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4. How does your program differ from similar ones provided in the community? How do the programs complement those offered by other agencies. The county health department is the only agency charged by Florida Statute with control of communicable disease, the provision and regulation of environmental health services, and primary care, primarily to those who are uninsured or underinsured. We are responsible for protecting the public health of the community. By Florida Statute 154.01, county health departments operate in partnership with the county. This relationship is solidified each year in the state and county contract, signed by both agencies. Our primary care services focus on prevention and education as part of the medical visit, and we are the largest provider of primary care to the indigent in the county. The health department's vision is to work in concert with a number of community agencies towards an integrated health care system. We view ourselves as part of a publicly funded primary care network that serves as a safety net for Medicaid, uninsured, underinsured, and working poor. The health department's primary care programs, including the Gifford Health Center, serve the majority of our county in cooperation with Treasure Coast Community Health, and the VNA mobile van, which provides episodic care throughout the county. We most recently responded again this year to Hurricane Irma with staff at the Special Needs Shelter. Hurricanes Matthew and Irma costs for our portion of unreimbursed FEMA expenses that will not be reimbursed is at $170,390. 5. Please describe the staffing requirements of these programs. Be specific in indicating the number of paid professional positions and paid support staff positions. Communicable Disease -26.45 FTE Primary Care -76.11 FTE Environmental Health -15.88 FTE* *Further information on breakdown of programs within these categories is included with this request. 6. Do these programs utilize volunteers? If yes, please briefly describe. As part of our primary care program, we have partnered with the Indian River County Medical Society for the We Care program. We Care provides limited access to specialty care through volunteer physicians who receive sovereign immunity for those patients they see under the program. Patients are referred through the health department or Treasure Coast Community Health Center. The patients must meet income qualification for charity care through Indian River Medical Center. We Care Coordinators then arrange for services through the program. Referral to the program does not guarantee services, and emergency care is not provided. As the patients are dependant on the generosity of volunteers, and services are entirely donated, there are often long intervals between referrals and care provided. The We Care volunteer physician program provided $1,254,312 worth of services to patients referred in 2017, a 13% increase over 2016. A second nurse coordinator was hired in the beginning of 2015, and we hired a physician in March of 2016. • 217 Primary Care Patient Visits seen in the health department by volunteer physicians • 269 Specialty Care Patient Visits seen in the health department by volunteer physicians • 541 Specialty Care Patient Visits seen in the physician's office • 1054 Radiological Procedure Interpretations • 297 Special Procedures/Surgical Procedures with Anesthesia 26