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HomeMy WebLinkAbout2018-126-E Health - Empowerment navigator servicesDocuSign Envelope ID: 142010D9 -C369- 4874- 8D8D- CE32D6CD555E ORANGE COUNTY HEALTH DEPARTMENT FAMILY SUCCESS ALLIANCE OUTSIDE AGENCY PERFORMANCE AGREEMENT FY 2018 -19 THIS AGREEMENT, made and entered into the first day of July 7018, ( "Effective Date ") by and between the County of Orange, a political subdivision of the State of North Carolina, 200 South Cameron Street, Hillsborough, North Carolina, 27278, on behalf of the Orange County Health Department ( "County") and Empowerment, Inc., located at 109 N. Graham Street, Suite 200, Chapel Hill, NC 27516 ( "Provider "). WITNESSETH: WHEREAS, it is in the interests of the County that said program be assisted by the County and thereby enhance its availability to residents of the County, and said program addresses an important community human services need, as identified by the Board of Commissioners; NOW, THEREFORE, in consideration of the above and the mutual covenants and conditions hereafter set forth, the County and Empowerment agree as follows: 1. Term of the Agreement. The term of this Agreement shall be a program year beginning July 1, 2018 to June 30, 2019. 2. Scope of Services. a. Provider will provide services, as outlined in the attached Outside Agency Funding Application Scope of Services and any amendments or revision thereto which is attached as Exhibit "A" and incorporated by reference, to the residents of Orange County. The Scope of Services may be different from the original application based on County appropriation; however, any revisions or amendments to this Agreement must be approved in writing by the County and attached to this Agreement. b. The Provider shall be solely responsible for the means, methods, techniques, sequence, safety program and procedures necessary to properly and fully complete the work set forth in the Scope of Services. 3. Funding. a. The County agrees to appropriate for the provision of services described in Exhibit A, Scope of Services and more particularly described in the Program Budget, the maximum sum of two hundred thirty eight thousand seven hundred twenty four dollars ($238,724). b. All funds appropriated shall be used for purposes described in Exhibit A. Any funds not used for the purposes stated shall be returned to the County. Any changes in the use of funds must be authorized in writing by the County prior to any expenditure of the funds by the Provider. If the funds are expended not in accordance with the Scope of Services, at the discretion of the County the Provider may be required to repay the funds to the County. c. The Provider shall be paid in monthly installments within thirty (30) days of receipt of an accounting of Provider's actual expenditures properly submitted to County. The first payment is contingent upon receipt of the fully executed agency's performance agreement in addition to an accounting of Provider's actual expenditures. Revised 512016 Page I of 6 DocuSign Envelope ID: 142010D9 -C369- 4874- 8D8D- CE32D6CD555E d. The County's obligation to make additional payments is contingent upon receipt of quarterly Progress Reports, which show satisfactory progress toward completion of performance measures and an accounting of expenditures as detailed in the attached Scope of Services. e. Once Provider has satisfied its obligations as provided in (d) final payment will be made within 21 days after receipt of the Progress Report and Request for Reimbursement or 21 days after due date of Progress Report whichever is later. f. The County is not obligated to provide any other support to Provider in this or in succeeding fiscal years. 4. Agency Reporting. a. Provider will provide Orange County a Progress Report by 10/15/18, 1/15/19, and 4/15/19 that includes a summary of satisfactory progress toward completion of performance measures. Provider will also provide a Final Report by 7/15/19 that includes a fiscal report and final evaluation and performance measures as outlined in Exhibit A. b. Provider agrees to allow the County to inspect its financial books and records, which document costs of those services, upon reasonable notice during normal working hours. 5. Termination. a. In the event of any of the circumstances set forth below (hereinafter referred to as "default "), the County may immediately terminate this Agreement, in whole or in part, and from time to time. Notice of termination must be in writing, state the reason or reasons for the termination, and specify the effective date of the termination: i. In the event that Provider shall cease to exist as an organization or shall enter bankruptcy proceedings, be declared insolvent, or liquidate all or substantially all of its assets, or significantly reduce its services or accessibility to Orange County residents during the term of this Agreement; or ii. In the event that Provider shall fail to render a satisfactory accounting as provided section 4 above, the County may terminate this Agreement and Provider shall return all payments already made to it by the County for services which have not been provided or for which no satisfactory accounting has been rendered; or iii. In the event of any fraudulent representation by the Provider in an invoice or other verification required to obtain payment under this Agreement or other dishonesty on a material matter relating to the performance of services under this Agreement. iv. Nonperformance, incomplete service or performance, or failure to satisfactorily perform any part of the work identified in the Scope of Services or to comply with any provision of this Agreement, as determined by the County in its sole discretion. v. Failure to adhere to the terms of applicable county, state or federal laws, regulations, or stated public policy. Page 2 of 6 Revised 512016 DocuSign Envelope ID: 142010D9 -C369- 4874- 8D8D- CE32D6CD555E b. In the event of default by the Provider, the county may elect to terminate this Agreement, in whole or in part and/or require the Provider to repay the funds within ten (10) business days from written notice of default. The County may (but shall not be required to) grant the Provider an opportunity to cure the default without termination of this Agreement. This clause shall not be interpreted to limit the County's remedies in law or in equity. c. Notwithstanding the foregoing, either party may terminate the agreement at any time without penalty; provided that written notice of such termination is furnished to the other party at least 30 days prior to termination. In the event of such termination, any payment due shall be prorated to the date of termination and any unused funds shall be returned to the County within 10 days of termination. d. Any termination of this Agreement for default under this section that is later deemed to be unjustified shall be deemed a termination for convenience. 6. Insurance. a. General Requirements. The Provider shall purchase and maintain, during the period of performance of this Agreement, insurance: i. Worker's Compensation. For protection from claims under workers' or workmen's compensation acts; ii. Comprehensive General Liability Insurance covering claims arising out of or relating to bodily injury, including bodily injury, sickness, disease or death of any of the Consultant's employees or any other person and to real and personal property including loss of use resulting thereof; iii. Comprehensive Automobile Liability Insurance, including hired and non -owned vehicles, if any, covering personal injury or death, and property damage; and b. Limits of Coverage: Minimum limits of insurance coverage shall be as follows: INSURANCE DESCRIPTION MINIMUM REQUIRED COVERAGE • Worker's Compensation Limits for Coverage A - Statutory State NC & Coverage B - Employers Liability $500,000 each accident, disease policy limit and disease each employee • Commercial General $1,000,000 Each Occurrence Liability $2,000,000 Aggregate • Automobile Liability $500,000 Combined Single Limit c. All insurance policies (with the exception of Worker's Compensation and Professional Liability) required under this Agreement shall name the County as an additional insured party and as a certificate holder. Evidence of such insurance and all correspondence shall be sent to: Orange County Risk Manager Post Office Box 8181 Hillsborough, NC 27278 Page 3 of 6 Revised 512016 DocuSign Envelope ID: 142010D9 -C369- 4874- 8D8D- CE32D6CD555E d. Nothing in this section is intended to affect or abrogate the County's sovereign immunity defenses. e. If County's Risk Manager determines additional insurance coverage is required such additional insurance shall consist of Sexual Abuse and Molestation Rider. Provider shall not commence work until such insurance is in effect and certification thereof has been received by the County's Risk Manager. 7. Relationship of the Parties. Provider is an independent contractor of the County. Provider represents that they have or will secure, at his own expense, all personnel required in performing the services under this Agreement. Such personnel shall not be employees or have any contractual relationship with the County. All personnel engaged in work under this Agreement shall be fully qualified and shall be authorized and permitted under federal, state and local law to perform such services. Compliance with all Laws. The Provider, at its sole expense, shall comply with all laws, ordinances, orders and regulations of the federal, state or local governments, as well as their respective departments, commissions, boards, and officers, which are in effect at the time of execution of this Agreement or are adopted at any time following execution of this agreement. 9. Subcontract. The County and Provider deem the services provided under this Agreement to be personal in nature and Provider may not subcontract any rights or duties under this Agreement to any other party without prior written consent from the County. 10. Assignment. The Provider shall not assign this Agreement, including the rights to payment, to any other party without the prior written consent of the County. 11. Indemnification. Each party shall hold the other harmless from all loss, liability, claims or expense arising from bodily injury, including death or property damage, to any person or persons caused in whole or in part by its own employees functioning under this Memorandum of Agreement and shall bear responsibility for liability, claims or expenses arising from the acts or omissions of the party's own personnel to the extent provided by North Carolina law. Nothing in this section is intended to affect or abrogate the either Party's sovereign immunity defenses. 12. Non - Appropriation. This Agreement is subject to the availability of funds to purchase the specified services and may be terminated at any time if such funds become unavailable. 13. Non - Discrimination. Provider agrees as part of consideration of the granting of funds by Orange County the parties hereto for themselves, their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race, color, gender, national origin, age, handicap, religion, sexual orientation, familial status or veterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended. This provision is enforced by action for specific performance, injunctive relief, or other remedy as by law provided; this provision shall be binding on the grantees, the successors and assigns of the parties hereto with reference to the above subject manner. 14. Living Wage. Orange County is committed to providing its employees with a living wage and encourages agencies if funds to pursue the same goal. The County's living wage is $13.75 per Page 4 of 6 Revised 512016 DocuSign Envelope ID: 142010D9 -C369- 4874- 8D8D- CE32D6CD555E hour. To the extent possible, Orange County recommends that Orange County Schools provide a living wage to its employees. 15. Notice. The Parties hereto agree and understand that written notice, mailed or delivered, to the last known address shall constitute sufficient notice to the County and the Provider. All notices required and/or made pursuant to this Agreement to be given to the County and the Provides shall be in writing and mailed to the party addressed as follows: County: Orange County Health Department ATTN: Kimberlee Quatrone Post Office Box 8181 Hillsborough, NC 27278 Provider: Empowerment, Inc. 109 N. Graham St., Suite 200 Chapel Hill, NC 27516 16. Entire Agreement. This Agreement, including any referenced attachments, constitutes the entire Agreement between the parties and shall supersede, replace or nullify any and all prior Agreements of understandings; written or oral, relating to the matters set forth herein, and any such prior Agreements or understandings shall have no force or affect whatsoever on this Agreement. The County and Provider have read this Agreement and agree to be bound by all of its terms, and further agree that this Agreement constitutes the complete and exclusive statement of the Agreement between the County and Provider. 17. Severability. All clauses found herein shall act independently of each other. If a clause is found to be illegal or unenforceable, it shall have no effect on the other provisions of this Agreement. It is understood by the parties hereto that if any part, term or provision of this Agreement is by the Courts held to be illegal or in conflict with any laws of the State of North Carolina or the United States, the validity of the remaining portions or provisions shall not be affected, and the rights and obligations of the parties shall be construed and enforced as if the Agreement did not contain the particular part, term or provision held to be invalid. 18. Governing Law. The laws of the State of North Carolina shall govern all aspects of this Agreement. In the event that it is necessary for either party to initiate legal action regarding this Agreement, venue shall lie in Orange County, North Carolina. The parties hereby waive their right to trial by jury in any action, proceeding or claim, arising out of this Agreement, which may be brought by either of the parties. By executing this Agreement Provider affirms that Provider and any subcontractors of Provider are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor, on the list created by the State Treasurer pursuant to G.S. 147 - 86.58. 19. Signatures. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the intent of the Parties to comply with Article I IA and Article 40 of North Carolina General Statute Chapter 66. IN WITNESS WHEREOF, Orange County and the Provider have signed this Agreement, effective on the last date this Agreement is signed by both parties as indicated by the dates set forth under signatures below. DocuSigned by: iPdhvus bab-� 6CE548CED19F40F... Delores Bailey "of the Provider For and on behalf of Orange County Government Page 5 of 6 Revised 512016 7/18/2018 Date DocuSign Envelope ID: 142010D9 -C369- 4674- 8D8D- CE32D6CD555E Doc u5igned by: �76GtiIn �4. R" *fir Yii 063799d6755E477. Bonnie Hammersley, County Manager Page 6 (?f 6 Revised 512016 7/19/2018 Date DocuSign Envelope ID: 142010D9 -C369- 4874- 8D8D- CE32D6CD555E EXHIBIT A Ref: Family Success Alliance Zone 6 Navigators Purpose: To provide Navigator services for the Family Success Alliance in Zone 6 as outlined in detail below and described in Exhibit B, Navigator Job Description. Protect Scope: Provider will: 1. Coordinate logistics to allow navigators to operate out of provider office. a. Provide Wi -Fi internet connection. b. Provide access to photocopier for small print jobs (less than 10 copies). Larger print jobs can be done at Orange County Health Department (OCHD). c. Provide key or other procedures to allow navigator access to the office during regularly scheduled hours. d. Provide a work space for each navigator that includes a desk, chair and access to basic office supplies (pens, notebooks, stapler, etc.). e. Offer an orientation to review office procedures and locations for supplies, printing, meeting space, and payroll procedures and reporting weekly hours. Use an orientation protocol to track topics and completion dates. f. Include navigator in agency meetings, as relevant and appropriate. g. Provide a locked location to store paper documents that only navigators are able to access. 2. Provide program support to the navigators. a. Either the Executive Director or other program staff is available to answer questions about the services of the organization or other related community -based services. b. Either the Executive Director or other program staff will provide guidance on how to assist zone families with service referrals and issues of confidentiality. c. Either the Executive Director or other program staff will work with navigators to identify areas of collaboration and partnership between provider and FSA to include client referrals, co- sponsoring of community and outreach events, and other options. d. Either the Executive Director or other program staff will be available to provide job shadowing to increase navigator understanding of the provider agency and to increase community contacts and network. e. Either the Executive Director or other program staff will provide support and guidance as needed in other unspecified areas. 3. Orientation /Training. a. OCHD and provider will discuss training needs and requirements and develop a mutually agreed upon schedule to meet the requirements. Training must include review of the Navigator Manual and its associated policies and procedures. b. Training and orientation may cause the normal work schedule to vary. 1 DocuSign Envelope ID: 142010D9 -C369- 4874- 8D8D- CE32D6CD555E EXHIBIT A c. Navigators will attend FSA Project Team meetings, held at OCHD in Hillsborough, every two weeks, a monthly partner meeting, bimonthly Advisory Council meetings and other FSA related meetings as needed. d. OCHD may request that Navigators attend additional trainings or meetings to meet the skills and knowledge required for their duties. 4. Working with the OCHD program manager, provide support for navigator performance measures outlined below. a. Community Engagement and Outreach: Navigator will be assigned 1 -2 community based organizations (ex. service providers, faith groups, neighborhood associations) to regularly attend meetings and represent the FSA project and identify opportunities for mutual support and objectives. Updates from these meetings should be shared in weekly reports and at biweekly FSA Project Team meetings. Permission to attend additional meetings or events must come from OCHD Program Manager. b. Family Engagement: Navigator team will meet performance goals as follows: • Contact 100% (n =60) of the 2018 Zone 6 Kindergarten Readiness Cohort to offer Zone Navigator support. Follow -up with those not enrolled again by January 31St 2019. • Enroll 50% (n =30) of the 2018 Zone 6 Kindergarten Readiness Cohort • Meet monthly with enrolled families from all Cohort groups. c. Family Goals: • Ensure that 50% of enrolled cohort families with children 0 -5 years old have early childhood goals. • Ensure that 80% of enrolled cohort families have completed an Education Goal Checklist for each five to eighteen year old in enrolled families. d. Resource Referrals: • Navigator will identify and connect zone families to needed resources with a goal of 8 -10 referrals per month. Referrals should be documented weekly in the Efforts to Outcomes system. i. Ensure that 80% of families with children 0 -5 years old are actively enrolled in a high quality (3 -5 star) early learning center or a parenting support class or program (e.g. Incredible Years, Orange Literacy). ii. Work to connect enrolled families with children 8 -18 years old to an adult mentor. iii. Ensure that 50% of children age 5 -18 years old in enrolled families have a structured summer activity that includes academic components. iv. Ensure that 50% of children age 5 -18 years old in enrolled families have a structured after school activity that includes academic components. e. School -based Support: Navigator will be available to zone schools on an as needed basis to support FSA - related activities. Navigator will document hours and activities in the weekly reports as a way to formalize this component of the position. 2 DocuSign Envelope ID: 142010D9 -C369- 4874- 8D8D- CE32D6CD555E EXHIBIT A f. Data Collection and forms: Navigators will use intake and other client forms created and updated by FSA program manager. Navigators will receive instruction from OCHD staff on methods for conducting ongoing needs assessment data and incorporating local knowledge and conditions into evaluation of FSA. 5. Conduct supervision of the navigators. a. Provider will review weekly activities reports and conduct a brief weekly check in with each navigator located at the agency. Provider should refer any issues that cannot be addressed internally to FSA Program Manager in a timely manner. b. Conduct formal 6 month and one year performance reviews for each Navigator located at the agency with the FSA Program Manager. 6. Provisional status and monitoring of agreement a. Hiring: Provider will coordinate with OCHD to recruit, interview and select appropriate candidates. b. Probationary period: Provider will follow internally established protocols for employee probationary period. c. Disciplinary action: Provider will follow internally established protocols for monitoring any activity or behavior that requires disciplinary action and report that to OCHD. d. Termination: Provider will follow internally established protocols for termination and will notify OCHD. Any final termination decision will be made after a meeting with OCHD program staff. e. Position Open: Should the position become open due to termination or attrition, provider and OCHD will re -open the position and re -start the hiring process outlined above with an expectation of filling the position in a 30 -day time period. New hire will start as an OCHD temp for the first 4 -6 weeks for training and orientation purposes. f. Navigator reporting: Navigator will provide written feedback to OCHD regarding any perceived violation of the agreement and OCHD will provide guidance to develop solutions amenable to all parties. OCHD Program Manager will: 1. Serve as a liaison between Provider and zone navigators. Conduct co- working sessions on site on a weekly basis. Schedule to be determined with OCHD and site supervisor. 2. Meet monthly with each navigator to review performance measures and family progress. 3. Provide assistance with logistics for monitoring navigator activities and performance, including identification of priority programs and recruitment /referrals and information for Navigators to share with families. 4. Compile program, service, and other opportunities for Zone families from community partners and send to Provider to share with Navigators. 5. Provide supplies for navigators as needed for community events and outreach. 3 DocuSign Envelope ID: 142010D9 -C369- 4874- 8D8D- CE32D6CD555E EXHIBIT A 6. Provide initial training and orientation for new navigators at the Health Department and distribute equipment (laptop computer, cell phone, client file bag and lock). Training will include use and ongoing support for the Efforts to Outcomes client database system. 7. Identify ongoing learning and training opportunities for zone navigators and send to Provider. Personnel: 4. 5 full time zone navigators Cost: Up to $266,724, of which up to $28,000 (10.5 %) will be provided by Empowerment, Inc. as an In- Kind contribution. Payment schedule is outlined in the contract. Budget Categories: (Exhibit C includes detailed budget) 1. Salaries: Will range from $15.00 - $18.36 per navigator salary schedule. 2. Payroll Taxes: Estimated at 6.2% Social Security, 1.45% Medicare, 2.496% SUTA 3. Fringe Benefits, including health insurance and workers compensation: Estimated based on 1.8% workers comp, $533.17 /month for health insurance, plus $50 monthly HSA contribution, and $45.29 /month per person for dental insurance 4. Overhead: Calculated at 15% of salary, benefits and payroll taxes 5. Mileage: Calculated at $0.545 /mile for up to 250 miles per month per full time navigator and pro- rated for navigators working less than full time 6. Training: Calculated at $500 per navigator, per year 7. Office space: $625 per month 8. Navigator supervision: $2,500 9. Payroll processing: $14.53 per month, per navigator 10. Office Supplies: $500 (can be used for furniture and other basic office supplies) 11. Neglect and Abuse Insurance: $1,738 Provider Deliverables: 1. Complete a site orientation protocol for each navigator within the first month of navigator employment with agency. 2. Review weekly activity reports from each Zone 6 Navigator. Report any concerns with navigator performance to FSA Program Manager. 3. Meet monthly with FSA Project Manager to check in and review priorities and challenges. 4. Provide timely monthly invoices. Payment will be processed within 2 -3 weeks of receipt of invoice. 5. Provide a quarterly expense and performance report (no later than October 15, January 15, April 15, and July 15) that documents each budget category and includes receipts as appropriate to FSA Project Program Manager. FSA Project Manager will provide the template to be used. 6. Conduct a formal 6 month performance review with new hires and an annual review at one year for all navigators with the FSA Program Manager. 4 DocuSign Envelope ID: 142010D9 -C369- 4874- 8D8D- CE32D6CD555E Exhibit B ,air FAMILY SUCCESS ALLIANCE Zone Navigator Job Announcement Salary: Salary based on education and experience Description: This is an invitation to join a strong team of dedicated professionals working to dramatically improve student achievement and family success for families struggling to make ends meet in the Chapel Hill /Carrboro area known as Zone 6, of the Family Success Alliance, Orange County. The position will serve as a "navigator" for families living in Zone 6 as part of the work of the Family Success Alliance. This position will be a dynamic one, responding to the needs of the community and zone partners to assist the work. Much of the work will be done in neighborhood, schools and community settings with families. We are looking for someone who knows the community and public schools well and understands the challenges faced by families living in poverty. This versatile, on the ground position, will connect with families to make program and resource referrals in areas such as housing, mental health, mentoring, health and wellness and career training and financial education while reporting on needs and obstacles to child and family success. We are looking for someone who can work independently and passionately while partnering with school staff, service providers, faith -based and community groups and neighborhood organizers and activists to develop a culture of achievement and success among all children and families in the zone. This position will be located at a local nonprofit organization. Support and supervision will be in coordination with the Family Success Alliance Program Manager located at the Orange County Health Department. Examples of Duties This position will be responsible for the long -term strategy and day to day activities required to support child and family success in Zone 6. Duties include but are not limited to: • Assist in recruiting and supporting a caseload of up to 20 families enrolled in the navigator program through monthly meetings, goal setting, resource referrals and peer support. • Act as a coach for families to model skills for parents to be their child's first teacher. • Utilize program forms to document progress in a timely, accurate manner with assigned families using a data tracking system. Training on use of the database will be provided. • Assist in recruiting and supporting families participating in summer kindergarten readiness program. • Be the go- between and "connector" between families and service providers to tailor programs to meet family needs and goals. • Support families to access needed programs and assist them in signing up and participating in programs. • Attend community meetings such as neighborhood association meetings, related local task force and /or coalition meetings to promote FSA, build relationships with other advocates and stay current on community changes, challenges and opportunities. • Document and celebrate project successes in the zone and contribute to the overall community -based identity of FSA. • Attend FSA project, partner, Advisory Council and navigator group supervision meetings and participate in overall project planning and decision - making. DocuSign Envelope ID: 142010D9 -C369- 4674- 8D8D- CE32D6CD555E Exhibit Typical Qualifications • Prefer candidates that are from the community with children that attend a zone school and can identify with families struggling to make ends meet. • Must possess strong people skills. • Ideal candidates are bilingual (Spanish) and bicultural applicants. [when applicable] • Requires a minimum combination of education and experience equivalent to a high school diploma or a GED with a preference for candidates that are enrolled in or have goals for higher education. Skills /Abilities • Ability to connect with and build trusting relationships with families struggling to make ends meet. • An excitement and passion for identifying and connecting with students and families who can benefit from program participation. • Demonstrate cultural sensitivity and the ability to work with diverse groups. • Possess a range of communication skills that can be employed in various settings and with families that are the most in need. • Uses personal experiences of overcoming obstacles as a tool for helping others build success while also maintaining professional boundaries and confidentiality. Knowledge • Candidates should be resourceful and knowledgeable of community resources, with a working knowledge of county /municipal systems and agencies that support children and families. • An understanding of the role that structural barriers play in health and academic disparities is preferable. • Knowledge of the history of the community and the ways that may shape local culture, and individual behavior and identity. • Knowledge of neighborhoods located in the zone and zone schools. Requirements • This position requires transportation and some night and weekend hours. DocuSign Envelope ID: 142010D9 -C369- 4874- 8D8D- CE32D6CD555E EMPOWERMENT Family Success Alliance Number of Hours FTE # months Salary Rate of Pay Bi- weekly Rate of Pay per Month Monthly Subtotal Taxes Social Security- Co Paid 6.2% of S &W Medicare - Co Paid 1.45% of S &W SUTA Tax - Co Paid 2.496% of S &W Monthly Subtotal Benefits Navigator FT (40 1 hours) 3 40 FT Hourly 40 1.0 FTE 1.0 12 12 $ 18.36 $38,188.80 $ 16.32 $3,182.40 3,182.40 $2,828.80 3,182.40 Navigator FT (40 Navigator PT (30 hours) 0.5 hours) FT Hourly 20 PT Hourly FTE 0.5 FTE 11 $33,945.60 $ 17.00 $17,680.00 2,828.80 $1,473.33 1,473.33 2,828.80 1,473.33 6.20% 197.31 6.20% 175.39 6.20% 91.35 1.45% 46.14 1.45% 41.02 1.45% 21.36 2.496% 79.43 2.496% 70.61 2.496% 36.77 50.00 322.89 50.00 287.01 50.00 149.48 Worker's Compensation 1.8% of S &W 1.80% 57.28 1.80% 50.92 1.80% 26.52 Company Paid Health Ins $533.17/mo EE +ER 533.17 533.17 533.17 533.17 533.17 533.17 Health Savings Account $50.00 /mo EE 50.00 50.00 50.00 50.00 50.00 50.00 Company Paid Dental Ins $45.29/mo EE 45.29 45.29 45.29 45.29 45.29 45.29 Monthly Subtotal 1 3 685.74 679.38 # Full Time 654.98 Payroll Processing $14.53/mo 14.53 14.53 14.53 14.53 14.53 14.53 Monthly subtotal 14.53 14.53 14.53 Total Monthly Cost 4,205.56 3,809.72 2,292.33 Total Annual Salary, Taxes, Benefits & Payroll per Navigator 50,466.72 45,716.63 27,507.94 Total Salary, Benefits & Taxes (annual) $ 50,292.36 $ 136,626.81 $ 25,055.78 15% Overhead (annual) 7,543.85 20,494.02 3,758.37 Training $500 per Navigator (annual) 500.00 500.00 500.00 Mileage per Navigator (.545/m x 250 m /mo) per FTE 1,635.00 1,635.00 817.50 Number of Navigators 1 3 1 # Full Time # Full Time # Part Time Office Space ($625/mo) Navigator Supervision ($2500) Neglect & Abuse Insurance Policy (flat amount) Office Supplies Annual Budget Total 156,232.27 Salary Subtotal 15,851.33 Taxes Subtotal 39,891.37 Benefits Subtotal 857.27 Payroll Subtotal 4.5 215,124.56 Salary, Taxes, Benefits, Payroll Subtotal 214,267.29 Salary, Taxes, Benefits Subtotal 31.796.24 Overhead Subtotal 2,500.00 Training Subtotal 7,357.50 Mileage Subtotal 7,500.00 Office Space Subtotal 2,500.00 Supervision Subtotal 1,738.00 Insurance Subtotal $500.00 Total Project Cost 266,723.97 Amount of In -Kind Funds Contributed by Empowerment, Inc. 28,000.00 Amount Due Empowerment by Orange County Health Department 238,723.97 DocuSign Envelope ID: 142010D9 -C369- 4874- 8D8D- CE32D6CD555E EMPOINC -01 DMASON AC ©�� CERTIFICATE OF LIABILITY INSURANCE �� DATE(MMIDDIYYYY) 06/27/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: PHONE FAX (A/C, No, Ext): (919) 968 -4472 (A/C, No): (919) 942 -4221 Summers Thompson Lowry, Inc. 100 Europa Drive Suite 571 ADDRESS: info @STLinsure.com Chapel Hill, NC 27517 -2393 INSURERS AFFORDING COVERAGE NAIC # INSURER A: First Nonprofit Insurance Co INSURED INSURER BJechnollogy Insurance Company Inc 42376 INSURER C X Empowerment, Inc. Delores Bailey NPP1005089 06/16/2018 109 N. Graham St. #200 INSURER D: DAMAGE TO RENTED PREMISES Ea occurrence INSURER E: Chapel Hill, NC 27516 -2328 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM DD YYYY POLICY EXP MM DD YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X DWI OCCUR X NPP1005089 06/16/2018 06/16/2019 DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY El PECOT- [::] LOC PRODUCTS - COMP /OP AGG $ $ OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR /PARTNER/EXECUTIVE TWC3715015 06/16/2018 06/16/2019 X PER OTH- STATUTE ER E.L. EACH ACCIDENT 500,000 $ OFFICER /MEMBER EXCLUDED? ❑ (Mandatory in NH) N/A E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 500,000 $ A General Liability NPP1005089 06/16/2018 06/16/2019 Occurrenc 1,000,000 A Sexual Abuse & Moles NPP1005089 06/16/2018 06/16/2019 Per Occurence 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is additional insured as respects written contract. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2016/03) @ 1988 -2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange Count Government 9 Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 8181 Hillsborough, INC 27278 AUTHORIZED REPRESENTATIVE l.I F� S , 5 ACORD 25 (2016/03) @ 1988 -2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD