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c STATE OF FLORIDA DEPARTM5NT OF HEALTH AND REHABILITATIVE SERVICES TITLE XX - SSA AGREEMENT THIS AGREEMENT, entered into this 20th day of September 1976 by and between the State of Florida, Department of Health and Rehabilitative Services, hereinafter referred to as the Department and Indian River County Board of County Comrmssioners hereinafter referred' to as the "Donor'; WITNESSETH: WHEREAS, the State of Florida, Department of Health and Rehabilitative Services, by authority granted in Chapter 409, Florida Statutes 1973, Chapter 20, Florida Statutes and.Chapter 75-48 Laws of Florida administers federal funds under Title XX of the Social Security Act which must be matched with state and/or local funds in accordance with Title 45, Code of Federal Regulations, Chapter II, Part 228, or if said provisions are revised, revoked and/or transferred to a new Part in the Code of Federal Regulations, said funds must be matched in accordance with the provi- sions of the new applicable Parts of the Code of Federal Regulations; and all amend- ments thereof, and, WHEREAS, Donor wishes to make a financial contribution to the Department to be used for the provision of services, said contribution of the Donor to be matched -by Federal funds, and WHEREAS, services.will be provided to those eligible to receive said services under the standards of eligibility of the Department. NOW, THEREFORE, in consideration of the mutual undertakings and agreements hereinafter set forth, the Department and the Donor agree as follows: 1. Donation. A. Donor shall contribute to the Department the sum of $ 3,100.00 to be added to state funds in the amount of $4.584.00 for the purpose of obtaining federal funds in the amount of $ 23,047,00 for a total of .$ 30, 731.00 to be used for the provision of I&R, Transp., yield I&R, A.H.A. services to those eligible under the standards of eligibility of the Department. Donor's contribu- -tion shall be made in ra or payments of $775.00• , with the first of said payments being made on 7 ecember 1, 1976 and subsequent payments being made on march, 1, .June 1, and Sept. 1, 1977 r B. Certified public expenditures may, vary from contribution to contribution but the total amount of the certified public expenditures at the end of this•contract period will not be more than the agreed-upon total contribution due under this contract. Certified public expenditures used must be eligible to be considered as.certified public expenditures under the applicable federal regu- lations, and rulings by the Social and Rehabilitation Service of the United States Department of Health, Education and Welfare. Said certification shall be on the. forms and in the manner designated by the Department. 6/76 SEP 2 21976 26 399 J