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10. <br />11. <br />b. The subcontractor has not been barred from doing business at the federal level. <br />c. The subcontractor is able to produce a notarized <br />12. <br />13. <br />(Authorized Signature)(Date) <br />Record Retention and Disposition. All community service providers are responsible for maintaining custody of records and <br />documentation to support the allowable expenditure of funds, service provision, and the reimbursement of services. Service <br />providers must adhere to the approved record retention and disposition schedule posted semiannually on the website of the <br />NC Department of Health and Human Services Controller at . <br />Service providers are not authorized to destroy records related to the provision of services under this Agreement except in <br />compliance with the approved DHHS retention and disposition schedule, which allows for the proper destruction of records <br />based on a schedule by funding source and fiscal year. The agency agrees to comply with 07 NCAC 04M .0510 when <br />deciding on a method of record destruction. Confidential records will be destroyed in such a manner that the records cannot <br />be practically read or reconstructed. <br />________________________________________________________________________ <br />http://www.ncdhhs.gov/control/retention/retention.htm <br />Providers of In-Home Aide, Home Health, Housing and Home Improvement, and Adult Day Care or Adult Day Health Care <br />shall sign and return the attached assurance to the area agency on aging indicating that recipients of these services have been <br />informed of their client rights, as required in Section 314 of the 2006 Amendments to the Older Americans Act. <br />Subcontracting – All HCCBG community service providers must assure that subcontractors (for-profit and non-profit <br />entities only) meet the following requirements: <br />Confidentiality and Security. Per the requirements in 10A NCAC 05J and Section 6 of the Home and Community Care <br />Block Grant Procedures Manual, client information in any format and whether recorded or not shall be kept confidential and <br />not disclosed in a form that identifies the person without the informed consent of the person or legal representative. <br />Community service providers, including subcontractors and vendors, must adhere to all applicable federal, state and <br />departmental requirements for protecting the security and confidentiality of client information including but not limited to <br />appropriately restricting access, establishing procedures to reduce the risk of accidental disclosures from data processing <br />systems, and developing a process by which the Division of Adult Aging Services is notified of suspected or confirmed <br />security incidents and data breaches. <br />a. The subcontractor has not been suspended or debarred. (N.C.G.S. §143C-6-23, 09 NCAC 03M) <br />d. All licenses, permits, bonds and insurance necessary for carrying out Home and Community Care Block Grant services <br />will be maintained by both the community service provider and any subcontractors. <br />e. The subcontractor is registered as a charitable, tax-exempt (501c3) organization with the Internal Revenue Service (non- <br />profit subcontractors only). <br /> “State Grant Certification of No Overdue Tax Debts.” <br />Docusign Envelope ID: 33187FF3-2913-4BF6-A737-FFB28C0A4B95 <br />7/18/2025