Item L1 L.1
G BOARD OF COUNTY COMMISSIONERS
County of Monroe � � Mayor Sylvia Murphy,District 5
The Florida Keys l'U � � Mayor Pro Tern Danny Kolhage,District 1
�pw° Michelle Coldiron,District 2
Heather Carruthers,District 3
David Rice,District 4
County Commission Meeting
September 18, 2019
Agenda Item Number: L.1
Agenda Item Summary #5998
BULK ITEM: Yes DEPARTMENT: County Administrator
TIME APPROXIMATE: STAFF CONTACT: Lindsey Ballard (305) 292-4443
n/a
AGENDA ITEM WORDING: Approval of the contract between Monroe County Board of County
Commissioners and the State of Florida, Department of Health for operation of the Monroe County
Health Department - contract year 2019-2020.
ITEM BACKGROUND: Review of annual contract for County funding of the local health
department.
PREVIOUS RELEVANT BOCC ACTION: This is the annual renewal of an agreement between
Monroe County and the Florida Department of Health that has continued for 20+years.
CONTRACT/AGREEMENT CHANGES:
Increase in funding from previous fiscal year contract.
STAFF RECOMMENDATION: Approval.
DOCUMENTATION:
Signed BOCC Contract
FINANCIAL IMPACT:
Effective Date: October 1, 2019
Expiration Date: September 30, 2020
Total Dollar Value of Contract: $1,243,000.00 (County portion)
Total Cost to County: $1,243,000.00
Current Year Portion: $0
Budgeted: Yes
Source of Funds:
CPI:
Packet Pg. 1729
L.1
Indirect Costs:
Estimated Ongoing Costs Not Included in above dollar amounts:
Revenue Producing: If yes, amount:
Grant:
County Match:
Insurance Required: n/a
Additional Details:
REVIEWED BY:
Cynthia Hall Completed 08/29/2019 6:45 PM
Budget and Finance Completed 08/30/2019 8:00 AM
Maria Slavik Completed 09/03/2019 9:52 AM
Kathy Peters Completed 09/03/2019 11:06 AM
Board of County Commissioners Pending 09/18/2019 9:00 AM
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L.1.a
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 2019-2020
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, 2019.
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."
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B. County Health Departments were created throughout Florida to satisfy this
legislative intent through "promotion of the public's health, the control and eradication of
preventable diseases, and the provision of primary health care for special populations."
C. Monroe County Health Department ("CHD") is one of the created County Health
Departments.
D. It is necessary for the parties hereto to enter into this contract in order to ensure U
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,
2019, through September 30, 2020, 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 B. 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 I) 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.
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L.1.a
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.
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4. FUNDING. The parties further agree that funding for the CHD will be handled as U
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 11.
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 11, Part II is an amount not to exceed $3,631,735.00
(State General Revenue, State Funds, Other State Funds and Federal Funds listed on
the Schedule Q. 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 11, Part II is an
amount not to exceed $ 1,243,000.00 (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 Packet Pg. 1732
L.1.a
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 increaseldecrease, 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.
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e. The name and address of the official payee to whom payments shall be made is:
County Health Department Trust Fund
Monroe County
P. O. Box 6193
Key West, FL 33040
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 U
director/administrator of the CHD shall ensure that non-categorical sources of funding are U
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 CHID 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 Packet Pg. 1733
L.1.a
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 U
data set as specified in the most current version of the Client Information
System/Health Management Component Pamphlet;
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N. Financial procedures specified in the Department of Health's Accounting
Procedures Manuals, Accounting memoranda, and Comptroller's U
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 Packet Pg. 1734
L.1.a
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 U
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.
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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 Packet Pg. 1735
L.1.a
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:
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i. March 1, 2020 for the report period October 1, 2019 through U
December 31, 2019;
ii. June 1, 2020 for the report period October 1, 2019 through
March 31, 2020;
K. September 1, 2020 for the report period October 1, 2019
through June 30, 2020; and
iv. December 1, 2020 for the report period October 1, 2019
through September 30, 2020.
7. FACILITIES AND EQUIPMENT. The parties mutually agree that:
a. CHD facilities shall be provided as specified in Attachment IV to this contract and the
County shall own the facilities used by the CHD unless otherwise provided in Attachment IV.
b. The County shall ensure adequate fire and casualty insurance coverage for County-
owned CHD offices and buildings and for all furnishings and equipment in CHD offices
through either a self-insurance program or insurance purchased by the County.
6 Packet Pg. 1736
L.1.a
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.
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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 U
in person to the other party's contract manager with proof of delivery.
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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.
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9. MISCELLANEOUS. The parties further agree:
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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, 2020, 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: For the County:
Michael Seiler Roman Gastesi
Business Manager III County Administrator
1100 Simonton Street 1100 Simonton Street
Key West, FI 33040 Key West, FI 33040
305-676-3823 305-292-4441
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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 11 (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 11t day of October,
2019.
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BOARD OF COUNTY COMMISSIONERS STATE OF FLORIDA Q
C14
FOR MONROE COUNTY DEPARTMENT OF HEALTH Q
C14
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SIGNED, BY: SIGNED BY:
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NAME: NAME: Scott A. Rivkees,, MD a
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TITLE: TITLE: State Surgeon General
DATE: DATE: 0
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ATTESTED TO:
SIGNED BY: SIGNED BY:
NAME: NAME: Robert Eadie, JD
TITLE: TITLE: CHID Director/Administrator
DATE: DATE:
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L.1.a
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 Requirement
1. Sexually Transmitted Disease Requirements as specified in F.A.C.64D-3, F.S.381 and F.S.394.
Program U
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2. Dental Health Periodic financial and programmatic reports as specified by the
program office.
3. Special Supplemental Nutrition Service documentation and monthly financial reports as specified in
Program for Women, Infants and DHM 150-24*and all federal,state and county requirements
Children(including the WIC detailed in program manuals and published procedures.
Breastfeeding Peer Counseling
Program)
4. Healthy Start/Improved Pregnancy Requirements as specified in the 2007 Healthy Start Standards and 0
Outcome Guidelines and as specified by the Healthy Start Coalitions in
contract with each county health department.
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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 U
(OMB Circular A-1 10)OMB CircularA-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 (n
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 I(Continued)
Packet Pg. 1739
Attac
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L.1.a
levels as documented in Florida SHOTS and supported by CHD
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 CHD 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. cv
11. General Communicable Disease Carry out surveillance for reportable communicable and other acute U
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 CHD 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.
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3. FEL1ERr'4J.FCJN"I)S -STATE �
007000 .,1113S 1)131.di.1StiIS"I'.`ti:tid'i1;I'Et(B1„Ix.,1'w1.4iP:til`:HQ +SCY 1aI)93 (X 60.098 11 ( 1
0
007000 WIC C6R EASTFEa?DIM', PHE;II r`OI_-NS1�,'1JN'PM)(:; 50000 (1 A)'0 0 0 50 �3
007000 ('0e%STALBE'Atl'1"1 WATER dIU A1FT) 114};ti,l'BORIV,' 1181,8 0 1I,818 f) 11 �
007000 ("'t)1, PRI,"HE„NSW.0 t"X B:h .Mt :'(I'fl'"p Q..".1➢iDV)-l'HB(; ;3,r.1Y11f) t,) 35,Cy00 f1 30
007000 FA HLY PLANNING TITLE:; 1,RANT i.i 861 35,861 0 35 0
007000 EHOCSIM,'(,)i'I"01t'8'C NITIES I^"011t II'I I(titl),`v'S WITH.1111E I t:;i 13 0 1 12,7-13 0 112
cm
007000 Tit'RRI9°ANE CRIS[S('()A(, I"t)OD AND 4VN"1 HR 3,000 0, t.q M: 0 �
007000 1"tl, MT,"`v'IZATION 19 TP)\'I'[.AN :38,582 0 38,582 d1 ;ts r_
4)
007000 :M ,11 SPECIAL°1A1.6'I'CM7("1 I ti1''I<wtti vl:;lr l'd^E(H19*,". NCY 12.9 85 o 12,985 12
007000 BASE X"t"D^ti1:+,I1 NI'lYP I^1T"AITLI)ItiESSt"APA.BILITY 819,90-1 0 81).00 0 8 �
007000 RIDS I'I E,1'E;:v'1'1t„N II1 A56 0 116,056 0 11(; �
007000 9?YAN WHITE TITLE 11 ti'Alti;X31t\NT 12,E 701 X) 123,701 7 123,
007000 WItl'•PW-1(-',ILVM AI)MINI:aTRAI"ION 1317 O(1tluM 0 3 IT,1)00 O i 17,
015075 Y I'i'LI"MIa,N I A.L SCHOOL HEALTH 1) 123,839 d) i'2.'",,
015075) RE,EJ"(1I1E 13.E1.1H111 1kf'.):T ADMIN P),:cf1�1 1) il,iaO-I 0 1),
01507 REK"(1};^P,HEALTH S("Iti ENI (:PE:11ii31`it, i,1SI:ti''1''til';I1"Itl'ES 52.800 0 5—1.81)0 ) 52,
01S00." EC's.1ti"''FirrI Ti•➢TLE: 11 1l)�1I'I)1Li'(I 17Iti13WE:S 60 M7 0 60,107 O W,
FEDERAL FUNDS TC)Tr"#I, 1,616 198 0 i 616'198 Y l,616,
4.FEES ASSESSED BY STATE OR FEDERAL RULES -STATE
0,01020 C'IIFr STATE.W11)E", ENVIItC)`wNtENTA1,FT"'Es 110920 0 1 10,920
0010992 CHl)STATi?,Va II'E E;;`,:1IIM I NMENTAL FEES ES �i,l(�,Sii"2 0 13.6)62 0 E3.
001206 tl,)N SITE SI 1V.AP F IY&: POS,11, 2 187 A 2,187 0 2,
00120E3 AANITY110N('E10' FItl AT"I'S A1`011)I`81'ECTId)\19 161 o 2°W1 0 2,
001206 ;`E1"AC ANK HEGSE;.1HCH til'&t( II.-1i{X 11? 50 1) 50 C& 50
001206 I'I'E31,14' 14`1 1 11 w'1; ['1 Bi)T,l'f^;l1'vl'1"1 VE'1^"S'loll,. H °i h.V SrEa3 S 12 0 8,83 2 Packet Pg. 1742
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51 04 i
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CD t�� pax�, er1xbm t 30, ICb2R
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0111206, 15EG IATIo N C'11tw'I13)DY PIE''RCIM S-'t1.oNS 75) 0
o01206 'L1Na'IM.; ^"YG'1G:.,('('91? 17 fl) 17 (b
7 W 71w'3 Vl
4191('.VO, MOBILES HOXII,&f,,% 1",1.5iK FEES ( 199 0 1.199 0 1,
FEES ES ASSESSED BY STAT"EI OR FEDERAL RULES TOTAL 200 IW) 0 200 189 it 200
5.OTHER CASH CONTRFFiU'I iONS -STATE:
1 ) Y 0
0110001 1)1d_1W 1)(ANN FRO XI PlllLIC I-1I:.�#L" lJ VNIT 103,29, 0 103,297 0 4o;I �
0
OTHER CASH CONTR[I3UTION'1"1-TAL 103,297 103,297 0 Im t�
cd
h.MEDICAID•STATLXOUNTY:
001057 ('111)CLINIC FEES 0 5,710 5,7--W 0 5 �3
0
001117 CIfD 1'[,IN FEES 0 25 25 0
0011111 t'I1111'L.IN(1.. }'@^;I':ti 5;,.,^,)11 ..5 ,199
MEI)ICA-[D TOTAI, 59,364 59,46.1 0
7.ALLOCABLE REVENUE-STATE; •"
A),1wI13 tdE; C"^.IG.1I,w'1 I vTa'W� (;II^ati ,E;(b 'Ip;E,S iaG1i`s:1'C`ttu ti. .�k-0 10 7911 ro 10.799 0 10 0
1�
ALLOCABLE REVENUE TOTAL 10790 0 111.719'. 0 10
0
£1. OT14ER STATE CONTRIBUTIONS NOT IN CHI)TRUST F^IJND-STATE; g,
A AIll 0 ) 0 --,:W,2021 530 0
11ROC1'fl M1'dt 0 (} 0 17,800 1 r
WI1'I'1L4)ikldw"NI 0 0 0 90,1,3110 901
(IEAL°(TTI 1.AR010'(TORIES cm
0 Cl 11 7."I:ii i
lNEW';`y`tZATIONS 0 0 0 w311„895 1511
r—
I.ITHER STATE GONTR:[BUTICNS TOTAL 0 0 0 2 117-1.;If,'l 2,071. 4)
9. DIRECT LOCAL CCuNTRfBu,`ICONS-BC,C ITAX DISTRICT �
001005 1:`1I1) 1,1 are;%. 1,Rl,ti"I's:NUE":&f.X}'1^',til)I"1'( RES 0 7131,820 731,3't 1 0 781
U1I1;005 ICI S[. w'If.1I'I11� '.1 il'.kC+:PS 41rAti'9C(1Ba;1"GAB. '1"1 11Q.;1t;G° 0 I,GlJW) 1G1,180 0 Wl
DIREC:T COUNTY CONTRIBUTIONS TOTAL 0 1,3 1;3.1W0 1.a 1:;3.1;00 0 1,2 13
101 FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION COUNTY
WI11i l Cl-it)[CLINI FEE`a 0 1.01 3511 101.2 i0 0 101
001077 CI-lIl 1"(.I"^k FF"F',S 0 IT 080 17AS') 0 17
001077 ( ENE:RAI^111X`tiI(;(1. I3II^:S wl;li 'Nu"1.S I)RU(( I'1.R IIA..sES l 1 000 1,000 0 1
001W& 1wE1(1 LI)1',kI,E;\W'Ift11 w (E '1`.4L i'E}i:S 0 13'1.1 ) 1.31,89.1 1) 1-31
11111 V IO 5 11 M.STATISTICS(E RTI1'tED RE 4"(6PDS 0 E,,6,295 66.295 0 66
FEES AUTHORIZED BY COUNTY TOTAL 0 ;,&T 521 3 17..:21 0 3.17
11.OTHER CASH AND LOCAL CONTRIB(ITIONS-COUNTY
0010281 b:::1I() "UNIC LEES 0 111:.3r;82 1111,682 1,) 193
0010*-11) d 1"11_NT 3 10(3 1TE;'0 1"N1 E;.kNI.1 E::tilsEINSE:"1°1i-1t'(til ti't i 1 15,595 457 5 95 0 15,:591:
001090 11)C1.11NI( fl':1's 68 121. 68 121
Packet Pg. 1743
xtlacnrmrn.,_ -anw .. w .age, „
1
"Ontrlb b lT�ii bd0artmen '
i
W7010 lii. "WHI EIITLEIIq q'1MIIM}3CTTO('Ifl) 0 2604120 :tg4J.920 0 260,
0(17010 W'111T:T"I°TTLE II °1)Il V)(""l°'T°O('1~II7 0 2(1O.I)'19 26),919 0 2Y(➢.
010300 ("111)`AI,E'0 -'E RITES IN()I?OD I':SI1)[�',OF STATE ()VT 0 +2,118 s 52.:86 0 82,
010500 C H1)l 4.1.1.E OF E:IM'M"T 'N;S I 0 R 0I I".S1I)H;()I :,3T.N I'F,a1M)0'""f` 0 92,6-56 9:.1,656 0 92.
011001 (."III) f lli;:11 q'l lw'�"'T"11r°1`('CT. 1.1"I C4�)� ('Y 9�""q'�TC 1l:'"P (:d �}�ry,1(7(1 �910 I1(y) O 290
03111I)(D ('111)(`I,1 ll,FEES ) 750,000 75(),000 f) 7.0,
09 002 lDR,%,w`DOWN FROM I'1'BLIC HEALTH ('NIT ) -307.97-1 -307„371 ) :107,
OTHER CASH AND LOCAL CONT"ldT1dT1'1"iONS"T'()TA 0 1 7:3(3.105 1,7',,6.l05 7 1.736
12"Al�LOC#T3T.E REVENUE—C;()i.lNTY
031005) Q;,l°,vl T316,,('I,,ItiTC'l.1631I S SI";11�'Il;:'T") a I)l7C'LI l'C Tt(,I9.1SIi;S I) 10,799 10,799 () 1().. CD
d',1')UNT"i ALLOCABLE REVk:T('TJT!;'rOT'AL ) 1,17.799 16),799 [D 1o' Cel
C.$
13. Ei1dIC:L1INGS'CC7iSNl"Y 0
! co
`NI'A1,lr"ENTAL Es41I T\'.VI.T '1"�`.11.I,"q^'s ) ) () 097,605 597,
0111P':iz(Specify) 9 (7 1) O
2
L T ILITIF S 0 l) 0 83,<169 i S,
I>l ILG.)Nf', '1BAE 1 H.:w.1.NCE 4 ) 0 75,22 5,
I 4SI1-RANf"F,' 1) ( Cl (D
CTIIER
OTHER("peci1''P
BUILDINGS TOTAL d;B 1 Y) 87 1,63 1 a1, t3
14.OTHER COUNTY C(5N'"T"IC,TL3I1'I"IONS NOT IN(;HD TBdUS`i'FUND COUNTY �
G8
LQI'II'?EN'C/VEHICLE F'1.'L("11ASES 0 Cr
' EliI1"T..I:1M MINT%.lti.1:WCE p (1 I] lD �
0TIIk^R('()I'N'l"YCON,rI(.1131"NON(SI'Efll;,Y) I] (') I) ('1
OTi-E (.'N)I"NTY¢"t.)N,rid.I'11T_TION fl,S9 EX"ITTa")') d) C7 4) 1D
OTHER COUNTY CCDNTRI BUTTONS"TOTAL () () a) 01
Ci,RANT7 TOTAL CIID PROGRAM 4,216,320 4 39 i 99"2 "t Mi 13,312 2 946,129 10,5 i9,
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A. COMMUNICABLE DISEASE CONTROL
8AL'bGV`NI:ZAX'ION ll(:1V1 H.71 5578 7,620 693 2 13 111 2l'5,-111 208,691 193Hl 851933 "'kII.
si'xE.ALLY E"f3A`S DIS C1029 1411 272 151) I4 111 101:31V 11)136 it IN I(i 7T-) I V2 V3l,8 1193,
fAA".ATGJtiE'ICl$AF: TE(y,w '11AD 0'75 77 D431,d ;l 909131 77,k1^aE 3:➢"0." 3 ) i37.
1fEA",AEf7ti li1CA"ES1,1 A: ('13 ;(13<1'21 0,40 0 0 0 J i7 4 0
HTVA AIDS P ATIl'ti v l"d„ARE^, (03,,v3) 1339 355 2,215 105.315 172.750 1T1 7'50 V15,31 1 626,750 L 1 2"+ 179 1756
ADAP (03API'll 2'3 1V7 2*2317 43"099 26,lD99 22,177 i'(a'3 0 7fi,
I1.P$E9$(,".I'A.t,d 1'S GIGJtP I,It 21 55 3012,4 it>,Ill 35111 3R129 1:90534 0 130, �
COMM.UN SC'I?V (If)fa) 2.01. 0;4 2 195 15,410 529),,G 52,944; 1:5,1ID 196 7;52 () 1`,xJ
0
11EIIA'TITI ili)fS6 N Vf6 I'm 1i�j 3'21"41 37900 W,400 3'?..I91 1to 768 20 1.110, u
CD
Cd
1'1 ISP.AI3E";1M 9:45:1_ RESPONSE' CLC II 180 7 6t.276 71.970 1,970 G1,277 w"i� t93 0 37A. CD
Cd
RLTT GE dS 1$E:.AI,"I'E$ a 1V,H) 1 29 379 1 097 33(i15 :r 579 27 579 23,€14 102 9.1'7 D 02, (�
VITALP$,ECA CVtG)S 8LHO> 1,50 1,500 1,383 22,301 "1ifJlii 26,015 ,'2.:303 0 96647
COMMUNICABLE DISEASE 51313'rOTAl, 10.:"t3 ' 31-H 20,+575 '967 01:3 1,127.' )I V 1271'Nl S)(37,012 1,976620 2213,207 11,£),
S. PRIMARY CAR&
("IlluON`O DISEASE P LEXEEti'1 ION V"It.() (210l E 52 IQ) I DOI V)A;,:l 3S.1-17 15,117 30,1 33 1 V)"(30 t Io
U-
'w'x"Er" 42E.%Vil ri2(i «..V,,,3 IiTO d°yeir"l3"" 121 WI 121 01 196 i6O VRi2I2�; 0 lEr'2.
POBA€"CON SE;ENTE'RVE^.N'TION (2tD 1,68 0 k"i1 35,193 1V,498 11,39 35.,ID1 E).4783 1,.i,I �
WIC E113Ey:<ASIk EEDI:N(,61,:E^:13.p,()A NS$:I ENG (21.bbD A :15 1,.6 5 21,(,'1r3 8.712 28.712 :`-t,fV 5 I06hSu I0(,
u
FAMILYP-''l,.A°NINI, 4 `235 3,:37 1.970 7N 97020 1l31452 113162 97.020 19137.50 Pith-4 1,"2fS,
E.AII''f3CFtiTR!E'D 4:.251 000 0 t') 2,997, Il4; 3,196 2996 12985 0 12, o
m
d 2'27) 2,71 583 S 620 47.8 N 55.*)9 5,809 17,81-, 0 207 39 207,
G8
(Sdd;4 PKK,EHE NSIVE(,111LD HEALTH 1-2"'2y0 000 0 0 0 0 0 3 0 0 �
Cm
[1lVAf`t"'11Y G'1kdl d:1GALBY (230 ?,i1 59(5 2.98I3 12,115 19,11-17 V),1.:57 12.114 0 1,82,O,03 182., 05
411HOOL HHV? IXII (2:34) 3. 4l 1 19„'70`L 70 812 42.593 A2.593 7(.812 306 r41C0 0 303, r_
GE
4 k 1E fl??fl'IE. SA'E:d411V'LL'E°IE:,.kI:I"fl9 4(a:Hi) 2.18 SC:i"r:N Haft) CH'651 'r(719 if 7l!) 18,655 167,102 9'V,tO5 2,),
CY
41 iP`tiA9'l"!"9I';.wLV,7"IIn)I:A"I^;LOPMENTN 2334 S.15 0 229 68,029 i9,:318 7918 C38,030 Ltr:34):91 131711, 291,
DE:vTAE,.(9EALTI-3 T21W 3 761'2 9921 35 872 11811 lk 8 t 1 .35872 5,E377 1111119 155,
PRIMARY CARFSUBTOTAL 1311 1357 $MSG),ITP; 610277 711,81fS TH,MG 610,278 1,P)13189 71908 2,641.
C. ENVIRONMENTAL HEALT'EC:
'Water and Onaiue Sewage PrD ria;ms
AE A;3E3.\C'EE S141ti1 l'Y)E INi V 1:3-175 I).3'„D 1.17 317 12,^S f, 1 1,!)r):i 1 L,)915 12,157 55 70 0 )5,
UNIET'ED t,',6L; 1A+'.A f"E^31 -;A,TEA1S (V)7) 0 90 J ) D, J 1 J J
6 :BLICA A11;l1.YSP1 A0 'V'>;34 )iJO ➢ 1l D 1 O 0 S J
f ltl l�"I'l WATER SYSTEM (359) 000 0 U 0 0 J O 0 0
4rNSITL SEW A,A, "rNI- %TNIE•:NT 2; DI SH)S,AL I3161! B 51 1 076 9111 27 723 32:M,7, 52 3:3 i 27 r`_'-& 85 537 V`tq) 120
Group Total 1 93 I i:J':S 1,301 10,579 17.330 17,MO V),581 11 2-41 31 5SO 175.
Facility Programs
'E'.ATT,lr_w V A("Il,lT4 SEEN 1C"Es 4 91-Y) U 12 1::2 Ski 1 97Y3 -1,307 "307 V:179 S,571 3.
h'Y n(13 8V5"a kI. k? 4;p}f3N O 76 R IS L)l 121 45 1 1.914:3 t L flH° 12'i-1s5 IH 156 i NO i:r f;5(9
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rll1f71`I'^`..'41u1^"0'". (..",1'G.CI""t 16151.d 012 1D3 ,18 2 095 2, I 2,➢11 2,IP,m6 9079,' CD 9
ISa31t:A. "i"1.AA13X Xll CAM P 4 352) 0 00 ) 1) ) 7 I 0 )
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A1")fill,l:11()AI1 .,k�lJl'AVtle l,371➢ W 7,12 i11i 343 7,12A 1 E,'77'li 17105
POOL.YB ATI11NG,,.PI.,A('E S (36 0) 1 5 l-I'a" 176 26.572 30,9fll .10 99 1 26,572 d 21 N :150 81")1 1.Q i,
I;11 a:414^DID AI.WASTE~„rd;QI4-"1.( ES 6.t61) ().1;3 25 165 7.1011 H 61.E6 81,636 7,.105 i''7 811, 1 211➢ t`u,
TANNIN'(]lw AQ°Sl',l'1'"1' 1?Pt0"Il::'E4 (Evd9) 01 1 t) 181 21.1 31.1 139 83 200 �
0roupTotal I 1,07Y1 1„25 6,863 6r8Jlaa7 6'8)1i60 S,Ektifl V75,010 ri0,1)39
Groundwater Contaminat Dn U
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s'f'111I,A(1E:"1'.A°vG COMPLIANCE SERVICES (.355Y 1.9: 160 112 37,635 13A)7 13.44)7 37,6334 899 1621614 k6i11, CD
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1 S,6D 000 0 0 0 of d) 0 ) �$
Group Total 1 92 11;0 112 37 6%5 tl,')"n 37,63 1 S9.:I T(i2 1GA 1663
Community Hygiene
�IA1I'NITYE'NVIIt !I(°:.ANXH (S45 000 D ) Y
U
I,EAD AQ')!""I'I'Y1A`IN'CA *:Rf 1X!ES '1ei1)) )I) 3 )
C�
1'l'14LQr"til,l .A`IIE; X la?) 0 00 ) 0 ) 0 0 �
1L ;ER h I^ C, 1) r),00 6) (;D 0 0 ) Q7 f3 i) 0
:^S4tI,IP,T&'Vr1Sfl'I^:I)iSI'!v�r- a'",
SAN"ITAKI 7,Q'ItiAN'u'H (36r) 0`() 19 1 5.706 LA23 i R23 3,706 160158 (D 16,
RABIES S1'IBA1`31,1.,ANt EI (36'630 0 08 10 1 118 1689 1669 1-H7 6E 273 D ).
r1It1 OH%'IR!"S ;I_'RVEH, R16 7X I)fll,) 0 J 0 ) 0
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F1X411E i'['/:h0id'6E1t6:Bktu9XC ➢".v'BH oL 6368) 0,00 f) 0 0 0 f) p 0 �
WATER l'OI,I„A'TlO N C370) I).(➢O 0 9 9 9 a'Y 67 0 �
ate°
q;tiIJOO ACR C371) Y 3 7 9 3 6 (D
Q'1➢k11',41_"l3 'I.tv(:'"E4 (37:0 6 151,r ➢ 1, 10,865 1766.1 1766'J HOW,; 1,155 1d,i:d(Y1 177 �
Group Total 3 7-1 I.i,tE1 L61 t 16', 19 u3,!)76I a E ri763 1666➢19 23 186 1715,X)-1 199,
E:NVIROi"�b:NEN,'rAL HEALTH SUBTOTAL ➢tY.02 E. 6-, 1A-111, 183,096 :167,4;A ..1E36i". 3A::t,WO 39I_t,635 15 ^;1*i 793,
1). NON-OPFMATIONAL COSTS:
@^:NA'1I{(?:'tiNiV.."w'V',AI,HE;.5LTH 39`0 (&'lfl 7 ) p571 1 ,12 I "s'm 3.372 15,907 7 15,
AIEDPI.:AIDBI BA('N 1i311 itW a) 1) I.(i 1'I U) I:'r (i4) )
NON-OPERATIONAL,6;('?ST°S`wsUl$"L'I:D"I"A4T,, 0 M t I 3 I37 1 31)1 I R)I i.;5�i F )i3 ? 15
"rOTtAL CONTfUCT 83 rl') '(i O758 21-1.960 1 '761 073 2,057581 20,57 5E 1 761,1M7, I.'3dta:320 :A 111(I.DI;.d'.i 7IWA
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ACt;cr%r c r,II.F°'3v7 III Page"1 u!r
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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 U
benefiting from federal financial assistance. CD
CD
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 r.3
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.
0
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.
co
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.
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ATTACHMENT V
MONROE COUNTY HEALTH DEPARTMENT
SPECIAL PROJECTS SAVINGS PLAN
CASH RESERVED OR ANTICIPATED TO BE RESERVED FOR PROJECTS
CONTRACT YEAR STATE COUNTY TOTAL
2018-2019' $ 0 $ 0 $ 0
2019-2020•' $ 0 $ 0 $ 0
2020-2021"' $ 0 $ 0 $ 0
2021-2022"' $ 0 $ 0 $ 0
PROJECT TOTAL $ 0 $ 0 $ 0
SPECIAL PROJECTS CONSTRUCTIONIRENOVATION PLAN
O
PROJECT NUMBER: L)
CD
PROJECT NAME: CD
cv
cv
LOCATION/ADDRESS: L3
U
PROJECT TYPE: NEW BUILDING ROOFING co
RENOVATION PLANNING STUDY
NEW ADDITION OTHER
SQUARE FOOTAGE: 0
PROJECT SUMMARY: Describe scope of work in reasonable detail.
O
U
U
U
(n
START DATE (Initial expenditure of funds)
COMPLETION DATE:
DESIGN FEES: $ 0
CONSTRUCTION COSTS: $ 0
FURNITURE/EQUIPMENT: $ 0
TOTAL PROJECT COST: $ 0
COST PER SQ FOOT: $ 0
Special Capital Projects are new construction or renovation projects and new furniture or equipment associated with these projects and
mobile health vans.
'Cash balance as of 9/30/19
Cash to be transferred to FCO account.
"•Cash anticipated for future contract years.
Packet Pg. 1749
Attachment V-Page 11 of 11