Backup Documents 09/27/2016 Item #16D13 1 6 0 1 3
COMMUNITY AND HUMAN SERIVCES
INTEROFFICE MEMORANDUM
TO: Board Minutes and Records
FROM: Lisa N. Carr, Grants Coordinator, CHS
DATE: September 29, 2016
RE: Agreements between Area Agency on Aging for Southwest Florida, Inc and
Collier County
Please find attached a fully executed document that was 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 September 27,2016 Item 16D13, 16D14 and 16D15.
Thank you for your assistance.
16D13
Amendment 005 July 2015 to June 2016 CCE 203.15.005
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
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 with the final allocation for the 2015-2016 contract
year,and revise ATTACHMENT III and ATTACHMENT VIII.
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$747,137.95, 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.
This amendment shall be effective June 30, 2016. 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.
IN WITNESS WHEREOF, the parties hereto have caused this 3 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: 1I6fO ' SIGNED BY: IgLt/t/lk /U2 ( l;
NAME: Steve Carnell NAME: MARIANNE G LORINI
TITLE: Public Services Department Head TITLE: PRESIDENT/CEO/
DATE: YHA, DATE: Ul5-1(40
Federal Tax ID: 59-6000-558
Fiscal Year Ending Date: 09/30
Approved as to form and legality
\\V?
1 Assistant County Attorney eN `(,k
, Amendment 005 July 2015 to June 2016 CCE 203.15.005
1 6 013
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 $ 747,137.95
TOTAL AWARD $ 747,137.95
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
2
, An`iendment 005 July 2015 to June 2016 CCE 203.15.005
16013
ATTACHMENT VIII
COMMUNITY CARE FOR THE ELDERLY PROGRAM
ANNUAL BUDGET SUMMARY
for
Collier County Board of County Commissioners,
Collier
CCE Services $747,137.95
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
3
1 6 0 1 3
Revised August 2007
Attestation Statement
Agreement/Contract Number CCE 203.15
Amendment Number 005
I, Steve 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
Collier County Board of County Commissioners .
(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.
0/4 i 41/4
rip' Air
1�6
Signature of Reci lent/Contractor representative Date
Approved as to form and legality
Assistant County Attorney .5 �
Revised August 2007
a
Amendment 004 July 2015 to June 2016 ADI 203.15.004
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC. 16 D 13
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 Commissioners("Contractor"),amends agreement ADI 203.15.
The purpose of this amendment is to amend 4. Contract Amount with the final allocation for the 2015-2016 contract
year,and revise ATTACHMENT III and ATTACHMENT VIII.
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$284,945.86, 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.
This amendment shall be effective June 30, 2016. 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.
IN WITNESS WHEREOF, the parties hereto have caused this 3 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: t,/ j/104ft
SIGNED BY: j 04 -
NAME: Steve Carnell NAME: MARIANNE G LORINI
TITLE: Public Services Department Head TITLE: PRESIDENT/CEO
DATE: S I ti f'ZO( DATE: g/ 1Ae
Federal Tax ID: 59-6000-558
Fiscal Year Ending Date: 09/30
Approved as to form and legality
Assistant County Attorney at.\
1 \
Amendment 004 July 2015 to June 2016 ADI 203.15.004
A4ACHl li I
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
Alzheimer's Disease Initiative General Revenue/TSTF-Collier 65004 $ 284,945.86
TOTAL AWARD $ 284,945.86
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
2
Amendment 004 July 2015 to June 2016 ADI 203.15.004
1 6 013
ATTACHMENT VIII
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
ANNUAL BUDGET SUMMARY
for
Collier County Board of County Commissioners,
Collier
ALLOCATION TOTAL $ 284,495.86
3
0
- Revised August 2007
Attestation Statement 16 D 13
Agreement/Contract Number ADI 203.15
Amendment Number 004
I, Steve 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
Collier County Board of County Commissioners .
(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.
ti Ofi
5//7// 6
, i
Signatu • of Rej
ent/Contractor representative Date
Approved as to form and legality
Assistant County Attorney
Revised August 2007
15
Amendment 004 July 2015 to June 2016 HCE 203.15.004
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC. 16 II 13
HOME CARE FOR THE ELDERLY 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 Commissioners("Contractor"), amends agreement HCE 203.15.
The purpose of this amendment is to amend 4. Contract Amount with the final allocation for the 2015-2016 contract
year, and revise ATTACHMENT IH and ATTACHMENT VI.
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$52,334.87,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.
This amendment shall be effective June 30, 2016. 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.
IN WITNESS WHEREOF, the parties hereto have caused this 3 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: 4 'AYd ,000 SIGNED BY: f. t //6V:44::,
NAME: STEVE CARNELL NAME: MARIANNE G LORINI
TITLE: PUBLIC SERVICES DEPARTMENT HEAD TITLE: PRESIDENT/CEO�j
4YDATE: l / DATE: 0%//�(o
Federal Tax ID: 9-60 0-558
Fiscal Year Ending Date: 09/30
Approved as to form and legality
Assistant Countye: 09/30
032
1 � 5b�'
Amendment 004 July 2015 to June 2016 HCE 203.15.004
16013
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
Home Care for the Elderly General Revenue -Collier 65.001 $ 52,334.87
TOTAL AWARD $ 52,334.87
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
2
O��
• Amendment 004 July 2015 to June 2016 HCE 203.15.004
16013
ATTACHMENT VI
HOME CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
Collier County Board of County Commissioners
Collier
HCE Services $52,334.87
3
Revised August 2007 16013
Attestation Statement
Agreement/Contract Number HCE 203.15
Amendment Number 004
I, Steve 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
Collier County Board of County Commissioners
(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.
opi
p
% izo77
Signature of Recipient/Contractor representative Date
Approved as to form and legality
Assistant County Attorney fT tot*
`
Revised August 2007