Item C22Revised 2/95
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: October 15, 2003
Bulk Item: Yes ® No ❑
Division: Management Services
Department: Administrative Services
AGENDA ITEM WORDING: Authorization for the Mayor to execute the fiscal year 2004
contract with the Rural Health Network of Monroe County to provide rp imqu health care in
Monroe County.
ITEM BACKGROUND: Services offered at various locations throughout the County, and on
medi-van, which visits all areas of the County.
PREVIOUS RELEVANT BOCC ACTION: Approval of funding amounts as part of the FY2004
budget process and funding in previous budget years
CONTRACT/AGREEMENT CHANGES: none except term beginning and ending dates and
more general description of services
STAFF RECOMMENDATION: approval
TOTAL COST: $150,000.00
COST TO COUNTY: $150,000.00
REVENUE PRODUCING: Yes ❑ No
BUDGETED: Yes ® No ❑
SOURCE OF FUNDS: ad valorem taxes
AMOUNT PER MONTH
YEAR
APPROVED BY: COUNTY ATTY ® OMB/PURCHASING ® RISK MANAGEMENT
DIVISION DIRECTOR APPROVAL:.
Sheila A. Barker
DOCUMENTATION: INCLUDED: ® TO FOLLOW: ❑ NOT REQUIRED: ❑
DISPOSITION: AGENDA ITEM #:
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract with: Rural Health Network Effective Date: 10/1/03
Expiration Date: 9/30/04
Contract Purpose/Description: Approval of contract with Rural Health Network to provide
primary health care to disadvantaged citizens in Monroe County.
Contract Manager: David P. Owens
(Name)
for BOCC meeting on 10/15/03
4482 OMB/Grants Mgt.
(Ext.) (Department)
Deadline: 09/30/03
CONTRACT COSTS
Total Dollar Value of Contract: $150,000.00 Current Year Portion: $150,000.00
Budgeted? Yes X No Account Codes: 001-04571-530340
Grant: $0.00
County Match: $0.00
ADDITIONAL COSTS
Estimated Ongoing Costs: $0.00 For:
(Not included in dollar value above) (eg. Maintenance
CONTRACT REVIEW
Changes Date Out
Date In Needed Reviewer
Division Director Yes❑ No[
Risk Management `/�y/p3 YesQ No❑ I/a1/ 3
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O.M.B./Purchasing C�[*6Yes❑ No['�`
County Attorney CI' `a-� 03 Yes[-] No[Y
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OMB Form Revised 9/11/95 MCP #2
AGREEMENT
Rural Health Network of Monroe County, Florida, Inc.
This Agreement is made and entered into this day of
, 2003, between the BOARD OF COUNTY COMMISSIONERS OF
MONROE COUNTY, FLORIDA, hereinafter referred to as "Board" or "County," and
RURAL HEALTH NETWORK OF MONROE COUNTY, FLORIDA, INC., hereinafter
referred to as "Provider."
WHEREAS, the Provider is a not -for -profit corporation established for the
provision of health -related services to the disadvantaged citizens of Monroe County,
and
WHEREAS, it is a legitimate public purpose to provide county -wide primary
health care, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein,
it is agreed as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the
Provider substantially and satisfactorily performing and carrying out the duties of
the Board as to providing primary health care in Monroe County, Florida, shall pay
to the Provider the sum of ONE -HUNDRED, FIFTY -THOUSAND, AND NO/100
DOLLARS ($150,000.00) for the fiscal year ending September 30, 2004.
2. TERM. This Agreement shall commence on October 1, 2003, and
terminate September 30, 2004, unless earlier terminated pursuant to other
provisions herein.
3. PAYMENT. Payment will be paid periodically, but no more frequently
than monthly as hereinafter set forth. Reimbursement requests will be submitted
to the Board via the Clerk's Finance Office. The County shall only reimburse,
subject to the funded amounts below, those reimbursable expenses which are
reviewed and approved as complying with Florida Statutes 112.061 and Attachment
A - Expense Reimbursement Requirements. Evidence of payment by the Provider
shall be in the form of a letter, summarizing the expenses, with supporting
documentation attached. The letter should contain a certification statement as well
as a notary stamp and signature. An example of a reimbursement request cover
letter is included as Attachment B.
After the Clerk of the Board examines and approves the request for
reimbursement, the Board shall reimburse the Provider. However, the total of said
reimbursement expense payments in the aggregate sum shall not exceed the total
amount shown in paragraph one during the term of this agreement.
4. SCOPE OF SERVICES. The Provider, for the consideration named,
covenants and agrees with the Board to substantially and satisfactorily perform and
carry out the duties of the Board in providing primary health care in Monroe County,
Florida.
5. RECORDS. The Provider shall maintain appropriate records to insure
a proper accounting of all funds and expenditures, and shall provide a clear financial
audit trail to allow for full accountability of funds received from said Board. Access
to these records shall be provided during weekdays, 8 a.m. to 5 p.m., upon request
of the Board, the State of Florida, or authorized agents and representatives of the
Board or State.
The Provider shall be responsible for repayment of any and all audit
exceptions which are identified by the Auditor General of the State of Florida, the
Clerk of Court for Monroe County, an independent auditor, or their agents and
representatives. In the event of an audit exception, the current fiscal year contract
amount or subsequent fiscal year contract amounts shall be offset by the amount of
the audit exception. In the event this agreement is not renewed or continued in
subsequent years through new or amended contracts, the Provider shall be billed by
the Board for the amount of the audit exception and the Provider shall promptly
repay any audit exception.
6. INDEMNIFICATION AND HOLD HARMLESS. The Provider
covenants and agrees to indemnify and hold harmless Monroe County Board of
County Commissioners from any and all claims for bodily injury (including death),
personal injury, and property damage (including property owned by Monroe
County) and any other losses, damages, and expenses (including attorney's fees)
which arise out of, in connection with, or by reason of services provided by the
Provider occasioned by the negligence, errors, or other wrongful act or omission of
the Provider's employees, agents, or volunteers. The provider agrees to comply
with Monroe County General Insurance Requirements, as shown on Attachment C,
and agrees to carry and provide evidence of the required coverages described on
Attachments D through G.
7. INDEPENDENT CONTRACTOR. At all times and for all purposes
hereunder, the Provider is an independent contractor and not an employee of the
Board. No statement contained in this agreement shall be construed so as to find
the Provider or any of its employees, contractors, servants or agents to be
employees of the Board.
S. COMPLIANCE WITH LAW. In providing all services pursuant to this
agreement, the Provider shall abide by all statutes, ordinances, rules and
regulations pertaining to or regulating the provision of such services, including
those now in effect and hereinafter adopted. Any violation of said statutes,
ordinances, rules and regulations shall constitute a material breach of this
agreement and shall entitle the Board to terminate this contract immediately upon
delivery of written notice of termination to the Provider.
9. COMPLIANCE WITH COUNTY GUIDELINES. The Provider must
demonstrate and sustain compliance with:
(a) 501(c)(3) Registration;
(b) Board of Directors of five or more;
(c) Annual election of Officers and Directors;
(d) Annual provision of annual report to County;
(e) Corporate Bylaws;
(f) Corporate Policies and Procedures Manual;
(g) Hiring policies for all staff;
(h) Cooperate with County monitoring visits; and
(i) Semi-annual performance reports to be presented to County.
10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The Provider
shall assure that all professionals have current and appropriate professional licenses
and professional liability insurance coverage. Funding by the Board is contingent
upon retention of appropriate local, state and/or federal certification and/or
licensure of the Provider's program and staff.
11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of
the services and/or reimbursement of services shall be amended by an agreement
amendment, which must be approved in writing by the Board.
12. NO ASSIGNMENT. The Provider shall not assign this agreement
except in writing and with the prior written approval of the Board, which approval
shall be subject to such conditions and provisions as the Board may deem
necessary. This agreement shall be incorporated by reference into any assignment
and any assignee shall comply with all of the provisions herein. Unless expressly
provided for therein, such approval shall in no manner or event be deemed to
impose any obligation upon the Board in addition to the total agreed upon
reimbursement amount for the services of the Provider.
13. NON-DISCRIMINATION. The Provider shall not discriminate against
any person on the basis race, creed, color, national origin, sex or sexual orientation,
age, physical handicap, or any other characteristic or aspect which is not job -
related in its recruiting, hiring, promoting, terminating or any other area affecting
employment under this agreement. At all times, the Provider shall comply with all
applicable laws and regulations with regard to employing the most qualified
person(s) for positions under this agreement. The Provider shall not discriminate
against any person on the basis of race, creed, color, national origin, sex or sexual
orientation, age, physical handicap, financial status or any characteristic or aspect
in its providing of services.
14. AUTHORIZED SIGNATURES. The signatory for the Provider below,
certifies and warrants that:
(a) The Provider's name in this agreement is the full name as designated
in its corporate charter, if a corporation, or the full name under which the Provider
is authorized to do business in the State of Florida.
(b) He or she is empowered to act and contract for the Provider; and
(c) This agreement has been approved by the Board of Directors of the
Provider if the Provider is a corporation.
15. NOTICE. Any notice required or permitted under this agreement shall
be in writing and hand -delivered or mailed, postage pre -paid, by certified mail,
return receipt requested, to the other party as follows:
For Board:
David P. Owens, Grants Administrator and
Gato Building
1100 Simonton Street
Key West, FL 33040
For Provider
Mark L. Szurek
Executive Director
Rural Health Network of Monroe County
Post Office Box 4966
Key West, FL 33041-4966
Monroe County Attorney
PO Box 1026
Key West, FL 33041
16. CONSENT TO JURISDICTION. This agreement shall be construed by
and governed under the laws of the State of Florida and venue for any action
arising under this agreement shall be in Monroe County, Florida.
17. NON -WAIVER. Any waiver of any breach of covenants herein
contained to be kept and performed by the Provider shall not be deemed or
considered as a continuing waiver and shall not operate to bar or prevent the Board
from declaring a forfeiture for any succeeding breach, either of the same conditions
or covenants or otherwise.
18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be
continued at a level sufficient to allow for continued reimbursement of expenditures
for services specified herein, this agreement may be terminated immediately at the
option of the Board by written notice of termination delivered to the Provider. The
Board shall not be obligated to pay for any services or goods provided by the
Provider after the Provider has received written notice of termination, unless
otherwise required by law.
19. PURCHASE OF PROPERTY. All property, whether real or personal,
purchased with funds provided under this agreement, shall become the property of
Monroe County and shall be accounted for pursuant to statutory requirements.
20. ENTIRE AGREEMENT. This agreement constitutes the entire
agreement of the parties hereto with respect to the subject matter hereof and
supersedes any and all prior agreements with respect to such subject matter
between the Provider and the Board.
IN WITNESS WHEREOF, the parties hereto have caused these presents to be
executed as of the day and year first written above.
(SEAL)
ATTEST: DANNY L. KOLHAGE, CLERK
a
Deputy Clerk
Witness
Witness
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
Im
Mayor/Chairman
RURAL HEALTH NETWORK OF
MONROE COUNTY, FLORIDA, INC.
(Federal ID No.
By
President
MONROE COUNTY ATTORNEY
A OVER A T F R
UZANNE A. HUTTON
A SISTANT UNTTY��T��TORNEY
Data,__ �_---
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations,
county travelers, and contractual parties who have reimbursable expenses associated with
Monroe County business. These guidelines, as they relate to travel, are from Florida Statute
112.061.
A cover letter summarizing the major line items on the reimbursable expense request needs
to also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records
of this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be
considered for reimbursement. Remember, the expense should be paid prior to requesting a
reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the
contract. This document should not be considered all-inclusive. The Clerk's Finance
Department reserves the right to review reimbursement requests on an individual basis.
Any questions regarding these guidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter -company allocations are not
considered reimbursable expenditures unless appropriate payroll journals for the charging
department are attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is
needed. If a Payroll Journal is provided, it should include: dates, employee name, salary or
hourly rate, total hours worked, withholding information and payroll taxes, check number
and check amount. If a Payroll Journal is not provided, the following information must be
provided: check amount, check number, date, payee, support for applicable payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for
reimbursement. For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are
not allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement.
The log must define the date, number of copies made, source document, purpose, and
recipient. A reasonable fee for copy expenses will be allowable. For vendor services, the
vendor invoice and a sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Telefax, Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller,
the telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of
Travel Expenses. Travel must be submitted in accordance with Florida Statute 112.061.
Credit card statements are not acceptable documentation for reimbursement. If attending a
conference or meeting a copy of the agenda is needed. Airfare reimbursement requires the
original passenger receipt portion of the airline ticket. A travel itinerary is appreciated to
facilitate the audit trail. Auto rental reimbursement requires the vendor invoice. Fuel
purchases should be documented with paid receipts. Taxis are not reimbursed if taken to
arrive at a departure point: for example, taking a taxi from one's residence to the airport for
a business trip is not reimbursable. Parking is considered a reimbursable travel expense at
the destination. Airport parking during a business trip is not.
A detailed list of charges is required on the lodging invoice. Balance due must be zero.
Room must be registered and paid for by traveler. The County will only reimburse the
actual room and related bed tax. Room service, movies, and personal telephone calls are
not allowable expenses.
Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal
guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before
noon and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m.
for dinner reimbursement.
Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while
on County business. An odometer reading must be included on the state travel voucher for
vicinity travel. Mileage is not allowed from a residence or office to a point of departure. For
example, driving form one's home to the airport for a business trip is not a reimbursable
expense.
Non -allowable Expenses
The following expenses are not allowable for reimbursement: capital outlay expenditures
(unless specifically included in the contract), contributions, depreciation expenses (unless
specifically included in the contract), entertainment expenses, fundraising, non -sufficient
check charges, penalties and fines.
ATTACHMENT B
ORGANIZATION
LETTERHEAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, FL 33040
Date
The following is a summary of the expenses for ( Organization name) for the time
period of to
Check # Payee
Reason
_u07hT,
101
Company A
Rent
$ X,XXX.XX
102
Company B
Utilities
XXX.XX
104
Employee A
P/R ending 05/14/01
XXX.XX
105
Employee B
P/R ending 05/28/01
XXX.XX
(A) Total X.XXX.XX
(B) Total prior payments $ X,XXX.XX
(C) Total requested and paid (A + B) $ X,XXX.XX
(D) Total contract amount $ X,XXX.XX
Balance of contract (D-C) $ X,XXX.XX
I certify that the above checks have been submitted to the vendors as noted and
that the expenses are accurate and in agreement with the records of this
organization. Furthermore, these expenses are in compliance with this
organizations_ contract with the Monroe County Board of County Commissioners
and will not be submitted for reimbursement to any other funding source.
Executive Director
Attachments (supporting documentation)
Sworn to and subscribed before me this day of 2003
by who is personally known to me.
Notary Public Notary Stamp
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO 10-1990
MONROE COUNTY, FLORIDA
warrants that he/it has not employed, retained
or otherwise had act on his/its behalf any former County officer or employee in violation of
Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of
Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County
may, in its discretion, terminate this contract without liability and may also, in its discretion,
deduct from the contract or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or employee.
Date:
STATE OF
COUNTY OF
(signature)
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
who, after first being sworn by me, affixed his/her
signature (name of individual signing) in the space provided above on this day of
19
NOTARY PUBLIC
My commission expires:
OMB - MCP FORM #4
PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list following
a conviction for public entity crime may not submit a bid on a contract to provide
any goods or services to a public entity, may not submit a bid on a contract with a
public entity for the construction or repair of a public building or public work,
may not submit bids on leases of real property to public entity, may not be
awarded or perform work as a contractor, supplier, subcontractor, or consultant
under a contract with any public entity, and may not transact business with any
public entity in excess of the threshold amount provided in Section 287.017, for
CATEGORY TWO for a period of 36 months from the date of being placed on the
convicted vendor list."
Attachment J
1996 Edition
WORKERS' COMPENSATION
INSURANCE REQUIREMENTS
FOR
CONTRACT
BETWEEN
MONROE COUNTY, FLORIDA
AND
Prior to the commencement of work governed by this contract, the Contractor shall obtain
Workers' Compensation Insurance with limits sufficient to respond to Florida Statute 440.
In addition, the Contractor shall obtain Employers' Liability Insurance with limits of not less than:
$100,000 Bodily Injury by Accident
$500,000 Bodily Injury by Disease, policy limits
$100,000 Bodily Injury by Disease, each employee
Coverage shall be maintained throughout the entire term of the contract.
Coverage shall be provided by a company or companies authorized to transact business in the
state of Florida.
If the Contractor has been approved by the Florida's Department of Labor, as an authorized self -
insurer, the County shall recognize and honor the Contractor's status. The Contractor may be
required to submit a Letter of Authorization issued by the Department of Labor and a Certificate
of Insurance, providing details on the Contractor's Excess Insurance Program.
If the Contractor participates in a self-insurance fund, a Certificate of Insurance will be required.
In addition, the Contractor may be required to submit updated financial statements from the fund
upon request from the County.
WC1
Administration Instruction
#4709.3 87
Attachment E
1996 Edition
MEDICAL PROFESSIONAL LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT
BETWEEN
MONROE COUNTY, FLORIDA
AND
Recognizing that the work governed by this contract involves the providing of professional
medical treatment, the Contractor shall purchase and maintain, throughout the life of the contract,
Professional Liability Insurance which will respond to the rendering of, or failure to render
medical professional services under this contract.
The minimum limits of liability shall be:
$250,000 per Occurrence/$750,000 Aggregate
If coverage is provided on a claims made basis, an extended claims reporting period of four (4)
years will be required.
MED1
Administration Instruction
#4709.3 66
Attachment F
1996 Edition
GENERAL LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT
BETWEEN
MONROE COUNTY, FLORIDA
AND
Prior to the commencement of work governed by this contract, the Contractor shall obtain
General Liability Insurance. Coverage shall be maintained throughout the life of the contract and
include, as a minimum:
• Premises Operations
• Products and Completed Operations
• Blanket Contractual Liability
• Personal Injury Liability
• Expanded Definition of Property Damage
The minimum limits acceptable shall be:
$300,000 Combined Single Limit (CSL)
If split limits are provided, the minimum limits acceptable shall be:
$100,000 per Person
$300,000 per Occurrence
$ 50,000 Property Damage
An Occurrence Form policy is preferred. If coverage is provided on a Claims Made policy, its
provisions should include coverage for claims filed on or after the effective date of this contract.
In addition, the period for which claims may be reported should extend for a minimum of twelve
(12) months following the acceptance of work by the County.
The Monroe County Board of County Commissioners shall be named as Additional Insured on all
policies issued to satisfy the above requirements.
GL1
Administration Instruction
94709.3 53
Attachment G
1996 Edition
VEHICLE LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT
BETWEEN
MONROE COUNTY, FLORIDA
AND
Recognizing that the work governed by this contract requires the use of vehicles, the Contractor,
prior to the commencement of work, shall obtain Vehicle Liability Insurance. Coverage shall be
maintained throughout the life of the contract and include, as a minimum, liability coverage for:
Owned, Non -Owned, and Hired Vehicles
The minimum limits acceptable shall be:
$100,000 Combined Single Limit (CSL)
If split limits are provided, the minimum limits acceptable shall be:
$ 50,000 per Person
$100,000 per Occurrence
$ 25,000 Property Damage
The Monroe County Board of County Commissioners shall be named as Additional Insured on all
policies issued to satisfy the above requirements.
VL1
Administration Instruction
#4709.3 80