FY2000 10/13/1999
AGREEMENT
This Agreement is made and entered into this /5 ti day of V C / . 1999,
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA,
hereinafter referred to as "Board" or "County," and the GUIDANCE CLINIC OF THE MIDDLE
KEYS, INC., hereinafter referred to as "Provider."
WHEREAS, the Board and the Provider desire to enter into an agreement wherein the
Board contracts for services from the Provider for the rendering of mental health services to
the citizens of the Middle Keys, Monroe County, Florida, and
WHEREAS, the Board is vested and charged with certain duties and responsibilities
relating to the mental health and guidance of the citizens of Monroe County, and
WHEREAS. such services have been rendered by the Provider in the past and have
been invaluable to the citizens of the Middle Keys, and
WHEREAS. it is proper and fitting to enter into an agreement for services to be
rendered in the forthcoming fiscal year 1999-2000, 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 and obligations of the
Board, shall reimburse the Provider for a portion of the Provider's expenditures for Baker Act
hospital, physician and crisis stabilization services, as billed by the Provider, for clients
qualifying for such services under applicable state and federal regulations and eligibility
determination procedures, and for Baker Act transportation services, non-Baker Act mental
health services and substance abuse treatment. This cost shall not exceed a total
reimbursement of Four Hundred Ninety-eight Thousand Nine Hundred Dollars ($498,900.00),
during the fiscal year 1999-2000, payable as follows:
a) Pay to the Provider the sum of Three Hundred Sixteen Thousand Seven Hundred
Eighty-three Dollars ($316,783.00) for Baker Act hospital, physician and crisis stabilization
services.
b) Pay to the Provider the sum of Thirty-seven Thousand Three Hundred Eighty-six
Dollars ($37,386.00) for the providing of transportation of patients in Monroe County to
treatment facilities.
c) Pay to the Provider the sum of Forty-seven Thousand Seven Hundred Eighty
Dollars ($47,780.00) for rendering counseling services.
d) Pay to the Provider the sum of Ninety-six Thousand Nine Hundred Fifty-one
Dollars ($96,951.00) for substance abuse treatment services.
2. TERM. This Agreement shall commence on October 1, 1999. and terminate
September 30, 2000, unless earlier terminated pursuant to other provisions herein.
3. PA YMENT. Payment will be paid monthly as hereinafter set forth. Baker Act
Billing Summary Forms, certified monthly financial and service load reports will be made
available to the Board to validate the delivery of services under this contract. The monthly
financial report is due in the office of the Clerk of the Board no later than the 15th day of the
following month. After the Clerk of the Board pre-audits the certified report, the Board shall
reimburse the Provider for its monthly expenses. However, the total of said monthly
payments in the aggregate sum shall not exceed the total amount of $498,900.00 during the
term of this agreement. To preserve client confidentiality required by law, copies of
individual client bills and records shall not be available to the Board for reimbursement
purposes but shall be made available only under controlled conditions to qualified auditors
for audit purposes.
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 rendering counsel in the matter of mental health and guidance to the
citizens of the Middle Keys, Monroe County, Florida. The Provider shall provide these services
in compliance with Florida Statutes Chapter 394. Said services shall include, but are not
limited to, those services described in Provider's Details of Specific Program for Which
Funding is Requested, attached hereto as Exhibit C and incorporated herein.
5. RECORDS. The Provider shall maintain appropriate records to insure a proper
accounting of all funds and expenditures, and shall provide a clear financial audit trail to
allow for full accountability of funds received from said Board. Access to these records shall
be provided during weekdays, 8 a.m. to 5 p.m., upon request of the Board, the State of
Florida, or authorized agents and representatives of the Board or State.
The Provider shall be responsible for repayment of any and all audit exceptions which
are identified by the Auditor Genera' 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 extent of liability is in
no way limited to. reduced, or lessened by the insurance requirements contained elsewhere
within this agreement.
7. INDEPENDENT CONTRACTOR. At all and for all purposes hereunder, the
Provider is an independent contractor and not an employee of the Board. No statement
contained in this agreement shall be construed so as to find the Provider or any of its
employees, contractors, servants or agents to be employees of the Board.
8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement,
the Provider shall abide by all statutes, ordinances, rules and regulations pertaining to or
regulating the provision of such services, including those now in effect and hereinafter
adopted. Any violation of said statutes, ordinances, rules and regulations shall constitute a
material breach of this agreement and shall entitle the Board to terminate this contract
immediately upon delivery of written notice of termination to the Provider.
9. COMPLIANCE WITH COUNTY GUIDELINES. The Provider demonstrate and
sustain compliance with:
(a) 501 (c)(3) Registration;
(b) Board of Directors of seven or more;
(c) Annual election of Officers and Director;
(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. INSURANCE. As a pre-requisite of the services supplied under this contract, the
Provider shall obtain, at its own expense, insurance to cover its activities.
12. 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.
13. 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.
14. 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.
15. 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.
16. NOTICE. Any notice required or permitted under this agreement shall be in
writing and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt
requested. to the other party as follows:
For Board:
Monroe County Attorney
310 Fleming Street
Key West, Florida 33040
For Provider:
Dr. David Rice, Executive Director
Guidance Clinic of the Middle Keys, Inc.
300041 st Street
Marathon, Florida 33050
17. 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.
18. 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.
19. 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.
20. 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.
21. 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
agree . respect to such subject matter between the Provider and the Board.
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./ fN'~. EREOF, the parties hereto have caused these presents to be executed
as 1(~~~x~lt~ r first written above.
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ATTES~' LHAGE, CLERK
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
BY~~~,~~~
Deputy Clerk
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By ,
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Mayor/Chairman
Witness
GUIDANCE CLINIC OF THE ~IDDLE KEYS, INC.
(FederallD No. 5q 1+5' g '5 2 ~)
By i~,/b
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Director
By
Witness
President
jconiimkguide
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY. FLORIDA
ETHICS CLAUSE
warrants that he/it has not employed, retained
or othef\vise had act on his/its behalf any formcr County officcr or employce in violation of
Section 2 ofOrdinancc no. 10-1990 or any County officcr or employee in violation of
Section 1 of Ordinance No. 10-1990. For breach or violation of this provision thc County
1l1;t\'. ill its discretion. terminate this contract without liability and mav also. in its discrction,
- .
deduct from the contract or purchase price, or otherwise recover, the full amount of any fec,
commission. percentage, gift. or consideration paid to thc formcr County officcr or employee.
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(stgnature)
Date: /rr9-:J/lf
STATE OF
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COUNTY OF
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,1999.
LJlrtuILu- ~ ~AL
NOTARY BLIC
My commission expires: tP 7, Of,; 'cltJO!j
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OMB - Mep FORM #4
"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."
,
i .
.
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 should also
contain a certified statement such as:
I certify that the attached expenses are accurate and in agreement with the records
of this organization. Furthermore, these expenses are in compliance with this
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. Intercompany 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
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 detail list of charges is required on the lodging invoice. Balance 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
Revised 9/99
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as it relates to the County contract is required for reimbursement.
For overnight or express deliveries, the 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 it relates 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 is
required and a sample of the finished product.
Supplies, Services, etc.
For supplies or services ordered vendor invoice.
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.
HUMAN SERVICE ORGANIZATION
LETTERHEAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, FL 33040
Date
ATTACHMENT B
The following is a summary of the expenses for (Human Service Organization name) for the time
period of 05/01199 to 05/31/99.
Check # Payee Reason
101 Realty Co. May rent
102 Electric Co. May utilities
103 Phone Co. May phones
104 John Doe P/R ending 05/14/99
105 John Doe P/R ending OS/28/99
(A) Total
(B) Total prior payments $ 4,500.00
(C) Total requested and paid (A + B) $ 7,900.00
(D) Total contract amount $15,000.00
Balance of contract (D-C)
Amount
$ 1,500.00
250.00
50.00
800.00
800.00
$ 3.400.00
$ 7.100.00
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 and subscribed before me the _ day of 1999/2000.
Notary Public Notary Stamp
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1. Provide your agency's board-approved written mission statement.
"...to employ trained personnel; provide suitable offices for the treatment of mental and
emotional illnesses of individuals and any other program and service to the mentally of
Monroe County, Florida, as a charitable and nonprofit undertaking; by constructive and
preventive services to individuals suffering from emotional and mental illnesses; to
render a social service to the community, and by thorough research, education,
consultation and cooperation with other organization of the community, to carry forward a
program for mental health."
2. Explain specifically how your agency plans to use the money you are requesting; Le., rent,
salaries, expansion of services or service area or general agency operations?
GCMK will use County funds in four program areas:
Program Area # Service Units $ Requested
Substance Abuse Detoxification Services. 620 $96,951
Mental Health Services, including assessment, outpatient services,
and outpatient medical services. 592 $47,780
Baker Act Inpatient Services: GCMK's crisis stabilization unit (CSU)
is a Baker Act receiving facility and provides crisis stabilization and
treatment services to adults ($18 years) who are in sufficient
emotional distress as to require acute care and continuous
monitoring to assure their safety and the safety of others. 1456 $316,783
Baker Act Transportation for persons throughout the County who
required crisis stabilization at the GCMK's CSU or another CSU.
This service is required by law. 125 $37,386
TOTAL 2793 $498,900
3. If your funding request is greater than last year, explain in detail, what the increase is
expected to buy.
Not Applicable - same amount requested.
4. How has your agency initiated any new, creative or innovative projects to aadress social
service needs in our community. If so, give a brief description. Inetude a description of any
innovative projects that you would like to try, but have not yet been able to secure funding.
i Please include any awards or special recognition your agency may have received this past year.
In October 1997, GCMK became the Community Transportation Coordinator for Monroe
County and continues into the next fiscal year.
In December 1997, GCMK was selected by Prison Health Services to provide psychiatric
services in the Monroe County Detention Center. This contract continues.
In February 1998, GCMK placed a Forensic Case Manager in the Monroe County
Detention Center at the request of MCSO and Florida Department of Children and
Families. These services continue to be provided in the jail.
Monroe County Application
Human Services Organization Funding
FY 99/00
5