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HomeMy WebLinkAboutItem N06COUNTY of MONROE The Florida Keys BOARD OF COUNTY COMMISSIONERS Mayor Michelle Lincoln, District 2 Mayor Pro Tem David Rice, District 4 Craig Cates, District 1 James K. Scholl, District 3 Holly Merrill Raschein, District 5 Regular Meeting March 11, 2026 Agenda Item Number: N6 26-0595 BULK ITEM: Yes DEPARTMENT: Administration TIME APPROXIMATE: STAFF CONTACT: Tina Boan AGENDA ITEM WORDING: Approval of a revocable License Agreement between the Florida Department of Health in Monroe County (FDOH) and the Florida Keys Healthy Start Coalition, Inc., for use of designated space within FDOH's leased space in the County -owned Gato Building located at 1100 Simonton Street, Key West, Florida, subject to certain terms, insurance requirements, and indemnification provisions, running in favor of the County, as further set forth in the License Agreement. ITEM BACKGROUND: Monroe County owns the Gato Building located at 1100 Simonton Street, Key West, Florida. A portion of the facility is leased to the State of Florida for use by FDOH to provide public health services to the community. The Florida Keys Healthy Start Coalition, Inc. Has been approved by the State pursuant to Section 383.216, Fla. Stat. And Rule 64F-2.003, Florida Administrative Code, as a Healthy Start Coalition. Pursuant to the Coalition and FDOH's Contract #: HS-2022-2023, and its subsequent renewals, the Coalition provides state and federal funding, some sourced from the U.S. Department of Health and Human Services, to FDOH in exchange for provision of certain Healthy Start community -based prenatal and infant health care services. In accordance with that grant agreement, the Coalition requires the use of designated space within FDOH's located in the Gato Building. The License Agreement between FDOH and the Coalition allows the Coalition to support maternal and child health programs in coordination with FDOH staff to ensure continuity of such services. The License Agreement expressly provides that Monroe County shall possess the right to revoke the license at any time, preserves the County's sovereign immunity, requires full insurance coverage naming the County as additional insured, includes broad indemnification protections benefiting the County, and maintains FDOH's operational priority. County Administration recommends that BOCC approve the License Agreement heretofore described, pursuant to Paragraph 14 of its Lease Agreement with FDOH, because the License Agreement between FDOH and the Coalition serves a valid public purpose by facilitating maternal and family health services within an existing County -owned public health facility. PREVIOUS RELEVANT BOCC ACTION: On March 25, 2025, the Board approved the 2024- 2025 Lease Agreement between Monroe County and the State of Florida — Department of Health, entitled: "Lease Agreement Gato Building," dated March 25, 2025, for use of the Gato Building by the Florida Department of Health in Monroe County for public health services. INSURANCE REQUIRED: Yes CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATION: Approval. This revocable license agreement allows the Florida Keys Healthy Start Coalition to utilize space within the Gato Building under FDOH's existing lease agreement with Monroe County. DOCUMENTATION: License Agreement between FDOH & Florida Keys Healthy Start Coalition, Inc. Delegation of Signature Authority for Department of Health in Monroe County- Dr. Fry to Dr. Roby Certificate of Insurance Lease Agreement (Gato Bldg) between Monroe County (BOCC) and the State of Florida- Department of Health FINANCIAL IMPACT: Effective Date: Upon approval by BOCC Expiration Date: N/A Total Dollar Value of Contract: $0 Total Cost to County: N/A Current Year Portion: N/A Budgeted: N/A Source of Funds: N/A CPI: N/A Indirect Costs: N/A Estimated Ongoing Costs Not Included in above dollar amounts: N/A Revenue Producing: No If yes, amount: Grant: N/A County Match: N/A Insurance Required: Yes = ��� i �! �! i I M! WK-SMWIT-Iff faffU4441AMMM LICENSE AGREEMENT (A portion of Gato Building, 1100 Simonton Street Key West, Florida 33040) This License Agreement is made and entered into this I" day of February, 2026 , by and between Florida Department of Health (FiD►OH) in Monroe County, hereinafter "FDOH," 1100 Simonton Street, Key West, Florida 33040, and Florida Keys Healthy Start Coalition, Inc. hereinafter "LICENSEE", whose principal address is 3132 Northside Drive, Key West, Florida 33040, for management and operation of the Healthy Babies, Keys to Kids, and Keys to Supporting Families services, hereinafter "SERVICES". WITNESSETH: WHEREAS, the Healthy Start Coalition office co -located with FDOH-Monroe hereinafter "Premises," at 1100 Simonton Street Key West, Florida 33040 is owned by the COUNTY and used by the COUNTY for a variety of public business purposes, such as a community service site; and WHEREAS, the Monroe County Board of County Commissioners (hereinafter the "COUNTY"), as the property owner, leased a portion of the Premises to the State of Florida, Department of Health ("FDOH") to provide public health services to the community; and WHEREAS, FDOH wishes to delegate space within its leased premises ("FDOH Premises") to the Florida Keys Healthy Start Coalition, Inc. ("LICENSEE") for the provision of services; and WHEREAS, the LICENSEE was organized for the purpose of serving women and families of all economic levels; and WHEREAS, it is a legitimate public purpose to provide facilities for health services for the community; and WHEREAS, FDOH has determined that it is in the best interest of the public for the LICENSEE to use the FDOH Premises in order to facilitate mutual obligations of said parties as set forth in the parties' grant Contract #: HS-2022-2023, as may be amended or extended by the parties, and WHEREAS, the COUNTY routinely allows its facilities to be used by other governmental agencies, not -for -profit entities, and individuals subject to state and county laws and policies, and upon submission of appropriate insurance and release/indemnification documents; and WHEREAS, this is a revocable license granted to LICENSEE in order to fulfill the express purposes stated herein, and is subject to all terms and conditions of the underlying Lease Agreement between COUNTY (as property owner) and FDOH entitled "Lease Agreement Gato Building" dated April 17, 2024, as amended or extended by the parties thereto; and WHEREAS, consistent with paragraph 14 of the above referenced "Lease Agreement Gato Building," this revocable license agreement is only effective upon approval of the County's Board of County Commissioners, and it is expressly understood that such obligations of FDOH contained therein extend to and bind the LICENSEE; and WHEREAS, it is necessary for FDOH to also preserve its ability to utilize the FDOH Premises for any Public Health functions if it should become necessary. NOW, THEREFORE, in consideration of the covenants hereinafter to be kept and preformed, FDOH and the LICENSEE agree that the LICENSEE may use the FDOH Premises subject to the following conditions: I. RECITALS. The above -stated recitals are adopted herein as if set forth in full. The license provided herein is revocable at any time and for any reason whatsoever by FDOH and/or COUNTY; and the LICENSEE's use of the FDOH Premises is subject to the approval of County's Board of County Commissioners. 2. FDOH PREMISES. The FDOH Premises which are the subject of this License Agreement is a portion of the building that is authorized for use by FDOH pursuant to the "Lease Agreement Gato Building" between COUNTY and FDOH, dated April 17, 2024, and as such lease may be amended or extended from time to time, regarding real property located at 1100 Simonton Street Key West, Florida 33040. 3. UNDERLYING LEASE. All obligations upon FDOH, as set forth in the above referenced Lease, are hereby adopted and expressly imposed upon the LICENSEE. For clarification purposes, and consistent with paragraph 14 of the above referenced Lease, this revocable license is subject to approval of the County's Board of County Commissioners, and it is expressly understood that the COUNTY owes no duties to LICENSEE under the above -referenced Lease, for any reason pursuant to any legal theory derived therefrom. The LICENSEE expressly acknowledges and agrees that it holds no third -party beneficiary rights thereunder. To extent there is a conflict between LICENSEE's obligations set forth hereunder and those extended to the LICENSEE pursuant to the Lease, the more restrictive provision upon LICENSEE will prevail. 4. TERM. The term of this License Agreement shall ran concurrent with the term of the parties' grant Contract #: HS-2022-2023, as may be amended or extended by the parties. (Attachment A). To the extent that the contractual relationship (grant funding, etc.) between FDOH and LICENSEE is terminated or naturally ends, the LICENSEE's possessory interest in the FDOH Premises under this revocable license is automatically extinguished without further action by either party. 5. USE OF PREMISES. The FDOH Premises shall be actively used to provide Healthy Start Coalition Services for the Monroe County area on a coordinated basis with FDOH staff to ensure that no FDOH functions are displaced as a result of programs scheduled by LICENSEE. During the operation of programs, the LICENSEE will be held responsible for reasonable supervision of the programming area, including security against predators for children and the elderly for any programs provided for same. If the LICENSEE observes any activity which it reasonably believes to be a nuisance or an illegal activity, including alcoholic beverages or unlawful narcotics being possessed, used, or consumed by persons on the premises, the LICENSEE will promptly contact Monroe County's County Administrator and the Monroe County Sheriffs Office. 6. HOURS OF OPERATION. LICENSEE's programs are not limited to the hours that the Premises is regularly open. LICENSEE's programs shall take place only during the hours 2 MRC09 scheduled in advance between the parties and approved in advance in writing by the FDOH Administrator or her designee. Arrangements will be made by FDOH to provide the LICENSEE with keys to the front entrance. Other equipment in the facility is expressly reserved for FDOH purposes and shall not be moved, operated, or otherwise accessed by LICENSEE. 7. COMPLAINTS. LICENSEE shall inform FDOH and COUNTY immediately of any incidents, accidents, and calls to law enforcement, and shall cooperate in any investigation of complaints about the use or condition of the FDOH Premises. 8. CANCELLATION/TERMINATION. Either party may give notice to the other party of breach of the terms of this Agreement. If the noticed breach is not cured within thirty (30) days of receipt of the notice, the non -breaching party may terminate the Agreement effective fifteen calendar days after notice that the breach has not been cured and notice of the termination. Any waiver by either party of any covenants of this Agreement shall not be deemed or considered to be a continuing waiver and shall not operate to bar or prevent either party from declaring a forfeiture for any succeeding breach either of the same conditions or of any other conditions. Either party may cancel this agreement without cause by providing at least thirty (30) days prior written notice to the other party. All contractual obligations of either party remain in full force up to the effective date of termination. Both parties shall remain liable after termination of this Agreement for all obligations, including but not limited to, any outstanding payments, through the effective date of termination. The parties expressly agree that the COUNTY reserves the right to revoke this license at any time (effective immediately) with written notice to FDOH. 9. RETURN OF PREMISES. At the end of the term of this Agreement or any extensions thereof, the LICENSEE shall vacate and peacefully surrender the premises to FDOH. 10. INDEPENDENT LICENSEE. At all times and for all purposes hereunder, the LICENSEE is an independent LICENSEE and not an employee of FDOH, nor the Monroe County Board of County Commissioners. No statement contained in this License Agreement shall be construed so as to find the LICENSEE or any of its employees, licensees, servants, or agents to be employees of FDOH or the Board of County Commissioners. 11. INDEMNIFICATION AND HOLD HARMLESS. Notwithstanding any minimum insurance requirements prescribed elsewhere in this License Agreement, and in exchange for the value of $ 10 attributed to the special use of FDOH Premises, the LICENSEE shall defend, indemnify, and hold harmless FDOH and the COUNTY (including the County's elected and appointed officers and employees) from and against any claims, actions or causes of action, any litigation, administrative proceedings, appellate proceedings, or other proceedings relating to any type of injury (including death), loss, damage, fine, penalty or business interruption, and any costs or expenses that may be asserted against, initiated with respect to, or sustained by, any indemnified party by reason of, or in connection with: (A) any activity of the LICENSEE or any of its employees, agents, contractors or other invitees during the term of this License Agreement; (B) the negligence or recklessness, intentional wrongful misconduct, errors or other wrongful act or omission of the LICENSEE or any of its employees, agents, sub -contractors or other invitees; or (C) the LICENSEE's default in respect of any of the obligations that it undertakes under the terms of this License Agreement. Furthermore, LICENSEE agrees to defend, indemnify and hold harmless FDOH and the COUNTY (including the County's elected and appointed officers and employees) from all such claims, fees, royalties, or costs for its use of any patent, trademark, or copyrighted materials, and any suits or actions of any name that may be brought by virtue of this License Agreement, against the indemnified parties for the infringement of any patents, trademarks or copyrights claimed by any person, firm, or corporation. By entering into this License Agreement, LICENSEE expressly acknowledges that its duty to indemnify and hold harmless FDOH and the COUNTY, as provided in this section, includes claims which arise from, or are in any way attributable to, the alleged negligent acts or omissions of the indemnified parties. Nothing contained herein is intended, nor may it be construed, to waive the FDOH's and/or the COUNTY's rights and immunities under the common law or Section 768.28, Florida Statutes, as amended from time to time; nor will anything included herein be construed as consent to be sued by any third parties in any matter arising out of this License Agreement. Insofar as the claims, actions, causes of action, litigation, proceedings, costs or expenses relate to events or circumstances that occur during the term of this License Agreement, this section will survive the expiration of the term of this License Agreement or any earlier termination of this License Agreement. 12. INSURANCE. Prior to the LICENSEE's use of the FDOH Premises within the Gato Building under this License Agreement, the LICENSEE shall obtain, at its own expense, insurance as follows: a. COMMERCIAL GENERAL LIABILITY INSURANCE. Commercial general liability coverage with limits of liability of not less than $1,000,000.00 per occurrence combined single limit for Bodily Injury Liability and Property Damage Liability. Such coverage must include, as a minimum: Premises Operations, Products and Completed Operations, Blanket Contractual Liability, and Personal Injury Liability. An Occurrence Form policy is preferred. If coverage is provided on a Claims Made policy, its provisions should include coverage for claims filed on or after the effective date of this License Agreement. In addition, the period for which claims may be reported should extend for a minimum of twelve (12) months following the end of LICENSEE's use of the FDOH Premises as authorized hereunder. b. COMPREHENSIVE AUTOMOBILE LIABILITY INSURANCE. Motor vehicle liability insurance, including applicable no-fault coverage, with limits of liability of not less than $300,000.00 per occurrence, combined single limit for Bodily Injury Liability and Property Damage Liability. If single limits are provided, the minimum acceptable limits are $200,000.00 per person, $300,000.00 per occurrence, and $200,000.00 property damage. Coverage shall include all owned vehicles, all non -owned vehicles, and all hired vehicles, c. WORKERS COMPENSATION LIABILTIY INSURANCE. Where applicable, coverage to apply for all employees at the minimum statutory limits as required by Florida Law. For the Commercial General Liability and Comprehensive Automobile Liability Insurances, the Monroe County Board of County Commissioners, 1100 Simonton Street, Key West, Florida 33040, must be named as Additional Insured on all policies issued to satisfy the above requirements. Such insurance coverage shall be primary insurance with respect to the County, its officials, employees, agents, and volunteers. Coverage shall be provided by a company or companies authorized to transact business in the State of Florida and acceptable to FDOH and COUNTY. The LICENSEE shall maintain the required insurance throughout the entire term of this License Agreement and any extensions. Failure to comply with this provision may result in the immediate termination of the license agreement and vacation of the FDOH Premises. All insurance policies must specify that they are not subject to cancellation, non -renewal, material change, or reduction in coverage unless a minimum of thirty (30) days prior notification is given to FDOH and COUNTY by the insurer. The LICENSEE shall provide FDOH and COUNTY, as satisfactory evidence of the required insurance, either a MRC09 certificate of insurance or a certified copy of the actual insurance policy. The acceptance and/or approval of the LICENSEE'S insurance shall not be construed as relieving the LICENSEE from any liability or obligation assumed under this License Agreement or imposed by law. In the event that the LICENSEE allows subcontractors access to the FDOH Premises, LICENSEE specifically agrees to require the subcontractor to possess all insurance policies required by the COUNTY and to identify the COUNTY as an Additional Insured on the required policies, as stated herein. Any deviations from these General Insurance Requirements must be requested in writing on the County prepared form entitled "Request for Waiver of Insurance Requirements" and approved by Monroe County Risk Management. 13. COMPLIANCE WITH LAW. In providing all services pursuant to this License Agreement, the LICENSEE shall abide by all statutes, ordinances, resolutions, and rules and regulations pertaining to or regulating the provisions of such services, including those in effect and those hereinafter adopted. Any violation of said statutes, ordinances, resolutions or rules and regulations shall constitute a material breach of this License Agreement and shall entitle FDOH to terminate this License Agreement if such breach remains uncured thirty (30) days after delivery of written notice of termination to the LICENSEE. FDOH may thereupon remove from the FDOH Premises any personal property of the LICENSEE. 14. NO ASSIGNMENT. The LICENSEE shall not assign this License Agreement. 15. NON-DISCRIMINATION. FDOH, and LICENSEE 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. FDOH and LICENSEE agree 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 VII of the Civil Rights Act of 1964 (PL 88-352) which prohibits discrimination in employment on the basis of race, color, religion, sex, 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 disability; 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. 3601 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; I O)Monroe County Code Chapter 14, Art, 11, which prohibits discrimination on the basis 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. 16. AUTHORIZED SIGNATORY. The signatory for the LICENSEE, below, certifies and warrants that: a) The LICENSEE'S name in this License Agreement is its full name as designated in its corporate charter, if a corporation, or the full name under which LICENSEE is authorized to do business in the State of Florida, b) He or she is empowered to act and contract for the LICENSEE. c) This License Agreement has been approved by the Board of Directors of the LICENSEE. 17. NOTICE. All written correspondence to FDOH shall be dated and signed by an authorized representative of the Licensee. Any notice required or permitted under this License Agreement shall be in writing and hand -delivered, delivered by a national courier service with overnight delivery and signed receipt, or mailed, postage pre -paid, by certified mail, return receipt requested, to the other party as noted below. The place of giving notice shall remain the same as set forth herein until changed in writing in the manner provided in this paragraph. Notice is deemed received by LICENSEE when hand delivered by national courier service with proof of delivery or by U.S. Mail upon verified receipt or upon the date of refusal or non -acceptance of delivery. Notice shall be sent to the following persons: 18. CONTACT PERSONS. The following, or their designees, are the contact persons in connection with this License Agreement: For FDOH FDOH Administrator Carla A. Fry PhD Cx1and,cffhalt -soy 305-619-5395 Facilities Coorjdinator Gio Grossi Gi*." ssi,,,&f1health.sz For Licensee Healthy Start Coalition CEO Arianna Nesbitt ceo@keyshealthystart.org 19. 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 management Agreement shall be exclusively in Monroe County, Florida. This Agreement is not subject to arbitration. 20, NON -WAIVER. Any waiver or any breach of covenants herein contained to be kept and performed by either party shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the other party from exercising any of its remedies under this License Agreement, at law or in equity for any succeeding breach, either of the same condition or covenants or otherwise. w 1 * I'' M is R OR IN WITNESS WHEREOF, each party has caused this License Agreement to be executed by its duly authorized representative. Mark Roby By: 4sw Carla A. Fry, PhD, MN, LICENSEE: FWAIL)A,,KEYS HEALTHY START, INC. By: _ r"AA Arianna Nesbitt President / CEO "ATTACHMENT A" Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 FLORIDA KEYS HEALTHY START COALITION FLORIDA Standard CONTRACT FOR SERVICES PROVIDED IN MONROE COUNTY THIS CONTRACT, is entered into between the Florida Keys Healthy Start Coalition, Inc., hereinafter referred to as the "Coalition," and the Florida Department of Health in Monroe County, hereinafter referred to as the "Provider," and jointly referred to as the "parties." The purpose of this contract is to provide Coordinated Intake and Referral (CI&R) services and Healthy Start services in Monroe County. The parties hereto agree as follows: RECITALS: WHEREAS, The primary objectives of the CI&R and Healthy Start initiatives are to reduce infant mortality and morbidity, to improve pregnancy outcomes, and to enhance the health and development of children from birth to age three; and WHEREAS, Healthy Start Coalitions are a central component of this initiative in their local mission to unite people an resources to improve the health and well-being of pregnant women, children, and their families in Monroe County; and WHEREAS, The major goals of Healthy Start Coalitions are to establish, implement and monitor a system of care for pregnant women and children from birth to age three, and to administer CI&R, Healthy Start care coordination and Fatherhood services at an increased level of intensity and duration; and WHEREAS, CI&R, Healthy Start and Fatherhood services offer outreach to pregnant women, women of childbearing age, father figures with active roles in the family, and children from birth to age three. The Healthy Start system of care offers universal prenatal and infant screenings to identify pregnant women and infants who are at risk for adverse birth, health, and developmental outcomes. CI&R and Healthy Start eligible pregnant women and children from birth to age three are also offered care coordination and wraparound services that support families in reducing risk factors. Fatherhood engagement aims to increase participation in services and strengthen family and child well-being. WHEREAS, the Coalition has been created to develop services and resources for maternal and infant care in Monroe County of the State of Florida; and, WHEREAS, the Coalition is desirous of developing comprehensive and professional CI&R, Healthy Start care coordination and Fatherhood services for the residents of Monroe County in Florida needing maternal and infant care; and has been authorized by the Florida Department of Health to oversee the development of these services and resources through contracts with health care providers; and, WHEREAS, the Provider is capable and willing to provide suitable services to persons needing maternal and infant care; NOW, THEREFORE, in consideration of the mutual covenants contained herein, the parties hereto agree as follows: THE PROVIDER HERETO AGREES: A. To provide services in accordance with the conditions specified in Attachment I. B. Requirements of §287.058, Florida Statutes (FS). To provide units of deliverables, including reports, findings, and drafts as specified in Attachment I, to be received and accepted by the Coalition prior to payment. The duties to be performed must be met for the completion of this Contract as specified in Attachment I. To allow public access to all documents, papers, letters, or other materials subject to the provisions of Chapter 119, F.S., made or received by the Provider in conjunction with this Contract. It is expressly understood that the Provider's refusal to comply with this provision shall constitute an immediate breach of this Contract. C. To the Following Governing Law. 1. State of Florida Law. This Contract is executed and entered into in the State of Florida, and shall be construed, performed, and enforced in all respects in accordance with the laws, rules, and regulations of the State of Florida. Each party shall perform its obligations herein in accordance with the terms and conditions of the Contract and all attachments incorporated herein by reference. Page 1 1 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 2. Federal Law. a. If this contract contains federal funds, the provider shall comply with the provisions of 45 CFR, Part 74, and/or 45 CFR, Part 92, and other applicable regulations as specified in Attachment I. b. If this agreement includes federal funds and more than $2,000 of federal funds will be used for construction or repairs, the provider shall comply with the provisions of the Copeland "Anti -Kickback" Act (18 U.S.C. 874 and 40 U.S.C. 276c), as supplemented by Department of Labor regulations (29 CFR part 3, "Contractors and Subcontractors on Public Building or Public Work Financed in Whole or part by Loans or Grants from the United States"). The act prohibits providers from inducing, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he/she is otherwise entitled. All suspected violations must be reported to the Coalition. C. If this agreement includes federal funds and said funds will be used for the performance of experimental, developmental, or research work, the Provider shall comply with 37 CFR, part 401, "Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Governmental Grants, Contracts and Cooperative Agreements". d. If this contract contains federal funds and is over $100,000, the Provider shall comply with all applicable standards, orders, or regulations issued under §306 of the Clean Air Act, as amended (42 U.S.C. 1857(h) et seq.), §508 of the Clean Water Act, as amended (33 U.S.C. 1368 et seq.), Executive Order 11738, and Environmental Protection Agency regulations (40 CFR Part 15). The provider shall report any violations of the above to the Coalition. e. To comply with the provisions of Section 216.347 F.S. which prohibits the expenditure of contract funds for the purpose of lobbying the Legislature, the judicial branch, or a State agency. If this contract contains federal funding in excess of $100,000, the Provider must, prior to contract execution, complete the Certification Regarding Lobbying form, Attachment V. If a Disclosure of Lobbying Activities form, Standard Form LLL, is required, it may be obtained from the contract manager. All disclosure forms as required by the Certification Regarding Lobbying form must be completed and returned to the contract manager. f. Employment of unauthorized aliens is a violation of §§274A (e) of the Immigration and Naturalization Act (8 U.S.C. 1324 a) and section 101 of the Immigration Reform and Control Act of 1986. Such violation shall be cause for unilateral cancellation of this contract by the Coalition. The Provider is required to use the U.S. Department of Homeland Security's E-Verify Employment Eligibility Verification system, https://e- verify.uscis.gov/emp, to verifythe employment eligibility of all newly hired employees used bythe Provider under this contract pursuant to section 448.095, Florida Statutes. The Provider must include in related subcontracts, if authorized under this contract, a requirement that subcontractors performing work or providing services pursuant to this Contract use the E-Verify system to verify employment eligibility of all newly hired employees used by the subcontractor for the performance of services under this contract. The Provider must provide the Coalition with an affidavit stating that they, and any of their subcontractors, do not employ, contract with, or subcontract with an unauthorized alien. The Provider must maintain a copy of such affidavit for the duration of the contract and submit the affidavit to the Coalition. If the Coalition or the Florida Department of Health has a good faith belief that the Provider or a subcontractor of the Provider knowingly violated section 448.095(1), Florida Statues, and notifies the Provider of such, but the Provider otherwise complied with this statute, the Coalition is required to immediately terminate the contract with the Provider. g. The Provider shall comply with President's Executive Order 11246, Equal Employment Opportunity (30 FIR 12319, 12935, 3 CFR, 1964-1965 Comp. P.339), as amended by President's Executive Order 11375, and as supplemented by regulations at41 CFR, Part60. h. The Provider and any subcontractors agree to comply with the Pro -Children Act of 1994, Public Law 103- 277, which requires that smoking not be permitted in any portion of any indoor facility used for the provision of federally funded services including health, day care, early childhood development, education or library services on a routine or regular basis, to children up to age 18. Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible entity. Page 1 2 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 i. Health Insurance Portability and Accountability Act of 1996 (HIPAA): Where applicable, the Provider will comply with HIPAA as well as all regulations promulgated thereunder (45 CFR Parts 160,162, and 164). j. Provider is required to submit a W-9 to the Department of Financial Services (DFS) electronically prior to doing business with the State of Florida via the Vendor Website at https://flvendor.myfloridacfo.com. Any subsequent changes shall be performed through this website; however, if provider needs to change their FEID, they must contact the DFS Vendor Ombudsman Section at (850) 413-5519. k. If the provider is determined to be a Subrecipient of federal funds, the provider will comply with the requirements of the American Recovery and Reinvestment Act (ARRA) and the Federal Funding Accountability and Transparency Act, by obtaining a DUNS (Data Universal Numbering System) number and registering with the Federal Central Contractor Registry (CCR). No payments will be issued until the provider has submitted a valid DUNS number and evidence of registration (i.e., a printed copy of the completed CCR registration) in CCR to the contract manager. To obtain registration and instructions, visit https://fedgov.dnb.com/webform and www.ccr.gov. D. Audits, Records, and Records Retention 1. Provider shall establish and maintain books, records, and documents (including electronic storage media) in accordance with generally accepted accounting principles, procedures, and practices, which sufficiently and properly reflect all revenues and expenditures of funds provided by the Coalition under this Contract. 2. Provider shall retain all client records, financial records, supporting documents, statistical records, and any other documents (including electronic storage media) pertinent to this Contract for a period of ten (10) years after termination of the Contract, or if an audit has been initiated and audit findings have not been resolved at the end of ten (10) years, the records shall be retained until resolution of the audit findings or any litigation which may be based on the terms of this contract. 3. Refusal by the Provider to allow access to all records, documents, papers, letters, or other material or on -site activities related to this Agreement performance shall constitute a breach of this agreement. 4. The Provider shall be responsible for all storage fees associated with all records maintained under this Agreement. The Provider is also responsible for the destruction of all records that meet the retention schedule noted above. 5. Upon completion or termination of the Contract and at the request of the Coalition, the Provider will cooperate with the Coalition to facilitate the duplication and transfer of any records or documents belonging to the Coalition during the required retention period as specified in Section I, paragraph D.2. above. 6. Provider shall assure that these records shall be subject at all reasonable times to inspection, review, or audit by Federal, State, or Coalition staff. 7. Coalition staff, state, and Federal auditors, pursuant to 45 CFR, Part 92.36(i)(10), shall have full access to and the right to examine any of Provider's Contract and related records and documents, regardless of the form in which kept, at all reasonabletimes for as long as records are retained. 8. Provider shall provide a financial and compliance audit to the Coalition and to ensure that all related party transactions are disclosed to the auditor. 9. Provider shall include the aforementioned audit and record keeping requirements in all approved Contracts and assignments. 10. Provider shall complete the Federal Subrecipient and Vendor Determination Checklist annually. 11. If this contract indicates that the Provider is a recipient or subrecipient, the Provider will perform the required financial and compliance audits in accordance with the Single Audit Act Amendments of 1996 and OMB Circular A-133, and/or section 215.97 Florida Statutes, as applicable and conform to the following requirements: a. Documentation. 1) Provider shall maintain separate accounting of revenues and expenditures of funds under this contract and each CSFA or CFDA number identified on Exhibit 1 attached hereto in accordance with generally accepted accounting practices and procedures. Expenditures which support provider activities not solely authorized under this contract must be allocated in accordance with applicable laws, rules and regulations, Page 13 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 and the allocation methodology must be documented and supported by competent evidence. 2) Provider must maintain sufficient documentation of all expenditures incurred (e.g., invoices, canceled checks, payroll detail, bank statements, etc.) under this contract which evidences that expenditures are: a) allowable under the contract and applicable laws, rules and regulations; b) reasonable; and c) necessary in order for the recipient or subrecipient to fulfill its obligations under this contract. 3) The aforementioned documentation is subject to review by the Coalition, Department and/or the State Chief Financial Officer and the Provider will timely comply with any requests for documentation. b. Financial Report. 1) Provider shall submit an annual financial report stating, by line item, all expenditures made as a direct result of services provided through the funding of this contract to the Coalition within 30 days of the end of the contract. If this is a multi —year contract, the Provider is required to submit a report within 30 days of the end of each year of the contract. Each report must be accompanied by a statement signed by an individual with legal authority to bind recipient or subrecipient certifying that these expenditures are true, accurate and directly related to this contract. 2) Provider shall ensure that funding received under this contract in excess of expenditures is remitted to the Coalition within 30 days of the earlier of the expiration of, or termination of, this contract. Provider shall keep and maintain public records that ordinarily and necessarily would be required by the Provider in order to perform the service. a. Public Records 1) Provider shall provide the public with access to such public records on the same terms and conditions that the public agency would provide the records and at a cost that does not exceed the cost provided in Chapter 119, FS, or as otherwise provided by law; ensure that public records that are exempt or that are confidential and exempt from public record requirements are not disclosed except as authorized by law; meet all requirements for retaining public records; transfer to the public agency, at no cost, all public records in possession of the contractor upon termination of the contract; and destroy any duplicate public records that are exempt or confidential and exempt. All records stored electronically must be provided to the public agency in a format that is compatible with the information technology systems of the agency. 2) Keep and maintain public records, as defined by Chapter 119, FS, that are required by the State of Florida, Department of Health, and the Coalition to perform the services required by the contract. Upon request from the Department's custodian of public records, provide the Department with a copy of the requested public records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed that provided in Chapter 119, Florida Statutes, or as otherwise provided by law. Ensure that public records that are exempt or are confidential and exempt from public record disclosure are not disclosed, except as authorized by law for the duration of the contract term and following completion of the contract if Provider does not transfer the public records to the Department. Upon completion of the contract, transfer to the Department, at no cost, all public records in possession of Provider or keep and maintain public records required by the Department to perform contract services. If Provider transfers all public records to the Department upon completion of the contract, Provider will destroy any duplicate public records that are exempt or confidential and exempt. If Provider keeps and maintains public records upon completion of the contract, Provider will meet all applicable requirements for retaining public records. All records stored electronically must be provided to the Department, upon request of the Department's custodian of public records, in a format that is compatible with the information technology systems of the Department. The Department may unilaterally terminate this contract if Provider refuses to allow access to all public records made or maintained by Provider in conjunction with this contract, unless the records are exempt from section 24(a) of Art. I of the State Constitution and section 119.07 1 , Florida Statutes. If the Provider has questions regarding the application of Chapter 119, Page 14 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 Florida Statutes, to the Provider's duty to provide public records relating to this contract, contact the custodian of public records at (850) 245- 4005, publicrecordsrequest@flhealth.gov or 4052 Bald Cypress Way, Bin A02, Tallahassee, FL 32399 3) Cooperation with Inspectors General: To the extent applicable, Provider acknowledges and understands it has a duty to and will cooperate with the inspector general in any investigation, audit, inspection, review, or hearing pursuantto section 20.055(5), FS. E. Monitoring by the Coalition. To permit the Coalition Board of Directors and Coalition staff, with appropriate client authorization, to inspect any records, papers, documents, facilities, goods, and services of the Provider which are relevant to this Contract. The Provider will correct all noted deficiencies identified by the Coalition during such review within the specified period of time set forth in the review report. The Provider's failure to correct noted deficiencies may, at the sole and exclusive discretion of the Coalition, result in any one or any combination of the following: (1) the Provider being deemed in breach or default of this contract; (2) the withholding of payments to the Provider by the Coalition; and (3) the termination of this Contract for cause per 287.058 (1)(h), FS. F. Indemnification. NOTE: Paragraph I.F.1. and I.F.2. are not applicable to contracts executed with state agencies or subdivisions, as defined in §768.28, FS. The Provider shall be liable for and shall indemnify, defend, and hold harmless the Coalition, their funders, and all of their officers, agents, and employees from all claims, suits, judgments, or damages, consequential or otherwise and including attorneys' fees and costs, arising out of any act, actions, neglect, or omissions by the Provider, its agents, or employees during the performance or operation of this contract or any subsequent modifications thereof, whether director indirect, and whether to any person or tangible or intangible property. The Provider's inability to evaluate liability or its evaluation of liability shall not excuse the Provider's duty to defend and indemnify within seven (7) days after such notice by the Coalition is given by certified mail. Only adjudication or judgment after highest appeal is exhausted specifically finding the provider not liable shall excuse performance of this provision. The Provider shall pay all costs and fees related to this obligation and its enforcement by the Coalition. The Coalition's failure to notify the Provider of a claim shall not release the Provider of the above duty to defend. NOTE: This section, I.F, Indemnification, is not applicable to contracts executed with state agencies or subdivisions, as defined in section 768.28, Florida Statutes. G. Insurance. 1. Provider shall provide adequate liability insurance coverage on a comprehensive basis and hold such liability insurance at all times during the existence of this Contract and any renewal(s) and extension(s) of it. Upon execution of this Contract, unless it is a state agency or subdivision as defined by §768.28, FS, the Provider accepts full responsibility for identifying and determining the type(s) and extent of liability insurance necessary to provide reasonable financial protections for the Provider and the clients to be served under this Contract. The limit of coverage under each policy maintained by the Provider does not limit the Provider's liability and obligations under this Contract. Upon the execution of this Contract, the Provider shall furnish the Coalition written verification supporting both the determination and existence of such insurance coverage. Such coverage may be provided by a self-insurance program established and operating under the laws of the State of Florida. The Coalition reserves the rightto require additional insurancewhere appropriate. To the extent required by law, the Provider shall be self -insured against, or shall secure and maintain during the life of this Agreement, Worker's Compensation Insurance for all its employees connected with the work of this Agreement and, in case any work is subcontracted, the Provider shall require the subcontractor similarly to provide Worker's Compensation Insurance for all of the latter's employees unless such employees engaged in work under this Agreement are covered by the Provider's self-insurance program. Such self-insurance or insurance coverage shall comply with the Florida Worker's Compensation law. In the event hazardous work is being performed by the Provider under this Agreement and any class of employees performing the hazardous Page 15 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 work is not protected under Worker's Compensation statutes, the Provider shall provide, and cause each subcontractor to provide, adequate insurance satisfactory to the Coalition, for the protection of its employees not otherwise protected. The Provider shall provide adequate Automobile Liability Insurance to pay claims for damages to property, and for injuries to or death of any person or persons arising out of or related in any way to activities or the presence of its employees, agents or contractors on the Subject Property. The Provider shall set the limits of liability necessary to provide reasonable financial protections to the Provider, the Coalition, and the State of Florida under this Agreement. All insurance policies shall be with insurers licensed or eligible to transact business in the State of Florida. The Provider's current insurance policy(ies) shall contain a provision that the insurance will not be canceled for any reason except after thirty (30) calendar days written notice. The Provider shall provide thirty (30) calendar days written notice of cancellation to the Coalition's Contract Manager. The Provider will provide Insurance certificates identifying the aforementioned coverage upon execution of this Contract. Confirmation insurance policies required to be maintained by the Provider shall be written to insure losses on an "occurrence basis" and be primary and non-contributory to any insurance otherwise carried by the Coalition. H. Safeguarding Information. Provider shall not use or disclose any information concerning a recipient of services under this Contract for any purpose not in conformity with state and federal law or regulations except upon written consent of the recipient, or his responsible parentor guardian when authorized by law. I. Assignments and Subcontracts. Provider shall neither assign the responsibility of this contract to another party nor subcontract for any of the work contemplated under this contract without prior written approval of the Coalition, which shall not be unreasonably withheld. Any sub -license, assignment, or transfer otherwise occurring shall be null and void. 2. The Provider shall be responsible for all work performed and all expenses incurred with the project. If the Coalition permits the provider to subcontract all or part of the work contemplated under this contract, including entering into subcontracts with vendors for services and commodities, it is understood by the Provider that the Coalition shall not be liable to the subcontractor for any expenses or liabilities incurred under the subcontract and the Provider shall be solely liable to the subcontractor for all expenses and liabilities incurred under the subcontract. J. Return of Funds. Provider shall return to the Coalition any overpayments due to unearned funds or funds disallowed pursuant to the terms of this Contract that were disbursed to the Provider by the Coalition. In the event the Provider or its independent auditor discovers that overpayment has been made, the Provider shall repay said overpayment within twenty-five (25) calendar days without prior notification from the Coalition. In the event the Coalition first discovers an overpayment has been made, the Coalition will notify the Provider by letter of such a finding. Should repayment not be made in a timely manner, the Coalition will charge interest of one (1) percent per month compounded on the outstanding balance commencing thirty (30) calendar days after the date of notification. K. Incident Reporting. Abuse, Neglect, and Exploitation Reporting: In accordance with Florida law an employee of the Provider who knows or has reasonable cause to suspect that a child, aged person, or disabled adult is or has been abused, neglected, or exploited shall immediately report such knowledge or suspicion to the Florida Abuse Hotline on the single statewide toll -free telephone number (1-800-96ABUSE). Chapter 415, FS, pertains strictly to the mandatory reporting of abuse of vulnerable adults whereas Chapter 39, FS imposes reporting requirements related to the abuse of children. L. Purchasing. Procurement of Materials with Recycled Content: It is expressly understood and agreed that any products or materials which are the subject of or are required to carry out this contract shall be procured in accordance with the provisions of section 403.7065, FS. MyFloridaMarketPlace Vendor Registration: Each vendor doing business with the State of Florida for the sale of commodities or contractual services as defined in section 287.012, FS, shall register in the MyFloridaMarketPlace Page 16 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 system unless exempted under Rule 60A-1.030(3), FAC. MyFloridaMarketPlace Transaction Fee: The State of Florida, through the Department of Management Services, has instituted MyFloridaMarketPlace, a statewide Procurement system. Pursuant to section 287.057(22)(C), FS, all payments shall be assessed a Transaction Fee of one percent (1.0%), which the Provider shall pay to the State. For payments within the State accounting system (FLAIR or its successor), the Transaction Fee shall, when possible, be automatically deducted from payments to the vendor. If automatic deduction is not possible, the vendor shall pay the Transaction Fee pursuant to Rule 60A-1.031(2), FAC. By submission of these reports and corresponding payments, vendor certifies their correctness. All such reports and payments shall be subject to audit by the State or its designee. The Provider shall receive a credit for any transaction Fee paid by the Provider for the purchase of any item(s) if such item(s) are returned by the Provider through no fault, act, or omission of the Provider. Notwithstanding the foregoing, a Transaction Fee is non-refundable when an item is rejected or returned, or declined, due to the Provider's failure to perform or comply with specifications or requirements of the agreement. Failure to comply with these requirements shall constitute grounds for declaring the vendor in default and recovering reprocurement costs from the vendor in addition to all outstanding fees. Providers delinquent in paying transaction fees may be excluded from conducting future business with the State. Alternative Contract Source: This Contract may be used as an alternative contract source, subject to approval from the Florida Department of Management Services, pursuant to section 287.042(16), Florida Statutes and Florida Administrative Code Rule 60A-1.045. M. Transportation Disadvantaged. If clients are to be transported under this contract, the Provider will comply with the provisions of Chapter 427, FS,and Rule Chapter 41-2, FAC. The Provider shall submit to the Department the reports required pursuant to Volume 10, Chapter 27, DOH Accounting Procedures Manual. N. Civil Rights Requirements. Civil Rights Certification: The Provider will comply with applicable provisions of DOH publication, "Methods of Administration, Equal Opportunity in Service Delivery." O. Independent Capacity of the Contractor. 1. In the performance of this Contract, it is agreed between the parties that the Provider is an independent contractor and that the Provider is solely liable for the performance of all tasks and deliverables contemplated by this Contract which are not the exclusive responsibility of the Coalition. 2. The Provider, its officers, agents, employees, or subcontractors, in performance of this contract, shall act in the capacity of an independent Contractor and not as an officer, employee, or agent of the Coalition. Nor shall the Provider represent to others that it has the authority to bind the Coalition unless specifically authorized to do so. 3. Unless justified by the Provider and agreed to by the Coalition in Attachment I, the Coalition will not furnish services of support (e.g., office space, office supplies, telephone service, secretarial, or clerical support) to the Provider. 4. All deductions for social security, withholding taxes, contributions to unemployment compensation funds, and all necessary insurance for the Provider, the Provider's officers, employees, agents, subcontractors, or assignees shall bethe responsibility of the Provider. P. Sponsorship. As required by section 286.25, FS, if the Provider is a non -governmental organization which sponsors a program financed wholly or in part by state funds, including any funds obtained through this Contract, it shall, in publicizing, advertising, or describing the sponsorship of the program, state: Sponsored by (Provider's name), the State of Florida, Department of Health and the Florida Keys Healthy Start Coalition, Inc. If the sponsorship reference is in written material, the words State of Florida, Department of Health shall appear in the same size letters or type as the name of the organization and the Healthy Start Coalition. Q. Use of Funds for Lobbying Prohibited. To comply with the provisions of section 11.062, FS, and section 216.347, FS, which prohibit the expenditure of Contract Page 17 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 funds for the purpose of lobbying the Legislature, judicial branch, or a state agency. R. Public Entity Crime and Discriminatory Vendor. 1. Pursuant to section 287.133, FS, the following restrictions are placed on the ability of persons convicted of public entity crimes to transact business with the Coalition: When a person or affiliate has been placed on the convicted vendor list following a conviction for a public entity crime, he/she 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 a public entity, may not be awarded or perform work as a Contractor, supplier, 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, FS, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list. 2. Pursuant to section 287.134, FS, the following restrictions are placed on the ability of persons convicted of discrimination to transact business with the Coalition: When a person or affiliate has been placed on the discriminatory vendor list following a conviction for discrimination, he/she 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 a public entity, may not be awarded or perform work as a Contractor, supplier 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, FS, for CATEGORY TWO for a period of 36 months from the date of being placed on the discriminatory vendor list. S. Patents, Copyrights, and Royalties. If any discovery or invention arises or is developed in the course or as a result of work or services performed under this Contract, or in any way connected herewith, the Provider shall refer the discovery or invention to the Coalition to be referred to the Department of State to determine whether patent protection will be sought in the name of the State of Florida. Any and all patent rights accruing under or in connection with the performance of this Contract are hereby reserved to the State of Florida. 2. In the event that any books, manuals, films, or other copyrightable materials are produced, the Provider shall notify the Coalition to notify the Department of State. Any and all copyrights accruing under or in connection with the performance under this Contract are hereby reserved to the State of Florida. The Provider, unless a state agency, shall indemnify and save harmless the State of Florida and its employees from liability of any nature or kind, including cost and expenses for or on account of any copyrighted, patented, or unpatented invention, process, or article manufactured bythe Provider. The Provider has no liabilitywhen such claim is solely and exclusively due to the Department of State's alteration of the article. The State of Florida will provide prompt written notification of claim of copyright or patent infringement. Further, if such claim is made or is pending, the Provider may, at its option and expense, procure for the Department of State, the right to continue use of, replace, or modify the article to render it non -infringing. If the Provider uses any design, device, or materials covered by letters, patent, or copyright, it is mutually agreed and understood without exception that the bid prices shall include all royalties or cost arising from the use of such design, device, or materials in anyway involved in the work. T. Construction or Renovation of Facilities Using State Funds. Any state funds provided for the purchase of or improvements to real property are contingent upon the provider granting to the state a security interest in the property at least to the amount of the state funds provided for at least five (5) years from the date of purchase or the completion of the improvements or as further required by law. As a condition of a receipt of state funding for this purpose, the Provider agrees that, if it disposes of the property before the Department's interest is vacated, the Provider will refund the proportionate share of the state's initial investment, as adjusted by depreciation. U. Information Security and Information Technology. The Provider shall maintain confidentiality of all data, files, and records including client records related to the services provided pursuant to this agreement and shall comply with state and federal laws, including, but not limited to sections 384.29, 381.004, 392.65, and 456.057, FS. Procedures must be implemented by the Provider to ensure the protection and confidentiality of all confidential matters. These procedures shall be consistent with the Department of Health Information Security Policies, as amended, which is incorporated herein by reference and the receipt of which is Page 18 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 acknowledged by the Provider, upon execution of this agreement. The Provider will adhere to any amendments to the Coalition's security requirements provided to it during the period of this agreement. The Provider must also comply with any applicable professional standards of practice with respect to client confidentiality. Provider staff that have access connectivity to the Coalition's approved secure database shall be required to complete Security Awareness Training and HIPAA Training. The Provider shall also be required to sign a Data Security and Confidentiality Agreement and submit the completed form to the Coalition's Information Security designee. The requirements described in this Item must be completed before access to the approved secure data system is provided and annually thereafter. V. Smartphone Applications. If the Provider uses smartphone applications (apps) to allow providers direct access to documents and/or content, the Provider shall comply with the following. The Provider shall receive approval from the Provider's Information Technology Department before implementation of a smartphone application. 1. The smartphone application shall disclaim that the application being used is not private and that no PHI or personally identifiable information (PII) should be published on this application by the Provider; and 2. The Provider shall ensure that software applications obtained, purchased, leased, or developed are based on secure coding guidelines. For example: OWASP [Open Web Application Security Project] Secure Coding Principles — http://www.owasp.org/index.php/Secure Coding Principles; CERT Security Coding - http://www.cert.org/secure-coding/;T and ToplOSecuritycodingPractices— https://www.securecoding.cert.org/confluence/display/seccode/Top+10+Secure+Coding+Practices W. Prohibition of Gratuities. The Provider shall certify that no elected official or employee of the State of Florida has or shall benefit financially or materially from this Agreement in violation of the provisions of Chapter 112, F.S. This Agreement may be terminated if it is determined that gratuities of any kind were either offered or received by any of the aforementioned parties. II. THE COALITION AGREES: A. Contract Amount To pay for contracted services according to the conditions of Attachment I, a projected amount not to exceed $350,000.00 annually, subject to the availability of funds. The Coalition's performance and obligation to pay under this Contract is contingent upon an annual appropriation by the Legislature through the Department of Health and Medicaid funds earned through the Agency for Health Care Administration. The costs of services paid under any other Contract or from any other source are not eligiblefor reimbursement under this Contract. B. Contract Payment. See Attachment I. III. THE COALITION AND THE PROVIDER MUTUALLY AGREE A. Effective and Ending Dates. This Contract with the Provider shall begin upon execution of both parties or on July 1, 2022 (whichever is earlier), and end on June 30, 2023, inclusive. B. Termination. 1. Termination at Will. This Contract may be terminated by either party upon no less than sixty (90) calendar days' notice in writing to the other party, without cause, unless a lesser time is mutually agreed upon in writing by both parties. Said notice shall be delivered by certified mail, return receipt requested, or in person with proof of delivery. 2. Termination Because of Lack of Funds. In the event funds to finance this Contract become unavailable, the Coalition may terminate the contract upon no less than twenty-four (24) hours' notice in writing to the Provider. Said notice shall be delivered by certified mail, return receipt requested, or in person with proof of delivery. The Coalition shall be the final authority as to the Page 1 9 availability and adequacy of funds. In the event of termination of this Contract, the Provider will be compensated for any work satisfactorily completed prior to notification of termination. 3. Termination for Breach. This Contract may be terminated for the Provider's non-performance upon no less than twenty-four (24) hours notice in writing to the Provider. If applicable, the Coalition may employ the default provisions in Chapter 60A- 1.006 (3), FAC. Waiver of breach of any provisions of this Contract shall not be deemed to be a waiver of any other breach and shall not be construed to be a modification of the terms of this Contract. The provisions herein do not limitthe Coalition's rightto remedies at lawor in equity. C. Renegotiation or Modification. Modifications of provisions of this Contract shall only be valid when they have been reduced to writing and duly signed by both parties. The rate of payment and dollar amount may be adjusted retroactively to reflect price level increases and changes in the rate of payment when these have been established through the negotiation process and subsequently identified in the Coalition's operating budget. D. Official Payee and Representatives (Names, Addresses and Telephone Numbers). 1. The name (Provider name as shown on page 1 of this contract) and mailing address of the official payee to whom the payment shall be made is: Florida Department of Health in Monroe County 1100 Simonton Street, Key West, FL 33040 2. The name of the contact person, street address and phone number where financial and administrative records are maintained is: Robert B. Eadie, Administrator Florida Department of Health in Monroe Countv 1100 Simonton Street, Key West, FL 33040 3. The name, address, and phone number of the Provider's representative responsible for administration of the program under this Contract is: Robert B. Eadie, Administrator Florida Department of Health in Monroe County 1100 Simonton Street, Key West, FL 33040 305-293-7500 4. The name of the contact person, address, and telephone number where the Coalition's financial and administrative records are maintained is: Arianna N. Nesbitt, Chief Executive Officer Florida Keys Healthy Start Coalition, Inc. 3132 Northside Drive, Suite 102, Key West, FL 33040 :zns_')4Q_9a')a 5. The name, address, and telephone number of the Contract Manager for the Coalition for this Contract is: Ja M. Good, Chief Operating Officer Florida Keys Healthy Start Coalition, Inc. 3132 Northside Drive, Suite 102 KP\/ UIPCY Fi aanan Standard Contract - Healthy Start Direct Services Page 110 30.493-1424 6, Orion change of representAlv" OMM05, addresses, telephone nurnber5) by ptthor party, notice shall he provided in writing to the other party and said notIfIcation attached to originals of this contract, E. All Terra and Conditions Included, This contract And its attachmerits as referenced, Attachments I - X11, contain all the terms and conditions agreed iron by the parties. Them are no provisions, terms, conditions, or obligations other than those contained herein, and this Contract shall supersede all previous communications, representations, or agreements, either verbal or written between the parties. if any term or provision of the Contract is found to be illegal or unenforceable, the remainder of the Contract sh al I remain in full force and effect and such term of provision shall be stricken. I have read the above contract and understand each section and paragraph INWTNESSTHERFOF, the parties hereto have caused this 73itagecontrad to be executed by their undlersignedoMcials as duly authorized. W a Lit W� t. D., 9 PRCMIDEq�k)-Pfl " 4Skjned by Nance: Robert Eadie,JO 7TTLE: Ad�M[1110',War DATE COALITION: f ( '.fty'3 Signed by, Name: Erin Muir TITLE: President, FXHSC Board of Directors DATE: Page 1 11 This Page intentionally Left Blank Page 1 12 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 SCHEDULE OF EXHIBITS & ATTACHMENTS ATTACHMENTS: I. Contractual Responsibilities II. Complaints and Grievances Procedure III. Assurances for the Balanced Budget Act of 1997 IV. Debarment Certification V. Certification Regarding Lobbying VI. Civil Rights Compliance Checklist VII. FKHSC Financial Policies and Procedures for Subcontracted Providers Vill. Healthy Start Care Coordinator Training Policy and Procedures IX. Business Associate Agreement X. Definition of Terms XI. Financial and Compliance Audit/Exhibit XII. Healthy Start MomCare Network Exhibit Page 1 13 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 ATTACHMENT I CONTRACTUAL RESPONSIBILITIES A. Services to be Provided. 1. General Description. a. General Statement. Florida Department of Health in Monroe County, (hereinafter referred to as Provider) will address the health and wraparound service needs of pregnant women, Interconception women, and children from birth up to age three who are not enrolled in Medicaid for the funds provided under the Base Healthy Start Funds. Provider will address the health and wraparound service needs for those pregnant women and children up to age three enrolled in Medicaid for the funds provided by the Agency for Health Care Administration (AHCA). This will include Healthy Start Care Coordination and wraparound services and other related services in accordance with the Florida Department of Health Healthy Start Standards and Guidelines. b. Authority. 1) Florida Keys Healthy Start Coalition, Inc., hereinafter referred to as "Coalition," is granted authority under Section 383.216, FS, and Chapters 64F-2 and 64F-3, FAC, and Ch. 18-009, §3 at 452, Laws of Fla. 2) The Coalition has been granted authority under the federal waiver and pursuant to section 409.906, FS, to provide counseling, education, risk -reduction and case management services, and quality assurance for all enrollees of the waiver. The Agency for Health Care Administration shall contract with an administrative services organization representing all Healthy Start Coalitions providing risk appropriate care coordination and other services in accordance with a federal waiver and pursuant to s. 409.906. The contract shall require the network of coalitions to provide counseling, education, risk -reduction and case management services, and quality assurance for all enrollees of the waiver. The agency shall evaluate the impact of the MomCare network by monitoring each plan's performance on specific measures to determine the adequacy, timeliness, and quality of services for pregnant women and infants. The agency shall support this contract with certified public expenditures of general revenue appropriated for Healthy Start services and any earned federal matching funds. c. Scope of Services. 1) Lead Agency Designation. a) The Provider is designated as the lead agency for Healthy Start Care Coordination services and related activities in: Monroe County b) The Coalition will retain oversight responsibility as stated in the Healthy Start Standards and Guidelines, hereby made a part of this contract by reference. 2) Prenatal and Infant Risk Screening. a) The Provider shall assist the Coalition in promoting the use of the Florida Prenatal and Infant (postnatal) Risk Screening instruments by community prenatal and infant care providers. b) Where applicable, the Provider will work with prenatal care medical providers to meet screening rate goals and will collaborate with Coalition staff to provide training and education as necessary. Screens will be entered into Florida Department of Health and Well Family Systems. c) The Provider will work with the Coalition to implement a system of regularly communicating with the health care providers of Healthy Start participants. This feedback will focus on patient status, services delivered, and related information. 3) Coordinated Intake and Referral a) The Provider shall deliver comprehensive CI&R services including participant Intakes, support, referral to appropriate agencies and providers for the needs identified, and coordination of medical services if needed. b) Upon completion of the CI&R Intake, the Provider shall refer participants into local home visiting programs as Page 1 14 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 discussed with participants and if accepted by the participants. 4) Comprehensive Healthy Start Care Coordination. a) The Provider shall deliver comprehensive Healthy Start care coordination including participant assessment and prioritization, development of participant plans of care, anticipatory guidance, support, referral to appropriate providers for the coordination of clinical and support services, and follow-up to assure identified risks are reduced and needs are met. b) The Provider shall make an assessment of the Healthy Start participants' needs that are consistent with the delivery of risk -appropriate care. 5) Healthy Start Services. a) The Provider shall deliver Healthy Start services, either through its staff or through a referral to community agencies, to address priority needs of Healthy Start participants. b) The services shall include assessment of needs, prenatal and parenting education, general emotional support, stress management, nutrition education, breastfeeding education and support, smoking cessation, interconceptional counseling, community referrals based on risks and needs, child developmental screenings, and other screenings and service provisions offered in accordance with this contract and the Healthy Start Standards and Guidelines (HSSG) and as directed by the Coalition. If there is a discrepancy in service provisions between the HSSG and Coalition directives, the Coalition directives will prevail. c) Provider shall coordinate the provision of services with Medicaid managed care plans for Healthy Start participants who are enrolled in the Statewide Medicaid Managed Care program to ensure services are not duplicated. d) Provider shall implement a care coordination model (herein referred to as the "Healthy Start Pathways") that connects all at -risk Medicaid eligible pregnant women, infants, and children to evidence -based care using individualized pathways designed to produce healthy outcomes. d. Healthy Start Program Purpose. 1) The primary purpose of the Healthy Start Program is to increase delivery of effective, evidence -based services that reduce infant mortality, reduce the number of low birthweight infants, and improve health and developmental outcomes for participants, including Medicaid recipients. Healthy pregnancies, births, and outcomes will decrease costs for health insurance companies including the Medicaid Program. 2. Participants to be Served. a. Participants to be served are pregnant women, interconceptional women, fathers, and infants from birth up to age three. b. This contract will also provide Healthy Start interconceptional care (ICC) services to all participants who are determined through the CI&R Intake or the Healthy Start care coordination process to need services as outlined in the Healthy Start Standards and Guidelines. c. Participants are initially screened by the Coordinated Intake and Referral (CI&R) program. Pregnant women, ICC women, and infants up to age 3 who agree to receive Healthy Start services are then referred by CI&R to the Healthy Start program. d. Referrals come into CI&R via the Florida prenatal and infant risk screens, community referrals, and by self -referral. B. Manner of Service Provision. 1. Service Tasks. a. Community Development Activities 1) Provider shall support and assist the Coalition in community development activities that increase awareness of the program and/or promote improved birth outcomes for pregnant women and infants to include participation in the Fetal and Infant Mortality Review (FIMR) process. Coordinated Intake and Referral Services Page 1 15 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 1) Coordination with the Medicaid Managed Care Plans a) The Provider shall coordinate with the Medicaid managed care plans on services provided to participants who are enrolled in the Statewide Medicaid Managed Care program and who are also receiving services from a Healthy Start Coalition, including: (1) Data/information transfers to and from the Medicaid managed care plans; (2) Attempting to contact high acuity referrals from Medicaid managed care plans within one (1) business day, and providing feedback to the health plans as to the outcome of the high acuity referrals; (3) With appropriate consent, notifying the Medicaid managed care plans of recipients with substance exposure so they may provide and facilitate additional support and treatment; (4) Scheduled and non-scheduled communications via telephone calls and emails; and (5) Communication with, and participation in, interdisciplinary care team (ICT) meetings with Medicaid managed care plans and Healthy Start representatives, as needed. b) The Provider shall maintain ongoing communications with the Medicaid managed care plans to coordinate the provision of services for pregnant women, infants and children under the age of thirty-six months who are jointly enrolled in the Statewide Medicaid Managed Care program and have been referred to the Monroe County CI&R program. The Provider shall facilitate communications with the Medicaid managed care plans to ensure that there is no duplication in the provision of services. c) The Provider shall participate in Interdisciplinary Care Team (ICT) meetings with the Medicaid managed care plans as directed by the Coalition, as follows: (1) The Provider may participate in regularly scheduled ICT meetings with the participant's managed care plan in order to match, but not overlap, the participant with the most appropriate community - based services and resources; and (2) The Provider shall provide participants with a plan of care to assist and support them in accessing needed services and resources. The Provider shall ensure that the plan of care does not duplicate the managed care plan's care coordination efforts. (3) The Provider shall additionally schedule and present a minimum of one (1) client in a regularly scheduled ICT meeting with the participant's Medicaid managed care plan each quarter. 2) CI&R Participant Services a) Participant Eligibility Criteria for CI&R services: (1) The following participants are eligible for CI&R services: a) Pregnant Women residing in Monroe County b) Infants and children ages birth through age thirty-six (36) months residing in Monroe County c) Women who have suffered a pregnancy loss (miscarriage, stillbirth), an infant death, or have had a child placed out of the home, such as adoption or removal by the Department of Children and Families, and who are less than twelve (12) months postpartum b) The Provider shall provide attempt to provide Initial Intakes through its CI&R program to all referred pregnant women, children, and women who have delivered a baby within the past 12 months but do not have the child with them c) The Provider shall provide Initial Intakes to participants who were offered, qualified for, and accepted the CI&R service. During the Intakes, the Provider shall: (2) Complete an Initial intake using the approved Intake Form (3) Identify and discuss any risks factors that may be present that affect pregnancy and child outcomes (4) Identify immediate needs and provide community referrals (5) Offer local maternal and child home visiting programs to all participants and complete the referrals for participants who accept services Page 1 16 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 (6) Provide CI&R contact information to all participant should they have future questions or concerns c. Healthy Start Services 1) Care Coordination with the Medicaid Managed Care Plans a) The Provider shall coordinate with the Medicaid managed care plans on services provided to participants who are enrolled in the Statewide Medicaid Managed Care program and who are also receiving services from a Healthy Start Coalition, including: (1) Data/information transfers to and from the Medicaid managed care plans; (2) With appropriate consent, notifying the Medicaid managed care plans of recipients with substance exposure so they may provide and facilitate additional support and treatment; (3) Scheduled and non-scheduled communications via telephone calls and emails; and (4) Communication with, and participation in, interdisciplinary care team (ICT) meetings with Medicaid managed care plans and Healthy Start representatives, as needed. b) The Provider shall maintain ongoing communications with the Medicaid managed care plans to coordinate the provision of services for pregnant women, infants and children under the age of thirty-six months who are jointly enrolled in the Statewide Medicaid Managed Care program and receiving services through the Monroe County Healthy Start program. The Provider shall facilitate communications with the Medicaid managed care plans to ensure that there is no duplication in the provision of services. c) The Provider shall participate in Interdisciplinary Care Team (ICT) meetings with the Medicaid managed care plans and Healthy Start Home Visiting representatives to discuss providers who are identified as appropriate for ICT staffing, as agreed upon by the managed care plans and Healthy Start, as follows: (1) The Provider shall participate in, or conduct, regularly scheduled ICT meetings with the participant's managed care plan in order to match, but not overlap, the participant with the most appropriate community -based services and resources; and (2) The Provider shall provide participants with a plan of care to assist and support them in accessing needed services and resources. The Provider shall ensure that the plan of care does not duplicate the managed care plan's care coordination efforts and shall share this information with the participant' managed care plan within thirty (30) calendar days of completion. (3) The Provider shall additionally schedule and present a minimum of one (1) client in a regularly scheduled ICT meeting with the participant's Medicaid managed care plan each quarter. 2) Healthy Start Prenatal and Infant -Child Pathways. a) Participant Eligibility Criteria for the Healthy Start Prenatal and Infant Pathway (1) The following participants are eligible for the Prenatal and Infant -Child Pathways if they have been identified to be at risk for poor birth, health, or developmental outcomes: a) Pregnant Women b) Infants and children ages birth through age thirty-six (36) months d) Based on the information obtained through the CI&R process and Healthy Start client assessment, the Provider shall provide enhanced care coordination services through its Healthy Start Prenatal and Infant - Child Pathway program to pregnant women and children who are identified as being at risk for poor birth, health, or developmental outcomes. e) The Provider shall assign each recipient participating in the Healthy Start Prenatal and Infant - Child Pathway program to a care coordinator. f) Within thirty (30) calendar days of participant enrollment in the Healthy Start Prenatal and Infant- Childprogram,the Providershall: (1) Complete a face-to-face initial assessment using the Healthy Start Prenatal or Postnatal Comprehensive Assessments; Page 1 17 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 (2) Identify risks during the assessment and from the participant's screening tools such as the perinatal depression, intimate partner violence, substance abuse, and child developmental delays tools; (3) Provide referral information to the participant for access to community services, including the reason for the referral, based on the risks and needs identified; and (4) Evaluate any additional services needs and provide information to address risk factors and referrals to community resources as needed. g) The Provider shall ensure that all Pathway services are provided face-to-face with the participant. The Provider may also engage in communications on the participant's behalf (e.g., contact with community providers, etc.). Other Healthy Start non -Pathway services may be provided telephonically, such as follow- up to referrals made. h) The Provider shall ensure that pregnant women who are participating in the Healthy Start Prenatal Pathway receive the following additional services: (1) Evidence -based information, education, and screening (e.g., smoking cessation, perinatal depression, substance use, stress management, prenatal care); (2) Assess and address the social determinants of health; (3) Facilitation of the participant's participation in the Interconception Care Curriculum; and (4) Assistance as needed to ensure they access prenatal and postpartum medical care. The Provider shall ensure that infants and children who are participating in the Healthy Start Infant -Child Pathway receive the following services: (1) Parent education using the approved curriculum; (2) Developmental screenings and referrals to community resources, as necessary; and (3) Assistance in finding a primary care provider. j) If the Provider fails to comply with the requirements of this section, the Provider may be subject to liquidated damages and/or sanctions pursuantto Section C.1.c. (3) Interconception Care Counseling (ICC) Pathway. (a) The Provider shall provide Interconception Care (ICC) services during the period of time when a Healthy Start participant is between pregnancies as a preventive strategy to reduce risk factors that may affect the health and well-being of the mother and child, and that of any future children. The following participants are eligible for ICC services based on their risk status: (1) Mothers of infants and children up to thirty-six (36) months of age in which the infant/child is currently participating in Healthy Start services; and (2) Women who have suffered a pregnancy loss (miscarriage, stillbirth), an infant death, or have had a child placed out of the home, such as adoption or removal by the Department of Children and Families, and who are less than twelve (12) months postpartum. (b) The Provider shall: (1) Initiate ICC services within thirty (30) calendar days postpartum or thirty (30) calendar days after receipt of referral; (2) Provide face-to-face services connecting women with local resources and counseling on contraceptive options, including the Long -Acting Reversible Contraceptives (LARCs); (3) Provide face-to-face services to improve participation in the Family Planning Waiver (FPW): i. For clients who are participating during their third trimester, introduce the FPW and strongly encourage participation; ii. Further encourage participation by contacting the participant's health plan and requesting they assist in educating participant on the benefits of the FPW program; iii. Provide participant with instructions during ICC face-to-face visits on how to complete the Page 1 18 Florida Keys Healthy Start Coalition, Inc. FPW application process. Contract #: HS-2022-2023 (c) The Provider shall provide all participants meeting the eligibility criteria above with ICC services in accordance with the approved Florida DOH Healthy Start Standards and Guidelines and as directed by the Coalition. (d) If the Provider fails to comply with the requirements of this section, the Provider may be subject to financial consequences and/or sanctions pursuantto Section C.1.c. (4) Fatherhood Engagement. (a) The Provider shall provide fatherhood services using the eligibility criteria and designated curriculum in accordance with the Florida DOH directives, Healthy Start Standards and Guidelines and as directed by the Coalition. c) Service Provider Training 1) The Provider will comply with the Coalition's Healthy Start Care Coordinator Training Policies and Procedures (Attachment VIII). 2) The Provider will participate in webinar trainings and workshops, meetings, and conference calls, or any other training activities as directed and required by the Coalition. d) Data Entry 1) Prenatal and Infant Universal Screening Tools a) Provider shall enter into appropriate data bases screening tool information as required for both prenatal and infant screens within 5 days of receipt to ensure appropriate and timely registration in both Florida Department of Health and Well Family Systems. 2) CI&R Services. a) Provider shall ensure that services performed by Healthy Start funded staff are accurately coded and documented into the participant's Well Family System (WFS) database record within one (1) business day. 3) Healthy Start Services. a) Provider shall ensure that services performed by Healthy Start funded staff are accurately coded and documented into the participant's Well Family System (WFS) database record within one (1) business day. 4) Fatherhood Services. a) Provider shall ensure the services performed by Healthy Start funded staff are accurately coded and documented into the participant's Well Family System (WFS) database record within one (1) business day. e) Customer Service/Call Number 1) The Provider shall incorporate and implement a complaint resolution and customer service tracking system. The Provider shall provide a U.S. based local telephone number to address customer service inquiries. 2) Provider may use an interactive voice response system provided that at each level the callers can choose to speak with a "live" person during normal business hours. 3) The Provider shall return all telephone calls and emails received during normal business hours up to 4:00 p.m. local time, on the same business day. Telephone calls and emails received after 4:00 p.m. local time, shall be returned within one business day. 4) For calls received outside of normal business hours, the Provider shall provide the caller with a message that advises of the Provider's hours of operation, provides instructions for how to leave a message and how to request assistance, if needed, related to emergencies. 5) The Provider will provide a local customer service telephone number for all complaints, grievances, referrals and general questions regarding the Healthy Start Program for their area. 6) The customer service telephone number shall be staffed with trained personnel during normal business Page 1 19 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 hours of 8:00 a.m. to 5:00 p.m., local time Monday through Friday, excluding State of Florida observed holidays. 7) The Provider shall ensure that the individual numbers provide a before and after business hours message advising the caller of the hours of operation and allowingthem to leave a message. 8) In accordance with Title VI of the Civil Rights Act of 1964, the Provider shall provide, free of charge, foreign language interpreter and translation services, and auxiliary aids and services to achieve effective communication with individuals requiring such assistance. The Provider shall ensure that there is a response to all written inquiries as soon as possible but no longer than three (3) business days from the date of receipt. 9) The Provider shall ensure that the message that is played for callers who are on hold does not include non - health related or marketing information. The Provider shall submit messages played while a caller is on hold to AHCA via the Coalition for prior approval. 10) If the Provider fails to comply with the requirements of this section, the Provider may be subject to financial consequences and/or sanctions pursuantto Section C.1.c. ff) Medicaid and Managed Care Organizations 1) The Provider shall verify eligibility for Medicaid prior to providing any service. The Provider shall maintain a record of the participant's Medicaid identification number in the client's WFS database file. The Provider shall ensure that services provided are in coordination with the participant's Medicaid managed care plan. g) Outreach and Training Materials 1) The Provider shall use appropriate outreach materials, training materials and instructional manuals. Outreach materials include flyers for events, Facebook pages or other social media, brochures, and any other materials that promote the Healthy Start program. Training materials include manuals, brochures, handouts, and audio/visual aids. All outreach material, training materials, and instructional manuals must be reviewed and approved by the AHCA and DOH through the Coalition prior to implementation. The Provider must submit all materials needing approval to the Coalition prior to any distribution. 2) The Provider shall provide written information on the Healthy Start Program and how to obtain help with a problem or concern related to their Healthy Start services to all participants. 3) At a minimum, program information shall include: a) Information describing the Healthy Start program; b) How to file a grievance if a problem or concern cannot be resolved; c) Written information on the Healthy Start Program, along with the name, address, and telephone number of whom to contact to register a complaint or grievance; d) Customer Service/Toll-Free Call Number information, as specified in this Contract; and e) Information on oral translation services, language services and alternate formats for educational materials offered at no chargeto the participant. 4) The Provider shall develop a comprehensive written cultural competency plan describing how services are provided in a culturally competent manner to recipients, including those with limited English proficiency. 5) The Provider shall ensure that all materials including outreach and training materials developed for the Medicaid population adhere to the following policies and procedures: a) All materials must be at or near the fourth -grade reading comprehension level so that the materials are understandable (in accordance with section 1932(a)(5) of the Social Security Act as revised through Section 4701 of the 1997 Balanced Budget Act) and must be available in alternative formats (such as large print, video or audio recordings, or Braille) appropriate for persons with disabilities, free of charge. Materials shall be distributed in accordance with Section 4707 of the 1997 Balanced Budget Act. The Provider shall ensure that all written information is available in English, Spanish, Creole and other prevalent non-English languages, as appropriate. For the purposes of this Contract, prevalent means a non-English language spoken by at least five percent (S%) of the population covered under this Page 120 Florida Keys Healthy Start Coalition, Inc. Contract. Contract #: HS-2022-2023 b) The Provider shall ensure that there is a comprehensive written cultural competency plan describing how services are provided in a culturally competent manner to participants, including those with limited English proficiency. The Provider shall ensure that oral interpretation services (or services in other appropriate means) are available to Healthy Start participants who speak any non-English language. c) The Provider shall ensure that there is notification to its participants of the availability of oral interpretation services and information on how to access oral interpretation services. The Provider shall notchargethe participantsfor language services. d) All written materials used by the Healthy Start Program must be approved by ACHA and DOH through the Coalition prior to their use or dissemination to participants. 2. Staffing Requirements. a. Staffing Levels. 1) The Provider shall establish staffing levels necessary for the completion of deliverables required by this attachment, and as outlined in the Healthy Start Standards and Guidelines, to ensure the optimal delivery of services to participants at an increased level of intensity and duration. 2) Provider shall ensure that there is a sufficient number of staff fluent in both English and Spanish to provide all contracted services or employ or contract with an interpreter as needed in order to fulfill the requirements of the Contract. 3) The Provider shall maintain copies of staff's current licenses and board certifications in a centralized administrative file. b. CI&R and Healthy Start Provider Qualifications. 1) CI&R Staff and Healthy Start workers must meet one or more of the following educational requirements and have received all required trainings. a) Minimum of a four-year college degree in social sciences; a health -related field such as nursing, health education, health planning, or health care administration; social work; or b) Associate degree and licensure as a Registered Nurse with three years of public health/maternal-child health experience or licensure as a Licensed Practical Nurse with four years of public health/maternal child health experience. c) Paraprofessionals working under the supervision of (a) above, must have a high school diploma or its equivalent and meet the additional requirements as specified in the Healthy Start Standards and Guidelines. d) The Provider shall meet all requirements for doing business in the State of Florida c. Staffing Changes. 1) The Provider shall notify the Coalition within one (1) business day of any staff member with access to WFS and/or LMS leaving the employment of Healthy Start so access to the databases can be removed. Notification shall be by e-mail to the Coalition's Contract Manager. 2) The Provider shall notify the Coalition within five (5) business days by email of any staffing changes including terminations, new hires, and new positions. d. Staffing Obligations. 1) The Provider shall have at least one staff member attend each of the following by conference call, virtually or, if applicable, in person: QM/PI and monitoring meetings with the Coalition, Fetal and Infant Mortality Review (FIMR) Case Review Team meetings, quarterly Coordinated Intake and Referral meetings, quarterly FIMR Community Action Team meetings, Quarterly ICT calls with Medicaid plans and additionally as needed as described in section B.1.b.1). 3. Service Location and Equipment. a. Service Delivery Location. Page 121 Florida Keys Healthy Start Coalition, Inc. 1) The Provider's service area is Monroe County. Contract #: HS-2022-2023 2) The Provider shall ensure that the services are delivered in locations that are accessible to the population being served. b. Service Times. 1) The Provider must be available Monday through Friday from 8:00 a.m. to 5:00 p.m., Eastern Time except for state holidays or administrative leave granted by the organization. 2) In the event all staff are out of the office, the Provider must have voicemail capabilities that must be checked daily Monday through Friday. The Provider shall ensure that all telephone calls are returned on the following business day. c. Changes in Location. The Provider shall notify the Coalition in writing of any changes in the Provider's office location a minimum of two (2) weeks prior to the change. d. Equipment. 1) The Provider may use funds received from this contract for the purchase of equipment as defined and approved in the Provider's Budget Request Form (Form A). 2) The Provider is allowed to purchase equipment up to $1,000.00 that is necessary for the provision of services under this contract. 3) Coalition approval is required for the purchase of equipment over $1,000.00. 4. Deliverables. a. Financial Reports. 1) Annual Financial Report. The Provider shall submit the following form within 30 days of execution of the contract: a) Form A— Invoice/Budget Request. This multi -use form can be used for budget submission and invoice for payment of services. Line item budget request to include a total of projected expenditures with a line item justification for each approved categorical expense. This form shall include a list of current staff who are partially or fully funded through this contract. The completed form will include each employee's initials, title, FTE with Healthy Start, and salary and fringe benefits costs. If changes occur to personnel, the updated list must be submitted with the next quarter's expenditure report. 2) Quarterly Financial Reports. The Provider shall submit the following form(s) within twenty (20) calendar days following the end of each quarter. a) Form A— Invoice. Line item list of expenditures for the previous quarter. Form A shall also include a list of current staff who are partially or fully funded by this contract with each employee initials, title, FTE with Healthy Start, and salary and fringe benefits costs calculated forthe previous quarter. b. Quality Assurance and Emergency Management Plans 1) Annual Plans. The Provider shall submit the following documentation within thirty (30) calendar days following execution of the contract: a) Emergency Management Plan: The Provider shall establish and maintain a Coalition -approved emergency management plan that describes the processes the Provider shall follow to ensure ongoing provision of services in a disaster or manmade emergency. The emergency management plan will include a risk assessment, procedures to comply with this Agreement during disasters, a communication plan during disasters, and training schedules for Provider staff. The emergency plan shall include a disaster recovery and business contingency plan. b) Internal Quality Assurance (IQA) Plan: The Provider shall establish and maintain a Coalition -approved Internal IQA Plan to ensure the appropriate administration of all responsibilities specified in this resulting Agreement. The Provider shall ensure that there are written procedures, program goals and objectives, and problem -solving activities to evaluate internal program and organizational activities for Healthy Start services. The Provider shall Page 122 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 ensure the IQA addresses the following minimum elements: (1) Quality assessment and monitoring activities to ensure that all functions are performed timely in accordance with this Agreement, including but not limited to a review of the following: a) Policies and procedures; b) Performance measurement results; c) Internal grievances; d) Complaints by recipients and other external parties; e) Opportunities for improvement; f) The frequency and type of supervision for staff; and g) Remediation strategy when the Provider is in jeopardy of not meeting contractual requirements. The IQA plan shall stipulate that the Coalition shall be notified within five (5) business days of discovery. c. and Quality Improvement Reports. 1) Monthly QA/QI Report. The Provider shall submit the following form(s) within ten (10) calendar days after the end of each month of service: a) Form B — Healthy Start Staff and Services Report. Monthly report on client services data; Healthy Start staff services, trainings, and community activities; and Provider needs. b) Form C — Medicaid Performance Measures Report. Monthly report on review of Performance Measures as shown in reports in the Well Family System. c) Form D — Birth Outcomes Report. Monthly report on birth outcomes for women in Healthy Start prenatally who delivered. 2) Quarterly QA/QI Reports. The Provider shall submit the following form(s) within fifteen (15) calendar days after the end of each quarter of service: a) Form E — Healthy Start Record Reviews. The Provider shall complete a minimum of fifteen (15) in-depth record reviews per quarter. At least twelve (12) reviews should be from open cases and at least three (3) reviews should be from closed cases. Record reviews will include cases for infants, prenatal clients, and interconceptional clients. b) Form F— Record Reviews Summary Report. Record review summary reports shall be compiled and submitted by the Provider quarterly. This report will contain of a compilation of all cases reviewed during the quarter as submitted on Form E. c) Forms G & H — CI&R Record Reviews. The Provider shall complete a minimum of eight (8) CI&R records reviews per quarter, with at least five (5) for prenatal clients and three (3) for infant clients. All of the reviews should be for clients who were closed to CI&R during the quarter. d. Medicaid Client Services 1) Direct Client Pathway Services. The Provider shall provide and code for a minimum of ten (10) CI&R Initial Intakes and fifteen (15) Healthy Start Pathway services for Medicaid clients per calendar month. Two telephonic ICC services in CI&R can replace one CI&R Initial Intake. Healthy Start Pathway services are defined as all Initial Assessments, all face-to-face ongoing care in which education and services were provided and/or evaluation tools were used, and all Interconceptional Care Pathway services. 5. Performance Specifications. a. Core Services Performance Measures. 1) At least 85.0 percent of CI&R clients will receive an Initial Intake, or an attempt to provide an intake, within five (5) business days of receipt of screen or referral (Measure A) 2) At least 85.0 percent of CI&R records will contain documentation that status of Initial Intake has been sent to the healthcare provider within thirty (30) calendar days from first attempt to contact when the provider is known and there is release to do so (Measure B) 3) At least 85.0 percent of Healthy Start clients will receive an Initial Assessment, or an attempt to assess, within five (5) Page 123 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 business days of completion of the Initial Intake (Measure C) 4) At least 85.0 percent of sampled client encounters will be coded accurately (Measure D) 5) At least 85.0 percent of all client data, codes, case notes, and any other documentation will be entered into the client database system within one (1) business day of the service, or attempted service, being provided (Measure E) 6) At least 85.0 percent of Healthy Start client records will contain documentation of an Individualized Plan of Care (IPC) at each participant encounter (Measure F) 7) At least 85.0 percent of Healthy Start client records will contain documentation of follow-up of IPC and follow-up of referrals made at each subsequent encounter (Measure G) 8) At least 90.0 percent of Healthy Start client records will contain documentation that mandatory curriculum and tools were used or justification as to why they were was not used (Measure H) 9) At least 90.0 percent of all client records will have ongoing documentation of their medical visits and upcoming appointments (Measure I) e. Performance Measures for Medicaid Participants. 1) At least 85.0 percent of Healthy Start clients enrolled in the Prenatal or Infant -Child Pathway shall be screened for depression using the Edinburgh Postnatal Depression Screen according to the schedule outlined in the Perinatal Depression Screening Intervention Pathway (Measure 1) 2) At least 85.0 percent of Healthy Start clients enrolled in the Prenatal or Infant -Child Pathway who were screened for depression and had a positive score shall be referred to available services for depression based on the recommended Perinatal Depression Screening & Intervention Pathway (Measure 2) 3) At least 85.0 percent of Healthy Start clients enrolled in the Infant Pathway will receive the required ASQ-3 or ASQ-SE developmental screenings based on the schedule outlined in the Development Screening & Intervention Pathway (Measure 3) 4) At least 85.0 percent of Healthy Start clients enrolled in the Infant -Child Pathway who score below the cut- off value on the ASQ-3 or ASQ-SE shall be referred to the available service outlined in the Screening & Intervention Pathway (Measure 4) 5) At least 85.0 percent of post-partum clients enrolled in the Interconception Care Pathway shall receive education on the Florida Family Planning Waiver (Measure 5). 6. Monitoring and Evaluation. a. Provider Responsibilities. 1) Required Reports. Once all reports have been received and reviewed, the Coalition shall have five (5) business days to accept or reject the reports and notify Provider of any discrepancies in the reports. After notification, the Provider shall have five (5) business days to make corrections and resubmit for acceptance. Once reports have been approved, revisions will not be accepted and adjustments should be made in the next reporting period. 2) Coalition Monitoring and Site Visits. The Provider agrees to cooperate in all such monitoring and evaluation activities established by the Coalition in this contract. The Provider shall make available to the Coalition and its staff all records and documentation, including CI&R, Fatherhood and Healthy Start participant records and supporting documentation, necessary for monitoring and evaluation, to the extent authorized by Florida law. 3) Internal Quality Assurance Program Plan. The Provider shall conduct regular quality assurance and quality improvement activities pertaining to the services outlined in this contract. A copy of the plan for conducting these activities will be signed and submitted to the Coalition (see B.4.b.1)b) b. Coalition Responsibilities. Page 124 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 1) QA/QI Reviews, Monitoring Meetings, and Site Visits. a) The Coalition shall monitor and evaluate the Provider's quality of service provisions and documentation. Monitoring and evaluation shall include, but is not limited to, review of client records, reports, and data in the Well Family System database; review of records, reports, data, and other documentation submitted by the Provider; interviews with Provider staff; and review of client surveys. The Coalition's monitoring and evaluation may include Coalition staff, Department of Health staff, Healthy Start MomCare Network staff, Agency for Health Care Administration staff, Coalition Board members, and Provider staff. b) The Coalition will conduct monthly data review and quarterly monitoring meetings with the Provider. The meetings will consist of review of services, sharing program updates, review of other issues, and support from the Coalition. The Coalition and Provider will have frequent contact as needed in addition to the monthly monitoring meetings. c) The Coalition shall conduct an annual site visit, looking at the Provider's quality of service provisions, delivery of services, client documentation and services, community needs, and Provider needs. The Coalition will create a Reports of findings and will submit it to the Provider within sixty (60) days of completion of the site visit. 2) Financial Monitoring Review and Site Visit. a) The Coalition shall review and monitor the Provider's expenditure reports quarterly. b) The Provider maintain and have available for monitoring the Provider's financial records and fiscal procedures. Monitoring and evaluation shall include, but is not limited to, all financial reports and documents generated by the Provider in the performance of the contract to include back-up documentation or interviews with the Provider's fiscal staff as requested by the Coalition. . c) The Coalition's monitoring and evaluation may include State of Florida Department of Financial Services, Coalition staff, Department of Health staff, Healthy Start MomCare Network staff, Agency for Health Care Administration staff, Coalition Board members, and Provider staff. c. Resolution of Issues/Problems Identified. 1) By execution of this contract the Provider agrees to be bound by its conditions and acknowledges and agrees that its performance must meet the standards set forth herein. If the Provider fails to meet the terms of this contract, the Coalition shall notify the Provider in writing of the specific performance failures and shall requirethe Provider to respond to the notification. 2) Performance Improvement and Corrective Action Plans are developed in conjunction with the Provider in the event that Performance Specifications are not being met, contract requirements have not been met, or in the event that the program has had ongoing problems with program performance and has failed to meet goals set to improve performance. a) Performance Improvement Plan (PIP). (1) A PIP is based on failure to meet monthly or quarterly Performance Specifications. (2) The plan may be initiated by the Provider or by the Coalition. b) Corrective Action Plan (CAP). (1) A CAP is based on a program's failure to meet Performance Specifications, failure to meet the goals set in previously placed PIPS, failure to meet contract requirements, and/or significant signs that the program is not functioning effectively and/or efficiently. (2) The Coalition is responsible for developing a CAP that is mutually agreed upon by the Provider and the Coalition. In the event a mutual agreement cannot be reached, the Coalition shall have final determination of the CAP requiring conformance with the contract. If the Provider fails to achieve compliance with the CAP within the specified time frame, the Coalition has the authority to terminate the contractfor cause in the absence of any extenuating or mitigating circumstances. c) Development of PIPS and CAPs. (1) Delineate services and processes that need improvement. (2) Define strategies and process changes designed to directly improve performance outcomes. Page 125 Florida Keys Healthy Start Coalition, Inc. (3) Include, at a minimum: C. Method of Payment. 1. Contract Amount. Contract #: HS-2022-2023 (a) Baseline data (when available) and a specific goal measurement to be achieved and maintained; (b) The expected outcomes; (c) The expected resolution dates; (d) The status of progress toward full implementation of strategies and their impact on the performance outcome; and (e) Discussion of additional strategies that will be attempted or of strategies found to be ineffective that will be discontinued. (a) The Coalition shall pay the Provider a maximum total dollar amount not to exceed $ 350,000.00, based on the Coalition's current Funding. Funds shall be paid quarterly based upon the Provider's submitted invoice. The Coalition's performance obligation to pay under this contract is contingent upon an annual appropriation of the budgets of the State and Federal governments. Funds are subject to the availability of funds from DOH, AHCA, and HSMN. Delays in payment which result from failure of DOH, AHCA, or HSMN to provide timely payments of these shall not constitute breach of this contract. Provider agrees to continue service delivery without interruption during such periods. (b) Any unexpended funds at the end of the contract period shall be retained by or returned to the Coalition. The Provider may be allowed, based on the discretion of the Coalition, to carry forward obligated, but not expended funds into the first quarter of the next fiscal year but must return all unexpended funds. 2. Disbursement of Funds 1) The Provider must request payment on a quarterly basis through submission of properly completed invoices (Form A) within 30 days following the end of the period for which payment is being requested. Upon confirmation of receipt of notification of the invoice, the Provider has 15 business days to make revisions and resubmit the invoice as requested. 2) The Coalition shall have ten (10) business days from date of receipt of all funds for the month of services from the State of Florida, Department of Financial Services, and the Healthy Start MomCare Network to disburse the funds to the Provider. 3) The cost of services paid under any other contract or from any other source are not eligible for reimbursement under this Contract. b. Financial Consequences. Performance Standards Requirement Liquidated Damages that may be Imposed 1) Completed a minimum of 10 CI&R Initial Intakes (code $75.00 for each number of CI&R Initial Intakes 3315 in the Well Family System (WFS) with Medicaid below 10 per month. clients per month. Two telephonic ICC services (code 5020) can replace one CI&R Intake. 2) Provide a minimum of 15 Pathway services to Medicaid $210.00 for each number of Pathway services clients per month. Pathway services include all Initial below 15 per month. Assessments, ICC services, and face-to-face ongoing care services. Counts will come code 3320 in the WFS. 3) The Provider shall ensure that all five Medicaid $500.00 per Medicaid performance measure per performance measures (measures 1-5) are for met each month in which performance measures are calendar month. unmet. Page 1 26 Contract #: HS-2022-2023 Florida Keys He Ithy Start Coalition Inc. 4) The Provider shall ensure that all other Performance Not meeting Performance Measures Standards Measures are met. may result in termination of contract. 5) The Provider shall submit required reports within the Failure to submit reports by the prescribed time time prescribed bythe Coalition. will result in a two percent (2%) reduction quarterly payment and then $50.00 per business day until submitted. 6) The Provider shall submit an Emergency Management $150.00 per day for each business day past the Plan that will include a Disaster Recovery Plan to the due date in which the Coalition has not received Coalition within 30 calendar days after execution of this the document. contract. 7) The Provider shall submit an Internal Quality Assurance $150.00 per day for each business day past the Plan to the Coalition within 30 calendar days after due date in which the Coalition has not received execution of this contract. the document. 8) The Provider shall not give to Medicaid clients any printed $500.00 for each incident in which non -approved material that has not been pre -approved by AHCA. If the material was disseminated to Medicaid clients. Provider has printed material they would like to have approved, the material will be given to the Coalition by the 10th of each month. It will not be distributed until receiving approval. 9) The Provider shall submit ad hoc reports within fourteen $2,000.00 for each missed occurrence. (14) calendar days after the request is made from the Coalition. 10) The Provider shall not use program data or client $500.00 to $5,000.00 per incident, per information for activities outside those required by this occurrence, depending upon the severity in which contract. All use of Program data or client information the Provider inappropriately releases program must be approved by AHCA via the Coalition. data or client information. 11) The Provider shall maintain a complaint/grievance log and $150.00 per occurrence that is not in compliance. report complaints and/or grievances as required in the contract. 12) The Provider shall comply with data maintenance $150.00 per occurrence that is not in compliance. requirements as outlined in this contract. 13) The Provider shall ensure staffing levels are sufficient to $150.00 per day for each business day past the complete all responsibilities outlined in the Contract, and five business day requirement in which the that qualified staff are delivering all services. The Provider Coalition has not received the documentation. shall notify the Coalition, in writing, within five (5) business days of changes to staffing. 14) The Provider shall develop and submit background $250.00 per occurrence that is not in compliance. screening and use E-Verify as required in the contract. 15) The Provider shall not release client's personal health $500.00 to $5,000.00 per incident, per information (PHI) in accordance with the Health occurrence, depending upon the severity in which Portability and Accountability Act (HIPAA) contract. the Provider inappropriately releases PHI. Page 127 Contract #: HS-2022-2023 Florida Keys He Ithy Start Coalition Inc. 16) The Provider shall comply with public records laws in $5,000.00 per occurrence that is not in accordance with 119.07 F.S. compliance. 17) Complete initial renewal background screenings will occur $250.00 per occurrence that is not in compliance. within the required timeframes. D. Special Provisions. 1. Background Screening. The Provider shall ensure that Provider's staff and subcontracted staff who have direct service contact with CI&R, Healthy Start and/or Fatherhood clients, or who have direct access to any PII, PHI, or financial information, including managing employees, have a Level 2 background screening or criminal history (state and national) background check as provided in section 943.0542(2), FS. If there are questions as to whether a background screening is required for a particular position the subcontracted Provider should consult with the Coalition. Initial screening includes fingerprint checks through the Florida Department of Law Enforcement (FDLE) and the Federal Bureau of Investigation (FBI). The subcontracted Provider must initiate background screening, including fingerprinting, at the time an applicant or subcontractor accepts a job offer or a volunteer agrees to perform services for the organization. The subcontracted Provider must provide written confirmation to the Coalition that the background screening has been completed with respect to each employee and volunteer of the subcontracted Provider providing direct services. No employee or volunteer shall remain in service with Provider or a subcontractor with an unfavorable background screening or a background screening that reflects the offenses listed in section 435.04(2), FS. The background screening results shall be retained on file at the Provider's location. Failure to comply with background screening requirements may result in the termination of the contract. Background screening will be completed with results every five years. The Provider does not have to re -screen staff or subcontracted staff that have been previously screened for purposes of employment within this same agency within the last five years. 2. Balanced Budget Act of 1997. The Provider shall ensure their system of care for pregnant women, infants and children from birth to age three includes the Assurances for the Balanced Budget Act of 1997, Attachment I 1 1 . 3. Civil Rights Compliance Checklist. A standardized questionnaire must be completed if Provider is a recipient of a federal funding program. This questionnaire is included as Attachment VI and must be completed by Provider as a condition of this Contract. 4. Completion or Termination of Contract. Upon completion or termination of the Contract and at the request of the Coalition, the Provider shall cooperate with the Coalition to facilitate the duplication and transfer of any records, documents, and educational material belonging to the Coalition duringthe required retention period as specified. S. Confidentiality. The Provider will receive appropriate and relevant information concerning Medicaid enrolled recipients consistent with legal guidelines outlined in section 409.907, FS. The Provider shall ensure and safeguard the use and disclosure of information pertaining to current or former Medicaid enrolled recipients and comply with all state and federal laws pertaining to confidentiality of the enrolled recipient information. Medicaid enrolled recipient information is strictly confidential, and under no circumstances shall this information be duplicated or provided to anyone for any purpose other than the activities required by this contract. Medicaid and non -Medicaid recipient information may not be utilized to solicitfor other services offered by the Provider not covered in this contract. 6. Contract Renewal. This contract may be renewed on a yearly basis for no more than three (5) years beyond the initial contract. Such renewals shall be made by mutual agreement and shall be contingent upon satisfactory fiscal and programmatic Page 128 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 performance evaluations as determined by the Coalition. Renewal shall be subject to the availability of funds. 7. Operational Space. Provider shall make available designated office space within the GATO building for the use of Coalition staff in support of Provider's contracted services. The space shall be always accessible to Coalition staff and secured by a locking mechanism routinely available only to Coalition and Provider Healthy Start staff. The space provided may be in a singular area or divided into two separate spaces and be adequate for a minimum of one employee workstation, files, and sufficient area to procure, store and make available to Provider's clients needed goods (diapers, strollers, safe sleep and car safety equipment) in support of the shared goal of assisting Monroe County families enrolled in Healthy Start services access needed resources. 8. Daily Operations and Policies and Procedures. The Healthy Start Standards and Guidelines is intended to guide the operation of the Healthy Start program, and can be located at the following website: http://www.floridahealth.gov/programs-and-services/childrens- health/healthy-start/index.html. When there is a conflict of language between the Healthy Start Standards and Guidelines and this contract, the contract shall govern. 9. Data Use and Disclosure. The AHCA and HSMN shall have the right to use, disclose, or duplicate all Florida Medicaid participant data developed, derived, documented, or furnished by the Provider resulting from the contract. AHCA maintains ownership of the data sets and all Medicaid participant records used in the Program. Upon the written request of AHCA, HSMN, or the Coalition, copies of Medicaid participant records relating to the Provider shall be transferred to AHCA, HSMN, and/or the Coalition at no expense to AHCA, HSMN, and/or the Coalition. No data (such as utilization and trends) shall be disseminated, published or incorporated into a separate central database or warehouse without the express prior written consent of AHCA and HSMN via the Coalition. The Provider shall not use the data for marketing purposes, unless approved by AHCA and HSMN via the Coalition. AHCA authorizes the Provider to issue press releases about services provided to AHCA, HSMN, and Medicaid participants and the outcomes from these services with prior written consent of AHCA and HSMN via the Coalition. The Provider agrees not to distribute these releases without AHCA or HSMN's prior approval of the final language. The data shall be used solely for purposes of the Program, unless approved by the AHCA or HSMN. AHCA and HSMN reserve the right to share data and/or reports obtained from this contract with any State of Florida Agency deemed appropriate. 10. Debarment and Lobbying Certification. If this Contract contains federal funding in excess of $100,000, the Provider shall, prior to contract execution, complete and return to the Contract Manager the Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion form, Attachment IV, and the Certification Regarding Lobbying form, Attachment V. 11. Disaster Recovery Plan. The Provider shall develop and maintain a disaster recovery plan. The disaster recovery plan shall limit service interruption to a period of twenty-four (24) clock hours and shall ensure compliance with all requirements under this contract. The records back-up standards and a comprehensive disaster recovery plan shall be developed and maintained by the Provider for the entire period of the contract. The Provider shall ensure a disaster recovery plan for restoring day-to-day operations including alternate locations for the Provider to conduct the requirements of this contract. The Provider shall maintain database back-ups in a manner that shall eliminate disruption of service or loss of data due to system or program failures or destruction. The Provider shall finalize the disaster recovery plan within thirty (30) calendar days after the contract execution date. The Coalition may request to review the Provider's disaster recovery plan. 12. E-Verify System. Page 129 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 The Provider agrees to utilize the U.S. Department of Homeland Security's E-Verify system, https://e- verify. uscis.gov/em P, to verify the employment eligibility of all new employees hired during the contract term by the Provider. The Provider shall also include a requirement in subcontracts that the subcontractor shall utilize the E-Verify system to verify the employment eligibility of all new employees hired during the contract term. Contractors meeting the terms and conditions of the E-Verify System are deemed to be in compliance with this provision. 13. Failure to Provide Services. Failure of the Provider to provide services required under this contract may result in the Coalition withholding any payment due to the Provider. 14. Force Majeure. The Coalition shall not be liable for any excess costs to the Provider if the Coalition's, AHCA's, or HSMN's failure to perform under the contract arises out of causes beyond the control and without fault or negligence on the part of the Coalition, Network or Agency. The Provider shall not be liable for performance of the duties and responsibilities of the contract when its failure to perform arises from causes beyond its control and without fault or negligence on the part of the Provider. These include destruction to the facilities or extended dislocation of staff due to hurricanes, fire, war, riots, and other similar acts. The Provider shall have a Coalition approved emergency management plan specifying what actions the Provider shall conduct to ensure the ongoing provisions of services in a disaster or manmade emergency. The emergency plan shall include a disaster recovery and business contingency plan. 15. Fraud and Abuse. The Provider shall report fraud and abuse to AHCA, with a copy to the Coalition and HSMN, as referenced in 42 CFR 455.1(a)(1). For each complaint of fraud and abuse, the Provider must supply the following: a. Name and Medicaid number b. Source of complaint c. Type of provider d. Nature of complaint e. Approximate dollars involved f. Legal and administrative disposition of the case The Provider shall cooperate with AHCA and/or state during an investigation of fraud or abuse, complaint, or grievances. 16. H I PAA. Where applicable, the Provider shall comply with the Health Insurance Portability and Accountability Act (42 U.S.C. section 210 et seq.) as well as regulations promulgated thereunder (45 C.F.R. Parts 160, 162 and 164). 17. Well Family System Access. The Provider shall comply with applicable professional standards of practice with respect to participant confidentiality and information obtained through access to WFS as stated in this Contract. 18. Legislative Decrease in Funding. Funds may be reduced in this contract through forthcoming legislative appropriations and later identified in the operation budget. If this contract is executed prior to the amount of the decrease being known or effective, then an amendment must be executed for the decrease. The Provider shall submit a revised budget and budget narrative detailing the adjusted funding amount. 19. Legislative Increase in Funding. Additional funds may be added to this contract through forthcoming legislative appropriations and later identified in the operation budget for the increase of funding. If this contract is executed prior to the amount of increase being known or effective, then an amendment must be executed for the increase. The Provider shall submit a revised budget and budget narrative detailingthe use of the additional funds. 20. Misuse of Symbols, Emblems, or Names in Reference to Medicaid. No person or the Provider may use, in connection with any item constituting an advertisement, solicitation, circular, book, Page 130 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 pamphlet or other communication, or broadcast, telecast, or other production, alone or with other words, letters, symbols or emblems the words "Medicaid," "Agency for Health Care Administration," or "Healthy Start MomCare Network" except as required in this contract, unless prior written approval is obtained from AHCA via the Coalition. Specific written authorization from the AHCA and HSMN, via the Coalition, is required to reproduce, reprint, or distribute any AHCA form, application, or publication for a fee. State and local governments are exempt from this prohibition. A disclaimer that accompanies the inappropriate use of Program or Network terms does not provide a defense. Each piece of mail or information constitutes a violation. 21. Non -Expendable Property. Non -expendable property is defined as tangible personal property of a non -consumable nature that has an acquisition cost of $250 or more per unit and an expected useful life of at least one year, and hard -bound books, which are not circulated to students or the general public, with the value or cost of $250 or more. Hardback books with a value or cost of $250 or more should be classified as OCO (Other Capital Outlay) expenditures. All such property purchased with funds from this contract shall be listed on the property records of the Provider. Said listing shall include a description of the property, model number, manufacturer's serial number, funding source, information needed to calculate the federal and/or state share, date of acquisition, unit cost, property inventory number, and information on the location, use and condition, transfer, replacement or disposition of the property. All such property purchased with Healthy Start funds from this contract shall be inventoried on the Property Purchase List (Form G). Title (ownership) to all non -expendable property acquired with funds from this contract shall be vested in the Coalition upon completion or termination of the contract. If the Provider is a county health department, title (ownership) to all non -expendable property acquired with funds from the contract shall be vested in the Department of Health upon completion or termination of the contract. At no time shall the Provider dispose of non -expendable property purchased with Healthy Start funds from this contract except with the permission of the Coalition in accordance with their instructions. 22. Other Funds. The Provider may utilize funds obtained from sources other than those provided through this Contract for either the operation of the Provider or for contracting with other subcontracted providers to deliver direct participant services. These funds may include, but are not limited to, gifts, contracts, grants, or donations from local, state, and federal agencies, community service agencies, corporations, and private citizens. 23. Unexpended Funds. The Provider must ensure that funding received under this contract in excess of expenditures is remitted to the Coalition by check within 45 days following the contract period. In the event of contract termination, the Provider must ensure that funding received under this contract in excess of expenditures is remitted to the Coalition within 45 days of termination of the contract. Page 131 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 ATTACHMENT II COMPLAINTS AND GRIEVANCES PROCEDURE Informing Participant of their Complaint and Grievance Rights A participant is defined as a person receiving services, or who has been referred to receive services, from the Coordinated Intake and Referral program and/or from the Healthy Start program. CI&R and Healthy Start participants are advised, through written information provided by the CI&R and/or Healthy Start program, how to obtain help with a problem or concern related to their CI&R and/or Healthy Start services. Information is given on how to file a grievance if the problem or concern cannot be resolved. The CI&R and/or Healthy Start program's written information contains the name, address, and telephone number for the participantto contact and register a complaint or grievance. The Provider shall ensure that there are written procedures that address the participant's rights, including, but not limited to, the following: • How to receive information about available service options; • The right to be treated with respect and in consideration of their dignity and privacy; • The right to participate in decisions regarding their care; and • Freedom to exercise their rights. The Provider shall ensure that the participant's decision to exercise their rights does not adversely affect the services that the participant receives through the CI&R and/or Healthy Start Program. If the Provider fails to comply with the requirements of this section, the Provider may be subject to financial consequences and/or sanctions pursuantto Attachment I, Section C.1.c. Complaints A complaint is defined as any expression of dissatisfaction by a participant, including dissatisfaction with the administration or provision of services, which relates to the quality of care provided. Registering a Complaint When a participant expresses a dissatisfaction that requires follow-up, the person receiving the complaint will document the details on a CI&R / Healthy Start Services Complaint Summary Sheet (Attachment). The person completing the form will give the form to their immediate supervisor the same day the complaint is received. The supervisor will assign someone to investigate the complaint and assign a date for final findings and resolution within five business days of the date of the receipt of the complaint. Action on a Complaint The person assigned to investigate the complaint will document the findings on the CI&R / Healthy Start Services Complaint Summary Sheet. The CI&R / Healthy Start Services Complaint Summary Sheet will then be reviewed by the supervisor who will indicate concurrence with the findings and resolution by dating and signing the form. The person assigned to the complaint will then contact the complainant by phone or letter and inform them of the outcome. If resolution of the complaint requires assistance from outside parties, written consent of the complainant must be obtained prior to further action. This contactwill bedocumented. Documentation from contacts with any involved party of the complaint (i.e., document date, time, name of person and information received) will be attached to the CI&R / Healthy Start Services Complaint Summary Sheet. If a mutual resolution cannot be agreed to between the supervisor and person filing a complaint, the participant will have the right to a mediator or a meeting with the Coalition's grievance committee (typically consisting of Coalition Director, board members and at least one consumer) prior to reporting to the Department of Health (DOH) and Agency for Health Care Administration (AHCA). Note, at any time the participant may request to contact DOH, Healthy Start MomCare Network and AHCA. Page 132 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 Cross-referenced files and a log are kept, recording the name and address of each participant registering a complaint. A copy of the completed CI&R / Healthy Start Services Complaint Summary Sheet is kept in the file. The supervisor will send a copy of the complainant's completed and de -identified CI&R / Healthy Start Services Complaint Summary Sheet to the Healthy Start Coalition's Executive Director within two business days after the resolution of the complaint. Medical Care Complaint When a quality of medical care complaint is reported, the supervisor will, within the same business day, report the complaint to the Healthy Start Coalition's Executive Director. The Healthy Start Coalition's Executive Director will refer the complaint within two business days to AHCA's District Medicaid Office and the Healthy Start MomCare Network Contract Manager. Any investigation will be conducted by AHCA. AHCA will be responsible for any investigation and follow up on all medical carecomplaints. Grievance A grievance is defined as a written complaint submitted by or on behalf of a participant regarding the availability, delivery, or quality of services. Filing a Grievance All grievances must be submitted in writing and date stamped upon receipt. Written consent to release this information is obtained from the participant. Action on a Grievance Upon receipt of a grievance, the CI&R / Healthy Start Services Grievance Summary Sheet (Attachment) is completed and the grievance is attached. The person receiving the grievance and completing the C&&R / Healthy Start Services Grievance Summary Sheet will, within thesame business day, notify their immediate supervisor and forward the written grievance and the CI&R / Healthy Start Services Grievance Summary Sheet to the supervisor. The supervisor will review the grievance and the CI&R / Healthy Start Services Grievance Summary Sheet, and, within the same business day, notify the Healthy Start Coalition's Executive Director. The supervisor is responsible for resolving operational type grievances. They will provide a written response to the grievant within thirty days from the initial filing bythe participant. Cross-referenced files and a log are kept, recording the name and address of each participant registering a grievance. A copy of the completed CI&R / Healthy Start Services Grievance Summary Sheet is kept in the file. The participant shall have the right to seek review of the grievance findings and recommendations to the Healthy Start Coalition,The Network, and AHCA. Medical Care Grievance When a quality of medical care grievance is reported, the supervisor will report the grievance, within the same business day, to the Healthy Start Coalition's Executive Director. The Healthy Start Coalition's Executive Director will refer the grievance within two business days to AHCA's District Medicaid Office and the Healthy Start MomCare Network Contract Manager. AHCA will be responsible for any investigation and follow up on all medical care grievances. Adverse Incident Report The purpose of this report is to ensure timely and accurate reporting of adverse incidents occurring within the CI&R and/or Healthy Start program. This report must be completed and submitted to the Coalition within one (1) business day from when the adverse incident occurred. Page 133 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 CI&R / HEALTHY START SERVICES COMPLAINT SUMMARY SHEET Date Received: Received By: Name and Title Last Name of Complainant First Name MI Address (Number, Street, Apartment) City, State and Zip Code Home Phone Work Phone Medicaid I.D. Number Type of Complaint: Operational _ Medical Other Name and Telephone Number of Person or Care Provider Involved (If Applicable) Name Telephone Number Summary of Complaint: [Include Witness(es) if Applicable] Supervisor complaint referred to: _ Date: Assigned to by supervisor: _ Date: Investigation and Findings: Actions taken: Supervisor Review: _ _ Date: Supervisor Signature and Title Date Copy Sent to Healthy Start Coalition Executive Director: Page 134 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 CI&R / HEALTHY START SERVICES GRIEVANCES SUMMARY SHEET Date Received Received By: Name and Title Last Name of Grievant First Name MI Address (Number, Street, Apartment) City, State and Zip Code Home Phone Work Phone Medicaid I.D. Number Type of Grievance: Operational __ Medical Other _ Name and Telephone Number of Person or Care Provider Involved (If Applicable) Name Telephone Number Summary of Grievance: [Include Witness(es) if Applicable] Supervisor Notified: Date Time Supervisor Review: _ Date Time _ Signature Healthy Start Coalition Executive Director Notified By: Date: Time: Investigation and Findings: Actions taken: Page 135 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 ADVERSE INCIDENT REPORT The purpose of this document is to provide a tool to ensure timely and accurate reporting of adverse incidents occurring within CI&Rand/or Healthy Start program and its participant. Please submit this completed form via email to the CI&R / Healthy Start Contract Manager within one (1) business day from when a CI&R and/or Healthy Start participant experiences an adverse incident. PARTICIPANT INFORMATION: First Name: Healthy Start Case #: Participant Directly Impacted by Adverse Incident: ❑ Prenatal ❑ Infant -Child ❑ Interconception Care INCIDENT INFORMATION: Incident Date: Incident: ❑ Child Health ❑ Confirmed Child Maltreatment ❑ Home Visitor Initiated 911 Call ❑ Participant Formal Grievance ADDITIONAL INCIDENT INFORMATION: Staff Member Completing Form (type/print): Approximate time of Incident: ❑ Participant Death ❑ Participant Suicidal Attempt ❑ Participant Homicidal Ideation or Attempt ❑ Other _ Date: NOTE: Submission of this form does not satisfy mandatory reporting requirements. PROVIDER agency is expected to follow its adopted policies and procedures regarding investigation of and documentation requirements pertaining to any adverse incident reported. Page 136 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 ATTACHMENT III ASSURANCES FOR BALANCED BUDGET 1. The Florida Department of Health ("Department"), the Agency for Health Care Administration ("Agency'), and Centers for Medicare and Medicaid Services may inspect and audit any financial records of the Department or Department's subcontractors relating to the Healthy Start Coordinated Care System for Pregnant Women and Infants. For purposes of this contract, the Healthy Start Coordinated Care System for Pregnant Women and Infants include participants referred into the Coordinated Intake and Referral program and/or into the Healthy Start program, as well as participants who are receiving CI&R and/or Healthy Start services. 2. The Department assures written information will be available to the Healthy Start Coordinated Care System for Pregnant Women and Infants participants in the prevalent non-English languages in Florida. The Department assures enrollees are not charged for any interpretation services. 3. The Department assures providers of the Healthy Start Coordinated Care System for Pregnant Women and Infants will have in place grievance procedure for program participants. 4. The Department assures the providers of the Healthy Start Coordinated Care System for Pregnant Women and Infants services will attempt to contact participants within five business days of receipt of participant's name and contact information to assuretimely access to program services. 5. The Department assures the providers of the Healthy Start Coordinated Care System for Pregnant Women and Infants services will provide written materials in an easily understood language and format. Communications shall be at or near the fourth (4th) grade comprehension level. Written material will be available in alternative formats that take into consideration special needs. 6. The Agency assures that Healthy Start Coordinated Care System for Pregnant Women and Infants program participants will receive the same notice of any disenrollment from Medicaid as that provided to any other Medicaid recipient. 7. The Agency assures that Healthy Start Coordinated Care System for Pregnant Women and Infants program participants will receive the same notice of the right to a grievance procedure, appeal, and fair hearing procedures and timeframes as provided to any other Medicaid recipient. 8. The Department assures the providers of the Healthy Start Coordinated Care System for Pregnant Women and Infants services will inform the enrollee of their rights to change prenatal care providers and the mechanism to do so when the enrollee is notified of their prenatal care provider assignment. The provider will, within 30 days of eligibility notification from the Agency's fiscal agent, register the enrollee with the selected prenatal care provider. If the enrollee has not made a decision within 30 days, the provider will assign a prenatal care provider by selecting from prenatal care providers within a thirty -minute drive of the enrollee's residence. If there is more than one prenatal care provider who meet this requirement, the provider shall assign a prenatal care provider to the enrollee based upon a locally established unbiased protocol. 9. The Department assures the providers of the Healthy Start Coordinated Care System for Pregnant Women and Infants services will inform the enrollee recipient that her prenatal care provider can be changed for up to 60 days from provider enrollment. However, after 60 days, it is recommended that the recipient would only change providers for the following reasons: a) Change of recipient's county of residence; b) Cause, such as recipient's inability to schedule appointments in a timely manner with the provider, or patient/ provider conflict; c) Prenatal care provider termination from Medicaid or relocation; d) Recommendation of provider based on complications of recipient's pregnancy such as to a Regional Perinatal Intensive Care Center provider; and e) If automatic assignment of a prenatal care physician was made by the Provider, the Provider shall recommend that the recipient not change her provider after 60 days from the date notified. 10. The Department assures the Provider may not discriminate for the participation or reimbursement of any staff who is acting within the scope of his or her license or certification under applicable State law, solely on the basis of that license or certification. Page 1 37 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 11. The Department will assure that the Healthy Start Coordinated Care System for Pregnant Women and Infants provider staffing levels has adequate capacity to perform the roles and responsibilities as outlined in the Healthy Start Standards and Guidelines. 12. In the event a provider of the Healthy Start Coordinated Care System for Pregnant Women and Infants services is aware a woman is no longer pregnant, the Provider will make a good faith effort to notify the Agency of the change in eligibility status. 13. The Department will assure that each enrollee is free to exercise his or her rights, and that the exercise of those rights does not adversely affect the way the providers or the Department treat the enrollee. 14. The Department will assure that providers will be held in compliance with all Federal and State laws and regulations including title VI of the Civil Rights Act of 1964; title IX of the Education Amendments of 1972 (regarding education programs and activities); the Age Discrimination Act of 1975; the Rehabilitation Act of 1973; and the Americans with Disabilities Act. 15. The Department will assure that providers may not prohibit, or otherwise restrict, a staff health care professional acting within the lawful scope of practice from advising or advocating on behalf of an enrollee for the enrollee's health status, medical care, or treatment options, including any alternative treatment that may be self-administered; for any information the enrollee needs in order to decide among all relevant treatment options; for the risks, benefits, and consequences of treatment or non -treatment; for the enrollee's right to participate in decisions regarding his or her health care, includingthe rightto refuse treatment, and to express preferences about future treatment decisions. 16. The providers will submit marketing products, and drafts of products that can reasonably be interpreted as intended to market to potential enrollees, to the Department prior to distribution. 17. The Department assures the provider delivery network is sufficient to provide adequate access to all services as per the Healthy Start Standards and Guidelines and is supported by written contract agreements. 18. The Department assures that the providers meet the Healthy Start Standards and Guidelines for timely access to services. Timely access to services will be a component of the quarterly performance monitoring by the provider and the Department. The Department will monitor quarterly performance improvement plans on any providers not meeting performance measures. 19. The Department assures that the providers follow the Healthy Start Standards and Guidelines criteria for the delivery of services in a culturally competent manner to all enrollees and participants, including those with limited English proficiency. 20. The Department assures that the provider network is sufficient in number, mix, and geographic distribution to meet the needs of the anticipated number of enrollees and participants in theservicearea. 21. The Department assures that the providers will notify the Department and the Agency of any enrollment problems via routinely scheduled conference calls. 22. The Department assures the providers of the Healthy Start Coordinated Care System for Pregnant Women and Infants services, where applicable, will comply with the Health Insurance Portability and Accountability Act as well as all regulations promulgated thereunder (45 CFR, Parts 160, 162 and 164). 23. The Department assures the providers of the Healthy Start Coordinated Care System for Pregnant Women and Infants services will identify if the enrollee or participant has any special needs and assist in the receipt of care. 24. The Department assures the providers of the Healthy Start Coordinated Care System for Pregnant Women and Infants services will perform services as set forth in the Healthy Start Standards and Guidelines. 25. The Department assures the providers of the Healthy Start Coordinated Care System for Pregnant Women and Infants services will maintain staffing levels necessary for the completion of the optimum level of program services. The provider will not arbitrarily deny or reduce the amount, duration, or scope of a service solely because of the diagnosis or condition. 26. The Department assures the providers will submit to the Department on a quarterly basis a progress report on the achievement of agreed upon performance measures by providers, copies of quality assurance monitoring reports, quality assurance/quality improvement summary record review forms. Compensation to staff performing quality improvement/ quality assurance activities will not provide incentive for the staff to deny, limit or discontinue necessary services to any enrollee/participant. 27. The Department assures the providers will develop and implement a written plan for quarterly quality monitoring and evaluating of services. This plan shall specify any records, reports, documents, tools and methods to be utilized in Page 138 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 conducting monitoring and evaluation activities. 28. The Department assures the providers will meet the provider competencies and qualifications as outlined in the Healthy Start Standards and Guidelines. 29. The Department assures the providers may not employ or contract with staff excluded from participation in Federal health care programs under either section 1128 or section 1128Aof the Social Security Act. 30. The Department assures that any provider subcontracts include the applicable requirements of 42 CFR Part 438, services are evaluated for quality, specific activity and report responsibilities, and provides for corrective action sanctions if the subcontractor's performance is inadequate. 31. The Department assures that any provider subcontracts are monitored for performance on an ongoing basis and the provider has an annual contract monitoring review. 32. The Department assures that the provider and subcontractor will develop a corrective action plan for any deficiencies identified through the contract monitoring of subcontracts. 33. The Department assures the Healthy Start Standards and Guidelines are based on valid research, reviewed and updated as appropriate in consultation with the providers, and consider the needs of the enrollees and participants. 34. The Department assures the providers will not knowingly have a relationship, as a director, owner or employee, with an individual who is debarred, suspended, or otherwise excluded from participating in procurement activities under the Federal Acquisition Regulation or from participating in non -procurement activities under regulations issued under Executive Order No.12549 or under guidelines implementing Executive Order No. 12549; an individual who is an affiliate, as defined in the Federal Acquisition Regulation, of a person described in paragraph (a)(1). 35. The Department assures that the Agency and the Centers for Medicare and Medicaid Services may inspect and audit any financial records of the providers or the providers' subcontractors relating to the Healthy Start Coordinated Care System for Pregnant Women and Infants. There will be no restrictions on the right of the Agency and the Centers for Medicare and Medicaid Services to conduct whatever inspections and audits are necessary to assure quality, appropriateness or timeliness of services and reasonableness of their costs. 36. The Department assures that any enrollee and participant survey results may be disclosed to the Agency, and upon request, disclosed to enrollees and participants. 37. The Department assures the right in written provider contracts to make any and all reasonable determinations it deems necessary to protect the best interest of the State of Florida and the health, safety and welfare of the enrollee and participant. Such determinations may include, but are not limited to, all terms and conditions of, and any amendments to the contract. 38. The Department assures the providers' performance must meet the standards set forth in contract and is bound by contract conditions. If the provider fails to meet contract terms the Department will notify the provider in writing of the specific performance failures and may require the provider to respond to the performance failures by developing a corrective action plan that is mutually agreed upon by the provider and the Department. In the event a mutual agreement cannot be reached, the Department will have final determination of the corrective action plan requiring conformance with the contract. If the provider fails to achieve compliance with the corrective action plan, the Department has the authority to terminate the contract for cause in the absence of any extenuating or mitigating circumstances. The determination of extenuating or mitigating circumstances is the exclusive determination of the Department. 39. The Department assures the Center for Medicare and Medicaid Services, the Health and Human Service Inspector General, the U.S. Comptroller General, or any of their duly authorized representatives, have the right of timely and unrestricted access to any books, documents, papers, or other records of providers that are pertinent to the awards, in order to make audits, examinations, excerpts, transcripts and copies of such documents. This right also includes timely and reasonable access to staff personnel for the purpose of interview and discussion related to such documents. The rights of access are not limited to the required retention period but shall last as long as records are retained. 40. The Department assures contracts shall contain provisions requiring Equal Employment Opportunity Provisions. 41. The Department assures if any discovery or invention arises or is developed in the course or as a result of work or services performed under this contract, or in any way connected herewith, the provider shall refer the discovery or invention to the Department to be referred to the Department of State to determine whether patent protection will be sought in the name of the State of Florida. Any and all patent rights accruing under or in connection with the performance of this contract are hereby reserved to the State of Florida. Page 1 39 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 42. The Department assures the provider shall comply with all applicable standards, orders, or regulations issued under §306of the Clean Air Act, as amended (42 U.S.C. 1857(h) et seq.), §508 of the Clean Water Act, as amended (33 U.S.C. 1368 et seq.), Executive Order 11738, and Environmental Protection Agency regulations (40 CFR Part 15). 43. The Department assures the provider shall certify that no Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or an employee of any Agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in the connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan or cooperative agreement. The Department assures provider will include the language of this certification in the award documents for all sub -awards at all tiers (including subcontracts, sub -grants and contracts under grants, loans and cooperative agreements) and that all sub -recipients shall certify and disclose accordingly. 44. The Department assures the provider will certify that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this contract/subcontract by any federal Department or Agency. 45. The Department assures the provider shall ensure that all contract material records and documentation are maintained for a period of ten years after the end of the contract or the completion of the financial audit, whichever is later. The provider shall ensure that all records and documentation containing medical information on individual participants are maintained for a minimum period of ten years. Page 140 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 ATTACHMENT IV CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION CONTRACTS/SUBCONTRACTS This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, signed February 18, 1986. The guidelines were published in the May 29, 1987 Federal Register (52 Fed. Reg., pages 20360-20369). INSTRUCTIONS 1. Each provider whose contract/subcontract equals or exceeds $25,000 in federal monies must sign this certification prior to the execution of each contract/subcontract. Additionally, providers who audit federal programs must also sign, regardless of the contract amount. DOH cannot contract with these types of providers if they are debarred or suspended by the federal government. 2. This certification is a material representation of fact upon which reliance is placed when this contract/subcontract is entered into. If it is later determined that the signer knowingly rendered an erroneous certification, the Federal Government may pursue available remedies, including suspension and/or debarment. 3. The provider shall provide immediate written notice to the contract manager at any time the provider learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4. The terms "debarred", "suspended", "ineligible", "person", "principal", and "voluntarily excluded", as used in this certification, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the contract manager for assistance in obtaining a copy of those regulations. 5. The provider agrees, by submitting this certification, that it shall not knowingly enter into any subcontract with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this contract/subcontract unless authorized by the federal government. 6. The provider further agrees by submitting this certification that it will require each subcontractor of this contract/subcontract, whose payment will equal or exceed $25,000 in federal monies, to submit a signed copy of this certification. 7. The Department of Health may rely upon a certification of a provider that it is not debarred, suspended, ineligible, or voluntarily excluded from contracting/subcontracting unless it knows that the certification is erroneous. 8. This signed certification must be kept in the contract manager's file. Subcontractor's certifications must be kept at the contractor's business location. CERTIFICATION (1) The prospective provider certifies, by signing this certification, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this contract/subcontract by any federal department or agency. (2) Where the prospective provider is unable to certify to any of the statements in this certification, such prospective provider shall attach an explanation to this certification. (3) By initialing, Contract Manager confirms that prospective provider has not been listed in the System for Award Management (SAM) database Verification Date Name: Robert B. Eadie, JD Title: Administrator Signature: Attachment IV — Debarment Certification Date: Page 141 Florida Keys Healthy Start, Inc. Contract #: HS-2022-2023 ATTACHMENT V CERTIFICATION REGARDING LOBBYING Certification for Contracts, Grants, Loans and Cooperative Agreements The undersigned certifies, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or an employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid, to any person for influencing or attempting to influence an officer or an employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with this Federal contract, grant, loan or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, Disclosure Form to Report Lobbying, in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub- awards at all tiers (including subcontracts, sub -grants and contracts under grants, loans and cooperative agreements) and that all sub -recipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by §1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Signature: Name of Authorized Individual: Robert B. Eadie, JD Name of Organization: Florida Department of Health in Monroe County Address of Organization: 1100 Simonton Street, Key West, FL 33040 12/96 Date: Attachment V — Certification Regarding Lobbying Page 142 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 ATTACHMENT VI CIVIL RIGHTS COMPLIANCE CHECKLIST STATE OF FLORIDA DEPARTMENT OF HEALTH For the Fiscal Year July 1, 2022 to June 30, 2023 Facility / Program County Monroe Florida Department of Health in Monroe Count Address 1100 Simonton Street Completed By City, State, Zip Code Key West, FL 33040 Date Telephone Briefly describe the geographic area served by the program/facility and the type of services provided: Provides CI&R and Healthy Start client services to women, infants, and their families who reside in Monroe County. Minimum Requirements COMMENTS Local - County Complies? If, No or N/A, Explain briefly procedures or policy refs Yes No N/A Requirement: DOH Policy— Designation of Compliance Officer. Programs and facilities that employ 15 or more persons must designate at least one person to coordinate efforts to comply with the requirements of Title VI of the Civil Rights Act of 1964 (Title VI); HHS Assurances; as well as Section 504 of the Rehabilitation Act of 1972 (Section 504), the ADA of 1990 (ADA), and the Age Discrimination Act of 1975. 1. Has your organization assigned the local responsibility for insuring compliance with the HHS Assurances for Title VI of the Civil Rights Act of 1964 (Title VI), as amended, under Y N the contract between the Florida Department of Health and the U.S. Department of Health and Human Services to someone in your organization? la. Who is designated as the local 0 Title VI Coordinator? 1b. What is this person's position title? 2. Have all contracted service providers with 15 or more employee Y N designated a Title VI Coordinator? - a Section 504 coordinator: Y N - a contact person for ADA and Y N Limited English Proficiency (LEP) requests 3. Has your organization appointed an employee with compliance monitoring responsibilities for Section 504, ADA, Y N and the Age Discrimination Act of 1975? If not the same as the Title VI coordinator (#1 above), provide the name, position title and contact information. Page 143 Florida Ke s HealthV Start Coalition Inc. Contract #: HS-2022-2023 Requirement: DOH Policy- Equal Access and Participation (Participation). Programs and facilities will maintain and record statistics which will document equal access and participation in compliance with Title VI, including participant demographics and program qualification requirements, including numbers applying for services, enrollment, and number not enrolled. Requirement- Equal Access and Participation: Reporting Community Outreach and Advocacy 4. Does your organization document the dissemination of information to the community (including clients, Y N potential clients and advocacy groups) about HHS's Title VI programs and your organization's commitment to compliance with civil rights and non-discrimination? 4.a - Does your organization regularly meet or communicate with community organizations and Y N advocacy groups? 4.b - What community organizations and advocacy groups do you communicate regularly with, and Y N how? List on a separate sheet Requirement— Equal Access and Participation: Reporting Compliance 5. Does your organization record and maintain statistics which will document equal access and Y N participation in compliance with Title A ? 5.a - Do your records identify participants and applicants in each program at each center or location, Y N and if so, do you record race, color, national origin, age, gender and disability status? 5.b - Are the participation rates Y N reported to the EO Section - and how often? 5.c - Do you report the number and Y N enrollment rates of applicants and the number of participants who complete each program? 5.d - Do you offer and collect Y N participant satisfaction surveys for each program? 5.e - Who has physical custody of Y N the records on applicants and participants, and surveys? Requirement- Equal Access and Participation: Limited English Proficiency and Auxiliary Aids Plan 6. Does your organization annually review the Department's LEP and Auxiliary Aids Plan (LEP/AA) and Y N incorporate any changes in the local LEP/AA Planprovisions? 6.a Who is designated as the (Name, Title and Phone number) LEP/AA Plan contact and coordinator? Page 144 Flnrida Kevs Healthv Start Coalitinn. Inc Cnntract #- HS-2022-2023 6.b Does the above individual annually review and update the local Y N resources and referrals for your organization? Requirement- Equal Access and Participation: Communications 6.c Does your organization provide Y N an updated list of local resources and referrals to staff and/or training, to provide information on how to access the list of resources? If so, does it include the following: 6.c.1. Description of auxiliary aids Y N available for use in each phase of the service delivery process 6.c.3. Does the organization have a requirement for training for direct services field staff, institutional staff Y N and other staff who deal with the public? If so, does it include the following: 6.c.3a. Procedures to be used by Y N direct service staff in requesting appropriate auxiliary aids 6.c.3b. Florida Relay Service Y N (FRS) phone number (711) publicized for communications 6.c.3c. Full range of Y N communication options, at no cost 6.c.3d. A list of formal arrangements with interpreters who can accurately and fluently express and receive in Y N sign language? The names, addresses, phone numbers and hours of availability of interpreters must be readily available to direct services employees. 6.c.3e. — Accessibility to Y N supplemental hearing devices as needed. 6.c.3f. - Use of written Y N communication in lieu of verbal communications. 6.c.3g. — Use of Flash cards to Y N communicate. 6.c3h. At least one telecommunications device, or an Y N arrangement to share a TDD line with other facilities. 6.c.4. Information that use of family members may be used only if they are specifically requested by a Y N hearing impaired person. Page 145 Flnrida Kevs Healthv Start Coalitinn. Inc Cnntract #- HS-2022-2021 7. Does the organization have a written Monitoring Procedure which includes: - Description of how client needs Y N are assessed. - Approval responsibility for request Y N for and obtaining the requested auxiliary aid or interpreter Standard time for DOH to provide Y N service(s) FRS phone number (711) publicized Y N Name of CHD/CMS Director or Y N Administrator is provided and displayed Name and contact information for local EO Coordinator, ADA Y N Coordinator and to request LEP/AA Plan services displayed in each location Name and contact information for the DOH EO Manager is provided Y N and displayed A procedure (including Poster) for notifying clients and applicants of the availability of auxiliary aids and Y N procedures for requesting an auxiliary aid 7a - List of Locations where DOH Posters have been posted; and when Y N the last On -site was done to ascertain Posters are visible and current? 7b - Training and Meeting Notices contain required contact information Y N to request services Requirement: DOH Policy - Notice of Tine VI Rights and Complaint Procedures — Programs/facilities must make available to their participants, beneficiaries or any other interested parties information on their right to file a complaint of discrimination with either the Florida Department of Health or the United States Department of Health and Human Services (HHS). The information may be supplied verbally or in writing to every individual, or may be supplied through the use of an equal opportunity policy poster displayed in public areas of the facility. 8. Does your organization inform participants, beneficiaries or other interested parties of their right to file a Y N complaint of discrimination with either the DOH or the U S Department of Health and Human Services HHS ? 8a — How do you inform and instruct your employees and provider personnel of the commitment to Y N compliance with federal regulations regarding nondiscrimination? 8b — Do you have an established procedure for reporting internal grievance or complaints for possible Y N discrimination or civil rights violations? Page 146 Flnrida Kpvs Hpalthv Start Coalitinn. Inc Cnntract #: HS-2022-2023 8c — Have your local procedures been reviewed and approved by the DOH EO Section? Y N 8d — Has your organization provided all participants or applicants for services with contact information for Y N the state Equal Opportunity office EO Section in Tallahassee? 8e — Have your employees or applicants for employment been provided with contact information for Y N the Department Equal Opportunity office (EO Section) in Tallahassee and informed of their right to file a discrimination complaint ? 8f— Is there a written record made of information regarding a person's request to file a complaint and who Y N provided it? 8g. Does your organization ensure the EO Section is informed of any report by a client or employee of Y N possible or alleged violation of discrimination laws within recommended time frames? Requirement: DOH Policy - Reporting Requirements: Self -Evaluation (Physical Accessibility). Programs and facilities must conduct a self -evaluation to identify any accessibility barriers, using the four step process that includes (1) evaluate current practices and policies to identify any that do not complaint with Section 504 or the ADA; modify policies and practices that do not meet requirements; take remedial steps to eliminate any discrimination that has been identified; and maintain the self -evaluation on file. Assure the program/facility is physically accessible to disabled individuals. Physical accessibility includes designated parking areas, curb cuts or level approaches, ramps and adequate width to entrances. The lobby, public telephone, restroom facilities, water fountains, information and admissions offices should be accessible. Door widths and traffic areas of administrative offices, cafeterias, restrooms, recreation areas, counters and serving lines should be observed for accessibility. Switches and controls for light, heat, ventilation, fire alarms, and other essentials should be installed at an appropriate height for accessibility for mobility -impaired individuals. 9. Has your organization, and each program, conducted and submitted a self -evaluation in the past three to Y N five years? (Forms: Program Self -Evaluation, Communication Access, and an ADA Facility Accessibility Checklist s 9a —Has a copy of each completed Y N self -evaluation been provided to the compliance officer and the DOH EO Section? 9b — Has there been any new construction or renovation work done Y N on the facility in which the programs are provided since the last self - evaluation? 9c — Was a self -evaluation completed following completion of the work or Y N provided by the contractor 9d — Has your organization identified any areas in which compliance Y N should or could be improved? 9e — What has the organization done to address previous compliance Y N issues or to improve compliance in the previous ear? Requirement: DOH Policy - Reportln Requirements: Training. 10. Has the local compliance officer Y N or designee completed DOH's EO training in the last 3 ears? Page 147 Flnrida Kevs Healthv Start Coalitinn. Inc Cnntract #: HS-2022-2023 10a. Have all employees completed Y N DOH's orientation to EO rights: in New Hire training, or in the last 3 years, or when new policies or procedures have been promul ated? Requirement: DOH Policy- Reporting Requirements: Staff Recruitment and Selection 11. Are recruitment and selection files maintained for not less than two Y N years after the selection is processed? 12. Do recruitment announcements include the "Equal Employment Y N Opportunity" nondiscrimination statement (tagline) in all job vacancy announcements? 13. Is there any written guidance regarding advertising position Y N vacancies in local newspapers? In minority newspapers? 14. Are other methods used to publicize job vacancies? If so, Y N describe. Page 148 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 ATTACHMENT VII FINANCIAL POLICIES AND PROCEDURES MANUAL FOR SUBCONTRACTED PROVIDERS Table of Contents I. Definitions and Acronyms A. Definitions B. Acronyms II. Basic Policy Statement III. Line of Authority A. Board of Directors B. Executive Committee C. Coalition Staff IV. Allowable Expenditures A. Base Direct Service Contract Funds B. Medicaid Waiver Direct Service Contract Funds V. Unallowable Expenditures A. Base Direct Service Contract Funds B. Medicaid Waiver Direct Service Contract Funds C. All Contract Funds Page 149 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 I. DEFINITIONS AND ACRONYMS A. Definitions Administrative Support: Support not directly related to services, such as personnel, budget, payroll, bookkeeping, purchasing; also means work assisting an administrator through office management. Rollover Funds: Unexpended funds from the previous contract that were approved to be used in the subsequent contract year. B. Acronyms FAHSC: Florida Association of Healthy Start Coalitions FKHSC: Florida Keys Healthy Start Coalition WFS: Well Family System II. BASIC POLICY STATEMENT A. Florida Keys Healthy Start Coalition, Inc., hereafter referred to as the Coalition, is committed to responsible financial management. The entire organization including the Board of Directors and staff will work together to ensure that all financial matters of the organization are addressed with care, integrity and in the best interest of the Coalition. B. The policy and procedural guidelines contained in this manual are designed to: 1. Provide a framework for submission and approval of budgets and budget adjustments; 2. Ensure the best use of FKHSC funds; and 3. Ensure compliance with federal, state, local and nonprofit funding requirements. III. LINE OF AUTHORITY A. Board of Directors. Has the authority to and is responsible for: 1. Executing any policies it deems to be in the best interest of the organization within parameters of the organization's articles of incorporation, bylaws, contractual requirements and federal, state and local law; and 2. Approving subcontracted providers' annual budgets, budget adjustments, and proposed budgets for rollover funds. B. Chief Executive Officer Has the authority to and is responsible for: 1. Considering matters referred to it by the President of the Board of Directors; and 2. Exercising, in the absence of the Board of Directors, authority of the Board of Directors provided, however, that the delegation shall not operate to relieve the Board of Directors of any responsibility imposed by law or the bylaws. C. Chief Executive Officer a Coalition Staff Has the authority to and is responsible for: Page 150 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 1. Fulfilling the services needed by the Coalition as specified in their contracts with the Department of Health and the Healthy Start MomCare Network. 2. Collecting, reviewing, and approving subcontracted Providers' annual budgets, quarterly budgets, budget adjustments, and proposed budgets for rollover funds; 3. Reviewing subcontracted Providers' budgets for accuracy and allowable expenditures; 4. Conducting an annual fiscal audit of each subcontracted provider; and 5. Providing quarterly financial statements to the Board of Directors. IV. ALLOWABLE EXPENDITURES Expenditures must be actually incurred; supporting documentation is required. A. Direct Service Contract Funds 1. Care Coordination and Wraparound services 2. Outreach to identify participants 3. Educational materials 4. Staff training 5. Mileage reimbursement at the approved state rate (travel is subject to limits/per diems in §112.061, FS) 6. Up to 5% of invoiced amount per quarter for administrative support to include actual business expenses such as utilities, vehicles, custodial services, and indirect program administration. V. UNALLOWABLE EXPENDITURES A. Direct Service Contract Funds 1. Services that are not CI&R and are not care coordination or fatherhood services as stated in the Healthy Start Standardsand Guidelines 2. Clinical Prenatal Care 3. Educational Materials not approved byAHCA/DOH 4. Food (including snacks and drinks) 5. Vehicles 6. Gas/Fuel (unless for a rental car) 7. Vehicle maintenance 8. Transporting participants 9. Undocumented expenditures 10. Purchase and presentment of plaques for outstanding service* 11. Entertainment for visiting dignitaries* 12. Decorative items (globes, statues, potted plants, picture frames, etc.)* * (Per Rule 3A-40.103, F.A.C.) ** This list is not all-inclusive The critical budget question is always, "are the costs reasonable, allowable and necessary?" The answer to all three must be "yes." Page 151 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 ATTACHMENT VIII HEALTHY START CARE COORDINATOR TRAINING POLICIES AND PROCEDURES The following trainings must be completed upon hire (within 60 days) and prior to providing services to Healthy Start participants. Training requirements may change throughout the contract year as directed by the Coalition. A. Healthy Start System of Care: 1. All direct service staff must be trained on the Healthy Start System of Care 2. Training will bevia aDOH and HSMN approved method as directed by the Coalition. 3. The following LMS web training(s) must be completed: a. Well Family System Documentation on the New System of Care B. Cultural Diversity and Health Equity: 1. All direct service staff must receive cultural diversity training. Recertification must be completed at a minimum of once every five years. 2. The Coalition will make every effort to identify available cultural diversity training for new staff if assistance is needed. 3. The direct service staff may identify and attend cultural diversity training subject to approval by the Coalition. 4. The following LMS web training(s) must be completed: a. Health Equity in Maternal and Child Health 12.20 C. Prenatal and Parenting Education and Support: 1. Healthy Start care coordinators providing services to prenatal and infant -child participants must complete training in the use of the Partners for a Healthy Baby curriculum. 2. The Coalition will make every effort to facilitate the Partners for a Healthy Baby training provided by the HSMN Training Institute. 3. The following LMS web training(s) must be completed: a. Using Partners for a Healthy Baby to Support Pregnant and Postpartum Women At Risk for or Experiencing Depression D. Interconception Education and Counseling: 1. Healthy Start care coordinators providing services to prenatal and infant -child participants must complete the mandatory training in the use of the Interconception Education and Counseling curriculum approved by DOH. 2. The Coalition will make every effort to facilitate the Interconception Education and Counseling training provided by the HSMN Training Institute. 3. The following LMS web training(s) must be completed: a. Family Planning Contraceptive Counseling: Family Planning 101 b. One Key Question E. Fatherhood Education and Counsel 1. Healthy Start care coordinators providing services to fatherhood participants must complete the mandatory training in the use of the Fatherhood Education and Counseling curriculum approved by DOH. 2. The Coalition will make every effort to facilitate the Fatherhood Education and Counseling training provided by the DOH or other training entity. 3. The following LMS web training(s) must be completed: a. Any Fatherhood training identified as such in LMS Page I S2 Florida Kevs Healthv Start Coalition. Inc. Contract #: HS-2022-2023 b. Women's Health Series Part 1, 2, and 3: Preconception Health, Prenatal Health, Breastfeeding and Nutrition F. Tobacco Education and Cessation: 1. Healthy Start care coordinators providing services to prenatal and infant -child participants must complete training in the use of the SCRIPT curriculum. 2. The Coalition will make every effort to facilitate the SCRIPT training provided by the HSMN Training Institute. 3. Healthy Start Care Coordinators will learn how to refer all participants who smoke, or have household members who smoke, to the Florida Tobacco -Free Quitline and web -based cessation programs. 4. The following LMS web training(s) must be completed: a. SCRIPT Video Links — English and Spanish. G. Perinatal Depression: 1. Care Coordinators providing services to prenatal and infant -child participants must complete training in the use of the Mothers and Babies Curriculum. 2. The Coalition will make every effort to facilitate this training that is provided by the HSMN Training Institute. 3. The following LMS web training(s) must be completed: a. Edinburgh Depression Scale Training (Web Training) b. Documenting Perinatal Depression Activities in the Well Family System H. Substance Abuse: 1. The following LMS web training(s) must be completed: a. Substance Abuse Model 3: Strategies for Working with Substance -Involved Families b. SBIRT Screening, Brief Intervention and Referral to Treatment in the Perinatal Period I. Ages and Stages Questionnaire: 1. Healthy Start care coordinators providing services to infant -child participants must complete training in the use of following the Ages and Stages Questionnaires: ASQ-3, birth to 36 months; ASQ-SE, 12 months. 2. The Coalition will make every effort to facilitate this training that is provided by the HSMN Training Institute. 3. The following LMS web training(s) must be completed: a. Using the ASQ-3 and ASQ-SE2 Together J. Intimate Partner Violence: 1. The following LMS web training(s) must be completed: a. Screening for and Identifying Intimate Partner Violence K. Breastfeeding Education and Support: 1. Healthy Start care coordinators providing services to infant -child participants must complete a Coalition -approved course of at least 20 hours of breastfeeding training that meets the requirements of the HSSG within six (6) months of hire. 2. If a Healthy Start care coordinator is currently a Certified Lactation Counselor (CLC) or certified as an International Board of Lactation Consultant (IBCLC), they do not need the 20 hours of breastfeeding training. 3. The Coalition will make every effort to facilitate the Breastfeeding Education and Support training Page 153 Florida Kevs Healthv Start Coalition. Inc. Contract #: HS-2022-2023 ATTACHMENT IX BUSINESS ASSOCIATE AGREEMENT (Florida Department of Health in Monroe County is the Business Associate) This Business Associate Agreement ("Agreement"), effective July 1, 2022 (the "Effective Date"), is entered into by and between the Florida Department of Health in Monroe County ("Business Associate") and the Florida Keys Healthy Start Coalition, Inc. ("Covered Entity'). The parties to this Attachment agree that the following provisions constitute a business associate agreement for purposes of complying with the requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This Attachment is applicable if the Business Associate is a business associate within the meaning of the Privacy and Security Regulations, 45 C.F.R. 160 and 164. The Business Associate certifies and agrees as to abide by the following: 1. Definitions. Unless specifically stated in this Attachment, the definition of the terms contained herein shall have the same meaning and effect as defined in 45 C.F.R. 160 and 164. Protected Health Information. For purposes of this Attachment, protected health information shall have the same meaning and effect as defined in 45 C.F.R. 160 and 164, limited to the information created, received, maintained or transmitted by the Business Associate from, or on behalf of, the Coalition. b. Security Incident. For purposes of this Attachment, security incident means the attempted or successful unauthorized access, use, disclosure, modification, or destruction of information or interference with system operations in an information system and includes any event resulting in computer systems, networks, or data being viewed, manipulated, damaged, destroyed or made inaccessible by an unauthorized activity. 2. Applicability of HITECH and HIPAA Privacy Rule and Security Rule Provisions. As provided by federal law, Title XIII of the American Recovery and Reinvestment Act of 2009 (ARRA), also known as the Health Information Technology Economic and Clinical Health (HITECH) Act, requires a Business Associate (Florida Department of Health in Monroe County) that contracts with the Coalition, a HIPAA covered entity, to comply with the provisions of the HIPAA Privacy and Security Rules (45 C.F.R. 160 and 164) and comply with 45 C.F.R. 162 as applicable. 3. Use and Disclosure of Protected Health Information. The Business Associate shall comply with the provisions of 45 CFR 164.504(e)(2)(ii). The Business Associate shall not use or disclose protected health information other than as permitted by this Agreement or by federal and state law. The sale of protected health information or any components thereof is prohibited except as provided in 45 CFR 164.502(a)(5). The Business Associate will use appropriate safeguards to prevent the use or disclosure of protected health information for any purpose not in conformity with this Agreement and federal and state law. The Business Associate will implement administrative, physical, and technical safeguards that reasonably and appropriately protect the confidentiality, integrity, and availability of electronic protected health information the Coalition creates, receives, maintains, or transmits on behalf of the Coalition. 4. Use and Disclosure of Information for Management, Administration, and Legal Responsibilities. The Business Associate is permitted to use and disclose protected health information received from the Coalition for the proper management and administration of the Business Associate or to carry out the legal responsibilities of the Business Associate, in accordance with 45 C.F.R. 164.504(e)(4). Such disclosure is only permissible where required by law, or where the Business Associate obtains reasonable assurances from the person to whom the protected health information is disclosed that: (1) the protected health information will be held confidentially, (2) the protected health information will be used or further disclosed only as required by law or for the purposes for which it was disclosed to the person, and (3) the person notifies the Business Associate of any instance of which it is aware in which the confidentiality of the protected health information has been breached. 5. Disclosure to Third Parties. The Business Associate will not divulge, disclose, or communicate protected health information to any third party for any purpose not in conformity with this Agreement without prior written approval from the Coalition. The Business Associate shall ensure that any agent, including a subcontractor, to whom it provides protected health information received from, or created or received by the Business Associate on behalf of the Coalition, agrees to the same terms, conditions, and restrictions that apply to the Business Associate with respect to protected health information. The Business Associate's subcontracts shall fully comply with the Page 1 54 Florida Kevs Healthv Start Coalition. Inc. requirements of 45 CFR 164.314(a)(2)(iii). Contract #: HS-2022-2023 6. Access to Information. The Business Associate shall make protected health information available in accordance with federal and state law, including providing a right of access to persons who are the subjects of the protected health information in accordance with 45 C.F.R. 164.524. Amendment and Incorporation of Amendments. The Business Associate shall make protected health information available for amendment and to incorporate any amendments to the protected health information in accordance with 45 C.F.R. 164.526. 8. Accounting for Disclosures. The Business Associate shall make protected health information available as required to provide an accounting of disclosures in accordance with 45 C.F.R. 164.528. The Business Associate shall document all disclosures of protected health information as needed for the Coalition to respond to a request for an accounting of disclosures in accordance with 45 C.F.R. 164.528. 9. Privacy Protection. The Business Associate shall permit an individual to request a restriction on the use and disclosure of protected health information about the individual to carry out treatment, payment, or health care operations; and disclosures permitted under 164.510(b) in accordance with 45 C.F.R. 164.522. The Business Associate shall permit an individual to request to receive communications of protected health information from the Business Associate by alternative means or at alternative locations in accordance with 45 C.F.R. 164.522. 10. Access to Books and Records. The Business Associate shall make its internal practices, books, and records relating to the use and disclosure of protected health information received from, or created or received by the Business Associate on behalf of the Coalition, available to the Secretary of the Department of Health and Human Services ("HHS") or the Secretary's designee for purposes of determining compliance with the HHS Privacy Regulations. 11. Reporting. The Business Associate shall make a good faith effort to identify any use or disclosure of protected health information not provided for in this Agreement. To Coalition. The Business Associate will report to the Coalition in the manner and format obtained from the Agreement Manager, within ten (10) business days of discovery, any use or disclosure of protected health information not provided for in this Agreement of which the Business Associate is aware. The Business Associate will report to the Coalition in the manner and format obtained from the Agreement Manager, within twenty-four (24) hours of discovery, any security incident of which the Business Associate is aware. A violation of this paragraph shall be a material violation of this Agreement. Such notice shall include the identification of each individual whose unsecured protected health information has been or is reasonably believed by the Business Associate to have been, accessed, acquired, used, or disclosed during such breach. b. To Individuals. In the case of a breach of protected health information discovered by the Business Associate, the Business Associate shall first notify the Coalition of the pertinent details of the breach and upon prior review by the Coalition shall notify each individual whose unsecured protected health information has been, or is reasonably believed by the Business Associate to have been, accessed, acquired, used or disclosed as a result of such breach. Such notification shall be in writing by first-class mail to the individual (or the next of kin if the individual is deceased) at the last known address of the individual or next of kin, respectively, or, if specified as a preference by the individual, by electronic mail. Where there is insufficient, or out-of-date contact information (including a phone number, email address, or any other form of appropriate communication) that precludes written (or, if specifically requested, electronic) notification to the individual, a substitute form of notice shall be provided, including, in the case that there are 10 or more individuals for which there is insufficient or out-of-date contact information, a conspicuous posting for a period of at least 90 days on the Web site of the covered entity involved or notice in major print or broadcast media, including major media in the geographic areas where the individuals affected by the breach likely reside. In any case deemed by the Business Associate to require urgency because of possible imminent misuse of unsecured protected health information, the Business Associate may also provide information to individuals by telephone or other means, as appropriate. C. To Media. In the case of a breach of protected health information discovered by the Business Associate where the unsecured protected health information of more than 500 persons is reasonably believed to have been, accessed, acquired, used, or disclosed, after prior review by the Coalition, the Business Associate shall provide notice to prominent media outlets serving the State, relevant portion of the State, or jurisdiction involved. Page 1 55 Florida Kevs Healthv Start Coalition. Inc. Contract #: HS-2022-2023 To Secretary of Health and Human Services (HHS). The Business Associate shall cooperate with the Coalition to provide notice to the Secretary of HHS of unsecured protected health information that has been acquired or disclosed in a breach. i. Business Associates Who Are Covered Entities. In the event of a breach by the Business Associate, or a contractor or subcontractor of the Business Associate, and the Business Associate is a HIPAA covered entity, the Business Associate, not the Coalition, shall be considered the covered entity for purposes of notification to the Secretary of HHS pursuant to 45 CFR 164.408. The Business Associate shall be responsible for filing the notification to the Secretary of HHS and will identify itself as the covered entity in the notice. If the breach was with respect to 500 or more individuals, at least 5 business days prior to filing notice with the Secretary of HHS the Business Associate shall provide a copy of the notice and breach risk assessment to the Coalition for review. Upon prior review by the Coalition of the notice and breach risk assessment, the Business Associate shall file the notice with the Secretary of HHS within the notification timeframe imposed by 45 C.F.R. 164.408(b) and contemporaneously submit a copy of said notification to the Coalition. If the breach was with respect to less than 500 individuals, the Business Associate shall notify the Secretary of HHS within the notification timeframe imposed by 45 C.F.R. 164.408(c) and shall contemporaneously submit a copy of said notification to the Coalition. Content of Notices. All notices required under this Attachment shall include the content set forth in 42 U.S.C. 17932(f) and 45 C.F.R. 164 Subpart D, except those references therein to a "covered entity" shall be read as references to the Business Associate. Financial Responsibility. The Business Associate shall be responsible for all costs related to the notices required under this Attachment. Other Reporting. The Business Associate shall comply with any other applicable reporting requirements in conformity with federal and state laws. If notifications are made under any such laws, copies of said notifications shall be provided contemporaneously to the Coalition. 12. Mitigation. Business Associate shall mitigate, to the extent practicable, any harmful effect that is known to the Business Associate of a use or disclosure of protected health information in violation of this Attachment. 13. Termination. Upon the Business Associate's discovery of a material breach of this Attachment, the Coalition shall have the right to assess liquidated damages as specified elsewhere in the agreement to which this Attachment is included, and/or to terminate this Agreement. 14. Effect of Termination. At the termination of this Agreement, the Business Associate shall return all protected health information that the Business Associate still maintains in any form, including any copies or hybrid or merged databases made by the Business Associate; or with prior written approval of the Coalition, the protected health information may be destroyed by the Business Associate after its use. If the protected health information is destroyed pursuant to the Coalition's prior written approval, the Business Associate must provide a written confirmation of such destruction to the Coalition. If return or destruction of the protected health information is determined not feasible by the Coalition, the Business Associate agrees to protect the protected health information and treat it as strictly confidential. The Business Associate has caused this Attachment to be signed and delivered by its duly authorized representative, as of the date set forth below. Signature of Authorized Representative Printed Name of Authorized Representative Date Title Page 1 56 Florida Keys Healthy Start Coalition Inc. Contract #: HS-2022-2023 Page 57 intentionally left blank. Florida Keys Healthy Start Coalition Inc. Contract #: HS-2022-2023 ATTACHMENT X DEFINITION OF TERMS 1) Ad HOC — A report designed for a specific purpose, case or situation. 2) Administrative Services Organization (ASO) — For the purposes of this Contract, an entity representing all Healthy Start Coalitions providing risk appropriate care coordination and other services in accordance with a federal waiver and pursuant to section 409.906, F.S 3) AHCA—This term refers to Agency for Health Care Administration. 4) Ages and Stages Questionnaire— A developmental tool to screen children for developmental delays. 5) At -risk — Participants who have factors in their lives that predispose them to risk for adverse outcomes. 6) Attempt to Contact —The work efforts related to tryingto contact a Healthy Start referred participant. Attempts to contact can include phone calls, letters, and face-to-face attempts. 7) Broadcast— Video, audio, text, or email messages transmitted through an internet, cellular. or wireless network for display on any device. 8) Business Dav— Monday through Friday, except holidays observed by regular State of Florida employees. Timeframes requiring completion within a number of business days shall mean by 5:00 p.m. local time on the last business day. 9) Calendar Da —The consecutive days of a month, including weekends and holidays. 10) Care Coordination —The coordination, facilitation and provision of care services, as defined under the process referenced in Section 383.011, Florida Statutes and the Healthy Start Standards and Guidelines, that are identified through screening and assessment that is aimed at helping families receive the appropriate interventions and reducing Healthy Start participant risk and maximizing outcome. 11) CFR —Code of Federal Regulations. 12) Community Health Assessment Resource Tool Set (CHARTS) — One -Stop site for Florida Public Health Statistics and community health data. This site also provides Florida's Healthy Start Coalitions with on-line access to Prenatal and Risk Screenings, Interconception care, substance use, care coordination, and wraparound service reports along with other Florida health dat. 13) Child — A child from their first birthday (age 1) up until their P birthday. 14) Community Development Activities —Activities that increase awareness of the program, increase participant rates, screening rates and/or promote improved birth outcomes for pregnant women and infants. Activities include but are not limited to: health fairs; community presentations. Interagency network meetings, committee meetings; Services Delivery Plans; baby showers; board and coalition development, community service projects; social media efforts; and partnership development efforts. 15) Community Family Planning Services — Resources and services available within a community to support a woman's reproductive life course and services provided under Title X. 16) Community Resources — Supportive opportunities and services provided by others in the community that may complement or overlap those provided by Healthy Start. Examples include prenatal and primary care providers, postpartum home visitors, teen pregnancy programs, substance abuse treatment providers, religious organizations, and neighborhood and community centers. 17) Complaint — Any oral or written expression of dissatisfaction by a recipient or provider that relates to the quality of services provided pursuant to this Contract. Possible subjects for complaints include, but are not limited to, the quality of care, the services provided, aspects of interpersonal relationships such as rudeness of a staff member, failure to respect the recipient's rights, or provisions of services that relate to the quality of care rendered by a provider pursuant to the provider's Healthy Start Agreement. A complaint is a subcomponent of the grievance and appeal system. A complaint is not considered a grievance until the written complaint is received by the Coalition. 18) Coordinated Intake and Referral (CI&R)— A community -based program that provides intakes for pregnant women, infants/children, and ICC women and refers them to local maternal and child health home visiting programs based on risks and needs. 19) Deliverable —The tangible work product resulting from this contract which is to be described and provided to the contract manager in the form and manner at the time requested by this contract. 20) DOH — Florida Department of Health. Page 158 Florida Keys Healthy Start Coalition Inc. Contract #: HS-2022-2023 21) Direct Service — Per Chapter 64F-2.001(4), Florida Administrative Code, the professional and paraprofessional activities that entail a cost in time and effort spent in personal contact with participants of prenatal and infant health services. Such activities include, but are not limited to, routine prenatal care, health and social services, case management of participants, and outreach to specific individuals. 22) Edinburgh Postnatal Depression Scale— A screening tool to assist in identifying possible symptoms of depression in women. 23) Encounter —A direct service encounter is unduplicated by date of service. For example, if a client has a home visit and a phone call on the same day, it is considered one encounter. A direct service encounter is direct contact with a participant's provider via the telephone or face to face. 24) Enrollee — A woman, infant, or child that is enrolled in Medicaid and qualifies for the Healthy Start Coordinated Care System for Pregnant Women and Infants services. 25) Executive Summary Report (ESR) — Monthly Healthy Start service report from the Department's data system, compiled by the Office of Planning, Evaluation and Data Analysis, that summarizes data from birth records, Healthy Start screening, and services report data sets. 26) Face -to -Face Contact — Interaction that occurs in person with the enrollee. 27) Fetal and Infant Mortality Review (FIMR) — Information is abstracted and compiles on fetal and infant deaths in local communities that receive funding by DOH to do so. FKHSC has a FIMR program that reviews up to nine (9) Monroe County fetal and infant death cases per year. 28) FIMR Case Team Review (CRT) Team — This team meets monthly to discuss three cases that are abstracted and presented by the FIMR staff. This Team looks at strengths and barriers for each case presented and suggests recommendations for local community actions that may help to decrease infant and fetal deaths. 29) FIMR Community Action Team (FIMR CAT) — This team meet quarterly to put recommendations from the FIMR CRT team into community actions. 30) Family Planning Waiver — The Family Planning Waiver (FPW) Program provides family planning and family planning -related services to eligible women ages 14 through 55. Eligibility is limited to women with family incomes at or below 191 percent of the Federal Poverty level, who lose Medicaid pregnancy coverage after 60 days postpartum, or women who have lost Medicaid coverage for reasons other than the expiration of the 60-day postpartum period. Women enrolled in the program are eligible for up to 24 months for Family Planning Waiver services. 31) Family Support Plan (FSP) — The purpose of the Family Support Plan is to involve participants/families in activities that may reduce their identified risk factors and may improve birth outcomes and child health and development outcomes. A FSP is not a plan of care. It is a participant -centered plan that help participants/families to create their own goals. 32) Fatherhood Engagement Activities — Individualized services provided to fathers that aim to increase participation in home -visiting services and strengthen family and child well-being. A father includes any father figure with an active role within the family unit of an enrolled pregnant woman, infant, and/or child. 33) Follow-up — Communication with the participant, either by phone, in person, or by letter. 34) Financial Consequence —As required pursuant to Section 287.058, Florida Statutes, if Provider fails to perform in accordance with the contract. 35) Grievance — A written complaint submitted by or on behalf of an enrollee or provider to the Coalition, DOH, AHCA, or the HSMN pertaining to the availability, coverage, delivery, or quality of services provided pursuant to this Contract. Grievances are of a more serious nature and generally require investigation into allegations regarding the quality of care and a complaint. 36) Health Equity —The concept that everyone should have a fair opportunity to attain their full health potential, regardless of their social, economic, demographic, or geographic background, and that no one should be disadvantaged from achieving that potential. 37) Health Management System (HMS) —The Department of Health's data system that compiles prenatal risk screens data as entered by county health department staff. 38) Healthy Families Florida (Monroe) — Healthy Families Florida is a community -based, voluntary home visiting program designed to enable children to grow up healthy, safe, and nurtured. The program promotes positive parenting and healthy child development, thereby preventing abuse and other poor childhood outcomes. 39) Healthy Start —A comprehensive maternal and infant health care program, established by the Department, that provides education and Page 159 Florida Keys Healthy Start Coalition Inc. Contract #: HS-2022-2023 referrals to pregnant women, women with children under the age of three years, women who have had a recent loss (miscarriage, stillbirth, infant death), and women who have recently had an infant placed out of the home by adoption or removal by the Department of Children and Families. 40) Healthy Start Coalition —An organization or a group of individuals who have demonstrated their interest in forming a community prenatal and infant health Coalition, have completed the establishment process per Rule 64F-2.003 and have been approved by the Department of Health as a Healthy Start Coalition to provide universal risk screening, risk appropriate care coordination and other interventions to all pregnant women and newborn infants in Florida in accordance with a federal waiver and pursuant to Section 409.906, F. S. In the event that a Coalition is not established in a county, by section 383.216, F.S., the management of the Healthy Start Program is carried out by the local county health department. For the purposes of this Contract, the term "Coalition" includes the county health department when the county health department is acting in the role of the Coalition. Also referred to as "Coalition", means an alliance of private and public individuals or groups organized, consistent with Section 383.216, Florida Statutes, to assess needs, prepare plans, build community support, and ensure services are available to promote and protect the health and well-being of pregnant women, Interconceptional women and children from birth to age three. 41) Healthy Start MomCare Network (HSMN) - For the purposes of this Agreement, HSMN is the ASO that represents all Healthy Start Coalitions to assure services are provided in accordance with Medicaid waiver and state law requirements. 42) Healthy Start Standards and Guidelines — Document that creates standards, criteria and guidelines for implementation of Healthy Start services and use of Healthy Start funds. 43) Healthy Start Universal Prenatal and Infant Screens— Statutorily mandated screening of all of Florida's pregnant women and newborn infants to help identify those at risk for poor birth outcome, health, or developmental outcomes. 44) HITECH Act — Legislation that addresses the privacy and security concerns associated with the electronic transmission of health information, in part, through several provisions that strengthen the civil and criminal enforcement of the HIPAA rules 45) Home Visitation Advisory Committee —A group of at least one representative from each participating home visiting agency, Healthy Start Care Coordination staff and Healthy Start Coalition staff. 46) Individualized Plan of Care (IPC) —A written statement in a participant's chart initiated at the initial assessment that states the interventions needed based on risks and needs and the plan of action to be pursued. The ICP evaluated and updated at each subsequent encounter. 47) Infant — Newborn up until their 11T birthday. 48) Initial Assessment — A face-to-face assessment of enrollee's risks and service needs. This assessment is completed by a face-to-face evaluation in collaboration with the enrollee and family if appropriate. This face-to-face assessment is usually done after the Initial Contact. 49) Initial Intake —The legislatively mandated point -of -entry into Healthy Start care coordination. Verbal communication, either by telephone or face-to-face, that initiates the Healthy Start program process. 50) Interconception Care and Counseling (ICC) — ICC services provide comprehensive information and education for up to 12 months after delivery related to the optimal health status needed by any woman of reproductive age to improve the birth outcome of a potential subsequent pregnancy. ICC is a set of interventions that aim to identify and modify biomedical, behavioral, and social risks to a women's health or pregnancy outcome through prevention and management. 51) Interconception Care Curriculum — Health based curriculum that includes information on women's health topic that may influence outcomes of a woman's future pregnancies. 52) Interconception Woman —A woman who has previously been pregnant and is capable of becoming pregnant in the future who has risk factors that may lead to a poor pregnancy outcome and is also a Healthy Start prenatal client; a mother who is being provided services on behalf of her Healthy Start infant, or any non -pregnant woman who had a pregnancy and has risk factors that may lead to a poor subsequent pregnancy outcome. 53) Internal Quality Assurance (IQA) —A systematic approach to continuously assess and improve the overall quality of a program or service by identifying positive and negative program processes, services, and outcomes. IQA is facilitated through measurement and analysis of performance measures and contract deliverables. Periodic measurement and evaluation of program outcomes provide assurance that program practices are consistent with contractually established standards, guidelines, and procedures. The ongoing monitoring of services, outcomes and processes impacting service delivery are key factors are achieving quality maintenance and quality improvement. Page 160 Florida Keys Healthy Start Coalition Inc. Contract #: HS-2022-2023 54) Learning Management System (LMS) — Online training portal administered by MIECHV to track professional development for home visiting workforce. 55) Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) —A program that gives pregnant women and families, particularly those considered at -risk, necessary resources and skills to raise children who are physically, socially, and emotionally healthy and ready to learn. 56) Medicaid —The medical assistance program authorized by Title XIX of the Social Security Act, 42U.S.C.S.1936, and administered in Florida by the Agency for Health Care Administration. 57) Medicaid Enrollee — A pregnant woman, infant or child who is enrolled in Medicaid. 58) Memorandum of Agreement (MOA) — An agreement between the Provider and another provider of Healthy Start services, such as psychosocial counseling or data entry, that contains: purpose or goal; agencies involved; roles and responsibilities; requirements; procedures; interagency dispute process; time period covered; and signatures and date. 59) Motivational Interviewing — A goal -directed, client -centered counseling style to elicit behavioral change by helping clients to explore and reduce ambivalence. The approach has been scientifically proven effective across a variety of clients and for a variety of issues, including substance abuse, health promotion, medical treatment adherence, and mental health issues. 60) Outreach — A systematic, family -centered, community -based activity that promotes improved pregnancies and infant health outcomes through public awareness, education and access to services. This includes participant identification and education, provider recruitment and retention, and community education. All these efforts are designed to increase participant, provider and community awareness in an effort to link pregnant women and infants to needed services, and/or make these services more accessible. 61) Participant — Pregnant women, interconceptional care women, fathers and infants/children from birth up until their 3rd birthday who have been referred for Healthy Start services. If a participant is an infant/child, the term "participant" includes their parent(s) or guardian(s). This term is interchangeable with the term "client." 62) Partners for a Healthy Baby —A research -based and practiced -informed curriculum developed by the Florida State University Center for Prevention and Early Intervention Policy used to strengthen home visiting models and improve birth outcomes, reduce rates of child abuse, increase intervals between pregnancies, strengthen families, enhance child health outcomes, and support maternal self- sufficiency. 63) Protected Health Information — For purposes of this Agreement, protected health information shall have the same meaning and effect as defined in 45 CFR and 164, limited to the information created, received, maintained or transmitted by the Provider from, or on behalf of AHCA, DOH, HSMN, or the Coalition. 64) Quality Assurance/Quality Improvement (QA/QI) — The continuous process for internal and external evaluation and reporting on the structure, process and outcome of the prenatal and infant health care delivery network. The process evaluates the extent to which Providers are in compliance with pre -established standards, and includes corrective action planning and implementation aimed at services not meeting standards. 65) Quarter —A three-month period of the contract. The quarters for this contract are July through September (first quarter); October through December (second quarter); January through March (third quarter); and April through June (fourth quarter) 66) Record Review —A process of determining the quality assurance and improvement by reviewing Healthy Start participant records. 67) Referral —A written form provided to the client or directly to a community agency to assist a participant in receiving a service from a community agency. 68) Risk Appropriate Care — The provision of supports and services that directly address identified risk factors that participants or families are unable to solve without assistance. The concept of risk appropriate care implies that if the family is capable of solving the risk without external intervention, then resources will not be used with that family but rather will be targeted to those most at need. 69) Risk Screening — Healthy Start risk screening is the collection of information on the designated prenatal and infant screening forms. The forms are scored to assess risk and identify those women and infants most vulnerable of experiencing adverse health outcomes. Screening differs from assessment in that screening only identifies those most likely to be at increased risk; an assessment is necessary to determine service needs. 70) SCRIPT (Smoking Cessation Reduction in Pregnancy Treatment) —The Healthy Start Program core service component for smoking cessation in accordance with Chapter 10 of the Healthy Start Standard and Guidelines. Providers must offer the SCRIPT program to all pregnant women and mothers who smoke. The SCRIPT program requires a mandatory training. If a woman decline the program, or if the caregiver who smokes is not the mother, they must be referred to the Tobacco Free Florida's Quitline and website. Both programs Page 161 Florida Keys Healthy Start Coalition Inc. Contract #: HS-2022-2023 are evidence -based. 71) Service Delivery Plan —The coalition -written document, adopted by the Board and members and approved by DOH, in addition to the Healthy Start program core set of outcomes and performance measures, establishes outcome and process objectives using an Assessment Protocol for Excellence in Public Health (APEX/PH) or other approved needs assessment model. Priority service needs, priority target groups and programmatic strategies for the Coalition's service area are also developed. The Service Delivery Plan describes the community network that will ensure early and continuous prenatal, infant and child health care for all persons in need in the service area. The first Service Delivery Plan is submitted at the inception of the coalition being approved by DOH and is updated at intervals determined by DOH. 72) Social Determinants of Health — Factors in the social, economic, and physical environment that influence health, including housing, employment, education, transportation, poverty, racism, and toxic stress. 73) Tracking — Those activities related to following up on referrals or the receipt of other services to determine whether Healthy Start participants are able to access or continue participation in services. 74) Unexpended Funds — Funds earned from the previous contract year that were not expended. 75) Unit —Time spent providing services to a participant during a visit and follow up activities generated from that encounter or attempted encounter. 76) Universal Prenatal and Infant Screening — The use of selected risk factors to identify pregnant women and infants who are at increased risk for mortality and morbidity, birth complications or adverse outcomes as designated in accordance with Florida Administrative Code, Section 64C-7.011. 77) Well Family System — The Florida Association of Healthy Start Coalitions data system developed to enhance the service delivery, reporting and evaluation of the Florida Healthy Start Program. 78) Wraparound Services —The services provided to participants that maximize access to and participation in comprehensive prenatal and child health care such as participant identification, childbirth education, parenting education and support, nutritional counseling and support, psychosocial counseling, smoking cessation counseling, breastfeeding education and support, home visiting, ICC, and other services that optimize outcomes. 79) Other definitions of terms used in this contract are as set forth in Chapters 64F-2 and 64F-3, F.A.C. and the Healthy Start Standards and Guidelines that are hereby incorporated by reference. If any changes are made to these documents during the year, the contracted Provider agrees to abide by these changes, after notice of such changes and a reasonable time to comply is provided by the Coalition, or such changes are adopted or incorporated by reference in the rules of the Coalition. Page 162 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 ATTACHMENT XI Financial and Compliance Audit AUDIT REQUIREMENTS FOR AWARDS OF STATE AND FEDERAL FINANCIAL ASSISTANCE The administration of resources awarded by the Department of Health to recipient organization may be federal or state financial assistance as defined by 2 CFR § 200.40 and/or section 215.97, Florida Statutes, and may be subject to audits and/or monitoring by the Department of Health, as described in this section. For this agreement, the Department of Health has determined the following relationship exist: Vendor/Contractor (215.97(z), F.S.) and (2 CFR § 200.23). Funds used for goods and services for the Department of Health's own use and creates a procurement relationship with Recipient which is not subject to single audit act compliance requirements for the Federal/State program as a result of this contract agreement. A vendor/contractor agreement may a Iso be used with an established Service Organization (SO) that is serving as a Third- Party Administrator and in this case, is subject to SSAE18 audit reporting requirements (see Part III. Other Audit Requirements). 2. X Recipient/Subrecipient of state financial assistance (215.97(o)(y), F.S.). Funds may be expended only for allowable costs resulting from obligations incurred during the specified contract period. In addition, any balance of unobligated funds which has been advanced or paid must be refunded to the Department of Health as the state awarding agency. As well as funds paid in excess of the amount to which the recipient/subrecipient is entitled under the terms and conditions of the contract must be refunded to the Department of Health. Recipient/Subrecipient of federal financial assistance (2 CFR § 200.40) . Funds paid in excess of the amount to which the recipient/subrecipient is entitled under the terms and conditions of the contract must be refunded to the Department of Health as the Pass -Through state awarding agency. In addition, the recipient/subrecipient may not earn or keep any profit resulting from Federal financial assistance, unless explicitly authorized by the terms and conditions of the Federal award or this agreement. Note: A vendor/contractor vs. recipient/subrecipient determination must conclude with the completion of Exhibit 2 to identify the recipient's audit's relationship with the department. MONITORING In addition to reviews of audits conducted in accordance with 2 CFR Part 200, Subpart F (formerly A-133) - Audit Requirements, and section 215.97, Florida Statutes (F.S.), as revised (see AUDITS below), monitoring procedures may include, but not be limited to, on -site visits by Department of Health staff, limited scope audits as defined by 2 CFR §200.425, or other procedures. By entering into this agreement, the recipient agrees to comply and cooperate with any monitoring procedures or processes deemed appropriate by the Department of Health. In the event the Department of Health determines that a limited scope audit of the recipient is appropriate, the recipient agrees to comply with any additional instructions provided by Department of Health staff to the recipient regarding such audit. The recipient further agrees to comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Chief Financial Officer (CFO) or Auditor General. Page 1 63 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 AUDIT GUIDANCE PART I: FEDERALLY FUNDED This part is applicable if Recipient is a State or local government or a non-profit organization as defined in 2 CFR §200.90, §200.64, and §200.70. If a recipient expends $750,000 or more in Federal awards during its fiscal year, the recipient must have a single or program - specific audit conducted in accordance with the provisions of 2 CFR 200, Subpart F - Audit Requirements. EXHIBIT 1 to this form lists the federal resources awarded through the Department of Health by this agreement. In determining the federal awards expended in its fiscal year, the recipient shall consider all sources of federal awards, including federal resources received from the Department of Health. The determination of amounts of federal awards expended should be in accordance with the guidelines established in 2 CFR §§200.502-503. An audit of the recipient conducted by the Auditor General in accordance with the provisions of 2 CFR §200.514 will meet the requirements of this Part. In connection with the audit requirements addressed in Part I, paragraph 1, Recipient shall fulfill the requirements relative to auditee responsibilities as provided in 2 CFR §§ 200.508-.512. If a recipient expends less than $750,000 in Federal awards in its fiscal year, the recipient is not required to have an audit conducted in accordance with the provisions of 2 CFR 200, Subpart F - Audit Requirements. If the recipient expends less than $750,000 in federal awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of 2 CFR 200, Subpart F - Audit Requirements, the cost of the audit must be paid from non-federal resources (i.e., the cost of such an audit must be paid from recipient resources obtained from other than federal entities). Note: Audits conducted in accordance with this part shall cover the entire organization for the organization's fiscal year. Compliance findings related to contracts with the Department of Health shall be based on the contract agreement's requirements, including any rules, regulations, or statutes referenced in the contract. The financial statements shall disclose whether the matching requirement was met for each applicable contract. All questioned costs and liabilities due to the Department of Health shall be fully disclosed in the audit report with reference to the Department of Health contract involved. If not otherwise disclosed as required by 2 CFR § 200.510, the schedule of expenditures of Federal awards shall identify expenditures by funding source and contract number for each contract with the Department of Health in effect during the audit period. Financial reporting packages required under this part must be submitted within the earlier of 30 days after receipt of the audit report or 9 months after the end of Recipient's fiscal year end. Page 164 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 PART II: STATE FUNDED This part is applicable if the recipient is a nonstate entity as defined by section 215.97(1)(n), Florida Statutes. If a recipient expends a total amount of state financial assistance equal to or in excess of $750,000 in any fiscal year of such recipient (for fiscal years ending June 30, 2017 or thereafter), recipient must have a State single or project- specific audit for such fiscal year in accordance with section 215.97, Florida Statutes; applicable rules of the Department of Financial Services; Chapter 10.550 (local governmental entities) or Chapter 10.650 (nonprofit and for -profit organizations), Rules of the Auditor General. EXHIBIT I to this contract indicates state financial assistance awarded through the Department of Health by this contract. In determining the state financial assistance expended in its fiscal year, recipient shall consider all sources of state financial assistance, including state financial assistance received from the Department of Health, other state agencies, and other nonstate entities. State financial assistance does not include Federal direct or pass - through awards and resources received by a nonstate entity for Federal program matching requirements. In connection with the audit requirements addressed in Part 11, paragraph 1, recipient shall ensure that the audit complies with the requirements of section 215.97(8), Florida Statutes. This includes submission of a financial reporting package as defined by section 215.97(2), Florida Statutes, and Chapter 10.550 (local governmental entities) or Chapter 10.650 (nonprofit and for -profit organizations), Rules of the Auditor General. If a recipient expends less than $750,000 in state financial assistance in its fiscal year (for fiscal years ending June 30, 2017 or thereafter), an audit conducted in accordance with the provisions of section 215.97, Florida Statutes, is not required. In the event that a recipient expends less than $750,000 in state financial assistance in its fiscal year and elects to have an audit conducted in accordance with the provisions of section 215.97, Florida Statutes, the cost of the audit must be paid from the nonstate entity's resources (i.e., the cost of such an audit must be paid from recipient resources obtained from other than state funds). Note: An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year. Compliance findings related to contracts with the Department of Health shall be based on the contract's requirements, including any applicable rules, regulations, or statutes. The financial statements shall disclose whether the matching requirement was met for each applicable contract. All questioned costs and liabilities due to the Department of Health shall be fully disclosed in the audit report with reference to the Department of Health contract involved. If not otherwise disclosed as required by Florida Administrative Code Rule 691-5.003, the schedule of expenditures of state financial assistance shall identify expenditures by contract number for each contract with the Department of Health in effect during the audit period. Financial reporting packages required under this part must be submitted within 45 days after delivery of the audit report, but no later than 9 months after recipient's fiscal year end for local governmental entities. Non-profit or for -profit organizations are required to be submitted within 45 days after delivery of the audit report, but no later than 9 months after recipient's fiscal year end. Notwithstanding the applicability of this portion, the Department of Health retains all right and obligation to monitor and oversee the performance of this contract as outlined throughout this document and pursuant to law. Page 1 65 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 PART III: OTHER AUDIT REQUIREMENTS This part is applicable to a contractor, vendor and/or provider organization serving as a third -party administrator on behalf of FDOH programs and is classified or determined in the FDOH contract agreement to be a Service Organization (SO). If the contracted entity is determined to be a Service Organization (SO), the entity must perform an attestation to the Service Organization Controls (SOC) and submit to FDOH a "Statement on Standards for Attestation Engagements (SSAE18) audit report within the assigned timeframe as agreed upon in the SO's contract agreement. The hired Auditor must make an evaluation consistent with the FDOH contract terms and conditions to determine which SSAE18 report types to perform for the required SOC types. Below are the options availablefor the SSAE18 reports; TYPES: SOC 1 — A report on controls over financial reporting. ➢ Type 1 Report - Report on the fairness of the presentation of management's description of the service organization's system and the suitability of the design of the controls to achieve the related control objectives included in the description as of a specified date. ➢ Type 2 Report - Report on the fairness of the presentation of management's description of the service organization's system and the suitability of the design and operating effectiveness of the controls to achieve the related control objectives included in the description throughout a specified period. (Auditor conducts testing) SOC 2 — A report on controls that may be relevant to security, availability, processing Integrity, confidentiality or privacy. These reports are intended to meet the needs of a broad range of users that need detailed information and assurance about the controls at a service organization relevant to security, availability, and processing integrity of the systems the service organization uses to process users' data and the confidentiality and privacy of the information processed by these systems. These reports can play an important role in: • Oversight of the organization • Vendor management programs • Internal corporate governance and risk management processes • Regulatory oversight Y Type 1 Report - Report on the fairness of the presentation of management's description of the service organization's system and the suitability of the design of the controls to achieve the related control objectives included in the description as of a specified date. Type 2 Report - Report on the fairness of the presentation of management's description of the service organization's system and the suitability of the design and operating effectiveness of the controls to achieve the related control objectives included in the description throughout a specified period. (Auditor conducts testing) Page 166 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 PART IV: REPORT SUBMISSION 1. Copies of single audit reporting packages for state financial assistance (CSFA) and federal financial assistance (CFDA) conducted in accordance with 2 CFR § 200.512 and section 215.97(2), Florida Statutes, shall be submitted by or on behalf of recipient directly to: A. The Department of Health as follows: SingleAUdlts@flhealth.gov Pursuant to 2 CFR § 200.521, and section 215.97(2), Florida Statutes, recipient shall submit an electronic copy of the reporting package and any management letter issued bythe auditor to the Department of Health. Audits must be submitted in accordance with the instructions set forth in Exhibit 3 hereto and accompanied bythe "Single Audit Data Collection Form, Exhibit 4." Files which exceed electronic email capacity may be submitted on a CD or other electronic storage medium and mailed to: Florida Department of Health Bureau of Finance & Accounting Attention: FCAM, Single Audit Review 4052 Bald Cypress Way, Bin B01 Tallahassee, FL 32399-1701. B. The Auditor General's Office as follows: One electronic copy email by or on behalf of recipient directly to the Auditor General's Office at: flaudgen localgovt@aud.state.fl.us. One paper copy mail to: Auditor General's Office Claude Pepper Building, Room 401 111 West Madison Street Tallahassee, Florida 32399-1450 2. In addition to item 1, electronic copies of reporting packages for federal financial assistance (CFDA) conducted in accordance with 2 CFR § 200.512 shall also be submitted by or on behalf of recipient directly to each of the following: A. The Federal Audit Clearinghouse (FAC), the Internet Data Entry System (IDES) is the place to submit the Federal single audit reporting package, including form SF -SAC, for Federal programs. Single audit submission is required under the Single Audit Act of 1984 (amended in 1996) and 2 CFR § 200.36 and § 200.512. The Federal Audit Clearinghouse requires electronic submissions as the only accepted method for report compliances. FAC's website address is: https://harvester.census.gov/facweb/ B. When applicable, other Federal agencies and pass -through entities in accordance with 2 CFR §200.331 and § 200.517. 3. Copies of SSAE18 reports and supporting documents shall be submitted by or on behalf of SO/Third Party Administrator directlyto the FDOH designated Contract Manager (CM) as outlined in each SO contract agreement. Note: Any reports, management letter, or other information required to be submitted to the Department of Health pursuant to this contract shall be submitted timely in accordance with 2 CFR § 200.512 and Florida Statutes, Chapter 10.550 (local governmental entities) or Chapter 10.650 (nonprofit and for -profit organizations), Rules of the Auditor General, as applicable. Recipients, when submitting financial reporting packages to the Department of Health for audits done in accordance with 2 CFR § 500.512 or Chapter 10.550 (local governmental entities) or Chapter 10.650 (nonprofit and for -profit organizations), Rules of the Page 167 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 Auditor General, should indicate the date that the reporting package was delivered to recipient in correspondence accompanying the reporting package. PART V: RECORD RETENTION Recipient shall retain sufficient records demonstrating its compliance with the terms of this contract for a period of six years from the date the audit report is issued and shall allow the Department of Health or its designee, the CFO, or the Auditor General access to such records upon request. Recipient shall ensure that audit working papers are made available to the Department of Health, or its designee, CFO, or Auditor General upon request for a period of six years from the date the audit report is issued, unless extended in writing by the Department of Health. End of Text Page 168 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 EXHIBIT 1 Contract #: HS-2022-2023 FederalAward Identification #: B04MC33830 (Maternal and Child Health Block Grant) 1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: Federal Agency 1 HRSA (Health Resources and Services Admin, Dept of HHS) CFDA# 93.994 Title Title V $ 33,186.60 Federal Agency 1 HRSA— State Match CFDA# 93.994 Title Title V $ 127,913.40 TOTAL FEDERAL AWARDS $ 161,100.00 COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS: 2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: State financial assistance subject to section 215.97, Florida Statutes: CSFA# Titl State financial assistance subject to section 215.97, Florida Statutes: CSFA# Titl TOTAL STATE FINANCIAL ASSISTANCE AWARDED PURSUANT TO SECTION 215.97, FLORIDA STATUTES COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANTTO THIS AGREEMENT ARE AS FOLLOWS: Financial assistance not subject (exempt) to section 215.97, Florida Statutes or 2 CFR § 200.40: $ Financial assistance not subject (exempt) to section 215.97, Florida Statutes or 2 CFR § 200.40: $ Matching and Maintenance of Effort Matching resources for federal Agency(s): Agency: HRSA-HHS CFDA# 93.994 Title Title V-State Match $ 127,913.40 Maintenance of Effort (MOE): Agency: CFDA# Title $ *Matching Resources, MOE, and Financial Assistance not subject to section 215.97, Florida Statutes or 2 CFR § 200.306 amounts should not be included by recipient when computingthe threshold for s ingle audit requirements totals. However, these amounts could be included under notes in the financial audit or footnoted in the Schedule of Expenditures of Federal Awards and State Financial Assistance (SEFA). Matching, MOE, and Financial Assistance not subject to section. 215.97, Florida Statutes or 2 CFR § 200.306 is not considered State or Federal Assistance. Page 1 69 Florida Keys Healthy Start Coalition, Inc. EXHIBIT 2 Contract #: HS-2022-2023 Recipients who receive state or federal resources may or may not be subject to the audit requirements of 2 CFR § 200.500, and/or section 215.97, Florida Statutes, recipients who are determined to be recipients or subrecipients of federal awards and/or state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I and/or Part II of Exhibit 1 is met. Recipients who have been determined to be vendors are not subject to the audit requirements of 2 CFR § 200.501, and/or section 215.97, Florida Statutes. Recipients who are "higher education entities" as defined in Section 215.97(2)(h), Florida Statutes, and are recipients or subrecipients of state financial assistance, are also exempt from the audit requirements of Section 215.97(2)(a), Florida Statutes. Regardless of whether the audit requirements are met, recipients who have been determined to be recipients or subrecipients of Federal awards and/or state financial assistance must comply with applicable programmatic and fiscal compliance requirements. For the purpose of single audit compliance requirements, the Recipient has been determined to be: Vendor/Contractor not subject to 2 CFR § 200.501 and/or section 215.97, Florida Statutes X Recipient/subrecipient subject to 2 CFR § 200.501 and/or section 215.97, Florida Statutes Exempt organization not subject to 2 CFR § 200.501; For Federal awards for -profit subrecipient organizations are exempt as specified in 2 CFR § 200.501(h). Exempt organization not subject to section 215.97, Florida Statutes, for state financial assistance projects, public universities, community colleges, district school boards, branches of state (Florida) government, and charter schools are exempt. Exempt organizations mustcomplywith all compliance requirements set forth within the contract. For other audit requirements, the Recipient has been determined to be: Service Organization (SO) subject to SSAE18 reporting requirements NOTE: If a recipient is determined to be a recipient/subrecipient of federal and or state financial assistance and has been approved by the department to subcontract, it must comply with section 215.97(7), Florida Statutes, and Florida Administrative Code Rule 691- .5006, [state financial assistance] and 2 CFR § 200.330 [federal awards]. PART II: FISCAL COMPLIANCE REQUIREMENTS FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Recipients who receive Federal awards, state maintenance of effort funds, or state matching funds on Federal awards and who are determined to be a subrecipient must comply with the following fiscal laws, rules and regulations: 1. 2 CFR Part 200- Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards 2. Reference Guide for State Expenditures 3. Other fiscal requirements set forth in program laws, rules, and regulations *Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in the 2 CFR § 200.401(5) (c). **For funding passed through U.S. Health and Human Services, 45 CFR Pa rt 92; for funding passed through U.S. Department of Education, 34 CFR Pa rt 80. STATE FINANCIAL ASSISTANCE. Recipients who receive state financial assistance and who are determined to be a recipient/subrecipient must comply with the following fiscal laws, rules and regulations: 1. Section 215.97, Florida Statutes 2. Florida Administrative Code Chapter 691-5, 3. State Projects Compliance Supplement 4. Reference Guide for State Expenditures 5. Other fiscal requirements set forth in program laws, rules and regulations This document may be obtained online through the FLHealth website under Audit Guidance. *Enumeration of laws, rules and regulations herein is not exhaustive or exclusive. Funding to recipients will be held to applicable legal requirements whether or not outlined herein. Page 170 Florida Keys Healthy Start Coalition, Inc. EXHIBIT 3 Contract #: HS-2022-2023 INSTRUCTIONS FOR ELECTRONIC SUBMISSION OF SINGLE AUDIT REPORTS Part I: Submission to FDOH Single Audit reporting packages ("SARP") must be submitted to the Department in an electronic format. This change will eliminate the need to submit multiple copies ofthe reporting package to the Contract Managers and various sections within the Department and will result in efficiencies and cost savings to recipient and the Department. Upon receipt, the SARP's will be posted to a secure server and accessible to Department staff. The electronic copy of the SARP should: ➢ Be in a Portable Document Format (PDF). Include the appropriate letterhead and signatures in the reports and management letters. Be a single document. However, if the financial audit is issued separately from the Single Audit reports, the financial audit reporting package may be submitted as a single document and the Single Audit reports may be submitted as a s ingle document. Documents which exceed 8 megabytes (MB) may be stored on a CD and mailed to: Bureau of Finance & Accounting, Attention: FCAM, Single Audit Review, 4052 Bald Cypress Way, Bin B01 (HAFA), Tallahassee, FL 32399- 1701. ➢ Be an exact copy of the final, signed SARP provided bythe Independent Audit firm. Not have security settings applied to the electronic file ➢ Be named using the following convention: [fiscal year] [name of the audited entity exactly as stated within the audit report].pdf. For example, if the SARP is for the 2016-17 fiscal year for the City of Gainesville, the document should be entitled 2016 City of Gainesville.pdf Be accompanied by the attached "Single Audit Data Collection Form." This document is necessary to ensure that communications related to SARP issues are directed to the appropriate individual(s) and that compliance with Single Audit requirements is properly captured. Questions regarding electronic submissions may be submitted via e-mail to SingleAudits@flhealth.gov or by telephone to the Single Audit Review Section at (850) 245-4185. Part II: Submission to Federal Audit Clearinghouse Click Here for instructions and guidance to submit the completed SF -SAC report to the Federal Audit Clearinghouse website or click Here to access the SF -SAC Worksheet & Single Audit Component Checklist Form. Part III: Submission to Florida Auditor General Click Here for questions and other instructions for submitting Single SAC reports to the State of Florida, Auditor General's Office Page 171 Single Audit Data Collection Form Part 1: GENERAL INFORMATION 1. Fiscal period ending date for the Single Audit. 2. Auditee Identification Number a. Primary Employer Identification Number (EIN) Month Day Year 3. ADDITIONAL ENTITIES COVERED IN THIS REPORT Employer Identification # 4. AUDITEE INFORMATION a. Auditee name: Auditee Primary DUNS#: b. Auditee address (number and street) City State Zip Code c. Auditee contact Name: Title: d. Auditee contact telephone 1 1 - e. Auditee contact FAX 1 1 - f. Auditee contact E-mail 6. AUDITEE CERTIFICATION STATEMENT —This is to certify that, to the best of my knowledge and belief, the auditee has: (1) engaged an auditor to perform an audit in accordance with the provisions of 2 CFR § 200. 512 and/or section 215.97, Florida Statutes, for the period described in Item 1; (2) the auditor has completed such audit and presented a signed audit report which states that the audit was conducted in accordance with the aforementioned Circular and/or Statute; (3) the attached audit is a true and accurate copy of the final audit report issued by the auditor for the period described in Item 1; and (4) the information included in this data collection form is accurate and complete. I declare the foregoing is true and correct. b. Are multiple EINs covered in this report OYes ONo c. If "yes", complete No. 3. Name of Entity 5. PRIMARY AUDITOR INFORMATION a. Primary auditor name: b. Primary auditor address (number and street) City State Zip Code c. Primary auditor contact Name: Title: d. Primary auditor contact telephone 1 1 - e. . Primary auditor E- mail () - f. Audit Firm License Number AUDITEE CERTIFICATION Date��, Date Audit Received from Auditor: /...... Name of Certifying Official: (Please print clearly) Title of Certifying Official: (Please print clearly) Signature of Certifying Official: Page 172 Florida Keys Healthy Start Coalition, Inc. Contract #: HS-2022-2023 N/A TOTAL AWARD ATTACHMENT XII HEALTHY START MOMCARE NETWORK EXHIBIT FLORIDA DEPARTMENT OF HEALTH IN MONROE COUNTY, 2022-2023 FY FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: Federal Program 497 Department of Health and Human Services CFDA#: 93.778 Medicaid Assistance Payments $59,376.00 STATE FUNDS AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING MATCHING FUNDS FOR FEDERAL PROGRAMS: Federal Program 497 Department of Health and Human Services CFDA#: 93.778 Medicaid Assistance Payments $36,624.00 STATE FUNDS AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING FUNDS SUBJECT TO SECTION 215.97 F.S.: 0.00 $96,000.00 Page 173 FLORIDA KEYS HEALTHY START COALITION, INC. FLORIDA DEPARTMENT OF HEALTH - MONROE COUNTY CONTRACT RENEWAL #003 ORIGINAL CONTRACT HS 2022-2023 THIS RENEWAL is entered into between the Florida Keys Healthy Start Coalition, Inc., hereinafter referred to as the 'CoaUbon" and the Monvoe County s4ealkh Department, hereinafter referred to as the Provider..' As provided in Attachment 1 of Contract HS 2022-2023, the Coalition is exercising its option to renew this contract if mutually agreed to by both parties beginning July 1, 2025, and ending on June 30, 2026. The amount of said renewal shall not exceed S360,000 All provisions of said contract and any attachments thereto (thee "contract") shall stay In full force and effect for this Tenewat, IN WITNESS WHEREOF, the parties have executed this renewal by their undersigned officials as duly authorized PROVIDER: FLORIDA DEPARTMENT OF HEALTH - MONROE COUNTY SIGNED BY NAME CARLA FRY PhD. MSN-.N TITLE Administrator DATE June 30, 2025 COALITION: FLORIDA KEYS HEALTHY START COALITION SIGNED BY NAME- CHRISTINE HELMS, RN, BSN. CEN TITLE Board Chair DATE June 30, 2025 Mission: To protect, promote & improve the health of all people in Florida through integrated state, county & community efforts. Vision: To be the Healthiest State in the Nation MEMORANDUM DATE: 12/31/2025 Ron DeSantis Governor Joseph A. Ladapo, MD, PhD State Surgeon General TO: Dr. Mark Roby, Director of Nursing Monroe County Health Departmeny FROM: Carla A. Fry, Administrator Monroe County Health Department SUBJECT: Delegation of Authority, Florida Department of Health —Monroe This memorandum serves as notice that effective Friday, January 2nd, 2026, at 8:00 am, the delegation of authority for the Florida Department of Health in Monroe County will reside with Dr. Mark Roby, Director of Nursing. Delegation will remain in effect for the duration of my assignment with Hillsborough County. With this assignment, you are hereby the delegated authority to effectively operate and manage the Florida Department of Health in Monroe County. Should a public health emergency arise in Monroe County, I will return to my post immediately as discussed with the Board of County Commissioners. I appreciate your willingness to take on these duties and responsibilities during my interim assignment. I will make myself available as needed as will the Office of the County Health Systems. Florida Department of Health Monroe County Florida Accredited ealt Department 1100 Simonton Street Key West, Florida 33040 In Public Health Accreditation Board 305-293-7500 FloridaHealth.gov ACC)R " CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 2/25/2026 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Acrisure East Insurance Services, LLC 100 Passaic Avenue Suite 120 CONTACT NAME: PHONE FAX A/c No EXt : (AC,No): A DRIESS, INSURER(S) AFFORDING COVERAGE NAIC# Fairfield NJ 07004 INSURERA: Alliance of Nonprofits for Insurance, Risk Retenti 10023 License#: 1202869 INSURED FLORKEY-10 INSURER B Florida Keys Healthy Start Coalition Inc. P.O. BOX 6166 INSURER C : INSURER D : Key West FL 33041 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1544401899 REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL I SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y 02-CP-0033182-01-13 6/30/2025 6/30/2026 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $ 20,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY PRO LOC El JECT PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY Y 02-CP-0033182-01-13 6/30/2025 6/30/2026 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER OTH- STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ NIA E.L. DISEASE- EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: 1100 Simonton St., Rm 1-188, Key West FL 33040 Monroe County Board of County Commissioners is included as additional with regards to the above captioned policies provided a signed written contract exists requiring such a status. Per the terms of the policy coverage for an additional insured is contingent upon an underlying written agreement with the name insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County Board of County Commissioners 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West FL 33040 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD GV�S COURTq ° � A Kevin Madok, CPA - �o ........� � Clerk of the Circuit Court &Comptroller Monroe County, Florida �z cooN DATE: April 7, 2025 TO: William DeSantis, Director Facilities Maintenance Chrissy Collins Executive Administrator Alice Steryou Contract Monitor FROM: Liz Yongue, Deputy Clerk SUBJECT: March 25, 2025 BOCC Meeting The following items have been executed and added to the record: C20 Lease Agreement with the State of Florida Department of Health, Monroe County Health Department to provide continued office space at the Roth Building, 50 High Point Road, Tavernier, FL. The County leases the space to the Health Dept. at no costs for the year. C21 Lease Agreement with the State of Florida Department of Health, Monroe County Health Department, to provide continued office space at the Ruth Ivins Center, 3333 Overseas Highway, Marathon, FL. The County leases this space to the Health Dept. at no charge for the year. C22 Lease Agreement with the State of Florida Department of Health, Monroe County Health Department to provide continued office space at the Gato Building, 1100 Simonton Street, Key West, FL. The County leases the space to the Health Dept. at no costs for the year. Should you have any questions please feel free to contact me at (305) 292-3550. cc: County Attorney Finance File KEY WEST MARATHON PLANTATION KEY 500 Whitehead Street 3117 Overseas Highway 88770 Overseas Highway Key West, Florida 33040 Marathon, Florida 33050 Plantation Key, Florida 33070 LEASE AGREEMENT QAT0 BUILDING 25th March This Agreement is made and entered into this +6th day of ApFA, 2025, by MONROE COUNTY, a political subdivision of the State of Florida, whose address is 1100 Simonton Street, Key West, Florida 33040, ("COUNTY" or the "LESSOR"), and STATE OF FLORIDA, DEPARTMENT OF HEALTH, MONROE COUNTY HEALTH DEPARTMENT ("TENANT" or the "LESSEE"), a non-profit corporation incorporated in the State of Florida, whose address is 1100 Simonton Street, Key West, Florida 33040. WHEREAS, the COUNTY leases premises to other governmental agencies and not -for - profit organizations serving the County community; and WHEREAS, the State of Florida, Department of Health, Monroe County Health Department has requested use of County office space; and WHEREAS, the State of Florida, Department of Health, Monroe County Health Department provides essential services to the citizens of Monroe County, and works to improve the health of the public through preparedness, education, prevention, the delivery of clinical services, and by conducting environmental inspection and testing programs; and WHEREAS, the COUNTY owns an office building known as the Gato Building at 1100 Simonton Street, Key West, Florida; and WHEREAS, the Gato Building has a number of vacant offices due to the reduction of the County workforce; and WHEREAS, the COUNTY has determined that it is in the best interests of Monroe County to lease unused office space at the Gato Building; NOW, THEREFORE, IN CONSIDERATION of the promises contained herein the parties agree to the following: 1. PROPERTY. The COUNTY leases to the LESSEE 10,115 square feet of office space, storage, and common area in the Gato Building, which is shown on Exhibit "A" and Exhibit "B" hereafter identified as the "Premises." Exhibit "A"- First Floor Gato Building — Floor Plan, Exhibit "A"- Second Floor Gato Building — Floor Plan, and Exhibit "B"- Rooms with Square Footage, are attached hereto and made a part of this Agreement. 2. TERM. The term of this Agreement is for a period of one (1) year beginning May 1, 2025, and terminating on April 30, 2026. 3. USE AND CONDITIONS. The premises shall be used solely for the purposes of delivering State of Florida, Department of Health, Monroe County Health Department services, including public health related education, chronic disease prevention, preparation for emergencies affecting public health, maintenance of vital statistics information and certifications, administrative support, delivery of clinical services, and environmental testing and inspection programs. If the Premises are used for any other purpose, the COUNTY shall have the option of immediately terminating this Agreement. LESSEE shall not permit any use of the Premises in any manner that would obstruct or interfere with any COUNTY functions and duties. The LESSEE will further use and occupy said Premises in a careful and proper manner, and not commit any waste thereon. LESSEE will not cause, or allow to be caused, any nuisance or objectionable activity of any nature on the Premises. Any activities in any way involving hazardous materials or substances of any kind whatsoever, either as those terms may be defined under any State or Federal laws or regulations or as those terms are understood in common usage, are specifically prohibited. The LESSEE will not use or occupy said Premises for any unlawful purpose and will, at LESSEE's sole cost and expense, conform to and obey any present or future ordinance and/or rules, regulations, requirements and orders of governmental authorities or agencies respecting the use and occupation of said Premises. These covenants of the LESSEE shall also be binding on the use of the Premises by personnel, volunteers, or clients of LESSEE in accessing any common areas of the Gato Building, 4. RENT. For the use of the Premises, the LESSEE must pay the COUNTY the sum of $- 0- per year, for 10,115 square feet of office space at $-0- per square foot, which rental sum is due in monthly installments of $-0-. The COUNTY will invoice the LESSEE each month and these twelve (12) monthly payments shall be remitted to Monroe County Clerk's Office, 500 Whitehead Street, Key West, FL 33040. If a warrant in payment of an invoice is not issued within forty (40) days after receipt of the invoice and receipt, inspection, and approval of the goods and services, the LESSEE shall pay to the LESSOR, in addition to the amount of the invoice, interest at a rate established pursuant to Florida Statutes, Section 55.03(l) on the unpaid balance from the expiration of such forty (40) day period until such time as the warrant is issued to the LESSOR. a) Additional consideration from each party: Electricity, office maintenance, office cleaning, and local phone calls will be provided by LESSOR at no additional cost to LESSEE, unless the occupation of the Premises has a significant impact on any of such costs to LESSOR, in which case the parties will either renegotiate the consideration or mutually terminate this agreement. LESSEE shall be entitled to use the common areas of the Gato Building, such as bathrooms, lobby, and other common areas incidental to the purpose of their occupancy of the Premises, including use of conference rooms. 5. TAXES. The LESSEE must pay all taxes and assessments, including any sales or use tax, levied by any government agency with respect to the LESSEE's operations on the Premises. If at any time after any tax or assessment has become due or payable, the LESSEE, or its legal representative, neglects to pay the tax or assessment, LESSOR shall be entitled to pay the tax or assessment at any time after that and the amount paid by LESSOR shall be deemed to be additional rent for the leased Premises, due and payable by the LESSEE. 6. INSURANCE. The Department of Health, State of Florida, provides General Liability Coverage for Monroe County Health Department Operations through the Division of Risk Management and the State Risk Management Trust Fund. Florida Statutes, Chapter 284 and Section 768.28(16) authorize the State to administer a self-insurance program and Florida Statutes, Section 768.28(5) currently sets the general liability coverage limits as follows: $200,000 each person; $300,000 each occurrence. LESSEE and/or State of Florida, Department of Health shall reimburse LESSOR for its pro rata share of insurance costs for certain vehicles owned by the COUNTY, but fully utilized by LESSEE in its operations, and its proportionate share of building insurances as set forth in the Contract between Monroe County Board of County Commissioners and State of Florida Department of Health for Operation of the Monroe County Health Department Contract Year 2024-2025 ("Core Contract"), as more specifically set forth in Addendum I to the Core Contract. 2 7. ' CONDITION OF PREMISES. The LESSEE must keep the Premises in good order and condition. The LESSEE must promptly repair damage to the Premises. At the end of the term of this Agreement, the LESSEE must surrender the Premises to the COUNTY in the same good order and condition as the Premises were on the commencement of the term, normal wear and tear excepted. The LESSEE is solely responsible for any improvements to land and appurtenances placed on the Premises. 8. IMPROVEMENTS. No structure or improvements of any kind shall be placed upon the land without prior approval in writing by the County Administrator, a building permit issued by the COUNTY and any other agency, federal or state, as required by law. Any such structure or improvements shall be constructed in a good and workmanlike manner at LESSEE's sole cost and expense. Subject to any landlord's lien, any structures or improvements constructed by LESSEE shall be removed by the LESSEE at LESSEE's sole cost and expense, by midnight on the day of termination of this Agreement or extension hereof, and the land restored as nearly as practical to its condition at the time this agreement is executed unless the Board of County Commissioners accepts in writing delivery of the Premises together with any structures or improvements constructed by LESSEE. Portable or temporary advertising signs are prohibited. LESSEE shall perform, at the sole expense of LESSEE, all work required in the preparation of the property or premises hereby leased for occupancy by LESSEE; and LESSEE does hereby accept the leased property or premises as now being in fit and tenantable condition for all purposes of LESSEE. COUNTY reserves the right to inspect the leased area and to require whatever adjustment to structures or improvements as COUNTY, in its sole discretion, deems necessary. Any adjustments shall be done at LESSEE's sole costs and expense. Any building permits sought by LESSEE shall be subject to permit fees at LESSEE's sole cost and expense. 9. INDEMNIFICATI,!QN/HOLD HARMLESS. The parties to this Lease Agreement stipulate that each is a state governmental agency as defined by Florida Statutes and represents to the other that it has purchased suitable Commercial General Liability, Business Automobile Liability, and Workers' Compensation insurance, or is self -insured, in amounts adequate to respond to any and all claims within the limitations of Sections 768.28 and Chapter 440, Florida Statutes, arising out of the activities governed by this Lease Agreement. As between the governmental entity parties to this Lease Agreement, each party is responsible for any negligent acts or omissions on the part of its own employees, agents, contractors, and subcontractors and shall defend, indemnify and hold the other governmental entity party harmless from claims arising out of such negligent acts or omissions, and agrees to be liable to the statutory limits for any damages proximately caused by said acts or omissions, or intentional tortious acts. The governmental entity parties to this agreement stipulate that the agreement does not contain any provision that requires one party to indemnify or insure the other party for the other party's negligence or to assume any liability for the other party's negligence. The governmental entities are prohibited from entering into agreements to indemnify another agency or subdivision of the state for the other entity's negligence or to assume any liability for the other entity's negligence. Nothing contained in this Section shall be construed to be a waiver by either party of any protections under sovereign immunity, Section 768.28, Florida Statutes, or any other similar 3 provision of law. Nothing contained herein shall be construed to be a consent by either party to be sued by third parties or to be liable to third parties in any matter arising out of this or any other Agreement. The COUNTY and the other governmental agency do not get named as an additional insured on each other's policies. 10. ' NON-DISCRIMINATION. LESSOR and LESSEE 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 Lease Agreement automatically terminates without any further action on the part of any party, effective the date of the court order. LESSOR and LESSEE agree 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 in employment on the basis of race, color, religion, sex, 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 disability; 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 patient records; 8) Title VIII of the Civil Rights Act of 1968 (42 USC §§3601 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 §§ 12101 Note), as may be amended from time to time, relating to nondiscrimination on the basis of disability; 10) Monroe County Code Chapter 14, Article 11, which prohibits discrimination on the basis of race, color, sex, religion, 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 Lease Agreement. 11. ' TERMINATION. This Agreement may be terminated with cause at the discretion of the COUNTY in the following circumstances: a) LESSEE fails to pay the rent when due; b) LESSEE fails to obtain the insurance required under this Lease or allows the required insurance coverage to lapse or fall below the minimum required; or c) LESSEE otherwise breaches the terms of this Lease. Unless the COUNTY has accepted in writing a delay in performance of duties, the failure to perform said duties shall constitute a default under the terms of this agreement. In the case of default/breach, the COUNTY shall first give LESSEE a written notification stating the default/breach and that LESSEE has ten (10) days to correct the default/breach. If the LESSEE has not commenced correction of the default/breach at the end of the ten (10) days, then the COUNTY may terminate the Lease in its discretion. If it shall be necessary to employ the services of an attorney in order to enforce its rights under this Agreement, the COUNTY shall be entitled to reasonable attorney's fees. Waiver of a default in any particular month shall not bind the COUNTY 4 to forego the provisions of this paragraph and any subsequent default shall be grounds for termination. The COUNTY may in its discretion treat the LESSEE in default and terminate this Agreement immediately, without prior notice, upon failure of LESSEE to comply with any provision of this Agreement. LESSEE may terminate this Agreement upon giving thirty (3 0) days' prior written notice to COUNTY. COUNTY may terminate this Agreement without cause by providing LESSEE with written notice of termination at least sixty (60) days prior to the date of termination. 12. 'EF DAULT. LESSOR'S right to repossess, operate, or sublease: If the rental reserved by this Lease or other charges to be paid under this Lease by LESSEE, or any part of this Lease, are not paid when due and remain unpaid for a period of ten (10) days after notice in writing, or if LESSEE fails to promptly perform any covenant, condition, or agreement by it to be performed under this Lease and such failure shall continue for a period of ten (10) days after notice in writing specifying the nature of such failure, or if LESSEE abandons the demised Premises, or if LESSEE breaches any obligation under this Lease to be performed by it which cannot be cured, then, and in any such event, LESSEE shall be deemed to be in default and LESSOR, without further notice may at its option take possession of the leased Premises, including all improvements and fixtures and equipment located at, in or about the Premises. By legal proceedings, LESSOR shall take, operate, or sublease the Premises, in whole or in part, for the account of the LESSEE as the LESSOR in good faith may deem proper, for a term not exceeding the unexpired period of the full term of this Lease. LESSOR shall receive all proceeds and rent accruing from such operation or subleasing of the leased Premises or fixtures and equipment. LESSOR shall apply these proceeds first, to the payment of all costs and expenses incurred by the LESSOR in obtaining the possession of, and the operation or subleasing of the Premises or fixtures and equipment, including reasonable attorney's fees, commissions, and collection fees, and any alteration or repairs reasonably necessary to enable the LESSOR to operate or sublease the Premises or fixtures and equipment; and second, to the payment of all such amounts as may be due or become payable under the provisions of this Lease. The remaining balance, if any, given by the LESSOR to the LESSEE, shall be paid over to the LESSEE at the expiration of the full term of this Lease or on the sooner termination of the Lease by written notice of termination. Repossession or subleasing not a termination; LESSOR'S right to terminate not forfeited: No repossession, operation, or subleasing of the Premises or of fixtures and equipment shall be construed as an election by the LESSOR to terminate this Lease unless a written notice of such intention is given by the LESSOR to the LESSEE. Notwithstanding any such operation or subleasing without termination of this Lease, the LESSOR may at any time after that elect to terminate the Lease in the event that the LESSEE remains in default under this Lease. LESSEE'S obligation to pay deficiencies: In the event the proceeds of rentals received by the LESSOR under the provisions of this Section are insufficient to pay all costs and expenses and all amounts due and becoming due under this Lease, the LESSEE shall pay to the LESSOR on demand such deficiency as may occur or exist. LESSOR'S right to terminate Lease: In the event of LESSEE'S default, LESSOR may, at its option without further notice, terminate this Lease and all interest of LESSEE under this Lease, and may then take possession of the leased Premises by legal proceedings. LESSOR'S right on termination to recover amount equal to rent reserved: If this Lease is terminated by the LESSOR by reason of any default by LESSEE, LESSOR shall be entitled to W recover from the LESSEE, at the time of such termination the excess, if any, of the amount of rent reserved in this Lease for the balance of the term of the Lease. LESSOR'S remedies are cumulative: Each and all of the remedies given to the LESSOR in this Lease or by law are cumulative, and the exercise of one right of remedy shall not impair its right to exercise any other right or remedy. 13. ' DEFAULT -WAIVER. The waiver by the LESSEE or the COUNTY of an act or omission that constitutes a default of an obligation under this Agreement does not waive another default of that or any other obligation. 14. ASSIGNMENT. The LESSEE may not assign this Agreement or assign or subcontract any of its obligations under this Agreement without the approval of the COUNTY's Board of County Commissioners. All the obligations of this Agreement will extend to and bind the legal representatives, successors, and assigns of the LESSEE and the COUNTY. 15. SUBORDINATION., This Agreement is subordinate to the laws and regulations of the United States, the State of Florida, and the COUNTY, whether in effect on commencement of this Lease or adopted after that date. 16. GOVERNING LAWSNENUE. This Agreement is governed by the laws of the State of Florida applicable to contracts made and to be performed entirely in the State. In the event that any cause of action or administrative proceeding is instituted for the enforcement or interpretation of this Lease Agreement, the LESSOR and LESSEE agree that venue will lie in the appropriate court or before the appropriate administrative body in Monroe County, Florida. The LESSOR and LESSEE agree that, in the event of conflicting interpretations of the terms or a term of this Lease 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. 17. ' MUTUAL REVIEW. This Agreement has been carefully reviewed by the LESSEE and the COUNTY. Therefore, this Agreement is not to be construed against either party on the basis of authorship. 18. NOTICES. Notices in this Agreement, unless otherwise specified, must be sent by certified mail to the following: COUNTY County Administrator Christine Hurley 1100 Simonton Street Key West, FL 33040 And County Attorney Monroe County 1111 12th Street Suite 408 Key West, FL 33040 0 LESSEE Monroe County Health Department Carla Fry, Administrator 1100 Simonton Street Key West, FL 33040 19. ' RELATIONSHIP OF PARTIES, LESSEE is, and shall be, in the performance of all works, services, and activities under this Agreement, an independent agency, and not an employee, agent, or servant of the COUNTY. LESSEE shall exercise control, direction, and supervision over the personnel and volunteers who use the Premises. LESSEE shall have no authority whatsoever to act on behalf and/or as agent for the COUNTY in any promise, agreement, or representation other than specifically provided for in this Agreement. The COUNTY shall at no time be legally responsible for any negligence on the part of LESSEE, its employees, agents, or volunteers resulting in either bodily or personal injury or property damage to any individual, property, or corporation. 20. FULL UNDERSTANDING. This Agreement is the parties' final mutual understanding. It replaces any earlier agreements or understandings, whether written or oral. This Agreement cannot be modified or replaced except by another written and signed agreement. 21. RIGHT OF INgRESS, AND EGRESS. LESSEE, its agent, employees, customers, suppliers, and patrons shall have the right of ingress and egress to and from the leased Premises, which shall not be unreasonably restricted by the COUNTY. 22. RIGHT OF INSPECTION AND REPAIRS. LESSOR shall have access to the Premises, and each and every part thereof, during LESSEE'S regular business hours for the purpose of inspecting the same, making repairs, and posting notices that LESSOR may deem to be for the protection of the LESSOR or the property. 23. AMENDMENTS TO BE IN WRITING. This Lease may be modified or amended only by a writing duly authorized and executed by both LESSOR and LESSEE. It may not be amended or modified by oral agreements or understandings between the parties unless the same shall be reduced to writing duly authorized and executed by both LESSOR and LESSEE. 24. HOLDING OVER. No holding over and continuation of any business of the LESSEE after the expiration of the term hereof shall be considered to be a renewal or extension of this Lease unless written approval of such holding over and a definite agreement to such effect is signed by the LESSOR defining the length of such additional term. Any holding over without consent of the LESSOR shall be considered to be a day-to-day tenancy at a rental of three (3) times the daily rate of the fixed minimum monthly rental provided herein, computed on the basis of a thirty (30) day month. 25. ENTIRE AGREEMENT. This writing embodies the entire agreement and understanding between the parties hereto, and there are no other agreements and understandings, oral or written, with reference to the subject matter hereof that are not merged herein and superseded hereby. Any amendment to this Lease shall be in writing, approved by the Board of County Commissioners, and signed by both parties before it becomes effective. 26. LEVERABILITY. If any term, covenant, condition or provision of this Lease 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 Lease Agreement, shall not be affected thereby; and each remaining term, covenant, condition, and provision of this Lease 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 Lease Agreement would prevent the accomplishment of the original intent of this Lease Agreement. The LESSOR and LESSEE agree M to reform the Lease Agreement to replace any stricken provision with a valid provision that comes as close as possible to the intent of the stricken provision. 27. ' ATTORNEY'S FEES AND COSTS. In the event of any proceeding arising out of or related to this Lease Agreement, each party shall assume and pay its own expenses, including without limitation court costs, legal fees, expert fees and costs of appeal, for any suit, action, or proceeding(s) arising hereunder. Mediation proceedings initiated and conducted pursuant to this Lease 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. 28. BINDING EFFECT. The terms, covenants, conditions, and provisions of this Lease Agreement shall bind and inure to the benefit of the LESSOR and LESSEE and their respective legal representatives, successors, and assigns. 29. AUTHORITY. Each party represents and warrants to the other that the execution, delivery, and performance of this Lease Agreement have been duly authorized by all necessary County and corporate action, as required by law. 30. ADJUDICATION OF DISPUTES OR DISAGREEMENTS. LESSOR and LESSEE 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 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 Lease Agreement or by Florida law. 31. COOPERATION'. In the event any administrative or legal proceeding is instituted against either party relating to the formation, execution, performance, or breach of this Lease Agreement, LESSOR and LESSEE 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 Lease Agreement or provision of the services under this Lease Agreement. LESSOR and LESSEE specifically agree that no party to this Lease Agreement shall be required to enter into any arbitration proceedings related to this Lease Agreement. 32. COVENANT OF NO INTEREST. LESSOR and LESSEE covenant that neither presently has any interest, and shall not acquire any interest, which would conflict in any manner or degree with its performance under this Lease Agreement, and that the only interest of each is to perform and receive benefits as recited in this Lease Agreement. 33. CODE OF ETHICS. LESSOR 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. 34. No SOLICITATION/PAYMENT. The LESSOR and LESSEE 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 Lease 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 Lease Agreement. For the breach or violation of the provision, the LESSEE agrees that the LESSOR shall have the right to terminate P this Lease Agreement without liability and, at its discretion, to offset from monies owed, or otherwise recover, the fall amount of such fee, commission, percentage, gift, or consideration. 35. PUBLIC RECORDS COMPLIANCE. LESSEE must comply with Florida public records laws, including but not limited to Chapter 119, Florida Statutes and Section 24 of Article I of the Constitution of Florida. The COUNTY and LESSEE shall allow and permit reasonable access to, and inspection of, all documents, records, papers, letters or other "public record" 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 LESSEE in conjunction with this Lease Agreement and related to contract performance. The COUNTY shall have the right to unilaterally cancel this Lease Agreement upon violation of this provision by the LESSEE. Failure of the LESSEE to abide by the terms of this provision shall be deemed a material breach of this Lease Agreement and the COUNTY may enforce the terms of this provision in the form of a court proceeding and shall, as a prevailing party, be entitled to reimbursement of all attorney's fees and costs associated with that proceeding. This provision shall survive any termination or expiration of the Lease Agreement. The LESSEE is encouraged to consult with its advisors about Florida Public Records Law in order to comply with this provision. Pursuant to Fla. Stat., Sec. 119.070 1, and the terms and conditions of this Lease Agreement, the LESSEE is required to: (1) Keep and maintain public records that would be required by the COUNTY to perform the service. (2) Upon receipt from the COUNTY'S custodian of records, provide the COUNTY with a copy of the requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law. (3) Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the duration of the Lease Agreement term and following completion of the agreement if the LESSEE does not transfer the records to the COUNTY. (4) Upon completion of the Lease Agreement, transfer, at no cost, to the COUNTY all public records in possession of the LESSEE or keep and maintain public records that would be required by the COUNTY to perform the service. If the LESSEE transfers all public records to the COUNTY upon completion of the agreement, the LESSEE shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the LESSEE keeps and maintains public records upon completion of the agreement, the LESSEE shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to the COUNTY, upon request from the COUNTY'S custodian of records, in a format that is compatible with the information technology systems of the COUNTY. (5) A request to inspect or copy public records relating to a COUNTY contract must be made directly to the COUNTY, but if the COUNTY does not possess the requested records, the COUNTY shall immediately notify the LESSEE of the request, and the LESSEE must provide the records to the COUNTY or allow the records to be inspected or copied within a reasonable time. If the LESSEE does not comply with the COUNTY'S request for records, the COUNTY shall enforce the public records contract provisions in accordance with the Lease Agreement, notwithstanding the COUNTY'S option and right to unilaterally cancel this agreement upon violation of this provision by the LESSEE. A LESSEE who fails to provide the public records to the COUNTY or pursuant to a valid public records request within a reasonable time may be subject to penalties under Section 119. 10, Florida Statutes. The LESSEE shall not transfer custody, release, alter, destroy, or otherwise dispose of any public records unless or otherwise provided in this provision or as otherwise provided by law. oil KM�M[41-1 WON wanmrogizinismes Kv 0 IM START11 1111MIM-111,1313=011 M1111M 36. ' NQN-WAIVER OF IMMUNITY. Notwithstanding the provisions of Sec. 768.28, Florida Statutes, the participation of the LESSOR and LESSEE in this Lease 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 LESSOR be required to contain any provision for waiver. 37. 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 LESSOR, when performing their respective functions under this Lease 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. 38. NON -RELIANCE BY NON-PARTIES. No person or entity shall be entitled to rely upon the terms, or any of them, of this Lease 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 LESSOR and LESSEE agree that neither the LESSOR nor the LESSEE 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 Lease Agreement separate' and apart, inferior to, or superior to the community in general or for the purposes contemplated in this Lease Agreement. 39. ATTESTATION& LESSEE agrees to execute such documents as the LESSOR may reasonably require, to include a Public Entity Crime Statement, an Ethics Statement, and a Drug - Free Workplace Statement. 40. EXECUTION IN COUNTERPARTS. This Lease 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 Lease Agreement by signing any such counterpart. 10 41. EFFECTIVE DATE. This Agreement will take effect on May 1, 2025. IN WITNESS WHEREOF, each party has caused this Agreement to be executed by its duly authorized representative. �FE )jlw BOARD OF COUNTY COMMISSIONERS OF A11 ST UIN MADOK, CLERK - MONROE COUNTY, FLORIDA, LESSOR Iq By �, w ;�A Deputy Clerk ayor/Chairman STATE OF FLORIDA, DEPARTMENT OF �- HEALTH, MONROE COUNTY HEALTH DEPARTMENT, LESSEE Witness #n1 Signa re / % 1i't Q 4j 3//a��aa f By Printed Name Date Title Administrator / Health Officer Witness # 2 Signature Date - 1 0' Zols -� 5,, F a Printed Name Date 'A CCD 11 ,: 3/11/2025 EXHIBIT "A" First Floor Gato Building — Floor Plan IN IHR� r PLBC)r� �AMMI, A 19 EXHIBIT 66A99 Second Floor Gato Building -- Floor Flan 14 LjF9 SAFETY FIL.AN- GAto MOLDING jjI 15 EXHIBIT "B" Rooms with Square Footage 16 Gato-Health Department EXHIBIT 13 Room S 280 4 40 6 7 40 8 88 9 88 10 '176 18 12 22 13 304 15 88 80 35 18 88-7 40 20 44 21 88 23 24 88 25 SUM �10,et 2B 40 26--- 127 2 96 28 95 29 30 96 31 256 32 Bo Bo 35 1 30 37 192 ,38 128 7 39 —Ho 40 176 4 .. 1 256 42 42 so 112 112 258 113 192 123 121 137 50 Corridors 1225 MM 17 IR M # S uare Footage HEALTHY STARTSUFTE 175 CE 200, CE 88 CE B8 GE 275 1-176 248 1-177 176 1-177 rear 100 1-177 rear 65 1-181 83 1.188 114 57 1-184 so 1-187 81 UPS7AIRS 242 310 241 243 116,9 2" 170 245 145 246 8,5 247 85 248 85 249 85 250 (halt , REf V t Ft 'I�, a 15 115 Net Nrea 7,731 Common Areas 2,384 1,665 1,565 ACC)R " CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 2/25/2026 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Acrisure East Insurance Services, LLC 100 Passaic Avenue Suite 120 CONTACT NAME: PHONE FAX A/c No EXt : (AC,No): A DRIESS, INSURER(S) AFFORDING COVERAGE NAIC# Fairfield NJ 07004 INSURERA: Alliance of Nonprofits for Insurance, Risk Retenti 10023 License#: 1202869 INSURED FLORKEY-10 INSURER B Florida Keys Healthy Start Coalition Inc. P.O. BOX 6166 INSURER C : INSURER D : Key West FL 33041 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1544401899 REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL I SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y 02-CP-0033182-01-13 6/30/2025 6/30/2026 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $ 20,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY PRO LOC El JECT PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY Y 02-CP-0033182-01-13 6/30/2025 6/30/2026 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER OTH- STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ NIA E.L. DISEASE- EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: 1100 Simonton St., Rm 1-188, Key West FL 33040 Monroe County Board of County Commissioners is included as additional with regards to the above captioned policies provided a signed written contract exists requiring such a status. Per the terms of the policy coverage for an additional insured is contingent upon an underlying written agreement with the name insured. APPROVED BY RISK MANAGEMENT BY 4Z_ _ I draa.2 DATE 127.26 WAIVER N/A X YES WC provided under separate cover Monroe County Board of County Commissioners 1100 Simonton Street Key West FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD IFEMPLOYERS° Workers' Compensation and Employers Liability Insurance Policy EMPLOYERS PREFERRED INS. CO. Policy Number From olicy PeriodTo A Stock Company EIG 6031889 00 07/16/2025 07/16/2026 EVAN.StangardTime atthe address ofthe Insured as state herein Transaction POLICY DECLARATIONS NCCI Carrier # 31283 WCIRB CARRIER# PRIOR POLICY NUMBER NEW 1. Named Insured and Address Agent F ORIDA KEYS HEALTHY START COA APPALACHIAN UNDERWRITERS INC 0002975 OBOX6166 PO BOX 800 EY WEST FL 33041-6166 OAK RIDGE, TN 37831 Customer # Carrier # 31283 Additional Locations: Telephone: 8883769633 FEIN # Risk ID # Entity of Insured 650051482 1 CORPORATION 2. The Policy Period is from 07/16/2025 to 07/16/2026 12:01 a.m. Standard Time at the Insured's mailing address. 3. A. Workers Compensation Insurance: Part ONE of the policy applies to the Workers Compensation Law of the states listed here: FL B. Employers Liability Insurance: Part TWO of the policy applies to work in each state listed in Item 3A. The limits of our liability under Part TWO are: Bodily Injury by Accident $ 1,000,000 each accident Bodily Injury by Disease $ 1,000,000 policy limit Bodily Injury by Disease $ 1,000,000 each employee C. Other States Insurance: Part THREE of the policy applies to the states, if any, listed here: All states except ND, OH, WA, WY and states listed in item 3.A. D. This policy includes these endorsements and schedules: See attached schedule. 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates, and Rating Plans. All information required below is subject to verification and change by audit. Minimum Premium $ Assessments and Taxes $ APPROVED BY RISK MANAGEMENT SEE EXTENSION OF INFORMATION PAGE BY c ,UQ„. DATE 13 .2.2 WAIVER N/A -XYES 185 Expense Constant $ 160 Premium Discount $ Total Estimated AnnualPremium $ 1,425 ❑ This is a Three Year Fixed Rate Policy Premium Adjustment Period: ® Annual; Countersigned this Day of „ Issued Date: 06/30/2025 Issuing Office EMPLOYERS PREFERRED INS. CO. P.O. BOX 539003 HENDERSON, NV 89053-9003 Issued Date 06/30/2025 WC990630 (5/98 Ed.) ❑ Semiannual; ❑ Quarterly; ❑ Monthly INSURED COPY Authorized Representative Page 1 of 4