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Item C11 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: 6-17-2009 Division: _County Administrator Bulk Item: Yes X No _ Department: Social Services/In-Home Services_ Staff Contact Person/Phone#: Sheryl Graham/X4510 AGENDA ITEM WORDING: Approval for Continuation of a contract between Monroe County Board of County Commissioners and Hospice of the Florida Keys, Inc. d/b/a Visiting Nurse Association, to provide direct in-home services for the elderly and disabled as provided under grants to Monroe County from the Alliance for Aging (e.g., ADI, CCE& OAA) and the Department of Children and Families (e.g., CCDA) ITEM BACKGROUND: Monroe County is the Lead Agency for Case Management/CCE by the alliance for Aging, Inc had has the CCE, OAA and HCE grants to provide in-home services for the elderly. The County also has a grant by DCF under CCDA to provide in-home services for the disabled. Approval will allow Hospice of the Florida Keys, Inc. d/b/a Visiting Nurse Association to be the primary subcontractor for in-home respite, homemaker, personal care, and chore services. Only service hours authorized by Monroe County Social Services Department will be paid to V.N.A. PREVIOUS RELEVANT BOCC ACTION: Approval on 11/19/08 of Addendum 002 to the Hospice of the Florida Keys contract 7-1-08 to 6-30-09. CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATIONS: Approval TOTAL COST: Approx. $355,000.00 INDIRECT COST: _-0-_BUDGETED: Yes No _ COST TO COUNTY: Approx. $355,000.00 SOURCE OF FUNDS: Grants REVENUE PRODUCING: Yes N/A No AMOUNT PER MONTH Year APPROVED BY: County Atty X OMB/Purchasing X Risk Management_X_ DOCUMENTATION: Included X Not Required DISPOSITION: AGENDA ITEM # Revised 1/09 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Hospice of the Florida Keys, Inc. Contract d/b/a Visiting Nurse Association Effective Date: July 1, 2009 Expiration Date: June 30, 2010 Contract Purpose/Description: Approval of continuation of the contract between the Monroe County Board of County Commissioners (Monroe County Social Services/In-Home Services Program)and Hospice of the Florida Keys, Inc for Fiscal year July 1, 2009 through June 30, 2010. VNA will continue to be the primary provider for respite, homemaker, personal care and chore services. Contract Manager: Sheryl Graham 4510 Social Services/Stop 1 (Name) (Ext.) (Department/Stop#) For BOCC meeting on 6/17/2009 Agenda Deadline: 6/2/2009 CONTRACT COSTS Total Dollar Value of Contract: approx. $355,000.00 Current Year Portion: $ Budgeted?Yes X No❑ Account Codes: _125__6153609 - _125_-6153809 - - - County Match: Required N/A _125 -_6153009 - - - Additional Match: _125_-_6153709 - - - Total Match$-0- ADDITIONAL COSTS Estimated Ongoing Costs: $ /yr For: of included in dollar value above (e.g.Maintenance,utilities,janitorial,salaries,etc CONTRACT REVIEW Changes Date Out Date In Needed view Division Director �j�o� Yes ❑ No Risk Man ement �� � Yes ❑ No 0. ./PurcHasing �`�� I�a1 Yes ❑ N County Attorney `� / Yes ❑ No 2 6� Comments: OMB Form Revised 2/27/01 MCP#2 CONTRACT THIS AGREEMENT, made and entered into this 18th day of Tune, 2008, A.D., by and between MONROE COUNTY, FLORIDA, a political subdivision of the State of Florida (hereinafter called the -Owner" or "County"), and Hospice of the Florida Keys, Inc. d/b/a Visiting Nurse Association , (hereinafter called the -Contractor"). WHEREAS, the County provides In-Home services to the elderly and disabled residing throughout Monroe County; and WHEREAS, the County receives funding from the Alliance for Aging, Inc., the Florida Department of Children and Families, and the Florida Agency for Health Care Administration for the purposes of providing in-home services countywide; and WHEREAS, the County has provided in-home services to assist the vulnerable elderly and/or disabled residents to remain in their homes and maintain independence for over 25 years; and WHEREAS, the County desires to contract for in-home services to ensure that such services are available throughout the County; and WHEREAS, Contractor is qualified and desires to provide in-home services; NOW THEREFORE, in consideration of the mutual covenants and provisions contained herein, the parties agree as follows: That the parties hereto, for the consideration hereinafter set forth,mutually agree as follow: 1. THE CONTRACT The contract between the Owner and the Contractor, of which this agreement is a part, consists of the contract documents, which are as follows: This agreement and any amendments executed by the parties hereafter, together with the response to RFP and all required insurance documentation. In the event of a discrepancy between the documents, precedence shall be determined by the order of the documents as just listed. 2. SCOPE OF THE WORK The Contractor shall provide In-Home Services for the County. The Contractor warrants that it is authorized by law to engage in the performance of the activities herein described, subject to the terms and conditions set forth in these contract documents. The provider shall at all times exercise independent, professional judgment and shall assume professional responsibility for the services to be provided. Contractor shall provide services using the following standards, as a minimum requirement: A. The Contractor shall maintain adequate staffing levels to provide the services required under this contract. 3 B. The personnel shall not be employees of or have any contractual relationship with the County. [IF APPROPRIATE: To the extent that Contractor uses subcontractors or independent contractors, this contract specifically trquires that the level of independence normally exercised by such subcontractors and independent contractors be curtailed and that they be supervised by the Contractor.] C. All personnel engaged in performing services under this contract shall be fully qualified, and, if required, to be authorized or permitted under State and local law to perform such services. 3. PAYMENTS TO THE CONTRACTOR A. The Contractor shall submit to the county an invoice with supporting documentation acceptable to the Clerk on a weekly basis. Acceptability to the Clerk is based on generally accepted accounting principles and such laws, rules and regulations as may govern the Clerk's disbursement of funds. B. Upon Monroe County's receipt of said invoices Monroe County Clerk's Office shall submit payment to the Contractor no later than four weeks after receipt of invoice(s). 4. TERM OF CONTRACT The term of this contract is for one year, commencing on the 1st day of July . 2009, and ending on the 30th day of JjLne 2010. The County shall have the option to renew this agreement for two (2) additional one-year periods. The contract amount agreed to herein may be adjusted annually in accordance with the percentage change in the Consumer Price Index (CPI) for all urban consumers (CPI-U) for the most recent 12 months available. 5. CONTRACTOR'S RESPONSIBILITIES A. The Contractor will perform only authorized in-home services in the homes of elderly and/or disabled residents in the Areas 1, 2, 3 and 4 for the unit rate(s) specified herein. Only those in-home services that are specifically authorized by the County as documented by the Social Services Department will be reimbursable. In-Home Services will be provided by the Contractor in accordance with DOEA definitions/specification, by agencies that hold necessary licenses, and by individual workers qualified to perform such services as detailed in Florida Department of Elder Affairs (DOER) 2008 Client Services Manual and the Home and Community Based Services, Draft handbook, January 2003, the State of FL Department of Children & Families (DCF) CFOP 140-8, Community Care for Disabled Adults (CCDA), and in accordance with the Agency for Health Care Administration (AHC A) guidelines as required and any subsequent modifications thereto. B. The in-home services Contractor will provide under these terms and conditions are X respite care, X homemaker, X personal care, X chore, _ _emergency home repair/housing improvement, and _material aid as defined by DOEA in the 2003 and 2008 handbooks, DCF CFOP 140-8 for 1 CCDA, and AHCA guidelines as noted above and any subsequent revisions thereto. C. The Contractor will provide in-home services during the term of this contract for the unit rates as agreed upon and that follow: V0.00 un' for respite care, $20.00/unit for homemaker, $25.00/unit for personal care, $25.00/unit for chore, $ unit for emergency home repair/housing improvement, and I for material aid. A unit for each service is defined by DOER in the 2003 and 2008 draft handbooks, DCF CFOP 140-8 for CCDA, and AHCA guidelines as noted above and any subsequent revisions thereto. The number of units of services performed for each client must be preauthorized by the County The Contractor will be reimbursed for all necessary travel for client's needs. This can include travel to and in between client homes, from V.N.A. offices, shopping for clients, etc. However, travel from worker's homes at the start of the work day and travel to worker's homes at the end of the work day will not be reimbursed. D. The Contractor will provide the in-service(s) detailed in "B" above for the unit rate agreed upon in "C" above in geographic Areas X 1, X2, X 3, and X 4 in order to ensure that in-home services are available countywide. E. The Contractor will in all cases provide in-home services within the timeframes required by DOER as defined by DOER in the 1998 and 2003 handbooks, DCF CFOP 140-8 for CCDA, and AHCA guidelines as noted above and any subsequent revisions thereto. The Contractor agrees that the County Administrator will designate representatives to visit the Contractor's facility(ies) periodically to conduct random open file evaluations and other contract monitoring activities during the Contractor's normal business hours. F. The Contractor has, and shall maintain throughout the term of this contract, appropriate licenses and approvals required to conduct its business, and that it will at all times conduct its business activities in a reputable manner. Proof of such licenses and approvals shall be submitted to the County upon request. G. .The Contractor must maintain approval status from the Alliance for Aging, Inc., as a Medicaid Waiver Provider of Choice. 6. CONTRACTOR'S FINANCIAL RECORDS Contractor shall maintain all books, records, and documents directly pertinent to performance under this Agreement in accordance with generally accepted accounting principles consistently applied. Each party to this Agreement or their authorized representatives shall have reasonable and timely access to such records of each other party to this Agreement for public records purposes during the term of the Agreement and for six years following the termination of this Agreement. If an auditor employed by the 2 County or Clerk determines that monies paid to Contractor pursuant to this Agreement were spent for purposes not authorized by this Agreement, the Contractor shall repay the monies together with interest calculated pursuant to Sec. 55.03, FS, running from the date the monies were paid to Contractor. 7. PUBLIC ACCESS The County and Contractor shall allow and permit reasonable access to, and inspection of, all documents, papers, letters or other materials in its possession or under its control subject to the provisions of Chapter 119, Florida Statutes, and made or received by the County and Contractor in conjunction with this Agreement; and the County shall have the right to unilaterally cancel this Agreement upon violation of this provision by Contractor. 8. HOLD HARMLESS AND INSURANCE The Contractor covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners of Monroe County 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 Contractor or any of its Subcontractor(s) in any tier, occasioned by the negligence, errors, or other wrongful act of omission of the Contractor or its Subcontractors in any tier, their employees, or agents. The extent of liability is in no way limited to,reduced, or lessened by the insurance requirements contained elsewhere within this agreement. Prior to execution of this agreement, the contractor shall furnish the Owner Certificates of Insurance indicating the ininit um coverage litnitations as indicated by an "X" on the attached forms identified as INSCKLST 1-5, as further detailed on forms WC1, GLI, GIR 1, and VU, each attached hereto and incorporated as part of this contract document, and all other requirements found to be in the best interest of Monroe County as may be imposed by the Monroe County Risk Management Department. Non-Waiver of Immunity. Notwithstanding he provisions of Sec. 286.28, Florida Statutes, the participation of the County and the Contractor in this Agreement and the acquisition of any commercial liability insurance coverage, self-insurance coverage, or local government liability insurance pool coverage shall not be deemed a waiver of immunity to the extent of liability coverage, nor shall any contract entered into by the County be required to contain any provision for waiver. 9. INDEPENDENT CONTRACTOR At all times and for all purposes under this agreement the Contractor is an independent contractor and not an employee of the Board of County Commissioners of Monroe 3 County. No statement contained in this agreement shall be construed so as to find the Contractor or any of his employees, contractors, servants, or agents to be employees of the Board of County Commissioners of Monroe County. 10. NONDISCRIMINATION County and Contractor agree that there will be no discrimination against any person, and it is expressly understood that upon a determination by a court of competent jurisdiction that discrimination has occurred, this Agreement automatically terminates without any further action on the part of any party, effective the date of the court order. Contractor agrees to comply with all Federal and Florida statutes, and all local ordinances, as applicable, relating to nondiscrimination. These include but are not limited to: 1) Title VI of the Civil Rights Act of 1964 (PL 88-352) which prohibits discrimination on the basis of race, color or national origin; 2) Title IX of the Education Amendment of 1972, as amended (20 USC ss. 1681- 1683, and 1685- 1686), which prohibits discrimination on the basis of sex; 3) Section 504 of the Rehabilitation Act of 1973. as amended (20 USC s. 794). which prohibits discrimination on the basis of handicaps; 4) The Age Discrimination Act of 1975. as amended (42 USC ss. 6101- 6107) which prohibits discrimination on the basis of age; 5) The Drug Abuse Office and Treatment Act of 1972 (PL 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (PL 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; 7) The Public Health Service Act of 1912, ss. 523 and 527 (42 USC ss. 690dd-3 and 290ee-3), as amended, relating to confidentiality of alcohol and drug abuse patent records; 8) Title VIII of the Civil Rights Act of 1968 (42 USC s. et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; 9) The Americans with Disabilities Act of 1990 (42 USC s. 1201 Note), as maybe amended from time to time, relating to nondiscrimination on the basis of disability; 10) Monroe County Code Ch. 13, Art. VI, prohibiting discrimination on the bases of race, color, sex, religion, disability, national origin, ancestry, sexual orientation, gender identity or expression, familial status or age; and 11 )Any other nondiscrimination provisions in any Federal or state statutes which may apply to the parties to, or the subject matter of, this Agreement. 11. ASSIGNMENT/SUBCONTRACT The Contractor shall not assign or subcontract its obligations under this agreement, except in writing and with the prior written approval of the Board of County Commissioners of Monroe County and Contractor, which approval shall be subject to such conditions and provisions as the Board may deem necessary. This paragraph shall be incorporated by reference into any assignment or subcontract and any assignee or subcontractor shall comply with all of the provisions of this agreement. Unless expressly provided for therein, such approval shall in no manner or event be deemed to impose any additional obligation upon the board. 12. COMPLIANCE WITH LAW In providing all services/goods pursuant to this agreement, the Contractor shall abide by all statutes, ordinances, rules and regulations pertaining to, or regulating the provisions of, such services, including those now in effect and hereinafter adopted. Any violation of said statutes, 4 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 contractor. The contractor shall possess proper licenses to perform work in accordance with these specifications throughout the term of this contract. 13. DISCLOSURE AND CONFLICT OF INTEREST The Contractor represents that it, its directors, principles and employees, presently have no interest and shall acquire no interest, either direct or indirect, which would conflict in any manner with the performance of services required by this contract, as provided in Sect. 112.311, et. seq., Florida Statutes. County agrees that officers and employees of the County recognize and will be required to comply with the standards of conduct for public officers and employees as delineated in Section 112.313, Florida Statutes, regarding, but not limited to, solicitation or acceptance of gifts; doing business with one's agency; unauthorized compensation; misuse of public position, conflicting employment or contractual relationship; and disclosure or use of certain information. Upon execution of this contract, and thereafter as changes may require, the Contractor shall notify the County of any financial interest it may have in any and all programs in Monroe County which the Contractor sponsors, endorses, recommends, supervises, or requires for counseling, assistance, evaluation, or treatment. This provision shall apply whether or not such program is required by statute, as a condition of probation, or is provided on a voluntary basis. The County and Contractor warrant that, in respect to itself, it has neither employed nor retained any company or person, other than a bona fide employee working solely for it, to solicit or secure this Agreement and that it has not paid or agreed to pay any person, company, corporation, individual, or firm, other than a bona fide employee working solely for it, any fee, commission, percentage, gift, or other consideration contingent upon or resulting from the award or making of this Agreement. For the breach or violation of the provision, the Contractor agrees that the County shall have the right to terminate this Agreement without liability and, at its discretion, to offset from monies owed, or otherwise recover, the full amount of such fee, commission, percentage,gift, or consideration. 14. ARREARS The Contractor shall not pledge the County's credit or make it a guarantor of payment or surety for any contract, debt, obligation, judgment, lien, or any form of indebtedness. The Contractor further warrants and represents that it has no obligation or indebtedness that would impair its ability to fulfill the terms of this contract. 15. NOTICE REQUIREMENT Any notice required or permitted under this agreement shall be in writing and hand delivered or mailed, postage prepaid, to the other party by certified mail, returned receipt requested, to the following: 5 FOR COUNTY: Monroe County Administrator and County Attorney 1100 Simonton Street PO Box 1026 Key West, FL 33040 Key West, Fl. 33041-1026 FOR CONTRACTOR: Hospice of the Florida Keys, Inc. d/b/a Visiting Nurse Association 1319 William Street Key West, FL 33040 16. TAXES The County is exempt from payment of Florida State Sales and Use taxes. The Contractor shall not be exempted by virtue of the County's exemption from paying sales tax to its suppliers for materials used to fulfill its obligations under this contract, nor is the Contractor authorized to use the County's Tax Exemption Number in securing such materials. The Contractor shall be responsible for any and all taxes, or payments of withholding, related to services rendered under this agreement. 17. TERMINATION The County may terminate this contract for cause with seven (7) days notice to the contractor. Cause shall constitute a breach of the obligations of the Contractor to perform the services enumerated as the Contractor's obligations under this contract. A. Either of the parties hereto may terminate this contract without cause by giving the other party sixty (60) days written notice of its intention to do so. 18. GOVERNING LAW, VENUE, INTERPRETATION, COSTS,AND FEES A. This Agreement shall be governed by and construed in accordance with the laws of the State of Florida applicable to contracts made and to be performed entirely in the State. B. In the event that any cause of action or administrative proceeding is instituted for the enforcement or interpretation of this Agreement, the County and Contractor agree that venue will he in the appropriate court or before the appropriate administrative body in Monroe County, Florida. C. The County and Contractor agree that, in the event of conflicting interpretations of the terms or a term of this Agreement by or between any of them the issue shall be submitted to mediation prior to the institution of any other administrative or legal proceeding. D. Severability. If any term, covenant, condition or provision of this Agreement (or the application thereof to any circumstance or person) shall be declared invalid or unenforceable to any extent by a court of competent jurisdiction, the remaining terms, covenants, conditions and provisions of this 6 Agreement. shall not be affected thereby; and each remaining term, covenant, condition and provision of this Agreement shall be valid and shall be enforceable to the fullest extent permitted by law unless the enforcement of the remaining terms, covenants, conditions and provisions of this Agreement would prevent the accomplishment of the original intent of this Agreement. The County and Contractor agree to reform the Agreement to replace any stricken provision with a valid provision that comes as close as possible to the intent of the stricken provision. E. Attorney's Fees and Costs. The County and Contractor agree that in the event any cause of action or administrative proceeding is initiated or defended by any party relative to the enforcement or interpretation of this Agreement, the prevailing party shall be entitled to reasonable attorney's fees, court costs, investigative, and out-of-pocket expenses, as an award against the non-prevailing party, and shall include attorney's fees, courts costs, investigative, and out-of-pocket expenses in appellate proceedings. Mediation proceedings initiated and conducted pursuant to this Agreement shall be in accordance with the Florida Rules of Civil Procedure and usual and customary procedures required by the circuit court of Monroe County. F. Adjudication of Disputes or Disagreements. County and Contractor agree that all disputes and disagreements shall be attempted to be resolved by meet and confer sessions between representatives of each of the parties. If no resolution can be agreed upon within 30 days after the first meet and confer session, the issue or issues shall be discussed at a public meeting of the Board of County Commissioners. If the issue or issues are still not resolved to the satisfaction of the parties, then any party shall have the right to seek such relief or remedy as may be provided by this Agreement or by Florida law. G. Cooperation. In the event any administrative or legal proceeding is instituted against either party relating to the formation, execution, performance, or breach of this Agreement, County and Contractor agree to participate, to the extent required by the other party, in all proceedings, hearings, processes, meetings, and other activities related to the substance of this Agreement or provision of the services under this Agreement. County and Contractor specifically agree that no party to this Agreement shall be required to enter into any arbitration proceedings related to this Agreement. 19. BINDING EFFECT The terms, covenants, conditions, and provisions of this Agreement shall bind and inure to the benefit of the County and Contractor and their respective legal representatives, successors, and assigns. 20. AtiTHORITY Each party represents and warrants to the other that the execution, delivery and performance of this Agreement have been duly authorized by all necessary County and corporate action, as required by law. 7 21. CLAIMS FOR FEDERAL OR STATE AID Contractor and County agree that each shall be, and is, empowered to apply for, seek, and obtain federal and state funds to further the purpose of this Agreement; provided that all applications, requests, grant proposals, and funding solicitations shall be approved by each party prior to submission. 22. PRIVILEGES AND IMMUNITIES All of the privileges and immunities from liability, exemptions from laws, ordinances, and rules and pensions and relief, disability, workers' compensation, and other benefits which apply to the activity of officers, agents, or employees of any public agents or employees of the County, when performing their respective functions under this Agreement within the territorial limits of the County shall apply to the same degree and extent to the performance of such functions and duties of such officers, agents,volunteers, or employees outside the territorial limits of the County. 23. LEGAL OBLIGATIONS AND RESPONSIBILITIES Non-Delegation of Constitutional or Statutory Duties. This Agreement is not intended to, nor shall it be construed as, relieving any participating entity from any obligation or responsibility imposed upon the entity by law except to the extent of actual and timely performance thereof by any participating entity, in which case the performance may be offered in satisfaction of the obligation or responsibility. Further, this Agreement is not intended to, nor shall it be construed as, authorizing the delegation of the constitutional or statutory duties of the County, except to the extent permitted by the Florida constitution, state statute, and case law. 24. NON-RELIANCE BY NON-PARTIES. No person or entity shall be entitled to rely upon the terms, or any of them, of this Agreement to enforce or attempt to enforce any third-party claim or entitlement to or benefit of any service or program contemplated hereunder, and the County and the Contractor agree that neither the County nor the Contractor or any agent, officer, or employee of either shall have the authority to inform, counsel, or otherwise indicate that any particular individual or group of individuals, entity or entities, have entitlements or benefits under this .Agreement separate and apart, inferior to, or superior to the community in general or for the purposes contemplated in this Agreement. 25. ATTESTATIONS Contractor agrees to execute such documents as the County may reasonably require,to include a Public Entity Crime Statement, an Ethics Statement, and a Drug-Free Workplace Statement. 26. NO PERSONAL LIABILITY No covenant or agreement contained herein shall be deemed to be a covenant or agreement of any member, officer, agent or employee of Monroe County in his or her individual capacity, and no member, officer, agent or employee of Monroe County shall be liable personally on this Agreement or be subject to any personal liability or accountability by reason of the execution of this Agreement. 27. EXECUTION IN COUNTERPARTS This Agreement may be executed in any number of counterparts, each of which shall be regarded as an original, all of which taken together shall constitute one and the same instrument and any of the parties hereto may execute this Agreement by singing any such counterpart. 8 28. SECTION HEADINGS Section headings have been inserted in this Agreement a s a matter of convenience of reference only, and it is agreed that such section headings are not a part of this Agreement and will not be used in the interpretation of any provision of this Agreement. 29. MUTUAL REVIEW This agreement has been carefully reviewed by the Contractor and the County. Therefore, this agreement is not to be construed against any party on the basis of authorship. IN WITNESS WHEREOF the parties hereto have executed this Agreement on the day and date first written above in four (4) counterparts, each of which shall, without proof or accounting for the other counterparts, be deemed an original contract. (SEAL) BOARD OF COUNTY COMMISSIONERS Attest: DANNY L. KOLHAGE, CLERK OF MONROE COUNTY, FLORIDA By: By: Deputy Clerk Mayor/Chairman (SEAL) HOSPICE OF THE FLORIDA KEYS, INC d/b/a VISITING NURSE ASSOCIATION t By: Title: Attest: By: By: WITNESS WITNESS Title: Title: UfITY Off AS T 1 PEaRo ASS co'' Y ATTO f�EY Dom, 9 coR�" CERTIFICATE OF LIABILITY INSURANCE OP ID A3 DATE(MWDD/YYYY) HOSPI-3 05 12/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Bouchard-Clearwater ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 101 Starcrest Drive HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P 0 Box 6090 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Clearwater FL 33758-6090 Phone: 727-447-6481 Fax:727-449-1267 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: American Alternative Ina Co 19720 ' INSURER B: 1 Hospice of the Florida Keys INSURER C: Gre Wheeler 1319 William St INSURER D: Key West FL 33040-4736 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN LTR NSA OLICY EFFECTIVE PO TYPE OF INSURANCE POLICY NUMBER DATE MMIDD/YYYY DATE MM/DD ' LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X INItD COMMERCIAL GENERAL LIABILITY I VHHHHG305144203 03/10/09 03/10/10 PREMISES EM aoccurence) j $ 1,000,000 X CLAIMS MADE 7,OCCUR MED EXP(Any one person) s 50,000 RETRO DATE 3/10/88 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE s 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s 3,000,000 I}{ POLICY JE° LOC Emp Ben 1 000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT I ANY AUTO (Ea accident) $ i 1 ALL OWNED AUTOS BODILY INJURY 1$ SCHEDULED AUTOS (Par person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) I PROPERTY DAMAGE i$ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ El OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE s2,000,000 A OCCUR CLAIMS MADE VHHHHU505007903 03/10/09 03/10/10 AGGREGATE s2,000,OOO j$ DEDUCTIBLE $ �X RETENTION s O $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N TO LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIV rrE.tL.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED) (Mandatory In NH) Ifyes,desa be underL.DISEASE-EA EMPLOYEEI$ SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER I A ; DIRECTORS &OFFICER VHHHHD405010703 03/10/091 03/10/10 Liability 3,000,000 DED $2500 Aggregate 3,000 000 DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION FORINFO DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 SO SHALL FOR INFORMATION PURPOSES ONLY IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. ALIT ;-77 ATIVE ACORD 25(2009/01� 988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ADDENDUM 002 THIS ADDENDUM is entered into this 19rn day of November, 2008, A.D., between the MONROE COUNTY BOARD OF COUNTY COMMISSIONERS (hereinafter called the "County"), and Hospice of the Florida Keys, Inc. dlb/a Visiting Nurses Association, (hereinafter call the"Contractor"). WHEREAS on June 18, 2008, the parties entered a Contract for the purposes of providing in- home services countywide. The purpose of this Addendum is to make the following changes and clarification to said contract: 1. Section 3 (Payments to the Contractor) of the Contract dated June 18,2008,shall be amended to read: A. The Contractor shall submit to the county an invoice with supporting documentation acceptable to the Clerk on a weekly basis. Acceptability to the Clerk is based on generally accepted accounting principles and such laws, rules and regulations as may govern the Clerk's disbursement of funds. B. Upon Monroe County's receipt of said invoices Monroe County Clerk's Office shall submit payment to the Contractor no later than 6 weeks after receipt of invoice(s). 1. Section 5(Contractor's Responsibilities) of the Contract dated June 18,2008, shall be amended to read: A. The Contractor will perform only authorized in-home services in the homes of elderly and/or disabled residents in the Areas 1, 2, 3 and 4 for the unit rate(s) specified herein. Only those in-home services that are specifically authorized by the County as documented by the Social Services Department will be reimbursable. In-Home Services will be provided by the Contractor in accordance with DOEA definitions/specification, by agencies that hold necessary licenses, and by individual workers qualified to perform such services as detailed in Florida Department of Elder Affairs (DOER) 2008 Client Services Manual and the Home and Community Based Services, Draft handbook, January 2003, the State of FL Department of Children& Families (DCF) CFOP 140-8, Community Care for Disabled Adults (CCDA), and in accordance with the Agency for Health Care Administration (AHCA) guidelines as required and any subsequent modifications thereto. B. The in-home services Contractor will provide under these terms and conditions are X respite care, X homemaker, X personal care, X chore, emergency home repair;housing improvement, and _material aid as defined by DOER in the 2003 and 2008 handbooks, DCF CFOP 140-8 for CODA, and AHCA guidelines as noted above and any subsequent revisions thereto. C. The Contractor will provide in-home services during the term of this contract for the unit rates as agreed upon and that follow: 519.00/unit for respite care, 519.00,'unit for homemaker. S25.00�unit for personal care, 525.00/unit for chore, 6 p f $ unit for emergency home repair/housing improvement, and $ /unit for material aid. A unit for each service is defined by DOEA in the 2003 and 2008 draft handbooks, DCF CFOP 140-8 for CODA, and AHCA guidelines as noted above and any subsequent revisions thereto. The number of units of services performed for each client must be preauthorized by the County The Contractor will be reimbursed for all necessary travel for client's needs. This can include travel to and in between client homes, from V.N.A. offices, shopping for clients, etc. However, travel from worker's homes at the start of the work day and travel to worker's homes at the end of the work day will not be reimbursed. E. The Contractor will in all cases provide in-home services within the timeframes required by DOEA as defined by DOEA in the 2003 and 2008 handbooks, DCF CFOP 140-8 for CCDA, and AHCA guidelines as noted above and any subsequent revisions thereto. 2. All changes in this addendum will be effective as of July 1,2008. The remaining terms of the Contract entered into June 18,2008 and Addendum I to said contract, not inconsistent herewith,shall remain in full force and effect. IN WITNESS WHEREOF, the parties have caused these presents to be executed in their respective names. BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA �ttes�� j DANNY'L rWWAGE, CLERK By.� Mayor George R. Neugent Deputy clerk HOSPICE OF THE FLORIDA KEYS d/b/a VISITING NURSES ASSOCIATION Attest: By: !. _ Liz ern, president/CEO By: OR WITNESSES: ;e D PPR - R ASSISTANT C)sRNEY '�((( � 2 {6 Date �..__.7 �w__ "`"""