Item C05 C.5
Coty f � ,�� ,' BOARD OF COUNTY COMMISSIONERS
�� Mayor David Rice,District 4
The Florida Keys � Mayor Pro Tem Craig Cates,District I
y Michelle Coldiron,District 2
James K.Scholl,District 3
Ij Holly Merrill Raschein,District 5
County Commission Meeting
June 15, 2022
Agenda Item Number: C.5
Agenda Item Summary #10619
BULK ITEM: Yes DEPARTMENT: County Administrator
TIME APPROXIMATE: STAFF CONTACT: Lindsey Ballard(305) 292-4443
No
AGENDA ITEM WORDING: Approval of Amendment 4A1 to Core Contract between Monroe
County and Monroe County Department of Health for FY 21/22, to add new civil rights certificate
(Attachment III).
ITEM BACKGROUND: This amendment revises Attachment III to the Core Contract between
Monroe County and Monroe County Department of Health for FY 21-22. Attachment III is a civil
rights certificate. The new language was requested by State Department of Health.
PREVIOUS RELEVANT BOCC ACTION:
The annual Core Contract for FY 21/22 was approved by the BOCC.
CONTRACT/AGREEMENT CHANGES:
Addition of new civil rights certificate
STAFF RECOMMENDATION: Approval.
DOCUMENTATION:
Amendment 4A1 to Core Contract Monroe County with new Civil Rights cert
Core Contract 21-22
FINANCIAL IMPACT:
Effective Date: June 15, 2022
Expiration Date: September 30, 2022
Total Dollar Value of Contract: (amendment: $0)
Total Cost to County: No cost
Current Year Portion:
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C.5
Budgeted: Yes
Source of Funds: N/A
CPI: N/A
Indirect Costs:
Estimated Ongoing Costs Not Included in above dollar amounts:
Revenue Producing: If yes, amount:
Grant:
County Match:
Insurance Required: No
Additional Details:
None
REVIEWED BY:
Cynthia Hall Completed 05/13/2022 9:44 AM
Lindsey Ballard Completed 05/31/2022 11:54 AM
Board of County Commissioners Pending 06/15/2022 9:00 AM
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C.5.a
STATE OF FLORIDA
DEPARTMENT OF HEALTH �?
AMENDMENT#A1
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This amendment entered into between the State of Florida, Department of Health,
hereinafter referred to as "the State" and the Monroe County Board of County
Commissioners, hereinafter referred to as "the County", amend the contract pertaining to
the operation of the Monroe County Health Department for Contract Year 2021-2022.
The contract is amended as follows:
1. Page 5, Section 6.n., is deleted in its entirety and replaced with the following:
n. The CHD shall comply with the provisions contained in the Civil Rights
Compliance and Non-Discrimination Certificate, hereby incorporated into
this contract as Attachment III.
2. Attachment III, Civil Rights Certificate, is deleted in its entirety and replaced with
the revised Attachment III, attached hereto.
3. This amendment will begin on October 1, 2021, or the date on which the
amendment has been signed by both parties, whichever is later.
All provisions in the contract and any attachments thereto in conflict with this U
amendment are hereby changed to conform with this amendment.
All provisions not in conflict with this amendment are still in effect and are to be
performed at the level specified in the contract.
This amendment and all its attachments are hereby made a part of the contract.
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IN WITNESS THEREOF, the parties hereto have caused this two-page
amendment to be executed by their officials thereunto duly authorized. a
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County: Monroe State of Florida Dept. of Health
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SIGNED SIGNED 0
BY: BY: c)
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NAME: NAME: Robert B. Eadie
TITLE: TITLE: Administrator
DATE: DATE:
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Approval as to form and legal sufficiency: E
Monroe County Attorney's Office 5-13-2022
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C.5.a
ATTACHMENT III
CIVIL RIGHTS COMPLIANCE AND
NON-DISCRIMINATION
CERTIFICATE
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1. The CHD 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.
2. The CHD assures that it will comply with 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.
3. Assurance of Civil Rights Compliance: The CHD hereby agrees that it will comply with Title VI of the
Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.); Title IX of the Education Amendments of 1972 (20
U.S.C. 1681 et seq.); Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794); the Age E
Discrimination Act of 1975 (42 U.S.C. 6101 et seq.); Title II and Title III of the Americans with Disabilities
Act (ADA) of 1990, as amended by the ADA Amendment Act of 2008 (42 U.S.C. 12131-12189) and as
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implemented by Department of Justice regulations at 28 CFR Parts 35 and 36; Executive Order 13166,
"Improving Access to Services for Persons with Limited English Proficiency" (August 11, 2000); all
provisions required by the implementing regulations of the U.S. Department of Agriculture (7 CFR Part
15 et seq.); and FNS directives and guidelines to the effect that no person shall, on the ground of race,
color, national origin, age, sex, or disability, be excluded from participation in, be denied the benefits of,
or otherwise be subjected to discrimination under any program or activity for which the agency receives
Federal financial assistance from FNS; and hereby gives assurance that it will immediately take
measures necessary to effectuate this agreement. U
By providing this assurance, the CHD agrees to compile data, maintain records and submit records and
reports as required to permit effective enforcement of the nondiscrimination laws, and to permit
Department personnel during normal working hours to review and copy such records, books and
accounts, access such facilities, and interview such personnel as needed to ascertain compliance with
the non-discrimination laws. If there are any violations of this assurance, the Department of Agriculture 0
shall have the right to seek judicial enforcement of this assurance. U
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This assurance is given in consideration of and for the purpose of obtaining any and all Federal 0
financial assistance, grants, and loans of Federal funds, reimbursable expenditures, grant or donation
of Federal property and interest in property, the detail of Federal personnel, the sale and lease of, and
the permission to use Federal property or interest in such property or the furnishing of services without
consideration or at a nominal consideration, or at a consideration that is reduced for the purpose of t0
assisting the recipient, or in recognition of the public interest to be served by such sale, lease, or
furnishing of services to the recipient, or any improvements made with Federal financial assistance 0
extended to the Program applicant by USDA. This includes any Federal agreement, arrangement, or U
other contract that has as one of its purposes the provision of cash assistance for the purchase of food,
and cash assistance for purchase or rental of food service equipment or any other financial assistance
extended in reliance on the representations and agreements made in this assurance.
This assurance is binding on the CHD, its successors, transferees, and assignees as long as it receives E
or retains possession of any assistance from the Department. The person or persons whose
signatures appear below are authorized to sign this assurance on the behalf of the CHD.
4. Confidentiality of Data, Files, and Records: The CHD agrees to restrict the use and disclosure of
confidential USDA, Women, Infant, and Children (WIC) applicant and participant information as specified
in 7 CFR § 246.26(d)(1)(i) in accordance with 7 CFR § 246.26(d)(1)(ii), as applicable.
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C.5.b
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 2021-2022
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, 2021.
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
coordination between the State and the County in the operation of the CHD.
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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 U
and incorporated herein by reference.
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2. TERM. The parties mutually agree that this contract shall be effective from October 1,
2021, through September 30, 2022, 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 Ili of Attachment II hereof, in order to
maintain the following three levels of service pursuant to section 154.01(2), Florida Statutes,
as defined below:
a. "Environmental health services" are those services which are organized and operated
to protect the health of the general public by monitoring and regulating activities in the
environment which may contribute to the occurrence or transmission of disease.
Environmental health services shall be supported by available federal, state and local funds
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C.5.b
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, HIWAIDS, 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:
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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.
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i. The State's appropriated responsibility (direct contribution excluding any state U
fees, Medicaid contributions or any other funds not listed on the Schedule C) as
provided in Attachment ll, Part II is an amount not to exceed $ U
4,123,563.00 (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 1 398 760.00 (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
Department Trust Fund that is attributed to the CHD shall be carried forward to the next
contract period.
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C.5.b
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 N
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., U
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 U
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.
c. The CHD shall maintain books, records and documents in accordance with the
Generally Accepted Accounting Principles (GAAP), as promulgated by the Governmental
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C.5.b
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 6X, 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;
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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. N
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 U
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 U
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 Il, Part I of this contract, with special capital projects explained in Attachment V.
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
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C.5.b
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.
L The CHD shall not use or disclose any information concerning a recipient of services
except as allowed by federal or state law or policy.
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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 E
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 U
applicable professional standards of practice with respect to client confidentiality.
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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
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 lll.
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C.5.b
o. The CHD shall submit quarterly reports to the County that shall include at least the
following:
L 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.
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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:
L March 1, 2022 for the report period October 1, 2021 through
December 31, 2021;
ii. June 1, 2022 for the report period October 1, 2021 through
March 31, 2022;
iii. September 1, 2022 for the report period October 1, 2021
through June 30, 2022; and N
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iv. December 1, 2022 for the report period October 1, 2021
through September 30, 2022.
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7. FACILITIES AND EQUIPMENT. The parties mutually agree that:
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a. CHD facilities shall be provided as specified in Attachment IV to this contract and the
County shall own the facilities used by the CHD unless otherwise provided in Attachment IV.
b. The County shall ensure adequate fire and casualty insurance coverage for County-
owned CHD offices and buildings and for all furnishings and equipment in CHD offices
through either a self-insurance program or insurance purchased by the County.
c. 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.
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C.5.b
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.
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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 parry'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 "2!
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, 2022, 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: N
For the State: For the County:
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Michael Seiler Roman Gastesi
Business Manager III County Administrator U
1100 Simonton Street 1100 Simonton Street
Key West, FI 33040 Key West, FI 33040
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305-676-3825 305-292-4441
If different contract managers are designated after execution of this contract, the name,
address and telephone number of the new representative shall be furnished in writing to the
other parties and attached to originals of this contract.
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C.5.b
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),
Attachment VI (three pages), and Addendum I (one page) to be executed by their
undersigned officials as duly authorized effective the 1st day of October, 2021.
BOARD OF COUNTY COMMISSIONERS STATE OF FLORIDA
FOR MONROE COUNTY DEPARTMENT OF HEALTH
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SIGNED BY: SIGNED BY:
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NAME: NAME: Scott A. Rivkees, MD
TITLE: TITLE: State Surgeon General
DATE: DATE:
ATTESTED TO:
SIGNED BY: SIGNED BY: <
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NAME: NAME: Robert Eadie
TITLE: TITLE: CHD Director/Administrator
DATE: DATE:
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Approved as to form and legal sufficiency:
Monroe County Attorney's Office
Assistant County Attorney
9-17-2021
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C.5.b
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:
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Service Requirement
1, Sexually Transmitted Disease Program Requirements as specified in F,A.C, 64D-3, F.S 381 and F,S 384.
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2 Dental Health Periodic financial and programmatic reports as specified by the
program office. y
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 detailed
Children(including the WIC 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 cv
seq,,,42 CFR part 59,subpart A,45 CFR parts 74&92,2 CFR 215 C14
(OMB Circular A-110)OMB Circular A-1 02, F.S. 381.0051, F.A.C. T_
64F-7,„ F,A C 64F-16,and F.A.C.64F-19. Requirements and y
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): 0
Recommendations of CDC and the U.S.Office of Population Affairs L)
published on the Office of Population Affairs website. Programmatic 0
annual reports as specified by the program office as specified in the U
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 Perioft 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-1-Page f of 2
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C.5.b
ATTACHMENT I(Continued
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•
, HIVIAIDS Program Requirements as specified in F.S. 384.25 and F.A.C.64D-3.030 and
640-3.031.Case reporting should be on Adult HIVIAIDS Confidential
Case Report CDC Form DH2139 and Pediatric HIVIAIDS
Confidential Case Report CDC Form DH2140.
Requirements as specified in F.A.C.6413-2 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 HIVIAIDS Patient Care programs are found in the Patient
Care Contract Administrative Guidelines. ;
.8. 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.
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10. Tuberculosis Tuberculosis Program Requirements as specified in F.A.C.64D-3 y
and F,S, 392. U
11, General Communicable Disease Carry out surveillance for reportable communicable and other acute
Control diseases,detect outbreaks,respond to individual cases of reportable C
diseases„investigate outbreaks,and carry out communication and
quality assurance functions, as specified in F.A.C.64D-3, F.S.381,
F,& 384 and the CHD Epidemiology Guide to Surveillance and
Investigations.
12 Refugee Health Program Programmatic and financial requirements as specified by the
program office. E
.or the subsequent replacement if adopted during the contract period.
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C.5.b
ATTACHMENT H
MONROE COUNTY HEALTH DEPARTMENT
Part U,Sources of Contributions to County Health Department
October 1,2021 to September 30,2022
State CHD County Total CHD
Trust Fund CHD Trust Fund Other
(cash) 'lust Fund (crib) 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 34,241 0 34�241 0 34,241
015040 SEXUALLY TRANSMITTED DISEASE CONTROL PROGRAM GR 16,755 0 16..755 0 16,7M
015040 DENTAL SPECIAL INITIATIVE PROJECTS 6,797 0 6,797 0 6,797
015040 EPIDEMIOLOGY SURVEILLANCE GENERAL REVENUE 79,035 0 79,035 0 79,035
015040 FAMILY PLANNING GENERAL REVENUE 34,239 0 34,239 0 34,239 ,O
015040 HEPATITIS AND LIVER FAILURE PREVENTION&CONTROL 72,000 0 72,.000 0 72„00C
015040 PRIMARY CARE PROGRAM 199742 0 199,742 0 199„742 U
015040 RACIALÐNIC DISPARITIES•CHD EXPENSES 55,000 0 55,000 0 55,000
015040 SCHOOL HEALTH SERVICES•GENERAL REVENUE 96,223 0 96„223 0 96.223
016050 CHD GENERAL REVENUE NON°CATEGORIC".AL 1,425,962 0 1„425.962 0 L.425,962
GENERAL REVENUE TOTAL 2.093,546 0 2,093..546 0 2,093,.546 ca
2.NON GENERAL REVENUE-STATE
015010 ENVIRONMENTAL BIOMEDIC",AL WASTE PROGRAM 3„150 0 3,l50 0 3,150
015010 TOBACCO STATE AND COMMUNITY INTERVENTIONS 121„086 0 121„086 0 121,086 �
NON GENERAL REVENUE TOTAL 124„236 G 124,,236 0 124,236
S.FEDERAL FUNDS-STATE
007000 AIDS DRUG ASSISTANCE PROGRAM ADMIN HQ 69„519 0 69,519 0 69,519
007000 WIC BREASTFEEDING PEER COUNSELING PROG 75,396 0 75,396 0 75,396
CN
007000 COASTAL BEACH WATER QUALITY MONITORING 15,605 0 15,605 0 15,605
007000 COMPREHENSIVE COMMUNITY CARDIO•PHBG 55,013 0 55,013 0 55,013
007000 FAMILY PLANNING TITLE X-GRANT 51,544 0 51,544 0 51,544
007000 HOUSING OPPORTUNITIES FOR PERSONS WITH AIDS 664„113 0 664,113 0 664,113 O
L)
007000 HURRICANE CRISIS COAG ENVIRONMENTAL HEALTH 325 0 325 0 325
007000 IMMUNIZATION ACTION PLAN 42,.621 0 42,621 0 42,621 O
007000 MCH SPECIAL PRJCT UNPLANNED PREGNANCY 12,985 0 12,985 0 12,985
007000 MCH BLOCK GRANT FLORIDA'S HEALTHY BABIES 12,868 0 12,868 0 12,868
007000 BASE COMMUNITY PREPAREDNESS CAPABILITY 92,461 0 92„461 0 92,461
007000 AIDS PREVENTION 119,124 0 119.124 0 119,124
007000 RYAN WHITE TITLE 11 CARE GRANT 198,362 0 19&362 0 198,362
007000 WIC PROGRAM ADMINISTRATICON 387,953 0 387,,953 0 387,953
015075 S't"PPLEMENTAL SCHOOL HEALTH 123,815 0 123,815 0 123,815
015075 REFUGEE HEALTH SCREENING REIMBURSEMENT ADMIN 3,341 0 3,341 0� 3,341
015075 REFUGEE HEALTH SCREENING REIMBURSEMENT SERVICES 23,036 0 23,036 0 23,036
018005 RYAN WHITE TITLE It ADAP DRUG REBATES 71,505 CI 71,505 0 71,505
FEDERAL FUNDS TOTAL 2,019,586 41 2,019,586 0 2,019„586
t FEES ASSESSED BY STATE OR FEDERAL RULES-STATE
001020 CHD STATEWIDE ENVIRONMENTAL FEES 78,,,004 0 78,004 0 78,004
001092 ON SITE SEWAGE DISPOSAL PERMIT FEES 1,049 0 1,049 0 1,049
001092 CHD STATEWIDE ENVIRONMENTAL FEES 2,373 0 2,373 0 2,373
Attachmenl_II_Part II-Page 1 of 3
Packet Pg. 257
C.5.b
ATTACHMENT H
MONROE COUNTY HEALTH DEPARTMENT
Part Il,Souroea of Contributions'to County Health Department
October 1,2021 to September 30,2022
State CHD County Total CHD
'Duet Fund CHD Trust Fund Other
(cash) Trust Fund (cash Contribution Total
001206 ON SITE SEWAGE DISPOSAL PERMIT FEES 4,337 0 4,337 0 4,337
001206 SANITATION CERTIFICATES(FOOD INSPECTION) 2.011 0 2,011 0 2,011
001206 SEPTIC TANK RESEARCH SURCHARGE -35 0 35 0 35
001206 PUBLIC SWIMMING POOL PERMIT FEES,10%HQ TRANSFER 7,425 0 7,425 0 7,425
001206 REGULATION OF BODY PIERCING SALONS 90 0 90 0 90
001206 TANNING FACILITIES 47 0 47 0 47
001206 ONSITE SEWAGE TRAINING CENTER 5 0 5 0 5 „2
001206 TATTO PROGRAM ENVIRONMENTAL HEALTH 808 0 808 0 808
001206 MOBILE HOME&RV PARK FEES I„936 0 1.936 0 1,936 O
U)
FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL 98,120 0 98,120 0 98,120
�9
5.OTHER CASH CONTRIBUTIONS°STATE'
0 f) 0 0 0
090001 DRAW DOWN FR()M P'1:1'RLIC HEALTH IL."NIT 127,%187 0 127,,,387 0 127,387 0
OTHER CASH CONTRIBUTION TOTAL 127,387 0 127387 0 127,387
6.MEDICAID•STATE/COUNTY:
001057 ("HD CLINIC,FEES 0- 959 959 I;p 959
001148 CHD CLINIC FEES C� 44,308 44,308 0 44,308 �
MEDICAID TOTAL q'D 45,267 45 267 0 45.267
7.ALLOCABLE REVENUE•STATE: N
CN
018000 CHD CLINIC FEES 1,387 if), 1,387 0 1,387 N
031005 CHD CLINIC FEES 9 9 Q, 9
031005 GENERAL CLINIC RABIES SERVICES&DRUG PURCHASES "a,0#,M',) 05,000 0 5,000
031005 TRUST FOR AMERICA'S HEALTH ACREEEMENT 2,500 I:) 2,500 0 2,500
ALLOCABLE REVENUE TOTAL 8,896 0 8,896 0 8,896
O
8.OTHER STATE CONTRIBUTIONS NOT IN CHD TRUST FUND•STATE L)
AD'P '3 0 0 99,261 99,261 9=
PHARMACY DRUG PROGRAM 0 0 01 7,236 7,236
WIC PROGRAM 0 0 0 823,226 823,226
BUREAU OF PUBLIC HEALTH LABORATORIES 0 0 0 8,023 8.023
IMMUNIZATIONS 0 101 4) 472,001 472,001
OTHER STATE CONTRIBUTIONS TOTAL 0 0 0 1,409,747 1,409,747
9.DIRECT LOCAL CONTRIBUTIONS•BCC/TAX DISTRICT
008005 CHD LOCAL REVENUE&EXPENDITURES 0 931,.580 931,580 0 931,580
0,08005 IMMUNIZATION CAMPAIGN MONROE COUNTY BOrf.X' 0 457,180 467,180 0 467,180
DIRECT COUNTY CONTRIBUTIONS TOTAL 10, 1398,760 1„398,760 icl, 1,398,760
10.FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION•COUNTY
001077 CHD CLINIC FEES 10 25,730 25,730 0 25,730
001094 CHD LOCAL ENVIRONMENTAL FEES 0 128,599 128,599 0 128,599
001110 VITAL STATISTICS CERTIFIED RECORDS 0 65,000 65.000 0 65,000
Attachment II Part II-Page 2 of 3
Packet Pg. 258
C.5.b
ATTACHMENT II
MONROE COUNTY HEALTH DEPARTMENT
Part II,Sources of Contributions to County Health Department
October 1,2021 to September 30,2022
State CHD County Total CHD
Trust Fund CHD Trust Fund ' Other
(cash? Trust Fund (cash) Contribution Total
FE&S AUTHORIZED BY COUNTY TOTAL 0 219.329 219,329 0 219,329
11.OTHER CASH AND LOCAL CONTRIBUTIONS-COUNTY
001029 CHD CLINIC FEES 0 139.380 139,380 0 139,380
001029 GENERAL CLINIC RABIES SERVICES&DRUG PURCHASES 0 283 283 0 283
001029 CURANT 340B REVENUE AND EXPENSE TRACKING 0 60,000 60,000 (if 60,000
001090 CHD CLINIC FEES 0 50,507 59,507 0 59,507
007010 RYAN WHITE TITLE III•DIRECT TO CHD 0 396,051 396,051 0 396,051
007010 RYAN WHITE TITLE III•DIRECT TO CHD 0 238,210 238,210 q';I 238,210 U
007010 RYAN WHITE PART C.COVID•19 RESPONSE 0 39,932 39,932 0 39,932
010300 ON SITE SEWAGE DISPOSAL PERMIT FEES 0 8 8 0 8
010300 STATE UNDERGROUND PETROLEUM RESPONSE ACT 0 420 420 0 420
010400 CHD SALE OF SERVICES IN OR OUTSIDE OF STATE GOUT 0 2,400 2,400 0 2.400
010500 CHD SALE OF SERVICES IN OR OUTSIDE OF STATE GOVT 0 93,497 93,497 0 93,497
011001 CHD HEALTHY START COALITION CONTRACT 0 290„000 290,000 0 290,000
090002 DRAW DOWN FROM PUBLIC HEALTH:UNIT 0 585„929 585,929 0 585„929
OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL 0 1,905„617 1„905,6L7 0 1„905.617
12.ALLOCABLE REVENUE•COUNTY
018000 CHD CLINIC FEES 0 1,387 1,387 0 1,387 0)
as
031005 CHD CLINIC FEES 0 9 9 0 9 E
031005 GENERAL CLINIC RABIES SERVICES&DRUG PURCHASES 0 5,000 5,000 0 5,000
031005 TRUST FORAMERICA'S HEALTH AGREEEMENT 2,500 2,500 (r 2,500 C.1
COUNTY ALLOCABLE REVENUE TOTAL (p 8„896 81896 0 8,896 N
a.+
U
13.BUILDINGS-COUNTY
ANNUAL RENTAL EQUIVALENT VALUE 0, 0 0 597.605 597,605 (0
OTHER(Specify) 0 P) 0 0 2!
UTILITIES O 0 0 83,369 83,369 (0
BUILDING MAINTENANCE 0 75,223 75,223 ,i
GROUNDS MAINTENANCE 0 0 0 115.566 115,566
INSURANCE 0 (m 0 0 4 E
OTHER(Specify) 0 01 0 0 0
OTHER(Specify) 0 1:1 0 0 0
BUILDINGS TOTAL 0 10, 0 8710763 871„763
14,OTHER COUNTY CONTRIBUTIONS NOT IN CHD TRUST FUND.COUNTY
EQUIPMENT I VEHICLE PURCHASES 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 4,471,771 $,577.869 8,049,640 2,28L510 10,331„160
ASachawl II Part II-Page 3 of 3
Packet Pg. 259
C.5.b
ATTACHMENT H
MONROE COUNTY HEALTH DEPARTMENT
Part HI,Planned Staffing,Clients,Services and Expenditures By Program Service Area Within Each Level of Service !
October 1,2021 to September 30,2022
Quarterly Expendittze Plan
FTE's Clients Services/ let ' 2nd 8rd 4th Grand '
(0,00) units Visits (Whole dollars only) State County Total
A. COMMUNICABLE DISEASE CONTROL'
IMMUNIZATION 001) 8.93 4,301 6.186 287.864 246.802 287.864 246.802 48,995 1,020,337 1,069,332
SEXUALLY TRANS.DIS. (102) 1.69 2136 483 57,183 49,027 57,183 49,027 16.755 195,665 212,420
HIVIAIDS PREVENTION WAD 3.25 0 1,175 74,079 63,512 74.079 63.513 274.978 205 275,183
HIVIAIDS SURVEILLANCE (03A2) 0.00 0 0 0 0 0 0 0 0 0
HIVIAIDS PATIENT CARE (03A3) 9.24 215 1.337 423,704 363.264 423.704 363.264 873,955 699,981 1.573,936
ADAP (03A4) 1.34 0 0 28,016 24,019 28.016 24,019 103,998 82 104.070
TUBERCULOSIS (109) 0.77 8 17 25,105 21,524 "5,105 21,524 93.210 48 93,259
COMM.DIS.SURV. (Io6) 4.25 0 401 108.832 93.308 108.832 93,309 404.281 0 404,281 U
U)HEPATITIS (109) 1.33 162 203 69.247 59,369 69.247 59,369 257.094 148 257.232
PREPAREDNESS AND RESPONSE (118) 2.48 0 174 64,318 55.143 64.318 55,144 238,923 0 238,923 ,
1�9
REFUGEE HEALTH (118) 0.85 364 902 18.277 15,670 18,277 15.671 67.842 53 67.595
U
VITAL RECORDS 080) 1.38 2.101 7,342 32.515 27.877 32,515 27,877 0 120,784 120,784
0)
COMMUNICABLE DISEASE SUBTOTAL 36,47 7.417 18.220 1.189,140 1,019,515 L189,140 1,019,619 2,380,011 2,037,303 4AM314
B. PR0&4xY CARE:
CHRONIC DISEASE PREVENTION PRO (210) 2.48 0 0 52.537 45.042 52,537 45.042 195,158 0 195,158
WIC (21W1) 6.11 1.707 9,312 131.485 112,729 131485 112,729 488,428 0 488,428
TOBACCO USE INTERVENTION (212) 2.43 0 0 54.752 46,942 54,752 46.942 203.388 0 203.388 9=
0)
WIC BREASTFEEDING PEER COUNSELING (21 W2) 1.60 0 2.242 29.096 24,946 29,096 24,945 108,083 0 108,083
FAMILY PLANNING (223) 4.32 1,374 3,026 117.042 100,347 117.042 100,347 397,511 37,2G7 434.778 N
CN
IMPROVED PREGNANCY OUTCOME (225) 0.00 0 0 3.496 2,997 3.496 2.996 12.985 0 12,985 v
N
HEALTHY START PRENATAL(227) 2.60 494 2,491 54.854 47,030 54.954 47.030 0 203,768 203,768
U
COMPREHENSIVE CHILD HEALTH (229) 0.00 0 0 0 0 0 0 0 0 0
HEALTHY START CHILD (231) 2,51 488 2.514 50.433 43,239 50,433 43.239 0 187.344 187.344 O
L)
SCHOOL HEALTH (234) 2.17 0 89,957 74.907 64.222 74.907 64.222 278.258 0 278.258
O
COMPREHENSIVE ADULT HEALTH (237) 527 500 2,108 150.222 128.794 150.222 128.793 199.742 358,289 558.031 L)
COMMUNITY HEALTH DEVELOPMENT (238) 2,24 0 107 65„449 56.113 65.449 56,114 15,368 227.757 243.125
DENTAL HEALTH (240) 19)42 337 338 15136 IZ977 16.136 12,978 56.227 0 56.227
PRIMARY CARE SUBTOTAL 12.15 4,10) 112.095 799,409 685..178 799,409 685.377 1,955,149 1.014.425 2.969.573
C. ENVIRONMENTAL HEALTH:
Water and Onaite Sawate Progmme
COSTAL BEACH MONITORING (347) 0,43 419 419 10,981 9,414 10.981 9.414 26,879 13,911 40.790
LIMITED FSE PUBLIC WATER SYSTEMS (357) 0.00 0 0 0 01 66 0 0 0 0
PUBLIC'WATER SYSTEM (358) 0.00 0 0 0 (1 0 0 0 0 0
PRIVATE WATER SYSTEM (359) 0,00 0 y 0 0 0 0 0 0 0
ONSITE SEWAGE TREATMENT&DISPOSAL (361) 1.10 484 442 21,771 18„6CA 21.771 1&666 1.049 79,824 80.873
Group Taal 1.51 903 861 32.752 2&079 32,752 28.080 27„928 93,735 121.663
Facility Pmerame
TATTOOFACILITYSERVICES (344) 0,19 209 49 4„283 3.672 4,293 3.672 15,910 CY 15,910
Attachment 1t Part HI-Page t of 2
Packet Pg. 260
C.5.b
ATTACHMENT II
MONROE COUNTY BFALTH DEPARTMENT
Part III,Planned Staffing.Clients,Services and Expenditures By Program Service Area Within Each Level of Service
October 1,202I to September 30,2022
Quarterly Expenditure Plan
PTE's Clients Services/ 1st 2nd 8rd '4th Grand
(0.00) Units visits (Whole dollars only) State' County Total
FOOD HYGIENE (348) 0.63 278 334 12,870 11.034 12,870 11.033 19,051 28.756 47,807
BODY PIERCING FACILITIES SERVICES (349) 0.11 14 22 2,398 2,D56 2,398 2.056 S10 81098 8,908
GROUP CARE FACILITY (351) 0.15 195 180 3.526 3,023 3,526 3,023 0 13.098 13,098
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) 0.55 318 338 11,120 9,534 11,120 9.533 17.424 23,883 41.307
POOLSIBATHING PLACES (360) 2.04 921 2Z7 35,503 30,438 35,503 30,438 25,501 106.381 131.882
U
BIOMEDICAL WASTE SERVICES (364) 0.63 6.50 497 12,765 10,944 12,765 10,945 12,875 34,544 47,419
TANNING FACILITY SERVICES (369) 0.16 0 0 3.970 3,404 1970 3,403 419 14,328 14,747 U
U)
Group Total 4,46 2.585 3,677 86,435 74,105 86,435 74.103 91,990 229,088 321,078
Groundwater Contamination P
STORAGE TANK COMPLIANCE SERVICES (355) 0.00 0 0 0 0 0 0 0 0 0
U
SUPER ACT SERVICES (356) 0.00 0 0 0 0 0 0 0 0 0
Group Taal 0.00 0 0 0 0 0 0 0 0 0
Community I4jgi—
COMMUNITY ENVIR.HEALTH (345) 0.00 0 0 0 0 0 0 0 0 0 °
INJURY PREVENTION (346) 0.00 0 D 0 0 0 0 0 0 0
LEAD MONITORING SERVICES (350) 0,00 0 0 0 0 0 0 0 0 0 a
0)
PUBLIC SEWAGE (362) 0.00 0 0 0 0 0 0 0 0 0
SOLID WASTE DISPOSAL SERVICE (363) OAO 0 0 0 0 0 0 0 0 0
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SANITARY NUISANCE (365) 0.30 34 141 6,437 5,518 6,437 5,518 0 23,910 23,910
CN
RABIES SURVEILLANCE (366) 0.50 0 200 11.885 10,190 11.885 10.190 0 44,150 44.150
U
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 O
()
WATER POLLUTION (370) 0.00 0 0 0 0 0 0 0 0 0
INDOORAIR(371) 0.00 0 0 0 0 0 0 0 0 0 O
(,3
RADIOLOGICAL HEALTH (372) 0.00 0 0 0 0 0 0 0 0 0
TOXIC SUBSTANCES (373) 1.74 730 730 36,391 31.200 36,391 31,199 0 135.191 135,181
Group Total 2.54 764 1.071 54,713 46,909 54,713 46.907 0 203,241 203.241 U
ENVIRONMENTALHFALTHSUBTOTAL 8.53 4,252 5.609 173.900 149,092 173.900 149.0W 119,918 526,064 646.982
D. NON-OPERATIONAL COSTS:
NONOPERATIONAL COSTS (699) 0,00 0 1) 1) 0 0 a 0 0 0
ENVIRONMENTAL HEALTH SURCHARGE (399) 0.00 D 0 4,496 3„855 4.496 3'„M15 16,694 8 16,702
MEDICAID BUYBACK (611) 0,00 0 11) 19 16 19 15 01 69 69
NON-OPERATIONAL COSTS SUBTOTAL 0.00 0 3 4.515 2,871 4,515 3 870 16,694 77 16.771
TOTAL CONTRACT 77,15 16,569 135.924 2,166,964 1„857.856 2.166,964 1.857,856 4,471„771 3,577„869 8,049,640
AUachmeM_lY_Pun III-Pop 2 of 2
Packet Pg. 261
C.5.b
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
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discrimination on the basis of race, color or national origin in programs and activities receiving or U)
benefiting from federal financial assistance.
P
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 �y
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.
E
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. N
N
6. All regulations,guidelines and standards lawfully adopted under the above statutes. The applicant agrees N
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, o
subcontractors, subgrantees or others with whom it arranges to provide services or benefits to U
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 U
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 E
being denied.
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Attachment III-Page 1 of 1
Packet Pg. 262
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C.5.b
ATTACHMENT V
MONROE COUNTY HEALTH DEPARTMENT
SPECIAL PROJECTS SAVINGS PLAN
CASH RESERVED OR ANTICIPATED TO BE RESERVED FOR PROJECT$
CONTRACT YEAR STATE CiDUNTY TOTAL
2020-2021' $ 0 $ 0 $ 0
2021-2022" $ 0 $ 0 $ 0
2022-2023— $ 0 $ 0 $ 0
2023-2024"' $ 0 $ 0 $ 0
PROJECT TOTAL $ 0 $ 0 $ 0
SPECIAL PROJECTS CONSTRUCTIONIRENOVATION PLAN 2
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PROJECT NUMBER: t)
PROJECT NAME:
LOCATIONIADDRES&
PROJECT TYPE NEW BUILDING ROOFING
RENOVATION PLANNING STUDY
NEW ADDITION OTHER
SQUARE FOOTAGE; p
PROJECT SUMMARY: Describe scope of work in reasonable detail
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START DATE (Initial expenditure of funds)
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COMPLETION DATE:
DESIGN FEES: $ 0
CONSTRUCTION COSTS: $ 0
FURNITUREIEQUIPMENT: $ 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 9130/21
Cash to be transferred to FCO account.
Cash anticipated for future contract years.
ARachrwnt V-Page 1 of 1
Packet Pg. 264
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C.5.b
ADDENDUMI
TO 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 2021 —2022
This addendum is executed by the parties to provide additional clarification to the
agreement between the Monroe County Board of County Commissioners ("County") and
the State of Florida Department of Health ("State")for the operation of the Monroe County
Health Department ("CHD")for the contract year beginning October 1, 2021.
PAYMENTS MADE BY THE STATE TO THE COUNTY
In order to get a more complete picture of the financial arrangement between the two
parties, it should be noted that the State is making payments to the County for various
services. These are services rendered by the County or by a third party, and the State is
receiving benefit. The following is a list of the services handled in this manner:
• Vehicle Maintenance
The State is responsible for the cost of maintenance and repairs of vehicles used for
Health Department operations. Most of the repairs are handled by the county
garage and invoiced to the CHD.
• Vehicle Fuel
The County charges the State for fuel whenever the County pumps are used. N
• Vehicle Insurance
The County carries the title, registration, and associated insurance coverage for all U
vehicles. The State reimburses the County for their share of these costs.
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• Building Insurance
The County owns the facilities where the CHD conducts business. The County, in
turn, carries the building insurance and charges back the Health Department for their
share of the costs. The facilities are listed in Attachment IV.
• County Courier Costs
The County operates a courier service making deliveries between county facilities.
The State is charged a reasonable fee for the use of these services.
• County Phone lines
The State is obligated to pay the County for the use of miscellaneous telephone and
fax lines. These lines could not be transferred to the new CHD phone system at the
time of the last upgrade.
Page 1 of 1
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