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HomeMy WebLinkAbout2010-223 � 1 i oglajU 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 2010 -2011 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 , 2010 . 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 , 2010 , through September 30 , 2011 , 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 1 f 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 ll . 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 $ 3 , 509 , 413 (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 . ii. The County ' s appropriated responsibility (direct contribution excluding any fees, othercash orlocal contributions) as provided in Attachment ll , Part II is an amount not to exceed $ 580 , 056 (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 1 County Health Department Trust Fund that is attributed to the CHID 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 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 CHID 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 CHID 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 CHID 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 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 CHID 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 . 004 , 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 CHID 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 DE58OL1 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 , 2011 for the report period October 1 , 2010 through December 31 , 2010 ; ii. June 1 , 2011 for the report period October 1 , 2010 through March 31 , 2011 ; iii. September 1 , 2011 for the report period October 1 , 2010 through June 30 , 2011 ; and iv. December 1 , 2011 for the report period October 1 , 2010 through September 30 , 2011 . 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 , 2011 ) 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 , Fl . , 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 25 page agreement to be executed by their undersigned officials as duly authorized effective the 1 � day of October , 2010 . BOARD OF COUNTY COMMISSIONERS STATE OF FLORIDA FOR INDIAN RIVER COUNTY FOR INDIAN RIVER COUNTY DEPARTMENT OF HEALTH r SIGNED BY : j tA SIGNED BY : 4: 2 t _ NAME : Peter D . 0 ' Bryan NAME : Ana M . Viamonte Ros , M . D . , M . P . H . TITLE : Chairman TITLE : State Surgeon General DATE : September 21 , 2010 DATE : 9136 /0 ATTESTED TO : SIGNED BYE: y SIGNED BY : NAME : LL� 00A ALLG ,u NAME : Miranda fee M . P . H . JX BARTON G-G- 1. F.6R„ ,. , o ,,, ,, T ,,,,, °„ T TITLE : CHD Director/Administrator DATE : q / al / 10 DATE : A° V� • ogle . • Ss 4a a O .`�• • • • . �O ay PPR � V � � m y�;z� a . � s a ' 1a a • ° a � O n ° unty Ad inistrator ay ; a :099 f OQ�Q-o� APPROVED AS TO�JrG�t a°•�AColi AND LEGAL SUFFICQENCY BY ALAN g. ICH cOQDN TY 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 CHID 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 CHID 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-31 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) , 383. 06, 384 . 23, 384 . 251 385. 202, 392. 53 FS. 381 and CHD 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 CHD 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 Share Estimated County Share of CHD Trust Fund of CHD Trust Fund Balance as of 09/30/ 10 Balance as of 09/30/ 10 Total 1 . CHD Trust Fund Ending Balance 09/30/ 10 819 , 907 958 , 248 127781155 2 . Drawdown for Contract Year October 1 , 2010 to September 30 , 2011 ( 349 , 606 ) ( 365 , 040 ) ( 714 , 646 ) 3 . Special Capital Project use for Contract Year October 1 , 2010 to September 30 , 2011 4 . Balance Reserved for Contingency Fund 4701301 5931208 11063 , 509 October 1 , 2010 to September 30 , 2011 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 . ATTACHMENT II. INDIAN RIVER COUNTY HEALTH DEPARTMENT Part II. Sources of Contributions to County Health Department October 1 , 2010 to September 30, 2011 State CFID County Total CMD Trust Fund CIlD Trust Fund Other (cash) Trust Fund (cash) Contribution Total 1 . GENERAL REVENUE - STATE 015040 ALG/CESSPOOL IDENTIFICATION AND ELIMINATION 0 0 0 0 0 015040 ALG/CONTR TO CI-IDS-AIDS PATIENT CARE 1005000 0 1007000 0 100, 000 015040 ALG/CONTR TO CI-IDS-AIDS PATIENT CARE NETWORK 0 0 0 0 0 015040 ALG/CONTR TO CHDS-AIDS PREV & SURV & FIELD STAFF 0 0 0 0 0 015040 ALG/CONTR TO CHDS- DENTAL PROGRAM 17,908 0 17, 908 0 17,908 015040 ALG/CONTR TO CHDS-MIGRANT LABOR CAMP SANITATION 1 ,302 0 11302 0 13302 015040 MINORITY OUTREACH- PENALVER CLINIC - MIAMI- DADE 0 0 0 0 0 015040 PRIMARY CARE SPECIAL DENTAL PROJECT' S 65923 0 6,923 0 61923 015040 SPECIAL NEEDS SHELTER PROGRAM 0 0 0 0 0 015040 STATEWIDE DENTIS'T'RY NETWORK - ESCAMBIA 0 0 0 0 0 015040 STD GENERAL REVENUE 0 0 0 0 0 015040 VARICELLA IMMUNIZATION REQUIREMENT 55844 0 5 , 844 0 51844 015040 HEALTHY START MED WAIVER - SOBRA 0 0 0 0 0 015040 HEALTHY START MED•WAIVER - CLIENT SERVICES 0 0 0 0 0 015040 JESSIE TRICE CANCER CTR/HEALTH CHOICE - MIAMI- DADE 0 0 0 0 0 015040 LA LIGA CONTRA EL CANCER 0 0 0 0 0 015040 MANATEE COUNTY RURAL HEALTH SERVICES 0 0 0 0 0 015040 METRO ORLANDO URBAN LEAGUE '1'EENAGE DREG PREV 0 0 0 0 0 015040 COUNTY SPECIFIC DENTAL PROJECTS - ESCAMBIA 0 0 0 0 0 015040 DENTAL SPECIAL INITIATIVES 31295 0 3 ,295 0 33295 015040 DUVAL TEEN PREGNANCY PREVENTION 0 0 0 0 0 015040 FL CLPPP SCREENING & CASE MANAGEMENT 0 0 0 0 0 015040 FL HEPATITIS & LIVER FAILURE PREVENTIONCONTROL 0 0 0 0 0 015040 HEALTHY BEACHES MONITORING 10,232 0 10,232 0 10 ,232 015040 ALG/IPO 1-IEAL'I' HY START/IPO 0 0 0 0 0 015040 ALG/PRIMARY CARE 1775645 0 1775645 0 177, 645 015040 ALG/SCHOOL HEAL TFUSUPPLEMENTAL 50,932 0 50 , 932 0 50,932 015040 CHILD HEALTH MEDICAL SERVICES 0 0 0 0 0 015040 COMMUNITY SMILES - MIAMI-DADE 0 0 0 0 0 015040 COMMUNITY TB PROGRAM 35,993 0 355993 0 35,993 015040 ALG/CONTR. TO CHDS -IMMUNIZATION OUTREACH TEAMS 10,359 0 10,359 0 10,359 015040 ALG/CONTR. TO CHDS- INDOOR AIR ASSIST FROG 9, 541 0 9, 541 0 9 , 541 015040 ALG/CONTR . TO CI-IDS -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 14,263 0 14,263 0 14,263 015040 ALG/FAMILY PLANNING 335096 0 33 , 096 0 33 , 096 015050 ALG/CONTR TO CHDS 1 ,6483411 0 1 , 648 ,411 0 1 , 648 ,41 1 GENERAL REVENUE TOTAL 2 , 125 , 744 0 2, 125 , 744 0 2, 125 , 744 2 , NON GENERAL REVENUE - STATE 015010 ALG/CONTR TO CHDS- REBASING TOBACCO TF 26,466 0 26,466 0 26,466 015010 ALG/CONTR. TO CI-IDS-BIOMEDICAL WASTE/DEP ADM TF 12,263 0 125263 0 125263 015010 ALG/CONTR. TO ClIDS-SAFE DRINKING WATER PRG'DEP ADM 0 0 0 0 0 015010 BASIC SCHOOL HEAL'T' H - TOBACCO TF 0 0 0 0 0 015010 CHD PROGRAM SUPPORT 0 0 0 0 0 015010 ENVIRONMENTAL HEALTH PACE PROJECTS 3500 0 355000 0 35 ,000 015010 FOOD AND WATERBORNE DISEASE PROGRAM ADM TF/DACS 0 0 0 0 0 015010 FULL SERVICE SCHOOLS - TOBACCO TF 74,304 0 745304 0 74,304 Version : 4 Page 1 of 7 ATTACHMENT 11. INDIAN RIVER COUNTY HEALTH DEPARTMENT Part H . Sources of Contributions to County Health Department October 1 , 2010 to September 30, 2011 State CIID County Total CIID Trust Fund CIID Trust Fund Other (cash) Trust Fund (cash) Contribution Total 2 , NON GENERAL REVENUE - STATE 015010 IMMUNIZATION SPECIAL PROJECT 407 0 45807 0 41807 015010 PUBLIC SWIMMING POOL PROGRAM 0 0 0 0 0 015010 SUPPLEMENTAUCOMPREHENSIVE SCI-TOOL HEALTH - TOB TF 70,277 0 70,277 0 70,277 015010 TOBACCO COMMUNITY INTERVENTION 0 0 0 0 0 015020 TRANSFER FROM ANOTHER STATE AGENCY 0 0 0 0 0 015020 TRANSFER FROM ANOTHER STATE AGENCY 0 0 0 0 0 015020 TRANSFER FROM ANOTHER STATE AGENCY 0 0 0 0 0 015060 Non-Categorical Tobacco Rebasing 0 0 0 0 0 NON GENERAL REVENUE TOTAL 2233117 0 223 , 117 0 2235117 3 . FEDERAL FUNDS - State 007000 AFRICAN AMERICAN TESTING INITIATIVE(AATI) 0 0 0 0 0 007000 AIDS PREVENTION 515788 0 51 , 788 0 515788 007000 AIDS SURVEILLANCE 0 0 0 0 0 007000 BIOTERRORISM HOSPITAL PREPAREDNESS 28, 763 0 28, 763 0 28,763 007000 CHILDHOOD LEAD POISONING PREVENTION 0 0 0 0 0 007000 COASTAL BEACH MONITORING PROGRAM 8,976 0 81976 0 87976 007000 TUBERCULOSIS CONTROL - FEDERAL GRANT 0 0 0 0 0 007000 WICADMINISTRATION 685 ,038 0 685 , 038 0 685 , 038 007000 WIC BREASTFEEDING PEER COUNSELING 42,250 0 425250 0 425250 007000 STD FEDERAL GRANT - CSPS 0 0 0 0 0 007000 STD PROGRAM - PHYSICIAN TRAINING CENTER 0 0 0 0 0 007000 STD PROGRAM - PHYSICIANS TRAINING CENTER 0 0 0 0 0 007000 STD PROGRAM INFERTILITY PREVENTION PROJECT( IPP) 0 0 0 0 0 007000 SYPHILIS ELIMINATION 0 0 0 0 0 007000 TITLE X MALE PROJECT 0 0 0 0 0 007000 RYAN WHITE 0 0 0 0 0 007000 RYAN WHITE - EMERGING COMMUNITIES 0 0 0 0 0 007000 RYAN WHITE PART B SUPPLEMENTAL 0 0 0 0 0 007000 RYAN WHITE-AIDS DRUG ASSIST PROGADMIN 355000 0 35 ,000 0 355000 007000 RYAN WHITE-CONSORTIA 0 0 0 0 0 007000 STATE INDOOR RADON GRANT 0 0 0 0 0 007000 NATIONAL COMPREHENSIVE CANCER CONTROL PROGRAM 0 0 0 0 0 007000 ORAL HEALTH WORKFORCE ACTIVITIES 0 0 0 0 0 007000 ORAL HEALTH WORKFORCE ACTIVITIES2010-2011 0 0 0 0 0 007000 131-IP - CITIES READINESS INITIATIVE 0 0 0 0 0 007000 PUBLIC HEALTH PREPAREDNESS BASE 93 ,683 0 93 , 683 0 937683 007000 RAPE PREVENTION & EDUCATION GRANT 0 0 0 0 0 007000 IMMUNIZATION FIELD STAFF EXPENSE 0 0 0 0 0 007000 IMMUNIZATION SUPPLEMENTAL 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 BGTF-GADSDEN SCHOOL CLINIC 0 0 0 0 0 007000 MCH BGTF-HEALTHY START IPO 0 0 0 0 0 007000 FGTF/FAMILY PLANNINGTITLE X 57, 072 0 575072 0 57,072 007000 FGTF/IMMUNIZATION ACTION PLAN 27, 094 0 27 , 094 0 275094 007000 HEALTH PROGRAM FOR REFUGEES 0 0 0 0 0 007000 HEALTHY PEOPLE HEALTHY COMMUNITIES 32, 541 0 32, 541 0 32, 541 Version : 4 Page 2 of 7 ATTACHMENT H. INDIAN RIVER COUNTY HEALTH DEPARTMENT Part 11 . Sources of Contributions to County Health Department October 1 , 2010 to September 30, 2011 State CHD County Total CHD Trust Fund CHD Trust Fund Other (cash) Trust Fund (cash) Contribution Total 3 , FEDERAL FUNDS - State 007000 FIIV HOUSING FOR PEOPLE LIVING WITH AIDS 0 0 0 0 0 007000 HIV INCIDENCE SURVEILLANCE 0 0 0 0 0 007000 COLORECTAL CANCER SCREEN ING2009- 10 0 0 0 0 0 007000 DIABETES PREVENTION & CONTROL PROGRAM 0 0 0 0 0 007000 FAMILY PLANNING - TITLE X 0 0 0 0 0 007000 FGTF/AIDS 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 015009 MEDIPASS WAIVER- FILTHY STRT CLIENT SERVICES 0 0 0 0 0 015009 MEDIPASS WAIVER-SOBRA 0 0 0 0 0 015075 SCHOOL HEALTH/SUPPLEMENTAL 98 ,347 0 98 , 347 0 98 ,347 007055 ARRA Federal Grant - Schedule C 0 0 0 0 0 015075 Inspections of Summer Feeding Program 0 0 0 0 0 FEDERAL FUNDS TOTAL 151605552 0 1 , 160, 552 0 11160, 552 4, FEES ASSESSED BY STATE OR FEDERAL RULES - STATE 001020 TANNING FACILITIES 25129 0 2, 129 0 2° 129 001020 BODY PIERCING 270 0 270 0 270 001020 MIGRANT HOUSING PERMIT 0 0 0 0 0 001020 MOBILE HOME AND PARKS 135481 0 13 ,481 0 135481 001020 FOOD HYGIENE PERMIT 19,272 0 19,272 0 19,272 001020 BIOHAZARD WASTE PERMIT 14, 590 0 14, 590 0 14, 590 001020 PRIVATE WATER CONSTR PERMIT 0 0 0 0 0 001020 PUBLIC WATER ANNUAL OPER PERMIT 31483 0 3 ,483 0 33483 001020 PUBLIC WATER CONSTR PERMIT 0 0 0 0 0 001020 NON-SDWA SYSTEM PERMIT 0 0 0 0 0 001020 SAFE DRINKING WATER 0 0 0 0 0 001020 SWIMMING POOLS 541085 0 54,085 0 54, 085 001092 OSDS PERMIT FEE 142, 164 0 142, 164 0 142, 164 001092 I & 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 HEALTH FEES 5 ,285 0 5 ,285 0 53285 001092 OSDS REPAIR PERMIT 0 0 0 0 0 001 170 LAB FEE CHEMICAL ANALYSIS 0 0 0 0 0 001170 WATER ANALYSIS-POTABLE 0 0 0 0 0 001 170 NONPOTABLE WATER ANALYSIS 0 0 0 0 0 010304 MQA INSPECTION FEE 0 0 0 0 0 001206 Central Office Surcharge 24,282 0 245282 0 24'282 FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL 279 ,041 0 279 ,041 0 279 ,041 5 , OTHER CASH CONTRIBUTIONS - STATE 010304 STATIONARY POLLUTANT STORAGE_ TANKS 94, 196 0 94, 196 0 94, 196 090001 DRAW DOWN FROM PUBLIC HEALTH UNIT 349,606 0 34906 0 349, 606 OTHER CASH CONTRIBUTIONS TOTAL 44302 0 443 , 802 0 443 , 802 Version : 4 Page 3 of 7 ATTACHMENT II. INDIAN RIVER COUNTY HEALTH DEPARTMENT Part 11 , Sources of Contributions to County Health Department October 1 , 2010 to September 30, 2011 State CHD County Total CMD Trust Fund CIID "frust Fund Other (cash) Trust Fund (cash) Contribution Total 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 255988 25 ,988 51 ,976 0 51 , 976 001079 MEDICAID CASE MANAGEMENT 0 0 0 0 0 001081 MEDICAID CHILD HEALTH CHECK UP 118,468 189, 562 308, 030 0 3085030 001082 MEDICAID DENTAL 177,343 283, 767 461 , 110 0 461 , 110 001083 MEDICAID FAMILY PLANNING 19, 743 17703 197,426 0 197,426 001087 MEDICAID STD 1503 2406 391009 0 39,009 001089 MEDICAID AIDS 3 , 090 41944 8 ,034 0 8 ,034 001 147 Medicaid HMO Capitation 0 0 0 0 0 001 191 MEDICAID MATERNITY 0 0 0 0 0 001192 MEDICAID COMPREHENSIVE CHILD 1983997 318 ,416 517,413 0 5175413 001 193 MEDICAID COMPREHENSIVE ADULT 99,954 159,937 259, 891 0 259, 891 001 194 MEDICAID LABORATORY 0 0 0 0 0 001208 MEDIPASS $2 . 00 ADM . FEE 56, 550 56, 550 113 , 100 0 113, 100 001059 Medicaid Low Income Pool 0 0 0 0 0 001051 Emergency Medicaid 0 0 0 0 0 001058 Medicaid - Behavioral Health 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 0 0 0 0 001055 Medicaid - Hospital 0 0 0 0 0 001148 Medicaid HMO Non-Capitation 0 0 0 0 0 001074 Medicaid - Newborn Screening 0 0 0 0 0 MEDICAID TOTAL 715 , 136 15240, 853 15955 , 989 0 15955,989 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 0 114 ,430 1141430 LABORATORY SERVICES 0 0 0 66,974 667974 TB SERVICES 0 0 0 0 0 IMMUNIZATION SERVICES 0 0 0 56505 5655805 STD SERVICES 0 0 0 0 0 CONSTRUCTION/RENOVATION 0 0 0 0 0 WIC FOOD 0 0 0 21219, 888 272199888 ADAP 0 0 0 4541135 4545135 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 ,421 ,232 3 ,421 ,232 Version : 4 Page 4 of 7 ATTACHMENT II. INDIAN RIVER COUNTY HEALTH DEPARTMENT Part 11 . Sources of Contributions to County Health Department October 1 , 2010 to September 30, 2011 State CHI) County Total CHI) "frust Fund CHD Trust Fund Other (cash) Trust Fund (cash) Contribution Total 9 , DIRECT LOCAL CONTRIBUTIONS - COUNTY 008030 Contribution from Health Care Tax 0 0 0 0 0 008034 BCC Contribution from General Fund 0 580, 056 580, 056 0 580 , 056 DIRECT COUNTY CONTRIBUTION TOTAL 0 580, 056 580, 056 0 580,056 10 , FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION - COUNTY 001060 Vital Statistics - Other Fees 0 103 1 , 803 0 103 001077 RABIES VACCINE 0 0 0 0 0 001077 CHILD CAR SEAT PROG 0 0 0 0 0 001077 PERSONAL HEALTH FEES 0 279, 526 279, 526 0 279 , 526 001077 AIDS CO-PAYS 0 0 0 0 0 001094 ADULT ENTER PERMIT FEES 0 0 0 0 0 001094 LOCAL ORDINANCE FEES 0 60,398 60,398 0 60,398 001114 NEW BIRTH CERTIFICATES 0 31 , 040 315040 0 31 ,040 001 115 Vital Statistics - Death Certificate 0 159,420 159,420 0 159,420 001 117 VITAL_ STATS-ADM . FEE 50 CENTS 0 1 ,945 1 ,945 0 1 ,945 001073 Co-Pay for the AIDS Care Program 0 0 0 0 0 001025 Client Revenue from GRC 0 0 0 0 0 001040 Cell Phone Administrative Fee 0 0 0 0 0 FEES AUTHORIZED BY COUNTY TOTAL 0 534, 132 5345132 0 5341132 11 . OTHER CASH AND LOCAL CONTRIBUTIONS - COUNTY 001009 RETURNED CHECK ITEM 0 0 0 0 0 001029 THIRD PARTY REIMBURSEMENT 0 98 , 162 98 , 162 0 98, 162 001029 I-IEALTH MAINTENANCE ORGAN (HMO) 0 0 0 0 0 001054 MEDICARE PART D 0 0 0 0 0 001077 RYAN WHITE TITLE LL 0 0 0 0 0 001090 MEDICARE PART B 0 25 , 867 255867 0 25 , 867 001190 Health Maintenance Organization 0 0 0 0 0 005040 INTEREST EARNED 0 0 0 0 0 005041 INTEREST EARNED-STATE INVESTMENT ACCOUNT 0 1304 13 , 084 0 1304 007010 U . S . GRANTS DIRECT 0 0 0 0 0 008010 Contribution from City Government 0 0 0 0 0 008020 Contribution from Health Care Tax not thru BCC 0 117645992 11764,992 0 1 , 7645992 008050 School Board Contribution 0 0 0 0 0 008060 Special Project Contribution 0 0 0 0 0 010300 SALE OF GOODS AND SERVICES TO STATE AGENCIES 0 544 544 0 544 010301 EXP WITNESS FEE CONSULTNT CHARGES 0 0 0 0 0 010405 SALE OF PHARMACEUTICALS 0 0 0 0 0 010409 SALE OF GOODS OUTSIDE STATE GOVERNMENT 0 0 0 0 0 011001 HEALTH-IY START COALITION CONTRIBUTIONS 0 365 , 975 365 , 975 0 365 ,975 011007 CASH 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 RECOVERIES-OTHER 0 0 0 0 0 090002 DRAW DOWN FROM PUBLIC HEALTH UNIT 0 365 , 040 365 , 040 0 365 , 040 011000 GRANT DIRECT-NOVA UNIVERSITY CI-ID TRAINING 0 0 0 0 0 011000 GRANT-DIRECT 0 173 , 894 173 , 894 0 173 , 894 Version : 4 Page 5 of 7 ATTACHMENT Ho INDIAN RIVER COUNTY HEALTH DEPARTMENT Part :II. Sources of Contributions to County Health Department October 1 , 2010 to September 30, 2011 State CFID County Total CIID Trust Fund CFID Trust Fund Other (cash) Trust Fund (cash) Contribution Total 11 . OTHER CASH AND LOCAL CONTRIBUTIONS - COUNTY 011000 GRANT DIRECT-COUNTY HEALTH 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- DIRECT 0 0 0 0 0 011000 GRANT DIRECT-QUANTUM DENTAL 0 0 0 0 0 011000 GRANT DIRECT-HEALTH CARE DISTRICT PAHOKEE 0 0 0 0 0 011000 GRANT- DIRECT 0 0 0 0 0 011000 GRANT-DIRECT 0 0 0 0 0 011000 GRANT-DIRECT 0 0 0 0 0 011000 GRANT-DIRECT 0 0 0 0 0 011000 GRANT-DIRECT 0 0 0 0 0 011000 GRANT DIRECT-ARROW 0 0 0 0 0 010402 Recycled Material Sales 0 0 0 0 0 010303 FDLE Fingerprinting 0 0 0 0 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 35200 3 ,200 0 3 ,200 010400 Sale of Goods Outside State Government 0 0 0 0 0 010500 Refugee Flealth 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 DOFI/DOC Interagency Agreement 0 0 0 0 0 008040 BCC Grant/Contract 0 0 0 0 0 011002 ARRA Federal Grant - Sub- Recipient 0 0 0 0 0 OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL 0 21810, 758 2 , 8105758 0 2, 8101758 12, ALLOCABLE REVENUE - COUNTY 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 COUNTY ALLOCABLE REVENUE TOTAL 0 0 0 0 0 13 . BUILDINGS - COUNTY ANNUAL RENTAL EQUIVALENT VALUE 0 0 0 4935142 4931142 GROUNDS MAINTENANCE 0 0 0 0 0 OTT-1ER (SPECIFY) 0 0 0 0 0 INSURANCE 0 0 0 0 0 UTILITIES 0 0 0 159,031 159, 031 OTHER (SPECIFY) 0 0 0 0 0 BUILDING MAINTENANCE 0 0 0 127, 663 127 , 663 BUILDINGS TOTAL 0 0 0 779 , 836 779, 836 14, OTHER COUNTY CONTRIBUTIONS NOT IN CFID TRUST FUND - COUNTY EQUIPMENT/VEHICLE PURCHASES 0 0 0 0 0 Version : 4 Page 6 of 7 ATTACHMENT II. INDIAN RIVER COUNTY HEALTH :DEPARTMENT Part II. Sources of Contributions to County Health Department October 1 , 2010 to September 30, 2011 State CHI) County Total CHD Trust Fund CMD Trust Fund Other (cash) Trust Fund (cash) Contribution Total 14 . OTHER COUNTY CONTRIBUTIONS NOT IN CHD TRUST FUND - COUNTY VEHICLE INSURANCE 0 0 0 0 0 VEI-IICLE MAINTENANCE 0 0 0 0 0 OTHER COUNTY CONTRIBUTION (SPECIFY) 0 0 0 0 0 O"ITIER COUNTY CONTRIBUTION (SPECIFY) 0 0 0 0 0 OTHER COUNTY CONTRIBUTIONS TOTAL 0 0 0 0 0 GRAND TOTAL CHD PROGRAM 459475392 5 , 165 ,799 10 , 113 , 191 45201 , 068 14,3145259 Version : 4 Page 7 of 7 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 , 2010 to September 30, 2011 Quarterly Expenditure Plan FTE ' s Clients Ist 2nd 3rd 4th Grand (0.00) Units Services (Whole dollars only) State County Total A . COMMUNICABLE DISEASE CONTROL : IMMUNIZATION ( 101 ) 5 . 90 8, 830 22,413 125 , 797 107, 826 125, 797 1075825 167, 866 299,379 4673245 STD ( 102) 7 . 85 1 ,490 6, 568 1005938 86, 519 100,938 863519 175 , 841 199 , 073 374,914 A . I . D . S . ( 103) 4 . 27 1 ,272 81538 71 ,276 61 , 093 71 ,276 61 , 093 227 ,602 371136 264, 738 TB CONTROL SERVICES ( 104) 2 .42 922 3 ,460 4066 345873 401686 345873 88,976 62, 142 151 , 118 COMM . DISEASE SURV. ( 106) 1 . 05 0 280 205377 17,467 20,377 17,467 75 ,688 0 75 ,688 HEPATITIS PREVENTION ( 109) 0 . 00 0 0 0 0 0 0 0 0 0 PUBLIC HEALTH PREP AND RESP ( 116) 2. 83 0 75 6701 485115 7701 58, 114 2515831 0 251 , 831 VITAL STATIS"rICS ( 180) 1 . 10 7, 825 20 , 300 13 , 718 11 ,759 13, 718 113759 0 50 ,954 50,954 COMMUNICABLE DISEASE SUBTOTAL 25 .42 20,339 61 ,634 440, 593 3675652 450, 593 377, 650 9875804 64804 11636,488 B. PRIMARY CARE : CHRONIC DISEASE SERVICES (210) 1 . 12 21245 2,025 22,261 19,080 22,261 195080 8202 0 8202 TOBACCO PREVENTION (212) 0 . 00 0 0 0 0 0 0 0 0 0 W . I . C . (221 ) 15 . 51 7 ,900 49, 155 241 ,351 206, 872 241 ,351 206, 873 896,447 0 896,447 FAMILY PLANNING (223) 12 . 08 3 , 070 9,415 196, 679 168 , 582 196, 679 168, 584 2231403 507, 121 730, 524 IMPROVED PREGNANCY OUTCOME (225) 0 . 00 0 0 0 0 0 0 0 0 0 HEALTHY START PRENATAL (227) 4 . 72 735 1500 77,292 665250 77,292 66,250 0 28704 2875084 COMPREHENSIVE CHILD HEALTH (229) 22 . 71 45098 22, 614 389,346 333 , 725 389, 346 3335726 315 , 184 111305959 1 ,446, 143 HEALTHY START INFANT (231 ) 2 . 76 300 71678 45 ,275 38, 807 45 ,275 3808 15 , 537 1521628 168 , 165 SCHOOL HEALTH (234) 5 . 45 0 2475000 955385 81 , 758 95,385 81 , 758 354,286 0 3545286 COMPREHENSIVE ADULT HEALTI-1 (237) 36 . 14 6,941 32, 858 750, 002 642, 859 750,005 642, 851 11028, 558 1 , 757, 159 2, 7855717 DENTAL HEALTH (240) 10 . 59 23545 155949 229 , 739 1963919 2295739 196, 919 336,479 516 , 837 853 ,316 PRIMARY CARE SUBTOTAL 111 . 08 27 , 834 402,494 25047,330 1 , 754, 852 2 ,047 ,333 1 ,754, 849 3 ,252, 576 4,351 , 788 716045364 C . ENVIRONMENTAL HEALTH : Water and Onsite Sewage Programs COASTAL BEACH MONITORING (347) 0 . 23 204 162 73421 65360 71421 61360 27 ,206 356 27, 562 LIMITED USE PUBLIC WATER SYSTEMS (357) 0 . 57 37 490 10, 595 9,081 10, 595 9, 081 22, 503 16, 849 39,352 PUBLIC WATER SYSTEM (35 8) 0 . 12 0 260 25300 1 ,972 2,300 1 ,972 8 ,365 179 81544 PRIVATE WATER SYSTEM (359) 1 . 35 86 770 24,659 21 , 137 24,659 21 , 137 34 , 804 56, 788 91 , 592 INDIVIDUAL SEWAGE DISP. (361 ) 4 . 09 850 35050 71 ,273 61 , 092 71 ,273 61 , 092 25703 7, 127 264 ,730 Group Total 6 .36 1 , 177 4, 732 116,248 9042 116,248 99, 642 350,481 81 ,299 431 , 780 Facility Programs FOOD HYGIENE (348) 0 . 59 99 520 11 ,059 91479 11 , 059 9 ,478 39,915 15160 41 ,075 BODY ART (349) 0 . 03 2 33 762 654 762 654 2, 785 47 2, 832 GROUP CARE FACI LITY (35 1 ) 0 .32 132 252 6, 196 5 ,311 6, 196 5,310 10 , 501 125512 23 , 013 MIGRANT LABORCAMP (352) 0 . 03 4 54 680 583 681 583 1 ,959 568 2, 527 HOUSING , PUBLIC BLDG SAFETY, SANITATION(353)08 48 160 1 , 760 1 , 509 13761 1 , 509 6,422 117 6 , 539 MOBILE HOME AND PARKS SERVICES (354) 0 . 18 53 126 3 ,404 25918 3 ,404 25918 12,386 258 12,644 SWIMMING POOLS/BATHING (360) 1 . 10 348 734 16,934 15 ,944 26,934 17,943 76, 078 1 , 677 77, 755 BIOMEDICAL WASTE SERVICES (364) 0 . 37 123 148 7, 156 65133 7, 156 61133 265008 570 265578 TANNING FACILITY SERVICES (369) 0 . 04 6 13 615 527 615 527 2,238 46 2,284 Group Total 2 . 74 815 21040 48 , 566 43 ,058 58 , 568 455055 178 , 292 16 ,955 195 ,247 Version : 1 Page 1 of 2 ATTACHMENT IIe INDIAN RIVER COUNTY HEALTH DEPARTMENT Part III. Planned Staffing, Clients, Services, And Expenditures By Program Service Area Within Each Level Of Service October 1 , 2010 to September 30, 2011 Quarterly Expenditure Plan FTE' s Clients Ist 2nd 3rd 4th Grand (0.00) Units Services (Whole dollars only) State County Total C . ENVIRONMENTAL HEALTH : Groundwater Contamination STORAGE_ TANK COMPLIANCE (355) 1 . 12 110 270 21 ,357 18 ,306 21 ,357 18 , 307 77,904 1 ,423 79 , 327 SUPER ACT SERVICE (356) 0 . 16 8 42 2,992 2, 565 2,992 2, 566 8, 131 2,984 11 , 115 Group Total 1 . 28 118 312 24,349 20, 871 24,349 20, 873 86, 035 4,407 90 ,442 Community Hygiene OCCUPATIONAL HEALTI-1 (344) 0 . 02 0 47 423 363 423 362 857 714 15571 CONSUMER PRODUCT SAFETY (345) 0 . 64 0 700 13 , 050 11 , 186 13 , 050 115185 47 ,472 999 485471 INJURY PREVENTION (346) 0 . 04 0 0 770 660 770 659 1 , 561 11298 2, 859 LEAD MONITORING SERVICES (350) 0 . 01 2 3 123 105 123 106 251 206 457 PUBLICSEWAGE (362) 0 . 07 13 72 13824 1 , 563 1 , 824 1 , 564 0 63775 6, 775 SOLID WASTE DISPOSAL (363) 0 . 04 0 18 761 652 761 651 1 , 527 1 ,298 2, 825 SANITARY NUISANCE (365 ) 0 . 19 46 343 3 ,706 3 , 176 3 ,706 3 , 176 75514 63250 135764 RABIES SURVEILLANCE/CONTROL SERVICES (366)) 19 25 72 4, 136 3 , 545 4, 136 3 , 547 8407 61957 15 , 364 ARBOVIRUS SURVEILLANCE (367) 0 . 01 0 3 163 140 163 141 333 274 607 RODENT/ARTFIROPOD CONTROL (368) 0 . 01 0 10 313 268 313 267 636 525 1 , 161 WATER POLLU'rION (370) 0 . 33 0 460 7,092 6,079 7,092 61080 0 26,343 26,343 AIR POLLUTION (371 ) 0 . 19 0 70 45684 4, 015 404 4, 013 145366 3, 030 171396 RADIOLOGICAL HEALTH (372) 0 . 01 0 0 187 160 187 161 382 313 695 TOXIC SUBSTANCES (373) 0 . 22 53 112 41464 3, 827 41464 33827 8, 898 79684 16, 582 Group Total 1 . 97 139 010 417696 35 ,739 41 ,696 35 , 739 92,204 62, 666 1547870 ENVIRONMENTAL HEALTH SUBTOTAL 12 . 35 2,249 81994 230, 859 199,310 240, 861 2015309 707,012 1655327 8721339 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 148 . 85 50,422 473 , 122 2, 7185782 2,321 , 814 25738, 787 2,3337808 4,947,392 55165 , 799 10, 113 , 191 Version : 1 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 101642 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 YEAR STATE COUNTY TOTAL 2008-2009 $ $ $ 2009-2010 $ $ $ 2010-2011 $ $ $ 2011 -2012 $ $ $ 2012 -2013 $ $ $ 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. N/A 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 . 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 / IPO ( 225/25 ) 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 . 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 .