SCP2 DCF RFP 2324 099.pdf

CONTRACT NO. [Enter Contract No.]

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EXHIBIT A – SPECIAL PROVISIONS

The following provisions supplement or modify the provisions of Items 1 through 11 of the Standard Contract Part One, as provided herein:

A.1. ENGAGEMENT, TERM AND CONTRACT DOCUMENT

Standard Contract, Section 1.4.1.1, is hereby added to read:

A.1.1. CBC Lead Agency – Per subsection 409.986(3)(d), a single entity with which the

Department has a contract for the provision of care for children in the child protection and child welfare system in a community that is no smaller than a county and no larger than two contiguous judicial circuits.

A.1.2. Child Maltreatment – Any willful act or threatened act that results in any physical, mental, or sexual injury or harm that causes or is likely to cause the child’s physical, mental, or emotional health to be significantly impaired. Child maltreatment includes acts or omissions.

A.1.3. Home Visit – A visit performed in a home or occasionally another suiteable location for the purpose of service provision.

A.1.4. Home Visitor – The Home Visitors shall be licensed Registered Nurses (RN). Home Visitors should facilitate referrals to family-centered treatment and recovery services for those with probable substance use disorders and address the social and emotional needs of the Focus Children and young children in families affected by substance use.

A.1.5. Medical Assistance Treatment (MAT) – Use of FDA approved medications, in combination with counseling and behavioral therapies, to provide a “whole patient” approach to the treatment of substance abuse disorders.

A.1.6. Plan of Safe Care – To address the nation’s prescription drug and opioid epidemic Congress passed the Comprehensive Addiction and Recovery Act of 2016. Section 503 of the act adds provisions to the Child Abuse Prevention and Treatment Act (CAPTA) related to infants who are affected by prenatal substance exposure. A Plan of Safe Care must address the needs of both the infant and affected family members. A Plan of Safe Care ensures the mother, infant and family members receive the necessary supports to prevent the negative outcomes associated with an infant’s prenatal exposure to substance use. A Plan of Safe Care must be developed, implemented and monitored for infants who have been affected by exposure to controlled substances or alcohol. A Plan of Safe Care is intended to be developed at the earliest point the mother’s use or infant’s exposure has been identified. In addition, home visitors will provide referrals for voluntary services tailored to the families’ needs.

A.1.7. State Fiscal Year (SFY) – A continuous twelve (12) calendar month period of time beginning on July 1 of each calendar year and ending on June 30 of each calendar year.

A.1.8. State of Florida Approved Holidays – A maximum of nine (9) days during a calendar year.

These days are limited to the following: New Year’s Day, Birthday of Martin Luther King, Jr., Memorial Day, Independence Day, Labor Day, Veteran’s Day, Thanksgiving, and Christmas Day. If any of these holidays fall on Saturday, the preceding Friday shall be observed as a holiday. If any of these holidays fall on Sunday, the following Monday shall be observed as a holiday.

A.1.9. Substances – May include legal or illegal substances, controlled substances, or alchohol.

A.1.10. Focus Child – A child whose birth resulted in the family being eligible for services.

A.1.11. Warm Handoff - Ensuring the client is connected with someone who can provide what he or she needs.

A.2. STATEMENT OF WORK

See Exhibit B.

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A.3. PAYMENT, INVOICE AND RELATED TERMS

See Exhibit F.

A.4. GENERAL TERMS AND CONDITIONS

There are no additional provisions to this section of the Standard Contract.

A.5. RECORDS, AUDITS AND DATA SECURITY

There are no changes or additions to this section.

A.6. INSPECTIONS, PENALTIES, AND TERMINATION

There are no additional provisions to this section of the Standard Contract.

A.7. OTHER TERMS

There are no additional provisions to this section of the Standard Contract.

A.8. FEDERAL FUNDS APPLICABILITY

There are no additional provisions to this section of the Standard Contract.

A.9. CLIENT SERVICES APPLICABILITY

There are no additional provisions to this section of the Standard Contract.

A.10. PROPERTY

There are no additional provisions to this section of the Standard Contract.

A.11. AMENDMENT IMPACT

There are no additional provisions to this section of the Standard Contract.

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EXHIBIT B – SCOPE OF WORK

B.1. SCOPE OF SERVICE

This evidence-based Home Visiting prevention program is focused on serving infants who are prenatally affected by controlled substances, either legal or illegal, or alcohol, and their families.

The services shall connect parents or caregivers with knowledgeable professionals on subjects such as infant care, substance use treatment and support, child development and knowledge of parenting, concrete supports, family functioning/resiliency, nurturing and attachment, children’s social and emotional competence, and social supports.

B.2. MAJOR CONTRACT GOALS

The major goal of this Contract is to ensure that infants prenatally affected by substance use and their families receive evidence-based early intervention Home Visiting services. Additional program goals include increased rate of positive child development, parent/caregiver child attachment, improved birth outcomes, improved school readiness, and increased stability and health of the entire family unit.

B.3. SERVICE AREA/LOCATIONS/TIMES

B.3.1. The Provider’s administrative offices shall be located at the address specified in Standard

Contract Part One, Section 1.3.3.

B.3.2. The Provider’s administrative offices shall be open from 8:00 A.M. to 5:00 P.M., Eastern

Standard Time, Monday through Friday, with the exception of the Provider’s board-approved holidays. Providers shall meet at times and locations convenient and comfortable for the families, this includes after-hours sessions.

B.3.3. The Provider shall notify the Contract Manager, in writing, thirty (30) calendar days in advance of any changes in the street or mailing address, telephone number, electronic mail address, or facsimile number that affects the Department’s ability to contact the Provider.

B.3.4. Changes in service times and any additional holidays that the Provider wants to observe require approval in writing by the Department.

B.4. CLIENTS TO BE SERVED

Clients to be served include pregnant women and/or parents of infants prenatally affected by substance use. If possible, services should begin as early as a substance use concern is identified, but no later than a child’s first birthday. Services for clients may continue after the Focus Child turns one (1) year old. Clients must agree to participate, as all services are voluntary.

B.5. CLIENT ELIGIBILITY

A client must be pregnant and substance use has been identified as a concern, or a client must be caring for a child under age one (1) who has been affected prenatally by substance use.

B.5.1. A client may continue to receive services after the Focus Child’s first birthday based on the fidelity of the model and the identified needs of the client who agrees to continue to receive services.

B.5.2. Pregnant women with probable substance use who are currently involved in the child welfare system are eligible for services.

B.5.3. Clients currently involved or working with another voluntary Home Visiting program are not eligible.

B.5.4. Other minor children living in the same home as the Focus Child shall have their needs identified and addressed.

B.5.5. Parents with substance use concerns will receive services and treatment.

B.6. CLIENT DETERMINATION

The delivery of services under this Contract shall be based on the fidelity of the evidence-based model, concerns that the Focus Child has been affected prenatally by substance use, and the parent or caregiver’s willingness to participate. All services are voluntary and must be in cooperation with the parent or caregiver. The Provider shall determine initial and ongoing eligibility based on the terms and conditions of the Contract, and the Department will make the final determination in the event of a dispute.

B.7. EQUIPMENT

Equipment, property, and information technology resources may be purchased in accordance with Standard Contract Part One, Section 10, Property, and Section F.6. Information and Technology Resources (ITR). All property purchased under Contract #______ between the Provider and the Department shall be listed on a property inventory list as described in Section C.2.7, Reports, and Standard Contract Part One, Section 10, Property. The Provider shall list all property/equipment purchased under this Contract on a property/equipment inventory list. Said listing shall include a description and location of the property. A copy of the inventory list is to be maintained in the Contract Manager’s file.

B.8. CONTRACT LIMITS

The Provider recognizes and agrees that any and all work performed without specific direction from the Department shall be deemed to be gratuitous and not subject to charge by the Provider or compensation by the Department.

EXHIBIT C – TASK LIST

The Provider shall perform all functions necessary for the proper delivery of services including, but not limited to, the following:

C.1. SERVICE TASKS

The delivery of services under this Contract shall be based on the parent’s/caregiver’s willingness to participate and the infant (i.e. Focus Child) having been prenatally affected by substance use. To prevent child maltreatment the Provider shall perform the following tasks for eligible clients:

C.1.1. Referrals. The Provider shall accept referrals for potential clients from the following entities including, but not limited to: child welfare professionals, pediatricians, Child Protection Team, OBGYN or prenatal providers, hospitals and birthing centers, and midwives.

C.1.2. Schedule Home Visit. The Provider shall make a concerted effort to contact potential clients resulting from the referrals to determine eligibility and schedule Home Visits.

C.1.3. Home Visit. Visits should focus on linking pregnant women with prenatal care, promoting strong parent-child attachment, coaching parents on learning activities that improve their Focus Child’s development, and providing substance use counseling and services.

C.1.3.1. The Provider shall provide comprehensive support services to eligible children and their caregiver/guardian, including:

C.1.3.1.1. Initial Assessment. An assessment of each Focus Child and parent/caregiver referred to the Provider.

C.1.3.1.2. Plan of Safe Care. The Provider shall develop a Plan of Safe Care or assess an existing plan for modification for each family in concert with the family.

C.1.3.1.3. The Home Visitor shall seek the cooperation of all household members and engage with the family during the period that the family is being served by the Provider.

C.1.3.1.4. The Provider shall conduct regular screening to help identify possible infant health and developmental concerns.

C.1.3.1.5. Based on the needs identified through the families’ disclosure, Plan of Safe Care or other assessment, the Provider shall provide one-on-one skill building, services or linkages of services to the family, Warm Handoffs for referrals to community partners, and individualized education to parent’s and caregivers.

C.1.4. Community Partners. The Provider shall connect and collaborate with community partners.

C.1.4.1. The Provider shall collaborate with the following entities, including but not limited to:

C.1.4.1.1. Lead Agencies;

C.1.4.1.2. Hospitals;

C.1.4.1.3. Treatment providers;

C.1.4.1.4. OB/GYN;

C.1.4.1.5. Midwives;

C.1.4.1.6. Pediatricians;

C.1.4.1.7. Child Protective Investigators (CPI);

C.1.4.1.8. County Health Departments; or C.1.4.1.9. Any community or State entity providing referral services.

C.1.4.2. Clinical Treatment and Community Supports. The Provider’s services shall include approaches to coordinate and create linkages with clinical treatment and community supports. Clinical treatments include but are not limited to: non-judgmental screening and assessment, MAT, treatment planning, mental health services, case management, or continuing care. Community supports include, but are not limited to: recovery support, family strengthening, childcare, transportation, education, or employer support services.

C.1.5. Travel. The Provider may be reimbursed for travel related to Home Visits and training, in accordance with Sections C.2.6.3, services may cover multiple counties/circuits and require an overnight stay. The Provider may also travel for the purpose of coordinating with community partners to provide services to the Focus Children and their families. Travel will be reviewed and approved by the Department.

C.1.6. Training. The Provider may attend trainings related to providing Home Visiting services upon Department approval.

C.1.7. Outreach. To raise awareness of Home Visiting and referral services to the community partners and eligible families, the Provider may publicize the program and engage in outreach.

C.1.7.1. All materials created or purchased for the outreach services shall be reviewed and approved by the Department.

C.1.8. Service Termination. The Provider shall provide notice to the family when their services are terminated.

C.1.9. Successful Completion of Program. The Provider shall report the number of families who successfully complete the Home Visiting services at the end of each contract year. A successful completion is defined as a family that completes the service tasks and identified needs of the PSC that are mutually agreed upon between the Provider and the family. The concerns of the family have been addressed, and the Provider has documented observable progress that the family has made in meeting their goals.

C.1.10. The Provider shall report to the Department the percentage of families that have been reported to the Florida Abuse Hotline and documented in FSFN for substantiated child maltreatment from the total group of families that have successfully completed the program 12 months ago or longer.

C.2. ADMINISTRATIVE TASKS

C.2.1. Staffing

C.2.1.1. Staffing Levels. The Provider shall maintain the full-time equivalent positions to consistently and reliably provide the required services.

C.2.1.1.1. Provider Representative Position: The Provider shall have a representative, as identified in Section 1.2.3., Standard Contract Part One , assigned to administer all aspects of the Contract.

C.2.2. Professional Qualifications C.2.2.1. The minimum qualifications of staff described in Section C.2.1.1, Staffing Levels, are established in the Provider’s position description narratives, which are hereby incorporated by reference, and maintained in the Department’s contract file.

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C.2.3. Staffing Changes C.2.3.1. Upon change or vacancy in any of the Full Time Equivalent (FTE) staff positions described in Section C.2.1.1, Staffing Levels, the Provider shall notify the Contract Manager, in writing, within five (5) calendar days of the change or vacancy.

C.2.3.2. Any change in the Provider Representative, identified in Section 3.2, Standard Contract Part 1 , shall be provided by the Provider to the Department’s Contract Manager, immediately, in writing.

C.2.4. Subcontracting C.2.4.1. This Contract allows the Provider to subcontract for the provision of all services under this Contract, subject to the provisions of Section 4.4, Standard Contract Part 1.

The subcontractor at any tier level must comply with the E-Verify clause as subject to the same requirements as the Provider. Written requests by the Provider to subcontract for the provision of services under this Contract shall be routed through the Contract Manager for Department approval.

C.2.4.2. The Provider may subcontract with, including but not limited to, an organization, agency or business that specializes in substance use treatment, mental health services, infant and child health, infant mental health, and/or child brain development.

C.2.4.3. The request to subcontract shall be reviewed and if approved, approval shall be in writing by the Contract Manager prior to procurement of the subcontract. Payment to the Provider shall not be authorized until Contract Manager approval is obtained.

C.2.4.4. A copy of each executed subcontract shall be provided to the Contract Manager within ten (10) calendar days of the execution date of the subcontract. Payment to the Provider shall not be authorized until Contract Manager is in receipt of each executed Subcontract.

C.2.4.5. The Contract Manager shall review any request to amend any subcontract prior to the execution of the amendment and if approved, approval shall be in writing.

C.2.4.6. A copy of each subcontract amendment shall be provided to the Contract Manager within ten (10) calendar days of the execution date of the Subcontract amendment.

C.2.4.7. The Department’s agreement to allow these services to be subcontracted does not in any way alter the Provider’s responsibility to the Department for all work performed under this Contract.

C.2.5. Coordination with Other Agencies.

C.2.5.1. The Provider shall coordinate with referral sources and other providers currently or previously providing services.

C.2.5.2. The Provider may collaborate with the local CBC Lead Agency, Department , and other local entities to coordinate referrals for the children.

C.2.5.3. The failure on the part of other entities does not alleviate the responsibility of the

Provider to perform required tasks under the Contract.

C.2.6. Records and Documentation

The Provider shall maintain the following records and documentation:

ADMINISTRATIVE DOCUMENTS

# Title Due Date # Copies Contents

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1. Civil Rights Compliance

Checklist

Due on or prior to contract begin date and annually thereafter

1 electronic Form CF-0946

2. Statement of No Involvement

Due on or prior to contract begin date

1 electronic Form CF-1130

3. Certification Regarding Debarment

Due on or prior to contract begin date

1 electronic Form CF-1125

4. Authorized Signature

Authority for the Provider’s

Representative to Sign Contract

Due on or prior to contract begin date

1 electronic Authorized Signature Authority for the Provider’s Representative to sign contract

5. Authorized Signature

Authority for the Provider’s

Representative to Sign Invoices

Due on or prior to contract begin date

1 electronic Authorized Signature Authority for the Provider’s Representative to

Sign Invoices

6. General Liability Insurance

Due on or prior to contract begin date and annually thereafter

1 electronic Certificate of Insurance

7. Security Agreement Form

Upon staff employment by the

Grantee, Subcontractors to

Grantee

1 electronic CF-0114 Form

FEDERAL DOCUMENTS

8. FFATA

Due on or prior to contract start date and annually thereafter

1 electronic Form CF-1111

9.

HHS On-Line

Monthly Summary Report

Due on the 5th of every month

1 electronic copy

SPOC will enter the Monthly Summary Report directly into the database https://fs16.formsite.com/DCFTrainin g/Monthly-Summary- Report/form_login.html and forward confirmation of submission to the Contract Manager.

See Section 9.3 Standard Contract Part One

FISCAL DOCUMENTS

https://fs16.formsite.com/DCFTraining/Monthly-Summary-Report/form_login.html https://fs16.formsite.com/DCFTraining/Monthly-Summary-Report/form_login.html

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10. Financial and Compliance Audit

One hundred-eighty

(180) days after the end of each State

Fiscal Year.

See Attachment 4 See Attachment 4

C.2.6.1. The Provider shall work with the Department to ensure the reliability of data collected through established reporting formats appropriate to the program.

C.2.6.2. The Provider shall maintain all source documents or supporting documentation used to determine compliance with performance measures and deliverables.

C.2.6.3. Copies of travel logs and requests for reimbursement for staff travel, including

Authorization to Incur Travel DFS-AA-13 and Voucher for Reimbursement of Traveling Expenses DFS-AA-15.

C.2.6.4. The Provider shall keep accurate records to support the Monthly reports and any Departmental performance standards required, including:

C.2.6.4.1. Records for each family shall contain;

C.2.6.4.2. Documentation of the Initial Assessment including the results of any screening or assessment tool used and any collateral information collected during the Initial Assessment;

C.2.6.4.3. Summary of visits, referrals, and service provision; and C.2.6.4.4. Documentation of Plan of Safe Care coordination services provided.

C.2.7. Reports (programmatic and to support payment)

The Provider shall deliver the following reports to the Contract Manager to document the completion of deliverables as specified in Exhibit D, Deliverables, that shall be received by the Contract Manager prior to the Request for Payment and approved by the Contract Manager prior to authorizing payment for each state fiscal year in accordance with the schedule below. If the due date for a report falls on a State of Florida Approved Holiday or weekend, the report will be due the next business day.

REPORTS SCHEDULE

# Title Due Date # Copies Contents

1. Performance

Measures Compliance Report

By the 15th calendar day of the month, following the previous month of service.

electronic copy

See Attachment 1

2. Request for Payment

By the 15th calendar day of the month, following the previous month of service.

electronic copy

See Attachment 2

3. Monthly Activity Report

By the 15th calendar day of the month, following the previous month of service.

electronic copy

See Attachment 3

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REPORTS SCHEDULE

# Title Due Date # Copies Contents

4. Inventory

Report Annually on June 30th and 30 days prior to the completion of the Contract.

electronic copy

See Section 10, Property of Standard Contract Part One

C.2.7.1. Delivery of reports shall not be construed to mean acceptance of those reports.

Acceptance of required reports shall constitute a separate act and must be approved by the Contract Manager as such.

C.2.7.2. The Department reserves the right to reject reports as incomplete, inadequate, or unacceptable according to the limits set forth in this Contract. The Provider shall, without additional compensation, correct or revise any incomplete, inadequate, or unacceptable reports.

C.2.7.3. The Department, at its option, may allow additional time for the Provider to remedy the objections noted by the Department, or the Department may, after giving the Provider a reasonable opportunity to make a report complete, adequate, or acceptable to the Department, declare this Contract is in default.

C.2.7.4. The Provider shall work with the Department to ensure the reliability of data collected through established reporting formats appropriate to the program.

C.3. STANDARD CONTRACT REQUIREMENTS Provider will perform all acts required by Sections 4, 5, 7, 8 and 9 of Standard Contract Part One.

EXHIBIT D – DELIVERABLES

D.1. Service Units

D.1.1. A unit of service is described in Exhibit F, Method of Payment. Each unit of service shall be delivered in accordance with the terms and conditions of this Contract and performed in a manner acceptable to the Department.

D.2. Deliverables D.2.1. The Provider shall maintain and deliver the following to the Contract Manager to document the completion of deliverables. Documentation of the completed deliverable shall be received by the Contract Manager by the listed due date and prior to the Request for Payment for approval by the Contract Manager prior to authoring payment. If the due date falls on a State of Florida Approved Holiday or weekend, the deliverable documentation will be due the next state business day.

# Title Due Date # Copies Contents

1. Performance

Measures Compliance Report

By the 15th calendar day of the month, following the previous month of service.

electronic copy

The Provider shall report their performance under the contract to the Department.

See Attachments 1

2. Maintain a Single Point of Contact (SPOC) for Support to the Deaf or Hard of Hearing - List

By the 5th day of each Quarter for the previous Quarter from each Provider and their sub-providers to include any change in the Single Point of Contact copy

Single Point of Contact list for the provider and each subcontractor to include:

1. Name

2. Position/Title

3. Agency

4. Street Address

5. Mailing Address

6. Telephone Number

7. Email address

3. HHS On-Line Monthly Summary Report

By the 15th calendar day of the month, following the previous month of service.

electronic copy

SPOC will enter the Monthly Summary Report directly into the database https://fs16.formsite.com/DCFTraining/M onthly-Summary-Report/form_login.html and forward confirmation of submission to the contract manager.

4. Monthly Activity Report

By the 15th calendar day of the month, following the previous month of service.

electronic copy

1. The Provider shall report the number of:

2. Referrals received;

3. Successful contacts made with referred families within the first 30-days of the referral received;

4. Families willing to engage in services;

5. Initial assessments completed for each family;

6. Plan of Safe Care created/modified for families receiving services;

# Title Due Date # Copies Contents

7. Families who received referrals from the Provider;

8. Total number of Home Visits performed each Month;

9. Families that received Monthly Home

Visits;

10. Families actively receiving Home

Visiting services;

11. Families who completed services;

12. Families who did not complete services and terminated services.

See Attachment 3

5. Assessment Tool Section C- 1.3.1.2

Due 10 days after Contract is executed.

electronic copy

Series of questions to ask the family which provides information to the Provider on the family and helps to inform service provision.

8. Inventory Report Section B-7

Annually before June 30th copy

See Section 10, Property, of Standard Contract Part One

9. Annual Successful Completion Report Section C-1.9

Annually 30 days following the end of the fiscal year.

electronic copy

The Provider shall report the number of families who successfully complete the Home Visiting services at the end of each contract year.

The Provider shall report to the Department the percentage of families that have been reported to the Florida Abuse Hotline and documented in CCWIS for substantiated child maltreatment from the total group of families that have successfully completed the program 12 months ago or longer.

10. Reports to the Florida Abuse Hotline

Annually 30 days following the end of the fiscal year.

electronic copy

The Provider shall report to the Department the number of families that have been reported to the Florida Abuse Hotline and documented in CCWIS for substantiated child maltreatment from the total group of families that have successfully completed the program 12 months ago or longer.

D.2.2. The Department reserves the right to reject reports, documents and/or deliverables as incomplete, inadequate, or unacceptable according to the limits set forth in this Contract.

The Provider shall, without additional compensation, correct or revise any incomplete, inadequate, or unacceptable reports, documents and/or deliverables.

D.3. MINIMUM LEVEL OF SERVICE FOR DELIVERABLES

D.3.1. The minimum level of service for each deliverable shall be:

D.3.1.1. Services shall be delivered by the dates set out in Exhibit D.2.1.

D.3.1.2. Evidence of proper completion of each deliverable through submission of required documentation set out in Exhibit D.2.1.

D.3.1.3. Services shall be in compliance with Exhibit D, as applicable.

EXHIBIT E – MINIMUM PERFORMANCE MEASURES

E.1. MINIMUM PERFORMANCE MEASURES

See Attachment 1, Performance Measure Compliance Report, for a description of performance measures.

E.1.1. Performance Evaluation Methodology.

E.1.1.1 Performance Standards Statement: By execution of this Contract, the Provider hereby acknowledges and agrees that its performance under the Contract must meet the standards set forth above and will be bound by the conditions set forth in this Contract. If the Provider fails to meet these standards, the Department, at its exclusive option, may allow a reasonable period, not to exceed six (6) months, for the Provider to correct performance deficiencies. If performance deficiencies are not resolved to the satisfaction of the Department within the prescribed time, and if no extenuating circumstances can be documented by the Provider to the Department’s satisfaction, the Department must terminate the Contract. The Department has the sole authority to determine whether there are extenuating or mitigating circumstances.

E.1.2. Performance Measures for SFY 2024-2025.

# Performance Measure Performance Evaluation Methodology

1. The Provider will serve a minimum of 480 unduplicated families per contract year – a minimum of 40 unduplicated families per month.

The provider shall provide services to at minimum number of unduplicated families per month. The Provider shall report the number of families that received any services as stated in C.1 Service Tasks.

2. For families who were successfully contacted by the Provider and who request services, the Provider shall perform an initial assessment of 95% of families within 30 days of contact.

The Provider shall perform an initial assessment of the families for which they provide services.

The Provider shall report the number of initial assessments completed within 30 days of contact for families that voluntarily agree to receive services during the service period divided by the number of families who should have had an initial assessment within the reporting period and report the percentage. 95% of initial assessments must be completed within 30 days of contacting the family.

3. 85% of infant program participants will have a Plan of Safe Care in place within 30 days of their enrollment date. Enrollment is defined as having completed the program’s initial assessment. The Provider shall create or modify a Plan of Safe Care (PSC) for all the Focus Children and their families who volunteer to receive their services and consent to a PSC.

The Provider shall report the total number of focus children who had a Plan of Safe Care executed within 30 days of the completion of the initial assessment during the reporting period divided by the total number of focus children in the reporting period and report the percentage.

85% of infant program participants will have a PSC in place within 30 days of their initial assessment.

4 80% of program participants scoring positive for depression will receive a Mental Health Service that treats depression within 15 days of the positive score’s date.

The Provider shall report on the total number of clients that were referred for mental health services within 15 days of a positive score on a depression assessment during the reporting period divided by the program’s total number of positive depression scoring clients in the reporting period, and report the percentage.

5. The Provider shall perform Home Visits with the families they serve on a minimum of a monthly basis, throughout the period in which the family is being actively served. 90% of participating families will receive a minimum of one home visit each the month.

The Provider will perform minimum a monthly Home Visit with each family they serve. The Provider shall report the number of families that received a monthly Home Visit during the reporting period divided by the number of active families enrolled in the program.

6. 80% of families served will successfully complete the Home Visiting services at the end of each contract year. A successful completion is defined as a family that completes the service tasks and identified needs of the PSC that are mutually agreed upon between the Provider and the family.

The concerns of the family have been addressed, and the Provider has documented observable progress that the family has made in meeting their goals.

Annually 30 days following the end of the fiscal year.

The Provider shall report the number of families who successfully complete the Home Visiting services at the end of each contract year.

7. 70% of the families that have successfully completed the program will not have been reported to the Florida Abuse Hotline and documents in CCWIS for substantiated child maltreatment.

Annually 30 days following the end of the fiscal year.

The Provider shall report to the Department the percentage of families that have been reported to the Florida Abuse Hotline and documented in CCWIS for substantiated child maltreatment from the total group of families that have successfully completed the program 12 months ago or longer.

EXHIBIT F – METHOD OF PAYMENT

F.1. This is a cost reimbursement multi-year contract. The Provider shall be reimbursed for allowable expenditures for the delivery of services pursuant to the terms of the contract not to exceed $TBD for cost reimbursement. This Contract is funded by and subject to annual legislation appropriations and Department approval for continued funding with the Provider for services. The annual funding levels, subject to availability of funds, are as follows:

State Fiscal Year

(SFY)

Dollar amount

SFY 2024-2025 $ TBD

SFY 2025-2026 $ TBD

SFY 2026-2027 $ TBD

F.1.1. All costs associated with the delivery of services must be in accordance with the

Department of Financial Services’ Reference Guide for State Expenditures:

https://myfloridacfo.com/docs-sf/accounting-and-auditing-libraries/state-agencies/reference-guide-for-state-expenditures.pdf?sfvrsn=b4cc3337_2

F.1.2. Funds received under this title will supplement, not supplant, other State and local public funds designated for the start-up, maintenance, expansion, and redesign of community-based and prevention-focused programs and activities designed to strengthen and support families to prevent child abuse and neglect.

F.1.3. Funding Sources Child Abuse Prevention And Treatment Act (CAPTA) Grant COMPS-805.pdf (govinfo.gov)

F.2. Invoice Requirements

F.2.1. The Provider shall submit its invoice for expenditures for reimbursement on a monthly basis through submission of a properly completed invoice, Request for Payment, Attachment 2, within 15 (#) calendar days following the Month for which payment is being requested.

F.2.2. Notwithstanding the provisions of s. 215.422(1), F.S., the Department shall have ten (10) working days to inspect and approve the Request for Payment.

F.3. Service Delivery Documentation Requirements The Provider shall maintain records documenting the total number of recipients and names (or unique identifiers) of recipients to whom services were provided and the date(s) that the services were provided so that an audit trail documenting service provision can be maintained.

F.4. Restriction of Expenditures Items expressly prohibited from purchase with these contract funds include but are not limited to items such as: flowers, awards or plaques, meals (excluding meals associated with travel per Chapter 112, F.S.) including bottled water, snacks, refreshments, entertainment, and promotional items that do not have a specific statutory authority including but not limited to ribbons and wrist bands.

F.5. Expenditures https://myfloridacfo.com/docs-sf/accounting-and-auditing-libraries/state-agencies/reference-guide-for-state-expenditures.pdf?sfvrsn=b4cc3337_2 https://myfloridacfo.com/docs-sf/accounting-and-auditing-libraries/state-agencies/reference-guide-for-state-expenditures.pdf?sfvrsn=b4cc3337_2

Expenditures shall meet the minimum requirements established by the Department of Financial Services, Division of Accounting and Auditing, Bureau of Auditing, Reference Guide for State Expenditures, which is available at the Department of Financial Services web site.

F.6. Information and Technology Resources The Provider must receive written approval from the Department prior to purchasing any Information Technology Resource (ITR) with contract funds. The Provider agrees to secure prior written approval by means of an Information Resource Request (IRR) form before the purchase of any ITR. The Contract Manager is responsible for serving as the liaison between the Provider and the Department during the completion of the IRR, in accordance with the CFOP 50-4, Policy on Information Resource Requests. The Provider will not be paid or reimbursed for any ITR purchase made prior to obtaining the Department’s written approval.

F.7. ADDITIONAL FINANCIAL CONSEQUENCES

F.7.1. Financial Consequences The following financial consequences apply in addition to the Financial Consequences provided in Section 6.1, Standard Contract Part 1.

F.7.2. In addition to the financial penalties set out in Rule 65-29.001, F.A.C., for failure to comply with a requirement for corrective action, the Department shall assess financial consequences for failure to meet the performance measures outlined in Attachment 1, Performance Measures Compliance Report. Financial consequences shall be applied based upon the remedies identified in Attachment 1.

F.7.3. Upon the Department’s decision to impose financial consequences, written notification will be sent to the Provider. Notification will outline the performance measures for which financial consequences are being imposed, the Department’s concerns, the amount of the financial consequence and the Month the deduction will be made on the invoice. The Contract Manager will deduct the amount of financial consequences imposed from the Provider’s next Monthly invoice as specified in the written notification.

F.7.4. In the event that an extenuating circumstance beyond the control of the Provider affects the timely submission of a service unit, the Provider may request an extension of that specific due date as follows:

F.7.4.1. Extenuating circumstances will not be considered for the late submission of the final invoice as described in Section 3.3.2, Standard Contract Part 1.

F.7.4.2. The Provider’s representative possessing contract signature authority shall attest to and document the extenuating circumstance to the Contract Manager by the specified due date of the deliverable or service unit on Provider letterhead.

F.7.4.3. This written request shall detail the steps that the Provider has put into place to submit the required deliverable or service unit timely and provide a specific proposed due date for submission of the late deliverable or service unit.

F.7.4.4. This individual shall also detail the steps to avoid a future recurrence of such extenuating circumstance.

F.7.4.5. Submission of said attestation to the Contract Manager does not constitute acceptance of the attestation.

F.7.4.6. It is specifically intended by the parties that acceptance, in writing by the Contract Manager, of the required attestation documenting the extenuating circumstance beyond the control of the Provider shall constitute a separate act and shall occur, if at all, within seven (7) calendar days following receipt of the attestation.

F.7.4.7. Barring Department acceptance of extenuating circumstances beyond the control of the Provider, the Department’s Contract Manager shall assess financial consequences against the Provider for each performance measure not met.

F.7.4.7.1. Submission of an unacceptable invoice, supporting documentation, or report:

F.7.4.7.1.1. An unacceptable invoice or supporting documentation contains inaccurate or incomplete information or supporting documentation as specified in Exhibit F, Method of Payment.

F.7.4.7.1.2. An unacceptable report contains inaccurate or incomplete information or data and relates to any report the Provider is required to submit. The report may relate to tasks, activities, deliverables, data collection or analysis, or performance measures as specified in Section C.2.7, Reports.

F.7.4.7.1.3. Financial Consequences will be assessed for the Month that performance measures are not met.

ATTACHMENT 1

Performance Measure Compliance Report

Reporting Period: _________ through _________ # Performance Measure Performance Evaluation

Methodology Compliance

N/D Financial Consequences (FC) FC

Applied

1. The Provider will serve a minimum of 480 unduplicated families per contract year – a minimum of 40 unduplicated families per month.

The provider shall provide minimum services to at least 40 unduplicated families per month. The Provider shall report the number of families that received any services as stated in C.1 Service Tasks.

Financial consequences in the amount of 5% of the total invoice amount will be assessed for each family not served under the minimum target, each monthly service period. The financial consequences shall be deducted from the Request for Payment that corresponds to the reports for the service period.

The sum of monthly financial consequences will not exceed 80% of the total monthly invoice.

2. For families who were successfully contacted by the Provider and who request services, the Provider shall perform an initial assessment of 95% of families within 30 days of contact.

The Provider shall perform an initial assessment of the families for which they provide services. The Provider shall report the number of initial assessments completed within 30 days of contract for families that voluntarily agree to receive services during the service period divided by the number of families who should have had an initial assessment within the reporting period and report the percentage.

Financial consequences in the amount of 3% of the total invoice amount will be assessed for each initial assessment not performed, each monthly service period. The financial consequences shall be deducted from the Request for Payment that corresponds to the reports for the service period.

The sum of the total amount of applied monthly financial

3. 85% of infant program participants will have a Plan of Safe Care in

The Provider shall report the total number of focus children who had a

Financial consequences in the amount of 10% of the total place within 30 days of their enrollment date. Enrollment is defined as having completed the program’s initial assessment. The Provider shall create or modify a Plan of Safe Care (PSC) for all the Focus Children and their families who volunteer to receive their services and consent to a PSC.

Plan of Safe Care executed within 30 days of the completion of the initial assessment during the reporting period divided by the total number of focus children in the reporting period multiplied and report the percentage.

invoice amount will be assessed for failure to reach the minimum accepted percentage for each monthly service period, with additional financial consequences in the amount of 1% of the total invoice amount being assessed for each percentage point under 80% compliance The financial consequences shall be deducted from the Request for Payment that corresponds to the reports for the service period.

The sum of the total amount of applied monthly financial

4. 80% of program participants scoring positive for depression will receive a Mental Health Service that treats depression within 15 days of the positive score’s date.

The Provider shall report on the total number of clients that were referred for mental health services within 15 days of a positive score on a depression assessment during the reporting period divided by the program’s total number of positive depression scoring clients in the reporting period and report the percentage.

Financial consequences in the amount of 10% of the total invoice amount will be assessed for failure to reach the minimum accepted percentage for each monthly service period, with additional financial consequences in the amount of 1% of the total invoice amount being assessed for each percentage point under 75% compliance.

The sum of the total amount of applied monthly financial

80% of the total monthly invoice

5. The Provider shall perform Home Visits with the families they served on a minimum of a monthly basis, throughout the period in which the family is being actively served. 90% of participating families will receive a minimum of one home visit during the month.

The Provider will perform minimum a monthly Home Visit with each family they serve. The Provider shall report the number of families that received a monthly Home Visit during the reporting period divided by the number of active families enrolled in the program.

Financial consequences in the amount of 10% of the total invoice amount will be assessed for failure to meet the minimum accepted percentage for each monthly service period, with additional financial consequences in the amount of 1% of the total invoice amount being assessed for each percentage point under 85% compliance. The financial consequences shall be deducted from the Request for Payment that corresponds to the reports for the service period.

The sum of the total amount of applied monthly financial

80% of the total monthly invoice

6. 80% of the families will successfully complete the Home Visiting services at the end of each contract year. A successful completion is defined as a family that completes the service tasks and identified needs of the PSC that are mutually agreed upon between the Provider and the family. The concerns of the family have been addressed, and the Provider has documented observable progress that the family has made in meeting their goals.

Annually 30 days following the end of the fiscal year.

The Provider shall report the number of families who successfully complete the Home Visiting services at the end of each contract year.

Financial consequences in the amount of 10% of the total invoice amount will be assessed for failure to meet minimum performance in the service period, with additional financial consequences in the amount of 1% of the total invoice amount being assessed for each percentage point under 75% compliance. The financial consequences shall be deducted from the final Request for Payment of the fiscal year.

The sum of the total amount of applied monthly financial

PCMT-03 4 v.24.1 consequences will not exceed 80% of the total monthly invoice

7. 70% of the families that have successfully completed the program will not have been reported to the Florida Abuse Hotline and documents in CCWIS for substantiated child maltreatment.

Annually 30 days following the end of the fiscal year.

The Provider shall report to the Department the percentage of families that have been reported to the Florida Abuse Hotline and documented in CCWIS for substantiated child maltreatment from the total group of families that have successfully completed the program 12 months ago or longer.

Financial consequences in the amount of 10% of the total invoice amount will be assessed for failure to meet minimum performance in the service period, with additional financial consequences in the amount of 1% of the total invoice amount being assessed for each percentage point under 65% compliance. The financial consequences shall be deducted from the final Request for Payment of the fiscal year..

The sum of the total amount of applied monthly financial

ATTACHMENT 2

REQUEST FOR PAYMENT

STATE FISCAL YEAR 2023-2024

INVOICE #:

PROVIDER NAME: ________________________ VENDOR NUMBER:

ADDRESS: ________________________

CONTRACT #: _____________

TELEPHONE #: ____________

In In accordance with the contract, all required reports must be submitted by the required due dates prior to the submission of this Request for Payment. If required reports or this Request for Payment were not submitted by the required due dates or did not meet the described content requirements, financial consequences will be applied by the Contract Manager.

I CERTIFY THAT THIS REQUEST FOR PAYMENT IS AN ACCURATE REFLECTION OF THE

ACTIVITIES FOR THIS PERIOD, THAT THE AMOUNT REQUESTED IS ONLY FOR ALLOWABLE

EXPENDITURES SPECIFIED IN THE LINE-ITEM BUDGET USED TO ESTABLISH THE UNIT

COST OF THESE SERVICES, AND THAT ALL EXPENDITURES ARE DIRECTLY RELATED TO

THE PURPOSES OF THIS CONTRACT.

Original Authorizing Signature Title Date

# UNIT OF SERVICE MAXIMU

M # OF

UNITS

# UNITS

DELIVER

ED

UNIT

PRICE

BALANC

E

AMOU

NT

REQU

ESTED

TOTAL AMOUNT

REQUESTED

FOR DEPARTMENT USE ONLY

DATE SERVICES PROVIDED:

DATE DELIVERABLE RECEIVED:

DATE DELIVERABLE REVIEWED & APPROVED:

DATE INVOICE RECEIVED:

DATE PAYMENT APPROVED:

AUTHORIZING SIGNATURE:

TITLE: Contract Manager TELEPHONE:

NOTE: This report format and method of reporting is subject to changes by the Department as deemed necessary to accurately report on services provided through contracted services. This template may be changed without the need for formal amendment.

FOR DEPARTMENT USE ONLY

OCA: _______________ AMOUNT:

TOTAL AUTHORIZED:

NOTE: This report format and method of reporting is subject to changes by the Department as deemed necessary to accurately report on services provided through contracted services.

This template may be changed without the need for formal amendment.

ATTACHMENT 3

MONTHLY ACTIVITY REPORT

Time Period Covered by the Report: From (mm/dd/yy): _____________ To (mm/dd/yy): _____________

Activities

State Fiscal Year YT D

Tot al

Jul Au g

Se p Q1 Oct No v De c Q2 Ja n Fe b

Ma r Q3 Ap r Ma y

Ju n Q4

1. Referrals received

2.

Successful contacts made with referred families within the first 30-days of the referral received

3. Families willing to engage in services

4. Initial assessments completed for each family

5. Each Plan of Safe Care created or modified for families receiving Home Visiting services

6. Families who received referrals from the Provider

7. Total number of Home Visits performed each Month

8. Number of program participants scoring positive on depression assessment

9.

Number of program participants scoring positive on depression assessment who received a Mental Health Service that treats depression within 15 days of the positive score’s date

10. Families that received monthly Home Visits

By signing this report, I certify to the best of my knowledge and belief that the report is true, complete and accurate and the expenditures, disbursements and cash receipts are for the purposes and objectives set forth in the terms and conditions of the contract award.