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HomeMy WebLinkAboutFY2025 11/12/2025 GVS COURTq° o: A Kevin Madok, CPA - �o ........ � Clerk of the Circuit Court& Comptroller Monroe County, Florida �z cooN DATE: January 23, 2026 TO: John Quinn, Assistant Director Office of Management& Budget FROM: Liz Yongue, Deputy Clerk SUBJECT: November 12, 2025 BOCC Meeting The following item has been executed and added to the record: F2 Contract beginning Oct. 1, 2025 (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 a County share of$1,584,443 for County FY2025- 2026. Should you have any questions please feel free to contact me at(305) 292-3550. cc: County Attorney Finance File KEY WEST MARATHON PLANTATION KEY 500 Whitehead Street 3117 Overseas Highway 88770 Overseas Highway Key West, Florida 33040 Marathon, Florida 33050 Plantation Key, Florida 33070 CONTRACT BETWEEN MONROE COUNTY BOARD OF COUNTY COMMISSIONERS AND STATE OF FLORIDA DEPARTMENT OF HEALTH FOR OPERATION OF THE MONROE COUNTY HEALTH DEPARTMENT CONTRACT YEAR 2025-2026 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, 2025 (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, 2025(retroactivelyleffective),through September 30, 2026,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 senJice pursuant to section 154.01(2), Florida Statutes, as defined below: a. "Environmental health services" are those services that are organized and operated to protect the health of the general public by monitoring and regulating activities in the environment that may contribute to the occurrence or transmission of disease. Environmental health services shall be supported by available federal, state,and local funds and shall include 1 those services mandated on a state or federal level. Examples of environmental health services include but are not limited to, food hygiene, safe drinking water supply, sewage, and solid waste disposal,swimming pools, group care facilities, migrant labor camps,toxic material control, radiological health, and occupational health. b. "Communicable disease control services" are those services that protect the health of the general public through the detection, control, and eradication of diseases that are transmitted primarily by human beings. Communicable disease services shall be supported by available federal, state, and local funds and shall include those services mandated on a state or federal level. Such services include, but are not limited to, epidemiology, sexually transmissible disease detection and control, HIWAIDS, immunization,tuberculosis control,and maintenance of vital statistics. c. "Primary can: 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 gild 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. L The State's appropriated responsibility(direct contribution excluding any state fees, Medicaid contnbutions, or any other funds not listed on the Schedule C) as provided in Attachment 11, Part II is an amount not to exceed $ 3.892.558(state General Revenue, State Funds, Other State Funds and Federal Funds listed on the Schedule Q. The State's obligation to pay under this contract is contingent upon an annual appropriation by the Legislature. Y. The County's appropriated responsibility (direct contribution excluding any fees, othercash,oriocal contributions)as provided in Attachment II, Part II is an amount not to exceed$1,584,443 (amount listed under the"Board of County Commissioners Annual Appropriations section of the revenue attachment). b. Overall expenditures will not exceed available funding or budget authority,whichever is less, (either the current year or from surplus trust funds) in any service category. Unless requested otherwise, any surplus at the end of the term of this contract in the County Health Department Trust Fund that is attributed to the CHD shall be carried forward to the next contract period. 2 c. Either party may establish service fees as allowed by law to fund activities of the 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 oflthe 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 bp' 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 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 6.1. and 6.k., below. Books, records, and documents must be adequate to allow the CHD to comply with the following reporting requirements: L The revenue and expenditure requirements in the Florida Accounting Information Resource System; and U. 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 specked in the State's Accounting Procedures Manuals,Accounting memoranda, and Comptroller's memoranda; and W. 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.1 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 dearly illustrates the amount which has been credited to each party. The planned use of surplus funds shall be reflected in Attachment 11, Part I of this contract,with special capital projects explained in Attachment V. f. There shall be no transfer of funds between the three levels of services without a contract amendment unless the CHD director or administrator determines that an emergency exists wherein a time delay would endanger the public's health and the State's Deputy Secretary for County Health Systems have approved the transfer. The State's Deputy Secretary for County Health Systems shall forward written evidence of this approval to the CHD within 30 days after an emergency transfer. 4 g. The CHD may execute subcontracts for services necessary to enable the CHD to cant' out the programs specified in this contract. Any such subcontract shall include all aforementioned audit and record-keeping requirements. h. At the request of either party, an audit may be conducted by an independent certified public accountant on the financial records of the CHD, and the results made available to the parties within 180 days after the close of the CHD fiscal year. This audit will follow requirements contained in OMB Circular A-133,as revised, and may be in conjunction with audits performed by the County government. If audit exceptions are found, then the director or administrator of the CHD will prepare a corrective action plan and a copy of that plan and monthly status reports will be furnished to the contract managers for the parties. I. The CHD shall not use or disclose any information concerning a recipient of services except as allowed by federal or state law or policy. j. The CHD shall retain all client records, financial records, supporting documents, statistical records, and any other documents (including electronic storage media) pertinent to this contract for five years after termination of this contract. If an audit has been initiated and audit findings have not been resolved at the end of five years, the records shall be retained until the resolution of the audit findings. k. The CHD shall maintain the confidentiality of all data, files, and records that are confidential under the law or are otherwise exempted from disclosure as a public record under Florida law. The CHD shall implement procedures to ensure the protection and confidentiality of all such records and shall comply with sections 384.29, 381.004, 392.65, and 456.057, Florida Statutes,and all other state and federal laws regarding confidentiality. All confidentiality procedures implemented by the CHD shall be consistent with the State's Information Security Policies, Protocols, and Procedures. The CHD shall further adhere to any amendments to the State's security requirements and shall comply with any applicable professional standards of practice concerning client confidentiality. I. The CHD shall abide by all State policies and procedures, which by this reference are incorporated herein as standards to be followed by the CHD. m. The CHD shall establish a system through which applicants for services and current clients may present grievances over denial, modification, or termination of services. The CHD will advise applicants of the right to appeal a denial or exclusion from services,of failure to take account of a client's choice of service, and right to a fair hearing to the final governing authority of the CHD. Specific references to existing laws, rules, or program manuals are included in Attachment I of this contract. n. The CHD shall comply with the provisions contained In the Civil Rights Compliance and Non-Discrimination Certificate, hereby incorporated into this contract as Attachment III. o. The CHD shall submit quarterly reports to the County that shall include at least the following: 5 i. The DE3851-1 Contract Management Variance Report and the DE580L1 Analysis of Fund Equities Report; and ii. A written explanation to the County of service variances reflected in the year- end DE385L1 report if the variance exceeds or falls below 25 percent of the planned expenditure amount for the contract year. However, if the amount of the service-specific variance between actual and planned expenditures does not exceed three percent of the total planned expenditures for the level of service in which the type of service is included, a variance explanation is not required. A copy of the written explanation shall be sent to the 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 1,2026, for the reporting period of October 1, 2025, through December 31, 2025; and ii. June 1, 2026, for the reporting period of October 1, 2025, through March 31, 2026; and iii. September 1, 2026,for the reporting period of October 1, 2025 through June 30, 2026; and iv. December 1,2026, for the reporting period of October 1, 2025 through September 30, 2026. 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 CHp operations. Vehicles purchased through the County Health Department Trust Fund shall b sold at fair market value when they are no longer needed by the CHD and the proceeds retunted to the County Health Department Trust Fund. s & 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. l'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 Jiuly 1, 2026, it is agreed that the performance and payment under this contract are contingent upon an annual approprialiion by the Legislature, under section 287.0582, Florida Statutes. b. Contract Managers. The name and addresses, of the contract managers for the parties Linder this contract are as follows: For the State: For the County: Dr. Carla A Fry Christine Hurley Name Name CHID Administrator County Administrator Title Title County of Monroe County of Monroe 1100 Simonton Street 1100 Simonton Street Key West, FL 33040 Key West, FL 33040 Address Address QarIa1EfYQ,bP, v H t�r ne 111OM-0eCOLM 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 d. Notices. Any notices provided under this contract must:be delivered by certified mail, return receipt requested, in person with proof of delivery, or by email to the email address of the respective party.identified in Section 9.b., above. In WITNESS THEREOF, the parties hereto have caused this .8 page contract, plus its attachments as referenced, including Attachment I (2 pages), Attachment -= Part I (I page), Attachment II Part II (3 pages), Attachment II - Part: III (2pages.), Attachment Ili : I page), Attachment IV (:I: page.), Attachment V (I page), Addendum I (2 pages), and Schedule County Health Department by Appropriation Category (3 pages), to be executed b : their undersigned officials as duly authorized to be retroactively effective as of the 1st day of October, 2025. BOARD OF COUNTY COMMISSIONERS STATE OF FLORIDA FOR MONROE COUNTY. DEPARTMENT OF HEALTH )1SIGHED.B` : SIGNED BY: —. Michelle Lincoln NAME: -'I :- 1-- NAME: Jose h A. Lada •q M.D. Ph.D. TITLE: Mayor . .: TITLE: State Surgeon General • E .November 12,2025 DATE: ...,. - ATTESTED TO: SIGNED BY: SIGNED BY:NAME: NAME: /_Zo TITLE: TITLE: CHD.Administrator DATE: DATE: VO - 7.5 Approved as to legal form &sufficiency: •v a M. Lewis�►:?.�sa o.�o a a:+,1 LV., Assistant County Attorney .., 1§:CAlk.A CAD :V/16AA-tOlyworiv t��pu Clerk ATTACHMENTI MONROE COUNTY HEALTH DEPARTMENT PROGRAM SPECIFIC REPORTING REQUIREMENTS AND PROGRAMS REQUIRING COMPLIANCE WITH THE PROVISIONS OF SPECIFIC MANUALS Some health services must comply with specific program and reporting requirements In addition to the Personal Health Coding Pamphlet(DHP 50-20).Environmental Health Coding Pamphlet(DHP 50-21)and FLAIR requirements because of federal or state law,regulation or rule. If a county health department is funded to provide one of these services,it must comply with the special reporting requirements for that service. The services and the reporting requirements are listed below: Service Requirement 1. Sexually Transmitted Disease Requirements as specified in F.A.C.6413-3,F.S.381 and F.S.384. Program 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 Children(including the WIC detailed 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. Fantlly Planning Requirements as specified in Public Law 91-572,42 U.S.C.300,at seq.,42 CFR part 59,subpart A,45 CFR parts 74&92,2 CFR 215 (OMB Circular A-110)OMB Circular A-102,F.S.381.0051,F.A.C. 64F-7,FAC.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 Requiremerrts)(2014)and the Providing Quality Family Planning Services(QFP): Recommendations of CDC and the U.S.Office of Population Affairs published on the Office of Population Affairs website. Programmatic annual reports as specified by the program office as specified In the annual programmatic Scope of Work for Family Planning and Maternal Child Health Services,including the Family Planning Annual Report(FPAR),and other minimum guidelines as specified by the Policy Web Technical Assistance Guidelines. S. Immunization Perlcdlc 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 Horses(DH Form 150-615)and Rule 64D-3.046,F.A.C. In addition,periodic reports as specified by the department pertaining to the survelilancefinvestigation of reportable vaccine-preventable diseases,adverse events,vaccine accountability,and assessment of immunization 9 Attachment—I-Page 1 of 2 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 FAC.64D-3.030 and 64D-3.031.Case reporting should be on Adult HIVIAIDS Confidential Case Report CDC Form DH2139 and Pediatric HIV/AIDS Confidential Case Report CDC Form DH2140. Requirements as specified in FAC.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 Fortes 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 Carty out surveillance for reputable communicable and other acute Control diseases,detect outbreaks,respond to Individual cases of reportable diseases,Investigate outbreaks,and carry out communication and quality assurance functions,as specified in F.A.C.64D-3,F.S.381.F.S.384 and the CHD Epidemiology Guide to Surveillance and Investigations. 12. Refugee Health Program Programmatic and financial requirements as specified by the program office. *or the subsequent replacement if adopted during the contract period. 10 AtlachmenU-Page 2 of 2 § La G v ■ o to o & 2 � � ■ e 2 § R a f a $ § 8 2 00 .2 B 2 C z O § aaI 9 E0U 7 § di Cc © I � 2 , a � k 19 § . a w § o o - � toa & § � 2 Go co \ k § § W f 7 ' tr k 2 D k E § E ■ o Q _ w § . n w \ . $ � § �■ 0. © k 2 ® k $ IL 8 m k m Em - $ 4) ■e 8 ■$ �E § � a C _ CD! 129 _U3 $m � o �a . a 704 CL% §7 § S 0 a e � � .g _ k no wk wo w vi £ MENT N �� « �� " i7 / / �' , rauc as as tralz zxaaa u 1 F, solo < "it rt �"�t `aari,E flash Total mum .AIDS I°L@.'4PI N 1'96 N A;,SC'6wVN^:I'➢.E.AWE ANNUAL d,07K .1 0-, iY �. h w y2 0150M t"VN'17 ,2 I,,L12i H 7:>s1 VML:0o 0� 14E:XU AI"IAll ,4"1"1`F:f1 1)Iti1411..SE(,IilK"N'HOtI'PIB OG,IiAM("0l y;"T" i6.75i, u)!,iu,Sal INVI'1."iTI"tiEPI04h,*CTS 6W1:; 0 6,0,,2 'WW, E 79,0:i 1,W1 5 T°+.w,+i5 rJ;510Vb 1^'.AMI L'i f°L..l.,^NIM 11"1;:~al""IN.M,RE'VE'"NL', : 74,9 W 0 klll,9W P3 118,9.S9 6715040 III?A,A'I'I IIS A`>Z`IY IJV[,."Il I"AIT.1.11E,1,PlIf`'l,,'N°I'V41?, &CONTROL 'N,r:".ti 7"I,326 tJt5010 I'I:G MANY'("r1(wl�:PRO,'I�11,AM 2111 e16 i 01511101 IthG'I AV„C E'TICNIC IflSP,`RI'l F:S-CH 1)EXPENSES ;r.lAMO 0b°.:.c34ltiy M-1010 S(l'lookHEAI,I'f1 1.11M]C ISI 96.'".'2a 7 976„22:6 t6 ,-wlo S'vV'tMMING �O('I"I1Bi1981'9tGteitA.%I 10,2(10 �0,:!oo t10,,24"0 0150'o Cl11)Gu:N ERA 4.RI-A'K'x111B";."3Y'Iti-4",1'1 E^;1"'Yi'd'1C CA 1, k,M22,e.21 (IFNE RAL,f;EVE E.,N"UE"'COT AL 4, 2.559.350 2.NON 17 E NEIEIAL R1,N NUE- ,rA'P.E: 1Si,'mo mIEw67`,.W41:,wf""',1.IM)"'r11.YJ1(7,CAI,WASTE 9°IUkrI ANI M1M50181 1 W,;, 32 NON NENE,1;iII,RE,VEyNIwE:'P'C7'1'AL d"14,1�1a,r �) M 79" I) V.71"19�1 3.'E"11:C71"adAL FONDS-"»)`1"rA'T°I;1: 0d'1','Mgh =AhI'D."vlpflfl :i+v:. S+ kw"q"o1,`w"Visl"9'LC,MCPBC.V,'w8,"'<I:RMl;ti1-f,Q "=6",'i12 0 d.sl:,M 0 57"'712 0 ,'Ojo I E I,:k C4DI,NSl^;:1.1,NG N'@eK'C 10,.Jw.3's 0 W2 6a:1% Ct t6 2 6137 (k6YA"M COAh I.4f BEACH Ad fC t"A',oV."l"f:(I fi�;1,:V'hI'u'Y',"�Ma"v;'�+1 flM1�bOw"I."��"(; t R r f 3 0 W701jr6 007of M ""A.A)IS,V"N.A°""?"tl:"we,"1I Ll; -twGPA`J"G" 00'TP M6 I'1."MAC IIL"CII I;"s:[ICA,`~alRUC"'CG,RE A"":WV'C'ITI9e1141dC'.,f3lV.k..,'L'ILAT.I e.?rt.6iS3-i I 0 12S"69d 01170 MU H iC..„ l,\(w OP OR G,NI'llEs F M 11;kESO.NS WW'I I"If:ACAS 673;)0 M7 hn;?P 7s(Y 0 679.750 dit'rT(1 M INFANT"AV3)11I","1LI'T'Y 0 is 11,"7.51 007(M0 1AINKJ:AIX A` I()r� AC"I IM.M;A PLAN „r.r:3.; z 00.6A2 0070 M ACAT+hRNALa'SOHI'r"+fITY 11319 k I„1M9 I1":319 E44,a"TI7tlDMS 13,APBs`.CHk'n^w UNI"1"V i'ldd^:N'.W61"1.6Ai ESE C",`4['A!'VICAT'w 103,1115 10J,S.",Cu 901,V15 4(m,M"7(M6MO BASE REGIONAL["ME:f AID L1');vEss a"AMBN ATY 1 12 9," 0 1:2.9,14 11'",1M i17i4)`s IK) AIDS I${1"kIH?:N`V"1177w'. 96.7hl 0 a,61.71-„ 0 96,71 1 0V'N7000 RY A"s WHITE I"I"I I F II C AI:E� C itANT 'N,0 II 1,6 d 1 7(1,17 B iii 1'70,G;1 (77i7o0o W IC 9`I`GSbM iY'e.,AM.A1N.AI'I:'v!"iTRA'T"fI2;""e" 5a 1,9S6 5a1,9 SSC 01507"i -+(:'C100t,HG-:r4Lll1„rGt:MlNI("EIS 12l$, .99 Wa MY,5 9"lkr;9;°Lt>dT":HE-AI"1"fGw.C:'NSfi.I". fltiCYl f';1 CL3G:6C I, 1f^. "I':AG) &T i65a D 1.562 i62 0I195 IM FUG EEETI^.'a9"9`RISC:8C1.9""?C!M 1GC9?B@h18.'IiSI:1+VK 9'S6°UVIC'K 1, �YM [Mr+E! 16, 12 dpll, 0,5 BLY'.A"^ W"d1'E911?;`llB l" EII.AI)AP D10,11fR1,17:"i ES 7I.',(7r1 nl. Ml 71.i05 FE:L)T11LehI,FU?4'P1C^a TOTAL 2I,426 716 o :".L1.16 ;9CE 1 ."d 16 4.FEES ASSESSED FAY s,rA;"1E OR bEMET+AL Eit1LES-SPA,rE 00N.'ro CICIDti1"Al'I^7W91YCC:kY:NVI92C)`NIY4';'„41fl I,l'tG;'V,,F [)13Ik1�M:3 6.Y;ti:B B[.,`sE.,WA 1(X4.f7f,`=i9lS7AI.I^I'.1�1119 1°1?eM^.a Y�,.r(Yk 4l 9a..�QbM fA LT.�l4PI 12, A,M'a o,rwn i VN Baal"M. I,Page}1 M.3 lr, ,///%/ ✓,. /// r.. ..., // ✓ „/ /,/ ,/ /,it/<„ ////i/�/ / ,/ ,.. //„ / c. /, ..✓ rrr' r / r, / / / / / r .: ,,,,/i / `, �,.... / .✓ / „ter /.. r ,..,, / ,. , ,,,,,., /,/ /... /i ,//,.,,, .,,, rr /,,, <///,,,/, ,,,, r, r/, i it:✓, w)CA1UlN;; t I^,CS ti"I°W"S'1?'€"7tllwh C":�;V1910)`wWCf';l'W I kV,tl"1•:r�^;ti 1`tC1P1 l7 V I�)dA01 Cw X.",lY'w(7 00l:?i1d; W<.S V1:.w,E'V":`C MSPOSM,PKRMIT t•I:F,S 14 00120(i `LWNO"I%,TION i'h'IR°I lFWAW1 I, (Ft34wlw I" 1'i",(`R Iw")fib 2,370 0 ?370 0 2.370 00I20C, P1:r1;MC;S%W I:%I,%II I'00I.PER) 1 11Q"I'IL(V`C.FEE 11.29'1 Cb '1,991 0k 11.199 w1CD1.206. 141,,,G '1„'TIO, OFI51SM PII WANC,S,WLONS ^5 f) 75 Clo Ar"", 001206 TA,170 P R0)Ok W;C1 1,7NVIICta,NNIE•N \1 PtE.•'hl.:1( 862 0 862 0 6CS2 001206 M6)ISILE;110h:E 3„ RV I". Pt, l EJ,',S 2,GiR{ 0 2,10 H 01 2.1CD0 FEES ASSESSED BY STATE OR E T'Dii;ItAl,RULES TOTAL 1!)2^a!9 9+3.:w.,,t 929 &.OTHER CASH CONTRIBUTIONS,STATEE 013IQ05 GENERAL(`L.L`+14"RABIES ,ti:l')VRG•l; V'Cl'W 1d.1:-E'S 9,91 ; 0 9,906 0 17„906 0I:+0001 17I(R '9Y9J b"'u FROM 6'UM.W,11{,: 111 Ci*:T'r 1"_l0 656 0 120,856 0 120,S;',0 OTHER CASH K"01a"vTRII3lI"f`IO TOTAL AL 6wb, fl:^ dh I30—162 6,MEDICAID•S'TA"I'1V/C OUNIY W0 10,7,, l r )G , , 4: .,S l 0.4 A 001ro IS CM)(1UNRFEES 0 5 Vlo ai'.d50 0 51,150 MEDICAID TOTAL 0G 1 706 Sa I 0) 70,1GA 001009 C"191.)C1,I`dW FEES 2 W,, 2.5o 250 oiS,00o ("1rI1)(11NIC 1^1":ES I. :-)-"2 0 1,522 0 1,522 6.CI°I'HLItS6"rW6I,C;C;)N:"'l'9C11Rt.JTtG:1fi3 NOT IN CHI)TRUST FUND STATE Al):,%P 0 3 W73,20,` w73,20s NL:OIR»ti1.1w"y MUG I'1COG]"x"tM ) CD 41 9.2,)l 9 25-1 WIC I°k0(',,kAM 8 CD 0 1,a6l169 1,563,V6 Mi ItKAU OF I'1."MAC wIFALI'lI 1.111t)10,W'rIk RlKs 0 0 01 1:,179 9\1:W1UNI"/.'AIlONS 0 ,W.f1C,k r;&;,1,IfG;w.'1 OTHER STATE:COWRIIC'C.TIONS TOTAL 01 0 2,911.21,V 2 9I t.2 9.CDIREC"I'LOCAL CON°I`&LGIb'UTIONS•BCJCC'H'AX I'.MS"4'1t1(':"I° :a C"I!'E:Y LOCAL MN EN '1' sc tl., b'1;"Clp➢"l.E$I; ;,11:3 5'S4 1=➢1% :" -i.1 U3 014Y~iP.70t,i 1'�I%�l'0i^ti IF WTR'6;N„S4 l;'�16'Rtbba"igC)ell(pI;A"C:V4"�+'I"R"VpaC:)("+f" 01 ^''p:14a 55 ,350 uM 5'r,�C oO•r DIRECT COUNTY COTMa'TRIEiIF"S"IC)C^;s"I'C)TAL 2 1 1 l 7",9 2 11l 799 2A k 1.'791S) 10.FEES.AUTHO RIzEr)BY COUNTY ORDINANCE C)1R RR SOLUTION°COUNTY' uu1025 ('III:.)C.8 d"Slw 1 El%'S t11 •r';E:u .wc1a) r0 4tln 00107a-, 4°E9tD t°1"I_.id;'FErflw,iS CDYA':No7 GF,\FJ?,AL('1JNIC 10:.WI:111.m: p•;ICW'1l ka0 '9:wI{1,011°UM Lk. ,,Fs E} I„WO L3100 t,i I,.300 twtwl'09.1 (111)Lf)a,`AL I;NVI R(1;ti"),tlP,: I".M.FEE,, 0 166�00 166,SDO IG16,80D 001110 VVI•,W:l,STATISTICS "PA01FIE'l)I"PX1,01U)f3 0 60,000 60.000 0 60,000 FEES AUTHORIZED BY COUNTY TOTAL 0 2,62,053 262, !",,3 0 .^"'1.",.053 / /UA r y„,y o„ 7FK"R7 �`/, �AiCN��I`kBRFC"mbr //%/ ri /r// /i /� ri/ r r r r ri r mm /p / /r Total I O1`IIER CASH AND LOCAL CONTRIBUTIONS COUNTY V1fNR029 CM)CLINIC I VE,; aY TdY,E73 7o c/:I 0 +"0.'Djk 3 0(B➢,02!. t,ENEAL1I ('I.A.Nt('I tAM ES SEI ZV IC ES 84 S:')IEI PAJd0 pfA;4E S' 9) :,d00 ¢k 2.1Mr 001029 (TILAN I','10 B REVENUE A:t V7 0 29I OH; 2941)E4; 0 291,01,6 06YIMm (°E91)d't,LY:IC'I'FI-:„; Ei 29,Y'1.6 29 7'I6 !-,'il6 u0/]1�'ol IGY 1„ %VIIITN ,l TIT I,F;III•LYIIdE(`I°4'rY r'IID =Ysat.:q III 16E ,Ye;TYo°..W 0017WII8 MAN"w"r°flEY"R"NC: t'I"R LF Hl -DIREiC11 TO 6'HD ,0 '14!G �?09,*;� a 209,.126 oal(D500 C°ENI)Sb%LEDt,;SEWVICESV d:E'IdOUPS1DF;0YR ,`yTATI.(;4dVT 0 t 10,5 1R1 I0711 Cy ErYi 77I Lola FLt'71G IM B EASI 1:e4'tiCER I'C)t:% D.YI'6CD; I';EDI,6`;Y"I IW,1 CCECA.N I' C 500 '500 0 MWIM 6"EBIE Hil" l I"DIY S'I',YE0'(Y):YLET WIt C ON't"PAC"'"1' 26 ,CIM 2 6 t slDO 0 2tt' ,00 oIlor t':"dq"LT110N V0a:'k' ) tY °r�`r.�if7C °Yas.�YY811 6i :7r,�..Y7¢7 OW012 IJId'..°'4YY CDIY"t' N FROM PURLIC ELFIALTH E;M"E" to �tiit°��)4'� -'o6 stY4E Gr -1'4Y,�+bEa fD'I HI.II CASH AND LOCAL CONTRIBUTIONS TTRIBUTIONS k'CD"CAL 7':6 W6 5 I°z.YCLLOC;a4,B F,'ICEXT?:atiUE,.CO U "T°Y tYiNDt 09 t`H D o LI:ti,R(°18„I.; ?;`;u t>IY ()I!Yr-W)uY 6'I6gY c"i pNBC:"i k k;:8 a1 1.s,•':!^ t 5 2, 1. .,:! COUNTY ALLOCABLE ItI VENUE°I'C)'Tju, 1°'+73 '72 772 I.I.BUILDINGS°COUNTY ANNUAL Edt'^;;NT.Ue EQUIVALENT LAID"Fr f} o'HILH(Sliovil'r°1 0 BE 4:llE VIII V:T W :4t 9 ea dBCE11,DINR ;^I"tlNTV„':YN"I°l; 0 B 5,:2 6;ICtYf %D,S SEAL :" BB:;.`ti,l`tit'I;", 0 1 15,566 it+1'S BN=,;C EC1N("k?� (1 ul �t YM Ca 011 k QSp'cd%) CD"V`9IIRBE(k;yu�.r.aC;'P €) o„Y 4i ip uD BUILDINGS TC)TAL 763, 14,OTHER GOWN C ONTRIBU 1 IIONS NOT IN(.H D?Rus'C h`td1"d'D COUNTY BRI,SC,I4 6Pr''N'r/4"4,fIIC`lA-,I'ulif"losI'•: ti."I?CVI("U,t^;I:�Y�EIIC.'w,^ti4"Y•: li 71 ob tE 97 4'E^;Itlt'I,E*..1I,tIMIIs"«,'4;'+,t'I�:': VY tV tit I�Y VY C„,Y"I'HEH d OL',„tiT'Y C'C:IN"E"hI14I,r"I ION(SR'I:(:IE""Y"E CY Y7 6;6 Yl r;Y C,Y'I'IEER I"Y'Y'UN I Y CO N'I'IG1 Ht HON(r;P:C"IFY OTHER COUNTY CONTRIBU'I IONS'l'OTAL 0 GRAND'I'C)"T'6 1,C"II"I:D I'IdOC"TRAM T o i, �„ .,, /i /n / ,r �/ r. / / ,,//,/%,/,,,:. //r ! /ii r/... / /r/ii✓ rill ,, ,, ;,%r� ,ur r./ / -l. <.. / �... ,.., ,.✓„/ / ,,,r�/ it „... A. CONIMUNICABLE DISFIASE CONTROL 2:32 1 1 .fi (1 1n ,, ;Nwi y4f t'L:E 9144.w4 1 i1110Si' 6 SF G.)t X"€I4'ANS I,N.S 1"023 I;,) 621 ryl,it5! Vli! '9 P'li 6,r+q3 ,226+¢;. 11NQ.7`t.'r 1llVrv.gGh"1°1td?:VENT117',N flo'Ol) .:.-0,1 ai t'"' "'.r.:�d., r11s 2 2,06, 4,2793 Z' v7 du; 26'y,64 6Vt ,.�Ctl� :a)➢11 t.iII.'%N(,1: ¢wl'u:� 6I ar ra II a 0 611W.,h11b.,B'A V'u1^.',I"g'. 1kV• 4e k li A 1 ,{,u°V 173'171 ;i 4,lbordM &7"1,717 t tS 9".C.,rR:k i4..g 79 ;66.2 ST AR.)hl' otP 7,Y 6V 1.".., 47 f) ,Vi.;?Q"R :%Q":96 7,I "G1 2S9 1 i.g.� 7N °p"UMIA➢ L'Ll(„)"iIs 1t1 O i76 �t-X.N.:1;1 2.L',J'11 11, „u l64'1a9 2,91 1Q^1,;112 ('O"IM I)IS S1 HY "Otl ' i 1", tr N„Fr:2 iS.-16 R),&71 51 2p6 ,"'.2 1 102,1;7 1 2,02.1�3+ HE;I'11I01 ltir)u G1 2'd.2;: ;,I,.r,I"' "I 433 rlb I+S7 a17 999„56'7 9'RQ.1".WH KON FS.S 1,Ck'i 10,'S I47"T.S1-; i k1JV1 73,5 k1..1)`S 41.tm3,l'V .1:MI)?) dsA, i%CJ :t,7.i.1:^,13 I!€^'FUGEEl NaFAlITIP W,-i 13 Pt'.AO7 BI:V, If1,;W7 "". 2 Gii,M IO is,b3I V11^.4,1,HM1.RHS IIiojl 1.37 I GSm'i 1 VYi '.I eQ°< 4f'r"!ll1 aI^"W'' 1r.72?" 11 201,20E 1?0-1'_0:9 C.OL)d.'4+SIJ:d1'6,":"r.BLEl DISEASE 41.iB"!'1'J'1`AU'," b"7 l,�w) u.dIiIIS IU 959 tl 21:IJ"rU 1(1; i yf71 1.2 1,150 !o un uA): tJ2,12 0l"I6 I<r,w;9,300 ('11;htYYNIC Y7N'�KNS,F 111O `ENV'ION PR l2 VO t't14 ,9; a71 ,w.:T,�t a gr41 .Vl tl.'Sa'4 2,^Mi 1"t ra.1 '1 I191.'d:k.lt '`IC" r",°1�Wi'1b ri.;",'+" 1°a,ri t5!,S:C lw`i�.+"+1 1,a!# if.i ,. V 1 970' ,03000 "t°!:)1➢lY CH C.S1i 1 "1"EIV.1:NM)"W" u',:9:!i ,:1.. 0 Q 6t")�74+ ..r.°�,r lira [,�,46i0 t P,'7 ,'li iai[D i ,;;33„tiB4tl 4'7tw:'BRF 1s'1"➢"KX,DIN,I PEEF C4A' ''SE.J'n tl;,1 1A,2i ti;='N U 7,@aii 4,.121 4;:.di"�7"r "�.�1'71 ,6'Yd193 1.19,,-,2,, G 1�39.214 Y'N..h:*N"^.t"wt, €."'Sa,r vtS"r' d',) + °72 .3.w,.z1t1; dgs1lr,y :!,dti7.uvluF „¢,�.,atSr1 t9"t.'S:1 fl4 6B°r 71;M� � ;:ea;':tb FNIPC^)%Oi,n"s1"k€1)C)..4+:A"k'rBi Y'r'PoY,"1AD (".'�'t} 1 :3� 1'u Q `:',a„",.a 4i l6I i,4 t 116!r1 J H) Sl,rt 41 PHf,;"A 1 M1f. (,^'»:"d7 Y C 1'+91 9 6'^ 61 Kl i 9 rG-1� r.:°➢ �,d";.ti^Fi,1 ),}a.os KF C"C;h'~I!9Eh.VdM"N*""Y4 f (tNIP,14IiP..4l.L"H k:k:C'.b, 000 U 0 1-0 X219 136 X;68 1P -'Aj2 16 19Cr:,19.19B .'9'rE:CG"1161 LP& e¢,il} ?S a,w.V:d t;w" L1 �2V"t, I^'L1.NI L,2111 St�EttAapl^FIPCr"(ll 1'fit t;":{;,1 ?..E) sd 31 9. di aui'°t9 6a i ,"9 1;6"i0 !N6'J'0 q"fi1';11Ck31 PVV`,"r',id'vF J.i)t.il,C`HFAkXH t XI i;Pk 21wB r1W CXti'1111 d°). 1Ita1 1t8'0,1 N291)0 Y:19'''i1 9'W13 11V'A'14 HF,%IXtI PM 'M(1^I'W`.1 (23,) 4.YT 0 I,.7"yt V W 1i !� !27 "I i 41 r T.' tl21 1*19'I ',lh, ld,' 'i%:-w17 ''Sf;,.,961 I`tlt'.:ti'1AIJILY,LTH i2io) OM Q CI .;13'Io9 2""^6 -10 112Y "aro 2,9S !1_". A:7 Q 112„1,7 F''It;C'AI&RY CARE SUBTOTAL :2.15 rc,11 I 1 .66'7 I 9.'tO'"t 0115 lqa,+ 9 Iry 2:;,? .k 0 s5t4.W6 999 707 1 069.U73 C ENVIRONMENTAL HEA LTII1 Wvit4•r and Onaito So.aIge I'rngg;ra.rn® I"4')E;1".11 10",W11%1(MNHII'R"dlHNG 4:w';"R 0,"0 atl:➢ `111 117,!:^1 Y.4 lo" i,,.;n?a 93 ,25 1—,'87 1 1) 57, 1 I,IMII1.11U:'HN"I'I;LIE5VA. ENS')S'gI..`1l t,)7'd 0(9) Q 41 di 0 1 0 Q Q 0 1`I:1941.41")Ar.h°Ik°uli y'r w^i"1.51 8dV5P36 11,r)1r Q ft Q 0 {) L'1 Q 0 0 I'1k1'4 1TF 14'ATF1I 'YYISTI,14 a 1r;91 0.00 0 Q Q 0 0 O l) Q 0 (➢pti;;tllC^:ti6�W4"dhr�p^".S"1GI:,V.'1';41 L'v11's.I")N 1"G YaeM1., u:OW 1..2 2",S I'27 i",OW 3,5'.J t'AW) 0 22 1 6.'aI 161,"l2A 167"21 'nNG I;10' 60,532 .."i1 ".1tki Pvtf"r;C': `r.'746 'r I.'S7.`, Vrr I.,l:!9 :!2!).69S Facility Prograrno '1":1,1"(101^" CH'I1'r cil;pt4'VI q,„^" i3-4-I1 tllr:6 Ili1) [SB t`",iW gt^.`i7 Ii.€rJ1 YsE!J 10Wlk 51,6SA G1.F1H,"d I'001)p15'(It^: b, (3N tl 1,:?7 11,15 to.,!7t i,.4)'; liM -:1 J41113 ;1 :!00 97.VO4 tµ, (H 1.5 Ftstlac Ir ,rl 11 Pwl„Ill.Pogo 7 or / gay 'e, / / Arn W// "�� kaCxr, �aut � auu � a /i �/ / � D ��tt M.uaxt ', AMR, 7f i r i 9'IC}gkr llffltC"Nd, #2 rh i.;4i; ,Y,21i0 ."�dtl I:R(, I,P(%'LRIr:F,V"I8:>Ull, 9.knl} Eu.-d`,t l60 !T a7.:+J71 §M..S(➢: Iti�."�'C ','d:rt ti �� G:1Y et7,15—, "C D;R 1N'('9„tSGtHItl CAMP GCB'' +d'"v�.tB rr 4aa1 rl PS tt r1 al �� Ci au Gl, I I;;II,~,Ia'CI k I'0.'IC I,LI,I . ";I"'aD it AO1 0 q 91 3 tl,lar!.Y \I9"d BG1 V.l;Id(7:AI8:,4ti 6➢f',Afld lti 1,'v1N N.B'_' ...., I.J'f+ Yu,t4,:S1 R➢j6A lKb,t Vdfi¢n 'Y,:C1 t9Of I:, xl'�,N.^rri ;iil,r il! I"d,ML,„ RANI6' w 1i;M 1 0 ' 3:&,"Mfuti 39,G:?'d "1.aff '61i"� ;I zi<,p 14i,7"�;e I4tlC9"C0.KDRIAL WAS EI I..ItGICES4-wv 04.2 1+2. 4:ptS n.;ll'za 7,('Mr�17i S2t,,gC i:l",AX6 .d16:! 11114;i? MT9I TANNING F N'f.'IL IT `ERVWF" Wtital 001 Cu Cl t21:3 , "C.'� 1 I:,fi 666 raeWl Cznaa¢T" A a I ;k ia4 W1I.-W2 36'973 7 0g! Yltd 9 211v.tt, "e,107 G)mindwrater C onta&Ixl�nfsLion L�°PW9(tl.'aC I)'J'A M' COMPLIANCE A`C E SCCCV It 1 ' (:m,"P rv.47tA ID I'd tl tp (t [t tY i1 a SUPER.MV"'t" U 00 IN 0 ft Q (I kJ 47 tb 9 Gro'unTutaC ol,all',P Y� V.N YJ tN (h f7 4:' f9 4Y Community Hygiene C'td:Mlt➢4 .t Ill"t"P;:~,'VI9t I#'4�i,M1`i 1R r i.,n:�Ni �l Off 0 n « n n INJi'ILV PItENE 9'uON Q: tl) u,IM 0 9 31 Stow t+6 f 1,1i'6 9 C.396 ill!"A17 MONO"I'(WING SH I-0a ICES S fltC'I(MI it,(M 0 0 1Y it VLIBiI61' city 0 0 0 a 0a w(.BLflVd W Y3"d'P?I'bI`;d f}ti:AL:�d•MfA`IL:h: a S4d,p) Ci 1 9) 0 41 sC Ir 1'A r;i U t1 S\.MT.UO'`4'C.ilw.VNC P; Q:,a,YP o}.IC1 n 'W .°:'.m / ;4:^. 3 P-", 9t.lMES. .I',WltVL94JAN(;"E: rw66) PW u! tl 14Up V. f BCiI 136 i'; 1 CAI BOPIV"I Vt 'slAtVI:AL., r,y;"JY fj Q0 td n n p ul 6'a Rifkl,M,l'.YM'11ROl'd7d7G°ONT° 1,01,2'9s;riJ ix.W Cl 4p fii '%YA 1-"8 I'IdL.Li"I'ION (3"'i'M 010 CX ;.I ii(d 0 ida t) 2.163 I.*dLAt)l9N A I V (.i717 001. 9'I 0 :?'I,# E+7, ^.11'i 1^1"7 r) 9XtP1 ,µ0 RAMR9e.rIr11G,A ddl;rMV."1"6I 6;I'" ra.M CI fp 0 rB ¢I 0 0 a JONIC wtllRsl v;tit'Fi; CITO L R'; .W6 �1316 v„"&tl,". at 62 36 9' 32'T T6 Q 7 1i„1715 jx'Y aft Group Total 9r1 I'M➢ , G�i,',S'"W'7 d',.129 19 19u 1t.a 6 I',1,GI�l Irif.V,fllON ENVIRONMENTAL HrALTH SUBTOTAL 9°.: W14 .1 t16 a t s:;3 t'F.Q i;o 21, 9 f)611 22il""i.!5 '2'07, � D. NON-CPE'.ILG'd OZIALCO,SSTS. ;4"ON a'al"L;IdATIONAI.COST,,t C 09) 0 9 o 0 ENVl1@C7:tiMC-NT" I,PiVt.,1I Tfl SURC H VIAG 0 U ?V'5124 11'3i1 i i'2 4 AI ..Cb..rg.A3 1) 21),6^.yN# ..1'16dC1IVAIII BUYBACK K WHIP Ojmf 0 19 Ca 9 0 6 �1 C➢ NCB:4f•C PERATION L COSTS SUBTOTAL 0,00 b D 21 0.'Ir'C"1 i2 I'sl 5 ..O 1Sf, �Y w 'E"CPPAl,CONTILkC'fl W"1ffl I t M91 ,r,.0 121 _.,v i.p59 _.453; in 2,3.1 u",q 2 1 9 8 1 fi 9.(1Ci1 i4„9PT 16 got If_FA�i Of4• an c+M l ATTACHMENT III MONROE COUNTY HEALTH DEPARTMENT CIVIL RIGHTS COMPLIANCE AND NON-DISCRIMINATION CERTIFICATE 1. The CHD agrees to complete the Civil Rights Compliance Questionnaire, DH Forms 946 A and B(or the subsequent replacement if adopted during the contract period), if so requested by the Department. 2. The CHD assures that it will comply with the Omnibus Budget Reconciliation Act of 1981, P.L.97-35, which prohibits discrimination on the basis of sex and religion in programs and activities receiving or benefiting from federal financial assistance. 3. Assurance of Civil Rights Compliance: The CHD hereby agrees that it will comply with Title VI of the Civil Rights Act of 1964(42 U.S.C.2000d et seq.);Title IX of the Education Amendments of 1972(20 U.S.C. 1681 et seq.); Section 504 of the Rehabilitation Act of 1973(29 U.S.C. 794);the Age Discrimination Act of 1975(42 U.S.C.6101 et seq.);Title II and Title III of the Americans with Disabilities Act(ADA)of 1990,as amended by the ADA Amendment Act of 2008(42 U.S.C. 12131-12189)and as implemented by Department of Justice regulations at 28 CFR Parts 35 and 36; Executive Order 13166, "Improving Access to Services for Persons with Limited English Proficiency"(August 11,2000);all provisions required by the implementing regulations of the U.S. Department of Agriculture(7 CFR Part 15 et seq.);and FNS directives and guidelines to the effect that no person shall,on the ground of race, color, national origin,age,sex,or disability,be excluded from participation in, be denied the benefits of, or otherwise be subjected to discrimination under any program or activity for which the agency receives Federal financial assistance from FNS;and hereby gives assurance that it will immediately take measures necessary to effectuate this agreement. By providing this assurance,the CHD agrees to compile data, maintain records and submit records and reports as required to permit effective enforcement of the nondiscrimination laws,and to permit Department personnel during normal working hours to review and copy such records, books and accounts,access such facilities,and interview such personnel as needed to ascertain compliance with the non-discrimination laws. If there are any violations of this assurance,the Department of Agriculture shall have the right to seek judicial enforcement of this assurance. This assurance is given in consideration of and for the purpose of obtaining any and all Federal financial assistance,;grants,and loans of Federal funds, reimbursable expenditures,grant or donation of Federal property and interest in property,the detail of Federal personnel,the sale and lease of,and the permission to use Federal property or interest in such property or the furnishing of services without consideration or at a nominal consideration,or at a consideration that is reduced for the purpose of assisting the recipient,or in recognition of the public interest to be served by such sale,lease,or furnishing of services to the recipient,or any improvements made with Federal financial assistance extended to the Program applicant by USDA. This includes any Federal agreement, arrangement,or other contract that has as one of its purposes the provision of cash assistance for the purchase of food, and cash assistance for purchase or rental of food service equipment or any other financial assistance extended in reliance on the representations and agreements made in this assurance. This assurance is binding on the CHD,its successors,transferees,and assignees as long as it receives or retains possession of any assistance from the Department. The person or persons whose signatures appear below are authorized to sign this assurance on the behalf of the CHD. 4. Confidentiality of Data, Files,and Records:The CHD agrees to restrict the use and disclosure of confidential USDA,Women, Infant,and Children(WIC)applicant and participant information as specified in 7 CFR§246.26(d)(1)(i)in accordance with 7 CFR§246.26(d)(1)(11),as applicable. Attachment—III-Page 1 of 1 Kc � 0 E© a G ■ — § e t % � CY ■ t � 2 k k k o S S § 9 % ■ $ � . @ m ■ s e » f a@ IL v v SO % ■ - a ■ ■ ■§ ■ i f f cx _ ° 2 ® 0 \ § 2 & ! ) a « a ■ m � � � � ■ 2 � 2 ® ■ e § � � a • _ $ § § e 8 R k Go © C', ■ l § kkK � & § k \ % ig — LX j ■ � § � & 2 ■ ■J s 2 U � � 22 �e �_�■ § �� ■ � k � ■@ 2 . 'A ®�JI c; k @ II § A I/� C o $ JL Q § k 2 to 7 2 __° ]■ 2 �� �� � k k © k m m k _ a § k In Q0 ATTACHMENT V MONROE COUNTY HEALTH DEPARTMENT SPECIAL PROJECTS SAVINGS PLAN CASH RESERVEO OR NMCIPATED TO BE RESERVED FOR PROJECTS CONTRACT YEAR STATE COUNTY TOTAL 2024-2025• $ 0 $ 0 $ 0 2025-2026** $ 0 $ 0 $ 0 2026.2027— $ 0 $ 0 $ 0 2027-2028— $ 0 $ 0 $ 0 PROJECT TOTAL $ 0 $ 0 $ 0 SPECIAL PROJECTS CONSTRUCTION)RENOVATION PLAN PROJECT NUMBER: PROJECT NAME: LOCATIONIADDRESS: PROJECT TYPE: NEW BUILDING ROOFING RENOVATION PLANNING STUDY NEW ADDITION OTHER SQUARE FOOTAGE: 0 PROJECT SUMMARY: DescAe scope o/work in reasonabte detaf. START DATE (rnwd wwnd&m orAmds) COMPLETION DATE: DESIGN FEES: $ 0 CONSTRUCTION COSTS: $ 0 FURNITUREIEQUIPMENT: $ 0 TOTAL PROJECT COST: $ 0 COST PER SQ FOOT: $ 0 19 AtlatlhmeM_V-Page 1 of 1 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 2025-2026 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, 2025 (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 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. New or replacement parts will be billed as a direct pass- through of costs. Labor will be billed at the County's shop labor rate (cost/hour) in effect at the time of service. 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 their 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 charges back the CHD for their share of the costs. The facilities are listed in Attachment IV. 5. County Courier Costs To the extent that the County operates a courier service to make deliveries between county facilities, the State will be charged a reasonable fee for the use of these services. County will issue invoice(s)for same to the CHD. Page 1 of 2 20 PROPERTY PURCHASED BY THE CHD Per F.S. 274.11, title to all property purchased by the 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 that holds data), in which case it should be recorded too. (The dollar value was raised from $1,000 to$5,000 in 2020.) Page 2 of 2 21 r4 r^i c V,, vk 4q Qq r� rn "I In 1-1 1+1 Cn orbpry r 11 rl 1-4 ri 11 �l rd fl rg I r� C-1 CA r'l r2 u 1:4 tn M, m C-1 ra �l rl �r 1 rl r i r �l CIA IA r� fli "I ("I IN tj ri) It r 4 m IN r,l rl oc Ic Ic �j r i �ji rj 61 1 1 r,k r r i M`i �7j ' ,;,— I, rl 1'71 7 M M M In rn rl Cjrp= �j� rj r-4 I- e,1 411 r I r I r'l I r 1 4 C,I ri r �4 r-1 N r,t iz4 pz �ZL iz� 00 74 CL u 7:5 z z 7 C u Ln L14 LLJ 0 L) L; ct ri C, r Ce l U4 ct 6ou ................ 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