FY2004 10/15/2003
Clem 0111le
Circuit coun
Danny L. Kolhage
Office (305) 292-3550 Fax (305) 295-3663
Memnrandum
To:
Dave Owen,
Grants Management
Isabel C. DeSantis, I . V
Deputy Clerk ).f"
Thursday, November 13, 2003
From:
Date:
At the BOCC meeting on October 15, 2003, the following was approved:
Contract between Monroe County and Florida Healthy Kids Corporation, whereby
Monroe County agrees to provide matching funds in the amount of$38,493 for the period
of July 1, 2003 through June 30,2004.
Guidance Clinic of the Middle Keys, Inc. provides funding for various mental
health and transportation-disadvantaged services in Monroe County, in the amount of
$750,964.00.
Attached hereto are fully executed duplicate originals of the subject documents
for your handling. Should you have any questions concerning this matter, please do not
hesitate to contact this office.
cc: County Attorney
Finance
File ~
..
AGREEMENT
This Agreement is made and entered into this /ts#-day of a 0/ , 2003,
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 2003-2004, 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 SEVEN
HUNDRED FIFTY THOUSAND, NINE-HUNDRED, SIXTY-FOUR, AND NO/100 DOLLARS
($750,964.00), during the fiscal year 2003-2004, payable as follows:
a) Pay to the Provider the sum of FORTY-TWO THOUSAND, THREE-HUNDRED, FIFTY-
ONE, AND NO/100 DOLLARS ($42,351.00) for Community Transportation Coordinator services.
b) Pay to the Provider the sum of FIVE-HUNDRED TWENTY-EIGHT THOUSAND,
NINETEEN, AND NO/100 DOLLARS ($528,019.00) for Baker Act Inpatient, Residential Detox, and
Mental Health/Substance Outpatient counseling services and community mental health and
substance abuse services.
c) Pay to the Provider the sum of EIGHTY-SIX THOUSAND, TWO-HUNDRED EIGHTY-
SEVEN, AND NO/100 DOLLARS ($86,287.00) for residential treatment services, including
detoxification, long-term substance abuse treatment, and long-term psychiatric treatment
services.
d) Pay to the provider the sum of NINETY-FOUR THOUSAND, THREE HUNDRED,
SEVEN, AND NO/100 DOLLARS ($94,307.00) for Baker Act transportation.
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 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.
Payment for Baker Act and Marchman Act transportation services shall be made according to the
rate schedule set forth in Attachment D, subject to the maximum amounts set forth in Paragraph
1. d. above. 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 shown in Article 1, above, 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. The
organization's final invoice must be received within sixty days after the termination date of this
contract shown in Article 2 above.
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. Baker Act and Marchman Act transportation services
which are covered under this agreement may be subcontracted, but are subject to the rates set
forth in Attachment D, and the limitations above. The subcontractor shall be subject to all of the
conditions of this contract, including but not limited to insurance and hold-harmless requirements,
as is the Provider.
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 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.
COUNTY:
COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the
(a) evidence of the organization's 501(c)(3) status;
(b) a list of the organization's Board of Directors of which there must be five or more;
(c) evidence of annual election of Officers and Directors;
(d) an annual audited financial report ;
(e) a copy the organization's Corporate Bylaws, which must address the organization's
mission, board and membership composition, election of officers, and so on;
(f) a copy of the organization's Corporate Policies and Procedures Manual which must include
hiring policies for all staff, drug and alcohol free workplace provisions, equal employment
opportunity provisions, and so on;
(g) cooperation with County monitoring visits;
(h) semi-annual performance reports. These reports should include performance
measurements which will demonstrate the level of accomplishment of goals for which funding
has been provided.
(i) other reasonable reports and information related to compliance with applicable laws,
contract provisions and the scope of services that the County may from time to time request.
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, general liability and professional liability 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. Baker Act and Marchman Act
transportation services may be subcontracted, as set forth in Paragraph 4, above. 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:
David P. Owens, Grants Administrator
1100 Simonton Street
Key West, FL 33040
and
Monroe County Attorney
PO Box 1026
Key West, FL 33041
For Provider:
Dr. David Rice, Executive Director
Guidance Clinic of the Middle Keys, Inc.
3000 41st Street
Marathon, Florida 33050
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17. CONSENT TO JURISDICTION. This
governed under the laws of the State of Florida and
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.
,~1i~:.:~"~N-TIRE AGREEMENT. This agreement constitutes the entire agreement of the
pa~. ..'. ~.<.:.:.;.}...'............eTi............ et..p.'W.....Jth respect to the subject matter hereof and supersedes any and all prior
agw~rft$iW~h respect to such subject matter between the Provider and the Board.
~~.~.:,~:,.~~..."ESS ~HER~OF, the parties hereto have caused these presents to be executed as
ofil:l~~ntf,year first written above.
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(SEA~~
ATTES' .<"'1:. KOLHAGE, CLERK
By~(i~~
Deputy CI rk
BOARD OF COUNTY COMMISSIONERS
OF MON~07COUN~~LORIDA
~~~ ///. ~
By
Mayor/Chairman
SUZAN A. HUTTON
Date ASSISTANT1t:tV'1' :JORNEY
GUIDANCE CLINIC OF THE MIDDLE KEYS, INC.
(Federal ID No.6 q -I Y. -t 1'3 ;;...,"/ )
By ~. 1. Dir~
By ~1Jr C. V~
I President : \.
( \, \j
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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
Auser 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 Amount
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 OS/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
ATTACHMENT C
Baker Act inpatient services, residential detoxification services, mental health and
substance abuse outpatient services, Baker Act vehicles, Keys to Recovery residential
substance abuse treatment, and community transportation coordination.
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY. FLORIDA
ETHICS CLAUSE
O/A/OAN't:.Ctvlt/le.IJ/m- /)1/00L€ JriJI-"> h/~ 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 an d 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.
~
/ (signature)
Date: Octo be,y- I $' J ~ 003
STATE OF
rl 0 y- \ d c..
Hc'i1I\ rOe...
COUNTY OF
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
n<!....b.... ca. C. '"B\U' se....ll who, after first being sworn by me, affixed his/her
signature (name of individual signing) in the space provided above on this l5 ;-h.. day of
CkJ-o b e,r'" , 2 <:>Q1L.
NOTARY PUBLIC
My commission expires: , .:J....,!.3-it I:J...OO ~
~~
/
l1J~.~:'f~ Marianne K. Benvenuti
:*: :.: MY COMMISSION # 00163344 EXPIRES
. . l..l December 29, 2006
;,n.~" BONDED THIlU TROY FAIN INSWHCf, INC.
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 da~e of being placed on the convicted vendor list."
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• 1 � V
ORI"/NAL GUIDANC 30 IINICIO STREET THE MIIDDLL 41 , NKEYS, INC. Opy
MARATHON, FL 33050
(v) 305/289-6150 /(f) 305/289-6158
deb.barsell@gcmk.org
August 15, 2003 n --
Darren Guttman l" rn
e 60- +Th
Jessrica Corporation � f 5
B00 14th Street �t.1"r" ( � 3
Key West, FL 33040 y-e '�*1`��'
e . VlI
RE: LETTER OF AGREEMENT &Act. >wc-
Dear Mr. Guttman:
The Guidance Clinic of the Middle Keys, Inc. (GCMK), hereby enters into an agreement
with Jessrica Corporation to provide coordination and transportation services for Baker
Act/Marchman Act (BA/MA) clients throughout Monroe County and to/from Miami-Dade
County as required. The effective term of this agreement is October 1, 2003-
September 30, 2004.
GCMK will supply Jessrica with two Chevrolet Caprices meeting Jessrica maintenance
specifications; one to be stationed in Key West at a Jessrica location and one to be
stationed in Marathon at GCMK headquarters. A BA/MA backup vehicle (Ford Crown
Victoria) will be stationed at GCMK at Safeport located at 301 White Street in Key
West. Jessrica will have access to this backup vehicle in the event that either of the
two Caprices is out of service.
GCMK will pay for the fuel and maintenance of the three vehicles used for BA/MA
transportation. Jessrica will coordinate the maintenance for the Caprice located in Key
West. Invoices for routine maintenance (labor and parts) on the Caprice will be
forwarded to GCMK Transportation Coordinator for payment. Jessrica will not charge
an extra fee for coordinating the maintenance of the vehicle. Jessrica must obtain prior
approval from the GCMK Transportation Coordinator to initiate major vehicle repairs.
GCMK will coordinate the maintenance for the Caprice located in Marathon and the
Crown Victoria located in Key West.
GCMK will maintain insurance on the two Caprices and one backup Crown Victoria
assigned to BA/MA transportation service. Jessrica will be named as an "additional
insured"for these three cars. Jessrica will report and document accidents involving
GCMK vehicles and incidents involving clients to the proper authorities and immediately
thereafter contact GCMK.
All Jessrica drivers operating GCMK vehicles will hold a Class D Florida Driver's
License and be approved for GCMK insurance coverage. Upon execution of this
1 caiLonIN
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agreement, Jessrica will fax to GCMK Transportation Coordinator a current list of
drivers - including a copy of the driver's license and social security number for each
driver-for approval to operate GCMK vehicles. Prior to adding a driver, Jessrica will
fax to GCMK Transportation Coordinator or designee a copy of the drivers license and
social security number of the person. GCMK will initiate procedures to add the driver to
GCMK vehicle insurance. Jessrica cannot use the driver until it has received written
notification that the driver has been added to the GCMK insurance coverage.
Additionally, Jessrica will fax a copy of picture identification and social security number
for each escort to GCMK Transportation Coordinator or designee. Jessrica cannot use
the escort until it has received written notification that the escort has been approved by
GCMK.
GCMK will supply Jessrica with a cell phone. Jessrica will follow the transportation
protocol and complete the documentation provided as Attachment 1-3 herein.
The following fee structure is established for the period of the agreement:
Maximum Jessrica
# Roundtrips' Client Pickup Point Client Drop-off Point Payment
Key West Key West $130
298 rPf Key West Marathon $130
- Marathon Key West $130
Marathon Marathon $130
Marathon Key Largo $130
40 n Marathon Miami-Dade County $250
lib Key Largo Miami-Dade County $250
23 j"/ /, _ Key West Miami-Dade County $350
GCMK Preeuthorizalion Required for All Trips Below
Approval for below fees will be granted only when the Marathon BA/MA vehicle is engaged with another
BA/MA trip that woulQpreclude another picku within a reasonable period of time.
Maximum Car Client Pickup Jessrica
# Roundtrips` Location Point Client Drop-off Point Payment
3 ijv Key West Marathon&North Key Largo $225
5 Key West Marathon&North Miami-Dade County $350
2 lL'?' Monroe County Beyond Miami-Dade $480
'To be rene6ofiated in April 2004 if necessary.
Timely payment for services rendered is ensured by adherence to the following
invoicing procedures:
• Jessrica will submit two statements/invoices per month; one covering the trips
made from the first through the fifteenth and one covering trips made from the
sixteenth through the end of the month. Jessrica will send statements/invoices
to GCMK within 5 business days after the end of the billing period.
• Jessrica will include required documentation with each statement/invoice.
• Jessrica statements/invoices for BA/MA trips will be submitted to the attention of
GCMK Stabilization Unit Director.
2 CHILDREN
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• GCMK Stabilization Director will review statement/invoice, mediate any
discrepancies with Jessrica, and forward approved invoice to GCMK Finance
Department.
• GCMK will mail payment to Jessrica within 7 working days (Finance Department)
upon receipt of statement/invoice by the Stabilization Unit Director.
This agreement will begin on October 1, 2003 and will terminate on
September 30, 2004. The agreement can be cancelled by either party with 60 days ,
written notice.
GCMK and Jessrica enter into this agreement including Attachments 1-3 by affixing
signatures below:
Debbie Barsell, MSW, CAP
Darren Guttman
Executive Vice President, GCMK Jessrica Corporation
Attachments:
1. GCMK Transportation Protocol
2. GCMK Transportation Record and Payment Authorization Sheet
3. Statement
"Pending County funding Approval.
3 O^GMLPR IEM
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bir
•
ATTACHMENT I
GUIDANCE CLINIC OF THE MIDDLE KEYS TRANSPORTATION PROTOCOL:
THE TRANSPORTATION OF BAKER ACT AND MARCHMAN ACT CLIENTS
A. Client Related Rules:
1. All chants will be transported with a driver and an escort(who may also be a driver.)
2. All drivers and escorts must be approved by the Transportation Department of the
GCMK prior to accepting a driving assignment.
3. Client transportation within Monroe County may be conducted with a driver and an
escort.
4. Client transportation outside of Monroe County must be made with 2 drivers.
5. Client must be observed for any unusual behaviors including hurting self/others u
sudden medical conditions. Report/respond to conditions immediately. Nurse on Duty.
Do not go after the client.
B. At the time of pick up for a Baker Act or Marchman Act client, a driver must obtain the
original Baker Act or Marchman Act paper work from the Pick Up facility. If the original
paper work is not available the driver must immediately report this information to the
GCMK Nurse on Duty for further direction.
7. A female client requires a female escort or a female driver.
8. A parent is not allowed to travel In the Baker Act vehicle with a Baker Act or Marchman
Act minor. Parents may follow in another car.
9.- Only one client may be transported at a tkne In the Baker Act vehicle.
10.Clients are not to smoke lit the car.
11.Clients are not to be placed In handcuffs or any type of restraints for any reason by a
driver or escort.
12.A client's movement is not to be impeded with any physical restraint unless directed by
a nurse/MG/law enforcement officer.
13.ff a client is violent during transport and poses a treat to safety, stop the vehicle and call
911, than notify the Nurse on Duty of the situation.
14.A client shall not be left alone in the vehicle for any reason.
15.Client is encouraged to use restroom facilities prior to departure. If the trip is generated
from Key West and a stop is required, the GCMK may be used for that purpose.
18.A client may use aluminum/metal cans. Bottle caps must be removed prior to client use.
Clients may not have any metal utensils or other hard products such as pencils or pens.
17.A client may not shop during a stop.All efforts should be made to avoid stops. If a stop
is required, It should be short and without delay.
18.if a client must use a public facility, the client must be escorted to the restroom and the
driver must remain outside the restroom door until the client leaves the restroom. The
driver will remain in conversation with client while the client is in the restroom.
B. Coordination of Transportation Rules:
1. Transportation arrangements for Baker Act and Marchman Act clients are under the
direction of the Unit Nurse on Duty/GCMK per contractual arrangements with Jessrica
Corp. No other agency is authorized to contact Jessrica directly for transportation.
rev. 09/18/02 1
Created on 9/18/2002 12:39 PMTransportation Rules
DEC-15-03 16:45 FROM:MONRQ,F,_CO PURCHASING OMB ID: 30529'515 PAGE 2/4
2. All trips will be made within the approved fee structure.
3. All trips will be made using the closest vehicle and the shortest distance unless
preauthorization is obtained from the Unit Nurse on Duty at the GCMK.
4. Clients may be picked up at only approved locations. The GCMK Nurse on Duty will
communicate the pick up location. Approved locations will include :
Hospitals Detention Facility
Mental Health Clinics Anchor Away
Safeport With a GCMK staff member
5. At Depoo: Call security with phone located on the first floor.
8. At GCMK: Use the"Cad" button on the Intercom box next to the elevator.
7. At GCMK, staff members will place the client in the vehicle for departure and will assist
the client from the vehicle at time of arrival.
8. The facility responsible for the departing client for a trip longer than 2 hours shall
provide a brown bag snack. All minors shall be supplied with a snack for any trip over 1
hour.
9. If a driver determines a client is too dangerous to transport, the GCMK Nurse on Duty
must be notified. The Nurse shall make arrangements for alternative transportation.
10. If a client absconds at lime of or during transport, immediately report the information to
the GCMK Nurse on Duty. Do not go after the client.
11. "Jail Hold'clients from the Monroe County Detention Facility shall be picked up from
the Sallyport area only. To access the Sallyport area,the driver must drive the car
within 1 foot of the Sallyport entrance. If the door does not open, the escort must use
the speaker mounted on the wall next to the Sallyport entrance to request entrance.
Once Inside, Detention Facility staff will bring the client to the car.When the client Is
inside the car and the doors are locked, the Sallyport area exit doors will open.
12.The driver/escort must determine from the Pick Up facility If the client has been
searched and encourage staff to conduct a search prior to transport. If the client is not
searched prior to transport, the driver must commutate this Information to the Duty
Staff Member prior to opening the client door at the Designation point.
13. Driver/escort must respond to the pick up point within 1 hour and 15 minutes.
C. Reimbursement related rules
1. All cancelled and otherwise diverted trips will be reported on the Transportation
Record and Payment Authorization Sheet.
2. Daily inspection checklist will be maintained for all Baker Act vehicles and sent
monthly to the GCMK Transportation Coordinator.
3. Transportation Record and Payment Authorization Sheets and a Statement of services
rendered will be faxed to the Stabilization Unit Director on the first and sixteenth of
-- each month.
4. If the driver arrives without the original Baker or Marchman Act paperwork, Jessrlca
will obtain the paper work without charge to the GCMK.
rev. 09/18/02 2
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DEC-15-03 16:45 FROM:MONRQ". CO PURCHASING OMB ID:3052515 PAGE 3/4
ATTACHMENT 2
V
GUIDANCE CLINIC OF THE MIDDLE KEYS
9000 41"ST.Ocean
Marathon, FL 33050
Voice 305-288.8160 • Fax 305-289-6157
TRANSPORTATION RECORD AND PAYMENT AUTHORIZATION SHEET
Transportation Type: a Baker Act o Marchman Act
Date: Client Name:
Time Called: Time of Pick Up:
Time of Drop Off: Time van returned to Duty:
Vehicle: o KW Caprice a Mar Caprice a Crown Vic
Place of Pick Up:
(Where did you pick up the Client:Facility Neme/Cky)
Authorized Staff Signature at Pick Up Facility:
Time:
Destination:
(When did you take the Client:Facility Name/City)
Authorized Staff Signature at Designation Facility:
Time:
(Staff member accepting client)
Driver Name:
Escort Name:
Beginning Miles: Pick Up Mlles:
Drop Off Mlles: Ending Mites:
FOR GCMK USE ONLY:
Amount to be paid:
Stabilization Unit Director Signature:
DEC-15-03 16:46 PROM:MONRCI000 PURCHASING OMB I0:3052Z;$515 PAGE 4/4
ATTACHMENT 3
Statement
Date:
Jessrica Corp.
800 Catherine St.
Key West, Florida 33040
Stabilization Unit Director
Guidance Clinic of the Middle Keys
3000 41m St. Ocean
Marathon, FL 93050
Re: Baker Act and Marchman Act transportation
The following is a break down for trips from to
Data Name Pick Up Cost Vehicle
Designation _ 1 2 3
TOTAL
Jessrica Corp Representative Signature GCMK CFO Signature