Exhibits A through CEXHIBIT "A"
"SCOPE OF SERVICES"
The Contractor agrees to provide the following services to youth referred to the
Success University program:
Service Documentation of Service
Letter to Parent for each child missing ;Copy of letter to Parent (attached)
three unexcused school des ~ ___ _ _ __
School or Home Meeting following letter to Sign-in sheet (attached)
parents
Assistance with completion of Care :Care Coordination Plan (attached)
Coordination Plan for eligible clients and
their families
Follow-up communication with parents and Status Update Form (attached)
students
Weekly Attendance Tracking School Attendance
Contractor further agrees to the terms and conditions established by The Children's
Trust, the primary source of funds for Success University, as delineated in its Core
Contract with the City of Miami Beach, Contract Number 903-109, dated August 1,
2009.
Related Definitions:
School or Home Meeting -School or Home Meeting must be attended by the youth
student, parent or guardian of the youth, Community Involvement Specialist and one
representative from the City of Miami Beach; it is documented by sign-in sheet.
Weekly Attendance Tracking -Weekly attendance tracking is documented by the
School Attendance Report and clearly indicates the dates and classes from which the
youth was absent or present.
Letter to Parent -Letter to parent is prepared from a set template and documented
as a copy of the signed letter.
Care Coordination Plan -The Care Coordination .Plan is a tool that provides a
comprehensive, individualized proposal that addresses the holistic needs of clients
and their families.
Follow-up Communication -Follow-up Communication with parents and students
includes the submission of the Care Coordination Plan to the client and their family by
e-mail or mail and at least one phone conversation during which details of the Care
Coordination Plan are explained.
Services will be deemed as provided when the following documentation is provided
within the noted timeframes:
_~.. .
Service Documentation ~ Submission Deadline
Letter to Parent :Copy of letter i 72 business hours from
1. identification of eligibility_ _____
12
Service Deliverables
Service Unit of Service ~ Service Location Timeframe_
~~~~
Letter to Parent Up to 500 youths Miami Beach :All eligible clients will
'Senior High School 'have letters mailed
I ~ within 72 business
:hours of receipt of
........................................................................................................................
School or Home 1.....................................................................................................................
One each for up to
referral
.................................. .....
Miami Beach :All eligible school
~ Meeting 500 youths; follow-up ;Senior High School :meetings will be
meeting for up to 200 :completed within thirty
youths ~ (30) days of receipt of
.................................................................:............................................................. ................................................................................................................. referral
.
.
.
..
.
Assistance with One each for up to .
.
.
...
...................................................................................................
; Miami Beach All eligible clients will
Completion of Care ; 400 youths 'Senior High School ;have Care Coordination
Coordination Plan ~ :Plan completed within 5
.business days of the
Family Group
i
._.__.
;Conference
._.._....
p l
Follow u ,
One each for u to
p Miami Beach :All clients~for whom
Communication ' 400 youths Senior High School ;Care Coordination
:Plans are developed
will receive follow-up
services within 72
business hours from
completion of Care
........._.____._._...._...._._._ ____....._..._____._..__._.__._.___._.._~ ,_._.___ _._......_._._.______._~___ ___~ ;Coordination Plan
____ _ _ ~_____
_
Weekly Attendance i Up to 400 youths ;Miami Beach ;All enrolled youth will _~
Tracking ~ ;Senior High School have attendance
.................._ ~.__......__ 1_._.__..____......__.____.._._.__ ~ ~_...._..~ records checked_weekly
Failure to meet contracted service units within the allocated timeframe may result in
the City subsequently reducing the Contractor's service level and allocated funding
accordingly.
If the Contractor is unable to fulfill the contracted service level within the allocated
timeframe for each service component, the City reserves the right to reduce service
levels accordingly across the funded service spectrum.
13
If the Contractor is unable to fulfill the contracted service level and the City
subsequently reduces service and funding levels, the City reserves the right to select
another vendor to fulfill the remaining service units. The City will select the alternate
vendor at its sole discretion.
Reporting Requirements
The Contractor will provide the City with a Monthly Progress Report and
reimbursement request utilizing the City's Reporting and Reimbursement Forms
(attached). In the event that the third of the month lands on a Saturday, Sunday or
holiday, the report must be submitted the following business day.
Reports and reimbursement requests will be submitted via any of the following
methods:
• Electronic mail
• Facsimile
• Standard mail
• Hand delivery
Reports will not be considered acceptable unless the following is met:
• Forms are completely and accurately filled
• Necessary back-up materials are included (client documentation, expense
receipts, time logs, etc.)
• Reports bear the signature of the person submitting the report on behalf of
the Contractor
The failure to submit required reports and invoices in a timely manner for two
consecutive periods will result in the forfeiture of one (1 %) percent of the combined
billed total for the two periods in question. These forfeited funds will be used
exclusively for client incentive .materials as approved by the Miami Beach Service
Partnership Governing Board. These forfeited funds will be submitted to the City by
the Contractor via check within 30 days.
Engagement Strategies
The Contractor will adhere to the following engagement strategies in the delivery of
services:
• Advise the client and his/her parents and/or guardians of the scheduled
appointment for Intake & Assessment.
• Provide client and his/her parents and/or guardians information regarding
tutoring and other available services.
14
Evaluation
In the continuing effort to ensure programming excellence, clients will be provided
with evaluation forms at the end of each programming component to gauge their
satisfaction with services provided. The evaluation forms will be provided by the City
and must be administered:
• Completion of Services Evaluation Form
Monitoring & Performance Reviews
The City of Miami Beach reserves the right to inspect, monitor and/or audit the
Contractor to ensure contractual compliance. This includes, but is not limited to:
• Review of on-site service delivery
• Inspection and review of client, budgetary and employee files (for those
employees providing services under this contract)
The monitoring tool provided by The Children's Trust, "Community and Neighborhood
Services System of Care Programmatic Site Visit Form", will be used to guide
inspections and monitoring visits. (Copy included herein.)
Master Calendar
The Contractor will notify the City of any client appointment or anticipated service
delivery at least 72 hours in advance of the .appointment or service delivery for
inclusion in the Success University Master Calendar that is distributed to all members
of the Miami Beach Service Partnership. The Master Calendar will be updated daily
and distributed to the Partnership as needed.
Training Requirements
Frontline personnel (those conducting trainings) will be required to complete the
following trainings prior to service provision:
Intake & Assessment Services ^ Program Overview Training
^ Intake & Assessment Training
^ Community OS Software Training
^ Client Evaluation Survey Training
^ Care Coordination Plan Training
While initial training expenses are covered by the City, the Contractor agrees to
reimburse the City for the early departure (termination) of any trained staff member
prior to this contract's termination on a pro-rated basis as follows:
15
Training Cost
n
g ____ ~
A _ __
~~
take &
ssessment Tra Wing
~
~ ~ ~
~~33
~
~?
_,._
_ ~ _
_
3 Community OS_Traininc~____..__.___ ......................._....._._____~.._ ~_
.... _ ... ___
. _._......_........__.~,
__..________.__ ~ .___._.
~___._._. _.._._. ~
_
_
_.,
_ ~______._ $133.12
_Client..Evaluation._SurveY_Train.!.n9........ 1
.
6
64
_$
:
Care Coordination Plan Training _ .
.
.
_
.....
$66.56
16
EXHIBIT "B"
INVOICING
The Contractor agrees to provide the invoicing and services documentation as
indicated in the Monthly Progress Report and Monthly Reimbursement Form, as
attached to this Exhibit, by the third (3~d) of the subsequent month.
17
EXHIBIT "C"
ATTACHMENTS
The following documents are attached:
• Copy of Letter to Parent (1 page)
• School Meeting Sign-in Sheet (1 page)
• Care Coordination Plan (1 page)
• Status Update Form (2 pages)
• Progress Report (1 page)
• Invoice Form (1 page)
• Programmatic Site Visit Form (9 pages)
18
Superintendent of Schools
Alberto M. Carvatha
August 31, 2009
Dear Parent-
Miami-Dade County School Beard
Dr. Solomon C. Stinson. Chair
Dr. Marta Perez, Vice Chair
Agustin J. Sarrera
Renier Diaz de la Portilla
Dr. Lawrence S. Feldman
Perla Tabares Hantman
Dr. Wilbert "Tee" Holloway
Dr Martin Karp
Ana Rivas Logan
You are receiving this letter because your child has missed at least three unexcused
school days. Miami Beach Senior High School has been selected to participate in the
Success University Program funded by The Children's Trust. This truancy prevention
program provides students missing three unexcused school days and their families with
a variety of services to ensure regular school attendance.
School attendance is mandatory in the State of Florida. Please contact us by phone
so that we may set up a time for a school meeting with you and your child. At this
meeting, school and Success University staff will discuss with you what, if any,
additional services may be needed to ensure daily school attendance. All students
missing three unexcused school absences must have a parent meeting with school and
Success University staff.
For those students and families having difficulty attending school, the Success
University Program will provide direct support including:
• Family assessment-
• Family Group Conferencing
• Care Coordination Plans
• Referral and direct services
While we are sure that you will make every effort to ensure daily school attendance, we
are pleased to offer this resource to ensure your success.
Sincerely,
Miami Beach Senior High School • 2231 Prairie Avenue • Miami Beach, FL 33139 • Dr. Rosann Sidener, Principal
305-532-4515. 305-531-9209 (FAX) • miamibeachhigh.dadeschools.net
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Case Worker
Contact Date
Data Tracker Date
Client Name First ~1liddle Last
Client Address Apartment /# Zip Code
Home Telephone Cellular Telephone E-Mail Address
Contact Date Contact Location
O Home O Other O Phone Contact
Indicate Persons Present O Client O Mother/ Step-Mother O Father/ Step-Father
~ Other Females # O Other Males #
Phone Call Log Date: Date: Date:
Time: Time: Time:
O Messa e O No Answer O Messa e 0 No Answer O Messa e O No Answer
Referral Follow-up
riease inaicate the service neeas reco nizea m prior visits and their subsequent follow-up
Service Need Agency Referred Current Status
Current Home Status
Please provide an update on the client and family's status fnr each catannrv ha~n~u
Housing
(Housing situation
includin affordabilit
Financial
(Employment, living costs,
etc.
Familial
(Family dynamics,
relationshi s, etc.
Educational
(Academic progress,
school attendance, etc.
Health
(Physical, mental and
dental
Success University Audit
Indicate the Success Universit com onents/services that have been accessed b client as of this contact.
O Intake & Assessment O Referral Services O Family Conferencing O Tutoring
O 7 Habits Teens/Families O Em to ment Services OMB Helpers Client/ Parent O SHARE Prooram
Success University Client Contact Form
Revised August 2009
Truancy Reduction Update
Indicate the status of the client's truancy reduction goals. Reference the Care Coordination Plan and/or FGC
Attendance Contract
Additional Narrative/Observations
Inaicate any aaaitionai comments inciuaing oaservations regaraing the client ana~or ram
New Needs Identified
IIIUIl.C1lG CII 1~/ IICW IICCUJ LI IG1l ICI.~UIIG IGIClltll A-CI VIIiC,.
Need Identified
Referral Provided/Agency
Service Reminders
Please ensure you review all of the items helnw with rliPnt and family
Service Reminder Yes No
Did ou ensure that all contact information is accurate and u -to-date? O O
Did ou rovide famil with this month's SHARE Food Pro ram information? O O
Did ou remind client and arent of the im ortance of adherin to the Attendance Contract? O ~
Next Scheduled Encounter
maicate your next scneawea encounter wren cuent and location
Date Time Location Purpose
O Family Conferencing
O Follow-up Home Visit
O No follow-u ex ected
Success University Client Contact Form 2
Revised August 2009
Attachment Checklist
Invoice ^
Referral Status Report ^
Primary Business Address Address 2
Phone: (340) 555-0167 Fax: (340)555-0168
N A R R A T I V E
Contract #:
Invoice Date;
Reporting
Month
City, ST ZIP Code Country
E-mail: someone@example.com Web site: www.xyz.com
N V 0
Contact ~;
Invoice Date;
Bill To:
OfFce of Community Services
City of Miami Beach
1700 Convention Center Drive
Miami Beach, Florida 33139
C E
• f ~ - . ~
..
Subtotal
Please make sure to submit all contractually required documentation with invoice. (Performance
Balance Due
REMITTANCE
Date ofReceipt.•
Date ofApprova/;
Amount Due;
Amount Paid;
Primary Business Address Address 2 City, ST ZIP Code Country
Phone: (340) 555-0167 Fax: (340) 555-0168 E-mail: someone@example.com Web site: www.xyz.com
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