Okaloosa County BOCC — October 7, 2014 — AH105 OKALOOSA BCC amendment #7 renewal Fully Executed — reading text

http://www.flsenate.gov/Welcome/index.cfm?CFID=105701865&CFTOKE N=34016817 G. State Administrative Procedures and Services Chapter 120, F.S. Administrative Procedures Act Chapter 287, F.S. Procurement of Personal Property and Services Chapter 815, F.S. Computer - Related Crimes Section 112.061, F.S. Per diem and Travel Expenses* Section 112.3185, F.S. Additional Standards for State Agency Employees Section 215.422, F.S. Payments, Warrants & Invoices; Processing Times Section 216.181(16)(b), F.S. Advanced funds invested in interest bearing accounts *Travel Expenses are specified in the DFS Reference Guide for State Expenditures http://www.myfloridacfo.com/aadir/reference%5Fguide/reference_quide.htm Ill. FLORIDA ADMINISTRATIVE CODE (RULES) A. Child Welfare and Community Based Care All references to F.A.C. may be found at the following website: https://www.firules.org/default.asp Rule 65C-12, F.A.C. Emergency Shelter Care Rule 65C-13, F.A.C. Substitute Care of Children Rule 65C-14, F.A.C. Group Care Rule 65C-15, F.A.C. Child Placing Agencies B. Substance Abuse and Mental Health Services Rule 65C-12, F.A.C. Emergency Shelter Care Rule 65D-30, F.A.C. Substance Abuse Services Office Rule 65E-4, F.A.C. Community Mental Health Regulation Rule 65E-5, F.A.C. Mental Health Act Regulation Rule 65E-10, F.A.C. Psychotic and Emotionally Disturbed Children Purchase of Residential Services Rules Rule 65E-12, F.A.C. Public Mental Health, Crisis Stabilization Units, Short Term Residential Treatment Programs Rev.07/01/2014 Exhibit F PSMAI No. HC__ OCBOCC Page 4 Contract No. AH105 08/29/14 Exhibit F Performance Contract SAMH Services Program Rule 65E-14, F.A.C. Community Substance Abuse and Mental Health Services- Financial Rules Rule 65E-15, F.A.C. Continuity of Care Case Management Rule 65E-20, F.A.C. Forensic Client Services Act Regulation C. Financial Penalties Rule 65-29, F.A.C. Penalties on Service Providers Reduction/withholding of funds Rule 65-29.001, F.A.C. Financial Penalties for a Provider's Failure to Comply With a Requirement for Corrective Action IV. MISCELLANEOUS A. Department of Children and Families Operating Procedures CFOP 155-10, Services for Children with Mental Health & Any Co-occurring Substance Abuse Treatment Needs In Out of Home Care Placements http://Awww.dcf.state.fl.us/admin/publications/policies/155-10.pdf CFOP 215-6, Incident Reporting and Client Risk Prevention http://Awww.dcf.state.fl.us/publications/policies/215-6.pdf B. Federal Cost Principles OMB Circular A-21, Cost Principles for Educational Institutions http:/Awww.whitehouse.gov/omb/circulars_a021 2004 OMB Circular A-87, Cost Principles for State, Local and Indian Tribal Governments http:/Awww.whitehouse.gov/omb/circulars_a087_2004 OMB Circular A102, Grants and Cooperative Agreements with State and Local Governments http://www.whitehouse.gov/omb/circulars_a102 OMB Circular A-122, Cost Principles for Non-profit Organizations http:/Awww.whitehouse.gov/omb/circulars_a122 2004 C. Audits OMB Circular A-133, Audits of States, Local Governments and Non-Profit Organizations Rev.07/01/2014 Exhibit F PSMAI No. HC_ OCBOCC Page 5 Contract No. AH105 08/29/14 Exhibit F Performance Contract SAMH Services Program http://www.whitehouse.gov/sites/default/files/omb/assets/a133/a133 revised 200 Z.pdf Section 215.97, F.S., Florida Single Audit Act http://Awww.leg.state.fl.us/statutes/index.cfm?App mode=Display Statute&Search String=&URL=0200-0299/0215/Sections/0215.97.htm| Comptrollers Memorandum #03 (1999-2000): Florida Single Audit Act Implementation http:/Awww.myfloridacfo.com/aadir/cm0/cm990003.htm D. Administrative Requirements 45 CFR, Part 74 - Uniform Administration Requirements for Awards and Subawards to Institutions of Higher Education, Hospitals, other Non-Profit Organizations and Other Commercial Organizations http://www.access.gpo.gov/nara/cfr/waisidx_06/45cfr74_06.html 45 CFR, Part 92 - Uniform Administration Requirements (State and Local Governments)\ http://www.access.qpo.gov/nara/cfr/waisidx _06/45cfr92_06.html OMB Circular A110, Uniform Administrative Requirements for Grants and Other Agreements http://www.whitehouse.gov/omb/circulars/a110/a110.html E. Data Collection and Reporting Requirements Rule 65E-14.022, F.A.C. https://www. flrules.org/qateway/ruleNo.asp?ID=65E-14.022 Section 397.321(3)(c), F.S., Data collection & dissemination system http://www.leg.state.fl.us/Statutes/index.cfm?App mode=Display Statute&Searc h_String=&URL=0300-0399/0397/Sections/0397.321.html Section 394.74(3)(e), F.S., Data Submission http://www.leg.state.fl.us/Statutes/index.cfm?App mode=Display Statute&Searc h_String=&URL=0300-0399/0394/Sections/0394.74.html Section 394.77, F.S., Uniform management information, accounting, and reporting systems for providers. http://www.leg.state.fl.us/Statutes/index.cfm?App mode=Display Statute&Searc h_String=&URL=0300-0399/0394/Sections/0394.77.html CFP 155-2, Mental Health and Substance Abuse Data Measurement Handbook http://www.dcf.state.fl.us/programs/samh/pubs _reports.shtml Rev.07/01/2014 Exhibit F PSMAINo. HC__ OCBOCC Page 6 Contract No. AH105 Integrated Rate/Purchase of Service Contract SAMH Services Program EXHIBIT E Section! INVOICE Provider Name: Okaloosa County Board of County Commissioners Regular Address: Final Contract #:AH105 Time Period: To Date: / / [Section | State Activity/ No. Clients} Contract Units State Collection | Collection Billable Cost Center Served Rate Provided Cost Source Amount Amount 1 2 3 4 5 6 7 8 Drug Court Case Manager $ 2,275.92 Forensic Mental Health $ 4,079.00 Mental Health Court Case Manager $ 3,922.97 MH Pretrail Officer $ 3,093.44 TOTAL INVOICE AMOUNT = $ Section Ill | Vendor ID: This Section to be completed by the Department. ORG: Code Invoice No, | Amount Owed] Gategory Fund OCA Amount Due |) Adv Balance | Recoup | Due (owed) MSA11 MHAO9 |Section IV | | certify that the above invoice is a true and accurate reflection for this period's activities as stipulated in this contract Signature of Agency Official Title CF-MH 1048, Jul 2006 (07/01/2011) Exhibit E Page 1 PSMAI No. HC07 Contract No. Integrated Rate/Purchase of Service Contract SAMH Services Program EXHIBIT E-1 INVOICE ATTACHMENT Provider Name: Regular Address: Final Vendor ID: Contract #: Time Period: To Date: / / Social Clients Served Security Contract Units State Collection Collection Billable By Activity/Cost Center Number Rate Provided Cost Source Amount Amount 1 2 3 4 5 6 7 8 (Activity/Cost Center) List Client Names Sub-Total $ $ $ (Activity/Cost Center) List Client Names Sub-Total $ $ $ (Activity/Cost Center) List Client Names Sub-Total $ $ $ GRAND TOTALS = $ $ $ I certify that the services itemized on this invoice have been provided and are in accordance with terms and conditions of this contract. Signature of Agency Official Title This document contains confidential information that shall be secured from unauthorized access in accordance with ss. 394.455(3), 394.4615, 397.501(7), F.S. This Exhibit is not required to follow the Exhibit B (Invoice) through the full payment cycle. CF-MH 1048, Jul 2006 Exhibit E-1 PSMAI No. HCO7 (07/01/2011) Page 2 Contract No.