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Backup Documents 12/11-12/2012 Item #16D18 ORIGINAL DOCUMENTS CHECKLIST & ROUTING II 1 TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper.Attach to original document.Original documents should be hand delivered to the Board Office.The completed routing slip and original documents are to be forwarded to the Board Office only after the Board has taken action on the item.) ROUTING SLIP Complete routing lines#1 through#3 as appropriate for additional signatures,dates,and/or information needed.If the document is already complete with the exception of the Chairman's signature,draw a line through routing lines#1 through#3,complete the checklist,and forward to the BCC Office(line#4). Route to Addressee(s) Office Initials Date (List in routing order) 1. Lisa Can,Grants Coordinator Housing, Human,Veterans Services LC 12/13/12 Department 2. Jennifer B. White,ACA Office located within Housing, Human, ► �� Veterans Services Department ‘2.\k--\\ ���`� 3. County Attorney's Office County Attorney's Office 4. BCC Office Board of County Commissioners 5. Minutes and Records Clerk of Court's Office 'm rzfv f(2- PRIMARY CONTACT INFORMATION (The primary contact is the holder of the original document pending BCC approval.Normally the primary contact is the person who created/prepared the executive summary.Primary contact information is needed in the event one of the addressees above,need to contact staff for additional or missing information.All original documents needing the BCC Chairman's signature are to be delivered to the BCC office only after the BCC has acted to approve the item.) Name of Primary Staff Lisa Can Phone Number 239-252-2339 Contact Agenda Date Item was 12/11/12 Agenda Item Number 16-01" Approved by the BCC --\ Type of Document David Lawrence Center Contract 1 Attached INSTRUCTIONS&CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is appropriate. Yes N/A(Not (Initial) Applicable) 1. Original document has been signed/initialed for legal sufficiency.(All documents to be signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney.This includes signature pages from ordinances,resolutions,etc.signed by the LC County Attorney's Office and signature pages from contracts,agreements,etc.that have been fully executed by all parties except the BCC Chairman and Clerk to the Board and possibly State Officials.) 2. All handwritten strike-through and revisions have been initialed by the County Attorney's Office and LC all other parties except the BCC Chairman and the Clerk to the Board 3. The Chairman's signature line date has been entered as the date of BCC approval of the document or LC the final negotiated contract date whichever is applicable. 4. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's signature and LC initials are required. 5. In most cases(some contracts are an exception),the original document and this routing slip should be LC provided to the BCC office within 24 hours of BCC approval.Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 6. The document was approved by the BCC on 12/11/12 and all changes made during the meeting LC �r have been incorporated in the attached document. The County Attorney's Office has reviewed _ the changes,if applicable. I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05 «matter number»/«document number» 16 018 MEMORANDUM Date: December 26, 2012 To: Lisa Carr, Grants Coordinator Housing, Human & Veteran Services From: Martha Vergara, Deputy Clerk Minutes & Records Department Re: David Lawrence Center Contract Attached for your records is a copy of the document referenced above, (Item #16D18) approved by the Board of County Commissioners on December 11, 2012. The Minutes and Record's Department will maintain the original in the Board's Official Records. If you have any questions please call me at 252-7240. Thank you 16 018 STANDARD NONPROFIT/GOVERNMENT CONTRACT Funding Source: THE COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS AND DAVID LAWRENCE MENTAL HEALTH CENTER, Inc. THIS CONTRACT is made and entered into by and between Collier County, a political subdivision of the State of Florida, hereinafter referred to as "COUNTY" and David Lawrence Mental Health Center, Inc. d/b/a David Lawrence Center, a private nonprofit corporation existing under the laws of the State of Florida, hereinafter referred to as "DAVID LAWRENCE CENTER". WHEREAS, this Agreement is funded by local funds matched with Federal funds as provided in the October 23, 2012 Letter of Agreement between COUNTY and Agency for Healthcare Care Administration that allows COUNTY participation in an intergovernmental transfer program, and, WHEREAS, COUNTY believes it to be in the public interest to provide substance abuse and mental health services to the Collier County residents through the DAVID LAWRENCE CENTER according to this Contract, and NOW THEREFORE, in consideration of the mutual covenants, promises, and representations contained herein COUNTY and the DAVID LAWRENCE CENTER agree as follows: ARTICLE I SCOPE OF SERVICES Provision of substance abuse and mental health services in accordance with Exhibit 5. Program must be implemented to serve residents of Collier County in accordance with Chapters 394 and 397, Florida Statutes, and all exhibits hereto. ARTICLE II TERM OF CONTRACT This Contract shall begin October 1, 2012 and end September 30, 2013 unless terminated as specified in Article IX, Suspension/Termination. The COUNTY may, at its discretion and with the consent of the DAVID LAWRENCE CENTER, renew the Agreement under all of the terms and conditions contained in this Agreement for three (3) additional one (1)year periods. The COUNTY shall give DAVID LAWRENCE CENTER 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. ARTICLE III COMPENSATION AND REPORTS A. Contract Payment Once invoiced by the DAVID LAWRENCE CENTER and validated, the COUNTY will submit payments on a quarterly reimbursement basis to the Naples Community Hospital for services delivered in accordance with Exhibit 5. The DAVID LAWRENCE CENTER agrees to accept as full compensation the total annual amount not to exceed $1,154,200.00 as committed to by the County and total compensation through the matching program of $1,385,040.00. Payments will be authorized only for work Page 1 of 46 16010 completed and/or services delivered during the term of the contract as stated in ARTICLE II: TERM OF CONTRACT, and prior to the payment request date. Documentation of eligible expenses will be provided as stated in Article III C. Contract Deliverables. Payment is subject to the provisions of Article III B Deferred Payment/Return of Funds and Article IX, Suspension/Termination. All requests for payment shall be submitted in accordance with Exhibit 1. Funding is contingent upon the availability of funds. SALES TAX. The DAVID LAWRENCE CENTER shall pay all sales,consumer, use and other similar taxes associated with the Work or portions thereof, which are applicable during the performance of the Work. The COUNTY has agreed to purchase the service(s) listed in Article I. For unit rate contracts, this contract is for the payment of a fixed number of units of service at the fixed unit rate, as detailed in Exhibit 5. Approved Budget Category Annual County Program Area and AHCA Total Program Area Funding Allocation Adult Mental (a) Emergency $563,000 $1,039,000 Health Services (b)Medical Services $363,000 (c)Immokalee Medical $25,000 (d)Immokalee $88,000 Outpatient Adult (a) Detox $100,000 $230,000 Substance Abuse (b) Outpatient $60,000 (c)Drug Court $70,000 Children's (a) Medical $58,040 $116,040 Mental Health (b) Urgent Care $58,000 B. Deferred Payment/Return of Funds The COUNTY may defer payment to the DAVID LAWRENCE CENTER for noncompliance with contract deliverables or program requirements. If, as a result of monitoring or audit, units of service provided are not properly documented, a payment may be deferred. If units are found to be unallowable, no future payments will be made until the full amount of overpayment is remitted to the COUNTY or a repayment agreement is accepted by the COUNTY. If the monitoring or audit occurs after the term of this contract, the DAVID LAWRENCE CENTER will be required to remit funds to the COUNTY in accordance with the Page 2 of 46 repayment conditions below. 16 IJ 18 i The DAVID LAWRENCE CENTER agrees to return to the COUNTY any overpayments due to funds disallowed pursuant to the terms of this Contract and/or COUNTY, State or Federal requirements. The DAVID LAWRENCE CENTER will be required to reimburse the COUNTY for any acts of non- compliance resulting in disallowed costs or fines. C. Contract Deliverables 1. Required Reports (checked boxes are applicable) El EXHIBIT 1- Payment Request - Due: Quarterly by the 20th of the following month. All payments will be reimbursement for expenses/services rendered during the contract term and paid prior to final payment request due date as indicated in the Contract Closeout Section (Article III 2 D). Copies of supporting documentation are required as part of the Payment Request for review before payment will be made by Housing, Human and Veteran Services. Reimbursement for eligible expenses will be made after review and authorization of a correct and complete Exhibit 1 and all required back -up documentation. Eligible expenses are defined as uncompensated expenses/services delivered during the term of the contract'and paid prior to final payment request due date as indicated in the Contract Closeout Section (Article III 2 D). Appropriate back-up/supporting documentation may be requested at anytime and may include, but is not limited to: cancelled checks, vendor invoices, authorized purchase orders, attendance/service logs, other funder invoices, expenditure spreadsheets or other original documentation, as well as a copy of the DAVID LAWRENCE CENTER'S check issued with authorized signature. Two-sided copies of back-up documentation are preferred. The Exhibit 1 (Payment Request) must be submitted with an authorized signature. Processing of payment requests is also subject to requirements and conditions as outlined in Exhibit 5 Program Guidelines. CI EXHIBIT 2- Program/Demographics/Beneficiary Report —Due: As indicated on Exhibit 2. E1 EXHIBIT 3 — Performance Outcomes Report — Due: As indicated on Exhibit 3. El EXHIBIT 4 - Certificate of Insurance - Insert in contract. Ear EXHIBIT 5 — Statement of Work — Insert in contract. For all reports except the Exhibit 1 (Payment Request), either an email or hard copy of reports is acceptable. The Exhibit 1 (Payment Request) must have original signatures. Other reports requiring signatures can have an electronic signature or a scanned copy of the report with signature. 2. Required Documents Page 3 of 46 16 D 1 ((ji, D Audited Financial Statement and Management Letter for fiscal year(s) in which contract funds are expended — Due Date: Non profits - 180 days following the end of DAVID LAWRENCE CENTER'S fiscal year(s); Q Copy of latest IRS Form 990 Return of Organization Exempt From Income Tax- Due Date: Non profits — 180 days following the end of DAVID LAWRENCE CENTER'S fiscal year(s) El Monitoring Reports — A copy of monitoring reports issued from other sources that fund any program covered under this contract and copies of DAVID LAWRENCE CENTER'S response to the funding agency are due to the COUNTY no later than 30 days after receipt by the DAVID LAWRENCE CENTER. D. Contract Closeout Q State Mandated: Final Payment Request— Due: 30 days after contract end ARTICLE IV AUDITS, MONITORING, AND RECORDS A. Monitoring The DAVID LAWRENCE CENTER agrees to permit persons duly authorized by the COUNTY to inspect all records, papers, documents, facility's goods and services of the DAVID LAWRENCE CENTER and/or interview any clients and employees of the DAVID LAWRENCE CENTER to be assured of service delivery and performance of the terms and conditions of this contract to the extent permitted by the law after giving the DAVID LAWRENCE CENTER reasonable notice. The monitoring is a limited scope review of the contract and agency management and does not relieve the DAVID LAWRENCE CENTER of its obligation to manage in accordance with applicable rules and sound management practices. Following such monitoring the COUNTY will deliver to the DAVID LAWRENCE CENTER a written report regarding the manner in which services are being provided. The DAVID LAWRENCE CENTER will be requested to respond and rectify all noted deficiencies within the specified period of time indicated in the monitoring report or provide the COUNTY with a reasonable and acceptable justification for not correcting the noted shortcomings. The DAVID LAWRENCE CENTER'S failure to correct or justify the deficiencies within the time specified by the COUNTY may result in the withholding of payments, being deemed in breach or default, or termination of this Contract. B. Audits and Inspections The DAVID LAWRENCE CENTER will make all records referenced in Article IV. C. and all items included on financial statements available for audit or inspection purposes at any time during normal business hours and as often as COUNTY deems necessary. The Clerk of Courts Internal Audit Division, the Federal or State grantor agency (if applicable), Collier County employees, or any of their duly authorized representatives have the right of timely and unrestricted access to any books, documents, papers, or other records of DAVID LAWRENCE CENTER or Certified Public Accountant (CPA) that are pertinent to the contract, in order to make audits, examinations, excerpts, transcripts and copies of such documents. If contract non-compliance or material weaknesses in the organization are noted, the COUNTY or other authorized representatives have the right to Page 4 of 46 16 018 unlimited access to records during an audit or inspection. This includes timely and reasonable access to a DAVID LAWRENCE CENTER'S personnel for the purpose of interview and discussion related to such documents. C. Records The DAVID LAWRENCE CENTER shall retain all financial, client demographics, and programmatic records, supporting documentation, statistical records, and other records, which are necessary to document service provision, expenditures, income and assets of the DAVID LAWRENCE CENTER by funding source, program, and functional expenses category during the term of this contract and a minimum of three (3) years from the date of contract expiration. The retention period may be longer depending on the funding source. If any litigation, claim, negotiation, audit, or other action involving the records has been initiated before the expiration of the retention period, the records shall be retained for one (1) year after the final resolution of the action and final resolution of all issues that arise from such action. D. Independent Audit A complete independent financial audit of the agency's financial statements in accordance with Generally Accepted Accounting Principals (GAAP) and/or current Generally Accepted Government Auditing Standards (GAGAS) as applicable is required and must include the following: • auditor's opinion • requisite reports on internal control and compliance, if required • management letter addressing internal controls (Note: If there were no items to be addressed, the letter must still be completed and state that no comments were noted.) • management's response to such letter • the programs that are funded by this Collier County contract either in the statement of functional expenses, revenues and expenditures, footnotes, schedule of Federal awards and State financial assistance or as supplemental data in the financial statements. The statement should be consistent with programs detailed in the corresponding proposal(s), exhibit(s), and attachment(s). An original, bound or disk version from auditors must be submitted. The audit must be submitted to the COUNTY no later than one hundred eighty (180) days following the end of a non- profit DAVID LAWRENCE CENTER'S fiscal year. If applicable, any corrective action plan must be submitted. Failure to submit the report within the required time frame can result in the withholding of payment, or termination of the contract by the COUNTY. The audit must be conducted by an independent, licensed certified public accountant with an unqualified opinion on their current peer review and must be in accordance with the General Accounting Office (GAO) Yellow Book, Generally Accepted Government Auditing Standards, OMB Circular A-133 "Audits of States, Local Governments and Non-Profit Organizations" if applicable, the Florida Single Audit Act (F.S. 215.97) if applicable, and the Auditor General Rule 10.550 (Government) or 10.650 (Not For Profit) as applicable. Copy of the latest Form 990 must also be submitted no later than one hundred eighty (180) days following the end of a DAVID LAWRENCE CENTER'S fiscal year. Page 5 of 46 16 018 ARTICLE V AMENDMENTS DAVID LAWRENCE CENTER must submit in writing a request for any contract amendment, and provide supporting documentation for the request which details the nature of, and justification for the requested change and the desired effective date of the change(s). The COUNTY reserves the right to approve or deny all contract amendments requests. An amendment shall be documented and signed by authorized representatives of both parties. ARTICLE VI CONTRACTOR STATUS A. Independent Contractor It is the Parties' intention that the DAVID LAWRENCE CENTER will be an independent contractor and not the County's employee for all purposes, including, but not limited to, the application of the Fair Labor Standards Act minimum wage and overtime payments, Federal Insurance Contribution Act, the Social Security Act, the Federal Unemployment Tax Act, the provisions of the Internal Revenue Code, Florida revenue and taxation law, Florida Worker's Compensation law and Florida Unemployment Insurance Law. The DAVID LAWRENCE CENTER will retain sole and absolute discretion in the judgment of the manner and means of carrying out the DAVID LAWRENCE CENTER'S activities and responsibilities hereunder. The DAVID LAWRENCE CENTER agrees that it is a separate and independent enterprise from the public employer, that it has made its own investment in its business, and that it will utilize a high level of skill necessary to perform the work. This agreement shall not be construed as creating any joint employment relationship between the DAVID LAWRENCE CENTER and COUNTY, and COUNTY will not be liable for any obligation incurred by the DAVID LAWRENCE CENTER, including, but not limited to, unpaid minimum wages and/or overtime premiums. NO PARTNERSHIP. Nothing herein contained shall create or be construed as creating a partnership between the County and the DAVID LAWRENCE CENTER or to constitute the DAVID LAWRENCE CENTER as an agent of the COUNTY. B. Subcontracts Primary roles and responsibilities of DAVID LAWRENCE CENTER cannot be subcontracted. It is mutually agreed that any program component that is subcontracted by DAVID LAWRENCE CENTER must have a written contract upon execution of this contract. Procurement and/or bidding of non primary roles and responsibilities must be awarded on a fair and non collusive basis and must be in compliance with all applicable Collier County, State of Florida and Federal standards. The DAVID LAWRENCE CENTER must ensure each subcontractor conforms to the terms and conditions of this contract and if applicable Attachment A, Program Guidelines and must be subject to indemnification as stated in Article VIII. ARTICLE VII CONFLICT OF INTEREST The DAVID LAWRENCE CENTER agrees 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 in this contract. The DAVID LAWRENCE CENTER further agrees that no person having any such interest shall be employed or engaged for said performance. The DAVID LAWRENCE CENTER agrees that no employee, officer, agent of the DAVID LAWRENCE CENTER or its sub recipients shall participate in the selection, award or administration of a contract or construction bid if a conflict-of-interest, Page 6 of 46 16 018 either real or implied, would be involved. The DAVID LAWRENCE CENTER or sub recipient employees, officers and agents should refrain from accepting gratuities, favors or anything of monetary value from contractors or potential contractors based on the understanding that the receipt of such an item of value would influence any action or judgment of the DAVID LAWRENCE CENTER. For federally funded contracts, conflict-of-interest provisions described in 24 CFR 85.36 and 84.42 and all other established, applicable HUD regulations must be followed. ARTICLE VIII RISK MANAGEMENT A. Hold Harmless and Indemnity Clause To the fullest extent permitted by applicable law, DAVID LAWRENCE CENTER shall protect, defend, indemnify, save and hold COUNTY, the Board of County Commissioners, its agents, officials, and employees harmless from and against any and all claims, demands, fines, loss or destruction of property, liabilities, damages, for claims based on the negligence, misconduct, or omissions of the DAVID LAWRENCE CENTER resulting from the DAVID LAWRENCE CENTER'S work as further described in this contract, which may arise in favor of any person or persons resulting from the DAVID LAWRENCE CENTER'S performance or non-performance of its obligations under this contract except any damages arising out of personal injury or property claims from third parties caused solely by the negligence, omission(s) or willful misconduct of the County, its officials, commissions, employees or agents, subject to the limitations as set out in Florida general law, Section 768.28, Florida Statutes, as amended. Further, DAVID LAWRENCE CENTER hereby agrees to indemnify the County for all reasonable expenses and attorney's fees incurred by or imposed upon the County in connection therewith for any loss, damage, injury or other casualty. DAVID LAWRENCE CENTER additionally agrees that the County may employ an attorney of the County's own selection to appear and defend any such action, on behalf of the County, at the expense of the DAVID LAWRENCE CENTER. The DAVID LAWRENCE CENTER further agrees to pay all reasonable expenses and attorney's fees incurred by the County in establishing the right to indemnity. The DAVID LAWRENCE CENTER further agrees that it is responsible for any and all claims arising from the hiring of individuals relating to activities provided under the Contract. All individuals hired are employees of the DAVID LAWRENCE CENTER and not of the COUNTY. Duty to Defend: The duty to defend under this Article VIII is independent and separate from the duty to indemnify, and the duty to defend exists regardless of any ultimate liability of the DAVID LAWRENCE CENTER, COUNTY and any indemnified party. The duty to defend arises immediately upon presentation of a claim by any party and written notice of such claim being provided to the DAVID LAWRENCE CENTER. The DAVID LAWRENCE CENTER'S obligation to indemnify and defend under this Article VIII will survive the expiration or earlier termination of this Agreement until it is determined by final judgment that an action against the COUNTY or an indemnified party for the matter indemnified hereunder is fully and finally barred by the applicable statute of limitations. B. Insurance — Non- Profit DAVID LAWRENCE CENTER The DAVID LAWRENCE CENTER agrees to secure and maintain the insurance coverage outlined below during the term of this Contract. The DAVID LAWRENCE CENTER agrees that this insurance requirement shall not relieve or limit DAVID LAWRENCE CENTER'S Page 7 of 46 16 D 18 liability and that the COUNTY does not in any way represent that the insurance required is sufficient or adequate to protect the DAVID LAWRENCE CENTER'S interests or liabilities, but are merely minimums. Certificate(s) of Insurance naminc,Collier County Board of County Commissioners as Certificate Holder and additional insured will be attached to this contract as an exhibit. Name and address for Certificate Holder should be: Collier County Board of County Commissioners. Certificate(s) must be provided for the following: 1. Workers' Compensation— Statutory benefits as defined by Florida Statute 440 encompassing all operations contemplated by this contract or agreement to apply to all owners, officers, and employees. Employers' liability will have minimum limits of: $100,000 per accident $500,000 disease limit $100,000 disease limit per employee 2. Commercial General Liability — Coverage shall apply to premises and/or operations, products and/or completed operations, independent contractors, contractual liability, and broad form property damage exposures with minimum limits of: $100,000 bodily injury per person (BI) $300,000 bodily injury per occurrence (BI) $100,000 property damage (PD) or $300,000 combined single limit (CSL) of BI and PD The General Liability Policy Certificate shall name "Collier County, a political subdivision of the State of Florida, its agents, employees, and public officials" as "Additional Insured". The DAVID LAWRENCE CENTER agrees that the coverage granted to the Additional Insured applies on a primary basis, with the Additional Insured's coverage being excess. 3. Business Auto Liability —The following Automobile Liability will be required and coverage shall apply to all owned, hired, and non-owned vehicles used with minimum limits of: $100,000 bodily injury per person (BI) $300,000 bodily injury per occurrence (BI) $100,000 property damage (PD) or $300,000 combined single limit (CSL) of BI and PD 4. Directors & Officers Liability — Entity coverage to cover claims against the organization directly for wrongful acts with limits not less than $100,000. 5. Fidelity Bonding — Covering all employees who handle the agency's funds. The bond amount must be equivalent to the highest daily cash balance or a minimum amount of $50,000. C. Notice of cancellation or modification The COUNTY will be given thirty (30) days notice prior to cancellation or modification of any stipulated insurance. Such notification will be in writing by registered mail, return receipt requested and addressed to the Grant Coordinator. Page 8 of 46 0 Q IX SUSPENSION TERMINATION 16 0 1 8 ARTICLE / 1 A. Suspension The COUNTY reserves the right to suspend funding for failure to comply with the requirements of this contract. Agencies that fail to submit required documents by the due date can be suspended, and payment will be withheld until all requirements are satisfied. In the event DAVID LAWRENCE CENTER ceases operation for any reason or files for protection from creditors under bankruptcy law, any remaining unpaid portion of this Contract, less funds for expenditures already incurred, shall be retained by the COUNTY and the COUNTY shall have no further funding obligation to the DAVID LAWRENCE CENTER with regard to those unpaid funds. B. Termination by COUNTY The COUNTY may at any time and for any reason cancel this Contract by giving thirty days (30) written notice to the DAVID LAWRENCE CENTER by Certified Mail following a determination by the Board of County Commissioners, at its sole discretion, that such cancellation is in the best interest of the people of the county. From the date of cancellation, neither party shall have any further obligation unless specified in the termination notice. For unit rate contracts, if program is not operational within forty- five (45) days from contract start date, funds for said program will be withdrawn and contract will be amended or terminated. C. Termination by DAVID LAWRENCE CENTER The DAVID LAWRENCE CENTER may at any time and for any reason cancel this Contract by giving thirty days (30) prior written notice to the COUNTY by Certified Mail of such and specifying the effective date. COUNTY'S obligation to make any payments under any provision of this Contract shall cease on the effective date of termination. ARTICLE X ASSURANCE, CERTIFICATIONS, AND COMPLIANCE The DAVID LAWRENCE CENTER agrees that compliance with these assurances and certifications constitutes a condition of continued receipt of or benefit from funds provided through this Contract, and that it is binding upon the DAVID LAWRENCE CENTER, its successors, transferees, and assignees for the period during which services are provided. PERMITS: LICENSES:TAXES. In compliance with Section 218.80, F.S.,all permits necessary for the prosecution of the Work shall be obtained by the DAVID LAWRENCE CENTER. 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 DAVID LAWRENCE CENTER. The DAVID LAWRENCE CENTER shall also be solely responsible for payment of any and all taxes levied on the DAVID LAWRENCE CENTER. In addition, the DAVID LAWRENCE CENTER 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 DAVID LAWRENCE CENTER agrees to comply with all laws governing the responsibility of an employer with respect to persons employed by the DAVID LAWRENCE CENTER. Page 9 of 46 16 D 18 IMMIGRATION LAWS: The COUNTY will not intentionally award contracts to any contractor/vendor who knowingly employs unauthorized alien workers, constituting a violation of the employment provisions contained in 8 U.S.C. Section 1324 a(e) Section 274A(e) of the Immigration and Nationality Act (INA). The COUNTY shall consider the employment by DAVID LAWRENCE CENTER of unauthorized aliens a violation of Section 274A(e) of the INA. Such violation by the recipient of the employment provisions contained in Section 274A(e) of the INA shall be grounds for unilateral cancellation of the contract by the COUNTY. OTHER REQUIREMENTS: The DAVID LAWRENCE CENTER further assures that all contractors, subcontractors, or others with whom it arranges to provide services or benefits to participants or employees in connection with any of its programs and activities are not discriminating against those participants or employees in violation of statutes, regulations, guidelines and standards. By acceptance of this funding, the DAVID LAWRENCE CENTER assures and certifies the following: A. That they will comply with all applicable laws, ordinances, and regulations of the United States, the State of Florida, the COUNTY, and the municipalities as said laws, ordinances, and regulations exist and are amended from time to time. In entering into this contract, the COUNTY does not waive the requirements of any COUNTY or local ordinance or the requirements of obtaining any permits or licenses that are normally required to conduct business or activity contemplated by the DAVID LAWRENCE CENTER. B. That they will comply with all applicable Federal, State and local anti-discrimination laws. C. That they will administer their programs under procedures, supervision, safeguards, and such other methods as may be necessary to prevent fraud and abuse, and that it will target its services to those who most need them. D. That if clients are to be transported under this contract, the DAVID LAWRENCE CENTER will comply with the provisions of Chapter 427, Florida Statutes, which requires the coordination of transportation for the disadvantaged. E. That any products or materials purchased with contract funds shall be procured in accordance with the provisions of Chapter 403.7065, Florida Statues, which refers to the procurement of products or materials with recycled content. F. That they will comply with Chapter 39.201, Florida Statutes, that any person who knows, or has reasonable cause to suspect, that a child is abused, abandoned, or neglected by a parent, legal custodian, caregiver, or other person responsible for the child's welfare, as defined in this chapter, shall report such knowledge or suspicion to the Florida Abuse Hotline (1-800-962-2873). G. That they will comply with Chapter 415.1034, Florida Statutes, that any person who knows or has reasonable cause to suspect that a vulnerable and or disabled adult has been abused, neglected, or exploited, shall immediately report such knowledge or suspicion to the Florida Abuse Hotline (1-800-962-2873). Page 10 of 46 16 018 4 H. That if personnel in programs under this contract work directly with children or youths and vulnerable or disabled adults, the DAVID LAWRENCE CENTER will comply with the provisions of Chapters 435.03 and 435.04, Florida Statutes, which requires employment screening. I. That they will comply with Chapter 216.347, Florida Statutes, which prohibits the expenditure of contract funds for the purpose of lobbying the legislature, State or county agencies. J. That they will notify the COUNTY immediately of any funding source changes and/or additions from other sources that are different from that shown in the DAVID LAWRENCE CENTER'S application/proposal. This notification must include a statement as to how this change in funding affects provision of service as well as the use of and continued need for COUNTY funds. K. That they will acknowledge support for activities funded wholly or in part by COUNTY funds. In publicizing, advertising, or describing the sponsorship of the program, state "Sponsored by Collier County Board of County Commissioners". If the sponsorship is in written material, the words "Collier County Board of County Commissioners"shall appear in the same size letters or type as the name of the organization. L. That they will notify the COUNTY of any SIGNIFICANT changes to the DAVID LAWRENCE CENTER organization to include Board Membership (roster), Articles of Incorporation and Bylaws within ten (10) working days of the effective date. M. For federally funded programs, that they will comply with applicable uniform administrative requirements as described in 24 CFR part 84 and 85 and HUD requirements as described in 24 CFR part 5. N. The DAVID LAWRENCE CENTER shall comply with requirements as defined in section 504 of the Rehabilitation Act of 1973 (http://www.section508.gov/index.cfm?FuseAction=Content&ID=15) and the American Disability Act (ADA) (http://www.ada.gov/) as implemented by 28 CFR Part 35 (http://ecfr.gpoaccess.gov/cgi/t/text/text- idx?c=ecfr&tpl=/ecfrbrowse/Title28/28cfr35 main 02.tp1). A Single-Point-of-Contact shall be required if the agency employs fifteen (15) or more employees. The Single-Point-of-Contact will ensure effective communication with deaf or hard-of-hearing customers or companions in accordance with Section 504 and the ADA and coordinate activities and reports with the DAVID LAWRENCE CENTER's Single-Point-of-Contact. O. The DAVID LAWRENCE CENTER shall ensure that Collier County funds are restricted to people legally able to reside in the United States and Collier County residents. ARTICLE XI HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 (HIPAA) The COUNTY, pursuant to the Federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a "covered entity" as the law defines that term. Any "personal health information" (PHI) as defined by the law that the COUNTY receives pursuant to this Agreement is subject to the disclosure and security requirements of HIPAA. Transfer of information to the COUNTY Page 11 of 46 16 018 sufficiently "de-identified" to no longer be considered PHI is encouraged as being in the best interest of client PHI confidentiality to the extent that client services are unaffected. Particular methods to accomplish the highest levels of client service coupled with PHI confidentiality shall be an on-going task of the effected staffs of the COUNTY and DAVID LAWRENCE CENTER. ARTICLE XII CONTRACT DISPUTE RESOLUTION PROCEDURE VENUE. Any suit or action brought by either party to this Agreement against the other party relating to or arising out of this Agreement must be brought in the appropriate federal or state courts in Collier County, Florida, which courts have sole and exclusive jurisdiction on all such matters Any dispute between the parties with respect to provisions contained in a Collier County BoaRD OF County Commissioner contract or issues that arise pertinent to a contract shall be resolved as follows: The parties may, by mutual agreement, attempt to resolve their dispute in the following manner within a thirty(30)day period. If both parties are in agreement,the thirty(30)day time period can be extended for an additional ten (10) days. a. Duly authorized representatives shall meet as often as mutually agreeable to discuss in good faith the dispute and to negotiate a mutually agreeable resolution. Authorized representatives for HHVS include Grant Coordinator, and Manager of Federal and State Grants. b. During the course of the dispute process requests made by one Party to the other for non-privileged information, reasonably related to the dispute shall be responded to in good faith. c. If the dispute is unable to be resolved between the authorized representatives within the specified time period, it will be forwarded to the Department Director for resolution. A decision by the Director will be issued within ten days. d. If the dispute remains unresolved after the Department Director's decision, the issue including all pertinent background information will be forwarded to the Division Administrator for consideration. e. Either Party may at any time commence formal court proceedings, which shall be immediately communicated in writing, and will end the process of Dispute Resolution as described in this section. ARTICLE XIII NOTICES Official notices concerning this Contract will be directed to the following authorized representatives: DAVID LAWRENCE CENTER: COUNTY: Name: Name: Attn: LISA CARR Title: Title: Grant Coordinator Agency: Agency: Housing, Human and Veteran Svc Address: Address: 3339 East Tamiami Trail Suite 211 Naples, Florida 34112 Telephone: Telephone: (239) 252-2339 Fax: Fax: (239) 252- 6517 E-Mail : E-Mail: LISACARR@COLLLIERGOV.NET The signatures of the two persons shown below are designated and authorized to sign all applicable reports: OR Name (printed/typed) Name (printed/typed) Page 12 of 46 Signature Signature 16018 Title Title In the event that either party designates different representatives after execution of this contract, notice of the name and address of the new representative will be rendered in writing by authorized officer of DAVID LAWRENCE CENTER to the COUNTY. ARTICLE XIV SPECIAL PROVISIONS DISASTER/EMERGENCY ASSISTANCE. If needed, DAVID LAWRENCE CENTER may be called upon to assist the COUNTY during a natural disaster or emergency. This includes the use of the DAVID LAWRENCE CENTER'S facility to assist with Emergency Food Stamp pre registration if facility is operational and computer terminals are available. DAVID LAWRENCE CENTER will be responsible to notify United Way 211 immediately after a disaster declaration if the location is accessible and operational and of any DAVID LAWRENCE CENTER staff who are available to assist with recovery efforts. 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. 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. 2004-05, 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 ASSIGNMENT: DAVID LAWRENCE CENTER shall not assign this Agreement or any part thereof, without the prior consent in writing of the COUNTY. Any attempt to assign or otherwise transfer this Agreement, or any part herein, without the COUNTY's consent, shall be void. If DAVID LAWRENCE CENTER does, with approval, assign this Agreement or any part thereof, it shall require that its assignee be bound to it and to assume toward DAVID LAWRENCE CENTER all of the obligations and responsibilities that DAVID LAWRENCE CENTER has assumed toward the COUNTY. ARTICLE XV ALL TERMS AND CONDITIONS INCLUDED ORDER OF PRECEDENCE: In the event of any conflict between or among the terms of any of the Contract Documents, the terms of the Agreement shall take precedence over the terms of all other Contract Documents. This contract and its attachments, and any exhibits referenced in said attachments, together with any documents incorporated by reference, contain all the terms and conditions agreed upon by the parties. There are no provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all previous communications, representations, or agreements, either verbal or written between the parties. If any term or provision of this contract is legally determined unlawful or unenforceable, the remainder of the contract shall remain in full force and effect and such terms or provisions shall be stricken. Page 13 of 46 16 018 IN WITNESS THEREOF, DAVID LAWRENCE CENTER and COUNTY have caused this 46 page contract and all Contract Exhibits and Attachments as indicated on next page to be executed by their undersigned officials as duly authorized. Page 14 of 46 DAVID LAWRENCE CENTER: COLLIER COUNTY: 1613 1841 HIBIT2 .s c T Z - G 'LT4%'y,Ew By: FRED W.COYLE Name (print) �J Name (pri ) /44'4/(Signature of authorized officer) (Signature of authorized • fic- G/" 0 Chairman, Board of County Commissioners Title Title /1/19/12 Date Date STATE OF FLORIDA ATTEST: CLERK OF CIRCUIT COURT COUNTY OF COLLIER By: •� . 18/4 The foregoing instrument was acknowledged before me this day of ,f2012, Title: ►.- 7; �. K! —� by ` 0 `kz ` Date: ,: who is personally known to m4 or who has AttOStit. MONO produced as identification signitrot and who ❑ did (, did not) take an oath. APPROVED AS TO FORM AND LEGAL SUFFICIENCY: NOTA'Y: COUNTY ATTORNEY'S OFFICE B ►..... : . . . � �� . �a By: otary of Publ c (S gnature)4 Title: Ass■ska")+ CoJ,.d-y4+{-o-ray trnbPr\v - sx.yg . Name (typed) Date: \2.0\'a o", KIMBERLY K.MAYEU 1+ •j T. MY COMMISSION N DD 967715 • EXPIRES:June 29,2014 • y`' Bonded Thru Notary Public Undo/titers 16 018 EXHIBIT 1 PAYMENT REQUEST Line Item Contract Mail to: Collier County)lousing,Human and Veteran Services Ccmract# Agency:David Lawrence Center ATTR: Lisa Carr.Grant Coordinator Mailing Address: Expenditures for period: Phone __ F.R.Y. Phone_23P-2E2-2339 Check appropriate li=ne E-mail: FAX: _Regular Reimbursement E-Marl: Final Reimbursement Final Payment Reports ate due by the twentieth calendar day after the end of the reporting period, •••'•?1:.110pl owed 6ui .t:':••• :•:;:•: B .1{pp roved l tnnual: C.Balance Forward end D-Total Paid E Remaining Balance End of :CS6 ties, eel'iRiblitkd ill ::: ••••:• : Butiget74diotidif:• of prior month Expenditures for Reporting Period(CoL C-D) Reporting Period I ADltL �UBSTrtIi4 AcBH66;:::-: :I cHtt�•Iwi:a�[itf: : CHILD: UBETtitNCEABUSE•:•:- $ t.1\titi'.\t\titititititil�lti•:ti1ti!: S - S - f - PROVIDER: By signing below.I certify that the work and;or services provided and FOR COLLIER COUNTY USE ONLY reported in Exhibit 1 are for uncompensated expenses units,and have been By signing below,I certify that to the best of my completed andior delivered to the best of my knowledge. I further attest that knowledge and abilities,the work andfor services payment has been made in accordance with all applicable statutes,regulations and provided have been inspected,monitored or reviewed and approved County contract I understand that knowingly providing false information appear to be in compliance with all applicable statutes, could result in investigation and prosecution. r>n,dasinns and annrnvad rnunty rnntrart Signature of Authorized Offtciat: AUTHORIZED BY: APPROVED AMOUNT: 5 - Date arc red: DATE APPROVED: Page 16 of 46 16018 DAVID LAWRENCE CENTER DEMOGRAPHICS OF CLIENTS SERVED Reporting period:October 1,2012-September 30,2013 UNDUPLICATED CLIENT Adult Adult Children's Child/Adolesc. CHARACTERISTICS Mental Substance Mental Substance Health Abuse Health Abuse Total Number served: AGE GROUP I 5 and under 6-12 years _ 13-17 years 18-30 years 31-50 years 51-61 years 62 and over Not collected ITotal GENDER Male Female Not collected ITotal RACE American Indian or Alaska Native Asian Black or African American Native Hawaiian or Pacific Islander White Multi-Racial Other Not collected ITotal ETHNICITY Hispanic or Latino Not Hispanic or Latino Not collected ITotal LEGAL RESIDENCE AT REFERRAL Goodland 34140,34145 Immokalee 34142 Lely 34113 Marco Island 34140,34145 Naples 34102,34103,34104,34105,34112,34113 Naples Manor 34113 Naples Park 34108 Orangetree 34120 Pelican Bay 34108 Pelican Ridge 34108 Plantation Island 34139,34141 Vineyards 34116,34119 Out of county Not collected Homeless I Total C:1Documents and Settingslgeoffreymagon\Local Settings\Temporary Internet Files t Content.OutlooktLEAO2E9Z1Exhibit 2 Demographics DLC 2013 FORM Page 17 of 46 16 018 EXHIBIT 3 PERFORMANCE OUTCOME REPORT Provider Name: David Lawrence Center Program: Emergency Services Section 1 ONLY to be completed at time of contract execution. Section 2 to be completed for full term of the contract due October 31, 2013 for time period 10/01/12-9/30/13 SECTION ONE To Be Completed and returned with contract OUTCOME # 1: Crisis Stabilization Unit 1. Outcome Statement including# or%: 1,200 admissions (10% increase from previous year) will be processed to the Crisis Stabilization Unit during contract year. 2. List the Activities or Services provided by this program. The Crisis Stabilization Unit provides short term, inpatient crisis stabilization and support for individuals or adults who are either at risk of harming themselves or others due to a mental health crisis. David Lawrence Center manages the only Baker Act receiving facility for Collier County which includes emergency services and the Crisis Stabilization Unit. 3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome. Outcome information is tracked via electronic medical record and presented quarterly via internal reports capturing numbers of CSU admissions. END OF SECTION ONE Page 18 of 46 16018 PERFORMANCE OUTCOME REPORT Provider Name: David Lawrence Center Program: Emergency Services SECTION TWO Reporting Period: Contract year—October 1,2012—September 30,2013 Due : QUARTERLY Can be submitted by mail, email or fax OUTCOME # 1: Crisis Stabilization Unit 1. Outcome Statement including# or%: 1,200 admissions (10% increase from previous year) will be processed to the Crisis Stabilization Unit during contract year. 2. From data collected during the term of the contract, provide the following information: A. How many admissions were processed into this program during the specified time period? B. How many unduplicated clients were measured for this outcome during the time period? C. If answers A and B are different, explain why(sampling, outcome population definition, etc.)? N/A END OF SECTION TWO Agencies are welcome to submit a '/2 page narrative explanation. This could include explanation regarding your actual versus target percentage and any comments about the outcome results or the outcome process. Page 19 of 46 160 in PERFORMANCE OUTCOME REPORT Provider Name: David Lawrence Center Program: Emergency Services Section 1 ONLY to be completed at time of contract execution. Section 2 to be completed for full term of the contract due October 31,2013 for time period 10/01/12-9/30/13 SECTION ONE To Be Completed and returned with contract OUTCOME #2: Emergency Services Assessment Center 1. Outcome Statement including# or%: 1,451 assessments will be completed in the Emergency Services Assessment Center during contract year. 2. List the Activities or Services provided by this program. The Emergency Services Assessment Center provides Psychiatric Evaluations and Clinical Assessments for individuals or adults who in crisis. These assessments are completed within the scope of the Baker Act. David Lawrence Center manages the only Baker Act receiving facility for Collier County which includes emergency services and the Crisis Stabilization Unit. 3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome. Outcome information is tracked via electronic medical record and presented quarterly via internal reports capturing numbers of assessments completed in the Emergency Services Assessment Center. END OF SECTION ONE Page 20 of 46 PERFORMANCE OUTCOME REPORT 16 018 Provider Name: David Lawrence Center Program: Emergency Services SECTION TWO Reporting Period: Contract year—October 1,2012—September 30,2013 Due : QUARTERLY Can be submitted by mail, email or fax OUTCOME #2: Emergency Services Assessment Center 1. Outcome Statement including# or%: 1,451 assessments will be completed in the Emergency Services Assessment Center during contract year. 2. From data collected during the term of the contract, provide the following information: A. How many assessments were completed in this program during the specified time period? B. How many unduplicated clients were measured for this outcome during the time period? C. If answers A and B are different, explain why (sampling, outcome population definition, etc.)? Same individuals are sometimes assessed more than one time during the reporting period. END OF SECTION TWO Agencies are welcome to submit a %2 page narrative explanation. This could include explanation regarding your actual versus target percentage and any comments about the outcome results or the outcome process. Page 21 of 46 PERFORMANCE OUTCOME REPORT 1.6 D 18 Provider Name: David Lawrence Center Program: Emergency Services Section 1 ONLY to be completed at time of contract execution. Section 2 to be completed for full term of the contract due October 31,2013 for time period 10/01/12-9/30/13 SECTION ONE To Be Completed and returned with contract OUTCOME #3: Emergency Services Assessment Center 1. Outcome Statement including# or%: 330 individuals will be released from Baker Act placement and diverted from inpatient Crisis Stabilization Unit admission during contract period. 2. List the Activities or Services provided by this program. The Emergency Services Assessment Center diverts provides Psychiatric Evaluations and Clinical Assessments for individuals or adults who in crisis. These assessments are completed within the scope ofthe Baker Act. Individuals may be held in an emergency services screening area according to the regulations of the Baker Act and may be released following professional evaluation that determines Baker Act criteria is no longer met. David Lawrence Center manages the only Baker Act receiving facility for Collier County which includes emergency services and the Crisis Stabilization Unit. 3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome. Outcome information is tracked via electronic medical record and presented quarterly via internal reports capturing Baker Act evaluation and release data. END OF SECTION ONE Page 22 of 46 16 018 1. PERFORMANCE OUTCOME REPORT Provider Name: David Lawrence Center Program: Emergency Services SECTION TWO Reporting Period: Contract year—October 1,2012—September 30,2013 Due : QUARTERLY Can be submitted by mail, email or fax OUTCOME #3: Emergency Services Assessment Center 1. Outcome Statement including# or%: 330 individuals will be released from Baker Act placement and diverted from inpatient Crisis Stabilization Unit admission during contract period. 2. From data collected during the term of the contract, provide the following information: A. How many individuals were released and diverted from Crisis Stabilization Unit admission during the specified time period? _ B. How many unduplicated clients were measured for this outcome during the time period? C. If answers A and B are different, explain why(sampling, outcome population definition, etc.)? END OF SECTION TWO Agencies are welcome to submit a 1/2 page narrative explanation. This could include explanation regarding your actual versus target percentage and any comments about the outcome results or the outcome process. Page 23 of 46 PERFORMANCE OUTCOME REPORT 16 018 Provider Name: David Lawrence Center Program: Emergency Services Section 1 ONLY to be completed at time of contract execution. Section 2 to be completed for full term of the contract due October 31,2013 for time period 10/01/12-9/30/13 SECTION ONE To Be Completed and returned with contract OUTCOME # 4: Crisis Stabilization Unit 1. Outcome Statement including%: 85%or more of individuals discharged from the Crisis Stabilization Unit (CSU) will not be readmitted during the 30 days following discharge. 2. List the Activities or Services provided by this program. The Adult Crisis Stabilization Unit provides short term, inpatient crisis stabilization and support for persons who are either at risk of harming themselves or others due to a mental health crisis. The CSU is the only Baker Act receiving facility for Collier County. 3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome. Outcome information is tracked via electronic medical record database and presented quarterly via internal reports capturing numbers and percentages of people re-admitted within 30 days. • END OF SECTION ONE Page 24 of 46 16fl18 PERFORMANCE OUTCOME REPORT Provider Name: David Lawrence Center Program: Emergency Services SECTION TWO Reporting Period: Contract year—October 1,2012—September 30,2013 Due : QUARTERLY Can be submitted by mail, email or fax OUTCOME #4: Crisis Stabilization Unit 1. Outcome Statement including %: 85%or more of individuals discharged from the Crisis Stabilization Unit (CSU) will not be readmitted during the 30 days following discharge. 2. From data collected during the term of the contract,provide the following information: A. How many unduplicated clients did the CSU admit during the specified time period? B. How many unduplicated clients were measured for this outcome during the time period? C. If answers A and B are different, explain why(sampling, outcome population definition, etc.)? D. How many of the unduplicated clients from B achieved the outcome during the time period? E. Outcome percentage (D divided by B): END OF SECTION TWO Agencies are welcome to submit a V2 page narrative explanation. This could include explanation regarding your actual versus target percentage and any comments about the outcome results or the outcome process. Page 25 of 46 16 !] 18 .. PERFORMANCE OUTCOME REPORT Provider Name: David Lawrence Center Program: Adult Medical Services Section 1 ONLY to be completed at time of contract execution. Section 2 to be completed for full term of the contract due October 31,2013 for time period 10/01/12-9/30/13 SECTION ONE To Be Completed and returned with contract OUTCOME #5: Adult Medical Services 1. Outcome Statement including# or%: 1844 individuals who do not have Medicaid or Medicare coverage will be served in Adult Medical Services. 2. List the Activities or Services provided by this program. Medical Services include Psychiatric Evaluations and Medication Management for persons who are experiencing mental health problems that are serious and acute or related to a services and persistent mental illness. Services also include nursing services in addition to coordination with primary care physician. 3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome. Outcome information is tracked via electronic medical record and presented quarterly via internal reports capturing numbers served. END OF SECTION ONE Page 26 of 46 16 0 18 PERFORMANCE OUTCOME REPORT Provider Name: David Lawrence Center Program: Adult Medical Services • SECTION TWO Reporting Period: Contract year—October 1,2012—September 30,2013 Due : QUARTERLY Can be submitted by mail, email or fax OUTCOME #5: Adult Medical Services 1. Outcome Statement including# or%: 1844 individuals who do not have Medicaid or Medicare coverage will be served in Adult Medical Services 2. From data collected during the term of the contract, provide the following information: A. How many unduplicated clients did this program serve during the specified time period? B. How many unduplicated clients were measured for this outcome during the time period? C. If answers A and B are different, explain why(sampling, outcome population definition, etc.)? END OF SECTION TWO Agencies are welcome to submit a %2 page narrative explanation. This could include explanation regarding your actual versus target percentage and any comments about the outcome results or the outcome process. Page 27 of 46 PERFORMANCE OUTCOME REPORT Provider Name: David Lawrence Center Program: Adult Substance Abuse Outpatient Section 1 ONLY to be completed at time of contract execution. Section 2 to be completed for full term of the contract due October 31, 2013 for time period 10/01/12-9/30/13 SECTION ONE To Be Completed and returned with contract OUTCOME # 6: Adult Substance Abuse Outpatient 1. Outcome Statement including# or%: 343 individuals who do not have Medicaid or Medicare coverage will be served in Adult Substance Abuse Outpatient Services. 2. List the Activities or Services provided by this program. Substance Abuse Outpatient Services include group and individual therapy and may also include family therapy. Different levels of group therapy are available based on the intensity of the substance abuse or dependency. Treatment focuses on helping the individual accept his/her addiction and support the individual in establishing a recovery lifestyle. 3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome. Outcome information is tracked via electronic medical record and presented quarterly via internal reports capturing numbers served. END OF SECTION ONE Page 28 of 46 PERFORMANCE OUTCOME REPORT 16 1) 18 Provider Name: David Lawrence Center Program: Adult Substance Abuse Outpatient Services SECTION TWO Reporting Period: Contract year—October 1,2012—September 30,2013 Due : QUARTERLY Can be submitted by mail, email or fax OUTCOME #6: Adult Substance Abuse Outpatient Services 1. Outcome Statement including# or%: 343 individuals who do not have Medicaid or Medicare coverage will be served in Adult Substance Abuse Outpatient Services. 2. From data collected during the term of the contract,provide the following information: A. How many unduplicated clients did this program serve during the specified time period? B. How many unduplicated clients were measured for this outcome during the time period? C. If answers A and B are different, explain why(sampling, outcome population definition, etc.)? END OF SECTION TWO Agencies are welcome to submit a %2 page narrative explanation. This could include explanation regarding your actual versus target percentage and any comments about the outcome results or the outcome process. Page 29 of 46 16 B 18 PERFORMANCE OUTCOME REPORT Provider Name: David Lawrence Center Program: Detox Services Section 1 ONLY to be completed at time of contract execution. Section 2 to be completed for full term of the contract due October 31, 2013 for time period 10/01/12-9/30/13 SECTION ONE To Be Completed and returned with contract OUTCOME # 7: Detox Services 1. Outcome Statement including# or%: 470 admissions will be served in Detox Program. 2. List the Activities or Services provided by this program. The Detox program is a voluntary, medically- managed program for individuals who are in need of detoxification services utilizing American Society (of) Addiction Medicine level III.7d admission criteria. 3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome. Outcome information is tracked via electronic medical record and presented quarterly via internal reports capturing numbers served. END OF SECTION ONE Page 30 of 46 PERFORMANCE OUTCOME REPORT 16018 Provider Name: David Lawrence Center Program: Detox Services SECTION TWO Reporting Period: Contract year—October 1,2012—September 30,2013 Due : QUARTERLY Can be submitted by mail, email or fax OUTCOME# 7: Detox Services 1. Outcome Statement including# or%: 470 admissions will be served in Detox Program. 2. From data collected during the term of the contract, provide the following information: A. How many unduplicated clients did this program serve during the specified time period? B. How many unduplicated clients were measured for this outcome during the time period? C. If answers A and B are different, explain why(sampling, outcome population definition, etc.)? END OF SECTION TWO Agencies are welcome to submit a V2 page narrative explanation. This could include explanation regarding your actual versus target percentage and any comments about the outcome results or the outcome process. Page 31 of 46 16018 PERFORMANCE OUTCOME REPORT Provider Name: David Lawrence Center Program: Adult Drug Court Program Section 1 ONLY to be completed at time of contract execution. Section 2 to be completed for full term of the contract due October 31,2013 for time period 10/01/12-9/30/13 SECTION ONE To Be Completed and returned with contract OUTCOME #8: Adult Drug Court Program 1. Outcome Statement including# or%: 63 individuals who do not have Medicaid or Medicare coverage will be served in Adult Drug Court program. 2. List the Activities or Services provided by this program. The Adult Drug Court Program diverts offenders with substance abuse and drug related criminal activity from the criminal justice system by offering them an opportunity to proactively deal with their dependence rather than face punitive alternatives. 3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome. Outcome information is tracked via electronic medical record and presented quarterly via internal reports capturing numbers served. END OF SECTION ONE Page 32 of 46 16018 PERFORMANCE OUTCOME REPORT Provider Name: David Lawrence Center Program: Adult Drug Court SECTION TWO Reporting Period: Contract year—October 1,2012—September 30,2013 Due : QUARTERLY Can be submitted by mail, email or fax OUTCOME # 8: Adult Drug Court Program 1. Outcome Statement including# or%: 63 individuals who do not have Medicaid or Medicare coverage will be served in Adult Drug Court program. 2. From data collected during the term of the contract, provide the following information: A. How many unduplicated clients did this program serve during the specified time period? B. How many unduplicated clients were measured for this outcome during the time period? C. If answers A and B are different, explain why(sampling, outcome population definition, etc.)? END OF SECTION TWO Agencies are welcome to submit a 1/2 page narrative explanation. This could include explanation regarding your actual versus target percentage and any comments about the outcome results or the outcome process. Page 33 of 46 1601P PERFORMANCE OUTCOME REPORT Provider Name: David Lawrence Center Program: Immokalee Medical Services Section 1 ONLY to be completed at time of contract execution. Section 2 to be completed for full term of the contract due October 31,2013 for time period 10/01/12-9/30/13 SECTION ONE To Be Completed and returned with contract OUTCOME #9: Immokalee Medical Services 1. Outcome Statement including#or%: 83 individuals who do not have Medicaid or Medicare coverage will be served in Immokalee Medical Services. 2. List the Activities or Services provided by this program.Medical Services provided in the Immokalee Community that include Psychiatric Evaluations and Medication Management for persons who are experiencing mental health problems that are serious and acute or related to a services and persistent mental illness. Services also include nursing services in addition to coordination with primary care physician. 3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome. Outcome information is tracked via electronic medical record and presented quarterly via internal reports capturing numbers served. END OF SECTION ONE Page 34 of 46 16 018 PERFORMANCE OUTCOME REPORT Provider Name: David Lawrence Center Program: Immokalee Medical Services SECTION TWO Reporting Period: Contract year—October 1,2012—September 30,2013 Due : QUARTERLY Can be submitted by mail,email or fax OUTCOME #9: Immokalee Medical Services 1. Outcome Statement including# or%: 83 individuals who do not have Medicaid or Medicare coverage will be served in Immokalee Medical Services 2. From data collected during the term of the contract, provide the following information: A. How many unduplicated clients did this program serve during the specified time period? B. How many unduplicated clients were measured for this outcome during the time period? C. If answers A and B are different, explain why(sampling, outcome population definition, etc.)? END OF SECTION TWO Agencies are welcome to submit a 1/2 page narrative explanation. This could include explanation regarding your actual versus target percentage and any comments about the outcome results or the outcome process. Page 35 of 46 16018 PERFORMANCE OUTCOME REPORT Provider Name: David Lawrence Center Program: Immokalee Outpatient Services Section 1 ONLY to be completed at time of contract execution. Section 2 to be completed for full term of the contract due October 31,2013 for time period 10/01/12-9/30/13 SECTION ONE To Be Completed and returned with contract OUTCOME # 10: Immokalee Outpatient Services 1. Outcome Statement including# or%: 147 individuals who do not have Medicaid or Medicare coverage will be served in Immokalee Outpatient Services. 2. List the Activities or Services provided by this program. Immokalee Outpatient services include substance abuse and mental health services designed to promote emotional health and well-being. Mental Health Services include assessment, individual and group treatment services and case management services for persons who are experiencing mental health problems that are serious and acute or related to a severe and persistent mental illness. Substance Abuse Outpatient Services include group and individual therapy and may also include family therapy. Different levels of group therapy are available based on the intensity of the substance abuse or dependency. 3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome. Outcome information is tracked via electronic medical record and presented quarterly via internal reports capturing numbers served. END OF SECTION ONE Page 36 of 46 16018 PERFORMANCE OUTCOME REPORT Provider Name: David Lawrence Center Program: Immokalee Outpatient Services SECTION TWO Reporting Period: Contract year—October 1,2012—September 30,2013 Due : QUARTERLY Can be submitted by mail, email or fax OUTCOME # 10: Immokalee Outpatient Services 1. Outcome Statement including# or%: 147 individuals who do not have Medicaid or Medicare coverage will be served in Immokalee Outpatient Services 2. From data collected during the term of the contract, provide the following information: A. How many unduplicated clients did this program serve during the specified time period? B. How many unduplicated clients were measured for this outcome during the time period? C. If answers A and B are different, explain why (sampling, outcome population definition, etc.)? END OF SECTION TWO Agencies are welcome to submit a %2 page narrative explanation. This could include explanation regarding your actual versus target percentage and any comments about the outcome results or the outcome process. Page 37 of 46 PERFORMANCE OUTCOME REPORT 16018 Provider Name: David Lawrence Center Program: Childrens Medical Services Section 1 ONLY to be completed at time of contract execution. Section 2 to be completed for full term of the contract due October 31,2013 for time period 10/01/12-9/30/13 SECTION ONE To Be Completed and returned with contract OUTCOME # 11: Childrens Medical Services 1. Outcome Statement including# or%: 524 children who do not have Medicaid or Medicare coverage will be served in Childrens Medical Services. 2. List the Activities or Services provided by this program. Medical Services include Psychiatric Evaluations and Medication Management for persons who are experiencing mental health problems that are serious and acute or related to a services and persistent mental illness. Services also include nursing services in addition to coordination with primary care physician. 3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome. Outcome information is tracked via electronic medical record and presented quarterly via internal reports capturing numbers served. END OF SECTION ONE Page 38 of 46 16 0 18 PERFORMANCE OUTCOME REPORT Provider Name: David Lawrence Center Program: Childrens Medical Services SECTION TWO Reporting Period: Contract year—October 1,2012—September 30,2013 Due : QUARTERLY Can be submitted by mail, email or fax OUTCOME # 11: Childrens Medical Services 1. Outcome Statement including# or%: 524 children who do not have Medicaid or Medicare coverage will be served in Childrens Medical Services. 2. From data collected during the term of the contract,provide the following information: A. How many unduplicated clients did this program serve during the specified time period? B. How many unduplicated clients were measured for this outcome during the time period? C. If answers A and B are different, explain why(sampling, outcome population definition, etc.)? I END OF SECTION TWO Agencies are welcome to submit a V2 page narrative explanation. This could include explanation regarding your actual versus target percentage and any comments about the outcome results or the outcome process. Page 39 of 46 16 D 18 PERFORMANCE OUTCOME REPORT Provider Name: David Lawrence Center Program: Childrens Urgent Care Services Section 1 ONLY to be completed at time of contract execution. Section 2 to be completed for full term of the contract due October 31,2013 for time period 10/01/12-9/30/13 SECTION ONE To Be Completed and returned with contract OUTCOME # 12: Childrens Urgent Care Services 1. Outcome Statement including# or%: 422 children who do not have Medicaid or Medicare coverage will be served in Childrens Urgent Care Services. 2. List the Activities or Services provided by this program. Childrens Urgent Care Services consist of activities aimed at providing centrally accessed quality clinical assessments as well as diverse and brief treatment to the children of Collier County. Treatment services include crisis intervention, individual treatment, group treatment and family treatment in the areas of mental health and substance abuse/dependency. 3. How is outcome measured? List the tools/approaches/methods used to track or measure this outcome. Outcome information is tracked via electronic medical record and presented quarterly via internal reports capturing numbers served. END OF SECTION ONE Page 40 of 46 PERFORMANCE OUTCOME REPORT 16 018 Provider Name: David Lawrence Center Program: Childrens Urgent Care Services SECTION TWO Reporting Period: Contract year—October 1,2012—September 30,2013 Due : QUARTERLY Can be submitted by mail, email or fax OUTCOME # 12: Childrens Urgent Care Services 1. Outcome Statement including# or%: 422 children who do not have Medicaid or Medicare coverage will be served in Childrens Urgent Care Services. 2. From data collected during the term of the contract, provide the following information: A. How many unduplicated clients did this program serve during the specified time period? B. How many unduplicated clients were measured for this outcome during the time period? C. If answers A and B are different, explain why(sampling, outcome population definition, etc.)? END OF SECTION TWO Agencies are welcome to submit a '/2 page narrative explanation. This could include explanation regarding your actual versus target percentage and any comments about the outcome results or the outcome process. Page 41 of 46 av\,64- 16 D 18 OPID: KP ACORO" DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 11/19/12 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 305-665-2622 NA CT NAME: Weinstein Jones&Assoc.-CG 305-665-3236 PHONE FAX 5915 Ponce De Leon Blvd.,#29 (A/C,No,Eat): (NC,No): Coral Gables,FL 33146 E-MAIL FRANKLIN JONES ADDRESS: PRODUCER DAVID-6 CUSTOMER ID#: INSURER(S)AFFORDING COVERAGE NAIC# INSURED DAVID LAWRENCE MENTAL HLTH CTR INSURER A:MENTAL HEALTH RISK RET. — 6075 BATHEY LANE INSURER B:MENTAL HEALTH RISK RET. NAPLES,FL 34116 INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE LTR (NSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY X CCL0005137 01/15/12 01/15/13 DAMAGE TO 0 PREMISES(Ea occurrenceRENTED 300 00) $ , CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY JEl LOC $ I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per accident) NON-OWNED AUTOS $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ _ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITS , ER ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A PROF.LIAB. CCL0001883 01/15/12 01/15/13 EA.CLAIM 1,000,000 A DIRECTORS&OFF CD00001284-$1MIL LIMIT 01/15/12 01/15/13 AGGREGATE 3,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES Attach ACORD 101 Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER IS LISTED AS ADDITONAL INSURED. CERTIFICATE HOLDER CANCELLATION COLLIER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE COLLIER COUNTY BOARD OF THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. COMMISSIONERS AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD 6-12 1,6 1318 Exhibit 5 Statement of Work Name of Agency: David Lawrence Center For all programs Collier County purchases services and assists with the costs that are in addition to funding by Central Florida Behavioral Health Network (CFBHN), the managing entity for substance abuse and mental health funding for the Florida Department of Children and Families. Program: Emergency Services (Crisis Stabilization Unit) 1) DLC Projected Cost to provide a unit of service = $457.10 2) DLC county Unit Rate = $457.10 3) State Maximum Rate = $291.24 4) CFBHN Contract Rate = $391.24 5) Hours, days, location of operation: 24 hours day / 7 days a week 6075 Bathey Lane Naples 6) Activities/services provided: Short term crisis stabilization and support for individuals who are either at risk of harming themselves or others due to a mental health crisis. Individuals may receive voluntary or involuntary services within the scope of the Florida Baker Act. David Lawrence Center is the only Baker Act receiving facility in Collier County. 7) Target population: Children and Adults experiencing acute and serious mental health problems. Program: Emergency Services (Emergency Services Assessment Center) 1) DLC Projected Cost to provide a unit of service = $49.56 2) DLC county Unit Rate = $49.56 3) State Maximum Rate = $43.17 4) CFBHN Contract Rate = $43.17 5) Hours, days, location of operation: 24 hours day / 7 days a week 6075 Bathey Lane Naples 6) Activities/services provided: Evaluations, assessments or crisis intervention counseling for individuals in crisis. Individuals may receive voluntary or involuntary services within the scope of the Florida Baker Act. David Lawrence Center is the only Baker Act receiving facility in Collier County. 7) Target population: Children and Adults experiencing acute and serious mental health or substance abuse problems. Page 43 of 46 16 D 18 Program: Adult Medical Services 1) DLC Projected Cost to provide a unit of service = $372.70 2) DLC county Unit Rate = $372.70 3) State Maximum Rate = $369.55 4) CFBHN Contract Rate = $369.55 5) Hours, days, location of operation: 8:00 - 5:00 Monday thru Thursday; 8:00 - 3:00 Friday 6075 Bathey Lane Naples 6) Activities/services provided: Psychiatric evaluation, medication management and nursing services. 7) Target population: Adults experiencing mental health problems or severe and persistent mental illness. Program: Adult Substance Abuse Outpatient 1) DLC Projected Cost to provide a unit of service = $121.28 2) DLC county Unit Rate = $121.28 3) State Maximum Rate = $91.09 4) CFBHN Contract Rate =$91.09 5) Hours, days, location of operation: 8:00 - 5:00 Monday & Thursday; 8:00 - 7:00 Tuesday & Wednesday.; 8:00 - 3:00 Friday 6075 Bathey Lane Naples 6) Activities/services provided: Group and individual therapy primarily but may also include family therapy. Different levels of group therapy are available based on the intensity of the substance abuse or dependency. 7) Target population: Adult individuals experiencing substance abuse or dependency problems. Program: Detox 1) DLC Projected Cost to provide a unit of service = $221.27 2) DLC county Unit Rate = $221.27 3) State Maximum Rate = $204.94 4) CFBHN Contract Rate = $204.94 5) Hours, days, location of operation: 24 hours day / 7 days a week 6075 Bathey Lane Naples 6) Activities/services provided: Medically managed detoxification program. 7) Target population: Adults presenting with symptoms of alcohol or substance withdrawal or signs that withdrawal syndrome is imminent. Page 44 of 46 16018 Program: Adult Drug Court 1) DLC Projected Cost to provide a unit of service = $121.28 2) DLC county Unit Rate = $121.28 3) State Maximum Rate = $91.09 4) CFBHN Contract Rate =$91.09 5) Hours, days, location of operation: 8:00 - 5:00 Monday & Thursday; 8:00 - 7:00 Tuesday & Wednesday.; 8:00 - 3:00 Friday 6075 Bathey Lane Naples 6) Activities/services provided: Long term substance abuse treatment program that includes weekly group and individual treatment, as well as case management services. 7) Target population: Adults with substance dependency problems and also clients experiencing felony charges. Program: Immokalee Medical Services 1) DLC Projected Cost to provide a unit of service = $372.70 2) DLC county Unit Rate = $372.70 3) State Maximum Rate = $369.55 4) CFBHN Contract Rate = $369.55 5) Hours, days, location of operation: 8:00 - 6:00 Monday - Thursday 425 North First Street Immokalee, Florida 34142 6) Activities/services provided: Psychiatric evaluation, medication management and nursing services. 7) Target population: Individuals in the Immokalee Community experiencing mental health problems or severe and persistent mental illness in need of Psychiatric evaluation or medication. Program: Immokalee Outpatient Services 1) DLC Projected Cost to provide a unit of service = $121.28 2) DLC county Unit Rate = $121.28 3) State Maximum Rate = $91.09 4) CFBHN Contract Rate =$91.09 5) Hours, days, location of operation: 8:00 - 6:00 Monday - Thursday 425 North First Street Immokalee, Florida 34142 6) Activities/services provided: Substance Abuse or mental health treatment services that may include assessment, individual therapy, group therapy, family therapy and case management services. 7) Target population: Individuals experiencing either acute or chronic mental health problems or substance abuse or dependency problems. Page 45 of 46 16 018 Program: Children's Medical Services 1) DLC Projected Cost to provide a unit of service = $372.70 2) DLC county Unit Rate = $372.70 3) State Maximum Rate = $369.55 4) CFBHN Contract Rate = $369.55 5) Hours, days, location of operation: 8:00 - 5:00 Monday thru Thursday; 8:00 - 3:00 Friday 6075 Bathey Lane Naples 6) Activities/services provided: Psychiatric evaluation, medication management and nursing services. 7) Target population: Children experiencing emotional problems or severe emotional disturbance. Program: Children's Urgent Care 1) DLC Projected Cost to provide a unit of service = $49.56 2) DLC county Unit Rate = $49.56 3) State Maximum Rate = $43.17 4) CFBHN Contract Rate = $43.17 5) Hours, days, location of operation: 8:00 - 5:00 Monday & Thursday; 8:00 - 7:00 Tuesday & Wednesday.; 8:00 - 3:00 Friday 6075 Bathey Lane Naples 6) Activities/services provided: Evaluations, assessments, crisis intervention counseling or brief treatment. 7) Target population: Children experiencing acute and serious mental health or substance abuse problems. Page 46 of 46