Backup Documents 03/08/2022 Item #16D11 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 a 1 1
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 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#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1. Tracey Smith Community and Human TS 03/01/2022
Services
2. County Attorney Office—JAB County Attorney Office 3 / V I A2
3. BCC Office Board of County
Commissioners V l M /5/ 3/6/Z 2-
4. Minutes and Records Clerk of Court's Office
PRIMARY CONTACT INFORMATION
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,may need to contact staff for additional or missing information.
Name of Primary Staff Tracey Smith,Grants Coordinator 252-1428
Contact/ Department
Agenda Date Item was 03/08/2022 ✓ Agenda Item Number J_ I I
Approved by the BCC (Q a T IJ t
Type of Document AMENDMENT #1 BETWEEN COLLIER Number of Original 3
Attached COUNTY AND COLLIER HEALTH Documents Attached
SERVICES INC.
PO number or account
number if document is
to be recorded
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. Does the document require the chairman's original signature —J\`A v►-y Q v / TS
2. Does the document need to be sent to another agency for additional signatures? If yes, N/A
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be Yes
signed by the Chairman,with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney.
4. 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
5. The Chairman's signature line date has been entered as the date of BCC approval of the
document or the final negotiated contract date whichever is applicable. V10 M
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's TS
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip
should be provided to the County Attorney Office at the time the item is input into SIRE. c
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!
8. The document was approved by the BCC on above date and all changes made during
the meeting have been incorporated in the attached document. The County N I Pt
Attorney's Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the
BCC,all changes directed by the BCC have been made,and the document is ready for the n
Chairman's signature.
160 i 1
MEMORANDUM
Date: March 9, 2022
To: Tracey Smith, Grant Coordinator
Community & Human Services
From: Martha Vergara, Sr. Deputy Clerk
Minutes & Records Department
Re: Amendment #1 to Agreement between Collier County and
Collier Health Services, Inc.
Enclosed please find two (2) fully executed originals of the document referenced above
(Agenda Item #16D11), approved by the Board of County Commissioners on Tuesday,
March 8, 2022.
If you have any questions, please contact me at 252-7240.
Thank you.
Enclosure
tr
16011
FAIN# B-20-UW-12-0016
Federal Award Date 09/22/2020
Federal Award Agency HUD
CFDA Name Community
Development Block
Grant-CV
CFDA/CSFA# 14.218
Total Amount of Federal $1,170,800.39
Funds Awarded
Subrecipient Name Collier Health Services,
Inc.,dba Healthcare
Network
DUNS# 085019511
FEIN 59-1741277
R&D NA
Indirect Cost Rate NA
Period of Performance 04/01/2021 —03/30/2023
Fiscal Year End 3/31
Monitor End: 05/31/2023
FIRST AMENDMENT TO
AGREEMENT BETWEEN COLLIER COUNTY,FLORIDA
AND
Collier Health Services, Inc. dba Healthcare Network
CDBG-CV Healthcare Services
This AMENDMENT is made and entered into as of this $ day ofM`v1/4-r)-N 2022,
by and between Collier County, a political subdivision of the State of Florida(COUNTY) having
its principal address at 3339 E Tamiami Trail, Suite 211, Naples, FL 34112 and Collier Health
Services Inc., dba Healthcare Network (SUBRECIPIENT), a private non-profit organization
having its principal office at 1454 Madison Ave, Immokalee, FL 34142.
WHEREAS, the COUNTY has entered into an Agreement with the United States
Department of Housing and Urban Development (HUD) for a grant for the execution and
implementation of a Community Development Block Grant (CDBG) Program in certain areas of
Collier County, pursuant to Title I of the Housing and Community Development Act of 1974 (as
amended), codified as 42 USC 5301 et. se. and subject to 24 CFR Part 570; and
WHEREAS, on April 27, 2021, Agenda Item 16.D.3, the COUNTY entered into an
Agreement with Collier Health Services, Inc. dba Healthcare Network to further undertake the
responsibilities and obligations of the Community Development Block Grant (CDBG) - CV
Program.
COLLIER HEALTH SERVICES,INC.dba HEATHCARE NETWORK
CD-CV21-01
Case Management Healthcare Services for Low to Moderate Income Residents OVD
Page 1
16D ! 1
WHEREAS,the parties wish to amend the Agreement by adding a third project component
for case management technology, reallocate the budget, modify the language in payment
deliverables and remove the Uniform Relocation Act Policy as a required policy as it does not
apply.
NOW, THEREFORE, in consideration of the covenants and agreements contained
herein, and for other good and valuable consideration,the Parties hereby agree that the COUNTY
will provide a Grant to SUBRECIPIENT upon and subject to all general conditions, terms,
covenants,and agreements herein set forth:the parties hereto agree to amend the Agreement as set
forth below.
Words Sough are deleted; Words Underlined are added.
PART I
SCOPE OF WORK
The SUBRECIPIENT shall,in a satisfactory and proper manner and consistent with any standards required
as a condition of providing CDBG-CV assistance as provided herein and,as determined by Collier County
Community and Human Services(CHS)Division, perform the tasks necessary to conduct the program as
follows:
Project Name: COVID Case Management Healthcare Services
Description of project and outcome: Collier Health Services Inc will provide a case
management/care navigation program to serve the needs of our most vulnerable patients who have
been diagnosed or are at risk for contracting COVID-19 in an effort to minimize disease severity
and acute and/or chronic complications.
Project Component One: Staffing—Salary costs
Project Component Two: Testing and Testing Supplies
Project Component Three: Technology including but not limited to, laptops, software,
subscriptions/member fees,cell phones and services, and/or equipment and supplies.
* * *
COLLIER HEALTH SERVICES,INC.dba HEATHCARE NETWORK
CD-CV21-01
Case Management Healthcare Services for Low to Moderate Income Residents
Page 2
oV J
16011
1.1 GRANT AND SPECIAL CONDITIONS
A. Within sixty (60) calendar days of the execution of this Agreement, the
SUBRECIPIENT must deliver,to CHS for approval,a detailed project schedule for
the completion of the project.
B. The following resolutions and policies must be submitted within sixty (60) days of
this Agreement:
® Affirmative Fair Housing Policy
• Affirmative Action/Equal Opportunity Policy
® Conflict of Interest Policy
• Procurement Policy
f 1 Uniform Relocation Act Policy
• Sexual Harassment Policy
• Section 3 Policy
• Section 504/ADA Policy
• Fraud, Waste, and Abuse Policy
• Limited English Proficiency Policy (LEP)
® Violence Against Women Act(VAWA)Policy
• LGBTQ Policy
PROJECT DETAILS
A. Project Description/Project Budget
Description Federal Amount
Project Component One: Staffing—Salary costs $950,000.00
$898,375.00
Project Component Two: Testing and Testing Supplies $220,800.39
Project Component Three: Technology including but not limited to $51,625.00
laptops, software, subscriptions/member fees, cell phones and
services and/or e•ui.ment and su.elks.
Total Federal Funds: $1,170,800.39
* * *
COLLIER HEALTH SERVICES,INC.dba HEATHCARE NETWORK
CD-CV21-01
Case Management Healthcare Services for Low to Moderate Income Residents
Page 3
I 6 0 1 1
C. Payment Deliverables
Payment Deliverable Payment Supporting Documentation Submission Schedule
Project Component One: Staffing Submission of supporting documents Submission of
—Salary costs must be provided as backup,as evidenced monthly invoices no
by Exhibit B, signed and dated later than the 20th day
timesheets,check stubs,payroll registers, of the following
bank statements/cancelled checks and any month
other additional documentation as
requested. 10%retainage will be held
from each pay request until final
monitoring clearance and achievement of
the national objective.
Project Component Two: Testing Submission of supporting documents Submission of
and Testing Supplies must be provided as backup,as evidenced monthly invoices no
by receipts, invoices, credit card later than the 20th day
statements,bank statements and any other of the following
additional documentation as requested. month
10%retainage will be held from each pay
request until final monitoring clearance
and achievement of the national
objective.
Project Component Three: Submission of supporting documents Submission of
Technology including but not must be provided as backup,as evidenced monthly invoices no
limited to laptops, software, by Exhibit B,receipts, invoices,credit later than the 20th day
subscriptions/member fees, card statements,bank statements, of the following
cell phones and services, cancelled checks and any other additional month
and/or equipment and supplies, documentation as requested.
10/o retainage will be held from each pay
request until final monitoring clearance
and achievement of the national
objective.
Signature Page to Follow
COLLIER HEALTH SERVICES,INC.dba HEATHCARE NETWORK
CD-CV21-01
Case Management Healthcare Services for Low to Moderate Income Residents
Page 4 ^
16I) 11
IN WITNESS WHEREOF, the SUBRECIPIENT and the COUNTY, have each
respectively, by authorized person or agent, hereunder set their hands and seals on the date first
written above.
ATTEST: BOARD OF CO 'i''. • . . SIONERS OF
CRYSTAL K.KINZEL,CLERK COLLIIER�C� � ORIDA
C/�� / C' fr
By:t. • ��►
Attest is to Chat uty Cle WIL 'M L. MC r•1 EL JR.,C RMAN
signature only.
•
q g Date: � I A�
',,ems. 7
COLLIER HEALTH SERVICES, INC.dba
Dated: 2oZ2 HEALTHCARE NETWORK
(SEAL)
By:
TAMI RAZNOFF,CHIEF FINA A
OFFICER �/
Date: I �� U�`
Approved as to form and legality:
JenniferBel ed� a \
Assistant County Attorney \?-\
\\
Date: 3 1 b\a)%
COLLIER HEALTH SERVICES,INC.dba HEATHCARE NETWORK
CD-CV21-01
Case Management Healthcare Services for Low to Moderate Income Residents
Page 5
e