Agenda 01/28/2020 Item #16D 2 (3rd Amendment to Agreement CC w/David Lawrence Mental Health Center, Inc, CCSO & NAMI of CC)01/28/2020
EXECUTIVE SUMMARY
Recommendation to approve and authorize the Chairman to sign the Third Amendment between
Collier County and the David Lawrence Mental Health Center, Inc., Collier County Sheriff’s Office
and NAMI of Collier County.
OBJECTIVE: To maintain compliance with the Department of Children and Families (DCF) grant
requirements and implement substance abuse and mental health services for persons in Collier County
involved with the criminal justice system.
CONSIDERATIONS: The Criminal Justice Mental Health Substance Abuse (CJMHSA) program was
established by the State to provide funding to communities. These funds can be used to plan, implement,
or expand initiatives that increase public safety, avert increased spending on criminal justice, and improve
the accessibility and effectiveness of treatment services for adults and juveniles who have a mental
illness, substance abuse disorder, or co-occurring mental health and substance abuse disorders and who
are in, or at risk of entering, the criminal justice system.
On June 13, 2017, Agenda Item #16D4, the Board of County Commissioners (Board) approved Collier’s
agreement with the DCF, and on July 11, 2017, Agenda Item #16D8, the Board approved the associated
subrecipient agreements with David Lawrence Mental Health Center, Inc. (DLC), Collier County
Sheriff’s Office (CCSO), and NAMI of Collier County to implement a three-year Criminal Justice Mental
Health Substance Abuse Reinvestment Grant Program. The agreements became effective July 1, 2017 and
expire June 30, 2020.
On June 26, 2018, Agenda Item #16D15, the Board approved the First Amendment to the master
agreement and corresponding subrecipient agreements. On April 23, 2009, Agenda Item #16D7, the
Board approved the Second Amendment to the master agreement and corresponding subrecipient
agreements.
The Third Amendment to the subrecipient agreements addresses budget changes and modifies the
financial penalty language as follows:
David Lawrence Center, CJMHSA-001 agreement makes the following changes:
1. Revise staffing levels.
2. Clarify and outline the protocol for releasing retainage and penalties held from the subrecipients
upon the completion of the grant agreement.
Collier County Sherriff’s Office, CJMHSA-002 agreement includes the following actions:
1. Budget modification for Program Year 3 to move money out of the salary line item for the
Reintegration Specialists in order to be able to cover benefits.
2. Clarify and outline the protocol for releasing retainage and penalties held from the subrecipients
upon the completion of the grant agreement.
3. Add language to allow ten percent (10%) line item budget shifts.
NAMI of Collier County agreement includes the following:
1. Clarify and outline the protocol for releasing retainage and penalties held from the subrecipients
upon the completion of the grant agreement.
FISCAL IMPACT: The proposed action has no new Fiscal impact. Funds are budgeted within Human
Services Grant Fund (707), and Human Services Match Fund (708), Project 33513.
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01/28/2020
GROWTH MANAGEMENT IMPACT: There is no Growth Management impact associated with this
Executive Summary.
LEGAL CONSIDERATIONS: This item is approved for form and legality and requires a majority vote
for Board action - JAB
RECOMMENDATION: To approve and authorize the Chairman to sign the Third Amendment between
Collier County and the David Lawrence Mental Health Center, Inc., Collier County Sheriff’s Office and
NAMI of Collier County.
Prepared By: Rachel Brandhorst, Grant Coordinator, Community and Human Services Division
ATTACHMENT(S)
1. DLC CJMHSA Executed Grant 2017-2020 (PDF)
2. DLC Amendment # 1 (PDF)
3. DLC Executed Amendment No. 2 (PDF)
4. CCSO Executed CJMHSA Grant 2017-2020 (PDF)
5. CCSO Amendment No1 (PDF)
6. CCSO Executed Amendment No. 2 (PDF)
7. NAMI executed CJMHSA Grant 2017-2020 (PDF)
8. NAMI Amendment No1 (PDF)
9. NAMI Executed Amendment No.2 (PDF)
10. DLC Amendment No. 3 (PDF)
11. NAMI Amendment No. 3 (PDF)
12. CCSO Amendment No. 3 (PDF)
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01/28/2020
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.D.2
Doc ID: 11214
Item Summary: Recommendation to approve and authorize the Chairman to sign the Third
Amendment between Collier County and the David Lawrence Mental Health Center, Inc., Collier County
Sheriff’s Office and NAMI of Collier County.
Meeting Date: 01/28/2020
Prepared by:
Title: Grants Coordinator – Community & Human Services
Name: Rachel Brandhorst
12/27/2019 1:10 PM
Submitted by:
Title: Manager - Federal/State Grants Operation – Community & Human Services
Name: Kristi Sonntag
12/27/2019 1:10 PM
Approved By:
Review:
Community & Human Services Blanca Aquino Luque Additional Reviewer Completed 12/30/2019 4:31 PM
Community & Human Services Maggie Lopez Additional Reviewer Completed 12/31/2019 10:53 AM
Community & Human Services Tami Bailey Additional Reviewer Completed 01/03/2020 9:55 AM
Community & Human Services Kristi Sonntag CHS Review Completed 01/03/2020 1:01 PM
Operations & Veteran Services Kimberley Grant Level 1 Reviewer Completed 01/07/2020 11:26 AM
Public Services Department Todd Henry Level 1 Division Reviewer Completed 01/07/2020 12:29 PM
Grants Erica Robinson Level 2 Grants Review Completed 01/13/2020 9:44 AM
Public Services Department Steve Carnell Level 2 Division Administrator Review Completed 01/14/2020 1:09 PM
County Attorney's Office Jennifer Belpedio Level 2 Attorney of Record Review Completed 01/15/2020 8:29 AM
County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 01/15/2020 11:51 AM
Grants Valerie Fleming Level 3 OMB Gatekeeper Review Completed 01/16/2020 9:59 AM
Grants Therese Stanley Additional Reviewer Completed 01/16/2020 12:21 PM
County Manager's Office Sean Callahan Level 4 County Manager Review Completed 01/20/2020 1:03 PM
Board of County Commissioners MaryJo Brock Meeting Pending 01/28/2020 9:00 AM
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16.D.2.aPacket Pg. 1712Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1713Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1714Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1715Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1716Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1717Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1718Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1719Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1720Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1721Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1722Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1723Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1724Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1725Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1726Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1727Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1728Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1729Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1730Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1731Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1732Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1733Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1734Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1735Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1736Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1737Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1738Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1739Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1740Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1741Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1742Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1743Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1744Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1745Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1746Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1747Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1748Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.aPacket Pg. 1749Attachment: DLC CJMHSA Executed Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.bPacket Pg. 1750Attachment: DLC Amendment # 1 (11214 : CJMHSA Amendment No.3)
16.D.2.bPacket Pg. 1751Attachment: DLC Amendment # 1 (11214 : CJMHSA Amendment No.3)
16.D.2.bPacket Pg. 1752Attachment: DLC Amendment # 1 (11214 : CJMHSA Amendment No.3)
16.D.2.bPacket Pg. 1753Attachment: DLC Amendment # 1 (11214 : CJMHSA Amendment No.3)
16.D.2.bPacket Pg. 1754Attachment: DLC Amendment # 1 (11214 : CJMHSA Amendment No.3)
16.D.2.bPacket Pg. 1755Attachment: DLC Amendment # 1 (11214 : CJMHSA Amendment No.3)
16.D.2.bPacket Pg. 1756Attachment: DLC Amendment # 1 (11214 : CJMHSA Amendment No.3)
16.D.2.bPacket Pg. 1757Attachment: DLC Amendment # 1 (11214 : CJMHSA Amendment No.3)
16.D.2.bPacket Pg. 1758Attachment: DLC Amendment # 1 (11214 : CJMHSA Amendment No.3)
16.D.2.bPacket Pg. 1759Attachment: DLC Amendment # 1 (11214 : CJMHSA Amendment No.3)
SECOND AMENDMENT TO AGREEMENT CJMHSA-001 BETWEEN
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
AND
DAVID LAWRENCE MENTAL HEALTH CENTER, INC.
This Amendment, is entered into this 2-3 \f-d\ day of scn \2019, by
and between David Lawrence Mental Health Center, Inc. hereinafter referred to as Subrecipient
and Collier County, a political subdivision of the State of Florida, hereinafter referred to as
COUNTY," collectively stated as the"Parties."
WHEREAS, on July 11, 2017, the County and Subrecipient entered into an agreement for
Subrecipient to provide "FIRST grant services"to Collier County residents (hereinafter referred to
as the "Agreement"); and
WHEREAS, on June 26, 2018 the Board of County Commissioners approved the First
Amendment to the agreement which defined a successful discharge, added staff to participant
ratio, provided clarification to the Planning Council requirements, outlined subrecipient match
obligation, modified Exhibit G, added Exhibit J and added Exhibit K; and
WHEREAS, the parties desire to modify the Agreement to update Section 16, revise
contact information in Section 22, modify Exhibit C to add additional requirements and revise
contact information, modify Exhibit E to reduce the targets and corresponding performance
evaluation methodologies, modify Exhibit G to reflect the requirement of a monthly client tracking
report, replace Exhibit H-1 and add Exhibit L, Monthly Client Tracking Report; and
WHEREAS, the effective date of this amendment shall be April 1, 2019.
NOW, THEREFORE, in consideration of foregoing Recitals, and other good and valuable
consideration, the receipt and sufficiency of which is hereby mutually acknowledged, the Parties
agree to modify the Agreement as follows:
Words Strusk-T-hfeugh are Deleted; Words Underlined are added
1. Section 16, Data Security is replaced with the following:
The Subrecipient shall comply with the following information security requirements whenever the
Subrecipient has access to Department data information systems or maintain any client or other
confidential information in electronic form:
16.1 An appropriately skilled individual shall be identified by the Subrecipient to function as its
Information Security Officer. The Information Security Officer shall act as the liaison to the
County's security staff and will maintain an appropriate level of information security for
Department's information systems or any client or other confidential information the Subrecipient
is collecting or using in the performance of this Contract. An appropriate level of security includes
approving and tracking all who request or have access, through the Subrecipient's access, to
Department's information systems or any client or other confidential information. The Information
Security Officer will ensure that any access to County or Department's information systems or
any client or other confidential information is removed immediately upon such access no longer
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being required for Subrecipient's performance under this contract.
16.2 The Subrecipient shall complete the latest Department of Children and Families security
awareness training to all who request or have access, through the Subrecipient's access, to
information systems or any client or other confidential information.
16.3 All who request or have access, through the Subrecipient's access, to information systems
or any client or other confidential information shall comply with, and be provided a copy of the
Department's CFOP 50-2, and shall sign the DCF Security Agreement form CF 0114 annually. A
copy of CF 0114 may be obtained from the County Grant Coordinator.
16.4 The Subrecipient shall prevent unauthorized disclosure or access, from or to information
systems or client or other confidential information. Client or other confidential information on
systems and network capable devices shall be encrypted per the Department's CFOP 50-2.
16.5 The Subrecipient agrees to notify the Grant Coordinator as soon as possible, but no later
than five (5) business days following the determination of any potential or actual unauthorized
disclosure or access to Department information systems or to any client or other confidential
information.
16.6 The Subrecipient shall, at its own cost, comply with section 501.171, F.S. The Subrecipient
shall also, at its own cost, implement measures deemed appropriate by the County or the
Department to avoid or mitigate potential injury to any person due to potential or actual
unauthorized disclosure or access to Department's information systems or to any client or other
confidential information.
2. Section 22, Notices
All Notices from the Subrecipient to the County shall be deemed duly served if mailed or faxed
to the County to:
Collier County Government Center
Community and Human Services Division
3339 Tamiami Trail, East
Suite 211
Naples, Florida 34112
Attention: Dawn Whelan,Rachel Brandhorst Grant Coordinator
Telephone: 239-252-4230-239-398-8932
Facsimile: 239-252-6571
3. Exhibit C-Task List, C-1 Service Tasks is amended to add the following:
C-1.2.3 A Monthly Client Tracking Report shall be used to record the efforts made to contact
individuals that have been discharged from the program. The information shall include but is not
limited to, client ID, date entered into HMIS, date of discharge, telephone number, date of call,
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contact status, housing status, current address, employment status, employer information, staff
comments, and staff ID.
C-1.2.4 All clients are to be entered into the Homeless Management Information System (HMIS)
C-1.2.5 Subrecipient will provide a voucher for one(1)gift card provided by NAMI to be distributed
to clients at the time of discharge to encourage clients to participate in follow-up activities one-
year post discharge.
4. Exhibit C-Task List, C-7 Reports is amended to add the following:
C.7.1.3 Monthly Client Tracking Report A monthly tracking report to record the efforts made to
contact clients that have been discharged from the program. The form shall include: client ID,
date entered into HMIS,date of discharge, telephone number, date of call, contact status, housing
status, current address, employment status, employer information, staff comments, staff ID.
5. Exhibit C-Task List, C-7.2 Reporting Schedule
Table 1 - Reporting Schedule
Report Title Report Due Date(s)
Submit Report to:
Community & Human
Quarterly Program Status 5th day of the quarter following the quarter Services,
Report of program services or activities Attention awn
Whelan; Rachel
No later than 30 days following the ending Brandhorst, Grant
Final Program Status Report date of the Contract Coordinator
I
Community & Human
Monthly Client Tracking Report 5th day of each month
Services, Attention:
Rachel Brandhorst,
Grant Coordinator
Community & Human
Monthly Expenditure Report The 30th day after prior month end Services, Attention:
Blanca Aquino-Luque
6. Exhibit E, Performance Measures is amended as follows:
Subrecipient shall submit quarterly performance reports for the following measures:
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E-1. PERFORMANCE MEASURES. The following qualitative performance measures are
established pursuant to the contract and shall be maintained during the term of this Contract and
reported quarterly.
E-1.3-604 40% of Program participants not residing in a stable housing environment at
program admission will report living in a stable housing environment within 90 days of Program
admission.
E-1.4 60% 60% of Program participants will be assisted in applying or be linked to Social
Security or other benefits for which they may have been eligible but were not receiving at
Program Admission.
E-1.6 60% 40% of Program participants not employed at Program admission who are
employed full or part-time within 180 days of Program admission.
E-2. PERFORMANCE EVALUATION METHODOLOGY. The County will monitor the
Subrecipients performance in achieving the standards in Section E-1 according to the
following methodology.
E-2.3. For the measure in Section E-1.3.,the total number of Program participants not residing
in a stable housing environment at program admission who live in a stable housing
environment within 90 days of Program admission DIVIDED BY the total number of Program
participants not residing in a stable housing environment at Program admission shall be
GREATER THAN OR EQUAL TO 60°4.40%
E-2.4. For the measure in Section E-1.4., the total number of program participants who were
eligible for, but not receiving, social security or other benefits at program admission who are
assisted with applying for such benefits within 180 days of admission DIVIDED BY the total
number of program participants who were eligible for, but not receiving, those benefits at
program admission shall be GREATER THAN OR EQUAL TO 8044,60%
E-2.6. For the measure in Section E.1.6.,the total number of program participants not enrolled
at Program admission who are employed full or part-time within 180 days of Program
admission DIVIDED BY the total number of Program participants not employed at Program
admission shall be GREATER THAN OR EQUAL TO 60%,40%
E-3. For the following measures the Subrecipient shall provide client data for tracking to NAMI
on a quarterly basis as evidence by the Outcome Tracking Log (to be submitted with each request
for payment);
E.3.1. 60% 10% of Program participants not resident in a stable housing environment at
Program admission will report living in a stable housing environment one year following
Program discharge.
E.3.2. 60% 10% of Program participants not employed at Program admission who are
employed full or part-time within one year following Program discharge.
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Packet Pg. 1763 Attachment: DLC Executed Amendment No. 2 (11214 : CJMHSA Amendment No.3)
E-4. The County will monitor through the annual monitoring process conducted by the CHS
Grants Compliance Unit the Subrecipients performance in providing data to NAMI and
participation in achieving the standards in Section E-3, according to the following
methodology.
E.4.1. For the measure in Section E.3.1. the total number of Program participants not
residing in a stable housing environment at program admission who live in stable housing one
year following Program discharge DIVIDED BY the total number of Program participants not
residing in stable housing at Program admission shall be GREATER THAN OR EQUAL TO
60% 10%
E.4.2 For the measure in Section E.3.2. the total number of Program participants not
employed at Program admission who are employed full or part-time one year following
Program discharge DIVIDED BY the total number of Program participants not employed at
Program admission shall be GREATER THAN OR EQUAL TO 60%, 10%
7. Exhibit G, Deliverable and Report Table is amended as follows:
Report/Deliverable Name Supporting Document Due Date
Quarterly Payment As detailed in Exhibit F.1.4 5th day of the month
Request and Exhibit H following the end of the
quarter
Match Match documentation, Annually
Exhibit H-1
Monthly Financial Report Exhibit J The 30th day after prior
month end
Reconciliation of Exhibit K 1st day of August
Expenditures following the end of each
fiscal year
Quarterly Program Quarterly Service Report 5th day of the month
Services Report following the end of the
quarter
Final Program Report Final Program Report 30 days following the
Template ending date of the
agreement
Incident Report Incident Report Per Occurrence
Employment Screening Certification from each July 31 and per
Certification employee working on grant occurrence for each new
hire
5
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Packet Pg. 1764 Attachment: DLC Executed Amendment No. 2 (11214 : CJMHSA Amendment No.3)
Security Awareness Certificate for those staff 1 At contract execution
Training entering data into State and annually thereafter.
System
Insurance (Director& Insurance Within 30 days of
Officer, Workmen's Comp,Certificate/Deceleration expiration
Liability)
Favorable Conditions Attestation Form July 31 and annually
thereafter.
Financial and Compliance Exhibit I Annually within 9 months
Audit of Fiscal Year End
Disaster Plan Plan Within 30 days of
contract execution and
within 30 days of any
changes to the plan.
Deaf-and-Hard of Hearing Single Point of Contact and 5th day of the month
ADA Report following the end of the
quarter
CHS Conflict of Interest Conflict of Interest Form Within 30 day of hire for
each new employee
working on the grant.
Monthly Client Tracking Exhibit L 5th day of the month
Report following the end of the
quarter
8. Exhibit H-1, Match Submission is hereby replaced in its entirety as attached.
9. Exhibit L, Monthly Client Tracking Report is hereby added in its entirety as attached.
SIGNATURE PAGE TO FOLLOW
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Packet Pg. 1765 Attachment: DLC Executed Amendment No. 2 (11214 : CJMHSA Amendment No.3)
IN WITNESS WHEREOF, the parties hereto, have each, respectively, by an authorized person
or agent, have executed this Contract on the date and year first written above.
ATTEST: David Lawrence Mental Health Center, Inc.
Crysta Kinzel, CL RK
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Approval for form and legality: COLLIER COU
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CJ J By: C' :e_
Jenni er A. Belpedio C„, Will' L. McDaniel, Jr., CHA ` AN
Assistant County Attorney C 's. \\
Date: 4 \'A- \\C
7
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Packet Pg. 1766 Attachment: DLC Executed Amendment No. 2 (11214 : CJMHSA Amendment No.3)
EXHIBIT"H-1"
COLLIER COUNTY COMMUNITY AND HUMAN SERVICES
MATCH SUBMISSION
SECTION I:MATCH SUBMISSION
Sub recipient Name:
Sub recipient Address:
Project Name:
Project No: Match Request# 1
Total Match: $0.00
Period of Availability:
SECTION I:STATUS OF FUNDS
1. Grant Match Amount
2. Sum of Past Claims Paid on this Account
3. Total Match Amount Awarded Less Sum Of Past
Claims Paid on this Account 0.00
4. Amount of Previous Unpaid Requests(Insert any unpaid request)
5. Amount of Today's Request
8. Current Grant Balance (Initial Match Less Sum of all
requests)
I certify that this match submission has been made in accordance with the terms and conditions of the Agreement between the
COUNTY and us as the SUBRECIPIENT.To the best of my knowledge and belief,all grant requirements have been followed.
Signature Date
Title
Authorizing Grant Accountant
Authorizing Grant Coordinator
Supervisor Department Director
approval required$15,000 and above) approval required$15,000 and above)
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Packet Pg. 1767 Attachment: DLC Executed Amendment No. 2 (11214 : CJMHSA Amendment No.3)
Exhibit L
Monthly Client Tracking Report
Discharge
Client ID HMIS Date Date Phone Number Date(s)of Calls Contact? Housing Status Address Employed?FT/PT? Employer Staff Comments Staff ID
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16.D.2.dPacket Pg. 1769Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1770Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1771Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1772Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1773Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1774Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1775Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1776Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1777Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1778Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1779Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1780Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1781Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1782Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1783Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1784Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1785Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1786Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1787Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1788Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1789Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1790Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1791Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1792Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1793Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1794Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1795Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1796Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1797Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1798Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1799Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1800Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1801Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1802Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1803Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1804Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1805Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.dPacket Pg. 1806Attachment: CCSO Executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.ePacket Pg. 1807Attachment: CCSO Amendment No1 (11214 : CJMHSA Amendment No.3)
16.D.2.ePacket Pg. 1808Attachment: CCSO Amendment No1 (11214 : CJMHSA Amendment No.3)
16.D.2.ePacket Pg. 1809Attachment: CCSO Amendment No1 (11214 : CJMHSA Amendment No.3)
16.D.2.ePacket Pg. 1810Attachment: CCSO Amendment No1 (11214 : CJMHSA Amendment No.3)
SECOND AMENDMENT TO AGREEMENT CJMHSA-002 BETWEEN
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
AND
COLLIER COUNTY SHERIFF'S OFFICE
This Amendment, is entered into this day of 2019, by
and between the Collier County Sheriffs Office hereinafter referred to as Su recipient and Collier
County, a political subdivision of the State of Florida, hereinafter referred to as "COUNTY,"
collectively stated as the "Parties."
WHEREAS, on July 11, 2017, the County and Subrecipient entered into an agreement for
Subrecipient to provide"FIRST grant services" to Collier County residents (hereinafter referred to
as the "Agreement"); and
WHEREAS, on June 26, 2018 the Board of County Commissioners approved the First
Amendment to the agreement which defined a successful discharge, clarified the quarterly CIT
training requirement, revised the Planning Council requirements, reflected staffing changes, and
outlined subrecipient match obligation; and
WHEREAS, the parties desire to modify the Agreement to update Section 16, revise
contact information in Section 22, modify Exhibit C to add additional requirements and revise
contact information and replace Exhibit H-1; and
WHEREAS, the effective date of this amendment shall be April 1, 2019
NOW, THEREFORE, in consideration of foregoing Recitals, and other good and valuable
consideration, the receipt and sufficiency of which is hereby mutually acknowledged, the Parties
agree to modify the Agreement as follows:
Words amuck Through are deleted; Words Underlined are added.
1. Section 16, Data Security is replaced by the following:
The Subrecipient shall comply with the following information security requirements whenever the
Subrecipient has access to Department data information systems or maintain any client or other
confidential information in electronic form:
16.1 An appropriately skilled individual shall be identified by the Subrecipient to function as its
Information Security Officer. The Information Security Officer shall act as the liaison to the
County's security staff and will maintain an appropriate level of information security forDepartment's information systems or any client or other confidential information the Subrecipient
is collecting or using in the performance of this Contract. An appropriate level of security includes
approving and tracking all who request or have access, through the Subrecipient's access, to
Department's information systems or any client or other confidential information. The Information
Security Officer will ensure that any access to County or Department's information systems or
any client or other confidential information is removed immediately upon such access no longer
being required for Subrecipient's performance under this contract.
16.2 The Subrecipient shall complete the latest Department of Children and Families security
1
16.D.2.f
Packet Pg. 1811 Attachment: CCSO Executed Amendment No. 2 (11214 : CJMHSA Amendment No.3)
awareness training to all who request or have access, through the Subrecipient's access, to
information systems or any client or other confidential information.
16.3 All who request or have access, through the Subrecipient's access, to information systems
or any client or other confidential information shall comply with, and be provided a copy of the
Department's CFOP 50-2, and shall sign the DCF Security Agreement form CF 0114 annually. A
copy of CF 0114 may be obtained from the County Grant Coordinator.
16.4 The Subrecipient shall prevent unauthorized disclosure or access, from or to information
systems or client or other confidential information. Client or other confidential information on
systems and network capable devices shall be encrypted per the Department's CFOP 50-2.
16.5 The Subrecipient agrees to notify the Grant Coordinator as soon as possible, but no later
than five (5) business days following the determination of any potential or actual unauthorized
disclosure or access to Department information systems or to any client or other confidential
information.
16.6 The Subrecipient shall, at its own cost, comply with section 501.171, F.S. The Subrecipient
shall also, at its own cost, implement measures deemed appropriate by the County or the
Department to avoid or mitigate potential injury to any person due to potential or actual
unauthorized disclosure or access to Department's information systems or to any client or other
confidential information.
2. Section 22, Notices
All Notices from the Subrecipient to the County shall be deemed duly served if mailed or
faxed to the County to:
Collier County Government Center
Community and Human Services Division
3339 Tamiami Trail, East
Suite 211
Naples, Florida 34112
Attention: Dawe Rachel Brandhorst Grant Coordinator
Telephone: 239 252 '1230 239-398-8932
Facsimile: 239-252-6571
3. Exhibit C-Task List, C-1 Service Tasks
C-1.2.3 All clients are to be entered into the Homeless Management Information System (HMIS)
4. Exhibit C-Task List, C-2.6 Reporting Schedule
2
16.D.2.f
Packet Pg. 1812 Attachment: CCSO Executed Amendment No. 2 (11214 : CJMHSA Amendment No.3)
Table 1 - Reporting Schedule
Report Title Report Due Date(s) Submit Report to:
Quarterly Program Status 5th day of the quarter following the quarter Community &
Report of program services or activities
Human Services
Attention: Dawn
Wheian, Rachel
No later than 30 days following the ending Brandhorst, Grant
Final Program Status Report
date of the Contract Coordinator
f
5. Exhibit H-1, Request for Payment is hereby replaced as attached.
SIGNATURE PAGE TO FOLLOW
3
16.D.2.f
Packet Pg. 1813 Attachment: CCSO Executed Amendment No. 2 (11214 : CJMHSA Amendment No.3)
IN WITNESS WHEREOF, the parties hereto, have each, respectively, by an authorized person
or agent, have executed this Contract on the date and year first written above.
ATTEST: Collier County Sheriff's Office
CRYSTAL K. KINZEL, CLERK
t ;Ck-eckh-11/4COCS) 1(±)//By:
Attest aS PtiNaAERK
s!pature only,
Title: .D f eri Cc
Date:
Approval for form and legality: COLLI ERCp
mac A
By:
J niter A. Bel io C Wham L. McDaniel, Jr., CHA -MAN
Assistant County Attorney 4.-}-
r \ 1
01/4\Date: 4-/a) 1
4
16.D.2.f
Packet Pg. 1814 Attachment: CCSO Executed Amendment No. 2 (11214 : CJMHSA Amendment No.3)
EXHIBIT H
PAYMENT/MATCH REQUEST
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COLLIER COUNTY C•_OMMUNITY.AND HUMAN'
iT I31rQ1J ; '?I3_ '11i1J117.mac
SECTION 1 REQUEST FOR PAYMENT
t „? em Yom.-4`i e e g i r .., .fi e ®f
Sub recipient Address 3319 E'Tamiami Trail, Na les FL, 34119--
serns.'d i>;.•
Project`N-• LHZS4.- Pai. .,....,.:,,,, ,_
1? e rXi`fid,! !.-'l S b`-G_-_
Period of Aveilability
SECTION I.. STATUS OF FUNDS=---77:3; ‘-;';-,,:---('
s -- l-° `dam
2 Sum of Pasl..--.t CI'aid on this Account
f„i` r
i,
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f 1,Q% Retaina• ge Axnouut Withheld
7 Total Amount ofltetauiagc Withheld
tom. ' 4:- 6 o._l a'Al - ----"%0
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1'
cci Ufy that this request f0.1,13,-::i payine t hs bean made in accoi4daYnce tth the terns
COUNT _.::.,:4;',:,-.
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and us as'°theiStmREC'II 7 NT . 'o the best of7n lcnc,wledge nil belie
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16.D.2.f
Packet Pg. 1815 Attachment: CCSO Executed Amendment No. 2 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1816Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1817Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1818Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1819Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1820Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1821Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1822Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1823Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1824Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1825Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1826Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1827Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1828Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1829Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1830Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1831Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1832Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1833Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1834Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1835Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1836Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1837Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1838Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1839Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1840Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1841Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1842Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1843Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1844Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1845Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1846Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1847Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1848Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1849Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.gPacket Pg. 1850Attachment: NAMI executed CJMHSA Grant 2017-2020 (11214 : CJMHSA Amendment No.3)
16.D.2.hPacket Pg. 1851Attachment: NAMI Amendment No1 (11214 : CJMHSA Amendment No.3)
16.D.2.hPacket Pg. 1852Attachment: NAMI Amendment No1 (11214 : CJMHSA Amendment No.3)
16.D.2.hPacket Pg. 1853Attachment: NAMI Amendment No1 (11214 : CJMHSA Amendment No.3)
16.D.2.hPacket Pg. 1854Attachment: NAMI Amendment No1 (11214 : CJMHSA Amendment No.3)
16.D.2.hPacket Pg. 1855Attachment: NAMI Amendment No1 (11214 : CJMHSA Amendment No.3)
16.D.2.hPacket Pg. 1856Attachment: NAMI Amendment No1 (11214 : CJMHSA Amendment No.3)
16.D.2.hPacket Pg. 1857Attachment: NAMI Amendment No1 (11214 : CJMHSA Amendment No.3)
16.D.2.hPacket Pg. 1858Attachment: NAMI Amendment No1 (11214 : CJMHSA Amendment No.3)
16.D.2.hPacket Pg. 1859Attachment: NAMI Amendment No1 (11214 : CJMHSA Amendment No.3)
16.D.2.hPacket Pg. 1860Attachment: NAMI Amendment No1 (11214 : CJMHSA Amendment No.3)
SECOND AMENDMENT TO AGREEMENT CJMHSA-003 BETWEEN
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
AND
NAMI COLLIER COUNTY, INC.
This Amendment, is entered into this Z3 v-c\day of 2019, by
and between the NAMI Collier County Inc., hereinafter referred to as S brecipient and Collier
County, a political subdivision of the State of Florida, hereinafter referred to as "COUNTY,"
collectively stated as the "Parties."
WHEREAS, on July 11, 2017, the County and Subrecipient entered into an agreement for
Subrecipient to provide"FIRST grant services"to Collier County residents (hereinafter referred to
as the "Agreement"); and
WHEREAS, on June 26, 2018 the Board of County Commissioners approved the First
Amendment to the agreement which defined a successful discharge, added staff to participant
ratio, provided clarification to the Planning Council requirements, outlined subrecipient match
obligation, modified Exhibit G, added Exhibit J and added Exhibit K; and
WHEREAS, the parties desire to modify the Agreement to change the Subrecipient's legal
name, update Section 16, revise contact information in Section 22, modify Exhibit C to add
additional requirements and revise contact information, modify Exhibit E to reduce the targets and
corresponding performance evaluation methodologies, modify Exhibit G to reflect the requirement
of a monthly client tracking report, replace Exhibit H-1 and add Exhibit L, Monthly Client Tracking
Report; and
WHEREAS, the effective date of this amendment shall be April 1, 2019
NOW, THEREFORE, in consideration of foregoing Recitals, and other good and valuable
consideration, the receipt and sufficiency of which is hereby mutually acknowledged, the Parties
agree to modify the Agreement as follows:
Words Words Underlined are added
1. NAMI of Collier County is hereinafter referred to as NAMI Collier County
2. Section 16, Data Security is replaced by the following:
The Subrecipient shall comply with the following information security requirements whenever the
Subrecipient has access to Department data information systems or maintain any client or other
confidential information in electronic form:
16.1 An appropriately skilled individual shall be identified by the Subrecipient to function as its
Information Security Officer. The Information Security Officer shall act as the liaison to the
County's security staff and will maintain an appropriate level of information security for
Department's information systems or any client or other confidential information the Subrecipient
is collecting or using in the performance of this Contract. An appropriate level of security includes
approving and tracking all who request or have access, through the Subrecipient's access, to
Department's information systems or any client or other confidential information. The Information
1
16.D.2.i
Packet Pg. 1861 Attachment: NAMI Executed Amendment No.2 (11214 : CJMHSA Amendment No.3)
Security Officer will ensure that any access to County or Department's information systems or
any client or other confidential information is removed immediately upon such access no longer
being required for Subrecipient's performance under this contract.
16.2 The Subrecipient shall complete the latest Department of Children and Families security
awareness training to all who request or have access, through the Subrecipient's access, to
information systems or any client or other confidential information.
16.3 All who request or have access, through the Subrecipient's access, to information systems
or any client or other confidential information shall comply with, and be provided a copy of the
Department's CFOP 50-2, and shall sign the DCF Security Agreement form CF 0114 annually. A
copy of CF 0114 may be obtained from the County Grant Coordinator.
16.4 The Subrecipient shall prevent unauthorized disclosure or access, from or to information
systems or client or other confidential information. Client or other confidential information on
systems and network capable devices shall be encrypted per the Department's CFOP 50-2.
16.5 The Subrecipient agrees to notify the Grant Coordinator as soon as possible, but no later
than five (5) business days following the determination of any potential or actual unauthorized
disclosure or access to Department information systems or to any client or other confidential
information.
16.6 The Subrecipient shall, at its own cost, comply with section 501.171, F.S. The Subrecipient
shall also, at its own cost, implement measures deemed appropriate by the County or the
Department to avoid or mitigate potential injury to any person due to potential or actual
unauthorized disclosure or access to Department's information systems or to any client or other
confidential information.
3. Section 22, Notices
All Notices from the Subrecipient to the County shall be deemed duly served if mailed or faxed
to the County to:
Collier County Government Center
Community and Human Services Division
3339 Tamiami Trail, East
Suite 211
Naples, Florida 34112
Attention: Rachel Brandhorst Grant Coordinator
Telephone: 249452-4230-239-398-8932
Facsimile: 239-252-6571
4. Exhibit C-Task List, C-1 Service Tasks
C-1.2.3 A Monthly Client Tracking Report shall be used to record the efforts made to contact
individuals that have been discharged from the program. The information shall include but is not
limited to, client ID, date entered into HMIS, date of discharge, telephone number, date of call,
2
16.D.2.i
Packet Pg. 1862 Attachment: NAMI Executed Amendment No.2 (11214 : CJMHSA Amendment No.3)
contact status, housing status, current address, employment status, employer information, staff
comments, and staff ID.
C-1.2.4 All clients are to be entered into the Homeless Management Information System (HMIS)
C-1.2.5 Subrecipient will provide a voucher for one (1) gift card to be distributed to clients at the
time of discharge to encourage clients to participate in follow-up activities one-year post
discharge. The Subrecipient shall be responsible for the purchase of all gift cards to be distributed
to DLC.
5. Exhibit C-Task List, C-2.5, Reports
C.2.5.1.3 Monthly Client Tracking Report: A monthly tracking report to record the efforts made
to contact clients that have been discharged from the program. The form shall include: client ID,
date entered into HMIS,date of discharge, telephone number, date of call, contact status, housing
status, current address, employment status, employer information, staff comments, staff ID.
6. Exhibit C-Task List, C-2.5.2 Reporting Schedule
Table 1 - Reporting Schedule
Report Title Report Due Date(s)
Submit Report to:
Community & Human
Quarterly Program Status 5th day of the quarter following the quarter Services,
Report of program services or activities Attention: Dawn
Whela Rachel
No later than 30 days following the ending Brandhorst, Grant
Final Program Status Report =CoordinatordateoftheContracti
Community & Human
Monthly Client Tracking Report 5th day of each month SeRachel Brandhorst,
Grant Coordinator
10th day of the month following the end of
Community & Human
I Quarterly Expenditure Report
the quarter
Services, Attention:
Blanca Aquino-Luque
7. Exhibit E, Performance Measures
Subrecipient shall submit quarterly performance reports for the following measures:
3
16.D.2.i
Packet Pg. 1863 Attachment: NAMI Executed Amendment No.2 (11214 : CJMHSA Amendment No.3)
E-1. MINIMUM PERFORMANCE MEASURES. The following qualitative performance
measures are established pursuant to the contract and shall be maintained during the term of this
Contract and reported quarterly.
E-1.1.80-% 60% of Program participants will be assisted in applying or be linked to Social
Security or other benefits for which they may have been eligible but were not receiving at
Program Admission.
E-1.2.90% of successfully discharged individuals (i.e. not arrested while enrolled)
participating in the Quality of Life Assessment facilitated by the Peer Specialist shall have
an improvement score from admission to discharge.
E-2. PERFORMANCE EVALUATION METHODOLOGY. The County will monitor the
Subrecipients performance in achieving the standards in Section E-1 according to the following
methodology and the Subrecipient shall use this methodology in determining overall compliance
when submitting the outcome report quarterly to the County.
E-2.1 For the measure in Section E-1.1., the total number of program participants who were
eligible for, but not receiving, social security or other benefits at program admission who are
assisted with applying for such benefits within 180 days of admission DIVIDED BY the total
number of program participants who were eligible for, but not receiving, those benefits at program
admission shall be GREATER THAN OR EQUAL TO 80%. 60%
E-2.2 For the measure in Section E.1.2., the total number of individuals successfully discharged
i.e., not rearrested while enrolled) from the Program who agreed to participate in the Peer
Specialist facilitated Quality of Life Assessment at admission DIVIDED BY the total number of
individuals successfully discharged from Program who agreed to participate in the Peer Specialist
facilitated Quality of Life Assessment at discharge showing improved scores shall be GREATER
THAN OR EQUAL TO 90%.
E-3. For the following measures the Subrecipient shall receive client data for tracking from
David Lawrence Mental Health Center, Inc. and the Collier County Sherriff Office on a
quarterly basis evidenced by the Outcome Tracking Log (to be submitted with each
request for payment):
E-3.1. 60%40% of Program participants not residing in a stable housing environment at program
admission will report living in a stable housing environment within 90 days of Program admission.
E.3.2. 60%40% of Program participants not employed at Program admission who are employed
full or part-time within 180 days of Program admission.
E.3.3 60- 10% of Program participants not employed at Program admission who are employed
full or part-time one year following Program discharge.
E.3.4. 699,610% of Program participants not residing in a stable housing environment at program
admission will report living in a stable housing environment one year following Program discharge.
E-4. The County through the annual monitoring process conducted by the CHS Grants
4
16.D.2.i
Packet Pg. 1864 Attachment: NAMI Executed Amendment No.2 (11214 : CJMHSA Amendment No.3)
Compliance Unit shall evaluate the Subrecipients performance with receiving performance
data from David Lawrence Mental Health Center, Inc. and participation in achieving the
standards in Section E-3, according to the following methodology:
E.4.1. For the measure in Section E-3.1., the total number of Program participants not residing
in a stable housing environment at program admission who live in a stable housing environment
within 90 days of Program admission DIVIDED BY the total number of Program participants not
residing in a stable housing environment at Program admission shall be GREATER THAN OR
EQUAL TO 60%. 40%
E-4.2. For the measure in Section E-3.2, the total number of program participants not employed
at Program admission who are employed full or part-time within 180 days of Program admission
DIVIDED BY the total number of Program participants not employed at Program admission shall
be GREATER THAN OR EQUAL TO 60%. 40%
E-4.3. For the measure in Section E-3.3., the total number of Program participants not employed
at Program admission who are employed full or part-time one year following Program discharge
DIVIDED BY the total number of Program participants not employed at Program admission shall
be GREATER THAN OR EQUAL TO 60%. 10%
E.-4.4. For the measure in Section E-3.4., the total number of Program participants not residing
in a stable housing environment at program admission who live in stable housing one year
following Program discharge DIVIDED BY the total number of Program participants not residing
in stable housing at Program admission shall be GREATER THAN OR EQUAL TO 60%, 10%
8. Exhibit G, Deliverable and Report Table
Report/Deliverable Name Supporting Document Due Date
Quarterly Payment As detailed in Exhibit F.1.4 5th day of the month
Request and Exhibit H following the end of the
quarter
Match Match documentation, Annually
Exhibit H-1
Quarterly Financial Report Exhibit J 10th day of the month
following the end of the
quarter
Reconciliation of Exhibit K 1St day of August following
Expenditures the end of each fiscal year
Quarterly Program Quarterly Service Report 5th day of the month
Services Report following the end of the
quarter
Final Program Report Final Program Report 30 days following the
Template ending date of the
agreement
Incident Report Incident Report Per Occurrence
5
16.D.2.i
Packet Pg. 1865 Attachment: NAMI Executed Amendment No.2 (11214 : CJMHSA Amendment No.3)
Employment Screening I Certification from each July 31 and per
Certification employee working on grant occurrence for each new
hire
Security Awareness Certificate for those staff At contract execution and
Training entering data into State annually thereafter.
System
Insurance (Director& Insurance Within 30 days of
Officer, Workmen's Comp, Certificate/Deceleration expiration
Liability)
Favorable Conditions Attestation Form July 31 and annually
thereafter.
Financial and Compliance Exhibit I Annually within 9 months
Audit of Fiscal Year End
Disaster Plan Plan Within 30 days of contract
execution and within 30
days of any changes to
the plan.
Deaf-and-Hard of Hearing Single Point of Contact and
5th day of the month
ADA Report following the end of the
quarter
CHS Conflict of Interest Conflict of Interest Form Within 30 day of hire for
each new employee
working on the grant.
Monthly Client Tracking Exhibit L 5th day of each month
Report
9. Exhibit H-1, Match Submission is hereby replaced in its entirety as attached.
10. Exhibit L, Monthly Client Tracking Report is hereby added in its entirety as attached.
SIGNATURE PAGE TO FOLLOW
6
16.D.2.i
Packet Pg. 1866 Attachment: NAMI Executed Amendment No.2 (11214 : CJMHSA Amendment No.3)
IN WITNESS WHEREOF, the parties hereto, have each, respectively, by an authorized person
or agent, have executed this Contract on the date and year first written above.
ATTEST: NAMI Collier County, Inc.
CRYSTAL K. KINZE LERK
By: CtQL-44.4.4.0(
76*--kut
A ie ,t94fiTI I ERK
signate.ofy.
Title: COE
Date: 7.64)//c::240/7
Approval for form and legality: COLLIER C• d+
Ce)
k 00lor
By:
Jennifer A. Belpedio W iam L. McDaniel, Jr., CHAIRMAN
Assistant County Attorney c$Y \
Date:y1a3119
7
16.D.2.i
Packet Pg. 1867 Attachment: NAMI Executed Amendment No.2 (11214 : CJMHSA Amendment No.3)
EXHIBIT"H-1„a
COLLIER COUNTY COMMUNITY AND HUMAN SERVICES
MATCH SUBMISSION
SECTION I:MATCH SUBMISSION
Sub recipient Name. =- .. ..... 4:.r.. .
Sub recipient Address:
Project Name:1 u
Project No: Match Request#
Total Match: $0.00
Period of Availability:
SECTION I:STATUS OF FUNDS
1. Grant Match Amount
2. Sum of Past Claims Paid on this Account
3. Total Match Amount Awarded Less Sum Of Past
Claims Paid on this Account 0.00
4. Amount of Previous Unpaid Requests(Insert any unpaid request)
5. Amount of Today's Request
8. Current Grant Balance (Initial Match Less Sum of all
requests)
I certify that this match submission has been made in accordance with the terms and conditions of the Agreement between the
COUNTY and us as the SUBRECIPIENT.To the best of my knowledge and belief,all grant requirements have been followed.
Signature Date
Title
Authorizing Grant Accountant
Authorizing Grant Coordinator
Supervisor Department Director
approval required$15,000 and above) approval required$15,000 and above)
16.D.2.i
Packet Pg. 1868 Attachment: NAMI Executed Amendment No.2 (11214 : CJMHSA Amendment No.3)
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16.D.2.i
Packet Pg. 1869 Attachment: NAMI Executed Amendment No.2 (11214 : CJMHSA Amendment No.3)
16.D.2.j
Packet Pg. 1870 Attachment: DLC Amendment No. 3 (11214 : CJMHSA Amendment No.3)
16.D.2.j
Packet Pg. 1871 Attachment: DLC Amendment No. 3 (11214 : CJMHSA Amendment No.3)
16.D.2.j
Packet Pg. 1872 Attachment: DLC Amendment No. 3 (11214 : CJMHSA Amendment No.3)
16.D.2.j
Packet Pg. 1873 Attachment: DLC Amendment No. 3 (11214 : CJMHSA Amendment No.3)
16.D.2.k
Packet Pg. 1874 Attachment: NAMI Amendment No. 3 (11214 : CJMHSA Amendment No.3)
16.D.2.k
Packet Pg. 1875 Attachment: NAMI Amendment No. 3 (11214 : CJMHSA Amendment No.3)
16.D.2.k
Packet Pg. 1876 Attachment: NAMI Amendment No. 3 (11214 : CJMHSA Amendment No.3)
16.D.2.l
Packet Pg. 1877 Attachment: CCSO Amendment No. 3 (11214 : CJMHSA Amendment No.3)
16.D.2.l
Packet Pg. 1878 Attachment: CCSO Amendment No. 3 (11214 : CJMHSA Amendment No.3)
16.D.2.l
Packet Pg. 1879 Attachment: CCSO Amendment No. 3 (11214 : CJMHSA Amendment No.3)
16.D.2.l
Packet Pg. 1880 Attachment: CCSO Amendment No. 3 (11214 : CJMHSA Amendment No.3)