Backup Documents 11/09/2010 Item #10A ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 10 A TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO V
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper.Attach to original document.Original documents should be hand delivered to the Board Office.The completed routing slip and original
documents are to be forwarded to the Board Office only after the Board has taken action on the item.)
ROUTING SLIP
Complete routing lines#1 through#4 as appropriate for additional signatures,dates,and/or information needed.If the document is already complete with the
exception of the Chairman's signature,draw a line through routing lines#1 through#4,complete the checklist,and forward to Sue Filson(line#5).
Route to Addressee(s) Office Initials Date
(List in routing order)
1. Jane McDonald Housing and Human Services (.j
1 r C' /Zro -,e'/C)
2. Colleen Greene Assistant County Attorney
C1Y16r 0-lib 1 10
3. Fred W. Coyle, Chairman BCC
4.
5. Ian Mitchell, Executive Manager Board of County Commissioners 0 _ i 2/
(fig)
6. Minutes and Records Clerk of Court's Office
PRIMARY CONTACT INFORMATION
(The primary contact is the holder of the original document pending BCC approval.Normally the primary contact is the person who created/prepared the executive
summary.Primary contact information is needed in the event one of the addressees above,including Sue Filson,need to contact staff for additional or missing
information.All original documents needing the BCC Chairman's signature are to be delivered to the BCC office only after the BCC has acted to approve the
item.)
Name of Primary Staff Marcy Krumbine Phone Number (239) 252-8442
Contact
Agenda Date Item was November 9,2010 Agenda Item Number 10A
Approved by the BCC
Type of Document Agreement Number of Original 2
Attached Documents Attached
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column, whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Original document has been signed/initialed for legal sufficiency. (All documents to be
signed by the Chairman,with the exception of most letters,must be reviewed and signed ` 1
by the Office of the County Attorney. This includes signature pages from ordinances, ''l
resolutions,etc. signed by the County Attorney's Office and signature pages from l u
contracts,agreements,etc.that have been fully executed by all parties except the BCC
Chairman and Clerk to the Board and possibly State Officials.) 1
2. All handwritten strike-through and revisions have been initialed by the County Attorney's ( n/a
Office and all other parties except the BCC Chairman and the Clerk to the Board 1,�'.,.
3. The Chairman's signature line date has been entered as the date of BCC approval of the _" ,tJI
document or the final negotiated contract date whichever is applicable. 1
4. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's , j
' 1 ,di
signature and initials are required. j;'
5. In most cases(some contracts are an exception),the original document and this routing slip
should be provided to Ian Mitchell in the BCC office within 24 hours of BCC approval. it
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines! \--:- }
6. The document was approved by the BCC on 11/9/2010 and all changes made during I
the meeting have been incorporated in the attached document.The County Attorney's � ;,�
Office has reviewed the changes, if applicable. `ii..
i
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05
10A
MEMORANDUM
Date: December 16, 2010
To: Marcy Krumbine, Director
Human Services Department
From: Teresa Polaski, Deputy Clerk
Minutes & Records Department
Re: Agreement with the David Lawrence Mental Health
Center, Inc.
Enclosed please find one (1) original, as referenced above (Agenda Item
#10A), which were approved by the Board of County Commissioners on
Tuesday, November 9, 2010.
The Minutes & Records Department has retained the original for the
Board's Records.
If you should have any questions, please contact me at 252 -8411.
Thank you.
Enclosure
10A
MEMORANDUM
Date: December 16, 2010
To: Bonnie Baer, Assistant General Operations Manager
Clerk's Finance & Accounting
From: Teresa Polaski, Deputy Clerk
Minutes & Records Department
Re: Agreement with the David Lawrence Mental Health Center
Attached please find a copy of the document referenced above, (Agenda Item
#10A), which was approved by the Board of County Commissioners on
Tuesday, November 9, 2010.
If you have any questions, please call me at 252 -8411.
Thank you.
Enclosure
10A
AGREEMENT
THIS AGREEMENT entered into this ✓day of fl 6 ' , 2010 at Naples, Collier
County, Florida, by and between the Board of Founty Commissioners, Collier County, Florida,
hereinafter referred to as the COUNTY, and the David Lawrence Mental Health Center, Inc.,
located at 6075 Bathey Lane Naples, FL 34116, hereinafter referred to as the CENTER.
WHEREAS, the COUNTY is desirous of helping financially and has deemed it to be in
the public interest to do so for David Lawrence Mental Health, Inc.; and
WHEREAS, the COUNTY wishes to fund mental health and alcoholism services
provided by the CENTER as it is authorized to do so under its government; and
WHEREAS, the CENTER has contracted with the State of Florida, Department of
Children and Families to act as a provider of mental health and substance abuse services as
described by the approved District 8 Mental Health and Substance Abuse Plan of the Florida
Department of Children and Families.
NOW, THEREFORE, in consideration of the mutual undertaking and agreements
hereinafter set forth, the COUNTY and CENTER agree as follows:
I. The CENTER shall:
A. Provide mental health and alcoholism services consistent with the approved
Florida Department of Children and Families District 8 Mental Health and
Substance Abuse Plan [ "District Plan "], incorporated herein by reference, and
shall do so in compliance with all state, federal and local laws and ordinances and
regulations.
B. Serve as an independent contractor, not an agent or employee of Collier County,
for the transportation and care of patients restrained pursuant to the Florida
"Baker Act," Florida Statutes, Chapter 394.451, et seq., adhering to all regulatory
and legal requirements of said act, Rule 10E- 5.040, F, of the Florida
Administrative Code and all other pertinent laws, rules and regulations.
C. Provide detoxification services consistent with the approved District Plan.
D. Provide these services within the boundaries of the COUNTY, Florida.
E. Possess, maintain and keep current all necessary license(s).
10A
F. Adhere to all conditions applicable to the administration of mental health funds
pursuant to Florida Statutes, Chapter 394.451, et seq., and the administrative rules
attendant thereto.
G. Maintain adequate financial records and reports relating to all funds paid by the
COUNTY under this Agreement.
H. Maintain books, records, documents and other evidence of accounting procedures
and practices that fully and properly reflect all direct and indirect costs of any
nature expended in the performance of this Agreement and paid for with
COUNTY funds.
1. Maintain adequate fiscal accounting procedures for the audit or review of any
expenditures, as requested by the COUNTY from time to time.
J. Allow, upon request the inspection, review or audit of its fiscal records by
COUNTY personnel upon request by COUNTY.
K. Collect fiscal and operational statistical data pertaining to the care and treatment
of all patients served and funded by the COUNTY on a regular basis and deliver
these written fiscal statistical reports on a quarterly basis to the COUNTY Human
Services Director by the 10`h day of the month immediately following the
preceding quarter.
L. Submit payroll records and activity data to the COUNTY Housing and Human
Services Director on a quarterly basis in order that the disbursement of COUNTY
funds to reimburse the CENTER for such expenditures shall be in accordance
with the pre- auditing and accounting procedures on the part of the Board of
County Commissioners as mandated by Sections 129.08 and 129.09, Florida
Statutes.
M. Retain all books, records and other documents relative to this Agreement for three
(3) years after final payment.
N. Acting as an independent contractor and not as an employee of the COUNTY in
operating aforementioned services, the CENTER shall be liable for, and shall
indemnify, defend, and hold the COUNTY, State and Federal Government
harmless from and against all claims, suits, judgments, damages, losses and
attorney's fees and expenses arising from its operations and provision of the
aforementioned services during the course of this agreement
During the term of this agreement the CENTER shall procure and maintain
liability insurance coverage. The liability insurance coverage shall be in amounts
not less than $1,000,000 per person and $2,000,000 per incident or occurrence for
personal injury, death, and property damage or any other claims for damages
2
10A
caused by or resulting from the activities under this Agreement. Such policies of
insurance shall name the COUNTY as an additional insured. The CENTER shall
submit written evidence of having procured all insurance policies required herein
no later than 10 days after the effective date of this Agreement and shall submit
written evidence of such insurance policies to the COUNTY Housing and Human
Services Director and to the COUNTY's Risk Management office. The CENTER
shall purchase all policies of insurance from a financially responsible insurer duly
authorized to do business in the State of Florida. The CENTER shall be
financially responsible for any loss due to failure to obtain adequate insurance
coverage and the failure to maintain such policies or certificate in the amounts set
forth herein shall constitute a breach of this agreement.
O. Submit to the COUNTY each year a copy of its annual audited financial
statements.
it. The COUNTY shall:
A. Provide $899,300 to the Agency for Health Care Administration (AHCA) for the
purpose of funding the Low Income Pool (LIP) program, and AHCA will provide
matching funds in the amount of $134,895.
B. Work with the Agency for health Care Administration (AHCA) and Physicians
Regional Medical Center (PRMC) to ensure that quarterly payments are made to DLC
in advance, at least one -fourth (1/4) of the total allocation for "Operational Funds"
approved for the CENTER by the Board of County Commissioners as specified in
Section III -D of this Agreement, in accordance with the approved District Plan.
C. The total contribution to DLC is $1,034,195. If AHCA is unable to provide the full
match funding ($134,895), Collier County may provide supplemental funds to ensure
that the total contribution is available, subject to the availability of Collier County's
funds.
1II. The CENTER and COUNTY mutually agree:
A. The term of this agreement is from October 1, 2010 to September 30, 2011.
B. This Agreement may be terminated by either party upon thirty (30) days prior
notice in writing to the other party.
C. This Agreement is subject to an annual item of appropriation contained in the
annual County budget.
D. The entire financial obligation of the COUNTY under this Agreement shall not
exceed one million thirty -four thousand, one hundred and ninety -five dollars
3
10A
($1,034,195), subject to the availability of funds. The $1,034,195 includes the
funding for all Operational costs, including transportation of Baker Act
participants. The matching funds shall come from local sources and shall be
utilized as part of the matching requirements of Section 394.76(9)(a) and (b),
Florida Statutes.
E. There will be no discrimination on the basis of race, color, sex, religious
background or national origin in performance of this Agreement in regard to
provisions of service or in regards to employment.
F. No modification, amendments or alterations to the terms or conditions contained
herein shall be effective unless contained in a written document and fully
executed by both parties.
G. The CENTER shall not assign the performance of services called for in the
Agreement without the written consent of the COUNTY.
H. All notices, requests, consents and other communications required or permitted
under this Agreement shall be in writing addressed to:
If to the COUNTY:
Collier County Housing, Human and Veteran Services Director
Health and Public Services Building
3301 East Tamiami Trail
Naples, FL 34112
If to the CENTER:
Chief Executive Officer
David Lawrence Mental Health Center, Inc.
6075 Bathey Lane
Naples, FL 34116
or to such other address as any party may designate by notice complying with the
terms herein stated.
El
10A
IN WITNESS WHEREOF, the parties hereto have set their hands and seals the day and
year first above written.
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIQ11f�';AN�)CK, Clerk COLLIER COUNTY, FLORIDA
1
y(� L t;
By: _
De�r �F�rainn o Fred W. Coyle, Chairman' `
Board of Count Commissioners
aign�tiuce,?t!a?�; . Y
Date: November 9, 2010
DAVID LAWRENCE CENTER:
Approved as to form and
legal sufficiency ��
By:
David Schimmel, Chief Executive Officer
a Date: November 9, 2010
t ant County Attorney
Collier County
5