Loading...
HomeMy WebLinkAbout05/11/2021BOARD OF COUNTY COMMISSIONERS INDIAN RIVER COUNTY FLORIDA COMMISSION AGENDA TUESDAY, MAY 11, 2021 - 9:00 AM Commission Chambers Indian River County Administration Complex 180127th Street, Building A Vero Beach, Florida, 32960-3388 www.ircgov.com COUNTY COMMISSIONERS Chairman, Joseph E. Flescher, District 2 Jason E. Brown, County Administrator Vice Chairman, Peter D. O'Bryan, District 4 Dylan Reingold, County Attorney Commissioner Susan Adams, District 1 Jeffrey R. Smith, Clerk of the Circuit Court and Comptroller Commissioner Joseph H. Earman, District 3 Commissioner Laura Moss, District 5 This meeting can be attended virtually via Zoom. Instructions can be found at the end of this agenda and also online at www.ircgov.com. 1. CALL TO ORDER 2.A. A MOMENT OF SILENT REFLECTION FOR FIRST RESPONDERS AND MEMBERS OF THE ARMED FORCES 2.B. INVOCATION Pastor Alex Pappas, Ocean's Unite Lutheran Church 3. PLEDGE OF ALLEGIANCE Jason Brown, County Administrator 4. ADDITIONS/DELETIONS TO THE AGENDA / EMERGENCY ITEMS 5. PROCLAMATIONS and PRESENTATIONS 5.A. Presentation of Proclamation Honoring Nancy Mossali on Her Retirement From Indian River County. Board of County Commissioners Office of County Attorney with Thirty -Five Years of Service Attachments: Proclamation 5.11. Presentation of Proclamation Recognizing, May 09-15, 2021 as National Police Week and May 15, 2021 as Peace Officers Memorial Day Attachments: Proclamation May 11, 2021 Page 1 of 4 5.C. Presentation of Proclamation Designating May 9 Through May 15, 2021, As Economic Development Week In Indian River County Attachments: Proclamation 6. APPROVAL OF MINUTES 7. INFORMATION ITEMS FROM STAFF OR COMMISSIONERS NOT REQUIRING BOARD ACTION 8. CONSENT AGENDA 8.A. Declaration of Unity of Title for County Owned Property Known as the Hallstrom Farmstead Conservation Area Attachments: Staff Report Declaration of Unity of Title Exhibit "A" to Declaration of Unity of Title Request for Parcel Combination 9. CONSTITUTIONAL OFFICERS and GOVERNMENTAL AGENCIES 9.A. Indian River County Sheriff Eric Flowers re: Financial Items Attachments: Memo to Board Hayes Construction Thompson's Remodeling Plexi -Chemie 10. PUBLIC ITEMS A. PUBLIC HEARINGS 10.A.1. Request from Turbo Transport Services LLC for a Class "E" Certificate of Public Convenience and Necessity to provide . Wheelchair transports originating from Indian River County - Administrative Attachments: Staff Report COPCN Application B. PUBLIC DISCUSSION ITEMS 10.B.1. Request to Speak from Connie Clark re: Utility Bill at 4776 34 Ave Attachments: Public Discussion Request Clark C. PUBLIC NOTICE ITEMS 11. COUNTY ADMINISTRATOR MATTERS 12. DEPARTMENTAL MATTERS A. Community Development May 11, 2021 Page 2 of 4 B. Emergency Services C. General Services D. Human Resources 12.D.1. Addition of Surgery Plus Benefit as Optional Benefit for Individuals Insured on the County's Group Health Plan Attachments: Staff Report Proposal Overview Sample Agreement - City of Sebring 12.D.2. Medical and Pharmacy Benefit - Recommendations for Plan Year 2621/22 Attachments: Staff Report Pharmacy PBM Marketing Savings Summary 12.D.3. Results of Employer Clinic Survey and Next Steps Attachments: Staff Report Clinic Survey Results Lockton Clinic Proposal E. Information Technology F. Office of Management and Budget G. Public Works H. Utilities Services 13. COUNTY ATTORNEY MATTERS 13.A. Children's Services Dedicated Millage Attachments: Staff Report Children's Services Dedicated Millage 14. COMMISSIONERS MATTERS A. Commissioner Joseph E. Flescher, Chairman B. Commissioner Peter D. O'Bryan, Vice Chairman C. Commissioner Susan Adams 14.C.1. Approval of Special Rate for Use of the Fairgrounds Following Events at Sandridge Golf Club Attachments: Commissioners Memo D. Commissioner Joseph H. Earman E. Commissioner Laura Moss May 11, 2021 Page 3 of 4 15. SPECIAL DISTRICTS AND BOARDS A. Emergency Services District B. Solid Waste Disposal District 15.B.1. Final Pay CCNA2018 WO Monitoring/Reporting and Gifford Road Landfill No. 7 to Geosyntec for One Year of Groundwater. Related Consulting Services at . the Former South Attachments: Staff .Report Project Completion Report and Final Invoice C. Environmental Control Board 16. ADJOURNMENT Except for those matters specifically exempted under the State Statute and Local Ordinance, the. Board shall provide an opportunity for public comment prior to the undertaking by the Board of any action on the agenda, including those matters on the Consent .Agenda. Public comment shall also be heard on any proposition which the Board is:to take action which was either not on the Board agenda or distributed to the public prior to the commencement of the meeting. Anyone who may wish to appeal any decision which may be made at this meeting will need to ensure that a verbatim record of the proceedings is made which includes the testimony and evidence upon which the appeal will be based. Anyone who needs a special accommodation for this meeting may contact the County's Americans with Disabilities Act (ADA) Coordinator at (772) 226-1223 at least 48 hours in advance of meeting. Anyone who needs special accommodation with a hearing aid for this meeting may contact the Board of County Commission Office at 772-226-1490 at least 20 hours in advance of the meeting. The full agenda is available on line at the Indian River County Website at www.ircgov.com The full agenda is also available for review in the Board of County Commission Office, the Indian River County Main Library, and the North County Library. Commission Meetings are broadcast live on Comcast Cable Channel 27 Rebroadcasts continuously with the following proposed schedule: Tuesday at 6:00 p.m. until Wednesday at 6:00 a.m., Wednesday at 9:00 a.m. until 5:00 p.m., Thursday at 1:00 p.m. through Friday Morning, and Saturday at 12:00 Noon to S: 00 p.nL May 11, 2021 Page 4 of 4 s-'4 PROCLAMATION HONORING NANCY MOSSALI ON HER RETIREMENT FROM INDIANRIVER COUNTYBOARD OF COUNTY COMMISSIONERS OFFICE OF CO UNTYA TTORNEY WHEREAS, Nancy Mossali retires from the Indian River County, Office of County Attorney, effective May 27, 2021; and WHEREAS, Nancy Mossali began her career as a Legal Assistant with Indian River County, Office of County Attorney on May 27,1986; and WHEREAS, in May 2016, Nancy Mossali due to her deep experience, broad knowledge and amazing ability to get everything done, was promoted to Senior Legal Assistant; and WHEREAS, Nancy Mossali has served this County and the Public with distinction and selflessness. During her thirty-five years of service, she was dedicated, and her work was greatly appreciated by the Board, all six of the County Attorneys she served, citizens, and co-workers alike, and NOW, THEREFORE, BE IT PROCLAIMED BY THE BOARD OF COUNTY COMMISSIONERS OF INDIAN RIVER COUNTY, FLORIDA, that the Board applauds Nancy Mossali's efforts on behalf of the County, and the Board wishes to express their appreciation for the dedicated service she has given to Indian River County for the last thirty-five years, and BE IT FURTHER PROCLAIMED that the Board of County Commissioners and staff extend heartfelt wishes for success in her future endeavors! Adopted this 11 th day of May, 2 02 1. BOARD OF COUNTY COMMISSIONERS INDIAN RIVER COUNTY, FLORIDA Joseph E. Flescher, Chairman 1 PROCLAMATION RECOGNIZING MAY 9 THROUGH 15, 2021 AS NATIONAL POLICE WEEK WHEREAS, there are more than 900,000 law enforcement officers serving in communities across the United States, including the dedicated members of the Indian River County Sheriff's Office and Indian River County municipal police departments; and WHEREAS, in 1962, President John F. Kennedy signed a proclamation which designated May 15th as National Peace Officers Memorial Day and the week in which that date falls as National Police Week; and . WHEREAS, on average, one law enforcement officer is killed in the line of duty somewhere in the United States every 54 hours. Since the first known line -of -duty death in 1791, more than 24,000 U.S. law enforcement officers have made the ultimate sacrifice; and WHEREAS, over the past decade (2010-2020) the average annual number of officer fatalities has been 163. In 2020, 359 law enforcement officers died in the line of duty; additionally 22 canines died in the line of duty; and WHEREAS, the National Law Enforcement Officers Memorial Fund honors and remembers those recently fallen law enforcement officers who have paid the ultimate price and given their lives to protect and serve; and NOW, THEREFORE, BE IT PROCLAIMED BY THE BOARD OF COUNTY COMMISSIONERS, INDIAN RIVER COUNTY, FLORIDA that May 9-15, 2021 is recognized as National Police Week in honor of the service of law enforcement officers in our community and communities across the nation and that May 15 is recognized as Peace Officers Memorial Day, in honor of all fallen officers and their families and U.S. flags should be flown at Half - Staff. Adopted this 11th day of May, 2021. BOARD OF COUNTY COMMISSIONERS INDIAN RIVER COUNTY, FLORIDA Joseph E. Flescher, Chairman Peter D. O'Bryan, Vice Chairman Susan Adams Joe Earman Laura Moss 2 4c PROCLAMATION DESIGNATING MAY 9 THROUGH MAY 15, 2021, AS ECONOMIC DEVELOPMENT WEEK IN INDIAN RIVER COUNTY WHEREAS, Economic Development Week is an event created by the International Economic Development Council to celebrate the achievements of Economic, Workforce and Community Development practitioners throughout the nation; and WHEREAS, economic development is defined as "A set of programs and policies that aid in the creation, retention and expansion of jobs and the development of a stable tax base"; and WHEREAS, economic developers promote the economic well-being and quality of life for their respective communities by facilitating the process of job creation and career development opportunities for local residents while diversifying the local tax base; and WHEREAS, economic developers stimulate entrepreneurism to help establish the next generation of new businesses, which is the hallmark of the American economy; and WHEREAS, economic developers are engaged in a wide variety of settings including rural and urban; local, state, and federal governments; public-private partnerships; higher education; and a variety of other institutions, including the Indian River County Chamber of Commerce; and WHEREAS, economic developers collaborate with regional workforce boards and training providers to enhance the skills of career seekers and develop meaningful skill sets for our future workforce, thereby advocating for an inclusive economy while enhancing our competitiveness. NOW, THEREFORE, BE IT PROCLAIMED BY THE BOARD OF COUNTY COMMISSIONERS, INDIAN RIVER COUNTY, FLORIDA that the week of May 9th through May 15th; 2021, be recognized as ECONOMIC DEVELOPMENT WEEK IN INDIAN RIVER COUNTY. Adopted this 11th day of May, 2021. BOARD OF COUNTY COMMISSIONERS, INDIAN RIVER COUNTY, FLORIDA Joseph E. Flescher, Chairman Peter D. O'Bryan, Vice Chairman Susan Adams Joe Earman Laura Moss 3 CONSENT:. 5/11/2021 1?4 Office of INDIAN RIVER COUNTY ATTORNEY Dylan Reingold, County Attorney William K. DeBraal, Deputy County Attorney Susan J. Prado, Assistant County Attorney MEMORANDUM TO: Board of County Commissioners FROM: William K. DeBraal - Deputy County Attorney DATE: May 4, 2021 SUBJECT: Declaration of Unity of Title for County Owned Property Known as the Hallstrom Farmstead Conservation Area In January, 2019 the County was notified that its grant application was approved for $148,500 with a County match of $148,500 to construct a parking area, restrooms, water and sewer connections, walking trails, and pavilions with regard to the Hallstrom Farmstead Conservation Area property; and under the grant agreement, the project is required to be completed by September 22, 2022. During the pre -application review process, Community Development noted that a Declaration of Unity of Title was required to combine the seven parcels into one tract. A Declaration of Unity of Title has been prepared for the Board's consideration, along with the Indian River County Property Appraiser's form of Request for Parcel Combination. FUNDING: The only cost associated with this agenda item is the recording fees for the Declaration of Unity of Title in the amount of $44.00. Funding is budgeted and available from Optional Sales Tax/Parks/Hallstrom Farmstead Conservation Area Account No. 31521072- 066510-19027. RECOMMENDATION: Authorize the Chairman of the Board of County Commissioners to execute both the Declaration of Unity of Title and Request for Parcel Combination form with regard to combining the seven parcels known as the Hallstrom Farmstead Conservation Area into one tract, and authorize staff to. record the Declaration of Unity of Title in the Public Records of Indian River County, Florida and submit the Request for Parcel Combination to the Indian River County Property Appraiser's Office. /nhm Attachments: Declaration of Unity of Title and form of Request for Parcel Combination cc: Wesley Davis - Property Appraiser /� DECLARATION OF UNITY OF TITLE WHEREAS, the undersigned is the fee simple owner of the following described property situate in Indian River County, Florida: See Exhibit "A" attached hereto and made a part hereof (known as the Hallstrom Farmstead Conservation Area) and; WHEREAS, the undersigned has made application for issuance .of a development order on a project designed in a manner which necessitates the above-described parcels being held in single ownership as one entire tract; and . NOW, THEREFORE, the undersigned declares that such parcels will in the future, be held and treated as one single parcel of land, which is not to be divided for sale or transfer of ownership other than as a single tract unless then current land development regulations are met; and . The covenant stated herein shall be considered binding on all future successors and owners and shall be strictly enforceable by Indian River County, Florida in accordance with its land development regulations, and shall remain valid until such time as released in writing by an authorized representative of the Community Development Department of Indian River County, Florida, by recorded document. WITNESS the hand and seal of the undersigned, this day of May, 2021. OWNER: INDIAN RIVER COUNTY, a political subdivision of the State of Florida MAILING ADDRESS: 180127 1h Street Vero Beach, FL 32960 IIN Joseph E. Flescher, Chairman Board of County Commissioners BCC approved: ATTEST: Jeffrey R. Smith, Clerk of Court and Comptroller By: Deputy Clerk Approved as to form and legal sufficiency: By: William K. DeBraal Deputy County Attorney STATE OF FLORIDA COUNTY OF INDIAN RIVER The foregoing instrument was acknowledged before me, by means of ❑ physical presence or ❑ online notarization, this day of May, 2021 by Joseph E. Flescher, Chairman of the Board of County Commissioners of Indian River County, a political subdivision of the State of Florida, who is ❑ personally known or ❑ produced identification in the form of NOTARIAL SEAL: NOTARY PUBLIC printed name: Commission No.: Commission expiration: 6 EXHIBIT "A" HALLSTROM FARMSTEAD CONSERVATION AREA Legal Descriptions: PARCEL 1: ALL THAT PORTION OF THE SOUTHEAST % OF THE SOUTHWEST % OF SECTION 30, TOWNSHIP 33 SOUTH, RANGE 40 EAST, LYING WEST OF THE FLORIDA EAST COAST RAILWAY RIGHT OF WAY; SAID LAND LYING AND BEING IN INDIAN RIVER COUNTY, FLORIDA. LESS AND EXCEPT ROAD RIGHT OF WAY FOR OLD DIXIE HIGHWAY, AS IT PRESENTLY EXISTS. PARCEL 2: ALL THAT PORTION OF THE NORTHEAST % OF THE NORTHWEST % OF SECTION 31, TOWNSHIP 33 SOUTH, RANGE 40 EAST, LYING WEST OF THE RIGHT OF WAY FOR OLD DIXIE HIGHWAY AND LESS THE 5 ACRE PARCEL CONVEYED TO THE INDIAN RIVER COUNTY HISTORICAL SOCIETY BY WARRANTY DEED RECORDED IN OFFICIAL RECORDS BOOK 1341, PAGE 776, PUBLIC RECORDS OF INDIAN RIVER COUNTY, FLORIDA. PARCEL 3: THE NORTH %2 OF THE NORTHEAST % OF THE NORTHWEST % LYING EAST OF THE EASTERLY RIGHT OF WAY FOR OLD DIXIE HIGHWAY AND WEST OF THE FLORIDA EAST COAST RAILWAY RIGHT OF WAY, SECTION 31, TOWNSHIP 33 SOUTH, RANGE 40 EAST, SAID LAND LYING AND BEING IN INDIAN RIVER COUNTY, FLORIDA. PARCEL 4: THAT PART OF THE NORTH % OF THE NORTHWEST % OF THE NORTHEAST %, LYING WEST OF THE FLORIDA EAST COAST RAILWAY RIGHT OF WAY, SECTION 31, TOWNSHIP 33 SOUTH, RANGE 40 EAST, SAID LAND LYING AND BEING IN INDIAN RIVER COUNTY, FLORIDA. PARCELS: THE NORTH 250 FEET OF THE SOUTH % OF THE NORTHWEST % OF THE NORTHEAST Y4 OF SECTION 31, TOWNSHIP 33 SOUTH, RANGE 40 EAST, LYING WEST OF THE FLORIDA EAST COAST.RAILWAY RIGHT OF WAY; SAID LAND LYING AND BEING IN INDIAN RIVER COUNTY, FLORIDA. PARCEL 6: THE NORTH 250 FEET OF THE SOUTH %2 OF THE NORTHEAST % OF THE NORTHWEST % OF SECTION 31, TOWNSHIP 33 SOUTH, RANGE 40 EAST, LYING EAST OF THE EAST RIGHT OF WAY OF OLD DIXIE HIGHWAY; SAID LAND LYING AND BEING IN INDIAN RIVER COUNTY, FLORIDA. PARCEL 7: TRACTA, FIRST REPLAT.IN VERO BEACH HIGHLANDS, UNIT ONE, A SUBDIVISION ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 7, PAGE 40 OF THE PUBLIC RECORDS OF INDIAN RIVER COUNTY, FLORIDA. 7 Indian River County Property Appraiser www.ircpa.org General Instructions for Requesting Parcel Split or Combination PLEASE CHECK WITH THE PROPER AGENCY TO VERIFY THE EFFECT OFA COMBINE OR SPLIT OF THE PROPERTY TO ENSURE THE CREATION OF A LEGAL LOT. List: all current parcel number(s) or tax account number(s) under the column titled Parcel Number(s). Each parcel should be contiguous in the same municipality. The Indian River County Property Appraiser will not create or draft property descriptions. > If the property is metes and bounds then a survey MUST provide a sketch and legal description clearly defining each new parcel boundary. ➢ If the property is in a platted subdivision then a survey MAY NOT be required (to be determined by the appropriate jurisdiction's staff). ➢ NOTE: For combinations, parcels must be titled in thesame name(s) and must be.contiguous. > Your request will be accepted at any time during the year; however, the Indian River County Property Appraiser's Office works within theTax Roll Calendar. Onceouroffice receives your request, the tax roll calendar will determine if your request can be completed for the current year or processed for the following year. Sign and date the form. NOTE: Forms must be signed by the current owner or the owner's designated representative. Forms signed by prospective buyers will not be processed. The processing time by the Indian River County Property Appraiser's Office WILL NOT hinder the sale of a property, issuance of permits, or any outside agency's process. Please contact us at (772) 567-8000 or by email: Appraiser@ircpa.org with anyquestions. This form must be completed in its entirety. Incomplete forms will not be processed. Indian River County Property Appraiser www.ircpa.org Request for Parcel Split or Combination SPLIT E:] COMBINE PARCEL NUMBER(S) OR TAX ACCOUNT NUMBER(S) 33403000000500000009.1 33403100000100000006.1 33403100000100000003.3 33403100004000100001.0 33403100000300000001.0 Overall Site Address: 1701 Old Dixie Hwy SW *Does the request require a survey? If so, is that provided? *Does a Unity of Title exist on the parcel(s) above? Yes *If yes, has a Release of Unity of Title been recorded? Signature (Comm.Dev.Rep) M Office (County or municipality) IMPORTANT NOTICE Date Pursuant to Florida Statute 197.192, the Property Appraiser's Office will not split or combine parcels until all taxes due or delinquent have been paid to the Tax Collector. It should also be noted that a parcel split/combination by the Property Appraiser is for taxation purposes only and does not imply suitability for parcel development. Please contact the appropriate land development or planning and zoning department of your jurisdiction for questions concerning property development. HOMESTEAD/NON-HOMESTEAD PROPERTIES AFFECTED BY ASSESSMENT LIMITATION ® I/We understand that splitting or combining property may increase taxes by affecting existing capped values. If you choose to reverse the process at a future date, the cap will not be restored to its former level. PROPERTY APPRAISER TO BE HELD HARMLESS It is the responsibility of the owner to ensure all prior or current tax amounts on any parcels being split or combined with any other parcels are paid in full to the Tax Collector. This agency is not responsible for any delinquent taxes, penalties, or interest that could occur and accrue due to negligence on the part of the property owner, the owner's representatives, or other parties when requesting parcel splits or combinations. Furthermore, if the property is encumbered by a mortgage, it is the owner's responsibility to seek prior approval from the mortgage company for any changes to the property involving a split or combination. If this request is being presented by anyone other than the owner, a Power of Attorney or a Letter of Authorization from the owner must be supplied. By signing below, whether by the owner or the owner's representative, the owner acknowledges they have read and understand the aforementioned and availed themselves of the opportunity to ask any questions, seek clarification, or obtain additional information prior to this action being requested. Signature: Date: Print Name: Joseph E. Flescher, Chairman, Board of County Commissisoners of Indian River County, Florida Phone: 772-226-1244 mvietze@ircgov.com 9 Email: Sheriff Eric Flowers y Indian River County Sheriff's Office May 5, 2021 The Honorable Joseph E. Flescher, Chairman Indian River Board of County Commissioners 1801 27th Street Vero Beach, FL 32960-3388 Re: 1. FY21 Optional Sales Tax Reallocation — Correctional Facility 2. DEA Equitable Sharing Fund, County Fund 121 — Reserve DEA Equitable Share 3. Law Enforcement Trust Fund, County Fund 112 — Special Law Enforcement Dear Chairman Flescher: Item #1: The Capital Improvement Plan for fiscal year ending 9/30/2021 has $100,000 allocated to the Correction's Medical Housing Design/Construction. At this time, there are critical improvements that are needed to be done to other areas of the facility, specifically, the kitchen in order to become compliant with Health Department standards. Please find attached the obtained quotes for the flooring portion of the Kitchen project. The decision was made to select the Plexi - Chemie quote of $79,470. There will be additional work for plumbing, electrical and propane gas assistance, all of which the costs are unknown at this time. I respectfully request that the Board of County Commissioners authorize the reallocation of the full $100,000 funds so that these critical improvements can be completed. Item #2: According to the Department of Justice's (DOJ) Equitable Sharing Program, law enforcement agencies are allowed to spend forfeited funds for purposes that directly supplement the appropriate resources of the recipient.law enforcement agency. These funds are the direct result of our deputies' diligent law enforcement efforts and are derived mainly from drug-related offenses. None of the funds are derived from county tax dollars. Pursuant to the rules of the DOJ, I am requesting that $55,502 from the DEA Equitable Sharing Fund to be used to equip our Special Investigations Unit. Item #3: Florida Statute 932.7055, the Florida Contraband Forfeiture Act, provides that proceeds and interest earned from the forfeiture of real or personal property shall be used for providing additional equipment and may not be used to meet normal operating expenses of the law enforcement agency. These funds are the direct result of our deputies' diligent law enforcement 10 efforts and are derived mainly from drug related offenses. None of the funds are derived from county tax dollars. Pursuant to the above statute; I am requesting that $30,000 from our Law Enforcement Trust Fund be used to purchase law enforcement protective equipment which is essential in the replacement of old, aged out protective equipment. The requested amount also allows for donations to select charities. Please place these items under Constitutional Officers for the May 11, 2021 board agenda for discussion. Sincerely, Eric Flowers Sheriff EF/ac 4055 41st Avenue • Vero Beach, FL 32960 • (772) 569-6700 • www.iresheriff.org 2? 00Z 11 H AY E S Indian River County Jail 3/26/2021 4055 41st Avenue C o n s t r u c t i o n Vero Beach, FL i Group AREA GENERAL Main Building SUBTOTAL: CONTRACTORFEEI5% TOTAL /TEM# MCRIP7701V OF WORK F-WAIA7E 1 GENERAL CONDITIONS S 21000.00 2 DUMPSTERn FMP FACILITIES/TEMP PROTECTION S 350.00 3 PERMIT na 4 TEMP UTILITIES provided by owner 1 Kitchen Floor AppmL 5,300.00 SF Including Storage S 63,600.00 Hayes Construction Group, Inc. 772-226-0061 CGC 1506170, CCC1329309, CFC1428738 S 65,950.00 S 9,892.50 S 75,842.50 12 HAYES Construction Group PROPOSAL March 26, 2021 Mr. Jeffery Ripple Indian River County Sheriff Department Corrections Department 4055 41" Ave . Vero Beach, FL 32966 RE: Kitchen Floor Replacement We are pleased to present you with the following proposal for the renovation of the building located at the above address:. SCOPE OF WORK. Flooring • Prepare existing floors to receive new flooring one section at a time • Apply a two part epoxy flooring with non-skid aggregate • Flooring to.wall transition will be 6" • Epoxy to be a high traffic product • Flooring alternate will be. an applied flooring such as vinyl • Any modification to floor outlet, plumbing etc. is NOT included • An exact plan of progression is to be approved by the IRCSO • All materials to be approved prior to commencement of work • Floor preparation is contingent on acceptable substrate NOTE: **All pricing is subject to change once final design and specifications are provide** * *Additional work not specifically described above will be an additional cost. Any unforeseen conditions found will be documented, priced out and sent to the client. The client will be required to give approval for the additional cost of work before the work will resume. In some cases it will not be possible to provide pricing for unforeseen conditions, in those cases the work will be done on a COST PL US basis using the rates below. Superintendent $60.00 per hour General Services $45.00 per hour Painting • Drywall • Door Repair (not new install) • Demolition Carpenter $55.00 per hour Laborer $35.00 per hour Contractors Fee 20% on Invoices - Elevated Results - P.O. +Box 1114 1 New Beach, FL 32961 1 772.226.0061 1 brian@hayesgroupinc.com 13 Respectfully Submitted, Brian Hay Hayes Construction Group, Inc. HAYES Construction 4— G r o u p Acceptance, Owner/Owner Representative Date: - Elevated Results - P.O. Box 1114.1 Vero Beach, FL 32961 1 772.226.0061 1 brian@hayesgroupinc.com 14 Thompson's Remodeling R. Todd : u1gu1Tli1 l�lull��uu r r r u 111 11111111 & Home Repair, Inc. PROPOSAL/CONTRACT April 08, 2021 Indian River County. Sheriffs Office 4055 41 st Ave. Vero Beach; FL 32960 Project: Non-skid epoxy flooring in the Kitchen Dear Sgt. Ripple, State Licensed Insured Please accept this correspondence as our proposal to complete work at project site: 4055 41 st Ave. Proposed Scope of Work We agree to provide all materials and labor needed to remove existing flooring and install a new epoxy floor system, details below: Kitchen:. • Chip -up and dispose of all existing floor tile. • Grind the existing concrete floors to obtain the proper slopes and surfaces to apply the new epoxy finishes. • Delete existing for drains that are not in areas of use, the plumbing sewer line as needed. • Provide and install new floor sink drains where the existing sinks are rusted out and or damaged. • Repair the stainless steel floor sink drain grates as needed. • Rebuild the curbs and float floors in areas that are needed to obtain the proper pitch to divert the water into the drains. • Apply a professional commercial grade two-part epoxy nonskid floor aggregate (color to be determined) Total Price $47,900.00 P.O. Box 430 • Vero Beach, FL 32961-0430 Office (772) 564-8008 - Fax (772) 564-6760 remode1er00@gmai l.c.om Contractor License # CGC1510956 Roofing License # CCC 1327801 Plumbing License #CFC 1428384 Electrical License #EC13007485 15 February 10, 2021 Rev. April 08, 2021 Epoxy flooring Page.2 Contractor is responsible for all necessary permits Contractor is responsible for the daily cleanup and the proper storage of supplies. Contractor is not. responsible for damages caused by any acts of nature. Contractor is not responsible for driveways, sidewalks, planters, plants, flowers, shrubbery, sod, or irrigation, unless otherwise specified by this proposal. We grant a (1) year craftsmanship Warranty, from the completion date of this project. Due to the unpredictability of the construction material and labor market, this proposal is good for 20 days from the date of this correspondence All work to be performed as specified above and completed in a substantial workman like manner for the sum of $47,900.00 Forty Seven Thousand Nine Hundred Dollars ****'`1100 • Amount due upon acceptance 25% • Performance_draw as needed after the tile floor removal • Balance payment due upon completion Any alterations or deviation from above .specifications involving extra costs will be executed only upon a written change order and will become an extra change over and above the proposed price. All agreements are contingent upon strikes, accidents or delays beyond our control. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. Thompson's Remodeling and Home Repair Inc. is hereby authorized to do the work as specified. Signature: Date: Authorized Representative Signature: Date: R. Todd Thompson, Contractor P.O. Box 430 • Vero .Beach, FL 32961-0430 Office (772) 564-8008 - Fax (772) 564-6760 remodeler00@gmail.com. Contractor License # CGC1510956 Plumbing License #CFC1429384 Roofing License # CCC 1327801 Electrical. License #EC13007485 16 Emilie L. Enzmann From: Todd Thompson <todd@thompsonsremodeling.com> Sent: Thursday, April 8, 20217:44 AM To: Emilie L. Enzmann Cc: Michelle Barkley Subject: <EXTERNAL EMAIL> Kitchen flooring proposal Attachments: Kitchen Epoxy flooring proposal 4.8.21.pdf CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. If unsure, hit the Phish Alert button. Good morning, Please see I have made the revisions as you requested to the kitchen for proposal. Please let me know if you have any questions or concerns. Have a wonderful day!! Thanks R. Todd Thompson President Thompson's Remodeling, Inc. P.O. Box 430 Vero Beach, FL. 32961 Phone: 772.564.8008 Cell: 772.473.9900 Fax: 772.564.6760 email: todd[a)thomremo.com Contractor Lie. # CGC1528411*"Electrical Lie. # EC13007485** Roofing Lie. # CCC132375— This; a -,mail message and any attachments -are confidential and' contain information intended only for the addressees.. Any, retention', storage; forwarding, retransmission, publication or other use ordisclosure of this message or any of its attachments by any other person is strictly prohibited. Ifyou have. received this transmission in error,- please. notify the sen der•immediately, Also, please destroy the original. message, including all attachments and all copies. 'Thank you. 17 Emilie L. Enzmann From: Emilie L. Enzmann Sent: Monday, March 29, 2021 10:53 AM To: 'Michelle Barkley' Subject: Kitchen Floor Project Attachments: Thompson's Kitchen Floor Prc ject:pdf Michelle, Good Morning! Please provide an updated quote (see attached) for the Kitchen Floor project. -lease quote JUST the KITCHEN FLOOR. We are moving ahead with this project next and I need updated quotes. Thanks for your usual prompt attention to the matter. Emilie Enzmann, Accounting Admin&bator Bureau ofCoirecdons Indian River County Sheriffs Office 405541st Avenue i Vero Beach, FL 32960 M-978-6301 eenzmann(ftahedff.nro 18 Hi -Performance Seamless Flooring Solutions (904) 693-8778 Office • (904) 693-8700 Fax JSEB/WMBE Certified Company April 28, 2021 Emilie Enzmann Accounting Administrator Bureau of Corrections Indian River County Sheriff's Office 4055 41 It Avenue Vero Beach, Fl. 32960 Re: IRC Jail Kitchen Floor Replacement project measuring 4500 SQFT. Emilie, Thank you for the opportunity to attend a pre-bid walk-thru to quote on the IRC Jail Kitchen Floor Replacement project. We are quoting the Plexi -Chemie Inc. brand of resinous epoxy flooring. Plexi - Chemie is a manufacturer and installer of resinous epoxy flooring and walls. The Floor will be delivered as follows: • Dumpster (IRC)— Provided by IRC • Removal (IRC) —All electrical including unplugging and plugging of cords, plumbing and gas disconnect and connect, and any cutting or welding is to be done by the County. , Removal and installation of the large u -shaped stainless sink(s) are to be done by the County. • Demolition —removal of the existing epoxy flooring and quarry tile and setting bed (Dish Pit), broom swept and vacuumed. • Surface Prep- shot blast, scarify, and diamond grind to achieve a clean workable profile. • Prime- PlexiGlaze #4 Primer • Pitch and Fill- with 1-2 inches of PlexiClad Deep Fill High Strength Epoxy Mortar Underlayment @ Dish Pit, Fryer Cooktop, and Ovens areas. This is to acquire positive drainage and give additional heat resistance to the floor. • Install — the P1exiCrete HD Cementitious Urethane Flooring System @ 3/8th inch thick in Red, Gray, or Quartz finish. This includes the 54nch integral cove base. Once cured...... • Install Grout Coat-PlexiCoat F Novalac Epoxy @ IS mils • Install Topcoat — P1exiCrest XP Polyaspartic Urethane Top Coat in Red or Gray. • Warranty — This project carries a 5 -year warranty The investment for;4;50.0 SQFTs_quare feet-@ $1-7.66 per -square foot�.is $79,470.00. This includes the demolition of existing floor, all surface preparation by mechanical means only, pitch and fill (1-2 inches of High Strength PlexiClad Deep Fill Epoxy Mortar Underlayment (for Dish Pit, Fryer Cooktop and Oven Areas totaling 960 SQFT),.the PlexiCrete HD Urethane Mortar Flooring System, 800 lineal feet of 5 -inch -high integral cove base, grout and top coats. 606-6 Lane Avenue North, Jacksonville, FL 32154 www.nlerichendenet 19 A Hi,Performance Seamless Flooring Solutions (904) 693-8778 Office * (904) 693-8700 Fax JSEB/WMBE Certified Company We are a state -certified woman -owned minority business enterprise (WMBE, WDBE). Price is for one mobilization. We hope to win the job! Sincerely, Joanne T. Grant 904-477-9902 606-6 Lane Avenue North, Jacksonville, FL 32254 wivte.ale-richende.net 20 PLEXI-CHEMIE INC. Product Data Sheet For: 606-6 Lane Avenue North Jacksonville, FL 32254 Phone (904) 693-8800 FAX (904) 693-8700 www.plexi-chemie.com PLEXICLAD DEEPFILL DESCRIPTION PlexiClad DeepFill is 100% solids, power -troweled epoxy filler. PlexiClad DeepFill is installed at a thickness of — 2" thick depending on the erosion of the concrete, required patch or required fill. It is designed to rehabilitate worn concrete and as a protective filler or pitching material in preparation for coatings or overlayments. PlexiClad Deep Fill exhibits exceptional strength while offering excellent chemical resistance. TYPICAL USES PlexiClad DeepFill is used as a deep fill epoxy grout material in heavy-duty forklift traffic aisles, high abrasion and impact areas, wet processing areas, and as a superior deep fill grout that offers a resin rich install. It is used to level and pitch new and existing surfaces prior to resinous flooring installation. FEATURES VOC compliant, chemical resistant, high impact resistance, high abrasion resistance, high compressive strength, and impact resistant. FORMULATION Each unit is comprised of 2 gallons of Part A (resin), 1 gallon of Part B (activator), Part C (color pack), and 125 lbs. of Part D (graded silica aggregate and 50 lbs. 1/8" —1/4" pea gravel). DURABILITY PlexiClad DeepFill is extremely durable and performs extremely well in areas requiring high impact and abrasion resistance. PlexiClad DeepFill also works well in spillage and wet processing areas, as well as areas where sanitation and dust free environments are required. COVERAGE Coverage @'/4" (125 - 150 square feet per unit). Coverage@ 1" (50 — 75 square feet per unit). Coverage @ 2" (18 — 24 square feet per unit). SURFACE PREPARATION Remove oil, grease, chemicals and contaminants by mechanical preparation. Preferred method of mechanical preparation is shot-blasting, diamond grinding, and scarification. Use hand-held diamond grindersin hard -to -reach areas. PlexiClad DeepFill 1IPage 21 MIXING Premix Part A (resin), Part B (activator), and Part C (color .pack) in a running rotary drum mixer. Mix parts together for approximately 30 seconds. Slowly add Part D (aggregate), and mix until a lump -free, thoroughly wetted -out matrix is obtained. INSTALLATION Install PlexiClad DeepFill on primed substrate. Screed by hand with screed bar. Immediately after placing, material must be power -troweled or hand troweled to a minimum of VV thickness. CURE RATE 6-8 hours prior to application of troweled epoxy or urethane mortar. PHYSICAL PROPERTIES Compressive Stren th ASTM C-579 7,800 si Tensile Strength STM C-307 1,700 psi Abrasion Resistance STM D-1044 `0.10 gm CS -17 Wheel, 1 k load loss max Water Absorption ASTM C-413 0.32% Flexural Strength ASTM C-580 4,200 psi Shore D Hardness ASTM D-2240 85 Heat Distortion Degrees F 175°F Bond Strength to 100% Concrete (dry) substrate failure Pot Life @ 75• 1 45 mins. WARRANTY Plexi -Chemie Inc. warrants its products to conform to its manufacturing standards. Plexi -Chemie Inc. will replace or refund the purchase price of non -conforming product at the seller's option; such remedy being exclusive of all others and sole remedy available to the buyer. Buyer hereby expressly waives claim to additional damages. Any claim under this warranty must be made in writing within 7 days of discovery of non-compliance and no later than one year from the date of delivery of product. No representative, distributor or applicator of these products is authorized to modify product data or warranty. Notice: The technical data contained herein are true and accurate to the best of our knowledge. All products are offered and sold subject to Plexi -Chemie Standard Conditions of Sale. Published technical data and instructions are subject to change without prior notice. Please be sure the Safety Data Sheet is read and understood before using any Plexi -Chemic product. PlexiClad DeepFill 21fnoe 22 �LEM-CHEMIE INC. Product Data Sheet For: 606-6 Lane Avenue North Jacksonville, FL 32254 Phone (904) 693-8800 FAX (904) 693-8700 www.plexi-chemie.com PlexiCrete HD Description: PlexiCrete HD is a self -priming four component, 100% solids, high performance urethane mortar flooring system comprised of a urethane binder, pigments; powders and cementitious aggregates. This system is installed at a nominal thickness ranging from 3/16", 1/4", 3/8" to 1/2" depending on application requirements. It is designed for a variety of applications, new or damaged, on concrete. This system provides conventional protection plus thermal -shock resistance, with a wide range of both caustic and acid resistance. PLEXICRETE HD ADVANTAGES: 4, Chemical Resistance - polyurethane technology provides superb protection against caustics, organic and inorganic acids, solvents and most chemicals used today in industry. 4- Thermal Shock Resistance - PlexiCrete HD and concrete have a similar coefficient of thermal expansion from under -50°F to 265°F. PlexiCrete HD withstands continuous hot water washdowns. 4- Impact. Resistance - while epoxy and vinyl esters can crack and spall, PlexiCrete HD will absorb an impact and distribute the force throughout the system. Downtime - no primers or sealers are required due to the resin -rich properties. Fast curing in less than 6 hours. Full cure in 12 hours. Non -Slip _ the surface can be customized to any facility requirements... from decorative self -leveling to aluminum - oxide solid color broadcast. ADA compliant under wet and dry conditions. F Odorless Materials - no tainting of food products due to freedom from objectionable odors during application. VOC compliant. h Thermal Comfort - PlexiCrete HD provides superior insulation over concrete. ir- Hygiene - PlexiCrete HD eliminates tile joints, minimizes cracking as occurs in traditional monolithic flooring, and eliminates potential bacteria growth. Hydrostatic Pressure - PlexiCrete HD will withstand up to 14-20 lbs. of vapor transmission in the slab without delamination. It also allows the concrete to breathe and is a solution for many moisture problems 4- Color Stable - PlexiCrete HD will remain color stable and will not change color over time. Areas of Application: 4-1 Food & Beverage (FDA/USDA Accepted) 4r- Bakery -G- Food Processing 4- Dairy 4- Meat Processing Soda & Juice Facilities `e- Brewery 4- Prepared Foods 4- Commercial Kitchens 4- Chemical Processing Animal Rooms Secondary Containment 4- Pharmaceutical 4- Pulp & Paper Chemical Resistance: PlexiCrete HD flooring system resists spills and in many cases immersion of: Acid Alkali. Hydrochloric KOH Phosphoric Ammonium Chloride Sulfuric Sodium Hydroxide Also resists hot fatty oils, diesel fuel, and organic solvents (MEK, Acetone, Toluene) Full chemical resistance chart available upon request Packaging: 1 unit is comprised of: ,'w- 128 oz. of PlexiCrete Resin (Part A) 6,� 100 oz. of PlexiCrete Hardener (Part B) h 8 oz. of Color Pack 50 Ib. bag of PlexiCrete HD Aggregate PlexiCrete HD Data Sheet 11 23 Colors: ASTM C-579 Surface Preparation: Unlike competitors' products, PlexiCrete HD is PlexiCrete HD and all of our high performance available in the following colors: resurfacing systems always require surface preparation 1.6 x 10(-5) °F Density by mechanical means only: Shotblasting and diamond <s^ Tile Red grinding. No other preparation method is acceptable 4- Granada Gray for the long-term success of any floor. 4- Blue ASTM C-469 6- Green Installation: 4- Saber Gray PlexiCrete HD requires a degree of knowledge of 2.6 x 10 (6) psi Thermal Conductivity industrial flooring that is unique to urethane mortars. 6.8 BTU-in/hr-fl2°F Water Absorption This includes proper preparation of surface and <0.03% Abrasion Resistance preparation of PlexiCrete installation. Please contact us 0.05 mg loss Slip Resistance ADA Minimum for a copy of our comprehensive installation Greater than .05 (All textures wet & dry) Adhesion instructions. Physical Properties: Compressive Strength ASTM C-579 10.500 psi Tensile Strength ASTM C-307 2,500 psi Coefficient of Thermal Expansion ASTM C-531 1.6 x 10(-5) °F Density ASTM C-905 130 Ibs./ti3 I Resistance to Fungi Growth ASTM G-21 passes, rating of one Impact Resistance ASTM D-2794 no visible damage or deterioration at min 160 inch - pounds Comprehensive Modulus ASTM C-469 1.7 x 10(5) psi Flexural Strength ASTM C-580 2,625 psi Flexural Modulus of Elasticity ASTM C-580 2.6 x 10 (6) psi Thermal Conductivity ASTM C-177 6.8 BTU-in/hr-fl2°F Water Absorption ASTM C-413 <0.03% Abrasion Resistance ASTM D4060 @ 1000 cycles 0.05 mg loss Slip Resistance ADA Minimum ASTM F-1679 Greater than .05 (All textures wet & dry) Adhesion ASTM D-4541 500 psi 100% concrete failure, exceeds concrete Hardness ASTM D-2240 81344 Heat Resistance >_250°F Continuous exposure) Bond Strength ACI 503R >400 psi 100% concrete failure Flammability ASTM E-648 Class I — Self Extinguishing Notice: The technical data contained herein are true and accurate to the best of our knowledge. All products are offered and sold subject to Plexi -Chemie Standard Conditions of Sale. Published technical data and instructions are subject to change without prior notice. Please be sure the Safety Data Sheet is read and understood before using any Plexi -Chemie product. PlexiCrete HD Data Sheet 2113age 24 PLEXI—CHEMIE INC. Product Data Sheet For: PLEXICOAT F NOVOLAC Description: PlexiCoat F is a 100% solids, chemical resistant novolac epoxy, clear or pigmented, used to coat or line concrete, masonry, or other polymeric surfaces where high chemical and thermal protection is required. PlexiCoat F is designed for service in harsh chemical environments. PlexiCoat F is used to upgrade the chemical and heat resistance of PlexiOuarh_ and PlexiChip floors, as a binder in troweled surfacers and other applications. PlexiCoat F provides excellent chemical resistance for primary and secondary containment and will provide exceptional service near high temperature processes areas. Certain exposures will require PlexiCrete (urethane mortar) and PlexiCoat P (hi -functioning hybrid resin). PlexiCoat F is available in clear, pigmented regular and fast cure and flake. Features and Benefits: PlexiCoat F has excellent chemical resistance to organic and inorganic chemicals. Positive cure in cool and damp conditions. �^ 100% non-volatile & odorless for applications in occupied facilities. Materials comply with USDA requirements for use in federally inspected Meat and Poultry Plants. fi^ PlexiCoat F is an excellent coating for concrete, steel, aluminum and wood surfaces. It is formulated to provide better chemical resistance to dilute acids, caustics and solvents than conventional epoxy systems. PlexiCoat F can be used as a coating system where high chemical resistance is required. PlexiCoat F can be used with a quartz or chip broadcast system. PlexiCoat F can be used as a mortar binder for very heavy duty and chemical resistant flooring. Typical Applications: �^ Cafeterias, restaurants and hospital rooms Pharmaceutical facilities Food plants of all types r- Beverage and processing plants Institutional kitchens Battery storage areas ^ Hangar floors Animal care facilities �^ Labs- floors and walls Secondary containments 606-6 Lane Avenue North Jacksonville, FL 32254 Phone (904) 693-8800 FAX (904) 693-8700 www.plexi-ch emie.com Limitations: Do not apply in temperatures less than 40°F or greater than 95°F. Material cures slower at cooler temperatures and working time will be reduced at higher temperatures. Both components should be stored at ambient temperatures between 65'F and 80°F. Do not apply to slabs on grade unless vapor mitigation issues have been addressed. Surface Preparation: Surface must be prepared to remove all sealers, curing compounds, oils, greases and other contaminants and laitance. As a standard rule, stand mix concrete should be cured a minimum of 28 days. Cure Schedule (7a. 75°F: Pot Life* 35 minutes Tack free* 6 hours Foot traffic* 12 hours Forklift traffic* 24 hours Full chemical exposure 7 days *Low temp products will cure approximately 40% faster than standard cure. Service Temperature (Mortar Systems): 200°F (immersion) 350°F (dry heat) Packaging: 2 to 1 ratio Packaged in 3 and 15 gallons units. A & B mixed viscosity is 800 cps. Coverage: Determined by type of service but a generally PlexiCoat F should be applied at a minimum of coats as a coating, at a minimum of 10 mils per coat (160 sq. ft. /gal. minimum). PlexiCoat F Novolac can be used as a binder for 1/8" inch shop floors, or %d' inch troweled epoxy mortars. Installation: 1. As a coating system: Premix parts A&B separately prior mixing A&B together for approximately 2 minutes. Always mix by mechanical means. Always mix mechanically until a uniform blend is obtained. 2. Asa binder -for P1exiOuartz: Follow standard color quartz application techniques. 3. PlexiClad troweled mortar. See P1exiClad data sheet. PLEXICOAT F NOVOLAC DATA SHEET I I15Qe Typical Physical Properties: Compressive Strength ASTM D-695 14,000 psi Tensile Elongation ASTM D-638 15-20% 2875 psi Flexural .Stren h ASTM D-790 9,600 psi Abrasion Resistance CS -17 Wheel, 1.000 g load 1000 cycles ASTM D-1044 107 mg loss Hardness ASTM D-2240 66+ Bond Strength to Concrete (dry) ASTM D-4541 475 psi Concrete Failure Heat Distortion ASTM D-648 150°F Elongation at Break ASTM D-638 10% Water Absorption ASTM D-570 0.09% VOC Content SODIUM HYPOCHLORITE — 5% 0 g/L PlexiCoat F Chemical Resistance Guide: 1: Suitable for continuous service or immersion. C: Suitable for secondary containment (72 hour immersion) or intermittent immersion, followed by regulated clean-up. L: Limit use to splash and spillage, followed by regulated spill removal al and clean-up within four hours. T: Consult Plexi-Chemie's Technical Department for evaluation assistance. NR: Not recommended ACETIC ACID -50% C BROMINE WATER -5% L SEA WATER I ACETONE L BUTADIENE T SILVER NITRATE I ADIPIC ACID I BUTYLACETATE C SKYDROL 500 B I ALCOHOL (ETHYL) C BUTYALCOHOL C SODIUM HYDROXIDE— 35% 1 ALCOHOL (METHEL) C CALCIUM CARBONATE I SODIUM HYPOCHLORITE — 5% C ADIPIC ACID I CALCIUM CHLORIDE I SULFURIC ACID -20% I ALCOHOL ETHYL C CASTOR OIL I T O L U L E N E. C ALCOHOL METHEL C CHLORINE DIOXIDE NR TOLUENE SULFONiC ACID C ADIPIC ACID I CHLORINE WATER SATURATED NR 1-1-1 T R I C H L O R O E T H A N E C ALCOHOL (ETHYL) C CITRIC ACID I TRICHLOROETHANE (TCE) C ALCOHOL (METHEL) C CORN OIL I TRICHLORACETIC ACID - 20% NR BENZALDEHYDE NR METHYL ISOBUTYL KETONE C WATER (DISTILLED AND DEMINERALIZED I BENZENE C NITRIC ACID- 10% L WHITE LIQUOR PULP AND PAPER) I BENZENE SULFONIC ACID — 50% C NITRIC ACID— 40% NR XYLENE C BENZYL ALCOHOL NR NITRIC ACID -60% NR SEA WATER 1 BENZYL CHLORIDE T OILS (ANIMAL) I SILVER NITRATE 1 BORIC ACID 1 OILS (MINERAL) I SKYDROL 500 B I BRINE 1 Notice: The technical data contained herein are true and accurate to the best of our knowledge. All products are offered and sold subject to Plexi -Chemie Standard Conditions of Sale. Published technical data and instructions are subject to change without prior notice. Please be sure the Safety Data Sheet is read and understood before using any Plexi -Chemie product. PLEXICOATF NOVOLAC DATA SHEET 21Paoe zn 26 606-6 Lane Avenue North Jacksonville, FL 32254 Phone (904) 693-8800 FAX (904) 693-8700 www.plexi-chemie.com Product Data Sheet For: PlexiCrest XP Polyaspartic (Ester) Urethane Coating DESCRIPTION PlexiCrest XP Polyaspartic (Ester) Urethane, clear or pigmented, is a state of the art high solid, no VOC's (Volatile Organic Compound), aliphatic polyurea that was developed for UV stable (colorfast) polyurea flooring applications as a primer, body coat, grout coat, top coat or a standalone coating. PlexiCrest XP can also be installed as a clear topcoat over a quartz or flake broadcast system. This new generation polyurea displays fast cure times and excellent adhesion characteristics. PlexiCrest XP is designed to be quick gelling (15 minutes) in order to optimize leveling and wetting properties. This state of the art polyurea elastomeric displays excellent chemical resistance, water insensitivity, and UV resistance (in any color) at a wide range of temperatures. PlexiCrest XP will provide a glossy, smooth finish when fully cured. Aggregate can be broadcast into this self -leveling material to provide a non-skid surface. PlexiCrest XP emits virtually no odors and can be applied indoors with minimal disturbance contributed to high V.O.C. levels found in most epoxies and polyurethanes. This product meets USDA and FDA specifications. PlexiCrest XP can be applied at temperatures as low as minus -20° F and as high as 85° F. FEATURES 4- VOC Compliant 6- Excellent UV Resistance (non -yellowing) Fast Setting (within 20-30 minutes) <r- High Gloss/ Water Clear Finish 4r High Strength Greater Abrasion/Chemical/Impact Resistance 4- Excellent Weatherability 4- Good Resiliency/Can be pigmented One day install time High build thickness in one coat :- Forms excellent bond No out -gassing AVAILABLE COLORS *Clear, most primary colors (including white) *Custom tinting available PACKAGING/COVERAGE I0 -gallon kit: I five -gallon pail of Part A and I five - gallon pail of Part B TYPICAL PROCESSING PROPERTIES Gel Time (75° F) Pot Life 15-20 minutes Tack free time (75° F) 45 minutes Open to foot traffic 2 hours. Volume Ratio 1A:113 STORAGE Material containers should always be stored indoors in a minimum temperature range of 68*F — 85*F (20° C — 29°C). The product has a shelf life of 1 year from the date of manufacture. MIXING Part A and Part B should be mixed individually before combining. Combine Part A and Part B, mixing thoroughly, using a mechanical mixer (Jiffy Mixer) at medium speeds. Mix for approximately 1 minute (DO NOT OVERMIX). Use care to scrape the sides of the container to ensure that no unmixed material remains. Use caution not to whip too much air into the material as this may result in pinhole blisters or shortened pot life. Do not mix more material that can applied in 10- 15 minutes. Otherwise, material will start generating heat and accelerate the curing process; It will shorten the working time. APPLICATION PlexiCrest XP can be spread using a notched squeegee, brush or nap roller for the application. It should be noted that the thicker the application, the longer the curing process takes. At 70°F (21 °C) and 50% relative humidity, each coat needs to cure a minimum of 2-4 hours. Allow a PLEXICRESTXP DATA SHEET 1Page 27 minimum of 4 hours before permitting light pedestrian traffic and at least 24-48 hours before permitting heavy pedestrian or -auto traffic onto the finished surface. Higher temperatures and/or high humidity will accelerate the cure time. Use caution in batch sizes and thickness of application. Low temperature and/or humidity extend the cure time. TYPICAL PHYSICAL PROPERTIES EQUIPMENT CLEANUP Equipment should be cleaned with an environmentally safe solvent, as permitted under local regulations, immediately after use. Solids Content 78%f 5% mixed Tensile Strength, psi ASTM D412 .5000-8000 Hardness Shore D ASTM D2240 70-75 Flexibility 1/81 inch mandrel ASTM D1737 Pass Elongation ASTM D412 30-50% Viscosity, cp @ 750 Mixed 35 S 400 Tear Strength ASTM D624 350 psi Taber Abrasion ASTM D4060 22 m Gel Time min @ 75°F 15-20 Initial Set Time min R 75°F 20-30 Mix Color Clear Mix Ratio IA:l B b volume Cure Time 1-2 hrs. VOC 30-40 Flammability Self -extinguishing over concrete This product contains isocyanate and curative material. Notice: The technical data -contained herein are true andaccurate to the best of our knowledge. All products are offered and sold subject to Plexi -Chemie Standard Conditions of Sale. Published technical data and instructions are subject to change without prior notice. Before using any Plexi -Chemie product, be sure the Safety Data Sheet is read and understood. PLEXICREST XP DATA SHEET 211'aae Emilie L. Enzmann From: Joanne Grant <JGrant@plexi-chemie.com> Sent: Wednesday, April 28, 2021 5:44 PM To: Emilie L. Enzmann Cc: Pasquale Sicilia; Elizabeth Self; Michelle White Subject: <EXTERNAL EMAIL> IRC Jail Kitchen Epoxy Flooring Quote Attachments: IRC Sheriff's Jail Kitchen Vero Beach Epoxy Flooring Project Quote .pdf, PlexiClad DeepFill Product Data Sheet.pdf, PLEXICRETE HD..pdf, PlexiCoat F Novolac.pdf; PLEXICREST XP polyaspartic ester.pdf CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. If unsure, hit the Phish Alert button. Hello Emilie, Attached, please find our quote for the IRC Jail Kitchen Epoxy Floor Replacement project. Thank you for reaching out to US. Sincerely, Joanne Joanne Grant President Plexi -Chemie, ,Inc. DBA Industrial Flooring. Specialists DBE/MBE Certified 606-6 Lane Avenue North Jacksonville, FL 32254 Phone: 904-693-8800 Cell: 904-477-9902 igr—ant@plexi-chemie.com www.nlexi-chemie.com 91 ®s�" 1 29 logl INDIAN RIVER COUNTY, FLORIDA MEMORANDUM TO: Honorable Board of County Commissioners THROUGH: Jason E. Brown, County Administrator THROUGH: Tad Stone, Director Department of Emergency Services FROM: Erin Sawyer, Staff Assistant IV Department of Emergency Services DATE: May 4, 2021 SUBJECT: Request from Turbo Transport Services LLC for a Class "E" Certificate of Public Convenience and Necessity to provide Wheelchair transports originating from Indian River County - Administrative It is respectfully requested that the information contained herein be given formal consideration by the Indian River County Board of County Commissioners (the "Board") at the next scheduled meeting. Background: Chapter 304 of the Indian River County Code of Ordinance (the "Code") governs certificates of public convenience and necessity in Indian River County for various uses, including wheelchair vehicle services. Per section 304.07 of the Code, after an application has been received by Indian River County, the EMS director makes an investigation and a determination of the public need for the proposed service in the geographical area requested. As part of this investigation, the EMS director contact the medical director, all other service providers in the county, and any municipality in which the applicant desires to provide service. The EMS director also is required to schedule a public hearing before the Board with notice to all other service providers in the requested service area, any municipality in the requested service area and to the general public.by publication in the local newspaper with at least one week's notice. At the public hearing, the Board shall consider the EMS director's recommendation and any input from other service providers, municipalities, or interested groups or citizens and may grant or deny the requested certificate of public convenience and necessity. 30 In making his recommendation, the EMS director shall consider the following factors: (a) The population density and composition of the likely areas within which the proposed ALS, BLS, or nonemergency medical transport service will operate. (b) The need of the people in the area for ALS, BLS, or non -emergency medical transport service. (c) A comparison of estimated annual requests for service in the particular certificate category with the current number of vehicles satisfying requests. (d) Such other factors as may be considered important by the EMS director. Analysis: On March 3, 2020, Turbo Transport Services LLC submitted an application for Class "E" Certificate of Public Convenience and Necessity to provide Wheelchair transport service originating within Indian River County. Pursuant to the Code, staff initiated an investigation to be made regarding the application. There are two (2) other providers who hold a Class `B" certificate in the County as follows: Arc of Indian River County Senior Resource Several attempts were made for all current providers, municipalities, interested groups and the Medical Director to attend an informal meeting for the purpose of receiving information about the proposed service and discuss the need for additional service in the County. Both of the providers did not have any concerns with the addition of another Class "E" COPCN. Recommendation: Staff recommends that the Board conduct the public hearing and -take input from any interested party and upon conclusion of the hearing, approve and grant a Class "E" COPCN to Turbo Transport Services LLC for a period of two (2) years. Attachments: Application for Certificate of Public Convenience and Necessity for Turbo Transport Services LLC. 31 PTMfNr INDIAN RIVER COUNTY (uQ Pg.i�r; p DEPARTMENT OF EMERGENCY SERVICES 9�FN y SSP, APPLICATION FOR CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY (COPCN) APPLICANT NAME: Turbo Transport Services LLC DATE: 3/1/2021 APPLICATION FEE: $100.00 APPLIES TO INITIAL APPLICATIONS ONLY. If payment applicable, make check payable to INDIAN RIVER COUNTY FIRE RESCUE. ® This is a new application; fee is attached. ❑ This is a renewal of our present COPCN. ❑ This is a renewal of our present COPCN with ownership or classification changes. CLASSIFICATION OF CERTIFICATE REQUESTED Please check applicable boxes and options. Class A ❑ [—]BLS DALS Governmental entities that use advanced life support vehicles to conduct a pre- hospital EMS ALS/BLS service. Class B ❑ DBLS DALS Agencies that provide non -emergency ambulance inter -facility medical transport at the ALS/BLS level. Class C Q DBLS DALS Agencies that provide non -emergency ambulance inter -facility medical transports which require special clinical capabilities and require a physician's order. Class D ❑ DBLS DALS Agencies that provide non -emergency ambulance medical transports limited to out of county transfers. Class E CE Wheelchair 1 Wheelchair/Stretcher ,Ambulatory Transport Agencies that provide wheelchair transportation service only where said services are paid for in part or in whole either directly or indirectly with government funds. Class E1 GID✓ Wheelchair II Wheelchair/StretcherIlAmbulatory Transport Agencies that provide wheelchair vehicle service where said services are not paid for in part or in whole either directly or indirectly with government funds. UABetMBeth Casano EOCICOPCMRENEWAL PACKETSICOPCN Application.doc 1 32 H. COMPANY DETAILS 1. NAME OF AGENCY: Turbo Transport Services LLC MAILING ADDRESS: 826 Everglade SE CITY Palm Bay COUNTY Brevard ZIP CODE: 32909 BUSINESS PHONE: 407-72474327 2. TYPE OF OWNERSHIP(i.e. Private, Government, Volunteer, Partnership, etc.): Partneship 3. MANAGER'S NAME: Samuel ROny ADDRESS: 826 Everglade SE, Palm Bay, FI 32909 PHONE #: 561-420-3018 4. PROVIDE NAME OF OWNER(s) OR LIST ALL OFFICERS, PARTNERS, DIRECTORS, AND SHAREHOLDERS, IF A CORPORATION (attach a separate sheet if necessary): NAME ADDRESS Shardy Sauveur; 826 Everglade SE, Palm Bay, FL 32909, Owner/CEO Samuel Rony; 826 Everglade SE, Palm Bay, FL 32909, Owner/CFO POSITION 5. PROVIDE NAMES AND ADDRESSES OF AT LEAST THREE (3) LOCAL REFERENCES NAME ADDRESS Robert Glaeser, 759 SW Federal Hwy # 201, Stuart, FL 34994, (941) 777-6013 Eddie Bettencourt, Port Saint Lucie, Florida (772) 333-1610 PHONE # UABeth\Beth Casano EOCICOPCMRENEWAL PACKETMOPCN Application.doc 2 33 6. FUNDING SOURCE: Non -emergency transportation brokers 7. RATE SCHEDULE ATTACHED? YES O NO O N/AO 8. LIST THE ADDRESS(es) OF YOUR BASE AND ALL SUB=STATIONS: 2408 South 10th Street, Fort Pierce, FI 34982 826 Everglade SE, Palm Bay, FI 32909 III. COMMUNICATIONS INFORMATION: TYPES OF RADIOS/EQUIPMENT: Online Walkie Talkie Pro App 1. RADIO FREQUENCY (ies) Cell phones Mediroutes N/A 2. RADIO CALL NUMBER(s) 3. LIST ALL HOSPITALS AND OTHER EMERGENCY AGENCIES WITH WHICH YOU HAVE DIRECT RADIO COMMUNICATIONS: FROM AMBULANCE N/A U:1BethlBeth Casano EOC\COPCNIRENEWAL PACKEMCOPCN Application.doc FROM BASE STATION 3 34 IV. ADDITIONAL INFORMATION REQUIRED TO BE SUBMITTED WITH THIS APPLICATION: RENEWAL APPLICANTS FOR CLASSES A -D NEED ONLY #'s 4 - 9 RENEWAL APPLICANTS FOR CLASSES E AND E-1 NEED ONLY #'s 6 — 9 1. Factual Statement indicating the public need and services, including studies supporting the demonstrated demand and feasibility for the proposed service(s) and deficiencies in existing services, and any other pertinent data you wish to be considered. Q2. Factual statement of the proposed services to be provided, including type of service, hours and days of operation, market to be served, geographic areas to be serviced, and any other pertinent data you wish to be considered. F✓ 3. Factual Statement indicating the ability of the applicant to manage and provide the proposed services, including the management plan, maintenance facilities, insurance program, accounting system, system for handling complaints, system for handling accidents and injuries, system for providing the county monthly operating reports and any other pertinent data you wish to be considered. 4-5 Q✓ 4. Copy of Standard Operating Procedures. Q 5. Copy of Medical Protocols. R6. Copy of your insurance policy— must show coverage limits — W1 7. Vehicle Information. For each vehicle provide the following: a. Make, Model, Year, Manufacturer b. Mileage c. VIN # d. Tag Number e. Passenger capacity (E/E1 classification) f. Indicate ALS/BLS (A -D classification) Q✓ 8. Personnel Roster. For each employee. provide the following: a. Name — Last, First and Middle Initial b. Driver's License # (if commercial, specify class) & Expiration Date ADDITIONAL INFO REQUIRED FOR A -D classifications c. Emergency Medical Service Certification and # (EMT or Paramedic) d. Expiration date of Certification e. Whether or not has an Emergency Vehicle Operation Certificate. 10 9. Fee Schedule Incl: Service Type, Base Rate, Mileage, Waiting & Special Charges U:\Beth\Beth Casano EOC\COPCN\RENEWAL PACKETS\COPCN ApplicaGon.doc 4 35 V. NOTARIZED STATEMENTS Fill in Statements as applicable. E or E1 APPLICANTS I, ,C , the representative of Applicant Name I UL v � c�O %k -c eA tv, do hereby.attest that the Business ame of Service above named service me is all the requirements of, and that 1 agree to comply with, all applicable provisions of Chapter 304, Life Support and Wheelchair Services. A -D APPLICANTS 1, , the representative of Appl cant Name VUR S do hereby attest that Business Name of lervice the above named service will provide continuous service on a 24-hour, 7 -day week basis. I do hereby attest that the above named service meets all the requirements for operation of an ambulance service in the State of Florida as provided in Chapter 401, Part III, Florida Statutes, Chapter 64E-2, Florida Administrative Code, and that I agree to comply with all the provisions of Chapter 304, Life Support Services. ALL APPLICANTS I further acknowledge that discrepancies discovered during the effective period of the Certificate of Public Convenience and Necessity will subject this service and its authorized representati ective action and penalty provided in the referenced au r ty and th t t the best of my knowledge, all statements on this p4 lign arp. u and correct. , TURE DATE Before me personally appeared the said JR f" l UL�7L '0\00 � who says that he/she executed the above instrument of his/her own free will and accord, with full knowledge of the purpose thereof. Sworn and subscribed in my presence this �,�ay of My commission expires: NOTARY PUBLIC go ft Notary Public State of Florida ?° Kathleen Bree My Commission GG 929701 <h��Q� Expires I2JI012023 U:\Beth\Beth Casano EOC\COPCN\RENEWAL PACKETS\COPCN Application.doc 36 Indian River Press Journal 1801 U.S. 1, Vero Beach, FL 32960 AFFIDAVIT OF PUBLICATION INDIAN RIVER COUNTY ATTORNEYS OFFIC 1801 27TH ST VERO BEACH, FL 32960-3388 STATE OF WISCONSIN COUNTY OF BROWN Before the undersigned authority personally appeared, said legal clerk, who on oath says that he/she is a legal clerk of the Indian River Press Journal, a daily newspaper published at Vero Beach in Indian River County, Florida: that the attached copy of advertisement was published in the Indian River Press Journal in the following issues below. Affiant further says that the said Indian River Press Journal is a newspaper published in Vero Beach in said Indian River County, Florida, and that said newspaper has heretofore been continuously published in said Indian River County, Florida, daily and distributed in Indian River County, Florida, for a period of one year next preceding the first publication of the attached copy of advertisement; and affiant further says that she has neither paid or promised any person, firm or corporation any discount, rebate, commission or refund for the purpose of securing this advertisement for publication in the said newspaper. The Indian River Press Journal has been entered as Periodical Matter at the Post Offices in Vero Beach, Indian River County, Florida and has been for a period of one year next preceding the first publication of the attached copy of advertisement. 05/012021 Subscribed and swora before on May 2, 2021: Notary, State of WI, County of Brown TARA MC7NDL.00t-i Notary Public Mate of Wisconsin _j My commission expires August 6, 2021 Publication Cost: $117.99 Ad No: 0004711528 Customer No: 1310775 PO #: Legal Action 9 of Affidavits NOTICE OF PUBLIC HEARING NOTICE IS HEREBY GIVEN that the Board of County Commis- sioners of Indian River Coun- ty will conduct a Pub- lic Hearing to consider the fol- lowing: AN APPLICATION FOR A CLASS "E" AND CLASS "E1" CERTIFI- CATE OF PUBLIC CONVEN- IENCE AND NECESSITY BY TURBO TRANSPORT SERVICES L.L.C., TO PROVIDE WHEEL- CHAIR, STRETCHER AND AM- BULATORY TRANSPORTATION SERVICES, AS DEFINED IN AND PURSUANT TO CHAPTER 304, INDIAN RIVER COUNTY CODE. The Public Hearing will be held on Tuesday, May 11, 2021 at 9:05 a.m., or as soon thereafter as the matter may be heard, in the County Com- mission Chambers located on the first floor of Building A of the County Administrative Complex, 1801 27th Street, Vero Beach, Florida 32960, at which time interested parties may be heard with respect to the application. Any proposed documents may be ascertained by the public during regular business hours (830 a.m. to 5:00 p.m., Mon- day through Friday) at the De- partment of Emergency Serv- ices, located at 4225 43rd Ave- nue, Vero Beach, Florida 32967. Anyone who may wish to ap- peal any decision which may be made at this meeting will need to ensure that a verba- tim record of the proceedings is made, which includes testi- mony and evidence upon which the appeal is based. Anyone who needs a special accommodation for this meet- ing must contact the County's Americans With Disabilities Act (ADA) Coordinator at 772- 226-1223 at least 48 hours in advance of the meeting. INDIAN RIVER COUNTY BOARD OF COUNTY COMMIS- SIONERS JOSEPH E. FLESCHER, CHAIRMAN PUB: May 2, 2021 TCN4711528 /fq. _bG -) t-« 1 al cii 7 t0 r0 al LL -L U u'00.7 -mm 0LM1,•1 v, OWN (� ry N om Z :j- O' C+ >� 0 O- O to C 00 ILA }wv) 6rc. I V-Wcc� N.CL � wry CL�p ^ LL 0 3tp =?y=7 .0 G �T�� KO C n1Y �o � Qav W r n^ a mE vEEM U 1 7LOo a >OO ui 0. O R c1 v Y R d y�� a ca .aRUyo O. airdNl M 10WM Nam Q V��y VV EN O Y> - - w Ln - ,+Or aE4---oi ca ]G_R t+ r Y O yrs .•�; O ,n 0.5 >InM c,_Om` �o - r > C G/ -ON R 0. wL C N.� N C ., i w O c y�� c4t'Qi ,ti.,� IL N� a1 R3-. r.. _'T. Ol f'Ra+L �Ry vF'•R YLdr J OY Z',pv,R O" y43__ -C rV JR cc 15 - N'«-cOwy ,rw O. Nv-*'Ow R .�7� Q,;, ON V)Nr yr, Ln - C0NR7 r. O R R 7 .. O C R� N N .-- V) C i R R O C RV, "'1 c. p2O 3 J: �vV`°'^N O` NO J+, Ov-0v 0 OT O CN•0 v0t Or' O J 0 v +•' ...N i! ��Yp QC`COS o -N QCwCO��N O.r. N. VOE �O�.ar(ry N <4 f4 R N O V) v O VI v- -v w•` V) O H• L Y N R W r cq ', O1 � N w m V1 . . °. N J V O M N r .. N N S Rv- � R 0, ^R VCE -A R E V CE 'a0a Rf`�0- �>, �yj-6't3 t:•D� 14M 3 T U -E �ON L'rC� 0`/ L d RN m O� �OO�i� t! R J�0 OmM r R dL y 0 0 �� O J O O pmN_>r R E vo -6 Nrn �E°a ��y� m':vovw^ `°° o� LwR>^' v R m"ov ao din I R Iry . Oy 7n 0V1V>TdO r -0--r O a! 001 w V ma/�E >. 0 � O ri3Ow- a/ d L V 5 r 7 , tL w N a/ R Q a! a Of M01 m V Ec M 12v 4,- (Y)R- N`C yLL ccV1a0 .dL VL.0 N3 V1_ LL C 7,Q -•OR v co dL LL t-' Q, R R; C RNm ti 7 w -t' 2o al 7CF w O wN^ u. 7 v0,=t'a/I O SCz Rr4 O O)3 p -L 0 `�M dJ R c4 1L 7 R�^2}aE`ot Q R '^>v OV.m7-R� �wxo-Vm_kn OV m7- N 8=o L=7 V R: CO3 N7F- al -a0 Rv Ap mOC..� N O 017-R� E> o v > aRo wal._L E c- ny���R3 rn I++Ia-`r3E�'o �'. warn wo-rn3t, 07 w cL3E LL o� n s a W N._ R Nma�0 _ Y �r� Vrn3 v1Lo R.`alvl�Ew°� vrn3 v, f « vQw v_rp o I O R y 0).. R -0 al a/ _ a/ Q Q A '0 a)+�' C ` R a! .. V �' C '.5-T Oj C aJ C 3 aJ �'ooca a, Rev Oo�mo3�c�"�a7��cav Olo�m°�=w m E aaz 1-a,co�0p�'p.; �Z Omoa= mu- O R D VdF- Z vr,w OIVti av1>�alnwQd►- Zig �.� -0 4) R A v maH 2v�i.L...R.. rn1mnQ� R am ^ iF Z �.� o)vm `0 �' -c`NO C._ 'W1�- u"u cuwi N +'-0• RO/J,.0 J �F-}W V)FO O a).f6 >O'- _ Er a! L... ,.. 0 0y NLLQ 5 O R O w aR M j p 2 m m'm p, • ,Ty ^ p}pnJZQmxZm :fwo _ cx wQ-O _ E OIC al aR+ c _ 'A winIPAm ° -ow,- C � I Oc_j ,}' 2t Q�� W FtA � OQ " N .' 3 E v« o R lJ ►- F- ►- . o �°E�y`,v°'coo> a W} �EiOLLar a,00f oc, Eof��.' = O, �Vn xz��Q�°i }}Q Q NN y Q3 a 'r. V� j- I �a`R m. =.- ati �drr c a/L�.N c V �+R, ,, W^'1^ 7Z Q�mF� F- N� r> QZ C r `1 V1 d'..•. WV1 l7O ;E1�. C+L•' 4) W;r Z7 .0. Gl aal ,-0 3:21 N 7 Nor O m•R co 3i+,++ 011 � OVwJ O� ^Nm�z d^ ^� ' 7 Q y 7._ R mlL V VO Z Q Oini c iv •_ > �. V1 yr 7 O R v 70 u wd V ..�0. �^ , _ Q p�=- O) O aR• v i. O:n R R cQON'� ,�, Rr•0 O- L N.N .. N .'D .N*' O C•° `� AZO wN. w��ZiLL - >'m O?� _ }+CORS Va! "6R -..LVO `!`OVV) r� F-CRN._2 O-c•=m^')L 00.N�"• 73MW�e-• `V m 2m VO M OIL. ~Lr ��L�--0301 ('WNM NCO ONTR.o CC rC )O)R aR-•.T7..j 7v�0i �QOWWOO F�oZidOONO_j uj ZQ' , r a! 0101 L a/ r a! t� . F- O W �- '�., L �. r `:, ?>N,n v- v m LY 3 oO rnR,L., -0 V 0-a u = 3_C a yds zQw I.- ,cc ~10ca Oo , � d O 'a vI - TO w m R x y c= c R _.> ►-Z'r} w . vw)-� ° mo ° Cy m 4'•`=Z�r`-,y-,-. a,'r^'�°� °� cQ M80 3: 0 y_•. N -O 7.L-3 R.� �� O OOV UZOQ�NF-v�Q jUw' �0. ao •, m y I' R u Q-.. v c a > E U. v z w v� ° w vv 'w._.a R °' m� c °' >`w E y�Z _ M!�N mW�JawOaO�i'"'w� mC re ECri- vc >,r_'A;m mz R .w -�' Ri rnr.Cj'^ o 9 OO�Om..Lc0 c �ZOV. ZOOfalct-7r7 20 4)'-RE-w7V H r1 -� >>OwOt-u80 OYw� �:�• i ,OD Cv V;N1r ►-',-n�V..R:av •d-dFf n- Ru.._.r V v R v 3u1 u,. :+.c ._ o1v� E;-.rN1F- i. dIDH v_j) S2OdQ d;Q } ^s }N.1'C ZC,a a!� c >."' r-- v..r ' O :>:w R >,= N.: C - p V1 t. Z.aplu W c z o ui 'a . o m E o O > , m w r . ,R- � �C~er Z N.O O.R._ fp vl , 0 la w y N•- y1 . .• cL • t7 +• pd g�> V WQ-Q^10 ° E o 'Q :+- � C E p ar E 3 c a, a "I &r, N Z a! m f w v M R o. i'i Q 0 a, 2 ?:",z.0 RL . V WZ w3:04zm0 - >,N 4), o, y)o ca! ; °Li.cN ouo rL M> yr 7� N E �� r 3 O� '�•�"WO ~_ VO -W H -WV .3 RR'I].,rCw OI 0. N `r yC w y p RO O > a1 t1 D c'y'0C M.` wRN Er �M L-i,+R v d NwVO Lui > 3a1 p[i VVINW QOW d� Q1�8M=O=•-+t+ al - E+='c Ria �L d..�jvR RaL. O C - V im �''p�•°•o Ow wF-p_ d-zQz c. - Eo -:)Er -m-.,= ar. mt .3 3 d R c� N ai. mpap +, } V• m7=V•C wa JW.O>WZu'V� R �RV'i m�N�'v�70 RyNR >,C Er �C9� yam"• =M•al F -W _. `m' LUOM 0 _ov1°°ZdO-T< Ov .a,�a�s�oQ�o;;3'. •0-irisE.�,m R°Ndesa>im ==eiio _m - W� v 'N F '0._ : V! cR m O S a! r >,O -uC C 'LL W E •a t _ y O r p a/ W - N O O `.a x 0= 3 y 1-gd�zdWi-`vI f•w, 7N R C R o >rV �° .a1 C=a 0 w R � O -d.,, w o= 0. 0r c3 0 L KO W N N - !LL N�~-c601 VV1>_Z� H}QF`> V~pLO= wm% p•E O1r 01O�we L RC 39R LRv VRr 4. LLz NN �o Lu WRo9` 'aCOQ~�NOwQm j=..°1aVrOXa1« - Ow�Eoc�j 3>a/�c RL 3oNcQM� O.VIu; Vmy•OaRiC dQ Wo .e�-YmZ d°RRyO�Vdm .Cd V0,6Sa/p CRRe''v9 +' =E7yONv ZGax�C v ;F, P: =u=- Q >�Vcaj- >VIQ 4rLNT ao �, R °��orE o-Ev�R>� of E'cQ�c Q�Wd-LN zuj- V ,O-OLOj.a�0 QW`'IwD�jx�wng LwoxIN.RI=ORLRL Cd7pMp'RNI7N rLWImENO-C CvMEt'> ZOOOS7V }- Z Z r •w i+- �„�•y.��.V _m v! d L N r E r r V> 3 E r Q v -m a-_ c M Q o.a =- E 3 Q R ._ Q Q N R CO IA u d r y* =Mala, +=o «,;act a/o- arm vv;. + m NOm�aL.+.0 mr7 N+0.•RCv-Op CN•fl OrQ Rr Ov, •Op0 .. C y _ �^= OfC T V ... v N (DE' N a! V O.r •> M.i_. Nl.* L •C 01`-N �'' O' a! - _ a! N •QN - •0 1' {• al '�+ W_ p R 7 C .,C O O) G �"' ` > d'. romO d a! S- a) L L L R `O '0 y- R wQ =..� a) 3Ld w air' -O >, -CrR 701jV N'Evi3R� tIORC-�Ov,' aR V1 �Q' �Q d � r R CM R 7'i W vY 'O •V7 ay -0 RC°�tO • O. L a! N `� R _ a! V O' 2 CVa7+.vR�'0O °CRL��.d'.��R'0ER wLC >, °O410a' alb � Jd d of -_ tO OOM 3 (vv :� V 00 'A M3:n O E R 7~O•-. v w3 °Iam.-oM' o WE`a>" -° CL N 41-a/ c"M C E R N E- a!•- L RL v C >ONooe 1-� j u- w 01 zoom► -j aci ry N aw 7 _ LL R�rN o�O-ON y3��7yrV13'>w Oyo OL iF0 -� vvcR,al OiN,p .w� It wmd R �rC d�R w WQ O ,a 0':5'�d aJ t -CJ> if dNRL••jv 1 t!'��i- a) w0 E3c- �� ,-,C V. �, L.12 R�' 6'm`!Q `1 L O N N W a! O.Ry O 0)�^ .R O'w NN V- KGC Vdu- - d'Kd D. t= °2 r } iAw C O C- 01QR d y < a! 7.�-' VEL ary a/ �`'. a/ QO/1nEd V QCy°+ N�3 a1-- 01 •0. a/NC ^ WO d= WO p IO V• a: O y 0) WF W V 10,pc0`REu'd < Q�w t0E R Oi Nw }, N7wROL R:d 7 LL- aJ d O N- 3 =;E `L 0 O.R 7 _ O 7;0 R •C to rnar3 O�R O1 +N O`V. e7=d'Q2.O- aa,3* � � F- WD � J Z O• C K'-1 °m 82 LE 7 �' r 7 d E R d O w a/ � < O �RC�ap alb v r R -w c 0) W` al •- al •> R al R• R Q W L � C i >:� •3 � O Q LL 0 O ai •0 d a1 L LL > OI0 C O t', 0 >. m R r R LL ... c M r a! •a a/ N al r •- '1•� al N O_ N L. ,� C Z 30 �`yv-ROCL WL 01w -Cary NO3Ld_=tL' �0EC 0500 .R LL Y.` vd V � T L N N d � f N - _c O -._r ON3OF-a CL O>>N rrLVv,nr Qr F-u+._N ONQ-. v, CL to Cd aN� OL�N 1T�`Q It �Q o r Q Rcood° a, 0310«`°0� 3 °�M30 ws ^y`ocoo�`� �cv"ia�i° �p'u'MC R r `N v t,LLv E •0 Y wE 'DJ cLr--ul trOr ald v+.0 Er Rpm C.� v 70�` Ra1>O E.cwUuIN�omac R L v 7 C N .E R d -0 ?t+ .= .r -r v O ,pOLONai N O .R al F+ R R Q V d d _d a'C>aO�Nr RVI Q W N 'fl 00),vR._7C O`7 rma! V'i. a_ •-� V N p C C'u R> E zmW N va.7 C,?, ap Q�m 7N LU of t Z- >. O a0 0OO_v.a>M E >: > y dalw00-rd W-5- R 0 7 V -O w w 7 �LE�L O�a3Yv `E V LLC �zF m _a/Ct> c� � CMN'J L Q0NO.ON E 0. V�Z N'L'C�EQ�j QW>vtn zo-C CL� E O C C V .N `7Q ,m 0400 MOQ 1 U. AA __ 01 m RN d� 1 1 W Z OD 16 E o `m rr v1 -ON r•n a! R._ Oast .i �=>=4m1 prwO V • TL..w a/ tJ N C'C-C C �.0 3' Ol vim �d 7 c O -W 0 7yvm.N V V O NM O- c Ra O �_o-0 Q�0 J 3. .CM- 2RCvyVF yOrI 'C wN•- 01 d `� •ONL 01•- a/�i a a/d Ld7O M dO0) = R; o c Z 0- co R 'Ov 7N+_R�R0'al LL ET >, r w O.w r.. a/7°. QOV V lL V mr-p.O-d :>CrN�LLO >=dM OJ�== 0. 7S+II ��/� a�!•�°C�O n.+L" V O a/'u,c v t E• •V a! R "O L>-C F...Z 00 V 7> O^ .. °` N r N O R> m .Om E OC1..CV O R a/ N O U. R•- E��` � N 7 R .� - V .O O •- RL 70.2 C O -C � 3 J 0w 70��V j(CL cZj J �d C) a1Q y N F �^ F R 00 y� >�3 N �w Z -° CO t'' �O yN 4; C 7 > �� m a/�• N =>a L m m v r W C'm C•O yL O >.L'�t EL'v W Y Q. O �; >.0 > V)O 1+ m a)N m.Cdi--• a=im avis N a1LM._ R O R R 7M._tp R O C._ y._._ NrNdd�- mr3 rdNdCmLV ENd V rd L O C- CRC p `pr 7+' F'N 3 E R 0.3 R QR 3 LL.H OJtn> INDIAN RIVER COUNTY BOARD OF COUNTY COMMISSION REQUEST TO BE SCHEDULED FOR PUBLIC DISCUSSION Any organization or individual wishing to address the Board of County Commission shall complete this form and submit it to the Indian River County Administrator's Office. PUBLIC DISCUSSION INFORMATION Indian River County Code Section 102.04(10)(b): as a general rule, public discussion items should be limited to matters on which the commission may take action Indian River County Code Section 102.11(3): limit remarks to three minutes unless additional time is granted by the commission NAME OF INDIVIDUAL OR ORGANIZATION: 4776 34 Ave ADDRESS: Connie Clark PHONE: 772-501-4246 Utility Bill SUBJECT MATTER FOR DISCUSSION: IS A DIGITAL/ELECTRONIC PRESENTATION PLANNED? ❑ YES W1 NO WHAT RESOLUTION ARE YOU REQUESTING OF THE COMMISSION? ARE PUBLIC FUNDS OR ACTIVITIES REQUIRED? El YES z NO WHAT FUNDS OR ACTIVITIES ARE REQUIRED TO MEET THIS REQUEST? For IRC Staff only: Transmitted to Administrator Via: ❑ Interactive Web Form 9E -Mail 9 Hand Delivered Phone COUNTY ADMINISTRATOR: MEETING DATE: Jason E. Brown May 11, 2021 37 Mo DEPARTMENTAL MATTERS INDIAN RIVER COUNTY MEMORANDUM To: Jason Brown County Administrator From: Suzanne Boyll Human Resources Director Date: May 2, 2021 Subject: Addition of SurgeryPlus Benefit as Optional Benefit for Individuals Insured on the County's Group Health Plan Background Indian River County offers a Group Health Plan to eligible employees, retirees and dependents of the Board of County Commissioners, Sheriff's Office, Clerk of Circuit Court, Property Appraiser, Tax Collector and Supervisor of Elections. The plan performance is reviewed throughout the year and opportunities for cost savings and benefit enhancements or modifications are reviewed, evaluated, and presented to the Board of County Commissioners for consideration. Staff has been presented with a program to create an enhanced benefit for our covered members as well as provide a savings to the plan. The program presented for consideration is SurgeryPlus, which is a supplemental benefit for non -emergent surgeries using a national network of Surgeons of Excellence that have been credentialed by SurgeryPlus. The overall goal of the program is to improve quality and outcomes for plannable surgical procedures and also to reduce overall costs to the plan and covered members. Under SurgeryPlus, covered members would have an additional option to choose from when seeking a provider to perform certain non -emergent surgeries. The types of procedures by category are: • Joint replacement & Revision • Spine • Orthopedic • Cardiac • Gynecology • Hernia Repair • Ear, Nose & Throat (ENT) • Gastroenterology (GI) • Gallbladder • Thyroid • Pain Management Procedures To qualify as a Surgeon of Excellence, licensed providers must be board certified, be fellowship trained, have no State sanctions, complete a reputational review, and pass a comprehensive malpractice review.. This credentialing process ensures a high level of quality for surgical 38 outcomes, and contracted bundled pricing ensures a savings to the plan and the member versus costs under the PPO network pricing with Florida Blue. The SurgeryPlus network of providers is nationwide, which means that all of our group health plan participants (employees, retirees, and dependents) would have access to obtain services at the SurgeryPlus Centers of Excellence. Group plan participants who are planning a non -emergent surgery would contact SurgeryPlus directly and be provided a full-service member experience as outlined below: Member Experience Critical for Utilization Full -Service Concierge, Driven by Live -Contact The First Contact 0 Engage the member by listening and understanding their needs © Educate the member on their choices, the importance of surgeon selection, and financial incentives Organization © Set clear expectations on next steps and, process The Member Journey Locate Find best fitting Surgeon of Excellence i.... •i�.i Schedule Book appointments & manage logistics {�1"Iv/ Coordinate follow up Bundle service providers Ensure complete & transfer records member satisfaction ---------------------------- Typical case includes 15+ live calls Covered employees, retirees and dependents accessing the Centers of Excellence through SurgeryPlus, will also have reduced out -of- pocket costs due to the waiver of employee cost share (deductible & co-insurance). Approved travel costs and lodging will also be paid and billed according to the terms of the SurgeryPlus program. SurgeryPlus offers three pricing models for their program: 1) Fixed Fee $4.00 PEPM ($3.00 Intro Rate in Year 1) + .25 PEPM marketing fee 2) Hybrid Fee $2.00 PEPM and 15% of coordinated services fee + .25 PEPM marketing fee 3) Variable Fee 35% of coordinated services fee + .25 PEPM marketing fee 39 SurgeryPlus is so confident that this program would result in savings, they are willing to guarantee that savings will be double the value of the fees paid under the program. The greatest potential return on investment (ROI) is under the Fixed Fee model where the plan would experience the full benefit of savings rather than sharing the savings under the Hybrid Fee or Variable Fee model with SurgeryPlus. The estimated first year annual fee is $60,336 under the Fixed Fee model ($3 PEPM). This would increase to $80,448 in the second year ($4 PEPM). The marketing costs would be an additional $5,028 annually ($.25 PEPM based on 1,676 employees/retirees), and robust marketing of the program to members is required in order to secure a savings guarantee. SurgeryPlus anticipates that we will experience a minimum guaranteed initial net savings of $60,336 and that additional savings would be generated as utilization increases. The proposal indicates that a typical savings would be expected between the range of $298K to $695K dependent upon utilization. Use of the SurgeryPlus program is optional and members will have no out-of-pocket costs when utilizing this program. Employees may continue to utilize the Florida Blue group health plan benefits for these planned procedures; however, members choosing to do so will be responsible for out-of-pocket costs (deductibles, copays, and coinsurance). Attached is a sample agreement from the City of Sebring. If approved by the BOCC, staff will negotiate an agreement similar to the terms of the City of Sebring agreement. Once an agreement is reached, covered members would be provided SurgeryPlus communications explaining the SurgeryPlus benefit to include a personalized member card and begin accessing the plan benefits at a date to be determined. Marketing would also occur throughout the year to encourage utilization. Funding Funding for SurgeryPlus administrative fees, claims, and approved travel costs, would be from the group insurance trust. Based on the 2x performance guarantee, the cost of the program would be covered by the overall plan savings that are realized. Recommendation Staff respectfully requests the Board of County Commissioners approve the addition of the SurgeryPlus benefit under the Fixed Fee pricing model, authorize staff to negotiate an agreement consistent with the City of Sebring agreement, and authorize the Chairman of the Board to execute the negotiated agreement and any and all documents necessary to effectuate the agreement. Attachment: SurgeryPlus Proposal Overview Sample Agreement — City of Sebring 40 t a a a ' I to aim O V N� L � � CL O L O U Q CL 5 C � � O U L Qj E.- > a L Q — L E E N D u 0 W Cp f6 L U U vNi ?• � N 4- i N +_► -0— Q E a� ° a� N L E+-+ . Q �' Cf O w U cn Ln cn N et CL a L F N u WAN, D N El 0 M l' m E N _ O CL o � a Q \ .- V) E ) o ' N -C_ U "' O O N c Q O N N Q O •� U � � � Q E N• � N• O � � N O �- �- O C Q 4 Ln OO U UO . 3 0 Ln C: O 0 0 } U O O) i C3 — O O N � � a) U Q U N O N O • U O - O O N � O U N > O N J m °6 c C .V a) U • °' Q a E'} N O N 3 O p w ►i+irl{i� .c a U)aUi a� a N � ; � Ow m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . O TNS W • V N 0 N U .. O U O U 06 7C) c m 1 -'J O U -C) Q . (� •C N O U O N N Q V (D �Q �, H 0 ,*,_ L U- C L • o • W W U O � N Q 1 -'J a Rn le i p O -pp0 ,s �s E a Rn le W N >. 7 3 .L Ty u a ° a'i c y T d! N N Q H O O � s U u N rn W •�j� O� a o o a N Q v u m z a s •� � t t + t t O c L � O C W u oc »- c o CD C /f y O I �1 U O H :� a d 'a 3 a O O ^ C C aQ N� u m z o: + + + + O c � o y u CL a� t 0 t�0 U m «D � C� G� 'D o co ° o 0 u m+ z cn o 0 N o � N a Q U CL CL N }�O a U Q a— H .O u i > w N > a 'N (T N 72 Z) Q c a o ,p Q 15 C3 •� 0— — Q) 0-0 Ea)(D U o� O 1 N L O a) M 1 �, V� o, aijaJu7 6uiloi}uapaj:) UD!Olsi( d co v .C: 0 CO y O ELO O O V 0101- o OO > u C X O u.i U o _ •tea, s .° ate-+ !0 o U m N o c o a N con ++ j �.•N 2 4� o (DY 'a . ° M � d m fC: o s tw m +-+ Oj, -0 C U t4 o O o +� N =3N _ LA _ C- U =53 Q V > p LO l6 o . +J L 4l N �. Q. 4� CL C 3 m '� ••Ir = 3 o v s N LU m3 :� o _ •tea, s .° ate-+ !0 o U m N �_ m a N con ++ j �.•N 2 N (DY 'a . ° d , fC: o a -I tw m Ln3 o� moil 41U +� N U — V1 0%- 0 C- U =53 v r tq a B C O CL N fY � :5; N --------------O O O U O j O LL v � L C � � N f0 f0 cU � U =3 O dol O _0 N N N i� o O L L O O j O LL v 4� N N fU C N f0 N L cU N =3 O E N _0 N N O O U C: U N L O M O E -Ln s U m W aim 00 It (U -0 E 0 C U -O CL o L o +� 4- -C - s N a� — U > 3 in C c CU O E C �" E tw C fC N fC U E s c +� E U cc Q� w O 4- U E o s a. O U -� O O = +, O CL N O N N i O Q E O O O +� CL C E c cu >_ o 75 O O Q U L {+ O Q W v Ecv E ° .N L cm ai > O O O cr — C uN fC LJ 4J o cu � v EL -� '-a, U LA .� .O � N � :3!0 Q = N +, -0 - O v1 O O M O 0 E NO u O Y sZ c>s N O u° E a i.i o 17 co D O N N U iD E •— O O N H w 4) O LM4 _ �X '-W— LL O N_ W E Q of v O O X 0 g iz '— o O CYM ) N a--+ ca O = O M co CL 4— O •_ O _y O � a) UO O Lot of v O O X 0 g iz '— o O CYM ) rr Ol N a--+ ca N y, M O U Q) =3 a) UO U N C6 L aJ U U- �p a -J a -J L LL i O a bz U — s + V �aA a--+ O 4A s =3 co o 4-J N N L O Q) O -C = ,n 4-J o4 -J ry cn L O to rr Ol (n a -J L N y, M U c .v co a) 4-J N 0 U- �p cv 4-J coCL CLL O O O O U) 4-' O O N N M O ca rr Ol c U U O Ua) .La� 0 O C C m0 Q a, E oa U)m 20 0 C 0 E� c cE 0)" 22 0 fa a C _U (2 w O • N N Q � U N _U Q ° • w O m D c m U vpi C N D N N U a a c O O E w O 0 m O 7C) w U O � O o E N O 0- O N N L 0 N (� N ii • O U CL _O O ^` W O O O U O C c Q O U Y m ° o .0 L a E r�i O = UO U w c U U O Ua) .La� 0 O C C m0 Q a, E oa U)m 20 0 C 0 E� c cE 0)" 22 0 fa a C O (2 w O • N N Q � U N _U Q 0 • w w m D c m •� vpi C N Q >. N N U a a c O O E w O m O $ w U O � O a� o O 0- Q N N Q N (� L N _ O CL C ^` W 7 ° _ O U O U Y E U a E O O w• c'On wU O O O 0 O O TW U N(� O O O O �O 0 0 U i U a O N O 2 O W � L � C U 0 p Q Q Q E ELI) N CLN Q) U 0C: IL IL > U •' O N . O N O VD7C) OL C U E ° O Q c U U O Ua) .La� 0 O C C m0 Q a, E oa U)m 20 0 C 0 E� c cE 0)" 22 0 fa a O (2 w O • N N Q � U N _U Q 0 • w w m D c m vpi • Q >. N N U a a c O O E w O m O $ w U a� o O 0- Q N N U c O (� L N _ O C N ° • • O U O U U O C U O O c'On wU p w O O • U N(� O O • 0 C U U o� a G c U U O Ua) .La� 0 O C C m0 Q a, E oa U)m 20 0 C 0 E� c cE 0)" 22 0 fa a O (2 • N N Q � U N _U Q � O • w w m D c vpi in c U U O Ua) .La� 0 O C C m0 Q a, E oa U)m 20 0 C 0 E� c cE 0)" 22 0 fa a (2 p N m U • ° a 0 70 o • 0- Q m Lli w. (� L N _ O ° -0 U c'On wU c U U O Ua) .La� 0 O C C m0 Q a, E oa U)m 20 0 C 0 E� c cE 0)" 22 0 fa a 0 LIQ W V AC 4) W i •� 4) ^L , W V O O XU W W U N O N h U LL. u Q PLAN AGREEMENT This Plan Agreement (this "Agreement") is made effective as of February 1, 2021 (the "Effective Date") by and between Employer Direct Healthcare, LLC, a Delaware limited liability company with its principal place of business located at 2100 Ross Avenue, Suite 550, Dallas, Texas 75201 ("EDH") and the City of Sebring, a Florida municipal corporation, with its principal place of business located at 368 South Commerce Avenue, Sebring, Florida 33870 ("Sponsor"). EDH and Sponsor are referred to collectively as the "Parties" and individually as a "Party." RECITALS EDH has a contracted network of physicians, hospitals, and other healthcare providers and facilities which provide non -emergent, planned surgical and medical procedures according to rates and terms negotiated by EDH. EDH's contracted network of providers is made available to individuals through self-funded health benefit plans that incorporate EDH's network offering. III. As part of EDH's network offering, EDH assists the individuals electing to utilize EDH's network with administrative, settlement, case management, and travel and logistics services relating to the individuals' medical procedures. IV. Sponsor has established a self-funded health benefit plan for the benefit of Sponsor's employees, employees' dependents, and retirees. V. Sponsor wishes to engage EDH so that EDH's network offering may be incorporated into Sponsor's health benefit plan and made available to the eligible participants enrolled in such plan. follows: Accordingly, in consideration of the promises and mutual covenants contained herein, the Parties agree as ARTICLE 1. DEFINITIONS Except as otherwise specifically indicated, the following terms shall have the following meanings in this Agreement (such meanings to be equally applicable to both the singular and plural forms of the terms defined): 1.1 "Accompanying Person" means an individual utilizing Travel Services other than a Participant. 1.2 "Case Rate" means the pre -determined charge for an Episode of Care which includes the total of all technical, professional, facility, and other medical services billed by Providers and associated with a Diagnosis Case Code. 1.3 "Convenience Item" means a service, supply, or otherwise which is not considered necessary for a Participant's medical care, "Convenience Items" may include, without limitation, telephone use, premium television access, and guest meals. A Participant shall have sole financial responsibility for any Convenience Item. 1.4 "Diagnosis Case Code" means the code, determined by a Provider, identifying the anticipated Episode of Care for a Participant. In the case of an inpatient procedure, the ,"Diagnosis Case Code" will be the Medicare: Severity Diagnosis Related Group ("MS -DRG") and/or the Current Procedural Terminology Codes ("CPT Codes") associated with the procedure which may be further modified to identify the specific care protocol. 1.5 "Episode of Care" means the collective services rendered by any Provider and/or any Provider's professional and medical staff relating to a Diagnosis Case Code. An "Episode of Care" begins on the day a Participant first. receives services from a Provider related to such Diagnosis Case Code and ends when the Participant is discharged from the hospital or other healthcare facility to return or travel home. Services provided and expenses -1- 52 billed as part of an "Episode of Care" commonly include, but are not necessarily limited to: (a) equipment used by a hospital or facility; (b) in-hospital or in -facility medications or biologics and supplies; (c) implants; (d) laboratory testing and services; (e) in-hospital meals; (f) hospital confinement days; (g) pre and post in-hospital or in -facility nursing care; (h) pre and post in=hospital physical therapy; (i) follow-up consultations; and (j} any other Medically Necessary Service related to the Diagnosis Case Code. An "Episode of Care" shall not include: (w) any diagnostic testing provided in advance of a medical procedure to determine whether or not such procedure is a. Medically Necessary Service; (x):any Convenience Items; (y) :any medical procedure or medical care that is not a Medically Necessary. Service and (z) any Serious Reportable Events ("SREs"), as defined by the National Quality Forum. 1.6 "HIPAA" means the Health Insurance Portability and Accountability Act of. 1996, including the Administrative Simplification provisions of HIPAA Title II, Subtitle F, the implementing regulations at 45 C.F.R. Parts 160-164, and the Health Information Technology. for Economic and Clinical Health Act, enacted as part of the American Recovery_ and Reinvestment Act of 2009 ("HITECH"), all as amended from time to time. 1.7 "Medically Necessary Service" means a medical service or supply which is determined by a licensed medical professional to be appropriate and necessary for the symptoms, diagnosis or treatment of the medical condition of a Participant and within standards of medical practice within the community for that level of care. 1.8 "Network" means EDH's contracted network .of physicians, hospitals, and other healthcare providers and facilities which provide non -emergent, planned surgical and medical procedures according to rates and terms negotiated by EDH. The "Network" comprises a part of EDH's branded offering commonly referred to as the SurgeryPlus'" benefit offering. 1.9 "Network Services" means the services offered by EDH to Participants electing to utilize the Network for an Episode of Care. "Network Services" include EDH's assistance with the administrative, settlement, case management, and/or travel and logistics aspects of an Episode of Care and EDH's facilitation of interaction among Sponsor, Providers, Participants, the Plan, and/or the Plan Administrator. The "Network Services" comprise a part of EDH's branded offering commonly referred to as the SurgeryPlusT" benefit offering. 1.10 "Participant" means any person who has enrolled for coverage in the Plan and is eligible to utilize the Network. "Participants" may include persons eligible for coverage as employees, dependents, retirees, through COBRA, or otherwise as persons in good standing under the terms of the Plana 1.11 "Plan" means the self-funded health benefit plan offered by Sponsor. 1.12 "Plan Administrator" means a third -party administrator engaged by Plan Sponsor to administer benefits offered pursuant to the Plan. 1.13 "Provider" means a licensed or otherwise legally authorized provider of medical, surgical, hospital, professional, and/or other health-related services that offers such services through the Network. A "Provider" may be a physician, physician group, nurse or nurse practitioner, diagnostic or therapeutic ancillary services provider, facility, lab, or provider of durable medical or other necessary equipment. 1.14 "Travel Services means the services coordinated by EDH pursuant to this Agreement relating to a Participant's and Accompanying Person's transportation and lodging during an Episode of Care. 1.15 "Treating Physician" means a Participant's local treating physician, primary care physician, and/or any other physician or medical care provider supplying medical records for review by a Provider ARTICLE 2. EDH'S ROLE AND RESPONSIBILITIES 2.1 Network Services. EDH will assist and support Sponsor in communicating the availability of the Network and Network Services to Participants. EDH will offer the Network to all Participants, and EDH will provide the applicable Network Services for any Participant seeking to utilize the Network for an Episode of Care. -2- 53 2.2 Provider Requirements. (a) Credentials. EDH will require each Provider, including physicians and healthcare facilities, to cooperate with EDH's credentialing program. Such credentialing program may require such Providers to meet National Committee for Quality Assurance credentialing standards or Joint Commission on Hospital Accreditation credentialing standards.. EDH may also require Providers to comply with additional credentialing practices and programs, and EDH may require Providers to provide EDH with documentation supporting such credentialing: (b) Information Regarding Providers. EDH will request that Providers provide EDH with accurate and complete information such that EDH can effectively inform Sponsor and Participants about the availability, quality, and efficacy of the medical services offered by each Provider through the EDH member website. Providers shall be solely responsible for the accuracy and completeness of such information. 2.3 Utilization and Quality Assurance. (a) Utilization Stroteay. EDH will use commercially reasonable efforts to assist Sponsor with the performance of Sponsor's obligation to for and deliver a written utilization strategy relating .to the Network and Network Services, as further described in Exhibit A attached to this Agreement. (b) Notices to Participants. At a minimum, EDH will provide a written notice approved by Sponsor to all Participants advising them of the identity of, and relationship among EDH, the Participant, and Sponsor. (c) Participant Reports. Following appropriate HIPAA standards for the transfer of information relating to any Participant, EDH will periodically provide Sponsor with reports summarizing: (a) utilization of the Network and Network Services by Participants and (b) the medical outcomes of Participants utilizing the Network and Network Services for an Episode of Care. Upon reasonable written request, EDH will provide Sponsor access to pertinent documents maintained by EDH and required in connection with such reports, subject to the confidentiality requirements contained in Article 6 of this Agreement. 2.4 Parties Are Not Providers. The Parties acknowledge and agree that neither Party will provide medical advice, render any medical judgment, or make any medical recommendation (as to any Provider or medical treatment) to any Participant or to any other person or entity. The Parties further acknowledge and agree that Providers shall be solely responsible for (a) all matters relating to medical treatment and/or procedures of Participants and (b) all advisement, evaluation, recommendation, or other similar responsibility or obligation relating to medical treatments and/or procedures of Participants. 2.S Participant Clearance to Travel. From time to time, a Participant may be required to travel by automobile or airplane to a Provider for an Episode of Care. The Parties acknowledge and agree that it shall be the sole responsibility of Participant to obtain advice from the Provider or the Participant's Treating Physician whether, in such physician's independent medical opinion, Participant is fit to travel to Provider's location. Utilizing appropriate HIPAA standards regarding the release of medical records, EDH will assist a Participant, or the Participant's representative, with the collection and transfer of medical records and other documentation among the Participant, Treating Physician, and Provider. 2.6 Limited Role of EDH. The Parties acknowledge and agree that EDH's role is strictly limited to offering the Network and providing the Network Services. The Parties further.acknowledge and agree that EDH is not a fiduciary of Sponsor or the Plan,.and EDH shall not be deemed to have any discretionary authority or control regarding management of Sponsor or management or interpretation of the Plan. The Parties further acknowledge and agree that EDH does not assume, insure, guaranty, or underwrite the liability, responsibility, or performance of any other party. The Parties further acknowledge and agree that EDH shall have no responsibility for collecting premiums or contributions for insurance coverage or for establishing a premium fiduciary account. -3- 54 2.7 Disclaimer of Warranties. Except as expressly set forth in this Agreement, the services provided by EDH under this Agreement are furnished as is, where is, with all faults and without warranty of any kind, express or implied, including any warranty of quality, merchantability, or fitness for a particular use or purpose. For the avoidance of doubt, EDH makes no warranty, express or implied, concerning: (a) any Provider or other vendor providing services relating to an Episode of Care; or (b) information transmitted in good faith by EDH from third - party sources. 2.8 Non -Discrimination. EDH will not discriminate in delivery of the Network or Network Services to Participants on the basis of race, religion, national origin, sex, marital status, sexual orientation, health status, disability, source of payment for services, or age. 2.9 Written Agreement. The Parties understand and agree that EDH is not permitted to act without a written agreement between EDH and Sponsor. Any written agreement between EDH and Sponsor, including this Agreement, shall be retained as part of the official records of both EDH and Sponsor for the duration of the agreement and for five (5) years thereafter. ARTICLE 3. SPONSOR'S ROLE AND RESPONSIBILITIES 3.1 Project Executive. Sponsor will designate in writing an individual project executive having the authority to assist EDH in implementing and marketing the Network and Network Services (the "Project Executive"). The Project Executive will be EDH's primary point of contact for Sponsor with respect to Sponsor's fulfillment of its obligations under this Agreement. 3.2 Implementation. Sponsor will be responsible for: (a) providing EDH with employee claims data, including protected health information, so that EDH may most accurately analyze savings and, subject to the approval of Sponsor, implement appropriate targeted marketing strategies; (b) providing EDH with Participants' eligibility and enrollment data to be used by EDH for testing and implementation purposes; (c),amending the Plan to incorporate the Network and Network Services as available for eligible Participants who require certain medically necessary procedures and who select to receive such treatment from Providers participating in the Network; (d) facilitating the coordination of the operational processes of EDH, Sponsor, the Plan, and/or any Plan Administrator with regard to eligibility verification, case management, pre -certification, and billing; (e) facilitating EDH's integration with other health services providers, plans, or third -party administrators; (f) identifying and facilitating communication opportunities for EDH to reach Participants needing treatments or procedures available through the Network; and (g) approving a written utilization strategy as set forth in Exhibit A and permitting its subsequent execution. 3.3 Marketing. Sponsor will use commercially reasonable efforts to encourage Participants to utilize the Network and Network Services. Without limiting the generality of the preceding sentence, Sponsor's efforts shall include the approval and assistance with: (a) the delivery of a written utilization strategy, as described in Exhibit A attached to this Agreement; (b) the implementation of an introductory and ongoing communication plan consistent with such utilization strategy; (c) the provision of introductory and ongoing education and information to Participants about the Network and Network Services; and (d) the implementation of EDH's member website on Sponsor's website specifically for Participants. 3.4 Employee Eligibility. On a weekly basis, whether directly or indirectly, Sponsor will provide EDH an employee eligibility file per the specifications outlined by EDH during the implementation process. Provision of such employee eligibility file is imperative so that EDH may properly determine whether a participant is entitled to Network Services and to ensure the appropriate calculation of EDH Fees. 3.5 Use of Marks. Sponsor and EDH each reserve the right to the, control and use of their respective names, copyrights, symbols, trademarks, and service marks (the "Marks'). No Party shall use another Party's Marks in advertising, promotional materials, or otherwise without the prior written consent of the Party owning such Marks. Notwithstanding anything to the contrary in this Agreement, the Parties agree that, within a reasonable -4- 55 amount of time after the Effective Date, the Parties will distribute a mutually approved press release announcing certain terms of this Agreement. Additionally, notwithstanding anything to the contrary in this Agreement, Sponsor will permit Sponsor's logo to be displayed on EDH's website and in EDH's marketing materials to current or prospective clients, provided that any use of Sponsor's logo shall conform to the reasonable guidelines and specifications set forth by Sponsor. In addition, and for the avoidance of doubt, EDH's provision of information related to Providers, the Network, or the Network Services to third parties under executed non -disclosure agreements, including information gathered in EDH's credentialing process, shall not be prohibited under this Agreement. 3.6 Plan Interpretation and Compliance. Sponsor shall be the final arbitrator and have the final authority regarding interpretation, application, and. administration of the Plan. Accordingly, EDH shall have no responsibility or obligation with respect to interpretation, application, or administration of the Plan. Sponsor shall bear all responsibility for the Plan's compliance with applicable state and federal laws and regulations, including the Federal Employment Retirement Income Security Act ("ERISA"). In furtherance of such obligation, Sponsor shall be solely responsible for satisfying any and all reporting, notice, disclosure, or filing requirements imposed by ERISA or any other state or federal law or regulation applicable to the Plan. 3.7 Taxes. Sponsor or the Plan, as applicable, .shall be solely responsible for the payment of all required federal, state, or local taxes which may arise as a result of the services administered by EDH pursuant to this Agreement. Accordingly, EDH shall have no obligation with respect to payment of any such taxes. ARTICLE 4. SCHEDULING, PRICING, AND PAYMENT 4.1 Provider Acceptance of Patient. Following Provider's initial review of Participant's medical records and information, and subject to a physical examination and medical assessment of Participant, as needed, Provider will confirm to EDH whether or not, in Provider's independent medical opinion, Participant is a suitable candidate for an Episode of Care at a Provider's location, and Provider will advise EDH of the Diagnosis Case Code related to such Episode of Care. Provider will establish treatment protocols for each Episode of Care and modify such protocols for Participant, if needed. Provider will notify EDH of any changes in the Diagnosis Case Code or anticipated Episode of Care. Sponsor shall confirm to EDH that Participant has met any obligations related to a Plan deductible prior to beginning an Episode of Care. 4.2 Patient Scheduling. Upon acceptance of a Participant by a Provider, EDH's confirmation of the Participant's coverage under the Plan, and EDH's receipt of payment from the Participant of the Participant's remaining deductible (if applicable), EDH will coordinate and schedule the services to be provided in connection with the anticipated Episode of Care amongthe Participant, the Provider, and any vendors of Travel Services, if applicable. 4.3 Pricing. (a) Claims. Sponsor shall pay EDH the aggregate sum of all claims, fees, costs, expenses or other charges relating to an Episode of Care which are submitted to EDH by Providers, vendors of Travel Services, or any other:provider of goods or services related to an Episode of Care (each such claim, fee, cost, expense, or charge, a "Claim" and collectively, "Claims'). Any Claim related to medical services rendered by a Provider will be charged by EDH and paid by Sponsor according to the Case Rates or any other pricing terms independently agreed to by EDH and the Provider. EDH.will itemize and fully disclose any Claims in an Invoice (defined below). . (b) EDH Fees. In addition to payment for Claims, each month, Sponsor shall pay to EDH a fee equal to $4.00 per eligible employee of Sponsor (the "Network Use Fee"). During the first year of the Initial Term, Sponsor shall receive a discount on the Network Use Fee. Accordingly, during the first year of the Initial Term only, the Network Use Fee shall be $3.00 per eligible employee of Sponsor. Additionally, each month, Sponsor shall pay EDH a fee for EDH's marketing and implementation services equal to $0.25 per eligible employee of Sponsor (the "Marketing Fee"). The Network Use Fee and the Marketing Fee shall be collectively referred to as the "EDH Fees." The number of eligible employees to be used in calculating the EDH Fees shall be the monthly weighted average of -5- 56 eligible employees of Sponsor according to the Sponsor -provided employee eligibility files of the prior month. EDH will fully disclose the EDH Fees in an Invoice. (c) Changes in Plan Design. Sponsor acknowledges and agrees that, as of the Effective Date, the Plan documents do not include any requirement that EDH and/or the Network be the exclusive source of medical coverage for any procedure or category of medical services (any such requirement in the Plan documents, a "Plan Carveout"). If at any time during the term of this Agreement the Plan documents are amended to include a Plan Carveout other than a Plan Carveout for bariatric medical procedures, then, during the period in which any such Plan Carveout is effective, the method for calculating the Network Use Fee specified in Section 4.3(a) shall be negotiated and agreed to by the parties. 4.4 EDH Savings Guarantee. (a) Guarantee. Within a reasonable time after expiration of the Initial Term (defined below), EDH will compare all Episodes of Care over the Initial Term to Sponsor's actual historical bundled case rates and claims data, where available and applicable, or if not available or applicable, to EDH's observed historical average bundled case rates and claims data (in either case, the "Historical Case Rates'. ). Using the Historical Case Rates determined to be applicable by EDH, EDH will calculate Sponsor's savings during the Initial Term based on the difference between the actual Case Rates paid by Sponsor to EDH during the Initial Term and the Historical Case Rates, avoided complication savings, and avoided procedure savings (the "EDH Savings"). At the end of the Initial Term, EDH will provide Sponsor with a tabulation of the EDH Savings and the Network Use Fees over the Initial Term. Any Network Use Fees paid by Sponsor in excess of the EDH Savings shall be credited to Sponsor (the "Guarantee Amount") such that the Network Use Fees and EDH Savings are equal over the Initial Term (the "Guarantee"). If applicable, the Guarantee Amount will be credited by EDH against future amounts due from Sponsor during a Renewal Term (defined below), or if a Renewal Term is not applicable, EDH will remit the Guarantee Amount directly to Sponsor. (b) Example of Calculation of Guarantee. Assume that the actual Case Rates paid by Sponsor to EDH for procedures during the Initial Term were $75,000. Also assume that the Historical Case Rates for the same procedures were $100,000. Assume that Sponsor saved $5,000 because of an avoided spine procedure, and Sponsor saved $10,000 because of an avoided knee replacement complication. Finally, assume that Network Use Fees during the Initial Term totaled $20,000. The calculation of EDH Savings would be $100,000.00 minus $75,000.00 plus $5,000.00 plus $10,000. Thus, the EDH Savings would be $40,000.00. The calculation of net savings for the purposes of the Guarantee would be $40,000.00 minus $20,000.00, or $20,000.00. Because the EDH Savings exceeded Network Use Fees over the Initial Term, EDH would not owe any amount to Sponsor as a result of the Guarantee. (c) Requirement of Utilization Strategy. As set forth in Exhibit A to this Agreement, the Parties shall mutually agree to the terms of a written utilization strategy which shall include the schedule and nature of communications relating to Sponsor's implementation and marketing of the Network and Network Services. As further set forth in Exhibit A, a copy of such written utilization strategy shall be provided to each Party and shall be attached to this Agreement as an addendum to Exhibit A. Notwithstanding anything to the contrary in this Agreement, if the Parties cannot mutually agree to the terms of such a written utilization strategy or if such utilization strategy is not attached as an addendum to Exhibit A of this Agreement, the Guarantee shall be null and void. 4.5 Invoicine and Payment. Periodically during the term of this Agreement, EDH will prepare and submit to Sponsor an invoice fully disclosing and itemizing the amounts to be paid by Sponsor pursuant to the terms of this. Agreement (each, an "Invoice"). Any such Invoice may include, without limitation, amounts related to Claims and/or amounts related to any applicable EDH Fees. Not more than 10 days after Sponsor's receipt of an Invoice, Sponsor will pay directly to EDH the amounts included in such Invoice via wire transfer or electronic funds transfer. After receiving payment from Sponsor, EDH will pay the appropriate Providers and vendors of Travel Services. 4.6 Cancellation Prior to Medical Procedure. If a Participant, for any reason, is not admitted by a Provider, or if a Participant cancels a scheduled procedure at any time prior to performance of the Episode of Care, -6- 57 Sponsor shall be responsible for the cost of Provider's review of Participant's medical records, the cost of any pre- admission testing or treatment provided by a Provider, any expenses related to Travel Services, and any other fees, costs, or expenses actually incurred. EDH will refund any deductible received by the Patient within fifteen (15) business days of cancellation of the Episode of Care and will promptly notify Sponsor of such refund of deductible. Any such charges will be listed in an Invoice. 4.7 Urgent or Emergency Medical Services. If at any time during an Episode of Care, Provider determines that any Medically Necessary Service that is not otherwise included within the Case Rate must be performed on an urgent or emergency basis to preserve the life or health of the Participant, Sponsor will be responsible for payment of the Provider'scharges for any such Medically Necessary Service as part of the Episode of Care. The amounts of such charges will be calculated and charged by EDH according to the pricing terms set :forth in the agreement between EDH and the Provider.. Any such charges will be listed in an Invoice. 4.8 Elective Changes by Participant. This Agreement does not include or permit authorization of elective changes by a Participant after a Provider has accepted the Participant. Moreover, this Agreement does not cover changes to other factors reasonably under control of the Participant during an Episode of Care. Any request by Participant to Provider for such elective changes and Provider's decision to render such elective services will be considered outside of the Network and not subject to the scope of this Agreement. EDH will have no obligation or responsibility with respect to such elective services. 4.9 Termination of an Episode of Care. EDH's obligations under this Agreement extend only through the end of an Episode of Care, which, as defined in Article 1 of this Agreement, terminates upon discharge of a Participant. In the event an Episode of Care extends thirty (30) days beyond the date the Participant was originally admitted by a Provider, the Episode of Care shall be deemed terminated. The Parties acknowledge and agree that EDH shall have no obligations or liability with respect to services rendered by a Provider after the termination of an Episode of Care. The Parties further acknowledge and agree that payment for any services rendered by 'a Provider after the termination of an Episode of Care shall be the responsibility of the Participant, Sponsor, or the Plan. 4.10 Proof of Patient Financial Responsibility. EDH or a Provider may require proof of a Participant's ability to pay for additional or unforeseen services requested or required during an Episode of Care. Such assurance may take the form of proof of coverage under the Plan or a deposit, surety, or letter of credit in such amount as reasonably required. 4.11 Disputes Regarding Adiustments to Price. In the event that a Participant, Sponsor, or the Plan Administrator on behalf of Sponsor makes a factually supported assertion that a physician -initiated urgent or emergency service was not a Medically Necessary Service, EDH will retain an independent arbitrator having appropriate clinical expertise for the purpose of determining the medical necessity of such care. EDH will require Provider to supply to the arbitrator such Participant's medical records as the arbitrator may reasonably request. If the arbitrator determines that all or a portion of such care was not a Medically Necessary Service, the charges associated with such care will be canceled or reduced pro -rata with such determination. Each party to the arbitration will bear its respective arbitration expenses and each will pay its pro -rata portion of the arbitrator's charges and expenses. The arbitrator's decision shall be final and binding upon Provider, Participant, Sponsor, and/or Plan Administrator, as applicable. 4.12 Delinquent Payment. If Sponsor fails to pay EDH any amount due to a Provider within sixty (60) days following Sponsor's receipt of an Invoice itemizing such amount, EDH may notify the Provider of such failure, and EDH may engage in good faith efforts to facilitate resolution of any payment issues or disputes. If EDH is unable to resolve such payment issues or disputes within thirty (30) days of such engagement, EDH may notify the Provider, and the Provider may terminate its agreement with EDH with regard to the Sponsor failing to make payment. The Provider may then seek to recover payment for amounts due directly from Sponsor. In such event, Sponsor will lose the benefit of any contractual rates setforth in EDH's agreements with the Provider, and Sponsor shall be responsible for the full amount of the Provider's charges. This provision is in addition to, and not in lieu of, any other rights and remedies available to EDH under this Agreement, at law, or in equity. -7- 58 4.13 Past Due Accounts. Past due accounts will be subject to the reimbursement of collection costs and the applicable state default interest rate. ARTICLE 5. TERM AND TERMINATION 5.1 Term. This Agreement shall commence as of the Effective Date and shall remain in effect for a three (3) year period ending January 31, 2024 (the "Initial Term"). Following the Initial Term, this Agreement shall automatically renew for successive one-year periods (each such period, a "Renewal Term") unless either Party provides written notification of non -renewal to the other Party not less than sixty (60) days prior to the end of the then -current term. 5.2 Termination. (a) Termination for Convenience. This Agreement may be terminated by either Party for any reason, or no reason whatsoever, upon one hundred eighty (180) days' written notice of termination to the other Party. In the event Sponsor gives notice of termination of this Agreement in accordance with this Section 5.2(a) prior to the expiration of the Initial Term, the Parties agree as follows: (i) the Guarantee provided in Section 4.4 shall be void; and EDH will have no payment obligation with respect Section 4.4; (ii) during the 180 -day period following Sponsor's notice of termination, in lieu of payment of the Network Use Fee, Sponsor shall pay to EDH a fee equal to the greater of (A) thirty-five percent (35.0%) of the aggregate sum of all Claims arising during that period or (B) $4.00 per eligible employee of Sponsor per month (in either case, the "Early Termination Fees"); and (iii) Sponsor shall immediately pay EDH a fee equal to $24.00 per eligible employee of Sponsor (the "Breakup Fee"), provided that Sponsor shall not be obligated to pay the Breakup Fee if Sponsor provides notice of termination to EDH during the final twelve (12) months of the Initial. Term. The number of eligible employees to be used in calculating any such Early Termination Fees or Breakup Fee shall be the monthly weighted average of eligible employees of Sponsor according to the Sponsor -provided employee eligibility files of the month prior. to Sponsor's notice of termination. EDH will itemize and fully disclose the Early Termination Fees and Breakup Fee in monthly Invoices during the period following Sponsor's notice of termination. Notwithstanding anything herein to the contrary, Sponsor shall not be permitted to give notice of termination or terminate this Agreement pursuant to this Section 5.2(a) during the first twelve (12) months of the Initial Term. (b) Termination for Cause. Either Party may terminate this Agreement for cause upon written notice to the other Party specifying the nature of such cause for termination. For purposes of this Agreement, "cause" shall be construed to mean (i) a material misrepresentation made by one Party to the other Party relating to this Agreement; or (ii) a material breach of an obligation to be performed by either Party under this Agreement that is not cured within thirty (30) days of written notice of such breach or for which reasonable steps to cure are not undertaken and diligently and continuously pursued if such cure cannot reasonably be achieved during such thirty (30) day period. (c) Termination for Insolvency. This Agreement shall terminate, without notice: (i) upon the institution by or against.either Party of insolvency, receivership, or bankruptcy proceedings or any other proceedings for the settlement of either Party's debts; (ii) upon either Party making an assignment for the benefit of creditors; or (iii) upon either Party's dissolution or ceasing to do business. 5.3 Effect of Termination. Termination of this Agreement for any reason shall not affect the obligation of any Party to pay any amount due or to perform any duty that arose prior to the effective date of such termination. Upon termination of this Agreement for any reason, each Party shall discontinue representing that it is affiliated with the other Party. 5.4 Continuity of Care. In the event of termination of this Agreement for any reason, EDH shall continue to satisfy all of its obligations under this Agreement relating to the medical procedure of any Participant which was scheduled or coordinated by EDH on or before the effective date of such termination but was not to be completed until after the effective date of such termination. The continuing obligations of EDH pursuant to the -8- 59 preceding sentence shall cease when any such Participant has been discharged and medically released by a Provider for return to the Participant's home location or another appropriate medical provider or facility. Sponsor shall be responsible for paying to EDH any Claims and/or EDH Fees incurred as a result of the services rendered after termination of this Agreement. 5.5 No Solicitation of Providers. During the term of this Agreement and for a period of twelve (12) months after termination of the Agreement, Sponsor agrees that it will not: (a) enter into a contract directly with any Provider; (b) solicitor attempt to solicit any Provider; or (c) divert or attempt to divert any Provider away from EDH for purposes of contracting directly with Sponsor for the provision the services provided under this Agreement. ARTICLE 6. RECORDKEEPING, AUDIT RIGHTS, AND CONFIDENTIALITY 6.1 Recordkeeoing. EDH shall retain all books and records relating to EDH's performance of this Agreement, including medical records, and shall provide access to such books, records, and information for a minimum period of seven (7) years following the provision of services under this Agreement to any Participant or such longer period of time as may be required by applicable state or federal law. Applicable state or federal regulatory authorities shall have access to such books and records for the purposes of examination, audit and inspection. Notwithstanding anything to the contrary in this Section 6.1, in the event EDH and Sponsor terminate this Agreement for any reason, EDH may, by written agreement with Sponsor, transfer all records to another third - party administrator: rather than retain them for seven (7) years. In such cases, the new third -party administrator shall acknowledge, in writing, that it is responsible for retaining the records of EDH as required in this Section 6.1. 6.2 Audit Rights. EDH shall permit Sponsor or Sponsor's representatives to conduct site visits, audits, and inspect the books, records, and information of EDN relating to EDH's provision of services under this Agreement. Such access and inspection shall be provided by EDH during normal business hours and within thirty (30) days after such request is made in writing to EDH. EDH or any Provider may charge a reasonable amount for retrieving, copying, or transmitting such records. 6.3 Confidentiality. (a) Limitations on Confidential Information. Either Parry may, in the course of the relationship established by this Agreement, disclose to the other Party confidential, non -.public information concerning such Party's pricing, methodologies, fee schedules, volume of business, methods, systems, practices, plans, and/or other confidential or proprietary information, except as may be required by law (collectively "Confidential Information"). Each Party acknowledges and agrees that it will hold all Confidential Information of the other Party in strict confidence. Each Party undertakes and agrees to use, and.to cause each of its representatives to use, all commercially reasonable means (in any case, not less than reasonable care) to safeguard the confidentiality of all Confidential Information of the other Party in the same manner that the Party safeguards its own confidential and/or proprietary information. Each Party acknowledges and agrees that it will not, without prior written consent of the other Party: (a) use any Confidential Information of the other Party for its own benefit; or (b) disclose any Confidential Information of the other Party to any third party. If.either Party receives a request or demand to disclose all or any part of the Confidential Information of the other Party under the terms of a subpoena or order issued by a court of competent jurisdiction, an agency of any State of the United States or of any other jurisdiction, or otherwise, inclusive of a request for public records, the Party receiving such request agrees to promptly notify the other Party of the existence, terms and circumstances surrounding the request so that the Party whose Confidential Information is subject to the request may, at its option, seek a protective order or other appropriate relief or remedy within ten (10) days of receipt of such notice. Each Party acknowledges and agrees that if a protective order or other remedy is not timely sought or obtained, the Party subject to the request will furnish only that portion of the Confidential Information which is legally required and such Party will use all reasonable efforts to ensure that confidential treatment will be accorded such Confidential Information. For the avoidance of doubt, this Agreement and any fee schedules and/or discounts associated with this Agreement shall be considered "Confidential Information." -9- 60 (b) Participant Records. All medical, billing, and other records regarding Participants will be kept confidential by the Parties, in accordance with applicable state and federal laws. The Parties will share such information internally only with those having a need to know such information and shall advise any such persons of their confidentiality obligations. 6.4 HIPAA Compliance. EDH may receive Protected Health Information (as defined pursuant to HIPAA) from Sponsor, the Participants, the Plan, or the Plan Administrator. Accordingly, EDH shall comply with the provisions of that certain Business Associate Agreement dated November 30, 2020 executed by Sponsor and EDH, which .is attached to this Agreement as Exhibit B and fully incorporated by reference. Sponsor will coordinate delivery and execution of any future agreements which may be required pursuant to HIPAA to allow Sponsor and/or Plan Administrator to transfer relevant Protected Health Information to EDH. 6.5 Survival. The provisions of this Article 6 shall survive any termination of this Agreement. ARTICLE 7. INDEMNIFICATION AND LIMITATION OF LIABILITY 7.1 Indemnification. (a) EDH Indemnification. EDH will indemnify, defend, and hold harmless Sponsor and Sponsor's past, present, and future affiliates, governing persons, officers, equity owners, and employees from and against the full amount of any and all liabilities, losses, penalties, fines, damages, and expenses incurred or suffered by Sponsor with respect to any and all claims, controversies, suits, legal actions, and proceedings (including mediation and arbitration proceedings), whether civil, criminal, investigative, administrative, or legislative, asserted, initiated, filed, claimed, or otherwise pursued by a third party arising from or caused by (i) the breach of any term, covenant, agreement, condition, representation, or warranty under this Agreement by EDH, or (ii) the negligence or willful misconduct of EDH; provided, however, EDH's indemnification obligation under this Section 7.1(a) shall be prorated to the extent any such losses incurred by Sponsor are contributed to by a breach of this Agreement by Sponsor or the negligence or willful misconduct of Sponsor. (b) Sponsor Indemnification. Subject to the limitations set forth in Fla. Stat. sec. 768.28, Sponsor will indemnify, defend, and hold harmless EDH and EDH's past, present, and future affiliates, governing persons, officers, equity owners, and employees from and against the full amount of any and all liabilities, losses, penalties, fines, damages, and expenses incurred or suffered by EDM with respect to any and all claims, controversies, suits, legal actions, and proceedings (including mediation and arbitration proceedings), whether civil, criminal, investigative, administrative, or legislative, asserted, initiated, filed, claimed, or otherwise pursued by a third party arising from or caused by (i) the breach of any term, covenant, agreement, condition, representation, or warranty under this Agreement by Sponsor, (ii) or (ii) the negligence or willful misconduct of Sponsor; provided, however, Sponsor's indemnification obligation under this Section 7.1(b) shall be prorated to the extent any such losses incurred by EDH are contributed to by a breach of this Agreement by EDH or the negligence or willful misconduct of EDH. 7.2 Limitation of Liability. (a) Limitation of Liability. Except as set forth in Section 7.2(b), below, (i) in no event shall either Party be liable to the other for special, indirect, incidental, consequential, punitive, exemplary, or tort damages (including lost business, profits, or goodwill) arising out of or relating to this agreement, an exhibit, amendment, and/or addendum, regardless of whether the claim arises in tort, contract, or otherwise, and even if the other Party has been advised of the possibility of such damages, and (ii) in no event shall either Party's aggregate liability to the other Party under this agreement, an exhibit, amendment, and/or addendum and with respect to the services provided pursuant thereto exceed one million dollars ($1,000,000). The foregoing limitations of liability represent the allocation of risk between the Parties under this agreement and ate essential elements of the basis of the bargain between the Parties. Notwithstanding anything in this Section 7.2(a) to the contrary, to the extent the -10- 61 limitations of liability set forth in Fla. Stat. § 768.28 are applicable to sponsor in any proceeding, the statutory limitations set forth therein shall apply in lieu of this Section 7.2(a). (b) Exceptions. Notwithstanding anything to the contrary contained in Section 7.2(a) above, the foregoing limitations of liability in no way limit any rights and remedies either Party may have with respect to: (i) Sponsor's obligations to pay EDH any amount due pursuant to this Agreement, including, without limitation, Sponsor's obligations to pay Claims and EDH Fees; (ii) EDH's obligation to pay the Guarantee Amount to Sponsor; (iii) breaches of Section 6.3 of this Agreement; (iv) breaches of the Business Associate Agreement between the Parties, attached hereto as Exhibit B; or (v) willful misconduct or fraud. 7.3 Survival. The provisions of this Article 7 shall survive any termination of this Agreement. ARTICLE 8. DISPUTE RESOLUTION 8.1 Dispute Resolution Procedure. (a) Negotiation. In the event any dispute arises between the Parties under or concerning this Agreement, or the breach thereof (a "Dispute"), the Parties will meet and confer in good faith and attempt to resolve the Dispute. If the Parties do not resolve the Dispute within thirty (30) days of the first meeting, then either Party may, by providing written notice, require both Parties to submit the dispute to mediation. (b) Binding Arbitration. If any such negotiation and/or mediation does not resolve the Dispute, and if any Party wishes to pursue the Dispute, the Dispute shall be submitted to binding arbitration administered by the American Arbitration Association ("AAA") in accordance with its Commercial Rules. The award of the arbitrator(s) shall be final and binding upon the Parties, and either Party may have judgment entered upon the award by any court of competent jurisdiction. Each Party shall bear its respective arbitration expenses and each shall pay its pro -rata portion of the arbitrator's charges and expenses. Notwithstanding any rules of AAA to the contrary, the arbitrator(s) shall not be permitted to award punitive or exemplary damages. 8.2 Participant Complaint Resolution. EDH will maintain a written procedure to provide timely response to and resolution of any Participant's inquiries, complaints, and grievances in connection with the Network, Network Services, Providers, or any Episode of Care. 8.3 Survival. The provisions of this Article 8 shall survive any termination of this Agreement. ARTICLE 9. MISCELLANEOUS PROVISIONS 9.1 Relationship of the Parties. The sole relationship between the Parties to this Agreement is that of independent contractors. This Agreement does not create a joint venture, partnership, agency, employment, or other relationship between the Parties, and neither Party shall have the right or authority to assume, create, or incur any liability or any obligation of any kind, express or implied, on behalf of the other Party except as provided expressly in this Agreement. 9.2 Compliance with Healthcare Laws.. By entering into this Agreement, the Parties specifically intend to comply with all applicable laws, rules and regulations, including: (i) the federal Anti -kickback Statute (42 U.S.C. § 1320a-7b(b)); (ii) the limitation on certain physician referrals, also referred to as the Stark Law (42 U.S.C. § 1395nn); and (iii) any applicable state or federal privacy laws. Accordingly, no part of any consideration paid hereunder is a prohibited payment for the recommending or arranging for the referral of business or the ordering of items or services, nor are the payments arising hereunder intended to induce illegal referrals of business. 9.3 Authority to Bind. Each Party represents and warrants that: (a) it is duly organized, validly existing, and in good standing under the laws of the state of its formation; (b) it has the full power and authority to execute and deliver this Agreement and to perform all of its obligations under this Agreement; (c) the provisions of this -11- 62 Agreement and the performance by the Party of its obligations under this Agreement are not in conflict with its organizational documents or any other agreement to which it is a party or by which it is bound; and (d) the person executing this Agreement has the full authority and capacity to bind the Party. 9.4 Negotiated Agreement. Each Party acknowledges and agrees that the terms and language of this Agreement were the result of negotiations among the Parties, and that each Party had the opportunity to. seek advice from counsel of its choosing. As a result, there shall be no presumption that any ambiguities in this Agreement shall be resolved against any particular Party. 9.5 Amendments. This Agreement may only be amended with the mutual written consent of both Parties. 9.6 Entire Agreement. This Agreement and the Exhibits and Addenda attached hereto constitute the entire.understanding between the Parties. Any prior agreements, negotiations, commitments, and understandings, whether oral or written, with respect to the subject matter of thisAgreement, not expressly set forth herein, are not valid or binding on either Party. 9.7 Headings. The headings in this Agreement are inserted for convenience only and shall not affect the construction or interpretation of this Agreement. 9.8 Assignment. This Agreement may be assigned, transferred, or conveyed by operation of law only with the prior written consent of the other Party, but such consent shall not be unreasonably withheld. 9.9 Waiver of Rights. The failure of either Party to enforce any term or provision of this Agreement will not be construed as a waiver of such provision or of the right of such Party to enforce the same or any other provision. 9.10 Governing Law. This Agreement shall be governed by ERISA and all applicable regulations thereunder. To the extent not preempted by ERISA or any other federal law, this Agreement shall be construed in accordance with the laws of the State of Texas without regard to any state choice of law statutes. 9.11 Severability. If any term or provision of this Agreement is found by a court of competent jurisdiction to be invalid, illegal, or otherwise unenforceable, the same shall not affect the other terms or provisions hereof or the whole of this Agreement, but such term or provision shall be deemed modified to the extent necessary in the court's opinion to render such .term or provision enforceable, and the rights and obligations of the Parties shall be construed and enforced accordingly, preserving to the fullest permissible extent the intent and agreements of the Parties herein set forth. 9.12 Notices. Any notice, request, demand, or other communication required or permitted pursuant to this Agreement shall be in writing and shall be deemed to have been duly given if: (a) delivered by hand and receipted for by the Party to whom said notice or other communication shall have been directed, (b) mailed by certified or registered mail with postage prepaid, on the third business day after the date on which it is so mailed; (c) if sent by reputable overnight courier and receipted for by the Party to whom said notice or other communication shall have been directed. The addresses for such notices or communications shall be as set forth below: To EDH: Employer Direct Healthcare, LLC Attn: General Counsel 2100 Ross Avenue, Suite 550. Dallas, Texas 75201 . To Sponsor City of Sebring Attn: City Administrator 368 South Commerce Avenue Sebring, Florida 33870 9.13 Counterparts. This Agreement may be executed in one or more counterparts, each of which will be deemed to be an original copy of this Agreement and all of which, when taken together, will be deemed to constitute one and the same Agreement. This Agreement maybe executed and delivered by electronic transmission. -12- 63 9.14 Force Maieure. Neither Party shall be liable for any failure, inability or delay to perform hereunder, if such failure, inability, or delay is due to war, strike, fire, explosion, sabotage, accident, casualty, or any other cause beyond the reasonable -control of the Party so failing, providing due diligence is used by that Party in curing such cause and in resuming performance. 9.15 Rights and Remedies. Unless expressly limited by this Agreement, the rights and remedies of the Parties provided for in this Agreement are in addition to any other rights and remedies provided by law. [Signature Pages to Follow) -13- 64 Each Party has read this Agreement, including all Exhibits, and agrees to be bound by its terms and conditions. Once fully executed, this Agreement is valid, binding, and enforceable against each Party in accordance with its terms. Employer Direct Healthcare, LLC : eY 1/ l Name: John Zutter City of Sebring ��- Name: Scott Noethlich I WT Title: CEO Title: City Administrator -14- 65 EXHIBIT A Procedures Regarding Written Utilization Strategy The Parties understand and agree that the objectives of each Party with respect to this Agreement can only be accomplished if the Network and Network Services are utilized by eligible Participants during the term of this Agreement. The Parties further agree that maximum utilization of the Network and Network Services by the Participants can most effectively be accomplished through the collaborative efforts of both Parties. Accordingly, EDH and Sponsor shall mutually agree to the terms of a written utilization strategy which shall include the schedule and nature of communications relating to EDH and Sponsor's implementation and marketing of the Network and Network Services. Sponsor shall have the ultimate obligation to formulate and draft the written utilization strategy, obtain the signatures of each Party, and circulate a fully executed copy of such utilization strategy to both Parties. However, EDN will assist Sponsor by suggesting proven strategies and communications that may be integrated as milestones into the written utilization strategy. Examples of such proven strategies and marketing communications that maybe incorporated as milestones into the written utilization strategy include, but are not limited to: (a) meetings and training sessions between EDH and any of Sponsor's benefits or human resources representatives; (b) EDH's attendance at Sponsor's health fairs or vendor summits, (c) EDH-led webinar presentations or Q&A sessions for employees; (d) Sponsor -led open enrollment meetings or other Sponsor -led informational events; (e) training sessions relating to the Network and Network Services hosted by EDH; and (f) marketing communications released to any or all of the following: (i) enrolled employees or dependents; (ii) Sponsors human resources employees, benefit teams, or health fair coordinators; (iii) Sponsor's benefit program vendors; (iv) Sponsor's safety managers or supervisors; and/or (v) any Sponsor -identified key contacts that may help drive employee awareness of the benefits associated with the Network and Network Services. EDH will carry out the design and delivery of any marketing communications agreed to by the Parties in the written utilization strategy. The utilization strategy described herein shall be agreed to in writing by the Parties and shall be attached as an addendum to this Exhibit A on or before February 1, 2021. The Parties agree and understand that it may be necessary to revise certain terms of the utilization strategy to drive implementation and utilization. As a result, the Parties agree that they may amend the terms of an existing utilization strategy from time to time, but only by mutual written consent of the Parties. -1- 66 EXHIBIT B [Exhibit B Begins on the following Page] 67 CITY OF SEBRING AGENDA ITEM SUMMARY MEETING DATE: December 15, 2020 PRESENTER: Robinson AGENDA ITEM#: 8 H - Surgery Plus (EDH) Business Associate Agreement BACKGROUND: Health insurance plan changes were presented to Council on October 20, 2020. Surgery Plus was a benefit added to allow employees and dependents the option to receive covered services in an inpatient, outpatient, surgery center, in -office, or other health care facility setting from a Provider in the Surgery Plus (EDH) Network at no cost to the employee and a reduced contract rate to the City. The attached Business Associate Agreement is required to outline the use and disclosure of protected health information. The agreement has been reviewed by Bob Swaine. REQUESTED MOTION: Approve Business Associate Agreement as presented. COUN L ACTION: /APPROVED Moved b2--Iiv�y • Seconde by: � DENIED Dettmanowrance tewart tarlisl TABLED TO: OTHER 68 BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement (this "BA Agreement") is made effective as of 11/30/2020 :, 2020 (the "Effective Date") by and between City of Sebring, a Florida municipal corporation, with its principal place of business located at 368 South Commerce Avenue, Sebring, Florida 33870 ("Covered Entity") and Employer Direct Healthcare, LLC, a Delaware limited liability company with its principal place of business located at 2100 Ross Avenue, Suite SSO, Dallas, Texas 75201 ("Business Associate"). Covered Entity and Business Associate are referred to collectively as the "Parties" and individually as a "Party." RECITALS Business Associate has a contracted network of physicians, hospitals, and other healthcare providers and facilities which.provide non -emergent, planned surgical and medical procedures according to rates and terms negotiated by Business Associate. II. Business Associate's contracted network of providers is made available to individuals through self-funded health benefit plans that incorporate Business Associate's network offering. III. Covered Entity has established a self-funded health benefit plan for the benefit of Covered Entity's employees, employees' dependents, and retirees. IV. Business Associate and Covered Entity are exploring a service agreement (the "Service Agreement") pursuant to which Business Associate would agree to coordinate and deliver its network offering to and on behalf of Covered Entity. V. The Parties desire to enter into this BA Agreement because, as part of the negotiation and performance of the Service Agreement, Covered Entity must disclose Protected Health Information to Business Associate or Business Associate must otherwise access, create, or use Protected Health Information. Accordingly, in consideration of the promises and mutual covenants contained herein and other good and valuable consideration, the Parties agree as follows: 1. Definitions. Capitalized terms used but not otherwise defined in this BA Agreement shall have the same meaning ascribed to such terms in the Health Insurance Portability and Accountability -Act of 1996 ("HIPAA"), any and all regulations promulgated thereunder including the standards for privacy of individually identifiable health information at 45 C.F.R. Parts 160 and 164 ("Privacy Rule") and the standards for the security of electronic protected health information at 45 C.F.R. 160, 162, and 164.("Security Rule") (the Privacy Rule and the Security Rule are collectively referred to herein as the "HIPAA Rules"), and the Health Information Technology for Economic and Clinical Health Act ("HITECH") provisions of the American Recovery and Reinvestment Act of :2009 ("ARRA"). 2. Use and Disclosure of Protected Health Information. Business Associate may use and disclose Protected Health Information as permitted or required under this BA Agreement, the Service Agreement, and as Required by Law, but Business Associate shall not otherwise use or disclose any Protected Health Information. Business Associate shall not use or disclose Protected Health. Information received from Covered Entity in any manner that would constitute a violation of the HIPAA Rules if so used or disclosed by Covered Entity. To the extent Business Associate carries out any of Covered Entity's obligations under HIPAA, Business Associate shall comply with the requirements of HIPAA that apply to Covered Entity in the performance of such obligations. Without limiting the generality of the foregoing, Business Associate is permitted to use or disclose Protected Health Information as set forth below: (a) Business Associate may use Protected Health Information internally for Business Associate's proper management and administrative services or to carry out its legal responsibilities. (b) Business Associate may disclose Protected Health Information to a third -party for Business Associate's proper management and administration, provided that: .1_ 69 V) the disclosure is Required by Law, (ii) Business Associate makes the disclosure pursuant to an agreement consistent with Section 6 of this BA Agreement; or (iii) Business Associate makes the disclosure pursuant to a written confidentiality agreement under which the third -party is required to: (A) protect the confidentiality of the Protected Health Information; (B) only use or further disclose the Protected Health Information as Required by Law orfor the purpose for which it was disclosed to the third -party; and (C) notify Covered Entity of any acquisition, access, use, or disclosure of Protected Health Information in a manner not permitted by the confidentiality agreement. (c) Business Associate may use Protected Health Information to provide Data Aggregation services relating to the, Health Care Operations of Covered Entity if required or permitted under the Service Agreement. (d) Business Associate may de -identify any and all Protected Health Information obtained by Business Associate under this BA Agreement or the.Service Agreement at any location, and use such de -identified data, all in accordance with the de -identification requirements of the Privacy Rule. 3. Safeguards. Business Associate shall use appropriate safeguards to prevent the use or disclosure of Protected Health Information other than as permitted or required by this BA Agreement. In addition, Business Associate shall implement Administrative Safeguards, Physical Safeguards and Technical Safeguards that reasonably and appropriately protect the Confidentiality, Integrity and Availability of Electronic Protected Health Information that it creates, receives, maintains or transmits on behalf of Covered Entity. Business Associate shall comply with the HIPAA Security Rule with respect to Electronic Protected Health Information. 4. Minimum Necessary Standard. To.the extent required by the "minimum necessary" requirements of HIPAA, Business Associate shall only request, use and disclose the minimum amount of Protected Health Information necessary to accomplish the purpose of the request, use or disclosure. 5. Mitigation. Business Associate shall take reasonable steps to mitigate, to the extent practicable, any harmful effect (that is known to Business Associate) of a use or disclosure of Protected Health Information by Business Associate in violation of this BA Agreement or HIPAA. 6. Subcontractors. Business Associate shall enter into a written agreement meeting the requirements of 45 C.F.R. §§ 164.504(e) and 164.314(a)(2) with each Subcontractor (including, without limitation, a Subcontractor that is an agent under applicable law) that creates, receives, maintains or transmits Protected Health Information on behalf of Business Associate. Business Associate shall ensure that the written agreement with each Subcontractor obligates the Subcontractor to comply with restrictions and conditions that are at least as restrictive as the restrictions and conditions that apply to Business Associate under this BA Agreement. 7. Reporting Reauirements. (a) Business Associate shall, without unreasonable delay, but in no event later than three (3) business days after becoming aware of any acquisition, access, use, or disclosure of Protected Health Information in violation of this BA Agreement by Business Associate, its employees, other agents or contractors, or by a third -party to which Business Associate disclosed Protected Health Information (each, an "Unauthorized Use or Disclosure"), report such Unauthorized Use or Disclosure to Covered Entity. (b) Business Associate shall, without unreasonable delay, but in no event later than three (3) business days after becoming aware of any Security Incident, report it to Covered Entity. Notwithstanding the foregoing, pings, port scans, and similar routine attempts on Business Associate's firewall that are successfully blocked shall not require reporting due to the infeasibility of recording and reporting all such pings, port scans, and other routine events. 2_ 70 M Business Associate shall, without unreasonable delay, but in no event later than three (3) business days after discovery of a Breach of Protected Health Information (whether secured or unsecured), report such Breach to Covered Entity In accordance with 45 C.F.R. § 164.410. 8. Access to Protected Health Information. Within ten (10) business days of a request by Covered Entity for access to Protected Health Information about an Individual contained_ in any Designated Record Set of Covered Entity maintained by Business Associate, Business Associate shall make available to Covered Entity such Protected Health Information for so long as Business Associate maintains such information in the Designated Record Set. If Business Associate receives a request for access to Protected Health Information directly from an Individual, Business Associate shall forward such request to Covered Entity within five (5) business days. 9. Availability of Protected Health Information. Within ten (10) business days of receipt of a request from Covered Entity for an amendment to an Individual's Protected Health Information contained in any Designated Record Set of Covered Entity maintained by Business Associate, Business Associate shall provide such Protected Health Information to Covered Entity for amendment and incorporate any such amendments in the Protected Health Information (for so long as Business Associate maintains such information In the Designated Record Set) as required by 45 C.F.R. § 164.526. If Business Associate receives a request for amendment to Protected Health Information directly from an Individual, Business Associate shall forward such request to Covered Entity within five (5) business days. 10. Accounting of Disclosures. Within ten (10) business days of notice by Covered Entity to Business Associate that it has received a request for an accounting of disclosures of Protected Health Information (other than disclosures to which an exception to the accounting requirement applies), Business Associate shall make available to Covered Entity such information as is in Business Associate's possession and is required for Covered Entity to make the accounting required by 45 C.F.R. § 164.528. 11. Availability of Books and Records. Business Associate shall make its internal practices, books and records relating to the use and disclosure of Protected Health Information received from or created or received by Business Associate on behalf of, Covered Entity available to the Secretary for purposes of determining Covered Entity's and Business Associate's compliance with HIPAA. 12. Restrictions and Limitations in Notice of Privacy Practices. Subject to Florida Statute 119.07 et seq., Business Associate shall comply with any reasonable limitation in Covered Entity's notice of privacy practices to the extent that such limitation may. affect Business Associate's use or disclosure of Protected Health Information and Business Associate receives notification of such reasonable limitation. Business Associate shall comply with any reasonable restriction on the use or disclosure of Protected Health Information that Covered Entity has agreed to or is required to abide by.under 45 C.F.R. § 164.522, to the extent that such restriction may affect Business Associate's use or disclosure of Protected Health Information. 13. Term. The term of this BA Agreement shall commence on the Effective Date. This Agreement shall terminate when all of the Protected Health Information provided by Covered Entity, or created and received by Business Associate on behalf of the Covered Entity, is destroyed or returned to the Covered Entity or otherwise as set forth in Section 14 of this Agreement. 14. Vermination Upon Breach. Any other provision of this BA Agreement or the Service Agreement notwithstanding, this BA Agreement and the Service Agreement may be terminated by Covered Entity in the event of a material breach by Business Associate of the terms and conditions of this BA Agreement. Covered Entity shall provide thirty (30) days' written notice in sufficient detail to enable Business Associate to understand the specific nature of the breach and afford Business Associate an opportunity for Business Associate to cure the breach or end the violation. Should Business Associate fail to cure the breach within such thirty (30) daytime frame, Covered Entity may terminate this BA Agreement and the Service Agreement; provided however, that in the event termination is not feasible, in Covered Entity's sole discretion, Covered Entity shall have the right to report the breach to the Secretary. In the event that Business Associate becomes aware of a pattern of activity or a practice of Covered Entity that constitutes a breach or material violation of the obligations of Covered Entity under this BA Agreement, Business 71 Associate may terminate. this BA Agreement and the Service Agreement. Business Associate shall provide Covered Entity thirty (30) days' written notice in sufficient detail to enable Covered Entity to understand the nature of the breach or material violation and afford Covered Entity an opportunity to cure the breach or end the violation. Should Covered Entity fail to cure the breach or end the violation within such thirty (30) day time frame, Business Associate may terminate this BA Agreement and the Service Agreement; provided however, that in the. event termination is not feasible, in Business Associate's sole discretion, Business Associate shall have the right to report the breach or violation to the Secretary. 15. Return or Destruction of Protected Health Information upon Termination. Upon expiration or termination of the Service Agreement or this BA Agreement, Business Associate shall either. return or destroy all Protected Health Information received from Covered Entity or created or received by Business Associate on behalf of Covered Entity and which Business Associate still maintains in any form. Notwithstanding the foregoing, to the extent that Covered Entity and Business Associate mutually determine that it is not feasible to return or destroy such Protected Health Information, the terms and provisions of this BA Agreement shall survive termination with regard to the Protected Health Information still in the possession of Business Associate, and such Protected Health Information shall beused or disclosed solely for such purpose or purposes which prevented the return or destruction of such Protected Health Information. 16. Indemnification. Business Associate (the "Indemnifying Party') shall indemnify, defend and hold harmless the Covered Entity (the "Indemnified Party") and its officials, employees, affiliates, agents, and representatives from.and against any and all third party liabilities, costs, claims, suits, actions, proceedings, demands, losses, and liabilities of any kind (including court costs and reasonable attorneys' fees) brought by a third party, arising from or relating to the acts or omissions of the Indemnifying Party or any of its directors, officers, subcontractors, employees, affiliates, agents, and representatives in connection with Indemnifying Party's performance under this BA Agreement or the Service Agreement. The indemnification provisions of this Section 16 shall survive the termination of this BA Agreement. 17. Effect. The provisions of this BA Agreement shall control with respect to Protected Health Information that Business Associate receives from or on behalf of Covered Entity, and the terms and conditions of this BA Agreement shall supersede any conflicting or inconsistent terms or provisions of any existing or future agreement between the Parties, including the Service Agreement and all exhibits and attachments thereto. 18. Relationship of the Parties. Covered Entity and Business Associate acknowledge and agree that Business Associate is at all times acting as independent contractor of Covered Entity under this BA Agreement and not as an employee, agent, partner, or joint venturer of Covered Entity. 19. Regulatory References. A reference in this BA Agreement to a section in HIPAA, the HIPAA Rules, or HITECH means the section as it may be amended from time -to -time. 20. Amendments. This BA Agreement may only be amended by mutual written consent of the Parties. The Parties agree to :amend this BA Agreement from time to time as reasonably necessary for Covered Entity to comply with the requirements of HIPAA. 21. Assignment. This BA Agreement may be assigned, transferred, or conveyed by operation of law only with the prior written consent of both Parties, but such consent shall not be unreasonably withheld. 22. No Third -Party Beneficiaries. The Parties have not created and do not intend to create by this BA Agreement any third -party rights, including, but not limited to, third -party rights for Covered Entity's participants. 23. Headings. The headings in this BA Agreement are inserted for convenience only and shall not affect the construction or interpretation of this BA Agreement. 24. Notices. Any notice, request, demand, or other communication required or permitted pursuant to this BA Agreement shall be in writing and shall be deemed to have been duly given if: (a) delivered by hand and 72 receipted for by the Party to whom said notice or other communication shall have been directed, (b) mailed by certified or registered mail with postage prepaid, on the third business day after the date on which it is so mailed; (c) if sent by reputable overnight courier and receipted for by the Party to whom said notice or other communication shall have been directed; or (d) if sent by email or other similar means of electronic communication (with confirmed receipt), upon receipt of transmission notice by the sender. The addresses for such notices or communications shall be as set forth below or as specified by a Party in writing: To Covered Entity: City of Sebring Attn: City Administrator 368 South Commerce Avenue Sebring, Florida 33870 To Business Associate: Employer Direct Healthcare, LLC Attn: Legal Department 2100 Ross Avenue, Suite 550 Dallas, Texas 75201 25. Counterparts. This.BA Agreement may be executed in one or more counterparts, each of which will be deemed an original copy of this BA Agreement and all of which, when taken together, will be deemed to constitute one and the same instrument. This BA Agreement may be executed and delivered by electronic transmission. [Signature Pages to Follow] 73 Each Party has read this BA Agreement and agrees to be bound by its terms and conditions. Once fully executed, this BA Agreement is valid, binding, and enforceable against each Party in accordance with its terms. City of Sebring By: Name: ��` r lb Title: fy\ br Employer Direct Healthcare, LLC _ Docu819 d by: By: Name: Doug Monkhouse Title: General counsel =6- 74 EXHIBIT C REGULATORY ADDENDUM This Regulatory Addendum (this "Addendum") is made effective as of January 1, 2021 by and between Employer Direct Healthcare, LLC, a Delaware limited liability company with its principal place of business located at 2100 Ross Avenue, Suite 550, Dallas, Texas 75201 ("EDH") and the City of Sebring, a Florida municipal corporation, with its principal place of business located at 368 South Commerce Avenue, Sebring, Florida 33870 ("Sponsor"). EDH and Sponsor are referred to collectively as the "Parties" and individually as a "Party." This Addendum is intended by the Parties to supplement the Plan Agreement (the "Agreement"), dated effective as of January 1, 2021. The Parties desire to supplement the Agreement to specifically reference certain provisions of law applicable to third -party administrators and to comply with those laws. Accordingly, pursuant to the terms and conditions of the Agreement and in consideration of the mutual promises contained herein, the Parties agree as follows: 1. Michigan. The Parties desire to supplement the Agreement to specifically reference certain provisions of Michigan law applicable to third -party administrators and to comply with those laws to the extent applicable and not preempted by federal law, as follows: In Michigan, Sponsor shall provide written notice to each individual covered by the Plan of the following information, with respect to services provided by EDH in relation to the Plan: (a) what benefits are being provided; (b) of changes in benefits; (c) the fact that individuals covered by the Plan are not insured or are only partially insured, as the case may be; (d) if the Plan is not insured, the fact that in the event the Plan or Sponsor does not ultimately pay medical expenses that are eligible for payment under the Plan for any reason, the individuals covered by the plan may be liable for those expenses; (e) the fact that the EDH or any third -party administrator merely processes claims and does not insure that any medical expenses of individuals covered by the Plan will be paid; (f) the fact that complete and proper claims for benefits made by individuals covered by the Plan will be promptly processed but that in the event there are delays in processing claims, the individuals covered by the Plan shall have no greater rights to interest or other remedies against the EDH or any third -party administrator than as otherwise afforded them by law. 2. Nevada. The Parties desire to supplement the Agreement to specifically reference certain provisions of Nevada law applicable to third -party administrators and to comply with those laws to the :extent applicable and not preempted by federal law, as follows: 683A.087 EDH may advertise the insurance which it administers, if any, only after it receives the approval of Sponsor. 683A.0873(1) EDH shall maintain at its principal office adequate books and records of all transactions between itself, Sponsor and the individuals covered by the plan. The books and records must be maintained in accordance with prudent standards of recordkeeping for insurance and with regulations of the Commissioner of the Nevada Division of Insurance ("Commissioner" 1 for a period of five (5) years after the transaction to which they respectively relate. After the five (5) year period, EDH may remove the books and records from Nevada, store their contents on microfilm or return them to Sponsor. 683A.0873(2) The Commissioner may examine, audit and inspect books and records maintained by EDH under the provisions of this section to carry out the provisions of NRS 6798.230 to 6798.300, inclusive. 683A.0873(3) The names and addresses of persons covered .by the plan or any other material which is in the books and records of EDH are confidential except when used in proceedings against EDH. 683A.0873(4) Sponsor may inspect and examine all books and records to the extent necessary to fulfill all contractual obligations to insured persons, subject to restrictions in the. written agreement between Sponsor and EDH. -1- 75 EXHIBIT C 683A.0877(1-7) The following pertains to fiduciary accounts, to the extent applicable: 1. All insurance charges and premiums collected by EDH on behalf of Sponsor and return premiums received from Sponsor are held by EDH in a fiduciary capacity. 2. Money must be remitted within fifteen (15) days to the person or persons entitled to it or be deposited within fifteen (15) days in one or more fiduciary accounts established and maintained by EDH in a bank, credit union or other financial institution in this state. The fiduciary accounts must be separate from the personal or business accounts of EDH. 3. If charges or premiums deposited in an account have been collected for or on behalf of more than one plan sponsor, EDH shall cause the bank, credit union or other financial institution where the fiduciary account is maintained to record clearly the deposits and withdrawals from the account on behalf of each sponsor. 4. EDH shall promptly obtain and keep copies of the records of each fiduciary account and shall furnish any sponsor with copies of the records which pertain to him upon demand of the Sponsor. 5. EDH shall not pay any claim by withdrawing money from the fiduciary account in which premiums or charges are deposited. 6. Withdrawals must be made as provided in the agreement between Sponsor and EDH fo r: a. Remittance to the Sponsor b. Deposit in an account maintained in the name of the Sponsor c. Transfer to and deposit in an account for the payment of claims d. Payment to a group policyholder for remittance to the insurer entitled to the money e. Payment to EDH for commission, fees or charges f. Remittance of return premiums to persons entitled to them 7. EDH shall maintain copies of all records relating to deposits or withdrawals and, upon the request of Sponsor, provide Sponsor with copies of those records. 683A.0879(1-5) EDH shall approve or deny health .claims within thirty (30) days of receipt and shall pay claims within thirty (30) days of approval. If EDH requires additional information to approve or deny a claim, EDH shall notify the claimant of the request for additional information within twenty (20) days after receipt of the claim. EDH shall notify the provider of all the specific reasons for the delay. EDH shall approve or deny the claim, within thirty (30) days of receiving additional information, and, if the claim is approved, pay the claim within thirty (30) days of receiving additional information. Interest on claims that are not paid shall equal prime rate at the largest bank in Nevada as determined by the Commissioner of Financial Institutions on January 1 or July 1, plus six percent .(6%), calculated from thirty (30) days after the date on which the claim is approved until the claim is paid. Claimants shall not be requested to resubmit information already -2- 76 EXHIBIT C provided, unless a legitimate reason is provided and the purpose is not to delay payment, harass the claimant, or discourage filing of claims. EDH shall not pay.only a part of a claim that has been approved and is fully payable. 683A.088 Each claim paid by EDH from money collected for or on behalf of Sponsor must be paid by a check or draft upon and as authorized by.Sponsor. 683A.0883(1-2) (1) The compensation paid to EDM for its services may be based upon premiums or charges collected, on number of claims paid or processed or on another basis agreed upon by EDH and Sponsor, except as provided in subsection (2) below. (2) Compensation paid to EDH .may not be based upon or contingent upon: (a) The claim experience of the policies which it handled; (b) The savings realized by EDH by adjusting, settling or paying the losses covered by Sponsor 3. New Jersey. The Parties desire to supplement the Agreement to specifically reference certain provisions of New Jersey law applicable to third -party administrators and to comply with those laws to the extent applicable and not preempted by federal law, as follows: MRS 176:276-6 The Agreement shall be retained as part of the official records of EDH for the NJAC 11:23-3.1(b) duration of the Agreement and for five years thereafter. NIRS 176:278-6(a) EDH will provide Sponsor the services described in the Agreement and will be NJAC 11:23-3.1(c)(1) compensated as stated in the Agreement. NIRS 17B:27B-6(b) Sponsor will be responsible for the provision of enrollment and eligibility NJAC41:23-3.1(c)(2)(i) information to EDH. MRS 17B:27B-6(b) Sponsor will be responsible to EDH to arrange for a preliminary or escrowed NJAC 11:23-3.1(c)(2)(ii) deposit of funds by Sponsor as described in the Agreement, if any. MRS 17B:27B-6(b) Sponsor will be responsible for the transmittal of funds from Sponsor to EDH for NJAC 11-.23-3.1(c)(2)(iii) the purpose of paying claims as described in the Agreement. MRS 17B:27B-6(b) Sponsor will be responsible for notifying EDH of modifications in the Sponsor's NJAC 11:23-3.1(c)(2)(iv) benefit plans. NIRS 1713:2713-6(b) Sponsor will be solely responsible for the cost of any ineligible claims paid by EDH. NJAC 11:23-3.1(c)(2)(v) MRS 178:276-6(b) Sponsor will be solely responsible for any liability incurred on account of any NJAC 11:23-3.1(c)(2)(vi) overdue payments by EDH. NIRS 17B:27B-6(b) Sponsor will be solely responsible for procuring any reinsurance or stop -loss NJAC 11:23-3.1(c)(2)(vii) insurance relative to the benefit plans under the Agreement. NJ RS 176:27B -6(c) EDH will maintain appropriate.back-up systems against the loss of the records. NJAC 11:23-3.1(c)(3)(i) MRS 17B:27B-6(c) EDH will establish and maintain appropriate financial controls. NJAC 11:23-3.1(c)(3)(ii) MRS 17B:27B-6(c) Sponsor may at its sole expense employ an outside auditor to conduct any claims NJAC 11:23-3.1(c)(3)(iii) audit under the Agreement. -3- 77 EXHIBIT C NIRS 17B:27B-6(c) EDH hereby represents and warrants to Sponsor that EDH has, and during the NJAC 11:23-3.1(c)(3)(iv) term of the Agreement will maintain, general liability insurance, valuable papers insurance, errors and omissions coverage, and such other coverage as required under NJAC 11:23-3.1(c)(3)(iv) in connection with EDH's performance of its obligations under the Agreement. MRS 17B:27B-6(c) EDH will make all records referred to the Agreement, including, without NJAC 11:23-3.1(c)(3)(v)&(vi) limitation, claims disbursements and experience records, available for the Sponsor's inspection from time to time during normal business hours. In addition, the claims disbursements and experience records will be available at Sponsor's request, including monthly reports if requested. NJAC 11:23-3.1(c)(3)(vii) To the extent applicable, EDH will prepare and provide to Sponsor all the data for any prompt -pay reports as may be required for Sponsor to comply with New Jersey law. No prompt -pay penalties are provided for under the Agreement. NIRS 17B:27B-7(b) Sponsor shall own the records generated by EDH pertaining to Sponsor, except NJAC 11:23-3.2(b) that EDH shall retain the right to continuing access to books and records to permit EDH to fulfill all of its contractual obligations to Sponsor. NIRS 17B:27B-7(c) if the Agreement is canceled, EDH may, with the written agreement of Sponsor, NJAC 11:23-3.2(c) transfer all records to a new administrator instead of retaining them for five years. NJ RS 17B:27B-10 All funds remitted to EDH by Sponsor shall be held by EDH in a separate account NJAC 11:23-3.5 maintained in the name of Sponsor or in a separate account maintained jointly in the names of Sponsor and EDH. If funds have been collected by EDH from a provider or enrollee on behalf of Sponsor, they shall be maintained in a separate account maintained in the name of Sponsor, maintained jointly in the names of Sponsor or EDH or remitted to the Sponsor, as provided in the Agreement. Funds shall not be commingled with any other funds of EDH or other clients of EDH. If an account is jointly held by EDH and Sponsor, it shall be maintained in a State or Federally chartered insured depository institution, and EDH shall provide Sponsor with a monthly accounting of all transactions in that account. Sponsor shall have the responsibility to make available to EDH funds necessary to enable EDH to pay claims in a timely manner, as provided in the Agreement. EDH shall not be liable to any party for the failure of Sponsor to make funds available to pay claims. Copies of all records pertaining to the collection of funds shall be made available to Sponsor as provided in the Agreement. MRS 1713:276-11 Any policies, certificates, booklets, termination notices or other written NJAC 11:23-3.6 communications delivered by Sponsor to EDH for delivery to enrollees shall be delivered by EDH promptly, in accordance with the instructions of Sponsor and the terms of the Agreement. Notwithstanding any of the foregoing, in the event any of the provisions of any of the foregoing states' laws that are determined or cited as not being applicable to the Agreement are or become applicable to the Agreement, such provisions shall apply and shall supersede any provisions in the Agreement to the contrary. [Signature Pages to follow] -4 78 EXHIBIT C Each Party has read this Addendum and.agrees to be bound by its terms and conditions. Employer Direct Healthcare, LLC City of Sebring n By: By: �. Name: John Zutter Name: Scott Noethlich Title: CES Title: City Administrator -5- 79 DEPARTMENTAL MATTERS INDIAN RIVER COUNTY MEMORANDUM To: Jason Brown County Administrator From: Suzanne Boyll Human Resources Director Date: May 3, 2021 Subject: Medical and Pharmacy Benefit Recommendations for Plan Year 2021/2022 Background Indian River County provides employee and retiree group health insurance through a partially self-insured plan. Health insurance is available to full-time employees (budgeted at 30 hours per week or more) and eligible retirees of the Board of County Commissioners and the respective Constitutional Officers (Sheriff, Property Appraiser, Tax Collector, Clerk of Courts, and the Supervisor of Elections) to include their eligible dependents. Medical and pharmacy claims and plan administration expenses are funded from contributions made by employer and employee/retiree contributions. The County purchases stop loss insurance for extraordinary and aggregate claims experience to protect against high cost claims. The current stop loss individual deductible is $300,000 with an aggregate deductible of $100,000. The health insurance plan is an essential part of the employee benefit package and important to recruitment and retention efforts. The County has engaged the services of a professional benefits consultant, Lockton Companies, to review plan experience and provide recommendations to maintain a benefits package that is: ' ✓ Affordable ✓ Competitive ✓ Sustainable The County offers two health insurance plans — the Premier Silver Plan and Premier Gold Plan. The medical benefit is administered by Florida Blue and the pharmacy benefit is administered by RX Benefits using Express Scripts Pharmacy Benefit Manager (PBM). Both plans have the same access to the Blue Options provider network through Florida Blue and access to the same network of pharmacies through Express Scripts. The differences between the two plans are the deductible, copayment, and coinsurance amounts and the monthly premium paid by the employee or retiree for coverage under the plan Summary of Premier Silver and Premier Gold Plan Benefits: Florida Blue BQueOptivns Plan At -A -Glance Plan Nurmer �Casl_shwne�g,=,Puteseatrefs Fiesparusib [Prr rrier.S�rer-P 053U2] �remier1fiold lily-(KMW9, In-Nebarnirk SINN) S11.000 f $2,000 WOO i S 1.2D0 Out -of -Ne ym* $2.000:1$4.000 $1.2D0 I $2,40D In -Net park 3D% 2D% Out-of-Nelrmrk 4D% 3D-96 • In-NehvoA MOOC 1512,000 $3.00()1$8,000 Out -of NeurEwk 58.0001$15,000 54.000 158,000 In-NeWm* Family Physician 340 Copayment $30 Copayment In-Netucrk S idist $fay Copayrnent S50 Copayment Out-oaf-Neuurexk DED + 4D% DED + 3D96 In-NeWork General Medical S10 Copayment $10 Copayment In-Nebwrk Dermatology $20 Copayment $20 Copayment Out-aF-N-'.=Tk NIA NIA In-Nehuork Family Physfician $5 Copayment 35 Copayment In-NeWerk Speci ist $b Copayment 35 Copayment Out-cf Ne.1,=a k IDED + 40% DED + 3D% In-Netmrk 40 Copayment S30 Copayment Out-of-N=_irk IDED + 4D% DED + 30% In-NeWmrk PAD $50D + DED + 3096 PAD $200 + DED +20% Out-of-Neusmrk PAD $ I.WO + DED + 40% PAD S40D +IDED + 3D% In-Nehvcrk IDED + 3DD6 DED + 2DO6 Out-& Netrx rk INN DED + 30% INN DED + 20% In-Nehnark IDED + 3D% DED + 2D% Out -of Nensswk INTI DED + 30% INNDED + 20% In-Neterork Family Physkian I Specialist. No Charge No Charge Out -of Netumrir 411% 30% In-Nehvcrk No Charge No Charge Out-of-Nebwork DED + 40% DED + 30% tri-Netivarock 325 Copayment S15 Copayment Out-of-Ne.'wcir k DED + 40% DED + 3D% Outpatien Flospitat Faci l'ry Premier Sih. er PE�n 053fl2 Premier Gold Plan -03559 (per visr} (Surgicsl M -Neff mirk Option '1: DED + 30% Option 1: DED + 20% Out-of-Nelwork DED + 4D% DED + 3D% En -Network, (Copayment Waived if Admitted) (Copayment Waived if Admitted) S500 Copayment + DED + 30% $250 Copayment + DED + 20% Out-of-Nedrxirk 5500 Copayment + lNN DED + 30?b $250 Copayment + INN DED + 20% tri -Network 5401 Copayment S30 Copayment Out-of-Nedrmak S40 Copayment S30 Copayment In-Nelwrmrk IDED + 30% DED + 20% Out-of-Ne€vmak INN DED + 30% INN. DED + 20% In -Network Family Physiician orSpecaallst 3D% $200 Copayment Out-of-Nefiarovk IDED +4D% DED + 30% - M&gx= - . tn-Network 3D% $200 Copayment Out-of-Netww k DED + 40% DED + 30% w En -Network DED + 305 DED + 20% Out -o1 -Network DED +4Dl% DED + 30% fn -Ne k $50D PAD + DED + 3+0S'S PAD $200 +DED + 2096 Out-of-Nef lurk S ..000 IPA'D + DED + 40% PAD $400 +IDED + 30% En -Network SEID Copayment $45 Copayment Out -of -Network DED +4D % DED + 3D% 1X Calendar Year Deductible Per Person $1M (manse be rnetbefore NIA Capayments ap;pfltr) Generic 55 Copayment $10 Copay Preferred Brand Name $ 5 Copayment S50 Copay Non -Preferred Brand Name $95 Copayment $75 Copay Mad Order Dnrg (GO -Day Supply) Express :Script 2x Retail Capay Express Script 2x IRetail Copay Maintenance MedIncalfan 2X Copayment at Covered! 2X C©payment at Covered Pharmacies Pharmacies pian RE;eren:E-, rtlt-4f- :-Max 82n" ce,EjHliF For rrr crmaia E]Ihg that may be charged by an a"-nehwk pmvlaer, pime resat kr tie tiuta.`-tfetmvrk `EMeM recticn em tow StmrrmMy at C ovsmge document IkagttosuM rs Fim = Eaw_ VM-= r ushg a lab other elate chest, p!aasR be sure to corarm ttt°tr are contracted viva Flo rMaBlue%Bin Oprkrrro I--M=prsarto reoem. goserebe-s. The current funding for the employee health insurance program Is: Employer, employee, and retiree contributions total approximately $23.6M annually. The enrollment in each plan as of March 2021 is: Silver Plan Gold Plan Single 225 Soo Family 171 783 Total 396 1,283 Plan Financial Performance The plan's financial performance since FY2010 is reflected below. Based on actuarial projections, it is anticipated we Will be on budget for the current plan year. Health Program Net Revenues FY10 JY20 Projected 2010 2011 2012 2013 2014 2015 2016(1) 2017 2018(2) 2019 2020 2021(3) $3,000,000 $2,000,000 $1,000,000 $0 —$1,000,000 -$2,000,000 2' -tou\3U NI 10 IN 50 98 44,99Y-' X lw� X RIX\ I 109 ............ �X N —$3,000,000 Current Current Current Total Employee Employer Monthly Monthly Monthly Premium Premier Silver Employee $15.00 $700.00 $715.00 Premier Silver Family $207.50 $1,105.00 $1,312.50 Employer, employee, and retiree contributions total approximately $23.6M annually. The enrollment in each plan as of March 2021 is: Silver Plan Gold Plan Single 225 Soo Family 171 783 Total 396 1,283 Plan Financial Performance The plan's financial performance since FY2010 is reflected below. Based on actuarial projections, it is anticipated we Will be on budget for the current plan year. Health Program Net Revenues FY10 JY20 Projected 2010 2011 2012 2013 2014 2015 2016(1) 2017 2018(2) 2019 2020 2021(3) $3,000,000 $2,000,000 $1,000,000 $0 —$1,000,000 -$2,000,000 2' -tou\3U NI 10 IN 50 98 44,99Y-' X lw� X RIX\ I 109 ............ �X N —$3,000,000 Current Current Current Total Employee Employer Monthly Premium Premium Premium I Premier Gold Employee $110-00 $700.00 $810.00 Premier Gold Family $400.00 $1,105-00 $1,505.00 J Employer, employee, and retiree contributions total approximately $23.6M annually. The enrollment in each plan as of March 2021 is: Silver Plan Gold Plan Single 225 Soo Family 171 783 Total 396 1,283 Plan Financial Performance The plan's financial performance since FY2010 is reflected below. Based on actuarial projections, it is anticipated we Will be on budget for the current plan year. Health Program Net Revenues FY10 JY20 Projected 2010 2011 2012 2013 2014 2015 2016(1) 2017 2018(2) 2019 2020 2021(3) $3,000,000 $2,000,000 $1,000,000 $0 —$1,000,000 -$2,000,000 2' -tou\3U NI 10 IN 50 98 44,99Y-' X lw� X RIX\ I 109 ............ �X N —$3,000,000 `. '\' \\\� , Our actual Health Plan experience through March 2021 indicates the following: • Employee & Retiree enrollment averages 1,672 members • Average of 3,675 individuals are insured under the group medical/6n • 23.6% of members are enrolled in the Premier Silver Plan and 76ll d in the Premier Gold Plan • 27 high cost claimants over $50K totaling $3.3M in claims during tths of the plan year • Stop Loss reimbursement of $17,639 resulting in net claims of $ high cost claimaints • The Premier Silver Plan is performing well and the Premier Gold Pat a loss. • Overall plan performance is 91.2% during the first six (6) m plan year. However, the ongoing expenses related to high cost claims ar expected to impact the plan over the next six (6) months and it is anticipated we will ti d the plan year on budget. The Self -Insurance Fund balance through March 2021 indicates` the fund balance history and actual fund balance as of March 31, 2021 as listed below: Fiscal Year 1End Fund (Balance History Septernber 30t, 2018 Septeimber 30, 2019 September 30, 2020 $13,148,724 $12,197,911 $12,807,,209 FA Fund Ralance Change Tihr ugh 2nd Quarter FY 20/21 September 30, 2020 March 31,202Y Inc./Dec. °fo Inc./Dec. $121807,209 1 $13,500,11 $692,903 5.41'°l0 Funding for the health plan is providecjky employer, employee, and retiree contributions to the plan as well as OPEB funding. Whilyf Whileis projected we will end the current plan year on budget, projections indicate additional fun ng of $1,561,000 will be required for the plan year beginning October 1, 2021. This increase is ased on a 5.5% medical trend, a 10% pharmacy trend, increase in stop loss premiums, and in ease administrative costs (ASO) fees. The projections assume $1,830,000 in pharmacy r ates. Funding requirements for FY21/22 are projected at $25,186,000. Medical and Pharmac Administration The County plan has in existing Administrative Services Agreement (ASO) with Florida Blue. This agreement wase Bred into on June 5, 2018 and is for a period of five (5) years expiring on September 30, 3. The curren /Pharmacy Benefit Administrator (PBA) is RXBenefits and the Pharmacy Benefit Manager BM) is Express Scripts. Lockton has completed PBM marketing for the upcoming plan year. ine (9) proposal were reviewed and analyzed. The analysis included comprehensive final ial comparison using Lockton's proprietary repricing model utilizing our claims data, pricing guarantees, bidding terms, clinical programs, formularies, pharmacy networks, mail order and -4 Our actual Health Plan experience through March 2021 indicates the following: • Employee & Retiree enrollment averages 1,672 members • Average of 3,675 individuals are insured under the group medical plan • 23.6% of members are enrolled in the Premier Silver Plan and 76.4% are enrolled in the Premier Gold Plan • 27 high cost claimants over $50K totaling $3.3M in claims during the first 6 months of the plan year • Stop Loss reimbursement of $17,639 resulting in net claims of $3.25M for 27 high cost claimaints • The Premier Silver Plan is performing well and the Premier Gold Plan is running at a loss. • Overall plan performance is 91.2% during the first six (6) months of the plan year. However, the ongoing expenses related to high cost claims are expected to impact the plan over the next six (6) months and it is anticipated we will end the plan year on budget. The Self -Insurance Fund balance through March 2021 indicates the fund balance history and actual fund balance as of March 31, 2021 as listed below: E�aF Year End IFunc19 Ba[ancye H�st►y; September 30, 20.1 S pternber 30, 2019 September 30, 2020 $13,148,724 $12,197,911 $12,807,209 Fund i3acance Change Through 2ndl Quarter Fir 20%21 September 30,2020: T March 31,2021. Inc./Dec. % Inc./Dec.. $12;8.07,209 $13,500,112 $692,903 SA1% Funding for the health plan is provided by employer, employee, and retiree contributions to the plan as well as OPEB funding. While it is projected we will end the current plan'year on budget, projections indicate additional funding of $1,561,000 will be required for the plan year beginning October 1, 2021. This increase is based on a 5.5% medical trend, a 10% pharmacy trend, increase in stop loss premiums, and increase administrative costs (ASO) fees. The projections assume $1,830,000 in pharmacy rebates. Funding requirements for FY21/22 are projected at $25,186,000. Medical and Pharmacv Administration The County plan has an existing Administrative Services Agreement (ASO) with Florida Blue. This agreement was entered into on June 5, 2018 and is for a period of five (5) years expiring on September 30, 2023. The current Pharmacy Benefit Administrator (PBA) is RXBenefits and the Pharmacy Benefit Manager (PBM) is Express Scripts. Lockton has completed PBM marketing for the upcoming plan year. Nine (9) proposal were reviewed and analyzed. The analysis included comprehensive financial comparison using Lockton's proprietary repricing model utilizing our claims data, pricing guarantees, bidding terms, clinical programs, formularies, pharmacy networks, mail order and g— g specialty medications. Projected potential savings range from 4.5% to 8.9%. A PBM Market Savings Summary of the various proposals is attached. While there are potential financial savings that could be realized by selecting another P M, the disruption to our covered members would be impactful. Therefore, staff is recommeficling that we continue with RXBenefits and Express Scripts under improved pricing. The es ' ated annual savings is $449,543 or 7.3%. Affordable Offering affordable and competitive benefits is an important part of o F recruitment and retention strategy. Establishing the proper funding and maintainin ffordable health coverage options is an ongoing consideration. Employer Contribution - Staff is recommending an increase igAhe employer contribution for both the Premier Silver and Premier Gold plans by $50 a m nth for both single and family coverages. This will provide an additional $1,007,400 in f nding leaving a remaining FY21/22 funding shortfall of $553,600. Employee Premium - Additionally, in order to megt'the projected funding, staff is recommending an increase in the Premier Gold an employee premiums of $10 per month for single coverage and $20 per month for family overage. This will generate an additional $247,920 in funding and reduce the projecte FY21/22 funding shortfall to $305,680. There is no increase in the Premier Silver Plan employee premiums. The recommended 10/1/2021 premiur ,As are: Option 1 Provides $1,201,320 in Afiditional Funding Increase in Employer Both Plans & Employee in Gold Only / 10/121 Monthly Employee Premium 10/1/21 Monthly Employer Premium 10/1/2021 Total Monthly Premiums Premium Silver Single $15.00 $750.00 $765.00 Premier Silver Family $207.50 $1,155.00 $1,362.50 Premier Gold Single $120.00 $750.00 $870.00 Premier Gold Family/ $420.00 $1,155.00 $1,575.00 The recomm ded premiums without an employee increase are: Option 2 Prdvides $1,007,400 in Additional Funding No Incre �4 in Employee Premiums 10/1/21 Monthly Employee Premium 10/1/21 Monthly Employer Premium 10/1/2021 Total Monthly Premiums Pre ium Silver Single $15.00 $750.00 $765.00 P -emier Silver Family $207.50 $1,155.00 $1,362.50 Premier Gold Single $110.00 $750.00 $860.00 DR specialty medications. Projected potential savings range from 4.5% to 8.9%. A PBM Marketing Savings Summary of the various proposals is attached. While there are potential financial savings that could be realized by selecting another PBM, the disruption to our covered members would be impactful. Therefore, staff is recommending that we continue with RXBenefits and Express Scripts under improved pricing. The estimated annual savings is $449,543 or 7.3%. Affordable Offering affordable and competitive benefits is an important part of our recruitment and retention strategy. Establishing the proper funding and maintaining affordable health coverage options is an ongoing consideration. Employer Contribution - Staff is recommending an increase in the employer contribution for both the Premier Silver and Premier Gold plans by $50 a month for both single and family coverages. This will provide an additional $1,007,400 in funding leaving a remaining FY21/22 funding shortfall of $553,600. Employee Premium - Additionally, in order to meet the projected funding, staff is recommending an increase in the Premier Gold Plan employee premiums of $10 per month for single coverage and $20 per month for family coverage. This will generate an additional $247,920 in funding and reduce the projected FY21/22 funding shortfall to $305,680. There is no increase in the Premier Silver Plan employee premiums. The recommended 10/1/2021 premiums are: Option 1 Provides $1,255,320 in Additional Funding Insleik inXrnployer 'Bbth:Plaris 8c Employee, n I. 6old Drily ' `T�s ; . 10/1/21Wbrithly ;�Err�ployee Premium 10/1/21 Mpnthly tEmployer :Premium 10/;1/,.1021 Total *Monthly Premluins Premium Silver Single _- - _ _ $15:00. '$75:0.00 $765.00 ', rern (, ilver Family $207.50 $11155:00 $1;3.62:50 Premium`S :0 $155,9 A $765.00ilvSing` Premier Gold Single $120.00 $750.00 "$870.00 iPremier,.Gold Family $420.0.0 $1,155:00 $1,575.00 The recommended premiums without an employee increase are: Option 2 Provides $1,007,400 in Additional Funding No Increase in Employee, "=��r .' 10/1/21Monthly_ .10/1/21 Monthly '10/1'/2021 Total Premiums= ;::. .fi { Employee Premium Employer,Premium Mo 'thly.Premiums Premium`S :0 $155,9 A $765.00ilvSing` PremierSilver Family ,t $207:50 'j �; :x`$1;155 00 " a `$1,362.50 -P.,remier Gold Single r F$110.00 $750.00 $860:00 Premier Gold Family $400.00 $1,155.00 $1,555.00 Retiree Premiums Under Florida Statute 112.0801 "retirees and their eligible dependents shall be offered t e same health and hospitalization insurance coverage as is offered to active employees ata pr ium cost of no more than the premium cost applicable to active employees. For retired a ployees and their eligible dependents, the cost of continued participation may be paid b/hire mployer or by the retirees..." The County subsidizes retiree coverage for eligible retirees wct to continue coverage under our group plan. Subsidy amounts are based on the retire s date, years of service, and date of retirement date. There are 28 different retiree rateefor each Plan. The retiree subsidy is based on a reduced monthly premium for b7the Silver and Gold Plans as reflected below. Premier Silver - Current Single Family Total Monthly Premium $7X5.00 $1,312.50 Reduced Retiree Subsidy Premium 700.00 $1,105.00 Premier Gold - Current S!iirn;gJ:e Family Total Monthly Premium $810.00 $1,505.00 Reduced Retiree Subsidy Pr mium $795.00 $1,297.50 Subsidy amounts range from 20% to 6/0. The subsidized premium for retiree insurance under the Premier Silver Plan ranges from 280.00 to $560.00 per month for single coverage and from $442.00 to $884 per month for fa ily coverage. The subsidized premium for retiree insurance under the Premier Gold Plan ran es from $318.00 to $636.00 per month for single coverage and from $519.00 to $1,038.00 per onth for family coverage. Individuals with a hire date on or after February 1, 2006 who retire from the County and who continue coverage and a not eligible for the County subsidy and their monthly premium is the Reduced Retiree Subsoy Premium for either single or.family coverage. Retirees also recei e a health insurance subsidy from the Florida Retirement System (FRS) of $5 for each year 4nt rvice up to a maximum of $150.00 per month. The County does not receive any subsidy pZ from the FRS. The FRS subsidy is paid directly to the retiree in the monthly retirement payment. The County provides additional funding for the cost of providing retiree coverage fdirough OPEB funding. In addition to the Group Health Plan, Medicare eligible retirees are also provided the opportunity to `droll in the Florida Blue Medicare Advantage PPO Plan at a current monthly premium of �emium 57.24 per month.. Eligible spouses may also enroll under this plan at the same monthly of $257.24. This premium amount may change annually based on the renewal from Florida Blue. 86 Premier Gold Family I $400.00 Retiree Premiums Under Florida Statute 112.0801 "retirees and their eligible dependents shall be offered the same health and hospitalization insurance coverage as is offered to active employees at a premium cost of no more than the premium cost applicable to active employees. For retired employees and their eligible dependents, the cost of continued participation may be paid by the employer or by the retirees..." The County subsidizes retiree coverage for eligible retirees who elect to continue coverage under our group plan. Subsidy amounts are based on the retiree's hire date, years of service, and date of retirement date. There are 28 different retiree rates for each Plan. The retiree subsidy is based on a reduced monthly premium for both the Silver and Gold Plans as reflected below. Premier Silver Current Single Family Total Monthly Premium $715.00 $1,312.50 Reduced Retiree Subsidy Premium $700.00 $1,105.00 =Premier Gold- Current Single Family. Total Monthly Premium $810.00 $1,505.00 Reduced Retiree Subsidy Premium $795.00 $1,297.50 Subsidy amounts range from 20% to 60%. The subsidized premium for retiree insurance under the Premier Silver Plan ranges from $280.00 to $560.00 per month for single coverage and from $442.00 to $884 per month for family coverage. The subsidized premium for retiree insurance under the Premier Gold Plan ranges from $318.00 to $636.00 per month for single coverage and from $519.00 to $1,038.00 per month for family coverage. Individuals with a hire date on or after February 1, 2006 who retire from the County and who continue coverage and are not eligible for the County subsidy and their monthly premium is the Reduced Retiree Subsidy Premium for either single or family coverage. Retirees also receive a health insurance subsidy from the Florida Retirement System (FRS) of $5 for each year of service up to a maximum of $150.00 per month. The County does not receive any subsidy payment from the FRS. The FRS subsidy is paid directly to the retiree in the monthly retirement payment. The County provides additional funding for the cost of providing retiree coverage through OPEB funding. In addition to the Group Health Plan, Medicare eligible retirees are also provided the opportunity to enroll in the Florida Blue Medicare Advantage PPO Plan at a current monthly premium of $257.24 per month. Eligible spouses may also enroll under this plan at the same monthly premium of $257.24. This premium amount may change annually based on the renewal from Florida Blue. Retiree subsidy premiums for each of the funding options would be as follows: Silver Plan Single Retiree Subsidy Premium Total.Single Premium Family Retiree Subsidy Premium Ally Tota;/iu Prem Current $700.00 $715.00 $1,105.00 $,e,312.50 Option 1 $735.00 $750.00 $1,155.00 $1,362.50 Option 2 $735.00 $750.00 $1,155.00 $1,362.50 Gold Plan Single Retiree Subsidy Premium Total Single Premium Family Retiiee Subsidy Premium Total Family Premium Current $795.00 $810.00 $1,$7.50 $1,375.00 Option 1 $855.00 $870.:00 $1,367.50 $1,575.00 Option 2 $845.00 $860.00 $1,347.50 $1,555.00 Competitive Plans Maintaining a group health plan that is affordable, co �petitive and sustainable is our ultimate goal. Employer plans differ greatly from one plan to nother. Staff is recommending that no changes be made to the plan benefits. Below i a comparison of the Option 1 premiums compared to other employers. Employee Monthly P $300 $250 $200 $150 $134$142 $100 $SO 35 $46 $15 'r.7 Ili'. ium Comparison - Single Coverage $53 full $54 $o 11 [ $o $113 S212 $O-�LJ_�L 1W _Ctrl iLill W��fYi�W' •iW 1IL1' [Lii y�V.�IL o"a c1 00 0' �1pp 10 �`O 05 �Q �a P 011 .� .ac c c eye c o� c Q\a Q\a h ,, 0° 1• eQ O 0 O ti 1 �a �a ct c\ L e �c , O as �.e °a eQ aQ p5 aQ aQ aQ ooc °°0 Joh J0� J°� o°� 000 � oar° 0°0 pa �a, \�0 oac oac oac aet� ..oe`C aA`° aA`° acaco ` ` �a e �•e\ Qa\� Qa�� �a Qo�`� Qo{``'` C`a°0ea°r pear G`�° ccA`e 0c�`0 cd�' ala Q, \ao plea pie, plea �� °y ok RE Retiree subsidy premiums for each of the funding options would be as follows: <...."-.-�, ,: 4�..a, 9 , Silver Flan 'Single Retiree F `. Y'"Total Single"' `'Family Retiree' .. - z -1Total'Farriily Subsidy Premium Premium `Subsid''OremiumY 'Premium - Current -$700.00 $715.00 $1,105.00 $1,312.50 OFtiflri 1, Yr_, L :$75A bOr;=r 765.00 ,$1;155.00 $1,362:50 Option 2 $750:00 •'$765 00 $1',`155:00 $1;,362:50 Gold Plan _ SingleAetir'ee ' Total^Single r 'Family Retiree• • TotaRamil:y Subsidy Premium Premium Subsidy Premium Prernibrri Current $795.00 $810.00 $1,297.50 $1,375.00 Option'2 $845 $860:00 $1;347!50' x$1,555.:00 Competitive Plans Maintaining a group health plan that is affordable, competitive and sustainable is our ultimate goal. Employer plans differ greatly from one plan to another. Staff is recommending that no changes be made to the plan benefits. Below is a comparison of the Option 1 premiums compared to other employers. Employee Monthly Premium Comparison - Single Coverage $300 $280 I � I i I $250 $212 i t .. $200 i $150 $134?142 5120 r $113 $100$85 $80 i p r $72 S75 $53 $54 I $50 $35 $46 $37 $25$24 $ ® $ O $0 $O x $0 ; $O Lo, q,' CP a �PA��o��o��Jc`¢o5.��y a��aacyer�ti`aQo�cQtie��ecae�a atiA \a ati�aQ\ lb a .aLce�.A 'R) O0�o eno e a�cc atc Qa (cy 6 'An' cQ d' . a`ac a�a° ice ice ice yam. yti�yi kJe o Employee Monthly Premiums Comparison - Family Coverage $1,000 $900 $'806 $871 $800 -'$705_ $700 $688: $600 $558' $532; $500 $420 $385 $435 $464$395$493$473. $400 _$356 °$330$369 $352 $300 $208' $179$233' $228 $200 - -$135! $100 - - $0 O� a �Q �� P o� .aor ao oti eye -Q,p c'Z� O Q � � �• i a`� Q a Q a h Q a Q a Q a F� o,a� moo` �� �c� o,A �o`J �o`� � � toe ��° aJ a� 0a oo ��� e0: 5e .a ep ca ca to . cL°J e�Lo L°; L0 LoJ \ L° \ QPet`a °\ °\ ��� ,a�a ,aca ,a�a �Jc 4�0 �` Q Qac Q Qo� Q°c`�' `��earQ,eac �•� cor°ro°� \ao a�ao. 4, \off �o °`�� C A I Following approval by the Board, staff will prepare for the annual open enrollment and communicate any premiums changes to all employee groups and retirees. During open enrollment, employees and retirees would be eligible to enroll in either the Premier Silver Plan or the Premier Gold Plan. Medicare eligible retirees would also have the option of enrolling in the Medicare Advantage Plan or choosing to enroll in a Medicare Supplement or Medicare Advantage Plan available through the market place. Funding Current funding for the health plan is provided by employer, employee and retiree contributions to the plan as well as OPEB funding. Below is an overview of the funding amounts that would be provided by each of the two options identified above. Option 1 increases the Employer Contribution by $50 per month and increases the Employee Contribution for only the Premium Gold Plan by $10 per month for single coverage and by $20 per month for family coverage. Employee Contributions for the Premier Silver Plan remain unchanged under both options. Current Funding $23,625,000 FY 21/22 Projected Funding Requirement - $1,561,000 needed $25,186,000* Funding Provided by Option 1 will be $1,255,320 $24,880,320 Funding Provided by Option 2 will be $1,007,400 $24,632,400 *Does not include minimum guaranteed savings of $60.31K from SurgeryPlus if approved. Recommendation Staff recommends and respectfully requests the Board of County Commissioners approve, effective with the plan year beginning October 1, 2021, Option 1 providing for an increase in the employer paid monthly premiums by $50 for single coverage and $50 for family coverage for both the Premier Silver and the Premier Gold Plans, increasing the monthly employee premium RK under the Premier Gold Plan by $10 for single coverage and $20 for family coverage, providing for no increase in the employee premium under the Premier Silver Plan, and retaining existing plan benefits to include PBM services through RXBenefits & Express Scripts under improved pricing. Attachment: Pharmacy PBM Marketing Savings Summary O o� N O o v u O C C vi O —_ O V O ra a,. N L O k c a) d +.' L Q X Q- E a) N N n 61 V w �, -O � � � C Q aJ �n -O O ............... v u° a Er> -0 • O v �( �c� V1 L t$ O vi +1 a; m aa, u V a1 +, -a c L E co i '.F. > + + _0 4-+ L O v 'O Ov Ol N "_-c -0 UZ ............... CO 0+, ■ f _0 a� m C: E - o IO '� 'L CQC CC� O u-0 Q N Q -o C C a, L o Q C N _ M 4- co c a v. c ,n V Q } 0- ai a a — O 0 CL 0 O w (n m Q V -1 i Q E Ql ............... f ■ ■ O x in V — E 75E 0 a, — M m 5 Ln O — V D in Q a) a O f/R� y a--+ L L V . M +L d 7 QJ ................ >, -0 cr-, >� . . O o� N 00�Cwwrnm V `V N \ aoiw`a, 4- O N N O c OZZ rl 00�Cwwrnm L o \ aoiw`a, 4- O > c OZZ rl ll� Cd eq M N O N j, L r M N > M Vm1 " LA c CO Vi 4+ cm _c m 4-.% C r di Wi Q f r di a) Vfu W O O M N N L O N o 00 c V� l0 M Vi _O m N co l6 O Q) O l0 M Qi C: m LA ' O N � Ol N br9 C O 6rA M '• %0 ��+ cng bq co - In N O O O r O O M lD M Hf b9 17, cc� G m° O N L N° O r V1 c0 N ko N N m tD Ln N _ M •. r w O .• C: =3O C 4- C e {J �v V 0.9 c C o C C �_ Q � O .O -- M in O O tG N c Q1 • ul tCl m 00 � N � b4 b9 Ol m N V1 •• l0 O v m° 00 � r M .0 r N N =3C C VI W � O Cil O l0 � t0 N� 00 M V1 r e o Q1. 01 yj V1 m u w O s N E >, a O �^ N � a) O OL H > •� O W a) 0 O> Li 0 >, — .N Q Z u� s 0 L� a a)EU Orc 000 G Q a) ¢ co LA O C 7 NN N t0' [+i k N r to r •• o c O • U_ co o c • c O. N O L Q c O to c co P/11 1 01 n 1- is a > v V .4- .�_^ N r O O O O ut T r a �° c0 N N bA to - M r •• LO k Qi !A N k Q, Vi N w 'f .4 00 00 M N kD too rA i0 n N N ID ci to d4 6r9 brA bA -' Ow w w� r 'T O T N 6mi Ili cyi 0 bq dy O tNl1 001, w� vr,v. -• w '. C O c_O rO O a, 0) V o O r N to ,Zr, Ol di to c0 N c0 O 00 N 01 g to Ql M M 00 00 O0' 00 N 0o Qj 00 M N Ln C b'f bq b9 Hi M OO N (1 W Vl IR cq011 CD br9 br9 b9 � m � m m N N�2 N N 00 Cf l0 fV Oi rmn O L Oi r n M b ID 0 di Nw 0 cmc M O r e4 r .n w w w w w � ��Vi M00 al N Vii N 0 CO u9 10 tNA l00 w : � wO _. oO W_ m ____m � m O m cmc OOp O w N 0 r r ' w I w w w _ d o ^w z z z z a `5 5 5 5 . W v a as ;,aa a e p �% u 10 LL N d OJ li Q- V :a kn Q N w C •y N V1 w Q m ccN L rn N LL m, y C C 2 "- C N U P V R y F P y d p O a Y m v, o- E to c a 0 0 •' O O. c .2 ¢ 0 0 w a w o 02 02 0 w L c 4- O > c OZZ rl M N O N j, L rZ C > 0 Q c 4+ _0 :3 _c m 4-.% C Q f t N a) Vfu Qi -c N c O 1p _O c Q l6 O Q) C: O a) N +r C O N ru V)4- _ m N cu Q a) cc� G Q) fl- c N L E a� V C: =3O 4- C {J �v V 0.9 c C o C C �_ Q � N E E Ol N C 4 C C :3 � N c5+J (0 40 N ,� L O4.1 v .0 O CL =3C C � O O l0 � m e o V) o m u w O s N E >, a i �^ N � a) O OL H > •� O W a) 0 O> Li 0 >, — .N Q Z u� s 0 L� a a)EU n3 Q G Q a) ¢ a� LA O U Q-2 a, °1 o c O • U_ V1 c O. N O L Q c O to c a) -0E- pc:4' 01 c 1- is a > v V .4- .�_^ 19 �I M s V) }J tA 0 V N rM y V W V X Q1 rO i2 •i --j ^E WC N C N N � m 5 O ^i (p EN C W t a--+ Ln Ln L- W E W Ln 0 N V W T- n V, 'p .O a O J c ao G! 7 y C - T O! .O N N O' .' V to M Ol C' m Q 01 l0 m Q. T H N .r; O cn t/1 X O O_' LL = c 7 7 d @ f0 V V O L 7 N 7 Q C O C 0 V 3 0 CLIJOl L v1 C O- J 3 0 Yp L i2 n p m \ t o n l7 C,N c L c m vmi �^ mO a, 'i LL 7 a u a Q F R N m N n 7 a O o w Q' m a tA a o M W c V, a 3 E J N w � C O T 1w,O N` N m !n U N C 1 7 7 m u u OL CM) C L F- cy 7 Q a N 3 m a c J 7 m C O To o o rn o a `r° o a000 n m y Gl mH U N Vl � t0 W n • a C 7 7 y G V V O L N y 1 -5 P 7 D CfQ a LA L a c ain v - - - c A E Oc w L p •- J C O o o rn 0 00 C N V! y T O y n� � m - I� N M 01 m O a - N - - 7 - E- V I� Ol f�1 < C 7 G N co V V O L 7 X C L F Ncy 7 Q C C O d O u O N O O T E N N N '_ L C L n J 3 O o 0 co c c 7 t 3 1p r M rnLn Lf! vi LL N Q F O N co n v a 7 N U a a LCO a L "O a0+ ,may d O - 3 m- c E .0 C « O m a C M• N C T J V1 1- o N 0 m li IV C 7 ,O d jp M In V V Vl N o 7 .0 C M N �I O U V C 7 d N C L �-- j Q T m 7 • ^ LL d l0 Ql m ^ l!1 o m m N r p 0 a` o N V M M m N Ol Vl rvi M M ONi N m LL V V t0 V (0 c - u m a 0 a E - u !o n n E - V q n a E N41 E E E A! G w G d E w (uv Q v cm m E Q E w j Cl aEi N Gl 7 E 3 E 0 j j .6 .6 0 .7 Q, 7 O LL LL YL Z)�!o AIo N V W T- 3i O c W vi V 0- 4- 0 - N 40 O z x W W ^L W m _O O O AO 0)m` 0)m` 0 4—j M m W vi V 0- 4- 0 - N 40 O z x lal W �V m o M�maoa O 0)m` 0)m` 0 W vi V 0- 4- 0 - N 40 O z x x m o M�maoa 0)m` 0)m` 0 0 m O a CL ° O m v o m O N N ID M N 'O m Y . N c Y O a, a ° m =3� v ° c m Y O z 0 0 O Co O Co O O pp O O O m Y �}O y o 0 z O V N t0 0n 0 c0 cc0 a OLA OR o m O ^� � O ° S C N O` O O � L � co N -0 m O O a f0 ° E Lu °O O c z p M N op O O 0 O m CL v m O ,y m °m r o N i = . .: z ° Ol ° m M O 0 O z G N O y E Z > -o v a w m cL m cLE c V + r V E Y V W m °- m H C GC v E E C o .C) B. T F E N N V N VY J m m O p p O O a z m # 4k o �k o O� C1 r INDIAN RIVER COUNTY MEMORANDUM TO: Jason Brown County Administrator FROM: Suzanne Boyll' st- "to Human Resources Director DATE: May 4, 2021 SUBJECT: Review of Employer Clinic Survey and Next Steps BACKGROUND: The Board of County Commissioners directed staff to proceed with surveying our employees to determine interest in an employer sponsored clinic. Staff worked with our consultant Lockton Companies to develop survey questions. The survey instrument was provided to each of the Constitutional Offices for distribution to the workforce. A total of 608 responses were received and 241 individuals provided supplemental comments. Three hundred and fifty (350) respondents were from BOCC employees. The survey results are attached and highlighted below. Indian (River Employer Clinic (Interest Survey b`#tiich agency do you work for? Response P�cePyt Respon� Yotaf Bood of C=7ty Goctvnissioners — — — - - — — - - - 67.19% SherEW Ofte 1POMM1796 1.65% 101 CW&CBtfaecour°fs P-Perly 62396 Zit SupeniiWrof s 0-6796 x--37 L.`4 J Tax CdUedur's Mce- 6.06% 36 TcW # of irespondents 608. Statistics basedon 594 resp~ardenM O6ltesed• f 4skipped. Mere do you nunnzMy 4o forum care for yotu mmx ffhesses47 Response P�cePyt Respon� Yotaf Pimaiytare Ptrysiciaar — — — - - — — - - - 67.19% Va hd V=U (usmg a smart 1.65% 10 phone orrvideo dm*- tkgerdcam centerIF 34:88% Zit C"wernemce CvMatt lea c�tuc {such as at t NS orrJafgmettsj [1-_12% 37 — l 0.17% Tomf o odents 608. Statistics based on X605 mspandertm 0'.= 3 ski,PPcd- 94 LH -1LH -1 EFsfy are yo, to +fish an Ernployer Gir is to heat you minor illnesses? "Perwnt Respoeae I se TOW Very — - — 68:51% 7 Woaklaon4d. = 29:76% 180 Nlautd riot ase an �i 11:74% 71 Total # oflrespondenis 603. Statistics based on 505 iresponderrts: 0 t7--Wmd: 3 skipped. Hw Omly are you to visit an Eirrployer Clinic for heats ax,,dvng'chronic condi5on nnenagernent? PR ;e ercent Reponse Hery w* — - — 39.04% 7 vSottri consid 40.69% 247 Woutd not ase an Employer Cfmric 2026% 123 Total# of respondents 600. Statistics based on 607 nespandem . 0 Shred; a skipped. =Bar3y ora you to a i�2aro EmN�ager Clinic inr bion trSc ings7 A biometric saeening is a clknical screenaw tat is to easure oertam'h:n charctY� 2sS The gad of a orrreiric screening is to give you a snapsW of your heaRh to h=at;ts Response Reponse and aEert you arrir,po65,b[a ,risks_ IBiom is saeenargs usually measure height, vreight, body mass srdez (810). biood prestos. blood ct>aiestern9, and blood sagaz Percent To7aP very M:ety 67.9996 L� _ J W,.m a nsift INa<dd not ase an EnVloyer clinic Toral it orresgrondenis SM. Stafistus based on 607 resp*ndermr 0ulcered; a skipped. The majority of respondents are supportive of an employer sponsored clinic. Some respondents have indicated they would never utilize an employer sponsored clinic. Respondents' comments indicate concerns related to cost, services provided, hours of operations, privacy and confidentiality, the type of provider that would staff the clinic, etc. The complexities associated with establishing an Employer Clinic would require professional services of subject matter experts to assist the County in this project. Lockton Companies is well qualified to perform these services. FUNDING The initial cost of pursing an employer sponsored clinic would be $75,000 Professional Consulting Services Fee which would be paid from the Health Insurance Trust. ' The actual cost of establishing a clinic would be determined during this project based on the type of clinic that was implemented. RECOMMENDATION: Staff respectfully requests that if it is the consensus of the Board of County Commissioners to pursue further evaluation of an employer sponsored clinic, Lockton Companies be engaged to oversee this project as reflected in the attached proposal at a cost of $75,000. Attachment: Clinic Survey Results Lockton Clinic Proposal 95 a�"FRr� Indian River Employer Clinic Interest Survey Which agency do you work for? Response Percent Response TOtal Board of County Commissioners Responsspo cent Pere 58.92% 350 Sheriffs' Office 57.19% 17% 101 Clerk of the Courts 1.65% 11.11 % 66 —�_–_ Property Appraiser D 6.23% 37 - Supervisor of Elections 34.88% 211 Convenience Care Walk -In Clinic (such as at CVS orWalgreens) Tax Collector's Office D 6.06% 36 Total # of respondents 808. Statistics based on 594 respondents; 0 filtered; 14 skipped. _�" Page 1 of 11 Where do you normally go for medical care for your minor illnesses? Responsspo cent Pere Rense Total Primary Care Physician d - 57.19% 346 ` LLVL,irtual Visits (using a smart phone or video chat) 1.65% Would consider 29.75% 180 Urgent Care Center J 34.88% 211 Convenience Care Walk -In Clinic (such as at CVS orWalgreens) 0 6.12% 37 Emergency room Statistics based on 605 respondents; 0 filtered; 3 skipped. Total # of respondents 808. Statistics based on 605 respondents; 0 filtered; 3 skipped. _�" Page 1 of 11 How likely are you to visit an Employer Clinic to treat your minor illnesses? Response Response Total Very likely FE 39.04% 237 Would consider 29.75% 180 Would not use an Employer Clinic 11.74°/6 71 Would not use an Employer Clinic 20.26% 123 Total # of respondents 608. Statistics based on 605 respondents; 0 filtered; 3 skipped. _�" Page 1 of 11 How likely are you to visit an Employer Clinic for health coaching/chronic condition management? Response Percent Response Total Very likely 39.04% 237 Would consider 40.69°i6 [1247] Would not use an Employer Clinic 20.26% 123 Total # of respondents 608. Statistics based on 607 respondents; 0 filtered; 1 skipped. _�" Page 1 of 11 How likely are you to visit an Employer Clinic for biometric screenings? A biometric screening is a clinical screening that is done to measure certain health characteristics. The goal of a biometric screening is to give you a snapshot of your health 1 and alert you to any possible health risks. Biometric screenings usually measure height, weight, body mass index (BMI), blood pressure, blood cholesterol, and blood sugar. Response Percent Response Total Very likely 57.99% 352 Would consider SOO25.54% 155 Would not use an Employer Clinic _7 F16.47%F 100 97 Please list any concerns you would have about using an Employer Clinic. Respootanse Tl_ 241 I think it would be great! NONE Would this take the place of a primary care doctor who you have a long term relationship and knows your health history? Required to go to the clinic for referrals to specialists, when you have an ongoing illness. Cost - Would the employee be required to pay more if they choose to forgo the Clinic and go to their primary care doctor. CONFIDENTIALYITY OF SENSITIVE MEDICAL INFORMATION. personally I go to specialists for my health issues so an employer clinic would not work for me. I would be more likely to use an employer clinic if it operated more like a primary care physician's office versus a walk-in clinic. I prefer a primary care physician because you can create a professional relationship and the physician is familiar with or has access to your health history. I would not use an employer clinic at all if I still had the option to use my own doctor. Even if I had to drive more to get to my own doctor, I would still prefer that and to work with someone of my choosing. If I want a clinic, I will just use one of the MANY walk -in -clinics that we have around here. Why spend the money on an Employer Clinic when pre-existing walk-ins are already here? Drop the costs on walk-ins and it might encourage people to go there more. Also, you will never be able to get rid of ER visits that don't result in an admission. What happens if someone cuts themselves late in the evening after the clinics have closed? They have no choice but to go to the ER to get stitched up. No admission for stitches... Driving up the costs for us to go to the ER is unfair because you think people are needlessly going there. Where else are they supposed to go after the walk-ins close? No concerns I do not subscribe to the County's healthcare plan, as I bring my own insurance from a prior, long-term occupation from which I'm now retired. Concerns would be the way the clinic would work. Yes, they would see us as patients but still answer to our employers who pay the bill. I feel that we would not get the same care that we could get elsewhere plus if someone were to ever leave employment here they then would have to go through the hassle of re- establishing with another physician else where. How much is it going to cost me? Confidentiality I would go to a clinic vs urgent care if it was convenient and if I had confidence in the staff and services provided. I would also go to a clinic for health screenings & biometrics. I use urgent care when I am unable to see my GP. I recentley have set up with a female GP and would not change doctors. Larger increase in healthcare costs! Privacy. Running into co-workers. My previous employer had an on site Doctor's office. I have no concerns. It would be convenient and easier than going to CVS Minute clinic or a Primary Care Dr. none and would gladly use the clinic if offered. None I don't believe your health care and your workplace should be under the same umbrella. Part of the beauty of health insurance is to choose which doctor/healthcare provider you want to use based on your preferences. I believe most people have standing relationships with certain doctors and want to be able to continue to go to them due to the level of comfort and knowledge of their history. It's hard to start fresh with a new doctor. I also like the anonymity of not having the same doctor as my work colleagues. No one needs to know that I was at a doctor and with an employer clinic, everyone knows everyone. I would be concerned that the Employer Clinic might get too overwhelmed considering the number of County employees especially if you were to use it as your primary care physician. Also, would it be cheaper for employees? If an employer clinic is established will it eliminate the ability to go to our Primary or a walk-in should we need it. Or would there be an additional fee such as a "facility fee" that we are charged with the new plan Cost I already have a long standing relationship with current doctors. Access to physicians, as opposed to a nursing, PA or MA only staff. Ya 11 I think it's a great idea. I was actually discussing this earlier today. None No thank you. Smaller government for me. I THINK THIS IS A GREAT BENEFIT FOR THE COUNTY AND THE EMPLOYEES. THIS WOULD HELP KEEP MEDICAL COSTS DOWN. A WIN WIN FOR EVERYONE! The only concern I have is if this will raise the employee's cost for insurance. If it significantly raises the cost of our premiums, it would hurt my pay and I don't like the idea of having a job just to pay for insurance. I cannot afford for the insurance premiums to go up too much. Otherwise, I think it is an excellent idea. Cost. My only concern would be what it would do to insurance costs. If it would raise costs of insurance in order to build I would be opposed to it because lately every time we receive a cost of living adjustment it seems our insurance rates go up as well. I think as an Urgent Care or Walk-in facility it is a good idea. I would not use it as a Primary Care. great idea If there is an employee clinic that we can go to would that eliminate altogether going to a Walk -In clinic if need be? Would the clinic be accessible 7 days/week like the walk-in clinics? Is there a co -pay involved? I would definitely want to stay with my Primary Care Physician for physicals, etc. If the clinic would have personnel that is fully qualified to perform medical functions and give proper advise/care With the almost yearly increases in health care coverage costs, I don't understand how setting up and maintaining a clinic will be cost effective to us. Since salaries of the professionals will likely be capped, what quality of healthcare would we get? I foresee good physicians moving to the private sector to earn more, and we are stuck with looking to replace them with? Just a thought, How about joining other municipalities in attempt to having more leverage in obtaining lower costs for health coverage? I have an established relationship with my current Dr. who ironically works at Urgent Family Care right here in Vero. I feel that she understands and listens to me and I'm not sure I would be willing to leave her. N/A Answers are provided under the assumption that the medical professional on staff would be a RN, PA, or DO at a minimum it would be very helpful ii THINK IT WOULD BE VERY CONVIENENT FOR COLDS, ETC. No concerns. This should happen ASAP. Please stop dragging your feet and make this happen. If this would bring the cost down for family coverage, 2 adults I would do it. Not sure why the county doesn't consider an HMO seems like it would cost less. Came from Georgia with BCBS paying 39.00 a month for family coverage for 4 people it was an HMO much smaller company. 1 would be worried about not having the same doctor consistently in an employer clinic. Privacy Increased monthly health care fees No concerns at this time as little information is yet available. 1 believe this to be a positive step forward. Thank You No concerns at all. It is very beneficial to the county and it's employees, this would be a great resource for everyone. I don't have any concerns ...... I think it would be great, and convenient How much it will cost, will it be an additional deduction on my paycheck? How private will my information be from my employer? Can non -employees use the facility to supplement the costs? Will it be available for families? Will specialists be made available? 1 would love to have a time -frame available to see a dermatologist or a chiropractor. Cost, how convenient it is, Ability to get an appointment I would use this rather than Urgent Care for after-hours medical care for minor injuries or illness. Otherwise, I'd just use my primary care physician. Would not have the same doctors to follow my health care Not open for long enough hours yy I have no concerns. It's a great idea as long as quality health care is provided. I usually don't see anyone unless the illness heads towards major. Minor illnesses I treat at home as it's more convenient. If there was a clinic, I might l actually have minor illnesses treated. Al^"!r! nrcfcr fn m�infnin rnn+in"i+a. of rorc ...i+h m nha.oiri­ .. v...v Y•..,.., av ,,,a+., .aa,.i., vv. n„...,.� v. w... ...u. ...Y +.i....u.Y wia. N..�.a.a.iw .. Patient confidentiality, or lack thereof. I have no concerns. Indian River County needs This, I had a clinic at my last fire department and it was fantastic everyone in the county utilize it it was cheaper and more convenient please make this happen ASAP Information could possibly be used against employee if information was shared with the employer. N/A j Confidentiality, work conditions/hours/pay/insurance coverages potentially being affected, vaccine/medication/care mandates No concerns. Would very much like to see one Receiving appropriate treatment and not rushed to move on to another patient MI y concerns are not so much with a clinic as 1 have been seeing my physician for a number of years and he knows my history and any current issues I have. Additionally, he is convenient to my home in Sebastian, None, it seems like a good idea. I do not have any concerns, in the past, when I worked for Martin County Property Appraiser Office, which they had an excellent facility and no copays and also a pharmacy onsite. I have always used Employer Clinics. [None that 1 am aware of. Due to a very long patient history with my primary doctor, I wouldn't change doctors. NI o concerns, it might be a good idea to have one. For most of my health care needs I feel it's best for me to stay with a primary care physician as they know mebest and I've been established with them for quite a while. L- - - - - - - --- — — --- -- _ - — -- — Quality of care, and confidence in the health care professionals is most important in any health needs that I have. I don't think it will be utilized for the money it will cost to implement it. Perhaps lower costs on other medical option instead of a clinic that most likely won't be used. 1 would not like to be limited to whom we would be able to see because some medical conditions require specialty doctors that are not local such as Mayo Clinic etc. NONE AT THIS TIME. r— ----------------- hOW INSURANCE WOULD HANDLE IT No concerns Lwould this be used by family members also? would there be multiple locations? Same as anywhere else. Quality of the equipment, staff, etc Others may operate more like a Primary Care Physician's office, establishing long-term relationships of care with patients and offering a comprehensive range of services. I would be interested in the possibilities I I am not familiar with it. If it would be a "compliment to our plan" would our insurance cover it and we would be responsible for copays. Is this just for County workers regardless of the division? Why are they considering this? Increased cost in insurance premiums Locations, one or multiple? Confidentiality, better worker comp help? Would referrals to specialists be easier/faster to get? Co -pays be less? Would it be employees only, or extended to our immediate family? privacy — Behavior/Mental Health care would also be great 1�� 1 Cost Confidentiality l Availability None. I think it would be an awesome resource for all employees. None! This is a great idea! Are they able to make "referrals" to and for out of town/network doctors. Will the providers be the same or will they rotate between other clinic (contract employees)? Or will they be county health employees ? I truly believe this will save county dollars and possible increases in health insurance due to inflated EMergency room prices and private practices. Hopefully county administration could visit PBCfR Palm Beach Fire Rescue county clinic as it's been a huge success. Currently I am still utilizing the virtual visit. Hoping to go to regular visits soon. My two concerns for an employee clinic are the quality of care by the provider and having timely access without having to wait weeks for an appointment. I have experienced both of these issues at St Lucie bocc and city of PSL. Thank you. Privacy LI will forever keep medical and employer separate. If this is mandated, I will drop my insurance and still go to my primary care doctor! None. Would appreciate the convenience. none j No concerns, but I don't go to doctor's offices very often. When can we start using it? Quality of health care So as long that the Health Information kept confidential, The Employer has no access to the employee health records We should have had this already This is a great idea. I can't believe it's taken this long to even talk about it. cost and would it be available 24/7? how easy would it be to be seen Will be retiring in near future. Live in Brevard county. None i HAVE A PRIMARY CARE PHYSICIAN WHICH I USE FOR THESE SERVICES ON A REGULAR BASIS. MY DOCTOR WOULD ALWAYS BE MY FIRST it CHOICE. SHOULD MY DOCTOR LEAVE PRACTICE, I WOULD SIMPLY FIND ANOTHER PRIMARY CARE, PRIMARILY BASED ON REFERRAL FROM FRIENDS, FAMILY AND CO-WORKERS Quality. My interest would greatly depend on the quality of care provided. I WOULD LOVE A EMPLOYEE CLINIC ON SITE, VERY CONVENIENT FOR THE COUNTY EMPLOYEES. Would the information be share with my primary care physician in order to keep records up to date? I think it is hard enough to find a doctor(s) that you like and once found it would be hard to get me to change. could employee clinic services be provided by local urgent care and practitioners? Would dependents who are currently on your insurance be allowed to use this facility as well, such as spouse and children? Would Retired employees and they spouses who are on insurance be allowed to use? i Would there be an additional or increase in current insurance to cover the coast of building and maintaining this facility or would it just be covered by the 1 people who actually use it? I don't think I have any at this time. I would be concerned about the availability of the clinic and the possibility of seeing the same healthcare professional. It is important to me to build relationships with my providers so that I feel like they understand my history and other health concerns. For a minor illness, it may be one thing, but I have a primary doctor that I trust and, as such, much prefer to go to for my health and wellness ed S. j 11 no concerns, just would use it over other options that are cost effective for the plan as well I think it's a great idea! Eventually the cost would be the excuse for a rise in insurance cost and come out of all employees pockets. However, if we don't than again it would be an excuse as well. So all in all it seems like a facade for premium rise. Cost No Concerns, I think it is a great idea! NA I would still like to have the option to be able to go somewhere else at a reasonable price. I would be concerned about relying on this clinic then having it cease to be available it budget issues arise. It has been very difficult to get into see my Primary Care Physician in the past two years due to snowbirds. End up having to go to a walk -in -clinic when sick. If the County does start a clinic, it would have to be equipped to see sick patients'- same day they call and without a long wait time. Would want to have a GOOD Rated Doctor or PA. Someone that is willing to take the time to talk and review chart, you are not just a number. Need someone that understands women's hormone changes: weight gain, thinning hair and not say it is part of getting older. A Holistic Approach since usually not covered by insurance. I have been established with my primary care physician and specialist for many years. Not sure if I would use the Employee Clinic or not. I have been with my primary Doctor for a very long time and do not wish to change to someone who does not know my medical history. My wife has chronic conditions that are being managed by her primary physician and specialists for numerous years presently. My decision would be based on care provided. As with any doctor if 1 felt the care was substandard I would not continue. I've been with my PC Dr. since 2005 so I would be more inclined to use employer clinic as urgent care rather than Primary care. This is awesome. Thank you for considering this option. Privacy would be the only concern. None. Its a nice option to have as long as it wouldn't become a sole source Would depend on the doctor and the comfort level and amount of trust for me personally. Cost I am afraid my privacy will be infringe upon. I am afraid they will not have doctors, they will be interims or etc. The wait time is very long. I can go to my doctor and not have a long wait time. None that I can think of at this time. [Privacy issues, employees discussing others health among themselves around fellow employees. Fellow employees trying to discover information about each other. I prefer to use a doctor that is familiar with me. Not interested in walk in clinics Location Availability. How long it takes to get an appt. NO concerns All answers above are dependent on more information provided. Like cost to visit, experience of healthcare providers on site, etc. none No I would not like to give up my existing Internal Medicine Specialist, who acts as my primary care physician as well. I also would be concerned that my employer would potentially have more direct access to my care, based on reports that the clinic would need to provide to the employer. My primary care physician already does all this and has all my records. Would consider only for an immediate urgent need. Location would be the only issue. I'm not driving to the north end of the county from where I live off Oslo Rd. when I can go to the Care Spot on 58th and 60. I think it is a great idea. This county would be moving in the right direction. None I would not want to give up my primary care doctor if this comes into effect. I would hope that doctor's that are currently in network wouldn't be then made out of network so we couldn't see our primary doctor's and have to use this employer clinic. None Need for continued confidentiality. Would there still be patient doctor confidentiality or would I have to fear taking to the doctor about issues and it getting out and turning into public knowledge at my employer. Concerned the initial start-up cost would be passed along to the employees. I have no concerns, I think it would be a great idea to implement this idea. Having assisted with the opening with the Care Here clinic for the SDIRC, I feel that they have their benefits. The clinic for the SDIRC was slow to develop but after establishing, employees did like the convenience. The biggest issue is finding the perfect provider fit for your employees. There are several individuals that have undocumented health issues because they do not have a PCP and often times critical illnesses are found by the clinic physicians through the BMI/Annual physical screenings. This is an great benefits to employees but I would feel that it should not be staffed by Cleveland Clinic, as their reputation has soured in the mouths of patients and physicians alike. The cost co pay, location, hours... The plan premium costs for our health insurance keeps going up substantially EVERY year. The expensive gold plan forced many to go to the cheaper silver plan that is water -downed plan from what we previously were offered. Due to economic hardship employees were forced to opt for the lesser quality plan. Please do some homework and fix the rising premium costs. Think out of the box and offer the employee clinic. Affordable, good health insurance is one of the benefits of why I left private industry that hit me with a a huge pay cut. Now i am paying more and more to have it. $$$$$$$$$$$$$$$$$$$ None None Is this open to immediate family/dependents of employee? Quality of health care/treatment provided and credentials of medical staff. Would service hours be 24/7 to accommodate those who work varying shifts? No concerns None Will there be availability of Appointment Times and Days. Its a great way for self care with out having to take off for dr appts. It gives gauge of changes in I and blood pressure. I have established doctors Patient confidentiality in the employer-employee setting here is terrible. My supervisor should not know anything about my medical history, conditions, or concerns unless I provide those to them. HIPAA violations should not occur. Time open and the health care professional doing the exam. Is any of my information open to public record request? Will services rendered from this clinic be offered only to Federal Agencies in this county? or other non-federal agencies in this county as well? cost getting same day appointments if sick Privacy I would be concerned that eventually I would not be able to continue to see my current doctors. N/A I am happy with my PCP which is rare. I would guess the clinic would only be as good as the staff managing it. Employer provided medical service does not appeal to me. Health care should not be provided by employers. Reduction in health insurance service to offset the cost of obtaining the Clinic. Conflict of interest potential exists between two parties, right? Cost and privacy Confidentially and H.I.P.A. (H.I.P.P.A.) The only concern would be the price. Not at this time It's an excellent idea and you should proceed. I have a private insurance I like my own Doctors Would this clinic be open on off days such as Saturdays and/or Sundays Only concerns are quality of doctors and keeping the same doctors for continuity of care. none, I think its a great idea My question, like alot of people, is how will this be funded? I'm sure it has to come from somewhere, will it be deductions from county employees, and say the decision is not to have a clinic, will that cause our insurance premiums to go up, due to the chance we had for employer healthcare clinic? What would also be nice to see if the county offered a child daycare for parents. I'm sure that could be funded somehow, there's always a way, sometimes what lacks is planning and initiative. My only question is cost. not having the option of using the Doctor of MY choice... It would be nice to have a clinic on campus available to employees. To much personal information, and total access to all my health records. That can be stored, stolen or hacked by a third party. I have been using the same Doctor for twenty years, and every three months I have biometric screening done and yearly blood work. The only one that I sign access of my records to is my wife & Doctor. I do not have much faith in the internet of personal data, and personal health information to be made available to my employer or any third party. Thank you. I would only worry if the access would be open to different schedules None wait times probability of getting an appointment. Access. I live in Satellite Beach. Accessibility Quality of clinicians. Quality of equipment and diagnostic tools. Customer service I do not have any concerns and think it would be a great idea to have this type of clinic for county employees. WOULD THE HOURS BE AVAILABLE TO OUR 12 HOUR SHIFTS.WOULD WE GET MEDS FOR FREE OF AT A REDUCED RATE. WHAT SORT OF SCEENINGS WOULD THEY OFFER TO SAVE ON COPAYS THAT WE PAY AT OUT REGULAR DOCTORS OFFICES. would consider if copays were less; such as x-ray copay...at $200 each time, plus mri if needed, it becomes quite costly! will consider what would the difference be in using a primary care and going to an employer clinic That it could possibly limit your healthcare options or providers. Privacy. Where would the clinic be located? I would want assurances my medical information would remain private. if the county thought we were unfit Loss of job. 104 11 I usually would rather visit my primary doctor or specialists that I have already been working with. I have used Employer clinics and have had mostly good experiences, however, I have also seen employers push you to go there instead of a place of your choice. And that concerns me and I wonder if they have access to whether or not you went for a visit. My main concern would be that 1 like my doctors and have been working with them for a long time. But I would certainly consider going to an urgent care type facility that wouldn't cost more. Otherwise, if there is a charge to visit, I'd rather just go where 1 go now. confidentiality MY ONLY CONCERN WOULD BE "WHO" THE DOCTOR IS AND IF I WOULD GET ALONG WITH HIM/HER. If it will lower the insurance costs I would be happy because our insurance costs are rising faster then cost of living, every year we get a COLA then it is negated and then some by rising insurance costs. Would be concerned about the quality of the personnel employed at the employee clinic. No privacy ..and I can see the Hippa law being broken.. Have established primary care provider as well as specialists & would likely not change. With the Health Insurance I have now, there is no out-of-pocket expense when Igo to my primary care physician. So if there were any charges associated with the clinic, I probably would not use these services. would want to continue with the current doctors that I am established with. This is a terrible idea None No concern. Hours of Operation. Would dependents on the plan have to utilize the employer clinic as well? medical private and confidential information not reported to employer I think it would be a relief to not wonder if I am choosing to visit the right Dr or not. I don't know how to pick a DR on my own. 1 would be glad to have an employer health community. I'm concerned about any cost involved. I have been involved in another employer clinic where there was no charge and it worked very well! Hoping this will too. Would definitely cut down on healthcare cost. depends on location and hours (as I don't live in IRC) I would be concerned if the clinic didn't have the equipment or staff to treat me or my family. Being turned away for any reason would be a huge disappointment. It would be great if a clinic was equipped to treat what an urgent care walk in facility could treat. I don't carry county health insurance so I would be unlikely to use the clinic. If it would not be available to retirees, then this survey is moot. Cost and privacy When I worked at Orange County we had an Employer based clinic for injuries that occurred on the job. The staff they hired were mostly physician's assistants or entry level doctors. I still can not throw a ball or run thanks to poor treatment they provided over 30 years ago. I would consider using employer clinic for minor issues but would prefer Primary Care for anything more serious/chronic. My concern with the employer clinic providing more comprehensive services is that it would eliminate other options and/or be more costly. I would need a few more details to consider this. Thank you Concerns about limited operating hours and/or weekend visits. Also, concerns about lack of pediatric care for dependents for minor illnesses. no concerns Costs Great option as long as it doesn't foreclose the options we have now. Part time not covered by insurance 105 Page 10 of 11 I have no concerns. I used to be part of an organization which used Care Here for their employee clinic. It was great. It is really a benefit I miss and would love to see the County pick up. Quality of care and proper funding for needed equipment would be a major concern with the past funding of IRC government entities. Hours of operation. Also will my family be able to use the clinic. None. I believe an employer clinic would benefit everyone who works for the county. I think it would benefit the county and its employees to have the clinic but we need to see the numbers. Other counties are able to do this, find out how they make it successful. Total # of respondents 608. Statistics based on 241 respondents; 0 filtered; 867 skipped. 106 June 4, 2020 RE: ONSITE CLINIC CONSULTING FOR INDIAN RIVER COUNTY Dear Indian River County, Thank you for giving us the opportunity to partner with you to build a best -in -class program onsite clinic. We view this initiative as a several -phased process, as described below. Phase I — Program Inventory and Assessment (2-4 months) Population Health Claims Review ❖ Focus on populations at clinic locations o Preventive Care o Chronic Conditions o Gaps in Care o Risk Scores Conduct Feasibility Study & Clinic Evaluation using Infolock®: ❖ Will complete a feasibility study, a high-level analysis of claims data to understand utilization trends and the prevalence of specific risk factors. The study also identifies potential savings related to cost diversion. Phase Ib — Employee Focus Groups (1-2 months), Optional ❖ Lockton facilitated, employee focus groups to determine interest and cultural connection to having these services available. ❖ Pending timing can opt for virtual focus groups. Phase II — Request for Proposal (RFP) and Process Management (3-4 months) Establish Onsite Clinic Goals and Scope of Services: Establish program goals and scope for the Request for Proposal Confirmation of clinic design (e.g. hours of operation, location, build out needs, access, etc.) 41- Confirmation of staffing models and clinical scope (e.g., episodic/acute care, predentive care, wellness health coaching, primary care, chronic condition management, occupational medicine, executive physicals, laboratory, pharmacy dispensing, etc.) ❖ Confirmation of access (e.g. who will have access to the clinic?) ❖ Confirmation of Indian River County's budget for the clinic ❖ Confirmation of clinic facility and potential build out Request for Proposal: We will include the strategic goals and scope of services as determined above. The RFP will address the following topics: ❖ Company background, philosophy, experiences and references ❖ Account management model and account team experiences/capabilities ❖ Staffing model and qualifications of staff (Medical Doctor, Physician Assistant, Nurse Practitioner, Nurse Assistant, etc.) 106 ❖ Integration with current/future health and wellness programs ❖ Wellness program design and features: portal, health coaching, disease management, health webinars, nutrition and physical activity tracking tools, physical activity tracking devices, etc. ❖ Compliance considerations ❖ Technology requirements and capabilities ❖ Employee and employer reporting ❖ Fees/cost ❖ References ❖ Performance/ service guarantees RFP Evaluation and Recommendations: ❖ Evaluation of the RFP responses with a proposed pricing scenario ❖ Executive summary of recommended finalists ❖ Participation in and facilitation of 2-3 finalist meetings and/or site visits Phase III — Implementation Oversight (2-3 months) ❖ Contract negotiations o Review standard contract language provided with RFP responses o Determine additional criteria to be met by the vendor such as: ➢ Service and performance expectations ➢ Reporting schedule ➢ Data transfers ➢ Additional fees for data transfers HIPAA compliance ❖ Establish project meeting schedule with detailed agendas provided by selected vendor ❖ Ensure proper data integration protocols are established ❖ Ensure timeline matches the negotiated contract terms regarding quality and timeliness ❖ Confirmation of communication strategy o Partner with clinic vendor to strategize launch and ongoing communications Phase IV — Evaluation & InfolockO Data Analysis (Ongoing) ❖ Infolock® data mapping of onsite clinic utilization ❖ Annual report review of onsite clinic assessment ❖ Evaluate and compare to key performance metrics identified. Some examples may include: o Utilization rate by member type o Utilization by visit types and diagnoses/conditions o Outreach and engagement levels related to lifestyle and disease coaching o Risk and compliance impact of those engaging in the clinic vs. non clinic users ❖ Recommendations for enhancements /modifications to clinic scope and services as new data becomes available Lockton Team Health Risk Solutions Consultant, Melissa Anchia, will be the engagement `.`lead" for this initiative. Melissa will work with Sue Cugno, Unit Manager, and Kristen Robles, Senior Account Manager, to work through 107 each phase of the project. We will work with Indian River County throughout providing updates and collaboration through each phase. Lockton Fee Our fee for this full engagement is $75,000. Compensation can be structured in a manner that is convenient to Indian. River County. Phase I: $25,000 Phase 1b: $10,000, Optional Phase II: $25,000 Phase III: $15,000 Phase IV: Included in ongoing BOR scope of service Thank you again for your consideration. We look forward to discussing this with you. Sincerely, Lockton Companies 108 134 MEMORANDUM TO: Board of County Commissioners FROM: Dylan Reingold, County Attorney DATE: April 29, 2021 SUBJECT: Children's Services Dedicated Millage BACKGROUND. On February 25, 2020, the Indian River County Board of County Commissioners ("Board") conducted a workshop and provided guidance to the County Attorney on various issues pertaining to the dedicated millage for the Children's Trust. The guidance addressed the proposed millage rate, sunset date, millage phase-in, Children's Trust Advisory Board membership, executive director position and staffing, and the use of dedicated millage funds. After the workshop, the County Attorney's Office began drafting the proposed ordinance, which called for the referendum and established a new chapter of the Indian River County Code of Ordinances pertaining to the dedicated millage and the other issues noted above. On May 5, 2020, in response to the COVID-19 pandemic, and at the request of County staff and representatives supporting the referendum, the Board voted to defer placing the matter on the November 2020 ballot. At the time, the County Attorney's Office noted that it would bring the matter and a draft ordinance back to the Board in 2021 for consideration of placing the matter on the November 2022 ballot. Since then, County staff has had several productive meetings with the representatives supporting the referendum. Based upon the input from the Board at the workshop and from the representatives supporting the referendum, the County Attorney's Office has drafted the attached ordinance for review and comment from the Board. The ordinance establishes a 15 member Children's Trust Advisory Board, consisting of fhe following members: 1. County Commissioner 2. Judge living in Indian River designated by Chief Judge 3. Superintendent of Schools 4. Department of Children and Families, Assistant District Administrator for Indian River County. 5. Department of Health County Health Department Administrator 110 Board of County Commissioners April 29, 2021, Page 2 6. Law Enforcement officer 7. Representative from the Indian River County Hospital District. 8-12. Five (5) voting members from the community appointed by the Board of County Commissioners, which individuals shall have some form of expertise in the arena of children's services, such as a physician, licensed mental health professional, or child advocate. 13. One voting member appointed by the Board of County Commissioners, who represents the Taxpayers' Association of Indian River County. 14. One voting member, appointed by the Board of County Commissioners, who is an accountant. 15. One (1) at -large voting member shall be appointed by the Board of County Commissioners. The funding for the Children's Trust would be based upon an ad valorem tax of 0.2000 of a mill from 2023-2024 to 2025-2026, 0.2500 of a mill from 2026-2027 to 2028-2029, and 0.3333 of a mill from 2029-. 2030 to 2034-2035. The funds will be used to promote the health and well-being of children, which encompasses socioeconomic, physical, mental, social, emotional, environmental and educational health. A number of purposes are described in the ordinance, however in an attempt to address the concern with the duplication of funds expended by other agencies, the ordinance does not permit funds to be used to pay for or reimburse services provided by other governmental entities or their employees. The ordinance includes an executive office director who would serve under the purview of the County Administrator, who will undertake various functions including, but not limited to, providing administrative support for the Children's Trust Advisory Board meetings, monitoring agencies receiving funds, writing appropriate grants, producing written materials, reviewing applications . for funding, reporting to the Children's Trust Advisory Board, preparing annual budgets, writing and presenting annual reports. The office will consist of a director or manager and adequate staff to perform all duties provided for under the Children's Trust Chapter of the County Ordinance Code. The ordinance calls for a referendum at the November 8, 2022 election and would expire 12 years after such date, if the millage is approved by the voters. Since the workshop on February 25, 2020, it has been determined that the most practicable method by which to dedicate the Children's Trust millage would be to establish a special dependent district. In order to establish a .special district countywide, per section 125.01(5)(a), Florida Statutes, the special district would be subject to the approval of the governing body of the incorporated area affected. Thus, the councils of the five municipalities will need to approve the special district in order to have the millage rate applicable in the incorporated areas of the County. If the Board approves moving forward with the draft ordinance, County staff would work with the representatives supporting the referendum, to seek support of a resolution from each of the municipalities. Additionally, the County Attorney's Office would make such changes to the draft ordinance to reflect the establishment of the special dependent district. 111 Board of County Commissioners April 29, 2021 Page 3 FUNDING. The Children's Trust expenses will be solely funded by the millage proceeds collected as detailed in the referendum. RECOMMENDATION. The County Attorney's Office recommends the Indian River County Board of County Commissioners provide guidance on the proposed ordinance and authorize County staff to work with the representatives supporting the referendum in obtaining the approval from the municipalities and drafting any resolutions to effectuate such approval.. The County Attorney's Office also recommend that the Board authorize setting a public hearing on the ordinance, incorporating any changes made by the Board, after obtaining the approvals from the municipalities. ATTACHMENT. Ordinance 112 AN ORDINANCE OF THE BOARD OF COUNTY COMMISSIONERS OF INDIAN RIVER COUNTY, FLORIDA, REPEALING PART II (CHILDREN'S SERVICES ADVISORY COMMITTEE) OF CHAPTER 103 (COMMISSIONS AND BOARDS); ENACTING CHAPTER 215 (CHILDREN'S TRUST DEDICATED MILLAGE) OF THE CODE OF INDIAN RIVER COUNTY, FLORIDA SETTING FORTH A DEDICATED MILLAGE FOR CHILDREN'S TRUST AND REVISING THE ADMINISTRATION AND FUNDING OF CHILDREN'S SERVICES; PROVIDING FOR REFERENDUM FOR DEDICATED MILLAGE; AND PROVIDING FOR CODIFICATION, SEVERABILITY, REPEAL OF CONFLICTING PROVISIONS, SUNSET OF DEDICATED MILLAGE AND AN EFFECTIVE DATE. NOW, THEREFORE, BE IT ORDAINED BY THE BOARD OF COUNTY COMMISSIONERS OF INDIAN RIVER COUNTY, FLORIDA THAT: Section 1. Enactment Authority. Article VIII, section 1 of the Florida Constitution and chapter 125, Florida Statutes vest broad home rule powers in counties to enact ordinances, not inconsistent with general or special law, for the purpose of protecting the public health, safety and welfare of the residents of the county. The Indian River County Board of County Commissioners specifically determines that the enactment of this ordinance is necessary to protect the health, safety and welfare of the residents of Indian River County. Section 2. Repeal of Part II (Children's Services Advisory Committee) of Chapter 103 (Commissions and Boards) of the Code of Indian River County, Florida. Part II (Children's Services Advisory Committee) of Chapter 103 (Commissions and Boards) of the Code of Indian River County, Florida, is hereby repealed in its entirety. Section 3. Enactment of Chapter 215 (Children's Trust Dedicated Millage) of the Code of Indian River County, Florida. Chapter 215 (Children's Trust Dedicated Millage) of the Code of Indian River County, Florida is hereby enacted to read as follows: CHAPTER 215. CHILDREN'S TRUST DEDICATED MILLAGE. Section 215.01. - Purpose. The purpose of the dedicated millage for the Children's Trust is to promote the health and well-being of children in a healthy community. The term "healthy" encompasses socioeconomic, physical, mental, social, emotional, environmental and educational health. 113 Section 215.02. - Objective. (1) The objective of the Children's Trust is to provide a unified system of planning and delivery within which children's needs can be identified, targeted, evaluated and addressed by the Children's Trust Advisory Board. (2) Definition of child. Any person who has not attained the age of eighteen (18) years, also minor. (3) This objective will be met by the Children's Trust Advisory Board through the powers and functions of the Board of County Commissioners as follows: a) Recommended to provide and maintain in the county, services for children as the Children's Trust Advisory Board determines are needed for the general well being of the county. b) Collect information and statistical data and conduct research helpful to the Children's Trust Advisory Board and the county in deciding the needs of children in the county. c) Consult, collaborate, and coordinate with other agencies dedicated to the well being of children to the end that unnecessary duplication of services will be prevented. d) Recommend the allocation of funds to agencies that provide services for the benefit of children in Indian River County. e) Recommend standards for evidence based measurable outcomes within the request for proposal and monitor the agencies for actual performance on agreed upon standards. f) Recommend to employ, pay and provide benefits for any part-time or full-time position needed to execute the foregoing powers and functions. Section 215.03. - Appointment to the Children's Trust Advisory Board. (1) The membership of the Children's Trust Advisory Board shall consist of fifteen (15) voting members who must be residents of Indian River county as follows: a) Seven (7) ex -officio voting members. Those members shall be: 1. County Commissioner 2. Judge living in Indian River designated by Chief Judge 114 KA 3. Superintendent of Schools 4. Department of Children and Families, Assistant District Administrator for Indian River County. 5. Department of Health County Health Department Administrator 6. Law Enforcement officer 7. Representative from the Indian River County Hospital District. b) Five (5) voting members from the community appointed by the Board of County Commissioners, which individuals shall have some form of expertise in the arena of children's services, such as a physician, licensed mental health professional, or child advocate. c) One voting member appointed by the Board of County Commissioners, who represents the Taxpayers' Association of Indian River County. d) One voting member, appointed by the Board of County Commissioners, who is an accountant. e) One (1) at -large voting member shall be appointed by the Board of County Commissioners.' (2) The members appointed by the Board of County Commissioners shall have been residents of Indian River County for at least twenty-four (24) months prior to nomination. Such members shall be appointed for four-year terms, except that the length of the terms of the initial appointees shall be adjusted to stagger the terms. No at -large member shall serve for more than two (2) consecutive four-year terms. (3) No designee of principals will be allowed for any member of the Children's Trust Advisory Board. (4) Except in the event of a conflict between with this Chapter, the Children's Trust Advisory Board shall be subject to the provisions of Chapter 103 of the Indian River County Code of Ordinances. Section 215.04. - Duties of the Children's Trust Advisory Board members. (1) Identify and assess the needs of the children in Indian River County and submit to the Board of County Commissioners a written description of: a) The activities, services, and opportunities available to Indian River County children. 115 b) The activities, services, and opportunities that need to be provided to Indian River County's children. c) The anticipated schedule for providing those activities, services, and opportunities. d) The manner in which children will be served, including a description of collaboration and partnerships that will be made with community organizations, state and local educational agencies, federal agencies, public assistance agencies, the juvenile courts, foster care agencies, and other applicable public and private agencies and organizations. e) The strategy that will be used for interagency coordination and collaboration to maximize existing human and fiscal resources. f) The special outreach efforts that will be undertaken to provide services to promote healthy children. (2) Provide orientation to all new Children's Trust Advisory Board members, to allow them to perform their duties and understand the Sunshine Law. (3) Based upon board of county commissioner's fiscal year, provide an annual written report and presentation in January to the Board of County Commissioners. (4) Provide an updated short term and long-term plan to the Board of County Commissioners to include, but not limited to: a) Programs, services, and activities that meet the objectives of the Children's Trust Advisory Board. b) A detailed budget for activities, services, and programs recommended to receive funding from the Board of County Commissioners. Section 215.05. - Sub -committees. (1) The Children's Trust Advisory Board may establish the change of membership in or termination of the existence of any sub -committees. Each sub -committee shall be named and shall have and may exercise such powers as delegated by the Children's Trust Advisory Board through the Board of County Commissioners. Sub -committees may be composed of Children's Trust Advisory Board members and citizens who are Indian River County residents. Only Children's Trust Advisory Board members shall serve as sub -committee chairs. A minimum of three people will serve on each sub -committee. (2) There shall be standing sub -committees created by the Children's Trust Advisory Board. The Children's Trust Advisory Board chair shall appoint the sub -committee 116 chairs with the approval of the Children's Trust Advisory Board. Annually standing sub -committees will evaluate their effectiveness and make recommendations to the Children's Trust Advisory Board. a) Nominating sub -committee: Potential appointees shall submit resumes to the Board of County Commissioners and the board will make the selection. b) Community needs assessment and planning sub -committee: Identify and assess the needs of children of Indian River County through a needs assessment and asset mapping; submit to the Board of County Commissioners through the Children's Trust Advisory Board a written description of those needs. Provide and update short term and long term plan to the Children's Trust Advisory Board including, but not limited to: i) Programs, services, and activities that meet the objectives of the children's services advisory board. ii) A detailed budget for activities, services, and programs recommended to receive funding from the Board of County Commissioners. c) Grant review and program sub -committee: In coordination with the executive office director, review and revise requests for proposal (RFP) based on need determination and set priorities. Submit to Children's Trust Advisory Board for approval. Review and recommend letters of intent submitted by agencies requesting funding. Through executive office director, notify selected grant applicant of second step process. Review final RFPs and make recommendations for funding to Children's Trust Advisory Board, who will then recommend to the Board of County Commissioners for funding. Receive, review and present to Children's Trust Advisory Board members' quarterly (at a minimum) reports from funded agencies. Conduct program evaluations throughout the funding period, schedule and attend site visits to funded program. d) Other sub -committees deemed necessary to fulfill the duties of the Children's Trust Advisory Board may be established by the Children's Trust Advisory Board chair, with the expressed consent of the Board of County Commissioners. Section 215.06. - Meetings. (1) The Children's Trust Advisory Board will meet at least quarterly or as called by the chair. a) All members are expected to attend all meetings. If a member's annual attendance drops below the seventy-five (75) percent mark the executive office 117 director shall submit a report to the Board County of Commissioners for their consideration of possible removal from Children's Trust Advisory Board. b) Members of the Children's Trust Advisory Board shall serve without compensation. (2) The fiscal year of the Children's Trust Advisory Board will be the same as the Indian River County Board of Commissioners. Section 215.07. - Funding. (1) In order to promote and improve children's health and well-being, and to fund quality programs and services for children residing in Indian River County, the Indian River County Board of County Commissioners shall dedicate each year an ad valorem tax of 0.2000 of a mill from 2023-2024 to 2025-2026, 0.2500 of a mill from 2026-2027 to 2028-2029, and 0.3333 of a mill from 2029-2030 to 2034-2035. (2) The amount of revenue to be generated by the dedicated millage shall be reported to the advisory board by the director as soon as reasonably possible after the property appraiser certifies the tax roll and shall be accounted for by the clerk separate and apart from all other county funds. (3) Effective beginning in 2023-2024, the dedicated millage for the Children's Trust shall replace existing funding provided by the county's Children's Services Advisory Board and may be expended only for funding programs and services for children in accordance with the provisions of this article. (4) Any funds derived from the dedicated millage not used during any fiscal year and all interest earned on such funds shall be accounted for and used only for the purposes established in this article for the dedicated millage. Section 215.08. Use of Funds. It is the intent of this chapter that the funds generated by the dedicated millage shall be used for the development and authorization of continuing programs to improve the quality of life for all children in Indian River County. The dedicated millage will be expended for children's services to promote the health and well-being of children, which encompasses socioeconomic, physical, mental, social, emotional, environmental and educational health. Such programs and services may include, but shall not be limited to the following purposes: 1) To allocate and provide funds for agencies in Indian River County which are operated for the benefit of children. 118 2) To support programs and services which will enhance academic achievement and assist all children to achieve literacy and perform at grade level in core areas such as reading, math and science. 3) To provide and maintain in Indian River County such guidance, psychological, or psychiatric programs and services as the county determines are needed for the general welfare of the children and families of Indian River County. 4) To support programs and services which promote and improve the physical health and well-being of all children, including physical and recreational activities. 5) To support programs and services designed to stop child abuse before it starts. 6) To provide funds to programs and services that keep our children off the streets and away from drugs, alcohol and other risky behaviors. 7) To provide prenatal care programs where such programs will improve birth outcomes for all children. 8) To provide for such other services for all children as the county determines are needed for the general welfare of Indian River County. 9) To collect information and statistical data which will be helpful to the county in deciding the needs of children and to develop techniques for monitoring the efficacy of funded programs and services including, but not limited to the gathering of data, measuring outcomes, goal effectiveness, research. 10)To provide or coordinate training, professional development and other support to Children's Trust funded agencies which will ultimately improve service delivery and desired outcomes for children. 11)To consult, coordinate and collaborate with local, state and national entities which promote best practices, professional standards and advocacy focusing on the health, well-being and education of children and families. 12)To lease or purchase such equipment and personal property, up to $5,000, as are needed to execute the foregoing programs and services. 13)To employ and pay, on a part-time or full-time basis, personnel needed to execute the foregoing programs and services. 14)To provide for administrative expenses limited to Indian River County staff implementing this chapter and operating supplies, directly related to tasks necessary to fulfill the scope and purposes of this chapter, in an amount not to 119 exceed eight (8) per cent of the annual dedicated millage for that fiscal year, to be determined at the time of budget adoption. Such children's services may be provided in accordance with the provisions of this article and such rules, policies and procedures as may be established by resolution of the county, which_ may include, but shall not be limited to programs providing for grants to not-for-profit agencies for the reimbursement of expenditures for operational and overhead expenses for the creation, development and implementation of programs, grants to not-for-profit agencies or children based upon funding all or a portion of the cost of services rendered, the purchase of services or, where children's services can most economically and efficiently be provided by county, through the establishment of county - run programs. Funding will not be used to pay for or reimburse services provided by other governmental entities or their employees. Section 215.09. — Process for Distribution of funds. 1) The application process will be in the form of a request for proposal. Each completed application shall contain expected results stated in required evidence based measurable terms for review by the Children's Trust Advisory Board and a copy of the most recent financial audit. Governmental agencies are excluded from the financial audit requirement. 2) Announcement of plan. As soon as reasonably possible after submission of the advisory board's annual report and initial funding plan for children's programs and services, the county shall approve or modify the plan and announce the availability of funding for the upcoming fiscal year. The announcement will include a description of services and programs recommended for funding from the dedicated millage. The announcement will include information pertaining to funding applications, rules and procedures pertaining to the award of funds and applicable dates for submission of applications and all details pertinent thereto. 3) Funding request evaluation. Evaluations of agencies submitting funding applications shall include, but not be limited to, site visits, interviews, and application review. Applications received will be assessed on the basis of specified criteria and will include, but not be limited to, the following items: a. Organization's capability. The qualifications and experience of the applicant in providing quality human services and the agency's financial capability. b. Evidence based outcomes from prior years. c. Need for service. Appropriate goals and objectives in response to the advertisement of funding availability. 120 d. Soundness of methodology. The goal and objectives, description of services with timeline and documented coordination with other service providers. e. Evaluation. The program's process and outcome objectives, data collection system and evaluation design. Cost effectiveness. The proportion of budget applied to direct services, funds from other sources, funds requested, current and projected long range efficiency. g. Children and families served. The extent to which the application addresses services to meet identified needs of the target population. h. Neighborhood -based initiatives. The extent and degree to which the application focuses on a local area or neighborhood. Response to a specified strategy. The applicant's identification of and appropriate response to a specified primary strategy. j. Application. The relative completeness, clarity and conciseness of the response to all required items in the funding announcement and application. 4) Prior to budget hearings, the Children's Trust Advisory Board shall submit a line item request, by program, to the Board of County Commissioners for funding consideration. This total request will be within the boundaries of the aggregate funding allocated for children's services by the Board of County Commissioners as set forth in section 215.07. Section 215.10. - Function of executive office director. The executive office director of the County, under the purview of the County Administrator, will provide all services needed to support the services set forth in this, chapter, including, but not limited to, completing reports and activities required to meet the objectives of the Children's Trust Advisory Board. These activities will include, but are not limited to, administrative support for the Children's Trust Advisory Board meetings and be the official record repository for said records, keeping other records, monitoring agencies receiving funds, writing appropriate grants, producing written materials, reviewing applications- for funding, reporting to the Children's Trust Advisory Board, preparing annual budgets, writing and presenting annual reports. The office of the executive office director shall consist of a director or manager and adequate staff to perform all duties provided for under this chapter. Section 215.11. - Bookkeeping and audit. 121 Any agency funded through the process set forth in this chapter shall be required to keep adequate records reflecting the use of funds and services provided. These records shall be made available to the Children's Trust Advisory Board or Board of County Commissioners upon reasonable demand. The executive office director shall, at a minimum; review and records quarterly and prepare written reports for the Children's Trust Advisory Board. All agencies must provide the Children's Trust Advisory Board with an audit based upon standard accounting procedures. Section 215.12. - Procedures handbook. The procedure handbook shall be adopted by the Board of County Commissioners by resolution, which sets out the operating procedures of the Children's Trust Advisory Board. Section 215.13. Sunset. This Chapter shall expire on November 8, 2034, twelve (12) years after the date such authority to dedicate millage for children's services was submitted to the electors of Indian River County voting in a referendum. Section 4. Codification. It is the intention of the Board of County Commissioners that the provision of this ordinance shall become and be made part of the Indian River County Code, and that the sections of this ordinance may be renumbered or re -lettered and the word ordinance may be changed to section, article or such other appropriate word or phrase in order to accomplish such intention. Section 5. Severability. If any part of this ordinance is held to be invalid or unconstitutional by a court of competent jurisdiction, the remainder of this ordinance shall not be affected by such holding and shall remain in full force and effect. Section 6. Conflict. All ordinances or parts of ordinances in conflict herewith are hereby repealed. Section 7. Referendum Approval. A question shall be placed on the ballot at the November 8, 2022 election to be held in Indian River County for referendum approval by the electors of Indian River County to be worded substantially as follows: "In order to fund improvements in quality children's development, physical and mental health, and other services for children residing in Indian River County, shall Indian River County dedicate each year an ad valorem tax of 0.2000 of a mill from 2023-2024 to 2025- 2026, 0.2500 of a mill from 2026-2027 to 2028-2029, and 0.3333 of a mill from 2029-2030 to 2034-2035?" For dedicated millage for Children's Services Against dedicated millage for Children's Services 122 Section 8. Sunset Date. This ordinance shall expire on November 8, 2034, twelve (12) years after the date such authority to dedicate millage for children's services was submitted to the electors of Indian River County voting in a referendum. Section 9. Effective Date. This ordinance shall become effective on November 8, 2022 only if a majority vote "yes" in favor of the dedicated millage for children's services, at the referendum scheduled for November 8, 2022. If a majority vote "no" against such authority, this ordinance shall be null and void. This ordinance was advertised in the Indian River Press Journal on the day of , 2021, for a public hearing to be held on the —day of , 2021, at which time it was moved for adoption by Commissioner , seconded by Commissioner , and adopted by the following vote: Chairman Joseph E. Flescher Vice -Chairman Peter D. O'Bryan Commissioner Susan Adams Commissioner Joseph H. Earman Commissioner Laura Moss The Chairman thereupon declared the ordinance duly passed and adopted this _ day of , 2021. ATTEST: Jeffrey R. Smith, Clerk and Comptroller M Deputy Clerk BOARD OF COUNTY COMMISSIONERS OF INDIAN RIVER COUNTY, FLORIDA Joseph E. Flescher, Chairman This Ordinance was filed with the Department of State on the day of , 2021. 123 INDIAN RIVER COUNTY BOARD OF COUNTY COMMISSIONERS INTER -OFFICE MEMORANDUM TO: Members of the Board of County Commissioners DATE: SUBJECT: Approval of Special Rate for Use of the Fairgrounds Following Events at Sandridge Golf Club FROM: Susan Adams Commissioner, District 1 I would appreciate a discussion with my fellow commissioners regarding the concept of a venue package for the use of Sandridge Golf Club and the Fleetwood Center under specific circumstances as described below. BACKGROUND: Sandridge Golf Club hosts several charity golf tournaments throughout the year that are organized and funded by various non-profit community organizations. These events generally include opening ceremonies and golf with awards and closing events held at the Sandridge Cafe, which currently accommodates up to 150 people. In recent years, the Vietnam Veterans of Indian River County Inc. have held the Mary Snyder Golf Tournament at Sandridge. This popular event has grown to over 250 participants and volunteers. It is wonderful to see this, and other successful events grow through the years. However even though this is a great problem to have, it means that Sandridge is unable to host the awards and closing events due to a limited seating capacity. In order to find a solution to the current capacity limitations, Sandridge staff in cooperation with its food an&beverage concessionaire is willing and able to set up and hold the post event activities in the Fleetwood Center at the IRC Fairgrounds. It should be noted that in recognition of the increased usage and growth of events held at Sandridge, the Sandridge Clubhouse Addition Project will be coming to the BOCC for consideration on a future agenda. This project is intended to address the limited capacity at the facility allowing IRC to help foster and grow these successful events that are so important to the viability of our community non-profit groups. 124 On May 4, 2021, the Vietnam Veterans of IRC Inc. approached the Board of County Commissioners to seek a waiver of the fees associated with the use.of the Fairgrounds following the golf tournament. The Board discussed how to best balance the need for the event to be moved due to facility capacity, while taking into consideration that they have already contracted to use the facilities at Sandridge. Further discussion was had regarding. creating a process that could be applied to other events and non-profit organizations that may be facing similar circumstances. During the discussion, the idea was proposed to create a package or special rate that would apply in the described specific circumstances. PROPOSAL: It is proposed that the Board of County Commissioners approve a special rate applicable to the Fairgrounds facility rental rate schedule equivalent to 75% of the non-profit rate following a charitable golf tournament at Sandridge Golf Club exceeding 150 participants. It is further recommended to sunset this special rate upon completion of the planned Sandridge Clubhouse Addition Project. I believe that this proposal would strike a balance between protecting taxpayer dollars and supporting the role that fundraisers hold for non -profits allowing them to raise funds to put valuable resources back into our community. After speaking with staff, it is my understanding the proposal would cover the overhead cost of using the facility and.coupled with some additional savings that come with using 2 county facilities and the same concessionaire, the Vietnam Veterans of IRC would bear a minimal fiscal impact for their event, which should be further offset by the generous pledges made by various individuals at the May 4th BOCC meeting. Thank you for your consideration. 125 11S181 SWDD Item Indian River County, Florida Solid Waste Disposal District Board Memorandum Date: April 30, 2021 To: Jason E. Brown, County Administrator From: Vincent Burke, PE, Director of Utility Services Prepared By: Himanshu H. Mehta, PE, Managing Director, Solid Waste Disposal District Subject: Final Pay CCNA2018 WO No. 7 to Geosyntec for One Year of Groundwater Monitoring/Reporting and Related Consulting Services at the Former South Gifford Road Landfill Descriptions and Conditions: On April 21, 2020, the Solid Waste Disposal District (SWDD) Board approved CCNA-2018-Work Order No. 5 to Geosyntec Consultants, Inc. (Geosyntec) in the amount of $86,751. The work was done in accordance with requirements by the Florida Department of Environmental Protection (FDEP) for groundwater monitoring and reporting for an additional one-year period and annual pollution remediation liabilities evaluation for the Former South Gifford Road Landfill site. Analysis: Geosyntec has satisfactorily completed all of the tasks described in the scope of work for a total invoiced amount of $86,749.62, including the final invoice of $6,007.07. Attached is Geosyntec's letter report describing in more detail the services provided under this work order. Funding: Funding for this work is budgeted and available in account number 31521734-033490-03004, which is the Optional Sales Tax Fund used for infrastructure needs of the County. Costs associated with the landfills are authorized uses of the Optional Sales Tax Fund, in addition to infrastructure. Description Account Number Amount Optional Sales Tax/Landfill/Other Contractual 31521734-033490-03004 $6,007.07. Services/Landfill Groundwater Testing Recommendation: Solid Waste Disposal District staff recommends that its Board approve Geosyntec's final invoice amount of $6,007.07. Attachment: 1. Geosyntec Project Completion Report & Final Invoice 126 SWDD Agenda - Final Pay Geosyntec WO CCNA -2018 -WO No. 7 Page 1 of 1 Geosyntec" consultants Mr. Himanshu Mehta, P.E. Managing Director Indian River County Solid Waste Disposal District 1325 74h Avenue Southwest Vero Beach, Florida 32968 1120 North 121 Avenue Pensacola, Florida 32501 PH 850.477.6547 www.geosymec.com 20 April 2021 Subject: Project Completion Report One Year of Groundwater Monitoring/Reporting and Related Consulting Services IRC CCNA-2018-Work Order No. 7 South Gifford Road Landfill Dear Mr. Mehta: Geosyntec Consultants (Geosyntec) is pleased to present to you this project completion report for Geosyntec Project No. FR0766R - One Year of Groundwater Monitoring/Reporting and Related Consulting Services for the former South Gifford Road Landfill site. This project was completed under CCNA-2018-Work Order No. 7, authorized on 21 April 2020, pursuant to the Continuing Contract Agreement for Continuing Engineering Services between Indian River County (IRC), Solid Waste Disposal District (SWDD) and Geosyntec, dated 17 April 2018. This report has been prepared as a supplement to our final Invoice No. 432540 dated 16 April 2021, which is attached. SCOPE OF WORK The scope of work authorized under Work Order No. 7 addressed the FDEP-required semi-annual groundwater monitoring and reporting for one year (two sampling and reporting events) and related consulting services. .The project was executed under the following phases (tasks): (i) Project Management; (ii) Meetings/Regulatory Interaction; (iii) Annual Pollution Remediation Liabilities Evaluation; (iv) Semi -Annual Sampling Activities; and (v) Data Evaluation and Semi -Annual Reporting. Below is a summary of the work. by phase that Geosyntec performed under this work authorization. Phase 1— Proiect Management Under this phase, Geosyntec performed project planning and management responsibilities, such as correspondence with IRC SWDD and FDEP, invoice review and completion, project coordination, and project administration. PR21014 Project Completion WO No 7_FRO766R engineers p scientists I innovators 127 Mr. Himanshu Mehta 20 April 2021 Page 2 Phase 2 - Meetings/Re2ulatory Interaction Under this phase, Geosyntec provided ongoing support to IRC SWDD related to interaction and negotiation with FDEP. Phase 3 - Annual Pollution Remediation Liabilities Evaluation Under this phase, Geosyntec prepared the annual environmental liability evaluation in response to Governmental Accounting Standards Board Statement No. 49 (GASB No. 49), Accounting and Financial Reporting for Pollution Remediation Obligations, which requires the inclusion and calculation of pollution remediation obligations. The report included the evaluation of three sites, Former South Gifford Road Closed Landfill (470141 " Street), Old Administration Building (1840 25th Street); and Former Premier Citrus Property (375 82nd Avenue) and was submitted to IRC on 29 October 2020. Phase 4 — Semi -Annual Sampling Activities Under this phase, Geosyntec conducted field preparation and groundwater sampling activities for two semi-annual groundwater monitoring events in June and December 2020 and a confirmation sampling event conducted in March 2021. Throughout these three sampling events, a total of 58 groundwater samples were collected under this work authorization. Additionally, Geosyntec provided oversite for a contractor to clear overgrown vegetation around well clusters in December 2020. Phase 5 — Data Evaluation/Reporting Under this phase, Geosyntec prepared the semi-annual reports for the June and December 2020 events. As part of the report preparation, Geosyntec completed database management, data evaluation, trend evaluation, table preparation, and GIS figure preparation. Each report was submitted to IRC SWDD for review and comment prior to submittal to FDEP.. The 2020 Annual Groundwater Monitoring Report was approved by FDEP on 7 April 2021 and included approval to discontinue monitoring at five monitoring well locations and to discontinue analysis of dissolved gases, total organic carbon, and microbial populations (Dhc and vcrA) at eight additional monitoring well locations. BUDGET The approved budget for Work Order No. 7 was $86,751. The total invoiced amount, including the final invoice, is $86,749.62. Therefore, Geosyntec completed this project within the approved budget. PR21014_Project Completion WO No 7_FRO766R engineers p scientists I innovators 128 Mr. Himanshu Mehta 20 April 2021 Page 3 CLOSURE Geosyntec appreciates the opportunity to provide services to Indian River County. If you have any question regarding this correspondence, please feel free to contact the. undersigned at 850:483.5102. Sincerely, Crystal Towns, P.G. Geologist �, •!'W4 .., 1 Joseph Applegate, P.G. Senior Principal Geologist PR21014 Project Completion WO No 7 FRO766R engineers I scientists p innovators 129 Mr. Himanshu Mehta 20 April 2021 Page 4 Table 1 Summary of Invoices .Submitted for Geosyntec's Project Number FR0766R South Gifford Road Landfill Geosyntec Project Number/IRC Work Authorization ]dumber Invoice No. Invoice Date Amount FR0766R (IRC Work Order.No. 7) 402342 05/20/2020 $2,800.31 404622 06/15/2020 $3,038.44 408149 07/24/2020 $14,743.19 410352 08/17/2020 $5,137.15 412956 09/16/2020 $2,784.86 414907 10/09/2020 $2,781.00 417938 11/11/2020 $2,701.18 421789 12/20/2020 $2,706.33 424512 01/22/2021 $21,081.63 427318 02/23/2021 $8,302.55 429539 03/17/2021 $14,665.91 432540 04/16/2021 $6,007.07 TOTAL $86,749.62 PR21014_Project Completion WO No 7_FRO766R engineers I scientists I innovators 130 Geosyntec"' consultants Mr. Himanshu Mehta, P.E. Managing Director Indian. River County Solid Waste Disposal District 1325 74th Avenue Southwest Vero Beach, Florida 32968 Subject: , Project Management Report and Transmittal of Invoice South Gifford Road Landfill Dear Mr. Mehta: 1120 North 121 Avenue Pensacola, Florida 32501 PH 850.477.6547 www.geosyntee.com 20 April 2021 Geosyntec Consultants (Geosyntec) prepared this project management report to address the Plume Groundwater Monitoring project being conducted by Geosyntec on behalf of Indian River County (IRC) Solid Waste .Disposal District (SWDD) at the South Gifford Road Landfill site. This report presents: (i) a budget overview for this project; (ii) a summary of activities completed to date; (iii) a discussion of the work reflected on the enclosed invoice; and (iv) recommended actions for the site. The enclosed invoice reflects labor and expenses through 28 March 2021 for work.being performed at the South Gifford Road Landfill. Table 1 provides invoicing details for the project. Work Order No. 7 was approved by IRC on 21 April. 2020 and the budget for the project was developed using labor rates that were approved by IRC for use in 20.18. PROJECT MANAGEMENT SUMMARY Geosyntec's Proiect No. FR0766R: One Year of Groundwater Monitoring/Reporting and Related Consulting Services (IRC Work Order No. 7) Budget Overview Invoice No. 432540 dated 16 April 2021 for $6,007.07, Project No. FR0766R is enclosed. Listed below is a summary of the budget, including invoiced amount, and remaining budget. Geosyntec is within the budget appropriated for this project. Approved Budget: $ 86,751.00 Invoiced Amount to -date: $ 86,749.62 Remaining Budget: $ 1.38 FR0766R/PR21020 131 engineers I scientists I innovators Mr. Himanshu Mehta 20 April 2021 Page 2 Work Completed to Date The Summer 2020 semi-annual groundwater monitoring event was completed from 2 to 3 June 2020. The semi-annual groundwater monitoring report was submitted to FDEP on 31 July 2020. The annual IRC Pollution Remediation Liabilities Evaluation was submitted to .IRC on 29 October 2020. Brush clearing around the well clusters and the Winter 2020 semi-annual groundwater sampling event was completed the weeks of 30 November 2020 and 14 December 2020, respectively. Upon review of the December 2020 groundwater monitoring data, laboratory results from two monitoring wells were inconsistent with historical results at these locations. A confirmation sampling event was conducted in March 2021, and confirmation data was included in the annual report. The 2020 Annual Groundwater Monitoring Report was submitted to FDEP on 31 March 2021 and included recommendations to discontinue monitoring at five monitoring well locations and to discontinue analysis of dissolved gases, total organic carbon, and microbial populations (Dhc and vcrA) at eight additional monitoring well locations. The annual report and all recommendations were approved by FDEP in a letter dated 7 April 2021. Work Reflected on Enclosed Invoice Labor and expenses reflected on the enclosed invoice are attributed to: Labor indicated as professional services ($5,415.00) is attributed to project management and administration, confirmation groundwater sampling activities conducted in March 2021, associated data management, and preparation and submittal of the annual report. Reimbursable expenses ($429.62) are associated with the March 2021 confirmation groundwater sampling activities and include costs for laboratory analysis, field vehicle usage, field sampling equipment and related courier services, and per diem for field staff. The remainder of the. invoice is associated with a communications fee per the contract. Recommended Actions None. CLOSURE Geosyntec appreciates the opportunity to provide services to Indian River County. If you have any questions regarding this correspondence, please feel free to contact me at (850) 483-5102. Sincerely, O /; Crystal Towns, P.G. Project Geologist Enclosure FR0766WPR21020 .engineers I scientists I innovators 132 Table 1 Summary of Invoices Submitted for Geosyntec's Project Number FR0766R South Gifford Road Landfill Geosyntec Project Number/IRC Work Authorization Number t Invoice No. Invoice Date Amount FR0766R (IRC Work Order No. 7) 402342 05/20/2020 $2,800.31 404622 06/15%2020 $3,038.44 408149 07/24/2020 $14,743.19 410352 08/17/2020 $5,137.15 412956 09/16/2020 $2,784.86 414907 10/09/2020 $2,781.00 417938 11/11/2020 $2,701.18 421789 12/20/2020 $2,706.33. 424512 1/22/2021 $21,081.63 427318 2/23/2021 $8,302.55 429539 03/17/2021 $14,665.91 432540 04/16/2021 $6,007.07 TOTAL $86,749.62 FR0766R/PR21020 engineers I scientists I innovators 133 Geosyntec co nsultants INDIAN RIVER COUNTY SWDD 1325 74TH AVENUE SW VERO BEACH, FL 32968 Attention: HIMANSHU MENTA, P.E. PLEASE REMIT PAYMENT TO: Geosyntec Consultants, Inc. 900 Broken Sound Parkway NW, Suite 200 Boca Raton, Florida 33487-3575 USA Tel (561) 995-0900 Fax (561) 995-0925 Invoice #: 432540 Invoice Date: 4/16/2021 Project: FR0766R Project Name: 2020 GIFFORD GWM For Professional Services Rendered through transaction date: 3/2812021 If you have questions about this invoice, please contact Crystal Towns at 850.483.5102 WORK ORDER 7 DATED 21 APRIL 2020 Statement Prior Billings $80,742.55' Current Invoice $6,007.07 Billed To Date $86,749.62 Paid To Date $66,076.64 Professional Services 3.0% Communication Fee Reimbursable Expenses Current Invoice **Amount Due This Invoice ** Project Budget Expended to Date Contract Balance **Amount Due This Invoice ** $5,415.00 $162.45 $429.62 ----------------- $6,007.07 $6,007.07 $86,751.00 $86,749.62 $1.38 $6,007.07 134 Project: FR0766R -- 2020 GIFFORD GWM Invoice #:432540 Phase: 01) PROJECT MANAGEMENT Class/ Employee Name. Hours Rate Amount PROJECT ADMINISTRATOR PHILLIPS, NICOLE 0.50 65.00 32.50 STAFF PROFESSIONAL WILSON, TED 1.00 120.00 120.00 PROFESSIONAL TOWNS, CRYSTAL 1.00 160.00 160.00 Total Phase: 01) PROJECT MANAGEMENT Phase Labor 312.50 3.0% Communication Fee 9.38 Phase: 04) SAMPLING Class/ Employee Name Hours Rate Amount CLERICAL ASSISTANT HOCKETT, KIM 0.25 50.00 12.50 STAFF PROFESSIONAL WILSON, TED0.75 120.00 90.00 JOSLYN, RYAN 11.00 120.00 1,320.00 Vendor Name Doc Nbr Date Cost Multiplier Amount Subcontractors-Billable TESTAMERICA LABORATORIES, INC. 4000033292 03/16/2021 115.00 1.07 123.05 Q Postage/Courier-Billable FEDERAL EXPRESS 730004532 03/03/2021 38.25 1.00 38.25 F - I Vehicle .Operating-Billable JOSLYN, RYAN 0044752962 03/03/2021 32.51 1.00 32.51 Equip. Rental & Maint-Billable U.S. ENVIRONMENTAL RENTAL CORP. 86877 03/09/2021 180.81 1.00 180.81 Per Diem-Billable JOSLYN, RYAN 0044752962 03/02/2021 55.00 1.00 55.00 Total Phase: 04) SAMPLING Phase Labor 1,422.50 3.0% Communication Fee 42.68 Phase Expense 429.62 Phase: 05) DATA EVAL / REPORTING Class/ Employee Name Hours Rate Amount PROFESSIONAL TOWNS, CRYSTAL 18.50 160.00 2,960.00 SENIOR PRINCIPAL APPLEGATE, JOE 3.00 240.00 720.00 Total Phase: 05) DATA EVAL / REPORTING Phase Labor 3,680.00 3.0% Communication Fee 110.40 Total Proiect Labor 5,415.00 3.0% Communication Fee 162.45 INCPMGEOPH Page 2 Project: FR0766R -- 2020 GIFFORD GWM Invoice # :432540 Total Project Expense 429.62 Total Project: FR0766R - 2020 GIFFORD GWM 6,007.07 INCPMGEOPH Page tioti eurofins Environment Testing. America IM] Invoice/ edit No. 4000033292 Invoice Date March 16. 2021 Terms Net 120 days Federal Tax ID 23-2919996 Remit to TestAmerica Laboratories, Inc. PO BOX 3891 Carol Stream, IL 0132-3891 Wi a Citibank ABA: 031 00209 Acct# 3142981 SWIFT Code: CITIUS33 ACH Citibank ABA: 031 00209 Acct# 3142981 SWIFT Code: CITIUS33 ill to: Geosyntec Consultants Inc Attn: Accounts Payable 316 S Baylen St Suite 201 Pensacola, FL 32502 Geosyntec Consultants, Inc. 20 N. 12th Avenue Pensacola, FL 32501 o: P.O. Number W.O. Number ontract Number Work Ordere b FR0766Q 00004427 Crystal T wns Job Description Site Name SDG Number Invoice Contact See below Crystal T wns Job No. Job Description Receipt Date Quantity Unit Price Amount Method/Test Description J200186-1 Gifford Landfill-Ve o Beach, Fl 03/04/2021 8260B - Volatile Organic Compounds Safe and Environmentally Responsible Waste Management (per sample) 2.00 2.00 55.00 2.50 0.00 5:00 Project Number tient Number Project Manager Subtotal (USD) $115.00 40005606 4191 4 Mark Swafford Latest Sample Receipt Date Latest Report Date Phone Number Total (USD) $115.00 03/04/2021 03/16/2021 850 471-6207 For proper ere it, please include invoice number on all remittance. Eurofms TestAmerica, Pensacola -3355 McLemore Drive, Pensacola, FL 32514 This invoice falls under.Eurofins TestAmerica Standard T&C's of Net 30 Days unless superseded by another valid contract vehicle in fm lo.f1 place at the time these services were rendered. u w Kc c m Z v g OOy ONU 8 ¢ e ei O Z C I m 02 R N T aU 2 c O _ I Z Q Z Z.Z 2 r Q Sc n 0 V C< Q ei+ n O Q N f 2 0 0. O Q N r 7>� N pp U N N Ga) v Gm u w m d f v t 1 Z UO ti p� 0 m u x�QNxta t CoQ oxo m 3ra m I ZN 22i¢Q mp Ww L a UO -V d d i D. Q [DUO W LL U' 2--�Y..a j wou(eyuoo 10 JagwnN 11101 XV)IM I m W ^. a 1 a n N o 0 c c to m h J o v U Vl 7 N N N A E as •� s o f � m � ¢ I m U £ o ro u Q Q m C7 w 0 N O C N o N C m `m opO Ov W O Q u C n E m _ m c OOA • 909ZO ¢ O (ON jo.sW,4SVWSW u++0Y1d m y N u g cn a R Y � 3 � c� J (ON jo saA) eldwft paiallld pled a ai '^ U n n r o 0 o0 m W U U I U a E > uchd O � a i N~U �� 0 n• V o 0 a d t� V V% q I C h� rn~ o r7 L 0 m I, � ccd �(Ij oCD 2 "4 � a v K 1p tt :i E E I 7.�� O c 0 N ` N a' v a tai O 3 a` y V) M m c 0 _N ', o N1, o 0 a £ N co4�' 0 v L o Z N 0 y v� O U l_V{ m j — 'pT u IL G lip C% O E uQQcU c o m u y m c ma d C d Li M v ?li �zII E o a' u 3 N `m a N N LL W m J L 1' C pplJ V 7 _Z T iri Z N rd IJ N 5 N Eo-oZ 2 D d CL m oL Q4 00 y E'I� U�U mvo UC7 a ua nti a w u eL0 1 u) a 0 w lD jum FedEx. Invoice Number 7-300-04532 FedEx Express Shipment Summary By Reference I—D ice Date Account Number Paaf M a r 09, 2021 FedEx Express Shipments (Original) Rated Special Weight Transportation Handling' RetChg/Tax leference Shipments lbs Charges Charges Credits/Other Discounts Total Charge: FR0766R 1 43.0 , 105.66 . 2.33 -69.74 36.25 Total FedEx Express 1 43.0 $105.66 $2.33 -$69.74 $38.25 TOTAL THIS INVOICE USD $38.25 :edEx Express Shipment Detail By Reference (Original) hip Date: Mar 03, 2021 Cust. Ref.: FR0766R Ref.#2: 04 ayor: Shipper Ref.#3:** The Earned Discount for this ship date has been calculated based on a revenue threshold of S 1193699.17 Fuel Surcharge - FedEx has applied a fuel surcharge of 6.50% to this shipment Distance Based Pricing, Zone 2 Automation INET Sender Recipient Tracking ID 773056571600 Kim Hackett ERIC MORGAN Service Type FedEx Priority Overnight Geosyntec Consultants US ENVIRONMENTAL RENTAL Package Type Customer Packaging 6770 S. Washington Ave. Suite 1202 TECH BLVD Zone 02 TITUSVILLE FL 32780 US TAMPA FL 33619 US Packages 1 Rated Weight 43.0 lbs, 19.5 kgs Transportation Charge 105.66 Delivered Mar 04, 2021 12:19 Discount -59.17 Svc Area Al Earned Discount -10.57 Signed by V.LEWIS Fuel Surcharge 2.33 FedEx Use 000000000/1486/_ Total Charge USD $38.25 FR0766R Reference Subtotal USD $38.25 Total FedEx Express USD $38.25 FedEx@ Billing Online FedEx Billing Online allows you to efficiently manage and pay your FedEx invoices online. It's free, easy and secure. FedEx Billing Online helps you streamline your billing process. With all your FedEx shipping information available in one secure online location, you never have to worry about misplacing a paper invoice or sifting through reams of paper to find information for past shipments. Go to fedex.c.om to sign up today! 139 140 0 — Payments — PLEASE REMIT ALL PAYMENTS TO: 166 Riverview Ave, Waltham, MA, 02453 "` Total Reflects a $50.31 Discount'"* Rentals E7 U.S. Environmental U S Environmental Rental Corp Loc FL1 Delivery/Other 1202 Tech Blvd INVOICE# 86877 Rentals - Sales - Service Tampa, FL 33619 Inv. Date'03/09/21 D E V IC E & DATA E X P E R T I S E (813)628-4200 FINAL INVOICE usenvironmental.com (888) 550-8100 Rented To: Delivery Location: Geosyntec Consultants Geosyntec Titusville 900 Broken Sound Parkway,N.W 6770 South Washington Ave Suite 200 Suite 3 Boca Raton FL 33487 Titusville FL 32780 Ryan Joslyn /(321) 747-1940 Ordered By: Ryan:Joslyn Ship Date: 02/26/21 Start Date: 03/02/21 Tue VAL PO#: FR0766R/04/123B :Ship Method: Fed Ex Ground Through: 03/03/21 Wed VAL Account #: GEOCON 119 Bill To: Project#: Qty Item Description Day Week 4W Discount Total 1 3510-1022 Ysi 556 30% 91.00 Serial #: 15D100992 130.00 329.00 938.00 Out Date: 03/02/21 1 7150 Rental Accs - Ysi 556 30% 0.00 Out Date: 03/02/21 1 7151 Ra - Ysi 556 Flow Cell 0.00 Out Date: 03/02/21 1 7152 Ra - Ysi 556/600 Storage Cup 0.00 Out Date: 03/02/21 1 4000-1290 Geotech Geopump Model Ii 30% 22.40 Serial #: 06421 U 32.00 94.00 281.00 Out Date: 03/02/21 1 7650 Rental Accs - Geopump Peri 30% 0.00 Out Date: 03/02/21 1 7651 Ra - Geotech Dc Cable Assembly 0.00 Out Date: 03/02/21 1 7652 Ra - Geotech Ac Cable 0.00 Out Date: 03/02/21 1 7654 Ra - Geotech 12V Battery 0.00 Out Date: 03/02/21 5 10151 Tubing Silicone S15 Geotech 2.28 -1.71 9.69 1 40005 Nitrile Pf Gloves X-Large 21.95 21.95 1 DEL Shipping Charge Nontaxable 18.00 18.00 — Payments — PLEASE REMIT ALL PAYMENTS TO: 166 Riverview Ave, Waltham, MA, 02453 "` Total Reflects a $50.31 Discount'"* Rentals 113.40 Sales 31.64 Delivery/Other 18.00 Damage Waiver'. 9.07 Sales Tax 8.70 Total 180.81 Amount Billed. 180.81 03/09/21 14:22:19 Page 1 141