FY1998 10/15/1997u
AGREEMENT
This Agreement is made and entered into this C` 1 �,� day of lJ / G 1997,
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter
referred to as "Board" or "County," and HOSPICE OF THE FLORIDA KEYS, INC., hereinafter
referred to as "Provider."
WHEREAS, the Board and the Provider desire to enter into an agreement wherein the
Board contracts for services from the Provider in providing the medical, psychological, physical
and social needs of terminally ill persons and their families and to mobilize other community
resources to meet such needs for the citizens of Monroe County, and
WHEREAS, such services have been provided by the Provider in the past and leaves
been invaluable to the citizens of Monroe County, and =
WHEREAS, such services will promote independence and home care for terminate ill
persons, and
WHEREAS, the Board recognizes the public purpose to be met by an agreement for -
services to be rendered in fiscal year 1997-98, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is
agreed as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the Provider
substantially and satisfactorily performing and carrying out the duties of the Board as to
rendering services to the citizens of Monroe County, in matters of health and education in
regard to the care of terminally ill persons, shall pay to the Provider the sum of Fifty Thousand
Dollars ($50,000.00) for fiscal year 1997-98.
2. TERM. This Agreement shall commence on October 1, 1997, and terminate
September 30, 1998, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT. Payment will be paid periodically, but no more frequently than
monthly as hereinafter set forth. Reimbursement requests will be submitted to the Board via the
Clerk's Finance Office. The County shall only reimburse, subject to the funded amounts below,
those reimbursable expenses which are reviewed and approved as complying with Florida
Statutes 112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of
payment by the Provider shall be in the form of a letter, summarizing the expenses, with
supporting documentation attached. The letter should contain a certification statement as
well as a notary stamp and signature. An example of a reimbursement request cover letter is
included as Attachment B.
After the Clerk of the Board examines and approves the request for reimbursement, the
Board shall reimburse the Provider. However, the total of said reimbursement expense
payments in the aggregate sum shall not exceed the total amount of $50,000.00 during the
term of this agreement.
4. SCOPE OF SERVICES. The Provider, for the consideration named, covenants and
agrees with the Board to substantially and satisfactorily perform and carry out the duties of the
Board in providing the medical, psychological, physical and social needs of terminally ill
persons and their families and shall mobilize other community resources to meet such needs for
the citizens of Monroe County, Florida. Said services shall include, but are not limited to, those
services described in Provider's Details of Specific Program for Which Funding is Requested,
attached hereto as Exhibit C and incorporated herein.
5. RECORDS. The Provider shall maintain appropriate records to insure a proper
accounting of all funds and expenditures, and shall provide a clear financial audit trail to
allow for full accountability of funds received from said Board. Access to these records shall be
provided during weekdays, 8 a.m. to 5 p.m., upon request of the Board, the State of Florida, or
authorized agents and representatives of the Board or State.
The Provider shall be responsible for repayment of any and all audit exceptions which
are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe
County, an independent auditor, or their agents and representatives. In the event of an audit
exception, the current fiscal year contract amount or subsequent fiscal year contract amounts
shall be offset by the amount of the audit exception. In the event this agreement is not
renewed or continued in subsequent years through new or amended contracts, the Provider
shall be billed by the Board for the amount of the audit exception and the Provider shall
promptly repay any audit exception.
6. INDEMNIFICATION AND HOLD HARMLESS. The Provider covenants and agrees to
indemnify and hold harmless Monroe County Board of County Commissioners from any and all
claims for bodily injury (including death), personal injury, and property damage (including
property owned by Monroe County) and any other losses, damages, and expenses (including
attorney's fees) which arise out of, in connection with, or by reason of services provided by the
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Provider occasioned by the negligence, errors, or other wrongful act or omission of the
Provider's employees, agents, or volunteers.
7. INDEPENDENT CONTRACTOR. At all and for all purposes hereunder, the Provider
is an independent contractor and not an employee of the Board. No statement contained in
this agreement shall be construed so as to find the Provider or any of its employees,
contractors, servants or agents to be employees of the Board.
8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement,
the Provider shall abide by all statutes, ordinances, rules and regulations pertaining to or
regulating the provision of such services, including those now in effect and hereinafter
adopted. Any violation of said statutes, ordinances, rules and regulations shall constitute a
material breach of this agreement and shall entitle the Board to terminate this contract
immediately upon delivery of written notice of termination to the Provider.
9. PROFESSIONAL RESPONSIBILITY AND LICENSING. The Provider shall assure that
all professionals have current and appropriate professional licenses and professional liability
insurance coverage. Funding by the Board is contingent upon retention of appropriate local,
state and/or federal certification and/or licensure of the Provider's program and staff.
10. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be amended by an agreement amendment, which
must be approved in writing by the Board.
11. NO ASSIGNMENT. The Provider shall not assign this agreement except in writing
and with the prior written approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This agreement shall be
incorporated by reference into any assignment and any assignee shall comply with all of the
provisions herein. Unless expressly provided for therein, such approval shall in no manner or
event be deemed to impose any obligation upon the Board in addition to the total agreed
upon reimbursement amount for the services of the Provider.
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12. NON-DISCRIMINATION. The Provider shall not discriminate against any person on
the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap,
or any other characteristic or aspect which is not job -related in its recruiting, hiring, promoting,
terminating or any other area affecting employment under this agreement. At all times, the
Provider shall comply with all applicable laws and regulations with regard to employing the
most qualified person(s) for positions under this agreement. The Provider shall not discriminate
against any person on the basis of race, creed, color, national origin, sex or sexual orientation,
age, physical handicap, financial status or any characteristic or aspect in its providing of
services.
13. AUTHORIZED SIGNATURES. The signatory for the Provider below, certifies and
warrants that:
(a) The Provider's name in this agreement is the full name as designated in its
corporate charter, if a corporation, or the full name under which the Provider is authorized to
do business in the State of Florida.
(b) He or she is empowered to act and contract for the Provider; and
(c) This agreement has been approved by the Board of Directors of the Provider if
the Provider is a corporation.
14. NOTICE. Any notice required or permitted under this agreement shall be in
writing and hand -delivered or mailed, postage pre -paid, by certified mail, return receipt
requested, to the other party as follows:
For Board:
Monroe County Attorney
310 Fleming Street
Key West, FL 33040
For Provider:
Liz Kern, President
Hospice of the Florida Keys, Inc.
1319 William Street
Key West, Florida 33040
Louis LaTorre, Social Services Director
and Public Service Building
5100 College Road
Key West, FL 33040
15. CONSENT TO JURISDICTION. This agreement shall be construed by and
governed under the laws of the State of Florida and venue for any action arising under this
agreement shall be in Monroe County, Florida.
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16. NON -WAIVER. Any waiver of any breach of covenants herein contained to be
kept and performed by the Provider shall not be deemed or considered as a continuing
waiver and shall not operate to bar or prevent the Board from declaring a forfeiture for any
succeeding breach, either of the same conditions or covenants or otherwise.
17. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be
continued at a level sufficient to allow for continued reimbursement of expenditures for
services specified herein, this agreement may be terminated immediately at the option of the
Board by written notice of termination delivered to the Provider. The Board shall not be
obligated to pay for any services or goods provided by the Provider after the Provider has
received written notice of termination, unless otherwise required by law.
18. PURCHASE OF PROPERTY. All property, whether real or personal, purchased
with funds provided under this agreement, shall become the property of Monroe County and
shall be accounted for pursuant to statutory requirements.
19. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the
parties hereto with respect to the subject matter hereof and supersedes any and all prior
agreements with respect to such subject matter between the Provider and the Board.
/
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,. l*LWITNESS WHEREOF, the parties hereto have caused these presents to be executed as
�Y and year first written above.
BOARD OF COUNTY COMMISSIONERS
A NY L. KOLHAGE, CLERK OF MO ROE OUNTY, FLORIDA
1,
Deputy-
iconiihospice
9 Ari-
!�d ?. Me! "I �ap' A III!
HOSPICE OF THE FLORIDA KEYS, INC.
(Federal ID No. Ste? Ti`1, aP'c1)
By—
Exectbive Director
APPRO D AS TO F R
A GaL '.CI
5 BY
Z Nis:= ON
DATE Ld q
ATTACHMENT A
Expense Reimbursement Requirements
This document is intended to provide "basic" guidelines to Human Service Organizations, county
travellers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061,
which is attached for reference.
A cover letter summarizing the major line items on the reimbursable expense -equest should also
contain a certified statement such as:
I certify that the attached expenses are accurate and in agreement with the records of this
organization. Furthermore, these expenses are in compliance with this organizatiorfs contract
with the Monroe County Board of County Commissioners.
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines should be directed to Stephanie Griffiths at 305-292-3528.
Payroll:
A certified statement verifying the accuracy and authenticity of the payroll expenses.
If a Payroll Journal is provided, it should include:
Payroll Journal dates
employee name, salary, or hourly rate
hours worked during the payroll journal dates
withholdings where appropriate
check number and check amount
If a Payroll Journal is not provided the following must be listed:
check number, date, payee, check amount
support for applicable payroll taxes
Original vendor invoices must be submitted for Worker's Compensation an:. lability insurance
coverage.
Telephone expenses:
A user log of pertinent information must be remitted: the party called, the caller, the telephone
number, the date, and the purpose of the call must be identified.
Telefax, fax, etc.:
A fax log is required. The log must define the sender, the intended recipient, the date, the number
called, and the reason for sending the fax.
Supplies, services, etc.:
For supplies or services ordered the County requires the original vendor invoice.
Rents, leases, etc.:
A copy of the rental agreement or lease is required. Deposits and advance p,..:yments will not be
allowable expenses.
Postage, overnight deliveries, courier, etc.:
A log of all postage expenses as it relates to, the County contract is required for reimbursement.
For overnight or express deliveries, the original vendor invoice must be includcc.
Reproductions, copies, etc.:
A log of copy expenses as it relates to the County contract is required for r( imbursement. The
log must define the date, number of copies made, source document, purpo.;e, and -ecipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the original vendor
invoice is required and a sample of the finished product.
Travel expenses: please refer to Florida Statute 112.061.
Travel expenses must be submitted on a State of Florida Voucher for Reims •irsement of
Travel Expenses. Credit card statements are not acceptable documentation for r• .m. irsement.
Airfare reimbursement requires the original passenger receipt portion of the airline : icket. A
travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the original vendor invoice. Fuel purchases should be
documented with original paid receipts.
Original taxi receipts should be provided. However, reasonable fares will be reimbi rsed without
receipts. Taxis are not reimbursed if taken to arrive at a departure point: for exal. ole, taking a
taxi from one's residence to the airport for a business trip is not reimbursable.
0 iginal toll receipts should be provided. However, reasonable tolls will be reimbursed without
receipts.
Parking is considered a reimbursable travel expense at the destination. Airport parking during a
business trip is not.
Lodging reimbursement requires a detail listing of charges. The original lodging invoice must be
submitted. The County will only reimburse the actual room and related bed tax. Room service,
movies, and personal telephone calls (see previous guidelines) are not allowable expenses. Per
diem lodging expenses may apply. Again, refer to Florida Statute 112.061.
Meal reimbursement is breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal guidelines
are that travel must begin prior to 6 am for breakfast reimbursement, before noon and end after
2pm for lunch reimbursement, and before 6pm and end after 8 pm for dinner reimbursement.
Mileage reimbursement is calculated at 20 cents per mile for personal auto mileage while on
� county business. Effective October 1, 1994, mileage will be reimbursed at 25 cents per mile. An
odometer reading must be included on the state travel voucher for vicinity travel. A mileage map
is attached for reference to allowable miles from various Florida destinations.
Mileage is not allowed from a residence or office to a point of departure: for example, driving
from one's home to the airport for a business trip is not a reimbursable expense.
Data processing, PC time, etc.:
The original vendor invoice is required for reimbursement. Intercompany allocations are not
considered reimbursable expenditures unless appropriate payroll journals for the charging
department (see Payroll above) are attached and certified.
The following expenses are not allowable for reimbursement:
penalties and fines
non -sufficient check charges
fundraising
contributions
capital outlay expenditures (unless specifically included in the contract)
depreciation expenses (unless specifically included in the contract)
SGRIFFITHS
WP5I\PR0CEDURIEXP REIM
ATTACHMENT B
IIUMAN SERVICE ORGANIZATION LETTERHEAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, Florida 33040
(Date)
The following is a summary of the expenses for (Human Service Organization name) for the time
period of to
Check # Pavee
101
A Company
102
B Company
103
D Company
104
Person A
105
Person B
(A) Total
(B) Total prior payments
Reason
(C) Total requested and paid (A + B)
(D) Total contract amount
Balance of contract (D - C)
Amount
rent
$xxxx. xx
utilities
$xx:{x.x c
phones
$xxxx.xx
payroll
$xx--x.xx
payroll
$xx cx.xx
$XXXX.xx
$xxxx.xx
$xxxx.xx
I certify that the above checks have been submitted to the vendors as noted and that the expenses
are accurate and in agreement with the records of this organization. Furthermore, these expenses
are in compliance with this organization's contract with the Monroe County Board of County
Commissioners and will not be submitted for reimbursement to any of her funding source.
Executive Director
Attachments (supporting documentation)
Sworn and subscribed before me this _ day of
Em
Notary Public Notary Stamp
"A person or affiliate who has been placed on the convicted vendor list
following a conviction for public entity crime may not submit a bid on a
contract to provide any goods or services to a public entity, may not submit
a bid on a contract with a public entity for the construction or repair of a
public building or public work, may not submit bids on leases of real
property to public entity, may not be awarded or perform work as a
contractor, supplier, subcontractor, or consultant under a contract with any
public entity, and may not transact business with any public entity in excess
of the threshold amount provided in Section 287.017, for CATEGORY
TWO for a period of 36 months from the date of being placed on the
convicted vendor list."
Cam81 : u ► 1 ) : •:•I • 1 ••1
I Lei a ;•): FROM II WX a Ito)I I00
ETHICS CLAUSE
HOSPICE OF THE FLORIDA KEYS, INC. warrants that Wit has not employed, retained
or otherwise had act oniEWits behalf any former County officer or employee in violation of
Section 2 of Ordinance no. 10-1990 or any County officer or employee in violation of
Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County
may, in its discretion, terminate this contract without liability and may also, in its discretion,
deduct from the contract or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or employee.
HOSPICE OF THE FLORIDA KEYS, INC.
B '
Liz Kern, EO (signature)
Date: 1(O 01 t
STATE OF FLORIDA
COUNTY OF MONROE
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
LIZ KERN
who, after first being sworn by me, affixed hisilier
signature (name of individual signing) in the space provided above on this 24th day of
October 19 97
NO FARPUBLIC
My commission expires:
OMB - MCP FORM #4
EXHIBIT 20
Details of specific Program for which Funding is Requested
21. Please give a one paragraph description of the agency program for which
you are requesting funding.
The priority thrust of this organization is to provide top quality, cost
effective, sensitive services to residents of Monroe County who have life
limiting illnesses. This funding request is for monetary support to
assist the agency in caring for indigent residents who are terminally ill.
With hospice care, most people can live their lives to the fullest and
remain in their own places of residences through death. This approach,
which comprehensively addresses and provides care relating to physical,
social, emotional and spiritual needs, offers Monroe County families and
friends the opportunity to remain together. To conclude there is no place
like home. This organization does everything possible to make this a
pleasant, safe and practical reality. Also, with strong supportive
services made available by this applicant, programs (such as those for
bereavement) continue for families well after a loved ones death. This
type of specialized care is important to not only surviving family members
and friends, but to the entire community. with assistance during the
grieving process, people get on with their lives as productive, intact
citizens.
EXHIBIT 21
Details of Specific Program for which Funding is Requested
22• What need or problem in this community does this program address? Include
Your target population.
Services for the terminally ill are targeted toward an anticipated 793
deaths of Monroe County residents for Fy 196-197 (estimated per figures
given in a report by the Agency for Health care Administration, "Hospice
Programs & Medicare Certified Home Health Agencies", 2/2/96).
Particular attention is paid to several diagnoses which exceed the
national norm by Monroe County (AIDS and several forms of cancer). Other
target populations include those with various forms of heart disease,
stroke and infectious diseases such as pneumonia and influenza.
23.
EXHIBIT 22
Details of specific Program for Which
Funding is Requested
What data supports this need. Attach copies of any relevant documents or
cite report.
The program for which this applicant is requesting funding is included or
implied in various priorities, as identified by HRs and the Health and
Human services Board for 11B (from the Needs Assessment and strategic Plan
Update - Monroe county, 1996). These priorities are as follows:
1. control Disease. While this applicant is a direct care provider to
those terminally ill, it•s mission also includes education and
supportive services (particularly to those with AIDS or cancer).
2• Reduce substance Abuse. Assisting and supporting families dealing
with grief, directly helps in limiting or eliminating problems with
substance abuse.
3,4,5.Children will grow up in permanent families free from abuse and
neglect. Persons with mental illnesses will be integrated into the
community. Reduce teen pregnancy.
Again, with supportive, professional services readily available during one
of the most stressful periods of ones life (impending/actual loss of a
loved one), the above potential problem areas will be greatly reduced.
8,9. Disabled adults and the elderly will be protected and maintained in
their communities. vulnerable persons with developmental
disabilities will be protected and will have productive lives.
These two priorities are perhaps the most obvious reasons which support
rationale for this applicants fundraising. All efforts are made to
prevent institutionalization and to enable terminally ill people to remain
at home in their community. Again, family members and significant others
who also fit into the categories of disabled and elderly will be supported
to be independent and self efficient to the extent possible.
10,11. Persons will possess economic self-sufficiency. Reduce infant
mortality.
With supportive and preventive services rendered to family members and
significant others, along with care for the dying person, both of these
potential problem areas are reduced or prevented.
The other document which supports the need for services to the terminally
ill and their families is the "1996 - Health Data sourceBook,N South FL -
District 11, published by The Health Council of South Florida.
EXHIBIT 23
Details of specific Program for which Funding
is Requested
24. where is this program being offered? List all sites and hours of
operation.
This applicant offers services throughout Monroe County, 24 hours/day, 7
days/week, from three locations:
1319 William Street (MH 0.25)
Rey West, FL 33040
305/294-8812
6799 overseas Highway, #5 (MM 50)
Marathon, FL 33050
305/743-9048
92001 U.S. #1, (MM 92.1)
Tavernier, FL 33070
305/852-7887
In addition to services being offered during the organizations regular
office hours (8 am - 5 pm), a minimum of three on -call registered nurses
are available for direct care between closing time and opening time.
services are provided 24 hours/day (every day, including weekends and
holidays).