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Agenda 03/08/2011 Item #16D3 ,.i_;,:L!;;_~~~f~t&~~~+r:, 3/8/2011 Item 16.0.3. :" ,~",' . .{""'\ JXECUTIVE S~Y Approve Change .OrderNo..cl to Contract 10-5423With,PhysiliianLed Access Netw'~ Inc. for 'I{ealth Infol'lllation Technology Grant with the D~t of Health and . HUDlan$ervices,<l{ealthReS4nlrC($ and Services Ad..-".istra.n.iD ...t.Ile..2lmount of 545,008. OBJECTIVE: To increase the dollar mnount of Contract # 01 0-5428 in the ~ount of $45,000 for the Physician Led Access Network (PLAN), Inc. to compl~te a project with a . Health Information Technology Grant funded by the Departrnent.ofHealtl1andHl.I111an Services,Hea1th Resources and Services Administration CONSIDERATIONS: On January 13, 2009, Agen4a Item 16D2,theBoard of County Commissioners approvedCotttr'act. #. 10-5428 with.PLAN toestahUsh asbared information database between the portals. of entry for the uninsured into thesys.temtoensure patients' needs will be met by the apPropriate medical service in a more;: timely and cost-efficientmanntr. The contract, for $10$;,211, was renewed on January 14, 201 o and extended throu.gh December 31,2011. . Unforturnately, partner organization Health Planning C01Plcil of SWFloridawas unable to implement the chosensof.\ware due to staffmg changes and fiscal constrajnts in PLAN. r--.\ Now, PLAN is able to effectively \ltilize' an information database software that isbeing~by many of our not forprofi.tagencies and also Collier County Social Services Program. to better serve the healthcarenee<Isofthe ~uredpopulation.ofCollier CQunty. The increased dollar flmount is to effectively implement the new infortnationdatabasesysttmt for PLAN. FISCJ\LI~PACT:.ll1efiscal impact to.theChange Order No.1 is $45,000. The funds are available under the earmark. No general furids are associated with thisitem. , GRO~MANAGE!\fENTIMf;cACT: There is no growth management impact as$()C~ with this Executive Summary. LEGAL CONSIDERA nONS: . This item is legally siJfficiel1t for Board action. This item requires a simple majority vote. ~ JBW RECOMMENDATION: That the Board of County Commissioners approves change order No. 1 to Contract 1 0~5428 to increase the contract amount by $45,000 for the Physician Led Access Network and authorizes the Chairman to. sign the Change Order. Prepared by: Marcy Knnnbine, Director, Housing,. Human and Veteran Services r"\ Packet Page -816- 3/8/2011,: ;r;;/.::'::>i::'a:":/i~' (""'\ COLLIER COlJNTY 80ard of COunty COmmi....",rs Item Number: 16.D.3. Item Sum.mary: . Approve Ch..nge. Order No.1 to Contract l(}"S42~. WithPb~$iCi~~;~;\\ Access Network,'nc. for;a He;althlnformation Technology Grant With the Department .Qf.'Heatth and Human Services, HeJfth Resources. and Services Administration in th~ amount of $4S,()OO. Meeting Date: 3/8/2011 Prepared By Name: KrumbineMarcy Title: Director- Housing & }iunUm Services,HousinSt Human. & Veteran SCt"Vices 2118/2011 11:30:50 AM Submitted by r"'\ Title: Director - HQJ.l$mg~ Human Services,Housing, Human~ Vetera,n Services Name: KrumbineMarcy 2/18/20111l:30:5LAM ) Approved By Name: AlonsoHailey Title: Administrative Assistant,Domestic Animal Services Date: 2/18/2011 3:09:16 PM Name: PriceLen Tide: Administrator - Administrative Services, Date: 2/18/2011 3:38:50 PM Name: AckermanMaria Date: 2/22/2011 2:30:55 PM Name: FoordMarlene Title: Grant Development&Mgmt Coordinator, Grants Date: 2/22/20112:45:53 PM f"""', Name: RamseyMarla Packet Page -817- {""'\ {""'\ r\ Title: Acknmistrator, Public Services. Date:2123/20H 12:11:34 PM Name: WhiteJennif~r Title: Assistant County Attorney,County Attorney Date; 212412011 10:24:58 AM Name: KlatzkowJeff Title: County Attorney, Date: 2124/20112:54:01PM 3/8/2011 Item 16.0.3. Name: PryorCheryl Title: Managementl Budget Analyst, S<:nior"Office ofMan~enlent& Bu4iet Date: 2/25/201112:19:40 PM . "Nanje:.lsacksonMark Title:.r..corpFiri~ial and MgmtSvs,CMO Date:2126/20111:11:50PM Packet Page ..;818- 3/8/2011 Item 16.D.3. ~. AGREEMENT THIS AGREEMENT, made and entered into on this 13th day of January, by and between Physician Led Access Network of Collier County, authorized to do business in the State of Florida whose business address is 1012 Goodlette-Frank Rd., Suite #201, Naples, Florida 34101, hereinafter called the "Contractor" (or "Consultant") and Collier County, a political subdivision of the State of Florida, Collier County, Naples, hereinafter call the" County" : WITNESSETH: 1. COMMENCEMENT. The contract shall be for a twenty (20) month period, commencing on January 1 2009, and terminating on August 31, 2010. In the event that additional grant funding becomes available or the grantor extends the grant award, the County may, at its discretion and with the consent of the Consultant, extend the Agreement under all of the terms and conditions contained in this Agreement for two (2) additional one (1) year periods. The County shall give the Consultant written notice of the County's intention to extend the Agreement term not less than ten (10) days prior to the end of the Agreement term then in effect. ~ 2. STATEMENT OF WORK: The Contractor shall provide services in accordance with the terms and conditions of Attachment" A", hereto attached and made an integral part of this agreement. Additional related services may be provided by the Contractor subject to the issuance of Change Orders as approved in advance by the County. Services provided under this contract may include, but not be limited to, the following: a. Establish a shared information database to provide for a more effective and efficient method of health care service for the uninsured population in Collier County. Allowable costs associated with the project are included in Attachment B and consist of the following: 1) Personnel costs and associated fringe benefits 2) Supplies 3) Travel in compliance with Chapter 112, Florida Statute 4) Communication/Marketing/Other 5) Other Contractual costs, i.e. consultants, rent, telecommunications ~ 3. COMPENSATION. The County shall pay for contracted services performed on behalf of PLAN for the performance of this Agreement a total amount of One hundred five thousand two hundred and eleven dollars, ($105,211) based on Packet Page -819- 3/8/2011 Item 16.D.3. allowable expenses incurred. Payment will be made to project vendors upon receipt of a proper invoice and in compliance with Section 218.70 Florida Statutes, otherwise known as the "Florida Prompt Payment Act" and a signed affidavit from the PLAN Executive Director, attesting that the work has been completed. Collier County reserves the right to withhold and/ or reduce an appropriate amount of any payments for work not performed or for unsatisfactory performance of Contractual requirements. ~ The County and U.S. Department of Health and Human Services, Health Resources and Services Administration have agreed that these funds will only be used to fund projects that demonstrate expertise in the area of Health Information Technology. 4. NOTICES. All notices from the County to the Contractor shall be deemed duly served if mailed or faxed to the Contractor at the following address: Physician Led Access Network (PLAN) of Collier County, Inc. 1012 Goodlette-Frank Rd., Suite #201 Naples, Florida 34101 Paul Mitchell, M.D., Board Vice-Chairman Phone: (239) 434-0008 Fax: 239-417-8900 ~ All notices from the Contractor to the County shall be deemed duly served if mailed or faxed to the County to: Collier County Government Center Housing and Human Services Department 3301 Tamiami Trail East Bldg. H/211 Naples, Florida 34112 Attn: Marcy Krumbine, Director Phone: 239-252-2273 Fax: 239-252-2638 The Contractor and the County may change the above mailing address at any time upon giving the other party written notification. All notices under this Agreement must be in writing. 5. NO PARTNERSHIP. Nothing herein contained shall create or be construed as creating a partnership between the County and the Contractor or to constitute the Contractor as an agent of the County. ~ 2 Packet Page -820- 3/8/2011 Item 16.0.3. ~. 6. CONDITIONS. a. Special Conditions: The Contractor agrees to comply with the requirements set forth in the Notice of Grant Award Terms and Conditions (Attachment A). b. Compliance with Local and Federal Rules, Regulations and Laws: During the performance of this agreement, the Contractor agrees to comply with any applicable laws, regulations and orders listed below by reference and incorporated and made a part hereof. The Contractor further agrees to abide by all other applicable laws: ~, i. 24 CFR Part 1 - The regulations promulgated pursuant to Title VI of the 1984 Civil Rights Act. 11. Age Discrimination Acts of 1973. 111. OMB Circular A-133 concerning audits. IV. Executive Order 11914 - Prohibits discrimination with respect to the handicapped in federally assisted projects. v. Florida Statutes, Chapter 112 - which deals with conflict of interest. vi. 45 CFR Part 74.25 Revision of budget and program plans. vii. OMB Circular A-l22 - concerning cost principles. viii. 24 CFR Part 84 - Uniform Administrative Requirements for Grants and Agreements with Institutions of Higher Education, Hospitals and Non-Profit Organizations. 7. SUBCONTRACTS. Any work or services subcontracts by the Contractor shall be specifically by written contract or agreements, and such subcontracts shall be subject to each provision of this Agreement and applicable County, State, and Federal guidelines and regulations. Prior to execution by the Contractor of any subcontract hereunder, such subcontracts must be submitted by the Contractor to Housing and Human Services for its review and approval. None of the work or services covered by the Agreement, including but not limited to consultant work or services, shall be subcontracted by the Contractor or reimbursed by the County without prior written approval of the Housing and Human Services Director or his designee. 8. AMENDMENTS. The County may, at its discretion, amend this Agreement to conform to changes required by Federal, State, County or Health Resources and Services Administration (HRSA) guidelines, directives, and objectives. Such amendments shall be incorporated by written amendment as a part of this Agreement and shall be subject to approval of Collier County. Except as otherwise provided herein, no amendment to this Agreement shall be binding on ~ 3 Packet Page -821- 3/8/2011 Item 16.D.3. either party unless in writing, approved by the County and signed by each Party's . designee. ~ 9. PERMITS: LICENSE TAXES. In compliance with Section 218.80, F.S., all permits necessary for the prosecution of the Work shall be obtained by the Contractor. Payment for all such permits issued by the County shall be processed internally by the County. All non-County permits necessary for the prosecution of the Work shall be procured and paid for by the Contractor. The Contractor shall also be solely responsible for payment of any and all taxes levied on the Contractor. In addition, the Contractor shall comply with all rules, regulations and laws of Collier County, the State of Florida, or the U. S. Government now in force or hereafter adopted. The Contractor agrees to comply with all laws governing the responsibility of an employer with respect to persons employed by the Contractor. 10. NO IMPROPER USE. The Contractor will not use, nor suffer or permit any person to use in any manner whatsoever, County facilities for any improper, immoral or offensive purpose, or for any purpose in violation of any federal, state, county or municipal ordinance, rule, order or regulation, or of any governmental rule or regulation now in effect or hereafter enacted or adopted. In the event of such violation by the Contractor or if the County or its authorized representative shall deem any conduct on the part of the Contractor to be objectionable or improper, the County shall have the right to suspend the contract of the Contractor. Should the Contractor fail to correct any such violation, conduct, or practice to the satisfaction of the County within twenty-four (24) hours after receiving notice of such violation, conduct, or practice, such suspension to continue until the violation is cured. The Contractor further agrees not to commence operation during the suspension period until the violation has been corrected to the satisfaction of the County. ~ 11. PROHIBITION OF GIFTS TO COUNTY EMPLOYEES: No organization or individual shall offer or give, either directly or indirectly, any favor, gift, loan, fee, service or other item of value to any County employee, as set forth in Chapter 112, Part III, Florida Statutes, Collier County Ethics Ordinance No. 2004- 53, and County Administrative Procedure 5311. Violation of this provision may result in one or more of the following consequences: a. Prohibition by the individual, firm, and/ or any employee of the firm from contact with County staff for a specified period of time; b. Prohibition by the individual and/ or firm from doing business with the County for a specified period of time, including but not limited to: submitting bids, RFP, and/ or quotes; and, c. immediate termination of any contract held by the individual and/ or firm for cause. ~ 4 Packet Page -822- 3/8/2011 Item 16.D.3. ~, 12. TERMINATION. Should the Contractor be found to have failed to perform his services in a manner satisfactory to the County as per this Agreement, the County may terminate said agreement immediately for cause; further the County may terminate this Agreement for convenience with a seven (7) day written notice. The County shall be sole judge of non-performance. 13. NO DISCRIMINATION. The Contractor agrees that there shall be no discrimination as to race, sex, color, creed or national origin. a. Executive Order 13166, August 11,2000 requires recipients receiving Federal financial assistance to take steps to ensure that people with limited English proficiency can meaningfully access health and social services. Contractor's organization must comply with this requirement as set forth in Attachment A, page 4 item 9. 14. INSURANCE. The Contractor shall provide insurance as follows: ~ . A. Commercial General Liability: Coverage shall have minimum limits of $1,000,000 Per Occurrence, Combined Single Limit for Bodily Injury Liability and Property Damage Liability. This shall include Premises and Operations; Independent Contractors; Products and Completed Operations and Contractual Liability. B. Business Auto Liability: Coverage shall have minimum limits of $500,000 Per Occurrence, Combined Single Limit for Bodily Injury Liability and Property Damage Liability. This shall include: Owned Vehicles, Hired and Non-Owned Vehicles and Employee Non-Ownership. C. Workers' Compensation: Insurance covering all employees meeting Statutory Limits in compliance with the applicable state and federal laws. The coverage must include Employers' Liability with a minimum limit of $1,000,000 for each accident. Special Requirements: Collier County shall be listed as the Certificate Holder and included as an Additional Insured on the Comprehensive General Liability Policy. ~ Current, valid insurance policies meeting the requirement herein identified shall be maintained by Contractor during the duration of this Agreement. Renewal certificates shall be sent to the County 30 days prior to any expiration date. There shall be a 30 day notification to the County in the event of cancellation or modification of any stipulated insurance coverage.a 5 Packet Page -823- 3/8/2011 Item 16.D.3. Contractor shall insure that all subcontractors comply with the same insurance requirements that he is required to meet. The same Contractor shall provide County with certificates of insurance meeting the required insurance provisions. ".-.., 12. INDEMNIFICATION. To the maximum extent permitted by Florida law, the Contractor or Consultant shall indemnify and hold harmless Collier County, its officers and employees from any and all liabilities, damages, losses and costs, including, but not limited to, reasonable attorneys' fees and paralegals' fees, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of Contractor or Consultant or anyone employed or utilized by the Contractor or Consultant in the performance of this Agreement. This indemnification obligation shall not be construed to negate, abridge or reduce any other rights or remedies which otherwise may be available to an indemnified party or person described in this paragraph. This section does not pertain to any incident arising from the sole negligence of Collier County. 13. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf of the County by the Housing and Human Services Department. .~ 14. CONFLICT OF INTEREST: Contractor represents that it presently has no interest and shall acquire no interest, either direct or indirect, which would conflict in any manner with the performance of services required hereunder. Contractor further represents that no persons having any such interest shall be employed to perform those services. 15. COMPONENT PARTS OF THIS CONTRACT. This Contract consists of the attached component parts, all of which are as fully a part of the contract as if herein set out verbatim: Notice of Grant Award Terms and Conditions (Attachment A) 16. SUBJECT TO APPROPRIATION. 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. ,.-.....,. 6 Packet Page -824- 3/8/2011 Item 16.D.3. r"'. IN WITNESS WHEREOF, the Contractor and the County, have each, respectively, by an authorized person or agent, hereunder set their hands and seals on the date and year first above written, . .', I' . . ....t".. ~ '". . ATI~" . ..t) €IF e....... .,. . ....... '1.16', .,..., . " .. v:"#. . . P:~"'t E. Ikpck:~~rk of Courts ,.l~'I~:'; ~~'~i::.'\;r.~ ". ~ \ YJ,; ,.;, bifte' ,'~, , . ': "'.:..,.. ....... . . . .'. '''A' . '-'.' ....,...'...,~ 1~~'r. , ',"'." ''';''''1' BOARD OF COUNTY COMMISSIONERS COLLIER COUNTY, FLORIDA By: :J~1L . Tbm Henning, Cha~ January 13, 2009 ~~ L[). t o-<";~ '- 'DEi~t'2.A H DA H- LM 4 N ~ S "..--.... ypejprint witness namet Physician Led Access Network (PLAN) of Collier County By: ~8.~P Paul Mitchell, M.D, PLAN Board Vice-Chairman January 13, 2009 Second Witness I ~.rn iJCC/1;' Q / s. tTypejprint witness namet Approved as to form and legal sufficiency: ~1r1~ Colleen M. Green~ Assistant County Attorney .-. 7 Packet Page -825- 3/8/2011 Item 16.D.3. ATTACHMENT B ............., Budget Summary Budget Category Amount A. Personnel $ 50.667 B. Fringe Benefits $ 15.200 C. Travel $ 3.200 D. Equipment $ 0 E. Supplies $ 5.144 F. Construction $ 0 G. Consultants / Contracts $ 11.000 H. Other $ 20.000 Total Direct Costs $105.211 /'"""'.. I. Indirect Costs 0 TOTAL PROJECT COSTS $105.211 ~ 8 Packet Page -826- 2. PROGRAM CFDA: 93.888 r'~ 11. APPROVED BUDGET: (Excludes Direct Assistance) lXJ Grant Funds Only [J Total project costS including grant funds and all other fillSnclal partlcipatlon ~ 3/8/2011 Item 16.D.3. ATTACHMENT A Peg., DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES AND. SERVICES ADMINISTRATION -- $ 0.00 $0.00 $0.00 $0.00 $ 323,911.00 13. RECOMMENDED FUTURE SUPPORT: (Subject to the availability of fund& and satisfactory progress or project) 14. APPROVED DiReCT ASSISTANCE BUDGET: (In lieu of caSh) a. Amount of Direct AssIstance b. Less Unawarded Balance of Current Year's Funds c. Less Cumulative Prior Awards(s) This Budget Period d. AMOUNT OF DIRECT ASSISTANCE THIS ACTION $0.00 $0.00 $0.00 $0.00 fA] REMARKS: (Other Terms and Conditions Attacl1ed lXJ Y.. [] No) Electronically all1111H1 by Dorothy M. Kelley. G,..nfs Manag"",.nt Off1r:er DIl: 081261%008 1T. OBJ. CLASS: 41.51 18. CRS.EIN: 159600055BA1 19. FUTURE RECOMMENDED FUNDING: 1. DATE ISSUED: 0812612008 3. SUPERCEDES AWARD NOTICE dated: . _Ihot__.._.....-,.__..__.-,_ 4.. AWARD NO.: 4b. GRANT NO.: 5. FORMER GRANT NO.: 10181T10T69-01-00 0181110769 NOTICE OF GRANT AWAAO 6. PROJECT PERIOD: AUTHORIZATION (Legislation/Regulation) FROM: 09101/2008 THROUGH: 08/3112010 PubDc Health Servica Act, TrtIe III, Section 330(A} as Amended T. BUDGET PERIOD: Public Health Service Ad., TIUe III, Section 330A FROM: 09101/2008 THROUGH: 08/31/2010 Public Health Service Act, TIUe III, Section 330(1). P.L. 107-251. 8. TITLE OF PROJECT (OR PROGRAM): Con9!1lSSiollSlly-Mandated Health Information Technology Grants II. GRANTEE NAME AND ADDRESS: 10. DIRECTOR: (PROGRAM DIRECTORIPRINC/PAL INVESTIGATOR) Collier County Marcy KlUmbln. . 3301 Tamlami Trail E Collier County Naple., FL 34112-3969 3301 Tamiaml Trail East Naplea , FL 34112-3969 12. AWARD COMPUTAllON FOR FINANCIAL ASSISTANCE a. Authorized Financial Assistance This Period $ 323,811.00 b. Less Unobligated Balance from PriOl' Budget Periods I. Additional Authority II. Offset Co Unawarcled Balance of Current Year's Fund$ d. Less CUmulative Prior Award(s) This Budget Period e. AMOUNT OF FINANCIAL ASSISTANCE THIS ACTION 8. Salaries and Wages: $ 26,250.00 b. Fringe Benefits: S 8,061.00 c. Total Personnel Costs: $ 34.311.00 d. Consultant Costs: $ 0.00 e. Equipment: $ 0.00 f. Supplies: $ 41.300.00 g. Travel: $ 4,400,00 . h. Construction/Alteration and Renovation: $ 0.00 l. Other: $ 82,400.00 J. Consortium/Contractual Costs: $161,500.00 k. Trainee Related Expenses: $ 0.00 r. Trainee Stipends: $ 0.00 m. Trainee Tuition and Fees: $ 0.00 n. Trainee Travel: $ 0.00 o. TOTAL DIRECT COSTS: $323,911.00 p. INDIRECT COSTS: (Rate: % of S&WfTAOC) $ 0.00 q. TOTAL APPROVED BUDGET: $ 323,911.00 I. Less Non-federal Resources: $ 0.00 iI. Federal Share: $ 323.911.00 15. PROGRAM INCOME SUBJECT TO 45 CFR Part 74.24 OR 45 CFR 92.25 SHALL BE USED I" ACCORD WITH ONE OF THE FOLLOWING ALTERNATIVES: AooAddJlIon a-Deduction CooCOIIt Sharing 01' Matching O-other Estimated Program Income: $ 0.00 16. THIS AWARD IS BASED ON AN APPLICATION SUBMllTED TO, AND AS APPROVED BY HRSA, IS ON THE ABOVE TITLED PROJECT AND IS SUBJECT TO THE TERMS AND CONDmONS INCORPORATED EITHER DIREeTL Y OR BY REFERENCE IN THE FOLLOWING: .. n..,..__...__. b. Tho.........____cc ---..-..---.Ofty'----d.41C1'llPo~7....41CFR ....02__..... ----......----op~IO..UIO/l~Iho__d__,.....I.............d..__...._II_.._....._____..._ --...---- ~ Packet Page -827- 3/8/2011 Item 16.D.3. NOTICE OF GRANT AWARD (Continuation Sheet) Page 2 Date Issued: 08/26/2008 Award Number: 1 D1BIT10769-01-00 " HRSA Electronic Handbooks (EHBs) Registration Requirements The Project Director of the grant (listed on this NGA) and the Authorizing Official of the grantee organization are required to register (if not already registered) within HRSA's Electronic Handbooks (EHBs). Registration within HRSA EHBs is required only once for each user for each organization they represent. To complete the registration quickly and efficiently we recommend that you note the 10-cligit grant number from box4b of this NGA. After you have completed the initial registration steps (i.e., created an individual account and associated it with the correct grantee organization record), be sure to add this grant to your portfolio. This registration in HRSA EHBs is required for submission of noncompeting continuation applications. In addition, you can also use HRSA EHBs to perform other activities such as updating addresses, updating email addresses and submitting certain deliverables electronically. Visit https:/Igrants.hrsa.gov/webexternal/login.asp to use the system. Additional help is available online and/or from the HRSA Call Center at 1-877-464-4772. Terms and Conditions Failure to comply with the special remarks and condition(s) may result in a draw down restriction being placed on your Payment Management System account or denial of future funding. Program Terms: 1. Telemedicine Projects: Whenever a third-party payer can be billed for a consult, the grantee may not provide the involved clinician(s) with a grant-funded clinician incentive payment. This remains the rule even when the clinician incentive payment is more than what the third-party payer will reimburse. This also applies when a State Medicaid agency will reimburse for a consult, but the grantee has not yet established its own internal procedure to bill Medicaid. 2. The Universal Service Provisions of the Telecommunications Act of 1996 should make telecommunication rates for eligible rural health providers comparable with rates for urban providers and in many cases thereby reduce transmission costs to rural providers. All eligible applicants and their eligible grant. funded network members must ~ apply for a Universal Service subsidy as soon as possible or demonstrate to OHIT that applying would not provide any financial advantage. Further information on Universal Service is available at: (http://www.rhc.universalservice.org). 3. It is the policy of HRSA to make available to the public the results and accomplishments of the activities that it funds. Therefore, it is incumbent upon project directors, program directors, and principal investigators to make results and accomplishments of their activities available to the public. Prior approval is not required for publishing the results of an activity under a grant. Recipients shall place an acknowledgement of HRSA grant support and a disclaimer, as appropriate, on any publication, briefing paper, report, or other document that is written, published, or otherwise produced (e.g., website, electronic work products) with such support and, if feasible, on any document (electronic or paper) reporting the results of or describing a grant-supported activity. The acknowledgement shall read: "This publication (report, briefing paper, document, website, etc.) was made possible by grant number from the Office of Health Information Technology, Health Resources and Services Administration, DHHS" or "The project described was supported by grant number from the Office of Health Information Technology, Health Resources and Services Administration, DHHS: THREE copies of documents or reports (electronic or paper), resulting from work performed under a HRSA grant-supported project or activity MUST be submitted to OHIT, no matter what the media by which they are disseminated (e.g., publications in joumals, reports, CD-Rom, web). In addition, copies of presentations to major organizations should acknowledge HRSA support and be submitted to the OHIT project officer. THREE reprints of publications or work products resulting from work performed under a HRSA grant supported project or activity MUST be submitted to the OHIT project officer. 4. In the event the grantee organization anticipates that Federal funding available through this award will not be expended by the project period end date, the grantee is required to submit to the grants management representative and project officer indicated in the "contacts" section of this document a request for a no-cost extension to complete goals and objectives. This request, under an original signature of an authorized grant official should be submitted at least 60 days prior to the expiration of the project periOd and include: (a) the grant number, (b) the additional time desired, (c) the grant project goals and objeCtives to be completed and (d) the Federal funds available to complete the 1'""'""'\ goals and objectives with categorical budget and justification. ," Packet Page -828- 3/8/2011 Item 16.D.3. NOTICE OF GRANT AWARD (Continuation Sheet) Page 3 Date Issued: 08/26/2008 Award Number: 1 0181T10769-01-00 ,,-... 5. The grantee institution may retain the entire right, title and interest throughout the world to any inv~ntion (as de~ned in 45 CFR, Section 74.36) it conceives, develops, or implements in the performance of work under this grant, subject to the provisions of the Department of Commerce's regulation 37 CFR Part 401 and 35 U.S.C. 203. The Federal government, however, shall have a nonexclusive, nontransferable, irrevocable, paid-up license to obtain and use the invention for or on behalf of the United States throughout the world. 6. Data Collection and Evaluation: Applicants accepting this award must, if requested, participate in the Office for the Advancement of Telehealth (OAT) data collection and evaluation of telemedicine activities. 7. Telehealth Inventory Assessment: Applicants accepting this award must complete, if requested, a "HRSA Telehealth Inventory." This inventory collects data about the Telehealth capabilities of the grantee's institution and those of the network members. OHIT will provide information regarding this inventory at the time of request. 8. OAT Grantee Directory: Applicants accepting this award must provide information for OHIT's Grantee Directory/Profiles. Further instructions will be provided by OHIT. The current Telehealth directory is available online at: http://telehealth.hrsa.gov/grants/grantee.htm . . 9. Grantees are requested to attend and participate in the OHIT grantee meetings. Programmatic and logistical details will be provided later. 10. When responding to reporting requirements, conditions, and requests for post award amendments to the Division of Grants Management Operations, please send a courtesy copy of your correspondence to the designated project officer. Standard Terms: ~ 1. All discretionary awards issued by HRSA on or after October 1, 2006, are subject to the HHS Grants Policy Statement (HHS GPS) unless otherwise noted in the Notice of Award (NoA). Parts I through III of the HHS GPS are currently available at ftp:/Iftp.hrsa.gov/grants/hhsgrantspolicystatement.pdf and it is anticipated that Part IV, HRSA program-specific guidance will be available at the website in the near future. In addition, HRSA-specific contacts will be appended to Part III of the GPS which identifies Department-wide points of contact. Please note that the Terms and Conditions explicitly noted in the award and the HHS GPS are in effect. Once available, Part IV, HRSA program-specific guidance will take precedence over Parts I and II in situations where there are conflicting or otherwise inconsistent policies. 2. The HHS Appropriations Act requires that when issuing statements, press releases, requests for proposals, bid solicitations, and other documents describing projects or programs funded in whole or in part with Federal money, all grantees receiving Federal funds, including but not limited to State and local governments, shall clearly state the percentage of the total costs of the program or project which will be financed with Federal money, the dollar amount of Federal funds for the project or program, and percentage and a dollar amount of the total costs of the project or program that will be financed by nongovernmental sources. 3. Recipients and sub-recipients of Federal funds are subject to the strictures of the Medicare and Medicaid anti-kickback statute (42 U.S.C. 1320a - 7b(b) and should be cognizant of the risk of criminal and administrative liability under this statute, specifically under 42 U.S.C. 1320 7b(b) Illegal remunerations which states, in part, that whoever knowingly and willfully: (A) Solicits or receives (or offers or pays) any remuneration (including kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in cash or in kind, in return for referring (or to induce such person to refer) an individual to a person for the furnishing or arranging for the furnishing of any item or service, OR (B) In return for purchasing, leasing, ordering, or recommending purchasing, leasing, or ordering, or to purchase, lease, or order, any goods, facility, services, or item ~. ....For which payment may be made in whole or in part under subchapter XIII of this chapter or a State health care program, shall be guilty of a felony and upon conviction thereof, shall be fined not more than $25,000 or imprisoned for not more than five years, or both. 4. The HHS Appropriations Act requires that to the greatest extent practicable, all equipment and products purchased with funds made available under this award should be American-made. Packet Page -829- 3/8/2011 Item 16.D.3. NOTICE OF GRANT AWARD (Continuation Sheet) Page 4 Date Issued: 08126/2008 Award Number: 1 D1BIT10769-01-00 .r"'\ 5. Items that require prior approval from the awarding office as indicated in 45 CFR Part 74.25 [Note: 74.25 (d) HRSA has not waived cost-related or administrative prior approvals for recipients unless specifically stated on this Notice of Grant Award] or 45 CFR Part 92.30 must be submitted in writing to the Grants Management Officer (GMO). Only responses to prior approval requests signed by the GMO are considered valid. Grantees who take action on the basis of responses from other officials do so at their own risk. Such responses will not be considered binding by or upon the HRSA. In addition to the prior approval requirements identified in Part 74.25, HRSA requires grantees to seek prior approval for significant rebudgeting of project costs. Significant rebudgeting occurs when, under a grant where the Federal share exceeds $100,000, cumulative transfers among direct cost budget categories for the current budget period exceed 25 percent of the total approved budget (inclusive of direct and indirect costs and Federal funds and required matching or cost sharing) for that budget period or $250,000, whichever is less. For example, under a grant in which the Federal share for a budget period is $200,000, if the total approved budget is $300,000, cumulative changes within that budget period exceeding $75,000 would require prior approval). For recipients subject to 45 CFR Part 92, this requirement is in lieu of that in 45 CFR 92.30(c)(1 }(ii) which permits an agency to require prior approval for specified cumulative transfers within a grantee's approved budget. [Note, even if a grantee's proposed rebudgeting of costs falls below the significant rebudgeting threshold identified above, grantees are still required to request prior approval, if some or all of the rebudgeting reflects either a change in scope, a proposed purchase of a unit of equipment exceeding $25,000 (if not included in the approved application) or other prior approval action identified in Parts 74.25 and 92.30 unless HRSA has specifically exempted the grantee from the requirement(s).] 6. Payments under this award will be made available through the DHHS Payment Management System (PMS). PMS is administered by the Division of Payment Management, Financial Management Services, Program Support Center, which will forward instructions for obtaining payments. Inquiries regarding payment should be directed to: Payment Management, DHHS, P.O. Box 6021, Rockville, MD 20852, http://www.dpm.psc.gov/ or Telephone Number: 1-877-614-5533. 7. The DHHS Inspector General maintains a toll-free hotline for receiving information concerning fraud, waste, or abuse ..-"'"""\ under grants and cooperative agreements. Such reports are kept confidential and callers may decline to give their names if they choose to remain anonymous. Contact: Office of Inspector General, Department of Health and Human Services, Attention: HOTLINE, 330 Independence Avenue Southwest, Cohen Building, Room 5140, Washington, D. C. 20201, Email: Htips@os.dhhs.gov or Telephone: 1-800-447-8477 (1-800-HHS-TIPS). 8. Submit audits, if required, in accordance with OMB Circular A-133, to: Federal Audit Clearinghouse Bureau of the Census 1201 East 10th Street Jefferson, IN 47132 PHONE: (310) 457-1551, (800)253-0696 toll free http://harvester.census.gov/sac/facconta.htm 9. EO 13166, August 11, 2000, requires recipients receiving Federal financial assistance to take steps to ensure that people with limited English proficiency can meaningfully access health and social services. A program of language assistance should provide for effective communication between the service provider and the person with limited English proficiency to facilitate participation in, and meaningful access to, services. The obligations of recipients are explained on the OCR website at http://www.hhs.gov/ocr/lep/revisedlep.html. 10. This award is subject to the requirements of Section 106 (g) of the Trafficking Victims Protection Act of 2000,as amended (22 U.S.C. 7104). For the full text of the award term, go to http://www.hrsa.gov/grantsltrafficking.htm. If you are unable to access this link, please contact the Grants Management Specialist identified in this Notice of Grant Award to obtain a copy of the Term. Reporting Requirements: 1. Due Date: Within 90 days of Budget End Date The grantee must submit a Financial Status Report SF-269A1Short Form (http://www.psc.gov/forms/sf) within 90 days after the budget period end date. This report should NOT reflect cumulative reporting from budget period to budget period and must be submitted to the HRSA, Division of Grants Management Operations, 5600 Fishers Lane, Room 11A-02, Rockville, MD 20857-0001. 2. Due Date: Within 365 days of Award Issue Date Technical progress reports are required at annual intervals, when the due date coincides with the conclusion of the .r"'\ Packet Page -830- 3/8/2011 Item 16.0.3. NOTICE OF GRANT AWARD (Continuation Sheet) Page 5 Date Issued: 08/26/2008 Award Number: 1 01 BIT10769-01-00 ~ project, the final report will also serve as the progress report. Reports should include a summary of what has been accomplished during the reporting period and what has been learned, as well as basic information required by OHIT to measure the progress of the program. A copy of the format to be used, as well as instructions for submitting the report, will be provided by OHIT. Failure to comply with these reporting requirements will result in deferral or additional restrictions of future funding decisions. Contacts: Program Contact: For assistance on programmatic issues, please contact Makeda Clement at: OHIT 5600 Fishers Ln RM 7C-26 Rockville, MD 20857-0001 Phone: (301 )443-6977 Email: MClement@hrsa.gov Division of Grants Management Operations: For assistance on grants administration issues, please contact Hazel N. Booker at: HRSAlDGMO/GSFB 5600 Fishers Ln RM 11 A-02 Rockville, MD 20857-0001 Phone: (301 )443-4236 Email: nbooker@hrsa.gov Fax: (301 )443-6686 ,--.. Responses to reporting requirements, conditions, and requests for post award amendments must be mailed to the attention of the Office of Grants Management contact indicated above. All correspondence should include the Federal grant number (item 4 on the award document) and program title (item 8 on the award document). Failure to follow this guidance will result in a delay in responding to your request. ---.... Packet Page -831- 3/8/2011 Item 16.0.3. clt,. Cmmt;y Aclmnistrative Services Division Purdlasing . ,.-.., January 5, 2010 Ms. Deb Cecere Physician Led Access Network (PLAN) 1012 Goodlette Frank Road, Suite 201 Naples,FL3410 1 Fax; Email: deb@plancc.org RE: Renewal of Contract #10-5428 "Physician Led Access Network (PLAN)" Dear Ms. Cecere: Collier County has been under Contract with your company for the referenced services for the past year. ,.-.., The County woulc;J like to renew this agreement under the same terms and conditions for one (1) additional year in accordance with the renewal clause in the agreement~ If you are agreeable to renewing the referenced contract, please indicate your intentions by providing the appropriate information as requested below: f . . ~ lam agreeable to renewing the present contract for Physician Led Access . · 'Network (PLAN) under the same terms, conditions, and pricing as the existing contract. _ I am not agreeable to renewal of this contract~ If you are agreeable to renewing the contract, said renewal will be in effect from January 1, 2010 until December 1, 2011. Also, please provide a current insurance certificate .for our files, as per the original contract requirements. Due to the volume of insurance certificates received in the Purchasing Department, the contract number should be referenced on the certificate to ensure that our records are updated accordingly. ,.-.., P.;ll,,~"ir9 D-:;p;;rtment:. 3301 Tamiwrri T!tI~ East. Neples. f'lorida 34112 . t.'1m Cbliiergov.!wilplltctii>s!ng Packet Page -832- 3/8/2011 Item 16.D.3. ~ Page 2 of 2 RE:Renewal of Contract #10-5428 "Physician Led Access Network (PlAN)" Please return this letter to the Purchasing Department with your response and insurance certificate as soon as possible. Your prompt attention is urgently requested. If you have any questions you may contact me at 239-252~6020, email brendareaves@collierQov.net and fax 239-252-6592 or 239-732-0844. Best regards, Brenda Reaves Contract Technician Acceptance: Physician Led Access Network (PLAN) ".-., contra~.t'c r/.VendO. r. By: .tJJ.x1iJ../ .~ Signature 'b-e.\J (cue)! e" -. () r eJftC~' ovvS '{h 0.. ~ C'-\ -t--1.- Typed Name and Title (Corporate Officer) Date: (..... \1.. \ D ~ In order to make sure our contact information is current, please provide the following: Contact person :~ft> c.<e 0-t... V..-IJ Phone # f 7 f.t -30 Iv Fax # 7?; s-- 1;)... q7 Email de1.@9>1M.lCL..M C} Address: ill z,. G>O&~~t/\{L) rJ. 1St}, t-e ZoJ;tJApI-e.s.3Lf 102- C:Marcy Krumbine, HHS Packet Page -833- a~~ 3/8/2011 Item 16.D.3. Administratfve Services OMsion Purchasing Purchasing Department Change Modification Form ~ IZI Contract Change Request o Work Order Modification Contract #: 10- Mod#: .J.. POlWork Order #: Project Name: PLAN HIT Project 5428 Project #: Project Manager: Margo Department: HHVS Contractor/Firm Name: Physician Led Castorena Access Network Original Contract/Work Order Amount Current BCC Appro\.ed Amount Current ContractlWork Order Amount Dollar Amount of this Change Revised New Contract/Work Order Total I $ Cumulati\.e Changes I $105,211'.00 $ . 105,211~OO::" . $ 105,211.00 $45,000.00: I 150,211.00 I $45,000.00 II 1113/091602 Original BCC Approval Date; Agenda Item # ).r.Tl/a Last BCC Approval Date; Agenda Item # 42.77% I Change from Current BCC Appro\.ed Amount 42.77% I Change from Current Amount Original notice to proceed completion date: 8/31/10 Number of days added (if extension, must attach current insurance certificate(s) from SAP or obtain from vendor : 0 o Add new task(s) Completion Date, Description of the Task{s) Change, and Rationale fortheCh~l'tge Last approved completion date: Revised completion date (includes this 12/31/11 change): 12/31/11 Explain why additional days are needed (detailed/specific): nfa Change task(s) o Delete task(s) x Other (specify): Add grant funding 1. Provide a detailed and specific explanation of the requested change(s) to the task(s): The requested change is to increase the dollar amount of the contract by $45,000 to facilitate the implementation of the information database. This change will allow for reimbursement for expenses as detailed in the original contract during the entire contracted period 2. Provide detailed rationale for the requested change: Before this point in time, the organization was unable to choose an information database that was within their financial means. With the increased support of the Client Track software, they are now able to fully use and access this system to better serve the un and underinsured clientele. 3. Provide explanation why change was not anticipated in original scope of work: In the original scope, it was anticipated that this work would be performed by another contracted agecy, Health Planning Council(HPC) of SW Florida. Due to the choice of software, HPC was unable to complete their scope and the completion of the tasks and implementation is being transferred to PLAN. 4. Describe the impact if this change is not processed: PLAN will not be able to complete the requirements of the grant and the federal funds will not be fully expended. Type of Change/Modification .'. o 1. Planned / Elective I 0 2. Unforeseen conditions/circumstance I x 3. Quantity or price adiustment 04. Correction of error(s) I 0 5. Value added I 06. Schedule adjustment -.., Change Requested By o Contractor/Consultant DOwner Revised: 2/2111 1 Packet Page -834- wiewed by (Purchasing Professional): ....-.. ~. Packet Page -835- Date: Date: r Revised: 2/2/11 2 3/8/2011 Item 16.D.3. CHANGE ORDER ,r"\ CHANGE ORDER NO." CONTRACT NO 10-5428 BeC Date: January 13. 2009 Agenda Item: 16 D2 TO: Deb Cecere. Executive Director Physician Led Access Network - PLAN 1012 Goodlette R. Suite 201 Naples. FL DATE: February 10. 2011 PROJECT NAME: PLAN HIT grant PROJECT NO.: N/A Under our AGREEMENT dated January 13. 2009. You hereby are authorized and directed to make the following change(s) in accordance with terms and conditions of the Agreement: increase the level of funding to complete the HIT project. FOR THE Additive Sum of: Forty five thousand dollars ($45,000). Original Agreement Amount $105,211 Sum of Previous Changes $Q ,..-..., This Change Order add $45.000 Present Agreement Amount $150.211 The time for completion shall be the same number of calendar days due to this Change Order. Accordingly, the Contract Time is now _n/a (_) calendar days. The substantial completion date is December 31, 2011 and the final completion date is the same date. Your acceptance of this Change Order shall constitute a modification to our Agreement and will be performed subject to all the same terms and conditions as contained in our Agreement indicated above, as fully as if the same were repeated in this acceptance. The adjustment, if any, to the Agreement shall constitute a full and final settlement of any and all claims of the Contractor arising out of or related to the change set forth herein, including claims for impact and delay costs. Accepted: ~ huLU;y I ~ ' 20" . Organization Physicifi Led Access Network By:J.;'+lAL OlL I~ 0 Deborah Cecere OWNER: BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA By: DE;b~ ~ .~ Marcy Krumbine Packet Page -836- 3/8/2011 Item 16.D.3. ~ CONTRACT SPECIAL T By: ~m(Jd, Lyn ood Date: ATTEST: BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY FLORIDA Dwight E. Brock, Clerk BY: BY: Fred W. Coyle, Chairman Approved As To Form and Legal Sufficiency: ...-.. Print Name: Deputy County Attorney ~ Packet Page -837- 3/8/2011 Item 16.D.3. CHANGE ORDER ~ CHANGE ORDER NO.1 CONTRACT NO 10-5428 BCC Date: J anuarv 13. 2009 Agenda Item: 16 D2 TO: Deb Cecere. Executive Director Physician Led Access Network - PLAN 1012 Goodlette R. Suite 201 Naples. FL DATE: February 10. 2011 PROJECf NAME: PLAN HIT grant PROJECf NO.: N/A Under our AGREEMENT dated January 13.2009. You hereby are authorized and directed to make the following change(s) in accordance with terms and conditions of the Agreement: increase the level of funding to complete the HIT project. FOR THE Additive Sum of: Fortv five thousand dollars ($45.000). Original Agreement Amount $105.211 Sum of Previous Changes $Q ,.-....., This Change Order add $45.000 Present Agreement Amount $150.211 The time for completion shall be the same number of calendar days due to this Change Order. Accordingly, the Contract Time is now _nJa C-) calendar days. The substantial completion date is December 31, 2011 and the final completion date is the same date. Your acceptance of this Change Order shall constitute a modification to our Agreement and will be performed subject to all the same terms and conditions as contained in our Agreement indicated above, as fully as if the same were repeated in this acceptance. The adjustment, if any, to the Agreement shall constitute a full and final settlement of any and all claims of the Contractor arising out of or related to the change set forth herein, including claims for impact and delay costs. Accepted: $10.{ I ~ ' 20lL Organization Physiciipil Led Access Network 1\. By,~kL (l.L<1U--, Deborah Cecere OWNER: BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA DEP AR'}:m:NT DIRECT /~ ----e ,.-....., By: Marcy Krumbine Packet Page -838- ,,-..., .?j~/3211Item 16.D.3. CONTRACT SPECIAL T By: ~ In rJ~ Lyn ood Date: ATTEST: BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY FLOR.IDA Dwight E. Brock, Clerk BY: BY: Fred W. Coyle, Chairman Approved As To Form and Legal Sufficiency: ~""5\0~ ,,-..... Print Name: 3erW\l(€" P.1, L0~-\1 \to Deputy County Attorney --.. Packet Page -839-