FY2020 10/16/2019 „ CCURTC`11
hap'•JV CuIOyf ”, Kevin Madok, CPA
ir if,
'kw. Clerk of the Circuit Court& Comptroller—Monroe County, Florida
DATE: October 4, 2019
TO: Roman Gastesi
County Administrator
Lindsey Ballard, Aide
to the County Administrator
FROM: Pamela G. Hanco .l).C.
SUBJECT: September 18th BOCC Meeting
Enclosed are three duplicate originals of the following item, executed on behalf of Monroe
County, for your handling:
Ll 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.
Please be sure to return a fully executed copy to this office once signed by the state for the
record. Should you have any questions, please feel free to contact me at (305) 292-3550.
cc: County Attorney
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
r �
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."
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
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 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.
1
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, Park 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 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 $ 1,243,000.00 (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
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
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
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;
iii. 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.
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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 DE385L1 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 DE385L1 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, 2020 for the report period October 1, 2019 through
December 31, 2019;
ii. June 1, 2020 for the report period October 1, 2019 through
March 31, 2020;
iii. 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
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, 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, Fl 33040 Key West, Fl 33040
305-676-3823 305-292-4441
7
•
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,
2019.
BOARD OF COUNTY COMMISSIONERS STATE OF FLORIDA
FOR MONROE COUNTY DEPARTMENT OF HEALTH
SIGNED BY: / SIGNED BY:
NAME: Sylvia J. Murphy NAME: Scott . Rivk , MD
'" '-zi; Mayor TITLE: State Surgeon General
•
G-',-1 , _ Aar' :VI-1.0 l 9 DATE: t( 1/17
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V : 1 1
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es " y;` -v'- -' TO: KEVIN MADOK, CLERK
o' �cqs�
4.�.w , `� BY: SIGNED BY: i� ir �
NAME: Pamela Hancock NAME: Robert Eadie, JD
TITLE: Deputy Clerk TITLE: CHD Director/Administrator
DATE: 1 5',Zo 11 DATE: e ///,
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:Eli a' MONROE COUNTY ATTORNEY
d t AP AS TO ORRM:
C� 7' uJ d �` - nr p
1..L.1 n -I a:: CHRISTINE LIMBERT-BARROWS
"� -? ASSISTANT CO ATT Y
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DATE: I
8
ATTACHMENT I
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. 384.
Program
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
Outcome 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 CircularA-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 I(Continued)
Attachment_I-Page 1 of 11
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.
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 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.
•
•
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 09/30/19 403296 58320 461616
2. Drawdown for Contract Year -403297 307974 -95323
October 1, 2019 to September 30, 2020
3. Special Capital Project use for Contract Year 0 0 0
October 1, 2019 to September 30, 2020
4. Balance Reserved for Contingency Fund -1 366294 366293
October 1, 2019 to September 30, 2020
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
•
ATTACHMENT II
MONROE COUNTY HEALTH DEPARTMENT
Part II,Sources of Contributions to County Health Department a.
October 1,2019 to September 30,2020
State CHD County Total CHD
Trust Fund CHD Trust Fund Other
w... .....--;,,, ...,t (cash) Trust Fund (cash) Contribution Total
1.GENERAL REVENUE-STATE
015040 AIDS PREVENTION&SURVEILLANCE-GENERAL REVENUE 73,552 0 73,552 0 73,552
015040 CHD-TB COMMUNITY PROGRAM 29,681 0 29,681 0 29,681
015040 SEXUALLY TRANSMITTED DISEASE CONTROL PROGRAM GR 16,755 0 16,755 0 16,755
015040 DENTAL SPECIAL INITIATIVE PROJECTS 5,977 0 5,977 0 5,977
015040 EPIDEMIOLOGY SURVEILLANCE GENERAL REVENUE 79,035 0 79,035 0 79,035
015040 FAMILY PLANNING GENERAL REVENUE 33,539 0 33,539 0 33,539
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 1,286,928 0 1,286,928 0 1,286,928
GENERAL REVENUE TOTAL 1,893,432 0 1,893,432 0 1,893,432
2.NON GENERAL REVENUE-STATE
015010 ENVIRONMENTAL BIOMEDICAL WASTE PROGRAM 3,951 0 3,951 0 3,951
015010 TOBACCO STATE AND COMMUNITY INTERVENTIONS 118,154 0 118,154 0 118,154
NON GENERAL REVENUE TOTAL 122,105 0 122,105 0 122,105
3.FEDERAL FUNDS-STATE
007000 AIDS DRUG ASSISTANCE PROGRAM ADMIN HQ 60,098 0 60,098 0 60,098
007000 WIC BREASTFEEDING PEER COUNSELING PROG 50,000 0 50,000 0 50,000
007000 COASTAL BEACH WATER QUALITY MONITORING 14,818 0 14,818 0 14,818
007000 COMPREHENSIVE COMMUNITY CARDIO-PHBG 35,000 0 35,000 0 35,000
007000 FAMILY PLANNING TITLE X-GRANT 35,861 0 35,861 0 35,861
007000 HOUSING OPPORTUNITIES FOR PERSONS WITH AIDS 442,743 0 442,743 0 442,743
007000 HURRICANE CRISIS COAG FOOD AND WATER 3,000 0 3,000 0 3,000
007000 IMMUNIZATION ACTION PLAN 38,582 0 38,582 0 38,582
007000 MCH SPECIAL PRJCT UNPLANNED PREGNANCY 12,985 0 12,985 0 12,985
007000 BASE COMMUNITY PREPAREDNESS CAPABILITY 89,904 0 89,904 0 89,904
007000 AIDS PREVENTION 116,056 0 116,056 0 116,056
007000 RYAN WHITE TITLE II CARE GRANT 123,701 0 123,701 0 123,701
007000 WIC PROGRAM ADMINISTRATION 347,000 0 347,000 0 347,000
015075 SUPPLEMENTAL SCHOOL HEALTH 123,839 0 123,839 0 123,839
015075 REFUGEE HEALTH SCREENING REIMBURSEMENT ADMIN 9,504 0 9,504 0 9,504
015075 REFUGEE HEALTH SCREENING REIMBURSEMENT SERVICES 52,800 0 52,800 0 52,800
018005 RYAN WHITE TITLE II ADAP DRUG REBATES 60,307 0 60,307 0 60,307
FEDERAL FUNDS TOTAL 1,616,198 0 1,616,198 0 1,616.198
4.FEES ASSESSED BY STATE OR FEDERAL RULES-STATE
001020 CHD STATEWIDE ENVIRONMENTAL FEES 140,920 0 140,920 0 140,920
001092 CHD STATEWIDE ENVIRONMENTAL FEES 43,662 0 43,662 0 43,662
001206 ON SITE SEWAGE DISPOSAL PERMIT FEES 2,487 0 2,487 0 2,487
001206 SANITATION CERTIFICATES(FOOD INSPECTION) 2,461 0 2,461 0 2,461
001206 SEPTIC TANK RESEARCH SURCHARGE 50 0 50 0 50
001206 PUBLIC SWIMMING POOL PERMIT FEES-10%HQ TRANSFER 8.842 0 8,842 0 8,842
AttachmentJH Part II-Paae 4 of 11
ATTACHMENT II
MONROE COUNTY HEALTH DEPARTMENT
Part II,Sources of Contributions to County Health Department
October 1,2019 to September 30,2020
State CHD County Total CHD
Trust Fund CHD illiikTrust Fund Other
(cash) Trust Fund. (cash) Contribution Total
001206 REGULATION OF BODY PIERCING SALONS 75 0 75 0 7.5
001206 TANNING FACILITIES 47 0 47 0 47
001206 TATTO PROGRAM ENVIRONMENTAL HEALTH 746 0 746 0 746
001206 MOBILE HOME&RV PARK FEES 1,199 0 1,199 0 1,199
FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL 200,489 0 200,489 0 200,489
5.OTHER CASH CONTRIBUTIONS-STATE:
0 0 0 0 0
090001 DRAW DOWN FROM PUBLIC HEALTH UNIT 403,297 0 403,297 0 403,297
OTHER CASH CONTRIBUTION TOTAL 403,297 0 403,297 0 403,297
6.MEDICAID•STATE/COUNTY:
001057 CHD CLINIC FEES 0 5,740 5,740 0 5,740
001147 CHD CLINIC FEES 0 25 25 0 25
001148 CHD CLINIC FEES 0 53,599 53,599 0 53,599
MEDICAID TOTAL 0 59,364 59,364 0 59,364
7.ALLOCABLE REVENUE-STATE:
031005 GENERAL CLINIC RABIES SERVICES&DRUG PURCHASES 10,799 0 10,799 0 10,799
ALLOCABLE REVENUE TOTAL 10,799 0 10,799 0 10,799
8.OTHER STATE CONTRIBUTIONS NOT IN CHD TRUST FUND-STATE
ADAP 0 0 0 530,202 530,202
PHARMACY DRUG PROGRAM 0 0 0 17,800 17,800
WIC PROGRAM 0 0 0 904,200 904,200
BUREAU OF PUBLIC HEALTH LABORATORIES 0 0 0 7,268 7,268
IMMUNIZATIONS 0 0 0 614,895 614,895
OTHER STATE CONTRIBUTIONS TOTAL 0 0 0 2,074,365 2,074,365
9.DIRECT LOCAL CONTRIBUTIONS-BCC/TAX DISTRICT
008005 CHD LOCAL REVENUE&EXPENDITURES 0 781,820 781,820 0 781,820
008005 IMMUNIZATION CAMPAIGN MONROE COUNTY BOCC 0 461,180 461,180 0 461,180
DIRECT COUNTY CONTRIBUTIONS TOTAL 0 1,243,000 1,243,000 0 1,243,000
10.FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION-COUNTY
001073 CHD CLINIC FEES 0 101,250 101,250 0 101,250
001077 CHD CLINIC FEES 0 47,085 47,085 0 47,085
001077 GENERAL CLINIC RABIES SERVICES&DRUG PURCHASES 0 1,000 1.000 0 1,000
001094 CHD LOCAL ENVIRONMENTAL FEES 0 131,894 131,894 0 131,894
001110 VITAL STATISTICS CERTIFIED RECORDS 0 66,295 66,295 0 66,295
FEES AUTHORIZED BY COUNTY TOTAL 0 347,524 347,524 0 347,524
11.OTHER CASH AND LOCAL CONTRIBUTIONS-COUNTY
001029 CHD CLINIC FEES 0 193,682 193,682 0 193,682
001029 CURANT 340B REVENUE AND EXPENSE TRACKING 0 45,595 45,595 0 45.595
001090 CHD CLINIC FEES 0 68.121 68.121 0 68,121
Attachment_II_Part_II-Page 5 of 11
ATTACHMENT II
MONROE COUNTY HEALTH DEPARTMENT
Part II,Sources of Contributions to County Health Department
October 1,2019 to September 30,2020
State CHD County Total CHD
Trust Fund CHD Trust Fund Other
(cash) Trust Fund
iciu41O Coatributioa;: Total
007010 RYAN WHITE TITLE III•DIRECT TO CHD a 260,920 260.92o 0 60.920
007010 RYAN WHITE TITLE HI•DIRECT TO CHD 0 260,919 260,919 0 260,919
010300 CHD SALE OF SERVICES IN OR OUTSIDE OF STATE GOVT 0 82,386 82,386 0 82,386
010500 CHD SALE OF SERVICES IN OR OUTSIDE OF STATE GOVT 0 92,656 92,656 0 92,656
011001 CHD HEALTHY START COALITION CONTRACT 0 290,000 290,000 0 290,000
031000 CHD CLINIC FEES 0 750,000 750,000 0 750,000
090002 DRAW DOWN FROM PUBLIC HEALTH UNIT 0 -307,974 -307,974 0 -307,974
OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL 0 1,736,305 1,736,305 0 1,736,305
12.ALLOCABLE REVENUE-COUNTY
031005 GENERAL CLINIC RABIES SERVICES&DRUG PURCHASES 0 10,799 10,799 0 10,799
COUNTY ALLOCABLE REVENUE TOTAL 0 10,799 10,799 0 10,799
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 CHD PROGRAM 4,246,320 3,396,992 7,643,312 2,946,128 10,589,440
Attachment_II_Part fl-Page 6 of 11
ATTACHMENT II
MONROE COUNTY HEALTH DEPARTMENT
Part III,Planned Staffing.Clients,Services and Expenditures By Program Service Area Within Each Level of Service
October 1,2019 to September 30,2020
Quarterly Expenditure Plan
FTE's Clients Services/ 1st 2nd 3rd 4th Gr:
,wAA,r,ui ..sa«:.:.: :,. (0.00) Units Visits (Whole dollars only) State County To
A. COMMUNICABLE DISEASE CONTROL.
IMMUNIZATION (101) 8.74 5,578 7,620 208,693 243,414 243,414 208,693 49,381 854,833 904,214
SEXUALLY TRANS.DIS. (102) 1.84 272 459 34,411 40,136 40,136 34,410 16,755 132,338 149,093
HIV/AIDS PREVENTION (03A1) 3.68 0 2,075 77,960 90,931 90,931 77,961 337.783 0 337,783
HIV/AIDS SURVEILLANCE (03A2) 0.00 0 0 0 0 0 0 0 0 0
HIV/AIDS PATIENT CARE (03A3) 13.39 355 2,215 405,315 472,750 472,750 405,314 626,750 1,129,379 1,756,129
ADAP (03A4) 1.41 23 40 22,377 26,099 26,099 22,377 96,952 0 96,952
TUBERCULOSIS (104) 1.44 21 55 30,128 35,141 35,141 30,129 130,539 0 130,539
COMM.DIS.SURV. (106) 2.01 0 2,395 45,410 52,966 52,966 45,410 196,752 0 196,752
HEPATITIS (109) 1.16 190 236 32,494 37,900 37,900 32,494 140,768 20 140,788
PREPAREDNESS AND RESPONSE (116) 3.80 0 0 64,276 74,970 74,970 64,277 278,493 0 278,493
REFUGEE HEALTH (118) 1.29 379 1,097 23,645 27,579 27,579 23,644 102,447 0 102,447
VITAL RECORDS (180) 1.50 1,500 4,383 22,304 26,015 26,015 22.303 0 96,637 96,637
COMMUNICABLE DISEASE SUBTOTAL 40.26 8,318 20.575 967.013 1,127,901 1,127,901 967,012 1,976,620 2,213,207 4,189,827
B. PRIMARY CARE:
CHRONIC DISEASE PREVENTION PRO (210) 1.52 460 1,001 30,133 35,147 35,147 30,133 130,560 0 130,560
WIC (21W1) 6.26 2,085 15,700 106,658 124,404 124.404 106,660 462,126 0 462.126
TOBACCO USE INTERVENTION (212) 1.68 0 64 35,493 41,398 41,398 35,494 153,783 0 153,783
WIC BREASTFEEDING PEER COUNSELING (21W2) 1.35 0 1,675 24,616 28,712 28,712 24,615 106,655 0 106,655
FAMILY PLANNING (223) 3.37 1,970 3,778 97,020 113,162 113,162 97,020 403,750 16,614 420,364
IMPROVED PREGNANCY OUTCOME (225) 0.00 0 0 2,997 3.496 3,496 2,996 12,985 0 12,985
HEALTHY START PRENATAL (227) 2.71 583 3,620 47,848 55,809 55,809 47,847 0 207,313 207,313
COMPREHENSIVE CHILD HEALTH (229) 0.00 0 0 0 0 0 0 0 0 0
HEALTHY START CHILD (231) 2.71 596 2,986 42,145 49,157 49,157 42,144 0 182,603 182,603
SCHOOL HEALTH (234) 4.35 0 149,702 70,812 82,593 82,593 70,812 306,810 0 306,810
COMPREHENSIVE ADULT HEALTH (237) 2.48 269 860 48,654 56,749 56,749 48,655 167,402 43,405 210,807
COMMUNITY HEALTH DEVELOPMENT (238) 2.15 0 229 68,029 79.348 79,348 68,030 163,041 131,714 294,755
DENTAL HEALTH (240) 4.83 7,612 9,921 35,872 41,841 41,841 35,872 5,977 149,449 155,426
PRIMARY CARE SUBTOTAL 33.41 13,575 189,536 610,277 711,816 711,816 610,278 1,913,089 731,098 2,644,187
C. ENVIRONMENTAL HEALTH:
Water and Onsite Sewage Programs
COSTAL BEACH MONITORING (347) 0.39 317 317 12,856 14,995 14,995 12,857 55,703 0 55.703
LIMITED USE PUBLIC WATER SYSTEMS (357) 0.00 0 0 0 0 0 0 0 0 0
PUBLIC WATER SYSTEM (358) 0.00 0 0 0 0 0 0 0 0 0
PRIVATE WATER SYSTEM (359) 0.00 0 0 0 0 0 0 0 0 0
ONSITE SEWAGE TREATMENT&DISPOSAL (361) 1.54 1,076 984 27,723 32,335 32,335 27.724 85,537 34,580 120,117
Group Total 1.93 1.393 1,301 40,579 47,330 47,330 40.581 141,240 34.580 175,820
Facility Programa
TATTOO FACILITY SERVICES (344) 0.12 122 36 1.978 2,307 2,307 1,979 8,571 0 8,571
FOOD HYGIENE (348) 0.76 119 154 12,845 14,983 14.983 12,845 48,556 7,100 55.656
Attachment_II_Part_III-Page 7 of 11
ATTACHMENT II
MONROE COUNTY HEALTH DEPARTMENPy
Part III,Planned Staffing.Clients,Services and Expenditures By Program Service Area Within Each Level of Service -
October 1,2019 to September 30,2020
Quarterly Expenditure Plan
FTE's Clients Services/ 1st 2nd 3rd 4th Gr.,.
(0.00) Units Visits (Whole dollars only) State County Total'
BODY PIERCING FACILITIES SERVICES (349) 0.03 I f S oil 7 72 772 661 2;305 500 2.866
GROUP CARE FACILITY (351) 0.12 48 48 2,095 2,444 2,444 2,096 9,079 0 9,079
MIGRANT LABOR CAMP (352) 0.00 0 0 0 0 0 0 0 0 0
HOUSING&PUB.BLDG. (353) 0.00 0 0 0 0 0 0 0 0 0
MOBILE HOME AND PARK (354) 0.41 87 140 7,127 8,313 8,313 7,128 13,776 17,105 30,881
POOLSBATHING PLACES (360) 1.55 442 976 26,572 30,994 30,994 26,572 64,238 50,894 115,132
BIOMEDICAL WASTE SERVICES (364) 0.43 254 165 7,404 8,636 8,636 7,405 27,841 4,240 32,081
TANNING FACILITY SERVICES (369) 0.01 0 0 181 211 211 180 583 200 783
Group Total 3.43 1,076 1,525 58.863 68,660 68,660 58,866 175,010 80,039 255,049
Groundwater Contamination
STORAGE TANK COMPLIANCE SERVICES (355) 1.92 160 412 37,635 43,897 43,897 37,634 899 162,164 163,063
SUPER ACT SERVICES (356) 0.00 0 0 0 0 0 0 0 0 0
Group Total 1.92 160 412 37,635 43;897 43,897 37,634 899 162,164 163,063
Community Hygiene
COMMUNITY ENVIR.HEALTH (345) 0.00 0 0 0 0 0 0 0 0 0
INJURY PREVENTION (346) 0.00 0 0 0 0 0 0 0 0 0
LEAD MONITORING SERVICES (350) 0.00 0 0 0 0 0 0 0 0 0
PUBLIC SEWAGE (362) 0.00 0 0 0 0 0 0 0 0 0
SOLID WASTE DISPOSAL SERVICE (363) 0.00 0 0 0 0 0 0 0 0 0
SANITARY NUISANCE (365) 0.20 19 84 3,706 4,323 4,323 3,706 16,058 0 16,058
RABIES SURVEILLANCE (366) 0.08 0 10 1,448 1,689 1,689 1,447 6,273 0 6,273
ARBORVIRUS SURVEIL. (367) 0.00 0 0 0 0 0 0 0 0 0
RODENT/ARTHROPOD CONTROL (368) 0.00 0 0 0 0 0 0 0 0 0
WATER POLLUTION (370) 0.00 0 0 0 0 0 0 0 0 0
INDOOR AIR (371) 0.00 0 0 0 0 0 0 0 0 0
RADIOLOGICAL HEALTH (372) 0.00 0 0 0 0 0 0 0 0 0
TOXIC SUBSTANCES (373) 2.46 1,517 1,517 40,865 47,664 47,664 40,866 1,155 175,904 177,059
Group Total 2.74 1,536 1,611 46,019 53,676 53,676 46,019 23,486 175,904 199,390
ENVIRONMENTAL HEALTH SUBTOTAL 10.02 4,165 4,849 183,096 213,563 213,563 183,100 340,635 452,687 793,322
D. NON-OPERATIONAL COSTS:
NON-OPERATIONAL COSTS (599) 0.00 0 0 0 0 0 0 0 0 0
ENVIRONMENTAL HEALTH SURCHARGE (399) 0.00 0 0 3,671 4,282 4,282 3,672 15,907 0 15,907
MEDICAID BUYBACK (611) 0.00 0 0 16 19 19 15 69 0 69
NON-OPERATIONAL COSTS SUBTOTAL 0.00 0 0 3,687 4,301 4301 3,687 15,976 0 15,976
TOTAL CONTRACT 83.69 26,058 214,960 1,764,073 2,057,581 2,057,581 1,764,077 4,246,320 3,396,992 7,643,312
Attacnment_II_Part_III-Page 8 of 11
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-2019-2020
Monroe County Health Department •
Facilities Utilized by the County Health Department
Complete Location Facility Description Lease/ Type of Complete SQ Employee
(Street Address,City,Zip) And Offical Building Agreement Agreement Legal Name Feet Count
Name(if applicable) Number (Private Lease thru of Owner (FTE/OPS/
(Admin,Clinic,Envn Hlth, State or County,other- Contract)
etc.) please define)
1100 Simonton Street,Key West,FL Gato Building:Administration, Lease through Monroe
33040 Clinic,Healthy Start,Vital Statistics County Monroe County BOCC 10,115 42
5503 College Road,Key West,FL Juvenile Justice Building: Lease through Monroe
33040 Environmental Health County Monroe County BOCC 583 2
3333 Overseas Highway,Marathon, Ruth Ivins Center:Clinic, Lease through Monroe
FL 33050 Environmental Health County Monroe County BOCC 4,618 5
50 High Point Road,Tavernier,Fl Roth Building:Clinic,Environmental
33070 Health Lease through Monroe County Monroe County BOCC 5,803 14
Lease through Monroe County
•
Roosevelt Sands Center: and City of Key West on our
105 Olivia Street,Key West,Fl 33040 • Community Health behalf Monroe County BOCC 2224 6
•
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_IV-Page 10 of 11
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 CONSTRUCTION/RENOVATION PLAN
PROJECT NUMBER:
PROJECT NAME:
LOCATION/ADDRESS:
PROJECT TYPE: NEW BUILDING ROOFING
RENOVATION PLANNING STUDY
NEW ADDITION OTHER
SQUARE FOOTAGE: 0
PROJECT SUMMARY: Describe scope of work in reasonable detail.
•
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 FCC account.
***Cash anticipated for future contract years.
Attachment_V-Page 11 of 11