Backup Documents 01/09/2024 Item #16D 7 16D7
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the
exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1. Joshua Thomas, Grants Coordinator Community & Human 01/09/24
Services
2. Derek D. Perry County Attorney Office 0 041 \tit
3. Minutes and Records Clerk of Court's Office
42124' 0:62.
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees
above,may need to contact staff for additional or missing information.
Name of Primary Staff Joshua Thomas/CHS Operations Grants Phone Number 239-252-8995
Contact/ Department Coordinator
Agenda Date Item was January 9,2024 Agenda Item Number 16 D7
Approved by the BCC
Type of Document OAA ARP Amendment Number of Original 1
Attached Documents Attached
PO number or account N/A
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature?STAMP is OK N/A
2. Does the document need to be sent to another agency for additional signatures? If yes, N/A
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be JT
signed by the Chairman,with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the JT
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's JT
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip JT
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on 01/09/24 and all changes made during JT N/A is not an
the meeting have been incorporated in the attached document. The County option for
Attorney's Office has reviewed the changes,if applicable. this line.
9. Initials of attorney verifying that the attached document is the version approved by the N/A is not axe
BCC,all changes directed by the BCC have been made,and the document is ready for the /l r1fo
l
option;
Chairman's signature. 0/t✓ this line..
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12
September 2021 -September 2024 ARPA 203.22.01
AMENDMENT ONE G D 7
BETWEEN
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
AND
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
This Amendment, entered into between Collier County Board of County Commissioners and Area Agency on
Aging for Southwest Florida,Inc. (Contractor),hereby amends contract ARPA 203.22.
WHEREAS,the purpose of this Amendment is to increase service unit rates effective starting January 1st,
2024 through September 30,2024.
NOW THEREFORE, in consideration of the mutual covenants and obligations set forth herein,the receipt
and sufficiency of which are hereby acknowledged,the Parties agree to the following:
1. Attachment XIV, Service Rate Report, is hereby replaced.
All provisions in the contract and any attachments thereto in conflict with this Amendment shall be and are hereby changed
to conform to this Amendment.
All provisions not in conflict with this Amendment are still in effect and are to be performed at the level specified in the
contract.
This Amendment and all its attachments are hereby made part of the contract.
IN WITNESS THEREOF, the Parties have caused this three(3)page Amendment to be executed by their officials as
duly authorized,and agree to abide by the terms,conditions and provisions of Contract ARPA 203.22, as amended. This
Amendment is effective on the last date the Amendment has been signed by both Parties.
AREA AGENCY ON AGING FOR SOUTHWEST COLLIER COUNTY BOARD OF COUNTY
FLORIDA,INC. COMMISSIONERS
SIGNED: SIGNED:
Digitally signed by Maricela Digitally signed by WilliamsTanya
Maricela Morado Morado WilliamsTanya Dace:2023.,2.,5,,:50:04-OS00'
Date:2024.01.12 08:03:31-05'00'
NAME: MARICELA MORADO NAME: TANYA R. WILLIAMS
TITLE: CEO/PRESIDENT TITLE: HEAD
s estgnee o t e ounty anager,
Pursuant to Resolution No. 2018-202.
DATE: DATE:
01/12/2024 jZ Ps /Zo 2.3
1
Federal Tax ID:59-6000558
Fiscal Year Ending Date:09/30
DUNS:076997790
Ap r ved as to Form and Legality:
IAA--
Derek D. Perry
Assistant County Attorney
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September 2021 -September 2024 ARPA 203.22.01
16D7
ATTACHMENT XIV SERVICE RATE REPORT
COLLIER COUNTY
PROGRAM:FEDERALLY FUNDED FROM:9/01/2021-9/30/2024
HIGH REIMBURSEMENT
PROGRAM SERVICE METHOD OF PAYMENT RATE UNIT TYPE
CONGREGATE HOLIDAY/EMERGENCY SHELF MEALS Fixed Fee/Unit Rate $15.14 MEAL
CONGREGATE MEALS Fixed Fee/Unit Rate $15.14 MEAL
CONGREGATE MEALS(SCREENING) Fixed Fee/Unit Rate $48.31 HOUR
R P 3 C I CONGREGATE MEALS FOR MANAGED LONG-TERM CARE Fixed Fee/Unit Rate $15.14 MEAL
CLIENTS
CONGREGATE MEALS GUEST Fixed Fee/Unit Rate $15.14 MEAL
CONGREGATE MEALS VOLUNTEERS Fixed Fee/Unit Rate $15.14 MEAL
NUTRITION EDUCATION Fixed Fee/Unit Rate $1.72 PARTICIPANTS
HOME DELIVERED MEALS Fixed Fee/Unit Rate $9.71 MEAL
HOME DELIVERED MEALS GUEST Fixed Fee/Unit Rate $9.71 MEAL
RP3C2 NUTRITION EDUCATION Fixed Fee/Unit Rate $1.72 PARTICIPANTS
SCREENING&ASSESSMENT Fixed Fee/Unit Rate $57.92 HOUR
ADULT DAY CARE-DAYS Fixed Fee/Unit Rate $t 26.00 DAY
CARE TRANSITIONS INTERVENTION Cost Reimbursement Cost Reimbursement EPISODE
CASE MANAGEMENT Fixed Fee/Unit Rate $105.00 HOUR
EMERGENCY ALERT RESPONSE Fixed Fee/Unit Rate $1.76 EPISODE
HOMEMAKER Fixed Fee/Unit Rate $29.07 HOUR
HOUSING IMPROVEMENT* Cost Reimbursement Cost Reimbursement EPISODE
MATERIAL AID* Cost Reimbursement Cost Reimbursement EPISODE
PERSONAL CARE Fixed Fee/Unit Rate $30.10 HOUR
PET SUPPORT SERVICES Cost Reimbursement Cost Reimbursement EPISODE
RECREATION MATERIALS(EMERGENCIES ONLY)* Cost Reimbursement Cost Reimbursement EPISODE
RESPITE IN-FACILITY Fixed Fee/Unit Rate $14.59 HOUR
RESPITE IN-HOME Fixed Fee/Unit Rate $29.53 HOUR
RP3B
SCREENING&ASSESSMENT Fixed Fee/Unit Rate $57.92 HOUR
SKILLED NURSING SERVICES Fixed Fee/Unit Rate $55.06 HOUR
SPECIALIZED MEDICAL EQUIPMENT,SERVICES,AND Cost Reimbursement Cost Reimbursement EPISODE
SUPPLIES*
TAILORED CAREGIVER ASSESMENT AND REFERRAL- Cost Reimbursement Cost Reimbursement EPISODE
TCARE
TECHNOLOGY Cost Reimbursement Cost Reimbursement EPISODE
TECHNOLOGY-EQUIPMENT PURCHASE OR LEASE Cost Reimbursement Cost Reimbursement EPISODE
TECHNOLOGY-INSTALL Cost Reimbursement Cost Reimbursement EPISODE
TECHNOLOGY-STAFF SUPPORT Cost Reimbursement Cost Reimbursement EPISODE
TRANSPORTATION* Cost Reimbursement Cost Reimbursement TRIP
TRANSPORTATION TO MEAL SITE FOR MANAGED LONG- Cost Reimbursement Cost Reimbursement EPISODE
TERM CARE CLIENTS*
CARE TRANSITIONS INTERVENTION Cost Reimbursement Cost Reimbursement EPISODE
PET SUPPORT SERVICES Cost Reimbursement Cost Reimbursement EPISODE
RECREATION MATERIALS(EMERGENCIES ONLY)* Cost Reimbursement Cost Reimbursement EPISODE
RESPITE IN-FACILITY Fixed Fee/Unit Rate $14.59 HOUR
RESPITE IN-HOME Fixed Fee/Unit Rate $29.53 HOUR
SCREENING&ASSESSMENT Fixed Fee/Unit Rate $57.92 HOUR
RP3E
TAILORED CAREGIVER ASSESMENT AND REFERRAL- Cost Reimbursement Cost Reimbursement EPISODE
TCARE
TECHNOLOGY Cost Reimbursement Cost Reimbursement EPISODE
TECHNOLOGY-EQUIPMENT PURCHASE OR LEASE Cost Reimbursement Cost Reimbursement EPISODE ,
TECHNOLOGY-INSTALL Cost Reimbursement Cost Reimbursement EPISODE
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1 6 D 7
September 2021 - September 2024 ARPA 203.22.01
TECHNOLOGY-STAFF SUPPORT Cost Reimbursement Cost Reimbursement EPISODE
CARE TRANSITIONS INTERVENTION Cost Reimbursement Cost Reimbursement EPISODE
CHILD DAY CARE Fixed Fee/Unit Rate $20.96 HOUR
HOME DELIVERED MEALS Fixed Fee/Unit Rate $9.71 MEAL
PET SUPPORT SERVICES Cost Reimbursement Cost Reimbursement EPISODE
SCREENING&ASSESSMENT Fixed Fee/Unit Rate $57.92 HOUR
RP3EG
TECHNOLOGY Cost Reimbursement Cost Reimbursement EPISODE
TECHNOLOGY-EQUIPMENT PURCHASE OR LEASE Cost Reimbursement Cost Reimbursement EPISODE
TECHNOLOGY-INSTALL Cost Reimbursement Cost Reimbursement EPISODE
TECHNOLOGY-STAFF SUPPORT Cost Reimbursement Cost Reimbursement EPISODE
DIRECT PAY HOUSING IMPROVEMENT* Cost Reimbursement Cost Reimbursement EPISODE
HOUSING IMPROVEMENT* Cost Reimbursement Cost Reimbursement EPISODE
MATERIAL AID* Cost Reimbursement Cost Reimbursement EPISODE
RP3ES
SPECIALIZED MEDICAL EQUIPMENT,SERVICES,AND Cost Reimbursement Cost Reimbursement EPISODE
SUPPLIES*
SPECIALIZED MEDICAL EQUIPMENT,SERVICES,AND Cost Reimbursement Cost Reimbursement EPISODE
SUPPLIES-DIRECT PAY*
*As stipulated in contract,these services are provided on a cost reimbursement basis.
G�O
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