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Grant Agreement with Douglas Gardens Community Mental Health, Inc. Zc3 c —3 , oG MIAMI BEACH CITY OF MIAMI BEACH FISCAL YEAR 2019-2020 GRANT AGREEMENT PROJECT NO.: 2020-CMB-09 This GRANT AGREEMENT is made and entered into this t day of 17e-Cl+6c , 20 lei by and between the City of Miami Beach, Florida (hereinafter the "City"), and the Douglas Gardens Community Mental Health Center of Miami Beach, Inc., a Florida not-for-profit corporation (hereinafter the"Grantee"). This Agreement is effective October 1, 2019, the "Effective Date." ARTICLE I /GRANT DESCRIPTION GRANTEE:- Douglas Gardens Community Mental Health, Inc. Center of Miami Beach, Inc. GRANTEE CONTRACT ADMINISTRATOR: Ms. Eleanor Lanser, LCSW/CEO Mr. Larry J. Long, MAcc, CFO ADDRESS: 1680 Meridian Avenue, Suite 501 CITY, STATE, ZIP: ' Miami Beach, FL 33139-2719 PHONE, FAX, E-MAIL: 305-531-5341,305-532-5322, Elanser@dgcmhc.org GRANT AMOUNT: $22,000 PROJECT DESCRIPTION: See Exhibit 1 hereto GRANT PROJECT BUDGET: See Exhibit 2 hereto GRANT TERM: October 1, 2019 — September 30, 2020 EXPENDITURE DEADLINE: September 30, 2020 PROJECT COMPLETION DATE: September 30, 2020 FINAL REPORT DEADLINE: October 15, 2020 FINAL REIMBURSEMENT REQUEST DEADLINE: October 15, 2020 c IN WITNESS WHEREOF, the parties hereto have executed this Agreement. FOR CITY: City of Miami Beach, Florida ATTEST: 41By: s'' �. 10�d Rafael E. Gra ado, City glerk. i I ` �; ; Ji my L. Morales, City Manager * INCORP ORATED `' - %' • ' Date `!� ;,i'„'•• 4,7 a ,1 FOR GRANTEE: Douglas Gardens Community Mental Health Center of Miami Beach, Inc. Federal ID# 59-1923396 ATTEST: '1 # 1 i BY: At 4....4.__AAVA.0-7 ' li'�c___ 4.4v‘,wair-#11 .i,ai 01 dl WI/ 111111111I - Autd St•nature Larry J. Long, MAcc, CFO Mary `leanor Lanser,LCSW,CEO Print Name and Title Print Name and Title IA- (?- 19 Date APPROVED AS TO FORM & LANG AGE 81:04F/TLC, ON Page 2 i,Z�Z ( t City Attorney Dote W4 ARTICLE II l GENERAL CONDITIONS 1. PARTIES: The parties to this Agreement are the Grantee listed in Article I, and the City, a municipal corporation organized under the laws of the State of Florida. The City has delegated the responsibility of administering this Grant to the City Manager or the City Manager's authorized designee (the"Contract Administrator"). 2. PROJECT DESCRIPTION: The Grantee may only use the Grant for the purposes that are specifically described in the Project Description,attached hereto as Exhibit 1.Any modification to Exhibit 1, Project Description, shall not be effective unless approved by a written amendment to this Agreement signed by the City and Grantee. Grantee agrees that all funding provided by the City pursuant to this Agreement will be used exclusively for goods or services to be provided within the City of Miami Beach. 3. GRANT PROJECT BUDGET: Subject to the availability of City funds, the maximum amount payable to Grantee for goods or services rendered under this Agreement shall not exceed the Grant Amount as set forth in Article I of this Agreement. Grantee agrees that should available City funding be reduced, the amount payable under this Agreement will be reduced at the sole option of the City of Miami Beach. All of the grantee's expenditures are subject to the terms of this Agreement, and as specified in the Grant Project.Budget, attached hereto as Exhibit 2.Any modification to Exhibit 2, Project Budget, shall not be effective unless approved, in writing, by the City and Grantee. Notwithstanding the foregoing, no modification to the project budget shall exceed the Grant Amount set forth in Article I of this Agreement. Any request by Grantee to modify Exhibit 2, Project Budget, shall be made in writing, using City approved forms, detailing and justifying the need for such changes. 4. REPORTS:This Grant has been awarded with the understanding that the activities and services contemplated under the Project Description will mutually contribute to the enhancement of services available to City residents, businesses, and visitors. As a condition of disbursements of grant funds, and to demonstrate that the Grant is fulfilling, or has fulfilled, its purpose, the Grantee must submit quarterly reports to the Contract Administrator by the following dates: January 15th, April 15th, July 15tH and the final report by October 15t1 New Grant awards will not be released to the Grantee until all Final Reports for previously awarded grants are received. The City may withhold any future payments of the Grant, or the award of any subsequent Grant, if it has not received all reports required to be submitted by Grantee, or if such reports do not meet the City's reporting requirements. Any reports may be disseminated by the City without the prior written consent of the Grantee. All quarterly reports must be submitted on Exhibit 3, the Grant Quarterly Status Report Form, detailing Grantee's compliance at the time of a partial reimbursement request. Page 3 5. REIMBURSEMENT REQUESTS: Reimbursement requests may be submitted to the City at any time during the Grant Term. All reimbursement requests must be made after expenditures have occurred. All reimbursement requests for funds must be submitted on Exhibit 4, Grant Reimbursement Request Form.All reimbursement requests must be submitted prior to October 15th, 2020.Grantee shall provide the City with copies of all receipts, invoices, cancelled checks(with copies of both front of back) and proof of expenditures of Grant monies. Grantee shall provide the City with and shall categorize all receipts, invoices, cancelled checks, and other documentation, according to the categories set forth in the grant budget. Invoices and checks must be directly related to expenses for Grant-funded activities taking place within the 2019-20 Fiscal Year. 6. AMOUNT OF GRANT AND PAYMENT SCHEDULE: Thetotal amount of the Grant is set forth in Article I, subject to the restrictions set forth herein. In awarding this Grant, the City assumes no obligation to provide financial support of any type whatsoever in excess of the total Grant amount. Cost overruns are the sole principal responsibility of the Grantee. The Grant funds will only be remitted to the Grantee once the.Mayor and City Commission have approved the grant award, and once all parties have executed this Agreement. 7. GRANT RESTRICTIONS: Grant funds awarded pursuant to this Agreement may not be used for the following expenditures: remuneration of City employees for services rendered as part of a project funded by this Grant; debt reduction; social and/or fundraising events; cash prizes; lobbying or propaganda materials; charitable contributions; or events not open to the public. 8. NO GUARANTEE OF FUNDING: The grantee acknowledges that the receipt of this grant does not imply a commitment on behalf of the City to continue or provide funding beyond the terms specified in this Agreement. 9. PROGRAM MONITORING AND EVALUATION: The City Manager or the City Manager's designee may monitor and conduct an evaluation of the Project under this Grant, which may include, with or without limitation, visits by City representatives to Grantee's offices and/or the site of any project funded by this Grant, to observe Grantee's programs, procedures, and operations, or to discuss the Grantee's programs with Grantee's personnel;and/or requests for submittal of additional documentation or written reports, prior to the Project completion date, evidencing Grantee's progress on the Project. 10. BANK ACCOUNTS AND BONDING: Grantee shall maintain all monies received pursuant to this Agreement in an account with a bank or savings and loan association that is located in Miami-Dade County. The Grantee shall provide the City with the name of the bank or savings and loan association, as well as the name and title of all individuals authorized to withdraw or write checks on Grant Funds. 11. ACCOUNTING AND FINANCIAL REVIEW: Funded activities by this Grant must take place during the City's fiscal year for which the Grant is approved (October 1 —September 30). The Grantee Page 4 shall keep accurate and complete books and records of all receipts and expenditures of Grant funds, in conformance with reasonable accounting standards. These books and records, as well as all documents pertaining to payments received and made in conjunction with this Grant, including,without limitation, vouchers, bills, invoices, receipts and canceled checks, shall be dated within the fiscal year for which they are approved and retained in Miami-Dade County in a secure place and in an orderly fashion by the Grantee for at least three (3) years after the Expenditure Deadline specified in in this Agreement. These books, records, and documents may be examined by the City, and/or its authorized representatives, at the Grantee's offices during regular business hours and upon reasonable notice. Furthermore,the City may, at its expense, audit or have audited,all the financial records of the Grantee, whether or not purported to be related to this Grant. Grantee costs or earnings claimed under this Agreement may not also be claimed under any other Agreement from the City of Miami Beach or from any other entity. Any claim for double payment by Grantee shall be a material breach of this Agreement. 12. PUBLICITY AND CREDITS: The Grantee must include the City logo and the following credit line in all publications related to this Grant: "This Project is funded in whole or in part by a grant from the City of Miami Beach." Grantee's failure to comply with this paragraph may preclude future grant funding from the City, in the same manner as if Grantee defaulted under this Agreement. '13. LIABILITY AND INDEMNIFICATION: Grantee shall indemnify and hold harmless the City and its officers, employees, agents, and contractors, from and against any and all actions (whether at law or in equity), claims, liabilities, losses, expenses, or damages, including, without limitation, attorneys' fees and costs of defense,for personal, economic, or bodily injury, wrongful death, or loss of or damage to property, which the City or its officers, employees, agents and contractors may incur as a result of claims, demands, suits, causes of action or proceedings of any kind or nature arising out of, relating to, or resulting from the performance of this Agreement by the Grantee or its officers, employees, agents, servants, partners, principals or contractors. Grantee 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 City, where applicable, including appellate proceedings, and shall pay all costs, judgments, and attorneys'fees which may issue thereon. Grantee expressly understands and agrees that any insurance protection required by this Agreement, or otherwise provided, shall in no way limit its obligation, as set forth herein, to indemnify, hold harmless, and defend the City or its officers, employees, agents, and contractors as herein provided. If the Grantee is a government entity, this indemnification shall only be to the extent and within the limitations of Section 768.28, Florida Statutes, subject to the provisions of that Statute whereby the Grantee entity shall not be held liable to pay a personal injury or property damage claim or judgment by any one person which exceeds the sum of $200,000, or any claim or judgment or portions thereof, which, when totaled with all other claims or judgments paid by the government entity arising out of the Page 5 same incident or occurrence, exceed the sum of$300,000 from any and all personal injury or property damage claims, liabilities, losses or causes of action which may arise as a result of the negligence of the Grantee entity. 14. ASSIGNMENT: The Grantee shall not be permitted to assign this Grant, and any purported assignment will be void, and shall be treated as an event of default pursuant to this Agreement. 15. COMPLIANCE WITH LAWS: The Grantee agrees to abide by and be governed by all applicable Federal, State, County and City laws, including but not limited to Miami-Dade County's Conflict of Interest and Code of Ethics Ordinance, as amended, which is incorporated herein by reference as if fully set forth herein, and Chapter 2, Article VII of the City Code, as amended, which is incorporated herein by reference as if fully set forth herein. 16. DEFAULT/TERMINATION PROVISIONS: In the event the Grantee shall fail to comply with any of the provisions of this Agreement,the City Manager or the City Manager's designee may terminate this Agreement and withhold or cancel all or any unpaid installments of the Grant upon giving five (5) calendar days written notice to the Grantee, and the City shall have no further obligation to the Grantee under this Agreement. Further, in the event of termination, the Grantee shall be required to immediately repay to the City all portions of the Grant which have been received by the Grantee, as of the date that the written demand is received. Any uncommitted Grant funds which remain in the possession or under the control of the Grantee as of the date of the Expenditure Deadline specified in this Agreement must be returned to the City within fifteen (15) days after the Expenditure Deadline. If such funds have been committed but not expended, the Grantee must request in writing from the City Manager an extension of the Expenditure Deadline which, if approved, shall be for a period not to exceed one (1) year. Grant funds which are to be repaid to the City pursuant to this Section are to be repaid upon demand by delivering to the City Manager a certified check for the total amount due, payable to the City of Miami Beach, Florida. These provisions shall not waive or preclude the City from pursuing any other remedies that may be available to it under the law. Notwithstanding the provisions of this Section, and without regard to whether City has exercised the Default provisions thereof, the City reserves the right, at its sole and absolute discretion, to discontinue funding of the Grant if it is not satisfied with the progress of the Project or the content of any required written report. In the event of discontinuation of the Grant or at the close of the Project, any unexpended Grant Funds shall be immediately returned to the City, except where the City Manager has agreed in writing to alternative use of the unused/unexpended Grant Funds. Page 6 17. INSURANCE REQUIREMENTS: A. Verification of Coverage Grantee shall provide the required insurance certificates, endorsements or applicable policy language effecting coverage required by this Section, as follows. All certificates of insurance and endorsements are to be received prior to any work commencing. However, failure to obtain 'the required coverage prior to the work beginning shall not waive the Grantee's obligation to provide them. The City of Miami Beach reserves the right to require complete, certified copies of all required insurance policies, including endorsements required by these specifications, at any time. i. Worker's Compensation Insurance as required by Florida Statute, Chapter 440, and Employer's Liability Insurance with limits of no less than $1,000,000 per accident for bodily injury or disease. ii. Commercial General Liability on a comprehensive basis, including products and completed operations, contractual liability, property damage, bodily injury and personal & advertising injury combined single limit of$1,000,000 per occurrence for bodily injury and property damage. City of Miami Beach must be shown as an additional insured with respect to this coverage. iii. Automobile Liability Insurance covering all owned, non-owned and hired vehicles used in connection with the work, in an amount not less than $500,000 combined single limit per occurrence for bodily injury and property damage. iv. Medical Malpractice Insurance in the name of the provider, in an amount not less than $1,000,000. B. Additional Insured Status The City of Miami Beach must be covered as an additional insured with respect to liability arising out of work or operations performed by or on behalf of the Grantee. C. Waiver of Subrogation Grantee hereby grants to City of Miami Beach a waiver of any right to subrogation which any insurer of the Grantee may acquire against the City of Miami Beach by virtue of the payment of any loss under such insurance. Grantee agrees to obtain any endorsement that may be necessary to affect this waiver of subrogation, but this provision applies regardless of whether or not the City of Miami Beach has received a waiver of subrogation endorsement from the insurer. Page 7 D. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best's rating of no less than A:VII, unless otherwise acceptable to the City of Miami Beach Risk Management Office. E. Special Risks or Circumstances The City of Miami Beach reserves the right to modify these requirements, including limits, based on the nature of the risk, prior experience, insurer, coverage, or other special circumstances. Certificate Holder Certificate holder must read: CITY OF MIAMI BEACH c/o HR Department/Risk Management Division 1700 Convention Center Drive Miami Beach, FL 33139 F. Compliance with the foregoing requirements shall not relieve the grantee of its liability and obligation under this section or under any other section of this Agreement. 18. NO WAIVER: No waiver of any breach or failure to enforce any of the terms, covenants, conditions or other provisions of this Agreement by either party at any time shall in any way affect, limit, modify or waive either party's right thereafter to enforce or compel strict compliance with every term, covenant, condition or other provision hereof. 19. WRITTEN NOTICES: Any notices required under this Agreement will be effective when delivered to the City in writing and addressed to the City Contract Administrator. Any notices required under this Agreement will be effective when delivered to the Grantee in writing and addressed to the Grantee Contract Administrator. • 20. CAPTIONS USED IN THIS AGREEMENT: Captions, as used in this Agreement, are for convenience of reference only and should not be deemed or construed as in any way limiting or extending the language or provisions to which such captions may refer. 21. CONTRACT REPRESENTS TOTAL AGREEMENT: This contract, including its special conditions and exhibits, represents the whole and total agreement of the parties. No representations, except those contained within this agreement and its attachments, are to be considered in construing its terms. No modifications or amendments may be made to this Agreement unless made in writing and signed by both parties. Any change to the Grant Amount shall require approval by appropriate action by the Mayor and City Commission. 22. CITY CONTRACT ADMINISTRATOR: All contract related questions, reports and requests for reimbursements to be submitted to the City Contract Administrator listed below. Page 8 Judy Hoanshelt Director, Grants Management Division City of Miami Beach Office of Budget and Performance Improvement 1700 Convention Center Drive Miami Beach, FL 33139 Tel: 305-673-7510/305-673-7000 ext. 26183 Fax: 786-394-4675 Email: judvhoanshelt(c�miamibeachfl.00v ARTICLE III/MISCELLANEOUS PROVISIONS 23. The Grant awarded herein is the result of a finding by the City, based on representatives, documents, materials and other information supplied by Grantee,that the Grantee is performing a public purpose through the programs, projects, and/or services recommended for support. As such, use of Grant funds for any program component not meeting this condition will be considered a breach of the terms of this Agreement and will allow the City to seek remedies including, but not limited to, those outlined in this Grant Agreement. 24. The Grantee also accepts and agrees to comply with the following Special Conditions: The Grantee hereby agrees that it will comply with Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.) prohibiting discrimination on the basis of race, color, national origin, handicap, or sex. The Grantee hereby agrees that it will comply with City of Miami Beach Human Rights Ordinance as codified in Chapter 62 of the City Code, as may be amended from time to time, prohibiting discrimination in employment, housing and public accommodations on account of actual or perceived race, color, national origin, religion, sex, intersexuality, gender identity, sexual orientation, marital and familial status, age, disability, ancestry, height, weight, domestic partner status, labor organization membership, familial situation, or political affiliation. The City endorses, and Grantee shall comply with, the clear mandate of the Americans with Disabilities Act of 1990 (ADA) to remove barriers, which prevents qualified individuals with disabilities from enjoying the same employment opportunities that are available to persons without disabilities. The City also endorses the mandate of the Rehabilitation Act of 1973 and Section 504 and prohibits discrimination on the basis of disability and requires that Grant recipients provide equal access and equal opportunity and services without discrimination on the basis of any disability. Page 9 25. GOVERNING LAW AND EXCLUSIVE VENUE: This Agreement shall be governed by, and construed in accordance with, the laws of the State of Florida, both substantive and remedial, without regard to principles of conflict of laws. The exclusive venue for any litigation arising out of this Agreement shall be Miami-Dade County, Florida, if in State court, and the U.S. District Court, Southern District of Florida, if in federal court. BY ENTERING INTO THIS AGREEMENT, GRANTOR AND GRANTEE 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. 26. FLORIDA PUBLIC RECORDS LAW: A. Grantee shall comply with Florida Public Records law under Chapter 119, Florida Statutes, as may be amended from time to time. B. The term"public records"shall have the meaning set forth in Section 119.011(12), which means all documents, papers, letters, maps, books, tapes, photographs, films, sound recordings, data processing software, or other material, regardless of the physical form,characteristics, or means of transmission, made or received pursuant to law or ordinance or in connection with the transaction of official business of the City. C. Pursuant to Section 119.0701 of the Florida Statutes, if the Grantee meets the definition of "Contractor"as defined in Section 119.0701(1)(a), the Grantee shall: i. Keep and maintain public records required by the City to perform the service; ii. 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; iii. 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 Grantee does not transfer the records to the City; iv. Upon completion of the Agreement, transfer, at no cost to the City, all public records in possession of the Consultant or keep and maintain public records required by the City to perform the service. If the Consultant transfers all public records to the City upon completion of the Agreement, the Grantee shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the Grantee Page 10 keeps and maintains public records upon completion of the Agreement,the Consultant 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 custodian of public records, in a format that is compatible with the information technology systems of the City. D. REQUEST FOR RECORDS; NONCOMPLIANCE i. 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 Consultant of the request, and the Grantee must provide the records to the City or allow the records to be inspected or copied within a reasonable time. ii. Grantee's failure to comply with the City's request for records shall constitute a breach of this 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. iii. A Grantee who fails to provide the public records to the City within a reasonable time may be subject to penalties under s. 119.10. E. CIVIL ACTION i. If a civil action is filed against a Grantee to compel production of public records relating to the City's contract for services, the court shall assess and award against the Grantee the reasonable costs of enforcement, including reasonable attorneys' fees, if: a. The court determines that the Grantee 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 Grantee has not complied with the request, to the City and to the Grantee. ii. A notice complies with subparagraph (i)(b) if it is sent to the City's custodian of public records and to the Grantee at the Grantee's address listed on its contract with the City or to the Grantee'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. Page 11 iii. A Grantee 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. F. IF THE GRANTEE HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE GRANTEE'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS AGREEMENT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT: CITY OF MIAMI BEACH ATTENTION: RAFAEL E. GRANADO, CITY CLERK 1700 CONVENTION CENTER DRIVE MIAMI BEACH, FLORIDA 33139 E-MAIL: RAFAELGRANADOAMIAMIBEACHFL.GOV PHONE: 305-673-7411 27. BOARD TRAINING: Pursuant to Resolution 2018-30552, Grantee is required to have 51% or more of its board membership complete the City's training for board members, if all three of the following apply: 1) the agency is a non-profit; 2) the agency has an annual operating budget of less than $5 million; and, 3) the grant award is for $25,000 or more in City funds. The Board Training must be completed within the last two years prior to the receipt of City funds. THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK. Page 12 EXHIBIT 1 PROJECT DESCRIPTION BACKGROUND/DESCRIPTION OF NEED The Grantee is a publicly funded provider of mental health services for the Miami Beach area. More than 65% of individuals served are identified as low income and/or without income. Linkage to services is deemed crucial for mental health care and treatment, as well as access to prescribed medication by the psychiatric provider. PROGRAM DESCRIPTION Grantee provides services as part of this Agreement by: 1) Operating the Aftercare program to assist residents and new clients who are transitioning from the hospital back to the community setting, and who are also experiencing an emotional/ psychiatric crisis of emergency proportions. 2) Paying for prescription medical co-payments on behalf of low-income elderly and disabled Miami Beach residents. The transition to the community is supported by the Aftercare provider who _ assists individuals to face challenges after a crisis. LOCATION Douglas Gardens Community Mental Health Center 1680 Meridian Avenue, Suite 501 Miami Beach, Florida 33139. GRANT ACTIVITIES Activity Activity Description Description of Service Number of Name Recipients Service Recipients Aftercare The Aftercare Case Manager meets Miami Beach residents being 500 clients Services with individuals discharged from a treated in an inpatient psychiatric unit, to engage in follow-up psychiatric facility or recently treatment and care. discharged from an inpatient episode of care. Prescription The prescription co-payment for Co-payment fees for 175 clients co-pay elderly and disabled residents enables medications prescribed by a individuals to maintain medication psychiatric provider. levels and achieve psychiatric stability. Page 13 1�1► GOALS/OUTCOMES Outcorrre-= easel - Target .:Reporting Timeline Linkage to mental health Aftercare follow-up within Approximately 500 Quarterly reporting services. seven (7) days post in- hospital discharge patient admission. clients will access service. STAFFING Position Title Description/Responsibilities to Grant Program Aftercare Case The Aftercare Case Manager will meet with staff and individuals regarding Manager needed services weekly while in-patient in the hospital. Subsequent services will be provided to link the individuals to appropriate needed services. • Page 14 EXHIBIT 2 PROJECT BUDGET Douglas Gardens Community Mental Health, Inc. Budget Line Item Description Project Budget Staff Salary and Wages: Salary for Aftercare Case Manager. $16,850 (Aftercare Case Manager) Approximately$1,404.17 monthly. Medication Co-Payments Cost per prescription varies; funds are $5,150 provided for an amount not to exceed line item subtotal. Total $22,000 1�+ Page 15 EXHIBIT 3 CITY OF MIAMI BEACH GRANT QUARTERLY STATUS REPORT FORM CMB GRANT AGREEMENT NO.: GRANTEE NAME: GRANTEE ADDRESS: GRANTEE CONTRACT ADMINISTRATOR: GRANTEE CONTRACT ADMINISTRATOR'S E-MAIL ADDRESS: REPORT PERIOD: ❑ Oct. 1 - Dec. 31 ❑ Jan. 1 —Mar. 31 ❑ Apr. 1 —Jun. 30 ❑ Jul. 1 -Sept.30 Due Jan. 15 Due Ap. 15 Due Jul. 15 Due Oct. 15 GOALS/OUTCOMES: Outcome Measure Target Accomplishments To-Date PROBLEM ENCOUNTERED: OTHER NOTABLE ITEMS: Grantee Report Prepared By: Name Signature/Date City of Miami Beach Report Reviewed By: Name Signature/Date Page 16 EXHIBIT 4 CITY OF MIAMI BEACH GRANT REIMBURSEMENT REQUEST FORM Part 1of2 CMB AGREEMENT NO.: GRANTEE NAME: GRANTEE ADDRESS: GRANTEE CONTRACT ADMINISTRATOR: GRANTEE CONTRACT ADMINISTRATOR'S E-MAIL ADDRESS: REQUEST No. Amount of Assistance 3� — _Less Previous Total Disbursements: L.-.-...._.__—...........__.................._..__.�_ Balance Available: Funds Requested This Disbursement: Certification of Payment: I certify that the above expenses were necessary and reasonable for the maintenance and operation of our premises and in accordance with this agreement. Grantee Report Prepared By: Name Signature/Date City of Miami Beach Report Reviewed By: Name Signature/Date Page 17