Loading...
HomeMy WebLinkAbout2019-146CONTRACT 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 2019-2020 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, 2019. 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 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 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, 2019, through September 30, 2020, 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 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. 1 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. 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 $3,066,815 (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 ll, Part II is an amount not to exceed $717,155 (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 CHD 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 3 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; 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 4 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. 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 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 CHD shall submit quarterly reports to the County that shall include at least the following: 1. The DE385L1 Contract Management Variance Report and the DE580L1 Analysis of Fund Equities Report; ii. A written explanation to the County of service variances reflected in the year end DE385L1 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 CHD's control: 1. March 1, 2020 for the report period October 1, 2019 through December 31, 2019; ii. June 1, 2020 for the report period October 1, 2019 through March 31, 2020; September 1, 2020 for the report period October 1, 2019 through June 30, 2020; and iv. December 1, 2020 for the report period October 1, 2019 through September 30, 2020. 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. 6 b. The County shall ensure 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 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 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 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, 2020, 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: For the County: Mayur Rao Kristin Daniels Name Name Administrative Services Director II Budget Director Title Title 1900 27th Street 1801 27th Street Vero Beach, FI., 32960-3383 Vero Beach, FI., 32960-3383 Address Address 772-794-7464 Telephone 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, 2019. BOARD OF COUNTY COMMISSIONERS STA FOR INDIAN RIVER COUNTY DEPARTOFMENT OFFLORIDA HEALTH NFQTE BY: NAME: Bob Solari TITLE: Chairman 4,r , NAIV E Scott A. Rivkees, MD :couiilLE: Surgeon General and Secretary SIGNED BY: DATE: September 10, 2019 • ATTESTED TO. SIGNED BY: NAME: TITLE: . DATE: L_92 .Qr l l �1 2c q APPROVED AS TO FORM AND LEGAL SUFFICIENCY ,, -------------- BYLO DYLAN PEING flVii,wtirry TTOb�N.fty 8 DATE: SIGNED BY: (3\ )s, )OJ NAME: Miranda C. Hawker, MPH TITLE: CHD Director/Administrator DATE: 14+ (,(; 2019 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 Requirement Sexually Transmitted Disease Program 2. Dental Health 3. Special Supplemental Nutrition Program for Women, Infants and Children (including the WIC Breastfeeding Peer Counseling Program) 4. Healthy Start/ Improved Pregnancy Outcome 5. Family Planning 6. Immunization 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. Requirements as specified in the 2007 Healthy Start Standards and Guidelines and as specified by the Healthy Start Coalitions in contract with each county health department. 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. 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 2 7. Environmental Health 8. HIV/AIDS Program 9. School Health Services 10. Tuberculosis 11. General Communicable Disease Control 12. Refugee Health Program levels as documented in Florida SHOTS and supported by CHD Guidebook policies and technical assistance guidance. Requirements as specified in Environmental Health Programs Manual 150-4* and DHP 50-21* 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. 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. 64F-6. Tuberculosis Program Requirements as specified in F.A.C. 64D-3 and F.S. 392. 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 F.A.C. 64D-3, F.S. 381, F.S. 384 and the CHD Epidemiology Guide to Surveillance and Investigations. 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 2 ATTACHMENT I1 INDIAN RIVER COUNTY HEALTH DEPARTMENT PART I. PLANNED USE OF COUNTY HEALTH DEPARTMENT TRUST FUND BALANCES Estimated State Share of CHD Trust Fund Balance Estimated County Share of CHD Trust Fund Balance Total 1. CHD Trust Fund Ending Balance 09/30/19 2. Drawdown for Contract Year October 1, 2019 to September 30, 2020 85548 282526 368074 -85548 284686 199138 3. Special Capital Project use for Contract Year 0 0 0 October 1, 2019 to September 30, 2020 4. Balance Reserved for Contingency Fund 0 567212 567212 October 1, 2019 to September 30, 2020 Special Capital Projects are new construction or renovation projects and new furniture or equipment associated with these projects, and mobile health vans. Attachment_II_Part_I - Page 1 of 1 ATTACHMENT II INDIAN RIVER COUNTY HEALTH DEPARTMENT Part II, Sources of Contributions to County Health Department October 1, 2019 to September 30, 2020 State CHD County Total CHD Trust Fund CHD Trust Fund Other (cash) Trust Fund (cash) Contribution Total 1. GENERAL REVENUE - STATE 015040 AIDS PATIENT CARE 100,000 0 100,000 0 100,000 015040 CHD • TB COMMUNITY PROGRAM 24,736 0 24,735 0 24,735 015040 DENTAL SPECIAL INITIATIVE PROJECTS 0 0 0 0 0 015040 FAMILY PLANNING GENERAL REVENUE 38,600 0 38,600 0 38,600 015040 PRIMARY CARE PROGRAM 183,226 0 183,226 0 183,226 015040 SCHOOL HEALTH SERVICES - GENERAL REVENUE 136,867 0 136,867 0 136,867 015050 CHD GENERAL REVENUE NON -CATEGORICAL 1,361,058 0 1,361,058 0 1,361,058 GENERAL REVENUE TOTAL 1,844,486 0 1,844,486 0 1,844,486 2. NON GENERAL REVENUE • STATE 015010 ENVIRONMENTAL BIOMEDICAL WASTE PROGRAM NON GENERAL REVENUE TOTAL 8,108 0 8,108 0 8,108 8,108 0 8,108 0 8,108 3. FEDERAL FUNDS - STATE 007000 WIC BREASTFEEDING PEER COUNSELING PROG 50,000 0 50,000 0 50,000 007000 COASTAL BEACH WATER QUALITY MONITORING 10,268 0 10,268 0 10,268 007000 COMPREHENSIVE COMMUNITY CARDIO - PHBG 124,302 0 124,302 0 124,302 007000 FAMILY PLANNING TITLE X - GRANT 53,921 0 53,921 0 53,921 007000 HURRICANE CRISIS COAG FOOD AND WATER 1,025 0 1,025 0 1,025 007000 IMMUNIZATION ACTION PLAN 34,951 0 34,951 0 34,951 007000 MCH SPEC PRJ SOCIAL DETERMINANTS HLTH COMM EDU 23,113 0 23,113 0 23,113 007000 BASE COMMUNITY PREPAREDNESS CAPABILITY 90,819 0 90,819 0 90,819 007000 BASE EMERGENCY OPERATIONS COORDINATON (ESF8) 72,734 0 72,734 0 72,734 007000 WIC PROGRAM ADMINISTRATION 467,655 0 467,655 0 467,655 015075 SUPPLEMENTAL SCHOOL HEALTH 150,068 0 150,068 0 150,068 018005 AIDS DRUG ASSISTANCE PROGRAM ADMIN HQ 39,388 0 39,388 0 39,388 018005 RYAN WHITE TITLE II GRANT/CHD CONSORTIUM 90,000 0 90,000 0 90,000 FEDERAL FUNDS TOTAL 1,208,244 0 1,208,244 0 1,208,244 4. FEES ASSESSED BY STATE OR FEDERAL RULES - STATE 001020 CHD STATEWIDE ENVIRONMENTAL FEES 141,975 0 141,975 0 141,975 001092 CHD STATEWIDE ENVIRONMENTAL FEES 315,679 0 315,679 0 315,679 001206 ON SITE SEWAGE DISPOSAL PERMIT FEES 24,996 0 24,996 0 24,996 001206 SANITATION CERTIFICATES (FOOD INSPECTION) 2,405 0 2,405 0 2,405 001206 SEPTIC TANK RESEARCH SURCHARGE 4,745 0 4,745 0 4,745 001206 SEPTIC TANK VARIANCE FEES 50"% 201 0 201 0 201 001206 PUBLIC SWIMMING POOL PERMIT FEES -10% HQ TRANSFER 1,880 0 1,880 0 1,880 001206 DRINKING WATER PROGRAM OPERATIONS 526 0 526 0 526 001206 REGULATION OF BODY PIERCING SALONS 138 0 138 0 138 001206 TANNING FACILITIES 217 0 217 0 217 001206 ONSITE SEWAGE TRAINING CENTER 95 0 95 0 95 001206 TATTO PROGRAM ENVIRONMENTAL HEALTH 868 0 868 0 868 001206 MOBILE HOME & RV PARK FEES 2,719 0 2,719 0 2,719 FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL 496,444 0 496,444 0 496,444 Attachment_II_Part_II - Page 1 of 3 ATTACHMENT II INDIAN RIVER COUNTY HEALTH DEPARTMENT Part II, Sources of Contributions to County Health Department October 1, 2019 to September 30, 2020 5. OTHER CASH CONTRIBUTIONS - STATE: 090001 DRAW DOWN FROM PUBLIC HEALTH UNIT OTHER CASH CONTRIBUTION TOTAL 6. MEDICAID • STATE/COUNTY: 001148 CHD CLINIC FEES MEDICAID TOTAL State CHD County Total CHD Trust Fund CHD Trust Fund Other (cash) Trust Fund (cash) Contribution Total 0 85,548 85,548 O 0 O 85,548 O 85,548 O 0 0 85,548 O 85,548 O 33,100 33,100 0 33,100 O 33,100 33,100 0 33,100 7. ALLOCABLE REVENUE - STATE: 001004 CHD STATEWIDE ENVIRONMENTAL FEES 3,585 0 3,585 0 3,585 031005 GENERAL CLINIC RABIES SERVICES & DRUG PURCHASES 20,000 0 20,000 0 20,000 ALLOCABLE REVENUE TOTAL 23,585 0 23,585 0 23,585 8. OTHER STATE CONTRIBUTIONS NOT IN CHD TRUST FUND - STATE ADAP 0 0 0 229,196 229,196 PHARMACY DRUG PROGRAM 0 0 0 5,175 5,175 WIC PROGRAM 0 0 0 1,734,366 1,734,366 BUREAU OF PUBLIC HEALTH LABORATORIES 0 0 0 14,825 14,825 IMMUNIZATIONS 0 0 0 463,572 463,572 OTHER STATE CONTRIBUTIONS TOTAL 0 0 0 2,447,134 2,447,134 9. DIRECT LOCAL CONTRIBUTIONS - BCC/TAX DISTRICT 008005 HUMAN AND CHILDRENS SERVICES PROGRAM 0 71,987 71,987 0 71,987 008005 CHD FEDERAL & LOCAL INDIRECT EARNINGS 0 8,420 8,420 0 8,420 008020 CHD LOCAL REVENUE & EXPENDITURES 0 357,376 357,376 0 357,376 008040 CHD LOCAL REVENUE & EXPENDITURES 0 717,155 717,155 0 717,155 DIRECT COUNTY CONTRIBUTIONS TOTAL 0 1,154,938 1,154,938 0 1,154,938 10. FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION - COUNTY 001077 CHD CLINIC FEES 0 20,752 20,752 0 20,752 001094 CHD LOCAL ENVIRONMENTAL FEES 0 235,288 235,288 0 235,288 001110 VITAL STATISTICS CERTIFIED RECORDS 0 201,240 201,240 0 201,240 FEES AUTHORIZED BY COUNTY TOTAL 0 457,280 457,280 0 457,280 11. OTHER CASH AND LOCAL CONTRIBUTIONS - COUNTY 001029 CHD CLINIC FEES 0 3,200 3,200 0 3,200 001090 CHD CLINIC FEES 0 5,400 5,400 0 5,400 010300 INSPECTIONS OF SUMMER FEEDING PROGRAM • DOE 0 4,863 4,863 0 4,863 010300 STATE UNDERGROUND PETROLEUM RESPONSE ACT 0 980 980 0 980 010400 CHD SALE OF SERVICES IN OR OUTSIDE OF STATE GOVT 0 500 500 0 500 011000 REVENUE CONTRACT/MOA W/NO REPORTING REQUIREMENT 0 112,540 112,540 0 112,540 011001 CHD HEALTHY START COALITION CONTRACT 0 2,410 2,410 0 2,410 011001 HEALTHY START NURSE FAM PARTNERSHIP EXPAND CHD 0 80,000 80,000 0 80,000 090002 DRAW DOWN FROM PUBLIC HEALTH UNIT 0 -284,686 -284,686 0 -284,686 Attachment_I I_Part_II - Page 2 of 3 ATTACHMENT II INDIAN RIVER COUNTY HEALTH DEPARTMENT Part II, Sources of Contributions to County Health Department October 1, 2019 to September 30, 2020 OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL 12. ALLOCABLE REVENUE - COUNTY 001004 CHD STATEWIDE ENVIRONMENTAL FEES 031005 GENERAL CLINIC RABIES SERVICES & DRUG PURCHASES 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 State CHD County Total CHD Trust Fund CHD Trust Fund Other (cash) Trust Fund (cash) Contribution Total -74,793 -74,793 l) -74,793 O 3,585 3,585 0 3,585 0 20,000 20,000 0 20,000 O 23,585 23,585 0 23,585 O 0 0 455,938 455,938 O 0 0 0 0 O 0 0 153,560 153,560 O 0 0 82,068 82,068 0 0 0 0 0 O 0 0 0 0 O 0 0 0 0 O 0 0 0 0 O 0 0 691,566 691,566 14. OTHER COUNTY CONTRIBUTIONS NOT IN CHD TRUST FUND - COUNTY EQUIPMENT / VEHICLE PURCHASES 0 0 0 0 0 VEHICLE INSURANCE 0 0 0 0 0 VEHICLE MAINTENANCE 0 0 0 0 0 OTHER COUNTY CONTRIBUTION (SPECIFY) 0 0 0 0 0 OTHER COUNTY CONTRIBUTION (SPECIFY) 0 0 0 0 0 OTHER COUNTY CONTRIBUTIONS TOTAL 0 0 0 0 0 GRAND TOTAL CHD PROGRAM 3,666,415 1,594,110 5,260,525 3,138,700 8,399,225 Attachment_II_Part_II - Page 3 of 3 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, 2019 to September 30, 2020 Quarterly Expenditure Plan FTE's Clients Services/ lat 2nd 3rd 4th Grand - (0.00) Units Visits (Whole dollars only) State County Total A. COMMUNICABLE DISEASE CONTROL: IMMUNIZATION (101) 1.58 1,244 1,713 44,877 52,343 52,343 44,876 54,951 139,488 194,439 SEXUALLY TRANS. DIS. (102) 1.77 532 683 38,955 45,436 45,436 38,956 135,808 32,975 168,783 HIV/AIDS PREVENTION (03A1) 1.43 0 6,436 22,394 26,120 26,120 22,395 97,002 27 97,029 HIV/AIDS SURVEILLANCE (03A2) 0.00 0 0 3 4 4 3 14 0 14 HIV/AIDS PATIENT CARE (03A3) 4.92 335 918 113,404 132,271 132,271 113,404 478,987 12,363 491,350 ADAP (03A4) 0.74 0 0 12,874 15,017 15,017 12,874 55,768 14 55,782 TUBERCULOSIS (104) 1.15 50 114 19,675 22,949 22,949 19,676 77,748 7,501 85,249 COMM. DIS. SURV. (106) 2.99 0 234 54,970 64,116 64,116 54,971 238,173 0 238,173 HEPATITIS (109) 0.00 0 0 0 0 0 0 0 0 0 PREPAREDNESS AND RESPONSE (116) 1.30 0 0 27,834 32,464 32,464 27,834 120,596 0 120,596 REFUGEE HEALTH (118) 0.00 0 0 0 0 0 0 0 0 0 VITAL RECORDS (180) 1.22 7,721 23,974 17,435 20,335 20,335 17,435 0 75,540 75,540 COMMUNICABLE DISEASE SUBTOTAL 17.10 9,882 34,072 352,421 411,055 411,055 352,424 1,269,047 267,908 1,526,955 B. PRIMARY CARE: CHRONIC DISEASE PREVENTION PRO (210) 1.81 14 312 35,870 41,838 41,838 35,871 148,836 6,581 155,417 WIC (21W1) 8.88 4,143 25,612 139,804 163,065 163,065 139,804 605,738 0 605,738 TOBACCO USE INTERVENTION (212) 0.00 0 0 0 0 0 0 0 0 0 WIC BREASTFEEDING PEER COUNSELING (21W2) 1.06 0 1,136 15,620 18,219 18,219 15,621 67,679 0 67,679 FAMILY PLANNING (223) 4.80 935 1,362 89,181 104,019 104,019 89,180 341,898 44,501 386,399 IMPROVED PREGNANCY OUTCOME (225) 0.00 0 0 0 0 0 0 0 0 0 HEALTHY START PRENATAL (227) 0.67 3 79 12,482 14,558 14,558 12,482 0 54,080 54,080 COMPREHENSIVE CHILD HEALTH (229) 0.38 77 164 8,517 9,934 9,934 8,517 0 36,902 36,902 HEALTHY START CHILD (231) 0.60 0 0 11,377 13,270 13,270 11,376 0 49,293 49,293 SCHOOL HEALTH (234) 3.47 0 38,619 79,809 93,087 93,087 79,808 344,791 1,000 345,791 COMPREHENSIVE ADULT HEALTH (237) 9.89 764 1,823 196,294 228,952 228,952 196,294 192,925 657,567 850,492 COMMUNITY HEALTH DEVELOPMENT (238) 0.64 0 1,006 12,061 14,068 14,068 12,060 52,257 0 52,257 DENTAL HEALTH (240) 0.00 0 0 0 0 0 0 0 0 0 PRIMARY CARE SUBTOTAL 32.20 5,936 70,113 601,016 701,010 701,010 601,013 1,754,124 849,924 2,604,048 C. ENVIRONMENTAL HEALTH: Water and Onsite Sewage Programa COSTAL BEACH MONITORING (347) 0.09 58 65 3,442 4,015 4,015 3,442 14,865 49 14,914 LIMITED USE PUBLIC WATER SYSTEMS (357) 0.37 26 398 7,365 8,591 8,591 7,365 15,604 16,308 31,912 PUBLIC WATER SYSTEM (358) 0.10 3 214 1,813 2,115 2,115 1,813 27 7,829 7,856 PRIVATE WATER SYSTEM (359) 1.31 8 1,247 25,230 29,428 29,428 25,230 479 108,837 109,316 ONSITE SEWAGE TREATMENT & DISPOSAL (361) 5.62 1,594 5,903 96,638 112,716 112,716 96,639 322,514 96,195 418,709 Group Total 7.49 1,689 7,827 134,488 156,865 156,865 134,489 353,489 229,218 582,707 Facility Programs TATTOO FACILITY SERVICES (344) 0.12 95 51 1,959 2,286 2,286 1,959 8,322 168 8,490 FOOD HYGIENE (348) 0.84 125 533 15,325 17,875 17,875 15,324 41,370 25,029 66,399 Attachment_II_Part_III - Page 1 of 2 ATTACHMENT II INDIAN RIVER COUNTY HEALTH DEPARTMENT Part III, Planned Staffing. Clients, Services and Expenditures By Program Service Area Within Each Level of Service October 1, 2019 to September 30, 2020 Quarterly Expenditure Plan FTE's Clients Services/ 1st 2nd 3rd 4th Grand (0.00) Units Visits _ (Whole dollars only) MI& State County Total BODY PIERCING FACILITIES SERVICES (349) 0.02 6 8 360 420 420 361 1,550 11 1,561 GROUP CARE FACILITY (351) MIGRANT LABOR CAMP (352) HOUSING & PUB. BLDG. (353) MOBILE HOME AND PARK (354) POOLSBATHING PLACES (360) BIOMEDICAL WASTE SERVICES (364) TANNING FACILITY SERVICES (369) Group Total Groundwater Contamination 0.34 65 109 6,304 7,352 7,352 6,304 19,436 7,876 27,312 0.07 4 29 1,332 1,553 1,553 1,332 5,223 547 5,770 0.15 0 25 3,079 3,591 3,591 3,080 133 13,208 13,341 0.19 57 124 3,389 3,953 3,953 3,388 11,759 2,924 14,683 1.06 380 1,257 18,665 21,771 21,771 18,666 72,800 8,073 80,873 0.78 528 742 13,063 15,236 15,236 13,064 56,021 578 56,599 0.01 4 7 299 349 349 300 1,292 5 1,297 3.58 1,264 2,885 63,775 74,386 74,386 63,778 217,906 58,419 276,325 STORAGE TANK COMPLIANCE SERVICES (355) 0.00 0 0 0 0 0 0 0 0 0 SUPER ACT SERVICES (356) 0.06 8 21 1,068 1,245 1,245 1,068 16 4,610 4,626 Group Total- 0.06 8 21 1,068 1,245 1,245 1,068 16 4,610 4,626 Community Hygiene COMMUNITY ENVIR. HEALTH (345) 0.33 0 774 6,060 7,069 7,069 6,060 8,928 17,330 26,258 INJURY PREVENTION (346) 0.00 0 0 0 0 0 0 0 0 0 LEAD MONITORING SERVICES (350) 0.01 0 0 117 136 136 117 502 4 506 PUBLIC SEWAGE (362) 0.52 1 380 9,106 10,621 10,621 9,106 145 39,309 39,454 SOLID WASTE DISPOSAL SERVICE (363) 0.02 0 14 397 463 463 396 7 1,712 1,719 SANITARY NUISANCE (365) 0.15 28 8 3,317 3,869 3,869 3,318 5,030 9,343 14,373 RABIES SURVEILLANCE (366) 0.29 43 117 6,126 7,145 7,145 6,126 9,288 17,254 26,542 ARBORVIRUS SURVEIL. (367) 0.05 0 5 811 946 946 810 1,229 2,284 3,513 RODENT/ARTHROPOD CONTROL (368) 0.00 0 0 111 130 130 111 1 481 482 WATER POLLUTION (370) 0.14 0 70 2,811 3,278 3,278 2,811 12,105 73 12,178 INDOOR AIR (371) 0.15 0 36 3,099 3,614 3,614 3,099 43 13,383 13,426 RADIOLOGICAL HEALTH (372) 0.01 0 0 151 177 177 151 2 654 656 TOXIC SUBSTANCES (373) 0.18 14 47 3,573 4,167 4,167 3,573 5,263 10,217 15,480 Group Total 1.85 86 1,451 35,679 41,615 41,615 35,678 42,543 112,044 154,587 ENVIRONMENTAL HEALTH SUBTOTAL 12.98 3,047 12,184 235,010 274,111 274,111 235,013 613,954 404,291 1,018,245 D. NON -OPERATIONAL COSTS: NONOPERATIONAL COSTS (599) 1.00 0 0 16,615 19,379 19,379 16,614 0 71,987 71,987 ENVIRONMENTAL HEALTH SURCHARGE (399) 0.00 0 0 8,953 10,442 10,442 8,953 38,790 0 38,790 MEDICAID BUYBACK (611) 0.00 0 0 115 135 135 115 500 0 500 NON -OPERATIONAL COSTS SUBTOTAL 1.00 0 0 25,683 29,956 29,956 25,682 39,290 71,987 111,277 TOTAL CONTRACT 63.28 18,865 116,369 1,214,129 1,416,132 1,416,132 1,214,132 3,666,415 1,594,110 5,260,525 Attachment a Part W - 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_III - Page 1 of 1 Attachment IV Fiscal Year - 2019 - 2020 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 Hlth, etc) Lease/ Agreement Number Type of Agreement (Private Lease thru Sate 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 NIA County Owned Commissioners for Indian River County 36,475 63.28 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_IV - Page 1 of 1 CONTRACT YEAR 2018-2019* 2019-2020** 2020-2021*** 2021-2022*** PROJECT TOTAL PROJECT NUMBER: PROJECT NAME: LOCATION/ADDRESS: ATTACHMENT V INDIAN RIVER COUNTY HEALTH DEPARTMENT SPECIAL PROJECTS SAVINGS PLAN NOT APPLICABLE CASH RESERVED OR ANTICIPATED TO BE RESERVED FOR PROJECTS STATE 0 $ 0 $ 0 $ 0 $ 0 $ COUNTY TOTAL 0 $ 0 0 $ 0 0 $ 0 0 $ 0 0 $ 0 SPECIAL PROJECTS CONSTRUCTION/RENOVATION PLAN PROJECT TYPE: NEW BUILDING ROOFING RENOVATION PLANNING STUDY NEW ADDITION OTHER SQUARE FOOTAGE: 0 PROJECT SUMMARY: Describe scope of work in reasonable detail. START DATE (Initial expenditure of funds) : COMPLETION DATE: DESIGN FEES: $ 0 CONSTRUCTION COSTS: $ 0 FURNITURE/EQUIPMENT: $ 0 TOTAL PROJECT COST: $ 0 COST PER SQ FOOT: $ 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 9/30/19 ** Cash to be transferred to FCO account. *** Cash anticipated for future contract years. Attachment_V - Page 1 of 1