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04/21/2004 .~ AMEND~NTTOAGREE~NT (Non-Profit Organization Lease of Office Space at the Ruth Ivins Center in Marathon, and the Department of Health Clinic in Tavernier.) TIllS Amendment is made and entered into this 21st day of April 2004, between the COUNTY OF MONROE and PLANNED PARENTHOOD OF GREATER MIAMI AND THE FLORIDA KEYS, INC., in order to amend the agreement dated June 14, 2000, as amended on October 18, 2000, as renewed on June 20, 2001, May 15, 2002, and March 19, 2003 (copies of which are incorporated hereto by reference) as follows: 1. Revise the agreement to reflect the termination of services at the Department of Health Clinic in Tavernier, thereby decreasing the fee for monthly utility consumption and upkeep costs from $200.00 per month to $100.00 per month keeping only the office space at the Ruth Ivins Center in Marathon. Effective March 16, 2004. 2. In all other respects, the original agreement between the parties dated June 14, 2000, amended October 18,2000, as renewed on June 20, 2001, May 19, 2002, and March 19, 2003, remains in full force and effect. IN WITNESS WHEREOF, the parties have hereunto set their hands and seal, the day and year first written above. (Seal) Attest: DANNY L. KOLHAGE, CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA ~J~ . eputy Clerk BY~ David P. Rice, Mayor Pro Tem c::f.j~W-~ ~ Witness ~~~~ PLANNED PARENTIfOOD OF GREATER MIAMI AND THE FLORIDA KEYS, me. ~~~~ ~C\A~nJ Title ~ C<c 0 , % ~ = :21 0 1:1 = Z })0- J:'"' r- :o("):z:: .:z ,.." 0,....2: ~ 0 ""~-< -< go:- f ..." -...J 0 <=~;r. :::0 z. 0 .Dot -f (") r- :::0 :<:-I:I: :z ,.." .., J> 9 ~ ,.... C> a )l- "" en ::0 U1 Cj MeN ROE COUNT\' Al,. .:'JEY ~... ""IEDA..... 0~ . . tb 'V!..'!~~OANEY ['aJ.;._~3r~O't .. - _1 \ ~ - I ,@ II=' i IUI II leu. UI Loa IlJ IVUU oi Greater Iv\iarni and the Florida Keys. Inc. L:jl j';I"""O-" Chair Vice-Chair .....:I/.I!1,\. ,\kfjqwt-il Secretarv ;f'.!n D. S!".-h:.ll Treasurer '.Inn C. P.1~lrnil. CP,,\. Board ofT,uslees 3fjr'\'~H;' Dubbm .-\,,"-(l\\ If7 March 16,2004 ~'..'n:1 t.oh.lT~ Board of County Commissioners County of Monroe 3583 S. Roosevelt Boulevard Key West, Florida 33040 :e~n [J(lf:!1cn Fif'id :..::, t)p."LJlrl1l' '..,;1n a. '~e 'or :.;i!:.irtl 1\..1\ nor ':'(-~1~.1I1:f' L,';:ln .J". ';'.j~:n \~~'.n.lf(i ... :;':.i!'; r. \',;'\.:,on. \1.0. "l1:r;(".., ..;.~::::,~\ JI-In~f;pn Dear Commissioners: ;:,; ~ ~;~t., t'.~ \:,-! ~:,~ €1t2'T1.1 \ :li.1r Pre,idenl! CEO _, .'. -'~"::E: ='_ ":<.....f!""..~' I regret to inform you that we will not be providing family planning services in Tavernier, effective immediately. We deeply regret this move, but a number of things have occasioned this decision. ~) ;".1:1 5,,:-r.:)~ed G..ne,al Counsel \tedical Director .: ,.,~.:." ;-;;"" \I.U.. nCOG ..f',:a ;31..;; Beginning in May of2001, we requested consideration to move into new space at the old Mariner's Hospital when renovations were completed. As recently as January 14, 2004, we were told there was no space for us. As board and staff looked at the eventual closing of the Tavernier site in June of this year, we reviewed the issues that we've had in providing services in Tavernier. Jean D. Sh"han Famih. Plaming Clinic . .;';':' ~..\. ":-:h.l.,,\e-n:Je ;..:..:.~.:. ::}.2 .).,d~inl~lratlOn :..:.,~}.: ):', 3 (:;;lIC :".._:::..-'i" !:t'il..c::.nn 'olth "iam. F.rnil_ Planning Clinic :,' ......=. . _3:~ f-~~f'~; '"p.;'" \~ :I:': r:;('l~;(:.\ 3.,161 .'~..:.,.,~.--:;., Ci~:( . .-;.... ::~,:c:" Fi'lrll:J 3 J:H Let me say first that without your generosity, we could not have provided services at all. The cost to us for renting a suitable facility would have been prohibitive. . .~..,<'.::;.{..;~,:i El.:;:,zC-1tll..'ln Sou th Beach Farnil_ Planning Clinic ~ ~":'.'.:;':' ~,t~ :-t!'l"e! -..._.~~. .....1);.' C!ir:;( ..' ,;...- ".,p"!., 3.~' -j.... -~.-....:.,._,.J. C'i"!,( Secondly, 35% of services provided have been to patients at 150% of the poverty level or below; therefore below our costs, or free. "endon Famil_ PLanning Clinic ',&"'~:::. ~~;~"!n:t BU;;ijU.,~ fft-.lr ''';'':' ~ 1.\. t30~th ~~-h;! SU!fe H'9 ..-~~~ S'''(lt)~'jnt: Ct.';'1!er Thirdly, there is a shortage of advanced registered nurse practitioners available in the Florida Keys and to provide services in Tavernier we have had to contract with a practitioner who lives in Key West, and pay mileage. South D.de F.rnil_ Planning Clinic - . '::-2' ..: '-.\ ..: :6th :':rt"~! ... .:-~ F(.,'~:r..l 3,~ -,; ,';.':.~3..c;,..:.! CliniC ':\.,,:~,"-$1.'3 Edt:i,:.~;ion LIdia B. Slo~.. Fornil_ Plonnins Clinic ":';, ,::r.,g..:.,: -\\t"n~(' \- :.'; ~- ~ ',~oi\ Ci:-w. All of this means we have not been able to break even, and with the anticipated closing in June, the board, staff and I decided we could no longer sustain these losses. -,.r'''' l'~ :=:':'~~i.:.1 ~;~\"\-;) ~...:.-.'.'...":,~ Ed~;I..t.:;('W~ Sl~lrr "nore Familv Planning Clinic - ~ ". ,.'..O:',!.;, l~' ..;:"\'. .1\. ~Ultl' 1..J, l '..,.;,.~:,hlr i:'ll:-;n.1 :.~..:")tl ....~..:..L'l..:,." ,";",!;," FJ.(h 01 life line: ~ '':;-.2t\'';..20hl \\l"h"ih.~: \\\\\\.pp~m.org Board of County Commissioners Monroe County Page 2. We will continue to provide services in Marathon and will make every effort to accommodate patients coming from Tavernier, but a down-turn in the economic climate in the United States has increased the demands for free services and decreased donor contributions to fill in the gap. We have had a wonderful experience and I am grateful to all of you for your willingness to work with us. I am available to talk to you about this and, as always, am willing to come to a .Commission meeting. It is with real sorrow that we-make this move. Sincerely, ~ D. Joan Sampieri President/CEO Cc: Anna Velasquez, Director of Patient Services Karen Beal, Director of Public Affairs Bill Spear, Facilities Manager John Pascucci, Rural Health Network A11D.Mymik, Contract Facilities Manager