Item AFiscal Year 2005 Budget Process
% over Ad Valorem
Dates Changes Made Changes Budget Total Rollback Taxation
July 14, 2004 $295,753,845 8.07 $70,293,145
HSAB Board Recommendations Approved
($31,550.00 already in Budget) -
Added $20,000 for Habitat for Humanity KW & LK
Added $5,000 Caring Friends for Seniors $25,000 $295,778,845
Other Non- Profit ( Direct Funding)
Added $ 7,500 (3) AARP's
Added $ 1,241 Healthy Kids
Added $27,500 Fine Arts Council
Added $ 331
Added $ 5,000 Big Pine Athletic
Added $ 643 Upper Keys YMCA
Added $50,000 Rural Health Network $92,215 $295,871,060
------------------------ -
Added $36,734 Monroe County Health Dept. $36,734 $295,907,794
Added $58,609 Teen Court $58,609 $295,966,403
July 20, 2004 Rate Reduction Worker's Compensation Fund** ($506,511) $295,209,892 7.64 $70,011,624
** Budget Impact is approximately 750,000
.
Proposals for County
Funding of Non -Profits
July, 2004
Human Services Advisory Board
Recommendations
Proposals for Funding Directly from BOCC
Monroe County Health Department
Fiscal Year 2005
Human Services Advisory Board (HSAB) Recommendations
In February, 2002, the Board of County Commissioners adopted new policies and
procedures governing the future funding recommendations of the HSAB. Projects were to
be included in these three categories: medical services, core social services, and quality of
life services. Those policies are attached.
On March 18, 2004, the BOCC approved a total funding level of $1,347,950.00 for
Fiscal Year 2005. The HSAB has returned to the BOCC a funding level of $1,379,500.00,
$31,550.00 above the BOCC instruction. The recommendations are enclosed.
Human Services Review Committee Recommendations
At the special meeting of the Board of County Commissioners July 31, 2001, the
Commission voted to establish a committee which was "charged with identifying a core
group of non-profit organizations to be funded by the BOCC and establish criteria to qualify
for funding." Members of the committee were: Commissioner Dixie Spehar, Monroe County
Health Department Director Jake Rutherford, Rural Health Network Healthy Kids Director
Keith Douglass, Wesley House Executive Director Joseph Barker, Human Services Advisory
Board Chairperson Alexsandra Leto, and Guidance Clinic of the Middle Keys Director of
Operations Debbie Barsell. This committee has met several times, and has categorized
services into three groups, listed criteria for funding in each group, and established
percentage guidelines to assist the Human Services Advisory Board (HSAB) in making its
funding recommendations.
The recommendations of the Human Services Review Committee are as follows:
• The overall human service funding of the BOCC was considered. Funding required by
law, such as Baker Act services, will remain directly funded by the BOCC, as will funding
for cultural programs. Mental health services, medical services, and recreational
services, formerly funded directly by the BOCC as part of the non -governmental, human
and social services budget process, will now apply to the HSAB.
• The HSRC recommends the establishment of a basic human services plan to assist and
identify the needs and allocate resources to purchase in a request for purchase (RFP)
process for multi -year funding and service to ensure appropriations, consistency and
efficiency. This plan should be a comprehensive plan to identify the human and social
needs of Monroe County.
• The FY02 funding for agencies now recommended to apply to the Human Services
Advisory Board totals $1,288,852.00. This will be an increase in both the amount and
the number of agencies applying to the HSAB, but not an overall increase in total
funding. The amount of funding and the number of agencies for subsequent years may
vary.
• The three groups are medical services (physical, mental and behavioral care services),
core services (non -medical but basic essential human needs services), and quality of life
improvement services (services to improve the quality of life for any individual or
community). A listing of these groups and the criteria for each are attached.
• As guidelines for the Human Services Advisory Board to consider in making its funding
recommendations, medical services would receive 65%, core services 30%, and quality
of life improvement services 5% of total funding. The actual recommendations of the
Human Services Advisory Board may vary from these guidelines at the discretion of the
HSAB. The accompanying spreadsheet shows the three groups of services and the FY02
totals and percentages of each. An illustrated sample is attached.
• With the recommended decrease in the percentage share of funding for the quality of life
group of services, the Committee agreed to request that the Sheriff's Shared Asset
Forfeiture Fund Advisory Board increase funding in this area accordingly as well as from
the United Way. Committee member Keith Douglass addressed the Shared Asset
Forfeiture Fund Advisory Board at its January meeting, and they indicated their
willingness to collaborate in appropriating funds to social services agencies.
MEDICAL SERVICES
This group is designed to accommodate organizations that provide primary and secondary
medical services, dental services, and mental and behavioral health services.
Services to Include
Physical, mental, and behavioral care services including but not limited to substance abuse
and direct and indirect primary and secondary medical and dental care for the economically
and mentally disadvantaged.
Criteria
1. 501(c)(3) designation as a registered non-profit organization with the Internal Revenue
Service.
2. Annual unqualified audit for organizations that expend over $300,000.00 (wording
changed from "less than" to "over" at Commission meeting April 17, 2002).
3. Non -duplication of services and should contribute to and coordinate with the overall
continuum of services network.
4. Have requirements to obtain local match funds from their state, federal funding, private
sources, and/or a requirement to maintain a sustainability plan, including demonstrated
successful fundraising history.
5. Licensed by appropriate state and/or federal agency to provide the required services.
Weight
6. Be considered a traditional basic "core" service historically supported by local
governments and requiring a significant amount of local and other funding.
7. Requires recurring funds at the local level in addition to other funding sources.
8. Description of services funded that relate to Medical Services.
9. Consideration should be given to organizations with a demonstrated history of having a
"waiting" list or demonstrated need.
CORE SOCIAL SERVICES RELATED TO SAFETY AND SECURITY SERVICES
This group is designed to accommodate organizations that provide non -medical, but
otherwise basic, essential human needs services to the disadvantaged.
Services to Include
• Services for the homeless and near homeless, who are abandoned or removed from the
home because of violence, legal issues, or family dysfunction, or are in need of food,
clothing, or housing.
• Emergency disaster relief, including, but not limited to, rescue and temporary shelter.
• Services for adult and child daycare, health and hygiene services.
• End -of -life support for the disadvantaged of any age.
Criteria
1. Documented 501(c)(3) non-profit organization by Internal Revenue Service.
2. Annual unqualified audit for organizations that expend over $300,000.00 (wording
changed from "less than" to "over" at Commission meeting April 17, 2002).
3. Non -duplication of services and should contribute to and coordinate with the overall
continuum of services network.
4. Have requirements to obtain local match funds from their state, federal funding, private
sources, and/or a requirement to maintain a sustainability plan, including demonstrated
successful fundraising history.
S. Licensed by appropriate state and/or federal agency to provide the required services.
Weight
6. Requires recurring funds at the local level in addition to other funding sources.
7. Consideration should be given to organizations with a demonstrated history of having a
"waiting" list or demonstrated need.
8. Consideration should be given first to organizations providing countywide services
and/or completing the existing network of like services.
9. Description of services funded that relate to Core Social Services.
QUALITY OF LIFE IMPROVEMENT SERVICES
This group is designed to accommodate organizations that provide services created to
improve the quality of life for any individual or community.
Services to Include
Educational, preventative, and other services including recreational and cultural
services.
Information, referral, educational, training and guidance services.
Criteria
Weight
1. Documented 501(c)(3) non-profit organization by Internal Revenue Service.
2. Annual or financial statement or a business plan for organizations that expend over
$300,000.00 (wording changed from "less than" to "over" at Commission meeting April
17, 2002).
3. Non -duplication of services and should contribute to and coordinate with the overall
continuum of services network.
4. Description of services funded that relate to Quality of Life Services.
NOTE:
It should be further noted that priority will be given to proposals which:
1. Target the working poor and financially -vulnerable citizens, racial and ethnic minority
citizens and/or citizen groups with a demonstrated, unmet need.
2. Provide services, which have a demonstrated effect on: reducing other costly medical,
social, judicial and/or other services (prevention) and/or supplementing current effective
services (augmentation).
Human Services Advisory Board Recommendations for County Fiscal Year 2005
Agency
SAFF FY04
FY 04
FY05 Requested
HSAB
recommended
Medical Services
Care Center/Lower Keys
0.00
193,035.00
284,970.00
310,000.00
Guidance Clinic/Middle Keys
8,000.00
321,267.00
321,267.00
360,000.00
Guidance Clinic/Upper Keys
0.00
91,935.00
0.00
0.00
Hospice
0.00
39,559.00
40,000.00
45,000.00
Rural Health Net. Healthy Kids outreach
5,000.00
34,614.00
70,000.00
38,000.00
Womankind
10,000.00
24,724.00
25,000.00
28,000.00
Total Medical Services
23,000.00
705,134.00
741,237..00
781,000.00
.": ,.
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Core Services
American Red Cross
0.00
24,724.00
30,000.00
27,000.00
Catholic Charities
7,500.00
19,135.00
0.00
0.00
Domestic Abuse Shelter
10,000.00
28,702.00
40,000.00
35,000.00
Florida Keys Children's Shelter
2,168.00
98,897.00
125,000.00
95,000.00
Florida Keys Outreach Coalition
10,000.00
19,708.00
30,000.00
25,000.00
Fountains of Living
0.00
0.00
15,000.00
5,000.00
Habitat for Humanity - KW Lower Keys
0.00
0.00
50,000.00
5,000.00
Habitat for Humanity - Upper Keys
0.00
0.00
50,000.00
5,000.00
Heron/Peacock
10,000.00
39,559.00
80,000.00
50,000.00
Monroe Assoc for Retarded Citizens
10,000.00
47,836.00
65,000.00
65,000.00
PACE Center for Girls
0.00
22,746.00
30,563.00
26,000.00
Samuel's House
10,000.00
37,581.00
40,000.00
40,000.00
Wesley House
10,000.00
91,657.00
180,000.00
100,000.00
Total Core Services
69,668.00
430,545.00
735,563.00
478,000.00
Quality of Life Services
Big Brothers/Big Sisters
9,000.00
21,164.00
30,000.00
23,000.00
Big Pine Athletic Association
500.00
40,000.00
0.00
0.00
Boys and Girls Club
3,549.00
29,669.00
35,000.00
32,000.00
Caring Friends for Seniors
3,000.00
10,000.00
10,000.00
5,000.00
DOLPHINS to Stop Domestic Violence
0.00
0.00
0.00
0.00
Florida Keys Area Health Education Center
0.00
37,000.00
5,000.00
Heart of the Keys Youth Recreation
5,000.00
29,669.00
0.00
0.00
Hel line
0.00
14,835.00
58,700.00
17,000.00
Just for Kids
0.00
4,945.00
95,000.00
10,000.00
Literacy Volunteers
5,000.00
6,132.00
8,632.00
6,500.00
Monroe Youth Challenge
5,000.00
0.00
45,000.00
22,000.00
YMCA Upper Keys
0.00
12,857.00
0.00
0.00
Total Quality of Life Services
31,049.00
169,271.00
319,332.00
120,500.00
Total
123,717.00
1,304,950.00
1,796,132.00
1,379,500.00
Available Funds
1,347,950.00
Fiscal Year 2005
Proposals for Funding Directly from the BOCC
Each year the BOCC funds a number of non-profit organizations that provide services
throughout the County. This year, many of the usual organizations have returned and one
organization, not previously funded, is asking for two grants. Total requests are
$1,841,931.00, as opposed to Fiscal Year 2004 approved funding of $787,216.00, a
$1,054,715.00 increase.
The summary table and requests are attached.
Monroe County Board of County Commissioners
FY 05 Non - Profit Funding
FY 04 FY 05 % Add'1 & New Currently
Other Non Profit - (Not - HSAB) Cost Ctr Adopted Requested Inc /Dec Requests Budgeted
.,28
Lower Keys HARP
00501
2,500
5,000
100%
2,500
2,500
, ,29
Middle Keys HARP
00502
2,500
5,000
100%
2,500
2,500
,/30
Big Pine HARP
00504
2,500
5,000
100%
2,500
2,500
\,31
Older American Volunteer Prgrn
00505
4,000
4,000
0%
0
4,000
\,32
Middle Ke s Guidance Clinic
01507/8
301,059
301,059
0%
0
301,059
33
Healthy Kids
03211
38,493
39,734
3%
1,241
38,493
34
Fine Arts Council
03502
45,000
115,000
156%
70,000
45,000
\•35
Historic Florida Keys Foundation
03503
30,000
30,000
0%
0
30,000
36
Heart of The Keys Youth*
03703
29,669
30,000
1%
331
29,669
37_Big
Pine Athletic Association*
03704
40,000
45,000
13%
5,000
40,000
38
Upper Ke s YMCA*
03710
12,857
13,500
5%
643
12,857
\,39
Guidance Clinic Transport
04542
42,351
42,351
0%
0
42,351
40
Rural Health Network
04571
150,000
200,000
33%
50,000
150,000
41
Keys to Recovery Program
68607
86,287
86,287
0%
0
86,287
42
Florida Keys Wild Bird Center
new
0
20,000
100%
20,000
0
43 1
Florida Keys Wild Bird Center inew
0
900,000
100%
900,000
0
Subtotal 787,216 1,841,931 1 1,054,7151 787,216
* Previously included in HSAB funding
In addition to increase in Budget request, the HARP is asking for 3 part-time and one full time position estimated
to cost $50,000 in addition to the $7,500 as listed above.
AARP Chapter
LOWER KEYS CHAPTER #1351, AARP INC
1016 GEORGIA STREET
KEY WEST, FL 33040
APRIL 12, 2004
JIM ROBERTS, MONROE COUNTY ADMINISTRATOR
1100 SIMONTON STREET
KEY WEST, FL 33040
RE: BUDGET FOR FISCAL YEAR 2005
ORG CODE: 00501-LOWER KEYS AARP
FUND: 001-GENERAL FUND
AFTER REVIEWING OUR EXPENSES FOR FISCAL YEAR 2003 AND SPENDING THUS
FAR IN 2004, WE, MY BOARD AND MYSELF FEEL THE NEED TO REQUEST
ADDITIONAL FUNDING FOR 2005.
RATIONAL FOR INCREASING OPERATING EXPENSES:
--530400--TRAVEL&PER DIEM --MEMBERS ARE VOLUNTEERS WHO TRAVEL FOR
THE CHAPTER, i.e.: OAAB MEETINGS & WORKSHOPS FOR EDUCATION, BOTH TO
GAIN INFORMATION TO SHARE WITH SENIORS
--530410--PHONE&POSTAGE/FREIGHT--CURRENTLY WE PAY OUR AOL SRVICE AND
POSTAGE FROM OUR AARP ACCOUNT. TELEPHONE AND ON-LINE SERVICES ARE
FOR THE COUNTY COMPUTERS. THESE RATES CONTINUE TO INCREASE. POSTAGE
COSTS HAVE INCREASED DUE TO INCREASE IN MEMBERSHIP
--530440--RENTAL&LEASE --- OUR ZEROX MACHINE BEARLY FUNCTIONS AND IS
OBSOLETE FOR REPAIRS. WE NEED TO LEASE A NEW MACHINE.
--530460--REPAIR&MAINTENANCE--QUESTIONABLE WHEN THIS SERVICE IS
NEEDED, BUT ALWAYS A POSSIBILITY
--530470--PRINTING&BINDING--IN THE PAST WE HAVE USED THIS ACCOUNT FOR
PURCHASING TICKETS
--530510--OFFICE SUPPLIES --INCREASED UTILIZATION OF THE COMPUTERS AND
ZEROX, AS WELL AS THE SENIOR CENTER BRINGS GREATER EXPENSE FOR
SUPPLIES. MEMBERSHIP HAS INCRESED DURING 2004
--530520--OPERATING SUPPLIES --AS DESCRIBED ABOVE
AARP chapters are affiliated with, but separately incorporated from HARP.
PERSONNEL FOR FISCAL YEAR 2005
NEW 0001--PART TIME POSITION (RECEPTIONIST) --EXPENDITURE DETAIL IS
ATTACHED
RATIONAL FOR REQUEST: FUNDING IS NO LONGER AVAILABLE THROUGH SCSEP.
THE RESPONSIBILITIES FOR THIS POSITION WOULD INCLUDE BUT NOT BE
LIMITED TO: LTRIAGE TELEPHONE REQUESTS FOR SERVICE, 2. ASSIST SENIORS
COMING TO THE CENTER WITH QUESTIONS, 3. ASSIST WITH COMPUTER USE
SCHEDULING & 4. PROVIDE ASSISTANCE TO AARP CHAPTER OFFICERS.
NEW--- ACTIVITIES COORDINATOR FOR ALL SENIOR CENTERS --A POSITION
COVERING ALL SENIOR CENTERS COUNTY WIDE ---DETAIL ATTACHED
YOUR ASSISTANCE AND GUIDANCE DURING THE BUDGET PROCESS WILL BE
APPRECIATED. PLEASE ADVISE ME AS NECESSARY. THANK YOU.
SINCERELY, /
FRANCES CARLISLE, PRESIDENT
LOWER KEYS CHAPTER #13151, AARP INC.
TELEPHONE--292-2159
E-NIAIL--frane1513@aol.com
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14z4P%P Chapter
MIDDLE KEYS AARP #2324
Date: April 8, 04
RE: Staffing Needs
Mr. James Roberts
Monroe County Administrator
1100 Simington St.
Key West, FL 33040
Dear Mr. Roberts,
We at the Middle Keys AARP chapter in Marathon are requesting that the
position of part-time receptionist be reinstated in the county personnel
system. Since "Experience Works" assumed responsibility for that position
a year ago, we still are without a receptionist. It is my understanding that is
true in both the Big Pine and Key West chapters also. The job description
would require a entry level salary ($10,361 per year), which does not appear
to be that unreasonable for four hours a day as a receptionist. See
attachment A for the cost figures of this position.
In addition, the three exiting chapters would to have a full time "Senior
Activities Director" for the county. This person would coordinate the
activities for all three (hopefully four in the near future) senior centers,
especially for exterior functions. Locally we are having a very difficult time
getting people to do that type of work, yet it is needed for a properly
functioning senior center. It has been suggested that this position would be
a level eight salary scale (approximately $50,000 per year). See attachment
B for the cost figures of this position.
Sincerely:
William R. Cum ins
President, AARP 2324
HARP chapters are affiliated with, but separately incorporated from HARP.
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Contract Option (600-340-03-1, Type 1, Gass 1)
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Plans Include:
• 2,000 Copies, overage @ 0.0195
• Full service: Unlimited (Parts & Labor)
• All supplies included except paper & staples
• Training and Consulting for Key Operators
Optional Accessories: (Monthly Cost)
215Stand-Cabinet Stand
PKTPRO 100-Pocket Pro 100
• Systems Analyst Support
24 Mont
36 Month
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S68.SS
S54 93
24 Month 36_ Month
S 11, 75 $ 8.23
$ 8.39 $ 5.87
$155.00 per hour
CIMAPT'ER
No. 2466
Norman Bohrer, Chapter President
Big Pine Keys' Senior Center
380 Key Deer Boulevard
Big Pine Key, FL 33043 PHONE 872-3990
Chartered 1976
April 7, 2004
Mr. Jim Roberts, County Administrator
1100 Simonton Street
Key West, FL 33040
Dear Sir:
We hereby request the funding as submitted in the attached 2005 Budget Request and supporting
documentation. Please forward to the proper authority_
The Big Pine Key Senior Center volunteer operations have expanded over the years as the
community has grown and as a result of new community service expansions.
Burdens for operation of the activities in prior years have been absorbed by this AARP Chapter's
private funds, which see attached. Some of these are rightly the responsibility of county government.
Furthermore, new operations, such as public computer access and necessary copying facilities, require
funding.
Moreover, personnel from each center has been withdrawn and there is a need for a countywide
coordinator of programmed activities at all four senior service sites.
I trust these submitted forms and support data are sufficient to move things forward. I am alert to
responding to your needs for any further information. Thank you.
Very truly yours,
���
Norman F. Bohrer
An AARP Chapter
QT�
Norman Bohrer, Chapter President
Big Pine Keys' Senior Center
380 Key Deer Boulevard
Big Pine Key, FL 33043 PHONE 872-3990
Chartered 1976
April 7, 2004
Fiscal Year 2005 Bud et -00504 Bi or Pine Aa 001 GENERAL FUND BOCC
Personnel Request
Part time Receptionist: Continually in the past under SCSEP our Center has had a receptionist and
welcomer at the front desk. Responds to calls, on -site queries, program explanations and maintaining
the distributions of printed materials and updating bulletin boards, and as such, this position requires
four hours each normal weekday. In past practice, the person in the position has also aided people who
were infirm in navigating and using the center. See attached Issue Expenditure Detail Item. #1
Activities Coordinator: There is a need for a county -wide coordinator of activities at the four senior
center sites. Many activities and programs can be improved and shared between sites with coordination.
This position would require knowledge, in general elderly health activities, public relations, human
relations, planning and program creation. Also desirable is abilities in general community service
liaison beyond the elder population. See attached Issue Expenditure Detail Item. #2
Norman F. Bohrer
A
An AAR-P Chapter
Au¢-V-03 I I : 3 6 From -Budder Office Supplies
111F-J J-J %-J t-J U 1V1 Z !r 1 UUNIrAIN i
3052963849 T-885 P.00Z/008 F-044
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40WI Work Center M 15 i
16 Pages Per Minute
Speclal Features:
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• 30-sheet Duplex Automatic Document Feeder.
• 100-sheet Bypass Tray holds special stock& (19-43 Ibs ),
• Paper tray holds s6o sheets In standard sizes from 5 x 7 to 9 x 14.
Copy, Print. secure Fax and Color Scan -to -PC
• Scansoff"° OmniPage SE v1.0 and Paporport Deluxe e.0 .
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Color scanning ; monp 8 seeods per page ; color 120 sec. per page (Tl 31k) dpl.
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• Operating System - Windows 96JOSint4.0 f2000fMe
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• d MS memory fax (320 pages); 8pead Dial - 90 locations,
Contract Options (600-340-034, Type 1, Class 1)
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• 2,000 Copies, overage @ 0.0195
• Full service: Unlimited (farts & Labor)
• All supplies included except paper & staples
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• PKTPRO100-Pocket Pro 100
24 Mont
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RURAL HEALTH NETWORK
(305)293-7570 P.1
Healt�YWS and KidCare
Post Office Box 980
Tallahassee, Florida 32302
850.224.KIDS(5437)
850.224.0615(FAX)
June 7, 2004
Mr. Keith Douglass
P.O. Box 932
Long key, Florida 33001 C O 5+ O 3 Z
Dear Mr. Douglass:
Your application for local match credit has been received and reviewed by Healthy Kids.
I am pleased to inform you that a credit of $25,000 has been awarded. With this credit,
the local match obligation for Monroe County for the 2004-2005 fiscal year is reduced to
$39,734. Your commitment to the health of children in your county is to be
commended.
In order to continue existing coverage for those enrollees who do not meet Title XXI
eligibility requirements, the remaining amount must be secured either through a financial
agreement or a deposit of at least one -quarter of the amount with quarterly deposits to
follow throughout the fiscal year. A copy of Healthy Kids' standard financial agreement
was provided to you previously and an electronic version can be downloaded from our
website at www.healthykids.org. Financial agreements or the first deposit are due by
July 1, 2004.
Thank you for your contributions and activities on behalf of the Healthy Kids program.
Should you have any questions, please feel free to contact me at (850) 224-5437,
extension 6108.
Sincerely, ,¢
U
Jennifer Kiser Lloyd
Director of External Affairs
\jkl
`0/f"_,V
April 19, 2004�Z�+=
James Roberts, County Administrator Monroe County Board of County Comm�sPdne"" �i*
1100 Simonton Street
.r
Key West, FL 33040
Dear Mr. Roberts:
This letter supports the Art Council's annual request for funds from the Board of
County Commissioners.
(:$:,:,:
5,000 i the amount requested from general revenue for 2004/05 FY.
We asked Mayor Nelson and the commissioners for their suggestions about our
request. They recommended a funding increase from both general revenue and
tourist tax funds. Both general revenue and tourist taxes are typical funding sources
for other arts councils, such as in Dade and Broward counties.
The total projected budget for the Arts Council for the upcoming fiscal year year is
$495,000. The balance of the budget will be raised from the municipalities and the
private sector, including members, businesses and foundations.
We promote all the arts in all the keys, all the time. By promote, we don't just mean
advertising and marketing, although we do that too. We mean
Building a strong cultural infrastructure.
Connecting artists to each other and to their audiences.
Making grants to individual writers, performers & visual artists.
Making grants to cultural organizations.
Advising new and emerging artists and organizations.
Bringing concerts into the senior citizen nutrition program.
Providing arts education for children.
Publishing information on what to do and what to see in the arts in the Keys.
Maintaining an award -winning website at www.keyarts.com
Managing rotating exhibits of art in public buildings.
Serving as staff to the Art in Public Places committee.
Th you for the opportunity to be of service to the community.
i t
r
ne Girard, Chair Monica Haskell, President and Executive Director
1100 Simonton Street, Key West, FL 33040
305-295-4369/ Fax:305-295-4372
email: info@keysarts.com / www.keysarts.com
USE OF FUNDS
Arts Education Touring Program
Senior center music programs
Special project
Operating, education and technology
ArtReach grants
Hospital performance series
Artist in School grants
Gallery Guide & Cultural Calendar
Writers & dance awards, special projects
Economic impact study
ArtReach, Emergency grants
See detail
See detail
TOTAL
Detail:
$4,000
Insurance
Professional fees
$5,00
Equipment
$2,500
Occupancy (phone, copier, storage,
etc.)
e
$4,000
Core Staff
$50,000
Membership & development
$7,500
Public relations
$7,500
Artist fees
$12,500
Internet
$3,500
Promotion
- $5,000
Printing
$5,000
Program expense
$3,500
Travel expense
$5,000
$115,000
Copy: Sal Zapulla
$10,000
$15,000
$15,000
$25,000
$30,000
$10,000
$10,000
$25,000
$50,000
$50,000
$25,000
$115,000
$115,000
$495,000
SOURCE OF FUNDS
So. FI. Cultural Consortium
FI. Div. of Cultural Affairs
Nat. Endowment for the
Arts
Rodel Foundation
Membership dues
Lower Keys Health Systems
License tag funds
Advertising sales
Corporate & private funds
Municipalities
Auction & events
BOCC
TDC
1100 Simonton Street, Key West, FL 33040
305-295-4369/ Fax:305-295-4372
email: into@keysarts.com / www.keysarts.com
2
810 33rd Street Gulf
P.O. Box 500836
Marathon, FL 33050-0836
Marathon Reaeation Center
March 30, 2004
Sal Zappulla, Budget Director
1100 Simonton Street
Key West, FL 33040
Re: Request for Funding
Dear Sir:
The Marathon Recreation Center a.k.a. Heart of the Keys Recreation Center Association, Inc. would
like to thank the Commission for their gracious support of our agency, we are a 501 {c}3 non-profit
organization that provides recreational activities for youths ages 8-18 years old in the Middle Keys.
Our agency offers many different activities in a safe, drug -free environment throughout the school
year and summer. The center programs include basketball, kickball, flag football and volleyball.
Homework assistance, book clubs, computer research and games are also offered along with open
activities at the center that includes billiards/pool, board games, arts-n-crafts, video games, movies,
ping pong and table hockey. Dances are held frequently on weekends for teens ages 13 and up, along
with Friday Fun Nights for grades 3rd thru 6d'. Special events such as talent shows, skits and youth
seminars are also hosted by the Center. Cultural and educational activities include jazz & hip hop
dance, tumbling, aerobics and field trips to museums and zoos.
Community members are also invited occasionally to speak about safety issues. The recreation
center's cheer competition team opened to ages 9-18 years old condition and compete nationally
against other teams in dance, cheer and tumble routines. The sailing club offers sailing instruction
and hands on experience in constructing boats and sailing regattas for youths ages 8 — 13 years old.
The center and it's programs are very vital to the youth and commun' . le Keys and your
funding along with United Way of Monroe County has helped continue to m e a difference
with our youth. We would like to request funding in the amoun of $30,000.00 pie a see attached a
summary budget for our agency.
Again thank you for all that you do for our youth, if you have any further questions please contact
Anthony Culver # 305-743-7926 or Rosemary Stayduhar #305-743-1343 or email address:
Sincerely,
-' <�
Antho y uN4 , Executive Director
March 30, 2004
Page 2
Marathon Recreation Center
Attachment A: Summary Budget
Organization Name:
Organization Address:
Organization Phone/Fax:
Organization Contact:
Contact Phone:
Heart of the Keys Recreation Association, Inc.
a.k.a. Marathon Recreation Center
810 3 � � Box 00836
FL 33050-0836
(305) 7434164 Email: Marathonrec@digitalsail.com
Diane Culver, Program Director
(305) 743-7926
Proposed 2004 Budget
Exoenditures
Salaries Ex. Director
29600.00
Revenue Source
Monroe County 29000.00
Prgm. Director
15000.00
Municipalities Mth.
18000.00
PT Prgm. Asst.10000.00
Rental Fees (Private)
500.00
Payroll Taxes
6000.00
Donations (BPW,etc.)
2500.00
Subtotal Personnel:
60600.00
Grants/Foundations
20000.00
Sheriffs Asset Forf.
5000.00
Postage
50.00
United Way
13500.00
Office Supplies
1500.00
Sports Fees: Sailing
1000.00
Telephone
500.00
Basketball
1000.00
Educational materials
Cheer Prgm.
1000.00
& Equipment
4000.00
Commissions/Vending
391.00
Professional Fees
1500.00
Fundraising: Marine auction,
Rent ($1 per year)
1.00
Family Fun Day, Dances, etc.
5400.00
Utilities (In -Kind)
0.00
Eqpt. Repair & Maint.
500.00
Travel — Field Trips
5000.00
Printing
540.00
Miscellaneous
100.00
Proposed Budget continued -
Expenditures
Sailing Club 500.00
Summer Rec 10000.00
Lic./Ins./Worker's Comp.11000.00
Basketball 500.00
Cheer Prgm. 1000.00
Total Expenses $97291.00
Revenue
Total Revenue $97291.00
Big Pine
Athletic
Association
P.O. Box 430089
Big Pine Key, FL 33043
Phone: 305-872-0292
Fax:305-872-7049
Email: BPKPark@aol.
U�
ti
c
The BPAA is a
supported by:
io"
tJnlGed Vft!J
of Monroe County
Jf11 .t 4 ?004 r;" 6/4/04
Dear Mr. Roberts,
This letter is a request for funding for the Big Pine Athletic
Association to be placed in the 2004-05 budget as a line
item.
In the past the BPAA has been funded by the county through
the HSAB. This year the BOCC has directed us along with
the Heart of the Keys and the YMCA, to make our funding
request directly to the County Commission.
In the past several years we have received the amount of
$40,000.00. Due to the success of our programs for the youth
of Monroe county, which has increased the number of chil-
dren that we serve and in turn our ex enses and the rising
cost insurance and day to d xp. se , we � sk that we be
considered for the amount $45,000.00.
The use of these funds will be the same as in the past.
Funds are to be used for— employee payroll, liability insur-
ance, supplies; phone, security, sanitary facilities rental, and
newsletter expenses.
Please contact me for any further information that I may need
to supply. 305— 872— 0292
Thank you for your attention to this matter.
Respectfully,
Scott Wade
Exec. Dir.
Big Pine Athletic Assoc.
Cc. Sal Zappulla �'
T
YMCA
4 Greater Miami
Board of Directors
Joseph M. Matthews
Chairman
Tomas P. Erban
Chair Elect
Paul J. Hanna
Secretary
David H. Promoff
Treasurer
Robert Beyra
Mercedes Busto
James L. Davis
Carl Durnberg
Douglas E. Ede
John P. Fox
The Rt. Rev. Leo Frade
Irene V. Hernandez
"-4hur H. Hertz
erick Jackson, Jr.
Felipe E. Madrigal
Charlie E. Martinez
Angel Medina, Jr.
Claudio Medina
Tom Mesa
Frank R. Nero
Leslie S. Porter
Sharon Ragoonan
Rev. Walter T. Richardson
William R. Robbins, Jr.
M. J. "Manny" Rodriguez
Roger L. Rosenberger
Carlos A. Sabater
Suzanne Salichs
The Hon. Joe Sanchez
Robert J. Shelley III
Merrett R. Stierheim
Osvaldo M. Vento, Jr.
Alfred Sanchez
Prey,-' t and CEO
March 22, 2004
James L. Roberts, County Administrator
1100 Simonton Street
Key West, Florida 33040
Re: Upper Keys YMCA
Dear Mr. Roberts,
i
APR - 2 2004 f i
i
The YMCA of Greater Miami's Upper Keys Branch has been the non-profit of choice
addressing the needs of children, family and the community in ways that bring together a
safe and caring environment that promotes positive values, a sense of community and
physical, mental and spiritual development. The YMCA has successfully served the youth
in the Key Largo and Upper Keys communities for over 6 years, by providing recreational
activities, character development and other meaningful programs for youths of all ages
and income levels.
The $12,857.00 funding award received from Monroe County last fiscal year, 2003-2004,
proved to be a major successful component for our summer camp, sports leagues and
after -school care programs in the Upper Keys/Key Largo areas.
We look forward to erving these communities with successful YMCA
programs and reques $13,500 in',continuation funding for the up -coming fiscal year,
2005. This amount reflec increase over last year to cover increase in costs. The
funds will address the expenses of the programs listed by providing various program
supplies, equipment, field trips, promotion/publications, salaries and other miscellaneous
expenditures. Please see detailed budget attached.
Below, please find a brief description of the programs we will offer to the community:
After -school Program: The YMCA After -school Program combines educational
enhancement, enrichment, cultural, and recreational activities as well as providing safe,
engaging environments that motivate and inspire learning for participants while their
parent(s) are working. The after -school program will be offered for 39 weeks when public
school is in session. The hours of operation will be from the time school is dismissed until
6:00 pm. Program service days will be Monday — Friday following the regular school
calendar.
Activities/Services include: a) nutritious snacks; b) arts & crafts; c) music &
movement; d) drama/theater; e) language/reading; f) math/reasoning; g) science/nature;
h) cultural awareness; i) free choice; j) recreational games, sports, indoor and outdoor
games, etc.; k) educational activities, homework assistance; and 1) opportunities for
parental involvement.
Summer Camp: In order to build strong kids, strong families, and strong communities,
the YMCA has been committed to offering high -quality day camp program for youth
between the ages of 5 — 12 from 8:00 am to 5:30 pm weekdays. All youth participating in
this program will experience growth and learning by: receiving quality in every aspect of
the program; helping them develop healthy self esteem; allowing them to learn through
discovery and play; providing a variety of challenging activities in both small and large
group settings; offering developmentally appropriate activities to help them develop
physically, emotionally, intellectually, socially and spiritually. In addition youth will also be
provided with: nutritious snacks; a safe space, age appropriate equipment and supplies,
YMCA of Greater Miami Association Office
1200 NW 78 Avenue - Suite 200 - Miami, Florida 33126
Tel (305) 357-4000 - Fox (305) 357-6633 - ymca@ymcamiami.org • www.ymcorniami.org
We build strong kids, strong families, strong communities.
Itib%"tl United Way
and most importantly, care givers - that aid in their development. These caregivers will provide
opportunities that will allow youth to create ideas and plan their own activities; appreciate diversity and
uniqueness of their peers; engage in their community to help develop their social skills and community
pride. The summer camp program will be offered for 10 weeks from the end of May through the first week of
August.
Activities/Services will include: a) nutritious snacks; b)guest speakers and community role
models to speak on topics such as fire & police safety, gun safety, career choices, cultural diversity,
environmental issues, etc. c) a variety of recreational activities such as sports, dance, arts & crafts,
drama, indoor/outdoor games, swimming lessons, etc.; d) cultural activities; e) variety of field trips; and f)
opportunities for parental involvement.
Youth Sports: The YMCA seeks to increase participation in youth sports by offering a variety of sports
programs on a year round basis. Youth between the ages of 4-17 will be provided with opportunities to
enhance their physical activity, increase skills, develop sportsmanship, increase self esteem, and learn to
work as a team, to name a few. Programs to be offered include: Soccer, Basketball, Cheerleading, Flag
Football and Tennis. A variety of these programs will be offered four times per year. Each season will be
eight to ten weeks long depending on the sport. Tennis will be offered on a monthly basis from September
to May.
All of our programs are being offered at Key Largo Community Park, 500 St. Croix Place, Key Largo,
33037
We thank you in advance for your consideration of continuation funding for 2005, if you have any
questions, feel free to contact Sue Loyzelle, Grant Development Director at 305-357-4000, ext 126.
YMCA of Greater Miami
Cc: David Owens, Grants Administrator
Sal Zappulla, Budget Director
Don Clark, Director Homestead YMCA
Sue Loyzelle, Grant Development Director
,R
/ Yt"--
I
Kurt Stelzner
Program Coordinator
Upper Keys YMCA
U:\Tyling\Monroe County\Monroe County 2005\Request Letter.doc
PROGRAM EXPENSES
Upper Keys YMCA
Funding Request
Postage
$
100
Program /Office/Food Supplies
$
3,000
Telephone
$
-
Professional Fees
$
-
Promotion & Publications
$
300
Rent
$
-
Utilities
$
-
Re air and Maint.
$
-
Travel/Field Trips
$
3,000
Conference & Meetings
$
-
Miscellaneous
$
477
Administrative Overhead
$
1,322
Total Expenses 1 $ 1395001
FL®RIDR KEYS WILD BIRD CENTER
May 30, 2004
James L. Roberts
County Administrator
1100 Simonton St., Room 2-205
Key West, FL 33040
Dear Mr. Roberts:
I am writing to you to make application to Monroe County for financial support of the Florida Keys
Wild Bird Rehabilitation Center, Inc.
The Center provides unique and essential services to not only our native wild birds but also the
people who care enough about our environment to rescue birds in need. The importance of our
wild birds to the Keys is demonstrated in many corporate logos. Approximately half of the 808
birds that we received last year came from unincorporated Monroe County. This historic trend has
continued into 2004 with the 305 birds received to date.
These numbers are to be expected, given service areas of 15 miles on Key Largo, Ocean Reef,
and referrals from the middle and lower Keys. This also fits with the majority of our birds' injuries
being caused by encounters with fishing tackle. Waterbirds and people compete for fish: the
former for survival, the latter for recreation. With our release rate at nearly 40%, we are returning a
hundreds of these birds to the wild to continue reproducing their species. This is a great relief to
the hundreds of caring people who are their frontline rescuers.
The Center has survived for two decades primarily through the generosity of these caring people,
not only the local rescuers but also current visitors and long-time members from throughout the
nation. The attached P & L for last year provides more details. As grateful as we are for their
support, we are appealing to the County for financial assistance for two reasons.
The major reason for our request is that our income has diminished as a result of the national
economic softness. For the first four months of '04, income was down $9,280, 7.42%, from this
period last year. (See the attached comparison report.) Accordingly, we have trimmed Our
expenses by $5,363, 4%, but there is little else we can cut.
The second reason is that one cost will go up significantly, and inescapably. Our Director, Laura
Quinn, is 75 years old. She no longer has the physical stamina to work the 70-hour weeks that she
has been working — at no pay. In the understandable absence of a volunteer to replace her, we
have hired someone with veterinary experience. This is a significant increase in our payroll. Like
many other small Keys employers, we are unable to offer our staff any health insurance coverage.
Therefore, we are requesting financial support from the County in the amount of $20,000.00.
While this would be in the form of general operating support, it would consist of 50% of the direct
medical care for the birds and 2.5% of the overall environmental education facility.
Page 1.
93600 OVERSEAS HIGHWAY, TAVERNIER, fl. 33070 (305) 852-4486
FLORIDA KEYS WILD RIRD REHABILITATION CENTER, INC. IS R TAX-EXEMPT, NOT -FOR -PROFIT AGENCY DESIGNATED AS S01 (C)(3) 8Y THE I.R.S. EIN: 65-0020988
A copy of the official registration and financial information may be obtained from the division of consumer services by tolling
1-800-435-73S2 within the state. Registration does not imply endorsement, approval, or recommendation by the state.
May 30, 2004, Page 2.
In detail, the medical expenses for bird care last year, consisted of the following:
supplies and medications,
7,080
equipment,
2,266
hyperbaric therapy,
1,209
disposal,
816
services,
830
subtotal, approx.
12,200
and medical staff payroll,
8,650
Total,
$20,850.
Half of that, for the birds received from
the County, is $10.425.
Keeping the facility open every day of the year to provide environmental education to locals and
visitors and a sanctuary for permanently disabled native birds totaled $363,257. (See enclosed
annual comparison report.) Deducting the above medical expenses leaves $352,832. Multiplying
that by the percentage of our contributing members from the County living on Key Largo, (2.5%),
is $8,820, which, with $10,425, is $19,245.
Granted, this may seem a little arbitrary, but it seems logical that the County at large should
support the resources that we provide to the citizens of and visitors to Monroe County.
There is one other point of information that needs to be explained. Laura Quinn will retire and the
Wild Bird Center property will be sold. Her retirement will be a gradual, phased reality that is being
addressed with new staff and the increasing involvement of Dr. Bob Foley. The property and
residence that is currently personally owned by Laura will be purchased by the State. Laura will
move into a nearby home similar to the one she sold to build the current Center. The assets of the
Florida Keys Wild Bird Rehabilitation Center, all of the other improvements to the property and the
materials and equipment used to operate the facility, will remain through a management and lease
agreement with the State. The Center will continue to operate as usual.
Ultimately, a much larger and more extensive wildlife and environmental education center will be
created on the scarified property across the highway as a project of the South Florida Resource
Conservation and Development Council. That will be the new home -of our Center. This r.eA.
location contains sufficient scarified property to allow many new activities that are not possible on
our current, limited property. It will be a first-class facility.
We are asking for your support now so that we can continue to provide to the orphaned, ailing and
injured wild birds, and the caring citizens of the county the services they need during this lengthy
transitional period.
Thank you for your consideration of this application.
Sincerely,
C"
Bruce B. Horn -
Operations Manager
FLORIDA KEYS WILD BIRD CENTER
June 25, 2004
>.3 U N 2 9 2004
James L. Roberts __ _
County Administrator
1100 Simonton St., Room 2-205 - -t
Key West, FL 33040
Re: Potential purchase of Wild Bird Center property.
Dear Mr. Roberts:
Way bacK in 1984, Laura Quinn established the Florida Keys Wild Bird Rehabilitation Center, Inc.
as a facility to provide a refuge for the temporary and permanently disabled native wild birds that
had been treated and saved by Bob Foley, DVM. The Center flourished to the point of outgrowing
her residential site and in 1991 relocated to the current 5-%2 acre site on the bay at MM 93.6. The
Center was granted a minor conditional use permit* in 1991 and has received an Institutional
Overlay on the 2010 FLUM*. It currently leases* the property and facilities in the residence from
Ms. Quinn for $500/month.
THE MISSION OF THE CENTER IS:
to reduce the suffering of sick and injured wild birds;
to reduce the occasions of their injury through education;
to reduce environmental hazards that place these birds at risk;
to increase the number of birds, both common and endangered,
that are released to live in the wild.
The Center is comprised of treatment and laboratory facilities, boardwalks through natural habitats,
educational exhibits, parking and restroom facilities for the public. The upstairs of the residence is
for the Director, an employee, and Interns. The growth of the Center was initially driven by a
constantly increasing number of birds arriving from throughout the 130-miles of the Keys. In 2003
we admitted over 800 birds, with more than 700 being brought in by caring citizens. We also
received 14,000 visitors last year, facilitated by being open to the public every day of the year.
These visitors donated on -site more than $80,000 last year. The quarterly newsletter, Footprints*,
sent to people who have asked to be members, raised $115,330, and over $70,000 was received
through grants. The total income was nearly $287,000.
The reason for this letter is that Ms. Quinn is now 75 years of age and her health shows the years
of physically hard work seven days a week. As long as she is in residence, she cannot really
retire. In order to move off the premises and into a home equivalent to the one she sold to buy the
current property, she must have access to her investment in this property.
Page 1.
93600 OVERSEAS HIGHWAY, TAVERNIER, FL 33070 (305) 852-4486
FLORIDA KEYS WILD BIRD REHABILITATION CENTER, INC. IS A TAX-EXEMPT, NOT -FOR -PROFIT AGENCY DESIGNATED AS 501 (C)(3) BY THE I.R.S. EIN: 65-0020988
A copy of the official registration and financial information may be obtained from the division of consumer services by tolling
1-800-435-7352 within the state. Registration does not imply endorsement, approval, or recommendation by the state.
June 25, 2004, Page 2.
The proposal has the goals of allowing Ms. Quinn to retire from the Center while insuring the
continued existence of the Center under lease from the county, with the directorship of Dr. Foley,
and the perpetual protection of this precious property.
Acquisition of this property by Monroe County is consistent with the Comprehensive Plan in at least
five ways.
1. By providing employee housing in the residence, the goal of developing affordable
housing is met.
2. Environmentally sensitive lands will be preserved, as demonstrated in reviewing the HEI*
conducted in the initial permitting process.
3. Habitats of rare, threatened or endangered species of plants and animals will be
preserved, as demonstrated in reviewing the HEI*, and also by the rehabilitation of listed wild birds.
4. Community character of Monroe County is enhanced by the continued existence of a
facility to which our caring citizens can take sick or injured wild birds and also where visitors can
learn about our unique and delicate environment.
5. The open space, scenic corridors and viewsheds will be protected in perpetuity.
On May 5, 2004, the property was appraised* Gene B. Gracer. Mr. Gracer concluded that "the
present use of the property, as improved, is the Highest and Best Use of the property". His opinion
of the "As Is" Market Value is $930,000.
Ms. Quinn has placed an asking price of $900,000 on the bay bottom tract (RE #89040), the
"Warshaw Property", (RE #480160), and the residential improvements thereon.*
Thank you for your consideration of this proposal.
Sincerely,
Bruce B. Horn
Operations Manager/Sect., FKWBRC, Inc.
Agent for:
Laura B. Quinn
Director/Owner of Record
* These documents will be presented upon request.
CC: Mark Rosch, via FAX
Mayor Nelson, via FAX
Fiscal Year 2005
Monroe County Health Department
The Health Department has requested an additional $36,734.00, or 11.9% over
Fiscal Year 2004.
FLORIDA DEPA
Jeb Bush 11-rEfl
John O. Agwunobi, M.D. M.B.A.
Governor Secretary
Date: July 9, 2004
To: Sal Zappula, Monroe County Office of Management and Budget
Jim Roberts, Monroe County Administrator
From: Christopher Smith C41-�
�
Operations Manager
Monroe County Health Department
Subject: . 2004-2005 Budget Request
In our continuing effort to provide for the health needs of the population of Monroe County, we
at Monroe County Health Department are requesting the following funding for the 2004-2005
fiscal year.
County Tax Revenue- $342,033.54 (11.9% increase)
Small Quantities Waste Generator Contract $75, 540.51 (1.9% increase)
The 11.9% in the tax revenue represents an effort to maintain and improve Monroe County
Health Department's Environmental Health Program.
The 1.9% for the Small Quantities Waste Generator Contract is consistent with the consumer
price index.
Thank you for considering our request for the funding of these important public health activities
and it is our hope that they will be viewed favorably and as important to the well being of the
citizens of Monroe County
MONROE COUNTY HEALTH DEPARTMENT
Gato Building
1100 Simonton Street
P.O. Box 6193
Key West, Florida 33041-6193
rznsl 101-1'411) . FAY rzn51101-AR71
1°voDIM11 r. 13Ult1 Gl j Pi --. AAPP-BPK 872-26t. y For July z , 2004
Comments before BOCC, Key West, on 2005 Senior Center Budget
As the generation of WWII passes, so too are the elders who volunteer.
There's a marked lessening of involvement throughout the volunteer world... Senior
Centers are being enveloped in the quicksand of time and younger generation are reluctant
to volunteer.
It `s become clear that today a more structured support system is required to appeal to,
and involve, volunteers. The time has come to supplant the structure that is passing away.
TOWARD this end, the counsel of Senior Center Executives urges that a new policy
and approach be pursued which includes the following budget items:
1. Employ a part-time Receptionist/Greeter at each active Senior Center Site to
replace recently eliminated personnel.
2. Employ a full-time, county -wide, Activities Coordinator with duties which
directly advise the volunteer operators of Senior Centers on county processes. These
would include: reports and budget preparation, volunteer activity methods and enrolling,
site management and program reporting. Also required would be a concentrated use of the
media for furthering site or county -wide goals and cementing community relations.
3. Increase substantially the funding of Senior Centers, since they now encompass
added community services and programs which benefit a larger local community reach.
Without such actions now, your volunteers and Centers will slip away from the
community.
CALL upon me for any information or help you may require.
Thank you for your attention.
Rural Health I
rk
Health Care Access
Partners:
Florida Department
of Health
US Dept of HHS: Health
Resources & Services
Administration
Monroe County Board of
county Commissioners
Health Foundation of
South Florida, Inc.
U.S. Departmmt of
Housing And Urban
Development
Chairman
Robert It Luse, CEO
Mariners Hospital
Vice -Chair
The Honorable Dixie Spel
Monroe County
Commissioner — District 1
Secretary
Debbie Premaza, RN. BSN,
Regional Director,
Lifelines Home Health Care
Treasurer
William Kwalick,
Key Largo Chamber
Of Commerce
President & CEO
Mark L. Szurek, Ph.D.
Health
Network of Monroe County, Florida, Inc.
P.O. Box 4966, Key West, Florida 33041-4966
2003-2004 YEAR-END REPORT AND
2004-2005 FUNDING PROPOSAL
Especially Prepared For
THE MONROE COUNTY COMMISSION
Administration, Finawce or Health Services
VOICE 305-293-7570; FAX 305-293-7573
Program Development„ Insurance Projects & KidCare -VOICE 305-517 9002; FAX 305-517-9004
W W WAmmc.org
Health Rural Celebratipg 10 Tears of Service in Wonroe Coa nLy
rk
Health 1993-2003
p ' Network of Monroe County, Florida, Inc.
P.O. Box 4966, West, Florida 33041-4966
_. Key
The Monroe County Commission July 20, 2004
1100 Simonton St.
Key West, FL 33040
Dear Mayor and Members of the Commission:
Thank you very much for your continued support of the programs conducted by the Rural Health
Network of Monroe County (RHNMC). Through your generosity we have been able to operate the
four mobile and fixed -site primary medical care clinics and a new dental clinic. Your support of the
Florida KidCare program has enabled a record number of children to have a medical home, with more
than 5,200 participating. In addition, we have made significant progress towards the development of a
countywide health care plan for everyone unable to obtain affordable health insurance. You have
invested in these initiatives and should feel proud that your support is making a difference in the lives
of your less -fortunate constituents
The RHNMC is making application to the federal government for approval to create a new
"Community Health Center" (CHC) in Marathon and have been working with Fishermen's Hospital in
a cooperative effort to locate both the primary care facility and a new oral health care operation in one
complex. The CHC will qualify for a substantial amount of federal dollars heretofore unavailable to
our community, and enable us to double the number of days of operation each week, providing
comprehensive primary medical services on an equal access basis, throughout the county.
Unfortunately, the funding would not be available for a number of months and the cost to continue
to operate the primary care clinics presents a difficult challenge. The primary care clinics served over
3,800 people, many requiring repeat visits due to the seriousness of their medical .issues, totaling
12,000 patients serves provided More than $350,000 in prescription medications was dispensed to
those in need as well.
Funding from Monroe County is critical to our continued operation and provides evidence to our
new federal partners that we have significant local community support. In addition, the clients give
what little they can. We are also in the lengthy process of obtaining Medicaid Provider status, which
will enable the RHNMC to obtain reimbursement for some of the services performed. We need your
help to sustain the operation in the short term this year. You have been providing $150,000 for the past
two years to support the primary medical care program. The RHNMC asks that you invest $200,000
for our primary care program for the coming year, while we complete the requirements for
CHC status. I have included a Health Services Synopsis and proposal supporting documentation for
your review and thank you for willingness to help us help others in need.
Douglass
Administration, eommsijty Outreach, Finance, or Health Services
VOICE 305-293-7570. FAX 305-293-7573; Dental Clinic 305-295-3115
Program Development, Insurance Projects & KWCare -VOICE 305-517-9004 FAX 305-517-9004
www.nralhealth-f kwidakeys.org
HEALTH SERVICES 2004
2004 continued as a year of challenge for Health Services. The oral health program hired
a full time dentist, although this was also temporary in that the dentist had to leave in a
year. The dentist formally left our clinic in May '04. We were fortunate enough to be
able to recruit our previous dentist, (who had relocated to Pensacola), to travel to the
Keys for 3 weeks per month for 6 months in order to keep the service available, as we
continue our search for a fill time dentist.
As this occurred, the ARM in the Lower Keys became pregnant, left for maternity leave
and decided to accept a position in Haiti. She formally left our clinic in mid June '04.
Our Staff RN in the Lower Keys also left our organization in order to travel for a year,
this occurring in mid June.
Thd target population of the dental clinic continues to be predominantly adults and
children who have not been able to seek dental care in recent years, due to their inability
to pay the high cost that care and due to the unavailability of discxxmted oral health
services with a sliding fee schedule. The clinic continues to provide the following
services to these patients: comprehensive and limited exams, radiographs, preventive
services (prophylaxis, fluoride applications, and sealants), moons, root canal therapy
(excluding molars), restorations (amalgam and composite fillings), and removable
prosthodontics (space maintainers, partial and full dentures).
Oral Health Statistics
Total Patients: Of 1,650 of current patients, 370 were new patients
Females: 808 or 49•/a
Males: 942 or 51%
Children under 12: 160 or 10'/0
Children 13 to 20: 90 or 9%
Adults over 50: 246 or 260/6
Adults 21 to 50: 270 or 49%
The primary care program, due to the diligent planning and grant writing of the CEO, has
now formally applied for Federal 330 funding (Community Health Center) and status.
This will allow the Network to expand clinic hours in bath the Upper and Middle Keys to
5 days a weer, while providing the Lower Keys with continued coverage and the
possibility of expansion of services on Big Pine Key.
With the absence of staff since April '04, the Network continued to staff all
designated sates, despite the fact that the Lower Keys had limited services, operating
primarily with a RN and administrative assistant.
Primary Health Care Statistics
Total Patients Visits: 3,8W
Total Patient Services: 12,000
Patients, Upper Keys: 1600
Patient Services UK: 48M
Patients, Marathon: 900
Patient Services Marathon: 2700
Patients, Big Pine: 360
Patients Services Big Pine: 1080
Patients, St Clare Clinic: 1000
Patient Services: 3000
Even with the personnel problems, primary care was provided for approximately 3,860
patients, who received approximately 12,000+ services. Through our pharmacy
assistance program, Health Services brought over $350,000 worth of prescription
medications into Monroe County. All other statistics remain unchanged, reflecting the
only county wide primary health care available throughout Monroe County.
Primary care patient problems range from simple episodic problems to chronic health
conditions. Services provided included physical examinations, women's health exams,
laboratory testing, pharmaceutical assistancey immunizatnonsy basic first aid, wound care,
STD and TB screening, health education and prevention, and referral services.
"A major problem that affected both the primary care and oral health components was
Personnel problems, in that the hiring of a practitioner and dentist proved to be a daunting
exercise. It took approximately 6 months to find the needed personnel to fill the
positions. The major obstacle was salary and cost of living in Monroe County.
Unfortunately, we are having to begin this process as we enter 2004 since both the dentist
and practitioner will be leaving for personal reasons." The paragraph in quotation marks
is from last year's report (03-04). As of this meeting, we are still trying to hire a full time
dentist and may have possibly hired a semi -retired physician, willing to work in the
vacant ARNP position. "'
HEALTH SERVICES SYNOPSIS FOR FISCAL YEAR 2003
The Rural Health Network's primary care component achieved Rural Health Clinic status
in July 2003 and is in the process of qualifying as a Medicaid provider, which will
provide reimbursement for many services. The Network continued to staff all designated
sites, even though finding and keeping qualified staff presented a significant challenge to
the Network. Even with the personnel challenges, primary care services were offered to
approximately 4,500 patients, who received approximately 13,500 services.
Finding and keeping qualified primary care and oral health personnel is an ongoing
challenge. New funds are necessary to obviate this situation and retain qualified health
care givers. Salaries and the cost of living in Monroe County are the major obstacles.
Marathon's fixed -site clinic at the Ruth Ivens Health Department facility served about
1,000 patients while dispensing about $100,000 in prescription medications. Mobile Van
1 in the Upper Keys saw 2,000 patients, and also dispensed about $100,000 in
prescription medications. The Mobile Van 2 located in Big Pine Key served just fewer
than 600 patients, and St. Clare Clinic in Key West serviced over 1,000 patients of which
approximately 400 were homeless. Through our pharmacy assistance program, Health
Services brought over $300,000 worth of prescription medications into Monroe County.
All other statistics remain unchanged, reflecting the only county wide primary health
care available in Monroe County.
The primary care clinics see adults and children who cannot afford to see a physician
who does not provide discounted services or a sliding fee schedule. Most patients have
complaints ranging from simple episodic problem to chronic health conditions. Services
provided included physical examinations, women's health exams, laboratory testing,
pharmaceutical assistance, immunizations, basic first aid, wound care, STD and TB
screening, health education and prevention, and referral services.
The first dental clinic for the indigent opened in January 2003. Since its inception, 415
patients have receives 1,940 services. The dental clinic predominantly sees adults and
children who have not been able to seek dental care in recent years, due to their inability
to pay the high cost and a lack of discounted oral health services with a sliding fee
schedule. Many patients require three or four repeat visits and present with extensive
caries, periodontal disease, and dental alveolar infections.
The clinic provides the following services to these patients: comprehensive and limited
exams, radiographs, preventive services (prophylaxis, fluoride applications, and sealants),
extractions, root canal therapy (excluding molars), restorations (amalgam and composite
fillings), and removable prosthodontics (space maintainers, partial and full dentures).
Future plans include the establishment of a community health center (CHC) providing
both primary medical and oral health care at complex in Marathon and the creation of a
dental clinic in the Upper Keys as well.
APPLICATION FOR FUNDING
MONROE COUNTY GOVERNMENT
uctwer _i , zvu4 - se temper su, zuu!3
GENCY PROFILE
gency Name: Rural Health Network of Monroe County, FL, Inc. Operating Since 1993
Mailing Address: PO Box 4966
City, State, Zip: Key West, FL 33041-4966
Agency Phone: 305-293-7570 Fax: 305-293-7573
Email: mszurek@rhnmc.org
TDhom should we contact with questions regarding this application (name and phone number):
r. Mark L. Szurek (@ 305-293-7570 ext 10) or Mr. Keith Douglass (@ 305-517-9002)
1' QT1F�reTrnN' aJ
To the best of our knowledge and belief, the information contained in this application and attachments is true and
correct. Monroe County is hereby authorized to verify all information contained herein, and we understand that any
inaccuracies, omissions, or any other information found to be false may result in rejection of this application. This
certifies that this request for funding is consistent with our organization's Articles of Incorporation and Bylaws and
has been approved by a majority of the Board of Directors.
We affirm that the Agency will use Monroe County funds for the purposes as submitted in this Application for
Funding. Any change will require written approval from the Monroe County Board of County Commissioners.
We understand that the agency must substantially meet the eligibility criteria to be considered for Monroe County
funding and that any applicable attachments not included disqualify the agency's application.
We further understand that meeting the Eligibility Criteria in no way ensures that the agency will be recommended for
funding by the Human Services Advisory Board. These recommendations are determined by service needs of the
community, availability of funds, etc. Approval of HSAB funding recommendations is granted by the Monroe County
Board of County Commissioners.
Typed Name of
Executive Director: Mark L. Szurek, Ph.D.
Signature
Date:
Typed Name of Board President/Chairman:
Mr. Robert H. Luse
Signature
Date:
1
1
rMMARY O. F SIGNIFICANT CHANGE
equestions in this section pertain to major changes that have occurred within the organization's past fiscal year. If there
been a change, answer the. 4uestion with a brief summary. If there has been rho change, check "NO."
YES NO
Significant change in staffing and/or management x
including the Executive "Direc:ttoo?
ar Wolunteer Governance and/or Structure? X
NMC will be changing its Board structure in mid-2004. The Board Bylaws will allow for 13 members, 7 of whom will be
nsumers, 3 of whom will originate from among health providers, and 3 of whom will originate from the faith -community,
ocal government, business and/or the community -at -large. The final roster of Board members will not be determined and
tified until July 2004.
ending Sburces {toss or Addition of Revenue}? X
anization Missionlf tr egic Direction? x
hangs in; Programs/services,(Addition or Deletion of Programs)? X
jftniflcant Change In Servl*004 <Dosts and/or Effectiveness Measures? X
neint soselCNent Demographics? X
Naborative i�ftorts/fteiafionstytps with 'other Service Providers? X
P",
NARRATIVE OVERVIEW OF REQUESTED FUNDING
1. Provide your agency's board -approved written mission statement.
To improve the access to and quality of health care for all residents of Monroe County, FL.
2. Explain specifically how your agency plans to use the money you are requesting. e.g. rent, salaries, expansion of
services or service area, or general agency operations.
Funds Requested - $200,000. (Primary care services for the uninsured). Applied to operational and salary expenses for
services medical personnel that serve Key Largo, Tavernier, Islamorada and Marathon.
N Y'ou PW 110;uab the fuMe as.nratCh,, moat Ibt. a t#is of -oath You are Owid", tha aouroe, and ft percorrtoga of mataft Kok required,
ta4sed cn the ofail or pint and tnatdi, �r a ye t6tad or a nt end Ch is 10p Q4 nd he tequM d mdbch
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Summarize your organization's financial sustainability plan (one-half page max.).
A. Maximize KidCare enrollment thereby offsetting direct service costs to RHNMC. Enhance Medicaid, Medicare,
KidCare and private insurance reimbursements where possible. Enforce a sliding fee scale to ensure fair patient
cost -participation.
B. Establish and sustain dialogue with county and municipality authorities about local health need gaps, impact,
costs and funding possibilities.
C. Pursue state and federal grant funding options on a continual basis. Establish community health partnerships
to maximize grant "attractiveness" and applicability.
D. Research and pursue foundation grant opportunities and sustained support.
E. Identify yearly fundraising needs and goals, and actively implement fundraising plan(s). Routinely, assess
effectiveness of plan implementation.
F. Maintain high quality programs in all respects to maximize public confidence in donations and giving.
Summarize your organization's strategic plan (one-half page max.).
The RHNMC Strategic Plan is four -pronged. It seeks to...
A. Effect and maintain direct health service programs (primary care and dental care) targeting the uninsured.
B. Establish a countywide oral health care program for the uninsured over the next 3 years.
C. Remain the County lead agency for KidCare.
D. Sustain the RHNMC infrastructure through an ongoing program of quality assurance, program services assessment
[han
evaluation, fiscal accountability, utilization review, and the accessingof appropriate and funding.
f your request is greater than last year, explain in detail what the increase is expected to fund. If the increase is for more
one additional item, list the items in order of priority with the amount of each. Do not list your agency's budget by line
here - that information will be requested in the attachments.
increase in funding is requested to meet the salary, fringe, supply and operational funding needs of this health service.
Prior years' funding did not meet all costs attached to the provision of these services. This request is the first increase in
funding sought in the last 3 years.
VOLUNTEERS (including Board Members)
6. Is there representation of your client population on your Board, or is there an advisory group on which clients are
present? What is the authorized number of Board positions specified in your by-laws?
RHNMC's current Board is composed of 28 members, with 36 seats allowed by the ByLaws. Of these, there are 3
consumer seats designated, as well as 2 seats reserved for the community -at -large.
In action taken by the Board on January 26, 2004, Network ByLaws were amended to reflect a more consumer -oriented
governance. Effective July 2004, 7 seats will be designated for consumers (who must have been/or are current recipients
of care from a RHNMC clinic). There will also be an additional 6 seats for Board Members: 3 of these seats will be
occupied by provider organizations (currently elected to those seats: Lower FL Keys Hospital; Fishermen's Hospital; -
Mariners Hospital); as well as 3 seats that may be occupied by the community -at -large, the faith community, business,
Currently 2 have been filled through Board election by local county (Comm.
and/or government. seats government
Spehar) and the business community (Key Largo Chamber). The remaining seat will be dedicated to a faith community
representative.
7. Fifty-five (55) Volunteers contributed a total of 4,403 hours to our agency this past year.
Board: 336 hours (28 Members @ 3 hrs
Programs: 3,800 hours (Children's
Committees: 267 hours (exec. comm. @
ea. x 4 mtgs/yr)
Dental Sealant Project [2,100 hrs] +
4 mtgs/yr x 4 members x 3 hrs [48 hrs]
vol. pediatrician [200 hrs] + PA
+ health ins. task force (10 members x
student rotations [1,000 hrs] +
7 mtgs x 3 hrs ea [210 hrs] +
KidCare Council meetings [180 hrs] +
membership & nominating comm. (1
volunteer RN (320 hrs)
mtg x 3 members x 3 hrs [9 hrs]
8. How do you utilize volunteers in the operation of your agency?
A. Board and other Board appointed committee activities. B. Direct health service staff. C. Kidcare Advisory
Councils. D. Health Insurance Task Force.
9. Briefly describe the training the volunteers receive.
All volunteers sign a contract with RHNMC that identifies what responsibilities are expected of the volunteer by RHNMC
and what services will be rendered by the volunteer, to include specification of dates, times and locations that volunteer
services will be provided. All volunteers receive an administrative overview of the Network to include what a rural
health network is, policies & procedures, administrative chain -of -command, confidentiality restraints (including HIPAA
compliance), safety in the workplace, violence in the workplace, an orientation to the drug -free workplace policy, a
review of universal safety precautions, and a supervised orientation to the volunteer setting. (RHNMC Policy dz
Procedures # Per 2.32, P. 59)
AGENCY ORERATIONS
10. Does your agency have a formal grievance procedure for clients? If yes, briefly describe. How are clients made
aware of the procedure?
All clients receive a printed brochure that describes RHNMC compliance with HIPAA privacy laws, and how to express a
grievance when a client may feel that their confidentiality has been breached, and/or how to express any grievance. All
directed to the health director direct director. The
ggririevances are services (in terms of services) and/or to the executive
dnector (by policy) has 72 hours to investigate the grievance and respond to the complaint, once a formal grievance is
received. If the response by the director is unsatisfactory, the complaintant is directed to the executive committee (the
RHNMC Board Officers), and informed when the next meeting of that committee will convene. (All RHNMC meetings
fall under the Florida Sunshine Law.) The executive committee will hear the complaint and make a determination. All
decisions of the committee are final. (RHNMC Policy & Procedure #'s Per 2.22 [p. 50], HSQ 4.13 [p. 90], and Section 8, [p.
146].)
11. Are any client services performed under a sub -contract?
RHNMC does not subcontract any county funds with any other entities or organizations.
12 How do you network with other organizations? Describe any sharing of costs, referrals of clients, etc Are any
services funded by the County subcontracted to another organization? We are looking for more detail than your
membership in Interagency Council. An example of an appropriate answer is "one of Agency X'S employees works out of our
branch" or "we jointly fund X positions with ABC Agency."
The Rural Health Network of Monroe County by its very design and by Florida statute (381.0406) is a "network",
in addition to being a direct provider of services. Its 28 member Board of Directors is composed of representation
from all 3 county hospitals; 3 physician -hospital organizations; 4 chambers of commerce; state, federal and county
government representation; substance abuse and mental health services; the faith community; the major health
service providers; long-term care representation; special women and children's medical services; special health
services, the health department, and consumers. All RHNMC quarterly Board meetings are designed to secure
input, feedback and approval from the health care community and the community -at -large for its initiatives.
RHNMC is subject to the FL Sunshine law and publicly notices all scheduled meetings. These publicly noticed
meeting provide an opportunity for health care providers and the public to scrutinize the plans and initiatives of
RHNMC to ensure non -duplication of services. RHNMC is the county's health care coalition.
As a service provider organization, RHNMC has actively networked with other social and health care agencies in this
community. (1) As the recipient of US Dept. of HUD grant FL14B00-4001, RHNMC has shared over 50% of its grant
funds with the Guidance Clinic of the Middle Keys [for inpatient substance abuse detoxification], FL Keys Outreach
Coalition [for basic human needs], and the US Fellowship of FL, Inc (case management). In a renewal application (2004),
RHNMC will share over 84% of HUD grant revenues with the Guidance Clinic, Catholic Charities and Samuel's House.
(2) RHNMC directors serve on the following Boards: Boys Scouts of America, FL Keys Children's Shelter, Monroe
County Educational Foundation, Southernmost Homeless Assistance League, Inc., the American Cancer Society, the
Healthy Start Coalition of the FL Keys and the FL Coalition for the Homeless. (3) RHNMC is a member in good standing
with the FL Community Health Center Alliance, (Monroe Co.) Inter -Agency Council, and the FL Rural Health
Association. (4) RHNMC has partnered with the Monroe Co. Health Department in health outreach initiatives for the
children's hand -washing campaign, head lice prevention and children s dental care. (5) The executive director of RHNMC
served as chairman of the county s homeless coalition for 4 consecutive years (1998-2001), and RHNMC was a founding
member of that non-profit organization (6) RHNMC has partnered with the Monroe Co. Sheriff's Department and local
fire departments (Key West, Marathon, Islamorada and Key Largo) to offer the children s safety car seat program. (7)
RHNMC has twice been the recipient of the (state's) Davis Productivity Award for its contributions to FL KidCare (in
2001 and 2002); has been recognized by the FL Department of Health as a model of successful health are access; and has
been recognized by Texas A&M University: School of Rural Public Health as a Best Practices Model in 2002-2003. (8) In
2003, RHNMC received the Concern Award from the National Association of Counties (NACo) for its dental care project,
and also from NACo, the Achievement Award, for its primary care program, as a result of this county funding partnership.
13. Is your agency monitored (for example, by Dept. of Children and Families, a parent organization, or a state or federal
agency)? If yes, by whom and how often? If not, how does your agency document and measure its service performance
and success rates?
RHNMC is monitored by the FL Department of Health: Office of Rural Health. As a state certified rural health
network, RHNMC operates under FS 381.0406, and is required annually to submit a Board approved work -plan for
contract inclusion. This plan must include measurable goals and objectives that will be achieved by the Network
over the course of the contract year. Measures of objective attainment are submitted in quarterly reports. The
Florida Department of Health conducts an annual inspection of each certified rural health network.
FINANCIAL INFORMATION
14. Is your agency receiving any cash or in -kind services e.g. free rent, utilities, maintenance, etc. from the County
or any other source? If so, briefly explain below and be sure to include the fair value in Attachments E and G.
RHNMC receives the equivalent of free rent in a lease authorized by the Key West City Commission and signed by
the Key West Housing Authority under the US Navy's BRAC Project, wherein homeless service providers may
access housing in former Navy property at $1.00 per year x 50 years. RHNMC currently occupies Z 2 bedroom
units for administrative purposes under this plan. Fair market value is placed at $2,000 per month per unit, or
$48,000.00 (total in -kind) per year at that site.
RHNMC is also a guest of the county and health department at the Ruth Ivins Center in Marathon. RHNMC
performs basic outpatient primary care from that facility two days per week. Estimated in -kind value is placed at
$24,000 per year.
RHNMC's dental program is currently housed at the Department of juvenile Justice Building on Stock Island in
Key West. RHNMC is not charged rent at this location, but is assessed a monthly maintenance fee of
approximately $1,100 per month Estimated yearly rent equivalent is $24,000.
15. Please specify the percentage of total agency revenue that goes to the following:
Fundraising Expenses: 2.6% Administrative Expenses: 16.7%1
#)El'All WOO* PR1 r 4M FORFUNDING IS RE4`lUESTwon sop, 11,12 (Ali "hrnw is D & E)
16. Please give a one -paragraph description of each program for which you are requesting funding.
This project constitutes the only provision of direct primary health care services for the uninsured throughout this county.
RHNMC uses 2 medically egtupped mobile vans and 2 land based sites to accomplish its health care outreach. Services
are provided in Key Largo, Tavernier, Islamorada, Marathon, Big Pine and Key West. Approximately 3,500 unduplicated
patients are seen per year, while RHNMC provides over 15,000 different services and experiences over 4,5W visits. Staff
teams at each site are composed of a mid -level licensed practitioner (PA or ARNP), an RN and an administrative (health)
technician. All medical staff are supervised by an on -call medical director (MD) who also provides technical assistance
and quality assurance review on a monthly basis. RHNMC provides laboratory assistance at little -above wholesale costs,
while all eligible patients for the pharmaceutical assistance program may receive free prescription medications. In 2002-
2003, RHNMC provided the retail equivalent of over $650,000 in prescription drugs to over Z500 RHNMC primary care
patients.
17. Where and when are these programs being offered? List all sites and hours of operation.
RHNMC's primary care services include sites at Key Largo (MM 105; St. Justin Martyr Church; Mondays;10:30 am
to 6:30 pm), Tavernier (MM 90, San Pedro Church, Tuesdays;10:30 am to 6:30 m), Islamorada (MM 81;
Islamorada Library; Wednesday;10:30 am to 6:30 pm), Marathon (MM 50; Ruth Ivies Center; Thursdays & Fridays;
9am to 6pm), Big Pine Key (MM 30, St. Peter's Church, Thursdays;10:30 am to 6:30 pm) and Key West (MM 0; St.
Clare's c, 2700 Flagler Ave.; Tuesdays, Wednesdays & Fridays; 9am to 6pm). The RHNMC dental clinic on
Stock Island in the Dept. of juvenile Justice Bldg., is operational on Tuesdays through Fridays, 9-5.
Funding is requested to support primary care services in the Upper and Middle Keys.
18. What need or problem in this community does each program address? Include a description of your tappet
population.
This project targets under/uninsured adults and children throughout the county, and directly addresses the need
for accessible and affordable primary health care for the uninsured of this County.
19. What are the causes (not the symptoms) of this problem or need?
RHNMC's assessment of the health care need lists the following variables as contributors to the lack of affordable
primary health care in Monroe County. (1) Monroe County maintains the highest cost -of -living rate in the state, and has
so for the last 22 years. Most middle and low-income residents simply cannot afford health care insurance and/or
potential health care costs. (2) Spiraling professional liability insurance premiums for providers makes overhead
increasingly more difficult to absorb for many practitioners, causing a flight" to the mainland, and higher health care
I RHNMC administrative staff are also assigned direct service and operational responsibilities.
costs. (3) The Agency for Health Care Administration study (2001) cited Monroe County as maintaining a rate of
uninsured at 25% for all county residents, one of the highest in the state. Recent samplings of health insurance coverage
reveals that many county businesses simply cannot afford health insurance for their employees, while most premiums are
out of reach for middle and low-income households.
20. What does your agency do to address these causes?
RHNMC has established primary health care clinics throughout the county. It offers health care services on a sliding fee
scale basis. Through foundation contributions, state and federal grants, and local support, RHNMC has been able to
continue to provide low-cost primary health care for the uninsured. RHNMC is also the lead agency for a community -
based endeavor that seeks to establish and sustain an affordable health insurance product for all dozens, regardless of
income.
21. What statistical data support the need(s) listed in number 18, above? Examples include crime statistics, census
bureau data, studies by impartial organizations, Bureau of Labor Statistics reports, objective surveys, etc. Attach copies of
any relevant documents. (Attach MUA/MUP Print Out)
The Health Council of South Florida's assessment of health care in Monroe County (2003, funded by the BOCC)
M,,,t�d affordable health care as the # 2 priority health care need in this county. Part of this need is addressed by
spary care program through its partnership with the BOCC as well as other municipal, foundation and state
. Tn addition the Florida Department of Health lists Monroe County as a Medically Underserved Area (MUA), with
a Medically Underserned Population (MUP) - official federal and state designations of health care service shortage areas.
22. What measurable outcomes do you plan to accomplish in the next funding year?
Patient Services:
1. In a random survey of 25% of all clients treated in 2004-2005, 90% will claim that their health has improved as a
result of their visit to a RHNMC clinic.
2. Ina random survey of 25% of all clients treated in 2004-2005, 90% will claim that the professional healthcare
treatment they received was "good" or better.
Safety & Cleanliness:
1. Ina random survey of 25% of all clients treated in 2004-2005, 90% will report that the clinical setting was clean
and sanitary.
2. Ina random survey of 25% of all clients treated in 2004-2005, 90% will report that there was no evidence of any
unsafe conditions or practices in the clinical setting.
23. How will you measure your outcomes?
RHNMC personnel will survey 25 % of all clients treated on a random basis, yearly. In addition to those variables listed
above (# 22), RHNMC will assess client satisfaction issues in several other areas as well. Annual and routine inspections
of clinic settings will ensure client safety, while annual inhouse training for current and new employees will ensure client
privacy, safety, and quality care.
NMI 1 A�Ip SNIT CQS7
20. List all program units of service, i.e. 1 unit = 1 hour counseling; 1 unit = 1 night shelter/1 meal, etc) . or state why this
does not apply to your operation.
A unit of service is defined as fifteen minutes of primary health care at an RHNMC clinic site.
Services include physical examinations; pediatric services, wound care; HIV, STD & hepatitis testing; women's health
examinations; health education, counseling and prevention programs; laboratory services; vision and hearing exams;
pregnancy testing; immunizations; first aid; referral services, and pharmaceutical assistance.
7
a. Indicate the full cost of the unit of service. This cost should include administration, etc. The unit cost should be
the same for all funding sources of the program. Explain how you developed the cost per unit (e.g. total cost of
program divided by total units; total cost of program divided by total clients, etc.).
Full Cost, Unit of Service = $23.84
Total Unit of Service Cost Calculation: Total Cost of Services ($381.5601)
(Units of Service per Year=16,000 [80 hrs/wk x 50 wks/yr x 4 units/hr).
Total Cost -of -the -Program Calculation: Administration (Ex. Director [0.1 fte], Finance Managgeer [0.1 fte]) = 11 +
Clinic Personnel (MD ® $12K + Health Services Director ® $52K [®25% or 13,000] + ARNP @ 7W + RN ® $42K +
admin. asst. @ 43K = $188,800 + Fringe ® 20% = 7 760 + Supplies x 1 Yr = $45,000 + Rent, utilities, equipment =
25 000 + Insurance (liability, general, health) = $35,000 + Equipment depreciation ®10%/yr = $10,000• + inhouse
pharmaceutical supplies ($40,000) Grand Total = $381,560
b. 3 Year Unit Comparison: Provide the "cost per unit of service" for the past, current and proposed fiscal years.
Provide the numbers of units of service for the past, current and the proposed fiscal years.
PROPOSED - YEAR- PR F, i D — CURRENT ACTUAL -PRIOR
UNIT TYPE ENDING MC3M YEAR�END[NG 9/30/04 YEAR ENDING 9/3,0103
COST PER UNIT V4 hr $23.842 $24.173 $23.24
health
a e)
2 Decrease in unit cost for FY 05 accounted for by re -assignment and deletion of non -essential support positions.
3 Accounted for by increase in professional liability insurance for the corporation.
8
CRITERIA FOR ELIGIBILITY AND ATTACHMENT CHECKLIST
AGENCY NAME: Rural Health Network of Monroe County, FL, Inc.
THIS AREA FOR H.S.A.S. AND STAFF NOTES ONLY.
. C"CVI�GINH
SHpMI,,AFfiER THE LST °P#GE t?F THE APLIGA�3N
NOT APPLtC1�BLE PEE SO IND1IrATE AND EXPLAIN
ED?ANATAAC
COMMENTS
YES
ILIA
A. Board Information Form
X
B. Agency Salary Detail
X
C. Profile of Clients Served
X
D — G. Financial Information
X
H. Copy of most recent CPA Audit Report or financial statement `
X
No management letter formed
part of the auditor's review.
1. Copy of most recent IRS Form 990
X
J. Copy of current fee schedule
X
K. Copy of IRS Tax Exempt 501(c)(3) Certificate
X
L. Copy of Current Monroe County and City Occupational Licenses
X
M. Copy of Florida Dept. of Children And Families License or
Certification
X
Ucensure is not required for
health services from D C & F.
N. Copy of any other Federal or State Licenses
X
O. Copy of Florida Dept. of Health Licenses/Permits
X
P. Copy of Florida Consumer's Certificate of Exemption
X
Q. Florida Dept. of Agriculture & Consumer Services Reg. No.
X
R. Copy of front page of Agency's EEO Policy/Plan
X
S. Copy of front page of Agency's ADA Transition Plan
X
RF MC remains ADA
compliant, otherwise.
T. Copy of Summary Report of most current Evaluation/Monitoring "` X No corrective action plan was
indicated.
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