Backup Documents 12/11-12/2012 Item #16D16 Amendment 002 CCE 203.12.002
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
dba SENIOR CHOICES OF SOUTHWEST FLORIDA
STANDARD CONTRACT DI 6
COMMUNITY 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. dba Senior Choices
of Southwest Florida("Agency") and Collier County Board of County Commissioners, ("Recipient"), amends agreement
CCE 203.12.
The purpose of this amendment is to revise Attachment VIII,Budget Summary by adding Respite Care(Facility Based)
RESF (24 hrs)service to the Rate Summary section.
This amendment shall be effective on July 1, 2012. 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 2 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. DBA SENIOR CHOICES OF
SOUTHWEST FLORIDA
-
SIGNED BY: • ; ,�t`,�•1 I SIGNED BY: (<12(—cxerti'�—�
NAME: Stephen Y. Carnell NAME: LEIGH A A NOWAK
TITLE: Interim Public Services Administrator TITLE: BOARD PRESIDENT
DATE: DATE: ))-I /3 /12
Federal Tax ID: 59-60005 88
Fiscal Year Ending Date: 09/30
AWViad as to form & legal Sufficiency
Assistant County Attorney
1
Amendment 002 6 D 1 6 CCE 203.12.002
ATTACHMENT VIII
COMMUNITY CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
for
Collier County Board of Commissioners
Collier County
1. CCE Spending Authority $589,107.00
2. Case Management and 72,250.00
Case Aide
Total $661,357.00
RATE SUMMARY
for
Collier County Board of Commissioners
Collier County
Collier County Total Unit Cost Reimbursement Rate-90%
Case Management $55.56 $50.00
Case Aide $30.00 $27.00
Adult Day Care $12.22 $11.00
Chore $22.22 $20.00
Enhanced Chore $28.89 $26.00
Companion $22.22 $20.00
Skilled Nursing $40.00 $36.00
EARS $ 1.24 $ 1.12
Homemaking $21.11 $19.00
Personal Care $24.44 $22.00
Respite-In Home $24.44 $22.00
Respite Facility $12.22 $11.00
Respite Care—Facility Based(24 Hrs.) $150.00 $135.00
Specialized Medical Equipment,
Services&Supplies $Cost Reimbursement $90%Cost Reimbursement
Transportation $Cost Reimbursement $90%Cost Reimbursement
2
16016
Attestation Statement
Agreement/Contract Number CCE 203.12
Amendment Number 002
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 dba as Senior Choices of Southwest Florida and
Collier County Board of Commissioners
(Signature of 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.
/At/
Pr (I tv (I (1(AL
Stephen Y.Carnell,Inter Administrator Date
Collier County Public Services Division
Approved as to form & legal Sufficiency
Acaistant County Attorney -