Item N1BOARD OF COUNTY COMMISSIONERS
County of Monroe A
Mayor Heather Carruthers, District 3
( T$ne Florida Keys (, Mayor Pro Tem George Neugent, District 2
t� ) ��` ��
�' Danny L. Kolhage, District 1
David Rice, District 4
Sylvia J. Murphy, District 5
County Commission Meeting
July 20, 2016
Agenda Item Number: N.1
Agenda Item Summary #1828
BULK ITEM: Yes DEPARTMENT: County Administrator
TIME APPROXIMATE: STAFF CONTACT: Lindsey Ballard (305) 292-4443
N/A
AGENDA ITEM WORDING: Approval of First Amendment to the core contract for FY 16 with
Florida Department of Health.
ITEM BACKGROUND: Amendment to planned expenditures, revenue and special project for
County funding of local health department. This Amendment reduces the County's contribution to
the overall County Health Department budget in FY 16 by $288K, and increases the amount of
County's contribution to a "special projects savings plan" by $300K, to pay for design, construction
costs, and furniture/equipment at a new Key West location for the Health Department at the band
room at the Douglass School. (The City of Key West intends to renovate the existing location for
the Roosevelt Sands Center clinic at the gymnasium and has offered the band room location as an
alternative.)
The new location will require a new lease between the County and the City. The lease will be
presented to the County Board of County Commissioners once negotiated, in a subsequent meeting.
PREVIOUS RELEVANT BOCC ACTION:
This is an amendment to an agreement between Monroe County and Florida Department of Health
("core contract") that has continued for 20+ years. On October 21, 2015, the Board of County
Commissioners approved the contract between the parties for FY 16.
CONTRACT/AGREEMENT CHANGES:
As specified in paragraph 3, the CHD shall provide services as set forth on Part III of Attachment II.
Please find the following: Revised Attachment II, Parts II and III, incorporating the changes
indicated in the summary and covering the period subsequent to the contract amendment. A Revised
contract Attachment II, Part I, and attachment V updating planned special projects. There is no
change to the dollar value of this contract.
STAFF RECOMMENDATION: Approval
DOCUMENTATION:
First Amendment, attachment to agenda item
FINANCIAL IMPACT:
Effective Date: October 1, 2015
Expiration Date: September 30, 2016
Total Dollar Value of Contract: $3,763,586.00 (increase of $11,301.00)
Total Cost to County: $3,763,586.00
Current Year Portion: $3,763,586.00
Budgeted:
Source of Funds:
CPI: N/A
Indirect Costs: N/A
Estimated Ongoing Costs Not Included in above dollar amounts: N/A
Revenue Producing: No If yes, amount:
Grant: N/A
County Match: N/A
Insurance Required: N/A
Additional Details: County portion for FY 16 decreases by $288K in other areas and increases by
$300K in Special Projects Savings Plan, to pay for design/construction/furniture/equipment of new
Band Room at Douglass School.
REVIEWED BY:
Christine Limbert
Skipped
07/01/2016 11:04 AM
Cynthia Hall
Completed
07/01/2016 2:18 PM
Budget and Finance
Completed
07/05/2016 8:42 AM
Maria Slavik
Completed
07/05/2016 9:45 AM
Kathy Peters
Completed
07/05/2016 11:11 AM
Board of County Commissioners
Pending
07/20/2016 9:00 AM
FIRST AMENDMENT TO
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 2015-2016
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 this r day of July 2016.
RECITALS
WHEREAS, the parties entered into the Agreement intended to serve as a core contract
between the parties on October 1, 2015; and
WHEREAS, Attachment II, Part I to the Agreement sets forth the planned use of funds
by the State and the County Health Department (CHD) in delivering various services; and
WHEREAS, Attachment II, Parts II and III to the Agreement sets forth the fees that may
be charged by the State and the County Health Department (CHD) in delivering various
services, planned expenditures and revenue; and
WHEREAS, Attachment V to the Agreement sets forth the special projects saving plan
by the State and the County Health Department (CHD); and
WHEREAS, the State and the CHD desire to amend the planned expenditures and
revenue; and
WHEREAS, the County is in agreement with the request for this amendment;
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. Attachment II, Parts I, II & III and Attachment V to the Agreement are removed and
replaced entirety with Exhibit A to this First Amendment, which shall henceforth constitute
the new Attachment II, Parts I, II & Ill and Attachment V to the Agreement.
2. In all other respects the Agreement between the parties remains the same.
In WITNESS THEREOF, the parties hereto have caused this page agreement to
be executed by their undersigned officials as duly authorized effective the day of July
2016.
BOARD OF COUNTY COMMISSIONERS
FOR MONROE COUNTY
SIGNED BY:
NAME:
TITLE:
DATE:
ATTESTED TO:
SIGNED BY:
NAME:
TITLE:
DATE:
STATE OF FLORIDA
DEPARTMENT OF HEALTH
SIGNED BY:
NAME: Celeste Philip, MD, MPH
TITLE: Surgeon General/Secretary of Health
DATE:
SIGNED BY:
NAME: Robert B. Eadie, J.D.
TITLE: CHD Director/Administrator
DATE:
fL 4u8WPu8WV Hoa: 88L) s' eusft o4 4u9wq3e44e'4u9wPu9wva' :us uoe
Rick Scott
Mission' Governor
To protecL promote & improve the hearth
of all people in Florida through integrated
state, county & community efforts_ � Celeste Philip, MO, MPH
HEALTHSurgeon General and Secretary
Vision: To be the Healthiest state Za the Nation
June 28„ 2016
Mr. Roman Gastesi, County Administrator
Monroe County Board of County Commissioners
1100 Simonton Street
Key West, FL 33040
RE: FY 2015-2016 Contract between the Monroe County Board of County Commissioners and the
Florida Department of Health for operation of the Monroe County Health Department
Dear Mr. Gastesi:
As specified in paragraph 3, the CHD shall provide services as set forth on Part III of Attachment II.
Please find the following,
• Revised Attachment II, Parts li and III, incorporating the changes indicated in the summary
and covering the period subsequent to the contract amendment
• A revised Attachment II, Part 1, and Attachment V updating planned special projects
Please note, there is no change to the level of funding allocated per the Monroe County BOCC budget
process, merely an update of information regarding anticipated resources and their use for the contract
year.
If you have any questions, please feel free to contact Raymond Sanders at 305-809-5651.
Sincerely,
Enclosures
Cc: Beth Benton, Office of Budget and Revenue Management
Florida Department of Health
Division of XXXi r,
Accredited Health Department
4052Bald Cypress
r� Public�, Health Accreditation Board
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N CY) 1 IT
1. GENERAL REVENUE - STATE
COMMUNITY PRIMARY CARE SERVICES - AHCA
015040 AIDS PATIENT CARE
015040 AIDS PREVENTION & SURVEILLANCE - GENERAL REVENUE
015040 AIDS NETWORK REIMBURSEMENT
015040 CHD - TB COMMUNITY PROGRAM
tvote:
Amends SEXUALLY TRANSMITTED DISEASE CONTROL PROGRAM GR
015040 ALG/CESSPOOL IDENTIFICATION & ELIMINATION PROG
015040 FAMILY PLANNING GENERAL REVENUE
015040 HEPATITIS AND LIVER FAILURE PREVENTION & CONTROL
015040 PRIMARY CARE PROGRAM
015040
015050 CHD GENERAL REVENUE NON -CATEGORICAL
GENERAL REVENUE TOTAL
2. NON GENERAL REVENUE - STATE
015010 ENVIRONMENTAL BIOMEDICAL WASTE PROGRAM
015010 TOBACCO STATE AND COMMUNITY INTERVENTIONS
NON GENERAL REVENUE TOTAL
3. FEDERAL FUNDS - STATE
007000 AIDS DRUG ASSISTANCE PROGRAM ADMIN
007000 AIDS DRUG ASSISTANCE PROGRAM ADMIN HQ
007000 AIDS SURVEILLANCE - CORE
007000 WIC BREASTFEEDING PEER COUNSELING PROG
007000 COASTAL BEACH WATER QUALITY MONITORING
007000 COMPREHENSIVE COMMUNITY CARDIO - PHBG
007000 CMS-MCH PURCHASED CLIENT SERVICES 2014-2015
007000 FAMILY PLANNING TITLE X - GRANT
007000 HOUSING OPPORTUNITIES FOR PERSONS WITH AIDS
007000 IMMUNIZATION ACTION PLAN
007000 MCH SPECIAL PRJCT UNPLANNED PREGNANCY
007000 MCH SPECIAL PROJECT PRAMS
007000 HPP AND PHEP COOP AGRMT PHEP EBOLA SUPPLEMENT 42
007000 PHP PUBLIC HEALTH PREPAREDNESS BASE ALLOC
007000 AIDS PREVENTION
007000 RYAN WHITE TITLE II CARE GRANT
007000 RYAN WHITE TITLE II GRANT/CHD CONSORTIUM
007000 WIC PROGRAM ADMINISTRATION
015075 INSPECTIONS OF SUMMER FEEDING PROGRAM - DOE
015075 SUPPLEMENTAL SCHOOL HEALTH
015075 REFUGEE HEALTH SCREENING REIMBURSEMENT
FEDERAL FUNDS TOTAL
24,255
0
24,255
0
24,
370,000
0
370,000
0
370,
73,552
0
73,552
0
73,
259,200
0
259,200
0
259,
15,784
0
15,784
0
15,
16,755
0
16,755
0
16,
53,768
0
53,768
0
53,
32,678
0
32,678
0
32,
72,000
0
72,000
0
72,
0
199,742
0
199,742
0
199,
96,224
0
96,224
0
96,
co
N
985,029
0
985,029
0
985,
00
Z
2,198,987
0
2,198,987
0
2,198,
3,719
0
3,719
0
3,
118,154
0
118,154
0
118,
121,873
0
121,873
0
121,
0
27,888
0
27,888
0
27,
9,261
0
9,261
0
9,
5,808
0
5,808
0
5,
43,799
0
43,799
0
43,
18,439
0
18,439
0
18,
r-
35,000
0
35,000
0
35,
E
8,000
0
8,000
0
8,
L
60,775
0
60,775
0
60,
-
LL
414,184
0
414,184
0
414,
15,649
0
15,649
0
15,
16,405
0
16,405
0
16,
4,487
0
4,487
0
4,
69,692
0
69,692
0
69,
118,412
0
118,412
0
118,
126,490
0
126,490
0
126,
81,550
0
81,550
0
81,
516,464
0
516,464
0
516,
292,300
0
292,300
0
292,
1,587
0
1,587
0
1,
123,839
0
123,839
0
123,
175,509
0
175,509
0
175,
2,165,538
0
2,165,538
0
2,165,
Attac Packet Pg. 1601
4. FEES ASSESSED BY STATE OR FEDERAL RULES - STATE
001020 CHD STATEWIDE ENVIRONMENTAL FEES
001092 CHD STATEWIDE ENVIRONMENTAL FEES
001206 ON SITE SEWAGE DISPOSAL PERMIT FEES
001206 SANITATION CERTIFICATES (FOOD INSPECTION)
001206 SEPTIC TANK RESEARCH SURCHARGE
001206 SEPTIC TANK VARIANCE FEES 50%
001206 PUBLIC SWIMMING POOL PERMIT FEES-10% HQ TRANSFER
001206 REGULATION OF BODY PIERCING SALONS
001206 TANNING FACILITIES
001206 TATTO PROGRAM ENVIRONMENTAL HEALTH
001206 MOBILE HOME & RV PARK FEES
FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL
5. OTHER CASH CONTRIBUTIONS - STATE:
090001 DRAW DOWN FROM PUBLIC HEALTH UNIT
OTHER CASH CONTRIBUTION TOTAL
6. MEDICAID - STATEICOUNTY:
001057 CHD CLINIC FEES
001147 CHD CLINIC FEES
001148 CHD CLINIC FEES
MEDICAID TOTAL
7. ALLOCABLE REVENUE - STATE:
018000 CHD CLINIC FEES
018000 CHD LOCAL REVENUE & EXPENDITURES
018000 RYAN WHITE TITLE II CARE GRANT
018000 RYAN WHITE TITLE III -DIRECT TO CHD
037000 RYAN WHITE TITLE III - DIRECT TO CHD
ALLOCABLE REVENUE TOTAL
8. OTHER STATE CONTRIBUTIONS NOT IN CHD TRUST FUND - STATE
ADAP
PHARMACY DRUG PROGRAM
WIC PROGRAM
BUREAU OF PUBLIC HEALTH LABORATORIES
IMMUNIZATIONS
OTHER STATE CONTRIIBUTIONS TOTAL
9. DIRECT LOCAL CONTRIIBUTIONS -1BCCITAX DISTRICT
008005 CHD LOCAL REVENUE & EXPENDITURES
008005 IMMUNIZATION CAMPAIGN MONROE COUNTY BOCC
DIRECT COUNTY CONTRIBUTIONS TOTAL
89,731
0
89,731
0 89,
257,775
0
257,775
0 257,
14,774
0
14,774
0 14,
1,680
0
1,680
0 1,
530
0
530
0
150
0
150
0
5,000
0
5,000
0 5, r-
0
30
0
30
0
92
0
92
0
626
0
626
0
1,710
0
1,710
c o
0 1, co
N
372,098
0
372,098
0 372, 00
r
0
0
0
0
29,021
0
29,021
0 29, r-
0
29,021
0
29,021
0 29, tm
0
0
0
323
323
0
0
3
3
0
0
37,141
37,141
0 37,
0
37,467
37,467
0 37, r_
0
r_
0
44
0
44
0
250
0
250
0
L
21
0
21
0 —
104
0
104
0
350
0
350
0
769
0
769
0
0
0
0
620,603 620,
0
0
0
69,071 69,
0
0
0
1,007,122 1,007,
0
0
0
11,062 11,
0
0
0
677,463 677,
0
0
0
2,385,321 2,385,
0
967,618
967,618
0 967,
0
146,889
146,889
0 146,__
0
1,114, 507
1,114, 507
0 1,114, 507
Attac Packet Pg. 1602
10. FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION - COUNTY
001025 CHD CLINIC FEES
001073 CHD CLINIC FEES
001077 CHD CLINIC FEES
001094 CHD LOCAL ENVIRONMENTAL FEES
001110 VITAL STATISTICS CERTIFIED RECORDS
FEES AUTHORIZED BY COUNTY TOTAL
11. OTHER CASH AND LOCAL CONTRIIBUTIONS - COUNTY
001029 CHD CLINIC FEES
001090 CHD CLINIC FEES
005000 CHD LOCAL REVENUE & EXPENDITURES
007010 RYAN WHITE TITLE III DIRECT TO CHD
007010 RYAN WHITE TITLE III DIRECT TO CHD
010300 CHD LOCAL ENVIRONMENTAL FEES
010300 CHD SALE OF SERVICES IN OR OUTSIDE OF STATE GOVT
010400 CHD SALE OF SERVICES IN OR OUTSIDE OF STATE GOVT
010500 CHD SALE OF SERVICES IN OR OUTSIDE OF STATE GOVT
011000 MULTIGENERATIONAL COMMUNITY PARK GRANT - HFSF
011000 SMOKE FREE HOUSING GRANT
011000 CHD LOCAL REVENUE & EXPENDITURES
011001 CHD HEALTHY START COALITION CONTRACT
012020 CHD LOCAL REVENUE & EXPENDITURES
090002 DRAW DOWN FROM PUBLIC HEALTH UNIT
OTHER CASH AND LOCAL CONTRIIBUTIONS TOTAL
12. ALLOCABLE REVENUE - COUNTY
018000 CHD CLINIC FEES
018000 CHD LOCAL REVENUE & EXPENDITURES
018000 RYAN WHITE TITLE II CARE GRANT
018000 RYAN WHITE TITLE III -DIRECT TO CHD
037000 RYAN WHITE TITLE III - DIRECT TO CHD
COUNTY ALLOCABLE REVENUE TOTAL
13. ]BUILDINGS - COUNTY
ANNUAL RENTAL EQUIVALENT VALUE
OTHER (Specify)
UTILITIES
BUILDING MAINTENANCE
GROUNDS MAINTENANCE
INSURANCE
OTHER (Specify)
OTHER (Specify)
]BUILDINGS TOTAL
0 881
881 0
0 35,395
35,395 0
0 91,249
91,249 0
0 260,307
260,307 0
0 79,172
79,172 0
0 467,004
467,004 0
0 200,043
200,043 0
0 105,467
105,467 0
0 9,645
9,645 0
0 108,000
108,000 0
0 480,784
480,784 0
0 179
179 0
0 72,375
72,375 0
0 2,200
2,200 0
0 47,328
47,328 0
0 14,625
14,625 0
0 24,425
24,425 0
0 5
5 0
0 280,237
280,237 0
0 15
15 0
0 498,512
498,512 0
0 1,843,840
1,843,840 0
0 44
44 0
0 250
250 0
0 21
21 0
0 104
104 0
0 350
350 0
0 769
769 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
35,
91,
r
260,
79, E
467, r_
0
200,
105,
9 co
CV
co
108, T--
480, p
72,
2,
47,
14,
24,
280,
498,
1,843,
597,605 597,
0
83,369 83,
75,223 75,
115,566 115,
0
0
0
871,763 871,763
Attac Packet Pg. 1603
14. OTHER COUNTY CONTRIBUTIONS NOT IN CHD TRUST FUND - COUNTY
EQUIPMENT / VEHICLE PURCHASES
VEHICLE INSURANCE
VEHICLE MAINTENANCE
OTHER COUNTY CONTRIBUTION (SPECIFY)
OTHER COUNTY CONTRIBUTION (SPECIFY)
OTHER COUNTY CONTRIBUTIONS TOTAL
GRAND TOTAL CHD PROGRAM
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4,888,286
3,463,587
8,351,873
3,257,084
Attac Packet Pg. 1604
A. COMMUNICABLE DISIEASIE CONTROL:
IMMUNIZATION (101)
SEXUALLY TRANS. DIS. (102)
HIV/AIDS PREVENTION (03A1)
HIV/AIDS SURVEILLANCE (03A2)
HIV/AIDS PATIENT CARE (03A3)
ADAP (03A4)
TUBERCULOSIS (104)
COMM. DIS. SURV. (106)
HEPATITIS (109)
PREPAREDNESS AND RESPONSE (116)
REFUGEE HEALTH (118)
VITAL RECORDS (180)
COMMUNICABLIE DISEASEE SUBTOTAL
B. PRIMARY CARTE:
CHRONIC DISEASE PREVENTION PRO (210)
WIC (21W1)
TOBACCO USE INTERVENTION (212)
WIC BREASTFEEDING PEER COUNSELING (21W2)
FAMILY PLANNING (223)
IMPROVED PREGNANCY OUTCOME (225)
HEALTHY START PRENATAL (227)
COMPREHENSIVE CHILD HEALTH (229)
HEALTHY START CHILD (231)
SCHOOL HEALTH (234)
COMPREHENSIVE ADULT HEALTH (237)
COMMUNITY HEALTH DEVELOPMENT (238)
DENTAL HEALTH (240)
PRIMARY CARE SUBTOTAL
C. ]ENVIRONMENTAL HEALTH:
Water and Onsite Sewage Programs
COSTAL BEACH MONITORING (347)
LIMITED USE PUBLIC WATER SYSTEMS (357)
PUBLIC WATER SYSTEM (358)
PRIVATE WATER SYSTEM (359)
ONSITE SEWAGE TREATMENT & DISPOSAL (361)
Group Total
Facility Programs
TATTOO FACILITY SERVICES (344)
9.67
1.83
4.22
Amends
previously
16.35
1.37
1.07
0.89
1.56
3.38
2.04
1.07
43.49
5,736
285
378
22
483
175
20
0
0
440
1,558
9,333
8,378 204,662 238,713 204,662 238,714 15,658 871,093 886,
481 29,977 34,964 29,977 34,964 16,757 113,125 129,
655 75,668 88,258 75,668 88,259 327,646 207 327,
30 1,678 1,957 1,678 1,958 7,269 2 7,: r-
4,375 626,727 731,000 626,727 731,001 2,039,106 676,349 2,715,
®P
500 20,897 24,374 20,897 24,373 90,474 67 90,
110 20,632 24,065 20,632 24,066 15,785 73,610 89,
580 17,960 20,948 17,960 20,947 0 77,815 77,1
344 29,745 34,694 29,745 34,693 128,801 76 128,
6,239 72,765 84,872 72,765 84,872 188,104 127,170 31k
936 59,976 69,954 59,976 69,954 259,760 100 259, 00
ill
00
4,748 17,076 19,918 17,076 19,918 0 73,988 73,'
27,376 1,177,763 1,373,717 1,177,763 1,373,719 3,089,360 2,013,602 5,102,'
0.02
0
0
1,750
2,041
1,750
2,041
4,835
2,747
7,
5.55
4,691
19,291
93,163
108,663
93,163
108,662
403,651
0
403,E
2.46
0
367
47,228
55,086
47,228
55,087
154,154
50,475
204,1
0.48
0
633
13,140
15,326
13,140
15,327
56,933
0
56,'
3.66
1,065
2,026
95,907
111,864
95,907
111,863
247,772
167,769
415,'
0.00
0
0
0
0
0
0
0
0
3.40
825
5,211
50,501
58,903
50,501
58,902
0
218,807
218,
0.00
0
1
20
23
20
24
0
87
2.94
840
4,219
40,702
47,474
40,702
47,475
0
176,353
176,
6.13
0
175,820
79,136
92,302
79,136
92,302
342,876
0
342,
3.97
378
1,337
88,865
103,651
88,865
103,651
224,001
161,031
385,,
1.05
0
985
26,398
30,790
26,398
30,790
41,323
73,053
114,
0.00
0
0
0
0
0
0
0
0
29.66
7,799
209,890
536,810
626,123
536,810
626,124
1,475,545
850,322
2,325, ,
0.39
394
396
7,603
8,867
7,603
8,867
18,439
14,501
32,'.
0.00
0
0
0
0
0
0
0
0
0.00
0
0
50
59
50
59
0
218
0.00
0
0
0
0
0
0
0
0
4.71
1,951
7,465
67,892
79,188
67,892
79,189
184,013
110,148
294,
5.10
2,345
7,861
75,545
88,114
75,545
88,115
202,452
124,867
327,
0.13
0
36
1,944
2,268
1,944
2,269
4,508
3,917
8,
FOOD HYGIENE (348)
BODY PIERCING FACILITIES SERVICES (349)
GROUP CARE FACILITY (351)
MIGRANT LABOR CAMP (352)
HOUSING & PUB. BLDG. (353)
MOBILE HOME AND PARK (354)
POOLS/BATHING PLACES (360)
BIOMEDICAL WASTE SERVICES (364)
TANNING FACILITY SERVICES (369)
Group Total
Groundwater Contamination
STORAGE TANK COMPLIANCE SERVICES (355)
SUPER ACT SERVICES (356)
Group Total
Community Hygiene
COMMUNITY ENVIR. HEALTH (345)
INJURY PREVENTION (346)
LEAD MONITORING SERVICES (350)
PUBLIC SEWAGE (362)
SOLID WASTE DISPOSAL SERVICE (363)
SANITARY NUISANCE (365)
RABIES SURVEILLANCE (366)
ARBORVIRUS SURVEIL. (367)
RODENT/ARTHROPOD CONTROL (368)
WATER POLLUTION (370)
INDOOR AIR (371)
RADIOLOGICAL HEALTH (372)
TOXIC SUBSTANCES (373)
Group Total
IENVIRONNI1ENTAL HEALTH SUBTOTAL
D. NON -OPERATIONAL COSTS:
NON -OPERATIONAL COSTS (599)
ENVIRONMENTAL HEALTH SURCHARGE (399)
MEDICAID BUYBACK (611)
NON-OPEERATIONAL COSTS SUBTOTAL
TOTAL CONTRACT
0.57
51
268
8,890
10,369
8,890
10,368
21,560
16,957
38,
0.02
6
7
268
313
268
314
746
417
1,
0.08
15
24
1,192
1,391
1,192
1,391
0
5,166
5,
0.00
0
0
0
0
0
0
0
0
0.00
0
0
0
0
0
0
0
0
0.55
140
343
7,925
9,244
7,925
9,244
18,673
15,665
r
34,
®P
2.60
894
2,075
34,812
40,604
34,812
40,605
36,573
114,260
150,
0.48
269
292
6,954
8,110
6,954
8,110
13,188
16,940
30,
0.00
0
0
109
127
109
128
378
95
E
4.43
1,375
3,045
62,094
72,426
62,094
72,429
95,626
173,417
269,1
1.58
221
458
27,422
31,984
27,422
31,985
0
118,813
118, 00
ill
00
0.00
0
0
0
0
0
0
0
0
1.58
221
458
27,422
31,984
27,422
31,985
0
118,813
118, E
1.41 0 517 24,847 28,981 24,847 28,980 0 107,655 107,E
0.00 0 0 0 0 0 0 0 0
0
0.00
0
0
0
0
0
0
0
0
0.00
0
0
0
0
0
0
0
0
E
0.00
0
0
0
0
0
0
0
0
t4f
0.16
34
101
2,502
2,919
2,502
2,919
0
10,842
10,1
ate'+
0.04
1
13
654
763
654
764
0
2,835
2,1
+'
0.00
0
0
0
0
0
0
0
0
0.00
0
0
0
0
0
0
0
0
0.00
0
0
0
0
0
0
0
0
0.00
0
0
87
101
87
102
0
377
�+
�
0.00
0
0
135
157
135
156
0
583
0.79
46
46
13,911
16,226
13,911
16,226
0
60,274
60,'
2.40
81
677
42,136
49,147
42,136
49,147
0
182,566
182,
13.51
4,022
12,041
207,197
241,671
207,197
241,676
298,078
599,663
897,'
0.00
0
0
0
0
0
0
0
0
0.00
0
0
5,840
6,812
5,840
6,811
25,303
0 25,;
0.00
0
0
0
0
0
0
0
0
0.00
0
0
5,840
6,812
5,840
6,811
25,303
0 25,;
86.66
21,154
249,307
1,927,610
2,248,323
1,927,610
2,248,330
4,888,286
3,463,587 8,351,
bi
ATTACHMENT V
MONROE COUNTY HEALTH DEPARTMENT
SPECIAL PROJECTS SAVINGS PLAN
CASH RESERVED OR ANTICIPATED TO BE RESERVED FOR PROJECTS
CONTRACT YEAR
STATE COUNTY
TOTAL
2014-2015'
$
0 $ 0
$
0
2015-2016"
$
0 $ 300000
$
300000
2016-2017"'
$
0 $ 0
$
0
2017-2018"'
$
0 $ 0
$
0
PROJECT TOTAL
$
0 $ 300000
$
300000
SPECIAL PROJECTS CONSTRUCTION/RENOVATION PLAN
PROJECT NUMBER: TBD
PROJECT NAME: CLINIC ENHANCEMENTS 2016-2017
LOCATION/ADDRESS: Key West, FL 33040
PROJECTTYPE: NEW BUILDING ROOFING
RENOVATION X PLANNING STUDY
NEW ADDITION OTHER
SQUARE FOOTAGE: 0
PROJECT SUMMARY: Describe scope of work in reasonable detail.
FDOH Monroe would like to add a dental area in Key West. The project will involve renovation, equipment, pluming
and electrical. The project is anticipated to begin in September of 2016, and to be completed by December 2017.
Dental care in Key West specifically is in demand, with only one provider currently accepting Medicaid clients.
Adding dental space will increase capacity and give FDOH Monroe the ability to hire a part time dentist to provide
services to low income clients.
START DATE (Initial expenditure of funds) 9/1/16
COMPLETION DATE: 12/31/17
DESIGN FEES: $ 50000
Attachment: irs en en , attachment to agenda its ( Amendment ) 3of9
CONSTRUCTION COSTS
75000
FURNITURE/EQUIPMENT: $ 175000
TOTAL PROJECT COST: $ 300000
COST PER SQ FOOT: $ 0
Special Capital Projects are new construction or renovation projects and new furniture or equipment associated with these projects and
mobile health vans.
Cash balance as of 9/30/15
" Cash to be transferred to FCO account.
"' Cash anticipated for future contract years.
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 2016-2016
This contract is made and entered into between the State of Florida, Department of Health
("State") and the Monroe County Board of County Commissioner; ("County"), through their
undersigned authorities, effective October 1, 2015.
RECITALS
A. Pursuant to Chapter 154, Florida Statutes, 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 created County Health
Departments.
D. It is necessary for the parties hereto to enter into this contract in order to ensure
coordination between the State and the County in the operation of the CHD.
NOW THEREFORE, in consideration of the mutual promises set forth herein, the
sufficiency of which are hereby acknowledged, the parties hereto agree as follows:
1. RECITALS. The parties mutually agree that the forgoing recitals are true and correct
and incorporated herein by reference.
2. TERM. The parties mutually agree that this contract shall be effective from October 1,
2015, through September 30, 2016, or until a written contract replacing this contract is
entered into between the parties, whichever is later, unless this contract is otherwise
terminated pursuant to the termination provisions set forth in paragraph 8. below.
3. SERVICES MAINTAINED BY THE CHD. The parties mutually agree that the CHD
shall provide those services as set forth on Part III of Attachment II hereof, in order to
maintain the following three levels of service pursuant to section 154.01(2), Florida Statutes,
as defined below:
a. "Environmental health services" are those services which are organized and operated
to protect the health of the general public by monitoring and regulating activities in the
environment which may contribute to the occurrence or transmission of disease.
Environmental health services shall be supported by available federal, state and local funds
and shall include those services mandated on a state or federal level. Examples of
environmental health services include, but are not limited to, food hygiene, safe drinking
water supply, sewage and solid waste disposal, swimming pools, group care facilities,
migrant labor camps, toxic material control, radiological health, 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 is set forth in Part 11 of
Attachment II hereof. This funding will be used as shown in Part I of Attachment II.
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 $ 4 275,646
(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.
li'. The County's appropriated responsibility (direct contribution excluding any fees,
other cash or local contributions) as provided in Attachment 11, Part 11 is an
amount not to exceed $_ 1,091,804 (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 contract in the County Health
Department Trust Fund that is attributed to the CHD shall be carried forward to the next
contract period.
2
c. Either party may establish service fees as allowed by law to fund 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 contract 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 11 and send a
copy of the revised pages to the County and the Department of Health, Office df Budget and
Revenue Management. If the County initiates the increase/decrease, the County shall notify
the CHD. The CHD will then revise the Attachment 11 and send a copy of the revised pages
to the Department of Health, Office of Budget and Revenue Management.
e. The name and address of the official payee to whom payments shall be made is:
County Health Department Trust Fund
Monroe County
PO Box 6193
Key West, FL 33041
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 -today direction of the Deputy Secretary for County Health Systems. The
director/administrator shall be selected by the State with the concurrence of the County. The
director/administrator of the CHD shall ensure 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 Division of
Public Health Statistics and Performance Management 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 contract. 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 the
Generally Accepted Accounting Principles (GAAP), as promulgated by the 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
Information Resource (FLAIR) System;
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;
N. 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/Healfh 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 this 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
4
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
County Health Systems has approved the transfer. The Deputy Secretary for County Health
Systems 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 contract. 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 contract for a period of five (5) years after termination of this contract. If an audit has
been initiated and audit findings have not been resolved at the end of five (6) 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.
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
5
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 contract.
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:
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, Office of Budget and Revenue Management.
p. The dates for the submission of quarterly reports to the County shall be as follows
unless the generation and distribution of reports is delayed due to circumstances beyond the
CHD's control:
March 1, 2016 for the report period October 1, 2015 through
December 31, 2015;
W. June 1, 2016 for the report period October 1, 2015 through
March 31, 2016;
UK September 1, 2016 for the report period October 1, 2015
through June 30, 2016; and
iv. December 1, 2016 for the report period October 1, 2015
through September 30, 2016.
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 ensure 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.
6
c. All vehicles will be transferred to the ownership of the County and registered as County
vehicles. The County shall ensure 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.
B. TERMINATION.
a. Termination at Will. This contract 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 contract
become unavailable, either party may terminate this contract 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 contract may be terminated by one party, upon no less
than thirty (30) days notice, because of the other parry'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 contract 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 contract.
9. MISCELLANEOUS. The parties further agree:
a. Availabilit of Funds. If this Agreement, any renewal hereof, or any term, performance
or payment hereunder, extends beyond the fiscal year beginning July 1, 2016, 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 Man ers. The name and address of the contract managers for the parties
under this contract are as follows:
For the State:
Mary Vanden Brook, J.D.
Name
Administrative Services Director
Title
PO Box 6193
1100 Simonton Street
For the County:
Roman Gastesi
Name
County Administrator
Title
1100 Simonton Street
Key West, FL 33040
Address
305-809-5612
Telephone
Key West, FL 33040 _
Address
305-292-4441
Telephone
If different contract managers are designated after execution of this contract, 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 contract.
c. C_apbLons. The captions and headings contained in this contract 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 eight page contract, with its
attachments as referenced, including Attachment I (two pages), Attachment II (six pages),
Attachment III (one page), Attachment IV (one page), and Attachment V (one page), to be
executed by their undersigned officials as duly authorized effective the Vt day of October,
2015.
BOARD OF COUNTY COMMISSIONERS
FOR MONROE COUNTY
SIGNED BY: -
NAME: . 0A-gae,
TITLE: Inak Z rr
DATE: Lo � all — t S
ATTESTED TO:
SIGNED BY:
NAME:
TITLE:
DATE:
STATE OF FLORIDA
DEPARTMENT OF HEALTH
NAME: John H. Armstrona. MD
TITLE: Sur urt General/Secre_taa_of Health
DATE:
SIGNED BY: '
NAME: Robert B. Eadie, J.D.
TITLE: CHD D' c _ r/Administrator
DATE:
t� ............
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 few, 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 Noted below.
Service
Requirement
1 Sexually Transmitted Disease
Requirements as specified in F.A.C. 6413-3, F.S. 381 and F,S
Program
384.
2 Dental Health
Periodic financial and programmatic reports as specified by the
program office.
3, Special Supplemental Nutrition
Service documentation and monthly financial reports as specified
Program for Women, Infants and
in DHM 150-24• and all federal, state and county requirements
Children (including the WIC
detailed In program manuals and published procedures.
Breastfeeding Peer Counseling
Program)
4 Healthy Start/ Improved Pregnancy
Requirements as specified in the 2007 Healthy Start Standards
Outcome
and Guidelines and as specified by the Healthy Start Coalitions in
contract with each county health department.
5, Family Planning
Requirements as specified in Public Law 91-572, 42 U.S,C, 300.
at seq., 42 CFR part 59, subpart A, 45 CFR parts 74 & 92, 2 CFR
215 (OMB Circular A-110) OMB Circular A.102, F.S. 381,0051,
F.A,C. 64F-7, F.A.C. 64F-16, and F,A.C, 64F-19. Requirements
and Guidance as specified to the Program Requirements for Title
X Funded Family Planning Projects (Tide X Requirements)(2014)
and the Providing Quality Family Planrung Services (OFP)
Recommendations of CDC and the U.S Office of Population
Affairs published an the Office of Population Affairs website,
Programmatic annual reports as specified by the program office
as specified in the annual programmatic Scope of Work for Family
Planning and Maternal Child Health Services., Including the Family
Planning Annual Report (FPAR), and other minimum guidelines
as specified by the Policy Web Technical Assistance Guidelines.
3, Immunization
Periodic reports as specified by the department pertaining to
immunization levels in kindergarten and/or seventh grade
pursuant to Instructions contained in the Immunization Guidelines -
Florida Schools, Childcare Facilities and Family Daycare Homes
(DH Form 150-615) and Rule 6413-3.048, F.A.C. In addition,
periodic reports as specified by the department pertaining to the
surveillance/investigation of reportable vaccine -preventable
diseases, adverse events, vaccine accountability, and
assessment of immunization
ATTACHMENT I (Continued)
AftwhmenLl - P p 1 of r 1
levels as documented in Florida SHOTS and supported by CHO
Guidebook policies and technical assistance guidance.
T. Environmental Health Requirements as specified in Environmental Health Programs
Manual 15D4" and DHP 50.21`
8. HNIAIDS Program Requirements as specified in F.S. 384.25 and F.AC. 640-3.030
end 6413-3.031. Case reporting should be on Adult HNIAIDS
Confidential Case Report CDC Form DH2139 and Pediatric
HIV/AIDS Confidential Case Report CDC Form DF112140.
Requirements as specified in FAC. 64D-2 and 64D-3, F.S. 381
and F.S. 384. Soc k>demographic and risk data on persons
lasted for HIV in CHD dinics should be reported on Lab Request
DH Form 1828 in accordance with the Forms fnshuction Guide.
Requirements for the HNIAIDS Patient Care programs are found
in the Patient Care Contract Administrative Guidelines.
9. School Health Services Requirements as specified in the Florida School Health
Administrative Guidelines IMay 2012). Requirements as specified
In F.S. 381 ZM, F.S. 381.O057, F.S. 402.3026 and F.A.C. 64F-6.
10. Tuberculosis Tuberculosis Program Requirements as specified in FAC. 641)-3
and F.S. 392.
11 General Communicable Disease Carry out surveillance for reportable Communicable and other
Control acute diseases, dated outbreaks, respond to individual cases of
reportable diseases, investigate outbreaks, and carry out
communication and quality assurance functions, as spedfied in
F.A.C. 64D-3, F.S. 381, F.S. 384 and the CHD Epidemiology
Guide to Surveillance and Investigations.
12. Refugee Health Program Programmatic and financial requirements as specified by the
program office.
r the subsequent replacement if adopted during the contract period
Attachment l - Page 2 of 17
d
0
X,
c
uj
LL
ra
H
V
� dy
m m
C-4 pi
fQ
+o
m
C
Q
LD
E
W
m
0
0
c
9
15
C
m
a.
ATTACH ERM 17
140MOZ COLWff HFALM DBPARTUMM
Park It. Saurme of Clantrilmlions to County RoaM Departzmant
0"w 1. WIG to 8"tembor N. 2016
State MM County TOW OW
Tent trend (m Trust Fund
(cub) TmtPmd CommW
L GENERAL, REVENUE - STATE
015040 AEDSPAvEiN"reAm',
00mwo
yl-f-ylu 1"Miwi,
015040 ALGICESSIX)OT. IT)FNT1PIi7 ATION & ELIMINATION PROG
0150-10 IIAMILY PLANNING GENERAL REVENUE
016040 HVI'ATLUS AND LIVER FAJI,UI?E PREVENTION L -CONTROL
015040 ;lRiMARY rARr PROGRAM
0150-10 SCHO01. "NAT.T14 SPRVICUS - OrNrRAI. REVENUE
0 15050 ('110 r-I%'NERAL REVENUE NON -CATEGORICAL
Vi BNETAL VYAqQ4MP,-'1JTAT,
2. NON GENERAL REVENUE - STATE
NON GENERAL REVENUE TOTAL
3. VZTERAL FI WIS - itrATH
00701H) A] D9 DRUG ASSISTANCE PROGRAM ADM IN
007000 A] DS DRUG ASSISTANCE PROORA-M ADNHN IIQ
0070M) Al DS SURVLPI LL&NC E - CORE
007000 WIC IIRF&%-rFEEDIN(; PEER COUNSELING PROG
Bn7(X)fl COASTAL BEACI I WATER QUALITY MONITORING
OD7000 COMPREHENSIVE COMMUNITY CARDIO - PHBG
007(W FAMILY PLANNING TITLE X - GRANT
607(K)O HIN ISING OPPORTUNITIES FOR PERSONS WITH AIDS
007qKlfD IMMUNIZATION ACTION PLAN
4W)7001) MCH SPPCIAL PRJLT UNPLANNED PREGNANCY
007000 NICH SVLCIAL PROJECT PIL96NIS
007000 PlIP PUBLIC HEALTH PRFI'AREDNESS BME ALLOC
007ULN) AIDS PREVENTION
00?GOCI RYAN WHITr TITLE II CARNGRANT
00000 RYAN WHITE TITLE u GRjv4T/cmD comscirrium
0071XID WIC PROGRAM ADMINISTRNHON
016076 INSPECTIONS OF SUMMER FEEDING PROGRAM
015075 SUPPLEMENVU, SCHOOL HFA2H
01507o RE10 IJG CE HEALTH SCREENING JiLIM BL� RSrM.VNT
FEDERAL FUNDS TOTAL
I'll, '', 1, 1p I.Ir ' IT 9 l99 ow L-1,;
-991uim 17
001020 CHD STATEWIDE ENVIRONMENTAL FEES
WHIM CHD STATEWIDE ENVIRONMENTAL I'19ES
(I(l � 206 ON SITE SFWA(' , F DISPOSAL PERM IT FEES
001200 SANITATION CERTIFICATES (rOOD INSPE(.'FIGN)
Mar
ConbiRrution TOW
370,000
0
371➢,000
0
370,000
7J,552
a
73,562
0
73,552
2.519 200
0
259 260
0
2fiq,200
15,78,1
a
15,784
0
15,794
16,756
0
16,755
U
16,765
53,766
0
63,768
n
h3,766
32678
0
32.678
0
.1-D 670
12,000
0
72,(XXI
0
72,OUU
199,742
0
199,742
0
ID93,742
96,223
0
96,223
0
K223
1,184,2.12
0
4184.242
0
3.164,242
2,371942
0
2,373942
0
1'17111N412
1.736
a
1.536
0
1336
3739
0
3,719
it
1 71H
1 IN, 114
0
9IR,154
0
118,164
123, SM)
Ll
I 'A"609
0
123,609
26,682
0
26,582
0
28,681.1
5907
0
5.9D7
U
5,907
1562
0
1662
0
1,662
!'6117
0
55L777
0
65,777
18,439
0
18A39
0
18,439
16,M)o
0
35000
a
35,000
57,525
0
157,625
a
57,025
1`13 965
19
393 fK;5
a
393,965
8,024
S'V24
0
o'el'i
75
11
75
0
71
2D,816
0
I -NI A I rl
0
05,753
D
95703
0
96,75,3
118,70(1
0
118,701)
0
9 KWHI
80,851
0
80.867
0
80,857
482 113
0
482, t4l
0
482,143
307,914
0
337.944
9
337.944
1 3o
0
129
0
129
12s'839
0
123,&49
0
123 839
144,591
G
144691
0
144,591
2"008'228
0
OU8,228
0
2008,228
kvi.849
92A49
0
92,049
150,264
L50,20,1
a
160, 264
12,000
ty
iz000
a
I%000
2,000
0
2,000
0
2,000
Agachmcnt-R-P�ll - Pa" 4 of i 1
ATTACEMMMU
MONRON COUM UMTH DIWARTMMM
Part fl, Somwe d OunUfttim to Commity HeAM Dapadmitt
Octobw 1. 2015 to 99plembar 80,
2016
state cm
catmey
Touldim
Thiss Fmd
CHD
TrutFund
Other
insh)
Trunt Puad
tomb)
Conidktion
TOW
001200 SEPTIC TANK RESEARCH SURCHARGE
625
0
525
0
625
001206 SEPTIC TANK VARIANCE FEES 60%
50
0
so
0
50
001206 PUBLIC SWIMMING POOL PERMIT FEES-10% HQ TRANSFER
6,0G0
0
5,000
0
0.000
001206 DRINKING WATER PROGRAM OPERATIONS
12
0
12
0
12
001206 REGULATION OF BODY PIERCING SALONt;
60
0
60
0
60
001206 TANNING FACILITIES
117
0
117
0
117
001206 ONSITE SEWAGE TRAINING CENTER
is
0
is
0
Is
001206 TArrO PROGRAM ENVIRONMENTAL HEALTH
955
0
955
0
955
001206 MOBILE HOME & RV PARK PItHS
2,004
0
2,004
0
2,004
FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL
265.854
0
265,864
0
266,864
5. OTHER CASH CONTRIBUTIONS - STATE:
0
0
090001 DRAW DOWN FROM PUBLIC HEALTH UNIT
0
0
0
0
0
OTHRR CASH CONTRIBUTION TOTAL
0
0
0
0
d
S. MEDICAID - STATEICOUNTY:
001067 CHD CLINTCFEES
0
720
720
11720
001148 CHI)CLINICFEES
0
36X3
36,863
D
36,063
MEDICAID TOTAL
0
37'sm
37,683
0
37,583
7. ALIA)CABLE REVENUE - STATE'
018000 CHD LOCAL REVENUE& EXPENDITURILS
500
0
Boo
0
500
037000 RYAN WIHTE TITLE III - DIRECTTO CHD
850
0
360
0
SSG
ALLOCABLE REVENUE TOTAL
850
0
8500
BBO
0, OTHER STATE CONTRIBUTIONS NOT IN CHD TRUST FUND - STATE
ADAP
0
0
0
620.603
620,603
PHARMACY DRUG PROGRAM
D
0
0
69.071
69,071
WIC PROGRAM
0
0
0
1,007,L22
1.ow,122
BUREAU OF PUBLIC HEALTH LABORATORIES
0
0
a
111wi
11,062
IMMUNIZATIONS
0
0
0
677.463
677,463
OTHER STATE CONTRIBUTIONS TOTAL
0
0
0
2,365;321
2.11M.321
9. DIRECT LOCAL CONTRIBUTIONS - BCC/TAX DISTRICT
008005 CHD LOCAL REVENUE & EXPEND [TURES1
0
801.890
801,890
0
1101,890
GUBDUS IMMUNIZATION CAMPAIGN MONROE COUNTY ROCC
0
289,914
289,914
13
289,914
DIRECT COUNTY CONTRIBUTIONS TOTAL
0
D
1,091,804
to, FEES AUTHORIZED By COUNTY'oPDINANCE OR RESOLUTION - COUNTY
001025 CHD CLINIC FEES
0
691
Sol
0
691
001073 CIIDCLINIC FERS
0
36,000
35,00()
0
no'coo
001077 CHD CLINIC FEES
0
104,258
104,256
0
104,256
001094 CHD LOCAL ENVIRONMENTAL FEES
0
137,627
137.627
0
137,627
001110 VITAL STATISTICS CERTIFIED RECORDS
0
73,000
73.000
0
78.000
FEES AUTHORIZED BY COUNTY TOTAL
0
ifili'm
260,574
0
350,674
It. OTHER CASH AND LOCAL CONTRIBUTIONS - COUNTY
AbudVnKtk_lLPukll - Poe 5 ci 1 i
ATTACIDEM13
MONROB COUNTY HUM DIPPARTMWO
Put 14 Sources of Conewbutiong 10 county Hoau Deartmem
October 1, 2015 to sopbmbw so, 2016
State CHD
County
Total CHD
Trust Fund
Can'
TIUSt AAnd
Othar
(suM
Trut Fund
6A)
Obntribadon
Total
001029 CIID CLINIC FEES
0
245,030
245.930
0
245,830
omM CHD CLINIC FEES
0
120,970
120,00
0
120,970
005000 CHD LOCAL REVENUE A EXPENDITURES
0
11,000
II.ODU
0
11,1101)
OD7010 RYAN WHITE TITLE [if DIRECT TO CHD
0
145,000
145;000
0
146,(M
007010 RYAN WHITE TITLE III DIRECT TO CHD
0
869,483
369,483
0
169.493
010300 CHD STATEWIDE ENVIRONMENTAL FE2.9
0
204
204
0
204
010300 CHD LOCAL ENVIRONMENTAL FEES
0
1, sto
1.510
0
1,610
010300 CHD SALE OF SERVICES IN OR OUTSIDE OF STATE GOVT
0
71,w2
71,602
a
71,602
010400 CHD SALE OF SERVICES IN OR OUTSIDE OF STATE GOVT
0
41200
4,200
0
4.200
010500 CHD SALE OF SERVICES IN OR OUTSIDE OPSTATE GO VT
a
70,301
70,891
a
70,381
011000 SMOKE FREE HODSING GRANT
a
24.425
24,425
0
24.425
011001 CHD HEALTHY START COALITION CONTRACT'
0
290.000
290.000
0
290,000
012020 CHD LOCAL REVENUE: & LXPENDITI'RF' .9
0
Is
15
0
is
ONW2 DRAW DOWN FROM PUBLIC HEALTH 1.7NIT
0
916,844
910,844
a
916,844
07HER CASH AND LOCAL ODNTRIBUTIONS TOTAL
0
=IA74
$271,474
U
2,271,474
12. ALLOCABLE. RRVKNUR • COUNTY
0180M CHD LOCAL REVENUE& EXPENDITURES
0
rm
sm
0
Soo
037000 RYAN WHITE TITLE 111 • DIRECT TO CHD
0
250
350
0
350
COUNTY ALLOCABLE REVENUE TOTAL
0
850
Soo
ON
13. BUILDINGS - COUNTY
ANNUAL RENTAL EQUIVALENT VALUE
0
0
0
507,606
69760
OTHER (Spemify)
0
0
0
0
0
UTILITIES
0
0
0
OZ 369
03'am
BUILDING MAINTENANCE
0
0
0
75,=3
76,22.1
GROUNDS MAINTENANCE
0
0
0
116,fim
115,56fl
INSURANCE
0
0
0
0
0
OTHER (Specify)
0
0
0
0
0
OTHER (Specify)
0
0
0
0
0
BUILDINGS TOTAL
0
0
0
pujm
811,763
14. OTHER COUNTY CONTRIBUTIONS NOT IN CHD TRUST FUND - COUNTY
EQUIPMENT I VEHICLE PURCHASES
0
U
0
0
0
VEHICLE INSURANCE
0
a
0
0
0
VEHICLE MAINTENANCE
0
0
0
0
0
OTHER COUNTY CONTRIBUTION ISPECI M-
0
0
0
0
a
OTHER COUNTY CO BUTTON (SPECI
0
0
0
0
0
OTHER COUNTY C ON
0
0
0
0
0
GRAND TOTAL CHD PROGRAM
4J72.483
3,752,286
&6124308
3,267.084
11,781,952
II par�G - p2gs 8 of I I
ATT U
KONR= COUMI'Y MMIMMPAJITAMW
Past III, Planed Staffin. Clients, Beniesa and 8syoadataraa ily Pn>iram ilorrimAnaWitkinlisak Lard of 8oerim
Oetabor If NIB to As tabor MX 9t118
qumzlwit toile Plan
MIS
011=24 sardwal
lot
fad
8rd
4th
Grand
(0,00
IIa#a
Visits
Mob dallon a*)
8tato
County
TOW
DIBFASR CONTROL,
IMMUNIZATION (ID0
0.05
5,7zi
8,360
21G,576
252,612
21G,578
252,011
8,824
DW,755
939,979
SEXUALLY TRANS. 1315. (1
176
274
462
30,681
36,785
:1Qpl
IMARS
123,566
9,374
132,M2
RIVIAIDS PREVENTION (DUO)
4107
SEfi
92,49A
70,74
92,497
192,252
151,351
343,603
FI1VIA117SSUR 1 CFI (0
0.04
22
au
7=
842
722
842
1,562
1,566
8,128
f11VIAI S PATIENT E MAO
IE21
479
4,338
634,820
740,446
634,S0
740,446
Z134939
811602
2,750,541
ADAr (03A4)
1,32
I6
218
21,036
25,235
21,636
25,234
93:616
123
93,739
TUBERCULOSIS (100
1104
26
162
23,158
24,678
21„158
24,b79
1G.764
MAN
91,672
COMM i11S.Sunv. (Ice
0.67
0
561
16.956
22.11D
I&SM
2.^t10
G
AZI32
82,132
HEPATITIS (109)
11
245
357
30,926
38,011
30,
3%071
7ZON
61994
133,994
PRFPAREDNESSANDRESPONSE (I IG)
7.28
0
fi3O 7
96,477
76,371
6€,477
76,3r.?
95'm
t97,944
281,
RE G H TH (118)
1,97
NB
904
50913
59.207
50,033
5%
21%978
183
224161
VITAL RECORDS (10
101
1.51K
015
17,823
Z1,795
11,629
20,7Wb
a
77,248
77149
COVJMNICABLE DISEASE SUBTOTAL4185
ROM
1.18&
1. 710
1,1
1,385JOS
2.962
2,189,260
5,161220
11 PIUMARY CARD
CHRONIC DISEASE PREVENTION PRO (21
0. W2
D
0
1.335
1,558
1.335
11558
3,4Da
Z378
11798
C {21 o
5.35
4,52€
Imm
UK=
114313
9KO07
114,311
424,640
0
120,640
TOBACCOUSE I 6 i7N 42LO
2,09
0
M2
45,554
53.134
45,5H
61134
197,376
0
197.6-:76
WtC HHUSMEEDING 1'KER UNSLLINI (21W 4
0,47
0
15,170
17,71*
IS,174
17,71*
66.768
0
65,7wt
FAMILY PLANNING (22a)
3.54
1,030
1,990
87,682
102,270
87,OAZ
twm
327,556
52,347
37R903
IMPROVED PREGNrA ME (229
0.00
G
0
1,967
4,626
3,967
4,626
17,16C
0
17,1
HEALTHY Y PRENATAL (2 7)
138
920
0,180
KM
63.900
KG23
n8w
a
23(L996
236.
Yt PREHE 'iV CIIIIJ) HKANTH (2'
V.Mi
Vl
0
w
24
20
24
88
0
68
HEALTHY START CHILD (230
2.83
937
4,.204
4t842
62,303
44..642
62,302
13,426
18QW3
IK289
SCH LPIEAL,TH (234)
603
0
144.270
7JAW,
93,107
79,825
€13,I07
220,062
125M
346, ,
COMPREHENSIVE ADULT HR T'II (M
39I
373
L3I7
88,27fi
lazom
88,278
102,965
109,742
102,711
MUG
COMMUNITY HEALTH DEVELOPMENT (a
101
0
947
26,067
30101
28,1167
30,404
D
lIZ942
J,IZ 362
DENTAL HEALTH (240)
GAO
0
0
0
6
0
0
0
0
0
PRIMARY CARE SUBTOTAL2713
7.501
177AGII
5545.460
636,209
543,456
930,207
1,4 ,2 2
ON 0713
%363,928
C. EDMIRONMENTALFIRALTH.
COSTA]. BEACH RTN(I M47)
0.30
384
0,rm
11 181
9,UG
11,181
1A1439
23,096
4I O14
LIMITED USE PUBLIC'WATER SYSTEMS (357)
0.00
d
0
0
0
0
0
0
0
0
P11131,IC WATER SYSTEM [IBM
0.00
0
D
16s
1811
Ras
183
tl
ml
NO
PRIVATE WATER SYSTEM (36%
0.00
0
0
0
0
0
a
0
0
0
ONS179SEWAGE TI ' E III$ I. (361)
463
1,877
Mwfr
7077
80,402
74,071
811.401
212700
119J91
312R 57
Ctaua Toud
4 DI
z2fli
MSG
63,021
97,767
03,1121
97,766
221,206
1.11.969
383,174
FaciLity Pingrame
TATTOO r Cll SERVICES (344)
0.12
D
3
2,013
2, •
2,043
2,394
4,500
053
9,893
FOOD HYGIENE (348)
q&I
F.:'3'
:mjI
10A?U
12,670
10.870
12,680
17,943
29,168
47.099
BODY PIERCING FACILiTIESSERVICES (349)
002
8
1
316
360
316
369
916
405
1670
Atl vnk_1LP _dt Pope 7 o 8 t
ATTACK MW H
MONRM COMM EMAM t)ZPARThMNT
PMA 111, Planed 8MMag.
011ests, Swvka nd ftep&tum Sr Pmeraw Somles Am WMW Raeb Level of Bard"
OdaWr 41018 to September so, soon
QUTLG* RxPeadliars PIM
Me
cifivata 114"I"d
let
god
Bed
4th
Gmad
(0.00
Usas
vialto
(Whole dellffirs ff*)
state
rmunty
TaW
OROUPCARr ncmmy (35t)
UANI
17
27
1.560
lJ108
1°558
isle
0
6,762
6,762
MIGRANT LABOR cAmit (352)
0.00
0
0
U
0
0
0
0
0
HOUSING & PUB BLDU. (363)
it
0
a
0
a
0
0
0
a
MOMY, ROME AND PARK (054)
0.39
143
349
8,750
U)MB
8.769
10,217
19,799
10,163
37.951
MOM SMATHING 1'1ACM9 (360
2.62
001
2.091
w 119
45,627
89,119
45,627
4?,8M
126.6112
1 ( 492
BIOMEDICAL WASTE SYMCKS (3c.0
0.62
292
ate
8,291
9,970
8,291
9,670
11'81a
24jI2
35.922
TANNI NC VAC ILMY SERVICES (399)
ftol
2
143
197
143
168
454
is?
621
(4go.0 Toga
4.56
L418
3.127
75E99
82.90
71.09
92, M
97.220
210,840
MAW
Ehoundwater Contamination
STORAGE TANK COMPLIANCE SERVICES M59
352
213
441
'T 9K30
M588
27J939
32,M9
Q
12100
121055
M )PNIt ACT SMOCKS (350
KIM)
It
a
0
U
U
a
0
0
0
Group Total
162
M
441
27.939
WAS
27,939
321189
0
121,D58
121,055
Community Ifygnpoo
COW.MUNITY FNVIR HEALTH (346)
1,35
0
495
25,764
0p039
25,7M
'M 040
0
IL1,587
111.587
INJURY PRFVt'NTION (340
t1w
0
0
0
U
0
9
0
0
a
LEAD MOOKNO SERVICES 1250)
0.00
a
0
0
0
0
0
0
0
1P
PUBIA,'.m. SEWAGE M)
0.00
a
0
0
0
0
ti
0
0
Ij
SOLID WASTE DISPOSAL SERVICE 4363)
6.00
0
0
0
a
a
E)
a
0
0
SANITARY NUMAKM t3aW
U 18
39
ILI
8,127
8,647
T127
AIMM
0
13,647
0,547
RABIES SURVEILLANCE (360
006
1
to
746
00
745
870
0
1230
3,23a
ARIVjRVIRUSstUjvEIL #_%O)
0,00
a
0
a
0
0
U
a
0
0
RODENTIARTHROPODCONTRUL C.
0.00
0
a
0
a
0
0
a
0
0
WATER POLLUTION (370
0,00
0
0
0
a
0
a
0
0
0
INDOORAIR M,70
0.00
a
a
as
104
59
IDA
a
ONG
H86
RAINOIA)UICALHOALTH (372)
0106
a
0
139
162
139
102
0
602
Mr.
TOXtCSUHSTANCZS (374
0. 82
47
47
1b,ID4
17,722
Ifi,194
17,723
0
fis,flm
w
Group Total
140
97
679
45.0=L9
52,044
40,048
G2,545
0
191"Ass
195,186
I�MXOMMENTAL HEALTH SUBTOTAL
13.41
I'm
fi,M
= 9M
265,828
221.507
20,832
318,425
ob9,049
987474
D. NON -OPERATIONAL COSTS:
NON-OPERATIGNAL COSTS (50
coo
a
0
0
a
0
0
0
ENVIRONMENTAL HEALTH St rRCHARGE M19)
0 w
0
0
A,:418
6, 1 L-2
6,248
61121
22,?41
0
V4741
MEDICAIDBUYBACK (BID
Goo
0
0
0
0
a
0
a
0
a
NON -OPERATIONAL COSTS SUBTOTAL
0.00
0
D
6,249
6,122
5,249
61121
22,741
0
22.741
TOTAL CONTRACT
80,90
20,6M
212,2R7
1967,616
1294.860
1,967,516 2,0409
4,772,,184
3,752,285
8,5124709
AltwdwwrtA.PwLmi . Faeo 8 of 91
ATTACHMENT Ill
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). H 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 at 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 at seq., which prohibits discrimination
on the basis of age in programs or activities receiving or benefiting from federal financial assistance..
5,. The Omnibus Budget Reconciliation Act of 1981. P_L, 97-35, which prohibits discrimination on the basis
of sex and religion In programs and activities receiving or benefiting from federal financial assistance.
6. All regulations; guidelines and standards lawfully adopted under the above statutes. The applicant agrees
that compliance with this assurance constitutes a condition of continued receipt of or benefit from federal
financial assistance, and that it Is binding upon the applicant, its successors, transferees, and assignees
for the period during which such assistance is provided. The applicant further assures that all contracts,
subcontractors, subgrantees or others with whom it arranges to provide services or benefits to
participants or employees in connection with any of its programs and activities are not discriminating
against those participants or employees in violation of the above statutes, regulations, guidelines, and
standards. In the event of failure to comply, the applicant understands that the grantor may, at ib
discretion, seek a court order requiring compliance with the ferns of this assurance or seek other
appropriate judicial or administrative relief„ to include assistance being terminated and further assistance
being denied.
Anachmenl ill Page 9 of 11
ATTACHMENT IV
MONROE COUNTY HEALTH DEPARTMENT
FACILITIES UTILIZED BY THE COUNTY HEALTH DEPARTMENT
Facility
Gato Building: Administration, Clinic,
Healthy Start, Vital Statistics
Roosevelt Sands Center. Clinic, WIC
Lxa n I
1100 Simonton Street, Key West, FL Monroe County
33M
105 Olivia Street, Key West, Fl. 33040 City of Key West subject to Intedocal
agreement with Monroe County for FLDOH-
Monroe use
Juvenile Justice Building: Environmental 5W3 College Road, Kay west, FL 33040
Health
Murray E. Nelson government Center, 1022050 Overseas Highway, Key Largo, FL
Environmental Health 33037
Ruth Mns Center Clinic, Environmental 3333 Overseas Highway, Marathon, FL
Health 33050
Roth Building: Clinic 50 High Point Road, Tavernier, FL 33070
Monroe County
Monroe County
Monroe County
Monroe County
AftedunenLN Pow 10 of I
CONTRACT YEAR
2014-2015*
20162DIG`•
2016-2017-
2017-2018—
PROJECT TOTAL
PROJECT NUMBER-,
PROJECT NAME:
LOCATIONADDRESS;
PROJECT TYPE;
SQUARE FOOTAGE;
PROJECT SUMMARY:
START DATE (read expo w&marAwM
COMPLETION DATE
DESIGN FEES;
CONSTRUCTION COSTS:
FURNITUREIEQUIPMENT
TOTAL PROJECT COST,
COST PER SO FOOT
ATTACHMENT
MONROE COUNTY HEALTH DEPARTMENT
SPECIAL PROJECTS SAVINGS PLAN
CASH RESERVED OR AtMCIPATED TO BE: RESERVED FM PROJECTS
STATE
ReTo
Spade$ Capital Projects are now construction or renovation projects and now furniture of equipment associated with those projects and
mobile health vans.
'Cash balance as of 9=15
—Cash to be transferred to FCO account.
— Cash anticipated for fultim contract years.
AnmhffmLV - Page I I of I I
FEE RESOLUTIONS 2015-2016
PURPOSE: To establish public health service fees In order to expand existing public health services
to the community at large.
A. 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 3`d 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 56-66-13. 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
reimbursement is accepted as payment in full.
(3) Injection fee for parenteral medications per Injection $ 35
(4) Lab fees - All laboratory and pathology fees are subject to
sliding scale fee adjustment based upon OMB Federal
Guidelines.
1. Specimens tested in clinic -(hemoglobin, urine,
blood sugar, mono, wet mount, strep) $ 20
ii. Pregnancy test No charge
B. COMMUNITY PUBLIC HEALTH SERVICES
(1) Tuberculosis X-ray for suspected, confirmed or
Symptomatic contact or case No charge
(2) Tuberculosis Skin or blood 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 or blood Test, with reading, any other
than listed above in C. (1). $ 35
(5) Tuberculin assessment of clients with a past history of
positive skin test $ 35
(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
L Office/Outpatient Visit, New $178
Paget of S Monroe County Health Department Core Contract 201S-2016
ii. Office/Outpatient Visit, Established $117
(7) Required Vaccines for children up to age 18 and eligible for No Charge
the Vaccine for Children program
(8) Vaccine administration fee (child or adult) other than item $ 23.50
11 below
(9) County sponsored vaccinations for TdAP, HPV, Seasonal Flu, No Charge for
and population -specific needs for Pneumonia for uninsured residents earning
or underinsured residents 400% of Federal
Poverty Level or less
(10) County sponsored immunizations for uninsured Take Stock No Charge
in Children's Experiment in International Living Scholarship
recipients
ill) Seasonal Flu vaccinations for those not covered in items 7 $ 22 product+ $10
or 9 above Admin fee = $ 32 total
charge
(12) All other Immunizations not covered in items 8, % 10 above
Cost of vaccine x 2 +
$23.50 injection fee
(13) Class/Seminar attendance registration per person charge
for health care, social work and counseling employees
I. AIDS 101
No Charge
ii. AIDS 500
No Charge
III. AIDS 501
No Charge
(14) International Certificates of Vaccination
Cost x 3.5
C. VITAL STATISTICS
(1) Birth Certificates
$ 16
(2) Additional Birth Certificate Copies
$ 16
(3) Protective Covers
$ 4
(4) Death Certificates —Certified Copy
$ 13
(5) Additional Death Certificate Copies
$ 13
(6) Express Fee
$ 10
D. MEDICAL RECORDS
Copying of Medical Record (per page)
$1
E. PUBLIC RECORDS
Copying of Public Record (per page)
$1
A service fee of
F. RETURNED/DISHONORED CHECKS: (S 215.34j2) F.S)
$15 or 5% of the
face amount of the
check, draft, or
money order
Page 2 of 5 Monroe County Health Department Core Contract 2015-2016
whichever is
greater, not to
exceed $150
G. PUBLIC HEALTH AND MEDICAL PREPAREDNESS
Submission and Review of Required Annual Comprehensive
Emergency Management Plan for Home Health Agencies,
Fee Schedule, Environmental Health County Fee List
(in addition to State Fees on alternate Fee Schedule)
1. ONSITE SEWAGE DIPOSAL PROGRAM (OSTDS) County Fee
a.
Application and plan review for construction permit for
$ 100
new systems
b.
Application and approval for existing system, if system
$ 10
inspection not required.
c.
Application and Existing System Evaluation with inspection
$ 50
d.
Application for permitting of an new Performance -based
$ 75
treatment system
e.
Site Evaluation
No charge
f.
Site re-evaluation
$ 40
g.
Permit or permit amendment for new systems
$ 25
h.
Initial system inspection
$ 50
L
System re-inspection(stabilization, non-compliance, or
$ 25
other inspection after initial inspection.
J.
Research fee (State Fee)
No charge
k.
Repair Permit with inspection
$ 50
I.
Application for system abandonment permit
$ 45
m.
Tank manufacturer's inspection per annum
$ 20
n.
Amendment to an Operating Permit
No charge
o.
Septage Disposal Service Permit per annum 2X per yr
$ 45
inspection
p.
Portable or temporary toilet service permit per annum
$ 45
q.
Additional charge per pump out vehicle
$ 5
r.
Annual operating permit industrial/manufacturing zoning
No charge
or commercial sewage waste
s.
Biennial Operating permit for aerobic treatment unit or
No charge
performance -based treatment system
t_
Aerobic treatment unit maintenance entity permit per
No charge
annum
u.
Variance application for a single family residence per each
$100
lot or building site
v.
Variance application for a multifamily or commercial
$140
building site
w.
Inspection for construction of an Injection well (FL Keys)
$ 95
Page 3 of 5 Monroe County Health Department Core Contract 2015-2016
x. OSTDS Operating Permit Late Fee (45 days past due) $ 50
y. Per request -Expediting -Fast Track Permitting New & $ 500
Existing (48 hour turn -around) Charged in addition to state
fee
z. Letter of Coordination for development review $ 250
committees
aa. Expedited OSTDS Variance Processing. Received within 6 $ 500
days of monthly deadline. Charged in addition to state fee
bb. OSTDS PBTS screening test fee $ 25
II. PUBLIC SWIMMING POOLS
a. Annual permit- up to and including 25,000 gallons $115
b. Annual permit - more than 25,000 gallons $100
c. Non routine Inspection (no charge for first Inspection $100
d. Exempted condominiums/Cooperatives with over 32 units $ 25
III. MOBILE HOME & RECREATIONAL VEHICLE PARKS
a. Annual permit for 5 to 25 spaces $125
b. Annual permit for 26 to 149spaces $3.50 per space
c. Annual permit for 150 and above spaces $ 400
IV. FOOD ESTABLISHMENTS
a.
Annual Permit for Fraternal/Civic
$ 35
b.
Annual Permit School Cafeteria Operating for 9 months or
$105
less
c.
Annual Permit School Cafeteria Operating for more than 9
$125
months
d.
Annual Permit for Movie Theaters
No charge
e.
Annual Permit forlails/Prisons
No charge
f.
Annual Permit for Bars/Lounges
$ 35
g.
Annual Permit for Residential Facilities
$ 65
h.
Annual Permit for Limited Food Service
$115
1.
Child care center
$ 40
J.
Caterer
$ 45
k.
Mobile Food Units
$ 45
1.
Other Food Service
$ 35
m.
Vending machine dispensing potentially hazardous food
No charge
n.
Plan review per hour public schools, colleges, and
$ 20
vocational teaching facilities are exempt from this fee
o.
Food establishment worker training course per person
No charge
p.
Alcoholic beverage inspection approval
$15
q.
Request for inspection
$10
r.
Re -inspection (for each re -inspection after the first)
No charge
s.
Temporary event food service establishment
$100
(a)sponsor w/o existing sanitation certificate
t.
b) vendor or booth at an establishment or location w/o an
$ 50
Page 4 of 5
Monroe County Health Department Core Contract 2015-2016
(I,tuawpuawd HO(3: 8Z86) wail epuaBe of tuawyaette `tuawpuewd tsar :tuawyoettb
r ;
Z
existing sanitation certificate
u. Late renewals $15
V. BIOMEDICAL
a. Generators $ 40
b. Storage Facilities $ 40
c. Late Fee $ 20
VI. TANNING FACILITIES
a. Annual Permit $100
b. Fee per Device No charge
c. Consultation $ 50
d. Late Renewal Fee No charge
VII. BODY PIERCING ESTABLISHMENTS
a. License Fee $100
b. Temporary Establishment $15
c. Late fee No charge
d. Consultation $ 50
Vlll. HEALTHY HOMES PROGRAM
a. Healthy home Assessment Voluntary Inspection living $ 300
unit(radon, COZ, Mold Safety)
b. Public Education -Per Attendee $ 25
Page 5 of 5 Monroe County Health Department Care Contract 2015-2016