HomeMy WebLinkAbout2018-164CONTRACT BETWEENCE/V�
INDIAN RIVER COUNTY BOARD OF COUNTY COMMISSIONERS
AND OCT 1 6 2019
STATE OF FLORIDA DEPARTMENT OF HEALTH
FOR OPERATION OF THE
INDIAN RIVER COUNTY HEALTH DEPARTMENT
CONTRACT YEAR 2018-2019
This contract 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, 2018.
RECITALS
A. Pursuant to Chapter 154, Florida Statutes, 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 created County
Health Departments.
D. It is necessary for the parties hereto to enter into this contract in order to ensure
coordination between the State and the County in the operation of the CHID.
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 foregoing recitals are true and correct
and incorporated herein by reference.
2. TERM. The parties mutually agree that this contract shall be effective from October 1,
2018, through September 30, 2019, or until a written contract replacing this contract is
entered into between the parties, whichever is later, unless this contract is otherwise
terminated pursuant to the termination provisions set forth in paragraph 8. below.
3. SERVICES MAINTAINED BY THE CHID. 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.
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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 is 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 $ 3,037,042
(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,
other cash or local contributions) as provided in Attachment II, Part II is an
amount not to exceed $ 696,267 (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 contract in the County Health
2
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 contract 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, Office of Budget and
Revenue Management. If the County initiates the increase/decrease, the County shall notify
the CHD. The CHID will then revise the Attachment II and send a copy of the revised pages
to the Department of Health, Office of Budget and Revenue Management.
e. The name and address of the official payee to whom payments shall be made is:
County Health Department Trust Fund
Indian River County Health Department
Accounts Receivable, 1900 27th 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 Secretary for County Health Systems. The
director/administrator shall be selected by the State with the concurrence of the County. The
director/administrator of the CHD shall ensure that non -categorical sources of funding are
used to fulfill public health priorities in the community and the Long Range Program Plan.
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
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maintained by the CHD in accordance with the terms of this contract. 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 the
Generally Accepted Accounting Principles (GAAP), as promulgated by the 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 paragraphs 6.i. and
6.k., 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
Information Resource (FLAIR) System;
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;
N. 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 this 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 which has been
credited to each participating governmental entity. The planned use of surplus funds shall be
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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 Secretary for
County Health Systems has approved the transfer. The Deputy Secretary for County Health
Systems 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 contract. 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 contract for a period of five (5) years after termination of this contract. 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. 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.
1
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 contract.
n. The CHD shall comply with the provisions contained in the Civil Rights Certificate,
hereby incorporated into this contract as Attachment III.
o. The CHID shall submit quarterly reports to the County that shall include at least the
following:
The DE3851_1 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
year end DE3851_1 report if the variance exceeds or falls below 25 percent
of the planned expenditure amount for the contract year. 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, Office of Budget and Revenue
Management.
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
CND's control:
March 1, 2019 for the report period October 1, 2018 through
December 31, 2018;
ii. June 1, 2019 for the report period October 1, 2018 through
March 31, 2019;
iii. September 1, 2019 for the report period October 1, 2018
through June 30, 2019; and
iv. December 1, 2019 for the report period October 1, 2018
through September 30, 2019.
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.
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b. The County shall ensure adequate fire and casualty insurance coverage for County -
owned CHID offices and buildings and for all furnishings and equipment in CHID 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 ensure 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 CHID 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 CHID and the proceeds returned to the County Health Department Trust Fund.
8. TERMINATION.
a. Termination at Will. This contract 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 contract
become unavailable, either party may terminate this contract 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 contract 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 contract 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 contract.
9. MISCELLANEOUS. The parties further agree:
a. Availability of Funds. If this contract, any renewal hereof, or any term, performance or
payment hereunder, extends beyond the fiscal year beginning July 1, 2019, it is agreed that
the performance and payment under this contract 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 contract are as follows:
For the State:
Mayur Rao
Name
Business Manager
For the County:
Michael R Symkowski
Name
Budget Director
190027 th Street
Vero Beach, FI., 32960-3383
Address
772-794-7464
Telephone
1801 27th Street
Vero Beach, FI., 32960-3383
Address
772-567-8000 Ext. 1214
Telephone
If different contract managers are designated after execution of this contract, 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 contract.
c. Captions. The captions and headings contained in this contract are for the
convenience of the parties only and do not in any way modify, amplify, or give additional
notice of the provisions hereof.
In WITNESS THEREOF, the parties hereto have caused this eight page contract, with its
attachments as referenced, including Attachment I (two pages), Attachment II (six pages),
Attachment III (one page), Attachment IV (one page), and Attachment V (one page), to be
executed by their undersigned officials as duly authorized effective the 1St day of October,
2018.
BOARD OF COUNTY COMMISSIONERS STATE OF FLORIDA
FOR INDIAN RIVER COUNTY •.,�o��jiv C9A, PARTMENT OF HEALTH
SIGNED BY: _ SIg4l� D BY:
--�, 2f
P--
NAME: Peter D. o'sryan ?�'�'E: Celeste Philip, MD, MPH F
L(Jul TY.
TITLE: Chairman ... TITLE: Surgeon General and Secretary
DATE: September 11, 2018 DATE: �� /a Al
ATTESTED TO: Jeffrey R. Smith, Clerk _
// ��)j of,,,,//Co d C troller
SIGNED BY:WA ICSIGNED BY:
AV
NAME: Rhonda Zirkle NAME: Miranda . Hawker, MPH
TITLE: Deputy Clerk TITLE: CHD Administrator
DATE: September 11, 2018 DATE: 9 A I/V
APPROVED AS TO FORM
AND LEGAL SU'F=r=iC F
BY 8
DYLA►`., RFINGOLL,
Cle WNTY ATTORNEY
ATTACHMENT I
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
1. Sexually Transmitted Disease
Program
2. Dental Health
3. Special Supplemental Nutrition
Program for Women, Infants and
Children (including the WIC
Breastfeeding Peer Counseling
Program)
Requirement
Requirements as specified in F.A.C. 64D-3, F.S. 381 and F.S. 384.
Periodic financial and programmatic reports as specified by the
program office.
Service documentation and monthly financial reports as specified in
DHM 150-24* and all federal, state and county requirements
detailed in program manuals and published procedures.
4. Healthy Start/ Improved Pregnancy Requirements as specified in the 2007 Healthy Start Standards and
Outcome Guidelines and as specified by the Healthy Start Coalitions in
contract with each county health department.
5. Family Planning Requirements as specified in Public Law 91-572, 42 U.S.C. 300, et
seq., 42 CFR part 59, subpart A, 45 CFR parts 74 & 92, 2 CFR 215
(OMB Circular A-110) OMB Circular A-102, F.S. 381.0051, F.A.C.
64F-7, F.A.C. 64F-16, and F.A.C. 64F-19. Requirements and
Guidance as specified in the Program Requirements for Title X
Funded Family Planning Projects (Title X Requirements)(2014) and
the Providing Quality Family Planning Services (QFP):
Recommendations of CDC and the U.S. Office of Population Affairs
published on the Office of Population Affairs website.
Programmatic annual reports as specified by the program office as
specified in the annual programmatic Scope of Work for Family
Planning and Maternal Child Health Services, including the Family
Planning Annual Report (FPAR), and other minimum guidelines as
specified by the Policy Web Technical Assistance Guidelines.
6. Immunization Periodic reports as specified by the department pertaining to
immunization levels in kindergarten and/or seventh grade pursuant
to instructions contained in the Immunization Guidelines -Florida
Schools, Childcare Facilities and Family Daycare Homes (DH Form
150-615) and Rule 64D-3.046, F.A.C. In addition, periodic reports
as specified by the department pertaining to the
surveillance/investigation of reportable vaccine -preventable
diseases, adverse events, vaccine accountability, and assessment
of immunization
ATTACHMENT I (Continued)
Attachment_I - Page 1 of 11
levels as documented in Florida SHOTS and supported by CHD
Guidebook policies and technical assistance guidance.
Environmental Health Requirements as specified in Environmental Health Programs
Manual 150-4* and DHP 50-21*
HIV/AIDS Program Requirements as specified in F.S. 384.25 and F.A.C. 64D-3.030
and 64D-3.031. Case reporting should be on Adult HIV/AIDS
Confidential Case Report CDC Form DH2139 and Pediatric
HIV/AIDS Confidential Case Report CDC Form DH2140.
Requirements as specified in F.A.C. 64D-2 and 64D-3, F.S. 381 and
F.S. 384. Socio -demographic and risk data on persons tested for
HIV in CHD clinics should be reported on Lab Request DH Form
1628 in accordance with the Forms Instruction Guide.
Requirements for the HIV/AIDS Patient Care programs are found in
the Patient Care Contract Administrative Guidelines.
9. School Health Services Requirements as specified in the Florida School Health
Administrative Guidelines (May 2012). Requirements as specified
in F.S. 381.0056, F.S. 381.0057, F.S. 402.3026 and F.A.C. 6417-6.
10. Tuberculosis Tuberculosis Program Requirements as specified in F.A.C. 64D-3
and F.S. 392.
11. General Communicable Disease Carry out surveillance for reportable communicable and other acute
Control diseases, detect outbreaks, respond to individual cases of
reportable diseases, investigate outbreaks, and carry out
communication and quality assurance functions, as specified in
F.A.C. 64D-3, F.S. 381, F.S. 384 and the CHD Epidemiology Guide
to Surveillance and Investigations.
12. Refugee Health Program Programmatic and financial requirements as specified by the
program office.
.or the subsequent replacement if adopted during the contract period.
Attachment_I - Page 2 of 11
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 09/30/18
54381 396374 450755
2. Drawdown for Contract Year
October 1, 2018 to September 30, 2019
-54381 -97323 -151704
3. Special Capital Project use for Contract Year
October 1, 2018 to September 30, 2019
C
4. Balance Reserved for Contingency Fund
October 1, 2018 to September 30, 2019
0 0
0 299051 299051
Special Capital Projects are new construction or renovation projects and new furniture or equipment associated with these projects, and mobile health vans.
Attach ment_II_Part_I - Page 3 of 11
ATTACHMENT II
INDIAN RIVER COUNTY HEALTH DEPARTMENT
Part II, Sources of Contributions to County Health Department
October 1, 2018 to September 30, 2019
1. GENERAL REVENUE - STATE
015040 AIDS PATIENT CARE
015040 CHD - TB COMMUNITY PROGRAM
015040 DENTAL SPECIAL INITIATIVE PROJECTS
015040 FAMILY PLANNING GENERAL REVENUE
015040 PRIMARY CARE PROGRAM
015040 SCHOOL HEALTH SERVICES - GENERAL REVENUE
015050 CHD GENERAL REVENUE NON -CATEGORICAL
GENERAL REVENUE TOTAL
2. NON GENERAL REVENUE - STATE
015010 ENVIRONMENTAL BIOMEDICAL WASTE PROGRAM
NON GENERAL REVENUE TOTAL
3. FEDERAL FUNDS - STATE
007000 WIC BREASTFEEDING PEER COUNSELING PROG
007000 COASTAL BEACH WATER QUALITY MONITORING
007000 COMPREHENSIVE COMMUNITY CARDIO - PHBG
007000 CMS -MCH PURCHASED CLIENT SERVICES
007000 FAMILY PLANNING TITLE X - GRANT
007000 IMMUNIZATION ACTION PLAN
007000 MCH SPECIAL PRJCT UNPLANNED PREGNANCY
007000 MCH BLOCK GRANT FLORIDA'S HEALTHY BABIES
007000 BASE COMMUNITY PREPAREDNESS CAPABILITY
007000 BASE PUB HLTH SURVEILLANCE & EPI INVESTIGATION
007000 AIDS PREVENTION
007000 WIC PROGRAM ADMINISTRATION
015075 INSPECTIONS OF SUMMER FEEDING PROGRAM - DOE
015075 SUPPLEMENTAL SCHOOL HEALTH
018005 AIDS DRUG ASSISTANCE PROGRAM ADMIN HQ
018005 RYAN WHITE TITLE II GRANT/CHD CONSORTIUM
FEDERAL FUNDS TOTAL
4. FEES ASSESSED BY STATE OR FEDERAL RULES - STATE
001020 CHD STATEWIDE ENVIRONMENTAL FEES
001092 CHD STATEWIDE ENVIRONMENTAL FEES
001206 ON SITE SEWAGE DISPOSAL PERMIT FEES
001206 SANITATION CERTIFICATES (FOOD INSPECTION)
001206 SEPTIC TANK RESEARCH SURCHARGE
001206 SEPTIC TANK VARIANCE FEES 50%
001206 PUBLIC SWIMMING POOL PERMIT FEES -10% HQ TRANSFER
001206 DRINKING WATER PROGRAM OPERATIONS
001206 REGULATION OF BODY PIERCING SALONS
001206 TANNING FACILITIES
001206 ONSITE SEWAGE TRAINING CENTER
State CHD
County
Total CHD
Trust Fund
CHD
Trust Fund Other
(cash)
Trust Fund
(cash) Contribution
Total
100,000
0
100,000
0
100,000
24,243
0
24,243
0
24,243
5,977
0
5,977
0
5,977
42,593
0
42,593
0
42,593
183,226
0
183,226
0
183,226
136,867
0
136,867
0
136,867
1,343,145
0
1,343,145
0
1,343,145
1,836,051
0
1,836,051
0
1,836,051
8,113
0
8,113
0
8,113
8,113
0
8,113
0
8,113
49,000
0
49,000
0
49,000
10,420
0
10,420
0
10,420
35,000
0
35,000
0
35,000
14,776
0
14,776
0
14,776
75,357
0
75,357
0
75,357
34,951
0
34,951
0
34,951
2,984
0
2,984
0
2,984
25,402
0
25,402
0
25,402
92,396
0
92,396
0
92,396
71,434
0
71,434
0
71,434
63,894
0
63,894
0
63,894
441,800
0
441,800
0
441,800
6,273
0
6,273
0
6,273
150,068
0
150,068
0
150,068
35,396
0
35,396
0
35,396
90,000
0
90,000
0
90,000
1,199,151
0
1,199,151
0
1,199,151
132,317
0
132,317
0
132,317
270,002
0
270,002
0
270,002
24,996
0
24,996
0
24,996
2,405
0
2,405
0
2,405
4,745
0
4,745
0
4,745
201
0
201
0
201
1,292
0
1,292
0
1,292
523
0
523
0
523
138
0
138
0
138
217
0
217
0
217
95
0
95
0
95
Attachment -11 -Part -11 -Page 4 of 11
ATTACHMENT II
INDIAN RIVER COUNTY HEALTH DEPARTMENT
Part II, Sources of Contributions to County Health Department
October 1, 2018 to September 30, 2019
State CHD County Total CHD
Trust Fund CHD Trust Fund Other
(cash) Trust Fund (cash) Contribution
001206 TATTO PROGRAM ENVIRONMENTAL HEALTH 868 868 0
001206 MOBILE HOME & RV PARK FEES 1,698 0 1,698 0
FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL 439,497 0 439,497 0
6. OTHER CASH CONTRIBUTIONS - STATE:
090001 DRAW DOWN FROM PUBLIC HEALTH UNIT
OTHER CASH CONTRIBUTION TOTAL
6. MEDICAID • STATE/COUNTY
001057 CHD CLINIC FEES
001148 CHD CLINIC FEES
MEDICAID TOTAL
7. ALLOCABLE REVENUE - STATE:
001004 CHD STATEWIDE ENVIRONMENTAL FEES
031005 GENERAL CLINIC RABIES SERVICES & DRUG PURCHASES
031005 SPECIAL HEALTH TRANSFER
ALLOCABLE REVENUE TOTAL
8. OTHER STATE CONTRIBUTIONS NOT IN CHD TRUST FUND - STATE
ADAP
PHARMACY DRUG PROGRAM
WIC PROGRAM
BUREAU OF PUBLIC HEALTH LABORATORIES
IMMUNIZATIONS
OTHER STATE CONTRIBUTIONS TOTAL
9. DIRECT LOCAL CONTRIBUTIONS - BCC/TAX DISTRICT
008005 HUMAN AND CHILDRENS SERVICES PROGRAM
008005 CHD FEDERAL & LOCAL INDIRECT EARNINGS
008020 CHD LOCAL REVENUE & EXPENDITURES
008040 CHD LOCAL REVENUE & EXPENDITURES
DIRECT COUNTY CONTRIBUTIONS TOTAL
10. FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION - COUNTY
001025 CHD CLINIC FEES
001077 CHD CLINIC FEES
001094 CHD LOCAL ENVIRONMENTAL FEES
001110 VITAL STATISTICS CERTIFIED RECORDS
FEES AUTHORIZED BY COUNTY TOTAL
11. OTHER CASH AND LOCAL CONTRIBUTIONS - COUNTY
001029 CHD CLINIC FEES
001090 CHD CLINIC FEES
006000 CHD LOCAL REVENUE & EXPENDITURES
868
1,698
439,497
0
0
0
0
0
54,381
0
54,381
0
54,381
54,381
0
54,381
0
54,381
0
98,189
98,189
0
98,189
0
949,145
949,145
0
949,145
0
1,047,334
1,047,334
0
1,047,334
2,100
0
2,100
0
2,100
15,000
0
15,000
0
15,000
23,500
0
23,500
0
23,500
40,600
0
40,600
0
40,600
0
0
0
206,578
206,578
0
0
0
9,492
9,492
0
0
0
1,842,919
1,842,919
0
0
0
18,352
18,352
0
0
0
399,870
399,870
0
0
0
2,477,211
2,477,211
0
66,478
66,478
0
66,478
0
24,460
24,460
0
24,460
0
951,944
951,944
0
951,944
0
696,267
696,267
0
696,267
0
1,739,149
1,739,149
0
1,739,149
0
12,164
12,164
0
12,164
0
216,392
216,392
0
216,392
0
90,289
90,289
0
90,289
0
217,944
217,944
0
217,944
0
536,789
536,789
0
536,789
0
33,741
33,741
0
33,741
0
23,811
23,811
0
23,811
0
1,489
1,489
0
1,489
AttachmeM_II_Part_II
- Page 5 of 11
010300 STATE UNDERGROUND PETROLEUM RESPONSE ACT
010300 CHD SALE OF SERVICES IN OR OUTSIDE OF STATE GOVT
010400 CHD SALE OF SERVICES IN OR OUTSIDE OF STATE GOVT
011000 REVENUE CONTRACT/MOA W/NO REPORTING REQUIREMENT
011000 CHD CASH DONATION / NON-SPECIFIC
011000 CHD LOCAL REVENUE & EXPENDITURES
011001 CHD HEALTHY START COALITION CONTRACT
090002 DRAW DOWN FROM PUBLIC HEALTH UNIT
OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL
12. ALLOCABLE REVENUE - COUNTY
001004 CHD STATEWIDE ENVIRONMENTAL FEES
031005 GENERAL CLINIC RABIES SERVICES & DRUG PURCHASES
031005 SPECIAL HEALTH TRANSFER
COUNTY ALLOCABLE REVENUE TOTAL
13. BUILDINGS • COUNTY
ANNUAL RENTAL EQUIVALENT VALUE
OTHER (Specify)
UTILITIES
BUILDING MAINTENANCE
GROUNDS MAINTENANCE
INSURANCE
OTHER (Specify)
OTHER (Specify)
BUILDINGS TOTAL
.CHMENT II
NTY HEALTH DEPARTMENT
itions to County Health Department
B to September 30, 2019
14. OTHER COUNTY CONTRIBUTIONS NOT IN CHD TRUST FUND - COUNTY
EQUIPMENT / VEHICLE PURCHASES
VEHICLE INSURANCE
VEHICLE MAINTENANCE
OTHER COUNTY CONTRIBUTION (SPECIFY)
OTHER COUNTY CONTRIBUTION (SPECIFY)
OTHER COUNTY CONTRIBUTIONS TOTAL
GRAND TOTAL CHD PROGRAM
State CHD
County
Total CHD
Trust Fund
CHD
Trust Fund
Other
(cash)
Trust Fund
(cash)
Contribution
Total
0
967
967
0
967
0
396
396
0
396
0
1,679
1,679
0
1,679
0
15,402
15,402
0
15,402
0
2,000
2,000
0
2,000
0
70,165
70,165
0
70,165
0
2,243
2,243
0
2,243
0
97,323
97,323
0
97,323
0
249,216
249,216
0
249,216
0
2,100
2,100
0
2,100
0
15,000
15,000
0
15,000
0
23,500
23,500
0
23,500
0
40,600
40,600
0
40,600
0
0
0
455,938
455,938
0
0
0
0
0
0
0
0
153,560
153,560
0
0
0
82,068
82,068
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
691,566
691,566
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3,577,793
3,613,088
7,190,881
3,168,777
10,359,658
Attachment_II_Part_II - Page 6 of 11
Attachment_II-Part _III - Page 7 of 7 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,
2018 to September
30,
2019
Quarterly
Expenditure Plan
FTE's
Clients Services/
let
2nd
3rd
4th
Grand
(0.00)
Units
Visits
A
(Whole dollars
only)
a
State
County
Total
A. COMMUNICABLE DISEASE CONTROL:
IMMUNIZATION (101)
2.61
1,771
2,381
55,639
64,896
55,639
64,895
141,556
99,513
241,069
SEXUALLY TRANS. DIS. (102)
3.31
910
1,169
52,307
61,010
52,307
61,011
190,372
36,263
226,635
HIV/AIDS PREVENTION (03A1)
1.55
0
7,825
25,534
29,782
25,534
29,781
106,262
4,369
110,631
HIV/AIDS SURVEILLANCE (03A2)
0.00
0
0
7
8
7
9
30
1
31
HIV/AIDS PATIENT CARE (03A3)
2.16
382
638
48,392
56,443
48,392
56,442
176,552
33,117
209,669
ADAP (03A4)
0.65
1
1
10,992
12,821
10,992
12,822
46,852
775
47,627
TUBERCULOSIS (104)
1.24
174
291
21,319
24,866
21,319
24,867
24,243
68,128
92,371
COMM. DIS. SURV. (106)
2.94
0
230
50,584
59,000
50,584
58,999
132,112
87,055
219,167
HEPATITIS (109)
0.00
0
0
0
0
0
0
0
0
0
PREPAREDNESS AND RESPONSE (116)
1.36
0
1
28,586
33,342
28,586
33,341
123,855
0
123,855
REFUGEE HEALTH (118)
0.00
0
0
0
0
0
0
0
0
0
VITAL RECORDS (180)
1.17
6,299
18,893
16,246
18,949
16,246
18,949
0
70,390
70,390
COMMUNICABLE DISEASE SUBTOTAL
16.99
9,537
31,429
309,606
361,117
309,606
361,116
941,834
399,611
1,341,445
B. PRIMARY CARE:
CHRONIC DISEASE PREVENTION PRO (210)
0.35
702
307
11,115
12,964
11,115
12,964
40,346
7,812
48,158
WIC (21WD
8.56
4,175
24,481
128,024
149,324
128,024
149,323
554,695
0
554,695
TOBACCO USE INTERVENTION (212)
0.00
0
0
0
0
0
0
0
0
0
WIC BREASTFEEDING PEER COUNSELING (21W2)
1.30
0
2,272
15,245
17,782
15,245
17,782
66,054
0
66,054
FAMILY PLANNING (223)
7.00
1,285
1,953
113,106
131,925
113,106
131,925
254,678
235,384
490,062
IMPROVED PREGNANCY OUTCOME (225)
0.00
0
0
0
0
0
0
0
0
0
HEALTHY START PRENATAL (227)
0.06
5
74
706
823
706
823
0
3,058
3,058
COMPREHENSIVE CHILD HEALTH (229)
7.41
1,395
3,211
119,084
138,898
119,084
138,898
0
515,964
515,964
HEALTHY START CHILD (231)
0.00
0
0
0
0
0
0
0
0
0
SCHOOL HEALTH (234)
4.04
0
25,701
78,694
91,786
78,694
91,786
340,210
750
340,960
COMPREHENSIVE ADULT HEALTH (237)
23.45
2,663
6,068
459,947
536,472
459,947
536,473
495,985
1,496,854
1,992,839
COMMUNITY HEALTH DEVELOPMENT (238)
1.51
0
1,713
28,197
32,888
28,197
32,889
98,671
23,500
122,171
DENTAL HEALTH (240)
8.97
2,856
5,788
157,667
183,899
157,667
183,899
116,299
566,833
683,132
PRIMARY CARE SUBTOTAL
62.65
13,081
71,568
1,111,785
1,296,761
1,111,785
1,296,762
1,966,938
2,850,155
4,817,093
C. ENVIRONMENTAL HEALTH:
Water and Onsite Sewage Programa
COSTAL BEACH MONITORING (347)
0.14
116
119
3,883
4,529
3,883
4,528
16,769
54
16,823
LIMITED USE PUBLIC WATER SYSTEMS (357)
0.25
36
407
4,404
5,137
4,404
5,136
16,824
2,257
19,081
PUBLIC WATER SYSTEM (358)
0.08
4
115
1,372
1,600
1,372
1,599
1,679
4,264
5,943
PRIVATE WATER SYSTEM (359)
1.32
5
1,653
23,698
27,641
23,698
27,641
218
102,460
102,678
ONSITE SEWAGE TREATMENT & DISPOSAL (361)
5.85
1,506
5,331
92,721
108,148
92,721
108,149
398,039
3,700
401,739
Group Total
7.64
1,667
7,625
126,078
147,055
126,078
147,053
433,529
112,735
546,264
Facility Programs
TATTOO FACILITY SERVICES (344)
0.10
0
34
1,663
1,940
1,663
1,940
7,168
38
7,206
FOOD HYGIENE (348)
0.46
86
433
8,073
9,416
8,073
9,415
34,788
189
34,977
Attachment_II-Part _III - Page 7 of 7 7
ATTACHMENT II
INDIAN RIVER COUN'T'Y HEALTH DEPARTMENT
Part III, Planned Staffing. Clients, Services and Expenditures By Program Service Area Within Each Level of Service
October 1 2018 to September 30 2019
Quarterly Expenditure Plan
FTE's Clients Services/ let 2nd 3rd 4th
(0.00) sits Visits s (Whole dollars only) State
BODY PIERCING FACILITIES SERVICES (349) 0.04 5 9 626 731 626 731 2,6£
GROUP CARE FACILITY (351) 0.48 78 165 7,958 9,282 7,958 9,281 7
MIGRANT LABOR CAMP (352) 0.06 3 19 1,159 1,352 1,159 1,353 1,3£
HOUSING & PUB. BLDG. (353) 0.16 0 33 3,028 3,532 3,028 3,533
MOBILE HOME AND PARK (354) 0.17 57 148 2,783 3,246 2,783 3,247 11,71
POOLS/BATHING PLACES (360) 1.10 424 1,404 18,376 21,433 18,376 21,434 78,%
BIOMEDICAL WASTE SERVICES (364) 0.67 366 423 10,323 12,040 10,323 12,040 43,5E
TANNING FACILITY SERVICES (369) 0.01 8 14 277 323 277 324 1,1E
Group Total 3.25 1,027 2,682 54,266 63,295 54,266 63,298 180,9E
Groundwater Contamination
STORAGE TANK COMPLIANCE SERVICES (355)
SUPER ACT SERVICES (356)
Group Total
Community Hygiene
COMMUNITY ENVIR. HEALTH (345)
INJURY PREVENTION (346)
LEAD MONITORING SERVICES (350)
PUBLIC SEWAGE (362)
SOLID WASTE DISPOSAL SERVICE (363)
SANITARY NUISANCE (365)
RABIES SURVEILLANCE (366)
ARBORVIRUS SURVEIL. (367)
RODENT/ARTHROPOD CONTROL (368)
WATER POLLUTION (370)
INDOOR AIR (371)
RADIOLOGICAL HEALTH (372)
TOXIC SUBSTANCES (373)
Group Total
ENVIRONMENTAL HEALTH SUBTOTAL
D. NON -OPERATIONAL COSTS:
NONOPERATIONAL COSTS (599)
ENVIRONMENTAL HEALTH SURCHARGE (399)
MEDICAID BUYBACK (611)
NONOPERATIONAL COSTS SUBTOTAL
TOTAL CONTRACT
County
16
34,400
3,628
13,064
335
1,297
1,192
5
54,164
Grand
Total
K
2,714
34,479
5,023
13,121
12,059
79,619
44,726
1,201
235,125
0.00
0
0
0
0
0
0
0
0
0
0.05
10
20
776
905
776
904
7
3,354
3,361
0.05
10
20
776
905
776
904
7
3,354
3,361
0.29
0
496
4,859
6,668
4,859
5,668
6,070
14,984
21,054
0.00
0
0
0
0
0
0
0
0
0
0.01
0
0
109
127
109
127
469
3
472
0.51
1,361
280
8,345
9,734
8,345
9,734
85
36,073
36,158
0.02
0
40
385
449
385
450
4
1,665
1,669
0.14
23
10
2,815
3,283
2,815
3,282
23
12,172
12,195
0.22
28
76
4,478
5,222
4,478
5,222
37
19,363
19,400
0.04
0
32
616
719
616
720
7
2,664
2,671
0.00
0
0
45
53
45
53
0
196
196
0.17
0
105
3,430
4,001
3,430
4,001
4,310
10,552
14,862
0.22
0
31
4,397
5,128
4,397
5,127
37
19,012
19,049
0.01
0
1
142
166
142
166
154
462
616
0.15
12
30
3,045
3,551
3,045
3,551
3,747
9,445
13,192
1.78
1,424
1,101
32,666
38,101
32,666
38,101
14,943
126,591
141,534
12.72
4,128
11,428
213,786
249,356
213,786
249,356
629,440
296,844
926,284
1.00
0
0
15,343
17,896
15,343
17,896
0
66,478
66,478
0.00
0
0
8,681
10,009
8,581
10,010
37,181
0
37,181
0.00
0
0
554
646
554
646
2,400
0
2,400
1.00
0
0
24,478
28,551
24,478
28,552
39,581
66,478
106,059
93.36
26,746
114,425
1,659,655
1,935,785
1,659,655
1,935,786
3,577,793
3,613,088
7,190,881
Attachment II_Part_III - Page 8 of 11
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—III - Page 9 of 11
Attachment IV
Fiscal Year - 2018 - 2019
Indian River County Health Department
Facilities Utilized by the County Health Department
Complete Location
(Street Address, City, Zip)
Facility Description
And Offical Building
Name (if applicable)
(Admin, Clinic, Envn Hfth,
etc.)
Lease/
Agreement
Number
Type of
Agreement
(Private Lease thru
State or County, other -
please define)
Complete
Legal Name
of Owner
SQ
Feet
Employee
Count
(FTE/OPS/
Contract)
1900 27th Street, Vero Beach,
Florida, 32960-3383
Administration, HR, Clinic, Vital
Statistics, Env. Health, WIC
N/A
County Owned
Commissioners for
Indian River County
36,475
87.99
4675 28th Court, Vero Beach,
Florida, 32967-1330
Clinic
NIA
Indian River County Hospital
District
Indian River County
Hospital District
10,642
10.6
Facility - a fixed site managed by DOH/CHD personnel for the purpose of providing or supporting public health services. Includes county -owned, state-owned, and
leased facilites. Includes DOH/CHD warehouse and administrative sites. Includes facilities managed by DOH/CHD that may be shared with other organizations.
Does not include schools, jails or other facilities where DOH/CHD staff are out -posted or sites where services are provided on an episodic basis. Attachment_lV - Page 10 of 11
CONTRACT YEAR
2017-2018*
2018-2019**
2019-2020***
2020-2021 ***
PROJECT TOTAL
PROJECT NUMBER:
PROJECT NAME:
LOCATION/ADDRESS:
PROJECT TYPE:
SQUARE FOOTAGE:
PROJECT SUMMARY:
ATTACHMENT V
INDIAN RIVER COUNTY HEALTH DEPARTMENT
SPECIAL PROJECTS SAVINGS PLAN
N/A
CASH RESERVED OR ANTICIPATED TO BE RESERVED FOR PROJECTS
STATE
COUNTY
$ 0 $ 0
$ 0 $ 0
$ 0 $ 0
$ 0 $ 0
$ 0 $ 0
SPECIAL PROJECTS CONSTRUCTION/RENOVATION PLAN
NEW BUILDING
RENOVATION
NEW ADDITION
0
Describe scope of work in reasonable detail.
START DATE (Initial expenditure of funds)
COMPLETION DATE:
DESIGN FEES:
CONSTRUCTION COSTS:
FURNITURE/EQUIPMENT:
TOTAL PROJECT COST:
COST PER SQ FOOT:
$ 0
$ 0
$ 0
e n
e
0
ROOFING
PLANNING STUDY
OTHER
TOTAL
$ 0
$ 0
$ 0
$ 0
$ 0
Special Capital Projects are new construction or renovation projects and new furniture or equipment associated with these projects and
mobile health vans.
* Cash balance as of 9/30/18
*` Cash to be transferred to FCO account.
*** Cash anticipated for future contract years.
Attachment_V - Page 11 of 11