A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, APPROVING, IN SUBSTANTIAL FORM, AMENDMENT NO. 8 TO THE MEMORANDUM OF UNDERSTANDING (MOU), DATED JULY 26, 2016, BETWEEN THE CITY AND THE MIAMI BEACH CHAMBER EDUCATION FOUNDATION, INC. (MBCEF); SAID AMENDMENT: (1) APPROVING HAZEL HEALTH, INC. (HAZEL) AND TELEHEALTH SERVICES USA, INC. D/B/A HAZEL HEALTH SERVICES (HAZEL SERVICES) (COLLECTIVELY, HAZEL HEALTH), AS THE CURRENT PROVIDER OF TELEHEALTH-BASED PRIMARY CARE, THERAPY AND COUNSELING SERVICES FOR THE SCHOOL BOARD OF MIAMI-DADE COUNTY (SCHOOL BOARD), IN ORDER TO FILL VACANCIES FOR THESE SERVICES AT CITY SCHOOLS, COMMENCING DURING THE 2023-2024 SCHOOL YEAR, AND EVERY YEAR THEREAFTER, AS NEEDED; AND (2) AUTHORIZING MBCEF, AS THE CITY'S FISCAL AGENT, TO NEGOTIATE AND EXECUTE ANY REQUIRED AGREEMENTS WITH THE SCHOOL BOARD AND/OR HAZEL HEALTH TO FUND THE SERVICES PROVIDED BY HAZEL HEALTH; AND AUTHORIZING MBCEF TO EXECUTE FUTURE FUNDING AGREEMENTS, WHICH MAY INCLUDE OTHER PROVIDERS, APPROVED BY THE SCHOOL BOARD FOR SIMILAR SERVICES, IN CONNECTION WITH THE FULFILLMENT OF THE NURSE ENHANCEMENT INITIATIVE; AND FURTHER AUTHORIZING THE CITY MANAGER AND CITY CLERK TO EXECUTE THE AMENDMENT.

The Administration recommends that the Mayor and City Commission adopt the Resolution.

The Education Compact with Miami-Dade County Public Schools (M-DCPS), established on January 16, 2008, includes the outcome to increase the health and well-being of students in Miami Beach public schools.  The activities included in the Compact agreement to support this outcome include the following:

·       The school District will maintain health clinics (nurse practitioners and/or registered nurses) at Fienberg-Fisher, Biscayne, Nautilus, and Miami Beach Senior High, subject to continued available funding, and will work with all Miami Beach schools to coordinate visits from the Health Connect on Wheels service (as available) or similar service to schools and/or Miami Beach recreation centers;

·       The District and the City will collaborate to deliver information regarding health and wellness education, prevention and intervention strategies regarding nutrition, physical activity levels, and health maintenance in accordance with the District’s Wellness Initiative;

·       The City will explore the development of a middle school-level after-school program. The District will collaborate with the City by assisting with the recruitment of students, including providing space within District-owned facilities as needed, and exploring expanded transportation options for participating students; and,

·       District will explore the expansion of full-time nurse practitioners and/or registered nurses at schools without health clinics, subject to available funding.

In the 2013-14 School Year, a municipal Nurse Initiative was implemented pursuant to a Memorandum of Understanding between the Participating Municipalities to provide a HCIOS team of professionals including a shared Registered Nurse, a full-time Medical Assistant, and a social worker, which is already funded by Miami-Dade County Public Schools for the 2013-14 School Year and the 2014-15 School Year. 

The benefits of HCIOS health teams include: a coordinated level of school-based healthcare, expanded health screenings, and assessments with access to follow-up care, mental and behavioral health services to identify and solve student health and educational issues, nutrition and health counseling, heath services for uninsured students with no other option for access to health care, emergency first aid/CPR, and chronic disease management.

By approval of Resolution 2015-42 on February 9, 2015, The Children’s Trust Board of Directors approved the release of RFP 2015-17:  School Health Programs to fund improved access to quality health care through providers delivering comprehensive services in the public schools to 145 pre-selected schools for School Years 2015-16, 2016-17, and 2017-18; the programs which are the subject of the RFP include all three (3) Miami Beach schools in the City’s original Nurse Initiative.

Due to the success of Nurse Initiatives in School Years 2013-2014 and 2014-2015 and the Enhanced Nurse Initiative in School Year 2015-2016, which were established at North Beach Elementary, Treasure Island Elementary, and Ruth K. Broad K-8 Center, Commissioner Steinberg made a motion at the April 13, 2016 (Item R9AA) Commission meeting, which was supported unanimously, to continue and expand behavioral health services for public schools within the City by providing for a licensed clinical social worker one day a week at Miami Beach Senior High School, Nautilus Middle School, Feinberg-Fisher K-8 Center, Biscayne Elementary School, and South Pointe Elementary School (the “Participating Schools”) for the 2016-2017 School Year and additional school years as well.

On July 26, 2016 the Miami Beach Chamber Education Foundation Inc. entered into a Memorandum of Understanding, for the extension of the Miami Beach Nurse Enhancement Initiative for behavioral health services, for these participating schools during the 2016-2017 school year.

Pursuant to Resolution No. 2016-29345, the Nurse Enhancement Initiative was continued for North Beach Elementary, Treasure Island Elementary, and Ruth K. Broad Bay Harbor K-8 Center, and, pursuant to Resolution No. 2016-29468, was expanded to include Miami Beach Senior High School, Nautilus Middle School, Fienberg Fisher K-8 Center, Biscayne Elementary School, and  South Pointe Elementary School (collectively, the “Participating Schools”), by providing for a licensed clinical social worker one day a week at each of the Participating Schools.

On May 25, 2017, the City and Miami Beach Chamber Education Foundation Inc. executed Amendment No. 1 to the MOU, continuing the Miami Beach Nurse Enhancement Initiative for the 2017-2018 school year.

On April 11, 2018, the Mayor and City Commission adopted Resolution No. 2018-30259, approving the expansion of mental health services at all public City elementary and middle schools, in an amount not to exceed $60,000. Resolution No. 2018-30259 increased funding for behavioral health services for the Miami Beach Nurse Enhancement Initiative for the 2018-2019 school year, providing funding for two (2) licensed clinical social workers, or agreed upon equivalent professional, at each of the following City schools for the indicated number of days: Miami Beach Senior High School, one (1) day; Nautilus Middle School, two (2) days; Fienberg Fisher K-8 Center, two (2) days; Biscayne Elementary School, two (2) days; South Pointe Elementary School, two (2) days; and North Beach Elementary, one (1) day, (collectively, the “City’s Participating Schools”); in a total amount not to exceed $114,000.

On August 30, 2018 the City and Miami Beach Chamber Education Foundation Inc. executed Amendment No. 2 to the MOU, continuing the Miami Beach Nurse Enhancement Initiative for the 2018-2019 school year.

On June 5, 2019, the Miami-Dade County Public School Board adopted a resolution relating to Item D-67, renaming Biscayne Elementary School to Biscayne Beach Elementary School; South Pointe Elementary to Miami Beach South Pointe Elementary; Nautilus Middle School to Miami Beach Nautilus Middle School; and Fienberg Fisher K-8 Center to Miami Beach Fienberg Fisher K-8.

Miami Beach Chamber Education Foundation Inc. provided funding, in an amount not to exceed $40,000.00, to support the Miami Beach Nurse Enhancement Initiative for the 2019-2020 school year with funds to be used from August 5, 2019 – June 5, 2020 and remaining funds to be used from August 5, 2020 to June 5, 2021. The City contributed funding in the amount of $139,000 (the “City’s Contribution”) to support the Miami Beach Nurse Enhancement Initiative for the 2019-2020 school year.

The Miami Beach Nurse Enhancement Initiative for behavioral health services for the City’s Participating Schools (the “Initiative”) for the 2019-2020 school year was established pursuant to, and as part of, a separate agreement to be entered into between Miami Beach Chamber Education Foundation Inc., The Trust and a healthcare provider approved by The Trust (the “Provider”) to provide for the staffing and the payment of certain costs associated with the Nurse Enhancement Initiative for the Participating Schools, for a total minimum global sum of $232,600.00, pursuant to which the City’s Participating Schools may receive additional days of service.

On September 11, 2019, the Mayor and City Commission adopted Resolution No. 2019-30957, approving Amendment No. 3 to the Memorandum of Understanding (“MOU”), dated July 26, 2016,  between the City of Miami Beach and the Miami Beach Chamber Education Foundation Inc. for the extension of the Miami Beach Nurse Enhancement Initiative for behavioral health services (the "Initiative") for Miami Beach Senior High School, Miami Beach Nautilus Middle School, Miami Beach Fienberg Fisher K-8 , Biscayne Beach Elementary School, North Beach Elementary, and Miami Beach South Pointe Elementary School.

Amendment No. 3 provided Initiative services for the 2019-2020 school year, in the amount not to exceed $139,000 (“City's Contribution”); and approved the City's Contribution to the Initiative for each subsequent school year, on a recurring basis, subject to funding approval during the City's budgetary process and provided that the City's Contribution amount does not exceed $139,000; and further authorized the City Manager and City Clerk to execute any and all required agreements and documents to implement the program.

Initiative services were not provided to some schools in the 2022-23 school year due to staffing challenges of our partners: Miami Beach South Pointe Elementary School, Miami Beach Fienberg Fisher K-8, Miami Beach Nautilus Middle School, and Biscayne Beach Elementary School. Alternate service models are being explored to fill the open mental health professional position for the 2023-24 school year to ensure services are available for all youth.

As of August 30, 2021, Miami-Dade County Public Schools entered an agreement with Hazel Health, Inc., a Delaware corporation (“Hazel”) and Telehealth Services USA, Inc., a California corporation, d/b/a Hazel Health Services (“Hazel Health Services”) (collectively, Hazel and Hazel Health Services shall be collectively referred to herein as “Hazel Health”) to provide therapy, counseling and non-clinical services such as telehealth technology, training, and technology support services.

As of December 8, 2023, Miami-Dade County Public Schools entered an agreement to extend the terms of the agreement with Hazel Health through the remainder of 2024.

Hazel Health shall provide the telehealth-based primary care, counseling and mental health services for students at Miami Beach Nautilus Middle, Miami Beach Fienberg Fisher K-8 Center,

Miami Beach South Pointe Elementary, and Biscayne Beach Elementary within the budget currently allocated for these services.

Hazel Health Services will provide suite of telehealth mental health services. Services include conducting behavioral health assessments, crisis consultation for the district to include clinical support for District staff, students and parents. Conducting care management activities including transitioning care to a long-term provider for long term care or psychiatry. 

District Technology and Support Requirements: The district shall provide its own Internet telecommunication lines necessary to effectively run the telehealth systems and equipment at District’s school(s), including all costs associated with installation (if needed), maintenance and monthly availability fees. District is responsible for providing its own information technology support staff for its equipment, connectivity, software, and technology.

District School Training: During the initial on-boarding and setup following the Effective Date, Hazel Health will be responsible for providing initial training and orientation to appropriate staff designated by District on telehealth technology utilized at District location(s). District agrees to fully collaborate with Hazel Health through this period of training and implementation. After the initial implementation and training performed by Hazel Health, District is solely responsible to provide ongoing training to its staff unless it elects to purchase additional optional training from Hazel Health.

The City seeks to add Hazel Health as a provider for the Nurse Enhancement Initiative, commencing for the 2023-2024 school year, to fill in the gap for these services at the City’s Participating Schools, and every year thereafter, as may be needed, to fulfill the Nurse Enhancement Initiative for behavioral health services for all of the participating schools.  In order to utilize the services of Hazel Health, the Miami Beach Chamber Education Foundation, Inc. would need to execute an agreement with the School Board and/or Hazel Health, which agreement would allow the Miami Beach Chamber Education Foundation, Inc., as the City’s fiscal agent, to fund the primary care, therapy, and counseling services provided by Hazel Health, as needed. 

For the 2023-2024 school year, the Miami Beach Chamber Education Foundation, Inc. would be negotiating and executing an agreement with the School Board and Hazel Health, in a form similar to the draft Master Service Agreement attached hereto.  The cost for the services to be provided by Hazel Health would be paid from previously approved funding for Fiscal Year 2023-2024, and prospectively would not increase the total approved cap for the City’s Contribution, in the annual amount of $139,000.00.

The City Manager recommends approving, in substantial form, Amendment No. 8 to the MOU, a draft copy of which is attached hereto; said Amendment approving Hazel Health, as the current provider of telehealth-based primary care, therapy and counseling services for the School Board, and authorizing , the Miami Beach Chamber Education Foundation, Inc., as the City’s fiscal agent, to negotiate and execute any required agreements with the School Board and/or Hazel Health, in order to fund primary care, therapy and counseling services, as needed, for the participating schools, commencing for the 2023-2024 school year.

Additionally, the City Manager recommends authorizing the Miami Beach Chamber Education Foundation, Inc. to execute future funding agreements, which may include other providers, approved by the School Board of Miami-Dade County for similar services, in connection with the fulfillment of the Nurse Enhancement Initiative.