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Resolution 012-1986
/( - - .J ... Dr. Jose Bofi11, Director Monroe County Public Health Unit RESOLUTION NO. 012 -1986 A RESOLUTION AUTHORIZING THE MAYOR AND CHAIRMAN OF THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, TO EXECUTE A CONTRACT BY AND BETWEEN THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS AND THE STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILI- TATIVE SERVICES CONCERNING THE MONROE COUNTY PUBLIC HEALTH UNIT. BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, as follows: That the Mayor and Chairman of the Board of County Commis- sioners of Monroe County, Florida, is hereby authorized to execute a Contract by and between the Board of County Commis- sioners of Monroe County, Florida, and the State of Florida Department of Health and Rehabilitative Services, a copy of same being attached hereto, concerning the Monroe County Public Health Unit. PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, at a regular meeting of said Board held on the 10th day of January, A. D. 1986. BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA \U"u.~ --~ .;-~ '"- ~ By .... - ~ ... ayor ha~rman ( Seal) Attest: v2!~ ()~ '- Lv' er ' ,iI ' It ' APPROVED AS TO FORM AND GAlSUFRC~NCY. BY Altomev's Off'C~ i ' ?$ WC0N-T RtCT ' ETt E EN _ � • ;� MONROE COUNTY .. . (BOARD. OF COUNTY COMMISSIONERS) • �4ND STATE .OF FLORIDA . . (DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES) . . rsuant .to the Laws . -of Florida , Chapter 83-177 , this contract is entered to between the Department of Health and Rehabilitative Services , herein- ter referred to as the "department " and Monroe County , hereinafter referred • as the "county . " This contract stipulates the services that will be pro- ded by county public health units (CPHU ' s ) , the sources and amount of funds et will be committed to the provision Of these _services , the administrative d programmatic requirements which will govern the use of these funds and e respective responsibilities of the Department and the County in enabling . e county public health units "to promote , protect , maintain, and - improve e health and Safety - of all citizens. and visitors of this state through a • stem of coordinated- Public Health Unit services . " . - General Provision : Both parties agree that the county public health unit : A. Shall provide services according to the conditions specified in .Attachment I and all other attachments to this contract . • B. Shall Fund the services specified in Attachment II , Section IV, at the funding level specified for each program service area in • that attachment . . . Federal and State Laws and Regulations : * Both parties agree that the county public health unit : • A. Shall comply with the provisions contained in.,the Civil Rights Certificate , hereby incorpor ted into this contract as Attachment III . - • • B. Shall comply with the . provisiions of 45 CFR, Part 74 , and other - applicable regulations if thii.s contract contains federal funds . C. Shall comply with all applicable • C standards , orders, or regula-. tions issued pursuant to the Clean Air Act as amended 442. USG ' _ . 1857 et seq. ) and the Federal Water .Pollution Control Act as • amended133 USC 1368 et seq.1., if this contract contains federal funds and the total .contract amount is over $100.000. • • • - • 1 i • j 111111( 6 . ' Shall comply with applicable) sections - of Chapter 27 , Florida :: ' . Statutes , (Transportation Services ). and Chapter 41 -1 , _Florida m Administrative Code , ( C.00rdinated Community. Trans . or.tstion Ser,- vices_) regarding the provision of transportation services for the Transportation: Disadvantaged if this contract contains any state or federal funds which! are used . to provide tor direct ' or indirect (ancillary ) transportation services . B . Records., Reports and Audits : Both parties agree that the county public health unit :' A. Shall maintain books , records 'and. documents - in accordance with accounting procedures and practices which sufficiently . and pro- perly reflect all expenditures of funds provided by the depart- ment , the county , and other- sources under this contract . Books , records and documents must 'be adequate _ to enable the county- pub- lic health unit to comply' wi h the following reporting require- ments.: . 1 .. The revenue and expenditure requirements- in the State Auto- -mated Accounting System 2: 2 at the coding' level -specified in Attachment IV of this contract ; •T , 2 . , The client registration and service reporting requirements - • of the minimum data set as specified in .Client Information • System/Health Management Component Manual and any revisions - subsequent to the January 1 , 1984 vers-ion , ' or - the equiva- lent as approved by the Health Program Office. : Any re.por • ting system used by or on behalf- of the county public health unit- to produce the- -above information must provide ff� - data in a machine. readable format approved by the depart- ment. which can be transferred electronically to the sClient • Information 'System; 3 . Financial ,-procedures specified in the department ' s Accoun ting- Procedures Manuals and Accounting Memoranda ; 4 . All appropriate county public health unit employees shall . - report .time , -- in. Client Information Sy:stem/Health Management Component compatible format by program component- for at least the sample periods- specified by the department ; and 5 . Any other state- and county program specific reporting re-: - quirements . detailed in Attachment XI and following, to this contract . . . . , - B. Shall assure these records shall ..be subject during normal. busi- - ness hours to inspect-ion, review or audit by state or county- per-- . sonnel duly authorized by the department or the county, - as well as by federal personnel. i .C. Shall retain all financial records, supporting documents, st.atis- • tical -records , .and -any other . documents pertinent to this - contract • 2 1 • j r` in" con - lance with retention - schedulEE requ in Hum 15.- 1 'Records Management Manuai . • . D. Shall allow-.persons duly authorized by state - or county , and fede- ral auditors , pursuant to 45 !CFR , Fart 74 . 24 ( a ) , ( b ) , and (d ) , to ' have. full access to , and the right to .e>:amine any of said records and documents during said retention period . - E. Shall include. these aforementioned audit and record-keeping re- ' • quirements. in all approved- subcontracts and assignments . Both parties futher agree that :' The department shall provide uniform financial statements of ' program account balances for each level of service on a quarterly basis to the county and. to the director or administrator of the county public health__, unit . ' F. Monitoring: • Both parties agree that the county public health unit shall. permit the department' and the county to monitor , as either determines necessary , . the budget 'and services plan detailed in Attachment II which will' be operated by the county - public health unit or its subcontractor or as- - signee . . . , Safeguarding Information : Both parties agree .that the. county, public health unit ,shall not use or • disclose any information concerning a recipient of services under this contract for any purpose not in conformity with the state law, regula- t .ions• or' manual (HRSM 50-1 ) , and federal reg'ulations ( 45 CFR,Fart 205 .50 ) except on.-wr'itten consent , of- the receipient , . o_ r his responsible 'parent or guardian when author ized , by lawL - I . 'Assignments:. • Both parties -agree that: the county public 'health unit shall not assign the responsibility of this contract to another party without the prior written approval of the department and the•: county . _ .No such -approval by • the department and the county of any assignment shall . be deemed in any • event or in any manner to :provide for the , incurrence of. any obligation of the department or the _county in addition to the dollar 'amount agreed - - upon in this contract . All such assignments shall be. subject to the conditions- of this contract. and to any conditions 'of approval that the . department and the county shall' deem necessary . iI . Subcontracts: • - . both parties agree that 'the county public health unit shall be permit- tedto execute subcontracts with the approval of 'the delebated authori- ty in the department for services necessary to enable-. the county public health unit to carry. out the programs specified in this contract , pro- . vided that the amount of any such subcontract shall not be for more 3 � ` T i t'n'.n' een ( 10 ) ent of '.t_he total value of this eoIt . . • • 4 In the event that the -county public ' health unit 'needy to execute a sub- contract for '_en amount greater than ` t.en ( 10.) percent of the value of this -contract ,". both parties t-o this contract must agree- in writing to such a subcontract prior to its execution_.. - . . No subcontracts shall be .'deeme-d in any manner to provide for ' the -incur- rence of 'any obligation of the department or the county in addition to the' =to.tal dollar amount agreed upon in this contract . All such subcon- tracts, shall be subject to. the.'.conditions of this contract and to any conditions of approval: -that the department and the county shall deem necessary : • . I . Payment for Services : . - . . . A. The department agrees_.:.- To pay ':for services identified in Attachment ' II as the state ' s 'responsibility in an amount not .to exceed $1 , 6301054 . This -a- . mount includes all revenues' from whatever source to 'be appropria.- ted by the state' to the Public `Health • Unit. Trust Fund, including . the state ' s share of all public , personal or primary care- fees . B. The county agrees : . - • To pay , for services identified in. Attachment II as the , monies to ' ' be generated in . Monroe • County in- an' amount not to exceed $334 , 606 . . . This amount- includes all revenues' from whatever sources tote ap- propriated by the County Public Health Unit Trust Fund ' for ser- ' vices provided by the county public health unit , including the county ' s share of all.. public , lpersonal and primary care fees . Of - the several revenue.. sources identified - in Attachment II , Section I , B (County ) , the Monroe Board of County Commissioners will be ' . • only responsible for the appropriation of $2041000 . The department_. and the county :muu ta:l.ly agree: • A. Effective 'date : ' . . 1 . Thia contract . shall begin on October 1 , '1985 or the date on . which the 'contract _ has been signed by both 'parties , which- : ; ever is later . _ 2.-. This contract shall end on September 30, 1986 . - B. ' . Termination: . - 1 . Termination because -of lack of. funds: In the event. funds to finance this contract bec_ome . unavai- lable, either .party .may terminate the contract upon no less . than twenty-four-A24 ) hoursJ notice in writing .to the other 1 -' - Ay . Said notice shall be del-iverecertified - mail , Apr receipt requested, or in: perso h . proof of deli- very . The department or the county shall be the --final et.- + thority as to the availability oi " their respective funds• as applicable.... Incase of cancellation . due to the unavailabl • - lity of funds , staffing and services :,shall be reduced aF-- propriately .' . • . • 2 . Termination for' breach: Unless' breach is waived by either party in writing , either party may , byi: writtenynotice to the other party, terminate this. contract :"upon no less than twenty-four (24 ) hours_ no- tice . Said -notice shall be delivered by certified mail , • return receipt .requested , or in person with. proof of deli- very . If applicable , either party may employ the default provisions in_. Chap"ter 13A-1 , Florida. Administrative Code. Waiver of breach, of any provision of this contract shall • not bendeemed to be alwaiver of any other breach and shall not be construed to be a modification of ' the terms of the . .- contract . The provisions' herein do not limit either party 's right to remedies at law or to damages . 3 . Termination at will : • This contract may be terminated by either party upon no . less than thirty (30 ) t days notice,, without cause . Said no.- tice shall be delivered by -Certified mail , return receipt. • : requested, or . i�n� person with proof of delivery . C. Notice and contact : . . . The contract manager . for the department for this contract 'is William L . Derbonne'. The representative of the county for this contract is Kermit Lewin . In the event that different represen- tatives are designated' by eiither party after execution of this contract , notice- of the . na a .and address of the new representa- - tive will be rendered in writing to the other party and said no- • tification attached to - originals ' of. thi's contract . D . Modification : • . ' Modifications of provisions of this contract , shall only be enfor- - ceable when they have been reduced to writing and duly signed by both parties to this contract . - - • E. Name and address of payee : . . The name and address ' of the official payee to whom the payment • - shall be aaade: Public Health Unit Trust- Fund, - . • - • ' • Monroe County . j . Public Service Building, .. . . 5 • • i ,,f•,..; I ' , I Villi•:- - . ITJT-7 -*-.'41 i Junior College Road 11111 " • Key West ., : Florida ; 33040 F . All ~terms and conditions included: This contract and its attachments as referenced , (Attachments I through. XVII ) ,• contain all the terms and conditions agreed upon by the parties . G. Amendment : The county and the department agree that the . County Administrator is authorized to amend this contract from time to time when sup- plementary funding may be Provided :from sources other than county funds in order to expand program services specified herein . IN WITNESS THEREOF, the parties hereto have caused this 449 page .con- act to be executed by their undersigned officials as duly authorized. STATE OF FLORIDA DEPARTMENT OF HEALTH AND LINTY REHABILITATIVE SERVICES • ' •• vii4 s = BY: (Departmental Authority ) ME: WILHELMINA F. HARVEY NAME: DAVID H. PINGREE TLE: MAYOR TITLE. SECRETARY OF H.R.S. TE: '� c'('": '(� D TE T ST • a NAME: Jose.J:-B-o ill ,- M.D. ME: Danny L. olhage TLE: Clerk of the Circuit Court TITLE : Public Health Unit Director — I/21_ — cc(.7 i 16th. Judicial District DATE:. TE \- —_�--1 APPR- D AS TO FORM A 0- AL'SUFFICIENCY @�BY -�- Attorney's Office . S / - 6 - • At t:act,m .nt I . p E C I A L. P F2 B g 0 NJ 2 . Public Health Unit Trust Fund : • Both parties agree ::. A. That all state and Local- fund to be expended by the county public health unit shall be deposig.ed- in th,e Public Health Unit Trust Fund maintained by the State Treasurer . B. That all state and local funds deposited in the Public Health Unit- Trust Fund ;shall: be experded by the Department solely for services :rendered by the county public health unit as specified in this contract , - except that.I nothing. shall prohibit the rende- ring of additional services ,not specified in this contract . C.C. That funds deposited in the`:.Piiblic Health Unit Trust for the county public health unit. in- Monroe County shall be accounted for separately from funds deposited for other county public health units, and shall be _used only for public health , unit services in Monroe County . D. That county public health units surplus funds accumulated prior to October .1 , 1984 are county funds to be used solely for pub- li.c health purposes in the county where they were generated . The surplus of $57,057.00 is to be included in whole: as part - of the county ' s annual contribution and the amount is reflected in. Attachment II ,, Section. I , under the Board of County .:Commission- ers contribution . . E. That any surplus funds , inclu1ding fees or accrued interest , re.-, maining in any.:public health 'unit account at : the end of the contract year , excluding funds accrued prior to October 1 , 1984 , shall be credited to the state or county , as appropriate , in such amounts as maybe determined 'by multiplying the surplus funds remaining in a program account by the percentage of Coun- ty Public Health Unit Trust Fund funding provided by each go- ver.nmental entity for the rendering of the particular health t service for which such account -was established . Such surplus . funds: may be applied .toward the funding -requirements of each participating governmental entity in _ the following year ; how- ever , in each such case , all surplus funds, including -fees and accrued interest', shall remailn in the trust fund, and shall be accounted for - in a manner whifch clearly illustrates the amount • which has been credited to each participating governmental en- tity•_ F. That :under no _ci rcumstances shall there be transfers of funds 'between 'the three' levels of s1ervice without a contract amend- ment duly signed :by both PartIlies to this contract. and the pro • - per budget amendments unless the county public health unit di- 7 • ' rector determines. that_. an emergence. exists wherein a . .t ime delay would" endanger ;t-he. Public ' s -health and the 'director. of the . • . Heal-th . Program Office h.al approved the. transfer . The•.director • of the Health Program" Off ice shml l °"forward written evidence of this approval - to the county, public health unit within 30 days after -the transfer . • . ' This contract - shahl . include at - Part 'of Attachment II a section - entitled "Planned Expenditures and Planned Services- .With_in' Each Level of Service. " This section shall inc-lude . the -fo-llowing information. .f.or .each program. service : area within each level of . • service : - the planned .number of fulltime equivalents • (FTE ' s) . - by level 0.4 service.;.. - . . . - the- planned number of services : to be provided; "- . ' • - the plann.e,d number of . individual/un:its to: be served ; and - the planned state',�and- county. expenditures. - Expenditure information shall , be _ displayed in a" quarterly- ,Plan . to facilitate monitoring of...contract performance . - ' . ' " Ad)ustments in the . planned expenditure of 'funds- for program ' - service .areas within each level of. service are permitted - - -, - - .. without• a modification to-this contract or a-.budget emend-, meat . If the -county- public health unit exceeds - the tolerance levels as _specified below es of the, end of the report . period , .the director/administrator of the county public health unit , must prepare a written explanation f.or each: program; serv.ice - "area which is out " of complia Ice : . 1 . ' The 'cumula.t ive percent variance cannot exceed by more than - . . 25 percent .the planned expenditures for a particular' pro.- gram service area or :fall below planned expenditures-:by -. more•"than :25 percent . . - . . . . 2. - However., if the cumulative- amount of. variance between ac- tual and -planned expenditures for. the report period 'for a .- program service area do' s -not .exceed one ( 1-) percent of - _ - the cumulative ,planned e!,xpenditures for " the level .of �ser - . v'icce in:wh:ich the 'prog.ram service area is included, a va ' , r iance explanation is': not - required . - G. The -required -dates -f.or: the county public health un-it ' direc.tor ' s • quarterly report to the county and. the department shall be as . follows: . " 1 . :4arch 1 , 1986" 'for :the: report- period October 1., .-1985 :: :, . " through December 31 , =:1995 1. : '. - 2. June 1., 1986 for the report period - October. 1 , 1.985 ' - ' . through March 31 , 1986.;. .: - - - - , . -. { . • y " s ., 3. . September 1`, 1966 for" the report period_ October• 1 ,' 19E:5 " - : w. • • through June. 3Q , 198E�.; a.nd . 4,. '"December 1 , . ,1966. for the1 report _period October 1 , 1985 through September 30 , 1E+66 . H. : Quarterly reports 'submitte.d :by county -public health unit ' direc- - ' tore -to the ' county and the department • shall' "include •at least the 'following sections: - 1 . A transmittal le.tt_er__.briefly summarizing county public health unit -activity year-to-date ;' 2 . A contract variance analysis whi"ch: a . Explains •the" reason for the variances in expenditure in any program= ser-,vice area wh-iche-xceeds the tole-. rance` levels established in paragraph F.1 ,2 above ; . b .- The steps'. that will be taken to . comply with the ' con • - tract expenditure ,,plan , including a contract amend- _ • merit , if necessary ;., :and co A timetable for completingthe steps . necessary tor: -comply with the...p-lan. Failure of -the: county public - health ._unit to accomplish the planned steps by the • dates established In the-_ written explanation .shall constitute' a.'breach of the- contract and the county- - or the department may. withhold funds from the con- ' tract or take-. other appropriate administrative ac '. . . ti-on to achieve Compliance, . . ' 3 . DE 135L1 "CPHU -Contraci management Report ; " - - 4 DE235L1 -- "An;alysic of. Fund Equities ; and `5 . DE25OL1 "Statement of Budget and Actual Expenditures Per - . . Revenue Contribution--Ratio . " ' - Ih. Fees : - . A. Environmental regulatory fees: ' -The department - shall •establish by- rule fees . for environmental regulatory "functions ''designaited in - this contract and conduct- - _ -te;d, by the-;.county public- health unit. . ,Such fees shall_ super- - - - sede ::any environmental. regulatory .fees .existing. prior 'to _.the .effective date of .thee depar:t6ent '-s. rule-._. The: county -may, bow- - ever, establish fees .pursu -ant to Florida Statutes, Section ' `IS81 .31.1 which -are not -inconsistent with department • rules -and : ".other, statutes, alter consul1tation "with the" department S. Public health services fees: • • • 1 . . 9 " . . _ .- : : 11 : * -77-- .. - '. ' . - - . -L . _ _ ' The de Ent may' estEbl,iih tq :rule;- fees fo lichealth ` . ' • services , .other than environmental, regulatory services , de- - • sisnated -in 'th-is contract end conducted by theicounty -public • health unit-. Such `fee.s , sha.1l supersede any other_ fees for a publ .ic .health service which a ;isted prior to the effective date of the department:' s rule . :the-county- may ,- 'however , establish fees pursuant :to Florida Statutes , Sect ion _.381 . 311 which. -are. - not inconsistent with department rules and " other , statutes . - All state or federally. authorized• -public health. services fees - shall b e - l i.sted' in Attachment •:V of this, contract . , A11 county - authori"zed public heal.th 'services` fees shall • be listed in At- tachment _ VI. `of this- contract . C. Personal health and -pr imar-y care fees:.-, • Either party-•°may establish .fees for . personal; health and- primary . care services designated. in this contract and- conducted by- the • - county public health `unit ,' ex.cept for- those •services- for -which fee schedules are specified :in-federal •or: -state law or`- regula- T. "tio'ns . Both pa-r.ties _ further: agree 1 That such fees shall be �establ ished by resolution .-o,f.- the Board:of County Commissioners ,,' if promulgated •bY. the . .coun- ty, or by . rule , .if promulgated •by the department ; 2'. That there shall be no duplication of fees by the depart- ' • - `ment and the - county- - for personal health .or primary care services. provided by ahe. county public health unit ; " ' 3 . -That personal health a.nd pr imar_y care fees -shall be listed in Attachments .;V` and -VI of- this cont-ract .• D. - Collection and use of fees :. . :' -. . Both "pa'rties agree . Thatproceeds .from all - fees collected. by Aor on ,behalf of _ the county -Public heal,th!-.unit-, whether for public, perso- nal , or primary_ care services, .shall only -be used __to fund .'services :provided. by the .county-, h publichealth unit ; - 2 . -That all fees collected by Or cm-n behalf -of the county pub- - Tic health unit, shall be deposited. with the State Treasury and.. credited : to the publi.i'c Health Un-it...Trust Fund or other- - appropriate state "account if ' required .by Florida Statute or the= State Comptroller; . - - - ' 3,. " That ._ '- - N/A - - •_ ' (,Specific-Fee ) . _ - . is exempted from. the above_provisions' _unti l N/A -because ' . this :fee was: -committed ' Pr,ior• to_ 'July 1 , .,1983 toward; r'e- t,irement of that obligation .on N/A . (Specific- Public Healthi_lity ) . e - - - . - • - - - . - Ill . ..Service Policies and Standards: •. : -._ . - -- Both parties agree .that-. t-he county public health_ ;unit shall adhere to the service , po.l icies and standards published 'by the -department in - program manuals- and other guidelines provided by the department as. a guide for providing each funded service specified. in' Attachment II of •this ;contract -.where such. manuals 'or• guidel_i•nes • exist . - IV. 'Personnel.: ' .• - . • . Both parties. agree : .. - . A. The..county p.ublic - health unit shall have at least the following employees : 1 . • A-. director -o.r . admin,istr�ator. appointed by :the Secretary of •the department after. consu.lta - tion-. with the staff director ' .of the. -Health". Program Olffice and with the concurrence . of the Board of County Com{missi-oners ;. . . - - 2 . .A -fulltime communi.ty, health nurse ; ._ 3. An environmental health specialist ; and -- A . A clerk. - - B. That all •department employees working in -the county, public • . health., unit- shall be supervised. by the department and subject : to:Department of. Administration rules .- - • • . • C. Staffing levels. shall be established ' in- .-th-is contract in: At- - • tach.ment I I , 'Sect ion IV, as FTE' s , and- may `be changed as funds • become. .ava ilab-le . 0. The number and classification• of employees •working in the .coun- ty .public health ' unit that' are county.. employees ,rather than de-.- - - . . . par.tment employees - shall be l,ist-ted in .At-tachrr;ent. VII of this contract . ' V. (Facilities: .. Both parties ' agree_: . - . A. -That ' count*" public health unit-• facilities shall -tbe .-provided .as . . - specified .in Attachment VIII of this contract.:- This"-attachment . shall include -a s9e.scription of all the ' faclitie.s :used by the - count'y Publ is health ainit , including, the annual rental equ.ive- - - lent value., and by/Whom they will :be funded. - . That responsibility-. for Maintenance Sot' shall be-.des- 11- . • • cr ibe in Attachment ValI , including the c _ of such mainte • - nance , and by whom it will be funded. • C. That .• the department . 'in conjunction with the county will conduct en annual assessment of the- adequacy -of county health unit fa- cilities , .,anti submit a report by the end of the contract year describing needed facility-,improvements or expansion, including the, estimated cost of such improvements or expansions . D. That the county shall own the facilities used by the 'county public health unit unless otherwise provided in Attachment VIII of this contract ; and E. That facilities and equipment provided by either party for the county, public health unit .shall be used for public , health- ser- vices provided that the county shall have the right to use such facilities and equipment , owped or leased by the county , as the need arises , to the extent that such use would not impose -en - unwarranted interference with the operation of the county pub- lic health unit . VI . Method of Payment : A. In each quarter of the contract year , the county shall deposit : .it'. least one fourth of its;- t{otal annual contribution to the County Public. Health Unit Trust Fund. At least one third of, this quarterly contribution 'shall be deposited no later than the last day of the first month in each quarter . S. :The department ' shall .relea°se on 'a quarterly basis , beginning the first day of the contract , an amount equal to one quarter- of, the total amount ' peclf led in this contract for state expen- ` diture excluding amounts for the following: Improved Pregnancy Outcome Maternal and Child Health Women, Infants, and Children Family Planning VII . Laboratory and Pharmacy Support : The department agrees to supply laboratory and pharmacy support ser- vices for the county public health unit . at least - at.' the level provi- - ded in the prior state fiscal year if funds are available . VIM . Other County Public Health Unit Activi.ty : (optional ) - Attachment X shall contain a listing of all public health activities in the county which supplement ors support the activities of ..the county public health unit ,-;but .arse_ not financed through the :Public Health Unity Trust Fund.` '"The contiract manager for the department and the contract representative for -t;he county should be notified in writing of changes 'i,� the agreements or amounts l isted. 'in- Attachment X which occur during the life t'o 'this contract, but _such changes do • • • nest requir ccntract amendment .! aX.a Emergencies : } Both parties agree , to the extent of their respective resources , that they may assist each other in meeting public health emergen- cies . • • • • • I ' 13 r.♦ V i 1 • • • A T T A C I-I II E M T I I • i.. . 14 i . • ( aged Pre9)e tad IErtl t�1,�i iu 309 1965 eta. i A t p _ • • ,• • - Statl� Sh®t 0 " Estin+etbd County Share Eetln�ted '' '`" Fund Of'County Trust Fund - .� •::.;� •' ;,,; 'l' ,; ' . • • � Of County Truth .,: Balance A. Of 'Balance As Of ;:, l , . :;.. ,, • September 30, 1905 Septa+ er 30, 1995 Total - 1 j • r ::!. 1 • l $q mow 4br Contract Year • - October - September 30, i986 -0- • -0- t -0- l'3>~ 1 • • ` :a f''' Cktsfbl�IP1 ;,Y' 5 = September id, 1986 57,057 • • ' stitieiiii dJeet: ;.: • Octobet 1e 1985 - September 30, 1986 • 1 It • ''' • tOt�';:;! s'•51,. 0• 57 - • 57,057. ' -0- 57057 • • � 15' . e '©then. - ' .Stata ..CPF•U Trust Fund Contributions Total - - ' 1. Viral Rtes 565,185 Contributions to CpHU- 565,185 • . gshool._Yikilek services 28,185 , 28,185 • Pregnantly putcotna 107',17A - 107,170 . r��4�� 1iar 1te•roon4•ng 182 i • 162 • Services. Referral . 1;599 ' 1,599 '° Cervical: CA. 87,450 ,' t , �'rll par. 87,450. z. Primary-Cate . . ' • . 262,550 262,550 • • [ -e,+.+ T.•.7..*4.,.s. ( /eAnp - . yital Statistics..venue 1 400 Re 400 .T Csr• . aen t. • ,060, • 1,0 • . 2. Federal F - 1a,i9� .N talk-Child esalth Services 14,'199.. 14,199 NCH elk-IPO. 81,767 . 81,767 • :AID-Alternate Sites • . 12,940 •.12,940 _AIDS-Alternate Sites • 19,878 , Title X-Faaaily. planning 66 • 3,197 3,197. prev.iisalth,81k-Hypertension 53,197 • IIC-Administrative Cost 50,000 - 225,792000 . • W1C-Food Distribution 225,792 • . * Othr:Sterilisation• . 60,28 5 ' 6 0,2 8 5 ' . Total Federal Fiords • - 322,832 • 225,792 548,624 ' 3. •Foes A beased by State.or Federal.- . .`- . Rules or Regulations: - 7 , • ,Public Hbaith • 172,895 172,.895 .64,006 • • ' - 64;006 ' • Total Fees 236,901 • • 236,901 . • * Reimbuased 4Y 11DPHE •16 . . . • • IL SOURCES OF CONTRIfITY10NS TO (Pllirirut, HML ill •. .. - • ' Other ' Ccntributinns'. Tote!State CPP�IJ Trust Fund . d. Othet Revenues: r: Dawn From Public Health . Unit Trust Fund Balance, if any . • r ' � 45,492 �, 45,492 �' • i Pharmacy 1,458 1,458 I • H1lS 'i'!d� Services 8,342 • 8,342 :. .. Immunisation services 6,008. . . HMS STD Services 6,008 HRS Laboratory Services , 29,921 29,921 Medicaid.Reimbursement • ' 10,000 -10,000 • ' Duilding: Renovation (Rey West) - 50,000 50.000 Toter Other'Revenues • 10,000 141,221 151c2• 21 . _ _- . Totes State Contributions 1,630,054' -- . ' 367,013 1, 97;06 -•- --.-.-.' ---"_— . • 1 • 0 • 17 . r - � .a • Other . ' County cc i-its Trust Fund Contributions Total . !laid' 'of blutity Commissioners: An u I Ap1,ropriation 204,000 204,000 Orin*tlfttiori From Public Health ^I Unit Trot Fund Balance, If any 1 *tetra ilottd of County Commissioners 204,000 204,000 • t; - f'eee Aah r12ed by County • Ordirtones or Resolution: .. Public• lealth , 29,400 28,400• •' iktirmtittisil. t$elllth 36,000 36,000- . . . . . . : ;:..-j Piitliotti dikr0 38,406 38,406 • total rem 102,806 102,806 *midi AptnI Equivalent Value 168,000 168,000 MaInttinsneo 10,000 10,000 . • 50,000 ;k •* Itdnt�etidb (key West) 50,000 . • . Total Figilkiliva 228,000 228,000 * '"Iri=itirt vv labor • 18 1i. SOURCES OF CONTRIBUTIONS TO PUUU', a . ` . Other Total . ` Ca�tY CPHU Trust Fund Contributions C • 4. Other,L. &a9 Contributions: 25,000 25:,.000 ; 'School ; d 2,900 , . City b Most • 2,800 It 1 Total Other 27,800 27,goo • um.County Co ltributiona 334,606 228,000 562,606 a . Wilt,0:04Ine PUBLIC HEALTH PROGRAM 1,964,660 595,013 2,5 9,673 e • 19 • o , . .mor • . . . . • 111 . BUDGET BY LEVEL OF SERVICE ; Budget (CPHUTF ) State County. Total A. Public Health Level - 1 . Salaries and Benefits 423,061 89 , 040 512 , 101 2. OPS _ - - 3 . Expenses 12 , 359 2 , 713 15, 072 . . 4 . Operating Capital Outlay 6 ,632 ' 1 , 368 8 , 000 Subtotal 442,052 93 ,121 535, 173 B. Personal Health Level • 1 . Salaries and Benefits 505,644 '. 85 , 172 590,816 2 . OPS • 123 ,844 72 ,956' : 196, 800 3 . Expenses 168,342 36,665 .205,007 4 . Opera-ting Capital Out.lay 40 , 17.2 8 , 286 . 48, 458 Subtotal 838 , 002 ' 203 , 0.79 1 , 041 , 061 ' C. Primary -Care. Level . 1 . Salaries and Benefits 14 , 192 14., 192 • 2 . OPS . . i . - 3 . Expenses 335 , 808 38 ,406 274 , 214 . 4 . Operating Capital Outlay - Subtotal . 350,000 38 , 406 388, 406 D. Total Public Health Services Budget - 1 . Salaries and Benefits 942 ,897 174 , 212 1 ,117 , 109. 2 . OPS 123 ,844 . 72 , 956 196 , 800 3 . Expenses 516,509 77 ,784 594 ,29.3 4 . Operating Capital 'Outlay 46,804 9 ,654 56, 458 Total Budget . 11630, 054 334 ,606 1.,964,660 . • • • 20 ! • IV:, PLANNED EXPENDITURES AND PLANNED SERVICES SV PROGRAM SERVICE AREA WITHIN EACH LEVEL OP SERVICE _._ .. _._...._ • • Octdbel' l:'• 1985 dto'Ss,tenbsr 30. 1986 • - �;1 No. of Quarterly Expenditure Plan . Ste/Cnty Totals • ,'t' - _-.. • _ .- ----IndiV. No. Of .._.. ._..,..� _-._�_._____ 6ras►e1 TOT-- • . FTE's Units Services 1st 2nd 3rd 4th ' State County . . A. Public Healthy ,.......�__a..�iesso• . --- __. .._ atuni - 2;5--"-"3190 6978--"' 12053 ' 12053 12053 :12054 . - 39824 '8389 • 48213 , 878 (102tlon (f011 .2.1 1456 4368 12656 12656 12656 12658 41817 8809 50626 .. STD 1(10 1.0 500 1200 8204 8204 8204 8206 27108 5710 . 32818 . AIDS (103) ' ( >! CaietroT'Ssrvieoi-('�4'7----'- 0.7' 1144 2090 3385 3385 3385 3388 11187 2356' 13543 • •w - feable Disease ' • wfl3ancelInvostisatfen..(i,06) 0.6 . 30 55 3352 3352 3352 3353 11076 2333 13409 . 1- 1 :-C'a�iii nt;cable 9Tsease .. _ - - _ - - 1-sSurveillance/InveSurveillance/InvestigationillaneOInvestl�ation (143) -. Water' Services (157. 150. 159, -160) 3.0 _ ' 196 742 15043 '15043 15043 , 15045 ' 49703 10471 60t 7• ......... - •. Ba.iadi iQ�iibti"Msry Cea. 6.1. _._ _ ;. • 162( 163., 170)• : 7.3 1145 4340 -39870 39870 39070 39870 .131730 27750 . . 159480 Feed''MletSVae (14tai 190) • • 3.5 470, 1880 18933 '18933 18933 18935 62556 ' 13178 75734 ._ .Fae•!rf t 1 31 92. 1t3. 154) _ 2 N4---- 474----861r' • .8e15 --- 8615 ----VIA"- 'L28467- 5997 - 34464--- ;,N --Community Amigo*.(144, 145. 155. 8 • 165I•.171s.172. 173)- 1.2 290 800 7223 .7223 7223 7226 �23867 5E20 28895 • f_ Vector Control 'tiles 7i ibs, 169) - 0.4" "210"" • 340 - " "2013 2013 2013 2016 6653 1482 5 - • Emergeney Msdieil.Sslr'vievs (146) 0.1 9 18 682 682 682 685 2256 475 2731 Vital 8tetisties (180)' 0:6 _ 1400 1400 1757 1757 1757 1760 5808 1223 7031 . "' - SUBTOTAL.. - 'A-- - 25.0"-- - 10184- 24475--"133786 133786 133786 133815 442052• 93121 535173 - '5. .• ..Persnnal Hoalths; ...._ .---' -•- . . , Cbto ie Disease 9ireieas 1210. 211. __ 212. 213. 219) 5:S--21-44 - 4754-' -27488 ,' 274e8- 27408� 27491 98885 19070 10*475'- - • Home Health. (215i . • - - q00 2974 626- 3600 • General Nutrition (228)__ _. 0.2 100 20® , 900 900 41300 9700 SPPPP' 900 • WIC• (221) • - • • . 3.3- 700' 3500 '- 12500 12500 12500 ..'' 12500 Family.P_1a?ninO (223) 9.0 ' 1800 ' ' 7200'. 58489 58489 58489 58491 193249 40709 23'.:958 .. , . Improved Pr!Onaney_Outcome (old maternity') (225) • - ' • • -• 4:6---300 2700-' -92234 92234. 92234 :'92235 - 202749 2 86188 , 368937 . OthsP Infant• Child and a Adolescent (2301 _ . 4.0 _ 1608 5229 17745 17745 . 17745 17747 58631 12351 70982 ' ' I -' --•' .- .5.0_ '.14079 ' 25891 " 25139 25139 25,139 • 25139 83059 17497 100556 I School Health (2`�43 Other Adult Health ..(/lrysical = - Oxtails etc.) (236)• 1.3' ' 600 . 900 5750 5750 5750 5750 18998 4002 23000 , -6 ervinta cis CTie�. _.--.... ___. 3.0-__-3271. .. ._7560 •-- 20023 ' 20023. 20023 - 20024 66157 13936 93 : SUBTOTAL36.0 24402 57934 260268 .260268 260268 260277 838002 203079 1041081 .. C. . -pr f Sr_r.Ci • ._, .--- . .. . . ..-- -. . .. • .... .. • .... . . .i. Ch'iltl Pri�. ry Care 1324) • 0;A 2588_ T2w8•- 35000 35000 35000 '.10362 .139998 15364 V IS5362 - . . Adult Primary Caro (337) 0.6 3600 10800 52500 52500 52500 75544 210002 23042 '233044 _ SUBTOTAL__ - _ • 1.0__-6000 18000 _ 87500 87500 87500 125906 350000 38406, 388406 _- • - 4 . TOTAL CONTRACT 62.0 40586 100409 _-481554 481554 481554 519998 1630054 334606 1964660- . • .2 -1. ' 1.2 . ATTACH' MENT III CIVIL RIGHTS CERTIFICATE ASSURANCE OF COMPLIANCE WITH TITLE VI OF THE CIVIL RIGHTS ACT OF 1964, SECTION 504 OF THE REHABILITATION ACT OF 1973, TITLE IX OF THE EDUCATION AMENDMENTS OF 1972, THE AGE DISCRIMINATION ACT OF 1975, AND THE OMNIBUS BUDGET RECONCILIATION ACT OF 19814 -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 applicant assures that it will comply with: 1m Title VI of the Civil Rights Act of`1964, as amended, 42 U.S.C. 2000d 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 emended, 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 contractors,subcontractors, subgrantees or others with whom it arranges to provide services or benefits to participants or employees in connection with any of its jprograms 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 apporpriate judicial or -administrative relief, to include assistence being terminated end-further as1sistance being denied. 22 _ 7 j ATTACHMENT IV.. *REVENUE AND EXPENDITURE CODING REQUIREMENTS ' General Principles The automated cost allocation system for the county public health units(CPHUs).wlll provide for.the allocation of expenditures recorded in the County Public Health Unit Trust Fund that cannot be conveniently charged on payment Loa specific program component. Career Service.end 1200 OPS Salaries will be coded To ORG Code Level 3 (L5 Code = 000) through Personnel Management Data System . (PMDS),. :except central administrative salaries chargeable to L5 Code 400. All 1300 OPS Salaries must be charged in State Automated Management Accounting System(SAMAS)to a specific program component(program service _ area) at Level-5 of the Organization Code. Similarly.Expenses and OCO will be coded to the - lowest uniquely identifiable Level 5 code. County public health unit expenditures coded in SAMAS will be allocated on the basis of data_ collected through -the Client Information System/Health Management Component (CIS/HMC)-time reporting system. Employee Activity Records (EAR) are used to record the time each employee spends in various progra components. County public health units using their own data systems will provide employee time information to the CIS/HMC system and this data will be processed in the same fashion. - Using employee salary information from the PMDS, personnel costs are generated for each program component for which,county public health unit staff have coded their time. Time. and costs associated with general_support program components, such as those for general — personal:br general public health, will be allocated to direct service program components based on the relative percentage of direct service time in each-of the relevant program components. For instance,if family planning direct service time was 20 percent of the direct service time coded in all personal health program components, then 20 percent-of the costs. associated with general personal health-would be,distributed to family planning. Once the appropriate time-cost percentages are determined for each program component, then these percentages will be_used to distribute allocable expenditures coded in SAMAS. • Coding Plan The SAMAS organization codes will- be used to identify specific program components (program service `areas) within each of the three Program Service Levels as follows: , L5 Codes Program Service Levels 100 through 199 _- Public Health Services 200 through 299 Personal Health Services — 300 through 399 Primary Health Services Codes 400 through 499 will be used for general.administrative .and support services, and . _ expenditures charged 'to these accounts will be allocated to the specific Program Components. Revenues and expenditures of each county-public health unit funded through the County Health.'Unit Trust Fund will be coded with the appropriate.SAMAS codes for Category, Objects and Other Cost Accumulator(OCA)as-prescribed by the State,Comptroller and/or as } 23 • • may be determined by the Department's Comptroller. The SAMAS Organization Code will be used as follows: . • • .L1 = 60 . • L2 .= District • • - L3 = County Code es assigned by the District Fiscal Office (71-89) L4 = Optional useby county public health unit as approved by the District Fiscal Office; (limited to-52-89) L5 = Program Service Level and Program Component described below A complete list of these codes • is Included at the end of this Attachment. • L5 = 000 - Revenues from state and county sources for the general use of the county public health unit end which are available to specific Program Components as specified in ithe contract. . All other revenues will be coded.to the appropriate L5 code for the Service Level or Program Component as specified in the contract. _ . Expenditures made- specifically for any Program Component not`expected to benefit any other Program Component shall be coded to the specific L5 Organization Code representing the Program Component'receiving.the benefit. Allocable expenditures will be charged to the following SAMAS accounts: Level 5 • -Code Allocation Criteria 000 Salaries, OPS (1200) Expenses and Operating Capital Outlay (other than those chargeable to General Administrative and Support • - Services) that will beI allocated on the.basis of.. time/cost'percentages to the Program Components within the three major Levels of Service. 100 Expenses and OCO allocable to ell Program Components within the _ Public Health Service Level (L5,codes: 101 through 199) in proportion to the time/cost,percentages determined for such Program Components. 109 Expenses,and OCO allocable only to Communicable Disease Control Program Components (L5 codes: 101 through 109) in proportion to the time/cost percentages determined for such Program Components. 175 Expense and.00O allocable only to Environmental Health Program Components (L5 codes: 144 through 174) in proportion to the - time/cost percentages determined for such Program Components. • 200 Expense and OCO allocable only'to Personal Health Program- . Components (L5 codes: 201 through.299)in proportion to the time/cost percentages:determined-for such Program:Components. . 300 Expense and OCO allocable only-to Primary Care Program Components (L5 codes:.301 through 399) in proportion to the timeJcost:percentages determined for such Program. Components. • • • . • 24 r - • I • Level 5 • • c Code Allocation Criteria 400 salaries and Other Expenditures for General Administrative and Support Services allocable to all other county public health unit Program Components (except codes L5 = 401 through 499) in • proportion to the time/cost percentages determined for such Program Components. All expenditures charged to L5 = 400 and 491 will be added to those charged at Level 3 (L5 = 000) for allocaion. - 491. Inventory 495 Administrative Services • Local projects or sub-unit activities for any of the Program Components identified by the L5 codes may be Identified at the county public health unit's option by the L4 Organization Codes. Such identification will allow the county public health unit to develop supplemental cost data from the SAMAS reports, but the county public health unit cost allocation system will ignore L4 codes in making Its distributions to the Program Component accounts._ m. .PROPOSED SAMAS CODING CHANGES Level 4 Level 5 - CPHU . Proposed _ • . Option Codes Public Health • XX 000 *CPI-IU Allocable Costs _ - • XX 100 .*General Public Health XX 101 Immunization Services XX 102 • Sexually Tra ismitted Disease Services (formerly VD) XX 103 Acquired Immune Deficiency Syndrome (AIDS) - . XX - 104 - Tuberculosis Control Services - - XX 106 - Communicable Disease Surveillance/Investigation XX 107 *Communicable Disease Pharmacy • - _ XX 108 *Communicable Disease Laboratory XX 109 *General Communicable Disease Control XX 143 Non-Communicable Disease Surveillance/Investigation XX 144 Occupation Health Services XX 145 . Consumer Product Safety XX 146 • Emergency Medical Services , XX 148 Food Hygiene XX 150 Food Hygiene Training . . - _ XX 151 Group Care Facilities . XX 152 —Migrant Labor Camp Services XX 153 Housing and Public Building Safety and Sanitation XX 154 .' :Mobile Home and Recreational Park Services . XX 155 . - Common`Cerier Sanitation XX 157 Private Water Systems . . . . • XX ' 158 •. Public Drinking Water Systems (Safe Drinking Water Act) . XX 159 Bottled Water . XX - 160 Swimming Pools/Bathing Places . • XX 161 •Individual Sewage Disposal • XX - 162 • Public Sewage . 5 , ... . . ill. • lir Level 4 • Level 5 . CPHU Proposed I . aation , Codes , + Public Health . XX • —163- Solid Waste Disposal - XX 164 Hazardous Materials . XX • 165 Sanitary Nuisance XX 166 • _ Rabies Surveilllance%Control Services XX 167 Arbovirus-Sur�velllance - I . XX 168 Rodent Control XX 169 Arthropod Control XX 170 Water Pollution Control ' XX 171 Air Pollution Control XX • 172 , Radiological Health • XX 173 Toxic Substances XX 174 *Environmental Health Laboratory • XX . 175 *General Environmental Health XX - 180 Vital Statistics Personal Health XX -200 *General Personal Health XX -210 Cardiovascular Disease Services. • XX- _211 Hypertension XX 212 Diabetes XX 213 Cancer - XX 215 Home Health XX 219 Health Risk Reduction XX 220 Nutrition - -XX • 221 WIC.. _ XX 223 Family Planning j XX 225 • Improved Pregnancy Outcome . - • XX 238 Infant, Chila & Adolescent XX 234 - School Health • • XX 236 ' . Adult Health XX 240 '- •• Dental Health - XX 241. *Personal Health Pharmacy XX 242 *Personal Heialth Laboratory - • Primary Care XX 300 *General Primary Health Care Program XX 329 Child Primary Care XX - 337 Adult Primary Care - . _ -XX 338 *Primary Care Pharmacy_ - XX 339 *Primary Care Laboratory . • General Administrative and Support Services _ -XX 400 *General'Administrative end Support Services XX 491 *Inventory . - *Allocable Accounts • . 26 - - - - j ' 11111 • • ANA ATTACHMENT V STATE FEE SCHEDULES, . EY SERV T CE Estimated Annual ' Revenue Accruing To t.evel of Service/Service Fe'e/Range The PHU Trust Fund i I . Pub l i c- Health Mobile Home and Recreational Vehicle Park: : 6 , 800 6-10 spaces 25.00 ' 11-50 spaces 50.00 - 51-200 spaces 75. 00 Over 200 spaces 100. 00 Swimming Pool. 2.5 . 00 1 , 700 Individual Sewage Disposal : Site Evaluation & Permits 70.00-90. 00 132,593 Reinspection 15.00 3 ,000 Variance eb..00 .. 28 ,802 ($1000. of this goes for r•e- search '& soil survey , and - is: not in TF) Total Public Health 172,895 • II . Personal Health Family Planning Statewide Fee 64 , 006 Schedules Total Personal Health 64 ,006 .TOTAL- STATE FEES 236,901 27 • ATTACHMENT VI COUNTY FEE SCHEDULES, RY SERVICE Estimated Level of Service/Service Fee/Range Annual Revenue I. Public Health STD Service_. $0-6. 00 10, 000 TB (Skin Test Screening ) 2.00 800 Vital Records ( Certified Copies ) 3. 00 17,000 Pre-Marital Blood Test 10.00 600 Total Public Health 1 28,400 II . Personal Health • Infant, Child, Adolescent Health 28,000 School Physical 12.00 Well-Child Clinic 0-6.00 Adult Health 0-6.00 39000 Dental Health 5.00 5,®00 Total Personal Health 369000 III . Primary Care Adult and Child $0-25. 00 38,406 Total Primary Care 38,406 Total County Fees 102,806 - 1 • 2'8 • ATTACHMENT VI I CLASSIFICATION AND NUMBER IOF: EMPLOYEES_ WORKING IN THE COUNTY PUBLIC HEALTH UNIT WHO ARE. PAID BY THE . COUNTY, BY LEVEL OF SERVICE • • N C) T A P P L I C A B L E • • • • • • • 29 ATTACHMENT VI I 1 FACILITIES Facility Annual Rental Description I..ocat ion Fquivalent Yalue Owned EY Key West Clinic Key West al20,000 Monroe County Mid Keys Clinic Marathon 2410CID Monroe County Upper Keys Clinic Tavernier 24 ,0013 2 Monroe County • • • Facility Maintenance : Responsible Party : Monroe County (Depa trnent , - County , Other Party ) Maintenance Cost : lo .ppo Maintenance Provider : 51onroe Coun t DtPprtrknt of Public ti_orks . - • • 30 5 .111 ATTACHMENT I, X DESCRIPTION OF USE OF PUBLIC HEALTH UNIT TRUST FUND BALANCES FOR SPECIAL PROJECTS, IF APPLICABLE • • h10 t AF 1 i cz b 1 E• • • • • • • 31 s Attachment X (Optional) _ ;', OTHER. P.UBLIC HEALTH ACTIVITIES IN THE COUNTY WHICH SUPPLEMENT THE ACTIVITIES OF THE COUNTY PUBLIC HEALTH UNIT (Programs Not Financed Through The Public Health Unit Trust Fund) • ;,, • Rel• ationship • (Contract,. Memorandum Contract or Sponsor Activity/Program of Agreement, etc.) of'an Agreement Provider Amount STATE FUNDED: . Laboratory Services Agreement DHRS CPHU . ' .29,921 . Drugs a Pharmacy- Agreement DHRS CPHU 45,492 v T.B. Services.. Agreement. DHRS CPHU • . 1,458 .,.,.__....__Immunization SErvices Agreement' . -DHRS • CPHU " — -8,342 __...—.-. STD Services Agreement DHRS CPHU ' 6,008 . Sterilization Agreement DHRS CPHU 60,285 . COUNTY FUNDED: . •• • . • N/A . . . o•; t; \ : • • • • ATTAD#�ENT XI PROGRAM SPECIFIC REPORTING REQUIREMENTS i Some health services must comply with specific reporting requirements in addition to the CIS/HMC mini'tnum date set end the SAMAS.2.2 requirements because of federal or state law, regulation or rile. Ifs county public fieaith unit 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 • 3.. Sexually Transmitted Disease Morbidity,screening and surveillance reports Program specified by the department. 2. Dental Health • • Monthly reporting on HRSH Form 1008 and • . . . •. -1jiRSM SO-11. _ ' 3.• - WIC • ' . •" • 4rvice%documentation end monthly financial reports as specified in.HRSM 150-24. 4. Improved Pregnancy.Outcome Quarterly reports on services, results of - . Program services and expenditures on HRSH3096. _ 5. Improved Pregnancy Outcome/: ; 'Code all certificates of live birth and • Vital Records Reporting certificates of fetal -death to •delineate the • • source of the prenatal care as required in HRSM 150-13 and the Florida Vital Statistics Code :Manual. • . - - .45. '• `familyPlanning ; • - ,. 'eriodic financial end programmatic reports as . specified In HRSM:150-27,-Chapter 14. -. • .. •. - • - • • 7. immunization - '.,4"eriodic reports as specified by the department . • • • •,•regarding •the.'surveillance/investigation of - - • • . . . :reportable -vaccine 7.rpreventable ..diseases, • • • vaccine _ . usage . accountability .end the • - 'assessment of various Immunization levels. 8. Primary Care . . (Reporting requirements to be provided.) _ _ - .. . -•.? _ - • . Lan ATTACHMENT XII • PROGRAMS REQUIRING COMPLIANCE • -WITH TI-E PROVISIONS OF SPECIFIC MANUALS • Some health services must comply with the specifics of their program manual to satisfy federal and state law, regulation or rule. If the aounty public health unit contract Includes funds to provide one of these programs, the county public health unit must comply with the details of the manuals)related to that program. The programs and their required manual are as follows: , • ' • Service Requirement 1. Improved Pregnancy Outcome. • HRSM 150-13 • 2. School Health Services HRSM 150-25, including the requirement for an _ annual plan as a condition for receipt of funding. • 3. Family Planning . .. . HRSR 150-27,Chapter 14,and all other manuals pertaining to the Family Planning Program. 4• WIC, • HRSM 150-24, and all other manuals,pertaining _ to the WIC program. . - • AI DS 1ps • HRSM 150-30 • S. - - . . • • • • . - { - ATTACHMENT XIII • FAMILY F ..AkNING PROGRAM (This attachment must be camF! leted for all county public health units which have a Family Planning Program ) • A. Special Provisions . 1 . At least 90 percent of the clients served by the. county public health unit in the family planning program shall have incomes at or -below 150 percent of the OMB poverty level . . 2 . The county public health unit wil conduct the following activi- • ties to help prevent adolescent pregnancy : • • Assist the School Board to develop curriculum for Family Life Education that is consistent throughout the county . Present programs at area high schools and riddle schools a= re- quested . Make every effort to give adolescents easy access to the cli- nic. - 3 . - The following agencies and organizations _ provide family plan- ning services in the county in addition to the county public ' health unit : • None . 4 . The planned budget for the county public health unit ' s farily . planning program, by source of revenue , is specified in Section B 'of this attachment . • • 35 „,. • a. coskirf PUBLIC HEALTH UNIT Ft.AWAELII FA1VitLY i-PLANT'at ., to...n..0.-pc,.. , ..,,. ...,... .:, October 1, 1985 to September 30, t98 . -• i 0 . „ ,.11 • .1 General coo end ... .. Witt Ma I Total .Title X •Fievemas Title XIX ' Other 3rd Party FACH alts •. , . , Personnel , . 11/1.,.613. 15 ,294 . 3 ,000 29, 391 64 ,006 . Fringe paneflta 25,675 25,675 I , . la 1 • .. Travel ” 7,352 . 7,352 • . Equipment H . , . •2,000 2 ,000 1 . . . ... &Wife iigiktlitettill .,.• *83,800 26,745 57 ,035 , • . • '.: Contraete 3,000 3 ,000 , .. 1 •f, Coratiruetlen . so 0 500. . . Other ;'• • • • l Direct %tyke Teti dbeiges • • ' . . Indireit gorile.Mt** . • : 1 •,7 , ,, . • . •,. smo, 234 ,ois 80,566 .• 3 ,000 86 ,446 64,00'6 • . , . ./ . • ' . :.: Progrign irrebtniii . . : ',.. • 234 r o 3.a • : Li- '1‘ 80,566 ' 3 ,000 .i: • .- ..._... :.,..,Lii• :...,;.1.—-0 ii6.:,.;,..,:i' • tit: •:,: Toted . . . .- :: t ; • 1 • ' .. . , . . :.-; . • . * INCLUDES STERILIZATION CONTRACTS WHICH • . • , •1:. • ARE IN 040000 EXPENSE CATEGORY . . . ' • • • • • - • , • . ,• . . • •, • . : .,„ . . - . . , • , • ,.i ' • . • • • , 36.. :-.i.;,. — ____ • ... :.;.--,-,. . . • . • • ` f - . ATTACHMENT X. I V ' IMPROVED PREGNANCY OUTCOME PROGRAM ( IPO) (This attachment *lust be comp IEted for all 'c.c.urlty publ-ic . health units which have an IPO program) . . • A4e General - information pertaining- to the county public health unit Ir.- . • Proved Pregnancy Outcome program: _. 1 . The following financial criteria wi l l - be used to determine eligibility for the IPO program: . HRSM 150-26C 19E5 OMB Poverty Guidelines ; Applicants up through fee group "E" who do not have insurance are eli . Bible . ( 185% poverty ) . Income determined by gross fa • - mily income past 12 months .. 2. Screening for financial -eligibility will be conducted by the county public health unit position or by the. unit (County Social Services , etc . ) identified.; below: Interviewing Clerk #43360 Key. West MCPHU Clerk Typist II . #28588 Marathon MCPHU . . - Clerk Typist II #28589 Tavernier MCPHU ' ' • 3. The county public health unit intends to. serve Medicaid eli- gible clients in its IPO Program. yes XX no • 4 . Medicaid eligible clients who are. not served by the county ' public health unit IPO program will receive prenatal care 4ror,; (e . g . , private physicians , primary care centers , etc. ) : . All Medicaid eligible women are . eligible for IPO - there is' no other provider in the county who will accept Medicaid 5. It is e>;pected that a total of 300 women will be served in the IPO program. Of this number , approximately 150 will be Medi- caid eligible or have some other 3rd party payor suppor-t -and approximately 150 will not be eligible for Medicaid and will • not have any other. 3rd party payor support . _ . Applicants with other 3rd party payor support -'are not eligible for the program.. 6. IPO patients Will deliver at -1identify the hospital , birth • cen- ter , etc. ) : . . . -Florida Keys Memorial Hospital - Key West ' 37 - Fisherman ' s FtitsF - t'arathon • 7 . Deliveries for ..IPO patients 1 wi l l be . performed by ( identify if OB/GYN or c.ther; Fr,) _ ician , eertii1Ed. nursE; n,., d::ife , Physician on-call , etc . ) : Dr . Ferr'in , Dr . Morse ( both OB-GYN) . - 'Key West H. Swallow, CNM :Key West Dr . Morse - Marathon Dr . Martinez ,' Dr . Daee, Dr . Valarezo ; - "Homestead( f.or Ta- vernier 8 . The :county' public health unit will be notified of patient de- liveries by the process identified below: Phone call. within 24 hours from the delivering care Over . Follow-up with records within 10 'days . 9 . .. Payment for hospital delivery costs for IPO, patients is the responsibility of : the IPO project the patient - XX other specify : 10 . Prenatal and postpartum care -for IPO patients will be provi- ded by the following staff or contract personnel : Staff , By Classification Contract Personnel., By Type . Linda Palumbo, ,CHN Key West - - , Peter Morse , MD Key West & Ma- Anne King , .ARNP Key West rathon Carmella Kornetti , CHN -Ma-' Frank Perrin , MD Key West rathon Helen 'Swallow, CNM Key West Cheryl Delay , SCHN Taver- Juvenal Martinez , MD Homestead nier . ' Eduardo Valarezo , MD Homestead • Hosain Daee ; MD Homestead 11 . Patient education will be provided as follows : Individual and group instruction at intake visit , . 28 , 32 & 36 week visits'. Provided at the CHU . Special adolescent classes are avail-able through the CNM as needed . Hospital tour, is pro- vided . . 12.. Patient .follow-up will be accomplished as ,.follows: Routine post-partum visit Jith delivering care-giver and Family Planning physical, exam at same. time . Post-partum home visit by CNM within 6 weeks of delivery . Referral to Well-Baby or EPSDT Programs at CHU and follow-up on_ referral by CHN. - 13. The county public health Unit . will .ensure that IPO patients re- turn for postpartum exams, ffamilY Planning and well-infant cll- . 3B, • i • nits ' b> the procedure 'defcr ited .below: • • As above - follow-up by mail , 'phone ,, or home., visit by . CHN or by DSA L , 14 . The county' public health unit shall 'input into • the CIS/H'•i[ sys- tem on a 'timely basis the number of services provided and the • number of clients served by. all subcontractors who are funded by it to provide IPO services . E. Special Requirements for Subcontractors : The following requirements shall be included in all subcontracts . with any agency, organization or person whom the county public health unit funds to provide IPO services : 1 . The subcontractor shall provide whatever service and client data the county public health . unit requires to . enable the • county public health unit ' to- enter this information for the subcontract into the CIS/HMC contract management ' system.• The . subcontractor shall submit such data in the format and accor - ding to the schedule specified by the county public health unit . 2 . The subcontractor shall provide whatever financial and outcome •data the . county public hearth unit requires to enable the : coun- ty.. publi.c health unit to complete its Quarterly IPO Status Re- port . The subcontractor shall submit such : data in the format and according to' the schedule specified by . the county public health unit . . • S . The subcontract shall comply with the personal health clinic • standards and the IPO standards specified in the departmept ' s Performance Review- System and HRS 150-13 .--. • ATTACHMENT XV ' . Y 6 PRIMARY CARE PROGRAM .(Th.is attachment must be completed for ill -County public health units ' which have a. Primary Care ' Program funded in whole or in part by the Health Care Access Act , Subsection- 409.266(6 ) (b ) , Florida Statutes ) A. The county public health ` unit shall : 1 . ' Provide. the services according to the schedule of hours described, including 24 hour coverage . ' 2 . Provide ' medical supervision as appropriate. and approved by the de- partment . . • 3. . Conduct a quality assurance program satisfactory` to the department . 4 . Participate in program accreditatio .activities and costs as reque!- ted , by the department with the objective of becoming accredited within • five- years . - 5. . Participate= In the department ' s developmental activities related to a standard medical records system that will be used by all primary care contractors . j . 6. Make available to department representatives the. medical and dental records of program patients ••for review. 7 . Provide the department with utilization, cost and revenue reports in the form and frequency specified by the department . 8. Make available to department representatives ell , files and records of program patients for_ review. . 9'. Charge , fees for , services rendered in accordance _with a fee schedule approved by the county. and' the department . 10. . : Identify the fees collected from the ':pr imary care program in its accounting system. Primary care fee's ' collected by the county public . health unit must be deposited in the County Public Health Unit Trust Fund and shall only be used to support the primary care program funded by this contract . Fees collected by any subcontractors must be used exclusively for ' the primary care program funded by this contract . All fees. collected ' "in 'excess° of budgeted amounts 'by any subcontractors -must 'be Adepotited in the County Public Health Unit Trustf.Fund. ' All fees . .collected in excess .of .budgeted amounts must be used for the primary care ,program end asap- - proved by the department through- a Clontrac.t amendment . ' 11 . APply a schedule, of discounts 'to fees charged to individuals with _family incomes below 200 percent of fthe federal 1AMB) , povertY . guideiines. • • 40 '' ..4 a' a ! - - - - . ... ,. . ' Ole . .i t:, '' . Individuals with family incomes below the poverty level must receive 100 ' 'Percent discounts . . 12. Ensure that funds provided by the Health Care Access Act for : the primary care program and any fees collected for services provided in this primary care program do- not supplenient funds from any other sources used to support public health services p-ovide.d by the contractor, and its sub contractors .. - 13. Provide the Health Program' Office in the department with copies of all subcontracts . - B.- Scope of Services (Complete for CPHU programs ) • . 1 . The hours of operation - for the primary care program. will be : Monday , Wednesday , Saturday 11 a .m. - to 5 p.m. and Tuesday and Thursday Noon- to - 8 p .m. , . • ' 2 . : •Twenty-four hour coverage for primary ,care patients will be .-provided . bY : . . Answering service- and-' 'on-call schedule" 3. The location and general description of the facility ( facili ties ) to be used to deliver services is : Flagler and White Street , Key West rented clinic; has been specifically renovated for primary care use. ' • 4. The' 'following ancillary .services will be provided onsite ,. or by the designated contractor : Onsite Contract • Laboratory Clinic and Hospital Florida Keys •Memorial Hospital X-ray - Hospital Florida .Keys Memorial Hospital • Pharmacy Clinic and Hospital , Florida Keys Memorial Hospital . Dental CPHU- . • .5. The referral arrangements - for speciality care will be. as . follows: — Contractual to appropriate specialist ' (s ) on Florida Keys Memo- r ial Hospital - staff . - . Z. -Agreements for hospital iaat ion are as follows:_ Hospital will accept on_ determination- -by ' primary care physi- slants ) if justified by pre-admission screening and certifi- cation. . . 41 - . • • 7 . Fetlent Litt nhi+niSEnient anoi outreach' w111 be concluded as • . follows : 1 . Concurrent , prospectivt and rFtIC'! FCt1ve rFv1Ew process . Hosppitr l ' r e ;: lst ins ut il17? tion review F 1 Ccedc! ► E ( s ) , 3 . Quality assurance committee of physicians/provviders . C . Organization ( Complete for CPHU Pro_grams ) 1 . The eligibility requirements for primary care patients will be : OMB Poverty Guidelines , up to 200% poverty- level . 2 . The sliding fee scale for the primary care program is attached . ( page 44 ) 3 . The mechanism to be employed to assure that feedback is re- ceived from patients regarding their satisfaction with the . program will be : . Individual comment cards distributed at t ;rr.e of Visit . 4 . The table of organization for program management and the .pro- vision of services is attached . (page 45, 46 and 47. 5. The monitoring and quality assurance review procedures for the primary care program will be as follows : See question 7 (above ) Monitoring also by special team from HRS (District XI ) D. 3udget (Complete for CPHU Programs ) . 1 • ' 1 . Total amount of budget : st3801406 . 2 . Total amount of .Florida Health Care Access Program contract : a350 , 000 . 3 . Total collections : f38 , 406 . 4 . Total county- and other funds : 0 . - 5 . Total in-kind contributions : 0 . • E. Pudaet (Combines CPHU pnd Subcontractor _Budgets ) 1 . Tdta- amount of budget : $360,406 . - 2 . Total amount of Florida Health Care Access Program contract : 8350,000.• - . • 42 • " • Wtt,;st, 3 . Total IRated collections : $38 • 406 . 4 . Total county and other funds : 0 . 5. Total in-kind contributions : 0 . F . Total Encounter and Users (Combine CPHU Subcontract ) p PHu gubcontraetors Totals Encounters 18 ,000 1131000 Users 6 ,000 6 , 000 • • • - • 43' v� } ' • • " �r • THE HEALTHCARE CENTER . Illii . . PRIMARY C " RE - Financial Eligibility-Fee Scale PerCe.nt , of Poverty • ' Family 100 101 --125 126 150 151 -179 176-185 186-200 ' LILLE 1 4 , 980 ' 4 , 981 - 6 ,226 7 , 471 - 8 , 716 9 ,214_ • - . or less - 6 ,225 7, 470 ' 8, 715 9, 213 91960 2 • 6 , 720 6 , 721 - 8,401 - 10 , 081 - 11 , 761 - 12,433- or less 8, 400 10,080 11 , 760 . 12, 432 13,440 3 8 , 460 • 8 , 461 - : . 10157 6- 12 ,691 - 14 , 806- 15,652- or less 10 ,575 1.2,69E . 14 ,805 15, 651 16 ,_920 4 10 , 200 10 , 201 - 12 ,751 - 15 , 301 - . 17 ,851 - 18,871 - or less 12 ,750 15 ,300 - • 17, 850 18_, 870 20_,400 • -5 11 , 940 11 ,941- 14 ,926- 17 , 911 -. 20 ,896- 22,090- or less 14 , 925 -- 17,910 - 20 , 895 ' 22 ,089 23,880 6 13 ,680 1.3 ,681 - . 17 , 101 - 20, 521 -. 23 ,941 - 25,309- or less 17 , 100 20, 520 23 , E+40 25, 308 27, 360 7 15 ,420 15 , 421 - 19 , 276- 23 , 131 - 26 , 986- 28,528- or less 19 , 275 ' 23_, 130 26, 985 28,527 30 , 840 • 8 17 , 160 17 ,.161 - _ 21 , 451 - 25 , 741 - . 30 , 031 - 31 ,747- or less 21 , 450 25,7140 . 30, 030 31 , 746 34 ,320 9 • 18 , 900 18 ,901 - 23 ,626- 28 , 351 - 33 ,076- 34 ,966- or less 23 , 625 28,350 33, 075 34 ,965 37,800 • 10 20 ,640 20 ,641 - 25, 801 - 30 , 961 - 36 , 121 - 38, 185 . or less 25 ,800 30,960 36, 120 38 , 184 41 ,280 ======_========__=======_•=====_========_=====_========________==_ Fee • GroupA B . C D E . F .8 _ Fee J - Percent • 0% 20% ' 40% 60% " 80% . 100% • • Initial 0 $6 $12 $18 - $24 $30 Office - Visit 0 . $4 $6 $12 $16 $20 Limited Service 0 $3 ' $6 $9 . $12 ' -. $15 44 . 1: PRIMARY CARE •, TABLE OF ORGi1M2ZATIO! • • • !HEALTH CARE ACCESS .PROGRAil • �MONROE COUNTY PUBLIC HEALTH UNIT MONROE BOARD OF COUNTY CO('!IISONERS FLORIDA KEYS MEMORIAL HOSPIT (Sub - Contractor) • Or. Jose J.' Bt4iil. Directed !George Awl, Adminietrati.or ate Hew Cge�_ =ie t i •; eanne Easton, Nursing ADirecto. Puroff,, Coordinate . . D. Rainer°, Phy'i• ' ZulemaCana a off•• etrative .CI • .. ,Doreen. Cahill, ARNP` —{John Johnson, RNI -- Part Time, RN j i t . .• 45 THE HEALTH CARE CENTER fs operated by THE FLORIDA KEYS MEMORIAL HOSPITAL HEALTH CARE CENTER and the MONROE COUNTY HEALTH DEPARTMENT.. . through funding provided by the DEPARTMENT OFS . STATE OF.FLORIDA • 0 tQo THE n 111 HEALTH CARE CENTER 1 . 1019 Flagler.Avenue Key West. Florida Phone: 296-2451• . medical services provided for CALL THE income eligible residents MONROE COUNTY of HEALTH DEPARTMENT The Lower Keys For Eligibility Appointment PUBLIC SERVICE BUILDING a cooperative effort of STOCK ISLAND FLORIDA KEYS MEMORIAL. HOSPITAL PHONE: 294-1021. - and MONROE COUNTY HEALTH DEPARTMENT sponsored by the DEPARTMENT OF HEALTH & ', ( . - REHABILITATIVE SERVICES AND THE STATE OF FLORIDA 46 a- • AM I ELIGIBLE FOR MEDICAL SERVICES WHAT SERVICES CAN I RECEIVE AT THE HEALTH CARE CENTER? : .AT THE HEALTH CARE CENTER? If you are a Medicaid recipient, you are sick visits, automatically eligible. _ for childhood & adult illnesses • If you are a Medicare recipient, and meet chronic disease control financial eligibility requirements, as de- minor wound care fined by the Federal Poverty Level Guide- health .education line, you may be eligible. + If your income is below two hundred ELIGIBILITY ALSO INCLUDES THE FOL- percent of the Federal Poverty Level LOWING SERVICES AT THE MONROE Guideline, you are eligible for health care COUNTY HEALTH DEPARTMENT: on.a sliding fee scale. BUT. FIRST YOU MUST APPLY AT THE birth control & family planning MONROE COUNTY HEALTH: DEPART- MENT. pregnancy testing male d female sterilization HOW DO I APPLY? routine childhood physical exams 1.-Take'proof of income or valid Medicaid immunization (childhood & travel) • card to the Monroe County Health Depart- pre-natal.care merit on Stock Island. pap smear (routine) 2. You will be interviewed, and if eligible, sexually transmitted disease services • you will be issued a special clinic card, tuberculosis screening - . imprinted with your name & fee group. dental.services (Minors living . at home with eligible parents or guardians are :automatically W.I.C. Program eligible.) 3. All cards expire after 12 months, and ELIGIBILITY DETERMINED ONLY AT THE must`be renewed. MONROE COUNTY HEALTH DEPARTMENT 4. You must present your card to the PATIENTS ARE SEEN AT THE HEALTH CARE CENTER when you .seek - HEALTH CARE CENTER treatment. BY APPOINTMENT ONLY ELIGIBILITY CARD MUST BE PRESENTED • AT TIME OF TREATMENT 47 lir- , . e f. A .E ATTACHMENT XV I A. I .D:S . BUDGET FY 65/66 •• . . PERSONNEL . 1 . 0 FTE ' Community Health Nurse 16,500 . AIDS Consultant/Counselor , . H 6 hrs per week X 5.0_ weeks' 0 $13/hr . • 3 ,900_ • TOTAL PERSONNEL 22 , 400 FXPENSES • • - ` Mobile :Unit Operation 3 RT Marathon 324 'miles 2 RT Big Pine 120 Miles 50 trips Key West . X 10 mi . /day • 0 ..75/mile . 1 , 008 • Printing/mailing specimens - _ 2 , 000 Vacutainers/needles 0 . 40 each • • '. 1 ,200 • Specimen containers & miscellaneous supplies 500' 32 initial medical evaluations 0 $65 each (OPS contract ) • 2, 000 - TOTAL EXPENSES • 6 ,708 , TRAINING/TRAVEL • • . Alternate site -workshop , Orlando , 1 day , 1 person ' ' 457 • National STD Conference, Atlanta , 3 -days , 1 . person . - '737 • • Counseling Workshop , Miami , ,2 days , 1 person 290 General Training Meeting , Orlando , 1. day , 1 Person 494 Training Workshop , Miami , 3 days ,' 3 people 850 ' - Follow-up Training , 2 People . _ 882 TOTAL TRAINING/TRAVEL . . • -3,710 ' • • TOTAL -BUDGET 329618 • • 48 -' . . I - "IIIW ' " 4' ' ' ATTACHMENT XVI BUILDING, RENOVATION • Building renovationto be done at. Key Weft facility . Repair. of front of building (entrance ) to include safety and -security features as follows : - Wheelchair ramp - Wheelchair-accessible lavoratories • - Outside. steps -and doorways . - Electrical wiring - Ornamental block screen wall , front and side of building Funds are allocated as follows : „ , MCPHU Trust Fund . S50 , 000 cash , _ Monroe County • Public Works Department $50,0D0 "in-kind" labor Total a100,000 Funds were appropriated during Fy 84-85, and will be used for FY. 85-86. • 49