Item C02 C2
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
April 17, 2024
Agenda Item Number: C2
2023-2315
BULK ITEM: Yes DEPARTMENT: Facilities Maintenance
TIME APPROXIMATE: STAFF CONTACT: Willie DeSantis
N/A
AGENDA ITEM WORDING:
Approval of a Lease Agreement with the State of Florida Department of Health, Monroe County Health
Department, to provide continued office space at the Ruth Ivins Center, 3333 Overseas Highway,
Marathon, FL. The County leases this space to the Health Dept. at no charge for the year.
ITEM BACKGROUND:
The Florida Department of Health(DOH) has been leasing a total of 4,618 square feet of office space at
the Ruth Ivins Center since about 1995. While the DOH had been using this office space, there had
never been a formal Lease Agreement entered into between the parties until June 20, 2018, when the
BOCC issued approval to execute a written Lease Agreement. The arrangement has been satisfactory
for both parties and DOH is once again requesting to enter into a lease for the space at no charge. The
term of this Agreement is for a period of one (1) year beginning May 1, 2024, through April 30, 2025,
at no charge to the DOH. Staff requests approval of a new Lease with the Health Dept. for the Ruth
Ivins Bldg.
PREVIOUS RELEVANT BOCC ACTION:
Annual Lease Agreement since 1995, with a formal written Lease Agreement approved in 2018. The
most recent Lease was approved on April 19, 2023.
INSURANCE REQUIRED:
Yes
CONTRACT/AGREEMENT CHANGES:
New one-year agreement with a term beginning May 1, 2024, through April 30, 2025, at no cost to the
DOH.
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STAFF RECOMMENDATION: Approval
DOCUMENTATION:
04-17-2024-Lease Agreement Ruth Ivins Bldg -Sign Page substitute.pdf
2023-2024-DOH—Core Contract-Exec.pdf
GL-8300---Liability_Certificate-23-24-Health—Dept.pdf
FINANCIAL IMPACT:
Effective Date: May 1, 2024
Expiration Date: April 30, 2025
Total Dollar Value of Contract: N/A
Total Cost to County: N/A
Current Year Portion: N/A
Budgeted: Yes
Source of Funds: N/A
CPI: No
Indirect Costs: N/A
Estimated Ongoing Costs Not Included in above dollar amounts:
Revenue Producing: No If yes, amount:
Grant: No
County Match: No
Insurance Required: Yes
Additional Details: Approval of annual lease agreements since 1995, with a formal agreement written
and approved by the BOCC in 2018. No rent is charged for this lease.
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LEASE AGREEMENT
RUTH IVINS CENTER
This Agreement is made and entered into this 17th day of April, 2024, by
MONROE COUNTY, a political subdivision of the State of Florida, whose address is
1100 Simonton Street, Key West, Florida 33040, ("COUNTY" or the "LESSOR"), and
STATE OF FLORIDA, DEPARTMENT OF HEALTH, MONROE COUNTY HEALTH
DEPARTMENT ("TENANT" or the "LESSEE"), a non-profit corporation incorporated in
the State of Florida, whose address is 1100 Simonton Street, Key West, Florida
33040.
WHEREAS, the COUNTY leases premises to other governmental agencies
and not-for-profit organizations serving the County community; and
WHEREAS, the State of Florida, Department of Health, Monroe County
Health Department has requested use of County office space; and
WHEREAS, the State of Florida, Department of Health, Monroe County
Health Department provides essential services to the citizens of Monroe County,
and works to improve the health of the public through preparedness, education,
prevention, the delivery of clinical services, and by conducting environmental
inspection and testing programs; and
WHEREAS, the COUNTY owns an office building known as the Ruth Ivins
Center at 3333 Overseas Highway, Marathon, Florida; and
WHEREAS, the Monroe County Health Department has occupied space in the
Ruth Ivins Center since about 1995; and
WHEREAS, the COUNTY has determined that it is in the best interests of
Monroe County to lease unused office space at the Ruth Ivins Center;
NOW, THEREFORE, IN CONSIDERATION of the promises contained herein
the parties agree to the following:
1. PROPERTY. The COUNTY leases to the LESSEE 4,618 square feet of office
space as shown on Exhibit "A" and Exhibit "B" - Rooms with square footage,
hereafter identified as the "Premises", which said exhibits are attached hereto and
made a part of this Agreement.
2. TERM. The term of this Agreement is for a period of one (1) year beginning
May 1, 2024, and terminating on April 30, 2025.
3. USE AND CONDITIONS. The Premises shall be used solely for the
purposes of delivering State of Florida, Department of Health, Monroe County
Health Department services, including public health related education, chronic
disease prevention, preparation for emergencies affecting public health,
maintenance of vital statistics information and certifications, administrative support,
delivery of clinical services, and environmental testing and inspection programs. If
the Premises are used for any other purpose, the COUNTY shall have the option of
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immediately terminating this Agreement. LESSEE shall not permit any use of the
Premises in any manner that would obstruct or interfere with any COUNTY functions
and duties.
The LESSEE will further use and occupy said Premises in a careful and proper
manner, and not commit any waste thereon. LESSEE will not cause, or allow to be
caused, any nuisance or objectionable activity of any nature on the Premises. Any
activities in any way involving hazardous materials or substances of any kind
whatsoever, either as those terms may be defined under any State or Federal laws
or regulations or as those terms are understood in common usage, are specifically
prohibited. The LESSEE will not use or occupy said Premises for any unlawful
purpose and will, at LESSEE's sole cost and expense, conform to and obey any
present or future ordinance and/or rules, regulations, requirements, and orders of
governmental authorities or agencies respecting the use and occupation of said
Premises. These covenants of the LESSEE shall also be binding on the use of the
Premises by personnel, volunteers, or clients of LESSEE in accessing any common
areas of the Ruth Ivins Center.
4. RENT. For the use of the Premises, the LESSEE must pay the COUNTY the
sum of $-0- per year, for 4,618 square feet of office space at $-0- per square foot,
which rental sum is due in monthly installments of $-0-. The COUNTY will invoice
the LESSEE each month and these twelve (12) monthly payments shall be remitted
to Monroe County Clerk's Office, 500 Whitehead Street, Key West, FL 33040. If a
warrant in payment of an invoice is not issued within forty (40) days after receipt of
the invoice and receipt, inspection, and approval of the goods and services, the
LESSEE shall pay to the LESSOR, in addition to the amount of the invoice, interest
at a rate established pursuant to Florida Statutes, Section 55.03(1) on the unpaid
balance from the expiration of such forty (40) day period until such time as the
warrant is issued to the LESSOR.
a) Additional consideration from each party:
Electricity, office maintenance, office cleaning, and local phone calls will be
provided by LESSOR at no additional cost to LESSEE, unless the occupation of the
Premises has a significant impact on any of such costs to LESSOR, in which case
the parties will either renegotiate the consideration or mutually terminate this
agreement. LESSEE shall be entitled to use the common areas of the Ruth Ivins
Center such as bathrooms, lobby, and other common areas incidental to the
purpose of their occupancy of the Premises.
5. TAXES. The LESSEE must pay all taxes and assessments, including any
sales or use tax, levied by any government agency with respect to the LESSEE's
operations on the Premises. If at any time after any tax or assessment has become
due or payable, the LESSEE, or its legal representative, neglects to pay the tax or
assessment, LESSOR shall be entitled to pay the tax or assessment at any time
after that and the amount paid by LESSOR shall be deemed to be additional rent for
the leased Premises, due and payable by the LESSEE.
6. INSURANCE. The Department of Health, State of Florida, provides General
Liability Coverage for Monroe County Health Department Operations through the
Division of Risk Management and the State Risk Management Trust Fund. Florida
Statutes, Chapter 284 and Section 768.28(16) authorize the State to administer a
self-insurance program and Florida Statutes, Section 768.28(5) currently sets the
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general liability coverage limits as follows: $200,000 each person; $300,000 each
occurrence.
Lessee and/or State of Florida, Department of Health shall reimburse Lessor for its
pro rata share of insurance costs for certain vehicles owned by the County, but fully
utilized by Lessee in its operations, and its proportionate share of building
insurances as set forth in the 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 ("Core Contract"), as
more specifically set forth in Addendum I to the Core Contract.
7. CONDITION OF PREMISES. The LESSEE must keep the Premises in good
order and condition. The LESSEE must promptly repair damage to the Premises.
At the end of the term of this Agreement, the LESSEE must surrender the Premises
to the COUNTY in the same good order and condition as the Premises were on the
commencement of the term, normal wear and tear excepted. The LESSEE is solely
responsible for any improvements to land and appurtenances placed on the
Premises.
8. IMPROVEMENTS. No structure or improvements of any kind shall be placed
upon the land without prior approval in writing by the County Administrator, a
building permit issued by the COUNTY and any other agency, federal or state, as
required by law. Any such structure or improvements shall be constructed in a
good and workmanlike manner at LESSEE's sole cost and expense. Subject to any
landlord's lien, any structures or improvements constructed by LESSEE shall be
removed by the LESSEE at LESSEE's sole cost and expense, by midnight on the day
of termination of this Agreement or extension hereof, and the land restored as
nearly as practical to its condition at the time this agreement is executed unless the
Board of County Commissioners accepts in writing delivery of the Premises together
with any structures or improvements constructed by LESSEE. Portable or temporary
advertising signs are prohibited.
LESSEE shall perform, at the sole expense of LESSEE, all work required in
the preparation of the property or premises hereby leased for occupancy by
LESSEE; and LESSEE does hereby accept the leased property or premises as now
being in fit and tenantable condition for all purposes of LESSEE.
COUNTY reserves the right to inspect the leased area and to require
whatever adjustment to structures or improvements as COUNTY, in its sole
discretion, deems necessary. Any adjustments shall be done at LESSEE's sole costs
and expense. Any building permits sought by LESSEE shall be subject to permit
fees at LESSEE's sole cost and expense.
9. INDEMNIFICATION/HOLD HARMLESS. The parties to this Lease
Agreement stipulate that each is a state governmental agency as defined by Florida
Statutes and represents to the other that it has purchased suitable Commercial
General Liability, Business Automobile Liability, and Workers' Compensation
insurance, or is self-insured, in amounts adequate to respond to any and all claims
within the limitations of Sections 768.28 and Chapter 440, Florida Statutes, arising
out of the activities governed by this Lease Agreement.
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As between the governmental entity parties to this Lease Agreement, each
party is responsible for any negligent acts or omissions on the part of its own
employees, agents, contractors, and subcontractors and shall defend, indemnify
and hold the other governmental entity party harmless from claims arising out of
such negligent acts or omissions, and agrees to be liable to the statutory limits for
any damages proximately caused by said acts or omissions, or intentional tortious
acts.
The governmental entity parties to this agreement stipulate that the
agreement does not contain any provision that requires one party to indemnify or
insure the other party for the other party's negligence or to assume any liability for
the other party's negligence. The governmental entities are prohibited from
entering into agreements to indemnify another agency or subdivision of the state
for the other entity's negligence or to assume any liability for the other entity's
negligence.
Nothing contained in this Section shall be construed to be a waiver by either
party of any protections under sovereign immunity, Section 768.28, Florida
Statutes, or any other similar provision of law. Nothing contained herein shall be
construed to be a consent by either party to be sued by third parties or to be liable
to third parties in any matter arising out of this or any other Agreement.
The COUNTY and the other governmental agency do not get named as an
additional insured on each other's policies.
10. NON-DISCRIMINATION. LESSOR and LESSEE agree that there will be no
discrimination against any person, and it is expressly understood that upon a
determination by a court of competent jurisdiction that discrimination has occurred,
this Lease Agreement automatically terminates without any further action on the
part of any party, effective the date of the court order. LESSOR and LESSEE agree
to comply with all Federal and Florida statutes, and all local ordinances, as
applicable, relating to nondiscrimination. These include but are not limited to: 1)
Title VI of the Civil Rights Act of 1964 (PL 88-352), which prohibits discrimination in
employment on the basis of race, color, religion, sex, or national origin; 2) Title IX
of the Education Amendment of 1972, as amended (20 USC ss. 1681-1683, and
1685-1686), which prohibits discrimination on the basis of sex; 3) Section 504 of
the Rehabilitation Act of 1973, as amended (20 USC s. 794), which prohibits
discrimination on the basis of disability; 4) The Age Discrimination Act of 1975, as
amended (42 USC ss. 6101- 6107) which prohibits discrimination on the basis of
age; 5) The Drug Abuse Office and Treatment Act of 1972 (PL 92-255), as
amended, relating to nondiscrimination on the basis of drug abuse; 6) The
Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and
Rehabilitation Act of 1970 (PL 91-616), as amended, relating to nondiscrimination
on the basis of alcohol abuse or alcoholism; 7) The Public Health Service Act of
1912, ss. 523 and 527 (42 USC ss. 690dd-3 and 290ee-3), as amended, relating to
confidentiality of alcohol and drug abuse patient records; 8) Title VIII of the Civil
Rights Act of 1968 (42 USC §§3601 et seq.), as amended, relating to
nondiscrimination in the sale, rental or financing of housing; 9) The Americans with
Disabilities Act of 1990 (42 USC §§ 12101 Note), as may be amended from time to
time, relating to nondiscrimination on the basis of disability; 10) Monroe County
Code Chapter 14, Article II, which prohibits discrimination on the basis of race,
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color, sex, religion, national origin, ancestry, sexual orientation, gender identity or
expression, familial status or age; and 11) Any other nondiscrimination provisions
in any Federal or State statutes which may apply to the parties to, or the subject
matter of, this Lease Agreement.
11. TERMINATION. This Agreement may be terminated with cause at the
discretion of the COUNTY in the following circumstances:
a) Lessee fails to pay the rent when due;
b) Lessee fails to obtain the insurance required under this Lease or allows
the required insurance coverage to lapse or fall below the minimum
required;
c) Lessee otherwise breaches the terms of this Lease.
Unless the COUNTY has accepted in writing a delay in performance of duties,
the failure to perform said duties shall constitute a default under the terms of this
agreement. In the case of default/breach, the COUNTY shall first give LESSEE a
written notification stating the default/breach and that Lessee has ten (10) days to
correct the default/breach. If the Lessee has not commenced correction of the
default/breach at the end of the ten (10) days, then the COUNTY may terminate
the Lease in its discretion. If it shall be necessary to employ the services of an
attorney in order to enforce its rights under this Agreement, the COUNTY shall be
entitled to reasonable attorney's fees. Waiver of a default in any particular month
shall not bind the COUNTY to forego the provisions of this paragraph and any
subsequent default shall be grounds for termination. The COUNTY may in its
discretion treat the LESSEE in default and terminate this Agreement immediately,
without prior notice, upon failure of LESSEE to comply with any provision of this
Agreement. LESSEE may terminate this Agreement upon giving thirty (30) days'
prior written notice to COUNTY.
COUNTY may terminate this Agreement without cause by providing Lessee
with written notice of termination at least sixty (60) days prior to the date of
termination.
12. DEFAULT. LESSOR'S right to repossess, operate, or sublease: If the rental
reserved by this Lease or other charges to be paid under this Lease by LESSEE, or
any part of this Lease, are not paid when due and remain unpaid for a period of ten
(10) days after notice in writing, or if LESSEE fails to promptly perform any
covenant, condition, or agreement by it to be performed under this Lease and such
failure shall continue for a period of ten (10) days after notice in writing specifying
the nature of such failure, or if LESSEE abandons the demised Premises, or if
LESSEE breaches any obligation under this Lease to be performed by it which
cannot be cured, then, and in any such event, LESSEE shall be deemed to be in
default and LESSOR, without further notice may at its option take possession of the
leased Premises, including all improvements and fixtures and equipment located at,
in or about the Premises.
By legal proceedings, LESSOR shall take, operate, or sublease the Premises,
in whole or in part, for the account of the LESSEE as the LESSOR in good faith may
deem proper, for a term not exceeding the unexpired period of the full term of this
Lease. LESSOR shall receive all proceeds and rent accruing from such operation or
subleasing of the leased Premises or fixtures and equipment. LESSOR shall apply
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these proceeds first, to the payment of all costs and expenses incurred by the
LESSOR in obtaining the possession of, and the operation or subleasing of the
Premises or fixtures and equipment, including reasonable attorney's fees,
commissions, and collection fees, and any alteration or repairs reasonably
necessary to enable the LESSOR to operate or sublease the Premises or fixtures
and equipment; and second, to the payment of all such amounts as may be due or
become payable under the provisions of this Lease. The remaining balance, if any,
given by the LESSOR to the LESSEE, shall be paid over to the LESSEE at the
expiration of the full term of this Lease or on the sooner termination of the Lease
by written notice of termination.
Repossession or subleasing not a termination; LESSOR'S right to terminate
not forfeited: No repossession, operation, or subleasing of the Premises or of
fixtures and equipment shall be construed as an election by the LESSOR to
terminate this Lease unless a written notice of such intention is given by the
LESSOR to the LESSEE. Notwithstanding any such operation or subleasing without
termination of this Lease, the LESSOR may at any time after that elect to terminate
the Lease in the event that the LESSEE remains in default under this Lease.
LESSEE'S obligation to pay deficiencies: In the event the proceeds of rentals
received by the LESSOR under the provisions of this Section are insufficient to pay
all costs and expenses and all amounts due and becoming due under this Lease, the
LESSEE shall pay to the LESSOR on demand such deficiency as may occur or exist.
LESSOR'S right to terminate Lease: In the event of LESSEE'S default,
LESSOR may, at its option without further notice, terminate this Lease and all
interest of LESSEE under this Lease, and may then take possession of the leased
Premises by legal proceedings.
LESSOR'S right on termination to recover amount equal to rent reserved: If
this Lease is terminated by the LESSOR by reason of any default by LESSEE,
LESSOR shall be entitled to recover from the LESSEE, at the time of such
termination the excess, if any, of the amount of rent reserved in this Lease for the
balance of the term of the Lease.
LESSOR'S remedies are cumulative: Each and all of the remedies given to
the LESSOR in this Lease or by law are cumulative, and the exercise of one right of
remedy shall not impair its right to exercise any other right or remedy.
13. DEFAULT-WAIVER. The waiver by the LESSEE or the COUNTY of an act or
omission that constitutes a default of an obligation under this Agreement does not
waive another default of that or any other obligation.
14. ASSIGNMENT. The LESSEE may not assign this Agreement or assign or
subcontract any of its obligations under this Agreement without the approval of the
COUNTY's Board of County Commissioners. All the obligations of this Agreement
will extend to and bind the legal representatives, successors, and assigns of the
LESSEE and the COUNTY.
15. SUBORDINATION. This Agreement is subordinate to the laws and
regulations of the United States, the State of Florida, and the COUNTY, whether in
effect on commencement of this Lease or adopted after that date.
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16. GOVERNING LAWS/VENUE. This Agreement is governed by the laws of
the State of Florida applicable to contracts made and to be performed entirely in
the State. In the event that any cause of action or administrative proceeding is
instituted for the enforcement or interpretation of this Lease Agreement, the
LESSOR and LESSEE agree that venue will lie in the appropriate court or before the
appropriate administrative body in Monroe County, Florida. The LESSOR and
LESSEE agree that, in the event of conflicting interpretations of the terms or a term
of this Lease Agreement by or between any of them, the issue shall be submitted to
mediation prior to the institution of any other administrative or legal proceeding.
17. MUTUAL REVIEW. This Agreement has been carefully reviewed by the
LESSEE and the COUNTY. Therefore, this Agreement is not to be construed against
either party on the basis of authorship.
18. NOTICES. Notices in this Agreement, unless otherwise specified, must be
sent by certified mail to the following:
COUNTY LESSEE
Acting County Administrator Monroe County Health Department
Kevin Wilson Carla Fry, Administrator
1100 Simonton Street 1100 Simonton Street
Key West, FL 33040 Key West, FL 33040
And
County Attorney
Monroe County
1111 12t" Street
Suite 408
Key West, FL 33040
19. RELATIONSHIP OF PARTIES. LESSEE is, and shall be, in the performance
of all works, services, and activities under this Agreement, an independent agency,
and not an employee, agent, or servant of the COUNTY. LESSEE shall exercise
control, direction, and supervision over the personnel and volunteers who use the
Premises. LESSEE shall have no authority whatsoever to act on behalf and/or as
agent for the COUNTY in any promise, agreement, or representation other than
specifically provided for in this Agreement. The COUNTY shall at no time be legally
responsible for any negligence on the part of LESSEE, its employees, agents, or
volunteers resulting in either bodily or personal injury or property damage to any
individual, property, or corporation.
20. FULL UNDERSTANDING. This Agreement is the parties' final mutual
understanding. It replaces any earlier agreements or understandings, whether
written or oral. This Agreement cannot be modified or replaced except by another
written and signed agreement.
21. RIGHT OF INGRESS AND EGRESS. LESSEE, its agent, employees,
customers, suppliers, and patrons shall have the right of ingress and egress to and
from the leased Premises, which shall not be unreasonably restricted by the
COUNTY.
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22. RIGHT OF INSPECTION AND REPAIRS. LESSOR shall have access to the
Premises, and each and every part thereof, during LESSEE'S regular business hours
for the purpose of inspecting the same, making repairs, and posting notices that
LESSOR may deem to be for the protection of the LESSOR or the property.
23. AMENDMENTS TO BE IN WRITING. This Lease may be modified or
amended only by a writing duly authorized and executed by both LESSOR and
LESSEE. It may not be amended or modified by oral agreements or understandings
between the parties unless the same shall be reduced to writing duly authorized
and executed by both LESSOR and LESSEE.
24. HOLDING OVER. No holding over and continuation of any business of the
LESSEE after the expiration of the term hereof shall be considered to be a renewal
or extension of this Lease unless written approval of such holding over and a
definite agreement to such effect is signed by the LESSOR defining the length of
such additional term. Any holding over without consent of the LESSOR shall be
considered to be a day-to-day tenancy at a rental of three (3) times the daily rate
of the fixed minimum monthly rental provided herein, computed on the basis of a
thirty (30) day month.
25. ENTIRE AGREEMENT. This writing embodies the entire agreement and
understanding between the parties hereto, and there are no other agreements and
understandings, oral or written, with reference to the subject matter hereof that are
not merged herein and superseded hereby. Any amendment to this Lease shall be
in writing, approved by the Board of County Commissioners, and signed by both
parties before it becomes effective.
26. SEVERABILITY. If any term, covenant, condition, or provision of this
Lease Agreement (or the application thereof to any circumstance or person) shall
be declared invalid or unenforceable to any extent by a court of competent
jurisdiction, the remaining terms, covenants, conditions, and provisions of this
Lease Agreement, shall not be affected thereby; and each remaining term,
covenant, condition, and provision of this Lease Agreement shall be valid and shall
be enforceable to the fullest extent permitted by law unless the enforcement of the
remaining terms, covenants, conditions, and provisions of this Lease Agreement
would prevent the accomplishment of the original intent of this Lease Agreement.
The LESSOR and LESSEE agree to reform the Lease Agreement to replace any
stricken provision with a valid provision that comes as close as possible to the
intent of the stricken provision.
27. ATTORNEY'S FEES AND COSTS. In the event of any proceeding arising
out of or related to this Lease Agreement, each party shall assume and pay its own
expenses, including without limitation court costs, legal fees, expert fees and costs
of appeal, for any suit, action, or proceeding(s) arising hereunder. Mediation
proceedings initiated and conducted pursuant to this Lease Agreement shall be in
accordance with the Florida Rules of Civil Procedure and usual and customary
procedures required by the circuit court of Monroe County.
28. BINDING EFFECT. The terms, covenants, conditions, and provisions of this
Lease Agreement shall bind and inure to the benefit of the LESSOR and LESSEE and
their respective legal representatives, successors, and assigns.
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29. AUTHORITY. Each party represents and warrants to the other that the
execution, delivery, and performance of this Lease Agreement have been duly
authorized by all necessary County and corporate action, as required by law.
30. ADJUDICATION OF DISPUTES OR DISAGREEMENTS. LESSOR and
LESSEE agree that all disputes and disagreements shall be attempted to be
resolved by meet and confer sessions between representatives of each of the
parties. If the issue or issues are still not resolved to the satisfaction of the parties,
then any party shall have the right to seek such relief or remedy as may be
provided by this Lease Agreement or by Florida law.
31. COOPERATION. In the event any administrative or legal proceeding is
instituted against either party relating to the formation, execution, performance, or
breach of this Lease Agreement, LESSOR and LESSEE agree to participate, to the
extent required by the other party, in all proceedings, hearings, processes,
meetings, and other activities related to the substance of this Lease Agreement or
provision of the services under this Lease Agreement. LESSOR and LESSEE
specifically agree that no party to this Lease Agreement shall be required to enter
into any arbitration proceedings related to this Lease Agreement.
32. COVENANT OF NO INTEREST. LESSOR and LESSEE covenant that neither
presently has any interest, and shall not acquire any interest, which would conflict
in any manner or degree with its performance under this Lease Agreement, and
that the only interest of each is to perform and receive benefits as recited in this
Lease Agreement.
33. CODE OF ETHICS. LESSOR agrees that officers and employees of the
COUNTY recognize and will be required to comply with the standards of conduct for
public officers and employees as delineated in Section 112.313, Florida Statutes,
regarding, but not limited to, solicitation or acceptance of gifts; doing business with
one's agency; unauthorized compensation; misuse of public position, conflicting
employment or contractual relationship; and disclosure or use of certain
information.
34. NO SOLICITATION/PAYMENT. The LESSOR and LESSEE warrant that, in
respect to itself, it has neither employed nor retained any company or person, other
than a bona fide employee working solely for it, to solicit or secure this Lease
Agreement and that it has not paid or agreed to pay any person, company,
corporation, individual, or firm, other than a bona fide employee working solely for
it, any fee, commission, percentage, gift, or other consideration contingent upon or
resulting from the award or making of this Lease Agreement. For the breach or
violation of the provision, the LESSEE agrees that the LESSOR shall have the right
to terminate this Lease Agreement without liability and, at its discretion, to offset
from monies owed, or otherwise recover, the full amount of such fee, commission,
percentage, gift, or consideration.
35. PUBLIC RECORDS COMPLIANCE. Lessee must comply with Florida public
records laws, including but not limited to Chapter 119, Florida Statutes and Section
24 of Article I of the Constitution of Florida. The COUNTY and LESSEE shall allow
and permit reasonable access to, and inspection of, all documents, records, papers,
letters or other "public record" materials in its possession or under its control
subject to the provisions of Chapter 119, Florida Statutes, and made or received by
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the COUNTY and LESSEE in conjunction with this Lease Agreement and related to
contract performance. The COUNTY shall have the right to unilaterally cancel this
Lease Agreement upon violation of this provision by the LESSEE. Failure of the
LESSEE to abide by the terms of this provision shall be deemed a material breach of
this Lease Agreement and the COUNTY may enforce the terms of this provision in
the form of a court proceeding and shall, as a prevailing party, be entitled to
reimbursement of all attorney's fees and costs associated with that proceeding. This
provision shall survive any termination or expiration of the Lease Agreement.
LESSEE is encouraged to consult with its advisors about Florida Public
Records Law in order to comply with this provision.
Pursuant to Fla. Stat., Sec. 119.0701, and the terms and conditions of this Lease
Agreement, the Lessee is required to:
(1) Keep and maintain public records that would be required by the COUNTY to
perform the service.
(2) Upon receipt from the COUNTY'S custodian of records, provide the COUNTY
with a copy of the requested records or allow the records to be inspected or copied
within a reasonable time at a cost that does not exceed the cost provided in this
chapter or as otherwise provided by law.
(3) Ensure that public records that are exempt or confidential and exempt from
public records disclosure requirements are not disclosed except as authorized by
law for the duration of the Lease Agreement term and following completion of the
agreement if the LESSEE does not transfer the records to the COUNTY.
(4) Upon completion of the Lease Agreement, transfer, at no cost, to the County
all public records in possession of the LESSEE or keep and maintain public records
that would be required by the COUNTY to perform the service. If the LESSEE
transfers all public records to the COUNTY upon completion of the agreement, the
LESSEE shall destroy any duplicate public records that are exempt or confidential
and exempt from public records disclosure requirements. If the LESSEE keeps and
maintains public records upon completion of the agreement, the LESSEE shall meet
all applicable requirements for retaining public records. All records stored
electronically must be provided to the COUNTY, upon request from the COUNTY'S
custodian of records, in a format that is compatible with the information technology
systems of the COUNTY.
(5) A request to inspect or copy public records relating to a COUNTY contract
must be made directly to the COUNTY, but if the COUNTY does not possess the
requested records, the COUNTY shall immediately notify the LESSEE of the request,
and the LESSEE must provide the records to the COUNTY or allow the records to be
inspected or copied within a reasonable time.
If the LESSEE does not comply with the COUNTY'S request for records, the
COUNTY shall enforce the public records contract provisions in accordance with the
Lease Agreement, notwithstanding the COUNTY'S option and right to unilaterally
cancel this agreement upon violation of this provision by the LESSEE. A LESSEE
who fails to provide the public records to the COUNTY or pursuant to a valid public
records request within a reasonable time may be subject to penalties under Section
119.10, Florida Statutes.
10
135
The LESSEE shall not transfer custody, release, alter, destroy, or
otherwise dispose of any public records unless or otherwise provided in
this provision or as otherwise provided by law.
IF THE LESSEE HAS QUESTIONS REGARDING THE
APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO
THE LESSEE'S DUTY TO PROVIDE PUBLIC RECORDS
RELATING TO THIS LEASE AGREEMENT, CONTACT THE
CUSTODIAN OF PUBLIC RECORDS, BRIAN BRADLEY AT
PHONE NO. 305-292-3470, BRADLEY-
BRIAN@)MONROECOUNTY-FL.GOV, MONROE COUNTY
ATTORNEY'S OFFICE, 1111 12TH STREET, SUITE 408, KEY
WEST, FL 33040.
36. NON-WAIVER OF IMMUNITY. Notwithstanding the provisions of Sec.
768.28, Florida Statutes, the participation of the LESSOR and LESSEE in this Lease
Agreement and the acquisition of any commercial liability insurance coverage, self-
insurance coverage, or local government liability insurance pool coverage shall not
be deemed a waiver of immunity to the extent of liability coverage, nor shall any
contract entered into by the LESSOR be required to contain any provision for
waiver.
37. PRIVILEGES AND IMMUNITIES. All of the privileges and immunities from
liability, exemptions from laws, ordinances, and rules and pensions and relief,
disability, workers' compensation, and other benefits which apply to the activity of
officers, agents, or employees of any public agents or employees of the LESSOR,
when performing their respective functions under this Lease Agreement within the
territorial limits of the County shall apply to the same degree and extent to the
performance of such functions and duties of such officers, agents, volunteers, or
employees outside the territorial limits of the County.
38. NON-RELIANCE BY NON-PARTIES. No person or entity shall be entitled
to rely upon the terms, or any of them, of this Lease Agreement to enforce or
attempt to enforce any third-party claim or entitlement to or benefit of any service
or program contemplated hereunder, and the LESSOR and LESSEE agree that
neither the LESSOR nor the LESSEE or any agent, officer, or employee of either
shall have the authority to inform, counsel, or otherwise indicate that any particular
individual or group of individuals, entity or entities, have entitlements or benefits
under this Lease Agreement separate and apart, inferior to, or superior to the
community in general or for the purposes contemplated in this Lease Agreement.
39. ATTESTATIONS. LESSEE agrees to execute such documents as the LESSOR
may reasonably require, to include a Public Entity Crime Statement, an Ethics
Statement, and a Drug-Free Workplace Statement.
40. EXECUTION IN COUNTERPARTS. This Lease Agreement may be executed
in any number of counterparts, each of which shall be regarded as an original, all of
11
136
which taken together shall constitute one and the same instrument and any of the
parties hereto may execute this Lease Agreement by signing any such counterpart.
41, EFFECTIVE DATE. This Agreement will take effect on May 1, 2024.
IN WITNESS WHEREOF, each party has caused this Agreement to be
executed by its duly authorized representative,
(SEAL) BOARD OF COUNTY COMMISSIONERS OF
ATTEST: KEVIN MADOK, CLERK MONROE COUNTY, FLORIDA, LESSOR
By _ By
As Deputy Clerk Mayor/Chairman
STATE OF FLORIDA, DEPARTMENT OF
HEALTH, MONROE COUNTY HEALTH
DEPARTMENT, LESSEE
Witness # 1 Signa ure
By
Printed Name Date
Title Administrator
Wi ness # 2 Signa re Date
Printed Na e Date
M,0�tROE COUNTY A"TT ORNEY'S OFFICE
5qVE[D'A8TQF0 M
1,44
PATINA EABLES
A&33STANT COUNTY ATTORNEE-Y
12 DATE
137
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EXHIBIT " B"
Rooms with Square Footage
15
140
Ruth Ivins Center Health Department-EXHIBIT B
Room ---§quare Foota e
101 55-06
102 81.61
103 47.78
104 370.76
105 127.70
106 228.24
107 75.02
107 75.02
108 84.09
109 17-50
110 94.73
111 67.22
112 58.05
11-3 126.09
114 121.50
115 54.50
117 22.47
118 22.47
- 119 40.83
120 - 40.83
121 121.98
122 66.64
122a 17.32
124 108.00
126 297.00
127 72.00
127 149.00
129 80.00
130 262.76
133 75.32
135 120.77
136 115.24
137 81.26
138/139 127.29
138/139 127.29
140 87.29
141 87.00
142 8.44
142 8.44
142 8.44
142 ---8.44
Corridors 777.00
TOTAL Snuare Footage
......4,618-39
141
Kevin Madok, CPA
% Clerk of the Circuit Court& Comptroller—Monroe County, Florida
DATE: December 18. 2023
TO: Roman Gastesi
County Administrator
Undsey Ballard,Aide
to die County Administrator
FROM: Pamela G. I lanco-k, .C.
SUBJECT: December 13' BOCC Meeting
Attached is an electronic copy of'the following item,executed on behalf of Monroe
County, for your handling
C2.5 Contract between Monroe County Board of County Commissioners and the State
of'Florida, Department of'I lealdi for operation of die Monroe County Health Department
contract year 2023-2021. 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,l) Adding Occupational Physicals.
Once die state has signed die document, please return a fully executed copy to this office
for the record. Should you have any questions please feel free to contact me at (305) 292-3.5.50.
The fully executed document has been added to the record, 02/29/2024.pgh
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
142
Ron DeSarntis
Mission: Governor
To protect,promote&improve the health
of all people in Florida through integrated 01" Joseph Aapto, MD, PhD
state, county&community efforts. ��
State Surgeon General
HEALTH
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, M N, RN
Administrator/Health Officer
Monroe County Health (Department
SUBJECT: Core Contract Certification for 2023-2024
INFORMATION L
❑ I 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 Docurnent hang a
8 Added "...,,Attachment VI three pages), and Addendum I two � es
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.
Signature ministr or(Dir, or) Gate
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:305/293-7500-FAX 305/809-5629 Im Public.Health Accreditation Board
FloriclaHealth.gov
143
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 11 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
144
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 11 of
Attachment 11 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,
othercash,or local contributions)as provided in Attachment 11, Part 11 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
145
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 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 CHD 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 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
146
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 6A., 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 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.
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147
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
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-1 33, 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.
L The CHD shall not use or disclose any information concerning a recipient of services
except as allowed by federal or state law or policy.
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 Ill.
o. The CHD shall submit quarterly reports to the County that shall include at least the
following:
5
148
i. The DE3851_1 Contract Management Variance Report and the DE580LI
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 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. CHD 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 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.
149
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 Fry PhD, MSN, RN Roman Gastesi
Name Name
County Health Dept Administrator County Administrator
Title Title
1100 Simonton Street 1100 Simonton Street
Key West,Fl. 33040 Key West, Fl. 33040
Address Address
Carla.Fry(d).flhealth.gov gastesi-roman(cDmonroecounty-fl.gov
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. 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.
7
150
d. N-9tippa: 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 11 (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 1st day of October 2023,
BOARD OF COUNTY COMMISSIONERS STATE OF FLORIDA
FOR MONROE COUNTY DEPARTMENT OF HEALTH
SIGNED BY: SIGNED BY:
Holly Merrill Raschein
NAME: Josgph�LLada
yor TITLE: Mate-qumeon.Gen.eral
Cmbcy 1.3.20213......
TO, KEVIN MADOK, CLERK
SIGNED
SIGNED BY:
Pamela Hancock
NAME-' NAME: Ca af PhpW4NRN
TITLE: As Depury,Clerk, 'TITLE: CHD Administrator
DATE: Decernber 13, 202 3 DATE: 2
r
Approved as to form and legal suffibency:
Mor iroeCotintyAttorriey'sC)ffuce '12-5-2023
I-tj %A?
151
�
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ATTACHMENT I
MONROE COUNTY HEALTH DEPARTMENT
PROGRAM SPECIFIC REPORTING REQUIREMENTS AND PROGRAMS REQUIRING
COMPLIANCE WITH THE PROVISIONS OF SPECIFIC MANUALS
�
Some health services must comply with specific program and reporting requirements in addition m the Personal Health
Coding Pamphlet(DVP50-2V . Environmental Health Coding Pamphlet 50-21)and FLAIR requirements because cf
federal or state law,regulation nrrule. Ka county health department is funded tn provide one o[these services,hmust
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 eu specified inF.A.C.O4D-3. F.8.381 and F.G,384.
2. Dental Health Periodic financial and programmatic reports sospecified by the
program office.
3. Special Supplemental Nutrition Service documentation and monthly financial reports ae specified in
Program for Women, Infants and DHK015O-24°and all federal,state and county requirements detailed
Children(including the WIC in program manuals and published procedures.
Breoo#eeding Peer Counseling
Program)
4. Healthy Start/Improved Pregnancy Requirements oo specified in the 2OO7 Healthy Start Standards and
Outcome Guidelines and aa specified hy the Healthy Start Coalitions in
contract with each county health department.
5. Family Planning Requirements ao specified in Public Law 31-572.42U.S.C.3OO.at
ooq..42tFR part 58.subpart A.45CFR parts 74&g2.2CFR215
(OMB Circular A-11O)OMB Circular/+1O2. F.8.381.U851. F.&C.
64F-7. F.A.C.6417-16.and F.A.C.64F-13. Requirements and
Guidance ao specified in the Program Requirements for Title X
Funded Family Planning Projects(Title XRequinomenta)(2O14)and
the Providing Quality Family Planning Services(QFP):
Recommendations of CDC and the U.S.Office of Population Affairs
published un the Office o[Population Affairs webmite. wmQmmmeVc
annual reports ua specified by the program office ao specified inthe
annual programmatic Scope nf Work for Family Planning and
Maternal Child Health Services,including the Family Planning
Annual Report(FpAR}.and other minimum guidelines oospecified
by the Policy Web Technical Assistance Guidelines.
6. Immunization Periodic reports aa specified hy the department pertaining 0o
immunization levels in kindergarten and/or seventh grade pursuant
to instructions containedin8ho|mmunizeionGuide|ineo-F|u,ida
Schools,Childcare Facilities and Family Daycare Homes(DHForm
150-815)and Rule G4D-3.U48. F.A.C, |n addition, periodic reports ao
specified by the department pertaining hothe
surveillance/investigation of reportable vaccine-preventable
diseases,adverse events,vaccine accountability,and assessment of
immunization
�
Attachment-1-Page I of 2
152
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|
/
/
/
ATTACHMENT|(Comtinmed)
levels ae documented in Florida SHOTS and supported by CH0
Guidebook policies and technical assistance guidance.
7. Environmental Health Requirements en specified in Environmental Health Programs
Manuai150~t and DMP5U-21°
8. HIV/AIDS Program Requirements eo specified inF.G.384.25ond F.A.C.O*D-3.U3Oand
04D-3.O31.Case reporting should beun Adult HIV/AIDS Confidential
Case Report CDC Form DH2138 and Pediatric HIV/AIDS
Confidential Case Report CDC Form DM2140.
Requirements ao specified inF,A.C.8xO- and 84D- . F.S.381and
F.R.384. 8oci*demogmphin and risk data on persons tested for
HIV inCHD clinics should bo reported on Lab Request OMForm
1G28in accordance with the Forms Instruction Guide. Requirements
for the H|WA|CS Patient Care programs are found in the Patient
Care Contract Administrative Guidelines.
g. School Health Services Requirements os specified in the Florida School Health
Administrative Guidelines(May 2O12) Requirements oo specified in
F.G.381.0058.F.S.381DO57. FS.4O2.3O2G and F.A%.64F-6.
10. Tuberculosis Tuberculosis Program Requirements ae specified inF.&C.64D-
and F.G.392.
11. General Communicable Disease Carry out surveillance for reportable communicable and other acute
Cnnun| diseases,detect outbreaks,respond m individual cases u*reportable
diseases,investigate outbreaks,and carry out communication and
quality assurance functions,an specified inF.&C.G4D- . E8.381.
F.G.884 and the CHD Epidemiology Guide\n Surveillance and
Investigations.
12, Refugee Health Program Programmatic and financial requirements am specified bythe
program office.
.or the subsequent replacement if adopted during the contract period.
AnachmemJ'Page oofo
153
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154
ATTACHMENT H
MONROE COUNTY HEALTH DEPARTMENT
Part H,Sources of Contributions to County Health Department
October 1,2023 to September 30,.2024
State CHD County Total CHD
Trust Fund CHD Trust Fund Other
(cash) Trust Fund (cash) Contribution Total
I.GENERAL REVENUE-STATE
0150-10 All)S I'li1,A'F:N'[ION A St'ItV}:ILL:AN( I: GENEILAL RLA ENVIF, 73,552 0 3,552 0 73.552
015010 ('HD-TB C'OMNII1NITY PROGRAM 50.067 0 50,067 0 50,067
0150-10 DISEASECONTROLPRO(: A-MGR 16.755 0 167515 0 16.755
015010 DENTAL Sllls('IAL INITIATIVE PROJL:("TS 6.934 0 6,934 0 (M)34
0150,10 I:PIDENHOLOGY SI'lW[NLLANCI':GENERAL M'ENI.IIE 79,035 0 79,035 0 79,035
0150-10 FAMILY PLANNING GENEILI,RIWENI'-E 79,727 0 79.727 0 79,727
01 5040 HI)PA'I'PI'IS.AND I IVER I':AIIA RE PREVI+;N RON&CONTROI, 72,000 0 72,000 0 72,000
01.5040 I'R1M_ARY CARL PROGI�tAM 199,742 0 199,712 0 199,7,12
015040 RACIAL:ÐNIC DISPARITIES-CHI)EXPENSES 52.000 0 52,000 0 52,000
015040 SCHOOL HEALTH SERVICES 96.223 0 96.223 0 96,223
015050 CHI-)GENERAL REVENUE NON CsA'ITEGOR:ICM, 1,632.396 0 1,632396 0 1,632 396
GENERAL REVENUE TOTAL 2.358.131 0 2,358.181 0 2.358.131
2.NON GENERAL REVENUE-STATE
015010 ENVIRONMENTAL WOMEDI('AL WASTE PROGRAM 3,514 0 3,511 0 3,5I4
015010 167.832 0 IG7 832 0 167,832
NON GENERAL REVENUE TOTAL 17 1,346 0 17 L346 0 17 L346
3.FEDERAL FUNDS-STATE
007000 AIDS DRt'(;ASSIS LANCE PROGRAM ADMIN IIIQ 62.952 0 62,952 0 62,952
007000 WIC BREAST FEEDING:;PEHR CO['NSELING I'H2OG 103,651 0 103,651 0 I0,3.651
007000 COASTAL[BEACH Ibm,lT,R MONITORING 20,532 0 20,532 0 20,532
007000 COMPRLHENSIVE(Y)1I1-Kt NITY CARDIO-PIIBG 35.000 0 35,000 0 35,000
007000 STRENG 1'HENING S'['D PLLWEN'1'ION AND CON'CROL. 25,000 0 25,000 0 25,000
007000 ELC COW1D ENHANCED DL'rEC'TION EXPANSION GRANT 12,106 0 12.IM 0 12,100'
007000 HLC COWID HAI/AR 39,560 0 39,5G0 0 39J560
007000 ElYCOVID N['RSIN(,HOXIE<C FACILITY STRIKE't'EAM 39.560 0 39 560 0 39,560
007000 HI,C COWID OTHE'R&LONG TERM CARE FAC STRIKE PEAiNI 39.560 0 39,560 0 39,560
00,000 I^'.^AMILI PLANNING TITLE X-(;RANT 53.690 0 1.690 0 53,690
007000 HE""A'I-I D[SPARIIIES GRANT(:OVII)-19 63,892 0 6:1,892 0 63.892
007000 Pl'BLIC 1-11,1 H IN111ASTRI V'rt'II$&AA'OI Kl'OR(P;/( LN'1'Rr1L 1 12K 196 0 128.196 0 12K 196
00,000 HC)['SING()PPORT['NITIES FOR PERSONS WITH AIDS 736.384 0 736,38-1 0 736 3N1
007000 INFANT MORTALITY 6 131 0 6 134 0 6 134
007000 I\I AI[NII,:A`I'IONA("PION PLAN 61.372 0 6L372 0 61,1372
007000 tilA'1'ERN.A1,MORTAl,1`PY 6,431 0 fl,4:3=1 0 (i 134
007000 MCH SPl^1('[AL PRO.IEC'1'PRAMS 12,985 0 12,985 0 12.985
007000 BASE CO1111t'NI'['I'P1Z[;P.AIyI;DNESS CAPABILITY 91.010 0 91.01.0 0 91.010
007000 AIDS PREVENTION 1.1.8,227 0 118,227 0 118,227
007000 RYAN WI[1'1 E T[TLE 11 CARE GRANT 1.49.587 0 119.587 0 119.587
007000 'I'll CONTROL PROJI+Y'T 4,771 0 1,771 0 1.771
007000 WIC PRO(;RA1[ADM IN]S'I'RATION 510,230 0 510,230 0 5M230
015075 SCHOOL HEALTH SERVICES 123.839 0 123839 0 12.3.839
015075 Rl,,'HA11 L HEALTH S('REHNING IiP:IIIB[1RSGAIE+'N'[':AUV[IN 67,686 0 67,6M 0 611,686
Attach ment_il_Part_II-Page 1 of 4
155
ATTACHMENT 1T
MONROE COUNTY HEALTH DEPARTMENT
Part ll,Sources of Contributions to CountyHealth Department
October 1,2023 to September 0,2024
State CAD County Total CHD
Trust Fund CHD Trust Fund Other
(cash) Trust Fund (cash) Contribution Total
015075 RLPL CxEh;II F.AL'1'II S('R;[;I;NING R[,I1[I3['FtSP,AIH;N'C SIsRV1:CiES 8.47,888 0 817,888 0 847.888
018005 RYAN WIEI'1'E`I'I'1'Ll;l[AI)AI'DRL`(l ItP:1A'CI?S 17,876 0 17,876 0 17,876
FEDERAL FUNDS TOTAL 3,378 422 0 3,378.122 ) 3.378 122
4.FEES ASSESSED BY STATE OR FEDERAL RULES STATE
001020 CHI)STATMIDF,EWIRONXIENTM,FEES 172,686,686 0 172.686 0 172,686
001092 ON SI'['E SEWAGE I)ISPOSAL PEWVH I FEES 19,086 0 19,086 0 19.086
001092 CHI)STATEWIDI:EWI O;`MEN'I'M,FEES 6.200 0 6,200 0 6,200
001200' SANITATION'CERTIFICATES(FOOL)INSJ1E(,,n0N) 2,138 0 2,138 0 2 138
001206 SEPTIC'IANK RESEARCH S1'RCI-IARGE 55 0 55 0 55
001203 P(T131,IGSWI.vIMIN(,POOL PLRNITI l'EES-10%H(1TRANSFER 12,189 0 12,1.89 f) 12.189
001206 REGULATION OF BODY PIERCING S.W)NS 90 0 90 0 90
001206 TA'I"CO PROGR,"I ENVIRONMENTM,HEALTH 950 0 950 0 9 5O
001206 MORILE,,H01IE&RV PARK FEES 2.046 0 2.046 0 2.016
FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL 215 140 0 215.440 O 215,440
5.OTHER CASH CONTRIBUTIONS-STATE:
031.005 11,198 0 1 1.198 0 11.198
090001 DIiAW DOWN FROM PI'I31,I('HEALTH 1'NI'I' 0 0 0 0 O
OTHER CASH CONTRIBUTION TOTAL 1 1,498 0 1 1.498
6.MEDICAID-STATE/COUNTY:
00105, CHD CLINIC FEES 0 13.378 13..378 0 13,378
0011-18 CHI)CLINIC FF,I:S 0 68.381 68,381 0 68,381
001118 160 160 0 160
MEDICAID TOTAL 0 82.219 82.219 82,219
7.ALLOCABLE REVENUE-STATE:
001009 CJ-H)('LINI('1'HES 100 0 100 0 1.00
01.8000 RYAN WHI'l'E'I'I'1'1,13II.Al)AP I)fi['(,[',Ef3r1'I'ES 26,815 0 26,815 0 26,815
018000 CHI)CLItiI( FE M 2,591 0 2,591 0 2.591
ALLOCABLE REVENUE TOTAL 29.506 0 29.506 O 29,506
8.OTHER STATE CONTRIBUTIONS NOT IN CHD TRUST FUND-STATE
AI)AP 0 0 0 80 7 694 807 69-1
PH.IRIIACY I)RI G PROGRAM 0 0 0 12,281 12,281
WI("PROGRANI 0 0 0 1,381.008 1381,008
14['ItE�l'l)l'PC'til,Ft`HI II,TH LABORATORIES 0 0 0 8.023 8,02:1
FII,MI'NIIATIONS 0 0 0 11391-18 1 1391-18
OTHER STATE CONTRIBUTIONS TOTAL 0 0 0 3 318 151 3.3 I8 151
9.DIRECT LOCAL CONTRIBUTIONS-BCC/TAX DISTRICT
00800:a (31I1)I,(.)(`AI,REVI,Nt'k',&I;NPIa:Ni)I'CI`1115 0 1073,677 1073.677 0 1073.679
00800;r I\ISl1NI'/,.1't'ION(".11]I'. I(:N.ltl)Nitt>I;t'(71"N'1'1I3()('(' 0 3-1.560 531,560 0 531.560
DIRECT COUNTY CONTRIBUTIONS TOTAL 0 1,608.237 1.608.237 0 1 608,237
Attachment-II-Part-II-Page 2 of 4
156
ATTACHMENT 11
MONROE COUNTY HEALTH DEPARTMENT
Part II,Sources of Contributions to County Health Department
October 1,2023 to September 30,2024
State CHD County Total CHD
Trust Fund CHD Trust Fund Other
(cash) Trust Fund (cash) Contribution Total
10.FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION•COUNTY
001025 CHI)CLINIC 1^EES 0 489 189 0 189
001093 CUL)CIANIC FEES 0 49 49 0 49
001099 ('HI)CLINIC FEES 0 36,746 .36.776 0 36.776
001094 ('}11)LOC.1L I3NVIRONYIIs'N CAI,Fl?I'sS 0 1 18,901 118,901 0 148,901
001110 0 64.188 64.188 0 61,188
FEES AUTHORIZED BY COUNTY TOTAL 0 250.703 250,703 0 250.703
11.OTHER CASH AND LOCAL CONTRIBUTIONS-COUNTY
001029 CHD CLINIC FEES 0 10'T.819 107.819 0 107.819
001029 GENERAL CIANIC RABIES Sh:RVICES&DRUG PURC ILASES 0 1,369 1,364) 0 1,369
001029 Cl`RANT 310Y RL1 LNUE AND ESPLNSE TRACKING 0 60,000 60.000 0 60,000
001.090 CHD CLINK"FEES 0 61,836 61,836 0 61 836
005000 ('HI)CLINIC FEES 0 20 20 0 20
007010 RYAN W111TE TITLE III-DIRECT TO('HI) 0 10R921 109,921 0 109.921
007010 RYAN W111TE TITLE III-DIRECT TO('HD 0 238.210 238,210 0 238.210
010500 ( HI)SALE OF SEItV10ES IN OR OUTSIDE OF STATE W)V'C ) 92,G57 9`>,657 0 92,657
011001 CHD HEALTHY START COALITION CONTRACT 0 360"000 360.000 0 360.000
090002 DRAW DOWN FR01I PUBIAC HEALTH UNIT 0 -59G.168 -596,168 0 -596.168
OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL 0 735,661 735.664 0 735.664
12.ALLOCABLE REVENUE-COUNTY
001009 C111)CLINIC FEES 0 100 100 0 100
01.8000 RYAN WHITE TI11E 11 ADAP DRUG REBATES 0 26,815 26"815 0 26.815
01.8000 CHD CLINIC FEES 0 2,591 2,591 0 2.591
COUNTY ALLOCABLE REVENUE TOTAL 0 39.506 29.506 0 29,506
13.BUILDINGS-COUNTY
ANNUAL BENTAI, 0 0 0 597,605 597,(i05
O'PHER(Spec)fy) 0 0 0 0 0
t 'I'ILITIRS 0 0 0 83,369 83,369
IWIL TAM;MAINTENANCE'I ENANCE' 0 0 0 7 5,223 75.223
CROUNI)S Bal 1 ENAN('I% 0 0 0 115.566 115,566
INSURANCE 0 0 0 0 0
OTHER(Specify) 0 0 0 0 O
O'IHEIi(Specify) 0 0 0 0 0
BUILDINGS TOTAL 0 0 0 871,76,3 871,763
14.OTHER COUNTY CONTRIBUTIONS NOT IN CHD TRUST FUND COUNTY
E01'IP0 ENT/YEf11CLEI'I-RCHASES 0 0 0 0 0
VEHICLE INSURANCIE 0 0 0 0 0
1"I;F{U'J.1: 11aIN I I NA?(CIS 0 0 0 0 0
OITIERCOUNTY-CONTRI fit'TION(SPECIFY) 0 0 0 0 0
)THER COt'NTY CONTRIBUTION(Sill,,}C'.IFY) 0 0 0 0 0
OTHER COUNTY CONTRIBUTIONS TOTAL 0 0 0 0 0
Attach ment_il_Part_II-Page 3 of 4
157
ATTACHMENT 111
MONROE COUNTY HEALTH DEPARTMENT
Part 11,Sources of Contributions to County Health Department
October 1,2023 to September 30,2024
State Crw County Total CHD
Trust Find CHD Trust Fund Other
(cash) Trust Fund (cash) Contribution Total
GRAND TOTAL CHD PROGRAM 6,167,643 2,706,329 8873.972 4,22Q217 13,094,189
Attachment_II_Part_II-Page 4 of 4
158
ATTACHMENT H
MONROE COUNTY HEALTH DEPARTMENT
Part III,Planned Staffing.Clients,Services and Expenditures By Program Service Area Within Each bevel of Service
October 1,2023 to September 30,2024
Quarterly Expenditure Plan'
FTWs Clients Services/ 1st 2nd 3rd 4th Grand
(0.00) Units Visits (Whole dollars only) State County Total
A. COMMUNICABLE DISEASE CONTROL:
FVMUNIZATION (101) 9.94 1,296 (3,',31(3 326,121 279,807 326,121 284 CM 532,981 684,101 1.217,082
SEXUALLY TEANS.DIS. (102) 2.08 82 171 69,129 59,257 69,129 60235 98,T5,1 158,996 257.750
RIV/AIDSPREVENTION (03AI) 2.11 0 1.10 73.185 (32,731 73,185 (33,771 272,870 i 272,875
HIV/AIDS Sl RVEILLANCE (WA2) 0.00 0 0 0 0 0 0 0 0 0
111V/AIDS PATIENT CARE (0313) 11.08 2M 1J372 153.816 389,009 153.816 395 139 913,519 7-18,531 1,(392,080
ADAP (03A0 0.98 0 0 22,792 1.9538 22.792 19,861 81,981 2 81,983
T(IBERCULOSIS (101) 1.30 1.6 117 11.3,18 35 I43 41,348 36,029 1.54,141 27 151,168
(Y)1ID1.MS SL'RV. (106) 1.26 0 3,152 127,117 1.09,217 127r117 111,0G3 175,1911 0 175,19 1
I11+11PATITIS (109) 1.9.1 388 427 36,062 30.91.2 36,062 31,121 131,-156 4 131 160
PREPAREDNESS ANI)PES110NSE. (116) 1.12 0 0 14.519 ;N 161 11.519 .38,792 165,991 0 165,991
RLFI'GEFIIF.MAII (1.1.8) 3,83 991 3,497 115,122 98,682 115,122 100,312 1292:11 1 129,238
\1TALRECORDS (180) 1.12 1519 L05.1 24,964 21399 21.964 21.750 93,071 93,077
COMMUNICABLE DISEASE SUBTOTAL 39.76 7,608 198119 334.805 1,MA 189 L„33.4,805 ] 163,099 3,292,151 1,684,747 1976,898
B. PRIMARY CARE:
('11RONIC DISEASE PIWXh,NTI0N PRO (210) 0.82 1,111. 9:5 28.368 21.31.7 28,368 21,717 105,710 0 105,770
WIC (21WI) 6.97 2,606 1 I.337 11-59,060 136 3-15 159,060 138,600 593,0(i5 593,0(i5
TOI3A000 L'SE INTERVENTION (212) 2,25 0 0 58.:i711 0,20({ 58,:570 7)1.O31 218,380 218,380
WIC BREAS FEEDING1'EERCO NSELING (21W2) 1.80 1,088 33,995 291-11 33,995 29623 126,751 0 126,751
FAVMILYPI,ANNINO (223) 1.18 1,115 2,347 1--17,246 126,219 147,246 128,305 112,611 136105 51 ON'
IMPROVED PREMNANCYOI`TCOX[E (225) 0.01 0 0 7,178 6153 7,178 6,253 26,7(i2 0 26,7(32
HEALTHY START PRENATAL, (227) 2.-17 139 1_821 62,515 53 611 62,545 )1,500 0 233.201 233,20-1
041F'IdE]4I NSIVI3:CI11Lll IIEAL'I'H (229) 0.00 0 U 0 0 0 U 0 0 0
IIEAI;III� S'I'AItT(1HI1,17 (231) 2-17 510 ?135 58..-1.10 50 091 58,110 50,922 0 217,896 217,896
SC110OL HEALTH (230 2.26 0 189,621 60,213 51.610 60,2-13 52195 22 1,621 0 221,621
O1IPREI(LNSIVE ADl'[;1'Fl ..1l;fl] (237) 3.38 289 875 8.1,722 72,623 81722 73.823 218.57:3 97,317 3 15 890
COMM UNITS I1E,AL991 DEVELOPMENT (238) 1.:31 0 881 1,51,205 1:12,181 151.205 1343(i9 57-1,963 0 571.963
DENTALHEALTII (210) (H)1 0 0 16.117 11098 16.117 11 332 61,:321 U 61,321
PRIMARY CARE SUBTOTAL 30.96 6,100 213,2W 871.019 7-16631 871,019 758,973 25(;2.823 684822 3,21761
C. ENVIRONMENTAL HEALTH:
Water and Onsite Sewage Programs
COSTAL BEACH',I0N1'F0lflNG (3,17) 0A1 117 117 6,357 5.460 6,357 i.510 23,704 0 23.701
LIMITED USE N'BIM'WATE''k SYSTEMS (357) 0.00 0 q 0 U 0 0 0 0 0
I'1'13LIC F\1 FI3 SS-STEM (3.58) 0.00 0 0 0 0 0 0 0 0
PRIVATE WATER SS STEM 059) 0.00 0 0 0 0 0 O 0 Q 0
ONSITE SL\VAGETRLATMENTKDISPOSAL (:Wl) 1,3-1 123 108 33,701 28,891 M,70-1 29,369 18,918 76.750 125668
Group Total 1,-18 510 225 10,061 313-11. -10,061 31,909 72,622 76,750 119,372
Facility Programs
TATTOO FACILITY SERVICES (:!11) C)_20 198 126 5,107 1,378 5,107 1 151 19,0 14 0 19,043
Attachment_II_Part_III-Page t of 2
159
ATTACHMENT II
MONROE COUNTY HKALTH DEPARTMENT
Part HI,Planned Staffing.Clients,Services and Expenditures By Program Service Area Within Each Level of Service
October 1,2023 to September 30,2024
Quarterly Expenditure Plan
FTE's Clients Services/ 1st 21nd 3rd 4th Grand
(0.00) Units Visits (Whole dollars only) State County 'Dotal
FOOD HYGIENE (348) 0.5.5 145 263 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) 0.011 18 25 1,254 1,075 1,254 1,091 3,131 1,543 1.67-1
MIGRANT LABOR,CAMP (352) 0.00 0 0 0 0 0 0 0 0
HOUSING&PUB.BLDG. (353) WX) 0 0 0 0 0 0 0 0
\40BILE HOME AND PARK (1351) 0.-10 234 334 12,090 10,363 12.090 10 YN 22,7li3 22.331 45,077
POOLS/BATHING PLACES (360) 2,12 671 1,751. 53,965 46,258 33,965 <17,022 121.952 79,258 201,210
BIOMEDICAL WASTE SERVICES (364) 0.27 226 21.8 6,914 5,926 6,914 6,024 1.5,512 10,266 25,778
CANNING FACILITY SERVICES (.369) 0,02 0 0 696 597 696 607 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 COiMPI.,IANCE SERVICES (355) 0.00 0 0 0 0 0 0 0 0
SL.IPER 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.HEALTPI (345) 0.04 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
LEAD NIONICORING 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.SERA I(l (363) 0.00 0 0 0 0 0 0 0 0 0
SANITARY NUISANCE (365) 0.0£3 7 14 953 817 9t53 832 2,381 1,171 3555
RABIESSITRVEILLANCE (366) ().()1 0 1 396 339 396 344 988 187 1,,17:5
ARBORVIRUS SURVEIL. (367) 0.00 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
INDOORAIR (371) 0.00 0 0 0 0 0 0 0 0 0
RADIOLOGI('AL 11E AUPH (372) 0.00 0 0 0 0 0 0 0 O U
'CONIC SL'B'r7 1NCES (378) 1.44 103 103 33,059 28,338 33,0159 28,805 0 123.261 123.261
Group Total 1..52 -110 418 15.-131 30,373 35 43-1 :10,871 5,892 126,223 132,115
ENVIRONMENTAL HEALTH SUBTOTAL 6.63 2.149 3,365 1.69,118 114,966 169.118 117.359 293,801 336.700 630.561.
D. NON-OPERATIONAL COSTS'
NON-OPER.ATIONAL COS'CS (599) 0.00 0 0 0 0 0 0 0 0
13NVIRON\IENTAI,HEALTH SI RCl1ARGE (399) 0.00 0 0 5,060 4.338 5,060 1,-110 18,868 0 18,868
MEDICAID M'YBACK (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 1.=110 18.868 0 18,868
TOTAL CONTRACT 77,35 16,157 236.417 2.380,002 2,040.127 2,380.002 2073,841 6,1(37.643 2,706.329 8.87:)„972
Aftachment_II_Part_III-Page 9 of 2
160
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 pehod). ifso 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 CHO hereby agrees that it will comply with Title V| of the Civil Rights
Act of 1964 (42 U.S.C. 2000d wtumqj; Title |X of the Education Amendments of 1972 (20 U.S.C. 1681 etaaqj;
Section 5O4nf the Rehabilitation Act of1S73(29U.S.C. 704);the Age Discrimination Act of1Q75 (42U.8.C. 8101
etueq.); Title || and Title ||| of the Americans with Disabilities Act (\DA) of 1990. an 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 Podn 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 (7CFR Part 15etoeq.); and FNG directives and guidelines to the effect that no person shall, onthe
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. |f 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 huuse 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 ur 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 bo 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 7CFR§24G.2G(d)(1)(ii). aaapplicable.
161
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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 of 1
163
ADDENDUM11
TO CONTRACT BE,
MONROE COUNTY BOARD OF C06NTY 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.
Page I of 2
164
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 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.
Page 2 of 2
165
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168
APPROVED BY RISK MANAGEMENT
BY,-
DATE 4/2/2024
WAIVER N/A YES
DEPARTMENT OF RNANgAL SERVICES
Division of Risk Management
STATE RISK MANAGEMENT
TRUST FUND
Policy Number: GL-830�0 General Liability
Certificate of Coverage
Name Insured: Department of Health
General Liability Coverage provided pursuant to Chapter 284, Part 11, Section 768.28,Florida
Statutes, and any rules promulgated thereunder.
Coverage Limits:
General Liability: $200,000.00 each person
$300,000.00 each occurrence
Inception Date: July 1, 2023
Expiration Date: July 1, 2024
DFS-DO-863
(REV.7/17)
169
DEPARTMENT OF FINANCIAL SERVICES
Division ofRisk Management
STATE RISK MANAGEMENT TRUST FUND
GENERAL LIABILITY
CERTIFICATE OF COVERAGE
In consideration of the provisions and stipulations contained herein or added hereto and for the premium charged, the State Rlsk Management Trust
Fund, hereinafter referred to as the "Fund certifies that the State department or agency named in this certificate is hereby provided general liability
coverage. Coverage shall)be effective on the inception date at 12:01 a.m.standard time.
This certificate is comprised'of the foregoing provisions and stipulations,together with such other provisions and stipulations as may be added hereto by
the Fund in the future:
I. COVERAGES (2) maintained for use exclusively on premises owned
General Liability Coverage--Bodily and Property damage by or rented to the named insured, including the
To pay on behalf of the insured all sums which the insured shall ways immediately adjoining,or
become legally obligated to pay as damages for injury or loss of (3) designed for use principally off public roads,or
property, personal injury, or death caused by the negligent or (4) designed or maintained for the sole purpose of
wrongful act or omission of any officer, employee, agent or affording mobility to equipment of the following types
volunteer of the named insured, as such terms may be further forming an integral part of or permanently attached
defined herein or by administrative rule, while acting within the to such vehicle; power cranes, shovels, loaders,
scope of his office or employment, pursuant to the provisions diggers and drills; concrete mixers (other than the
and limitations of Chapter 284, Part II and Section 768.28, mix-in-transit type); graders, scrapers, rollers and
Florida Statutes. other road construction or repair equipment, air-
compressors, pumps and! generators, including
It. DEFENSE,SETTLEMENT„SUPPLEMENTARY PAYMENTS spraying, welding, and building cleaning equipment;
With respect to such coverage as is afforded by this certificate, and geophysical exploration and well-servicing
the Fund shall: equipment.
(a) defend any proceeding against the insured seeking such
benefits and any suit against the insured alleging such IV. EXCLUSIONS
injury and seeking damages on account thereof, even if This certificate does not apply:
such proceeding or suit is groundless,false,or fraudulent. (a) to bodily injury or property damage arising out of the
The Fund will investigate all claims filed against the ownership, maintenance, operation, use, loading or
insured in order to determine the legal liability of the unloading of:
insured and to determine damages sustained by the (1) any automobile owned or operated by or rented or
claimant. The Fund will negotiate,settle,or deny the claim loaned to any insured,or
based'on these findings and appropriate Florida law, (2) any other automobile operated by any person in the
(b) pay all premiums on bonds to release attachments and on course of his employment by any insured, but this
appeal bonds required in any such defended suit for an exclusion does not apply to the parking of an
amount not in excess of the applicable limit of liability automobile on premises owned by, rented to, or
established in this certificate; controlled by the named insured or the ways
(c) pay all expenses incurred by the Fund, all costs taxed immediately adjoining, if such automobile is not
against the insured in any such suit, and all interest owned by,rented,or loaned to any insured;
accruing after entry of judgment until the Fund has paid, (b) to any action which may be brought against the named
tendered, or deposited in court that part of such judgment insured by anyone who unlawfully participates in riot,
as does not exceed the limit of the Fund's liability thereon; unlawful assembly,public demonstration,mob violence,or
(d) pay expenses incurred by the insured for such immediate civil disobedience if the claim arises out of such riot,
medical relief to others as shall be imperative at the time of unlawful assembly,public demonstration,mob violence,or
the accident. civil disobedience;
(c) to any obligation for which the insured or the Fund may be
Ill. DEFINITIONS held liable under any employer's liability or workers'
(a) Named Insured - The department or agency named compensation law;
herein. (d) to property damage to property owned or occupied by the
(b) Insured _State department or agency named herein,their insured;
officers,employees,agents or volunteers. (e) to property damage to premises alienated by the insured
(c) Volunteer-Any person who of his own free will, provides arising out of such premises or any part thereof;
goods or services to the named insured,with no monetary (f) to loss of use of tangible property which has not been
or material compensation as defined in Chapter 110, Part physically injured or destroyed,resulting from;
IV,Florida Statutes. (1) a delay in or lack of performance by or on behalf of
(d) Agent - Any person not an employee, acting under the the named insured of any contract or agreement;
direct control and supervision of a state agency or (2) the failure of the named insured's products, or work
department, for the benefit of a state agency or performed by or on behalf of the named insured to
department. meet the level of performance, quality fitness, or
(e) Automobile - A land motor vehicle, trailer, or semi-trailer durability warranted or represented by the named
designed and licensed for use on public roads (including insured;
machinery or apparatus attached thereto), but does not (g) to property damage to the named insured's products
include mobile equipment. arising out of such products or any part of such products;
(0 Mobile Equipment-A land vehicle(including machinery or (h) to property damage to work performed by or on behalf of
apparatus attached thereto),whether or not self-propelled'; the named insured arising out of the work or any portion
(1) not subject to motor vehicle registration,or
DFS-DO-863
Revised 11105 Page 1 of 2
170
thereof, or out of materials, parts, or equipment furnished giving evidence and obtaining the attendance of
in connection therewith; witnesses. The insured shall not, except at his own
(i) eminent domain proceedings or damage to persons or cost, voluntarily make any payment, assume any
property of others arising therefrom; obligation or incur any expenses other than for first
(�) to punitive damages;. ald to others at the time of accident.
(k) to actions of insureds committed in bad faith or with
maHciious purpose or in a manner exhibiting wanton and
willful disregard of human rights,safety,or property, (4) Action Against the Fund
(A) to professional medical liability of the Board' of regents, No action shall He against the Fund unless, as a
the physicians, officers, employees, or agents of the condition precedent thereto, the insured shall have
Board; been in full compliance with all of the terms of this
(m) to liability related in any way with nuclear energy; certificate and the provisions of applicable Florida
(n) to liability assumed by the insured under any contract or Statutes.
agreement; (5) Severability of Interest
(o) to final judgments in which the insured has been The term "'the insured" is used severally and not
determined to have caused the harm intentionally; collectively, but the inclusion herein of more than
(p) to awards for injunctive, declaratory, or prospective relief one insured shall not operate to increase the limits
rendered against an insured by any federal or state court, of the Fund's liability,
agency'or commission.
(6) Limits of Liability
V. CONDITIONS The limit of liability expressed as applicable to"each
A. Premium person" is the limit of the Fund's liability for all
Premium charges shall be assessed in accordance with damages, including damages for care and loss of
the provisions of Chapter 284,Part 11,Florida Statutes,and services, arising out of personal injury and property
any rules promulgated thereunder utilizing a retrospective damage sustained by one person as a result of any
rating arrangement premium calculation method whereby one occurrence; but the total liability of the Fund for
80% of the premium is based on losses actuaVy incurred all damages sustained by two or more persons as a
by the insured and 20% is based on the changes in risk resuit of any one occurrence shall not exceed the
exposures(employees, etc.)of an insured. The premium limit of liability as applicable"each occurrence"'
must be paid promptly by an insured agency from its (7) Other insurance
operating budget upon receiving the premium bill or If there is insurance applicable to any claim, the
invoice. coverage extended by this certificate shall apply only
as excess insurance over any and all other
B. Audit applicable insurance.
The Fund' shall be permitted' to examine and audit the (8) Terms of Coverage
insured's books and records at any time during the term of This certificate is issued for the purpose of
this coverage and any extension thereof, and within three confirming coverage as contemplated by Chapter
years after the final termination of this coverage, as far as 284, Part f, Florida Statutes. in the event of any
they relate to the premium bases or the subject matter of conflict between provisions or coverages in this
this coverage. certificate and the provisions of any Florida Statutes
or laws including, but not limited to the aforesaid,
C. Insured's Duties in the Event of Occurrence, Claim or said statutes and laws shall control.
Suit (9) Cancellation
(1) Event of Occurrence Failure of the Fund to receive the amount of
Written notice containing particulars sufficient to premiums billed to the insured agency within the
identify the insured, along with reasonably time frames allowed by law may result in
obtainable information with respect to the time,place cancellation of the certificate of coverage.
and circumstances thereof, the names and Payments must be made promptly from the insured's
addresses of the injured and all known witnesses, operating budget upon receipt of the premium bill as
shall immediately be given by or for the insured to specified in Section 284.36, Florida Statutes, and
the Fund. lack of prompt payment will result In a request from
(2) Notice of Claim or Suit the Fund to the Comptroller to transfer premiums
If claim is made by suit brought against the insured, from any available funds of the delinquent agency
the insured shall immediately forward to the Fund under the provisions of Section 284.44(7), Florida
every demand, notice, summons, or other process Statutes.
received by him or his representative. Failure by the
insured to advise the Fund of a claim or suit prior to D. Self-Insurance Coverage
a settlement agreement or the insured otherwise Coverage for defending and paying claims under this
obligating itself,shall void coverage by the Fund,for certificate is provided under the authority of Chapter
that claim. 284,Florida Statutes,wherein the state is authorized
(3) Assistance and Cooperation of the Insured to administer a self-insurance program. Provision of
The insured'shall cooperate with the Fund and,upon this certificate does not constitute the issuance of
the Fund's request, assist in making settlements, In insurance other than on,a self-insurance basis, and
the conduct of suits and in enforcing any right of payment of any covered claim obligations is
contribution or indemnity against any person or contingent upon availability of legislafve funding.
organization who may be liable to the insured
because of injury or damage with respect to which
coverage is afforded under this certificate, and the
insured shall upon request, make available all
agency records pertaining to a specific claim, shall
attend hearings and trials and assist in securing and
DFS-DO-863
Revised 11/05 Page 2 of 2
I
I
171 1