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Agenda 12/08/2020 Item #16D18 (Waiving application process for Round 3 activities related to COVID-19/CDBG-CV)12/08/2020 EXECUTIVE SUMMARY Recommendation to waive the formal application process for funding and activities related to COVID-19 CDBG-CV Round 3 activities for those impacted by the Coronavirus pandemic and make conditional awards to fund a permanent food storage facility for St. Matthew’s House to operate a food bank in the amount of $1,000,000, and fund a COVID case management system for Collier Health Services, Inc., in the amount of $950,000. OBJECTIVE: To waive the formal application process and make conditional awards for two (2) projects for the COVID-19 CDBG-CV Round 3 activities for those impacted by the Coronavirus Pandemic. CONSIDERATIONS: The U.S. Department of Housing and Urban Development (HUD) provides CDBG, HOME, and ESG entitlement funds to the County annually to address program-specific needs in the community. The Board of County Commissioners (Board) previously approved the 2019-2020 One Year Action Plan on June 25, 2019 - Agenda Item #16D2. As a result of the Coronavirus Pandemic, HUD is making additional funding available to local communities to address the pressing needs of those who have been impacted by COVID -19 including those who have lost their employment, business, or other income. On May 12, 2020, Agenda Item #16F1(f) the Board ratified the County Manager’s action to amend the 2019-2020 One Year Action Plan to recognize CDBG and ESG COVID-19 funding. On November 10, 2020, Agenda item 16.D.8, the Board approved another substantial amendment recognizing further CDBG and ESG COVID-19 funding, bringing the total of each to $4,232,728 and $3,183,770 respectively. During the required advertisement process, a public comment was received requesting match funding for a permanent food storage facility from St. Matthew’s House. The organizati on is seeking funds to purchase a permanent food storage facility in order to sustain increased food assistance operations into 2021. This project has identified a location and has garnered the support of the Richard M. Schulze Family Foundation in establishing a public/private partnership on the project. The Foundation has committed a $1,000,000 matching grant contingent upon St. Matthew’s House raising $1,000,000 in charitable support and securing $1,000,000 in government funding. Traditionally all HUD grant funds follow a formal application process for awarding funds. The CDBG- CV funds are not part the County’s annual allocation, but rather are appropriated to prevent, prepare and respond to the Coronavirus. These projects meet the intent of the appropriation and expediting the process allows the funds to be dispersed to meet the ongoing needs in the community. The County continues to have a need for food and medical services. Staff has identified CDBG-CV3 funding as an eligible source to fund the government portion of the requested project. The County’s approved Citizen Participation Plan for the 2016-2020 cycle, allows a limited application and pre-application process to when the grantee is providing matching dollars for a larger project. Staff is requesting to use an alternative solicitation process and make a conditional award to the St. Matthew’s House permanent food storage facility to support a food distribution project contingent on the grantee meeting all applicable grant requirements. On November 6, 2020, staff received an unsolicited application from Collier Health Services, Inc. dba Healthcare Network to stand up a COVID case management team to sustain and expand their current efforts to decrease health inequities to improve the health and wellness of children and adults in our targeted populations. The proposed project cost for a two-year period is $ 950,000. The proposal is attached as backup to this executive summary. 16.D.18 Packet Pg. 3143 12/08/2020 The “Open Door” or Unsolicited Application Process in the Collier County Citizen Participation Plan 2016-2020 allows application requests to be accepted and considered during any time throughout the program year until funds are no longer available. Staff is requesting to use this alternative solicitation process and a conditional award be made to Healthcare Network to move forward with the project. The project is contingent upon the proposed grantee meeting all applicable grant requirements. FISCAL IMPACT: CDBG-CV grant funds in the amount of $4,232,728 are budgeted within the Housing Grant Fund (705), Project 33674 CDBG-CV. Conditional awards of these projects, if fully funded, will reduce the amounts available within the CDBG-CV fund by $1,950,000.00 Program Total Allocation Conditional Award Remaining Funds CDBG-CV $4,232,728 $1,950,000 $2,282,728 LEGAL CONSIDERATIONS: GROWTH MANAGEMENT IMPACT: Acceptance and implementation of these amendments and corresponding agreements further the Goals, Objectives, and Policies of the Housing Element and the Growth Management Plan. RECOMMENDATION: To waive the formal application process for funding and activities related to COVID-19 CDBG-CV Round 3 activities for those impacted by the Coronavirus pandemic and make conditional awards to fund a permanent food storage facility for St. Matthew’s House to operate a food bank in the amount of $1,000,000, and fund a case management system for Collier Health Services, Inc. in the amount of $950,000. Prepared By: Kristi Sonntag, Director, Community & Human Services ATTACHMENT(S) 1. St Matthews CDBG CV-3 Funds (PDF) 2. Case Management Proposal (Final 11062020) (PDF) 16.D.18 Packet Pg. 3144 12/08/2020 COLLIER COUNTY Board of County Commissioners Item Number: 16.D.18 Doc ID: 14320 Item Summary: Recommendation to waive the formal application process for funding and activities related to COVID-19 CDBG-CV Round 3 activities for those impacted by the Coronavirus pandemic and make conditional awards to fund a permanent food storage facility for St. Matthew’s House to operate a food bank in the amount of $1,000,000, and fund a COVID case management system for Collier Health Services, Inc., in the amount of $950,000. Meeting Date: 12/08/2020 Prepared by: Title: – Corporate Business Operations Name: Sean Callahan 11/29/2020 9:19 AM Submitted by: Title: County Manager – County Manager's Office Name: Leo E. Ochs 11/29/2020 9:19 AM Approved By: Review: Community & Human Services Kristi Sonntag Additional Reviewer Completed 11/30/2020 1:46 PM Corporate Business Operations Sean Callahan Additional Reviewer Completed 11/29/2020 9:20 AM Grants Therese Stanley Level 2 Grants Review Completed 12/01/2020 1:08 PM Office of Management and Budget Debra Windsor Level 3 OMB Gatekeeper Review Completed 12/01/2020 1:13 PM Budget and Management Office Ed Finn Additional Reviewer Completed 12/02/2020 10:22 AM Grants Therese Stanley Additional Reviewer Completed 12/02/2020 10:42 AM County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 12/02/2020 2:16 PM County Manager's Office Leo E. Ochs Level 4 County Manager Review Completed 12/02/2020 4:17 PM Board of County Commissioners MaryJo Brock Meeting Pending 12/08/2020 9:00 AM 16.D.18 Packet Pg. 3145 ST. MATTHEW’S HOUSE Touching Hearts. Transforming Lives. 2601 AIRPORT ROAD SOUTH, NAPLES, FL 34112 PHONE (239) 774-0500 · FAX (239) 774-7146 · WWW.STMATTHEWSHOUSE.ORG Matthew 25:31-46 October 29, 2020 Mrs. Michelle McLeod Grants Coordinator, Community and Human Services 3339 Tamiami Trail E Suite 214 Naples, FL 34112 Dear Mrs. McLeod, For more than 30 years, St. Matthew’s House has been providing critical services to the disadvantaged in our community. Our soup kitchens haven't missed a day of feeding since their inception in 1988, and our shelters have been at capacity for more than a decade. Now, in the midst of the COVID-19 outbreak and resulting economic downturn, at-risk populations are facing even greater needs and vulnerabilities and are coming to St. Matthew’s House for assistance. Food insecurity is rising in our community at unprecedented rates as the working poor are faced with hard decisions to make ends meet, choosing between paying rent or buying groceries, seeking medical care or paying utility bills. In response to increased demand, St. Matthew’s House has scaled its mobile pantry to serve a record number of individuals and families who have been adversely affected by the Coronavirus outbreak. Since March 1, we have distributed shelf-stable food and fresh produce to a total of 54,989 households, compared to 2,140 households served during the same time period in 2019. To accommodate this 2500% increase in need, St. Matthew’s House began leasing a 10,000 square-foot warehouse facility for the purpose of storing, sorting and packaging large quantities of food for distribution to the community. Costs associated with this leased space are currently being reimbursed through CARES Act funds which are set to expire on December 30, 2020. However, the working poor are often the first and hardest hit in seasons of economic hardship, but the last to recover, meaning that increased need for our programs could continue for months or years after the immediacy of the crisis dissipates. As a result, we are now seeking funds to purchase a permanent food storage facility in order to sustain our increased food assistance operations into 2021. We have identified several viable options for sale including a 10,000 square foot facility for $3.9M on Industrial Avenue. Additionally, we have garnered support of the Richard M. Schulze Family Foundation in establishing a public/private partnership on the project. The Foundation has committed a $1,000,000 matching grant contingent upon St. Matthew’s House raising $1,000,000 in charitable support and securing $1,000,000 in government funding. Vann R. Ellison President & CEO, St. Matthew’s House 16.D.18.a Packet Pg. 3146 Attachment: St Matthews CDBG CV-3 Funds (14320 : CDBG-CV Waiver) 2601 AIRPORT ROAD SOUTH, NAPLES, FL 34112 PHONE (239) 774-0500 · FAX (239) 774-7146 · WWW.STMATTHEWSHOUSE.ORG Matthew 25:31-46 If awarded, CDBG-CV3 funds would equip St. Matthew’s House to continue preventing, preparing for and responding to increased community needs due to COVID-19. Owning a facility for this purpose would provide a sense of permanency for our relief efforts and ensure adequate space to expand capacity as needed in the future. Further, establishing a permanent warehouse would afford opportunities for increased collaboration with regional partners resulting in additional resources for our community. Midwest Food Bank has expressed an interest in expanding their presence into Collier County and would commit to stocking the warehouse if St. Matthew’s House secured a fixed location. With Midwest’s ability to source large quantities of food from local, state and national providers, this would effectively bring a second food bank to our area to complement the existing work being done by Harry Chapin. Smaller pantries and outreach programs will have access to these resources as well, increasing both the quantity and frequency of food distributions throughout our community. Lastly, the facility would continue to serve Collier County long-term, even after recovery from COVID-19 is complete. In the face of hurricanes, wildfires or other disasters, the warehouse could be converted to a staging area for community-wide emergency preparedness and response. For several years, St. Matthew’s House and county officials have identified the need for such an asset, which has only increased in light of the COVID-19 public health and economic crises. In the event that CDBG-CV3 funds cannot be used for the acquisition of a building, St. Matthew’s House would consider construction of a facility on existing property at 2601 Airport Road South. However, this option is less desirable in that zoning, permitting and environmental studies could prolong the project for months, failing to effectively respond to the immediacy of the COVID-19 crisis. For these reasons, it is our hope that you will consider allocating a portion of the available CDBG- CV3 funds to St. Matthew’s House so that we may continue to meet the growing and changing needs of our community both now and into the future. Sincerely, Vann R. Ellison President & CEO, St. Matthew’s House Vann R. Ellison President & CEO, St. Matthew’s House 16.D.18.a Packet Pg. 3147 Attachment: St Matthews CDBG CV-3 Funds (14320 : CDBG-CV Waiver) Project Title: Case Management to Improve Health Equity Prepared by: Collier Health Services, Inc. dba Healthcare Network 16.D.18.b Packet Pg. 3148 Attachment: Case Management Proposal (Final 11062020) (14320 : CDBG-CV Waiver) What is the problem in the health care system your group would like to change or address? Through community outreach and education, including door-to-door visits in vulnerable, underserved neighborhoods, Healthcare Network case management team would sustain and expand their current efforts to decrease health inequities to improve the health and wellness of children and adults in our targeted populations. Future community outreach would be expanded to address the many chronic conditions impacting health in these populations, including asthma, diabetes, hypertension, obesity and others. In addition to serving as navigators for primary care, dental care and behavioral health services available at Healthcare Network centers, four case managers would continue to develop trust with our underserved communities, enabling them to provide appropriate referrals and connections to social services, including food, housing, transportation and utilities. Health disparities exist during normal times in these communities and, with the pandemic, these inequities have only compounded, placing residents at increased risk for COVID-19. Community outreach through the COVID-19 team has been effective helping to dispel myths and address economic, language, cultural and literacy barriers that prevent people from understanding the highly infectious nature of the virus. To overcome the barriers, Healthcare Network would apply several tactics including door-to-door outreach to provide culturally appropriate education materials and messaging to encourage adherence to Covid-19 protocols as well as compliance with chronic illness treatment plans and medication regimens. When identified, the case management team would also help families connect with local resources for physical and mental health, food and housing assistance. In collaboration with the Department of Health-Collier, the case management team would be trained by Partners in Health (PIH) global staff utilizing the “accompaniment model” which ensures we are with the residents in their journey, not dictating what we think they need to do. Through this training, the case management team will be provided culturally appropriate education tools, using native languages, including Creole and Spanish. Currently, our COVID-19 team is in Immokalee helping to address the unique needs of returning migrant workers, providing educational resources and distributing masks. The community response has been positive. Residents receiving visits have often encouraged their neighbors to meet with the promotoras and told them about other places they should visit. Who is impacted by this problem—what are the demographics of the community affected? In Collier County, Naples and surrounding areas are among the wealthiest communities in the country. Yet in neighborhoods within Naples and in communities throughout the county, such as Immokalee, Golden Gate, Everglades City and East Naples, poverty rates are among the highest in the state. The economy includes agriculture and tourism, employing seasonal and sometimes transient populations with few skills and low annual wages. 16.D.18.b Packet Pg. 3149 Attachment: Case Management Proposal (Final 11062020) (14320 : CDBG-CV Waiver) Immokalee is an agricultural community with a poverty rate of 43.4%. One out of every 2.3 residents of Immokalee live in poverty. A total of 11,061 of 25,478 Immokalee residents reported income levels below the poverty line in the last year. The Poverty Rate across the state of Florida is 15.5%, meaning Immokalee has a dramatically higher than average percentage of residents below the poverty line when compared to the rest of Florida. Golden Gate has a poverty rate of 22.6%. One out of every 4.4 residents of Golden Gate lives in poverty. A total of 6,712 of 29,733 Golden Gate residents reported income levels below the poverty line in the last year. The Poverty Rate across the state of Florida is 15.5%, meaning Golden Gate has a dramatically higher than average percentage of residents below the poverty line when compared to the rest of Florida. Though Collier County’s population is mostly White, the county has an increasingly diverse population with 64 percent identifying as White only, 27 percent as Hispanic Latino, and 7 percent as Black/African American. Growth in the number of Hispanic/Latino, Black and multi-ethnic residents is expected to continue on an upward trend between now and 2040. There is a large income gap between the richest and poorest residents in the county. Large segments of the population earn six figures (28 percent), while a considerable percentage live below the federal poverty level (17 percent). In 2016, it was estimated that 58,901 residents (or 16.2 percent) of Collier County were uninsured. It was estimated that approximately 16.5 percent of resident in Collier County could not see a doctor due to costs. Source: Community Foundation of Collier County “Vital Signs” Why are you the best fit to lead this issue in the community you have identified? Healthcare Network is a Federally Qualified Health Center (FQHC), providing comprehensive primary and preventative healthcare including physical health, oral health and mental health services to persons of all ages. We are the only FQHC in Collier County. To achieve this recognition, we must meet rigorous governance, access, quality of care, service and cost standards. Healthcare Network is committed to ensuring quality healthcare is accessible to everyone in our community, regardless of employment, income and insurance status. Founded in 1977 to serve migrant farmworkers and their families in Immokalee, Healthcare Network now provides care to nearly 50,000 patients in practices throughout Collier County, including the Ronald McDonald Care Mobile and the Healthy and Smiles Mobile. Healthcare Network provides primary healthcare services including family care, obstetrics and gynecology, pediatrics, senior care and pharmacy, as well as dental and integrated behavioral health for both adults and children. The newest location, the Nichols Community Health Center, a 50,000-square-foot primary care medical center opened in April 2020 provides services to one of the most medically underserved communities in Collier County. 16.D.18.b Packet Pg. 3150 Attachment: Case Management Proposal (Final 11062020) (14320 : CDBG-CV Waiver) What is your relationship and role within the community? Healthcare Network works collaboratively in the communities we serve, with strong, positive relationships with elected and public officials, government agencies (Department of Health and others), law enforcement, business and community leaders, foundations, as well as other healthcare organizations. We have developed and maintained mutually beneficial relationships with the community hospital and health system, NCH Healthcare System, as well as the David Lawrence Center (acute and other mental health services). For nearly 45 years, Healthcare Network has been providing access to high-quality primary medical care to all, regardless of employment, income and insurance status. We offer a Sliding Fee Discount Program that reduces costs to uninsured and underinsured patients based on their income and family size. And, through our 340B Federal drug program, we can provide medications at discounted prices to qualified patients who are not able to pay for their prescriptions. What are the first three steps you would take to begin to address the problem? Utilizing existing quantitative and qualitative data from the recent COVID-19 home visits, determine the highest priorities for chronic health conditions which could positively be addressed with additional culturally sensitive education and connections to existing community resources. Build additional trust, buy in and support by hosting small group discussions and/or workshops (in person or virtually) to determine which key messages and what tools will have the greatest impact on behavior and lifestyle changes to address chronic health conditions for people in each community. Identify the pockets of neighborhoods with the largest at-risk populations and begin outreach efforts, including door-to-door visits. In addition to serving as navigators for primary care, dental care and behavioral health services available at Healthcare Network centers, four case managers would continue to develop trust with our underserved communities, enabling them to provide appropriate referrals and connections to social services, including food, housing, transportation and utilities. Limitations While we know that adding a case management team of 4 with a manager will make a large difference in the community it is necessary to note that this will likely not meet the entirety of the need in Collier County. A case manager typically only has a panel of about 150 patients. It is anticipated that the panels for the proposed case managers would be quickly filled. Capacity and need will be regularly evaluated. 16.D.18.b Packet Pg. 3151 Attachment: Case Management Proposal (Final 11062020) (14320 : CDBG-CV Waiver) Year 1 Budget Year 2 Budget Manager of Case Management @ 100%$80,000 $80,000 Case Manager (RN)  @ 100% $75,000 $75,000 Case Manager (RN)  @ 100% $75,000 $75,000 Case Manager (RN)  @ 100% $75,000 $75,000 Case Manager (RN)  @ 100% $75,000 $75,000 Sub‐Total Salaries $380,000 $380,000 Benefits and Taxes $95,000 $95,000 Total Salaries and Benefits Total $475,000 $475,000 Each Case Manager can handle a caseload of about 150 patients at a time Case Management Budget Proposal for Years 1‐2 Collier Health Services, Inc dba Healthcare Network 16.D.18.b Packet Pg. 3152 Attachment: Case Management Proposal (Final 11062020) (14320 : CDBG-CV Waiver) CORPORATE OFFICE 1454 Madison Avenue West Immokalee, FL 34142 HealthcareSWFL.org 16.D.18.b Packet Pg. 3153 Attachment: Case Management Proposal (Final 11062020) (14320 : CDBG-CV Waiver)