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FY2007 01/17/2007 DANNY L. KOLHAGE CLERK OF THE CIRCUIT COURT DATE: January 25, 2007 TO: Thomas Willi County Administrator ATTN: FROM: Connie Cyr Aid to County Administrator Pamela G. Hanc~ Deputy Clerk CY At the January 17, 2007, Board of County Commissioners meeting the Board granted approval and authorized execution of the Annual Contract between Monroe County and Florida Department of Health for public health services provided by the Monroe County Health Department, Contract Year 2006-2007. Enclosed are three duplicate originals of the Contract for your handling. Should you have any questions please do not hesitate to contact this office. cc: County Attorney Finanye Filet CONTRACT BETWEEN MONROE COUNTY BOARD OF COUNTY COMMISSIONERS AND STATE OF FLORIDA DEPARTMENT OF HEALTH FOR OPERATION OF THE MONROE COUNTY HEALTH DEPARTMENT CONTRACT YEAR 2006.2007 This agreement ("Agreement") is made and entered into between the State of Florida, Department of Health ("State") and the Monroe County Board of County Commissioners ("County"), through their undersigned authorities, effective October 1, 2006. 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, 2006, through September 30, 2007, 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 a, below. 3. SERVICES 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. "Environmental health services" are those services which are organized and operated to protect the health of the general public by monitoring and regulating activities in the environment which may contribute to the occurrence or transmission of disease. Environmental health services shall be supported by available federal, state and local 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 detection and control, HIV/AIDS, immunization, tuberculosis control and maintenance of vital statistics. c. "Primary care services" 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 Attachment II hereof. This funding will be used as shown in Part I of Attachment II. i. The State's appropriated responsibility (direct contribution excjuding 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 not to exceed $4,499,304 (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 II is an amount not to exceed $754,337.17 (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 attributed to the CHD shall be carried forward to the next contract period. 2 c. Either party may establish service fees as allowed by law to fund activitiE~s of the CHD. Where applicable, such fees shall be automatically adjusted to at least the Medicaid fee schedule. 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 shall 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 measured 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 reiating 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 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 3 compliance shall be documented. Such justification and compliance documentation shall be maintained by the CHD in accordance with the terms of this Agreement. State procedures must be followed for all leases on facilities not enumerated in Attachment IV. 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 (GASB), 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 law which are subject to the confidentiality provisions of paragraph 6.i., 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 shall 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 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 4 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 necessary 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 OMS 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 reference. 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. I. The CHD shall 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. 5 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 governing 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 III. 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 amount of the service specific variance between actual and planned expenditures does not exceed three percent of the total planned 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 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, 2007 for the report period October 1, 2006 through December 31,2006; ii. June 1, 2007 for the report period October 1, 2006 through March 31, 2007; iii. September 1 , 2007 for the report period October 1, 2006 through June 30, 2007; and iv. December 1, 2007 for the report period October 1, 2006 through September 30,2007. 7. FACILITIES AND EQUIPMENT. The parties mutually agree that: a. CHD facilities shall be provided as specified 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 CHD 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 mail, return receipt requested, or in person to the 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 obligation hereunder. 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. 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. Availabilitv of Funds. If this Agreement, any renewal hereof, or any term, performance or payment hereunder, extends beyond the fiscal year beginning July 1, 2007, 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. Contract Manaoers. The name and address of the contract managers for the parties under this Agreement are as follows: For the State: A ministrative Services Director Title County Administrator Title Post Office Box 6193 Gato, Bldg, 1100 Simonton Street Key West, FL 33041-6193 Gato, Bldg, 1100 Simonton Street Key West, FL 33040 Address Address 305-293-7539 Telephone 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. c. 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. 8 In WITNESS THEREOF, the parties hereto have caused this 41 page agreement to be executed by their undersigned officials as duly authorized effective the 1st day of October, 2006. BOARD OF COUNTY COMMISSIONERS FOR MONROE COUNTY STATE OF FLORIDA DEPARTMENT OF HEALTH SIGNEDB~Af~ NAME: fv1Alt:lo O. 'eNNAj(.c SIGNED BY: v~i ~J..-<.--.L-IJ-' NAM~l.i1. Ronv Francois. M.D.. M.S.P.H.. Ph.D. TITLE: MA'fo~ TITLE: Secretary ...~-';r""., DATE: JANW\~;!'P~~~~, DATE: 1").-. fe, .Of, ::::::~f;"'\~~GNED BY NAME: Susana Ma Mf) NAME: TITLE: DATE: DATE: CHD Directorl dm'nistrator J- ('(.,..- 0 (; TITLE: :J:: ...... 0 = .." C) = :z: l>' .... ,"- c- , :::Onz "\"1 o.z :Do '::J fTt;x-< :z n. r- N '"'\"i an' CJ'I (:J ~?~~; ~>.J > ::~D --inr-:,:: :z: P"~ ;-< :-i ~~ (") ." , '9 c, , '" ::;J:J J:> "" Co) C1 ..... 9 8. 9. ATTACHMENT I MONROE COUNTY HEALTH DEPARTMENT PROGRAM SPECIFIC REPORTING REQUIREMENTS AND PROGRAMS REQUIRING COMPLIANCE WITH THE PROVISIONS OF SPECIFIC MANUALS Some health 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 are listed below: Service Reauirement 1. Sexually Transmitted Disease Program Requirements as specified in FAC 64D-3, F.S. 381 and F.S. 384 and the CHD Guidebook. 2. Dental Health Monthly reporting on DH Form 1008". 3. Special Supplemental Nutrition Program for Women, Infants and Children. Service documentation and monthly financial reports as specified in DHM 150-24" and all federal, state and county requirements detailed in program manuals and published procedures. 4. Healthy Start! Improved Pregnancy Outcome 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. 5. Periodic financial and programmatic reports as specified by the program office and in the CHD Guidebook, Internal Operating Policy FAMPLAN 14" Family Planning 6. Periodic reports as specified by the department regarding the surveillance/investigation of reportable vaccine preventable diseases, vaccine usage accountability, the assessment of various immunization levels and forms reporting adverse events following immunization and Immunization Module quarterly quality audits and duplicate data reports. Immunization 7. Chronic Disease Program Requirements as specified in the Community Intervention Program (CIP) and the CHD Guidebook. Environmental Health Requirements as specified in DHP 50-4" and 50-21" HIV/AIDS Program Requirements as specified in Florida Statue 384.25 and 64D-3.016 and 3.017 FAC. and the CHD Guidebook. Case reporting on CDC Forms 50.42B (Adult! Adolescent) and 50.42A (Pediatric). Socio-demographic data on persons tested for HIV in CHD clinics should be reported on Lab Request Form 1628 or Post-Test Counseling Form 1633. These reports are to be sent to the Headquarters HIV/AIDS office within 5 days of the initial post-test counseling appointment or within 90 days of the missed post-test counseling appointment. 10 ATTACHMENT I (Continued) 10. School Health Services HRSM 150-25', including the requirement for an annual plan as a condition for funding. - 'or the subsequent replacement if adopted during the contract period. 11 3 -0 ~. ~ ~ l!! ~\l) ~ ~ CD ~ 0.0 o~ CD 't ~ 0 ~ wN CD -" ~(n CD ; .g ~ OJ OJ 10 o OJ en ;r 3 ~ 3 _C 03 :;: . -3' a CD 3 ~ ~ C o ~ ~ - en C 6i~ ~o. CD en ~ ;r ~ ~ CD 0 ~ 0 C ~ CD en ~ ~. C 0 ri :"'!' CD ~ ~ o "0 CD OJ ~ '" ~ (Q ~ CD en CD <' .CD o o ~ !!?, ~ ~ (Q o - !'" '" "0 CD (j CD "" o - ~ ;r CD Ol ~ ~ C 9< o "0 CD OJ ~ 5' (Q 0- C 0. (Q .!E. (fJ "0 CD o ~ o OJ "0 ~ -0 .Q. CD o '" Ol ~ CD ~ CD :;: o o ~ ~ ~ C $l 0' ~ o ~ ~ CD ~ o < Ol ~ 0' ~ "0 ~ o co' o '" OJ ~ 0. ~ CD :;: - C ~ ~ .. C ~ CD o ~ CD .0 ." "0 3 CD "" Ol en en o o 0)' ~ CD 0. :;: s: 3' CD en CD "0 ~ o co' o .'" Ol ~ 0. 3 o g CD ;r CD OJ s: < OJ ~ ~ z o 10 00;) o OJ o~ o-::J CD 0 ~ CD ~;u ",CD o~ 2%<' ~CD o 0. (fJo CD ~ ~~ 3 "" gs ~(Q WCD 01:: . '< "'-" Oc o~ "'0. -I ;r CD o ~ o - .. CD 3 en .'" 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GENERAL REVENUE - STATE 015040 ALG/CESSPOOL IDENTIFICATION AND ELIMINATION 128,707 0 128,707 0 128,707 015040 ALG/CONTR TO CHDS-AIDS PATIENT CARE 404,663 0 404,663 0 404,663 015040 ALG/CONTR TO CHDS-AIDS PREV & SURV & FIELD STAFF 105,802 0 105,802 0 105,802 015040 ALG/CONTR TO CHDS-DENTAL PROGRAM 13,333 0 13,333 0 13,333 015040 ALG/CONTR TO CHDS-MIGRANT LABOR CAMP SANITATION 0 0 0 0 0 015040 ALG/CONTR. TO CHDS-IMMUNIZATION OUTREACH TEAMS 6,592 0 6,592 0 6,592 015040 ALG/CONTR. TO CHDS-INDOOR AlR ASSIST PROG 0 0 0 0 0 015040 ALG/CONTR. TO CHDS-MCH HEAlTH - FIELD STAFF COST 0 0 0 0 0 015040 ALG/CO:--ITR. TO CHDS-SOVEREIGN I~!MUNITY 0 0 0 0 0 015040 ALG/CONTRIBUTION TO CHDS-PRIMARY CARE 17,256 0 ,17,256 0 17,256 015040 ALG/F AMIL V PLANNING 62,578 0 62,578 0 62,578 015040 ALG/IPO - OUTREACH SOCIAL WORKERS CAT. 050707 0 0 0 0 0 015040 ALGIIPO HEAL THY START 0 0 0 0 0 015040 ALGIlPO HEALTHY START/IPO CAT 050707 0 0 0 0 0 015040 ALGIlPO-INFANT MORTALITY PROJECT CAT. 050707 0 0 0 0 0 015040 ALG/MCH HEALTHY STAR T/IPO CAT 050870 0 0 0 0 0 015040 ALG/MCH-INFANT ~IORTALlTY PROJECT CAT. 050870 0 0 0 0 0 015040 ALG/MCH-OUTREACH SOCIAL WORKERS CAT 050870 0 0 0 0 0 015040 ALG/PRIMARY CARE 223,310 0 223,310 0 223.3 to 015040 ALG/SCHOOL HEAL TfI!SUPPLEMENTAL 41,665 0 41,665 0 41,665 015040 C ATE ESCAMBIA 0 0 0 0 0 015040 CHD SUPPORT SERVICES 0 0 0 0 0 015040 CLOSING THE GAP PROGRAM 0 0 0 0 0 015040 TOBACCO PREVENTION &amp: CESSATION PROGRAv! 52,816 0 52,816 0 52,816 015040 COMMUNITY TB PROGRAM 43,181 0 43,181 0 43,181 015040 DENTAL SPECIAL INlTlA TIVE PROJECTS 0 0 0 0 0 015040 DUVAL TEEN PREG:--I.'.NCY PREVENTION 0 0 0 0 0 015040 ENHANCED DENTAL SERVICES 0 0 0 0 0 015040 FL HEPATITIS & LIVER FAILURE PREVENTION/CONTROL 0 0 0 0 0 015040 HEALTH PROMOTION & EDUCA nON l:--IlTlA TIVES 58,823 0 58,823 0 58,823 015040 HEAL THY BEACHES ,10NITORlNG 29,262 0 29,262 0 29,262 015040 HEAL THY START - OAT A COLLECTION PROJECT STAFF 0 0 0 0 0 015040 LA LIGA CONTRA EL CANCER 0 0 0 0 0 015040 MEDlV AN PROJECT 0 0 0 0 0 015040 METRO ORLANDO URBAN LEAGUE TEENAGE PREG PREV 0 0 0 0 0 015040 PRIMARY CARE SPECIAL OEmAl PROJECTS 0 0 0 0 0 015040 PRIMAR Y CARE SPECIAL PROJECTS 0 0 0 0 0 015040 SCHOOL HEALTH-SUPPLEMENT-TAj\;F 11,581 0 11,581 0 11,581 015040 SPECIAL NEEDS SHELTER PROGRAM 0 0 0 0 0 015040 sm GENERAL REVENUE 21,016 0 21,016 0 2l,0]6 015040 VOLUNTEER SCHOOL HEALTH NURSE GRANT 0 0 0 0 0 015050 ALGiCONTR TO CHDS 1,981,220 0 1,981,220 0 1,981,220 GENERAL REVENUE TOTAL 3,201.805 0 3,201,805 0 3,201.805 2, NON GENERAL REVENUE - STATE 015010 ALG/CONTR TO CHDS-REBASING TOBACCO TF 21,864 0 21,864 0 21,86"+ 015010 BASIC SCHOOL HEALTH - TOBACCO TF 40,839 0 40,839 0 40,839 015010 CHD SUPPORT SERVICES 0 0 0 0 0 /3 2. NON GEl'iERAL REVENUE - STATE 015010 FL HEPATITIS & LIVER FAILURE PREVENTION/CONTROL 150,000 0 150.000 0 150.000 015010 FULL SER VICE SCHOOLS - TOBACCO TF 61,720 0 61,720 0 61.720 015010 ONSITE SEWAGE RESEARCH PROGRAM 157,000 0 157,000 0 157,000 015010 TOBACCO PREVENTION AND CESSATION PROGRAM 24,726 0 24,726 0 24,726 015010 PUBLIC SWIMMING POOL PROGRAM 0 0 0 0 0 015010 SUPER ACT PROGRA'>1 ADM TF 0 0 0 0 0 015010 SUPPLEMENTAL/COMPREHENSIVE SCHOOL HEALTH - TOB TF 0 0 0 0 0 015010 VARICELLA IMMUNIZATION REQUIREMENT TOBACCO TF 3,528 0 3,528 0 3,528 015020 BIOMEDICAL WASTE/DEP ADM TF 2,246 0 2,246 0 2,246 015020 SAFE DRINKING WATER PRG/DEP ADM 0 0 0 0 0 015020 FOOD AND WATERBOR:-JE DISEASE PROGRA'vl ADM TFIDACS 0 0 0 0 0 NON GENERAL REVENUE TOTAL 461,923 0 461,923 0 461,923 3. FEDERAL FUNDS - Slale 007000 AIDS PREVENTION 174,324 0 174,324 0 174,324 007000 AIDS SEROPREV ALENCE 0 0 0 0 0 007000 AIDS SURVEILLANCE 0 0 0 0 0 007000 BIOTERR SURVEILLANCE & EPIDEMIOLOGY 0 0 0 0 0 007000 BIOTERRORISM PLANNING & READINESS 148.236 0 148,236 0 148,236 007000 CDHPE PROGRAM 0 0 0 0 0 007000 CHD SUPPORT SERVICES 0 0 0 0 0 007000 CHILDHOOD LEAD POISONING PREVENTION 0 0 0 0 0 007000 COASTAL BEACH MONITORING PROGRAM 25,751 0 25,751 0 25,751 007000 COMPREHENSIVE CARDIOVASCULAR PROGRAM 0 0 0 0 0 007000 FGTF/ AIDS MORBIDITY 0 0 0 0 0 007000 FGTF/BREAST & CERVICAL CANCER-ADMIN/CASE MAN 0 0 0 0 0 007000 FGTF/FAMIL Y PLANNING TITLE X SPECIAL INITIATIVES 0 0 0 0 0 007000 FGTF/FAMIL Y PLANNING-TITLE X 7(807 0 74,807 0 74,807 007000 FGTF/IMMUNIZATION ACTION PLAN 9,998 0 9,99.8. 0 9,998 007000 FGTF/WIC ADMINISTRATION 233.750 0 233.750 0 233,750 007000 PAN FLU SUPPLEMENTAL PHASE 2 14,945 0 14,945 0 14.945 007000 HEALTH PROGRAM FOR REFUGEES 0 0 0 0 0 007000 HOUSING OPPORTUNITIES FOR PEOPLE WITH AIDS (HOPWA) 0 0 0 0 0 007000 IMMUNIZATION SUPPLEMENTAL 0 0 0 0 0 007000 IMMUNIZATION-WIC LINKAGES 0 0 0 0 0 007000 MCH BGTF-GADSDEN SCHOOL CLINIC 0 0 0 0 0 007000 MCH BGTF-HEAL THY START IPO 0 0 0 0 0 007000 MCH BGTF-INFANT MORTALITY PROJECT 0 0 0 0 0 007000 MCH BGTF-MCH/CHILD HEALTH 11,446 0 11,446 0 11,446 007000 MCH BGTF-MCH/DENT AL PROJECTS 0 0 0 0 0 007000 MCH BGTF-OUTREACH SOCIAL WORKERS 0 0 0 0 0 007000 PHp.CITIES RESPONSE II'ITIATIVE 0 0 0 0 0 007000 RAPE PREVENTION & EDCCATION GRA'lT 0 0 0 0 0 007000 SCHOOL HEALTH BASIC MOl-BLOCK GRANT 6.732 0 6,732 0 6,732 007000 RYAN WHITE 32.079 0 32.079 0 32,079 007000 RYAN WHITE - EMERGING COMMUNITIES 0 0 0 0 0 007000 RYAN WHITE-AIDS DRUG ASSIST PROG-ADMIN 22.443 0 22,443 0 22.443 007000 RYAN V./HITE-CONSORTIA 0 0 0 0 0 It/- 3. FEDERAL FUI'iDS - State 007000 STD FEDERAL GRANT - CSPS 0 0 0 0 0 007000 STD PROGRA.M . PHYSICIAN TRAINING CENTER 0 0 0 0 0 007000 STD PROGRAM INFERTILITY PREVENTION PROJECT (lPP) 0 0 0 0 0 007000 SYPHILIS ELIMINATION 0 0 0 0 0 007000 TESTING HIV SERONEGATIVE HEADQUARTERS 0 0 0 0 0 007000 TRAIKI~G A'lD EDUCATION 0 0 0 0 0 007000 TUBERCULOSIS CONTROL - FEDERAL GRANT 0 0 0 0 0 007000 WEST NILE VIRUS & EPIDEMIOLOGY PROJECTS 2006 0 0 0 0 0 007000 WIC BREASTFEEDING PEER COU;;SELING 0 0 0 0 0 007000 WIC BREASTFEEDING PEER COUNSELING PROG FFY 2005 0 0 0 0 0 007000 WIC NFRASTRUCTURE 0 0 0 0 0 015009 MEDIPASS WAIVER-HLTHY STRT CLIENT SERVICES 0 0 0 0 0 015009 MEDIPASS WAIVER-SOBRA 0 0 0 0 0 015075 TITLEXXIISCHOOl HEALTH/SUPPLEMENTAL 81.066 0 81.066 0 81.066 015075 NEW UNE 0 0 0 0 0 015075 NEW LINE 0 0 0 0 0 015075 NEW L1)iE 0 0 0 0 0 FEDERALFU~DSTOTAL 835,577 0 835,577 0 835.577 4. FEES ASSESSED BY STATE OR FEDERAL RULES - STATE 001020 MIGRANT HOUSING PERMIT 0 0 0 0 0 001020 MOBilE HOME AND PARKS 16.447 0 16.447 0 16,447 001020 FOOD HYGIEKE PERMIT 12,358 0 12,358 0 12,358 001020 BIOHAZARD WASTE PERMIT 5,505 0 5,505 0 5,505 001020 SWIMMING POOLS 48,436 0 48.436 0 48,436 001020 PRIVATE WATER SYSTEMS 110 0 110 0 110 001020 PUBLIC WATER ANNUAL OPER PERMIT 0 0 0 0 0 001020 PUBLIC WATER CONSTR PERMIT 0 0 0 0 0 001020 NON-SDWA SYSTEM PERMIT 165 0 161. 0 165 001020 S.'\FE DRINKING WATER 0 0 0 0 0 001020 TANNING FACILITIES 1.386 0 1.386 0 1,386 001020 BODY PIERCING 285 0 285 0 285 001092 INDIVIDUAL SEWAGE 312,135 0 312,135 0 312,135 001092 FOOD HYGIENE 854 0 854 0 854 001092 ENVIRO;-.JMENT AL HEALTH FEES 0 0 0 0 0 001092 OSDS REPAIR PERMIT 0 0 0 0 0 001092 OSDS PERMIT FEE 0 0 0 0 0 001092 I & M ZONED OPERATING PERMIT 0 0 0 0 0 001092 AEROBIC OPERATING PERMIT 0 0 0 0 0 001092 SEPTIC TANK SITE EVALUATION 0 0 0 0 0 001170 LAB FEE CHEMICAL A:'-JAL YSIS 0 0 0 0 0 001170 NO:-';POTABLE \V A TER ANAL YSIS 0 0 0 0 0 001170 WATER ANAL YSIS-POTABLE 0 0 0 0 0 010304 !\IQ.-\. I:'\:SPECTION FEE 3,500 0 3.500 0 3.50lJ FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL 401.181 0 401,181 0 401.181 5. OTHER CASH CONTRIBUTIONS - STA TE Is' 5. OTHER CASH COl'lTRIBUTIONS - STATE 010304 STA T10NAR Y POLLUTANT STORAGE TANKS 111.344 0 111.344 0 111.344 090001 DRAW DOWN FROM PUBLIC HEALTH UNIT 7.865 0 7.865 0 7,865 OTHER CASH CONTRIBUTIONS TOTAL 119.209 0 119.209 0 119,209 6. MEDICAID - ST A TE/COUIHY 001056 MEDICAID PHARMACY 2,062 2.938 5.000 0 5.000 001076 MEDICAID TB 0 0 0 0 0 001078 MEDICAID ADMINISTRATION OF VACCINE 250 250 500 0 500 001079 MEDICAID CASE MA"AGEMENT 0 0 0 0 0 001080 MEDICAID OTHER 0 0 0 0 0 001081 MEDICAID CHILD HEALTH CHECK UP 0 0 0 0 0 001082 MEDICAID DENTAL 1,237 1.763 3,000 0 3.000 001087 MEDICAID STD I.300 1,852 3,152 0 3,152 001089 MEDICAID AIDS 24,744 35.256 60.000 0 60.000 001147 MEDICAID HMO RATE 0 0 0 0 0 001191 MEDICAID MATERNITY 0 0 0 0 0 001192 MEDICAID COMPREHENSIVE CHILD 0 0 0 0 0 001193 MEDICAID COMPREHENSIVE ADULT 0 0 0 0 0 001194 MEDICAID LABORATORY 0 0 0 0 0 001083 MEDICAID F AMIL Y PLANNING 1,000 9.000 10.000 0 10.000 001208 MEDlPASS $3.00 ADM. FEE 2.075 2.075 4.150 0 4,150 MEDICAID TOTAL 32.668 53.134 85.802 0 85,802 7. ALLOCABLE REVENUE - STATE 018000 REFUNDS 0 0 0 0 0 037000 PRIOR YEAR WARRANT 0 0 0 0 0 038000 12 MONTH OLD WARRANT 0 0 0 0 0 ALLOCABLE REVENUE TOTAL 0 0 Q 0 0 8. OTHER STATE CONTRIBUTIONS riOT IN CHD TRUST FUriD - STATE PHARMACY SER VICES 0 0 0 74.224 74.224 LABORATORY SERVICES 0 0 0 63,700 63,700 TB SERVICES 0 0 0 0 0 IMMUNIZA TIOei SERVICES 0 0 0 192.738 192,738 STD SER VICES 0 0 0 0 0 CONSTRUCTION/RENOV A TION 0 0 0 0 0 \VIe FOOD 0 0 0 680,797 680,797 ADAP 0 0 0 0 0 DENTAL SERVICES 0 0 0 0 U OTHER (SPECIFY) 0 0 0 0 0 OTHER (SPECIFY) 0 0 0 0 0 OTHER STATE CONTRIBUTIONS TOTAL 0 0 0 1,011,459 LOIl,459 9. DIRECT COUNTY CONTRIBliTIONS - COUNTY 008030 Bee Contribution from Health Care Tax 0 754,337 754,337 0 754,337 008034 Bee Contribution from General Fund 0 0 0 0 0 If, BOARD OF COUNTY COMMISSIONERS TOTAL 0 754,337 754,337 0 75-1.337 10. FEES AUTHORIZED BY COI.'NTY ORDINANCE OR RESOLUTION - COUNTY 001060 VITAL STATISTICS FEES OTHER 0 845 845 0 845 00 lO77 RABIES VACCINE 0 0 0 0 0 00 I 077 CHILD CAR SEAT PROG 0 0 0 0 0 001077 PERSONAL HEALTH FEES 0 123,000 123,000 0 123,000 001077 AIDS CO-PAYS 0 0 0 0 0 001094 LOCAL ORDINANCE FEES 0 0 0 0 0 001094 ADULT ENTER. PERMIT FEES 0 0 0 0 0 001114 NEW BIRTH CERTIFICATES 0 13,396 13,396 0 ]3,396 001115 DEATH CERTIFICATES 0 55,212 55,212 0 55,212 001117 VITAL STA TS.ADM. FEE 50 CENTS 0 547 547 0 547 FEES AUTHORIZED BY COUI'iTY TOTAL 0 193,000 193,000 0 193.000 I L OTHER CASH AND LOCAL CO:>iTRIBUTIONS - COUNTY 001009 RETURNED CHECK ITEM 0 0 0 0 0 001029 THIRD PARTY REIMBURSEMENT 0 25.181 25,181 0 25.181 001029 HEALTH MAINTENANCE ORGAN. (HMO) 0 0 0 0 0 001054 MEDICARE PART D 0 0 0 0 0 001077 RYAN WHITE TITLE II 0 0 0 0 0 001090 MEDICARE PART B 0 22,000 22,000 0 22.000 005040. INTEREST EARNED 0 0 0 0 0 005041 INTEREST EARNED-STATE INVESTMENT ACCOUNT 0 13,142 13,142 0 13,142 007010 U.S. GRANTS DIRECT 0 474,887 474,887 0 474,887 010300 SALE OF GOODS AND SERVICES TO STATE AGENCIES 0 0 0 0 0 010301 EXP WITNESS FEE CONSULTNT CHARGES 0 0 0 0 0 010405 SALE OF PHARMACEUTICALS 0 0 0 0 0 010409 SALE OF GOODS OUTSIDE STATE GOVERNMENT 0 0 0 0 0 011000 GRANT -DIRECT 0 0 0 0 0 011000 GRANT -DIRECT 0 0 0 0 0 01 1000 GRANT-DIRECT 0 0 0 0 0 011000 GRANT-DIRECT 0 0 0 0 0 011000 GRANT-DIRECT 0 0 0 0 0 011000 GRANT -DIRECT 0 0 0 0 0 011000 GRANT-DIRECT 0 0 0 0 0 011000 GRANT.DIRECT 0 0 0 0 0 011001 HEAL THY START COALITION CONTRIBUTIONS ,0 340,773 340,773 0 340.773 011007 CASH DONA TrONS PRIVATE 0 0 0 0 0 012020 FINES AND FORFEITURES 0 0 0 0 0 012021 RETURN CHECK CHARGE 0 0 0 0 0 028020 INSURANCE RECOVERIES-OTHER 0 0 0 0 0 090002 DRAW DOWN FROM PUBLIC HEALTH UNIT 0 267,256 267,256 0 267.256 0080 I 0 Contribution from City Government 0 0 0 0 0 008020 Contribution from Health Care Tax not thru Bee 0 0 0 0 0 008050 School Board Contribution 0 0 0 0 0 OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL 0 1,143,239 1,143,239 0 1,143.239 )2, ALLOCABLE REVENUE - COUi'iTY J'7 12. ALLOCABLE REVENUE - COUNTY 018000 REFUNDS 0 0 0 0 0 037000 PRIOR YEAR WARRANT 0 0 0 0 0 038000 12 MONTH OLD WARRANT 0 0 0 0 0 COUI'iTY ALLOCABLE REVENUE TOTAL 0 0 0 0 0 13. BUILDIi'iGS - COUNTY ANNUAL RENTAL EQUIVALENT V AWE-GA TO/RIClT A VERNIER 0 0 0 446.000 446.000 BUILDING MAINTENANCE-GA TO/EH MARATHON, TAVERNIER, RUTH IVIIlS 0 0 45,560 45,560 I;JSURANCE 0 0 0 0 0 UTlLITIES-GA TO BUILDING.$15,232/MO* 12"'30% 0 0 0 55,749 55,749 GROUNDS MAINTENANCE 0 0 0 0 0 OTHER (SPECIFY) 0 0 0 0 0 OTHER (SPECIFY) 0 0 0 0 0 BUILDII'iGS TOTAL 0 0 0 547.309 547,309 14. OTHER COUNTY CONTRIBUTIONS I'iOT IN CHD TRUST FUND - COUNTY EQUIPMENTIVEHICLE PURCHASES 0 0 0 0 0 VEHICLE INSURANCE 0 0 0 0 0 VEHICLE MAINTE;JANCE 0 0 0 0 0 OTHER COUNTY CONTRIBUTION (SPECIFY) 0 0 0 0 0 OTHER COUNTY CONTRIBUTION (SPECIFY) 0 0 0 0 0 OTHER COUNTY CONTRIBUTIONS TOTAL 0 0 0 0 0 GRAND TOTAL CHD PROGRAM 5,052,363 2,143,710 7,196,073 1,558,768 8,754,841 /'6 A. COMMUNICABLE DISEASE CONTROL: VITAL STATISTICS (180) 1.20 0 0 15.666 17.945 15.666 17,945 47,197 20,025 67,222 IMMUNIZATION (101) 5.40 3,850 10,100 107.912 118.160 105,125 118,160 315.494 133.863 449,357 STD (102) 1.80 235 1,715 30,673 34,862 30,326 34,862 91,781 38,942 130,723 AIDS (103) 26,00 440 '12.500 606,435 651,349 587,732 651,3491,753,049 743,816 2,496,865 T8 CONTROL SERVICES (104) 1.30 70 440 23,119 25.149 21.738 25,149 66.808 28,347 95,155 COMM DISEASE SURV, (106) 1.10 0 1.030 17.365 20,146 17,365 20,146 52,673 22,349 75,022 HEPATITIS PREVENTION (109) 1.80 390 2,315 40,097 56,620 49.717 56,620 142,564 60,490 203,054 PUBLIC HEALTH PREP AND RESP (I 16) 2.40 0 4 29,051 49,272 43,918 49,272 120,419 51,094 171,513 COMMUNICABLE DISEASE SUBTOTAL 4IOO 4,985 28,104 870,318 973,503 871,587 973,503 2,589.985 1,098,926 3,688.91 I B. PRI:\IARY CARE: CHRONIC DISEASE SER VICES (2 I 0) 1.20 35 40 1,500 21.800 19.400 21,800 45,285 19,215 64,500 TOBACCO PREVENTION (2 I 2) 120 0 0 0 26,980 24,304 26,980 54.949 23,315 78,264 HOME HEALTH (215) 0,00 0 0 7 8 7 8 21 9 30 W.IC (221) 480 1.870 11,500 80.050 92.072 80.050 92.072 24 I .694 102,550 344,244 FAMIL Y PLANNING (223) 4,90 1.120 7,100 115,571 120,075 108,668 120.075 326,048 138,341 464,389 IMPROVED PREGNANCY OUTCOME (225) 0,00 2 2 320 374 320 374 975 413 1.388 HEAL THY START PRENATAL (227) 340 400 8,800 56,686 65,098 56,575 65,098 170,931 72,526 243.457 COMPREHENSIVE CHILD HEALTH (229) 0,60 135 305 13,457 14,651 13,406 14,651 39,433 16,732 56,165 HEALTHY START INFANT (231) 2.30 315 7.000 35,967 41,961 35,967 41,961 109,426 46.430 155,856 SCHOOL HEALTH (234) 4,60 0 81,000 75,737 85,956 75,737 85.956 227.049 96,337 323,386 COMPREHENSIVE ADULT HEALTH (23 7) 3.70 1,320 5,400 87,631 90,614 80,938 90,614 245,592 104,205 349,797 DENTAL HEALTH (240) 0,00 0 0 41 48 41 48 125 53 178 PRIMARY CARE SUBTOTAL 26.70 5,197 121.147 466,967 559,637 495,413 559,637 1,461,528 620,126 2,081,654 C. ENVIRONMENTAL HEALTH: Water and Onsite Sewage Programs COASTAL BEACH MONITORING (347) 1.50 2,100 3,150 23.997 24,011 22,695 24,0 if 66,499 28,215 94,714 LIMITED USE PUBLIC WATER SYSTEMS (357) 000 0 0 0 0 0 0 0 0 0 PUBLIC WATER SYSTEM (358) 000 0 0 0 0 0 0 0 0 0 PRIVATE WATER SYSTEM (359) 0,00 0 0 0 0 0 0 0 0 0 INDIVIDUAL SEWAGE DISP. (361) 7.70 7,895 21.200 161.148 182,737 156,839 182,737 479,858 203,603 683,461 Group Total 9.20 9,995 24,350 185,145 206,748 179.534 206,748 546,357 231.818 778,175 Facility Programs FOOD HYGIENE (348) 0.50 75 380 10.112 9,629 8,253 9,629 26,415 11,208 37,623 BODY ART (349) 000 0 0 0 0 0 0 0 0 0 GROUP CARE FACILITY (351) 030 590 880 5,187 5,365 4,599 5.365 14,404 6,112 20,516 MIGRANT LABOR CA1vfP (352) 0.00 0 0 0 0 0 0 0 0 0 HOUSING,PUBLIC SlOG SAFETY,SA'JITATION (35fl)00 0 0 II 12 II 12 32 14 46 J\lOBlLE HOME AND PARKS SERVICES (354) 0.30 110 245 7,845 7,449 3,536 4.125 16,117 6,838 22,955 SWIMMI:'oJG POOLS/BATHING (360) 100 1.776 4,120 21,766 25,167 21,766 25,167 65.903 27,963 93,866 BIOMEDICAL WASTE SERVICES (364) 0,40 1,350 1,370 7,345 8,355 7,345 8,355 22,046 9.354 31.400 TANNING FACILITY SERVICES (369) 000 5 10 312 297 255 297 815 346 U61 19 C, ENVIRONMENTAL HEALTH: Group Total 2.50 3,906 7,005 52,578 56,274 45,765 52,950 145,732 61,835 207,567 Groundwater Contamination STORAGE TANK COMPLIANCE (355) 220 700 1,570 46,662 53,679 46,662 53,679 140,899 59,783 200,682 SUPER ACT SERVICE (356) 000 0 2 349 352 349 352 984 418 1,402 Group Total 2.20 700 1,572 47,011 54;031 47,011 54,031 141,883 60,201 202,084 Community Hygiene RADIOLOGICAL HEALTH (372) 0.00 0 2 233 264 233 264 698 296 994 TOXIC SUBSTANCES (373) 0.80 250 250 1,117 16,432 14,132 16,432 33,780 14,333 48,113 OCCUPATIONAL HEALTH (344) 0.10 0 100 1,858 2,168 1,858 2,168 5,653 2,399 8,052 CONSUMER PRODUCT SAFETY (345) 0.00 0 15 114 145 124 145 378 160 538 INJURY PREVENTION (346) 0.00 0 0 0 0 0 0 0 0 0 lEAD MONITORI~G SERVICES (350) 000 0 0 0 0 0 0 0 0 0 PUBLIC SEWAGE (362) 0.00 0 0 96 112 96 112 292 124 416 SOLID WASTE DISPOSAL (363) 0.00 0 2 698 687 677 687 1,930 819 2,749 SANlT AR Y NUISANCE (365) 010 37 110 2,338 2,615 2,242 2,615 6,888 2,922 9,810 RABIES SUR VElllANCE/CONTROl SERVICES (36~00 2 15 479 559 479 559 1,458 618 2,076 ARBOVIRUS SUR VEIllANCE (367) 0.00 0 8 154 180 154 180 469 199 668 RODENT/ARTHROPOD CONTROL (368) 0.00 0 320 201 234 201 234 611 259 870 WATER POLLUTION (J70) 0.00 0 0 38 45 38 45 117 49 166 AIR POLLUTION (371) 0.00 0 0 122 143 122 143 372 158 530 Group Total 1.00 289 822 7,458 23,584 20,356 23.584 52,646 22,336 74,982 ENVIRONMENTAL HEALTH SUB TOT AL 14.90 14,890 33,749 292,192 340,637 292,666 337,313 886,618 376,190 1,262,808 D, SPECIAL CONTRACTS: SPECIAL CONTRACTS (599) 2.40 0 0 0 55,945 50,810 55,945 114,232 48,468 162,700 SPECIAL CONTRACTS SUBTOTAL 2.40 0 0 0 55,945 50,810 55,945 114,232 48,468 162,700 TOTALCO"iTRACT 85.00 25,072 183,000 1,629,477 1,929,722 1,710,476 1,926,398 5,052,363 2,143,710 7,196,073 t7l , ATTACHMENT III MONROE COUNTY HEALTH DEPARTMENT CIVIL RIGHTS CERTIFICATE The applicant provides this assurance in consideration of and for the purpose of obtaining federal grants, loans, contracts (except contracts of insurance or guaranty), property, discounts, or other federai financial assistance to programs or activities receiving or benefiting 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 discrimination 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 et 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 1981, 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 applicant 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 period during which such assistance is provided. The applicant further assures that all contracts, subcontractors, sub-grantees 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 empioyees 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 appiicant 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. 21 ATTACHMENT IV FACILITIES UTILIZED BY THE MONROE COUNTY HEALTH DEPARTMENT Facility Description Location Owned Bv Gato Building Administration Nursing Environmental Health 1100 Simonton Street Key West, FL 33040 County Health Care Center 1200 Kennedy Drive Key West, FL 33040 Lower Keys Medical Roosevelt Sands Center 105 Olivia Street Key West, FL 33040 County Ruth Ivins Center For Public Health 3333 Overseas Hwy. Marathon, FL 33050 County Environmental Health 13367 Overseas Hwy. Marathon, FL 33050 Alan Schmitt Roth Building Public Health Unit Environmental Health 50 High Point Road Tavernier, FL 33070 County 22 ATTACHMENT V MONROE COUNTY HEALTH DEPARTMENT SPECIAL PROJECTS SAVINGS PLAN IDENTIFY THE AMOUNT OF CASH THAT IS ANTICIPATED TO BE SET ASIDE ANNUALLY FOR THE PROJECT. CONTRACT YEAR STATE COUNTY TOTAL 2004-2005 $ $ $ 2005-2006 $ $ $ 2006-2007 $ $ $ 2007-2008 $ $ $ 2008-2009 $ $ $ PROJECT TOTAL $ $ $ SPECIAL PROJECT CONSTRUCTION/RENOVATION PLAN PROJECT NAME: LOCATION/ ADDRESS: PROJECT TYPE: NEW BUILDING RENOVATION NEW ADDITION ROOFING PLANNING STUDY OTHER SQUARE FOOTAGE: PROJECT SUMMARY: Describe scope of work in reasonable detail. ESTIMATED PROJECT INFORMATION: ST ART DATE (initial expenditure of funds) : COMPLETION DATE: DESIGN FEES: $ CONSTRUCTION COSTS: $ FURNITURE/EQUIPMENT $ TOTAL PROJECT COST: $ COST PER SO FOOT: $ Special Capital Projects are new contruction or renovation projects and new furniture or equipment associated with these projects and mobile health vans. ?:1 ATTACHMENT VI MONROE COUNTY HEALTH DEPARTMENT PRIMARY CARE "Primary Care" as conceptualized for the county health departments and for the use of categorical Primary Care funds (revenue object code 015040) is defined as: "Health care services for the prevention or treatment of acute or chronic medical conditions or minor injuries of individuals which is provided in a clinic setting and may include family planning and maternity care." Indicate below the county health department programs that will be supported at least in part with categorical Primary Care funds this contract year: _x_ _X_ _X_ Comprehensive Child Health (229/29) Comprehensive Adult Health (237/37) Family Planning (223/23) Maternal HealthllPO (225/25) Laboratory (242/42) Pharmacy (241/93) Other Medical Treatment Program (please identify) Describe the target population to be served with categorical Primary Care funds. The primary population served is under and non-insured. Does the health department intend to contract with other providers for the delivery of primary health care services using categorical (015040) Primary Care funds? If so, please identify the provider(s), describe the services to be delivered, and list the anticipated contractual amount by provider. 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