FY2012 10/19/2011DANNY L. KOLHAGE
CLERK OF THE CIRCUIT COURT
DA TE: October 31, 2011
TO: Lisa Tennyson
Grants Management y
FROM: Isabel C. DeSantis, D.C.
At the BOCC meeting held on October 19, 2011 the Board approved the following:
Item CIO American Red Cross, in the amount of $10,000; Be The Change -Kids
Come First Program, in the amount of $25,000; Be The Change -Monroe Youth Challenge
Program, in the amount of $20,000; Big Pine Athletic Association, in the amount of $44,000;
Boys and Girls Club, Inc., in the amount of $40,000; Domestic Abuse Shelter, in the amount of
$30,000; Florida Keys Area Health Education Center, in the amount of $35,000; Florida Keys
Children's Shelter, Inc., in the amount of $149,000; Florida Keys Healthy Start Coalition, Inc., in
the amount of $20,000; Florida Keys Outreach Coalition, Inc., in the amount of $34,000; Good
Health Clinic, Inc., in the amount of $40,000; Grace Jones Day Care Center, in the amount of
$29,000; Guidance Clinic/Care Center, in the amount of $1,118,119 - Mental Health
Services/$540,000.
Attached are photocopies of the subject documents for your handling. Should you have
any questions, please feel free to contact my office.
cc: County Attorney
Finance
File
AGREEMENT
This Agreement is made and entered into this 19 day of October, 2011, between the
BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as
"Board" or "County," and the GUIDANCE /CARE CENTER, 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 for the rendering of mental health services (Baker
Act and non -Baker Act), Baker Act transportation services, and substance abuse treatment, to the
citizens of Monroe County, Florida, and
WHEREAS, the Board is vested and charged with certain duties and responsibilities relating
to the mental health and guidance of the citizens of Monroe County, and
WHEREAS, such services have been rendered by the Provider in the past and have been
invaluable to the citizens of the County, and
WHEREAS, it is proper and fitting to enter into an agreement for services to be rendered in
the forthcoming fiscal year 2011 -2012, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed
as follows:
FUNDING
1. AMOUNT OF AGREEMENT. The Board, in consideration of the Provider
substantially and satisfactorily performing and carrying out the duties and obligations of the
Board, shall reimburse the Provider for a portion of the Provider's expenditures for Baker Act
hospital, physician and crisis stabilization services, as billed by the Provider, for clients qualifying
for such services under applicable state and federal regulations and eligibility determination
procedures, for Baker Act transportation services, for non -Baker Act mental health services, and
for substance abuse treatment. This cost shall not exceed a total reimbursement of ONE MILLION
ONE HUNDRED EIGHTEEN THOUSAND ONE HUNDRED NINETEEN AND NO /100 DOLLARS
($1,118,119.00), during the fiscal year 2012, payable as follows:
a) the sum of FIVE HUNDRED FORTY THOUSAND AND NO /100 DOLLARS ($540,000.00) for
residential services and mental health and substance abuse services, such as screening
and assessment, information and referral, outreach, prevention, intervention, counseling
and therapy, psychiatric services, aftercare, supportive housing, and psychosocial
rehabilitation.
b) the sum of THREE HUNDRED THIRTY -FOUR THOUSAND EIGHT HUNDRED EIGHTY AND
NO /100 DOLLARS ($334,880.00) for local match for Baker Act mental health services,
pursuant to FS 394, including emergency psychiatric examination, stabilization and short
term treatment; to include Crisis Stabilization unit services (emergency reception,
emergency screenings, psychiatric /medical evaluation, nursing observation, crisis
counseling and therapeutic activities);
c) the sum of ONE HUNDRED FORTY -SIX THOUSAND AND NO /100 DOLLARS ($146,000.00)
for Baker Act transportation services pursuant to FS 394;
d) the sum of TWENTY -EIGHT THOUSAND SIXTY -TWO AND NO /100 DOLLARS ($28,062.00)
for Community Transportation Coordinator related services.
Guidance Care Center FYI 2; page 1
e) the sum of SIXTY -NINE THOUSAND, ONE HUNDRED, SEVENTY- SEVEN, AND NO /100
DOLLARS ($69,177.00) for in -house residential substance abuse treatment program for
inmates of the Monroe Detention Center
2. TERM. This Agreement shall commence on October 1, 2011, and terminate September
30, 2012, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT. Payment will be paid monthly as hereinafter set forth. Baker Act Billing
Summary Forms, certified monthly financial and service load reports will be made available to the
Board to validate the delivery of services under this contract. The monthly financial report is due
in the office of the Clerk of the Board no later than the 15th day of the following month. Payment
for Baker Act and Marchman Act transportation services shall be made according to the rate
schedule set forth in Attachment D, subject to the maximum amounts set forth in Paragraph 1. a.
above. After the Clerk of the Board pre- audits the certified report, the Board shall reimburse the
Provider for its monthly expenses. However, the total of said monthly payments in the aggregate
sum shall not exceed the total amount shown in Article 1, above, during the term of this
agreement. To preserve client confidentiality required by law, copies of individual client bills and
records shall not be available to the Board for reimbursement purposes but shall be made
available only under controlled conditions to qualified auditors for audit purposes. The
organization's final invoice must be received within sixty days after the termination date of this
contract shown in Article 2 above.
Payment for services other than Baker Act will be made 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 Monroe County Code of Ordinances, State laws and regulations 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 notarized certification statement. An example of a reimbursement request cover letter
is included as Attachment B. The organization's final invoice must be received within thirty days
after the termination date of this contract shown in Article 2 above.
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 shown in Article 1, above,
during the term of this agreement.
4. 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.
S. CLAIMS FOR FEDERAL OR STATE AID. PROVIDER and County agree that each shall
be, and is, empowered to apply for, seek, and obtain federal and state funds to further the
purpose of this Agreement; provided that all applications, requests, grant proposals, and funding
solicitations shall be approved by each party prior to submission.
6. 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.
RECORDKEEPING
Guidance Care Center FY12; page 2
7. RECORDS. PROVIDER shall maintain all books, records, and documents directly
pertinent to performance under this Agreement in accordance with generally accepted accounting
principles consistently applied. Each party to this Agreement or their authorized representatives
shall have reasonable and timely access to such records of each other party to this Agreement for
public records purposes during the term of the Agreement and for four years following the
termination of this Agreement. If an auditor employed by the County or Clerk determines that
monies paid to PROVIDER pursuant to this Agreement were spent for purposes not authorized by
this Agreement, the PROVIDER shall repay the monies together with interest calculated pursuant
to Sec. 55.03, FS, running from the date the monies were paid to PROVIDER.
S. PUBLIC ACCESS. The County and PROVIDER shall allow and permit reasonable
access to, and inspection of, all documents, papers, letters or other materials in its possession or
under its control subject to the provisions of Chapter 119, Florida Statutes, and made or received
by the County and PROVIDER in conjunction with this Agreement; and the County shall have the
right to unilaterally cancel this Agreement upon violation of this provision by PROVIDER.
9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the
COUNTY the following (items A -I must be provided prior to the payment of any invoices):
(a) IRS Letter of Determination indicating 501(c)(3) status;
(b) List of the Organization's Board of Directors of which there must be five or more; for each
board member please indicate when elected to serve and the length of term of service;
(c) Evidence of annual election of Officers and Directors;
(d) Unqualified audited financial statement from most recent fiscal year for all organizations
that expend $150,000 a year or more; if qualified, include a statement of deficiencies with
corrective actions recommended /taken;
(e) IRS Form 990 from most recent fiscal year for all organizations;
(f) Organization's Corporate Bylaws, which must include the organization's mission, board
and membership composition, and process for election of officers;
(g) Organization's Policies and Procedures Manual which must include hiring policies for all
staff, drug and alcohol free workplace provisions, and equal employment opportunity
provisions;
(h) Specific description or list of services to be provided under this contract with this grant
(see Attachment C);
(i) Initial Performance Report describing services provided during the prior fiscal year. The
performance reports shall include statistical information regarding the types and
frequencies of services provided, a profile of clients (including residency) and numbers
served, and outcomes achieved.
(j) Final Performance Report describing services rendered during the current grant period (to
be furnished within 30 days after the contract end date.) The performance reports shall
include statistical information regarding the types and frequencies of services provided, a
profile of clients (including residency) and numbers served, and outcomes achieved.
(k) Cooperation with County monitoring visits that the County may request during the contract
year; and
(1) Other reasonable reports and information related to compliance with applicable laws,
contract provisions and the scope of services that the County may request during the
contract year.
RESPONSIBILITIES
10. 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 rendering counsel in the matter of mental health and guidance to the citizens of the
Monroe County, Florida. The Provider shall provide these services in compliance with Florida
Statutes Chapter 394. Baker Act and Marchman Act transportation services which are covered
Guidance Care Center FYI 2, page 3
under this agreement may be subcontracted, but are subject to the rates set forth in Attachment
D, and the limitations above. The subcontractor shall be subject to all of the conditions of this
contract, including but not limited to insurance and hold - harmless requirements, as is the
Provider.
11. ACCESS TO FUELING FACILITIES. The County shall provide access to the
Provider's vehicles at all County fueling facilities. The County shall grant the Provider a license for
the use of the real property and its improvements for each fueling site.
The Provider agrees that only those individuals authorized by the County to use the fueling
sites designated in this agreement shall have twenty -four hour access to said sites, and that they
shall either be maintained open or access otherwise provided to them by a uniform key system on
such a twenty -four hour basis.
The County shall bill the Provider for fueling and other related services and materials
utilized by the Provider at the fueling sites within the County's immediate control and as
previously set forth in this agreement. Said billing by the County to the Provider shall include an
administrative surcharge, as adopted by the Monroe County Board of County Commissioners
annually, for processing, servicing, and handling. The Provider shall reimburse the County within
thirty (30) days of the date of issuance of the bill.
Access to the Fuel Sentry System shall be provided by an electronic memory key, which
shall be issued by the County to all authorized designated users of the fueling sites, and as
contemplated by this Agreement. For purposes of uniformity, the Monroe County Fleet
Management Department shall be responsible for establishing a uniform electronic key system for
use by both the County and the Provider under this agreement, and shall establish and maintain
policies and procedures for identification, control, and distribution of all keys issued.
12. ATTORNEY'S FEES AND COSTS. The County and PROVIDER agree that in the event
any cause of action or administrative proceeding is initiated or defended by any party relative to
the enforcement or interpretation of this Agreement, the prevailing party shall be entitled to
reasonable attorney's fees, court costs, investigative, and out -of- pocket expenses, as an award
against the non - prevailing party, and shall include attorney's fees, courts costs, investigative, and
out -of- pocket expenses in appellate proceedings. Mediation proceedings initiated and conducted
pursuant to this Agreement shall be in accordance with the Florida Rules of Civil Procedure and
usual and customary procedures required by the circuit court of Monroe County.
13. BINDING EFFECT. The terms, covenants, conditions, and provisions of this
Agreement shall bind and inure to the benefit of the County and PROVIDER and their respective
legal representatives, successors, and assigns.
14. CODE OF ETHICS. County agrees that officers and employees of the County
recognize and will be required to comply with the standards of conduct for public officers and
employees as delineated in Section 112.313, Florida Statutes, regarding, but not limited to,
solicitation or acceptance of gifts; doing business with one's agency; unauthorized compensation;
misuse of public position, conflicting employment or contractual relationship; and disclosure or
use of certain information.
15. NO SOLICITATION/ PAYMENT. The County and PROVIDER warrant that, in respect
to itself, it has neither employed nor retained any company or person, other than a bona fide
employee working solely for it, to solicit or secure this Agreement and that it has not paid or
agreed to pay any person, company, corporation, individual, or firm, other than a bona fide
employee working solely for it, any fee, commission, percentage, gift, or other consideration
contingent upon or resulting from the award or making of this Agreement. For the breach or
violation of the provision, the PROVIDER agrees that the County shall have the right to terminate
Guidance Care Center FY12; page 4
this Agreement without liability and, at its discretion, to offset from monies owed, or otherwise
recover, the full amount of such fee, commission, percentage, gift, or consideration.
16. INDEPENDENT CONTRACTOR. At all times 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.
COMPLIANCE ISSUES
17. 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.
18. 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.
19. NON - DISCRIMINATION. County and PROVIDER agree that there will be no
discrimination against any person, and it is expressly understood that upon a determination by a
court of competent jurisdiction that discrimination has occurred, this Agreement automatically
terminates without any further action on the part of any party, effective the date of the court
order. County or PROVIDER agree to comply with all Federal and Florida statutes, and all local
ordinances, as applicable, relating to nondiscrimination. These include but are not limited to: 1)
Title VI of the Civil Rights Act of 1964 (PL 88 -352) which prohibits discrimination on the basis of
race, color or national origin; 2) Title IX of the Education Amendment of 1972, as amended (20
USC ss. 1681 -1683, and 1685 - 1686), which prohibits discrimination on the basis of sex; 3)
Section 504 of the Rehabilitation Act of 1973, as amended (20 USC s. 794), which prohibits
discrimination on the basis of handicaps; 4) The Age Discrimination Act of 1975, as amended (42
USC ss. 6101 -6107) which prohibits discrimination on the basis of age; 5) The Drug Abuse Office
and Treatment Act of 1972 (PL 92 -255), as amended, relating to nondiscrimination on the basis
of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and
Rehabilitation Act of 1970 (PL 91 -616), as amended, relating to nondiscrimination on the basis of
alcohol abuse or alcoholism; 7) The Public Health Service Act of 1912, ss. 523 and 527 (42 USC
ss. 690dd -3 and 290ee -3), as amended, relating to confidentiality of alcohol and drug abuse
patient records; 8) Title VIII of the Civil Rights Act of 1968 (42 USC s. et seq.), as amended,
relating to nondiscrimination in the sale, rental or financing of housing; 9) The Americans with
Disabilities Act of 1990 (42 USC s. 1201 Note), as maybe amended from time to time, relating to
nondiscrimination on the basis of disability; 10) Any other nondiscrimination provisions in any
Federal or state statutes which may apply to the parties to, or the subject matter of, this
Agreement.
AMENDMENTS, CHANGES, AND DISPUTES
20. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and /or reimbursement of services shall be accomplished by an amendment, which must be
approved in writing by the COUNTY.
21. ADJUDICATION OF DISPUTES OR DISAGREEMENTS. County and PROVIDER
agree that all disputes and disagreements shall be attempted to be resolved by meet and confer
sessions between representatives of each of the parties. If no resolution can be agreed upon
within 30 days after the first meet and confer session, the issue or issues shall be discussed at a
Guidance Care Center FY12; page 5
public meeting of the Board of County Commissioners. If the issue or issues are still not resolved
to the satisfaction of the parties, then any party shall have the right to seek such relief or remedy
as may be provided by this Agreement or by Florida law.
22. COOPERATION. In the event any administrative or legal proceeding is instituted
against either party relating to the formation, execution, performance, or breach of this
Agreement, County and PROVIDER agree to participate, to the extent required by the other party,
in all proceedings, hearings, processes, meetings, and other activities related to the substance of
this Agreement or provision of the services under this Agreement. County and PROVIDER
specifically agree that no party to this Agreement shall be required to enter into any arbitration
proceedings related to this Agreement.
ASSURANCES
23. COVENANT OF NO INTEREST. County and PROVIDER covenant that neither
presently has any interest, and shall not acquire any interest, which would conflict in any manner
or degree with its performance under this Agreement, and that only interest of each is to perform
and receive benefits as recited in this Agreement.
24. 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.
25. NON - WAIVER OF IMMUNITY. Notwithstanding the provisions of Sec. 768.28,
Florida Statutes, the participation of the County and the PROVIDER in this Agreement and the
acquisition of any commercial liability insurance coverage, self- insurance coverage, or local
government liability insurance pool coverage shall not be deemed a waiver of immunity to the
extent of liability coverage, nor shall any contract entered into by the County be required to
contain any provision for waiver.
26. ATTESTATIONS. PROVIDER agrees to execute such documents as the County may
reasonably require, to include a Public Entity Crime Statement, an Ethics Statement, and a Drug -
Free Workplace Statement.
27. AUTHORITY. Each party represents and warrants to the other that the execution,
delivery and performance of this Agreement have been duly authorized by all necessary County
and corporate action, as required by law.
INDEMNITY ISSUES
28. 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
PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the
PROVIDER'S employees, agents, or volunteers.
29. PRIVILEGES AND IMMUNITIES. All of the privileges and immunities from liability,
exemptions from laws, ordinances, and rules and pensions and relief, disability, workers'
compensation, and other benefits which apply to the activity of officers, agents, or employees of
any public agents or employees of the County, when performing their respective functions under
Guidance Care Center FYI 2; page 6
this Agreement within the territorial limits of the County shall apply to the same degree and
extent to the performance of such functions and duties of such officers, agents, volunteers, or
employees outside the territorial limits of the County.
30. NO PERSONAL LIABILITY. No covenant or agreement contained herein shall be
deemed to be a covenant or agreement of any member, officer, agent or employee of Monroe
County in his or her individual capacity, and no member, officer, agent or employee of Monroe
County shall be liable personally on this Agreement or be subject to any personal liability or
accountability by reason of the execution of this Agreement.
31. LEGAL OBLIGATIONS AND RESPONSIBILITIES: Non - Delegation of Constitutional
or Statutory Duties. This Agreement is not intended to, nor shall it be construed as, relieving any
participating entity from any obligation or responsibility imposed upon the entity by law except to
the extent of actual and timely performance thereof by any participating entity, in which case the
performance may be offered in satisfaction of the obligation or responsibility. Further, this
Agreement is not intended to, nor shall it be construed as, authorizing the delegation of the
constitutional or statutory duties of the County, except to the extent permitted by the Florida
constitution, state statute, and case law.
32. NON - RELIANCE BY NON - PARTIES. No person or entity shall be entitled to rely
upon the terms, or any of them, of this Agreement to enforce or attempt to enforce any third -
party claim or entitlement to or benefit of any service or program contemplated hereunder, and
the County and the PROVIDER agree that neither the County nor the PROVIDER or any agent,
officer, or employee of either shall have the authority to inform, counsel, or otherwise indicate
that any particular individual or group of individuals, entity or entities, have entitlements or
benefits under this Agreement separate and apart, inferior to, or superior to the community in
general or for the purposes contemplated in this Agreement.
GENERAL
33. Execution in Counterparts. This Agreement may be executed in any number of
counterparts, each of which shall be regarded as an original, all of which taken together shall
constitute one and the same instrument and any of the parties hereto may execute this
Agreement by signing any such counterpart.
34. 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:
Grants Administrator and
1100 Simonton Street
Key West, FL 33040
Monroe County Attorney
PO Box 1026
Key West, FL 33041
For PROVIDER
A.B. Maloy, Area Director
Guidance /Care Center Inc.
1205 Fourth Street
Key West, Florida 33040
35. GOVERNING LAW, VENUE, INTERPRETATION, COSTS, AND FEES. This
Agreement shall be governed by and construed in accordance with the laws of the State of Florida
applicable to contracts made and to be performed entirely in the State.
Guidance Care Center FYI 2; page 7
In the event that any cause of action or administrative proceeding is instituted for the
enforcement or interpretation of this Agreement, the County and PROVIDER agree that venue will
lie in the appropriate court or before the appropriate administrative body in Monroe County,
Florida.
The County and PROVIDER agree that, in the event of conflicting interpretations of the
terms or a term of this Agreement by or between any of them the issue shall be submitted to
mediation prior to the institution of any other administrative or legal proceeding.
36. 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.
37. SEVERABILITY. If any term, covenant, condition or provision of this Agreement (or
the application thereof to any circumstance or person) shall be declared invalid or unenforceable
to any extent by a court of competent jurisdiction, the remaining terms, covenants, conditions
and provisions of this Agreement, shall not be affected thereby; and each remaining term,
covenant, condition and provision of this Agreement shall be valid and shall be enforceable to the
fullest extent permitted by law unless the enforcement of the remaining terms, covenants,
conditions and provisions of this Agreement would prevent the accomplishment of the original
intent of this Agreement. The County and PROVIDER agree to reform the Agreement to replace
any stricken provision with a valid provision that comes as close as possible to the intent of the
stricken provision.
38. 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.
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
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wdancetare Center FYI 2; page 8
BOARD OF CIDUNTY COMMISSIONERS
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By
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GUIDANCE /CARE CENTER, � INC.
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ATTACHMENT A
Expense Reimbursement Requirements
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, 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.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"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 other funding source."
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 305 - 292 -3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter - company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate,
total hours worked, withholding information and paid payroll taxes, check number and check
amount. If a Payroll Journal is not provided, the following information must be provided: pay
period, check amount, check number, date, payee, support for applicable paid payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement.
For overnight or express deliveries, the vendor invoice must be included. -
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Guidance Care Center FYI 2; page 9
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.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel reimbursement requests must be submitted and will be paid in accordance with
Monroe County Code of Ordinances and State laws and regulations. Credit card statements are
not acceptable documentation for reimbursement. If attending a conference or meeting a copy of
the agenda is needed. Airfare reimbursement requires the original passenger receipt portion of
the airline ticket. A travel itinerary is appreciated to facilitate the audit trail. Auto rental
reimbursement requires the vendor invoice. Fuel purchases should be documented with paid
receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example, taking a
taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
considered a reimbursable travel expense at the destination. Airport parking during a business
trip is not.
A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room
must be registered and paid for by traveler. The County will only reimburse the actual room and
related bed tax. Room service, movies, and personal telephone calls are not allowable expenses.
Mileage reimbursement shall be at the rate established by ARTICLE XXVI, TRAVEL, PER DIEM,
MEALS, AND MILEAGE POLICY of the Monroe County Code of Ordinances. An odometer reading
must be included on the state travel voucher for vicinity travel. 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.
Meal reimbursement shall be at the rates established by ARTICLE XXVI, TRAVEL, PER DIEM,
MEALS, AND MILEAGE POLICY of the Monroe County Code of Ordinances. Meal guidelines state
that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon and end after 2
p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner reimbursement.
Non - allowable Expenses
The following expenses are not allowable for reimbursement: capital outlay expenditures (unless
specifically included in the contract), contributions, depreciation expenses (unless specifically
included in the contract), entertainment expenses, fundraising, non - sufficient check charges,
penalties and fines.
Guidance Care Center FYI 2, page 10
ATTACHMENT B
ORGANIZATION
LETTERHEAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, FL 33040
Date
The following is a summary of the expenses for ( Organization name for the time period
of to
Check #
Payee Reason
Amount
101
Company A Rent
$ X,XXX.XX
102
Company B Utilities
XXX.XX
104
Employee A P/R ending 05/14/01
XXX.XX
105
Employee B P/R ending 05/28/01
XXX.XX
(A)
Total
$ X XX
(B)
Total prior payments
$ X,XXX.XX
(C)
Total requested and paid (A + B)
$ X,XXX.XX
(D)
Total contract amount
$ X,XXX.XX
Balance of contract (D -C)
$ X.XXX.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 other funding source.
Executive Director
Attachments (supporting documentation)
Sworn to and subscribed before me this day of 200_
by who is personally known to me.
Notary Public
Notary Stamp
Guidance Care Center FY12; page 11
ATTACHMENT C
Insert a list of the services that will be provided by your organization under this contract.
Baker Act and non -Baker Act mental health services and substance abuse treatment, mental
health services, including detoxification, long -term substance abuse treatment, and long -term
psychiatric treatment services, crisis stabilization, community mental health and substance abuse
services, residential services and mental health and substance abuse services, such as screening
and assessment, information and referral, outreach, prevention, intervention, counseling and
therapy, psychiatric services, aftercare, supportive housing, and psychosocial rehabilitation;
Baker Act /Marchman Act transportation services; Community Transportation Coordinator related
services; and in -house residential substance abuse treatment services for detention center
inmates.
Guidance Care Center FY12; page 12
ATTACHMENT D
Attachment D, copy of subcontract for Baker Act Transportation services, will be
submitted for Commission approval at a later date. No Baker Act Transportation invoices
will be paid until Attachment D is approved.
Guidance Care Center FY12; page 13
PUBLIC ENTITY CRIME STATEMENT
"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."
Guidance Care Center M2; page 14
SWORN STATEMENT UNDER ORDINANCE NO. 10 -1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
k �/j, warrants that he /it has not employed, retained or
t
otherwise had a on his /its 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
(signature(
Date:
r 1 ��
STATE OF l
19 N
COUNTY OF .
PERSONALLY APPEA E BEFORE ME, the undersigned authority,
who, after first being sworn by me, affixed his /her
signature (name of individual signing) in the space provided above on this day of
1 c+b , 201.
NOTARY PUBLI
My commission expires:
OMB - MCP FORM #4
PATRICIA C. UNFERTH
Commission DD 724604
Expires January 15, 2012
W41d111nu Tmy Fain ftuM M �
Guidance Care Center FY12; page 15
DRUG -FREE WORKPLACE FORM
The undersigned vendor in accordance with Fl orida Statute 287.087 hereby certifies that:
617 i ii' am LP I � L l �/W � .C.� .
(Name of Business)
1. Publishes a statement notifying employees that the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance is prohibited in the workplace and
specifying the actions that will be taken against employees for violations of such prohibition.
2. Informs employees about the dangers of drug abuse in the workplace,
the business's policy of
maintaining a drug -free workplace, any available drug counseling, rehabilitation, and employee
assistance programs, and the penalties that may be imposed upon employees for drug abuse
violations.
3. Gives each employee engaged in providing the commodities or contractual services that are
under bid a copy of the statement specified in subsection (1).
4. In the statement specified in subsection (1), notifies the employees that, as a condition of
working on the commodities or contractual services that are under bid, the employee will abide by
the terms of the statement and will notify the employer of any conviction of, or plea of guilty or
law f the sited States o state, for Chapter v olat violation u occurring the workplace no substance
o later than five
law of the U
(5) days after such conviction.
5. Imposes a sanction on, or require the satisfactory participation in a drug abuse assistance or
rehabilitation program if such is available in the employee's community, or any employee who is
so convicted.
6. Makes a good faith effort to continue to maintain a drug -free workplace through
implementation of this section.
As the person authorized to sign the statement, I certify that this firm complies fully with the
above requirements.
STATE OF _`" �
COUNTY OF kk 0 Pf' �
(Signature MR spond
1 6 t?
Da e
PERSONALLY APPEARED EFORE ME, the undersigned authority,
'� f a 10 who, after first being sworn by me, (name of
individua signing) affixed his /her signature in the space provided above on this
day of �� , 2011 —.
My commission expires:
Notary Public
PATRICIA C. UNFERTH
Comm Iss .. DD 724604
les
Expires January 15, 2DI 2 ,0,9
%'.,jg BorpMTMuTroyfdnMw
Guidance Care Center FYI 2; page 16
Baker/Marchman Act
Transportation Sub -Contract
(Attachment D)
April 5, 201
DEC 16 2011
.- M.
Evan
Elanjess LL
P.O. Box 5 218
Marathon, L 33050
RE: LETTE
Dear Mr. G
The Guide)
provide coc
throughout
required.
G/CC will a
maintenarM
other in Me
G/CC will F
Elanjess w
for routine
Tranaporta
maintenan
Director to
Victoria loc
GUIDANCE/CARE CENTER, INC.
3000 41ST STREET, OCEAN
MARATHON, FL 33050
(v) 3.51434-9000 / (f) 305/434-9040
OF AGREEMENT — Amendment 1
Center, Inc. (G/CC) hereby enters into an agreement with Elanjess LLC to
i and transportation services for Baker AcI/Marchman Act (BA/MA) clients
County to/from Miami -Deft County as well as other destinations as
ply Elanjess with two Ford Crown Victoria vehicles, meeting Elanjess
specifications; one to be stationed in Key West at an Elanjess location and the
thou at G/CC headquarters.
f for the fuel and maintenance of the two vehicles used for BA/MA transportation.
000rdinate.the maintenance for the Crown Victoria located in Key West. Invoices
aintenance (labor and parts) on the Crown Victoria will be forwarded to G/CC's
m Director for payment. Elanjess will not charge an extra fee for coordinating the
i of the vehicle. Elan** must obtain prior approval from the G/CC Transportation
itiate major vehicle repairs. G/CC will coordinate the maintenance for the Crown
red in Marathon.
G/CC will m 3intain insurance on both of the vehicles. Elanjess will also be named as an
'additional i ured' for these two cars. Elanjess will report and document accidents involving
GICC vishic es and incidents involving clients to the proper authorities and immediately
thereafter pritact G/CC. All Elanjess drivers operating GiCC vehicles will hold a minimum of
a Class E F orida Driver's License and be approved for G/CC Insurance coverage by the
Transportation Director. Upon execution of this agreement, Elanjess will fax to G/CC's
Tran Director a current list of drivers - including a copy of the driver's license and
social sect ' number for each driver - for approval to operate G/CC vehicles. Prior to adding
a driver, njess will fax or email to G/CC's Transportation Director or designee a copy of the
driver's I' se, social security number and signed 'Request for Check of Driving Record" form
of the p G/CC will initiate procedures to add the driver to G1CC vehicle insurance.
Elanjess ca nnot use the driver for BA/MA transports until it has received written notification
that the drh er has been added to the G/CC insurance coverage. Additionally, Elanjess will fax
Zw.naopn. M.n.a«.�nrr+ner,ort+uome.ker�a+xo�oao��re�► �,..rt,,,t,a»_n,,,a+r�.doc Rvsa:03/11
a copy of pi identification and social security number for each escort to GfCC's
Tra Director or designee. Elanjess cannot use the escort for BA/MA transports
until 4 has written rwbication that the escort has been approved by G/CC. All BA/MA
L
complete a two hour Baker Ad Transportation Orientation conducted by GICC
within 30 days of being approved as a driver. Ail BAIMA drivers must attend a
Act annual review conducted by a G/CC staff member within one year of
' date annually. GICC w� pay BA/MA drfirers $15.00 per hour to attend the
nnual review.
GJCC wig s ly Elanjess with a cell phone. Elanjess will follow the transportation protocol
and com t o documentation provided as Attachment 1-3 herein.
The tee structure is established for the period of the agreement:
Key W
Marathon
$115
Marathon
$115
241
Key West
Marathon
$145
Maradm
Key West
$145
Marathon
Key Largo
$145
,
Car Client Pickup
Elanjeaa
# Roundtri
s Location Point
Client Point
Pa
2
Key West mwou on 6 Norm
Key L&TO
$225
3
Key West Ms►srrw 6 Abrrb
WrM-Dade Coun
$385
:Estimate
MCA ME
Eianless
0 Rou
CUM Pickup Point
Client Drop-off Point
P
Key Largo
Avon Park (Area)
$770
1
Marathon
Avon Park (Area)
$770
Key West
Avon Park(Area)
$770
Key Largo
Up- tj (McClenny Area)
$1.200
1
Marathon
UP -State (McClenny Area)
$1,200
Key West
Up-State(McClenny Area
1200
Timely payr ient for services rendered Is ensured by adherence to the following invoicing
procedures
t ierlAM� lye�nrr.n.potLtlome.wrAanxo�o•Zoi1%A Agnmmm1ai4—Mn ji,dx
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• Elan' ss will submit two statements/invoices per month; one covering the trips made
from first through the fifteenth and one covering trips made from the sixteenth
th h the end of the month. Elanjess wig send statements/invoices to G/CC within 5
busi days after the end of the billing period.
• Ela ' will include required documentation with each statementAnvoice.
• Ela ' statementsfinvoices for BA/MA trips will be submitted to the attention of G/CC
Stabi ization Unit Director.
• GICC Unit Director will review sb tementfinvoice, mediate any discrepancies with
E , and forward approved invoice to GICC Finance Department.
• CYCC will mad payment to Elanjess within 7 working days (Finance Department) upon
receipt of statementfinvoice by the Unit Director.
The agreement can be cancelled by either party with 30 days written notice.
G/CC and Efaniess enter into this agreement including Attachments 1-3 by affixing signatures
below.
A.B. Maky, JD, MPH Date
Area C
s l�
E ate _—
Elanjess LL
1. G/C Transportation Protocol
2. G/C Transportation Record and Payment Authorization Sheet
3. Statelment
AdW10-201IeA-NrNmM10-11-MW0311.da Rvsa:03n1
-3-
ATTACHMENT 1
GUIDANCE /CARE CENTER 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 informaation with client information shall 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 diets must be observed for any unusual behaviors including hunting 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 G/CC 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.
• VVhen a parent or other responsible party reports he/she plans to follow the
Baker Act vehicle, the Baker Act driver advises the parenVparty that our
primary responsibility is to the child and ensuring the safety of the child
therefore following our vehicle as a method of direction is not encouraged.
• The Baker Act Driver shall provide the parent1party with a Baker Act Family
Guide. (Note: Available January 2011).
10. Only one client may be transported at a time in the Baker Act vehicle.
11. Drivers, Escorts and 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 nurselMD/law enforcement officer.
14. N 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 at (305) 434-9000 ext. 1.
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
N.1Menaganent%Senior ManagementgranspaUdonlBakee Act\2010-2011110-11 BA. MA rules.doc Rvsd: 10/10
_1.
generated from Key West and a stop is required, the G/CC 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.
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/G/CC 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 driverslescort home if he/she has a concern.
3. AN trips will be made within the approved fee structure.
4. AN trips will be made using the closest vehicle and the shortest distance unless
preaut xxizadon is obtained from the Unit Nurse on Duty at the G/CC.
5. Clients may be picked up at only approved locations. The G/CC Nurse on Duty will
communicate the pick up location. Approved locations will include:
Hospitals, Detention Facility
Mental Health Clinics, Anchor Away
With a G/CC staff member
Or otherwise authorized by the G/CC Unit Director
6. At Depoo: Call security with phone located on the first floor.
7. At G/CC: Use the telephone call box next to the elevator.
8. At G/CC, 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. AO 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 Sheriffs 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 G/CC Nurse on Duty. Do not go after the client.
12. Neither Drivers nor Escorts are permitted to physically restrain a client. G/CC offers
a verbal de-escalation trailing 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 Sellyport entrance. If the door does not open, the escort must use
the speaker mounted on the wall next to the Sallyport entrance to request entrance.
N:1M:nagano t%Senior MamganenATnmVwadon\Baku Ada010-2011\10-11 BA -MA rules.doc Rvsd: 10/10
-2.
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 drivertescort must determine from the Pick Up fadr'ty if the client has been
searched and encourage staff to conduct a search prior to transport. H 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.
15. Driver/escort MUST respond to the pick up point within a maximumtime-frame of
1 hour and tt3 minutes.
C. Reimbursement related rules
t. 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 G/CC.
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Statement
Date:
Elanjess LLC
800 Catherine St.
Key West, Florida 33040
IP Unit Director
Guidance/Care Center
3000 41 d St. Ocean
Marathon, FL 33050
Re: Baker Act and Marchman Act transportation
The following Is a break down for trips from to
Pick Up
DesIgnation
�vvv
Elanjess LLC Representative Signature G/CC Finance Director or Designee Signature
N:Wlsnapement%Srtior Manapemsnt%Trnnsportat1an%8aker Act%2010-2011L4tchmnt 3 - Statement for Etanjes.doc
Rvsd: 10/10
ATTACHMENT 2
GUIDANCEICARE CENTER
3000 413T ST. Ocean
Marathon, FL 33050
Voice 305-434-9000 9 Fax 305-4344M
TRANSPORTATION RECORD AND PAYMENT AUTHORIZATION SHEET
Transportation Type: o 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: Faclky Name/Cky)
Authorized Staff Signature at Pick Up Facility:
Time:
Destination:
(When did you take the Clleft Facility Nam*Xlty)
Authorized Staff Signature at Designation Facility:
Time:
(Staff member accepting client)
Driver Name:
Escort Name:
Beginning Miles:
Drop Off Miles:
Pick Up Miles:
Ending Miles:
i FOR O/CC USE ONLY:"_--
j Amount to be paid: +
Unit Director Signature:
N:AftnagemenfSenior ManagemeriffranportationkBaker Act12010-2011Witechement 2.doc RVSD10/10