FY2007 1st Amendment 02/21/2007DANNYL. KOLHAGE
CLERK OF THE CIRCUIT COU.
DATE: March 9, 2007
TO: Salvatore Zappulla, Director
Office of Management & Budget
ATTN. Dave Owens
Grants Management
FROM: Pamela G. Hance
Deputy Clerk
At the February 21, 2007, Board of County Commissioner's meeting the Board granted
approval and authorized execution of and Amendment to Agreement between Monroe County
and Guidance Clinic of the Middle Keys, Inc., replacing Attachment C, which concerns
subcontracted Baker/Marchman Act transportation.
Enclosed is a dupicate original of the above -mentioned for your handling. Should you have any
questions please feel free to contact our office.
cc: County Attorney
Finance
File.
AMENDMENT TO AGREEMENT
This Amendment to Agreement is made and entered into this 21st day of February, 2007,
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter
referred to as "COUNTY," and The Guidance Clinic of the Middle Keys, Inc., hereinafter referred to as
"PROVIDER."
WHEREAS, the COUNTY and the PROVIDER entered into an agreement on October 18, 2006,
regarding the provision of mental health services, including sub-contracted Baker Act and Marchman
Act transportation services, for citizens of Monroe County; and
WHEREAS, PROVIDER has negotiated a new sub-contract for Baker Act and Marchman Act
transportation services, and,
WHEREAS, the COUNTY desires to amend said agreement to include the new Baker Act and
Marchman Act transportation sub-contract; NOW, THEREFORE,
1. The contract is amended by substituting the new Attachment C (Baker Act and Marchman Act
contract document dated October 1, 2006) in place of the current contract Attachment C,
which is blank.
2. All other provisions of the contract dated October 18, 2006, not inconsistent herewith, remain
in full force and effect.
IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as of
the day and year first written above.
(SEAL)
ATTEST: DANNY L. KOLHAGE, CLERK
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Deputy Clerk
BOARD OF COUNTY COMMISSIONERS
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By
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Guidance Clinic of the Middle Keys, Inc.,
(Federal ID No. 5Cf -IU ~-R<;2i.f---)
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Name and Title
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Date
Baker/Marchman Act
Transportation Sub-contract
(new Attachment C)
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ORIGINAL
GUIDANCE CLINIC OF THE MIDDLE KEYS, INC.
3000 41sT STREET, OCEAN
MARATHON, FL 33050
(v) 305/434-9000 / (I) 305/434-9040
October 1, 2006
Evan Guttman
Elanjess LLC
800 Catherine Street
Key West, FL 33040
RE: LETTER OF AGREEMENT
Dear Mr. Guttman:
The Guidance Clinic of the Middle Keys, Inc. (GCMK), hereby enters into an agreement
with Elanjess LLC to provide coordination and transportation services for Baker
Act/Marchman Act (BA/MA) clients throughout Monroe County, to/from Miami-Dade
County as well as other destinations as required. The effective term of this agreement
is October 1, 2006 -September 30, 2007.
GCMK will supply Elanjess with two vehicles, two Chevrolet Caprices meeting Elanjess
maintenance specifications; one to be stationed in Key West at an Elanjess location and
one to be stationed in Marathon at GCMK headquarters.
GCMK will pay for the fuel and maintenance of the two vehicles used for BA/MA
transportation. Elanjess will coordinate the maintenance for the Caprice located in Key
West. Invoices for routine maintenance (labor and parts) on the Caprice will be
forwarded to GCMK's Transportation Director for payment. Elanjess will not charge an
extra fee for coordinating the maintenance of the vehicle. Elanjess must obtain prior
approval from the GCMK Transportation Director to initiate major vehicle repairs.
GCMK will coordinate the maintenance for the Caprice located in Marathon.
GCMK will maintain insurance on both of the Caprices. Elanjess will be named as an
"additional insured" for these two cars. Elanjess will report and document accidents
involving GCMK vehicles and incidents involving clients to the proper authorities and
immediately thereafter contact GCMK.
All Elanjess drivers operating GCMK vehicles will hold a minimum of a Class E Florida
Driver's License and be approved for GCMK insurance coverage by the Transportation
Director. Upon execution of this agreement, Elanjess will fax to GCMK's Transportation
Director a current list of drivers - including a copy of the driver's license and social
security number for each driver - for approval to operate GCMK vehicles. Prior to
adding a driver, Elanjess will fax to GCMK's Transportation Director or designee a copy
1
Partially funded bv the Florida Department of Children & Families, District 11
~L('HILADREN
ISZl & FAMILIES
of the driver's license, social security number and signed "Request for Check of Driving
Record" form of the person. GCMK will initiate procedures to add the driver to GCMK
vehicle insurance. Elanjess cannot use the driver until it has received written
notification that the driver has been added to the GCMK insurance coverage.
Additionally, Elanjess will fax a copy of picture identification and social security number
for each escort to GCMK's Transportation Director or designee. Elanjess cannot use
the escort until it has received written notification that the escort has been approved by
GCMK.
GCMK will supply Elanjess with a cell phone. Elanjess will follow the transportation
protocol and complete the documentation provided as Attachment 1-3 herein.
The following fee structure is established for the period of the agreement:
Maximum Elanjess
# Roundtri s' Client Picku Point Client Dro -off Point Pa ment
Key West Key West $115
Marathon Marathon $115
241 Key West Marathon $145
Marathon Key West $145
Marathon Ke Lar 0 $145
24 Marathon Miami-Dade County $385
Ke Lar 0 Miami-Dade Count $385
28 Ke West Miami-Dade Count $385
GCMK Preauthorization Required for All Trips Below
Approval for below fees will be granted only when the Marathon BAlMA vehicle is engaged with
another BA/MA tri that would reclude another icku within a reasonable eriod of time.
Maximum Car Client Pickup Elanjess
# Roundtri s Location Point Client Dro -off Point Pa ment
2 Key West Marathon & North Key Largo $225
3 Key West Marathon & North Miami-Oade Count $385
GCMK Preauthorization Re uired for All Tri s Below
Maximum
# Roundtri s'
1
Client Picku Point
Key Largo
Marathon
Ke West
Key Largo
Marathon
Ke West
Elanjess
Pa ment
$770
$770
$770
$1,200
$1 ,200
$1,200
1
Timely payment for services rendered is ensured by adherence to the following
invoicing procedures:
2
Partially funded bv the Florida Department of Children & Families, District 11
~'('Hl'tPRE'N
~ & FAMIlieS
. Elanjess will submit two statements/invoices per month; one covering the trips
made from the first through the fifteenth and one covering trips made from the
sixteenth through the end of the month. Elanjess will send statements/invoices
to GCMK within 5 business days after the end of the billing period.
. Elanjess will include required documentation with each statement/invoice.
. Elanjess statements/invoices for BAlM A trips will be submitted to the attention of
GCMK Stabilization Unit Director.
. GCMK Stabilization Director will review statement/invoice, mediate any
discrepancies with Elanjess, and forward approved invoice to GCMK Finance
Department.
. GCMK will mail payment to Elanjess within 7 working days (Finance Department)
upon receipt of statement/invoice by the Stabilization Unit Director.
This agreement will begin on October 1, 2006 and will terminate on
September 30, 2007. The agreement can be cancelled by either party with 60 days
written notice.
GCMK and Elanjess enter into this agreement including Attachments 1-3 by affixing
. tures below:
CMK
\!...,/cq
{ Date
1/5/0,
I Date
Attachments:
1. GCMK Transportation Protocol
2. GCMK Transportation Record and Payment Authorization Sheet
3. Statement
3
Partiallv funded by the Florida Department of Children & Families, Oistricl11
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ATTACHMENT 1
GUIDANCE CLINIC OF THE MIDDLE KEYS TRANSPORTATION PROTOCOL:
THE TRANSPORTATION OF BAKER ACT AND MARCHMAN ACT CLIENTS
A. Client Related Rules:
1. Confidentially of a client and client related information shall be maintained at all
times.
2. Each client shall be treated with respect and dignity at all times.
3. No information with client information shall be leave the clinic unless part of a client
transfer packet to a designated facility. (No driver/escort shall maintain a personal
copy of the Transportation Record and Payment Authorization Sheet.)
4. Client transportation within Monroe County may be conducted with a driver and an
escort.
5. Client transportation outside of Monroe County must be made with one driver and
one escort.
6. A client must be observed for any unusual behaviors including hurting self/others or
sudden medical conditions. Report/respond to conditions immediately to the Nurse
on Duty.
7. At the time of pick up for a Baker Act or Marchman Act client, a driver must obtain
the original Baker Act or Marchman Act paper work from the Pick Up facility. If the
original paper work is not available the driver must immediately report this
information to the GCMK Nurse on Duty for further instructions.
8. A female client requires a female escort or a female driver.
9. A parent is not allowed to travel in the Baker Act vehicle with a Baker Act or
Marchman Act minor. Parents may follow in another car.
10. Only one client may be transported at a time in the Baker Act vehicle.
11. Clients are not to smoke in the car.
12. Clients are not to be placed in handcuffs or any type of restraints for any reason by a
driver or escort - or to be placed in the vehicle by others (i.e. Law Enforcement) in
handcuffs or any type of restraints
13. A client's movement is not to be impeded with any physical restraint unless directed
by a nurse/MDllaw enforcement officer.
14. If a client is violent during transport and poses a threat to safety, stop the vehicle and
call 911, than notify the Nurse on Duty of the situation.
15. A client shall not be left alone in the vehicle during the trip for any reason.
16. A client shall be under the observation of the driver or escort at all times during the
transport.
17. Client is encouraged to use restroom facilities prior to departure. If the trip is
generated from Key West and a stop is required, the GCMK may be used for that
purpose.
18. A client may not use aluminum/metal cans. Items for drinking shall be provided only
in a plastic container.
19. Clients may not have any metal utensils, glass or other hard products such as
pencils or pens.
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ATTACHMENT 1
GUIDANCE CLINIC OF THE MIDDLE KEYS TRANSPORTATION PROTOCOL:
THE TRANSPORTATION OF BAKER ACT AND MARCHMAN ACT CLIENTS
A. Client Related Rules:
1. Confidentially of a client and client related information shall be maintained at all
times.
2. Each client shall be treated with respect and dignity at all times.
3. No infonmation with client information shall be leave the clinic unless part of a client
transfer packet to a designated facility. (No driver/escort shall maintain a personal
copy of the Transportation Record and Payment Authorization Sheet.)
4. Client transportation within Monroe County may be conducted with a driver and an
escort.
5. Client transportation outside of Monroe County must be made with one driver and
one escort.
6. A client must be observed for any unusual behaviors including hurting self/others or
sudden medical conditions. Report/respond to conditions immediately to the Nurse
on Duty.
7. At the time of pick up for a Baker Act or Marchman Act client, a driver must obtain
the original Baker Act or Marchman Act paper work from the Pick Up facility. If the
original paper work is not available the driver must immediately report this
information to the GCMK Nurse on Duty for further instructions.
8. A female client requires a female escort or a female driver.
9. A parent is not allowed to travel in the Baker Act vehicle with a Baker Act or
Marchman Act minor. Parents may follow in another car.
10. Only one client may be transported at a time in the Baker Act vehicle.
11. Clients are not to smoke in the car.
12. Clients are not to be placed in handcuffs or any type of restraints for any reason by a
driver or escort - or to be placed in the vehicle by others (i.e. Law Enforcement) in
handcuffs or any type of restraints
13. A client's movement is not to be impeded with any physical restraint unless directed
by a nurse/MD/law enforcement officer.
14. If a client is violent during transport and poses a threat to safety, stop the vehicle and
call 911, than notify the Nurse on Duty of the situation.
15. A client shall not be left alone in the vehicle during the trip for any reason.
16. A client shall be under the observation of the driver or escort at all times during the
transport.
17. Client is encouraged to use restroom facilities prior to departure. If the trip is
generated from Key West and a stop is required, the GCMK may be used for that
purpose.
18. A client may not use aluminum/metal cans. Items for drinking shall be provided only
in a plastic container.
19. Clients may not have any metal utensils, glass or other hard products such as
pencils or pens.
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20. A client may not shop during a stop. All efforts should be made to avoid stops. If a
stop is required, it should be short and without delay.
21. If a client must use a public facility, the client must be escorted to the restroom and
the driver must remain outside the restroom door until the client leaves the restroom.
The driver will remain in conversation with client while the client is in the restroom.
B. Coordination of Transportation Rules:
1. Transportation arrangements for Baker Act and Marchman Act clients are under the
direction of the Unit Nurse on Duty/GCMK per contractual arrangement Elanjess
LLC. No other agency is authorized to contact Elanjess directly for transportation.
2. Final decision for a driver to transport is made by the nurse on duty. The nurse may
request a BAL be conducted or send a drivers/escort home if he/she has a concern.
3. All trips will be made within the approved fee structure.
4. All trips will be made using the closest vehicle and the shortest distance unless
preauthorization is obtained from the Unit Nurse on Duty at the GCMK.
5. Clients may be picked up at only approved locations. The GCMK Nurse on Duty will
communicate the pick up location. Approved locations will include:
Hospitals, Detention Facility
Mental Health Clinics, Anchor Away
With a GCMK staff member
6. At Depoo: Call security with phone located on the first floor.
7. At GCMK: Use the telephone call box next to the elevator.
8. At GCMK, staff members shall place the client in the vehicle for departure and will
assist the client from the vehicle at time of arrival.
9. The facility responsible for the departing client for a trip longer than 2 hours shall
provide a brown bag snack. All minors shall be supplied with a snack for any trip
over 1 hour.
10. When a driver reports a client is too dangerous to transport, the nurse on duty shall
work with the Sheriff's department to transport the client the client to the nearest
emergency room.
11. If a client absconds at time of or during transport, immediately report the information
to the GCMK Nurse on Duty. Do not go after the client.
12. Neither Drivers nor Escorts are permitted to physically restrain a client. GCMK
offers a verbal de-escalation training that all Elanjess drivers are encouraged to
attend.
13. "Jail Hold" clients from the Monroe County Detention Facility shall be picked up from
the Sallyport area only. To access the Sallyport area, the driver must drive the car
within 1 foot of the Sallyport entrance. If the door does not open, the escort must use
the speaker mounted on the wall next to the Sally port entrance to request entrance.
Once inside, Detention Facility staff will bring the client to the car. When the client is
inside the car and the doors are locked, the Sallyport area exit doors will open.
14. The driver/escort must determine from the Pick Up facility if the client has been
searched and encourage staff to conduct a search prior to transport. If the client is
not searched prior to transport, the driver must communicate this information to the
Duty Staff Member prior to opening the client door at the Designation point.
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15. Driver/escort must respond to the pick up point within a maximum time-frame of
1 hour and 15 minutes.
C. Reimbursement related rules
1. All cancelled and otherwise diverted trips will be reported on the Transportation
Record and Payment Authorization Sheet.
2. Transportation Record and Payment Authorization Sheets and a Statement of
services rendered will be faxed to the Stabilization Unit Director on the first and
sixteenth of each month.
3. If the driver arrives without the original Baker or Marchman Act paperwork, Elanjess
will obtain the paper work without charge to the GCMK.
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ATTACHMENT 2
GUIDANCE CLINIC OF THE MIDDLE KEYS
3000 41ST ST. Ocean
Marathon, FL 33050
Voice 305-434-9000 . Fax 305-434-9040
TRANSPORTATION RECORD AND PAYMENT AUTHORIZATION SHEET
Transportation Type: 0 Baker Act
o Marchman Act
Date: Client Name:
DOB:
Time Called:
Time of Pick Up:
Time of Drop Off:
Time van returned to Duty:
Vehicle:
KW vehicle
Mar vehicle
Place of Pick Up:
(Where did you pick up the Client: Facility Name/City)
Authorized Staff Signature at Pick Up Facility:
Time:
Time:
Destination:
(Where did you take the Client: Facility Name/City)
Authorized Staff Signature at Designation Facility:
(Staff member accepting client)
Driver Name:
Escort Name:
Beginning Miles:
Pick Up Miles:
Drop Off Miles:
Ending Miles:
_______n________________________________________ ________________________ ___________________
i FOR GCMK USE ONLY:
i Amount to be paid:
i Stabilization Unit Director Signature:
ATTACHMENT 3
Statement
Date:
Elanjess LLC
800 Catherine St.
Key West, Florida 33040
Stabilization Unit Director
Guidance Clinic of the Middle Keys
3000 4151 St. Ocean
Marathon, FL 33050
Re: Baker Act and Marchman Act transportation
The following is a break down for trips from to
Date Name Pick Up Cost Vehicle
Designation 1 2 3
TOTAL
Elanjess LLC Representative Signature GCMK Finance Director or designee Signature