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Agenda 01/10/2023 Item #16K6 (To report back to the Board as to potential conditions of a COVID19 Farmworker grant)SEE REVERSE SIDE Proposed Agenda Changes Board of County Commissioners Meeting January 10, 2023 Continue Item 11C to the February 14, 2023, BCC Meeting: Recommendation to direct the County Manager to bring an agreement with Comcast Cable Communications, LLC, (Comcast) to a future Board of County Commissioners (Board) meeting to expand broadband and other cable-related services to identified underserved portions of Collier County. (James French, Growth Management and Community Development Department Head) (All Districts) (Staff’s Request) Continue Item 16D1 to the January 24, 2023, BCC Meeting: Recommendation to approve and authorize the removal of uncollectible accounts receivables in the amount of $53,747.18 from the financial records of the Library Division in accordance with Resolution No. 2006-252 and authorize the Chairman to execute the attached Resolution. (All Districts) (Staff’s Request) Continue Item 16C2 to the January 24, 2023, BCC Meeting: Recommendation to approve a Resolution removing uncollectible accounts receivable and their respective balances from the financial records of Collier County Public Utilities Department in the amount of $8,539.44 within Water-Sewer District Operating Fund (408) and Landfill Operating Fund (470). (All Districts) (Staff’s Request) Continue Item 16G1 to the January 24, 2023, BCC Meeting: Recommendation to approve and authorize the removal of uncollectible accounts receivable in the amount of $2,050.36 from the financial records of the Airport Authority Fund (495) in accordance with Resolution 2006-252 and authorize the Chair to execute the attached Resolution. (All Districts) (Staff’s Request) Move Item 16K6 to be 12B to be heard at 10 AM: Report to the Board of County Commissioners in response to Public Comments at the December 13, 2022, Regular Meeting regarding potential conditions required by a COVID-19 Extra Mile Migrant Farmworker grant. (All Districts) (Commissioner Saunders’, Commissioner McDaniel’s, and Commissioner Hall’s Separate Requests) Notes: Correct discrepancy in Item 9B Title: Should be “Recommendation to deny” rather than “Recommendation to approve” to align with the recommendation published in the executive summary. TIME CERTAIN ITEMS: Companion Items 9A and 9B to be heard following the completion of items under sections 11 and 12: Isles of Capri Mixed Use Planned Unit Development (MPUD) Zoning District. Item 12B to be heard at 10 AM: Report to the Board of County Commissioners in response to Public Comments at the December 13, 2022, Regular Meeting regarding potential conditions required by a COVID- 19 Extra Mile Migrant Farmworker grant. 1/12/2023 9:57 AM 16. K.6 01 / 10/2023 EXECUTIVE SUMMARY Report to the Board of County Commissioners in response to Public Comments at the December 13, 2022, Regular Meeting regarding potential conditions required by a COVID-19 Extra Mile Migrant Farmworker grant. OBJECTIVE: To report back to the Board as to potential conditions of a COVID-19 Farmworker grant. Re - review of HHS Grant Number 1 NU58DP007038-01-00 Awarded to Collier County on August 23, 2021. CONSIDERATIONS: On April 15, 2021, County Staff became aware of potential federal grant funding for Collier County residents hard hit by the COVID-19 pandemic. On May 24, 2021, Collier County applied for a grant through the Department of Health & Human Services for the "Collier County Community Health Coalition (CCCHC): Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities." Collier County sought to use the grant funding to improve access to quality healthcare in the Immokalee and Golden Gate areas of Collier County since farmworkers in those communities were front-line, high risk during the COVID-19 pandemic with limited access to quality healthcare. On June 8, 2021, the Board of County Commissioners (BCC) approved, after -the -fact, the submittal of the grant application which sought total funding over a 3-year period of $1,446,255.00 for the program. On September 28, 2021, the BCC unanimously approved Year 1 funding to the program of $421,744.00 consistent with an HHS Grant Award in that amount dated August 23, 2021. As will be more fully discussed below, the conditions attached to the grant were included in the BCC's packet on this agenda item on September 28, 2021. Grants were awarded to 68 different governmental entities throughout the United States, including counties in at least 20 different states. Last, on December 14, 2021, the BCC approved a Subrecipient Agreement with Collier Health Services for the hiring and training of 6 new Community Health Workers (CHWs) to service the farmworker communities within Collier County. The Year I Award of $421,744.00 was premised on Collier County's application that sought to begin "to address the barriers that migrant farmworkers have historically faced in accessing healthcare." The goal, at the end of the 3 -year grant period, was to give 75,000 Collier County residents access to quality healthcare who previously had no such access. At the Board's December 13, 2022, meeting, a number of public speakers raised concerns about this grant, specifically as to the conditions of the grant. The Board asked for an afternoon staff report on the issue, which following discussion I stated I would come back with a report on the conditions of the grant. A copy of the transcript relating to this matter is included as part of the back-up. Part of the back-up to the September 28, 2021, item requesting Board approval of this grant, and presumably the crux of the issue with the public speakers, was the following: Packet Pg. 1306 16. K.6 01 / 10/2023 Coronavirus Disease 2019 (COVID-19) Funds: A recipient of a grant or cooperative agreement awarded by the Department of Health and Human Services (HHS) with funds made available under the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 (P.L. 116- 123); the Coronavirus Aid, Relief, and Economic Security Act, 2020 (the "CARES Act") (P.L. 116- 136); the Paycheck Protection Program and Health Care Enhancement Act (P.L. 116-139); the Consolidated Appropriations Act and the Coronavirus Response and Relief Supplement Appropriations Act, 2021 (P.L. 116-260) and/or the American Rescue Plan of 2021 [P.L. 117-2] agrees, as applicable to the award, to: 1) comply with existing and/or future directives and guidance from the Secretary regarding control of the spread of COVID-19; 2) in consultation and coordination with HHS, provide, commensurate with the condition of the individual, COVID-19 patient care regardless of the individual's home jurisdiction and/or appropriate public health measures (e.g., social distancing, home isolation); and 3) assist the United States Government in the implementation and enforcement of federal orders related to quarantine and isolation. In addition, to the extent applicable, Recipient will comply with Section 18115 of the CARES Act, with respect to the reporting to the HHS Secretary of results of tests intended to detect SARS—CoV-2 or to diagnose a possible case of COVID-19. Such reporting shall be in accordance with guidance and direction from HHS and/or CDC. HHS laboratory reporting guidance is posted at: httos:llwww. hh s. a ov/sites/defau It/fi I es/covid-19-laboratorv-data-renorti na-au i dan ce. ❑df. Further, consistent with the full scope of applicable grant regulations (45 C.F.R. 75.322), the purpose of this award, and the underlying funding, the recipient is expected to provide to CDC copies of and/or access to COVID-19 data collected with these funds, including but not limited to data related to COVID-19 testing. CDC will specify in further guidance and directives what is encompassed by this requirement. This award is contingent upon agreement by the recipient to comply with existing and future guidance from the HHS Secretary regarding control of the spread of COVID-19. In addition, recipient is expected to flow down these terms to any subaward, to the extent applicable to activities set out in such subaward. Though the Grant Award does reference that grant recipients should assist with existing and future directives as well as guidance from the Secretary of HHS regarding the control of and spread of COVID-19, to date there have been no mandates or directives from the HHS to county governments. It should be noted that such mandates or directives, if any, would likely fall on grant subrecipients rather than Collier County itself. Moreover, even if in the future HHS were to issue mandates or directives to Collier County that were to be found objectionable to the BCC, then in lieu of compliance, the grant could be returned at that time. In the interim, the grant funding continues to be used to provide Collier County residents in the migrant farmworker communities access to healthcare that they previously did not have access to. FISCAL IMPACT: None. GROWTH MANAGEMENT IMPACT: None. RECOMMENDATION: None at this time. Prepared by: Jeffrey A. Klatzkow, County Attorney ATTACHMENT(S) 1. CCR-fact-sheet-H (PDF) 2. Grant Award - 2021 08-31 CDC NU58DP007038 (PDF) 3. Grant Application (partial) - APP 2021 05-24 CDC CHWCRC (PDF) 4. Draft Minutes from 12-13-22 BCC meeting - discussion of COVID-19 Farmworker grant (PDF) Packet Pg. 1307 16. K.6 01/10/2023 COLLIER COUNTY Board of County Commissioners Item Number: 16.K.6 Doe ID: 24223 Item Summary: Report to the Board of County Commissioners in response to Public Comments at the December 13, 2022, Regular Meeting regarding potential conditions required by a COVID-19 Extra Mile Migrant Farmworker grant. Meeting Date: 01/10/2023 Prepared by: Title: Legal Assistant — County Attorney's Office Name: Wanda Rodriguez 12/22/2022 11:08 AM Submitted by: Title: County Attorney — County Attorney's Office Name: Jeffrey A. Klatzkow 12/22/2022 11:08 AM Approved By: Review: Grants Office of Management and Budget Office of Management and Budget County Attorney's Office Grants County Manager's Office Board of County Commissioners Erica Robinson Level 2 Grants Review Debra Windsor Level 3 OMB Gatekeeper Review Susan Usher Additional Reviewer Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Therese Stanley Additional Reviewer Dan Rodriguez Level 4 County Manager Review Geoffrey Willig Meeting Pending Completed 12/22/2022 3:30 PM Completed 12/27/2022 8:13 AM Completed 12/27/2022 8:40 AM Completed 12/28/2022 9:07 AM Completed 12/28/2022 1:39 PM Completed 01/04/2023 2:55 PM 01/10/2023 9:00 AM Packet Pg. 1308 Community HealthWorkers for • • • •ResilientCommunities Public health crises, such as COVID-19, worsen existing health disparities. Community health workers (CHWs) are frontline public health workers who are trusted members of the community they serve. CHWs are well -positioned to reach communities hit hardest by COVID-19, stop the spread of COVID-19, and make progress toward health equity. Overview and Mission Launched in August 2021, CDC's Community Health Workers for COVID Response and Resilient Communities initiative provides financial support and technical assistance to 69 states, localities, territories, tribes, tribal organizations, urban Indian health organizations, and health service providers to tribes. The CCR initiative consists of two funding opportunities intended to put more trained CHWs in the communities that have been hit hardest by COVID-19 and among populations at high risk for COVID-19 exposure, infection, and illness. About the Funding Opportunities Community Health Workers for COVID Response and Resilient Communities (CCR) (CDC-RFA-DP21-2109) • A 3-year grant that supports the training and deployment of CHWs to COVID-19 response efforts to build and strengthen community resilience to fight COVID-19 by addressing health disparities. Funds 68 organizations (Table 1). Community Health Workers for COVID Response and Resilient Communities —Evaluation and Technical Assistance (CCR-ETA) (CDC-RFA-DP21-2110) A cooperative agreement that supports training, technical assistance, and a national evaluation to strengthen capacity of grant recipients and their funded projects. Funds 3 organizations (Table 2). To learn more about Community Health Workers for COVID Response and Resilient Communities, visit www.cdc.gov/covid-community-health-workers National Center for Chronic Disease Prevention and Health Promot www.cdc.gov 1 0 @CDCChronic I www.cdc.gov/chronicdise..� Packet Pg. 1309 ■..,,�+■ ■. as. ..■ son ■ ..... Fir! ►-■ r Funded sta Alabama Mobile County Board of Health Alaska Alaska Department of Labor & Workforce Development Arizona Yuma County Arkansas Benton County Government California Alameda County Healthcare Services Agency County of San Diego Health & Human Services Agency San Joaquin County Human Services Agency Sonoma County Health Services Department Tulare County Health & Human Services Agency Commonwealth of the Northern Mariana Islands Commonwealth Healthcare Corporation Colorado Northeast Colorado Health Department Delaware Delaware State Department of Health Florida Collier County Georgia Georgia Department of Public Health Guam Guam Department of Public Health Hawaii Hawaii State Department of Health Illinois Chicago Department of Public Health Cook County Indiana Health and Hospital Corporation of Marion Co. St. Joseph County Department of Health Kansas Kansas Department of Health and Environment Kentucky Kentuckv State Cabinet for Health 16.K.6.a I and freely associated states Louisiana Louisiana Department of Health Maine Maine Department of Health and Human Services Maryland Maryland Department of Health Prince George's County Fire/EMS Massachusetts Boston Public Health Commission Massachusetts Department of Public Health Mississippi Mississippi State Department of Health Missouri County of St. Louis Washington County Ambulance District Montana Partnership Health Center Yellowstone City -County Health Department New Jersey Atlantic County Department of Human Services New Jersey Department of Health New Mexico County of Dona Ana New York City of Syracuse County of Schenectady North Carolina NC Department of Health & Human Services Public Health Authority of Cabarrus County Ohio County of Jackson Franklin County Board of Commissioners/Public Health Ohio Department of Health Oklahoma Oklahoma State Department of Health Oregon County of Lake National Center for Chronic Disease Prevention and Health Promot www.cdc.gov I W @CDCChronic I www.cdc.gov/chronicdise..� Packet Pg. 1310 00E_40� OEM: V�■■■■■ ■■■■ ■ ..... Funded states, localities, territories, and freely associated states, continued Pennsylvania Texas Alleghany County Health Department City of Austin, Austin Public Health Philadelphia Department of Public Health City of San Antonio Puerto Rico Harris County Municipio de Canovanas Virginia PR Science Technology and Research Trust Institute for Public Health Innovation Republic of the Marshall Islands Washington Ministry of Health and Human Services Seattle and King County Public Health Republic of Palau Washington State Department of Health Palau Ministry of Health Wisconsin Rhode Island Wisconsin Department of Health Services Rhode Island Department of Health Tennessee Metropolitan Government of Nashville & Davidson County Funded tribes, tribal organizations, urban Indian health organizations and health service providers to tribes Arizona Arizona Health Care Cost Containment System Tuba City Regional Healthcare Corporation California Tule River Indian Health Center Inc. United American Indian Involvement New Mexico Albuquerque Area Indian Health Board Oklahoma Cherokee Nation Cheyenne & Arapaho Tribes Wisconsin Red Cliff Band of Lake Superior Chippewa Arizona Arizona Board of Regents on behalf of Arizona State University Washington Washington State Department of Health Wisconsin Wisconsin Department of Health Services r a National Center for Chronic Disease Prevention and Health Promot www.cdc.gov 1 0 @CDCChronic I www.cdc.gov/chronicdise..� Packet Pg. 1311 16. K.6.b DEPARTMENT OF HEALTH & HUMAN SERVICES OFFICE OF THE SECRETARY Assistant Secretary for Legislation Washington, DC 20201 Collier County Community Health Coalition (CCCHC): Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities Centers for Disease Control and Prevention / CDC-NCCDPHP National Center for Chronic Diseases Prvntion & Hlth Promotion (DP) Grant Number, 1 NU58DP007038-01-00 Grantee Name) Collier County Board of County Commissioners Address 3299 Tamiami Trl E Ste 200, Naples, FL, 34112-5746 Congressional District 1 19 Phone Numberil 239-252-2486 Project Director or P.I. Kristi Sonntag Title of Grant Project Collier County Community Health Coalition (CCCHC): Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities CFDA No. 9� 3.495 Program Title CDC-RFA-DP21-2109 Community Health Workers for COVID Response and Resilien Award Amount 421744 E Type of Award Social Services Type of Action New Type of Financial Assistance Discretionary Grant Project Period , 08/31/2021 to 08/30/2024 Grant Budget Period' 08/31/2021 to 08/30/2022 HHS Office HHS Office Contact Stephanie Latham 770.488.2917 Packet Pg. 1312 j DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Recipient Information 1. Recipient Name Collier County Board of County Commissioners 3299 Tamiami Trl E Ste 200 Collier County of Florida Naples, FL 34112-5746 239-252-2951 2. Congressional District of Recipient 19 3. Payment System Identifier (ID) 1596000558AI 4. Employer Identification Number (EIN) 596000558 S. Data Universal Numbering System (DUNS) 076997790 6. Recipient's Unique Entity Identifier 7. Project Director or Principal Investigator Mrs. Kristi Sonmag PI - Director, Community & Human Services Kristi.Sonntag@colliercountyfl.gov 239-252-2486 8. Authorized Official Ms. Therese Stanley AO - Grants Compliance Manager Therese. Stanley@colliercountyfl.gov 239-252-8348 Federal Agency Information CDC Office of Financial Resources 9. Awarding Agency Contact Information Mrs. Rhonda Colbert Grants Management Specialist hvxl@cdc.gov 770-488-2848 10.Program Official Contact Information Dr. Monique Young Public Health Advisor/Project Officer Division of Cancer Prevention and Control hza4@cdc.gov 770-488-3434 16. K.6.b Notice of Award Award# 1 NU58DPOO7038-01-00 FAIN# NU58DPOO7038 Federal Award Date: 08/23/2021 Federal Award Information 11. Award Number 1 NU58DP007038-01-00 12. Unique Federal Award Identification Number (FAIN) NU58DP007038 13. Statutory Authority Coronavirus Aid, Relief, and Economic Security Act ("CARES Act") Public Law 116-136 Public Healtl Service Act 42 U.S.C.301(a) 14. Federal Award Project Title Collier County Community Health Coalition (CCCHC): Advancing Accessible and Equitable Healthcar Systems in Extra Mile Migrant Farmworker Communities 15. Assistance Listing Number 93.495 16. Assistance Listing Program Title Community Health Workers for Public Health Response and Resilient 17. Award Action Type New 18. Is the Award R&D? No Summary Federal Award Financial Information 19. Budget Period Start Date 08/31/2021 - End Date 08/30/2022 20. Total Amount of Federal Funds Obligated by this Action 20a. Direct Cost Amount 20b. Indirect Cost Amount 21. Authorized Carryover 22. Offset 23. Total Amount of Federal Funds Obligated this budget period 24. Total Approved Cost Sharing or Matching, where applicable 25. Total Federal and Non -Federal Approved this Budget Period 26. Project Period Start Date 08/31/2021 - End Date 08/30/2024 27. Total Amount of the Federal Award including Approved Cost Sharing or Matching this Project Period $421,744. N $421,744. 00 $0. Cl) ti $0. p d $0. 00 LO $0. Z $0. UQ $421,744. U r M ao O N Not Available N L 28. Authorized Treatment of Program Income 3 ADDITIONAL COSTS Q 29. Grants Management Officer - Signature L Ms. Stephanie Latham 0 Team Lead, Grants Management Officer d E t v 30. Remarks Q Packet Pg. 1313 SF'Jvh}Y. . w �' y DEPARTMENT OF HEALTH AND HUMAN SERVICES � Centers for Disease Control and Prevention yW,a w Recipient Information Recipient Name Collier County Board of County Commissioners 3299 Tamiami Trl E Ste 200 Collier County of Florida Naples, FL 34112-5746 239-252-2951 Congressional District of Recipient 19 Payment Account Number and Type 1596000558AI Employer Identification Number (EIN) Data 596000558 Universal Numbering System (DUNS) 076997790 Recipient's Unique Entity Identifier Not Available 31. Assistance Type Project Grant 32. Type of Award Other 34. Accounting Classification Codes Notice of Award Award# 1 NU58DP007038-01-00 FAIN# NLJ58DP007038 Federal Award Date: 08/23/2021 33. Approved Budget (Excludes Direct Assistance) I. Financial Assistance from the Federal Awarding Agency Only II. Total project costs including grant funds and all other financial participation a. Salaries and Wages $10,103.00 b. Fringe Benefits $1,999.00 c. Total Personnel Costs $12,102.00 d. Equipment $0.00 e. Supplies $0.00 f. Travel $0.00 g. Construction $0.00 h. Other $0.00 i. Contractual $409,642.00 j. TOTAL DIRECT COSTS $421,744.00 k. INDIRECT COSTS $0.00 1. TOTAL APPROVED BUDGET $421,744.00 In. Federal Share $421,744.00 n. Non -Federal Share $0.00 FY-ACCOUNT NO. DOCUMENT NO. I ADMINISTRATIVE CODE I OBJECT CLASS I AMT ACTION FINANCIAL ASSISTANCE I APPROPRIATION 1-9390H3H 21NU58DP007038C3 I DP 1 41.51 1$421,744.001 75-2024-0943 O M O ti O O IL 0 00 uJ z 0 c L) Packet Pg. 1314 16. K.6.b AWARD ATTACHMENTS Collier County Board of County Commissioners 1 NU58DP007038-01-00 1. Terms and Conditions 00 M O ti O O d a O LO Z U U Packet Pg. 1315 16. K.6.b AWARD INFORMATION Incorporation: In addition to the federal laws, regulations, policies, and CDC General Terms and Conditions for Non -research awards at https://www.cdc.gov/grants/federalregulationspolicies/index.html, the Centers for Disease Control and Prevention (CDC) hereby incorporates Notice of Funding Opportunity (NOFO) number DP21- 2109, entitled "Community Health Workers for COVID Response and Resilient Communities (CCR)", and application dated May 24, 2021, as may be amended, which are hereby made a part of this Non -research award, hereinafter referred to as the Notice of Award (NoA). Approved Funding: Funding in the amount of $421,744 is approved for the Year 1 budget period, which is August 31, 2021 through August 30, 2022. All future year funding will be based on satisfactory programmatic progress and the availability of funds. The federal award amount is subject to adjustment based on total allowable costs incurred and/or the value of any third -party in -kind contribution when applicable. Note: Refer to the Payment Information section for Payment Management System (PMS) subaccount information. Component/Project Funding: The NOFO provides for the funding of multiple components under this award. The approved component funding levels for this notice of award are: NOFO Component Amount Component A $421,744 Coronavirus Disease 2019 (COVID-19) Funds: A recipient of a grant or cooperative agreement o' awarded by the Department of Health and Human Services (HHS) with funds made available under the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 (P.L. 116- a 123); the Coronavirus Aid, Relief, and Economic Security Act, 2020 (the "CARES Act") (P.L. 116- o 00 LO 136); the Paycheck Protection Program and Health Care Enhancement Act (P.L. 116-139); the 0 Consolidated Appropriations Act and the Coronavirus Response and Relief Supplement Z U Appropriations Act, 2021 (P.L. 116-260) and/or the American Rescue Plan of 2021 [P.L. 117-2] U agrees, as applicable to the award, to: 1) comply with existing and/or future directives and guidance M from the Secretary regarding control of the spread of COVID-19; 2) in consultation and coordination o with HHS, provide, commensurate with the condition of the individual, COVID-19 patient care N regardless of the individual's home jurisdiction and/or appropriate public health measures (e.g., N social distancing, home isolation); and 3) assist the United States Government in the implementation -� and enforcement of federal orders related to quarantine and isolation. 3 In addition, to the extent applicable, Recipient will comply with Section 18115 of the CARES Act, with respect to the reporting to the HHS Secretary of results of tests intended to detect SARS—CoV-2 or to diagnose a possible case of COVID-19. Such reporting shall be in accordance with guidance and direction from HHS and/or CDC. HHS laboratory reporting guidance is posted at: https://www.hhs.gov/sites/default/files/covid-1 9-laboratory-data-reporting-guidance.pdf. Further, consistent with the full scope of applicable grant regulations (45 C.F.R. 75.322), the purpose of this award, and the underlying funding, the recipient is expected to provide to CDC copies of Packet Pg. 1316 16. K.6.b and/or access to COVID-19 data collected with these funds, including but not limited to data related to COVID-19 testing. CDC will specify in further guidance and directives what is encompassed by this requirement. This award is contingent upon agreement by the recipient to comply with existing and future guidance from the HHS Secretary regarding control of the spread of COVID-19. In addition, recipient is expected to flow down these terms to any subaward, to the extent applicable to activities set out in such subaward. Financial Assistance Mechanism: Grant Budget Revision Requirement: By September 30, 2021 the recipient must submit a revised budget with a narrative justification for the following cost: • Approved Funding - Recipient must submit a revised budget with a narrative justification based on the approved funding of $421,744. • Indirect Costs - Provide a current approved indirect cost rate agreement. • Contractual - Recipient must provide the six elements in accordance with the CDC Budget Preparation Guidelines. Failure to submit the required information in a timely manner may adversely affect the future funding of this project. If the information cannot be provided by the due date, you are required to contact the GMS identified in the CDC Staff Contacts section of this notice before the due date. Expanded Authority: The recipient is permitted the following expanded authority in the administration of the award. ® Carryover of unobligated balances from one budget period to a subsequent budget period. o Unobligated funds may be used for purposes within the scope of the project as originally o approved. Recipients will report use, or intended use, of unobligated funds in Section 12 a "Remarks" of the annual Federal Financial Report. If the GMO determines that some or all of the a LO unobligated funds are not necessary to complete the project, the GMO may restrict the recipient's M authority to automatically carry over unobligated balances in the future, use the balance to reduce z or offset CDC funding for a subsequent budget period, or use a combination of these actions. o U FUNDING RESTRICTIONS AND LIMITATIONS Indirect Costs: Indirect costs are not approved for this award, because indirect costs were not requested, or an approved Indirect Cost Rate Agreement has not been established. To have indirect costs approved for this grant, submit an approved indirect cost rate agreement to the grants management specialist no later than 9/30/2021. REPORTING REQUIREMENTS Required Disclosures for Federal Awardee Performance and Integrity Information System (FAPIIS): Consistent with 45 CFR 75.113, applicants and recipients must disclose in a timely manner, in writing to the CDC, with a copy to the HHS Office of Inspector General (OIG), all information related to violations of federal criminal law involving fraud, bribery, or gratuity violations potentially affecting the federal award. Subrecipients must disclose, in a timely manner in writing to Packet Pg. 1317 16. K.6.b the prime recipient (pass through entity) and the HHS OIG, all information related to violations of federal criminal law involving fraud, bribery, or gratuity violations potentially affecting the federal award. Disclosures must be sent in writing to the CDC and to the HHS OIG at the following addresses: CDC, Office of Grants Services Rhonda Colbert, Grants Management Specialist Centers for Disease Control and Prevention Branch 5 Supporting Chronic Diseases and Injury Prevention 2939 Flowers Road, MS TV2 Atlanta, GA 30341-4146 Email: Hvx1(cDcdc.gov (Include "Mandatory Grant Disclosures" in subject line) 110 U.S. Department of Health and Human Services Office of the Inspector General ATTN: Mandatory Grant Disclosures, Intake Coordinator 330 Independence Avenue, SW Cohen Building, Room 5527 Washington, DC 20201 Fax: (202)-205-0604 (Include "Mandatory Grant Disclosures" in subject line) or Email: MandatorVGranteeDisclosures(cDoig.hhs.gov Recipients must include this mandatory disclosure requirement in all subawards and contracts under this award. 00 Failure to make required disclosures can result in any of the remedies described in 45 CFR 75.371. o Remedies for noncompliance, including suspension or debarment (See 2 CFR parts 180 and 376, o and 31 U.S.C. 3321). a. 00 CDC is required to report any termination of a federal award prior to the end of the period of Z performance due to material failure to comply with the terms and conditions of this award in the z OMB -designated integrity and performance system accessible through SAM (currently FAPIIS). (45 a CFR 75.372(b)) CDC must also notify the recipient if the federal award is terminated for failure to r comply with the federal statutes, regulations, or terms and conditions of the federal award. (45 CFR o 75.373(b)) PAYMENT INFORMATION Payment Management System Subaccount: Funds awarded in support of approved activities have been obligated in a subaccount in the PMS, herein identified as the "P Account". Funds must be used in support of approved activities in the NOFO and the approved application. The grant document number identified on the bottom of Page 1 of the Notice of Award must be known to draw down funds. CDC Staff Contacts Grants Management Specialist: The GMS is the federal staff member responsible for the day -to - Packet Pg. 1318 16. K.6.b day management of grants and cooperative agreements. The GMS is the primary contact of recipients for business and administrative matters pertinent to grant awards. GMS Contact: Rhonda Colbert, Grants Management Specialist (GMS) Branch 5 Supporting Chronic Diseases and Injury Prevention Office of Grants Services (OGS) Office of Financial Resources (OFR) Office of the Chief Operating Officer (OCOO) Centers for Disease Control and Prevention (CDC) Hvxl@cdc.gov I Phone: 770-488-2848 Program/Project Officer: The PO is the federal official responsible for monitoring the programmatic, scientific, and/or technical aspects of grants and cooperative agreements, as well as contributing to the effort of the award under cooperative agreements. Programmatic Contact: Monique Young, Project Officer Centers for Disease Control and Prevention National Center for Disease Prevention and Health Telephone: 770-488-3434 Email: HZA4@cdc.gov Grants Management Officer: The GMO is the federal official responsible for the business and other non -programmatic aspects of grant awards. The GMO is the only official authorized to obligate federal funds and is responsible for signing the NoA, including revisions to the NoA that change the N terms and conditions. The GMO serves as the counterpart to the business officer of the recipient N organization. 00 M O GMO Contact: 0 Stephanie Latham, Grants Management Officer (GMO) a 0 Branch 5 Supporting Chronic Diseases and Injury Prevention 0, Office of Grants Services (OGS) 0 Z Office of Financial Resources (OFR) Office of the Chief Operating Officer (OCOO) Centers for Disease Control and Prevention (CDC) r Email: FZV6(@.cdc.gov I Telephone: 770-488-2197 Cl? Packet Pg. 1319 WORKSPACE FORM 1-800-518-4726 � GRAN -GOB" SUPPORT@GRANTS.GOVNTS.GOV This Workspace form is one of the forms you need to complete prior to submitting your Application Package. This form can be completed in its entirety offline usii Adobe Reader. You can save your form by clicking the "Save" button and see any errors by clicking the "Check For Errors" button. In -progress and completed foi can be uploaded at any time to Grants.gov using the Workspace feature. M L When you open a form, required fields are highlighted in yellow with a red border. Optional fields and completed fields are displayed in white. If you enter invalid 1 L incomplete information in a field, you will receive an error message. Additional instructions and FAQs about the Application Package can be found in the Grants.c 4) Applicants tab. p OPPORTUNITY & PACKAGE DETAILS: Opportunity Number: CDC-RFA-DP21-2109 Li Opportunity Title: Community Health Workers for COVID Response and Resilient Communities (CCR) Opportunity Package ID: PK000266150 CFDA Number: 93.495 CFDA Description: Community Health Workers for Public Health Response and Resilient Competition ID: CDC-RFA-DP21-2109 Competition Title: Community Health Workers for COVID Response and Resilient Communities (CCR) Opening Date: 03/25/2021 Closing Date: 05/24/2021 Agency: Centers for Disease Control - NCCDPHP Contact Information: WORKSPACEAPPLICANT & Stacy De Jesus Workspace ID: WS00679247 Application Filing Name: COLLIER CDC-RFA-DP21-2109 DUNS: Organization: 0769977900000 COLLIER, COUNTY OF Form Name: Application for Federal Assistance (SF-424) Form Version: 3.0 Requirement: Mandatory Download Date/Time: May 17, 2021 09:03:37 AM EDT Form State: No Errors Packet Pg. 1320 16. K.6.c OMB Number: 4040-0004 Expiration Date: 12/31/202; Application for Federal Assistance SF-424 * 1. Type of Submission: ❑ Preapplication ® Application ❑ Changed/Corrected Application ` 2. Type of Application: * If Revision, select appropriate letter(s): ® New ❑ Continuation * Other (Specify): ❑ Revision * 3. Date Received: 4. Applicant Identifier: Completed by Grants.gov upon submission. 5a. Federal Entity Identifier: 5b. Federal Award Identifier: State Use Only: 6. Date Received by State: 7. State Application Identifier: 8. APPLICANT INFORMATION: *a. Legal Name: Collier County Board of County Commissioners * b. Employer/Taxpayer Identification Number (EIN/TIN): * c. Organizational DUNS: 0769977900000 59-6000558 d. Address: * Streed: 3299 Tamiami Trail East Street2: suite 202 * City: County/Parish: Naples * State: FL: Florida Province: *Country: USA: UNITED STATES * Zip / Postal Code: 34112-5746 e. Organizational Unit: Department Name: Division Name: Community & Human Services Public Services f. Name and contact information of person to be contacted on matters involving this application: Prefix: Mrs . * First Name: Middle Name: Kristi * Last Name: Sonntag Suffix: Title: Director, Community & Human Services Organizational Affiliation: Collier County * Telephone Number: 23 9-252-24 8 6 Fax Number: *Email: Kristi.Sonntag@colliercountyfl.gov c c� L L Y L O E M LL t C to 2 r_ C) N N N R V_ Packet Pg. 1321 16. K.6.c Application for Federal Assistance SF-424 * 9. Type of Applicant 1: Select Applicant Type: B: County Government Type of Applicant 2: Select Applicant Type: Type of Applicant 3: Select Applicant Type: * Other (specify): " 10. Name of Federal Agency: Centers for Disease Control - NCCDPHP 11. Catalog of Federal Domestic Assistance Number: 93.495 CFDA Title: Community Health Workers for Public Health Response and Resilient * 12. Funding Opportunity Number: CDC-RFA-DP21-2109 * Title: Community Health Workers for COVID Response and Resilient Communities (CCR) 13. Competition Identification Number: CDC-RFA-DP21-2109 Title: Community Health Workers for COVID Response and Resilient Communities (CCR) 14. Areas Affected by Project (Cities, Counties, States, etc.): Add Attachment Delete Attachment View Attachment * 15. Descriptive Title of Applicant's Project: Collier County Community Health Coalition (CCCHC): Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities Attach supporting documents as specified in agency instructions. Add Attachments Delete Attachments View Attachments r- M N N V N U w U 2 U U U N Ln O N O N IL a Q V- M IZ C O O c2 Q CL Q C R V r C d z tt to a Packet Pg. 1322 Application for Federal Assistance SF-424 16. Congressional Districts Of: ` a. Applicant 19 * b. ProgramlProject 19 Attach an additional list or Program/Project Congressional Districts if needed. Add Attachment Delete, Atladhmcnt View Attachment 17. Proposed Project: `a. Start Date: 1o/oi/2o21 * b. End Date: 09/30/2024 18. Estimated Funding M; a. Federal 1,446,255.041 " b. Applicant 0 .00 c. State 0. 00 d, local 0.001 e. Other 0,001 ' f. Program Income 0.001 *g,TOTAL 1,446,255.04 * 19. Is Application Subject to Review By State Under Executive Order 12372 Process? a. This application was made available to the State under the Executive Order 12372 Process for review on �. b. Program is subject to E.O. 12372 but has not been selected by the State for review. ® c. Program is not covered by E.O. 12372. * 20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes," provide explanation in attachment,) ❑ Yes ® No If "Yes", provide explanation and attach Add Allacilrnent 11� Jele, Att )ch ci t View AUa',hmerit 21. *By signing this application, I certify (1) to the statements contained in the list of certifications— and (2) that the stateragnts herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances** and a e to comply with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or clat may subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001) ® *'IAGREE The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcem t or agency specific instructions. Authorized Representative: Prefix: Mr. ' First Name: Mark Middle Name: * Last Name: Isackson Suffix. * Title: County Manager * Telephone Number: 239-252-8383 Fax Number: "Email: Mark.Isacksonncolliercountyfl.gov ` Signature of Authorized Representative: Completed by Granls.gov upon submission. * Date Signed: 1completed by Granls.gov upon submission. W R u Cl) N N 1* N U U 2 U U 0 U N Lr'1 O N O N d a a r Q Packet Pg. 1323 �r � GRAT4'FS•'C30V'" WORKSPACE FORM 16 SUPPORT@GRANRANTS.GO.GOV This Workspace form is one of the forms you need to complete prior to submitting your Application Package. This form can be completed in its entirety offline usii Adobe Reader. You can save your form by clicking the "Save" button and see any errors by clicking the "Check For Errors" button. In -progress and completed foi can be uploaded at any time to Grants.gov using the Workspace feature. to L When you open a form, required fields are highlighted in yellow with a red border. Optional fields and completed fields are displayed in white. If you enter invalid 1 L incomplete information in a field, you will receive an error message. Additional instructions and FAQs about the Application Package can be found in the Grants.c 4) Applicants tab. p OPPORTUNITY & PACKAGE DETAILS: Opportunity Number: CDC-RFA-DP21-2109 Li Opportunity Title: Community Health Workers for COVID Response and Resilient Communities (CCR) t Opportunity Package ID: PK000266150 L T CFDA Number: 93.495 m CFDA Description: Community Health Workers for Public Health Response and Resilient R L Competition ID: CDC-RFA-DP21-2109 x W Competition Title: Community Health Workers for COVID Response and Resilient Communities (CCR) 0 C Opening Date: 03/25/2021 O Closing Date: 05/24/2021 V c Agency: Centers for Disease Control - NCCDPHP O O Contact Information: Stacy De JesusAPPLICANT Q d & WORKSPACE Workspace ID: WS00679247 N N Application Filing Name: COLLIER CDC-RFA-DP21-2109 v DUNS: 0769977900000 L) Organization: COLLIER, COUNTY OF U 2 Form Name: Budget Information for Non -Construction Programs (SF-424A) V C) Form Version: 1.0 p U Requirement: Mandatory le N Download Daterrime: May 20, 2021 01 :32 :32 PM EDT LO O T Form State: No Errors o N FORM ACTIONS:a Packet Pg. 1324 0 0 O N oco V N O N � O a E p z o O a x w w E c4 L O L a i O y.+ ci L N i O U 1 C O Z Z 0 0 U- Z W 0 0 m 6Valn03 uo :podeN : £ZZbZ) ONOMHO 303 VZ-50 LZOZ ddd - (lei:ped) uol;eollddy;uea0 :;uewLjoejjV Q r W C9 G m a z 0 F- U W U) c 0 Ln Ln a' 0 Ln Ln N c a' N a� a O � d rn a 7 m L a m m a N LL w Gf C w O z O 3 m z m N � N v LL 6R 6R L O 0 0 O 0 0 d a a N LL Li z a m 0 � a o 0 D Ln N a Lo N Ln N E @ L C C lo c C . 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This form can be completed in its entirety offline usii Adobe Reader. You can save your form by clicking the "Save" button and see any errors by clicking the "Check For Errors" button. In -progress and completed foi can be uploaded at any time to Grants.gov using the Workspace feature. M L When you open a form, required fields are highlighted in yellow with a red border. Optional fields and completed fields are displayed in white. If you enter invalid 1 L incomplete information in a field, you will receive an error message. Additional instructions and FAQs about the Application Package can be found in the Grants.c 4) Applicants tab. p OPPORTUNITY & PACKAGE DETAILS: Opportunity Number: CDC-RFA-DP21-2109 Li Opportunity Title: Community Health Workers for COVID Response and Resilient Communities (CCR) Opportunity Package ID: PK000266150 CFDA Number: 93.495 CFDA Description: Community Health Workers for Public Health Response and Resilient Competition ID: CDC-RFA-DP21-2109 Competition Title: Community Health Workers for COVID Response and Resilient Communities (CCR) Opening Date: 03/25/2021 Closing Date: 05/24/2021 Agency: Centers for Disease Control - NCCDPHP Contact Information: WORKSPACEAPPLICANT & Stacy De Jesus Workspace ID: WS00679247 Application Filing Name: COLLIER CDC-RFA-DP21-2109 DUNS: Organization: 0769977900000 COLLIER, COUNTY OF Form Name: Project Abstract Summary Form Version: 2.0 Requirement: Mandatory Download Date/Time: May 20, 2021 10:33:54 AM EDT Form State: FORM ACTIONS: No Errors Packet Pg. 1328 16. K.6.c OMB Number: 4040-0019 Expiration Date: 02/28/2022 Project Abstract Summary This Project Abstract Summary form must be submitted or the application will be considered incomplete. Ensure the Project Abstract field succinctly describes the project in plain language that the public can understand and use without the full proposal. Use 4, 000 characters or less. Do not include personally identifiable, sensitive or proprietary information. Refer to Agency instructions for any additional Project Abstract field requirements. If the application is funded, your project abstract information (as submitted) will be made available to public websites and/or databases including USAspending.gov. Funding Opportunity Number CDC-RFA-DP21-2109 CFDA(s) 93.495 Applicant Name Descriptive Title of Applicant's Project Project Abstract Collier County, located in Southwestern Florida, has been affected by high rates of COVID-19 from early on in the pandemic. The county is a major center for tomato growing and other large-scale agricultural production, and is home to many migrant farmworkers and other essential workers, approximately half of whom are un- or under - documented. These populations have been devastated by the COVID-19 pandemic given continued work in front-line, high -risk environments with limited worker protections; crowded housing that impede preventive measures such as social distancing and isolation of positive cases at home; and lack of access to quality healthcare or social support for those that do become infected. By hiring and partnering with individuals who represent the racial, ethnic, and cultural diversity of Immokalee and similar communities in the area, and who understand the social and structural context of the community within a network of social and clinical support, the Collier County Community Health Coalition (CCCHC) team has begun to address the barriers that migrant farm workers have historically faced to accessing healthcare. In this proposed Component A project, CCCHC partners, which include the Collier County government, the Healthcare Network, Department of Health Collier County, Partners In Health, the Coalition of Immokalee Workers, and Mision Peniel, will support efforts to expand the Community Health Program in the county by training and mentoring CHWs to serve Extra Mile communities in Collier County and to integrate the CHW function into care teams to support COVID-19 response efforts in communities hit hardest and among populations that are at high risk for COVID-19 exposure, infection, and poor health outcomes. CHWs will identify, counsel, and connect residents with COVID-19 and other chronic conditions to clinical care; serve as resource navigators in linking individuals to social support; and act as bridges between the community and the healthcare system by elevating community feedback and supporting individuals to overcome linguistic, geographic, and social barriers to care. By the end of the project period, the 384,900 individuals living in Collier County will have access to essential healthcare services, and the approximately 75,000 individuals living in and around Extra Mile communities, representing the most vulnerable communities in the region, will be directly connected to Packet Pg. 1329 WORKSPACE FORM 1-800-518-4726 � GRAN -GOB" SUPPORT@GRANTS.GOVNTS.GOV This Workspace form is one of the forms you need to complete prior to submitting your Application Package. This form can be completed in its entirety offline usii Adobe Reader. You can save your form by clicking the "Save" button and see any errors by clicking the "Check For Errors" button. In -progress and completed foi can be uploaded at any time to Grants.gov using the Workspace feature. M L When you open a form, required fields are highlighted in yellow with a red border. Optional fields and completed fields are displayed in white. If you enter invalid 1 L incomplete information in a field, you will receive an error message. Additional instructions and FAQs about the Application Package can be found in the Grants.c 4) Applicants tab. p OPPORTUNITY & PACKAGE DETAILS: Opportunity Number: CDC-RFA-DP21-2109 Li Opportunity Title: Community Health Workers for COVID Response and Resilient Communities (CCR) Opportunity Package ID: PK000266150 CFDA Number: 93.495 CFDA Description: Community Health Workers for Public Health Response and Resilient Competition ID: CDC-RFA-DP21-2109 Competition Title: Community Health Workers for COVID Response and Resilient Communities (CCR) Opening Date: 03/25/2021 Closing Date: 05/24/2021 Agency: Centers for Disease Control - NCCDPHP Contact Information: WORKSPACEAPPLICANT & Stacy De Jesus Workspace ID: WS00679247 Application Filing Name: COLLIER CDC-RFA-DP21-2109 DUNS: Organization: 0769977900000 COLLIER, COUNTY OF Form Name: Disclosure of Lobbying Activities (SF-LLL) Form Version: 2.0 Requirement: Mandatory Download Date/Time: May 20, 2021 11:32:21 AM EDT Form State: No Errors Packet Pg. 1330 16. K.6.c DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose lobbying activities pursuant to 31 U.S.C.1352 OMB Number: 4040-0013 Expiration Date: 02/28/2022 1. * Type of Federal Action: 2. * Status of Federal Action: 3. * Report Type: ❑ a. contract ❑ a. bid/offer/application ® a. initial filing ® b. grant ® b. initial award ❑ b. material change ❑ c. cooperative agreement ❑ c. post -award d.loan ❑ e.loan guarantee ❑ f. loan insurance 4. Name and Address of Reporting Entity: ®Prime F]SubAwardee Name Collier County Board of County Commissioners Street 1 Street 2 3299 Tamiami Trail East Suite 202 City State Zip Naples FL: Florida 34112 Congressional District, if known: 19 5. If Reporting Entity in No.4 is Subawardee, Enter Name and Address of Prime: 6. * Federal Department/Agency: 7. * Federal Program Name/Description: Centers for Disease Control Community Health Workers for Public Health Response and Resilient CFDA Number, ifapplicable: 93.495 8. Federal Action Number, if known: 9. Award Amount, if known: 1,456,840.04 10. a. Name and Address of Lobbying Registrant: Prefix * First Name Middle Name Becker Last Name Suffix Poliakoff Street f Street 2 1275 K Street, N.W. Suite 850 City State zip Washington DC: District of Columbia 20005 b. Individual Performing .Services (including address ifdifferentfrom No. 10a) Prefix Ms First Name Amanda Middle Name Last Name suffix Wccd Street 1 Street 2 1275 K Street, N.W. Suite 850 *City Washington State DC: District of Columbia zip 20005 11. Information requested through this form is authorized by title 31 U.S.C. section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when the transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to the Congress semi-annually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. " Signature: Completed on submission to Grants. gov *Name: Prefix *First Name Middle Name Mr. Mark * Last Name Suffix Isackson Title: County Manager Telephone No.: 239-252-8383 Date: Completed on submission to Grants.gov Federal Use Only: Authorized for Local Reproduction Standard Form - LLL(Rev. 7-97) Packet Pg. 1331 WORKSPACE FORM 1-80 SUPPORT@GRANTS.GOV � �RAivTS-GOB" NTS.GOV This Workspace form is one of the forms you need to complete prior to submitting your Application Package. This form can be completed in its entirety offline usii Adobe Reader. You can save your form by clicking the "Save" button and see any errors by clicking the "Check For Errors" button. In -progress and completed foi can be uploaded at any time to Grants.gov using the Workspace feature. M L When you open a form, required fields are highlighted in yellow with a red border. Optional fields and completed fields are displayed in white. If you enter invalid 1 L incomplete information in a field, you will receive an error message. Additional instructions and FAQs about the Application Package can be found in the Grants.c 4) Applicants tab. p OPPORTUNITY & PACKAGE DETAILS: Opportunity Number: CDC-RFA-DP21-2109 Li Opportunity Title: Community Health Workers for COVID Response and Resilient Communities (CCR) Opportunity Package ID: PK000266150 CFDA Number: 93.495 CFDA Description: Community Health Workers for Public Health Response and Resilient Competition ID: CDC-RFA-DP21-2109 Competition Title: Community Health Workers for COVID Response and Resilient Communities (CCR) Opening Date: 03/25/2021 Closing Date: 05/24/2021 Agency: Centers for Disease Control - NCCDPHP Contact Information: WORKSPACEAPPLICANT & Stacy De Jesus Workspace ID: WS00679247 Application Filing Name: COLLIER CDC-RFA-DP21-2109 DUNS: Organization: 0769977900000 COLLIER, COUNTY OF Form Name: Budget Narrative Attachment Form Form Version: 1.2 Requirement: Mandatory Download Date/Time: May 21, 2021 12:04:53 PM EDT Form State: FORM ACTIONS: No Errors Packet Pg. 1332 Budget Narrative File(s) 16. K.6.c * Mandatory Budget Narrative Filename: udget Narrative.pdf Add Mandatory Budget Narrative Delete Mandatory Budget Narrative View Mandatory Budget Narrative To add more Budget Narrative attachments, please use the attachment buttons below. Add Optional Budget Narrative Delete Optional Budget Narrative View Optional Budget Narrative Packet Pg. 1333 16. K.6.c Collier County Community Health Coalition (CCCHC): Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities Budget Narrative: The total budget requested for Year 1 of the proposed scope of work is $ 421,744.34 Collier County costs Grantee: $ 11,936.34 Personnel- $10,102.70 Grants Coordinator 0.10 FTE: $ 5,663.90 The Grant Coordinator will provide program administration, compliance review, project support, financial review, and oversight of the program sub recipients to ensure program compliance with applicable grant guidelines. Accountant 0.5 FTE: $ 2,782.35 The Accountant will oversee all fiscal aspects of the grant funds including grant payment requests, disbursements, contractual payments, and drawdowns from the grantor agency as applicable. The accountant will also ensure compliance with all other legal requirements of the grant and audit requirements. Operations Analyst 0.3 FTE: $ 1,656.45 The Operations Analyst will provide compliance review and monitoring of grant regulations, performs monitoring visits to sub -grantees and prepares closeout documentation. Fringe Benefit- $1,833.64 Collier County budget instruction manual identifies social security and Medicare (FICA) costs to be calculated at a rate of 7.65% (1.45% for Medicare and 6.20% for Social Security) of each employee's salary. Retirement is also available to full time employees and calculated at 10.5%. Benefit rates are standard for all employees and agree with acceptable IRS Contractual costs $409,808 Sub -grantee 1- Healthcare Network: $303,173 Personnel- $201,000: Six new full-time (LOE 100%) Community Health Workers will be hired to support Extra Mile communities, at a cost of $3,333 per month per CHW for 9 months to account for project launch time ($180,000 in total). HCN's Human Resources Manager ($875/month) and Community Health Manager ($875/month) will both dedicate 15% LOE to the hiring and management of the CHWs and project implementation over 12 months, totaling $21,000 for Year 1. Fringe Benefit- $40,200: HCN's fringe rate of 20% of salary costs has been applied proportionately to each project role's level of effort. Included in this rate are payroll taxes, payroll administration, health insurance, workers compensation insurance, and life insurance. Project Narrative 1 Collier County Community Health Coalition: Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities Packet Pg. 1334 16. K.6.c Travel- $1,680: Local travel- $1,680: HCN project administration and CHW staff will use their own vehicles for travel related to project implementation and will be reimbursed for mileage at a cost of $0.56, the federal GSA rate. Mileage needs are estimated at 250 miles per month for project administration roles (between 2 staff roles) for 12 months, and 350 miler per CHW (for 6 CHWs, 2,100 miles in total) for 9 months. Supplies- $5,300: Six basic smartphones will be purchased for use by the CHWs, costed at $250 each ($1,500 in total). Two laptops ($1,8000 each) will be purchased for project administration and data collection, for use in HCN offices, totaling $3,600. 10 CHW Training Manuals will be printed and bound at a cost of $20 each ($200 in total), to be distributed to CHWs and training facilitators. Other- $2, 700: Monthly phone plans will be provided for CHW work phones to enable consistent communication with community stakeholders and clients, at a monthly cost of $50 per phone (6 phones, $2,700 in total for 9 months). Indirect Charges- $52,293: HCN will apply an indirect rate of 20% against its total direct cost base of $261,464. Sub -grantee 2- Partners In Health: $106,635 Personnel- $60,606: The following four PIH staff will participate in the implementation of this project over the 12 months in Year 1: The Sr. Project Lead (LOE 15%, $18,750 in total) will provide regular technical input throughout the project implementation and will be the daily point of contact for PIH's programmatic contributions to this project. The Project Manama (LOE 20%, $13,600 in total) will support project implementation and contractual compliance, acting as the main point of contact for administrative purposes between PIH and Collier County. The Sr. Technical Advisor (LOE 10%, $17,200 in total) and the Director of Community Health Systems (LOE 10%, $11,056 in total) will provide expert support on CHW training and integration into the wider health system. Fringe Benefit- $13,333: PIH's fringe rate of 22% of salary costs has been applied proportionately to each project role's level of effort. Included in this rate are payroll tax, payroll administration, health and dental insurance, workers compensation insurance, life insurance, and 4053b matched contribution. Travel- $9,555: Local travel- $1,680: PIH staff based in Immokalee will use their own vehicles for travel related to project implementation and will be reimbursed for mileage up to a total of 250 miles per month (between 2 staff roles) at a cost of $0.56, the federal GSA rate. Project Narrative 2 Collier County Community Health Coalition: Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities Packet Pg. 1335 16. K.6.c Long-distance travel- $7,875: Two PIH staff based in Boston will travel to Collier County to provide direct support to the project implementation. Five trips of 5 days/4 nights each are planned in Year 1, including one trip for the Director of Community Health Systems and four trips (one per quarter) for the Sr. Technical Advisor. Included in the budget are return airfares from MA to FL ($300/trip, $1,500 in total), accommodation (20 nights (4 per trip) at $100/night, total $2,000), per diem (25 days (5 per trip) at $50/day (PIH standard rate), total $1,250), and rental car costs (25 days (5 per trip) at $125/day, total $3,125). Contractual- $5,000: Biostatistician support will be required for data analysis and assessment, to be contracted from PIH's research partner at the Brigham and Women's hospital, budgeted at $500/day for 10 days in Year 1. Indirect Charges- $18,141: PIH will apply its NICRA of 20.5% against its total direct cost base of $88,494. Project Narrative 3 Collier County Community Health Coalition: Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities Packet Pg. 1336 WORKSPACE FORM 1-80 SUPPORT@GRANTS.GOV � �RAivTS-GOB" NTS.GOV This Workspace form is one of the forms you need to complete prior to submitting your Application Package. This form can be completed in its entirety offline usii Adobe Reader. You can save your form by clicking the "Save" button and see any errors by clicking the "Check For Errors" button. In -progress and completed foi can be uploaded at any time to Grants.gov using the Workspace feature. M L When you open a form, required fields are highlighted in yellow with a red border. Optional fields and completed fields are displayed in white. If you enter invalid 1 L incomplete information in a field, you will receive an error message. Additional instructions and FAQs about the Application Package can be found in the Grants.c 4) Applicants tab. p OPPORTUNITY & PACKAGE DETAILS: Opportunity Number: CDC-RFA-DP21-2109 Li Opportunity Title: Community Health Workers for COVID Response and Resilient Communities (CCR) Opportunity Package ID: PK000266150 CFDA Number: 93.495 CFDA Description: Community Health Workers for Public Health Response and Resilient Competition ID: CDC-RFA-DP21-2109 Competition Title: Community Health Workers for COVID Response and Resilient Communities (CCR) Opening Date: 03/25/2021 Closing Date: 05/24/2021 Agency: Centers for Disease Control - NCCDPHP Contact Information: WORKSPACEAPPLICANT & Stacy De Jesus Workspace ID: WS00679247 Application Filing Name: COLLIER CDC-RFA-DP21-2109 DUNS: Organization: 0769977900000 COLLIER, COUNTY OF Form Name: Project Narrative Attachment Form Form Version: 1.2 Requirement: Mandatory Download Date/Time: May 21, 2021 12:08:08 PM EDT Form State: FORM ACTIONS: No Errors Packet Pg. 1337 16. K.6.c Project Narrative File(s) * Mandatory Project Narrative File Filename: Project Narrative.pdf Add Mandatory Project Narrative File Delete Mandatory Project Narrative File View Mandatory Project Narrative File To add more Project Narrative File attachments, please use the attachment buttons below. Add Optional Project Narrative File Delete Optional Project Narrative File View Optional Project Narrative File Packet Pg. 1338 16. K.6.c Collier County Community Health Coalition (CCCHC): Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities Table of Contents 1. Project Abstract Summary 2. Project Narrative A. Background B. Approach i. Purpose ii. Outcomes iii. Strategies and Activities 1. Collaborations 2. Target Populations C. Applicant Evaluation and Performance Measurement Plan D. Organizational Capacity of Applicants to Implement the Approach E. Work Plan F. Budget Narrative 3. Required Attachments i. CVs of Key Personnel ii. Staffing Plan iii. Letters of Support iv. Budget Narrative v. Table of Contents Packet Pg. 1339 16. K.6.c Project Narrative A. BACKGROUND: COVID-19 has brought the ruinous impacts of an uncontrolled pandemic to the US. More than 500,000 Americans have died in the space of just 12 months. Outbreaks across the country have laid bare the systemic injustice in the US health system, as communities of color bear the brunt of the pandemic. Collier County (CC), located in Southwestern Florida, has been affected by high rates of COVID-19 for over 12 months. For the week of May 7 -14, 2021, 120.29 cases per 100,000 people and fewer than 10 deaths have been recorded.1 Collier County serves as a major center for tomato growing and other large-scale agricultural production, with a $413 agricultural economy. Of Collier County's population of approximately 385,000, 28.2% are Latino, 6.72% are Black and 2.66% are from other minority groups. In the county, 12.2% live below the poverty line. 2 Despite pockets of wealth, economic inequity across the county is staggering. Parts of the county, including the Immokalee area, are some of the most vulnerable communities in the United States. It is home to many migrant farmworkers and other essential workers, approximately half of whom are un- or under -documented. Immokalee's population, which is 72.1 % Latino and 21.2% Black and which has a poverty rate of 42.4%3, has been devastated by the COVID-19 pandemic given continued work in front-line, high -risk environments with limited worker protections; crowded trailers that impede preventive measures such as social distancing and isolation of positive cases at home; and lack of access to quality healthcare or social support for those that do become infected. At the high of the pandemic, the community had one of the highest rates of COVID-19 in the state, with a positivity rate of 36%. In order to implement an effective COVID-19 response, and to build a more equitable healthcare system for the future, it is necessary to address the underlying structures that make migrant farmworkers and their families more susceptible to becoming sick and less likely to receive healthcare. The COVID-19 pandemic brought together a team of stakeholders in Collier County that has proven its capacity to bring COVID-19 related services to vulnerable households in Immokalee and to address the social determinants of health by positioning Community Health Workers (CHWs) as bridges, connected to clinical and social supports, rather than as islands, which stand alone without referral mechanisms. By hiring and partnering with individuals who represent the racial, ethnic, and cultural diversity of Immokalee and similar communities in the area, and who understand the social and structural context of the community within a network of social and clinical support, the Collier County Community Health Coalition (CCCHC) team has begun to address the socioeconomic, linguistic, and cultural barriers that migrant farm workers have historically faced to accessing healthcare. Importantly, while Immokalee offers an example of a population of agricultural laborers that has been disproportionately impacted by the pandemic, it is not the only underserved farm working community in Collier County. Rather, the health inequities that have been exacerbated by the COVID-19 pandemic call for expanded efforts to reduce barriers to healthcare services for multiple "extra mile" communities, those that require additional efforts and resources to reach 1 CDC COVID Data Tracker, hgps:Hcovid.cdc.gov/covid-data-tracker/#count, . Accessed 05/17/2021. 2 United States Census Bureau, 2014-2018 Poverty Rate in the United States by County, https://www.census.gov/library/visualizations/interactive/2014-2018-poverty-rate-by-county.html. Accessed 05/12/2021. 3 Data USA, Immokalee, FL, https://datausa.io/profile/geo/immokalee-fl/. Accessed 05/05/2021. Project Narrative 1 Collier County Community Health Coalition: Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities Packet Pg. 1340 16. K.6.c with quality care due to historically rooted cultural, socioeconomic, linguistic, and geographic vulnerabilities. B. APPROACH: The CCCHC partners, which include the Collier County government, the Healthcare Network (HCN), Department of Health Collier County (DOH-C), Partners In Health (PIH), the Coalition of Immokalee Workers (CIW), and Mision Peniel (MP), have been based in Immokalee and are in the process of expanding their work to Golden Gate, an underserved area that will serve as a home base alongside Immokalee, due to the presence of clinics in both communities. Through this grant, the team seeks to extend their work together as the CCCHC by recruiting, training, and mentoring CHWs from additional Extra Mile communities, which will allow for the geographic expansion of care into highly vulnerable areas that are scattered throughout the county to prevent geography from becoming a form of care rationing. By building upon the proven expertise of CCCHC members in community trust, access to local public health and healthcare delivery systems, and knowledge of best practices for responding to health emergencies and strengthening healthcare systems around the world, the CCCHC will extend its reach into remote geographic pockets of migrant farmworkers to operationalize healthcare as a human right throughout Collier County. i. Purpose: The CCCHC will support efforts to expand the Community Health Program beyond Immokalee by recruiting, training, and mentoring CHWs from Extra Mile communities in Collier County to identify, counsel, and connect residents with COVID-19 and other chronic conditions to clinical care; to serve as resource navigators in linking individuals to social support; and to act as bridges between the community and the healthcare system by elevating community feedback and supporting individuals to overcome linguistic, geographic, and social barriers to care. ii. Outcomes: Through local partnerships with farmworker communities and long-established expertise in building community health programs, we will hire, mentor, and host regular meetings with Extra Mile CHWs supporting satellite communities in Collier County, who will join an already robust training program in Immokalee. We will improve access to and quality of care for migrant farm workers by assigning CHWs to patients or households in these communities, where patient encounters will take place through regular visits with community members assigned via clinicians and/or regular home visits to households for outreach, education, vulnerability assessments, and referrals to clinics and local hospitals. Community health outcomes will be measured by embedding the program into a study, where pre- and post - activation scores and engagement scores will be measured. We anticipate improved activation and improved engagement with longitudinal care scores will be observed as outcomes of the program. Depending on the databases that are made accessible to the CCCHC, we can also examine the impact on the number of hospitalizations, which we anticipate will decrease due to improved access to primary and preventative care. By the end of the project period, the 384,900 individuals living in Collier County will have access to essential healthcare services, and the approximately 100,000 individuals living in Immokalee, Golden Gate, the farmworker communities of Naples Park, Lipman's Labor Camp, and Lely, and medically underserved communities in Everglades City, Goodland, Copeland and Chokoloskee, representing the most vulnerable communities in the region, will be directly connected to CHWs. Project Narrative 2 Collier County Community Health Coalition: Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities Packet Pg. 1341 16. K.6.c iii. Strategies and Activities: The CCCHC recognizes the disparate impact that COVID-19 has had on communities of migrant farm workers in Collier County and the underlying health inequities that the pandemic has exposed. The Coalition is committed to continuing to support an effective and equitable COVID-19 response and to begin rebuilding a healthcare system that is accessible to people who have been historically excluded from services by expanding the work of CHWs beyond Immokalee and Golden Gate and into satellite Extra Mile communities. Strategy 1: Train The training sub -strategy and activities proposed will increase CHW collaboration in public health -led actions to build and reinforce the knowledge and skills required to engage in community -wide efforts to manage COVID-19 among priority populations (Strategy CB1). 1.1 Expand the CHW workforce: To support the end of COVID-19 transmission and recovery from the pandemic, the CCCHC will expand the CHW workforce into Extra Mile communities of Collier County, which are defined by high levels of linguistic, socioeconomic, cultural, and geographic vulnerabilities. HCN includes CHWs (called Health Promoters) within their staffing structure as part of a continued Community Health Program in Immokalee and Golden Gate. Throughout the COVID-19 pandemic, Health Promoters have played a crucial role in rebuilding trust in the healthcare system. Because they speak the same languages and share lived experiences with many community members, these individuals best understand the local social and cultural landscape, making them expert resource navigators and accompagnatos. Furthermore, they serve as bridges between the community and the healthcare system by supporting migrant farm workers to overcome linguistic, socioeconomic, and cultural barriers to care, and elevating local voices to decision makers, which ensures that interventions are feasible and acceptable for the end recipients. Through this grant, the CCCHC will support the recruitment and training of CHWs to service the Extra Mile communities in Collier County, connecting migrant farm workers in harder to reach areas, especially those with pre-existing and chronic conditions, to healthcare services. Six Extra Mile CHWs will be trained through the established, rigorous CHW training program in Immokalee to be deplored to satellite communities. The training for CHWs, developed and delivered by PIH drawing on the organization's decades of experience in building community health programs in resource -limited settings around the world, begins with a 3- to 5-day orientation in the classroom, where the team learns about accompaniment, cultural humility, effective communication, addressing the social determinants of health, household visits, and case management. Sessions involve multiple opportunities for role play and discussion, supporting CHWs to practice what they have learned, foster supportive and collaborative team dynamics, and apply skills to their own life experiences. 1.2 Reinforce CHW capacity through continuous mentorship and support: After the initial training, PIH will provide continued boots -on -the -ground mentorship in the field to support and reinforce the learned skills in practice. PIH staff will accompany CHWs on household visits and during case management calls to both model effective interactions and to provide regular supportive feedback. PIH and HCN will also host monthly debrief sessions together with the Project Narrative 3 Collier County Community Health Coalition: Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities Packet Pg. 1342 16. K.6.c Immokalee, Golden Gate, and Extra Mile teams to exchange lessons learned, implement program improvements from feedback from the community, and conduct additional training sessions for ongoing CHW skill reinforcement and practice. Strategy 2: Deploy The deployment sub -strategies and activities proposed will engage organizations and care teams throughout the community in the promotion (Strategy C134) and integration (Strategy CB3) of the CHW function in delivering support services to support the public health response to COVID-19 among priority populations. 2.1 Promote the importance of the CHW role in the care team: The CCCHC will develop and disseminate messaging to educate organizations and care teams on the critical role that CHWs play in delivering services and managing the spread of COVID-19. Alongside CHW training sessions, PIH will engage HCN administrative staff and clinicians to understand the role of CHWs as members of the care team. Thus, all staff at the clinic will gain skills in communication and cultural humility to enhance patient experiences with the healthcare system, and every individual will understand their role in referral pathways between the community, clinics, and hospitals. Additionally, using their vast community connections, the CIW and Mision Peniel will share information about the services provided by CHWs to community members and other local organizations. The CIW will make announcements on their radio station and through their farmworker education sessions to increase the visibility of the CHW program and its supportive services for migrant farmworker communities. 2.2 Enhance community outreach: Once fully trained, Extra Mile CHWs will be deployed to conduct household visits and community outreach to share health information, on COVID-19 and other common or prevalent medical conditions, and to actively refer vulnerable individuals to clinical and social resources, which has been shown to improve healthcare outcomes across diverse settings. The CCCHC will strengthen existing referral pathways from the community to HCN clinics in Immokalee and Golden Gate and other social support providers in Collier County, beginning with the activities 2.3 and 2.4 described below. 2.3 Expand rapid testing: Testing services have improved through a series of targeted interventions that have enabled the rapid identification and support of COVID-19 cases, including the introduction of mobile testing in accessible geographic locations at convenient times; use of rapid tests rather than PCR tests; immediate connection to social support for positive cases at testing events; and distribution of food vouchers at events to incentivize testing. The team is currently hosting approximately three mobile testing events per week in Immokalee. The CCCHC will support testing efforts coupled with distribution of food vouchers in Immokalee, Golden Gate, and satellite communities to promote early detection and management of cases to stop the spread of COVID-19. Testing is more important now than ever given the new variant strains present in the US. Furthermore, distribution of food vouchers has supported those who have previously lacked access to testing in Immokalee to receive testing, especially farmworkers, which has enabled rapid connection to social support for the most vulnerable. The CCCHC plans to host 1-3 testing events in Collier County per week. The CHWs will promote testing events in advance to the community and attend the events to provide logistical and Project Narrative 4 Collier County Community Health Coalition: Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities Packet Pg. 1343 16. K.6.c language interpretation support. CHWs will provide education before and after an individual receives a test to ensure they understand the public health recommendations for preventing and managing COVID-19, and will support the delivery of results and the direct referral of COVID- positive patients to social support services that enable their safe isolation. 2.4 Promote equitable vaccination access: The first vaccination event in Immokalee resulted in the vaccination of only one Immokalee resident due to technological, linguistic, and logistical barriers to registration that led the event to be flooded with outsiders.4 Thus, the CCCHC has needed to adopt a rigorous outreach strategy to better promote the COVID-19 vaccine by actively identifying, educating, and registering Immokalee residents for vaccination opportunities. The team will implement strategies shown to promote equitable vaccination access, including: expansion of the Community Health program to support CHWs to go door-to- door to register residents for vaccination opportunities in Extra Mile communities; provision of linguistically and culturally appropriate informational materials to dispel myths and rebuild trust from a challenging historical legacy; address transportation issues to vaccine sites, or offer mobile/in-neighborhood vaccines; and accompaniment of individuals at vaccination events through connection to social supports. Vaccination events provide opportunity for a large number of community members to be connected to wrap around services. At these events, CHWs conduct vulnerability assessments to identify individuals in need of social support and follow-up with households to establish long- term relationships through regular visits providing supporting referrals to care services. Additionally, after CHWs are assigned to patients and/or households by clinicians, they will work with healthcare providers to address social determinants of health, providing food, housing, and other services needed to ensure recommendations for improving healthcare outcomes are feasible. Strategy 3: Engage The engagement strategies and activities proposed will promote (Strategy CB5), and document and facilitate (Strategy CB6) CHW engagement across communities and clinical settings in in the care, support, and follow-up of service provision to improve health outcomes for priority populations at highest risk, including those resulting from COVID-19. 3.1 Promote CHW engagement in additional communities and clinical settings: Building upon the relationships and strategies that have functioned throughout the COVID-19 response, the CCCHC will work to promote CHWs in advancing a long-term accessible, equitable, and resilient healthcare system for Collier County. CHWs will be housed at the Healthcare Network, the only Federally Qualified Health Center (FQHC) in Collier County. The Extra Mile CHWs will join the existing Immokalee and Golden Gate CHWs as valued members of the care team, expanding into additional communities the referral pathways through which CHWs identify patients in the community and schedule them appointments with clinicians at the HCN, arrange transport, and escort them through registration processes. The referral process will be bi- directional, with healthcare providers at the HCN also able to assign vulnerable patients to 'Freeman, L., COVID-19 vaccination appointments in Immokalee filled with Naples residents, Naples Daily News. January 5, 2021. https://www.ngplesnews.com/story/news/health/2021/01/05/residents-sarasota-broward-,get-covid-19-vaccination- immokalee/4132853001/. Accessed 05/01/2021. Project Narrative 5 Collier County Community Health Coalition: Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities Packet Pg. 1344 16. K.6.c CHWs for follow-up in their communities to address social determinants of health. During regular visits with assigned households, CHWs will provide food and other resources to patients, and, with household permission, share updates back with the clinical care team. CHWs will also continue to participate in COVID-related activities, such as testing and vaccination events, to enable the team to continue sharing linguistically, socially, and culturally accessible information to support communities to stop the spread of COVID-19. 3.2 Document and facilitate the continued CHW provision of care, support and follow-up services across clinical and community settings. Year 1- Expand systems to document CHW engagement in care, support and follow-up: The current data collection system used by the HCN Immokalee CHW Program will be improved and expanded to include Golden Gate and Extra Mile CHWs. Using tablets with pre -developed Microsoft Teams questionnaires, CHWs will collect the following data during household visits: demographic information, vulnerability assessment, incidence of COVID-19 in the household, pre-existing conditions, access to healthcare, and clinical and resource needs. As CHWs will be housed administratively at the HCN, they will be able to document individual information for patients at the clinic as part of the Electronic Health Record in Athena. This will enable information gained through the community health program to become part of a patient's health record, supporting clinicians to provide more holistic care. Years 2 and 3- Facilitate ongoing CHW involvement in care, support and follow-up: CHWs will be involved in the care, support, and follow-up of both COVID-positive and non-COVID patients. To identify COVID-positive patients, the CHWs will attend rapid testing events in the community, where individuals receiving positive results will be assigned a CHW case manager. This CHW will support the patient to conduct self -monitoring of symptoms with pulse oximeter and temperature readings, which can be used according to HCN protocols to refer individuals to clinical care, and to connect households impacted by COVID to social support, such as food and housing. To support non-COVID patients, CHWs will either identify individuals with pre- existing conditions through canvassing and household visits in the community, who can then be referred as patients to the HCN or to their preferred Primary Care Provider, or they can be assigned to patients identified as in need of support by care teams at HCN. CHWs will provide ongoing support through regular phone calls and household visits to provide food and other necessities, and emotional accompaniment to support adhere to treatment plans. 3.3 Expand integration of CHWs into social support systems: PIH has used social support to improve healthcare outcomes for the past three decades, from providing tuberculosis patients with food packages to enhance treatment adherence to alleviating transportation costs for HIV patients who would not otherwise be able to travel to the hospital to receive medications. For vulnerable populations, clinical care must be delivered hand in hand with social support to improve health outcomes. In Immokalee, Mision Peniel supports infectious cases to isolate and alleviates the economic burden on individuals impacted by COVID-19 by disbursing cash transfers to community members who test positive for COVID-19. Social support eases testing fears, provides short-term financial stability to positive cases, and has direct epidemiologic benefit through encouraging isolation to stop the spread of COVID-19. Project Narrative 6 Collier County Community Health Coalition: Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities Packet Pg. 1345 16. K.6.c Year 1-Embed social support into case management systems: The CCCHC will support the design and implementation of this social support system in satellite communities beyond Immokalee to extend the benefits of these services to others in need. The CCCHC will perform a resource mapping exercise to create an updated directory of social supports that are available in Collier County, and will expand their network of partners to build referral pathways from the community to organizations providing essential services such as food, housing, education, and childcare. CHWs will be trained to refer vulnerable community members, including both COVID-positive and COVID-negative individuals, to these services when needs are identified, and will provide follow up after referrals to ensure needs are addressed and support has been appropriately provided. Currently, Mision Peniel provides cash transfers to all patients who test positive for COVID in Immokalee. This system has been critical in supporting individuals to isolate by alleviating barriers that arise from missing work, such as fear of eviction and heightened food insecurity. The CCCHC will actively seek ongoing funding to expand the cash transfer system to other communities as the CHW program is expanded. Years 2 and 3- Integrate social support programming with the health system: The CCCHC will build a permanent network of social supports connected to clinical referral pathways to address the social determinants of health that impact healthcare outcomes for the most vulnerable. CHWs not only identify vulnerable patients in a community but also serve as resource navigators, connecting individuals to clinical and social supports. After the CCCHC creates an updated resource directory for Collier County, CHWs will be able to connect community members to the available services and identify and advocate for additional resources needed to fill gaps. 1. Collaborations: Collier County will serve as the lead applicant of the Coalition and will provide administrative oversight through its knowledge of the social, economic, and political systems that operate in the county as a whole. The Healthcare Network (HCN) will be the primary sub -grantee and will house the Community Health Workers (CHW) administratively. Partners In Health (PIH) will draw on its experiences building Community Health programs in remote areas around the world to collaborate on recruitment, training, and mentorship of CHWs beyond Immokalee and into satellite communities. The Department of Health (DOH) offers knowledge of and access to the local public health system. As Community -Based Organizations (CBOs), the Coalition of Immokalee Workers (CIW) and Mision Peniel (MP) represent important community voices and will serve as consultants through program design and implementation processes. The team will also work to develop relationships with similar organizations in Golden Gate, East Naples, and other communities in Collier County to expand membership of the CCCHC. Collier County has a longstanding relationship with the Department of Health, which operates as a county health department, and the Healthcare Network, which provides healthcare services throughout Southwest Florida. Their partnership with the Coalition of Immokalee Workers and Mision Peniel has been strengthened through their collective work to ground the COVID-19 response in community -driven efforts. While Partners In Health is the newest partner in Collier Project Narrative 7 Collier County Community Health Coalition: Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities Packet Pg. 1346 16. K.6.c County, the organization has quickly established deep relationships with the other stakeholders and the Immokalee community by training and mentoring the current Health Promoters in Immokalee. 2. Target Populations and Health Disparities: Migrant workers face staggering vulnerabilities to sickness due to historically rooted social, economic, and political systems that have structured health inequities into the living and working conditions of this population. To understand the structural vulnerability of farmworkers to illness, it is important to examine the history that has contributed to their marginalization. Exploitation in the agricultural industry was first established through the system of chattel slavery and was perpetuated through debt bondage, convict labor, and profiteering by growers, or farm owners, of immigrants and refugees, who are often fleeing economic and political devastation and lack choice or bargaining power in their workforce participation. The marginalization of farmworkers has been further codified through the establishment of exclusionary legislation, such as the National Labor Relations Act of 1935 and the Fair Labor Standards Act of 1938, which failed to include agricultural laborers in protecting workers' rights to organize and to receive minimum wages, respectively. These political, social, and economic systems make farmworkers a highly impoverished and underserved population, resulting from low wages without overtime pay, employment instability, lack of benefits, and stagnation of wages despite economic inflation.5 This socioeconomic vulnerability often positions farmworkers in hazardous and exploitative living and working conditions that make them more susceptible to illness but less likely to access healthcare services or social support. According to the National Agricultural Workers Survey (HAWS), 33% of migrant farmworkers live below the federal poverty line, placing them at increased risk of food insecurity and under/malnutrition, which have been associated with poor health outcomes and increased risk for development of non -communicable diseases.' At work, farmworkers perform dangerous and physically exhausting labor for long hours in harsh conditions, which exposes them to crush injuries, skin cancers, and inhalation of chemicals used on crops that have been associated with pulmonary diseases, neurotoxicity, and higher incidence of birth defects.' Despite high levels of structural vulnerability to poor health, 53% of farmworkers have no health insurance,8 which also prevents many individuals from seeking regular primary care for the identification and treatment of "silent" diseases like hypertension, hyperlipidemia, and diabetes. These health inequities have only been exacerbated during the COVID-19 pandemic. Many farmworkers live close together in trailers and sit shoulder -to -shoulder on buses that transport them to work, making social distancing nearly impossible and facilitating rapid transmission of 5 Fuentes, P., Reyes C., Gerardo, Murtagh, C., Nolan, C. & Palazueos, D. "Migrant Worker Health and Healthcare in COVID-19" in Primary Care in the COVID-19 pandemic, Basu, S., Alpert, I & Phillips, R, (Cambridge, Harvard Medical School Center for Primary Care), 285-295. (2021). 6 Hernandez, T. & Gabbard, S. Findings from the National Agricultural Workers Survey 2015-2015: A Demographic and Employment Profile of United States Farmworkers. (2018). Fuentes, P., et. al. (2021) s Hernandez, T. & Gabbard, S. Findings from the National Agricultural Workers Survey 2015-2015: A Demographic and Employment Profile of United States Farmworkers. (2018). Project Narrative 8 Collier County Community Health Coalition: Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities Packet Pg. 1347 16. K.6.c the coronavirus. When individuals do become sick, few can afford to stay home from work, which prevents them from being able to isolate effectively, and lack of access to healthcare causes many agricultural laborers to suffer worse health outcomes. Because farmworkers are uniquely vulnerable to the devastation of the COVID-19 pandemic, it is essential to identify and implement interventions to stop COVID-19 transmission, catalyze recovery, and rebuild healthcare systems that can better serve this historically marginalized population. The Community Health Program in Immokalee has demonstrated strategies that are effective for supporting this community to overcome barriers to care. By conducting outreach with linguistically, culturally, and socially accessible information, Community Health Workers have been able to promote coronavirus awareness and rebuild trust in the healthcare system. Additionally, by performing regular case management in the form of phone calls and household visits with COVID positive patients, CHWs have initiated rapid referrals to clinical care for individuals susceptible to poor health outcomes. Finally, by partnering with Mision Peniel, the Community Health Program in Immokalee has demonstrated the importance of embedding social support systems into clinical care in order to support individuals to overcome socioeconomic barriers to accessing care and/or adhering to clinical recommendations. Through the Collier County Community Health Coalition, the team will expand these strategies that have been proven to be effective into geographically remote communities in order to improve healthcare outcomes for marginalized populations throughout the county. C. APPLICANT EVALUATION AND PERFORMANCE MEASUREMENT PLAN: The proposed evaluation and performance management plan builds on the robust infrastructure for data collection, evaluation, and participatory input of the project partners. Data will be collected in semi-annual cycles to align with performance measurement reporting to CDC and the Evaluation/TA partners. Iterative feedback will be incorporated regularly to adjust and improve strategies over time. At a minimum each year, two success stories detailing the impacts of the different strategies and activities will be shared using the NCCDPHP Success Stories Application. The CCCHC will measure the impact of the Extra Mile Community Health Program on the communities it intends to serve through several metrics that have been used to demonstrate impact in previous peer -reviewed studies that have assessed the role of CHWs in connecting patients to healthcare services. The impact of the CHW Program on preventing and controlling COVID-19 infections and strengthening community resilience will be reflected in outputs including number of tests conducted each week, positivity rate, percent of cases connected to social support, percent of cases referred to clinical care, percent of population vaccinated, and number of hospitalizations per month if available. The extent to which the CHW Program contributes to changes in healthcare outcomes will be assessed through several measures, including pre- and post- activation scores and pre- and post- engagement after longitudinal care scores. Other metrics will be chosen based off feasibility and appropriateness after continued discussions with partners and may include a combination of the following: grit scale score; attachment style score; basic needs scale score; alcohol overuse score; drug use score; self -rated health score; perceived stress score; health literacy score; number of ED visits over time period; Project Narrative 9 Collier County Community Health Coalition: Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities Packet Pg. 1348 16. K.6.c and number of hospital admissions over time period. Data will be collected in 6 month increments at 0 months, 6 months, 12 months, 18 months, 24 months, 30 months, and 36 months. Data analysis and dissemination: Dr. Dan Palazuelos, PIH's Director of Community Health Systems, has a joint appointment with PIH, Harvard Medical School and the Brigham and Women's Hospital (BWH) in Boston, MA. To assess program impact, Dr. Palazuelos has already conducted an IRB-approved study tracking pre- and post- activation and longitudinal engagement scores in Immokalee, with support from his research team at BWH, which will be expanded to the new components of the CHW Program proposed here. PIH will track pre- and post- activation and longitudinal engagement scores through an IRB-approved study. Data generated through this project will be collected, analyzed, stored, and disseminated through these existing mechanisms, which would build on the team's previous experiences in conducting exploring the impact of COVID-19 on the Immokalee community. D. ORGANIZATIONAL CAPACITY OF APPLICANTS TO IMPLEMENT THE APPROACH: Collier Country has a long history of providing services to citizens that meet families' basic health and social needs, often stepping in when no other resource are available. The Community & Human Services (CHS) Division provides comprehensive services such as prescription and medical assistance to those in need, in addition to managing affordable housing opportunities in the community to support the most vulnerable residents. Collier County has provided targeted, community -based support to county residents throughout the COVID pandemic, working through County Caseworkers who assist residents in need. The county has provided meals and other food assistance for home -bound individuals and has facilitated financial assistance and linkage to other support services. Additionally, Collier County has hosted and supported early vaccination events for seniors and other high -risk populations, providing transportation services where needed. The CHS oversees grant activities for all of the public service divisions for Collier County and has a demonstrated track record of sound programmatic and fiscal oversight specifically in grant management. The most recent single audit revealed "no findings or management letter comments". Currently, CHS successfully administers approximately $21 million in federal and state grant funds. The entire government entity is supported by professionals in Human Resources, Risk Management, Office of Management and Budget, and Procurement. Each area is led by seasoned professionals with appropriate professional degrees and certification credentials. The County Attorney's Office reviews all documents for legality. Collier County demonstrates highly effective financial management through our written and implemented policies and procedures, qualified and trained financial staff, effective communications, cross training and self -assessments. To further ensure financial compliance of our program, the local Office of Management and Budget provides oversight on all aspects of financial grant management providing an additional layer of internal control over the application, budget, procurement, financial transactions, draws, reports and grant closeout. Furthermore, we Project Narrative 10 Collier County Community Health Coalition: Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities Packet Pg. 1349 16. K.6.c have a finance department separate from the Collier County Board of County Commissioners that provide pre and post audit functions for all fiscal components. To ensure compliance with program requirements, staff will receive internal training on administrative processing and financial tracking. Staff also attend/participate in any regional, state, and national conferences that help develop skills and ideas that will progress all involved or impacted by the CDC funding received. The Grant Coordinator and the Collier County Grant Compliance Unit examine physical records and cross reference information to confirm and maintain accuracy. To keep all CDC programmatic information including statutes, regulations, and applicable OMB circulars, the Grant Coordinator participates in all webinars and conference calls related to the program. The Grant Coordinator and the project accountant will regularly participate in any CDC sanctioned training opportunities and federally sponsored trainings focused on compliance requirements, OMB circular CFR part 200. Working with the fiscal department, the Grant Coordinator ensures responsible and timely spending of grant funds through fiscal oversight and budgetary maintenance. Collier County has established purchasing and procurement policies to oversee fund management and expenditures. Supplies and capital assets such as facilities and equipment will be tracked and distributed by the Grant Coordinator for use by the Community Health Workers, HCN and/or PIH staff. The project oversight for this CDC project funding, if awarded to Collier County, will be handled by Catherine Sherman, Grant Coordinator and will be responsible for ensuring all CDC grant funded activities comply with the federal funding announcement and all regulations and guidelines as established by the CDC and the Code of Federal Regulations. Ms. Sherman has two years of experience managing local, state and federal grant funds. The Grant Coordinator is responsible for communication with the grantor agency (CDC), project oversight, grant compliance, pay requests, developing and implementing policies, generating reports, developing public relations and communications, preparing media materials, and serving on applicable community boards, councils, and committees. For the fiscal responsibility, Blanca Aquino Luque, Accounting Supervisor, will perform all fiscal oversight and budgetary services for this CDC award on behalf of Collier County. Ms. Luque has over 15 years of experience in not -for - profit and government accounting and holds a CPA license. Under the direction of Tami Bailey, Federal and State Grant Manager for CHS; Kristi Sonntag, the Director of Community and Human Services; and Financial and Operational Support Manager,Maggie Lopez the department collectively holds 45 years of grants administration experience that will ensure sound programmatic and fiscal oversight, as well as, support for Ms Sherman and Ms. Luque throughout every aspect of the grant award. The Healthcare Network will be the primary sub -grantee and will house the Community Health Workers administratively and lead the recruitment, hiring, employment, orientation, development, coaching, counseling, and firing of team members. This will enable the Extra Mile CHWs to join the existing group of Health Promoters in Immokalee, which has a pre -established, rigorous training and support structure. The HCN will support administrative management of the CHWs. They will also assist in the development of scope of work plans and provide the clinical Project Narrative 11 Collier County Community Health Coalition: Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities Packet Pg. 1350 16. K.6.c infrastructure to continue hosting regular testing and vaccination events. Finally, HCN clinicians can support the identification and assignment of medically vulnerable cases and households to CHWs and receive referrals to their clinics when applicable. By sharing information with the community while connecting vulnerable households to essential resources, HCN's current team of Health Promoters has supported Immokalee residents to overcome barriers to protect themselves from COVID-19. In the first 8 months of the Immokalee program (July 2020 - February 2021), the groups of 6 - 12 Health Promoters, which were housed administratively by the DOH-C and HCN and trained and mentored by PIH, reached 2,800 households constituting 9,000 people, and distributed 17,000 masks and 8,000 informational packets. Partners In Health will be sub -granted as advisors to support identification of and outreach to remote communities, development of scope of work plans, design and implementation of training and materials, and assistance as implementers in the field through continued mentorship to the CHWs. For the last three decades, PIH has been a leader in fighting infectious disease and building strong community health systems around the world. The team works with governments and communities in 11 countries to build the capacity of health systems in partnership with local leaders. From Haiti to Peru to Liberia, PIH has walked shoulder to shoulder with partners through devastating outbreaks of Ebola, cholera, tuberculosis, and many other diseases. When the COVID-19 pandemic amplified the same health inequities seen abroad in the United States, the organization launched the US Public Health Accompaniment Unit to draw on lessons learned globally to support governments and communities around the country to respond to COVID-19. PIH now supports 16 states, counties, cities, tribal governments, and communities across the US, using the accompaniment model to guide their work. Accompaniment requires patients, communities, organizations, and governments to walk in bilateral partnerships in addressing health challenges and allows the person or group being accompanied to guide the journey. It is not technical assistance in the traditional sense because it is not passive; rather, accompaniment is regular, dedicated, at -the -elbow support that takes responsibility for outcomes. PIH has been in Immokalee since May 2020, and the organization has accompanied the team in the following tasks: recruitment and training of Health Promoters with development of training materials, ongoing refreshers, and continued mentorship in the field; design and implementation of workflow at rapid testing and vaccination events; and co -creation of social support systems, including cash transfer system with Mision Peniel. The Department of Health will serve as local public health department representatives. As advisors to the project, the DOH can shed light on local public health systems and support the team in developing contacts in other communities and hosting testing and vaccination events. The Coalition of Immokalee Workers is an internationally recognized organization dedicated to fighting human trafficking and gender -based violence at work and ensuring the recognition of human rights within the workplace for migrant workers. Built on a foundation of farmworker community organizing starting in 1993, the CIW is based in Immokalee and represents an important and powerful community voice. Throughout the COVID-19 pandemic, the CIW has supported the implementation of mobile testing. They have also partnered with Mision Peniel Project Narrative 12 Collier County Community Health Coalition: Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities Packet Pg. 1351 16. K.6.c and Partners In Health to design a social support system that supports community members impacted by COVID-19 to stay home and isolate, and they collaborated with the Department of Health and Department of Emergency Management to host walk-up vaccination events in April and May that have been attended by 2,000+ people, most of whom were farmworkers and Immokalee residents who would not otherwise have had access to vaccination services. The CIW will continue to advise the CCCHC to ensure interventions are community -driven, such as by supporting the mapping of vulnerable communities and helping to recruit and train Extra Mile CHWs. Finally, Mision Peniel is a pastoral ministry of charity and service, providing food, clothing, fellowship, and emergency support to farmworkers in partnership with Peace River Presbytery. From December 2020 through April 2021, the team disbursed $482,000+ in cash transfers to 400+ households impacted by COVID-19, many of whom were identified as positive cases at HCN and DOH testing events, proving their capacity to build and implement social support systems that are embedded in healthcare services. Mision Peniel will continue to serve as advisors to the team as they design and support permanent social support systems with partners throughout Collier County to address the social determinants of health and to integrate social support into clinical referral pathways. Together, the partners in the CCCHC offer important experiences in healthcare delivery, community health, advocacy, and social work that will make them successful in expanding the current CHW program into geographically remote communities. E. WORK PLAN: Activity Process Measure Responsible Completion Date Strategy 1• Train Period of Performance Outcome: Outcome Measures: • Increased skills/capacity/roles of # of CHWs successfully completing local public health -led COVID- CHWs to provide services and support 19 response training efforts as determined by relevant public health - for COVID-19 public health response led entities efforts among priority populations 1.1.1 Expand the CHW workforce # of new CHWs hired HCN, PIH October 31, 2021 # of new CHWs trained in COVID-19 response 1.2 Reinforce CHW capacity through # of feedback and learning exchange HCN, PIH July 31, continuous mentorship and support sessions held 2022 Ongoing # of additional CHW training sessions throughout held Year 2 & 3 Strategy 2: Deploy Period of Performance Outcome: Outcome Measures: • Increased workforce of CHWs # and type of organizations/entities that are integrating CHWs to delivering services to manage the support state/local public health -led COVID-19 response efforts. spread of COVID-19 # and type of messages developed and disseminated Project Narrative 13 Collier County Community Health Coalition: Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities Packet Pg. 1352 16. K.6.c 2.1 Promote the importance of the # and type of CHW-role promotion HCN, PIH December CHW role in the care team messages disseminated to other 31, 2021 members of the care team # and type of CHW-role promotion messages disseminated to the communityand local organizations 2.2 Enhance community outreach # of household visits conducted by HCN, PIH, July 31, CHWs in Extra Mile communities CIW, CC, 2022 DOH Ongoing # of community outreach events throughout supported with CHWs Year 2 & 3 2.3 Expand rapid testing # of COVID testing events held HCN, PIH, July 31, CIW, CC, 2022 # of individuals/households referred to DOH social support services through testing events 2.4 Promote equitable vaccination # of vaccination events held HCN, PIH, July 31, access CIW 2022 # of people vaccinated at vaccination events # of people at vaccination events referred for social support Strategy 3: Engage Period of Performance Outcome: Outcome Measures: • Increased utilization of community # of individuals within communities and/or clinical settings reached resources and clinical services for through messaging and education those at highest risk for poor health outcomes among priority populations # of patients referred for individual, specific named health and social conditions that increase the risk for COVID-19 within clinical and/or community settings. 3.1 Promote CHW engagement in # and type of community organization CC, HCN, July 31, additional communities and clinical engaged on CHW integration PIH, DOH 2O22 settings Ongoing # and type of clinical setting engaged throughout on CHW integration Year 2 & 3 3.2 Document and facilitate the continued CHW provision of care, support and follow-up services across clinical and community settings Year 1- Expand systems to document # of CHWs accessing and using HCN, PIH, December CHW engagement in care, support and electronic systems to document client DOH 31, 2021 follow-up: interactions Years 2 and 3- Facilitate ongoing CHW # and type of individual/household CC, HCN, Year 2 & 3 involvement in care, support and follow- interactions made by CHWs to provide PIH UP care/support CHW reports on progress and scope of involvement in care/support service structure 3.3 Expand integration of CHWs in social support systems Year 1- Embed social support into case # of new social support network HCN, PIH, July 31, management systemspartners identified and engaged MP 2022 Project Narrative 14 Collier County Community Health Coalition: Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities r_ 0 a d M N N U U x U U U N LO 0 T N 0 N a a Q V_ M a c 0 c� Q a Q c 'L^ V c d E z a Packet Pg. 1353 16. K.6.c # and type of social support services CC, HCN, Year 2 & 3 Years 2 and 3- Integrate social support accessed in Extra Mile communities PIH, CIW, programming with the health system MP Sustainability: Beginning in Year 2, the Coalition will develop plans for sustainability and replicability. To address sustainability, we will identify and advocate for policy changes that must be implemented to provide structural support to CHWs in the healthcare system; identify long term funding mechanisms through Return on Investment analyses; and strengthen existing clinical and social support referral pathways in partnership with local stakeholders. To ensure replicability, the Coalition will develop protocols, training materials, and job aides that can be used for replication based on CDC principles of adaptation; identify and develop avenues for sharing lessons learned, such as through the nationwide Learning Collaborative that is part of the Partners In Health U.S. Public Health Accompaniment Unit; and partner with other community health programs in the U.S. to provide mutual mentorship and technical assistance. F. BUDGET NARRATIVE The total budget requested for Year 1 of the proposed scope of work is $ 421,744.34 Collier County costs Grantee: $ 11,936.34 Personnel- $10,102.70 Grants Coordinator 0.10 FTE: $ 5,663.90 The Grant Coordinator will provide program administration, compliance review, project support, financial review, and oversight of the program sub recipients to ensure program compliance with applicable grant guidelines. Accountant 0.5 FTE: $ 2,782.35 The Accountant will oversee all fiscal aspects of the grant funds including grant payment requests, disbursements, contractual payments, and drawdowns from the grantor agency as applicable. The accountant will also ensure compliance with all other legal requirements of the grant and audit requirements. Operations Analyst 0.3 FTE: $1,656.45 The Operations Analyst will provide compliance review and monitoring of grant regulations, performs monitoring visits to sub -grantees and prepares closeout documentation. Fringe Benefit- $1,833.64 Collier County budget instruction manual identifies social security and Medicare (FICA) costs to be calculated at a rate of 7.65% (1.45% for Medicare and 6.20% for Social Security) of each employee's salary. Retirement is also available to full time employees and calculated at 10.5%. Benefit rates are standard for all employees and agree with acceptable IRS Project Narrative 15 Collier County Community Health Coalition: Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities Packet Pg. 1354 16. K.6.c Contractual costs $409,808 Sub -grantee 1- Healthcare Network: $303,173 Personnel- $201,000: Six new full-time (LOE 100%) Community Health Workers will be hired to support Extra Mile communities, at a cost of $3,333 per month per CHW for 9 months to account for project launch time ($180,000 in total). HCN's Human Resources Manager ($875/month) and Community Health Manager ($875/month) will both dedicate 15% LOE to the hiring and management of the CHWs and project implementation over 12 months, totaling $21,000 for Year 1. Fringe Benefit- $40,200: HCN's fringe rate of 20% of salary costs has been applied proportionately to each project role's level of effort. Included in this rate are payroll taxes, payroll administration, health insurance, workers compensation insurance, and life insurance. Travel- $1,680: Local travel- $1,680: HCN project administration and CHW staff will use their own vehicles for travel related to project implementation and will be reimbursed for mileage at a cost of $0.56, the federal GSA rate. Mileage needs are estimated at 250 miles per month for project administration roles (between 2 staff roles) for 12 months, and 350 miles per CHW (for 6 CHWs, 2,100 miles in total) for 9 months. Supplies- $5,300: Six basic smartphones will be purchased for use by the CHWs, costed at $250 each ($1,500 in total). Two laptops ($1,8000 each) will be purchased for project administration and data collection, for use in HCN offices, totaling $3,600. 10 CHW Training Manuals will be printed and bound at a cost of $20 each ($200 in total), to be distributed to CHWs and training facilitators. Other- $2, 700: Monthly phone plans will be provided for CHW work phones to enable consistent communication with community stakeholders and clients, at a monthly cost of $50 per phone (6 phones, $2,700 in total for 9 months). Indirect Charges- $52,293: HCN will apply an indirect rate of 20% against its total direct cost base of $261,464. Sub -grantee 2- Partners In Health: $106,635 Personnel- $60,606: The following four PIH staff will participate in the implementation of this project over the 12 months in Year 1: The Sr. Project Lead (LOE 15%, $18,750 in total) will provide regular technical input throughout the project implementation and will be the daily point of contact for PIH's programmatic contributions to this project. The Project Manager (LOE 20%, $13,600 in total) will support project implementation and contractual compliance, acting as the main point of contact for administrative purposes between PIH and Collier County. The Sr. Technical Advisor (LOE 10%, $17,200 in total) and the Director of Community Health Systems Project Narrative 16 Collier County Community Health Coalition: Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities Packet Pg. 1355 16. K.6.c (LOE 10%, $11,056 in total) will provide expert support on CHW training and integration into the wider health system. Fringe Benefit- $13,333: PIH's fringe rate of 22% of salary costs has been applied proportionately to each project role's level of effort. Included in this rate are payroll tax, payroll administration, health and dental insurance, workers compensation insurance, life insurance, and 4053b matched contribution. Travel- $9,555: Local travel- $1,680: PIH staff based in Immokalee will use their own vehicles for travel related to project implementation and will be reimbursed for mileage up to a total of 250 miles per month (between 2 staff roles) at a cost of $0.56, the federal GSA rate. Long-distance travel- $7,875: Two PIH staff based in Boston will travel to Collier County to provide direct support to the project implementation. Five trips of 5 days/4 nights each are planned in Year 1, including one trip for the Director of Community Health Systems and four trips (one per quarter) for the Sr. Technical Advisor. Included in the budget are return airfares from MA to FL ($300/trip, $1,500 in total), accommodation (20 nights (4 per trip) at $100/night, total $2,000), per diem (25 days (5 per trip) at $50/day (PIH standard rate), total $1,250), and rental car costs (25 days (5 per trip) at $125/day, total $3,125). Contractual- $5,000: Biostatistician support will be required for data analysis and assessment, to be contracted from PIH's research partner at the Brigham and Women's hospital, budgeted at $500/day for 10 days in Year 1. Indirect Charges- $18,141: PIH will apply its NICRA of 20.5% against its total direct cost base of $88,494. Project Narrative 17 Collier County Community Health Coalition: Advancing Accessible and Equitable Healthcare Systems in Extra Mile Migrant Farmworker Communities Packet Pg. 1356 WORKSPACE FORM 1-80 SUPPORT@GRANTS.GOV � �RAivTS-GOB" NTS.GOV This Workspace form is one of the forms you need to complete prior to submitting your Application Package. This form can be completed in its entirety offline usii Adobe Reader. You can save your form by clicking the "Save" button and see any errors by clicking the "Check For Errors" button. In -progress and completed foi can be uploaded at any time to Grants.gov using the Workspace feature. M L When you open a form, required fields are highlighted in yellow with a red border. Optional fields and completed fields are displayed in white. If you enter invalid 1 L incomplete information in a field, you will receive an error message. Additional instructions and FAQs about the Application Package can be found in the Grants.c 4) Applicants tab. p OPPORTUNITY & PACKAGE DETAILS: Opportunity Number: CDC-RFA-DP21-2109 Li Opportunity Title: Community Health Workers for COVID Response and Resilient Communities (CCR) Opportunity Package ID: PK000266150 CFDA Number: 93.495 CFDA Description: Community Health Workers for Public Health Response and Resilient Competition ID: CDC-RFA-DP21-2109 Competition Title: Community Health Workers for COVID Response and Resilient Communities (CCR) Opening Date: 03/25/2021 Closing Date: 05/24/2021 Agency: Centers for Disease Control - NCCDPHP Contact Information: WORKSPACEAPPLICANT & Stacy De Jesus Workspace ID: WS00679247 Application Filing Name: COLLIER CDC-RFA-DP21-2109 DUNS: Organization: 0769977900000 COLLIER, COUNTY OF Form Name: Other Attachments Form Form Version: 1.2 Requirement: Optional Download Date/Time: May 21, 2021 12: 10:37 PM EDT Form State: FORM ACTIONS: No Errors Packet Pg. 1357 16.K.6.c Other Attachment File(s) * Mandatory Other Attachment Filename: Table of Contents.pdf Add Mandatory Other Attachment Delete Mandatory Other Attachment View Mandatory Other Attachment To add more "Other Attachment' attachments, please use the attachment buttons below. Add Optional Other Attachment Delete Optional Other Attachment View Optional Other Attachment Packet Pg. 1358 _ (D — & u 84 QmOo uo :podoU E \ �6 f \ [ \ 2 $ —2 b> / $ < cD 0 f 'k .E 2i o\)\=4)0\ 'CL2.5 /I L CL ca \ O �<IfIQ«2 _ / k \ co cc;ƒ E LU 0 •E CIS� / LL CL # 2 t @ / \ \ \ ƒ 4 ƒ . .. .. \ £ Z Z QUDMHo oao -5 M zdd¥-(le|:ped )ugmmld¥jueeeewLj3e n¥ \ _ £ 2 ƒ$ = m �\\\/ as E \ /� E E � c / »/ E\ 2 V ------ � Q § z \ « « cu /a=[ 4 �E\\ j£=27 � =5R :\ 0 / ® t >2m� .2 CO <//ƒ E— g 4 _a) \ (— 4 I E \2 _--\ /2< m / ( / 6 a 2 �aS / CZ0 k I m E ® a E 0 CL CL/ � } � m 0jam z 0 § _ eE& //$< �£CO ƒ\E =IE L..— � / § 2: ; t------4------------------------- .\ ----/-------------- I E � � Blanca M. Aquino, CPA PROFESSIONAL SKILLS PROFILE 16. K.6.c Certified Public Accountant with more than 18 years of professional business experience including 2 years of accounting supervisory work, 8 years of experience maintaining the financial administration of federal, state, and local grants. Eight years of experience in financial accounting, reporting and fund accounting. Ability to understand and prepare a set of financial statements in accordance with GAAP/FASB/GASB. Worked analyzing historical costs and projecting future financial needs. Prepared, maintained, and administered annual corporate budgets (accrual basis) and grant budgets (modified accrual and cash basis) Monitored expenditure, analyzed budgets, prepared financial reports. Prepared budget amendments and journal entries as necessary. Reviewed and reconciled general ledger transactions. Experience assigning expenditures to proper cost center and verifying the proper posting of expenditures. Allocated monthly expenses according to the allocation plan and suggested modifications when necessary. Experience preparing a variety of financial and accounting records and reports including but not limited to revenue and expenditures reports, executives' summaries, and aging reports. Assisted with the annual single audit, researched, and provided information to auditors. Proficient in the accounting software SAP, Quantum and QuickBooks Pro, SQL, Word, Excel, Outlook, and Power Point. PROFESSIONAL EXPERIENCE Accounting Supervisor, Collier County, Naples FL Senior Accountant, Collier County, Naples, FL Grant Accountant, Collier County, Naples, FL 01/2020 to present 03/2016 to 01/2020 08/2015 to 03/2016 • Supervised the work of four grant accountants, grant coordinator and grant support specialist. Supervised the Division fiscal operations. • Approve purchase order, budget amendments, executives summaries, different financial reports for the grantor's agencies. • Prepared the annual budget for each grant and set the dot structure for the new fiscal year. • Analyzed historical costs and projected future financial needs. • Monitored grant expenditures, prepared budget amendments and journal entries as necessary. • Reconciles the general ledger. • Reviewed and approved sub recipient pay requests. • Monitored that grant expenditures are in accordance with grantor guidelines. • Supervised the financial performance of different Federal, State and Local grants. • Researched guidelines regulations to ensure compliance and allowable expenditures. Financial Analyst, Centerstone (formerly Manatee Glens) Bradenton, FL 02/2013 to 08/2015 r • Maintained all financial operations of federal, state, and local grants, including the preparation and submission of o cm monthly invoices, quarterly and annual expenditures. a • Worked with the following Federal, State and Local grants: a Q • Federal: OAG (VOCA=180,000 annually); CDBG and Shelter Plus Care (TBRA = $170,000 annually) • State: CFMHA (Central Florida Mental Health Association = $7,200,000 annually); DCF (Community Action 20 Team = $1,500,000 annually); Florida Department of Education (Supported Employment = $100,000 annually); m FCASV (Victims of Sexual Assault = $85,000 annually); Partner with the YMCA of Sarasota, funds came from DCF (Safe Children Coalition = $1,800,000 annually) o • Local: Manatee County (11 contracts: aging services, baker act adult and youth, hospital unit and detox, CAT team, sexual assault adult and youth and three drug courts = $2,500,000 annually); Sarasota County (three drug court Q contracts = $ 420,000 annually); Manatee Sheriff Office (SANE = $35,000 annually) Q • Prepared grant applications and reviewed contracts for grants awarded to the department. • Assisted in the preparation of the corporate annual budget. L � • Monitored the agency expenditures on a monthly basis to ensure funding is available for continuity of operations. • Allocated monthly expenditures to the proper cost center according to the plan allocation, using different drivers: E salary, miles driven, square footage, FTE. z • Prepared all grant related budgets. • Monitored expenditures, analyzed variances, prepared budget amendments as necessary. Q • Analyzed and communicated financial information effectively to internal and external stakeholders. • Assisted with the annual audit, including but not limited to the preparation of supporting schedules and the compilation of pertinent documentation. Performed the walkthrough with the auditors. Packet Pg. 1360 • Analyzed historical costs and projected future financial needs. 16.K.6.c • Reconciled General ledger accounts and performed a variety of accounting duties pertaining to the preparation an maintenance of the Department budget. Counter Manager/Sales, Macys Inc., Sarasota, FL 01/2008 to 02/2013 • Instrumental in supporting the counter rapid growth and expansion, including an increase in revenues and profitability. Supervised the work of 3 employees. Gained experience in public relations, special events and planning. Accounting Intern, Mike Lowe CPA, North Port, FL 01 /2010 to 02/2010 • Work directly with the tax accountant and got exposure to individual, partnership, corporate and estate tax return • Office duties as needed by the CPA. Assembled of client information and tax returns. Sales, Dillard's, Naples, FL 11/2004 to 01/2007 • Top -producing sales representative generated more than $150,000 sales on a yearly basis. Set and achieved personal sales goals while supporting the goals of the team. Supervisor, The Registry Resort and Club, Naples, FL 12/2003 to 12/2005 • Supervised the work of 12 employees. • Contacted front desk, housekeeping, and maintenance staff when guests had any request. Kept records of room availability and guests' accounts. • Addressed and solved guest comments or complaints. Assigned duties, inspected work, investigated complaints regarding the service, and took corrective action. EDUCATION • 5"' Year of Accounting University of South Florida, Sarasota, FL Graduate coursework: Governmental and Non -For -Profit Accounting, Advanced Financial Accounting, Law and the Accountant, Auditing II, Intermediate Financial Accounting III, Federal Taxation. • Bachelor of Science Accounting, Magna Cum Laude University of South Florida, Sarasota, FL • Bachelor in Hospitality Management, Magna Cum Laude University Ricardo Palma, Lima, Peru LICENSES • Certified Public Accountant AC 54235 • Certified Public Manager (Ongoing) AWARDS • Merit based scholarships awards for 3.8 GPA or higher to fund my accounting education: FICPA (2 years awarded) Venice Gulf Coast Community Foundation (3 years awarded), Women's Resource Center of Sarasota County (4 years awarded), and Community Foundation of Sarasota County (5 years awarded) Packet Pg. 1361 16. K.6.c Catherine Sherman - Grants Coordinator Bachelor of Science in Social Work / Franciscan University of Steubenville, Ohio Education Magna Cum Laude, from the CSWE accredited social work program on May 11, 2019. Experience Collier County, Community and Human Services / Grants Coordinator January 2021 - Current, 3339 Tamiami Trail E, Naples, FL 34112 Supervisor: Tami Bailey Oversee implementation of HUD-CDBG and DOJ-BJA funded grants projects. Coordinate subrecipients to monitor grant activity and compliance, and oversee program progress reporting. Ensure programmatic management, including: agreement writing, record keeping, Federal compliance, and grant timeliness. Collier County, Community and Human Services / Grants Support Specialist August 2020 - January 2021, 3339 Tamiami Trail E, Naples, FL 34112 Supervisor: Tami Bailey Review and approve applications for CARES Act grant assistance. Identify and collect necessary documentation needed for grant applications. Manage grant applicants within caseload to ensure Federal compliance and efficient disbursement of funds. Family Court, State of Delaware / Mediator September 2019 - August 2020, 500 N. King St. Wilmington, DE 19801 Supervisor: Rudolph Eackeard / 302-255-0200 Serve as a mediator for Family Court petitions, including: Protection from Abuse, Custody, Visitation, Guardianship, Child Support. Maintain extensive knowledge of and uphold Family Court statutes and procedures, while facilitating an effective and neutral setting in which litigants can discuss and overcome obstacles to reach an agreement. Family Counseling Center / Seasonal Office Assistant December 2017 - August 2019, 301 N. Van Buren St. Wilmington, DE 19805 Supervisor: Robert McCreary / 302-576-4136 Assisted in the daily functions of the office of the Counseling Center, as well as assisting in maintaining client and donor databases Eastern Ohio Correction Center (Women's) / Social Work Intern December 2019 - April 2019, 227 N. Market St. Lisbon, OH 44432 Supervisor: Ramona Rosenberg / 330-420-0288 Implemented Cognitive Behavioral based treatment concerning substance abuse and criminal thinking patterns, for both individuals and groups. Assessed bio-psycho-social needs of residents throughout treatment. Assisted in discharge planning into transitional living and community resources. Valley Hospice / Social Work Intern August 2018 - December 2019, 10686 OH-150 Rayland, OH 43943 Supervisor: Paul Dimmey, MSW / 740-859-5650 Assessed bio-psycho-social needs of patients and families, utilizing crisis intervention. Provided social and emotional support, and referrals to community resources. Packet Pg. 1362 16.K.6.c Office of the County Manager Mark Isackson 3299 Tamiami Trail East, Suite 202 -Naples Florida 34112-5746 - (239) 252-83B3 • FAX: (239) 2524010 May 24, 2021 Stacy De Jesus, Project Officer Department of Health and Human Services Centers for Disease Control and Prevention 1600 Clifton Rd. Atlanta, GA 30329-4027 Ref: CDC, Community Health Workers for COVID Response and Resilient Communities (CCR), CDC-RFA-DP21-2109 Dear Ms. De Jesus, am writing on behalf of the Collier County Board of County Commissioners to share our willingness to join the Collier County Community Health Coalition alongside Partners in Health (PIH), the Coalition of Immokalee Workers, the Healthcare Network, Mision Peniel, and the Collier County Department of Health. Grant funding from the Centers for Disease Control for Community Healthcare Workers for COVID-19 response will greatly assist the Immokalee community in Collier County. Immokalee has been disproportionately impacted by the COVID-19 pandemic due to the continued work of migrant farm workers in front-line high -risk environments with limited protection for workers, crowded living conditions, and limited access to healthcare and social services. Since June 2020, the Collier County Health Department has joined PIH, Healthcare Network (HCN) and Mision Peniel in implementing various work streams to respond to COVID-19 in Immokalee, including Health Promoter Programs, Rapid testing, Social Support, and Equitable vaccine access. Collier County is committed to collaborating with PIH, HCN, and the Coalition of Immokalee Workers to support the residents of Immokalee to recover from the effects of COVID-19 by continuing community outreach to connect people to essential clinical and social services; maintain rapid testing systems for early disease detection; conduct case management with social support connections to allow infected individuals to isolate; and expand vaccination access opportunities. Packet Pg. 1 3 Collier County supports the efforts of the County Health Department, Partners in Health, Healthcare Network, and the Coalition of Immokalee Workers to enhance the COVID-19 response in the Immokalee community. Funding from the CDC Community Health Workers for COVID Response and Resilient Communities Grant will greatly assist with these efforts. j-isacKson unty Manager Packet Pg. 1364 16. K.6.c Mission: To protect, promote & improve the health of all people in Florida through integrated state, county & community efforts. May 18, 2021 of n a HEALTH Collier County Vision: To be the Healthiest State in the Nation Stacy De Jesus Department of Health and Human Services Centers for Disease Control and Prevention 1600 Clifton Rd., Atlanta, GA 30329-4027 Ron DeSantis Governor Scott A. Rivkees, MD State Surgeon General Ref: Community Health Workers for COVID Response and Resilient Communities (CCR), CDC- RFA-DP21-2109 Dear Ms. De Jesus, My name is Kimberly Kossler, and I serve as the Administrator at the Department of Health in Collier County (DOH -Collier). I am writing to express our commitment to participating in the Collier County Community Health Coalition, as part of Collier County's application to the above referenced notice of funding opportunity. DOH -Collier is one of 67 county health departments that forms an integrated public health system serving the State of Florida by providing services mandated by Florida statutes and guided by the Centers for Disease Control and Prevention (CDC), Ten Essential Public Health Services and the Public Health Accreditation Board's (PHAB) Twelve Public Health Accreditation Domains. DOH -Collier provides essential public health services to more than 391,603 residents and approximately 1.67 million visitors to our county annually. We have 150 budgeted full-time employees and provide services for infectious disease prevention and control, immunizations, immigrant and refugee health, dental, family planning, WIC, Healthy Start, community health planning, chronic disease prevention and wellness programs, vital statistics, emergency preparedness, and environmental health services. This past year the health department provided 117,595 individual public health services excluding over 100,000 doses of COVID-19 vaccine administered throughout the County. Throughout the COVID-19 pandemic, DOH -Collier has been working alongside partners to implement an effective response to protect the health of all residents and visitors to Collier County. Our strategies have included: free walk-up and appointment -based COVID-19 testing in Naples and Immokalee; contact tracing for residents of Collier County; and free walk-up and appointment -based COVID-19 vaccination. We also partnered with the international non -governmental organization Partners In Health to design and implement the first COVID-19 Promotora Program in Immokalee from June 2020 - August 2020, where Promotoras visited door-to-door in Immokalee to share culturally, linguistically, and socially accessible information about COVID-19, connect residents to essential services, gather and elevate feedback on community needs. When this program ended in August 2020, we supported the Healthcare Network and Partners In Health to continue this outreach work through the Promotora Program that is housed at Healthcare Network. We look forward to our ongoing collaboration with Collier County, Healthcare Network, Partners In Health, the Coalition of Immokalee Workers, and Mision Peniel through the Collier County Community Florida Department of Health in Collier County Office of the Administrator • Kimberly Kossler, MPH, RN, CPH 3339 E. Tamiami Trail, Suite 145 • Naples, Florida 34112-4961 Accredited Health Department Public Health Accreditation Board Packet Pg. 1365 www.FloridaHealth.gov 16.K.6.c Health Coalition in order to continue protecting and promoting the health of all residents and visitors of Collier County. Thank you for your consideration and support. For any further inquiries, please contact me at (239)252- 8201 or Kimberly. Kossler(cD-flhealth.gov. Sinc rel , � Cs� Kimberly Ko sler, MPH, RN, CPH Administrator & Health Officer Florida Department of Health in Collier County 3339 Tamiami Trail East Naples, FL 34112 Packet Pg. 1366 16. K.6.c V!2 healthcare rI 0 network Stacy De Jesus Department of Health and Human Services Centers for Disease Control and Prevention 1600 Clifton Rd., Atlanta, GA 30329-4027 Ref: Community Health Workers for COVID Response and Resilient Communities (CCR), CDC-RFA-DP21-2109 Dear Ms. De Jesus, I am writing today as a representative of the Healthcare Network to express our commitment to joining the Collier County Community Health Coalition alongside Collier County, the Department of Health, Partners In Health, the Coalition of Immokalee Workers, and Mision Peniel. Healthcare Network (HCN) is a Federally Qualified Health Center (FQHC) in Southwest Florida dedicated to providing quality healthcare that is accessible to everyone regardless of ability to pay, insurance status, or documentation status. Since its founding in 1977, the HCN has been serving the community's healthcare needs through its private, not -for -profit model, providing comprehensive primary and preventative healthcare including physical health, oral health, and mental health to persons of all ages. We provide care to nearly 50,000 patients using a Sliding Fee Discount Program to reduce costs to uninsured and underinsured patients based on their income and family size. We work collaboratively with 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, including NCH Healthcare System, the local community hospital. As the Only FQHC in Collier County, we work to alleviate health disparities that exist during normal times in the underserved, vulnerable populations in Collier County. When the COVID-19 pandemic exacerbated these health inequities, we responded by recruiting, hiring, and training community health workers as part of a COVID-19 Health Promoter, or "Promotora," Program. Since August 2020, Partners In Health has providing promotora training and guidance to team members in their community work. PIH also provided short- term funding to expand the team in January 2021. The team employs several tactics to reduce the spread of COVID-19, including: door-to-door outreach to provide culturally appropriate education materials and messaging about COVID-19 prevention, transmission, testing, and vaccination; case management, including phone calls and household visits, for patients that are sick with COVID-19 to ensure rapid referral to clinical and social services when necessary; rapid and PCR mobile COVID-19 testing in the neighborhoods and community centers where Immokalee residents work and gather; and linguistic and logistical support at HCN and DOH vaccination events. 1454 Madison Avenue Immokalee, Florida 34142 P 239.658.3000 www. healthca reswfl.org PROVDING QUALITY HEALTHCARE FOR ALL SIN E 1977 Packet Pg. 1367 16.K.6.c The Health Promoter Program has been well received by the Immokalee community and partners, which has helped to rebuild trust in healthcare and other services among marginalized populations. We seek to extend the program throughout Collier County in order to maintain an effective and equitable COVID-19 response and to continue the healthcare system strengthening efforts in collaboration with community and government agencies beyond the pandemic. By hiring additional Health Promoters, we can expand our reach beyond Immokalee to increase access to quality care in other underserved Collier County communities, such as Golden Gate, Everglade, City, and East Naples. We believe that the partnerships that have been established over the past year make the Collier County Community Health Coalition well positioned to apply lessons learned during the COVID-19 pandemic well into the future. Thank you for your consideration. If you have any questions, please feel free to reach out at 23 9.65 8.3 066 or eptaszek@healtheareswfl.org. Best, ILI Emily Ptaszek, ZD, MBA, FACHE President & CEO Packet Pg. 1368 7 `Let mutual love continue. Do not neglect to show P hospitality to strangers, for by doing that some have • entertained angels without knowing it." — Hebrews 13:1 May 17, 2021 Stacy De Jesus Department of Health and Human Services Centers for Disease Control and Prevention 1600 Clifton Rd., Atlanta, GA 30329-4027 16.K.6.c M 0 • Islor � Peniel Ref: Community Health Workers for COVID Response and Resilient Communities (CCR), CDC-RFA-DP21-2109 Dear Ms. De Jesus, My name is Ruth DeYoe, and I serve as the mission coordinator at Mision Peniel. I am writing today on behalf of Mision Peniel to express our commitment to participating in the Collier County Community Health Coalition, as part of Collier County's application to the above refer- enced NOFO. In September 2006, Mision Peniel began as a pastoral ministry of charity and service, providing food, clothing, fellowship, and emergency support to farmworkers in Immokalee as an extension of Beth -El Farmworker Ministries. Since 2013, Mision Peniel has continued as a ministry of the Presbyterian Church (USA) in Southwest Florida. Each week, the mission serves between 300 to 700 farmworker community members at its food distribution and provides regular pastoral care to farm workers and their families, including counseling, fellowship opportunities, hospital visitation and assistance in orienting migrants to a new culture. We are committed to bringing people of faith and compassion together to act with farmworkers to achieve fundamental change in their living and working conditions while increasing public awareness of the need for reconcili- ation and bridge building between sectors. What we've learned from a year of coronavirus is that frontline workers are indispensable. They keep us safe, fed, and cared for. They keep our economy moving, yet too often they live paycheck -to -paycheck. Deemed "essential" in the face of a devastating global pandemic, they now also face the constant risk of contracting COVID-19. In Southwest Florida, this is the story of thousands of farmworkers and their families in the town of Immokalee. Most individuals and families in our community were excluded from federal COVID-19 stimulus payments and similarly do not qualify for other relief programs or social safety nets. Perhaps most disturbing is the fact that most are not offered paid time off or sick days, even if they test positive or fall ill with coronavirus. As a result, direct social support is critical, not only to provide security to farmworkers and their families, but also to contain the spread of COVID-19 by mak- ing it economically possible for workers to stay home from the fields and processing plants to recuperate and return to their work. 208 Boston Avenue PO Box 1204 Immokalee, Florida 34143 wwmmisionpeniel.com Packet Pg. 1369 16.K.6.c Recognizing the unique vulnerabilities faced by the Immokalee community, Misi6n Peniel set up a designated relief fund to alleviate the disparate impact of the pandemic on those who were directly affected by the virus. This fund has helped families pay rent, cover utility bills, and buy food, but its impact is felt community -wide. By meeting the urgent economic needs of COVID- positive essential workers, this kind of financial support is allowing individuals and family mem- bers to quarantine at home safely, curbing the spread of the virus. Emergency assistance is distributed by Misi6n Peniel through a new partnership with Partners In Health, augmenting Misi6n Peniel's existing network and infrastructure with additional admin- istrative and outreach support in order to effectively distribute cash assistance as quickly as possible. Individuals in need of assistance are identified in partnership with the Healthcare Net- work, which is conducting regular testing, as well as through outreach conducted by the Coali- tion of Immokalee Workers and Partners In Health. From May 2020 to April 2021, the team has distributed $73,848 in needs based assistance, and from December 2020 to April 2021, we have disbursed $482,840 in cash transfers to COVID-positive patients. As we reflect on the future of healthcare in Immokalee, we recognize the importance of social support in increasing access to quality care for the most vulnerable and addressing the social determinants of health. We are eager to bring our experiences in designing and implementing social support systems in Immokalee to serve as advisors on the Collier County Community Health Committee to promote the health of the entire population. Thank you again for your consideration of this proposal. If you have any questions or further in- quiries, please do not hesitate to contact me at 386-793-6151 or ruth(cDpeace rive rpresbytery.org In Supportive Partnership, Ruth DeYoe Mission Coordinator Misi6n Peniel 208 Boston Avenue PO Box 1204 Immokalee, Florida 34143 wwmmisionpeniel.com Packet Pg. 1370 16. K.6.c Partners In Health May 12, 2021 Stacy De Jesus Department of Health and Human Services Centers for Disease Control and Prevention 1600 Clifton Rd. Atlanta, GA 30329-4027 Ref: CDC, Community Health Workers for COVID Response and Resilient Communities (CCR), CDC-RFA-DP21-2109 Dear Ms. De Jesus, I am writing on behalf of Partners In Health (PIH) to share our willingness to join the Collier County Community Health Coalition in support of the application led by Collier County for the above referenced NOFO, alongside our partners at the Department of Health, the Coalition of Immokalee Workers, the Healthcare Network, and Mision Peniel. For the last 33 years, PIH has been a leader in fighting infectious disease and building strong community health systems around the world. Our team works with governments and communities in 11 countries to build the capacity of health systems in partnership with local leaders. From Haiti to Peru to Liberia, PIH has walked shoulder to shoulder with our partners through devastating outbreaks of Ebola, cholera, tuberculosis, and now, COVID-19. The response to this epidemic has laid bare the systemic injustice in the U.S. health system, as communities of color bear the brunt of the pandemic. Based on the early success of PIH's work in COVID-19 contact tracing in Massachusetts, PIH launched the US Public Health Accompaniment Unit (USPHAU) in April 2020 to support governments and communities around the country as they responded to COVID-19. Through a generous seed grant from The Audacious Project, PIH now supports 16 states, counties, cities, tribal governments and communities across the U.S. Our team supports our partners to respond to COVID-19, recover from a year of lost health, and reimagine more equitable health systems for the future. One community that has been disproportionately impacted by the COVID-19 pandemic is Immokalee, Florida due to the continued work of migrant farm workers in front-line, high -risk environments with limited worker protections, crowded living conditions, and limited access to healthcare or social services. Partners In Health first came to Immokalee at the request of the Coalition of Immokalee Workers (CIW), who raised the flag for additional support in June 2020. Since then, PIH has joined the CIW, Department of Health (DOH), Collier County, Healthcare Network (HCN), and Mision Peniel in implementing various work streams to respond to COVID- 19 in Immokalee, including: • Health Promoter Program: PIH has partnered with the HCN to train health promoters from Immokalee, who share linguistically, socially, and culturally accessible information Packet Pg. 1371 16.K.6.c on COVID-19 with the community. The Health Promoters also serve as resource navigators to connect individuals to essential social supports like food, medicine, and housing to address the social determinants of health that have been exacerbated by the pandemic. Because the Health Promoters represent the linguistic, racial, ethnic, and social diversity of Immokalee, they bring a rich understanding of the complex social and structural context and draw on their own lived experiences to connect with community members and to rebuild trust in the healthcare system. Rapid testing: Early testing events in Immokalee were inaccessible to the majority of residents due to linguistic barriers, schedules that conflicted with the work day, hard -to - reach locations, and lack of support for those that tested positive. In response, the team of PIH, HCN, and CIW now hosts mobile rapid testing events three times per week, where services are brought directly to the community. Social Support: Individuals from Immokalee that test positive for COVID-19 are eligible for financial resources via cash transfers from Mision Peniel. This social support enables COVID-19 patients to stay home during their infectious period while alleviating fears of eviction and heightened food insecurity that come from missing work. Equitable vaccine access: PIH has helped to implement strategies for equitable vaccine access by supporting the HCN Health Promoters to conduct community outreach, often going door-to-door to sign individuals up for vaccination opportunities and transporting patients to events. PIH is committed to collaborating with the Collier County Community Health Coalition to support the residents of Immokalee to recover from the effects of COVID-19 by continuing community outreach to connect people to essential clinical and social services; maintaining rigorous rapid testing systems to promote early detection of disease; conducting case management with connections to social support to enable infectious individuals to isolate; and expanding equitable access to vaccination opportunities. Once COVID-19 is brought under control, Immokalee can reimagine what health equity might look like for its residents, especially those who have been historically excluded from accessing healthcare services, by building a new Community Health workforce and integrating social support programming with the health system. We look forward to contributing our experiences in strengthening healthcare systems around the world while learning from partners with a rich historical, social, and structural understanding of Immokalee. Thank you for your consideration of this proposal. Should you require additional information, please contact me at cbroderick(a)-pih.org with any further questions. Sincerely, Caroline Broderick Sr. Director of Grants Management and Compliance Partners In Health Packet Pg. 1372 16. K.6.c Coalition May 17, 2021 Stacy De Jesus Department of Health and Human Services Centers for Disease Control and Prevention 1600 Clifton Rd., Atlanta, GA 30329-4027 Immokalee Workers Box 603, Immokalee, FL workers@ciw-online.org Ref: Community Health Workers for COVID Response and Resilient Communities (CCR), CDC-RFA- DP21-2109 Dear Ms. De Jesus, I am writing this letter as a representative of the Coalition of Immokalee Workers (CIW) in response to the request to join the Collier County Community Health Coalition. We are committed to being a part of this team as we believe this group is well poised to advance health equity in Immokalee, Florida. The CIW is an internationally recognized organization dedicated to fighting human trafficking and gender -based violence at work and ensuring the recognition of human rights within the workplace for migrant workers. Built on a foundation of farmworker community organizing starting in 1993, the CIW is based in Immokalee and represents an important and powerful community voice. Throughout the COVID-19 pandemic, the CIW has advocated for an equitable response alongside the community by calling for increased testing and vaccination. We have supported the implementation of mobile testing, and our staff attend events three times a week as volunteers to enhance the workflow and to ensure services are accessible to the community. We have partnered with Mision Peniel and Partners In Health to design a social support system that supports community members impacted by COVID-19 to stay home and isolate, and we have partnered with the Department of Health and Department of Emergency Management to host 15 walk-up vaccination events in April and May that have been attended by over 3000 people, most of whom were farm workers and Immokalee residents who would not otherwise have had access to vaccination services. We first began supporting the Collier County government and the Florida Department of Health in Immokalee in April 2020 at the start of the COVID-19 pandemic by advocating for increased testing and resources dedicated to the essential yet extremely vulnerable workers in our community. We worked to bring Doctors Without Borders to assist with testing. We have also been collaborating on the Immokalee Health Promoter Program since June 2020 with Partners In Health and later the Healthcare Network, and we've been working with Mision Peniel since September 2020 to implement a social support system that alleviates the disproportionate impact of COVID-19 on the community. We believe that our current working relationship with these partners sets us up to form a strong coalition that can collaborate to strengthen healthcare services in Immokalee moving forward. In the future, we seek to build upon lessons learned through COVID-19 and the partnerships that have been established to continue strengthening the healthcare system in Immokalee. We will work with the team to advance health education in the community through our regular radio shows and outreach work, and we will support the Health Promoter Program by identifying geographic areas of need, supporting recruitment of Health Promoters from the community, and advising on the various work streams. By joining the Collier County Community Health Coalition, we can help to elevate local voices and ensure decisions are informed and driven by the Immokalee community. Packet Pg. 1373 16. K.6.c Thank you for your consideration. If you have any questions, please do not hesitate to contact me at 239-986-0891 or juliakciw-online.org Sincerely yours, - L- vJ�M Julia Perkins Packet Pg. 1374 Form Approved Attachment G OMB Control Number0920-1132 PERFORMANCE PROGRESS and MONITORING REPORT Expiration Date: 10/31/2022 OFR Risk Questionnaire 1!9 Risk Questionnaire Instructions: Prior to making an award, the Centers for Disease Control (CDC) evaluates the degree of risk posed by an applicant. ! In filling out the Risk Questionnaire, each question should be answered as completely as possible, using extra pages if necessary. Please return your completed questionnaire i to [Name of Contact]. ! s General Information G S Legal Name of Organization Collier County Board of County Commissioners ! In which country (or countries) does your organization propose to operate for this USA NOFO? Please list all separated by commas. In which country is the headquarters or general office of your organization located? u USA Please identify what type of organization you are (non-profit, for -profit, educational Government agency p [ institution, other)? _ Is your organization incorporated or legally registered? Yes If not, please explain: e G Operational Risk p s Does your organization have a President/Director/Chief Executive Yes If not, please explain: Officer and Chief Financial Officer? U O Personnel Does your organization have written human resource (HR) policies Yes, enclosed If not, please explain: C and procedures? C List the number of employees within your organization. Full Time Employees: 1923 Part-time Employees: 54 L Volunteers: 19 Programmatic Performance Has your organization managed U.S. Government grants or cooperative agreements within the last 36 months? ! Received federal grant but not from CDC in the last 3 yearsFinancial Risk a 0 Does your organization have written accounting policies Yes, enclosed tw and procedures? c Explanation: Yes, Collier County has written accounting policies and Can your accounting records separate the receipts and payments of Yes Accounting a federal grant from the receipts and payments of your organization's System other activities? Can your accounting records summarize expenditures from a federal Yes grant according to different budget categories such as salaries, rent, supplies and equipment? ] C Does your organization have systems, policies, and procedures for Yes L tracking and approving hours worked by employees, contractors, and volunteers? Does your organization have internal controls and anti -corruption Yes Internal ethics codes that are emphasized by leadership? C Controls Does your organization have written project management policies, Yes � If no, please provide an explanation: C procedures, and systems? T C Is your organization familiar with U.S. government regulations Yes c concerning costs which can be charged to U.S. grants (Title 2, U.S. Code of Federal Regulations, Part 200, Subpart E)? Cash Does your organization have a bank account registered in its name Yes If not, please explain how you plan to manage funds from a potential award? Management and that is capable of segregating grant funds from other funds? What percent of your organization's capital is from federal funding? 4% (percentage = total federal funding in previous FY/ organization's annual gross revenue in previous FY) What is the dollar amount of your total current assets? (i.e. cash $ 708,211,458.00 C Z and other assets that are expected to be converted to cash within Going the next twelve months) Concern What is the dollar amount of your total current liabilities? (i.e. amounts $ 188,400,706.00 ! due to be paid to creditors within the next twelve months) ! What is the dollar amount of your total debt? < $ 592,391,158.00 C What is the dollar amount of your total assets? (e.g. cash, fixed i • • assets, accounts receivable, etc.) $ 4,037,086,994.00 + Does your organization have regular independent audits that you Yes G contract and pay for? Audit If yes, who performs the audit? S Clifton Larsen Allen LLC What was the date of the most recent audit and what was the result? Date: Opinion: 04/27/2021 Unmodified I i L CDC 0.1567 CS 323086 3/4/2021 RESET PRINT I Packet Pg. 1375 16. K.6.c From: StanleyTherese To: Thomasloshua; FleminaValerie Subject: FW: GRANT13370473 Grants.gov Submission Validation Receipt for Application Date: Monday, May 24, 2021 2:43:56 PM Therese M. Stanley Grants Compliance Manager Office of Management & Budget Grants Compliance Team 3299 Tamiami Trail E, Suite 201, Naples Florida 34112 Phone: 239.252.2959 Fax: 239.252.8828 -----Original Message ----- From: DoNotReply@grants.gov <DoNotReply@grants.gov> Sent: Monday, May 24, 2021 2:41 PM To: StanleyTherese <Therese.Stanley@colliercountyfl.gov> Subject: GRANT13370473 Grants.gov Submission Validation Receipt for Application EXTERNAL EMAIL: This email is from an external source. Confirm this is a trusted sender and use extreme caution when opening attachments or clicking links. Your application has been received and validated by Grants.gov and is being prepared for Grantor agency retrieval. UEL• JWKJKYRPLLU6 AOR name: Therese M Stanley Application Name: COLLIER CDC-RFA-DP21-2109 Opportunity Number: CDC-RFA-DP21-2109 Opportunity Name: Community Health Workers for COVID Response and Resilient Communities (CCR) htips:Happly07.grants.gov/apl2ly/login.faces?cleanSession--I You will be notified via email when your application has been retrieved by Grantor agency. Thank you. Grants.gov If you have questions please contact the Grants.gov Contact Center: support@grants.gov 1-800-518-4726 24 hours a day, 7 days a week. Closed on federal holidays. PLEASE NOTE: This email is for notification purposes only. Please do not reply to this email for any purpose. Under Florida Law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by telephone or in writing. Packet Pg. 1376 16. K.6.d December 13, 2022 TRANSCRIPT OF THE MEETING OF THE BOARD OF COUNTY COMMISSIONERS Naples, Florida December 13, 2022 LET IT BE REMEMBERED, that the Board of County Commissioners, in and for the County of Collier, and also acting as the Board of Zoning Appeals and as the governing board(s) of such special districts as have been created according to law and having conducted business herein, met on this date at 9:00 a.m., in REGULAR SESSION in Building "F" of the Government Complex, East Naples, Florida, with the following Board members present: Chairman: William L. McDaniel, Jr. Rick LoCastro Burt L. Saunders Chris Hall ALSO PRESENT: Dan Kowal Amy Patterson, County Manager Daniel Rodriguez, Deputy County Manager Jeffrey A. Klatzkow, County Attorney Crystal K. Kinzel, Clerk of the Circuit Court & Comptroller Troy Miller, Communications & Customer Relations Page 1 Packet Pg. 1377 16. K.6.d December 13, 2022 CHAIRMAN McDANIEL: I'm speaking out of turn just a little bit, but from all of us to you, past and present, thank you for what you've done for Bayshore and the enormous improvements to our community that have been contrived and derived by your efforts. So thank you. MS. PATTERSON: ***Commissioners, that brings us to Item 7, public comments on general topics not on the current or future agenda. Troy. MR. MILLER: Mr. Chairman, we have 12 registered speakers today; 11 here in the room, one online. We'll begin with Richard Schroeder. He'll be followed by Garrett FX Beyrent. CHAIRMAN McDANIEL: And, Garrett, if you would move to the other podium, as the doc is getting ready to -- and, everybody, as your name is called, if you would just take a position at the open podium, we'll be able to move through. Good morning, Doc. DR. SCHROEDER: Good morning, and welcome all the new folks. Dr. Richard Schroeder. At the September 13th commissioners' meeting, Year 2 of a three-year CDC grant that looks to be in the amount of about $1.3 million was passed unanimously that supports the community health workers for COVID-19 response. Ordinarily getting more money to public health workers would be welcomed, but not when the giver of the gift demands unquestioning obedience so -- to this gift, and this obedience, through the last couple of years, has demonstrated a lot of harm to society and caused untold suffering worldwide. The gift as given by the CDC requires compliance with existing and future directions of the HHS secretary in the United States government to enforce things like quarantine, isolation, lockdowns, Page 35 Packet Pg. 1378 16. K.6.d December 13, 2022 masking, all of the things that have now been proven to be harmful rather than helpful in the -- in the recent COVID-19 debacle. If you haven't figured it out by now, the COVID-19 pandemic is one of the most manipulated disease events in history, characterized by official lies from bureaucracies like the CDC's medical associations, medical boards, media, the W.H.O., and the like, and treatments formulated by the people who have no direct contact with patients such as Fauci, Gates, Eco Health Alliance, the CDC health organization, and so forth. One of the biggest lies the CDC told over the last two years is that the vaccines are safe. And the evidence is now overwhelming the whole host of new disease presentations not previously seen are being caused by the poorly tested and probably malignantly designed emergency use mRNA vaccines. This -- could we have the box of chocolates back. This is Forrest Gump's version of COVID-19 mRNA vaccine goodies. These particular diseases are listed in the Pfizer documents as complications of the vaccine that they tried to sequester for 75 years but were eventually subpoenaed and plus these have high correlation with administration of the SARS-CoV-2 vaccines. These are decreased fertility, blood clots, sudden adult death syndrome never before seen these vaccines were administered. And Guillon-Barre, heart attacks, miscarriages, stroke and so forth. Next slide, please. This is from the Department of -- this is military data showing healthy young recruits with dramatic increased in deaths, myocardial disease, and rapidly growing cancers after vaccine administration. Very unusual for young, healthy recruits, mostly male. And Slide 3, the final slide, is from the State of Florida's data analysis, Kyle Lamb, showing increase in excess mortality by age group following the beginning of the vaccine administration. And Page 36 Packet Pg. 1379 16. K.6.d December 13, 2022 you can see that the largest hit is being taken by young people. And I'll leave it to you to decide what may be causing this and how acceptance and money from the CDC plays a part in all this. Thank you. (Applause.) MR. MILLER: Your next speaker is Garret FX Beyrent. He will be followed by Dan Cook. MR. BEYRENT: For the record, Garret FX Beyrent. And I have two awards to be presented to our two new commissioners. And I was told by the Sheriff s Department to give the guy with the bushy beard -- that's Mr. Kowal there -- I'm supposed to give him this one. These are both from our favorite store, Walmart. But it's really interesting, because it's a failed item, and the reason it failed was because it was too technical for people to understand that if you want to look in the mirror, you have to take the film off it. I looked at it and I said, I don't understand what it is either. But in any case, I'll show you. The Sheriff s Department thought you would be the one that would be -- they said something about a cactus. Now, if you pull it off -- you push the button. If you pull off the film, you get the whole thing. You've got to pull the film off. Bad idea. Now, look into it. See, that's your future. Look into it. Isn't that cool? COMMISSIONER KOWAL: Yeah, it lights up. MR. BEYRENT: I didn't get one for you. There's only two available. The other one's for you. CHAIRMAN McDANIEL: I don't really need to see into my future. MR. BEYRENT: You take the film off it, and then you push the button, and you look into it. And you'll do anything I tell you to do, right? CHAIRMAN McDANIEL: There you go. Page 37 Packet Pg. 1380 16. K.6.d December 13, 2022 MR. BEYRENT: Isn't it cool the way you look into it? COMMISSIONER HALL: You're way back in there. MR. BEYRENT: Anyhow, thank you very much. CHAIRMAN McDANIEL: Absolutely, Garrett. COMMISSIONER KOWAL: Thank you. MR. MILLER: Your next speaker is Dan Cook. He'll be followed by Desre Burski. MR. COOK: Well, this is a good segue. I've got a gift for all the commissioners as well, but it's in the form of a resolution from the Republican Party of Collier County. And I'd like to speak about, generally, the county's relationship with the federal government and specifically the CDC, the Department of Health and Human Services. I echo a lot of the things that the doctor just said. This resolution that was passed by the Republican Party of Collier County last July notes that the World Health Organization is attempting to establish a global governing body to respond to so-called international health emergencies. And from my perspective I think the connection with the CDC and possibly the World Health Organization in collecting data regarding COVID-19, the quarantines, potential for -- you know, the collecting of the data from people regarding COVID-19, 1 see it as a violation of privacy. I look at the Florida Constitution, Article 1, Section 23, says that every natural person has the right to be let alone and free from governmental intrusion into the person's private life except as otherwise provided herein, meaning except what's provided in the Florida Constitution. So the concern, I believe, is that by the county accepting this grant from the CDC, are there strings attached? Are there requirements from the CDC or the Health and Human Services Department to relay COVID data back to the CDC? And so that's Packet Pg. 1381 16. K.6.d December 13, 2022 the concern that I'd like to bring up to the Board, and I'm not sure what is actually in this agreement. I'm not sure if it is reversible, but I'd just like to bring this concern to you guys to either consider sending that money back to the CDC and saying we're not going to be underneath the thumb of the CDC or at least just consider this in the future when future things like this come down the ramp. CHAIRMAN McDANIEL: Thank you. MR. COOK: I hand this -- CHAIRMAN McDANIEL: To the Clerk, County Attorney, either one. MR. MILLER: Your next speaker is Desre Burski. She'll be followed by Chris Fuller. MS. BURSKI: Hi. Good morning, everyone. I first want to wish everyone a blessed Merry Christmas and, Commissioner Hall and Commissioner Kowal, congratulations. I always appreciate this opportunity to be able to talk to you guys. My concern is following up from the last two speakers. I would like to request that Dan Cook and Dr. Richard and myself and any others that are interested get to meet with you all on a one-on-one basis because, as we all know, this is not a place for interaction. It's for us to, you know, deliver our concerns. We know what's happened over COVID. The last two or three years has been hell on earth, some places worse than others. Florida, we kind of scathed through. Governor DeSantis helped us. But I don't believe that we should be accepting money from the CDC, which is by way of instruction of the World Health Organization no doubt. My other question is, which other counties in Florida -- which other commissioners in the counties in Florida has accepted this like money from the CDC? I believe that this is the only one, and that it's 67 within the whole of the United States. I would like to request Page 39 Packet Pg. 1382 16. K.6.d December 13, 2022 that all this money goes back and that we maintain our sovereignty. Thank you. MR. MILLER: Your next speaker is Chris Fuller. He'll be followed by Kathy Meo. MR. FULLER: Good morning, gentlemen, and congratulations, new commissioners. I was living in France for a long time, for about 15 years, and during the COVID crisis, I realized that when you're living in a collective state, they almost unconsciously worship authoritarianism, state power, and I realized that when we were locked in our houses for 23 out of 24 hours a day and we needed papers to justify whatever we're going to do during that hour outside, I realized that I didn't want to raise my children in that, and I wanted to raise my children in freedom. Governor DeSantis seemed to be doing some good work here resisting the COVID narrative, which was put together by some very nefarious networks that include a World Economic Council, Bill Gates and his foundation, the CDC, which is absolutely discredited. The CDC has blood on its hands, gentlemen, and we've -- we've watched some nice photo ops today and some handshaking and some patting on the backs. When I -- if I'd known that Collier County was going to be the only county in Florida to accept CDC money last year, I wouldn't be living here. We want to know why you took that money, and we want you to send it back. The CDC -- think about it, look into it. You do the work. That's not my job. That's your job. When you accept $400,000 from somebody, you better know who you're accepting it from, and you better know what they're buying. Now they have a foothold in our community. You want to talk about local liberty. This is it right now, and this is a litmus -test issue. Line is drawn in the sand. They're Packet Pg. 1383 16. K.6.d December 13, 2022 already wargaming the next plan-demic for 2025, just like they wargamed the last one in October of 2019, and it's going to be more lethal. And they're pushing right now vaccines still. Vaccines. For six months now -- six -month -year -old [sic] children, they just last week said, let's keep going. We need to vaccinate these healthy children. Are you thinking men? Are you men with hearts? Wake up. Now's the time. Decide which side you're on. MR. MILLER: Your next speaker is Kathy Meo. She'll be followed by Jackie Keay. MS. MEO: Good morning, gentlemen. I would also like to say congratulations to Commissioner Kowal, Commissioner Hall. Thrilled you're both sitting up there. I'm confident that you will both do what you promised to do. And us, as your constituents, heard a lot of promises during your campaigns, and I know you'll follow through. So I'm really excited to have this new board up here. We're hoping and praying for you to fight for our God-given rights. As many of my prior speakers have addressed, there's a lot of issues and problems in our country. But us as citizens of Collier County, we have a lot of concerns, and it starts right here. As many of you know, I was just reelected as the secretary of the Collier County Republican Executive Committee. I hold myself out as an America first, pro -God, pro -Constitution, pro -life, pro -gun, and pro -America person/woman. I can define a woman. So I'm very passionate about all of that, all the above, and I believe we the people have spoken, especially here in Collier County, through getting like-minded patriots like you folks as well as the new three school board members, Kelly Lichter, Jim Moshier, Jerry Rutherford, and the CCREC. This also just happened in Lee County and their REC and Charlotte County and many, many other REC's Page 41 Packet Pg. 1384 16. K.6.d December 13, 2022 make money for each other, but really because we need to meet the needs of those in our community, all of the needs, and right now our commissioners are not doing that. The past commissioners have not done that. And based on the personal things that I've seen from, you know, real estate agents, they're not interested in doing that either. So, honestly, where are -- CHAIRMAN McDANIEL: Thank you, Elizabeth. MS. RADL• -- the affordable housing going to be living? CHAIRMAN McDANIEL: Elizabeth, Elizabeth, thank you. Your time is up. MR. MILLER: That was our final speaker under Item 7, sir. CHAIRMAN McDANIEL: Well, and that takes us -- Commissioner Saunders has a comment, and then we're going to take the court reporter's break. COMMISSIONER SAUNDERS: I'll take less than a minute. There's been a lot of conversation about the CDC grant that the county had accepted, and I'd like to have all the facts on the table. When this grant came up, we did have staff talk to us about what that money was going to be used for and what the strings -- what strings were attached with it. So I think -- especially for the benefit of the new commissioners, I think we need to have staff give us another analysis of what that grant was, because I don't think it's anything sinister. My recollection is that it's providing a lot of funding for -- not for COVID, but for a lot of folks that need some healthcare from our Health Department beyond that. So if you could arrange for that this morning or this afternoon, just five minutes on what that grant was, if we did something that was inappropriate in accepting it, then I want to know that. I don't think that's the case, so I just want everybody to hear all the facts. MS. PATTERSON: Absolutely. We're working on that right now. Page 51 Packet Pg. 1385 16. K.6.d December 13, 2022 CHAIRMAN McDANIEL: Quick report this afternoon when we come back? MS. PATTERSON: Sure. CHAIRMAN McDANIEL: Got it? You got it? COMMISSIONER LoCASTRO: Yeah, I got it. CHAIRMAN McDANIEL: I saw you. You don't need a strobe down there. I saw you light up. Commissioner LoCastro. COMMISSIONER LoCASTRO: Yeah. I just wanted to add to that -- and I had already sent a note to the County Manager that added to that, I mean, the point was made that no other county in Florida accepted the money, which I'd be flabbergasted if that was the truth. But if it is, I'd like to correct -- I'd like to know that fact at this -- before this meeting's over if -- and that shouldn't be hard to confirm. Totally different topic, but I do want to amend the record. I did have some disclosures. 913 and 9C. I had meetings and correspondence and emails for 913, and 9C I had meetings. So if that could be corrected and added to the record, I'd appreciate it. COMMISSIONER SAUNDERS: I think there may be a little bit of confusion. The disclosures that we do at the beginning of the meeting on the consent agenda are for items that are consent agenda. CHAIRMAN MCDANIEL: Right. COMMISSIONER SAUNDERS: Other than land -use matters that come up like the ones you're talking about -- COMMISSIONER LoCASTRO: When we get to the point, okay. COMMISSIONER SAUNDERS: Yeah, we have to disclose that at that time. CHAIRMAN McDANIEL: And I errorred [sic] this morning. Somebody write that down, I made a mistake. And I actually called out my disclosure on an item that we're actually going to hear, and Page 52 Packet Pg. 1386 16. K.6.d December 13, 2022 Good afternoon, Commissioners. Kristi Sonntag, Community and Human Services director. Before you is a brief presentation on the Centers for Disease Control Community Healthcare Workers Grant Award. To go back in time, in June of 2021, the Board approved the submission of our application. In September of'21, the county was notified that we had received our award, and it was subsequently accepted; in May of '22, the Board approved the submission of our Year 2 application; July we received notification of our award; and in September of '22 of this year, we accepted the Year 2 award. The funding is on a three-year cycle. Each year the county is required to apply for the subsequent year. Year 1 we received $421,744. Of that we spent 134,178. That is all we drew from the federal government for that -- for the grant for Year 1. That was due to a delay in hiring the community health workers. Year 2, we have drawn zero dollars to date. The grant award started in August. We've incurred $896 in administrative expenditures, and our partners have incurred $45,305. We have not yet applied for Year 3. Should we do that, we would come to the Board for your approval to apply. The program parameters include services to extra mile migrant communities. This is a non -research award. It provides for community health workers to assist vulnerable populations with access to healthcare and provide healthcare education. There are two partners that we have as -- well, actually, we've one sub-awardee who then sub -awards. Our sub-awardee is Collier Health Services, and they, in turn, sub -award to Partners in Health who provide education and training. CHAIRMAN McDANIEL: An enormous amount thereof. MS. SONNTAG: Uh-huh, yes, sir. The federal requirements, I will remind you that all of these are Page 91 Packet Pg. 1387 16. K.6.d December 13, 2022 part of the award; however, pursuant to the terms of the award, since the county has sub -awarded, we pass many of these requirements on to the sub-awardee. Those would be complying with existing and future directives, consultation and coordination with Health and Human Services related to the pandemic, assisting the U.S. government with isolation and quarantine information dissemination, providing access to data collected if applicable, and reporting on test results. This is a Health Department requirement, as we all know. Those requirements that are specifically applicable to the county would be anti -lobbying, the code of federal -- excuse me -- Code of Federal Regulations 24 2 CFR 200 and 45 CFR Part 75, and also the Federal Funding Accountability Transparency Act, also known as FFATA. There are performance requirements that the sub-awardee is required to meet, and then we roll those up and report those to the federal government, and those include the community health workers who must participate in training, which is offered by Partners in Health; integration of state and local public health efforts; doing outreach messaging; and reporting on the number of persons served. The overall program goal is -- there's a two -person team of community health workers. They're to require -- they are required to perform 20 home visits per month, one group presentation, and one media outreach event every six months. The primary focus of the community health worker is to work with vulnerable populations to integrate medical care, dental, mental health, housing, and a variety of other services. So it's an outreach program that engages participants to educate them in healthcare and service delivery. And with that, I'll accept any questions. CHAIRMAN McDANIEL: Commissioner Saunders. COMMISSIONER SAUNDERS: I guess the only question I Page 92 Packet Pg. 1388 16. K.6.d December 13, 2022 would ask, the funding, the $400,000 per year for three years, it sounds like we haven't drawn hardly any of that down? MS. SONNTAG: No, sir, we did not. We only drew down the 134- in Year 1. And, again, that was related to our partner. Collier Health Services had a really hard time hiring staff, and the majority of the funds is spent on salaries for the community health workers to go out into the community. And so by the time they got ramped up after the award, that's all the funding that was drawn for Year 1. It was the salaries. And we drew $10,000 in administrative. That was it. COMMISSIONER SAUNDERS: But you had almost nothing in Year 2. MS. SONNTAG: Year 2 just started, sir. COMMISSIONER SAUNDERS: Oh, okay. MS. SONNTAG: Yes, it started. Yes, I'm sorry. It started in August, and we just haven't drawn anything to date from the federal government. COMMISSIONER SAUNDERS: It sounded like we were in Year 3 from the presentation. MS. SONNTAG: Oh, I'm sorry. No. COMMISSIONER SAUNDERS: I understand now. CHAIRMAN McDANIEL: Well, I have personal experience. The Partners in Health organization was enormously beneficial during the pandemic. They were a group of physicians that came to Immokalee, established a promatura organization, people that actually went door to door and educated our population on the assets that were availed for the treatment of COVID, the -- if, in fact -- where masks were available. If you all will recall, I never advocated for or -- well, I advocated against masks, and -- but I also felt, as a government, these assets are provided, and folks that chose to wear a mask needed to Page 93 Packet Pg. 1389 16. K.6.d December 13, 2022 know where to go get one. People that chose to receive the vaccination needed to know where to go get one. And these people -- these promaturas actually went door to door in Immokalee with -- I called them goodie bags, and it was just a litany of information of folks that weren't really privy to that information as to where they could get those assets should their family choose to receive those assistance programs. So we had a -- we had enormous success with Partners in Health, necessarily, in that regard. My concern is the alleged obligation that goes to the federal government from us and whether or not that receipt of those funds obligates us or puts us in a status that I wouldn't really be happy about. MS. SONNTAG: So, Commissioner, the award terms are signed by the Board chair upon acceptance of the award; however, the award terms specify that if we have a sub -award, the sub-awardee is the one carrying out the program. We are required to pass all those regulatory requirements down to them. So the dissemination of information, that's a core function of what they do as community health workers, but that would be passed on to them as a sub-awardee. So does that answer your question? CHAIRMAN McDANIEL: Not really. MS. SONNTAG: Okay. CHAIRMAN McDANIEL: The concern is, you know, there -- a lot of times these grant programs come with strings, and I have reservation when national agencies such as the CDC or the World Health Organization start to dictate policy. Are we obligated in regard to those policies that necessarily might come down? MS. SONNTAG: We are obligated to ensure that our sub-awardee follows those. You know, if they're required to disseminate information, we're required to monitor the sub-awardee Packet Pg. 1390 16. K.6.d December 13, 2022 that they are disseminating information, that they're doing what the federal government wants, because we are not the provider of service. CHAIRMAN McDANIEL: Okay. MS. SONNTAG: We're just a pass -through entity. And we were the only awardee in Florida; however, I am not aware of the number of applicants from the State of Florida. Nationwide, there are well over 20 awardees for Year 2., but we are the only awardee in Florida. CHAIRMAN McDANIEL: Okay. So Collier County is -- it was represented we're the only ones that were in -- excuse me -- in the State of Florida that were awarded this grant. MS. SONNTAG: Correct, but I don't know if any other jurisdictions applied. I wouldn't have that information. CHAIRMAN McDANIEL: Gotcha. Okay. Thank you. Commissioner Kowal. COMMISSIONER KOWAL: She just answered my question, because I know we asked that earlier. CHAIRMAN McDANIEL: Yes. And, Commissioner LoCastro. COMMISSIONER LoCASTRO: Yeah. I think the clarification is when we heard from citizens who brought up a point that I felt, you know, had merit, we all did, that no -- you know, we were the only county that took money, that's different than saying -- than maybe no other counties applied for the grant. So that's not that 66 other counties applied and then changed their mind and then said no or the government came to them with free money and they said, absolutely not, we don't want it. So, I mean, this is what we have confirmed, that we know we were one of the few and maybe only counties that applied for the grant. It's -- and I think, did I hear you correctly, you said across the nation there was only about 20 grants? Did I hear that right? Page 95 Packet Pg. 1391 16. K.6.d December 13, 2022 MS. SONNTAG: Yeah. For Year 2, there's over 20. You'll see them: Arizona; Georgia had one awardee; California had five; the Samoan Islands -- COMMISSIONER LoCASTRO: Right. MS. SONNTAG: -- you know, so it's a variety nationwide. I can certainly provide that list if someone's interested. COMMISSIONER LoCASTRO: And I'm concerned, too, anytime we accept government money, or money from any source if it comes with strings. What I'm hearing here, nothing that really is catching my attention as, oh, my God, we need to give the money back because -- I mean, what I'm hearing here are things that did a lot of good in our county. But, I mean, I look to my colleagues here if there's something buried in here, because I think we would all have concerns that -- you know, it gave us 400,000, not 400 million, and so, you know, if it did come with some strings of significant concern that citizens discovered or are concerned about, you know, we obviously want to know that. I haven't heard any of that yet. I don't know if we need to do a deeper dive or, you know, that's basically it in a nutshell. I don't want to create, you know, a new story that's not there. Certainly, the accusation or the statement that we were the only county that accepted the money is actually not fully correct, because what I'm hearing is we -- it sounds like we might have been the only county that applied for it, which is different than turning it down, but, okay. MS. SONNTAG: And, again, I have no idea how many counties applied. And, you know, oftentimes we apply for grants and don't get funded at all. CHAIRMAN McDANIEL: Commissioner Saunders. COMMISSIONER SAUNDERS: Well, I think the question was, are there any CDC requirements ongoing that require the county Packet Pg. 1392 16. K.6.d December 13, 2022 to do things that would -- that would appear to be objectionable in any way? It sounds like the only requirements are the grant is to help provide information to families that may need the information, but it doesn't sound like there's any ongoing obligations on the part of Collier County as a consideration for acceptance of the grant; is that an accurate statement? MS. SONNTAG: That would be an accurate statement, and you mean beyond the term of the award. So post closeout, no, there would be -- that would end our obligation. But, again, we pass these all on to the sub-awardee as required by the grantor. COMMISSIONER SAUNDERS: Okay. Thank you. CHAIRMAN McDANIEL: Is there global language at the top -- I didn't mean to jump in there, Commissioner. Is there global language at the top of the award that would put Collier County in a compromising position with a particular directive that would come from one of these organizations? MS. SONNTAG: I would have to defer probably to the County Attorney's Office to read the language and let me know if they believe that to be true. MR. KLATZKOW: All of these grants have a plethora of documents -- boilerplate documents that are set up at the back, and they're almost all identical, notwithstanding which grant you're going for. And there are things like you won't discriminate, for example. CHAIRMAN McDANIEL: We don't. MR. KLATZKOW: That sort of thing. I'm not aware of anything in any grant that goes really beyond that. What I could do, if you'd like, is we'll go through the fine print of this and get back to the Commission as to whether or not there was anything there that's out of the ordinary. CHAIRMAN McDANIEL: I would like that. Again, I don't want to -- I would prefer that we not be in a compromising position Page 97 Packet Pg. 1393 16. K.6.d December 13, 2022 should an errant directive come from one of these agencies that was prohibitive to our citizens. I don't ever want to -- I don't ever want to do that. MR. KLATZKOW: These grants are not political. I mean, I know people want to make them political, but the grants aren't political. They're a sum of money to do a certain thing, and then, yes, there's a boilerplate, but it's all stuff -- don't break the law on this and don't break the law on that. But we will go through it. CHAIRMAN McDANIEL: And if my understanding is correct if -- let's just say a directive came from the World Health Organization that was contrary to the belief systems of what this board chose to put forward, we -- MR. KLATZKOW: We won't sign off on it. CHAIRMAN McDANIEL: -- would have to adhere to it. MR. KLATZKOW: My office wouldn't sign off on something like that. CHAIRMAN McDANIEL: And we would then be subject to a clawback in the event that we weren't in adherence to that. So that predominantly is our exposure, and I know that personally we -- like you said, we wouldn't -- we wouldn't actually go down that path, so... Commissioner Kowal. COMMISSIONER KOWAL: Yeah, I think what I'm getting from the people are that they're concerned that you talk about the subs and what they're required to report. And I think their concern is what are -- how much are they reporting? Is it names? Is it addresses? Things like that. And I think that's their biggest concern -- or is it hard numbers? Like, the realm I come from, like uniform crime reports, we did them every year. We had Part 1 crimes, we sent them numbers. We're like, hey, so many robberies, so many of these, so many burglaries. You know, there's not a whole lot attached to it. So I think that's their concern. It's not so Packet Pg. 1394 16. K.6.d December 13, 2022 much, you know -- because you guys know kind of the makeup of our community -- MS. SONNTAG: Right. COMMISSIONER KOWAL: -- and where they stand. MS. SONNTAG: Right. COMMISSIONER KOWAL: And when they're asking those questions, we want to have those answers, too, so... MS. SONNTAG: And to answer your question, we go out -- my division goes out and monitors to ensure that the sub -recipient is doing what they're supposed to be doing, and then any reports are hard numbers, 22, 16, 87. It's a collective number of numbers served. It isn't, you know, so and so's name, address, date of birth. No, that would be all protected health information under HIPAA, and we would not be able to divulge any of that information. COMMISSIONER KOWAL: Okay. Like I said, I think that would help if they could understand that, you know, and then the clarity because of the HIPAA and stuff like that, because that may help us down the road in, you know, coming to a conclusion. CHAIRMAN McDANIEL: And the reassurance that we're not going to lean out over our skis on some directive that comes from the World Health Organization that's contrary to what's best for our citizenry, so... Thank you. COMMISSIONER KOWAL: Thank you. MS. SONNTAG: Thank you. Have a nice day. CHAIRMAN McDANIEL: We'll endeavor. Which one do you want to do next? MS. PATTERSON: ***We have Items 9C, 9D5 11 B, and 11 C all dealing with the Brightshore Stewardship Receiving Area that was scheduled for no sooner than 1:00, so that would really be where we start. Packet Pg. 1395