Backup Documents 12/09/2014 Item #16D 5 16 0 _
HOUSING HUMAN AND VETERIAN SERIVCES
INTEROFFICE MEMORANDUM
TO: Board Minutes and Records
FROM: Lisa N. Carr, Grants Coordinator, HHVS
DATE: December 9, 2014
RE: Contract amendments between Area Agency on Aging for Southwest Florida, Inc
and Collier County: ADI 203.14.002, HCE 203.14.002, CCE 203.14.001 and
HM203.14.001
Please find attached one (1) each fully executed documents that were approved by the BCC on
the day listed below for recording in Minutes and Records. Feel free to contact me if you have
any questions.
BCC Approved on December 92014:
Item: 16.D ADI 203.114.001, HCE 203.14.001 and CCE 203.14.001
Item: 16.D.10- HM203.14.001
Thank you for your assistance.
Amendment 002 July 2014 to June 2015 ADI 203.14.002
AGING •
6 0
FOR SOUTHWEST FLORIDA, NC. 1 5
AREA AGENCY ON
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commissioners, ("Contractor"), amends agreement ADI 203.14.
The purpose of this amendment is to change effective date for rates and revise ATTACHMENT K, SERVICE RATE
REPORT.
Line denotes completion of above summary
This amendment shall be effective September 30, 2014. All provisions in the agreement and any attachments thereto in
conflict with this amendment shall be and are hereby changed to conform with this amendment
All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the
agreement.
This amendment and all of its attachments are hereby made a part of this agreement.
IN WITNESS WHEREOF, the parties hereto have caused this 2 page amendment to be executed by their officials there
unto duly authorized.
Recipient: COLLIER COUNTY BOARD OF AREA AGENCY ON AGING FOR SOUTHWEST
COUNTY COMMISSIONERS FLORIDA,INC.
SIGNED BY: ( C4� afil SIGNED BY: Wrgimosteti
ti
NAME: Stephen Y. Carnell NAME: MARIANNE G LORINI
TITLE: Public Services Administrator TITLE: PRESIDENT/CEO
DATE: u ( g ( )
DATE: ///) 2 l y
Federal Tax ID: 59-6000558
Fiscal Year Ending Date: 09/30
Approved as to form and legality
Assistant Cou t torney
1
Amendment 002 July 2014 to June 2015 ADI 203.14.002
16 0 5
ATTACHMENT K
SERVICE RATE REPORT
Rate Summary effective July 1 through July 31, 2014
HIGHEST METHOD OF
DELIVERABLES REIMBURSEMENT
UNIT RATE PAYMENTS
Case Aide: Collier $30.00 Fixed Fee/Unit Rate
Case Management: Collier $58.33 Fixed Fee/Unit Rate
Respite In-Facility: Collier $12.22 Fixed Fee/Unit Rate
Respite In-Home: Collier $25.67 Fixed Fee/Unit Rate
Specialized Medical Equipment, Services and Supplies Cost Reimbursement
Rate Summary effective August 1, 2014
HIGHEST METHOD OF
DELIVERABLES REIMBURSEMENT
UNIT RATE PAYMENTS
Case Aide: Collier $33.88 Fixed Fee/Unit Rate
Case Management: Collier $60.00 Fixed Fee/Unit Rate
Respite In-Facility: Collier $12.83 Fixed Fee/Unit Rate
Respite In-Home: Collier $25.67 Fixed Fee/Unit Rate
Specialized Medical Equipment, Services and Supplies Cost Reimbursement
2
1605
Attestation Statement
Agreement/Contract Number: ADI 203.14
Amendment Number 002
I, Stephen Y.Carnell ,attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
Public Services Administrator .
(Signature of Recipient/Contractor name) -
The only exception to this statement would be for changes in page formatting,due to the differences in
electronic data processing media,which has no affect on the agreement/contract content.
I
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1 , (r6 (, c_f_
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Signature of Reci i�/Contractor representative Date
g P
Approved as to form and legality
Assistant Conn omey
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Amendment 002 July 2014 to June 2015 HCE 203.14.002
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
16 0 5
HOME CARE FOR THE ELDERLY PROGRAM
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commissioners, ("Contractor"), amends agreement HCE 203.14.
The purpose of this amendment is to change effective date for rates and revise ATTACHMENT VII,RATE
SUMMARY
Line denotes completion of above summary -
This amendment shall be effective September 30, 2014. All provisions in the agreement and any attachments thereto in
conflict with this amendment shall be and are hereby changed to conform with this amendment
All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the
agreement.
This amendment and all of its attachments are hereby made a part of this agreement.
IN WITNESS WHEREOF, the parties hereto have caused this 2 page amendment to be executed by their officials there
unto duly authorized.
Recipient: COLLIER COUNTY BOARD OF AREA AGENCY ON AGING FOR SOUTHWEST
COUNTY COMMISSIONERS FLORIDA,INC.
•SIGNED BY: alts -f/ �G SIGNED BY: %2 z aA,t ,x G�.OrL(
NAME: Stephen Y. Carnell NAME: MARIANNE G. LORINI
TITLE: Public Services Administrator TITLE: PRESIDENT/CEO
DATE: (
DATE: ////
Federal Tax ID: 59-6000558
Fiscal Year Ending Date: 09/30 Approved as to form and legality
Nkk
1 —
Assistant County : y: a ey _ t\
Amendment 002 July 2014 to June 2015 HCE 203.14.002
•
1605
ATTACHMENT VII
RATE SUMMARY effective July 1 through August 31, 2014
for
Collier County Board of County Commissioners
Charlotte
SERVICES REIMBURSEMENT RATE
Collier
Case Management $55.56
Case Aide $30.00
RATE SUMMARY effective September 1, 2014
SERVICES REIMBURSEMENT RATE
Collier
Case Management $60.00
Case Aide $33.88
2
Attestation Statement
16D5
Agreement/Contract Number: HCE 203.14
Amendment Number 002
I, Stephen Y.Carnell ,attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
Public Services Administrator
(Signature of Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting,due to the differences in
electronic data processing media,which has no affect on the agreement/contract content.
1 ((
Signatu • of Recipie t/Contractor representative Date
Approved as to form and legality
Assistant County ney K
Amendment 001 July 2014 to June 2015 TCE 203.1470n1
1605 AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
COMMUNITY CARE FOR THE ELDERLY PROGRAM
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commissioners, ("Contractor"), amends agreement CCE 203.14.
The purpose of this amendment is to change effective date for rates and revise ATTACHMENT VII, RATE
SUMMARY.
Line denotes completion of above summary
This amendment shall be effective September 30, 2014. All provisions in the agreement and any attachments thereto in
conflict with this amendment shall be and are hereby changed to conform with this amendment
All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the
agreement.
This amendment and all of its attachments are hereby made a part of this agreement.
IN WITNESS WHEREOF, the parties hereto have caused this 2 page amendment to be executed by their officials there
unto duly authorized.
Recipient: COLLIER COUNTY BOARD OF AREA AGENCY ON AGING FOR SOUTHWEST
COUNTY COMMISSIONERS FLORIDA,INC.
SIGNED BY: t ( I SIGNED BY: 5U %'►�'"4.0Li.
� 1
NAME: Stephen Y. Carnell NAME: MARIANNE G LORINI
TITLE: Public Services Administrator TITLE: PRESIDENT/CEO
DATE: ( 1 I b f 14
DATE: //PR//S/
Federal Tax ID: 59-6000558
Fiscal Year Ending Date: 09/30
Approved as to form and legality
Assistant County mey ) 4,
1
\\\
Amendment 001 July 2014 to June 2015 CCE 703.14.1701
16 0 5
ATTACHMENT VII
COMMUNITY CARE FOR THE ELDERLY PROGRAM
RATE SUMMARY effective July 1 through August 31, 2014
for
Collier County Board of County Commissioners
Collier County Total Unit Cost Reimbursement Rate-90%
Case Management $58.33 $52.50
Case Aide $31.50 $28.35
Adult Day Care $12.22 $11.00
Chore $23.33 $21.00
Enhanced Chore $30.33 $27.30
Companion $23.33 $21.00
Skilled Nursing $40.00 $36.00
EARS $ 1.31 $ 1.18
Homemaking $21.50 $19.35
Personal Care $25.67 $23.10
Respite-in-Home $25.67 $23.10
Home Improvement $ Cost Reimbursement 90% Cost Reimbursement
Material Aid $ Cost Reimbursement 90% Cost Reimbursement
Specialized Medical Equipment,
Service& Supplies $ Cost Reimbursement 90% Cost Reimbursement
Transportation $ Cost Reimbursement 90% Cost Reimbursement
RATE SUMMARY effective September 1, 2014
Collier County Total Unit Cost Reimbursement Rate-90%
Case Management $60.00 $54.00
Case Aide $33.88 $30.50
Adult Day Care $12.83 $11.55
Chore $23.33 $21.00
Enhanced Chore $30.33 $27.30
Companion $23.33 $21.00
Skilled Nursing $42.00 $37.80
EARS $ 1.31 $ 1.18
Homemaking $21.50 $19.35
Personal Care $25.67 $23.10
Respite-in-Home $25.67 $23.10
Home Improvement $ Cost Reimbursement 90% Cost Reimbursement
Material Aid $ Cost Reimbursement 90% Cost Reimbursement
Specialized Medical Equipment,
Service& Supplies $ Cost Reimbursement 90% Cost Reimbursement
Transportation $ Cost Reimbursement 90% Cost Reimbursement
2
1605
Attestation Statement
Agreement/Contract Number CCE 203.14
Amendment Number 001
I, Stephen Y. Carnell ,attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
Public Services Administrator
(Signature of Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting,due to the differences in
electronic data processing media,which has no affect on the agreement/contract content.
1.6((lq
Signa ur of Reci ientContractor representative Date
g P
Approved as to form and legality
Assistant County mey
0