Item K1
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date:
1/17-18/01
Division: Monroe County Health Department
Sulk Item: Yes X
No
Department:
AGENDA ITEM WORDING:
Approval of the annual Core Contract between the Soard of County Commissioners and the
Florida Department of Health, Monroe County Health Department, for services provided in
Monroe County.
ITEM BACKGROUND:
This is the annual renewal of the standard contract between the County and the Monroe
County Health Department which has been in effect for 15+ years for services provided by the
MCHD in Monroe County.
PREVIOUS RELEVANT BOARD ACTION:
This contract has been renewed each year for the past 15+ years.
STAFF RECOMMENDATION:
Approval
TOTAL COST:
N/A
BUDGETED: Yes
No
COST TO COUNTY: N/A
REVENUE PRODUCING: Yes
NoL
AMOUNT: PER MONTH
YEAR:
APPROVED BY: County Attorney _ OMS/Purchasing
Risk Management
DIVISION DIRECTOR APPROVAL~~. a.-
Steve Mason, Actin'g Administrator
Monroe County Health Department
DOCUMENTATION: Included
X
To Follow
Not Required
DISPOSITION:
AGENDA ITEM #
I'1l1
!\10NROE COUNTY BOARD OF COlJ"?\TY COMMISSIOl'\~RS
CONTR.A.CT SUMMARY
Contract It
Contract with: Monroe County Health Department
Effective Date:10 t01 /00
---
Expiration Date: .3..J:lQ_J..lll
Health Dept.
Contract, Purpose/Description:
.'
Core Contract with the
Contract Manager: Steve Mason
(Name)
293-7544
(Exl. )
Health Department
(Department)
for BOCC meeting on 01./ 1 7
/ 01
Agenda Deadline: 01 /03 /01
~ -
CONTRA.CT COSTS
Total Dollar Value of Contract: $~ 295,000 Current Year portion: $ ?qt:): nnn
Budgeted? Yes X No Account Codes:
Grant: $
County Match: $
ADDITIONAL COSTS
N/A /yr For: (In-kind services)
(eg. maintenance, utilities, janitorial, salaries, etc.)
Estimated Ongoing Costs: $
(Not included in dollar value above)
County Attorney
/ 1
---
CONTR.A.CT REVIEW
Changes
Needed
Yes 1"0/"
(VJ _> ~~----
(J' C\. I l.JC;",-~ V~~*~'i'
(vr~(j0/JA~
,:....---
( ) S~ .~"'\\I\C-~
Reviewer
Date Out
Date In
Division Director
I~/:;::;WQQ
/ ~/;;t;I-f (J"D
j L/3:3:!~
Ris~ ~agement
o.~\l}Purchasing
l~J "J,';)../ co
\ L.rZZJ r.i) (
Ie? ~tJtJ .
_1_/-
Comments :
OMB Form Revised 8/30/95 Me? It2
l\10NROE COUNTY BOARD OF COlTNTY COlvlJ\1ISSIOl'.~RS
CONTRACT SUMMARY
Contract #
Contract with: Monroe County Health Department
Effective Date:l0 tH lOa
---
Expiration Date: ~/3JLI .ill
Health Dept.
Contract yurpose/Description:
Core Contract with the
Contract Manager: Steve Mason
(Name)
293-7544
(Ext.)
Health Department
(Department)
for BOCC meeting on 01 ,I 1 7 I 01
Agenda Deadline: 01 I 03 I 01
CONTRACT COSTS
Total Dollar Value of Contract: $~295, 000 Current Year Portion: $
Budgeted? Yes X No Account Codes:
Grant: $
County Match: $
?qc:; ()()()
.
ADDITIONAL COSTS
N/A Iyr For: (In-kind services)
(eg. maintenance, utilities, janitorial, salaries, ete.)
Estimated Ongoing Costs: $
(Nol included in dollar value above)
Date In
CONTRACT REVIEW
Changes
Needed Reviewer
Yes No./'
(V) _~ ~~-----
Date Out
Division Director
/~I7J-I~
I ~/~ a?'
Risk Management
_1_1-
I I
---
O.M.B./Purchasing _1_/-
" 1
---
County Attorney
/2- 1220lJ
( )
(~ ~/t:::&m
j. a. ').1 Of)
Comments :
~
OMB Form Revised 8/30/95 Me? It2
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 2000-2001
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, 2000.
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. I I
B. County Health Departments were created throughout
Florida to satisfy this legislative intent through
"promotion of the public I s health, the control and
eradication of preventable diseases, and the provision of
primary health care for special populations."
C.
f:'10D.!'o~ County Health Department ( "CHD I I )
of the County Health Departments created throughout
It is necessary for the parties hereto to enter
Agreement in order to assure coordination between
and the County in the operation of the CHD.
is one
Florida.
into this
the State
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, 2000, through September
30, 2001, 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 . 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 IAIDS,
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:
2
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 I I of Attachment I I
h81;eof. This funding will be used as shown in Part I of
Attachment II.
i. The State's appropriated responsibili ty
(direct contribution excluding any state authorized
fees or "OTHER" state revenues) as provided in
Attachment II, Part II is an amount not to exceed $ _
4,199,494. The State I 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 or "OTHER"
local revenues) as provided in Attachment II, Part II
is an amount not to exceed $ 339,000
b. Overall expenditures will not exceed available funding
(ei ther 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.
c. Either party may establish service fees as allowed by
law to fund activities of the CHD. These fees are listed in
Attachment II Part II. 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:
3
County Health Department Trust Fund
Monroe County
P.O. 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 Hi th
the concurrence of the Ccmty. The director/administrator of
the CHD shall insure that noncategorical 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.
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 pe!sonnel 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 Department of
Heal th 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 accordance with the terms of this
Agreement. State procedures must be followed for all leases
on facilities not enumerated in Attachment VI.
c. The CHD shall maintain books, records and documents in
accordance with those promulgated by the Generally Accepted
Accounting Principles (GAAP) and Governmental Accounting
4
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
no~ otherwise subject to disclosure as provided by law which
are subj ect 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
the Florida
(FLAIR) .
revenue and
Accounting
expenditure requirements in
System Information Resource
~~. 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 Departm~nt
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, then 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
5
the funding requirements of each participating governmental
enti ty in the following year. However, in each such case,
all surplus funds, including fees and accrued interest, shall
remain in the trust fund and shall be 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.
f. There shall be no transfer of funds between the three
levels of services without a contract amendment duly signed
by both parties to this contract and the proper budget
amendments 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 recordkeeping 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
concerning a recipient of services except as
federal or state law or policy.
information
allowed by
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.
6
) ~~.!.._,i'..!..,:;'
)":.~:~".~.~';;:1: ;~;:~:
k. The CHD shall maintain confidentiality of all data,
files, and records that are confidential under the law or are
otherwise excepted 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
sh?,ll comply with sections 384.29, 381.004, 392.65 and
455.667, 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
securi ty requirements and shall comply with any applicable
professional standards of practice with respect to client
confidentiality.
1. 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.
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:
~.
Report
Report;
The
and
DE385L1 Contract Management
the DE580L1 Analysis of Fund
Variance
Equities
ii. A written explanation to the county of service
variances reflected in the DE385L1 report if the
variance exceeds or falls below 25 percent of the
planned expendi ture amount. However, if the
cumulative amount of the variance between actual and
7
planned expenditures does not exceed one 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.
.'
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:
~. March 1, 2001 for the report period
October 1,2000 through December 31, 2000;
ii. June 1, 2001 for the report
October 1,2000 through March 31, 2001;
period
iii. September 1, 2001 for the report period
October 1, 2000 through June 30, 2001; and
~v. December 1, 2001 for the report period
October 1,2000 through September 30, 2001.
7. FACILITIES AND EQUIPl'lENT.
that:
The parties mutually agree
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.
8
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
ma-il, 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 my 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 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. Availabili ty of Funds. I f this Agreement, any
renewal hereof, or any term, performance or payment
hereunder, extends beyond the fiscal year beginning July 1,
~001, 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
f 0 11 0\-1 S :
For the State:
For the County:
Diana M. Mellon-Lacey
Name
James Roberts
Name
Senior Management Analyst Sup.
Title
County Administrator
Title
~lnn r.nllp~p Rn~n
P.O. Box 6193
Address
Key West, FL 33043-6193
(305) ?g~-7~~~
Telephone
AKciclrew;sc::t. FT. 13040
(305) 292-3423
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.
10
In WITNESS THEREOF, the parties hereto have caused this
page agreement to be executed by their undersigned officials as
duly authorized effective the 1st day of October, 2000.
.#
..
-.
BOARD OF COUNTY COMMISSIONERS
STATE OF FLORIDA
FOR
COUNTY
DEPARTMENT OF HEALTH
Mnnrnp
SIGNED BY:
SIGNED BY:
NAME:
NAME:
Robert G. Brooks
TITLE:
TITLE:
Secretary
DATE:
DATE:
ATTESTED TO:
SIGNED BY:
SIGNED BY:
~-~<"-~~
TITLE:
TITLE:
~~ue "" ASc-)~'
.qc.:.T~- ~'1
CHD B~~~cto~/ Administrator
NAME:
NAME:
DATE:
DATE:
,;:). / ~'):J. /00
11
ATTACHMENT I
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 CIS/HMC minimum data set and the SAMAS 2.2 requirements because of federal
or state '~aw, 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
Requirement
1.
Sexually Transmitted Disease
Program
Requirements as specified in FAC 64D-3
and F.S.384 and the CHD Guidebook
Internal Operating Policy STD 6 and 7.
2.
Dental Health
Monthly reporting on OH Form 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.
4.
Healthy Start/
Improved Pregnancy Outcome
Requirements as specified in the Healthy
Start Standards and Guidelines 1998 and as
specified by The Healthy Start Coalitions
in contract with each county health
department.
5.
Family Planning
periodic financial and programmatic
reports as specified by the program offiCE
and in the CHD Guidebook, Internal
Operating Policy FAMPLAN 14*
6.
Immunization
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.
7.
CHD Program
Requirements as specified in HRSM 150-3*
and HRS.M 50-9*.
8.
Chronic Disease Program
Requirements as specified in the Communit
Intervention Program (ClP) and the CHD
Guidebook.
9.
Environmental Health
Requirements as specified in OHP 50-4* ar
50-21*.
ATTACHMENT I (Continued)
J
~
Requirements as specified in Florida
Statue 384.25 and 640-3.016 and 3.017
F.A.C. and the CHD Guidebook. Case
reporting on CDC Forms 50.428 (Adult!
Adolescent) and 50.42A (Pediatric).
Socio-demographic data on persons tested
for HIV in CHO 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.
HIV!AIOS Program
11.
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.
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This is a working copy of the ATTACHMENT II. It is not a valid Contract Copy
MONROE COUNTY HEALTH DEPARTMENT
Part II. Sources of Contributions to County Health Department
CHD Trust Fund (cash) Other Contributions
STATE
1. GENERAL REVENUE
015050 ALG/Contributions To CIID (050329)
015011 ALG/Cont to CIID Primary Care (050329)
015065 "_. ALG/Cont to CHD AIDS Prev & Surv & Field StalT (050329)
015050 ALG/Cont to CIID Mig Lbr Camp San (050329)
015050 ALG/Cont 10 CliO 1I0me 11Ith Pilot proj (050329)
015050 ALG/Cont to CIID-Sovcrcign Immunity (050329)
015050 ALG/Cont to CHDs Pincllas Indigent Dent1 C1inic-UF (050329)
015050 ALG/Cont to CHDs-Dcntal Program (Cat. 050329)
015050 ALG/Cont to CHDs Immun Outrcach Teams (050329)
015050 ALG/Cont to CHDs Comm TB Program (050329)
015050 ALG/Cont to CHDs Indoor Air Assist (050329)
015050 ALG/Cesspoolldentilieation and Elimination (Cat. 050329)
015048 ALG/Cont to CHD STD Program (050329)
015037 ALG/Cont to CHDs Mtrnl & ChId Hlth Field Staff Cost (050329)
015050 Epidemiology Tming & Clinical Supp-Wakulla (CAT. 050329)
015123 ALG/Family Planning (050001)
015123 ALGlFamily Planning Planned Parcnthood NE FL (CAT. 050001)
015123 ALG/Family Planning (CAT. 05000 I) - Alachua Colposcopy
015065 ALG/Cont to CHD AIDS Pat Carc (050026)
015115 ALG/School Hcalth Sves (051106)
015140 ALG/School Health Supplemental (051106)
015124 ALG/IPO-IIcalthy StartllPO (050707)
015124 ALG/IPO-!nfant Mortality Projcct{CAT. 050707)
015124 ALGIIPO - Outrcach Social Workcrs (CAT. 050707)
015137 ALGIIPO Healthy Start Resource Moms & Dads (050707)
015137 ALG/Community Health Initiatives (052250)
015137 ALGIIPO-Hcalthy Start-Data Collect. Prj Staff(CAT. 050707)
015124 ALG/MCH-lIealthy Start/1 PO (050870)
015124 ALG/IPO Outreach Social Workcrs (CAT 050870)
015124 ALG/MCH-Infant Mortality Project (CAT. 050870)
015123 Planncd Parcnt Hood - Collicr and Sarasota (CAT. 050329)
015012 G/A Epilepsy Services (050082)
015011 ALG/Primary Care (050331)
015050 CA TE-Environmental Community-Escambia (052250)
015050 Ncw Horizons/Health Prevention-Dadc (052250)
015050 !nterdiscip. Mngd Care Initiative-Flagler & Vol usia (052250)
015050 Isabel Collier Read Prcntl Carc Clinic-Collicr & Lee(052250)
015050 Primary Carc Outreh Prgm-Sun coast Hosp-Pinellas (052250)
015050 Dunbar Health Center-Lee (052250)
015050 Roosevelt Sands Comm. Healthcare Ctr.-Monroe (052250)
015050 Medivan Projcct/Eldcrly !ntercst-Broward (052250)
015050 Hcalthy Beaches Monitoring
GENERAL REVENUE TOTAL
2. NON GENERAL REVENUE
015010 ALG/Contr. to CHDs-Rebasing (050329) Tobacco TF
015072 ALG/Cont to CHD Safe Drinking Watcr-DEP (050329) Adm TF
015026 ALG/Cont to C1lD Bio-Mcdieal WastclDEP (050329) /Adm TF
015170 Tobacco Coordination (106014) Tobacco TF
015172 Full Scrvice Schools - Tobacco (102258) Tobacco TF
015174 Basic School Hcallh - Tobacco (051106) Tobacco TF
015016 G/A Epilcpsy Prev and Educ (050083) /Epilcpsy TF
015084 Varicella Immunization Requiremcnt (050329) Tobacco TF
015010 ALG/Contr. to CHDs - FY 1999-00 Holdback
015020 Food and Waterborne Disease Program (050329) Adm TF
1,197,646
17,256
105,802
o
()
o
o
40,000
6,232
107,366
o
128,707
21,016
o
o
60,731
o
o
384.663
31,920
122,731
171,881
o
o
o
o
o
11.89 I
o
o
o
o
223,310
o
o
o
o
o
o
100,000
o
o
2.731.152
21,864
o
4,071
51,637
67,318
8,919
o
3,582
2,446
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
()
o
o
o
o
o
o
o
T o1:11
1.197,646
17,256
105,802
o
o
o
o
40,OOC
6,232
107,36E
o
128,70i
21,01E
C
C
60,731
C
C
384,66:
31,92(
122,73.
171,88
(
(
(
(
(
11,89
(
(
(
223,31
100,OC
2,731,1:
21,8!
4,0
51,6
67,3
8,9
3,5
2,4
This is a working copy of the ATTACHMENT II. It is not a valid Contract Copy
MONROE COUNTY HEALTH DEPARTMENT
Part II. Sources of Contributions to County Health Department
CHD.Trust Fund . (cash) /. Other Contr.ibutions
STATE
2. NON GENERAL REVENUE
015010 Pasco CHD Dental Program (050329) Tobacco TF
015010 Enhanccd Dental Services (050329) Tobacco TF
015010 ~ Fla Hepatitis & Liver Fail. Prev & Cnrl(050329)Tobacco TF
010304 Stationary Pollutant Storage-DEP
015121 Super Act Reimburscments
015113 SPL Prgm Rcimb ofCI-ID
NON GENERAL REVENUE TOTAL
3. FEDERAL FUNDS
015075 Refugcc Centcr Reimburscment
015075 Car Scat Rcimbursement.
015075 KidCare Outreach Program
007010 Bcach Walcr Sampling Study
007065 FG TF/ AIDS Prevcntion
007066 fG TF/Ryan White
007066 FG TF/Ryan Whitc
007066 FG TF/Ryan White- AIDS Drug Assist Prog.-Admin.
007062 FG TF/ AIDS Epidemiological Research Study
007049 fG TF/ALG/ Contr to CHDs-STD Prg-Infertility Prg
007049 FG TF/ALG/ Contr to CHDs-STD Prg-Syphilis Elimination
007049 fG TF/ALGI Conlr to CHDs-STD Program
007067 Tubcrculosis Control - Fcderal Grant
007084 Immunization Spccial Projcct
007084 fG TF/ALG/Contr to CHDs-lmmunization Action Plan
007085 Brcast and Cervical Cancer-Clicnt Services
007085 Brcast and Ccrvical Cancer-Admin/Case Management
007084 FG TF/ALG/Contr to CHDs-Project Field Staff
007084 Immunization Action Plan-WIC Immunization Linkagc
007133 ALG/f'amily Planning Titlc X-Sterilzations
007127 ALG/MC11-MCII Blk Grt.-Child Hcalth
007134 ALG/MCH-MCH Blk Grt Outreach Soc Wrkrs
007134 ALG/MCH-MCH Blk Grt-Outreach Soc Wrkrs
007134 ALG/MCH-MCH Blk Grt.-IPO Infant Mort. Proj.
007132 ALG/MCH-MCI-I B1k Grt.-Dental Projects
007134 ALG/IPO/MCH-Infant Mortality Projcct
007134 ALG/1PO-MCH I3lk. Grt.-IPO-Gadsdcn Sch Clinic
007127 ALG/MCH-MCH Blk Grt-Child Health Ages 0-1 Yr.
007134 ALG/MCH Blk Grt-Healthy Start/I PO
007134 ALG/IPO-MCH Blk Grt- Healthy Start/1PO
007063 Prev Hlth Blk GrtlHERR-Chronic Disease Init.
007133 ALG/Grants & Aids-Fam Ping Svcs-Title X
007133 ALG/Fam Ping-Title X-Duval The Bridge
015075 ALG/fam Ping - Prcgnancy I'rcv-TANF
007133 ALG/Grants & Aids-Fam Ping-Special Contracts-Title X
007030 Migrant Labor Sanitation
007056 FG TF Hcalth Program for Rcfug. (180000)
007068 FGTF/Fedcral Grants-AIDS Inmatc Intervcntion
007069 Minority Involvement in HIV/AIDS Program
007064 FGITF AIDS Seroprevalcnce
007064 FGITf' AIDS Surv/Serop
007051 WIC Infrastructurc Grant 2000-2001
007051 FG TF WIC Admin Transfer (050329)
007135 T ANI' Abstincnce Education
007135 Abstincnce Education Program Fcd Grants TF
015075 G/A Epilepsy Services-TANF
o
o
190.000
o
o
o
349,837
o
o
63,333
17,091
172.910
456,263
o
22,443
o
o
o
o
o
3,014
5,558
o
o
o
o
1.625
11,446
o
o
o
o
o
o
2,753
29,400
37,189
o
49,344
o
13,927
o
o
o
o
o
o
o
o
213,896
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
Total
o
o
190,000
o
o
o
349,837
o
o
63,333
17,091
172,910
456,263
o
22,443
o
o
o
c
C
3,OI~
5,55E
C
C
(
(
1,62~
11,44(
(
(
(
(
(
I
2,75
29,40
37,18
49,34
13,92
213,8
This is a working copy of the ATTACHMENT n. It is not a valid Contract Copy
MONROE COUNTY HEALTH DEPARTMENT
Part II. Sources of Contributions to County Health Department
CHD Trust Fund(cash) Other Contributions
ST ATE
3. FEDERAL FUNDS
007049 ALG/Contr to CHD-STD-Medical & Lab Svc Tmg Ctr
015075 Full Service Schoo1s-T ANI'
o 15075 ~. ALG/School Health-Supplcment-T ANI'
007058 FGrrF Diabetes Control
007044 Prcv I-11th Blk GrtlRapc Awarcncss
FEDERAL FUNDS TOTAL
4. FEES ASSESSED BY STATE OR FEDERAL RULES
00 I 091 Fcd. Rule Comm Disease
001092 Environmcntal Hcalth Fces
001113 Mobile Homc and Parks
001132 Food Hygiene Permit
001092 OSDS Repair Permit
001092 OSDS Permit Fee
001211 Safe Drinking Water
001136 1 & M Zoncd Operating Permit
001092 Acrobic Operating Pcrmit
001092 Scptic Tank Sitc Evalualion
001139 Migrant Housing Permit
001140 Biohazard Wastc Pcrmit
001166 Non-SDWA Systcm Pcrmit
001142 Non SDW A Lab Sample
001144 Tanning Facilitics
001145 Swimming Pools
001166 Public Watcr Conslr Pcrmit
001165 Private Watcr Constr Pcrmit
001166 Public Water Annual Opcr Pcrmit
001170 Lab Fcc Chemical Analysis
00 I 026 Returned Chcck Scr Fces
010403 Fecs-Copy of Public Doc
015055 Rcgislar Fccs (Ch. 382.34)
001135 OSDS Variance Fcc
015052 Transfcrs-Mobile Homc/RV Park
001149 Body Piercing
FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL
5. OTHER CASH CONTRIBUTIONS
090001 Draw down from Public Hcalth Unit
OTHER CASH CONTRIBUTIONS TOTAL
6. MEDICAID
001056 CHD Incm:Medicaid-Pharmacy
00 I 080 CI-ID Incm:Medicaid-Other
001081 CHD Incm:Medicaid-EPSDT
001082 CHD Incm:Mcdicaid-Dental
001083 CHD Incm:Medicaid-FP
001084 CHD Incm:Mcdicaid-Physician
00 I 085 CHD Incm:Medicaid-Nursing
001086 CHD Incm:Co-lnsurance
001087 CHD Incm:Mcdicaid-STD
001088 CHD Incm:Med Reimb AZT Disp Fee
001089 Mcdicaid AIDS
001147 Medicaid HMO Ratc
001148 Medicaid-HMO Admin
0 0
6,732 0
11,581 0
0 0
0 0
1,118,505 0
850 0
181,000 0
16,000 0
13,000 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
4,000 0
0 0
0 0
1.400 0
36,000 0
0 0
0 0
0 0
0 0
0 0
550 0
0 0
300 0
0 0
135 0
253,235 0
-492,076 0
-492,076 0
0 0
0 0
0 0
0 0
0 0
3,500 0
0 0
0 0
0 0
0 0
12,000 0
0 0
0 0
Total
o
6,732
11,581
o
o
1,118,505
850
181,000
16,000
13,000
o
o
o
o
o
o
o
4,000
o
o
1,400
36,000
o
o
o
o
o
550
o
300
o
135
253,23:
-492,071
-492,07,
3,5C
12,01
This is a worl\:ing copy of the ATTACHMENT II. It is not a valid Contract Copy
MONROE COUNTY HEALTH DEPARTMENT
Part II. Sources of Contributions to County Health Department
i CHD '[rustFund {cash) .., Other contributions ' 'To,W
STATE
6. MEDICAID
001181 CHD Incm:Medicaid Transportation 0 0 0
001190 .# Hcalth Maintcnancc Organ. (HMO) 0 0 0
001191 "CHD Incm:Medicaid Maternity 0 0 0
001192 CHD Incm:Medicaid Compo Child 0 0 0
001193 CHD Incm:Medicaid Compo Adult 100 0 10C
001194 CHD Incm:Medicaid SonagraITI 0 0 C
001208 Medipass $3.00 Adm. Fce 3,120 0 3,12C
MEDICAID TOTAL 18,720 0 18,72C
7. ALLOCABLE REVENUE
011007 Cash Donations Privatc 300 0 30e
001029 Third Party Rcimbursement 0 0 e
010301 Exp Witncss Fce Consultnt Charges 10 0 1(
005040 Interest Emed Statc Investment 100.000 0 100,00
005041 Interest Emed Local I nvestment 0 0 (
007010 U.S. Grants Direct to CHD 420.928 0 420.92
008094 Grnts/Contracts othcr Agencies Dircct 0 0
011098 Donation School Bascd Clinic 0 0
011099 Other GrantslDonations Direct 2,000 0 2,00
012020 Fines and Forfciturcs 0 0
018001 Refunds, Salary 1,290 0 1,29
018003 Rcfunds, othcr Personal Services 0 0
018004 Rcfunds, Expcnses 1.581 0 1,58
018006 Refunds, Opcrating Capital Outlay 0 0
018010 Rcfunds, Special Category 0 0
018011 Rcfunds, Olhcr 0 0
018099 Refunds, Certified Forward 0 0
037000 Prior Year Warrant 718 0 71
038000 12 Month Old Warrant 0 0
010300 Salc of Goods and Serviccs 1.000 0 I,OC
010402 Recycle Paper Sales 0 0
010403 Fees-Copics of Documenls 0 0
010405 Salc of pharmaceuticals 0 0
011055 Other Grant DOE 0 0
012021 Rcturn Chcck Charge 100 0 I(
018005 Refunds Grants to Local Gov't 0 0
029010 Sale of Fixed Assets 0 0
ALLOCABLE REVENUE TOTAL 527,927 0 527,9
8. OTHER STATE CONTRIBUTIONS NOT IN CHD TRUST FUND
State Pharmacy Services 0 49,178 49,1
State Laboratory Services 0 89,515 89,5
State TB Services 0 0
State Immunization Services 0 63,063 63,(
State STD Services 0 0
State Construction/Renovation 0 0
WIC Food 0 677,389 677,:
ADAP-AIDS Drug Assistance Program 0 643,916 643,'
Other (specify) 0 0
Othcr (spccify) 0 0
Other (specify) 0 0
OTHER STATE CONTRIBUTIONS NOT IN CHD TRUST FUND TOTAL 0 1,523,061 1,523,
TOTAL STATE CONTRIBUTIONS 4.507.300 1.523.061 6.030.
This is a working copy of the ATTACHMENT II. It is not a valid Contract Copy
MONROE COUNTY HEALTH DEPARTMENT
Part II. Sources of Contributions to County Health Department
CHDTr~st Fund (cash) Other Contributions
COUNTY
I. BOARD OF COUNTY COMMISSIONERS ANNUAL APPROPRIATIONS:
008030 Grants-County Tax Dircct
008034 Grants Cnty Commsn Other
274,000 0
65,000 0
339,000 0
12,000 0
48,000 0
25,000 0
8,000 0
45,000 0
0 0
800 0
0 0
0 0
0 0
425 0
0 0
139,225 0
0 0
0 0
0 0
265,060 0
2,000 0
35.000 0
10,000 0
0 0
270.000 0
0 0
0 0
0 0
582,060 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
BOARD OF-COUNTY COMMISSIONERS ANNUAL APPROPRIATIONS TOTAL:
2. FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION:
00 I 077 Primary Carc Fces
001093 Communicable Discase Fccs
001094 Environmental Health Fees
001114 New Birth Ccrtificatcs
001115 Dcath Ccrtificates
001116 Computcr Acccss Fee
001060 Vital Statistics Fees Other
001004 Child Car Scat Prog
001074 Adult Enlcr. Permit Fees
001195 Primary Care Transfer Fees
001117 Vital Stats-Adm. Fee 50 cents
001196 Water Analysis-Potable
FEES AUTHORIZED BY COUNTY ORDINANCE OR RESO,LUTION TOTAL
3. OTHER CASH AND LOCAL CONTRIBUTIONS
001072 Ryan Whitc Title I
001073 Ryan White Tillc 11
001075 Ryan WhitcTille III
090002 Draw down from Public Health Unit
00 I 090 Medicarc
008050 Grants-Cnly Sch Board Direct
0080 I 0 Grants Contracts Frm Cities Direct
008033 County Contributions For Facilitics
010302 Salc of Goods ,1Ild Scrvices to Stale Agencies
008095 Granls Cnty Sccl 403.102 Air Pol
008099 Reimb/Rcbate Local Govn't
008031 County AIDS Education
OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL
4. ALLOCABLE REVENUE
011007 Cash Donations Private
001029 Third Party Reimbursement
010301 Exp Witncss Fee Consultnt Charges
005040 Interest Emed State Investmcnt
005041 Intercst Emcd Locallnvcstment
007010 U.S. Grants Direct to CHD
008094 Grnts/Contracts olher Agencies Direct
011098 Donation School Based Clinic
011099 Othcr Grants/Donations Dircct
012020 Fines and Forfcitures
018001 Rcfunds. Salary
018003 Refunds. other Personal Services
018004 Refunds, Expcnses
018006 Refunds, Operating Capital Outlay
0180 I 0 Rcfunds, Special Category
018011 Refunds,Othcr
018099 Refunds, Certified Forward
037000 Prior Year Warrant
038000 12 Month Old Warrant
...,Total
274,00C
65,00C
339,00C
12,00(
48,001
25,001
8,001
45,001
(
80(
(
42
139,22
265,06
2,00
35,OC
10,00
270,OC
582,0(
This is a working copy of the A TT ACHMENT II. It is not a valid Contract Copy
MONROE COUNTY HEALTH DEPARTMENT
Part II. Sources of Contributions to County Health Department
CHD Trust Fund (cash) Other Contributions
COUNTY
4. ALLOCABLE REVENUE
010300 Sale of Goods and Services
010402 Recyclc Paper Salcs
010403 .< .,Fees-Copics of Documents
010405 Sale of pharmaccuticals
011055 Other Grant DOE
012021 Return Check Chargc
018005 Refunds Grants to Local Gov't
029010 Sale of Fixed Assets
COUNTY ALLOCABLE REVENUE TOTAL
5. BUILDINGS:
Annual Rental Equivalent Value
Maintcnancc
Ulilities
Olher
Othcr (spcci fy)
Olher (spccify)
Othcr (speci fy)
BUILDINGS TOTAL
6. OTHER COUNTY CONTRIBUTIONS NOT IN CHD TRUST FUND
Othcr County Contribution (spccify)
Other County Contribution (spccify)
Othcr County Contribution (spccify)
Othcr County Contribution (spccify)
Olhcr County Conlribution (specify)
OTHER COUNTY CONTRIBUTIONS NOT IN CHD TRUST FUND TOTAL
TOTAL COUNTY CONTRIBUTIONS
GRAND TOTAL CHD PROGRAM
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 225,000
0 20,000
0 50,000
0 0
0 0
0 0
0 0
0 295,000
0 0
0 0
0 0
0 0
0 0
0 0
1,060.285 295,000
5,567.585 1,818.061
Total
o
o
o
o
o
o
o
o
o
225,000
20,000
50,000
o
o
o
o
295,00C
1,355,28
7,385,64
This is a working copy of the ATTACHMENT II. It is not a valid Contract Copy
MONROE COUNTY HEALTH DEPARTMENT
Part Ill. Planned Staffing, Clients, Services, And Expenditures By Program Service Area Within Each Level Of Service
October 1,2000 to September 30, 2001
A. COMMUNICABLE DISEASE CONTROL:
.'
Immunization (101) 3.50 0 11,000 45,250 45,250 45,250 45,250 52,000 129,000 181,00C
STD (102) 2.00 80 1,600 24,500 24,500 24,500 24.500 10,000 88,000 98,00C
A.I.D.S. (103) 13.50 600 6,000 390,000 390,000 390,000 390,000 0 1,560,000 1,560,00(
T8 Control Services (104) 1.75 1,100 2,100 27,500 27,500 27,500 27,500 4.000 106,000 110,OO(
Co 111 111. Disease Surv. (106) 0.60 0 l-:50 9.500 9.500 9.500 9.500 34.000 4.000 38.00(
Hcpatitis Prcvention (109) 2.00 0 1,280 52,500 52,500 52.500 52,50() 20.000 190,000 210,001
Vital Statistics (180) 3.00 0 0 30,000 30.000 30,000 30.000 60,000 60,000 120,001
COMMUNICABLE DISEASE SUBTOTAL 26.35 1,780 22,830 579,250 579,250 579,250 579,250 180.000 2,13 7 ,000 2,317,00'
B. PRIMARY CARE:
Chronic Discasc Scrviccs (210) 1.25 50 1,100 16,000 16,000 16.000 16,000 16,000 48,000 64,OO(
Tobacco Prevention (212) 0.00 0 0 0 0 0 0 0 0
Home Health (215) 0.00 0 0 0 0 0 0 0 0
W.LC. (221) 5.25 2.500 12.500 57,500 57,500 57,500 57,500 15,000 215,000 230,00
Family Planning (223) 5.00 800 3,900 66,250 66.250 66,250 66.250 25,000 240,000 265,00
Improvcd Prcgnancy Outcomc (225) 0.20 25 550 2,250 2.250 2.250 2.250 0 9,000 9,00
Hcalthy Start Prcnatal (227) 3.75 375 21,000 50,000 50.000 50,000 50,000 0 200.000 200,00
Comprehensive Child Health (229) 0.50 40 150 20.000 20,000 20,000 20,000 20,000 60.000 80,00
Heallhy Start Infant (231) 2.30 175 15,000 29,000 29.000 29,000 29,000 16,000 100.000 116,00
School Hcalth (234) 8.25 0 90,000 92.000 92.000 92.000 92.()OO 35.000 333,000 368,00
Comprchensive Adult Health (237) 1.75 350 2,200 30,000 30,O()O 30.000 30.000 12,000 108.000 120,00
Dcntal Hcalth (240) 0.01 0 0 10.000 10,000 10,000 10,000 0 40,000 40,00
PRIMARY CARE SUBTOTAL 28.26 4,315 146,400 373,000 373,000 373,000 373,000 139,000 1,353,000 1,492,OC
C. ENVIRONMENTAL HEALTH:
Private Watcr Systcm (357) 0.00 0 0 0 0 0 0 0 0
Public Wiltcr System (358) 0.01 I 300 300 300 300 200 1,000 1,2C
Individual Sewage Disp. (361) 12.00 1,700 7,500 275,000 275,000 275,000 275,000 470,000 630,000 1,100,O(
Fuod Hygienc (348) 0.75 50 250 8,500 8,500 8.500 8,500 4,000 30,000 34,0<
Group Carc Facility (351) 0.35 113 200 4,000 4.000 4,000 4,000 0 16,000 16,01
Migrant Labor Camp (352) 0.00 0 0 0 0 0 0 0 0
Housing,Public Bldg Safety,Sanitation (353) 0.02 4 4 150 150 150 150 0 600 6'
Mobile Home and Parks Services (354) 0.75 50 250 7,500 7,500 7,500 7,500 7,500 22,500 30,0
Swimming Pools/Bathing (360) 1.00 160 600 12,000 12,000 12,000 12,000 40,000 8,000 48,0
Biomedical Wastc Services (364) 0.30 50 75 4,500 4,500 4,500 4,500 12,000 6,000 18,0
Tanning Facility Services (369) 0.02 5 10 300 300 300 300 0 1,200 1,2
Rabies Surveillance/Control Services (366) 0.07 I 30 1,000 1,000 1,000 1,000 1,000 3,000 4,(
Arbovirus Surveillance (367) 0.00 0 0 0 0 0 0 0 0
Rodcnt/Arthropod Control (368) 0.00 0 0 0 0 0 0 0 0
Storage Tank Compliancc (355) 3.00 400 800 37,500 37.500 37.500 37,500 0 150.000 150.c
Supcr Act Scrvice (356) 0.00 0 0 0 0 0 0 0 0
Occupational Health (344) 0.00 0 () 0 0 0 0 0 0
Consumer Product Safety (345) 0.00 0 0 0 0 0 0 0 0
This is a working copy ofthc ATTACHMENT II. It is not a valid Contract Copy
MONROE COUNTY HEALTH DEPARTMENT
Part III. Planned Staffing, Clients, Services, And Expenditures By Program Service Area Within Each Level Of Service
October 1,2000 to September 30, 2001
C.
Emergcncy Medic<t1 (346) 0.00 0 0 0 0 0 0 0 0
Lcad Monitoring Scrvices (350) 0.01 0 0 250 250 250 250 0 1,000 1,00(
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 (
Sanitary Nuisance (365) 1.50 30 80 35,000 35,000 35,000 35,000 140,000 0 140,001
Water Pollution (370) 0.80 0 1,400 12,000 12,000 12,000 12,000 0 48,000 48,001
Air Pollution (371) 0.00 0 0 0 0 0 0 0 0
Radiological Health (372) 0.00 0 0 0 0 0 0 0 0
Toxic Substances (373) 1.00 145 145 16,500 16,500 16,500 17,085 66,585 0 66,58
ENVIRONMENTAL HEALTH SUBTOTAL 21.58 2,709 11,349 414,500 414,500 414,500 415.085 741.285 917.300 1,658,58
D. SPECIAL CONTRACTS:
Special Contracts (599) 1.50 0 0 25.0()() 25,000 25.000 25.000 () 100.000 100,00
SPECIAL CONTRACTS SUBTOTAL 1.50 0 0 25,000 25,000 25.000 25,000 0 100.()OO 100,00
TOTAL CONTRACT 77.69 8,804 180,579 1,391,750 1.391,750 1,391,750 1,392.335 1,060,285 4,507,300 5,567,58
ATTACHMENT II I
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 federal financial assistance to programs or
activities receiving or benefiting from federal financial assistance. The provider
agrees to complete the Civil Rights Compliance Questionnaire, HRS Forms 946 A and B
(or tK~ 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
seq., which prohibits discrimination
origin in programs and activities
financial assistance.
1964, as amended, 42 U.S.C., 2000 Et
on the basis of race, color or national
receiving or benefiting from federal
2. Section 504 of the Rehabilitation Act of 1973, as amended, 29 U.S.C.
which prohibits discrimination on the basis of handicap in programs
activities receiving or benefiting from federal financial assistance.
794,
and
3. Title IX of the Education Amendments of 1972, as amended,
seq., which prohibits discrimination on the basis of
programs and activities receiving or benefiting from
assistance.
20 U.S.C. 1681 et
sex in education
federal financial
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 acti vi ties
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, 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.
ATTACHMENT IV
FACILITIES UTILIZED BY THE COUNTY HEALTH DEPARTMENT
.,
-.
Facility
Description
Location
Owned By
Public Service Building
5100 College Road
Key West, FL 33040
Monroe County
Roosevelt Sands Center
105 Olivia Street
Key West, FL 33040
City of Key
West
Ruth Ivins Center for
Public Health
3333 Overseas Hwy
Marathon, FL 33050
Monroe County
Monroe County Health Dept.
148 Georgia Avenue
Tavernier, FL 33070
Monroe County
Health Care Center
1200 Kennedy Drive
Key West, FL 33040
Lower Keys
Medical Center
Venetian Plaza
85960 Overseas Highway
Village of the Islands
FL 33036
Private Party
ATTACHMENT V
DESCRIPTION OF USE OF CHD TRUST FUND BALANCES
FOR SPECIAL CAPITAL PROJECTS, IF APPLICABLE
(From Attachment II, Part I)
~
..
$600,000 Construction/Renovation/Furnishings/Equipment
This project will be completed no later than September 2003
DESCRIPTION OF SPECIAL CONTRACTS.
(From Attachment II, Part III)
Please list separately
Special contracts are contracts for services for which there are no comparable
services in the county health department core programs; no service codes in
Departmental coding manuals; projects that are locally designed and have no
standard statewide set of services and therefore cannot be accounted for
within existing county health department programs. These contracts are coded
to FLAIR Level 5:599 and include some contracts formerly handled at the
district offices such as epilepsy, colposcopy, Project WARM, community
planning and special family planning and teen mother projects.
FLORIDA DEPARTMENT OF
ATTACHMENT VI
ENVIRONMENTAL HEALTH - ESTIMATED ANNUAL FEE REVENUES
FISCAL YEAR 2000 - 2001
EFFECTIVE 07/01/2000
I-I' .E.'.?A.;. ......,E:.,ffi... !.........'..
. .,'.., ,''':'''', ',_,'0_'
',- '.-
DESCRIPTION FEE DEPOSIT Est. Annual RevenuE
AMOUNT AMOUNT Accruing to CHD TF
PUBLIC SWIMMING POOLS AND BATHING PLACES
.'
1. Annual Permit - Up to (and including) 25,000 gallons 75.00 67.50 103
1 a. Transfer to headquarters 7.50
2. More than 25,000 gallons 160.00 144.00 247
2a. Transfer to headquarters 16.00
3. Exempted Condo Pools (over 32 units) 50.00 45.00 S
3a. Transfer to headquarters 5.00
OTHER FEES
Collected by the 12 delegated counties
Broward, Dade, Duval, Hillsborough, Lee, Manatee,
Collier, Palm Beach, Pinellas, Polk, Sarasota, Volusia, Escambia.
Variances for Okalossa, Santa Rosa, Walton counties
are processed by Escambia County as follows:
1. Plan review (new construction) 275.00 275.00
2. Plan review for modification of original construction 100.00 100.00
3. Plan/application review for bathing place development 275.00 275.00
4. Initial operating permit 125.00 125.00
5. Variance applications 240.00 216.00
5.a. Transfer to Headquarters 24.00
All other counties are to send the fee to Bureau of Facility
Programs in Tallahassee or the Environmental Engineering
section in Orlando as follows:
1. Plan review (new construction) 275.00 275.00
2. Plan review for modification of original construction 100.00 100.00
3. Plan/application review for bathing place development 275.00 275.00
4. Initial operating permit 125.00 125.00
5. Variance applications 240.00 240.00
MOBILE HOME & RECREATIONAL VEHICLE PARKS
(FEES ARE PRORATED ON A QUARTERLY BASIS)
1. Annual permit for 5 to 14 spaces 50.00 45.00 2
la. Transfer to headquarters 5.00
3.50 per
2. Annual permit for 15 to 171 spaces space 1C
2a. Transfer to headquarters 10%
3. Annual permit for 172 and above spaces 600.00 540.00 L
3a. Transfer to headquarters 60.00
MIGRANT LABOR CAMPS
1. Annual permit for facilities with 5-50 occupants 125.00 125.00
2. Annual permit for facilities with 51-100 occupants 225.00 225.00
3. Annual permit for facilities with over 100 occupants 500.00 500.00
"Must use County Health Department 181 (01-67)
Page 1
12/5/00
DESCRIOTION FEE DEPOSIT Est. Annual RevenuE
AMOUNT AMOUNT Accruing to CHD TF
BIOMEDICAL WASTE GENERATORS
1. Initial permit 55.00 55.00
2. Renewal of annual permit(except physician office generating
less than 251bs/30 days) postmarked by October 1 55.00 55.00 40
2. Renewal of annual permit(except physician office generating
less than 251bs/30 days) postmarked after October 1 75.00 75.00
o'
3. Storage facilities permit postmarked by October 1 55.00 55.00
3. Storage facilities permit postmarked after October 1 75.00 75.00
4. Treatment facilities operating permit by October 55.00 55.00
4. Treatment facilities operating permit after October 1 75.00 75.00
5. Transporter registration (one vehicle) postmarked by 10/1 55.00 55.00
5. Transporter registration (one vehicle) after 10/1 75.00 75.00
6. Transporter registration additional vehicle 10.00 10.00
TANNING FACILITIES
1. Annual license fee 150.00 135.00 9
1 a. Transfer to headquarters 15.00
2. Fee for each additional device 55.00 49.50 4
2.a. Transfer to headquarters 5.50
3. Late fee 25.00 25.00
BODY PERIERCING
1. Annual Licence Fee 150.00 135.00 1
1 a. Transfer to headquarters 15.00
2. Temporary Establishment 75.00 67.50
2a. Transfer to headquarters 7.50
3. Late fee 100.00 100.00
FOOD ESTABLISHMENTS
1. Annual Permit for Fraternal/Civic 160.00 144.00 12
1 a. Transfer to headquarters 16.00
2. Annual Permit School Cafeteria Operating for
9 months or less 130.00 117.00 11
2a. Transfer to headquarters 13.00
3. Annual Permit School Cafeteria Operating for more
than 9 months 160.00 144.00
3a. Transfer to headquarters 16.00
4. Annual Permit for Hospital/Nursing Food Service 210.00 189.00 15
4a. Transfer to headquarters 21.00
5. Annual Permit for Movie Theaters 160.00 144.00 2
5a. Transfer to headquarters 16.00
6. Annual Permit for Jails/Prisons r
210.00 189.00 ..
6a. Transfer to headquarters 21.00
7. Annual Permit for Bars/Lounges (Drink Service Only) 160.00 144.00 BC
7a. Transfer to headquarters 16.00
8. Annual Permit for Residential Facilities 110.00 99.00
8a. Transfer to headquarters 11.00
9. Annual Permit for Child Care Centers without C&F license 85_00 76.50
9a. Transfer to headquarters 8.50
**Must use County Health Department ISI (01-67)
Page 2
12/5/00
DESCR!PTlON FEE DEPOSIT Est. Annual Revenw
AMOUNT AMOUNT Accruing to CHD TF
10. Annual Permit for Limited Food Service 85.00 76.50
lOa. Transfer to headquarters 8.50
11. Annual Permit Other Food Service 160.00 144.00
11 a. Transfer to headquarters 16.00
12. Plan Review $35/hour $35/hour
13. Food Worker,Training 10.00 10.00
14. Request for Inspection 40.00 40.00
15. Reinspection (after the first reinspection) 30.00 30.00
16. Late Renewal 25.00 25.00
17. Alcoholic Beverage Inspection Approval 30.00 30.00 ~
ONSITE SEWAGE DISPOSAL PROGRAM (OSTDS)
1. Application for permitting of an onsite sewage 25.00 23.00 161
treatment and disposal system which includes
application and plan review for new and repair permits
1 a. Transfer to headquarters 2.00
2. Site evaluation for a new system 60.00 55.20 6S
2a. Transfer to headquarters 4.80
3. Site evaluation for a system repair or modification of system 40.00 36.80
3a. Transfer to headquarters 3.20
4. Site re-evaluation, new or repair or modification 40.00 36.80
4a. Transfer to headquarters 3.20
5. Permit for new systems, or modification to system 55.00 50.60
5a. Transfer to headquarters 4.40
6. New system or system modification installation inspection 55.00 50.60
6a. Transfer to headquarters 4.40
7. Research fee to be collected in addition, and concurrent with 5.00 5.00
the permit for a new system installation fee until 6/30/2002.
8. Repair permit issuance which includes inspection 50.00 41.40 41
8a. Transfer to headquarters 3.60
8b. Transfer to headquarters for training center 5.00
9. Inspection of system previously in use 50.00 46.00 41~
9a. Transfer to headquarters 4.00
10. Reinspection fee per visit for site inspections after system 25.00 23.00 2~
construction approval
lOa. Transfer to headquarters 2.00
11. Installation reinspection of non-compliant system per 25.00 23.00
each site visit
11 a. Transfer to headquarters 2.00
12. System abandonment permit, includes permit 40.00 36.80
issuance and inspection
12a. Transfer to headquarters 3.20
13. Annual operating permit fee for systems in 1M and 150.00 138.00 f
equivalent areas, and for systems receiving commercial waste
13a. Transfer to headquarters 12.00
14. Amendments or changes to the operating permit during 25.00 23.00
**Must use County Health Department 181 (01-67)
Page 3
12/5/00
DESCRI:'TION FEE DEPOSIT Est. Annual Revenue
AMOUNT AMOUNT Accruing to CHD TF
the permit period per change or amendment
14a. Transfer to headquarters 2.00
15. Aerobic treatment unit operating permit per annum 150.00 138.00 1065
15a. Transfer to headquarters 12.00
16. Tank manufacturer's inspection per annum 100.00 50.00 2
16a. Transfer to n.eadquarters 50.00
17. Septage disposal service permit per annum 50.00 46.00 4
17a. Transfer to headquarters 4.00
18. Additional charge per pumpout vehicle 25.00 23.00 4
18a. Transfer to headquarters 2.00
19. Portable or temporary toilet service permit per annum 50.00 46.00 2
19a. Transfer to headquarters 4.00
20. Additional charge per pumpout vehicle 25.00 23.00 1
20a. Transfer to headquarters 2.00
21. Septage stabilization facility inspection fee per annum 150.00 138.00
21a. Transfer to headquarters 12.00
22. Septage disposal site evaluation fee per annum 100.00 92.00
22a. Transfer to headquarters 8.00
23. Aerobic treatment unit maintenance entity permit per annum 25.00 23.00 6
23a. Transfer to headquarters 2.00
24. Variance application for a single family residence per 150.00 75.00
each lot or building site
24a. Transfer to headquarters 75.00
25. Variance application for a multi-family or commercial 200.00 100.00 51
building per each building site
25a. Transfer to headquarters 100.00
26. Inspection for construction of an injection well (FL Keys) 125.00 125.00 2.
Performance-based Treatment Systems
1. Application for permitting of a new performance-based 125.00 115.00
treatment system, which includes application and plan review
1 a. Transfer to headquarters 10.00
2. Permit for new performance-based treatment system 125.00 115.00
2a. Transfer to headquarters 10.00
3. Installation inspection for new performance-based systems 75.00 69.00
3a. Transfer to headquarters 6.00
6. Research fee to be collected in addition, and concurrent with 5.00 5.00
the permit for a new performance-based system installation fee
4. Repair permit issuance which includes inspection 125.00 115.00
4a. Transfer to headquarters 10.00
5. Inspection of system previously in use 25.00 23.00
5a. Transfer to headquarters 2.00
6. Reinspection fee per visit for site inspections after system 25.00 23.00
construction approval
6a. Transfer to headquarters 2.00
7. Installation reinspection of non-compliant system per 50.00 46.00
"'Must use County Health Department 181 (01-67)
Page 4
12/5/00
DESCRIPTION FEE DEPOSIT Est. Annual Revenue
AMOUNT AMOUNT Accruing to CHD TF
each site visit
7a. Transfer to headquarters 4.00
8. System abandonment permit, includes permit 75.00 69.00
issuance and inspection
8a. Transfer to headquarters 6.00
9. Annual operating permit fee for performance-based 200.00 184.00
..
treatment system. Fee charged second year of operation
9a. Transfer to headquarters 16.00
10. Review of application due to proposed amendments or 75.00 69.00
changes after initial operating permit issuance.
10a. Transfer to headquarters 6.00
11. Variance application for a single family residence per 150.00 75.00
each lot or building site
11 a. Transfer to headquarters 75.00
FEE COLLECTED AT HEADQUARTERS - Onsite Sewage
1. Application for innovative product approval 500.00 For headquarters use only
2. Application for registration including initial examination 75.00 For headquarters use only
3. Initial registration 100.00 For headquarters use only
4. Renewal of registration 100.00 For headquarters use only
5. Certificate of authorization each two-yar period 250.00 For headquarters use only
DRINKING WATER
1. First Year Public Water Annual Operation Permit and 75.00 67.50
Construction Permit - Limited Use
1 a. Transfer to headquarters 7.50
2. Second Year Public Water Annual Operation Permit -
Limited Use 70.00 63.00
2a. Transfer to headquarters 7.00
4. Private Water Construction Permit - serving 3 or 4 40.00 36.00
non-rental residences
4a. Transfer to headquarters 4.00
5. Initial Operating Permit Fee After March 31 of Any Year 35.00 31.50
5a. Transfer to headquarters 3.50
6. Non-SDWA Lab Sample (Sample Collection/Review
of Analytical Results/Health Risk Interpretation):
Delineated Area 50.00 50.00
Bacterial Sample Collection 40.00 40.00
Chemical Sample Collection 50.00 50.00
Combined Chemical microbiological 55.00 55.00
7. Reinspection of Private Water System 25.00 25.00
8. Reinspection of Public Water System 40.00 40.00
9. Delineated Area Clearance Fee 50.00 50.00
10. Limited Use Commercial Registered System 15.00 15.00
11. Limted Use Commercial Public Water System 25.00 25.00
Operating Permit Family Day Care Establishment
12. Limted Use Commercial Public Water System Operating Permit 15.00 15.00
"Must use County Health Department 181 (01-67)
Page 5
12/5/00
DESCRIPTION FEE DEPOSIT Est. Annual Revenue
AMOUNT AMOUNT Accruing to CHD TF
Family Day Care Establishment After March 31 of Any Year.
Safe Drinking Water Act (Delegated Counties)
1. Construction permit for each Category 1 through III treatment
plant, as defined in Rule 62-699.310, F.A.C.., with treatment
other than disinfection only.
a. Treatment plant~;. 5 MGD and above 7,500.00 7,500.00
b. Treatment plant - 1 MGD up to 5 MGD 6,000.00 6,000.00
c. Treatment plant - 0.25 MGD up to 1 MGD 4,000.00 4,000.00
d. Treatment plant - 0.1 MGD up to .025 MGD 2,000.00 2,000.00
e. Treatment plant - up to 0.1 MGD 1,000.00 1,000.00
2. Construction permit for each Category IV treatment plant, as
defined in Rule 62-699.310, F.A.C.., with treatment other than
disinfection only.
a. Treatment plant - 5 MGD and above 7,500.00 7,500.00
b. Treatment plant - 1 MGD up to 5 MGD 6,000.00 6,000.00
c. Treatment plant - 0.25 MGD up to 1 MGD 4,000.00 4,000.00
d. Treatment plant - 0.1 MGD up to .025. MGD 2,000.00 2,000.00
e. Treatment plant - 0.01 up to 0.1 MGD 1,000.00 1,000.00
f. Treatment plant - up to 0.01 MGD 400.00 400.00
3. Construction permit for each Category V treatment plant, as
defined in Rule 62-699.310, FAC.., - Disinfection Only
a. treatment plant - 5 MGD and above 5,000.00 5,000.00
b. Treatment plant - 1 MGD up to 5 MGD 3,000.00 3,000.00
c. Treatment plant - 0.25 MGD up to 1 MGD 1,000.00 1,000.00
d. Treatment plant - 0.1 MGD up to .025 MGD 500.00 500.00
e. Treatment plant - up to 0.1 MGD 300.00 300.00
4. Distribution and transmission systems, including raw water
lines into the plant, except those under general permit.
a. Serving a community public water system 500.00 500.00
b. Serving a non-transient non-community public water systems 350.00 350.00
c. Serving a non-community public water system 250.00 250.00
5. Construction permit for each public water supply well.
a. Well located in a delineated area pursuant to Chapter 62-524,
FAC.. 500.00 500.00
b. Any other public water supply well. 250.00 250.00
6. Major modifications to systems that alter the existing treatment
without expanding the capacity of the system and are not
considered substantial changes pursuant to
Rule 62-4.050(7) below.
a. MGD and above 2,000.00 2,000.00
b. .1 MGD up to 1 MGD 1,000.00 1,000.00
c. 0.01 up to.1 MGD 500.00 500.00
d. Up to 0.01 MGD 100.00 100.00
7. Minor modifications to systems that result in no change in the
treatment or capacity.
**Must use County Health Department IBI (01-67)
Page 6
12/5/00
DESCRiPTION FEE DEPOSIT Est. Annual RevenuE
AMOUNT AMOUNT Accruing to CHD TF
a. .1 MGD and above 300.00 300.00
b. Up to 0.1 MGD 100.00 100.00
8. Fines and Forfeitures Variable Variable
.#
-,
UMust use County Health Department ISI (01-67)
Page 7
12/5/00