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FY2023 11/15/2022
GVS COURTq° o: A Kevin Madok, CPA - �o ........ � Clerk of the Circuit Court& Comptroller Monroe County, Florida �z cooN DATE: July 10, 2023 TO: Lindsey Ballard Aide to the County Administrator FROM: Liz Yongue, Deputy Clerk SUBJECT: November 15, 2022 BOCC Meeting Please see the attached item, which has been executed and added to the record: Q2 Contract between Monroe County Board of County Commissioners and the State of Florida, Department of Health for operation of the Monroe County Health Department— contract year 2022-2023. Should you have any questions please feel free to contact me at(305) 292-3550. cc: County Attorney Finance File KEY WEST MARATHON PLANTATION KEY 500 Whitehead Street 3117 Overseas Highway 88770 Overseas Highway Key West, Florida 33040 Marathon, Florida 33050 Plantation Key, Florida 33070 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 2022-2023 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, 2022. State and County are jointly referred to as the "parties". RECITALS A. Pursuant to Chapter 154, Florida Statutes, the intent of the legislature is to "promote, protect, maintain, and improve the health and safety of all citizens and visitors of this state through a system of coordinated county health department services." B. County Health Departments were created throughout Florida to satisfy this legislative intent through the "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 to ensure coordination between the State and the County in the operation of the CHD. NOW, THEREFORE, in consideration of the mutual promises set forth herein, the sufficiency of which is hereby acknowledged, the parties hereto agree as follows: 1. RECITALS. The parties mutually agree that the foregoing recitals are true and correct and incorporated herein by reference. 2. TERM. The parties mutually agree that this contract shall be effective from October 1, 2022, through September 30, 2023, or until a written contract replacing this contract is entered into between the parties, whichever is later, unless this contract is otherwise terminated according to the termination provisions outlined in paragraph 8. below. 3. SERVICES MAINTAINED BY THE CHD. The parties mutually agree that the CHD shall provide those services as outlined in Part III of Attachment II hereof, 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 that are organized and operated to protect the health of the general public by monitoring and regulating activities in the environment that may contribute to the occurrence or transmission of disease. Environmental health services shall be supported by available federal, state, and local funds and shall include 1 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 that protect the health of the general public through the detection, control, and eradication of diseases that are transmitted primarily by human beings. Communicable disease services shall be supported by available federal, state, and local funds and shall include those services mandated on a state or federal level. Such services include, but are not limited to, epidemiology, sexually transmissible disease detection and control, HIV/AIDS, immunization, tuberculosis control, and maintenance of vital statistics. c. "primary care services" are acute care and preventive services that are made available to well and sick persons who are unable to obtain such services due to lack of income or other barriers beyond their control. These services are provided to benefit individuals, improve the collective health of the public, and prevent and control the spread of disease. Primary health care services are provided at home, in group settings, or in clinics. These services shall be supported by available federal, state, and local funds and shall include services mandated on a state or federal level. Examples of primary health care services include but are not limited to first contact acute care services; chronic disease detection and treatment; maternal and child health services; family planning; nutrition; school health; supplemental food assistance for women, infants, and children; home health; and dental services. 4. FUNDING. The parties further agree that funding for the CHD will be handled as follows, a. The funding to be provided by the parties and any other sources is outlined in Part II of Attachment II hereof. This funding will be used as shown in Part I of Attachment II. i. The State's appropriated responsibility (direct contribution excluding any state fees, Medicaid contributions, or any other funds not listed on the Schedule C) as provided in Attachment II, Part II is an amount not to exceed $ 4�733 (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, othercash, orlocalcontributions) as provided in Attachment II, Part II is an amount not to exceed $1 532677 (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 the 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. 2 c. Either party may establish service fees as allowed by law to fund activities of the CHID. 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 or decrease, the CHD will revise Attachment 11 and send a copy of the revised pages to the County and the State's Office of Budget and Revenue Management. If the County initiates the increase or decrease, the County shall notify the CHID in writing. The CHD will then revise Attachment 11 and send a copy of the revised pages to the State's 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 or ADMIN!�JRATOR. Both parties agree the director or 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 State's Deputy Secretary for County Health Systems, The director or administrator shall be selected by the State with the concurrence of the County. The director or administrator of the CHID shall ensure that non-categorical sources of funding are used to fulfill public health priorities in the community and the Long-Range Program Plan. 6. ADMINISTRATIVE POLICIES AND PROCEDURES. The parties hereto agree that the following standards should apply in the operation of the CHID: a. The CHID and its personnel shall, follow all State policies and procedures,, except to the extent permitted for the use Of County purchasing procedures as outlined, in subparagraph b., below. All CHID employees shall be State or State-contract personnel subject to State personnel rules and procedures. Employees will report time in the Health Management System compatible format by program component as specified by the State. b. The CHD shall comply with all applicable provisions of federal and state laws and regulations relating to its, operation with the exception that the use of County purchasing, procedures shall be allowed when it will result in a better price or service and no statewide purchasing contract has been implemented for those goods or services. In such cases, the CHD director or 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 CHID following the terms of this contract. State procedures must be followed for all leases on facilities not enumerated in Attachment IV. c. The CHID shall maintain books, records, and documents following the Generally Accepted Accounting Principles, as promulgated by the Governmental Accounting Standards Board, and the requirements of federal or state law. These records shall be maintained as 3 required by the State's 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 is subject to the confidentiality provisions of paragraphs 6.i. and 6.k., below. Books, records, and documents must be adequate to allow the CHD to comply with the following reporting requirements: i. The revenue and expenditure requirements in the Florida Accounting Information Resource System; and 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; and N. Financial procedures specified in the State's Accounting Procedures Manuals, Accounting memoranda, and Comptroller's memoranda; and iv. The CHD is responsible for assuring that all contracts with service providers include provisions that all subcontracted services be reported to the CHD in a manner consistent with the client registration and service reporting requirements of the minimum data set as specified in the Client Information System/Health Management Component Pamphlet. d. All funds for the CHD shall be deposited in the County Health Department Trust Fund maintained by the state treasurer. These funds shall be accounted for separately from funds deposited for other CHDs and shall be used only for public health purposes in Monroe County. e. That any surplus or deficit funds, including fees or accrued interest, remaining in the County Health Department Trust Fund account at the end of the contract year shall be credited or debited to the State or County, as appropriate, based on the funds contributed by each and the expenditures incurred by each. Expenditures will be charged to the program accounts by State and County based on the ratio of planned expenditures in this contract and funding from all sources is credited to the program accounts by State and County. The equity share of any surplus or deficit funds accruing to the State and County is determined each month and at the contract year-end. Surplus funds may be applied toward, the funding requirements of each party 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 that clearly illustrates the amount which has been credited to each party. The planned use of surplus funds shall be reflected in Attachment 11, 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 or administrator determines that an emergency exists wherein a time delay would endanger the public's health and the State's Deputy Secretary for County Health Systems have approved the transfer. The State's Deputy Secretary for County Health Systems shall forward written evidence of this approval to the CHD within 30 days after an emergency transfer. 4 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 certified public accountant 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„ as revised, and may be in conjunction with audits performed by the County government. If audit exceptions are found, then the director or administrator of the CHD will prepare a corrective action plan and a copy of that plan and monthly status reports will be furnished to the contract managers for the parties. i. The CHD shall not use or disclose any information concerning a recipient of services except as allowed by federal or state law or policy. j. The CHD shall retain all client records, financial records, supporting documents, statistical records, and any other documents (including electronic storage media) pertinent to this contract for five years after termination of this contract. If an audit has been initiated and audit findings have not been resolved at the end of five years, the records shall be retained until the resolution of the audit findings. k. The CHD shall maintain the confidentiality of all data, files„ and records that are confidential under the law or are otherwise exempted from disclosure as a public record under Florida law. The CHD shall implement procedures to ensure the protection and confidentiality of all such records and shall comply with sections 384.29, 381.004, 392.65, and 456.057, Florida Statutes, and all other state and federal laws regarding confidentiality. All confidentiality procedures implemented by the CHD shall be consistent with the State's Information Security Policies, Protocols, and Procedures. The CHD shall further adhere to any amendments to the State's security requirements and shall comply with any applicable professional standards of practice concerning client confidentiality. I. The CHD shall abide by all State policies and procedures, which by this reference are incorporated herein as standards to be followed by the CHD. 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 right to a fair hearing to the final governing authority of the CHD. 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 Compliance and Non-Discrimination Certificate, hereby incorporated into this contract as Attachment III. o. The CHD shall submit quarterly reports to the County that shall include at least the following: 5 i. The DE3851_1 Contract Management Variance Report and the DE580L1 Analysis of Fund Equities Report; and ii. A written explanation to the County of service variances reflected in the year- end DE385L1 report if the variance exceeds or falls below 25 percent of the planned expenditure amount for the contract year. However, if the amount of the service-specific variance between actual and planned expenditures does not exceed three percent of the total planned expenditures for the level of service in which the type of service is included, a variance explanation is not required. A copy of the written explanation shall be sent to the States Office of Budget and Revenue Management. p. The dates for the submission of quarterly reports to the County shall be as follows unless the generation and distribution of reports are delayed due to circumstances beyond the CHD's control: i. March 1, 2023, for the reporting period of October 1, 2022, through December 31, 2022; and ii. June 1, 2023, for the reporting period of October 1, 2022, through March 31, 2023; and iii. September 1, 2023, for the reporting period of October 1, 2022 through June 30, 2023; and iv. December 1, 2023, for the reporting period of October 1, 2022 through September 30, 2023. 7. FACILITIES AND EQUIPMENT. The parties mutually agree that: a. CHD facilities shall be provided as specified in Attachment IV to this contract and the County shall own the facilities used by the CHD unless otherwise provided in Attachment IV. b. The County shall ensure adequate fire and casualty insurance coverage for County- owned CHD offices and buildings and 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. 6 8. TERMINATION. a. Termination at Will. This contract may be terminated by either party without cause upon no less than 180 calendar days' notice in writing to the other party unless a lesser time is mutually agreed upon in writing by both parties. b. Termination Because of Lack of Fund . In the event funds to finance this contract become unavailable, either party may terminate this contract upon no less than 24 hours' notice. c. Termination for Breach„ This contract may be terminated by either party for a material breach of an obligation hereunder, upon no less than 30 days' notice. Waiver of a breach of any provisions of this contract shall not be deemed to be a waiver of any other breach and shall not be construed to be a modification of the terms of this contract. 9. MISCELLANEOUS. The parties further agree: a. Ava,ilabilitv of Funds. If this contract„ any renewal hereof, or any term, performance, or payment hereunder, extends beyond the fiscal year beginning duly 1, 2023, it is agreed that the performance and payment under this contract are contingent upon an annual appropriation by the Legislature, under section 287.0582, Florida Statutes. b. Contract Managers. The name and addresses of the contract managers for the parties under this contract are as follows: For the State: For the County: Carta A Fry PhD MSNRN Roman Oastesi Name Name Asst County Health Dept Director Count t Administrator Title Title 1100 Simonton Street 1100 Simonton Street Key West, Florida 33040 Key West, Florida 33040 Address Address Email Address Email Address 305) 578-3835 305 292-4441 Telephone Telephone Approved as to form and legal sufficiency: Monroe County Attorney's Office 11-1-2022 4. ffw If different contract managers are designated after the execution of this contract, the name, address, email address, and telephone number of the new representative shall be furnished in writing to the other parties and attached to the originals of this contract. c. Captions. The captions and headings contained in this contract are for the convenience of the parties only and do not in any way modify, amplify, or give additional notice of the provisions hereof. d. Notices. Any notices provided under this contract must be delivered by certified mail, return receipt requested, in person with proof of delivery, or by email to the email address of the respective party identified in Section 9.b., above. In WITNESS THEREOF, the parties hereto have caused this eight page contract, with its attachments as referenced, including Attachment'I ,(two.pages), Attachment II (seven pages), Attachment ill one page),, Attachment IV (one ,page); and Attachment V (one page), Attachment.VI (3 pages), and Addendum I ,,(2: pages) to be: executed by their undersigned officials as duly authorized eff..ective the 1st day of October 2022. BOARD OF COUNTY COMMISSIONERS STATE OF FLORIDA FOR MONROE COUNTY DEPARTMENT OF HEALTH A SIGNED BY:: _: SIGNED BY. 42 &'jj:2„;„&7 ;.• .Z.,,I A. ..._ . NAME: Crai e.Cates NAME: Joseph A.::,Ladapo2:'M.D.,Ph.D. TITLE::. Mayor ` TITLE: State Surgeon Genera! .. DATE. � `fit,." '...' , 14.; i''' a vo: KEVIN MADOK, CLERK t� l "-4. '�}' `° 1 c SIGNED BY: , .• �� P p vr..Y. Elizabeth Yongue NAME: __ Robert Eadie TITLE: Deputy Clerk TITLE: .CND.Director or Administrator DATE: 11 1.a 5.1 Zvi�- . DATE:_. /- r ry '' . ,-- ,,,-,n 0 cD 2 -n tD.C) 0' 8 �. `., . rp ATTACHMENTI MONROE COUNTY HEALTH DEPARTMENT PROGRAM SPECIFIC REPORTING REQUIREMENTS AND PROGRAMS REQUIRING COMPLIANCE WITH THE PROVISIONS OF SPECIFIC MANUALS Some health services must comply with specific program and reporting requirements in addition to the Personal Health Coding Pamphlet(DHP 50-20), Environmental Health Coding Pamphlet(DHP 50-21)and FLAIR requirements because of federal or state law, regulation or rule. If a county health department is funded to provide one of these services, it must comply with the special reporting requirements for that service. The services and the reporting requirements are listed below: Service Requirement 1. Sexually Transmitted Disease Program Requirements as specified in F.A.C.64D-3, F.S. 381 and F.S. 384, 2. Dental Health Periodic financial and programmatic reports as specified by the program office. 3, Special Supplemental Nutrition Service documentation and monthly financial reports as specified in Program for Women, Infants and DHM 150-24*and all federal, state and county requirements 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 seq.,42 CFR part 59,subpart A,45 CFR parts 74&92,2 CFR 215 (OMB Circular A-1 10)OMB Circular A-1 02, F.S.381.0051, F.A.C. 64F-7, F.A.C.64F-16, and F.A.C.64F-19. Requirements and Guidance as specified in the Program Requirements for Title X Funded Family Planning Projects(Title X Requirements)(2014)and the Providing Quality Family Planning Services(QFP): Recommendations of CDC and the U.S. Office of Population Affairs published on the Office of Population Affairs website. Programmatic annual reports as specified by the program office as specified in the annual programmatic Scope of Work for Family Planning and Maternal Child Health Services, including the Family Planning Annual Report(FPAR), and other minimum guidelines as specified by the Policy Web Technical Assistance Guidelines. 6. Immunization Periodic reports as specified by the department pertaining to immunization levels in kindergarten and/or seventh grade pursuant to instructions contained in the Immunization Guidelines-Florida Schools,Childcare Facilities and Family Daycare Homes(DH Form 150-615)and Rule 64D-3.046, F.A.C. In addition, periodic reports as specified by the department pertaining to the surveillance/investigation of reportable vaccine-preventable diseases, adverse events,vaccine accountability, and assessment of immunization Attachment-1-Page 1 of 12 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* 8. HIV/AIDS Program Requirements as specified in F.S. 384.25 and F.A.C.64D-3.030 and 64D-3.031.Case reporting should be on Adult HIV/AIDS Confidential Case Report CDC Form DH2139 and Pediatric HIV/AIDS Confidential Case Report CDC Form DH2140. Requirements as specified in F.A.C.64D-2 and 64D-3, F.S.381 and F.S.384. Socio-demographic and risk data on persons tested for HIV in CHD clinics should be reported on Lab Request DH Form 1628 in accordance with the Forms Instruction Guide. Requirements for the HIV/AIDS Patient Care programs are found in the Patient Care Contract Administrative Guidelines. 9, School Health Services Requirements as specified in the Florida School Health Administrative Guidelines(May 2012). Requirements as specified in F.S.381.0056, F.S.381.0057, F.S.402.3026 and F.A.0 64F-6. 10. Tuberculosis Tuberculosis Program Requirements as specified in F.A.C.64D-3 and F.S.392. 11 o General Communicable Disease Carry out surveillance for reportable communicable and other acute Control diseases,detect outbreaks, respond to individual cases of reportable diseases, investigate outbreaks, and carry out communication and quality assurance functions, as specified in F.A.C.64D-3, F.S.381, F.S. 384 and the CHD Epidemiology Guide to Surveillance and Investigations. 12. Refugee Health Program Programmatic and financial requirements as specified by the program office. .or the subsequent replacement if adopted during the contract period. Attachment-1-Page 2 of 12 \ \ \ k Cl) LO c 5 / k m ; # k / o r- o a I . \ \ � £ § CL z :3 k 0 \ \ o� \ co ; z J co/ \ _ m LU I-- 3A } k cn � Cl) Cl) cu _ LU k m co C14 N CL z P w w m z W Q I u j � e J � \ \ § \ c 2 ki ca d \ § b EE = . w co j \ j : � � & w / \ 0 a % § . 04 (D \ % §a a \ { §§ 2 / � RaN \ k k \ Cl) ; // m Q I / / / ) ( E 2 E ® � / § R0 — E t CL C C @ t ! A \ 0 $ / Cc $ \ \ \ § � \ a)� � . 2 $ R k B a) I ] 2 � � w D ¥ . e 0 % 5G . 8m CL = R ¥ � 0 Et U � 16 c � § 2 / £/ d / j & w 4 c AWACHMENT II MONROE COUNTY HEALTH DEPARTMENT Part M Sources of Contributions to County Health Department October 1,2022 to September 30`2023 State CED County Total CHD Trust Fund CHD Trust Fund Other (cash) Trust Fund (cash) Contribution Total 1.GENERAL REVENUESTATE 015040 AIDS PREVENTION&SURVEILLANCE-GENERAL REVENUE 73,522 0 73,522 0 73,522 015040 CHD-TB COMMUNITY PROGRAM 33,240 0 33,240 0 33,240 015040 SEXUALLY TRANSMITTED DISEASE CONTROL PROGRAM GR 16,755 0 16,755 0 16,755 015040 DENTAL SPECIAL INITIATIVE,PROJECTS 6,935 0 6,935 0 6,935 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 015040 HEPATITIS AND LIVER FAILURE PREVENTION&CONTROL 72,000 0 72,000 0 72,000 015040 PRIMARY CARE PROGRAM 199,742 0 199,742 0 199,742 015040 RACIALÐNIC DISPARITIES-CHD EXPENSES 52,000 0 52,000 0 52,000 015040 SCHOOL HEALTH SERVICES-GENERAL REVENUE 96,223 0 96,223 0 96,223 015050 CHD GENERAL REVENUE NON-CATEGORICAL 1,425,962 0 1,425,962 0 1,425,962 GENERAL REVENUE T 2,089,653 0 2,089,653 0 2,089,653 2.NON GE .STATE 015010 ENVIRONMENTAL BIOMEDICAL WASTE PROGRAM 3,381 0 3,381 0 3,381 NON GENERAL REVENUE TOTAL 3,381 0 3,381 0 3,381 3.FEDERAL FUNDS-STATE 007000 AIDS DRUG ASSISTANCE PROGRAM ADMIN HQ 61,183 0 61,183 0 61,183 007000 WIC BREASTFEEDING PEER COUNSELING PROG 66,515 0 66,515 0 66,515 007000 COASTAL BEACH WATER QUALITY MONITORING 16,059 0 16,059 0 16,059 007000 COMPREHENSIVE COMMUNITY CARDIO-PHBG 35,000 0 35,000 0 35,000 007000 STRENGTHENING STD PREVENTION AND CONTROL 22,616 0 22,616 0 22,616 007000 ELC COVID ENHANCED DETECTION EXPANSION GRANT 164,133 0 164,133 0 164,133 007000 EPIDEMIOLOGY FOODBORNE CAPACITY 1,047 0 1,047 0 1,047 007000 FAMILY PLANNING TITLE X-GRANT 59,108 0 59,108 0 59,108 007000 HEALTH DISPARITIES GRANT COVID-19 114,073 0 114,073 0 114,073 007000 HOUSING OPPORTUNITIES FOR PERSONS WITH AIDS 558,200 0 558,200 0 558,200 007000 INFANT MORTALITY 8,506 0 8,506 0 8,506 007000 IMMUNIZATION ACTION PLAN 49,843 0 49,843 0 49,843 007000 MCH SPECIAL PROJECT PRAMS 12,985 0 12,985 0 12,985 007000 MATERNAL MORTALITY 8,518 0 8,518 0 8,518 007000 BASE COMMUNITY PREPAREDNESS CAPABILITY 112,207 0 112,207 0 112,207 007000 AIDS PREVENTION 119,837 0 119,837 0 119,837 007000 RYAN WHITE TITLE II CARE GRANT 171,821 0 171,821 0 171,821 007000 TOBACCO STATE AND COMMUNITY INTERVENTIONS 121,086 0 121,086 0 121,086 007000 WIC PROGRAM ADMINISTRATION 448,917 0 448,917 0 448,917 015075 SUPPLEMENTAL SCHOOL HEALTH 123,839 0 123,839 0 123,839 015075 REFUGEE HEALTH SCREENING REIMBURSEMENT ADMIN 71,966 0 71,966 0 71,966 015075 REFUGEE HEALTH SCREENING REIMBURSEMENT SERVICES 215,360 0 215,360 0 215,360 018005 RYAN WHITE TITLE II ADAP DRUG REBATES 76,027 0 76,027 0 76,027 FEDERAL FUNDS TOTAL 2,638,846 0 2,638,846 0 2,638,846 Attachment-III-Part-0-Page 4 of 12 ATWERVIENT 11 October ,+2092 W SeptemberN dG023" State CUD CountY Total CUD T et FuAd, CUD Trust Fund Otber, 4.FEES ASSESSED BY STATE OR FEDERAL RULES-STATE 001020 CHD STATEWIDE ENVIRONMENTAL FEES 155,541 0 155,541 0 155,541 001092 ON SITE SEWAGE DISPOSAL PERMIT FEES 19,086 0 19,086 0 19,086 001092 CHD STATEWIDE ENVIRONMENTAL FEES 5,200 0 5,200 0 5,200 001206 ON SITE SEWAGE DISPOSAL PERMIT FEES 306 0 306 0 306 001206 SANITATION CERTIFICATES(FOOD INSPECTION) 2,130 0 2,130 0 2,130 001206 PUBLIC SWIMMING POOL PERMIT FEES-10%HQ TRANSFER 10,548 0 10,548 0 10,548 001206 REGULATION OF BODY PIERCING SALONS 123 0 123 0 123 001206 TATTO PROGRAM ENVIRONMENTAL HEALTH 778 0 778 0 778 001206 MOBILE HOME&RV PARK FEES 1,986 0 1,986 0 1,986 ES ASSESSED BY STATE OR FEDERAL RULES TOTAL 195,698 0 195,698 0 195,698 5.OTHER CASH CONTRIBUTIONS.STATE: 0 0 0 0 0 090001 DRAW DOWN FROM PUBLIC HEALTH UNIT 239,371 0 239,371 0 239,371 OTHER CASH CONTRIBUTION TOTAL 239,371 0 239,371 0 239,371 6.MEDICAID•STATE/CO 001057 CHD CLINIC FEES 0 7,387 7,387 0 7,387 001148 CHD CLINIC FEES 0 70,748 70,748 0 70,748 MEDICAID TOTAL 0 78,135 78,135 0 78,135 7.ALLOCABLE REVENUE-STATE: 001009 CHD CLINIC FEES 100 0 100 0 100 018000 CHD CLINIC FEES 2,499 0 2,499 0 2,499 031005 GENERAL CLINIC RABIES SERVICES&DRUG PURCHASES 5,613 0 5,613 0 5,613 031005 TRUST FOR ERICA'S HEALTH AGREEE NT 2,500 0 2,500 0 2,500 038000 CHD CLINIC FEES 100 0 100 0 100 ALLOCABLE T 10,812 0 10,812 0 10,812 8.OTHER STATE CONTRIBUTIONS NOT IN CED TRUST FUND-STATE ADAP 0 0 0 780,718 780,718 PHARMACY DRUG PROG 0 0 0 8,386 8,386 WIC PROGRAM 0 0 0 1,165,070 1,165,070 BUREAU OF PUBLIC HEALTH LABORATORIES 0 0 0 8,023 8,023 IMMUNIZATIONS 0 0 0 847,573 847,573 OTHER STATE CONTRIBUTIONS TOTAL 0 0 0 2,809,770 2,809,770 9.DIRECT LOCAL CONTRIBUTIONS.BCCITAX DISTRICT 008005 CHD LOCAL REVENUE&EXPENDITURES 0 1,008,397 1,008,397 0 1,008,397 008005 IMMUNIZATION CAMPAIGN MONROE COUNTY BOCC 0 524,280 524,280 0 524,280 DIRECT COUNTY CONTRIBUTIONS TOTAL 0 1,532,677 1,532,677 0 1,532,677 10.FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION.COUNTY 001025 CHD CLINIC FEES 0 1,800 1,800 0 1,800 Attachmen4_II_Part_II-Page 5 of 12 ATTACHMENTU XONROF,COUNTY '1' 17 R T Part,H,Sour of p �w to,'Cou4ty'Hovath D40tweut Qdoberl,,2022 to S�pteuxtft 30,2023` Stato H County Total CHD TruwFund CHD Trust Fund MOT (mb) 'Trust Fund (casb) Contribution Total 001077 CD CLINIC FEES 0 31,750 31,750 0 31,750 001094 CHD LOCAL ENVIRONMENTAL FEES 0 141,000 141,000 0 141,000 001110 VITAL STATISTICS CERTIFIED RECORDS 0 71,336 71,336 0 71,336 ES AUTHORIZED BY COUNTY TOTAL 0 245,886 245,886 0 245,886 11.OTHER CASH AND LOCAL CONTRIBUTIONS-COUNTY 001029 CHD CLINIC FEES 0 153,700 153,700 0 153,700 001029 CURANT 340B REVENUE EXPENSE TRACKING 0 30,000 30,000 0 30,000 001090 CHD CLINIC FEES 0 69,403 69,403 0 69,403 007010 RYAN WHITE TITLE III-DIRECT TO CHD 0 378,539 378,539 0 378,539 007010 RYAN WHITE TITLE III-DIRECT TO CHD 0 238,210 238,210 0 238,210 010300 CHD SALE OF SERVICES IN OR OUTSIDE OF STATE GOVT 0 56 56 0 56 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 GOUT 0 93,562 93,562 0 93,562 011000 SOS FOUNDATION 0 30,000 30,000 0 30,000 011001 CHD HEALTHY START COALITION CONTRACT 0 290,000 290,000 0 290,000 090002 DRAW DOWN FROM PUBLIC HEALTH UNIT 0 72,417 72,417 0 72,417 OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL 0 1,358,287 1,358,287 0 1,358,287 12.ALLOCABLE R -COUNTY 001009 CHD CLINIC FEES 0 100 100 0 100 018000 CHD CLINIC FEES 0 2,499 2,499 0 2,499 031005 GENERAL CLINIC RABIES SERVICES&DRUG PURCHASES 0 5,613 5,613 0 5,613 031005 TRUST FOR ERICA°S HEALTH AGREEEMENT 0 2,500 2,500 0 2,500 038000 CHD CLINIC FEES 0 100 100 0 100 COUNTY ALLOCABLEREVENUE TOTAL0 10,812 10,812 0 10,812 13.BUILDINGS-CO ANNUAL RENTAL EQUIVALENT VALUE 0 0 0 597,605 597,605 OTHER(Specify) 0 0 0 0 0 UTILITIES 0 0 0 83,369 83,369 BUILDING MAINTENANCE 0 0 0 75,223 75,223 GROUNDS MAINTENANCE 0 0 0 115,566 115,566 INSURANCE 0 0 0 0 0 OTHER(Specify) 0 0 0 0 0 OTHER(Specify) 0 0 0 0 0 BUILDINGS TOTAL 0 0 0 871,763 871,763 14.OTHER COUNTY CONTRIBUTIONS NOT IN CHD TRUST FUND COUNTY EQUIPMENT/VEHICLE PURCHASES 0 0 0 0 0 VEHICLE INSURANCE 0 0 0 0 0 VEHICLE MAINTENANCE 0 0 0 0 0 OTHER COUNTY CONTRIBUTION(SPECIFY) 0 0 0 0 0 OTHER COUNTY CONTRIBUTION(SPECIFY) 0 0 0 0 0 OTHER COUNTY CONTRIBUTIONS TOTAL 0 0 0 0 0 Atfachment_OPart_GI-Page 6 of 12 TrA,(ANT PutnI#Seams of C outrh tiliw to 06unt It Health DtpaxOwot stotoqm coun* Total CHD Trost and ontnbution TO GRAND TOTAL CHD PROGRAM 5,1.77,761 3,225,797 8,403,558 3,681,533 12,085,091. Attachment.-II-Part-II-Rage 7 of 12 ATTACHMENr 11` lwdONRO UOL1NTY HEALS DEPARTMENT PAO 11.1,p4ah64 sltafihtg. 'lam s Iona ExpendAlwas Ay Progaxa$"co Am tWitbim Level of FT "a Cheats SoM lot 2'a d Ud 4th Grand (0.00 Anita vie## (Who(Whou dollars odv) state county "Total COMMUNICABLE DISE&SE CONTROL: IMMUNIZATION (101) 11.14 4,023 6,267 316,11.5 271,023 316,115 271,023 538,568 635,708 1,1.74,276 SEXUALLY"TRANS.DIS. (102) 3A2 120 213 82,038 70,336 82,038 70,336 270,817 33,931. 304,748 HIV/AIDS PREVENTION (03AD 2.26 0 592 70,103 60,1.04 70,103 60,104 260,288 126 260,414 I V/AIDS SURVEILLANCE (03A2) 0.00 0 0 0 0 0 0 0 0 0 HIV/AID;PATIENT CARE (03A3) 1135 279 1,419 454,600 389,753 454,600 389,753 990,870 697,836 1,688,706 ADAP (03A4) 1.17 0 0 25,313 21,703 25,313 21,703 93,966 66 94,032 TUBERCULOSIS (104) 095 2 2 25,045 21,472 25,045 21,472 92,831 203 93,034 COMM,DIS.:SURV. (106) 8.17 0 605 :139,667 1.1.9,745 1.39,667 119,745 51.8,824 0 518,824 HEPATITIS (109) 031 53 58 21,424 1.8,368 21,424 18,369 79,545 40 79,585 PREPAREDNESS AND RESPONSE (116) 2.38 0 0 62,922 53,946 62,922 53,946 233,615 121 233,736 R.EFUGEEHEALTH (118) 3.58 618 1,597 99,069 84,937 99,069 84,937 367,811 201. 368,012 VITAL RECORDS (1180) L24 2,035 6,970 24,990 21,425 24,990 21,425 21,494 71,336 92,830 COMMUNICABLE DISE&SE% TOTAL 44.:36 7.130 17,723 1,321,286 1,132,812 1,321,286 1,132,813 3,468,629 1,439,568 4,908,197 B. PRIMARY CA CHRONIC DISEASE:PREVENTION PRO (210) 2,60 273 276 62,1.20 53,259 62,11.20 533,258 190,808 39,949 230,757 WIC (21.WI) 5.77 1'998 11,712 143,406 122,950 143,406 11.22,949 448,917 83,794 532,711. TOBACCO USE INTERVENTION (212) 2.38 0 0 45,532 39,037 45,53.12 39,037 121,086 48,052 169,1138 WIC BREASTFEEDING PEER COUNSELING (21W2) 0.91 0 1,603 19,250 116,504 19,250 1.6,503 66,515 4,992 71,507 FAMILY PLANNING (223) 390 884 1,946 1.19,560 1.02,505 11.1.9,560 102,505 93,347 350,783 444,130 IMPROVED PREGNANCY OUTCOME (225) 0,05 0 0 8,445 7,241. 8,445 7,241. 30,009 1,e363 31,372 HEALTHY START PRENATAL (227) 254 517 2,579 55,226 47,348 55,226 47,5349 0 205,11.49 205,1.49 COMPREHENSIVE CHILD HEALTH. (229) 0.00 0 0 0 0 0 0 0 0 0 HEALTHY START CHILD (231) 2.54 561 2,535 52,799 45,266 52,799 45,268 0 196,134 1,96,134 SCHOOL HEALTH (234) L84 0 166,61.3 611,445.3 52,679 61,443 52,679 220,062 8,1.82 228,244 COMPREHENSIVE ADULTHEALTH (237) 4.28 265 1,160 112,457 96,416 1.1.2,457 90,4115 199,742 2183,003 411.7,745 COMMUNITY HEALTH DEVELOPMENT (238) 2,61 0 240 76,094 65,240 76,094 65,240 1.16,573 166,095 282,668 DENTAL HEALTH (240) 0.07 0 0 113,374 14,895 17,374 11.4,895 6,935 57,6303 64,538 PEUMARYC „SUBTOTAL 29.49 4,498 188,664 '773,706 668.3,342 773,706 663,339 1,493,994 1,380,099 2,874,093 C. ENVIRONMENTAL AL BMALTH: Water and Onsite Sewage Programs COSTAL BEACH.MONITORING (347) 0.33 279 283 8,350 7,1.59 8,350 7,160 16,059 11.4,960 31,019 LIMITED USE PUBLIC WATER SYSTEMS (357) 0.00 0 0 0 0 0 0 b 0 0 PUBLIC WATER SYSTEM (358) 0100 0 0 0 0 0 0 0 0 0 PRIVATE WATER SYSTEM (359) 0.00 0 0 0 0 0 0 0 0 0 ONSITE SEWAGE TREATMENT&DISPOSAL (361) 1,01 351. 270 19,564 11.6,773 19,564 16,773 1.9,086 53.7,588 72,674 Group Total 1,34 630 553 27,911.4 23,932 27,91.4 23,933 35,145 68,548 11.0e3,693 Peealaty. Programs TAT'TOOFACILITCSERVICES (344) 01.2 237 81 2,059 1,765 2,059 1,764 7,501 146 7,647 Affachmenl,_If_Part_111-Page 8 of 12 ATTACHMNT,U PoTt,,l l�plenned StaMzg.Cliouts,Services and Hxponditums By Proottin Serviw,A*aW#hinEach rel'Of SOrvice October lr 2WZ9 to tea 0,20# ' �e Mtn clients let 23w 1 3rd Grand. % ) unita r1sits mule dollar iiwtii)' Ito County Total FOOD HYGIENE (348) 0.57 153 435 1.2,427 10,654 12,427 10,654 23,100 23,062 46,162 BODY PIERCING FACILITIES SERVICES (349) 0,17 t2 1.2 2,814 2,413 2,814 2,414 91.0 9,545 10,455 GROUP CARE FACILITY (351.) 0.13 1.00 1.26 2,078 1,782 2,078 1,782 0 '7,720 7,720 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) 0.57 570 435 1.2,049 10,330 12,049 10,329 19,000 25,757 44,757 POOLS/BATIIING PLACES" (360) 2.68 823 2,21.8 47,804 40,985 47,804 40,985 99,230 78,348 177,578 BIOMEDICAL WASTE SERVICES (364) 0.48 528 44.2 8,342 7,152 8,342 7,153 1.4,381 1.6,608 30,989 TANNING FACILITY SERVICES (369) 0.09 0 0 1,329 1,1.39 1.,329 1,139 0 4,936 4,936 Group Total 4,81 2,423 3,749 88,902 76,220 88,902 76,220 164,122 1.66,122 330,244 Groundwater Contamination STORAGE TANK COMPLIANCE;SERVICES (355) 0,00 0 0 0 0 0 0 0 0 0 SUPER ACT SERVICES (356) 0,00 0 0 0 0 0 0 0 0 0 Group Total 0.00 0 0 0 0 0 0 0 0 0 Community Hygiene COMMUNITY ENVIR.HEALTH (345) 0,00 0 0 0 0 0 0 0 0 0 INJURY PREVENTION (346) 0.00 0 0 0 0 0 0 0 0 0 LEAD MONITOWNG SERVICES (350) 000 0 0 0 0 0 0 0 0 0 PUBLIC,SEWAGE; (362) 0,00 0 0 0 0 0 0 0 0 0 SOLID WASTE DISPOSAL SERVICE (363) 0.00 0 0 0 0 0 0 4Y 0 0 SANITARY NUISANCE (365) 0.18 68 302 3,:1.98 2,742 3,198 2,741 1,1 11,879 11,879 RABIES SURVEILLANCE (366) 0.10 0 0 1,711 1,467 1,711 1,466 0 6,355 6,355 ARBORVIRUS SURVEIL, (367) 0,00 0 0 0 0 0 0 0 0 0 RODENT/ARTHROPOD CONTROL (368) 0.00 0 0 0 0 0 0 0 0 0 WATER.POLLUTION (370) 001 0 6 1.44 123 144 124 0 535 535 INDOOR AIR (371.) 0.00 0 0 0 0 0 0 0 0 0 RADIOLOGICAL HEALTH (372) 0.00 0 0 0 0 0 0 0 0 0 TOXIC SUBSTANCES (373) 199 498 498 4:1,086 35,225 41,086 35,225 0 152,622 152,622 Group Total 2,28 566 806 46,1.39 39,557 46,139 39,556 0 1.71,391 171,391 ENVIRONMENTAL NTAIaHEALTH SUBTOTAL 8.43 3,619 5,108 162,955 139,709 1.62,955 139,709 199,267 406,061 605,328 D. NON-OPERATIONAL COSTS: NONOPERATIONAL COSTS (599) 0,00 0 E'1 0 0 0 0 0 0 0 ENVIRONMENTAL HEALTHSURCIIARGE. (399) 0.00 0 0 4,272 3,663 4,272 3,664 15,871 0 1.5,871. MEDICAID BUYBACK(61.1) 000 0 0 19 16 19 15 0 69 69 NON-OPERATIONAL COSTS SUBTOTAL 0,00 0 0 4,291 3,679 4,291 3,679 15,871 69 15,940 TOTAL CONTRACT 82,28 15,247 21.1,495 2,262,238 1,939,542 2,262,238 11,939,540 5,177,7611 3,225,797 8,403,558 NHachrnent_Il.._Part,.111-Page 9 of 12 ATTACHMENT III MONROE COUNTY HEALTH DEPARTMENT CIVIL RIGHTS COMPLIANCE AND NON-DISCRIMINATION CERTIFICATE 1. The CHID 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 CHID 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 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 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. 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 shall have the right to seek judicial enforcement of this assurance. This assurance is given in consideration of and for the purpose of obtaining any and all Federal 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 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 extended to the Program applicant by USDA. This includes any Federal agreement, arrangement, or 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 CHID, its successors,transferees, and assignees as long as it receives 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. Attachment—III-Page 1 of 1 0 \ \ $ Go DOQ \ E J / k \ w \ E / cc Go ^ § ` / \ o © ? a LL a k § [ � » \ ( \ / a E ■ k k f ¥ g § 4) m ou ° o = z § o § o ) \ k k k 0 / � � ) � � - e | e co _ § \ e 0 o § a # � ® f / a § a \ 2 A k § K m \ \ I r r $ 2 2 2 ; £ (D co cc C) ■ © - s s o ± m $ ° § \ | ` J � 03 ± o / 2 k § \ � � k 'Q co § « { § § m k 2 2 n e ] ]CM m \ y / § 2 \ \ « § . 2 v \ \ ] cc 0) ( k . \ \ / v 2.0 ° \ ® Ag � \ \ Q) / e 2 = } k f I \k / � a . � ) f u a \ Q § � \ 2 \k � � t § % � o z £ | k � §� o ( to ) 2 § 2 « 0 .J « z $ cc \ 9 �3 2 ; / 2 § / \ / \ Q) \ . F CDco \ « ƒ§ 2 2 � \ k / �a) � r- a / ! § R § a 2k % k \ 77 0 32 f f g n IL § k ] 2 + » \ Q — I @ % co . . . . O / \ ATTACHMENT V MONROE COUNTY HEALTH DEPARTMENT SPECIAL PROJECTS SAVINGS PLAN CASH RESERVED OR ANTICIPATED TO BE RESERVED FOR PROJECTS CONTRACT YEAR STATE COUNTY TOTAL 2021-2022* $ 0 $ 0 $ 0, 2022-2023** $ 0 $ 0 $ 0 2023-2024*** $ 0 $ 0 $ 0 2024-2025*** $ 0 $ 0 $ 0 PROJECT TOTAL $ 0 $, 0 $ 0 SPECIAL PROJECTS CONSTRUCTION/RENOVATION PLAN PROJECT NUMBER: PROJECT NAME: LOCATION/ADDRESS' PROJECT TYPE: NEW BUILDING ROOFING RENOVATION PLANNING STUDY NEW ADDITION OTHER SQUARE FOOTAGE: 0 PROJECT SUMMARY; Describe scope of work in reasonable detail. START DATE (Initial expenditure of funds) COMPLETION DATE: DESIGN FEES: $ 0 CONSTRUCTION COSTS: $ 0 FURNITURE/EQUIPMENT: $ 0 TOTAL PROJECT COST: $ 0 COST PER SO 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 9130/22 **Cash to be transferred to FCO account. ***Cash anticipated for future contract years. 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O M M M M M M M p, N N N N N N N N N O O Q M CD O Cl O O O O O O O O N N o O O O O M O 'L M M Ic a 10CD n r � � � M O N N N r a. r 4.' _ O > O N O 'fl N N N N N N N N N "C r4 C4 N f1 N o 0 0 0 O Cl Cl O o p o o y ; N N N N N N N N N N N bl) Y + C� 0 U U z a� b Q a� ¢ s z z z w w w w F- no-, ce 2 ¢ z m m m 3 0 U C7 C7 Ca � .fl w w W X w m w w z o o x x x ¢ ¢ Z G� cUn vUi a ¢ ¢ L 02 U U Z F w O C � C}' cG U O o y z O 0 0 Q U U r( Ca U A 3 3 v ce t z U A ¢ 5r N Qj U O o o v v v v W) In p o 0 a> o CD o CD O y� o 0 0 0 0 0 0 0 0 a a o 0 0 0 0 0 0 0 o a O o 0 O CD0 0 0 o CD CD 0 0 CDO O CDO o 0 0 0 0 0 0 C. o O N O vi vi vi O� O N O vi N M E Vl vi M M M O !t O O O O ll O 7 N O� N O Vl M 6rr9 Cl) V3 � 6r�9 6M9 6r�9 69 69 64 � rl N � N � 614 614 oq c� a w x a a z C U z a � Q w 41 4 w x oU, Q x c7 o do ee W U ' rn C. In 7 N O �D M O� l- O O a O ral O O 7 O N O M M O C d 15 0 O M V1 F ¢ N M M M M M M M M M M M N N N N N N N O O O O C. O C. O O O O O N N A N o 0 0 0 0 0 0 0 C. 0 o 0 Cd O L M M M M m M M M M M M N N N N N N N N N N N N �v} N N N N N N N N N N N cc O\ 0 U U a� � O U z w o � z w z > w C7 O G7 zo a s rnrl z w Q Q x U PC C1 U A Q U Q q w w x ¢ o u z NOWN 0 0 0 0 0 0 0 0 0 0 o O o 0 0 0 0 0 0 m u U y v� vi a k o 0 0 0 0 0 0 0 0 0 0 ADDENDUM I 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 2022 — 2023 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, 2022. 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.. • Vehicle Insurance The County carries the title, registration, and associated insurance coverage for all vehicles. The State reimburses the County for their share of these costs. • 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 2 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 2022 — 2023 PROPERTY PURCHASED BY THE CHD Per F.S. 274.11 title to all property purchased by county health departments from any source shall be vested in the name of the counties and must be accounted for as otherwise provided in Chapter 274 (which requires property to be inventoried and recorded). Additionally, FAC 691-73 was revised in 2020, to provide that only property with a dollar value of$5,000 or more needs to be recorded, unless the item is "attractive" (e.g, an iPhone), in which case it should be recorded too. (The dollar value was raised from $1,000 to $5,000 in 2020.) The county clerk has opted to keep the value at $1,000 for property purchased by the CHD. Page 2 of 2