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FY2012 1st Amendment 09/21/2012 N • a AMENDMENT TO CORE CONTRACT n co o • THIS AMENDMENT to agreement is made and entered into this3 st,day s-. ,'; of September, 2012, between MONROE COUNTY (COUNTY) and STATE,OF o • FLORIDA DEPARTMENT OF HEALTH, Monroe County Health Departrnenf:,1 re o WHEREAS, a Core Contract (Contract) was entered into October 19, 2011, for the term October 1, 2011 through September 30, 2012, between the parties, providing cooperation and funding of State Health department services in Monroe County; and WHEREAS, it is desired to update several exhibits. NOW THEREFORE, IN CONSIDERATION of the mutual covenants contained herein the parties agree to the amended agreement as follows: 1. Attachment II, Part II: adjustments updated to revenue sources from Schedule C allocations, plus updates to program revenues based on the most current projections. 2. Attachment II, Part III: adjustments made to expenses, FTEs and services by programs to reflect current projections 3. Fee Schedule attachment has been updated for Special Vaccination Campaigns and public Seasonal Flu clinics. 4. The Department shall send a copy of this amendment to the State Department of Health, Bureau of Budget Management. 5. The remaining provisions of the Contract effective October 1, 2011, shall remain in full force and effect. 6. The signatories below represent that they have full authority to execute this amendment on behalf of their respective agencies. IN WITNESS WHEREOF, the parties have set theft hands and seal on the day and year first above written. FOR STATE OF FLORIDA HEALTH DEPART I) Ml TEST: DANNY L. KOLHAGE, CLERK aorG . By c. 'QaS� o,.tAA> Mary Vanden Brook DEVEMAIYAOK 9 /a-Vj1 Administrative Services Director FOR COUNTY: MONR COUNTY ORN Y AP el AS - - — — ------ PEDRO J. RCADO 1 ASSISTA EY Bate 8 3u 7 (SEAL) ATTEST: DANNY L. KOLHAGE, CLERK BY;.. C. /Yn Deputy Clerk 9 3A.24 BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA Mayor/Chairma — P al.—_ o MON E DAS C UNTYTO A AP/Y O PEDRO ASSI OUN ATT RN Y to3uz z . ti; CiL3 � ; K:s�g3v s�)� '-{ &r s, x�jus},r �j :x • r yti r(gas :i. . .w,rt i M F; ?'C4"' 1. WP-t j 4 •, Y t rvw 'Y��'�t.Tip f ^.'.''�` - ',.,• "ws:..1'i. '.. ,. . u' . 3 i:;.4 el 04s� Yt P PI5 1 *\• }t .. igP4 "le 'PP)1, �C 1 '4r • F z' b a w � '1 w y' �� xt t y. `iS` 'r.+e.. .t�s �..�;: � ��{a ,�""� t ��,�s �,� ..a 1. �e�'��to'� • , ✓� - - ... x� $'t ,a Y'' t�.�,e'q t'iy -1 J2J.'1 9 1•s� s d is t�'•K3 !' R3.us•, �,�s s .za3• h fi . 4''- Pt� ' Y.. • ` f �';":egg -, 0 . n:4` jt '.<3 'k *•tc,,kk '��ri 11 •-, 't'•'-.1)tn4` 2�'a' •:.4, .,,,... y4E •'a^ `.. � ..4; �, , p / X J 0 .,,C b k:+lII 1'I,b•. V'V�1 T14,.. 1 R „e. .,w '� ,`�,t Ms ' ``�'l�`?z Wf�: 'Ely 1 k p� Tiff,'- `, V �. w. € / �. .. * .....,...,0.: r • � u t a o. t+9 �. g34.. •ass a r��H ", r vAt: 4�''.`'`i�.Naa. t•s' 'Y, - 'i x z?w•i• ky¢�r?��.+ ,L��'�t; �3��• •,t �; .•,rn s f;`t��r. `v 'y cctia'����`J ,r�.,,, +•�i ;;�';5 •y 3 ;� �y��s a�d'',c, �,�n`,%� �ti'•r,,„ stj re+''F. 5,.. b�. i 2 , y , -44: { � (T- fi{ �tl k E 1 n a m '.Y,.: a . „ .: F£ `4'4��y�rvs �y? `s�,+ `' 3�I'': � � y`ti, <,� y >�3'�'s'' 0 ��<L.+ )�, ;•^ "� °3Y r°" L`:,- 7..�"i �b. :� ;y J � 3'{r �,�4''`��., r��i 'P.t rt� �i, fir. 'K'Ni 1 ,N.0 t�.�s� / ls,�l'1,�I�„l�� t :� 0 Xtp C"�d'r.l� �4d!W F.;'fi�c` tkey4,�,',•`i. .,^��'.,Y4'xe, .x;�c�; 'rki ':. ,. , }g]�:� ;4,,+,110`. i ya. s' , r Vol' a--.0,�`;?S�411641.6 :a 11 .s�• "^ .:'�,% t-.. `" , '' 8: r=.:ti".3uSr':tsikt.4:=a-.14Aiti::0.'... x'r�. 1•Yg.. . siMak t.,';. .;45 •%: xia..;,,A.\=:YSI �.).W. ...,A aA.t . 75� ,I-Q.,,,,.. . `_.$'c,. . ,._ �,: ,, 1, GENERAL REVENUE-STATE 015040 AIDS PREVENTION 73,552 0 73,552 0 73,552 015040 AIDS SURVEILLANCE 0 0 0 0 0 015040 ALG/CESSPOOL IDENTIFICATION AND ELIMINATION 64,707 0 64,707 0 64,707 • 015040 ALG/CONTR TO CHDS•AIDS PATIENT CARE 370,000 0 370,000 0 370,000 015040 ALGICONTR'l'O CI-IDS-AIDS PATIENT CARE NETWORK 0 0 0 0 0 • 015040 MG/CONTR.TO CHOS•SUVf;REIGN IMMUNITY 0 0 0 0 0 015040 ALG/IPO HEALTHY START/lP0 0 0 0 0 0 • 015040 ALG/PRIMARY CARE 199,742 0 199,742 0 199,742 015040 ALPHA ONE PROGRAM•MIAMI-DADE 0 0 0 0 0 • 015040 CHILD HEALTH MEDICAL SERVICES 0 0 0 0 0 • 015040 CLOSING TI•IL'GAP PROGRAM 0 0 0 0 0 015040 COMMUNITY SMILES-MJAMI•DADE 0 0 0 0 0 015040 COMMUNTTYT'BPROGRAM 29,145 0 29,145 0 29,145 015040 COUNTY SPECIFIC DENTAL PROJECTS•ESCAMBIA 0 0 0 0 0 015040 DENTAL SPECIAL INITIATIVES 0 0 0 0 0 015040 DUVAL TEEN PREGNANCY PREVENTION 0 0 0 0 0 015040 FAMILY PLANNING GENERAL"REVENUE 47,373 0 47,373 0 47,373 015040 FI,CLPPP SCREENING&CASE MANAGEM13NT 0 0 0 0 0 015040 FL HEPATITIS&LIVER FAILURE PREVENTION/CONTROL. 72,000 0 72,000 0 72,000 015040 I IEALTI IY START MED WAIVER•SORRA 0 0 0 0 0 015040 I IisALTI IY START MED-WAIVER•CLIENT SERVICES 0 0 0 0 0 015010 1ESS1E'I'RICE CANCER C1'R/HEALTH CHOICE•MIAMI-DADS 0 0 0 0 0 015040 LA LIGA-LEAGUE AGAINST CANCER-MIAMI-DADE 0 0 0 0 0 015040 MANATEE.COUNTY RURAL IIEAL'1'H SERVICES 0 0 0 0 0 015040 MI TROORLANDO URBAN LEAGUE TEENAGE FREE PREY 0 0 0 0 0 015040 MIGRANT LABOR CAMP SANITATION 0 0 0 0 0 015040 MINORFI'Y OUTREACH-PENALVI R CLINIC-MIAMI•DADE 0 0 0 0 0 015040 SCHOOL HEAI;111 GENERAL REVENUE 56,596 0 56,596 0 56,596 015040 SPECIAL NEEDS SKEETER PROGRAM 0 0 0 0 0 015040 STATEWIDE DENTISTRY NETWORK-ESCAMBIA 0 0 0 0 0 015040 SIT)GENERAL REVENUE 16,755 0 16,755 0 16,755 015050 NON-CATEGORICAL GENERAL REVENUE. 1,138,40E 0 1,138,406 0 1,138,406 GENERAL REVENUE TOTAL 2,068,276 0 2,068,276 0 2,066,276 2. NON GENERAL REVENUE-STATE 015010 ALG/CONIR.TO CI•lIS•BIOMEDICAL WASTE 2,679 0 2,679 0 2,679 015010 ALG/CONTR.TO CHDS-SAFE DRINKING WATER PRO 0 0 0 0 0 015010 AEG/PRIMARY CARE 0 0 0 0 0 015010 CHD PROGRAM SUPPORT' 0 0 0 0 0 015010 FOOL)AND WATERBORNE DISEASE PROGRAM ADM'I'F/DACS 0 0 0 0 0 015010 PUI3LIC SWIMMING POOL PROGRAM 0 0 0 0 0 015010 SCHOOL HEAL'1'H TOBACCO TF 41,000 0 41,000 0 41,000 015010 'I'U13ACC0 ADMINIS'I'RATTON&MANAGEMENT 0 0 0 0 0 015010 'f013ACCO ADMINISI'RA'ITVE SUPPORT 30,000 0 30,000 0 30,000 015010 TOBACCO COMMUNITY INTERVENTION 130,772 0 130,772 0 130,772 015020 WIC PROGRAM FOOL)COSTS SUPPLEMENTAL. 29,111 0 29,1 1 I 0 29,111 015020 'TRANSFER FROM ANOTHER STATE AGENCY 0 0 0 0 0 015020 TRANSFER PROM ANO'I'I IER STATE AGENCY 0 0 0 0 0 i • > ,,.x;;1.;,<a•..•:x�.:Eq,. ,�,. . ., ,•. x a :Mc.;t^>.',z;'Y :z liW?.? 1,. `..N' �'?;Yy:K'? t r, f1j:V :A. �0.0: ;v a t r ":"k'F2 -S.r,{'a- "4'-'- it,I G;Wile?l i%Jj �`iF. '+} 11r�.jrJA{. ;,,,..1 « kl,11,✓e' ��r. .) iat 5 � ,. +l X r y�J '�t v`'c 'r4 Ewk Md% ^.v". �� A Y . A Ste `+,,r f •,`V ., + c �:tr 9{r u,,, ` +��T i.��� ��� , £'+ '`�tfrr�" �..��tr,'�, ' �� w.: Q� AA �, c�i���i'd' ��y+� ��a�o;'',y�'Ci:_Is,;�•�r�r y ��xt�i „�g�?� ti S¢�\c�rx`.yr 1r .aa"hi> � ., ,. ro:'•�i�?` 6' •'J 0' r ,a V°s 4t' _`'4 '� i'S 3 tRytA�` > <.�'tr+ .� �. ,;i{�r*'�fl a Z4 �',''`f.,wa tt3" � ., 3 •,.4',c,<r.z �4."v-.. l$ k A,� t���'�; v�r la }"pm:k-�. , ,wh.n rJ �i.b � '4.• '[! a A "� E s 9� D c^ a. t< •cam n ;sr+i�>t K��r`+ � t A 1? '��� ,.•lft.?�h3<., :aF.t+e ',':x.$, l-ta; ay�F-' ��:,'�� <i s�;:iv r'�• .'`;"`�`R��.1 � �e.+,.�` '♦,s a,o f r 1.- S' i « , >��, ry 0 ., • ` °,n.,M,"��' � j ?4�} i, `vs s'' ' i �t' �,^y y��c�eY; va �`v-G1 J9�1j2J�ni•-a' - 2 7 �' ¢y JIR.. +. �1�"Yr�{ "�., ..i4 T. ������j^ �1,•.•'j?��� Vh Y ; .������.tl�,�s!�yj15 � ���'`�tj, A• L'M �. �.. L .<' F'w ;I;? i:i?� �'�rp. �S1` ,�� Rya tt C,���� 3 11'j S��Q. ti!1 aJ b'AgP �1.lroenia), a r �� g,. 'S` L ,,,� }.1040;4-:: •;a �. ,f i ��`. ,q TO.14 si ey o r-i�a.,t. ',a.sip S x• �"tY•it`�l v,1 sit r 4 .:1 ,>,,.• '„t,..� ..,•,,,.,4, x r 4`. F::0-Al.� 't`Ypti t .t(�41�„,:.43. s. k,"s k,..;k� h_3kz a , - Sy s t�a F j trs. k 'fit'�,a,v t ' �@°l•`d ,,,. v yv oat, T;e,T..Q 'vwsretip,07,4., ,,e' r 'z,' `e �,r 13 .-� �� ^-`^t�l..,,.r�.,tg<'.vrnl��Fa, % b. }., � rt;C•�����n .,.�. _. �":. "��:�J�,;' `',!'. �a .,r /�� -�ti �ex f ?r¢'.C:vi,c.t � •y Y.} s o.�;3 v3'4�� y`39�LS �� Y n ::, i�:Age �,;� ;�1 .l. ,,,�,Y.5;,:3t� ' a ,A Z-�Y��' i}�,�y���Y:R l a > 1 Rr, iag.,43; rt ? ; ?: u,, Ag :t y.. } ¢ ' tit �.�•dk ,a 4t� i cr.,;{yv`�,,. 0'� , ,� •e :• oo=q '2r:a+. 't� ;�'?it .� 3. �+�.a� 9, '•2[ �.r t4,wor * o ,a Y..ti a, M > x<. '� �,.0 .Y1`5zri . - SKt!„�, ^' t r �.. ° >,' r f'.i`" +a✓5 c �'cs ,II c+RyY:' 3ti'{?.. fix a ap r r �a,•; L ..u041..10,>y' kilfil A111 a a �(" •;�ya�d� .�.z,.y,�, .:��• ^ �^:h vt- ?'h•�✓ �• ,y ,y :.[� '.Y`�:- {��� '�Y�3• s �'^ .�:- �nri,t .Y's ,� , a ;"r..�'.!v'^S�:K,r' Y`'� � U s 1. ply,, r5-y� �k:4. T '09 r? . 1.-. 'k Sr t"� ,.f�.S{Y �8 .,:i*X. ikril, c v'` r� .410. `)`.g..91 4,l�0)l,'��4 t !''OIPI. :1'ff.Y��....,'Y%1:,r�..:t -ili.'�\'. '<;ti9.4.,1.t'�S*L.�YSS �.W..a.�.:�%..�b'�Z yn•�'N�:.a. �� t`:`..x5. -. „l�l:.:A::r.�a� u•�:.t�,?'.6u r....,-w1 i�.a.:.a..z.�� ril...,. ..-.�,:: ... .. -r..�. .. .. r' 2. NON GENERAL REVENUE-STATE 015060 NON-CATEGORICAL TOBACCO REBASING 21,117 0 21.117 0 21,117 NON GENERAL REVENUE TOTAL 254,679 0 254,679 0 254,679 3. FEDERAL FUNDS-State 007000 AIDS PREVENTION 129,224 0 129,224 0 129,224 007000 AIDS SURVEILLANCE 0 0 0 0 0 007000 B10'I'ERRORISM HOSPITAL PREPAREDNESS 0 0 0 0 0 007000 COASTAL BEACH MONITORING PROGRAM 21,319 0 21,319 0 21,319 007000 COLORECTAL CANCER SCREENING 2009-10 0 0 0 0 0 007000 ENI IANCE COMPREI IENSIVE PREVENTION PLANNING AND IMPL 9,032 0 9,032 0 9,032 007000 EXPANDED TESTING INITIATIVE(ETi) 0 0 0 0 0 007000 FGlT/AIDS MORBIDITY 0 0 0 0 0 007000 PG'IT/BREAST&CERVICAL CANCER•ADMIN/CASE MAN 0 0 0 0 0 007000 PGTP/FAMILY PLANNING TITLE X SPECIAL INITIATIVES 76,366 0 76,366 0 76,366 007000 POT1.71FAMILY PI.ANNING=T1'1'LE.X 84,671 0 64,671 0 84,671 007000 HEALTH PROGRAM FOR REFUGEES 0 0 0 0 0 007000 HEALTHY PEOPLE HIiAI;i'HY COMMUNTI'IES 21,917 0 21,917 0 21,917 007000 HIV HOUSING FOR PEOPLE LIVING WTI'H AIDS 0 0 0 0 0 007000 !'HIV INCIDENCE SURVEILLANCE 0 0 0 0 0 007000 IMMUNIZATION FEDERAL GRANT ACTIVITY SUPPORT 25,478 0 25,478 0 25,478 007000 IMMUNIZATION FIELD STAFF EXPENSE 0 0 0 0 0 007000 IMMUNIZATION WIC-LINKAGES 0 0 0 0 0 007000 IMMUNIZATION-WIC LINKAGES 0 0 0 0 0 007000 MCI'!DOTE-GADSDEN SCI'IOOL.CLINIC 0 0 0 0 0 007000 MCH DGTI'•HEALTI'IY S'rAR'TCOALITIONS 0 0 0 0 0 007000 ORAL I!EALTH WORKFORCE AC'I'IVTI'lES 0 0 0 0 0 007000 PHI'-CITIES READINESS INITIATIVE 0 0 0 0 0 007000 PUBLIC HEALTH PREPAREDNESS BASE 114,354 0 114,354 0 114,354 007000 RAPE PREVENTION&EDUCATION GRANT 0 0 0 0 0 007000 RYAN WHITE 82,591 0 82,591 0 82,591 007000 RYAN WHITE-EMERGING COMMUNITIES 0 0 0 0 0 007000 RYAN WHITE-AIDS DRUG ASSIST PROG•ADM1N 35,443 0 35,443 0 35,443 007000 RYAN WIIITE-CONSORTIA 0 0 0 0 0 007000 STATE INDOOR RADON GRANT 0 0 0 0 0 007000 STD FEDERAL GRANT-CSPS 0 0 0 0 0 007000 STD I'IZOGRAM INFER'I'IL1'I'Y PRI3VEN'J'ION PROJECT(IPI') 0 0 0 0 0 007000 SYPHILIS ELIMINATION 0 0 0 0 0 007000 TEENAGE PREGNANCY PREVENTION REPLICATION 2010-11 0 0 0 0 0 007000 'TEENAGE PREGNANCY PREVENTION REPLICATION 2011-12 0 0 0 0 0 007000 TITLE X HI V/AIDS PROJECT 0 0 0 0 0 007000 TITLE X MALE PROJECT 0 0 0 0 0 007000 'TOBACCO FAITH BASED PROJECT 0 0 0 0 0 007000 'TUBERCULOSIS CONTROL-FEDERAL GRANT 0 0 0 0 0 007000 WIC ADMINISTRATION 272,277 0 272,277 0 272,277 007000 WIC BREASTFEEDING PEER COUNSELING 50,125 0 50.125 0 50,125 015009 MEDIPASS WAIVER•I•II;I'1'IY S'I'RT CL.IEN'l'SERVICES 0 0 0 0 0 015009 MEDIPASS WAIVER-SOBRA 0 0 0 0 0 007055 ARRA Federal Grant•Schedule C 10,755 0 10,755 0 10,755 • ' 7 S }1:i 1F ">.L&Y•+3' ! •R, <tgcv `5 ,yp hY ��"`1�:.}„r N i .y,.tti, ... � ••':5.: .: r ,t;`t.•ss' j•'C- ''4�. ayt w*r7 W)%* •yid :,X. rFb 1` s- s.V ;•'n:Y'd'4d,:'v"'.+ i 3`' > 's 'a�' al; er `S`qj Yx .i �..` t k n CZ �.. 5 ! �, �`. +s1f ` * p f ,i cl�`ia, ie%3s ,M14 �,�,; �� 3s- } c� �" d..,. ',4� ,3:x�' � "' � ,' �t5� �aE: 1 ,e�.y�3 ,�,y�'t��z�`'i' v" .--,. f h �' li ' B. 4 h 0 ,?'�7 o t s DEll ;�� u.z�,,m)! i ' i. � + ny ,. T. �k•.( y �R aSv , s:��at' •t .�� r$. ay`firg % * ts • 3 e `4` + y ' •F ' i .'{ a e.ss 0 ' i ') «is • �`f+ �ti 1 26.;�; ': , „:,,t.,, .g•, � •fe. ,. {. 3;te •1y�(q ' 1• . }'.,rr by• `ii 3`�'y� wt i rb !� sue':?" t•.SILO �.( i k � &, a. t�- �s> C 1 t � '`" a t �%`'" it3�� N4rrFy { r, tx d r1 '� i`k .! .+ �s . .' it `'• 11S rnytvsi�+ 4tytc .F;- a 0 '4,-. Y.y� tij� { gt s t s te1 1 & jr �ss � rq"Yy� " ( ,.., ft•'1�t�i ull(�t °�' �4 � 1� ut�J'R!F tt°rx`'IOj�� .:.t,' a4--.0„ s.i. .�`�1 5w_ k•:.. Ps. x VSAzi,,A.. :.)An a:;:::4.. Y.,-'r .:..9Sn (':,,„4 a....1.A,...nod 'u..�s...,. .a. .. • 3. FEDERAL FUNDS-State • • 015075 ON SITE SEWAGE TREATMENT&DISPOSAL SYSTEM 4,500 0 4,500 0 4,500 015075 SCHOOL HEALTH•1 ras XXI 125,758 0 125,758 0 125,758 015075 Inspections of Summer Feeding Programs 0 0 0 0 0 015075 TRANSFER OF FEDERAL GRANT FROM OTl IER AGENCY 0 0 0 0 0 FEDERAL FUNDS TOTAL 1,063,810 0 1,063,810 0 1,063,810 4. FEES ASSESSED BY STATE OR FEDERAL RULES-STATE 001020 'TANNING FACILITIES 1,280 0 1,280 0 1,280 001020 BODY PIERCING 970 0 970 0 970 001020 MIGRANT HOUSING PERMIT 0 0 0 0 0 001020 MOTILE HOME AND I'ARKS 19,500 0 19,500 0 19,500 001020 FOOD IIYGIENE PERMIT 16,000 0 16,000 0 16,000 001020 BIOHAZARD WASTE PERMIT 10,155 0 10,155 0 10,155 001020 PRIVATE WATER CONS'I'R PERMIT 0 0 0 0 0 001020 PUBLIC WATER ER ANNUAL OVER PERMf1' 0 0 0 0 0 001020 PUBLIC WATER CONS'TR PERMIT 0 0 0 0 0 001020 NON•SDWA SYSTEM PERMIT' 0 0 0 0 0 001020 SAFE DRINKING WATER 0 0 0 0 0 001020 SWIMMING POOLS 76,287 0 76,287 0 76,287 001092 OSDS PERMIT FEE 283,000 0 283,000 0 283,000 001092 I&M ZONI3D OPERATING PERMIT' 0 0 0 0 0 001092 AEROBIC OPERATING PERMIT 0 0 0 0 0 001092 SEPTIC TANK SITE EVALUATION 0 0 0 0 0 001092 NON SDWA LAB SAMPLE 0 0 0 0 0 001092 OSDS VARIANCE FEE 0 0 0 0 0 001092 ENVIRONMENTAL HEALTH FEES 100 0 100 0 100 001092 OSDS REPAIR PERMIT 0 0 0 0 0 00t 170 LAB FEE CHEMICAL ANALYSIS 0 0 0 0 0 001 170 WATER ANAI.YSIS•PO.1'AI3LE 0 0 0 0 0 001 170 NONPO'I'ABI,E WATER ANALYSIS 0 0 0 0 0 010304 MQA INSPECTION FEE 2,89I 0 2,891 0 2,891 001206 Central Office Surcharge 36,102 0 36,102 0 36,102 FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL 446,285 0 446,285 0 446,285 5. OTHER CASH CONTRIBUTIONS-STATE 010304 STATIONARY POLLUTANT STORAGE TANKS 81,307 0 81,307 0 81,307 090001 DRAW DOWN FROM PUBLIC HEALTH UNIT 0 0 0 0 0 OTHER CASH CONTRIBUTIONS TOTAL 81,307 0 81,307 0 81,307 6. MEDICAID-STATE/COUNTY 001056 MEDICAID PHARMACY 0 0 0 0 0 001076 MEDICAID TB 0 0 0 0 0 001078 MEDICAID ADMINISTRATION OF VACCINE 12,228 12,228 24,456 0 24,456 001079 MEDICAID CASE MANAGEMENT 0 0 0 0 0 001081 MEDICAID CHILD 1-IEALT!•I CHECK UP 6,027 7,653 13,680 0 13,680 001082 MEDICAID DENTAL 0 0 0 0 0 001083 MEDICAID FAMILY PLANNING 2,867 25,804 28,671 0 28,671 t U.'1ty<3ff``,T 1,"a't�:,1 tt r t��i�`r,F����,� '�y'�'xa ��^�, :,t1�� rk� es{' ��i�%#�at>;��? ��f t rk° i�ah�� t-;1r .:� ;:: :S•., { 9->�`/�rti { ,�l ) r .z'x J .J. Y j °Y4`3 .j�l�j r:`.��l:a �t � r^�s t °.,� 'S .�. t< r�i'r Ir'�2'r\•z '`•n• •.,, .r '',•,f• c`7 t'•y,'v,::.r1.,,vial. fg:;:4.,�stir ZP,itV tjc t't Y,.•.•..Y., 1'71s SVi-.'; .+ !' * ^ r..; iw^0',;: „Fl$N„a• ''IY ek. to '$.!.. 3t •a '`^' . '9 a�•s+, f:4i/ �i & e * �.. :'ee�t A a i f` <:y�.`- 't • l''.tt,,.- �� ,( !•'fin.. ! 2f r a, r.*�,.yz� .� t I,{ +� � -� � r *ci4::;. i t 'h era P4 �J�t .r.. . � ` ia"r�,. >0 +�•4`""� t�pel;.:e ,.• t t �-y-t '. '" ` l t� MR`4 4t£s� ,, tYK t'ak>t 't •.x'.> S�!... {/• Ft ,�".�H t?�o r, t t �> '� i;S��•�` �i � . : y r:> ?•j�q ��i'�5�. -c�u l�f�,� f 4 :�� tp� 'i * `' �'`�`"�'�>"a°i Y�.£AU"Y>�try<t,;�8 _ � '`!1`�,..��•.��s''�L" � �``,�'�rK,•r .tt �� N�j'�c i'<�.�:,�, � �� 3b��'>•Ci3Yfi.� 'X� ;y,�o��1 .'a 4�.: t'�.'' r w>j SSf• ,� x Si 4 A '.y °<.-s � 't �L( ��3,ii, ;r 7q:. °y' 705� . •'.tCdfr ': ri f.k~SF '?q� e.:t �{� 8 %, t.,a;$�c l :it .±: :i.•.'3 ^'a Z•ad` •¢+ j` Ild 4�yf� i•�4 +ti, / V> AT tt 1. .X}.q^ 0 1 c' 5.-•..i _,fi -1 6. MEDICAID-STATE/COUNTY 001087 MEDICAID S•fD 1,871 2,375 4,246 0 4,246 001089 MEDICAID AIDS 40,196 51,035 91,231 0 91,231 001147 Medicaid HMO Capitation 0 0 0 0 0 001191 MEDICAID MATERNITY 0 0 0 0 0 001192 MEDICAID COMPREHENSIVE CHILD 0 0 0 0 0 001193 MEDICAID COMPREI IENSIVf?ADULT 90,764 115,236 206,000 0 206,000 001194 MEDICAID LABORATORY 0 0 0 0 0 001208 MEDIPASS 43.00 ADM.FEE 3,333 3,333 6,666 0 6.666 001059 Medicaid Low Income Pool 0 0 0 0 0 001051 Emergency Medicaid 0 0 0 0 0 • 001058 Medicaid-Behavioral Health 0 0 0 0 0 001071 Medicaid•Orthopedic 0 0 0 0 0 001072 Medicaid-Dermatology 0 0 0 0 0 001075 Medicaid-School Health Certified Match 13,218 16,782 30,000 0 30,000 001069 Medicaid-Refugee Health 0 0 0 0 0 001055 Medicaid-Hospital 0 0 0 0 0 001148 Medicaid 1IMO Non-Capitation 0 0 0 0 0 001074 Medicaid-Newborn Screening 0 0 0 0 0 MEDICAID TOTAL 170,504 234,446 404,950 0 404,950 7. ALLOCABLE REVENUE-STATE 018000 REFUNDS 0 0 0 0 0 037000 PRIOR YEAR WARRANT 0 0 0 0 0 038000 12 MONTH OLD WARRANT 0 0 0 0 0 ALLOCABLE REVENUE TOTAL 0 0 0 0 0 8. OTHER STATE CONTRIBUTIONS NOT IN CHD TRUST FUND-STATE PI IARMACY SERVICES 0 0 0 68,740 68,740 LABORATORY SERVICES 0 0 0 27,849 27,849 T13 SERVICES 0 0 0 0 0 IMMUNIZATION SERVICES 0 0 0 508,171 508,171 STD SERVICES 0 0 0 0 0 CONSTRUCTION/RENOVATION 0 0 0 0 0 WIC FOOD 0 0 0 876,356 876,356 ADAP 0 0 0 0 0 DENTAL SERVICES 0 0 0 0 0 OTHER 0 0 0 0 0 OTHER(SPECIFY) 0 0 0 0 0 OTHER STATE CONTRIBUTIONS TOTAL 0 0 0 1,481,116 1,481,116 9, D)RItCI'LOCAL CONTRIBUTIONS-BCC/TAX DISTRICT 008030 Contribution from I(calif)Care'lax 0 905,215 905,215 0 905,215 008034 13CC Contribution front General Fund 0 0 0 0 0 DIRECT COUNTY CONTRIBUTION TOTAL 0 905,215 905,215 0 905,215 10. FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION-COUNTY ::.,. ..�.A- .�,ea,. i;T' �3os• ,X' 4" 'WOW' e`,,e}....pjr. iY''i.H„ .6. .�:�� k n°�:i..7 :r:i... Y�.,. ... U: k x r i ���'Ai' .. .:�. �'a:��',sNg �' x.' ,��,�• Jay'•' r,<. Pa 1,' �� e �?i'��.,„� �.,,.,: a r° �t>v 'l i ,,fit y..i,•`^,� 1�2g; `•y , �`",h' .v? aS; ifff.'ti".F, _ ,6�1a` •r' `MC` Yy4 s! �h e, eS, ti a�7 X`n ;c 4 .. ��v', , 'y� Y�' '�Zg `, '� ' �'z 1 ,ft< •d :' s0 g , ri • m, x a 1a ' 1iTA rh v >1 ,1�`ti r�l'a`'<�r Pa.�i' St \.SS<'tn��.,'�,�wf34 n�',ic?f'' '' c. ?� 7' rx Y7. '' 8 dti. Sa 9 al'.. •`tf'``t�Y•t.14� • a ��� , r a?�... ' •{'^ 'w ; •cf tt S-: t, r• .,...„...1• ' * •' ':ia sc?`'I,,, `` 2�;.` ,Y�'^r �, ,} ., ,yA<%'? '1 to • .Q .I .S• k p f e 0 •.l?',.. .•r'o y �f t'r�.t J ,� e3??u j�� tis.w ,�,',.>` <`w }�„RL 'c , „ .Y •c ii :'��M v h..r� , ,Wi "' . ?'y�v� '.1 �:j.x .44, kkt":.:E:0`. ,.n' •:iia- �`�,4,,i -.0". 0SE'`, „,.p . ,,,,: '``� ,,r,',, '!' "S','s4�k, lr,,t��>; 7 ik't \y .a'�,,aa. ..y.�rt��'�F?'�wS� ....6.�: t, 2s: �`;[' i'ta y t., G h. 7A.. ��^' �f,^ aiclx,Y^;f��,�•>,�`,,,. �tr. Ii08 gr'�t-,x$ `-,'.•7. 'uV•t1,.��,S 1, ,r�sV1i rk s. <b�,r, ,5. „ai. 1,t,,o y2,00 ,` _xij 5 tax 'i'r ti.`f7•,.7,4e-Sl iwi F'•:2' •ri..'k '�5� S^t'`r2h �. S?,'l}yy4°r �m` i, �1."�`. ,y'' �',t .; `.,y. :, t 0{I,.. !RA LYE; `�t 't �:Rv/. ��,;;., rt�;•`�,.�-4 ,44,;, ",,..,"t -,- a.. 1 :„.t. '.5.,f�<�P � O,e..n„., �..1i'"_.,` ..q St" r,,,01' x,r,dp�^. .f°.:w,.S i'?fy,.y uds `;b'6..i i t.'t .tit ':�{.v.„_..FJf. x, •aS' �<s; •,zy .i •:S+'' 1y,4;, 4 '���,.•"r-`.,'.:Y,,,-,,,:.? r'i?`Zt auto.i•, Fc• ?..v �z` v �`. <•:•.> -I bU„,9:!h ,i u,. ..,,., F}.' ; f .�Y.� .+��,s,,N ,,.. ?�.:.0 �`a., �a �. � �_, g „Y [r s.• nd �l x. 1......� :<G nl� <.vL._.., > ....� ,�r...,'•:,r, -t d a :.,a..`.K'9,1�.4..,i A. .. .rb3..A m 4 R'�'�:i�:`�vv �i:�i. �. .315 n�.,•> �<•YS �8,c..�., r, . . .. .. ,. . . • 10. FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION-COUNTY 001060 CHD SUPPORT POSITION 0 2,600 2,600 0 2,600 001077 RABIES VACCINE 0 6,000 6,000 0 6,000 001077 CHILD CAR SEAT PROG 0 0 0 0 0 001077 PERSONAL HEALTH FEES 0 246,469 246,469 0 246,469 001077 AIDS CO-PAYS 0 5,744 5,744 0 5,744 001094 ADULT ENTER.PERMIT FEES 0 0 0 0 0 001094 LOCAL ORDINANCE FEES 0 185,788 185,788 0 185,788 001114 NEW 131R'I'1•I CERTIFICATES 0 22,500 22,500 0 22,500 001115 Vital Statistics-Death Certificate 0 56,677 56,677 0 56,677 001 1 17 VITAL S'T'ATS-ADM.FEE 50 CENTS 0 850 850 0 850 001073 Co-Pay for the AIDS Caro Program 0 0 0 0 0 001025 Client Revenue from GRC 0 0 0 0 0 001040 Cell Phone Administrative Pee 0 0 0 0 0 FEES AUTHORIZED BY COUNTY TOTAL 0 526,628 526,628 0 526,628 11. OTHER CASH AND LOCAL CONTRIBUTIONS-COUNTY 001009 RETURNED CHECK ITEM 0 0 0 0 0 001029 THIRD PARTY REIMBURSEMENT 0 278,079 278,079 0 278,079 001029 HEALTH MAINTENANCE ORGAN.(HMO) 0 0 0 0 0 001054 MEDICARE PART D 0 0 0 0 0 001077 RYAN WHITE TITLE 11 0 0 0 0 0 001090 MEDICARE PART B 0 260,337 260,337 0 260,337 001190 1•Icalth Maintenance Organization 0 0 0 0 0 005040 INTEREST EARNED 0 0 0 0 0 005041 INTEREST'EARNED-STATE INVESTMENT ACCOUNT 0 7,500 7,500 0 7,500 007010 U.S.GRANTS DIRECT 0 551,481 551,481 0 551,481 008010 Contribution from City Government 0 0 0 0 0 008020 Contribution from Health Care Tax not(km 13CC 0 0 0 0 0 008050 School Board Contribution 0 0 0 0 0 008060 Special Project Contribution 0 0 0 0 0 010300 SALE OF GOODS AND SERVICES TO STATE AGENCIES 0 0 0 0 0 010301 EXP WITNESS FEE CONSULTNT CHARGES 0 0 0 0 0 010405 SALE OF PHARMACEUTICALS 0 0 0 0 0 010409 SALE OF GOODS OUTSIDli STATE GOVERNMENT 0 0 0 0 0 011001 IIEAI:IT I Y START COALITION CONTRIBUTIONS 0 323,251 323,251 0 323,251 011007 CASH DONA'ITONS PRIVATE 0 54 54 0 54 012020 FINES AND FORFEITURES 0 4,000 4,000 0 4,000 012021 RETURN CHECK CI LARGE 0 0 0 0 0 028020 INSURANCE RECOVERIES-OTHER 0 0 0 0 0 090002 DRAW DOWN FROM PUI3I,IC HEALTH I UNIT 0 0 0 0 0 011000 GRAM'DIRECT-NOVA UNIVERSITY CHD TRAINING 0 0 0 0 0 011000 GRANT-DIRECT 0 0 0 0 0 011000 GRANT DIRECT-COUNTY HEALTH DEPARTMENT DIRECT SERVICES 0 100,000 100,000 0 100,000 011000 DIRECT-ARROW 0 0 0 0 0 011000 GRANT-DIRECT 0 0 0 0 0 011000 GRANT-DIRECT' 0 0 0 0 0 011000 GRANT DIRECT-QUANTUM DENTAL, 0 0 0 0 0 011000 GRANT DIRI?CT-HEALTH CARE DISTRICT PAHOKEE 0 0 0 0 0 • • • ;e;�:,o;�.�:;Y:,,�„ax, ,�- F } •v.:: *�ii:e>ra,v��✓.'.••n+//,,++,,,.Gw,.a�;,>;v �.(a,}. ....,.�4(;�,,,> �f}::;�`;�rq�F.!ax°s:c1�S'��r. s 7 ,�y,:�„�+" `xi'.:y'n?, cr� r > ;: �.} 3{i '�V `R`� \', 'N 3 Z.FP�tc'9't.' ,}. Y4� S.` ti.� t`` av:•�?�j:''1..: J`-Y a j'e;s r , u r r si• pAt. .; yf �'to .t, '°`1SC+'3, *#.d :A •� v.,, rY+",. �s t x Y' ,:t x 1r Rc 4 r'. A :' v t• ,I r 5r* a.r k' . �S�f' *y'b'�' ?„s a�;. �� �' �.,�v^ '4 I 1�s�1 �D S t�,` � � �, �,T� :s h�.e s}�,�' at ��,. ' 4' U`°"�i y r a j a iL r '''. l 1 �r .`r kY' 't< . -� r t ` at. a *,rC` e ,. , o r .a`� ,.7 ` h ., �,r ,a `a3: `� 't4'3 VY i. ''>�''ttr'` �K Y r ° <a t!x- ciih- }.. `h .e. -c '�-,"e, (,� �%n _ ? {, a;,�r..'� ;,{� d ` ` k•' sa ' say.>. a ''�. .?� , < ,,.‘,„..„ . ? �, g4 .A-;,*- o 'y �.�'x:', ac,f, #I'"'4 `%(1 ' k 1 ',t,0 1 :11fr a+t.t� 1 . , iCX • 1,44 'talf.{*Z 1S aI��Y'�.�f:;x t_. rt '� e 1 f'1� ,. �� Z ,C .- ell ,�;" " ,,i 3 '�; ` , , 'tSr� - YF,•E%`'t ♦%},: .. . Yi y 'f >3 -1,4 j5*}p :{ < , y. �t ,•.'4Vi' ,r `1.l,.. T' 'A,� S c a3�'_�,R iA.k. �. 4 SY � � C 1111 - �';�YY. A <' "3 ,! i b A S`. ° " ar' Rt-.(d x�L 1 * e o 8 0 ,r 0 1 !';''.......J..... Ifit i '� i R '7�x r,t ja,. swat x*0A.., 4 x �x +a r: •7,ut_ ,1 ! {, 5 i' ! � ..: 1r +�,�4.0. .M1...J.krr ytl.Lo F``�fa.'`'0-�1;>� y Z9•. Z •`J.f 4y 4 a RQ;aUY G `M, }.( ��'15. \•x , #\. n,4'� st t v. 7. >t' x v 1 r i •v C,;,'' /$'`ka�> }.s,. s w Y.s � ",.�u�,� y�� � .s� �w 4�., zee r � � � �;�,,, �V� �""'x�� ,��"�=t.y„�''a�`a nt`ti ���,.�v.> > �. �1 ,�q,'P a, ,,,s,x.2,s. Q ye. l` ,k,. ,,y � L! .i•,s vi• cktR t�'rI' viai 1�1E1;v'ste?:�'+vo-i ,,n r._ '. ` +i - Y'x2sza.,•', ,E.`s /'K+'.•a S `4,f 3•'•�.,R)'P4 'Y•. J.i fja. ,,:;;ntpy'`�i•,sZ.S(. t,. �' *Few.,.,4(; •T \''•f'%;;:,.� y t,...,�� (.„..1, ..,,. xck•Tds. ,.. ....:.;�.1, w4�,:fic,.i,,w,,,...r t,%,, .. v ,..a.—,,...a i?:�_ i,-earA".f.-::'"T ....4::`AI:-Di..A.,,,.Y...,c:.`1.d.ti,.:4....• <...A...��`i+. 4r:�+�<..•...a.T.....a_._.G.i,..ra....�.,....o ....,. .•..e.� I I. OTHER CASH AND LOCAL CONTRIBUTIONS-COUNTY 011000 GRANT-DIRECT 0 0 0 0 0 • 011000 GRANT-DIRECT' 0 0 0 0 0 011000 GRANT-DIRECT 0 0 0 0 0 011000 GRANT-DIRECT 0 0 0 0 0 011000 GRANI-DIRECT 0 0 0 0 0 011000 GRANT DIRECT-ARROW 0 0 0 0 0 010402 Recycled Material Sales 0 0 0 0 0 010303 FDLE Fingerprinting 0 0 0 0 0 007050 ARRA Federal Grant 0 0 0 0 0 001010 Recovery of Bad Checks 0 0 p 0 0 008065 FCO Contribution 0 0 p 0 0 011006 Restricted Cash Donation 0 0 p 0 0 028000 Insurance Recoveries 0 0 0 0 0 001033 CMS Management Fee-I'MPMPC 0 0 0 0 0 010400 Sale of Goods Outside State Government 0 90,751 90,751 0 90,751 0)0500 Refugee Health 0 82,700 82,700 U 82,700 005045 InterestEarned•Third Party Provider 0 0 0 0 0 005043 Interest Earned-Contract/Grant 0 0 0 0 0 01030E DOH/DOC Interagency Agreement 0 0 0 0 0 008040 l3CCGrant/Conuraet 0 0 0 0 0 011002 ARRA Federal Grant-Sub-Recipient 0 0 0 0 0 011004 LOW INCOME POOL-SU3RECIpIENT 0 0 0 0 0 OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL 0 1,698,153 1,698,153 0 I,698,I53 12, ALLOCABLE REVENUE-COUNTY 018000 REFUNDS 0 0 0 0 0 037000 PRIOR YEAR WARRANT 0 0 0 0 0 038000 12 MONfl'T OLD WARRANT 0 0 0 0 0 COUNTY ALLOCABLE REVENUE TOTAL 0 0 0 0 0 13, BUILDINGS-COUNTY ANNUAI.REN'I'At.EQUIVALENT VALUE 0 0 0 511,595 511,595 GROUNDS MAINTENANCE 0 0 0 0 0 OTHER(SPECIFY) 0 0 0 0 0 INSURANCE 0 0 0 0 0 UTILITIES 0 0 63,948 63,948 0T11ER(SPECIFY) 0 0 0 0 0 BUILDING MAINTENANCE, 0 0 60,260 60,260 BUILDINGS TOTAL 0 0 0 635,803 635,803 14. OTHER COUNTY CONTRIBUTIONS NOT IN CI ID TRUST FUND-COUNTY EQUIPMENT/VEHICLE PURCHASES 0 0 0 0 0 VEHICLE INSURANCE 0 0 0 0 0 VEHICLE MAINTENANCE 0 0 0 0 0 OTHER COUNTY CONTRIBUTION(SPECIFY) 0 0 0 0 0 On IER COUNTY CONTRIBUTION(SPECIFY) 0 0 0 0 0 r :T,c .. r 3 ✓y.�( y.a a afi is to ;>`;7 ,V ,.. ' w1/4..tc I.?� ,'� �., �� ��r�i , 2}d t�2^t` a `�w�' ,� '•s b�ti"3� x b ''� s a� • � v dry j �< • � 4 , -,e 11ut1.11i LufY-.�'1 • '— (t111 1 III ,: ' hs t 1 ,<, a' MQ. ftQE t 0*,. ` AI:'1'[i ul;x',6R p ` ,: . '�- �`� " a•.. .47V �k .x��u,•rly � . . .,. ,�.,'ia i S' in•p� r � a. r e� � t .y k M� 4 ,f , � ; I)'l r t (1 our es f C {�tr� t-PR io Cl "9... e kh D:e � nicnt 4 :` <•' v rT. ':a r � 'S�� � r - � �-`r y �r�r e!. s ti. p ; �fS1 ro�` J" �r ,�a �, �-' iifo • .� y.t. C ;tie-. ., ,' <.`-'fir `azi'4 ✓`' `�,..ri`S` .�1,` •-,.d-.;, .�' • �'n ,ba . •••..Yr¢ '�•.� tr,,$ �`' '4`�„ � XF.;` W' �.i: � ', vk3 1 •r'k'y.£c LQUyIt� 1pt311( f1I) . g� P ``.s s �'r� -�c S n. tf ''x t � �. 3 .• xal t V 'Yi r.Y.:t, +. F ' n )r . \it a.5. ."4. S ,,,�uxt .2 4..: =.itl 1L°'''' rr �E c. .'m���.: ^:::G'#3�.:�'as.-�:w:.�rL�-�..�"''�,E .�s.' �"' •i�• <� ,y�.,�'.t'` '2 ;' �Ci15L� ,�Tj;11S1,",1•�!na ....�.:1cAlf)...,:C¢31t��`�If 011 n�3:••�T91.. .. �"z�fi s"vim.C`,ixS rah r S•:.f:,e�v,rs .s. ��� \ :fyr. H: �..n. .r..xM�\.+..:,.S� �. OTHER COUNTY CONTRIBUTIONS TOTAL 0 0 0 0 0 GRAND TOTAL CHD PROGRAM 4,084,861 3,364,442 7,449,303 2,116,919 9,566,222 • ;w;•�,,�.: • . r , v.e i15}til",: - } -" nc b. - ' t.y : ,�,�a w.:♦r .' �,��- VZ `aY�.,r a :'t• wC, � 1 ,� t� y1�. �Yrt r ''rt'cr tz''', Sr{� f .S.t..�` _ ,�..,,;4,_. �, tt, >il ,t G.>,'` ,;,,. .4` "S. :N, f: ;,��yf":1?",i,'�,t`� A i� v.�. F >_ }f�• mr?.,S'- ,`u�S`;" =5�'i? 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COMMUNICABLE DISEASE CONTROL: • IMMUNIZA'I'ION(101) 4.56 5,800 7,000 132,479 113,553 132,479 113,553 86,419 405,645 492,064 STD(102) 1.59 300 650 32,620 27,960 32,620 27,960 69,788 51,372 121,160 HIV/AIDS PREVENTION(03A1) 4.52 0 0 87,417 74,929 87,417 74,929 324,692 0 324,692 111V/AIDS SURVEILLANCE(03A2) 0.07 0 0 1,461 1,253 1,461 1,253 3,127 2,301 5,428 HIV/AIDS PATIENT CARE(03A3) 13.75 650 3,200 370,945 317,953 370,945 317,953 462,410 915,386 1,377,796 ADAP(03A4) 1.20 50 0 20,212 17,325 20,212 17,325 75,074 0 75,074 113 CONTROL SERVICE'S(104) 1.33 175 700 32,876 28,179 32,876 28,179 114,128 7,982 122,110 COMM.DISEASE SURV.(106) 6.09 0 1,500 92,855 100,945 121,530 100,000 239,290 176,040 415,330 HEPATITIS PRI3VENTTON(109) 1.89 663 1,360 41,641 35,692 41,641 35,692 154,666 0 154,666 PUBLIC HEALTH PREP AND RESP(116) 3.13 0 600 56,371 48,318 56,371 48,318 209,378 0 7.09,378 VITAL.STATISTICS(180) 1.25 2,200 5,350 22,356 19,162 22,356 19,162 0 83,036 83,036 C;O!<'IMUNICABLE DISEASE SUBTOTAL 39.38 9,838 20,360 891,233 785,269 919,908 784,324 1,738,972 1,641,762 3,380,734 B. PRIMARY CARE: CI IRONIC DISEASE SER VICES(210) 0.11 0 0 3,092 2,650 3,092 2,650 11,484 0 11,484 '1'013ACC0 PR13VENTION(212) 1.30 0 400 36,706 31,462 36,706 31,462 136,336 0 136,336 WIC(21W I) 5.53 3,300 28,500 98,642 84,550 98,642 84,550 366,384 0 366,384 WIC BREAS('FEEDING PEER COUNSELING(21W2) 1.87 100 1,000 25,256 21,648 25,256 21,648 93,808 0 93,808 FAMILY PLANNING(223) 5.13 1,298 3,500 115,995 99,424 115,995 99,424 339,570 91,268 430,838 IMPROVED PREGNANCY OUTCOME(225) 0.00 0 0 0 0 0 0 0 0 0 IlEALTIIY START PRENATAL(227) 4.03 566 4,750 70,794 60,681 70,794 60,681 262,950 0 262,950 COMPREHENSIVE CHILD HEALTH(229) 0.22 150 300 4,369 3,745 4,369 3,745 15,355 873 16,228 HEALTHY START INFANT(231) 2.18 263 2,530 33,561 28,766 33,561 28,766 81,187 43,467 124,634 SCHOOL IIEALTTT(234) 4.66 0 85,000 80,901 69,343 80,901 69,343 280,584 19,904 300,488 COMPREHENSIVE ADULT Ill:AL;I'H(237) 16.78 2,800 8,700 370,433 317,514 370,433 317,514 324,157 1,051,737 1,375,894 COMMUNITY(•II;AL;I'II DEVELOPMENT(238) 0.23 0 0 4,330 3,711 4,330 3,711 9,266 6,816 16,082 DENTAL.I MALT!!(240) 0.00 0 0 0 0 0 0 0 0 0 PRIMARY CARE SUBTOTAL 42.04 8,477 134,680 844,079 723,494 844,079 723,494 1,921,081 1,214,065 3,135,146 C. ENVIRONMENTAL HEALTH: Water and Onsite Sewage Programs COASTAL BEACH MONITORING(347) 0.30 350 350 5,994 6,401 14,414 22,733 49,542 0 49,542 LIMITED USE PUI3L1C WATER SYSTEMS(357) 0.00 0 0 0 0 0 0 0 0 0 PUBLIC WATER SYSTEM(358) 0.00 0 0 0 0 0 0 0 0 0 PRIVATE WATER SYSTEM(359) 0.00 0 0 0 0 0 0 0 0 0 INDIVIDUAL SEWAGE DISP.(361) 10.44 3,927 10,579 149,589 128,219 149,589 128,219 318,366 237,250 555,616 Group Total 10.74 4,277 10,929 155,583 134,620 164,003 150,952 367,908 237,250 605,158 Facility Programs FOOD I IYGIENE(348) 0.31 38 188 4,532 3,885 4,532 3,885 9,696 7,138 16,834 Body Picrci'ig Facilities Services 0.00 6 12 0 0 0 0 0 0 0 GROUP CARE FACILITY(351) 0.09 35 40 1,075 922 1,075 922 2,301 1,693 3,994 MIGRANT LABOR CAMP(352) 0.00 0 0 0 0 0 0 0 0 0 I'IOUSING,PUI3LIC 13LDG SAFETY,SANIT'ATION(353)0.09 0 19 1,640 1,405 1,640 1,405 3,509 2,581 6,090 q ��y7 ;. sJ�N`�,,,,r a K�x` i'1i,"<t'i'4f y�4 4* .yr n 6" r am. c �,kicAt r�� �.:k�'{ �r4�'t�. cirki�s � r`� a3� 4 'ax J �kyt'1�u�R._ ,,c v'rr site, ils, t�'ys� 104 Tr ,4�'/A�Steg4.: ' ti.3�.2 �`S J • �a3.: y ,Te..Z,..:3' (]J]i 1 1tr�''�h i�j('�{@�[��'a p r' M1 ..'s �i �/ `1, r t GJ`R." �ect rr' "'.'���/� �f IX,y�i ', X d ^c' \V� tct �S'f��!'�_� 1 tt •, .?fi,�,� �i,- 'g`� Sc t 14?,,j �.�'.'r�_,i a 4<�;2� an iv-_ .• 4\.. b, J• ,,a 2kI � ID'iY"&i .c� } ° 'K wd,• ;,„ ;tItAl., ,l ,iI`` N ,400 Itg it , Ces- ;.--fit % r opgA ; : any{ tvi Rc 1. d „, Sfi+�4 xyn4. �. " +t' rFR ��y ,Y� ��,55.. ilQ�. v ,,$'�° s"'.F in ' X���' `C E4 a� c � :t+ .}.,Y 0----,4,. - > ,,ha,` .,,,0`'S Y♦ '- {-. ,., '''C i .A�#.i,h,3� Y T �- .,, , L., z1' 1�7�;C= y�? v� (�1 k 'eS ,.c`.� 4' CI.Q, F� ,Q�F I)�,d�jy�4 fix* tpyit s "d }$+ey, f '4)i < 4?r"� �,.�`^� �iYY.0 .s 45 r�S _t c�: x ki:, , v, ri'.;` F ',.Lxn41k r,, +...r'"`. 7< c� xy�: ?�S' `';w44 .'I ar i a '•_:^. ' « f2V qY. ,r l.11.,Q'%;,a0,5;;6 y .4 I .zx R X ; ±�f4�.'.s e�.e y �.c�,, r<;� ...' R•'F1t., R� <i,, ` '£ ••✓': �- `'d` 'li. f h c$, ,S'.n tl�• et k t cy rty, Y c C .7;;wi¢". + c Y,•S4'R' eS( ,?,jy� @ "N. Y'R,..:r3ar, '^'. "7a• '( ,f,�� fi .;�'�c '�,,, 4: : "'a :�`'x..�e �3` t �-a !a •f e '.' ��,�' 3 �Y 'iw� i .�[ � .e.\/ jS,r. ;'}�,�1„' \"3 a .�'�}''," A ., �... ➢ '°. 3:a Y�" a4 ty,'a::�. '.�.9,, n^':.,R r'" `l, SSW a.�': •fit' i sec. t d t'T ^�`�wrl' '��::� ... >. �'w'1;;�,'`�`�. '� t�"� 3`b}� .��� 4 „��,f �L�� {?.�3Y� ,i f �, '� 3'^' r < _ n n/:.w s,x:w� ):t @U f .m cur„, ,:�7 �r t r,440�7s '�S•,.M: . ,a a°1 a' v�• . a $ c,�^�4au�:Y�n e t ll" r Y4,s^��o:ila,zv. ;?:•4,.s1::; .l ..g *.. Q'ou ?� �a-h. IP... x. k r, r q�.� P�..,. S e.44; a: -=`a�s... ..,Y x';v • ,,. ...ss. j �.�F..>�.a.. ��i��a"l.�R�i..�:�.?3;�3.�t!`x'+<.,�,�1�.....kc' ?. G..�+..i9^_�P�.t�..s;'s;'x :�-�°✓•��Ia, �:3.a, 2:�.. .<�.,'C+,..,.�'�:�.'� •s'.��3ED."�...,cPi... c .. _. C. ENVIRONMENTAL HEALTH: Facility Programs MOBILE HOME;AND PARKS SI?RVICGS(354) 0.33 88 215 3,686 3,160 3,686 3,160 11,173 2,519 13,692 SWIMMING POOLS/BATHING(360) 1.43 415 1,400 19,981 17,126 19,981 17,126 42,747 31,467 74,214 BIOMEDICAL WASTE SERVICES(364) 0.12 100 200 1,863 1,597 1,863 1,597 3,986 2,934 6,920 'PANNING FACILITY SERVICES(369) 0.00 7 15 0 0 0 0 0 0 0 Group Total 2.37 689 2,089 32,777 28,095 32,777 28,095 73,412 48,332 121,744 Groundwater Contamination STORAGE TANK COMPLIANCE(355) 2.47 414 823 25,793 22,107 25,793 22,108 95,801 0 95.801 SUPER ACT SERVICE(356) 0.02 0 5 284 244 284 244 1,056 0 1,056 Group Total 2.49 414 828 26,077 22,351 26,077 22,352 96,857 0 96,857 Community Hygiene 'I'ATI'00 FACILL'I'I ES SERVICES 0.00 0 2 0 0 0 0 0 0 0 COMMUNITY ENVIR.HEALTH(345) 0.00 0 0 0 0 0 0 0 0 0 INJURY PREVENTION(346) 0.00 0 0 0 0 0 0 0 0 0 LEAD MONITORING SERVICES(350) 0.00 0 0 0 0 0 0 0 0 0 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) 0.19 85 236 2,215 1,899 2,215 1,899 4,741 3,487 8,228 RABIES SURVEILLANCE/CONTROL SERVICES(366)0,02 2 8 117 100 117 100 251 183 434 ARBOVIRUS SURVEILLANCE(367) 0.00 0 0 0 0 0 0 0 0 0 RODLN'17ARTI IROPOD CONTROL(368) 0.00 0 0 0 0 0 0 0 0 0 WATER POLLUTION(370) 0.00 0 0 0 0 0 0 0 0 0 INDOOR AIR(371) 0.00 0 0 458 392 458 392 980 720 1,700 RADIOLOGICAL HEALTH(372) 0.02 0 I 208 178 208 178 445 327 772 TOXIC SUBSTANCES(373) 1.00 922 924 16,000 15,000 16,000 15,000 0 62,000 62,000 Group Total 1.23 1,009 1,171 18,998 17,569 18,998 17,569 6,417 66,717 73,134 ENVIRONMENTAL HEALTH SUBTOTAL 16.83 6,389 15,017 233,435 202,635 241,855 218,968 544,594 352,299 896,893 D. NON-OPERATIONAL COSTS: Non-Operational Costs(599) 0.00 0 0 81 69 81 69 300 0 300 ENVIRONMENTAL 1'LEALTI'l SURCHARGE(399) 0.00 0 0 9,057 9,058 9,057 9,058 36,230 0 36,230 NON-OPERATIONAL COSTS SUBTOTAL 0.00 0 0 9,138 9,127 9,138 9,127 36,530 0 36,530 TOTAL CONTRACT 98.25 24,704 170,057 1,977,885 1,720,525 2,014,980 1,735,913 4,241,177 3,208,126 7,449,303 FEE RESOLUTIONS A. PURPOSE. To establish public health service fees in order to expand existing public health services to the community at large. B. PRIMARY CARE SERVICES. (1) Primary care and Ancillary services include well and sick adult and child health services and family planning services. These services will be charged at not more than 160% of the prevailing Medicare rate. Where there is no Medicare fee, the fee will be the Medicaid rate. Service levels will be determined utilizing current Medicare guidelines for coding and billing services provided, Discounting adjustments will be made to client fees based upon the current contract for services with Medicare and other 3rd party payers. In addition, sliding scale adjustments to fees for primary care services will be based upon Federal OMB guidelines and in accordance with State of Florida Department of Health Policy 56-66-08. Medicaid is billed at the current Medicaid Cost-based rate and reimbursement for these services is considered payment in full. (2) Pharmacy — Medications issued will be provided at the most recent cost. Medicaid is accepted as payment in full. (3) Injection fee for parenteral medications per injection $35.00 (4) Lab fees - All laboratory and pathology fees are subject to sliding scale fee adjustment based upon OMB Federal Guidelines. . .. ---_- a. Specimens tested in clinic- $10.00 (hemoglobin, urine, blood sugar, mono, wet mount, strep) b. Pregnancy test No charge C. COMMUNITY PUBLIC HEALTH SERVICES (1) Tuberculosis X-ray for suspected, confirmed or Symptomatic contact or case No Charge (2) Tuberculosis Skin Test for suspected, confirmed or Symptomatic contact or case No Charge (3) Tuberculosis (TB) Sputum Culture for suspected, confirmed, or symptomatic contact of case No Charge (4) Tuberculin (TB) Skin Test., with reading, any other than $35.00 listed above in C. (1). (5) Tuberculin assessment of clients with a past history of positive skin test $35.00 (6) Sexually Transmitted Diseases —The fee below will be adjusted considering the client sliding fee group which is calculated at eligibility determination, based on Federal OMB Guidelines. Medicaid identification will be accepted as full payment in lieu of charges. Monroe County Health Department Core Contract Attachment 8/30/2012 1 • Professional Component fees: Office/Outpatient Visit, New $178.00 Office/Outpatient Visit, Established $117.00 • (7) Required Vaccines for children up to age 18 and eligible for the Vaccine for Children program No Charge Administration fee charged to third party payer $35.00 (8) Special vaccination campaigns Accept insurance contracted amount, no co-pay or deductible to client. Where manufacturer offers rebate, assistance or replacement plans, un-insured clients are eligible for no cost. (9) Seasonal Flu shots given at public, $20 cash, check advertised clinics. (Does not apply to flu credit card; no shots administered at any of our clinical sites insurance accepted. during a scheduled appointment) Fee scale applies (10) All other Immunizations Cost of vaccine x 2 + $35 injection fee (11) Class/Seminar attendance registration Per person charge for health care, social work and counseling employees. AIDS 101 No Charge AIDS 500 No Charge AIDS 501 No Charge (12) Expendable medical/wound care supplies such as: Sponge Gauze, Bandages/Dressings, Gloves Cost x 3.5 (13) International Certificates of Vaccination Cost x 3.5 D. VITAL STATISTICS: (1) Birth Certificates: $ 16.00 Additional Copies $ 16.00 (2) Protective Covers $ 4.00 (3) Death Certificates— Certified Copy $ 20.00 Additional Copies $ 20.00 (4) Express Fee $ 10.00 Monroe County Health Department Core Contract Attachment 8/30/2012 2 E. MEDICAL RECORDS: Copying of Medical Record (per page) $ 1.00 • F. PUBLIC RECORDS: Copying of Public Record (per page) 25 cents G. RETURNED/DISHONORED CHECKS: (S. 215.34(2), F.S.) • A service fee of $15.00 or 5% of the face amount of the check, draft, or money order whichever is greater, not to exceed $150,00 H. PUBLIC HEALTH AND MEDICAL PREPAREDNESS New or annual review of Comprehensive Emergency Management Plan for Home Health Agencies, Hospices, Nurse Registries, Home Medical Equipment Providers $ 75.00 Monroe County Health Department Core Contract Attachment 8/30/2012 3