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Agenda 07/27/2010 Item #16D 4Agenda Item No. 16D4 July 27, 2010 Page 1 of 31 EXECUTIVE SUMMARY Recommendation that the Board of County Commissioners provide after - the -fact approval for the attached Outreach Focused Special Congressional Initiative grant application that was submitted to U.S. Department of Health and Human Services, Health Resources and Services Administration, in the amount of $594,000 and, if awarded, to serve as the Fiscal Agent and to authorize the County Manager or his designee to negotiate an agreement with the Physician Led Access Network (PLAN) to implement the program. OBJECTIVE: To have the Board of County Commissioners provide after - the -fact approval for a grant application for the Outreach Focused Special Congressional Initiative grant from the U.S. Department of Health and Human Services, Health Resources and Services Administration as specified in the Omnibus Appropriations Bill for Fiscal Year 2010 (P.L. 111-8). CONSIDERATIONS: In the fall of 2008, staff of the Housing and Human Services Department met with representatives of The Ferguson Group to discuss and present a project questionnaire on a proposed project for health care access for the uninsured in partnership with a local not for profit provider, the Physician Led Access Network (PLAN). PLAN is the community -based referral network that coordinates volunteer medical care for eligible low - income, uninsured adults in need of health services in Collier County. Led by local physicians, it is a community partnership that brings together physicians, community clinics, hospitals, diagnostic and laboratory facilities, and other healthcare providers through an integrated delivery system of volunteer care. PLAN is an initiative launched by the Collier County Medical Society. In 2009, PLAN served 480 residents and provided over 2,400 specialty physician visits /procedures for services valued at over $3.1 million dollars. This current appropriation was approved as part of the Omnibus Appropriations Bill for Fiscal Year 2010 (PL 111 -80). Upon notice of funding availability, the Housing, Human and Veteran Services Department would be required to submit an application for the funding through Grants.gov. The notice was received on June 8, 2010 and the grant application is due in Grants.gov on July 9, 2010. If awarded, Collier County will enter into an agreement with PLAN. This agreement, along with the actual grant agreement for the Federal dollars will be presented to the Board of County Commissioners for approval. Also, if this grant is funded, it will be the third Special Congressional Initiative Collier County has received. The first award in the amount $323,911 was received in 2008, and the second award in the amount of $141,570 was received in 2009. Both awards were funded as part of the Health Resources and Services Administration's Health Information Technology initiative. The purpose of the Outreach Focused Special Congressional Initiative program is to improve health care access to the uninsured in rural areas by increasing marketing, education and outreach. Funds will be used to increase access by implementing a new Primary Care Services Program that will include financial assistance for laboratory services, pharmacy access and the implementation and licensing of a new electronic database tracking system that will allow PLAN 7.cexnda !tem No. 16D4 July 27, 2010 age oo`31 and other participating community health providers to identify, serve and track those who qualify for indigent healthcare and other social services. Collier County Housing, Human and Veteran Services will serve as the Fiscal Entity for this grant. There is no match required and no general fund dollars will be expended. FISCAL IMPACT: Serving as the fiscal entity for the administration of this project will require a minimal amount of staff involvement. Administrative expenses and travel associated with the grant will be included in the application resulting in no further fiscal impact. GROWTH MANAGEMENT IMPACT: There is no growth management impact due to this request. LEGAL CONSIDERATIONS: This item has been reviewed and approved by the County Attorney's Office and is legally sufficient for Board action. - JBW RECOMMENDATION: That the Board of County Commissioners provide after- the -fact approval for the attached Outreach Focused Special Congressional Initiative grant application that was submitted to the U.S. Department of Health and Human Service, Health Resources and Services Administration in the amount of $594,000 and, if awarded, to serve as the Fiscal Agent and to authorize the County Manager or his designee to negotiate an agreement with the Physician Led Access Network (PLAN) to implement the program. Prepared by: Terri Daniels, Accounting Supervisor Housing, Human and Veteran Services Agenda Item No. 16D4 July 27, 2010 Page s of 51 COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS Item Number: 16D4 Item Summary: Recommendation that the Board of County Commissioners provide after - the -fact approval for the attached Outreach Focused Special Congressional Initiative grant application that was submitted to U.S. Department of Health and Human Services, Health Resources and Services Administration. in the amount of $594,000 and, if awarded, to serve as the Fiscal Agent and to authorize the County Manager or his designee to negotiate an agreement with the Physician Led Access Network (PLAN) to implement the program. Meeting Date: 7/27/2010 9.0000 AM Prepared By Terri A. Daniels Supervisor - Accounting Date Public Services Division Human Services 7(912010 4:16:45 PM Approved By Marcy Krumbine Director - Housing & Human Services Date Public Services Division Human Services 71912010 4:25 PM Approved By Kathy Carpenter Executive Secretary Date Public Services Public Services Admin. 71512010 4:20 PM Approved By Marlene J. Foord Grant Development & Mgmt Coordinator Date Administrative Services Administrative Services Division - 71912D10 4:35 PM Division Approved By Jennifer White Assistant County Attorney Date County Attorney County Attorney 7;1 212010 11:37 AM Approved By Marla Ramsey Administrator - Public Services Date Public Services Division Public Services Division 711 312010 12:01 PM Approved By pPAB Coordinator Date County Manager's Office Office of Management & Budget 7!13.'2010 1:17 PM Approved By Sherry Pryor Management; Budget Analyst, Senior Date Office of Management & Office of Mlanag_ement & Butlnet `114:201011:21 AM 2udyet Approved By Agenda Item No. 16D4 July 27. 2010 "Pge' of 31 Jeff Klatzkow County Attorney Date '114!2010 3:54 PM Approved By Leo E. Ochs, Jr. County Manager Date County Managers Office County Managers Office 7!15!2010 12:33 PM Cofer County Administrative Services Division Grants Coordination Agenda Item No. 16D4 July 27, 2010 Page 5 of 31 TO: Leo Ochs, County Manager Grip Application Reviewed and Approved by CouTi nat et ;rdeSi Q CC: Marcy Krumbine, III Co mt Man VS Director — 0 e r _ dat J FROM: Marlene Foor.Crants Coordinator After -the -Fact Approval by the BCC is required at the July 27 2010 BCC meeting DATE: July 6, 2010 SUBJECT: County Manager Review and Approval of a 2010 Health Care and Other Facilities Special Congressional Initiative grant application in the amount of $594,000.00 The Collier County Housing, Iluman, and Veteran's Services Department received the funding announcement for the 2010 Health Care and Other Facilities Special Congressional Initiative grant on June 8, 2010. This is the IIRSA `earmark' grant that continues the work HHVS has been doing with the health Care Access Physician Lead Access Network (PLAN). PLAN serves Collier County's low - income residents by providing access to specialty medical care for those who are uninsured. It is a community -based referral network that meets the needs of this population by coordinating volunteer medical care for eligible adults in immediate need of health care services. Originally launched as an initiative of the Collier County Medical Society and led by its physicians, it is a community partnership that brings toeether physicians, community clinics, hospitals, diagnostic and laboratory facilities and other affiliated healthcare providers through an integrated delivery system of volunteer care. the grant application must be electronically submitted on or before July 9, 2010. Due to the BCC's summer schedule, it is necessary to request your approval of the application to be followed by after- the -fact approval of the Board of Coumy Commissioners during the July 27'� meeting. Your approval of this grant application also certifies the required assurances (see attached) and that Collier County will comply with the terms and conditions of the -grant if awarded. Once you have reviewed the proposal, please sign in the box above and call me for pickup at 252 -4768. Your authorization also authorizes the Grants Offiee to electronically submit the application. "thank you and please let me know if you have any questions regarding this request. 3301 Fast'ramiami Trail •Naples, Florida 34112 (2391252 -4768 • (2391252 -8720 (fax) ��e �f 31 Agenda Item No. 16D4 July 27, 2010 Page 7 of 31 Primary Care Access for the Uninsured Physician Led Access Network (PLAN) of Collier County Collier County Government, Florida Housing and Human Services 3301 East Tamiami Trail Building H Naples, Florida 34120 239 - 252 -2273 (voice) 239 - 252 -2638 (fax) marcykrum bine(o)colliergov. net Project Summary / Abstract The Physician Led Access Network (PLAN) of Collier County proposes to expand its healthcare access program to offer a complete continuum of services for a population of approximately 45,000 low- income, uninsured residents. Requesting an amount of $594,000, this project addresses a gap where low- income, uninsured Collier County residents currently do not have access to primary health care services by adding a volunteer primary care program that includes laboratory and pharmacy assistance and a community -based technology information system to track that population's progress through the community's healthcare system. This primary care volunteer network will be the first step in building the health pathway for the underserved that do not have a medical home. Visits to the emergency room for primary care will be replaced by appointments with a volunteer physician or medical facility. Subsequently, patients will be able to see a specialist or undergo surgery if necessary and receive necessary diagnostic testing and prescriptions - -all through PLAN's volunteer program. PLAN is located in Collier County on the southern Gulf Coast of the Florida peninsula, due west of the Miami -Fort Lauderdale area. Collier County contains approximately 2,025,045 square miles of land area with a population of approximately 315,000. PLAN serves Collier County's low- income residents, including those in the rural area of Immokalee, by providing access to specialty medical care for those who are uninsured. It is a community -based referral network that meets the needs of this population by coordinating volunteer medical care for eligible adults in immediate need of health care services. Originally launched as an initiative of the Collier County Medical Society and led by its physicians, it is a community partnership that brings together physicians, community clinics, hospitals, diagnostic and laboratory facilities and other affiliated healthcare providers through an integrated delivery system of volunteer care. PLAN's mission is to eliminate health disparities, increase life expectancies and improve quality of life by increasing access to essential healthcare. The program goals include strengthening its network's existing charity care; connecting existing public community resources; and lowering improper emergency room utilization by establishing medical homes for those who currently cannot afford primary health care. These goals may be achieved by the addition of a primary care services program to PLAN's network. PLAN of Collier County Page 1 of 1 Outreach Focused Special Congressional Initiative H RSA -10 -214 Project Narrative Table of Contents Agenda Item No. 16D4 July 27. 2010 ra3e 3 of 1 Page A. Needs Assessment 1 B. Description of the Project Plan 2 C. Evaluation Plan 3 D. Sustainability and Impact 5 E. Resources / Capabilities 5 F. Budget Request 5 Age=nda Itern No. 16D4 July 27, 2010 Page 9 of 31 PROJECT NARRATIVE The Physician Led Access Network (PLAN) of Collier County proposes to expand its healthcare access program to address a gap where low - income, uninsured Collier County residents currently do not have access to primary health care services by adding a volunteer primary care program that includes laboratory and pharmacy assistance and a community -based technology information system to track at -risk population's progress through the community's healthcare system. This primary care volunteer network will be the first step in building the health pathway for the underserved that do not have a medical home. Visits to the emergency room for primary care will be replaced by appointments with a volunteer physician or medical facility. Subsequently, patients will be able to see a specialist or undergo surgery if necessary and receive necessary diagnostic testing and prescriptions- -all through PLAN's volunteer program. A. Needs Assessments According to the statistics published on February 17, 2010 by the County Health Rankings, a program of the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, of the estimated 2009 total Collier County population of 318,537, approximately 33% of the adult Collier County residents under age 65 are uninsured. United States Census Bureau 2005 statistics indicate that 45,000 of the uninsured population is 200% or below the federal poverty level. Collier County's Economic Development Council recently published a report that indicates the average wage in Collier County in 2007 was $38,000 and trending downward. In the Immokalee area of Collier County (a census designated place - CDP), the median income for a household was $24,315, and the median income for a family was $22,628. The per capita income for the CDP was $8,576. An initiative of the Collier County Medical Society, PLAN was created to close the gap in access to specialty care and has adopted as its mission the Healthy People 2010's goal of eliminating health disparities, increasing life expectancies and improving quality of life by increasing access to essential healthcare. PLAN serves individuals who are uninsured and whose household income is no greater than 200% of the federal poverty guidelines and have a medical need. The program recruits volunteer specialty physicians (and facilities) who agree to see eligible PLAN patients at their offices /facilities and provide services such as consultations, surgeries, diagnostics tests. Participating physicians and facilities do not receive any compensation from any source for their services provided through PLAN. PLAN is the only program where eligible individuals receive free medical specialty care. There are currently a few primary care clinics in this area that offer services on a sliding fee basis. Low - income, uninsured residents must find their own primary care physicians or facilities and are required to pay fees for any services received. Then, if the low- income patient needs to see a specialist, PLAN's physicians or facilities in may refer patients to PLAN so that they may receive volunteer treatment for specialty care or tests needed. A large gap in primary healthcare access has been identified in the community. Many individuals do not make it to the program because they cannot afford primary care services. An PLAN of Collier County: Page 1 of 1 Outreach Focused Special Congressional Initiative HRSA -10 -214 Agenda Item No. 16D4 July 27, 2010 P ^• ^e 10 of 1 uninsured person is less likely to seek treatment or have a regular source of care. Often those who cannot afford to obtain primary care treatment, seek care in the emergency rooms, only to learn that the medical care they require is not available since it is not considered life threatening. According to a survey conducted by the Collier County Medical Society, 85% of the primary care physician respondents indicated that they would prefer to treat their pro bono patients within the PLAN network because the patients would also be able to access ancillary services and specialty care through its network. Currently, primary care physicians are reluctant to treat their primary care patients on a pro bono basis because often these patients cannot afford to follow through with treatment. And, without access to laboratory or pharmacy services, our experience shows that patients have great difficulty remaining compliant with their physicians' orders. PLAN's home - grown, out -dated Microsoft Access database system cannot be utilized to process primary care services or share patient information. It is also not connected to other community resources information so that PLAN and other medical portals can refer at -risk individuals to the proper program. B. Description of the Project Plan PLAN proposes to increase access by implementing a new Primary Care Services Program that will include financial assistance for laboratory services, phanmacy access and the implementation and licensing of a new identified electronic database tracking system that will allow PLAN and the community to identify, serve and track those who qualify for indigent healthcare and other social services. Initially, PLAN will build on already existing relationships to add primary care volunteer physicians and facilities. At least 50 new physicians will be added during the year. A dedicated primary care patient coordinator will be assigned to conduct eligibility interviews and coordinate all primary care medical services through follow -up. PLAN will partner with LabCorp's LAP program which makes routine clinical tests available for uninsured patients at discounted prices. PLAN will also partner with a local pharmacy who will accept vouchers from PLAN for a limited formulary, emphasizing generic medications, and limiting expenditures per patient. By instituting this new primary care program. PLAN expects an increase of more than 100% in the number of low- income, uninsured residents served. Therefore, in order to ensure that all qualified uninsured residents are being referred to PLAN, non - qualified may find assistance in other appropriate medical care programs, and track qualified residents, PLAN proposes to implement and license a new, identified database tracking system to better coordinate primary care serves in the community. This system facilitates a community - focused, holistic approach to continuity of care for the indigent population by providing an automated eligibility detenmination, shared client record, longitudinal history of services appointments and medical visits; incorporates patient demographic data, treatments, services, reporting and a resource directory; automates the referral process; increases the at -risk population referred into PLAN's network of care as well as increase efficiency of care; promotes access to services, the best use of community network resources and coordination of care by reducing duplication of services, unnecessary emergency room visits and inpatient PLAN of Collier County: Page 2 of 2 Outreach Focused Special Congressional Initiative HRSA -10 -214 Agenda Item No. 16D4 July 27. 2010 Page 11 of 31 hospitalization; acts as a broader scope 2 -1 -1 system that helps connect the community with available services and resources; provide outcome reports that will illustrate individual and community results and measure return on investment; Initially, PLAN will implement the eligibility module to pre - screen patients for services offered by federal, state or local programs, including those that cover human, social, or medical services that improve health and quality of life; the Volunteer Physician Tracking module to manage all scheduling tasks, and ensures an equitable distribution of clients among providers; case management tools to automate assessments, track treatment histories to detect inappropriate emergency room visits; and a resource directory that quickly matches clients to community resources. Also the on -line referral center for our community partners to manage the referral process and track referral status ensuring that the client doesn't get lost in the shuffle. A plan will be developed and implemented to promote the system to the referral sites such as the hospitals, clinics, etc. who wish to become users of the system and the community -based modules. Estimated time for Phase 1 technology completion including training is approximately six months. This network will be established throughout additional multiple locations in the community such as the Collier County Housing and Human Services Department, Neighborhood Health Clinic and Senior Friendship Center among others. It is expected that at least 10 community users will commit to participation. Frequently, those in need do not utilize the programs and services that are available because they just do not know about them. CareSeope's Community module is a web portal 2 -1 -1 system that connects the entire community with programs, services and resources providing users with information about and referrals to human services resources and also health insurance programs, Medicaid and Medicare and health education. This module will be available on PLAN's website for access by the public. Estimated time for Phase 2 completion is approximately six months. Phase 2 will begin once Phase 1 is fully operational. C. Evaluation Plan To evaluate the new primary care services program success for improving healthcare access for low - income, uninsured residents, the project goals' outputs- and outcomes -based evaluation method will be used. The table below illustrates targeted outputs /outcomes to be measured by data collection from the electronic information database system and reported on a consistent basis. PLAN of Collier County: Page 3 of 3 Outreach Focused Special Congressional Initiative HRSA -10 -214 7 0 r M � O N O O � � y � N T Q V w O V c6 d V' nI Q) Q 7 � O U Q) U O O U u' w L O U Z O Q aC O O M A v L. O .n � y "O Z "� W v a Y s .� C' Y .C" .7 C❑ .0 � Y✓ yG v `7 �^" O vY. O v �' O v -Yi .y.. p Y v -yi Y T < a v a v v C ill � •• 7 'Y � v ❑ v y � � � ❑ w Y O .y-. chi u a c-d SUa. U O .z. cv F-O ti o v V w O V c6 d V' nI Q) Q 7 � O U Q) U O O U u' w L O U Z O Q aC Agenda Item No. 16D4 July 27. 2010 Page 13 of 31 Evaluation Plan / Goals and Objectives Goals Target Outputs Steps to Achieve Responsible Parties Time Frame 50 Primary Care . Recruit physicians from . Executive Director On- Physicians Recruited current network sources . Program going . Develop recruitment prog Manager /Patient Care Coordinator 300 -500 Primary Care . Recruit primary care . Executive Director On- Patients Enrolled physicians & facilities / Program Manager going Increased Access to Annually . Hire patient care coordinator e Executive Director Healthcare by . Communicate new program . Program Manager / adding Primary to providers and the public Patient Care Coord. Care Services Implementation . Purchase Implementation & • Executive Director . 9/1 Program to Identified, Integrated License . Executive . 10 /1 Volunteer Network Database Community- e Develop Milestones Director /Data thru Based Tracking System . Installation of Phase 1 Futures, Inc. 12/31 with 10 Referral . System Coord Community Users Generate an additional . Expand current base of . Program Manager On- $1M in -kind donated care volunteer appointments going available & physicians Reduce non- Reduction of 300 visits . assignment of medical home . Program Manager On- emergent use of (minimum 1 visit per new as evidenced by documented going ERs & # of primary care patient visit to participating primary hospitalizations enrolled) care physician /facility Maintaining Patient . Provide financial assistance . Patients' medical 60 days Compliance for laboratory services needs are after Increased Access to successfully being project Healthcare by treated. start adding Primary Patients Medical Needs . Measure Health Outcomes . Patients indicate 30 days Care Services are Met; Healthier their states of well- after Program to Population being improved project Volunteer Network - after accessing care start through volunteer network. Establish a Implement Phase 2 . Promote to Community • Increase in at -risk On- community- focused, Community-Based . Install Community Modules population referred going holistic approach to Modules of integrated into PLAN's 11 continuity of care database tracking system network of care, for low- income, other community uninsured services as well as population in increase efficiency Collier County of care. PLAN`s members are committed to evaluation because ongoing expansion of the system throughout the community will be accomplished by demonstrating the success of the Careseope system. PLAN of Collier County: Page 5 of 5 Outreach Focused Special Congressional Initiative HRSA -10 -214 N.genda Item No. 16D4 July 27, 2010 Page 14 of 31 D. Sustainability and Impact PLAN is a well - established organization with a network of 200 volunteer physicians and 40 volunteer medical facilities and the infrastructure and financial solidity to continue to support the primary care program and associated community information technology system. This commitment is confirmed by the Collier County Commission via adoption of a 10 -year strategic plan that includes a commitment to partner with community organizations such as PLAN to improve health care access for the uninsured. PLAN would not be as successful today if not for the support of these key stakeholders: Chief Executive Officers of the two local hospitals, directors of the community clinics, and the Collier County Medical Society. Representatives hold positions on PLAN's Board of Directors thereby taking an active interest in the program's success. PLAN is funded by the Collier County Department of Health, Collier County Department of Housing and Human Services, a national, private foundation and various state and local foundations that support community health programs. In -kind donated contributions by the volunteer healthcare providers surpassed $3.1 M in 2009 and $1 OM since PLAN's inception. The project will be publicized through Collier County's conununications program via relationships with local news media, electronic and printed newsletters, participation in and promotion to local community organizations and website as well as promotion by the very active board members. Expanding the program by offering volunteer primary care services will elevate PLAN to the distinctive position of becoming the community's prime health care conduit in the continuum of care addressing the needs of its low- income uninsured at -risk population. It will be yet another major step towards improving the quality of life at -risk residents. E. Resources / Capabilities Since PLAN became operational in 2003, the volunteer program has served over 1,700 patients and built a network of 200 physicians and 50 affiliated medical care groups including hospitals, clinics, surgical centers, radiological and diagnostic services. In 2009 it served 480 residents and provided over 2,400 specialty physician visits / procedures for services valued at $3.1 million dollars. For the first 6 months of 2010, we are ahead of 2009's pace in all categories. PLAN received a previous NRSA grant for research and potential development of a community - wide, multi - organizational, integrated database system in partnership with the Collier County Housing and Human Services Department, PLAN and its partners were successful in identifying a system, CareScope, which is currently being widely used in the United States by similar Access programs and most importantly, fits many of the original project's criteria. The Executive Director has many years of senior management experience in the private, public and non -profit sectors and is well - qualified to oversee the expansion of new services and the conversion to a new database tracking system for PLAN and the community. PLAN's specialty program employs two full -time, multi - lingual patient care coordinators offering skillful and sensitive assistance to at -risk residents. PLAN has successfully proactively indentified and recruited new members to the volunteer network to ensure capacity of services always expands. F. Budget Request Personnel costs represent 35% of the total budget request. Contract costs for the database system are 30 %0 Other costs are 29%0: supplies and travel are 6 %. Other than personnel, costs are start-up costs and will not have an impact on PLAN's future budgets. PLAN of Collier County: Page 6 of 6 Outreach Focused Special Congressional Initiative HRSA -10 -214 Agenda Item No 16D4 July 27, 2010 Page 15 of 81 YEAR 1 Budget Detail Worksheet and Narrative A. Personnel Name /Position Computation Cost Deb Cecere, Project Manager/ Executive Director $75,758 x .33 FTE $25,000 Funding a portion of the Executive Director's salary to oversee the implementation of this large scale systems project, evaluation, and plan for the community outreach activities necessary associated with support and coordination efforts of the community - based portion of the project. Systems Coordinator - TBD $40,000 x 1.0 FTE $40,000 Key member of implementation team will ensure seamless transition from existing PLAN system to new, web -based electronic community database tracking and referral system by developing and managing implementation methodologies through Discovery, System Development, User Acceptance Testing and Production Rollout phases at PLAN and initial 10 community referral sites. Michelle Jay, Program Manager $45,000 x .5 FTE $22,500 Responsible for managing the day -to -day operational and programmatic functions of the primary care and specialty volunteer physician and facilities network including recruitment of new primary care physicians. Rachelle Garcon, Primary Care Coor. $38,000 x 1.0 FTE $38,000 Will coordinate, administer and oversee all primary care medical services provided to qualified County residents by the volunteer physician and facilities network. Administrative Program Associate — TBD $38,000 x 1.0 FTE $38,000 Assists all three key personnel working independently and wholly responsible for complex administrative and supervisory tasks necessary to run PLAN's network efficiently. Will manage projects, conduct research and disseminate information by using various forms of communication. SUBTOTAL PERSONNEL B. Fringe Benefits Health Insurance, taxes, unemployment insurance, life insurance, retirement Type Project Director /Executive Director Systems Coordinator Program Manager Primary Care Coordinator Administrative Assistant C. Travel Computation $25,000 x 25% fringe $40,000 x 251/0 fringe $22,500 x 25% fringe $38,000 x 25% fringe $38,000 x 25% fringe SUBTOTAL FRINGE PLAN of Collier County Outreach Focused Special Congressional Initiative HRSA -10 -214 $163,500 Cost $ 6,250 $10,000 $ 5,625 $ 9,500 $ 9,500 $40,875 Page 1 Agenda Item No. '16D4 July 27. 2010 16 C 31 The $6,590 for travel is a required cost for local mileage and 2 out of state meetings. Purpose of Travel Location Item Computation Cost Local Mileage- reimbursement to staff 2,000 miles / $.55 $ 1,100 CareScope Users Group Meeting 2010 November 10 -12 Tennessee Executive Director and Systems Coordinator (Airfare @ $400 x 2) $ 800 Lodging (3 nights @ $150 x 2) $ 900 Ground trans /parking. ($125x2) $ 250 Meals ($50 day x 3 days x 2) $ 300 Communities Joined in Action - October 6 -8 Denver, Colorado Executive Director and Program Manager (Airfare C $400 x 2) $ 800 Lodging (5 nights (4., $150 x 2) $ 1,500 Ground trans /parking. ($155x2) $ 310 Meals ($63 day x 5 days x 2) $ 630 SUBTOTAL TRAVEL $ 6,590 D. Equipment Item Commutation Cost No equipment is requested SUBTOTAL EQUIPMENT $ -0— E. Supplies Supplv Items Commutation Cost General office supplies (i.e. paper $5,404 $5,404 Pens, ink cartridges, etc.) Recruitment Marketing - New Physician $20,000 $20,000 Recruiting Material, Primary Care Material: Printing, stationery, Stamps Computers Assigned to Systems Coor. 2 0,' $ ],100 $ 2,200 and Administrative Program Associate Minor Office furniture 2 ((�, $1,000 $ 2,000 Office furniture for two new positions Laptop System I laptop available for Systems Coordinator S1,350 $1,350 for travel to community -based users Laboratory & Pharmacy Vouchers 51,000 S 1,000 1,000 each printed (2,000 total) SUBTOTAL SUPPLIES $31,954 Page 2 PLAN of Collier County Outreach Focused Special Congressional Initiative HRSA -10 -214 Agenda Item No, 16D4 Jelly 27, 2010 Page 17 of 31 F. Construction Purpose Description of Work Cost No Construction is requested -0 G. Consultants / Contracts Consultants Computation Cost CareScope Database Tracking System for tracking patient, physician and appointment data; sharing patient information with community users and eligibility module for public use: Implementation fees plus Installation, Training & First Year of Service $99,920 Software Licensing Years 2 & 3 (includes 10% discount for pre - payment) $32,391 Software Licensing Years 4 & 5 (includes 12% discount for pre- payn7ent) $31,670 40 Add'1 consulting & travel hours @ $125/hr cons & $40 /travel $ 6,600 Temporary administrative assistance required during implementation Temp Agency for Data Entry Clerk $20/hr x 20 hrs / wk x 15 $ 6,000 SUBTOTAL CONSULTANTS $176,581 H. Other Costs Description Computation Cost Laboratory Subsidy 300 patients @ $300 $90,000 Required to keep patients compliant with physicians orders; will be used to subsidize primary care patients' laboratory costs in LabCorp's LAP program Pharmacy Services 300 patients @ $175 $52,500 Limited formulary, emphasizing generic medications, and limiting expenditures for any one participant to $300 per year for medications at local pharmacy. Marketing Development /Public Relations Physician Recruitment presentations facility /AV rental @$400x12 $ 4,800 Video Modification Modify current marketing video to include primary care program services $ 1,800 Marketing plan development Meetings /Events/ Communications $ 8,000 Inform the current network & community of new services available includes new program announcements, information meetings, physician acknowledgements electronic newsletters Website Development /Enhancement $ 3,000 Modifications to current website to include new CareScope Community Module allowing public access to module identifying eligibility for PLAN and other indigent care programs Phone and data service $500 per month x 12 months $ 6,000 Rent for additional office space $700 per month x 12 months $ 8,400 SUBTOTAL OTHER $174,500 I. Indirect Costs No Indirect Cost is requested — Page 3 PLAN of Collier County Outreach Focused Special Congressional Initiative HRSA -10 -214 Agenda Item No. 16D4 July 27, 2010 P:,qe 18 of 31 Budget Summary Federal Request $594,000 Non - Federal Amount $ 0 Page 4 PLAN of Collier County Outreach Focused Special Congressional Initiative HRSA -10 -214 Budget Category Amount A. Personnel $163,500 B. Fringe Benefits $ 40,875 C. Travel $ 6,590 D. Equipment $ 0 E. Supplies $ 31,954 F. Construction $ 0 G. Consultants / Contracts $176,581 H. Other $174,500 Total Direct Costs $594,000 I. Indirect Costs 0 TOTAL PROJECT COSTS $594,000 Federal Request $594,000 Non - Federal Amount $ 0 Page 4 PLAN of Collier County Outreach Focused Special Congressional Initiative HRSA -10 -214 Agenda item No. 16D4 July 27, 2010 Page 19 of 31 PRIMARY CARE PROGRAM STAFFING PLAN Deb Cecere, Executive Director /Project Manager, BSBA Degree. Cecere currently holds the position of Executive Director of PLAN. She has over 15 years of Senior Management experience and 10 years of sytems implementation experience. As Executive Director, Cecere oversees PLAN's specialty and primary care program by evaluating the results of program activities, ensuring that continuing contractual obligations are being fulfilled; allocating resources for greater program effectiveness and efficiency; developing policies and prograin objectives and lastly, fund development. The .33 FTE personnel cost is requested for Cecere's roles overseeing the development and management of the new primary care volunteer network and for providing leadership. Rachelle Garcon, Primary Care Patient Coordinator, Bachelor's Degree. The full -time dedicated coordinator will conduct eligibility interviews, surveys, coordinate all appointments with patients and physicians' offices, track results, coordinate ancillary care and conduct follow - up for an anticipated 300 -500 patients per year. Garcon has two years' experience at PLAN currently serving as a specialty care patient coordinator through our volunteer network. One FTE personnel cost is requested as this is a dedicated position to the project. TBD, Systems Coordinator, Bachelors Degree. Full -time, key position responsible for executing all aspects of implementing the electronic database system through complete project life cycle of requirements gathering / analysis, planning, schedule management, testing, documentation, rollout to 10 community users, end -user training and group facilitation utilization review. One FTE personnel cost is requested as this is a dedicated position to the project. Michelle Jay, Program Manager, Bachelors Degree. Will be responsible. for managing the day -to -day operational and programmatic functions of the primary care and specialty care volunteer physician and facilities network including recruitment of new primary care physicians. Jay's four years of experience in her current position has prepared her well for this role. As the current senior coordinator, she has taken the lead in recruiting new specialty physicians, preparing compliance reports, and finding community development opportunities. The .5 FTE personnel cost is requested as the manager will split her time between the primary care and specialty programs. TBD, Administrative Program Associate (APA), Bachelors Degree preferred. This is a key position working independently and supporting the Management team and Systems Coordinator. The APA perforins program management/compliance (research, reporting and correspondence); communications (website, electronic newsletter), financial recordkeeping, event coordination and general office duties. The incumbent should have previous substantiated project management, bookkeeping and senior level administrative experience. The .5 FTE is requested as the APA will split time between the primary care and specialty volunteer program. PLAN of Collier County Page 1 of 1 Outreach Focused Special Congressional Initiative HRSA -10 -214 Agenda Item No. 16D4 July 27, 2010 Pc,ge 20 of 31 PROJECT MANAGER Reporting to the Board of Directors the Project Manager will oversee the delivery of the CareScope electronic database tracking and referral system and work with the project team to support the impleincntation of the system. RESPONSIBILITIES: Define project scope, deliverables & key milestones; Identify perceived risks; Develop project plan; Identify resources needed and assigns individual responsibilities; Track project finances and resources; Ensure project meets deliverables; Provide project status updates with all stakeholders; ensure the efficiency and effectiveness of systems solutions deployed in support of PLAN's and the users goals and objectives; Ensure project documents are complete, current, and stored appropriately; Assures project legal documents are completed and signed. REQUIREMENTS: Must be able to provide project leadership including participating in meetings to discuss the implementation project and status, working closely with all stakeholders in defining project priorities, scope, resource requirements and timing deliverables; Project management experience including project planning, estimating, tracking and management. Bachelor's degree from four -year college or university: Strong verbal and written communications; Effective interpersonal skills and ability to work in a team environment; Previous experience with managing large, complex system implementations. PRIMARY CARE COORDINATOR Reporting to Program Manager coordinates, administers and oversees all primary care medical services provided to qualified Collier County residents by the volunteer physician and facilities network. RESPONSIBILITIES: Conducts patient pre - eligibility interviews to detertnine eligibility based on qualification guidelines; Collects all required documentation; Schedules appointments with participating volunteer physicians and facilities; Manages the coordination of all specialty care, diagnostics, lab work, hospitalization ; ensures confidentiality of client records; Reviews client care plans records to assure completeness, accuracy and timeliness of all required paperwork; Researches compliance issues (i.e. missed appointments) with client and providers; prepares reports: written correspondence to patients: records, maintains and updates all information in ACCESS referral database tracking system; Communicates with and maintains positive working relationships with all PLAN providers and their staffs. REQUIREMENTS: Bachelors degree or any equivalent combination of education, training, or experience; Bi- lingual (English /Spanish); understanding of medical terminology; Excellent communication and organizational skills; Ability to multi -task and prioritize; Strong office computer skills such as Microsoft Word, Excel and database. PLAN of Collier County Page 1 of 5 Outreach Focused Special Congressional Initiative HRSA -10 -214 Agenda Item No. 16D4 July 27, 2010 Page 21 of 31 PRIMARY CARE PATIENT COORDINATOR Reporting to Program Manager coordinates, administers and oversees all primary care medical services provided to qualified Collier County residents by the volunteer physician and facilities network. Specific Responsibilities Include: - Conducts patient pre - eligibility interviews via telephone - Conducts in- person patient eligibility interviews to determine eligibility based on qualification guidelines - Collects all required documentation - Refers and schedules appointments with PLAN's participating volunteer physicians and facilities for eligible patients. - Manages the coordination of all specialty care, diagnostics, lab work, hospitalization - Adheres to HIPAA requirements by ensuring the confidentiality of client records. - Reviews client care plans and client case records to assure completeness, accuracy and timeliness of all required paperwork - Researches compliance issues (i.e. missed appointments) with client and PLAN provider - Maintains all mandated client records; prepares reports. - Develops written correspondence to patients when necessary. - Records, maintains and updates patient, medical provider and appointment data in ACCESS referral database tracking system. - Prepares utilization reports from database and other support programs upon request from Executive Director. - Communicates with and maintains positive working relationships with all PLAN providers and their staffs. Qualifications /Skills: - Bachelor's degree or any equivalent combination of education, training, or experience - Bi- lingual (English /Spanish) - Understanding of medical terminology - Excellent communication and organizational skills - Ability to multi -task and prioritize - Critical thinking necessary for troubleshooting - Strong office computer skills such as Microsoft Word, Excel and database - Previous customer service experience is strongly preferred SYSTEMS COORDINATOR Reporting to the Executive, coordinator is a key member of the implementation team and will ensure a seamless transition from the existing PLAN system to a new, web -based electronic community database base tracking and referral system by developing and managing implementation methodologies through the Discoverv, Svstem Development, User Acceptance Testing and Production Rollout phases at PLAN and at leastl 0 community referral sites. PLAN of Collier County Page 2 of 5 Outreach Focused Special Congressional Initiative H RSA -10 -214 Agenda Item No. 16D4 July 2T 20'10 Page 22 of 31 Working closely with the vendor's implementation, development and client support teams and with the Project Manager, these responsibilities include: During Implementation - communicate effectively with the implementation project team includes conducting meetings review the features of the product, data, and data issues with the implementation - analysis of all system requirements and configuration & identification of key documentation - monitoring system configuration, customization and data migration or new data collection identified during the Discovery process - establishing & conducting test plans, training and developing procedures documentation - providing the primary technical support for implementation problem resolutions; user account setups, network security, system documentation Post - Implementation: This position will also responsible for day -to -day system integrity including: - Developing a mastery of the CareScope application and all related interfaces - Implementing additional new users as they are identified and committed - Developing and producing accurate and finely routine and special reports, and data retrievals for staff as needed, and is the point person for managing custom reporting requests - Developing, implementing, maintaining policies and procedures for ensuring the security and integrity of company databases and software applications - Accountability for the accuracy and integrity of membership data files; implementing quality control mechanisms: overseeing the data entry process; recommending and implementing policies, procedures and guidelines for data entry when necessary - Identifying, researching, and resolving technical problems, working with outside vendors /technical support as needed, and documenting, tracking and monitoring problems to ensure a timely resolution - Overseeing day -to -day integrity of database procedures, which may include conducting regular y audits of data to confimr use of accurate entry processes; identifying and eliminating duplicate records; archiving of records with no activity for specified period; and maintaining users security settings - Remaining informed on software updates, upgrades and additional services and Implementing systems upgrades as required by the software license - Training new users /staff on the use of the company's standard software applications and electronic database, as needed REQUIREMENTS: Successful candidate must be able to: Identify, understand and manipulate varied and multiple details; prioritize and establish deadlines; work effectively under pressure with multiple priorities and deadlines; train and effectively utilize staff and volunteers; work effectively with colleagues throughout the organization and the community QUALIFICATIONS: Previous systems implementation experience; Highly organized, with superior problem resolution and analytical skills: Excellent oral and written communication PLAN of Collier County Page 3 of 5 Outreach Focused Special Congressional Initiative H RSA -10 -214 Agenda Item No. 16D4 July 27, 2010 Page 23 of 31 skills Excellent knowledge of Microsoft Office® products, specifically Word, Excel, Access, Outlook and PowerPoint, Adept at supporting Windows Vista, Office 2007, Outlook computer hardware and peripherals. PROGRAM MANAGER Reporting to the Executive the Program Manager will be responsible for managing the day -to- day operational and programmatic functions of the primary care and specialty volunteer physician and facilities network including recruitment of new primary care physicians. RESPONSIBILITIES: The Program Manager should be able to identify new programmatic approaches and opportunities for more effective and efficient ways to manage the program as well as assist with data collection /reporting, financial tracking, correspondence, volunteer management, and fundraising opportunities thereby creating a successful, sustainable organization. The position requires flexibility, ability to work well under pressure while autonomously balancing multiple priorities and tasks. The specific responsibilities for this position include but are not limited to the following: New Primary Care Program - Planning and development of effective processes and procedures for the primary care and medical specialty services volunteer network operations - Development and delivery of Patient Care Coordinator training - Supervision of Patient Care Coordinators' patient intake and coordination processes as well as the collection and compilation of patients' Health Outcomes Surveys - Membership Recruitment - Assisting with the development of a volunteer physician recruitment program - Coordinating, managing and delivery of outreach and marketing efforts for membership and other special events that are determined to be effective - Program Operations - Building and maintaining relationships with volunteer members and organizations - Building a wide base of partnerships including local businesses, corporations, foundations, community groups, and other non- profits - Reviewing grant applications and reporting for programs; - Assisting the Executive Director with annual budget process - Managing publication of Annual Report, board book and outreach materials; - Establish, recruit and manage internships, part time employees and volunteers - Providing ongoing status and updates to the Executive Director. QUALIFICATIONS: Successful candidates should have: Previous program management experience or equivalent, Strong organizational and project management skills, Excellent interpersonal skills and ability to work well with board members, physician members and donors, Excellent verbal and written communication skills; Ability to work independently as well as collaboratively and manage time effectively' Enjoy working collaboratively on a wide variety of projects as well as have the ability to perform in a fast -paced and changing environment; Knowledge of essential computer applications, including Microsoft Word, Excel and database programs. _.. PLAN of Collier County Page 4 of 5 Outreach Focused Special Congressional Initiative H RSA -10 -214 Agenda Item No. 16D4 July 27, 2010 Page 24 of 31 ADMINISTRATIVE PROGRAM ASSOCIATE Report to Program / Executive Director, the Administrative Program Associate (APA) will work independently and will be wholly responsible for a variety of complex administrative and supervisory tasks necessary to run PLAN's volunteer network efficiently. Position will manage projects, conduct research and disseminate information by using various forms of communication. Contact with high -level community partners requiring use of business vocabulary, tact, discretion and judgment Responsibilities: Program & Compliance Coordinate work connected with physicians' volunteer hours, continuing medical education credits and acknowledgement program. Development and maintenance of Office Procedures Manual required by government grant award audits. Comply and respond to external agencies reporting requirements. Coordinate activities of any volunteer office staff including orientation, training and work assignment. Communications Maintain website with updated news /information; prepare publications such as electronic newsletters and other reports including research, compiling data, creating charts and graphs, writing and editing and coordinating the publication. Bookkeeping / Financial Performs bookkeeping activities including accounts payable and grants receivable, bank reconciliations, creates monthly financial reports, monitors account expenditures; maintains and reconciles budgets; processes payroll; coordinates payroll tax reporting. Prepares records for IRS reporting and acts as primary contact for annual tax audit. General Office Set up and coordinate meetings; prepare agendas, compile and distribute minutes; participate in board and committee meetings as directed. Prepare and compose confidential correspondence, receive and screen telephone calls and visitors, screen and prioritize mail, update and file organizational documents; collect and maintain inventory of office equipment & supplies; coordinate building and equipment maintenance requests; maintain keys and key log; order supplies, furniture, equipment; perform copying, faxing, emailing, filing as needed and directed. Assist in special events, such as fundraising activities and the annual meeting. Requirements: Successful candidate must: - have knowledge of office and administrative practices and principles - have skill in problem solving and decision - making - have excellent verbal and written communication skills - be highly organized and able to prioritize multiple tasks - work effectively under pressure with multiple priorities and deadlines - be able to follow assignments through to completion - maintain a high level of confidentiality - work effectively with colleagues throughout the organization and the community - train and effectively utilize staff and volunteers Qualifications: College degree preferred; several years of complex administrative experience required; knowledge and skill in accounting and budgeting procedures and techniques; QuickBooks experience prcferred; excellent knowledge of Microsoft Office a, products, specifically Word, Excel, Access, Outlook and PowerPoint PLAN of Collier County Page 5 of 5 Outreach Focused Special Congressional Initiative H R SA -10 -214 Agenda Item No. 16D4 July 27, 2010 Page 25 of 31 DEB CECERE PLAN EXECUTIVE DIRECTOR I PROJECT MANAGERE Cecere is a dynamic management professional with a diverse skill set and demonstrated success in start-up, turnaround and Fortune 500 environments. Her experience spans public, private and nonprofit arenas. SELECTED ACHIEVEMENTS Systems Implementation After graduating magna cum laude from Boston's Suffolk University in 1988 with a degree in marketing, Cecere began her career as a systems implementation professional where she developed a strong background in directing and managing large -scale technology systems implementation projects for Fortune 500 companies. Skilled in full project life cycle management, she also became highly proficient in strategy development, project leadership, client relationship management and accomplished in building high - performance teams for planning and executing key projects to on -time / on- budget completion. Business Owner After many years of directing projects for high profile companies such as Bain & Company, Tyco International and Fidelity Investments, Cecere left the corporate world to realize a dream. She created a very successful venture of her own vision - -a children's entertainment business. She developed the concept, raised capital launched the brand and very quickly became the region's premier children's event organization in Massachusetts. Non - Profit Cecere realized that her strength was development and building of brands, consequently after five years of operations, she sold the company and sought another challenge. She quickly found an opportunity to make a difference in the nonprofit sector at the Iacocca Foundation in Boston. Working very closely with the Executive Director, Cecere played a key role in raising millions of dollars for the Iacocca Foundation; managed operations and logistics for major fundraising events raising the profile of the family foundation and developed a new public charity for raising funds for special diabetes research projects at the Iacocca Foundation. In 2007, Cecere relocated to Naples with her family. Eager to learn about the nonprofit environment, she attended seminars at the Greater Naples Community Foundation, met with local executives and secured consulting projects for a healthcare related nonprofit before joining the Physician Led Access Network in 2009. Her reputation as an analytical and strategic leader able to quickly identify issues, filter options and establish the roadmap to achieve objectives has led her to be highly sought after for many volunteer positions. She has held positions on a school board, community associations and in the Naples area Cecere volunteers for a local theater company and Junior Achievement of Southwest Florida. PLAN of Collier County Page 1 of 2 Outreach Focused Special Congressional Initiative HRSA -10 -214 Agenda Item No 16D4 July 27. 2010 ,F 2n of 31 MICHELLE JAY — PROGRAM MANAGER Michelle Jay is currently a Senior Patient Care Coordinator. Joining PLAN four years ago, she is responsible for oversight and coordination of all specialty medical care for qualified Collier County residents within the PLAN network of volunteer physicians and medical facilities. In this role, Michelle is also PLAN's liaison to Florida's Volunteer Health Services Program. A natural problem solver and team player, Jay also takes the lead on many program projects including compliance and grant reporting. Prior to joining PLAN, Jay held a similar position in Collier County government in the Health and Human Services Department. She is a graduate of George Brown College with a degree in nutrition. Michelle is multi - lingual. RACHELLE GARCON — PRIMARY CARE PATIENT COORDINATOR Rachelle Garcon is currently a Patient Specialty Care Coordinator. She joined PLAN in 2008 and qualifies residents for the program as well as coordinates specialty medical care for eligible Collier County residents within the PLAN network of volunteer physicians and medical facilities. During her tenure, she has shown extreme sensitivity and empathy towards patients and uses her multi - lingual skills to effectively communicate with our diverse clients. She has also been very successful at developing strong relationships with our volunteer physicians and their staff. In her home country, Haiti, Garcon worked as a physiotherapist with the Health International Organization, Doctors without Borders. She is currently the Chairwoman of the Refugee Advisory Panel of Collier County and provides volunteer assistance to Spanish, French, and Creole speaking refugees with the American Red Cross in Collier County. Prior to joining PLAN, she graduated summa cum laude from Universidad of Pinar Del Rio (School of Physical Culture) in Cuba with a degree in Physiotherapy, Sport Medicine. Natural & Traditional Medicine. PLAN of Collier County Page 2 of 2 Outreach Focused Special Congressional Initiative HRSA -10 -214 Agenda Item No. 16D4 July 27, 2010 p2de 2, Of 31 N ( / l 11 1`: A 1. l 11 Description: Applicable # Per em Extended Software Licensing Client Module 10 2,195.00 21,950.00 Eligibility Module 10 495.00 4,950.00 Volunteer Physician Tracking /Scheduling Module 10 495.00 4,950.00 Advanced Case Management Module 10 495.00 4,950.00 MIS -To -Go Module 10 495.00 4,950.00 Community Module 1 19,995.00 19,995.00 sub - total: 36 175.00 (Years 2 and 3) 2 $ 17,995.00 35,990.00 Support and Hosting (Years 4 and 5) 2 $ 17,995.00 $ 35,990.00 Footnotes and Other Additional Considerations: A. For modular descriptions, see hard copy brochure and website: http: / /www.carescope.net, B. Our pricing assumes you have or will acquire and support all the appropriate hardware. C. Price includes standard level support by: phone, e -mail and on -line, Monday- Friday, 7:30 am -4:30 pm Eastern. 24/7/365. Platinum -level support available. Quote on request. If support or hosting services are terminated during years 2 or 3, pro -rated refunds will apply to any prepayments. D. Additional hours for services beyond those quoted hereinabove will be billed at $125 per hour or at a mutually agreed project price. Services may include: support, installation, training, project management, data migration, integration, conversion, interfaces, and customization. Travel costs associated with any additional services will be billed at our standard reimbursement rates plus $40 per travel hour. E. Above quote covers our minimum # of users (10) at PLAN or PLAN- related facilities in Collier County, FL. If you upgrade to an Enterprise License anytime within a year of initial contract execution, you will receive a full credit of the user licensing fee paid. An Enterprise License would cover unlimited users and facilities in a mutually agreed multi- county area. F. Installation is scheduled after we receive your formal purchase order that includes this quote as an attachment. subtotal: 61 745.00 Installation, Training and First Year Services Installation and Initial Consulting (On -Site Days) 3 1,200.00 3,600.00 Set-up and Administrative Training (On-Site Days) 3 1,200.00 3,600.00 End User Training (On -Site Days) 3 1,200.00 3,600.00 Travel (Three Trips, One Person) 3 1,460.00 4,380.00 Data Migration and Forms Services (50 Hour Block /3 Iterations: 1 5,000.00 5,000.00 Support and Hosting 1 17,995.00 17,995.00 sub - total: 36 175.00 (Years 2 and 3) 2 $ 17,995.00 35,990.00 Support and Hosting (Years 4 and 5) 2 $ 17,995.00 $ 35,990.00 Footnotes and Other Additional Considerations: A. For modular descriptions, see hard copy brochure and website: http: / /www.carescope.net, B. Our pricing assumes you have or will acquire and support all the appropriate hardware. C. Price includes standard level support by: phone, e -mail and on -line, Monday- Friday, 7:30 am -4:30 pm Eastern. 24/7/365. Platinum -level support available. Quote on request. If support or hosting services are terminated during years 2 or 3, pro -rated refunds will apply to any prepayments. D. Additional hours for services beyond those quoted hereinabove will be billed at $125 per hour or at a mutually agreed project price. Services may include: support, installation, training, project management, data migration, integration, conversion, interfaces, and customization. Travel costs associated with any additional services will be billed at our standard reimbursement rates plus $40 per travel hour. E. Above quote covers our minimum # of users (10) at PLAN or PLAN- related facilities in Collier County, FL. If you upgrade to an Enterprise License anytime within a year of initial contract execution, you will receive a full credit of the user licensing fee paid. An Enterprise License would cover unlimited users and facilities in a mutually agreed multi- county area. F. Installation is scheduled after we receive your formal purchase order that includes this quote as an attachment. o� fm o.. ":m N N y � 6 0 O Y R C_ 0 Z O O J U CL a E d Y N T N d R C Z R Q � J E L R 0 O a` E R a7 F al a a r O y U C y O d � 1`6 U � c m .i u N u _>1 ID :D N N 7 N 7 O U U d F- � @ U Q O = Q) U U m N C C Y 3 Z U) U 'O ZO H Z Q O H W Q J a o � p m .>_ U d X LU O> Y GI 0 ` a N d f/ N J O C a. = U R a @ 'c 'O = T N 2 O .0 @ a1 L L U N T a O. @ 0 O Y R C_ 0 Z O O J U CL a E d Y N T N d R C Z R Q � J E L R 0 O a` E R a7 F al a a r O y U C y O d � 1`6 U � c m .i d Y R E R Y V y C O C N � N IL Q 2 w O R @ U c C 'O aD O OR U � O R Y U R G c v 0 O m o CL U Lo 4 a) u'W" f�/1 N 0 0 N � J a) C 0 d u N u E U ID :D N N 7 N d Y R E R Y V y C O C N � N IL Q 2 w O R @ U c C 'O aD O OR U � O R Y U R G c v 0 O m o CL U Lo 4 a) u'W" f�/1 N 0 0 N � J a) C 0 d c m U @ U a Q) N m N C U.o m G oU Q) L a) = U @ 'c 'O = C N 2 O .0 @ a1 L U N T U a O. @ Q d U) Z r� CO # O - w U d � � � N I LL ui 76 U) a) U U O U 2 7 U) L co = O E 0 m(D D w _° o U T LL u m o m U a) o- Y_ U co Z U f Z .— N co it V it: LO W CO it PROCLAMATION WHEREAS, the Physician Led Access Network of Collier County (PLAN) is an initiative begun by the Collier County Medical Society to provide the safety net of access to healthcare for low - income, uninsured adults in our community; and, WHEREAS, PLAN is a community -based referral network that coordinates volunteer medical care for eligible, low- income adults in need of health services in Collier County; and, WHEREAS, PLAN coordinates quality healthcare for the underserved of our community; and, WHEREAS, PLAN is led by physicians and is a community partnership that brings together our physicians, community clinics, hospitals, diagnostic and laboratory facilities, and other healthcare providers through an integrated delivery system of care,- and, WHEREAS, recently the health care million, nine -hund community of C WHEREAS, National Friday, NOW DONE AND ORDERED ATTEST: i DW16 Et. BROCK, CLERK PLAN reached a milestone of three J*, donated care by the medical this week on :o ` s of Collier is a to the Collier c ,s of Collier in d re and 'COMMISSIONERS FLORIDA TOM HENNING, Collier County Page I of 3 Health Information Technology Special Congressional Initiative HRSA -08 -128 Page 44 of 49 yt '" June 30, 2010 Health Resources & Services Administration Re: Outreach Focused Special Congressional Initiative HRSA -10 -214 To whom it may concern: The Board of the Collier County Medical Society supports the Physician Led Access Network of Collier County and the primary care services project outlined in the HRSA application. In 2009, our community's physicians and related healthcare volunteers donated over three million dollars of in -kind care through PLAN. As a physician- driven initiative, this expanded use of the integrated volunteer network and it related information technology project would allow our physicians to provide coordinated charity care in a more efficient manner. This project specifically addresses the concerns of our physician members with retard to: 1) the over -use of the hospital emergency departments for non - emergent purposes because low - income individuals cannot afford primary care medical homes and 2) the lack of awareness of access options due to the inability to track patients through community's various medical points of entry. The ability to be able to provide volunteer primary healthcare to those who lack a medical home, to determine the appropriate healthcare access options for our low- income, uninsured population and to track those who require multiple indigeni community services via a web -based system will be critical to meeting PLAN 's goals. Thank you. Ja ie V. Talano, IVI.D. President of the Collier County Mledical Society June 28, 2010 Collier County Housing and Human Services 3301 E. Tamiami Trail Naples, FL 34112 RE: Outreach Focused Special Initiative To whom it may concern: CHS Healthcare supports the Physician Led Access Network (PLAN) of Collier County in its expansion to include primary care services to indigent patients in Collier County. PLAN has been and continues to be imperative in helping the uninsured and underserved adult population in Collier County. PLAN serves the community by providing specialty medical services to eligible, low income adult residents of Collier County who otherwise would have little to no access to specialty care. As demands on Primary Care services from non profit clinics and through CHS Healthcare have reached the breaking point, this initiative of the volunteer physicians of PLAN is fully supported by our organization Additionally, CHS Healthcare supports the funding to implement a web -based patient tracking and data collection system recommended for PLAN by The Health Planning Council of Southwest Florida as a result of a study funded by a previous HRSA Health Information Technology Grant. We wholeheartedly support their grant application, Sincerely, "14 g (ktm Richard B. Akin President /CEO