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Item O1 01 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 November 19, 2024 Agenda Item Number: 01 2023-3068 BULK ITEM: Yes DEPARTMENT: Administration TIME APPROXIMATE: STAFF CONTACT: Carla Fry n/a AGENDA ITEM WORDING: Approval of a contract beginning Oct. 1, 2024 (retroactively)between Monroe County Board of County Commissioners and the State of Florida, Department of Health for operation of the Monroe County Health Department with County share at $1,762,675 for County FY2024-2025. ITEM BACKGROUND: This is the annual agreement between Monroe County and the Florida Department of Health(DOH) that has continued for 20+years. The County pays for additional services, over and above the State contribution of$5,125,564. Three (3)primary services are performed by the DOH to serve Monroe County residents: 1. `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 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. 2. "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. 3. "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, 4146 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. PREVIOUS RELEVANT BOCC ACTION: INSURANCE REQUIRED: No CONTRACT/AGREEMENT CHANGES: Increase of funding from previous fiscal year contract driven primarily by the expansion of services throughout Monroe County resulting from an increase in patient volume. There was also an increase in all state salaries of 3% effective 7/1/2024. STAFF RECOMMENDATION: Approval. DOCUMENTATION: FDOH Core Contract—Executed Copy.pdf FINANCIAL IMPACT: TOTAL COST: BUDGETED: Yes x No COST TO COUNTY: $ 1,762,675 SOURCE OF FUNDS: 4147 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 2024-2025 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, 2024 (retroactively effective). 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, 2024 (retroactively effective), through September 30, 2025, or until a written contract replacing this contract is entered into between the parties, whichever is later, unless this contract is otherwise terminated according to the termination provisions outlined in paragraph 8., below. 3. SERVICES MAINTAINED BY THE CHD. The parties mutually agree that the CHD shall provide those services as outlined in Part III of Attachment II hereof, to maintain the following three levels of service pursuant to section 154.01(2), Florida Statutes, as defined below: a. "Environmental health services" are those services that are organized and operated to protect the health of the general public by monitoring and regulating activities in the environment that may contribute to the occurrence or transmission of disease. Environmental health services shall be supported by available federal, state, and local funds and shall include 1 4148 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, HIWAIDS, immunization, tuberculosis control, and maintenance of vital statistics. c. "Primary care services" are acute care and preventive services that are made available to well and sick persons who are unable to obtain such services due to lack of income or other barriers beyond their control. These services are provided to benefit individuals, improve the collective health of the public, and prevent and control the spread of disease. Primary health care services are provided at home, in group settings, or in clinics. These services shall be supported by available federal, state, and local funds and shall include services mandated on a state or federal level. Examples of primary health care services include but are not limited to first contact acute care services; chronic disease detection and treatment; maternal and child health services; family planning; nutrition; school health; supplemental food assistance for women, infants, and children; home health; and dental services. 4. FUNDING. The parties further agree that funding for the CHD will be handled as follows: a. The funding to be provided by the parties and any other sources is outlined in Part II of Attachment II hereof. This funding will be used as shown in Part I of Attachment II. i. The State's appropriated responsibility (direct contribution excluding any state fees, Medicaid contributions, or any other funds not listed on the Schedule C) as provided in Attachment II, Part II is an amount not to exceed $ 5,125,564 (State General Revenue, State Funds, Other State Funds and Federal Funds listed on the Schedule C). The State's obligation to pay underthis 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 II, Part II is an amount not to exceed $1,762,675 (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 4149 c. Either party may establish service fees as allowed by law to fund activities of the CHD. Where applicable, such fees shall be automatically adjusted to at least the Medicaid fee schedule. d. Either party may increase or decrease funding of this contract during the term hereof by notifying the other party in writing of the amount and purpose for the change in funding. If the State initiates the increase or decrease, the CHD will revise Attachment II and send a copy of the revised pages to the County and the State's Office of Budget and Revenue Management. If the County initiates the increase or decrease, the County shall notify the CHD in writing. The CHD will then revise Attachment II and send a copy of the revised pages to the State's Office of Budget and Revenue Management. e. The name and address of the official payee to whom payments shall be made is: County Health Department Trust Fund Monroe County Health Department 1100 Simonton Street Key West, FL 33040 5. CHD DIRECTOR or ADMINISTRATOR. Both parties agree the director or administrator of the CHD shall be a State employee or under contract with the State and will be under the day-to-day direction of the State's Deputy Secretary for County Health Systems. The director or administrator shall be selected by the State with the concurrence of the County. The director or administrator of the CHD shall ensure that non-categorical sources of funding are used to fulfill public health priorities in the community and the Long-Range Program Plan. 6. ADMINISTRATIVE POLICIES AND PROCEDURES. The parties hereto agree that the following standards should apply in the operation of the CHD: a. The CHD and its personnel shall follow all State policies and procedures, except to the extent permitted for the use of County purchasing procedures as outlined in subparagraph b., below. All CHD employees shall be State or State-contract personnel subject to State personnel laws, rules, and procedures. Employees will report time in the Health Management System compatible format by program component as specified by the State. b. The CHD shall comply with all applicable provisions of federal and state laws and regulations relating to its operation with the exception that the use of County purchasing procedures shall be allowed when it will result in a better price or service and no statewide purchasing contract has been implemented for those goods or services. In such cases, the CHD director or administrator must sign a justification, therefore, and all County purchasing procedures must be followed in their entirety, and such compliance shall be documented. Such justification and compliance documentation shall be maintained by the CHD following the terms of this contract. State procedures must be followed for all leases on facilities not enumerated in Attachment IV. c. The CHD shall maintain books, records, and documents following the Generally Accepted Accounting Principles, as promulgated by the Governmental Accounting Standards Board, and the requirements of federal or state law. These records shall be maintained as 3 4150 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 61 and 6.k., below. Books, records, and documents must be adequate to allow the CHD to comply with the following reporting requirements: i. The revenue and expenditure requirements in the Florida Accounting Information Resource System; and ii. The client registration and services reporting requirements of the minimum data set as specified in the most current version of the Client Information System/Health Management Component Pamphlet; and N. Financial procedures specified in the State's Accounting Procedures Manuals, Accounting memoranda, and Comptroller's memoranda;and iv. The CHD is responsible for assuring that all contracts with service providers include provisions that all subcontracted services be reported to the CHD in a manner consistent with the client registration and service reporting requirements of the minimum data set as specified in the Client Information System/Health Management Component Pamphlet. d. All funds for the CHD shall be deposited in the County Health Department Trust Fund maintained by the state treasurer. These funds shall be accounted for separately from funds deposited for other CHDs and shall be used only for public health purposes in Monroe County. e. That any surplus or deficit funds, including fees or accrued interest, remaining in the County Health Department Trust Fund account at the end of the contract year shall be credited or debited to the State or County, as appropriate, based on the funds contributed by each and the expenditures incurred by each. Expenditures will be charged to the program accounts by State and County based on the ratio of planned expenditures in this contract and funding from all sources is credited to the program accounts by State and County. The equity share of any surplus or deficit funds accruing to the State and County is determined each month and at the contract year-end. Surplus funds may be applied toward the funding requirements of each party in the following year. However, in each such case, all surplus funds, including fees and accrued interest, shall remain in the trust fund until accounted for in a manner that clearly illustrates the amount which has been credited to each party. The planned use of surplus funds shall be reflected in Attachment II, Part I of this contract, with special capital projects explained in Attachment V. f. There shall be no transfer of funds between the three levels of services without a contract amendment unless the CHD director or administrator determines that an emergency exists wherein a time delay would endanger the public's health and the State's Deputy Secretary for County Health Systems have approved the transfer. The State's Deputy Secretary for County Health Systems shall forward written evidence of this approval to the CHID within 30 days after an emergency transfer. 4 4151 g. The CHD may execute subcontracts for services necessary to enable the CHD to carry out the programs specified in this contract. Any such subcontract shall include all aforementioned audit and record-keeping requirements. h. At the request of either party, an audit may be conducted by an independent certified public accountant on the financial records of the CHD, and the results made available to the parties within 180 days after the close of the CHD fiscal year. This audit will follow requirements contained in OMB Circular A-133, as revised, and may be in conjunction with audits performed by the County government. If audit exceptions are found, then the director or administrator of the CHD will prepare a corrective action plan and a copy of that plan and monthly status reports will be furnished to the contract managers for the parties. i. The CHD shall not use or disclose any information concerning a recipient of services except as allowed by federal or state law or policy. j. The CHID 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 CHID 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 CHID 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 CHID shall establish a system through which applicants for services and current clients may present grievances over denial, modification, or termination of services. The CHID will advise applicants of the right to appeal a denial or exclusion from services, of failure to take account of a client's choice of service, and right to a fair hearing to the final governing authority of the CHD. Specific references to existing laws, rules, or program manuals are included in Attachment I of this contract. n. The CHD shall comply with the provisions contained in the Civil Rights Compliance and Non-Discrimination Certificate, hereby incorporated into this contract as Attachment III. o. The CHD shall submit quarterly reports to the County that shall include at least the following: 5 4152 i. The DE3851_1 Contract Management Variance Report and the DE580L1 Analysis of Fund Equities Report; and ii. A written explanation to the County of service variances reflected in the year- end DE3851-1 report if the variance exceeds or falls below 25 percent of the planned expenditure amount for the contract year. However, if the amount of the service-specific variance between actual and planned expenditures does not exceed three percent of the total planned expenditures for the level of service in which the type of service is included, a variance explanation is not required. A copy of the written explanation shall be sent to the State's Office of Budget and Revenue Management. p. The dates for the submission of quarterly reports to the County shall be as follows unless the generation and distribution of reports are delayed due to circumstances beyond the CHD's control: i. March 1, 2025, for the reporting period of October 1, 2024, through December 31, 2024; and ii. June 1, 2025, for the reporting period of October 1, 2024, through March 31, 2025; and N. September 1, 2025, for the reporting period of October 1, 2024 through June 30, 2025; and iv. December 1, 2025, for the reporting period of October 1, 2024 through September 30, 2025. 7. FACILITIES AND EQUIPMENT. The parties mutually agree that: a. CHD facilities shall be provided as specified in Attachment IV to this contract and the County shall own the facilities used by the CHD unless otherwise provided in Attachment IV. b. The County shall ensure adequate fire and casualty insurance coverage for County- owned CHD offices and buildings and all furnishings and equipment in CHD offices through either a self-insurance program or insurance purchased by the County. c. All vehicles will be transferred to the ownership of the County and registered as County vehicles. The County shall ensure insurance coverage for these vehicles is available through either a self-insurance program or insurance purchased by the County. All vehicles will be used solely for CHD operations. Vehicles purchased through the County Health Department Trust Fund shall be sold at fair market value when they are no longer needed by the CHD and the proceeds returned to the County Health Department Trust Fund. 6 4153 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 Christine Hurley Name Name Administrator County Administrator Title Title Monroe County Health Deparment County of Monroe 1100 Simonton Street 1100 Simonton Street Key West, FL 33040 Key West, FL 33040 Address Address Carla.Fry cDflhealth.gov Hurley-Christinee-monroecounty-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. 7 4154 c. Captions. The captions and headings contained in this contract are for the convenience of the parties only and do not in any way modify, amplify, or give additional notice of the provisions hereof. d. Notices. Any notices provided under this contract must be delivered by certified mail, return receipt requested, in person with proof of delivery, or by email to the, email address of the respective party identified i'!n Section 9.b., above. In WITNESS THEREOF, the parties hereto have caused this eight (8) page contract, plus its attachments as referenced, including Attachment I (two pages), Attachment 11 (Part 1 one page; Part 2 four pages; Part 3 two pages), Attachment III (one page), Attachment IV (one page)', and Attachment V (one, page), Attachment VI (four pages), and Addendum I (two pages) to be executed' by their undersigned officials as duly authorized to be retroactive to the 151 day of October 2024. BOARD OF COUNTY COMMISSIONERS STATE OF FLORIDA FOR MONROE COUNTY DEPARTMENT OF HEALTH SIGNED BY: SIGNED BY: NAME: NAME: jgser)h A. Ladapo, M.D. Ph.D, TITLE: I TITLE: .5tgle 5urgegn Ggl3ecal DATE- DATE: ATTESTED TO: SIGNED BY: SIGNED BY: ------------------- NAME: NAME: Qa[lg F[y, Phl).-Ma& R'N TITLE: TITLE: Administrator DATE: DATE: Approved as to legal form & sufficiency-, Eve M. Lewis'D',',1',"',1'0',`,",�eDd4`jy6r'�()`S o mj LcZo'sff Assistant County Attorney 8 4155 ATTACHMENTI MONROE COUNTY HEALTH DEPARTMENT PROGRAM SPECIFIC REPORTING REQUIREMENTS AND PROGRAMS REQUIRING COMPLIANCE WITH THE PROVISIONS OF SPECIFICMANUALS Some health services must comply with specific program and reporting requirements in addition to the Personal Health Coding Pamphlet(DHP 50-20),Environmental Health Coding Pamphlet(DHP 50-21)and FLAIR requirements because of federal or state law,regulation or rule. If a county health department Is funded to provide one of these services,it must comply with the special reporting requirements for that service.The services and the reporting requirements are listed below: Service Requirement 1. Sexually Transmitted Disease Program Requirements as specified in F.A.C.6413-3,F.S.381 and F.S.384. 2. Dental Health Periodic financial and programmatic reports as specified by the program office. 3. Special Supplemental Nutrition Service documentation and monthly financial reports as specified in Program for Women,Infants and DHM 150-24'and all federal,state and county requirements detailed Children(including the WIC in program manuals and published procedures. Breastfeeding Peer Counseling Program) 4. Healthy Start/Improved Pregnancy Requirements as specified in the 2007 Healthy Start Standards and Outcome Guidelines and as specified by the Healthy Start Coalitions in contract with each county health department. 5. Family Planning Requirements as specified in Public Law 91-572,42 U.S.C.300,et seq.,42 CFR part 59,subpart A,45 CFR parts 74&92,2 CFR 215 (OMB Circular A-1 10)OMB Circular A-102, F.S.381,0051, F.A.C. 64F-7, F.A.C.64F-16,and F.A.C.64F-19.Requirements and Guidance as specified in the Program Requirements for Title X Funded Family Planning Projects(Title X Requirements)(2014)and the Providing Quality Family Planning Services(QFP): Recommendations of CDC and the U.S.Office of Population Affairs published on the Office of Population Affairs website. Programmatic annual reports as specified by the program office as specified in the annual programmatic Scope of Work for Family Planning and Matemal Child Health Services,including the Family Planning Annual Report(FPAR),and other minimum guidelines as specified by the Policy Web Technical Assistance Guidelines. 6. Immunization Periodic reports as specified by the department pertaining to immunization levels in kindergarten and/or seventh grade pursuant to instructions contained in the Immunization Guidelines-Florida Schools,Childcare Facilities and Family Daycare Homes(DH Form 150-615)and Rule 64D-3.046,F.A.C. In addition,periodic reports as specified by the department pertaining to the surveillancernvestigation of reportable vaccine-preventable diseases,adverse events,vaccine accountability,and assessment of immunization 9 Attachment I-Page 2 of 2 4156 ATTACHMENT I(Continued) levels as documented in Florida SHOTS and supported by CHD Guidebook policies and technical assistance guidance. 7. Environmental Health Requirements as specified in Environmental Health Programs Manual 150-4*and DHP 50-21' S. HIV/AIDS Program Requirements as specified in F.S.384.25 and F.A.C.6413-3.030 and 64D-3.031.Case reporting should be on Adult HIV/AIDS Confidential Case Report CDC Form DH2139 and Pediatric HIV/AIDS Confidential Case Report CDC Form DH2140. Requirements as specified in F.A.C.64D-2 and 64D-3,F.S. 381 and F.S.384.Socio-demographic and risk data on persons tested for HIV in-CHD clinics should be reported on Lab Request DH Form 1628 in accordance with the Forms Instruction Guide.Requirements for the HIV/AIDS Patient Care programs are found in the Patient Care Contract Administrative Guidelines. 9. School Health Services Requirements as specified in the Florida School Health Administrative Guidelines(May 2012). Requirements as specified in F.S.381.0056, F.S.381.0057,F.S.402.3026 and F.A.C.64F-6. 10. Tuberculosis Tuberculosis Program Requirements as specified in F.A.C.64D-3 and F.S.392. 11. General Communicable Disease Carry out surveillance for reportable communicable and other acute Control diseases,detect outbreaks,respond to individual cases of reportable diseases, investigate outbreaks, and carry out communication and quality assurance functions,as specified in F.A.C.64D-3,F.S.381, F.S.384 and the CHD Epidemiology Guide to Surveillance and Investigations. 12. Refugee Health Program Programmatic and financial requirements as specified bythe program office. .or the subsequent replacement if adopted during the contract period. 10 Attachment I-Page 2 of 2 4157 co p _ � \ / o $ ) Q / @ S � q { a k § k �® 0 @ K § 2 § tea m tn 0 2 0 Q © m 0 ■ Qkin LU k � � ` z 2 � (D j wA � m e z k m _ LL $ ■ � � k k ■ z a w © a0 q c m w �CL fna _ 0 « 2 I k z w f � w o o ' o LL a ■ z uiT k 3 = / f « � � _ 0 § 0 0 w k z § � a % § # § k § \2 a § 22 CD � § >1C 2 S k 3 % § k f § 2 2R 22 S ke - »� / § $ kE @ a 2CL CL 0 3 e � A CO 2U) (a w £ R E R R e 2 L) a. 4 2 N (D L JM kk @B CL 2 � 2 - ) w / kC \ d 8 � a 2 § k kk kk 0 00 no w0 k w w w ¥ m ATTACHMENT II MONROE COUNTY HEALTH DEPARTMENT Part II,Sources of Contributions to County Health Department October L,2024 to September 130,2025 State ClID County Total CHD "Trust Fund CHD Trust Fund Other (cash) Trust Fund (cash) Contribution Total I.GENERAL,REVENUE-STATE 015040 AIDS IlkEVENTION&SURVI'JLL,^NCE-GENERAL,RFVI^:NUE 78,:'i5,2 0 78,552 0 015040 CHD-'I'll C.OMMONITY PIZOC➢RAM 4:3,7137 0 4i1.787 0 4 3,7S7 015040 SE'Y.LDAI,I,Y'1"F ANI-,MI"1'1'"1:1)IP SEASE if7t;11'd'I`WII,11110 MM GII, 16,7155 0 16,755 Il 19;.7519 W5040 DENTAL SPECIAL INITIATIVE F H0,1ECTS 6.3(M 0 6.303 1) 015040 (TKNERAL HEVENUE 79,03f7 0 79.0315 0 71).O IF, 015040 P.-M iIL,Y ITANNING,GENERAk I'CL',VI:NLTE 82.292 0 82 292 0 82 292 015040 I1H,,1�'ATITIS AND LIVER I"AII.L11 E PREVENTION&CONT1101, 72,000 0 72,000 0 72,000 015040 I'OMARY C'ARk�TIROCIHAM 204,786 0 204,786 0 264,786 M5040 RACIAL& I'a"I"I{rtilC"I91SF".'uIdI1'IF•;5^CHI)EX LNSKS 52.000 0 52.000 0 52,000 0150,10 SCIE JOL Ill"ALTII";EHV1C ES 96,223 0 96,223 0 96.223 01,6040 SWIMMING L,Er;SSONS'VOUCHEP ITOf11I,AM 6+400 0 6.400 17 6.400 015050 CHI)1")L,+11w.I'd,.h1..14EN:N4.!I^;NCS'N-CAsB"LSfMWA.1.. 1,7162.7f;1 0 1.732.761 0 L732.761. GENIMAL REVENUE TOTAL 2,170,S94 0 2,470,894 0 2,470,S91 2.NON GENERAL REVENUE-STATE 015010 ENVIRONMENTAL BIOMEDICAL ASTFE I'ItCICRAM 1„9175 0 3,975 0 3,975 015010TOB:ICC,C)STATE AND COMMUNITY INTEIiVENTIONS 1157,832 0 167.832 0 167-832 NON GENERAL.REVENUE TOTAL, 1.71,807 0 171,807 l) 171,807 3.FEDERAL FUNDS•STATE 007000 AIDS DRLIC ASSISTANCE PROGRAM ADMIN IIQ 45 993 0 45,9993 0 15,9913 007000 WIC IMEIASTPI E DINf f'Is'1^;E2 COUNSEIANI.I PROC 84L998 0 84,998 0 84,9998 007000 COASTAL 1,EACH WATER QUALITY MONIT011ING 16,432 0 16AS2 0 16,482 007000 COMI'RLIII-:NSIVE C'L)MMLINI'l,'Y CARDW• 111BG 35.000 0 35,000 0 135,000 007000 EL.C)COVID 1?.:NHANC"13';;I')D1,f FrriON EXPANSION GRANT 2.100 0 2,100 0 2.100 007000 FAMILY I'L,ANNING TITLE X-C,RANT 82,9613 0 132,91(113 0 82,963 007000 PUBLIC lILTH INERASTRUC TU &lV0RIC1•°OIl('EXFN'I"LtAL 1 128,1961 0 128,196 0 12S,196 007000 1IOLJSINf1 OPPOR'I'I1'NI'I'LE^as FOPPFR IONS WITH AIDS 542,743 0 512.7 93 0 542.743 007000 IMMUNIZATION tL VACCINES C111LDREN Cf)V'ID 19 IZESPON 47,6413 0 47,6'1:3 0 47.643 00700C) INFANT Mt11t'L'AL11'Y 11,:319 0 11.31",a 0 11,:319 6117000 IMMUNIZATION AC"'MON PLAN 59.7-10 0 91,"1 1v 0 59,740 007000 MATIPRNALMORTAL,ITY 11.319 0 1,:3119 0 11,31.19 00700C) BASE COMMUNITY 1'EdFPAREDNESS C"APABILIT'Y 93,390 0 !M'390 0 93,390 007000 AIDS PRI^.VENTION I161,0561 0 116,056 0 1111.056 (107000 ICYAN WHITE^.TITLE'Il C"ARh GRANT 195,1.17 0 195,1.17 0 1195,117 007000 )h'IC',IIHf)(,ItAMe1➢),IINISTItAI'IC.:YN 533,56i9 0 0 533,569 015075 SC'IR)OL E11.AI TH SERVICES 12:3,839 0 123.9,398 0 12.3,S 39 01:5075 R1:1''I(d1:1',IIEA1All SCREENING RI^1ItIBLJ1fhI1 fk.Tti7 \6)11[PS 64,FilM 0 611,1563 0 64.563 015075 REFI.IC;I*,E,HEALTH S(',REENING Itl'.IIw113L.111tiI,ME:N'I'SI^;3tVIC1'dti 1367,64)7 0 367,607 0 367,607 018005 RYAN W HITE TIT1,E' If ADAP DI UG REBATES 5:3,629 0 53,62E9 0 53,1I291 FEDERAL FUNDS TOTAL, 2.616,266 0 2,616,266 0 2,616.266 4.FEES ASSESSED BY STATE OR FEDERAL RULES-STATE 12. AtlaOL nu,r t 11 Part II-Page 1 of 4 4159 A'T"TT'ACM'ENT 11 MONROE COUNTY HEALTH DEPARTMENT Part II,Sources of Contributions to County Health Department October 1:,2024 to September 30,2023 State CHD County Total CHD Trust Fund : CHD Trust Fund Other (cash) Trust Fund (cash) Contribution Total NN01020 C"111D STATEWIDE ENVIRONMENTAL FEA,,S 145,535 0 1 4,r,53 i 0 145,535 0010112 ON SITESEWAGE DISPOSAL I11?IW'I'I°711lS 11,896 0 11.°896 0 11,896 (10)092 CIJD STATEWIDE ENVIRONMENTAL LEES 4,600 0 4,600 1D 1 600 001206 ON SITE SEWAGE:1)ISPOSA1,14R1411T E*EEaE 1,039 0 1,wo) 1) 1,039 001206 SANITATION C.ER'1'IEE('ATE S,(FOOD INSPECTION) 2,300 0 2,300 t] 2,M0 001206 SETTIC TANK RESEARCH SI.DICCHA`RG''I 55 0 00'1206 1111BIAC1 hWINIMING 11001,PERMIT I I°; 01X 1B)TRANSPIlIt 12,048 E',) 12,0,18 0 12,0,13 WI,206 REC,LiI.,TION OE BODY PIERCING SALONS 75 0 711' 0 75 001,206 TANNING FACILITIES 15 0 15 0 15 001206 TATTO PROGRAM KNVIRONNUlNTAL HEALTH %12 1m 912 C) WU 001206 MOBILE HOME&RV PARK 1'I,,ES 2,043 0 2,0413 0 2.043 FEES ASSESSED BY STATE OIL I EDERA.L RULES TOTAL. 1811,538 0 180,538 p o 80,538 Ca,OTHER CASH CONTRIBUTIONS.STA'IT,: 0:31005 C'EN ERA 1,11,ENIG,RA III[-.S SE,RV I('ES&DRUC> IIt.T11CIiA+1,,,S 21,058 0 21,058 0 21°I158 090001 DRAW DOWN E^"IIOM PUBLIC"I EAI,TII UNIT 11.937 0 11.93-1 O 11,937 OTHER CASH CONTRIBUTION TOTAL 32.990 0 32,995 12,$N,5 6.MEDICAID-STATE/COUNTY; 001057 C'11L1 C,'I,INIC',FEES 0 11,197 11.197 1,) 11.1,97 11¢)1057 6t,NE 1RA1,C'I:,ENIC RABIES SERVICES ES DRUG, PURC IIASES 0 163 I6;3 0 163 001148 t'11ID C LINW IlEES D 57,,109 C,7,409 0 57,409 MEDICAID TOTAL 0 68,769 68,769 0 68769 7.ALLOCABLE REVENUE-STATE,: WIWI (.'III)S'CA°I"1^'WII)I'I;N'VIIIONNII°: IAI,Pl,',]^'S 500 0 500 0 500 0OW09 C'111)CLINIC"1PLES 26, 0 2,5 0 25 014000 C III)CLINW FEES 20 0 20 0 20 ALLOCABLE REVENUE TOTAL 545 0 545 0 5,15 8.OTHER STATE CONTRIBUTIONS NOT IN CHU TRUST FUND•STATE AI)AP 0 0 0 161,595 161,595 PHARMACY DRUG PROGRAM C) 0 0 12,0(m9 I:S.0N WIC PROGRAM 0 0 N 1,381,009 1'38N 009 1311REa:AU OF]PUBLIC 11EALT11 LARORATORIE?L C) 0 0 8,023 8,023 IMMUNI:4ATiONS 0 0 0 10 r 5,929 1,095,929 OTHER STATE CONTRIBUTIONS TOTAL 0 0 0 2,658,565 2.65 )6 5 9.DIRECT LOCAL CONTRIBUTIONS-BCCITA.X DISTRICT 008005 C111)1,OCIA1,111?VENUP,&EXPENI)ITIMES' 0 1,205,I1'19 1,A11)5,319 C) 1,.05,119 008005ININIUNI7,ATION C'eYu1PAI41N NIONROE COUNTY BOCC 0 557,356 557,356 0 5,57.3.W, DIRECT COUNTY CONTRIBUTIONS TOTAL [N 1,762,675 ➢ 762,675 0 1,762,07a 10.EEES AUTHORIZED'BY COUNTY ORDINANCE OR RESOLUTION-COUNTY 001025('111)CLINIC'FEES 0 1,000 1,000 0 1.000 13 Attarlon'I••ent.h Bast I3-Parr:2 or 4 4160 ATTACHMENT 11 MONROE COUNTS"HEALTH DEPARTMENT Part 11,Sources of Contributions to County Health Department October 1,2024 to,September 30,2025 State CHD County "Total CHD Trust Fund CHD Trust Lund Other (caab) Trust Fund (cash) Contribution Total 001077 CIII)CI INIC FEES 0 2€,.522 8-522 2S,522. 001077 GENERA1,C1L1NIC RABIKS SER\.CES&L)M7G 11IIR('HA:°ES 0 998 99.1� 0 nrlrs 001094 ('111) 0 '158,650 ➢58651' tit V58,G50 001110 VITAL,STATISTICS C F',R'l'➢FJED RECORDS 0 5€10M 56,000 al 56j)(10 FEES AUTHORIZED BY COUNTY TOTAL.. .^.t ,1'i`0 ➢°).1'7t1 0 z s.),1'7C1 11.OTHER CASH AND LOCAL CONTRIBUTIONS•COUNTY 001020 CHD CLINIC FEES 0 70,790 70,7I)C➢ 0 70,700 001.02,9 G.EN ERA,1,CLINIC,RABI1^"S SEIMC FS&lDRIX;PIJRCIIA.SES Cl 1.,063 1.063 0 1.,061 001029 C"tiRANT 3-101f1 I11;VEN'UE,AND EX I.NSI TRACKING 0 297.000 297,000 0 297,000 001090 CHD CLINIC"FEE?S 0 22,329 22,329 0 12,3253 IMOIlld:91) GENLRALC:LINIC RABIESSERV'ICES&DRIJG PURC,9-IASES 0 104 NA 0 104 005000 (AID CLINIC I^F'E'S 0 50 50 0 50 IDl)V1.➢M CIII)CLINIC FFPES CE r;; 181,965 0 81,!t.'r 007010 ItYAi1 III•17lltl^)C'l"TO CHD 0 396,1.39 0 3%,639 OLO 00 CHD SALE P)1 S1;1d11C'l; IN OR OUTSIDE C)E>STATE,GOVT a 92,G.r,7 I1:.657 0 92J;57 011001 C"lil)HEALTHY START f,FOA[,1't"TON CONTRACT 0 360.000 '6(000 0 360,000 090002 DRAW DOWN hli(M PUBLIC;HEALTH UNIT 0 315,537 315,53 7 :i15..")Xi OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL 0 1,738,134 L738.134 0 1,738 134 M ALLOCABLE REVENUE,.COUNTY 001004 C IID STATEWIDE ENVIRONNIFN]'AL FEFN 0 500 500 0 500 001000 C II D CLINIC I`EES 1 2r"c 25 0 5 013000 CHD Cl INIC I°`9I;ES 0 20 20 0 20 COUNTY ALLOCABLE REVENUE TOTAL 0 545 0 545 13,BUILDINGS-COUNTY ANNUAL RI,,NTAI,EQUIVALENT VALUE 0 CI 0 5))7,605 597,605 OTHER(Specify) 0 0 0 0 0 UTILITIE'S 0 0 I;) 83 1C'i3 83,369 BUILDING NIAIN'1'1,',NAN(,E 0 0 0 15.223 75.223 (',ROUND;;MAINTENANCE 0 0 0 ➢1 z,Ia6(i 115.566 INSI.JIIANC;E 0 C) 0 0 1) OI'lEIt(tii,rvcify) 0 0 0 ) 0 OTIIEIi(Spvcil"y) 0 0 0 0 0 BUILDINGS TOTAL, 0 0 0 871,7(i:3 871.7wt 14.OTHER COUNTY CONTRIBUTIONS NOT IN CHD TRUST FUND COUNTY F7QUIl'NlENT 1 VEIIIC1LE,PUld(;;HASES 0 0 0 0 0 Vf,111C'LE'INSIIRANC'F, 0 0 0 0 0 VEHIC I,E,NIAl*TF' NANCIa, 0 &) 0 0 0 OTFIE tODUNTY CONTIUBUTION(SPECIFY) 0 1) 0 0 0 OTHER COUNTY CON'I'R111WHON(SPECIFY) 0 1) 0 0 0 OTHER COUNTY CONTRIBUTIONS TOTAL 0 0 0 0 0 14 A1ladvient 11 Part II-Page 2 of 4 4161 ATTACHMENT II MONROE COUNTY HEALTH DEPARTMENT Dart 11,Sources of CoutAbutiona to County Health Department October 1,,2024 to September 30,2025 State CH D County Total Cf-D Trust Fund CH D Truest Fund Other (cash) Trust Fund (cash) Contributiou Total GRAND 1"d'6`:NL CHL1PTt'.C)G.RANf 5"17,3,015 :3.81.5,e393 7,W1�k±„3::E�1� :1,,,30,3"8 12.818,661; 15 A1tadirm«aw H Pail YI-Page 1 of 4162 MC1NROE COUNTY HEALTH DEPARTMENT Part Ifq',Planned Staffing.Clients,Services and Expenditures By Program Service Area Within Each level of Service October 1,2024 to September 30,2026 Quarterly Expenditure Plan FTE's Clients Services/ lot 2nd 3rd 4th Grand (0,00) units Visits (Whole dollars only) State County Total A.COMMUNICARIX DISEASE CONTR= INTNIl.PNI'/.l\'1ION(It11.) iFi�`i :4,k;,`if'v 0,4al 270,728 232,067 270,72.H 235,903 9'?7,441 H,HIY.t)f3o 4.IIIIJ.-1;:d> 13EXUALLY"INANE; 1AS.$I(W 244 117 20,1 "'SL527 67,:313 78,52, 3;8,424 1.3;.755 2713.036 5)2.791 H3Vt<A,IDS PREVENTION(wA3) 2.59 0 12 69,295 I.P,29,'x Ni31,:3kt3 .5'�h,;3733 (3 rW::',70 I1PJ9,AIDS ESURVEILI.,ANCE,30:3A2) I)W 0 0 0 0 0 0 0 0 0 I13VrAIDS E A'13T1h3"3"CA131'.3t3:,3A:fn H4 t38 U0 1.163 129.7k3 :361,123 124.783 387(3.141 "e 4YI r199 ,WAP(03A4I 1.233 0 0 29.CW8 24.917 29.068 25,330 106.383 ip I0H.3H;3' 'I'll IFTWITLOSIS E 04) 1 At; .1':1 .1813 14,882 38,472 4-t S82 30,10S 4:3,7H7 123,557 167,344 CON"""D'SL.S'ljkV,(fl33fi) 1 86 0 L601 621.0,33 53.175 62.033 5.1,05.4 0 !U3 297, HI'J'ATIns; 1031) O,59 M1 91 22,401 16.345 21,401 1N,6.17 72.000 7.794 9,7!14 1 I I'A1,V(F,I)N KISS AN 1)R Ei:S'➢''I)N SE(I 1(0 3.1a"1 0 0 97.m.i H3.1GO ',37.014 84.,536 361,724 1) HKIF'TJCLC FIIGAIXII(318) 0.112 ,j�:17 h,4334 288,802 247,5633 2SS,802 251,6,0 1,076,815 0 1.0 6,41,5 VITAL RECORDS 080) 1.2,:3 1,690 4.1319 "27,4'79 23,5,55 2,7,479 .3,943 31 102,456 Ip„4,-'A; CCIMMUNTCAL7TEDISEASE SUBTOTAL 10,:35 8r198 21.6,18 3.414.012 E..EB2.3386 314,012 32.4118 3,OS9,019 2„183,�69 3,772,228 B.PRIMARY CARE: CHRONIC Il3P;h,.AS1.PRETV3G;N"RON PRO(230) 1 310 1,40 r,59 +31.507 27.008 11,007 ,a7,.4:54 117,476 0 117,476 WIC(21%V3) 6.42 l!N1 14 760 59, ll43 136,994 159,816 1;19,259 95,,88, 4) 0."0.88 5 TOBACCO USE;INTERVENTION(212) 2.30 0 1) 63.487 fi4.421 OAK 5,321 236,716 0 2.36„7'16 WIC BR1..'STFEE'DIM;I'F:F,Nt L(011'v+Fl.ENG("2E.W2) 131 0 1.Lj,r1 27.2k'37 234'W 27.2H7 73.778 101,742 V7 IOL.7,12 FA,%IILY PLANMNG(223) 1:3!3 802 1,876 1,i i,878 121,117 141,878 12.3,626 1ii15.217,5 363,74 1 ,'"H,999 IMPROVED PE I,"(;NANCY OM'CONIE(225) 0.08 0 13...'54 ,,.r:>1ri 6.1i511 5.712 24A38 3a 24.13S HEAL,1f)'ST,AIL"P PRENATA'I..,(227) 2.,51 517 1..S61 60,598 51.6 I'l 60.15H3H 52.803 0 212 i 913 5.9-13 COMPREHE7N',SI'VE CHILD IELALT11 U29) O.CIi 0 2EI3 231 2'1:3 256 0 1..093 1.,093 1IEAI,XII1';3'1%HTCIIILD12;31) 2.54 650 2.161. 56.14;I!) .9H,722 ,,a,,k3,'IS! 19,)28 0 21,1.92 111.92S f^b('.H45G'll,HF:rli,.'7"l4 32:3,0 2.:31 0 27'1,979 70„t3178 3�0,rv23 70,606 61,52:2 263,2", 0 263.257 (7C)Ml'&IE.kIE:NtiIY''I^'Ad81J (2:37) L81 282 H26 118,782 101,819 IIH,782. ,0.3,802 20i.7M6 238.099 112.885 3"trP,BTUNITY IIF,.%I,Tli DFV➢.I,uP',IE NI`("l:ar,) 6.57 0 3AI0 166.951 44:3,110 166,91,1 i45,4-It ";0.2t1 162.2,52 6.2.VrC 11F:NTAl,IIFFAIXlf I240) 0.02 0 0 22A07 19,207 22,40 10.526 6.303 77.'211 S3.";.17 PRIMARY CARE SUBTC)T4A., 298.893 927,00, 7!11,62-1 27,0(r5 S07,761 2.376.(.13 1,280,:M: 1 A3.395 C;. ENVIRONMENTAL IIF.,AI TH: Water and Onsito Sewage Progroma CO3S1°AL Ll:.1(Al'dONITORI. G0,M 0 2 :d133 216 M.39 6.A62. 7,530 6.56,9 1.6.4934 8.1.61.1 2)41.O"i I,I WITS)USE PUI'flAC AA'6ATF.It SY`tiTI{,YIS(:3Ei7) 0 00 0 0 0 0 0 0 I't 1T31..3 C'Ai'ATI-I'l4 S)S'ENI(:35K) 0,0u 0 3:1 0 C7 0 0 0 0 F9 PHIVATF WATER SYS.TENI(:35!0 11 on 1l n 0 0 0 a 0 0 0 i1Nti1'E"I:SI,W;ACEFi'I1Ch3rA°3"H13^:N'3'&ixis]'OS,AL(363) 0.51 190 92 12,Cf 1 10.656 12..131 10.633 11.g32 13 1A19 Ih6.J,;1 Clroep Total 0"313 406 JUN ➢31.97o t711: 139.970 17,,102 Jh,M1'3ua 46.030 71.333b Facility Programo 'I'A4"ro o FACILITY S1CRVICES(3.14) 0.`6 I:3A 41 5,923 5,077 5,923 5.100 10.oI8 1.2.065 2,2s083 16 A33a,hrn,an3 n Par31H-r.ago r of 4163 ATTACHMENT 11 1'f1f1NROE COUNTY HEALTH DEPARTMENT Pert 1U,Planted Staffmg,Clients,Services and Expenditures By Program Service Area Within Each Level,of Service October T,2024 to September 30,2025 Quarterly Expenditure Pfau F'TS's Clients Services/ let tad 3rd 4th Grand (6,I0) Units Visits (Whole dollars only) State County Total H^'tl(;1D Hl1,IENF(s4R) 2 46 10S :'CIS 10,4114 F 1.429 10"116 9,077 21,01132 17 AiW :Is,s 3s BODY EIEWIN£;I FACILITIES SI:RVII"I:S1340) 0,08 13 27 1,717 3°4TA 1,717 1,1!15 7w, 5"696 1;"401 £mROM,CARE FACILITY f350 01:1 81i 101 ;3,146 2.69f' 3,1116 2"741 ➢£1 11,.719 11"729 M11 R ANT LABOR CAMP(„1.52) 0.00 ➢7 0 £) 0 0 0 0 0 0 HCYUS]N(,,t;.PUB.III 1')('I.(353) 0,00 0 4'1 0 0 0 r'1 0 0 0 MG')1tILE,l1OME ANTI)PARK(73,`14) 0.4; 31.4 ;:C1y 10"6i2 9,1'nS 10,642 9,2r2 II1,532 21,I,➢, :9J;78 110I)L,ti/'I3,AT11TN(; (oio) 1,13 761 1.7 S 4a.9 0 -1 L926 IS 9111 112,fiI9 S9,:°22 9 3,01tg 142.:W"', 11,10lI;DIi1A1,,WASTE SI;R:VICE:S(:31i^i.Y 11.39 137 283 8.771 7.Cill,h S.77V 7.1143 14,702 ISJOI1. 32,703 T,ANNINI,I'ACll,l I'Y SI^=RA'ICI,ti(141Y0 O.l)1 I I F19 222 259 227 136 831 967 Group Teal 1.,92 I.°SSO 2.S➢0 K),781 713.!1@;(;' 833.78.,1 7H.234 ➢",I,"1s7 IS0,307 .334,761 Groundwater Conwnl:unfinn S`Y OUAI E TANI{C{!MI'IAIANL,1.SC:Ii,A'HI 1°S(i,355) 0,00 0 0 0 0 0 0 1') 0 0 tiUPI�R ACT SERVII I S t'i 0 01W 0 ¢➢ rl N1 0 n 11 0 0 Group Total 0.00 0 1') 0 0 E3 II 0 0 0 Community Hygiene COMM'UNETYENVIII.HEALTH(315) 0.05 0 0 1,170 1,003 1,170 'I"019 1 1.358 1„362 INJURY PREVEN"PI4Ytti 131(,) 0.011 0 1",16 lA71 1.716 3.-197 6,400 0 6,41R4➢ 1.4:.A.I)MONITORM.",41?I'tVICE°.S l3 0) 0.00 0 0 1) 0 0 0 0 0 0 PUBLIC SEWAGE(a02) 0 00 0 0 0 0 0 0 0 0 0 SOLID WASTE DIS OSAL SERVICE):3£i;SE Y3.02 0 0 406 34S 40I1 355 1 1.,51 1, 1.51r, SANJTARY NUISANCE(365) 0.02 7 11 4,M; 848 406 355 1 1,511 1,515 RAI31I^;1,SiURVEIId,ANI1;(3,66) 001 0 0 2,00 171 200 174 0 745 715 .A1030I'MHUS SUHVI]1,"Wi73 0 00 0 rl 11 0 0 0 0 0 ROI7L;N°G'i,AR'I'kIIdQ:J]'d)II CONTROL(368) 0.00 0 0 0 f'1 0 0 1;1 1'1 0 WATER POLLUTION(470) 0.00 0 0 0 0 0 0 11 0 0 INI30£:111 Alit(371) ll..01 0 0 259 22'2 259 227 1 966 13E67 RADIOLOGICAL H1^EM.,ni(372) ().1n.1 0 0 0 0 0 0 0 13 0 TK}NIC.S1,111STe>..NCA,".S(37;0 1,12 587 r,87 I1J43 2C.t9i� :91,1,13 27,1:37 93 I1fi O; 116,119 Group Total 1.1 3 094 598 ;1,1,300 ::St3.:1!i',I 35 300 10.764 6,500 125,123 131.623 ENVIRINMENTAI,H CALM SUBTOTAL 7,IN 2.8I0 3. 113 145,054 124.339 I45.054 126400 4£10 1M9,:31<" 351,1101 540,847 D.NON-OPERATIONAL COST& NON-OPERATIONAL COSTS QS*31'1) 0..00 0 0 0 0 0 0 0 11 (Y ENVIRONhIENTAL HIT.ALTH SURCHARGE V.4013) MOO 0 0 5,ow 4,:338 5"06U 4+M) 18.15(17 :14;1 IS"tsas MMIC'NIC1 BUY11,V l'C(in D 0,00 D 0 11 0 0 0 p ft 0 NON-OPERATIONAL COSTS SUBTOTAL 0.00 0 0 5,060 1 33S 5,000 1.410 113,11-10-1 361 111^86S TOTAL CONTRACT 81.11:3 17,1)1,2 332 i.217 °2,41I1,131 2,135;387 2,491,1:31 2,170,6,49 5,17"E,015 3.815.293 9,288.3:38 17 iA1iach—wt 11 1'+1r'E III-Page 4 al 2 4164 ATTACHMENT III TRAINING COUNTY HEALTH DEPARTMENT CIVIL RIGHTS COMPLIANCE AND NON-DISCRIMINATION CERTIFICATE 1. The CHD agrees to complete the Civil Rights Compliance Questionnaire, DH Forms 946 A and B(or the subsequent replacement if adopted during the contract period),if so requested by the Department. 2. The CHD assures that it will comply with the Omnibus Budget Reconciliation Act of 1981,P.L.97-35, which prohibits discrimination on the basis of sex and religion in programs and activities receiving or benefiting from federal financial assistance. 3. Assurance of Civil Rights Compliance:The CHD hereby agrees that it will comply with Title VI of the Civil Rights Act of 1964(42 U.S.C.2000d et seq.);Title IX of the Education Amendments of 1972(20 U.S.C.1681 at seq.);Section 504 of the Rehabilitation Act of 1973(29 U.S.C.794);the Age Discrimination Act of 1975(42 U.S.C.6101 et seq.);Title II and Title III of the Americans with Disabilities Act(ADA)of 1990,as amended by the ADA Amendment Act of 2008(42 U.S.C.12131-12189)and as implemented by Department of Justice regulations at 28 CFR Parts 35 and 36; Executive Order 13166, "Improving Access to Services for Persons with Limited English Proficiency"(August 11,2000);all provisions required by the implementing regulations of the U.S.Department of Agriculture(7 CFR Part 15 at seq.);and FNS directives and guidelines to the effect that no person shall,on the ground of race, color,national origin,age,sex,or disability,be excluded from participation in,be denied the benefits of, or otherwise be subjected to discrimination under any program or activity for which the agency receives Federal financial assistance from FNS;and hereby gives assurance that it will immediately take measures necessary to effectuate this agreement. By providing this assurance,the CHD agrees to compile data,maintain records and submit records and reports as required to permit effective enforcement of the nondiscrimination laws,and to permit Department personnel during normal working hours to review and copy such records,books and accounts,access such facilities,and interview such personnel as needed to ascertain compliance with the non-discrimination laws. If there are any violations of this assurance,the Department of Agriculture shall have the right to seek judicial enforcement of this assurance. This assurance is given in consideration of and for the purpose of obtaining any and all Federal financial assistance,grants,and loans of Federal funds,reimbursable expenditures,grant or donation of Federal property and interest in property,the detail of Federal personnel,the sale and lease of,and the permission to use Federal property or interest in such property or the furnishing of services without consideration or at a nominal consideration,or at a consideration that is reduced for the purpose of assisting the recipient,or in recognition of the public interest to be served by such sale,lease,or furnishing of services to the recipient,or any improvements made with Federal financial assistance extended to the Program applicant by USDA.This includes any Federal agreement,arrangement,or other contract that has as one of its purposes the provision of cash assistance for the purchase of food, and cash assistance for purchase or rental of food service equipment or any other financial assistance extended in reliance on the representations and agreements made in this assurance. This assurance is binding on the CHD,its successors,transferees,and assignees as long as it receives or retains possession of any assistance from the Department. The person or persons whose signatures appear below are authorized to sign this assurance on the behalf of the CHD. 4. Confidentiality of Data,Files,and Records:The CHD agrees to restrict the use and disclosure of confidential USDA,Women,Infant,and Children(WIC)applicant and participant information as specified in 7 CFR§246.26(d)(1)(i)in accordance with 7 CFR§246.26(d)(1)(ii),as applicable. 18 Attachment III-Page 1 of 1 4165 � � _ 0 / k 2 0 > © o f s Go cq - E J ( j k w / B � � 2 to © N L . CD _ a e � m o e k k k § k f f ƒ k ; 2 k 2 0 U § k k r ® § � 0 0 \ 2 § f - f \ k 0 0 0 2 � a c o , r. c C Q § ■CL § B { § 2 2 2 ± 2 Im 0 £ § k C I k © c § § ■ © � k j ~ ' z R E a > 2 » too c _ § © t m 2 o \ % k / C « k to ■ � , @ C o � ng cx $2 a k ® ® § $ � 2 � 2$ ■ /_ ■ § 0e i 2 § � � ) )_ � u '_ ' � _ 22 � � � _ k ® � � 2 2 � 2 � c �� 2 @ � - 2 �� 22 9E 2 § . 02 § § � } :5 PE f 0 �£ 2 i O � z k 2$ \ � § � kr } 0 . � 2 e e °k ex % J 8 A ° e R % k 2 � m � � � o §h $ I p / \ \ � } k ) kIS co E 2 » m $ v § \ \ / i ) { m / k ATTACHMENT V MONROE COUNTY HEALTH DEPARTMENT SPECIAL PROJECTS SAVINGS PLAN CASH RESERVED OR ANTICIPATED TO BE RESERVED FOR PROJECTS CONTRACT YEAR STATE COUNTY TOTAL 2023-2024' $ 0 $ 0 $ 0 2024-2025'• $ 0 $ 0 $ 0 2025-2026"• $ 0 $ 0 $ 0 2026-2027••' $ 0 $ 0 $ 0 PROJECTTOTAL $ 0 $ 0 $ 0 SPECIAL PROJECTS CONSTRUCTIONIRENOVATION 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 orfunds) COMPLETION DATE: DESIGN FEES: $ 0 CONSTRUCTION COSTS: $ 0 FURNITURE/EOUIPMENT: $ 0 TOTAL PROJECT COST: $ 0 COST PER SQ FOOT: $ 0 Special Capital Projects are new construction or renovation projects and new furniture or equipment associated with these projects and mobile health vans. Cash balance as of 9130/24 Cash to be transferred to FCO account. "•Cash anticipated for future contract years. 20 Attachment V-Page 1 of 1 4167 00 (D T- dq d. e w- = o o O o O o 0 0 0 0 0 0 o O O o O O p � O O O O O O O O O O O O O O O O O C r. C M O O v1 O� 4 O O N vi �D M d' 00 O� O O+ O G O. O, n N 'T N O O 7 — O� y O n N O+ — r% O — M rl M M 00 h N 00 N 00 Q� V fA 69 en �O N V' M ^ v'] T �y 69 69 69 69 69 69 69 v1 69 on 69 69 on 69 69 69 61 V1 w M v'1 M 'R In en In � wl a f� U U N N N N N N N� (� ? 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U CL a m N N N N N " N N M O O O O O O O O O O O O C, eq� O Q .O O O � kc � � > > 10 � � M y �c �c �c �c �c �o �o �c �o �c �o %D "C Q N 01 > O C " N N N N N N N N N N !�V N � •Q� O p N ` O C o 0 0 0 0 0 0 0 0 0 o CD ay � O\ ,� 0 N ch U a U W ° a as a o ¢ U z z 1104 w U j .a CC P. O a dd zgppw a o d p Z > 0w cp4 m En O p a 0 F- cn p a �A o R ¢ En F" a p UV U XA 2 0 z p ¢ ZU Im U m WF!' � CQp o 0 0 0 0 0 0 0 0 0 o > v CD v v C> 4r Q 0 0 CI v, U d o 0 0 0 0 0 0 0 o O CI 0 wl�at h -A 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 2024—2025 This addendum is incorporated into the agreement 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, 2024 (retroactively effective). PAYMENTS MADE BY THE STATE TO THE COUNTY In order to get a more complete picture of the financial arrangement between the two (2) 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: 1. Vehicle Maintenance The State is responsible for the cost of maintenance and repairs of vehicles used for CHD operations. Most of the repairs are handled by the County garage and invoiced to the CHD. 2. Vehicle Fuel The State is responsible for the cost of fuel whenever the County fuel pumps are used. County will issue invoice(s) for same to the CHD. 3. Vehicle Insurance The County carries the title, registration, and associated insurance coverage for all vehicles. The State reimburses the County for its share of these costs. County will issue invoice(s)for same to the CHD. 4. Building Insurance The County owns the facilities where the CHD conducts business. The County, in turn, carries the building insurance and will invoice the CHD for its share of the costs. The facilities are listed in Attachment IV. 5. 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 will issue invoice(s)for same to the CHD. 25 Page I of 2 4173 PROPERTY PURCHASED BY THE CHID 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.) 26 Page 2 of 2 4174