Backup Documents 02/10/2026 Item #16D 3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 p 3
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO XX.XX.XX BCC MT
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 Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1. NAME David R. Schwartz Community and Human DS 2/5/2026
Services
2. County Attorney Office— County Attorney Office CL 2
1to12.6
3. BCC Office Board of County
Commissioners V) 61 / 24012c
4. Minutes and Records Clerk of Court's Office
PRIMARY CONTACT INFORMATION
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 David R. Schwartz Phone Number 239-252-4899
Contact/ Depa►intent
Agenda Date Item was 2.10.26 Agenda Item Number 16.D.3
Approved by the BCC
Type of Document MEMORANDUM OF UNDERSTANDING Number of Original 1
Attached (MOU) Documents Attached
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 DS
2. Does the document need to be sent to another agency for additional signatures? If yes, DS
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 DS
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 DS
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 DS
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 DS
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip DS
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 lip
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 N/A is not
the meeting have been incorporated in the attached document. The County an option for
Attorney's Office has reviewed the changes,if applicable. ��� this line.
9. Initials of attorney verifying that the attached document is the version approved by the N/A is not
BCC,all changes directed by the BCC have been made,and the document is ready for the CO an option for
Chairman's signature. this line:
i6aJ
at. AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA
AGING AND DISABILITY RESOURCE CENTER
Area and
Agency
0,,Aging THE DEPARTMENT OF CHILDREN AND FAMILIES
and
COMMUNITY CARE FOR THE ELDERLY LEAD AGENCY
MEMORANDUM OF UNDERSTANDING FOR
ADULT PROTECTIVE SERVICES REFERRALS
This Memorandum of Understanding, made the 1st day of October, 2025, shall be in effect
indefinitely, and reviewed at minimum every five years, among Area Agency on Aging for
Southwest Florida/Aging and Disability Resource Center for Planning and Service Area 8; Collier
County Services for Seniors. the Community Care for the Elderly Lead Agency, and the
Department of Children and Families' (DCF) Adult Protective Services (APS) for referrals made
in Collier County.
The Department of Children and Families and the Department of Elder Affairs may, consistent
with their requirements under 415.106(2) and 430.205(5) F.S., amend this memorandum at any
time in the best interest of the program.
The purpose of this agreement is to ensure the timely delivery of services to the victims of abuse,
neglect and/or exploitation in need of services. Under this Memorandum of Understanding, Area
Agency on Aging for Southwest Florida/Aging and Disability Resource Center, Community Care
for the Elderly Lead Agency, and the Department of Children and Families agree to their
respective responsibilities as outlined in the Adult Protective Services Referrals Operations
Manual attached to this agreement and as periodically updated.
Objectives
1. To maintain a climate of cooperation among agencies to achieve equitable delivery of
services to vulnerable elder Floridians who are victims of abuse, neglect, and/or
exploitation.
2. To promote services and activities designed to protect vulnerable elders and prevent
premature institutionalization, pursuant to Chapters 415 and 430, F.S.
3. To participate,together by means of shared information, in tracking delivery of services to
elder Floridians who are victims of abuse, neglect and/or exploitation in need of home and
community-based services.
4. To provide technical assistance to,and consultation with,each other on matters pertaining
to actual service delivery and to share appropriate assessment information.
< ;:1r�
1603
Service Delivery Guidelines and Tracking Referrals in the APS Tracking Tool (ARTT)&
eCIRTS
For a referral designated by APS as a "high-risk referral," the referral will be staffed by APS and
the Lead Agency to determine the specific services needed. Such services may be time-limited
and designed to resolve the emergency or crisis situation that could place the person at risk of
further harm. For referrals received during business hours, the Lead Agency must initiate the
emergency or a crisis-resolving service(s) within 72 hours of receipt of the referral from APS.
Case management alone does not meet this requirement. For high-risk referrals that are currently
receiving services funded by DOEA, the 72-hour time frame includes not only existing services,
but also any additional emergency or crisis-resolving services.
Upon receipt of the referral, the Lead Agency must communicate to the consumer that services
put in place may be limited to 31 days. The provision of services(s) may exceed 31 days if:
• The emergency or crisis still exists. and continuation of the services is needed for
resolution; or
• The crisis is likely to return without the provision of services.
For high-risk APS referrals, an in-person 701 B and crisis-resolving service must be completed
within 72 hours 1)of receipt of the APS Referral Tracking Tool (ARTT) referral packet, if received
during business hours or 2) of receiving the call from APS staff, if received after business hours
(including evenings, weekends, and holidays). For intermediate and low-risk APS referrals, a
701S, 701A, or 701 B assessment must be completed within 14 calendar days 1)of receipt of the
ARTT referral packet, if received during business hours or 2) of receiving the call from APS staff,
if received after business hours (including evenings, weekends, and holidays). For APS referrals
sent after business hours, APS staff must call the designated Community Care for the Elderly
Lead Agency staff(for high-risk referrals) or Area Agency on Aging for Southwest Florida/Aging
and Disability Resource Center(for intermediate and low-risk referrals)to provide the information
specified in the APS Referrals Operations Manual.
Before services are terminated after 31 days,the client will be seen face-to-face by a Lead Agency
case manager. If it is determined that services can be safely terminated, APS will be contacted
(using contact information in the ARTT). APS staff will participate in a discussion with the client
regardless of the status of the case. CCE co-payments for services will be waived for high-risk
referrals during the first 31 days of service or until the vulnerable adult's crisis has been resolved
as determined by the Lead Agency and APS staff. If both parties agree that crisis-resolving
services can safely be terminated, the client may be placed on a waitlist for additional services if
appropriate. The case manager will complete and enter the new 701 B Form in eCIRTS.
If both parties do not agree that services can safely be terminated,the lead agency case manager
will assess the client's needs,and the assessment will be entered in eCIRTS.An APS investigator
supervisor and a case manager supervisor at the Lead Agency will jointly review the case to
resolve the issue(s), identified at staffing.
1
ii
1603
DCF APS staff uses the ARTT as follows to refer elders age 60 and older in need of home and
community-based services:
1. DCF APS staff enters information about each APS referral into the ARTT.
2. The ARTT automatically sends emails to the designated people in the aging network,
notifying them that a new referral has been made.
3. The aging network then acknowledges in the ARTT that the referral was received and
documents the action taken, which will automatically send emails to the appropriate DCF
staff.
4. Both DCF and aging network staff can review referral information in the ARTT for
individuals in their specified geographic region at any time.
Area Agency on Aging for Southwest Florida/Aging and Disability Resource Center defines below
which agency(ies) will be the intake entity(ies) for DCF's Adult Protective Services referrals in
each county in their Planning and Service Area.
All high-risk APS referrals from Collier will be sent to the following agency:
n Area Agency on Aging for Southwest Florida/Aging and Disability Resource Center
f2 Collier County Services for Seniors/Community Care for the Elderly Lead Agency
All intermediate risk APS referrals will be sent to the following agency:
• Area Agency on Aging for Southwest Florida/Aging and Disability Resource Center
❑ Community Care for the Elderly Lead Agency
All low risk APS referrals will be sent to the following agency:
S Area Agency on Aging for Southwest Florida/Aging and Disability Resource Center
Community Care for the Elderly Lead Agency
2
CA
16D3
Area Agency on Aging for Southwest
Florida/Aging and Disability Resource Department of Children and Families
Center:
Signature Signati
President and CEO Assistant Secretary
Title Title
10.07.25 12/30/25
Date Date
Collier County Services for
Seniors/Community Care for the Elderly
Lead Agency:
Signature
Dan Kowal, Chairman
2h(o/Z6
Date
,A.reSt'A�'L'1?"$l p.;.-L, CL
eputy Clerk
',fittest as to Chairman's
signature only
CAOO