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FY2004 12/18/2003 Cleltl ollhe Circul coun Danny L. KOlhage Memnrandum To: Christopher R. Smith Operations Manager Monroe County Health Department Isabel C. DeSantis,' \J Deputy Clerk f Thursday, January 8, 2004 From: Date: At the Board of County Commissioner's Meeting on December 17, 2003 the Board granted approval and authorized execution ofa Contract between Monroe County, State ofF1orida Department of Health and Monroe County Health Department for operation of the Monroe County Health Department Contract Year 2003-2004. Attached hereto are five (5) duplicate originals of the subject document executed by Monroe County for your handling. Please be sure that the set marked Monroe County Clerk's Office Orieinal and Monroe County Finance Deoartment's Orieinal are returned to my attention as quickly as possible. Should you have any questions concerning this matter please feel free to contact this office. Copies: Finance, w/o document County Attorney File V Jeb Bush Governor John O. Agwunobi, M.D., M.B.A. Secretary FLORIDA DEPARTMENT OF Date: December 26, 2002 To: Pam Hancock r-' -. --b- Monroe Counly Depuly Clerk_ :R- .~r- Christopher R. Smith t / ~~ Operations Manager ~-I From: Subject: Monroe County Health Department Core Contract Enclosed please find five (5) originals of the Monroe County Health Department Core Contract which was approved at the December 17, 2002 Board of County Commissioners Meeting. Please have these documents executed by the County and return all of them to me for forwarding to Tallahassee for final signature. When the documents are fully executed I will return an original for your files. Thank you for your assistance and if there are any questions, please call me at 293-7539. enclosure v~ >> D l"'\.. """ ~ J fl s. hct. v(.. t k re... tv y'Y' to me... MQ,y~ s\~ n . ~4 rk.q^fc.~l ~e-.lle.. MONROE COUNTY HEALTH DEPARTMENT Gato Building 1100 Simonton Street P.O. Box 6193 Key West, Florida 33041-6193 (305) 293-7500 . FAX (305) 292-6872 r,~~:,':',~c C:\:,:.:::~:./ 'j:>~:~J C,~:~~") ~:"'h''''!'!!l --. 1!I.!"!Ill:~lt,~lt~!:l~~....._":-".' _ .. '~t-_.". -~'"""""'-~ 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 2003-2004 This agreement ("Agreement") 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 , 2003. RECITALS A. Pursuant to Chapter 154, F.S., 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 "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 County Health Departments created throughout Florida. It is necessary for the parties hereto to enter into this Agreement in order to assure 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 are hereby acknowledged, the parties hereto agree as follows: 1. RECITALS. The parties mutually agree that the forgoing recitals are true and correct and incorporated herein by reference. 2. TERM. The parties mutually agree that this Agreement shall be effective from October 1, 2003, through September 30, 2004, or until a written agreement replacing this Agreement is entered into between the parties, whichever is later, unless this Agreement is otherwise terminated pursuant to the termination provisions set forth in paragraph 8, below. 3. SERVICES MAINTAINED BY THE CHD. The parties mutually agree that the CHD shall provide those services as set forth on Part III of Attachment" hereof, in order 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 which are organized and operated to protect the health of the general public by monitoring and regulating activities in the environment which 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, occupational health. b. "Communicable disease control services" are those services that protect the health of the general public through the detection, control, and eradication of diseases that are transmitted primarily by human beings. Communicable disease services shall be supported by available federal, state, and local funds and shall include those services mandated on a state or federal level. Such services include, but are not limited to, epidemiology, sexually transmissible disease detection and control, HIV/AIDS, immunization, tuberculosis control and maintenance of vital statistics. c. "Primary care services" are acute care and preventive services that are made available to well and sick persons who are unable to obtain such services due to lack of income or other barriers beyond their control. These services are provided to benefit individuals, improve the collective health of the public, and prevent and control the spread of disease. Primary health care services are provided at home, in group settings, or in clinics. These services shall be supported by available federal, state, and local funds and shall include services mandated on a state or federal level. Examples of primary health care services include, but are not limited to: first contact acute care services; chronic disease detection and treatment; maternal and child health services; family planning; nutrition; school health; supplemental food assistance for women, infants, and children; home health; and dental services. 4. FUNDING. The parties further agree that funding for the CHD will be handled as follows: a. The funding to be provided by the parties and any other sources are set forth 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 $4,026.843 State General Revenue, Other State Funds and Federal Funds listed on the Schedule C). The State's obligation to pay under this contract is contingent upon an annual appropriation by the Legislature. ii. The County's appropriated responsibility (direct contribution excluding any fees, other cash or local contributions) as provided in Attachment II, Part II is an amount not to exceed $379.792 (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 current year or from surplus trust funds) in any service category. Unless requested otherwise, any surplus at the end of the term of this Agreement 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. Fees are listed in Attachment" Part" of this contract and in the Environmental Health Fee Schedule that is provided by the Environmental Health Program Office. The estimated annual environmental health fee revenues accruing to the County Health Department Trust Fund are listed on Attachment VI. d. Either party may increase or decrease funding of this Agreement 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/decrease, the CHD will revise the Attachment" and send a copy of the revised pages to the County and the Department of Health, Bureau of Budget Management. If the County initiates the increase/decrease, the County shall notify the CHD. The CHD will then revise the Attachment" and send a copy of the revised pages to the Department of Health, Bureau of Budget Management. e. The name and address of the official payee to whom payments shall be made is: Monroe County Health Department Trust Fund 1100 Simonton Street POBox 6193 Key West. FL 33041-6193 5. CHD DIRECTOR/ADMINISTRATOR. Both parties agree the director/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 Deputy State Health Officer. The director/administrator shall be selected by the State with the concurrence of the County. The director/administrator of the CHD shall insure that non-categorical sources of funding are used to fulfill public health priorities in the community and the Long Range Program Plan. A report detailing the status of public health as measured by outcome measures and similar indicators will be sent by the CHD director/administrator to the parties no later than October 1 of each year (This is the standard quality assurance "County-State Goal Achievement" report located on the Department of Health Intranet). 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 set forth in subparagraph b., below. All CHD employees shall be State or State-contract personnel subject to State personnel rules and procedures. Employees will report time in the Client Information System/Health Management Component 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 3 Department of Health purchasing contract has been implemented for those goods or services. In such cases, the CHD director/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 in accordance with the terms of this Agreement. State procedures must be followed for all leases on facilities not enumerated in Attachment IV. c. The CHD shall maintain books, records and documents in accordance with those promulgated by the Generally Accepted Accounting Principles (GAAP) and Governmental Accounting Standards Board (GASB), and the requirements of federal or state law. These records shall be maintained as required by the Department of Health 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 are subject to the confidentiality provisions of paragraph 6.i., 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 System Information Resource (FLAIR). 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; iii. Financial procedures specified in the Department of Health's Accounting Procedures Manuals, Accounting memoranda, and Comptroller's memoranda; 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/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/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 the core contract, then funding from all sources is credited to the program accounts by state and county. The equity share of any surplus/deficit funds accruing to the state and county is determined each month and at contract year-end. Surplus funds may be applied toward 4 the funding requirements of each participating governmental entity 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 which clearly illustrates the amount which has been credited to each participating governmental entity. 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 duly signed by both parties to this contract and the proper budget amendments unless the CHD director/administrator determines that an emergency exists wherein a time delay would endanger the public's health and the Deputy State Health Officer has approved the transfer. The Deputy State Health Officer shall forward written evidence of this approval to the CHD within 30 days after an emergency transfer. g. The CHD may execute subcontracts for services necessary to enable the CHD to carry out the programs specified in this Agreement. 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 CPA 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 OMS Circular A-133 and may be in conjunction with audits performed by county government. If audit exceptions are found, then the director/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 Agreement for a period of five (5) years after termination of this Agreement. If an audit has been initiated and audit findings have not been resolved at the end of five (5) years, the records shall be retained until resolution of the audit findings. k. The CHD shall maintain confidentiality of all data, files, and records that are confidential under the law or are otherwise excepted 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 Department of Health Information Security Policies, Protocols, and Procedures, dated September 1997, as amended, the terms of which are incorporated herein by reference. The CHD shall further adhere to any amendments to the State's security requirements and shall comply with any applicable professional standards of practice with respect to client confidentiality. 5 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, except as otherwise permitted for some purchases using county procedures pursuant to paragraph 6.b. hereof. 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 of his/her right to a fair hearing to the final governing authority of the agency. Specific references to existing laws, rules or program manuals are included in Attachment I of this Agreement. n. The CHD shall comply with the provisions contained in the Civil Rights 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: i. The DE385L 1 Contract Management Variance Report and the DE580L 1 Analysis of Fund Equities Report; ii. A written explanation to the county of service variances reflected in the DE385L 1 report if the variance exceeds or falls below 25 percent of the planned expenditure amount. However, if the cumulative amount of the variance between actual and planned expenditures does not exceed one percent of the cumulative 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 Department of Health, Bureau of Budget Management. 6 p. The dates for the submission of quarterly reports to the county shall be as follows unless the generation and distribution of reports is delayed due to circumstances beyond the CHD's control: i. March 1, 2004 for the report period October 1, 2003 through December 31,2003; ii. June 1, 2004 for the report period October 1, 2003 through March 31, 2004; iii. September 1, 2004 for the report period October 1, 2003 through June 30, 2004; and iv. December 1, 2004 for the report period October 1 , 2003 through September 30, 2004. 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 assure adequate fire and casualty insurance coverage for County- owned CHD offices and buildings and for 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 assure 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. 8. TERMINATION. a. Termination at Will. This Agreement may be terminated by either party without cause upon no less than one-hundred eighty (180) calendar days notice in writing to the other party unless a lesser time is mutually agreed upon in writing by both parties. Said notice shall be delivered by certified mail, return receipt requested, or in person to the other party's contract manager with proof of delivery. b. Termination Because of Lack of Funds. In the event funds to finance this Agreement become unavailable, either party may terminate this Agreement upon no less than twenty-four (24) hours notice. Said notice shall be delivered by certified mail, return receipt requested, or in person to the other party's contract manager with proof of delivery. c. Termination for Breach. This Agreement my be terminated by one party, upon no less than thirty (30) days notice, because of the other party's failure to perform an 7 obligation hereunder. Said notice shall be delivered by certified mail, return receipt requested, or in person to the other party's contract manager with proof of delivery. Waiver of breach of any provisions of this Agreement 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 Agreement. 9. MISCEllANEOUS. The parties further agree: a. Availability of Funds. If this Agreement, any renewal hereof, or any term, performance or payment hereunder, extends beyond the fiscal year beginning July 1, 2002, it is agreed that the performance and payment under this Agreement are contingent upon an annual appropriation by the legislature, in accordance with section 287.0582, Florida Statutes. b. Modification. This Agreement and its Attachments contain all of the terms and conditions agreed upon between the parties. Modifications of this Agreement shall be enforceable only when reduced to writing and signed by all parties. c. Contract Manaqers. The name and address of the contract managers for the parties under this Agreement are as follows: For the State: For the County: Christopher R. Smith Name James Roberts Name Operations Manaqer Title County Administrator Title POBox 6193 GA TO BuildinQ, 1100 Simonton St Key West, Fl 33040 Address Key West, Fl 33040 Address 305/293-7539 Telephone 305/292-4441 Telephone If different contract managers are designated after execution of this Agreement, the name, address and telephone number of the new representative shall be furnished in writing to the other parties and attached to originals of this Agreement. d. Captions. The captions and headings contained in this Agreement are for the convenience of the parties only and do not in any way modify, amplify, or give additional notice of the provisions hereof. 8 In WITNESS THEREOF, the parties hereto have caused this 37 page agreement to be executed by their undersigned officials as duly authorized effective the /7# day of AJ.u.LhH~ t/()o.3 BOARD OF COUNTY COMMISSIONERS FOR MONROE COUNTY STATE OF FLORIDA DEPARTMENT OF HEALTH SIGNED BY~ L~NED~Y: I~. ~~,. NAME: /Jlv,I'a. vc;r. ~A~n NAM~JOhn O. AGwunobi. M.D..M.B.A. /' flItS:. /1J4y~r TITLE: Secretary : ':::.~ /' DATE:,S~~'~I 0).- / "? - 03 . /~/! -,) ..,.- \ij'Z.\\ Art ED; ..'1: . . ~ ~ \ ' ) ..." : , SIm:~g:1tY~C. M~ SIGNED BY: c;- ~ q" __ .""-"< ",;,,.,/ \'II NAW~:;2.:Zsc:t. .6'e/ C. ()e~,,~/s NAME: STEPHEN E. MASON TITLE: D -e. ~ v 1-1/ C/e. r /0 , /' /;).-/7-03 DATE: (.~.::l.V'-l DATE: TITLE: ActinG CHD Administrator DATE: C> \ \ (5 g I a-c-o 4 C', 1..0 ...J:; lc_ -- Ld -~ c~~. C) w... f-' 0-' ~~ !-.: >: 1...1": :c _.~,::.,.);- ,~... .....:c C'" "k ::.2.e:::==' a:: 0" .(.;0 CJ .....l .U U- I >-x::w co %,...Jo 0 W ::i. (. , x: W u.... <1.: .z:. -' _T o 0 -- = \: Ll. = c-.... 7. 8. 9. ATTACHMENT I MONROE COUNTY HEALTH DEPARTMENT PROGRAM SPECIFIC REPORTING REQUIREMENTS AND PROGRAMS REQUIRING COMPLIANCE WITH THE PROVISIONS OF SPECIFIC MANUALS Some health services must comply with specific program and reporting requirements in addition 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 FAC 64D-3 and F.S. 384 and the CHD Guidebook Internal Operating Policy STD 6 and 7. 2. Dental Health Monthly reporting on DH Form 1008*. 3. Special Supplemental Nutrition Program for Women, Infants and Children. Service documentation and monthly financial reports as specified in DHM 150-24* and all federal, state and county requirements detailed in program manuals and published procedures. 4. Healthy Start! Improved Pregnancy Outcome Requirements as specified in the Healthy Start Standards and Guidelines 1998 and as specified by the Health Start Coalitions in contract with each county health department. 5. Family Planning Periodic financial and programmatic reports as specified by the program office and in the CHD Guidebook, Internal Operating Policy FAMPLAN 14* 6. Immunization Periodic reports as specified by the department regarding the surveillance/investigation of reportable vaccine preventable diseases, vaccine usage accountability, the assessment of various immunization levels and forms reporting adverse events following immunization and Immunization Module quarterly quality audits and duplicate data reports. Chronic Disease Program Requirements as specified in the Community Intervention Program (CIP) and the CHD Guidebook. Environmental Health Requirements as specified in DHP 50-4* and 50-21* HIV/AIDS Program Requirements as specified in Florida Statue 384.25 and 64D-3.016 and 3.017 F.AC. and the CHD Guidebook. Case reporting on CDC Forms 50.42B (Adult! Adolescent) and 50.42A (Pediatric). Socio-demographic data on persons tested for HIV in CHD clinics should be reported on Lab Request Form 1628 or Post-Test Counseling Form 1633. 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GENERAL REVENUE-STATE 015011 ALGICONTRlBUTION TO CHDS-PRIMARY CARE 17,256 0 17,256 0 17,256 015011 ALG/PRIMARY CARE 223,310 0 223,310 0 223,310 015011 PRIMAR Y CARE SPECIAL PROJECT 0 0 0 0 0 015012 GIA EPILEPSY SERVICES 0 O' 0 0 0 015048 ALGICONTR TO CHDS-STD PROGRAM 21,016 0 21,016 0 21,016 015050 ALGICESSPOOL IDENTIFICATION AND ELIMINATION 128,707 0 128,707 0 128,707 015050 ALGICONTR TO CHDS 1,371,743 0 1,371,743 0 1,371,743 015050 ALGICONTR TO CHDS-MIGRANT LABOR CAMP SANITATION 0 0 0 0 0 015050 ALGICONTR. TO CHDS-DENT AL PROGRAM 20,000 0 20,000 0 20,000 015050 ALGICONTR. TO CHDS-IMMUNIZATION OUTREACH TEAMS 7,694 0 7,694 0 7,694 015050 ALGICONTR. TO CHDS-INDOOR AIR ASSIST PROG 0 0 0 0 0 015050 ALGICONTR. TO CHDS-SOVEREIGN IMMUNITY 0 0 0 0 0 015050 CITIZENS AGAINST TOXIC EXPOSURE (CA TE) 0 0 0 0 0 015050 COMMUNITY TB PROGRAM 74,107 0 74,107 0 74,107 015050 CONTR TO CHDS - DUVAL TEEN PREGNANCY PREVENTION 0 0 0 0 0 015050 FIRST STEP - MOTHERS AND INFANTS PROGRAM 0 0 0 0 0 015050 HEAL THY BEACHES MONITORING 29,262 0 29,262 0 29,262 015050 HEALTH PROMOTION & EDUCATION 58,823 0 58,823 0 58,823 015050 LA LIGA CONTRA EL CANCER 0 0 0 0 0 015050 MANATEE COUNTY RURAL HEALTH SERVICES 0 0 0 0 0 015050 MEDIV AN PROJECT - ELDERLY INTEREST 0 0 0 0 0 015050 METRO ORLANDO URBAN LEAGUE TEENAGE PREG PREV 0 0 0 0 0 015050 RED LEGISLATION - GAP GRANT (CAT 050310) 0 0 0 0 0 015050 SPECIAL NEEDS SHELTER PROGRAM 0 0 0 0 0 015065 ALGICONTR TO CHDS-AIDS PATIENT CARE 384,663 0 384,663 0 384,663 015065 ALGICONTR TO CHDS-AIDS PREY & SURV & FIELD STAFF 105,802 0 105,802 0 105,802 015115 VOLUNTEER SCHOOL HEALTH NURSE GRANT 0 0 0 0 0 015123 ALGIFAMIL Y PLANNING 62,578 0 62,578 0 62,578 015124 ALGIIPO - OUTREACH SOCIAL WORKERS CAT. 050707 0 0 0 0 0 015124 ALGIIPO HEAL THY START 0 0 0 0 0 015124 ALGIIPO HEALTHY STARTIIPO CAT 050707 0 0 0 0 0 015124 ALGIIPO-INFANT MORTALITY PROJECT CAT. 050707 0 0 0 0 0 015124 ALGIMCH HEALTHY STARTIIPO CAT 050870 0 0 0 0 0 015124 ALGIMCH-INFANT MORTALITY PROJECT CAT. 050870 0 0 0 0 0 015124 ALGIMCH-OUTREACH SOCIAL WORKERS CAT 050870 0 0 0 0 0 015137 ALGICONTR. TO CHDS-MCH HEALTH - FIELD STAFF COST 0 0 0 0 0 015137 HEALTHY START - DATA COLLECTION PROJECT STAFF 0 0 0 0 0 015140 ALG/SCHOOL HEALTH/SUPPLEMENTAL 41,665 0 41,665 0 41,665 015050 Health Promotion and Education Initiative 0 0 0 0 0 GENERAL REVENUE TOTAL 2,546,626 0 2,546,626 0 2,546,626 2. NON GENERAL REVENUE - STATE 001009 Debit Memo-Bad Checks 0 0 0 0 0 010304 Stationary Pollutant Storage Tanks 123,449 0 123,449 0 123,449 015000 Transfer 0 0 0 0 0 015010 ALGICONTR TO CHDS-REBASING TOBACCO TF 21,864 0 21,864 0 21,864 015010 ENHANCED DENTAL SERVICES TOBACCO TF 0 0 0 0 0 015010 FL HEPATITIS & LIVER FAILURE PREVENTION/CONTROL 150,000 0 150,000 0 150,000 2. NON GENERAL REVENUE - STATE 015010 SUPER ACT PROGRAM ADM TF 0 0 0 0 0 015016 G/A EPILEPSY PREVENTION AND EDUCATION EPILEPSY TF 0 0 0 0 0 015020 FOOD AND WATERBORNE DISEASE PROGRAM ADM TF 0 0 0 0 0 015026 ALG/CONTR. TO CHDS-BIOMEDICAL W ASTE/DEP ADM TF 3,600 0' 3,600 0 3,600 015047 SUPER ACT PROGRAM (CAT 050329 OCA 9VOOO)ADMIN TF 0 0 0 0 0 015072 ALG/CONTR. TO CHDS-SAFE DRINKING WATER PRG/DEP ADM 0 0 0 0 0 015084 VARICELLA IMMUNIZATION REQUIREMENT TOBACCO TF 4,118 0 4,118 0 4,118 015170 TOBACCO COORDINATION 0 0 0 0 0 015172 FULL SERVICE SCHOOLS - TOBACCO TF 61,720 0 61,720 0 61,720 015174 BASIC SCHOOL HEALTH - TOBACCO TF 40,839 0 40,839 0 40,839 NON GENERAL REVENUE TOTAL 405,590 0 405,590 0 405,590 3. FEDERAL FUNDS - State 007000 WINGATE DISEASE & SYMPTON PREVALENCE SURVEY 0 0 0 0 0 007000 CHILDHOOD LEAD POISONING PREVENTION 0 0 0 0 0 007000 COMPREHENSIVE CARDIOVASCULAR PROGRAM 0 0 0 0 0 007000 FEDERAL COASTAL BEACH MONITORING PROGRAM 27,625 0 27,625 0 27,625 007000 STATE PROGRAMS TO PREVENT OBESITY 2003-04 0 0 0 0 0 007030 PHBGIMIGRANT LABOR CAMP SANITATION 0 0 0 0 0 007044 PHBGIRAPE AWARENESS 0 0 0 0 0 007049 STD PROGRAM-CSPS 0 0 0 0 0 007049 STD PROGRAM-INFERTILITY PROJECT 0 0 0 0 0 007049 STD PROGRAM-MED & LAB SVCS TRNG CNTR 0 0 0 0 0 007049 STD PROGRAM-STD/PHY TRAINING CENTER 0 0 0 0 0 007049 STD PROGRAM-SYPHILIS ELIMINATION PROJECT 0 0 0 0 0 007051 FGTF/WIC ADMINISTRATION ] 85,469 0 185,469 0 185,469 007056 HEALTH PROGRAM FOR REFUGEES 0 0 0 0 0 007056 REFUGEE HEALTH TB TARGETED TESTING 0 0 0 0 0 007058 FGTF/DIABETES CONTROL 0 0 0 0 0 007062 FGTF/AIDS EPIDEMIOLOGICAL RESEARCH STUDY 0 0 0 0 0 007063 PHBG/COMPREHENSIVE COMM CARDIO HLTH PRGM 0 0 0 0 0 007064 AIDSSEROPREVALENCE 0 0 0 0 0 007064 EVAL INTEG HIV/AIDS SURV SYST PERFORMANCE 0 0 0 0 0 007064 FGTF/AIDS SURVEILLANCE 0 0 0 0 0 007065 AIDS PREVENTION ]72,745 0 172,745 0 172,745 007066 FGTFIRY AN WHITE 0 0 0 0 0 007066 FGTFIRY AN WHITE - EMERGING COMMUNITIES 0 0 0 0 0 007066 FGTF/R Y AN WHITE-AIDS DRUG ASSIST PROG-ADMIN 22,443 0 22,443 0 22,443 007066 FGTFIRYAN WHITE-CONSORTIA 533,786 0 533,786 0 533,786 007067 TUBERCULOSIS CONTROL - FEDERAL GRANT 0 0 0 0 0 007068 FGTF/AIDS INMATE INTERVENTION 0 0 0 0 0 007069 FGTF/AIDS MINORITY INVOLVEMENT IN HIV 0 0 0 0 0 007077 B10TERR SURVEILLANCE & CAPACITY/uS ATTACK 2002 0 0 0 0 0 007077 BIOTERR SURVEILLANCE & EPIDEMIOLOGY 0 0 0 0 0 007077 B10TERRORISM NETWORK COMMUNICATIONS 0 0 0 0 0 007077 BIOTERRORISM PLANNING & READINESS 58,735 0 58,735 0 58,735 007084 FGTF/IMMUNIZATION ACTION PLAN 6,078 0 6,078 0 6,078 007084 FGTF/IMMUNIZATION-PROJECT FIELD STAFF 0 0 0 0 0 3. FEDERAL FUNDS - State 007084 FGTFIIMMl'NIZATION-WIC LINKAGES 0 0 0 0 0 007084 IMMUNIZATION SPECIAL PROJECT 3,720 0 3,720 0 3,720 007084 IMMUNIZA nON SUPPLEMENTAL - 2002 0 0 0 0 0 007084 SMALLPOX VACCINATION PROJECT 0 0' 0 0 0 007085 FGTF/BREAST & CERVICAL CANCER-ADMIN/CASE MAN 0 0 0 0 0 007127 MCH BGTF-MCHlCHILD HEALTH 11,446 0 1I,446 0 11,446 007127 MCH BGTF-MCH/CHILD HEALTH AGES 0-1 YR 0 0 0 0 0 007132 MCH BGTF-MCHlDENT AL PROJECTS 0 0 0 0 0 007133 FGTF/FA.l\IlL Y PLANNING TITLE X SPECIAL INITIATIVES 0 0 0 0 0 007133 FGTFIFA1\IlL Y PLANNING-TITLE X 76,650 0 76,650 0 76,650 007134 MCH BGTF-GADSDEN SCHOOL CLINIC 0 0 0 0 0 007134 MCH BGTF-HEALTHY START IPO 0 0 0 0 0 007134 MCH BGTF-INFANT MORTALITY PROJECT 0 0 0 0 0 007134 MCH BGTF-OUTREACH SOCIAL WORKERS 0 0 0 0 0 007135 FGTF/ABSTINENCE EDUCATION PROGRAM 0 0 0 0 0 015021 MEDIP ASS W AIVER-HL THY STRT CLIENT SERVICES 0 0 0 0 0 015021 MEDIPASS WAIVER-SOBRA 0 0 0 0 0 015060 Entrant Reimburement Transfer 0 0 0 0 0 015075 FULL SERVICE SCHOOLS-TANF 6,732 0 6,732 0 6,732 015075 KIDCARE OUTREACH REFUGEE-ENTRANT 0 0 0 0 0 015075 SCHOOL HEALTH.SUPPLEMENT-TANF 1I,581 0 11,581 0 11,581 015075 TANF ABSTINENCE EDUCATION 0 0 0 0 0 015075 TITLEXXlISCHOOL HEAL THlSUPPLEMENT AL 81,066 0 81,066 0 81,066 FEDERAL FUNDS TOTAL 1,198,076 0 1,198,076 0 1,198,076 4. FEES ASSESSED BY STATE OR FEDERAL RULES _ STATE 001026 Returned Check Ser Fees 0 0 0 0 0 001091 Communicable Disease Fees 0 0 0 0 0 00/092 Environmental Health Fees 186,370 0 186,370 0 186,370 00/092 OSDS Repair Permit 0 0 0 0 0 001092 OSDS Permit Fee 0 0 0 0 0 001092 I & M Zoned Operating Permit 0 0 0 0 0 001092 Aerobic Operating Permit 0 0 0 0 0 001092 Septic Tank Site Evaluation 0 0 0 0 0 00 1I13 Mobile Home and Parks 47,451 0 47,451 0 47,451 00 1I32 Food Hygiene Permit 41,379 0 41,379 0 41,379 001135 OSDS Variance Fee 1,350 0 1,350 0 1,350 001139 Migrant Housing Permit 0 0 0 0 0 001140 Biohazard Waste Permit 15,5/0 0 15,5/0 0 15,510 001142 Non SDW A Lab Sample 0 0 0 0 0 00 1I44 Tanning Facilities 1,150 0 1,150 0 1,150 001145 Swimming Pools 35,725 0 35,725 0 35,725 001149 Body Piercing 1,620 0 1,620 0 1,620 001165 Private Water Constr Permit 0 0 0 0 0 001166 Public Water Annual Oper Permit 0 0 0 0 0 001166 Public Water Constr Permit 0 0 0 0 0 001166 Non-SDW A System Permit 0 0 0 0 0 001I70 Lab Fee Chemical Analysis I/O 0 1I0 0 I/O 4. FEES ASSESSED BY STATE OR FEDERAL RULES _ STATE 001211 Safe Drinking Water 0 0 0 0 0 010403 Fees-Copy of Public Doc 0 0 0 0 0 015052 Transfers-Mobile HomelRV Park 0 0 0 0 0 FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL 330,665 0 330,665 0 330,665 5. OTHER CASH CONTRIBUTIONS - STATE 090001 Draw down from Public Health Unit -State 65,892 0 65,892 0 65,892 015029 Tranfers Intra Agency 0 0 0 0 0 015121 Super Act Reimbursements 180 0 180 0 180 015139 Well Surveillance Reimbursement - Pesticide 0 0 0 0 0 OTHER CASH CONTRIBUTIONS TOTAL 66,072 0 66,072 0 66,072 6. MEDICAID - STATE/COUNTY 001052 Medicaid Receipts - Part B 0 0 0 0 0 001056 CHD Incm:Medicaid-Pharmacy 0 0 0 0 0 001059 Medicaid EIP 0 0 0 0 0 001080 CHD Incm:Medicaid-Other 0 0 0 0 0 001081 CHD Incm:Medicaid-EPSDT 0 0 0 0 0 001082 CHD Incm:Medicaid-Dental 0 0 0 0 0 001083 CHD Incm:Medicaid-FP 0 0 0 0 0 001084 CHD Incm:Medicaid-Physician 3,225 4,627 7,852 0 7,852 001085 CHD lncm:Medicaid-Nursing 24,231 34,769 59,000 0 59,000 001086 CHD Incm:Co-lnsurance 0 0 0 0 0 001087 CHD Incm:Medicaid-STD 0 0 0 0 0 001088 CHD Incm:Med Reimb AZT Disp Fee 0 0 0 0 0 001089 Medicaid AIDS 49,305 70,746 120,051 0 120,051 001147 Medicaid HMO Rate 0 0 0 0 0 001148 Medicaid-HMO Admin 0 0 0 0 0 001181 CHD Incm:Medicaid Transportation 0 0 0 0 0 001191 CHD Incm:Medicaid Maternity 0 0 0 0 0 001192 CHD Incm:Medicaid Compo Child 0 0 0 0 0 001193 CHD Incm:Medicaid Compo Adult 0 0 0 0 0 001194 CHD Incm:Medicaid Sonagram 0 0 0 0 0 001208 Medipass $3.00 Adm. Fee 1,663 2,387 4,050 0 4,050 MEDICAID TOTAL 78,424 112,529 190,953 0 190,953 7. ALLOCABLE REVENUE - STATE 018001 Refunds, Salary 0 0 0 0 0 018003 Refunds, other Personal Services 0 0 0 0 0 018004 Refunds, Expenses 700 0 700 0 700 018005 Refunds Grants to Local GOy't 0 0 0 0 0 018006 Refunds, Operating Capital Outlay 0 0 0 0 0 018010 Refunds, Special Category 0 0 0 0 0 0180 II Refunds, Other 0 0 0 0 0 018013 DMS Refunds by Journal Transfer-65900 0 0 0 0 0 018099 . Refunds, Certified Forward 0 0 0 0 0 029010 Sale of Fixed Assets 0 0 0 0 0 7. ALLOCABLE REVENUE - STATE 037000 Prior Year Warrant 0 0 0 0 0 038000 12 Month Old Warrant 0 0 0 0 0 ALLOCABLE REVENUE TOTAL 700 0, 700 0 700 8. OTHER STATE CONTRIBUTIONS NOT IN CHD TRUST FUND _ STATE State Pharmacy Services 0 0 0 68,031 68,031 State Laboratory Services 0 0 0 92,820 92,820 State TB Services 0 0 0 0 0 State Immunization Services 0 0 0 134,229 134,229 State STD Services 0 0 0 0 0 State Construction/Renovation 0 0 0 0 0 WIC Food 0 0 0 637,693 637,693 ADAP Drugs Asst Program 0 0 0 467,056 467,056 Other (specify) 0 0 0 0 0 Other (specify) 0 0 0 0 0 Other (specify) 0 0 0 0 0 OTHER STATE CONTRIBUTIONS TOTAL 0 0 0 1,399,829 1,399,829 9. DIRECT COUNTY CONTRIBUTIONS - COUNTY 008030 Grants-County Tax Direct 0 305,660 305,660 0 305,660 008034 Grants Cnty Commsn Other (SQWG) 0 74,132 74,132 0 74,132 BOARD OF COUNTY COMMISSIONERS TOTAL 0 379,792 379,792 0 379,792 10. FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION _ COUNTY 001004 Child Car Seat Prog 0 0 0 0 0 001060 Vital Statistics Fees Other 0 500 500 0 500 001062 Rabies Vaccine 0 0 0 0 0 001062 Rabies Vaccine 0 0 0 0 0 001074 Adult Enter. Permit Fees 0 0 0 0 0 001077 Primary Care Fees 0 11,514 11,514 0 11,514 001093 Communicable Disease Fees 0 50,700 50,700 0 50,700 001094 Environmental Health Fees 0 0 0 0 0 001114 New Birth Certificates 0 8,176 8,176 0 8,176 001115 Death Certificates 0 44,523 44,523 0 44,523 001 I 16 Computer Access Fee 0 0 0 0 0 001117 Vital Stats-Adm. Fee 50 cents 0 430 430 0 430 001195 Primary Care Transfer Fees 0 0 0 0 0 001196 Water Analysis-Potable 0 0 0 0 0 FEES AUTHORIZED BY COUNTY TOTAL 0 115,843 115,843 0 115,843 11. OTHER CASH AND LOCAL CONTRIBUTIONS _ COUNTY 001000 Fees Other 0 0 0 0 0 00101 0 Recovery-Bad Checks 0 0 0 0 0 001026 Returned Check Fee 0 0 0 0 0 001029 Third Party Reimbursement 0 0 0 0 0 001072 Ryan White Title I 0 0 0 0 0 11. OTHER CASH AND LOCAL CONTRIBUTIONS _ COUNTY 001073 Ryan White Title II 0 0 0 0 0 001075 Ryan White Title III 0 2,000 2,000 0 2,000 001090 Medicare 0 4,200 4,200 0 4,200 001190 Health Maintenance Organ. (HMO) 0 0' 0 0 0 005040 Interest Earned 0 0 0 0 0 005041 Interest Earned-State Investment Account 0 30,000 30,000 0 30,000 007010 U.S. Grants Direct 0 782,997 782,997 0 782,997 008010 Grants Contracts Frm Cities Direct 0 0 0 0 0 008031 County AIDS Education 0 0 0 0 0 008033 County Contributions For Facilities 0 0 0 0 0 008050 Grants-Cnty Sch Board Direct 0 35,000 35,000 0 35,000 008090 Grants other Local Govn't Direct 0 0 0 0 0 008094 Grnts/Contracts other Agencies Direct 0 0 0 0 0 008095 Grants Cnty Sect 403.102 Air Pol 0 0 0 0 0 008099 ReimbIRebate Local Govn't 0 0 0 0 0 010300 Sale of Goods and Services 0 0 0 0 0 01030 I Exp Witness Fee Consultnt Charges 0 0 0 0 0 010302 Sale of Goods and Services, to Other Agencies 0 0 0 0 0 010402 Recycle Paper Sales 0 0 0 0 0 010403 Fees-Copies of Documents 0 125 125 0 125 010405 Sale of pharmaceuticals 0 0 0 0 0 010408 Copy Fess Intra/Inter Agency 0 424 424 0 424 010409 Sale of Goods and Services Outside State Government 0 0 0 0 0 011 00 I Healthy Start Coalition Contributions 0 417,710 417,710 0 417,710 011007 Cash Donations Private 0 400 400 0 400 011098 Donation School Based Clinic 0 0 0 0 0 011099 Other GrantsIDonations Direct 0 47 47 0 47 011522 Other Grant DOE 0 0 0 0 0 012020 Fines and Forfeitures 0 0 0 0 0 012021 Return Check Charge 0 0 0 0 0 028010 Insurance Recoveries-Fire Losses 0 0 0 0 0 028010 Insurance Recoveries-Fire Losses 0 0 0 0 0 028020 Insurance Recoveries-Other 0 0 0 0 0 090002 Draw down from Public Health Unit -County 0 -370,691 -370,691 0 -370,691 00]015 Recovery of Collection of Agency Placements 0 0 0 0 0 011066 Ryan White Local Revenues 0 0 0 0 0 011067 AIDS Insurance Continuation Project 0 0 0 0 0 OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL 0 902,212 902,212 0 902,212 12. ALLOCABLE REVENUE - COUNTY 0]8001 Refunds, Salary 0 0 0 0 0 018003 Refunds, other Personal Services 0 0 0 0 0 018004 Refunds, Expenses 0 0 0 0 0 018005 Refunds Grants to Local Gov't 0 0 0 0 0 018006 Refunds, Operating Capital Outlay 0 0 0 0 0 0180/0 Refunds, Special Category 0 0 0 0 0 0]8011 Refunds, Other 0 0 0 0 0 018013 DMS Refunds by Journal Transfer-65900 0 0 0 0 0 12. ALLOCABLE REVENUE - COUNTY 018099 Refunds, Certified Forward 0 0 0 0 0 029010 Sale of Fixed Assets 0 0 0 0 0 037000 Prior Year Warrant 0 0 0 0 0 038000 12 Month Old Warrant 0 O' 0 0 0 COUNTY ALLOCABLE REVENUE TOTAL 0 0 0 0 0 13. BUILDINGS - COUNTY Annual Rental Equivalent Value 0 0 0 225,000 225,000 Maintenance 0 0 0 20,000 20,000 Utilities 0 0 0 50,000 50,000 Other (specify) 0 0 0 0 0 Other (specify) 0 0 0 0 0 Other (specify) 0 0 0 0 0 Other (specify) 0 0 0 0 0 BUILDINGS TOTAL 0 0 0 295,000 295,000 14. OTHER COUNTY CONTRIBUTIONS NOT IN CHD TRUST FUND _ COUNTY Other County Contribution of some unknow origin 0 0 0 0 0 Other County Contribution (specify) 0 0 0 0 0 Other County Contribution (specify) 0 0 0 0 0 Other County Contribution (specify) 0 0 0 0 0 Other County Contribution (specify) 0 0 0 0 0 OTHER COUNTY CONTRIBUTIONS TOTAL 0 0 0 0 0 GRANDTOTALCHDPROGRAM 4,626,153 1,510,376 6,136,529 1,694,829 7,831,358 Working Copying ATTACHMENT n. MONROE COUNTYHEALm DEPARTMENT Part m Planned Staffing, ClientJ, Senices, And Expenditures By Program Senice Area Within Each Level Of Senice October 1, 2003 to September 30, 2004 QIlIrlerIy Espeadlture Plan FTE's Clients 1st 2nd 3rd 4th Grand (0.00) Units Services (Whole dollars only) County State Total A. COMMUNICABLE DISEASE CONTROL: hnmunization (101) 3.75 2,500 5,200 49,838 49,838 49,838 49,838 0 199,352 199,352 SID (102) 2.00 200 1,500 30,441 30,441 30,441 30,441 0 121,764 121,764 AI.D.S. (103) 17.50 475 7,000 560,789 560,789 560,789 560,789 736,682 1,506,474 2,243,156 TB Control Services (104) 2.00 575 1,500 28,723 28,723 28,723 28,723 0 114,892 114,892 Corom. Disease Surv, (106) 0.60 0 800 8,541 8,541 8,541 8,541 0 34,164 34,164 Hepatitis Prevention (109) .2.25 475 1,000 37,500 37,500 37,500 37,500 0 150,000 150,000 Public Health Preparedness and Response (116) 1.50 0 0 14,684 14,684 14,684 14,683 0 58,735 58,735 Vital Statistics (180) 1.25 0 0 15,823 15,823 15,823 15,823 63,292 0 63,292 COMMUNICABLE DISEASE SUBTOTAL 30.85 4,225 17,000 746,339 746,339 746,339 746,338 799,974 2,185,381 2,985,355 B. PRIMARY CARE: Chronic Disease Services (210) 0.50 50 300 46,787 46,787 46,787 46,787 128,325 58,823 187,148 Tobacco Prevention (212) 0.00 0 0 0 0 0 0 0 0 0 Horne Heahh (215) 0.00 0 0 0 0 0 0 0 0 0 W.LC. (221) 6.00 1,500 10,000 79,842 79,842 79,842 79,842 0 319,368 319,368 Family Planning (223) 4.75 900 4,000 95,882 95,882 95,882 95,882 0 383,528 383,528 Improved Pregnancy Outcome (225) 0.00 0 0 0 0 0 0 0 0 0 Heahhy Start Prenatal (227) 3.50 300 10,000 57,438 57,438 57,437 57,437 229,750 0 229,750 Comprehensive Child Health (229) 0.70 100 400 29,928 29,928 29,928 29,928 5,757 113,955 119,712 Healthy Start Infant (231) 3.50 350 9,000 46,990 46,990 46,990 46,990 187,960 0 187,960 School Health (234) 9.00 0 100,000 203,750 203,750 203,750 203,750 69,769 745,231 815,000 Comprehensive Adult Health (237) 2.50 265 1,000 57,396 57,396 57,396 57,396 14,584 215,000 229,584 Dental Health (240) 0.05 0 0 12,500 12,500 12,500 12,500 0 50,000 50,000 PRIMARY CARE SUBTOTAL 30.50 3,465 134,700 630,513 630,513 630,512 630,512 636,145 1,885,905 2,522,050 C. ENVIRONMENTAL HEALTH: Water and On site Sewage Programs Coastal Beach Monitoring (347) 1.75 17 890 14,222 14,222 14,222 14,221 0 56,887 56,887 Limited Use Public Water Systems (357) 0.00 0 0 0 0 0 0 0 0 0 Public Water System (358) 0.00 0 0 866 866 866 866 0 3,464 3,464 Private Water System (359) 0.00 0 0 65 65 65 63 0 258 258 Individual Sewage Disp. (361) 12.00 3,000 3,000 32,476 32,476 32,476 32,474 125 129,777 129,902 Group Total 13.75 3,017 3,890 47,629 47,629 47,629 47,624 125 190,386 190,511 Facility Programs Food Hygiene (348) 3.00 60 .250 5,500 5,500 5,500 5,500 0 22,000 22,000 Body Art (349) 0.00 0 0 592 592 591 591 0 2,366 2,366 Group Care Facility (351) 0.50 80 150 2,675 2,675 2,675 2,675 0 10,700 10,700 Migrant Labor Camp (352) 0.00 0 0 0 0 0 0 0 0 0 Housing.Public Bldg Safety,Sanitation (353) 0.00 0 0 84 84 84 83 0 335 335 Mobile Home and Parks Services (354) 0.50 65 245 7,500 7,500 7,500 7,500 0 30,000 30,000 Swimming PoolslBathing (360) 3.00 482 1,220 31,802 31,802 31,802 31,802 0 127,208 127,208 Biomedical Waste Services (364) 0.30 40 60 1,963 1,963 1,963 1,961 0 7,850 7,850 Tanning Facility Services (369) 0.03 730 1,936 500 500 500 498 0 1,998 1,998 Working Copying ATTACHMENT D. MONROE COUNTY JIEALTH DEPARTMENT Part m Planned StafJing. Clients, Services, And Expenditures By Program Service Area Within Each Level Of Service October 1, 2003 to September 30, 2004 Quarterly Expenditure Plan ITE', Clients 1st 2nd 3rd 4th Grand (0.00) Units Services (Whole dollars only) County State Total C. ENVIRONMENTAL HEAl..m: Group Total 7.33 1,457 3,861 50,616 50,616 50,615 50,610 0 202,457 202,457 GroundwaterContunination Storage Tank. Compliance (355) 2.00 290 583 30,862 30,862 30,862 30,863 0 123,449 123,449 Super Act Service (356) 0.00 0 0 0 0 0 0 0 0 0 Group Total 2.00 290 583 30,862 30,862 30,862 30,863 0 123,449 123,449 Community Hygiene Occupational Health (344) 0.00 0 0 0 0 0 0 0 0 0 Consumer Product Safety (345) 0.00 0 0 145 145 145 145 0 580 580 Emergency Medical (346) 0.00 0 0 0 0 0 0 0 0 0 Lead Monitoring Services (350) 0,00 0 0 13 13 13 11 0 50 50 Public Sewage (362) 0.00 0 0 29 29 29 28 0 115 115 Solid Waste Disposal (363) 0.00 0 0 0 0 0 0 0 0 0 Sanitary Nuisance (365) 1.00 60 100 4,850 4,850 4,850 4,850 0 19,400 19,400 Rabies Surveillance/Control Services (366) 0.05 1 6 300 300 300 300 0 1,200 1,200 Arbovirus Surveillance (367) 0.15 0 20 917 917 917 918 0 3,669 3,669 Rodent! Arthropod Control (368) 0.00 0 0 141 141 141 142 0 565 565 Water Pollution (370) 0.00 0 0 2,855 2,855 2,855 2,855 0 11,420 11,420 Air Pollution (371) 0.00 0 0 194 194 194 194 0 776 776 Radiological Health (372) 0.03 0 0 200 200 200 200 0 800 800 Toxic Substances (373) 1.00 30 30 18,533 18,533 18,533 18,533 74,132 0 74.132 Group Total 2.23 91 156 28,177 28,177 28,177 28,176 74,132 38,575 112,707 ENVIRONMENTAL REALm SUBTOTAL 25.31 4,855 8,490 157,284 157,284 157,283 157,273 74,257 554,867 629,124 D. SPECIAL CONTRACTS: Special Contracts (599) 0.00 0 0 0 0 0 0 0 0 0 SPECIAL CONTRACTS SUBTOTAL 0.00 0 0 0 0 0 0 0 0 0 TOTAL CONTRACT 86.66 12,545 160,190 1,534,136 1,534,136 1,534,134 1,534,123 1,510,376 4,626,153 6,136,529 ATTACHMENT III MONROE COUNTY HEALTH DEPARTMENT CIVIL RIGHTS CERTIFICATE The applicant provides this assurance in consideration of and for the purpose of obtaining federal grants, loans, contracts (except contracts of insurance or guaranty), property, discounts, or other federal financial assistance to programs or activities receiving or benefiting from federal financial assistance. The provider 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. The applicant assures that it will comply with: 1. Title VI of the Civil Rights Act of 1964, as amended, 42 U.S.C., 2000 Et seq., which prohibits discrimination on the basis of race, color or national origin in programs and activities receiving or benefiting from federal financial assistance. 2. Section 504 of the Rehabilitation Act of 1973, as amended, 29 U.S.C. 794, which prohibits discrimination on the basis of handicap in programs and activities receiving or benefiting from federal financial assistance. 3. Title IX of the Education Amendments of 1972, as amended, 20 U.S.C. 1681 et seq., which prohibits discrimination on the basis of sex in education programs and activities receiving or benefiting from federal financial assistance. 4. The Age Discrimination Act of 1975, as amended, 42 U.S.C. 6101 et seq., which prohibits discrimination on the basis of age in programs or activities receiving or benefiting from federal financial assistance. 5. 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. 6. All regulations, guidelines and standards lawfully adopted under the above statutes. The applicant agrees that compliance with this assurance constitutes a condition of continued receipt of or benefit from federal financial assistance, and that it is binding upon the applicant, its successors, transferees, and assignees for the period during which such assistance is provided. The applicant further assures that all contracts, subcontractors, subgrantees or others with whom it arranges to provide services or benefits to participants or employees in connection with any of its programs and activities are not discriminating against those participants or employees in connection with any of its programs and activities are not discriminating against those participants or employees in violation of the above statutes, regulations, guidelines, and standards. In the event of failure to comply, the applicant understands that the grantor may, at its discretion, seek a court order requiring compliance with the terms of this assurance or seek other appropriate judicial or administrative relief, to include assistance being terminated and further assistance being denied. ATTACHMENT IV MONROE COUNTY HEALTH DEPARTMENT FACILITIES UTILIZED BY THE COUNTY HEALTH DEPARTMENT Facility Description Location Owned By GA TO Building 1100 Simonton Street Monroe County Key West, FL 33040 Health Care Center 1200 Kennedy Drive Lower Keys Medical Center Key West, FL 33040 Roosevelt Sands Center 105 Olivia Street City of Key West Key West, FL 33040 Ruth Ivins Center for 3333 Overseas Highway Monroe County Public Health Marathon, FL 33050 Environmental Health 13367 Overseas Highway Private Party Monroe CHD Marathon, FL 33050 Monroe County Health 148 Georgia Avenue Monroe County Department Tavernier, FL 33070 Venetian Plaza 85960 Overseas Highway Private Party Village of the Islands Is/amorada, FL 33036 ATTACHMENT V MONROE COUNTY HEALTH DEPARTMENT DESCRIPTION OF USE OF CHD TRUST FUND BALANCES FOR SPECIAL CAPITAL PROJECTS, IF APPLICABLE (From Attachment II, Part I) Include detailed Special Capital Project information, including description, cost by each project and anticipated completion date on this attachment. 1) $200,000 Upper Keys CHD, Renovation of Mariner's Hospital, Construction Estimated completion date December 2005 99-528 UK 8KOOO (EH, Nursing, WIC) $50,000 10/01/03-09/30/04 Est. $150,000 1 % 1 /04-09/30/05 Est. 2) $75,000 Technology Equipment/Hardware/Software Estimated completion date June 2005 99-528 TE 8KOOO DESCRIPTION OF SPECIAL CONTRACTS (From Attachment II, Part III) Please list separately Special contracts are contracts for services for which there are no comparable services in the county health department core programs; no service codes in Departmental coding manuals; projects that are locally designed and have no standard statewide set of services and therefore cannot be accounted for within existing county health department programs. 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