Backup Documents 01/13/2026 Item #16D 1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 0 1
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 1.13.26 BCC MTG
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 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#2,complete the checklist,and forward to the County Attomey Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1. Carolyn Noble Community and Human CN 1.13.26
Services
2. County Attorney Office— County Attorney Office
9-141111, I/0
3. BCC Office Board of County y
Commissioners �k y/t147/Sf )
4. Minutes and Records Clerk of Court's Office Atti ! '�/
PRIMARY CONTACT INFORMATION
1 `
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,may need to contact staff for additional or missing information.
Name of Primary Staff Carolyn Noble Phone Number 239-252.5321
Contact/ Department
Agenda Date Item was 1.13.26 BCC Mtg Agenda Item Number t6.D.I
Approved by the BCC
Type of Document 3 ORIGINAL DLC LIP MOU DOCUMENTS Number of Original 3 ORIGINAL
Attached Documents Attached DOCUMENTS
PO number or account
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature STAMP OK CN
2. Does the document need to be sent to another agency for additional signatures? If yes, N/A
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be Yes
signed by the Chairman,with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's YES
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip N/A
should be provided to the County Attorney Office at the time the item is input into SIRE.
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!
8. The document was approved by the BCC on above date and all changes made during
the meeting have been incorporated in the attached document. The County •
sty
l / ip l i ;iris
Attorney's Office has reviewed the changes,if applicable. `lh7 lh ,lE�
9. Initials of attorney verifying that the attached document is the version approved by the SIG\
BCC,all changes directed by the BCC have been made,and the document is ready for the - kiAb
Chairman's signature. it-:
1SD
MEMORANDUM
Date: January 15, 2026
To: Carolyn Noble, Grants
Community & Human Services
From: Martha Vergara, Sr. Deputy Clerk
Minutes & Records Department
Re: MOU between Collier County and David Lawrence Mental Health
Center, Inc.
CLHC, Inc
Enclosed please find two (2) originals of each document referenced above (Agenda
Item #16D1), approved by the Board of County Commissioners on Tuesday, January
13, 2026.
Once fully executed please forward a fully executed copy to our office for the
Board's Official Record; an original has been kept by our office for the Board of
County Commissioners Official Records.
If you have any questions, please contact me at 252-7240.
Thank you.
Enclosure
lID 1
State Mandated: LIP MOU
Fiscal Year of Award: FY 25-26
Agreement No.: LIP25-02
Activity: Substance Abuse and Mental
Health Services
RECIPIENT: David Lawrence Mental
Health Center,inc.
Total Award Amount: $2,371,401.00
UEI#: PBE3LMA8J4YI
_FEIN: 59-2206025
Period of 10/1/2025—9/30/2026
Performance:
Fiscal Year End: 6/30
MEMORANDUM OF UNDERSTANDING BETWEEN COLLIER COUNTY
AND
DAVID LAWRENCE MENTAL HEALTH CENTER,INC.
THIS MEMORANDUM OF UNDERSTANDING (MOU) is made and entered into on
this I3+4 day of Jatewe, ' 2026 by and between Collier County, a political
subdivision of the State of Florida (COUNTY), having its principal address as 3339 E. Tamiami
Trail,Naples,FL 34112,and David Lawrence Mental Health Center,Inc, (RECIPIENT)a private
not-for-profit corporation under agreement with the State of Florida,Department of Children and
Families, through the Central Florida Behavioral Health Network, Inc. contract, having its
principal address at 6075 Bathey Lane,Naples, FL 34116 .
WHEREAS, Section 125.01(1)(e), Florida Statutes, authorizes the COUNTY to provide
health welfare programs for the residents of Collier County to the extent not inconsistent with
general or special law; and
is
WHEREAS, the establishment and maintenance of such programs are in the common
interest of the people of Collier County; and
WHEREAS, The COUNTY desires the RECIPIENT to become a community health
partner to assist in providing services for substance use and mental health to eligible residents of
the COUNTY; and
I'I NOW THEREFORE,in consideration of the mutual benefits contained herein,it is agreed
by the Parties as follows:
PART I SCOPE OF SERVICES
RECIPIENT shall, in a satisfactory and proper manner and consistent with any standards required
as a condition of providing services as provided herein and, as determined by Collier County
Community and Human Services (CHS) Division, perform the tasks necessary to conduct the
program as follows:
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Project Name: Substance Abuse and Mental Health Services
Description of project and outcome: Provide substance abuse and mental health services
programs to residents of Collier County in accordance with Chapters 394 and 397, Florida
Statutes. RECIPIENT shall serve a minimum of 6,295 non-duplicated Collier County
residents/clients with at least one (1) unit of service as defined by F.A.C. 65E-14 during
the MOU period. Clients may receive duplicated services,although only one unit of service
will be applied to the minimum number of clients served. RECIPIENT and/or its
subcontractors shall provide timely responses to requirements.
1.1 SPECIAL CONDITIONS
A. RECIPIENT must submit the following policies and procedures to CHS within 60
days of execution of this MOU:
N Affirmative Action/Equal Employment Opportunity Policy
N Conflict of Interest Policy (COI) and related COI Forms
N Procurement Policy
N Sexual Harassment Policy
N Section 504/ADA Policy •
N Fraud, Waste, and Abuse Policy
N Language Assistance and Planning Policy (LAP)
i N Limited English Proficiency Policy (LEP)
N Violence Against Women Act (VAWA)Policy
B. Limited English Proficiency — Persons who, as a result of national origin, do not
speak English as their primary language and who have limited ability to speak,read,
write, or understand English ("limited English proficient persons" or "LEP
persons") may be entitled to language assistance under Title VI of the Civil Rights
Act of 1964 (Title VI)in order to receive a particular service,benefit, or encounter.
•In accordance with Title VI and its implementing regulations, RECIPIENT agrees
to take reasonable steps to ensure meaningful access to activities funded with LIP
Funds by LEP persons. Any of the following actions could constitute "reasonable
steps," depending on the circumstances: acquiring translators to translate vital
documents; advertisements or notices; acquiring interpreters for face-to-face
interviews with LEP persons; placing advertisements and notices in newspapers
that serve LEP persons; partnering with other organizations that serve LEP
populations to provide interpretation, translation, or dissemination of information
regarding the project; hiring bilingual employees or volunteers for outreach and
intake activities; contracting with a telephone line interpreter service; etc.
1.2 PROJECT DETAILS
A. Project Tasks
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RECIPIENT will accomplish the following checked tasks:
Maintain client files and retain at RECIPIENT'S location, and provide to the
COUNTY as requested
N Provide Quarterly Reports on project progress
❑ Ensure attendance by a representative from executive management at scheduled
partnership meetings, as requested by CHS
B. Performance Deliverables
Program Deliverable Supporting Documentation Submission Schedule
Insurance Proof of coverage in accordance Within 30 days following
with Exhibit B MOU execution and
annually within 30 days
after renewal
Business Associate Agreements Within 60 days of execution
Agreement of this MOU.
Recipient Policies Policies as stated in this MOU Within 60 days of MOU
execution
Quarterly Performance Exhibit C Quarterly by 30`h of the
Report month following quarter
end.
Quarterly Match Obligation CARISK Match Report Quarterly by the 30`l' of the
month following quarter end
DCF/CFBHN/ Final Audit/Monitoring Report Within 30 days of receipt
Accreditation Agencies including any plans of
Audit Reports corrective action
Single Audit Audit report and management Within 9 months of end of
letter fiscal year
is
Conflict of Interest Form Recipient Conflict of Interest Upon execution of the
Disclosure Form MOU all employees who
is
work on activities
associated with the program
and upon hiring of any new
employees who will work
on activities associated with
this MOU.
Whistleblower Protections Exhibit E Upon execution of the
Certification MOU all employees who
work on activities
associated with the program
and upon hiring of any new
employees who will work
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Program Deliverable Supporting Documentation Submission Schedule
on activities associated with
this MOU.
Affidavit Regarding Labor Affidavit Upon execution of this
and Services (Trafficking) MOU.
Form
,Never Contract with the Form Upon execution of this
Enemy Certification MOU
Drug-Free Workplace Exhibit F Upon execution of this
Certification MOU
C. Payment/Intergovernmental Transfer
a. The COUNTY shall make intergovernmental transfers (IOT) on behalf of the
RECIPIENT, in connection with the Low-Income Pool (LIP) program, to the
State of Florida (State) in accordance with the Letter of Agreement between the
COUNTY and the Agency for Health Care Administration (AHCA).
The COUNTY will remit to AHCA an amount not to exceed $2,371,401. The
COUNTY will transfer payment to the AHCA in the following manner:
i. The payments for the months July 2025 — June 2026 are subject CMS
approval of the LIP reimbursement and funding methodology document.
Once approved,AHCA sends an IGT invoice to the COUNTY. Upon receipt
of the IGT invoice from AHCA,the COUNTY will remit payment to AHCA.
AHCA subsequently provides LIP payment to RECIPIENT. This timeframe
has not yet been determined.
The COUNTY'S IGT payment in the amount of$2,371,401 shall serve as local
match for eligible mental health and substance use services. Should the
RECIPIENT'S match obligation decrease by 25 percent (25%) or more of the
required local match amount of $2,371,401 over the term of the MOU, the
COUNTY may withhold future match funding in the following fiscal year.
is The Low-Income Pool Agreement (LIP) with the State of Florida Agency for
Healthcare Administration (AHCA) reflecting the anticipated annual
distributions for State Fiscal Year 2025-2026 is hereby incorporated by
reference as Exhibit A to this MOU.
b. The COUNTY, CCSO, and David Lawrence Center (DLC) shall have an
agreement for a Behavioral Health Intervention Team (BHIT25-01) in the
amount of$594,235.91. CCSO will receive an invoice from the COUNTY. This
invoice, once paid to the COUNTY by CCSO, will be submitted to AHCA as
part of the DLC LIP match.
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1.3 PERIOD OF PERFORMANCE
The term of this MOU shall be October 1, 2025, through September 30, 2026, with no
renewal, unless terminated earlier in accordance with provisions of Paragraph 3.7,
Defaults, Remedies, and Termination.
1.4 NOTICES
Notices required by this MOU shall be in writing and delivered via mail (postage prepaid),
commercial courier, personal delivery, or sent by facsimile or other electronic means.
Either party may change the address to which notices are to be sent to it by giving written
notice of such change to the other party in the manner herein provided for giving notice.
Any notice, request, instruction, or other document delivered or sent as aforesaid shall be
effective on the date of delivery or sending. All notices and other written communications
under this MOU shall be addressed to the individuals in the capacities indicated below,
unless otherwise modified by subsequent written notice.
COLLIER COUNTY ATTENTION: Carolyn Noble, Grant Coordinator
Collier County Government
Community and Human Services Division
2671 Airport Pulling Road, Suite 202
Naples, Florida 34112
Email: Carolyn.Noble@collier.gov
Telephone: (239) 252-5321
RECIPIENT ATTENTION: Scott Burgess, CEO &President
David Lawrence Mental Health Center, Inc.
6075 Bathey Lane
Naples, Florida 34116
Email: scottb@dIcenters.org
Telephone: (239)354-1425
Remainder of Page Intentionally Left Blank
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PART II
CONTROL REQUIREMENTS
2.1 AUDITS
During the term of this MOU, RECIPIENT shall submit to the COUNTY a Single Audit
report, Management Letter, and supporting documentation nine (9) months after the
RECIPIENT'S fiscal year end (or one hundred eighty (180) days for recipients exempt
from Single Audit).
RECIPIENT must fully clear any deficiencies noted in audit reports within 30 days after it
receipt of the report. RECIPIENT'S failure to comply with the above audit requirements
will constitute a violation of this MOU and may result in withholding of future payments.
2.2 RECORDS AND DOCUMENTATION
RECIPIENT shall maintain sufficient records in accordance with Chapter 119, Florida
Statutes, to determine compliance with the requirements of this Agreement, the DCF
agreement,and all other applicable laws and regulations.This documentation shall include
but is not limited to, the following:
A. RECIPIENT shall keep and maintain public records that ordinarily and necessarily
would be required by the COUNTY to perform the service.
B. RECIPIENT shall make available to COUNTY at any time upon request by CHS,
all reports,plans, surveys, information,documents,maps,books,records,and other
data procedures developed,prepared, assembled, or completed by the RECIPIENT
for this Agreement. Materials identified in the previous sentence shall be in
accordance with generally accepted accounting principles (GAAP), procedures,
and practices,which sufficiently and properly reflect all revenues and expenditures
of funds provided directly or indirectly by this Agreement. These records shall be
maintained to the extent of such detail as will properly reflect all net costs, direct
and indirect labor, materials, equipment, supplies and services, and other costs and
expenses of whatever nature for which reimbursement is claimed under the
provisions of this Agreement.
C. Upon completion of all work contemplated under this Agreement, copies of all
documents and records relating to this Agreement shall be surrendered to CHS, if
requested. In any event, RECIPIENT shall keep all documents and records in an
orderly fashion in a readily accessible, permanent, and secured location for six (6)
years after the date of submission of the final progress report; However, if any
litigation, claim, or audit is started before the expiration date of the six (6) year
period, the records will be maintained until all litigation, claim, or audit findings
involving these records are resolved. If RECIPIENT ceases to exist after the
closeout of this Agreement, it shall notify the COUNTY in writing, of the location
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where the records are to be kept. 'The RECIPIENT shall meet all requirements for
retaining public records, and transfer at no cost to COUNTY all public records in
RECIPIENT'S possession upon termination of the Agreement and destroy any
duplicate exempt or confidential public records that are released from public
records disclosure requirements. All records stored electronically must be provided
to the COUNTY in a format that is compatible with the COUNTY'S information
technology systems.
IF THE RECIPIENT HAS QUESTIONS REGARDING THE
APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE
RECIPIENT'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO
THIS AGREEMENT, CONTACT THE CUSTODIAN OF PUBLIC
RECORDS AT 239-252-5837, Angel.Bates(a collier.gov, 3299 Tamiami Trail
E,Naples FL 34112.
is
D. RECIPIENT shall take reasonable cybersecurity and other measures to safeguard
information including protected personally identifiable information (PII) and other
types of information in accordance with 2 CFR 200.303(e). This includes
information that the State or the COUNTY designates as sensitive, or other
information the COUNTY considers sensitive and is consistent with applicable
Federal, State, and Local laws regarding privacy and responsibility over
confidentiality.
E. RECIPIENT shall provide the public with access to public records on the same
terms and conditions that the COUNTY would provide the records, and at a cost
that does not exceed the cost provided in Chapter 119, Florida Statutes, or as
i;
otherwise provided by law. RECIPIENT shall ensure that exempt or confidential
public records that are released from public records disclosure requirements are not
disclosed.
2.3 MONITORING
RECIPIENT agrees that CHS may carry out no fewer than one(1)annal on-site monitoring
visit and evaluation, as determined necessary. At the COUNTY'S discretion, a desktop
preview of the activities may be conducted in lieu of an on-site visit. The continuation of
this MOU is dependent upon satisfactory evaluations. Upon request by the COUNTY,
RECIPIENT shall submit information and status reports required by the COUNTY.
RECIPIENT shall allow on-site monitoring by the COUNTY or state. Such site visits may
be scheduled or unscheduled as determined by the COUNTY or state.
At any time during normal business hours and as often as the COUNTY (and/or its
representatives) may deem necessary, RECIPIENT shall make available for review,
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inspection, or audit all records, documentation, and any other data relating to al matters
covered by this MOU.
The COUNTY will monitor RECIPIENT'S performance in an attempt to mitigate fraud,
waste, and abuse, or non-performance based on goals and performance standards as stated
with all other applicable laws,regulations,and policies governing the funds provided under
this MOU. Substandard performance,as determined by the COUNTY, will constitute non-
compliance with this MOU. If RECIPIENT does not take corrective action within a
reasonable time period after being notified by the COUNTY, MOU suspension or
termination procedures may be initiated.
2.4 PREVENTION OF FRAUD,WASTE,AND ABUSE
RECIPIENT shall establish, maintain and utilize internal control systems and procedures
necessary to prevent, detect, and correct incidents of fraud, waste, and abuse in the
performance of this MOU, and provide proper and effective management of all program
and fiscal activities of the MOU. RECIPIENT'S internal control systems and all
transactions and• other significant events shall be clearly documented, and the
documentation shall be readily available for monitoring by the COUNTY.
RECEIPIENT shall provide COUNTY with complete access to all of its records,
employees, and agents for the purpose of monitoring or investigating the performance of
this MOU. RECIPIENT shall fully cooperate with COUNTY'S efforts to detect,
[ investigate,and prevent fraud, waste, and abuse.
RECIPIENT may not'discriminate against any employee or other person who reports a
{
violation of the terms of this MOU or any law or regulation, to the COUNTY or any
appropriate law enforcement authority, if the report is made in good faith.
2.5 CORRECTIVE ACTION
Corrective action plans may be required for noncompliance, nonperformance, or
unacceptable performance under this Agreement. Penalties may be imposed for failure to
implement or make acceptable progress on such corrective action plans.
To effectively enforce COUNTY Resolution No.2013-228,CHS has adopted an escalation
policy to ensure continued compliance by Recipients, Subrecipients, Developers, or any
entity receiving funds from the COUNTY. The escalation policy for noncompliance is as
follows:
A. Initial noncompliance may result in the COUNTY issuing Findings or Concerns to
RECIPIENT, which requires RECIPIENT to submit a corrective action plan to
CHS within 10 business days, following issuance of the report.
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• Any pay requests that have been submitted to CHS for payment will be held
until the corrective action plan has been submitted.
• CHS will be available to provide Technical Assistance(TA)to RECIPIENT, as
needed, in order to correct the noncompliance issue.
B. If RECIPIENT fails to submit the corrective action plan in a timely manner, CHS
may require a portion of the awarded grant amount to be returned to the COUNTY.
• CHS may require RECIPIENT to return upwards of 5 percent(5%)of the award
amount to the COUNTY, at the discretion of the Board.
• RECIPIENT may be denied future consideration, as set forth in Resolt.ition No.
2013-228.
C. If RECIPIENT remains noncompliant or repeats an issue that was previously
corrected and has been informed by CHS by certified mail of their substantial
noncompliance, CHS may require a portion of the awarded amount to be returned
to the COUNTY.
• CHS may require RECIPIENT to return upwards of 10 percent (10%) of the
award amount to the COUNTY, at the discretion of the Board.
• RECIPIENT will be in violation of Resolution No. 2013-228.
D. if after repeated notification RECIPIENT continues to be substantially
noncompliant, CHS may recommend the MOU or award be terminated.
•
CHS will make a recommendation to the Board to immediately terminate the
MOU. RECIPIENT will be required to repay all funds disbursed by the
COUNTY for the terminated project. This includes the amount invested by the
COUNTY for the initial acquisition of properties or other activities, if
applicable.
• RECIPIENT will be in violation of Resolution No. 2013-228.
If RECIPIENT has multiple agreements with CHS and is found to be noncompliant, the
above sanctions may be imposed across all awards, at the Board's discretion.
2.6 REPORTS
Payment may be contingent on the timely receipt of complete and accurate reports required
by this MOU and the resolution of monitoring findings identified pursuant to this MOU,
as deemed necessary by the County Manager or designee. Reports showing lack of
project activity may result in the withholding of payment or issuance of a Notice of
f Non-Compliance;
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During the term of this mou, RECIPIENT shall submit quarterly performance reports to
the COUNTY by the 30th day of the month following the prior quarter period end. Program
objectives, activities, and match expenditures including but not limited to, performance
data on client feedback with respect to the goals and objectives set forth in Exhibit C,which
is the reporting form to be used in fulfillment of this requirement. Other reporting
requirements may be required by the County Manager or designee in the event of program
changes; the need for additional information or documentation arises; and/or legislative
amendments are enacted. Reports and/or requested documentation not received by the due
date shall be considered delinquent and may be cause for default and termination of this
MOU.
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PART III
TERMS AND CONDITIONS •
3.1 SUBCONTRACTS
The parties agree that,upon approval by the COUNTY,the RECIPIENT shall be permitted
to execute subcontracts for the purchase of such services, articles, supplies, and equipment
that are both necessary and incidental to the performance of the work required under this
MOU. However, the RECIPIENT expressly understands that it shall assume the primary
responsibility for performing the services outlined in Part I of this MOU. RECIPIENT shall
cause all provisions of this MOU in its entirety to be included in and made a part of any
subcontract executed in the performance of this MOU.
3.2 ASSIGNMENT
The RECIPIENT and/or its subcontractors shall not assign or transfer this MOU, or any
interest, right, or duty herein, without the prior written consent of the COUNTY.
3.3 GENERAL COMPLIANCE
RECIPIENT is prohibited from using funds provided herein, or personnel employed in the
administration of the program for political activities, inherently religious activities,
lobbying, political patronage, and/or nepotism activities.
3.4 INDEPENDENT CONTRACTOR
Nothing contained in this MOU is intended to, or shall be construed in any manner, as
creating or establishing the relationship of employer/employee between the parties. The
RECIPIENT shall always remain an "independent contractor" with respect to the services
to be performed under this MOU. The COUNTY shall be exempt from payment of all
Unemployment Compensation, FICA, retirement, life and/or medical insurance, and
Workers' Compensation Insurance as RECIPIENT is independent from the COUNTY.
3.5 AMENDMENTS
The COUNTY or RECIPIENT may amend this MOU, at any time, provided that such
amendments make specific reference to this MOU, and are executed in writing, signed by
a duly authorized representative of each organization, and approved by the COUNTY's
Board. Such amendments shall not invalidate this MOU, nor relieve or release the
COUNTY or RECIPIENT from its obligations under this MOU.
•
•
The COUNTY may, at its discretion, amend this MOU to conform with Federal, State, or
Governmental guidelines, policies, available funding amounts, or other reasons. If such
amendments result in a change in the funding, scope of services, or schedule of activities
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to be undertaken as part of this MOU, such modifications will be incorporated only by
written amendment signed by both COUNTY and RECIPIENT.
3.6 INDEMNIFICATION
To the maximum extent permitted by Florida law, the RECIPIENT and/or its
subcontractors shall indemnify and hold harmless the COUNTY against any claims,
damages, losses, and expenses, including reasonable attorney's fees and costs, arising out
of or resulting from the RECIPIENT'S failure to pay for services or performance under
this MOU. This indemnification obligation shall not be construed to negate, abridge, or
reduce any other rights or remedies which otherwise may be available to an indemnified
party or person described in this paragraph.
The RECIPIENT shall jointly and severally indemnify and hold harmless the COUNTY
for all claims demands, actions, suits, losses, costs, charges, expenses, damages, and
liabilities whatsoever which the COUNTY may pay, sustain, suffer, or incur by reason of
or in connection with this MOU, including payment of all legal costs, including but not
limited to attorney's fees paid by the COUNTY.
This indemnification shall survive the termination and/or expiration of this MOU. This
section does not pertain to any incident arising from the sole negligence of COUNTY. The
foregoing indemnification shall not constitute a waiver of sovereign immunity beyond the
limits set forth in Section 768.28,Florida Statutes. This section shall survive the expiration
or termination of this MOU.
3.7 DEFAULTS, REMEDIES,AND TERMINATION
Either party may terminate this MOU thirty (30) calendar days after receipt of written
notice of intent to terminate from the other party and should the RECEIPIENT choose to
terminate the RECIPIENT is obligated to return the pro-rated share of the COUNTY'S
funds paid on the RECIPIENT'S behalf to AHCA.
Upon breach or default of this MOU, the aggrieved party may, by written notice to the
breaching party, terminate the whole or part of this MOU. Termination shall be upon no
less that 24 hours' notice, in writing, and delivered by certified mail or in person. Waiver
by each party of breach of any provisions of this MOU shall not be deemed to be a waiver
of any other or subsequent breach and shall not be construed to be a modification of the
terms of the MOU.
The following actions or inactions by RECIPIENT shall constitute a Default under this
MOU:
A. Failure to comply with any of the rules,regulations,or provisions referred to herein,
or such statutes, regulations, executive orders, and/or State of Florida guidelines,
policies, or directives as may become applicable at any time.
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B. Failure, for any reason, to fulfill its obligations under this MOU in a timely and
proper manner.
C. Ineffective or improper use of Funds provided under this MOU.
D. Submission of reports to the COUNTY that are incorrect or incomplete in any
material respect.
E. Submission of any false certification.
F. Failure to materially comply with any terms of this MOU.
G. Failure to materially comply with the terms of any other agreement between the
COUNTY and RECIPIENT, relating to the project
In the event of any default by RECIPIENT under this MOU,the COUNTY may seek any
combination of one or more of the following remedies:
A. Require specific performance of the MOU, in whole or in part
B. Require the use of or change in services provider
C. Require RECIPIENT to immediately repay to the COUNTY all funds that
RECIPIENT has received under this MOU.
D. Apply sanctions, if determined by the COUNTY to be applicable.
4 E. Stop all payments until identified deficiencies are corrected.
F. Terminate this MOU, by giving written notice to RECIPIENT specifying the
effective date of such termination. If the MOU is terminated by the COUNTY, as
provided herein, RECIPIENT shall have no claim of payment or benefit for any
incomplete project activities undertaken under this MOU.
It is further agreed that in the event general funds to finance all or part of the AHCA LIP
Agreement do not become available, the obligations or each party hereunder may be
terminated upon no less than 24 hours' notice in writing to the other party. Said notice shall
be delivered by certified mail or in person.
3.8 GRANTEE RECOGNITION/SPONSORSHIPS
RECIPIENT agrees that all notices, informational pamphlets, press releases,
advertisements, descriptions of program sponsorships, research reports, and similar public
notices, whether printed or digitally prepared and released by RECIPIENT for, on behalf
of, and/or about the Program shall include the statement:
"FINANCED IN PART BY COLLIER COUNTY COMMUNITY
AND HUMAN SERVICES DIVISION"
The statement shall appear in the same size letters or type as the name of the RECIPIENT.
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3.9 INSURANCE
RECIPIENT shall not commence any work and/or services pursuant to this MOU,until all
required insurance, as outlined in Exhibit B, has been obtained. Said insurance shall be
carried continuously during RECIPIENT's performance under this MOU.
{
3.10 CIVIL RIGHTS COMPLIANCE
In the performance of this MOU, there will be no discrimination against any employee or
person served based on race, color, sex, age, religion, ancestry, national origin, handicap,
or marital status. It is expressly understood that, upon receipt of evidence of such
discrimination, the COUNTY shall have the right to terminate this MOU for breach of
MOU.
The RECIPIENT and/or its subcontractors shall comply with Title VI of the Civil Rights
Act of 1964 (42 USC 2000(d)) regarding persons served.
The RECIPIENT and/or its subcontractors shall comply with Title VI of the Civil Rights
Act of 1964 (42 USC 2000(d)) regarding persons served.
The RECIPIENT and/or its subcontractors shall comply with Title VII of the Civil Rights
Act of 1964 (42 USC 2000(c)) regarding employees or applicants for employment.
The RECIPIENT and/or its subcontractors shall comply with Section 504 of the
Rehabilitation Act of 1973 regarding employees or applicants for employment and clients
served.
3.11 CONFLICT OF INTEREST
RECIPIENT must have written conflict of interest policies. The Program distinguishes
between two types of conflict of interest: one related to organizations that carry out the
project (recipients or subrecipients), and another specific to individuals involved in
providing services and day-to-day project operations. RECIPIENT shall have written
policies related to both types of conflicts of interest.
With respect to the use of LIP funds to procure services, equipment, supplies, or other
property,the RECIPIENT shall comply with 2 CFR part 200,318,24 CFR 570.611,and all
state and County statues, regulations, ordinances or resolutions governing conflicts of
interest. With respect to all other decisions involving the use of LIP funds, the following
restrictions shall apply: No person who is an employee, agency consultant, officer, or
elected or appointed official of the RECIPIENT and who exercises or has exercised any
functions or responsibilities with respect to assisted activities, or who is in a position to
participate in a decision-making process or gain inside information with regard to such
activities, may obtain a person or financial interest or benefit from the activity, or have an
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interest in any contract, subcontract, or agreement with respect thereto, or the process
thereunder, either for himself or herself or for those with whom he or she has family or
business ties, during his or her tenure for one year thereafter. If a conflict or a potential or
perceived conflict of interest is to occur, the RECIPIENT must contact the COUNTY to
determine whether an exception will be allowed as prescribed by the applicable federal
regulations.
In addition, RECIPIENT will not employ or subcontract any person having any conflict of
interest. RECIPIENT covenants that it will comply with all Federal Conflict of Interest, 2
CFR .200.318, and State and County statutes, regulations, ordinances, or resolutions
governing conflicts of interest. All RECIPIENT employees who work on activities
associated with this MOU shall complete the Subrecipient/Developer/Vendor Conflict of
Interest Disclosure Form prior upon execution,of this MOU. Any employees hired later,
during the period of performance for this MOU who will work on activities associated with
this MOU shall also complete and submit to the COUNTY the Conflict of Interest
Disclosure Form.
RECIPIENT will notify the COUNTY, in writing, and seek COUNTY approval prior to
entering into any contract with an entity owned in whole or in part by a covered person, or
an entity owned or controlled, in whole or in part,by the RECIPIENT.The COUNTY may
review the proposed contract to ensure that the contractor is qualified, and the costs are
reasonable. Approval of an identity of interest contract will be in the COUNTY'S sole
discretion. This provision is not intended to limit RECIPIENT'S ability to self-manage the
projects using its own employees.
3.12 SUBJECT TO APPROPRIATION
It is further understood and agreed by and between the parties herein that this MOU is
subject to appropriation by the Board of County Commissioners and release of funds by
AHCA.
3.13 INCIDENT REPORTING
If RECIPIENT provides services to clients under this MOU, RECIPENT and any
subcontractors shall report knowledge or reasonable suspicion of abuse, neglect, or
exploitation of a child, aged person, or disabled person to the COUNTY.
During the term of this MOU, RECIPIENT must report to the COUNTY in writing, within
one business day of occurrence, any substantial, controversial, or newsworthy incidents.
The Collier County Incident Report Form (Exhibit H) shall be used to report all such
incidents.
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3.14 SEVERABILITY
Should any provision of this MOU be determined unenforceable or invalid, such
determination shall not affect the validity or enforceability of any other section or part
thereof.
3.15 MISCELLANEOUS
RECIPIENT and COUNTY each binds itself,its partners,successors,legal representatives,
and assigns of such other part in respect to all covenants of this MOU,
All items incorporated by reference are as though physically attached. No other
agreements, oral or otherwise, regarding the subject matter of this MOU shall be deemed
to exist or to bind any of the parties hereto.
The RECIPIENT and/or its subcontractors shall obtain and possess throughout the term of
this MOU all licenses and permits applicable to its operations under federal,state,and local
laws, and shall comply with all fire, health, and other applicable regulatory codes.
RECIPIENT represents and warrants that the financial data, reports, and other information
it furnished to the COUNTY regarding the Program are accurate and complete, and
financial disclosures fairly represent the financial position of the RECIPIENT.
RECIPIENT understands that client information collected under this MOU is private and
the use or disclosure of such information, when not directly connected with the
administration of the COUNTY'S or RECIPIENT'S responsibilities with respect to
servicesprovided under this MOU, is prohibited unless written consent is obtained from
such person receiving services and, in the case of a minor, that of a responsible
parent/guardian.
The RECIPIENT and/or its subcontractors agree to safeguard the privacy of information
pursuant to HIPAA regulations.
RECIPIENT certifies that it has the legal authority to receive the funds under this MOU,
and its governing body has authorized the execution and acceptance of this MOU.
RECIPIENT also certifies that the undersigned person has the authority to legally execute
and bind RECIPIENT to the terms of this MOU.
The section headings and subheadings contained in this MOU are included for convenience
only and shall not limit or otherwise affect the terms of this MOU.
The MOU shall be construed in accordance with and governed by the laws of the State of
Florida, without giving effect to its provisions regarding the choice of laws. Any suit or
action brought by either party to this MOU against the other party relating to or arising out
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of this MOU 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,
All activities authorized by this MOU shall be subject to and performed in accordance with
the provisions and the terms and conditions of the MOU with the COUNTY, the
regulations, all applicable Federal, State, and Municipal laws, ordinances, regulations,
orders,and guidelines, including but not limited to any applicable regulations issued by the
COUNTY.
Electronic Signatures: This MOU and related documents entered into in connection with
this MOU, are signed when a party's signature is delivered by facsimile, e-mail, or any
other electronic medium. These signatures must be treated in all respects as having the
same force and effect as original signatures.
3.16 WAIVER
The COUNTY'S failure to act with respect to a breach by RECEPIENT does not waive its
right to act with respect to subsequent or similar breaches, The COUNTY'S failure to
exercise or enforce any right or provision shall not constitute a waiver of such right or
provision.
Remainder of Page Intentionally Left Blank
•
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PART IV
l GENERAL PROVISIONS
4.1 PERMITS, LICENSES, TAXES: In compliance with Section 218.80, Florida Statues,
•
RECIPIENT shall obtain all permits necessary for the performance of the Work. Payment
for all such permits issued by the COUNTY shall be processed internally by the COUNTY.
All non-COUNTY permits necessary for the performance of the Work shall be procured
and paid for by RECIPIENT.The RECIPIENT shall also be solely responsible for payment
of all taxes levied on the RECIPIENT. In addition,RECIPIENT 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 RECIPIENT agrees to comply with all laws governing
the responsibility of an employer with respect to persons it employs.
4.2 NO IMPROPER USE: The RECIPIENT will not use,nor offer or permit any person to use
in any manner whatsoever, COUNTY facilities for any improper, immoral, or offensive
purpose or for any purpose in violation of any federal, state, county, or municipal
ordinance, rule, order, or regulation, or any governmental rule or regulation now in effect
or hereafter enacted or adopted. In the event of such violation by the RECIPIENT,or if the
COUNTY or its authorized representative shall deem any conduct on the part of the
RECIPIENT to be objectionable or improper,the COUNTY shall have the right to suspend
the MOU. Should RECIPIENT fail to correct any such violation, conduct, or practice to
the satisfaction of the COUNTY within twenty-four (24) hours after receiving notice of
such violation, conduct, or practice, such suspension will continue until the violation is
cured. The RECIPIENT further agrees not to commence operation during the suspension
period until the violation has been corrected to the satisfaction of the COUNTY.
4.3 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 HI, Florida
Statutes, Collier County Ethics Ordinance No. 2004-53, and County Administrative
Procedure 5311. Violation of this provision may result in one or more of the following
consequences: a)prohibition by the individual,firm, and/or any employee of the firm from
contact with COUNTY staff for a specified period of time;b)prohibition by the individual
and/or firm from doing business with the COUNTY for a specified period of time,
including but not limited to submitting bids, RFPs, and/or quotes; and c) immediate
termination for cause of any contract held by the individual and/or firm.
is
4.4 DRUG-FREE WORKPLACE: RECIPIENT agrees that it will provide drug-free
workplaces, in accordance with the Drug-Free Workplace Act of 1988 (41 USC 701).
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4.5 DISPUTE RESOLUTION: Prior to the initiation of any action or proceeding permitted by
this MOU to resolve disputes between the parties,the parties shall make a good faith effort
to resolve any such disputes by negotiation. Any situations when negotiations, litigation •
and/or mediation shall be attended by representatives of RECIPIENT with full decision-
' making authority and by COUNTY's employee who would make the presentation of any
settlement reached during negotiations to COUNTY for approval. Failing resolution, and
prior to the commencement of depositions in any litigation between the parties arising out
of this MOU, the parties shall attempt to resolve the dispute through Mediation before an
agreed-upon Circuit Court Mediator certified by the State of Florida. Should either party
fail to submit to mediation as required hereunder, the other party may obtain a court order
requiring mediation under§44.102,Florida Statutes.The litigation arising out of this MOU
shall be adjudicated in Collier County, Florida, if in state court and the US District Court,
Middle District of Florida,if in federal court.BY ENTERING INTO THIS AGREEMENT,
COLLIER COUNTY AND THE RECIPIENT EXPRESSLY WAIVE ANY RIGHTS
EITHER PARTY MAY HAVE TO A TRIAL BY JURY OF ANY CIVIL LITIGATION
RELATED TO, OR ARISING OUT OF,THIS MOU.
https://www.flsenate.gov/Laws/Statutes/2012/44.102
4.6 ORDER OF PRECEDENCE: In the event of any conflict between or among the terms of
any of the MOU documents, the terms of the MOU shall take precedence over the terms of
all other MOU documents, except the terms of any Supplemental Conditions shall take
precedence over the MOU. To the extent any conflict in the terms of the MOU documents
cannot be resolved by application of the Supplemental Conditions, if any, or the MOU, the
conflict shall be resolved by imposing the more strict or costly obligation under the MOU
documents upon NAMI at the County's discretion.
4.7 VENUE: Any suit or action brought by either party against the other party relating to or
arising out of this MOU 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.
4.8 EQUAL EMPLOYMENT OPPORTUNITY: Executive Order 11246("Equal Employment
Opportunity"), as amended by Executive Orders 11375 and 12086 - which establishes
hiring goals for minorities and women on projects assisted with federal funds and as
supplemented in Department of Labor regulations. EO 11246.
https_//www.dol.gov/agencies/ofccp/executive-order-11246/as-amended
4.9 Title VII of the 1968 Civil Rights Act as amended by the Equal Employment Opportunity
Act of 1972, 42 USC § 2000e, et. seq. RECIPIENT will, in all solicitations or
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advertisements for employees placed by or on behalf of RECIPIENT, state that it is an
Equal Opportunity or Affirmative Action employer.
Title VII of the Civil Rights Act of 1964 I U.S. Equal Employment Opportunity
Commission (eeoc.gov)
4.10 Section 504 of the Rehabilitation Act of 1973,29 USC 776(b)(5),24 CFR 570,614 Subpart
K.
Section 504: https://www.hud.gov/sites/dfiles/documents/504compliance.pdf
29 USC 776: https://www.govinfo.gov/content/pkg/USCODE-2010-
title29/html/USCODE-2010-tit1e29-chap 16.htm
24 CFR 570.614: https://www.ecfr.gov/current/title-24/subtitle-B/chapter-V/subchapter-
C/part-570/subpart-K?toc=1
4.11 The Americans with Disabilities Act of 1990:
https://www.hug.gov/program offices/fair housing equal opp
Americans with Disabilities Act of 1990, As Amended I ADA.gov
4.12 Age Discrimination Act of 1975,Executive Order 11063,as amended by Executive Orders
11375, 12107, 12086, and 14173.
Age Discrimination Act of 1975
https://www.govinfo.gov/content/pkg/USCODE-1996-tit1e42/pdf/USCODE-1996-tit1e42-
chap76.pdf
11375: https://www.federalregister.gov/executive-order/11375
12107: https://www.archives.gov/federal-register/codification/executive-
order/12107.html
12086: https://www.archives.gov/Federal-register/codification/executive-
order/l 2086.html
14173: https://www.federalregister.gov/documents/2025/01/31/2025-02097/ending-
illegal-discrimination-and-restoring-merit-based-opportunity
4.13 EMPLOYMENT ELIGIBILITY: Per Florida Statute 448.095(3), all Florida private
employers are required to verify employment eligibility for all new hires beginning January
1, 2021. Eligibility determination is not required for continuing employees hired prior to
January 1,2021.
http://www.leg.state.fl.us/statutes/index.cfin?App mode=Display Statute&URL=0400-
•0499/0448/0448.html
For purposes of satisfying the requirement of this condition regarding verification of
employment eligibility, the RECIPIENT shall participate in, and use, E-Verify (www.e-
verify.gov), provided an appropriate person authorized to act on behalf of the recipient(or
contractor) uses E-Verify (and follows the proper E-Verify procedures, including in the
event of a "Tentative Non-confirmation" or a "Final Non-confirmation") to confirm
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employment eligibility for each hiring for a position in the United States that is or will be
funded (in whole or in part) with award funds.
Questions about E-Verify should be directed to DHS. For more information about E-
Verify visit the E-Verify website (https://www.e-verify.gov/) or email E-Verify at E-
Verify@dhs.gov. E-Verify employer agents can email E-Verify at E-
VerifyEmployerAgent@dhs.gov.
4.14 IMMIGRATION LAW COMPLIANCE: By executing and entering into this MOU, the
RECIPIENT is formally acknowledging, without exception or stipulation, that it is fully
responsible for complying with the provisions of the Immigration Reform and Control Act
of 1986 as located at 8 U.S.C. 1324, et seq. and regulations relating thereto, as either may
be amended. RECIPIENT'S failure to comply with the laws referenced herein shall
constitute a breach of this MOU and the COUNTY shall have the discretion to unilaterally
terminate this MOU immediately.
https://www.eeoc.gov/eeoc/history/35th/thelaw/irca.html
4.15 Unauthorized Aliens shall not be employed. Employment of unauthorized aliens shall be
cause for unilateral cancellation of this MOU by the COUNTY for violation of§274A of
the Immigration and Nationality Act. RECIPIENT and its subcontractors will enroll in and
use the E-Verify system established by the U.S.Department of Homeland Security to verify
the employment eligibility of its employees and its subcontractors' employees performing
under this MOU. Employees assigned to this MOU means all persons employed or
assigned(including subcontractors)by the RECIPIENT or subcontractor,during the Period
of Performance, to perform work pursuant to this MOU within the United States and its
territories.
4.16 RECORDS RETENTION: Florida Statutes 119.021 Records Retention
http://www.leg.state.fl.us/Statutes/index.cfin?App mode=Display Statute&URL-0100-
0199/0119/Sections/0119.021.html
4.17 CONTRACTS AND PUBLIC RECORDS: Florida Statutes, 119.071,Contracts and Public
Records
http_//www.leg.state.fl.us/Statutes/index.cfm?A p mocle=Displgy_Statute&UR.L=0100-
li 01.99/0119/Sections/01.19.071.htm l
ii
4.18 CONVICTED VENDOR LIST: As provided in § 287.133, Florida Statutes, by entering
into this MOU or performing any work in furtherance hereof,the RECIPIENT certifies that
it,its affiliates,suppliers,subcontractors and consultants who will perform hereunder,have
not been placed on the convicted vendor list,maintained by the State of Florida Department
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of Management Services, within the 36 months immediately preceding the date hereof.
This notice is required by § 287.133 (3) (a), Florida Statutes.
http://www.leg.state.fl.us/Statutes/index.cfm?App mode=Display Statutes Search Strip
g_&URL=0200-0299/0287/Sections/0287.133.html
4.19 FALSE CLAIM: Criminal, or Civil Violation: RECIPIENT must promptly refer any
credible evidence to COUNTY that a principal, employee, agent, contractor, subgrantee,
subcontractor, or other person has either (i) submitted a false claim for grit funds under
the False Claims Act or (ii) committed a criminal or civil violation of laws pertaining to
fraud, conflict of interest, bribery, gratuity, or similar misconduct involving subaward
agreement funds
4.20 POLITICAL ACTIVITIES PROHIBITED: None of the funds provided directly or
indirectly under this MOU shall be used for any political activities or to further the election
or defeat of any candidates for public office. Neither this MOU nor any funds provided
hereunder shall be utilized in support of any partisan political activities or activities for or
against the election of a candidate for an elected office.
k
4.21 2 CFR 200.15 Never contract with the enemy. Federal agencies, recipients, and
subrecipients are subject to the guidance implementing Never Contract with the Enemy in
2 CFR part 183.
h ttps://www.ecfr.gov/current/tit le-2/subtitle-A/chapter-II/part-2 00/subpart-C/sect i on-
200.215
https://www.ecfr gov/current/title-2/subtitle-A/chapter-I/part_l83
4.22 Whistleblower Protections:
a. In accordance with 2 CFR 200.217 and 41 U.S.C. § 4712, the RECIPIENT may not
discharge, demote, or otherwise discriminate against an employee in reprisal for
disclosing to any of the list of persons or entities provided below, information that
the employee reasonably believes is evidence of gross mismanagement of a federal
contract or grant, a gross waste of federal funds, an abuse of authority relating to a
federal contract or grant, a substantial and specific danger to public health or safety,
. or a violation of law, rule, or regulation related to a federal contract (including the
competition for or negotiation of a contract) or grant.
b. The list of persons and entities referenced in the paragraph above includes the
following:
i. A member of Congress or a representative of a committee of Congress;
ii. An Inspector General;
iii. The Government Accountability Office;
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{
iv. A Treasury employee responsible for contract or grant oversight or
management;
v. An authorized official of the Department of Justice or other law enforcement
agency;
vi. A court or grand jury; or
vii.A management official or other employee of Recipient, contractor, or
subcontractor who has the responsibility to investigate, discover, or address
misconduct.
The RECIPIENT shall inform its employees in writing of whistleblower rights and
remedies provided under 2 CFR 200.217 and 41 U.S.C. 4712, in the predominant native
language of the workforce. •
https://uscode.house.gov/view.xhtml?req=(title:41%20section:47 12%20edition:prelim)
All RECIPIENT employees directly involved with activities associated with this MOU
shall complete and submit to the COUNTY the Collier County Whistleblower Protections
Certification form (Exhibit F) prior to execution of this MOU. Any new employees hired
during the period of performance of this MOU shall also complete and submit the form to
the COUNTY.
ENTIRE MOU.This MOU constitutes the entire agreement between COUNTY and RECIPIENT
} for the use of Funds received under this MOU and it supersedes all prior or contemporaneous
communications and proposals, whether electronic, oral, or written between COUNTY and
RECIPIENT with respect to this MOU.
Signature Page to Follow
4A4
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IN WITNESS WHEREOF, the RECIPIENT and COUNTY have each respectively, by an
authorized person or agent, hereunder set their hands and seals on the date first written above.
ATTEST: AS TO COUNTY: .
CRYSTAL K. KINZEL, CLERK
,�tt nnrr
<<t`'�"' ' !r� BOARD OF COUNTY COMMISSIONERS OF
,� �?a., rs,c� ,, �v COLLIER COUNTY, FLORIDA
'fit • -'I :.•� -' aill.Lri
itit
�y� / ,
• ,, c� = By:
__ _e
. , `;';:_'
44,
%r.) , V 4
4
r if(3126
', r£` ,, 4, ap Dan Kowal, Chairman
„,44)rt3utrruti���J
AS TO RECIPIENT:
DAVID LAWRENCE MENTAL HEALTH
CENTER, INC.
. By:
SCOTT G , C & PRESIDENT
Date: /Z /6/ZC
[Please provide evidence of signing authority]
I
l Approv as to r 1 and legality:
Jeffrey A. atzk w, unty Attorney
i
Date: 1 (q
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EXHIBIT A
LOW INCOME POOL AGREEMENT
Low Income Pool Letter of Agreement
THIS LETTER OF AGREEMENT(.OA)is prude and entered into in duplicate on the 1�.3• ..
day of,_' pJ.'-•,_2025. by and behveen Collier County(the'iGT Provider')on behalf of
David Lawrence Behavioral Health and the Stale of Florida,Agency for Health Care
Administration(the 'Agency ). for flood and valuable consideration,the receipt and
sufficiency of which Is acknowledged
DEFINITIONS
'Charily care' or 'uncompensated charity care means that portion of hospital charges reported
to the Agency for which there is no compensation,other than restricted or unrestricted revenues
provided to a hospital by local governments or tax districts,regardless of the method of
payment Uncompensated care includes charily care lot the uninsured but does not include
uncompensatec care for insured individuals had debt or Medicaid and Children's Health
Insurance Program(CHIP)shortfall The stale and providers that are participating in the tow
Income Pool(LIP)will provide assurance that LIP clams include only costs associated with
uncompensated care that is furnished tnro,rgi'a charity care program and that adheres to the
principles of the healthcare Financial Management Association(HFtv1A)operated by the
provider
'intergovernmental Transfers(IGTs) means transfers of funds irons a non•Medicaid
governmental entity(e g.. counties.hospital taxing districts. providers operated by state or local
government)to the Medicaid agency IGTs must be compliant with 42 CFR Part 433 Subpart Fs
'Low Income Pool(LIP)' means providing government support for safety-net providers for the
costs of uncompensated charity care for low-income individuals who are uninsured
Uncompensated care includes charity care for the uninsured but does not include
uncompensated care for insured individuals bad debt. or Medicaid and CHIP shortfall
•Medicaid means the ntedrea assistance program authorised by Title XIX of the Social Security
Act 42 US C §§ 13ft6 el seq . ane regulations thereunder, as administered in Florida by the
Agency
A. GENERAL PROVISIONS
i, Per Senate Bill 2500. the General Appropriations Act of State Fiscal Year 2025•
2026. passed by the 2025 Florida I-ee:stature,the IGT Provider and the Agency agree
Mal the IGT Provider will remit lOT funds to the Agency in an amount not to exceed the
total of$2.371,401
a The 1G1 Provider and the Agency have agreed that these IGT lends will only oe
used to increase the provision of health services for the charity care of the ICT
Provider and the State of Florrr_ia at largo
b. The increased provision of charity care health services will be accomplishers
through the following Medicaid programs
j r LIP payments to hospitals, federally qualified health centers, Medical
School Physician Practices,community behavioral health providers, and
}
(
}
.._ er l30rrav.'a i+ea?ri LIP LO:.Sri'2025.26 !)
•
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16D 1
rural health centers pursuant to the approved Centers for Medicare
Medicaid Services Special Terms and Conditions.
2. The 1G T Provider will return the signed LOA to the Agency no later than October 1.
2025
3 Thu ICT Provider will pay 1G1 funds to the Agency in an amount not to exceed the total
of S2,371,401
a Per Florida Statute 409 930. annual payments for the months of July 2025 through
June 2026 are due to the Ager;cy no later than October 31, 2025, unless an
alternative plan is specifically approved by the agency
b. The Agency will bill the IG I Provider when payment is due
4 The lGT Provider and the Agency ague that the Agency will maintain necessary records
and supporting documentation applicable to health services covered by this 1..0A
c. Audits and Records
The IGT Provider agrees to maintain books. records, and document;
(including etectronic storage media)pertinent to performance under this
LOA in accordance with generally accepted accounting procedures and
practices.which sufficiently and properly reflect all revenues and
expenditures of funds piovided.
fhe ICI Provider agrees to ensure that these records shall be subject at
all reasonable times to inspection,review. or audit by slate personnel and
other personnel duly authorized by the.Agency, as well as by federal
personnel.
ii I he IG I Provider agrees to comply with public record laws as outlined :n
section 119 0701 Florida Statutes
d Retention of Records
i The 1GT Provider agrees to retain ail financial records. supporting
documents: statistical records, and any other documents(including
electronic storage medial pertinent to performance under this LOA for a
period of six(6)years after termination of this LOA. or if an audit has been
initialed and audit findings have not been resolved at the end of six (G)
years. the records shall be retained until resolution of the audit findings
ii Persons duly authorized by the Agency and federal auditors shall have full
access to and the right to examine any of said records and documents
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The rights of access in this section must not he limited to the required
retention period but shall last as long as the records are retained
e Monitoring
The IGT Prowler agrees to permit persons duly authorized by the
Agency to inspect any records papers and documents of thcr IG1
Provider which are relevant to this LOA
I Assignment and Suhcnniracts
•
r the IGT Provider agrees to neither assign the responsibility of this LOA
to another party nor subcontract for any of the work Contemplated under
this LOA without prior written approval of the Agency. No such approval
by the Agency of any assignment or subcontract shall be deemed in any
event or in any manner to provde to,the incurrence of any obligation of
the Agency :n adaitlon to the total dollar amount agreed upon in this
LOA All such assIgrimrints or subcontracts shot!be subject to the
conditions of this 1..0A ;inn to any conditions of approval that the Agtrncy
shall deem necessary
5 this LOA may only be amended upon written agreement signed by both parties
The IGT Provider and the Agency agree that any modifications to this LOA shalt be In
the same form, namely, the exchange of signed copies of a revised LOA.
f3 The IGT Provider confirms that there are no pre-arranged agreements(contractual or
otherwise) between the respective counties, taxing districts and/or the providers to
redirect any portion of these aforementioned charity care supplemental payments in
order to satisfy non-Medicaid non•,nunsrrred. and non-underinsured activities
•
7 The IGT Provider agrees the following provision shall be included in any agreements
between the IGT Provider and local providers where IGT funding is provided pursuant
to this LOA 'Funding provided u} this Agreement shall be prioritized sn that designated
IGT funding shall first he used to fund the Medicaid program(Including LIP or DSI tI and
used secondarily for other purposes..
R This 1.0A covers the period of July 1 2025. through June 30. 2026, and shad
be terminated September 30 2026 which includes the state's certified forward
Period
9 his LOA may be executed rt multiple counterparts each of which shall constitute an
original and each of which shall he Inl'y binding on any party signing at least one
counterpart
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$2,371,401.00
Total.pundk - _m_Ex_ nnod__- . -- -- '-- ------ - --
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' YV|TNE3SETH:
|N WITNESS WHEREOF,the ux/ovuhvvccouoegth/,!;>ovOo, | rxnofA0memeu\
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COLLIER COUNTY STATE OF FLORIDA,AGENCY FOR
HEALTH CARE ADMINISTRATION
01
SIGNED SIGNED
BY: | /K' L ov�
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NAME: _/_/n �N ( NAME: Stephanie Scanlon
TITLE: TITLE; Chief of Mod|onW Program
! _ Finance
DATE: /\@ /^~� /)-��--- DATE:
1{V1O�D)25
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16D 1
EXHIBIT B
INSURANCE REQUIREMENTS
The RECIPIENT shall furnish to Collier County Board of County Commissioners,do Community
and Human Services Division, 3339 Tamiami Trail East, Suite 213, Naples, Florida 34112,
Certificate(s) of Insurance evidencing insurance coverage that meets the requirements as outlined
below:
1. Workers' Compensation as required by Chapter 440, Florida Statutes.
2. Commercial General Liability,including products and completed operations insurance,
in the amount of$1,000,000 per occurrence and $2,000,000 aggregate. Collier County
Board of County Commissioners must be shown as an additional insured with respect
to this coverage.
3. Automobile Liability Insurance covering all owned, non-owned and hired vehicles
used in connection with this MOU, in an amount not less than $1,000,000 combined
single limit for combined Bodily Injury and Property Damage.
DESIGN STAGE(IF APPLICABLE)
In addition to the insurance required in I —3 above, a Certificate of Insurance must be provided as
follows:
4. Professional Liability Insurance, in the name of the CONTRACTOR or the licensed
design professional employed by the CONTRACTOR, in an amount not less than
$1,000,000 per occurrence/$1,000,000 aggregate providing for all sums which the
CONTRACTOR and/or the design professional shall become legally obligated to pay
as damages for claims arising out of the services performed by the CONTRACTOR or
any person employed by the CONTRACTOR in connection with this MOU. This
insurance shall be maintained for a period of two (2) years after the Certificate of
Occupancy is issued.
CONSTRUCTION PHASE(IF APPLICABLE)
In addition to the insurance required in 1 —4 above, the CONTRACTOR shall provide, or cause
its Subcontractors to provide, original certificates indicating the following types of insurance
coverage prior to any construction:
5. Completed Value Builder's Risk Insurance on an "All Risk" basis, in an amount not
less than 100 percent of the insurable value of the building(s)or structure(s).The policy
shall be in the name of Collier County Board of County Commissioners and the
CONTRACTOR.
6. In accordance with the requirements of the Flood Disaster Protection Act of 1973 (42
U.S.C. 4001), the CONTRACTOR shall assure that for activities located in an area
identified by the Federal Emergency Management Agency (FEMA) as having special
flood hazards,flood insurance under the National Flood Insurance Program is obtained
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16D 1
and maintained, as a condition of financial assistance for acquisition or construction
purposes(including rehabilitation).
OPERATION/MANAGEMENT PHASE(IF APPLICABLE)
After the Construction Phase is completed and occupancy begins,the following insurance must be
kept in force throughout the duration of the loan and/or MOU:
7, Workers' Compensation as required by Chapter 440, Florida Statutes.
8. Commercial General Liability including products and completed operations insurance
in the amount of$1,000,000 per occurrence and $2,000,000 aggregate. Collier County
Board of County Commissioners must be shown as an additional insured with respect
to this coverage.
9. Automobile Liability Insurance covering all owned, non-owned and hired vehicles
used in connection with this MOU in an amount not less than $1,000,000 combined
single limit for combined Bodily Injury and Property Damage.
10. Property Insurance coverage on an "All Risk" basis, in an amount not less than 100
percent of the replacement cost of the property. Collier County Board of County
Commissioners must be shown as a Loss payee, with respect to this coverage
A.T.I.M.A.
11. Flood insurance coverage for those properties found to be within a flood hazard zone,
is for the full replacement values of the structure(s) or the maximum amount of coverage
available through the National Flood Insurance Program(NFIP).The policy must show
Collier County Board of County Commissioners as a Loss Payee A.T.I.M.A.
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EXHIBIT C
PROGRESS REPORT
Recipient Name: David Lawrence Mental Health Center
Report Period:
Fiscal Year: FY 25-26
Organization/s: David Lawrence Mental Health Center
Program: LIP
Contact Name:
Contact Number:
4th Cumulative
1st 2nd 3rd To Total
QuarterQuarter Quarter Quarter Number to
Performance Measures 7/1- Date
10/1- 1/1-3/31 4/1-6/30 9/30 be served
12/31 Annually
#of nonduplicated Collier
County residents/clients 6295
who received at least one
unit of service
# Service Units delivered in
the Quarter to eligible
Collier County residents
State Mandated Match
Obligation per CFBHN
Agreement
Total Collection of other
local match sources (client
[ fees, donation, volunteers,
other municipalities etc.) _
r•
Signature Date
Title -. •
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Collier County
Community & Human Services Division
EXHIBIT D
INCIDENT REPORT FORM
Organization Name: David Lawrence Mental Health Center
Organization Address: 6075 Bathey Lane,Naples FL
Project No: LIP25-02
Grant Coordinator: Carolyn Noble
Date of Incident Time of Incident:
Report Submitted By:
(Name& Phone)
Description of Incident:Location/Address of Incident:
Was Police Report Filed? ❑ Yes ❑ No
If Yes, Police Report Number: Jurisdiction:
Were there any warning signs that this type of Incident could occur? ❑ Yes ❑ No
If Yes, Explain:
What actions will be taken to prevent a recurrence of a similar incident?
I certify under penalty of perjury under F.S. 837.06 that the contents of this form are true and correct.
Signature of Person Making Report Date
Printed Name
Title
ti
is
Return completed form to: Kristi Sonutag, Director,CHS
Collier County Community and Human Services Division
3339 Tam iami Trail East, Bldg. H,Suite 213 CA.()
Naples, FL 34112 Fax: (239)252-2638
16D 1
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EXHIBIT E
COLLIER COUNTY COMMUNITY&HUMAN SERVICES
WHISTLEBLOWER PROTECTIONS CERTIFICATION-STAFF
RECIPIENT Name: David Lawrence Mental Health Center
RECIPIENT Address: 6075 Bathey Lane, Naples, FL
Employee Name:
Project Name: LIP
Project No: LIP25-02
In accordance with 2 CFR 200.217 and 41 U.S.C. § 4712, RECIPIENT may not discharge, demote, or
otherwise discriminate against an employee in reprisal for disclosing to any of the list of persons or entities
provided below, information that the employee reasonably believes is evidence of gross mismanagement
of a federal contract or grant, a gross waste of federal funds, an abuse of authority relating to.a federal
contract or grants, a substantial and specific danger to public health or safety,or a violation of law, rule,or
regulation related to a federal contract(including the competition for or negotiation of a contract)or grant.
The list of persons and entities referenced in the paragraph above includes the following:
• A member of Congress or a representative of a committee of Congress
• An Inspector General
• The Government Accountability Office
• A Treasury employee responsible for contract or grant oversight or management
• An authorized official of the Department of Justice or other law enforcement agency
l: • A court or grand jury
• A management official or other employee of RECIPIENT, contractor, or subcontractor who has
the responsibility to investigate, discover,or address misconduct
RECIPIENT shall inform its employees in writing of whistleblower rights and remedies provided under
section 41 U.S.C. § 4712, in the predominant native language of the workforce.
By signing this form,I certify that I have reviewed and understand my Whistleblower rights and protections
as provided above.
is
Name:
Signature:•
Title:
si
Date:
Your typed name here represents your electronic signature
16D 1
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Collier County
Community & Human Services Division
EXHIBIT F
CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS
RECIPIENT Name: David Lawrence Mental Health Center
RECIPIENT Address: 6075 Bathe), Lane, Naples, FL
Grant/Project Name: LIP MOU
Grant/Project Number: LIP25-02
The RECIPIENT certifies that it will provide a drug-free workplace by:
(a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing,
possession or use of a controlled substance is prohibited in the grantee's workplace and specifying the
• actions that will be taken against employees for violation of such prohibition;
(b) Establishing a drug-free awareness program to inform employees about—
(1) The dangers of drug abuse in the workplace;
(2) The RECIPIENT'S policy of maintaining a drug-free workplace;
(3) Any available drug counseling, rehabilitation and employee assistance programs,and
(4) The penalties that may be imposed upon employees for drug abuse violations occurring in the
workplace.
(c) Making it a requirement that each employee to be engaged in the performance of the grant be given a
copy of the statement required by paragraph (a);
(d) Notifying the employee in the statement required by paragraph (a)that, as a condition of employment
under the grant, the employee will—
(1) Abide by the terms of the statement; and
(2) Notify the employer of any criminal drug statute conviction for a violation occurring in the
workplace no later than five days after each conviction;
(e) Notifying the agency within ten days after receiving notice under subparagraph (d)(2) from an
employee or otherwise receiving actual notice of such conviction;
(f) Taking one of the following actions,within 30 days of receiving notice under subparagraph(d)(2),with
respect to any employee who is so convicted—
(1) Taking appropriate personnel action against such an employee,up to and including termination;or
(2) Requiring such employee to participate satisfactorilyin a drugabuse assistance or rehabilitation
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program approved for such purposes by a Federal, State,or local health, law enforcement,or other
appropriate agency;
Making a good faith effort to continue to maintain a drug-free workplace through implementation of
paragraphs(a),(b),(c),(d),(e)and (f).
Authorized Representative Name:
Title:
Signature:
Date:
ii
Community&Human Services Division•3339 Tamiami Trail East,Suite 213•Naples,FL 34112-5361•239-252-CARE(2273)239-
Ili • • 252-CAFE(2233)•239-252-5713(RSVP)•www.collier,gov + ,N`)