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HomeMy WebLinkAbout2011-200 �? Ci CONTRACT BETWEEN `/ — o2A � 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 2011 =2012 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 , 2011 . 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 , 2011 , through September 30 , 2012 , 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 , and 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 who 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 to be provided by the parties and any other sources are set forth in Part 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 II , Part II is an amount not to exceed $ 2 , 966 , 593 (State General Revenue, State Funds, 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 . ii. 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 $ 551 , 053 (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 II 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 Health Department 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 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 in 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 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 the 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 CHID 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 references 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 . i. The DE385L1 Contract Management Variance Report and the DE580L1 Analysis of Fund Equities Report , ii. 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 : i. March 1 , 2012 for the report period October 1 , 2011 through December 31 , 2011 ; ii. June 1 , 2012 for the report period October 1 , 2011 through March 31 , 2012 ; iii. September 1 2012 for the report period October 1 , 2011 through June 30 , 2012 ; and iv. December 1 , 2012 for the report period October 1 , 2011 through September 30 , 2012 . 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 Department Trust 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 , 2012 , 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 Managers . The name and address of the contract managers for the parties under this Agreement are as follows : For the State : For the County : Mayur Rao Jason Brown Name Name Business Manager Budget Director Title Title 190027 th Street 1801 27th Street Vero Beach , FI . , 32960 - 3383 Vero Beach , Fl . , 32960 - 3383 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 23 page agreement to be executed by their undersigned officials as duly authorized effective the 1St day of October , 2011 . •'•••'�•Cj01Y1 ��ssio •• BOARD OF COUNTY COMMISSIQ1R • • V % STATE OF FLORIDA • : AD 008 FOR INDIAN RIVER COUNTY DEPARTMENT OF HEALTH 7 n ``•;`FR EOUPi�;.•• SIGNED BY : c�-� • •• ••• 'SIGNED BY : o NAME : Bob solari NAME : H . Frank Farmer, Jr. , MD , PhD , FACP TITLE : Chairman TITLE : State Surgeon General DATE : seotember 13 , 2011 DATE : z Z/ ATTESTED TO . SIGNED BY : '\ , ( 1 , , Get � , SIGNED BY : NAME : Terri Collins - Lister NAME : Miranda C . Swanson M . P . H . TITLE : commissioner Assistant TITLE : CHD Director/Administrator DATE . September 13 , 2011 DATE : AppROVED AS FF�CIEN Y AND LEGA( BYALAOL ICH COUNTY ATTORNEY 9 ATTACHMENT INDIAN RIVER COUNTY HEALTH DEPARTMENT PROGRAM SPECIFIC REPORTING REQUIREMENTS AND PROGRAMS REQUIRING COMPLIANCE WITH THE PROVISIONS OF SPECIFIC MANUALS Some health services must comply with specific program and reporting requirements in addition to the Personal Health Coding Pamphlet ( DHP 50 -20 ) , Environmental Health Coding Pamphlet ( DHP 50 -21 ) 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 Requirement 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 * . Additional reporting requirements , under development , will be required . The additional reporting requirements will be communicated upon finalization . 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 ( including the WIC requirements detailed in program manuals and published Breastfeeding Peer Counseling procedures . Program ) 4 . Healthy Start/ Requirements as specified in the 2007 Healthy Start Improved Pregnancy Outcome Standards and Guidelines and as specified by the Healthy Start Coalitions in 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 as documented in Florida SHOTS , the assessment of various immunization levels as documented in Florida SHOTS and forms reporting adverse events following immunization . 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 150-4 * 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 DH2139 and Pediatric HIV/AIDS Confidential Case Report CDC Form DH2140 . Socio . ATTACHMENT I ( Continued ) demographic data on persons tested for HIV in CHID clinics should be reported on Lab Request DH Form 1628 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 ) . 11 . Tuberculosis Tuberculosis Program Requirements as specified in FAC 64D -37 F . S . Specific Authority 381 . 0011 ( 13) , 381 . 003 (2) , 381 . 0031 (6) , 384. 33, 392. 53 (2) , 392. 66 FS Law Implemented 381 . 0011 (4), 381 . 003( 1) , 381 . 0031 ( 1), (2), (6) 5 383. 063 384 . 23, 384. 253 385. 202, 392. 53 FS. 381 and CHID Guidebook . 12 . General Communicable Disease Control Carry out surveillance for reportable communicable and other acute diseases , detect outbreaks , respond to individual cases of reportable diseases , investigate outbreaks , and carry out communication and quality assurance functions , as specified in the CHID Guide to Surveillance and Investigations . or the subsequent replacement if adopted during the contract period . ATTACHMENT II INDIAN RIVER COUNTY HEALTH DEPARTMENT PART I . PLANNED USE OF COUNTY HEALTH DEPARTMENT TRUST FUND BALANCES Estimated State Estimated County Share of CHD Trust Share of CHD Trust Fund Balance Fund Balance Total 1 . CHD Trust Fund Ending Balance 09/30/ 11 715 , 607 7547416 1 , 4707023 2 . Drawdown for Contract Year ( 2737707 ) ( 318 , 139 ) ( 591 , 846 ) October 1 , 2011 to September 30 , 2012 3 . Medicaid Buyback ( 1327948 ) ( 132 , 948 ) October 1 , 2011 to September 30 , 2012 4 . Balance Reserved for Contingency Fund 308 , 952 436 , 277 7457229 October 1 , 2011 to September 30 , 2012 Special Capital Projects are new construction or renovation projects and new furniture or equipment associated with these projects , and mobile health vans . ATTACHMENT II. INDIAN RIVER COUNTY HEALTH DEPARTMENT Part II. Sources of Contributions to County Health Department October 1 , 2011 to September 30, 2012 State CHD County Total CHD Trust Fund CHD Trust Fund Other (cash) Trust Fund (cash) Contribution Total 1 . GENERAL REVENUE - STATE 015040 AIDS PREVENTION 0 p 0 0 0 015040 AIDS SURVEILLANCE 0 0 0 0 0 015040 ALG/CESSPOOL IDEN "FIFICATION AND ELIMINATION 0 0 0 0 0 015040 ALG/CON FR TO CHDS-AIDS PATIENT CARP: 100. 000 0 100, 000 0 1001000 015040 ALG/CONFRTO CHDS-AIDS PATIENT CARE NETWORK 0 0 0 0 0 015040 ALG/CONI' R . 'I'O CHDS -SOVEREIGN IMMUNITY 0 0 0 0 0 015040 ALG/IPO HF. ALTI IY STARUIPO 0 0 0 0 0 015040 ALG/PRIMARY CARE 183 ,226 0 183 ,226 0 183 ,226 015040 ALPHA ONE PROGRAM - MIAMI- DADS 0 0 0 0 0 015040 CHILD IIEALTI I MEDICAL , SERVICES 0 0 0 0 0 015040 CLOSING THE GAP PROGRAM 0 0 0 0 0 015040 COMMUNITY SMILES - MIAMI-DADS 0 0 0 0 0 015040 COMMUNITY TB PROGRAM 31 ,316 0 31 . 316 0 31 ,316 015040 COUNTY SPECIFIC DENTAL PROJECTS - 1' SCAMBIA 0 0 0 0 0 015040 DENTAL SPECIAL INITIATIVES 6. 540 0 61540 0 6. 540 015040 DUVAI , TEEN PREGNANCY PREVENTION 0 0 0 0 0 015040 FAMILY PLANNING GENERAL REVENUE. 27 , 270 0 27 ,270 0 27.270 015040 FL CLPPP SCREENING & CASE MANAGEMENT 0 0 0 0 0 015040 FL HEPATITIS & LIVER FAILURE PREVENIIONCONFROL 0 0 0 0 0 015040 HEALTHY START MED WAIVER - SOBRA 0 0 0 0 0 015040 HEALTHY START MEI-WAIVFR - CLIENT SERVICES 0 0 0 0 0 015040 JESSIE TRICE CANCER CTR/HFALTII CI IOICE - MIAMI- DADS 0 0 0 0 0 015040 LA LIGA- LEAGUE AGAINST CANCER - MIAMI- DADS 0 0 0 0 0 015040 MANATEE COUNTY RURAL , HEALTH I SERVICES 0 0 0 0 0 015040 METRO ORLANDO URBAN LEAGUE TEENAGE PREG PREV 0 0 0 0 0 015040 MIGRANT LABOR CAMP SANITATION 0 0 0 0 0 015040 MINORITY OUTRF. ACI I- PF. NALVER CLINIC - MIAMI-DADS 0 0 0 0 0 015040 SCHOOL HEALTH GENERAL. REVENUE 68 . 256 0 68 ,256 0 68 .256 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 NON -CATEGORICALL, GENERAL REVENUE 1 ,310 , 058 0 1 , 310, 058 0 1 ,3101058 GENERAL REVENUE TOTAL 1 .7264666 0 1726 666 0 11726 , 666 2 . NON GENERAL REVENUE - STATE 015010 ALG/CON "IR . TO CHDS - BIOMEDICAL WASTE 13 ,353 0 13353 0 13 , 353 015010 ALG/CONTR . 'FO CHDS -SAFE DRINKING WATER PRG 0 0 0 0 0 015010 ALG/PRIMARY CARE 0 0 0 0 0 015010 CHD PROGRAM SUPPORT 0 0 0 0 0 015010 FOOD AND WATERBORNE DISEASE PROGRAM ADM TUDACS 0 0 0 0 0 015010 PUBLIC SWIMMING POOL PROGRAM 0 0 0 0 0 015010 SCHOOL . 1IFA I ,TI I TOBACCO TF 70 ,277 0 70,277 0 70,277 015010 TOBACCO ADMIN ISrFRATION & MANAGEMENT 0 0 0 0 0 015010 TOBACCO ADMINISTRATIVE SUPPORT 0 0 0 0 0 015010 TOBACCO COMMUNITY INTERVENTION 0 0 0 0 0 015020 "TRANSFER FROM ANOTHER SrFATEAGENCY 0 0 0 0 0 015020 TRANSFER FROM ANOTHER STATE AGENCY 0 0 0 0 0 015020 TRANSFER FROM ANOTHER STATFAG ENCY 0 0 0 0 0 Version : 2 Page 1 of 6 ATTACHMENT II. INDIAN RIVER COUNTY HEALTH DEPARTMENT Part II. Sources of Contributions to County Health Department October 1 , 2011 to September 30, 2012 State CHD County Total CHD Trust Fund CHD Trust Fund Other (cash) Trust Fund (cash) Contribution Total 2 . NON GENERAL REVENUE - STATE 015060 NON -CATEGORICAL TOBACCO REBASING 26,466 0 26 ,466 0 26,466 NON GENERAL REVENUE TOTAL 110 , 096 0 110, 096 0 110, 096 3 . FEDERAL FUNDS - State 007000 AIDS PREVENTION 51 , 788 0 51 . 788 0 51 , 788 007000 AIDS SURVEILLANCE 0 0 0 0 0 007000 BIOTFRRORISM HOSPITAL PREPAREDNESS 24 , 707 0 24, 707 0 24. 707 007000 COASTAL BEACH MONITORING PROGRAM 81271 0 8 ,271 0 8 ,271 007000 COLORFC"TAL CANCER SCRFFNING2009 - 10 0 0 0 0 0 007000 ENHANCE COMPREHENSIVE PREVENTION PLANNING AND IMPI , 0 0 0 0 0 007000 EXPANDED TESTING INITIA'TIVF( FTI) 0 0 0 0 0 007000 F( jr MORBIDITY 0 0 0 0 0 007000 FGTF/BREAST & CERVICAL CANCER-ADMIN/CASE MAN 0 0 0 0 0 007000 FGTF/FAMILY PLANNING TITLE X SPECIAL INITIATIVES 0 0 0 0 0 007000 FGTF/FAMILY PLANNING-TITLE X 61 , 876 0 61 , 876 0 611876 007000 HEALTH PROGRAM FOR REFUGEES 0 0 0 0 0 007000 HEALTHY PEOPLE HEALTHY COMMUNITIES 23 ,944 0 23 ,944 0 23 .944 007000 HIV HOUSING FOR PEOPLE. LIVING WITH AIDS 0 0 0 0 0 007000 HIV INCIDENCE SURVEILLANCE 0 0 0 0 0 007000 IMMUNIZATION FEDERAL GRANT ACTIVITY SUPPORT 16. 534 0 16 , 534 0 16, 534 007000 IMMUNIZATION FfEI . D STAFF EXPENSE 0 0 0 0 0 007000 IMMUNIZATION WIC- LINKAGES 0 0 0 0 0 007000 IMMUNIZATION-WIC LINKAGES 0 0 0 0 0 007000 MCH BG TF-GADSDEN SCI 1001 , CLINIC 0 0 0 0 0 007000 MCI I Block Grant - Special Projects Dental 55 , 809 0 55 . 809 0 55. 809 007000 ORAL I IEAL'TH WORKFORCE AC ' I� IVI 'TIES 0 0 0 0 0 007000 PIIP - CITIES READINESS INITIATIVE 0 0 0 0 0 007000 PUBLIC I IFALTII PREPAREDNESS BASE 126. 882 0 126 , 882 0 126 , 882 007000 RAPE PREVENTION & EDUCATION GRAN "T 0 0 0 0 0 007000 RYAN WHITE 0 0 0 0 0 007000 RYAN WHI Fl , - EMERGING COMMUNITIES 0 0 0 0 0 007000 RYAN WHITE-AIDS DRUG ASSIST PROG-ADMIN 35 , 000 0 35 , 000 0 35 , 000 007000 RYAN WHI'T' E-CONSORTIA 0 0 0 0 0 007000 STA"fE INDOOR RADON GRANT 0 0 0 0 0 007000 STD FEDERAL . GRANT - CSPS 0 0 0 0 0 007000 Sr IT) PROGRAM INFERTILITY PREVENTION PROJECT( IPP) 0 0 0 0 0 007000 SYPHILIS F. LIMINA"TION 0 0 0 0 0 007000 TF. F. NAGF. PREGNANCY PRFVEN 'I' ION REPLICA' 11ION2010- 11 0 0 0 0 0 007000 TEENAGE PREGNANCY PREVENTION REPLICATION2011 - 12 0 0 0 0 0 007000 TITLF X HIV/AIDS PROJECT 0 0 0 0 0 007000 ' TITLE X MALE 13IZOJEC' 11 0 0 0 0 0 007000 "TOBACCO FAITFI BASED PROJI CFF 0 0 0 0 0 007000 TUBERCULOSIS CONTROL - FEDERAL GRANT 0 0 0 0 0 007000 WIC ADMINIS"IRATION 5124499 0 512,499 0 512 ,499 007000 WIC BREASTFEEDING PEER COUNSELING 60125 0 60, 125 0 60 , 125 015009 MEDIPASS WAIVER- HL THY STRT CLIENT SERVICES 0 0 0 0 0 015009 MEDIPASS WAIVER-SORRA 0 0 0 0 0 007055 ARRA Federal Grant - Schedule C 0 0 0 0 0 Version : 2 Page 2 of 6 ATTACHMENT II. INDIAN RIVER COUNTY HEALTH DEPARTMENT Part II. Sources of Contributions to County Health Department October 1 , 2011 to September 30, 2012 State CHD County Total CHD Trust Fund CHD Trust Fund Other (cash) Trust Fund (cash) Contribution Total 3 . FEDERAL FUNDS - State 015075 ON SITE SEWAGE TREA' T' MENT & DISPOSAL SYS'T' EM 0 0 0 0 0 015075 SCI TOOL HEALFH TITLE XXI 1529396 0 152 , 396 0 152 ,396 FEDERAL FUNDS TOTAL 1 , 129, 831 0 1 , 129, 831 0 1 , 1294831 4 . FEES ASSESSED BY STATE OR FEDERAL RULES - STATE 001020 TANNING FACILITIES 2 ,214 0 2 ,214 0 21214 001020 BODY PIERCING 270 0 270 0 270 001020 MIGRANT HOUSING PERMIT 0 0 0 0 0 001020 MOBILE HOME AND PARKS 13 , 870 0 134870 0 13 ,870 001020 FOOD HYGIENE PERMIT 16 ,798 0 16 , 798 0 16,798 001020 BIOHAZARD WASTE PERMIT 15 , 530 0 15 , 530 0 151530 001020 PRIVATE WAFER CON STR PERMIT 0 0 0 0 0 001020 PUBLIC WATER ANNUAL OPER PERMIT 3 ,441 0 3 ,441 0 3 ,441 001020 PUBLIC WATER CONSFR PERMIT 0 0 0 0 0 001020 NON -SDWA SYSTEM PERMI "1' 0 0 0 0 0 001020 SAFE DRINKING WATER 0 0 0 0 0 001020 SWIMMING POOLS 54 , 085 0 54, 085 0 54, 085 001092 OSDS PERMI I FEE 204 , 124 0 204. 124 0 204, 124 001092 1 & M ZONED OPERATING PERMIT 0 0 0 0 0 001092 AEROBIC OPERATING PERMIT 0 0 0 0 0 001092 SEPTIC TANK SITE EVALUATION 0 0 0 0 0 001092 NON SDWA LAB SAMPLE 0 0 0 0 0 001092 OSDS VARIANCE FEE 0 0 0 0 0 001092 ENVIRONMENTAL HEALTFI FEES 1 ,420 0 1 ,420 0 1 ,420 001092 OSDS REPAIR PERMIT 0 0 0 0 0 001170 LAB FEE CHEMICAL ANALYSIS 0 0 0 0 0 001 170 WATER ANALYSIS-POTABLE 0 0 0 0 0 001 170 NONPOTABLE WAFER ANALYSIS 0 0 0 0 0 010304 INSPECTION FF. E 34678 0 3 , 678 0 3 , 678 001206 Central OfficC Surcharge 32 ,483 0 32,483 0 32.483 FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL 347 ,913 0 347913 0 347 , 913 5. OTHER CASH CONTRIBUTIONS - STATE 010304 STATIONARY POLLUTAN "I S' T'ORAGE FANKS 60. 717 0 60, 717 0 60 , 717 090001 DRAWDOWN FROM PUBLIC I IFALFH )INTI 273 . 707 0 273 707 0 2731707 OTHER CASH CONTRIBUTIONS TOTAL 334,424 0 334 ,424 0 334,424 6. MEDICAID - STATE/COUNTY 001056 MEDICAID PHARMACY 0 0 0 0 0 001076 MEDICAID TB 0 0 0 0 0 001078 MEDICAID ADMINIS"IRAFION OF VACCINE 21 .432 21 ,432 42 , 864 0 42 ,864 001079 MEDICAID CASE MANAGEMENT 0 0 0 0 0 001081 MEDICAID CI IILD HEALTH CHECK UP 138 , 866 176,308 315 , 174 0 315 , 174 001082 MEDICAID DENTAL 188,968 239, 919 428 . 887 0 428 , 887 001083 MEDICAID FAMILY PLANNING 17,297 155 ,669 172,966 0 172 . 966 001087 MEDICAID STD 20 , 602 26, 158 46, 760 0 46 , 760 001089 MEDICAID AIDS 10, 548 13 ,393 23 .941 0 23 ,941 Version : 2 Page 3 of 6 ATTACHMENT IL INDIAN RIVER COUNTY HEALTH DEPARTMENT Part II. Sources of Contributions to County Health Department October 1 , 2011 to September 30, 2012 State CHD County Total CHD Trust Fund CHD Trust Fund Other (cash) Trust Fund (cash) Contribution Total 6 . MEDICAID - STATE/COUNTY 001147 Medicaid HMO Capitation 0 0 0 0 0 001191 MEDICAID MATFRNITY 0 p 0 0 0 001192 MEDICAID COMPREHENSIVE CHILD 261 ,223 3314658 592 . 881 0 592 , 881 001193 MEDICAID COMPREHENSIVE ADULT 143 , 937 182 ,747 326 , 684 0 326, 684 001194 MEDICAID LABORATORY 0 0 0 0 0 001208 ME. DIPASS $3 . 00 ADM . FEE 641076 64, 076 128 , 152 0 128 , 152 001059 Medicaid Low Income Pool 0 0 0 0 0 001051 Emergency Medicaid 0 0 0 0 0 001058 Medicaid - Behavioral I Iealth 0 0 0 0 0 001071 Medicaid - Orthopedic 0 0 0 0 0 001072 Medicaid - Dermatology 0 0 0 0 0 001075 Medicaid - School Health Certified Match 0 0 0 0 0 001069 Medicaid - Refugee Health 0 00 p 0 001055 Medicaid - Hospital 0 0 0 0 0 001 148 Medicaid HMO Non-Capitation 0 0 0 0 0 001074 Medicaid - Newborn Screening 0 0 0 0 0 MEDICAID TOTAL 866, 949 1 ,211 , 360 2, 078 , 309 0 1078 ,309 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 8 . OTHER STATE CONTRIBUTIONS NOT IN CHD TRUST FUND - STATE PHARMACY SERVICES 0 0 0 49, 692 49. 692 LABORATORY SERVICES 0 0 0 51 ,437 519437 lB SERVICES 0 0 0 0 0 IMMUNIZATION SERVICES 0 0 0 672 , 319 672 ,319 STD SERVICES 0 0 0 0 0 CONSTRUCTION/RENOVA" fION 0 0 0 0 0 WIC FOOD 0 0 0 2, 143 , 930 2 , 143 ,930 ADAP 0 0 0 448 , 376 448 , 376 DENTAL SERVICES 0 0 0 0 0 O"fHER ( SPECIFY) 0 0 0 0 0 OTHER ( SPECIFY) 0 0 0 0 0 OTHER STATE CONTRIBUTIONS TOTAL 0 0 0 31365 , 754 3 , 365 , 754 9. DIRECT LOCAL CONTRIBUTIONS - COUNTY 008030 Contribution from health Care "Tax 0 0 0 0 0 008034 BCC Contribution from General Fund 0 551 , 053 5514053 0 551 , 053 DIRECT COUNTY CONTRIBUTION TOTAL 0 5519053 551 , 053 0 551 ,053 10. FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION - COUNTY 001060 Vital Statistics - Other Fees 0 2 , 208 2 ,208 0 21208 001077 RABIES VACCINE 0 0 0 0 0 Version : 2 Page 4 of 6 ATTACHMENT II, INDIAN RIVER COUNTY HEALTH DEPARTMENT Part II. Sources of Contributions to County Health Department October 1 , 2011 to September 30, 2012 State CHD County Total CHD Trust Fund CHD Trust Fund Other (cash) Trust Fund (cash) Contribution Total 10 . FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION - COUNTY 001077 Cl IILD CAR SEAT FROG 0 p 0 0 0 001077 PERSONAL HEAL'T' H FEES 0 312 ,793 312 ,793 0 3129793 001077 AIDS CO- PAYS 0 0 0 0 0 001094 ADULT ENTER. PERMIT FEES 0 0 0 0 0 001094 LOCAL ORDINANCE FEES 0 709212 70,212 0 70.212 001114 NEW BIRTH CERTIFICATES 0 41 , 620 419620 0 414620 001115 Vital Statistics - Death Certificate 0 157. 673 157 , 673 0 157 , 673 001117 VITAL STATS-ADM . FEE 50 CENTS 0 21343 2 .343 0 21343 001073 Co-Pay for the AIDS Care Program 0 00 0 0 001025 Client Revenue from GRC 0 0 0 0 0 001040 Cell Phone Administrative FCC 0 0 0 0 0 FEES AUTHORIZED BY COUNTY TOTAL 0 586 , 849 586.849 0 586 , 849 11 . OTHER CASH AND LOCAL CONTRIBUTIONS - COUNTY 001009 RETURNED CHECK ITEM 0 0 0 0 0 001029 THIRD PARTY RF. IMBURSEMEN ' I' 0 95 , 141 95 , 141 0 95 , 141 001029 HEALTH MAINTENANCE ORGAN ( I IMO) 0 0 0 0 0 001054 MEDICARE PART D 0 0 0 0 0 001077 RYAN W11ITE TITLE 11 0 0 0 0 0 001090 MEDICARE PARI' B 0 36 ,907 36, 907 0 36. 907 001190 Health Maintenance Organization 0 0 0 0 0 005040 IN FERES"l� EARNED 0 9. 600 9 , 600 0 91600 005041 INTEREST EARNED-STATE INVE'STMEN 'F ACCOUNT 0 0 0 0 0 007010 U . S . GRANTS DIRECT 0 0 0 0 0 008010 Contribution from City Government 0 0 0 0 0 008020 Contribution lrom Health Care Fax not thru BCC 0 1176092 1 , 764 , 992 0 1 , 764, 992 008050 School Board Contribution 0 0 0 0 0 008060 Special Project Contribution 0 0 0 0 0 010300 SALT OF GOODS AND SERVICES TO STATE AGENCIES 0 0 0 0 0 010301 EXP WITNESS FEE CONSUL"TNT CHARGES 0 0 0 0 0 010405 SALE OF PHARMACEU "FICA14S 0 0 0 0 0 010409 SALE OF GOODS OUTSIDE STATE GOVERNMENT 0 0 0 0 0 011001 HFAErI' HY START COALITION CONTRIBUTIONS 0 475 , 795 475 ,795 0 475 , 795 011007 CASA DONATIONS PRIVATE 0 0 0 0 0 012020 FINES AND FORFEITURES 0 0 0 0 0 012021 RETURN CHECK CHARGE 0 0 0 0 0 028020 INSURANCE RECOVFRIES-OTHER 0 0 0 0 0 090002 DRAW DOWN FROM PUBLIC HEALTH UNIT 0 318 , 139 319 , 139 0 318 , 139 011000 GRANT DIRECT-NOVA UNIVERSITY C1 11) TRAINING 0 0 0 0 0 011000 GRANT- DIRECF 0 0 0 0 0 011000 GRAN '1 ' DIRECT-COUNTY HEALTI I DEPARTMENT DIRECT SERVICES 0 0 0 0 0 011000 DIRECT-ARROW 0 0 0 0 0 011000 GRANT- DIRECT 0 0 0 0 0 011000 GRANT- DIRF. 0"F 0 0 0 0 0 011000 GRANT DIRECT-QUANTUM DENTAL 0 0 0 0 0 011000 GRANT DIRECT- HEALTH CARE DISTRICT PAIIOKEF 0 0 0 0 0 011000 GRANT- DIRECT United Way Dental 0 42 , 500 42 , 500 0 42 , 500 011000 GRANT-DIRECT St Johns Water 0 23 ,862 23 . 862 0 23 . 862 Version : 2 Page 5 of 6 ATTACHMENT II, INDIAN RIVER COUNTY HEALTH DEPARTMENT Part II. Sources of Contributions to County Health Department October 1 , 2011 to September 30, 2012 State CHD County Total CHD Trust Fund CHD Trust Fund Other (cash) Trust Fund (cash) Contribution Total 11 . OTHER CASH AND LOCAL CONTRIBUTIONS - COUNTY 011000 GRANT-DIRECT EH Legal Support 0 17 , 073 17 , 073 0 17 , 073 011000 ( IRAN "F- DIRECT 0 p 0 0 0 011000 GRANT- DIRECT 0 p 0 0 0 011000 GRANT DIRFCF-ARROW 0 0 0 0 0 010402 Recycled Material Sales 0 0 0 0 0 010303 FDLE Fingerprinting 0 00 p 0 007050 ARRA Federal Grant 0 0 0 0 0 001010 Recovery of Bad Checks 0 0 0 0 0 008065 FCO Contribution 0 0 0 0 0 011006 Restricted Cash Donation 0 0 0 0 0 028000 Insurance Recoveries 0 0 0 0 0 001033 CMS Management Fee - PMPMPC 0 3360 3 , 360 0 3 , 360 010400 Sale of Goods Outside State Government 0 0 0 0 0 010500 Refugee I Icalth 0 0 0 0 0 005045 Interest Earned-Third Party Provider 0 0 0 0 0 005043 Interest Earned-Contract/Grant 0 0 0 0 0 010306 DOH/DOC Interagency Agreement 0 0 0 0 0 008040 BCC Grant/Contract 0 82 ,314 82 ,314 0 82 , 314 011002 ARRA Federal Grant - Sub - Recipient 0 0 0 0 0 OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL 0 21869 , 683 2 , 8691683 0 2 , 869, 683 12 . ALLOCABLE REVENUE - COUNTY 018000 REFUNDS 0 0 0 0 0 037000 PRIOR YEAR WARRAN "F 0 0 0 0 0 038000 12 MONTH OLD WARRANT 0 0 0 0 0 COUNTY ALLOCABLE REVENUE TOTAL 0 0 0 0 0 13 . BUILDINGS - COUNTY ANNUAL RENTAL EQUIVALENT' VALUE 0 0 0 332 .652 332 , 652 GROUNDS MAINTFNANCF. 0 0 0 0 0 OTHER ( SPECIFY) 0 0 0 0 0 INSURANCE 0 0 0 0 0 UTILITIES 0 0 0 133 ,499 133 ,499 OTHER ( SPECIFY) 0 0 0 0 0 BUILDING MAINTFNANCF. 0 0 0 127 ,663 127 ,663 BUILDINGS TOTAL 0 0 0 593 , 814 593 ,814 14 . OTHER COUNTY CONTRIBUTIONS NOT IN CHD TRUST FUND - COUNTY FQUIPMFNT/VEEIICLF PURCHASES 0 0 0 0 0 VEIIICLE INSURANCE 0 0 0 0 0 VEHICLE MAINTENANCE-: 0 0 0 0 0 OTHER COUNTY CONTRIBUTION ( SPFCIFY) 0 0 0 0 0 OTHER COUNTY CONTRIBUTION ( SPECIFY) 0 0 0 0 0 OTHER COUNTY CONTRIBUTIONS TOTAL 0 0 0 0 0 GRAND TOTAL CHD PROGRAM 44515 , 879 51218 , 945 9, 7341824 31959, 568 13 , 694,392 Version : 2 Page 6 of 6 ATTACHMENT II, INDIAN RIVER COUNTY HEALTH DEPARTMENT Part III. Planned Staffing, Clients, Services, And Expenditures By Program Service Area Within Each Level Of Service October 1 , 2011 to September 30, 2012 Quarterly Expenditure Plan FTE's Clients Services/ 1st 2nd 3rd 4th Grand (0.00) Units Visits (Whole dollars only) State County Total A . COMMUNICABLE DISEASE CONTROL : IMMUNIZATION ( 101 ) 6 . 87 5 ,200 7, 850 126, 105 108, 090 126 , 105 108 , 090 183 , 302 285 , 088 468 , 390 SrFD ( 102 ) 6 . 31 1 . 477 2 ,200 90,294 77,394 905294 77 , 394 195 , 743 139 , 633 335 , 376 IIIV/AIDS PREVENTION (03A1 ) 1 . 14 305 505 16, 584 14,215 16, 584 14 ,216 58384 3 ,215 61 , 599 1IIV/AIDS SURVFII . ANCF ( 03A2) 0 . 00 0 0 0 0 0 0 0 0 0 H1V/AIDS PATIENTCARE (03A3 ) 4 . 78 947 11495 75 , 125 64 , 393 75 , 125 64394 208 , 881 70, 156 279 , 037 ADAP (03A4) 0 . 83 0 0 14 , 555 121476 14 , 555 12 ,477 509341 3 .722 54 , 063 TB CONTROL SERVICES ( 104 ) 2 . 66 825 21500 40 ,273 34 , 519 40 ,273 34,519 101 , 508 489076 149, 584 COMM . DISEASE SU RV. ( 106) 0 . 94 0 240 17, 817 15,272 17 , 817 15 , 272 41 ,467 24 , 711 66 , 178 HEPATITIS PREVENTION ( 109 ) 0 . 00 0 275 4 4 4 4 16 0 16 PUBLIC HEAL "FH PREP AND RESP ( I 16) 2 . 74 0 175 58 ,476 49, 396 58 , 477 69 , 735 219, 571 16,513 236 , 084 VITAL STATISTICS ( 180 ) 1 . 14 7 ,400 194200 14, 535 129458 14, 535 12,459 0 53 ,987 53 , 987 COMMUNICABLE DISEASE SUBTOTAL 27 . 41 164154 344440 4534768 388 ,217 4539769 408 , 560 1 , 059,213 645 , 101 1 , 704 , 314 B. PRIMARY CARE : CHRONIC DISEASE SFRVICL' S (210) 1 . 04 1 , 880 1 ,865 19,430 16, 653 19,430 16, 654 61 , 676 10091 72 , 167 TOBACCO PREVENTION (212) 0 . 00 0 0 0 0 0 0 0 0 0 WIC (21W1 ) 13 . 57 4, 768 35 ,430 191 , 100 163 . 801 191 , 100 163 , 801 6669879 42,923 709 , 802 WIC BREASTFEEDING PEER COUNSELING (21 W2) L l4 842 6,252 191022 16,304 19, 022 16 , 305 68 , 362 2 ,291 70 , 653 FAMILY PLANNING (223 ) 12 . 32 2 , 850 41900 175 , 826 150, 708 175 , 826 150 , 707 2375077 415 , 990 653 , 067 IMPROVED PREGNANCY OUTCONIF. (225 ) 0 . 00 0 0 0 0 0 0 0 0 0 HEAL"FHY S"FART PRENATAL (227) 4 . 52 730 5 , 095 72 , 191 61 , 878 72 , 191 61 , 879 18 ,958 2499181 2681139 COMPREHENSIVE CHILD HFiALTI1 (229 ) 26 . 31 31900 10, 651 374,417 320,929 374,417 320 , 929 485 , 009 905 ,683 1390 , 692 HEALTFIY START INFAN 'F (231 ) 2 . 56 210 11980 40,215 34470 40,215 34 ,468 0 149, 368 149 ,368 SCHOOL HEALTH (234) 4 . 92 0 205 ,200 86,076 739780 86,076 73 ,780 313 ,442 6,270 319, 712 COMPREHENSIVE ADULT HFALTH ( 237) 42 . 11 7 , 950 18 , 907 719, 253 616, 502 719,253 6164502 6609246 2 , 011 ,264 2 , 671 , 510 COMMUNITY HEALTH DFVFLOPMEN ' I ' (238 ) 0 . 00 0 0 0 0 0 0 0 0 0 DFNTAI , IIFAI .TH (240) 11 . 17 21780 6 , 173 211 , 654 181 ,418 211 ,654 181 ,417 251 , 694 534 ,449 786, 143 PRIMARY CARE SUBTOTAL 119 . 66 25 ,910 296 ,453 1 ,909, 184 1 , 636,443 1 , 909, 184 1 ,636 ,442 2 ,763 ,343 4, 327 , 910 7, 091 ,253 C . ENVIRONMENTAL HEALTH : Water and Onsite Sewage Programs COASTAL BEACH MONITORING ( 347 ) 0 . 16 144 144 64596 54653 6, 596 5 , 654 20 ,782 31717 24. 499 LIMITED USE PUBLIC WATER SYSTFMS (357 ) 0 . 43 17 375 7.998 61855 7,998 61855 11 ,470 18 ,236 29, 706 PUBLIC WATER SYSTFM (358 ) 0 . 10 0 235 1 ,916 1 ,643 1 ,916 14643 3 , 615 3 , 503 7 , 118 PRIVATF, WATER SYSTEM ( 359 ) 1 . 50 338 1 , 200 27. 838 23 , 861 27, 838 23 , 860 34 ,717 6080 103 . 397 INDIVIDUAL SF: WAGF DISP (361 ) 4 . 21 906 3 , 825 74, 616 63 ,957 74 , 616 63 ,956 2569475 20, 670 277 , 145 Group Total 6 . 40 1 ,405 5 , 779 118 ,964 101 ,969 1184964 101 ,968 327 , 059 114 , 806 441 , 865 Facility Programs 1=001) HYGIENE (348) 0 . 55 80 385 10, 590 9 , 077 10 , 590 9, 076 34,086 59247 39 , 333 BODY AR "F (349) 0 . 02 1 14 425 365 425 365 1 , 273 307 15580 GROUP CARE FAC ILI ' 14Y (351 ) 0 . 15 71 122 2, 887 2,475 2, 888 2 ,475 8 ,225 2, 500 10 , 725 MIGRANT LABOR CAMP (352) 0 . 07 3 46 1 ,260 11080 1 ,260 1 , 081 3 , 585 1 , 096 4,681 I10SING , PUBLIC BLDG SAFEFY, SANFFATIONQ53 )0 . 12 50 220 2 , 690 2 , 305 21690 2, 305 3 ,445 6 , 545 9 ,990 Version : 2 Page 1 of 2 ATTACHMENT II. INDIAN RIVER COUNTY HEALTH DEPARTMENT Part III. Planned Staffing, Clients, Services, And Expenditures By Program Service Area Within Each Level Of Service October 1 , 2011 to September 30, 2012 Quarterly Expenditure Plan FTE's Clients Services/ 1st 2nd 3rd 4th Grand (0.00) Units Visits (Whole dollars only) State County Total C . ENVIRONMENTAL HEALTH : Facility Programs MOBILE. HOME AND PARKS SERVICES (354) 0 . 16 51 136 1 , 705 7 ,000 1 , 705 11256 11 ,472 194 11 , 666 SWIMMING POOLS/BAT1IING (360) 1 . 13 295 745 21 ,392 18 ,336 21 , 392 18 , 337 72 , 629 6 , 828 79 ,457 BIOMEDICAL WASTE SERVICES ( 364) 0 . 32 210 220 5 , 790 41962 5 , 790 41962 211087 417 21 , 504 TANNING FACILITY SERVICES (369) 0 . 02 5 16 485 415 485 414 14763 36 1 , 799 Group Total 2 . 54 766 11904 474224 46, 015 471225 40,271 157 , 565 23 , 170 180, 735 Groundwater Contamination STORAGE TANK COMPLIANCE (355 ) 0 . 41 120 275 8 , 164 6, 997 8 , 164 6 ,997 30,026 296 30,322 SUPER ACT SERVICE (356) 1 . 00 109 196 18 , 509 15 , 865 18 , 509 154866 53 , 161 15 . 588 68 ,749 Group Total 1 . 41 229 471 26, 673 22 , 862 26 , 673 22 , 863 83 , 187 15 , 884 99 , 071 Community Hygiene OCCUPA"I10NAL HEALT11 (344) 0 . 00 0 0 21 18 21 17 39 38 77 COMMUNITY ENVIR. IIFA L "fH ( 345 ) 0 . 82 0 895 169852 149445 16 , 852 141444 31 , 836 30 ,757 62 ,593 INJURY PREVFNTION (346) 0 . 00 0 1 , l 15 66 56 66 56 187 57 244 LEAD MONITORING SFRVICES (350) 0 . 01 2 4 159 136 159 136 454 136 590 PUBLIC' SEWAGE (362 ) 0 . 06 12 85 11428 1 ,224 1 , 428 1 ,225 0 5305 51305 SOLID WASTE DISPOSAL (363 ) 0. 03 0 18 539 462 539 463 0 2 ,003 2 , 003 SANITARYNUISANCE (365 ) 0 . 15 22 146 3 , 143 2 ,694 3 , 143 24696 8 ,967 21709 11 , 676 RABIES SURVEILLANCUCONTROL SERVICES (366) 0 . 17 60 175 4, 045 3 ,468 4 , 045 31468 11 , 523 3 . 503 15 , 026 ARBOVIRUS SURVEILLANCE (367) 0 . 03 0 3 628 538 628 539 0 2 ,333 2333 RODEN PARTHROPOD ("ON ' IROL (368 ) 0 . 02 0 25 375 321 375 321 0 1 ,392 1 , 392 WATER POLLUTION (370) 0 . 68 0 630 12 , 343 10 , 580 12 ,343 10, 581 10 , 885 34,962 459847 INDOOR AIR ( 37 1 ) 0. 09 0 20 21175 1 , 865 2 , 175 1 , 865 69220 1 , 860 81080 RADIOLOGICAL I IEAL" I' H ( 372) 0 . 00 0 0 0 0 0 0 0 0 0 TOXIC SUB SrFANCES (373 ) 0 . 40 70 135 8 ,060 6,909 8 , 060 61908 22 ,918 71019 291937 Group Total 2 . 46 166 3 ,251 494834 42 , 716 49 , 834 42 , 719 93 , 029 92 , 074 185 , 103 ENVIRONMENTAL HEALTH SUBTOTAL 12 . 81 2, 566 11 ,405 242 , 695 213 , 562 242 , 696 207,821 660 , 840 2455934 906,774 D . NON-OPERATIONAL COSTS : Non-Operational Costs ( 599) 0 . 00 0 0 0 0 0 0 0 0 0 ENVIRONMENTAL HEALTII SURCHARGE ( 399) 0 . 00 0 0 6 , 740 6 ,903 11 , 694 7 , 146 32,483 0 32 ,483 NON -OPERATIONAL COSTS SUBTOTAL 0 . 00 0 0 6 ,740 6 ,903 11 , 694 7 . 146 32 ,483 0 32 , 483 TOTAL CONTRACT 159 . 88 44, 630 342 , 298 2 , 612 .387 21245 , 125 2 . 617343 2 ,259 , 9694, 515 , 879 5 ,218 ,945 91734 , 824 Version : 2 Page 2 of 2 ATTACHMENT III 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 , 190027 th Street County of Environmental Health , WIC , Vero Beach , FL 32960 - 3383 Indian River Administrative Headquarters 36 , 475 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 21 South Cypress Street City Of Fellsmere Fellsmere , FL 32948 -6714 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 YEAR STATE COUNTY TOTAL 2009-2010 $ $ $ - 2010 -2011 $ $ $ 2011 -2012 $ $ $ 2012 -2013 $ $ $ - 2013-2014 $ $ $ PROJECT TOTAL $ - $ - $ SPECIAL PROJECT CONSTRUCTION /RENOVATION PLAN PROJECT NAME : N / A LOCATION/ ADDRESS : PROJECT TYPE : NEW BUILDING ROOFING RENOVATION PLANNING STUDY NEW ADDITION OTHER SQUARE FOOTAGE : PROJECT SUMMARY : Describe scope of work in reasonable detail. ESTIMATED PROJECT INFORMATION : START DATE (initial expenditure of funds) COMPLETION DATE : DESIGN FEES : $ CONSTRUCTION COSTS : $ FURNITURE/EQUIPMENT $ TOTAL PROJECT COST : $ - COST PER SQ FOOT : $ # DIV/0 ! Special Capital Projects are new construction or renovation projects and new furniture or equipment associated with these projects and mobile health vans .