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PROVIDE HOME HEALTH AND HOMEMAKING SERVICES TO THOSE IN NEED AGREEMENT This Funds Agreement is made and entered into between the City of Clearwater, hereinafter referred to as the City, and Gulf Coast Community Care, hereinafter referred to as the Agency. WHEREAS, it has been determined to be highly desirable and socially responsible to provide home health and homemaking services to those who would not otherwise have a means to fill these needs; and WHEREAS, the City desires to help those in need by providing funding for the above services; and WHEREAS, the Agency provides such services and operates in the City; NOW, THERFORE, the parties agree as follows: ARTICLE I. TERM The term ofthis agreement shall be for a period of 12 months commencing on the 1 st day of October, 2000 and continuing through the 30th day of September, 2001 (the Termination Date) unless earlier terminated under the terms of this agreement. ARTICLE II. RESPONSIBILITIES OF THE AGENCY 1. Services to be Provided: The Agency shall provide the above stated service in accordance with the proposal submitted by the Agency and approved by the City, which is attached and incorporated herein by reference. 2. Area to be Served: Services rendered through this agreement shall be provided within the corporate limits of the City as it now exists and as its boundaries may be changed during he term of this agreement. 3. Scheduled Reports of Agency Activities: The Agency shall furnish the City Human Relations Department, Grants Coordinator, with an annual report of activities conducted under the provisions of this agreement by October 31, 2001. Each report is to identify the number of clients served, the costs of such service, and commentary on the viability, effectiveness, results of measurable goals and objectives as set out in the agency's proposal, and trends affecting the program. The agency will also provide a copy of its most recent independent financial audit. 4. Use and Disposition of Funds Received: Funds received by the Agency from the City shall be used to pay for the above services as further described in the grant proposal submitted by the Agency to the City. Funds existing and not used for this purpose at the -0 jO-c5/- CO ~i) end of this agreement term shall be deemed excess to the intended purpose and shall be returned to the City. 5. Creation, Use, and Maintenance of Financial Records: a) Creation of Records: Agency shall create and maintain financial and accounting records, books, documents, policies, practices, procedures and any information necessary to reflect fully the financial activities of the Agency. Such records shall be available and accessible at all times for inspection, review, or audit by authorized City representatives. b) Use of Records: Agency shall produce such reports and analyses that may be required by the City and other duly authorized agencies to document the proper and prudent stewardship and use of the monies received through this agreement. c) Maintenance of Records: All records created hereby are to be retained and maintained for a period not less than five (5) years from the termination of this agreement. 6. Non-discrimination: Notwithstanding any other provisions ofthis agreement during the term of this agreement, the Agency for itself, agents and representatives, as part of the consideration for this agreement, does covenant and agree that: a) No Exclusion from Use: No person shall be excluded from participation in, denied the benefits of, or otherwise be subjected to discrimination in the operation of this program on the grounds of race, color, religion, sex, age, national origin, or disability. b) No Exclusion from Hire: In the management, operation, or provision of the program activities authorized and enabled by this agreement, no person shall be excluded from participation in or denied the benefits of or otherwise be subject to discrimination on the grounds of or otherwise be subjected to discrimination on the grounds of race, color, religion, sex, age, national origin, or disability. c) Inclusion in Subcontracts: The Agency agrees to include the requirement to adhere to Title VI and Title VII of the Civil Rights Act of 1964 in all approved sub-contracts. d) Breach of Nondiscrimination Covenants: In the event of conclusive evidenced of a breach of any of the above non-discrimination covenants, the City shall have the right to terminate this agreement. 7. Liability and Indemnification: The Agency shall act as an independent contractor and agrees to assume all risks of providing the program activities and services herein agreed and all liability therefore, and shall defend, indemnify, and hold harmless the City, its officers, agents, and employees from and against any and all claims of loss, liability, and damages of whatever nature, to persons and property, including, without limiting the .<1 ,. generality of the foregoing, death of any person and loss of the use of any property, except claims arising from the negligence or willful misconduct of the City or City's agents or employees. This includes, but is not limited to matters arising out of or claimed to have been caused by or in any manner related to the Agency's activities or those of any approved or unapproved invitee, contractor, subcontractor, or other person approved, authorized, or permitted by the Agency in or about its premises whether or not based on negligence ARTICLE III. RESPONSIBILITIES OF THE CITY 1. Grant of Funds: The City agrees to provide a total grant of $4,950.00 to fund the program in accordance with this agreement and subject to City Commission budget approval. 2. Payments: The total amount requested will be paid by the City to the Agency within 30 days after execution of this agreement by the City and the Agency but no earlier than October 1 of the budget year for which the funds are authorized. ARTICLE IV. DISCLAIMER OF WARRANTIES This Agreement constitutes the entire Agreement of the parties on the subject hereof and may not be changed, modified, or discharged except by written Amendment duly executed by both parties. No representations or warranties by either party shall be binding unless expressed herein or in a duly executed Amendment hereof. ARTICLE V. TERMINATION 1. For Cause: Failure to adhere to any ofthe provisions of this agreement as determined by the City shall constitute cause for termination. This agreement may by terminated with 5 days notice without any further obligation by City. 2. Disposition of Fund Monies: In the event of termination for any reason, monies made available to the Agency but not expended in accordance with this agreement shall be returned to the City. ARTICLE VI. NOTICE Any notice required or permitted to be given by the provisions of this agreement shall be conclusively deemed to have been received by a party hereto on the date it is hand-delivered to such party at the address indicated below (or at such other address as such party shall specify to the other party in writing), or if sent by registered or certified mail (postage prepaid), on the fifth (5th) business day after the day on which such notice is mailed and properly addressed. 1. If to City, addressed to Grants Coordinator, Human Relations Department, P.O Box 4748, Clearwater, FL 33758 ~ 2. If to Agency, addressed to Gulf Coast Community Care, 14041 Icot Boulevard, Clearwater, FL 33760. ARTICLE VII. EFFECTIVE DATE The effective date ofthis agreement shall be as of the first day of October, 2000. .IN WITNESS WHEREOF, the parties hereto have set their hands and seals this ~ ----1L--- day of 'r v , 2001. CITY OF CLEARWATER, FLORIDA Countersigned: BY~:'~~~ William B. Home II, Interim City Manager Approved as to form: Jl&ldn, City Attorney Attest: ~~ ( wH HelL. Witnesses as to Agency: ~~1/) &~S>~ fla-eN 6~RNSrgltV A~est: ~ /'>>~<;, ~~(.. . (jLA-bY~ ScA-urZ-. \ " ,j ':"- ~ ---- - .- ~ '- - .~ - . '" =~_ >_:'~"C:';:~"_' -, ~ ... ~ .. ......'-- ;a CITY OF CLEARWATER SOCIAL SERVICES GRANT Phone: PROJECT APPLICATION FORM (727) 562-4060 for assistance Due: January 26,2001 A. Applicant Information Applicant: (Sponsor/Developer) Gulf Coast Community Care Organization Name: If different) Address: 14041 Icot Blvd. City; State; Zip Clearwater. FL 33760 Telephone Number: 538-7460 Contact Person: Michael Bernstein Title: President/CEO Telephone Number: 538-7460 Period for which funds are being requested: Fiscal Year 2000/200 I Signatur~. IJJ. ~MiChael A Bernstein. President/CEO' Board of Directors Chairperson Date Januarv 25, 2001 NOTE: The City of Clearwater reserves the right to fund applicants at a level lower than requested. * Special Note: Gulf Coast's Board of Directors has given the President/CEO the authority to sign all contracts and grants as specified in the agency's Constitution and Bylaws. 2 .<<l B. Acti vi ty (Check One) Adult Crime Child Abuse Elderly x Hunger Juvenile Crime Physical Illness (Xl Parenting Adolescents Substance Abuse Unsupervised Children Youth Development Other (Describe Below) 3 C. AMOUNT OF FUNDING CURRENTLY REQUESTED: (Not to exceed $10,000) $7.500 D. SPECIFICALLY FOR WHAT WILL THIS MONEY BE USED. (Line item budget for this amount) Funding equal to 450 hours of care will be applied toward homemaker services for low income frail elders and catastrophically disabled adults living in Clearwater, which will benefit 87 individuals. In-home assistance with basic tasks such as cooking, shopping and cleaning enable , frail elders and seriously disabled adults to remain in their own homes rather than be forced to move into more costly and restrictive settings, usually at taxpayers' expense. Clients typically receive three to four hours a week of homemaker services. These services, which are funded by the Dept. of Children and Families, and the Area Agency on Aging, require a 10% local match. E. BRIEF DESCRIPTION OF THE PROJECT YOU WISH TO FUND UTILIZING THIS GRANT. Gulf Coast has been providing in-home services to catastrophically disabled adults (e.g., quadriplegia, paraplegia, Muscular Dystrophy, Cerebral Palsy, stroke) since the early 1980's and to frail elders under the Older American's Act Title III Homemaker S"e1"Vices program since 1987. The goal of both programs is to enable the elderly and catastrophically disabled adults to remain in the least restrictive setting possible through access to in-home services such as cleaning, cooking and shopping. Homemaker services have a direct, positive impact on clients lives by meeting their physical needs and maintaining a healthy environment, and preventing them from entering nursing homes or assisted living facilities. F. BRIEF DESCRIPTION OF YOUR OVERALL ORGANIZATION. Gulf Coast Community Care is the major division of Gulf Coast Jewish Family and Mental Health Services, Inc., a 501 (c )(3) nonsectarian, human services agency which has been serving Pinellas County for over 40 years. The agency offers a range of services for children, adults and seniors in serious physical, mental, social, and financial need, enabling them to remain in the community with their families and loved ones instead of being forced into more costlv and restrictive institutional settings. Gulf Coast has been the lead agency providing: in-home services for low-income, disabled adults in the Tampa Bay area since the mid-1980's, and since 1987 has been providing in-home care for frail elders. The agency employs 39 homemakers providing in-home services, and 3 homemaker supervisors. Results of monitoring by the Dept. of Elder Affairs, the Area Agency on Aging and the Dept. of Children and Families, consistently note the agency is in compliance with program and funding requirements. The agency's main office and service location is in Clearwater (Icot Blvd.), as is a second office (Arcturas Ave.) 4 .al providing IllV/AIDS, employment and refugee services. G. NUMBER OF CLIENTS SERVED BY THIS PROGRAM. 124 frail elders and 333 disabled adults are served in Pinellas County. H. PERCENTAGE OF THESE CLIENTS WHO ARE CITIZENS OF CLEARWATER. 23% or (75 of333) severely disabled adults reside in Clearwater, and 10% (12 of 124) frail elders reside in Clearwater. There are approximately 74 individuals from Clearwater on the waiting list for services I. CURRENT OVERALL ORGANIZATION BUDGET (PLEASE ATTACH.) Please see attached. J. IF THIS IS START UP OR MATCHING MONEY, SPECIFY THE DETAILS i . e.: WHICH AGENCY OR ORGANIZATION WILL PROVIDE THE MATCH, THE REQUIREMENTS AND THE AMOUNT OF THE MATCH. There is a 100./0 local matching requirement for these funds, per our contracts with the Area Agency on Aging (Title ill Homemaker for Elders) and the Dept. of Children and Families (Community Care for Disabled Adults). K. IS YOUR AGENCY A REGISTERED 501 (C) (3) NON-PROFIT AGENCY OR IN THE PROCESS OF BECOMING ONE. Gulf Coast is a 501(c)(3) nonv.ofit agencv L. DOES YOUR FACILITY HAVE OR IS IT IN THE PROCESS OF ACQUIRING THE APPROPRIATE LICENSURE FOR THE DELIVERY OF THE SERVICES DESCRIBED IN THE APPLICATION. We have all proper licenses and authorizations to deliver homemaker services. 5 /jJ '. M. HAS YOUR ORGANIZATION RECEIVED OR IS IT EXPECTING TO RECEIVE FUNDING (WHETHER CASH OF IN-KIND CONTRIBUTIONS) FROM THE CITY OF CLEARWATER DURING THE FISCAL YEAR FROM OCTOBER 1, 2000 THROUGH SEPTEMBER 30, 2001? YES NO X IF YES, PLEASE EXPLAIN: N. Measurable Objective for the Program: 95% of Clients will maintain or improve their quality of life by remaininq independent in their own homes rather than movina to a nursina home or Assisted Livina Facility. H:\BARB\CLRWSOC.wpd 6 " UNIFIED FUNDING APPLICATION To: (fonder): City of Clearwater For time period of: October 1. 2000 - September 30. 2000 Applicant Information (print or tvDe): Legal Name of Organization Gulf Coast Jewish Familv Services/d/b/a Gulf Coast Community Care Complete Address: 14041 loot Boulevard Clearwater. FL 33760 Phone (727) 538-7460 Fax (727) 535-4474 E-Mail rnbernsteinuv.2cifs.ore Federal Tax Identification Number: 59-1229354 Contact Person: Michael Bernstein Title: President/CEO Organization Type: _Public_Private.lNon-Profrt_ Other Service Area:.l County_City of Other Agency Currently funded by (check all that apply): .l St. Petersburg .l Clearwater _ Largo .l PineIlas County .l Area Agency on Aging .l Juvenile Welfare Bd. .l United Way .lFlorida Dept. of Children & Families _Florida Dept. of Justice . _PineIlas County Foundation _Allegany Franciscan Foundation _Eckerd Family Foundation --X- Other: PineIIas Countv School Board PineIIas Workforce Board Certifications: (1) If required to register for solicitation of funds, is the Agency currently registered with the state? -X-Yes _ No The County?..LYes _No (2) If incorporated, has the Agency Annual Report been flied with the Florida Secretary of State? .l Yes _ No Name and Title of Agency Representative submitting this funding request: Harvev Landress. Vice-President for Plannine 2001 Received in funder's office by: Date: 7 00 '- BOARD OF DIRECTORS -# required in By Laws = 33 (Maximum) NAME/OFFICER OCCUPATION AREA OF EXPERTISE RACE/GENDER Myron Mensh, Esq. Lawyer Law White Male (Chairman) Barbara Bernstein Fundraising White Female (Vice Chairman) June Gelbart Fundraising White Female (Vice Chairman) Rabbi Gary Klein Rabbi Religion White Male (Treasurer) Gladys Schutz Philanthropy White Female (Secretary) David A. Bernstein, M.D. Physician Health Care White Male (Immediate Past Chairman) Eleanor Abbo Fundraising - _ White Female ~ardAmeer, Ph.D. Retired Health Care & White Male Management Consulting Tammy Bobo Homemaker V olunteerism & Advocacy White Female Nancy Bomstein Businesswoman Business White Female Dorothy Cohen Retired Business White Female Gertrude Debowsky Retired Education White Female Ruth Dikman V olunteerism White Female Syd Entel Businesswoman Business White Female Marjorie Eskenas Mental Health Advocacy White Female Florence L. Fayer Retired Education White Female Steven J. Gilbert Financial Planner Finance & Accounting While Male SHen Glassman Congressional Aide Government Relations White Female 8 '- BOARD OF DIRECTORS . ,\ME/OFFICER OCCUP AnON AREA OF EXPERTISE RACE/GENDER Elizabeth Goodman, Esq. Lawyer Law and White Female Government Relations David Greene Businessman Construction White Male William Israel Managemmt Management & Planning White Male Consultant Karl K. Jacobson, Esq. Lawyer Law White Female Walter Loebenberg Businessman Business and Health Care White Male Ronald Oxman Retired Businessman Philanthropy White Male Annette Raymund Social Work and White Female Volunteerism . Leslie A. Rubin Businessman Property Management White Male and Business Ronald Sakal Retired Health Care and Business -- White Male james H. Shimberg, Jr., Esq. Lawyer Law and Government White Male Relations Joseph B. Sterensis Businessman Business and Health Care White Male Earnest Williams Businessman Insurance and Government Black Male Relations 9 GULF COAST COMMUNITY CARE Frail Elders and Disabled Adults FY 00-0 I Revenue Other State Funding City of Clearwater City of St Petersburg United Way Pine lIas United Way of Pasco Medicaid First & Third Party Other Total Revenue 543,739 7,500 3,000 58,000 7,500 778,000 690 600 1,399,029 Expenses Salaries Fringe Building Occupancy Professional Services Travel Equipment Costs Medical & Pharmacy Subcontract Service Insurance Interest Operating Supp. & Expenses Direct Support Total Direct Expenses 793,467 89,569 19,251 25,800 49,917 9;6'11 176 93,284 31,904 11,315 29,374 37,584 1,191,252 Administrative Support 185,764 Total Expenditures 1,377,016 10 !- GULF COAST COMMUNITY CARE CONSOLIDA TED AGENCY FY 00-01 Revenue State ADM Other State Funding City of Clearwater Pinellas County City of St. Petersburg United Way of Pine lias County United Way of Pasco County United Way of Polk County Local Government Federal Grants Medicare Medicaid First & Third Party Donations Other In-Kind 3,228,230 2,947,184 7,500 43,888 3,000 103,220 30,000 35,300 646,313 149,799 53,675 4,051,912 648,337 70,950 460,636 559,603 13,039,547 Total Revenue Expenses Salaries Fringe Building Occupancy Professional Services Travel Equipment Costs Food Service Medical & Pharmacy Subcontract Service Insurance Interest Operating Supp. & Expenses Other In-Kind Direct Support Total Direct Expenses 6,287,001 820,753 614,427 325,309 328,21 1 156,095 291,088 36,217 II 1,284 229,276 168,686 852,071 100 559,603 326,710 11,106,831 Administrative Support 1,645,707 Total Expenditures 12,752,538 11