Agenda 04/23/2024 Item #16F 2 (Purchase Agreement and Business Associate Agreement w/Florida Behavioral Health Network, Inc. and BCC)04/23/2024
EXECUTIVE SUMMARY
Recommendation to approve a Purchase Agreement and a Business Associate Agreement between Central
Florida Behavioral Health Network, Inc., and Collier County Board of County Commissioners in the amount
of $163,170, to participate in the Coordinated Opioid Recovery (CORE) Network of Addiction Care program
in which funding will be used toward preventing and treating substance abuse in Collier County, authorize
necessary Budget Amendments, and authorize the County Manager, or their designee, to execute any
required documentation.
OBJECTIVE: To utilize CORE funding to disrupt the opioid epidemic through point of care and medication-
assisted treatment (MAT) with emphasis on the continuity of care.
CONSIDERATION: The CORE program, piloted by the State to address substance abuse and recovery to disrupt
the opioid epidemic, is managed by Central Florida Behavioral Health Network (CFBHN) through the Department
of Children and Families (DCF). In November 2023, Collier County was named as a CORE Expansion County to
the 12 Legacy Counties. Collier County EMS will work to support CORE objectives through a sustained system of
care to manage the complex medical needs of our patients.
EMS will provide MAT at the point of care in compliance with standing orders addressing immediate needs and
connecting patients with resources to support recovery. EMS has plans to deploy the following scope of work:
(a) Ensure around the clock access to initial treatment, ensuring the highest level of care.
(b) Ensure continuity of care and access to resources designed to support unrestricted treatment and access to
peer services.
(c) EMS will purchase and supply Deterra Kits to support a community wide at home drug disposal program
and Narcan.
(d) Purchase NarcBoxes and control panel for secure narcotics storage.
(e) Purchase tablets for field staff.
(f) Implement ImageTrend Community Health Add-on software for tracking, reporting, and analysis on
community paramedicine and mobile integrated healthcare (CP/MIH) projects.
EMS will be responsible to evaluate outcomes and adjust accordingly to ensure the continued effectiveness of the
program. This program will work in conjunction with CCSO Behavioral Health Bureau, Collier Health Services
Federally Qualified Health Center and David Lawrence Center. Collaboration with these agencies will ensure that
individuals receive a higher level of care and have access to clinic providers.
The Agreement has an effective date of April 1, 2024, and will continue in effect until June 30, 2024. The total
award amount is $163,170 and will support the required purchases of software, equipment, medical supplies and
other administrative costs. Community and Human Services Division will assist EMS staff with providing
administrative support associated with the grant administration and will utilize the administrative funds set aside to
support staff cost. EMS Division will utilize best procurement methods to procure items to include 3 quotes,
piggybacks, and waivers. Tablets are available through county approved contract, CDW. Due to the limited date
range of this agreement, division will not be going out for any solicitations.
FISCAL IMPACT: A budget amendment is necessary to recognize CFBHN revenue within the EMS Grant Fund
(4053), Project 33901 in the amount of $163,170.00. Funding is reimbursed at a prorated amount each month,
provided that EMS meets the stated deliverables. There is no match requirement associated with this agreement.
GROWTH MANAGEMENT IMPACT: There is no Growth Management impact associated with this item.
LEGAL CONSIDERATIONS: This item is approved for form and legality and requires a majority vote for Board
approval. - CJS
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04/23/2024
RECOMMENDATION: Approve a Purchase Agreement and a Business Associate Agreement between Central
Florida Behavioral Health Network, Inc., and Collier County Board of County Commissioners in the amount of
$163,170, to participate in the Coordinated Opioid Recovery Network of Addiction Care in which funding will be
used toward programs that prevent and treat substance abuse in Collier County, authorize necessary Budget
Amendments, and authorize the County Manager, or their designee, to execute any required documentation.
Prepared By: Cherie DuBock, Accounting Supervisor, EMS
ATTACHMENT(S)
1. CORE Business Associate Agreement (PDF)
2. CORE Agreement 4.12.24 (PDF)
3. Guidance Document 41 - CORE (PDF)
4. DCF Master Contract - Amendment 74 (PDF)
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04/23/2024
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.F.2
Doc ID: 28555
Item Summary: Recommendation to approve a Purchase Agreement and a Business Associate Agreement
between Central Florida Behavioral Health Network, Inc., and Collier County Board of County Commissioners in
the amount of $163,170, to participate in the Coordinated Opioid Recovery (CORE) Network of Addiction Care
program in which funding will be used toward preventing and treating substance abuse in Collier County, authorize
necessary Budget Amendments, and authorize the County Manager, or their designee, to execute any required
documentation.
Meeting Date: 04/23/2024
Prepared by:
Title: – Emergency Medical Services
Name: Cherie DuBock
04/12/2024 9:54 AM
Submitted by:
Title: – Emergency Medical Services
Name: Bruce Gastineau
04/12/2024 9:54 AM
Approved By:
Review:
Community & Human Services Tami Bailey Other Reviewer Completed 04/12/2024 10:24 AM
Community & Human Services Carolyn Noble Other Reviewer Completed 04/12/2024 11:50 AM
Procurement Services Francheska Correa Level 1 Purchasing Gatekeeper Completed 04/15/2024 8:59 AM
Emergency Medical Services Bruce Gastineau EMS Chief Review Completed 04/15/2024 9:31 AM
Community & Human Services Kristi Sonntag Other Reviewer Completed 04/16/2024 8:40 AM
Grants Erica Robinson Level 2 Grants Review Completed 04/16/2024 8:50 AM
Emergency Management Michael Choate Executive Director Review Completed 04/16/2024 11:31 AM
Procurement Services Sandra Srnka Procurement Director Review Completed 04/16/2024 12:56 PM
Office of Management and Budget Debra Windsor Level 3 OMB Gatekeeper Review Completed 04/16/2024 1:03 PM
Corporate Business Operations Jennifer Reynolds OMB Reviewer Completed 04/16/2024 1:31 PM
Office of Management and Budget Agnieszka Chudy OMB Reviewer Completed 04/16/2024 2:05 PM
County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 04/16/2024 2:18 PM
Grants Therese Stanley OMB Reviewer Completed 04/17/2024 10:11 AM
County Manager's Office Amy Patterson Level 4 County Manager Review Completed 04/17/2024 3:52 PM
Board of County Commissioners Geoffrey Willig Meeting Pending 04/23/2024 9:00 AM
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16.F.2.aPacket Pg. 1242Attachment: CORE Business Associate Agreement (28555 : CORE Grant Purchase Agreement)
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16.F.2.aPacket Pg. 1248Attachment: CORE Business Associate Agreement (28555 : CORE Grant Purchase Agreement)
16.F.2.cPacket Pg. 1249Attachment: CORE Agreement 4.12.24 (28555 : CORE Grant Purchase Agreement)
16.F.2.cPacket Pg. 1250Attachment: CORE Agreement 4.12.24 (28555 : CORE Grant Purchase Agreement)
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16.F.2.cPacket Pg. 1256Attachment: CORE Agreement 4.12.24 (28555 : CORE Grant Purchase Agreement)
Program Guidance for Managing Entity Contracts
Effective October 1, 2023
Guidance # 41
Coordinated Opioid Recovery (CORE) Network of Addiction Care
Contract Reference: Contract Exhibit A. Administration C-1.23
Authority: Section 394.9082, F.S. C-1.2.3.25
Frequency: Data submission every other week
I. Purpose
This document provides direction and guidance for administration, implementation, and management of Florida’s
Coordinated Opioid Recovery (CORE) Network of Addiction Care. This document outlines the purpose, policy, and
competencies intended to ensure that funds are used effectively to combat opioid use disorder in Florida, in
accordance with state and federal laws and regulations.
To ensure the implementation and administration of this project, the Managing Entity shall require that Network
Service Providers, Emergency Medical Providers, and Emergency Departments participating in a CORE project to
continue with service delivery and reporting as previously required during FY 22/23.
The Managing Entity shall not make any changes or variations from fidelity to the structure, implementation, and data
collection of the CORE model as stated in this document.
II. Program Requirements
1. Provide a 24/7 access point where an individual can access medication assisted treatment (MAT), including
weekends.
2. Ensure a clinic provider is available to receive individuals in need of services from the 24/7 access point,
and that first responders can provide MAT until the individual can be seen in the clinic.
3. Provide treatment for co-morbid alcohol and benzodiazepine use disorders.
4. Ensure individuals receiving services have access to higher levels of care if needed, including outpatient
detox.
5. Ensure the availability of clinical experts in addiction medicine, including licensed therapists in outpatient
services and access to primary care for all individuals served.
6. Perform necessary lab work on all individuals to identify any infectious diseases.
7. Ensure individuals served have access to psychiatric care at the providers clinic or in the community.
8. Ensure availability of peer support staff to assist in navigating the CORE network and other supportive
services needed.
9. Ensure care coordination is available based on an individual's need.
10. Ensure access to a variety of MAT, including buprenorphine (Buprenorphine) and Vivitrol, and referrals for
methadone, if appropriate.
11. Capacity to continue prescribing MAT as long as the prescriber determines the medication is clinically
beneficial, without any arbitrary limits on length of care.
12. Approach to dosing MAT that considers the specific circumstances and use pattern of the individual.
13. Availability to test biological specimens (e.g., urine, blood, hair) for fentanyl at the 24/7 access point and the
receiving clinic.
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Packet Pg. 1257 Attachment: Guidance Document 41 - CORE (28555 : CORE Grant Purchase Agreement)
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14. Network Service Providers, Emergency Medical Providers, and Hospital Emergency Departments shall use
the established clinic intake process.
15. Network Service Providers, Emergency Medical Providers, and Hospital Emergency Departments shall use
the established protocol for induction on buprenorphine.
16. Naloxone kits shall be available to individuals without specific conditional requirements.
17. Provide access to group and individual therapy and recovery support groups facilitated by recovery peer
specialists, where appropriate.
18. Procedures to address phases of treatment.
19. Ability to provide care to pregnant and parenting women.
20. Consistent monitoring of outcome measures and data including the use of the Brief Addiction Monitoring
(BAM) tool and reporting as outlined in Section VIII of this document.
III. Eligibility
The CORE model prioritizes adults aged 18 or older who experience any of the following:
1. A confirmed or suspected opioid overdose requiring naloxone administration.
2. Signs and symptoms of severe opioid withdrawal.
3. Acute opioid withdrawal as a chief complaint.
4. Individuals seeking support for opioid use disorder (OUD) at any county CORE partner location.
IV. CORE Program Model
The CORE model establishes a recovery-oriented continuum of care and support for those seeking treatment and
recovery support services for OUD. This comprehensive approach expands every aspect of overdose response and
treats all primary and secondary impacts of substance use disorder (SUD). The CORE model disrupts the revolving
door of addiction and overdose by providing primary care and peer navigators within the emergency department and
immediately connecting individuals to sustainable overall health care. Department approval is required before
implementing any variation of the CORE model.
The model includes the following tiered approach:
1. Rescue Response
2. Stabilization/ Assessment
3. Long-term Treatment
4. Recovery Supports
V. CORE Sustainability
Sustaining CORE projects in all counties will require blending and braiding from various funding sources at different
levels. All participating counties will be required to submit a CORE Sustainability Plan.
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Packet Pg. 1258 Attachment: Guidance Document 41 - CORE (28555 : CORE Grant Purchase Agreement)
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VI. Managing Entity Responsibilities
To ensure consistent statewide implementation and administration of CORE, the Managing Entity shall ensure all
program requirements as outlined in section II, are met through subcontracts with Network Service Providers. The
Managing Entity shall implement the CORE program model in accordance with the outlined programmatic standards
and in accordance with Florida’s Opioid Abatement requirements. The Managing Entity shall expend the funds on
approved purposes only. The Statewide Council on Opioid Abatement may pass additional measures and
requirements that the Department and Managing Entities must follow when evaluating compliance, performance, and
implementation. The CORE model program standards are as follows:
1. Rescue Response
a. Individual in need of services is treated by first responders (fire rescue/ Emergency Medical Services
(EMS) personnel).
b. Treatment includes use of specialized EMS protocols for overdose and acute withdrawal.
2. Stabilization/Assessment
a. Individual receives treatment in an emergency department (ED) with an addiction stabilization center.
b. Treatment options include medication-assisted treatment, which entails, at a minimum, the ability to
induct individuals on buprenorphine and issue a prescription for buprenorphine that lasts until their
initial appointment with a community-based provider prior to being released from the ED.
c. Individual is assessed and treated for emergent unmet health needs.
d. Specialty-trained medical staff recommend the care best suited for the individual and a peer navigator
facilitates a warm hand off to the long-term treatment provider.
3. Long-Term Treatment
a. Individual receives long-term-care and wrap around support.
b. Individual is treated by a team of licensed and certified professionals that specialize in treating
addiction.
c. Services may include long-term management of medication-assisted treatment, therapy, psychiatric
services, individualized care coordination, pharmacy services, and links to other health services.
d. Individuals shall receive services to address any identified social service needs.
4. Recovery Support
a. Certified Recovery Peer Specialists utilize direct lived experience with SUD and recovery to reduce
stigma and increase engagement into services.
b. Certified Recovery Peer Specialists facilitate warm hand-offs to treatment and recovery community
organizations.
5. Training
a. Ensure clinical and systems training are provided to counties to promote use of evidence-based
delivery of each component. Training topics should be developed based on need in counties.
16.F.2.d
Packet Pg. 1259 Attachment: Guidance Document 41 - CORE (28555 : CORE Grant Purchase Agreement)
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Effective no later than October 1, 2023, Managing Entities in areas with an existing CORE program shall execute
contracts or purchase orders with the pre-existing contracted partners for the implementation of the CORE Network
of Addiction Care.
The Department will identify the next 17 counties to establish a CORE program for implementation in FY 23/24.
VII. Network Service Provider and System Partner Responsibilities
Network Service Providers, Emergency Departments, and Emergency Medical Services shall identify staff to be
responsible for activities required through the CORE partnership. Network Service Providers and system partners
including EDs and EMS shall implement a system of care, known as CORE, and shall provide eligible individuals with
treatment that includes use of specialized protocols for overdose and acute withdrawal and provide MAT. CORE
partners shall work together identifying a point of contact, preferably the peer specialist, to provide warm hand-offs as
the individual transitions to different services.
Network Service Providers and system partners including EDs and EMS shall complete online CORE training
available on the CORE website and any other training required by the Department.
1. Emergency Medical Service - Emergency Medical Service partners shall:
a. Implement use of the EMS Pre-Hospital Buprenorphine-Naloxone Induction for Opioid Use Disorder.
b. Hire and train staff on using appropriate equipment, medication, and protocols.
2. Emergency Department- Emergency Departments shall:
a. Implement use of specialized protocols for overdose and acute withdrawal and provide medication
assisted treatment.
3. Network Service Providers/Receiving Clinics- Network Service Providers/Receiving Clinics shall:
a. Implement CORE model services and supports to provide treatment that includes use of specialized
protocols for overdose and acute withdrawal and medication assisted treatment.
b. Hire and train staff on the established protocols, medication assisted treatment and the use of the brief
addiction monitoring tool (BAM) in accordance with protocols.
VIII. Data and Reporting
1. Data Collection
Opioid settlement funds will be used to implement CORE. A required component of the state’s opioid
settlement is to use an evidence-based data collection process to analyze the effectiveness of substance
use abatement. The opioid settlement states that the State and Local Governments shall receive and report
expenditures, service utilization data, demographic information, and national outcome measures in a similar
fashion as required by the 42.U.S.C. s. 300x and 42 U.S.C. s. 300x-21.
a. Managing Entities shall ensure that all CORE partners comply with the required data collection
process.
b. Data collection should be based on standardized procedures to ensure consistency and accuracy
across all service providers.
c. To evaluate the effectiveness of substance use abatement, the data collection process should
include tracking and measuring key outcome indicators related to opioid use disorder treatment,
such as retention rates, reduction in overdose incidents, and improvements in overall well-being.
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Packet Pg. 1260 Attachment: Guidance Document 41 - CORE (28555 : CORE Grant Purchase Agreement)
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2. Data Management And Privacy
a. All data collected should be stored in a secure and centralized database, accessible only to
authorized personnel, to facilitate accurate reporting and analysis.
b. Regular data audits should be conducted to ensure data integrity and identify any discrepancies or
errors for timely correction.
3. Reporting Mechanism and Format
All CORE partners are required to continue reporting CORE data into the ClearPoint system in the
established format.
4. Data Analysis and Utilization
a. The Department and Managing Entity shall collaborate in analyzing the collected data to assess
the impact and effectiveness of the CORE program.
b. Data analysis should be used to identify potential areas of improvement, refine program strategies,
and inform evidence-based decision-making to enhance the overall effectiveness of the CORE
program.
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Packet Pg. 1261 Attachment: Guidance Document 41 - CORE (28555 : CORE Grant Purchase Agreement)
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Packet Pg. 1347 Attachment: DCF Master Contract - Amendment 74 (28555 : CORE Grant Purchase Agreement)
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Packet Pg. 1348 Attachment: DCF Master Contract - Amendment 74 (28555 : CORE Grant Purchase Agreement)
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Packet Pg. 1349 Attachment: DCF Master Contract - Amendment 74 (28555 : CORE Grant Purchase Agreement)
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Packet Pg. 1350 Attachment: DCF Master Contract - Amendment 74 (28555 : CORE Grant Purchase Agreement)
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Packet Pg. 1351 Attachment: DCF Master Contract - Amendment 74 (28555 : CORE Grant Purchase Agreement)
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Packet Pg. 1352 Attachment: DCF Master Contract - Amendment 74 (28555 : CORE Grant Purchase Agreement)
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Packet Pg. 1353 Attachment: DCF Master Contract - Amendment 74 (28555 : CORE Grant Purchase Agreement)
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Packet Pg. 1354 Attachment: DCF Master Contract - Amendment 74 (28555 : CORE Grant Purchase Agreement)
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Packet Pg. 1355 Attachment: DCF Master Contract - Amendment 74 (28555 : CORE Grant Purchase Agreement)
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Packet Pg. 1356 Attachment: DCF Master Contract - Amendment 74 (28555 : CORE Grant Purchase Agreement)
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Packet Pg. 1357 Attachment: DCF Master Contract - Amendment 74 (28555 : CORE Grant Purchase Agreement)
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Packet Pg. 1358 Attachment: DCF Master Contract - Amendment 74 (28555 : CORE Grant Purchase Agreement)
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Packet Pg. 1359 Attachment: DCF Master Contract - Amendment 74 (28555 : CORE Grant Purchase Agreement)
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Packet Pg. 1360 Attachment: DCF Master Contract - Amendment 74 (28555 : CORE Grant Purchase Agreement)
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Packet Pg. 1361 Attachment: DCF Master Contract - Amendment 74 (28555 : CORE Grant Purchase Agreement)