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Item C25 C25 BOARD OF COUNTY COMMISSIONERS COUNTY of MONROE �� i Mayor Holly Merrill Raschein,District 5 The Florida Keys Mayor Pro Tern James K.Scholl,District 3 Craig Cates,District 1 Michelle Lincoln,District 2 ' David Rice,District 4 Board of County Commissioners Meeting December 13, 2023 Agenda Item Number: C25 2023-1894 BULK ITEM: Yes DEPARTMENT: Administration TIME APPROXIMATE: STAFF CONTACT: Lindsey Ballard n/a AGENDA ITEM WORDING: Approval of the contract between Monroe County Board of County Commissioners and the State of Florida, Department of Health for operation of the Monroe County Health Department contract year 2023-2024. Changes/additions to Fee Schedule (attached). We are 1) increasing Vital Statistics fees 2) Adding Civil Surgeon Refugee Health Physicals 3) Adding School Health Physicals 4) Adding Occupational Physicals. ITEM BACKGROUND: Review of annual contract for county funding of the local health department. PREVIOUS RELEVANT BOCC ACTION: This is the annual renewal of an agreement between Monroe County and the Florida Department of Health that has continued for 20+years. INSURANCE REQUIRED: No CONTRACT/AGREEMENT CHANGES: Increase in funding from previous fiscal year contract driven primarily by the expansion of services throughout Monroe County. Changes/additions to Fee schedule. STAFF RECOMMENDATION: Approval. DOCUMENTATION: Core_Contract_C ertification_2023-24_-_Monroe_CHD_FINAL.pdf 1531 FINANCIAL IMPACT: $1,608,237 1532 Ron DeSantis Mission: Governor To protect,promote&improve the health of all people in Florida through integrated 7r ro"te r �'Z' Joseph A Ladapo, MD, PhD state count &community efforts. F r�^ � T Y Y e n State Surgeon General ' 9 I EALTH Vision:To be the Healthiest State in the Nation INTEROFFICE MEMORANDUM DATE: TO: Ty Gentle, Director Office of Budget and Revenue Management FROM: Carla Fry, PhD, MSN, RN Administrator/Health Officer Monroe County Health Department SUBJECT: Core Contract Certification for 2023-2024 INFORMATION ONLY ❑ 1 certify that no changes have been made to the Core Contract document or attachments by the County Health Department. x I certify that the following changes have been made to the Core Contract document or attachments by the Monroe County Health Department(requires Deputy General Counsel review and signature below): Page Paragraph Document Changes 8 Added ".....Attachment VI three pages), and Addendum I (two pages)" Page Section Attachment Changes Attachment VI and Addendum I added at the end of all other attachments x I certify that Attachment IV is complete and lists all facilities currently utilized by the Monroe County Health Department. T Sign or/Dr r) Datea A.km November 8, 2023 Signature (Deputy General Counsel) Date Florida Department of Health in Monroe County 1100 Simonton Street•Key West,Florida 33040 Accredited Health Department PHONE:3051293-7500•FAX 305/809-5629 « Public Health ACCredllaltdt n Board FloridaHealth.gov 1533 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 2023-2024 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, 2023. 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, 2023, through September 30, 2024, 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 1534 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 11. i. The State's appropriated responsibility (direct contribution excluding any state fees, Medicaid contributions, or any other funds not listed on the Schedule C) as provided in Attachment 11, Part 11 is an amount not to exceed $4,586,353.00 (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 11, Part II is an amount not to exceed $ 1,608,237.00 (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 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 1535 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 or decrease, the CHD will revise Attachment II 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 CHD in writing. The CHD will then revise Attachment II 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 Health Department 1100 Simonton Street Key West, FL 33040 5, CHD DIRECTOR or ADMINISTRATOR, 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 CHD shall ensure that non-categorical sources of funding are used to fulfill public health priorities in the community and the Long-Range Program Plan. 6. ADMINISTRATIVE POLICIES AND PROCEDURES. The parties hereto agree that the following standards should apply in the operation of the CHD: a. The CHD and its personnel shall follow all State policies and procedures, except to the extent permitted for the use of County purchasing procedures as outlined in subparagraph b., below. All CHD employees shall be State or State-contract personnel subject to State personnel laws, 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 CHD following 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 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 1536 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 iii. 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 II, 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 1537 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 1538 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 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 State's 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, 2024, for the reporting period of October 1, 2023, through December 31, 2023; and ii. June 1, 2024, for the reporting period of October 1, 2023, through March 31, 2024; and iii. September 1, 2024, for the reporting period of October 1, 2023 through June 30, 2024; and iv. December 1, 2024, for the reporting period of October 1, 2023 through September 30, 2024. 7. FACILITIES AND EQUIPMENT. The parties mutually agree that: a. CHID facilities shall be provided as specified in Attachment IV to this contract and the County shall own the facilities used by the CHID unless otherwise provided in Attachment IV. b. The County shall ensure adequate fire and casualty insurance coverage for County- owned CHID offices and buildings and all furnishings and equipment in CHID 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 CHID and the proceeds returned to the County Health Department Trust Fund. 6 1539 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 Funds. 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. Availability of Funds. If this contract, any renewal hereof, or any term, performance, or payment hereunder, extends beyond the CHID fiscal year beginning July 1, 2024, 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: Carla A F PhD. MSN RN Roman Gastesi Name Name County Health Dept Administrator County Administrator Title Title 1100 Simonton Street 1100 Simonton Street Key West FI. 33040 Key West FI. 33040 Address Address Carla.F!y@flhealth.gov astesi-roman monroecount -:f►. ov Email Address Email Address 305-676-3835 305-292-4441 Telephone Telephone 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. Captio,r s. 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. 7 1540 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 III (one page), Attachment IV (one page), Attachment V (one page), Attachment VI (three pages), and Addendum I (two pages) to be executed by their undersigned officials as duly authorized effective the 1 st day of October 2023. BOARD OF COUNTY COMMISSIONERS STATE OF FLORIDA FOR MONROE COUNTY DEPARTMENT OF HEALTH SIGNED BY: SIGNED BY: NAME: Holly Merrill Raschein NAME: Joseph A. Lada o M.D. Ph.D. TITLE: Mayor TITLE: State Surgeon General DATE: DATE: ATTESTED TO: KEVIN MADOK, CLERK SIGNED BY: SIGNED BY: NAME: Elizabeth Yongue NAME: Carla Fry, PhD MSN RN As Deputy Clerk TITLE: TITLE: CHD Administrator DATE: DATE: I v -Z,0'Z-3 Approved as to form and legal sufficiency: Monroe County Attorney's Office 12-5-2023 5 1541 ATTACHMENT MONROE COUNTY HEALTH DEPARTMENT PROGRAM SPECIFIC REPORTING REQUIREMENTS AND PROGRAMS REQUIRING COMPLIANCE WITH THE PROVISIONS OF SPECIFIC MANUALS Some health services must comply with specific program and reporting requirements in addition to the Personal Health Coding Pamphlet(DHP 50-20), Environmental Health Coding Pamphlet(DHP 50-21)and FLAIR requirements because of federal or state law, regulation or rule. If a county health department is funded to provide one of these services, it must comply with the special reporting requirements for that service. The services and the reporting requirements are listed below: Service Requirement 1. Sexually Transmitted Disease 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-110)OMB Circular A-102, F.S. 381.0051, F.A.C. 64F-7, F.A.C. 64F-16,and F.A.C. 64F-19. Requirements and Guidance as specified in the Program Requirements for Title X Funded Family Planning Projects(Title X Requirements)(2014)and the Providing Quality Family Planning Services(QFP): Recommendations of CDC and the U.S. Office of Population Affairs published on the Office of Population Affairs website. Programmatic annual reports as specified by the program office as specified in the annual programmatic Scope of Work for Family Planning and Maternal Child Health Services, including the Family Planning Annual Report(FPAR),and other minimum guidelines as specified by the Policy Web Technical Assistance Guidelines. 6. Immunization Periodic reports as specified by the department pertaining to immunization levels in kindergarten and/or seventh grade pursuant to instructions contained in the Immunization Guidelines-Florida Schools, Childcare Facilities and Family Daycare Homes(DH Form 150-615)and Rule 64D-3.046, F.A.C. In addition, periodic reports as specified by the department pertaining to the surveillance/investigation of reportable vaccine-preventable diseases,adverse events,vaccine accountability,and assessment of immunization Attachment-1-Page 1 c 1542 ATTACHMENT I (Continued) levels as documented in Florida SHOTS and supported by CHID 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 CHID clinics should be reported on Lab Request DH Form 1628 in accordance with the Forms Instruction Guide. Requirements for the HIV/AIDS Patient Care programs are found in the Patient Care Contract Administrative Guidelines. 9. School Health Services Requirements as specified in the Florida School Health Administrative Guidelines(May 2012). Requirements as specified in F.S. 381.0056, F.S. 381.0057, F.S.402.3026 and F.A.C. 64F-6. 10. Tuberculosis Tuberculosis Program Requirements as specified in F.A.C. 64D-3 and F.S. 392. 11. General Communicable Disease Carry out surveillance for reportable communicable and other acute Control diseases,detect outbreaks, respond to individual cases of reportable diseases, investigate outbreaks, and carry out communication and quality assurance functions, as specified in F.A.C. 64D-3, F.S. 381, F.S. 384 and the CHID Epidemiology Guide to Surveillance and Investigations. 12. Refugee Health Program Programmatic and financial requirements as specified by the program office. nor the subsequent replacement if adopted during the contract period. Attachment-1-Page 2 c 1543 / \ 00\ \ \ \ \ / / E / < \ \ 0 2 o g 2 \ \ \ m \ b z z \ § / « $ � ƒ ) £ g m _ cn 7 » k \ c I § k .� � J / $ 2 \ w & o 0 0 o q \ � _ § k e a � & I 5 w \ / zLU § z § \ : « R = e 2 ke = Q z co 12 $ q R \ § / 7 Q c I = § E =b }\I LU k _ & 2 .§ j \ / \ / 3 ® 3 73 § a ƒ \ / \ �\ t § / ( c \ m j j ./j / \ / k 2 (D / } \ L)C14 \ \ 2 / \ k\ E % n \ \ w / w ƒ w ¥ e \ + k + § + E 2 Co@0 / 2 / co/ / / k / w w w 4 m 1544 ATTACHMENT II MONROE COUNT'HEALTH DEPARTMENT Part II,Sources of Contributions to County Health Department October 1,2023 to September 3U,2624 State CHD County Total CHI} Trust Fund CHD Trust fund tither (cash), Trust Fund (cash) Contribution, Total 1.GENERAL REVENUE STATE 015040 AIDS PREVENTION&SURVEILLANCE GENERAL REVENUE 73,552 0 73,552 0 73,552 015040 CHD-TB COMMUNITY PROGRAM 50,067 0 50,067 0 50,067 015040 SEXUALLY TRANSMITTED DISEASE CONTROL PROGRAM GR 16,755 0 16,755 0 16,755 015040 DENTAL SPECIAL INITIATIVE PROJECTS 6,934 0 6,934 0 6,934 015040 EPIDEMIOLOGY SURVEILLANCE GENERAL REVENUE 79,035 0 79,035 0 79,035 015040 FAMILY PLANNING GENERAL REVENUE 79,727 0 79,727 0 79,727 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 RACIAL&ETHNIC DISPARITIES-CHD EXPENSES 52,000 0 52,000 0 52,000 015040 SCHOOL HEALTH SERVICES 96,223 0 96,223 0 96,223 015050 CHD GENERAL REVENUE NON-CATEGORICAL 1,632,396 0 1,632,396 0 1,632,396 GENERAL REVENUE TOTAL 2,358,431 0 2,358,431 0 2,358,431 2.NON GENERAL REVENUE-STATE 015010 ENVIRONMENTAL BIOMEDICAL WASTE PROGRAM 3,514 0 3,514 0 3,514 015010 TOBACCO STATE AND COMMUNITY INTERVENTIONS 167,832 0 167,832 0 167,832 NON GENERAL REVENUE TOTAL 171,346 0 171,346 0 171,346 3.FEDERAL FUNDS-STATE 007000 AIDS DRUG ASSISTANCE PROGRAM ADMIN HQ 62,952 0 62,952 0 62,952 007000 WIC BREASTFEEDING PEER COUNSELING PROG 103,651 0 103,651 0 103,651 007000 COASTAL BEACH WATER QUALITY MONITORING 20,532 0 20,532 0 20,532 007000 COMPREHENSIVE COMMUNITY CARDIO-PHBG 35,000 0 35,000 0 35,000 007000 STRENGTHENING STD PREVENTION AND CONTROL 25,000 0 25,000 0 25,000 007000 ELC COVID ENHANCED DETECTION EXPANSION GRANT 12,106 0 12,106 0 12,106 007000 ELC COVID HAI/AR 39,560 0 39,560 0 39,560 007000 ELCCOVID NURSING HOME&LTC FACILITY STRIKE TEAM 39,560 0 39,560 0 39,560 007000 ELC COVID OTHER&LONG TERM CARE FAC STRIKE TEAM 39,560 0 39,560 0 39,560 007000 FAMILY PLANNING TITLE X-GRANT 53,690 0 53,690 0 53,690 007000 HEALTH DISPARITIES GRANT COVID-19 63,892 0 63,892 0 63,892 007000 PUBLIC HLTH INFRASTRUCTURE&WORKFORCE/CENTRAL 1 128,196 0 128,196 0 128,196 007000 HOUSING OPPORTUNITIES FOR PERSONS WITH AIDS 736,384 0 736,384 0 736,384 007000 INFANT MORTALITY 6,434 0 6,434 0 6,434 007000 IMMUNIZATION ACTION PLAN 61,372 0 61,372 0 61,372 007000 MATERNAL MORTALITY 6,434 0 6,434 0 6,434 007000 MCH SPECIAL PROJECT PRAMS 12,985 0 12,985 0 12,985 007000 BASE COMMUNITY PREPAREDNESS CAPABILITY 91,010 0 91,010 0 91,010 007000 AIDS PREVENTION 118,227 0 118,227 0 118,227 007000 RYAN WHITE TITLE II CARE GRANT 149,587 0 149,587 0 149,587 007000 TB CONTROL PROJECT 4,771 0 4,771 0 4,771 007000 WIC PROGRAM ADMINISTRATION 510,230 0 510,230 0 510,230 015075 SCHOOL HEALTH SERVICES 123,839 0 123,839 0 123,839 015075 REFUGEE HEALTH SCREENING REIMBURSEMENT ADMIN 67,686 0 67,686 0 67,686 Attachment II Part 1I-P 1545 ATTACHMENT II MONROE COUNTY HEALTH DEPARTMENT Part II,Sources of Contributions to County Health Department October 1,2023 to September 30,2624 State CHD County Total CHI} Trust Fund CHD Trust fund tither (cash), Trust Fund (cash) Contribution, Total 015075 REFUGEE HEALTH SCREENING REIMBURSEMENT SERVICES 847,888 0 847,888 0 847,888 018005 RYAN WHITE TITLE II ADAP DRUG REBATES 17,876 0 17,876 0 17,876 FEDERAL FUNDS TOTAL 3,378,422 0 3,378,422 0 3,378,422 4.FEES ASSESSED BY STATE OR FEDERAL RULES-STATE 001020 CHD STATEWIDE ENVIRONMENTAL FEES 172,686 0 172,686 0 172,686 001092 ON SITE SEWAGE DISPOSAL PERMIT FEES 19,086 0 19,086 0 19,086 001092 CHD STATEWIDE ENVIRONMENTAL FEES 6,200 0 6,200 0 6,200 001206 SANITATION CERTIFICATES(FOOD INSPECTION) 2,138 0 2,138 0 2,138 001206 SEPTIC TANK RESEARCH SURCHARGE 55 0 55 0 55 001206 PUBLIC SWIMMING POOL PERMIT FEES-10%HQ TRANSFER 12,189 0 12,189 0 12,189 001206 REGULATION OF BODY PIERCING SALONS 90 0 90 0 90 001206 TATTO PROGRAM ENVIRONMENTAL HEALTH 950 0 950 0 950 001206 MOBILE HOME&RV PARK FEES 2,046 0 2,046 0 2,046 FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL 215,440 0 215,440 0 215,440 5.OTHER CASH CONTRIIBUTIONS-STATE: 031005 GENERAL CLINIC RABIES SERVICES&DRUG PURCHASES 14,498 0 14,498 0 14,498 090001 DRAW DOWN FROM PUBLIC HEALTH UNIT 0 0 0 0 0 OTHER CASH CONTRIIBUTION TOTAL 14,498 0 14,498 0 14,498 6.MEDICAID-STATEICOUNTY: 001057 CHD CLINIC FEES 0 13,378 13,378 0 13,378 001148 CHD CLINIC FEES 0 68,381 68,381 0 68,381 001148 GENERAL CLINIC RABIES SERVICES&DRUG PURCHASES 0 460 460 0 460 MEDICAID TOTAL 0 82,219 82,219 0 82,219 7.ALLOCABLE REVENUE-STATE: 001009 CHD CLINIC FEES 100 0 100 0 100 018000 RYAN WHITE TITLE II ADAP DRUG REBATES 26,815 0 26,815 0 26,815 018000 CHD CLINIC FEES 2,591 0 2,591 0 2,591 ALLOCABLE REVENUE TOTAL 29,506 0 29,506 0 29,506 8.OTHER STATE CONTRIIBUTIONS NOT IN CHD TRUST FUND-STATE ADAP 0 0 0 807,694 807,694 PHARMACY DRUG PROGRAM 0 0 0 12,281 12,281 WIC PROGRAM 0 0 0 1,381,008 1,381,008 BUREAU OF PUBLIC HEALTH LABORATORIES 0 0 0 8,023 8,023 IMMUNIZATIONS 0 0 0 1,139,448 1,139,448 OTHER STATE CONTRIBUTIONS TOTAL 0 0 0 3,348,454 3,348,454 9.DIRECT LOCAL CONTRIIBUTIONS-]BCC/TAX DISTRICT 008005 CHD LOCAL REVENUE&EXPENDITURES 0 1,073,677 1,073,677 0 1,073,677 008005 IMMUNIZATION CAMPAIGN MONROE COUNTY BOCC 0 534,560 534,560 0 534,560 DIRECT COUNTY CONTRIBUTIONS TOTAL 0 1,608,237 1,608,237 0 1,608,237 Attachment II Part 11-P 1546 ATTACHMENT II MONROE COUNTY HEALTH DEPARTMENT Part II,Sources of Contributions to County Health Department October 1,2023 to September 30,2624 State CHD County Total CHI} Trust Fund CHD Trust fund tither (cash), Trust Fund (cash) Contribution, Total 10.FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION COUNTY 001025 CHD CLINIC FEES 0 489 489 0 489 001073 CHD CLINIC FEES 0 49 49 0 49 001077 CHD CLINIC FEES 0 36,776 36,776 0 36,776 001094 CHD LOCAL ENVIRONMENTAL FEES 0 148,901 148,901 0 148,901 001110 VITAL STATISTICS CERTIFIED RECORDS 0 64,488 64,488 0 64,488 FEES AUTHORIZED BY COUNTY TOTAL 0 250,703 250,703 0 250,703 11.OTHER CASH AND LOCAL CONTRIIBUTIONS-COUNTY 001029 CHD CLINIC FEES 0 107,819 107,819 0 107,819 001029 GENERAL CLINIC RABIES SERVICES&DRUG PURCHASES 0 1,369 1,369 0 1,369 001029 CURANT 340B REVENUE AND EXPENSE TRACKING 0 60,000 60,000 0 60,000 001090 CHD CLINIC FEES 0 61,836 61,836 0 61,836 005000 CHD CLINIC FEES 0 20 20 0 20 007010 RYAN WHITE TITLE III DIRECT TO CHD 0 409,921 409,921 0 409,921 007010 RYAN WHITE TITLE III DIRECT TO CHD 0 238,210 238,210 0 238,210 010500 CHD SALE OF SERVICES IN OR OUTSIDE OF STATE GOVT 0 92,657 92,657 0 92,657 011001 CHD HEALTHY START COALITION CONTRACT 0 360,000 360,000 0 360,000 090002 DRAW DOWN FROM PUBLIC HEALTH UNIT 0 -596,168 -596,168 0 -596,168 OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL 0 735,664 735,664 0 735,664 12.ALLOCABLE REVENUE-COUNTY 001009 CHD CLINIC FEES 0 100 100 0 100 018000 RYAN WHITE TITLE II ADAP DRUG REBATES 0 26,815 26,815 0 26,815 018000 CHD CLINIC FEES 0 2,591 2,591 0 2,591 COUNTY ALLOCABLE REVENUE TOTAL 0 29,506 29,506 0 29,506 13.1BUILDINGS-COUNTY ANNUAL RENTAL EQUIVALENT VALUE 0 0 0 597,605 597,605 OTHER(Specify) 0 0 0 0 0 UTILITIES 0 0 0 83,369 83,369 BUILDING MAINTENANCE 0 0 0 75,223 75,223 GROUNDS MAINTENANCE 0 0 0 115,566 115,566 INSURANCE 0 0 0 0 0 OTHER(Specify) 0 0 0 0 0 OTHER(Specify) 0 0 0 0 0 ]BUILDINGS TOTAL 0 0 0 871,763 871,763 14.OTHER COUNTY CONTRIBUTIONS NOT IN CHD TRUST FUND-COUNTY EQUIPMENT/VEHICLE PURCHASES 0 0 0 0 0 VEHICLE INSURANCE 0 0 0 0 0 VEHICLE MAINTENANCE 0 0 0 0 0 OTHER COUNTY CONTRIBUTION(SPECIFY) 0 0 0 0 0 OTHER COUNTY CONTRIBUTION(SPECIFY) 0 0 0 0 0 OTHER COUNTY CONTRIBUTIONS TOTAL 0 0 0 0 0 Attachment II Part 11-P 1547 ATTACHMENT II MONROE COUNT'HEALTH DEPARTMENT Part II,Sources of Contributions to County Health Department October 1,2023 to September 30,2624 State CHD County Total CHI} Trust Fund CHD Trust fund tither (cash), Trust Fund (cash) Contribution, Total GRAND TOTAL CHD PROGRAM 6,167,643 2,706,329 8,873,972 4,220,217 13,094,189 Attachment II Part 11-P 1548 ATTACHMENT II MONROE COUNTY HEALTFI bkPARTM[ENT Part III,Planned Staffing.Clients,Services and Expenditures By Program Service Area Within Each Level of Service October 1,2423 to September;34;2024' Quarterly tx,penditure Plan- FTE's Clients Services/ 1st 2nd- 3rd 4th Grand' (0.66) Units visits- (Whole dollars only) State county Total A. COMMUNICABLE DISEASE CONTROL: IMMUNIZATION (101) 9.94 4,296 6,316 326,421 279,807 326,421 284,433 532,981 684,101 1,217,082 SEXUALLY TRANS.DIS. (102) 2.08 82 174 69,129 59,257 69,129 60,235 98,754 158,996 257,750 HIV/AIDS PREVENTION (03A1) 2.11 0 440 73,185 62,734 73,185 63,771 272,870 5 272,875 HIV/AIDS SURVEILLANCE (03A2) 0.00 0 0 0 0 0 0 0 0 0 HIV/AIDS PATIENT CARE (03A3) 11.08 283 1,372 453,816 389,009 453,816 395,439 943,549 748,531 1,692,080 ADAP (03A4) 0.98 0 0 22,792 19,538 22,792 19,861 84,981 2 84,983 TUBERCULOSIS (104) 1.30 16 117 41,348 35,443 41,348 36,029 154,141 27 154,168 COMM.DIS.SURV. (106) 4.26 0 3,452 127,447 109,247 127,447 111,053 475,194 0 475,194 HEPATITIS (109) 1.94 388 427 36,062 30,912 36,062 31,424 134,456 4 134,460 PREPAREDNESS AND RESPONSE (116) 1.12 0 0 44,519 38,161 44,519 38,792 165,991 0 165,991 REFUGEE HEALTH (118) 3.83 994 3,497 115,122 98,682 115,122 100,312 429,234 4 429,238 VITAL RECORDS (180) 1.12 1,549 4,054 24,964 21,399 24,964 21,750 0 93,077 93,077 COMMUNICABLE DISEASE SUBTOTAL 39.76 7,608 19,849 1,334,805 1,144,189 1,334,805 1,163,099 3,292,151 1,684,747 4,976,898 B. PRIMfARY CARE: CHRONIC DISEASE PREVENTION PRO (210) 0.82 1,141 95 28,368 24,317 28,368 24,717 105,770 0 105,770 WIC (21W1) 6.97 2,606 14,337 159,060 136,345 159,060 138,600 593,065 0 593,065 TOBACCO USE INTERVENTION (212) 2.25 0 0 58,570 50,206 58,570 51,034 218,380 0 218,380 WIC BREASTFEEDING PEER COUNSELING (21W2) 1.80 0 1,088 33,995 29,141 33,995 29,623 126,754 0 126,754 FAMILY PLANNING (223) 4.18 1,115 2,347 147,246 126,219 147,246 128,305 412,611 136,405 549,016 IMPROVED PREGNANCY OUTCOME (225) 0.01 0 0 7,178 6,153 7,178 6,253 26,762 0 26,762 HEALTHY START PRENATAL (227) 2.47 439 1,821 62,545 53,614 62,545 54,500 0 233,204 233,204 COMPREHENSIVE CHILD HEALTH (229) 0.00 0 0 0 0 0 0 0 0 0 HEALTHY START CHILD (231) 2.47 510 2,135 58,440 50,094 58,440 50,922 0 217,896 217,896 SCHOOL HEALTH (234) 2.26 0 189,624 60,243 51,640 60,243 52,495 224,621 0 224,621 COMPREHENSIVE ADULT HEALTH (237) 3.38 289 875 84,722 72,623 84,722 73,823 218,573 97,317 315,890 COMMUNITY HEALTH DEVELOPMENT (238) 4.31 0 881 154,205 132,184 154,205 134,369 574,963 0 574,963 DENTAL HEALTH (240) 0.04 0 0 16,447 14,098 16,447 14,332 61,324 0 61,324 PRIMARY CARE SUBTOTAL 30.96 6,100 213,203 871,019 746,634 871,019 758,973 2,562,823 684,822 3,247,645 C. ENVIRONMENTAL HEALTH: Water and Onsite Sewage Programs COSTAL BEACH MONITORING (347) 0.14 117 117 6,357 5,450 6,357 5,540 23,704 0 23,704 LIMITED USE PUBLIC WATER SYSTEMS (357) 0.00 0 0 0 0 0 0 0 0 0 PUBLIC WATER SYSTEM (358) 0.00 0 0 0 0 0 0 0 0 0 PRIVATE WATER SYSTEM (359) 0.00 0 0 0 0 0 0 0 0 0 ONSITE SEWAGE TREATMENT&DISPOSAL (361) 1.34 423 108 33,704 28,891 33,704 29,369 48,918 76,750 125,668 Group Total 1.48 540 225 40,061 34,341 40,061 34,909 72,622 76,750 149,372 ]utility Programs TATTOO FACILITY SERVICES (344) 0.20 198 126 5,107 4,378 5,107 4,451 19,043 0 19,043 Attachment II Part II 1549 2 ATTACHMENT II MONROE COUNTY HEALTFI bkPARTMENT Part III,Planned Staffing.Clients,Services and Expenditures By Program Service Area Within Each Level of Service October 1,2423 to September;34;2024' Q.arterly tx,penditure Plan- FTE's Clients Services/ 1st 2nd- 3rd 4th Grand' (0.66) Units visits- (Whole dollars only) State county Total FOOD HYGIENE (348) 0.55 145 263 12,599 10,800 12,599 10,978 29,786 17,190 46,976 BODY PIERCING FACILITIES SERVICES (349) 0.03 4 5 998 855 998 869 3,120 600 3,720 GROUP CARE FACILITY (351) 0.04 18 25 1,254 1,075 1,254 1,091 3,131 1,543 4,674 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) 0.40 234 334 12,090 10,363 12,090 10,534 22,743 22,334 45,077 POOLS/BATHING PLACES (360) 2.12 674 1,751 53,965 46,258 53,965 47,022 121,952 79,258 201,210 BIOMEDICAL WASTE SERVICES (364) 0.27 226 218 6,914 5,926 6,914 6,024 15,512 10,266 25,778 TANNING FACILITY SERVICES (369) 0.02 0 0 696 597 696 607 0 2,596 2,596 Group Total 3.63 1,499 2,722 93,623 80,252 93,623 81,576 215,287 133,787 349,074 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) 0.04 0 0 1,026 879 1,026 893 2,523 1,301 3,824 INJURY PREVENTION (346) 0.00 0 0 0 0 0 0 0 0 0 LEAD MONITORING SERVICES (350) 0.00 0 0 0 0 0 0 0 0 0 PUBLIC SEWAGE (362) 0.00 0 0 0 0 0 0 0 0 0 SOLID WASTE DISPOSAL SERVICE (363) 0.00 0 0 0 0 0 0 0 0 0 SANITARY NUISANCE (365) 0.03 7 14 953 817 953 832 2,381 1,174 3,555 RABIES SURVEILLANCE (366) 0.01 0 1 396 339 396 344 988 487 1,475 ARBORVIRUS SURVEIL. (367) 0.00 0 0 0 0 0 0 0 0 0 RODENT/ARTHROPOD CONTROL (368) 0.00 0 0 0 0 0 0 0 0 0 WATER POLLUTION (370) 0.00 0 0 0 0 0 0 0 0 0 INDOOR AIR (371) 0.00 0 0 0 0 0 0 0 0 0 RADIOLOGICAL HEALTH (372) 0.00 0 0 0 0 0 0 0 0 0 TOXIC SUBSTANCES (373) 1.44 403 403 33,059 28,338 33,059 28,805 0 123,261 123,261 Group Total 1.52 410 418 35,434 30,373 35,434 30,874 5,892 126,223 132,115 ENVIRONMENTAL HEALTH SUBTOTAL 6.63 2,449 3,365 169,118 144,966 169,118 147,359 293,801 336,760 630,561 D. NON-OPERATIONAL COSTS: NON-OPERATIONAL COSTS (599) 0.00 0 0 0 0 0 0 0 0 0 ENVIRONMENTAL HEALTH SURCHARGE (399) 0.00 0 0 5,060 4,338 5,060 4,410 18,868 0 18,868 MEDICAID BUYBACK (611) 0.00 0 0 0 0 0 0 0 0 0 NONOPERATIONAL COSTS SUBTOTAL 0.00 0 0 5,060 4,338 5,060 4,410 18,868 0 18,868 TOTAL CONTRACT 77.35 16,157 236,417 2,380,002 2,040,127 2,380,002 2,073,841 6,167,643 2,706,329 8,873,972 Attachment II Part II 1550 2 ATTACHMENT III MONROE COUNTY HEALTH DEPARTMENT CIVIL RIGHTS COMPLIANCE AND NON-DISCRIMINATION CERTIFICATE 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 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 CHD, 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. 1551 k 2 / f \ E / \ \ \ w E \ / k � 2LO \ / LL \ \ # o f f 0 \ o G $ d k ) 0 \ \ CL 2 ■ | S | S 0 2 0 0 0 2 § o ° ® y 22 ] 0 m ] m ) \ ± \ | | o { 2 / ) ) 0 / \ =§ a ® \ n 2 § { \ § § § \ \ \ \_ � 0 % 0 e0 j k \ > ~ o C14 o e ) 2 � a U- o 2 m w ® \ \ \ \ \ ° \ 2 � o tmLL gk ® § # § ) ) � \ \ k 2 2 $ © : \22A w e - e m 22t \ ` § I / / E § ] US % \ § E - E ƒ | � § - > 0 � Z <LL »w w a m k & k \ o 0 ® � \ / u o \ ¥ a Q t , � k � LL @m a ® 0m � fR & U. k \ _ \) § § \ � - E m IL § \ \ o \ o � LO j \ \ 1552 ATTACHMENT V MONROE COUNTY HEALTH DEPARTMENT SPECIAL PROJECTS SAVINGS PLAN CASH RESERVED OR ANTICIPATED TO BE RESERVED FOR PROJECTS CONTRACT YEAR STATE COUNTY TOTAL 2022-2023* $ 0 $ 0 $ 0 2023-2024** $ 0 $ 0 $ 0 2024-2025*** $ 0 $ 0 $ 0 2025-2026*** $ 0 $ 0 $ 0 PROJECT TOTAL $ 0 $ 0 $ 0 SPECIAL PROJECTS CONSTRUCTION/RENOVATION PLAN PROJECT NUMBER: PROJECT NAME: LOCATION/ADDRESS: PROJECT TYPE: NEW BUILDING ROOFING RENOVATION PLANNING STUDY NEW ADDITION OTHER SQUARE FOOTAGE: 0 PROJECT SUMMARY: Describe scope of work in reasonable detail. START DATE (Initial expenditure of funds) COMPLETION DATE: DESIGN FEES: $ 0 CONSTRUCTION COSTS: $ 0 FURNITURE/EQUIPMENT: $ 0 TOTAL PROJECT COST: $ 0 COST PER SQ FOOT: $ 0 Special Capital Projects are new construction or renovation projects and new furniture or equipment associated with these projects and mobile health vans. *Cash balance as of 9/30/23 **Cash to be transferred to FCO account. ***Cash anticipated for future contract years. Attachment_V-Page 1 1553 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 2023 —2024 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, 2023. 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. Pagel of 2 1554 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 2023 —2024 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. 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