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FY1998 11/12/1997BRANCH OFFICE 3117 OVERSEAS HIGHWAY MARATHON, FLORIDA 33050 TEL. (305) 289-6027 FAX (305) 289-1745 TO: FROM: DATE: `GOUNTYa J��,,�rtVip'4 OG9 lV:� R•tN u+ s: r iol o 410t COUNTt. t�C� 3�annpL.o[jage CLERK OF THE CIRCUIT COURT MONROE COUNTY 500 WHITEHEAD STREET KEY WEST, FLORIDA 33040 TEL. (305) 292-3550 FAX (305) 295-3660 M E M O R A N D U M Stephanie A. Walters, Administrator County Health Department Isabel C. DeSantis, Deputy Clerk .(1 C. &. November 26, 1997 BRANCH OFFICE 88820 OVERSEAS HIGHWAY PLANTATION KEY, FLORIDA 33070 TEL. (305) 852-7145 FAX (305) 852-7146 At the Board of County Commissioners' meeting of November 12, 1997, the Board granted approval and authorized execution of a Contract between Monroe County and the Florida Department of Health, Monroe County Health Department, for Health Department Services provided to the County. Attached hereto are three duplicate originals of the document executed by Monroe County for your follow-through with the department authority at the State of Florida Department of Health. Please be sure that one fully executed copy is returned to this office as quickly as possible. Should you have any questions, please do not hesitate to contact this office. cc: County Attorney County Administrator, w/o document ,Finance ✓File STANDARD CONTRACT BETWEEN MONROE COUNTY BOARD OF COUNTY COMMISSIONERS %, AND STATE OF FLORIDA DEPARTMENT OF HEALTH RECEIVED DEC 081997 Pursuant to Chapter 154, Florida Statutes this contract is entered into between the Department of Health, hereinafter referred to as the "department", and Monroe County, hereinafter referred to as the "county". This contract stipulates the services that will be provided by the Monroe County Health Department, hereinafter referred to as the CHD, the sources and amount of funds that will be committed to the provision of these services, and the admini-it-aviva.6 and programmatic requirements which will govern the o p� funds. This contract also defines the responsibilities of the department and the county iaregabliri tyke CHD "to promote, protect, maintain, and improve tke h-lt�} mid safety of the citizens and visitors through pro4t`oa of e public health, the control and eradication o% p ve abii.e diseases, and the provision of primary health ca�l rec fOX slec populations." �' �'' Cju D w v I. General Provision: w Both parties agree that the.CHD shall: A. Provide services according to the conditions specified in Attachment I and all other attachments to this contract; and B. Fund the services specified in Attachment II, Part III, at the funding level specified for each program service area in that attachment. II. Federal and State Laws and Regulations: Both parties agree that the CHD shall: A. Comply with the provisions contained in the Civil Rights Certificate, hereby incorporated into this contract as Attachment III; B. Comply with the provisions of 45 CFR, Part 74, and other applicable regulations if this contract contains federal funds; C. Comply with all applicable standards, orders, or regulations issued pursuant to the Clear Air Act as amended (42 USC 1857 et seq.), and the Federal Water Pollution Control Act as amended (33 USC 1368 et seq.), if this contract contains federal funds and the total contract amount is over $100,000; and D. Comply with applicable sections of Chapter 427, Florida Statutes, (Transportation Services) and Chapter 41-2, Florida Administrative Code, (Coordinated Community Transportation Services) regarding the provision of transportation services for the transportation disadvantaged if this contract contains any state, federal or local funds which are used to provide for direct or indirect (ancillary) transportation services. III. Records, Reports and Audits: Both parties agree that the CHD shall: A. Maintain books, records and documents in accordance with accounting procedures and practices which sufficiently and properly reflect all expenditures of funds provided by the department, the county and other sources under this contract. Books, records and documents must be adequate to enable the CHD to comply with the following reporting requirements: 1. The revenue and expenditure requirements in the State Automated Management Accounting Subsystem ( SAMAS) ; 2. The client registration and services reporting requirements of the minimum data set as specified in the Client Information System/Health Management Component (CIS/HMC) Manual and any revisions subsequent to the January 1, 1984 version, or the equivalent as approved by the State Health Office. Any reporting system used by or on behalf of the CHD to produce the above information must provide data in a machine readable format approved by the department which can be transferred electronically to the Client Information System; 3. The CHD is responsible for assuring that all contracts with service providers include provisions that all subcontracted services be reported back 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 Manual and any revisions subsequent to the January 1, 1984 version; 4. Financial procedures specified in the department's Accounting Procedures Manuals, Accounting memoranda's, and Comptrollers memoranda's; 2 5. All appropriate CHD employees shall report time in the Client Information System/Health Management Component compatible format by program component for at least the sample periods specified by the department; and 6. Any other state and county program specific reporting requirements detailed in attachments to this contract. B. Assure these records shall be subject during normal business hours to inspection, review or audit by state or county personnel duly authorized by the department or the county, as well as by federal personnel; C. Retain all financial records, supporting documents, statistical records, and any other documents pertinent to this contract in conformance with the retention schedules required in HRSM 15-1, "Records Management Manual", or the subsequent replacement if adopted during the contract period; D. Allow persons duly authorized by state or county, and federal auditors, pursuant to 45 CFR, Part 74.24(a), (b), and (d) to have full access to, and the right to examine said records and documents during said retention period; and E. Include these aforementioned audit and record -keeping requirements in all approved subcontracts and assignments. IV. Purchasing and Leasing Procedures: A. The CHD will adhere to the State of Florida purchasing rules and regulations except when purchasing or leasing through the county to obtain a better price or service. When purchases or leases are more cost effective through the county or by following county procedures a superior good or service can be acquired, the county procedures and regulations will be followed in their entirety. Copies of the State Purchasing Rules and Regulations shall be maintained at the CHD and if any purchases or leases are made through the county system, the county procurement procedures must also be in place for audit and management purposes. When purchasing or leasing through the county system, the order and payment must be documented to note that county procedures were used because they were more cost effective. B. Any lease entered into by a CHD which utilizes county rather than state procurement procedures must be U approved by action of the Board of County Commissioners. The lease must be voted on as an agenda item by the Board of County Commissioners prior to being signed by the delegated county official. Documentation of this approval, and the fact that all county procedures were followed must be maintained by the CHD. C. Procurements will be authorized by the issuance of a purchase order or the consummation of a contract prior to the acquisition of goods or services. Exceptions to this provision may be made as specified in department or county procurement directives. D. Both parties agree that the CHD shall follow general services operating procedures as specified in the department's General Services Procedures Manuals, General Services memoranda's, Department of management Services' procurement directives, and when operating under county authority all such county directives. V. Monitoring: Both parties agree that, as either determines necessary, the department and/or the county shall monitor the budget and services as detailed in Attachment II and operated by the CHD or its subcontractor or assignee. VI. Safeguarding Information: Both parties agree that the CHD shall not use or disclose any information concerning a recipient of services under this contract for any purpose not in conformity with the state law, regulations or manual (HRSM 50-2 Security of Data and Information Technology, or the subsequent replacement if adopted during the contract period) and federal regulation (45 CFR, part 205.50), except by written consent of the recipient, or his/her responsible parent or guardian when authorized by law. VII. Assignments: Both parties agree that the CHD shall not -assign the responsibility of this contract to another party without prior written approval of the department and the county. No such approval by the department and the county of any assignment shall be deemed in any event or in any manner to provide for the occurrence of any obligation of the department or the county in addition to the dollar amount agreed upon in this contract. All such assignments shall be subject to the conditions of this contract and to any 4 conditions of approval that the department and the county shall deem necessary. VIII.Subcontracts: Both parties agree that the CHD shall be permitted to execute subcontracts with the approval of the delegated authority in the department for services necessary to enable the CHD to carry out the programs specified in this contract, provided that the amount of any such subcontract shall not be for more than ten (10) percent of the total value of this contract. In the event that the CHD.needs to execute a subcontract for an amount greater than ten (10) percent of the value for this contract, both parties to this contract must agree in writing to such a subcontract prior to its execution. No subcontracts shall be deemed in any manner to provide for the occurrence of any obligation of the department or the county in addition to the total dollar amount agreed upon in this contract. All such subcontracts shall be subject to the conditions of this contract and to any conditions of approval that the department and the county shall deem necessary. IX. Insurance: The County agrees to provide adequate fire and casualty insurance coverage for all furnishings and equipment in CHD offices and buildings. Buildings used by the CHD that are owned by the County, and all furnishings and equipment owned by the County, shall be insured through the County's insurance program, which shall be either a self-insurance program or insurance purchased by the County. For any buildings, furnishings and equipment used by the CHD but not owned or insured through the County, it is the responsibility of the CHD to obtain adequate insurance coverage either through the County, the state, or Department of Management Services approved private insurance carrier. X. Payment for Services: A. The department agrees: To pay for services identified in Schedule "C" of the operating budget (General Revenue and Federal), and reflected in Attachment II, Part II, as the State's appropriated responsibility in an amount not to exceed $ 3,237,809 ; and the State share of all state authorized fees in an anticipated amount of $ 266,557 In addition, all "OTHER" state revenues from whatever sources to be appropriated to the County Health Department Trust Fund for services to k be provided by the county health department in an amount of $ 865,827 , for a grand total State cash contribution of $ 4,370,193 The State's obligation to pay under this contract is contingent upon an annual appropriation by the Legislature. B. The County agrees: To pay for services identified in Attachment II, Part II, as the county's responsibility in an appropriated amount not to exceed.$__ 346,000 In addition, the county shall provide its share of all county authorized fees in an anticipated amount of $ 225,024 These amounts, plus any "OTHER" local revenues in the amount of $ 37.000 includes all revenues from whatever sources to be appropriated to the County Health Department Trust Fund for services to be provided by the county health department for a grand total county cash contribution of $ 608,024 XI. The department and the county mutually agree: A. Effective date: 1. This contract shall begin on October 1, 1997 or the date on which the contract has been signed by both parties, whichever is later. 2. This contract shall end on September 30, 1998. B. Termination: 1. Termination because of lack of funds: In the event funds to finance this contract become unavailable, either party may terminate the contract upon no less then twenty-four hours notice in writing to the other party. Said notice shall be delivered by certified mail, return receipt requested, or in person with proof of delivery. The department or the county shall be the final authority as to the availability of funds. Staffing and services shall be reduced appropriately. 2. Termination for breach: Unless breach is waived by either party in writing, either party may, by written notice to the other party, terminate this contract upon no less that twenty-four (24) hours notice. Said 6 notice shall be delivered by certified mail, return receipt requested, or in person with proof of delivery. If applicable, either party may employ the default provisions in Chapter 13A-1, Florida Administrative Code. Waiver of breach of any provision 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 the contract. The provisions herein do not limit either party right to remedies at law or to damages. 3. Termination at will: This contract may be terminated by either party upon no less than thirty (30) days notice, without cause. Said notice shall be delivered by certified mail, return receipt requested, or in person with proof of delivery. C. Notice and contact: The department's contract manager for this contract is Diana Mellon -Lacey The county representative for this contract is James Roberts In the event that different representatives are designated by either party after execution of this contract, notice of the name and address of the new representative will be rendered in writing to the other party and said notification attached to originals of this contract. D. Modification: Modifications of provisions of this contract shall, unless otherwise specified in Attachment I, be enforceable only when they have been reduced to writing and duly signed by both parties to this contract. E. Name and address of payee: The name and address of the official payee to whom the payment shall be made is: County Health Unit Trust Fund, Monroe County, Key West F. All terms and conditions included: This contract and its attachments as referenced, (Attachment I through IX), contain all the terms and conditions agreed upon by the parties. 7 In WITNESS THEREOF, the parties hereto have caused this 52 page contract to be executed by their undersigned officials as duly authorized. BOARD OF COUNTY COMMISSIONERS STATE OF FLORIDA FOR MO OE COUNTY DEPARTME H TH SIGNSZ SIGNED BY: (Depar ment Authority) �aclG London Keith Be"elas TITLE°•� -Mayor DATE: i�i`6 - ; /a , l 9' 9 1 r ' ATTESTED TO ANNY L. �K(�OLKAGE. Clerk SIGNED='B-�r-. NAME: TITLE: DATE: AND L L SUFFICAS TO E C BY N NN DATE 0 NAME:Richard G. Hunter, Ph.D TITLE:Deputv_State Health Offic r DATE: SIGNED BY: CHD Director/Administrator NAME: Stephanie A. Walters TITLE: Administrator D• / ATTACHMENT I SPECIAL PROVISIONS I. County Health Department Trust Fund: Both parties agree: A. That all funds to be expended by the CHD shall be deposited in the County Health Department Trust Fund maintained by the state treasurer. B. That all funds deposited in the County Health Department Trust Fund which are subject to this contract shall be expended by the department solely for services rendered by the CHD as specified in this contract. Nothing shall prohibit the rendering of additional services not specified in this contract. C. That funds deposited in the County Health Department Trust Fund for the CHD in Monroe County shall be accounted for separately from funds deposited for other CHDs, and shall be used only for public health department services in Monroe County. If actual expenditures should exceed the total planned expenditure amount for either the county or the state as agreed to in this contract, the CHD will, by agreement between the department and the county, draw down from the trust fund balance, if any, to cover the excess expenditures, or will cut back services to come within budget. D. That any surplus/deficit funds, including fees or accrued interest, remaining in the County Health Department Trust Fund account at the end of the contract year shall be credited/debited to the state or county, as appropriate, based on the funds contributed by each and the expenditures incurred by each. Expenditures will be charged to the program accounts by state and county based on the ratio of planned expenditures in the core contract, then funding from all sources is credited to the program accounts by state and county. The equity share of any surplus/deficit funds accruing to the state and county is determined each month and at contract year end. Surplus funds may be applied toward the funding requirements of each participating governmental entity in the following year. However, in each such case, all surplus funds, including fees and accrued interest, shall remain in the trust fund and shall be accounted for in a manner which clearly illustrates the amount which has been credited to each participating governmental entity. The planned use of surplus funds shall be reflected in Attachment II, Part I of this contract, with special projects explained in Attachment VIII: 1) Funds designated for Special Projects must be used for capital projects and durable goods without significant recurring costs. Examples of projects meeting this criteria include construction and renovation of current facilities and associated infrastructure; purchase of information system hardware/software and purchase of telecommunications equipment. Examples of items not meeting this criteria include grant funds for direct services such as tobacco prevention and provision of child safety seats; staff salaries; retirement obligations; rent/leases and funds held in anticipation of Medicaid paybacks and/or budget reductions. The total amount of funds anticipated to be expended for special projects during the contract year must be shown in Part 1 of Attachment II, of this Contract. This includes funds to complete unfinished projects from previous years as well as for projects initiated during the contract year. Expenditure for Special Projects must be recorded in SAMAS with the appropriate Level 5 Organizational Code. More detailed Special Project information, including description and cost by each project, must be listed in Attachment VIII. 2) A cash reserve of 12 percent represents approximately six weeks of operating funds. Ongoing cash reserves in excess of 12 percent should be programmed to services. E. There shall be no transfer of funds between the three levels of services without a contract amendment duly signed by both parties to this contract and the proper budget amendments unless the CHD director/administrator determines that an emergency exists wherein a time delay would endanger the public's health and the Deputy Secretary for Health has approved the transfer. The Deputy Secretary for Health shall forward written evidence of this approval to the CHD within 30 days after an emergency transfer. F. That either party may increase or decrease funds to this contract by notifying the other party in writing of the amount and purpose for the increased/decreased funding, and allowing 30 days for written objection before the additional funds are released for expenditure or the state allocation is decreased. A decrease in funds must be related to a reduction, shortfall, or sequestering of anticipated appropriations. 10 G. That the contract shall include as Part III of Attachment II a section entitled "Planned Staffing, Clients, Service and Expenditures by Type of Service within Each Level of Service". This section shall include the following information for each type of service area within each level of service: - the planned number of full-time equivalents (FTE's) by level of service; - the planned number of services to be provided; - the planned number of individuals/departments to be served; and - the planned state and county expenditures. Expenditure information shall be displayed in a quarterly plan to facilitate monitoring of contract performance. H. That adjustments in the planned expenditure of funds for each type of service within each level of service are permitted without an amendment to this contract. I. That the CHD shall submit quarterly reports to the county and the department which shall include at least the following sections: 1. A transmittal letter briefly summarizing CHD activity year-to-date; 2. DE385L1 - "CHD Contract Management Variance Report; 3. DE58OL1 - "Analysis of Fund Equities"; and 4. A written explanation of the variances reflected in the DE385L1 report for each quarter of the contract year if the CHD exceeds the tolerance levels as specified below as of the end of the quarterly report period: a. The cumulative percent variance cannot exceed by more than 25 percent the planned expenditures for a particular type of service or fall below planned expenditures by more than 25 percent. b. However, if the cumulative amount of variance between actual and planned expenditures for the report period for a program service area does not exceed one percent of the cumulative planned expenditures for the level of service in which the type of service is included, a variance explanation is not required. 11 5. The CHD Contract Management Variance Report shall: a. Explain the reason expenditures in which exceeds established above; for the variances in any program service area the tolerance levels b. Specify steps that will be taken to comply with the contract expenditure plan, including a contract amendment, if necessary; and C. Provide a timetable for completing the steps necessary to comply with the plan. Failure of the CHD to accomplish the planned steps by the dates established in the written explanation shall constitute non-performance under the contract and the county or the department may withhold funds from the contract or take other appropriate administrative action to achieve compliance. J. The required dates for the CHD director's/ administrator's quarterly report to the county and the department shall be as follows: 1. March 1, 1998 for the report period October 1, 1997 through December 31, 1997; 2. June 1, 1998 for the report period October 1, 1997 through March 31, 1998; 3. September 1, 1998 for the report period October 1, 1997 through June 30, 1998; and 4. December 1, 1998 for the report period October 1, 1997 through September 30, 1998. II. Fees: A. Environmental regulatory fees: The department shall establish by administrative rule, fees for environmental regulatory functions designated in Attachment IV of this contract and conducted by the CHD. Such fees shall supersede any environmental regulatory fees existing prior to the effective date of the department's rule. The county may, however, establish fees pursuant to section 381.0016, Florida Statutes, which are not inconsistent with department rules and to state or federal law, after consultation with the department. 12 B. Communicable disease service fees: The department may establish by administrative rule, fees for communicable disease services, other than environmental regulatory services, designated in this contract and conducted by the CHD. The county may establish fees pursuant to section 381.0016, Florida Statutes, which are not inconsistent with department rules and other state or federal law. All state or federally authorized communicable disease services fees shall be listed in Attachment IV of this contract. All county authorized communicable disease services fees shall be listed in Attachment V of this contract. C. Primary Care Fees: The county may establish fees for primary care services designated in this contract and conducted by the CHD except for those services for which fee schedules are specified in federal or state law or regulations. Both parties further agree: 1. That such fees shall be established by resolution of the Board of County Commissioners, if promulgated by the county, or by administrative rule, if promulgated by the department; 2. That there shall be no duplication of fees by the department and the county for communicable disease or primary care services provided by the CHD; 3. That primary care fees shall be listed in Attachment V (county) of this contract. D. Communicable disease and primary care fees shall automatically be established by the department and the county at the Medicaid rate upon signature of this contract unless otherwise specified by either party according to procedures set forth in II, B and C of this section. E. Collection and use of fees: Both parties agree that: 1. Proceeds from all fees collected by or on behalf of the CHD, whether for environmental, communicable disease, or primary care services, shall only be used to fund services provided by the CHD; 13 2. All fees collected by or on behalf of the CHD shall be deposited with the State Treasury and credited to the County Health Department Trust Fund or other appropriate state account if required by Florida Statute or the State Comptroller. III. Service Policies and Standards: Both parties agree that the CHD shall adhere to the service policies and standards published by the department in program manuals and other guidelines provided by the department, where they exist, as a guide for providing each funded service specified in Attachment II, Part III of this contract. IV. Fair Hearing Guidelines: 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 IX of this contract. The CHD shall post in a readily accessible location and visible to all clients either procedures or a poster informing clients how they may contact the Human Rights Advocacy Committee (HRAC). V. Personnel: Both parties agree: A. The CHD shall have at least the following employees: 1. A director or administrator appointed by the Secretary of the department after consultation with the Deputy Secretary for Health or Deputy State Health Officer and with the concurrence of the Board of County Commissioners; 2. A full-time community health nurse; 3. An environmental health specialist; and 4. A clerk. 14 B. That all department employees working in the CHD shall be supervised by the department and subject to Department of Management Services rules and department rules. C. Staffing levels shall be established in this contract in Attachment II, Part III as FTE's, and may be changed in accordance with the availability of funds and/or program needs. D. The number and classification of employees working in the CHD that are county employees rather than department employees shall be listed in Attachment VI of this contract. VI. Facilities: Both parties agree that: A. CHD facilities shall be provided as specified in Attachment VII of this contract. This attachment shall include a description of all the facilities used by the CHD, including the location of the facility and by whom the facility is owned; B. The county shall own the facilities used by the CHD unless otherwise provided in Attachment VII of this contract; and C. Facilities and equipment provided by either party for the CHD shall be used for public health services provided that the county shall have the right to use such facilities and equipment, owned or leased by the county, as the need arises, to the extent that such use would not impose an unwarranted interference with the operation of the CHD. VII. Use of Funds for Lobbying Prohibited: The CHD agrees to comply with the provisions of section 216.347, Florida Statutes, which prohibits the expenditure of contract funds for the purpose of lobbying the Legislature or a state agency. VIII. Method of payment: A. The county shall deposit its annual contribution to the County Health Department Trust Fund as specified below. B. The department shall release state contributions to this contract as follows: 15 1. Funds appropriated as "Aid to Local Government" shall be released in four quarterly amounts, at the beginning of each quarter of the contract year; 2. WIC and other state funds appropriated in a cost reimbursement category (e.g. expense and special) shall be released on the basis of invoices documenting expenditures. IX. Laboratory and Pharmacy Support: The department agrees to supply laboratory and pharmacy support services for the CHD at least at the level provided in the prior state fiscal year if funds are available. X. Emergencies: Both parties agree, to the extent of their respective resources, that they may assist each other in meeting public health emergencies. XI. Sponsorship: In compliance with section 286.25, Florida Statutes, the CHD assures that all notices, informational pamphlets, press releases, advertisements, descriptions of the sponsorship of the program, research reports, and similar public notices prepared and released by the CHD shall include the statement: Sponsored by Monroe County Health Department and the "State of Florida, Department of Health." If the sponsorship reference is in written material, the words, "State of Florida, Department of Health" shall appear in the same size letters or type as the name of the organization. XII. Indicate in the space below the income eligibility limit for comprehensive primary care clients. 100 t of OMB Poverty Guidelines. XIII.Program Specific Reporting Requirements: Specific information not available through CIS/HMC or SAMAS must be supplied by completing the following: A. Specify in the space below the minimum number of clients who will receive comprehensive primary care services (clients registered in Program Component 88 who will receive services during this contract period). 16 B. Specify in the space below the amount of any county funds earmarked by the Board of County Commissioners for hospitalization in the Improved Pregnancy Outcome program if such funds are deposited in the County Health Department Trust Fund and included in the IPO line on Attachment II, Part III, of this contract. $ 0 C. Complete the planned Family Planning budget information on the following page for this contract period. XIV. County Fees: Those individual fees established by the county per ordinance or resolution and listed in Attachment V shall automatically be adjusted to, at least, the Medicaid reimbursement rate without formal amendment to this contract in accordance with section 154.06, Florida Statutes, should said reimbursement rate be increased or decreased. See Page 13, Section D. 17 r) O O N O t9 O Q w } U can a LLM z O U w O LL. U F O (' co a) °a C9 O : c z z z g CL } J_ < x LL X 0 w N z z Q J CL z w - CL a) w Q O a) a) N J Q w y_. F- z x o °= U I— N N U N :a r O r) O O O co c1r) ti N N N r) I oI t Al O CM O IC6 ti co a ivU� > No v c la— c m CL 'NoU) s o x cti ATTACHMENT II PLANNED FUNDING AND EXPENDITURES LLJ U Z Q m p Z D LL z D J LU Z I O U LL O w N D p ui Z Z d Q n. 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O 11 UHu 11 1 qq n 1 Hztl N w 13, m 11 O NI 1 >` rl II S4 U 1 w 11 A > 1 i e rl U E N 1 II :3 0) 1 11 11 z m 1 C) N II M O II H w u a w ro U U 11 O? m I H O 11 10 1L 1 II i4 ••'1 •.i I t II z cn 11 ' Ey II ^ z M II E O 1 .1 Z 11 I a II 1 � H II w II 1 -r1 E+ u 1 O to II I U II ' w it 1 H n 1 a u 1 w n 1 x u 1 t-i u 1 H II 1 IH a " II II 1 a u 11 1 F'1 II 1 II 1 II 1 w n 1 II 1 II � II I U O O O 00 00 O rl I r. O o 0 � N C a 1 � 1 � 1 I O O o 0 0 0 o, In d1 0 0 0 O to I N� �p I O N I In I 000 0 00 0 I 1 O o 0 0 0 0 1 In _I 0 0 C4 m rt �' N i v I V1 I I f7 I I 000 O O O o% I O% H 'n In Ln ka r t` N N I It I (n kD m I W o I r+ N I 0 I I r1 coo 0 O o I Ch I � In 1n Ln N r I CD In I OD H I O\ o 0 0 o O o In U1 1A 1n 1-4 r N N I rn . 1 f+1 I N I 01 I rn O O O 0 N '�Ln In � [- N N I m 1 r 1 m I I 1 V' O O a' 00 M U1 N Na N I CD I m 1 I (n I 01 I I O Ul I I O rn I to N 1Q ATTACHMENT III CIVIL RIGHTS CERTIFICATE The applicant provides this assurance in consideration of and for the purpose of obtaining federal grants, loans, contracts (except contracts of insurance or guaranty), property, discounts, or other federal financial assistance to programs or activities receiving or benefiting from federal financial assistance. The provider agrees to complete the Civil Rights Compliance Questionnaire, HRS Forms 946 A and B (or the subsequent replacement if adopted during the contract period), if so requested by the department. The applicant assures that it will comply with: 1. Title VI of the Civil Rights Act of 1964, as amended, 42 U.S.C., 2000 Et seq., which prohibits discrimination on the basis of race, color or national origin in programs and activities receiving or benefiting from federal financial assistance. 2. Section 504 of the Rehabilitation Act of 1973, as amended, 29 U.S.C. 794, which prohibits discrimination on the basis of handicap in programs and activities receiving or benefiting from federal financial assistance. 3. Title IX of the Education Amendments of 1972, as amended, 20 U.S.C. 1681 et seq., which prohibits discrimination on the basis of sex in education programs and activities receiving or benefiting from federal financial assistance. 4. The Age Discrimination Act of 1975, as amended, 42 U.S.C. 6101 et seq., which prohibits discrimination on the basis of age in programs or activities receiving or benefiting from federal financial assistance. 5. The Omnibus Budget Reconciliation Act of 1981, P.L. 97-35, which prohibits discrimination on the basis of sex and religion in programs and activities receiving or benefiting from federal financial assistance. 6. All regulations, guidelines and standards lawfully adopted under the above statutes. The applicant agrees that compliance with this assurance constitutes a condition of continued receipt of or benefit from federal financial assistance, and that it is binding upon the applicant, its successors, transferees, and assignees for the period during which such assistance is provided. The applicant further assures that all contracts, subcontractors, subgrantees or others with whom it arranges to provide services or benefits to participants or employees in connection with any of its programs and activities are not discriminating against those participants or employees in connection with any of its programs and activities are not discriminating against those participants or employees in violation of the above statutes, regulations, guidelines, and standards. In the event of failure to comply, the applicant understands that the grantor may, at its discretion, seek a court order requiring compliance with the terms of this assurance or seek other appropriate judicial or administrative relief, to include assistance being terminated and further assistance being denied. ATTACHMENT IV STATE FEE SCHEDULES, BY SERVICE LEVEL OF SERVICE/SERVICE: I. COMMUNICABLE DISEASE: AIDS, HIV, Alternate Site Testing PRIMARY CARE: Fee $20 (optional) Estimated Annual Revenue Accruing To The CHD Trust Fund Subtotal $ 1000.00 Subtotal $ 2500.00 p- C ao ........... :Vc SIN 0 0 ii a a -A x.4.0.- .21 1 vi 4) cm cc CL V E W °.„ ° ,r LL. in d a V N W a a w U W W W m EH Dr OD o� I 01 ti C co C; m a w S&1 A W U WW W CD ON ENat I at xa H z 0 a H W o� L a CD C co W a A w U to rA WW W m m C1 EH I ch 01 a� a E-+ z 0 a H W W a ca W x U N W x EH x m V d E C9 y ATTACHMENT V COUNTY FEE SCHEDULES, BY SERVICE LEVEL OF SERVICE/SERVICE: Fee/Range I. COMMUNICABLE DISEASE: Immunizations Varied STD Medicaid HIV Testing 0 Tuberculosis Varied Vital Statistics Varied II. PRIMARY CARE: Chronic Disease Varied Family Planning Medicaid Comprehensive Adult Health Medicaid Comprehensive Child Medicaid III. ENVIRONMENTAL HEALTH: Estimated Annual Revenue Accruing To The CHD Trust Fund 15,000 2,000 0 2,000 700 Subtotal $ 19.700 10,000 5,000 20,000 50,000 Subtotal S 85_,000 Group Care Facilities Varied DEP Storage Tank Program Varied Small Quantities Hazardous Waste Varied _ OSTDS Operating Permit Revenue 160.00 12,000 102,077 65,000 25,000 Subtotal $204,077 Total County Fees $308.777 �'1RlICn nN? !'I CLASSIFICATI011 AUD Y=zR OT EI�LOYl�WOMEM IN "a COUNTY MMLIC RULTR UNIT VRO MM PUD W MM COMM,, HY LZV= OF SERVICE, It UWaCAM �,ei ;: p z4: Tuberculosis Sexually Transmitted Disease HIV PRIMARY CARE Basic Care Middle & Upper Keys Nutritionist EPSDT High Risk Adults & Children Various *Senior Community Health Nurse *Direct Services Aide 0.5 0.5 Advanced Registered Nurse Practitioner 1.0 *Nutritionist 0.5 *Advanced Registered Nurse Practitioner 0.5 Senior Community Health Nurse 1.0 Environmental Health Specialist *'Secretary Specialist *Indicates partially funded position 1.0 0.5 ATTACHMENT VII FACILITIES USED BY THE CHD Facility DescriQn T'cc-ation Monroe County Health Department 5100 College Road Key West, Florida Monroe County Health Department Monroe County Health Department Health Care Center 148 Georgia Avenue Tavernier, Florida 3333 Overseas Highway Marathon, Florida 1200 Kennedy Drive Key West, Florida Monroe County Monroe County Monroe County The Lower Florida Keys Health Systems, Inc. Roosevelt Sands Community Health Douglas Square City of Key Resource Center 105 Olivia Street West Key West, Florida ATTACHMENT VIII DESCRIPTION OF USE OF CHD TRUST FUND BALANCES FOR SPECIAL PROJECTS, IF APPLICABLE (From Attachment II, Part I) None ATTACHMENT IX PROGRAM SPECIFIC REPORTING REQUIREMENTS AND PROGRAMS REQUIRING COMPLIANCE WITH THE PROVISIONS OF SPECIFIC MANUALS Some health services must comply with specific program and reporting requirements in addition to the CIS/HMC minimum data set and the SAMAS 2.2 requirements because of federal or state law, regulation or rule. If a county health department is funded to provide one of these services, it must comply with the special reporting requirements for that service. The services and the reporting requirements are listed below: Service Reauirement 1. Sexually Transmitted Disease Requirements as specified Program in HRSM 150-22*. Requirements as specified in Policy 87-7-5 regarding State Health Office STD Program review and approval of personnel/budget actions. 2. Dental Health Monthly reporting on HRSH Form 1008*. Special Supplemental Food Program for Women, Infants and Children. 4. Improved Pregnancy Outcome 5. Family Planning Service documentation and monthly financial reports as specified in HRSM 150-24* and all federal, state and county requirements detailed in the program manuals and published procedures. Requirements as specified in HRSM 150-13A*. Quarterly reports of services and outcome on HRSH Form 3096*. Program Quarterly Progress Report, Quarterly Summary Report, Presumptive Eligibility/ Medicaid Determination Log by all providers authorized to determine presumptive eligibility. Periodic financial and programmatic reports as specified in HRSM 150.27*. t 1. NO 7. M a ATTACHMENT IX (Continued) Immunization CHD Program Chronic Disease Program Environmental Health 10. AIDS Program Periodic reports as specified by the department regarding the surveillance/investigation of reportable vaccine preventable diseases, vaccine usage accountability, the assessment of various immunization levels and forms reporting adverse events following immunization. Requirements as specified in HRSM 150-3* and HRSM 50-9*. Requirements as specified in the Reference Guide to CHIP and HRS* forms identified in HRSM 150-8* and 150-12*. Requirements as specified in HRSM 50-10*. Requirements in HRSM 150-30* and case reporting on CDC Form 50.42. Socio-demographic data on persons tested for HIV in CHD clinics should be reported on CDC HIV Counseling & Testing Report Form. These reports are to be sent to the Headquarters AIDS office within 30 days of the initial post-test appointment regardless of clients' return. 11. School Health Services HRSM 150-25*, including the requirement for an annual plan as a condition for funding. *or the subsequent replacement if adopted during the contract period.