Resolution 399-2020 RESOLUTION NO. 399 -2020
A RESOLUTION OF THE BOARD OF COMMISSIONERS OF MONROE COUNTY, FLORIDA
AUTHORIZING THE SUBMISSION OF A GRANT APPLICATION TO THE FLORIDA
DEPARTMENT OF LAW ENFORCEMENT FOR THE FEDERAL FISCAL YEAR (FFY) 2019
RESIDENTIAL SUBSTANCE ABUSE TREATMENT (RSAT) PROGRAM
WHEREAS, the Florida Department of Law Enforcement has announced the funding for
Federal Fiscal Year 2019 Residential Substance Abuse Treatment Grant (RSAT) Program; and
WHEREAS, the Monroe County Board of Commissioners is the eligible applicant
representing the county in the State of Florida in the preparation and submission of the grant
proposal for the "Men's Jail In-House Drug Abuse Treatment Program"; and
WHEREAS, to be eligible for consideration of funding, applications were required to be
submitted, no later than October 30, 2020, using the FDLE Subgrant Information Management
On-Line (SIMON) grant management system; now therefore
BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE
COUNTY, FLORIDA, that:
1. The Board of County Commissioners approve the submission of the Residential
Substance Abuse Treatment (RSAT) grant application;
2. The Mayor is hereby authorized to sign acceptance of award and all related
documents for the Federal Fiscal Year 2019 grant funds to the Florida Department of
Law Enforcement, Office of Criminal Justice Grants, Residential Substance Abuse
Treatment (RSAT) Grant Program;
3. This resolution shall be effective upon adoption by the Board of County
Commissioners and execution by the Presiding Officer and Clerk.
PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, at a
regular meeting of said Board held on the 17th day of November 2020.
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„�„r Mayor Michelle Coldiron Yes -
�: �, Mayor Pro Tem David Rice Abstain -
Commissioner Craia Cates Absent r
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cCommissioner Eddie Martinez Yes -
� - Commissioner Mike Forster Yes
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\ .>;,i,( - • Kevin Madok, lerk Monroe Coun ram,)\�\ • r missiotrers
, 0. � IIImo/ o (PM)
As Deputy Clerk Mayor
Monroe County Attorney, Approved as to Form: Christine Limbert-Barrows,Assistant County Attorney
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Christine Lim bert-Ba rrows ro,"„o, ,,,,r -o, .."""°�n'.""'m°`"
Application for Funding Assistance
Florida Department of Law Enforcement
Residential Substance Abuse Treatment
Subgrant Recipient
Organization Name: Monroe County Board of Commissioners
County: Monroe
Chief Official
Name: Heather Carruthers
Title: Mayor
Address: 530 Whitehead Street
City: Key West
State: FL Zip: 33040-6547
Phone: 305-292-3430 Ext:
Fax: 305-292-3577
Email: carruthers-heather@monroecounty-fl.gov
Chief Financial Officer
Name: Kevin Madok
Title: Clerk of Court
Address: Post Office Box 1980
City: Key West
State: FL Zip: 33041-1980
Phone: 305-295-3130 Ext:
Fax:
Email: kmadok@monroe-clerk.com
Application Ref#2020-RSAT-133 Section#1 Page 1 of 2
Contract# -RSAT-MOLAR---
OCJG-005(rev.April 2005)
Application for Funding Assistance
Florida Department of Law Enforcement
Residential Substance Abuse Treatment
Implementing Agency
Organization Name: Monroe County Board of Commissioners
County: Monroe
Chief Official
Name: Heather Carruthers
Title: Mayor
Address: 530 Whitehead Street
City: Key West
State: FL Zip: 33040-6547
Phone: 305-292-3430 Ext:
Fax: 305-292-3577
Email: carruthers-heather@monroecounty-fl.gov
Project Director
Name: Janet Gunderson
Title: Senior Grants and Finance Analyst
Address: 1100 Simonton Street
Room 2-213
City: Key West
State: FL Zip: 33040-3110
Phone: 305-292-4470 Ext:
Fax: 305-292-4515
Email: Gunderson-Janet@monroecounty-fl.gov
Application Ref#2020-RSAT-133 Section#1 Page 2 of 2
Contract# -RSAT-MOLAR---
OCJG-005(rev.April 2005)
Application for Funding Assistance
Florida Department of Law Enforcement
Residential Substance Abuse Treatment
General Project Information
Project Title: MEN'S JAIL IN-HOUSE DRUG ABUSE TREATMENT PROGRAM
Subgrant Recipient: Monroe County Board of Commissioners
Implementing Agency: Monroe County Board of Commissioners
Project Start Date: 1/1/2021 End Date: 12/31/2021
Problem Identification
South Florida, including Monroe County and the Florida Keys, continues to have the unfortunate
distinction of being designated as a high-intensity drug trafficking area and, as such, is a leading
illicit drug importation area. This has increased the availability of illicit drugs in Monroe County
resulting in drug abuse rates higher than both the state and national averages. The Drug
Enforcement Agency noted in their 2019 Opioid Report that from 2006 to 2012 there were
30,791,325 prescription pain pills, enough for 60 pills per person per year, supplied to Monroe
County. The Florida Department of Corrections recorded 3,295 drug/narcotic arrests in Monroe
County for males during the six-year period of 2012 through 2017. The lowest recorded number of
arrests during this time was 456 in 2015; the highest was 673 in 2017 - an increase of nearly 48%
over two years. In 2017, Key West Police Department made 254 drug/narcotic arrests (37.7% of
drug/narcotic arrests in Monroe County). Of individuals arrested in Monroe County on
drug/narcotic related charges in 2017, 76.5% are White, 22.0% are African American, and 1.5%
are Asian. According to the Florida Department of Corrections, in December 2018, Monroe
County had the fourth highest rate of incarceration among all Florida counties: 7.5 per 1,000
population. This is an increase from 6.6 in December 2017. The FDLE 2018 Medical Examiners
Commission Drug Report indicates that compared to 2017 report 3,693 (9 more) individuals died
with at least one prescription drug in their system that was identified as the cause of death. The
most frequently occurring drugs found in those who died were alcohol (5,140), benzodiazepines
(4,624, including 1,654 alprazolam occurrences), cocaine (2,856), fentanyl (2,703), marijuana
(2,590), morphine (1,863), oxycodone (1,181), amphetamine (1,103), methamphetamine (1,056),
and fentanyl analogs (1,052). Prescription drugs account for 58 percent of all drug occurrences in
their report when alcohol is excluded. South Florida, including Monroe County and the Florida
Keys, like many areas of the country has seen an influx of opiate related deaths and increase in
opiate abuse. Clearly substance abuse treatment remains a need for our community. The Monroe
County Sheriff's Office, Public Defender, and State Attorney's office have indicated a continued
need for diversion and treatment services including programs which will allow the county to
decrease the number of days' individuals spend incarcerated.
The project proposed by the service provider supports Monroe County's strategic plan that
addresses an identified priority in reducing criminal recidivism related to substance use. If we do
not address and treat current substance use in our inmates research has concluded that
conditions are ripe for the opioid epidemic to worsen in the coming years and that current efforts
to reduce misuse of prescription opioids are unlikely to have a significant effect on the number of
opioid overdose deaths in the near future. What's needed, they wrote, is a multipronged approach
that includes not only programs that monitor and restrict prescriptions, but one that also improves
access to treatment, expands the number of interventions that reduce the harms associated with
opioid use, and reduces exposure to illicit opioids. [1]. The proposed
Application Ref#2020-RSAT-133 Section#2 Page 1 of 5
Contract# -RSAT-MOLAR---
OCJG-005(rev.April 2005)
Application for Funding Assistance
Florida Department of Law Enforcement
Residential Substance Abuse Treatment
program increases access to treatment and provides comprehensive substance abuse treatment
to inmates during incarceration.
[1] Devitt, Michael, "Research Shows Nation's Opioid Epidemic Is Far from Over, More
Comprehensive Approach Is Needed to Reduce Opioid Use, Deaths; For family physicians who
grapple with the effects of the opioid epidemic on a daily basis, there's new evidence that things
may, unfortunately, get worse before they start to get better", 20 Feb, 2019. American Academy of
Family Physicians (AAFP) <https://www.aafp.org/news/health-of-the-
public/20190220opioidprojections.htmI>
In addition, on May 13, 2020 Miami Herald reported that with coronavirus-related stress on the
rise, so is alcohol and drug use, according to a national survey. Findings by The Recovery Village,
a Florida-based network of addiction treatment facilities, reflect an "expected" increase in
substance use during the pandemic, with Americans reporting a 55% rise in alcohol consumption
in April 2020. When it came to illicit drugs, 36% of Americans reported increased use of marijuana
and prescription opioids, among others. "Experts have already started to voice concerns on the
secondary effects America is yet to see from COVID-19", researchers wrote, among them being
"increased rates of addiction afterward due to the stress of isolation, boredom, decreased access
to recovery resources and unemployment". The jail-based program has been able to provide
substance abuse treatment throughout the pandemic and it is expected these services will
continue to be crucial to this community given these statistics.
Summary of project accomplishments from pre-existing subgrant (2020-RSAT-MONR-1-D2-002)
that have been achieved:
Data reported in "Completions" and "Reincarcerations" sections the Quarterly Performance Report
from the most recent grant periods, January 1, 2020 through September 30, 2020
*Completions- "How many successful RSAT completions were released in the community during
the reporting period?" Jan-20 to Mar-20 = 13; Apr to June = 12; Jul to Sept = 11; Total Successful
Completions = 36
*Completions- "During the reporting period, how many successful RSAT completions were
released into the community with a continuity of care arrangement, re-entry and/or transitional
plan?" Jan-20 to Mar-20 = 12; Apr to June = 12; Jul to Sept = 10; Total Successful Completions
Released with a Continuity of Care Arrangement = 34
*Reincarcerations- "How many successful RSAT completions were released, and subsequently
reincarcerated on a new criminal charge during the reporting period?" Jan-20 to Mar-20 = 3; Apr
to June = 0; Jul to Sept = 0; Total Successful Completions Released then Reincarcerated = 7 (8%
of successful completions)
In the proposal of 2020-RSAT-MONR-1-D2-002 it was estimated that 8% of the successful
completions would be reincarcerated for a new criminal charge; data results from 2020-RSAT-
MONR-1-002 indicate a successful outcome which was met. Note: The largest number of arrests
were in first quarter prior to COVID-19. We also follow recidivism for the year following discharge.
It is important to note that average
Application Ref#2020-RSAT-133 Section#2 Page 2 of 5
Contract# -RSAT-MOLAR---
OCJG-005(rev.April 2005)
Application for Funding Assistance
Florida Department of Law Enforcement
Residential Substance Abuse Treatment
rate of recidivism for the year following incarceration is 6%.
In summary, a multipronged approach that includes not only programs that monitor and restrict
prescriptions, but one that also improves access to treatment, expands the number of
interventions that reduce the harms associated with opioid use, and reduces exposure to illicit
opioids; this program is more important now, than ever.
Project Summary (Scope of Work)
The Jail-In House Drug Treatment Program (JIP) located within the Monroe County Detention
Center began in 1997. It remains today as one of the few such programs operated within a county
jail in Florida and the only opportunity for some men to receive intensive drug abuse treatment
within Monroe County. Moreover, these men are able to get treatment quickly instead of being
one of the 66% of substance abusing Florida residents who desire help but are unable to access
treatment due to Florida's lengthy waiting list for substance abuse services as reported by the
Florida Department of Children and Families. This program has been able to attain and maintain a
very low recidivism rate for participants in the last 10 years with the addition of evidence-based
practices and special attention to the unique needs of substance abusing men. The program has
a very close relationship with county judges, attorneys, and the administration of the Monroe
County Detention Center as well as city and county authorities. Men who complete treatment are
often granted early release from incarceration to begin rebuilding their lives, thereby saving the
county the expense of their continued detainment. Clients are taught coping skills to manage
stress, anxiety, triggers to relapse. Groups also cover job interviewing skills, resume creation,
professionalism, budgeting, opening a bank account and household management skills. These
skills attained within the context of treatment increases the chances of sustained recovery,
healthier family and other personal relationships and safer communities; as they have
successfully completed an intensive, comprehensive treatment program.
The Jail In-house Program (JIP)was developed in order to provide substance abuse treatment
services to county inmates to lay the foundation for sustained recovery. The majority of clients are
court ordered by the Drug Court, Circuit Court and County Court Judges in Monroe County. The
rest enter the program as volunteers who have met the criteria for drug/alcohol treatment and will
be in the county jail a minimum of 182 days. JIP will serve 70 male inmates. Clients must have a
minimum of six months'jail time to complete the program, agree to follow all program rules
including the absence of disciplinary infractions while incarcerated and complete all program
assignments and attend groups five days per week. Once clients have been referred to JIP, a
biopsychosocial and program orientation is completed to determine treatment needs within seven
(7) days of receiving court order. Additional assessments are conducted including Mental Health
Status and the Post Traumatic Check List (PCL-5)which identify suicide risk levels, trauma and
impairments in functioning. If a mental health diagnosis is identified as part of the assessment, the
client receives a referral for mental health services. These clients continue to participate in the
JIP to address the substance use disorder and criminal thinking and behavior. During client
treatment, JIP program staff will collaborate with other service providers, since treatment of co-
occurring disorders are seen as a vital part of recovery from substance abuse. Admission policies
are welcoming to individuals with co-occurring disorders, learning disabilities, illiteracy and other
special individualized needs allowing access for all who probably otherwise would not receive
services.
Application Ref#2020-RSAT-133 Section#2 Page 3 of 5
Contract# -RSAT-MOLAR---
OCJG-005(rev.April 2005)
Application for Funding Assistance
Florida Department of Law Enforcement
Residential Substance Abuse Treatment
Client-centered individualized treatment plans, funded by this RSAT program are tailored to the
needs of men, are a cornerstone of gender-responsive treatment. Following completion of the
comprehensive assessment the JIP counselors and clients collaboratively develop a person-
centered Wellness Plan in the first month of service. This plan is continuously being developed
and then reviewed and updated with the participant every 30 days throughout the course of the
program.
JIP treatment services are delivered by three (3) program staff and one (1) program coordinator.
Groups are facilitated five (5)days per week. In addition, each program participant is assigned a
primary counselor/case manager for monthly individual sessions, to assist with treatment
planning, provide comprehensive case management and to monitor progress and discharge
planning.
Treatment services use several evidence-based practices including Cognitive Behavioral Therapy
(CBT) curriculum entitled "Substance Abuse and Criminal Conduct: Strategies for Self-
Improvement and Change, Pathways to Responsible Living" authored by Harvey Milkman and
Kenneth Wanberg which includes a client workbook for them to keep. Moral Reconation Therapy
(MRT), is also used to decrease recidivism among criminal offenders by increasing moral
reasoning. Additionally, treatment in the correctional setting incorporates trauma-informed and
gender- responsive treatment through the use of the evidenced-based. "Seeking Safety"
treatment model to promote the healing and edification of the human spirit. These relational
models support the development of healthy relationships with self, significant others, and the
community at large in order to reduce the risk of relapse and recidivism. An evidenced-based
Relapse Prevention Therapy program will also be incorporated.
Clients are required to complete all program service components in 2 phases in a minimum of six
months. Each phase of treatment includes phase specific"dorm-work" assignments that are
reviewed and graded by program staff. Clients are only allowed to phase up to level 2 and
successfully graduate the program once all assignments are completed and presented to staff and
their JIP peers. Clients are required to submit daily homework assignments, attend groups and
maintain their behavior in the dorm and groups. When clients move from one phase to the next is
not pre-determined and the timeline is individualized based on progress. To ensure the program
achieves its intended outcomes and community impact, outcome data is collected from the
electronic health record so the program can monitor deliverables; assess where it needs
improvements; and make timely adjustments to address the desired outcomes more effectively
and efficiently. JIP staff submit monthly status report to Jail Program Director. Program
coordinator submits quarterly and annual reports to the County grant administrators.
Treatment in the program is a minimum of six (6) months and a maximum of one (1)year.
Successful program completion rate will be 80% or higher. Recidivism will be collected and
monitored post-discharge using the county arrest data system. JIP staff plan for the client's
discharge. Aftercare services are encouraged as a part of re-entry planning and last up to six (6)
months once the client is released. Aftercare includes both mental health and substance abuse
needs. Clients are given appointments with a psychiatrist as part of aftercare and assigned a case
worker to help them with appointments, treatment adherence, accessing of community services
and medication assistance. If MAT (Medication Assisted Treatment) is needed it will be added to
discharge planning to occur post release.
Application Ref#2020-RSAT-133 Section#2 Page 4 of 5
Contract# -RSAT-MOLAR---
OCJG-005(rev.April 2005)
Application for Funding Assistance
Florida Department of Law Enforcement
Residential Substance Abuse Treatment
Corrections staff conduct random drug testing of program participants with tests provided by the
contracted services. If a client tests positive for drugs, there is disciplinary action resulting in 30
days in lock down and a return to court for judicial review of the case. Tests used are the Reditest
icup which is a 10 panel dip sticks testing for amphetamine, benzodiazepines, cocaine, opiates,
synthetic opiates, THC, PCP, barbiturates, and MDMA.
The JIP program has been evaluated and accredited by the Council on Accreditation for
Rehabilitation Facilities (CARF) over the past 12 years. In our last site visit in June 2019, JIP met
the highest CARF standards and received recognition for its positive relationships between
correctional staff and program staff. This program is fully CARF accredited through June 2021.
Application Ref#2020-RSAT-133 Section#2 Page 5 of 5
Contract# -RSAT-MOLAR---
OCJG-005(rev.April 2005)
Application for Funding Assistance
Florida Department of Law Enforcement
Residential Substance Abuse Treatment
General Performance Info:
Performance Reporting Frequency: Quarterly
Prime Purpose Area: 0001 - Residential Substance Abuse Treatment
State Purpose Area: 0001 - Residential Substance Abuse Treatment
Activity Description
Activity: Other Drug Treatment
Target Group: Adult Males
Geographic Area: State of Florida
Location Type: Jail
Objectives and Measures
Objective: 1 -The subrecipient must complete the Performance Measures Worksheet and
submit to the Office of Criminal Justice Grants (OCJG)on April 30, July 30, August
30, and January 30.
Measure: 3
The subrecipient must complete the Performance Measures Worksheet and submit
to the Office of Criminal Justice Grants (OCJG) no later than April 15, July 15,
October 15 and January 15.
Goal: Yes
Objective: PSO-01 - Continuance of the success, reflected by a low recidivism rate, of the Men's
Jail In-house Drug Abuse Treatment Program, a multi-pronged approach to substance
abuse treatment that includes: Psychosocial Assessment, Individual Counseling,
Group Therapy and Case Management, including Aftercare Planning; thus providing
substance abusing men the tools for a sustained recovery, healthier family and safer
communities.
Application Ref#2020-RSAT-133 Section#3 Page 1 of 2
Contract# -RSAT-MOLAR---
OCJG-005(rev.April 2005)
Application for Funding Assistance
Florida Department of Law Enforcement
Residential Substance Abuse Treatment
Section Questions:
Question: How many beds/slots will receive RSAT services?
Answer: 80
Question: What is the total population of the facility in which the RSAT program is located.
Answer: 596
Question: How many participants are anticipated to complete the RSAT program within the
subgrant period?
Answer: 75
Question: How many participants are anticipated to enter the RSAT program within the subgrant
period?
Answer: 80
Question: Provide the physical address(es)for the facility in which the RSAT program is
located.
Answer: Monroe County Detention Center
5525 College Road
Key West, FL 33040
Application Ref#2020-RSAT-133 Section#3 Page 2 of 2
Contract# -RSAT-MOLAR---
OCJG-005(rev.April 2005)
Application for Funding Assistance
Florida Department of Law Enforcement
Residential Substance Abuse Treatment
General Financial Info:
Note: All financial remittances will be sent the Chief Financial Officer
of the Subgrantee Organization.
Financial Reporting Frequency for this Subgrant: Quarterly
Is the subgrantee a state agency?: No
FLAIR/Vendor Number: 596000749
Budget:
Budget Category Prime Match Total
Salaries and Benefits $0.00 $0.00 $0.00
Contractual Services $0.00 $0.00 $0.00
Expenses $100,000.00 $33,334.00 $133,334.00
Operating Capital $0.00 $0.00 $0.00
Outlay
Indirect Costs $0.00 $0.00 $0.00
--Totals -- $100,000.00 $33,334.00 $133,334.00
Percentage 74.9996 25.0003 100.0
Project Generated Income:
Will the project earn project generated income (PGI)? No
Application Ref#2020-RSAT-133 Section#4 Page 1 of 6
Contract# -RSAT-MOLAR---
OCJG-005(rev.April 2005)
Application for Funding Assistance
Florida Department of Law Enforcement
Residential Substance Abuse Treatment
Budget Narrative:
Budget Category/Description of services purchased/Unit Cost per Service/Total Costs:
Salaries and Benefits = $0
Contractual Services = $133,334
1)Assessments 283 quarter hours @ $19.27/gtr. hr. = $5,453
2) Individual Counseling 1,038 quarter hours @ $16.87/gtr. hr. = $17,511
3) Group Therapy 10,042 quarter hours @ $4.22/qtr. hr. = $42,377
4) Case Management 2,994 quarter hours @ $22.71/gtr. hr. = $67,993***
Expenses = $0
Operating Capital Outlay = $0
Indirect Costs = $0
Total Budget = $133,334
***(Rounded Down for the Budget)
Source of Local Governmental Cash Match: Ad Valorem Tax
Budget Narrative - Details:
The budget reflects costs directly associated with the provision of substance abuse treatment,
mental health, and educational services to inmates in the Monroe County Detention Center. The
unit cost rates were derived by using the hourly rates from the FY 2020-21 State funding contract
for Substance Abuse and Mental Health (SAMH) services and dividing by four(4) to arrive at the
quarter hour (.25) rates.
A contract with the service/treatment provider will be developed to be utilized during the
established grant period. The contract period with the service provider will be within the subgrant
period. The contract with the service provider will be provided to FDLE upon execution of the
agreement.
Psychosocial Assessment: Monroe County through a contracted service/treatment provider will
interview all program participants for the purposes of data collection of educational, employment,
criminal, medical, family, substance abuse and mental health histories to assist in the
determination of the inmates' appropriateness for the program and to update treatment plans.
Unit of Service: Client direct service quarter hour(.25) Unit Rate per qtr. hr.: $19.27
Units Requested: 283 quarter hours to be paid for by this grant.
Total Cost: $5,453.41
Individual Counseling: Monroe County through its contracted service/treatment provider will
provide one-on-one counseling to all program participants to review progress and develop
treatment plans and work on treatment plan goals and objectives.
Unit of Service: Client direct service quarter hour(.25) Unit Rate per qtr. hr.: $16.87
Units Requested: 1,038 quarter hours to be paid for by this grant.
Total Cost: $17,511.06
Application Ref#2020-RSAT-133 Section#4 Page 2 of 6
Contract# -RSAT-MOLAR---
OCJG-005(rev.April 2005)
Application for Funding Assistance
Florida Department of Law Enforcement
Residential Substance Abuse Treatment
Budget Narrative (Continued):
Group Therapy: Monroe County through its contracted service/treatment provider will provide
group therapy to all program participants weekly. Group counseling among program participants
will be conducted to include the introduction of"Self-help groups" and their attendance to establish
an ongoing support network.
Unit of Service: Client direct service quarter hour(.25) Unit Rate per qtr. hr.: $4.22
Units Requested: 10,042 quarter hours to be paid for by this grant.
Total Costs: $42,377.24
Case Management: Monroe County through its contracted service/treatment provider will provide
the coordination of adjunctive services, discharge and aftercare planning, communication with
collateral contacts, linkage with other treatment resources to all program participants.
Unit of Service: Client direct service quarter hour(.25) Unit Rate per qtr. hr.: $22.71
Units Requested: 2,994 quarter hours to be paid for by this grant.
Total Cost: $67,993.74
TOTAL PROGRAM COST$133,334.00 (rounded)
Monthly invoices will be provided to Monroe County by the service/treatment provider detailing
services performed during the period for which they seek payment. These are reviewed by Monroe
County staff prior to approval of payment.
Basis for Unit Cost: Each service is based on the cost centers cited in the Florida Department of
State Administrative Code (FAC); Department of Children and Families; Division of Mental Health,
Chapter: Community Substance Abuse and Mental Health Services; Financial Rule No. 65E-
14.021 (Unit Cost Method of Payment). Financial Rule 65E-14.021, Schedule of Covered Services
was updated on 4/27/2016.
https://www.firuies.org/gateway/RuieNo.asp?title=COMMUNITY%20SUBSTANCE%20ABUSE%20
AND%20MENTAL%20HEALTH%20SERVICES%20-%20FINANCIAL%20RULES&ID=65E-14.02
1
Psychosocial Assessment
Description -This Covered Service includes the systematic collection and integrated review of
individual-specific data, such as examinations and evaluations. This data is gathered, analyzed,
monitored and documented to develop the person's individualized plan of treatment and to monitor
recovery. Psychosocial assessment specifically includes efforts to identify the person's key
medical and psychological needs, competency to consent to treatment, history of mental illness or
substance use and indicators of co-occurring conditions, as well as clinically significant
neurological deficits, traumatic brain injury, organicity, physical disability, developmental disability,
need for assistive devices, and physical or sexual abuse or trauma.
Unit of Measure: Direct Staff Hour Treatment Provider Contract: $77.08
Subgrant Application: $19.27 per quarter(.25) hour
Individual Counseling
Description - Outpatient services provide a therapeutic environment, which is designed to improve
the functioning or prevent further deterioration of persons with mental health and/or substance
abuse problems. These services are usually provided on a regularly scheduled basis by
appointment, with arrangements made for non-
Application Ref#2020-RSAT-133 Section#4 Page 3 of 6
Contract# -RSAT-MOLAR---
OCJG-005(rev.April 2005)
Application for Funding Assistance
Florida Department of Law Enforcement
Residential Substance Abuse Treatment
Budget Narrative (Continued):
scheduled visits during times of increased stress or crisis. Outpatient services may be provided to
an individual or in a group setting. The group size limitations applicable to the Medicaid program
shall apply to all Outpatient services provided by a SAMH-Funded Entity. This covered service
shall include clinical supervision provided to a service provider's personnel by a professional
qualified by degree, licensure, certification, or specialized training in the implementation of this
service.
Unit of Measure: Direct Staff Hour Treatment Provider Contract: $67.48
Subgrant Application: $16.87 per quarter(.25) hour
Group Therapy
Description - Outpatient services provide a therapeutic environment, which is designed to improve
the functioning or prevent further deterioration of persons with mental health and/or substance
abuse problems. These services are usually provided on a regularly scheduled basis by
appointment, with arrangements made for non-scheduled visits during times of increased stress or
crisis. Outpatient services may be provided to an individual or in a group setting. The group size
limitations applicable to the Medicaid program shall apply to all Outpatient services provided by a
SAMH-Funded Entity. This covered service shall include clinical supervision provided to a service
provider's personnel by a professional qualified by degree, licensure, certification, or specialized
training in the implementation of this service.
Unit of Measure: Direct Staff Hour Treatment Provider Contract: $16.88
Subgrant Application: $4.22 per quarter(.25) hour
Case Management
Description - Case management services consist of activities that identify the recipient's needs,
plan services including aftercare, link the service system with the person, coordinate the various
system components, monitor service delivery, and evaluate the effect of the services received.
This covered service shall include clinical supervision provided to a service provider's personnel by
a professional qualified by degree, licensure, certification, or specialized training in the
implementation of this service.
Unit of Measure: Direct Staff Hour Treatment Provider Contract: $90.84
Subgrant Application: $22.71 per quarter(.25) hour
Application Ref#2020-RSAT-133 Section#4 Page 4 of 6
Contract# -RSAT-MOLAR---
OCJG-005(rev.April 2005)
Application for Funding Assistance
Florida Department of Law Enforcement
Residential Substance Abuse Treatment
Section Questions:
Question: What is the Operating Capital Outlay threshold used by the subgrantee?
Answer: 0
Question: What percentage of the total cost of this project is being funded by sources other than
this award?
Answer: 51
Question: What is the expiration date of the current SAM.gov registration?
Answer: 4/13/2021
Question: If contractual services in the budget are based on unit costs provide a definition for
each cost and the methodology or basis for the unit cost.
Answer: Basis for Unit Cost: Each contractual service is based on the cost centers cited in the
Florida Department of State Administrative Code (FAC); Department of Children and
Families; Division of Mental Health, Chapter: Community Substance Abuse and
Mental Health Services; Financial Rule No. 65E-14.021 (Unit Cost Method of
Payment). Financial Rule 65E-14.021, Schedule of Covered Services was updated
on 4/27/2016.
https://www.firuies.org/gateway/RuieNo.asp?title=COMMUNITY%20SUBSTANCE%2
OABUSE%20AND%20MENTAL%20HEALTH%20SERVICES%20-
%20FINANCIAL%20RULES&ID=65E-14.021
*Psychosocial Assessments 283 quarter hours @ $19.27 = $5,453.41
Definition of Psychosocial Assessment: An interview will be conducted all program
participants for the purposes of data collection for educational, employment, criminal,
medical, family, substance abuse and mental health histories to assist in
determination of the inmates' appropriateness for the program and to update
treatment plans.
*Individual Counseling 1,038 quarter hours @ $16.87= $17,511.06
Definition of Individual Counseling: The provision of one-on-one counseling for all
program participants to review progress and develop treatment plans and work on
treatment plan goals and objectives.
*Group Therapy 10,042 quarter hours @ $4.22 = $42,377.24
Definition of Group Therapy: Provision of group counseling for all program
participants to include the introduction of"Self-help groups" and their attendance to
establish an ongoing support network.
*Case Management 2,994 quarter hours @ $22.71= $67,993.74
Definition of Case Management: The coordination of adjunctive services, discharge
and aftercare planning, communication with collateral contacts, linkage with other
treatment resources.
Total Contractual Services = $133,334 (rounded)
Question: Does the subgrantee receive a single grant in the amount of$750,000 or more from
the U.S. Department of Justice?
Answer: No
Application Ref#2020-RSAT-133 Section#4 Page 5 of 6
Contract# -RSAT-MOLAR---
OCJG-005(rev.April 2005)
Application for Funding Assistance
Florida Department of Law Enforcement
Residential Substance Abuse Treatment
Question: If the budget contains salaries and benefits, will this project result in a net personnel
increase, or continue to fund a prior federally grant funded net personnel increase?
Answer: No
Question: If indirect cost is included, has the subrecipient included its approved Indirect Cost
Plan with the application?
Answer: No
Application Ref#2020-RSAT-133 Section#4 Page 6 of 6
Contract# -RSAT-MOLAR---
OCJG-005(rev.April 2005)
Application for Funding Assistance
Florida Department of Law Enforcement
Residential Substance Abuse Treatment
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Monroe County Board of Commissioners
ATTACHMENT 1 :
Active SAM.gov Registration
Application Ref#2020-RSAT-1 33 Additional Requirements
Contract#- RSAT-MOLAR--
10/29/2020 View Details-Entity Registration I System for Award Management
VQD A NEW WAY TO SIGN IN-If you already have
a SAM account,use your SAM email for login.gov. ®'
Login.gov F'AQs
ALERT:SAM.gov will be down for scheduled maintenance Saturday,11/14/2020 from 8:00 AM to 5:00 PM.
Entity Dashboard
r Entity Overview ®• . •
Entity Registration Entity Registration
r Core Data
Page Description
E Assertions This page contains a view of the entire Entity Registration record.To print of save a copy of this registration,select Print.To view a
E Reps&Certs specific section of the registration, select one of the sub-navigation links (for example, Core Data or POCs) under Entity
Registration.To access a previous version of this registration,pick from the record drop-down list then select View Selected
a POCs Record.The page will reload to display the record.
Exclusions ----------
PRINT
P Active Exclusions
r Inactive Exclusions Current Record � .
P Excluded Family
Members DUNS Number: 073876757
�15 Y:ett3 lIfi"rL"�Iv D&B Legal Business Name: Monroe,County of
'
Doing Business As: (none)
Core Data
Business Information:
Business Start Date: 07/02/1823
Fiscal Year End Close Date: 09/30 j
Company Division Name: Office of Management and Budget
Company Division Number:
Corporate URL: hUp://www.monroecounty-fl.gov
Congressional District: FL 26
Initial Registration Date: or/o6/2003
Submission Date: 04/13/2020
Activation Date: 04/15/2020
Expiration Date: 04/13/2021
Physical Address:
Address Line r: itoo Simonton St Rm z 205
City: Key West
State/Province: FL
Country: UNITED STATES
ZIP/Postal Code: 33040 - 3110
Mailing Address:
https://sam.gov/SAM/pages/public/entitySearch/entitySearchEntityRecord.jsf 1/7
10/29/2020 View Details-Entity Registration I System for Award Management
Address Line t: noo SIMONTON STREET''
Address Line 2: ROOM 2-205
City: KEY WEST
State/Province: FL
Country: UNITED STATES
ZIP/Postal Code: 33040'; 3110
CAGE: 3CtZ4
Does this entity have an Immediate Owner? No
Does this entity have any Predecessors? i No
Country of Incorporation:
State of Incorporation:
Business Types
Check the registrant's Reps&Certs,if present,under FAR 52.212-3 or FAR 52.219-1 to determine if
the entity is an SBA-certified HUBZone small business concern.Additional small business
information may be found in the SBA's Dynamic Small Business Search if the entity completed the
SBA Supplemental Pages during registration.
Government Type
U.S.Local Government
County
Entity Structure
U.S.Government Entity
Entity Type
US Local Government
Purpose of Registration
All Awards
Other Governmental Entities
Planning Commission
Transit Authority
Housing Authorities Public/Tribal
Airport Authority
Do you accept credit cards as a method of payment? No '
Account Details:
CAGE Code: 3CtZ4
Electronic Funds Transfer:
Automated Clearing House(ACH):
Registrants in the System for Award Management(SAM)respond to the Executive Compensation questions in accordance with
Section 6202 of P.L.lio 252,amending the Federal Funding Accountability and Transparency,Act(P.L.log 282).This
https://sam.gov/SAM/pages/public/entitySearch/entitySearchEntityRecord.jsf 2/7
10/29/2020 View Details-Entity Registration I System for Award Management
information is not displayed in SAM,It is sent to USAspending.gov for display in association with an eligible award.Maintaining
an active registration in SAM demonstrates the registrant responded to the questions.
Registrants in the System for Award Management(SAM)respond to proceedings questions in accordance with FAR 52,209-7,
FAR 52,209-9,or 2.C,F.R.20o Appendix XIL Their responses are not displayed in SAM,They are sent to'FAPIIS.gov for display
as applicable.Maintaining an active registration in SAM demonstrates the;registrant responded to the proceedings questions.
I authorize my entity's non sensitive information to be displayed in SAM public search results: Yes
Assertions
NAICS Codes selected
921110 Yes Executive Offices
921190 Other General Government Support
Product&Service Codes Selected
PSC Description
Worldwide:
Location(Optional)_
Do you wish to enter EDI Information for your non-government entity?
Do you wish to be included in the Disaster Response Registry? No
Does your company require bonding to bid on Contracts?
Geographic Area Served:
Representations and Certifications
https://sam.gov/SAM/pages/public/entitySearch/entitySearchEntityRecord.jsf 3/7
10/29/2020 View Details-Entity Registration I System for Award Management
I have read each of the FAR and DFARS provisions presented on this page.By submitting this certification,
I,';Christina Brickell,am attesting to the accuracy of the representations and certifications contained
herein,including the entire NAICS table.I understand that I may be subject to criminal prosecution under
Section tool,Title 18 of the United States Code or civil liability under the False Claims Act if I misrepresent I
Monroe,County of in any of these representations or certifications to the Government.
READ ONLY PROVISIONS-The following FAR and DFARS provisions are provided for you to read.They do
not require completion of any data.Select the provision number to expand and review the full text.When
certifying to the information on this page,you are also certifying that you have read each one of these
provisions.
FAR 52 203-�1''Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions
FAR 52 03"t£�:Prohibition on Contracting with Entities that Require Certain Internal Confidentiality Agreements or Statements
Representation
FAK 522-M19m7 M Prohibition on Contracting with Inverted Domestic Corporations,
FA12 52.212-5:Contract Terms and Conditions Required to Implement Statutes or Executive Orders-Commercial Items.
&R.5 2,23a:Compliance with Veterans':Employment Reporting Requirements
EAR 52.222'5U::Combating Trafficking in Persons
FAR 52.22 -;56:Certification Regarding Trafficking in Persons Compliance Plan.
FAQ 52-22% Biobased Product Certification
EA-&52==25-20 Prohibition on Conducting Restricted:Business Operations in Sudan-Certification
FAR 59-225:25:Prohibition on Contracting with Entities Engaging in Certain Activities or Transactions Relating to Iran-
Representation and Certifications
E&5Z.127-�.,Royalty..Information(Alternate I)
The FAR and DFARS provisions shown below have been populated based on data you provided earlier in your
registration.Please open and review each provision before you proceed from this page.If you need to correct
any data,a link will be provided to the relevant page for editing.
By maintaining an active entity registration in SAM,the entity complied with requirements to report proceedings data in
accordance with FAR 52.209-7Information Regarding Responsibility Matters and with requirements to report executive
compensation data in accordance with FAR 52.204 io Reporting Executive Compensation and First-Tier Subcontract Awards.
FAR 59_203 2:Certificate of Independent Price Determination.
FAR 52.-2o.4e3:Taxpayer Identification
EAtt 52.zo4e5:Women-Owned Business(Other Than Small Business)
EA&59.2o4.-y 7:Ownership or Control of Offeror
FAR 52ezo4-go:Predecessor of Offeror
FAR 52.204 2L--Covered Telecommunications Equipment or Services-Representation
RARe52.209 9:Prohibition on Contracting with Inverted Domestic Corporations-Representation
LA_1 5=22C19=5:Certification Regarding Responsibility Matters
FAR 52. 09iii:Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law
https://sam.gov/SAM/pages/public/entitySearch/entitySearchEntityRecord.jsf 4/7
10/29/2020 View Details-Entity Registration I System for Award Management
E R 52.2122-3:Offeror Representations and Certifications-Commercial Items
LIf no NAICS table is displayed,this registrant may not be considered a small business.
FA 5224os4:Place of Performance-Sealed Bidding';
F'A 2 5za2t5A--,Place of Performance
t Ate 5L,Z c}- :Small Business Program Representations(Alternate I)
If no NAICS table is displayed,this registrant may not be considered a small business.
FAI 52-2 9A Equal Low Bids
M 52.222-18.Certification Regarding Knowledge of Child Labor for Listed End Products
FEAR 5&N2-22:Previous Contracts and Compliance Reports
FAIR 59-_2=-25:Affirmative Action Compliance
FA_12 52.222'48:Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance,Calibration,or
Repair of Certain Equipment-Certification
FM 5222;--52:Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services-
Certification
QR 52_223 4 Recovered Material Certification
L-'AR 52.223zq:Estimate of Percentage of Recovered Material Content for EPA Designated Items(Alternate I)
AL52Z22322c Public Disclosure of Greenhouse Gas Emissions and Reduction Goals Representation.
FA RR 5Z�k25-2:Buy American Certificate
FAR 522_225a4R Buy American-Free Trade Agreements-Israeli Trade Act Certificate
A&'51225 6.Trade Agreements Certificate
LM5&22o-e2:Historically Black College or University and Minority Institution Representation
FAR 52.�27z!5:Representation of Limited Rights Data and Restricted Computer Software
The Grants Certifications are a common set of certifications and representations required by Federal statutes or regulations in
accordance with the grants guidance under Title 2 of the Code of Federal Regulations(2 CFR 200.208 Certifications and
Representations).Those non-Federal entities who intend to apply for,or are already recipients of Federal grants or;agreements,
must read and agree to the corresponding certifications and representations.Registrants who reply yes to the following question
are required to keep these certifications and representations current,accurate,and complete as part of their entity registration.
Does Monroe,County of wish to apply for a Federal financial assistance project or program,or is Monroe,County of currently the
recipient of funding under any Federal financial assistance project or program? Yes
Points of Contact
https://sam.gov/SAM/pages/public/entitySearch/entitySearchEntityRecord.jsf 5/7
10/29/2020 View Details-Entity Registration I System for Award Management
Accounts Receivable POC
Electronic Business POC
Title:
First Name: CHRISTINA
Middle Name:
Last Name: BRICKELL
US Phone: (305)292-4466!
Extension:
NON US Phone:
Notes:
Address Line 1: ttoo SIMONTON STREET
Address Line 2: ROOM 2-213
City: KEY WEST
State/Province: FL
Country: UNITED STATES
ZIP/Postal Code: 33040 3110
Government Business POC
Title:
First Name: Christina
Middle Name:
Last Name: Brickell
US Phone: (305)292-44$2
Extension:
NON US Phone:
Notes:
Address Line t: noo SIMONTON ST.
Address Line 2: ROOM 2-213
City: KEY WEST
State/Province: FL
Country: UNITED STATES
ZIP/Postal Code: 33040 - 3110
Electronic Business Alternate POC
Title:
First Name: TINA
Middle Name:
Last Name:+ BOAN
US Phone: ' (305)292-4470
Extension:
NON US Phone:
https://sam.gov/SAM/pages/public/entitySearch/entitySearchEntityRecord.jsf 6/7
10/29/2020 View Details-Entity Registration I System for Award Management
Notes:
Address Line 1: noo SIMONTON STREET
Address Line 2: ROOM 2 213
City: KEY WEST
State/Province: FL
Country: UNITED STATES
ZIP/Postal Code: 33040( 3110
Government Business Alternate POC
Title:
First Name: TINA
Middle Name:
Last Name:` BOAN';
US Phone: (305)292-4470
Extension:
NON US Phone:
Notes:
Address Line r: itoo SIMONTON ST.
Address Line 2: ROOM 2-213
City: KEY WEST
State/Province: FL
Country: UNITED STATES
ZIP/Postal Code: 33040( 3110
• •
https://sam.gov/SAM/pages/public/entitySearch/entitySearchEntityRecord.jsf 7/7
Application for Funding Assistance
Florida Department of Law Enforcement
Residential Substance Abuse Treatment
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Monroe County Board of Commissioners
ATTACHMENT 2:
EEO Certification
Application Ref#2020-RSAT-1 33 Additional Requirements
Contract#- RSAT-MOLAR--
CERTIFICATION FORM
Compliance with the Equal Employment Opportunity Plan (Equal
Employment Opportunity Program) Requirements
Recipient's Monroe County Board Of Commissioners
Name:
Address: 1100 Simonton Street,Key West FL 33040-3110
Recipient Subrecipient Law Enforcement Agency: No
Type:
DUNS 073876757 Vendor Number(only if direct 596000750
Number: recipient):
Name of Calvin Allen Title of Contact Person: EEO Coordinator
Contact
Person:
Telephone (305)-292-4470 E-Mail Address: alien-calvin@monroecounty-
Number: fl. ov
Subreci ients: No
Declaration Claiming Exemption from the EEOP Utilization Report
Submission Requirement
The following exemptions apply:
Filed Utilization Report in
previous year
I,Calvin Allen(authorized official),certify that Monroe County Board Of Commissioners(recipient
organization),is not required to prepare an EEOP Utilization Report during 2020 fiscal year)for the reason(s)
checked above,pursuant to 28 C.F.R.Section 42.302.I further certify that Monroe County Board Of
Commissioners(recipient organization),will comply with applicable federal civil rights laws that prohibit
discrimination in employment and in the delivery of services.
Calvin Allen,EEO Coord. Calvin Allen 81'13/2020
Print or Type Name and Title Signature Date
CERTIFICATION FORM
Compliance with the Equal Employment Opportunity Plan (EEOP) Requirements
Please read carelid4,the In.ttructions (see beinw)anal then complete Section A or Section B or Section C, not all three. If recipient
cont letes Section A or C and sttb- rants a sin le a«and laver S500,000, in addition,please complete Section D.
Recipient's Name: Monroe County Board of Commissioners
Address: 1100 Simonton Street, Key West, FL 33040-3110
Is agency a; ❑ Direct or rX Sub recipient of OJP, OVW or COPS funding? I Law Enforcement A enc ? ,l Yes cxNo
DUNS Number: 073876757 1 Vendor Number(only if direct recipient) NIA
Name and Title of Contact Person: Alana Thurston
Telephone Number: (305) 292-4461 E Mail Address: Thurson-Alana@MonroeCounty-fl.gov
Section A Declaration Claiming Complete Exemption from the EEOP Requirement
Please check all the following banes that apply.
*Less than fifty employees. ❑Indian Tribe ❑Medical Institution.
Nonprofit Organization ❑ Educational Institution ❑Receiving a single award(s)less than$25,000,
11 __ e. .._.............. [responsible
official], certify that
[recipient] is not required to prepare an EEOP for the reason(s)checked above, pursuant to 28 C.F.R.§ 42.302.
1 further certify that [recipient]
will comply with applicable federal civil rights laws that prohibit discrimination in employment and in the delivery of
services.
1f recipient sub-grants a single cnvard over S500,000, in addition,please complete Section D
Print or T• e,Fame and Title Signature Date
Section B—Declaration Claiming Exemption from the ESOP Submission Requirement and Certifying
That an ESOP Is on File for Review
0 a recipient agencY has jy y or more eniplo've s and is receiving a single award or,subou ard, of S 25,000 or score, but less than S500,000, then
the recipient cigenc-v does not hat-e to submit an h EOP to the OCR jbr review as long as at certiijies the followiq (42 C.f`.R.§42.305):
1, Alana Thurston [responsible
official], certify that Monroe County Board of Commissioners _
[recipient], which has fifty or more employees and is receiving a single award or subaward for$25.000 or more, but less
than $500,000,has formulated an EEOP in accordance with 28 CFR pt. 42,subpt. E. 1 further certify that within the last
menty-four months,the proper authority has formulated and signed into effect the EEOP and, as required by applicable
federal law, it is available for review by the public,employees, the appropriate state planning agency, and the Office for
Civil Rights, Office of Justice Programs, U.S. Department of Justice. The EEOP is on file at the following office:
_U,S.DDepagment of Justice, Bureau-of Justice Assistance, Office of Justice Programs
[organization], ®.
DOJ Office Civil Rights OCR website at: www.ojp.gov/aboullwr/eeop
[address].
Alana Thurston, Human Resources Coordinator 20
Print or A e,Xam and Title Si nature to
Section C—Declaration Stating that an EEOP Short Form Has Been Submitted to the Office for Civil
Rights for Review
If a recipient ageney has fifty or more employees and is receiving a single award. or subaward,of$500,000 or more, then the recipient agency
must send an EEOP Short Form to the OCR for review.
I, [responsible
official], certify that
[recipient], which has fifty or more employees and is receiving a single award of$500,000 or more, has formulated an
EEOP in accordance with 28 CFR pt. 42, subpt. E, and sent it for review on
[date] to the Office for Civil Rights, Office of Justice Programs, U.S. Department of Justice.
If recipient sub-grants a single award over$500,000, in addition please complete Section D
Print or Type Name and Title Signature Date
Application for Funding Assistance
Florida Department of Law Enforcement
Residential Substance Abuse Treatment
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Monroe County Board of Commissioners
ATTACHMENT 3:
Subaward Management Capabilities & Compliance Questionnaire (SMQ)
Application Ref#2020-RSAT-1 33 Additional Requirements
Contract#- RSAT-MOLAR--
FQLE Subaward Management Upon completion,email a copy of
Capabilities and Compliance
this form to:
Questionnaire (SMQ) criminaljustice@fdle.state.fl.us
Grant Program: JAG F PREA ' NARIP ' NCHIP RSAT PSN
El Other:
Subrecipient: Monroe Co. Board of Commis FEID: 596000749 DUNS: 73876757
OVERVIEW
In order to meet eligibility requirements, applicants must be able to document compliance with the following prior to
receiving a subaward:
2 C.F.R Part 25—Universal Identifier and System for Award Management Requirements
28 C.F R Part 42—Nondiscrimination;Equal Employment Opportunity, Policies and Procedures
i 2 C.F.R Part§200.318-326—Federal Procurement Standards
9 2 C,F.R§200.300-309—Standards for Financial and Program Management
INSTRUCTIONS
Applicants seeking federal financial assistance from the Florida Department of Law Enforcement (FDLE), Office of
Criminal Justice Grants (OCJG) should complete this questionnaire and provide all applicable documents with the
submission of their application. Failure to provide appropriate forms, certifications, policies, procedures, or other
documentation for the proposed project may result in special conditions being placed on the subaward.
This form, along with other application forms, may be submitted to criminal',ustice@fdle.state-fl.us if scanned at the
highest resolution(at least 600 dpi).
Note: Each applicant only needs to submit one pre-award monitoring packet regardless of how many applications for
funding are being submitted.Applicants should ensure all"project-specific"forms can be easily identified.
CONTACT INFORMATION
For questions regarding this pre-award monitoring packet, contact FDLE's Office of Criminal Justice Grants at (850)
617-1250 or criminaliustice@fdle-state.fl.us.
APPLICATION POINT-OF-CONTACT(POC1
Please provide a point-of-contact to coordinate any additional information requests FDLE's Office of Criminal Justice
Grants may have during review of this packet and your application
Name: Janet Gunderson
Title: Grants Coordinator
Agency: Monroe Countv Board of Commissioners
Phone: (305) 292-4470
Email: Gunderson-Janet(cD Mon roeCounty-FL.aov
The following section consists of a series of questions to aid in determining compliance with federal regulations
required to properly administer these funds. Please read all questions carefully as some questions may require
coordination with other divisions/bureaus in your agency (i.e. finance, purchasing, human resources, etc.),
Additionally, to avoid possible special conditions being placed on your subaward, please ensure all requested
documentation is submitted with this questionnaire.
Subrecipient Financial Rev. 6/2020
Capabilities and Internal Controls
The SUBRECIPIENT has undergone the following types of audits:
Single Audit ❑ Financial Statement ❑ Defense Contract Agency Audit
Audit Programmatic Audit for:
Other Audit:
None of the above
The SUBRECIPIENT'S most recent audit was conducted:
❑✓ Within the past 12 months ❑ Within the past two years ❑ More than two years ago
Name of Auditing Agency/Firm: Cherry Bekaert LLP
Most recent auditor's opinion:❑Unqualified/Unmodified Qualified/Modified ❑ Other
Number of Findings on most recent audit only:
Were material weaknesses noted in the audit? ❑Yes FV1No
Were significant deficiencies noted in the audit? a Yes No
Has the subrecipient addressed all findings and provided a
management response or implemented corrective action? 1:1 Yes No ZN/A
• • -• •- •
1. Is the applicant entity a non-profit organization(including a non- Yes No NA
profit institution of higher education)as described in 26 U,S.C.
501(c)(3)AND exempt from taxation under 26 U,S,C. 501(a)?
If"No"or"N/A"skip to Section III:Accounting System; If"Yes",
complete questions 2 and 3 below.
2. Does the applicant non-profit organization maintain offshore
accounts for the purpose of avoiding paying the tax describe in 26 Yes No
U.S.C. 511(a)?
3 With respect to the most recent year the applicant non-profit
organization was required to file a tax return,does the applicant
non-profit organization believe(or assert)that it satisfies the Yes No
requirements of 26 C.F.R.53.4958-6 relating to the Z El
reasonableness of compensation for certain individuals?
Helpful Hint—answers to these questions may need to be obtained from your finance department.
1. Which of the following best describes the organization's accounting system:
El Manual Automatic [] Combination
2. Does the accounting system identify the receipt and expenditure of Yes No
funds separately for each grant? Z El
3. Does the accounting system record and track expenditures for Yes No
each grant by budget categories in the approved budget? Z Li
4, Does the accounting system have the capability to record, track, Yes No
and document cost share or match for each rant?
5. Is the organization documentation to support recorded match or Yes No
cost share available if requested? Z El
6. Does the accounting/financial system include budgetary controls to
prevent incurring obligations in excess of total funds or budget Yes No
category(i.e. personnel,travel,etc.)?
T Is the financial management system capable of producing the
following:
a, Detailed Activity Ledger? Yes No
Subaward Management Capabilities Rev. 6/2020
and Compliance Questionnaire
Pcb. Cash Control Register? 0 Yes No
. Property Control Register?(equipment purchases) Yes No
Helpful Hint—answers to these questions may need to be obtained from your finance and/or purchasing
de artment.
1. Are the duties of the person responsible for maintaining financial 1 Yes No
records separated from an cash-related functions? 1:1
2. Are personnel who perform disbursement functions prohibited from Yes No
purchasing, receiving and inventorying items? L
If no, are these functions approved by a third party? Yes No Z✓ N/A
3. Is the signing of disbursement checks limited to individuals:
a. Who are authorized to make disbursements? Yes No
b. Whose duties do not include:
- Posting and recording of accounts receivable? ❑✓ Yes No
- Approving vouchers for payment? Z Yes 1:1 No
4. Describe the financial process/accounting mechanism used by the applicant to track grant funds separately
from general revenue,other federal projects,and/or multiple funding sources.
Each grant has their own unique cost center and grant cost center accounts are
reconciled quarterly.
5. What measures are used to verify all cost elements on a reimbursement are allowable under an approved
subaward agreement?
Expenses charged to the grant are reviewed twice prior to approval for payment. First,the
expenses are reviewed by the grant's Project Director and second by the Clerk of the Court's office
6. What internal control measures are used to safeguard sensitive information (i.e. personally identifiable
information, law enforcement sensitive information,etc.) relating to activities,expenditures, documentation,
etc.?
Participants in the program are identified as a numeric code when tracking
activities and services received from the grant funded program.
7. Did financial staff verify that grant funds would not be used to
supplant local funds that had already been appropriated for the Z Yes 1:1No
rant project or activities?
8. How long is the agency required to retain grant files and records of grant purchases?
Five years
0
Helpful Hint—answers to these questions may need to be obtained from your human resource department.
1. Is the entity aware it must comply with federal civil rights
regulations including certifications and plan requirements? Yes No
2. Please indicate if any of the following apply to the applicant organization:
❑ Indian Tribe ❑ Nonprofit Organization ❑ Educational Institution11 Medical Institution
F7Does not apply to applicant organization
Subaward Management Capabilities Rev. 6/2020
and Compliance Questionnaire
3. Does the entity have more than 50 employees?......_... r7TY—esM No
4. Does the entity receive federal funding under the U.S. Department
of Justice, including any funds passed through another entity, of ❑✓ Yes M No
$25,000 or more, but less than$500,000?
5. Does the entity receive federal funding under the U.S. Department �
of Justice, including any funds passed through another entity, of Yes 21 No
$500,000 or more?
6 Does the organization notify employees AND program participants
that it does not discriminate on the basis of race, color, national ❑✓ Yes ® No
origin, religion, sex, disability or age?,_
7. Does the applicant organization have a written policy or procedure
instructing employees AND program participants how to file a �✓ Yes No
complaint regarding discrimination?
8. Has the applicant organization had any findings of discrimination Yes EZI No
issued b a State or Federal court in the ast three ears?
Helpful Hint—answers to these questions may need to be obtained from your finance and/or purchasing
department
1. Does the organization maintain written procurement procedures? Yes F—] No
2. Does the procurement system provide a mechanism to determine Yes1:1 No
selection on a competitive basis? IZI
3. Does the procurement system include provisions for checking the Yes No
Excluded Parties List(s am. ov prior to award? IZI
*For OG7G Personnel Only:If a copy of the organization's procurement procedures has been received,please
cam fete the procurement Poky t~hec*list
Helpful Hint—answers to these questions may need to be obtained from your finance and/or purchasing
department.
1. Does the organization's property management system provide and
maintain the following information:
a. A description of the equipment? Yes ElNo
b. A property identification number? I I I Yes ❑ No
c. Source of the property, including award number if grant Yes No
funded? El
d. Who the title vests with? 0 Yes ❑ No
e. Acquisition date? 0 Yes ❑ No
f. Federal share of property cost, if federally funded? 0 Yes ❑ No
g. Location and condition of property? 7 Yes ❑ No
h. Ultimate disposition information? 7 Yes ❑ No
2. Is documentation regarding property management for grant funded Yes No
items available? IZI
3. Does the agency assure that grant funded property is maintained Yes No
and insured in compliance with federal requirements?
• 19-110 111 ky,lei 0 111091-
1. Does the applicant entity have written policies, procedures, and/or
guidance designed to ensure that any subawards made by the
applicant entity under a federal award — (1) clearly document Yes No
applicable federal requirements, (2)are appropriately monitoring by bLi
the applicant, and (3) comply with the requirements in 2 CFR 200
see 2 CFR 200.331 ?
2. Is this applicant entity aware of the difference between subawards
under federal awards and procurement contracts under federal Yes No
awards, including the different roles/responsibilities associated with IZI
each?
Subaward Management Capabilities Rev. 6/2020
and Compliance Questionnaire
__.......... _
3. Does the applicant entity have written policies and procedures
designed to prevent the applicant entity from issuing a contract underI If I Yes No
a federal award to any entity or individual that is suspended or
debarred from such awards?
• lei z
T. Is the applicant entity designated "high risk" by a federal grantI IYes No
makin a enc or other ass-throw h entity
Yj
• e •
On behalf of the applicant entity, I certify to the Florida Department of Law Enforcement that the information provided
above is complete and correct to the best of my knowledge. I have the requisite authority and information to make
this certification on behalf of the applicant entity.
Title: Mayor Phone: (305) 292-3430
Date; Signature:
Subaward Management Capabilities Rev. 6/2020
and Compliance Questionnaire
Application for Funding Assistance
Florida Department of Law Enforcement
Residential Substance Abuse Treatment
9'gj-'�""' '9" aj
M:1
Monroe County Board of Commissioners
ATTACHMENT 4:
Certification Regarding Lobbying: Debarment, Suspension and Other
Responsibility Matters and Drug Free Workplace Requirements
Application Ref#2020-RSAT-1 33 Additional Requirements
Contract#- RSAT-MOLAR--
y.. Lobbying Debarment upon completion,mail a copy of this form to:
t Florida Department of Law Enforcement
and Drug Free Workplace Office of Criminal Justice Grants
Certification P.O. Box 1489
Tallahassee, FL 32302-1489
Applicants should refer to the regulations cited below to determine the certification to which they are required to attest.
Applicants should also review the instructions for certification included in the regulations before completing this form.
Signature of this form provides for compliance with certification requirements under 28 CFR Part 69, "New Restrictions on
Lobbying" and 28 CFR Part 67, "Government-wide Debarment and Suspensions (Non-procurement) and Government-wide
Requirements for Drug Free Workplace (Grants)". The certifications shall be treated as a material representation of fact
upon which reliance will be placed when the Office of Criminal Justice Grants determines to award the covered transaction,
grant, or cooperative agreement.
1. Lobbying
As required by Section 1352, Title 31 of the U.S.Code, and implemented at 28 CFR Part 69,for persons entering into a
grant or cooperative agreement over$100,000,as defined at 28 CFR Part 69,the applicant certifies that:
(a) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or
employee of Congress, or an employee of a member of Congress in connection with the making of any federal
grant, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or
modification of any federal grant or cooperative agreement.
(b) If any funds other than federal appropriated funds have been paid or will be paid to influence an officer or employee
of any agency, a member of Congress, an officer or employee of Congress, or an employee of a member of
Congress in connection with this federal grant or cooperative agreement, the undersigned shall complete and
submit Standard Fora LLL--"Disclosure of Lobbying Activities", in accordance with its instructions.
(c) The undersigned shall require that the language of this certification be included in the award documents for all
subawards at all tiers (including subgrants, contracts under grants and cooperative agreements, and subcontracts)
and that all subrecipients shall certify and disclose accordingly.
2. Debarment,Suspension and Other Responsibility Matters
As required by Executive Order 12549, Debarment and Suspension,and implemented at 28 CFR Part 67-
(a) The applicant certifies that it and its principals:
(i) Are not presently debarred, suspended, proposed for debarment, declared ineligible, sentenced to a denial of
federal benefits by a State or Federal court, or voluntarily excluded from covered transactions by any federal
department or agency;
(ii) Have not within a three-year period preceding this application been convicted of or had a civil judgement
rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to
obtain, or performing a public transaction; violation of Federal or State antitrust statutes or commission of
embezzlement,theft forgery, bribery,falsification or destruction of records, making false statements,or receiving
stolen property;
(iii)Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State,
or local)with commission of any of the offenses enumerated in paragraph(a)(ii)of this certification; and
(iv)Have not within a three-year period preceding this application had one or more public transactions (Federal,
State or local)terminated for cause or default.
(b) Where the applicant is unable to certify to any of the statements in this certification, he or she shall attach an
explanation to this application.
3. Drug Free Workplace
As required by the Drug-Free Workplace Act of 1988, and implemented at 28 CFR Part 67, Subpart F, as defined at 28
CFR Part 67 Sections 67.615 and 67.620—
(a) The applicant certifies that it will or will continue to provide a drug-free workplace by:
(i) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession,
or use of a controlled substance is prohibited in the subgrantee's workplace and specifying the actions that will
Certification Regarding Lobbying; Debarment, Suspension, Page 1 of 2
and Other Matters; and Drug Free Workplace Requirements OCJG-001 (rev. 9/2018)
r'M � Upon completion,mail a copy of this form to:
mts Lobbying, Debarment Florida Department of Law Enforcement
Office of Criminal Justice Grants
and Drug Free Workplace P.O. Box 1489
�= Certification Tallahassee, FL 32302-1489
be taken against employees for violation of such prohibition;
(ii) Establishing an on-going drug-free awareness program to inform employees about—
(1) The dangers of drug abuse in the workplace;
(2) The subgrantee's policy of maintaining a drug-free workplace;
(3) Any available drug counseling, rehabilitation,and employee assistance programs;and
(4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace.
(iii)Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of
the statement required by paragraph(i);
(iv)Notifying the employee in the statement required by paragraph (i)that, as a condition of employment under the
grant,the employee will—
(1) Abide by the terms of this statement; and
(2) Notify the employer in writing of his or her conviction for a violation of criminal drug statute occurring in the
workplace no later than five(5)calendar days after the conviction.
(v) Notifying the agency, in writing, within ten (10) calendar days after receiving notice under subparagraph (iv)(2)
from an employee or otherwise receiving actual notice of such conviction. Employers of convicted employees
must provide notice including position title to: Florida Department of Law Enforcement,Office of Criminal Justice
Grants, RO Box 1489, Tallahassee, FL 32302-1489. Notice shall include the identification number(s) of each
affected grant.
(vi)Taking one of the following actions within thirty (30) calendar days of receiving notice under subparagraph
(iv)(2),with respect to any employee who is convicted—
(1) Taking appropriate personnel action against such an employee, up to and including termination, consistent
with the requirements of the Rehabilitation Act of 1973,as amended; or
(2) Requiring such employee to participate in a drug abuse assistance or rehabilitation program approved for
such purposes by a Federal,State, or local health, law enforcement,or other appropriate agency.
(vii) Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs
(i)through(vi).
(b) The subgrantee may insert in the space provided blow the site(s) for the performance or work done in connection
with
As the duly authorized representative of the applicant, I hereby certify that applicant will comply with the following
certifications:
❑✓ Certification Regarding Lobbying(required for applications over$100,000)
✓❑ Certification Regarding Debarment,Suspension and Other Responsibility Matters(required for all applicants)
�✓ Certification Regarding Drug-Free Workplace(required for state agency applications)
Subrecipient: Monroe County Board of Commissioners
Printed Name: Neathe arr t , r Title: Mayor
Signature: Date: to
Z-- ---- U
Certification Regarding Lobbying; Debarment, Suspension, Page 2 of 2
and Other Matters; and Drug Free Workplace Requirements OCJG-001 (rev. 9/2018)
Application for Funding Assistance
Florida Department of Law Enforcement
Residential Substance Abuse Treatment
9'gj-,�,"" ,V, aj
"��,"qv- -�,"qvq,
Monroe County Board of Commissioners
ATTACHMENT 5:
Subrecipient vs. Contractor Determination Checklist
Application Ref#2020-RSAT-1 33 Additional Requirements
Contract#- RSAT-MOLAR--
Subrecipient vs.
Contractor Determination Upon completion, mail email a copy of this
Checklist form to: cri inaliustice&fdle.state.fl.us
Applicant Name: Monroe County Board of CommiSSila Application#:
Third Party Name: Guidance/Care Center
In accordance with 2 C.F.R. 200.330, a pass-through entity must make a case-by-case determination whether each
contractual agreement it makes under a federal award classifies the third party as subrecipient or contractor. There
are certain requirements which must be met depending on the relationship between a pass-through entity and its
third party.
Florida Department of Law Enforcement, Office of Criminal Justice Grants (OCJG) is ultimately responsible for
ensuring a correct determination is made under the federal program. In the event of a dispute regarding the
determination, OCJG may seek final determination from the U.S. Department of Justice, Office of Justice Programs.
Please answer the following questions in relation to the contractual service proposed in your grant
application/award:
1. Will the third party provide goods/services related to crime and criminal ❑ Yes No
justice to the public?
2. Will the third party provide crime or criminal justice services to individual ❑ Yes No
members of the public?
3. Will the third party develop, adapt, or otherwise improve training and Yes 7 No
technical assistance materials to meet the needs of entities or individuals
working to address crime, improve criminal justice, or assist victims of
crime?
4. Will the third party provide training or technical assistance to entities or ❑ Yes No
individuals working to address crime, improve criminal justice, or assist
victims of crime?
5. Will the third party develop, or improve, technology useful in addressing Yes No
crime, improving criminal justice, or assisting victims of crime?
6. Will the third party collect and analyze data, or conduct research and Yes No
evaluation, on issues related to crime, criminal justice, and victimization?
7. Will the third party provide services which are designed, modified, or Yes 7 No
adapted to meet particular needs?
8. Will the third party make determinations as to who may be eligible for the 7 Yes No
services proposed in the application?
9. Will the third party make determinations (or evaluate) regarding the Yes No
quantity and types services a program participant will receive?
10. Will the third party be required to submit data which is necessary to Yes No
complete the performance reporting under the proposed application?
If any of 1-10 is ves, the contractual relationship is a subrecipient. Otherwise the contractual relationship is a
contractor. Please see page two for important information regarding your determination.
DETERMINATION: 7 Subrecipient ❑ Contractor
Subrecipient vs. Contractor Checklist OCJG-012(3/2020)
Subrecipient vs.
Contractor Determination Upon completion, mail email a copy of this
Checklist form to: cri inaliustice&fdle.state.fl.us
Compliance Requirements Based on the Relationship Determination
Failure to address or provide documentation of compliance with the appropriate requirements as listed below may
result in a withholding of funds condition being placed on the award. This type of condition will prevent the review
and approval of any reimbursement requests ultimately delaying payment.
For a subrecipient determination:
✓❑ Third party has a DUNS number AND active SAM.gov registration.
Contractual agreement addresses all required elements in 2 CFR 200.331(a).
A risk assessment has been developed to evaluate the third party's level of risk. (OCJG Example)
✓❑A monitoring tool has been developed to monitor the third party's compliance with all applicable federal
award conditions, rules, regulations, etc. (OCJG Example)
Written policies and procedures exist to document the award, management, and monitoring of any third
party subrecipient.
For a contractor determination:
✓❑ Third party is not on the excluded parties(suspended/debarred) list in SAM.gov
Contractual agreement addresses all required elements in 2 CFR 200 Appendix 11.
✓❑ Selection of the third party is in accordance the federal procurement standards identified in 2 CFR
200.318-326.
✓❑ Selection of the third party is free from any direct or perceived conflict of interest.
✓❑ If the selection of the third party is by non-competitive procurement methods, a sole source justification
form has been submitted to OCJG.
❑ Documentation related to the method of procurement, selection of the contract type, contractor
selection/rejection, and the basis for the contract price is available upon request.
A documented cost analysis has been completed and all elements are allowable, reasonable, necessary
and allocable to the proposed project.
**********************************************For FDLE Use Only************************************************
❑ Agree with the determination made by the OCJG applicant
❑ Disagree with the determination made by the OCJG applicant;the relationship appears to be that of a:
❑ Subrecipient ❑ Contractor
Justification/Comments:
Approved By: Date:
Subrecipient vs. Contractor Checklist OCJG-012(3/2020)
10/29/2020 View Details-Core Data I System for Award Management
VQD A NEW WAY TO SIGN IN-If you already have
a SAM account,use your SAM email for login.gov. ®'
Login.gov F'AQs
ALERT:SAM.gov will be down for scheduled maintenance Saturday,11/14/2020 from 8:00 AM to 5:00 PM.
Entity Dashboard ®®
r Entity Overview ®` . • ..
Entity Registration Review Core Data
P Core Data
P Assertions
ICI i
E Reps&Certs Current Record
P POCs
DUNS Number: 085566461
p Exclusions D&B Legal Business Name: GUIDANCE/CARE CENTER,INC.
E Active Exclusions Doing Business As: Guidance Clinic of Middle Keys
P Inactive Exclusions
P Excluded Family
Members
RFrL"RLIv TO S:L-kRCTI Business Information:
Business Start Date: 05/09/1973
Fiscal Year End Close Date: o6/30
Company Division Name:
Company Division Number:
Corporate URL:
Congressional District: FL 26
Initial Registration Date: 02/11/2004
Submission Date: o8/03/2020
Activation Date: 08/03/2020
Expiration Date: 08/03/2021
Physical Address:
Address Line r: 3000 41st Street Ocean
City: Marathon
State/Province: FL
Country: UNITED STATES
ZIP/Postal Code: 33050 - 2373
Mailing Address:
Address Line 1: 3000 4tST STREET OCEAN
Address Line 2:
City: MARATHON
State/Province: FL
Country: ! UNITED STATES
ZIP/Postal Code: 33050, 2373
https://sam.gov/SAM/pages/public/entitySearch/entitySearchCoreReview.jsf 1/3
10/29/2020 View Details-Core Data I System for Award Management
CAGE: 3QSB8
Does this entity have an Immediate Owner? No
Does this entity have any Predecessors? i No
ME ;ii
Doing Business As: Guidance Clinic of Middle Keys
Country of Incorporation: UNITED STATES
State of Incorporation: FL
Correspondence Flag:
Business Types
Check the registrant's Reps&Certs,if present,under FAR 52,212-3 or FAR 52,219-1 to determine if
the entity is an SBA-certified HUBZone small business concern.Additional small business
information maybe found in the SBA's Dynamic Small Business Search if the entity completed the
SBA Supplemental Pages during registration.
Entity Structure
Corporate Entity(Tax Exempt)
Profit Structure
Non-Profit Organization
Entity Type
Business or Organization
Purpose of Registration
All Awards
Do you accept credit cards as a method of payment? Yes
Account Details:
CAGE Code: 3QSB8
Electronic Funds Transfer:
Automated Clearing House(ACH):
Registrants in the System for Award Management(SAM)respond to the Executive Compensation questions in accordance with
Section 6202 of P.L.110-252,amending the Federal Funding Accountability and Transparency Act(EL, 09-282).This
information is not displayed in SAM,It is sent to USAspending.gov for display in association with an eligible award.Maintaining
an active registration in SAM demonstrates the registrant responded to the questions.
Registrants in the System for Award Management(SAM)respond to proceedings questions in accordance with FAR 52,209-7,
FAR 52,209-9,or 2.C,F.R.20o Appendix XIL Their responses are not displayed in SAM,They are sent to'FAPIIS.gov for display
as applicable.Maintaining an active registration in SAM demonstrates the;registrant responded to the proceedings questions.
https://sam.gov/SAM/pages/public/entitySearch/entitySearchCoreReview.jsf 2/3
10/29/2020 View Details-Core Data I System for Award Management
I authorize my entity's non-sensitive information to be displayed in SAM public search results: Yes
• • .
https://sam.gov/SAM/pages/public/entitySearch/entitySearchCoreReview.jsf 3/3
Application for Funding Assistance
Florida Department of Law Enforcement
Residential Substance Abuse Treatment
9'gj-,�,"" ,V, aj
"��,"qv- -�,"qvv,
Monroe County Board of Commissioners
ATTACHMENT 6:
Sole Source Justification
Application Ref#2020-RSAT-1 33 Additional Requirements
Contract#- RSAT-MOLAR--
Office of Criminal Justice Grants
{W& ' SOLE SOURCE JUSTIFICATION APPROVAL FORM
Email completed form to: criminaliustice&fdle.state.fl.us
Noncompetitive procurement, or sole source, is procurement based on the submission of a proposal/quote from only
one source. Sole source procurements on a federal award must adhere to 2 C.F.R. §200.320(f), 200.407, and
Section 3.8 of the Department of Justice Grants Financial Guide. Agencies intending to use non-competitive
procurement practices must complete and submit this form to the Office of Criminal Justice Grants for approval.
Please attach additional pages if more space is required.
Brand names do not constitute a legitimate request for a sole source procurement. For example, Taser is a brand
name of"conducted electrical weapon" sold by Axon. However, "conducted electrical weapons" are sold by multiple
different manufacturers/vendors.
Note: Failure to obtain approval for sole source prior to expending funds is at subgrantee risk. If the sole source is
not approved, those costs may be disallowed on a reimbursement request.
Select Program: RSAT Application/Grant Number:
Subgrantee: Monroe County Board of Commissioners Sole Source Category: Single Source
SECTION I: Provide a brief description of the project, the amount designated for sole source procurement, the
purpose of the item/service, and an itemized budget for the sole source amount.
The project will administer and provide evidence-based substance abuse treatment services
to men incarcerated in the Monroe Co. Detention Center. 100% of the grant ($133,334)will
be designated for the sole source procurement, therefore, 100% of the budget ($133,334)will
be allocated to the Contractual Services budget category. Within contractual services there
are four (4) primary components to the evidence-based substance abuse treatment services:
Client Assessment, Individual Therapy, Group Therapy & Case Management. The program
has been proven to be successful through the tracking of the rate of recidivism upon release.
SECTION II: Provide an explanation as to why it is necessary to procure the item/service in a noncompetitive
manner. This description should address, at a minimum, each point below based on the sole source category
selected above.
Single Source Public Emergency Inadequate Competition
- Uniqueness of items or services to - Description of emergency - Describe result of market survey
be procured - Need for the item/service in to determine available
- How agency determined item or relation to the emergency competition
service is only available from a - Effects of delay on project - If no market survey was
single source activities if sole source is conducted, explain why
- Explanation of the need for the not approved
vendor/providers expertise in
relation to the grant project
The Guidance/Care Center (G/CC), a 501c3 not-for-profit organization, is the only organization with a
proven track record for successfully working with Detention Center officials & staff for many years.
Also, is currently the only organization approved by the Florida Department of Children & Families to
provide substance abuse treatment services on-site at the Monroe County Detention Center. G/CC
has proven the Jail In-house Program to be successful through the tracking of a low rate of recidivism
upon release. A market survey was not conducted because of the nature of the market in Monroe
County; a rural community, physically isolated due it's location and the availability of only one (1) road
to get in/out of the county and the limitations of affordable workforce housing.
OCJG-011 (rev. 3/2020)
Office of Criminal Justice Grants
SOLE SOURCE JUSTIFICATION APPROVAL FORM (continued)
Section III:Conflict of Interest Certification
By signing below, I certify there is no conflict of interest between the subgrantee and the proposed
vendor/provider. I also attest the Excluded Parties List (www.sam.gov) was checked and the proposed
vendor/provider is not suspended or debarred from receiving federal funds. Finally, I certify this
procurement complies with federal, state, and local laws and regulations.
Name: Heather arruthers Title: Mayor
Signature: Date: 1010124W
FDLE USE ONLY-Section IV: Sole source review checklist to assess and approve or deny a request for
! sole source procurements under a federal award, The sole source approval request only needs to meet
one of the qualifying situations listed on this checklist. If any questions have a"No"answer the justification
should be denied or you must request the information be updated/changed,
For noncompetitive procurement due to SINGLE SOURCE:
a) Does independent research through internet searches or
discussions with subject matter experts corroborate that the item is Yes No ❑N/A
available only from a single source?
b) Does Section II demonstrate the uniqueness of items or services to be procured from the proposed vendor/contractor (e.g. compatibility Yes No N/A
issues,etc.)?
c) Does the request demonstrate and support how the agency
determined the item or service is only available from one source(i.e. Yes No N/A
market survey, independent agency research, proprietary system)?
d) Does the request demonstrate a significant need for the
vendor/providers expertise in relation to the grant project? Yes No N/A
For noncompetitive procurement due to PUBLIC EMERGENCY:
a) Is there a public emergency such as a natural disaster or Yes No ❑ N/A
catastrophic event?
b) Has there been a declared state of emergency in which these Yes No N/A
goods or services will be needed? -
c) Is there an immediate health or safety concern? ❑Yes No N/A
For noncompetitive procurement due to INADEQUATE COMPETITION:
a) Does the request adequately describe the efforts to competitively
contract for this item(i.e. RFP/Bids, nature of response,etc,)? Yes No N/A
11
b) Does the request adequately describe the efforts to ensure the Yes No N/A
contract pricing is fair and reasonable?
c) Does the request provide results of a market survey to determine -
competition availability or explain why no survey was conducted? Yes � No NIA
Date Received:, Approved
Reviewed By: Change Requested
Date: Denied
OCJG-011 (rev. 3/2020)
License Number
LIC-1046047
Stalhe% of Florida
Department of Children and Families
CERTIFIES
Guidance/Care enter, Inc.
Is licensed in accordance with Chapter 397,Florida Statutes to provide substance abuse services for
Aftercare
located a :
Site: 3 1205 Fourth Street Signature Date: 5/28/2020
Accredited By: CARF Key West,FL 33040 Effective Date: 7/11/2020
Expiration Date: 7/10/2021
=,r &
License Type: Regular uesleogae
Site: 2 5525 rdlege Rd Signature Date: 5/28/2020
Key lest, FL 33040 13A-)Accredited By: CARF Effective Date: 7/11/2020
Expiration Date: 7/10/2021
License Type: Regular YamileDlaz
Site: 5 99198 Overseas Hwy. Suite 5 Ste + Signature Date: 5/28/2020
Suite 5 SAD
Accredited By: CARF Key Largo, FL 33037 Effective Date: 7/11/2020
Explratlon Date: 7/10/2021
License Type: Regular YamlleDlaz
Site: 4 3000 41st Street Ocean4 Signature Date: 5/28/2020
Marathon, FL 33050
Accredited By: CARF Effective Date: 7/11/2020
Expiration 7/10/2021
Date:
License Type: Regular Yamlle Diaz
Accredited By Commission on Accreditation of Rehabilitation Facilities (CARF)
"This license was Issued based,In part,on the survey report of a Department recognized accrediting organization"
License Number
LIC-1046041
S L le of Florida j6at
Department of Children and Families
CERTIFIES
Guidance/Care Center, Inc.
Is licensed In accordance with Chapter,497,Florida Statutes to provide substance abuse services for
Case Management
located at-
Site:3 1205 Fourth Street Signature Date: 5/28/2020
Key West,FL 33040
Accredited By:CARF Effective Date: 7/11/2020
Expiration Date: 7/10/2021
License Type: Regular va"Ok DWI
Site:2 5525 Caliege Rd Signature Date: 5/26/2020
Key West,FL 33040 1.1
Accredited By:CARE Effective Date: 7/11/2020
Expiration Date:7/10/2021
License Type: Regular UT11OW87
Site:5 99198 Overseas Hwy.Suite 5 Ste Signature Date: 5128/2020
Suite 5
Accredited By:CARF Key Largo,FL 33037 Effective Date: 7/11/2020
Expiration DoW 7/10/2021
License Type: R"u1sr ymft Owl
Site:4 3000 41st Street Ocean Signature Date. 5/28/2020
Marathon,FL 33050
Accredited By:CARP WhetiVe Datc 7111/2020
Expiration 7/10/2021
Date,
Llcerssefype. Aogulw yamk 01.3,
Accredited By Commission on Accreditation of Rehabilitation Facilities(CARF)
"This license was Issued based,In part,on the survey report of a Department recognized accrediting organization"
License Number
LIC-1046043
t a tmft 0---f r'10--- r i d a
Department of Children and Families
CERTIFIES
Guidance/Care Center, Inc.
Is licensed in accordance with Chapter,397, Florida Statutes to provide substance abuse services for
General Intervention
located at:
Site: 3 1205 Fourth Street a Signature Date: 5/28/2020
Key West, FL 3304
Accredited By: CARF Effective Date: 7/11/2020
J " Expiration Date: 7/10/2021
License Type: Regular Yarn'Ie Dlaz
Site: 2 5525 College Rd Signature Date: 5/28/2020
Accredited By: CARF Key West, FL 33040 Effective Date: 7/11/2020
Expiration Date: 7/10/2021
License Type: Regular YamlleDlaz
Site: 5 99198 Overseas Hwy. Suite 5 Ste Signature Date: 5/28/2020
suite 5
Accredited By: CARF Key Largo, FL 33037 3 Effective Date: 7/11/2020
Expiration Date: 7/10/2021
License Type: Regular YamlleDlaz
Site: 4 3000 41st Street Ocean Signature Date: 5/28/2020
Marathon, FL 33050
Accredited By: CARF Effective Date: 7/11/2020
Expiration 7/10/2021
Date:
License Type: Regular YamlleDlaz
Accredited By Commission on Accreditation of Rehabilitation Facilities (CARF)
"This license was Issued based,In part,on the survey report of a Department recognized accrediting organization"
License Number
LIC-1046048
Department of Children and Families
CERTIFIES
Guidance/Care Cenr, Inc.
Is licensed In accordance with Chapter 397, Florida Statutes to provide substance abuse services for
Intensive Outpatient Treatment
located at;
Site: 3 1205 Fourth Street Signature Date: 5/28/2020
Key West, FL 33040
Accredited By: CARF 1110 Effective Date: 7/11/2020
� � .k13 Expiration Date: 7/10/2021
F ;. .
License Type: Regular v3mta itr.ax
Site: 2 5525 College Rd Signature Date: 5/28/2020
Key West, FL 33040
Accredited By: CARF Effective Date: 7/11/2020
Expiration Date: 7/10/2021
License Type: Regular YamlleDlaz
Site: 5 99198 Overseas Hwy. Suite 5 Ste rw Signature Date: 5/28/2020
- suite 5
Accredited y: CARF Key Largo, FL 33037 Effective Date: 7/11/2020
Expiration Date: 7/10/2021
License Type: Regular YamlleDlaz
Site: 4 3000 41st Street Ocean Signature Date: 5/28/2020
Marathon, FL 33050 P$10Accredited By: CARF Effective Date: 7/11/2020
Expiration 7/10/2021
Date:
License Type: Regular YamlleDlaz
Accredited By Commission on Accreditation of Rehabilitation Facilities (CARF)
"This license was Issued based,In part,on the survey report of a Department recognized accrediting organization"
License Number
LIC-1046040
ASP t a t6e o y-g-' PrI o r i d-ja
Department of Children and Families
CERTIFIES,
Guidance/Care Center, Inc.
Is licensed In accordance with Chapter 39,7,Florida Statutes to provide substance abuse services for
Level 1 Prevention
located at;
Site:3 1205 Fourth Street Signature Date: 5/28/2020
Key West,FL 33040
Accredited By:CARF Effective Date: 7/11/2020
- L F -11 1 U 4Q (71 XA Expiratlon Date: 7/10/2021
License Type: Regular F Nnlla Diaz
Site:2 5525 College Rd Signature Date: 5/28/2020
Accredited By:CARF Key West,FL 33040 Effective Date: 7/11/2020
Expiration Date:7/10/2021
License Type: Regular Vainve Diaz
Site:5 99198 Overseas Hwy.Suite 5 Ste Signature Date: 5/28/2020
Suite 5
Accredited By:CARF Key Largo,FL 33037 Effective Date: 7/11/2020
Expiration Date:7/10/2021
License Type: Regular Yzm11aDMz
Site:4 3000 41st Street Ocean Signature Date: 5/28/2020
Accredited By:CARF Marathon,FL 33050 CV) Effective Date: 7i`1`112626
Expiration 7/10/2021
Date:
License Type: Regular Y.M116 Diaz
Accredited By Commission on Accreditation of Rehabilitation Facilities(CARF)
"This license was Issued based,In part,on the survey report of a Department recognized accrediting organization"
License Number
LIC-1046042
S L ur-lorida j6at e o Y'L
Department of Children and Families
CERTIFIES
Guidance/Care Center, Inc.
Is licensed In accordance with Chapter 307,Florida statutes to provide substance abuse services for
Level 2 Prevention
located at:
Site:3 1205 Fourth Street Signature Date: 5/28/2020
Key West,FL 33040
Accredited By:CARF Effective Date: 7/11/2020
Expiration Date: 7/10/2021
License Type: Regular V.,11,Do.,
Site:2 5525 College Rd Signature Date: 5/28/2020
Accredited By:CARF Key West,FL 33040 pSk) Effective Date: 7/11/2020
Expiration Date; 7/10/2021
License Type: Regular Vamile 01az
Site:5 99198 Overseas Hwy.Suite 5 Ste (ICA- Signature Date: 5/28/2020
Suite 5 VU
Accredited By:CARF Key Largo,FL 33037 Effective Date: 7/11/2020
Expiration Date: 7/10/2021
License Type: Regular ymhow
Slte:4 3000 41st Street Ocean Seg na te re Date: 512812020
Marathon,FL 33,050,
Accredited By:CARF Efreal ve Daio: 711112020
Expiration 7/10/2021
Date:
Llcerise Type: Aegw!.r Y.MlxViaz
Accredited By Commission on Accreditation of Rehabilitation Facilities(CARF)
"This license was Issued based,In part,on the survey report of Department recognized accrediting organization"
License Number
LIC-1046045
FloridaState of
Department of Children and Families
CERTIFIES
Guidance/Care Center, Inc.
Is licensed In accordance with Chapter 3,97e Florida Statutes to provide substance abuse services for
Outpatlent Detafficatlon
located att
Site:3 1205 Fourth Street I Signature Date: 5/28/2020
Accredited By:CARF Key West,FL 33040 Ick) Effective Date. 7t1112020
-; I A Expiration Date:7/10/2021
License Type: Ragular Ya"Urs Q,4az
Site:2 5525 College Rd } Signature Date: 5/28/2020
Key West,FL 33040 IAccredited By;CARF 3k) Effective Date: 7l11l2020
Expiration Date: 7/10/2021
License Type: Ragelar Yarnkowz
Site;5 44148 Overseas Hwy.Suite 5 Ste (� � Signature Date, 5/28/2020
Suite 5
Accredited By:CARF Key Largo,FL 33037 VU Effective Date: 7/11/2020
Expiration Date: 7/10/2021
License Type: Regular Ydmkolax
Site:4 3000 41st Street Ocean , Sgnatur D.te: 5/28/2020
Marathon,FL 33050
Accredited By:CARF ` Effective Sate: 711112020
Expiration 7/10/2021
Date:
License Type: Regular Yamke ow
Accredited By Commission on Accreditation of Rehabilitation Facilities(CARF)
"This license was Issued based,In part,on the survey report of a Department recognized accrediting organization"
License Number
LIC-1046046
Stabm of Florida
Department of Children land Families
CIERTTFIES
Guidance/Care Center, Inc.
Is licensed In accordance with Chapter 3,97,Florida,Statutes to provide substance abuse services for
Outpatient Treatment
located at:
Site: 3 1205 Fourth Street Signature Date: 5/28/2020
Accredited By: CARF Key West, FL 33040 Effective Date: 7/11/2020
Expiration Date: 7/10/2021
License Type: Regular Ym&Diaz
Site: 2 5525 College Rd Signature Date: 5/28/2020
Accredited By: CARF Key West, FL 33040 13A,) Effective Date: 7/11/2020
Expiration Date: 7/10/2021
License Type; Regular yamlleDlaz
Site: 5 99198 Overseas Hwy. Suite 5 Ste Signature Date: 5/28/2020
Suite 5
Accredited By: CARF Key Largo, FL 33037 A) Effective Date: 7/11/2020
EXPIrAon Date: 71100021
License Type: Regular YarrilleDlez
Site: 4 3000 41st Street Ocean Signature Date: 5/28/2020
Marathon, FL 33050
Accredited By: CARF Effective Date: 7/11/2020
Expiration 7/10/2021
Date:
License Type: Regular Yarn1le Diaz
Accredited By Commission on Accreditation of Rehabilitation Facilities(CARF)
"This license was Issued based,In part,on the survey report of a Department recognized accrediting organization"
License Number
LIC-1046039
btaxc- --of Florida
Department of Children and Families
CERTIFIES
Guidance/Care Center, Inc.
Is licensed In accordance with Chapter 397,Florida Statutes to provide substance abuse services for
Treatment Alternatives for Safer Communities
located at:
Site: 3 1205 Fourth Street Signature Date: 5/28/2020
Key West, FL 33040 1
Accredited By: CARF lk) Effective Date: 7/11/2020
Expiration Date: 7/10/2021
License Type: Regular VAKIAODW
Site: 2 5525 College Rd Signature Date: 5/28/2020
Accredited By: CARF Key West,FL 33040 Effective Date: 7/11/2020
Expiration Date: 7/10/2021
License Type: Regular Yamlle Diaz
Site: 5 99198 Overseas Hwy.Suite 5 Ste Signature Date: 5/28/2020
Suite 5
Accredited By: CARF Key Largo, FL 33037 Effective Date: 7/11/2020
Expiration Date: 7/10/2021
License Type: Regular YarrilleDlaz
Site: 4 3000 41st Street Ocean 0 Signature Date: 5/28/2020
Accredited By: CARF Marathon, FL33050 Effective Date: 7/11/2020
Expiration 7/10/2021
Date:
License Type: Regular Yamlle Diaz
Accredited By Commission on Accreditation of Rehabilitation Facilities(CARF)
"This license was Issued based,In part,on the survey report of a Department recognized accrediting organization"
License Number
LIC-1 046071
State of Florida
Department of Children and Families
CERTIFIES
Guidance/Care Center, Inc.
Is licensed In accordance With Chapter 397,Florida,Statutes to provide substance abuse services for
Addictions Receiving Facility
located at:
Site: 4 3000 41st Street Ocean Signature Date: 6/21/2019
Marathon,FL 33050
Accredited By: CARF Effective Date: 7/11/2020
Expiration Date: 7/10/2021
&A
License Type: Regular Bed Capaclty 11 Yamile Diaz
Accredited By Commission on Accreditation of Rehabilitation Facilities(CARF)
"This license was issued based,in part,on the survey report of a Department recognized accrediting organization"
License Number
LIC-1046070
Floridab1a'E=A-& Op,-f
Department of Children and Families
CERTIFIES
Guidance/Care Center, Inc.
Is licensed In accordance with Chapter 397, Florida Statutes to provide substance abuse services for
Inpatient Detoxification
located at:
Slte: 4 3000 41st Street Ocean Signature Date: 6/21/2019
Marathon, FL 33050 1k)
Accredited By: CARF Effective Date: 7/11/2020
a� Expiration Date: 7/10/2021
License Type: Regular Bed Capacity: B Yomlle Diaz
Accredited By Commission on Accreditation of Rehabilitation Facilities (CARF)
"This license was Issued based,In part,on the survey report of a Department recognized accrediting organization"
Application for Funding Assistance
Florida Department of Law Enforcement
Residential Substance Abuse Treatment
9'gj-,�,"" ,9" aj
"��,"qv- -�,"qvq,
Monroe County Board of Commissioners
ATTACHMENT 7:
Employee Eligibility Verification
Employees of the Service Provider
Application Ref#2020-RSAT-1 33 Additional Requirements
Contract#- RSAT-MOLAR--
E-Verify Tutorial - Knowledge "Pest Results Page l of l
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Nazneen Khatib(NAZN2144),your score is 89.29%
Naveen Khat b,you successfully completed this tutorial and passed the E-Verify Knowledge Test on October 23.,201 T
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Current Year 2,020 GAI 501 ; EST CAR.E�.NC Cc:2Y 2021--%10:11 0:50A.Prl(CST)
Case Closed�Case#2020163193628FH)
Employment Authorized
You have closed case(21D2D1 53193626FI).Record-Hs case venficatioi-oi-:he employee's Form 1=9 or pm--. he case details wd keep on file.
Last Name
Ain,,s,mna
First Name
Kaylee.
Middle Inifiall
M
Other Names Used
Birth,Date
Dec 12,1997
Socnall SeCUrity NUmber
xxx-xx-15033
Empl,oyee EmaillAddreS3
Citizenship Status
Us Citizen:
DOCLInnent Type
Us passlpol?
DOOLInnent NL]Imber
54� '6 M1561
Document Expiration Date
Oct 20,2026
Hire Date
Jun 1,2020
Employer Case Idl
',AF513A.647
Client Company Name
GU:D.A.NCPE CARE CENTER INC
SLIbrinitted By
*hatib
SLIbIllitted On,
JUIP 1.2020