Agenda 05/26/2009 Item #16D11
Agenda Item No. 16011
May 26, 2009
Page 1 of 32
EXECUTIVE SUMMARY
Recommendation that the Board of County Commissioners provide after-the-fact approval
for the attached Health Care and Other Facilities Special Congressional Initiative grant
application that was submitted to the United States Health Resources & Services
Administration in the amount of $141,570 and, if awarded, to serve as the Fiscal Agent and
to authorize staff to negotiate agreements with the participating agencies.
OBJECTIVE: To have the Board of County Commissioners provide after-the-fact approval for
a grant application for the Health Care and Other Facilities Special Congressional Initiative
Special Congressional Initiative earmark from the United States Health Resources & Services
Administration as specified in the Omnibus Appropriations Bill for Fiscal Year 2009 (P.L. 111-
8).
CONSIDERATIONS: In the fall of2008, 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). A total of 20 county projects were
originally submitted for consideration to The Ferguson Group representatives. The Ferguson
Group professionally evaluated the funding potential of each project. Based on opportunities
available, the PLAN project was one of nine (9) projects recommended for Collier County's
Fiscal Year 2009 Federal Legislative Agenda. The Board of County Commissioners approved
this project as one of their legislative priorities on February 12, 2008.
This appropriation was approved as part of the Omnibus Appropriations Bill for Fiscal Year
2009 (PL 111-8), signed into law on March 22, 2009. Upon notification of the approval of the
federal earmark for the Health Care Access/Physician Led Access Network (PLAN), Housing
and Human Services was directed to wait for instructions forthcoming to apply for the grant.
These instructions were received on April 13, 2009 and the grant application is due in Grants.gov
on May 11,2009. The purpose of this Collier County Health Care Access/Physician Led Access
Network (PLAN) program is to improve health care access to the uninsured by increasing
marketing, education and outreach. Funds will be used to purchase equipment and software to
permit the electronic transfer of information from access points and portals of entry as well as for
educational and outreach activities.
.-
When the grant is awarded, Collier County will enter into an agreement with participating
agencies. These agreements, along with the actual grant agreement for the federal dollars will be
presented to the Board of County Commissioners for approval. 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 our physicians, it 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
volunteer care. PLAN is an initiative launched by the Collier County Medical Society. This past
year, PLAN coordinators facilitated over 1300 patient encounters; these patients received over
one million nine hundred thousand dollars in donated care.
Agenda Item No. 16011
May 26, 2009
Page 2 of 32
Collier County Housing and Human 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 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. This item is not quasi judicial, and as such ex parte disclosure is not
required. This item requires majority vote only. This item is legally sufficient for Board
approval. - CMG
RECOMMENDATION: That the Board of County Commissioners provide after-the-fact
approval for the attached Health Care and Other Facilities Special Congressional Initiative grant
application that was submitted to the United States Health Resources & Services Administration
in the amount of $141,570 and, if awarded, to serve as the Fiscal Agent and to authorize staff to
negotiate an agreement with participating agencies to implement the program.
Prepared by: Marcy Krumbine, Director, Housing and Human Services
Item Number:
Item Summary:
Meeting Date:
Page 1 of I
Agenda Item No. 16011
May 26, 2009
Page 3 of 32
COLLIER COUNTY
BOARD OF COUNTY COMMISSIONERS
16011
Recommendation that the Board of County Commissioners provide after-the-fact approval for
the attached Health Care and Other Facilities Special Congressional Initiative grant
application that was submitted to the United States Health Resources & Services
Administration in the amount of $141,570 and, If awarded, to serve as the Fiscal Agent and
to authorize staff to negotiate agreements with the participating agencies.
5/26/200990000 AM
Prepared By
Marcy Krumbine
Public Services
Director
Date
Housing & Human Services
5/8/20093:33:50 PM
Approved By
Marcy Krumbine
Public Services
Director
Date
Housing & Human Services
5/8/20093:37 PM
Approved By
Kathy Carpenter
Public Services
Executive Secretary
Public Services Admin.
Date
5/11/20098:45 AM
Approved By
Marlene J. Foord
Administrative Services
Grants Coordinator
Date
Administrative Services Admin.
5/11/2009 2:59 PM
Approved By
Colleen Greene
County Attorney
Assistant County Attorner
County Attorney Office
Date
5/13/20094:35 PM
Approved By
Jeff Klatzkow
County Attorney
County Attorney
County Attorney Office
Date
5/14/20092:54 PM
Approved By
Marla Ramsey
Public Services
Public Services Administrator
Date
Public Services Admin.
5/15/200912:55 PM
Approved By
OMB Coordinator
County Manager's Office
OMB Coordinator
Date
Office of Management & Budget
5/15/2009 4:31 PM
Approved By
Sherry Pryor
County Manager's Office
Management & Budget Analyst
Office of Management & Budget
Date
5/18/20092:55 PM
Approved By
Leo E. Ochs, Jr.
Board of County
Commissioners
Deputy County Manager
Date
County Manager's Office
5/18/20093:29 PM
file:/ /C:\AgendaTest\Export\ 130-Mav%2026, %202009\ 16.%20CONSENT%20AGENDA \ I... 5/20/2009
~
Administrative Services Division
Collier County Government Center
3301 East Tamiami Trail
Naples, Florida 34112
marlenefoord(Q)collierswv.net
(239) 252-4768
(239) 252-8720 (fax)
Agenda Item No. 16011
R~; M.ay.26, 2009
C:~'.p~{ e 4 of 32
OFFiCE OF THE COU~!TY 1\/fANAGEP
'l
* -
fl,cr; 0'.
TO:
Jim Mudd, County Manager
Leo Ochs, Deputy County Manager
Applications
by County
submittal:
CC:
Marcy Krumbine, HHS Director
FROM:
Marlene Foord, Grants Coordinator
After-the-Fact Approval by the BCC is
required at the May 26. 2009 BCC
meeting.
DATE:
May 7, 2009
SUBJECT: County Manager Approval of Health Care and Other Facilities Special Congressional
Initiative grant application
As a result of the Fiscal Year 2009 Legislative Agenda, Collier County is the recipient of a Special
Congressional Initiative from the United States Health Resources & Services Administration. This
appropriation was approved as part of the Omnibus Appropriations Bill for Fiscal Year 2009 (PL 111-
8), signed into law on March 22, 2009. Upon notification of the approval of the federal earmark for
the Health Care Access/Physician Led Access Network (PLAN), Housing and Human Services was
directed to wait for instructions forthcoming to apply for the grant. These instructions were received
on April 13, 20~ and the grant application is due in Grants.gov on May 11,2009. (
Due to the minimal time given to draft the application compared with the NOVUS deadline, it is
necessary to request your approval of the application to be followed by after-the-fact approval of the
Board of County Commissioners during the May 26th meeting.
Since this is an online submittal, your signature is not required on any of the grant documentation and
is only needed in the box above to authorize electronic submittal.
Once you have reviewed the application, please sign and date in the box above and call me at
252-4768 for pickup.
Please let me know if you have any questions.
Agenda Item No. 16011
May 26, 2009
Page 5 of 32
PLAN Health Care Access for the Uninsured
Collier County Government, Florida
Housing and Human Services
3301 East Tamiami Trail
Building H
Naples, FL 34120
239-252-2273 (voice) 239-252-2638 (fax)
marcvkrum bine(aJ,CO Uienwv .net
Abstract
Collier County Government proposes to expand and develop a full access program with a
complete continuum of services for a population of approximately 45,000 low income
uninsured residents. Requesting an amount of$l41,570 Collier County Government will
purchase the equipment and software needed to implement a Health Information
Technology project for the electronic transfer of information linking data from the
hospitals' systems, the community's clinics that serve as access to care for the poor and
the private practice participating healthcare providers into PLAN. In addition, diagnostic
equipment to help serve the low income population with health care will be purchased for
participating clinics. Once the information network is operational, the project plans to
develop and implement a marketing plan for full penetration of the population of
individuals who are uninsured.
Collier County is located on the southern gulf coast of the Florida peninsula, due west of
the Miami-Ft. Lauderdale area. Naples, located in the western and coastal area of Collier
County, is the largest of the 3 incorporated cities in Collier County. Everglades City, lies
south and east of Naples and recently incorporated City of Marco Island lies south along
the Gulf of Mexico. Collier County contains approximately 2,025.45 square miles of land
area with a population of approximately 335,000.
Housing and Human Services (HHS) serves Collier County's very low, low and
moderate income residents, including the senior population by providing access to health
care, developing volunteer services with retirees, assisting with affordable
homeownership and other housing opportunities, maintaining safe and decent housing
and independent living for seniors, utilizing federal and state grants to build safe, livable
and healthy communities and to meet the local government mandates of human services
in Collier County. HHS will contract with the Physician Led Access Network (PLAN) to
meet the needs of health care access for the uninsured. 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 our physicians, it 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 volunteer care. PLAN is an initiative launched by the
Collier County Medical Society.
Agenda Item No. 16011
May 26, 2009
Page 6 of 32
;
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.::::- GRANTS.GOV.
Grant Application Package
Opportunity Title:
Offering Agency:
CFDA Number:
CFDA Description:
Opportunity Number:
Competition 10:
Opportunity Open Date:
Opportunity Close Date:
Agency Contact:
Health Care and Other Faci11ties Awards Special Congres
Health Resources & Services Administration
193.887
!Health Care and Other Facolities
iHRSA-09-163
3355
I 04/10/2009
I 05/11/2009
Paul Murphy
Division of Facilities Compliance and Recovery
E-mail: hcof2009@hrsa.gov
Telephone: 301-443-3665
Fax: 301-443-0619
This opportunity is only open to organizations, applicants who are submitting grant applications on behalf of a company, state, local or
tribal government, academia, or other type of organization.
. Application Filing Name: Icollier Physician Led Access Network
Mandato Documents
Move form to
Complete
Mandato Documents for Submission
Budget Information for Construction Programs (S:.
Application for Federal Assistance (SF-424)
HHS Checklist Form PHS-5161
Budget Narrative Attachment Form
pro'ect Narrative Attachment Form
Move form to
Delete
Assurances for Construction Programs (SF-424D)
Move Form to
Delete
Optional Documents for Submission
r -~
- -n. ~'
o tional Documents
Move Form to
Submission List
-
Enter a name for the application in the Application Filing Name field.
. This application can be completed in Its entirety offline; however, you will need to login to the Grants.gov website during the submission process.
- You can save your application at any time by clicking the "Save" button at the top of your screen.
- The "Save & Submll. button wil not be functional until all required data fields In the application are completed and you clicked on the .Check Package for Error>;. button and
confirmed all data required data fields are completed.
Open and complete all of the document5 listed in the "Mandatory Documents" box. Complete the SF-424 form first.
- It is recommended that the SF-424 form be the fir>;t form completed for the application package. Data entered on the SF-424 will populate data flelds in other mandatory and
optional forms and the user cannot enter data in these fields.
. The forms listed in the "Mandatory Documents" box and "Optional Documents" may be predefined forms. such as SF-424, forms where a document needs to be attached.
such as the Project Narrative or a combination of both. "Mandatory Documents. are required for this application. "Optional Documents" can be used to provide additional
support for this application or may be required for specific types of grant activity. Reference the application package Instructions for more information regarding "Optional
Documents",
- To open and complete a form, simply click on the form's name to seiect the ~em and then click on the => button. This w~1 move the document to the appropriate "Documents
for Submission" box and the form will be automatically added to your application package. To view the form. scroll down the screen or select the form name and click on the
"Open Form" button to begin completing the required data fields. To remove a form/document from the "Documents for Submission" box, click the document name to select ~,
and then click the <= button. This will return the form/document to the .Mandatory Documents" or "Optional Documents" box.
- All documents listed in the .Mandatory Documents. box must be moved to the "Mandatory Documents for SubmiSSion" box. When you open a required form. the fields which
must be completed are highlighted in yellow w~h a red border Optional fields and completed fields are displayed In while. If you enter invalid or incomplete information in a
field, you will receive an error message.
Click the "Save & SubmU" button to submit your application to Grants.gov.
- Once you have properly completed all required documents and attached any required or opliOnal documentation, save the completed application by clicking on the "Save.
button.
- Click on the "Check Package for Error>;" button to ensure that you have completed all required data fields. Correct any errors or If none are found, save the application
package.
- The .Save & Submit" button will become active: click on the "Save & Subm~" button to begin the application submission process"
- You will be taken to the applicant login page to enter your Grants.gov usemame and password. Follow all onscreen instructions for submission.
Agenda Item No. 16011
May 26, 2009
Page 7 of 32
OMS Number: 4040..Q004
Expiration Date: 0113112009
Application for Federal Assistance SF-424 Version 02
. 1. Type of Submission: .2. Type of Application: . If Revision. select appropriate leller(s):
o Preapplication [8] New I I
[g] Application D Continuation . Other (Specify)
D Changed/Corrected Application D Revision I I
. 3. Date Received: 4. Applicant Identifier:
ICompleted by GnInls.gov upon submission. I I I
5a. Federal Entity Identifier: . 5b. Federal Award Identifier:
I 1 I I
State Use Only:
6. Date Received by State: 1 I 17. State Application IdentifIer: I I
8. APPUCANT INFORMATION:
. a. Legal Name: ICOllier County I
. b. EmployerfTaxpayer Identification Number (EINfTlN): . c. Organizational DUNS:
1596000558 / 1076997790 I
d. Address:
. Street1: 13301 Tamiami Trail E. I
Stree12: 1 I
. City: INaPlee I
County: I I
. State: I FL: Florida I
Province: I I
. Country: I USA: UNITED STATES I
. Zip I Postal Code: 134112 I
e. Organizational Unit:
Department Name: Division Name:
IHOUSing and Human Services I /PUbliC Services I
f. Name and contact Information of person to be contacted on matters Involving this application:
Prefix: I I . First Name: IMarcy I
Middle Name: I I
. Last Name: !KrUmbine I
Suffix: I I
Title: IDirector I
Organizational Affiliation:
I I
. Telephone Number: 1239 252-2273 I Fax Number: 1239 252-2638 I
. Email: ImarCYkrumbine@colliergov.net I
...-
Agenda Item No. 16011
May 26, 2009
Page 8 of 32
OMS Number: 4040-0004
Expiration Date: 01/31/2009
Application for Federal Assistance SF-424 Version 02
9. Type of Applicant 1: Select Applicant Type:
IB: County Government I
Type of Applicant 2: Select Applicanl Type:
I I
Type of Applicant 3: Select Applicant Type:
I I
. Other (specify):
I I
.10. Name of Federal Agency:
IHeal th Resources & Services Administration I
11. Catalog of Federal Domestic A5IIIstance Number:
193.887 I
CFDA Title:
IHeal t h Care and Other Facilities I
.12. Funding Opportunity Number:
!HRSA-09-163 I
"Title:
Health Care and Other Facilities Awards Special Congressional Initiative
13. Competition Identification Number:
13355 I
Title:
I I
14. Areas Affected by Project (Cities. Counties, States. etc.):
Collier County. including the area of Immokalee
.15. Descriptive Title of Applicanfs Project:
Health Care Access/physician Led Access Network (PLAN)
Attach supporting documents as specified in agency instructions.
It,tAdd~mehlS. I 1....~~ii"'tt8(:tlrn!!l!ll!liJ~ IH1;~.ew~~~~;,~
",.,.:._,,,,,,~,,,;,,,,'..,;..,,. ,'..,,,. .:: "0','.-' . _ ... ,:.: :.::
Agenda Item No. 16011
May 26, 2009
Page 9 of 32
OMB Number: 4040-0004
Expiration Date: 01/31/2009
Application for Federal Assistance SF-424 Version 02
16. Congressional Districts Of:
. a. App~cant 114/25 I . b. Program/Project 114/25 I
Attach an additional list of ProgramIPtoject Congressional Districts if needed.
I I lir~_!:b~i'j~ I~." ""'1 IF'.'.....'.......'...'...."'. "J
),'" '."'llfiiilil'~i:
. ..... ,..... ~H.......JL m":!,(Ji!i~~~iij;j!Tht.;.).
17. Proposed Project:
. a. Start Date: 110/01/2009 I . b. End Date: 109/30/2010 I
18. Estimated Funding ($):
. a. Federal I 141,570.001
. b. Applicant I 0.001
. c. State I 0.001
. d. Local I 0.001
.e. Other I 0.001
of. Program Income 1 0.001
. g. TOTAL I 141,570.001
. 19. Is Application Subject to Review By State Under executive Order 12372 Process?
0 a. This application was made available to the State under the Executive Order 12372 Process for review on I I.
[g] b. Program is subject to E.O. 12372 but has not been selected by the State for review.
D c. Program is not covered by E.O. 12372.
. 20. Is the Applicant Delinquent On Any Federal Debt? (If -Ves., provide explanation.)
DYes [g] No 1~:ri'i'~~IA~~~~1iWc~
21. 'By signing this application, I certify (1) to the statements contained In the list of certifications'" and (2) that the statements
herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances'" and agree to
comply with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may
subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001)
[g] ., I AGREE
.. The list of certifications and assurances. or an internet site where you may obtain this list. is contained in the announcement or agency
specific instructiorls.
Authorized Representative:
Prefix: I I . First Name: IDonna I
Middle Name: I 1
. Last Name: IFiala I
Suffix: I I
'ntle: IChairman, Board of County Commissioners I
. Telephone Number. 1239 252-8097 I Fax Number. 1239 252-3602 I
. Email: Idonnafiala@colliergov.net I
. Signature of Authorized Representative: IcomPleted by Grants.gov upon SUbmiSSIon. I . Date Signed: jcompleted by Grants.gov upoo submission. I
Authorized for Local Reproduction
Standard Form 424 (Revised 1012005)
Prescribed by OMS Circular A-1 02
Application for Federal Assistance SF-424 Version 02
* Applicant Federal Debt Delinquency Explanation
The following field should contain an explana~on if the Applicant organiza~on is deWnquent on any Federal Debt. Maximum nu mber of
characters that can be entered is 4,000. Try and avoid extra spaces and carriage returns to maximize the availability of space.
Agenda Item No. 16D11
May 26, 2009
Page 10 of 32
OMS Number: 4040-0004
Expiration Date: 01/31/2009
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PHS-6161.1 (7100)
CHECKLIST
Agenda Item No. 16011
May 26, 2009
Page 12 of 32
OMB Approval No 0920-0426
Clearance Officer, 1600 Clillon Road. MS 0-24. Atlanta. GA 30333. ATTN: PRA
(0920-0428). Do not send the completed form to this address.
NOTE TO APPLICANT:
Public Burden Statement:
Public reporting burden of this collection of information is estimated to average 4
hours per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed. and
completing and reviewing the collection of information. An agency may not
conduct or sponsor. and a person is not required to respond to a collection of
information unless tt displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this
collection of Information, Including suggestions for reducing this burden to COCo
This form must be completed and submitted wtth the original of your
application. Be sure to complete both sides of this form. Check the
appropriate boxes and provide the information requested. This form should be
attached as the last age of the signed original of the application. This page Is
reserved for PHS staff use only.
Type of Application:
[g] NEW
o Noncompeting Continuation 0 Competing Continuation
o Supplemental
PART A: The following checklist Is provided to assure that proper signatures, assurances, and certifications have been submitted.
Included NOT Applicable
1. Proper Signature and Date ............................ [g]
2. Proper Signature and Date on PHS-5161-1 .Certifications. page. ............................ [g]
3. Proper Signature and Date on appropriate .Assurances" page, i.e.. SF-424B (Non-Construction Programs)
or SF-424D (Construction Programs) ........... [g]
4. If your organization currently has on file with DHHS the following assurances, please identify which have
been filed by indicating the date of such filing on the line provided. (All four have been consolidated into a
single form, HHS Form 690)
[g]
[BJ
[g]
[g]
Civil Rights Assurance (45 CFR 80) ..........................................
Assurance Concerning the Handicapped (45 CFR 84) .................
Assurance Concerning Sex Discrimination (45 CFR 86) ..............
Assurance Concerning Age Discrimination (45 CFR 90 & 45 CFR 91) ........................
5. Human Subjects Certification, when applicable (45 CFR 46) .....................................
o
[gJ
PART B: This part is provided to assure that pertinent information has been addressed and Included In the application.
YES NOT Applicable
1. Has a Public Health System Impact Statement for the proposed program/project been completed and
distributed as required? ...............................................................
2. Has the appropriate box been checked on the SF-424 (FACE PAGE) regarding intergovemmental review
under E.O. 12372 ? (45 CFR Part 100) ...............
3. Has the entire proposed project period been identified on the SF-424?..................
4. Have biographical sketch(es) with job description(s) been attached. when required?..............
5. Has the "Budget Information" page, SF-424A (Non-Construction Programs) or SF-424C (Construction
Programs). been completed and included? ............................
6. Has the 12 month detailed budget been provided? ......................................................
7. Has the budget for the entire proposed project period with sufficient detail been provided? ...................
B. For a Supplemental application. does the detailed budget address only the additional funds requested?
9. For Competing Continuation and Supplemental applications, has a progress report been included?
PART C: In the spaces provided below, please provide the requested information.
Business Official to be notlfl9d if an aw.ord IS to be made
Name: Prefix: I
. Last Name: IMudd
Title: !count V Manaqer
OrganizaUon: !collier County
Address: .Stnlel1: 13301 Tamiami Trail E.
Streel2: I
IJames
Mi.- Name: Iv
SUffix: I
. First Name:
. City INaples
. State: IFL: Florida
. Country IUSA: UNITED STATES
. Telephone Number: 1239 252-8383
E-mail Address: Ii amesmudd@collierqov.net
Fax Number:
Province:
. Zip I Postal Code: h 4 11 2
APPLICANT ORGANIZATION'S 12.DIGIT DHHS EIN (If already assigned)
0-159-6000558 1- c=J
o
[g]
[g]
o
[gJ
[gJ
[g]
o
o
~
[BJ
o
o
[gJ
[gJ
Agenda Item No. 16011
May 26, 2009
Page 13 of 32
PHS.a181.1 (7100)
~
PART C (Continued): In the spaces provided below, ple..e provide the requested Information.
Program OirectorlProject OifectorlPrincipallnvesUgator designated 10 dirncl the proposed project
Nam.: Prefix: I I . Filtll Nama: !MarCy
Title: IDirector
Organization: !collier County Housinq & Human Services
. Last Name:
IKrumbine
Suffix:
Address:
. Street1: 13301 Tamiami Trail E.
Stree12:
'Clly: INaples
. Slale: IFL: Florida
. Country jUSA: UNITED STATES
'TelephoneNumber: 1239 252-2273
Provioce:
. Zip I Postal Code: \3 4112
E......all Addres.: !marcvkrumbine@collierqov.net
Fax Number: 1239 252-2638
SOCIAL SECURITY NUMBER
HIGHEST DEGREE EARNED
PART 0: A private, nonprofit organization must Include evidence of Its nonprofit status with the application. Any of the following Is acceptable
evidence. Check the appropriate box or complete the Kprevlously FlledK section, whichever Is applicable.
o
o
o
o
o
(a) A reference to the organization's listing in the Intemal Revenue Service's (IRS) most recent list of tax-exempt organizations described in section
501 (c)(3) of the IRS Code.
(b) A copy of a currently valid Intemal Revenue Service Tax exemption certificate.
(c) A statement from a State taxing body, State Attomey General, or oll1er appropriate State official certifying that the applicant organization has a
nonprofit status and that none of the net earnings accrue to any private shareholders or individuals.
(d) A certified copy of the organization's certificate of incorporation or similar document if it clearly establishes the nonprofit status of the organization.
(e) Any of the above proof for a State or national parent organization, and a statement signed by the parent organization that the applicant organization
is a local nonprofit affiliate.
If an applicant has evidence of current nonprofit status on file with an agency of PHS, it will not be necessary to file similar papers again, but the place
and date of filing must be indicated.
Previously Filed with: . (Agency)
on . (Date)
INVENTIONS
If this is an application for continued support, include: (1) the report of inventions conceived or reduced to practice required by the terms and conditions of
the grant; or (2) a list of inventions already reported. or (3) a negatiw certification.
EXECUTIVE ORDER 12372
Effective September 30,1983. Executive Order 12372
(Intergovernmental Review of Federal Programs) directed OMB to
abolish OMB Circular A-95 and es1ablish a new process for consulting
with State and local elected officials on proposed Federal financial
assistance. The Department of Health and Human Services
implemented the Executive Order through regulations at 45 CFR Part
100 (Inler-governmental Review of Department of Health and Human
Services Programs and Activities). The Objectives of the Executive
Order are to (1) increase Slate flexibility to design a consultation
process and select the programs it wishes to review, (2) increase the
ability of State and local elected offICials to inlluence Federal decisions
and (3) compel Federal officials to be responsive to State concerns. or
explain the reasons.
The regulations at 45 CFR Part 100 were published in Federal
Registeron June 24, 1983, along with 8 notice identifying the
Department's programs that are subject to the provisions of Executive Order
12372. Information regarding PHS programs subject to Executive Order 12372
Is also available from the appropriate awarding office.
Stales participating in this program establish State Single Points of Contact
(SPOCs) to coordinate and manage the review and comment on proposed Federal
financial assistance. Applicants should contact the Governors office for
information regarding the SPOC, programs selected for review, and the
consultation (review) process designed by their State.
Applicants are to certify on the face page of the SF-424 (attached) whether the
request is for a program covered under Executive Order. 12372 and, where
appropriate. whether the State has been given an opportunity to comment.
Agenda Item No. 16011
May 26, 2009
Page 14 of 32
Budget Narrative File(s)
* Mandatory Budget Narrative Filename: inal Budget Detai 1 Worksheet Round I I . doc
p,'....."',..,.~. '.' "'J:l;"''''''''':~'fi'~s'lleel''''''Marir.iaf\S\J~tl'Na#atlvelIM~i''''''',U~'Narra~1
_VIII!~ry...,_",~fJ"ll." ....,..,',..Qf)'-liI.... ..1. ....... _T ..,.,.......... .
To add more Budget Narrative attachments, please use the attachment buttons below.
12,~.:Q~O~!I,~\!~g~jtf~~l"fll~~!l!h9Pq~~1,~nil~~~~' 1~';~~iton;U~~~~~~}.~
Agenda Item No. 16011
May 26,2009
Page 15 of 32
Project Narrative File(s)
* Mandatory Project Narrative File Filename: INarrative2009 (2) .doc
I~~~~~ If[i...~~._.lrtli].rllQllv_.~F~~
To add more Project Narrative File attachments, please use the attachment buttons below.
I'" ilrliit'.iimw;atiD\1li.~~!IIII'tri:iiimt~"'I'.l.~iillfriii\f"""'II\~~;"'ri';'itiI'!t:ir""'~B
~,~~,'"'ffli1l.t~1m""!!",,,'4 _1I~""Ili~ll'!O~"."j~l};~ ,~'ll',l!f~~1t!rtil1 ." ."qt,;j~J1!tIW~L",
Agenda Item No. 16D 11
May 26, 2009
Page 16 of 32
CERTIFICATION REGARDING LOBBYING
Certification for Contracts, Grants, loans. and Cooperative Agreements
The undersigned certifies. to the best of his or her knowledge and belief. that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any
person for influencing or attempting to influence an officer or employee of an agency, a Member of
Congress. an officer or employee of Congress, or an employee of a Member of Congress in connection with
the awarding of any Federal contract, the making of any Federal grant. the making of any Federal loan, the
entering into of any cooperative agreement. and the extension, continuation, renewal, amendment, or
modification of any Federal contrac~ grant. loan. or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a Member of Congress. an
officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal
contract, grant, loan. or cooperative agreement, the undersigned shall complete and submit Standard
Fonn-llL, "Disclosure of Lobbying Activities," in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents
for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans. and
cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification
is a material representation offact upon which reliance was placed when this transaction was made or
entered into. Submission of this certification is a prerequisite for making or entering into this transaction
imposed by section 1352, title 31. U.S. Code. Any person who fails to file the required certification shall be
subject to a civil penalty of not less than $10.00 0 and not more than $100,000 for each such failure.
Statement for Loan Guarantees and loan Insurance
The undersigned states, to the best of his or her knowledge and belief, that
If any funds have been paid or will be paid to any person for influencing or attempting to influence an officer
or employee of any agency, a Member of Congress, an officer or employee of Congress. or an employee of
a Member of Congress in connection with this commitment providing for the United States to insure or
guarantee a loan, the undersigned shall complete and submit Standard Fonn-LLL, "Disclosure of Lobbying
Activities," in accordance with its instructions. Submission of this statement is a prerequisite for making or
entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the
required statement shall be subjec t to a civil penalty of not less than $10,000 and not more than $100,000
for each such failure.
* APPLICANTS ORGANIZATION
ICollier County
* PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE
Prefix: I I . First Name: IDonna
* Last Name: IFl.ala
'fl Titk!: jChairman. Board of County COOITlissioners
I Middle Name: I
I Suffix: I
* SIGNATURE: Icompleted on submission to Grants.gov
* DATE: \completed on submission to Grants.gov I
L
Agenda Item No. 16011
May 26, 2009
Page 17 of 32
OMS Approval No.4040-0009
Expiration Date 07130/2010
Public reporting burden for this collection of information is estimated to average 15 minutes per respon~e, includin~ ti~e for reviewing
instructions, searching existing data sources, gathering and maintaining the data n~ed, and. com~letlng a~d r~vlewl~g the COlle~tIon of
information. Send comments regarding the burden estimate or any other aspect of thiS collection of Information, Including suggestions for
reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0042), Washington, DC 20503.
ASSURANCES - CONSTRUCTION PROGRAMS
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT
AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
NOTE' Certain of these assurances may not be applic~ble to your p~oJect or p~ogram. If yo~ have ~uestions, pl~ase con~.ct the
. Awarding Agency. Further, certain Federal assistance awarding agencies may require applicants to certify to additional
assurances. If such is the case, you will be notified.
As the duly authorized representative of the applicant:, I certify that the applicant:
1. Has the legal authority to apply for Federal assistance,
and the institutional, managerial and financial capability
(including funds suffICient to pay the non-Federal share
of project costs) to ensure proper planning,
management and completion of project described in
this application.
2. Will give the awarding agency, the Comptroller General
of the United States and. if appropriate, the State,
the right to examine all records. books, papers, or
documents related to the assistance; and will establish
a proper accounting system in accordance with
generally accepted accounting standards or agency
directives.
3. Will not dispose of, modify the use of, or change the
terms of the real property title or other interest in the
site and facilities without permission and instructions
from the awarding agency. Will record the Federal
awarding agency directives and will include a covenant
in the title of real property acquired in whole or in part
with Federal assistance funds to assure non-
discrimination during the useful life of the project
4. Will comply with the requirements of the assistance
awarding agency with regard to the drafting, review and
approval of construction plans and specifications.
5. Will provide and maintain competent and adequate
engineering supervision at the construction site to
ensure that the complete work conforms with the
approved plans and specifications and will fumish
progressive reports and such other information as may be
required by the assistance awarding agency or State.
6. Will initiate and complete the work within the applicable
time frame after receipt of approval of the awarding agency.
7. Will establish safeguards to prohibit employees from
using their positions for a purpose that constitutes or
presents the appearance of personal or organizational
conflict of interest, or personal gain.
Previous Edition Usable
8. Will comply with the Intergovemmental Personnel Act
of 1970 (42 U.S.C. 994728-4763) relating to prescribed
standards of merit systems for programs funded
under one of the 19 statutes or regulations specified in
Appendix A of OPM's Standards for a Merit System of
Personnel Administration (5 C.F.R. 900, Subpart F).
9. Will comply with the Lead-Based Paint Poisoning
Prevention Act (42 U.S.C. 9~801 et seq.) which
prohibits the use of lead-based paint in construction or
rehabilitation of residence structures.
10. Will comply with all Federal statutes relating to non-
discrimination. These include but are not limited to: (a)
Title VI of the Civil Rights Act of 1964 (P.L. 88-352)
which prohibits discrimination on the basis of race,
color or national origin; (b) Title IX of the Education
Amendments of 1972, as amended (20 U.S.C. 991681
1683, and 1685-1686), which prohibits discrimination
on the basis of sex; (c) Section 504 of the
Rehabilitation Act of 1973, as amended (29) U.S.C.
9794), which prohibits discrimination on the basis of
handicaps; (d) the Age Discrimination Act of 1975, as
amended (42 U.S.C. 996101-6107), which prohibits
discrimination on the basis of age; (e) the Drug Abuse
Office and Treatment Act of 1972 (P.L. 92-255), as
amended relating to nondiscrimination on the basis of
drug abuse; (f) the Comprehensive Alcohol Abuse and
Alcoholism Prevention, Treatment and Rehabilitation
Act of 1970 (P.L. 91-616), as amended, relating to
nondiscrimination on the basis of alcohol abuse or
alcoholism; (g) 99523 and 527 of the Public Health
Service Act of 1912 (42 U.S.C. 99290 dd-3 and 290 ee
3), as amended, relating to confidentiality of alcohol
and drug abuse patient records; (h) Title VIII of the
Civil Rights Act of 1968 (42 U.S.C. 993601 et seq.), as
amended, relating to nondiscrimination in the sale,
rental or financing of housing; (i) any other
nondiscrimination provisions in the specific statue(s)
under which application for Federal assistance is being
made; and (j) the requirements of any other
nondiscrimination statue(s) which may apply to the
application.
Authorized for Local Reproduction
Standard Form 424D (Rev. 7-97)
Prescribed by OMB Circular A-1 02
11. Will comply, or has already complied, with the
requirements of Titles II and III of the Uniform Relocation
Assistance and Real Property Acquisition Policies Act of
1970 (P.L 91-646) which provide for fair and equitable
treatment of persons displaced or whose property is
acquired as a result of Federal and federally-assisted
programs. These requirements apply to all interests in real
property acquired for project purposes regardless of
Federal participation in purchases.
12. Will comply with the provisions ofthe Hatch Act (5 U.S.C.
991501-1508 and 7324-7328) which limit the political
activities of employees whose principal employment
activities are funded in whole or in part with Federal funds.
13. Will comply, as applicable, with the provisions of the Davis-
Bacon Act (40 U.S.C. 99276a to 276a-7), the Copeland Act
(40 U.S.C. 9276c and 18 U.S.C. 9874), and the Contract
Work Hours and Safety Standards Act (40 U.S.C. 99327-
333) regarding labor standards for federally-assisted
construction subagreements.
14. Will comply with flood insurance purchase requirements of
Section 102(a) of the Flood Disaster Protection Act of 1973
(P.L 93-234) which requires recipients in a special flood
hazard area to participate in the program and to purchase
flood insurance if the total cost of insurable construction
and acquisition is $10,000 or more.
15. Will comply with environmental standards which may be
prescribed pursuant to the following: (a) institution of
environmental quality control measures under the
* SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL
* APPLICANT ORGANIZATION
lcollier County
Agenda Item No. 16011
May 26, 2009
Page 18 of 32
National Environmental Policy Act of 1969 (P.L. 91-
190) and Executive Order (EO) 11514; (b) notification
of violating facilities pursuant to EO 11738; (c)
protection of wetlands pursuant to EO 11990; (d)
evaluation of flood hazards in floodplains in accordance
with EO 11988; (e) assurance of project consistency
with the approved State management program
developed under the Coastal Zone Management Act of
1972 (16 U.S.C. 991451 et seq.); (f) conformity of
Federal actions to State (Clean Air) implementation
Plans under Section 176(c) of the Clean Air Act of
1955, as amended (42 U.S.C. 997401 etseq.); (g)
protection of underground sources of drinking water
under the Safe Drinking Water Act of 1974, as
amended (P.L 93-523); and, (h) protection of
endangered species under the Endangered Species
Act of 1973, as amended (P.L. 93-205).
16. Will comply with the Wild and Scenic Rivers Act of
1968 (16 U.S.C. 991271 et seq.) related to protecting
components or potential components of the national
wild and scenic rivers system.
17. Will assist the awarding agency in assuring compliance
with Section 106 of 1he National Historic Preservation
Act of 1966, as amended (16 U.S.C. 9470), EO 11593
(identification and protection of historic properties), and
the Archaeological and Historic Preservation Act of
1974 (16 U.S.C. 99469a-1 et seq).
18. Will cause to be performed the required financial and
compliance audits in accordance with the Single Audit
Act Amendments of 1996 and OMB Circular No. A-133,
"Audits of States, Local Governments, and Non-Profit
Organizations. "
19. Will comply with all applicable requirements of all other
Federal laws, executive orders, regulations, and policies
governing this program.
. TITLE
IChairman, Board of County Commissioners
* DATE SUBMITIED
lcompleted on submission to Grants.gov
SF-424D (Rev. 7-97) Back
Agenda Item No, 16011
May 26, 2009
Page 19 of 32
ATTACHMENTS FORM
Instructions: On this form, you will attach the various files that make up your grant application. Please consult with the appropriate
Agency Guidelines for more infonnation about each needed file. Please remember that any files you attach must be in the document format
and named as specified in the Guidelines.
Important: Please attach your files in the proper sequence. See the appropriate Agency Guidelines for details.
1) Please attach Attachment 1
2) Please attach Attachment 2
3) Please attach Attachment 3
4) Please attach Attachment 4
5) Please attach Attachment 5
6) Please attach Attachment 6
7) Please attach Attachment 7
8) Please attach Attachment 8
9) Please attach Altachment9
10) Please attach Attachment 10
11) Please attach Attachment 11
12) Please attach Attachment 12
13) Please attach Attachment 13
14) Please attach Attachment 14
15) Please attach Attachment 15
IAttach~nt 1
IAttachment 2
IAttaChment 3
- COlliercountYlll~~~~:~~)~jGl' Iy:~~t.l~ I~,w,....;\t
- Non-FederalFUlII'i~..~ I~ 1.lliifAiI~lt
11':....:[;W!jfijI~r"'"!"~ Ir~~"ll::~iim.~ I~~,;,.."!i,,..".::ll..';:r."'.,~".;"m!t
equipment.xls .;\<'j"f:\~:,..;~g~ h~:~ ~~~~1l~5i1
Ilr;,~yrWii_i;~ 1~~.I~l11ii{~~~.;jJ
I 1',:.'.+i,'"i'i''1i''' , liWo;"" ")$it.1'd 1~4I!\lIifJ:.'lliiWiiii\"'~t:;.;t IY'l:", "';?:::!i~il<';;:illffill'2iii!rr}i'W.
,",:i~l#~~3 (&~~11p!!!Lf,'.iI _~1"'''''CIIfQI:l!1.~:ii.1
_ . 11','if~A'l'iaWl:'llWffl~''''~ 1'!~l.tm"~ If~~'lli1LF.""''''Cil'':'':''''''''''~iF....j.
Informat~onRe3 "<I,,, ..... " . .......iJfa ,'. . '. ...". ... ...... .~ ,JIlIl!i1W.,1~"."m!mf"l
J 1"k""""'~:iI~"""W!'''l1l ':ni~~:olWl:t.'''''tll.~..1ii!'' '..Ldi.::;.Jjj""'Tl
- Environmental~ ,Wjif2.~~i~~im~miljtrb ~~"'r~~~I~~~I~n\r.i~,~~I~~jiiiLJ
- pub1ishedNoti~ I~i:~.;~~~~~ 1:1~k' Igi:~~W>>~~m~
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11"'"'!"A!i'~U:.i."e""""'J:tj"':;'II':~G'" ""',r".""'!!1"';:"""""';;"'I' 1':"""''/111' .',i'., ....'" ....""'.j
. ,{ii:',!"",,,,(~i;IJ.00ll..!n1ii'~:, .;.:;~~tli:ltfi~~~'. ,;:.;;i:1~11!!Y-l'!~1l~t\i~~;!1:;.
II;mi!.~~.~m;f~'.lm't~~_~,.'1:1Iti~;~6J;j:.:i~
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IAt tachment 5
IAttachment 6
!Attachment 7
!AttaChment 8
jAt tachment 9
- SF-LLL.pdf
Agenda Item No. 16011
May 26, 2009
Page 20 of 32
Narrative
Table of Contents
Page
Basic Information
Applicant Business Name
Applicant Location
Brief Mission Statement
Description and Location of Proposed Project
Time Frames
Entity Type
1
1
1
1
1
2
2
Issues
2
Agency Initiatives
3
Project Description
4
Agenda Item No. 16011
May 26, 2009
Page 21 of 32
Narrative
Basic Information
Applicant Business Name
The Collier County Department of Housing and Human Services is the county government
applicant for this project on behalf of the Physician Led Access Network, a 501 c3 corporation.
Together, the partnership is implementing a Health Information Technology project by adopting
an electronic infonnation network between the portals of entry for the low income adults into the
system.
Applicant Location
This network will be created and established throughout multiple locations in Collier County,
Florida, including Naples and rural Immokalee.
Brief Mission Statement
The Collier County Medical Society in collaboration with other community healthcare
stakeholders initiated a volunteer healthcare access referral program that became PLAN in
January 2005. PLAN is now the community conduit for access to specialty health care for low
income uninsured adults with over 150 physicians and other healthcare providers participating.
PLAN's mission is to close the gap in access to care, focusing on specialty care, as an initiative
of the Collier County Medical Society
Description and Exact Location of the Proposed Proiect
Collier County is located on the southern gulf coast of the Florida peninsula, due west of the
Miami-Fort Lauderdale area. Naples, located in the western and coastal area of Collier County,
is the largest of the three incorporated cities in Collier County. Everglades City lies south and
east of Naples and recently incorporated City of Marco Island lies south along the Gulf of
Mexico. Collier County contains approximately 2,025.45 square miles of land area, larger than
the states of Delaware and Rhode Island with a population of approximately 339,000. The rural
predominantly migrant community of Immokalee is approximately 45 miles from the coastal
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May 26, 2009
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City of Naples. Bus transportation is limited within the metropolitan area and even more so in
the outlying areas.
Requesting an amount of $141,570 Collier County Govemment will purchase the equipment and
software needed to implement a Health lnfonnation Technology project for the electronic
transfer of information linking data from the hospitals' systems, the community's clinics that
serve as access to care for the poor and the private practice participating healthcare providers
into PLAN. The County will also facilitate the purchase of key equipment to assist clinic
providers with the health care of the uninsured, low income population of Collier County. Once
the information network is operational, the project plans to develop and implement a marketing
plan for full penetration of the population of individuals who are uninsured.
Time Frames
The project, which began III September of 2008, will continue with equipment purchase and
implementation in October of 2009. The initial implementation of the equipment, software and
marketing of the program should be completed by September of 20 10.
Entity Type
Collier County Housing and Human Services is a department within Collier County government.
The County is the applicant on behalf of the Physician Led Access Network, a 50lc3 corporation
in the State of Florida.
Issues
This project has faced a number of significant and unexpected challenges since its inception.
First and foremost, the key partnering organization, the Physician Led Access Network (PLAN)
experienced a complete tumover of staffing including the Executive Director and a patient care
coordinator overseeing the software implementation. Both positions for the organization needed
to be advertised and filled and training for their positions within PLAN was paramount so
services to the most vulnerable of our citizens to continue.
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May 26, 2009
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In addition to these key personnel changes, Collier County and the number of organizations that
are part of this network, are each experiencing the effects of the downturn in the economy.
Hiring freezes, lay-offs and early retirement packages have left many of our partners with
minimal staffing levels and therefore it is difficult to initiate new projects. Finally, some of our
key partners are launching their own significant health infonnation technology projects and have
prioritized their staffing levels on their own projects with less time available for coordinated
projects.
There have also been some challenges in the implementation of the Client Track software
because of staffing changes with the contractor. The project is now investigating other software
options that may be more feasible for the transfer of information at this time.
Agency Initiatives
This project will support key HRSA/agency initiatives. The main initiative is the establishment
of electronic transfer of health infonnation to more efficiently assist the low income uninsured
and enhance the provision of clinical services at delivery sites (#2 and #3). In addition, the
project will raise public awareness regarding the improper use of the Emergency Room (#7). The
project will also increase the range of services at these facilities and target special populations.
(#12 and #13)
Collier County Government, in partnership with PLAN, is creating a health infonnation network
throughout multiple locations in Collier County including rural Immokalee. As a technology
infrastructure is constructed, the project will focus on efficient, electronic transfer of patient
information and will also develop solid data collection methodologies for reporting on results
and cost-savings attributable to PLAN. Once the transfer of infonnation is operational, a full
scale marketing effort will be implemented to educate the low income population regarding the
improper use of the emergency room and properly divert individuals to more appropriate
providers of the health services needed. In addition to the transfer of electronic infonnation,
several key pieces of equipment will be purchased to enhance the delivery of clinical services at
both the Marian E. Fether Clinic in Immokalee and Senior Friendship Clinic in Naples; both sites
are part of the health care network established to serve the low income population of Collier
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County. The County is home to over 75,000 citizens who are over the age of 60 and 22% of the
general population is uninsured. This equipment will directly enhance the level of service and
quality of health care given to the uninsured and underinsured population in Collier County.
The implementation of this electronic network will increase the at risk population referred into
the PLAN network of care as well as increase efficiency of care. As outcome measurements are
developed and tracked, cost-savings may be realized as use of emergency care decreases. In
establishing a network of trained volunteers, an outreach program will be instituted in the
Emergency Department of the participating hospitals to institute awareness of access to follow
up care and referral to participating PLAN physicians and providers.
Project Description
Without the Physician Led Access Network (PLAN), a low-income uninsured patient has no
financial access to needed specialty care, such as specialty consultation, surgery, or expensive
tests such as an MRI or endoscopy. Some seek care in the emergency rooms, only to learn that
the specialty care they require is not available since it is not considered life threatening. Others
either live with debilitating pain or their condition continues to worsen to the extent that they can
no longer work or care for their families.
With PLAN, a patient's PLAN affiliated primary care doctor can refer the patient to PLAN for
the specialty care or tests needed. PLAN's staff members make an appointment with the
volunteer specialist who can provide the care this patient needs. With the support of many types
of health care providers, the patient receives the necessary hospitalization, lab tests, and
medication they need but cannot afford. Because PLAN encompasses a broad network of health
care providers, the cost of providing free care is spread among many, rather than concentrated on
a few.
In order to successfully design and implement this project plan, partners will be building on
already existing relationships with local physicians, hospitals and clinics. Since 2003, PLAN has
worked with NCH Healthcare System's hospitals and since 2005, worked with Physicians
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May 26, 2009
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Regional Medical Center. Both hospitals have active board members on the Physician Led
Access Network. A representative from Collier Health Services Inc., the primary care clinic,
also serves on the Board of Directors of PLAN as does the Senior Friendship Center, Inc. These
on-going relationships have contributed to the successful implementation of the current service
network. In 2008, PLAN has facilitated over 1300 patient encounters and built a network of 150
health care providers. The close relationship with the Collier Medical Society whose Executive
Director and Past President also serve on the PLAN board of directors facilitates on-going and
expanding local clinician support. In 2008 PLAN enrolled 381 new patients, many of whom are
referred to PLAN from participating physicians and provided 898 specialty doctor visits, for
services valued at more than $2 million. Since PLAN has been built upon partnerships with
local physicians, hospitals and primary care clinics, the foundation for a partnership for shared
health information is already in place.
To implement an electronic inforn1ation network, it will be necessary to build relationships with
and effectively communicate with IT personnel in the above mentioned locations.
The health information network will be web-based to allow for back-up and recovery. Within all
emergency preparedness/disaster plans, each organization will account for the security and safety
of their data, and PLAN will be responsible for the collected data.
In order to establish a patient-level infonnation transfer from Providers to the Physician Led
Access Plan Network (PLAN) into a database with reporting capabilities to allow for trend
analysis, segment targeting and potentially coordinated case-management while ensuring HIP A
compliance, a Technical Advisory Panel (TAP) has been organized which consists of
IT/data/information practitioners from the participating partners. This group is identifying which
data should be transferred, what is the best method to transfer, what is the best software to use
and a report of what are the best practices of other access networks around the country for the
electronic transfer of data. This group, led by the Health Planning Council of SW Florida, our
technical contractor provider, has been interviewing staff members from area hospitals, clinics,
Collier County Government, and PLAN. Staff members include nurses, registration staff,
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Agenda Item No. 16011
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administrators, case managers and others who would potentially be involved in the electronic
transfer of infoffi1ation or have practical knowledge to enhance the planning process.
As the technical needs of the project are detennined, the hardware and software needs will be
evaluated to implement the data transfer. The equipment list, which is located in the appendix,
will include the following:
a. Equipment for providers who do not meet all the technical needs of the project (i.e. a
computer with web access) for a clinic.
b. Scanning equipment to allow for easy access and transfer of patient information within
the hospitals, primary care clinics and PLAN
c. Purchase/preparationlcustomization of the software. Development of the necessary fonns
and reports.
d. Training for Provider staff and PLAN staff on the software selected and the process in
general.
Following the determination of the technical/equipment needs of the project, the participants will
further identify the types of patient-level data to be transferred from the providers to PLAN and
will also develop privacy protocols. In establishing a network of trained volunteers, an outreach
program will be instituted in the Emergency Department of the participating hospitals to institute
awareness of access to follow up care and referral to participating PLAN physicians and
providers.
The project has also determined equipment needs to enhance the provision of clinical services at
participating sites. These pieces of equipment are noted in the detailed equipment list. Senior
Friendship Center (SFC) and Collier Health Services (CHS) are private, not-for-profit health care
providers who provide services for PLAN patients. CHS is in need of a new ultrasound machine
to allow for a telemedicine program. A mid-range ultrasound machine is about $80,000 to
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Agenda Item No. 16011
May 26, 2009
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$85,000. The telemedicine program will allow the PLAN patients to receive most efficient and
effective medical care. SFC is in need of a number of smaller pieces of equipment. A
HemapointH2 is used to measures hemoglobin and hematocrit. Hematocrit and hemoglobin
measurements are blood tests. They are part of a complete blood count, or CBC. An
electrocardiogram (EKG or ECG) is a device which graphically records the electrical activity of
the muscles of the heart. It is used to identify normal and abnormal heartbeats. First invented in
the early 1900s, the EKG has become an important medical diagnostic device. A bone
ultrasonometer is used to measure bone density. A urinalysis machine examines urine to allow
for a clinical diagnosis. Often disorders can be found that do not have obvious symptoms. SFC
would also benefit from two digital scales that also measure height and Body Mass Index (BMI).
This equipment will directly enhance the level of service and quality of healthcare given to the
uninsured and underinsured population in Collier County.
The Physician Led Access Network of Collier County, Inc (PLAN) and Housing and Human
Services, a department of Collier County Government, are both well established organizations
with infrastructures and the financial solidity to continue to support the Health Information
Electronic Network. This commitment is con finned by the written mandate of the Collier
County Commissioners. PLAN continues to be funded by the Collier County Department of
Health, the Collier County Department of Housing and Human Services, grants and various
foundations supporting community health programs as well as the donated care of in kind
contributions by the volunteer healthcare providers surpassing $1.9 million dollars in 2008.
Additional support exists across the organizations that will be a part of this multi faceted project.
The Collier County Board of County Commissioners has adopted as part of its 10 year strategic
plan a commitment to partner with community organizations to improve health care access for
the uninsured. In particular the Board of County Commissioner has chosen this project as a
legislative priority for the past three years and has supported the endeavor to obtain this funding,
envisioning it as a great opportunity to benefit the health and welfare of all Collier County
residents but especially the community's most needy citizens.
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Agenda Item No. 16011
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Attachment 3
Itemized Equipment List
Items Unit Cost Total Cost Capitalized Per
County Policv
8 Scannina Systems wI Scanners $ 2,500.00 $ 20,000.00 yes
5 Comouters $ 2,500.00 $ 12,500.00 yes
1 Software $ 36,500.00 $ 36,500.00 no
5 Software XP $ 900.00 $ 4,500.00 no
1 Trainina $ 5,000.00 $ 5,000.00 no
1 Ultra Sound Machine $ 40,000.00 $ 40,000.00 yes
1 HemaPointH2 $ 1,500.00 $ 1,500.00 yes
1 EKG Machine $ 6,300.00 $ 6,300.00 yes
1 Bone Ultrasonometer $ 7,500.00 $ 7,500.00 yes
1 Urinalysis Machine $ 900.00 $ 900.00 no
2 Diaital Scales $ 885.00 $ 1,770.00 no
I TOTAL $ 136,470.00
Dwight E. Brock
Clerk of Courts
';.(;e\J:pty-of G6~li er
CLERK OF THE CIRCUIT COURT
COLLIER COUNTY -GaUR T~OUSE
3301 TAMIAMI TRAIL EAsT
P.O. BOX 413044 . .
NAPLES, FLORIDA~MOI-3d"44
v~ I
Agenda Item No. 16011
May 26, 2009
Page 29 of 32
Clerk of Courts
Accountant
Auditor
Custodian of County Funds
May 8, 2009
Paul Murphy
Division of Facilities Compliance and Recovery
Dear Mr. Murphy,
As part of the application process for the Health Care and Other Facilities Special Congressional Initiative
earmark for Collier County Board of County Commissioners, we are required to submit an affirmation regarding
our capitalization policy.
I affirm that the items that are identified on Attachment 3 as "yes" under the capitalized per county policy column
are being treated as capital items under the Collier County Board of County Commissioner's accounting system.
This is in accordance with the existing Collier County capital asset policy.
Sincerely,
Crysta . Kinzel
Director of Finance and Accounting
Collier County Clerk of the Circuit Court
Phone-(239) 732-2646
Wcbsite- ~vww.coIlLcrcle.1k._i.:mlJ
Fax-(239) 775-2755
E mail- !,:() Hi GTs:Jfrk (~t\':~11Lit;rt;JfIl<'.~9}m
Budget Category
A. Personnel
B. Fringe Benefits
C. Travel
D. Equipment
E. Supplies
F. Construction
G. Consulting
H. Indirect Costs
Budget Summary
Agenda Item f\Jo. 16011
May 26, 2009
Page 30 of 32
Budget Justification
Table of Contents
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Agenda Item No. 16011
May 26, 2009
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Budget Justification
A. Personnel
N ame/Position Computation Cost
Accounting Supervisor $76,000 x .05 FTE $3,800
This staff person will assist key personnel in acquisition and coordination of equipment.
SUBTOTAL
$3,800
B. Fringe Benefits
N ame/Position Computation
Accounting Supervisor $1,300
Health Insurance, taxes, retirement unemployment insurance, life insurance.
Cost
$1,300
SUBTOTAL
$1,300
C. Travel
No travel requested is requested
SUBTOTAL
$ 0
D. Equipment
Description
Computation
Cost
Scanning System & Scanners 8 @ $2,500 $20,000
Scanning equipment will be located in the 4 ED's, PLAN, and the 3 primary clinics
Computers 5 @ $2,500 $12,500
Total of five computers. Three (3) to be located at PLAN, one (1) at Sf. Friendship Center, and
one (1) for County Office. Computers will be used for accessing the database via the internet
and retrieving additional information from participating PLAN providers
Software
Microsoft XP software for 5 computers 5 @ $900 $4,500
Client tracking software I @ $36,500 $36,500
Software for tracking and transfer of patient level data and associated development costs.
Software training for PLAN and providers 1 @ $5,000 $5,000
Ultrasound Machine 1 @ $80,000 $40,000
To be located at Collier Health Services. This will allow for better use of the telemedicine
program as current equipment is not compatible.
*ReQuestin2 half of total cost of equipment.
HemaPointH2 1 @ $1,500 $1,500
To be located at Senior Friendship Center. Measures Hemoglobin and Hemacrit.
EKG Machine 1 @ $6,300
To be located at Senior Friendship Center.
$6,300
Page 1 of2
Bone Ultrasonometer I @ $7,500
To be located at Senior Friendship Center.
Urinalysis Machine I @ $900
To be located at Senior Friendship Center
Digital Scale 2 @ $885
To be located at Senior Friendship Center. Scale measures height and BMI.
SUBTOTAL
E. Supplies
No supplies requested
SUBTOTAL
F. Construction
No Construction is requested
SUBTOTAL
G. Consulting
No Consulting is requested
SUBTOTAL
H. Indirect Costs
No Indirect Cost is requested
SUBTOTAL
Budget Summary
Budget Category
A.
B.
C.
D.
E.
F.
G.
H.
Personnel
Fringe Benefits
Travel
Equipment
Supplies
Construction
Consultants / Contracts
Other
1.
Total Direct Costs
Indirect Costs
Agenda Item No. 16011
May 26, 2009
Page 32 of 32
$7,500
$900
$1,770
$136,470
$ 0
$ 0
$ 0
$ 0
Amount
$ 3,800
$ 1.300
$ 0
$136,470
$ 0
$ 0
$ 0
$ 0
$141,570
o
TOTAL PROJECT COSTS $141.570
Federal Request $141.570
Non-Federal Amount $ 0
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