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FY1992 01/29/1992 } . 1.992 STANDARD CONTRACT BETWEEN F:LEP cnc Pr"OF MflNnOF COUNTY` FEB -7 P2 :1 BOARD OF COUNTY COMMISSIONERS AND lK Ik MONROE [flUN' Y. Fl. STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES Pursuant to the Laws of Florida, Chapter 83-177 and 154, F.S. as revised, this contract is entered into between the Department of Health and Rehabilitative Services, hereinafter referred to as the "department, " and MONROE County, hereinafter referred to as the "county." This contract stipulates the services that will be provided by the county public health unit, hereinafter referred to as the CPHU, the sources and amount of funds that will be committed to the provision of these services, the administrative and programmatic requirements which will govern the use of these funds, and the respective responsibilities of the department and the county in enabling the CPHU "to promote, protect, maintain, and improve the health and safety of its citizens and visitors through promotion of the public health, the control and eradication of preventable diseases, and the provision of primary health care for special populations. " I. General Provision: Both parties agree that the CPHU shall: A. Provide services according to the conditions specified in Attachment I and all other attachments to this contract; and B. Fund the services specified in Attachment II, Part III, at the funding level specified for each program service area in that attachment. II. Federal and State Laws and Regulations: Both parties agree that the CPHU shall: A. Comply with the provisions contained in the Civil Rights Certificate, hereby incorporated into this contract as Attachment III; B. Comply with the provisions of 45 CFR, Part 74, and other applicable regulations if this contract contains federal funds; 1 C. Comply with all applicable standards, orders, or regulations issued pursuant to the Clean Air Act as amended (42 USC 1857 et seq. ) and the Federal Water Pollution Control Act as amended (33 USC 1368 et seq. ) , if this contract contains federal funds and the total contract amount is over $100, 000; and D. Comply with applicable sections of Chapter 427, Florida Statutes, (Transportation Services) and Chapter 41-1, Florida Administrative Code, (Coordinated Community Transportation Services) regarding the provision of transportation services for the transportation disadvantaged if this contract contains any state, federal or local funds which are used to provide for direct or indirect (ancillary) transportation services. III. Records, Reports and Audits: Both parties agree that the CPHU shall: A. Maintain books, records and documents in accordance with accounting procedures and practices which sufficiently and properly reflect all expenditures of funds provided by the - - department, the county and other sources under this contract. Books, records and documents must be adequate to enable the CPHU to comply with the following reporting requirements: 1. The revenue and expenditure requirements in the State Automated Management Accounting System 2.2; 2 . The client registration and service reporting requirements of the minimum data set as specified in the Client Information System/Health Management Component Manual and any revisions subsequent to the January 1, 1984 version, or the equivalent as approved by the State Health Office. Any reporting - - - system used by or on behalf of the CPHU to produce the above information must provide data in a machine readable format approved by the department which can be transferred electronically to the Client Information System; 3. The CPHU is responsible for assuring that all contracts with service providers include provisions that all subcontracted services be reported back to the CPHU in a manner consistent with the client registration and 2 service reporting requirements of the minimum data set as specified in the Client Information System/Health Management Component Manual and any revisions subsequent to the January 1, 1984 version; 4 . Financial procedures specified in the department's Accounting Procedures Manuals and Accounting Memoranda; 5. All appropriate CPHU employees shall report time in the Client Information System/Health Management Component compatible format by program component for at least the sample periods specified by the department; and 6. Any other state and county program specific reporting requirements detailed in attachments to this contract. B. Assure these records shall be subject during normal business hours to inspection, review or audit by state or county personnel duly authorized by the department or the county, as well as by federal personnel; C. Retain all financial records, supporting documents, statistical records, and any other documents pertinent to this contract in conformance with the retention schedules required in HRSM 15-1, "Records Management Manual" ; D. Allow persons duly authorized by state or county, and federal auditors, pursuant to 45 CFR, Part 74. 24 (a) , (b) , and (d) to have full access to, and the right to examine any of said records and documents during said retention period; and E. Include these aforementioned audit and record- keeping requirements in all approved subcontracts and assignments. Both parties further agree that: The department shall provide uniform financial statements of program account balances for each level of service on a quarterly basis to the county and to the director or administrator of the CPHU. IV. Monitoring: Both parties agree that, as either determines necessary, the department and/or the county shall 3 monitor the budget and services as detailed in Attachment II and operated by the CPHU or - its subcontractor or assignee. V. Safeguarding Information: Both parties agree that the CPHU shall not use or disclose any information concerning a recipient of services under this contract for any purpose not in conformity with the state law, regulations or manual (HRSM 50-2 Security of Data and Information Technology) and federal regulations (45 CFR, part 205. 50) , except by written consent of the recipient, or his/her responsible parent or guardian when authorized by law. VI. Assignments: Both parties agree that the CPHU shall not assign the responsibility of this contract to another party without prior written approval of the department and the county. No such approval by the department and the county of any assignment shall be deemed in any event or in any manner to provide for the incurrence of any obligation of the department or the county in addition to the dollar amount agreed upon in this contract. All such assignments shall be subject to the conditions of this contract and to any conditions of approval that the department and the county shall deem necessary. VII. Subcontracts: Both parties agree that the CPHU shall be permitted to execute subcontracts with the approval of the delegated authority in the department for services necessary to enable the CPHU to carry out the programs specified in this contract, provided that the amount of any such subcontract shall not be for more than ten (10) percent of the total value of this contract. In the event that the CPHU needs to execute a subcontract for an amount greater than ten (10) percent of the value of this contract, both parties to this contract must agree in writing to such a subcontract prior to its execution. No subcontracts shall be deemed in any manner to provide for the incurrence of any obligation of the department or the county in addition to the total dollar amount agreed upon in this contract. All such subcontracts shall be subject to the conditions of this contract and to any conditions of approval that the department and the county shall deem necessary. 4 VIII. Payment for Services: A. The department agrees: To pay for services identified in Schedule "C" of, the operating budget (General Revenue and Federal) , and reflected in Attachment II, Part II, as the State's appropriated responsibility in an amount not to exceed $ 2.047.084 and the State share of all state authorized fees in an anticipated amount of $ 155.860. In addition, all "OTHER" state revenues from whatever sources to be appropriated to the HRS County Public Health Unit Trust Fund for services to be provided by the county health unit in an amount of $ 952 686 , for a grand total State cash contribution of $ 3,155,635 . The State's obligation to pay under this contract is contingent upon an annual appropriation by the legislature. B. The county agrees: To pay for services identified in Attachment II, Part II, as the county's responsibility in an appropriated amount not to exceed $ 217 487 In addition the county shall provide its share of all county authorized fees in an anticipated amount of $ 265 47R These amounts, plus any "OTHER" local revenues in the amount of $ 81.135 includes all revenues from whatever sources to be appropriated to the HRS County Public Health Unit Trust Fund for services to be provided by the county health unit for a grand total county cash contribution of $ 564.045 • IX. The Department and The County Mutually Agree: A. Effective date: 1. This contract shall begin on October 1, 1991 or the date on which the contract has been signed by both parties, whichever is later. 2. This contract shall end on September 30, 1992 B. Termination: 1. Termination because of lack of funds: 5 In the event funds to finance this contract become unavailable, either party may terminate the contract upon no less than twenty-four hours notice in writing to the other party. Said notice shall be delivered by certified mail, return receipt requested, or in person with proof of delivery. The department or the county shall be the final authority as to the availability of their respective funds as applicable. In case of cancellation due to the unavailability of funds, staffing and services shall be reduced appropriately. 2. Termination for breach: Unless breach is waived by either party in writing, either party may, by written notice to the other party, terminate this contract upon no less than twenty-four (24) hours notice. Said notice shall be delivered by certified mail, return receipt requested, or in person with proof of delivery. If applicable, either party may employ the default provisions in Chapter 13A-1, Florida Administrative Code. Waiver of breach of any provision of this contract shall not be deemed to be a waiver of any other breach and shall not be construed to be a modification of the terms of the contract. The provisions herein do not limit either party's right to remedies at law or to damages. 3 . Termination at will: This contract may be terminated by either party upon no less than thirty (30) days notice, without cause. Said notice shall be delivered by certified mail, return receipt requested, or in person with proof of delivery. C. Notice and contact: The contract manager for the department for this contract is Clyde C. Collins Business Manager . The representative of the county for this contract is Thomas Brown, Monroe County Adminstrator . In the event that different representatives are designated by either party after execution of this contract, notice of the name and address of the new representative will be rendered in writing to 6 the other party and said notification attached to originals of this contract. D. Modification: Modifications of provisions of this contract shall, unless otherwise specified in Attachment I, be enforceable only when they have been reduced to writing and duly signed by both parties to this contract. E. Name and address of payee: The name and address of the official payee to whom the payment shall be made is: Public Health Unit Trust Fund, MONROE County, Florida F. All terms and conditions included: This contract and its attachments as referenced, (Attachments I through TX ) , contain all the terms and conditions agreed upon by the parties. In WITNESS THEREOF, the parties hereto have caused this 48page contract to be executed by their undersigned officials as duly authorized. STATE OF FLORIDA DEPARTMENT OF HEALTH AND BOARD OF COUNTY COMMISSIONERS REHABILITATIVE SERVICES FOR MONROE COL TY shale al :. tk „ . r ° SIGNED BYr ILVGNED BY: (Department A thority1-1 NAME: Wilhelmina Harvey NAME: H. James Towev TITLE: Mayor, Monroe County TITLE: District Administrator DATE: I-A, PA DATE: '4 _ /0 D y ATTESTED TO• y L. Kolh ���yyy Clerk L SIGNED BY: � Kolbe2tt hAIGNED BY: Q CPHU Director/ Administrator NAME: Danny L. KolhaQe NAME: Richard H. Shera. Sr. TITLE: Monroe County Clerk TITLE:Acting Adminstrator DATErw I'�f' f� DATE: AI. LE .4L UFFI Y. BY • Attorneys Office wr l5 -& i4i, 7 ATTACHMENT I SPECIAL PROVISIONS I. Public Health Unit Trust Fund: Both parties agree: A. That all funds to be expended by the CPHU shall be deposited in the County Public Health Unit Trust Fund (CPHUTF) maintained by the state treasurer. B. That all funds deposited in the Public Health Unit Trust Fund shall be expended by the department solely for services rendered by the CPHU as specified in this contract. Nothing shall prohibit the rendering of additional services not specified in this contract. C. That funds deposited in the Public Health Unit Trust Fund for the CPHU in Monroe County shall be accounted for separately from funds deposited for other CPHUs, and shall be used only for public health unit services in Monroe County. If actual expenditures should exceed the total planned expenditure amount for either the county or the state as agreed to in this contract, the HRS county public health unit will , by agreement between the department and the county, draw down from the trust fund balance, if any, to cover the excess expenditures, or will cut back services to come within budget. D. That any surplus funds, including fees or accrued interest, remaining in the CPHUTF account at the end of the contract year shall be credited to the state or county, as appropriate, in such amounts as may be determined by multiplying the surplus funds remaining in a program account by the percentage of County Public Health Unit Trust Fund funding provided by each governmental entity for the rendering of the particular health service for which such account was established. Such surplus funds may be applied toward the funding requirements of each participating governmental entity in the following year. However, in each such case, all surplus funds, including fees and accrued interest, shall remain in the trust fund and shall be accounted for in a manner which clearly illustrates the amount which has been credited to each participating governmental entity. The planned use of surplus funds shall be 8 reflected in Attachment II, Part I of this contract, with special projects explained in Attachment VIII. E. There shall be no transfers of funds between the three levels of service without a contract amendment duly signed by both parties to this contract and the proper budget amendments unless the CPHU director/administrator determines that an emergency exists wherein a time delay would endanger the public's health and the Deputy Secretary for Health has approved the transfer. The Deputy Secretary for Health shall forward written evidence of this approval to the CPHU within 30 days after an emergency transfer. F. That either party may increase or decrease funds to this contract by notifying the other party in writing of the amount and purpose for the increased/decreased funding, and allowing 30 days for written objection before the additional funds are released for expenditure or the state allocation is decreased. A decrease in funds must be related to a reduction, shortfall, or sequestering of anticipated appropriations. G. That the contract shall include as Part III of Attachment II a section entitled "Planned Staffing, Clients, Services and Expenditures by Type of Service Within Each Level of Service. " This section shall include the following information for each type of service area within each level of service: - the planned number of full-time equivalents (FTE's) by level of service; - the planned number of services to be provided; - the planned number of individuals/units to be served; and the planned state and county expenditures. Expenditure information shall be displayed in a quarterly plan to facilitate monitoring of contract performance. H. That adjustments in the planned expenditure of funds for each type of service within each level of service are permitted without an amendment to this contract. I. That the CPHU shall submit quarterly reports to the county and the department which shall include at least the following sections: 9 1. A transmittal letter briefly summarizing CPHU activity year-to-date; 2 . DE385L1 - "CPHU Contract Management Variance Report"; 3 . DE580L1 - "Analysis of Fund Equities" ; and 4 . A written explanation of the variances reflected in the DE385L1 report for each quarter of the contract year if the CPHU exceeds the tolerance levels as specified below as of the end of the quarterly report period: a. The cumulative percent variance cannot exceed by more than 25 percent the planned expenditures for a particular type of service or fall below planned expenditures by more than 25 percent. b. However, if the cumulative amount of variance between actual and planned expenditures for the report period for a program service area does not exceed one percent of the cumulative planned expenditures for the level of service in which the type of service is included, a variance explanation is not required. 5. The CPHU Contract Management Variance Report shall: a. Explain the reason for the variances in expenditures in any program service area which exceeds the tolerance levels established above; b. Specify steps that will be taken to comply with the contract expenditure plan, including a contract amendment, if necessary; and c. Provide a time table for completing the steps necessary to comply with the plan. Failure of the CPHU to accomplish the planned steps by the dates established in the written explanation shall constitute non-performance under the contract and the county or the department may withhold funds from the contract or take other appropriate administrative action to achieve compliance. 10 J. The required dates for the CPHU director's/ administrator's quarterly report to the county and the department shall be as follows: 1. March 1, 1992 for the report period October 1, 1991 through December 31, 1991; 2. June 1, 1992 for the report period October 1, 1991 through March 31, 1992 ; 3 . September 1, 1992 for the report period October 1, 1991 through June 30, 1992 ; and 4 . December 1, 1992 for the report period October 1, 1991 through September 30, 1992. II. Fees: A. Environmental regulatory fees: The department shall establish by administrative rule fees for environmental regulatory functions designated in Attachment IV of this contract and conducted by the CPHU. Such fees shall supersede any environmental regulatory fees existing prior to the effective date of the department's rule. The county may, however, establish fees pursuant to Florida Statutes, Section 381. 311 which are not inconsistent with department rules and other statutes, after consultation with the department. B. Communicable disease services fees: The department may establish by administrative rule, fees for communicable disease services, other than environmental regulatory services, designated in this contract and conducted by the CPHU. The county may establish fees pursuant to Florida Statutes, Section 381.311 which are not inconsistent with department rules and other statutes. All state or federally authorized communicable disease services fees shall be listed in Attachment IV of this contract. All county authorized communicable disease services fees shall be listed in Attachment V of this contract. 11 C. Primary Care fees: Either party may establish fees for primary care services designated in this contract and conducted by the CPHU except for those services for which fee schedules are specified in federal or state law or regulations. Both parties further agree: 1. That such fees shall be established by resolution of the Board of County Commissioners, if promulgated by the county, or by administrative rule, if promulgated by the department; 2. That there shall be no duplication of fees by the department and the county for communicable disease or primary care services provided by the CPHU; 3 . That primary care fees shall be listed in Attachments IV (state) and V (county) of this contract. D. Collection and use of fees: Both parties agree that: 1. Proceeds from all fees collected by or on behalf of the CPHU, whether for environmental, communicable disease, or primary care services, shall only be used to fund services provided by the CPHU; 2 . All fees collected by or on behalf of the CPHU shall be deposited with the State Treasury and credited to the Public Health Unit Trust Fund or other appropriate state account if required by Florida Statute or the State Comptroller. III. Service Policies and Standards: Both parties agree that the CPHU shall adhere to the service policies and standards published by the department in program manuals and other guidelines provided by the department, where they exist, as a guide for providing each funded service specified in Attachment II, Part III of this contract. 12 IV. Fair Hearing Guidelines: The provider shall establish a system through which applicants for services and current clients may present grievances over denial, modification or termination of services. The contractor will advise applicants of the right to appeal a denial or exclusion from services, of failure to take account of a client's choice of service, and of his/her right to a fair hearing to the final governing authority of the agency. Specific references to existing laws, rules or program manuals are included in Attachment IX of this contract. The provider shall post in a readily accessible location and visible to all clients either procedures or a poster informing clients how they may contact the Human Rights Advocacy Committee (HRAC) . V. Personnel: Both parties agree: A.The CPHU shall have at least the following employees: 1. A director or administrator appointed by the Secretary of the department after consultation with the Deputy Secretary for Health and with the concurrence of the Board of County Commissioners; 2. A full-time community health nurse; 3. An environmental health specialist; and 4. A clerk. B. That all department employees working in the CPHU shall be supervised by the department and subject - - - -- to Department of Administration rules. C. Staffing levels shall be established in this contract in Attachment II, Part III as FTE's, and may be changed in accordance with the availability of funds and/or program needs. D. The number and classification of employees working in the CPHU that are county employees rather than department employees shall be listed in Attachment VI of this contract. 13 VI. Facilities: Both parties agree that: A. CPHU facilities shall be provided as specified in Attachment VII of this contract. This attachment shall include a description of all the facilities used by the CPHU, including the location of the facility and by whom the facility is owned; B. The county shall own the facilities used by the CPHU unless otherwise provided in Attachment VII of this contract; and C. Facilities and equipment provided by either party for the CPHU shall be used for public health services provided that the county shall have the right to use such facilities and equipment, owned or leased by the county, as the need arises, to the extent that such use would not impose an unwarranted interference with the operation of the CPHU. 14 VII . Method of Payment: A. The county shall deposit its annual contribution to the County Public Health Unit Trust Fund as specified below. Upon receipt of Ad Valorem Tax Revenues, a percentage of Monroe County Real Estate Tax Revenues B. The department shall release state contributions to this contract as follows: 1. Funds appropriated as "Aid to Local Government" shall be released in four quarterly amounts, at the beginning of each quarter of the contract year; 2 . WIC and other state funds appropriated in a cost reimbursement category (e.g. expense and special) shall be released on the basis of invoices documenting expenditures. VIII. Laboratory and Pharmacy Support: The department agrees to supply laboratory and pharmacy support services for the CPHU at least at the level provided in the prior state fiscal year if funds are available. • IX. Emergencies: Both parties agree, to the extent of their respective resources, that they may assist each other in meeting public health emergencies. X. Sponsorship: In compliance with Section 286.25 Florida Statutes, the provider assures that all notices, informational pamphlets, press releases, advertisements, descriptions of the sponsorship of the program, research reports, and similar public notices prepared and released by the provider shall include the statement: Sponsored by HRS - Monroe County Public Health Unit Provider 15 and the State of Florida, Department of Health and Rehabilitative Services. " If the sponsorship reference is in written material, the words, "State of Florida, Department of Health and Rehabilitative Services" shall appear in the same size letters or type as the name of the organization. XI. Indicate in the space below the income eligibility limit for comprehensive primary care clients. 150 % of OMB Poverty Guidelines. XII. Program Specific Reporting Requirements: Specific information not available through CIS/HMC or SAMAS must be supplied by completing the following: A. Specify in the space below the minimum number of clients who will receive comprehensive primary care services (clients registered in Program Component 88 who will receive services during this contract period) . 2000 B. Specify in the space below the amount of any county funds earmarked by the Board of County Commissioners for hospitalization in the Improved Pregnancy Outcome program if such funds are deposited in the CPHU Trust Fund and included in the IPO line on Attachment II, Part III, of this contract. • $ 0000 C. Complete the planned Family Planning budget information on the following page for this contract period. XIII. County Fees: Those individual fees established by the county per ordinance or resolution and listed in Attachment V shall automatically be adjusted to, at least, the Medicaid reimbursement rate without formal amendment to this contract in accordance with F.S. 154.06 should said reimbursement rate be increased or decreased. 16 • o n 0 m to n co .1 In O n N 0 en N n 0 cn 0 .1 '-4 .0 n in .O V V CO .y .+ COT N 4J .. r N 0 . E * C 0 >. >. L e to rn F. y 0 n 0 ONL U a C `O N 0 en 0 n a . d O In v ON N N N N N 5 W 9 in in L U laC O 4. n 0 U U C W O e. 7 .. C-. 0 0 L` • U U C -y = U O U N o co co O b U 'O c en co n o .o o v co N in O .. U - N O no 0 n ti U O I n e 0 .-. ✓ I -a0 .O S + o o Ii n .. .� O -- C u. I T J U < X E n i-" U .. X to J a) L - .-I < • L - r • o r rt 4 to L 0 J • G .] L .I W q ' •. - to '0 .0 <• a) .I C r m en en L L W W 0 O in to 0' = U . ..I tZ C > . L al W n o n n S 0 t-. 0 N CO CO ▪ 9 C ▪ 0 X N C .-y U 0 C. >' N .. E L >, = .ti 0 4 O W E _ U Ul SI W II tp c o C C W 4.1 AL.. 111 0 \ W O y N to ..i ri '0 > -.I N 0 -I A I0L 'C U C W L 1. m .. ••I UI C to 0 ra 11 CS v1 L - U W W N a/ •.I N 1-1 0' W 0 N 9 0' CO al 9 0) .-•-I < I X V. .4 --I C 0 0) U O la 01 koa y la .-I -.t O 4J 9 W W L. --I 'u O. .] -U W V1 tO CO) W L U I+ E Vi W .I L W y U 9 < Ut . •r+ y .. —I G C X W O p C L N C W w C E 0 o = to D. 0 0 0 ,- N N •`-•N C. N O' (4 '-•.i tl..l E • • • ATTACHMENT II PLANNED FUNDING & EXPENDITURES • 18 H . 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O n pa ..W A !n n ID .r a 0 0 in a 0 0 • n ATTACHMENT III CIVIL RIGHTS CERTIFICATE The applicant provides this assurance in consideration of and for the purpose of obtaining federal grants, loans, contracts (except contracts of insurance or guaranty) , property, discounts, or other federal financial assistance to programs or activities receiving or benefitting from federal financial assistance. The provider agrees to complete the Civil Rights Compliance Questionnaire, HRS Forms 946 A and B, if so requested by the department. The applicant assures that it will comply with: 1. Title VI of the Civil Rights Act of 1964 , as amended, 42 U.S.C. , 2000d et seq. , which prohibits discrimination on the basis of race, color, or national origin in programs and activities receiving or benefitting from federal financial assistance. 2 . Section 504 of the Rehabilitation Act of 1973 , as amended, 29 U.S.C. 794, which prohibits discrimination on the basis of handicap in programs and activities receiving or benefitting for federal financial assistance. 3. Title IX of the Education Amendments of 1972 , as amended, 20 U.S.C. 1681 et seq. , which prohibits discrimination on the basis of sex in education programs and activities receiving or benefitting 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 benefitting for federal financial assistance. 5. The Omnibus Budget Reconciliation Act of 1981, P.L. 97-35, which prohibits discrimination on the basis of sex and religion in programs and activities receiving or benefitting from federal financial assistance. 6. All regulations, guidelines and standards lawfully adopted under the above statutes. 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 36 assignees for the period during which such assistance is provided. The applicant further assures that all contractors, 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. • 37 ATTACHMENT IV STATE FEE SCHEDULES, BY SERVICE Estimated Annual Revenue Accruing To The JEVEL OF SERVICE/SERVICE: Egg CPHU Trust Fund I, COMMUNICABLE DISEASE: AIDS, HIV, Alternate Site Testing $20 (optional) Subtotal $ 4,800 II. PRIMARY CARE: Subtotal $ 0000 38 ATTACHMENT IV STATE FEE SCHEDULES, BY SERVICE Estimated III. ENVIRONMENTAL HEALTH: Annual Revenue To The HRS/CPHU T. .SWIMMING POOLS AND BATHING PLACES: Fee Trust Fund - Original construction plan review and approval/swimming pools $275 (1) 3,300 - Original construction plan review and approval/bathing places $150 (1) -0- - Modification of original construction $100 (1) 2,300 - Initial operating permit $125 (1) 3,375 - Annual operating permit up to (and including) 25, 000 gallons $ 25 (2) 1,450 - Annual operating permit in excess of 25,000 gallons $ 75 (2) 4,575 (1) Fee amount charged by HSEH and the 14 counties that have environmental engineering units. (2) Maximum fee is charged by HRS CPHUs. B. ONSITE SEWAGE DISPOSAL SYSTEMS (OSDS) : - Soil testing/site evaluation $ 40 28,860 - Permit (standard subsurface system) $ 50 (1) 11,900 - Permit (mound system) $ 50 (1) 29,800 - Repair permit $ 40 3,760 ' - Existing system approval $ 40 (2) 3,800 - Septic tank manufacturing inspection $ 50 200 (annual) - Septage disposal service permit $ 50 200 (annual) - Septic tank pumpout vehicle inspection (per vehicle) $ 10 80 - Portable/temporary toilet service permit (annual) $ 50 100 - Portable toilet pumpout vehicle (per vehicle) $ 10 50 - Reinspection of non-compliance OSDS $ 25 7,400 - variance application OSDS (single family) $100 (3) 700 (multi-family & commercial) $150 (3) 150 - Industrial/Manufacturing Permit (annual) $150 39 - Aerobic treatment unit permit $150 2,850 - Aerobic treatment unit maintenance service permit $ 25 150 (1) A $5 research fee is collected until 6/30/93. (2) Applies where FHA/VA requests system reinspection and where county ordinance requires inspection for change of building occupancy. (3) 50% of the variance application fee is placed in the applicable CPHU Trust Fund, 50% of fee is placed in specific HSEH variance account. C. MOBILE HOME & RECREATIONAL VEHICLE PARKS/CAMPS (annual fees) : - 6 to 10 spaces $ 25 400 - 11 to 50 spaces $ 50 4,000 - 51 to 200 spaces $ 75 3,375 - over 200 spaces $100 3,725 D. MIGRANT LABOR CAMPS (annual fees) : - 5 to 50 residents $ 75 -0- - 51 to 100 residents $150 - over 100 residents $225 -0- E. BOTTLED WATER (annual fees) : - Bottled water plants & dealers $500 (1) - Bottled Water Dealers $200 (2) -o- - Water vending machines (per machine) $ 50 (3) (1) Increased fees will be used for laboratory costs associated with store shelf monitoring program. CPHUs will receive $150 annually. HSEH will continue to permit. (2) HSEH will issue permits. (3) Water vending machines will continue to be permitted by HSEH. CPHUs will receive $30 per machine, effective June 1992 . F. HIOHAZARDOUS WASTE (annual fees) : - Generators (Except physician office generating less than 25 lbs/30 days) $ 50 5,000 G. TANNING DEVICES (annual fees) : Effective Oct. 1, 1991 - Tanning Devices (per device) $125 -0- 40 H. FOOD ESTABLISHMENTS - Non DBR Food Service (annual) $150 15,000 - Food Processors (dairy plants exempted) (annual) $150 1,500 - School Lunch Rooms (annual) $150 - 1 ,500 - Institutional Food Service (annual) $150 300 - Movie Theater (annual) $150 900 - Variance for Food Establishment $150 1,500 - Emergency Variance for Food Establishments $300 1,500 *- Individual Grocery Stores Single Operation $150 4,500 *- Multiple Grocery Store Operations (e.g. , supermarkets) $100 will be charged for inspection and $50 for each unit within the store (e.g. , meat market, bakery) $100 + $50 1,300 * Amount collected will be divided and transferred to DACS. I. DRINKING WATER: - Limited Use Community or Commercial Public Water System (annual) $ 40 - Sample Collection/Review of Analytical Results/Health Risk Interpretation Including Delineated Areas $ 40 -0- - Private System Construction or Ownership Change Servicing More Than One Residence $ 40 480 Statute has a range of fees for most services; however, all state that the minimum will be collected until rules are adopted. We anticipate larger fees for several rules upon revision. Most permit functions will be assessed a $5 surcharge to be transferred to HSEH to provide staffing for training, monitoring and evaluation. 41 ATTACHMENT V COUNTY FEE SCHEDULE, BY SERVICE Estimated Annual Revenue Accruing To The EVEL OF SERVICE/SERVICE Fee/Range CPHU Trust Fund COMMUNICABLE DISEASE: Immunizations 15.35 6,322 STD 0-10 4,744 AIDS 0-70 12,000 TB 0-8 1,546 Vital Statistics .5-7 40,876 Subtotal $ 65,488 11. PRIMARY HEALTH CARE: IPO 0-1700 2,702 Chronic Disease 0-50 1,568 HCC Patient Fees 0-70 112,816 Well Baby 0-40 9,490 Adult Health 0-50 24,366 School Physicals 0-30 6,374 Family Planning 0-92 19,374 Subtotal $ 176,690 III. ENVIRONMENTAL HEALTH: Reimbursement From D.P.R. 75 23,250 Subtotal $ 23 o5n Total County Fees $ 265 478 42 • ATTACHMENT VI • CLASSIFICATION AND NUMBER OF EMPLOYEES WORKING IN THE COUNTY PUBLIC HEALTH UNIT WHO ARE PAW BY THE COUNTY, BY LEVEL OF SERVICE, IF APPLICABLE VEL OF SERVICE/SERVICE: Position Classification Number I. COMMUNICABLE DISEASE: N.A. II. PRIMARY HEALTH CARE: N.A. III. ENVIRONMENTAL HEALTH: . N.A. 43 ATTACHMENT VII FACILITIES UTILIZED BY THE CPHU cility •scriotion Location Owncd By KEY WEST CLINIC KEY WEST MONROE COUNTY MIDDLE KEYS CLINIC MARATHON MONROE COUNTY UPPER KEYS CLINIC TAVERNIER MONROE COUNTY AIDS PREVENTION CENTER (APC) KEY WEST KNIGHT REALTY, INC. HEALTH CARE CENTER (HCC) KEY WEST LOWER FLORIDA KEYS HEALTH SYSTEMS, INC. 44 ATTACHMENT VIII DESCRIPTION OF USE OF PUBLIC HEALTH UNIT TRUST FUND BALANCES FOR SPECIAL PROJECTS, IF APPLICABLE (From Attachment 11, Part.!) N/A 45 • ATTACHMENT IX PROGRAM SPECIFIC REPORTING REQUIREMENTS AND PROGRAMS REQUIRING COMPLIANCE WITH THE PROVISIONS OF SPECIFIC MANUALS Some health services must comply with specific program and reporting requirements in addition to the CIS/HMC minimum data set and the SAMAS 2.2 requirements because of federal or state law, regulation or rule. If a county public health unit is funded to provide one of these services, it must comply with the special reporting requirements for that service. The services and the reporting requirements arc listed below: Service Requirement 1. Sexually Transmitted Disease Requirements as specified Program in HRSM-150-22. Requirements as specified in Policy 87-7-5 regarding State Health Office STD Program review and approval of personnel/budget actions. 2. Dental Health Monthly reporting on HRSH Form 1008. 3. Special Supplemental Food Service documentation and Program for Women, Infants monthly financial reports and Children. as specified in HRSM 150.24E and all federal, state and county requirements detailed in the program manuals and published procedures. 4. Improved Pregnancy Outcome Requirements as specified in HRSM 150-13A. Quarterly reports of services and outcome on HASH Form 3096. Program Quarterly Progress Report, Quarterly Summary Report, Presumptive Eligibility/Medicaid Determination Log by all providers authorized to determine presumptive eligibility. 5. Family Planning Pcriodic financial and programmatic reports as specified in HRSM 150-27. 46 f • ATTACHMENT IX (continued) 6. Immunization Periodic reports as specified by the department regarding the surveillance/investigation of reportable vaccine preventable diseases, vaccine usage accountability, the assessment of various immunization levels and forms reporting adverse events following immunization. 7. CPHU Program Requirements as specified in HRSM 150-3 and HRSM 50-9. 8. Chronic Disease Program Requirements as specified in the Reference Guide to CHIP and HRS forms identified in HRSM 150-8 and 150-12. 9. Environmental Health Requirements as specified in HRSM 50-10. 10. AIDS Program Requirements in HRSM 150-30 and case reporting on CDC Form 50.42. Socio-demographic data on persons tested for HIV in CPHU clinics should be reported on CDC HIV Counseling & Testing Report Form. These reports are to be sent to the Headquarters AIDS office within 30 days of the initial post-test appointment regardless of clients' return. 11. School Health Services HRSM 150-25, including the requirement for an annual plan as a condition for funding. • 47 ATTACHMENT X LOBBYING Use of Funds for Lobbying Prohibited. The Provider agrees to comply with the provisions of section 216. 347, Florida Statues, which prohibits the expenditure of contract funds for the purpose of lobbying the legislature or a state agency. 48