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HomeMy WebLinkAbout2008-294 � 0 CONTRACT BETWEEN INDIAN RIVER COUNTY BOARD OF COUNTY COMMISSIONERS AND STATE OF FLORIDA DEPARTMENT OF HEALTH FOR OPERATION OF THE INDIAN RIVER COUNTY HEALTH DEPARTMENT CONTRACT YEAR 20084009 This agreement ("Agreement") is made and entered into between the State of Florida , Department of Health ("State") and the Indian River County Board of County Commissioners ("County") , through their undersigned authorities , effective October 1 , 200-8-w - - - RECITALS 008: - - - RECITALS A . Pursuant to Chapter 154 , F . S . , the intent of the legislature is to "promote , protect, maintain , and improve the health and safety of all citizens and visitors of this state through a system of coordinated county health department services . " B . County Health Departments were created throughout Florida to satisfy this legislative - -intent -through - " promotion- - of the -public' s health , the control and eradication of preventable diseases , and the provision of primary health care for special populations . " C . Indian River County Health Department ("CHD ") is one of the County Health Departments created throughout Florida . It is necessary for the parties hereto to enter into this Agreement in order to assure coordination between the State and the County in the operation of the CHD . NOW THEREFORE , in consideration of the mutual promises set forth herein , the sufficiency of which are hereby acknowledged , the parties hereto agree as follows : 1 . RECITALS . The parties mutually agree that the forgoing recitals are true and correct and incorporated herein by reference . 2 . TERM . The parties mutually agree that this Agreement shall be effective from October 1 , 2008 , through September 30 , 2009 , or until a written agreement replacing this Agreement is entered into between the parties , whichever is later, unless this Agreement is otherwise terminated pursuant to the termination provisions set forth in paragraph 8 , below. 3 . SERVICES MAINTAINED BY THE CHD . The parties mutually agree that the CHD shall provide those services as set forth on Part III of Attachment II hereof, in order to maintain the following three levels of service pursuant to Section 154 . 01 (2) , Florida Statutes , as defined below: a . " Environmental health services" are those services which are organized and operated to protect the health of the general public by monitoring and regulating activities in the environment which may contribute to the occurrence or transmission of disease . I Environmental health services shall - be supported by available federal , state and local funds and shall include those services mandated on a state or federal level . Examples of environmental health services include , but are not limited to , food hygiene , safe drinking water supply , sewage and solid waste disposal , swimming pools , group care facilities , migrant labor camps , toxic material control , radiological health , occupational health . b . "Communicable disease control services" are those services which protect the health of the general public through the detection , control , and eradication of diseases which are transmitted primarily by human beings . Communicable disease services shall be supported by available federal , state , and local funds and shall include those services mandated on a state or federal level . Such services include , but are not limited to , epidemiology , - - sexually -transmissible disease detection and control , HIV/AIDS , immunization , tuberculosis control and maintenance of vital statistics . C. " Primary care services" are acute care and preventive services that are made available- to well- and- -sick -persons - -wha - are - unable- to obtain- such - -services due to lack of income or other barriers beyond their control . These services are provided to benefit individuals , improve the collective health of the public , and prevent and control the spread of disease . Primary health care services are provided at home , in group settings , or in clinics . These services shall be supported by available federal , state , and local funds and shall . .include - services mandated on a state or federal level . Examples of primary health care services include , but are not limited to : first contact acute care services ; chronic disease detection and treatment; maternal and child health services ; family planning ; nutrition ; school health ; supplemental food assistance for women , infants , and children ; home health ; and dental services . 4 . FUNDING . The parties further agree that funding for the CHD will be handled as follows: - a . The funding Icy be -provided - by -the - parties -and any other sources -are setforth- irrPart II of Attachment II hereof. This funding will be used as shown in Part I of Attachment II . i. The State's appropriated responsibility (direct contribution excluding any state fees, Medicaid contributions or any other funds not listed on the Schedule C) as provided in Attachment ll , Part II is an amount not to exceed $ 3 , 656 , 026 (State General Revenue, Other State Funds and Federal Funds listed on the Schedule C) . The State's obligation to pay under this contract is contingent upon an annual appropriation by the Legislature . h. The County's appropriated responsibility (direct contribution excluding any fees, othercash orlocal contributions) as provided in Attachment II , Part II is an amount not to exceed $ 734 . 900 (amount listed under the "Board of County Commissioners Annual Appropriations section of the revenue attachment) . b . Overall expenditures will not exceed available funding or budget authority, whichever is less , (either current year or from surplus trust funds) in any service category. Unless requested otherwise , any surplus at the end of the term of this Agreement in the 2 County- - Health- Department - Trust- - Fund - that - is attributed- to the - CHD - shall be carried forward to the next contract period . c. Either party may establish service fees as allowed by law to fund activities of the CHD . Where applicable , such fees shall be automatically adjusted to at least the Medicaid fee schedule. d . Either party may increase or decrease funding of this Agreement during the term hereof by notifying the other party in writing of the amount and purpose for the change in funding . If the State initiates the increase/decrease , the CHD will revise the Attachment 11 and send a copy of the revised pages to the County and the Department of Health , Bureau of Budget Management. If the County initiates the increase/decrease , the County shall notify the CHD . The CHD will then revise the Attachment II and send a copy of the revised pages. to the- Department of Health , Bureau of Budget Management. e . The name and address of the official payee to who payments shall be made is : County Health Department Trust Fund Indian River County Accounts Receivable 190027 th Street, Vero Beach , FL 32960-3383 5 . CHD DIRECTOR/ADMINISTRATOR . Both parties agree the director/administrator of the CHD shall be a State employee or under contract with the State and will be under the day-to-day direction of the Deputy State Health Officer. The director/administrator shall be selected by the State with the concurrence of the County. The director/administrator of the CHD shall insure that non-categorical sources of funding are used to fulfill public health priorities in the community and the Long Range Program Plan . A report detailing the status of public health as measured by outcome measures and similar indicators will be sent by the CHD director/administrator to the parties no later than October 1 of each year (This is the standard quality assurance "County Health Profile " report located on the Office of Planning, Evaluation & Data Analysis Intranet site). 6 . ADMINISTRATIVE POLICIES AND PROCEDURES . The parties hereto agree that the following standards should apply in the operation of the CHD : a . The CHD and its personnel shall follow all State policies and procedures , except to the extent permitted for the use of county purchasing procedures as set forth in subparagraph b . , below. All CHD employees shall be State or State-contract personnel subject to State personnel rules and procedures . Employees will report time in the Health Management System compatible format by program component as specified by the State . b . The CHD shall comply with all applicable provisions of federal and state laws and regulations relating to its operation with the exception that the use of county purchasing procedures shall be allowed when it will result in a better price or service and no statewide Department of Health purchasing contract has been implemented for those goods or services . In such cases , the CHD director/administrator must sign a justification therefore , and all county-purchasing procedures must be followed in their entirety, and such 3 compliance shall be documented . Such justification and compliance documentation shall be maintained by the CHD in accordance with the terms of this Agreement . State procedures must be followed for all leases on facilities not enumerated in Attachment IV. c. The CHD shall maintain books , records and documents in accordance with those promulgated - by -the - Generally -Accepted -Accounting - Principles - (GAAP) and Governmental Accounting Standards Board (GASB) , and the requirements of federal or state law. These records shall be maintained as required by the Department of Health Policies and Procedures for - Records Management and shall be -open for - inspection at any time by the parties and the public, except for those records that are not otherwise subject to disclosure as provided by law which are subject to the confidentiality provisions of paragraph 6 . i . , below. Books , records and documents must be adequate to allow the CHD to comply with the following reporting requirements : i. The revenue and expenditure requirements in the Florida Accounting System Information Resource ( FLAIR) . ii. The client registration and services reporting requirements of the minimum data set as specified iri the - most current version of the Client Information System/Health Management Component Pamphlet ; iii. Financial procedures specified in the Department of Health 's Accounting Procedures Manuals , Accounting memoranda , and Comptroller's memoranda ; iv. The CHD is responsible for assuring that all contracts with service providers include provisions that all subcontracted services be reported to the CHD in a manner consistent with the client registration and service reporting requirements of the minimum data set as specified in the Client Information System/Health Management Component Pamphlet. d . All funds for the CHD shall be deposited in the Indian River County Health Department Trust Fund maintained by the state treasurer. These funds shall be accounted for separately from funds deposited for other CHDs and shall be used only for public health purposes in Indian River County. e . That any surplus/deficit funds , including fees or accrued interest , remaining in the County Health Department Trust Fund account at the end of the contract year shall be credited/debited to the state or county, as appropriate , based on the funds contributed by each and the expenditures incurred by each . Expenditures will be charged to the program accounts by state and county based on the ratio of planned expenditures in the core contract and funding from all sources is credited to the program accounts by state and county. The equity share of any surplus/deficit funds accruing to the state and county is determined each month and at contract year-end . Surplus funds may be applied toward the funding requirements of each participating governmental entity in the following year. However, in each such case , all surplus funds , including fees and accrued interest, shall remain in the trust fund until accounted for in a manner which clearly illustrates the amount 4 which has been credited to each participating governmental entity. The planned use of surplus funds shall be reflected in Attachment II , Part I of this contract , with special capital projects explained in Attachment V. f. There shall be no transfer of funds between the three levels of services without a contract amendment unless the CHD director/administrator determines that an emergency exists wherein a time delay would endanger the public's health and the Deputy State Health -Officer- has - approved- 4he -transfer: - The - Deputy State Health Officer shall forward written evidence of this approval to the CHD within 30 days after an emergency transfer. g . The CHD may execute subcontracts for services necessary to enable the CHD to carry out the programs specified in this Agreement. Any such subcontract shall include all aforementioned- -audit- and- -record keeping- -requirements. - - - h . At the request of either party, an audit may be conducted by an independent CPA on the financial records of the CHD and the results made available to the parties within 180 days after the close of the CHD fiscal year. This audit will follow requirements contained in OMB Circular A- 133 and may be in conjunction with audits performed by county government. If audit exceptions are found , then the director/administrator of the CHD will prepare a corrective action plan and a copy of that plan and monthly status reports will be furnished to the contract managers for the parties . i . The CHD shall not use or disclose any information concerning a recipient of services except as allowed by federal or state law or policy. j . The - CHD shall - - retain all client records , financial records , supporting documents , statistical records , and any other documents (including electronic storage media) pertinent to this Agreement for a period of five (5) years after termination of this Agreement. If an audit has been initiated and audit findings have not been resolved at the end of five (5) years , the records shall be retained until resolution of the audit findings . k. The CHD shall maintain confidentiality of all data , files , and records that are confidential under the law or are otherwise exempted from disclosure as a public record under Florida law. The CHD shall implement procedures to ensure the protection and confidentiality of all such records and shall comply with sections 384 . 29 , 381 . 0041 392 . 65 and 456 . 057 , Florida Statutes , and all other state and federal laws regarding confidentiality. All confidentiality procedures implemented by the CHD shall be consistent with - the Department of Health - Information Security Policies , Protocols , and Procedures , dated April 2005 , as amended , the terms of which are incorporated herein by reference . The CHD shall further adhere to any amendments to the State' s security requirements and shall comply with any applicable professional standards of practice with respect to client confidentiality . I . The CHD shall abide by all State policies and procedures , which by this reference are incorporated herein as standards to be followed by the CHD , except as otherwise permitted for some purchases using county procedures pursuant to paragraph 6 . b . hereof. 5 m . The CHD shall establish a system through which applicants for services and current clients may present grievances over denial , modification or termination of services . The CHD will advise applicants of the right to appeal a denial or exclusion from services , of failure to take account of a client's choice - of service , and of his/her right to a fair hearing to the-final- -governing- - authority-of the- -agency. - - Specific -Teferences to existing laws , rules or program manuals are included in Attachment I of this Agreement. n . The CHD shall comply with the provisions contained in the Civil Rights Certificate , hereby incorporated into this contract as Attachment III . o . The CHD shall submit quarterly reports to the county that shall include at least the following : L The DE385L1 Contract Management Variance Report and the DE580L1 Analysis -of Fund- -Equities - R-eport, ne A written explanation to the county of service variances reflected in the DE385L1 report if the variance exceeds or falls below 25 percent of the planned expenditure amount . However, if the amount of the service specific variance between actual and planned expenditures does not exceed three percent of the total planned expenditures for the level of service in which the type of service is included , a variance explanation is not required . A copy of the written explanation shall be sent to the Department of Health , Bureau of Budget Management. 6 p . The dates for the submission of quarterly reports to the county shall be as follows unless the generation and distribution of reports is delayed due to circumstances beyond the CHD ' s control : L March 1 , 2009 for the report period October 1 , 2008 through December 31 , 2008 ; ii. June 1 , 2009 for the report period October 1 , 2008 through March 31 , 2009 ; iii. September 1 , 2009 for the report period October 1 , 2008 through June 30 , 2009 ; and IV* December 1 , 2009 for the report period October 1 , 2008 through September 30 , 2009 . 7 . FACILITIES AND EQUIPMENT. The parties mutually agree that: a . CHD facilities shall be provided as specified in Attachment IV to this contract and the county shall own the facilities used by the CHD unless otherwise provided in Attachment IV. b . The county shall assure adequate fire and casualty insurance coverage for County- owned CHD offices and buildings and for all furnishings and equipment in CHD offices through either a self-insurance program or insurance purchased by the County. c. All vehicles will be transferred to the ownership of the County and registered as county vehicles . The county shall assure insurance coverage for these vehicles is available through either a self-insurance program or insurance purchased by the County. All vehicles will be used solely for CHD operations . Vehicles purchased through the County. Health - DepartmentTrust - Fund -shall. be -sold -at -fair - market -value -when - they are -no - _ longer needed by the CHD and the proceeds returned to the County Health Department Trust Fund . 8 . TERMINATION . a . Termination at Will . This Agreement may be terminated by either party without cause upon no less than one-hundred eighty ( 180) calendar days notice in writing to the other party unless a lesser time is mutually agreed upon in writing by both parties . Said notice shall be delivered by certified mail , return receipt requested , or in person to the other party's contract manager with proof of delivery. b . Termination Because of Lack of Funds . In the event funds to finance this Agreement become unavailable , either party may terminate this Agreement upon no less than twenty-four (24) hours notice . Said notice shall be delivered by certified mail , return receipt requested , or in person to the other party's contract manager with proof of delivery. c. Termination for Breach . This Agreement may be terminated by one party , upon no less than thirty (30) days notice , because of the other party's failure to perform an obligation hereunder. Said notice shall be delivered by certified mail , return receipt requested , or in person to the other party's contract manager with proof of delivery. Waiver of breach of any provisions of this Agreement shall not be deemed to be a waiver of any- -other - breach - -and- -shall - not -be -construed- -to be a modification of the terms of this Agreement. 9 . MISCELLANEOUS . The parties further agree : a . Availability of Funds . If this Agreement, any renewal hereof, or any term , performance or payment hereunder, extends beyond the fiscal year beginning July 1 , 2009 , it is agreed that the performance and payment under this Agreement are contingent upon an annual appropriation by the Legislature , in accordance with section 287 . 0582 , Florida Statutes . b . - - Contract -Manaaers. The - name and address of the contract managers for the parties under this Agreement are as follows : For the State : For the County: Mavur- -Rao - Jason -Brown Name Name Business Manager Budget Director Title Title 1900 27th Street 180127" Street Vero Beach , FI . , 32960=3383 Vero Beach FI . , 32960-3365 Address Address 772-794-7464 772-567-8000 Ext. 1214 Telephone Telephone If different contract managers are designated after execution of this Agreement, the name , address and telephone number of the new representative shall be furnished in writing to the other parties and attached to originals of this Agreement. c . Captions . The captions and headings contained in this Agreement are for the convenience of the parties only and do not in any way modify, amplify, or give additional notice of the provisions hereof. 8 In WITNESS THEREOF , the parties hereto have caused this 24 page agreement to be executed by their undersigned officials as duly authorized effective the 1st day of October, 2008 , BOARIY OF -COUNTY-COMMISSIONERS- - STATE OF FLORIDA INDIAN -RIVER-COUNTY FOR INDIAN RIVER COUNTY DEPARTMENT OF HEALTH SIGNED SIGNED BY: NAME : Wesley S . Davis for Sandra L . Bowden NAME, lasM. Viamonte Ros. M. D. . M. P. H . TITLE : Vice-Chairman for Chairman of the BoardTITLE : State Surgeon General DATE : September 16 , 2008 DATE : 0 ATTESTED ;TO . SIGNED BY: SIGNED BY: r NAME : ` v ' !� � � v NAME : Miranda C. Swanson , M. P . H . TITLE .- 'pu rl/ L-eg TITLE : CHID Administrator DATE . q ' l ft Zob DATE : 524&,Lc) e - 4unty" V A inistratw APPROVED A § T6 f6NM AND LE4� f, E , � - MuY BY "*A. p � G'P'1`' T Y 9 ATTACHMENT INDIAN RIVER COUNTY HEALTH DEPARTMENT PROGRAM SPECIFIC REPORTING REQUIREMENTS AND PROGRAMS REQUIRING COMPLIANCE WITH THE PROVISIONS OF SPECIFIC MANUALS Some health -servicesmustcomply with specific" program and reporting requirements in addition to the Personal Health Coding Pamphlet ( DHP 50-20) , Environmental Health Coding Pamphlet ( DHP 5041 ) and FLAIR requirements because of federal or state law, regulation or rule. If a county health department is funded to provide one of these services, it must comply with the special reporting requirements for that service. The services and the reporting requirements are listed- below: - - Service istedbelow: - Service Rhe uirement 1 . Sexually Transmitted Disease Requirements as specified in FAC 64D-3, F . S. 381 and Program F . S . 384 and the CHD Guidebook. 2 , Dental Health Monthly reporting on DH Form 1008*, 3 , Special Supplemental Nutrition Service documentation and monthly financial reports as Program for Women , Infants specified in DHM 150-24* and all federal , state and county and Children . requirements detailed in program manuals and published procedures. 4 . Healthy Start/ Requirements as specified in the 2007 Healthy Start Improved Pregnancy Outcome Standards and Guidelines and as specified by the Healthy Start -Coalitionsin -contract with each county health department. 5. Family Planning Periodic financial and programmatic reports as specified by the program office and in the CHD Guidebook, Internal Operating Policy FAMPLAN 14* 6, Immunization Periodic reports as specified by the department regarding the surveillance/investigation of reportable vaccine preventable diseases, vaccine usage accountability, the assessment of various immunization levels and forms reporting adverse events following immunization and Immunization Module quarterly quality audits and duplicate data reports. 7 . Chronic Disease Program Requirements as specified in the Healthy Communities, Healthy People Guidebook, 8. Environmental Health Requirements as specified in Environmental Health Programs Manual 1504* and DHP 50=21 * 9. HIV/AIDS Program Requirements as specified in F. S. 384 . 25 and 64D-3 . 016 and 3. 017 F. A. C . and the CHD Guidebook. Case reporting should be on Adult HIV/AIDS Confidential Case Report CDC Form 50 .42A and Pediatric HIV/AIDS Confidential Case Report CDC Form 50. 426. Socia demographic data on persons tested for HIV in CHD clinics should be reported on Lab Request DH Form 1628 ATTACHMENT I (Continued) or Post-Test Counseling DH Form 1628C . These reports are to be sent to the Headquarters HIV/AIDS office within 5 days of the initial post-test counseling appointment or within 90 days of the missed post-test counseling appointment. 10. School Health Services Requirements as specified in the Florida School Health Administrative Guidelines (April 2007) . *or the subsequent replacement if adopted during the contract period . ATTACHMENT 11 INDIAN RIVER COUNTY HEALTH DEPARTMENT PART 1. PLANNED USE OF COUNTY HEALTH DEPARTMENT TRUST FUND BALANCES i Estimated State Share Estimated County Share of CHD Trust Fund of CHD Trust Fund Balance as of 09/30/08 Balance as of 09/30/08 Total 1 , CHD Trust Fund Ending Balance 09/30/08 656, 139 664 , 858 13320, 997 2 . Drawdown for Contract Year October 1 , 2008 to September 30, 2009 ( 144,416) ( 146, 336) (2909752) 3. Special Capital Project use for Contract Year (89 ,406) (90, 594) ( 180, 000) October 1 , 2008 to September 30, 2009 4, Balance Reserved for Contingency Fund 422, 317 4279928 850,245 October 1 , 2008 to September 30, 2009 Note: The total of items 2 , 3 and 4 must equal the ending balance in item 1 . Special Capital Projects are new construction or renovation projects and new furniture or equipment associated with these projects, and mobile health vans. Pursuant to 154. 02 , F. S . , At a minimum , the trust fund shall consist of: an operating reserve, consisting of 8. 5 percent of the annual operating budget, maintained to ensure adequate cash flow from nonstate revenue sources. ��" �X : nn r t ^, t f x k R4 ,^� . rt'�rjr>e Sr y� ,k E y `mb+'4 ee INDIAN" RWXR C,000- 2Y���� O'w 9bi t R F 1 . GENERAL REVENUE - STATE 015040 ALG/CESSPOOL IDENTIFICATION AND ELIMINATION 0 0 0 0 0 015040 ALG/CONTR TO CHDS-AIDS PATIENT CARE 969000 0 969000 0 969000 015040 ALG/CONTR TO CHDS-AIDS PREV & SURV & FIELD STAFF 0 0 0 0 0 015040 ALG/CONTR. TO CHDS-DENTAL PROGRAM 0 0 0 0 0 015040 ALG/CONTR TO CHDS-MIGRANT LABOR CAMP SANITATION 11202 0 12202 0 19202 015040 ALG/CONTR. TO CHDS-IMMUNIZATION OUTREACH TEAMS 11 ,058 0 119058 0 119058 015040 ALG/CONTR. TO CHDS-INDOOR AIR ASSIST PROG 99541 0 99541 0 9,541 015040 ALG/CONTR. TO CHDS-MCH HEALTH — FIELD STAFF COST 0 0 0 0 0 015040 ALG/CONTR. TO CHDS-SOVEREIGN IMMUNITY 0 0 0 0 0 015040 ALG/CONTRIBUTION TO CHDS-PRIMARY CARE 15, 157 0 159157 0 159157 015040 ALG/FAMILY PLANNING 349581 0 34,581 0 34,581 015040 ALG/IPO HEALTHY START/IPO 0 0 0 0 0 015040 ALG/PRIMARY CARE 1949188 0 1945188 0 1949188 015040 ALG/SCHOOL HEALTH/SUPPLEMENTAL 499307 0 49,307 0 49,307 015040 CATE - ESCAMBIA 0 0 0 0 0 015040 CHD SUPPORT POSITION 0 0 0 0 0 015040 CLOSING THE GAP PROGRAM 0 0 0 0 0 015040 COMMUNITY TB PROGRAM 519392 0 51 ,392 0 519392 015040 DENTAL SPECIAL INITIATIVE PROJECTS 299743 0 299743 0 299743 015040 DUVAL TEEN PREGNANCY PREVENTION 0 0 0 0 0 015040 ENHANCED DENTAL SERVICES 509321 0 50,321 0 50,321 015040 FL CLPPP SCREENING & CASE MANAGEMENT 0 0 0 0 0 015040 FL HEPATITIS & LIVER FAILURE PREVENTION/CONTROL 0 0 0 0 0 015040 HEALTHY BEACHES MONITORING 109232 0 109232 0 109232 015040 HEALTHY PEOPLE HEALTHY COMMUNITIES 79613 0 7,613 0 79613 015040 HIV/AIDS JAIL LINKAGE PROJECT 0 0 0 0 0 015040 INDIGENT DENTAL CARE — ESCAMBIA 0 0 0 0 0 015040 LA LIGA CONTRA EL CANCER 0 0 0 0 0 015040 MEDIVAN - BROWARD 0 0 0 0 0 015040 METRO ORLANDO URBAN LEAGUE TEENAGE PREG PREV 0 0 0 0 0 015040 PENALVER CLINIC - MIAMI-DADE 0 0 0 0 0 015040 PRIMARY CARE SPECIAL DENTAL PROJECTS 0 0 0 0 0 015040 SPECIAL NEEDS SHELTER PROGRAM 0 0 0 0 0 015040 STATEWIDE DENTISTRY NETWORK - ESCAMBIA 0 0 0 0 0 015040 STD GENERAL REVENUE 0 0 0 0 0 015050 ALG/CONTR TO CHDS 119239512 0 1 ,9239512 0 199239512 GENERAL REVENUE TOTAL 294839847 0 21483 ,847 0 214839847 2. NON GENERAL REVENUE - STATE 015010 ALG/CONTR TO CHDS-REBASING TOBACCO TF 25,407 0 25,407 0 25,407 015010 BASIC SCHOOL HEALTH - CMS TF 89314 0 8,314 0 89314 015010 BASIC SCHOOL HEALTH - TOBACCO TF 67,212 0 67,212 0 67,212 015010 CHD PROGRAM SUPPORT 0 0 0 0 0 015010 CHD SUPPORT EXPENSE 0 0 0 0 0 015010 CHD SUPPORT POSITION 0 0 0 0 0 015010 CHRONIC DISEASE PREVENTION PROGRAM 0 0 0 0 0 015010 FL HEPATITIS & LIVER FAILURE PREVENTION/CONTROL 0 0 0 0 0 015010 FULL SERVICE SCHOOLS - TOBACCO TF 71 ,332 0 71 ,332 0 712332 gg '� s.:• � ' �A 4 h. � er L t 1 sni A SV� . c Y `.'#4 hEs aG* v YI +rW IJn f x w yi ^j{ R3 •�`4,, ' ky k:• ' , T ` r 'C ,+` w i f u. +... V f y � 1 t� 4. %+A�ryii . k�'' A ,�(. V �Si ;ys''s s` `g,� Ott F w'"' '9 'seri 6`^YC. ra`y u; � P I �� r•a ' � � sY � ��1 rfA `� j�k ��� • I � d � � �, t NC . s-P �4. m �. 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I ' ' 1 1 . 1 1 ' 1 11 1 ' • / • ' 1 1 1 1 1 1 1 1 1 1 11 1 ' • 1 1 1 1 1 11 1 ( 1 1 1 1 1 11 1 • ' • 1 1 1 1 1 11 1 • • : 1 1 1 1 1 1 1 1 ' • 1 • 1 1 1 1 1 1 1 1 • 104 1 Lei • • 1 ' 111 / • / • • 1 . 1 1 t �^' t4 t � . �' s i F�� � � a t `a4 " A �' :t5`� s e S ,i�. ,` ^• z . a„ . . �, . � . , .+ + Rc " � , := sa .i�; 4 � . �� � g Y t +4 'AAs +. �ry . w �$' '3•.,rsaw £ Y�, � ; na ' f d � t`E y a r :.. .✓ r �Y�y iA5 t¢ i ¢ u�: a y < . ' y. j5�. , I�i�{� '"7a ? „ w 6. MEDICAID - STATE/COUNTY 001056 MEDICAID PHARMACY 0 0 0 0 0 001076 MEDICAID TB - - - - 0 0 0 0 0 001078 MEDICAID ADMINISTRATION OF VACCINE 179828 179828 35,656 0 35,656 001079 MEDICAID CASE MANAGEMENT 0 0 0 0 0 001080 MEDICAID OTHER 713 1 ,017 11730 0 19730 001081 MEDICAID CHILD HEALTH CHECK UP 1629934 2329153 3959087 0 395,087 001082 MEDICAID DENTAL 1189719 1699155 2879874 0 287,874 001083 MEDICAID FAMILY PLANNING 129666 1139995 126,661 0 1269661 001087 MEDICAID STD 29148 3 ,060 59208 0 5,208 001089 MEDICAID AIDS 0 0 0 0 0 001147 MEDICAID HMO RATE 0 0 0 0 0 001191 MEDICAID MATERNITY 549986 78,345 133,331 0 133 ,331 001192 MEDICAID COMPREHENSIVE CHILD 1729168 245,311 417,479 0 417,479 001193 MEDICAID COMPREHENSIVE ADULT 1089575 154,700 263 ,275 0 2639275 001194 MEDICAID LABORATORY 0 0 0 0 0 001208 MEDIPASS $3 .00 ADM. FEE 409486 40,486 80,972 0 80,972 001059 Medicaid Low Income Pool 0 0 0 0 0 MEDICAID TOTAL 691 ,223 1 ,056,050 1 ,747,273 0 1 ,747,273 7. ALLOCABLE REVENUE = STATE 018000 REFUNDS 0 0 0 0 0 037000 PRIOR YEAR WARRANT 0 0 0 0 0 038000 12 MONTH OLD WARRANT 0 0 0 0 0 ALLOCABLE REVENUE TOTAL 0 0 0 0 0 L OTHER STATE CONTRIBUTIONS NOT IN CHD TRUST FUND - STATE PHARMACY SERVICES 0 0 0 94,025 94,025 LABORATORY SERVICES 0 0 0 789548 789548 TB SERVICES 0 0 0 0 0 IMMUNIZATION SERVICES 0 0 0 610,027 610,027 STD SERVICES 0 0 0 0 0 CONSTRUCTION/RENOVATION 0 0 0 0 0 WIC FOOD 0 0 0 2,451 ,590 2,4519590 ADAP 0 0 0 0 0 DENTAL SERVICES 0 0 0 0 0 OTHER (SPECIFY) 0 0 0 0 0 OTHER (SPECIFY) 0 0 0 0 0 OTHER STATE CONTRIBUTIONS TOTAL 0 0 0 3,2349190 392349190 9e DIRECT COUNTY CONTRIBUTIONS — COUNTY 008030 BCC Contribution from Health Care Tax 0 0 0 0 0 008034 BCC Contribution from General Fund 0 7349900 7349900 0 734,900 DIRECT COUNTY CONTRIBUTION TOTAL 0 734,900 734,900 0 7349900 10. FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION - COUNTY 001060 CHD SUPPORT POSITION 0 11502 19502 0 1 ,502 t�' J, �� . � �. nC 6 Y i4 a• � 2���8' �,'S�yb � �'��� .. SFs� . Y �� �� , ab+v�'k T��� ]y'�*I Lf' 1 �` ! ; 1 3x' E ¢ � � ! t M f I � *8i F ( 4 � � � I � �i G � 1 h � �` R��F�Y• 'Cb � �$4d � � •h�i 3 � � � a+� ,� s�.�* Y'bt � ' e � aft yf»" 'g@ D� +{ �, z c � a • Y k �^ Lx•' f�r ?�Y x1 g ; 5 Y .r r �9 x `Fxix � ? ; a . 1 1 1 1 ' 11 • IL 1 0 / 1 11 1 I 1 1 1 1 1 11 1 1 1 " • 1 1 1 1 1 11 1 • I 1 1 11 1 • / 1 1 • • ' 1 , , 1 1 . . , 11 1 ` ' • • ' • I 1 1 , � 1 , 1 I , 11 1 ' • 1 1 1 1 1 1 11 1 1 1 1 1 1 1 1 1 1 , • 11 . � : I I 1 1 1 • 1 1 1 1 1 , . � , 1 , • 11 11 ' 1 I 1 1 1 1 1 11 1 11 ' / 1 1 � 1 , • 1 • 1 ' 1 ' 11 1 1 • ' 1 • 1 I 1 1 1 11 1 I I 1 1 1 1 1 11 ' 1 • ; , 1 1 1 1 1 11 1 I / 1 • 1 111 111 1 111 11 : 1 1 , , , , I • , I • 1 • . „ • , . , 1 • • • • 1 1 1 1 • • • 1 / • I 1 1 • • 1 . . 1 1 • • 1 1 1 1 ' • 1 1 1 1 1 1 1 1 • 1 1 1 1 1 1 1 . 1 ' • 111 • I / • 1 1 1 1 1 1 111 / 1 ; , � • 1 : , 1 111 / I ' 1 1 1 I 1 1 111 1 1 1 1 1 1 1 111 1 1 1 1 1 1 1 111 / 1 I 1 1 1 1 111 / 1 1 1 1 1 1 111 1 1 1 1 1 1 1 11 I 1 • • • I ' • 1 . • „ 1 • • 1 11 1 • • 1 1 1 1 1 1 1 1 I • • ' 1 1 1 1 1 1 1 I 1 1 1 : 1 1 1 • • 1 1 1 1 1 I ' lll • ' 1 • • 1 1 1 111 / I ' • / 1 1 1 1 1 1 111 11 ' I / • 1 I 1 1 1 1 1 1 1 1 I ' • 10 11 1 1 1 1 1 �` ux, e'q h'�u ' " r, '•f . .... � + r ,ti VSs ,y.{k, »a7i4 5i i > rT'sa y . ��,< r `r . l .x z . e 'L. r.r "irk • rs �° * : < sx pas '� r � `� ' � �y� r t k1X'� .. ea 4 � � � , � � � �tf x � { �� � h � � I � � � • ° • � 1 k' t 3 "+ ���fi�ty�A:.v. y&'`^se �F., wt� vw �' st �;�i`"5s'fi b. '" :, yx f Ai • { - Ck w ,.. •- � ' "... . , . •. „xN !..aye td :. s' r'u fin✓ • . _ _ y .3 � t . � 1 it i 1 1 1 I : 1 1 111 / • 1 1 1 1 1 111 / 1 ' • 1 1 1 1 1 1 111OAN In NJ It • 1 1 1 1 1 Ell 1 1 11 11 1 11 1 111 • ' AA KIM I1 1 1 1 1 1 : 111 • • / 1 1 1 1 1 1 1 I 1 1 ► 11 1 11 1 1 1 111 I 1 1 1 I 1 1 1 1 1 ' • / I 1 1 1 1 1 • I I 1 1 1 1 1 • 1 1 1 1 1 1 • 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 • I • • I ' • 1 1 1 1 1 1 • I • • 1 ' • I 1 1 1 i 1 /"1 3 4 g3 tAXTW! C.1 aye tr ga. � Ii � 45 , "rs'ra% ,7 .1 1 . Bey 3 ✓� N ° �' � 9 }"� 1 i e e�f ��Tr ,y n � Part III. Planned Staflipg, liea VIII I r h IN J. IIA I � 1 A. COMMUNICABLE DISEASE CONTROL: VITAL STATISTICS ( 180) 1 .69 61200 20, 104 199062 219622 17,428 21 ,533 0 799645 7045 IMMUNIZATION ( 101 ) 5 .57 71260 179600 155,026 1249285 1239530 93 ,006 1689588 3279259 4959847 STD ( 102) 5 . 11 19013 49240 639495 72,881 65,792 67,092 218, 101 51 , 159 269,260 A.I.D.S. ( 103 ) 3 .23 11250 9, 160 449214 51 ,690 38,459 42,546 148,331 28,578 176,909 TB CONTROL SERVICES ( 104) 1 .98 410 19800 29,308 219313 33, 116 31 ,923 102,937 12,723 1159660 COMM. DISEASE SURV. ( 106) 1 .35 0 330 329315 159839 9,606 359595 93 ,355 0 93,355 HEPATITIS PREVENTION ( 109) 0.00 0 0 0 0 0 0 0 0 0 PUBLIC HEALTH PREP AND RESP ( 116) 2.51 0 0 66,355 81 , 186 909094 72,327 3099962 0 3099962 COMMUNICABLE DISEASE SUBTOTAL 21 .44 169133 539234 409,775 3889816 378,025 364,022 1 ,041 ,274 4999364 195409638 B. PRIMARY CARE: CHRONIC DISEASE SERVICES (210) 1 . 14 1 ,850 1 ,520 179564 15,948 16,212 299712 639549 159887 799436 TOBACCO PREVENTION (212) 0.00 0 0 0 0 0 0 0 0 0 HOME HEALTH (215) 0.00 0 0 0 0 0 0 0 0 0 W.I.C. (221 ) 9.66 3,890 369200 131 ,439 138,569 1059178 136,492 5119678 0 5119678 FAMILY PLANNING (223 ) 10.92 29712 9,618 156,534 1769763 1509405 162,302 3039622 3429382 64004 IMPROVED PREGNANCY OUTCOME (225) 0.00 0 0 0 0 0 0 0 0 0 HEALTHY START PRENATAL (227) 4.28 660 149000 669007 67,431 739418 66,338 0 273, 194 2739194 COMPREHENSIVE CHILD HEALTH (229) 23 .53 31750 199230 3479443 430,688 337,910 339,084 4209950 190349175 1 ,4559125 HEALTHY START INFANT (23 1 ) 2.53 170 69750 399852 43,454 39,033 29,211 0 151 ,550 151 ,550 SCHOOL HEALTH (234) 5. 10 0 529000 919568 107, 155 94,888 599390 349,001 4,000 353 ,001 COMPREHENSIVE ADULT HEALTH (237) 39.96 6,020 229785 7089681 791 ,390 667,072 7449215 111469701 1 ,7649657 299119358 DENTAL HEALTH (240) 10. 17 29800 12,200 2109840 233,864 205,226 157,713 2829675 5249968 8079643 Healthy Start Interconception Woman (232) 0.00 0 0 0 0 0 0 0 0 0 PRIMARY CARE SUBTOTAL 107.29 21 ,852 174,303 197699928 290059262 1 ,6899342 19724,457 390789176 491109813 70188,989 C. ENVIRONMENTAL HEALTH: Water and Onsite Sewage Programs COASTAL BEACH MONITORING (347) 0. 16 490 490 6,017 69028 4,826 52854 22,725 0 229725 LIMITED USE PUBLIC WATER SYSTEMS (357) 0.39 36 380 79540 4,206 10,398 6,892 18,873 109163 299036 PUBLIC WATER SYSTEM (358) 0. 12 12 120 29720 734 51509 928 92891 0 99891 PRIVATE WATER SYSTEM (359) 1 . 14 160 730 239577 239689 16,204 17,021 89049 72,442 80,491 INDIVIDUAL SEWAGE DISP. (361 ) 4.97 19420 49650 799124 939037 92,233 1109229 3379161 37,462 374,623 Group Total 6.78 29118 6,370 1189978 127,694 129, 170 140,924 396,699 120,067 5169766 Facility Programs FOOD HYGIENE (348) 0.48 105 530 8,602 89899 11 ,054 6,585 0 35, 140 35, 140 BODY ART (349) 0.01 5 18 49 156 74 235 514 0 514 GROUP CARE FACILITY (35 1 ) 0.49 148 256 99378 10,227 7,759 89894 360258 0 36,258 MIGRANT LABOR CAMP (352) 0.01 4 30 253 490 293 127 19163 0 11163 HOUSING,PUBLIC BLDG SAFETY,SANITATION (359)42 126 304 89081 8,722 69745 6,222 0 299770 29,770 MOBILE HOME AND PARKS SERVICES (354) 0.20 56 170 29990 59697 10634 49819 159140 0 15, 140 SWIMMING POOLS/BATHING (360) 0.59 330 984 12, 149 105891 119972 119699 429040 49671 469711 BIOMEDICAL WASTE SERVICES (364) 0.66 195 199 4,534 14,927 59950 199419 339623 119207 44,830 x + y a yK v 1 9 1 '.� "3 1x� ♦n " x ti, x "' p�A �,��'u � . .. r x4 �'� art ate' s , n i S`'�rd �'��' ,a���d�4 � ra' ;� '2 y.• cj ;, '• s xV'} j{ fid 4 C. ENVIRONMENTAL HEALTH. Facility Programs TANNING FACILITY SERVICES (369) 0.08 10 28 1 ,237 19916 499 2,001 5,653 0 5,653 Group Total 2.94 979 2,519 47,273 619925 45,980 600001 134,391 805788 2159179 Groundwater Contamination STORAGE TANK COMPLIANCE (355) 1 .86 170 436 329484 349295 38,997 389602 144,378 0 144,378 SUPER ACT SERVICE (356) 0. 18 15 130 3,612 49914 2,317 29345 139188 0 131188 Group Total 2.04 185 566 369096 399209 419314 40,947 157,566 0 157,566 Community Hygiene RADIOLOGICAL HEALTH (372) 0.00 0 0 0 0 0 173 173 0 173 TOXIC SUBSTANCES (373) 0.07 12 46 19062 39102 721 19692 0 69577 69577 OCCUPATIONAL HEALTH (344) 0.01 0 20 625 937 0 56 11456 162 1 ,618 CONSUMER PRODUCT SAFETY (345) 0.00 0 2 0 0 79 0 79 0 79 INJURY PREVENTION (346) 0.00 0 0 0 0 0 0 0 0 0 LEAD MONITORING SERVICES (350) 0.01 0 1 225 159 0 937 0 11321 1 ,321 PUBLIC SEWAGE (362) 0. 13 11 260 32756 39843 19967 39435 69370 6,631 139001 SOLID WASTE DISPOSAL (363) 0.27 0 26 3,032 3,530 49552 4,704 159818 0 15,818 SANITARY NUISANCE (365) 0.44 9 75 39717 79780 12,215 39484 0 27, 196 27, 196 RABIES SURVEILLANCE/CONTROL SERVICES (3666)09 37 104 39772 39128 257 1 , 11 l 0 89268 8,268 ARBOVIRUS SURVEILLANCE (367) 0.00 0 2 28 29 28 29 0 114 114 RODENT/ARTHROPOD CONTROL (368) 0.01 0 17 158 613 181 329 1 ,281 0 11281 WATER POLLUTION (370) 0. 15 0 752 49277 49130 59182 5,580 29300 16,869 199169 AIR POLLUTION (371 ) 0. 12 0 45 2,250 2, 192 39174 49651 129267 0 129267 Group Total 1 .30 69 10350 220902 299443 28,356 26, 181 399744 679138 1069882 ENVIRONMENTAL HEALTH SUBTOTAL 13 .06 39351 109805 2259249 2589271 244,820 2689053 7289400 267,993 9969393 D. SPECIAL CONTRACTS: SPECIAL CONTRACTS (599) 0.00 0 0 0 0 0 0 0 0 0 SPECIAL CONTRACTS SUBTOTAL 0.00 0 0 0 0 0 0 0 0 0 TOTAL CONTRACT 141 .79 41 ,336 238,342 29404,952 2,652,349 293129187 2,356,532 4,8479850 41878, 170 9,726,020 ATTACHMENT NI- INDIAN RIVER COUNTY HEALTH DEPARTMENT CIVIL RIGHTS CERTIFICATE The applicant provides this assurance in consideration of and for the purpose of obtaining federal grants, loans , contracts (except contracts of insurance or guaranty), property, discounts, or other federal financial assistance to programs or activities receiving or benefiting from federal financial assistance. The provider agrees to complete the Civil Rights Compliance Questionnaire , DH Forms 946 A and B (or the subsequent replacement if adopted during the contract period) , if so requested by the department. The applicant assures that it will comply with : 1 . Title VI of the Civil Rights Act of 1964 , as amended , 42 U . S. C . , 2000 Et seq . , which prohibits discrimination on the basis of race, color or national origin in programs and activities receiving or benefiting from federal financial assistance . 2 . Section 504 of the Rehabilitation Act of 1973, as amended , 29 U . S . C . 794 , which prohibits discrimination on the basis of handicap in programs and activities receiving or benefiting from federal financial assistance. 3 . Title IX of the Education Amendments of 1972 , as amended , 20 U . S . C . 1681 et seq . , which prohibits discrimination on the basis of sex in education programs and activities receiving or benefiting from federal financial assistance . 4 . The Age Discrimination Act of 1975, as amended , 42 U . S. C. 6101 et seq . , which prohibits discrimination on the basis of age in programs or activities receiving or benefiting from federal financial assistance. 5 . The Omnibus Budget Reconciliation Act of 1981 , P. L. 97-35, which prohibits discrimination on the basis of sex and religion in programs and activities receiving or benefiting from federal financial assistance. 6 . All regulations, guidelines and standards lawfully adopted under the above statutes. The applicant agrees that compliance with this assurance constitutes a condition of continued receipt of or benefit from federal financial assistance, and that it is binding upon the applicant, its successors, transferees, and assignees for the period during which such assistance is provided . The applicant further assures that all contracts , subcontractors, subgrantees or others with whom it arranges to provide services or benefits to participants or employees in connection with any of its programs and activities are not discriminating against those participants or employees in violation of the above statutes, regulations, guidelines , and standards. In the event of failure to comply, the applicant understands that the grantor may, at its discretion , seek a court order requiring compliance with the terms of this assurance or seek other appropriate judicial or administrative relief, to include assistance being terminated and further assistance being denied . ATTACHMENT IV INDIAN RIVER COUNTY HEALTH DEPARTMENT FACILITIES UTILIZED BY THE COUNTY HEALTH DEPARTMENT Facility Description Location Owned By Clinic , Dental , Vital Statistics , 1900 27th Street County of Environmental Health , WIC , Vero Beach , FL 32960-3383 Indian River Administrative Headquarters 39 , 200 sq . ft. Gifford Health Center 467528 th Court Indian River County 10 , 642 sq ft Vero Beach , FL 32967- 1330 Hospital District Co- Located Site : WIC 12196 County Road 512 Treasure Coast Fellsmere , FL 32948-5463 Community Health ATTACHMENT V INDIAN RIVER COUNTY HEALTH DEPARTMENT SPECIAL PROJECTS SAVINGS PLAN IDENTIFY THE AMOUNT OF CASH THAT IS ANTICIPATED TO BE SET ASIDE ANNUALLY FOR THE PROJECT, CONTRACT YEARTS ATE COUNTY TOTAL 2006-2007 $ $ $ - 2007-2008 $ $ $ 2008-2009 $ 89 ,406 $ 90 , 594 $ 180 , 000 2009-2010 $ $ $ - 2010-2011 $ $ $ - PROJECT TOTAL $ 89 ,406 $ 90 , 594 $ 180 , 000 SPECIAL PROJECT CONSTRUCTIONIRENOVATION PLAN PROJECT NAME : INDIAN RIVER COUNTY HEALTH DEPARTMENT LOBBY RENOVATION LOCATION/ ADDRESS : 1900 27TH STREET , VERO BEACH , FLORIDA, 32960 PROJECT TYPE : NEW BUILDING ROOFING s RENOVATION X PLANNING STUDY NEW ADDITION OTHER SQUARE FOOTAGE : 41400 PROJECT SUMMARY: Describe scope of work in reasonable detail. The work area consists of the existing Lobby, Waiting , Check-in area , a portion of the Medical Records area and the Clinic Exam/Office suite north of the Waiting room . The existing Waiting/Check-in will be demolished and six new clerical staions will be constructed with a new enclosed office and an interpreter station . The Medical Records room work includes minor demo and new casework. ESTIMATED PROJECT INFORMATION : START DATE (initial expenditure of funds) : 10/1 /2008 COMPLETION DATE : 4/30/2008 DESIGN FEES : $ 27 , 976 CONSTRUCTION COSTS : $ 152 , 024 FURNITURE/EQUIPMENT $ TOTAL PROJECT COST: $ 1801000 COST PER SQ FOOT: $ 40 . 91 Special Capital Projects are new contructlon or renovation projects and new furniture or equipment associated with these projects and mobile health vans. ATTACHMENT VI INDIAN RIVER COUNTY HEALTH DEPARTMENT PRIMARY CARE " Primary Care" as conceptualized for the county health departments and for the use of categorical Primary Care funds (revenue object code 015040) is defined as: "Health care services for the prevention or treatment of acute or chronic medical conditions or minor injuries of individuals which is provided in a clinic setting and may include family planning and maternity care. " Indicate below the county health department programs that will be supported at least in part with categorical Primary Care funds this contract year: X Comprehensive Child Health (229/29) X Comprehensive Adult Health (237/37) X -- Family Planning (223/23) Maternal Health/IPOJ225/25y X Laboratory (242/42) Pharmacy (241 /93) Other Medical Treatment Program (please identify) Describe the target population to be served with categorical Primary Care funds . The target population served with categorical Primary Care funds are the residents of Indian River County , who fall at or below 200% Federal Poverty . Does the health department intend to contract with other providers for the delivery of primary health care services using categorical (015040) Primary Care funds? If so , please identify the provider(s) , describe the services to be delivered , and list the anticipated contractual amount by provider. In addition , contract providers are required to provide data on patients served and the services provided so that the patients may be registered and the service data entered into HMS . No .