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Item C21County of Monr S ti o i» oG �T� BOARD OF COUNTY COMMISSIONERS / fi Mayor George Neugent, District 2 leOI1d8 Ke Sou', y f i Mayor Pro Tern David Rice, District 4 •. =�1 Danny L. Kolhage, District 1 Heather Carruthers, District 3 w Sylvia J. Murphy, District 5 County Commission Meeting May 17, 2017 Agenda Item Number: C.21 Agenda Item Summary #2917 BULK ITEM: Yes DEPARTMENT: Budget and Finance TIME APPROXIMATE: STAFF CONTACT: Laura DeLoach (305)292 -4482 No AGENDA ITEM WORDING: Approval of the Monroe County Designated Receiving System Plan, as presented by the designated Managing Entity for Monroe County and Miami/Dade County, South Florida Behavioral Health Network (SFBHN), for a centralized receiving system for Monroe County as required by Senate Bill 12 (Chapter 2016 -241), for implementation July 1, 2017. ITEM BACKGROUND: In 2016 Senate Bill 12 relating to mental health and substance abuse, was approved, providing amendments to Florida Statute Chapter 394, Mental Health. Under F. S. 394.4573, counties along with the managing entity and community stakeholders are to plan a designated receiving system. The plan is to be completed and implemented by July 1, 2017. On March 2, 2017 South Florida Behavioral Health Network (SFBHN) held a Monroe County SB 12 Planning meeting with community members and providers (attendance roster attached). As a result of the meeting an action plan for a Centralized Receiving System for Monroe County was developed. Attached is the Designated Receiving System Plan and background information including the March 2nd meeting agenda and the referenced statute. PREVIOUS RELEVANT BOCC ACTION: Monroe County annually provides required matching funds for substance abuse and mental health services including transportation. CONTRACT /AGREEMENT CHANGES: No STAFF RECOMMENDATION: Approval DOCUMENTATION: 5 -17 -17 Agenda Backup -MC Designate Receiving System Plan FINANCIAL IMPACT: Effective Date: 07/01/2017 Expiration Date: N/A Total Dollar Value of Contract: N/A Total Cost to County: $0 Current Year Portion: N/A Budgeted: N/A Source of Funds: N/A CPI: No Indirect Costs: No Estimated Ongoing Costs Not Included in above dollar amounts: N/A Revenue Producing: No Grant: No County Match: N/A Insurance Required: N/A Additional Details: If yes, amount: None. REVIEWED BY: Christine Limbert Maria Slavik Tina Boan Kathy Peters Board of County Commissioners Completed 04/21/2017 4:28 PM Completed 04/21/2017 4:32 PM Completed 05/01/2017 4:10 PM Completed 05/01/2017 4:21 PM Pending 05/17/2017 9:00 AM Monroe County Designated Receiving System Plan In accordance with Florida Statute 394, Florida Mental Health Act Florida Statute 397, Hal S. Marchman Alcohol and Other Drug Services Act 2017 -2020 Monroe County DRS Plan Page 1 of 24 Contents I. Background/ Purpose: ............................................................................................................. 3 II. Monroe County's Designated Receiving System ( DRS) ..................... ............................... 4 III. Inventory of Participating Service Providers ........................................ ............................... 6 IV. Designated Receiving System (DRS) Agreements ............................... ............................... 8 Attachment A — Process Flow for Centralized Receiving System Monroe ..... ............................... 9 Attachment B — Transportation Plan Monroe ................................................ ............................... 10 Attachment C — Agreements .......................................................................... ............................... 15 Attachment D — Sign In Sheet Monroe County Public Meeting ................... ............................... 24 Monroe County DRS Plan Page 2 of 24 I. Background/ Purpose: In accordance with the changes promulgated by Senate Bill 12 to Florida Statute 394 (Florida Mental Health Act, commonly referred to as the "Baker Act "), and Florida Statute 397 (commonly referred to as the Marchman Act), Monroe County in collaboration with South Florida Behavioral Health Network (the Managing Entity) have completed this Designated Receiving System (DRS) Plan. Implementation of this plan assures the coordinated provision of emergency services for people in need of help for behavioral health disorders and supports a comprehensive behavioral system of care. This DRS Plan describes how the community shall ensure the provision of the "No Wrong Door Model" defined in FS 394.4573. This description includes the organization of the DRS and how it responds to individual needs and integrates services among various providers. The designated receiving system may be organized in any manner which functions as a no- wrong -door model. Such models include, but are not limited to: A central receiving system is identified as a system that consists of a designated central receiving facility that serves as a single entry point for persons with mental health or substance use disorders, or co- occurring disorders. The central receiving facility shall be capable of assessment, evaluation, and triage or treatment or stabilization of persons with mental health or substance use disorders, or co- occurring disorders. A coordinated receiving system as a system that consists of multiple entry points that are linked by shared data systems, formal referral agreements, and cooperative arrangements for care coordination and case management. Each entry point shall be a designated receiving facility and shall, within existing resources, provide or arrange for necessary services following an initial assessment and evaluation. A tiered receiving system consists of multiple entry points, some of which offer only specialized or limited services. Each service provider shall be classified according to its capabilities as either a designated receiving facility or another type of service provider, such as a triage center, a licensed detoxification facility, or an access center. All participating service providers shall, within existing resources, be linked by methods to share data, formal referral agreements, and cooperative arrangements for care coordination and case management. o The DRS may be organized in any manner that functions as a No- Wrong -Door Model that responds to individual needs and integrates the services of various providers. Monroe County DRS Plan Page 3 of 24 The County and the Managing Entity shall review and update, as necessary, the designated receiving system at least once every 3 years. An accurate inventory of the participating service providers shall be maintained and made available at all times to all first responders in the service area. II. Monroe County's Designated Receiving System (DRS) Monroe County's Designated Receiving System is best described as a centralized receiving system. In Monroe County, there are 2 designated receiving facilities which are both publicly funded (Guidance Care Center, Inc. and Lower Keys Medical Center). SFBHN currently funds a total of 12.80 beds at these public receiving facilities — 10.92 are CSU beds and 1.88 are DETOX beds. The following are the number of funded beds at each facility, by type: • Guidance Center Center, Inc. — 9.10 Adult CSU beds 1.88 DETOX beds • Lower Keys Medical Center — 1.82 Adult CSU beds *Note: Contract bed totals are subject to change due to rate enhancements. The County's approach to develop the designated receiving system for Monroe County is one that attempts to maintain the current process for Baker Acts for law enforcement, so that they are transporting Baker Acts to the nearest most appropriate receiving facility (as is the case currently). This is consistent with the requirement in Senate Bill 12 to ensure that there is a "no wrong door" approach for acute care services. SFBHN held a public meeting in Monroe County for input and will continue to receive feedback from the stakeholders on the continued implementation of the Designated Receiving System through its community needs process. The sign in sheet for the public meeting can be found in Attachment D. SFBHN has identified the Guidance /Care Center as the provider that will be designated as the central receiving facility for the centralized receiving system, described above. Consumer is taken by Law Enforcement to the nearest receiving facility, which is the centralized receiving system: The consumer can be referred to the centralized receiving system through multiple entry points: as a transfer from other facilities (such as jails /prisons, courts or hospitals), as a self - referral, as a consumer that is picked up by law enforcement for a Baker Act/Marchman Act, etc. If the consumer is referred to the centralized receiving system because he /she is picked up by law enforcement as a result of a Baker Act, then he /she is taken to the nearest receiving facility (public /private). If the nearest receiving facility is a public receiving facility, then the consumer will be screened for both behavioral health and financial eligibility (indigent vs. private pay). If that consumer meets acute care criteria and there is capacity at that public receiving facility, then he /she will be accepted, stabilized and treated. Once the person is stabilized, if the consumer is Monroe County DRS Plan Page 4 of 24 determined to be indigent, then the designated receiving facility will create a discharge plan, which includes a recommended level of care. The consumer will also be screened for care coordination through SFBHN. If that consumer meets criteria for care coordination, then a referral will be made to SFBHN's Care Coordination Department. If the person does not meet criteria for care coordination, then a referral will be made to an SFBHN provider that has the recommended level of care within their treatment continuum. If it is determined that the consumer meets acute care criteria, but the public receiving facility doesn't have capacity, then the public receiving facility will coordinate a transfer to another receiving facility that has capacity. It is important to note that if the consumer is a Baker Act, then the law allows for the receiving facility to keep that consumer as long as they do not go over 10% of their licensed bed capacity. However, if the consumer is a Marchman Act, which does not allow for that flexibility should the receiving facility be at licensed capacity, then the receiving facility must coordinate the transfer of that consumer to another public receiving facility and /or hospital that has capacity. If it is determined (through the screening process) that the consumer does not meet criteria for acute care, then the public receiving facility will determine the recommended level of care for that consumer. If the recommended level of care is one that is actively managed by SFBHN (Short-term Residential Treatment (SRT), Residential treatment), then SFBHN's Adult System of Care Department will be contacted in order to coordinate that referral. If the recommended level of care for that indigent consumer is not actively managed by SFBHN, then the receiving facility will contact the SFBHN provider directly. Referrals will be made to best match the consumers with their needs and geographic preference. If no preference or specific needs are noted, then referrals are made on a rotating basis. All referrals that come through the centralized receiving system will be well documented and will available for review to SFBHN. Consumer is taken by Law Enforcement to the nearest receiving facility, which is a private receiving facility: If the consumer is referred to the centralized receiving system because he /she is picked up by law enforcement as a result of a Baker Act, then he /she is taken to the nearest receiving facility (public /private). If the nearest receiving facility is a private receiving facility, then he /she will be screened to determine if he /she meets acute care criteria. If he /she meets criteria, then the consumer will remain at the private receiving facility and will be stabilized and treated. A discharge plan will be made by the private receiving facility, which includes a recommended level of care. If it is determined that the consumer is an indigent consumer and meets acute care criteria, then a consumer may be transferred to the centralized receiving system for continued acute care services and /or referral to lower level of care services. Consumer is self - referred for any publically funded service: Monroe County DRS Plan Page 5 of 24 If the consumer is seeking publically funded services, the consumer can access care through the centralized receiving facility. The centralized receiving facility has satellite offices throughout Monroe County which allows for screening and level of care assessment. Based on the consumers identified needs, the facility will make referrals accordingly including for acute care services if necessary. A Process Flow of the Centralized Receiving System is found in Attachment A. The Transportation plan that outlines how consumers needing acute care are transported can be found in Attachment B. HI. Inventory of Participating Service Providers Voluntary Assessment and Evaluation Facilities Facility Capabilities/Limitations Does the facility Substance Use have agreements to Disorders/Mental accept DRS Health Patients? Disorders /Co- Occurring? Guidance Care CSU, Detox, Screening Yes - pending Yes Center, Inc. & Assessment Lower Keys CSU Only No Yes Medical Center Involuntary Assessment and Evaluation Facilities Facility Capabilities/Limitations Does the facility Substance Use have agreements to Disorders/Mental accept DRS Health Patients? Disorders /Co- Occurring? Guidance Care CSU, Detox, Screening Yes - pending Yes Center, Inc. & Assessment Lower Keys CSU Only No Yes Medical Center Triage Centers for Mental Health Facility Capabilities/Limitations Does the facility Substance Use have agreements to Disorders/Mental Monroe County DRS Plan Page 6 of 24 Monroe County DRS Plan Page 7 of 24 accept DRS Health Patients? Disorders /Co- Occurring? Guidance Care Yes - pending Yes - pending Yes Center, Inc. Lower Keys CSU Only No Yes Medical Center Triage Centers for Substance Use Disorders Facility Capabilities/Limitations Does the facility Substance Use have agreements to Disorders/Mental accept DRS Health Patients? Disorders /Co- Occurring? Guidance Care CSU, Detox, Screening Yes - pending Yes Center, Inc. & Assessment Involuntary Treatment for Mental Health Disorders Facility Capabilities/Limitations Does the facility Substance Use have agreements to Disorders/Mental accept DRS Health Patients? Disorders /Co- Occurring? Guidance Care CSU, Detox, Screening Yes - pending Yes Center, Inc. & Assessment Lower Keys CSU Only No Yes Medical Center Involuntary Treatment for Substance Use Disorders Facility Capabilities/Limitations Does the facility Substance Use have agreements to Disorders/Mental accept DRS Health Patients? Disorders /Co- Occurring? Monroe County DRS Plan Page 7 of 24 Guidance Care Center, Inc. CSU, Detox, Screening & Assessment Yes - pending Yes IV. Designated Receiving System (DRS) Agreements Through SFBHN's Acute Care Data System partners can share data and be aware of available beds in the Centralized Receiving System. SFBHN has been working with Knight Software (KIS) to expand the current service data system to fully integrate Utilization Management, Acute Care reporting and Financial Reporting into one, cohesive application. The KIS Integrated Solution has been developed with the goal to improve the clinical and psychosocial outcomes of stakeholders within the mental healthcare system by providing a system for securely sharing clinical and psychosocial information across authorized healthcare providers to facilitate coordination of care and improve outcomes. The first phase of the new KIS Utilization Management system was implemented effective March 1, 2016. The system is currently capturing adult screening and assessment data. The second phase of referral and bed management is currently in development. The KIS Integrated Solution will allow providers within the network to enroll consumers, record clinical and other psychosocial history, coordinate their care through management of referrals and shared access to the clinical information, and document the outcomes of care. A full description of the data functions can be found in SFBHN's Information Technology (IT) Plan and is available at "rw" , , st1)fm.or . Network providers have individual contracts and executed Business Associate Agreements (BAAs) through their main contract with SFBHN which allows for data sharing and coordination of care. Providers collaborate with SFBHN and each other to ensure consumers are linked to services. Agreements can be found in Attachment C. Monroe County DRS Plan Page 8 of 24 Attachment A — Process Flow for Centralized Receiving System Monroe -Page Left Intentionally Blank- Monroe County DRS Plan Page 9 of 24 I Monroe County ONLY Consumer picked up by Law jails /prissonsona, , c courttsa, , hospitals) Transfers. ot facilities„ Iij Consumer Self - Referral ll Enforcement (LE)for Baker/ .r Marchman Acts Taken to Taken to Consumer screened for both Centralized nearest 6ehadioral health and - - - - - -- Receiving f recolal eligibility Receiving c- -,,,, 0111( Facility 312 requires "no wrong our" for cute care services. — pri.— for LF will remain re sarresoasto eliminate Istance traveled. In addition, re single law enforcement .—Cy /ambulance would >ntinue to Poll —the xis[i ng (as modified) Lk— �Doea the cons, met. �' meet criteria for acute ou reP tuber of new admissions in FY 15 -16 in ,consumer have, mroe County insurance /other Yes c urce of . _.:.p4Ym'91" cial Screenera yes ult Mental Health. 1,680 4 ult Substance Abuse: 428 5738,60_' ildren's Mental Health: 225 No $110.724 ildren's Substance Abuse: 151 provider 'Meets Criteria for Acute Care' yes .1.1zott bees the CR No F provider have —► No capacity? - Consul er transferred to another receiving facility that has capacity Does the consumer ri criteria for Care Coordination (Cl If level of care is - 1hlat1sthe' managed by recommended _ SFBHN (SRT, - {@vel of care?'' Residential), ° - - contact SFBHN If level of care i5 not managed by SFBHN, —tact provider directly r of new SFBHN ,or, in FY 15 -16 in Monroe County 1,347 n: 314 Legend_ Process Subprc�ess Decision' Point Potential C enof Add ol—I Info. p $tart /End Yes /No I Consumer I I remains at facility for services Past discharge, consumer could be referred to CRT or private provider for lower level of care services .Qaes tha Wings for Incraaeed volume ,consumer have, ilato'y servlCes: insurance /other Yes c urce of . _.:.p4Ym'91" cial Screenera 28 FTFa 5112,008 arge planners 2.8 FTEs $1a' OOC 4 28 FTEs $ 92. erage 5738,60_' 3ti ng [209x} Refer to No $110.724 private provider and /or CRF onant SFBHN resonrces available to fun, 51,294,903 x - $ 183,643 Support - $ 104,277 smenl 5 758,267 Available: $1,841,090 funded heds: 10,92 AMU] 7X funded heds: 1,88 ASA I funded beds: 12.817' to: This is subject to change due to rate enhancements enal resources needed ec fund CFF Wings for Incraaeed volume expected for ilato'y servlCes: local Clinical Assessors 4.2 rTEs 5210,0_3 cial Screenera 28 FTFa 5112,008 arge planners 2.8 FTEs $1a' OOC 28 FTEs $ 92. erage 5738,60_' 3ti ng [209x} $135,,05 Fringe toy') $110.724 Cost for 1 cnr $ 942,515 Monroe County DRS Plan Page 10 of 24 Attachment B — Transportation Plan Monroe Transportation Plan for Baker Act and Marchman Act Involuntary Examinations Department of Children and Families Circuit 16 (Monroe County) This transportation plan shall describe methods of transport to a facility within the designated receiving system for individuals subject to involuntary examination under the Baker Act s. 394.463 or involuntary admission under the Marchman Act s. 397.6772, s. 397.679, s. 397.6798, or s. 397.6811. When any law enforcement officer has custody of a person based on either noncriminal or minor criminal behavior that meets the statutory guidelines for involuntary examination pursuant to s. 394.463, the law enforcement officer shall transport the person to the appropriate facility within the designated receiving system pursuant to a transportation plan or an exception or to the nearest receiving facility if neither apply. Persons who meet the statutory guidelines for involuntary admission pursuant to s. 397.675 may also be transported by law enforcement officers to the extent resources are available and as otherwise provided by law. Such persons shall be transported to an appropriate facility within the designated receiving system pursuant to a transportation plan or an exception or to the nearest facility if neither apply. The Florida Mental Health Act, usually referred to as "The Baker Act," states that a person may be taken to a receiving facility for involuntary examination if there is reason to believe that the person has a mental illness and because of his or her mental illness: The person has refused voluntary examination after conscientious explanation and disclosure of the purpose of the examination; or the person is unable to determine for himself or herself whether examination is necessary; and without care or treatment, the person is likely to suffer from neglect or refuse to care for himself or herself, such neglect or refusal poses a real and present threat of substantial harm to his or her well- being; and it is not apparent that such harm may be avoided through the help of willing family members or friends or the provision of other services; or there is a substantial likelihood that without care or treatment the person will cause serious bodily harm to himself or herself or others in the near future, as evidenced by recent behavior. The Marchman Act is the Florida Substance Abuse Impairment Act which requires that a person who meets the criteria for involuntary admission if there is good faith reason to believe that the person is substance abuse impaired or has a co- occurring mental health disorder and, because of such impairment or disorder: Has lost the power of self - control with respect to substance abuse; and is in need of substance abuse services and, by reason of substance abuse impairment, his or her judgment has been so impaired that he or she is incapable of appreciating his or her need for such services and of making a rational decision in that regard, although mere refusal to receive such services does not constitute evidence of lack of judgment with respect to his or her need for such services; or Monroe County DRS Plan Page 11 of 24 without care or treatment, is likely to suffer from neglect or refuse to care for himself or herself, that such neglect or refusal poses a real and present threat of substantial harm to his or her well- being; and that it is not apparent that such harm may be avoided through the help of willing family members or friends or the provision of other services, or there is substantial likelihood that the person has inflicted, or threatened to or attempted to inflict, or, unless admitted, is likely to inflict, physical harm on himself, herself, or another. The law requires that each county shall designate a single law enforcement agency within the county, or portions thereof, to take a person into custody upon the entry of an ex parte order or the execution of a certificate for involuntary examination by an authorized professional and to transport that person to the appropriate facility within the designated receiving system pursuant to this transportation plan. The law enforcement agency may decline to transport the person to a receiving facility only if: a. The jurisdiction designated by the county has contracted on an annual basis with an emergency medical transport service or private transport company for transportation of persons to receiving facilities pursuant to this section at the sole cost of the county; and b. The law enforcement agency and the emergency medical transport service or private transport company agree that the continued presence of law enforcement personnel is not necessary for the safety of the person or others. The Monroe County Sherriff s Department and City of Key West Police Department provide transportation of consumers under the Baker Act and /or Marchman Act throughout Monroe County. Monroe County Transportation Plan guidelines for Baker Act: If a law enforcement officer believes that a person has an emergency medical condition as defined in s. 395.002, the person should be first transported to a hospital for emergency medical treatment, regardless of whether the hospital is a designated receiving facility or part of the centralized receiving system. Law enforcement should transport consumers meeting the requirements for an involuntary examination under the Baker Act to the nearest receiving facility, unless the consumer is an inmate, at which time, law enforcement should transport the consumer directly to the Central Receiving Facility (Guidance Care Center, Inc.). A list of Monroe County designated receiving facilities that can provide medical examination and treatment of persons for whom an involuntary examination has been initiated under the Baker Act can be found in Appendix A. Monroe County Transportation Plan guidelines for Marchman Act: If a law enforcement officer believes that a person has an emergency medical condition as defined in s. 395.002, the person should be first transported to a hospital for emergency medical treatment, regardless of whether the hospital is a designated receiving facility or part of the centralized receiving system. Monroe County DRS Plan Page 12 of 24 Law enforcement should transport consumers (Adults and Minors) under the Marchman Act to the nearest Addiction Receiving Facility. A list of Monroe County designated receiving facilities that can provide medical examination and treatment of persons for whom an involuntary examination has been initiated under the Marchman Act can be found in Appendix A. Monroe County DRS Plan Page 13 of 24 Appendix A Designated Receiving Facilities The following is a list of Monroe County psychiatric facilities designated by the Florida Department of Children and Families to receive and hold persons with mental illness for involuntary examination and short-term treatment. This list is subject to change from time to time as new facilities are designated and others are closed or have their designations removed. Public Receiving Facilities Guidance Care Center 3000 41 Street Ocean, Marathon 305- 434 -7660 Lower Fl. Keys Health System (DePoo Hospital) 1200 Kennedy Drive Key West, Florida 33040 (305) 294 -5531 Addiction Receiving Facilities The following is a list of Monroe County Addiction Receiving Facilities (ARFs) designated by the Florida Department of Children and Families to receive and hold persons under a Marchman Act for involuntary examination and short-term treatment. This list is subject to change from time to time as new facilities are designated and others are closed or have their designations removed. Guidance Care Center (ARF & Inpatient Detox) 3000 41 Street Ocean, Marathon 305- 434 -7660 Monroe County DRS Plan Page 14 of 24 Attachment C — Agreements BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement ( "Agreement ") is entered into by and between South Florida Behavioral Health Network, Inc. ( "SFBHN') and «Legal Company Name » (individually each a "Party" or "Associate" and collectively the "Parties" or the "Associates "). The Effective Date of this Agreement shall be July 1, 2016 ( "Agreement Effective Date "). RECITALS A. SFBHN and ((Legal—Company—Name)), are each deemed to be Covered Entities under the Health Insurance Portability and Accountability Act ( "HIPAA ") and may, from time to time, each act as a Business Associate on behalf of the other to provide services in accordance with one or more agreements (the "Underlying Agreements "). A. SFBHN is deemed to be a Business Associate under the Prime Contract with the Florida Department of Children and Families and obligated to comply with HIPAA, the HITECH Act, and any regulations promulgated thereunder, with respect to the PHI it creates, maintains, receives, or transmits on behalf of ((Legal Company Name » . B. ((Legal Company Name » acknowledges that all provisions, terms and conditions, or amendments, addendum, changes or revisions applicable to the ((Legal Company Name » made subsequent to the initial execution of the Prime Contract, (Contract entered into between the Florida Department of Children and Families) and SFBHN, not in conflict with this Business Associate Agreement shall be binding upon the ((Legal Company Name » and the ((Legal Company Name » agrees to comply with same. The Prime Contract is incorporated by reference in this Business Associate Agreement. C. The Associates both acknowledge that they are each obligated to comply with the Privacy Rule, the Security Rule, the Breach Notification Rule, the Health Information Technology for Economic and Clinical Health ( "HITECH ") Act, s. 501.171, F.S., and other laws and regulations pertaining to the access, use, disclosure, and management of Protected Health Information ( "PHI ") without limitation, PHI in an electronic format (EPHI). D. In the event that either Party (or both Parties) is a Program, as defined by the federal regulations governing the Confidentiality of Alcohol and Drug Abuse Patient Records, at 42 CFR Part 2 (the "Substance Abuse Regulations "), the Underlying Agreements may also require each of the Parties to create, receive, transmit, or maintain patient information on behalf of the other that is subject to the Substance Abuse Regulations. As such, the Associates further acknowledge that they are each obligated to comply with those regulations, with respect to a Program's patient information. E. The Associates intend to protect the privacy and provide for the security of patient information, including PHI, pursuant to this Agreement, and all in compliance with Applicable Law. Monroe County DRS Plan Page 15 of 24 F. The Parties acknowledge that this Agreement supplements and amends each of the Underlying Agreements only with respect to the creation, use, or disclosure of patient information, including PHI. Except as so supplemented or amended, the terms of the Underlying Agreements shall govern the matters addressed in this Agreement and in each of the Underlying Agreements. NOW, THEREFORE, in consideration of the mutual promises below, the Parties agree as follows: Section 1. Definitions Capitalized terms used in this Agreement and not otherwise defined herein shall have the meanings set forth in the HIPAA Rules, which definitions are incorporated in this Agreement by reference. Capitalized terms used in this Agreement are defined as follows: a. " Applicable Law means HIPAA, the HITECH Act, and all regulations issued thereunder, as well as the Substance Abuse Regulations and any other applicable federal and state law. b. " Breach " shall have the meaning given to such term under the Breach Notification Rule, including, but not limited to, 45 CFR § 164.402. c. " Breach Notification Rule shall mean the Breach Notification Standards at 45 CFR Parts 160 and 164. d. " Business Associate shall have the same meaning as given to such term in 45 CFR § 160.103. e. " Covered Entity shall have the same meaning as given to such term in 45 CFR § 160.103. f. " Electronic Protected Health Information or " ePHI " shall have the meaning given to such term under the HIPAA Rules, including, but not limited to, 45 CFR § 160.103, as applied to the information that each Associate creates, maintains, receives from, or transmits on behalf of the other Associate. g. " Enforcement Rule shall mean the Compliance and Enforcement Standards at 45 CFR Part 160. h. " HIPAA " means the Health Insurance Portability and Accountability Act of 1996 ( "HIPAA "), Public Law No. 104 -191, and any regulations promulgated thereunder. i. " HIPAA Rules shall mean the Privacy, Security, Breach Notification, Enforcement, and Transaction Rules at 45 CFR Parts 160, 162, and 164. " HITECH Act means the Health Information Technology for Economic and Clinical Health ( "HITECH ") Act, Public Law No. 111 -005, and any regulations promulgated thereunder. k. " Privacy Rule shall mean the Standards for Privacy of Individually Identifiable Health Information at 45 CFR Parts 160 and 162 and Part 164, Subparts A and E, 42 U.S.C. 1320d -5 and 1320d -6. Monroe County DRS Plan Page 16 of 24 I. " Program " shall have the same meaning as given to such term in 42 CFR § 2.11. m. " Protected Health Information" or "PHI shall have the same meaning given to such term under the HIPAA Rules, including, but not limited to, 45 CFR § 160.103, as applied to the information created or received by each Associate from, or on behalf of, the other Associate. n. " Required by Law shall have the same meaning as given to such term in 45 CFR § 164.103. o. " Secretary " shall mean the Secretary of the Department of Health and Human Services or his or her designee. p. " Security Rule shall mean the Security Standards at 45 CFR Parts 160 and 162 and Parts 164, Subparts A and C. q. " Subcontractor " shall have the same meaning as given to such term in 45 CFR § 160.103. r. " Substance Abuse Regulations shall mean the Confidentiality of Alcohol and Drug Abuse Patient Records regulations, at 42 CFR Part 2. s. Transaction shall have the same meaning given to such term under the Transaction Rule, including, but not limited to, 45 CFR § 160.103. t. " Transaction Rule shall mean the Standards for Electronic Transactions at 45 CFR Parts 160 and 162. u. " Unsecured PHI shall have the same meaning given to such term, as "unsecured protected health information," under the Breach Notification Rule, including but not limited to, 45 CFR § 164.402, as applied to the information created or received by each Associate from, or on behalf of, the other Associate. Section 2. Permitted Uses and Disclosures of PHI a. Uses and Disclosures of PHI Except as otherwise limited in this Agreement, Associates may each use or disclose PHI received from or created on behalf of the other Associate only to perform such functions, activities, or services for, or on behalf of, each other pursuant to the Underlying Agreements. b. Permitted Uses of PHI by Associates Except as otherwise limited in this Agreement, Associates may each use the PHI received from or created on behalf of the other Associate (i) for their respective proper management and administration, (ii) to carry out their respective legal responsibilities; and (iii) for Data Aggregation purposes for the Health Care Operations of the other Associate. Associates may use PHI to create de- identified health information, in accordance with the HIPAA Rules at 45 CFR § 164.514, and may use such de- identified health information. C. Permitted Disclosures of PHI by Associates Except as otherwise limited in this Agreement, Associates may each disclose PHI (i) for their proper management and administration; (ii) to carry out their respective legal responsibilities; (iii) as Required by Law; and (iv) for Data Aggregation purposes for the Health Care Operations of the other Associate. If Monroe County DRS Plan Page 17 of 24 an Associate intends to disclose PHI to a third party, prior to making any such disclosure, such Associate shall first obtain, (i) reasonable written assurances from such third party that PHI will be held confidential in a manner that is consistent with the terms of this Agreement and will only be used or disclosed as Required by Law or for the purposes for which it was disclosed to such third party, and (ii) a written agreement from such third party to notify Associate of any breaches of confidentiality of the PHI, to the extent it has obtained knowledge of such breach, without unreasonable delay, and in any event within sufficient time to meet any breach notification requirements under the HIPAA Rules. Section 3. Obligations and Activities of Associates (as Business Associates) Associates shall each comply with all obligations and requirements for Business Associates under Applicable Law with respect to PHI, and shall have the following obligations: a. Appropriate Safeguards Associates shall each implement administrative, physical, and technical safeguards that reasonably and appropriately protect the confidentiality, integrity, and availability of PHI, in accordance with 45 CFR § 164.308, physical safeguards as set forth at 45 CFR § 164.310, and technical safeguards as set forth at 45 CFR § 164.312; including, policies and procedures regarding the protection of PHI and /or ePHI set forth at 45 CFR § 164.316 and the provisions of training on such policies and procedures to applicable employees, subcontractors, independent contractors, and volunteers, that reasonably and appropriately protect the confidentiality, integrity, and availability of the PHI and /or ePHI that the Provider creates, receives, maintains or transmits. Associates shall take immediate steps to limit or avoid recurrence of any security breach and take any other action pertaining to such unauthorized access or disclosure required by applicable federal and state laws and regulations regardless of any actions taken by SFBHN or The Florida Department of Children and Families. b. Reporting of Improper Use or Disclosure (i) Each Associate shall report to the other Associate, in writing, any use or disclosure of PHI not provided for by this Agreement, including any Breach of Unsecured PHI or any Security Incident of which it becomes aware as required at 45 CFR 164.410, and any security incident of which it becomes aware. (ii) ((Legal Company Name » shall provide notification to SFBHN Security Officer, Privacy Officer and Contract Manager as soon as possible, but no later than four (4) business days following the determination of any breach or potential breach of personal and confidential data. (iii) «LegalCompanyName» shall provide notification to SFBHN Privacy Officer and Contract Manager within twenty -four (24) hours of notification by the US Department of Health and Human Services of any investigations, compliance reviews or inquiries by the US Department of Health and Human Services concerning violations of HIPAA (Privacy, Security Breach). C. Data Breach Notification No later than four (4) business days following any breach affecting 500 or more individuals , either Associate shall provide to the other, in writing the elements as required by s. 501.171, F.S. to permit SFBHN to comply with the HIPAA Breach notification requirements set forth in the Prime Contract, 45 C.F.R. §§ 164.400, et seq., Monroe County DRS Plan Page 18 of 24 and in s. 501.171, F.S. Associates, as applicable, at its own cost, shall notice affected parties no later than thirty (30) days following the determination of any breach or potential breach of personal or confidential data as provided in § 817.5681, Fla. Stat. Following a HIPAA Breach (Privacy, Security Breach), each Associate will have a continuing duty to inform the other Associate of new and material information learned regarding the HIPAA Breach. d. Mitigation Procedures Each Associate agrees to mitigate, to the extent practicable, any harmful effect that is known to it of a use or disclosure of PHI by such Associate in violation of the requirements of this Agreement, or the HIPAA Rules. e. Subcontractors and Agents Each Associate shall ensure that any agent, including a Subcontractor, to whom it provides PHI, agrees (in writing) to the same restrictions and conditions that apply through this Agreement to such Associate with respect to such PHI. Associates shall implement and maintain sanctions against agents and Subcontractors that violate such restrictions and conditions, and shall attempt to mitigate the effects of any such violation. Each Associate and their Subcontractors and Agents are directly liable under the civil and criminal enforcement provisions set forth at Section 13404 of the HITECH Act and section 45 CFR § 164.500 and 164.502(E) of the Privacy Rule (42 U.S.C. 1320d -5 and 1320d -6), as amended, for failure to comply with the safeguards, policies and procedures requirements and any guidance issued by the Secretary of Health and Human Services with respect to such requirements f. Access to PHI Each Associate agrees to provide access to PHI in a Designated Record Set to the other Associate or, as directed by the other Associate, to an Individual, at the written request of the other Associate within a reasonable time and manner, sufficient to allow the other Associate to meet the requirements of 45 CFR § 164.524. Each Associate agrees to disclose PHI in electronic format to the other Associate or, as directed by the other Associate, to an Individual or an Individual's designee, as may be necessary to satisfy the other Associate's obligations under 45 CFR §§ 164.524(c)(2)(ii) and (3)(ii) regarding an individual's request for an electronic copy of PHI. g. Amendment of PHI Each Associate shall make any amendment(s) to PHI in a Designated Record Set that the other Associate directs or agrees to, pursuant to 45 CFR § 164.526, in a time and manner reasonably designated by the other Associate. h. Documentation of Disclosures Each Associate agrees to document such disclosures of PHI and information related to such disclosures as would be required for the other Associate to respond to a request by an Individual for an accounting of disclosures of PHI in accordance with 45 CFR § 164.528. i. Accounting of Disclosures Each Associate agrees to provide to the other Associate, within thirty (30) business days, information collected in accordance with Section 3(f) of this Agreement, sufficient to permit the other Associate to respond to a request by an Individual, or on behalf of an Individual, for an accounting of disclosures of PHI in accordance with 45 CFR § 164.528. j. Minimum Necessary Each Associate shall request, use, and disclose only the minimum amount of PHI necessary to accomplish the purpose of the request, use, or disclosure to the extent that the minimum necessary standard is applicable to the disclosure under 45 CFR § 164.502(b). Monroe County DRS Plan Page 19 of 24 k. Governmental Access to Records Each Associate agrees to make its internal practices, books, and records relating to the use and disclosure of PHI received from the other Associate, or created on behalf of the other Associate, available to the Secretary for purposes of determining either or both Associates' compliance with the HIPAA Rules. I. Standard Transactions If an Associate conducts, in whole or in part, any Transactions electronically on behalf of the other Associate, such Associate shall comply with the applicable requirements of 45 CFR Part 162 and shall require that any agents or Subcontractors that perform, in whole or in part, such Transactions on its behalf, agree in writing to comply with such requirements. Such Associate will not enter into any trading partner agreement in connection with conducting Standard Transactions on behalf of the other Associate: (i) that changes the definition, data condition, or use of a data element or segment in a Standard Transaction; (ii) adds any data element or segment to the maximum defined data set; (iii) uses any code or data element that is marked as "not used" in the Standard Transaction's implementation specification or is not in the Standard Transaction's implementation specification; or (iv) changes the meaning or intent of the Standard Transaction's implementation specification. m. Qualified Service Organization Agreement In the event that either Associate (or both Associates) is a Program, as defined by the Substance Abuse Regulations, each Associate agrees to provide the services, as described in the Underlying Agreements, and further (i) acknowledges that in receiving, storing, processing, or otherwise dealing with any information from a Program about the patients in the Program, it is fully bound by the provisions of the Substance Abuse Regulations; and (ii) agrees to resist in judicial proceedings any effort to obtain access to information pertaining to such patients otherwise than as expressly provided for in the Substance Abuse Regulations. Section 4. Oblieations of Associates (as Covered Entities). a. Notice of Privacy Practices Each Associate shall notify the other Associate of any limitation(s) in its notice of privacy practices, under 45 CFR § 164.520 and under s. 501.171, F.S. , to the extent that such limitation(s) may affect the other Associate's use or disclosure of PHI. b. Notification of Changes Regarding Individual Permission Each Associate shall notify the other Associate of any changes in, or revocation of, permission by an Individual to use or disclose PHI, to the extent that such changes may affect the other Associate's use or disclosure of PHI. C. Notification of Restrictions to Use or Disclosure of PHI Each Associate shall notify the other Associate of any restriction(s) imposed on the use or disclosure of PHI that such Associate has agreed to or is obligated to support in accordance with 45 CFR § 164.522, to the extent that such restriction may affect the other Associate's use or disclosure of PHI. The other Associate agrees to abide by such restriction to the extent applicable and provided that it is made aware of the restriction in a reasonable and timely manner. d. Permissible Requests bV Associates Neither Associate shall request the other Associate to use or disclose PHI in any manner that would not be permissible under Applicable Law if done by such Associate, except as permitted under this Agreement. e. Marketing, Fundraising and Research Each Associate shall follow guidance in the HIPAA Monroe County DRS Plan Page 20 of 24 Rule regarding marketing, fundraising and research located at Sections 45 CFR § 164.501, 45 CFR § 164.508 and 45 CFR § 164.514. Section 5. Term and Termination a. Term The term of this Agreement shall commence as of the Agreement Effective Date and shall terminate when all of the PHI provided by each Associate to the other Associate is destroyed or returned, or, if it is infeasible to return or destroy the PHI, protections are extended to such information, in accordance with Section 5(c), or when one party gives the other fifteen (15) calendar days notification of termination in writing to the other party or such time as mutually agreed upon by both parties. b. Termination for Cause A breach by either Associate of any provision set forth in Sections 2, 3 or 4 of this Agreement may, in the sole discretion of the other Associate, be deemed to constitute a material breach of this Agreement if such breach is not cured, or a plan is not enacted to enable a cure, within thirty (30) business days of receiving written notice from the non - breaching Associate. Upon occurrence of such material breach, the non - breaching Associate may immediately terminate this Agreement, notwithstanding any provision in this Agreement to the contrary. C. Effect of Termination (i) Except as provided in paragraph (ii) of this Section 5(c), upon termination of this Agreement for any reason, each Associate shall return or destroy all PHI received from the other Associate, or created or received by each Associate on behalf of the other Associate, and shall retain no copies of the PHI. Each Associate agrees to impose the same obligations to return or destroy PHI, in writing, on each of its Subcontractors or agents to the extent they are or may be expected to come into possession of such PHI. (ii) In the event that an Associate determines that returning or destroying the said PHI is infeasible, such Associate shall provide notification of the conditions that make return or destruction infeasible to the other Associate and shall extend the protections of this Agreement to such PHI and limit further uses and disclosures of such PHI to those purposes that make the return or destruction infeasible, for so long as such Associate maintains such PHI. Section 6. Indemnification Each Associate (the "Indemnifying Associate ") will indemnify, defend, and hold harmless the other Associate (the "Indemnified Associate ") from any and all claims, losses, liabilities, damages, judgments, fees, expenses, awards, civil monetary penalties, and costs (including reasonable attorneys' and court fees and expenses) arising out of or related to any Breach or alleged Breach of Unsecured PHI created, received, maintained, transmitted, or otherwise used by the Indemnifying Associate and arising from the Indemnifying Associate's breach, or failure to perform pursuant to this Agreement (collectively, a "Claim "). This indemnification does not cover any claims, losses, liabilities, damages, judgments, fees, expenses, awards, civil monetary penalties, and costs resulting from the negligence or willful misconduct of the Indemnified Associate, or any of Indemnified Associate's employees, contractors, or agents (except Indemnifying Associate). This indemnification is contingent upon (i) Indemnified Associate giving prompt written notice to Indemnifying Associate of any Claim for which indemnification is sought, and (ii) Indemnified Associate giving Indemnifying Associate sole control of the defense, including selection of Monroe County DRS Plan Page 21 of 24 counsel, and related settlement negotiations regarding the Claim, except that Indemnifying Associate will not enter into a final settlement involving discharge of any claims against Indemnified Associate without Indemnified Associate's prior consent. Indemnified Associate may participate in the defense of any Claim at Indemnified Associate's own cost. Indemnified Associate agrees that it will assist and cooperate in the defense and related settlement of the Claim, at its expense, as the Indemnifying Associate may reasonably request. Section 7. Regulatory References A reference in this Agreement to a section in the HIPAA Rules, the Substance Abuse Regulations, or any other Applicable Law means the section as in effect or as amended, and for which compliance is required by either or both Associates. Section 8. Amendment. The Parties agree to take such action to amend this Agreement from time to time as is necessary for both to comply with Applicable Law. Such amendment shall be in writing and signed by both the Parties. Section 9. Survival. The respective rights and obligations of the Parties under Section 5(c) and Section 6 of this Agreement shall survive the termination of the Agreement. Section 10. No Third Party Beneficiaries Nothing express or implied in this Agreement is intended to confer, nor shall anything herein confer, upon any person other than the Parties and their respective successors or assigns, any rights, remedies, obligations or liabilities whatsoever. Section 11. Interpretation Any ambiguity in this Agreement shall be resolved in favor of a meaning that permits the Parties to comply with Applicable Law. Section 12. Waiver No delay or omission by either Party to exercise any right or remedy under this Agreement will be construed to be either acquiescence or the waiver of the ability to exercise any right or remedy in the future. Section 13. Severability In the event any part or parts of this Agreement are held to be unenforceable, the remainder of this Agreement shall continue in effect. Section 14. Governing Law. This Agreement shall be governed by the laws of Florida IN WITNESS WHEREOF, the Parties hereto have duly executed this Agreement as of the Agreement Effective Date. «Legal_Company_Name_» SOUTH FLORIDA BEHAVIORAL HEALTH NETWORK, INC. SIGNED SIGNED BY: BY: NAME: «ContractSigner» NAME: John W. Dow Monroe County DRS Plan Page 22 of 24 TITLE: ((Signer Title>> Date: Federal Tax ID# (or SSN): «Fed ID» TITLE: President and CEO Date: Monroe County DRS Plan Page 23 of 24 Attachment D — Sign In Sheet Monroe County Public Meeting Monroe County DRS Plan Page 24 of 24 + ti : i i !. • / � e ) r !� � r . r _ � f � ._ � : • ... � �• - .. _ +•. � !I�'� 1 •tij 7 •� � r li�� �.I;lrl[ it ;/ I 1 -. Monroe County DRS Plan Page 24 of 24 Monroe County Provider Visits Friday, March 3,2017 AGENDA -11wo. -p - r 9 0am — Volunteers of America I 0:00arn — Florida Keys Outreach Coalition (FKOC) 11:30 am — Guidance Care Center (GCC) CSU Marath] Statutes & Constitution :View Statutes : Online Sunshine Page I of 3 ..................... Select Year: 2016 v Go .......... The 2016 Florida Statutes department's evaluation of each plan. (1) As used in this section: monitor service delivery, and evaluate patient outcomes to ensure the client is receiving the appropriate services. (c) "Coordinated system of care" means the full array of behavioral and related services in a region or community offered by all service providers, whether participating under contract with the managing entity or by another method of community partnership or mutual agreement. (d) "No-wrong-door model" means a model for the delivery of acute care services to persons who have mental health or substance use disorders, or both, which optimizes access to care, regardless of the entry point to the behavioral health care system. (2) The essential elements of a coordinated system of care include: (a) Community interventions, such as prevention, primary care for behavioral health needs, therapeutic and supportive services, crisis response services, and diversion programs. (b) A designated receiving system that consists of one or more facilities serving a defined geographic area and responsible for assessment and evaluation, both voluntary and involuntary, and treatment or triage of patients who have a mental health or substance use disorder, or co-occurring disorders, Statutes & Constitution :View Statutes: Online Sunshine care, and criminal and juvenile justice organizations. (g) Outpatient services, (h) Residential services. (i) Hospital inpatient care. (j) Aftercare and other postdischarge services. Page 2 of 3 . I 111111 I; 11111 1111 # Copyright ci 1995-2017 The Florida Legislature - Privacy Statement - Contact Us http://www.leg.state.fl.us/STATUTES/index.cfm?App.mode=Display Statute&Search 312812017 THE FLORIDA SENATE 2016 SUMMARY OF LEGISLATION PASSED Committee on Children, Families, And Elder Affairs CS /SB 12 — Mental Health and Substance Abuse by Appropriations Committee and Senators Garcia, Galvano and Ring The bill addresses Florida's system for the delivery of behavioral health services. The bill provides for mental health services for children, parents, and others seeking custody of children involved in dependency court proceedings. The bill identifies the components of a coordinated system of care to be provided for individuals with mental illness or substance use disorder and defines a "No Wrong Door" model for accessing care. The Agency for Health Care Administration (AHCA) and the Department of Children and Families (DCF) are directed to modify licensure requirements through the rulemaking process if possible, to create an option for a single, consolidated license to provide both mental health and substance use disorder services. For modifications requiring statutory revisions, the agency and the department shall produce a plan for consolidation to the Legislature by November 1, 2016. Additionally, by December 31, 2016, AHCA and DCF are directed to develop a plan to increase federal funding for behavioral health care; compile detailed documentation of the cost and reimbursements for Medicaid covered services provided to Medicaid eligible individuals by providers of behavioral health care services. If the report provides clear and convincing evidence that Medicaid reimbursements are less than the costs of providing services, the agency and the department shall request additional trust fund authority necessary to draw down Medicaid funds as a match for the documented general revenue expenditures supporting covered services delivered to eligible individuals. To more closely align the Baker Act (mental illness) and Marchman Act (substance abuse), the bill modifies the legal procedures and timelines, as well as processes for assessment, evaluation, and provision of services. The duties and responsibilities of DCF are revised for the contract and oversight of the managing entities'. The duties and responsibilities of the managing entities are also revised. The new duties include, among others, the requirement to conduct a community behavioral health care needs assessment every three years in the geographic area served by the managing entity; determine the optimal array of services to meet the needs identified in the needs assessment and develop strategies to divert people with mental illness or substance use disorder from the criminal justice system and collaborate with the Department of Juvenile Justice and the state court system to integrate behavioral health services with the child welfare system. ' See s. 394.9082, F. S. A managing entity is a not - for -profit corporation organized in Florida which is under contract with DCF on a regional basis to manage the day -to -day operational delivery of behavioral health services through an organized system of care and a network of providers who are contracted with the managing entity to provide a comprehensive array of emergency, acute care, residential, outpatient, recovery support, and consumer support services related to behavioral health. This summary is provided for information only and does not represent the opinion of any Senator, Senate Officer, or Senate Office. CS /SB 12 Page: 1 Committee on Children, Families, 2016 Summary of Legislation Passed And Elder Affairs By September 1 of each year, beginning in 2017, each managing entity is required to develop and submit a plan to the department describing the strategies for enhancing services and addressing three to five priority needs in the service area. The plans must be developed with input from consumers and their families, local governments, local law enforcement agencies, and other stakeholders. The department is directed to update the crisis stabilization services utilization database. The database is renamed the acute care services utilization database. Managing entities are required to collect utilization data from all public receiving facilities situated within its geographical service area and all detoxification and addictions receiving facilities under contract with the managing entity. The bill allows a crisis stabilization unit, a short-term residential treatment facility, or an integrated adult mental health crisis stabilization and addictions receiving facility that is collocated with a centralized receiving facility to be in a multi -story building and may be authorized on floors other than the ground floor. The department is to develop certain forms to be used by law enforcement for use when a person is taken into custody under chapter 397. The department is also to develop a website and post standard forms to be used to file a petition for involuntary admission under the Marchman Act. The bill has a fiscal impact of $400,000 in nonrecurring funds from the Operations and Maintenance Trust Fund to DCF for the purpose of modifying the existing crisis stabilization database to collect and analyze data and information pursuant to s. 397.321, F.S. If approved by the Governor, these provisions take effect July 1, 2016 Vote: Senate 38 -0; House 118 -1 This summary is provided for information only and does not represent the opinion of any Senator, Senate Officer, or Senate Office. CS /SB 12 Page: 2 County of Monroe The Florida Keys s :rte x BOARD OF COUNTY COMMISSIONERS Mai or Georve NeuLcnt. Di.qrict 2 Mai or Pro 1'em DaN id Rice, District 4 [leather Carruthers, District 3 Dann} L Kolhage, District I Stiykia.L Murphy, District 5 Interoffice Memorandum Date: May 10, 2017 To: Kevin Madok, Clerk of the Court County Clerk's Office From: Commissioner David Rice, District 4 RE: NOTICE OF VOTING CONFLICT Per Florida Statute 112.3143, 1 hereby disclose by written memorandum that I will abstain from the vote on certain issues brought before the Monroe County Board of Commissioners with entities of which I am involved. I will abstain from the vote on issues concerning the following entities: Guidance Care Center, Inc., a private, not-for-profit entity, which receives some of its operational funding from the County, as I currently sit on the Board of Directors of the Care Center, I am also a member of the Board of the Historic Florida Keys Foundation, Inc. At the May 17, 2017 BOCC meeting, I will abstain from the vote on the following Ench Copy of agenda item summary of the referenced itens(s) astachedfor documentation. State of Florida For 88 for each its FORM 8B MEMORANDUM OF VOTING CONFLICT FOR COUNTY, MUNICIPAL, AND OTHER LOCAL PUBLIC OFFICERS LAST NAME —FIRST NAME — MIDDLE NAME DA D PAY — NAME OF BOARD, COUNCIL, MMISSIOK AUTHORI O COMMITTEE lYlarl�a. -�'ovn C aI -CL mt ssron MAILING ADDRESS 1 M oe-4 1 6 l L ^ THE BOARD, COUNCIL, COMW ION, AUTHORITY OR COMMITTEE ON WHICH I SERVE IS A UNIT F: r ft r 1- O CITY OUNTY 13 OTHER LOCAL AGENCY CITY U COUNTY NAME OFPOUTICA IVISI N: (y)o (1 ro 'LL n (flaira menro¢— DATE ON WHICH VOTE OCCURRED MY POSITION IS: ELECTI E O APPOINTIVE WHO MUST FILE FORM 813 This form is for use by any person serving at the county, city, or other local level of government on an appointed or elected board, council, commission, authority, or committee. It applies to members of advisory and non - advisory bodies who are presented with a voting conflict of interest under Section 112.3143, Florida Statutes. Your responsibilities under the law when faced with voting on a measure in which you have a conflict of interest will vary greatly depending on whether you hold an elective or appointive position. For this reason, please pay close attention to the instructions on this form before completing and filing the form. INSTRUCTIONS FOR COMPLIANCE WITH SECTION 112.3143, FLORIDA STATUTES A person holding elective or appointive county, municipal, or other local public office MUST ABSTAIN from voting on a measure which would inure to his or her special private gain or loss. Each elected or appointed local officer also MUST ABSTAIN from knowingly voting on a measure which would inure to the special gain or loss of a principal (other than a government agency) by whom he or she is retained (including the parent, subsidiary, or sibling organization of a principal by which he or she is retained); to the special private gain or loss of a relative; or to the special private gain or loss of a business associate. Commissioners of community redevelopment agencies (CRAs) under Sec. 163.356 or 163.357, F.S., and officers of independent special tax districts elected on a one -acre, one -vote basis are not prohibited from voting in that capacity. For purposes of this law, a "relative" includes onfy the officer's father, mother, son, daughter husband, wife, brother, sister, father -in -law, mother -in -law, son -in -law, and daughter -in -law. A "business associate' means any person or entity engaged in or carrying on a business enterprise with the officer as a partner, joint venturer, coowner of property, or corporate shareholder (where the shares of the corporation are not listed on any national or regional stock exchange) ELECTED OFFICERS: In addition to abstaining from voting in the situations described above, you must disclose the conflict: A PRIOR TO THE VOTE BEING TAKEN by publicly stating to the assembly the nature of your interest in the measure on which you are abstaining from voting; and WITHIN 15 DAYS AFTER THE VOTE OCCURS by completing and filing this form with the person responsible for recording the minutes of the meeting, who should incorporate the form in the minutes. APPOINTED OFFICERS: Although you must abstain from voting in the situations described above, you are not prohibited by Section 112.3143 from otherwise participating in these matters. However you must disclose the nature of the conflict before making any attempt to influence the decision, whether orally or in writing and whether made by you or at your direction. IF YOU IN.TEMD TO MAKEAUY ATTEMPT TO INFLUENCE T-HE OECal01_ PRIOR TO -THE M€E—TING AT AA"CH -THE VOTE WILL $E TAKEN: • You must compiete and file this form (before making any attempt to influence the decision) with the person responsible for recording the minutes of the meeting, who will incorporate the form in the minutes. (Continued on page 2) CE FORM 8B - EFF. 11/2013 PAGE 1 Adopted by reference in Rule 34- 7.010(1)(f), F.A.C. APPOINTED OFFICERS (continued) • A copy of the form must be provided immediately to the other members of the agency. • The form must be read publicly at the next meeting after the form is filed. IF YOU MAKE NO ATTEMPT TO INFLUENCE THE DECISION EXCEPT BY DISCUSSION AT THE MEETING: • You must disclose orally the nature of your conflict in the measure before participating. • You must complete the form and file it within 15 days after the vote occurs with the person responsible for recording the minutes of the meeting, who must incorporate the form in the minutes. A copy of the form must be provided immediately to the other members of the agency, and the form must be read publicly at the next meeting after the form is filed. DISCLOSURE OF LOCAL OFFICER'S INTEREST ' f 1. ,Dav d t 1 ,2,1 Li- , hereby disclose that on �7 20 _ (a) A measure came or will come before my agency which (check one or more) inured to my special private gain or loss; inured to the special gain or loss of my business associate, inured to the special gain or loss of my reiallve, inured to the special gain or loss of by I whom I am retained; or inured to the special gain or loss of which is the parent subsidiary, or sibling organization or subsidiary of a principal which has retained me. (b) The measure before my agency and the nature of my conflicting interest in the measure is as follows: I currently sit on the Board of Directors of the Guidance Care Center, Inc. I am also a member of the Board of the Historic Florida Keys Foundation, Inc. SEE ATTACHED AGENDA ITEM SUMMARY =& C-2-1 Ml. ('7 2-07 If disclosure of specific information would violate confidentiality or privilege pursuant to law or rules governing attorneys, a public officer, who is also an attorney, may comply with the disclosure requirements of this section by disclosing the nature of the interest in such a way as to provide the public with notice of the conflict Y} [ 2 201 ? Date Filed J Signature NOTICE' UNDER PROVISIONS OF FLORIDA STATUTES §11- 2.317 A FAILURE TO MAKE ANY REQUIRED DISCLE}SURE CONSTITUTES GROUNDS FOR AND MAY BE PUNISHED BY ONE OR MORE OF THE FOLLOWING: IMPEACHMENT REMOVAL OR SUSPENSION FROM OFFICE OR EMPLOYMENT, DEMOTION, REDUCTION IN SALARY, REPRIMAND, OR A CIVIL PENALTY NOT TO EXCEED $10,000. CE FORM 8B - EFF. 11/2013 PAGE 2 Adopted by reference in Rule 347 010(1)0, F.A.C. �I County of Monroe y The Florida Keys _ BOARD COU COM1ytISS[O ERS Mayor Ge Ncugent District 2 g Mayor Pro Tern David Rice, District 4 Danny L. Kolhage, District I Heather Carruthers, District 3 Sylvia J. Murphy, District 5 County Commission Meeting May 17, 2017 Agenda Item Number. C.21 Agenda Item Summary #2917 BULK ITEM: Yes DEPARTMENT: Budget and Finance TIME APPROXIMATE: STAFF CONTACT: Laura DeLoach (305)292 -4482 No AGENDA ITEM WORDING: Approval of the Monroe County Designated Receiving System Plan, as presented by the designated Managing Entity for Monroe County and Miami/Dade County, South Florida Behavioral Health Network (SFBHN), for a centralized receiving system for Monroe County as required by Senate Bill 12 (Chapter 2016 -241), for implementation July 1, 2017. ITEM BACKGROUND: In 2016 Senate Bill 12 relating to mental health and substance abuse, was approved, providing amendments to Florida Statute Chapter 394, Mental Health. Under F.S. 394.4573, counties along with the managing entity and community stakeholders are to plan a designated receiving system. The plan is to be completed and implemented by July 1, 2017. On March 2, 2017 South Florida Behavioral Health Network (SFBHN) held a Monroe County SB 12 Planning meeting with community members and providers (attendance roster attached). As a result of the meeting an action plan for a Centralized Receiving System for Monroe County was developed. Attached is the Designated Receiving System Plan and background information including the March 2 nd meeting agenda and the referenced statute. PREVIOUS RELEVANT BOCC ACTION: Monroe County annually provides required matching funds for substance abuse and mental health services including transportation. CONTRACT /AGREEMENT CHANGES: No STAFF RECOMMENDATION: Approval DOCUMENTATION: 5 -17 -17 Agenda Backup -MC Designate Receiving System Plan FINANCIAL IMPACT: Effective Date: 07/41/2017 Expiration Date: N/A Revenue Producing: No Grant: No County Match N/A Insurance Required: N/A Additional Details: If yes, amount: Completed 04/21/2017 4 PM Completed 04/21/2017 4:32 PM Completed 05/01/2017 4:10 PM Completed 05/01/2017 4-21 PM Pending 05/17/2017 9:00 AM FORM 8B MEMORANDUM OF VOTING CONFLICT FOR COUNTY, MUNICIPAL, AND OTHER LOCAL PUBLIC OFFICERS LAST NAME - -FIRST NAME -- MIDDLE NAME R,ZC- E Oro D PA Y — NAME OF BOARp, COUNCIL. C MMISSION, AUTHORI O COMMITTEE (Y1on+tia -�'ovn L�a�� omr�i rv�t MAILING ADDRESS 1 33 fy) 6 l b THE BOARD. COUNCIL, COMMI ION, AUTHORITY OR COMMITTEE ON WHICH I SERVE ISA UW F: o C-4 n r - 0 CITY OUNTY CI OTHER LOCAL4GENCY CITY COUNTY NAME OF POLITICAL UBDIVISI N roa U n may, m alra T M n r0¢. -- DATE ON WHICH VOTE OCCURRED - mo ll MY POSITION IS: ELECT1 G APPOINTIVE WHO MUST FILE FORM 813 This form is for use by any person serving at the county, city, or other local level of government on an appointed or elected board, council, commission, authority. or committee. It applies to members of advisory and non - advisory bodies who are presented with a voting conflict of interest under Section 112.3143, Florida Statutes. Your responsibilities under the law when faced with voting on a measure in which you have a conflict of interest will vary greatly depending on whether you hold an elective or appointive position. For this reason, please pay close attention to the instructions on this form before completing and filing the form. INSTRUCTIONS FOR COMPLIANCE WITH SECTION 112.3143, FLORIDA STATUTES A person holding elective or appointive county, municipal, or other local public office MUST ABSTAIN from voting on a measure which would inure to his or her special private gain or loss. Each elected or appointed local officer also MUST ABSTAIN from knowingly voting on a measure which would inure to the special gain or loss of a principal (other than a government agency) by whom he or she is retained (including the parent, subsidiary, or sibling organization of a principal by which he or she is retained); to the special private gain or loss of a relative; or to the special private gain or loss of a business associate. Commissioners of community redevelopment agencies (CRAs) under Sec. 163.356 or 163.357, F.S., and officers of independent special tax districts elected on a one -acre, one -vote basis are not prohibited from voting in that capacity. For purposes of this law, a "relative" includes only the officer's father, mother, son, daughter husband, wife, brother, sister, Father -in -law, mother -in -law, son -in -law, and daughter -in -law_ A "business associate" means any person or entity engaged in or carrying on a business enterprise with the officer as a partner, joint venturer. coowner of property, or corporate shareholder (where the shares of the corporation are not listed on any national or regional stock exchange). ELECTED OFFICERS: In addition to abstaining from voting in the situations described above, you must disclose the conflict: PRIOR TO THE VOTE BEING TAKEN by publicly stating to the assembly the nature of your interest in the measure on which you are abstaining from voting; and WITHIN 15 DAYS AFTER THE VOTE OCCURS by completing and filing this form with the person responsible for recording the minutes of the meeting, who should incorporate the form in the minutes. APPOINTED OFFICERS: Although you must abstain from voting in the situations described above, you are not prohibited by Section 112.3143 from otherwise participating in these matters. However, you must disclose the nature of the conflict before making any attempt to influence the decision, whether orally or in writing and whether made by you or at your direction. lF YOU-INTEND TO.MAKEANYATTEMPTTO INFLUENCE THE DECISIOUP-RIORTO M€ETINGAT WHW,4T##€VATE—WILL -Br_- TAKEN: • You must complete and file this form (before making any attempt to influence the decision) with the person responsible for recording the minutes of the meeting, who will incorporate the form in the minutes. (Continued on page 2) A CE FORM 8B - EFF. 11/2013 PAGE 1 Adopted by reference in Rule 347.010(1)(1), F.A.C. APPOINTED OFFICERS (continued) • A copy of the form must be provided immediately to the other members of the agency. • The form must be read publicly at the next meeting after the form is filed. IF YOU MAKE NO ATTEMPT TO INFLUENCE THE DECISION EXCEPT BY DISCUSSION AT THE MEETING: • You must disclose orally the nature of your conflict in the measure before participating. • You must complete the form and file it within 15 days after the vote occurs with the person responsible for recording the minutes of the meeting, who must incorporate the form in the minutes. A copy of the form must be provided immediately to the other members of the agency, and the form must be read publicly at the next meeting after the form is filed. DISCLOSURE OF LOCAL OFFICER'S INTEREST i Da vi [ Q '" - f � l � � hereby disclose that on � I 20 (a) A measure came or will come before my agency which (check one or more) NIA inured to my special private gain or loss; inured to the special gain or loss of my business associate, inured to the special gain or loss of my refahve, inured to the special gain or loss of / whom I am retained; or _✓ inured to the special gain or loss of n el- Ff ty t da K �4 is the parent subsidiary, or sibling organization or subsidiary of a principal which(Aas retained me. (b) The measure before my agency and the nature of my conflicting interest in the measure is as follows: I currently sit on the Board of Directors of the Guidance Care Center, Inc. I am also a member of the Board of the Historic Florida Keys Foundation, Inc. SEE ATTACHED AGENDA ITEM SUMMARY =tt: ,04 m3�, 1 Z I by which If disclosure of specific information would violate confidentiality or privilege pursuant to law or rules governing attorneys, a public officer who is also an attorney, may comply with the disclosure requirements of this section by disclosing the nature of the interest in such a way as to provide the public with notice of the conflict M a r z 2- - Oate Flied Signature NOTKG€: UNO PROVISIONS OF - FL - §'f T2. - 317, A FAII=URE FO NTAKE ANYREGUrRED - DI-SCLO -SUFFE CONSTITUTES GROUNDS FOR AND MAY BE PUNISHED BY ONE OR MORE OF THE FOLLOWING: IMPEACHMENT REMOVAL OR SUSPENSION FROM OFFICE OR EMPLOYMENT, DEMOTION, REDUCTION IN SALARY, REPRIMAND, OR A CIVIL PENALTY NOT TO EXCEED $10,000. CE FORM 86 - EFF. 11/2013 PAGE 2 Adopted by reference in Rule 347 010(1)(1), F.A.C. County of Monroe BOARD OF COUNTY COMMISSIONERS Mayor George Neugent, District 2 The Florida Keys Mayor Pro Tern David Rice, District 4 Danny L. Kolhage, District I Heather Carruthers, District 3 Sylvia J. Murphy, District 5 County Commission Meeting May 17, 2017 Agenda Item Number. DA Agenda Item Summary #2925 BULK ITEM: Yes DEPARTMENT: Tourist Development Council TIME APPROXIMATE: STAFF CONTACT: Ammie Machan (305) 296 -1552 N/A AGENDA ITEM WORDING: Approval of an Amendment to Agreement with Historic Florida Foundation Keys, Inc. for the Oldest House Roofing, Structural Repair and Plumbing Upgrade project to extend the completion date of project and to amend Exhibit A of Agreement outlining Scope of Services ITEM BACKGROUND: Historic Florida Keys. Inc. has requested to extend the completion date of the Oldest House Roofing, Structural Repair and Plumbing Upgrade project and to amend Exhibit A of Agreement Outlining Scope of Service for the project. DAC I approved same at their meeting of April 5, 2017 TDC approved same at their meeting of April 25, 2017 PREVIOUS RELEVANT BOCC ACTION: BOCC approved original agreement at their meeting of March 23, 2016 BOCC approved amendment to extend agreement at their meeting of January 30, 2017. CONTRACT /AGREEMENT CHANGES: Extension to Agreement and Revised Scope of Service STAFF RECOMMENDATION: Approval DOCUMENTATION: Historic Florida Keys Foundation - Amendment, Request and Original Agreement FINANCIAL IMPACT: Effective Date: March 23, 2016 Expiration Date: September 30, 2017 Revenue Producing: No Grant: County Match: Insurance Required: Yes Additional Details: If yes, amount: 05117117 117-77040 - TDC BRICKS& MORTAR 117 $20,736.00 REVIEWED BY: Maxine Pacini Completed 0412712017 12 PM Christine Limbert Completed 0412712017 5 PM Budget and Finance Completed 04/28/2017 10:12 AM Maria Slavik Completed 04128/2017 1034 AM Kathy Peters Completed 05/01/2017 10:56 AM Board of County Commissioners Pending 05/17/2017 9:00 AM