FY2013 11/20/2012 DANNY L. KOLHAGE
CLERK OF THE CIRCUIT COURT
DATE: December 7, 2012
TO: Robert Eadie, JD.
CHD Director /Administrator
ATTN: Bunny VanBourgondien
Contract Administrator
FROM: Pamela G. Hanccfck3"-) C.
At the November 20, 2012, Board of County Commissioner's meeting, the Board granted
approval and authorized execution of Item M1 a Contract between Monroe County Board of
County Commissioners and the State of Florida, Department of Health for operation of the
Monroe County Health Department - contract year 2012- 2013.
Enclosed are five duplicate originals of the above - mentioned, executed on behalf of
Monroe County, for your handling. Please be sure to return two fully executed originals for the
C'lerk's record and for the Finance Department. Should you have any questions, please do not
hesitate to contact this office.
cc: County Attorney
Finance
File ✓
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 2012 -2013
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, 2012.
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 CHID.
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, 2012, through September 30, 2013, 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 CHID The parties mutually agree that the CHD
shall provide those services as set forth on Part III of Attachment If 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, and 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 it hereof. This funding will be used as shown in Part I of Attachment II.
i. The State's appropriated responsibility (direct contribution excluding any state fees,
Medicaid contributions or any other funds not listed on the Schedule C) as provided in
Attachment II, Part II is an amount not to exceed $ 4,168.860 (State General
Revenue, State Funds, Other State Funds and Federal Funds listed on the Schedule C). The
State's obligation to pay under this contract is contingent upon an annual
appropriation by the Legislature.
ii. The County's appropriated responsibility (direct contribution excluding any fees,
other cash orlocal contributions) as provided in Attachment ll, Part II is an amount not
to exceed $ 939,070 (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 CHID 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. As allowed by law, Monroe County Health Department has established
.Communicable disease control and Primary care services rates at 160% of the Medicare
Fee Schedule, rounded up to the next whole dollar. Monroe County Health Department
has established Environmental Health Services Fees--in- line -- with - local - recommendations- - - - - --
and economic factors
d. Either party may increase or decrease funding of this Agreement during the term
hereof by notifying the other party in writing of the amount and purpose for the change in
funding. If the State initiates the increase /decrease, the CHD will revise the Attachment II
and send a copy of the revised pages to the County and the Department of Health,
Bureau of Budget Management. If the County initiates the increase /decrease, the County
shall notify the CHD. The CHD will then revise the Attachment II and send a copy of the
revised pages to the Department of Health, Bureau of Budget Management.
e. The name and address of the official payee to who payments shall be made is:
County Health Department Trust Fund
Monroe County
PO Box 6193
1100 Simonton Street
Key West, FL 33040
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 Secretary for Statewide Services. The
director /administrator shall be selected by the State with the concurrence of the County.
The director /administrator of the CHD shall insure that non - categorical sources of funding
are used to fulfill public health priorities in the community and the Long Range Program
Plan. A report detailing the status of public health as measured by outcome measures
and similar indicators will be sent by the CHD director /administrator to the parties no later
than October 1 of each year (This is the standard quality assurance "County Health Profile" report
located on the Office of Planning, Evaluation & Data Analysis Intranet site).
6. ADMINISTRATIVE POLICIES AND PROCEDURES The parties hereto agree that
the following standards should apply in the operation of the CHD:
a. The CHD and its personnel shall follow all State policies and procedures, except to
the extent permitted for the use of county purchasing procedures as set forth in
subparagraph b., below. All CHD employees shall be State or State- contract personnel
subject to State personnel rules and procedures. Employees will report time in the Health
Management System 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 facilities not enumerated in Attachment IV.
c. The CHD shall maintain books, records and documents in accordance with those
promulgated by the Generally Accepted Accounting Principles (GAAP) and Governmental
Accounting Standards Board (GASB), and the requirements of federal or state law. These
records shall be maintained as required by the Department of Health Policies and
Procedures for Records Management and shall be open for inspection at any time by the
parties and the public, except for those records that are not otherwise subject to disclosure
as provided by law which are subject to the confidentiality provisions of paragraph 6.i.,
below. Books, records and documents must be adequate to allow the CHD to comply with
the following reporting requirements;
i. The revenue and expenditure requirements in the Florida Accounting
System Information Resource (FLAIR).
ii. The client registration and services reporting requirements of the
minimum data set as specified in the most current version of the Client
Information System /Health Management Component Pamphlet;
iii. Financial procedures specified in the Department of Health's Accounting
Procedures Manuals, Accounting memoranda, and Comptroller's
memoranda;
iv. The CHD is responsible for assuring that all contracts with service
providers include provisions that all subcontracted services be reported
to the CHD in a manner consistent with the client registration and
service reporting requirements of the minimum data set as specified in
the Client Information System /Health Management Component
Pamphlet.
d. All funds for the CHD shall be deposited in the County Health Department Trust
Fund maintained by the state treasurer. These funds shall be accounted for separately
from funds deposited for other CHDs and shall be used only for public health purposes in
Monroe County.
e. That any surplus /deficit funds, including fees or accrued interest, remaining in the
County Health Department Trust Fund account at the end of the contract year shall be
credited /debited to the state or county, as appropriate, based on the funds contributed by
each and the expenditures incurred by each. Expenditures will be charged to the program
accounts by state and county based on the ratio of planned expenditures in the core
contract and funding from all sources is credited to the program accounts by state and
county. The equity share of any surplus /deficit funds accruing to the state and county is
determined each month and at contract year -end. Surplus funds may be applied toward
the funding requirements of each participating governmental entity in the following year.
However, in each such case, all surplus funds, including fees and accrued interest, shall
remain in the trust fund until accounted for in a manner which clearly illustrates the amount
which has been credited to each participating governmental entity. The planned use of
surplus funds shall be reflected in Attachment 11, 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 Secretary
for Statewide Services has approved the transfer. The Deputy Secretary for Statewide
Services 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.
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 which applicants for services and current
clients may present grievances over denial, modification or termination of services. The
CHD will advise applicants of the right to appeal a denial or exclusion from services, of
failure to take account of a client's choice of service, and of his /her right to a fair hearing to
the final governing authority of the agency. Specific references to existing laws, rules or
program manuals are included in Attachment I of this Agreement.
n. The CHD shall comply with the provisions contained in the Civil Rights Certificate,
hereby incorporated into this contract as Attachment Ill.
o. The CHD shall submit quarterly reports to the county that shall include at least the
following:
i. The DE3851-1 Contract Management Variance Report and the DE580L1
Analysis of Fund Equities Report;
ii. A written explanation to the county of service variances reflected in the
DE3851-1 report if the variance exceeds or falls below 25 percent of the planned
expenditure amount. However, if the amount of the service specific variance
between actual and planned expenditures does not exceed three percent of the
total planned expenditures for the level of service in which the type of service is
included, a variance explanation is not required. A copy of the written
explanation shall be sent to the Department of Health, Bureau of Budget
Management.
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, 2013 for the report period October 1, 2012 through
December 31, 2012;
ii. June 1, 2013 for the report period October 1, 2012 through
March 31, 2013;
N. September 1, 2013 for the report period October 1, 2012
through June 30, 2013; and
iv. December 1, 2013 for the report period October 1, 2012
through September 30, 2013.
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. Availability of Funds If this Agreement, any renewal hereof, or any term,
performance or payment hereunder, extends beyond the fiscal year beginning July 1,
2013, it is agreed that the performance and payment under this Agreement are contingent
upon an annual appropriation by the Legislature, in accordance with section 287.0582,
Florida Statutes.
b. Contract Managers The name and address of the contract managers for
the parties under this Agreement are as follows:
For the State:
For the County;
Mary Vanden Brook
Name
Administrative Services Director
Title
PO Box 6193
Gato Building, 1100 Simonton St.
Key West, FL 33041
Address
305 -809 -5612
Telephone
Roman Gastesi
Name
County Administrator
Title
Gato Building, 1100 Simonton St.
Key West, FL 33041
Address
305- 292 -4441
Telephone
If different contract managers are designated after execution of this Agreement, the name,
address and telephone number of the new representative shall be furnished in writing to
the other parties and attached to originals of this Agreement.
C. Captions The captions and headings contained in this Agreement are for
the convenience of the parties only and do not in any way modify, amplify, or give
additional notice of the provisions hereof.
In WITNESS THEREOF, the parties hereto have caused this page agreement to be
executed by their undersigned officials as duly authorized effective the 1 day of October, 2012.
BOARD OF COUNTY COMMISSIONERS
FOR Monroe COUNTY
SIGNED ' SIGNI
NAME George R. Neugent
TITLE: Mayor /Chairman
DATE November 2 0, 2012
NAME
TITLE
DATE
STATE OF FLORIDA
ATTESTED TO:
SIGNED B�Y�� D.C. SIGNED BY:
NAME Amy Heavilin
NAME: Robert Eadie, J.D.
TITLE: Clerk Ad Interim
DATE November 2 2012
TITLE: CHD Director Administrator f
DATE: / 0 0;�7
DEPARTMENT OF HEALTH
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DEPARTMENT OF HEALTH
ATTACHMENT
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
1. Sexually Transmitted Disease
Program
2. Dental Health
3. Special Supplemental Nutrition
Program for Women, Infants
and Children (including the WIC
Breastfeeding Peer Counseling
Program)
4. Healthy Start/
Improved Pregnancy Outcome
5. Family Planning
6. Immunization
7. Environmental Health
13
Requirement
Requirements as specified in F.A.C. 64D -3, F.S. 381 and
F.S. 384.
Monthly reporting on DH Form 1008 *. Additional reporting
requirements, under development, will be required. The
additional reporting requirements will be communicated upon
finalization.
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.
Requirements as specified in the 2007 Healthy Start
Standards and Guidelines and as specified by the Healthy
Start Coalitions in contract with each county health
department.
Periodic financial and programmatic reports as specified
by the program office.
Periodic reports as specified by the department regarding
the surveillance /investigation of reportable vaccine
preventable diseases, vaccine usage accountability as
documented in Florida SHOTS, the assessment of various
immunization levels as documented in Florida SHOTS and
forms reporting adverse events following immunization.
Requirements as specified in Environmental Health Programs
Manual 150 -4* and DHP 50 -21*
HIV /AIDS Program Requirements as specified in F.S. 384.25 and
F.A.C. 64D -3.030 and 64D - 3.031. Case reporting should be
on Adult HIV /AIDS Confidential Case Report CDC Form
DH2139 and Pediatric HIV /AIDS Confidential Case Report
CDC Form DH2140.
10
ATTACHMENT I (Continued)
9. School Health Services
10, Tuberculosis
11. General Communicable Disease Control
Socio - demographic data on persons
tested for HIV in CHD clinics should be reported on Lab
Request DH Form 1628 or Post -Test Counseling DH Form
1628C. 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.
Requirements as specified in the Florida School Health
Administrative Guidelines (May 2012).
Tuberculosis Program Requirements as specified in F.A.C.
64D -3 and F,S. 392.
Carry out surveillance for reportable communicable and other
acute diseases, detect outbreaks, respond to individual cases
of reportable diseases, investigate outbreaks, and carry out
communication and quality assurance functions, as specified
in the CHD Guide to Surveillance and Investigations.
"or the subsequent replacement if adopted during the contract period,
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1. GENERAL. REVENUE- STA'T'E
015040
AIDS PRI:VL:NI'ION
73,552
0
73,552
0
73,552
015040
AIDS SO RVFIL,I.,ANCI:.
0
0
0
0
0
015040
Al,(i /CESSPOOL IDI NTIFICA'1'ION AND FL,IMINATION
64,707
0
64,707
0
64,707
015040
AL,G /CONTR'1'0 Cl IDS -AIDS PATIf:'NT CAR1
370,000
0
370,000
0
370,000
015040
ALWCONIRTOCHDS -AIDS PA "I'IGNFCARFNETWORK
194,400
0
194,400
0
194.400
015040
AL GICON TR'1'OClIDS- SOVLiREICINIMMUNITY
0
0
0
0
0
015040
MINORLI'Y OUI'RI:ACLI- PENAI.VI.:R CLINIC - MIAMI -DADF'
0
0
0
0
0
015040
PRI ?PARFDNI GRANT MA'1'Cl1
4,691
U
4,09I
0
4,691
015040
SCHOOL. FI1 AI.1 U :NFRAL. RLiVl.,NUl
55,223
0
55 "223
0
55,223
015040
STAI'I3N'iDE DIL'WHSTRY NETWORK - L SCAMBIA
0
0
0
0
0
015040
STD G[-'NI:RAI.. RGVENIJI{
161,755
0
16.755
0
16,755
015040
T'RI ASURU' COAST MI DWI F1, RY - MARTIN
(>
0
0
0
0
015040
1 IIAI.TLIYSTAR'I'ML' WAIVER- C1-IEN 'I'SFAVIC13S
0
"D-
0
0
0
0
015040
J1'SSII TRICE CANCER CTR /I ll'AI:I'I I Cl IOICI - MIAMI -DADS
0
0
0
0
0
015040
LA LIGA- L,L;AGU AGAINS f CANCER - MJAM1 -DADI:
0
0
0
0
0
015040
MANA'H +' COUNTY RURAL IWALTII SERVICES
0
0
0
0
0
015040
Ml.. RO ORLANDO URBAN LFAUUI: - ORANGLI'
0
0
0
0
0
015040
MIGRANT LABOR CAMP SANI'FATION
(1
0
0
0
0
015040
DFNTAL SITCIAL IN1'HATIVf'S
0
0
0
0
0
015040
DUVAI,'ll i:N PRHGANCY PRLiVI N'IION - DUVAL
0
0
(1
0
0
015040
FAMILY PLANNING GI.`NERAL RI.-*VI Nl11.i
47,373
0
47,373
0
47,373
015040
Fl., CLPPP SCRITNINO & CASF MANAGIaMFN'F
0
0
0
0
0
015040
FL. l IIiPA "Il "I'IS & LIVER I AI1.l1R1 PRIiV13N'1'ION /CON'fR01_
72,000
0
72.000
0
72,000
015040
1113A1.:Il IY START MCiD 1NAiVl.l2 • SOI3RA
0
0
U
0
0
015040
Ai.G /IPO I IL:AIAI IY ST'AR'I711
0
0
0
0
0
015040
/V,Ci /PRIMARY CART:
199,740
0
199,740
0
199,740
015040
13RFAST' & CERVICAL - ADMINISTRATION /CASK MANA(;I.;M1.N'I'
0
0
0
0
0
015040
COMMUNITY SMILL:S - MIAMI-DADF
0
0
0
0
0
015040
C'ONIM1JN1'I 'Y "1'13 PROGRAM
32,536
0
32,536
0
32,536
015040
COUNTY SPECIFIC DI N "I'.AL PROJECI:S - FSCAM131A
(1
0
0
O
0
015050
NON -CATT GORICAL WiNFRAL REVI"NUF
1,078.429
0
1,078,429
0
1,078,429
GENERAL, REVENUE TOTAL
2,209.406
0
2.209,406
0
2,209,406
2. NON
GENERAL REVENUE -STATE
015010
AL.G/ CON" fR. 1' OC 'IiDS- 131ON11:DIC'AI.WAS "I'f.:
3,380
0
3380
0
3,380
015010
AL.G /CONTR.'1'OC)IDS -SAFE? DRINKING WATFR PRO
0
0
0
0
0
015010
CIiD PROGRAM SUPPORT"
0
0
0
0
0
015010
1.001) AND WATER13ORNU DISI ASF PROGRAM ADM TF /DACS
0
0
0
0
0
015010
PRITARILDNISS GRANT MA'I'C'11
0
0
0
0
0
015010
PUBLIC SWIMMING POOL" PROGRAM
0
0
0
0
0
015010
SCHOOL IiGAL;FfITOi3ACCOTP
41,000
0
41,000
0
41,000
015010
JOBACCO ADMINIS'I'RA "I'ION & MANAGI'M XF
0
0
0
0
0
015010
TOBACCO COMMUNITY INTURVEN'I'ION
109.255
0
109,255
0
109,255
015020
'1'RANSFI-'R FROM ANO'I'l WIR S'I'A'Ll AGI NC'Y - WIC2S
26.664
0
26.664
0
26,664
015020
IRANSP)3R FROM ANOTI IF'R STATI: AGENCY - INDIR
30,000
U
30,000
0
30,000
015020
I'RANSFhR FROM ANO'I'ITFA S'I'A "I'1 AGENCY
0
0
0
0
0
015060
NON- C'A "I'1 (iORICAL TO13A000 RFBASING
16,745
0
16,745
0
16,745
(3
3. FEDERAL FUNDS - State
007000
A13S "I'iNI:NC:I: 1 :DL1CA'I'ION GRANT PROGRAM
0
0
p
0
0
007000
AIDS PIOWE"N" ION
143,281
0
143,281
0
143,281
007000
AIDS SIJRVI
0
0
0
0
0
007000
I3I0TERRORISM HOSPITAI. PRl PAR(:DNI :SS
0
0
O
0
0
007000
CHRONIC D1SIiASf.: PRLiVIiN'fION & I IFA1:I'l l PROMOTION
32,000
0
32,000
0
32.000
007000
COASTAL-. 131 ACI I MONITOIZING PROGRAM
29,764
0
29,764
0
29,764
007000
T UBI:RCUI -OSIS CONI'ROI.. - 1- GRANT
0
0
O
0
0
007000
IJNIN'1'I:NL)IiD /IJNWANT'1i1) PRI G- 'I "I :I:N PREGNANCY PREV
37,228
0
37,228
0
37,228
007000
WIC ADMINIST'RATTON
291,672
0
291,672
0
291,672
007000
WIC f3RI:AS'TPEI:DING P1 13R COONSI LING
7Z 106
0
77106
0
77,106
007000
S'I'D I'EDERAL GRANT CSPS
0
0
0
0
0
007000
STD PIZOGIZAM INI PKI:VI NI PIZOIE:CT(II'P)
0
0
0
0
0
007000
SYPHILIS 13LfMINATION
(!
0
0
0
0
007000
TEENAGE PREGNANCY PREVENTION lZI-T (CATION
0
0
0
0
0
007000
'TITLE; X IIIV /AIDS PROJI CT
0
0
0
0
0
007000
1'O13ACCO FAITH BASED PROJECT
0
0
0
0
0
007000
RAPT: PRE',VI:iNTION &, I- DUCATION
0
0
0
0
0
007000
RYAN WI I1'Tl
96,450
0
96,450
0
96,450
007000
1ZYAN WI IITI' - I- MERGING COMMUNITIES
0
0
0
0
0
007000
RYAN WHIT 'L: -AIDS DIZIIG ASSISI' I'ROO -ADMIN
35,443
0
35,443
0
35,443
007000
IZYAN WI II F- C'ONSORTTA
355,914
0
355,914
0
355,914
007000
SAI'T-' SI.FI:P I:DIICA'I`ION
0
0
0
0
0
007000
MINOIITY INVOI_VI! :MI:N'1' IN IIIV /AIDS PIZOGRAM
(1
0
0
0
0
007000
PIIP - CITI[.SREADINESSINIIIAIIVE
0
0
0
0
0
007000
PIZECONC PTTON HIiAI,T I I CARL',
0
0
0
0
0
007000
PREGNANCY ASSOCIATED MORTALTTY PREVENTION
0
0
0
0
0
007000
PUBLIC ITLAI IT I W RASTRUCTUM.'
8,639
0
8,639
0
8,639
007000
PUBLIC I ICAL'I'l I PREPAREDNESS BASE
154,699
0
154,699
0
154,699
007000
IMMUNIZATION WIC LINKAGLS
0
0
0
0
0
007000
MCH 13GIT- GADSDEN SCI 1001.. C1..ANIC
0
0
O
0
0
O07000
MCI 113(; TI: -IJL AI :1T IY START COALITIONS
0
0
0
0
(1
007000
:MCI( QUALITY IMPROVI::MI :N "I'AC'I'IVI "I'II - S MCI -1136
0
0
0
0
0
007000
MINORITY AIDS INITIATIVE:
0
0
0
0
0
007000
MINORITY AIDS INITIATIVLi T'CE COL.L.ABORATIVE
0
0
0
0
0
007000
IY;1 '1: /I'AMII.Y PLANNING - TITLE.' X
78,097
0
78,097
0
78,097
007000
1IFAL:I'ITY IIOMES AND LEAD POISONING GIZAN'T
0
0
0
0
0
007000
1 H I IOUSING POIZ hTiO1'L,Li LIVING WIl'I I AIDS
390,590
0
390,590
0
390,590
007000
H1V INC'IDENCI:: SURVEILLANCE'
0
0
0
0
0
007000
IMMUNIZATION FEDERAL.. GRANT ACTIVITY SUPPORT
14,646
{}
14,646
0
14,646
007000
IMMUNIZATION FIELD Sl'APF EXPENSI
0
0
0
0
0
007000
COL.OREC AL CANCTiR SCREENING 2009 -10
0
0
0
0
0
007000
T)I:N'TAL K-"RVICI:S
0
0
(I
0
0
007000
ENI IANCIi COMPIZL':I IENSIVI" PREVENTION PIANNING AND IMPL
0
0
0
0
0
007000
I:XPANDIcDIT=S'I'ING INI'TIATIVI' (FTI)
0
0
O
0
0
007000
PG'IP/AIDS MOIWIDITY
0
0
0
0
0
007000
PG'TP/13R1::AS"T & CERVICAL CANCEII -ADMIN /CASE MAN
0
O
0
0
0
1�
NON GENERAL REVENUE TOTAL 227,044 0 227,044 0 227,044
J. P EDEKA1, FUNDS -State
015009
MI DIPASS WAIVER-1 S'112'ft.'L,II'N'1'SIiRViC'I S
015009
MI.'DIPASS WAIVIiR- S013RA
007055
ARRA FEDERAL (;RANT- SCI I13DULF C
015075
SCI 1001, 1il.:AL1'M 1'I'I'L G XXI
013075
SUMMU:R FOOD PROGRAM INSPL'CI'IONS
015075
Refugee I leahh
FEDERAL
FUNDS TOTAL
4. FEES
ASSESSED BY STATE OR FEDERAL RULES - STATE
001020
PANNING 1'AC'll.lTllS
001020
BODY PIERCING
001020
MIGRANT MOUSING PfiRMl'I'
001020
M01311,E ROMP AND PARKS
001020
POOL) HYGIENE PERMIT
001020
13101IAI.ARD 1VAS'I'I: PERMIT
001020
PRIVATI: WATER CONSTR PERMIT
001020
PUBLIC WATER ANNUAL OPER PI?RMIT
001020
P(1i3UC WATER C'ONS'I'R PLAMIT
001020
NON -SI)WA SYS'1'1:iM PtiRM1T
001020
SAFE DRINKING WATER
001020
SWIMMING POOLS
001092
OSDS PERMTI' PEE
001092
1 R M ZONED OPERATING PLiRMIT
001092
AFROI31C OPERATING PERMIT
001092
SI. TIC TANK SITH EVALUATION
001092
NON SDWA LAB SAMPLIi
001092
OSDS VARIANCE ITT
001092
ENVIRONMI:NTAI.IWAL:I'lI1 -T S
001092
OSDS REPAIR PI. RMIT
001170
LAB I'1 13 C1iliMICAI. ANALYSIS
001170
WATER ANALYSIS- POTA131-E
001 170
NONPOTABLi WATI-,'R ANALYSIS
010304
MQA INSPECTION FIE:
001206
CENTRAI.OF'l(T SURCLIARGL?
FEES ASSESSED
BY STATE OR FEDERAL RULES TOTAL
5. OTHER CASH CONTRIBUTIONS - STATE
010304
STATIONARY POLLIl'I'AN'1' S'I'ORA(il:i'I'ANKS
090001
DRAW DOWN FROM PUBLIC I II A1_TI I UNIT
OTHER CASK CONTI2Il3UTIONS TOTAL
6. MEDICAID-STATE/COUNTY
0010%
MEDICAID PLIARMACY
001076
MEDIC'AID'T13
001078
ML:DICAID ADMINISTRATION 01" VACCINE
001079
MEDICAID CASI MANAGI MENT
001081
MEDICAID CfIILD MLAL I'l I Cl IECK UP
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
123.839
0
123,839
0
123,839
200
0
200
0
200
76,000
0
76.000
0
76,000
1,945,568
0
1,945,568
0
1,945,568
1,395
0
1,395
0
1.395
1,265
0
1,265
0
1,265
O
0
0
0
0
21,000
0
21,000
0
21,000
17,521
0
17,521
0
17.521
6.740
0
6,740
0
6,740
0
0
0
0
0
0
0
0
0
0
0
0
{)
0
0
0
0
O
0
0
0
0
0
0
0
41,500
0
41,500
0
41,500
180.292
0
180,292
0
180.292
0
0
0
0
0
0
0
0
0
(1
0
0
0
0
0
0
(
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1,525
0
1,52)
0
1,525
0
0
0
0
0
271,238
U
271,238
0
271,238
68.000
0
68,000
0
68,000
0
0
0
0
0
68.000
0
68,000
0
68,000
0
0
0
0
0
0
0
0
0
0
0
22,944
22,944
0
22,944
0
0
0
0
0
0
11,809
11.809
0
11,809
4J
{) 0
{)
0
0
0 26,757
26,757
0
26,757
0 4,405
4,405
0
4,405
0 91,206
91.206
0
91,206
0 0
0
0
0
0 0
0
0
0
0 0
0
0
0
0 135,169
135,169
0
135,169
0 0
0
0
0
0 5,780
5,780
0
5,780
0 0
0
0
0
0 0
0
0
0
0 0
0
0
0
0 0
0
0
0
0 0
0
0
0
0 17,981
17,981
0
17,981
0 0
0
p
0
0 0
0
0
0
(Y 0
0
0
0
(Y 0
0
0
0
0 316,051
316,051
0
316.051
0 0
0
0
0
0 0
p
0
0
0 0
0
()
0
0 0
0
0
0
0 0
0
70,32.5
70,325
0 0
0
22,834
22,834
0 0
0
0
0
0 0
0
585,795
585,795
0 0
0
0
0
0 0
0
0
0
0 0
0
915,670
915,670
0 0
0
498,388
498,388
0 0
0
0
0
0 0
0
0
0
0 0
0
0
0
0 0
0
2,093,012
2,093,012
0 0
0
0
0
0 0
0
0
0
0 0
0
0
0
0 0
0
0
0
I�
9. DIRECT LOCAL CONTRIBUTIONS - BCC /TAX DISTRICT
008034 13CC CON'TR1BURON PROM Gl "- FUND 0 939 939,000 0 939,000
DIRECT COUNTY CONTRIBUTION TOTAL 0 939,000 939.000 0 939,000
10. FEES AUTHORIZED BV COUNTY ORDINANCE OR RESOLUTION - COUNTY
001060
CHD SUPPORT POSl1'I0N
0
2.600
2,600
0
2.600
001077
RABIFS, VACCINE
0
1,300
1,300
0
1.300
001077
CIiIL.D CAR SEA 'L PROG
0
0
0
0
0
001077
P13R.SONAI. I1 AL'I'lI PF:1 5
0
227,301
227.301
0
227,301
001077
AIDS CO -PAYS
0
0
0
0
0
001094
ADUI:I' I N'IT R. PI :RMI'1' P1'I:S
0
0
0
0
0
001094
LOCAL ORDINANCI P1313S
0
145.999
145.999
0
145,999
001114
N1W131RT1 :Rl'lIIC1l'1S
0
19,000
19.000
0
19,000
001 1 IS
VI'T'AL S'1'AI'IS "fICS - DfiA "Ili CEI�!'ll'ICA'I'E'.
0
51,000
51.000
0
51,000
001 117
VITAL. STA'I:S -ADM. H-1`50 CLiNI'S
0
700
700
0
700
001073
CO -PAY FOR THY' AIDS C'AR1: PROGRAM
0
9,856
9,856
0
9,856
001025
CL.II:N'I' 121:vI NUT? PROM GRC'
0
0
0
0
0
001040
CELT. PHONLi ADMINIS•I'RATIVI? HT
0
0
0
0
FEES AUTHORIZED
BV COUNTY TOTAL
0
457,756
457,756
0
457.756
11. OTIIER CASH AND LOCAL. CONTRIBUTIONS - COUN'T'Y
001009
Rli'1'1JRNI'iD C'1113CK ITLiM
0
0
0
0
0
001029
THIRD PARTY RHMI3LJRSI MI:N 'I'
0
245.138
245,138
0
245,138
001029
1WAL'I'II MAINTf:NANCI ORGAN. (I IMO)
0
0
0
0
0
001054
MI DICARF.. PART I
0
0
0
0
0
001077
RYAN WlilTft'II'I'Ll: 11
0
0
0
0
0
001090
MEDICARE PART 13
0
260.250
260,250
0
260,250
001190
HEALTH MAIN'I'IiNANCI-' OR(iANI %A "I'ION
0
0
0
0
0
005040
IN "Il RE:S'I' hARN1:D
0
0
0
0
0
005041
]N "1'1 :IZI R'I'l-ARNI ?D- S'I'A'l'Ii INVLiS'I'MEN'I'AC000N'I'
0
12,000
12.000
0
12,000
007010
U.S. GRANTS DIRECT
0
695,328
695328
0
695,328
008050
SCHOOL BOARD CONIA1131iT(ON
0
0
0
0
0
008060
SPl?CIAI, PROJECT CONTR113U'IION
0
0
0
0
0
010300
SAl..li OP GOODS AND SLiRVICI'.S'1'0 STATE AG ..:NC'ILiS
0
0
0
0
0
010301
EXP WITNI3SS Fl-T' ('ONSUI; I'NT CI IARGES
0
0
0
0
0
010405
SALL: OP PI1ARMAC[:IITICAI S
0
0
0
0
0
010409
SAID: 01: GOODS OUTS01- S'l'A'1'1-' (;OV1 RNMIiN'1'
0
0
0
0
0
011(1(11
HFAL)liY SI'ARTCOALITION CONTRIBU HONS
0
330.000
330,000
0
330,000
011007
CASH DONATIONS PRIVA'IT'
0
0
0
0
0
012020
PINES AND IY)RPEITURES
0
0
0
0
0
012021
RI: LURN C11GCK C)]AR(ili
0
0
0
0
0
028020
INSURANCIE REC'OVERII S- OI'LIL :R
0
0
0
0
0
090002
DRAW DOWN FROM PUBLIC HIiAL:IIi UNIT
0
0
0
0
0
011000
GRAN'I' DIRIXT -NOVA UNIVERSITY CHI) TRAININO
0
0
0
0
0
011000
GRANT- DlRE'CI'
0
10,000
10.000
0
)0,000
011000
GRAN•I' DIRLC °I'- COUNTY I] AL: H 1)1a'AR'I'MIiN'1' 1)1R1iC 'f SI:RVIC'13S
0
0
0
0
0
011000
D1Rl!z.C'I' -ARROW
0
0
(!
0
0
011000
GRANT )IM CI'
0
0
0
0
0
I�)
11. OTHER CASH AND LOCAL CONTRIBUTIONS - COUNTY
011000 GRANT-DIRECT
0
0
0
0
0
011000 GRANT - DIRECT'
0
0
0
0
0
011000 GRAN'I' DIRICI' -ARROW
0
0
0
0
0
011000 GRANT 1.)IRGCI'- Ql1AN1'1)M DI'MI'AI,
0
0
0
U
0
011000 GRANT' D1R1fiT -I IFAL:I'l l CART: DISTRICT' IIAIIOKEai
0
0
0
0
0
011000 GRANT - DIRECT
0
0
0
0
0
011000 GRANT - DIRT,("'
0
0
0
0
0
011000 GRANT - DIRK " 1'
0
0
0
0
0
011000 GRANT - DIRECT
0
0
0
p
0
010402 RECYCI.IID MATE IZIAI., SAI.E'S
0
0
0
0
0
010303 FIRE" PINGI3RPRINTING
0
0
0
0
0
007050 ARRAFI?DERAI,GRAN'L
0
0
0
0
0
001010 RECOVERY OF HAD Cl IECKS
0
0
0
0
0
008065 FCO CONTRIBUTION
0
0
0
0
0
011006 1z17 au °11'D CASl1 DONATION
0
0
a
0
0
028000 INSURANCI-' RGCOVF'IW,:S
0
0
(1
0
0
001033 CMS MANAGIiMIiN'T F[:I - PMPMPC
0
0
0
0
0
010400 SALE' OF GOODS OUTSIDE STA'TF GOVERNMENT
0
122,657
122,657
0
122,657
010500 RI FUGE IWAI -TI 1
0
0
0
0
0
005045 IN'1'1 1:ARNI- '[)']'BIRD PARTY PROVIDER
0
0
0
0
0
005043 INI'ERI S'I' FA1ZN1 D- CONTRACT/GRAN'T
0
0
0
0
0
010306 DOl I /DOC INTFIZAGENCY AGRI:I -MEN'
0
0
0
0
0
011002 ARRA FFD1:1ZAL GRAN'E - SLJB- REiCIP1I'N''I'
0
0
0
p
0
Of 1004 LOW INCOME P001, - SUI3RECIPII NT
0
0
0
0
0
O'T'HER CASH AND LOCAL CONTRIBUTIONS TOTAL
0
1,675,373
1,675,373
0
1,675.373
12. ALLOCABLEREVENUE- COUNTY
018000 RFRJNDS
0
0
0
0
0
037000 PRIOR YEAR WARRANT
0
0
0
0
0
038000 12 MONTI I OLD WARRANT
0
0
0
0
0
COUNTY ALLOCABLE REVENUE TOTAL
0
0
0
0
0
13. BUILDINGS-COUNTY
ANNl1AI, RIWFAI, 13QUIVAI..]. VALUI
0
0
0
527,454
- 127,454
GROUNDS MAIN'TENANC'E
0
p
0
102A00
102,000
0'1'1 ILA (SPGCIFY)
0
0
0
U
U
INSURANCE:
0
p
U
0
0
U'1'11,11
0
0
U
65,930
65,930
()')'III'R (SPI.i(.
0
p
U
0
0
BUILDING MAIN'TI NANCI-
0
0
0
65,128
65.128
BUILDINGS TOTAL
0
0
0
760.512
760,512
14. OTHER COUNTY CONTRIBUTIONS NOT IN CHD'FRUST FUND - COUNTY
EQUIPMENT/VEI11C'Lk PUR(AIASI S
0
0
0
0
0
VI HICH:INSURANCE
0
0
0
0
0
VIII110JE MAIN ENANCI:
0
0
p
p
0
0'1'I IL'R C'OIJN'I'Y CONTRIBUTION (SPL:CIFY)
0
U
0
0
0
/I
H
14. OTHER COUNTY CONTRIBUTIONS NOT IN 0111) TRUST FUND - COUNTY
0*)') 11'J2 COUNTY CONTRIBUTION (SNL;CII 1'} (} 0 0
OTHEa2 COUNTY CONTRIBUTIONS TOTAL 0 0 0 0
GRAND TOTAL CHD PROGRAM 4,721,256 3,388,180 8,169,436 2,8 10,962,960
A. COMMUNICABLE DISEASE CONTROL:
IMMUNIZATION (101)
6.00
5,000
14,500
135.479
107,890
135,479
107.890
119,348
367,390
486,738
S - 1 . 1)(102)
2.00
260
1,666
32.620
27,255
31,370
27,255
70,508
47.992
118,500
111V /A1DS PRFVI NT TON (03A1)
4.50
250
5,000
67,500
57,500
67,500
57,500
250,000
0
25000
1iIV /A1DS SURVFILL.ANCF (03A2)
0.17
21
31
3,700
3,300
3,700
3,300
8,330
5,670
14,000
111V/AIDS PA H NT CARE (03A3)
17.00
500
5,600
426,000
863,325
903,325
883,325
1.672,260
1,403,715
3,075,975
ADAP (03A4)
120
8
15
19.980
17,020
19.980
17,020
74,000
0
74.000
"1'13 CONTROL SERVI(T's(104)
1,40
225
1.260
37,102
29,605
27,827
29.605
118,639
5,500
124,139
COMM. 1)1S1;AS1: SL1RV. (106)
1.20
0
1,500
28.385
24,180
28.385
24,f80
62.552
42,578
105,130
111- TATITIS PI21 VI:iN'IION (109)
1.00
416
2,050
25,699
44,470
32,199
44.470
140,838
0
146,838
PUBLIC 111 ALT1 f PRIT AND RI SP (116)
3.43
0
1,000
37,500
36,815
48.936
36,815
160,066
0
160,066
VITAL S'fA'I'ISTICS(180)
1.25
2,006
5,i0(t
19,515
15,749
19,515
15,749
0
70,528
70,528
COMMUNICABLE DISEASE SUBTOTAL
39.15
8.686
38,122
833,480
1,227,109
1,318,216
1.247,109
2,682,541
1,943,373
4.625 X114
B. PRIMARY CARE:
CHRONIC DISHASI: SI.RVICI3S (210)
0.17
0
0
8,640
7,360
8,640
7,360
32,000
0
32,000
1013ACCO PREVENTION (212)
1.46
(1
25
29,499
25,129
29,499
25.129
109,256
0
109,256
WIC (21 WI)
5.53
1.887
16,350
92,075
73,350
80,006
73.350
318,781
0
318,781
N +1C 1310 ASTlT -EDING PEER COUNSI:L.1NO (21 W2)
1.78
0
600
20,635
17,866
21,310
17,866
77,677
0
77,677
FAMILY PLANNING (223)
5.13
1,250
14,500
97,400
96,254
128.589
96,254
334,798
83,609
418,497
IMPROVED PRF-GNANCY 00TCON41 (225)
0.00
0
0
(t
0
0
0
0
0
0
I II.:AL I HY START PRI NATAL (227)
3.25
590
8.600
46,831
51,612
59,345
51,612
83,760
125,640
209,400
C'OMPRFIIFNSIVE C1ULD l ILALTT I (229)
0.72
375
2.134
8,900
7,820
8.460
6,820
27.200
4,800
32,000
HIALTHYSTART'INFANT(231)
2.18
340
6,000
34,140
24.288
37,884
24,288
72.360
48,240
120,600
SCI 1001, HE- A1,111 (234)
4.66
0
100,000
52,600
69,274
81,321
69,274
220.104
52,365
272.469
C'OMPRI?HI£NSIVF AINII,T III -AL:T] 1 (23 7)
10.23
1,500
8,700
240,858
342,859
342,859
218.818
286,359
859.075
1,14i,434
COMMl1NITY f1EALITT 1)HVI;1,01)M1:NT (238)
023
0
0
0
0
0
0
0
0
0
DEN 'TAI.III AI.:T11 (240)
0.00
0
0
0
0
0
0
0
0
0
PRIMARY CARE SUBTOTAL
35.34
5,942
156,909
631,578
715,8)2
797.913
590,811
1,562,295
1,173,819
2,736,114
C. ENVIRONMENTAL HEALTH:
Water and Onsite Sewage Programs
COASTAL RIiACII MONITORING (347)
0.35
350
350
7,875
6,708
7,875
6,708
29.166
0
29,166
LIMITED USI: PUBLIC WAT L.'R SYSIT?MS (357)
0.00
0
0
0
0
0
0
0
0
0
P(113LIC WATER SYSTEM (358)
0.00
0
0
0
0
0
0
0
0
0
PRIVAIT" WATT ?R 3YSTFM (359)
0.00
0
0
0
0
0
0
0
0
0
INDIVIDUAL SI WAGI? ASP. (36 1)
6.44
3,927
10,579
109,485
93,265
109,485
91265
241,273
164,227
405,500
Group Total
6.79
4,277
10.929
117.360
99,973
117,360
99,973
270,439
164,227
434,666
Facility Programs
FOOD IIYGIL-'N6 (348)
0.52
45
206
4,285
3,125
5,685
3.625
9,948
6,772
16,720
BODY PIFRCING FACILITIES SFRVICFS
0.05
7
7
0
0
0
0
0
0
0
OROM) CARE FACILITY (351)
0.06
35
55
459
1,047
1,326
1.047
2,308
1,571
3,879
MIGRANT LABOR CAMP (352)
0.00
0
0
0
0
0
0
0
0
0
I100SiN(i.Pl BLIC 131.DG SAFFTY.SANITATTON (353)0.09
0
4
0
100
0
100
119
81
200
NO
['at t Ill, Planned St ng,:Cl►ents,'Servtces,
C. ENVIRONMENTAL HEALTH:
:Working
MONROE
F7 P's
0 00
( )
.opyxng
COUNTY
And
_.
OcfoUer
,,.Cticnts
.. 'Units
ATTACHMEN'
HEALTI:1?EPARTMENT
Expenditures
J, 2 to
Scrvtcesl
V�stts
By hr.,ogram
September
Quarterly
1st
II
Service
30, 201
ExpendltoreAL»n
end,.
(Hholc;dollarsoijtY)
Aree
3rd
Within Each;)i,wel
ath
pl:
Statc
ervtce •°
` County
Grand
'Cot n1
Facility Programs
MOBILE 'l TOME AND PARKS SERVICES (354)
0.59
115
250
6,650
3,968
2,662
3,968
10,263
6,985
17,248
SWIMMING P00 LS /13AT I IING (.160)
1.27
562
1,325
13,800
19.053
18,661
19,053
41,987
28,580
70,567
1310MIMIC'AL WASTE' SF.RVICLiS (364)
0.49
153
155
6,960
1.775
1.990
1,775
7,438
5,062
12,500
'PANNING FACILITY SERVICES (369)
0.01
5
10
0
0
0
0
0
0
0
Group Total
3.08
922
2,012
32.154
29,068
30.324
29,568
72,063
49,051
121,)14
Groundwater Contamination
STORAGE TANK COMI'L.IANCE (355)
1.06
210
400
24,631
20.369
24.631
20,369
90.000
0
90,000
SUM"R ACPSFRVICI -{ (356)
0A1
0
2
174
148
174
148
644
0
644
Group Total
1.07
210
402
24,805
20,517
24,805
20,517
90,644
0
90,644
Community Hygiene
TATTOO PACLN'IES SI RVICI:S
0.03
0
20
0
0
0
0
0
0
0
COMMUNITY 1 NV1R. IIFIALTI1 (345)
0.00
Q
3
0
0
0
0
0
0
0
INJURY PREVENTION (3461
0.00
0
0
0
0
0
0
0
0
0
LVAD MONITORING SI :RVICES (350)
0.01
I
1
0
0
0
0
0
0
0
PUBLIC SFWAGI.- (362)
0.00
1
1
0
0
0
0
0
0
0
SOLID WAS'111 DISPOSAL (363)
0.00
0
0
0
0
0
0
0
0
0
SANITARY NUISANCE (365)
023
80
200
3,093
2,635
3,093
2,635
6,816
4,640
1 1,456
RABIES SURVI:11,1_ANC 1 I - -/CON - I - ROI. SIiRVICI-S (3(1(1)0.02
3
15
450
383
450
383
991
675
1.666
AR130VIRUS SURVI ILLANCLi (367)
0.00
0
0
0
0
0
0
0
0
0
RODL:N UARTT IROPOD CONI•ROL (368)
0.02
0
0
0
0
0
0
0
0
0
WATER 1 LUI - ION (370)
0.00
0
0
0
0
0
0
0
0
0
INDOOR AIR (37 1)
0.00
0
0
458
392
458
392
980
720
1,700
RADIOLOGICAL, I ]EIAL'1'I I (372)
0.02
O
1
208
178
208
178
445
327
772
TOXIC SUBSTANCI :S (373)
0.98
1,400
1,400
13,864
11,810
13,864
11,810
0
51,348
51,348
Group Total
1.31
1.485
1,641
18,073
15,398
18,073
15,398
9,232
57.710
66,942
ENVIRONMENTAL HEALTH SUBTOTAL
12.25
6.894
14,984
192,392
164,956
190.562
165,456
442,378
270,988
713.366
U. NON OPERATIONALCOSTS:
NON - OPERATIONAL COST'S (599)
0.20
0
0
6,542
0
0
0
6,542
0
6,542
ENVIRONMENTAL. IIFALTII SURC'I IARG11 (399)
0.00
0
0
6,875
6,875
6,875
6,875
27.500
0
27,500
NON - OPERATIONAL COSTS SUBTOTAL
0.20
0
0
13.417
6.875
6,875
6,875
34,042
0
34,042
TOTAL CONTRACT
86.94
21,522
210.015
1,670.867
2,114,752 2,313,566
2,010,251 4,721,256
3,388,180
8,109,436
II
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.
3. 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 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
Description
Gato Building
Administration
Nursing
Environmental Health
Health Care Center
Location
1100 Simonton Street
Key West, FL 33040
3134 Northside Drive
Building B
Key West, FL 33040
Murray E. Nelson Government Center 102050 Overseas Highway
Environmental Health Key Largo, FL 33037
Roosevelt Sands Center
105 Olivia Street
Key West, FL 33040
Ruth Ivins Center
Roth Building
3333 Overseas Highway
Marathon, FL 33050
50 High Point Road
Tavernier, FL 33070
Owned By
Monroe County
MW &JC, LLC and
Leased to
Monroe County
For MCHD use
Monroe County
City of Key West
subject to Inter -local
Agreement with Monroe
County for MCHD use
Monroe County
Monroe County
a 'IJ
ATTACHMENT V
MONROE COUNTY HEALTH DEPARTMENT
SPECIAL PROJECTS SAVINGS PLAN
IDENTIFY THE AMOUNT OF CASH THAT IS ANTICIPATED TO BE SET ASIDE ANNUALLY FOR THE PROJECT.
CONTRACT YEAR STATE COUNTY TOTAL
2007 -2008 $ $ $
2008 -2009 $ $ $ _
2009 -2010 $ $ $ _
2010 -2011 $ $ $
2011 -2012 $ $ $ _
PROJECT TOTAL $ N/A $ N/A $ N/A
SPECIAL PROJECT CONSTRUCTION /RENOVATION PLAN
PROJECT NAME:
LOCATION/ ADDRESS:
PROJECT TYPE:
NEW BUILDING
ROOFING
_
RENOVATION
_
PLANNING STUDY
NEW ADDITION
OTHER
SQUARE FOOTAGE:
PROJECT SUMMARY: Describe scope of work in reasonable detail.
ESTIMATED PROJECT INFORMATION:
START DATE (initial expenditure of funds) :
COMPLETION DATE:
DESIGN FEES:
$
CONSTRUCTION COSTS:
$
FURNITURE /EQUIPMENT
$
TOTAL PROJECT COST:
$ _
COST PER SQ FOOT: $
Special Capital Projects are new construction or renovation projects and new furniture or equipment
associated with these projects and mobile health vans.
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 nb 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 3 I 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 reirnbursement 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
10/11/2012
as
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 10/11/2012
'�I'v
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 10/11/2012
a'1
Monroe County Iealth Department — Fee Schedule, Environmental Health
County Fee List (In addition to State Fees on alternate Fee Schedule)
• — w w i- ra,Nat,c3 y9.uv per space 5s.bu per space
Annual permit for 150 and above spaces 400
DESCRIPTION
ONSITE SEWAGE DIPOSAL PROGRAM (OSTDS)
County Fee
Application and plan review for construction permit for new systems
100
Application and approval for existing system, if system inspection not required.
10
Application and Exisiting System Evaluation with inspection
50
Application for permitting of an new Performance -based treatment system
75
Site Evaluation
0
Site re- evaluation
40
Permit or permit amendment for new systems
25
Initial system inspection
50
System re inspection (stab Ilization, non-compliance, or other inspection after initial
inspection.
25
Research fee (State Fee)
0
Repair Permit with Inspection
50
Application for system abandonment permit
45
Tank manufacturer's inspection per annum
20
Amendment to an Operating Permit
0
Septage Disposal Service Permit per annum 2X per yr inspection
45
Portable or temporary toilet service permit per annum
45
Additional charge per pump out vechicle
5
Annual operating permit industrial /manufacturing zoning or commercial sewage
waste
0
Biennial Operating permit for aerobic treatment unit or performance -based
treatment system
0
Aerobic treatment unit maintenance entity permit per annum
0
Variance application for a single family residence per each lot or building site
100
Variance application for a multifamily or commercial building site
140
Inspection for construction of an Injection well (FL Keys)
95
OSTDS Operating Permit Late Fee (45 days past due)
50
Per request - Expediting -Fast Track Permitting New & Exisitng (48 hour turn-
around) Charged in addition to state fee
500
Letter of Coordination for development review committees
250
Expedited OSTDS Variance Processing. Received within 6 days of monthly
deadline. Charged in addition to state fee
500
OSTDS PBTS screening test fee
25
PUBLIC SWIMMING POOLS
Annual permit- up to and including 25,000 gallons
115
Annual permit - more than 25,000 gallons
100
Non routine inspection(no charge for first inspection
100
Exempted condominiums /Cooperatives with over 32 units
25
MOBILE HOME & RECREATIONAL VEHICLE YARI(S
Annual permit for 5 to 25 spaces
Ann, Imi — — —
125
• — w w i- ra,Nat,c3 y9.uv per space 5s.bu per space
Annual permit for 150 and above spaces 400
FOOD ESTABLISHMENTS
Annual Permit for Fraternal /Civic
35
Annual Permit School Cafeteria Operating for 9 months or less
105
Annual Permit School Cafeteria Operating for more than 9 months
125
Annual Permit for Movie Theaters
0
Annual Permit for Jails /Prisons
0
Annual Permit for Bars /Lounges
35
Annual Permit for Residential Faciliites
65
Annual Permit for Limited Food Service
115
Child care center
40
Caterer
45
Mobile Food Units
45
ther Food Service
35
ending machine dispensing potentially hazardous food
[are
0
lan review per hour public schools, colleges, and vocational teaching facilities
exempt from this fee
20
Food establishment worker training course per person
0
Alcoholic beverage inspection approval
15
Request for inspection
10
Re- inspection (for each reinspection after the first)
0
Temporary event food service establishment (a)sponser w/o existing
sanitation certificate
100
b) vendor or booth at an establishment or location w/o an existing sanitation
certificate
50
Late renewals
15
BIOMEDICAL
Exempt Facilities
50
Generators
40
Storage Facilities
40
Late Fee
20
TANNING FACILITIES
Annual Permit
100
r Device
0
F Fee
tation
50
newal Fee
0
BODY PIERCING ESTABLISHMENTS
Fee
100
orary Establishment
15
P License
Late fee
0
ultation
50
HEALTHY HOMES PROGRAM
Healthy home Assessment Voluntary Inspection living unit (radon, CO2,
Mold,Safety}
300
Public Education -Per Attendee
25
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