Backup Documents 10/13/2015 Item #16D 7 160 7
COMMUNITY AND HUMAN SERIVCES
INTEROFFICE MEMORANDUM
TO: Board Minutes and Records
FROM: Lisa N. Carr, Grants Coordinator, CHS
DATE: October 14, 2015
RE: Area Agency on Aging for Southwest Florida,Inc amendments
Please find attached one (1) each fully executed documents that were approved by the BCC on
the day listed below for recording in Minutes and Records. Feel free to contact me if you have
any questions.
BCC Approved on October 13,2015; Item: 16.D.6
Recommendation to approve after-the-fact Amendments and Attestation Statements with Area
Agency on Aging for Southwest Florida.Inc.for the Community Care for the Elderly.Alzheimer's
Disease Initiative and Home Care for the Elderly programs and authorize Budget Amendments to
ensure continuous funding for FY 2014/2015. (Net Fiscal Impact$26.967.41)
BCC Approval on October 13, 2015; Item: 16 D. 7
Recommendation to approve"after-the-fact"Amendments and Attestation Statements with Area
Agency on Aging for Southwest Florida.Inc.for the Community Care for the Elderly and Alzheimer's
Disease Initiative grant programs and budget amendments to ensure continuous funding for FY
2015/2016.
Thank you for your assistance.
Amendment 001 July 2015 to June 2016 ADI 203.15.001
16D7
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commissioner("Contractor"), amends agreement ADI 203.15.
The purpose of this amendment is to amend 4. Contract Amount, increase the allocation by$41,425.00,6. Official
Payee and Representatives Contractor Name correction,and revise ATTACHMENT III,FUNDING SUMMARY and
ATTACHMENT VII,ANNUAL BUDGET SUMMARY.
Line denotes completion of above summary
4. Contract Amount:
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount
not to exceed$277,450.00, or the rate schedule, subject to the availability of funds. Any costs or services paid for
under any other contract or from any other source are not eligible for payment under this contract.
6. Official Payee and Representatives(Names.Addresses.and Telephone Numbers):
The Contractor name, as shown on page 1 of this Collier County Board of County Commissioners
Community and Human Services
a. contract, and mailing address of the official payee
3339 E Tamiami Trail,Building H
to whom the payment shall be made is: Naples,FL 34112
Kimberley Grant,Director
The name of the contact person and street address Collier County Board of County Commissioners
b. do Community and Human Services
where financial and administrative records are 3339 E Tamiami Trail,Building H
maintained is: Naples,FL 34112
Kimberly Grant,Director
The name, address,and telephone number of the Collier County Board of County Commissioners
c. representative of the Contractor responsible for do Community and Human Services
administration of the program under this contract 3339 E Tamiami Trail,Building H
Naples,FL 34112
is: (239)252-2273
This amendment shall be effective August 04, 2015. All provisions in the agreement and any attachments thereto in
conflict with this amendment shall be and are hereby changed to conform with this amendment
All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the
agreement.
This amendment and all of its attachments are hereby made a part of this agreement.
1
Amendment 001 July 2015 to June 2016 ADI 203.15.001
160 ?
IN WITNESS WHEREOF, the parties hereto have caused this 4 page amendment to be executed by their officials there
unto duly authorized.
Recipient: COLLIER COUNTY BOARD OF AREA AGENCY ON AGING FOR SOUTHWEST,
COUNTY COMMISSIONERS FLORIDA,INC.
Cf/f/iii
SIGNED BY: � l , SIGNED BY: Abiat.
NAME: Stephen Y. Camell NAME: MARIANNE G LORINI
TITLE: Public Services Department Head TITLE: PRESIDENT/CEO
DATE: q, ' g- i DATE: 10/S//<
Federal Tax ID: 59-6000-558
Fiscal Year Ending Date: 09/30
Approved as to form and legality
Assistant County Attorney �
2
cry
Amendment 001 July 2015 to June 2016 ADI 203.15.001
160 ?
ATTACHMENT III
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO
THIS CONTRACT CONSIST OF THE FOLLOWING:
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES
AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: N/A
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS
CONTRACT CONSIST OF THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD $0
STATE FINANCIAL ASSISTANCE SUBJECT TO Sec. 215.97,F.S.
PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT
Alzheimer's Disease Initiative General Revenue/TSTF-Collier 65004 $ 277,450.00
TOTAL AWARD $ 277,450.00
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED
PURSUANT TO THIS CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE
Section 215.97,Fla. Stat.
Chapter 69I-5,Fla.Admin.
Code
3
Amendment 001 July 2015 to June 2016 ADI 203.15.001
1607
ATTACHMENT VII
ANNUAL BUDGET SUMMARY
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
for
Collier County Board of County Commissioners
Collier
ALLOCATION TOTAL $ 277,450
4
Revised August 2007 1 6 ® 7
Attestation Statement
Agreement/Contract Number 203.15
Amendment Number 001
I, Stephen Y. Carnell ,attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
Public Services Department Head
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting,due to the differences in
electronic data processing media,which has no affect on the agreement/contract content.
• ; /
i • �, t/ q—Ig—(r
Signature o Recipient/Contractor representative Date
Approved as to form and legality
Assistant County Attorney 055\`7
Os.
Revised August 2007
Amendment 001 July 2015 to June 2016 CCE 203.15.001
r '
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC. 16 0 7
COMMUNITY CARE FOR THE ELDERLY PROGRAM CONTRACT
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commissioners("Contractor"),amends agreement CCE 203.15.
The purpose of this amendment is to amend 4. Contract Amount, increase the allocation by$41,690.00,6. Official
Payee and Representatives Contractor Name correction, add Escort and Other Services, and revise ATTACHMENT III
and ATTACHMENT VI,ANNUAL BUDGET and RATE SUMMARY.
Line denotes completion of above summary
4. Contract Amount:
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount
not to exceed$789,435.00,or the rate schedule, subject to the availability of funds. Any costs or services paid for
under any other contract or from any other source are not eligible for payment under this contract.
6. Official Payee and Representatives (Names.Addresses.and Telephone Numbers):
Collier County Board of County Commissioners
The Contractor name, as shown on page 1 of this Community and Human Services
a. contract,and mailing address of the official payee 3339 E Tamiami Trail, Building H
to whom the payment shall be made is: Naples,FL 34112
Kimberley Grant,Director
The name of the contact person and street address Collier County Board of County Commissioners
b' where financial and administrative records are c/o Community and Human Services
3339 E Tamiami Trail,Building H
maintained is: Naples,FL 34112
Kimberly Grant,Director
The name, address,and telephone number of the Collier County Board of County Commissioners
c' representative of the Contractor responsible for do Community and Human Services
administration of the program under this contract 3339 E Tamiami Trail,Building H
is: Naples,FL 34112
(239)252-2273
This amendment shall be effective August 06, 2015. All provisions in the agreement and any attachments thereto in
conflict with this amendment shall be and are hereby changed to conform with this amendment
All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the
agreement.
This amendment and all of its attachments are hereby made a part of this agreement.
1
Amendment 001 July 2015 to June 2016 CCE 203.15.001
1607
IN WITNESS WHEREOF, the parties hereto have caused this 4 page amendment to be executed by their officials there
unto duly authorized.
Recipient: COLLIER COUNTY BOARD OF AREA AGENCY ON AGING FOR SOUTHWEST
COUNTY COMMISSIONERS FLORIDA,INC.
SIGNED BY: 10 I' � ' / SIGNED BY: Atelgotrit %AAA,
NAME: Stephen Y. Carnell NAME: MARIANNE G LORINI
TITLE: Public Services Department Head TITLE: PRESIDENT/CEO
DATE: Cr— k (5 DATE: Id/6/1
Federal Tax ID: 59-6000-558
Fiscal Year Ending Date: 09/30
Approved as to form and legality
Assistant County Attorney h t• \\e-
QA" '
``
2
1607
Amendment 001 July 2015 to June 2016 CCE 203.15.001
ATTACHMENT III
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO
THIS CONTRACT CONSIST OF THE FOLLOWING:
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES
AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: N/A
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS
CONTRACT CONSIST OF THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
$0
STATE FINANCIAL ASSISTANCE SUBJECT TO Sec. 215.97,F.S.
PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT
Community Care for the Elderly General Revenue -Collier 65.010 $ 789,435.00
TOTAL AWARD $ 789,435.00
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED
PURSUANT TO THIS CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE
Section 215.97,Fla. Stat.
Chapter 691-5,Fla.Admin.
Code
3
Amendment 001 July 2015 to June 2016 CCE 203.15.001
16D ?
ATTACHMENT VI
ANNUAL BUDGET SUMMARY
COMMUNITY CARE FOR THE ELDERLY PROGRAM
for
Collier County Board of County Commissioners
Collier
CCE Services $789,435.00
RATE SUMMARY
for
Collier County Board of County Commissioners
Collier County Total Unit Cost Reimbursement Rate-90%
Case Management $60.00 $54.00
Case Aide $33.88 $30.50
Adult Day Care $12.83 $11.55
Chore $23.33 $21.00
Enhanced Chore $30.33 $27.30
Companion $23.33 $21.00
Escort $21.66 $19.50
Skilled Nursing $42.00 $37.80
EARS $ 1.31 $ 1.18
Homemaking $21.50 $19.35
Personal Care $25.67 $23.10
Respite-in-Home $25.67 $23.10
Other $ 2.22 $ 2.00
Home Improvement $Cost Reimbursement 90% Cost Reimbursement
Material Aid $Cost Reimbursement 90% Cost Reimbursement
Specialized Medical Equipment,
Service& Supplies $ Cost Reimbursement 90% Cost Reimbursement
Transportation $ Cost Reimbursement 90% Cost Reimbursement
4
e
Revised August 2007 16 0 7
Attestation Statement
Agreement/Contract Number 203.15
Amendment Number 001
I, Stephen Y.Carnell ,attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
Public Services Department Head
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting,due to the differences in
electronic data processing media,which has no affect on the agreement/contract content.
Signature of R cipient/Con ractor representative Date
Approved as to form and legality
Assistant County Attorney
Revised August 2007
an