HomeMy WebLinkAbout2023-207A TRUE COPY
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CONTRACT BETWEEN RYAN L. BUTLER, CLERK
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 2023-2024
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, 2023. State and County are jointly referred
to as the "parties".
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 the "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 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 is 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,
2023, through September 30, 2024, or until a written contract replacing this contract is entered
into between the parties, whichever is later, unless this contract is otherwise terminated
according to the termination provisions outlined in paragraph 8. below.
3. SERVICES MAINTAINED BY THE CHD. The parties mutually agree that the CHD shall
provide those services as outlined in Part III of Attachment II hereof, 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 that are organized and operated to
protect the health of the general public by monitoring and regulating activities in the
environment that may contribute to the occurrence or transmission of disease. Environmental
health services shall be supported by available federal, state, and local funds and shall include
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RYAN L. BUTLER, CLERK
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 that protect the health of
the general public through the detection, control, and eradication of diseases that 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 outlined 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 $3,839,499(State General
Revenue,- State Funds, Other State Funds and Federal Funds listed on the Schedule C).
The State's obligation to pay under this contract is contingent upon an annual
appropriation by the Legislature.
ii. The County's appropriated responsibility (direct contribution excluding any fees,
othercash, orlocalcontributions) as provided in Attachment II, Part II is an amount
not to exceed $775,604 (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 the 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
Department Trust Fund that is attributed to the CHD shall be carried forward to the next contract
period.
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C. Either party may establish service fees as allowed by law to fund activities o�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 or decrease, the CHD will revise Attachment II and send a copy of
the revised pages to the County and the State's Office of Budget and Revenue Management.
If the County initiates the increase or decrease, the County shall notify the CHD in writing. The
CHD will then revise Attachment II and send a copy of the revised pages to the State's 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 or ADMINISTRATOR. Both parties agree the director or 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 State's Deputy Secretary for County Health Systems. The director
or administrator shall be selected by the State with the concurrence of the County. The director
or 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 outlined in subparagraph b.,
below. All CHD employees shall be State or State -contract personnel subject to State
personnel laws, 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
purchasing contract has been implemented for those goods or services. In such cases, the
CHD director or administrator must sign a justification, therefore, and all County purchasing
procedures must be followed in their entirety, and such compliance shall be documented. Such
justification and compliance documentation shall be maintained by the CHD following 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 following the Generally
Accepted Accounting Principles, as promulgated by the Governmental Accounting Standards
Board, and the requirements of federal or state law. These records shall be maintained as
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RYAN L. BUTLER, CLERK
required by the State's 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 is 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:
The revenue and expenditure requirements in the Florida Accounting
Information Resource System; and
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; and
iii. Financial procedures specified in the State's Accounting Procedures
Manuals, Accounting memoranda, and Comptroller's memoranda; and
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 or 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
or 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 or deficit funds accruing to the State and County is determined each month and at the
contract year-end. Surplus funds may be applied toward the funding requirements of each
party 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 that clearly
illustrates the amount which has been credited to each party. 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 or administrator determines that an emergency exists
wherein a time delay would endanger the public's health and the State's Deputy Secretary for
County Health Systems have approved the transfer. The State's Deputy Secretary for County
Health Systems shall forward written evidence of this approval to the CHD within 30 days after
an emergency transfer.
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RYAN L. BUTLER, CLERK
g. The CHID may execute subcontracts for services necessary to enable the CHID 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 certified
public accountant on the financial records of the CHID, and the results made available to the
parties within 180 days after the close of the CHID fiscal year. This audit will follow requirements
contained in OMB Circular A-133, as revised, and may be in conjunction with audits performed
by the County government. If audit exceptions are found, then the director or 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 CHID shall not use or disclose any information concerning a recipient of services
except as allowed by federal or state law or policy.
j. The CHID shall retain all client records, financial records, supporting documents,
statistical records, and any other documents (including electronic storage media) pertinent to
this contract for five years after termination of this contract. If an audit has been initiated and
audit findings have not been resolved at the end of five years, the records shall be retained
until the resolution of the audit findings.
k. The CHID shall maintain the 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 CHID 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 CHID shall be consistent with the State's Information Security
Policies, Protocols, and Procedures. The CHID shall further adhere to any amendments to the
State's security requirements and shall comply with any applicable professional standards of
practice concerning 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 CHID.
m. The CHID shall establish a system through which applicants for services and current
clients may present grievances over denial, modification, or termination of services. The CHID
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 right to a fair hearing to the final governing authority
of the CHID. Specific references to existing laws, rules, or program manuals are included in
Attachment I of this contract.
n. The CHID shall comply with the provisions contained in the Civil Rights Compliance and
Non -Discrimination 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:
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RYAN L. BUTLER, CLERK
The DE3851_1 Contract Management Variance Report and the DE580L1
Analysis of Fund Equities Report; and
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 State's
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 are delayed due to circumstances beyond the CHD's
control:
i. March 1, 2024, for the reporting period of October 1, 2023, through
December 31, 2023; and
ii. June 1, 2024, for the reporting period of October 1, 2023, through
March 31, 2024; and
iii. September 1, 2024, for the reporting period of October 1, 2023
through June 30, 2024; and
iv. December 1, 2024, for the reporting period of October 1, 2023
through September 30, 2024.
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 ensure adequate fire and casualty insurance coverage for County -
owned CHD offices and buildings and 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.
R
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8. TERMINATION. RYAN L. BUTLER, CLERK
a. Termination at Will. This contract may be terminated by either party without cause upon
no less than 180 calendar days' notice in writing to the other party unless a lesser time is
mutually agreed upon in writing by both parties.
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 24 hours'
notice.
c. Termination for Breach. This contract may be terminated by either party for a material
breach of an obligation hereunder, upon no less than 30 days' notice. Waiver of a 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 CHID fiscal year beginning July 1, 2024, it is agreed
that the performance and payment under this contract are contingent upon an annual
appropriation by the Legislature, under section 287.0582, Florida Statutes.
b. Contract Managers. The name and addresses 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
190027 1h Street 1801 27th Street
Vero Beach, FI., 32960-3383
Address
Mayur.rao(cD-fl.health.gov
Email Address
772-794-7464
Telephone
Vero Beach, FI., 32960-3383
Address
kdaniels(aD_ircgov.com
Email Address
772-567-8000 Ext. 1214
Telephone
If different contract managers are designated after the execution of this contract, the name,
address, email address, and telephone number of the new representative shall be furnished in
writing to the other parties and attached to the 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.
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RYAN L. BUTLER, CLERK
d. Notices. Any notices provided under this contract must be delivered by certified mail,
return receipt requested, in person with proof of delivery, or by email to the email address of
the respective party identified in Section 9.b., above.
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 1 st day of October 2023.
BOARD OF COUNTY COMMISSIONERS
FOR INDIAN RIVER COUNTY
STATE OF FLORIDA
DEPARTMENT OF HEALTH
SIGNED BY: IGNED BY:
NAME: Joseph H. Ear=' NAME: Joseph A. Ladapo, M.D., Ph.D.
�'''�� ��''' TITLE: State Surgeon General
TITLE: Chairman cu��
DATE: September 26, 2023 DATE:
ATTESTED TO:
SIGNED BY: `` R
NAME: %.0A .VCLwnleS
TITLE:r Ic.
DATE:gJ Orgill a3
0
SIGNED BY:
NAME: Miranda C Swanson, MPH
TITLE: CHD Director or Administrator
DATE: q/�3
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ATTACHMENT I RYAN L. BUTLER, CLERK
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 2
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RYAN L. BUTLER, CLERK
levels as documented in Florida SHOTS and supported by CHID
Guidebook policies and technical assistance guidance.
7. Environmental Health Requirements as specified in Environmental Health Programs
Manual 150-4' and DHP 50-21"
8. 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. 64F-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 CHID 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 -1 - Page 2 of 2
ATTACHMENT II
INDIAN RIVER COUNTY HEALTH DEPARTMENT
PART I. PLANNED USE OF COUNTY HEALTH DEPARTMENT TRUST FUND BALANCES
Estimated State
Share of CHD Trust
Fund Balance
I . CHD Trust Fund Ending Balance 09/30/23
2. Drawdown for Contract Year
October 1, 2023 to September 30, 2024
313845
-313845
Estimated County
Share of CHD Trust
Fund Balance
1649402
-386272
Total
1963247
-700117
3. Special Capital Project use for Contract Year 0 0 0
October 1, 2023 to September 30, 2024
4. Balance Reserved for Contingency Fund 0 1263130 1263130
October 1, 2023 to September 30, 2024
Special Capital Projects are new construction or renovation projects and new furniture or equipment associated with these projects, and mobile health vans.
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Attachment_II_Part_I - Page 1 of 1
ATTACHMENT II
INDIAN RIVER COUNTY HEALTH DEPARTMENT A TRUE COPY
CERTIFICATION ON LAST PAGE
Part I1, Sources of Contributions to County Health Department RYAN L. BUTLER, CLERK
October 1, 2023 to September 30, 2024
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
015040 CHD - TB COMMUNITY PROGRAM
015040 FAMILY PLANNING GENERAL REVENUE
015040 PRIMARY CARE PROGRAM
015040 RACIAL & ETHNIC DISPARITIES - CHD EXPENSES
015040 SCHOOL HEALTH SERVICES
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 AIDS DRUG ASSISTANCE PROGRAM ADMIN HQ
007000 WIC BREASTFEEDING PEER COUNSELING PROG
007000 COASTAL BEACH WATER QUALITY MONITORING
007000 COMPREHENSIVE COMMUNITY CARDIO - PHBG
007000 STRENGTHENING STD PREVENTION AND CONTROL
007000 ELC COVID ENHANCED DETECTION EXPANSION GRANT
007000 FAMILY PLANNING TITLE X - GRANT
007000 PUBLIC HLTH INFRASTRUCTURE & WORKFORCE/CENTRAL 1
007000 INFANT MORTALITY
007000 IMMUNIZATION ACTION PLAN
007000 MCH SPEC PRJ SOCIAL DETERMINANTS HLTH COMM EDU
007000 BASE COMMUNITY PREPAREDNESS CAPABILITY
007000 BASE PUB HLTH SURVEILLANCE & EPI INVESTIGATION
007000 AIDS PREVENTION
007000 RYAN WHITE TITLE II GRANT/CHD CONSORTIUM
007000 WIC PROGRAM ADMINISTRATION
015075 SCHOOL HEALTH SERVICES
FEDERAL FUNDS TOTAL
4. FEES ASSESSED BY STATE OR FEDERAL RULES - STATE
001020 CHD STATEWIDE ENVIRONMENTAL FEES
001092 ON SITE SEWAGE DISPOSAL PERMIT 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
100,000
0
100,000
0
100,000
30,597
0
30,597
0
30,597
51,533
0
51,633
0
51,533
183,226
0
183,226
0
183,226
52,000
0
52,000
0
52,000
136,867
0
136,867
0
136,867
1,696,194
0
1,696,194
0
1,696,194
2,250,417
0
2,250,417
0
2,250,417
6,862
0
6,862
0
6,862
6,862
0
6,862
0
6,862
39,388
0
39,388
0
39,388
60,000
0
60,000
0
60,000
12,886
0
12,886
0
12,886
115,000
0
115,000
0
115,000
27,993
0
27,993
0
27,993
130,591
0
130,591
0
130,591
17,092
0
17,092
0
17,092
152,988
0
162,988
0
152,988
14,776
0
14,776
0
14,776
49,880
0
49,880
0
49,880
23,113
0
23,113
0
23,113
92,629
0
92,629
0
92,629
83,823
0
83,823
0
83,823
56,262
0
56,262
0
56,262
80,000
0
80,000
0
80,000
606,322
0
606,322
0
606,322
150,068
0
150,068
0
150,068
1,712,811
0
1,712,811
0
1,712,811
160,032
0
160,032
0
160,032
289,870
0
289,870
0
289,870
1,662
0
1,662
0
1,662
25,130
0
25,130
0
25,130
2,614
0
2,614
0
2,614
6,153
0
6,153
0
6,153
867
0
867
0
867
11,265
0
11,265
0
11,265
456
0
456
0
456
4,089
0
4,089
0
4,089
AttachmeM_II_Part_II - Page 1 of 3
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ATTACHMENT II
INDIAN RIVER COUNTY HEALTH DEPARTMENT A TRUE COPY
:ERTIFICATION ON LAST PAGE
Part If, Sources of Contributions to County Health Department '?YAN L. SUTLER, CLERK
October 1, 2023 to September 30, 2024
001206 TANNING FACILITIES
001206 TATTO PROGRAM ENVIRONMENTAL HEALTH
001206 MOBILE HOME & RV PARK FEES
FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL
5. OTHER CASH CONTRIBUTIONS - STATE:
031005 GENERAL CLINIC RABIES SERVICES & DRUG PURCHASES
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
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
008040 CHD LOCAL REVENUE & EXPENDITURES
DIRECT COUNTY CONTRIBUTIONS TOTAL
10. FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION - COUNTY
001077 CHD CLINIC FEES
001077 GENERAL CLINIC RABIES SERVICES & DRUG PURCHASES
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
010300 STATE UNDERGROUND PETROLEUM RESPONSE ACT
010300 MIGRANT LABOR HOUSING INSPECTION H -2A PROGRAM
011000 BLUE FOUNDATION COUNTY GRANTS
011000 REVENUE CONTRACT/MOA W/NO REPORTING REQUIREMENT
011000 HEALTHY START NURSE FAM PARTNERSHIP EXPAND CHD
State CHD
County
Total CHD
Trust Fund
CHD
Trust Fund
Other
(cash)
Trust Fund
(cash)
Contribution
Total
300
0
300
0
300
1,565
0
1,565
0
1,565
1,811
0
1,811
0
1,811
505,814
0
505,814
0
505,814
20,721
0
20,721
0
20,721
313,845
0
313,845
0
313,845
334,566
0
334,566
0
334,566
0
8,935
8,935
0
8,935
0
21,280
21,280
0
21,280
0
30,215
30,215
0
30,215
7,122
0
7,122
0
7,122
7,122
0
7,122
0
7,122
0
0
0
416,874
416,874
0
0
0
784
784
0
0
0
2,555,183
2,555,183
0
0
0
18,135
18,135
0
0
0
48,623
48,623
0
0
0
3,039,599
3,039,599
0
775,604
775,604
0
775,604
0
775,604
775,604
0
775,604
0
345
345
0
345
0
280
280
0
280
0
266,626
266,626
0
266,626
0
280,000
280,000
0
280,000
0
547,251
547,251
0
547,251
0
10,306
10,306
0
10,306
0
4,780
4,780
0
4,780
0
2,254
2,254
0
2,254
0
1,782
1,782
0
1,782
0
95,000
95,000
0
95,000
0
20,502
20,502
0
20,502
0
92,292
92,292
0
92,292
Attachment_II_Part_II - Page 2 of 3
ATTACHMENT II
INDIAN RIVER COUNTY HEALTH DEPARTMENT A TRUE COPY
Part II, Sources of Contributions to County Health Department CERTIFICATION ON LAST PAGE
RYAN L. BUTLER, CLERK
October 1, 2023 to September 30, 2024
State CHD County Total CHD
Trust Fund CHD Trust Fund Other
(cash) Trust Fund (cash) Contribution Total
011001 CHD HEALTHY START COALITION CONTRACT 0 2,090 2,090 0 2,090
090002 DRAW DOWN FROM PUBLIC HEALTH UNIT 0 386,272 386,272 0 386,272
OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL 0 615,278 615,278 0 615,278
12. ALLOCABLE REVENUE • COUNTY
001004 CHD STATEWIDE ENVIRONMENTAL FEES
COUNTY ALLOCABLE REVENUE TOTAL
13. BUILDINGS - COUNTY
ANNUAL RENTAL EQUIVALENT VALUE
OTHER (Specify)
UTILITIES
BUILDING MAINTENANCE
WABASSO SITE - ANNUAL RENATL EQUIVALENT VALUE
WABASSO SITE - UTILITIES
WABASSO SITE - BUILDING MAINTENANCE
OTHER (Specify)
BUILDINGS TOTAL
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
0
7,122
7,122
0
7,122
0
7,122
7,122
0
7,122
0
0
0
528,888
528,888
0
0
0
0
0
0
0
0
200,613
200,613
0
0
0
127,663
127,663
0
0
0
80,562
80,562
0
0
0
30,558
30,558
0
0
0
19,446
19,446
0
0
0
0
0
0
0
0
987,730
987,730
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
4,817,592
1,975,470
6,793,062
4,027,329
10,820,391
Attachment_II_Part_II - Page 3 of 3
ATTACHMENT H
INDIAN RIVER COUNTY HEALTH DEPARTMENT
Part IR, Planned Staffing. Clients, Services and Expenditures By Program Service Area Within EacA "Ef
Attachment II_Part_III - Page 1 of 2
October 1, 2023 to September 30, 2024
CERTIFICATION ON LAST PAGE
RYAN
L. BUTLER, CLERK
Quarterly
Expenditure Plan
FTE's
Clients Services/
1st
2nd
3rd
4th
Grand
(0.00)
Units
Visits
(Whole dollars only)
State
County
Total
A COMMUNICABLE DISEASE CONTROL:
IMMUNIZATION (101)
2.88
552
654
77,902
66,778
77,902
67,882
95,307
195,157
290,464
SEXUALLY TRANS. DIS. (102)
4.92
310
386
125,153
107,280
125,153
109,053
70,171
396,468
466,639
HIV/AIDS PREVENTION (03A1)
2.92
0
4,096
72,267
61,947
72,267
62,971
269,452
0
269,452
HIV/AIDS SURVEILLANCE (03A2)
0.07
0
0
1,497
1,283
1,497
1,304
6,581
0
5,581
HIV/AIDS PATIENT CARE (03A3)
4.02
227
504
121,285
103,965
121,285
105,683
427,821
24,397
452,218
ADAP (03A4)
0.72
18
270
16,728
14,339
16,728
14,577
62,372
0
62,372
TUBERCULOSIS (104)
1.30
32
68
35,982
30,844
36,982
31,354
41,749
92,413
134,162
COMM. DIS. SURV. (106)
8.85
0
9
214,198
183,610
214,198
186,646
798,652
0
798,652
HEPATITIS (109)
0.00
0
0
0
0
0
0
0
0
0
PREPAREDNESS AND RESPONSE (116)
0.99
0
1
29,821
25,562
29,821
25,985
111,189
0
111,189
REFUGEE HEALTH (118)
0.00
0
0
0
0
0
0
0
0
0
VITAL RECORDS (180)
2.68
8,647
30,494
47,780
40,957
47,780
41,633
0
178,150
178,150
COMMUNICABLE DISEASE SUBTOTAL
29.35
9,786
36,482
742,613
636,565
742,613
647,088
1,882,294
886,585
2,768,879
B. PRIMARY CARE:
CHRONIC DISEASE PREVENTION PRO (210)
1.29
0
365
26,498
22,714
26,498
23,091
98,801
0
98,801
WIC (21W1)
9.86
5,116
35,949
202,112
173,250
202,112
176,114
753,588
0
753,588
TOBACCO USE INTERVENTION (212)
0.00
0
0
0
0
0
0
0
0
0
WIC BREASTFEEDING PEER COUNSELING (21W2)
2.21
0
4,826
27,158
23,280
27,158
23,666
101,262
0
101,262
FAMILY PLANNING (223)
4.27
127
176
105,219
90,193
105,219
91,683
360,721
31,593
392,314
IMPROVED PREGNANCY OUTCOME (225)
0.27
1
63
6,330
5,426
6,330
5,614
23,600
0
23,600
HEALTHY START PRENATAL (227)
0.65
1,114
5,027
16,321
13,990
16,321
14,222
0
60,854
60,854
COMPREHENSIVE CHILD HEALTH (229)
0.00
0
0
0
0
0
0
0
0
0
HEALTHY START CHILD (231)
0.59
696
2,889
15,204
13,033
15,204
13,248
0
56,689
56,689
SCHOOL HEALTH (234)
3.40
0
88,744
92,643
79,413
92,643
80,725
345,424
0
345,424
COMPREHENSIVE ADULT HEALTH (237)
0.00
0
0
0
0
0
0
0
0
0
COMMUNITY HEALTH DEVELOPMENT (238)
7.58
0
3,907
172,613
147,963
172,613
150,410
453,599
190,000
643,599
DENTAL HEALTH (240)
0.00
0
0
0
0
0
0
0
0
0
PRIMARY CARE SUBTOTAL
30.12
7,054
141,946
664,098
569,262
664,098
578,673
2,136,995
339,136
2,476,131
C. ENVIRONMENTAL HEALTH:
Water and Onsite Sewage Programs
COSTAL BEACH MONITORING (347)
0.10
71
71
5,253
4,503
5,253
4,576
19,393
192
19,585
LIMITED USE PUBLIC WATER SYSTEMS (357)
0.47
33
534
10,821
9,276
10,821
9,429
4,753
35,594
40,347
PUBLIC WATER SYSTEM (358)
0.13
0
161
2,613
2,239
2,613
2,276
47
9,694
9,741
PRIVATE WATER SYSTEM (359)
1.28
25
1,556
33,158
28,423
33,158
28,892
496
123,135
123,631
ONSITE SEWAGE TREATMENT & DISPOSAL (361)
7.53
2,851
10,220
150,774
129,243
150,774
131,380
313,534
248,637
562,171
Group Total
9.51
2,980
12,542
202,619
173,684
202,619
176,553
338,223
417,252
755,475
Facility Programs
TATTOO FACILITY SERVICES (344)
0.22
155
62
5,265
4,513
5,265
4,588
19,218
413
19,631
FOOD HYGIENE (348)
1.83
130
411
39,522
33,878
39,522
34,438
103,261
44,099
147,360
Attachment II_Part_III - Page 1 of 2
ATTACHMENT H
INDIAN RIVER COUNTY HEALTH DEPARTMENT
Part III, Planned Staffing. Clients, Services and Expenditures By Program Service Area Within Each Level of Service
October 1, 2023 to September 30, 2024 A TRUE COPY
CERTIFICATION ON LAST PAGE
Quarterly Expenditure Plan RYAN L. BUTLER, CLERK
FTE's Clients Services/ 1st 2nd 3rd 4th Grand
(0..00) Unite Visits (Whole dollars only) State County Total
BODY PIERCING FACILITIES SERVICES (349)
0.01
1
2
399
342
999
346
1,457
29
1,486
GROUP CARE FACILITY (351)
0.63
89
118
14,129
12,111
14,129
12,311
244
52,436
52,680
MIGRANT LABOR CAMP (352)
0.22
14
57
5,494
4,709
5,494
4,786
2,086
18,397
20,483
HOUSING & PUB. BLDG. (353)
0.13
1
19
3,452
2,959
3,452
3,008
49
12,822
12,871
MOBILE HOME AND PARK (354)
0.28
58
110
6,973
5,977
6,973
6,077
21,515
4,485
26,000
POOLS/BATHINGPLACES (360)
1.91
403
1,517
41,872
35,893
41,872
36,487
148,891
7,233
156,124
BIOMEDICAL WASTE SERVICES (364)
1.67
518
543
34,582
29,644
34,582
30,134
104,336
24,606
128,942
TANNING FACILITY SERVICES (369)
0.04
7
12
1,102
945
1,102
961
3,928
182
4,110
Group Total
6.94
1,376
2,851
152,790
130,971
152,790
133,136
404,985
164,702
569,687
Groundwater Contamination
STORAGE TANK COMPLIANCE SERVICES (355)
0.00
0
0
0
0
0
0
0
0
0
SUPER ACT SERVICES (356)
0.04
0
1
899
770
899
783
15
3,336
3,351
Group Total
0.04
0
1
899
770
899
783
15
3,336
3,351
Community Hygiene
COMMUNITY ENVIR. HEALTH (345)
0.10
0
67
2,870
2,460
2,870
2,500
41
10,659
10,700
INJURY PREVENTION (346)
0.00
0
0
0
0
0
0
0
0
0
LEAD MONITORING SERVICES (350)
0.06
0
0
1,074
921
1,074
935
22
3,982
4,004
PUBLIC SEWAGE (362)
0.93
10
47
18,646
15,984
18,646
16,248
361
69,163
69,524
SOLID WASTE DISPOSAL SERVICE (363)
0.00
0
0
25
22
25
22
0
94
94
SANITARY NUISANCE (365)
0.19
26
28
5,029
4,311
5,029
4,383
72
18,680
18,752
RABIES SURVEILLANCE (366)
0.16
52
131
4,463
3,826
4,463
3,889
62
16,579
16,641
ARBORVIRUS SURVEIL. (367)
0.00
0
0
0
0
0
0
0
0
0
RODENT/ARTHROPOD CONTROL (368)
0.00
0
0
0
0
0
0
0
0
0
WATER POLLUTION (370)
0.29
0
63
8,088
6,933
8,088
7,047
114
30,042
30,156
INDOOR AIR (371)
0.00
0
0
42
36
42
35
1
154
155
RADIOLOGICAL HEALTH (372)
0.00
0
0
21
18
21
17
0
77
77
TOXIC SUBSTANCES (373)
0.15
11
25
4,046
3,468
4,046
3,526
57
15,029
15,086
Group Total
1.88
99
361
44,304
37,979
44,304
38,602
730
164,459
165,189
ENVIRONMENTAL HEALTH SUBTOTAL
18.37
4,455
15,755
400,612
343,404
400,612
349,074
743,953
749,749
1,493,702
D. NON -OPERATIONAL COSTS:
NONOPERATIONAL COSTS (599)
0.00
0
0
0
0
0
0
0
0
0
ENVIRONMENTAL HEALTH SURCHARGE (399)
0.00
0
0
14,550
12,472
14,550
12,678
54,250
0
54,250
MEDICAID BUYBACK (611)
0.00
0
0
27
23
27
23
100
0
100
NONOPERATIONAL COSTS SUBTOTAL
0.00
0
0
14,577
12,495
14,577
12,701
54,350
0
54,350
TOTAL CONTRACT
77.84
21,295
194,183
1,821,900
1,561,726
1,821,900
1,587,536
4,817,592
1,975,470
6,793,062
Attachment -11 -Part -111 - Page 2 of 2
A TRUE COPY
CERTIFICATION ON LAST PAGE
ATTACHMENT III RYAN L. BUTLER, CLERK
XXX COUNTY HEALTH DEPARTMENT
CIVIL RIGHTS COMPLIANCE AND NON-DISCRIMINATION CERTIFICATE
The CHD agrees to completethe Civil Rights Compliance Questionnaire, DH Forms 946 A and B (orthe subsequent
replacement if adopted during the contract period), if so requested by the Department.
2. The CHD assures that itwill comply with the Omnibus Budget Reconciliation Act of 1981, P.L. 97-35, which prohibits
discriminationon the basis of sex and religion in programs and activities receiving orbenefiting f romfederal financial
assistance.
Assurance of Civil Rights Compliance: The CHID hereby agrees that it will comply with Title VI of the Civil Rights
Act of 1964 (42 U.S.C. 2000d et seq.); Title IX of the Education Amendments of 1972 (20 U.S.C. 1681 et seq.);
Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794); the Age Discrimination Act of 1975 (42 U.S.C. 6101
et seq.); Title II and Title III of the Americans with Disabilities Act (ADA) of 1990, as amended by the ADA
Amendment Act of 2008 (42 U.S.C. 12131-12189) and as implemented by Department of Justice regulations at 28
CFR Parts 35 and 36; Executive Order 13166, "Improving Access to Services for Persons with Limited English
Proficiency" (August 11, 2000); all provisions required by the implementing regulations of the U.S. Department of
Agriculture (7 CFR Part 15 et seq.); and FNS directives and guidelines to the effect that no person shall, on the
ground of race, color, national origin, age, sex, or disability, beexcluded from participation in, be denied the benefits
of, orotherwise be subjected to discrimination under any program oractivity forwhich the agency receives Federal
financial assistance from FNS; and hereby gives assurance that it will immediately take measures necessary to
effectuate this agreement.
By providing this assurance, the CHD agrees to compile data, maintain records and submit records and reports
as required to permit effective enforcement of the nondiscrimination laws, and to permit Department personnel
during normal working hours to review and copy such records, books and accounts, access such facilities, and
interview such personnel as needed to ascertain compliance with the non-discrimination laws. If there are any
violations of this assurance, the Department of Agriculture shall have the right to seek judicial enforcement of this
assurance.
This assurance is given in consideration of and for the purpose of obtaining any and all Federal financial
assistance, grants, and loans of Federal funds, reimbursable expenditures, grant or donation of Federal property
and interest in property, the detail of Federal personnel, the sale and lease of, and the permission to use Federal
property or interest in such property or the furnishing of services without consideration or at a nominal
consideration, or at a consideration that is reduced for the purpose of assisting the recipient, or i n recognition of
the public interest to be served by such sale, lease, or furnishing of services to the recipient, or any improvements
made with Federal financial assistance extended to the Program applicant by USDA. This includes any Federal
agreement, arrangement, or other contract that has as one of its purposes the provision of cash assistance for the
purchase of food, and cash assistance for purchase or rental of food service equipment or any other financial
assistance extended in reliance on the representations and agreements made in this assurance.
This assurance is binding on the CHD, its successors, transferees, and assignees as long as it receives or retains
possession of any assistance from the Department. The person or persons whose signatures appear below are
authorized to sign this assurance on the behalf of the CHD.
Confidentiality of Data, Files, and Records: The CHD agrees to restrict the use and disclosure of confidential USDA,
Women, Infant, and Children (WIC) applicant and participant information as specified in 7 CFR § 246.26(d)(1)(i) in
accordance with 7 CFR § 246.26(d)(1)(ii), as applicable.
Attachment IV
Fiscal Year - 2023 - 2024
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
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
NIA
County Owned
Commissioners for
Indian River County
36,475
70.84
8445 64th Ave, Wabasso,
Florida, 32970
Wabasso Site
NIA
County Owned
Commissioners for
Indian River County
5,556
7.00
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
2022-2023*
2023-2024**
2024-2025***
2025-2026***
PROJECT TOTAL
PROJECT NUMBER:
PROJECT NAME:
LOCATION/ADDRESS:
PROJECT TYPE:
SQUARE FOOTAGE:
PROJECT SUMMARY:
STATE OF FLORIDA
ATTACHMENT V INDIAN RIVER COUNTY
INDIAN RIVER COUNTY HEALTH DEPARTMENT THIS IS TO CERTIFY THAT THIS ISA
TRUE AND CORRECT COPY OF THE
SPECIAL PROJECTS SAVINGS PLAN ORIGINAL ON FILE IN THIS OFFICE.
N/A RYAN Wnfil ,(xFR!(
CASH RESERVED OR ANTICIPATED TO BE RESERVED FOR PROJEC`.' ouNr <o�
BY
DE RK
STATE COUNTY Q �2
DATE -! L;L
$ 0 $ „0 $ 0
$ 0
$ 0
e ^
$ 0
$ 0
P
SPECIAL PROJECTS CONSTRUCTION/RENOVATION PLAN
NEW BUILDING ROOFING
RENOVATION PLANNING STUDY
NEW ADDITION OTHER
0
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
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 9/30/23
** Cash to be transferred to FCO account.
*** Cash anticipated for future contract years.
Attachment_V - Page 1 of 1