. Amend Section 202.A.3 under Client Service Level for Other Supportive Services- Food, by replacing it with the following:
a. Number of unduplicated clients to be served: 160b. Average cost per person served: $625.
§4. Amend Section 204.H, Reporting Outcomes, by replacing its entirety with thefollowing:
H. Outcomes and Performance Goals
1. HUD- Required Outcomes Report
Outcomes: Only if applicable, the Contractor shall provide anoutcomes report based on the "HOPWA Outcomes on Access toCare and Support" required by HUD. Accordingly, the number ofhouseholds who have accomplished each of the following will bereported to LAHD:
a. Has a housing plan for maintaining or establishing stable oron-going residency.
b. Had contact with a case manager/benefit counselor at leastonce in the last three months.
c. Had contact with a primary health care provider at least oncein the last three months.
d. Has medical insurance coverage or assistance.e. Obtained an income producing job created by the Contractor
during the program year.f. Obtained an income producing job through an outside
agency during the program year.
2. Performance Goals: Within 30 days of contract execution, LAHD, inconjunction with the Contractor, will develop performance goals,which shall be reported to LAHD on a schedule and in a format asdetermined by LAHD.
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Performance goals are benchmarks, which will be assessed at theend of the contract term to determine feasibility.
3. The Contractor shall report these outcomes to LAHD on a scheduleand in a format as determined by LAHD.
§5. Amend Section 205, Policies and Procedures, to delete the language in itsentirety and replace it with the following:
The Contractor shall maintain written Policies and Procedures for the fiscal andprogrammatic management of the HOPWA program, which must be submitted toLAHD for approval within 30 days of contract or contract amendment execution.
Policies and Procedures shall contain, at minimum, all elements listed below, asapplicable to the Contractor's HOPWA program.
A. Program and fiscal management of the HOPWA components: OtherSupportive Services - Food. Policies and procedures must comply withall HOPWA contract provisions and federal HOPWA regulations.
B. All aspects of the Contractor's HOPWA program component(s) asdesignated in the scope(s) of services including, but not limited to:
1. Program location, hours, staffing, and supervision;2. HOPWA eligibility requirements and required documentation:
HIV/AIDS diagnosis form and income eligibility according toHOPWA regulations, using for income eligibility portions of 24 CFRPart 5 (also used by the Housing Choice Voucher Program or"Section 8") and as required by LAHD;
3. Other eligibility program requirements specific to the program (inaccordance with HOPWA regulations and LAHD approval);
4. How clients will be evaluated by appropriately trained staff forsupportive service needs;
5. IAHP requirements using the LAHD approved common forms(Exhibit H);
6. Documentation required to be in the file (e.g., IAHP, HIV diagnosis,income eligibility using HOPWA-required forms, services provided,referrals and outcomes of referrals, case notes, follow-up contactand assessments, housing location services and outcomes, incomeat intake and exit, etc.);
7. Timelines for providing services, housing location, and any otherrequired program activities;
8. Identification and outreach to underserved and most vulnerablepopulations;
9. Staff training;10. Vendor solicitation, requirements, and contracting, as
applicable;11. Referral agency MOUs as applicable;12. Client satisfaction survey.
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C. Internal fiscal and programmatic quality control, including:
1. How client services will be monitored to ensure quality of services,timeliness, and adherence to contract goals and servicerequirements.
2. Documenting time spent on the program, approval of time cards,and other fiscal requirements under federal regulations. Time cardsmust show the total gross pay to the staff person - not just theHOPWA amount - the number of hours spent on the HOPWAprogram, and be signed by the staff person and supervisor. ForExecutive Directors/Presidents/CEOs, the time cards must besigned by an authorized signatory for the Board of Directors.
D. Protecting the privacy and confidentiality of all clients.
E. File management and maintenance for both hard copy and e-files andrecords retention; records maintenance; and reporting.
F. Client termination procedures
G. Client grievance and appeal procedures, including an appeal process upto LAHD.
H. Conflict of Interest. Pursuant to 24 CFR 574.625, organizations musthave policies in place that identify and handle potential conflicts of intereston the part of board members, staff persons, and other representatives ofthe organization, such as volunteers. In developing these policies, pleaserefer to Chapter 3, Basic Oversight Elements, Conflict of Interest, in HUD'sHOPWA Grantee Oversight Resource Guide, Updated in 2010.
I. Drug and/or alcohol use by clients, including steps to deal with relapsingclients to ensure their abilities to remain housed.
J. Ensuring the safety and security of staff and clients, including addressingviolence and the sale and use of controlled substances.
K. If applicable, payment of rent by clients during periods of hospitalization.
L. Ensuring that the Contractor, Referral Agencies, and Vendors are incompliance with the Americans with Disabilities Act, Section 504 of theRehabilitation Act, Fair Housing laws, and reasonable accommodationsrequirements to allow persons with disabilities equal access to all housingand services (refer to Section 415 of this Contract).
M. All written policies and procedures as noted above or elsewhere in thisAgreement are subject to inspection by City staff.
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§6. Amend the first sentence of Section 301, Compensation and Method of Payment,paragraph A, by deleting the total dollar amount of "Fifty ThousandDollars ($50,000.00)" and replacing it with the new amount of "One HundredThousand Dollars ($100,000.00)." This amendment adds One HundredThousand Dollars ($100,000.00) for a new total of One Hundred Fifty ThousandDollars ($150,000.00).
§7. Amend Section 301.B, Compensation of Payment, by replacing the expenditureperiod from "October 1, 2011 to March 31, 2012" to "April 1, 2012 to March 31,2013".
§8. Amend Section 414, Conflict of Interest, by deleting the first sentence inSubsection B.1 and replacing it with the following:
The City requires that all Contractors/Sub-Contractors adopt a Code of Conductwhich at minimum reflects the constraints discussed in LAHD's Policy on Conflictof Interest Directive Number 12-0001.
§9. Amend Section 415.B.1, Compliance with State and Federal StatutesRegulations, by deleting subsection c and replacing it with the following:
c. Americans with Disabilities Act
Contractor hereby certifies that it will comply with the Americans withDisabilities Act, 42 USC §12101 et seq., and its implementing regulations(ADA), the Americans with Disabilities Act Amendments Act of 2008(ADAAA) , Pub. L. 110-325 and all subsequent amendments, Section 504 ofthe Rehabilitation Act of 1973 (Rehab. Act), as amended, 29 USC 794 and24 CFR Parts 8 and 9, the Uniform Federal Accessibility Standards (UFAS),24 CFR, Part 40, and the Fair Housing Act, 42 U.S.C. 3601, et seq.; 24 CFRParts 100, 103, and 104 (FHA) and all implementing regulations. TheContractor will provide reasonable accommodations to allow qualifiedindividuals with disabilities to have access to and to participate in itsprograms, services and activities in accordance with the provisions of theADA, the A DAAA , the Rehab Act, the UFAS and the FHA and allsubsequent amendments. Contractor will not discriminate against personswith disabilities or against persons due to their relationship to or associationwith a person with a disability. Any subcontract entered into by theContractor, relating to this Agreement, to the extent allowed hereunder,shall be subject to the provisions of this paragraph.
§10. Exhibit F, Budget, is hereby amended and replaced with a revised Budget. Therevised Exhibit F is attached hereto and incorporated herein.
§11. Exhibit H, HOPWA Programs Intake, Assessment, and Housing Plan Forms ishereby amended and replaced with a revised format. The revised Exhibit H isattached hereto and incorporated herein.
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§12. Except as herein amended, all terms and conditions of the Agreement shallremain in full force and effect.
§13. This Amendment is executed in four (4) duplicate originals, each of which isdeemed to be an original. This Amendment includes seven (7) pages and two(2) Exhibits, which constitute the entire understanding and agreement of theparties.
[Remainder of page left intentionally blank.]
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I \ "I
IN WITNESS WHEREOF, the City of Los Angeles Housing Department and theContractor have caused this Agreement to be executed by their duly authorizedrepresentatives.
APPROVED AS TO FORM:CARMEN A. TRUTANICH, City Attorney
By~~~~-y~~~~~~sistant City Attorney
q/?f)/JVDate ------------~----------ATTEST:
JUNE LAGMAY, City Clerk
(Contractor's Corporate Seal)
City BTRC Number: 152417-001-9Internal Revenue Service Number: 95-4115863
Council File Number11-212011-1593
Executed this I 0,'771 day of_S_e#_1_""F'AVI__ f!>_e.-£L_~ , 2012
For: THE CITY OF LOS ANGELESMercedes MarquezInterim General ManagerLos An~Housing Dep~.
By ~~.~~Print Name vSjAM o.sv::. (? Cc....avTitle (:JQ3-(;..u0VG.-.OF-FICr~
Executed this ...;.J'T"0~__ day of____________ ~7.~~~~~~~ ,2012
Said Agreement is Number C-120332-1 of City Contracts Amendment First
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EXHIBITF
HOPW A BUDGETApril 1, 2012 - March 31,2013
Page 1 of1
Agency Name:Component Name:Reimbursement Period:
Project Angel FoodOther Supportive Services - FoodApril 1, 2012 through March 31, 2013
Contract No. 120332-1
OPERATING COSTSOPERATING COSTSLocation(s) IServices Provided Total Costs922 Vine St, LA 90010 IFood* $ 93,000.00
SUB-TOTAL 1$ 93,000.00
* Note: During the 12 month contract period Project Angel Food will spend $302,745 on direct food costs for clients diagnosed with HlV/AIDS.Therefore, the HOPWA grant amount of $100,000 pays for 1/3rd of the food cost for clients diagnosed with HIV/AIDS.In addition to the above food costs, there are costs to cook and deliver meals to clients which are not included in the HOPWA budget,
ADMINISTRATIONADMINISTRATION - 7% MAXIMUMLocation(s) Services Provided Total Costs922 Vine St, LA 900 I0 1Office Space* $ 7,000.00
SUB-TOTAL 1$ 7,000.00* Portion $583 per month of monthly mortgage of $24,000.
GRAND TOTAL 100,000.00
HOPWA PROGRAMS INTAKE ASSESSMENT & HOUSING PLAN FORMS EXHIBIT H 1 of 4E
Intake Date: RA: IHS:••••••••••••••
................. Tel.: AR:F.Name: L.Name: 1 M.I.: DOB: Age: 110#: IIDType:B.Place: SSN: Address: City: Zip: 1 SPA:Tel. #: VM: 1 Gender: 1 Race: 1 Hispanic:Email: Okto Email: 1 Internet Access: Average Gross Income (Over Past 3Months)Language Spoken: Recent TBResults: 1 TB Date: Type of Income Ave Amt.
Diagnosis: Mother's Maiden Name: Gross Employment Inc.Transmission: Emergency Contact: Tel.: Unemployment Ins. (UI)Domestic Violence: Medical Facility: State Disability Ins. (SDI)Veteran: Hon. Dis.: Primary Physician: Sup. Security Inc. (SSI)Fam. Status: # Medical Coverage By: Soc. Sec. Dis. Ins. (SSDI)
Other Household Mem. DOB Race H Relationship Social Security (Retirement)Private Disability Ins.
General Relief (GR)VAPension
CalWorksOther:
Total Ave. Gross Monthly Inc. $ 0.00HUD FV12Monthly Income Limits 1 Person 2 Persons 3 Persons 4 Persons 5 Persons 6 Persons 7 Persons 8 Persons
80%Area Median Income $3,937.50 $4,500.00 $5,062.50 $5,620.83 $6,070.83 $6,520.83 $6,970.83 $7,420.8350%of Area Median Income $2,462.50 $2,812.50 $3,162.50 $3,512.50 $3,795.83 $4,075.00 $4,358.33 $4,637.50
, HOUSING ASSSESSMENT (Check AI/That Apply or Fillin Info.)
Current living Sit.: Lease ITenancy Ilfhomeless,reason:1Rent:1 Ct's SharJ Bedrooms: Utilities: Current R/I 0% Rent Past Duel3 Day Notice: Are Util. Past Due: Util.Amd Shut-Off Court Date: Lockout Date:Eviction: Reason for Eviction:1 Homeless W/in 12 Months: Chron, Homeless']
Util. Dis. Credit? Roommates? Shared Hsg.? SUb. Hsg.: SUb. Hsg. Type:1Sex Offender: Crim. Bgrd: Spec. Accom.: #ofSrv. Ani. Type:1 BUdged I W/nBgdSTRMU: STRMUPast 2: STRMUPast 3 PHP: Moves 12: Moves 4 vrs: IAccepts Sec.8: App. For SUb. Hsg: Date Appl: Applied With:1 R/I Before Loss:I 0%
Housing Plan: PCM: I PCM/BS:I IPHcp:1 HOPWAILAHDJob:1 Not HOPWAILAHDJob: rEli.SUb. Hsg.: Eli.Pub.lPriv. Benefits: Med. Insurance/Assistance: 1 Voucherl By:1
.... Housing Quality (Check if the client has any of thetollowing problems with their housing.) NON£~
. .•i) PSYCHOSOCIALASSESSIVIENT(Doestheclfentiu:llleanyoftheiollj"JVinil is~uis/needs:Chec/('lIl that apply) NONE:Medical Compliance Employment HIVPrevention I I Mental Health Transportation IBenefits Environmental life Skills Issues DMH Ct: Other:Child Care/Safety Nutrition/Food Legal Risk BehaviorDomes. Vio. Sur Developmental Medical Social Support Sys HOUSING.STATUSEducational Family Reunification Medication Substance UseBy signing below, I.hereby certify under penalty of perjury and to the best of my knowledge that the informat.ion on this form is true andcorrect in all respectS. The. Referring Agency declares and certifies that all of the information provided has been verified.
B~signingbelovv,l~erebY.certify~nder~enaltyofperjuryand(oth~~est.ofnlY knowled!Jethat.theinformati.()no~thisform is true and eorreet in 'all.respects, and I am agreeing to the. above assigned, plan. The Referring Agency declares andcertifies that all of the inforrnation provided has been verified.
Print Client's Name: Client's Signature: Date:
Print Provider's Name:
Revised 8/20/2012
Provider's Signature: Date:
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HOPWA PROGRAMS INTAKE. ASSESSMENT & HOUSING PLAN FORMS EXHIBIT H 3 of 4
Print Client's Name: Client's Signature: Date:
Narrative/Notes of Needs:
Housing Outcome:l:~ient:IJY signing below, I hereby certify under penalty of perjury and to the best of my knowledge that the information onthis form is true and correct in all respects, and I am agreeing to the above housing plan.
Referring AgencY:iThe Referring Agency declares and certifies that anoftheinformation provided on the application isaccur.ate and has verified that the identity of the individual requesting a.ssistal1ce is the one. identified. as the individual on thediagnosis.
lfapplicable,confirmation of the. diagnosis was provided verbally by:--,~~~==~~~-,,-~~ __ -,--~~~on, and they may bereachedat(\---~~ _~~~~(NAME OF THE PERSON CONTACTED ATCLINIC OR HOSPITAL) (DATE OF VERIFICATION)
Since the last time yOUl11e~~htl1~~lient, hastheclien~ri~~!E!1I that apply, le.aveblank if N/Al ..•.ill~iti:~~~:I·!·Evicted: Affordabllitv: Health Care: Substance Abuse: SSI/SSDI:
'. . CASECLOSURE .
Budget: Quality: Medication: Income Source: Date Applied:Counselinq: Utilities: Viral load: Employed: Status:lost Benefits: Relocated: CD4: lost Job: Date Approved:Benefits: Overcrowding: New STI: VocationaI/Emp.: IPCM/BS: Safety: Mental Health: Transitional Hsg:
PROGRESSNOTES . . . .
File Audited On: By:.... CASECONFERENCE.
Print Provider's Name: Provider's Signature:
Date of Case Conference: Clinical Supervisor's Signature:
Notes:
Print Provider's Name: Provider's Signature: Date: Date of Case Closure:Housing Stability Assessment at time of Case Closure:
Date:3n1 AttemptAttempts to notify Ct of closure 1st Attempt
Contact Type:Status of IHP:Referrals Provided:Reason for Disenrollment:
