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FY2003 11/20/2002 CLERK OF THE CIRCUIT COURT MONROE COUNTY BRANCH OFFICE MARATHON SUB COURTHOUSE 3117 OVERSEAS HIGHWAY MARATHON, FLORIDA 33050 TEL. (305) 289-6027 FAX (305) 289-1745 MONROE COUNfY COURTHOUSE 500 WHITEHEAD STREET, SUITE 101 KEY WEST, FLORIDA 33040 TEL. (305) 292-3550 FAX (305) 295-3663 BRANCH OFFICE PLANTATION KEY GOVERNMENT CENfER 88820 OVERSEAS HIGHWAY PLANTATION KEY, FLORIDA 33070 TEL. (305) 852-7145 FAX (305)852-7146 MEMORANDUM DATE: December 16, 2002 TO: Christopher R. Smith, Operations Manager Monroe County Health Department Pamela G. Hanc~ Deputy Clerk CY FROM: At the November 20, 2002, Board of County Commissioner's meeting the Board granted approval and authorized execution of a Contract ( annual Core) between Monroe County, State of Florida Department of Health, and the Monroe County Health Department for operation of the Monroe County Health Department Contract Year 2002-2003. Enclosed please find four duplicate originals of the above mentioned, executed on behalf of Monroe County, for your handling. Please be sure that the fully executed "Monroe County Clerk's Original" and the "Monroe County Finance Division's Original" are returned to our office as soon as possible. Should you have any questions please feel free to contact our office. Cc: County Administrator wlo document Finance wlo document County Attorney File ./ ~. ....... Coum., CJerk'a omu Ori&J-ll 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 2002-2003 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, 2002. 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, 2002, through September 30,2003, 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/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 excludina 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 $4.009.917 (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 excludina any fees, other cash or local contributions) as provided in Attachment II, Part II is an amount not to exceed $362.113 (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. c. Either party may establish service fees as allowed by law to fund activities of the CHD. Where applicable, such fees shall be automatically adjusted to at least the Medicaid fee schedule. Fees are listed in Attachment II Part II of this contract and in the Environmental Health Fee Schedule which is provided by the Environmental Health Program Office. The estimated annual environmental health fee revenues accruing to the County Health Department Trust Fund are listed on At~9chment VI. d. Either party may increase or decrease funding of this Agreement during the term hereof by notifying the other party in writing of the amount and purpose for the change in funding. If the State initiates the increase/decrease, the CHD will revise the Attachment II and send a copy of the revised pages to the County and the Department of Health, Bureau of Budget Management. If the County initiates the increase/decrease, the County shall notify the CHD. The CHD will then revise the. Attachment II and send a copy of the revised pages to the Department of Health, Bureau of Budget Management. e. The name and address of the official payee to whom payments shall be made is: County Health Department Trust Fund Monroe County 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-State Goal Achievemenf' report located on the Department of Health Intranet). 6. ADMINISTRATIVE POLICIES AND PROCEDURES. The parties hereto agree that the following standards should apply in the operation of the CHD: a. The CHD and its personnel shall follow all State policies and procedures, except to the extent permitted for the use of county purchasing procedures as set forth in subparagraph b., below. All CHD employees shall be State or State-contract personnel subject to State personnel rules and procedures. Employees will report time in the Client Information System/Health Management Component compatible format by program component as specified by the State. b. The CHD shall comply with all applicable provisions of federal and state laws and regulations relating to its operation with the exception that the use of county purchasing procedures shall be allowed when it will result in a better price or service and no statewide Department of Health purchasing contract has been implemented for those goods or services. In such cases, the CHD director/administrator must sign a justification therefore, and all county purchasing procedures must be followed in their entirety, and such compliance shall be documented. Such justification and compliance documentation shall be maintained by the CHD in accordance with the terms of this Agreement. State procedures must be followed for all leases on facilitie$.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.L, 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, 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 the funding requirements of each participating governmental entity in the following year. However, in each such case, all surplus funds, including fees and accrued interest, shall remain in the trust fund until accounted for in a manner which clearly illustrates the amount which has been credited to each participating,.governmental entity. The planned use of surplus funds shall be reflected in Attachment II, Part I of this contract, with special capital projects explained in Attachment V. 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 OMB Circular A-133 and may be in conjunction with audits performed by county government. If audit exceptions are found, then the director/administrator of the CHD will prepare a corrective action plan and a copy of that plan and monthly status reports will be furnished to the contract managers for the parties. i. The CHD shall not use or disclose any information concerning a recipient of services except as allowed by federal or state law or policy. j. The CHD shall retain all client records, financial records, supporting documents, statistical records, and any other documents (including electronic storage media) pertinent to this Agreement for a period of five (5) years after termination of this Agreement. If an audit has been initiated and audit findings have not been resolved at the end of five (5) years, the records shall be retained until resolution of the audit findings. k. The CHD shall maintain confidentiality of all data, files, and records that are confidential under the law or are otherwise exempted from disclosure as a public record under Florida law. The CHD shall implement procedures to ensure the protection and confidentiality of all such records and shall comply with sections 384.29, 381.004, 392.65 and 456.057, Florida Statutes, and all other state and federal laws regarding confidentiality. All confidentiality procedures implemented by the CHD shall be consistent with the Department of Health Information Security Policies, Protocols, and Procedures, dated September 1997, as amended, the terms of which are incorporated herein by 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. m. The CHD shall establish a system through ~hich 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 cumulative amount of the variance between actual and planned expenditures does not exceed three percent of the cumulative expenditures for the level of service in which the type of service is included, a variance explanation is not required. A copy of the written explanation shall be sent to the Department of Health, Bureau of Budget Management. 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, 2003 for the report period October 1, 2002 through December 31 , 2002; ii. June 1, 2003 for the report period October 1, 2002 through March 31, 2003; iii. September 1 , 2003 for the report period October 1, 2002 through June 30, 2003; and . iv. December 1,2003 for the report period October 1,2002 through September 30,2003. 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 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 beyon~t. the fiscal year beginning July 1, 2003, 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 Manaaers. The name and address of the contract managers for the parties under this Agreement are as follows: For the State: For the County: Christopher Smith Operations Manager Post Office Box 6193 Key West, Florida 33040 305/293-7539 James Roberts County Administrator GATO Building, 1100 Simonton St Key West, Florida 33040 305/292-4441 If different contract managers are designated after execution of this Agreement, the name, address and telephone number of the new representative shall be furnished in writing to the other parties and attached to originals of this Agreement. d. Captions. The captions and headings contained in this Agreement are for the convenience of the parties only and do not in any way modify, amplify, or give additional notice of the provisions hereof. In WITNESS THEREOF, the parties hereto have caused this 9 page agreement to be executed by their undersigned officials as duly authorized effective the 1st day of October, 2002. FOR MONROE COUNTY STATE OF FLORIDA DEPARTMENT OF HEALTH BOARD OF COUNTY COMMISSIONERS ::::0 BY~1t ?:1~ t;t~ Ii '-I OK II U v SIGNED BY: ~ ~.!---.-r ~ NAME: ~'(;hn O. Aawunobi. M.D.. M.B.A. TITLE: Secretary DATE: I-X- d'~3 D.C.. SIGNEO~~ NAME: R. C. Rutherford. M. ..M.P.H. TITLE: DATE: P7~ 2.... a.ooz. TITLE: CHD Director/Administrator DATE: tD (l cf fuz-- --. '" ..r- ~ " CJ L1 ~.,:l -0',- ~.~. ",..) r- ~,,,... ...-....... - " <- rrl o~ ~f:!;a 0 rFJ-.r- " ~ ,::-) -;-.", .." ANN~, ~TTON C--:-')n: CJl 0 ~:.= ;0 :'; ::0 DATE /~ ~ Ov- ::~' r:: J ~:J -< CJ _" =" PI . ,-l-'- ..,,' )> - ('") I Cj " 0 )> fq :::0 (.) C,:. 0 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 and F.S. 384 and the CHD Guidebook Intemal Operating Policy STD 6 and 7. 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. 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. Chronic Disease Program Requirements as specified in the Community Intervention Program (CIP) and the CHD Guidebook. 8. Environmental Health Requirements as specified in DHP 50-4* and 50-21* 9. 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 50.428 (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. 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. 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GENERAL REVENUE - STATE 015011 ALG/CONTRIBUTION TO CHDS-PRIMARY CARE 17,256 0 17,256 0 17,256 01501 I ALG/PRIMAR Y CARE 223,310 0 223,310 0 223,310 015012 G/A EPILEPSY SERVICES 0 0 0 0 0 015048 ALG/CONTR TO CHDS-STD PROGRAM 21,016 0 21,016 0 21,016 015050 ALG/CESSPOOL IDENTIFICATION AND ELIMINA no 128,707 0 128,707 0 128,707 015050 ALG/CONTR TO CHDS 1,275,276 0 1,275,276 0 1,275,276 015050 ALG/CONTR TO CHDS-MIGRANT LABOR CAMP SANI 0 0 0 0 0 015050 ALG/CONTR. TO CHDS-DENTAL PROGRAM 20,000 0 20,000 0 20,000 015050 ALG/CONTR. TO CHDS-IMMUNIZATION OUTREACH 7,203 0 7,203 0 7,203 015050 ALG/CONTR. TO CHDS-INDOOR AIR ASSIST PROG 0 0 0 0 0 015050 ALG/CONTR. TO CHDS-SOVEREIGN IMMUNITY 0 0 0 0 0 015050 CA TE-ENVIRONMENT AL COMMUNITY HEALTH PR 0 0 0 0 0 015050 COMMUNITY ENV HLTH ADVISORY BOARD PILOT P 0 0 0 0 0 015050 COMMUNITY TB PROGRAM 83,595 0 83,595 0 83,595 015050 CONTRTOCHDS-DUVALTEENPREGNANCYPRE 0 0 0 0 0 015050 FAMU - RAISING GRETNA PROGRAM 0 0 0 0 0 015050 FIRST STEP - MOTHERS & INFANTS PROGRAM 0 0 0 0 0 015050 HEALTHY BEACHES MONITORING 29,027 0 29,027 0 29,027 015050 INTERDISCIPLINARY MANAGED CARE SERENITY H 0 0 0 0 0 015050 LA LIGA CONTRA EL CANCER 0 0 0 0 0 015050 LAB ASSISTANCE PROGRAM 0 0 0 0 0 015050 MANATEE COUNTY RURAL HEALTH SERVICES 0 0 0 0 0 015050 MEDIVAN PROJECT-ELDERLY INTEREST 0 0 D 0 0 015050 METRO ORLANDO URBAN LEAGUE TEENAGE PREG 0 0 0 0 0 015050 QUALITY MANAGEMENT DEMO PROJECT 0 0 0 0 0 015050 RED LEGISLATION - GAP GRANT (CAT 050310) 0 0 0 0 0 015050 RED LEGIS LA nON - GAP GRANT - IMMUN. (CAT 05 0 0 0 0 0 015050 SPECIAL NEEDS SHELTER PROGRAM 0 0 0 0 0 015065 ALG/CONTR TO CHDS-AIDS PATIENT CARE 384,663 0 384,663 0 384,663 015065 ALG/CONTR TO CHDS-AIDS PREY & SURV & FIELD S 105,802 0 105,802 0 105,802 015115 VOLUNTEER SCHOOL HEALTH NURSE GRANT 0 0 0 0 0 015123 ALG/F AMIL Y PLANNING 62,578 0 62,578 0 62,578 015124 ALG/IPO - OUTREACH SOCIAL WORKERS CAT. 0507 0 0 0 0 0 015124 ALG/IPO HEALTHY START 0 0 0 0 0 015124 ALG/IPO HEALTHY ST ART/IPO CAT 050707 0 0 0 0 0 015124 ALG/IPO-INFANT MORTALITY PROJECT CAT. 0507 0 0 0 0 0 015124 ALG/MCH HEALTHY START/IPO CAT 050870 0 0 0 0 0 015124 ALG/MCH-INFANT MORTALITY PROJECT CAT. 050 0 0 0 0 0 015124 ALG/MCH-OUTREACH SOCIAL WORKERS CAT 0508 0 0 0 0 0 015137 ALG/CONTR. TO CHDS-MCH HEALTH - FIELD STAF 0 0 0 0 0 015137 ALG/IPO-HEALTHY START-DATA COLLECTION PR 0 0 0 0 0 015140 ALG/SCHOOL HEALTH/SUPPLEMENTAL 41,665 0 41,665 0 41,665 GENERAL REVENUE TOTAL 2,400,098 0 2,400,098 0 2,400,098 2. NON GENERAL REVENUE - STATE 001009 Debit Memo-Bad Checks 0 0 0 0 0 010304 Stationary Pollutant Storage Tanks 118,086 0 118,086 0 118,086 015000 Transfer 0 0 0 0 0 2. NON GENERAL REVENUE - STATE 015010 ALG/CONTR TO CHDS-REBASING TOBACCO TF 21,864 0 21,864 0 21,864 015010 ENHANCED DENTAL SERVICES TOBACCO TF 0 0 0 0 0 015010 FL HEPATITIS AND LIVER FAILURE PREVENTION/CO 150,000 0 150,000 0 150,000 015010 SUPER ACT PROGRAM ADM TF 0 0 0 0 0 015016 G/A EPILEPSY PREVENTION AND EDUCATION EPIL 0 0 0 0 0 015020 FOOD AND WATERBORNE DISEASE PROGRAM AD 0 0 0 0 0 015026 ALG/CONTR. TO CHDS-BIOMEDlCAL W ASTE/DEP A 3,672 0 3,672 0 3,672 015029 Tranfers Intra Agency 0 0 0 0 0 015047 SUPER ACT PROGRAM (CAT 050329 OCA 9VOOO)AD 0 0 0 0 0 015072 ALG/CONTR. TO CHDS-SAFE DRINKING WATER PRG 0 0 0 0 0 015084 VARICELLA IMMUNIZATION REQUIREMENT TOBAC 3,855 0 3,855 0 3,855 015121 Super Act Reimbursements 0 0 0 0 0 015170 TOBACCO COORDINATION 52,559 0 52,559 0 52,559 015172 FULL SERVICE SCHOOLS - TOBACCO TF 61,720 0 61,720 0 61,720 015174 BASIC SCHOOL HEALTH - TOBACCO TF 40,839 0 40,839 0 40,839 015139 Well Surveillance Reimbursement - Pesticide 0 0 0 0 0 NON GENERAL REVENUE TOTAL 452,595 0 452,595 0 452,595 3. FEDERAL FUNDS - State 007000 CHILDHOOD LEAD POISONING PREVENTION 0 0 0 0 0 007000 RAPE PREVENTION & EDUCTION PROGRAM 0 0 0 0 0 007000 FEDERAL COASTAL BEACH MONITORING PROGRA 27,626 0 27,626 0 27,626 007030 PHBG/MIGRANT LABOR CAMP SANITATION 0 0 0 0 0 007044 PHBG/RAPE AWARENESS 0 0 0 0 0 007049 FRINGE BENEFITS FOR POSITION # 081332 0 0 0 0 0 007049 STD PROGRAM-CSPS 0 0 0 0 0 007049 STD PROGRAM-INFERTILITY PROJECT 0 0 0 0 0 007049 STD PROGRAM-MED & LAB SVCS TRNG CNTR 0 0 0 0 0 007049 STD PROGRAM-STD/PHY TRAINING CENTER 0 0 0 0 0 007049 STD PROGRAM-SYPHILIS ELIMINATION PROJECT 0 0 0 0 0 007051 FGTF/WIC ADMINISTRATION 171,012 0 171,012 0 171,012 007056 HEALTH PROGRAM FOR REFUGEES 0 0 0 0 0 007056 REFUGEE HEALTH PROGRAM 0 0 0 0 0 007058 FGTF/DIABETES CONTROL 0 0 0 0 0 007062 FGTF/AIDS EPIDEMIOLOGICAL RESEARCH STUDY 0 0 0 0 0 007063 PHBG/COMPREHENSIVE COMM CARDlO HLTH PRG 0 0 0 0 0 007064 FGTF/AIDS SURVEILLANCE 0 0 0 0 0 007065 AIDS PREVENTION 189,152 0 189,152 0 189,152 007066 FGTF/RYAN WHITE 0 0 0 0 0 007066 FGTF/RY AN WHITE - EMERGING COMMUNITIES 0 0 0 0 0 007066 FGTF/R Y AN WHITE-AIDS DRUG ASSIST PROG-ADMl 22,443 0 22,443 0 22,443 007066 FGTF/RY AN WHITE-CONSORTIA 550,986 0 550,986 0 550,986 007067 TUBERCULOSIS CONTROL - FEDERAL GRANT 0 0 0 0 0 007068 FGTF/AIDS INMATE INTERVENTION 0 0 0 0 0 007069 FGTF/AIDS MINORITY INVOLVEMENT IN HIV 0 0 0 0 0 007077 BIOTERRORISM EDUCATION & TRAINING 80,000 0 80,000 0 80,000 007077 BIOTERRORISM NETWORK COMMUNICATIONS 0 0 0 0 0 007077 BIOTERRORISM PLANNING & READINESS 68,780 0 68,780 0 68,780 3. FEDERAL FUNDS - State 007084 FGTF/IMMUNIZA TION ACTION PLAN 6,322 0 6,322 0 6,322 007084 FGTF/IMMUNIZA TION-PROJECT FIELD STAFF 0 0 0 0 0 007084 FGTF/IMMUNIZA TION- WIC LINKAGES 0 0 0 0 0 007084 IMMUNIZATION ACTION PLAN 5,690 0 5,690 0 5,690 007084 IMMUNIZATION SPECIAL PROJECT 3,483 0 3,483 0 3,483 007084 IMMUNIZATION SUPPLEMENTAL - 2002 0 0 0 0 0 007084 PERINATAL DISEASE PREVENTION 0 0 0 0 0 007085 FGTF/BREAST & CERVICAL CANCER-ADMIN/CASE M 0 0 0 0 0 007127 MCH BGTF-MCH/CHILD HEALTH 11,446 0 11,446 0 11,446 007127 MCH BGTF-MCHlCHILD HEALTH AGES 0-1 YR 0 0 0 0 0 007132 MCH BGTF-MCH/DENTAL PROJECTS 0 0 0 0 0 007133 FGTF/FAMIL Y PLANNING TITLE X SPECIAL INITIA 0 0 0 0 0 007133 FGTF/FAMILY PLANNING-TITLE X 70,057 0 70,057 0 70,057 007134 MCH BGTF-GADSDEN SCHOOL CLINIC 0 0 0 0 0 007134 MCH BGTF-HEALTHY START \PO 0 0 0 0 0 007134 MCH BGTF-INFANT MORTALITY PROJECT 0 0 0 0 0 007134 MCH BGTF-OUTREACH SOCIAL WORKERS 0 0 0 0 0 007135 FGTF/ABSTINENCE EDUCATION PROGRAM 0 0 0 0 0 015021 MEDIPASS WAIVER-HLTHY STRT CLIENT SERVICES 0 0 0 0 0 015021 MEDIPASS WAIVER-SOBRA 0 0 0 0 0 015060 Entrant Reimburement Transfer 0 0 0 0 0 015075 FULL SERVICE SCHOOLS- T ANF 6,732 0 6,732 0 6,732 015075 KIDCARE - TITLE XIX 50,000 0 50,000 0 50,000 015075 SCHOOL HEALTH-SUPPLEMENT-TANF 11,581 0 11,581 0 11,581 015075 T ANF ABSTINENCE EDUCATION 0 0 0 0 0 015075 Refugee Program 0 0 0 0 0 FEDERAL FUNDS TOTAL 1,275,310 0 1,275,310 0 1,275,310 4. FEES ASSESSED BY STATE OR FEDERAL RULES - STATE 001026 Returned Check Ser Fees 0 0 0 0 0 001091 Communicable Disease Fees 0 0 0 0 0 001092 Environmental Health Fees 171,000 0 171,000 0 171,000 001092 OSDS Repair Permit 0 0 0 0 0 001092 OSDS Permit Fee 0 0 0 0 0 001092 Aerobic Operating Permit 0 0 0 0 0 001092 Septic Tank Site Evaluation 0 0 0 0 0 001113 Mobile Home and Parks 17,135 0 17,135 0 17,135 001132 Food Hygiene Permit 12,385 0 12,385 0 12,385 001135 OSDS Variance Fee 400 0 400 0 400 00 I 092 I & M Zoned Operating Permit 0 0 0 0 0 001139 Migrant Housing Permit 0 0 0 0 0 001140 Biohazard Waste Permit 3,500 0 3,500 0 3,500 001142 Non SDW A Lab Sample 0 0 0 0 0 001144 Tanning Facilities 2,000 0 2,000 0 2,000 001145 Swimming Pools 38,560 0 38,560 0 38,560 001149 Body Piercing 880 0 880 0 880 001165 Private Water Constr Permit 0 0 0 0 0 001166 Non-SDW A System Permit 0 0 0 0 0 4. FEES ASSESSED BY STATE OR FEDERAL RULES - STATE 001166 Public Water Constr Permit 0 0 0 0 0 001166 Public Water Annual Oper Permit 0 0 0 0 0 001170 Lab Fee Chemical Analysis 0 0 0 0 0 001211 Safe Drinking Water 0 0 0 0 0 010403 Fees-Copy of Public Doc 560 0 560 0 560 015052 Transfers-Mobile Home/RV Park 0 0 0 0 0 FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL 246,420 0 246,420 0 246,420 5. OTHER CASH CONTRIBUTIONS - STATE 090001 Draw down from Public Health Unit 26,079 0 26,079 0 26,079 OTHER CASH CONTRIBUTIONS TOTAL 26,079 0 26,079 0 26,079 6. MEDICAID - ST A TE/COUNTY 001056 CHD Incm:Medicaid-Pharmacy 0 0 0 0 0 001080 CHD Incm:Medicaid-Other 0 0 0 0 0 001081 CHD Incm:Medicaid-EPSDT 0 0 0 0 0 001082 CHD Incm:Medicaid-Dental 0 0 0 0 0 001083 CHD Incm:Medicaid-FP 4 36 40 0 40 001084 CHD Incm:Medicaid-Physician 915 1,185 2,100 0 2,100 001085 CHD Incm:Medicaid-Nursing 123,757 160,284 284,041 0 284,041 001086 CHD Incm:Co-lnsurance 0 0 0 0 0 001087 CHD Incm:Medicaid-STD 0 0 0 0 0 001088 CHD Incm:Med Reimb AZT Disp Fee 0 0 0 0 0 001089 Medicaid AIDS 47,256 61,204 108,460 0 108,460 001147 Medicaid HMO Rate 0 0 0 0 0 001148 Medicaid-HMO Admin 0 0 0 0 0 001181 CHD Incm:Medicaid Transportation 0 0 0 0 0 001191 CHD Incm:Medicaid Maternity 0 0 0 0 0 001192 CHD Incm:Medicaid Compo Child 17,341 22,459 39,800 0 39,800 001193 CHD Incm:Medicaid Compo Adult 0 0 0 0 0 001194 CHD Incm:Medicaid Sonagram 0 0 0 0 0 001208 Medipass $3.00 Adm. Fee 989 1,282 2,271 0 2,271 001052 Medicaid Receipts - Part B 0 0 0 0 0 001059 Medicaid EIP 0 0 0 0 0 MEDICAID TOTAL 190,262 246,450 436,712 0 436,712 7. ALLOCABLE REVENUE - STATE 005040 Interest Erned State Investment 0 0 0 0 0 005041 Interest Erned Locallnvestrnent 0 0 0 0 0 018001 Refunds, Salary 0 0 0 0 0 018003 Refunds, other Personal Services 0 0 0 0 0 018004 Refunds, Expenses 500 0 500 0 500 018005 Refunds Grants to Local Gov't 0 0 0 0 0 018006 Refunds, Operating Capital Outlay 0 0 0 0 0 018010 Refunds, Special Category 0 0 0 0 0 018011 Refunds, Other 0 0 0 0 0 018099 Refunds, Certified Forward 0 0 0 0 0 7. ALLOCABLE REVENUE - STATE 029010 Sale of Fixed Assets 0 0 0 0 0 037000 Pri or Year W arran t 0 0 0 0 0 038000 12 Month Old Warrant 0 0 0 0 0 ALLOCABLE REVENUE TOTAL 500 0 500 0 500 8. OTHER STATE CONTRIBUTIONS NOT IN CHD TRUST FUND. STATE State Pharmacy Services 0 0 0 70,504 70,504 State Laboratory Services 0 0 0 89,461 89,461 State TB Services 0 0 0 0 0 State Immunization Services 0 0 0 106,623 106,623 State STD Services 0 0 0 0 0 State Construction/Renovation 0 0 0 0 0 WIC Food 0 0 0 614,290 614,290 ADAP Drug Assistance Program Category III 0 0 0 170,138 170,138 Other (specify) 0 0 0 0 0 Other (specify) 0 0 0 0 0 Other (specify) 0 0 0 0 0 OTHER STATE CONTRIBUTIONS TOTAL 0 0 0 1,051,016 1,051,016 9. BOARD OF COUNTY COMMISSIONERS ANNUAL APPROPRIATIONS - COUNTY 008030 Grants-County Tax Direct 0 290,000 290,000 0 290,000 008034 Grants Cnty Commsn Other 0 72,113 72,113 0 72,113 BOARD OF COUNTY COMMISSIONERS TOTAL 0 362,113 362,113 0 362,113 10. FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION - COUNTY 001004 Child Car Seat Prog 0 0 0 0 0 001060 Vital Statistics Fees Other 0 600 600 0 600 001074 Adult Enter. Permit Fees 0 0 0 0 0 001077 Primary Care Fees 0 12,500 12,500 0 12,500 001093 Communicable Disease Fees 0 52,350 52,350 0 52,350 001094 Environmental Health Fees 0 0 0 0 0 001114 New Birth Certificates 0 7,480 7,480 0 7,480 001115 Death Certificates 0 44,403 44,403 0 44,403 001116 Computer Access Fee 0 0 0 0 0 001117 Vital Stats-Adm. Fee 50 cents 0 416 416 0 416 001195 Primary Care Transfer Fees 0 0 0 0 0 001196 Water Analysis-Potable 0 0 0 0 0 001062 Rabies Vaccine 0 0 0 0 0 001062 Rabies Vaccine 0 0 0 0 0 FEES AUTHORIZED BY COUNTY TOTAL 0 117,749 117,749 0 117,749 11. OTHER CASH AND LOCAL CONTRIBUTIONS - COUNTY 00 I 0 10 Recovery-Bad Checks 0 0 0 0 0 001026 Returned Check Fee 0 0 0 0 0 001029 Third Party Reimbursement 0 0 0 0 0 001072 Ryan White Title 1 0 0 0 0 0 11. OTHER CASH AND LOCAL CONTRIBUTIONS - COUNTY 001073 Ryan White Title [J 0 0 0 0 0 001075 Ryan White Title III 0 650 650 0 650 001090 Medicare 0 500 500 0 500 001190 Health Maintenance Organ. (HMO) 0 0 0 0 0 008010 Grants Contracts Frm Cities Direct 0 0 0 0 0 008031 County AIDS Education 0 0 0 0 0 008033 County Contributions For Facilities 0 0 0 0 0 008050 Grants-Cnty Sch Board Direct 0 35,000 35,000 0 35,000 008090 Grants other Local Govn't Direct 0 0 0 0 0 008094 Grnts/Contracts other Agencies Direct 0 0 0 0 0 008095 Grants Cnty Sect 403.102 Air Pol 0 0 0 0 0 008099 Reimb/Rebate Local Govn't 0 0 0 0 0 010300 Sale of Goods and Services 0 0 0 0 0 010301 Exp Witness Fee Consultnt Charges 0 0 0 0 0 010302 Sale of Goods and Services, to Other Agencies 0 151,200 151,200 0 151,200 010402 Recycle Paper Sales 0 0 0 0 0 010403 Fees-Copies of Documents 0 0 0 0 0 010405 Sale of pharmaceuticals 0 0 0 0 0 010409 Sale of Goods and Services Outside State Government 0 0 0 0 0 011001 Healthy Start Coalition Contributions 0 145,000 145,000 0 145,000 011007 Cash Donations Private 0 1,120 1,120 0 1,120 011098 Donation School Based Clinic 0 0 0 0 0 011099 Other Grants/Donations Direct 0 67 67 0 67 011522 Other Grant DOE 0 0 0 0 0 012020 Fines and Forfeitures 0 0 0 0 0 012021 Return Check Charge 0 0 0 0 0 090002 Draw down from Public Health Unit 0 -74,382 -74,382 0 -74,382 007010 U.S. Grants Direct 0 693,528 693,528 0 693,528 001000 Fees Other 0 0 0 0 0 OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL 0 952,683 952,683 0 952,683 12. ALLOCABLE REVENUE - COUNTY 005040 Interest Erned State Investment 0 30,000 30,000 0 30,000 005041 Interest Erned Local Investment 0 0 0 0 0 018001 Refunds, Salary 0 0 0 0 0 018003 Refunds, other Personal Services 0 0 0 0 0 018004 Refunds, Expenses 0 0 0 0 0 018005 Refunds Grants to Local Gov't 0 0 0 0 0 018006 Refunds, Operating Capital Outlay 0 0 0 0 0 018010 Refunds, Special Category 0 0 0 0 0 018011 Refunds, Other 0 0 0 0 0 018099 Refunds, Certified Forward 0 0 0 0 0 029010 Sale of Fixed Assets 0 0 0 0 0 037000 Prior Year Warrant 0 0 0 0 0 038000 12 Month Old Warrant 0 0 0 0 0 COUNTY ALLOCABLE REVENUE TOTAL 0 30,000 30,000 0 30,000 13. BUILDINGS - COUNTY Annual Rental Equivalent Value 0 0 0 225,000 225,000 Maintenance 0 0 0 20,000 20,000 Other-Utilities 0 0 0 50,000 50,000 Other (specify) 0 0 0 0 0 Other (specify) 0 0 0 0 0 Other (specify) 0 0 0 0 0 Other (specify) 0 0 0 0 0 BUILDINGS TOTAL 0 0 0 295,000 295,000 14. OTHER COUNTY CONTRIBUTIONS NOT IN CHD TRUST FUND - COUNTY Other County Contribution (specify) 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 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 GRANDTOTALCHDPROGRAM 4,591,264 1,708,995 6,300,259 1,346,016 7,646,275 Workillg CopyirIgA1'1'ACHMENI n~ ; "<':::~:r, MONROE COUNTYHEALTHDEPARTMEN"1'~';' '~':_;::::, ',( ,...1,.... "', :~;:<--~; !~q' Part m Planned Staffing. Clients. Services. And Expenditures By Progn.m Service Area Withb1'Each Level of Service - " ',-' ''-' ,": ',- - - - ,." ,,', -', ' _ - " - - .-.',-. - -', ""'-' -', - - '" -- - ,..,::,_", · -"" - ",':> -: -:'-:~':.::::;-D~:\:.-:'?,':::;~~f.::;t<:'<~l;'-/?f:~~/;t~:.:;::~':;.:::f:'::\;.::~:S<:..::;:/:),\.-',~<>:;:>~ ';" Octoberl, 2002 to September 30. 2003 ,. > '. ...' ,,, , ,-.;.-~:-._': c' ';,-,.;J .'" '<. .,,",;.>1::..>.- ;3~,":'- ,:.' . '~ .. FTE's (0.00) CUents Units Services 1st ; - :<;::-~:,::,-~:::.: -:.'.-";::--'-," ,,- ~.C~mrty 'State Grand Total A COMMUNICABLE DISEASE CONTROL: Immunization (101) 3,75 0 5,200 40,507 41,394 41,394 41,394 0 164,689 164,689 STD(102) 2,00 63 1,333 28,200 28,200 28,200 28,200 0 112,800 II 2,800 ALD,S, (103) 17.00 465 6,900 518,138 518,138 518,138 518,139 758,349 1,314,204 2,072,553 TB Control Services (104) 2.00 575 1,400 37,153 37,153 37,153 37,153 0 148,612 148,612 Conun. Disease Surv. (106) 0.75 0 880 12,963 12,963 12,963 12,963 51,852 0 51,852 Hepatitis Prevention (109) 1.75 0 980 37,500 37,500 37,500 37,500 0 150,000 150,000 --.~. Public Health Preparedness and Response (116) 2.00 0 0 16,531 37,195 37,195 57,859 0 148,780 148,780 Vital Statistics (180) 1.25 0 0 14,931 14,931 14,931 14,931 59,724 0 59,724 COMMUNICABLE DISEASE SUBTOTAL 30.50 1,103 16,693 705,923 727,474 727,474 748,139 869,925 2,039,085 2,909,010 B. PRIMARY CARE: Chronic Disease Services (210) 1.00 76 500 2,600 2,600 2,600 2,600 0 10,400 10,400 Tobacco Prevention (212) 1.00 0 5 22,399 22,398 22,398 22,398 0 89,593 89,593 Home Health (215) 0.00 0 0 0 0 0 0 0 0 0 W.I.c. (221) 6.00 1,500 9,300 104,616 104,616 104,616 104,616 0 418,464 418,464 Family Planning (223) 4.50 590 3,340 114,366 115,367 II 5,367 115,366 36 460,430 460,466 Improved Pregnancy Outcome (225) 0.00 0 0 0 0 0 0 0 0 0 Healthy Start Prenatal (227) 3.50 200 14,600 57,400 57,400 57,400 57,400 229,600 0 229,600 Comprehensive Child Health (229) 0.75 55 530 27,072 27,072 27,072 27,072 0 108,288 108,288 Healthy Start Infant (231) 4.25 300 13,000 47,709 47,709 47,710 47,709 190,837 0 190,837 School Health (234) 9.00 0 110,000 192,441 295,441 194,041 144,041 195,284 630,680 825,964 . Comprehensive Adult Health (237) 2.50 265 1,200 45,072 45,072 45,072 45,072 0 180,288 180,288 Dental Health (240) 0.00 0 0 30,775 30,775 30,775 30,774 0 123,099 123,099 PRIMARY CARE SUBTOTAL 32.50 2,986 152,475 644,450 748,450 647,051 597,048 615,757 2,021,242 2,636,999 C. ENVIRONMENTAL HEALm: Water and Onsite Sewage Programs Coastal Beach Monitoring (347) 1.75 17 14 6,906 6,907 6,907 6,906 0 27,626 27,626 Private Water System (357) 0.00 0 0 0 0 0 0 0 0 0 Public Water System (358) 0.00 0 0 135 135 135 135 0 540 540 Individual Sewage Disp. (361) 12.00 500 3,000 86,910 89,748 89,748 35,015 151,200 150,221 301,421 Group Total 13.75 517 3,014 93,951 96,790 96,790 42,056 151,200 178,387 329,587 Facility Programs Food Hygiene (348) 0.50 60 250 5,708 5,708 5,708 5,708 0 22,832 22,832 Body Art (349) 0.00 0 0 0 0 0 0 0 0 0 Group Care Facility (351) 0.25 80 150 3,462 3,462 3,462 3,462 0 13,848 13,848 Migrant Labor Camp (352) 0.00 0 0 67 67 67 67 0 268 268 Housing,Public B1dg Safety,Sanitation (353) 0.00 0 0 70 70 70 70 0 280 280 Mobile Home and Parks Services (354) 0.50 65 245 6,645 6,645 6,645 6,645 0 26,580 26,580 Swimming Pools/Bathing (360) 2.00 482 1,220 27,654 27,654 27,654 27,654 0 110,616 1I0,616 Biomedical Waste Services (364) 0.30 40 60 4,008 4,008 4,008 4,008 0 16,032 16,032 Tanning Facility Services (369) 0.03 3 II 276 276 276 276 0 1,104 1,104 Group Total 3.58 730 1,936 47,890 47,890 47,890 47,890 0 191,560 191,560 Grand Total C. ENVIRONMENTAL HEALTH: Groundwater Contamination Storage Tank Compliance (355) 2.00 290 583 29,521 29,522 29,522 29,521 0 118,086 118,086 Super Act Service (356) 0.00 0 0 0 0 0 0 0 0 0 Group Total 2.00 290 583 29,521 29,522 29,522 29,521 0 118,086 118,086 Convnunity Hygiene Occupational Health (344) 0.00 0 0 0 0 0 0 0 0 0 Consumer Product Safety (345) 0.00 0 0 70 ........ 70 70 70 0 280 280 Emergency Medical (346) 0.00 0 0 0 0 0 0 0 0 0 Lead Monitoring Services (350) 0.00 0 0 98 98 98 98 0 392 392 Public Sewage (362) 0.00 0 0 0 0 0 0 0 0 0 Solid Waste Disposal (363) 0.00 0 0 0 0 0 0 0 0 0 Sanitary Nuisance (365) 0.25 60 200 3,114 3,114 3,114 3,114 0 12,456 12,456 Rabies Surveillance/Control Services (366) 0.05 1 8 857 857 857 857 0 3,428 3,428 Arbovirus Surveillance (367) 0.15 0 100 2,131 2,131 2,131 2,131 0 8,524 8,524 Rodent! Arthropod Control (368) 0.00 0 0 35 35 35 35 0 140 140 Water Pollution (370) 0.30 0 170 3,837 3,837 3,837 3,837 0 15,348 15,348 Air Pollution (371) 0.00 0 0 74 74 74 74 0 296 296 Radiological Health (372) 0.03 0 0 5\0 5\0 510 510 0 2,040 2,040 Toxic Substances (373) 1.00 30 30 18,028 18,029 18,028 18,028 72,113 0 72,113 Group Total 1.78 91 508 28,754 28,755 28,754 28,754 72,113 42,904 115,017 ENVIRONMENTAL HEALTH SUBTOTAL 21.11 1,628 6,041 200,116 202,957 202,956 148,221 223,313 530,937 754,250 D. SPECIAL CONTRACTS: Special Contracts (599) 0.00 0 0 0 0 0 0 0 0 0 SPECIAL CONTRACTS SUBTOTAL 0.00 0 0 0 0 0 0 0 0 0 TOTAL CONTAACT 84.11 5,717 175,209 1,550,489 1,678,881 1,577,481 1,493,408 1,708,995 4,591,264 6,300,259 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 federal 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, 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 MONROE COUNTY HEALTH DEPARTMENT FACILITIES UTILIZED BY THE COUNTY HEALTH DEPARTMENT ,.- Facility Owned By Descri ption Location GA TO Building 1100 Si monton Street Monroe County Key West, FL 33040 Health Care Center 1200 Kennedy Drive Lower Keys Medical Center Key West, FL 33040 Roosevelt Sands Center 105 Olivia Street City of Key West Key West, FL 33040 Ruth Ivins Center for 3333 Overseas Highway Monroe County Public Health Marathon, FL 33050 Environmental Health 13367 Overseas Highway Private Party Monroe CHD Marathon, FL 33050 Monroe County Health 148 Georgia Avenue Monroe County Department Tavernier, FL 33070 Venetian Plaza 85960 Overseas Highway Private Party Village of the Islands Islamorada, FL 33036 ATTACHMENT V MONROE COUNTY HEALTH DEPARTMENT DESCRIPTION OF USE OF CHD TRUST FUND BALANCES FOR SPECIAL CAPITAL PROJECTS, IFAPPLlCABLE (From Attachment II, Part I) 1) $80,000 RSC, Roosevelt Sands Center Construction/Renovation/Fu rnishings/Equipment Estimated completion date November 2002 2) $200,000 Upper Keys CHD, Mariner's Hospital Construction/Renovation/Fu rn ishings/Equipment.. Estimated completion date December 2004 3) $182,390 CSPAD, Cesspit Replacement Project Estimated completion date June 2003 4) $75,000 Technology Equipment/Hardware/Software Estimated completion date June 2003 DESCRIPTION OF SPECIAL CONTRACTS (From Attachment II, Part III) (599) 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 of 599 and include some contracts formerly handled at the district offices such as epilepsy, Project WARM, community planning and special family planning and teen mother projects. ATTACHMENT VI MONROE COUNTY HEALTH DEPARTMENT ESTIMATE OF ENVIRONMENTAL HEALTH FEES FISCAL YEAR 2002 . 2003 Est. Ann. Revenue DESCRIPTION FEE DEPOSIT ORG OBJECT Accruing to CHD AMOUNT AMOUNT L41L5 CODE Trust Fund PUBLIC SWIMMING POOLS AND BATHING PLACES 38,560.00 1. Annual Permit - Up to (and including) 25,000 gallons 75.00 67.50 XX-360 001145 ......,.' 1a. Transfer to headquarters 7.50 99-910 001205 2. More than 25,000 gallons 160.00 144.00 XX-360 001145 2a. Transfer to headquarters 16.00 99-910 001205 3. Exempted Condo Pools (over 32 units) 50.00 45.00 XX-360 001145 3a. Transfer to headquarters 5.00 99-910 001205 OTHER FEES Collected by the 13 delegated counties Broward, Dade, Duval, Hillsborough, Lee, Manatee, Collier, Palm Beach, Pinellas, Polk, Sarasota, Volusia, Escambia. Permits and variances for Okaloosa, Santa Rosa, Walton, Bay, Homes, and Washington Counties are processed by Escambia County and variances and permits for Pasco County are processed by Pinellas County are processed as follows: 1. Plan review (new construction) 275.00 275.00 XX-360 001092 2. Plan review for modification of original construction 100.00 100.00 XX-360 001092 3. Plan/application review for bathing place development 275.00 275.00 XX-360 001092 4. Initial operating permit 125.00 125.00 XX-360 001092 5. Variance applications 240.00 216.00 XX-360 001092 5.a. Transfer to Headquarters 24.00 99-910 001205 All other counties are to send the fee to Bureau of Water Programs in Tallahassee or the Environmental Engineering section in Orlando as follows: 1. Plan review (new construction) 275.00 275.00 00-000 001044 2. Plan review for modification of original construction 100.00 100.00 00-000 001044 3. Plan/application review for bathing place development 275.00 275.00 00-000 001044 4. Initial operating permit 125.00 125.00 00-000 001044 5. Variance applications 240.00 240.00 00-000 001044 MOBILE HOME & RECREATIONAL VEHICLE PARKS 17,135.00 (FEES ARE PRORATED ON A QUARTERLY BASIS) 1. Annual permit for 5 to 14 spaces 50.00 45.00 XX-354 001113 1 a. Transfer to headquarters 5.00 99-910 001113 3.50 pel 2. Annual permit for 15 to 171 spaces space XX-354 001113 2a. Transfer to headquarters 10% 99-910 001113 3. Annual permit for 172 and above spaces 600.00 540.00 XX-354 001113 3a. Transfer to headquarters 60.00 99-910 001113 MIGRANT LABOR CAMPS 0.001 ATTACHMENT VI MONROE COUNTY HEALTH DEPARTMENT ESTIMATE OF ENVIRONMENTAL HEALTH FEES FISCAL YEAR 2002 . 2003 Est. Ann. Revenue DESCRIPTION FEE DEPOSIT ORG OBJECT Accruing to CHD AMOUNT AMOUNT L4IL5 CODE Trust Fund 1. Annual permit for facilities with 5-50 occupants 125.00 125.00 XX-352 001139 2. Annual permit for facilities with 51-100 occupants 225.00 225.00 XX-352 001139 3. Annual permit for facilities with over 100 occupants 500.00 "'500.00 XX-352 001139 BIOMEDICAL WASTE GENERATORS 3,500.00 I 1. Initial permit 55.00 55.00 XX-364 001140 2. Renewal of annual permit(except physician office generating less than 251bsl30 days) postmarked by October 1 55.00 55.00 XX-364 001140 2. Renewal of annual permit(except physician office generating less than 251bsl3O days) postmarked after October 1 75.00 75.00 XX-364 001140 3. Storage facilities permit postmarked by October 1 55.00 55.00 XX-364 001140 3. Storage facilities permit postmarked after October 1 75.00 75.00 XX-364 001140 4. Treatment facilities operating permit by October 55.00 55.00 XX-364 001140 4. Treatment facilities operating permit after October 1 75.00 75.00 XX-364 001140 5. Transporter registration (one vehicle) postmarked by 10/1 55.00 55.00 XX-364 001140 5. Transporter registration (one vehicle) after 10/1 75.00 75.00 XX-364 001140 6. Transporter registration additional vehicle 10.00 10.00 XX-364 001140 TANNING FACILITIES 2,000.00 1. Annual license fee 150.00 135.00 XX-369 001144 1a. Transfer to headquarters 15.00 99-910 001144 2. Fee for each additional device 55.00 49.50 XX-369 001144 2.a. Transfer to headquarters 5.50 99-910 001144 3. Late fee 25.00 25.00 XX-369 001092 BODY PERIERCING 880.00 1 1. Annual Licence Fee 150.00 135.00 XX-364 001149 1a. Transfer to headquarters 15.00 99-910 001149 2. Temporary Establishment 75.00 67.50 XX-364 001149 2a. Transfer to headquarters 7.50 99-910 001149 3. Late fee 100.00 100.00 XX-364 001149 FOOD ESTABLISHMENTS 12,385.00 I 1. Annual Permit for Fraternal/Civic 160.00 144.00 XX-348 001132 1 a. Transfer to headquarters 16.00 99-910 001132 2. Annual Permit School Cafeteria Operating for 9 months or less 130.00 117.00 XX-348 001132 2a. Transfer to headquarters 13.00 99-910 001132 3. Annual Permit School Cafeteria Operating for more than 9 months 160.00 144.00 XX-348 001132 3a. Transfer to headquarters 16.00 99-910 001132 4. Annual Permit for Hospital/Nursing Food Service 210.00 189.00 XX-348 001132 ATTACHMENT VI MONROE COUNTY HEALTH DEPARTMENT ESTIMATE OF ENVIRONMENTAL HEALTH FEES FISCAL YEAR 2002 - 2003 Est. Ann. Revenue DESCRIPTION FEE DEPOSIT ORG OBJECT Accruing to CHD AMOUNT AMOUNT L4IL5 CODE Trust Fund 4a. Transfer to headquarters 21.00 99-910 001132 5. Annual Permit for Movie Theaters 160.00 144.00 XX-348 001132 .""'" Sa. Transfer to headquarters 16.00 99-910 001132 6. Annual Permit for JailS/Prisons 210.00 189.00 XX-348 001132 6a. Transfer to headquarters 21.00 99-910 001132 7. Annual Permit for Bars/Lounges (Drink Service Only) 160.00 144.00 XX-348 001132 7a. Transfer to headquarters 16.00 99-910 001132 8. Annual Permit for Residential Facilities 110.00 99.00 XX-348 001132 Sa. Transfer to headquarters 11.00 99-910 001132 9. Annual Permit for Child Care Centers without C&F license 85.00 76.50 XX-348 001132 Sa. Transfer to headquarters 8.50 99-910 001132 10. Annual Permit for Limited Food Service 85.00 76.50 XX-348 001132 10a. Transfer to headquarters 8.50 99-910 001132 11. Annual Permit other Food Service 160.00 144.00 XX-348 001132 11a. Transfer to headquarters 16.00 99-910 001132 12. Plan Review $35/hour $35/hour XX-348 001092 13. Food Worker Training 10.00 10.00 XX-348 001092 14. Request for Inspection 40.00 40.00 XX-348 001092 15. R einspection (after the first reinspection) 30.00 30.00 XX-348 001092 16. Late Renewal 25.00 25.00 XX-348 001092 17. Alcoholic Beverage Inspection Approval 30.00 30.00 XX-348 001092 ONSITE SEWAGE DISPOSAL PROGRAM (OSTDS) 161,400.001 1. Application for permitting of an onsite sewage 25.00 23.00 XX-361 001092 treatment and disposal system which includes application and plan review for new and repair permits 1 a. Transfer to headquarters 2.00 99-910 001203 2. Site evaluation for a new system 60.00 55.20 XX-361 001092 2a. Transfer to headquarters 4.60 99-910 001203 3. Site evaluation for a system repair or modification of system 40.00 36.80 XX-361 001092 3a. Transfer to headquarters 3.20 99-910 001203 4. Site re-evaluation, new or repair or modification 40.00 36.80 XX-361 001092 4a. Transfer to headquarters 3.20 99-910 001203 5. Permit for new systems, or modification to system 55.00 50.60 XX-361 001092 5a. Transfer to headquarters 4.40 99-910 001203 6. New system or system modification installation inspection 55.00 50.60 XX-361 001092 6a. Transfer to headquarters 4.40 99-910 001203 7. Research fee to be collected in addition, and concurrent with 5.00 5.00 99-910 001201 the permit for a new system installation fee until 6/3012002. ATTACHMENT VI MONROE COUNTY HEALTH DEPARTMENT ESTIMATE OF ENVIRONMENTAL HEALTH FEES FISCAL YEAR 2002 - 2003 Est Ann. Revenue DESCRIPTION FEE DEPOSIT ORG O!:IJECT Accruing to CHD AMOUNT AMOUNT L4IL5 CODE Trust Fund 8. Repair permit issuance which includes inspection 50.00 41.40 XX-361 001092 8a. Transfer to headquarters 3.60 99-910 001203 ,.. 8b. Transfer to headquarters for training center 5.00 99-910 001067 9. Inspection of system previously in use 50.00 46.00 XX-361 001092 Sa. Transfer to headquarters 4.00 99-910 001203 10. Reinspection fee per visit for site inspections after system 25.00 23.00 XX-361 001092 construction approval 10a. Transfer to headquarters 2.00 99-910 001203 11. Installation reinspection of non-compliant system per 25.00 23.00 XX-361 001092 each site visit 11 a. Transfer to headquarters 2.00 99-910 001203 12. System abandonment permit, includes permit 40.00 36.80 XX-361 001092 issuance and inspection 12a. Transfer to headquarters 3.20 99-910 001203 13. Annual operating permit fee for systems in 1M and 150.00 138.00 XX-361 001092 equivalent areas, and for systems receiving commercial waste 13a. Transfer to headquarters 12.00 99-910 001203 14. Amendments or changes to the operating permit during 25.00 23.00 XX-361 001092 the permit period per change or amendment 14a. Transfer to headquarters 2.00 99-910 001203 15. Aerobic treatment unit operating permit (biennial) 100.00 92.00 XX-361 001092 15a. Transfer to headquarters 8.00 99-910 001203 16. Tank manufacturer's inspection per annum 100.00 50.00 XX-361 001092 16a. Transfer to headquarters 50.00 99-910 001203 17. Septage disposal service permit per annum 50.00 46.00 XX-61 001092 17a. Transfer to headquarters 4.00 99-910 001203 18. Additional charge per pumpout vehicle 25.00 23.00 XX-361 001092 18a. Transfer to headquarters 2.00 99-910 001203 19. Portable or temporary toilet service permit per annum 50.00 46.00 XX-361 001092 19a. Transfer to headquarters 4.00 99-910 001203 20. Additional charge per pumpout vehicle 25.00 23.00 XX-361 001092 208. Transfer to headquarters 2.00 99-910 001203 21. Septage stabilization facility inspection fee per annum 150.00 138.00 XX-361 001092 21a. Transfer to headquarters 12.00 99-910 001203 22. Septage disposal site evaluation fee per annum 100.00 92.00 XX-361 001092 22a. Transfer to headquarters 8.00 99-910 001203 23. Aerobic treatment unit maintenance entity permit per annum 25.00 23.00 XX-361 001092 23a. Transfer to headquarters 2.00 99-910 001203 ATTACHMENT VI MONROE COUNTY HEALTH DEPARTMENT ESTIMATE OF ENVIRONMENTAL HEALTH FEES FISCAL YEAR 2002 . 2003 Est. Ann. Revenue DESCRIPTION FEE DEPOSIT ORG OBJECT Accruing to CHD AMOUNT AMOUNT L41L5 CODE Trust Fund 24. Variance application for a single family residence per 150.00 75.00 XX-361 001135 400 each lot or building site 24a. Transfer to headquarters "75.00 99-910 001204 25. Variance application for a multi-family or commercial 200.00 100.00 XX-361 001135 building per each building site 2Sa. Transfer to headquarters 100.00 99-910 001204 26. Inspection for construction of an injection well (FL Keys) 125.00 125.00 XX-361 001092 Performance-based Treatment Systems 10,000.00 I 1. Application for permitting of a new performance-based 125.00 115.00 XX-361 001092 treatment system, which includes application and plan review 1a. Transfer to headquarters 10.00 99-910 001203 2. Permit for new performance-based treatment system 125.00 115.00 XX-361 001092 2a. Transfer to headquarters 10.00 99-910 001203 3. Installation inspection for new performance-based systems 75.00 69.00 XX-361 001092 3a. Transfer to headquarters 6.00 99-910 001203 6. Research fee to be collected in addition, and concurrent with 5.00 5.00 99-910 001201 the permit for a new performance-based system installation fee 4. Repair permit issuance which includes inspection 125.00 115.00 XX-361 001092 4a. Transfer to headquarters 10.00 99-910 001203 5. Inspection of system previously in use 25.00 23.00 XX-361 001092 Sa. Transfer to headquarters 2.00 99-910 001203 6. Reinspection fee per visit for site inspections after system 25.00 23.00 XX-361 001092 construction approval 6a. Transfer to headquarters 2.00 99-910 001203 7. Installation reinspection of non-compliant system per 50.00 46.00 XX-361 001092 each site visit 7a. Transfer to headquarters 4.00 99-910 001203 8. System abandonment permit, includes permit 75.00 69.00 XX-361 001092 issuance and inspection Sa. Transfer to headquarters 6.00 99-910 001203 Biennial Operating Permits 100.00 92.00 XX-361 001092 9a. Transfer to headquarters S.OO 99-910 001203 10. Review of application due to proposed amendments or 75.00 69.00 XX-361 001092 changes after initial operating permit issuance. 1 Oa. Transfer to headquarters 6.00 99-910 001203 11. Variance application for a single family residence per 150.00 75.00 XX-361 001135 each lot or building site 11 a. Transfer to headquarters 75.00 99-910 001204 ATTACHMENT VI MONROE COUNTY HEALTH DEPARTMENT ESTIMATE OF ENVIRONMENTAL HEALTH FEES FISCAL YEAR 2002 - 2003 Est. Ann. Revenue DESCRIPTION FEE DEPOSIT ORG OBJECT Accruing to CHD AMOUNT AMOUNT L4IL.5 CODE Trust Fund 12. Performance-based Treatment System Maintenance 25.00 23.00 XX-361 001092 (Per annum) _.~ 12a. Transfer to headquarters 2.00 99-910 001203 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 0.001 1. First Year Public Water Annual Operation Permit and 75.00 67.50 XX-357 001166 Construction Permit - Limited Use 1a. Transfer to headquarters 7.50 99-910 001166 2. Second Year Public Water Annual Operation Permit - Limited Use 70.00 63.00 XX-357 001166 2a. Transfer to headquarters 7.00 99-910 001166 4. Multi-Family Water Construction Permit - serving 3 or 4 40.00 36.00 XX-357 001165 non-rental residences 4a. Transfer to headquarters 4.00 99-910 001165 5. Initial Operating Permit Fee After March 31 of Any Year 35.00 31.50 XX-357 001166 5a. Transfer to headquarters 3.50 99-910 001166 6. Non-SDWA Lab Sample (Sample Collection/Review of Analytical Results/Health Risk Interpretation): Delineated Area 50.00 50.00 XX-357 001142 Bacterial Sample Collection 40.00 40.00 XX-357 001142 Chemical Sample Collection 50.00 50.00 XX-357 001142 Combined Chemical microbiological 55.00 55.00 XX-357 001142 7. Reinspection of multi-family Water System 25.00 25.00 XX-357 001092 8. Reinspection of Public Water System 40.00 40.00 XX-357 001092 9. Delineated Area Clearance Fee 50.00 50.00 XX-357 001092 10. Limited Use Commercial Registered System 15.00 15.00 XX-357 001092 11. Limted Use Commercial Public Water System 25.00 25.00 XX-357 001092 Operating Permit Family Day Care Establishment 12. Limted Use Commercial Public Water System Operating Permit 15.00 15.00 XX-357 001092 Family Day Care Establishment After March 31 of Any Year. Safe Drinking Water Act (Delegated Counties) 0.001 1. Construction permit for each Category I through III treatment plant, as defined in Rule 62-699.310, FAC.., with treatment ATTACHMENT VI MONROE COUNTY HEALTH DEPARTMENT ESTIMATE OF ENVIRONMENTAL HEALTH FEES FISCAL YEAR 2002 - 2003 Est. Ann. Revenue DESCRIPTION FEE DEPOSIT ORG OBJECT Accruing to CHD AMOUNT AMOUNT L4IL5 CODE Trust Fund other than disinfection only. a. Treatment plant - 5 MGD and above 7,500.00 7,500.00 XX-358 001211 ....... b. Treatment plant - 1 MGD up to 5 MGD 6,000.00 6,000.00 XX-358 001211 c. Treatment plant - 0.25 MGD up to 1 MGD 4,000.00 4,000.00 XX-358 001211 d. Treatment plant - 0.1 MGD up to .025 MGD 2,000.00 2,000.00 XX-358 001211 e. Treatment plant - up to 0.1 MGD 1,000.00 1,000.00 XX-358 001211 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 XX-358 001211 b. Treatment plant - 1 MGD up to 5 MGD 6,000.00 6,000.00 XX-358 001211 c. Treatment plant - 0.25 MGD up to 1 MGD 4,000.00 4,000.00 XX-358 001211 d. Treatment plant - 0.1 MGD up to .025 MGD 2,000.00 2,000.00 XX-358 001211 e. Treatment plant - 0.01 up to 0.1 MGD 1,000.00 1,000.00 XX-358 001211 1. Treatment plant - up to 0.01 MGD 400.00 400.00 XX-358 001211 3. Construction permit for each Category V treatment plant, as defined in Rule 62-699.310, F.A.C.., - Disinfection Only a. treatment plant - 5 MGD and above 5,000.00 5,000.00 XX-358 001211 b. Treatment plant - 1 MGD up to 5 MGD 3,000.00 3,000.00 XX-358 001211 c. Treatment plant - 0.25 MGD up to 1 MGD 1,000.00 1,000.00 XX-358 001211 d. Treatment plant - 0.1 MGD up to .025 MGD 500.00 500.00 XX-358 001211 e. Treatment plant - up to 0.1 MGD 300.00 300.00 XX-358 001211 4. Distribution and transmission systems, including raw water lines into the plant, except those under general permit. a. Serving a community public water system SOO.OO 500.00 XX-358 1211 b. Serving a non-transient non-community public water systems 350.00 350.00 XX-358 001211 c. Serving a non-community public water system 2SO.00 250.00 XX-358 001211 5. Construction permit for each public water supply well. a. Well located in a delineated area pursuant to Chapter 62-524, F.A.C.. 500.00 500.00 XX-358 001211 b. Any other pUblic water supply well. 250.00 2SO.OO XX-358 001211 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. 1 MGD and above 2,000.00 2,000.00 XX-358 001211 b. .1 MGD up to 1 MGD 1,000.00 1,000.00 XX-358 001211 c. 0.01'up to.1 MGD 500.00 500.00 XX-358 001211 ATTACHMENT VI MONROE COUNTY HEALTH DEPARTMENT ESTIMATE OF ENVIRONMENTAL HEALTH FEES FISCAL YEAR 2002 - 2003 Est. Ann. Revenue DESCRIPTION FEE DEPOSIT ORG OBJECT Accruing to CHD AMOUNT AMOUNT L4IL5 CODE Trost Fund d. Up to 0.01 MGD 100.00 100.00 XX-358 001211 7. Minor modifications to systems that result in no change in the ,. treatment or capacity. a. .1 MGD and above 300.00 300.00 XX-358 001211 b. Up to 0.1 MGD 100.00 100.00 XX-358 001211 8. Fines and Forfeitures Variable Variable XX-358 012020 9. General Permit Fee for any General Permit not specifically listed: 100.00 100.00 XX-358 001211 a. General Permits requiring Progfessional Engineer or Professional 250.00 250.00 XX-358 001211 Geologist certification a. General Permits not requiring Progfessional Engineer or 100.00 100.00 XX-358 001211 Professional Geologist certification