Backup Documents 03/11/2025 Item #16D 6 16D6
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 02/25/25
Services
2. Jeff Klatzkow, County Attorney County Attorney Office
�Akf M� 3/1i45
3. BCC Office Board of County
Commissioners
4. Minutes and Records Clerk of Court's Office
PRIMARY CONTACT INFORMATION 405-
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact inform ion is needed in the event one of the
addressees above,may need to contact staff for additional or issing information.
Name of Primary Staff Joshua Thomas/C Operations Grants Phone Number 239-252-8995
Contact/ Department Coordinator
Agenda Date Item was March 11,2025 Agenda Item Number 16 DP 7
Approved by the BCC
Type of Document Adult Protective Services MOU Number of Original
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 JT
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
jgnature 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 03/11/25 and all changes made during JT .,,
the meeting have been incorporated in the attached document. The County !on•
Attorney's Office has reviewed the changes,if applicable. li e(';
9. Initials of attorney verifying that the attached document is the version approved by the i
BCC,all changes directed by the BCC have been made,and the document is ready for the Siik b •on
Chairman's signature.
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
MEMORANDUM OF UNDERSTANDING
FOR ADULT PROTECTIVE SERVICES REFERRALS
This Memorandum of Understanding (MOU) is entered into by and between
the following entities:
Area Agency on Aging for Southwest Florida, Inc.
Department of Children and Families
Collier County Board of County Commissioners
PURPOSE
Together, the Parties enter into this Memorandum of Understanding(MOU)to ensure the
timely delivery of services to victims of abuse, neglect, or exploitation. Under this MOU,
the Area Agency on Aging for Southwest Florida, Department of Children and Families, and
Collier County Board of County Commissioners agree to their respective responsibilities as
outlined in the Adult Protective Services Referrals Operations Manual.
OBJECTIVES
1. To maintain a climate of cooperation among agencies in order to achieve equitable
delivery of services to vulnerable elder Floridians who are victims of abuse, neglect, or
exploitation.
2. To promote services and activities designed to protect vulnerable elders and prevent
premature institutionalization, pursuant to Chapters 415 and 430, Florida Statutes.
3. To participate,together by means of shared information, in tracking delivery of services
to elder Floridians who are victims of abuse, neglect, or exploitation in need of home
and community-based services.
4. To provide technical assistance to, and consultation with, each other on matters
pertaining to actual service delivery and to share appropriate assessment information.
The Aging and Disability Resource Center (Area Agency on Aging for Southwest Florida)
defines below which agency will be the intake entity for the Department of Children and
Families' Adult Protective Services referrals in each county in their Planning and Service Area.
All Adult Protective Services (APS) referrals in Collier County, regardless of risk level will be
sent to the following agency:
t/ Area Agency on Aging for SWFL Collier County Board of County
Commissioners
_D_6-
All "high" risk APS referrals will be sent to the following agency:
V Area Agency on Aging for SWFL ✓ Collier County Board of County
Commissioners
All "intermediate" risk APS referrals will be sent to the following agency:
4/ Area Agency on Aging for SWFL Collier County Board of County
Commissioners
All "low" risk APS referrals will be sent to the following agency:
✓ Area Agency on Aging for SWFL Collier County Board of County
Commissioners
The Department of Children and Families and the Department of Elder Affairs may, consistent
with their requirements under ss. 415.106(2) and 430.205(5)(a)(b), F.S., amend this
memorandum at any time in the best interest of the program.
This Memorandum of Understanding shall be in effect indefinitely and reviewed every five
years.
Area Agency on Aging for Southwest
Florida, Inc.: Department of Children and Families:
Signed: Signed:
Name: Name:
Title: Title:
Date: Date:
ATTEST: BOARD OF COUNTY COMMISSIONERS
Crystal Ks Kinzel,.c1prk of•Courts COLLIER COUNTY, FLORIDA
By By: Ato"./....,."14401•44—
Attest as to ai Deputy Clerk Burt L. Saunders, Chairman
signature 6r!!y
Appro • as • •, •• . • legality: Date: 3/11 05
Jeffrey . Kla i \ , County Attorney