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ATTACHMENT IL <br /> INDIAN RIVER COUNTY HEALTH DEPARTMENT <br /> Part II. Sources of Contributions to County Health Department <br /> October 1 , 2011 to September 30, 2012 <br /> State CHD County Total CHD <br /> Trust Fund CHD Trust Fund Other <br /> (cash) Trust Fund (cash) Contribution Total <br /> 6 . MEDICAID - STATE/COUNTY <br /> 001147 Medicaid HMO Capitation 0 0 <br /> 0 0 0 <br /> 001191 MEDICAID MATFRNITY 0 p <br /> 0 0 0 <br /> 001192 MEDICAID COMPREHENSIVE CHILD 261 ,223 3314658 592 . 881 0 592 , 881 <br /> 001193 MEDICAID COMPREHENSIVE ADULT 143 , 937 182 ,747 326 , 684 0 326, 684 <br /> 001194 MEDICAID LABORATORY 0 0 <br /> 0 0 0 <br /> 001208 ME. DIPASS $3 . 00 ADM . FEE 641076 64, 076 128 , 152 0 128 , 152 <br /> 001059 Medicaid Low Income Pool 0 0 <br /> 0 0 0 <br /> 001051 Emergency Medicaid 0 0 0 0 0 <br /> 001058 Medicaid - Behavioral I Iealth 0 0 0 0 0 <br /> 001071 Medicaid - Orthopedic 0 0 0 0 0 <br /> 001072 Medicaid - Dermatology 0 0 0 0 0 <br /> 001075 Medicaid - School Health Certified Match 0 0 0 0 0 <br /> 001069 Medicaid - Refugee Health 0 00 p 0 <br /> 001055 Medicaid - Hospital 0 0 0 0 0 <br /> 001 148 Medicaid HMO Non-Capitation 0 0 0 0 0 <br /> 001074 Medicaid - Newborn Screening 0 0 0 0 0 <br /> MEDICAID TOTAL 866, 949 1 ,211 , 360 2, 078 , 309 0 1078 ,309 <br /> 7. ALLOCABLE REVENUE - STATE <br /> 018000 REFUNDS 0 0 0 0 0 <br /> 037000 PRIOR YEAR WARRANT 0 0 0 0 0 <br /> 038000 12 MONTH OLD WARRANT 0 0 0 0 0 <br /> ALLOCABLE REVENUE TOTAL 0 0 0 0 0 <br /> 8 . OTHER STATE CONTRIBUTIONS NOT IN CHD TRUST FUND - STATE <br /> PHARMACY SERVICES 0 0 0 49, 692 49. 692 <br /> LABORATORY SERVICES 0 0 0 51 ,437 519437 <br /> lB SERVICES 0 0 0 0 0 <br /> IMMUNIZATION SERVICES 0 0 0 672 , 319 672 ,319 <br /> STD SERVICES 0 0 0 0 0 <br /> CONSTRUCTION/RENOVA" fION 0 0 0 0 0 <br /> WIC FOOD 0 0 0 2, 143 , 930 2 , 143 ,930 <br /> ADAP 0 0 0 448 , 376 448 , 376 <br /> DENTAL SERVICES 0 0 0 0 0 <br /> O"fHER ( SPECIFY) 0 0 0 0 0 <br /> OTHER ( SPECIFY) 0 0 0 0 0 <br /> OTHER STATE CONTRIBUTIONS TOTAL 0 0 0 31365 , 754 3 , 365 , 754 <br /> 9. DIRECT LOCAL CONTRIBUTIONS - COUNTY <br /> 008030 Contribution from health Care "Tax 0 0 0 0 0 <br /> 008034 BCC Contribution from General Fund 0 551 , 053 5514053 0 551 , 053 <br /> DIRECT COUNTY CONTRIBUTION TOTAL 0 5519053 551 , 053 0 551 ,053 <br /> 10. FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION - COUNTY <br /> 001060 Vital Statistics - Other Fees 0 2 , 208 2 ,208 0 21208 <br /> 001077 RABIES VACCINE 0 0 0 0 0 <br /> Version : 2 Page 4 of 6 <br />