09-101 Catholic Charities of San JoseFIRST AMl?NDMENT
TO HUMAN SERVICE GRANT FUNDS
CITY/NON-PROFIT CONTRACT
The First Amendment to Contract is entered into between Catholic Charities of San Jose
(Long Term Care Ombudsman) (CORPORATION) and the City of Cupertino
(CITY) to amend the Contract entered into pursu;~nt to the allocation and disbursement of
Human Service Grant funds to Corporation dated Apr 15, 2008 (CONTRACT).
WHEREAS, the CITY has reserved a portion of its General Fur~to be used on activities that
benefit Cupertino's residents; and
WHEREAS, the City Council authorized the Cit}~ Manager execute amendments with
organizations as needed to implement the FY 20Ci9/10 allocation of Human Service Grant
funds; and
WHEREAS, the parties wish to enter into this arr~endment to extend the term of the
CONTRACT, revise the Project Description, Implementation Time Schedule and Project
Budget;
THEREFORE, the parties agree as follows:
1. Section I, entitled "Project," is revised to :read as follows:
"CITY agrees to allocate a portion of its current Human Service Grant budget to
CORPORATION, being the sum of Three Thousand One Hundred Eighty Seven Dollars
and No Cents ($3,187.00).
for the purpose of implementing the CORPORATION'S project, as more particularly
described in numerous exhibits as noted herein, attached to this First Amendment.
2. Section II, entitled "Term," Parts A & B are revised to provide a contract end date of
June 30, 2010.
3. Supplement Exhibit A, the Project Descri~~tion, Exhibit B, the Performance
Measurements, Exhibit C, Proposed Implementation Time Schedule, and Exhibit D,
Project Budget, with Revised Exhibits "A through D," attached hereto and
incorporated herein by this reference.
4. All terms, covenants and conditions stated in the CONTRACT, which are not herein
amended, remain in full force and effect.
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H:\-CDBG\Subrecipient Agreements\t~UMAN SERVICE GRANT CONTR.~CT AMENDMENT 4-29-081.docx
EXHIBIT A
PROJECT PROPOSAL COVER SHEET
Name of Applicant: Catholic Charities of San Jose, dba Catholic Charities of Program Year:
Santa Clara County July 1, 2009- June 30, 2010
Contact Person: Title: Project # (For Office Use Only)
Wanda Hale Pro ram Mana er
Address: City: State: Zip Code:
2625 Zanker Road, Suite 200 San Jose CA 95134-2107
Telephone number: Fax Number: E-mail Address:
408-325-5260 408-944-0776 whale ccs'.or
Name of Project/Program:
Lon Term Care Ombudsman Pro ram
Project/Program Location:
2625 Zanker Road, Suite 200, San Jose, CA 95134-2107
^ Single Family ^ Homeownership ^ New Construction
^ Multifamily ^ Rental ^ Rehabilitation
^ Mixed Use
~ Public Service
Project Description:
Please describe the project with as many details a~~ possible. Include general information, such
as the number of units, number of Cupertino residents that will be served, services that will be
provided, etc.
Ombudsmen have a combination of functions: visitation, complaint and crisis response
and advocacy. Ombudsmen will advocate for the dignity, compassionate treatment,
quality of life and quality of care for residents of Cupertino's long term care facilities to
make sure they have a voice in their own carE: and treatment. Our clients are the frail,
chronically ill, primarily elderly individuals with physical and/or mental impairments that
prevent them from living independently. Ombudsmen will provide community contact
through regular visitation to long term care facilities and positively influence the outcome
of complaints
On behalf of the residents of Cupertino long term care facilities the Long Term Care
Ombudsman Program will provide advocacy to make sure they have a voice in their
own care and treatment. The Program will demonstrate and maintain a regular, ongoing
visibility to these residents (200 unduplicated/yr) through the presence of trained and
certified Ombudsmen. Unannounced visitatlion (36/yr) allows the Ombudsman to
personally observe any actual or potential problems and the opportunity to identify and
address issues before they become larger systemic problems. Ombudsmen will
identify, receive, investigate, and resolve complaints (12/yr), including violations of
personal rights and allegations of elder abuse for primarily elderly (60+) residents in
Cupertino's 3 Nursing Facilities and 6 Assisted Living/Residential Care Facilities for the
Elderly.
EXHIBIT B
CITY OF CUPERTINO
PROJECT WORK PLAN
FY 200/20010
AGENCY NAME Catholic Charities of Santa Clara County DATE PREPARED July 8, 2009
PROJECT NAME Long Term Care Ombudsman Program
Specific Activities
Products or Milestones to be accomplished Benchmarks or Beneficiaries
(Use Specific Numerical Data When Possible) For Each Quarter
When Possible
3r 4` TOTAL
Ombudsman Presence
Ombudsman visitation will promote the 1.a. Conduct a minimum of 36 on site visits to 9 9 9 9 36
interest, well being and rights of Cupertino long term care facilities.
Cupertino long term care facility
residents. Ombudsman will observe the 1.b. Personal contact with a minimum of
environment and monitor conditions in 200 residents in Cupertino long term
long term care facilities and work to care facilities 50 50 50 50 200
improve the delivery of long term care
services.
Complaint Investigation
The primary purpose of the Long Term 2. Investigate a minimum of 12 complaints 3 3 3 3 12
Care Ombudsman Program is to receive,
,identify, investigate and impartially
resolve complaints made by, or on behalf
of residents of long term care facilities.
Anyone may initiate a complaint on
behalf of the resident.
EXHIBIT C
Proposed Implementation Time Schedule
Fiscal Year 2009 -2010
Agency Name: Catholic Charities of Santa Clara County
Project Name: Long Term Care Ombudsman Program
Date: July 8, 2009
S ecific Activities Jul Au Se Oct Nov Dec'' Jan Feb ar A r Ma Jun
Resident contacts -200 unduplicated residents contacted
durin site visits 25 25 15 15 15 15 15 15 15 15 15 15
Facility site visits - 36 on site visit to Cupertino long
+o,..,., ,.,,..,, ~ ,.:,:+:,.,.
1V1111 NGL14 1C1V11111VJ 3 3 3 3 3 3 3 3 3 3 3 3
Complaint Investigations -Investigate 12 complaints
made by or on behalf of Cupertino long term care
residents 1 1 1 1 1 1 1 1 1 1 1 1