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Kevin Madok CPA
Clerk of the Circuit Court & Comptroller — Monroe County, Florida
DATE: December 14, 2017
TO: Lindsey Ballard
Aide to the County Administrator
FROM: Pamela G. Hanc4*.C.
SUBJECT: November 14" BOCC Meeting
Attached are four (4) duplicate originals of Item P1, Contract with the State of Florida,
Department of Health, for operation of the Monroe County Health for operation of the Monroe
County Health Department - Contract Year 2017 -2018, executed on belialf' of' Monroe County for
your handling.
Please be sure to return two fully executed originals to me once returned from the state.
Should you have any questions, please feel free to contact me at ext. 3130. Thank you.
cc: County Attorney w/o document
Finance
File
KEY WEST
MARATHON
PLANTATION KEY
PK/ROTH BUILDING
500 Whitehead Street
3117 Overseas Highway
88820 Overseas Highway
50 High Point Road
Key West, Florida 33040
Marathon, Florida 33050
Plantation Key, Florida 33070
Plantation Key, Florida 33070
305- 294 -4641
305- 289 - 6027
305- 852 -7145
305 - 852 -7145
CONTRACT BETWEEN
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
AND
STATE OF FLORIDA DEPARTMENT OF HEALTH
FOR OPERATION OF THE
MONROE COUNTY HEALTH DEPARTMENT
CONTRACT YEAR 2017 -2018
This contract is made and entered into between the State of Florida, Department of Health
( "State ") and the Monroe County Board of County Commissioners ( "County "), through their
undersigned authorities, effective October 1, 2017.
RECITALS
A. Pursuant to Chapter 154, Florida Statutes, the intent of the legislature is to
"promote, protect, maintain, and improve the health and safety of all citizens and visitors of
this state through a system of coordinated county health department services."
B. County Health Departments were created throughout Florida to satisfy this
legislative intent through "promotion of the public's health, the control and eradication of
preventable diseases, and the provision of primary health care for special populations."
C. Monroe County Health Department ( "CHD ") is one of the created County Health
a Departments.
D. It is necessary for the parties hereto to enter into this contract in order to ensure
coordination between the State and the County in the operation of the CHD.
NOW THEREFORE, in consideration of the mutual promises set forth herein, the
sufficiency of which are hereby acknowledged, the parties hereto agree as follows:
1. RECITALS The parties mutually agree that the foregoing recitals are true and correct
and incorporated herein by reference.
2. TERM The parties mutually agree that this contract shall be effective from October 1,
2017, through September 30, 2018, or until a written contract replacing this contract is
entered into between the parties, whichever is later, unless this contract is otherwise
terminated pursuant to the termination provisions set forth in paragraph 8. below.
3. SERVICES MAINTAINED .BY THE CHD The parties mutually agree that the CHD
shall provide those services as set forth on Part III of Attachment II hereof, in order to
maintain the following three levels of service pursuant to section 154.01(2), Florida Statutes,
as defined below:
a. "Environmental health services" are those services which are organized and operated
to protect the health of the general public by monitoring and regulating activities in the
environment which may contribute to the occurrence or transmission of disease.
Environmental health services shall be supported by available federal, state and local funds
and shall include those services mandated on a state or federal level. Examples of
environmental health services include, but are not limited to, food hygiene, safe drinking
water supply, sewage and solid waste disposal, swimming pools, group care facilities,
migrant labor camps, toxic material control, radiological health, and occupational health.
b. "Communicable disease control services" are those services which protect the health
of the general public through the detection, control, and eradication of diseases which are
transmitted primarily by human beings. Communicable disease services shall be supported
by available federal, state, and local funds and shall include those services mandated on a
state or federal level. Such services include, but are not limited to, epidemiology, sexually
transmissible disease detection and control, HIV /AIDS, immunization, tuberculosis control
and maintenance of vital statistics.
c. "Primary care services" are acute care and preventive services that are made
available to well and sick persons who are unable to obtain such services due to lack of
income or other barriers beyond their control. These services are provided to benefit
individuals, improve the collective health of the public, and prevent and control the spread of
disease. Primary health care services are provided at home, in group settings, or in clinics.
These services shall be supported by available federal, state, and local funds and shall
include services mandated on a state or federal level.- Examples of primary health care
services include, but are not limited to: first contact acute care services; chronic disease
detection and treatment; maternal and child health services; family planning; nutrition; school
health; supplemental food assistance for women, infants, and children; home health; and
dental services.
4. FUNDING The parties further agree that funding for the CHD will be handled as
follows:
a. The funding to be provided by the parties and any other sources is set forth in Part II
of Attachment II hereof. This funding will be used as shown in Part I of Attachment II.
i. The State's appropriated responsibility (direct contribution excluding any state
fees, Medicaid contributions or any other funds not listed on the Schedule C) as
provided in Attachment II, Part II is an amount not to exceed $ 4,793,306
(State General Revenue, State Funds, Other State Funds and Federal Funds listed on the
Schedule C). - The State's obligation to pay under this contract is contingent
upon an annual appropriation by the Legislature.
ii. The County's appropriated responsibility (direct contribution excluding any fees,
other cash or local contributions) as provided in Attachment II, Part II is an
amount not to exceed $ 1,165,070 (amount listed under the "Board of - County
Commissioners Annual Appropriations section of the revenue attachment).
b. Overall expenditures will not exceed available funding or budget authority, whichever
is less, (either current year or from surplus trust funds) in any service category. Unless
requested otherwise, any surplus at the end of the term of this contract in the County Health
2
Department Trust Fund that is attributed to. the CHD shall be carried forward to the next
contract period.
c. Either party may establish service fees as allowed by law to fund activities of the CHD.
Where applicable, such fees shall be automatically adjusted to at least the Medicaid fee
schedule.
d. Either party may increase or decrease funding of this contract during the term hereof
by notifying the other party in writing of the amount and purpose for the change in funding. If
the State initiates the increase /decrease, the CHD will revise the Attachment II and send a
copy of the revised pages to the County and the Department of Health, Office of Budget and
Revenue Management. If the County initiates the increase /decrease, the County shall notify
the CHD. The CHD will then revise the Attachment II and send a copy'of the revised pages
to the Department of Health, Office of Budget and Revenue Management.
e. The name and address of the official payee to whom payments shall be made is:
County Health Department Trust Fund
Monroe County
PO Box 6193
Key West, FL 33041
5. CHD DIRECTOR /ADMINISTRATOR Both parties agree the director /administrator of
the CHD shall be a State employee or under contract with the State and will be under the
day -to -day direction of the Deputy Secretary for County Health Systems. The
director /administrator shall be selected by the State with the concurrence of the County. The
director /administrator of the CHD shall ensure that non - categorical sources of funding are
used to fulfill public health priorities in the community and the Long -Range Program Plan.
6. ADMINISTRATIVE POLICIES AND PROCEDURES The parties hereto agree that
the following standards should apply in the operation of the CHD:
a. The CHD and its personnel shall follow all State policies and procedures, except to the
extent permitted for the use of County purchasing procedures as set forth in subparagraph
b., below. All CHD employees shall be State or State- contract personnel subject to State
personnel rules and procedures. Employees will report time in the Health Management
System compatible format by program component as specified by the State.
b. The CHD shall comply with all applicable provisions of federal and state laws and
regulations relating to its operation with the exception that the use of County purchasing
procedures shall be allowed when it will result in a better price or service and no statewide
Department of Health purchasing contract has been implemented for those goods or
services. In such cases, the CHD director /administrator must sign a justification therefore,
and all County purchasing procedures must be followed in their entirety, and such
compliance shall be documented. Such justification and compliance documentation shall be
maintained by the CHD in accordance with the terms of this contract. State procedures must
be followed for all leases on facilities not enumerated in Attachment IV.
3
c. The CHD shall maintain books, records and documents in accordance with the
Generally Accepted Accounting Principles (GAAP), as promulgated by the Governmental
Accounting Standards Board (GASB), and the requirements of federal or state law. These
records shall be maintained as required by the Department of Health Policies and
Procedures for Records Management and shall be open for inspection at any time by the
parties and the public, except for those records that are not otherwise subject to disclosure
as provided by law which are subject to the confidentiality provisions of paragraphs 6.i. and
6.k., below. Books, records and documents must be adequate to allow the CHD to comply
with the following reporting requirements:
i. The revenue and expenditure requirements in the Florida Accounting
Information Resource (FLAIR) System;
ii. The client registration and services reporting requirements of the minimum
data set as specified in the most current version of the Client Information
System /Health Management Component Pamphlet;
N. Financial procedures specified in the Department of Health's Accounting
Procedures Manuals, Accounting memoranda, and Comptroller's
memoranda;
iv. The CHD is responsible for assuring that all contracts with service
providers include provisions that all subcontracted services be reported to
the CHD in a manner consistent with the client registration and service
reporting requirements of the minimum data set as specified in the Client
Information System /Health Management Component Pamphlet.
d. All funds for the CHD shall be deposited in the County Health Department Trust Fund
maintained by the state treasurer. These funds shall be accounted for separately from funds
deposited for other CHDs and shall be used only for public health purposes in Monroe
County.
e. That any surplus /deficit funds, including fees or accrued interest, remaining in the
County Health Department Trust Fund account at the end of the contract year shall be
credited /debited to the State or County, as appropriate, based on the funds contributed by
each and the expenditures incurred by each. Expenditures will be charged to the program
accounts by State and County based on the ratio of planned expenditures in this contract
and funding from all sources is credited to the program accounts by State and County. The
equity share of any surplus /deficit funds accruing to the State and County is determined each
month and at contract year -end. Surplus funds may be applied toward the funding
requirements of each participating governmental entity in the following year. However, in
each such case, all surplus funds, including fees and accrued interest, shall remain in the
trust fund until 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 capital projects explained in
Attachment V.
4
f. There shall be no transfer of funds between the three levels of services without a
contract amendment unless the CHD director /administrator determines that an emergency
exists wherein a time delay would endanger the public's health and the Deputy Secretary for
County Health Systems has approved the transfer. The Deputy Secretary for County Health
Systems shall forward written evidence of this approval to the CHD within 30 days after an
emergency transfer.
g. The CHD may execute subcontracts for services necessary to enable the CHD to
carry out the programs specified in this contract. Any such subcontract shall include all
aforementioned audit and record keeping requirements.
°h. At the request of either party, an audit may be conducted by an independent CPA on
the financial records of the CHD and the results made available to the parties within 180
days after the close of the CHD fiscal year. This audit will follow requirements contained in
OMB Circular A -133 and may be in conjunction with audits performed by County
government. If audit exceptions are found, then the director /administrator of the CHD will
prepare a corrective action plan and a copy of that plan and monthly status reports will be
furnished to the contract managers for the parties.
i. The CHD shall not use or disclose any information concerning a recipient of services
except as allowed by federal or state law or policy.
j. The CHD shall retain all client records, financial records, supporting documents,
statistical records, and any other documents (including electronic storage media) pertinent to
this contract for a period of five (5) years after termination of this contract. If an audit has
been initiated and audit findings have not been resolved at the end of five (5) years, the
records shall be retained until resolution of the audit findings.
k. The CHD shall maintain confidentiality of all data, files, and records that are
confidential under the law or are otherwise exempted from disclosure as a public record
under Florida law. The CHD shall implement procedures to ensure the protection and
confidentiality of all such records and shall comply with sections 384.29, 381.004, 392.65
and 456.057, Florida Statutes, and all other state and federal laws regarding confidentiality.
All confidentiality procedures implemented by the CHD shall be consistent with the
Department of Health Information Security Policies, Protocols, and Procedures. The CHD
shall further adhere to any amendments to the State's security requirements and shall
comply with any applicable professional standards of practice with respect to client
confidentiality.
I. The CHD shall abide by all State policies and procedures, which by this reference are
incorporated herein as standards to be followed by the CHD, except as otherwise permitted
for some purchases using County procedures pursuant to paragraph 6.b.
m. The CHD shall establish a system through which applicants for services and current
clients may present grievances over denial, modification or termination of services. The CHD
will advise applicants of the right to appeal a denial or exclusion from services, of failure to
5
take account of a client's choice of service, and of his /her right to a fair hearing to the final
governing authority of the agency. Specific references to existing laws, rules or program
manuals are included in Attachment I of this contract.
n. The CHD shall comply with the provisions contained in the Civil Rights Certificate,
hereby incorporated into this contract as Attachment III.
o. The CHD shall submit quarterly reports to the County that shall include at least the
following:
i. The DE3851-1 Contract Management Variance Report and the DE580L1
Analysis of Fund Equities Report;
ii. A written explanation to the County of service variances reflected in the
year end DE3851-1 report if the variance exceeds or falls below 25 percent
of the planned expenditure amount for the contract year. However, if the
amount of the service specific variance between actual and planned
expenditures does not exceed three percent of the total planned
expenditures for the level of service in which the type of service is included,
a variance explanation is not required. A copy of the written explanation
shall be sent to the Department of Health, Office of Budget and Revenue
Management.
p. The dates for the submission of quarterly reports to the County shall be as follows
unless the generation and distribution of reports is delayed due to circumstances beyond the
CHD's control:
i. March 1, 2018 for the report period October 1, 2017 through
December 31, 2017;
ii. June 1, 2018 for the report period October 1, 2017 through
March 31, 2018;
iii. September 1, 2018 for the report period October 1, 2017
through June 30, 2018; and
iv. December 1, 2018 for the report period October 1, 2017
through September 30, 2018.
7. FACILITIES AND EQUIPMENT The parties mutually agree that:
a. CHD facilities shall be provided as specified in Attachment IV to this contract and the
County shall own the facilities used by the CHD unless otherwise provided in Attachment IV.
b. The County shall ensure adequate fire and casualty insurance coverage for County -
owned CHD offices and buildings and for all furnishings and equipment. in CHD offices
through either a self- insurance program or insurance purchased by the County.
C.
c. All vehicles will be transferred to the ownership of the County and registered as
County vehicles. The County shall ensure insurance coverage for these vehicles is available
through either a self- insurance program or insurance purchased by the County. All vehicles
will be used solely for CHD operations. Vehicles purchased through the County Health
Department Trust Fund shall be sold at fair market value when they are no longer needed by
the CHD and the proceeds returned to the County Health Department Trust Fund.
8. TERMINATION
a. Termination at Will This contract may be terminated by either party without cause
upon no less than one - hundred eighty (180) calendar days notice in writing to the other party
unless a lesser time is mutually agreed upon in writing by both parties. Said notice shall be
delivered by certified mail, return receipt requested, or in person to the other party's contract
manager with proof of delivery.
b. Termination Because of Lack of Funds In the event funds to finance this contract
become unavailable, either party may terminate this contract upon no less than twenty -four
(24) hours notice. Said notice shall be delivered by certified mail, return receipt requested, or
in person to the other party's contract manager with proof of delivery.
c. Termination for Breach This contract may be terminated by one party, upon no less
than thirty (30) days notice, because of the other party's failure to perform an obligation
hereunder. Said notice shall be delivered by certified mail, return receipt requested, or in
person to the other party's contract manager with proof of delivery. Waiver of breach of any
provisions of this contract shall not be deemed to be a waiver of any other breach and shall
not be construed to be a modification of the terms of this contract.
9. MISCELLANEOUS The parties further agree:
a. Availability of Funds If this contract, any renewal hereof, or any term, performance or
payment hereunder, extends beyond the fiscal year beginning July 1, 2018, it is agreed that
the performance and payment under this contract are contingent upon an annual
appropriation by the Legislature, in accordance with section 287.0582, Florida Statutes.
b. Contract Managers The name and address of the contract managers for the parties
under this contract are as follows:
For the State:
Mary Vanden Brook, J.D.
Administrative Services Director
1100 Simonton Street
Key West, FL 33040
For the County:
Roman Gastesi
County Administrator
1100 Simonton Street
Key West, FL 33040
305 - 809 -5612 - 305 - 292 -4441
If different contract managers are designated after execution of this contract, the name,
address and telephone number of the new representative shall be furnished in writing to the
other parties and attached to originals of this contract.
c. Captions The captions and headings contained in this contract are for the
convenience of the parties only and do not in any way modify, amplify, or give additional
notice of the provisions hereof.
In WITNESS THEREOF, the parties hereto have caused this eight page contract, with its
attachments as referenced, including Attachment I (two pages), Attachment II (six pages),
Attachment III (one page), Attachment IV (one page), and Attachment V (one page), to be
executed by their undersigned officials as duly authorized effective the 1St day of October,
2017.
BOARD OF COUNTY COMMISSIONERS
FOR MONROE COUNTY
SIGNED BY: -"
NAME David Rice
STATE OF FLORIDA
DEPARTMENT OF HEALTH
SIGNED BY: ' 2�=
NAME: Celeste Philip, MD, MPH
TITLE: Surgeon General and Secretary
DATE: / > lag // - -7
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SIGNED = / ?9_.i
Pamela Hancock
TITLE Deputy Clerk
DATE: 2.0 -7
MONROE COUNTY ATTORNEY
AP OVEN TO 0
C NTHIA L. ALL
A551STANT COU A - B EY
Oate
NAME: Robert Eadie, J.D.
TITLE: CHD DirectorlAdministrator
DATE: ' -11 1azl17
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TITLE Mayor
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TITLE Mayor
ATTACHMENT
MONROE COUNTY HEALTH DEPARTMENT
PROGRAM SPECIFIC REPORTING REQUIREMENTS AND PROGRAMS REQUIRING
COMPLIANCE WITH THE PROVISIONS OF SPECIFIC MANUALS
Some health services must comply with specific program and reporting requirements in addition to the Personal Health
Coding Pamphlet (DHP 50 -20), Environmental Health Coding Pamphlet (DHP 50 -21) and FLAIR requirements because of
federal or state law, regulation or rule. If a county health department is funded to provide one of these services, it must
comply with the special reporting requirements for that service. The services and the reporting requirements are listed
below:
Service
1. Sexually Transmitted Disease
Program
2. Dental Health
3. Special Supplemental Nutrition
Program for Women, Infants and
Children (including the WIC
Breastfeeding Peer Counseling
Program)
4. Healthy Start/ Improved Pregnancy
Outcome
Requirement
Requirements as specified in F.A.C. 64D -3, F.S. 381 and F.S. 384.
Periodic financial and programmatic reports as specified by the
program office.
Service documentation and monthly financial reports as specified in
DHM 150 -24" and all federal, state and county requirements
detailed in program manuals and published procedures.
Requirements as specified in the 2007 Healthy Start Standards and
Guidelines and as specified by the Healthy Start Coalitions in
contract with each county health department.
5. Family Planning Requirements as specified in Public Law 91 -572, 42 U.S.C. 300, et
seq., 42 CFR part 59, subpart A, 45 CFR parts 74 & 92, 2 CFR 215
(OMB Circular A -110) OMB Circular A -102, F.S. 381.0051, F.A.C.
64F -7, F.A.C. 64F -16, and F.A.C. 64F -19. Requirements and
Guidance as specified in the Program Requirements for Title X
Funded Family Planning Projects (Title X Requirements) (2014) and
the Providing Quality Family Planning Services (QFP):
Recommendations of CDC and the U.S. Office of Population Affairs
published on the Office of Population Affairs website.
Programmatic annual reports as specified by the program office as
specified in the annual programmatic Scope of Work for Family
Planning and Maternal Child Health Services, including the Family
Planning Annual Report (FPAR), and other minimum guidelines as
specified by the Policy Web Technical Assistance Guidelines.
6. Immunization Periodic reports as specified by the department pertaining to
immunization levels in kindergarten and /or seventh grade pursuant
to instructions contained in the Immunization Guidelines - Florida
Schools, Childcare Facilities and Family Daycare Homes (DH Form
150 -615) and Rule 64D- 3.046, F.A.C. In addition, periodic reports
as specified by the department pertaining to the
surveillance /investigation of reportable vaccine - preventable
diseases, adverse events, vaccine accountability, and assessment
of immunization
Attachment - Page 1 of 11
ATTACHMENT I (Continued)
levels as documented in Florida SHOTS and supported by CHID
Guidebook policies and technical assistance guidance.
7. Environmental Health Requirements as specified in Environmental Health Programs
Manual 150-4* and DHP 50 -21*
8. HIV /AIDS Program Requirements as specified in F.S. 384.25 and F.A.C. 64D -3.030
and 64D- 3.031. Case reporting should be on Adult HIV /AIDS
Confidential Case Report CDC Form DH2139 and Pediatric
HIV /AIDS Confidential Case Report CDC Form DH2140.
Requirements as specified in F.A.C. 64D -2 and 64D -3, F.S. 381 and
F.S. 384. Socio- demographic and risk data on persons tested for
HIV in CHID clinics should be reported on Lab Request DH Form
1628 in accordance with the Forms Instruction Guide.
Requirements for the HIV /AIDS Patient Care programs are found in
the Patient Care Contract Administrative Guidelines.
9. School Health Services Requirements as specified in the Florida School Health
Administrative Guidelines (May 2012). Requirements as specified
in F.S. 381.0056, F.S. 381.0057, F.S. 402.3026 and F.A.C. 64F-6.
10. Tuberculosis Tuberculosis Program Requirements as specified in F.A.C. 64D -3
and F.S. 392.
11. General Communicable Disease Carry out surveillance for reportable communicable and other acute
Control diseases, detect outbreaks, respond to individual cases of
reportable diseases, investigate outbreaks, and carry out
communication and quality assurance functions, as specified in
F.A.C. 64D -3, F.S. 381, F.S. 384 and the CHID Epidemiology Guide
to Surveillance and Investigations.
12. Refugee Health Program Programmatic and financial requirements as specified by the
program office.
*or the subsequent replacement if adopted during the contract period.
Attachment I - Page 2 of 11
ATTACHMENT II
MONROE COUNTY HEALTH DEPARTMENT
PART I. PLANNED USE OF COUNTY HEALTH DEPARTMENT TRUST FUND BALANCES
Estimated State Estimated County
Share of CHD Trust Share of CHD Trust
Fund Balance Fund Balance Total
1. CHD Trust Fund Ending Balance 09/30/17
2. Drawdown for Contract Year
October 1, 2017 to September 30, 2018
138445 131630 270075
-14549 423722 409173
3. Special Capital Project use for Contract Year
October 1, 2017 to September 30, 2018
0 0 0
4. Balance Reserved for Contingency Fund
October 1, 2017 to September 30, 2018
123896 555352 679248
Special Capital Projects are new construction or renovation projects and new furniture or equipment associated with these projects, and mobile health vans.
Attachment_II_Part_I - Page 3 of 11
2. NON GENERAL REVENUE - STATE
015010
ENVIRONMENTAL BIOMEDICAL WASTE PROGRAM
4,164
0
4,164
0
4,164
ATTACHMENT.II
TOBACCO STATE AND COMMUNITY INTERVENTIONS
118,154
0
118,154
0
:. MONROE,COUNTY'HEALTHDEPARTMENT
015010
HURRICAN MATTHEW EXECUTIVE ORDER 16-230
0
0
0
Fart: II, Sources of Contnbudi ne to Couatp Health: Department,
,.
0
NON GENERAL REVENUE TOTAL
122,318
October 1, 2017 to• September 30
122,318
0
122,318
3. FEDERAL FUNDS - STATE
State: CHII County
Total , 'CHD,
1
AIDS DRUG ASSISTANCE PROGRAM ADMIN HQ
-
- - CHD'
st.Fund
0
Trnat Fnnd
Other.
40,403
007000
(cash) `Truat;Fund
(cash) "
Coatribution
"Total
1. GENERAL REVENUE - STATE
70,202
007000
COASTAL BEACH WATER QUALITY MONITORING
17,088
015040
AIDS PATIENT CARE 370,000
0
370,000
0
370,000
015040
AIDS PREVENTION & SURVEILLANCE - GENERAL REVENUE 73,552
0
73,552
0
73,552
015040
AIDS NETWORK REIMBURSEMENT 259,200
0
259,200
0
259,200
015040
CHD - TB COMMUNITY PROGRAM 23,756
0
23,756
0
23,756
015040
SEXUALLY TRANSMITTED DISEASE CONTROL PROGRAM GR 16,755
0
16,755
0
16,755
015040
EPIDEMIOLOGY SURVEILLANCE GENERAL REVENUE 63,322
0
63,322
0
63,322
015040
FAMILY PLANNING GENERAL REVENUE 59,426
0
59,426
0
59,426
015040
HEPATITIS AND LIVER FAILURE PREVENTION & CONTROL 72,000
0
72,000
0
72,000
015040
PRIMARY CARE PROGRAM 199,742
0
199,742
0
199,742
015040
SCHOOL HEALTH SERVICES - GENERAL REVENUE 96,223
0
96,223
0
96,223
015050
CHD GENERAL REVENUE NON - CATEGORICAL 1,274,203
0
1,274,203
0
1,274,203
GENERAL REVENUE TOTAL 2,508,179
0
2,508,179
0
2,508,179
2. NON GENERAL REVENUE - STATE
015010
ENVIRONMENTAL BIOMEDICAL WASTE PROGRAM
4,164
0
4,164
0
4,164
015010
TOBACCO STATE AND COMMUNITY INTERVENTIONS
118,154
0
118,154
0
118,154
015010
HURRICAN MATTHEW EXECUTIVE ORDER 16-230
0
0
0
0
0
NON GENERAL REVENUE TOTAL
122,318
0
122,318
0
122,318
3. FEDERAL FUNDS - STATE
007000
AIDS DRUG ASSISTANCE PROGRAM ADMIN HQ
40,403
0
40,403
0
40,403
007000
WIC BREASTFEEDING PEER COUNSELING PROG
70,202
0
70,202
0
70,202
007000
COASTAL BEACH WATER QUALITY MONITORING
17,088
0
17,088
0
17,088
007000
COMPREHENSIVE COMMUNITY CARDIO - PHBG
44,273
0
44,273
0 '
44,273
007000
FAMILY PLANNING TITLE X - GRANT
52,305
0
52,305
0
52,305
007000
HOUSING OPPORTUNITIES FOR PERSONS WITH AIDS
399,225
0
399,225
0
399,225
007000
RVIMUNIZATION ACTION PLAN
38,582
0
38,582
0
38,582
007000
MCH SPECIAL PRJCT UNPLANNED PREGNANCY
17,153
0
17,153
0
17,153
007000
BASE COMMUNITY PREPAREDNESS CAPABILITY
104,557
0
104,557
0
104,557
007000
AIDS PREVENTION
133,664
0
133,664
0
133,664
007000
RYAN WHITE TITLE II CARE GRANT
120,976
0
120,976
0
120,976
007000
RYAN WHITE TITLE II GRANT /CHD CONSORTIUM
481,668
0
481,668
0
481,668
007000
WIC PROGRAM ADMINISTRATION
295,500
0
295,500
0
295,500
007000
ZIKA ELC M2 PREGNANCY REGISTRY
55,492
0
55,492
0
55,492
015075
SUPPLEMENTAL SCHOOL HEALTH
123,839
0
123,839
0
123,839
015075
REFUGEE HEALTH SCREENING REIMBURSEMENT ADMIN
7,067
0
7,067
0
7,067
015075
REFUGEE HEALTH SCREENING REIMBURSEMENT SERVICES
58,982
0
58,982
0
58,982
018005
RYAN WHITE TITLE II ADAP DRUG REBATES
60,307
0
60,307
0
60,307
FEDERAL FUNDS TOTAL
2,121,283
0
2,121,283
0
2,121,283
4. FEES ASSESSED BY STATE OR FEDERAL RULES - STATE
001020
CHD STATEWIDE ENVIRONMENTAL FEES
112,150
0
112,150
0
112,150
001092
CHD STATEWIDE ENVIRONMENTAL FEES
149,324
0
149,324
0
149,324
001206
ON SITE SEWAGE DISPOSAL PERMIT FEES
18,000
0
18,000
0
18,000
Attachment_I I_Part_I
I - Page 4 of 11
ATTACHMENT II. .
MONROE COUNTY
HEALTA DEPARTMENT
..
Part IIs. Sources of" Contribution -to County H3 bLIt&:Department
October 1, 2017 t,6 September 3Q. .
.StEte CfID , , ",.,.0
oujity Tp , , CIiD
- f
Trust "Fund '
CHI3 :TruatFund;,-
Otlier
_ `,: _ " _` -. ,` _ _: :._ _
_ _ • (web) , Trast Fund
Contribution
, Total:
001206 SANITATION CERTIFICATES (FOOD INSPECTION)
1,800
0
1,800
0
1,800
001206 SEPTIC TANK RESEARCH SURCHARGE
500
0
500
0
500
001206 PUBLIC SWINMIING POOL PERMIT FEES-10% HQ TRANSFER
3,500
0
3,500
0
3,500
001206 REGULATION OF BODY PIERCING SALONS
35
0
35
0
35
001206 TANNING FACILITIES
100
0
100
0
100
001206 TATTO PROGRAM ENVIRONMENTAL HEALTH
550
0
550
0
550
001206 MOBILE HOME & RV PARK FEES
1,750
0
1,750
0
1,750
FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL
287,709
0
287,709
0
287,709
5. OTHER CASH CONTRIBUTIONS - STATE:
0
0
0
0
0
090001 DRAW DOWN FROM PUBLIC HEALTH UNIT
14,549
0
14,549
0
14,549
OTHER CASH CONTRIBUTION TOTAL
14,549
0
14,549
0
14,549
6. MEDICAID - STATE /COUNTY-
001148 CHD CLINIC FEES
0
56,999
56,999
0
56,999
MEDICAID TOTAL
0
56,999
56,999
0
56,999
7. ALLOCABLE REVENUE - STATE:
031005 ZIKA PREGNANT WOMEN TESTING
4,623
0
4,623
0
4,623
ALLOCABLE REVENUE TOTAL
4,623
0
4,623
0
4,623
8. OTHER STATE CONTRIBUTIONS NOT IN CHD TRUST FUND - STATE
ADAP
0
0
0
590,528
590,528
PHARMACY DRUG PROGRAM
0
0
0
19,964
19,964
WIC PROGRAM
0
0
0
925,569
925,569
BUREAU OF PUBLIC HEALTH LABORATORIES
0
0
0
10,774
10,774
IMMUNIZATIONS
0
0
0
747,701
747,701
OTHER STATE CONTRIBUTIONS TOTAL
0
0
0
2,294,536
2,294,536
9. DIRECT LOCAL CONTRIBUTIONS - BCC /TAX DISTRICT
008005 CHD LOCAL REVENUE & EXPENDITURES
0
776,231
776,231
0
776,231
008005 IMMUNIZATION CAMPAIGN MONROE COUNTY BOCC
0
394,540
394,540
0
394,540
008040 CHD LOCAL REVENUE & EXPENDITURES
0
300,000
300,000
0
300,000
DIRECT COUNTY CONTRIBUTIONS TOTAL
0
1,470,771
1,470,771
0
1,470,771
10. FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION - COUNTY
001077 CHD CLINIC FEES
0
43,400
43,400
0
43,400
001094 CHD LOCAL ENVIRONMENTAL FEES
0
209,300
209,300
0
209,300
001110 VITAL STATISTICS CERTIFIED RECORDS
0
75,000
75,000
0
75,000
FEES AUTHORIZED BY COUNTY TOTAL
0
327,700
327,700
0
327,700
11. OTHER CASH AND LOCAL CONTRIBUTIONS - COUNTY
001029 CHD CLINIC FEES
0
162,300
162,300
0
162,300
001090 CHD CLINIC FEES
0
98,175
98,175
0
- 98,175
005000 CHD LOCAL REVENUE & EXPENDITURES
0
6,000
6,000
0
6,000
Attachment_II_Part_II - Page 5 of 11
ATTACHMENT' a
- MONROE. COUNTY'FIEALTH DEPARTMENT •
Part Il,: Sources of,Gontrlbutions to County Health. Department
.October 1 -2017 to X
..
State
County
Total CHD
Trust Fund
GIM
Trust Eund
r. Other..:
_..,.: ... _ ._._.:.: <..e_ .• -- ..__ _. _ : , ._..
(cash) ,- .TrastFiinda...;_
casl� ___
Contribution -
Total
007010 RYAN WHITE TITLE III DIRECT TO CHD
0
274,871
274,871
0
274,871
007010 RYAN WHITE TITLE III - DIRECT TO CHD
0
273,281
273,281
0
273,281
010300 CHD SALE OF SERVICES IN OR OUTSIDE OF STATE GOVT
0
76,819
76,819
0
76,819
010400 CHD SALE OF SERVICES IN OR OUTSIDE OF STATE GOVT
0
2,400
2,400
0
2,400
010500 CHD SALE OF SERVICES IN OR OUTSIDE OF STATE GOVT
0
52,468
52,468
0
52,468
011000 MULTIGENERATIONAL COMMUNITY PARK GRANT - HFSF
0
16,125
16,125
0
16,125
011000 NACCHO - MEDICAL RESERVE CORPS
0
27,000
27,000
0
27,000
011001 CHD, HEALTHY START COALITION CONTRACT
0
290,000
290,000
0
290,000
090002 DRAW DOWN FROM PUBLIC HEALTH UNIT
0
-423,722
-423,722
0
- 423,722
OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL
0
855,717
855,717
0
855,717
12. ALLOCABLE REVENUE- COUNTY
031005 ZIKA PREGNANT WOMEN TESTING
0
4,623
4,623
0
4,623
COUNTY ALLOCABLE REVENUE TOTAL
0
4,623
4,623
0
4,623
13. BUILDINGS - COUNTY
ANNUAL RENTAL EQUIVALENT VALUE
0
0
0
597,605
597,605
OTHER (Specify)
0
0
0
0
0
UTILITIES
0
0
0
83,369
83,369
BUILDING MAINTENANCE
0
0
0
75,223
75,223
GROUNDS MAINTENANCE
0
0
0
115,566
115,566
INSURANCE
0
0
0
0
0
OTHER (Specify)
0
0
0
0
0
OTHER (Specify)
0
0
0
0
0
BUILDINGS TOTAL
0
0
0
871,763
871,763
14. OTHER COUNTY CONTRIBUTIONS NOT IN CHD TRUST FUND - COUNTY
EQUIPMENT / VEHICLE PURCHASES
0
0
0
0
0
VEHICLE INSURANCE
0
0
0
0
0
VEHICLE MAINTENANCE
0
0
0
0
0
OTHER COUNTY CONTRIBUTION (SPECIFY)
0
0
0
0
0
OTHER COUNTY CONTRIBUTION (SPECIFY)
0
0
0
0
0
OTHER COUNTY CONTRIBUTIONS TOTAL
0
0
0
0
0
GRAND TOTAL CBS PROGRAM
5,058,661
2,715,810
7,774,471
3,166,299
10,940,770
Attachment - I I_Part_II - Page 6 of 11
ATTACIDdENT'II. '
MONROE COUNTY HEAL T-H DEPARTMENT
Pair III, Planned Staffing. Clients Services and Expenditures. Bp Program 3ercico Area Within Each Level of Service,
October 1, 2017 to September 30 , 20I8:
i
_
Quarterly Expenditure Plan,
FTE s
Clients Servigeaf ,
Yst
2n d
3rd ";
: `4th '
"Grand' .
(0 00)
Tmts
visits..
nl
(Who dollars Ohl'
to
$fate
County
all,
Tot '
_ _ ..
_ .,..
_
. ,- _
_ .
_..
A. COMMUNICABLE DISEASE CONTROL:
IIVIMUNIZATION (101)
7.28
4,263
6,027
164,815
192,237
164,815
192,238
71,248
642,857
714,105
SEXUALLY TRANS. DIS. (102)
1.51
308
470
25,452
29,686
25,452
29,686
55,547
54,729
110,276
HIV /AIDS PREVENTION (03A1)
8.63
0
3,878
134,547
156,933
134,547
156,934
507,115
75,846
582,961
HIV/AIDS SURVEILLANCE (03A2)
0.00
0
0
0
0
0
0
0
0
0
HIV /AIDS PATIENT CARE (03A3)
17.12
479
4,901
579,870
676,348
579,870
676,348
1,730,659
781,777
2,512,436
ADAP (03A4)
1.81
134
288
26,097
30,440
26,097
30,440
97,139
15,935
113,074
TUBERCULOSIS (104)
1.32
47
119
25,350
29,568
25,350
29,569
54,502
55,335
109,837
COMM. DIS. SURV. (106)
3.26
0
3,162
56,139
65,479
56,139
65,480
162,987
80,250
243,237
HEPATITIS (109)
1.57
337
436
28,092
32,766
28,092
32,765
107,945
13,770
121,715
PREPAREDNESS AND RESPONSE (116)
1.85
0
998
45,079
52,579
45,079
52,579
160,148
35,168
195,316
REFUGEE HEALTH (118)
1.22
357
793
26,803
31,262
26,803
31,261
105,479
10,650
116,129
VITAL RECORDS (180)
0.87
1,979
6,127
13,596
15,859
13,596
15,859
15,488
43,422
58,910
COMMUNICABLE DISEASE SUBTOTAL
46.39
7,904
27,199
1,125,840
1,313,157
1,125,840
1,313,159
3,068,257
1,809,739
4,877,996
B. PRIMARY CARE:
CHRONIC DISEASE PREVENTION PRO (210)
0.73
69
117
13,224
15,424
13,224
15,425
57,297
0
57,297
WIC (21W1)
5.23
2,734
17,485
90,231
105,244
90,231
105,244
390,950
0
390,950
TOBACCO USE INTERVENTION (212)
2.40
0
82
37,987
44,307
37,987
44,306
164,587
0
164,587
WIC BREASTFEEDING PEER COUNSELING (21W2)
1.08
0
1,354
14,593
17,021
14,593
17,020
63,227
0
63,227
FAMILY PLANNING (223)
1.86
532
1,038
47,318
55,190
47,318
55,190
154,231
50,785
205,016
IMPROVED PREGNANCY OUTCOME (225)
0.00
0
0
0
0
0
0
0
0
0
HEALTHY START PRENATAL (227)
3.21
551
4,145
52,244
60,936
52,244
60,935
0
226,359
226,359
COMPREHENSIVE CHILD HEALTH (229)
0.00
0
0
0
0
0
0
0
0
0
HEALTHY START CHILD (231)
2.99
501
3,240
41,821
48,779
41,821
48,780
181,201
0
181,201
SCHOOL HEALTH (234)
3.77
0
113,745
66,066
77,057
66,066
77,057
286,246
0
286,246.
COMPREHENSIVE ADULT HEALTH (237)
1.43
175
445
34,172
39,858
34,172
39,858
110,461
37,599
148,060
COMMUNITY HEALTH DEVELOPMENT (238)
5.16
0
1,018
88,200
102,875
88,200
102,875
107,537
274,613
382,150
DENTAL HEALTH (240)
0.00
0
0
0
0
0
0
0
0
0
PRIMARY CARE SUBTOTAL
27.86
4,562
142,669
485,856
566,691
485,856
566,690
1,515,737
589,356
2,105,093
C. ENVIRONMENTAL HEALTH:
Water and Onsite Sewage Programs
COSTAL BEACH MONITORING (347)
0.23
224
224
6,488
7,568
6,488
7,569
28,113
0
28,113
LIMITED USE PUBLIC WATER SYSTEMS (357)
0.00
0
0
0
0
0
0
0
0
0
PUBLIC WATER SYSTEM (358)
0.01
0
0
305
355
305
355
1,320
0
1,320
PRIVATE WATER SYSTEM (359)
0.00
0
0
0
0
0
0
0
0
0
ONSITE SEWAGE TREATMENT & DISPOSAL (361)
5.79
2,720
6,930
82,898
96,690
82,898
96,690
219,176
140,000
359,176
Group Total
6.03
2,944
7,154
89,691
104,613
89,691
104,614
248,609
140,000
388,609
Facility Programs
TATTOO FACILITY SERVICES (344)
0.01
0
2
147
171
147
172
637
0
637
FOOD HYGIENE (348)
1.05
166
291
14,932
17,417
14,932
17,417
56,998
7,700
64,698
Attachment-11-Part-111 - Page 7 of 11
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ATTACHMENT III
MONROE COUNTY HEALTH DEPARTMENT
CIVIL RIGHTS CERTIFICATE
The applicant provides this assurance in consideration of and for the purpose of obtaining federal grants, loans,
contracts (except contracts of insurance or guaranty), property, discounts, or other federal financial assistance to
programs or activities receiving or benefiting from federal financial assistance. The provider agrees to complete
the Civil Rights Compliance Questionnaire, DH Forms 946 A and B (or the subsequent replacement if adopted
during the contract period), if so requested by the department.
The applicant assures that it will comply with:
1. Title VI of the Civil Rights Act of 1964, as amended, 42 U.S.C., 2000 Et seq., which prohibits
discrimination on the basis of race, color or national origin in programs and activities receiving or
benefiting from federal financial assistance.
2. Section 504 of the Rehabilitation Act of 1973, as amended, 29 U.S.C. 794, which prohibits discrimination
on the basis of handicap in programs and activities receiving or benefiting from federal financial
assistance.
3. Title IX of the Education Amendments of 1972, as amended, 20 U.S.C. 1681 et seq., which prohibits
discrimination on the basis of sex in education programs and activities receiving or benefiting from
federal financial assistance.
4. The Age Discrimination Act of 1975, as amended, 42 U.S.C. 6101 et seq., which prohibits discrimination
on the basis of age in programs or activities receiving or benefiting from federal financial assistance_
5. The Omnibus Budget Reconciliation Act of 1981, P.L. 97 -35, which prohibits discrimination on the basis
of sex and religion in programs and activities receiving or benefiting from federal financial assistance.
6. All regulations, guidelines and standards lawfully adopted under the above statutes. The applicant agrees
that compliance with this assurance constitutes a condition of continued receipt of or benefit from federal
financial assistance, and that it is binding upon the applicant, its successors, transferees, and assignees
for the period during which such assistance is provided. The applicant further assures that all contracts,
subcontractors, subgrantees or others with whom it arranges to provide services or benefits to
participants or employees in connection with any of its programs and activities are not discriminating
against those participants or employees in violation of the above statutes, regulations, guidelines, and
standards. In the event of failure to comply, the applicant understands that the grantor may, at its
discretion, seek a court order requiring compliance with the terms of this assurance or seek other
appropriate judicial or administrative relief, to include assistance being terminated and further assistance
being denied.
Attachment_III - Page 9 of 11
Attachment IV
Fiscal Year - 2017 - 2018
Monroe County Health Department
Facilities Utilized by the County Health Department
Complete Location
(Street Address, City, zip)
Facility Description
And Offical Building
Name (If applicable)
(Admin, Clinic, Envn Hlth,
etc.)
Lease/
Agreement
Number
Type of
Agreement
(Private Lease thru
State or County, other -
please define)
Complete
Legal Name
of Owner
SQ
Feet
Employee
Count
(FTE /OPS/
Contract)
1100 Simonton Street, Key West, FL
33040
Gato Building: Administration,
Clinic, Healthy Start, Vital Statistics
Lease through Monroe Cou
Monroe Coun BOCC
10,115
58
5503 College Road, Key West, FL
33040
Juvenile Justice Building:
Environmental Health
Lease through Monroe County
M onroe County BOCC
583
3
102050 Overseas Highway, Key
Largo, FL 33037
Murray E. Nelson Government
Center: Environmental Health
Lease through Monroe County
Monroe Coun BOCC
963
10
3333 Overseas Highway, Marathon,
FL 33050
"Ruth Ivins Center: Clinic,
Environmental Health
Lease through Monroe County
Monroe County BOCC
4,618
10
50 High Point Road, Tavernier, FL
33070
Roth Building: Clinic
Lease through Monroe County
Monroe County BOCC
5,803
9
Facility - a fixed site managed by DOH /CHD personnel for the purpose of providing or supporting public health services. Includes county- owned, state - owned, and
leased facilites. Includes DOH /CHD warehouse and administrative sites. Includes facilities managed by DOH /CHD that may be shared with other organizations.
Does not include schools, jails or other facilities where DOH /CHD staff are out - posted or sites where services are provided on an episodic basis.
Attachment - Page 10 of 11
V
ATTACHMENT V
MONROE COUNTY HEALTH DEPARTMENT
SPECIAL PROJECTS SAVINGS PLAN
CONTRACT YEAR
2016 -2017*
2017- 2018 **
2018- 2019***
2019- 2020***
PROJECT TOTAL
PROJECT NUMBER:
PROJECT NAME:
LOCATION /ADDRESS:
PROJECT TYPE:
CASH RESERVED OR ANTICIPATED TO BE RESERVED FOR PROJECTS
$ 0
$
1200000
X PLANNING STUDY
NEW ADDITION
$ 0
$
0
$ 0
$
200000
$ 0
$
0
$ 0
$
1400000
SPECIAL PROJECTS CONSTRUCTION /RENOVATION PLAN
STATE
COUNTY
TOTAL
$ 200000
$ 0
$ 1400000
64417100
MONROE CHO FACILITY
NEW BUILDING
ROOFING
RENOVATION
X PLANNING STUDY
NEW ADDITION
OTHER
$ 1200000
$ 0
SQUARE FOOTAGE: 3700
PROJECT SUMMARY: Describe scope of work in reasonable detail.
FDOH Monroe would like to add a medical and dental clinic to a building being provided by the city of Key West. The
project will involve dental operatory equipment, clinic, intake, waiting area furnishings, office furnishings and
computers. The project is anticipated to begin in September of 2017 and completed by the Spring of 2019. Dental
and clinical care for HIV /AIDS patients in Key West is specifically in demand with only one provider currently
accepting Medicaid clients. Adding dental space will increase capacity and give FDOH Monroe the ability to hire a
dentist to provide services to low income, HIV /AIDS clients, and children (a chronically under - served population).
START DATE (initial expenditure of funds)
COMPLETION DATE:
DESIGN FEES:
CONSTRUCTION COSTS:
FURNITURE /EQUIPMENT:
TOTAL PROJECT COST:
COST PER SQ FOOT:
9/01/17
3/31/19
$ 0
$ 0
$ 1400000
$ 1400000
$ 378
Special Capital Projects are new construction or renovation projects and new furniture or equipment associated with these projects and
mobile health vans.
* Cash balance as of 9/30/17
** Cash to be transferred to FCO account.
* ** Cash anticipated for future contract years.
Attachment_V - Page 11 of 11