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Item C04 C4 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: C4 2023-2317 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 Roth Building, 50 High Point Road, Tavernier, FL. The County leases the space to the Health Dept. at no costs for the year. ITEM BACKGROUND: The Florida Department of Health (DOH) has been using a total of 5,803 square feet of office space at the Roth Building since about 2008. While the DOH had been using this office space for many years, it appeared there had never been a formal lease agreement entered into between the parties. On June 20, 2018, the BOCC issued approval to execute the first written Lease Agreement. The arrangement has been satisfactory for both parties and DOH is once again requesting to lease 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 cost to the DOH. Staff requests approval of another one-year Lease Agreement with the Health Dept. at the Roth Building. PREVIOUS RELEVANT BOCC ACTION: Annual Lease Agreement since 2008, with a formal written agreement approved and entered into between the parties 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. STAFF RECOMMENDATION: Approval 222 DOCUMENTATION: 04-17-2024-Roth Lease Agreement with exhibits-Health Dept Sign Page substituted.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 2008, with a formally written Lease approved in 2018. The Lease is at no charge to the Health Dept. 223 LEASE AGREEMENT ROTH BUILDING 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 Roth Building at 50 High Point Road, Tavernier, Florida; and WHEREAS, the Monroe County Health Department has occupied space in the Roth Building since about 2008; and WHEREAS, the COUNTY has determined that is in the best interests of Monroe County to lease unused office space at the Roth Building; NOW, THEREFORE, IN CONSIDERATION of the promises contained herein the parties agree to the following: 1. PROPERTY. The COUNTY leases to the LESSEE 5,803 square feet of office space, which is 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 immediately terminating this Agreement. LESSEE shall not permit any use of the 224 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 Roth Building. 4. RENT. For the use of the Premises, the LESSEE must pay the COUNTY the sum of $-0- per year, for 5,803 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 Roth Building, 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 2 225 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 440, Florida Statutes, arising out of the activities governed by this Lease Agreement. 3 226 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, color, sex, religion, national origin, ancestry, sexual orientation, gender identity or expression, familial status or age; 11) Any other nondiscrimination provisions in 4 227 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; or 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 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 5 228 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. 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 6 229 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. 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 7 230 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. 8 231 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 LEESSOR 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 9 232 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. The 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. 10 233 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 11 234 ^ . which Ldk8R together shall constitute one and the SDrn8 instrument and any of the p8nLi85 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 DF ATTEST: KEVIN MADOK, CLERK M[}NROECDUNTY, FLORIDA, LESSOR By By Deputy Clerk STATE OF FLORIDA, DEPARTMENT [)F HEALTH, M(}NR{)E COUNTY HEALTH DEPARTMENT, LESSEE Witness # 1 Signature &AND "(All) By Q Prin ed Name Date » \ , Title Administrator C>aL —"YJ 1� I Printed Na�uo�Date MONROE COUNTY'ATTORNEY'S OFPCE 12 235 EXHIBIT "'A" 13 236 N �WF lot 1>11 � j IRV ills! 1 0 I � J f g v� Pr ^t 9 e. r� t a � 1 j 7 v� iI n i _ 1 -• MA, IS M w �a pp y.x, f p` , f�f f x ifs I .n f .... ti_j # y ... I i U„V II aC , t� nl O r � 237 EXHIBIT "B" Rooms with Square Footage 15 238 Roth Health Department EXHIBIT B Room# 1 365.64 la 73.71 2 41.84 3 41.84 5 92.67 6 101.02 7 126.42 10 71.23 10 89.13 10a 34.58 10a 43.27 13 103.80 14 17.95 15 45.76 16 52.47 17 100.31 18 86.22 19 101.25 20 105.79 22 69.15 22 7.68 23 108.00 24 156.88 25 40.50 25 40.50 26 197.57 30 126.42- 31 50.22 33 110.08 36 121.03 38 130.90- 38a 38.50 40 70.09 40 112.88 41 80.00 41 a-f 398.06' 42 217.07 43 126.55' 45 111.78 46 58.77 Corridors 1,548.00 Em to ee Entrance 124.66 HVAC Room 8.63 Public Ent a 30.96 23.36 239 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 240 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 241 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 242 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. 2 243 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 3 244 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. 4 245 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: 5 246 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. 247 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. 7 248 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? 249 � � � | | 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 2 250 | | / / / 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 251 co LO 00 (D 00 CO ca (D 0) Nr (D ICT 0) C14 LO co m E < m 16 U") Co a m (D 00 OD (D 0) m v 0 E0 'IT CD 04 LO 2 z 2 CL 2 I-- =3 00 \ \ �U) z W 3 E uj C13 ■ w U) LL 0 Ir I-- z (n w cucn w Ix a < E z P :r LU CL LU -i W 0 I— W Z X =) _(D F- 0 1-- 0 z w 0 0 0 0 Z 0LL 0 ■ Lu w (nU- U) 0 D CL 0 ui z z 0 c aca ce) 0 0 Cf) IL 0 1c 0 = 0 8 C > 0 6 6 06 0 Cf) CO) Cl) C (D _ m cr) 0 " 4) 0 a) ca .0 cc a) E 4) (n ba) CD E E oll c c t = CL VD U) a) cn —0 U) cc w f 0 .2 0 70 Cl) CL m V) (D C*4 C-4 (D C14 o 0 LL 0 (D —0 ci C14 CN a. in m =3 3 -7 « r 7i .i5 a) - :Ll 0 a) (D 0 4) CL M m (D .2 0 2 CL 0 ca t 00 a) 0 ca 0 z & C6 252 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:&ETHNIC 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'1TEGOR: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&LTC 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 FAMILY 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 4 253 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 4 254 ATTACHMENT II 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 4 255 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 4 256 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 2 257 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 2 258 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. 259 t3) ca CL C. 0 co co > o EU L—L LU co 00 U. CO 0 3 a cts of m Z E 0 Ci z 2 2 0 0 0 0 C m c 0 CZ 0 a) %- m caas 0 c 0 ctl t3 (D CO -_I-- c c 0 0 CL 2 P 0 01 co r cm r r 4) z z 2 z 0 cc CL 0 (D 0 0 Q m o 0 > ID w w C4 m Co 0 a d c Nco co > CL —Q) C (4 N Im z O c 4z :tt to E uU co 0 42 C) 39 S 5 M — C co LD to ci to 4) 0 Ci E 2 0 m E cL E Z z it c > M m 9 4) . r- Ix > U. C 3�•> ui c 'Q .C-o Ui w C) rZ D L: M(b A 0 co c Z 0-M m (D co C,3 —co W) > to 0 _j _j 6 LL 0 wo r, 0 o x 10 5 0 U. 0 .5 Z E 0 c o M co 0 F I 260 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 1 261 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 2 262 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 2 263 -n :7; rl Do 'c oc If C` C?' '-t. 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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) 267 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 2 268 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 269 1