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FY1996 01/17/1996GOUNrI,r F c�oAM CUIQ`"J9 �4:b yA ♦i 4,,0 f �OUNr • ��� wannp Rotbage 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 M E M O R A N D U M To: James Roberts, County Administrator From: Isabel C. DeSantis, Deputy Clerk Date: February 12, 1996 BRANCH OFFICE 88820 OVERSEAS HIGHWAY PLANTATION KEY, FLORIDA 33070 TEL. (305) 852-7145 FAX (305) 852-7146 As you know, at the January 17, 1996 meeting, the Board granted approval and authorized execution of the standard contract with the State of Florida, Department of Health and Rehabilitative Services for the operation of the Public Health Unit. Attached hereto are two duplicate originals of the above document executed by Monroe County. It is my understanding that your office will follow-through and obtain the Department's signature. Please be sure that a fully executed copy is returned to this office as quickly as possible.. Should you have any questions concerning this matter, please do not hesitate to contact me. cc: County Attorney Finance ,/File j /, . /996 STANDARD'CONTRACT BETWEEN C f � agoww of - COMUIOWSSWAW ...� � y 4 'tLITATIVB DEPARTMENT OFis contract is IiEALTii`ND Pursuant to Chapter 154, Florida. of Health and Rehabutes ilitative entered intoDepartment between the Services, hereinafter refCrounty, - h as the naft a referred to as the ment"# and MONROE "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 ative committed to the provision of these servicovernhtheduseiofrthese and programmatic requirements which will g funds, and the respective responsibilities of the department, and the county in enabling the CPHU "to promote, protect, maintain, and improve the health and safetypublic ! the healthitithes and controlltand through promotion of the pub eradication of preventable diseases, and the provision of primary health care for special populations-" I. General Provision: Both -parties agree that the CPHU shall: tions A. in Atachmente I sand Ball other attachments to the specified this in Attachment 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; and B. Complother a apithplicable thecable regulations if trovisions of 45 his contract contains other PP federal funds; C. Comply with all applicable standards, orders, or amendedi(42 USC 1857petssegt) andtthe Federalhe Clear Water r Act as Wat r amen 368 et Pollution Control Act amended Lederal3 lands land thestotal if this contract contains �t isver $100,000; and coast :�.: • .. fV=-�5 ._ .._ :1.-�.. ^��'.�,�:�-_:�,..��-- - -- 1 w p s..secti_ons of Cha tar . 4271 Florida C. ��P. t on $irvici �' giap 41-2, anspo Statu . nistrative Coda, (Coordinated ;Community Florida;.: ion Ssrvicesj the r9 ision of _ Traa{s t regards_..:. trans portation services Lor theap°atan disadvantaged funds contract are contains ito provide !or ledaral or localtransportation services. direct or indirect (ancillary) III. Records, Reports and Audits: Both parties agree that the CPHU shall: A. Maintain books, records and documents iracti dancwhich with accounting procedures and p expenditures of sufficiently and properly reflect all funds provided by the department, the county and other sources under this contract. Books, records and dequate to enable the CPHU to comply documents must be a with the following reporting requirements: 1. The revenuetomated ManagementeAccrequirements uninting AuSystea 2.2; State Au 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 equivalentas ny approved by the State Health Office. reporting system used by or on behalf of the CPHU to produce hine readable informationve provide formatrmat approved by d ata amachine in a m department which Information System; ired electronically to the Client 3. The CPHU is responsible for assuringthat ainclude contracts with service providers 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 spec ified ied co the component anal ant nd Information revisionsSystem/Health subsequent Management Component M the January 11 1984 version; 4. Financial procedures specified in the department's Accounting Procedures Manuals and Accounting memoranda; 2 • 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 perl6ds speCitied -by the _ . deportment _ _ .. _ ; �-. -- t ; y-.•4 �z. c 6. Any other state and county -program spec: 3fii' reporting requirements det9iW . in attachments,. -to this contract. B. Assure these records shall be subject during normal business hours to personnel duly tiauthorized by the review or department state or county p 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 g. Include these aforementioned audit and record -keeping requirements in all approved subcontracts and assignments. Iv. Purchasing Procedures: 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, tand dented t e the county proceduresweesed because theyweremore 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. 3 vi. Safeguarding Information: Both parties agree that the CPHU shall not use or,disclose any intorsation concerning; a recipisn ,�,.&. Jcas sr : act for any purpose not in COMO this contract �0• - �_.. state law, regulations or *anna►1 and Information Technology) and Lederal_ _• ; 3 hisZOS . SO) , excel by writ_ _ten�sona her responsible parent or guar Y law. ` vil. 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 conditions hethis contract departm department andnd he toany it condions off approval 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 contract, provided that the amount of any such tnract shall not be for more than ten (10) percent of 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 he conditions i th t the this departm nt contract andand then county any shallconditions deem approval 4 IX. Insurances provide adequate property The County agrees to P ui ment in insurance coverage for all furnishings ildings and Bused by the health unit offices and buildings. the County, and all health unit that are owned by the County, including furnishings and equipment owned by shall be insured through the county's insurance program, which shall nce vehicles, be either her a self-insurance program ay insurance purchased by the County. The health receipt of Pan for the annual cost of this insurance up For any invoice from the county's Riskwent used b Managent lthe Health Unit buildings, furnishings and egitupis the responsibility onsibility of the but not owned by the County, either health unit to obtainvauate insurance nc coverage through the state or prite 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 g 2,882,122 and the State share of all state authorized fees in an anticipated amount of $ 0 • In addition, all "OTHER" state revenues frost whatever sources to be appropriated to the HRS County Public Health Unit Trust Fund for services to be provided 6tby the county health unit in an amount of S.1, g or a grand total State cash contribution of $ 4,068,798 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 S 281.000 In addition, the county shall provide its share of all county authorized fees in an anticipated amount of S-129_. ; --s These amounts, plus any "OTHER" local revenues in the amount of $J7.000 , includes all revenues from whatever sources to be appropriated to the HRS County Public Health Unit Trust rund for services to be provided by the county health unit for a grand total county cash contribution of $ 441,230 • E XI. The department and the county mutually agree: Effective -`data i. This co tra'shali``nocr�or the date on -*hich t$.;f7conttac ::ba -been .signed by both parties=�biohsv .2. This contract shall end on September 30, 19 % 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 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. 2 C. Notice and contact: The ` cortrlt � CW#• the--dspartapent.:,..f9r this his r repres .event that J je ast bY_ either difleratt�t -'" - �- ce of the party after sxecutioti. df "this " contxil► Hams and address of the, nev representative and 1 said rendered in uniting to the otherp�'tY 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 wh�ththey parties tobeen thisreduced contractvritinq b and duly signed y g. 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 • F. All terms and conditions included: This contract and its attachments as containreferenced, (Attachment I through Tx ), the terms and conditions agreed upon by the parties. 7 In WITNESS THEREOF, page contract to be duly authorized. the parties hereto have caused this 56 executed by their undersigned officials as BOARD OF RUE- COMKISSIONSRS FOR COUNTY SIGNED NAME: SHIRLEY FREEMAN Mayor TITLE: DATE: 0/ /-'9Co ATTESTED TO: a� �Q� SIGNED B Q C' � Deput Clerk NAME: Dannv L. Kolhage TITLE: Clerk DATE: I 11. � kn-, STATE OF FLORIDA DEPARTKENT OF HEALTH AND REHABILITATIVE SERVICES SIGNE ( partment Authority) NAME: i%Nir�9 ! 4 • TITLE: VCT DATE : 3. 9. 9�0 SIGNED BY: CPHU Director/Administrator NAME: TITLE: DATE: N. ATTACHMENT I SPECIAL PROVISIONS I. County publiq Heal.#.,94t Trust Both parties agree:.- F _ nd. A. That all funds to t a expendbdiby .deposited in Y (CpHUTF) maintained by the state the CPHU all be Health Unit Trust Fund 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 moNEnF. 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 fundbalance, 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 contract, with special projects explained in Attachment MI. V] thr g. There shall be is transfers out a contrac t ndm the duly levels of services withouter signed by both parties to this contraotKand the .prCPHU amandmonts .. uni_ a the , budget: director/administrator detirai -the publios>. exists wherein a time delayptaro lry =o t - apprbV*d.;_ health and the a Deputy Secretary for 4" - shAl the transfer. CPHU forward written ter an emergency trans! idence of this l•to the within 30 days a! g . That either party may increase or nodecrease f uin surriting tifying the other party this contract by and purpose for the increased/decreased funding, of the amandt allowing 3o days for written objection funds are released before the athe st t allocation is decreased. o expenditure or A ust be decrease in funds msequestering fed e to a anticipated shortfall, appropriations. G. That the contraa shall include P f Staffing, Attachment I sectionentitled "Played Expenditures by Type of Service Clients, Service and Within Each Level of Service". This section shalo� include the following hinieachilevelaofon for service each type service area • _ the planned number of full-time equivalents (FTE's) by level of service; the planned number of services to be d number of individuals/unitsotodber the planned _ served; and expenditures. the planned state and county Expenditure information acilitatellmon torinq to a contract in a quarterly plan performance. H. That adjustments in the planned expenditure of funds for each type of s ut nn amendment to this contract ce within each level of ice are permitted without _. 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; 10 3. DE580Ll - "Analysis of Fund Equities"; and 4. A written explanation of the variances in the DE385L1 report for each QW� contract year if the CPHU exceeds'o levels as Spec fliedio�+ as of-= quarterly report per. reflected ter: ,; of ... the ., i. tolirance'- a. The cumulative percent art��v by more than 25percenth articular type of expenditures for a particular or fall below planned expenditures than 25 percent. planned service by more 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 inrwhich the te fance xplanationf is not required. e is included, a variance required, 5. The CPHU Contract Management Variance Report shall: a. Explain the reason for the viances in area expenditures in any program which - exceeds-- the tolerance levels established above; b. Specify steps that will taken plan� including comply with the contract expenditure a contract amendment, if necessary; and C. Provide a time table for completing the ai steps ure necessary to comply with the plan. of the CPHu to accomplish the planned steps by the dates established in the written explanation shall constitute non-performance under the contractwithhold funds tiro r the the department may appropriate contract or bake other appro P administrative action to achieve compliance. J. The nisstrrator'stes quarterly report to the for the cpHU ,co admi unty and the department shall be as follows: 1. March 1, 19 96 for the report period October 1, 19_25 through December 31, 1995 ; 2. June 1, 19_1 ._. for the report period October 1, 1995 through March 31, 19 96 .; 11 II. September 1, 1996 for the report period October 3. 11 19g_ through June 30, 1996f and 4. December 1;- 19�: for the. r�period: pOtober.,: , 1996 through September 30 Fees: t A. Environmental regulatory Lees. The department shall establish by administrative designated fees for envirormental regulatory functions 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 the department's rule. The county may,, howevera establish fees pursuant to section 381. 0016,, Statutes, toitent he statutes inconsistent aft r consultation wm pith the rules and department. B. Communicable disease service fees: The department may establish by administrative rule, fees for communicable diseaseservices designated in this environmental regulatory services, contract and conducted by the .CPHU. The _�unty.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 county listed in Attachment IV of this contract. All authorized communicable bVedisease serviceof this contracts fees shall be listed in Attachment C. Primary Care Fees: .The county may establish fees for primary care services designated in this contract and conducted by the CPHU except forthose ederal orees statafor lawich fee or regulations. schedules es are specified Both parties further agree: 1. That such fees shall be established by resolutioi! of the Board of County Commissioners, 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 carethe servicesyfor provided byithelCPHUsease or primary or r 12 isted 3 . That primary care fees os= �i be tract. in Attachment V county) L di prark- * ses shall D. Communicable sh _and the automatically-• 'Q rats u ri _ glciatusr;;:of . this county at the se�l se -- sit or. party contract I and" C of unless s sat fo according to pr this section. g, Collection and use of fees: Both parties agree that: 1. Proceeds from all fees collected by or on behalf CPHU whether for environmental, of the or primary care services, communicable disease, shall only be used to fund services provided by the CPHU• 2, All fees collected by or on behalf of the CPHU an shall be deposited with the State Treasury credited to the Countyappropriate Pu ic s at Health account Unit Trust i f Fund or other required by Florida Statute or the State Comptroller. — III. Service Policies and Standards: Both parties agree that theublishedshall byadhere departmentservice in Policies and standards P guidelines provided by the program manuals and exist, ther a guide for providing each department, where they funded service specified in Attachment II, Part III of this 'contract. Iv. Fair Hearing Guidelines: The provider shall establish a system through which resent applicants for services modification ication rent clients termination of grievances over denial, applicants of the services. The contractor will advise right to appeal a denial or exclusion from services, of failure to take account of a client's choice the =service, overning of his/her right to a fair pecif iari1gc references to existing authority of the agency. 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). 13 V. personnel: Both parties agr`40 '` v� at- licit thi following "employees: }._ A. The CPHU shalla _. 1. A director. or administrator t,� 'after consultation Secretary of the department with the Deputy Secretary for Health and with the concurrence of the Board of County Commissioners; Z. A full-time community health nurse; g. An environmental health specialist; and 4. A clerk. B. That all department employees department and the subject hato ll be -supervised by Department of Management Services rules. C. Staffing levels shall be established iand this contract tracted in Attachment II, Part III as FTE's, Y co in accordance with the availability of funds and/or program needs. D. The number and classification of employeeslyes rather working than in the CPHU that are county department employees shall be listed in Attachment VI of this contract. VI. Facilities: Both parties agree that: A. Attachment facilities shall be provided as specified dein shall Attachment VII of this contract. s attachminclude a description lofall ca ion offacilities facilityused and by the CPHU, including whom the facility is owned; B. The county shall e own W rovided he tin ities used Attachment by e f CPHU unless otherw P contract; and C. Facilities and equipment provided by either party r y foxes the CPHU shall be used for public provided that the county shall have the right to use such facilities and equipment, owned or leased by the county,of impose as the a narises, to the extent that such use unwarranted interference would nwith the w operation of the CPHU. 14 VII. Use of Funds for Lobbying Prohibited: the provisions of section which vIII.Method oi.payssntt A. The county shall deposit i its annual Unit Trust Fund iastispecif on to the ed County Public He below. B. The department lllrelease state contributions to this contract a 1. Funds appropriated as "Aid to Loterl o er nts„ at shall be relea ct each our quaquarterly t r of ythe contract the beginning year; 2. WIC and other state funds appropriated ens, in a cost and special) reimbursement category (e•9 P shall be released on the basis of invoices documenting expenditures. Laboratory and Pharmacy Support: The department agrees to supply laboratory and pharmacy support services for the cpHU aifleast a the level provided in the prior state fiscal Y X. Emergencies: Both parties agree, taathnt of their each other insmeetinq public resources, that they Y assist health emergencies. XI. sponsorship: tutest In compliance with at allonotices,5�informationalFlorida a pamphlets, provider assures that descriptions of the similar press releases, advertisements, P sponsorship of the program, research reports•rovidershall public notices prepared and released by the p include the statement: OE COUNTY PUBLIC Sponsored by provider and the State of Florida, Department of Health and Rehabilitative Services." If the sponsorship ofreference is in written material, the words, Department of Health and Rehabilitative Services" shall 15 size letters or type as the name of the appear in the same organization. XII. Indicate in the space below the income eligibility limit for comprehensive primary care clients. 10, i of OMB Poverty Guidelines. XIII.Program Specific Reporting Requirements: Specific information not available followie gh CIS/HMC or SAMAS must be -supplied by completing A, Specify in the space below the minimum number of clients who will receive comprehensiveprimary are services (clients registered in Program 99 who will receive services during this contract period). 5,000 • 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 nds are in the IPOosited in the cPHU line on Attachment rIIt Fund and included 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 st, the medicaid shall automatically be adjusted to, a reimbursement rate without 154 06 shouldormal sant d reimbursement in accordance to this contract with F rate be increased or decreased. See Page 12, Section D. 16 o `^ } � c ►- •a a O 2 LL M cn U Q O u' CE o Ln D m m O o U. Ln O N O C O p O..c -- Z Z Z 5 a J ?C x O u. o W Z Z 5 a t- z J LL O cn en < W ID > en r1 N N C7 GC U J m m A- Z X c t m o V P Go N A m U c �n .5 co m J O > co O O d m V O L x T 5~ � ~ COc N m m m m p x dR EFV` A ATTACHMENT II PLANNED FUNDING & EXPENDITURES 18 3 m r � a W N � = � o S � � ` O M 10 m m p = C LL E a U N W ca O m Q F- j Ln cn LU w = N ~ � U U m D E V < a W O m Z O U U. 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The provider agrees HRS federal financial civil Rights Compliance Questionnaire, complete by the department. Forms 946 A and B, if so requested The applicant assures that it will comply with: as 1. Title VI of the CivilRights Seq.°fwhich,prohibits amended, 42 U•S.0 , color or discrimination on ins basis of ande, activities national origin from federal financial receiving or benefitting assistance. 1973, as 2. Section 504 of the Rehabs �94tio whichof prohibits amended, 29 U.S.C. discrimination on the basis of handicap in programs and activities receiving or benefitting for federal financial assistance. of 97z, as 3. Title IX of the Education Amendmen Wh chlprohibits amended, 20 U.S.C. 1681 et seq.,ducation discrimination on the asis of receiving or * in eef fitting programs and activities from federal financial assistance. as amended, 42 4. The Age Discriminagt on 5eq , 19 which prohibits U.S.C. 6101 a in programs or discrimination on the basis benefitting for federal activities receiving financial assistance. omnibus Budget Reconciliation Act of 19811 5. The Omnwhich prohibits discrimination on the P.L. 9'7-35, sex and religion in programs and basis of or benefitting from federal activities receiving financial assistance. 6. All regulations, guidelines and standards lawfully adopted under the above statutes. 33 surance Th e applicant agrees that ontinued cwith ompliance receipt tofs orsbenefit constitutes a condition of c and that it is binding from federal financial assistance, transferees, and the applicant, its successo such assistance is upon rind during which assignees for del nt further .assures that all contracts, provided. The applicant or others with whom it arranges subcontractors, subgr articipants or employees to provide services or benefits programs and activities are in connection with any inst those participants or employees not discriminating g regulations, guidelines, g the in violation of the above statutes, at its and standards. In the evnt the grantor of failure t may, at applicant understands that eek a court order req uiring compliance with the discretion, sappropriate judicial terms of this assurance or s to includepp assistance being or administrative relief, denied. terminated and further assistance being 34 ATTACHKENT IV STATE FEE SCHEDULES, BY SERVICE SERVTCElSERVICE� I CO DISEASE: AIDS, HIV, Alternate Site Testing $20 (optional) 11. pR I LARY CAR s Estimated Annual Revenue Accruing To The CPHU Trust Fund ,Subtotal $ 0 Subtotal $ 0 -- 35 III. (1) (2) (3) (4) ATTACHMENT IV (CONTINUED) STATE FEE SCHEDULES, BY SERVICE ENVIRONMENTAL HEALTH: --- -- A. ONSITE SEWAGE DISPOSAL (OSDS) PROGRAM Fee Septic Tank Site Evaluation (Soil Testing/ Site Evaluation ............................$ SO OSDSPermit...................................$105 OSDSRepair Permit ............................$ 40 Existing System Approval ......................$ 40 Septic Tank ManufacturerInspection Permitt(Annual)ual)::5 50 50 Septage Disposal Septic Tank Pumpout Vehicle Inspection ...$ 25 (Per Vehicle) ............................. Portable/Temporary Toilet Service ....$ 50 Permit (Annual) ...................... .... Portable Toilet Pumpout Vehicles ..• .$ 25 (Per Vehicle)..........................Reinspection of Non-compliance OSDS ........... $1$ 25 50 Variance Application OSDS (Single Family) .•••• Variance Application OSDS (Multi -Family & Commercial Site) ....................... ......$200 Aerobic Treatment Plant (Annual) ........ " •..5150 Industrial/Manufacturing Permit (Annual)••••'•$150 Lime Stabilization Facility (Annual) ..... ••••• Septage Landspreading Site Evaluation (Annual) .......................... ......•••••.••..$ 40 $140 0 System Abandonment Permit.................. (1) (4) (2) (3) (3) Includes a $5 research fee to be n collected object codee0012010, 1996, transferred to headquarters using Applies where FHA/VA requests system reinspection and where county ordinance requires inspection for change of building occupancy. 50% of the variance application fee is placed in the applicable CPHU trust fund, 50% of fee placed in specific HSES variance account usinc revenue object code 001204. the CPHUs pursuant to construct: Includes a $5 surcharge collected by permit issuance to be transferred dassistanceoforothis progravide m monitoring, training, and administrative using revenue object code 001203. 9.1 ATTACHMENT IV (CONTINUED) STATE FEE SCHEDULES, BY SERVICE B. PUBLIC SWIMMING POOLS AND BATHING PLACES Fet Annual Permits: Up to (and including) 25,000 gallons .......... 25 (1) More than 25,000 gallons ......................$ 75 (1) Other Fees: Plan Review (New Construction) ..••••••••••••••S275 (2 Plan review for modification of $ original construction........ Plan/Application review fee for $150 (2) bathing place development ............... .... operating .S125 (2) _Initial op g permit ................... . (1) Maximum fee is charged by HRS CPHUs and lo% of that fee is transferred to headquarters and should be coded to: Planning and Evaluation Trust Fund GF 20, SF a 2, FID = 531003, BE = 60500200, IBI = 00, OCA = K3000, Object Code 001205, State Program = 0402000004, SI = RV llected by HSEH, the 12 delegated counties and (2) Fee amount co District I. C. MOBILE HOME & RECREATIONAL VEHICLE PARKS, Annual Permits: 5 Spac&s and Above................S3.50 per space (1)(2) ten (1) The minimum statutory fee sieelassessedgpered ufacilityecannotare wbetmoreby the department. The total than $600 or less than $50. (2) 10% of each permit shahisbsurchargershould beto acodedttos erusing revenue object code 001113. T GF — 10, SF = 21 FID = 021042, BE - 60500200, IBI = 00, OCA UQ000, Object Code = 001113, State Program - 0402000004, SI = RV D. MIGRANT LABOR CAMPS ' Annual Permits: ,,,...$125 Facilities with 5-50 occupants.......... Facilities with 51-100 Occupants..............$225 Facilities with over 100 residents ............ $500 37 E. F. (1) (2) ATTACHMENT IV (Continued) STATE FEE SCHEDULES, BY SERVICE BIOMEDICAL WASTE GENERATORS Fee Annual Permits: less (Except Physician Office Generating than 25 lbs./30 days) ........................$ 55 Other Fees: r the first reinspection).•$ 2 Reinspection (afte...........25 Late renewal........... ............ Mobile treatment machine registration ..•••••••$ 2 Fee DRINKING WATER Annual Permits: public Water Annual Operation Permit- Limited Use (Annual Operation Permit First P ear)..........$ 75 (1) public Water Annual operation (Annual Operation Permit Second Year and Beyond) .................................$ 70 (1) Other Fees: public Water Con strucgamnlee ollecti on/Review .$ 75 (1 Non-SDWA Lab Sample ( p of Analytical Results/Health Risk Interpretation): ,,.....$ 50 Delineated Area ............ .$ 40 Bacterial Sample Collection............ Chemical Sample Coln Permit' .. ' • • • ' • ...' $ 60 Private Water Cons $ 40 (2) (serving 3 or 4 non rental restemnces):::::$ 25 Reinspection of Private Water System ....:.....$ 40 Reinspection of public.Water Sy 50 stem Delineated Area Cleaan.Fee .... ::::::.......$100 (3) Lab Fee Chemical Analysis Includes a $5 surcharge that is transferred to training, monitoring, epidemiological samerevenue object technical assistance usingirtg Includes a training, technical $3 surcharge that is transferred to monitoring, epidemiological support, assistance using same revenue object (3) For collection of for the chemical statewide health fees by analysis program headquarters to provi program evaluations a code. headquarters to prov: program evaluations code. the CPHUs on behalf of the state lab. Fe of watusing revenueshallr sample object ecode ted to the budget 9 001170 38 (1) Includes a $10 surcharge that is transferred to training, monitoring, epidemiologicalPP technical assistance using revenue object code The $10 surcharge should be coded to: ATTACHMENT IV (CONTINUED) STATE FEE SCHEDULES, BY SERVICE Fee G. FOOD ESTABLISHKENT S Annual Permits: the Fraternal/Civic (Serving Public)..........$160 (1)(2) School Cafeteria operating for 9 months a. Op or less .......... $130 $160 (1)(2) (1)(2) b. Operating for more than 9 months (1)(2) Institutional Food Service....................$210 $160 (1) (2) Movie Theaters ...•••••••••• ................... ....,,,•$210 (1)(2) Jails/Prisons ...................•••••• Only) $160 (1)(2) Bars/Lounges (Drink Service ••••••••••::• .. .$110 . (1)(2) Residential Facili ties .......... .......,.....$ 85 (1)(2) Child Care Centers ...••••••••• .....•......$ 85 (1)(2) Limited Food Service.............. Other Fees: ......$ Plan Review ...... ,,, .$ Food Worker Training .•••••••••••••... . " P .......... $ Request For Inspection Reinspection (after the firstreinspection)...S Late renewal .......... •••• ..'•........$ Alcoholic Beverage Inspection Approval headquarters to provic program evaluations anc 001132. 35/hr 10 40 30 25 30 SF = J, FID = 021042, BE = 60500200, IBI = 00, OCA - 10000, GF 10, = 001132, State Program = 0402000004, SI : RV Object Code t 2) Includes a $5 surcharge that is transferred to headquarters to offs= ( purchasing and providing maintenance on equipment to be the cost of P used for this program using revenue object code 001119• The $5 surcharge should be coded to: 021042, BE = 60500200, IBI = 00, OCA = UU000, State Program = 0402000004, SI = RV GF = 10, SF = 2, FID = Object Code = 001119, W • ATTACHMENT IV (CONTINUED) STATE FEE SCHEDULES, BY SERVICE Feo H. TANNING FACILITIES Annual Permits: lus $55 per device after Per Facility device) 150 1 the first ......................... .S ters to a $10 surcharge that is transferred to program evaluationsoande (1� Includes a idemiological support, training, monitoring, p revenue object code 001144. technical assistance using l permit transferred to headquarters The $10 surcharge on each annua should be coded to: SF OCA = R9000, 021042, BE a 60500200, IBI 00RV � GF - 10, = 2, FID State Program 0402000004, gI Object Code - 001144, 40 ATTACHMENT V COUNTY FEE SCHEDULES, BY SERVICE Estimated Annual Revenue Accruing To The FPpLRanae CP Trust Fund �res�r �� SERVICE/S Y. rn�-m rr1TCABLE nTsEAS Varied 30,000 Immunizations Medicaid 5,000 STD Medicaid 2;000 HIV Testing Varied 500 Tuberculosis Varied 45,500 Vital Statistics subtotal $83 , 000 Varied 25,000 Chronic Disease Medicaid 30,000 Family Planning Varied 244,328 Healthy Start Mediciad 50,000 Comprehensive Adult Health Medicaid 60,600 Comprehensive Child Health Subtotal $ 409,928 . 4: Varied 2,000 Group Care Facilities Varied 109,906 DEP Storage Tank Program Subtotal $ 111,906 Total County Fees $ 604,834 41 ATTACHMENT VI CLASSIFICATION AND NUMBER OF EMPLOYEES WORKING IN THE _ COUNTY PUBLIC E<NTE�L OF tSERVICS ARE APPLICABLE PAID BY $ COUNTY, T, of SMT1 _E / SERVICE %. col,., CI AAT.F DISEASE: Tuberculosis Sexually Transmitted Disease HIV ' � l. , i�iZz�l U__-- - *Senior Community Health Nurse *Direct Services Aide Number 0.5 0.5 II. pRTMARY CARE: 1.0 Basic Care Middle & Upper Keys Advanced Registered Nurse Practitioner 0.5 Nutritionist *Nutritionist EPSDT *Advanced Registered Nurse Practitioner 0.5 High Risk Adults & Children Senior Community Health Nurse 1.0 Various Environmental Health Specialist 1.0 *Secretary Specialist 0.5 *Indicates partially funded position 42 ATTACHMENT VII FACILITIES UTILIZED BY THE CPHU Facility g.®e 12t m HRS Monroe County Public Health Unit HRS Monroe County Public Health Unit HRS Monroe County Public Health Unit HRS Health Care Center HRS Disease Prevention Center Roosevelt Sands Community Health Resource Center 5100 W College Road Key West, Florida 138 Georgia Street Tavernier, Florida 7999 Overseas Highway Marathon, Florida 1200 Kennedy Drive Key West, Florida 517 Whitehead Street Key West, Florida Douglas Square 105 Olivia Street Key West, Florida Monroe County Monroe County C. Chaplin d.b.a. Prime Properties The Lower Florida Key Health Systems, Inc. Joan R. Lord-Papy City of Key West 43 ATTACHMENT VIII DESCRIPTION OF USE OF PUBLIC HEALTH UNIT TRUST FUND BALANCES FOR SPECIAL PROJECTS, IF APPLICABLE (From Attachment II, Part I) The addendum to the FY 1994-95 contract regarding the construction of the Marathon Public Health Unit, attached hereto and incorporated herein, is continued through FY 1995-96. In addition, $400,000 is appropriated for renovation and/or relocation of the County Public Health Unit facility in Tavernier. 44 Addendum to S=andard Contract Between Morroo, Coo .ty Board of Co:r.►lssidr.ers - :.-. and Mate of _crida Department of Health and Rehabilitative Services for Plar.n4 n- and construction of Marathon Public Health Unit Ag reeme^. = made the last day be -Low wr===erg by and ce = �reea the BOARD OF COCti = Y CO'C :T SS =ON-RS OF MONROE CO`.:K _OR.DA ("County , NCO i�' itehead Street, Hey West, FL 33040, and the STATE OF FLORIDA, DEPARTMENT OF HEALTH PND for the Monroe County ::;blic Health Unit, whose address `_s 3:C0 W. College Road, Key West, FL 33040, WITNESSETH The County and aRS hereby ag_ee to add this addendum to that certain Standard Contract dated 1st day of October 1-994 as follows: 1. Addendum for Marathon Public Health Unit Site: The County and HRS have agreed =ha: the County will provide the Monroe County Public Health Unit (MCPHU) the site 'listed as "under rerovations" i. the Standard Cc::tr =• 45 M •a Al�o„gI not defined :n the Standard Contract, the ac-_,,:al t- • - _oa of :h sj :e referred is 3333 Overseas r+g•'•�ay, e Marathon, Floridav NOW, THEREFOREr for and in consideration of the.mutual - _cns contained. :ere:r. an-d F=c�•ises covenants, and cb�:g__ contained in the Standard Contact the County and HRS agrees as follows: 2. Project .-ju di^ A. =RS (through t e MCPHU) will provide fu.^:d ^.g P •c Realt:^. ^.it T=::st Fund In ne amo•_..: o--400,000. agrees to contribute $400,000 c '^in ccszs assCZ4 a--e4 ti:is project w:2: be paid frc;- funds that are provided by ;RS through the Y. r.J. B. The remainder cf the project costs, limited to S400,000, wil: be laid frc-. Alunds contributed by the County. 4. Funding Uses: A. The 5300,000 in funding for this project shall be used for costs associated with; planning, ar:.:^.itectura: services, pern_:tir.q, site preparation, construction./renovation., purc-asing, impact fees, 46 assessments, depos::s, charges and costs of whatsoever nature that Ma/ be required by any 10ca1, county# state, or federal entity for application, review, modi:icat-40n of plans or applications. B. All disbursement of H RS funds will be pr �,St =e` Cr�S. ac� c;;nted :�^- rc::c_} s,.:---ssion o_f ojec.. 5. Cou Ob'_iaations: Construction. and installation *morove ^ents of Faciliries and THE COUNTS Sp-p-rL ACT AS CONSTRUCTION MANAGER AND BE R=SPONSIBLE FOR zE FOLLOWING ACTIVITIES: Se -eve--.. and co;.-ra-t wl,} an -eering Consultant g, Approve site desigr., building program, cc -.==act dcc::re :s, ccns'-uctie.n, coroetitive bid process enter a _ r,:cr=en cc-t=ac= wit}: t*:e sLccess:.:l bidal er. C. roc;. ac:ninist=a=ion, sc: edu:es, cost _cr C^.. == , nA -ns- � ..1. _ -�:. �bSErVB: f on and approval . D. Insure that the consultants and the c ^ cc ract"a:±• a" requi red pe:--its prior to the start Of cCC,_ ,.: construction, filing approvals of plans with governmental bodies and es 'raving j ur isd=ction, that all work is �.:t_i_�- completed in accordance with -applicable codes and 47 local ar.d state requirements and acquire =a:io^s Or var_ •-es where regzired. that the schedule of c6�letion•,a_�:- - c, Insure So-•errbe: U9, 1996 be s:_ictlly adhered to. 6. =^'A uavmlless and Indemnification Co;:r:.y a.*:..d .;RS each represents to the other tat _ _ carries suitable p,„blic liability and property damage :_--nsured in amounts adequate to cover _ems-ra ce, or is se r claim within the limitations of Section 768.28 arising - e ~e^_ses under se o^is _ �ne p 1 ryreeriert and will continue to carry such insurance or the err re term of this f s. a. be respcnsib_e for any ac:s n� -ents Grad e.:.oioyees. =ach �:eyger.:.e _. o e part o: i�s agents -- -arty sha:'_ hold the other party harmless from all claims -e o` its agents, e�•oloyees and arts_::g f=on hey--y_ ... independent contra-t-rs in connection with this Agreement, and shall defend the other party against all claims arisir:5 out of such negligence of its agents, employees and incependent contractors '.:nde-- this lease. 7. Count Ri '.:ts: Use of Facilities In accordance with the Standard Contract, Attachment sec=ion v� (c) :i`_es and equipment provided by e_:*-e__ 48 I parry for the CPHU shall to used for public health servi;.es : rt to u-se su:.h; .;s;:a:1 have the �r 9 • - pr�•: _ded :ha: t`.e ccL . -y• facilities and equipment, owned oir leaaed�:6y�the county; as reed arises, to the exaent that such 'us0 would. -not - the impose an unwarranted interference with the operation of the 8. County Obli atio^s: Re lacement of Facilities Destruction - in the event of a partial or total cestruction of the pre^ises during the term of this Agreement from any cause, the County shall forthwith restore same as soot: as reasonac'_y pess:ble and :f eccncn:_cally feasible. Any partial or total destruction shall neither nor vole this AgrBeTen=• - 9. Coordina~ ion of r:,nst rue _ ion y�cS Ob..i �t_cn: HRS through Monroe County Public Health Unit (MCPHU) _ais of_; stall consul-- with and coordinate with the County _ Construction Manager for the planning, construction, _ns=allation and ',:se of the Facilities. The 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 Co,:rty and ::RS that HRS s::a:l have absolute control over the location and placement of the Facilities upon the Marathon M�-HU pre.r►ises. No other structures, it:.preverer,ts, or 49 f i-.%-_ores shall be paced -,Pon tte Marathon MCPHU premises w-:ss:cn of HRS• pr.y approval N _ : ' l7li t p r � = = is ' � :: e � �:� ... .� .: R:..:;.. - . ,;. _ . ,,.aA.t•�,,;:-a...a„G...•,r+f i-t;`� . , ,required by HRS hereunder shall not be unreasonably wi:t eld. 10. HRS Obli ation: Control over Premises The Cou-_y agrees that, in the event of the sale, lease - ^•her d; s^^s4 4 o. the premises currently owned by the c_ - Co,;n--y upon which the Facilities are located, the County s':a-- 'l insure at such lease, sale or other disposition is - s;:_-;ect to tis Agreement and will not interfere with HRS's --;..:s u::der :.._s A:reerent, so long as this Agree:neau- t s:a_ re-:ain in ful: force and effect. of Facilities spa__ .:a•e _: e r_5`t tc use t^e es nS - interference :0 promote, protect, maintain and improve t:Ae '.aa;th and sa_o:y of t-e citizens and visitors through promotion of cublic health, the control and eradication, of :e•;e^.table .::seases, and the provision of primary health care for special populations. 12. HRS Obligations: Supervision of Activities FRS shall_ be responsible for the supervision of all activities *,.vo'ving the use of the Facilities which HRS or xf_'?':U officials have sponsored, scheduled or over which ::nS would normally exercise control. 50 13. Co,.:nty Cbl ations• Fro -Rats Reimbursement to ==•� 1-;RS may cancel Agreement and elect to terminate itQ respons:bi'_::y .or operation: and mairte^ante of the Facilities because of a material breach of the Agreement t/ t*-e County. As defied by this Agree:ent, a material brea:: shall be one that subs:antially departs from the letter ant ��n eve;- of f } ~er�:s o` :his Agree: - the .ent. � - s;rit o the cancellation the County shall, within six (6) months of c=ncellation, re`Tbu=se FRS for the adjusted value of the Fa;,-lities put In by FRS. 13. This Agreement maf not be assigned, and the County c= rct r r s-:^he Faci--_}e5, RS May e.. _ ..^ _.,-ease any part of t t} press o::or written consent of the ct=er �_t-out a e:. 14. Notice of Breach; Cure In the evert of a breach of any term of this Agreeme-: �y one party, 4t shail be the obligation of the other parw to provide written notice of such breach or violation, and a reasonable period of time shall be allowed for the curing of such breach or violation, the reasonableness of the time period being dete^::ne� by the circumstances and .nature cf the breach. 15. Notice of unsafe Condition 51 In the even that either par:/ Becomes aware of an _:.s-:.-e sit -= n it stall correct :*..a sane or, i= sac^ :a aa_.o, the responsibility of the other pa==_l, notify the otter party of the hazard and the need for corrective action. In all other respects, the prcvisior.s of the Standard contract between the Monroe County Board Of County Corr_nissioners and the State of Florida Department of wealth and Rehabilitative Services, dated, October 1, 1994, shall _ regain in e`fect and be unchanged b;r this addendum. 52 1N WITNESS WHEREOF, the Board of County Com'nissicr-ers c: Xo::roe Cc.:^ty, :lor:da, •F;:rsuant to a a.ot'or. c�:;r :-.ade, seconded and passed in regular and open session and by and through its Mayor and Clerk; and HRS, by and t'=ought its District 11 Administrator and Monroe County P::blic Health Adri^-straLor, have affixed their respec:_•:e and representative hands and seals on the dates ind:cated. BOARD 0. COUNTY CC�'�'.ISSIC`:=RS (Sr..AI') ego OF MONROE COUNTY, FLORIDA Attest �AI�NY � K�I�iAGE, , 7 ny JY J �/ - V Date: ` (SEAL) OF Attest: SERVICES STATE 0.7 DEPARTMENT A\= By BY • mc?'Hu s ra fZ Date: 53 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 I. Sexually Transmitted Disease Program 2. Dental Health 3. Special Supplemental Food Program for Women, Infants and Children. A. Improved Pregnancy Outcome 5. Family Planning Requirement 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 150.27. 54 ATTACHMENT IX 6. Immunization 7. CPHU Program S. Chronic Disease Program 9. Environmental Health 10. AIDS Program 11. School Health Services (Continued) 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. 55 Addendum to Standard Contract Between Monroe County Board of Commissioners and State of Florida Department of Health and Rehabilitative Services County and HRS each represents to the other that is carries suitable public liability and property damage insurance, or is self -insured in amounts adequate to cover any claim within the limitations of Section 768.28 arising in connection with the lease of the premises under this Agreement and will continue to carry such insurance or remain self -insured during the entire term of this Agreement. Each party shall be responsible for any acts of negligence on the part of its agents or employees. Each party shall hold the other party harmless from all claims arising from negligence of its agents, employees and independent contractors in connections with this Agreement, and shall defend the other party against all claims arising out of such negligence of its agents, employees and independent contractors under this lease. 56