Backup Documents 04/14/2026 Item #16D 5ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 D 6
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 4.14.26 BCC MTG
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 Addressees (List in routing order)
Office
Initials
Date
1. Carolyn Noble
Community and Human
CN
2.5.25
Services
2. County Attorney Office —
County Attorney Office
3. BCC Office
Board of County
Commissioners
Dk b-T, *1/5/
V//q
4. Minutes and Records
Clerk of Court's Office
S
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
Carolyn Noble
Phone Number
239-252-5321
Contact / Department
Agenda Date Item was
4.14.26
Agenda Item Number
16.D.5
Approved by the BCC
Type of Document
3 AMEMDMENT # 1 TO BEHAVIORAL
Number of Original
3 DOCUMENTS
Attached
HEALTH SERVICES
Documents Attached
PO number or account
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark "N/A" in the Not Applicable column, whichever is
Yes
N/A (Not
appropriate.
(Initial)
Applicable)
1.
Does the document require the chairman's original signature STAMP OK
CN
2.
Does the document need to be sent to another agency for additional signatures? If yes,
N/A
rovide the Contact Information(Name; Agency; Address; Phone on an attached sheet.
3.
Original document has been signed/initialed for legal sufficiency. (All documents to be
Yes
signed by the Chairman, with the exception of most letters, must be reviewed and signed
by the Office of the County Attorney.
4.
All handwritten strike -through and revisions have been initialed by the County Attorney's
N/A
Office and all other parties except the BCC Chairman and the Clerk to the Board
5.
The Chairman's signature line date has been entered as the date of BCC approval of the
N/A
document or the foal negotiated contract date whichever is applicable.
6.
"Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
YES
si nature and initials are required.
7.
In most cases (some contracts are an exception), the original document and this routing slip
N/A
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
6L-D
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8.
The document was approved by the BCC on above date and all changes made during
]VIA is not
the meeting have been incorporated in the attached document. The County
Cl,�
an option for
Attorne '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
CILDan
WA is`noi
BCC, all changes directed by the BCC have been made, and the document is ready for the
option for
Chairman's signature.
this line.
Fiscal Year of Award:
2025
Agreement No.:
BHIT25-01
Acti%its_
Behavioral Health
Services
CONTRACTOR:
David Lawrence
Mental Health Center
Total Award Amount:
594.235.91
IJF"I rt:
P13E31.MA$J4Y1 1
FE:IN:
59-22060215
Period of Performance:
10/ 1 /2025-9, 30/2026
Fiscal Year End:
12(2026 i
FIRST AMENDMENT TO CONTRACTOR AGREEMENT BETWEEN
COLLIER COUNTY,
COLLIER COUNTY SHERIFF'S OFFICE
AND
DAVID LAWRENCE MENTAL HEALTH CENTER, INC
BEHAVIORAL HEALTH SERVICES.
THIS FIRST AMENDMENT, is made and entered into on this 0 day of
_. 2026 by and between Collier County, a political subdivision of the State o1'
Florida, (COUNTY) having its principal address as 3339 E. Tamiami Trail. Naples FL 34112,
Collier County Sheriffs Office (CCSO), authorized to do business under the laws of the State of
Florida, having its principal address at 3319 Tamiami Trail East, Suite 218, Naples, FL 34112; and
David Lawrence Mental Health Center, Inc, (CONTRACTOR) a private not -for -profit corporation
under agreement with the State of Florida, Department of Children and Families, through the
Central Florida Behavioral Health Network, Inc, contract, having its principal address at 6075
Bathey Lane, Naples, FL 34116.
WHEREAS, on November 11, 2025, Agenda Item 16.D.7., the Board of County
Commissioners of Collier County (Board) executed an agreement between COUNTY. CCSO, and
CONTRACTOR in which CONTRACTOR agreed to provide mental health services through
Behavioral Health Intervention services to Collier County residents in coordination with CCSO
and provide in -jail mental health services (the "Agreement'); and
WHEREAS, the Parties desire to amend the Agreement to update/add language in scope
of work, policies and forms, program details, notices, records and documentation. HIPPA,
miscellaneous and Exhibits B-1. E. E-1, F, G, 14, 1, and J.
NOW, THEREFORE, in consideration of the foregoing Recitals, and other good and
valuable consideration, the receipt and sufficiency of which is hereby mutually acknowledged, the
Parties agree to modify the Agreement as follows:
DAVID I.AWRENCE CENTER INC'
1311IT25-41 Amendment at
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1 SD5
Words Sm ••iThrough-are deleted; Words Underlined are added.
PART
SCOPE OF SERVICES
The CONTRACTOR shall in a satisfactory and proper manner and consistent with any standards
required as a condition of providing services as provided herein and as determined by Collier
County Community and Human Services (CHS) Division and CCSO, perform the tasks necessary
to provide mental health services to residents of Collier County.
Project Name: Behavioral Health Services
Description of Project: CONTRACTOR shall provide the services required by components
outlined below (i.e., 40 hours per week, excluding paid time off for vacation, holiday, sick
time, and other time away from work in accordance with CONTRACTOR's human
resources policies):
Project Component One: Behavioral Health inten,entron Team (BRIT) Services, Licensed
Clinician: The licensed clinician will participate on all calls with law enforcement in co -
response for the BHIT- Behavioral Health Services, and DLC staff shall assist with risk
management, provide wellness checks for clients, and provide referral services and linkage
with the appropriate service to clients.
Project Component Two: Baker Act -Related Psychiatric Services and Coordination:
CONTRACTOR shall provide services for Collier County jail inmates who are under
Baker Act that the CONTRACTOR is unable to accept at its facility, by providing
availability of a Psychiatrist (MD/DO) or Advanced Practice Registered Nurse (APRN),
and Baker Act Coordinator (BAC) for 12 hours (including travel time to jail and/or
courthouse) each, per week, Monday -Friday.
Baker Act Related Psychiatric Services: The Psychiatrist (MD/DO) or Advanced Practice
Registered Nurse (APRN) will:
• Complete Baker Act -mandated evaluations, perform medication consultations, and
satisfy Baker Act release/discharge. Telehealth may be utilized, when necessary, as
agreed by the parties.
• Consult with CCSO contracted medical staff regarding medication
recommendations and client prognoses. These services may be completed via
telehealth.
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DAVID LAWRENCE CENTER INC.
BHIT25-01
Amendment # I
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• Attend Baker Act -related hearings and court proceedings. Such participation will
be in -person unless the magistrate provides express permission for participation via
video conference.
The Baker Act Coordinator (BAC) will:
• Complete all necessary Baker Act -related paperwork.
• Attend Baker Act -related hearings and court proceedings as needed to represent
CONTRACTOR. Such participation will be in -person unless the magistrate
provides express permission for participation via video conference.
Project Component Three: Project Recovery Substance Use Treatment Program (PRP).
The CONTRACTOR will operate an intensive outpatient program for substance use
disorders for inmates in the Naples Jail Center.
All professionals provided by CONTRACTOR will:
• Be licensed, certified or registered (as appropriate in the respective areas of
expertise pursuant to applicable law).
• Have personnel files which shall include, but are limited to proof of professional
certification, position responsibilities, and annual security training certification.
Staffing Matrix
Position*
FTE
Paid Rate
Benefits
Fully
Rate
Loaded
Rate
Qualified Behavioral Health
2
32.46
7.47
39.93
Professional —B41 P
Psychiatrist (MD/DO) — Baker Act
0.30
164.54
37.84
202.38
Baker Act Coordinator — Baker Act
0.30
26.04
5.99
32.031
Qualified Behavioral Supervisor,
Licensed Clinician or masters level
registered intern expected to achieve
1
39.20
9.02
48.22
licensure within one year of starting
Project Recovery Program (PRP)
Supervisor role
Licensed Addiction Counselor — PRP
1
36.05
8.29
44.34
Addiction Counselor — PRP
1
28.35
6.52
34.87
Total FTEs
5.60
* The staff positions listed above are salaried exempt. Assumes Monthly Staffing Reconciliations
will include hours for vacation, sick. holiday. and training.
DAVID LAWREiNCE CENTER INC.
E3HIT25-01
Amendment 41
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1 6D511
1.1 POLICIES AND FORMS SPECIAL CONDITIONS
A. CONTRACTOR must submit the following Policies and Forms to CHS within 60 days
of execution of this Agreement. For policies that were established more than three (3)
years prior to the date of the Agreement CONTRACTOR must also provide the date
of the last review for each policy.
® Affirmative Action/Equal Employment Opportunity Policy
® Conflict of Interest Policy (COI) and related COI Forms
® Procurement Policy
® Sexual Harassment Policy
® Section 504/ADA Policy
® Fraud, Waste, and Abuse Policy
® Language Assistance and Planning Policy (LAP)
® Limited English Proficiency Policy (LEP)
® Business Associate Agreement between DLC and CCSO
Violence Against Women Act Policy (VAWA)
M Code of Ethics Policy
B. Limited English Proficiency - Persons who, as a result of national origin, do not speak
English as their primary language and who have limited ability to speak read write or
understand English ("limited English proficient persons" or "LEP persons") may be
entitled to language assistance under Title VI of the Civil Rights Act of 1964 (Title VI)
in order to receive a particular service, benefit, or encounter. In accordance with Title
VI and its implementing regulations, CONTRACTOR agrees to take reasonable steps
to ensure meaningful access to activities funded with LIP Funds by LEP persons. Any
of the following actions could constitute "reasonable steps," depending on the
4
DAVID LAWRENCE CENTER INC.
BHIT25-01
Amendment # I
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�6D5
circumstances: acquiring translators to translate vital documents-, advertisements or
notices: acquiring interpreters for face-to-face interviews with LEP persons: placing
advertisements and notices in newspapers that Serve LEP persons; partnering with other
organizations that serve LEP populations to provide interpretation translation or
dissemination of information regarding the project hiring bilingual employees or
volunteers for outreach and intake activities: contracting with a telephone line
interpreter service: etc.
1.2 PROGRAM DETAILS
A. Program Description/Program Budget
Description
Project Component 1: The licensed clinician will participate on all calls with law enforcement in
co -response for the 13141T Behavioral Health Services, and DLC staff shall assist with risk
management, provide wellness checks for clients and provide referral services and linkage with
the appropriate service to clients.
Project Component 2: The Psychiatrist (MD/DO) Advanced Practice Registered Nurse (APRN)
will complete Baker Act -mandated evaluations; perform medication consultations; satisfy Baker
Act release/discharge and consult with YesCare Correctional Health medical staff regarding
medication recommendations and client prognoses. These services may be completed via
telehealth. The MD/DO will also attend Baker Act -related hearings and court proceedings. Such
participation will be in -person unless the magistrate provides express permission for participation
via video conference.
The Baker Act Coordinator (BAC) will complete all necessary Baker Act -related paperwork and
attend Baker Act -related hearings and court proceedings as needed to represent CONTRACTOR.
Such participation will be in -person unless the magistrate provides express permission for
participation via video conference.
Project Component 3: Project Recovery Substance Use Treatment Program (PRP). The
CONTRACTOR will operate an intensive outpatient program for substance use disorders for
inmates in the Naples Jail Center.
Project Component 4: All professionals provided by CONTRACTOR will be licensed, certified
or registered (as appropriate in the respective areas of expertise pursuant to applicable law). All
personnel files shall include, but are limited to proof of professional certification, position
responsibilities, and annual security training certifications.
CONTRACTOR will accomplish the following checked project tasks:
® Maintain and retain at CONTRACTOR location, client files, records, and any other
client information, and provide to the COUNTY and/or CCSO as requested
DAVID LAWRENCE CENTER INC.
BHIT25-01
Amendment # I
CAO
� sDS
® Ensure all client data, tiles, records, accounts, and any other information of any
nature are maintained in accordance with the Health Insurance Portability and
Privacy Act (HIPAA).
® Enter all required data elements into the Collier County Data Collaborative.
® Provide Quarterly Performance Reports
® Identify Lead Program Manager
® Ensure attendance by a representative from executive management at scheduled
partnership meetings, as requested by CHS
B. Performance Deliverables
Program Deliverable
Supporting Documentation
Submission Schedule
Insurance
Proof of coverage in
Within 30 days following
accordance with Exhibit A and
Agreement execution and
Section 3.8
annually within 30 days
after renewal
Policies
Policies as stated in this
Within 60 days of
Agreement
Agreement execution
Quarterly Performance Report
Exhibit C
Quarterly by 30" of the
month following previous
quarter end.
HIPAA Business Associate
Agreement between CCSO and
Executed within 120 days
Agreement
CONTRACTOR
following agreement
execution
Professional Licenses
Copies of CONTRACTOR's
Upon agreement execution
professional licenses, certified
and annually, submitted to
or registered, (in their
Jail Administration.
respective areas of expertise per
State of Florida Law) allowing
them to perform the obligations
of this Agreement
CCSO Security Training
Certificate of Completion
Upon Agreement execution
and annually thereafter to
be submitted to CCSO
Administration
Position Responsibilities
Job Description
Upon Agreement execution
and at any time job
description changes;
submitted to CCSO
Administration
DAVID LAWRENCE CENTER INC.
BHIT25-01
Amendment k I
CAO
6 D5
Program Deliverable
Supporting Documentation
Submission Schedule
Annual Audit Monitoring
Report
Exhibit C
Annually, within 60 days
after CONTRACTOR'S
fiscal year end
Financial and Compliance
Audit
Audit, Management Letter, and
Supporting Documentation
Annually: nine (9) months
after FY end for Single
Audit OR one hundred
eighty (180) days after FY
end
Subrecipient/Developer/Vendor
SubfeeipientiDeyeleperNendef
Upon execution of the
Agreement, for all
employees who work on
activities associated with
the Project and upon hiring
of all new employees who
will work on activities
Conflict of Interest Disclosure
Form
r'en fli t intefest Disel
of stiff
Fefm Exhibit F
associated with the project.
Whistleblower Protections
Certification - Organization
Exhibit E
Upon execution of the
Agreement €er- all
. tiyities asseeiated with
Pr-ejeet hifing
the and upon
of all new efnpleyees and
prior to execution of all
subsequent amendments
Whistleblower Protections
Exhibit E-1
Upon execution of the
Certification — Contractor Staff
Agreement, for all
employees who work on
activities associated with
the Project and upon hiring
of all new employees who
will work on activities
associated with the project
Affidavit Regarding Labor and
Services (Trafficking)
Affidavit Exhibit G (Applicable
to DLC only)
Upon execution of this
Agreement and prior to
execution of all subsequent
amendments.
Never Contract with the Enemy
Exhibit H
Upon execution of this
Certification
Agreement and prior to
DAVID LAWRENCE: CENTER INC.
BH1125-01
Amendment #I
CAA
16D5�'
Program Deliverable
Supporting Documentation
Submission Schedule
execution of all subsequent
amendments.
Drug; -Free Workplace
Certification
Exhibit I
Within 30 days of
Agreement execution and
annually throughout the
period of performance.
Anti -Discrimination, Fair
Exhibit J
Within 30 days of
Agreement execution and
Housing, and Equal
Opportunity Certification
annually • throughout hroughout the
period of performance.
Consent to Verify Immigration t�
NA
Not Applicable
Status (SAVE)
1.6 NOTICES
Notices required by this Agreement shall be in writing and delivered via mail (postage
prepaid), commercial courier, personal delivery, or sent by facsimile or other electronic
means. Any party may change the address to which notices are to be sent to it by giving
written notice of such change to the other parties in the manner herein provided for giving
notice. Any notice, request, instruction, or other document delivered or sent as aforesaid
shall be effective on the date of delivery or sending. All notices and other written
communications under this Agreement shall be addressed to the individuals in the
capacities indicated below, unless otherwise modified by subsequent written notice.
COLLIER COUNTY ATTENTION: Carolyn Noble, Grant Coordinator
Collier County Government
Community and Human Services Division
2671 Airport Pulling Road, Suite 202
Naples, Florida 34112
Email: carolyn.noble� % . collier.gov
Telephone: (239) 252-5321
CCSO ATTENTION: Marien Ruiz, General Accounting Manager
Collier County Sheriff's Office
3319 Tamiami Trail East
Naples, FL 34112
Email: marien.ruiz@colliersheriff.org
Telephone: (239) 252-0852
CONTRACTOR ATTENTION: Scott Burgess, CEO & President
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DAVID LAWRENCE CENTER INC.
BHIT25-01
Amendment 41
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16D5
David Lawrence Mental Health Center. Inc.
6075 Bathey Lane
Naples, Florida 34116
Email: scottbndlcenters.org
Telephone: (239) 354-1425
PART II
REQUIREMENTS
is 1k fr
2.2 RECORDS AND DOCUMENTATION
The CONTRACTOR and/or its subcontractors shall keep orderly and complete records of
its accounts and operations related to the services provided under this Agreement for the
entire term of the Agreement plus three (3) years. The CONTRACTOR and/or its
subcontractors shall keep these records open to inspection by COUNTY personnel at
reasonable hours during the entire term of this Agreement. If any litigation, claim, or audit
commences prior to the expiration of the three (3) year period and extends beyond this
period, the records must remain available until any litigation, claim, or audit has been
resolved. Any person duly authorized by the COUNTY shall have full access to, and the
right to examine any of said records during said period. Access to Protected Health
Information (PHI) shall comply with federal laws and the Health Insurance Portability and
Accountability Act (HIPAA).
CONTRACTOR shall provide the public with access to public records on the same terms
and conditions that the COUNTY and CCSO would provide the records, and at a cost that
does not exceed the cost provided in Chapter 119, Florida Statutes or as otherwise provided
by law. CONTRACTOR shall ensure that exempt or confidential public records that are
free from public records disclosure requirements are not disclosed.
IF CONTRACTOR HAS QUESTIONS REGARDING THE
APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO
CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS
RELATING TO THIS AGREEMENT, IT SHALL CONTACT THE
CUSTODIAN OF PUBLIC RECORDS AT 239-252-0630,
Samantha.Addison(a,colliersheriff.org, 3319 Tamiami Trail East, Naples,
FL 34142.
9
DAVID LAWRENCE CENTER INC.
BHfl'25-01
Amendment # I
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16D5*
CONTRACTOR shall be responsible for the creation and maintenance of client files and
documentation that persons served were eligible under State of Florida requirements.
CONTRACTOR agrees that CHS shall be the final arbiter on the CONTRACTOR's
compliance.
CONTRACTOR shall document how it complied with the Program. components, the
aptJlicable regulations, and the eligibility requirements under which funding was received.
This includes special requirements such as necessary and appropriate determinations.
CONTRACTOR shall take reasonable cybersecurity and other measures to safeguard
information including protected personally identifiable information (PII) and other types
of information in accordance with 2 CFR 200.303(e). "This includes information that I4UD
DCF. CCSO or the COUNTY designates as sensitive, or other information the COUNTY
considers sensitive and is consistent with applicable Federal, State, and Local laws
regarding privacy and responsibility over confidentiality.
2.3 HIPAA COMPLIANCE
Some or all of the Services, and the files, books, accounts, records and other information
of any nature, however recorded or stored (Records), and related to the Services provided
by CONTRACTOR will be subject to the Health Insurance Portability and Accountability
Act (HIPAA) and Section 394.461 5, Florida Statutes. Accordingly, Records shall at all
times belong to CONTRACTOR and to the extent possessed by COUNTY and CCSO,
such possession shall be for the operation of the B141 Behavioral Health Services. The
COUNTY and CCSO's possession of the Records is solely for the purpose of enabling
CONTRACTOR to enhance its performance hereunder and upon termination of this
Agreement, the COUNTY and CCSO shall return any Records in its custody or possession
upon demand by CONTRACTOR.
CONTRACTOR certifies that it will conduct all of its obligations under this Agreement in
full compliance with the Health Insurance Portability and Accountability Act of 1996
(HIPAA) and ensure the complete confidentiality of all participant medical information
that may come into their possession during the term of this Agreement. CONTRACTOR
shall provide the COUNTY and CCSO with a fully executed Business Associate
Agreement as a requirement of this Agreement.
PART III
TERMS AND CONDITIONS
10
DAVID LAWRENCE CENTER INC.
13HI725-01
Amendment 41
C'A o
16 D5 11
3.13 MISCELLANEOUS
CONTRACTOR, CCSO, and COUNTY each binds itself, its partners, successors, legal
representatives, and assigns of such other party in respect to all covenants of this
Agreement.
CONTRACTOR represents and warrants that the financial data, reports, and other
information it furnished to the COUNTY and CCSO regarding the Program are accurate
and complete, and financial disclosures fairly represent the financial position of
CONTRACTOR.
CONTRACTOR understands that client information collected under this Agreement is
private and the use or disclosure of such information, when not directly connected with the
administration of the COUNTY's, CCSO's, or CONTRACTOR's responsibilities with
respect to services provided under this Agreement, is prohibited unless written consent is
obtained from such person receiving service and, in case of a minor, that of a responsible
parent/guardian.
CONTRACTOR certifies that it has the legal authority to receive the Funds under this
Agreement, and its governing body has authorized the execution and acceptance of this
Agreement. CONTRACTOR also certifies that the undersigned person has the authority to
legally execute and bind CONTRACTOR to the terms of this Agreement.
The section headings, subheadings, and numbers contained in this Agreement are included
for convenience of reference only and shall not limit or otherwise affect the terms of this
Agreement. If there is any conflict between any such headings, subheading, or numbers,
and the text of this Agreements, the text shall control. Each of the statement set forth in the
premises of this Agreement is incorporated in the Agreement as a valid and binding
representation of the party or parties to whom it relates.
All activities authorized by this Agreement shall be subject to and performed in accordance
with the provisions of the terms and conditions of the Agreement; the Regulations; and all
applicable Federal, State, and Municipal laws, ordinances, regulations, orders, and
guidelines, including but not limited to any applicable regulations issued by the COUNTY
and CCSO.
The Agreement Documents shall be construed in accordance with and governed by the
laws of the State of Florida, without ig ving effect to its provisions regarding choice of laws
Any suit or action brought by either party to this Agreement against the other party relating
DA VID L.AWRENCE CENTER INC.
13111125-U
Amendment # I
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1 gp5
to or arising out of this Agreement must be brought in the appropriate federal or state courts
in Collier County, Florida which courts have sole and exclusive jurisdiction on all such
matters.
The CONTRACTOR and/or its subcontractors shall obtain and possess throughout the
term of this Agreements all licenses and permits applicable to its operations under federal,
state, and local laws, and shall comply with all fire, health, and other applicable regulatory
codes.
Electronic Signatures. This Agreement, and related documents entered into in connection
with this Agreement, are signed when a party's signature is delivered by facsimile, e-mail,
or any other electronic medium. These signatures must be treated in all respects as having
the same force and effect as original signatures.
3.16 SUBJECT TO APPROPRIATIONS
It is further understood and agreed by and between the parties herein that this Agreement
is subject to appropriation by the Board of County Commissioners
12
DAVID LAWRENCE CENTER INC.
BHIT25-01
Amendment H I
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16D5
EXHIBIT B-1
Exhibit B Definitions, Behavioral Health Services Grant
Metric 1. Number of Persons Received at DLC under a Baker Act is defined as any
admission to Crisis Stabilization or Emergency Services which includes adult and children
This would also include any client admitted transferred or released regardless of referral
source. This would also include voluntary and involuntary referrals under the Baker Act_
Referral sources will consist of law enforcement ex parte internal and external outpatient
provider, hospital, and self -referrals.
Metric 2. Number of Admissions delivered to DLC by CCSO under a Baker Act initiated by
DLC Mobile Response Team (MRT) is defined as any admission where an MRT clinician
completed the request for involuntary examination (i.e., the Baker Act form) and then called
CCSO to transport the individual to DLC to complete the Baker Act evaluation process
Metric 3. Number of Provider visits with CCJ inmates under a Baker Act is defined as any
provider service completed with an individual who is physically located at the jail while under a
Baker Act. This includes any psychiatric evaluation or medication management service and
includes both in -person and telehealth visits.
CAo
6 D 5
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2 Cl-R 200.2
i 7
-11
U.S.C.
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16D5
EXHIBIT E
COLLIER COUNTY COMMUNITY & HUMAN SERVICES
WHISTLEBLOWER PROTECTIONS CERTIFICATION -ORGANIZATION
CONTRACTOR Name:
CONTRACTOR Address:
In accordance with 2 CFR 200." 17 and 41 U.S.C. 5 4712, CONTRACTOR may not discharge, demote, or
otherwise discriminate against an employee in reprisal for disclosingto o any of the list of persons or entities
provided below, information that the employee reasonably believes is evidence of gross mismanagement of
a federal contract or grant, a gross waste of federal funds, an abuse of authority relating to a federal contract
or grants, a substantial and specific danger to public health or safety, or a violation of law, nile, or regulation
related to a federal contract (including the competition for or negotiation of a contract) or grant.
The list of persons and entities referenced in the paragraph above includes the following:
• A member of Congress or a representative of a committee of Congress
• An Inspector General
• The Government Accountability Office
• A Treasury employee responsible for contract or grant oversight or mana eg ment
• An authorized official of the Department of Justice or other law enforcement agency
• A court or grand jury
• A management official or other employee of SUBRECIPIENT, contractor, or subcontractor who
has the responsibility to investigate, discover, or address misconduct
CONTRACTOR shall inform its employees in writing of whistleblower rights and remedies provided under
section 41 U.S.C. § 4712, in the predominant native language of the workforce.
By signing this form, I certify that Contractor Name will comply with all Whistleblower rights and
protections for its employees.
Signature:
CAO
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EXHIBIT E-1
COLLIER COUNTY COMMUNITY & HUMAN SERVICES
WHISTLEBLOWER PROTECTIONS CERTIFICATION — CONTRACTOR STAFF
CONTRACTOR Name:
CONTRACTOR Address:
Employee Name:
Project Name:
Project No:
In accordance with' C'F R_ 200.217 and -41_ l_ti.('._�, 7 I', CONTRACTOR may not discharge, demote. or
otherwise discriminate against an employee in reprisal for disclosingto o any of the list of persons or entities
provided below, information that the employee reasonably believes is evidence of gross mismana egg ment
of a federal contract or grant, a gross waste of federal funds, an abuse of authority relating to a federal
contract or grants, a substantial and specific danger to public health or safety, or a violation of law, rule, or
regulation related to a federal contract (including the competition for or negotiation of a contract) or grant.
The list of persons and entities referenced in the paragraph above includes the following:
• A member of Congress or a representative of a committee of Congress
• An Inspector General
• The Government Accountabilit)• Office
• A Treasury employee responsible for contract or grant oversight or mana eg ment
• An authorized official of the Department of Justice or other law enforcement agency
• A court or grand jury
• A management official or other employee of CONTRACTOR, contractor, or subcontractor who
has the responsibility to investigate, discover, or address misconduct
CONTRACTOR shall inform its employees in writing of whistleblower rights and remedies provided under
section 41 U.S.C. § 4712, in the predominant native language of the workforce.
By signing this form, I certify that I have reviewed and understand my Whistleblower rights and protections
as stated above.
Name:
Signature:
t:AO
1 6D5
EXHIBIT F
Collier Countv Department of Community and Human Services (CHS)
Subrecipient/DeveloverNendor Conflict of Interest Disclosure Form
The purpose of this document is to assist in the determination of whether additional restrictions, oversight,
or other conditions might be advisable prior to execution of any contract or providing assistance. The tern
"Conflict of Interest" refers to situations in which financial or other personal considerations may
compromise or have the appearance of compromising, professional judgment in following the rules and
regulations applicable to your award.
Please Note: A family member is defined as: a spouse child stepchild parent sibling, domestic partner or
relative by marriage.
Please answer every question in this form and complete the form attachment if applicable. This form must
be provided to your assigned CHS Grant Coordinator.
Employee Name:
Subrecipient/Sponsor Name:
Subrecipient/Sponsor Address:
Subrecipient/Sponsor City, State, Zip
Code:
Agreement Number
Funding Source:
Agreement Amount:
A. Family Relationships:
Does any employee board member or person in your agency have a family member directly or indirectly
involved or employed with CHS or Collier County that creates a conflict of interest or the appearance of a
conflict under HUD's Conflict of Interest regulations?
Yes n No (If YES, please complete the attachment)
B. Program Relationships:
Does any employee, board member or person in your agency serve or is appointed to an CHS and/or Collier
County Board/Committee that may create a conflict of interest. or the appearance of a conflict under the
Conflict of Interest regulations?
n Yes n No (If YES, please complete the attachment)
Does an employee of CHS and/or Collier County serve on your agency's Board of Directors, staff. or in
any capacity which may create a conflict of interest, or the appearance of a conflict under the Conflict of
Interest regulations?
(n Yes n No (If YES, please complete the attachment)
CAC)
I6D5
Does any elected official of Collier County serve on the agency's Board of Directors, which may create a
conflict of interest, or the appearance of a conflict under the C'onflict of Interest regulations?
n Yes n No (If YES, please complete the attachment
Is any employee, board member and/or person (as described above) in your agency involved in an other
ther
activity, directly or indirectly, with CHS and/or Collier Countyy of that may create a conflict of interest or
the appearance of a conflict under the Conflict of Interest regulations?
❑ Yes n No (If YES, please complete the attachment)
C. Business Relationships:
Is any employee, board member, person in your agency, or a family member involved as an investor, owner,
employee, consultant, contractor, or board member with an entity that has a contractual relationship with
CHS and/or Collier County to provide goods or services, sponsor development activities, and/or receive
referrals from CHS and/or Collier County?
[l Yes n No (If YES, please complete the attachment)
I understand that, under this agreement, no employee, board member, person in my agency, or family
member involved in workingon n the grant program, in any capacity, may be involved as an investor, owner,
employee consultant contractor, or board member with an entity that has a contractual relationship with
my organization to provide goods or services. sponsor development activities, and/or receive referrals.
n Yes n No
I have read and understand the Conflict of Interest Disclosure Form. I have disclosed all information
required by this disclosure if any, in an attached statement. 1 agree to comply with any conditions or
restrictions imposed by the CHS and/or Collier County to reduce or eliminate actual and/or potential
conflicts of interest I will update this disclosure form promptly, relevant circumstances change. I
understand that this Disclosure is not a confidential document.
If DCF determines that a conflict of interest exists, this contract may voided and terminated and yo
may required to return any and all undirtg allocated, whether used or not used.
Printed Name Date
Signature
CA O
v
Collier County-CHS
Conflict of Interest Disclosure Form Attachment
Employee Name:
CONTRACTOR Name:
CON'TRACTOR Address:
CONTRACTOR City, State, Zip
Code:
Agreement Number
Funding Source:
Agreement Amount:
If you answered YES to any question on the previous page please complete the relevant section(s) below
and provide this completed form to your Grant Coordinator.
If you answered NO to ALL the questions, you may discard this attachment.
A. Familv Relationships:
1. Name of the family member(s) directly or indirectly
involved or employed by CHS/Collier County:
2. Do any of the family members work in the program
n YES (� NO
area?
3. Are any of the family members elected officials of
Collier County? YES n NO
4. Relationship:
5. Position:
B. Program Relationships:
1.Other Activities: Name and describe and
federal/county activity and/or program that you/your
organization are directly or indirectly involved with?
2. Have you used the agencies' name, resources
(facilities personnel, or equipment), or confidential n YES n NO
information in connection with the activity and/or
program described in # I above?
If YES, describe the resource used
3. Name of the employee, board member or person (as
described above) serving or appointed to serve on an
CHS and/or Collier County Committee/Board/pro >r� am:
4. Name of board/committee:
5. Does any CHS employee or County official serve on (� YES n NO
Your encv's Board of Directors?
t-AO
16D5
If yes, please complete the following information:
Name:
Position:
Department:
Supervisor:
C. Business Relationships:
Please complete this section for EACH business relationship or attach a separate explanation of
business and research activities.
1. Name of Business:
2. Categorize the business' relationship with
CHS and/or Collier Counri.
❑ Consultant or Advisor
(� Research Activities
n Business or Referrals
(� Other contractual or business relationship
Briefly describe the business, or licensing_
activ ijy:
3. Who is involved with the business? — Check ❑ Employee Name:
all that apply ❑ Family member (name & relationship) -
Describe the position or involvement — Check
all that apply
4. Are they receiving any type of
compensation?
If YES, describe:
5. Who at the CHS and/or Collier County
oversees the relationshir)with this business?
Name:
Title:
Department:
Phone:
n Owner/Investor
❑ Board Member
❑ Employee/Manager
❑ Other:
n YES n NO
Printed Name Date
Signature
16D5
EXHIBIT G
AFFIDAVIT REGARDING LABOR AND SERVICES (Applicable to DLC Only)
Effective July 1, 2024, pursuant to 787.06(13 ), Florida Statutes, when a contract is executed, renewed,
or extended between a nongovernmental entity and a governmental entity, the nongovernmental entib
must provide the governmental entity with an affidavit signed by an officer or a representative of the
nongovernmental entijy under penalty of perjury attesting that the nongovernmental entity does not use
coercion for labor or services.
Nongovernmental Entity's Name:
Address:
Phone Number:
Authorized Representative's Name:
Authorized Representative's Title:
Email Address:
Project Name:
Project Number
AFFIDAVIT
I (Name of Authorized Representative), as authorized representative
attest that (Name of Nongovernmental Entity) does not use coercion for labor
or services as defined in � 787.06, Florida Statutes.
Under penalty of perjury I declare that I have read the foregoing Affidavit and that the facts stated in it are true.
(Signature of authorized representative) Date
STATE OF
COUNTY OF
Sworn to (or affirmed) and subscribed before me, by means of ❑ physical presence or ❑ online notarization this
day of 20 , by (Name of Affiant), who produced
their as identification or are personally known to me.
Notary Public (not required when digitall
Commission Expires
Personally Known ❑ OR Produced Identification 0
Type of Identification Produced:
CAO
1 6 D5
EXHIBIT H
COLLIER COUNTY COMMUNITY & HUMAN SERVICES
NEVER CONTRACT WITH THE ENEMY CERTIFICATION
CONTRACTOR Name:
CONTRACTOR Address:
Pro-ect Name:
Project No:
In accordance with 2 CFR._Fart 183 and 2_CFR 200.1.5 CONTRACTOR shall exercise due diligence to ensure that
no funds including supplies and services received under this Agreement are provided directly or indirectly
(including through subawards or contracts) to a person or entity who is actively opposing the United States or
coalition forces involved in a contingency operation in which members of the Armed Forces are actively engaged
in hostilities which must be completed through 2 CFR 180.300 prior to issuing a subaward or contract.
CONTRACTOR shall terminate or void in whole or in partany subaward or contract with a person or entity listed
in the System for Award Management (SAM ovg ) as a prohibited or restricted source pursuant to subtitle E of the
Title VIII of the NDAA for FY 2015 unless the Federal agency_ provides written approval to continue the subaward
or contract.
The COUNTY and/or Federal agencv has the authority to terminate or void this Agreement, in whole or in part, in
the COUNTY or Federal agency becomes aware that CONTRACTOR has failed to exercise due diligence as
required above or if the COUNTY or Federal agency becomes aware of any funds received under this Agreement
have been provided directly or indirectly to a person or entity who is actively opposing coalition forces involved in
a contingency operation in which members of the Armed Forces are actives engaged in hostilities.
By signing this form I certify that Contractor Name will not contract or subcontract with any person or entity that
is actively opposing the United States or which the Armed Forces are actively engaged in hostilities.
Name:
Signature:
Title:
CAO
16D5
Collier County
Community & Human Services Division
EXHIBIT I
CERTIFICATION REGARDING DRUG -FREE WORKPLACE REQUIREMENTS
The CONTRACTOR certifies that it will provide a drug -free workplace by:
(a) Publishing a statement notifying, employees that the unlawful manufacture, distribution, dispensing,
possession or use of a controlled substance is prohibited in the grantee's workplace and specifying, the
actions that will be taken against employees for violation of such prohibition;
(b) Establishing a drug -free awareness program to inform employees about—
(1) The dangers of drug abuse in the workplace;
(2) The S CONTRACTOR'S policy of maintaining a drug -free workplace;
(3) Any available drug, counseling, rehabilitation and employee assistance programs, and
(4) The penalties that may be imposed upon employees for drug abuse violations occurringin n the
workplace.
(c) Making it a requirement that each employee to be engaged in the performance of the grant be given a
copy of the statement required by paragraph (a);
(d) Notifying the employee in the statement required by paragraph_ (a) that, as a condition of employment
under the grant, the employee will—
(1) Abide by the terms of the statement; and
(2) Notify the employer of any criminal drug statute conviction for a violation occurrin in n the
workplace no later than five days after each conviction.
(e) Notifying the agency within ten days after receiving notice under subparagraph (d)(2) from an
employee or otherwise receiving actual notice of such conviction;
(f) Taking one of the following actions within 30 days of receiving notice under subparagraph (d)(2), with
respect to any employee who is so convicted—
(1) Taking appropriate personnel action against such an employee,p to and including termination; or
(2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation
program approved for such purposes by a Federal, State, or local health, law enforcement. or other
appropriate agency;
Making a good faith effort to continue to maintain a drug, -free workplace through implementation of
paragraphs (a), (b), (c), (d), (e) and (fl.
Authorized Re resentatiye Name:
Title:
Signature.
Date:
CA(,
1 6D5
Collier County
Community & Human Services Division
EXHIBIT J
CERTIFICATION OF COMPLIANCE WITH
ANTI -DISCRIMINATION FAIR HOUSING AND
EQUAL EMPLOYMENT OPPORTUNITY LAWS
CONTRACTOR Name:
Program and Project Name
Grant/Contract Number:
PURPOSE
As a condition of participation in programs funded or administered by Collier County, all subrecipients,
contractors, developers, and vendors must comply with all applicable federal, state, and local
nondiscrimination laws, rules, and regulations. This certification affirms compliance with those
requirements.
CERTIFICATION
The undersigned certifies that, in the performance of work under this agreement, Contractor Name and its
employees, agents, and subcontractors shall comply with non-discrimination, fair housing, and equal
opportunity laws, including but not limited to: (see attachment for definitions of laws and other regulations
Federal Non -Discrimination Laws:
1. Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq.) —prohibiting
discrimination on the basis of race, color, or national origin.
2. Title VII of the Civil Rights Act of 1964 —prohibiting; employment discrimination based on
race, color, religion, sex, or national origin.
3. Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. § 794) — prohibiting discrimination
based on disability.
4. The Americans with Disabilities Act of 1990 (42 U.S.C. & 12I01 et seq.).
5. Title II of The Age Discrimination Act of 1975 (42 U.S.C. § 6101 et seq.).
6. Title IX of the Education Amendments of 1972 (20 U.S.C.§ 1681 et seq.) — prohibiting
discrimination based on sex.
7. Section 109 of the Housing and Community Act of 1974 — prohibiting discrimination based on
race, color, national origin, religion, or sex
8. Section 808(e)(5) of Title VIII of the Civil Rights Act of 1968, as amended (The Fair Housing
Act 42 U.S.C. § 3601 et seq.) — prohibiting discrimination in housing -related activities.
9. Housing and Community Development Act of 1974 (§ 104(b)(2), as amended and the National
Affordable Housing, Act (§ 105(b)(3) — Requires Affirmatively Furthering Fair Housing
2. State and Local Requirements:
1. Chapter 760, Florida Statutes — Florida Civil Rights Act of 1992.
2. Collier County Ordinances and policies related to equal opportunity, fair housing, and
nondiscrimination in the provision of County -funded services.
-e
Communit% & Human Services Division • 3339 Tamiami Trail East, Suite 213 • Naples. FT 34112-5361 •239-252-C:ARE (2273) ICAO
239-252-CAFE (2233) • 239-252-5713 (RSVP) • w-.vNk.collier.gov
16D5
3. Equal Opportunity in Employment and Service Delivery:
The CONTRACTOR shall ensure that no person will on the grounds of race color, religion, sex. gender
identity° sexual orientation national origin ace disability, familial status. or any other protected
classification be excluded from participation in denied the benefits of or otherwise subjected to
discrimination under any program or activity receiving County funds.
4. Fair Housing:
The CONTRACTOR agrees to take affinnative steps to ensure equal access to all programs and services
and to carry out activities in a manner that supports the County's obligation to affirmatively further fair
housing.
The CONTRACTOR certifies that neither the subrecipient or its contractors have any pending or civil rights
legal proceedings against them or any "Probable Cause- civil rights detenninations -for fair housing and/or
equal opportunity violations in the delivery of its programs and/or services which have not been remedied.
CONTRACTOR will become informed of pertinent federal and local civil rights laws and regulations that
affect the execution of their services and activities.
5. Posting and Notice:
The CONTRACTOR agrees to post in conspicuous places available to employees applicants and program
participants, notices setting forth this policy of nondiscrimination.
6. Certification Statements:
The CONTRACTOR certifies that:
A. Programs and services are accessible to persons with disabilities.
B. Reasonable accommodation will be provided upon request.
C. Facilities used for funded activities are accessible or reasonable alternatives are provided.
D. No qualified individual with a disability will be excluded from participation or denied benefits.
The CONTRACTOR agrees to maintain records demonstrating compliance with all these requirements and
to cooperate with monitoring, audits and reviews conducted by the County, Grantor, or their designees.
The CONTRACTOR understands that failure to comply with these requirements may result in corrective
action repayment of funds suspension or termination of the agreement or other remedies permitted by
law.
Signature Page to Follow
Community & Iluman Services Division • 3339 Tamiami Trail East, Suite 213 • Naples, FL 341 12-5361 • 239-252-CARE (2273) CAO
?39-75)-CAFF 01131 • ?39-151-i713 /RSVP1 • aukv collier.onv
16D5
I hereby certify that the organization named above will comply with all applicable nondiscrimination laws and that
all activities under this agreement will be conducted in a manner free of discrimination as defined by the laws and
regulations cited herein.
Authorized Re resentative Name:
Title:
Si nature•
Date:
Or anization Name:
Address:
Phone:
Email:
Return completed certification via upload into Neighborly.
Community B Hurnan Services Division • 3339 Tamiami "trail East. Suite 213 • Naples. FL 34112-5361 • 239-252-CARE (2273) CAU
? 29-?5?-('AFi` r'+�i2t • ?i9-?5?_i71't tRSVPr • vtitivwv.rnllier onv
ATTACHMENT TO EXHIBIT J
For Information Purposes only
Please consider the emimrment before pnrrt,rg this page `,�
EQUAL OPPORTUNITY
Definitions of Laws and Regulations
Constitutional Basis. The guarantee of civil rights has a constitutional
as well as statutory base Civil rights laws are an extension and
interpretation of the equal protection and due process requirements of
the United States Constitution
Overlapping Coverage of Activities. More than one civil rights law
may apply to a single type of activity
D C. LANGUAGE ACCESS ACT OF 2004 Provides greater access
and participation in public services, programs and activities to
residents of the District of Columbia with limited or no -English
proficiency by requiring that District government programs,
departments and services assess the need for, and offer, oral language
services, provide written translations of documents into any non-English
language spoken by a limited or no -English proficient population that
constitutes 3 percent or 500 individuals whichever is less, of the
population served or encountered or likely to be served or
encountered 'Equal Access and Full Participation- allows LEP
residents to be informed of, participate in, and benefit lion public
services programs and activities offered by a city department or agency
at a level equal to English proficient individuals 'Limited or no English
Proficiency' means the inability to adequately understand the English
language or express oneself in the spoken or written English language
EXECUTIVE ORDER 131£6: Eliminates to the extent possible, limited
English proficiency as a barrier to full and meaningful participation by
beneficiaries in all federally assisted conducted programs and activities
Section 808(e)(5) of TITLE Vill OF THE CIVIL RIGHTS ACT OF
1968, as amended (FAIR HOUSING ACT)Requires grantees to
administer its housing and community development programs in a
manner to Affirmatively Further Fair Housing (AFFH)
HOUSING AND COMMUNITY DEVELOPMENT ACT of 1974 §104
(b)(2), as amended and the National Affordable Housing Act §105
(b)(3) Require that localities certify they will AFFH Policies should
actively promote greater housing opportunities for all persons while
maintaining a non-discriminatory environment in all aspects of pudic
and private housing markets Activities can range from education
outreach, enforcement, avoiding undue concentration of assisted
persons in areas with law- and moderate- income persons provide
translation and interpretaton services for persons who are Limited
English Proficient assist in the development of accessible housing for
persons with disabilities etc
EXECUTIVE ORDER 12892: Leadership and Coordination of Fair
Housing in Federal Programs Affirmatively Furthering Fair
Housir-g, as amended: Requires federal agencies to affirmatively
further fair housing in their programs and activities, and provides that
the Secretary of HUD wit be responsible for coordinating the effort
The Order also establishes the Presidenrs Fair Housing Council which
will be chaired by the Secretary of HUD
docat, adB3R"eupME :?
TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 (TITLE VI). Prohibits
discrimination based on race color or national origin in programs and
activities receiving 'Federal financial assistance' Complaints received
from a program participant or service recipient will be forwarded to the
Fair Housing Equal Opportunity division at the U S Department of
Housing and Urban Development
httos /i ww iusbco govtaVfcs/TNeVI-Overvlew
EXECUTIVE ORDER 11063, NON-DISCRIMINATION: (Non -
Discrimination and Equal Opportunifyin Housing) directs HUD and
all other executive departments and agencies to take appropriate action
to promote the abandonment of discriminatory practices regarding
property or facilities owned or operated by the Federal Government
or provided with Federal financial assistance in the sole, leasing, rental,
or other disposition of such property or facilities
AGE DISCRIMINATION ACT OF 1975 Prohibits (i) discrimination
based on age in programs or activities receiving Federal financial
assistance directly or through contractual licensing, or other
arrangements and (2) age distinctions or actions that have the effect
based on age of
e excluding individuals from denying them the benefits of, subjecting
them to discrimination under a program or activity receiving federal
financial assistance, or
• denying or limiting individuals their opportunity to participate in
any program or activity receiving Federal financial assistance
SECTION 109, HOUSING & COMMUNITY DEVELOPMENT ACT OF
1974 Requires that no person in the United States shall —on the grounds
of race. color national ongin. religion or sex— be excluded from
participation in, be denied benefits of. or be subjected to discrimination
under any program or activity receiving Federal financial assistance made
available under the Act Section 109 also directs that the prohibitions
against discrimination based on age under the Age Discrimination Act
and the prohibitions based on disability under Section 504 shall apply
to programs or activities receiving Federal financial assistance under Title
I programs
EXECUTIVE ORDER 11246, as amended: Bars discrimination in federal
employment because of race, color, religion, sex, or natonal ongin This
order was superseded by Executive Order 11478 (Sec 401 1101), which
called for affirmative action programs for equal opportunity at the agency
level under general supervision 0 the Civil Service Commission
Title II of the AMERICANS WITH DISABILITIES ACT of 1990: Title 11 of
the Americans With Disabilities Act prohibits discrimination based on
disability in programs services, and activities provided or made available
by public entities These provisions are the same as those in Section 504,
except they apply to all programs and activities— not just those funded with
Federal financial assistance HUD enforces Title II when it relates to state
and local public housing housing assistance and housing referrals
EXECUTIVE ORDER 13217. Commundy-Based Alternatives for
Individuals with Disabilities, 6i19,2001 Requires federal agencies to
evaluate their policies and programs to determine if any can be revised or
modified to improve the availability of community -based living
arrangements for persons with disabilities
TITLE iX OF THE EDUCATION AMENDMENTS OF 1972 - Title IX is a
comprehensive federal law that prohibits discrimination based on sex in
any feJerally funded education program or activity The principle objective
of Title lX is to avoid the use of federal money to support sexually
discriminatory practices in education programs such as sexual harassment
and employment discrimination. and to provide individual
tl "S
Cotnmunin_ K Human Ser%ices t)ivision - 3339 Tumiami trail hilt. Suite 213 - piapic.N. 11. 341 I_-53b1 • 239-252-('.ARF t2273) CAQ
?3() )i?4`AF1' II?i:i - 1119-1i1-i711 iRCI'Pi - ut3-xv w711ier c,ric
ATTACHMENT TO EXHIBIT J - PAGE 2
citizens effective protection against those practices. Title IX applies with
a few specific exceptions, to all aspects of federally funded education
programs or activities. In addition to traditional educational institutions
such as colleges, universities, and elementary and secondary schools,
Title IX also applies to any education or training program operated
by a recipient of federal financial assistance. Many of these education
program providerslrecipients became subject to Title IX regulations when
the Title IX final common rule was published on August 30, 2000,
APPLICABLE REGULATIONS
24 CFR Part 1: Nondiscrimination in Federally Assisted Programs
of HUD: Implementing regulations for Title Vt of the Civil Rights Act of
1964.
24 CFR Part 3: Nondiscrimination on the Basis of Sex in Education
Programs or Activities receiving Federal Financial Assistance:
Implementing regulations forTitle IX of the Education Amendments Act of
1972.
24 CFR Part 8: Nondiscrimination Based on Handicap:
Implementing regulations for Section 504 of the Rehabilitation Act of
1973. These regulations obligate recipients of funding to make their
programs accessible to persons with disabilities. The regulations also
establish physical accessibility requirements when Federal financial
assistance is used for new construction or rehabilitation of housing.
24 CFR Parts 91.225 (a)(1): Affirmatively Furthering Fair Housing
(CDBG Entitlement grantees): Each jurisdiction must certify that it will
affirmatively further fair housing, including conducting an analysis of
impediments to fair housing choice, taking appropriate actions, and
maintaining records.
24 CFR 570.487(b): Affirmatively Furthering Fair Housing (CDBG
states and small cities grantees):. Requires the state and each local
government to certify that it will affirmatively further fair housing. The
state is required to assume responsibility by (1) conducting an analysis
to identify impediments to housing choice; (2) taking appropriate actions
to overcome the effects of the impediments; (3) maintaining records of
analysis and actions, and (4) ensuring that units of local government
funded by the state comply with the certification requirements
24 CFR 570.601: Fair Housing (CDBG Entitlement grantees): The
following apply: Title VI of the Civil Rights Act of 1964 (and
implementing regulations at 24 CFR Part 1), Housing and Community
Development Act (including §104(b)(2)); and Executive Order 11063, as
amended by 12259 (with implementing regulations in 24 CFR part 107.
24 CFR Parts 100.125: Fair Housing. §100: Discriminatory conduct
under the Fair Housing Act §103: Fair Housing Complaint processing
§107: Nondiscrimination and equal opportunity in housing under EO
11063 §108: Compliance procedures for affirmative fair housing
marketing §110: Fair housing poster §115: Certification and funding of
State and local fair housing enforcement agencies §121: Collection of
data §125: Fair housing initiatives program.
24 CFR 570.206(c): Fair Housing Activities.. CDBG Program
Administrative Costs include the provision of fair housing services
designed to further the objectives of the Fair Housing Act, including
enforcement and other activities designed to further the objective of
avoiding concentrations of assisted persons in areas containing a high
proportion of low and moderate income persons.
24 CFR Part 91.325(b)(5): Compliance with anti -discrimination laws. A
certification that the grant will be conducted and administered in
Updated 03/I2.GPN.EG,TG
conformity with Title VI of the Civil Rights Act of 1964 and the Fair
Housing Act, and implementing regulations.
24 CFR 570.608 and Part 35: Lead -Based Paint: Children under
age six are particularly susceptible to hazards from lead based
paint. Owners of units where lead paint has been controlled can
affirmatively market those units to families with children. If a unit has
not undergone lead hazard control treatments, a family with children
may choose to live in the unit, if the housing provider advises the family
of the condition of the unit. A family cannot be forced to permanently
move from a unit if the family declines treatment of lead hazards,
although the housing provider can offer incentives for the move.
CPD•05-09 (issued November 3, 2005). Accessibility Notice: Section
504 of the Rehabilitation Act of 1973 and The Fair Housing Act and their
applicability to housing programs funded by the HOME Investment
Partnerships Program and the Community Development Block Grant
Program.
CPD•05.10 (issued November 3, 2005). Accessibility for Persons with
Disabilities to Non -Housing Programs funded by Community
Development Block Grant Funds — Section 504 of the Rehabilitation Act
of 1973, the Americans with Disabilities Act and the Architectural
Barriers Act
Major Community Development Based Grant (CDBG) activities and the
corresponding civil rights laws that affect them.
Cam' APPLICABLE FEDERAL CIVIL RIGHTS LAWS
ACTIVITY
Title Vt. Civil Rights Act of 1964
Benefits,
Section 109, Housing and Community Development Act of
Services
1974, as amended (HCDA 1974)
Methods of
Section 504, Rehabilitation Act of 1971 as amended
Administration
Age Discrimination Act of 1975 as amended Section
104 HCDA of 1974. as amended
Housing and Title Vill, Civil Rights Act of 1968, as amended (Federal
Related Fair Housing Law)
Facilities Executive Order 11063, as amended
Section 104 HCDA of 1974, as amended
Section 109, HCD Act of 1974, as amended
Section 3, Housing and Urban Development Act of 1968,
Employment as amended (HUDA of 1968)
Executive Order 11246. as amended
Section 504 Rehabilitation Act of 1973, as amended
Contracting Section 109. HCDA of 1974, as amended
(Business Section 3 HUDA of 1968. as amended
Opportunities)
Title VI, Civil Rights Act of 1964
Displacement' Section 109 HCDA of 1974, as amended
Relocation Title Vlll, Civil Rights Act of 1968, as amended
Section 104, HCDA of 1974, as amended
J� N
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('ornntunin & Iluman Service-, Division • 3339'Fannianti I rail East. Suite 213 • Naples. 1:1.. 341 12-5361 - 239-252-C'ARE (2273) CAO
I39-7i2-C'AF-11' 0� I21 • 119-151-5713 (RWP) • tv�vxv of) lli,-r nm
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IN WITNESS WHEREOF, the CONTRACTOR, CCSO, and COUNTY have each respectively,
by an authorized person or agent, hereunder set their hands and seals on the date first written above.
ATTEST:
CRYSTAL K. KIN EL, CLERK
eputy Clerk
Date. � y
-, r L)
uESSES-
�e . 44�
Witness 41 Signature
/, -C a tw-a
.ss 41 Printed Name
bc-�3 1sE kw' -Nu m
Witness #2 Printed Name
Approved as to form and legality:
I
C,D
Courtney L. DaSilva 3111/&
Assistant County Attorney
Date: / 17Zn
AS TO COUNTY:
BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA
By:
DANIEL KOWAI-, CHAIRPERS N
Date:
AS TO CCSO :
COLLIER COUNTY SHERIFF'S OFFICE
By:
KEVI A B SK,SHERIFF
Date: 5 -3 1-2k?
[Please provide evidence of signing authority]
AS TO CONTRACTOR:
DAVID LAWRENCE MENTAL HEALTH
CENTER, INC.
SCOtT VkG SS EO & PRESIDENT
Date:
[Please provide evidence of signing authority]
CA