PSA with Institute for Child & Family Health, Inc. a101& — ag3361
PROFESSIONAL SERVICES AGREEMENT
BETWEEN THE CITY OF MIAMI BEACH
AND
INSTITUTE FOR CHILD &fAMILY HEALTH, INC.
FOR
CHILD AND FAMILY SERVICES, PURSUANT TO
THE CITY'S SERVICE PARTNERSHIP INITIATIVE /J
A/
This Pr fessional Services Agreement ("Agreement") entered into this �2 day of
2017, between the CITY OF MIAMI BEACH, FLORIDA, a municipal corporation
organized and existing under the laws of the State of Florida, having its principal offices at
1700 Convention Center Drive, Miami Beach, Florida, 33139 ("City"), and INSTITUTE FOR
CHILD AND FAMILY HEALTH, INC., a non-profit Florida corporation, whose address is
15490 NW 7th Avenue, Suite 200, Miami, Florida 33169 (Contractor).
SECTION 1
DEFINITIONS
Agreement: This Agreement between the City and Contractor, including any
exhibits and amendments thereto.
City Manager: The chief administrative officer of the City.
Contractor: For the purposes of this Agreement, Contractor shall be deemed to be
an independent contractor, and not an agent or employee of the City.
Services: All services, work and actions by the Contractor performed or
undertaken pursuant to the Agreement.
Fee: Amount paid to the Contractor as compensation for Services.
Risk Manager: The Risk Manager of the City, with offices at 1700 Convention Center
Drive, Third Floor, Miami Beach, Florida 33139; telephone number
{305)673-7000, Ext. 6435; and fax number(305)673-7023.
SECTION 2
SCOPE OF WORK (SERVICES)
2.1 In consideration of the Fee to be paid to Contractor by the City, Contractor shall
provide Functional Family Therapy services for up to ten (10) children and their families, as
further described in Exhibit"A" hereto{the Services).
1
2.2 Contractor's Services, and any deliverables incident thereto, shall be completed in
accordance with the timeline and/or schedule in Exhibit "A," entitled "Scope of Services."
hereto.
2.3 Contractor agrees to be bound by and shall fully comply with the terms of the
Agreement, dated July 27, 2016, between The Children's Trust and the City of Miami Beach,
for place-based/countywide community partnerships (the "Children's Trust -Grant
Agreement"), which is incorporated herein and attached hereto as Exhibit C-1.
2.4 The City and Contractor agree to comply with the Business Associate Agreement
which is incorporated herein and attached hereto as Exhibit C-2.
SECTION 3
TERM
The term of this Agreement (Term) shall commence upon execution of this Agreement by all
parties hereto, and shall terminate on July 31, 2017. All Services to be rendered shall be
completed no later than July 31, 2017.
Notwithstanding the Term provided herein, Contractor shall adhere to any specific timelines,
schedules, dates, and/or performance milestones for completion and delivery of the
Services, as same is/are set forth in the timeline and/or schedule referenced in Exhibit A
hereto.
SECTION 4
FEE
4.1 In consideration of the Services to be provided, Contractor shall be compensated on
a fixed fee basis, in a total amount not to exceed Twenty-Five Thousand Dollars
($25,000.00).
4.2 Contractor shall be compensated for the Services, as set forth in Section 2 and
Exhibit "A", as follows:
The Contractor shall submit monthly requests for payment including payroll records
and other applicable back-up documentation no later than the 5th day of the
succeeding month. Compensation will be issued in corresponding monthly
installments. invoices are payable upon receipt of an invoice that is acceptable to the
City. Advance payments are not allowed. The aggregate maximum amount shall not
exceed sum of Twenty-Five Thousand Dollars ($25,000.00).
Invoices for services taking place prior to the beginning of the Agreement term are
not reimbursable. Similarly, invoices for services taking place after the end of the
Agreement term are not reimbursable.
2
The City assumes no obligation to provide financial support of any type in excess of
the total Agreement amount. All amounts submitted to the City must not be submitted
to any other funding agency for payment.
Contractor's compensation shall be further subject to and conditioned upon all or any portion
of the Services to be provided herein being allowable and within the Scope of Services
delineated in Exhibit"A".
4.3 Contractor shall provide the City with a detailed invoice, on a monthly basis, that
details all services performed by Contractor in a particular month. Contractor's invoices are
subject to the review and approval of the City Manager and/or his or her designee, who shall
be the Department Director of the Office of Housing and Community Services. The City shall
not remit any payments to Contractor unless Contractor provides the City with a detailed
invoice that is acceptable to the City.
4.4 INVOICING
Upon receipt of an acceptable and approved invoice, payment(s) shall be made within forty-
five (45) days for that portion (or those portions) of the Services satisfactorily rendered (and
referenced in the particular invoice).
Contractor shall submit monthly Reimbursement Requests, Monthly Service Summary
Reports, and accompanying Monthly Client Status Lists, as set forth in Exhibit "B", which
include an itemized, detailed description of the Services, or portions thereof, provided
(including the names of the clients served and dates of service provision) and cost(s) for
same.
Invoices shall be signed by an authorized employee of the Contractor, shall include a
detailed description of the Services (or portions thereof) provided, and shall be submitted to
the City at the following address:
Maria Ruiz, Department Director
Office of Housing and Community Services
1700 Convention Center Drive
Miami Beach, Florida, 33139
SECTION 5
TERMINATION
5.1 TERMINATION FOR CAUSE
If the Contractor shall fail to fulfill in a timely manner, or otherwise violates, any of the
covenants, agreements, or stipulations material to this Agreement, the City, through
its City Manager, shall thereupon have the right to terminate this Agreement for
cause. Prior to exercising its option to terminate for cause, the City shall notify the
3
Contractor of its violation of the particular term(s) of this Agreement, and shall grant
Contractor ten (10) days to cure such default. If such default remains uncured after
ten (10) days, the City may terminate this Agreement without further notice to
Contractor. . Notwithstanding the foregoing, if the default is of a nature that cannot be
cured, such as perpetrating a fraud, making a material misrepresentation, or creating
a temporary or permanent public health, welfare or safety issue, as determined by the
City Manager, in the City Manager's sole discretion, the City Manager may
immediately suspend the Services under this Agreement for a time certain, or, in the
alternative, terminate this Agreement on a given date, without providing Contractor
with an opportunity to cure. Upon termination, the City shall be fully discharged from
any and all liabilities, duties, and terms arising out of, or by virtue of, this Agreement.
Notwithstanding the above, the Contractor shall not be relieved of liability to the City
for damages sustained by the City by any breach of the Agreement by the Contractor.
The City shall be entitled to recover all costs of such actions, including reasonable
attorneys'fees, should the city prevail.
5.2 TERMINATION FOR CONVENIENCE OF THE CITY
THE CITY MAY ALSO, THROUGH ITS CITY MANAGER, AND FOR ITS
CONVENIENCE AND WITHOUT CAUSE, TERMINATE THE AGREEMENT AT ANY
TIME DURING THE TERM BY GIVING WRITTEN NOTICE TO CONTRACTOR OF
SUCH TERMINATION; WHICH SHALL BECOME EFFECTIVE WITHIN THIRTY (30)
DAYS FOLLOWING RECEIPT BY THE CONTRACTOR OF SUCH NOTICE. IF THE
AGREEMENT IS TERMINATED FOR CONVENIENCE BY THE CITY,
CONTRACTOR SHALL BE PAID FOR ANY SERVICES SATISFACTORILY
PERFORMED UP TO THE DATE OF TERMINATION; FOLLOWING WHICH THE
CITY SHALL BE DISCHARGED FROM ANY AND ALL LIABILITIES, DUTIES, AND
TERMS ARISING OUT OF, OR BY VIRTUE OF, THIS AGREEMENT.
5.3 TERMINATION FOR INSOLVENCY
The City also reserves the right to terminate the Agreement in the event the
Contractor is placed either in voluntary or involuntary bankruptcy or makes an
assignment for the benefit of creditors. In such event, the right and obligations for
the parties shall be the same as provided for in Section 5.2.
5.4 TERMINATION BY CONTRACTOR
5.4.1 TERMINATION FOR CLAUSE
If the City shall fail to pay any fees owed to contractor within forty-five (45) days
from receipt of an invoice for approved services under this Agreement, the
Contractor shall have the right to terminate the Agreement. In such case, contractor
shall be paid for any services satisfactorily performed up to the date of termination.
4
5.4.1 TERMINATION FOR CONVENIENCE
This Agreement may be terminated by the Contractor, for convenience, upon no
less than sixty {60) days' notice in writing to the City. Contractor will work with the
City to ensure a smooth transition of services.
Notwithstanding the above, the Contractor shall not be relieved of liability to the City
for damages sustained by the City by any breach of the Agreement by the
Contractor. The City shall be entitled to recover all costs of such actions, including
reasonable attorneys 'fees, should the City prevail.
SECTION 6
INDEMNIFICATION AND INSURANCE REQUIREMENTS
6.1 INDEMNIFICATION
Contractor agrees to indemnify and hold harmless the City of Miami Beach and its officers,
employees, agents, and contractors, from and against any and all actions, claims, liabilities,
losses, and expenses, including, but not limited to, attorneys' fees and costs, for personal,
economic, or bodily injury, wrongful death, loss of or damage to property, which may arise or
be alleged to have arisen from the negligent acts, errors, omissions or other wrongful
conduct of the Contractor, its officers, employees, agents, contractors, or any other person or
entity acting under Contractor's control or supervision, in connection with, related to, or as a
result of the Contractor's performance of the Services pursuant to this Agreement, except for
any such personal, economic, or bodily injury, wrongful death, loss of damage to property
which may arise or be alleged to have arisen from the gross negligence or willful misconduct
of the City of Miami Beach, its officers, employees, agents, other contractors or any other
person or entity acting under the City's control or supervision in connection with, related to,
or as a result of the City's performance pursuant to this Agreement. To that extent, the
Contractor shall pay all such claims and losses and shall pay all such costs and judgments
which may issue from any lawsuit arising from such claims and losses, and shall pay all
costs and attorneys' fees expended by the City in the defense of such claims and losses,
including appeals.
The parties agree that one percent (1%) of the total compensation to Contractor for
performance of the Services under this Agreement is the specific consideration from the City
to the Contractor for the Contractor's indemnity agreement. The provisions of this Section
6.1 and of this indemnification shall survive termination or expiration of this Agreement.
6.2 INSURANCE REQUIREMENTS
The Contractor shall not commence any work and/or Services pursuant to this Agreement
until all insurance required under this Section has been obtained and such insurance has
been reviewed and approved by the City's Risk Manager.
5
The Contractor shall maintain and carry in full force during the Term, the following insurance:
1. Commercial General Liability insurance, to include sexual molestation, in an
amount not less than $500,000 combined single limit per occurrence and $1,000,000
aggregate in a policy year. Deductibles exceeding $1,000 are discouraged, unless
Contractor can provide financial statements to support a higher deductible. The City
of Miami Beach must be designated and shown as an additional insured and the
certificate holder with respects to this coverage. The general liability policy must
contain coverage for the following:
a. Bodily Injury;
b. Property Damage;
c. No exclusions for Abuse, Molestation or Corporal Punishment;
d. No endorsement for premises only operations.
2. If applicable, Contractor Professional Liability insurance, with coverage
amounts not less than $250,000 per claim and in the aggregate. Defense costs
may be inside the limits of liability and the policy can be written on claims made form.
The City of Miami Beach is not required to be named as an Additional Insured.
Professional liability insurance is generally required when the scope of services uses
professional services that require certification or license(s) to provide direct services
to program participants.
3. Workers Compensation & Employers Liability, as required pursuant to Florida
Statutes. Worker's Compensation Insurance must cover all employees, non-
incorporated independent contractors or Contractors, and incorporated independent
contractors or Contractors that do not have worker's compensation coverage or a
valid State of-Florida exemption on file with the Department of Labor, as required by
Florida Statutes, Chapter 440. In the event that the Contractor is no longer exempt
from obtaining Worker's Compensation insurance, the Contractor must notify the City
of Miami Beach and provide the necessary certificate of insurance upon the
termination of the exemption. The employer's liability portion will be
$500,000/$500,000/$500,000 as a minimum.
The insurance must be furnished by insurance companies authorized to do business in the
State of Florida. All insurance policies must be issued by companies rated no less than "B+"
as to management and not less than "Class VI" as to strength by the latest edition of Best's
Insurance Guide, published by A.M. Best Company, Oldwick, New Jersey, or its equivalent.
All of Contractor'scertificates shall contain endorsements providing that written notice shall
be given to the City at least thirty (30) days prior to termination, cancellation or reduction in
coverage in the policy. The insurance certificates for-General Liability shall include the City
as an additional insured.
Original certificates of insurance must be submitted to the City's Risk Manager for approval
(prior to any work and/or services commencing) and will be kept on file in the Office of the
Risk Manager. The City shall have the right to obtain from the Contractor specimen copies of
the insurance policies in the event that submitted certificates of insurance are inadequate to
ascertain compliance with required coverage.
6
The Contractor is also solely responsible for obtaining and submitting all insurance
certificates for any sub-contractors.
Compliance with the foregoing requirements shall not relieve the Contractor of the liabilities
and obligations under this Section or under any other portion of this Agreement.
Failure by Contractor to comply with Section 6.2 shall be a material breach of this Contract.
The City will not disburse any funds under this contract until all required Certificates of
Insurance have been provided to and have been approved by the City's Risk Manager.
The Contractor shall not commence any work and or services pursuant to this Agreement
until all insurance required under this Section has been obtained and such insurance has
been approved by the City's Risk Manager.
Contractor and or Contractor's insurance agent, as applicable, shall notify the City, in writing,
of any material changes in insurance coverage, including, but not limited to, any renewals of
existing insurance policies, not later than thirty (30) days prior to the effective date of making
any material changes to the insurance coverage except for ten (10) days for lack of payment
changes. Contractor shall be responsible for ensuring that all applicable insurance is
maintained and submitted to the City for the duration of this Contract. In the event of any
change in Contractor's Scope of Services, Attachment A, the City may increase, waive, or
modify in writing any of the foregoing insurance requirements. Any request by a Contractor to
decrease, waive, or modify any of the foregoing insurance requirements must be approved,
in writing, by the City prior to any such decrease, waiver, or modification. In the event that an
insurance policy is canceled, lapsed, or expired during the effective period of this Contract,
the City shall withhold all payments to Contractor until a new Certificate of Insurance required
under this section is submitted and approved by the City. The new insurance policy shall
cover the time period commencing from the date of cancellation of the prior insurance policy.
The City may require Contractor to furnish additional and different insurance coverage, or
both, as may be required from time to time under applicable federal or state laws or the City
requirements. Provision of insurance by Contractor, in no instance, shall be deemed to be a
release, limitation, or waiver of any claim, cause of action or assessment that the City may
have against Contractor for any liability of any nature related to performance under this
Contract or otherwise. All insurance required hereunder may be maintained by Contractor
pursuant to a master or blanket policy or policies of insurance.
SECTION 7
LITIGATION JURISDICTIONNENUE/JURY TRIAL WAIVER
This Agreement shall be construed in accordance with the laws of the State of Florida. This
Agreement shall be enforceable in Miami-Dade County, Florida, and if legal action is
necessary by either party with respect to the enforcement of any or all of the terms or
conditions herein, exclusive venue for the enforcement of same shall lie in Miami-Dade
County, Florida. By entering into this Agreement, Contractor and the City expressly waive
any rights either party may have to a trial by jury of any civil litigation related to or arising out
of this Agreement.
7
SECTION 8
LIMITATION OF CITY'S LIABILITY
The City desires to enter into this Agreement only if in so doing the City can place a limit on
the City's liability for any cause of action, for money damages due to an alleged breach by
the City of this Agreement, so that its liability for any such breach never exceeds the sum of
the compensation/fee to be paid to Contractor pursuant to this Agreement, less any
amounts actually paid by the City as of the date of the alleged breach. Contractor hereby
expresses its willingness to enter into this Agreement with Contractor's recovery from the
City for any damage action for breach of contract to be limited to a maximum amount of the
sum of the compensation/fee to be paid to Contractor pursuant to this Agreement, less any
amounts actually paid by the City as of the date of the alleged breach.
Accordingly, and notwithstanding any other term or condition of this Agreement, Contractor
hereby agrees that the City shall not be liable to the Contractor for damages in an amount
in excess of the sum of the compensation/fee to be paid to Contractor pursuant to this
Agreement, less any amounts actually paid by the City as of the date of the alleged breach
for any action or claim for breach of contract arising out of the performance or non-
performance of any obligations imposed upon the City by this Agreement.
Nothing contained in this section or elsewhere in this Agreement is in any way intended to
be a waiver of the limitation placed upon the City's liability, as set forth in Section 768.28,
Florida Statutes.
SECTION 9
[INTENTIONALLY DELETED]
SECTION 10
GENERAL PROVISIONS
10.1 AUDIT AND INSPECTIONS
Upon reasonable verbal or written notice to Contractor, and at any time during normal
business hours (i.e., 9AM - 5PM, Monday through Fridays, excluding nationally recognized
holidays), and as often as the City Manager may, in his/her reasonable discretion and
judgment, deem necessary, there shall be made available to the City Manager, and/or such
representatives as the City Manager may deem to act on the City's behalf, to audit,
examine, and/ or inspect, any and all other documents and/or records relating to all matters
covered by this Agreement, including Contractor's financial records. Contractor shall
make available such records at its place of business at the address set forth in the
"Notices" section of this
8
Agreement. Further upon adequate written releases from the authorized legal guardian,
Contractor shall make available those records for which releases are required pursuant to
applicable privacy laws for audit purposes only. Contractor agrees to submit its agency
financial audit to the City within 30 days of completion, at least once during the Term of this
Agreement.
10.2 [INTENTIONALLY DELETETD]
10.3 ASSIGNMENT, TRANSFER OR SUBCONSULTING
Contractor shall not subcontract, assign, or transfer all or any portion of any work and/or
service under this Agreement without the prior written consent of the City Manager, which
consent, if given at all, shall be in the Manager's sole judgment and discretion. Neither this
Agreement, nor any term or provision hereof, or right hereunder, shall be assignable unless
as approved pursuant to this Section, and any attempt to make such assignment (unless
approved) shall be void.
Contractor shall be responsible for all Services performed, and all expenses incurred, under
this Agreement, including services provided and expenses incurred by any and all
subcontractors. The City shall not be liable to any subcontractor for any expenses or
liabilities incurred under any subcontract. Contractor shall be solely liable for any expenses
or liabilities incurred under any subcontract. Contractor shall hold harmless and defend, at
Contractor's expense, the City against any claims, demands or actions related to any
subcontract.
10.4 [INTENTIONALLY DELETED]
10.5 EQUAL EMPLOYMENT OPPORTUNITY
In connection with the performance of the Services, the Contractor shall not discriminate
against any employee or applicant for employment because of race, color, national origin,
religion, ancestry, sex, intersexuality, place of birth, physical handicap, gender identity,
sexual orientation, disability, marital and familial status, or age.
10.6 CONFLICT OF INTEREST
The Contractor herein agrees to adhere to and be governed by all applicable Miami-Dade
County Conflict of Interest Ordinances and ethics provisions, as set forth in the Miami-Dade
County Code, and as may be amended from time to time; and by the City of Miami Beach
Charter and Code (as may be amended from time to time); both of which are incorporated
by reference herein as if fully set forth herein.
The Contractor covenants that it presently has no interest and shall not acquire any
interest, direct or indirectly, which could conflict in any manner or degree with the
performance of the Services. The Contractor further covenants that in the performance of
this Agreement, Contractor shall not employ any person having such interest. No member
9
of or delegate to the Congress of the United States shall be admitted to any share or part of
this Agreement or to any benefits arising there from.
SECTION 11
NOTICES
All notices and communications in writing required or permitted hereunder, shall be
delivered personally to the representatives of the Contractor and the City listed below or
may be mailed by U.S. Certified Mail, return receipt requested, postage prepaid, or by a
nationally recognized overnight delivery service.
Until changed by notice in writing, all such notices and communications shall be addressed
as follows:
TO CONTRACTOR: Institute for Child & Family Health, Inc.
Attn: Suzy Schumer, LCSW, Chief Executive Officer
15490 NW 7th Avenue
Miami, Florida 33169
305-688-3541
TO CITY: City of Miami Beach
Office of Housing and Community Services
Attn: Maria Ruiz, Department Director
1700 Convention Center Drive
Miami Beach, Florida 33139
(305)673-7491
Notice may also be provided to any other address designated by the party to receive notice if
such alternate address is provided via U.S. certified mail, return receipt requested, hand
delivered, or by overnight delivery. In the event an alternate notice address is properly provided,
notice shall be sent to such alternate address in addition to any other address which notice
would otherwise be sent, unless other delivery instruction as specifically provided for by the
party entitled to notice.
Notice shall be deemed given on the day on which personally served, or the day of receipt by
either U.S. certified mail or overnight delivery.
SECTION 12
MISCELLANEOUS PROVISIONS
12.1 CHANGES AND ADDITIONS
This Agreement cannot be modified or amended without the express written consent of the
parties. No modification, amendment,or alteration of the terms or conditions contained herein
10
shall be effective unless contained in a written document executed with the same formality
and of equal dignity herewith.
12.2 SEVERABILITY
If any term or provision of this Agreement is held invalid or unenforceable, the remainder of
this Agreement shall not be affected and every other term and provision of this Agreement
shall be valid and be enforced to the fullest extent permitted by law.
12.3 ENTIRETY OF AGREEMENT
The City and Contractor agree that this is the entire Agreement between the parties. This
Agreement supersedes all prior negotiations, correspondence, conversations, agreements or
understandings applicable to the matters contained herein, and there are no commitments,
agreements or understandings concerning the subject matter of this Agreement that are not
contained in this document. Title and paragraph headings are for convenient reference and
are not intended to confer any rights or obligations upon the parties to this Agreement.
12.4 CONTRACTOR'S COMPLIANCE WITH FLORIDA PUBLIC RECORDS LAW
(A) Contractor shall comply with Florida Public Records law under Chapter 119, Florida
Statutes, as may be amended from time to time. Records made or received in
connection with this Agreement are public records under Florida law, as defined in
Section 119.011(12), Florida Statutes.
(B) Pursuant to Section 119.0701 of the Florida Statutes, if the Contractor meets the
definition of"Contractor" as defined in Section 119.0701(1)(a), the Contractor shall:
(1) Keep and maintain public records required by the City to perform the service;
(2) Upon request from the City's custodian of public records, provide the City with a
copy of the requested records or allow the records to be inspected or copied
within a reasonable time at a cost that does not exceed the cost provided in
Chapter 119, Florida Statutes or as otherwise provided by law;
(3) Ensure that public records that are exempt or confidential and exempt from
public records disclosure requirements are not disclosed, except as authorized
by law, for the duration of the contract term and following completion of the
Agreement if the Contractor does not transfer the records to the City;
(4) Upon completion of the Agreement, transfer, at no cost to the City, all public
records in possession of the Contractor or keep and maintain public records
required by the City to perform the service. If the Contractor transfers all public
records to the City upon completion of the Agreement, the Contractor shall
destroy any duplicate public records that are exempt or confidential and exempt
from public records disclosure requirements. If the Contractor keeps and
maintains public records upon completion of the Agreement, the Contractor
shall meet all applicable requirements for retaining public records. All records
stored electronically must be provided to the City, upon request from the City's
11
custodian of public records, in a format that is compatible with the information
technology systems of the City.
(C) REQUEST FOR RECORDS; NONCOMPLIANCE.
(1) A request to inspect or copy public records relating to the City's contract for
services must be made directly to the City. If the City does not possess the
requested records, the City shall immediately notify the Contractor of the
request, and the Contractor must provide the records to the City or allow the
records to be inspected or copied within a reasonable time.
(2) Contractor's failure to comply with the City's request for records shall constitute
a breach of the Agreement, and the City, at its sole discretion, may: (1)
unilaterally terminate the Agreement; (2) avail itself of the remedies set forth
under the Agreement; and/or (3) avail itself of any available remedies at law or
in equity.
(3) A Contractor who fails to provide the public records to the City within a
reasonable time may be subject to penalties under s. 119.10.
(D) CIVIL ACTION.
(1) If a civil action is filed against a Contractor to compel production of public
records relating to the City's contract for services, the court shall assess and
award against the Contractor the reasonable costs of enforcement, including
reasonable attorney fees, if:
a. The court determines that the Contractor unlawfully refused to comply with
the public records request within a reasonable time; and
b. At least 8 business days before filing the action, the plaintiff provided
written notice of the public records request, including a statement that the
Contractor has not complied with the request, to the City and to the
Contractor.
(2) A notice complies with subparagraph (1)(b) if it is sent to the City's custodian of
public records and to the Contractor at the Contractor's address listed on its
contract with the City or to the Contractor's registered agent. Such notices must
be sent by common carrier delivery service or by registered, Global Express
Guaranteed, or certified mail, with postage or shipping paid by the sender and
with evidence of delivery, which may be in an electronic format.
(3) A Contractor who complies with a public records request within 8 business
days after the notice is sent is not liable for the reasonable costs of
enforcement.
(E) IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF
CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO
PROVIDE PUBLIC RECORDS RELATING TO THIS AGREEMENT, CONTACT THE
CUSTODIAN OF PUBLIC RECORDS AT:
CITY OF MIAMI BEACH
ATTENTION: CITY CLERK
1700 CONVENTION CENTER DRIVE MIAMI BEACH, FLORIDA 33139
E-MAIL: RAFAELGRANADO(a)_MIAMIBEACHFL.GOV
PHONE: 305-673-7411
12
12.5 BACKGROUND SCREENING
In accordance with Sections 39.001, 943.0542, 984.01, and 1012.465, and Chapters 402,
430, 435, Florida Statutes, as applicable, employees, volunteers and subcontracted
personnel who work in direct contact with children or who come into direct contact with
children must complete a satisfactory Level 2 background screening prior to commencing
work pursuant to this Agreement.
All employees, volunteers and subcontracted personnel who work in direct contact with
children or who may come into direct contact with children at the site in question must
complete a Level 2 background screening and comply with the requirements thereto prior to
commencing work pursuant to this Contract. This requirement applies to all volunteers who
provide more than 10 hours of service, in any given calendar year, to children, youth and
their families. Occasional or transient repair or maintenance persons, vendor representatives,
contractors or subcontractors who have not completed a Level 2 background screening and
appear on the site should be escorted to their work areas and supervised the entire time they
are present to conduct their work.
All providers are required to review annually, at minimum, The Dru Sjodin National Sex
Offender Public Website.
Level 2 background screening investigations must be completed through the Florida
Department of Law Enforcement (FDLE) VECHS (Volunteer & Employee Criminal History
System) Program. Satisfactory background screening documentation will be accepted for
those agencies that already conduct business with either the Department of Children and
Families (DCF) or the Department of Juvenile Justice (DJJ) or the Miami-Dade County Public
School System (MDCPS). A clearance letter from MDCPS Office of Employment Standards
indicating the person has successfully completed a Level 2 screening shall be acceptable by
the City.
If background screenings are completed through VECHS, then Contractor shall complete
Attachment E: "Affidavit for Level 2 Background Screenings," for each contract term. The
Affidavit shall cover employees, volunteers, and subcontractors performing services under
this contract who are required to complete a Level 2 background screening as defined in this
section. Contractor shall keep Attachment E: "Affidavit for Level 2 Background Screenings" in
Contractors records for its personnel, volunteers, and sub-contractors. Contractor shall re-
screen each employee, volunteer, and/or subcontractor every five (5) years.
12.6 CONFIDENTIALITY
Contractor and the City understand that during the course of performing the Services
hereunder, each party may have access to certain confidential and proprietary information
and materials of the other party in order to further performance of the Services. The parties
shall protect confidential information and comply with applicable federal and state laws on
13
confidentiality to prevent unauthorized use, dissemination or publication of confidential
information as each party uses to protect its own confidential information in a like manner.
The parties shall not disclose confidential information to any third party (except that such
information may be disclosed to such party's attorneys), or to any employee of such party
who does not have a need to know such information, which need is related to performance of
a responsibility hereunder. However, this Agreement imposes no obligation upon the parties
with respect to confidential information which (a) was lawfully known to the receiving party
before receipt from the other, (b) is or becomes a matter of public knowledge through no fault
of the receiving party, (c) is rightfully received by the receiving party from a third party without
restriction on disclosure, (d) is independently developed by or for that party, (e) is disclosed
under operation of law, (f) is disclosed by the receiving party with the other party's prior
written approval, or (g) is subject to Chapter 119 of the Florida Statutes or is otherwise
required to be disclosed by law. The confidentiality provision of this Agreement shall remain
in full force and effect after the termination of this Agreement.
12.7 DATA SECURITY OBLIGATION
Contractor shall maintain an appropriate level of data security for the personally identifiable
information (PII) Contractor is collecting or using in the performance of this Contract. PII is
information that can uniquely identify, contact, or locate a single person or can be used with
other sources to uniquely identify individuals. Contractor shall maintain and adhere to a
written Data Security Policy that addresses requirements regarding the protection of PII from
unauthorized access and protection against data breaches and ensures Contractor is in
compliance with applicable federal and state standards with respect to transmission, receipt
and storage of PII on Contractor's computing network and as paper records. This policy shall
address the topics of computer passwords, screensavers that lock computers, securing
physical facilities, storing data, data use, data confidentiality agreements, and staff training
related to the policy. Additionally, Contractor is responsible for approving and tracking all
Contractor employees who request system or information access and ensuring that user
access has been removed from all terminated employees of Contractor. All employees and
independent contractors performing work or duties related to this Contract will sign a Data
Confidentiality Agreement prior to beginning work related to this Contract. Contractor must
also abide by all requirements to protect client protected personally identifiable information
(PPII).
Contractor shall fully comply with the data security obligations set forth in the Children's Trust
Grant Agreement, at Section 0-12, entitled "Data Security Obligation."
12.8 CHILDREN WITH DISABILITIES AND THEIR FAMILIES
Contractor understands that the City expects Contractor to meet any and all federal
standards under the Americans with Disabilities Act. Contractor must also implement
reasonable programmatic accommodations to include children with disabilities and their
families, whenever possible. Notwithstanding anything to the contrary, Contractor shall not
be required to make any alteration to any public school building or other building or structure
which is not owned by Contractor.
14
12.9 RESPONSIBILITY OF THE CONTRACTOR
With respect to the performance of the Services, the Contractor shall exercise that degree of
skill, care, efficiency and diligence normally exercised by recognized professionals with
respect to the performance of comparable services. In its performance of the Services, the
Contractor shall comply with all applicable laws, ordinances, and regulations of the City,
Miami-Dade County, the State of Florida, and the federal government, as applicable.
THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK.
15
IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by
their appropriate officials, as of the date first entered above.
FOR CITY: CITY OF MIAMI BEACH, FLORIDA
ATTEST:
.71 By: T � LSA
Rafael E. Granado ? ;r ditI L 's
City Clerk Cit:. Watia•er
(._ Ag
i
D to
FOR CONTRACTOR: INSTITUTE FOR CHILD & FAMILY
HEALTH, INC.
ATTEST:
By: 54;d/e-k k-'dv
I
/'
Print Name/Title Print Name/Title
3/7,-v7/
Date r
APPROVED AS TO
Corporate Seal FORM & LANGUAGE
& FOR EXECUTION
City Attorney Date
16
EXHIBIT"A"
"SCOPE OF SERVICES"
All Services related to this Agreement being provided to minor children or youth must be
administered in the presence of the minor's parent or legal guardian. Alternatively, the
Services may be provided in a safe, public space (e.g. the minor's school), but only if
approved in writing by the parent or legal guardian and the City. In limited circumstances, but
while the parent is still in the home, if in the opinion of the therapist, the therapist believes
that it is in the best interest of the child to be able to fully disclose in a safe and confidential
environment, the therapist may advise the parent and be allowed to converse with the child
outside of the presence of the parents.
Contractor staff must contact all clients referred to receive Services related to this Agreement
within two (2) business days of referral.
Contractor staff must advise the City of the status of all referrals for Services related to this
Agreement within five (5) business days of referral.
Contractor staff must contact client within 48 hours of referral and inform the City if clients are
unresponsive no later than 8 days after referrals are made.
Contractor staff must advise the City of any challenges to service delivery, including but not
limited to language barriers, capacity issues, client concerns, staff concerns, and scheduling
challenges, immediately.
The Contractor agrees to provide the following services to youth enrolled in the City of Miami
Beach Success University program:
Service Units Documentation of Service
of
Service
Functional I 10 Completion and execution of the following documents:
Family Therapy
Session 1. Programmatic Attendance Form signed by all
attendees, for all sessions, including intake/
assessment for services and direct client service
provision sessions
2. Symptoms and Functions Severity Scale — SFSS (Pre-
test and Post-test, for client and caregiver).
3. Family Functioning/Client Outcome Measure-COM
{Pre-test and Post-test for client and caregiver).
Notification email, to be sent from Contractor to City staff within
72 hours of service delivery.
17
Related Definitions:
Functional Family Therapy Services — Functional Family Therapy Services (FFTS) are
conducted by the Contractor's staff in accordance with the Contractor's policies and
procedures and in accordance with the Evidence-Based Program's certification standards.
The contents of and information discussed during the FFTS remain private, unless the
Contractor deems specific information to be relevant and/or important for the City's provision
of other services, or if information compiled in the FFTS is deemed to be relevant to the
safety of the client or others. The FFTS is documented by the full and accurate completion of
the Programmatic Attendance Form and includes the signatures of the client receiving the
service, clinician providing the service, and any additional individuals receiving or providing
services referenced herein. The FFTS is further documented by the Symptoms and
Functions Severity Scale —SFSS (Pre-test and Post-test, for client and caregiver) and Family
Functioning/Client Outcome Measure-COM (Pre-test and Post-test for client and caregiver)
for the purposes of recording outcome measures.
Should the Contractor encounter challenges in meeting the below stated service
deliverables within the required timeframes, the Contractor may request an extension.
The approval below and duration of all extensions are at the sole discretion of the City.
If the Contractor is unable to satisfy deliverables within the required timeframes, the
City reserves the right to conduct said services or assign said services to an alternate
vendor at its sole discretion.
Services must be provided in accordance with the below timeline and in response to
client needs. If the Contractor is found to be providing services primarily during the
second half of any calendar month, the City reserves the right to request
documentation to explain the delay in service provision.
Service Deliverables
Services must be delivered as follows:
Service Unit of Service Service Timeframe
Location
Functional Minimum of 8 to i Client Home I Initial FFTS Intake/Assessment
Family Therapy 12 sessions for j session will be completed within fifteen
Services 1 each of up to 10 ' (15)days of referral receipt. All eligible
children/families i FFTS will be completed within one
I ( hundred sixty(160) days of completed
FFTS Intake/Assessment session.
18
Service Documentation
Services will be deemed as provided when the following documentation is provided within the
noted timeframes:
Service Documentation Submission Deadline
Referrals -Miami Beach Service Partnership Referral Three (3) business days 1
Form(s) signed by staff and receiving from the identification of I
client(s). client need
Functional Family • Programmatic Attendance Form signed Notification Email: three
Therapy Services by all in attendance {3) business days from
-Referral process documentation for provision of service.
identified client (For referrals within and/or Programmatic Attendance
outside of the service partnership.) Form: monthly; by the 5th
-Internal documentation for the day of the succeeding
Contractor's records should be kept in month.
accordance with the Contractor's policies
and procedures and in accordance with the
Evidence-Based Program's certification
standards.
Notification Emails should be sent if documents are to be submitted via Samepage.
Notification Emails should be encrypted if documentation cannot be submitted via
Samepage. (ONLY if Contractor is able to encrypt emails for the protection of client
information)
Penalties for Failure to Perform
If the contractor fails, on two occasions, to submit required, accurate documentation in the
timeframe allotted, including the absence of notification email, the Contractor will forfeit two
(2%) percent of the combined billed total for the months in which inaccuracies took place.
Documents submitted within the required timeframe and found to be insufficient are subject
to penalties for failure to perform.
If the contractor fails, on three occasions, to submit required, accurate documentation in the
timeframe allotted within the contract Term, the Contractor is subject to termination of any
further service referrals, but Contractor will be allowed to complete the service units allotted
to existing clients. The decision to cease additional referrals rests in the sole discretion of the
City.
"Required, accurate documentation" may refer to:
• Monthly invoices
• Monthly narratives
• Monthly client lists
19
• Monthly in-kind hours, contributions, and/or Leverage
• Client Assessments
• Service documentation of any kind, including sign-in sheets
• Family Group Conference documents
• Any documents associated with mental health services, Service Evaluation forms, or
any other documentation required by this Agreement.
• Performance Measurement Tools
• Notification Emails
• Any document required by this Agreement
If any individual employed by or independently contracted with the Contractor fails, on more
than one occasion, to attend a scheduled client meeting without notifying the City of an
impending absence, the City reserves the right to remove that individual from the
Contractor's staff roster for the purposes of this Contract.
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 and terminate this Agreement at its discretion.
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.
Engagement Strategies
The Contractor will adhere to the following engagement strategies in the delivery of services:
• Provide client and his/her parents and/or guardians information regarding the
importance of adhering to school attendance policies, if applicable.
• Provide client and his/her parents and/or guardians information regarding the Care
Coordination process and all other available services.
• Reintroduce the services available through the Program at the beginning of client
interaction and as needed thereafter.
• Document every interaction with or on behalf of the client.
Employee/ Contractor File Review
The following documentation must be included in the employee/contractor file for all
employees/contractors providing services under this contract.
The following must be included in the employee files:
• Employment Application
• Evidence of degree/credentials
• Job Description Signed by Employee
2n
• Evidence of Required-Experience
• Florida Background Criminal Screening
• National FBI Background Criminal Screening (Level 2)
• Affidavit of Good Moral Character
• Proof of Knowledge of Policies & Procedures
• Confidentiality Agreement Re: Client Information
• Authorized time sheets, records, and attendance sheets to document the staff time
billed to provide Services pursuant to this Agreement
• Daily activity logs and monthly calendars of the provision of Services pursuant to this
Agreement
• Documentation of Contractor Training/In-Service Training
• Documentation of City-provided trainings
• Documentation of attendance at one CCDH training
• 1-9 Verification on File
Monitoring visits shall take place within thirty (30) days of the commencement of services.
The City will notify the Contractor a minimum of two (2) business days' notice prior to a
monitoring visit.
The City reserves the right to inspect employee/contractor files with due notice (at least forty-
eight (48) hours in advance of planned site visit) to ensure adherence to contractual
expectations as well as to ensure pre-screening prior to a monitoring visit by The Children's
Trust.
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. At a minimum, the Contractor must obtain evaluation forms from the
primary child client and the parent/guardian. The evaluation forms will be provided by the City
and will be administered by the care coordinator at the following times:
• Completion of Family Group Conference
• Completion of Care Plan Close-Out(program evaluation form)
The City will conduct intermittent performance evaluations for the purpose of monitoring the
Contractor's performance. The City will conduct said evaluations utilizing a tool of its choice
and at its sole discretion.
Reporting Requirements
Each month, the Contractor will provide the City with a monthly progress report, Client List,
and reimbursement request utilizing the City's Reporting and Reimbursement Forms (Exhibit
B) by 5:00 PM on the fifth (5th) of the following month. The client list detailing the dates,
services provided, and clients receiving said services must be included. If in-kind hours are
21
submitted, back-up documentation stating same must be included. In the event that the fifth
of the month lands on a Saturday, Sunday or holiday, the report must be submitted the
following business day. Reports are due to the-City on the following dates:
• Monday, September 5, 2016 • Monday, March 6, 2017
• Wednesday, October 7, 2016 • Wednesday, April 5, 2017
• Monday, November 7, 2016 • Friday, May 5, 2017
• Monday, December 5, 2016 • Monday, June 5, 2017
• Thursday, January 5, 2017 • Wednesday, July 5, 2017
• Monday, February 6, 2017 • Monday, August 7, 2017
Monthly reports and reimbursement requests may be submitted via any of the following
methods:
• Electronic mail
• Facsimile
• Standard mail
• Hand delivery
Monthly reports will not be considered acceptable unless the following is met:
• Forms are completely and accurately filled
• Necessary back-up materials are included (service documentation, sign-in sheets,
etc.)
• Reports bear the signature of the authorized agency representative submitting the
report on behalf of the Contractor
The City will document Contractor service level data and monthly reports via Active Strategy
software for inclusion in the monthly report to the Miami Beach Service Partnership
Governing Board as well as the City's website.
Miami Beach Service Partnership Meeting Attendance
The Contractor is required to have representation at each calendared Miami Beach Service
Partnership Governing Board meeting. Meetings will be held by means of telephone
conference via "Go To Meeting". Two mandatory in-person meetings will be held throughout
the contract year.
If the Contractor fails to have representation at the two in-person meetings, the City reserves
the right to reduce contracted service levels at its sole discretion.
22
Monitoring & Performance Reviews
The City 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 Agreement)
The monitoring tool provided by The Children's Trust, On-Site Monitoring Tool, will be used to
guide inspections and monitoring visits. (Copy included herein.)
Monitoring visits will take place within thirty (30) days of the commencement of services. The
City will notify the Contractor a minimum of two (2) business days' notice prior to a monitoring
visit.
Partner Performance Ratings
The Contractor agrees that its partner performance rating, the score awarded for
performance on the following measures, will be posted on the City's website on a bi-annual
basis:
• Timely and accurate submission of monthly progress report
• Timely and accurate submissions of monthly financial reports {reimbursement
requests)
• Delivery of contracted service units
• Promotion of the Miami Beach Service Partnership
• Attendance at Miami Beach Service Partnership Governing Board and related
committee(s) meetings
Ratings will be given for each performance measure based on the following:
Performance Measure Rating Rationale & Score
Timely and accurate submission of Monthly > "0"for failing to submit on time I
Service Summary Report > "10"for submitting on time
Timely and accurate submissions of > "0" for failing to submit accurate report with
monthly financial reports {Monthly back-up material on time
Reimbursement Request) > "10"for submitting accurate report on time
Delivery of contracted service units Possible score of 0 to 25 based upon
completion of projected service units. Score is
calculated by dividing the completed number of
service units by the total number of referred I
service units.
Timely and complete document submission Possible score of 0 to 20 based upon timely
and complete submission of service
documentation. Score is calculated by dividing
the number of service units submitted timely
and satisfactorily by the total number of service
23
units completed.
Attendance at Miami Beach Service Possible score of 0 to 10:
Partnership and related committee(s) 10 Points for attendance at Miami Beach
meetings Service Partnership meetings; 10 points for
Committee attendance (In the event that there
are no committee meetings scheduled, the
value for attendance at the Miami Beach
Service Partnership meeting will be 20.)
Issuance of Referrals Possible score of 0 to 25:
25 Points for issuing appropriate referrals !
through the care coordination plan/process.
Promotion & Public Relations Requirements
The Contractor agrees to receive Success University Program Brochures and have them
available for clients during all in-person client interactions.
The Contractor agrees to link its website to the City's Success University webpage. Such link
must be in place prior to the execution of this contract.
The Contractor agrees to indicate its membership in the Partnership in all self-produced
marketing materials that are produced for the benefit of youth and families.
Training Requirements
Personnel providing services under in this Contract will be required to complete the following
trainings prior to service provision, as delineated below:
Functional Family Therapy Services ❑ Program Overview Training
❑ Samepage Software Training
Personnel providing services under in this Contract will be required to complete the following
trainings within 90 days of contract finalization, as delineated below:
Functional Family Therapy Services ❑ CCDH Disability awareness training
❑
DCF Abuse & Neglect Online Training
❑ Injury Prevention Training
The Contractor agrees to send at least one representative to attend a City-sponsored grant
writing workshop by July 31, 2017. Alternately, the Contractor may submit documentation
indicating at least one member of its staff has attended another Grant Writing training in the
same period of time.
24
Contractor agrees to allow the City to audit each Contractor staff member during the
provision of mental health services for the purposes of maintaining fidelity. City audit may
take place by the third service provision by each Contractor staff member.
The Contractor agrees to send its Miami Beach Service Partnership Meeting representative
to a City-sponsored member refresher training before services are started for the 2016-2017
contract year.
In the event that any Contractor staff member does not satisfy the above training
requirements or if any mental health counselor staff does not attend one or more of the
required City provided or Quarterly Staff Development trainings, the City, as its sole
discretion, reserves the right to remove the staff member from the Contractor's roster for the
purposes of this Agreement.
Client Termination
Contractor staff must notify the Program Coordinator of client inactivity. If the Contractor has
not been able to reach a client, they must notify the Program Coordinator by the eighth (8)
day.
Contractor's Staff Roster
Contractor will provide the City with the following information for each individual employed by
or independently contracted with the Contractor to conduct services related to this
Agreement:
• Name
• Resume
• Credentials, to include degrees and licenses, as required by position
• Phone number
• E-mail address
• Days and times available for service provision{minimum of three weeknight or
weekend shifts available per week)
• Language Skills (minimum of one bilingual staff member required per every 10
contractually required clients)
• Total number of hours per week each staff member is able to commit
• Name of Supervisor and total number of hours per week committed to
supervision/staffing in support of activities related to this Agreement.
Contractor agrees to adhere to screening staff and contracted employees for minimum
requirements appropriate to positions related to this Agreement and in accordance with
Contractor's policies and procedures.
Contractor's staff members are required to wear identification while conducting services.
25
Contractor's employees and independent contractors providing Mental Health services and/or
Counseling Sessions must meet the following criteria, at minimum:
• A minimum of an earned master's degree from a mental health counseling program or
a program in a closely related field that is CACREP and/or regionally accredited
• Licensed as Registered Mental Health Counselor Intern or higher in the State of
Florida
• Obtained a mental health counselor qualified supervisor
Switchboard of Miami Registration
Contractor agency will register with Switchboard of Miami to ensure that agency information
is accurate and updated. This contractual obligation is directed by The Children's Trust.
Agency registration can be done at the following website: www.switchboardmiami.orq
Additional Documentation
The following documentation must be submitted with this executed agreement:
• All required insurance certificates
• Copy of most recent financial audit
• Copy of required business licenses and permits
• List of all members of Contractor's Board of Directors, if applicable
• Contractor's Board of Directors by-laws, if applicable
• Conflict of Interest policy
• Agency 990 Form
• Agency W-9 Form
THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK.
26
EXHIBIT "B"
INVOICING
The Contractor agrees to provide the invoicing and services documentation as indicated
utilizing the following forms attached herein:
• Monthly Service Summary Report, and
• Monthly Reimbursement Request
• Monthly Client Status List
27
Success University
City of Miami Beach
MONTHLY REIMBURSEMENT INVOICE&REPORT
Office of Community Services/Grant Reimbursement Request
Grant Name
Miami Beach Service Partnership/Success University
Contract Number
1621-1090-AGENCY NAME
Reporting Period
Sep-16 Initials
Expended Thus Far $ - Available Balance $ -
This Request $ -
Balance Remaining $ -
Fiscal Summary
SERVICE UNITS FUNDS
f •„,-4...•••.,7t14''', o ,,ir ° i tt' z,0 , ,: ,S .. ' Initials
Service Name $0.00 0 0 0 0 $ - $ - $ - $ -
Service Name $0.00 0 0 0 0 $ - $ - $ - $ -
Service Name $0.00 0 0 0 0 $ - $ - $ - $ -
Service Name $0.00 0 0 0 0 $ - $ - $ - $ -
Service Name $0.00 0 0 0 0 $ - $ - $ - $ -
Service Name $0.00 0 0 0 0 $ - $ - $ - $ -
Service Name $0.00 0 0 0 0 $ - $ - $ - $ -
Service Name i $0.00 0 0 0 0 $ - $ - $ - $ -
TOTALS $ - $ - $ - $ -
Documentation Checklist
Not
Documentation Submitted Submitted Initials
Service delivery documentation
List of clients served
Leverage/Match
Staff Member Hourly Rate Hourly Benefits #of Hours Line Total
Test,Test $ - $ - 0 $ -
$ - $ - $ -
$ - $ - $ -
$ -
$ $
$ -
$ $
Staff Total $ -
Space&Other in-Kind valve/urn cost Unit Quantity Line Total
$ $
$ -
$
$ $
$ - $ -
Space&Other $ -
everage/Match Tot $ -
I certify that the information provided above is accurate to the best of my knowledge and that I have included all documentation required to ascertain the delivery of
services as delineated in our contract with the City of Miami Beach.
Signature of Authorized Agency Representative Date
Date Receivedby City Miami Beach
AmoounttAuthorized for Reimbursement
Staff Member Activity Date Hours
Example,Test Attendance at GB Meeting 07/25/16 1.5
Calls to clients to inform about ACA seminar(clients:
Example,Test T.Example,T.Example,T.Example) 08/07/16 1
Coordinator, Care Unsuccessful attempts to contact clients(T.Example) 08/10/16 4
TOTAL-AUGUST 6.5
CLIENT LIST
Date Month
Receiving Client Name Type of Service Date of Service Submitted Billed
Doe,John (Example) MH Assessment 07/31/16 08/01/16 Aug-16
Doe,John (Example) Care Plan Contact#1 08/15/16 08/17/16 Aug-16
BUSINESS ASSOCIATE AGREEMENT
This Business Associate Agreement is made effective as of the 2 9 day of
I liNitc , 2017 by and between Institute for Child and Family Health, Inc., a Florida not-
for-profit corporation, located at 15490 NW 7th Ave., Miami, Florida 33169, hereinafter referred to as
the "Covered Entity," and: City of Miami Beach, a Florida municipal corporation, located at 1700
Convention Center Drive, Miami Beach, Florida 33139 hereinafter referred to as "Business
Associate", (individually, a "Party" and collectively, the "Parties").
WITNESSETH:
WHEREAS, certain privacy regulations, promulgated under the Health Insurance Portability and
Accounting Act ("HIPAA"), directs the Department of Health and Human Services to develop standards
to protect the security, confidentiality and integrity of Protected Health Information; and
WHEREAS, the Department of Health and Human Services has issued regulations that
modified 45 Code of Federal Regulation, Parts 160 and 164 (the "HIPAA Privacy Rule") and 45 C.F.R.
Part 160 and Part 164, Subparts A and C, the Security Standards for the Protection of Electronic
Protected Health Information ("Security Rule"); and
WHEREAS, Institute for Child and Family Health, Inc. is a "Covered Entity" as defined in 45
CFR Parts 160 and 164; and
WHEREAS, City of Miami Beach, is a "Business Associate" as defined in 45 CRF Parts 160
and 164; and
WHEREAS, the Covered Entity and the Business Associate are Parties to a Profession
Services Agreement of even date (Original Agreement) for Funder for Behavioral Health Services, in
connection with the provision of services, either party may disclose to the other certain Protected
Health Information ("PHI") that is subject to protection under the Health Insurance Portability and
Accountability Act of 1996 ("HIPAA"); and
WHEREAS, each party is willing to disclose (disclosing Party) to the other (receiving Party) the
Protected Health Information and the receiving Party is willing to use or disclosure Protected Health
Information pursuant to the terms and conditions of this Business Associate Agreement that will
become and Addendum to the Original Agreement; and
WHEREAS, the Parties wish to continue their arrangement whereby the Business Associate will
continue to provide the negotiated upon services to Covered Entity; and
THEREFORE, in consideration of the Parties' mutual promises and covenants contained herein,
and their continuing obligations pursuant to the Business Associate Agreement, and other good and
valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties agree
to fully comply with the provisions of this Agreement and to fully comply with the HIPAA Privacy Rule
and to protect the interests of both Parties.
1. DEFINITIONS:
1.1 Unless otherwise provided in this Agreement, capitalized terms shall have the same
meaning as set forth in the Privacy Rule or the Security Rule.
1.2 In the event of an inconsistency between the provisions of this Agreement and
mandatory provisions of the HIPAA Privacy Rule, as amended, the HIPAA Privacy Rule
shall control. Where provisions of this Agreement are different than those mandated in
the HIPAA Privacy Rule, but are nonetheless permitted by the HIPAA Privacy Rule, the
provisions of this Agreement shall control.
1.3 Business Associate is defined in a broad sense, any person(s) who perform on behalf of
a Covered Entity or provide to the Covered Entity a function, activity or service involving
the use or disclosure of individually identifiable health information.
1.4 Covered Entity means a health plan, a health care provider or a health care clearing
house that transmits any Protected Health Information in connection with a transaction.
1.5 Contract shall refer to this document.
1.6 Health and Human Services Privacy Regulations shall mean the Code of Federal
Regulations (C.F.R.) at Title 45, sections 160 and 164.
1.7 Parties shall mean the Business Associate and the Covered Entity.
1.8 Protected Health Information (defined in 45 CRF 164.501) means individually identifiable
health information including, without limitation, all information, data, documentation, and
materials, including without limitation, demographic, medical and financial information,
that relates to the past, present, or future physical or mental health or condition of an
individual; the provision of health care to an individual; or the past, present, or future
payment for the provision of health care to an individual; and that identifies the individual
or with respect to which there is a reasonable basis to believe the information can be
used to identify the individual.
1.9 Secretary shall mean the Secretary of the Health and Human Services or its authorized
designee(s).
1.10 HITECH: Shall mean Title XIII of the American Recovery and Reinvestment Act of 2009
("ARRA") called the Health Information Technology for Economic and Clinical Health Act
("HITECH") which codifies and expands on many of the requirements promulgated by
the Department of Health and Human Services ("DHHS") pursuant to the Health
Insurance Portability and Accountability Act of 1996 ("HIPAA") to protect the privacy and
security of protected health information ("PHI").
1.11 Designated Record Set: Shall have the same meaning set out in its definition at 45
C.F.R. 164.501.
1.12 Uses and Disclosures mean the Protected Health Information shall be used solely to
perform the contractual obligations between the Covered Entity and the Business
Associate.
2. CONFIDENTIALITY OBLIGATIONS:
2.1 Each Party acknowledges that all Protected Health Information that is used or disclosed
or made available in any form, including any paper record, oral communication, audio
recording, and electronic display by a disclosing Party, or its agents, including but not
Page 2 of 8
limited to its independent contractors to the receiving Party or its agents that is created
or received by the receiving Party on the disclosing Party's behalf shall be subject to this
Agreement.
2.2 All Protected Health Information concerning clients/consumers and their mental health
and/or substance abuse treatment, and/or HIV status, and/or child abuse and foster care
related documents and records, and/or including client identities, is confidential and
privileged pursuant to the Health Insurance Portability And Accountability Act, PL 104-
191, 42 U.S.C. '9501(1)(H). Accordingly, during the duration of this Agreement and
thereafter, the parties will not use or disclose any information regarding the
clients/consumers and their treatment, including their identities and diagnosis, except as
may be required to provide services in accordance with the terms of this Agreement, or
to use or disclose, publish, or disseminate any Protected Health Information concerning
the clients to any third party, without the express prior consent of the disclosing Party,
except as may be required by federal law or state law, including, without limitation,
Florida's Public Records law, Chapter 119, Florida Statutes, as may be amended from
time to time.
2.3 Implement Administrative, Physical, Security and Technical Safeguards that reasonably
and appropriately protect the confidentiality, integrity and availability of the Electronic
PHI that it creates, receives, maintains or transmits on behalf of Institute for Child and
Family Health or the City of Miami Beach, as applicable, and make its policies and
procedures, and documentation required by the Security Rule relating to such
safeguards, available to the Secretary of Health and Human Services for purposes of
determining Covered Entity's compliance with the Security Rule;
2.4 Ensure that any agent, including a subcontractor, to whom it provides Electronic PHI
agrees to implement reasonable and appropriate safeguards to protect that Electronic
PHI; and
2.5 Promptly report to Institute for Child and Family Health or the City of Miami Beach,
as applicable, any Security Incident with respect to Electronic PHI of which it becomes
aware.
3. SCOPE OF USES AND DISCLOSURES BY THE PARTIES OF PROTECTED HEALTH
INFORMATION:
3.1 Each Party is permitted to use and disclose Protected Health Information that has been
received or created by the other Party solely for achieving the intended purpose of its
obligations as set forth in the Original Agreement between the Parties evidencing their
business relationship or as required by law, including without limitation, the Rules and
any applicable state laws.
3.2 Unless otherwise limited herein, and in addition to the permitted uses and disclosures as
set forth in the Privacy Rule, and other applicable laws, either Party may use or disclose
Protected Health Information as follows:
I. If necessary, for the proper management and administration to the Business
Associate to carry out the legal responsibilities of the Business Associate, but only if
the following requirements are met:
(a) The disclosure is required by law; or
Page 3 of 8
(b) Business Associate or Covered Entity obtains reasonable written assurances
from the person to whom the information is disclosed that the Protected Health
Information will be held confidentially and used or further disclosed only as
required by law or for the purpose for which it was disclosed to the person; and
(ii) the person notifies the Business Associate or Covered Entity of any
instances of which it is aware in which the confidentiality of the Protected
Health Information has been breached; or
(c) For data aggregation services, if to be provided by Business Associate for the
health care operations of Covered Entity pursuant to any agreements between
the Parties evidencing their business relationship.
4. BUSINESS ASSOCIATE RESPONSIBILITES:
The Business Associate and Covered Entity agree to the following:
A. Limits of Uses and Disclosures
4.1 To use or disclose any Protected Health Information strictly for achieving the intended
purpose of its obligations as set forth in the Original Agreement between the Parties
evidencing their business relationship or as required by law, including without limitation,
the Rule and any applicable state laws.
4.2 Prevent the unauthorized use or disclosure of the confidential and Protected Health
Information and report to the other Party any unauthorized use or disclosure of the
confidential and Protected Health Information to which it may become aware as required
by 45 CFR ' 164.528. All such confidential and Protected Health Information will be
made available in accordance with 45 CFR ' 164.524.
B. Proper Safeguards
4.3 To implement and maintain appropriate safeguards to prevent the use or disclosure of
any and all Protected Health Information other than as permitted in this Agreement.
4.4 Ensure that their employees/agents, including a subcontractor, to whom it provides
Protected Health Information, received from or created by one Party on behalf of the
other Party and agrees to the same restrictions and conditions that apply to the
disclosing Party with respect to such information. In addition, each Party agrees to take
reasonable steps to ensure that its employees' actions or omissions do not cause it to
breach the terms of this Agreement.
C. Reports of Improper Uses and Disclosure
4.5 Report to the other Party, in writing and within 48 hours of becoming aware of any
unauthorized use or disclosure not permitted by pursuant to the terms of the Original
Agreement and with this Business Associate Agreement. All written reports regarding
the unauthorized use or disclosure of Protected Health Information must be immediately
submitted to the other Party at: Institute for Child and Family Health, Inc., Privacy
Officer at 15490 NW 7th Ave., Miami, Florida 33169, or City of Miami Beach, Office of
Housing and Community Services Director, at 1700 Convention Center Drive,
Miami Beach, Florida 33139.
Page 4 of 8
4.6 To the extent practicable, mitigate any harmful effect of which it is aware of any known
use or disclosure of Protected Health Information in violation of the Original Agreement
or this Business Associate Agreement.
4.7 Comply with the Security Rules, as required by HITECH, in a manner consistent with the
rule and regulations that may be adopted by relevant federal agencies, to keep all
electronic PHI in a secure manner.
4.8 Ensure that any agent, including a subcontractor, to whom it provides PHI received from,
or created or received by it on behalf of the other Party, agrees to the same restrictions
and conditions that apply through this Agreement to Business Associate with respect to
such information. 45 C.F.R. 164.502 and 164.308.
D. Record Inspection/Audit
4.9 Make available to the U.S. Secretary of Health and Human Services ("HHS") and the
Office of Civil Rights ("OCR) or any other officer of employee of HHS to whom authority
has been delegated, their internal practices, books, and records relating to the use and
disclosure of Protected Health Information for purposes of determining compliance with
the Privacy Rule, subject to any applicable legal privileges. This section shall survive
termination of this agreement.
4.10 Allow for HHS to audit Business Associate's records and practices related to use and
disclosure of Protected Health Information to ensure Covered Entity's compliance with
the terms of the HIPAA Privacy Rule.
E. Right to Access to Protected Health Information
4.11 Make available the Protected Health Information to the extent and in the manner
required by Section 164.524 of the HIPAA Privacy Rule.
4.12 Provide the Covered Entity with a right to access to any Protected Health Information
within five (5) days of such a request.
4.13 In the event that the client makes a request to the Business Associate for their Protected
Health Information, the Business Associate will inform the Covered Entity of the request.
If the Covered Entity determines that the client is to be provided with access to the
Protected Health Information, the Business Associate shall cooperate with the Covered
Entity to provide the client consumer with the Protected Health Information that has been
requested. The Business Associate shall not disclosure any Protected Health
Information before notifying the Covered Entity and receiving the authorization from the
Covered Entity to do so. Notwithstanding the foregoing, this requirement shall not apply
to any records which are subject to disclosure pursuant to Public Records Laws,
including, Chapter 119, Florida Statutes. No provision in this Business Associate
Agreement shall be construed to modify or void the Parties' requirement to comply with
Florida's Public Records Law, as more particularly described in Section 12.4 of the
Original Agreement.
4.14 Make Protected Health Information available for amendment and incorporate any
amendments to Protected Health Information.
Page 5 of 8
4.15 Document all uses and disclosure of Protected Health Information and all related
information to such uses and disclosures related
4.16 Make Protected Health Information available for purposes of accounting of disclosures.
F. Comply with Administrative, Technical, Physical, Organization and Security
Standards
4.17 Each Party must allow the other Party to review the security practices of the other Party
to ensure that the other Party has policies and procedures to prevent and correct
security violations; assess the vulnerability of the PHI they possess; implement security
measures to reduce vulnerabilities; discipline employees who fail to comply with the
required safeguarding of PHI; regularly review records of information system activities
and security incident tracking reports for violations. Each Party hereby gives the other
assurance that any and all PHI and any and all electronic PHI will be protected from
unlawful uses and disclosures.
4.18 Each Party shall comply with any and all regulatory requirements which may arise in the
future to comply fully with the Privacy Rules, the Security Rule and HITECH, including,
but not limited to, restrictions on disclosures to health plans, clarified minimum
necessary standards, expanded accounting requirements applicable to electronic health
records, revised prohibitions on sales of PHI and updated marketing and fundraising
restrictions.
4.19 Each Party acknowledges that, pursuant to HITECH, Each Party, its employees and
contractors, and any third parties, including their employees, contractors, and further
third parties, who may have access to or possession of It's PHI are subject to regulatory
oversight of the various federal and/or state agencies, and may be subject to both civil
and criminal penalties which may arise from violations of this Agreement, the Privacy
Rules, the Security Rule and HITECH.
G. Subcontractors and Agents
Each Party must ensure that any subcontractor(s) or agent(s) to whom it provides
Protected Health Information received from, or created or received by it on behalf of
Institute for Child and Family Health or the City of Miami Beach, as applicable,
agrees to the same restrictions, terms and conditions that apply to it with respect to the
uses and disclosures of Protected Health Information.
5. TERMS:
5.1 The term of this Agreement shall be effective as of the date of execution of this
Agreement.
6. TERMINATION:
6.1 Either Party shall have the right to immediately terminate the Original Agreement and
this Business Associate Agreement if it determines that the other Party has violated any
material term of this Agreement or has failed to comply with the required administrative,
technical, physical, or security standards or has failed to cure the privacy and / or
security violations.
Page 6 of 8
6.2 At termination of this Agreement, or upon request of the Covered Entity, whichever
occurs first, the Business Associate shall either return the Covered Entity's Protected
Health Information in their possession, if feasible, or destroy all Protected Health
Information received from, or is created or received by Business Associate on behalf of
Covered Entity that the Business Associate still maintains in any form. This section also
applies to any subcontractor or agents of the Business Associate. If such return or
destruction of the Protected Health Information is not feasible, the Business Associate
shall provide to the Covered Entity notification of the conditions that make the return or
destruction of the Protected Health Information infeasible; will extend the protections of
this Agreement to the Protected Health Information and limit further uses and
disclosures to those purposes that make the return or destruction of the information not
feasible. Notwithstanding the foregoing, Business Entity shall be permitted to retain any
and all information which it secured from the client. Additionally, Business entity shall be
permitted to retain any information and all records which Business Entity is required to
maintain pursuant to applicable law.
7. MISCELLANEOUS:
7.1 Except as expressly stated herein or the HIPAA Privacy Rule, the Parties to this
Agreement do not intend to create any rights in any third parties, nor will they be
deemed to create any relationship between the Parties other than that of independent
parties contracting with each other solely for the purposes of effecting the provisions of
the Original Agreement and this Agreement and any other agreements between the
Parties evidencing their business relationship.
7.2 The obligations of Business Associate and Covered Entity under this Section shall
survive the expiration, termination, or cancellation of this Agreement, and/or the
business relationship of the parties, and shall continue to bind each Party, its agents,
employees, contractors, successors, and assigns as set forth herein.
7.3 This Agreement may be amended or modified only in a writing signed by the Parties.
The Parties agree to seek modifications to this Agreement if necessary from time to time
to allow for the Covered Entity to comply with the requirements of the Privacy Rule and
the Security Rules, the Health Insurance and Accountability Act, Public Law 104-191
and HITECH. No Party may assign its respective rights and obligations under this
Agreement without the prior written consent of the other Party.
7.4. This Agreement will be governed by the laws of the State of Florida. No change, waiver
or discharge of any liability or obligation hereunder on any one or more occasions shall
be deemed a waiver of performance of any continuing or other obligation, or shall
prohibit enforcement of any obligation, on any other occasion.
7.5 The Parties agree that, in the event that any documentation of the arrangement pursuant
to which either Party provides services to the other contains provisions relating to the
use or disclosure of Protected Health Information which are more restrictive than the
provisions of this Agreement, the provisions of the more restrictive documentation will
control. The provisions of this Agreement are intended to establish the minimum
mandatory requirements regarding each Party's use and disclosure of Protected Health
Information.
Page 7 of 8
7.6 In the event that any provision of this Agreement is held by a court of competent
jurisdiction to be invalid or unenforceable, the remainder of the provisions of this
Agreement will remain in full force and effect.
IN WITNESS WHEREOF, the Parties have by their duly authorized representatives, set their
signatures and seals:
COVERED ENTITY: BUSINESS ASSOCIATE:
Institute for Child and Famil Health Cit of Mi. i Beach iorida
i _______ __._."--- > '
By: By: ........',
ame: Ms. Suzy Schumer Na Jimm L. Morales
Title: CEO Title City anager
Date: 3 2 2l Date: 3 1 f (-7
ATTEST:
74 3/2q IV) APPROVED AS TO
FORM & LANGUAGE
Rafael E.Granada,City Cly &F•r EXECUTION
1 •
3
City Attorney 4 if
Dote
, _
Page 8 of 8
EXHIBIT"C"
ATTACHMENTS
The following reference documents are attached:
• The Children's Trust Grant Agreement(Exhibit"C-1")
• Business Associate Agreement(Exhibit"C-2")
28
EXHIBIT "C-1"
THE CHILDREN'S TRUST GRANT AGREEMENT
29
FY 2016-2017
CONTRACT NO. 1721-1090
BETWEEN THE CHILDREN'S TRUST
AND CITY OF MIAMI BEACH
FOR PLACED-BASED COUNTYWIDE COMMUNITY PARTNERSHIPS
THIS CONTRACT is between The Children's Trust whose address is 3150 S.W. 3rd Avenue, 8th Floor, Miami, Florida 33129
and City of Miami Beach hereafter "Provider" whose address is 1700 Convention Center Drive, Miami Beach, Florida
33139.
In consideration of the mutual covenants herein, The Children's Trust and Provider (sometimes hereafter referred to
as "Parties") agree as follows:
A. EFFECTIVE TERM
The effective term of this Contract shall be from August 1, 2016 through July 31, 2017, subject to funding availability
and Provider's performance.
B. TERMS OF RENEWAL, if applicable
In the sole discretion of The Children's Trust, this Contract may be renewed with the acknowledgement of Provider.
In considering the exercise of any contract renewal, and in accordance with the Request for Proposal (RFP) and
Board authorization, renewal may not exceed a term equal to the term of the initial contract for a total maximum of
three (3) terms. The Children's Trust in its sole discretion will consider, but is not limited to, the following:
1. Provider meeting the performance requirements specified in this Contract.
2. Continued demonstrated and documented need for the services funded.
3. Program performance, fiscal performance, and compliance by Provider that is deemed satisfactory in The
Children's Trust's sole discretion.
4. The availability of funds. The Children's Trust is prohibited from creating obligations in anticipation of budgeted
revenues from one fiscal year to another without year to year extension provisions in the contract.
5. If applicable,The Children's Trust in its sole discretion will initiate re-negotiation of this Contract before the contract
term expires.
C. SCOPE OF SERVICES
1. Provider agrees to render services in accordance with the Scope of Services, Attachment A, hereafter"Services",
to this Contract. Provider shall implement the Services in a manner deemed satisfactory to The Children's Trust.
Any modification to the Services shall not be effective until approved, in writing, by The Children's Trust and
Provider.
2. The Services' activities and performance measures, as well as complete and accurate data and programming
information will be used in the evaluation of Provider's overall performance.
3. Provider agrees that all funding provided by The Children's Trust, pursuant to this Contract will be used exclusively
for services in and for the benefit of Miami-Dade County residents.
D. TOTAL FUNDING
Subject to the availability of funds,the maximum amount payable for Services rendered under this Contract shall not
exceed $ 425,000.00, with a required match of $ 0. Provider agrees that should available funding to The Children's
Trust be reduced, the amount payable under this Contract will be reduced at the sole option of The Children's Trust.
Provider agrees to adhere to Attachment B of this Contract: Other Fiscal Requirements, Budget and Method of
Payment.
City of Miami Beach Page 1 of 85
Contract#1721-1090;Resolution#2016-63
To the extent arising from a liability that is covered by the foregoing indemnification, Provider shall pay all
claims and losses in connection therewith and shall investigate and defend all claims, suits or actions of any
kind or nature in the name of The Children's Trust, where applicable, including appellate proceedings, and
shall pay all costs,judgments, and reasonable attorney's fees which may issue thereon. Provider agrees that
any insurance protection required by this Contract or otherwise provided by Provider shall in no way limit the
responsibility to indemnify, keep and save harmless and defend The Children's Trust or its officers, employees,
agents.
The provisions of this section on indemnification shall survive the expiration or termination of this Contract.
G. COPYRIGHTS AND RIGHT TO DATA/MATERIALS
Where activities supported by this Contract produce original writing, data,sound recordings, pictorial reproductions,
drawings or other graphic representations and works of similar nature,The Children's Trust has a license to reasonably
use, duplicate and disclose such materials in whole or in part in a manner consistent with the purposes and terms of
this Contract, and to have others acting on behalf of The Children's Trust to do so, provided that such use does not
compromise the validity of any copyright, trademark or patent. If the data/materials so developed are subject to
copyright,trademark or patent,legal title and every right,interest,claim or demand of any kind in and to any patent,
trademark or copyright, or application for the same, will vest in Provider or with any applicable third party who has
licensed or otherwise permitted Provider to use the same. Provider agrees to allow The Children's Trust and others
acting on behalf of The Children's Trust to have reasonable use of the same consistent with the purposes and terms
of this Contract, at no cost to The Children's Trust, provided that such use does not compromise the validity of such
copyright, trademark or patent.
H. OWNERSHIP AND LICENSING OF INTELLECTUAL PROPERTY
This Contract is subject to the provisions, limitations and exceptions of Chapter 119, Florida Statutes, regarding public
records. Accordingly, to the extent permitted by Chapter 119, Florida Statutes, Provider retains sole ownership of
intellectual property developed under this Contract. Provider is responsible for payment of required licensing fees if
intellectual property owned by other parties is incorporated by Provider into the services required under this Contract.
Such licensing should be in the exclusive name of Provider. Payment for any licensing fees or costs arising from the
use of others' intellectual property shall be at the sole expense of Provider.
As applicable for The Children's Trust under Fla. Stat. Section 768.28, and to the extent permitted by and within the
limitations of Fla. Stat. Section 768.28, the Parties shall indemnify and hold each other harmless from liability of any
nature or kind, including costs and expenses for or on account of third party allegations that use of any intellectual
property owned by the third party and provided,manufactured or used by the indemnifying Party in the performance
of this Contract violates the intellectual property rights of that third party.
I. BREACH OF CONTRACT AND REMEDIES
1. Breach
A material breach by Provider shall have occurred under this Contract if Provider through action or omission
causes any of the following:
a. Fails to comply with Background Screening, as required under this Contract.
b. Fails to provide the Services outlined in the scope of services (Attachment A) within the effective term of
this Contract;
c. Fails to correct an imminent safety concern or take acceptable corrective action;
d. Ineffectively or improperly uses The Children's Trust funds allocated under this Contract;
e. Does not furnish and maintain the certificates of insurance required by this Contract or as determined by
The Children's Trust;
f. Does not meet or satisfy the conditions of award required by this Contract;
g. Fails to submit, or submits incorrect or incomplete, proof of expenditures to support SAMIS disbursement
requests or advance funding disbursements;or,fails to submit,or submits incomplete or incorrect,detailed
City of Miami Beach Page 4 of 85
Contract#1721-1090;Resolution#2016-63
reports of requests for payment, expenditures or final expenditure reports; included, but not limited to
budgets, invoices, and amendments in Services & Activities Management System (SAMIS).
h. Does not submit or submits incomplete or incorrect required reports pursuant to the scope of Services in
this Contract;
i. Refuses to allow The Children's Trust access to records or refuses to allow The Children's Trust to monitor,
evaluate and review Provider's program, including required client data;
j. Fails to comply with child abuse and incident reporting requirements;
k. Attempts to meet its obligations under this Contract through fraud, misrepresentation or material
misstatement;
I. Fails to correct deficiencies found during a monitoring,evaluation or review within a specified reasonable
time;
m. Fails to meet the terms and conditions of any obligation or repayment schedule to The Children's Trust or
any of its agencies;
n. Fails to maintain the confidentiality of client files, pursuant to Florida and federal laws;
o. Fails to fulfill in a timely and proper manner any and all of its obligations, covenants, contracts and
stipulations in this Contract.
p. Fails to submit an Annual Financial Statement Audit and a Program-Specific Audit, as applicable, in
accordance with Section 0 and Attachment D of this contract.
q. Fails to submit an Audit Engagement Letter for either the Annual Financial Statement Audit or the Program
Specific Audit within thirty (30) days after Provider's fiscal year end.
Waiver of breach of any provisions of this Contract shall not be deemed to be a waiver of any other breach
and shall not be construed to be a modification of the terms of this Contract.
2. Remedies
If Provider fails to cure any breach within thirty (30) days after receiving written notice from The Children's
Trust identifying the breach,The Children's Trust may pursue any or all of the following remedies:
a. The Children's Trust may, at its sole discretion, enter into a written performance improvement plan with
Provider to cure any breach of this Contract as may be permissible under state or federal law. Any such
remedial plan shall be an addition to this Contract and shall not affect or render void or voidable any
other provision contained in this Contract, costs, or any judgments entered by a court of appropriate
jurisdiction.
b. The Children's Trust may suspend payment in whole or in part under this Contract by providing written
notice of suspension to Provider of such suspension and specifying the effective date of suspension, at
least five business days before the effective date of suspension. On the effective date of suspension
Provider may (but shall not be obligated to) continue to perform the Services in this Contract, but Provider
shall promptly cease using The Children's Trust's logo and any other reference to The Children's Trust in
connection with such Services. All payments to Provider as of the date of suspension shall cease, except
that The Children's Trust shall continue to review and pay verifiable requests for payment for Services that
were performed and/or for deliverables that were substantially completed at the sole discretion of The
Children's Trust, prior to the effective date of such suspension. The Children's Trust may also suspend any
payments in whole or in part under any other contracts entered into between The Children's Trust and
Provider by providing separate written notice to Provider of each such suspension and specifying the
effective date of suspension, which must be at least five business days before the effective date of such
suspension, in any event The Children's Trust shall continue to review and pay verifiable requests for
payment as provided for in such other contracts for services that were performed and/or for deliverables
that were substantially completed at the sole discretion of The Children's Trust prior to the effective date
City of Miami Beach Page 5 of 85
Contract#1721-1090;Resolution#2016-63
of such suspension. Provider shall be responsible for all direct and indirect costs associated with such
suspension including reasonable attorney's fees.
c. The Children's Trust may terminate this Contract by giving written notice to Provider of such termination
and specifying the date of termination at least five (5) business days before the effective date of
termination. In the event of such termination, The Children's Trust may (a) request Provider to deliver to
The Children's Trust clear and legible copies of all finished or unfinished documents,studies,surveys,reports
prepared and secured by Provider with Trust funds under this Contract subject to the rights of Provider as
provided for in Paragraphs G and H above; (b) seek reimbursement of any Trust funds which have been
improperly paid to Provider under this Contract; (c) terminate further payment of Trust funds to Provider
under this Contract, except that The Children's Trust shall continue to review and pay verifiable requests
for payment for services that were performed and/or deliverables that were substantially completed at
the sole discretion of The Children's Trust prior to the effective date of such termination; and/or (d)
terminate or cancel, without cause, any other contracts entered into between The Children's Trust and
Provider by providing separate written notice to Provider of each such termination and specifying the
effective date of termination,which must be at least five business days before the effective date of such
termination, in which event The Children's Trust shall continue to review and pay verifiable requests for
payment as provided for in such other contracts for services that were performed and/or for deliverables
that were substantially completed at the sole discretion of The Children's Trust prior to the effective date
of such termination. Provider shall be responsible for all direct and indirect costs associated with such
termination, including reasonable attorney's fees.
d. The Children's Trust may seek enforcement of this Contract including but not limited to filing an action with
a court of appropriate jurisdiction. Provider shall be responsible for all direct and indirect costs associated
with such enforcement,including reasonable attorney's fees,costs,and any judgments entered by a court
of appropriate jurisdiction, including all direct and indirect costs and reasonable attorneys' fees through
conclusion of all appellate proceedings, and including any final settlement or judgment.
e. The provisions of this Paragraph I shall survive the expiration or termination of this Contract.
J. TERMINATION BY EITHER PARTY
The parties agree that this Contract may be terminated by either party by written notice to the other party of intent
to terminate at least thirty (30) calendar days prior to the effective date of such termination.
K. INSURANCE REQUIREMENTS
Prior to, or on the date commencing the effective term of this Contract, Provider's insurance agent(s) shall provide
to The Children's Trust the following, as applicable: 1) Certificates of Insurance naming The Children's Trust as an
additional insured and the certificate holder on all applicable policies;and all applicable policies shall be maintained
in full force and effect for the entire term of this Contract.
Or,2) A letter of self-insurance indicating coverage applicable to a Florida municipal corporation required under this
section or as determined by The Children's Trust, except as required by Florida law for government entities.
Failure by Provider to comply with Section K, shall be a material breach of this Contract. The Children's Trust will not
disburse any funds under this contract until all required Certificates of Insurance, or letter(s) of self-insurance have
been provided to and have been approved by The Children's Trust.
Provider will carry insurance policies in the amounts and with the requirements indicated below:
1. Worker's Compensation Insurance covering all employees, non-incorporated independent contractors or
consultants, and incorporated independent contractors or consultants that do not have worker's
compensation coverage or a valid State of Florida exemption on file with the Department of Labor, as
required by Florida Statutes, Chapter 440. In the event that the Provider is no longer exempt from obtaining
City of Miami Beach Page 6 of 85
Contract#1721-1090; Resolution#2016-63
Worker's Compensation insurance, the Provider must notify The Children's Trust and provide the necessary
certificate of insurance upon the termination of the exemption. The employer's liability portion will be
$500,000/$500,000/$500,000 as a minimum.
2. Comprehensive General Liability insurance,to include sexual molestation,in an amount not less than$500,000
combined single limit per occurrence and $1,000,000 aggregate in a policy year. Deductibles exceeding
$1,000 are discouraged, unless Provider can provide financial statements to support a higher deductible.The
Children's Trust must be designated and shown as an additional insured and the certificate holder with
respects to this coverage. The general liability policy must contain coverage for the following:
a. Bodily Injury;
b. Property Damage;
c. No exclusions for Abuse, Molestation or Corporal Punishment;
d. No endorsement for premises only operations.
3. Automobile liability coverage for all owned and/or leased vehicles of Provider and non-owned coverage for
their employees and/or sub-contractors and transportation companies transporting program participants.
The amount of coverage is $1,000,000 combined single limit per occurrence for bodily injury and property
damage. The Children's Trust must be designated and shown as an additional insured and the certificate
holder with respects to this coverage. Coverage can be purchased as non-owned without hired auto
coverage when the cost is prohibitive for hired automobile coverage such as the case with the Florida
Automobile Joint Underwriting Association; but rental cars cannot be used in the course of Provider's regular
operations. Rental cars may be used for travel to attend conferences outside the tri-county area.
Transportation companies used by the Provider for the funded program must list The Children's Trust as a
certificate holder and as an additional insured.
4. Automobile liability coverage for all owned and/or leased vehicles of Provider and non-owned coverage for
their employees and /or sub-contractors not transporting program participants. The minimum amount of
coverage is $300,000 combined single limit per occurrence for bodily injury and property damage. The
Children's Trust must be designated and shown as an "Additional Insured as Their Interest May Appear" with
respects to this coverage. Coverage can be purchased as non-owned without hired auto coverage when
the cost is prohibitive for hired automobile coverage such as the case with the Florida Automobile Joint
Underwriting Association; but rental cars cannot be used in the course of Provider's regular operations. Rental
cars may be used for travel to attend conferences outside the tri-county area.
5. If applicable, Special Events Coverage, as determined by The Children's Trust. The liability coverage will be
the same as the coverage and limits required for comprehensive general liability and The Children's Trust must
be designated and shown as "Additional Insured as Their Interest May Appear." Special Events policies are
for short term functions and not meant to replace annual liability policies. The coverage is for the day or days
of the event and must provide coverage the day prior and the day following the event.
6. If applicable, Professional Liability insurance, as determined by The Children's Trust, with coverage amounts
determined by The Children's Trust but not less than $250,000 per claim and in the aggregate. Defense costs
may be inside the limits of liability and the policy can be written on claims made form. The Children's Trust is
not required to be named as an Additional Insured. Professional liability insurance is generally required when
the scope of services uses professional services that require certification or license(s) to provide direct services
to program participants.
7. Proof of Property Coverage is required for all capital equipment greater than or equal to$10,000, and when
Provider has capital equipment owned by The Children's Trust and said capital equipment is under the care
custody and control of Provider. The Children's Trust must be shown on the evidence of property coverage
as a Loss Payee. Property coverage shall survive the expiration or termination of this Contract until such time
the ownership of the capital equipment is transferred to Provider or such capital equipment is returned to The
Children's Trust.
City of Miami Beach Page 7 of 85
Contract#1721-1090; Resolution#2016-63
Certificate Holder
Certificate holder must read:
The Children's Trust
3150 SW 3rd Avenue, 8th Floor
Miami, Florida 33129
Classification and Rating
All insurance policies required above shall be issued by companies authorized to do business under the laws of the
State of Florida,with the following qualifications:
The company must be rated no less than "B" as to management, and no less than "Class V" as the financial strength,
by the latest edition of Best's Insurance Guide, published by A.M. Best Company, Oldwick, New Jersey, or its
equivalent, subject to the reasonable approval of The Children's Trust.
Provider and or Provider's insurance agent, as applicable, shall notify The Children's Trust, in writing, of any material
changes in insurance coverage, including, but not limited, to any renewals of existing insurance policies, not later
than thirty (30) days prior to the effective date of making any material changes to the insurance coverage except
for ten (10) days for lack of payment changes. Provider shall be responsible for ensuring that all applicable insurances
are maintained and submitted to The Children's Trust for the duration of this Contract.
In the event of any change in Provider's Scope of Services, Attachment A, The Children's Trust may increase, waive
or modify, in writing any of the foregoing insurance requirements. Any request by a Provider to decrease, waive or
modify any of the foregoing insurance requirements shall be approved, in writing, by The Children's Trust prior to any
such decrease,waiver or modification.
In the event that an insurance policy is canceled, lapsed or expired during the effective period of this Contract,The
Children's Trust shall withhold all payments to Provider until a new Certificate of Insurance required under this section
is submitted and approved by The Children's Trust. The new insurance policy shall cover the time period commencing
from the date of cancellation of the prior insurance policy.
The Children's Trust may require Provider to furnish additional and different insurance coverage, or both, as may be
required from time to time under applicable federal or state laws or The Children's Trust requirements. Provision of
insurance by Provider, in no instance, shall be deemed to be a release, limitation, or waiver of any claim, cause of
action or assessment that The Children's Trust may have against Provider for any liability of any nature related to
performance under this Contract or otherwise.
All insurance required hereunder may be maintained by Provider pursuant to a master or blanket policy or policies
of insurance.
L. PROOF OF TAX STATUS
Provider is required to keep on file the following documentation for review by The Children's Trust:
• The Internal Revenue Service (IRS) tax status determination letter, if applicable; and
• The most recent (two years) IRS form 990 or applicable tax return filing within six (6) months after Provider's fiscal
year end or other appropriate filing period permitted by law; and
• IRS form 941: employer's quarterly federal tax return. If required by The Children's Trust, Provider agrees to submit
form 941 within thirty (30) calendar days after the quarter ends and if applicable, any state and federal
unemployment tax filings. If form 941 and unemployment tax filings reflect a tax liability, then proof of payment
must be submitted within sixty (60) calendar days after the quarter ends.
City of Miami Beach Page 8 of 85
Contract#1721-1090; Resolution#2016-63
M. NOTICES
Written notices pursuant to this Contract shall be sent to the addresses for each Party appearing on the first page of
this Contract. Notices to The Children's Trust shall be marked to the attention of its President/CEO. It is each Party's
responsibility to advise the other Party in writing of any changes in responsible personnel for accepting Notices under
this Contract; mailing address, and/or telephone number.
N. AUTONOMY
The Parties agree that this Contract recognizes the autonomy of, and stipulates or implies no affiliation between, the
contracting parties. Provider is only a recipient of funding support and is not an employee, agent or instrumentality
of The Children's Trust, and Provider's agents and employees are not agents or employees of The Children's Trust.
O. RECORDS, REPORTS, AUDITS AND MONITORING
The provisions of this section shall survive the expiration or termination of this contract, consistent with Florida laws.
1. Accounting Records
Provider shall keep accounting records that conform to generally accepted accounting principles (GAAP). All such
records will be retained by Provider for not less than five years beyond the last date that all applicable terms of this
contract have been complied with, final payment has been received and appropriate audits have been submitted
to and accepted by The Children's Trust. However,if any audit, claim,litigation, negotiation or other action involving
this contract or modification hereto has commenced before the expiration of the retention period, then the records
shall be retained until completion of the action and resolution of all issues which arise from it, or until the end of the
regular retention period,whichever is later.
2. Financial Statement Audit
Within one-hundred eighty (180) days from the close of its fiscal year, Provider's independent certified public
accounting firm (CPA) must submit all of the following documents, electronically, to The Children's Trust,which
together comprise an annual financial statement audit conducted in accordance with GAAP and standards
contained in Government Auditing Standards issued by the Comptroller General of the United States (The Yellow
Book).The required items are:
a. An annual financial statement audit, performed by a CPA firm that is licensed and registered to conduct
business with the Florida Department of Business and Professional Regulation;
b. An annual financial statement audit conducted in accordance with auditing standards generally accepted
in the United States of America and the standards applicable to financial audits contained in Government
Auditing Standards;
c. Written communication encompassing the requirements of AU-C section 265, "Communicating Internal
Control Over Financial Reporting and on Compliance and Other Matters Based on an Audit of Financial
Statements Performed in Accordance With Government Auditing Standards;"
d. Written communication encompassing the requirements of AU-C section 260, "The Auditor's Communication
With Those Charged With Governance;"
e. A Single Audit conducted in accordance with OMB Circular A-133, Audit of States, Local Government and
Non-Profit Organizations or the Florida Single Audit Act, Florida Statutes 215.97, if applicable; and
f. A Management Letter; if no Management Letter is prepared by Provider's CPA firm, then the CPA firm must
expressly confirm, in writing, that no Management Letter was issued.
If Provider's annual financial statement audit is prepared by the Florida Auditor General, then the due date for
submitting the annual financial statement audit, as defined, is two-hundred seventy (270) days after the close of
Provider's fiscal year.
City of Miami Beach Page 9 of 85
Contract#1721-1090; Resolution#2016-63
Electronic filing of the annual financial statement audit, as defined, must be sent by Provider's CPA firm to the
following e-mail address: audits@thechildrenstrust.org.
Providers that are required to have a Single Audit agree to have their CPA firm submit the schedule of expenditures
pertaining to awards,summary schedule of prior audit findings,applicable auditor's reports and the corrective action
plan, if applicable.
3. Program-Specific Audit
Within 180 days of the close of its fiscal year, all Providers are required to have their CPA firm submit a program-
specific audit related to The Children's Trust contracts, electronically, in addition to the annual financial statement
audit.The program-specific audit shall be performed by an independent CPA firm that is licensed and registered to
conduct business with the Florida Department of Business and Professional Regulation, has performed audits under
Government Auditing Standards and is either a member of the AICPA or FICPA peer review program to include
government engagement reviews. This program-specific audit must encompass an audit of The Children's Trust
contract(s) as specified in Attachment D: Program-Specific Audit Requirements.
4. Audit Extensions
Audit extensions may be granted by The Children's Trust upon receipt, in writing, of such request with appropriate
justification by Provider and for a period of time not to exceed sixty (60) days after the initial due date. A copy of the
engagement letter, along with the anticipated audit completion date and any concerns from Provider's CPA firm
related to the audit must accompany the request. Approved audit extension requests allow for the continuation of
payment until such time that the extension expires.
In the event that either the annual financial statement audit or the program specific audit is not received in a timely
manner and in accordance with the previously stated due dates; and an audit extension has not been approved,
then The Children's Trust shall withhold all payments to Provider until the documents are received and determined to
be acceptable by The Children's Trust.
5. Engagement Letters
Audit Engagement Letters are due to The Children's Trust thirty (30) days after Provider's fiscal year end. Provider
agrees to submit an engagement letter for both the annual financial statement audit and the program specific audit,
electronically, to audits@thechildrenstrust.org Failure to submit an engagement letter may result in a breach of
contract, or other remedy, as deemed appropriate by The Children's Trust.
6. List of Approved Certified Public Accounting Firms
To receive reimbursement for the preparation of the program specific audit, as defined, Provider must choose from
a list of approved CPA firms, which are posted on The Children's Trust website. Inclusion in this pre-approved CPA
vendor pool requires a CPA firm to meet three (3) criteria, which are enumerated in Attachment B: Other Fiscal
Requirements, Budget and Method of Payment.
7. Access to Records
Provider shall permit access to all records including subcontractor records, which relate to this contract at its place
of business during regular business hours. Provider agrees to deliver such assistance as may be necessary to facilitate
a review or audit by The Children's Trust to ensure compliance with applicable accounting, financial and
programmatic standards.This would include access by The Children's Trust, or its designee,to Provider's independent
auditor's work papers for complying with federal, state and local requirements. The Children's Trust reserves the right
to require Provider to submit to an audit by an auditor of The Children's Trust's choosing and at The Children's Trust's
expense.
8. Monitoring
Provider agrees to permit The Children's Trust personnel or contracted agents to perform random scheduled and/or
unscheduled monitorings, reviews and evaluations of the program which is the subject of this contract,including any
subcontracts under this contract, using The Children's Trust approved monitoring tools. The Children's Trust or
contracted agents shall monitor both fiscal/administrative and programmatic compliance with all the terms and
conditions of the contract. Provider shall permit The Children's Trust or contracted agents to conduct site visits, client
interviews, client assessment surveys, fiscal/administrative review and other assessments deemed reasonably
necessary at The Children's Trust's sole discretion to fulfill the monitoring function. A report of monitoring findings will
City of Miami Beach Page 10 of 85
Contract#1721-1090;Resolution#2016-63
be delivered to Provider and Provider will remedy all deficiencies cited within the period of time specified in the
report.
9. Client Records
Pursuant to Florida Statute 119.071(5),The Children's Trust collects the last four digits of social security numbers of child
participants of funded programs and services for the following purposes: (a) to research, track and measure the
impact of The Children's Trust funded programs and services in an effort to maintain and improve such programs and
services for the future (individual identifying information will not be disclosed); and (b) to identify and match
individuals and data within and among various systems and other agencies for research purposes. The Children's
Trust does not collect social security numbers for adult participants.
Provider shall maintain a separate file for each participant. This file shall include all pertinent information regarding
program enrollment and participation. At a minimum, the file will contain enrollment information (including parent
registration consents and child demographics), service plans (as applicable), outcome measures (as set forth in
Attachment A), and notes documenting referrals, special needs, or incident reports. These files shall be subject to
the monitoring/review and inspection requirements under this contract, subject to applicable confidentiality
requirements. All such records will be retained by Provider for not less than five calendar years after the participant
is no longer enrolled. Provider agrees to comply with all applicable state and federal laws on privacy and
confidentiality.
10. Internal Documentation/Records Retention
Provider agrees to maintain and provide for inspection to The Children's Trust, during regular business hours the
following as may be applicable, subject to applicable confidentiality requirements: (1) personnel files of employees
which include hiring records, background screening affidavits, job descriptions, verification of education and
evaluation procedures; and (2) authorized time sheets, records and attendance sheets to document the staff time
billed to provide Services pursuant to this contract; and (3) daily activity logs and monthly calendars of the provision
of Services pursuant to this contract; and (4) training modules; and (5) pre and post session questionnaires; and (6)
all participant attendance records; and (7) participant consent and information release forms; and (8) agency
policies and procedures; and (9) such other information related to Service provision as described in Attachment A
and as required by this contract; all upon request by The Children's Trust. Provider shall retain all records for not less
than five years beyond the last date that all applicable terms of this contract have been complied with and final
payment has been received, and appropriate audits have been submitted to and accepted by The Children's Trust
and/or other appropriate agency.
11. Confidentiality
Provider and The Children's Trust understand that during the course of performing the Services hereunder,each party
may have access to certain confidential and proprietary information and materials of the other party in order to
further performance of the Services. The Parties shall protect confidential information and comply with applicable
federal and state laws on confidentiality to prevent unauthorized use, dissemination or publication of confidential
information as each party uses to protect its own confidential information in a like manner. The Parties shall not
disclose the confidential information to any third party (except that such information may be disclosed to such Party's
attorneys), or to any employee of such Party who does not have a need to know such information, which need is
related to performance of a responsibility hereunder. However, this Contract imposes no obligation upon the Parties
with respect to confidential information which (a) was lawfully known to the receiving party before receipt from the
other, (b) is or becomes a matter of public knowledge through no fault of the receiving party, (c) is rightfully received
by the receiving party from a third party without restriction on disclosure, (d) is independently developed by or for
that party, (e) is disclosed under operation of law, (f) is disclosed by the receiving party with the other party's prior
written approval or (g) is subject to Chapter 119 of the Florida Statutes or is otherwise required to be disclosed by law.
The confidentiality provision of this Contract shall remain in full force and effect after the termination of this Contract.
Provider shall specifically require all sub-contractors to comply with this paragraph.
12. Data Security Obligation
Data Security Definitions are defined and specified in Attachment G: Data Security Definitions attached to this
Contract.
City of Miami Beach Page 11 of 85
Contract#1721-1090; Resolution#2016-63
A. Standard of care
a. Provider acknowledges and agrees that, in the course of its Contract with The Children's Trust, Provider may,
directly or indirectly, receive or have access to Highly-Sensitive Personal information or Personal Information.
Provider shall comply with the terms and conditions set forth in this Contract in its collection, receipt,
transmission, storage, disposal, use and disclosure of such Highly-Sensitive Personal Information or Personal
Information and shall be responsible for the unauthorized collection, receipt, transmission, access, storage,
disposal, use and disclosure of Personal Information under its control or in its possession. Furthermore, Provider
shall be responsible for the actions and omissions of all Authorized Persons that are not Authorized Employees
concerning the treatment of such Highly-Sensitive Personal Information or Personal Information as if they were
Provider's own actions and omissions.
b. Personal Information is deemed to be property of The Children's Trust and is not property of Provider. The
Children's Trust will not collect Highly-Sensitive Personal Information. The Provider should not collect Client
Highly-Sensitive Personal Information.
c. In recognition of the foregoing, Provider agrees and covenants that it shall:
1. keep and maintain all such Highly-Sensitive Personal Information or Personal Information strictly
confidential;
2. use and disclose Personal Information solely and exclusively for the purposes for which the Personal
Information, or access to it,is provided pursuant to the terms and conditions of this Contract,and shall not
divulge, communicate, use, misuse, sell, rent, transfer, distribute, or otherwise disclose or make available
Personal Information for Provider's own purposes or for the benefit of anyone other than The Children's
Trust, in each case, without The Children's Trust's prior written consent, which may be withheld in its sole
and absolute discretion; and
3. not, directly or indirectly, disclose Personal Information to any person other than Authorized Persons (an
"Unauthorized Third Party"), without express written consent from The Children's Trust, which may be
withheld in its sole and absolute discretion. If any person or authority makes a demand on Provider
purporting to legally compel it to divulge any Personal Information, Provider shall (i) immediately notify The
Children's Trust of the demand before such disclosure so that The Children's Trust may first assess whether
to challenge the demand prior to Provider's divulging of such Personal Information; (ii) be responsible to
The Children's Trust for the actions and omissions of such Unauthorized Third Party concerning the treatment
of such Personal Information as if they were Provider's own actions and omissions; and (iii) require the
Unauthorized Third Party that has access to Personal Information to execute a written Contract agreeing
to comply with the terms and conditions of this Contract relating to the treatment of Personal Information.
Provider shall not divulge such Personal Information until the Children's Trust either has concluded not to
challenge the demand, or has exhausted its challenge, including appeals, if any.
B. Personal information security
a.Provider shall protect and secure data in electronic form containing such Highly-Sensitive Personal Information
or Personal Information.
At a minimum, Provider's safeguards for the protection of Personal Information shall include:
1. encrypting, securing, or modifying such Personal Information by any method or technology that removes
elements that personally identify an individual or that otherwise renders the information unusable.
2.limiting access of Personal Information to Authorized Employees and Authorized Persons;
3. securing business facilities, data centers, paper files, servers, back-up systems and computing equipment,
including, but not limited to, all mobile devices and other equipment with information storage capability;
4. implementing network, device application, database and platform security;
5. securing information transmission, storage and disposal;
City of Miami Beach Page 12 of 85
Contract#1721-1090; Resolution#2016-63
6. implementing authentication and access controls within media, applications, operating systems and
equipment;
7. encrypting Highly-Sensitive Personal Information stored on any mobile media;
8. encrypting Highly-Sensitive Personal Information transmitted over public or wireless networks;
9. implementing appropriate personnel security and integrity procedures and practices, including, but not
limited to, conducting backgrounds checks consistent with applicable law, as required by The Children's from
time to time;
10.providing appropriate privacy and information security training to Provider's employees, as required by The
Children's Trust from time to time; and
1 1.purchasing and maintaining cyber insurance coverage,if The Children's Trust deems necessary in its sole and
absolute discretion.
b. Provider shall dispose, or arrange for the disposal, of customer records containing Personal Information within
its custody or control when the records are no longer to be retained. Such disposal shall involve shredding,
erasing, or otherwise modifying Personal Information in its control or possession to make it unreadable or
undecipherable through any means.
c. During the term of each Authorized Employee's employment by Provider, Provider shall at all times cause such
Authorized Employees to abide strictly by Provider's obligations under this Contract. Provider further agrees
that it shall maintain a disciplinary process to address any unauthorized access, use or disclosure of Personal
Information by any of Provider's officers,directors, partners,principals,employees,agents or contractors.Upon
The Children's Trust's request, Provider shall promptly identify for The Children's Trust in writing all Authorized
Employees as of the date of such request.
d. Upon The Children's Trust's written request, Provider shall provide The Children's Trust with a network diagram
that outlines Provider's information technology network infrastructure and all equipment used in relation to
fulfilling its obligations under this Contract, including, without limitation: (i) connectivity to The Children's Trust
and all third parties who may access Provider's network to the extent the network contains Personal
Information; (ii) all network connections including remote access s and wireless connectivity; (iii) all access
control devices (such as (solely by way of example), firewall, packet filters, intrusion detection and access-list
routers); (iv) all back-up or redundant servers; and (v) permitted access through each network connection.
C. Security breach procedures
a. Provider shall:
1. provide The Children's Trust with the name and contact information for an employee of Provider who shall
serve as The Children's Trust primary security contact and shall be available to assist The Children's Trust
twenty-four (24) hours per day, seven (7) days per week as a contact in resolving issues associated with a
Security Breach;
2. notify The Children's Trust of a Security Breach immediately, but no later than forty-eight (48) hours after
Provider becomes aware of it; and
3.notify The Children's Trust of any Security Breaches by telephone at the following number: (305)571-5700/e-
mailing The Children's Trust with a read receipt at datasecurity@thechildrenstrust.org and with a copy by e-
mail to Provider's contract manager at The Children's Trust. The notice shall include, at a minimum: (1) the
date,estimated date,or estimated date range of the Breach of security;and (2) a description of the Personal
Information that was accessed or reasonably believed to have been accessed as a part of the Breach of
security.
b. Immediately following Provider's notification to The Children's Trust of a Security Breach, the parties shall
coordinate with each other to investigate the Security Breach. Provider shall fully cooperate with The
Children's Trust in The Children's Trust's handling of the matter,including,without limitation: (i) assisting with any
investigation; (ii) providing The Children's Trust with physical access to the facilities and operations affected;
(iii) facilitating interviews with Provider's employees and others involved in the matter; and (iv) making
available all relevant records,logs,files,data reporting and other materials required to comply with applicable
law, regulation, industry standards or as otherwise required by The Children's Trust, in its sole and absolute
discretion.
City of Miami Beach Page 13 of 85
Contract#1721-1090;Resolution#2016-63
c. Provider shall take steps to immediately remedy any Security Breach and prevent any further Security Breach
at Provider's expense in accordance with applicable privacy rights, laws, regulations and standards, or as
otherwise required by The Children's Trust in its sole and absolute discretion. Provider shall reimburse The
Children's Trust for reasonable costs incurred in providing individuals affected by a Security Breach with notice
of the breach and complimentary access for credit monitoring services, which The Children's Trust in its sole
and absolute discretion deems necessary to protect such affected individuals in light of the risks posed by the
Security Breach.
d. Provider agrees that it shall not inform any third party of any Security Breach without first obtaining The
Children's Trust's prior written consent,other than to inform a complainant that the matter has been forwarded
to The Children's Trust's legal counsel. Further, Provider agrees that The Children's Trust shall have the sole right
to determine: (i) whether notice of the Security Breach is to be provided to any individuals, regulators, law
enforcement agencies, consumer reporting agencies or others as required by law or regulation, or otherwise
in The Children's Trust's discretion; and (ii) the contents of such notice,whether any type of remediation may
be offered to affected persons, and the nature and extent of any such remediation.
13. Withholding of Payment
At the sole discretion of The Children's Trust, payment may be withheld for non-compliance of contractual terms. The
Children's Trust will provide payment upon satisfactory compliance with the contractual terms as solely determined
by The Children's Trust.
P. MODIFICATIONS
Any alterations,variations, modifications, extensions or waivers of provisions of this Contract including but not limited
to amount payable and effective term shall only be valid when they have been reduced to writing, duly approved
and signed by both Parties.
Q. GOVERNING LAW &VENUE
This Contract shall be interpreted and construed in accordance with and governed by the laws of the State of Florida
without regard to its conflicts of law provisions. Any controversies or legal problems arising out of the terms of this
Contract and any action involving the enforcement or interpretation of any rights hereunder shall be submitted to
the jurisdiction of the state courts of the Eleventh Judicial Circuit,in and for, Miami-Dade County, Florida.
R. STAFF AND VOLUNTEER BACKGROUND CHECK REQUIREMENTS
All employees, volunteers and subcontracted personnel who work in direct contact with children or who may come
into direct contact with children at the site in question must complete a Level 2 background screening that complies
with its requirements prior to commencing work pursuant to this Contract. This requirement applies to all volunteers
who provide services to children, youth and their families regardless of the number of hours they provide services.
Occasional or transient repair or maintenance persons who appear on the site should be escorted to their work areas
and then supervised during the time they are present to conduct their work.
All providers are required to review annually, at minimum, The Dru Sjodin National Sex Offender Public Website.
Level 2 Background screenings must be completed through the Florida Department of Law Enforcement (FDLE)
VECHS (Volunteer&Employee Criminal History System) Program. Satisfactory background screening documentation
will be accepted from those agencies that already conduct business with either the Department of Children and
Families (DCF) or the Department of Juvenile Justice (DJJ) or the Miami Dade County Public School System (MDCPS).
A clearance letter from the MDCPS Office of Employment Standards indicating the person has successfully
completed a Level 2 screening will be accepted.
In addition:
• The Provider shall complete Attachment E-1:Affidavit for Level 2 Background Screenings,the Affidavit shall cover
employees, volunteers, and subcontractors performing services under this contract who are required to
complete a Level 2 background screening as defined in this section.
• The Provider shall complete Attachment E-2: Child Care Affidavit of Good Moral Character, Attachment E-3:
Child Abuse & Neglect Reporting Requirements and Attachment E-4: Background Screening & Personnel File
Requirements.
City of Miami Beach Page 14 of 85
Contract#1721-1090; Resolution#2016-63
• Provider shall maintain AttachmentE-1:Affidavit for Level 2 Background Screenings, Attachment E-2: Child Care
Affidavit of Good Moral Character, Attachment E-3: Child Abuse & Neglect Reporting Requirements and
Attachment E-4: Background Screening & Personnel File Requirements in Provider's personnel, volunteers, and
sub-contractors' files.
• Provider shall re-screen each employee, volunteer and subcontractor every five years.
S. CHILDREN WITH DISABILITIES AND THEIR FAMILIES
Provider understands that The Children's Trust expects Provider to meet the federal standards under the Americans
with Disabilities Act. By policy of The Children's Trust, providers must also implement reasonable programmatic
accommodations to include children with disabilities and their families,whenever possible. Notwithstanding anything
to the contrary, Provider shall not be required to make any alteration to any public school building or other building
or structure which is not owned by Provider.
T. REGULATORY COMPLIANCE
1. Non-discrimination and Civil Rights
Provider shall not discriminate against an employee,volunteer,or client of Provider on the basis of race, color,
gender, pregnancy, marital status, familial status, sexual orientation, religion, ancestry, national origin,
disability, or age, except that programs may target services for specific target groups as may be defined in
the competitive solicitation.
Provider shall demonstrate that it has standards, policies, and practices necessary to render services in a
manner that respects the worth of the individual and protects and preserves the dignity of people of diverse
cultures, classes, races, religions, sexual orientation, and ethnic backgrounds.
Provider agrees to abide by Chapter 11A of the Code of Miami-Dade County ("County Code"),as amended,
which prohibits discrimination in employment, housing and public accommodations;Title VII of the Civil Rights
Act of 1968, as amended, which prohibits discrimination in employment and public accommodation; the
Age Discrimination Act of 1975, 42 U.S.C. Section 6101, as amended, which prohibits discrimination in
employment because of age; Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794, as amended,
which prohibits discrimination on the basis of disability; and the Americans with Disabilities Act, 42 U.S.C.
§12101 et seq., which prohibits discrimination in employment and public accommodations because of
disability.
It is expressly understood that upon receipt of evidence of discrimination under any of these laws, The
Children's Trust shall have the right to terminate all or any portion of this Contract. If Provider or any owner,
subsidiary, or other firm affiliated with or related to Provider, is found by the responsible enforcement agency
or the courts to be in violation of these laws, said violation will be a material breach of this Contract and The
Children's Trust will conduct no further business with Provider.
2. Public Entities Crime Act
Provider will not violate the Public Entities Crimes Act (Section 287.133, Florida Statutes), which essentially
provides that a person or affiliate who is a Provider, consultant or other provider and who has been placed
on the convicted vendor list following a conviction for a Public Entity Crime may not submit a bid on a
contract to provide any goods or services to The Children's Trust, may not submit a bid on a contract with The
Children's Trust for the construction or repair of a public building or public work, may not submit bids on leases
of real property to The Children's Trust, may not be awarded or perform work as a Provider supplier, sub
Provider, or consultant under a contract with The Children's Trust, and may not transact any business with
TheChildren's Trust in excess of the threshold amount provided in Section 287.017,Florida Statutes,for category
two purchases for a period of thirty-six (36) months from the date of being placed on the convicted vendor
list. Violation of this section shall result in cancellation of this Contract and recovery of all monies paid hereto,
and may result in debarment from The Children's Trust's competitive procurement activities.
3. Conflict of Interest
Provider represents that the execution of this Contract does not violate Miami Dade County's Conflict of
Interest and Code of Ethics Ordinance, and Florida Statutes§112 as amended,which are incorporated herein
by reference as if fully set forth herein. Provider agrees to abide by and be governed by these conflict of
interest provisions throughout the course of this Contract and in connection with its obligations hereunder.
City of Miami Beach Page 15 of 85
Contract#1721-1090; Resolution#2016-63
(Refer to http://www.miamidadeethics.com/Publications/code_of_ethics2010.pdf for the Code of Ethics
Ordinance).
4. Compliance with Sarbanes-Oxley Act of 2002
Provider shall comply with the following applicable provisions of the Sarbanes-Oxley Act of 2002,including:
Provider agrees not to alter, cover up, falsify, or destroy any document that may be relevant to an official
investigation.
Provider agrees not to punish whistleblowers or retaliate against any employee who reports suspected cases
of fraud or abuse.
5. Licensing
Provider (and subcontractor,as applicable,) shall obtain and maintain in full force and effect during the term
of this Contract any and all licenses,certifications,approvals,insurances,permits and accreditations,required
by the State of Florida, Miami-Dade County, relevant municipalities, The Children's Trust or the federal
government. Provider must be qualified and registered to do business in the State of Florida both prior to and
during the contract term with The Children's Trust.
6. Incident Reporting
An incident is defined as any actual or alleged event or situation that creates a significant risk of substantial
or serious harm to the physical or mental health, safety or well-being of a child participating in the program.
Reportable incidents include, but are not limited to, allegations of abuse, neglect or exploitation of a child,
injury of a participant, missing child or abandoned child, loss of property use for the program, or destruction
of property used in the program.
Provider shall immediately report knowledge or reasonable suspicion of abuse, neglect, or abandonment of
a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone
number (1-800-96-ABUSE). As required by Chapters 39 and 415, Florida Statutes, this is binding upon both
Provider and its employees.
Provider shall notify the contract manager of any incident as defined within three (3) days after Provider is
informed of such incident. Provider shall provide written notification of the incident together with a copy of
the incident report. The report must contain the following:
(1) Name of reporter (person giving the notice)
(2) Name and address of victim and guardian
(3) Phone number where the reporter can be contacted
(4) Date, time, and location of incident
(5) Complete description of incident and injuries, if any
Police report and actions taken shall be submitted to The Children's Trust within fifteen (15) days of the
incident. Provider shall provide written notification to The Children's Trust, within seven (7) days of any legal
action related to the incident.
7. Sexual Harassment
Provider shall complete an incident report in the event a program participant, client or employee makes an
allegation of sexual harassment, sexual misconduct or sexual assault by a Provider employee, volunteer or
anyone arising out of the performance of this Contract and Provider has knowledge thereof. Provider shall
provide written notification to The Children's Trust within three (3) business days after Provider is informed of
such an allegation. Provider shall provide written notification to The Children's Trust,within seven (7) business
days, if any legal action which is filed as a result of such an alleged incident.
8. Proof of Policies
Provider and subcontractor, as applicable, shall keep on file copies of its policies including but not limited to
confidentiality, incident reporting, sexual harassment, non-discrimination, equal opportunity and/or
affirmative action, Americans with Disabilities Act, and drug-free workplace.
City of Miami Beach Page 16 of 85
Contract#1721-1090; Resolution#2016-63
U. CONSENT
Provider must obtain parental/legal guardian consent for all minor participants to participate and/or for adult
participants in the program for services; and to share information with The Children's Trust for monitoring and
evaluation purposes.
Provider will ask participants to sign a voluntary Consent to Photograph form. The form is available in English,Spanish,
and Creole and can be downloaded from www.thechildrenstrust.org. The signed consent form for photography will
be maintained at the program site, with a copy filed in the participant's record. The consent shall be part of the
participants' registration form, and signed by parent/guardian before services commence or assessments are
administered. Any refusal of consent must be properly documented and signed by the parent or legal guardian on
the consent form.
V. PROGRAMMATIC DATA REPORTING
Demographic and service information on program participants will be provided to The Children's Trust as part of The
Children's Trust's research mission. Provider agrees to comply and participate in any data collection reporting,
including participant data as required by The Children's Trust and described in Attachment C to this contract,
Programmatic Data and Reporting Requirements, subject to confidentiality requirements. In addition, Provider
agrees to furnish The Children's Trust with complete and accurate reports in the timeframe and format to be
reasonably specified by The Children's Trust, and as described in Attachment C.
Provider must participate and provide agency (agency profile) and site(s) information to Switchboard of Miami 2-1-
1,The Children's Trust 24 hour helpline,as applicable and as defined in Attachment C: Programmatic Data Reporting
Requirements.
W. PUBLICITY
Provider agrees that activities, services and events funded by this Contract shall recognize The Children's Trust as a
funding source. Provider shall ensure that all publicity, public relations, advertisements and signs within its control
recognize The Children's Trust for the support of all contracted activities. The use of the official Children's Trust logo is
permissible.
Provider shall use its best efforts to ensure that all media representatives, when inquiring with Provider about the
activities funded by this Contract, are informed that The Children's Trust is a funding source. Provider shall, if it
possesses the appropriate technology, provide a link between the website and The Children's Trust's website.
X. PUBLICATIONS
Provider agrees to supply The Children's Trust, without charge, up to three copies of any publication developed in
connection with implementation of programs addressed by this Contract. Such publications will state that the
program is supported by The Children's Trust. Provider agrees that The Children's Trust will have use of copyrighted
materials developed under this Contract to the extent provided in, and subject to, the provisions of Paragraphs G
and H above.
To the extent permitted by the applicable journal or other publication source, Provider shall include The Children's
Trust logo and the following paragraph in all materials featuring programs funded by The Children's Trust, including
but not limited to newsletters, press releases, brochures, fliers, homepage of websites or any other materials for
dissemination to the media or general public:
English:
City of Miami Beach-Success University is funded by The Children's Trust. The Children's Trust is a dedicated source
of revenue established by voter referendum to improve the lives of children and families in Miami-Dade County.
Espanol:
City of Miami Beach - Success University esta financiado por El Fidecomiso de los Ninos (The Children's Trust). El
Fidecomiso de los Ninos es una fuente de financiacion, establecida por referendum para mejorar las vidas de ninos
y familias en el Condado de Miami-Dade.
City of Miami Beach Page 17 of 85
Contract#1721-1090:Resolution#2016-63
Kreyol:
City of Miami Beach - Success University Se Children's Trust ki finanse (pwogram sa-a). Children's Trust se yon sous
finansman elekte Miyami-Dade to kreye nan yon referandom. Finansman sa a dedye you pwogram k'ap amelyore
lavi ti moun ak fanmi yo.
Note: In cases where funding by The Children's Trust represents only a percentage of Provider's overall funding, the
above language can be altered to read "The (organization) is funded in part by The Children's Trust..."
Y. HEADINGS, USE OF SINGULAR AND GENDER
Paragraph headings are for convenience only and are not intended to expand or restrict the scope or substance of
the provisions of this Contract. Wherever used herein, the singular shall include the plural and plural shall include the
singular, and pronouns shall be read as masculine, feminine or neuter as the context requires.
-THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK-
City of Miami Beach Page 18 of 85
Contract#1721-1090;Resolution#2016-63
Z. TOTALITY OF CONTRACT/SEVERABILITY OF PROVISIONS
This Contract with its attachments as referenced below contains all the terms and conditions agreed upon by the
parties:
Attachment A: Scope of Services
Attachment B: Other Fiscal Requirements, Budget, and Method of Payment
Attachment C: Programmatic Data and Reporting Requirements
Attachment D: Program Specific Audit Requirements
Attachment E-1: Affidavit for Level 2 Background Screenings, if applicable
Attachment E-2:Child Care Affidavit of Good Moral Character, if applicable
Attachment E-3: Child Abuse & Neglect Reporting Requirements, if applicable
Attachment E-4: Background Screening & Personnel File Requirements, if applicable
Attachment F: Performance Improvement Plan, if applicable
Attachment G: Data Security Definitions
No other contract, oral or otherwise, regarding the subject matter of this Contract shall be deemed to exist or bind
the Parties. If any provision of this Contract is held invalid or void, the remainder of this Contract shall not be affected
thereby if such remainder would then continue to conform to the terms and requirements of applicable law.
CITY OF MIAMI BEACH. THE CHILDREN'S TRUST
MIAMI-DADE COUNTY, FLORIDA MIAMI-DADE COUNTY, FLORIDA
By: By:
(Signature of Authorized Representative) (Signature)
James R. Haj
(Type/Print Name)
President and CEO
(Type/Print Title)
Date: Date:
Provider Federal ID#59-6000372
Provider Vendor ID# CITYO109
Approved as to form and legal sufficiency
Date:
County Attorney
This contract is not valid until signed by both parties.
City of Miami Beach Page 19 of 85
Contract#1721-1090;Resolution#2016-63
ATTACHMENT A
SCOPE OF SERVICE
City of Miami Beach Page 20 of 85
Contract#1721-1090;Resolution#2016-63
Attachment A-Scope of Services*
SERVICE PARTNERSHIP
1. PROGRAM DESCRIPTION
City of Miami Beach is a place-based coalition of social service providers working together to provide
coordinated services to families and communities where children are at risk of child maltreatment or'!
chronic absenteeism,and children or youth who display disruptive behavior in school or in the community.
The Service Partnerships also provide community engagement activities that bring communities together
around the issues facing their communities.
Success University is an integrated Care Coordination-based human services program that partners with
a variety of organizations to provide holistic, comprehensive services to Miami Beach children and their
families.The program provides children and youth with personal and academic supports while providing,
their families with holistic, comprehensive services to ensure family stability and child success. Service
components include: Family Assessments, Care Coordination, Family Group Conferencing, Employment
Services, Mental Health Services, Functional Family Therapy, Suspension Diversion Services, Functional
Tutoring services,and targeted referrals to community-based services not available within the Partnership.
2. ELIGIBILITY SCREENING & PRIORITY RISK FACTORS
Eligibility for services will be determined through a standard screening and assessment that incorporates
geographic area and significant risk factors. Provider is expected to screen families to determine their
eligibility for coming into care using the following criteria. Families must identify with at least one risk
from the core program focus factors (2a) OR at least two risks from the associated program focus
factors (2b).
2a. Core program focus factors:
1. Child abuse or neglect: current or prior history of involvement with the child welfare system that did
not result in a court-order into foster care, shelter care or protective supervision
2. Child attendance, chronic absenteeism or truancy: child has been absent 6% or more days in the
current or previous school year, or the child has dropped out of school
3. Child behavior problems: child has symptoms or diagnosis of a behavioral, social or emotional
problems that have resulted in difficulty at home, school and/or the community; this may include
(but is not limited to) fighting, school suspension, and/or arrest or involvement in the juvenile justice
system
2b. Associated program focus factors:
1. Child academic performance: child has failed one or more academic subjects
2. Child exposure to violence: child has been exposed to domestic violence in the home
3. Child risk for abuse or neglect: suspected history or observed risk for child abuse or neglect but
without involvement with the child welfare system (e.g., harsh parenting, lack of parent/caregiver
understanding of child needs, development and/or parenting skills)
4. Parental functioning and supports: one or more parents/caregivers of the child have symptoms or
diagnosis of mental health,stress or substance abuse problems that have impacted their parenting
and/or family functioning
5. Basic needs: family has difficulty meeting their basic needs, such as adequate housing, access to
food, clothing and transportation
*NOTE: Attachment C contains additional requirements related to programmatic performance and data
reporting that must be followed in conjunction with Attachment A-Scope of Services.
City of Miami Beach Page 21 of 85
Contract#1721-1090;Resolution#2016-63
3. GEOGRAPHIC AREA(S)TO BE SERVED and SERVICE LOCATIONS
A majority of families enrolled are to reside within the geographic area specified below OR their
child(ren) attend one of the schools identified.
Geographic Area(s)/ZIP codes: 33139, 33140, 33141, 33154
Children attending schools in the Miami Beach Senior High School feeder pattern: South Pointe ES,
Fienberg-Fisher K-8 Center, Nautilus Middle School, Miami Beach Senior High School, North Beach ES,
Treasure Island ES, Ruth K. Broad/Bay Harbor K-8 Center,or Biscayne ES,and children attending day care
facilities located in the geographic area specified above.
Schools include: See Service Location(s)
4. SERVICE LOCATION(S)
Site Name Site Address City Zip Code # Families # Families
w/CWD
Client Homes (Functional Various Locations Miami 33139 25 0
Family Therapy) Beach 33140
33141
33154
Client Homes (Mental Health Various locations Miami 33139 20 0
Services) Beach 33140
33141
33154
Client Homes (Care Various locations Miami 33139 163 34
Coordination) Beach 33140
33141
33154
Client Homes (Academic Various locations Miami 33139 35 0
Support) Beach 33140
33141
33154
Public Spaces, City of Miami Various locations Miami 33141 14 0
Beach (Employment Services) Beach
Miami Beach City Hall (Family 1700 Convention Miami 33139 19 0
Group Conference) Center Drive Beach
North Shore Park &Youth 501 72nd Street Miami 33141 65 0
Center (Family Group Beach
Conference)
Biscayne ES* (Intake) 800 77th Street Miami 33141 35 0
Beach
Fienberg-Fisher K-8 Center* 1420 Washington Miami 33139 25 0
(Intake) Avenue Beach
Nautilus Middle School* 4301 N. Michigan Miami 33140 35 0
(Intake) Avenue Beach
Miami Beach Senior High 2231 Prairie Avenue Miami 33139 35 0
School* (Intake) Beach
Client Homes/Other locations Various locations Miami 33139 40 0
including City Hall, public Beach 33140
library, public spaces, Miami 33141
Beach Parks* (Intake) 33154
City of Miami Beach Page 22 of 85
Contract#1721-1090;Resolution#2016-63
5. SUBCONTRACTORS/IN-KIND AGENCY(IES)
5a. SUBCONTRACTORS
Agency Name Street Address City Zip Contact information Associated Activity/
Code Service Component
Advocate2Create 1250 South Miami Miami 33130 Patricia Timerman, Mental Health Services
Avenue #1103 305-482-3366
Ayuda, Inc. 7144 Byron Ave. Miami 33141 Cecilia Deloof (305) Care Coordination,
Beach 864-6885 Mental Health Services
Choices, et al, P.O. Box 645409 Miami 33269 Cheryl Polite-Eaford, Family Group
Inc. (305) 332-2074 Conferencing,
Suspension Diversion,
Care Coordination
Empowerment 99 NW 183rd St # Miami 33169 Andrea Wanza, (786) Care Coordination,
Tutoring 240B 489-2080 Mental Health Services ,
Tutoring
Institute for Child 430 West 66th St. Hialeah 33012 Terri Galindo, (305) Functional Family
& 685-8245 x1027 Therapy
Family Health, Inc.
Switchboard of 190 NE 3rd Street Miami 33132 Nathan Gomez, (305) Care Coordination,
Miami, Inc. 358-1640
Playing the Game 7144 Byron Miami 33141 Jeannette Blanca Care Coordination,
of Life Avenue, 2nd Floor Beach Egozi (305) 864-5237 Family Group
Conferencing
Teen Job Corps, 7356 Gary Miami 33141 Deborah Ruggiero Employment Services
Inc. Avenue Beach (305) 868-0635
5b. AGENCIES PROVIDING IN-KIND SERVICES
Agency Name Street Address City Zip Contact information Associated Activity/
Code Service Component
Get Credit 25 SE 2nd Ave. Miami 33131 Elizabeth Karwowski, Get Credit Healthy
Healthy, Suite 828 (877) 850-3444 ext. 106 provides credit repair&
Inc. education services and
is available to receive
targeted referrals from
the Partnership
Miami Beach 1920 Meridian Miami 33139 Wendy Unger, (305) City staff serves on the
Chamber of Avenue Beach 695-6829 Chamber's Education
Commerce as Business Council.
City of Miami Beach Page 23 of 85
Contract#1721-1090; Resolution#2016-63
Agency Name Street Address City Zip Contact information Associated Activity/
Code Service Component
Miami Beach 11645 Biscayne North 33181 Trudy Edwards (305) MBCHC is the main
Community Boulevard Miami 538-8835 Ext. 1712 provider of health
Health Center, Suite 207 services for the
Inc. (MBCHC) (Corporate office) uninsured and
underinsured in Miami
Beach. MBCHC pursues
grants with Partnership
members and has a
vested interest in the
well-being of the
community's children
and families.
Miami-Dade 1450 N.E.2nd Miami 33132 Lubby Navarro, (305) MDCPS provides
County Public Avenue 995-4240 ongoing program
Schools Suite 760 support and guidance,
especially for the
Suspension Diversion
service.
Miami-Dade 227 22nd Street Miami 33139 Jennifer Dewsnap- The MB Regional and
Public Beach Shipley, (305) 535-4220 North Shore Branch
Library System Libraries host
community-based
outreach events on
behalf of the
Partnership.
The On It 18520 NW 67th Miami 33015 Calvetta Phair, (305) The On It Foundation
Foundation, Inc. Avenue,Suite 186 244-6454 provides training to
children and families; it
pursues grants with
other Partnership
members.
CCDH 7990 SW 117 Miami 33183 Sheena VanDyke, The City hosts trainings
Avenue, Suite 135 (305) 596-1160 on behalf of CCDH and
requires all internal and
Partner staff to attend
at least one training
annually.
CCDH assists with the
development of Care
Plans for children with
disabilities,where
appropriate.
City of Miami Beach Page 24 of 85
Contract#1721-1090;Resolution#2016-63
6. ACTIVITIES
6a. Attendance-based Participant Numbers and Activities Table
Attendance-based activities are ongoing intensive services with participants for whom demographics
and individual attendance are reported. This table specifies the unduplicated number of participants
expected to complete the program (i.e., attend the required number of sessions). The number of
participants and required sessions per activity are identified below in the activities section.
Participants-Attendance-based Activities #of Unduplicated Participants
Families (of the parents and children below) 180
Parents/Caregivers 180
Children/Youth 197
%of families with children with disabilities 19%
Other Adults (i.e.staff/professionals/mentors) 0
# # Parents/ # Required Responsible
Activity/Service Name & Description Children/ Caregivers Others Sessions Agency(ies)
Youth
ELIGIBILITY SCREENING
Every participant receives a standard
screening to determine care
coordination eligibility based on risk
factors related to absenteeism,
maltreatment, and disruptive behavior.
Based on degree of concern yielded by
screening, participants are either: Not Not tracked Not Not N/A
A)Referred for services (different from tracked tracked tracked
Care Coordination) within or outside the
partnership
OR
B) Referred for Intake.
This activity is not reported for Trust
purposes.
INTAKE(Initial Assessment)
All participants determined to be eligible
for care coordination (through the
Screening) receive an Initial Assessment to
confirm eligibility. The Assessment defines
family strengths and service needs;
including the need for health Insurance
and medical home. N/A 180 N/A 1 City of Miami
Based on degree of concern and service families/cases Beach
needs yielded by the Assessment,
participants are either:
A) Referred for services within or outside
the partnership.
OR
City of Miami Beach Page 25 of 85
Contract#1721-1090;Resolution#2016-63
# # Parents/ # Required Responsible
Activity/Service Name & Description Children/ Caregivers Others Sessions Agency(ies)
Youth
B) Enrolled in Care Coordination.
A comprehensive tool must be used to
further assess the risk factors noted in the
screening and determine if Care
Coordination is needed.
Assessment Family Needs
Measure Assessment
Frequency Once
Schedule Rolling Enrollment
Once a family is enrolled in Care
Coordination, the reason(s) for eligibility
are entered into SAMIS
CARE COORDINATION
Participating caregiver receives
explanation of care coordination. The
results of the initial assessment and
outcome measurement tools are
discussed and additional needs for all
family members are identified. These
results and discussion inform the
development of the Care Plan, which
establishes the framework upon which the
family achieves its goals. The family's
support system is identified to define ways
they can support the goals established. 2 during Ayuda, City of
The Care Plan is developed in the first first 45 Miami Beach,
session and within 15 days of the days. & Switchboard of
assessment. N/A 163 N/A Miami, Playing the
families/cases Min. lx Game of Life,
Follow up sessions must take place at least month Empowerment
once a month during the time participant thereafter Tutoring, Choices,
is enrolled in care coordination. Care et al
Coordinator conducts scheduled
visits/contacts with family; determines if
referrals have been successful; reviews
and assists the family in pursuit of their
goals in the Care Plan; amends the care
plan as necessary; holds multidisciplinary
staffing as necessary.
When the family and the Care
Coordinator determine the goals of the
care plan have been met, and that no
additional services are needed, the Care
Coordinator closes the case.
City of Miami Beach Page 26 of 85
Contract#1721-1090;Resolution#2016-63
# Parents/ # Required Responsible
Activity/Service Name& Description Children/ Caregivers Others Sessions Agency(ies)
Youth
Frequency First session takes
place 15 days from
the Assessment date.
Minimum of 1 session
per month thereafter.
Intensity Minimum of 45
minutes.Sessions
should exceed the
minimum as needed.
Duration Minimum of 4 sessions
Schedule Rolling Enrollment
Referral and referral follow up data are
reported for all participants receiving
care coordination.
FAMILY TEAM MEETING
Family Team Meetings are strongly
encouraged for families participating in
Care Coordination who demonstrate
complex needs and/or where risk is
present.Through the active collaboration
of a team comprised of natural helpers,
direct service staff, family members and
caretakers, Family Team Meetings are an
effective means of developing a service
plan based on long term solutions and of
resolving issues that put children at risk.
These meetings serve to coordinate
clinical services; to establish therapeutic Choices, et al, City
goals, discuss therapy & counseling N/A 84 N/AN/A of Miami Beach,
services; to discuss safety issues; and to families/cases of
the Game
create a system of support as needed. of Life
EBP to be used is Family Group
Conferencing
Frequency as needed
Intensity 1-2 hours
Duration 1 meeting per
child
Schedule Year round
This activity is not included in
performance review evaluations.
City of Miami Beach Page 27 of 85
Contract#1721-1090;Resolution#2016-63
# # Parents/ # Required Responsible
Activity/Service Name & Description Children/ Caregivers Others Sessions Agency(ies)
Youth
SCHOOL DAY-SUSPENSION ALTERNATIVE
The Suspension Diversion (SD) activity is
triggered by referral from a Miami Beach
Senior High School feeder pattern school.
Students experiencing infractions which
typically result in outdoor suspensions may
attend the SD program in lieu of incurring
outdoor suspensions on their records.
Parent/legal guardian provides consent
& agrees to program terms. Students
attend the SD program daily until the
conclusion of their suspension term.
The Group Facilitator oversees
administrative and/or academic
instruction work commissioning complex
behavior management and teaching
activities while providing critical thinking
skills, classroom management, and
administrative services. Emphasis is
placed on independent judgment, daily
group meetings and reflective practices.
To address behavior modification, City of Miami
Facilitators foster awareness of the 60 0 0 1 Beach, Choices,
following goals: accountability; et al
community/school safety; and
competency development. Using a
strength-based approach, the Facilitator
elicits goals from the student which
address him/herself and those harmed by
their actions that resulted in their
suspension from school.
This is an informed Restorative Justice
model which uses techniques found in the
EBP Restorative Justice, which was
awarded endorsement by the US OJJDP.
As part of behavior modification services,
staff may conduct psychosocial groups,
circles, provide individual counseling,
and/or refer students to additional
services.
Frequency Daily
Intensity 6 hours
Duration 1-10 days
Schedule School Year
estimated to begin
September 2016.
City of Miami Beach Page 28 of 85
Contract#1721-1090;Resolution#2016-63
# # Parents/ # Required Responsible
Activity/Service Name & Description Children/ Caregivers Others Sessions Agency(ies)
Youth
JOB TRAINING/PLACEMENT
Services are provided on an ad hoc basis
and are contingent upon needs
identified through Care Plans. Provided to
youth and/or family members who are
authorized to work legally in the US,whose
families are in need of additional income,
and who are not able to find unsubsidized
employment. Provider supervises youth at
all times.Participants conduct community
service- type activities such as beach
clean-up, waterway restoration, graffiti
removal, and event support. Each session
begins with a 15-30 minute Employability
Skills training session focusing on such
topics as the importance of post-
secondary education, appropriate attire,
resume writing, interview skills, business
etiquette, etc. Provider may opt to place
youth in a suitable employment Teen Job Corps,
environment outside the normal location 14 0 0 30
of services. For secondary placement, Inc.
youth must show strong work skills and
supervisor must be background
screened. Employment Services for youth
are contingent upon students providing
documentation of school attendance
and/or absence of incidence of
disruptive behavior to supervisor.
Employment Services are temporary and
are limited to no more than 66 hours per
person, per contract year.
Frequency 2 times per week
Intensity 2 hours per session
Duration 18 weeks
Schedule Rolling enrollment
Estimated Sessions
begin in November
2016 and continue
on a rolling basis
BEHAVIORAL/MENTAL HEATH
INTERVENTION
Mental Health Assessments are provided
to determine clients' need for mental Ayuda,
health services and develop a treatment Advocate2Create,
plan. Master's level and higher Mental 18 2 0 12 Empowerment
Health Practitioners conduct services. Tutoring
Conducted in accordance with
provider's internal policies and
procedures referencing mental health
assessments.
City of Miami Beach Page 29 of 85
Contract#1721-1090;Resolution#2016-63
# # Parents/ # Required Responsible
Activity/Service Name & Description Children/ Caregivers Others Sessions Agency(ies)
Youth
Mental Health services are provided for 20
children, youth, family members, parents,
or families without access to mental
health services (such as those without
legal status or insurance) and showing
great need. Twelve therapeutic
counseling sessions are provided for each
client and sessions are to take place in the
client home and/or other location sites as
determined by the family.
Frequency 1 time per week
Intensity Minimum of 1 hour
per session
Duration 4 months
Schedule Rolling Enrollment
estimated to begin
September 2016.
FAMILY COUNSELING
Functional Family Therapy(FFT)
Functional Family Therapy is a well-
established, evidence-based family
therapy intervention for the treatment of
violent, criminal, behavioral, school, and
conduct problems with youth and their
families. FFT has received national
recognition for our successful youth
outcomes. It is an evidence-based,
outcome-driven prevention/intervention
treatment program for youth who have
demonstrated maladaptive, acting out Institute for Child &
behaviors and related syndromes. Each 25 0 0 8 Family Health
family receives the following services:
1. An intake/assessment session
2. 8-12 1.5 hour therapy sessions
3. A discharge/assessment session
including referrals for additional
services, as indicated
Average number of sessions: 8-12,
determined by the needs of the family.
During the therapy sessions, families
progress through all three phases of
treatment which includes:
Engagement/Motivation, Behavior
Change, and Generalization
City of Miami Beach Page 30 of 85
Contract#1721-1090; Resolution#2016-63
# Parents/ # Required Responsible
Activity/Service Name& Description Children/ Caregivers Others Sessions Agency(ies)
Youth
EBP Functional Family
Therapy
Frequency 1 time per week
Intensity 1.5 hours
Duration 6 months
Schedule Rolling enrollment
Estimated to begin
September 2016.
TUTORING
Children and youth performing below
grade level, facing academic
challenges, or referred by a teacher or
administrator in their school are eligible to
receive private Functional Tutoring. Prior
to the first session,the student receives an
Academic Assessment to determine
strengths and deficits. Services focus on
teaching the child and parent or youth
effective study skills and appropriate
behaviors to support educational success
so they may become academically self-
sufficient. Staff reinforce the importance
of regular, punctual attendance at every Empowerment
encounter. 35 0 0 8 Tutoring, City of
Miami Beach
Frequency One time per week
Intensity 60 minutes per
session
Duration 10 weeks
Schedule Rolling Enrollment
estimated to begin
September 2016.
City of Miami Beach Page 31 of 85
Contract#1721-1090;Resolution#2016-63
6b. Group Participant Numbers and Activities Table
Group activities are less intensive services and events which
participants
attend one or two times and for
which demographics and individual attendance are not collected.These activities may be open to the
public and do not require program enrollment.They are reported as aggregated attendance numbers.
Examples of these activities include community events, health fairs, back-to-school events, etc.
Attendees-Group Activities #of Attendees
# Children/Youth 50
# Parents/Caregivers 50
# Other Adults (i.e. staff/professionals/mentors) 40
SERVICE PARTNERSHIP MEETINGS
The lead agency coordinates regular partnership
meetings with the purpose of supporting the
development and sustainability of the partnership.
These meetings include activities guided towards
generating the deliverables identified in the
Quality and Outcomes Tables below.
Other activities may include the creation of an
asset map and contact database of all services in
the target neighborhood; making personal
appointments and attending community
meetings to determine key leaders and programs;
Convene aforementioned key leaders that
extend beyond Service Partnership to introduce
partnership, assess "community needs" in consult
with care coordination assessed needs of clients, City of Miami
and create a possible action plan around issues 0 0 12 N/A Beach
that can be addressed.
Frequency Monthly
Intensity Minimum of 2 hours
Duration 12 months (12
meetings)
Schedule Year round
City of Miami Beach Page 32 of 85
Contract#1721-1090;Resolution#2016-63
COMMUNITY ENGAGEMENT
Effective community engagement consists of
more than outreach efforts, which may imply
activities that merely disseminate information or
build awareness on topical concerns. Instead, the
emphasis is on activities that engage community
members in ongoing and regular dialogue and
discussion about community concerns and the
development of solutions for them.
Such activities may include a collaborative effort
between the Service Partnership and community
members to develop proposals for neighborhood
improvements related to child and family well-
being, or to address concerns to governmental
and other institutions that provide services to
families, promote positive opportunities for early
learning, literacy, parenting and youth
development, or to prevent drug and tobacco
use, by way of example only.
Community engagement may include events,but
as part of a broader design to engage community
members.
Activity #1: Family Service Day is a community City of Miami
engagement event designed to galvanize Beach in
members of the Miami Beach community in a call collaboration
for public service. Multiple targeted volunteer 50 50 40 N/A with all
projects take place, including environmental Partner
preservation, intergenerational relationship agencies
building, public school improvement projects,
community beautification projects, and more. A
specific area of North Shore Open Space Park is
designated for a community services fair, where
members of the partnership and other
organizations offering free services to the
community set up information booths. All of the
presenters are asked to follow one of the event
themes: literacy, mental health, academic
performance, family stability, community
cohesion, or school attendance.We also spotlight
Attendance Awareness Month and the Miami-
Dade Public Library, which brings its Bookmobile.
Volunteers are provided with lunch and souvenirs.
The purposes of this event are to: increase
community involvement; increase volunteerism;
strengthen family ties to the community;provide a
forum for residents within which they are
encouraged to provide feedback to service
providers; promote Attendance Awareness
Month; promote literacy to the entire community;
raise the visibility of Miami-Dade Public Library
System and local Miami Beach library branches;
and to inform the community about the
City of Miami Beach Page 33 of 85
Contract#1721-1090;Resolution#2016-63
Partnership, its members, and the resources
available via Success University and other Partner
agency programs. The event is scheduled for
September, 2016 and will be held at North Shore
Open Space Park and various satellite project sites
throughout the City of Miami Beach
Frequency Once per contract
year
Intensity Minimum of 2 hours
Duration 1 event
Schedule year round
7. PARTICIPANT OUTCOMES
7a. Required Participant Outcomes - These outcomes are required to be collected, and will be included
in performance reviews.
Associated
Outcome & Data Source/ Meaningful Activity &
Timing
Target% Measurement Tool(s) Improvement Service
Component
60%of Parental Stress Scale(PSS) For participants Pre-test should be Care
parents/caregiv # of items: 18 scoring 38 or higher administered by Coordination
•ers decrease . Scoring:Sum with Items 1, on the Pre-test, the 2nd Care
stress related to meaningful Coordination
2, 5, 6, 7, 8, 17, and 18
parenting improvement is session.
reverse scored. measured by at
• Range: 18-90 (higher least a 5 points
scores indicate greater decrease from pre Post-test should be
difficulty) to Post-test scores. administered
For participants during the closing
session.
37 or less on
the Pre-test,
meaningful
improvement is
measured by a
decrease or
maintenance of
the Pre-test score.
85%pf Strengths and Difficulties Post-test score Pre-test should be Care
parents/caregiv Questionnaire (SDQ) must be below 17. administered by Coordination
ers report a the 2nd Care
• # items:20 Coordination
decrease in their • Scoring:Sum of scores in all
child's problem session.
behavior of the items of the 4 scales
(Emotional Symptoms
Scale; Conduct Problems Post-test should be
Scale; Hyperactivity Scale; administered
Peer Problems Scale) during the closing
• Range:0-40 (higher scores session.
indicate greater difficulty)
City of Miami Beach Page 34 of 85
Contract#1721-1090;Resolution#2016-63
Associated
Outcome & Data Source/ Meaningful Activity&
Target% Measurement Tool(s) Improvement Timing Service
Component
60% of Adult Adolescent Parenting Measured by a Pre-test should be Care
parents/caregiv Inventory(AAPI): Constructs Post-test Sten score administered by Coordination
ers increase B through E of 5 or higher on the 2nd Care
positive each of the Coordination
parent/child or . # items:33 constructs (out of session.
family the high risk
• Scoring:Sten Scores
interactions. • Range: 1 (highest risk of category) OR a
abusive parenting Post-test score of 5 Post-test should be
behaviors) to 10 (lowest or higher on administered
The AAPI is risk) for each construct Construct B and An during the closing
required from at increase of 1 point session.
least 10%of the in 2 of the 3 other
families served constructs from Pre-
through Care to Post-test.
Coordination
AND to be used
with all families
coming into
care with child
maltreatment
(family violence/
child abuse or
neglect) as an
issue
7b. Additional Participant Outcomes-These outcomes are required to be collected, but will NOT be
included in performance reviews.
Associated
Outcome & Data Source/ Meaningful Activity&
Target% Measurement Tool(s) Improvement Timing Service
Component
Child/Youth does School Report Card**: All four grades Data will be Care
not fail any core Grades for English, Math, should be higher collected/ Coordination
courses (English, Science and Social Studies than F by the end reported one-
math, science, of the school year time, at the end
social studies) Scoring: Grade A-F in each of the school year.
of the four core courses.
Children/youth School Records** If 2015-16 school Pre-test data Care
will not be records are used based on the Coordination
suspended after Scoring:Total # of as a Pre-test, Post- latest school year
receiving outdoor/indoor suspensions test should be records to be
services. from school equal to 0 (zero). reported at
If 2016-17 school enrollment.
records are used Mid-Test data
as a Pre-test, Post- based on school
test should be records at the
equal to Pre-test. time of closing
City of Miami Beach Page 35 of 85
Contract#1721-1090;Resolution#2016-63
Associated
Outcome & Data Source/ Meaningful Activity&
Target% Measurement Tool(s) Improvement Timing Service
Component
Post-test data
based on end of
school year
records and
reported in July
School Report
Children/youth will Participants who Pre-test data Care
Cards/Records**
improve school are at risk for based on the latest Coordination
attendance rate. Scoring: Absences (Number of chronic school year
days absent by the student absenteeism records to be
divided by the total number of (Absent more than reported at
school days offered). 3%of days in the enrollment.
school year) will
Benchmarks
Definition decrease their risk
for Chronic
Absenteeism by one or more Post-test data
No risk Absent 0-3% benchmarks when based on end of
of days in the comparing Pre-to school year
school year Post-test. records and
(i.e., 5 school reported in July
days out of
the 180 days Participants not at
in the public risk (97%or higher
school year) attendance) for
Low Risk Absent 3.5- chronic
6%of days in absenteeism will
the school maintain or
year (i.e., 6- improve their
11 school Attendance Rate
days out of %.
the 180 days
in the public
school year)
High Risk Absent 6.5-
9.5%of days
in the school
year (i.e., 12-
17 school
days out of
the 180 days
in the public
school year)
Chronically Absent 10%
Absent or more days
in the school
year (18
public school
days)
**All providers will obtain parental consent using the form provided to comply with federal law(FERPA), prior to
accessing protected school records. Providers are encouraged to report school records directly into SAMIS
when the provider has FERPA-compliant,direct, access to school records.
City of Miami Beach Page 36 of 85
Contract#1721-1090; Resolution#2016-63
8. STAFFING TABLE
All persons delivering the services required by this contract must have the knowledge and skills, either by,
training, experience, education, or a combination thereof, to adequately and competently perform the
duties,obligations,and services set forth and to provide and perform such services to The Children's Trust's
satisfaction. All persons delivering the services described herein must be included in the Position
Management module of SAMIS.
Key
Position # FT/PT % Position Position
Title Staff Status Effort Type for Qualifications Duties
Svcs?
(X)
Office 2 FT 100% Employee X Bachelor's degree Program supervision,
Associate or greater in Public contractor supervision, staff
IV Administration, supervision, program
Education, Social administration, program
Work, or other operations,Suspension
related field and at Diversion service delivery and
least three years of client intake/enrollment,
experience working records keeping, client
within community- contact and care
based programs. coordination, report
One preparation, conduct home
year of relevant visits/client intake, develop
experience may be individualized Care Plans,
substituted for each innovate new engagement
year of required and marketing strategies, seek
education, up to funding opportunities,
two years. conduct fidelity reviews of all
Partners and Partner staff.
Case 1 FT 100% Employee X Associate's degree Data entry, assistance with
Worker or equivalent in client contact and care
college credits with coordination, provides client
major course work transportation, conduct client
in Social Work, home visits/intakes, filing and
Business, Criminal any other necessary support
Justice, Sociology, or direct service provision of
or Psychology program activities.
Some experience Interviews clients with
working in social problems such as personal
service,youth and family adjustments,
program, or related school attendance finances,
field employment, food, clothing,
Experience can housing, and physical needs
substitute for to determine nature and
education on a degree of problem, confers
year-for-year basis with principals and teachers
Driver's License regarding clients, visits families
bilingual of clients to resolve truancy
(English/Spanish) or problems and makes referral
(English/ Creole). to applicable agency, helps
Valid driver's client to modify attitudes and
license. patterns of behavior by
City of Miami Beach Page 37 of 85
Contract#1721-1090;Resolution#2016-63
Key
Position # FT/PT % Position Position
Title Staff Status Effort Type for
Svcs' Qualifications Duties
.
(X)
referral to social agency as
necessary, refers clients to
community resources, attends
staff meetings,workshops,
conferences, and parents
meetings, compiles records
and prepares reports, reviews
service plans and performs
follow-up to determine
quantity and quality of service
provided to client and status
of client's case, accesses and
records client and community
resource information, secures
supplementary information
such as employment, medical
records, or school reports, any
other necessary support or
direct service provision of
program activities.
Case 1 FT 60% Employee X Associate's degree Data entry, assistance with
Worker or equivalent in client contact and care
college credits with coordination, provides client
major course work transportation, conduct client
in Social Work, home visits/intakes, filing and
Business, Criminal any other necessary support
Justice, Sociology, or direct service provision of
or Psychology program activities.
Some experience Interviews clients with
working in social problems such as personal
service,youth and family adjustments,
program, or related school attendance finances,
field employment, food, clothing,
Experience can housing, and physical needs
substitute for to determine nature and
education on a degree of problem, confers
year-for-year basis with principals and teachers
Driver's License regarding clients,visits families
bilingual of clients to resolve truancy
(English/Spanish) or problems and makes referral
(English/ Creole). to applicable agency, helps
Valid driver's client to modify attitudes and
license. patterns of behavior by
referral to social agency as
necessary, refers clients to
community resources, attends
staff meetings,workshops,
conferences, and parents
meetings, compiles records
City of Miami Beach Page 38 of 85
Contract#1721-1090;Resolution#2016-63
Key
Position # FT/PT % Position Position
Title Staff Status Effort Type for Qualifications Duties
Svcs?
(X)
and prepares reports, reviews
service plans and performs
follow-up to determine
quantity and quality of service
provided to client and status
of client's case, accesses and
records client and community
resource information,secures
supplementary information
such as employment, medical
records, or school reports, any
other necessary support or
direct service provision of
program activities.
Division 1 FT 10% Employee X Graduation from an Oversee Service Partnership
Director accredited college operations, supervision of
or university with a Program Coordinators,
Bachelor's or support Program
Master's Degree Coordinators' efforts to secure
with major course and diversify funding of the
work in public or Partnership.
business
administration,
social services or
other related field.
Experience can
substitute for
education on a
year-for-year basis.
City of Miami Beach Page 39 of 85
Contract#1721-1090;Resolution#2016-63
ATTACHMENT B
OTHER FISCAL REQUIREMENTS,
BUDGET AND METHOD OF PAYMENT
City of Miami Beach Page 40 of 85
Contract#1721-1090;Resolution#2016-63
ATTACHMENT B
OTHER FISCAL REQUIREMENTS, BUDGET and METHOD OF PAYMENT
Advance payment requests
The Children's Trust offers advance payments up to 15%of the total contract value. Advance requests shall be limited
to governmental entities and not-for-profit corporations, in accordance with subsection 216.181 (16) (b), F.S. The
advance request must include the amount requested and a justification for the request. Advance requests must be
submitted using the designated form and must be approved in writing by The Children's Trust Contract Manager and
Chief Financial Officer or their designee.
Advance repayment
Advance repayment is due within 60 calendar days of receipt of the advance. Provider shall report the amount of
the advance repayment in SAMIS using the "advances/adjustments" button on the SAMIS reimbursement screen. If
a provider does not use SAMIS, then they are required to deduct their advance repayment from each invoice,
consecutively, until the advance is repaid in full.
Budget amendments/revisions
Budget amendments/revisions require written approval from the Contract Manager and The Children's Trust's Chief
Financial Officer or their designee. Request for budget amendments/revisions must be submitted to a Contract
Manager using SAMIS, or the appropriate form, as designated by The Children's Trust. All budget
amendments/revisions are subject to final approval by The Children's Trust. Budget amendments/revisions cannot be
used to increase the total contract amount or to modify the Scope of Services. No more than two budget
amendments/revisions may be approved during the contract term. Budget amendments/revisions will be disallowed
if they seek to revise retroactive costs not previously budgeted. All amendments/revisions must adjust for operational
activity effective as of the previously billed period. Budget amendment/revision requests must be submitted sixty (60)
days prior to the expiration of contract. Budget amendments/revisions will be incorporated into the contract.
Indirect Administrative Costs
In no event shall The Children's Trust fund indirect administrative costs in excess of ten (10%) percent of the total
contract amount.
List of Approved Certified Public Accountants or Certified Public Accounting Firms
To receive reimbursement for the preparation of the program specific audit, as defined, provider must choose from
a list of approved independent Certified Public Accounting (CPA) firms, which are posted on The Children's Trust
website. Inclusion in this pre-approved vendor pool requires that a CPA firm meet the following three criteria:
(a) participation in either the American Institute of Certified Public Accountants (AICPA) or the Florida Institute of
Certified Public Accountants (FICPA) peer review program as evidenced by submitting a triennial System Review
Report with a passing score to The Children's Trust;
(b) providing documentation that a CPA firm, or one of its associates, has adequate experience in governmental
accounting and/or nonprofit accounting with the application of Government Auditing Standards; and
(c) completion of an annual CPA training session sponsored by The Children's Trust finance department.
Direct Deposit of Payment
As a requirement of this Contract with The Children's Trust, Provider agrees that prior to, or on the date commencing
the effective term of this Contract, Provider will enroll in The Children's Trust direct deposit program.The direct deposit
program requires that all reimbursements received from The Children's Trust are directly deposited into the Provider's
designated bank account held in a United States financial institution.The format, including the terms and conditions
for the direct deposit of payment, can be found at http://www.thechildrenstrust.org/providers/forms/direct-deposit-
enrollment.
City of Miami Beach Page 41 of 85
Contract#1721-1090; Resolution#2016-63
Cost Reimbursement Method of Payment
The parties agree that this is a cost reimbursement method of payment contract; Provider shall be paid in
accordance with the approved budget and/or approved budget amendments/revisions as set forth in this
attachment. Provider also agrees to pay its subcontractors, vendors and employees for the fulfillment of services
provided in this contract, on a timely basis.
Invoice Requirements
Provider shall submit an electronic request for payment in the SAMIS system in accordance with the approved budget
or budget amendments/revisions. The request for payment is due on or before the fifteenth (15th) day of the month
following the month in which expenditures were paid (exclusive of legal holidays or weekends). The Children's Trust
will consider all invoices received after the fifteenth (15th) of each month as late,even if the cause of a late submission
is due to the delayed approval of a budget or amendment in the SAMIS system. The Children's Trust agrees to
reimburse Provider on a monthly basis. Any expense,included on a SAMIS reimbursement that is check dated greater
than two months prior to the invoice period will not be approved. The Children's Trust reserves the right to request
any supporting documentation related to this contract.
If there are subcontractors to this contract, then the Form D: Attestation of Payment must be either uploaded to the
SAMIS Document Repository no later than 30 days after payment to subcontractor. Upon the close of this contract,
Provider is required to complete Form E: Close-out Attestation of Payment, which must be uploaded to the SAMIS
Document Repository no later than thirty(30) days after payment to subcontractor. These forms may be downloaded
from The Children's Trust's website. For the purpose of payment only, a subcontractor is defined as an independent
agency that has entered into agreement with Provider to perform services pertaining to The Children's Trust funded
programs identified in this contract.
A final request for payment (last monthly invoice of the contract term) from Provider will be accepted by The
Children's Trust up to forty-five (45) days after the expiration of this contract. If Provider fails to comply, then all rights
to payment shall be forfeited.
If The Children's Trust determines that Provider has been paid funds,which are not in accordance with this contract,
and to which it is not entitled, then Provider shall return such funds to The Children's Trust or submit appropriate
documentation to support the payment within thirty (30) days of notification by The Children's Trust. After thirty (30)
days, The Children's Trust may recapture amounts due to The Children's Trust, from this or any contract by reducing
amounts requested to be reimbursed less the amount owed to The Children's Trust. The Children's Trust shall have the
sole discretion in determining if Provider is entitled to such funds in accordance with this contract, and The Children's
Trust's decision on this matter shall be binding.
In the event that Provider, its independent CPA firm or The Children's Trust discovers that an overpayment has been
made, Provider shall repay the overpayment within thirty (30) calendar days without prior notification from The
Children's Trust.
If Provider fails to serve the number of participants and/or fails to utilize the funds in accordance with the contract,
then The Children's Trust may amend the contract to reduce the amount of dollars. Any delay in amendment by The
Children's Trust is not deemed a waiver of The Children's Trust's right to amend or seek reimbursement for under-
serving participants in accordance with the contract.
A SAMIS request for payment will be deemed proper as defined by the Florida Prompt Payment Act, if the request
complies with the requirements set forth in this contract and is submitted on the forms prescribed by The Children's
Trust. Requests for payment and/or documentation returned to Provider for corrections may be cause for delay in
the receipt of payment. Late submission may result in delay in the receipt of payment. The Children's Trust shall pay
Provider within thirty (30) calendar days of receipt of Provider's properly submitted Request for Payment (i.e., SAMIS
invoice) and/or other required documentation.
The Children's Trust may retain any payments due until all required reports, deliverables or monies owed to The
Children's Trust are submitted and accepted by The Children's Trust.
City of Miami Beach Page 42 of 85
Contract#1721-1090; Resolution#2016-63
Supporting Documentation Requirements
Provider shall maintain original records documenting actual expenditures and services provided according to the
approved budget and scope of services. Supporting documentation shall be made available and provided to The
Children's Trust upon request.
Provider shall keep accurate and complete records of any fees collected, reimbursement or compensation of any
kind received from any client or other third party, for any service covered by this contract, and shall make all such
records available to The Children's Trust upon request. Provider shall maintain a cost allocation methodology that is
used to allocate its costs to ensure that The Children's Trust is paying only its fair share of costs for services, overhead
and staffing devoted to the program funded by this contract. Such methodology shall be made available to The
Children's Trust upon request.
-THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK -
City of Miami Beach Page 43 of 85
Contract#1721-1090;Resolution#2016-63
Budget Summary Report-Attachment B
City of Miami Beach-SPB 1721-1090/SPP 1579-1090 City of Miami Beach Success University
Fiscal Year 16-17(8/01/16-7/31/17)
Contract#: 1721-1090
CSC Program Allocation: $425,000
Budget Status: Submitted
Salary Accounts
Original Original Amended
Program CSC CSC
Account# Title Budget Budget Budget
511 Regular Salaries and Wages 174,623.00 157,969.00 157,969.00
521 FICA/MICA 2,534.00 2,292.00 2,292.00
522 Retirement Contributions 10,479.00 9,479.00 9,479.00
523 Life and Health Insurance 33,394.00 32,132.00 32,132.00
524 Workers Compensation 524.00 474.00 474.00
525 Unemployment Compensation 0.00 0.00 0.00
Salary Totals: 221,554.00 202,346.00 202,346.00
Expense Accounts
Original Original Amended
Program CSC CSC
Account# Title Budget Budget Budget
531 Travel (other than participants) 0.00 0.00 0.00
532 Travel (participants) 6,513.00 4,121.00 4,121.00
533 Meals(participants) 3,108.00 3,108.00 3,108.00
534 Space 0.00 0.00 0.00
535 Utilities 15,081.00 204.00 204.00
536 Supplies(office) 1,589.00 789.00 789.00
537 Supplies(program) 1,075.00 1,075.00 1,075.00
540 Non-Capital Equipment 0.00 0.00 0.00
550 Capital Equipment 0.00 0.00 0.00
591 Indirect Cost 0.00 0.00 0.00
611 Subcontractor 198,581.00 198,581.00 198,581.00
711 Professional Services(instructors) 0.00 0.00 0.00
721 Professional Services(certified teachers) 0.00 0.00 0.00
731 Professional Services(tutors) 0.00 0.00 0.00
741 Professional Services(consultants) 0.00 0.00 0.00
791 Professional Services(other) 7,776.00 7,776.00 7,776.00
811 Other(advertising) 0.00 0.00 0.00
821 Other(background screening) 225.00 0.00 0.00
831 Other(admission to field trips) 0.00 0.00 0.00
891 Other(other) 13,500.00 3,500.00 3,500.00
529 Fringe Benefits(other) 0.00 0.00 0.00
841 Program Specific Audit 3,500.00 1,500.00 1,500.00
751 Professional Services(Evaluation) 0.00 0.00 0.00
City of Miami Beach Page 44 of 85
Contract#1721-1090; Resolution#2016-63
Expense Accounts
Original Original Amended
Program CSC CSC
Account# Title Budget Budget Budget
851 Other(Volunteers) 0.00 0.00 0.00
852 Other(Special Events) 0.00 0.00 0.00
853 Other(Required Staff Training) 0.00 0.00 0.00
854 Other(Discretionary Funds) 2,000.00 2,000.00 2,000.00
855 Other(conference registration) 0.00 0.00 0.00
Expense Totals: 252,948.00 222,654.00 222,654.00
Salary and Expense Totals: 474,502.00 425,000.00 425,000.00
Program Funders
Summary Funders
Funder Type Funder Total Comment
In-Kind Contributions In-Kind Contributions(Summary) 49,502.00 Division Director contribution to the
program;transportation,technical
support, space and supplies.
Summary Funder Totals: 49,502.00
City of Miami Beach Page 45 of 85
Contract#1721-1090;Resolution#2016-63
Comprehensive Budget/Amendment Report-Attachment B
City of Miami Beach-SPB 1721.1090/SPP 1579-1090 City of Miami Beach Success University
Fiscal Year 16-17(8/01/16-7/31/17)
Contract#:1721-1090
Original Budget
Salary Data
Position Orig Amend Orig Amend Orig Amend Orig Amend Orig Amend Orig Amend
Salary Salary FICA FICA Retire Retire Insur Insur WC WC Unemp Unemp
Case Worker(361041
Staff: TBD,TBD(31329)
Gross: 38,336.00 38,336.00 2,933.00 2,933.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Program: 38,336.00 38,336.00 556.00 556.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
CSC: 38,336.00 38,336.00 556.00 556.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Original Distribution
Program Allocation CSC Allocation Match Allocation
Time Period #Of People Rate Wks Funded HrslWeek Amt Hrs)Week Amt Amt
Year Round 1.00 18.36 52.20 40.00 38,336.00 0.00 0.00
Year Round 1.00 18.36 52.20 0.00 0.00 40.00 38,336.00
Total Distribution to Program Salary 100% 38,336.00 100% 38,336.00 0% 0
Percentage of Distribution to Gross Salary 100% 100% 0%
Original Budget Narratives:
Full time position paid bi-weekly.
There are 52.2 weeks in the contract year.
No match
The City of Miami Beach does not contribute towards FICA for unclassified employees.The City of Miami Beach calculates the rate for MICA at 1.45%of employee salary.($38,336 x 1.45%=$555.87)
Budget Amendment Narratives:
Approved Date:
Position Orig Amend Orig Amend Orig Amend Orig Amend Orig Amend Orig Amend
Salary Salary FICA FICA Retire Retire Insur Insur WC WC Unemp Unemp
Case Worker(36106)
Staff: TBD,TBD(31329)
Page 46 of 85
City of Miami Beach
Contract#1721-1090;Resolution#2016-63
Gross: 38,336.00 38,336.00 2,933.00 2,933.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Program: 23,001.00 23,001.00 334.00 334.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
CSC: 23,001.00 23,001.00 334.00 334.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Original Distribution
Program Allocation CSC Allocation Match Allocation
Time Period #Of People Rate Wks Funded HrslWeek Amt HrslWeek Amt Amt
Year Round 1.00 18.36 52.20 0.00 0.00 24.00 23,001.00
Year Round 1.00 18.36 52.20 24.00 23,001.00 0.00 0.00
Total Distribution to Program Salary 60% 23,001.00 100% 23,001.00 0% 0
Percentage of Distribution to Gross Salary 60% 60% 0%
Original Budget Narratives:
Full time position paid bi-weekly.
There are 52.2 weeks in the contract year.
No match
The City of Miami Beach does not contribute towards FICA for unclassified employees.The City of Miami Beach calculates the rate for MICA at 1.45%of employee salary.($23,001 x 1.45%=$333.51)
Budget Amendment Narratives:
Approved Date: -
Position Orig Amend Orig Amend Orig Amend Orig Amend Orig Amend Orig Amend
Salary Salary FICA FICA Retire Retire Insur Insur WC WC Unemp Unemp
Division Director(30427)
Staff: TBD,TBD(31329)
Gross: 83,270.00 83,270.00 6,370.00 6,370.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Program: 16,654.00 16,654.00 242.00 242.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
csc: 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
City of Miami Beach Page 47 of 85
Contract#1721-1090;Resolution#2016-63
Original Distribution
Program Allocation CSC Allocation Match Allocation
Time Period #Of People Rate Wks Funded HrsfWeek Amt HrslWeek Amt Amt
Year Round 1.00 39.88 52.20 0.00 0.00 0.00 0.00
Year Round 1.00 39.88 52.20 8.00 16,654.00 0.00 0.00
Total Distribution to Program Salary 20% 16,654.00 0% 0.00 100% 16,654
Percentage of Distribution to Gross Salary 20% 0% 20%
Original Budget Narratives:
Work status:Full-time
Frequency of payment:Bi-weekly
Source of Match:City of Miami Beach
Budget Amendment Narratives:
Approved Date: -
Position Orig Amend Orig Amend Orig Amend Orig Amend Orig Amend Orig Amend
Salary Salary FICA FICA Retire Retire Insur Insur WC WC Unemp Unemp
Fringe Benefits(30340)
Staff: Benefits,Fringe(31330)
Gross: 0.00 0.00 0.00 0.00 15,476.00 15,476.00 38,439.00 38,439.00 724.00 724.00 0.00 0.00
Program: 0.00 0.00 0.00 0.00 10,479.00 10,479.00 33,394.00 33,394.00 524.00 524.00 0.00 0.00
CSC: 0.00 0.00 0.00 0.00 9,479.00 9,479.00 32,132.00 32,132.00 474.00 474.00 0.00 0.00
Original Budget Narratives:
MICA
The City of Miami Beach does not contribute towards FICA for unclassified employees.The City of Miami Beach calculates the rate for MICA at 1.45%of employee salary.
OA IV salary 48,316 5 1.45%=$700.58-701
OA IV salary 48,316 x 1.45%=$700.58-701
CW salary 38,336 x 1.45%_$555.87-556
CW salary 23,001 x 1.45%_$333.51-334
Total--$2292
CMB-v
Division Director(match funds)FICA$83,269.44 x 1.45%_$1,207.41 x 20%_$241.48-$242
Source of match is provided in-kind by the City of Miami Beach.
City of Miami Beach Page 48 of 85
Contract#1721-1090;Resolution#2016-63
RETIREMENT CONTRIBUTIONS:
Retirement(Pension)Contributions are for Full Time positions only.
CSC Allocation retirement:annual full-time salaries of$157,969.00 x 6%contribution=$9478.14—$9479
CMB->
Division Director(match funds)$83,269.44 x 6%=$4,996.1664 x 20%=$999.23—1,000
Source of match is provided in-kind by the City of Miami Beach.
Program allocation:1,000+9479=10479
Gross allocation:4,997+10,479=15476
WORKER'S COMP:
The City of Miami Beach contributes 0.3%towards Worker's Compensation Insurance for all employees.
Total Salaries of$157,969 x 0.3%=$473.91—474
CMB->
Division Director(match funds)$83,269.44 x 0.3%=$249.80 x 20%=$49.96—$50
Source of match is provided in-kind by the City of Miami Beach.
Program allocation:50+474=524
Gross allocation:250+474=724
LIFE AND HEALTH INSURANCE:
LIFE
$1 per week x 52.2 weeks x 4 employees=208.80—209
CMB->
Division Director(match funds):$1 per week x 52.2 weeks=$52.20 x 20%=$10.44—11
Source of match is provided in-kind by the City of Miami Beach.
HEALTH
$119.79 per week(individual insurance plan)x 52.2 weeks x 3 employees=$18,759.12;
$252.18 per week(family insurance plan)x 52.2 weeks x 1 employee=13,163.80
Total=31,922.92
CMB->
Division Director(match funds):$119.79 per week x 52.2 weeks=$6,253.04 x 20%_$1,250.61—1251
Source of match is provided in-kind by the City of Miami Beach.
City of Miami Beach Page 49 of 85
Contract#1721-1090;Resolution#2016-63
TOTAL LIFE AND HEALTH INSURANCE(CSC):209+31923=32,132
TOTAL LIFE AND HEALTH INSURANCE(PROGRAM):209+11+31923+1,251=33,394
TOTAL LIFE AND HEALTH INSURANCE(GROSS):209+53+31923+6,254=38,439
UNEMPLOYMENT COMPENSATION
The City of Miami Beach is self-insured and does not fund Unemployment Insurance separately.
Budget Amendment Narratives:
Approved Date: -
Position Orig Amend Orig Amend Orig Amend Orig Amend Orig Amend Orig Amend
Salary Salary FICA FICA Retire Retire Insur Insur WC WC Unemp Unemp
Office Associate IV(30734)
Staff:
Gross: 48,316.00 48,316.00 3,696.00 3,696.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Program: 48,316.00 48,316.00 701.00 701.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
CSC: 48,316.00 48,316.00 701.00 701.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Original Distribution
Program Allocation CSC Allocation Match Allocation
Time Period #Of People Rate Wks Funded Hrsiweek Amt HrslWeek Amt Amt
Year Round 1.00 23.14 52.20 0.00 0.00 40.00 48,316.00
Year Round 1.00 23.14 52.20 40.00 48,316.00 0.00 0.00
Total Distribution to Program Salary 100% 48,316.00 100% 48,316.00 0% 0
Percentage of Distribution to Gross Salary 100% 100% 0%
Original Budget Narratives:
Full time position paid hi-weekly.
There are 52.2 weeks in the contract year.
No match
The City of Miami Beach does not contribute towards FICA for unclassified employees.The City of Miami Beach calculates the rate for MICA at 1.45%of employee salary.($48,316 x 1.45%=$700.60)
Budget Amendment Narratives:
Approved Date: -
Position Orig Amend Orig Amend Orig Amend Orig Amend Orig Amend Orig Amend
Salary Salary FICA FICA Retire Retire Insur Insur WC WC Unemp Unemp
Page 50 of 85
City of Miami Beach
Contract#1721-1090;Resolution#2016-63
Office Associate IV(II)(31235)
Staff: Cunha,William(37732)
Gross: 48,316.00 48,316.00 3,696.00 3,696.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Program: 48,316.00 48,316.00 701.00 701.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
CSC: 48,316.00 48,316.00 701.00 701.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Original Distribution
Program Allocation CSC Allocation Match Allocation
Time Period #Of People Rate Wks Funded HrslWeek Amt HrslWeek Amt Amt
Year Round 1.00 23.14 52.20 40.00 48,316.00 0.00 0.00
Year Round 1.00 23.14 52.20 0.00 0.00 40.00 48,316.00
Total Distribution to Program Salary 100% 48,316.00 100% 48,316.00 0% 0
Percentage of Distribution to Gross Salary 100% 100% 0%
Original Budget Narratives:
Full time position paid bi-weekly.
There are 52.2 weeks in the contract year.
No match
The City of Miami Beach does not contribute towards FICA for unclassified employees.The City of Miami Beach calculates the rate for MICA at 1.45%of employee salary.($48,316 x 1.45%=$700.60)
Budget Amendment Narratives:
Approved Date: -
Salary Totals
Percentage of Program Distribution to Gross Salary: 68% Percentage of CSC Distribution to Gross Salary: 62%
Orig Amend Orig Amend Orig Amend Orig Amend Orig Amend Orig Amend
Salary Salary FICA FICA Retire Retire Insur Insur WC WC Unemp Unemp
Gross: 256,574.00 256,574.00 19,628.00 19,628.00 15,476.00 15,476.00 38,439.00 38,439.00 724.00 724.00 0.00 0.00
Program: 174,623.00 174,623.00 2,534.00 2,534.00 10,479.00 10,479.00 33,394.00 33,394.00 524.00 524.00 0.00 0.00
CSC: 157,969.00 157,969.00 2,292.00 2,292.00 9,479.00 9,479.00 32,132.00 32,132.00 474.00 474.00 0.00 0.00
Expense Data
City of Miami Beach Page 51 of 85
Contract#1721-1090;Resolution#2016-63
Account B Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
529 Fringe Benefits(other) 0.00 0.00 0.00 0.00
Original Budget Calculation:
=0+0
Original Budget Narratives:
Budget Amendment Narratives:
Approved Date: -
Account k Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
531 Travel(other than participants) 0.00 0.00 0.00 0.00
Original Budget Calculation:
Original Budget Narratives:
N/A
Budget Amendment Narratives:
Approved Date: -
Account It Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
532 Travel(participants) 4,121.00 4,121.00 6,513.00 6,513.00
Original Budget Calculation:
=4121+2392
Original Budget Narratives:
Requested Funding:3 months(maximum)emergency bus passes issued in accordance with TCT budget guidelines (1 p/household).556.25 per monthly pass(discounted rate)x 70 estimated
instances of need=$3,937.50+Single trip one use tickets;$2.25 each ticket x 81 instances of need for transportation and ineligible for MDT Transportation Disadvantaged Program=$183.
$3,937.50+$198=$4,135.50
In Kind:Participants needing transportation to or from service activities such as FGC will be transported using CMB passenger vans:15 miles/day x.575/mile x 100 days=$862.50.$2.25 each
ticket x 2 tickets per day x 170 service days x 2 students receiving transportation through MDT Transportation Disadvantaged Program$1,530.Total In kind 1530+862.5=2,392.50
Budget Amendment Narratives:
Approved Date: -
City of Miami Beach Page 52 of 85
Contract#1721-1090;Resolution#2016-63
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
533 Meals(participants) 3,108.00 3,108.00 3,108.00 3,108.00
Original Budget Calculation:
=3108
Original Budget Narratives:
Dinner for FGC:84 FGC x average of 3 people attending per conference x 4.93 per individual meal=1,242.36+Suspension Diversion meals:393 breakfasts x$1.66 per breakfast=$652.38;395 x
$3.07 per lunch=$1212.65 TOTAL$
Budget Amendment Narratives:
Approved Date: -
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
534 Space 0.00 0.00 0.00 0.00
Original Budget Calculation:
Original Budget Narratives:
Program administration space(9"x 11")will be provided at 555 17th Street.Rate is estimated at$28.95 per square foot per year though comparable space is often leased at a higher cost
($2,866.05 x 3 FT staff)=$8,598.15
Use of North Shore Park for Family Group Conferences at$175 per use x 65 uses(charge per room)=$11,375
Use of City of Miami Beach conference rooms for Family Group Conferences at$175 per use x 19 uses(charge per room) =$3,325.
Total: $23,298.15(all in-kind)
Source of Match:Provided in-kind by the City of Miami Beach
Budget Amendment Narratives:
Approved Date: -
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
535 Utilities 204.00 204.00 15,081.00 15,081.00
Original Budget Calculation:
=14877+204
Original Budget Narratives:
Annual fee of$204 for email services related to the Service Partnership
IN KIND Electricity and cleaning expenses are estimated at$40 per employee,per month:4 employees x$40 each x 12 months=$1,920; Employees'telephones,software licensing,intemet access
and 24/7 technical support am provided by the City in-kind at a cost of$3,085 per employee annually:4 employees fully dedicated to TCT funded program x$3,085 per employee=$12,340;Division
Director:1 employee x 20% dedicated to TCT funded program x$3,085=$617
617+12,340+1,920=514,877(total in-kind)
City of Miami Beach
Page 53 of 85
Contract#1721-1090;Resolution#2016-63
Source of Match:Provided in-kind by the City of Miami Beach
Budget Amendment Narratives:
Approved Date: -
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
536 Supplies(office) 789.00 789.00 1,589.00 1,589.00
Original Budget Calculation:
=800+789
Original Budget Narratives:
Justification/Calculations:Requested amount of$789 is 0.19%of TCT contract value(within limitation of 2%of the contract value as per 2015-2016 Budget Guidelines).
Source of Match:$800 Provided in-kind by the City of Miami Beach.City of Miami Beach covers costs for copier with toner and machine maintenance.
Budget Amendment Narratives:
Approved Date: -
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
537 Supplies(program) 1,075.00 1,075.00 1,075.00 1,075.00
Original Budget Calculation:
=1075
Original Budget Narratives:
Annual fee for Community OS educational software to enable client tracking by all partners$1,075
Budget Amendment Narratives:
Approved Date. -
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
540 Non-Capital Equipment 0.00 0.00 0.00 0.00
Original Budget Calculation:
Original Budget Narratives:
City of Miami Beach Page 54 of 85
Contract#1721-1090;Resolution#2016-63
Budget Amendment Narratives:
Approved Date: -
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
550 Capital Equipment 0.00 0.00 0.00 0.00
Original Budget Calculation:
=0+0
Original Budget Narratives:
Budget Amendment Narratives:
Approved Date: -
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
591 Indirect Cost 0.00 0.00 0.00 0.00
Original Budget Calculation:
Original Budget Narratives:
Budget Amendment Narratives:
Approved Date: -
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
611 Subcontractor 198,581.00 198,581.00 198,581.00 198,581.00
Original Budget Calculation:
=3402+22351+24413+15965+2225+15141+5000+21600+1470+11200+9686+4128+120
00+50000
Original Budget Narratives:
Intake-Initial Assessment(All partners):$48.60 each x 70 clients=3,402
Care Coordination(Choices,Switchboard,Empowerment Tutoring,Ayuda)
CC Assessment:$144.20 each x 155 clients=22,351
CC Follow Ups:$78.75 each x 155 clients x 2 per client=24,412.50
CC Close Out:$103 each x 155 clients=15,965
CC Flexible Check Ins:$27.81 each o 80 instances of need=2,225
City of Miami Beach Page 55 of 85
Contract#1721-1090;Resolution#2016-63 9
Family Group Conference(Choices):$180.25 each x 84 clients=15,141
Mental Health Services(Advocate2Create,Ayuda,Empowering Youth)
MH Assessment:$250 each x 20 clients=5,000
MH Sessions:$90 each x 20 clients x 12 sessions each=21600
Tutoring(Empowerment Tutoring)
Tutoring Assessment:$42 each x 35 clients=1,470
Tutoring Sessions:$40 each x 35 clients x 8 sessions each=11200
Employment Services(Teen Job Corps)
Employment Session Stipend:$21.62 each x 14 clients o maximum of 32 session per client=9,685.76
Employment Session Facilitation:$50.34 each x 82 sessions(rolling enrollment;participants will start at different times throughout the year)=4,127.88
Step Up Behavior Modification Services:$200 each x 60 clients=12000
Functional Family Therapy(Institute for Child&Family Health-Budget attached)=50,000
Budget Amendment Narratives:
Approved Date: -
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
711 Professional Services(instructors) 0.00 0.00 0.00 0.00
Original Budget Calculation:
Original Budget Narratives:
Budget Amendment Narratives:
Approved Date: -
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
721 Professional Services(certified teachers) 0.00 0.00 0.00 0.00
Original Budget Calculation:
Original Budget Narratives:
City of Miami Beach Page 56 of 85
Contract#1721-1090;Resolution#2016-63
Budget Amendment Narratives:
Approved Date: -
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
731 Professional Services(tutors) 0.00 0.00 0.00 0.00
Original Budget Calculation:
=0+0
Original Budget Narratives:
Budget Amendment Narratives:
Approved Date: -
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
741 Professional Services(consultants) 0.00 0.00 0.00 0.00
Original Budget Calculation:
=0+0
Original Budget Narratives:
Budget Amendment Narratives:
Approved Date: -
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
751 Professional Services(Evaluation) 0.00 0.00 0.00 0.00
Original Budget Calculation:
=0+0
Original Budget Narratives:
Budget Amendment Narratives:
Approved Date: -
City of Miami Beach Page 57 of 85
Contract#1721-1090;Resolution#2016-63
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
791 Professional Services(other) 7,776.00 7,776.00 7,776.00 7,776.00
Original Budget Calculation:
=7776
Original Budget Narratives:
School Liaison to conduct recruitment and engagement and to obtain participants'school records;$19.44 per hour x 400 hours annually=7,776
Budget Amendment Narratives:
Approved Date: -
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
811 Other(advertising) 0.00 0.00 0.00 0.00
Original Budget Calculation:
=0+0
Original Budget Narratives:
Budget Amendment Narratives:
Approved Date: -
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
821 Other(background screening) 0.00 0.00 225.00 225.00
Original Budget Calculation:
=75*3
Original Budget Narratives:
City of Miami Beach pays for a minimum of three volunteers to have background checks performed in-house,annually.Each individual is$75 x 3=225.
Source of Match:Provided in-kind by the City of Miami Beach.
Budget Amendment Narratives:
Approved Date: -
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
831 Other(admission to field trips) 0.00 0.00 0.00 0.00
City of Miami Beach Page 58 of 85
Contract#1721-1090;Resolution#2016-63
Original Budget Calculation:
=0+0
Original Budget Narratives:
Budget Amendment Narratives:
Approved Date: -
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
841 Program Specific Audit 1,500.00 1,500.00 3,500.00 3,500.00
Original Budget Calculation:
=1500+2000
Original Budget Narratives:
The total cost paid by the City for the program specific audit is$8,000.Across programs the City requests the maximum agency-wide amount of$6,000.Each program requests an equal share of
the cost($6,00014=$1,500)and the City covers the remaining balance($2,000)in-kind.
1,500+2,000
Budget Amendment Narratives:
Approved Date: -
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
851 Other(Volunteers) 0.00 0.00 0.00 0.00
Original Budget Calculation:
=0+0
Original Budget Narratives:
Budget Amendment Narratives:
Approved Date: -
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
852 Other(Special Events) 0.00 0.00 0.00 0.00
Original Budget Calculation:
=0+0
City of Miami Beach Page 59 of 85
Contract#1721-1090;Resolution#2016-63
Original Budget Narratives:
Budget Amendment Narratives:
Approved Date: -
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
853 Other(Required Staff Training) 0.00 0.00 0.00 0.00
Original Budget Calculation:
=0+0
Original Budget Narratives:
Budget Amendment Narratives:
Approved Date: -
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
854 Other(Discretionary Funds) 2,000.00 2,000.00 2,000.00 2,000.00
Original Budget Calculation:
=2000
Original Budget Narratives:
$2,000 is 0.47%of TCT contract value(within limitation of 2%of the contract value as per 2015-2016 Budget Guidelines).
Budget Amendment Narratives:
Approved Date: -
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
855 Other(conference registration) 0.00 0.00 0.00 0.00
Original Budget Calculation:
=0+0
Original Budget Narratives:
City of Miami Beach Page 60 of 85
Contract#1721-1090;Resolution#2016-63
Budget Amendment Narratives:
Approved Date: -
Account# Account Name Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
891 Other(other) 3,500.00 3,500.00 13,500.00 13,500.00
Original Budget Calculation:
=3500+10000
Original Budget Narratives:
Other-Emergency Services:assistance based on needs assessment and approval granted by the partnership director and Children's Trust staff. Assistance is limited to a one-time allotment of up
to$500 per family for up to 7 households=$3,500.
Other-Emergency Services IN-KIND:City of Miami Beach receives EFSP funding and provides emergency rent and utilities assistance to SU clients each year.Average amount$1,000 x 10 clients
served=10,000
Budget Amendment Narratives:
Approved Date: -
Expense Totals Orig CSC Budget Amend CSC Budget OrIg Prog Budget Amend Prog Budget
222,654.00 222,654.00 252,948.00 252,948.00
Salary and Expense Totals Orig CSC Budget Amend CSC Budget Orig Prog Budget Amend Prog Budget
425,000.00 425,000.00 474,502.00 474,502.00
City of Miami Beach Page 61 of 85
Contract#1721-1090;Resolution#2016-63
Subcontractor Budget
Organization Name: City of Miami Beach
Subcontractor Name: Institute for Child&Family Health
contract
Period: Aug, 1,2016-July 31,2017 12 months Areas in Blue to be completed by the Agency
PROGRAM BUDGET Insert Program Period Insert Program Period
Requested Funding Matching Funds Justification
SALARIES: % Amount jAmount
List Full-Time Employees
Annual
Salary
Position (12 mths)
Therapist 36,611.00 100% 36,611.00 0.00 Functional Family Therapist to provide direct services for a
minimum of 25 children and their families.This is a full time
employee of Institute for Child&Family Health.The position paid
bi-weekly.The requested funding amount is based on 26 pay
periods in the year.$17.534per hour x 40 hours per week x 52.2
weeks=36,611.There will be no"match"
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
Full-Time Total 1.00 36,611.00 0.00 0.00
List Part-Time/Seasonal Employees
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
Part-Time Total 0.00 0.00 0.00 0.00
TOTAL FTEs/SALARIES 1.00 $36,611.00 .00 $0.00
FRINGE BENEFITS
These are the actual expenses for fringe benefits for this staff
Fica/Mica Rate: 7.65% 2,800.74 0.00 member.36611 x 7.65%=2800.74
Existing cost of workers comp,per rate guidelines: .0088 x
W-Comp's Rate: 0.88% 322.18 0.00 36,611=322.18
1.65%State unemployment,and.6%Federal Unemployment on
first 7,000 in wages:2.25%°X 7000=157.50
U nem ploy Rate: 2.25°/ 157.50 0.00
Retirement Rate: 0.00% 0.00 -. 0.00
Other Specify&provide calculations
Health Ins. Cost per Staff $575.00 6900 $575.00 per month x 12 months=$6,900
Life Ins. Rate: 0.14% 50.40 Annual salary of$36,611 x.13765%=$50.40
Rate: '.. . ".. I,......
TOTAL FRINGE BENEFITS $10,230.81 $0.00 TCT Fringe is 27.9446391562645%of TCT Requested Salarie
Requested Matching
PROGRAM OPERATING EXPENSES: Funding Funds
Amount Amount
Travel(other than participants) 540.00 Staff travels to appointments in client homes.Reimbursement rate
of$0.54/mile x 800 miles annually=$432+$40 for tolls+$68
for oarkino=$540
Travel(participants)
Meals(participants)
Space(rent of a building)
Utilities(e.g.telephone,utilities) 420.00 Cellular phone for use in the field.$35 x 1 person x 12 months=
$420
Supplies-office (e.g.paper,printing,postage) 173.75 Costs include paper,ink,use of photocopiers,pens,and general
office supplies
Supplies-program(e.g.curricula,books) 100.00 This includes any program books or materials that are required for
the FFT model. (10 books at$10 each)
City of Miami Beach Page 62 of 85
Contract#1721-1090;Resolution#2016-63
Subcontractor Budget
Non-Capital Equipment(less than$1,000)(List each) 0.00 0.00
Capital Equipment(greater than$1,000)(List each) 0.00 0.00
Subcontractors (List each) 0.00 0.00
Professional Services 0.00 0.00
Instructor(List each) 0.00 0.00
Certified Teacher(List each) 0.00 0.00
Tutor(List each) 0.00 0.00
Professional Services/Independent Contractor- 0.00 0.00
Additional(List each)
0.00
Other 0.00 0.00
Volunteers
Advertising
Background screening
Admission to field trips
Program Specific Audit
Other-Additional(List each) 0.00 0.00
TOTAL OPERATING EXPENSES: $1,233.75 $0.00
Administrative/Indirect Costs
(Can not exceed 10%) 4% 1,924.44 Staff supervision,as contractually required per Evidence-Based
Practice guidelines
TOTAL BUDGET $50,000.00 0% $0.00
City of Miami Beach Page 63 of 85
Contract#1721-1090;Resolution#2016-63
ATTACHMENT C
PROGRAMMATIC/INITIATIVE
PERFORMANCE AND DATA
REPORTING REQUIREMENTS
City of Miami Beach Page 64 of 85
Contract#1721-1090; Resolution#2016-63
Attachment C: Data Requirements and Program Progress Metrics
SERVICE PARTNERSHIPS
The Children's Trust requires collecting ongoing measures of progress on the quantity, quality and effects
of service efforts. The purpose of data collection, reporting and analysis is to promote continuous
improvements in program quality and outcome achievement. Successful programs regularly monitor the
quality of their own implementation at the site level, offer staff training and coaching on program
components, and incorporate feedback from participants and staff. Program progress metrics may be
revised throughout the funding cycle depending on the initiative needs and additional program data.
PARTICIPANT DEMOGRAPHICS
DATA REQUIREMENT PROGRAM PROGRESS METRICS
Participant Demographics: Providers are expected Target Population: Providers are expected to
to collect and report the participant identifiable enroll and serve participants who meet the
information specified in the Child and Adult eligibility criteria, identified in the Target
Information Forms and in the demographics screens Population section of Attachment A.
in our data reporting system. Families of Children with Disabilities: Programs
Providers will update participant demographics are expected to serve the number of families
regularly when new information is collected (e.g., with children with disabilities specified in
new address, grade level). Attachment A.
PARTICIPANT ATTENDANCE
DATA REQUIREMENT PROGRAM PROGRESS METRICS
Attendance-based Data: Attendance-based Service Utilization: Programs are expected to
activities are ongoing intensive services that ensure that services offered are being utilized by
represent the core program activities and are participants.
attended by participants regularly (typically more Participant Engagement:The contracted
than two times). number of participants are receiving the
contracted number of sessions (i.e., the
expected and appropriate dosage or length of
service).
Group-based Data: Group-based activities are Programs are expected to ensure that
one or two time events for which demographics activities are offered and conducted as
and individual attendance are not collected. specified in Attachment A.
These activities are generally open to the public
and do not require program enrollment.They are
reported in the data system using aggregate
attendance numbers.
City of Miami Beach Page 65 of 85
Contract#1721-1090; Resolution#2016-63
PARTICIPANT OUTCOMES
DATA REQUIREMENT PROGRAM PROGRESS METRICS
Performance Measures (PM) Data: Measures of Participant Testina/Timely Screenings: Providers are
participant outcomes should be used both for expected to collect and report on the outcome
the purposes of understanding and tailoring to measures and screening tools identified in
meet individual needs at program entry (pre- Attachment A on a timely and accurate manner.
tests) and for tracking changes or benefits
realized over the course of the program Actual Outcome Achievement: Refers to the
(through comparing pre/post-tests). The number and percentage of participants who
specific outcomes and administration points meet each required outcome in relation to the
for each contract are described in detail in number of participants who were expected to
Attachment A. meet it.
If the original formats of the required measures Timely Referral/Referral Completion: Based on the
are not appropriate for some participants, results of the screenings specified in Attachment
providers may utilize approved adaptations or A, providers are expected to connect families with
alternate assessments,in consultation with The identified services needed. In addition to
Trust and its program and professional providing timely referrals, providers are expected
development providers. to follow up to ensure families are receiving the
quality services they need.
PROGRAM QUALITY MEASURES
DATA REQUIREMENT PROGRAM PROGRESS METRICS
Satisfaction Survey: Providers are expected to Participant Satisfaction:Satisfaction surveys help
administer satisfaction surveys to all parents gauge various dimensions of participants' and
upon completion of services or at the end of caregivers' overall satisfaction with programming
the contract year if the family is rolling over into (including safety, program elements most liked
the next year.The Trust's satisfaction survey and those in need of change, and whether the
guidelines can be found at The Children's Trust programming help children, or other participants).
website. Providers should be able to describe how they use
participant feedback to continuously learn about
Providers are required to submit a summary of
their satisfaction survey results through a web ways to improve their programs.
based reporting system.
City of Miami Beach Page 66 of 85
Contract#1721-1090; Resolution#2016-63
PROGRAM QUALITY MEASURES
DATA REQUIREMENT PROGRAM PROGRESS METRICS
Personnel Records: Staff Qualifications and Retention: Providers are expected to hire and
Providers shall maintain a retain staff and subcontractors with the necessary
personnel file for each qualifications/credentials. Providers are expected to produce proof of
staff member involved in required experience, education, and certifications/licensures as
the program, including specified in Attachment A, staffing table.
in-kind staff and Professional Development: Providers are expected to create and
volunteers. Each file implement a program and professional development plan that meets
should contain, at a all training and certification requirements of the selected evidence-
minimum, background based program(s) measurement and tools as applicable.
screening results, proof of
required education, Trust-sponsored/facilitated Trainings: Providers must ensure appropriate
professional staff and subcontractors attend various initiative-specific trainings
development provided by The Trust's program and professional development
credits/non-credits hours, providers annually as specified on The Children's Trust website. At a
and any required minimum, staff will be required to attend the following
certifications or meetings/trainings annually:
licensures. • New and renewal contract development;
• Contract management trainings;
• The Children's Trust provider meetings;
• SAMIS training for budgets, amendments, invoices, SAMIS
programmatic and reports trainings;
• Content-specific trainings related to program quality and
performance measures (e.g., Injury Free, CCDH, evidence-based
programs, and measurement tools).
Program Service Delivery: Activities Observation:Supervisors must regularly monitor staff as well as
Providers are expected subcontractors using the appropriate fidelity tool as well as hold regular
to deliver contracted reflective supervision meetings to ensure high quality service delivery.
services with fidelity to The Trust will complete various program observations and monitoring site
Attachment A. visits throughout the contract year. Program observation visits may be
announced or unannounced. In addition, providers are expected to
participate in technical assistance and quality improvement activities
provided by professional development providers.
City of Miami Beach Page 67 of 85
Contract#1721-1090;Resolution#2016-63
ADDITIONAL REQUIREMENTS
Compliance Items: Provider shall comply with all applicable compliance items specified in the core
contract, related contract attachments, and the "Required Documentation Checklist" posted on The
Children's Trust website.
Accommodations for Families of Children with Disabilities:The Children's Trust expects all programs to serve
families of children with disabilities, regardless of disability type or level, provided they can be safely and
reasonably accommodated in accordance with the Americans with Disabilities Act (ADA). Providers who
need assistance in determining whether they can safely and reasonably accommodate a family must
contact their assigned Inclusion Specialist from the resources available through The Children's Trust. All
families must be admitted into programs unless the assigned Inclusion Specialist determines reasonable
accommodations cannot be made.
Program Narrative Report:The Program Narrative Report captures a brief report of the program's successes,
challenges, and support needed. The report will be submitted to The Trust via the web-based reporting
system and following the guidelines provided in the Data Reporting Timeline below.
Accurate Timely Data Entry: Providers are expected to enter demographic, attendance, screening, and
assessment data in a timely manner, contributing to data accuracy and real time use of data. Providers
are expected to have processes in place to ensure data quality and integrity. Providers are expected to
collect and report outcome and screening data on all participants in our data reporting system.
Data Reporting Timeline: Provider shall comply with the web-based reporting requirements set forth in the
tables below. With each submission, Provider shall attest, based on his/her best knowledge, information
and belief, that all data submitted in conjunction with the reports are accurate, truthful and complete.
Providers will report individual participant attendance for each month by the 15th of the following month
at the latest.
Due Date* What to Report in the Web-Based Reporting System
15th Day Each - Prior month's new participant demographics, attendance data, screening
Month data, and any testing data
November 15th - Program Narrative Report (For services and activities rendered in August,
September, and October)
February 15th - Program Narrative Report (For services and activities rendered in November,
December, and January)
May 15th - Program Narrative Report (For services and activities rendered in February,
March, and April)
- Aggregated satisfaction survey responses
August 15th - Program Narrative Report (For services and activities rendered in May, June,
and July)
*NOTE: If a reporting due date falls on a weekend or holiday, the document shall be due on the following
business day.
City of Miami Beach Page 68 of 85
Contract#1721-1090; Resolution#2016-63
ATTACHMENT D
PROGRAM SPECIFIC AUDIT
REQUIREMENTS
City of Miami Beach Page 69 of 85
Contract#1721-1090; Resolution#2016-63
Attachment D
Program Specific Audit Requirements
The Program Specific Audit must encompass an audit of The Children's Trust contracts in accordance with section
03: Program Specific Audit of this contract. The comprehensive nature of auditing performed in accordance with
the standards set forth below places on the independent certified public accounting firm (CPA) the responsibility for
ensuring that (1) the audit is conducted by personnel who have the necessary skills; (2) independence is maintained;
(3) applicable standards are followed in planning and conducting audits and reporting the results; (4) the
organization has an appropriate internal quality control system in place; and (5) the organization undergoes an
external quality control review.
Program Specific Audits must be conducted in compliance with AU-C 935 and are required to include performing
tests of controls over compliance.
An auditor's risk assessment must include an expectation of the operating effectiveness of controls over compliance;
and in doing so;the assessed control risk must be assessed at low during the planning stage. If the auditor determines
a lack of controls and identifies risk of material noncompliance that demonstrates internal controls do not exist or are
not effective regarding the compliance requirement, a response to such risks should be developed, and a finding
(significant deficiency or material weakness) should be reported.
The auditor's test work and sample size of each compliance requirement should be the result of the assessed level
of inherent risk and control risk as it relates to each compliance requirement as stated in The Children's Trust
contracts.
The Program Specific Audit requires the following components (a sample format may be found on The Children's
Trust website):
a. Independent Auditor's Report on the Schedule of Expenditures of The Children's Trust Contracts;
b. Schedule of Expenditures of The Children's Trust Contracts;
c. Notes to Schedule;
d. Independent Auditor's Report on Compliance for each of The Children's Trust Contracts and Report on Internal Control
over Compliance;and
e. Schedule of Findings and Questioned Costs.
At a minimum, the auditor must include the following tests in their audit program to ensure that the compliance
requirements set forth in The Children's Trust compliance supplement are met. They are:
The Children's Trust Compliance Supplement to the Program Specific Audit:
Compliance Requirement Program Specific Audit Example
Implication
a). Internal Controls 1). An auditor's risk assessment A). Controls tested during the
must include an expectation of financial statement audit may
the operating effectiveness of not consider compliance as it
controls over compliance; and relates to the Children's Trust
in doing so; the assessed contracts. Overall control risk
control risk must be assessed at must consider each
low during the planning compliance requirement tested
stage. If the auditor determines during the program specific
a lack of controls and identifies audit. Separate risk assessment
risk of material noncompliance procedures and materiality
that demonstrates internal should be performed and
controls do not exist or are not generated for a program
effective regarding the specific audit.
compliance requirement, a
response to such risks should be
developed, and a finding
(significant deficiency or
City of Miami Beach Page 70 of 85
Contract#1721-1090;Resolution#2016-63
Compliance Requirement Program Specific Audit Example
Implication
material weakness) should be
reported.
The auditor's test work and
sample size of each
compliance requirement
should be the result of the
assessed level of inherent risk
and control risk as it relates to
each compliance requirement
as stated in The Children's Trust
contracts.
b). Budget vs. Actual 1).The approved budget is to A). Testwork should include a
Expenditures include the original approved schedule identifying each
contract as well as any contract and its
approved budget original/amended budget,
amendments/revisions. monthly billings, contract
utilization and any analytical
expectations that may identify
any overbillings.
i. SAMIS does not allow
providers to overbill any
budgeted line item or
contract allocation,
however, if contract
utilization is greater or
less than expected, this
could indicate that a
budgeted salary rate is
not the employee's
actual rate. Provider
must compensate
employees at the rate
stated on the budget.
Any difference in rate
would warrant a finding
in the Program Specific
Audit Report.
c). Allowable/Unallowable 1). Requires that the nature of A). If Provider asks to be
Activities and Costs services and type of costs paid reimbursed for 6 field trips to
are in agreement with the teach children social skills, then
contractual budget and/or were those field trips
Common unallowable costs: budget amendment/revision's enumerated in either the
1. Salary rates, payroll methods scope of services and budget contractual budget narrative or
and hours billed do not match guidelines. the contractual Scope of
original or amended budgets. AND/OR Services?
2. The amount of fringe
benefits billed to the Trust is Requires that activities B). If the contractual budget,
actually for employees not performed or costs paid with lists a Program Coordinator
included in contract budget The Children's Trust funds are position at$25.00/hour, then
and unrelated to the program. listed in the contractual budget does the provider actually pay
narrative or a contractual and charge The Children's Trust
$25.00/hour?
City of Miami Beach Page 71 of 85
Contract#1721-1090: Resolution#2016-63
Compliance Requirement Program Specific Audit Example
Implication
3. Professional services are budget amendment/revision
billed within regular salaries and narrative.
wages. C). If the contractual budget,
lists a Program Coordinator's
4. Capital purchases disguised
2). Any cost or service billed position,with dedicated time
as repairs. that is not approved in the charged to The Children's Trust
5. Sales taxes and tips. contract budget is a finding program of 25%, then does the
and reported as a questioned provider keep records of an
6. Fuel cost on the Program Specific employee's time to
7. Food and beverage costs for Audit Report. substantiate that 25%of time
parties, celebrations, end-of- was in fact earned and
program events, and charged to The Children's Trust
conferences or conventions, 3). If any cost or service is billed program?
unless while attending an out- in more than one contract, and
of town conference or the billings are in excess of the
total disbursement, or
convention. D). If 3 contracts list a Program
approved allocation, the Coordinator's total budgeted
8. Monetary gift cards as expense has been overbilled or salary as$100,000 and each
incentives. doubled billed and should be contract will reimburse$35,000
(A detailed listing of all costs considered a finding. (35%), then a possible
and activities considered overbilling of$5,000 may have
allowed and un-allowed canoccurred ($35,000*3=$105,000
4). Children's Trust funds must
be viewed in the Budgetsupplement a program, or 35%*3=105%Children's Trust
Guidelines form on thesupplanting is unallowable. A salary allocation).
Children's Trust website, provider may not use contract
www.thechildrenstrust.org/provifunds to defray any costs that E). If an invoice is submitted to
ders/forms.) the recipient already is The Children's Trust that
obligated to pay. (See includes food charges for end
example F) of the year parties and
celebrations, is that cost
allowable per The Children's
Trust budget guidelines? Food
costs for end of year
celebrations are NOT allowable
per The Children's Trust budget
guidelines.
F). If a provider, prior to
applying to participate in the
contracted program, had
committed to purchase 10 new
computers for another
program, then the provider
must purchase those 10
computers in addition to any
computers requested for the
Children's Trust program.
d). Cash Management 1). With the exception of the A). If payroll is paid on 3/31, is it
last month of the contract included in March's
period, do monthly invoices reimbursement?
represent cost actually paid
during the contract period
City of Miami Beach Page 72 of 85
Contract#1721-1090;Resolution#2016-63
Compliance Requirement Program Specific Audit Example
Implication
(cash basis), rather than costs B). If payroll is paid on 4/1, but
incurred or accrued. represents time charged in
March, is it included in April's
reimbursement?
e). Period of Availability 1). Requires Provider to charge A). If the active contract period
The Children's Trust grant with extends from 8/1/15 through
only allowable costs resulting 7/31/16, and Provider expenses
from obligations incurred during $250.00 for office supplies on
the funding period. 9/30/15, does that expenditure
apply to the active contract
period?
B).The following items warrant
the most attention at the
beginning and end of contract
periods:
i. Payroll from expired
contract is billed in the
first month of renewed
contract is unallowable
if it was paid during the
invoiced month but
was incurred in prior
contract. Reporting
requirements for final
invoice allow this
payroll to be expensed
and reimbursed in prior
contract. Only the
portion of payroll
incurred during the
contract period may
be billed.
ii. Utilities
iii. Insurances
f).Special Provisions 1). Eligibility requirements Each of the following special
related to contract provisions must be tested:
expectations such as type of
A). Insurance requirements
participants served, number of (further description in Section K
participants served and of Core Contract)
background checks should
NOT be tested as part of The i. Auditor should
Children's Trust program determine if all
specific audit. The program applicable insurance
specific audit is meant to test policies were carried
the fiscal viability of the during the fiscal year.
provider. Therefore, certain
B). Proof of tax status (further
core contract provisions that description in Section L)
support the fiscal viability of the
provider should be tested.
City of Miami Beach Page 73 of 85
Contract#1721-1090;Resolution#2016-63
Compliance Requirement Program Specific Audit Example
Implication
ii. Auditor should vouch to
applicable documents
verifying that all
incurred payroll and
unemployment taxes
have been paid.
C). Data security obligation
(further description in Section
0.12 of the Core Contract)
i. Auditor should obtain
and/or understand the
Provider's data security
policy.
D).Subcontractor agreements
(if applicable)
i. Auditor should obtain
and understand any
agreements made with
subcontracted parties.
Additionally, the auditor
should obtain an
understanding of any
Provider monitoring
procedures.
E). Matching Funds
i. In some cases, a
required match is
contracted. This will be
indicated in Section D
of the base contract.
Verify the applied
method the provider
uses to satisfy match
requirements. Also,
verify that provider
maintains
documentation to
backup match
requirements.
The independent auditor's report shall state that the audit was conducted in accordance with auditing standards
generally accepted in the United States of America; the standards applicable to financial audits contained in
Government Auditing Standards, issued by the Comptroller General of the United States, and the Program Specific
Audit requirements listed in The Children's Trust contract.
City of Miami Beach Page 74 of 85
Contract#1721-1090;Resolution#2016-63
ATTACHMENT E- 1
AFFIDAVIT UNDER PENALTY OF
PERJURY FOR LEVEL 2 BACKGROUND
SCREENINGS
City of Miami Beach Page 75 of 85
Contract#1721-1090; Resolution#2016-63
ATTACHMENT E-1
Affidavit under Penalty of Perjury for Level 2 Background Screenings
Affidavit under Penalty of Perjury Affirming Compliance with Background Screening for Provider Personnel,Volunteers,
and Subcontracted Personnel, as applicable.
In accordance with Sections 943.0542, 984.01, Chapter 430, 435, 402, 39.001, and 1012.465 Florida Statutes, and
pursuant to the requirements of Paragraph R. Background Screening of this Contract, the undersigned affiant makes
the following statement under oath and under penalty of perjury, which is a first degree misdemeanor, punishable
by a definite term of imprisonment not to exceed one year and/or a fine not to exceed $1,000, pursuant to Sections
837.012 and 775.082, Florida Statutes.
All full-time, part-time, contracted staff and volunteers, along with the staff and volunteers provided to the program
by a subcontractor have been checked against The Dru Sjodin National Sex Offender Public Website
http://www.nsopw.gov/eng (Check must have taken place within 30 calendar days prior to the signing of this
document.)
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
Before me, the undersigned authority, personally appeared (CEO/Executive Director) Authorized Provider
Representative of City of Miami Beach, who being by me first duly sworn, deposes and says:
I swear and affirm that the above-named contracted Provider is compliant with the requirements for personnel
background screening detailed in Sections 943.0542, 984.01, Chapter 435, 402,39.001, and 1012.465 Florida Statutes,
as applicable, for all personnel having direct contact with children.
(Signature of CEO/Executive Director/HR Director) Date
Sworn to and subscribed before me at Miami-Dade County, Florida this_day of , 20_by
Who is personally known to me
Who produced identification:
Type of identification
Signature of Notary Public
State of Florida at Large
Print, type or stamp name of notary public
My Commission Expires:
City of Miami Beach Page 76 of 85
Contract#1721-1090; Resolution#2016-63
ATTACHMENT E-2
CHILD CARE
AFFIDAVIT OF GOOD MORAL
CHARACTER
City of Miami Beach Page 77 of 85
Contract#1721-1090:Resolution#2016-63
vvrAR
,0/.. '{ ATTACHMENT E-2 10,m
CHILD CARE
,,, AFFIDAVIT OF GOOD MORAL CHARACTER
kit 1-1 PAHA 11-S COM,
State of Florida County of
Before me this day personally appeared who, being duly sworn, deposes and says:
(Applicant's/Employee's Name)
As an applicant for employment with, an employee of, a volunteer for, or an applicant to volunteer with
, I affirm and attest under penalty of perjury that I meet the moral character
requirements for employment, as required by Chapter 435 Florida Statutes in that:
I have not been arrested with disposition pending or found guilty of,regardless of adjudication, or entered a plea
of nolo contendere or guilty to, or have been adjudicated delinquent and the record has not been sealed or
expunged for, any offense prohibited under any of the following provisions of the Florida Statutes or under any
similar statute of another jurisdiction for any of the offenses listed below:
Relating to:
Section 393.135 sexual misconduct with certain developmentally disabled clients and reporting of such sexual misconduct
Section 394.4593 sexual misconduct with certain mental health patients and reporting of such sexual misconduct
Section 415.1 1 1 adult abuse,neglect,or exploitation of aged persons or disabled adults or failure to report of such abuse
Section 741.28 criminal offenses that constitute domestic violence,whether committed in Florida or another jurisdiction
Section 777.04 attempts,solicitation,and conspiracy
Section 782.04 murder
Section 782.07 manslaughter,aggravated manslaughter of an elderly person or disabled adult,or aggravated manslaughter of
a child
Section 782.071 vehicular homicide
Section 782.09 killing an unborn child by injury to the mother
Chapter 784 assault, battery,and culpable negligence,if the offense was a felony
Section 784.011 assault,if the victim of offense was a minor
Section 784.03 battery,if the victim of offense was a minor
Section 787.01 kidnapping
Section 787.02 false imprisonment
Section 787.025 luring or enticing a child
Section 787.04(2) taking,enticing,or removing a child beyond the state limits with criminal intent pending custody proceeding
Section 787.04(3) carrying a child beyond the state lines with criminal intent to avoid producing a child at a custody hearing or
delivering the child to the designated person
Section 790.1 15(1) exhibiting firearms or weapons within 1,000 feet of a school
Section 790.1 15(2) (b) possessing an electric weapon or device,destructive device,or other weapon on school property
Section 794.011 sexual battery
Former Section 794.041 prohibited acts of persons in familial or custodial authority
Section 794.05 unlawful sexual activity with certain minors
Chapter 796 prostitution
Section 798.02 lewd and lascivious behavior
Chapter 800 lewdness and indecent exposure
Section 806.01 arson
Section 810.02 burglary
Section 810.14 voyeurism,if the offense is a felony
Section 810.145 video voyeurism,if the offense is a felony
Chapter 812 theft and/or robbery and related crimes,if a felony offense
Section 817.563 fraudulent sale of controlled substances,if the offense was a felony
Section 825.102 abuse,aggravated abuse,or neglect of an elderly person or disabled adult
Section 825.1025 lewd or lascivious offenses committed upon or in the presence of an elderly person or disabled adult
Section 825.103 exploitation of disabled adults or elderly persons,if the offense was a felony
Section 826.04 incest
Section 827.03 child abuse,aggravated child abuse,or neglect of a child
Section 827.04 contributing to the delinquency or dependency of a child
Former Section 827.05 negligent treatment of children
Section 827.071 sexual performance by a child
Section 843.01 resisting arrest with violence
Section 843.025 depriving a law enforcement,correctional,or correctional probation officer means of protection or
communication
Section 843.12 aiding in an escape
Section 843.13 aiding in the escape of juvenile inmates in correctional institution
City of Miami Beach Page 78 of 85
Contract#1721-1090;Resolution#2016-63
Chapter 847 obscene literature
Section 874.05(1) encouraging or recruiting another to join a criminal gang
drug abuse prevention and control only if the offense was a felony or if any other person involved in the offense
was a minor
Section 916.1075 sexual misconduct with certain forensic clients and reporting of such sexual conduct
Section 944.35(3) inflicting cruel or inhuman treatment on an inmate resulting in great bodily harm
Section 944.40 escape
Section 944.46 harboring,concealing,or aiding an escaped prisoner
Section 944.47 introduction of contraband into a correctional facility
Section 985.701 sexual misconduct in juvenile justice programs
Section 985.711 contraband introduced into detention facilities
I understand that I must applicable acknowledge the existence of any criminal record relating to the above lists
of offenses including those under any similar statute of another jurisdiction, regardless of whether or not those
records have been sealed or expunged. Further, I understand that, while employed or volunteering at
in any position that requires background screening as a
condition of employment, I must immediately notify my supervisor/employer of any arrest and any changes in
my criminal record involving any of the above listed provisions of Florida Statutes or similar statutes of another
jurisdiction whether a misdemeanor or felony.This notice must be made within one business day of such arrest or
charge. Failure to do so could be grounds for termination.
I attest that I have read the above carefully and state that my attestation here is true and correct that my record
does not contain any of the above listed offenses. I understand, under penalty of perjury, all employees in such
positions of trust or responsibility shall attest to meeting the requirements for qualifying for employment and
agreeing to inform the employer immediately if arrested for any of the disqualifying offenses. I also understand
that it is my responsibility to obtain clarification on anything contained in this affidavit which I do not understand
prior to signing. I am aware that any omissions, falsifications, misstatements or misrepresentations may disqualify
me from employment consideration and,if I am hired, may be grounds for termination or denial of an exemption
at a later date.
SIGNATURE OF AFFIANT:
Sign Above OR Below, DO NOT Sign Both Lines
To the best of my knowledge and belief, my record contains one or more of the applicable disqualifying acts or
offenses listed above. I have placed a check mark by the offense(s) contained in my record. (If you have
previously been granted an exemption for this disqualifying offense, please attach a copy of the letter granting
such exemption.) (Please circle the number which corresponds to the offense(s) contained in your record.)
SIGNATURE OF AFFIANT:
Sworn to and subscribed before me this day of , 20_.
SIGNATURE OF NOTARY PUBLIC,STATE OF FLORIDA
(Print,Type,or Stamp Commissioned Name of Notary Public)
(Check one)
Affiant personally known to notary
OR
Affiant produced identification
City of Miami Beach Page 79 of 85
Contract#1721-1090;Resolution#2016-63
ATTACHMENT E-3
CHILD ABUSE & NEGLECT REPORTING
REQUIREMENTS
City of Miami Beach Page 80 of 85
Contract#1721-1090;Resolution#2016-63
ATTACHMENT E-3
dOA �
�
4A
"';r Child Abuse & Neglect Reporting Requirements
All child care personnel are mandated by law to report their suspicions of child abuse, neglect, or
abandonment to the Florida Abuse Hotline in accordance with s. 39.201 of the Florida Statutes(F.S.).
* Child care personnel must be alert to the physical and behavioral indicators of child abuse and
neglect.
"Child Abuse or Neglect" is defined in s.39.201, F.S.,as "harm or threatened harm" to a child's health
(mental or physical) or welfare by the acts or omissions by a parent, adult household member, other
person responsible for the child's welfare, or for purposes of reporting requirements by any person.
Categories include:
- Physical Abuse or Neglect (i.e. unexplained bruises, hunger, lack of supervision...)
- Emotional Abuse or Neglect (i.e. impairment in the ability to function, depression...)
-Sexual Abuse (i.e.withdrawal, excessive crying, physical symptoms...)
* Reports must be made immediately to the Florida Abuse Hotline Information System by
-Telephone at 1-800-96-ABUSE (1-800-962-2873), or
- Fax at 1-800-914-0004,or
- Online at http://www.dcf.state.fl.us/abuse/report/.
* Failure to perform duties of a mandatory reporter pursuant to s.39.201, F.S. constitutes a violation of
the standards in ss. 402.301-319, F.S. and is a felony of the third degree. Remember, it is each child
care personnel's responsibility to report suspected abuse and/or neglect.
* All reports are confidential. However, persons who are mandated reporters (child care personnel) are
required to give their name when making a report.
* It is important to give as much identifying and factual information as possible when making a report.
* Any person,when acting in good faith,is immune from liability in accordance with s.39.203(1)(a), F.S.
* For more information about child abuse and neglect, visit the Department's website at
www.myflorida.com/childcare and select "Training Requirements." The Department offers a 4-hour
Identifying and Reporting Child Abuse and Neglect course for child care providers. This course is an
overview of the various types of abuse and neglect, indicators that may be observed, the legal
responsibility of mandatory reporters,and the proper procedure for reporting abuse and neglect,as
required by ss. 402.305(2) and 402.313(1), F.S. The course is offered both online and instructor-based
throughout Florida.
This statement is to verify that on , 20 , I,
Date Print Name of Employee
Read and understood the information and my mandated reporting requirements.
Signature of Employee (for facility or large family child care home) Signature of Operator
City of Miami Beach Page 81 of 85
Contract#1721-1090; Resolution#2016-63
ATTACHMENT E-4
BACKGROUND SCREENING
& PERSONNEL FILE REQUIREMENTS
City of Miami Beach Page 82 of 85
Contract#1721-1090;Resolution#2016-63
ATTACHMENT E-4
4,
BACKGROUND SCREENING
& PERSONNEL FILE REQUIREMENTS
Place in employee file and attach all background screening documentation.
•P'tN ANL" 4*��~ Authority: s. 402.301-319, F.S., and s. 435, F.S.
vELrAM1r.uEs.cM
Name of Employee:
Name of Facility:
*Social Security #: Date of Birth: Employment Date:
*Pursuant to Chapter 435.05, F.S.,the Department's license/registration application requires personnel to give their Social Security
number for the purposes of background screening.Social security numbers are used by the Department for identity verification only.
Position Classification Position Type Age Group Assigned Education Level
(check one) (check all that apply) (check one) (check one)
Child Care Personnel Owner 0— 12 Months No High School/GED
Intermittent Volunteer Director 1 Year High School Student
Other Personnel Lead Teacher (must 2 Years High School/GED
select age group) 3 Years National Early Childhood Credential
VPK Instructor 4 Years Birth Through Five Child Care Credential
Assistant Teacher 4 Years VPK School-Age Child Care Credential
Substitute 5+Years Associates Degree
Mixed Bachelor's Degree
Not Applicable Master's Degree or Higher
SCREENING DOCUMENTATION
All child care personnel are required by law to be screened pursuant to Chapter 435,
F.S., as a condition of employment and continued employment.
Initial Screen
Date Livescanned Date completed
FINGERPRINT FDLE/FBI FDLE/FBI
Affidavit of Good Moral Character N/A
(due on or before employment,
following a 90 day break,or when
changing employers)
5 Year Re-screen
Date Livescanned Date completed
FINGERPRINT
FINGERPRINT
FINGERPRINT
OTHER REQUIREMENTS
Date Employment References Checked:
Names of References (attach additional documentation if necessary):
Leave of Absence Documentation from Employer (if applicable):
City of Miami Beach Page 83 of 85
Contract#1721-1090;Resolution#2016-63
ATTACHMENT G
DATA SECURITY DEFINITIONS
City of Miami Beach Page 84 of 85
Contract#1721-1090; Resolution#2016-63
ATTACHMENT G
Data Security Definitions
"Authorized Employees" means Provider's employees who have a need to know or otherwise access
Personal Information to enable Provider to perform its obligations under this Agreement.
"Authorized Persons" means (i) Authorized Employees; or (ii) Provider's subcontractors approved by The
Children's Trust who have a need to know or otherwise access Personal Information to enable Provider to
perform its obligations under this Agreement, and who are bound in writing by confidentiality obligations
sufficient to protect Personal Information in accordance with the terms and conditions of this Agreement.
"Unauthorized Third Party" means any person other than Authorized Employee or Authorized Person(s).
"Highly-Sensitive Personal Information" means an individual's (i) government-issued identification number
(including, without limitation, social security number, driver's license number or state-issued identified
number); (ii)financial account number,credit card number,debit card number,credit report information,
with or without any required security code, access code, personal identification number or password,
that would permit access to an individual's financial account; or (iii) biometric or health data.
"Personal Information" includes Highly-Sensitive Personal Information or any of the following:
(i) An individual's first name or first initial and last name in combination with any one or more of the
following data elements for that individual:
(1) A social security number;
(2) A driver license or identification card number, passport number, military identification number, or
other similar number issued on a government document used to verify identity;
(3) A financial account number or credit or debit card number, in combination with any required
security code, access code, or password that is necessary to permit access to an individual's
financial account;
(4) Any information regarding an individual's medical history, mental or physical condition,or medical
treatment or diagnosis by a health care professional; or
(5) An individual's health insurance policy number or subscriber identification number and any unique
identifier used by a health insurer to identify the individual.
(ii) User name or e-mail address, in combination with a password or security question and answer that
would permit access to an online account.
Notwithstanding the foregoing, the term "Personal Information"shall not include information (1) about an
individual that has been made publicly available by a federal, state, or local governmental entity; or (2)
that is encrypted, secured, or modified by any other method or technology that removes elements that
personally identify an individual or that otherwise renders the information unusable.
"Security breach"or"breach" means unauthorized access of data in electronic form containing personal
information, or a breach or alleged breach of this Agreement relating to such privacy practices. Good
faith access of Personal Information by an employee or agent of the covered entity shall not constitute a
breach of security under this Agreement, so long as the information is not used for a purpose unrelated
to the business of The Children's Trust, or as a result of any other unauthorized use.
City of Miami Beach Page 85 of 85
Contract#1721-1090;Resolution#2016-63
EXHIBIT "C-2"
BUSINESS ASSOCIATE AGREEMENT
30