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Item O3 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: June 15, 2005 Division: County Administration Bulk Item: Yes No Department: County Administration Staff Contact Person: Thomas Willi AGENDA ITEM WORDING: Approval of Addendum to Agreement with the State of Florida Department of Health for the operation of the Monroe County Health Department. ITEM BACKGROUND: The Board of County Commissioners approved a Contract on January 19, 2005 with the Monroe County Health Department for their operation for Contract Year 2004-2005. The Health Department is requesting additional funding of $250,000 to complete the construction and furnishing of an allotted space in the Roth Building that will be used for public health selVices. As per this Addendum, these additional funds shall be reimbursed to the County. PREVIOUS RELEVANT BOCC ACTION: As stated above. CONTRACT/AGREEMENT CHANGES: Allocation of an additional $250,000 to be reimbursed to the County from the Health Department. STAFF RECOMMENDATIONS: Approval. TOTAL COST: $250,000 BUDGETED: Yes No COST TO COUNTY: $250.000 SOURCE OF FUNDS: REVENUE PRODUCING: Yes No AMOUNTPERMONTH_ Year APPROVED BY: County Atty _ OMB/Purchasing _ Risk Management_ DIVISION DIRECTOR APPROVAL: g~ J. Wifli Thomas 1. Willi DOCUMENTATION: Included X Not Required_ DISPOSITION: AGENDA ITEM # ADDENDUM TO AGREEMENT This Addendum to Agreement is made and entered into by MONROE COUNTY (COUNTY), a political subdivision of the State of Florida, whose address is 1100 Simonton Street, Key West, FL 33040, and the State of Florida Department of Health (STATE) as the contracting agent for the Monroe County Health Department, a public agency of the State of Florida, whose address is 1100 Simonton Street, Key West, Fl. 33040. WHEREAS, the parties did enter into an agreement dated January 16, 2005, for the provision of core services for fiscal year 2004-2005; and WHEREAS, the STATE has been allotted space in the newly renovated Roth Building, previously know as Old Mariner's Hospital; and WHEREAS, the STATE provided an allocation in Exhibit V to the aforementioned contract to cover $250,000 of its share of the cost of renovation; and WHEREAS, the STATE now has no money to cover its share of the cost of renovation; NOW THEREFORE, in consideration of the following mutual promises, the parties agree as follows: 1. Paragraph 4 of the agreement dated January 19, 2005, shall be revised to read as follows: 4. FUNDING. The parties further agree that funding for the CHD will be handled as follows: a. The funding to be provided by the parties and any other sources are set forth in Part II of Attachment II hereof. This funding will be used as shown in Part I of Attachment II. i. The State's appropriated responsibility (direct contribution excluding any state fees, Medicaid contributions or any other funds not listed in Schedule C) as provided in Attachment II, Part II is an amount not to exceed $4,285,415 (State General Revenue, Other State Funds and Federal Funds fisted on the Schedule C). The State's obligation to pay under this contract is contingent upon an annual appropriation by the Legislature. ii. The County's appropriated responsibility (direct contribution excluding any fees, other cash or local contributions) as provided in Attachment II, Part II is an amount not to exceed $417,575 (amount listed under the "Board of County Commissioners Annual Appropriations section of the Revenue attachment) . b. Overall expenditures will not exceed available funding or budget authority, whichever is less (either current year or from surplus trust funds) in any service category. Unless requested otherwise, any surplus at the end of the term of this Agreement in the County Health Department Trust Fund that is attributable to the CHD shall be reimbursed to COUNTY to cover its advance of the $250,000 cost of renovating the Roth Building, and if any amount remains thereafter, that surplus shall be carried forward to the next contract period. 2. Paragraph 6.e. of the agreement dated January 19, 2005, shall be revised to read as follows: 6. e. That any surplus/deficit funds, including fees or accrued interest, remaining in the County Health Department Trust Fund account at the end of the contract year shall be credited to the County to the extent necessary to cover the $250,000 advance of the costs to renovate the Roth Building space allotted to the Health Department. Any monies remaining thereafter shall be credited or debited to the State or County, as appropriate, based on the funds contributed by each and the expenditures incurred by each. Expenditures will be charged to the program accounts by state and County based on the ratio of planned expenditures in the Core Contract and funding from all sources is credited to the program accounts by State and County. The equity share of any surplus/deficit funds accruing to the State and County is determined each month and at contract year-end. Surplus funds may be applied toward the funding requirements of each participating governmental entity in the following year. However, in each such case, all surplus funds, including fees and accrued interest, shall remain in the trust fund until accounted for in a manner which clearly illustrates the amount which has been credited to each participating governmental entity. The planned use of surplus funds shall be reflected in Attachment II, Part I of this contract, with special capital projects explained in Attachment V. 3. Attachment IV and Attachment V of the agreement dated January 19, 2005, shall be revised to read as depicted in the attachments IV and V, attached hereto and incorporated herein by reference. 4. The remaining terms of the Agreement entered January 19, 2005 I not inconsistent herewith, shall remain in full force and effect. IN WITNESS WHEREOF, the parties have caused these presents to be executed in their respective names. BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA Attest: DANNY L. KOLHAGE, CLERK By: By: Mayor Dixie M. Spehar Deputy Clerk STATE OF FLORIDA DEPARTMENT OF HEALTH Attest: By: John O. Agwunobi, M.D., M.B.A., By: M/P.H Susana May, M.D., M.P.H. CRD Director! Administrator Secretary of the Department ATTACHMENT IV FACILITIES UTILIZED BY THE MONROE COUNTY HEALTH DEPARTMENT Facility Number of Description Owner Square Location Foota2:e Emplovees GA TO Building 1100 Simonton Street 42 County AdminINursinglEnvHealth Key West, FL 33040 8,691 s.f. Health Care Center Lease 1200 Kennedy Drive 3,000 s.f. 9 Key West, FL 33040 Roosevelt Sands Center 105 Olivia Street 6 Lease Key West, FL 33040 2,000 s.f. Ruth Ivins Center 9 for Public Health 3333 Overseas Highway 5,000 s.f. County Marathon, FL 33050 Environmental Health 13367 Overseas Highway Lease MOlioe CHD Marathon, FL 33050 1,250 s.f. 7 Roth Building County 51 Highpoint Road 5,000 s.f. 20 Tavernier, FL 33070 ATTACHMENT V MONROE COUNTY HEALTH DEPARTMENT SPECIAL PROJECT SAVINGS PLAN IDENTIFY THE AMOUNT OF CASH THAT IS ANTICIPATED TO BE SET ASIDE ANNUALLY FOR THE PROJECT. CONTRACT YEAR STATE COUNTY TOTAL 2002-2003 $ $ $ 2003- 2004 $ $ $ 2004-2005 $ 150,000 $ $ - 150,000 2005-2006 $ 250,00 $ $- 250,000 2006-2007 $ $ $ PROJECT TOTAL $ 400~000 $ $ 400~000 SPECIAL PROJECT CONSTRUCTION/RENOV ATION PLAN PROJECT TITLE: Upper Kevs CHD~ Mariner's Hospital LOCATION: 60 Hieh Point Road~ Plantation Kev~ Florida CATEGORY: NEW FACIL TY ROOFING RENOVCATION --K- NEW ADDITION PLANNING STUDY SQUARE FOOTAGE: 5.747 PROJECT SUl\1l\1ARY: Construction and Renovation: site work, installation of utilities, landscaping, restoration of structural shell, new interior walls, doors, windows, hardware, carpet, vinyl, tile, plumbing and electrical. Furnishings and Equipment: medical equipment, office furnishings, filing systems, phone equipment and wiring, technology equipment and wiring, technology software. ESTIMATED PROJECT INFORMATION: START DATE (initial expenditure of funds) COMPLETION DATE: January -05 June--05 DESIGN FEES: CONSTRUCTION COSTS: FURNITUREIEQUIPMENT TOTAL PROJECT COST: COST PER SQ. FOOT: $ 2~ 700 $ 250~000 $ 200.000 $ 452~ 700 $ 44.00 j \ ^' CONT~CT BETWEEN MONROE COUNTY SOArfo OF COUNTY COMMISSIONERS AND STATE OF FLORIDA DEPARTMENT OF HEALTH FOR OPERATION OF THE MONROE COUNTY HEALTH DEPARTMENT CONTRACT YEAR 2004.2005 This agreement ("Agreement") is made and entered into between the State of Florida, Department of Health C'State") and the Monroe County Board of County Commissioners ("County"), through their undersigned authorities, effective October 1, 2004. RECITALS A. Pursuant to Chapter 154, F.S., the intent of the legislature is to "promote, protect, maintain, and improve the health and safety of all citizens and visitors of this state through a system of coordinated county health department services." B. County Health Departments were created throughout Florida to satisfy this legislative intent through "promotion of the pUblic's health, the control and eradication of preventable diseases, and the provision of primary health care for special populations." C. Monroe County Health Department ("CHD") is one of the County Health Departments created throughout Florida. It is necessary for the parties hereto to enter into this Agreement in order to assure coordination between the State and the County in the operation of the CHD. NOW THEREFORE, in consideration of the mutual promises set forth herein, the sufficiency of which are hereby acknowledged, the parties hereto agree as follows: 1. RECITALS. The parties mutually agree that the forgoing recitals are true and correct and incorporated herein by reference. 2. TERM. The parties mutually agree that this Agreement shall be effective from October 1, 2004, through September 30, 2005, or until a written agreement replacing this Agreement is entered into between the parties, whichever is later, unless this Agreement is otherwise terminated pursuant to the termination provisions set forth in paragraph 8, below. 3. SERVlCI;S MAINTAINED BY THE CHD. The parties mutually agree that the CHD shall provide those services as set forth on Part III of Attachment II hereof, in order to maintain the following three levels of service pursuant to Section 154.01 (2), Florida Statutes, as defined below: a. llEnvironmental health services~ are those services which are organized and operated to protect the health of the general public by monitoring and regulating activities ., ~.~'-'-~~--------,~-. .'_.'~___,_",,,,.,,.__.,'._...h~~.~, funds and shall include those services mandated on a state or federal level. Examples of environmental health services include, but are not limited to, food hygiene, safe drinking water supply, sewage and solid waste disposal, swimming pools, group care facilities, migrant labor camps, toxic material control, radiological health, occupational health. b. "Communicable disease control services" are those services which protect the health of the general public through the detection, control, and eradication of diseases which are transmitted primarily by human beings. Communicable disease services shall be supported by available federal, state. and local funds and shall include those services mandated on a state or federal level. Such services include, but are not limited to, epidemiology, sexually transmissible disease deteetion and control, HIV/AIDS, immunization, tuberculosis control and maintenance of vital statistics. c. "Primary care serviees" are acute care and preventive services that are made available to well and sick persons who are unable to obtain such services due to lack of income or other barriers beyond their control. These services are provided to benefit individuals, improve the collective health of the public, and prevent and control the spread of disease. Primary health care services are provided at home, in group settings, or in clinics. These services shall be supported by available federal, state, and local funds and shall include services mandated on a state or federal level. Examples of primary health care services include, but are not limited to: first contact acute care services; chronic disease detection and treatment; maternal and child health services; family planning; nutrition; school health; supplemental food assistance for women, infants, and children; home health; and dental services. 4. FUNDING. The parties further agree that funding for the CHD will be handled as follows: a. The funding to be provided by the parties and any other sources are set forth in Part II of Attaehment II hereof. This funding will be used as shown in Part I of Attachment II. i. T he State's appropriated responsibility (direct contribution excluding any state fees, Medicaid contributions or any other funds not listed on the Schedule C) as provided in Attachment II, Part II is an amount notto exceed $ 4,285.415 (State General Revenue. Other State Funds and Federal Funds listed on the Schedule C). The State's obligation to pay under this contract is contingent upon an annual appropriation by the Legislature. ii. The County's appropriated responsibility (direct contribution excluding any fees. other cash or local contributions) as provided in Attachment II, Part 1/ is an amount not to exceed $ 417,575 (amount listed under the "Board of County Commissioners Annual Appropriations section of the re venue attachment). b. Overall expenditures will not exceed available funding or budget authority, whichever is less, (either current year or from surplus trust funds) in any service category. Unless requested otherwise, any surplus at the end of the term of this Agreement in the County Health Department Trust Fund that is attributed to the CHD shall be carried forward to the next contract period. 2 ""~~----+"Yrl---ro_'_'."_'.m__c_n'~_.~____a_ e_ c. Either party may establish service fees as allowed by law to fund activities of the CHD. Where applicable, such fees shall be automatically adjusted to at least the Medicaid fee schedule. Fees are listed in Attachment II Part II of this contract and in the Environmental Health Fee Schedule that is provided by the Environmental Health Program Office. The estimated annual environmental health fee revenues accruing to the County Health Department Trust Fund are listed on Attachment VI. d. Either party may increase or decrease funding of this Agreement during the term hereof by notifying the other party in writing of the amount and purpose for the change in funding. If the State initiates the increase/decrease, the CHD will revise the Attachment II and send a copy of the revised pages to the County and the Department of Health, Bureau of Budget Management. If the County initiates the increase/decrease. the County shall notify the CHD. The CHD will then revise the Attachment II and send a copy of the revised pages to the Department of Health, Bureau of Budget Management. e. The name and address of the official payee to who payments shall be made is: County Health Department Trust Fund Monroe County 1100 Simonton Street Post Office Box 6193 Key West, FL 33041-6193 5. CHD DIRECTOR/ADMINISTRATOR. Both parties agree the director/administrator of the CHD shalf be a State employee or under contract with the State and will be under the day-to-day direction of the Deputy State Health Officer. The director/administrator shall be selected by the State with the concurrence of the County. The director/administrator of the CHD shall insure that non-categorical sources of funding are used to fulfill public health priorities in the community and the Long Range Program Plan. A report detailing the status of public health as measu red by outcome measures and similar indicators will be sent by the CHD director/administrator to the parties no later than October 1 of each year (This is the standard quality assurance "County Health Profile" report located on the Office of Planning, Evaluation & Data Analysis Intranet site). 6. ADMINISTRATIVE POLICIES AND PROCEDURES. The parties hereto agree that the following standards should apply in the operation of the CHD: a. The CHD and its personnel shall follow all State policies and procedures, except to the extent permitted for the use of county purchasing procedures as set forth in subparagraph b., below. All CHD employees shall be State or State-contract personnel subject to State personnel rules and procedures. Employees will report time in the Client Information System/Health Management Component compatible format by program component as specified by the State. b. The CHD shall comply with all applicable provisions of federal and state laws and regulations relating to its operation with the exception that the use of county purchasing procedures shall be allowed when it will result in a better price or service and no statewide 3 ,.._.,..M_"._~ ~~-----. CC.C_~U'"-'--+~C. _..___._ Department of Health purchasing contract has been implemented for those goods or services. In such cases, the CHD director/administrator must sign a justification therefore, and all county-purchasing procedures must be followed in their entirety, and such compliance shall be documented. Such justification and compliance documentation shall be maintained by the CHD in aecordance with the terms of this Agreement. State proeedures must be followed for all leases on facilities not enumerated in Attachment IVo c. The CHD shall maintain books, records and documents In accordance with those promulgated by the Generally Accepted Accounting Principles (GAAP) and Governmental Accounting Standards Board (GASS), and the requirements of federal or state law. These records shall be maintained as required by the Department of Health Policies and Procedures for Records Management and shall be open for inspection at any time by the parties and the public, except for those records that are not otherwise subject to disclosure as provided by I aw which a re subject to the confidentiality provisions of paragraph 6.1., below. Books, records and documents must be adequate to allow the CHD to comply with the following reporting requirements: i. The revenue and expenditure requirements in the Florida Accounting System Information Resource (FLAIR). ii. The client registration and services reporting requirements of the minimum data set as specified In the most current version of the Client Information System/Health Management Component Pamphlet; iii. Financial procedures specified in the Department of Health's Accounting Procedures Manuals, Accounting memoranda, and Comptroller's memoranda; iv. The CHD is responsible for assuring that all contracts with service providers include provisions that all subcontracted services be reported to the CHD in a manner consistent with the client registration and service reporting requirements of the minimum data set as specified in the Client Information System/Health Management Component Pamphlet d. All funds for the CHD shall be deposited in the County Health Department Trust Fund maintained by the state treasurer. These funds shall be accounted for separately from funds deposited for other CHDs and shall be used only for public health purposes in Monroe County. e. That any surplus/deficit funds, including fees or accrued interest, remaining in the County Health Department Trust Fund account at the end of the contract year shaH be credited/debited to the state or county, as appropriate, based on the funds contributed by each and the expenditures incurred by each. Expenditures will be charged to the program accounts by state and county based on the ratio of planned expenditures in the core contract and funding from all sources is credited to the program accounts by state and county. The equity share of any surplus/deficit funds accruing to the state and county is determined each month and at contract year-end. Surplus funds may be applied toward 4 the funding requirements of each participating governmental entity in the following year. However, in each such case, all surplus funds, including fees and accrued interest, shall remain in the trust fund until aceounted for in a manner which clearly illustrates the amount which has been credited to each participating governmental entity. The planned use of surplus funds shall be reflected in Attachment II, Part I of this contract, with special capital projects explained in Attachment v. f. There shall be no transfer of funds between the three levels of services without a contract amendment unless the CHD director/administrator determines that an emergency exists wherein a time delay would endanger the public's health and the Deputy State Health Officer has approved the transfer. The Deputy State Health Officer shall forward written evidence of this approval to the CHD within 30 days after an emergency transfer. g. The CHD may execute subcontracts for services neeessary to enable the CHD to carry out the programs specified in this Agreement. Any such subcontract shall include all aforementioned audit and record keeping requirements. h. At the request of either party, an audit may be conducted by an independent CPA on the financial records of the CHD and the results made available to the parties within 180 days after the close of the CHD fiscal year. This audit will follow requirements contained in OMB Circular A-133 and may be in conjunction with audits performed by county government. If audit exceptions are found, then the director/administrator of the CHD will prepare a corrective action plan and a copy of that plan and monthly status reports will be furnished to the contract managers for the parties. i. The CHD shall not use or disclose any information concerning a recipient of services except as allowed by federal or state law or policy. j. The CHD shall retain all client records, financial records, supporting documents, statistical records, and any other documents (including electronic storage media) pertinent to this Agreement for a period of five (5) years after termination of this Agreement. If an audit has been initiated and audit findings have not been resolved at the end of five (5) years, the records shall be retained until resolution of the audit findings. k. The CHD shall maintain confidentiality of all data, files, and records that are confidential under the law or are otherwise exempted from disclosure as a public record under Florida law. The CHD shall implement procedures to ensure the protection and confidentiality of all such records and shall comply with sections 384.29, 381.004, 392.65 and 456.057, Florida Statutes, and all other state and federal laws regarding confidentiality. All confidentiality procedures implemented by the CHD shall be consistent with the Department of Health Information Security Policies, Protocols. and Procedures, dated September 1997, as amended, the terms of which are incorporated herein by referenee. The CHD shall further adhere to any amendments to the State's security requirements and shall comply with any applicable professional standards of practice with respect to client confidentiality. 5 L The CHD shalt abide by all State policies and procedures, which by this reference are incorporated herein as standards to be followed by the CHD, except as otherwise permitted for some purchases using county procedures pursuant to paragraph 6.b. hereof. m. The CHD shall establish a system through which applicants for services and current clients may present grievances over denial, modification or termination of services. The CHD will advise applicants of the right to appeal a denial or exclusion from services, of failure to take account of a client's choice of service, and of his/her right to a fair hearing to the final goveming authority of the agency. Specific references to existing laws, rules or program manuals are included in Attachment I of this Agreement. n. The CHD shall comply with the provisions contained in the Civil Rights Certificate, hereby incorporated into this contract as Attachment Ill. o. The CHD shall submit quarterly reports to the county that shall include at least the following: i. The DE385L 1 Contract Management Variance Report and the DE580L 1 Analysis of Fund Equities Report; ii. A written explanation to the county of service variances reflected in the DE385L 1 report if the variance exceeds or falls below 25 percent of the planned expenditure amount. However. if the cumulative amount of the variance between actual and planned expenditures does not exceed three percent of the cumulative expenditures for the level of service in which the type of service is included, a variance explanation is not required. A copy of the written explanation shall be sent to the Department of Health, Bureau of Budget Management. 6 ,.-.,~~~._~,.~....~~"_U__~__. p. The dates for the submission of quarterly reports to the county shall be as follows unless the generation and distribution of reports is delayed due to circumstances beyond the CHD's control: i. March 1, 2005 for the report period October 1, 2004 through Deeember 31,2004; ii. June 1, 2005 for the report period October 1, 2004 through March 31, 2005; iii. September 1, 2005 for the report period October 1, 2004 through June 30, 2005; and iv. Deeember 1, 2005 for the report period October 1, 2004 through September 30, 2005. 7. FACILITIES AND EQUIPMENT. The parties mutually agree that: a. CHD facilities shall be provided as speeified in Attachment IV to this contract and the county shall own the facilities used by the CHD unless otherwise provided in Attachment IV. b. The county shall assure adequate fire and casualty insurance coverage for County- owned C HO offices and buildings and for all furnishings and equipment in CHD offices through either a self-insurance program or insurance purchased by the County. c. All vehicles will be transferred to the ownership of the County and registered as county vehicles. The county shall assure insurance coverage for these vehicles is available through either a self-insurance program or insurance purchased by the County. All vehicles will be used solely for CHD operations. Vehicles purchased through the County Health Department Trust Fund shall be sold at fair market value when they are no longer needed by the CHD and the proceeds returned to the County Health Department Trust Fund. 8. TERMINATION. a. Termination at Will. This Agreement may be terminated by either party without cause upon no less than one-hundred eighty (180) calendar days notice in writing to the other party unless a lesser time is mutually agreed upon in writing by both parties. Said notice shall be delivered by certified man. return receipt requested, 0 r i n person tot he other party's contract manager with proof of delivery. b. Termination Because of Lack of Funds. In the event funds to finance this Agreement become unavailable, either party may terminate this Agreement upon no less than twenty-four (24) hours notice. Said notice shall be delivered by certified mail, return receipt requested, or in person to the other party's contract manager with proof of delivery. c. Termination for Breach. This Agreement may be terminated by one party, upon no less than thirty (30) days notice, because of the other party's failure to perform an 7 __ _.._.....,.~,...O._u.__.___._.ao_,.____~--------._.._.~.._.~.__._. ,_. ,. c. Termination for Breach. This Agreement may be terminated by one party, upon no less than thirty (30) days notice, because of the other party's failure to perform an obligation hereunder. Said notice shalt be delivered by certified mail, return receipt requested, or in person to the other party's contract manager with proof of delivery. Waiver of breach of any provisions of this Agreement shall not be deemed to be a waiver of any other breach and shall not be construed to be a modification of the terms of this Agreement 9. MISCELLANEOUS. The parties further agree: a. Availability of Funds. If this Agreement. any renewal hereof, or any term, performance or payment hereunder, extends beyond the fiscat year beginning July 1, 2005, it is agreed that the performance and payment under this Agreement are contingent upon an annual appropriation by the legislature, in accordance with section 287.0582, Florida Statutes. b. Modification. This Agreement and its Attachments contain all of the terms and conditions agreed upon between the parties. Modifications of this Agreement shall be enforceable only when reduced to writing and signed by all parties. c. Contract Managers. The name and address of the contract managers for the parties under this Agreement are as follows: For the State: For the County: William CBim Conner Name Thoml;l~ J. Willi Name Acting Business Manaper Title County Administrator Title Post Office Box 6193 Gata Building, 1100 Simonton St Key West, Fl 33041..a193 (305) 293-7539 Telephone Gato Building. 1100 Simonton St Key West, Fl 33040 (305) 292-4441 Telephone If different contract managers are designated after execution of this Agreement, the name, address and telephone number of the new representative shall be furnished in writing to the other parties and attached to originals of this Agreement. d. Captions. The captions and headings contained in this Agreement are for the convenience of the parties only and do not in any way modify, amplify, or give additional notice of the provisions hereof. In WITNESS THEREOF, the parties hereto have caused this 37 page agreement to be executed by their undersigned officials as duly authorized effective the 1ffday of October, 2004. BOARD OF COUNTY COMMISSIONERS FOR MONROE COUNTY STATE OF FLORIDA DEPARTMENT OF HEALTH SIGNEDBy:L~ia >n ~ NAME: J)/ ~/{ :;PZtt-A:- TITLE: /f'l A~{;f2,. ATTESTED TO: SIGNED BY: NAME: TITLE: DATE: DATE: / he:, /s- I ( (seALI C~~ o TV CLERK Oate SIGNED BY: . j~~ ~~. p. ~1.Sm.J, .&t.OOE:~.-I MO. A~ NAME: John O. Aawunobi. M.D.. M.B.A.. M.P.H. TITLE: Secretary DATE: l - ":1- {,. -0 5'" SIGNED BY: ~ t\4' NAME: susa:~ Qv.~.~. M.~. TITLE: CHD Director/Administrator DATE: 12-/~'- / Of I / 9 ~T ..w-..-.'_~~_~""'-""'~_"".cr'_.~"~_._,,__....~.".,,.,~._~~. ATTACHMENT I MONROE COUNTY HEALTH DEPARTMENT PROGRAM SPECIFIC REPORTING REQUIREMENTS AND PROGRAMS REQUIRING COMPLIANCE VVlTH THE PROVISIONS OF SPECIFIC MANUALS Some heatth services must comply with specific program and reporting requirements In addition to the Personal Health Coding Pamphlet (DHP 50+20), Environmental Health Coding Pamphlet (DHP 50-21) and FLAIR requirements because of federal or state law, regulation or rule, If a county health department Is funded to provide one of these services, it must comply with the special reporting requirements for that service. The services and the reporting requirements am listed below: SelVioe Reaulrero~m 1. Sexually Transmitted Disease Program 2. Dental Health Requirements as specified in FAC 64()..3 and F.S. 384 and the CHO Guidebook Internal Operating PoHcy STO 6 and 7. Monthly reporting on OH Fonn 1008*. 3. Special Supplemental Nutrition Program for Women, Infants and Children. Service documentation and monthly financial reports as specified in OHM 150-24* and all federal, state and county requirements detailed In program manuals and published procedures. Requirements as specified In the Healthy Start Standards and Guidelines 1998 and as specified by the Health Start Coalitions in contract with each county health department. Periodic financial and programmatic reports as specified by the program office and In the CHD Guidebook, Internal Operating Policy FAMPLAN 14* Periodic reports as specified by the department regarding the sUlVeHl.ancellnvestigatlon of reportable vaccine preventable diseases, vacclne usage accountability, the assessment of vanous immunization levels and fOlms reporting adverse events following immunization and Immunization Module quarterfy quality audits and duplicate data reports. Requirements as specified In the Community Intervention Program (CIP) and the CHO Guidebook.. 4. Healthy Start! Improved Pregnancy Outcome $. Family Planning 6. Immunization 7. Chronic Disease Program 8. Environmental Health Requirements as specified In DHP 50-4* and 50-21- Requirements as speeffied in Flolida Statue 384.25 and 640..3.016 and 3.017 F AC. and the CHD Guidebook. Case reporting on COC Fonns 5O.42B (Adult! Adolescent) and 50.42A (Pediatric). Socio-demographic data on persons tested for HIV in CHO clinics should be reported on Lab Request Fonn 1628 or Post~ Test Counseling fonn 1633. These reports are to be sent to the Headquarters HIVlAIDS office within 5 days of the initial post-test counseling appointment or within 90 days of the missed post~test counseling appointment. HRSM 150-25*, including the requirement for an annual plan as a condition for funding. *or the subsequent replacement If adopted during the contract penod. 9. H1VlAlDS Program 10. School Health Services ~ f8 I I ~ l-'- tJ} j s ~ m ~ H~ ~ ~ ~ I~= ~ ~~j l- :::l Z 0:: ill I- ~ !Z ~ ~ 0.. I- W 0: = 0 <( I- J: a.. ~ ~ ~ I J: ~ !;l ~ w J:, Z J: iC :::I ~ o z o :J W 0 o u a: u. ~ 0 :it ~ :::I o W Z ~ a.. j~g f s Ilu.i ~ l ~~'O )1-1 i~~ w'Oi - l- tr ~ ~ . I i ~ I~ t j ~i Ii i f jB tB ~ J A~ J~ I ~ !j !I ! J ~ ~- I I ~ 1 f . 1 ~ i fa ~ [ .J ~ I t ;{. 1 '- ~ ~ ~! ~. ~ I j i ..: ~ c. j i ,I i t )i l . ~ I 18 I I lj u.~! sJ .it ~ i I :! 1 ~ ~ {II :(1 ~~ N III off I~ ! 1 ~i 0::-- ) I ~s U ~ I iJ ..r I rn a..~ 1. GENERAL REVENUE ~ STATE 015011 ALGlCONTRlBUTION TO CHDS-PRIMAR Y CARE 17,256 0 17 .256 0 17,256 OlSOI J ALGIPRIMARY CARE 223.3 fO 0 223.3 10 0 223,310 Ol50ll PRIMARY CARE SPECIAL PROJECT 0 0 0 0 0 015048 ALG/CONTR TO CHos-sm PROGRAM 11,016 0 21,016 0 21,016 015050 ALG/CESSPOOL IDENTIF1CA nON AND ELlMlNA nON 128,707 0 128,707 0 128,707 01 5050 ALG/CONTR TO CHOS 1,517,812 0 1,517,812 0 1,517,812 015050 ALG/CONTR TO el-lDS.MIGRANT LABOR CA.\ilP SANIT AnON 0 0 0 0 0 015050 ALO/CONTR. TO eHOS.DENT AL PROGRAM 20,000 0 20,000 0 20,000 0]5050 ALG/CONTR. TO CHDS-IMMUNlZA TION OUTREACH TEAMS 1,694 0 7,694 0 7,694 015050 ALG/CONTR. TO CHDS-INDOOR AlR ASSIST PROG 0 0 0 0 0 015050 ALG/CONTR. TO CHDS-SOVEREIGN IMML'N]TY () 0 0 0 0 015050 CITIZENS AGAINST TOXIC EXPOSURE (CAfE) 0 0 0 0 [} 015050 COMMUNITY TB PROGRAM 68,302 0 68,302 0 68,302 015050 CONTR TO CHOS . DUVAL TEEN PREGNANCY PREVENTION 0 0 0 0 0 015050 HEALTH PROMOTION & EDUCATION INITIATIVES 58,823 0 58,823 0 5U23 015050 HEALTHY BEACHES MONITORING 29,262 0 29,262 0 29,262 015050 LA UGA CONTRA EL CANCER () 0 0 0 0 015050 METRO ORLANDO URBAN LEAGUE TEENAGE PREG PREY 0 0 {) 0 0 015050 RED LEGISLA rlON . GAP GRANT (CAT 050310) 0 0 0 0 0 015050 SPECIAL NEEDS SHELTER PROGRAM 0 0 0 0 0 015065 ALG/CONTR TO CHDS.AlDS PATIENT CARE 466,663 0 466,663 0 466,663 015065 ALa/CONTR TO CHDS-AIDS PREV & SURV & FJELD STAFF 105,8!)2 0 105,802 0 105,802 015] 15 VOLUNTEER SCHOOL HEALTH NURSE GRANT 0 0 0 0 0 015123 ALG/FAMIL Y PLANNING 62,578 {} 62,578 0 62,578 015124 ALG/lPO - OUTREACH SOCIAL WORKERS CAT. 050701 0 {} 0 0 {) 015124 ALGIlPO HEALTHY START 0 0 0 0 0 015124 ALGIlPO HEALTHY ST ART!lPQ CAT 050701 0 0 0 0 0 Ol5124 ALGflPO-lNF ANT MORT AL1TY PROJECT CAT. 050707 0 0 0 0 {) 015124 ALGIMCH HEALTHY STARTlIPO CAT 050870 0 0 0 0 0 015124 ALGfMCH-INFA."'T MORT AUfY PRomer CAT. 050870 0 0 0 0 0 015124 ALG/MCH-QUTREACH SOCIAL WORKERS CAT 050870 0 0 0 0 0 015137 ALa/CONTR. TO CHDS.MCH HEALTH. FIELD STAFF COST 0 0 0 0 0 015137 HEALTHY START - DATA COLLECTION PROJECT STAFF 0 0 0 {) 0 0]5140 ALa/SCHOOL HEAL THlSUPPLEMENT AL 41,665 0 41,665 0 4!,665 GENERAL REVENUE TOTAL 2,768,890 0 2.768,890 f) 2. 768,89il 2, NON GENERAL REVENUE. STATE OllO08 RAP!D AIDS TESTING. JAlL 1NMATES 2003 0 0 0 0 0 015010 ALG/CONTR TO CHOS-REBASING TOBACCO IT 21,864 0 21,864 0 21,864 015010 ENHANCEO DENTAL SERVICES TOBACCO TF 0 0 0 0 0 015010 FL HEPATITIS & UVER FAILURE PREVENTION/CONTROL 150,000 0 150,000 0 150,000 015010 ONSllE SEWAGE SPECIAL PROJECf.ATF 0 () 0 0 0 015010 PACE EH 0 I) 0 0 0 015010 SUPER ACT PROGRAM ADM TF 0 () 0 0 0 Ol5020 FOOD AND WATERBORNE DISEASE PROGRAM ADM TF 0 0 0 0 0 o I 5026 ALG/CONTR. TO CHOS-BIOMEDICAL W ASTElDEP ADM TF 4,816 0 4,816 0 4,816 olson ALG/CONTR. TO CHDS-SAFE DRINKING WATER PRGIDEP ADM 0 0 0 0 0 015084 VARICELLA IMMUNIZATION REQUIREMENT TOBACCO TF 4,118 0 4,118 0 4,l!l! 2. NON GENERAL REVENUE w STATE 015172 FULL SERVICE SCHOOLS - TOBACCO TF 61,720 [) 61,720 0 61,720 015174 BASfC SCHOOL HEALTH - TOBACCO TF 40,839 0 40,839 0 40,839 NON GENERAL REVENUE TOTAL 283,357 0 283.357 0 283,357 3. FEDERAL FUNDS - State 007000 ARTHRITIS SELF-HELP COURSE 0 I) [) 0 [) 007000 CHILDHOOD LEAD POISONING PREVENTION 0 0 0 0 (l 007000 COMPREHENSIVE CARDIOVASCULAR PROGRAM [) [) 0 0 0 007000 FEDERAL COASTAL BEACH MONITORING PROGRAM 26,666 0 26,666 0 26.66{i 007000 GUl.F OF MEXICO PROGRAM- T A YWR CHD () 0 0 {I 0 007000 STATE PROGRAMS TO PREVENT OBESITY 2003-04 () 0 0 () 0 007030 PHBGIMIGRANT lABOR CAMP SANIT A TrON 0 (I 0 [) 0 007049 SID PROGRAM.CSPS 0 0 (} 0 0 007049 SID PROGRAM-CSPS-200S 0 0 0 0 0 007049 SID PROGRAM.INFERTILlTY PROJECT () 0 0 0 0 007049 sm PROGRAM-MED & LAB SVCS TRNG CNTR 0 0 0 [) [) 007049 SID PROGRAM-SYPHILIS ELlMlNA TlON PROJECT 0 0 0 () 0 007049 STDIHIV PREVENTION TRAINING CENTER 0 0 (} 0 0 00705] FGTFIWIC ADMINISTRA 110N 206,424 0 206,424 0 206,424 001056 HEALTH PROGRAM FOR REFUGEES 0 0 1) 0 0 007056 REFUGEE HEALTH TB TARGETED TESTING 0 0 0 {) 0 007063 PHBG/COMPREHENSIVE COMM CARDIa HLTIl PROM 0 0 1) 0 0 007064 AIDS SEROPREV ALENCE () 0 1) 1) 0 007064 EVAL INTEG HlVlAlDS SURV SYST PERFORMANCE () 0 0 0 0 007064 PGTF/AIDS SURVEILLANCE () () 0 1) 1) 001065 AIDS PREVENTION 17l,474 0 171,474 0 I il ,414 007066 FGTFIRYAN WHITE 0 0 0 0 0 007066 FOTFIRYAN WHITE. EMERGING COMMUNITIES 0 0 0 0 0 00706Q FOTFIR Y AN WHITE-AIDS DRUG ASSIST PROG-ADMIN 22,443 0 22,443 0 22,443 007066 FGTF/R Y AN WHITE-CONSORTfA 532,236 0 532,236 0 532,236 007067 TUBERCULOSIS CONTROL - FEDERAL GRANT 0 0 0 0 0 007068 fGTF/AIDS INMATE INTERVENTION 0 0 1) 0 0 007077 BIOTERR SURVEILLANCE & EPIDEMtOLOGY 1) 0 0 0 {) 007077 BIOTERRORISM. HOSPITAL PREPAREDNESS 2004-05 0 0 () 0 () 007077 BIOTERRORISM NETWORK COMMUNICATIONS 0 0 0 0 0 007077 BIOTERRORISM PLANNING & READINESS 69,248 0 69,248 0 69,248 001017 PUB HLTH PREP.EDUCA TlON & TRAlNING 0 0 0 0 0 007084 FGTFIIMMUNIZATlON ACTION PLAN 6,078 0 6,078 0 6.078 007084 F'GTfIIMMUNIZA110N-PROJECT fIELD STAFF 0 0 0 0 0 007084 FGTFm.1MUNIZA TION-WIC LINKAGES {} 0 0 0 {) 0070&4 ]MMUNIZATION ACflON PLAN 2004-2005 5,774 0 5,774 0 5,774 007084 lMMUNIZA TION FIELD S1 AFF 2004 0 0 0 0 0 007084 IMMUNIZA lION PROJECT - VFC 0 0 0 0 0 007084 IMMUNlZA TrON SPECIAL PROJECT 3,720 0 3,720 0 3,720 007084 IMMlJNIZA T10N SUPPLEMENTAL. 2004 0 {) 0 0 0 007084 IMMtJNlZA TlON SUPPORT GRANT. 2005 0 0 0 0 () 007085 FGTFIBREAST & CERVICAL CANCER-ADMIN/CASE MAN 0 0 0 0 {) 007127 MCH BGTf-MeH/CHILD HEALTH 11.446 (} 11,446 0 11,446 3, FEDERAL FUNDS - State 007132 MCH BGTf-MCHlDENT AL PROJECTS 0 0 0 0 () 007L33 FGTFIFAMIL Y PLANNING TJ1T,E X SPECIAL INlTIATIVES 0 0 0 0 0 007133 FGTF/FAMIL Y PLANNING-TITLE X 78,280 0 78,280 0 78.1&0 007134 MCH BGTF-GADSDEN SCHOOL CLINK 0 0 0 () :) 007134 MCH BGrF-HEALTHY START IPO 0 0 0 (I 0 007L34 MCH BGTF-INF ANT MORTALITY PROJECT 0 0 0 0 0 007L34 MCH BGTF.OUTREACH SOCIAL WORKERS 0 0 0 0 0 007L35 FGTF/ABSTINENCE EDUCATION PROGRAM 0 0 0 0 0 OL5009 Transfer of Federal Funds Within Agency 0 0 0 0 0 OL5021 MEDlPASS WAIVER-HLTIlY STRT CLIENT SERVICES 0 0 0 0 0 015021 MEDIPASS WAIVER-SOBRA 0 0 0 0 0 015060 Entrant Reimburement Transfer () 0 0 0 0 015075 FULL SERVICE SCHOOLS-TANF 6,732 0 6,732 0 6,732 015075 SCHOOL HEAL TH.SUPPLEMENT.T ANF 11,581 0 11,5&1 0 11,581 015075 TITLEXXIfSCHOOL HEAL THJSUPPLEMENT AL 81,066 0 81,066 0 81,066 015075 Refugee Screening Reimbursement 0 0 0 0 0 Ol5075 Summer Feeding Sites 0 0 0 0 0 FEDERAL FUNDS TOTAL 1,233,168 0 1,233,168 0 1,233,168 4, FEES ASSESSED BY STATE OR FEDERAL RULES. STATE 001092 Environmental Health Fees 28,000 0 28,000 0 28.000 00 1092 OS OS Repair Permit 1,300 0 1,300 0 1,300 001092 O$DS Permit Fee 56,000 0 56,000 0 56,000 001092 ! & M Zoned Operating Permit 1.500 0 1,500 0 1,500 001092 Aerobic Operating Permit 12,100 0 72.1 00 0 72,100 001092 Septic Tank Site Evaluation 79,941 0 79,941 0 79,941 001113 Mobile Home and Parks 18,000 0 18,000 0 L8,000 001132 Food Hygiene Permit 14,000 0 14,000 0 14,000 00 Ll35 OSDS Variance Fee 1,150 0 I,L50 0 1,150 001139 Migrant Housing Permit 0 0 0 0 0 001140 Biohazard Waste Permit 5,900 0 5,900 0 5,900 OOll42 Non SOWA Lab SlUIIple 0 0 0 0 0 001144 Tanning Facilities 1,670 0 1,670 0 1,670 DO! 145 Swimming Pools 48,000 0 48,000 0 4R,OOO 001149 Body Piercing 540 0 540 0 540 001165 Private Water Conslr Permit 0 0 0 0 0 OOJ ]66 Public Water Annual Oper Permit 0 0 0 0 0 001166 Publlc Water Conslr Pennit 0 0 0 0 0 001166 Non.SDWA System Permit 0 0 0 0 0 00 1I70 Lab Fee Chemical Analysis 0 0 0 0 0 001196 Water Analysis-Polable 0 0 0 0 0 001197 Nonpotable Water Analysis 0 0 0 0 0 oonlL Safe Drinking Water 0 0 0 0 0 010403 Fees-Copy of Public Doc 0 0 0 0 0 015052 Transfers-Mobile HomelRV Park 0 0 0 0 0 010303 MQA Inspection Fee 0 0 0 0 0 FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL 328,101 0 328,101 0 328,101 5. OTIIER CASH CONTRIBUTIONS - STATE 010304 Stationary Pollutant Storage Tanb 121,275 0 121,275 0 121,275 0]5029 Tranfcrs Intra Agency 0 (} 0 0 0 0]5121 Super Act Reimbursements 2,570 0 2,570 0 2.570 015139 Wcll Surveillance Reimbursement - pesticide 0 0 0 0 0 090001 Draw down from Public Health Unit 444,975 0 -444.975 0 444,975 OTHER CASH CONTRIBUTIONS TOTAL -321,130 0 -321,1]0 0 -32l,130 6. MEDICAID - ST A TE/COUNTY 001056 eRD Incm:Medicaid-Pharmacy 0 (} (} 0 0 001076 Medicaid-Tll 0 1} (} 0 0 001078 Medicaid-Administration Vaccine 0 0 0 0 0 001079 Medicaid-Case Management 0 0 0 0 1} 001080 CRD Incm:Medicaid.Other-Physician 001084 2,697 3,865 6,562 0 6.562 00108] CHD lncm:Medicaid.Child Health Checkup 0 0 0 0 0 001082 CHD Incm:Medicaid-Dental 0 0 0 0 0 001083 CHD Incm:Medicaid-FP 0 0 0 0 0 001085 CRn Incm:Medicaid-Nursing 0 0 0 0 0 001087 CRn Incm:Medicaid-STD 0 0 0 0 0 001089 Medicaid AIDS 45,210 64,790 110,000 0 110,000 001147 Medicaid HMO Rate 0 0 0 0 0 001191 CHD Incm:Mcdicaid Maternity 0 0 0 0 0 001192 CIlD Incm:Medicaid Compo Child 0 0 0 0 0 001193 eHD Incm:Medicaid Compo Adult 0 0 0 0 0 OO1l94 Medicaid-LAB 0 0 0 0 0 00120& Medipass $3.00 Adm. Fee 1,075 1,541 2,616 0 2.616 MEDICAID TOTAL 48,982 70,196 119,178 0 1 ]9,178 7. ALLOCABLE REVENUE. STATE 018001 Refunds, Salary 0 0 0 0 0 018003 Refunds, other Personal Services 0 0 0 0 0 018004 Refunds, Expenses 50 0 50 0 50 OlS006 Refunds, Operating Capital Outlay 0 0 0 0 0 0]8010 Refunds, Special Category 0 0 0 0 0 0]801l Refunds, Other 0 0 0 () 0 0180\3 DMS Refunds by journal Transfer-6S900 0 0 0 0 () 018099 Refunds, Certified Forward 0 0 0 0 G 037000 Prior Year Warrant 0 0 0 (I 0 038000 12 Month Old Warrant 0 0 0 0 0 ALLOCABLE REVENUE TOTAL 50 0 50 0 50 8. OTHER STATE CONTRIBUTIONS NOT IN eHD TRUST FUND - STATE Stale Phamlllcy Services 0 0 0 65,280 65,280 Statc Laboratory Services 0 0 0 89,978 89,978 Statc TB Services 0 0 0 0 0 State Immunization Services 0 0 0 148,759 148,759 State sm Services 0 0 0 0 0 State ConstructionfRcnovation 0 0 0 0 0 -- ~_..-'-~M~~..",.__~.~_~. 8. OTHER STATE CONTRIBUTIONS NOT IN enD TRUST FUND _ STATE WIC Food 0 0 0 655.164 655.164 ADM Aids Drug Assistance Program 0 0 0 467,056 467.056 Other (speeifY} 0 0 0 0 0 Other (specify) 0 0 0 0 0 Other (specify) 0 0 0 0 0 OTHER STATE CONTRIBUTIONS TOTAL 0 0 0 1.426,237 1,426,237 9. DIRECT COUNTY CONTRIBUTIONS _ COUNTY 008030 Grants-County Tax Direct 0 342,034 342,034 0 342,034 008034 Grants Cnty Commsn Other 0 15,54] 75,541 0 75,541 BOARD OF COUNTY COMMISSIONERS TOTAL 0 417,575 417,575 0 417,575 10, FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION _ COUNTY 001004 Child Car Seat Prog 0 0 0 0 0 00 1060 Vital Statistics Fees Other 0 40 40 0 40 001062 Rabies Vaccine 0 0 0 0 (' , 00 1074 Adult Enter, Pennit Fees 0 0 0 0 0 001077 Primary Care Fees 0 10,915 10,975 0 10,975 00\093 Communicable Disease Fees 0 58,376 58,376 0 58,376 001094 Environmental Health Fees 0 0 0 0 () 001 !]4 Ncw Birth Certificates 0 9,730 9,730 0 9.730 001115 Death Certificates 0 42,000 42.000 0 42,000 001117 Vital Slats-Adm. Fee 50 cents 0 500 500 0 500 FEES AUTHORIZED BY COUNTY TOTAL 0 121,621 121,621 0 !21,621 11. OTHER CASH AND LOCAL CONTRIBUTIONS _ COUNTY 00 I 009 Debit Memo-Bad Checks 0 0 0 0 0 001010 Recovery.Bad Checks 0 0 0 () 0 001015 Recovery of Collection of Agency Placements 0 0 0 0 {) 001026 Returned Check Fee 0 0 0 0 0 001029 Third Party Reimbursement 0 250 250 0 250 001072 Ryan White Title I 0 0 0 0 {) 001073 Ryan White Title II 0 0 0 0 0 001075 Ryan White Title III 0 5,000 5,000 0 $,000 001090 Medicare 0 21,250 21,250 0 21,250 001190 Health Maintenance OrgarL (HMO) 0 0 {) 0 0 005040 Interest Earned 0 0 0 (} {) 00504 ] Interest Elll1le<:l.State Investment Account (} 18,000 18,000 0 18,000 007010 UX Grants Direct 0 692,894 692.894 0 692,894 0080 10 Grants Contracts firm Cities Direct 0 0 0 0 0 00803] County AIDS Education (} 0 0 0 0 008050 Grants-Cnty Sch Board Direct 0 35,000 35,000 0 35,000 008090 Grants other Local Govn't Direct 0 0 0 0 0 008094 Grnts/Contracts other Agencies Direct 0 0 0 0 0 008095 Grants Cnty Secl 403.102 Air Pol 0 0 0 0 0 008099 ReimblRebate Local Govn't 0 0 0 0 0 010300 Sale of Goods and Services 0 {) 0 {) 0 J 1. OTHER CASH AND LOCAL CONTRIBIITIONS. COUNTY 010301 Exp Witness Fee Consultnt Charges 0 0 0 0 0 010403 F~s..copies of Documents 0 450 450 0 450 010405 Sale of phl\mlaceuticals 0 0 (} 0 0 010408 Copy Fess Intra/Inler Agency 0 0 0 0 0 010409 Sale of Goods Outside Stale Government 0 0 0 0 0 010500 Sales of Services Outside State Govemmnent 0 0 0 0 0 011001 Healthy Start Coal ition Contributions 0 310,458 310A58 0 310,458 011007 Cash Donations Private 0 0 0 0 0 011066 Ryan While Local Revenues 0 0 0 0 0 OllO67 AIDS Insurance Continuation Project 0 (} 0 0 0 011099 Other GranWDonations Direct 0 0 0 0 0 012020 Fines and Forfeitures 0 0 0 0 0 01202] Return Check Charge 0 0 0 0 0 02&020 Insurance Reroverie~-0ther 0 (} 0 0 0 090002 Draw down from Public Health Unit 0 -123,592 -123,592 0 -123.592 OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL 0 959,710 959,710 0 959,710 12. ALLOCABLE REVENUE - COUI'ol'TY 01&001 Refunds, Salary 0 (} 0 0 0 018003 Refunds, other Personal Services 0 0 0 (l I} 018004 Refunds. Expenses 0 0 I} 0 () 018006 Refunds, Operating Capital Outlay 0 0 0 0 0 018010 Refunds, Special Category 0 0 0 0 I} 01&011 Refunds, Other 0 0 0 0 0 018013 DMS Refunds by Journal Transfer-65900 0 0 0 0 0 018099 Refunds, Certified FOfWII1d 0 0 0 0 0 037000 Prior Year Warrant 0 0 0 1) 0 038000 12 Month Old Warrant 0 0 0 0 0 COUNTY ALWCABLE REVENUE TOTAL 0 {} 0 0 0 13. BUILDINGS - COUNTY Annual Rental Equivalent Value -GATOJRICrraverni~r $16.68 sir 0 0 0 261,720 261,720 Maintenance- Tav,RlC,EHMar,RSC,Gato 0 0 0 45,559 45,$59 UtJ!jtes- Oato $15,2321mo. 12 *30.5% 0 0 0 55,749 55,749 Other (specify) 0 0 0 0 0 Other (specify) 0 0 0 0 I} Other (specify) 0 0 0 0 0 Other (specify) 0 0 0 I} 0 BUILDINGS TOTAL (} 0 0 363,028 363,028 14, OTUER COUNTY CONTRffiUTIONS NOT IN CMD TRUST FUND ~ COUNTY Other County Contribution of some unknow origin {} 0 0 0 0 Other County Contribution (specify) 0 I} 0 0 0 Other County Contribution (specify) (} 0 0 {} 0 Other County Contribution (specify) 0 0 0 0 0 Other County Contribution (specify) 0 0 0 0 0 _"^.__.______~_~~~~m_.___~,~_~<...,__~~"~_.... OTHER COUNTY CONTRIBUTIONS TOTAL GRAND TOTAL cno PROGRAM o 4,341,418 o 1,569.102 o [,789,265 o 5,910,520 o 7,699,785 A. COMMUNICABLE DISEASE CONTROL: Immunization (to 1) 375 2,500 5,200 55,253 55,253 55,253 55,2:53 0 22!,012 221,012 STD 002} 2.00 200 1,500 33,485 33,485 33.485 33,485 0 133,940 133,940 A.l.D.S, (103) 17.50 475 7,000 504,710 504,710 504,710 504,710 696,720 1,322,120 2,DI8,840 TB Control Services (l 04 > 2.00 575 1,500 28,723 28,723 28,723 28,723 0 114,892 114,892 Comm. Disease Surv. (106) 0.60 0 800 13,077 13,077 13,077 13,077 0 52,30& 52,308 Hepatitis Prevention (109) 2.25 475 1,000 43,125 43,125 43,125 43,125 0 172,500 172,500 Public Health Preparedness and Response ( 116) 1.50 0 0 67,312 19,312 31,&12 31,812 73,000 71 ,248 150,248 V ital StatistiCS (1 SO) lAO 0 0 15,823 15,823 15,823 15,823 63,292 0 63,292 COMMUNICABLE DISEASE SUBTOTAL 31.00 4,225 17,000 761,508 713,508 726,008 726,008 833,012 2,094,020 2,927.032 R PRIMARY CARE: Chronic Disease Services (210) LSO 980 950 18,382 18,382 18,382 18,382 0 73,528 73,528 Tobacco Prevention (212) 0.00 0 0 0 0 0 0 0 0 0 Home Health (215) 000 0 0 0 0 0 0 0 0 0 W.l.c. (221) 600 1,500 10,000 64,358 64,358 64,358 64,3 58 0 257,432 257,432 Family Planning (223) 4.75 1,100 5,600 95,882 95,882 95,882 95,882 0 383,528 383,528 I mproved Pregnancy OUlcome (225) 0.00 0 0 0 0 0 0 0 0 0 Healthy Srart Prenatal (227) 3.50 400 10,000 63,685 63,685 63,685 63,685 254,740 0 254,740 Comprehensi ve Child Health (229) 0.70 280 400 20,860 20,860 20,860 20,860 0 83,440 83,440 Healthy Start Infant (231) 3.50 350 9,000 44,441 44,441 44,441 44,441 177,764 0 177,764 School Heal th (234) 9.00 0 100,000 97,384 97,3 84 97,384 97,Jl!4 35,Doo 354,536 389,536 Comprehensive Adult Health (237) 2.50 820 2,900 58,3 75 58,315 58,375 58,375 0 233500 233,500 Dental Health (240) 0.00 0 0 2,500 2,500 12,500 2,500 0 20,000 20,000 PRIMARY CARE SUBTOTAL 31.4S 5,430 l38,850 465,867 465,867 475,861 465,867 461,504 1,405.964 1,873,468 C. ENVIRONMENTAL HEALTH: Water and Onsite Sewage Programs Coastal Bcach Moniloring (347) 1.75 650 890 28,508 10,000 28,508 10,000 21,088 55,928 77,016 Limited Use Public Water Systems (357) 0.00 0 0 0 0 0 0 0 0 0 Public Water System (358) 0>00 0 0 0 0 0 0 0 0 0 Private Water System (359) 0,00 0 0 0 0 0 0 0 0 Q lndiv idual Sewage Disp. (361 ) l2.00 3,000 3,000 BUM BI,lM 131,164 BUM 0 524,656 524,656 Group Total 13.75 3,650 3,890 159,672 141,164 159,672 141,164 21,088 580.584 601.672 Facility Programs Food Hygiene (348) 3.00 60 250 7,157 7,IS7 7,151 7,157 0 28,628 28,628 Body Art (349) 0.00 0 0 1,914 1,914 1,914 1,914 0 7.656 7.656 Group Care Facility (351) 0.50 80 150 4,143 4,143 4,143 4.143 16,572 0 16,572 Migrant Labor Camp (352) 0.00 0 0 0 0 0 0 0 0 0 Housing,Public Bldg Safety,Sanitation (353) 000 0 0 0 0 0 0 0 0 0 Mobile Home and Parks Services (354) 0>50 65 280 9,076 9,076 9,076 9,076 0 36,3D4 36,304 Swimming Pools/Bathing (360) 3.00 482 1,220 24,907 24,907 24,907 24.907 50,957 48,671 99,628 fliomedkal Waste Services (364) 0.30 40 60 8,5&5 8,585 8,585 8,585 23,624 10,716 34,340 Tanning Facility Services (369) 0.03 5 11 0 0 0 0 0 0 0 C ENVIRONMENTAL HEALTH: Group Total 733 732 1,971 55,782 55,782 55,782 55)82 91,153 131,975 223,128 Groundwater Contamination Storage Tank CompllWlce (35 S) 2.00 290 583 41,899 47,899 . 87,899 47,899 110,321 121,275 23l,S96 Super Act Service (356) 0.00 0 0 1,000 1,000 1,000 1,000 0 4,000 4,000 Group Total 2.00 290 583 48.899 48,899 88,899 48,899 J 10,321 125,275 235,596 Community Hygiene Occupational Health (344} 0.00 0 0 300 300 300 300 I,200 0 1,200 Comumer Product Safely (345) 0.00 0 0 0 0 0 0 0 0 0 Emergency Medical (346) 0.00 0 0 0 0 0 {} 0 0 0 Lead Monitoring Services (350) 0.00 () 0 {} 0 0 0 0 0 {} Public Sewage (362) 0.00 0 0 {} 0 0 0 0 0 0 Solid Waste Disposal (363) 0.00 0 0 0 0 0 0 0 0 0 Sanitary Nuisance (365) 0,00 0 0 3,333 3.333 3,333 3,333 13,332 0 13,332 Rabies Surveillance/Control Services (366) 0,05 6 302 302 302 302 1.208 0 1,208 Arbovirus Surveillance (367) OJ5 0 20 709 709 109 709 2,836 0 2,836 Rodent/ Arthropod Control (368, {l.OO 0 (l 0 0 0 0 0 {) 0 Water Pollution (370) 0.00 0 0 1,223 1,223 1.223 \,223 4)\92 {) 4,892 Air Pollution (371) 0.00 0 0 900 900 900 900 0 3,600 3,600 Radiological Health (372) 0.03 0 0 450 450 450 450 1,800 {) \,800 Toxic Substances (373) 1.00 30 30 5,189 5,189 5,189 5,189 20,756 0 20,756 Group Total 1.23 3] 56 12,406 12,406 12,406 12,406 46,024 3,600 49,624 ENVIRONMENTAL HEALTH SUBTOTAL 24.3] 4,703 6,500 276,759 258,251 316,759 258,251 268,586 841,434 1,110,020 D, SPECIAL CONTRACTS: Special Contracts (599) 0.00 0 0 0 0 () 0 {) G (} SPECIAL CONTRACTS SUBTOTAL 0.00 0 0 0 0 0 0 0 {) {) TOTAL CONTRACT 86.76 14,358 162,350 1,504, IJ4 1,437,626 1,518,634 1,450,126 ],569,102 4,341,418 5,910,520 ATTACHMENT III MONROE COUNTY HEALTH DEPARTMENT CIVIL RIGHTS CERTIFICATE The appUcantprovides this assurance In consideration of and for the purpose of obtaining federal grants, .10805, contracts (except contracts of insurance or guaranty), property, diseounts, or other federal financial assistance to programs or activities receiving or benefrting from federal financial assistance. The provider agrees to complete the Civil Rights Compliance Questionnaire, DH Forms 946 A and B (or the subsequent replacement if adopted during the contract period), if so requested by the department The applicant assures that it will comply with: 1. Title VI of the Civil Rights Act of 1964. as amended, 42 U.S.C., 2000 Et seq., which prohibits discrimination on the basis of race, color or national origin in programs and activities receiving or benefiting from federal financial assistance. 2. Section 504 of the Rehabilitation Act of 1973, as amended. 29 U.S.C. 794, which prohibits discrimination on the baSis of handicap In programs and activities receiving or benefiting from federal financial assistance. 3. Title IX of the Education Amendments of 1972, as amended. 20 U.S.C. 1681 et seq., which prohibits di.sclimlnatlon on the basis of sex in education programs and activities receiving or benefiting from federal financial assistance. 4. The Age Discrimination Act of 1975, as amended, 42 U.S.C. 6101 at seq., which prohibits discrimination on the basis of age in programs or activities receiving or benefiting from federal financial assistance. 5. The Omnibus Budget Reconciliation Act of 1$181, P.L. 97-35, which prohibits discrimination on the basis of sex and religion In programs and activities receiving or benefiting from federal financial assistance. 6. All regulations, guidelines and standards lawfully adopted under the above statutes. The appUcant agrees that compliance with this assurance constitutes a condition of continued receipt of or benefit from federal financial assistance, and that It is binding upon the applicant, Its successors, transferees, and assignees for the penod during which such assistance is provided. The applicant further assures that all contracts. subcontractors, subgrantees or others with whom It arranges to provide services or benefits to participants or employees in connection with any of Its programs and activities are not discriminating against those participants or employees in connection with any of its programs and activities are not discriminating against those participants or employees In violation of the above statutes, regulations, guidelines, and standards, In the event of failure to comply, the applicant understands that the grantor may, at Its discretion, seek a court order requiring compliance with the terms of this assurance or seek other appropriate judicial or administrative relief. to include assistance being terminated and further assistance being denied. _~~~~_~__~~~~r~~~.-'~~.._--~~ ATTACHMENT IV FACILITIES UTILIZED BY THE MONROE COUNTY HEALTH DEPARTMENT Facility Square Number of Description Location Footaae Emplovees Owned Bv GATO Building 1100 Simonton street 8,691 s.!. 42 county Admin/Nursing /EnvHl th Key West, FL 33040 Health Care Center 1200 Kennedy Drive 3,000 s.f. 9 Lease Key West, FL 33040 Roosevelt Sands 105 Olivia Street 2,000 s.f. G Lease Center Key West, FL 33040 Ruth Ivins Center 3333 overseas Highway 5,000 s.f. 9 County For Public Health Marathon, FL 33050 Environmental Health 13367 overseas Highway 1,250 s. !. 7 Lease Monroe CRD Marathon, FL 33050 Monroe county Health 148 Georgia Ave 2,000 s. f- 10 County Department Tavernier, FL 33070 Venetian Plaza 65960 Overseas Highway 1,500 s.f. 7 Lease Islamorada village of the Islands Environmental Health Islamorada, FL 33036 _ _ ~,"~,~..~_,__~~,_-+,-~'_~CC__~_~'_~.CO~~L~_"-~ ATTACHMENT V MONROE COUNTY SPECIAL PROJECTS SAVINGS PlAN IDENTIFY "THE AMOUNT OF CASH tHAT IS ANllCIPATEO TO BE sa ASIDE ANNUALLY FOR lHE PROJECT yoNTRACT YEAR nAn J;;QWflY IQIAl. 2002-2003 S $ S 2003-2004 $ $ $ 2004-2005 $ 400,000 $ $ 400,000 2005-2006 $ $ $ 2Ol)6..2fJl1l S $ $ PROJECT TOTAL $ $ $ . ~!ll- SPECIAL PROJECT CONSTRUCTIONIRENOVAT1ON PLAN PROJECT TITLE: lOCATION: Upper K(Iy$ CHO, Merinet's HQSplbll 50 High Point Road, Plantation Key, F\olId$. SQUARE fOOTAGE: NEW FACIliTY RENOVATION )( NEVIl ADomON 5,141 ROOFING PLANNING STUDY CATEGORY: PROJECT sUMMARY: Conatructlon and RenovlItiOn: site WOfi(, ~ of utiIItlM, ~ping, r_oratiOn Cl! struetural sheU, _ Int!llior wah. cIooI'Il.windowa. h8rdwwG, ~. vinyl, tltIil. plumbinG and el~. FUl't1isIIings and Eql.lipmenl: medical equipment, oIIk:e fUrnl$h1ng$. filing systems, phone equipment and wlllng. t.ellnotogy equlpmIInt aM wIrinG. technology software. ESTIMATED PROJECT INFORMATION: START DATE (fI1lIieI"",_dllurufrunde): COMPLETION DATE: J~ June-06 COST PER sa FOOT: $ $ $ $ $ 2,100 197,300 200,000 400,000 DESIGN FEES: CONSTRUCTION COSTS: FURNITURE/E.QUIPMENT TOTAL PROJECT COST: 34.80 :; I- Z w :E ::I: o ~ c( I- Z W ~ ~ 11. W Q i: ..J < W :r: ~ z ::l o o w ~ z o :i W W W L.I. 5 i::i." ;x: 8 ...IN ~i Zo WN :Ect: Z<c Ow "> >..J z<C W(J u.W Oi:i: ~ :E 1= W w g f8 ,.... ....... ...... III II! Iii ! 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