FY1997 12/18/199630annp 1C. Iftotjagc
BRANCH OFFICE CLERK OF THE CIRCUIT COURT
3117 OVERSEAS HIGHWAY MONROE COUNTY
MARATHON, FLORIDA 33050 500 WHITEHEAD STREET
TEL (305) 289-6027 KEY WEST, FLORIDA 33040
FAX (305) 289-1745 TEL. (305) 292-3550
FAX (305) 295-3660
MEMORANDUM
TO: Stephanie Walters
M.C.P.H.UAdministrator
FROM: Ruth Ann Jantzen, Deputy Clerk •
DATE: January 22, 1997
BRANCH OFFICE
88820 OVERSEAS HIGHWAY
PLANTATION KEY, FLORIDA 33070
TEL (305) 852-7145
FAX (305) 852-7146
At the December 18, 1996 County Commission Meeting, the Board granted
approval and authorized execution of a Contract between Monroe County and the
Florida Department of Health and Rehabilitative Services (Department of Health,
effective 1/1/97), for the operation of the Public Health Unit.
Enclosed please find two duplicate originals of the above Contract, executed on
behalf of Monroe County. Please be sure that one fully executed copy is returned to this
office as soon as possible.
If you have any questi6us regarding the above, please do not hesitate to contact
this office.
Enclosure
cc: County Attorney
Finance
County Administrator, w/o document
File
i.
STANDARD CONTRACT BETWEEN
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
: we
STATE of FLORIDA DEPARTMENT OF HEALTH
Pursuant to Chapter 154, Florida Statutes this contract is
entered into between the Department of Health and Rehabilitative
Services, 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
county public health unit, hereinafter referred to as the CPHU,
the sources and amount of funds that will be committed to the
provision of these services, the administrative and programmatic`
requirements which will govern the use of these funds, and the
respective responsibilities of the department and the county in
enabling the CPHU "to promote, protect, maintain, and improve the
health and safety of the citizens and visitors through promotion
of the public health, the control and eradication of preventable
diseases, and the provision of primary health care for special
populations."
"Department", the State of Florida, Department of Health and
Rehabilitative Services, or its successor in interest and is
specifically intended to include the officers, agents, and
employees of the Department. It is expressly understood by the
parties that governmental reorganization occurs within the State
of Florida and that named entity which is responsible for the
operation of the County Public Health Units would change upon the
formation of the new Department of Health during the duration of
this contract. Upon the formation of the new Department of
Health, the name "County Public Health Units" shall be changed to
"County Health Departments" as amended in Section 154.02, F.S.
The word, "Department", as used herein, is intended to subtend -
and include the entity which is reponsible for the County Public
Health Units in the State of Florida, regardless of name.
I General Provision:
Both parties agree that the CPHU 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 State Laws and Regulations:
Both parties agree that the CPHU 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 CPHU 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 CPHU to comply
with the following reporting requirements:
1. The revenue and expenditure requirements in the
State Automated Management Accounting Subsystem;
2. The client registration and services 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, or the equivalent as
approved by the State Health Office. Any
reporting system used by or on behalf of the CPHU
2
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 CPHU is responsible for assuring that all
contracts with service providers include
provisions that all subcontracted services be
reported back to the CPHU 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;
5. All appropriate CPHU 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";
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 Procedures:
f � "
All county public health units will adhere to the State of
Florida purchasing rules and regulations except when
purchasing through the county to obtain a better price or
service. When purchases are more cost effective through the
county, the county procedures and regulations will be
followed. Copies of the State Purchasing Rules and
Regulations shall be maintained at the CPHU and if any
purchases are made through the county system, the County
Procurement procedures must also be in place for audit and
management purposes. When purchasing through the County
system, the order and payment must be documented to note the
county procedures were used because they were more cost
effective.
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
CPHU or its subcontractor or assignee.
VI. Safeguarding Information:
Both parties agree that the CPHU 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) 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 CPHU 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
conditions of approval that the department and the county
shall deem necessary.
VIII.Subcontracts:
Both parties agree that the CPHU shall be permitted to
execute subcontracts with the approval of the delegated
authority in the department for services necessary to enable
the CPHU to carry out the programs specified in this
4
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 CPHU 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 property insurance
coverage for all furnishings and equipment in health unit
offices and buildings. Buildings used by the health unit
that are owned by the County, and all furnishings and
equipment owned by the County, including vehicles, shall be
insured through the County's insurance program, which shall
be either a self-insurance program or insurance purchased by
the County. The health unit shall pay for the annual cost
of this insurance, upon receipt of an invoice from the
County's Risk Management Director. For any buildings,
furnishings and equipment used by the health unit but not
owned by the County, it is the responsibility of the health
unit to obtain adequate insurance coverage either through
the state, or private insurance.
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
$ 2,583,949; and the State share of all state
authorized fees in an anticipated amount of $0. In
addition, all "OTHER" state revenues from whatever
sources to be appropriated to the HRS County Public
Health Unit Trust Fund for services to be provided by
the county health unit in an amount of $ 1,698,206, for
a grand total State cash contribution of
$ 4,282,155. The State's obligation to pay under this
contract is contingent upon an annual appropriation by
the legislature.
5
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 $ 281,000. In addition, the
county shall provide its share of all county authorized
fees in an anticipated amount of $ 144,600. These
amounts, plus any "OTHER" local revenues in the amount
of $ 42,000, includes all revenues from whatever
sources to be appropriated to the HRS County Public
Health Unit Trust Fund for services to be provided by
the county health unit for a grand total county cash
contribution of $_ 467,600
XI. The department and the county mutually agree:
A. Effective date:
1. This contract shall begin on October 1, 1996 or
the date on which the contract has been signed by
both parties, whichever is later.
2. This contract shall end on September 30, 1997.
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
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
0
C.
10
E.
F.
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's 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.
Notice and contact:
The contract manager for the department for this
contract is Stephanie A. Walters. CHD Administrator.
The representative of the county for this contract is
James Roberts. Monroe County Administrator. 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.
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.
Name and address of payee:
The name and address of the official payee to whom the
payment shall be made is: Public Health Unit Trust
Fund, Monroe County, Florida.
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 58
page contract to be executed by their undersigned officials
as duly authorized.
NAME: "J
TITLE: tACIA In% —
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND
REHABILITATIVE SERVICES
SIGNED BY: 4 1
(D rtmen{{��t Authority)
NAME: �C �tl.�rt�- (9 " N", ,
TITLE • -7) t c
DATE: ( 1,111q4
ATTE$ ED TO:
t ATTEST DANNY L KOLHAOE CU3K
BY SIGNED BY
RK
NAME:
TITLE:
DATE:
CPHU Director/Administrator
NAME: �S
i
TITLE: �"tfc'
DATE : �y A 7
APPROVED AS TO FORM
Amn 08FFICIEN
NOiinH dppi O
Wb03 01 S`d a3n0 d`d
ATTACHMENT I
SPECIAL PROVISIONS
I. County Public Health Unit Trust Fund:
Both parties agree:
A. That all funds to be expended by the CPHU shall be
deposited in the County Public Health Unit Trust Fund
(CPHUTF) maintained by the state treasurer.
B. That all funds deposited in the County Public Health
Unit Trust Fund shall be expended by the department
solely for services rendered by the CPHU 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 Public Health
Unit Trust Fund for the CPHU in Monroe County shall be
accounted for separately from funds deposited for other
CPHUs, and shall be used only for public, health unit
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 HRS county public health unit 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 CPHUTF 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
E
contract, with special projects explained in Attachment
VIII:
1) Funds designated for Special Projects must go
for capital projects and durable goods without
significant recurring costs. Examples of projects
meeting this criteria include construction and
renovation of 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. Special project amounts in 113" above
should reflect the total amount of funds anticipated to
be expended for special projects during the contract
year. This includes funds to complete unfinished
projects from previous years as well as for projects
initiated during the contract year. More detailed
Special Project information, including description and
cost by each project, should 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 transfers 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 CPHU
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 CPHU
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/units 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 CPHU shall submit quarterly reports to the
county and the department which shall include at least
the following sections:
1. A transmittal letter briefly summarizing CPHU
activity year-to-date;
2. DE385L1 - "CPHU Contract Management Variance
Report;
3. DE58OLl - "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 CPHU 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.
5. The CPHU Contract Management Variance Report
shall:
a. Explain the reason for the variances in
expenditures in any program service area
which exceeds the tolerance levels
established above;
b. Specify steps that will be taken to comply
with the contract expenditure plan, including
a contract amendment, if necessary; and
C. Provide a time table for completing the steps
necessary to comply with the plan. Failure
of the CPHU 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 CPHU director's/
administrator's quarterly report to the county and the
department shall be as follows:
1. March 1, 1997 for the report period October 1,
19.E through December 31, 199E;
2. June 1, 1997 for the report period October 1,
1996 through March 31, 1997;
3. September 1, 19977 for the report period October
1, 1996 through June 30, 19-97; and
4. December 1, 1997 for the report period October 1,
1996 through September 30, 1997.
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
CPHU. Such fees shall supersede any environmental
regulatory fees existing prior to the effective date of
12
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 the statutes, after consultation with the
department.
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 CPHU. The county may
establish fees pursuant to section 381.0016, Florida
Statutes, which are not inconsistent with department
rules and other statutes. 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 CPHU
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 CPHU;
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:
13
1. Proceeds from all fees collected by or on behalf
of the CPHU, whether for environmental,
communicable disease, or primary care services,
shall only be used to fund services provided by
the CPHU;
2. All fees collected by or on behalf of the CPHU
shall be deposited with the State Treasury and
credited to the County Public Health Unit 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 CPHU 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 provider shall establish a system through which
applicants for services and current clients may present
grievances over denial, modification or termination of
services. The contractor 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 provider 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 CPHU shall have at least the following employees:
l.. A director or administrator appointed by the
Secretary of the department after consultation
with the Deputy Secretary for Health and_ with the
concurrence of the Board of County Commissioners;
14
2. A full-time community health nurse;
3. An environmental health specialist; and
4. A clerk.
B. That all department employees working in the CPHU shall
be supervised by the department and subject to
Department of Management Services 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 CPHU that are county employees rather than
department employees shall be listed in Attachment VI
of this contract.
VI. Facilities:
Both parties agree that:
A. CPHU 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
CPHU, including the location of the facility and by
whom the facility is owned;
B. The county shall own the facilities used by the CPHU
unless otherwise provided in Attachment VII of this
contract; and
C. Facilities and equipment provided by either party for
the CPHU 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 CPHU.
VII. Use of Funds for Lobbying Prohibited:
The CPHU 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.
15
VIII.Method of payment:
A. The county shall deposit its annual contribution to the
County Public Health Unit Trust Fund as specified
below.
B. The department shall release state contributions to
this contract as follows:
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 CPHU 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,
provider 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 provider shall
include the statement:
Sponsored by Monroe County Health Department
Provider
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.
16
XII. Indicate in the space below the income eligibility limit for
comprehensive primary care clients.
00
61. . •u: - .- �-
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).
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 CPHU Trust
Fund and included in the IPO line on Attachment II,
Part III, of this contract.
W"I
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 F.S. 154.06 should said reimbursement,
rate be increased or decreased. See Page 12, Section D.
17
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PART III
PLANNED STAFFING, CLIENTS, AND EXPENDITURES BY PROGRAM SERVICE
AREA WITHIN EACH LEVEL OF SERVICE
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ATTAiT 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 quaranty),
property, discounts, or other federal financial assistance
to programs or activities receiving or benefitting from
federal financial assistance. The provider agrees to
complete the Civil Rights Compliance Questionnaire, HRS
Forms 946 A and B, 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
receivinq or benefittinq 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 benefitting
for 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 benefittinq
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 Qf age in programs or
activities receiving or benefitting for 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 benefitting from federal
financial assistance.
6. All regulations, guidelines and standards lawfully
adopted under the above statutes.
35
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, transfer*", and
assignees for the period durijW. which ''i�uc�;_ assistance is
provided. The applicant further assures that all contracts,
subcontractors, subgrantees or others with whoa it arranges
to provide services or benefits to participants or mWloyoes
in connection with any of its programs and activLt1" 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.
W
ATTACHMENT IV
STATE FEE SCHEDULES, BY SERVICE
LEVEL OF SERVICE/SERVICE•
AIDS, HIV, Alternate Site Testing
37
F-=
$20 (optional)
Estimated
Annual Revenue
Accruing To The
CPHU Trust Fund
Subtotal $ 0
Subtotal $_0
Summary of Environmental Health Surcharges/Transfers
July 1, 1996
All surcharges/transfers are deposited to the Statewide Health
Programs, Administrative Trust Fund, GF = 10, SF = 2, FID = 021042,
BE = 600500200, IBI = 00, OCA = appropriate for fee,
Object Code = appropriate for fee, State Program = 0402000004,
SI = RV, unless otherwise noted.
Title $ Amount
OSTDS Permit (Standard subsurface,
fill or mound system
OSTDS Repair Permit
OSTDS Variance Fee (50%)
Single
.Family
Inspection System Previously In Use
New System Installation Inspection
Research Fee Collected Until 6/30/2002
OSTDS Permit (Standard, subsurface,
fill or mound)
Septic Tank Manufacturer's Inspection
Mobile Home/RV Parks
Food Hygiene Permit
Tanning Facilities
Public Water Construction Permit
Private Water Construction Permit
Public Water Annual
Public Swimming Pools and
Bathing Places
Lab Fee Chemical Analysis
5.00
5.00
75.00
100.00
5.00
5.00
5.00
10%
1ok
10%
100.00
Headqtrs
Revenue
Object
Code
001203
001203
001204
001204
001203
001203
001201
001203
001113
001132
001144
001164
001165
001166
001205
001170
Headqtrs
OCA
lE000
lE000
BY000
BY000
lE000
lE000
B9000
lE000
UQ000
10000
R9000
M5000
M5000
M5000
K3000 (1)
J5A00 (2)
(1) Deposited to Statewide Health Programs, Planning and Evaluation
Trust Fund. GF = 20, SF = 2, FID = 531003, BE = 60500200, IBI = 00,
OCA = K3000, Object Code = 001205, State Program = 0402000004, SI = RV
(2) Deposited to Statewide Health Programs, Planning and Evaluation
Trust Fund. GF = 20, SF = 2, FID = 531003, BE = 60500200, IBI = 00,
OCA = J5A00, Object Code = 001170, State Program = 0402030001, SI = RV
38
ATTACHMENT IV
STATE FEE SCHEDULES, BY SERVICE
III. ENVIRONMENTAL HEALTH:
Revenue
Object
A. ONSITE SEWAGE DISPOSAL (OSTDS) PROGRAM Fee Code
The following fees are required to accompany application for site
evaluations, construction or repair permits, and other services provided by
the department.
Application for permitting of an onsite
sewage treatment and disposal system which
includes application and plan review,
except repairs ..................................$
Site evaluation for a new system
25
60
.................$
Site evaluation for a system repair ..............$
40
Site re-evaluation, new or repair ................$
40
Permit for new systems, including standard
subsurface, filled or mounded system ............
$ 55
New system installation inspection ...............$
55
Research fee to be collected in addition, and
concurrent with the permit for a new system
installation fee until 6/30/2002................$
5
Repair permit issuance which includes inspection.$
50
Inspection of system previously in use ...........
$ 50
Reinspection fee per visit for site inspections
after system construction approval ...............$
25
Installation reinspection of non -compliant
system per each site visit ......................$
25
System abandonment permit, includes permit
issuance and inspection ........................$
40
Annual operating permit fee for systems in
industrial, manufacturing, and equivalent
areas, and for systems receiving commercial
sewage waste ....................... .............
$150
Amendments or changes to the operating
permit during the permit period per change
or amendment ....................................$
25
Aerobic treatment unit operating permit
perannum.......................................
$150
Tank manufacturer's inspection per annum.........
$100
Septage disposal service permit per annum........
$ 50
Additional charge per pumpout vehicle ............
$ 25
Portable or temporary toilet service permit
perannum.......................................$
50
Additional charge per pumpout vehicle ............
$ 25
Septage stabilization facility inspection
fee per annum per facility ......................$150
Septage disposal site evaluation fee per annum...
$100
Aerobic treatment unit maintenance entity
.permit per annum................................$
25
39
001092
001138
001138
001138
(1)
001134
(1)
001092
(2)
001201
(1)
001133
(1)
001`�92
001092
001092
001092
001136
001092
001137
(4) 001092
001092
001C92
001092
001092
001092
001092
001092
variance appiication for a single family
residence per each lot or building site ......... $150 (3) 001135
variance application for a multi -family or
commercial building per each building site ...... $200 (3) 001135
(1) Includes a $5 surcharge collected by the CPHUs pursuant to construction
permit issuance to be transferred to HSES to provide technical,
monitoring, training and administrative assistance for this program
using revenue object code 001203.
(2) $5 research fee to be transferred to HSES using revenue object code
001201.
(3) 50k of the variance application fee is placed in the applicable CPHU
trust fund; 50% of fee placed in a specific HSES variance account using
revenue object code 001204.
(4) 50t of the septic tank manufacturer inspection fee to be transferred to
HSES to provide engineer review of septic tank designs and onsite
inspections using revenue object code 001203.
The following fees are required to accompany applications for innovative
producC approval, registration of individuals or for a certificate of
authorization for partnerships and corporations. These fees are deposited by
the Onsite Sewage Program Office (HSES).
Application for innovative product approval $500
Application for registration including
initial examination ..............................$ 75
Initial registration ..............................$ 75
Renewal of registration ...........................$ 75
Renewal of inactive registration ..................$100
Certificate of authorization each
two-year period..................................$120
Renewal of inactive certificate of
authorization ................................... $150
40
-Reven�ie,
B. PUBLIC SWIMMING POOLS AND BATHING PLACES Fee Object
Code
Annual Permits:
Up to (and including) 25,000 gallons .......... $ 75 (1) 001145
More than 25,000 gallons ......................$160 (1) 001145
Exempted Condo Pools (over 32 units) .......... $ 50 (1) 001145
Other Fees:
Plan Review (New Construction)................$275 (2) 001092
Plan review for modification of
original construction ......................$100 (2) 001092
Plan/Application review fee for
bathing place development ..................$150
Initial operating permit
(2)
001092
......................$125
Variance Applications .........................$240
(2)
001092
(3)
001145
(1) Ten percent (10%) of the permit fee is transferred to HSEH to provide
training, monitoring, epidemiological support, program evaluations and
technical assistance. Permit fees are prorated on a biannual basis.
The 10% must be coded to the Planning and Evaluation Trust Fund in the
following manner:
GF = 20, SF = 2, FID = 531003, BE = 60500200, IBI = 00, OCA = K3000,
Object Code = 001205, State Program = 0402000004, SI = RV
(2) Fee collected by HSEH, the 12 delegated counties and
District I.
(3) Fee collected by HSEH and the CPHUs then transferred to HSEH.
Revenue
Object
C. MOBILE HOME & RECREATIONAL VEHICLE PARKS Fee Code
Annual Permits:
5 - 14 Spaces..................................$50 (1) 001113
15 - 171 Spaces .......................$3.50/space (1) 001113
172 and above................................$600 (1) 001113
(1) Ten percent (10%) of the permit fee is transferred to HSEH to provide
training, monitoring, epidemiological support, program evaluations and
technical assistance. Permit fees are prorated on a quarterly basis.
The 10% must be coded to the Administrative Trust Fund in the following
manner:
GF = 10, SF = 2, FID = 021042, BE = 60500200, IBI = 00, OCA = UQ000,
Object Code = 001113, State Program = 0402000004, SI = RV
41
D. MIGRANT LABOR CAMPS
Fee
Revenue
Object
Code
Annual Permits:
Facilities
with
5-50 occupants................$125
Facilities
with
51-100 occupants..............$225
Facilities
with
over 100 residents ............
$500
No fees are transferred to headquarters and the permits are not
prorated.
E. BIOMEDICAL WASTE GENERATORS
Annual Permits:
(Except Physician Office Generating less
than 25 lbs./30 days)......... .........:......$ 55
Storage Facilities Permit .....................$ 20
Treatment Facilities Operating Permit ......... $200
Other Fees:
001139
001139
001139
001140
001140
001140
Reinspection (after the first reinspection) ...
$ 25
001092
Late renewal ..................................$
25
001092
Mobile treatment machine registration .........
$ 25
001092
No fees are transferred to headquarters and the permits are not
prorated.
Revenue
Objec:
F. DRINKING WATER Fee Code
Annual Permits:
Public Water Annual Operation Permit- Limited Use
(Annual Operation Permit First Year)..........$ 75 (1) 001166
Public Water Annual Operation Permit -Limited Use
(Annual Operation Permit Second Year
and Beyond) .................................$ 70 (1) 001166
Other Fees:
Public Water Construction Permit -Limited Use..$
75 (1)
001164
Non-SDWA Lab Sample (Sample Collection/Review
of Analytical Results/Health Risk
Interpretation):
Delineated Area .........................$
50
001142
Bacterial Sample Collection .............
$ 40
001142
Chemical Sample Collection ..............$
60
001142
......Combined Chemical/Microbiological .......
$ 65
001142
Private Water Construction Permit
(serving 3 or 4 non -rental residences) .....
$ 40 (1)
001165
Reinspection of Private Water System ..........
$ 25
001092
Reinspection of Public Water System ...........
$ 40
001092
42
Delineated Area Clearance Fee .................$ 50 001092'-
Lab Fee Chemical Analysis .....................$100 (2) 001170
Lab Fee Bacterial Analysis ....................$ 10 (2) 001170
For Approved CPHUs:
Safe Drinking Water Fee 001211
CPHU retains 80a of the cost and transfers 20a
to DEP (DEP will bill the CPHU annually)
Fines and Forfeitures 012020
Planning and Evaluation Trust Fund:
Potable Water Analysis Fee. ................$10 (3) 00_197
Non -potable Water Analysis Fee................$20 (3) 001197
(1) Ten percent (10%) of the permit fee is transferred to HSEH to provide
training, monitoring, epidemiological support, program evaluations and
technical assistance. Permit fees are not prorated. The 10% must be
coded to the Administrative Trust Fund in the following manner:
GF = 10, SF = 2, FID = 0210421 BE = 60500200, IBI = 00, OCA = UQ000,
Object Code = 001113, State Program = 0402000004, SI = RV
(2) Fees collected by the CPHUs on behalf of the state lab for chemical a-�
bacterial analysis of water samples shall be deposited to Statewide
Health Programs, Planning and Evaluation Trust Fund:
(3)
G.
GF = 20, SF = 2, FID = 531003, BE = 60500200, IBI = 00,
OCA = J5A00, Object Code = 001170, State Program = 0402030001, SI = RV
These fees are deposited to the Planning and Evaluation Trust Fund,
Statewide Health Programs, using the following SAMAS account codes:
GF = 20, SF = 2, FID = 531003, BE = 60500200, IBI = 00,
OCA = J5A00, State Program=-0402000004, SI = RV
FOOD ESTABLISHMENTS
Annual Permits:
Fee
Fraternal/Civic.......................... .$160
School Cafeteria
a. Operating for 9 months or less .......... $130
b. Operating for more than 9 months ........ $160
Hospital/Nursing Food Service.................$210
Movie Theaters ........................... .$160
Jails/Prisons. ... .$210
Bars/Lounges (Drink Service Only).............$160
Residential Facilities. .$110
Child Care Centers ............................$ 85
Limited Food Service ........................ .$ 85
Other Food Service............................$160
43
Revenue
Object
Code
(1) 001132
001132
001132
001132
001132
001132
001132
001132
001132
001132
001132
0
ATTACHMENT V
COUNTY FEE SCHEDULES, BY SERVICE
Estimated
Annual Revenue
Accruing To The
LEVEL OF SERVICE/SERVICE:
Fee/Rance
CPHU Trust Fund
I. COMMUNICABLE DISEASE:
Immunizations
Varied
$30,000
STD
Medicaid
$12,000
HIV Testing
Medicaid
$ 2,000
Tuberculosis
Varied
$10,000
Vital Statistics
Varied
$65,000
II.
Subtotal $119,000
Chronic Disease Varied $ 35,000
Family Planning Medicaid $ 50,000
Healthy Start Varied $243,956
Comprehensive Adult Health Medicaid $100,000
Comprehensive Child Health Medicaid $ 75,000
Subtotal $503,956
III. ENVIRONMENTAL HEALTH:
Group Care Facilities Varied $ 25,000
DEP Storage Tank Program Varied $107,000
Subtotal $132,000
Total County Fees $754,956
44
ATTACHMENT VI
CLASSIFICATION AND NUMBER OF EMPLOYEES WORKING IN THE
COUNTY PUBLIC HEALTH UNIT WHO ARE PAID BY THE
COUNTY, BY LEVEL OF SERVICE, IF APPLICABLE
• ulut 1 � ' �
Tuberculosis *Senior Community Health Nurse
Sexually Transmitted Disease *Direct Services Aide
HIV
9 I's 100 X4 w1w.".
0.5
0.5
Basic Care Middle & Upper Keys Advanced Registered Nurse Prac. 1.0
Nutritionist *Nutritionist 0.5
Comprehensive Child Health *Advanced Registered Nurse Prac. 0.5
High Risk Adults & Children Senior Community Health Nurse 1.0
.01Uu i
Various Programs
Environmental Health Specialist 1.0
*Secretary Specialist 0.5
*Indicates partially funded position
45
ATTACHMENT VII
FACILITIES UTILIZED BY THE CPHU
Facility
Description Location Owned By
Monroe County Health Department 5100 W. College Rd Monroe County
Key West, Florida
Monroe County Health Department 138 Georgia Street Monroe County
Tavernier, Florida
Monroe County Health Department 7999 Overseas Highway D.Chaplin\dba
Marathon, Florida Prime
Properties
Health Care Center 1200 Kennedy Drive The Lower
Key West, Florida Florida Keys
Health Systems,
Inc.
Roosevelt Sands Community Health Douglas Square City of Key
Resource Center 105 Olivia Street
Key West, Florida
46
ATTACHMENT VIII
DESCRIPTION OF USE OF PUBLIC HEALTH UNIT TRUST FUND BALANCES
FOR SPECIAL PROJECTS, IF APPLICABLE
(From Attachment II, Part I)
The addendum of the FY 1994-95 contract regarding the
construction of the Marathon Public Health Unit, attached
hereto and incorporated herein, is continued through the
first six months of the current contract period.
$400,000 is appropriated for renovation and/or relocation of
the County Public Health Unit in Tavernier.
$275,000 is appropriated for additional site renovation
activities in Monroe County.
$51,619 is appropriated for equipment and communications
needs for full conversion to network access, universal
workstations, and enhancements to telephone systems.
47
Addendum to Standard Contract Between
Monroe County Board of Cor:nissicners
and
ztate ofFlorida
Department of Health and Rehabilitative Servi:.es
for Planning and Construction of
Marathon Public Health unit
Agreemen : :Wade the _ast day below wr_ -en, by and
ce_::een the SCARU OF COUNTY CC�^_'TSS:CNERS OF MONROE COUNT'',
and the STATE OF = I.ORT-A DEPARTMENT 0: : �F:.=;: F�
33.,•. , �
for _~e Monroe CoLnty _ . biic r:eal:r Unit, whCse ac.ress _s
CO w. Co lege Road, Key Vest, FL 33040,
WTTNESSETH
The Cou: :y and HRS hereby agree to add this
addendum to that certain Standard Contract dated -he
1st day of October 1994 as follows:
1.
Addendum for Marathon. Public Health Unit Site:
The County and RS '.ave agreed hat the County will
provide the Monroe County Pjbiic Health Unit (MCPHU) the
site listed as "under renovations" in the Standarc Cent
48
A'_t ough not defined in the Standard Contract, tte ac-ua:
of ne s:-e re_erre- --s is 3333 Overseas
M,arathor., Flor_da.
NOW, THEREFORE, for and in consideration of the T::tual
prc:-.ises, covenants, anal obi: t:cns contained ere_r. and;
contained in tie Standard Con --:act the County and E RS agrees
as .1ol lows:
2. P-o,ect
Funding:
A. : RS
(through
t-e MCPHU)
will provide
funding
=rcm the Cc•.:-:y Pub:yc 'lea 1t:n. _-it Tr:st Fund In the
cf _;�0,000.
B. _'ne Ccunzy agrees to contribute 5400,000
=..e f_rs= 54;; :0 _n costs assc.._a=e
'-fs prcject w:__ be paid frc-. f-inds t;.at are prov_. ed ty
3. 'he remainder c` t.-e project costs, 1_mi!_=ed
:.o S400, COC, will be paid frc7. 'Lu-ds contributed by t`:e
County.
4. Funding Uses:
A. The 5300,000 In. funding for this project
shall be used for costs associated with; planning,
are,itectura= services, perm _=ting, site preparation,
construction/renovation, purc=.asing, 4mpact fees,
49
assessments, deposits, charges and costs of whatsoever
.at'' th3t MT. a % °"e req'.:iYed by any :OCa' , `C::nt%, state, Or
fe::e-ral e.^.:it% foot app1 cat -on, review, modi:icat_c-n Of
plans or applications.
B. A1_ disbursement of HRS funds will be
--' nted for r�.:c} s'.:b:�-ssion of project ccst records.
al.. �.��: �. ...._..
5. County Obligations: Construction and Installation
of Facilities and improvements
TWE COUNTS SHP LL ACT AS CONSTRUCTION MANAGER AND BE
R=SpONST_BI�E FOR THE FOLLOWING ACTIVITIES:
A. Se_ect_r:,n and contract with an
Consultant
BP r n A::,�=cve s_�e des-;�, c'.:-.. c�ra.,,
CCn-tact d0c_"r.e _s, cons 1--uction, cc:rpe____ve bid process
bidder .
w- t. fte s ccess___
C. Cc:._rapt G�.:?�nistra=ion, sc: ed'.:_es, cost
c^- =ro+ �n� : o-.s =_ :c _ _� : �bserva _:,r: and aprrova' .
D. I. -sure that the consultants and the
cCn:rac:C_ra__ per..._ts prior to _'r.e s::=== c`
construction, filing approvals of plans with governmental
bodies and u:-_-:_es having J"r- cticn, that all work is
completed in accordance with applicable codes and
50
regulations, local and stare requirements and acquire
zC,n_..g; re-=...i..g cr =on—: ng :•aria:.Fes w11ere re ;u:red.
S. :::sure that the schedule of completion of
Sertembe= ^;9, 1996 be stri:.t_y adhered to.
6. !:ol: Harmless and indemnification
Cour:=y and HRS each represents to the other that
carr'es suitable public liability and property damage
insurance, or is self -insured in amounts adequate to cover
any claim within t!:e limitations of Section 768.28 arising
�.. c0nnect_�,n lease of the premises under this
Agreement and will continue to carry such insurance or
remair: d-..r_ng 1'.e entire term. of Lhis
Ag_eement. ra:.:. . =r--y shall be respcns__-_e for any acts c:
ne_gen.--e c:. _.•e _ _ar: o= _:s a�gen=S and E'C_Cfe25. .a:'?
g_
Party sl-a'_l hold t':e other party harmless from all claims
neg--ge-ze of its age: :s, employees and
in-lepe^dent contractors in connection with this Agreement,
and shall defend t^e other party against all claims arising
out of such negligence of its agents, employees and
�ndepender.t contractors '-nder this lease.
7. County Nights: Use of Facilities
In accordance with the Standard Contract, Attachment ,
Sec=_on V! (c) facilities and equipment provided by ei-::er
51
parry for the CPHU shall be used for public health services
pro; _aec�. t%e ::Ci:.'.t}'' S1:a_- :'.aVe t%e r:gr = to use such
`acilities and equipment, owned or leased by the county, as
the reed arises, to she extent tat such use would not
impose an unwarranted interference with the operation of the
8. County obligations: Replacement of Facilities
Destruction - In the event of a partial or total
destructior. of *he premises during the term of this
Agreement from any cause, the County shall forthwith restore
t`e same
as soot: as reasonably
poss-ble and
if eccno^ically
Feasible.
Any partial or total
destruction
shall neither
a-...: -
nor vc*d _.._s AgreeTer.:.
9. ERS Obligation Coordination of
ERS gh 'cn_oe Count; Public Health U (MCPHU)
of'; orals shall ccnsui-- with and coordinate with t::e County
Cor:s_ructior Manager for the planning, const=uc_ien,
s:al:at_on and use of t::e Facilities. Tne design,
construction, location and installation of the Facilities to
be placed on the Marathon site shall be approved in writing
by the HRS representatives, it being the intentions of the
County and HRS that HRS shall have absolute control over the
location and placement of the Facilities upon the Marathon
MCPHU premises. No other structures, improvements, or
52
fivlures shai_ be placedupon the Marathon MCPHU premises
A_=ncut pr_cr ::_:�:e�: per-_ss_c:. cf HRS. Any approval
required by HRS hereunder shall not be unreasonably
w; _..-e1d.
10. HRS Obligation: Control Over Premises
The Coun:, agrees that, in the event of the sale, lease
cr other disp�:sitien Of the premises currently owned by the
Co::.^.ty upon which the Facilities are located, the County
s::a:l insure `at su:.h lease, sale or other disposition is
s,:'4ect to t-.is Agreement and will not interfere with HRS's
.ts _.:de_ :'is A _reemen`, so long as this Agree7nent shall
remain in force and effect.
=R: R= Use of 7 a;:_' i` es
=RS s*-a__ '. e _-e r`g'":t tc use e Fac__-t_es w_--.--;_
_.. :erference _o pro^ete, protect, maintain and improve -e
..ems__h and s_rz=e v of tie citizens and visitors through
prcnotion of P;:b1ic health, the control and eradicatior. of
_-e entable t seases, and the provision of primary health
care for special populations.
12. HRS Ob=ioations: Supervision of Activities
ERS shall be responsible for the supervision of all
ac=ivities involving the use of the Facilities which HRS er
Y,CPHU officials ; ave sponsored, schec.:led or over which HRS
would normally exercise control.
53
13. County Cbliga, ions • Pro-Rata Reimbursement to -RS3
hRS may cancel t`_s- Agreement and e'_ec= to terminate
-s respons_b for operation and maintenance of =}.e
Facilities because of a material breach of the Agreement t/
-.e� by this Agreement, a material bre;--
tie County. As ::ef..
shall be one :ha-_ substantially departs from the letter
sc' ri t of the ter::s of this Agree-ent . In the event of
cancellation the County shall, within six (6) months of
cancellation, re::-,burse E RS for the adjusted value of the
ra;._lities PL, _r. by LRS.
13. Nc:--Ass_Cn e^t
This Agreement may not be assigned, and the County c_
ERR may r.c: tent cr s::b_ease any Dart of t`:e Fac:____ec,
A_� —out the e:'Cre:S �� wry :en consent of the
14. Notice of ?reach; Cure
in the even: of a breach of any term of this Agreeme:._
�y one party, _: shall. be the obi`gation or the other par=y
to provide written notice of such breach or violation, ar.:: a
reasonable period of time shall be allowed for the curing of
such breach or violation, the reasonableness of the time
period being determined by the circumstances and na:..re c=
the breach.
15. Notice of Unsafe Condition
54
In the event that either party becomes aware of an
it shall correct :..e saute or, if s;:z:: is
the responsibility 'of the other pa==y, notify the other
party of the hazard and the need for corrective action.
In all Other respects, the prcrisior.s of the Standard
-or.;ract between the Monroe County Board o: Couni-y
Commissioners and the State of Florida Department of Health
and Rehabilitative Services, dated, October 1, 1995, shall
_emiain in e`fect and be unchanged by this addendum.
55
IN WITNESS WHEREOF, the Board of County Con-lissior.ers Of
"or.ree Cc�^ty, :lor_da, 'F�rs�ant to a T.ct_c�
seconded and passed in regular and open session and by and
through its Mayor and Clerk; and HRS, by and t••=O';7 its
District 11 Administrator and Monroe County P;:blic Health
.:'.it Adr.^i^_StratOr, have affixed their respec�:ve anC
representative hands and seals on the dates indicated.
BOARD 01 COUNTY C01�^MISSIONERS
Attest • i�ANNY L. g0I$AGF, OF MONROE COUNTY,
FLORIDA
My
& Le AA X., VV
(SEAL)
OF Attest:
SERvICES
By
n/.
Date: /V .3 -9�-
56
TAT: DE
1�
ny 5a
tflaHU A:DMP11STi*T0fZ
3.2-7•9S
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 public health unit 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 RRecru r m n
1.
2.
3.
4.
5
Sexually Transmitted Disease
Program
Dental Health
Special Supplemental Food
Program for Women, Infants
and Children.
;-Improved Pregnancy Outcome
Family Planning
57
Requirements as specified
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.
Monthly reporting on HRSH
Form 1008.
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
15a.27.
ATTACHMENT IX (Continued)
6. Immunization
7. CPHU Program
8. Chronic Disease Program
9. Environmental Health
10. AIDS Program
11. School Health Services
58
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 CPHU 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.
HRSM 150-25, including the
requirement for an annual plan
as a condition for funding.