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HomeMy WebLinkAbout2000-29140 CONTRACT BETWEEN INDIAN RIVER COUNTY BOARD OF COUNTY COMMISSIONERS AND STATE OF FLORIDA DEPARTMENT OF HEALTH FOR OPERATION OF THE INDIAN RIVER COUNTY HEALTH DEPARTMENT"" CONTRACT YEAR 2000-2001 This agreement ("Agreement") is made and entered into between the State of Florida, Department of Health ("State") and the Indistn River County Board of County Commissioners (,"County`), through their undersigned authorities, effective October 1, 2000. RECITALS A. Pursuant to Chapter 154, F.S., the intent of the legislature is to "promote, protect, maintain, and improve the health and safety of all citizens and visitors of this state through a system of coordinated county health department services." B. County Health Departments were created throughout Florida to satisfy this legislative intent through "promotion of the public's health, the control and eradication of preventable diseases, and the provision of primary health care for special populations." C. Indian River County Health Department ("CHD") is one of the County Health Departments created throughout Florida. It is necessary for the parties hereto to enter into this Agreement in order to assure coordination between the State and the County in the operation of the CHD. NOW THEREFORE, in consideration of the mutual promises set forth herein, the sufficiency of which are hereby acknowledged, the parties hereto agree as follows: 1. RECITALS. The parties mutually agree that the foregoing recitals are true and correct and incorporated herein by reference. 2. TERM. The parties mutually agree that this Agreement shall be effective from October 1, 2000, through September 30, 2001, or until a written agreement replacing this Agreement is entered into between the parties, whichever is later, unless this Agreement is otherwise terminated pursuant to the termination provisions set forth in paragraph 8, below. 4D 40 4 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. 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, 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 an a state or federal level. Such services include, but are not limited to, epidemiology, sexually transmissible disease detection and control, HIMIDS, immunization, tuberculosis control and maintenance of vital statistics. c. "Primary care services" are acute care and preventive. services that are made available to well and sick persons who are unable to obtain such services due to lack of income or other barriers beyond their control. These services are provided to benefit individuals, improve the collective health of the public, and prevent and control the spread of disease. Primary health care services are provided at home, in group settings, or in clinics. These services shall be supported by available federal, state, and local funds and shall include services mandated on a state or federal level. Examples of primary health care services include, but are not limited to: first contact acute care services; chronic disease detection and treatment; maternal and child health services; family planning; nutrition; school health; supplemental food assistance for women, infants, and children; home health; and dental services. • • 4. FUNDING. The parties further agree that funding for the CHD will be handled as follows. a. The funding to be provided by the parties and any other sources are set forth in Fart 11 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 authorized fees or "OTHER" state revenues) as provided in Attachment II, Part II is an amount not to exceed $3,777,047. 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 or "OTHER" local revenues) as provided in Attachment II, Part II is an amount not to exceed $ 723,286. b. Overall expenditures will not exceed available funding (either current year or from surplus trust funds) in any service category. Unless requested otherwise, any surplus at the end of the term of this Agreement in the County Health Department Trust Fund that is attributed to the CHD shall be carried forward to the next contract period. C. Either party may establish service fees as allowed by law to fund activities of the CHD. These fees are listed in Attachment II Part II. Where applicable, such fees shall be automatically adjusted to at least the Medicaid fee schedule. d. Either party may increase or decrease funding of this Agreement during the term hereof by notifying the other party in writing of the amount and purpose for the change in funding. If the State initiates the increase/decrease, the CHD will revise the Attachment II and send a copy of the revised pages to the County and the Department of Health, Bureau of [,licky�,t. h9,n.�r_�e rnr rit . If the County initiates the increase/decrease, the County shall notify the CHD. The CHD will then revise the Attachment II and send a copy of the revised pages to the Department of Health, Bureau of Budget Management. e. The name and address of the official payee to who payments shall be made is: 3 40 • 40 County Health Department Trust Fund Indian River County 1900_ 27th Street Vera Fnach, ['L 32960 5. CHD DIRECTOR/ADMINISTRATOR. Both parties agree the director/administrator of the CHD shall be a State employee or under contract with the State and will be under the day- to-day direction of the Deputy State Health officer. The director/administrator shall be selected by the State with the concurrence of the County. The director/administrator of the CHD shall insure that noncategorical sources of funding are used to fulfill public health priorities in the community and the Long Range Program Plan.. A report detailing the status of public health as measured by outcome measures and similar indicators will be sent by the CHD director/administrator to the parties no later than October I of each year. 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 Client Information System/Pealth Management Component compatible format by program component as specified by the State. b. The CHD shall comply with all applicable provisions of federal and state laws and regulations relating to its operation with the exception that the use of county purchasing procedures shall be allowed when it will result in a better price or service and no statewide Department of Health purchasing contract has been implemented for those goods or services. In such cases, the CHD director/administrator must sign a justification therefore, and all county purchasing procedures must be followed in their entirety, and such compliance shall be documented. Such justification and compliance documentation shall be maintained by the CHD in accordance with the terms of this Agreement. State procedures must be followed for all leases on facilities not enumerated in Attachment VI. c. The CHD shall maintain books, records and documents in accordance with those promulgated by the Generally Accepted Accounting Principles (GAAP) and Governmental Accounting 4b • LJ Standards Board (GASB), and the requirements of federal and state law. These records shall be maintained as required by the Department of Health Policies and Procedures for Records Management and shall be open for inspection at any time by the parties and the public, except for those records that are not otherwise subject to disclosure as provided by law which are subject to the confidentiality provisions of paragraph 6.i,, below. Books, records and documents must be adequate to allow the CHD to comply with the following reporting requirements: I i. The revenue and expenditure requirements in the Florida Accounting System Information Resource (FLAIR) . ii. The client registration and services reporting requirements of the minimum data set as specified in the most current version of the Client Information System/Health Management Component Pamphlet; iii. Financial procedures specified in the Department of Health's Accounting Procedures Manuals, Accounting memoranda, and Comptroller's memoranda; iv. The CHD is responsible for assuring that all contracts with service providers include provisions that all subcontracted services be reported to the CHD in a manner consistent with the client registration and service reporting requirements of the minimum data set as specified in the Client Information System/Health Management Component Pamphlet. d. All funds for the CHD shall be deposited in the County Health Department Trust Fund maintained by the state treasurer. These funds shall be accounted for separately from funds deposited for other cHDs and shall be used only for public health purposes in Inrlirir, Rivet 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, in a proportionate amount based on the funds contributed by each and the expenditures incurred by each. Expenditures will be charged to the program accounts by state and county based on the ratio of planned expenditures in the core contract, then 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 i is 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 and shall be 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 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 duly signed by both parties to this contract and the proper budget amendments unless the CHD director/administrator determines that an emergency exists wherein a time delay would endanger the public's health and the Deputy State Health Officer has approved the transfer. The Deputy State Health officer shall forward written evidence of this approval to the CHD within 30 days after an emergency transfer. g. The CHD may execute subcontracts for services necessary to enable the CHD to carry out the programs specified in this Agreement. Any such subcontract shall include all aforementioned audit and recordkeeping 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 or required by federal or state law. j. The CHD shall retain all client records, financial records, supporting documents, statistical records, and any other documents (including electronic storage media) pertinent to this Agreement for a period of five (5) years after termination of this Agreement. If an audit has been initiated and audit findings have not been resolved at the end of five (5) years, the records shall be retained until resolution of the audit findings. k. The CHD shall maintain confidentiality of all data, files, and records that are confidential under the law or are otherwise excepted 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 455.667, Florida Statutes, and all other state and federal laws regarding confidentiality. All confidentiality procedures implemented by the CHD shall be consistent with the Department of Health Information Security Policies, Protocols, and Procedures, dated September 1991, as amended, the terms of which are incorporated herein by reference. The CHD shall further adhere to any amendments to the State's security requirements and shall comply with any applicable professional standards of practice with respect to client confidentiality. 1. The CHD shall abide by all State policies and procedures, which by this reference are incorporated herein as standards to be followed by the CHD, except as otherwise permitted for some purchases using county procedures pursuant to paragraph 6.b. hereof. m. The CHD shall establish a system through which applicants for services and current clients may present grievances over denial, modification or termination of services. The CHD will advise applicants of the right to appeal a denial or exclusion from services, of failure to take account of a client's choice of service, and of his/her right to a fair hearing to the final governing authority of the agency. Specific references to existing laws, rules or program manuals are included in Attachment I of this Agreement. n. The CHD shall comply with the provisions contained in the Civil Rights Certificate, hereby incorporated into this contract as Attachment III. o. The CHD shall submit quarterly reports to the county that shall include at least the following: i. The DE385L1 Contract Management Variance Report and the DE58OL1 Analysis of Fund Equities Report; ii. A written explanation to the county of service variances reflected in the DE365L1 report if the variance exceeds or falls below 25 percent of the planned expenditure amount. However, if the cumulative amount of the variance between actual and 1 • a planned expenditures does not exceed one percent of the cumulative expenditures for the level of service in which the type of service is included, a variance explanation is not required. A copy of the written explanation shall be sent to the Department of Health, Bureau of Budget Management. p.The dates for the submission of quarterly reports to the county shall be as follows unless the generation and distribution of reports is delayed due to circumstances beyond the CHD`s control: i. March 1, 2001 for the report period October 1,2000 through December 31, 2000; ii. June 1, 2001 for the report period October 1,2000 through March 31, 2001; iii. September 1, 2001 for the report period October 1, 2000 through June 30, 2001; and iv. December 1, 2001 for the report period October 1,2000 through September 30, 2001. 7. FACILITIES AND EQUIPMENT. The parties mutually agree that. a. CHD facilities shall be provided as specified in Attachment 1V to this contract and the county shall own the facilities used by the CHD unless otherwise provided in Attachment IV. b. The county shall assure adequate fire and casualty insurance coverage for County -owned CHD offices and buildings and for all furnishings and equipment in CHD offices through either a self-insurance program or insurance purchased by the County. C. All vehicles will be transferred to the ownership of the County and registered as county vehicles. The county shall assure insurance coverage for these vehicles is available through either a self-insurance program or insurance purchased by the County. All vehicles will be used solely for CHD operations. Vehicles purchased through the County Health Department trust fund shall be sold at fair market value when they are no longer needed by the CHD and the proceeds returned to the County Health Department trust fund. 8. TERMINATION. 8 +! 40 a. Termination at Will. This Agreement may be terminated by either party without cause upon no less than one -hundred eighty (180) calendar days notice in writing to the other party unless a lesser time is mutually agreed upon in writing by both parties. Said notice shall be delivered by certified mail, return receipt requested, or in person to the other party's contract manager with proof of delivery. b. Termination Because of hack of Funds. 1n the event funds to finance this Agreement become unavailable, either party may terminate this Agreement upon no less than twenty- four (24) hours notice. Said notice shall be delivered by certified mail, return receipt requested, or in person to the other party's contract manager with proof of delivery. c. Termination for Breach. This Agreement may be terminated by one party, upon no less than thirty (30) days notice, because of the other party's failure to perform an obligation hereunder. Said notice shall be delivered by certified mail, return receipt requested, or in person to the other party's contract manager with proof of delivery. Waiver of breach of any provisions of this Agreement shall not be deemed to be a waiver of any other breach and shall not be construed to be a modification of the terms of this Agreement. MISCELLANEOUS. The parties further agree: a. Availability of Funds. If this Agreement, any renewal hereof, or any term, performance or payment hereunder, extends beyond the fiscal year beginning July 1, 2001, it is agreed that the performance and payment under this Agreement are contingent upon an annual appropriation by the Legislature, in accordance with section 287.0552, Florida Statutes. b. Modification. This contain all of the terms and the parties. Modifications enforceable only when reduced parties. Agreement and its Attachments conditions agreed upon between of this Agreement shall be to writing and signed by all C. Contract Managers. The name and address of the contract managers for the parties under this Agreement are as follows: For the State: For the County: Lori ,J11rit-I - Jason Brown 9 40 4 4W Name Name Business Mana er III Budget Manager Title Title 1900 27th Street 1840 25th Street Vero Beach, FL 32960 Vero Beach, EL 32950 Address Address 561-794-7464 561-567-8000 Ext.214 Telephone Telephone If different contract managers are designated after execution of this Agreement, the name, address and telephone number of the new representative shall be furnished in writing to the other parties and attached to originals of this Agreement. d. Captions. The captions and headings contained in this Agreement are for the convenience of the parties only and do not in any way modify, amplify, or give additional notice of the provisions hereof. C.] 40 4w In WITNESS THEREOF, the parties hereto have caused this 32 page agreement to be executed by their undersigned officials as duly authorized effective the 16` day of October, 2000. BOARD OF COUNTY COMMISSIONERS STATE OF FLORIDA FOR INDIAN RIVER COUNTY DEPARTMENT OF HEALTH SIGNED BA -7 " OAt SIGNED BY: ti NAME: _Fran B, Adams NAME: --/ Rvber�t G. Brooks, llD TITLE: Chairman- TITLE:(: Secretary DATE: 0ctoder 3. 200Q DATE: ! 0 ATTESTED - SIGNED B y . SIGNED SY: NAbM: PATRICIA M. Rli]GkLY NAME: � can L. Kline, R.N. TITLE: DEPUTY CLERK TITLE: DATE: DOT $ 2000 DATE: CHI] Director/ Administrator CA'), �'OC2) -- • 40 i C-1 ATTACHMENT I PROGRAM SPECIFIC REPORTING REQUIREMENTS AND PROGRAMS REQUIRING MACOMPLIANCE WITH THE PROVISIONS OF SPECIFIC MANUALS Some health services must comply with specific program and reporting requirements in addition to the CIS/HMC minimum data set and the SAMAS 2.2 requirements because of federal or state law, regulation or rule. If a county health department is funded to provide one of these services, it must comply with the special reporting requirements for that service. The services and the reporting requirements are listed below: Service Requirement 1. Sexually Transmitted Disease Requirements as specified in FAC 64D-3 Program and F.S.384 and the CHD Guidebook Internal Operating Policy STD 6 and 7. 2. Dental Health Monthly reporting on. DH Form 1008*. w 3. Special Supplemental Nutrition Service documentation and monthly Program for Women, Infants financial reports as specified in DHM and Children. 150-24* and all federal, state and county requirements detailed in program manuals and published procedures. 4. Healthy Start/ Requirements as specified in the Healthy Improved Pregnancy Outcome Start Standards and Guidelines 1998 and as specified by The Healthy Start Coalitions in contract with each county health department. 5. Family Planning Periodic financial and programmatic reports as specified by the program office and in the CHD Guidebook, Internal Operating Policy FAMPLAN 14* 6. Immunization Periodic reports as specified by the department regarding the surveillance/ investigation of reportable vaccine preventable diseases, vaccine usage accountability, the assessment of various immunization levels and forms reporting adverse events following immunization and Immunization Module quarterly quality audits and duplicate data reports. 7. CHD Program Hequirr_ments as, speciIied in HRSM 150-3* .and HRSM B. Chronic Disease Program Requirements as specified in the Community Intervention Program (CIP) and the CHD Guidebook. 9. Environmental Health Requirements as specified in DJIP 50-4* and 50-21*. 40 40 40 ATTACHMENT I (Continued) 10. HIV/AIDS Program Requirements as specified in Florida Statue 384.25 and 64D-3,016 and 3.017 F,A.C. and the CHO Guidebook. Case reporting on CDC Forms 50.42B (Adult/ Adolescent) and 50.42A (Pediatric). Socio -demographic data on persons tested for HIV in CHD clinics should be reported on Lab Request Form 1620 or Post -Test Counseling Form 1633. These reports are to be sent to the Headquarters HIV/AIDS office within 5 days of the initial post- test counseling appointment or within 90 days of the missed post-test counseling appointment. L1. School Health services tIRSM 150-251, including the requirement for an annual pian as a condition for funding. *or the subsequent replacement if adopted during the contract period. W • C-1 U) w U 2 Q d Z D LL f/} D f.. Z z !J 11'1' z V u LL a w U) 7 0 LU 2 a f - (L' 9 w G li} Di � C G C ' a fl N CM Ln @ 7 Qi N N QLO LA cli {% Y[1 f3i 7. .Ow N 'E N U ap y © N C1 (�7} 3 CNC f+ r ,gyp E11 C tl] C p N 7 N C U�puO f0 tw3� N Z N CL E a y s c e'U Q N O 12 G N L fPl 'tj •C 9 °6 d N a 2 e c w O N •C C � IN 7. 7�N C :Z Q L57 N 'D N O N '4 LO N .�., N tV 131 (ry7 t6 0% to (a E- D co i2. on S+ U N Qq_�I LO 1p D •U it x,072$ � N O g 6C7 N 2 c c E co w > o ar =r E t4 CL v 0, cua O1 O7 C9 r� a 70 fes] .N CN c N w 'Y7 o m'A p p Lm'd 6! N C N N N IC E� 7 7 d. tl QN O l> � p 06 V O E N U 9 E d C 2 n% N N N AL1 E N _ 8 P 4.1N O U) v Gty �y+ C V yi M C1 Q p y o ,'� B V� !U SA u . is CL a Uco 0 o aa�ima Z5 LL CV Q N. y a O Nary N r i�]r CA N O C R �Y N d •N f!i y i0 c_�fl�pj ULO �j CL r N t7 rt Z' LL. ECa3. W +i ATTACHMENT 11 • _ l INDIAN RIVER COUNTY HEALTH DEPARTMEN^r Part It, Sources of Contriblrtions to County Health Department CIID Trust Fund (cash) father Contributions Total STATE. 1. GENERALREVENUE 01 5050 :\I.Ci+Cnnlributions Tn CIII)105032U1 841.9711 11 84-1.471) 015011 ALG;Conl 10 ('111) Primary Cur 1050329) 15.789 11 15.789 015065 ALC Kant to Cl IU AIDS Prcv & Sun^ & field Stalf(050329) 0 0 0 015050 ALGICont to Cl 10 Mig Lbr Camp San (050329) 1.748 0 2.748 015050 ALGICont to CHD I lome I lith pilot Proj (050329) 0 0 0 015050 ALGICont to CDD-Snvcrciyn Immunity (050329) 0 0 0 015050 ALGfCoat tnClJDs Pinellas Indigent Dentl Clinic -0F 405032"9) 0 0 0 015050 ALGICont to CI lDs-Denial Program (Cat. 050329) 0 0 0 015050 ALGICont to CIII)s Immun Outreach Teams (050329) 10,03 0 10.903 015050 ALGICont to CHDs Comm Tia Program (050329) 70.629 0 70,629 015050 ALGICont t0 C11D5Indmlr Air Assist (050329) 12,520 0 12.520 015050 ALGICcsspool Identification Ind Elimination (Cat. 050329) 0 0 0 015048 ALGICont to Cl 1D STD Program (050329) 0 0 0 - 015037 AI.(ICom to Cl$Ils Njiml R Clild Hldt Field Slan'Cost (050329) 0 0 0 015050 EEpidcmiology Tming & Clinical Supp-Wakulla (CAT 050329) 0 IJ 0 015123 ALGIFamily Planning (050001) 33,701 0 33.701 015123 AUW-nmily Planning Planned Parenthood NE FL (CAT. 05000 1) 0 0 0 015123 ALGIFamilyPlanning (CAT,050001)- Alachua Colposcupy 0 0 0 015065 ALGICont to CHD AIDS Pal Care (050026) 85,000 0 85.000 015115 ALGlSchool Health Svcs (051106) 56.607 0 56.607 015140 ALGISchool Health Supplcmcntnl (05 1106) 148.895 1) 148.895 015124 A1.0IIPO.11callhy Stari11P01050707) n 0 u 015124 ALGIIPC3-Infant Mortality I'r0jcct (CAT. 050707} 0 4 0 015124 ALGRPG-t7utreach Social W'orkcrs (CAT. 050707) 0 0 0 015137 ALGI1110 I lealthy Slart Itesource Moms & Dads (050707) 0 0 0 015137 ALG1Cummumty I [eahh Initiatives (052250) 0 0 0 015137 ALGIIP[}-Fioaahy-Slvl-[7araCulled PrjSlall-(CAT.050707) 0 0 0 015124 ALGIMCII-Ilealthy StarUlPO (054870) 149.892 0 149.892 015124 ALGRP4OutreachSocial Workers (CAT050870) 24,000 0 24.000 015124 ALGIMCH-Want Mortality Project (CAT- 050870) 0 0 0 015123 Planncd Parcnt I1ond - Collier and Sarasula (CAT. 050329) 0 0 0 015012 WA Lpilcpsy Services (050082) 0 0 0 015011 ALGiPrintary Care (05033 1) 204.314 1) 20.1.31.1 01505o CATI1-IllvironmentalConunmtity•I:scarnhia1052250) 0 0 0 015050 Ncw Itorizon511icalth Prevention -Bade (052250) 0 0 0 015050 Interdiscip. Mngd Carc Initiarive-F laglcr & Volusia (052250) 0 0 0 UFSU54 Isabel Collier I(cad Ptentl care CII"11c-C Vllicr & k.ec(052250) 0 0 0 015050 Primary Care nutrch Prgrn-Sun crust llosp-Pinellas (052250) 0 0 0 015050 Dunbar Health Comer-Lec (052250) 0 0 0 015050 RuoscvelISands Cifsnru.Healthearet:tr.-htanrtn;052250) U 0 0 015050 Medivan Project11::1dcrly Inlcrest-nr0ward1052250) 0 0 0 015050 11calthy 13 caches M"mitoring 1) (1 0 GENERAL REVENUE TOTAL 1,659.968 U 1,b511;968 2- NDN GENET AL REVENUE 015010 AMA:untr. to C'IID -Rebasing 0130329) 1Ohaccil l l• 27.287 0 27'87 1115072 AI.(iXont to 07117 Says Drinking W'utcr.Dj.P (05(1329) Adnt IT it 0 0 U1506 7LG;C'+nu it CkIIS l3"rrr•Slcdii rl N'axtrit)l.t'ilI51t32'tl Adm IF 43r" 7 3.99, 015170 Tobacco CuOrdinalion 41Obrl I.1) Tnbaceu 7'F 17.153 0 47.153 015172 Full Service Schools - Tohacco 1102:58) Tobacco TT- 83.115 0 83.115 - UIS0.1 1lasicSchoul IIc:4th- lobaccu4051106) tobacco IF 0.391 0 13,394 015016 GIA Epilepsy Prcv and L-'duc (050083)IFpilcpsy TF 0 0 (1 015084 Varicella lmmautieatlun 11c4urrcment 10503291 luhaecu 11: h.0't8 o n.048 0150to SUPER Act Prngrmn (050329) ASm IT (a Il 0 015020 fluid and W'arerhnme Disease Program (0503291 Adm IF 0 lY 0 1-1 40 ATTACHMENT 1I O INDIAN RIVER COUNTY IiEALTH DEPARTMENT Part It. Sources of+Conlrjbuljons to County Health Department CIID Trust Fund (cash) Other Contributions Total :NATE 2. NUN GENERAL RMIENLIE 1115010 Paseo CiiD Dcntak Pmgrnntil150J291 Tnhaccn TI-' U 0 ri 015010 Enhanced Dcolat Scry ices (05032911obacco IF 55,000 O 55.000 015010 Via 1lepatitis & LiN er Fail. Prev & Cnrl(050329) robaeco TF 0 0 0 010304 Stationary PollulantSlorage-DEP 90.252 0 90.252 015121 Super Act Reimbursements 2.000 0 2,000 NON GENERAL REVENUE TOTAL 333.265 0 333,265 3. FEDERAL FUNDS 015075 KidCarc Outreach Program 0 0 0 015075 KidCare On ucach Reftee/Enuant 0 0 0 007065 FGTF1AIDS Prevention 32.111 0 32,111 007066 FG'ri'fRyan mite 0 4 0 007066 FG TFIRyan Whitc 0 0 0 007066 FG Tr/Ryan White- AIDS Drug Assist Pfog,-Admin. 211.000 0 20.000 007062 FG TW AIDS Epidemiologica: Research Study U 0 0 007049 FG TFIALGI Contr to CHDs-STD Prg-Infertility Prg 0 0 0 007049 FGTFIAI.GIContr toClIDs-STD Pig-SyphilisHiminstion 0 0 0 - 007049 FG TF/ALG/ Contr to CHDs-STD Program 900 0 900 007067 Tuberculosis Control . Federal Grant 0 0 a 007084 immunization Special Project 5.272 Il 5.272 007084 rGTFIALG/ComrtoCIIDs-Immunization Action Plan 9,725 0 9.725 007085 Breast and Cervical Cancer-Clltat Services 0 0 0 007085 13reaSl and Cervical Cancer-AdminlCase Managealcat 0 0 0 007084 FG TF/ALG/Contr to CI IDs -Project Field Staff 0 0 0 007084 Immunization Action Plan -WIC Immunization (Alkege 0 0 0 007133 ALGA amity Planning Title X-Sterilzations 13.152 0 13.152 007127 AI.GIMCFI-MCI l 131k Grt. Child IWith 10,535 0 10.535 007134 ALGNCIf-MClI Rik Gn Oulreach Sue Wrkrs 0 0 0 007134 ALGIMCI WCI I Btk Cart -Outreach Sue Wrkr5 0 0 0 007134 ALG/MCI FMCl-I Blk Grt.-IPO Infant Mon, Pmj, 0 0 0 007132 ALGAICII-MCII [Ilk Grt. (halal Projccls 47.Rlli II 47.500 007134 ALGAPOIbtCH•Infiant Mortality Pmjcct 0 0 0 007134 ALGIIPO 4fClt iitk. GnAPO•Gadsdcn Sch Clinic 0 0 0 OU7127 ALGiMCl1 -M1CI1 Dlk Gn-Child l lcalth Ages U-1 Yr. 3,474 0 3.473 007134 ALG/MCII Rik Cin -healthy Slatt/IPO 39.460 0 39,460 007134 AL011PO-MCI I Rik Oft- I lcallhy Start/1110 U O 0 007063 PfcvlllthBlkGrAIERR-ChronicDisease Init. 89,105 0 89,105 0071.33 ALGIGrants & Aids -Faro 19ng Svcs-Tllle X 20.942 0 20.9-12 007133 A1.0Fam Ping -Tide X -Duval The Bridge 0 0 0 015075 ALGIram Ping - Pregnancy Pwv-(ANI' 13.268 0 13.268 007133 Al-010rants & Aids -Fin) Ping-SPe631 COnlfacts:r le X 0 0 0 `. UII7030 %ji'm Jill Labor Sawlatioll h'll it Q0 007056 FG TF I lcalth Prllgr:flll, for Refag- (I 80000 n U 0 007068 FGTFnFederal Grants -AIDS Inmate Imenemion n 0 0 _ OU7069 Minority Involvement in IfIVIAIDS Pmeram 0 0 0 007064 Hifl l- AIDS Senlpievulctice 0 'a n 007061 }ti(l1 AIDS SurviScrop 1) n n 007051 WIChtfras[rUA.ure Lir,ln!'_000-_Mill 277.4611 007051 FG TF WIC Admin Tramfcr [0503291 0 U 0 007135 TANF Abstinence Edueatiulr 0 f1 0 - - 007135 Abstinence Education Program FCC Granls FF U U 11 015075 GIA Fpdcysy Scrviets-TANF 0 tl 0 001049 ALGIConu m CI1D-STD-tiledieal & Lab Ste rmg ('11 n 0 0 015075 Full ServiceScllonls-TANF 8.314 tl 8.314 015075 ALGISchool Eltalth-Supplement-TANF 14.050 tl 1.1.050 • 40 ATTACHMENT H INDIAN RIVER COUNTY HEALTH DEPARTWNT Part IT. Srurces. of Contributions to Caunty Health Department CHP Trust Fund (cash) Other Contributions Total STATE 3. FEDERAL FUNDS 407058 FGIIT Diabetes Control 1) U n 007044 Itrcv 131Ili i[1k GrVRapa Awareness 0 0 0 FEDERAL FUNDS TOTAL 616.388 n 616.388 V 4. FEES ASSESSED BY STATE. OR FEDERAL RULES 'i 001091 Communicable disease Fees 0 0 0 00[092 Envitonm etual Hcalth Fees 105.219 0 145.219 001113 Mobile [ionic and Parks 12.500 0 12.500 001132 Food Ilygicne Permit 12.000 0 12,000 001092 OSDS Repair Permit 26.716 0 26,716 001092 OSDS Permh Fee 30.720 0 30.720 001211 Safe Drinking (Vater 1.995 0 L"s 001 136 ! & hi 7.oncd Operating Permit 0 0 0 001092 AcrohicOperating Pcrmi1 552 0 552 001692 Septic tank Site livaluaunn 30„773 0 30.773 001139 Mtigra a Housing Permit 0 0 0 001140 Biohazard Waste Permit 6.000 0 6,000 001166 )Jan-SDWA System Permit 0 0 0 001112 ;lnn SDWA Lab Sample 0 0 0 001144 Tanning Facilities 2.150 0 2.150 001115 Swimnning PnoIS 26.170 0 26.170 001166 Public Water Cnwr Perm 0 f} 0 001165 Privaw Water Constr Permit 0 0 0 001 [66 Public Wa(crAnnual OPcr FermiI 3..760 0 3.760 001170 Lab Fee Chemical Analysis 0 0 0 001026 Returned Check SCF Fecs 0 0 0 010403 Fees -Copy of Public Due 0 0 0 015055 Registar Fees Wk. 382.34) 0 0 0 001135 05p5 Variance Fee 0 p 0 015052 Transfers-Mnbllc HonnciRV Park 4 0 0 001149 Body PierCin_e 0 0 0 FEES ASSESSED BY STATE OR FEDERAL. RULES TOTAL, 258,555 rl 258.555 5. OTHER CASK CONTRIBUTIONS 090001 Drawdown from Public Ifealth Unit 0 0 0 OTHER CASA CONTRIBUTIONS TOTAL 0 0 1) G. MEDICAID 001056 C'HD Inca: Medicaid -Pharmacy 1) 0 0 001080 CHO hnem:Mcdicaid-Other 23.730 0 23.73[) WWIII CTIOmcmMedicaid-ITSD'I 1%5.751 0 175.'41 001082 CHp Inenn:Medieaid-Denial 44.881 0 44.881 001083 0111) Incm:Medicaid-FP 76.383 0 76.383 001084 CHD Incin Medicaid -Physician 0 0 0 001085 Cl ID Incm:Medicaid•Nursing 0 0 1) 001086 C'Hp 1ncm:C'irlasurance o 0 It 001087 C111)lncin-Waicaid.S-1D 5.187 4 5.187 041088 CHI) IncrwMed Rcimb ALT Disp Fee 0 0 0 001089 %,Wicaid AIDS 1,805 1) 1.805 001 [47 Medicaid 111.10 Rate 0 0 0 001146 Medicaid -I INTO Admin 990 0 990 001 i81. C'IID hinn:6lcdicaid Transportation !% 11 0 001190 Health Mainicnance Organ ;10610) 0 0 0 001191 Cl 11) 1ncni Medicaid Muleriiy 43.492 ri 43.492 • C1 ATTACHMENT 1I INDIAN RIVER COUNTY HEALTH DEPARTMENT Fart 11. Sources of Contributions to County Health Department CID Trust Fund (cash) Other Contributions Total STATE 6. MEDICAID 001192 Citt] Btcm:Medicaid Comp. (Auld ?86.107 II 286.107 90t193 CI 11) 1 ric av Mudicald Convp. Adult 138.5.45 1) 133.3I5 001194 CHD Inem:Medicaid Sonacram U 0 0 001208 Medipass 53.00 Adm. Fee 72.000 U 72.900 868.871 0 868-371 MEDWAID TOTAL 7. ALLOCABLE REVENUE 011007 Cash Donations Private 0 0 0 001029 Third Party ReimblASelltenl 0 0 0 DID301 Esp Wimcss Fee Consultnt Charges 9 0 005040 Interest Erred Slate Investment •10,000 0 40.900 00S041 Interest Ernes) local Investment 0 0 0 0 007010 11.S. Granas Direct to CHD 0 0 90$094 GmIslContraelsulher Agencies Direel 0 0 0 0 011098 Donation School Rascd Clinic 0 0 011099 Other GrantslDonations Direct n 9 0 012020 Fines and forfeitures 0 0 0 918001 Itefunds, Salary, 0 0 0 018003 Refunds, other Personal Scn ices 0 0 0 01800.1 Refunds.Expcnses 0 0 0 018006 Refunds, Operating Capital [Outlay 0 0 0 018010 Refmids, Spccial Category 0 0 U 018911 Refunds. Other 0 0 0 018099 Refunds. Certified Forward 0 0 0 037000 Prior Year Warrant 0 0 0 038900 12 Momh Old Warrant 0 0 0 010300 Sale of Goods and Services 0 0 0 010402 Rccycic Paper Sales 0 0 0 010.103 Fecs-CopicsofDocuments 0 0 0 010405 Sale of pllarm ice uticais 0 0 U 911055 Other Grant DOE'. 0 0 U 01.2021 Rcturn Chcck Charge 0 0 0 018005 Refunds Grants 1u Local Gov't 0 U 0 029010 Sale of Fixed Assets 0 0 9 ALLOCABLE REVENUE TOTAL 40.000 0 40,000 S. OTHER STATE CONTRIBUTIONS NOT IN CIID TRUST FUND State Pharmacy Services 0 0 0 Stale Laboratory Services 0 112 387 112387 Slate III Services 0 0 0 State tnnulnizalinn Services I) 138.658 138.658 State SID Services 0 0 0 State ConstrucliotllRenovanult 0 9 0 WIC Food 0 1,105,983 1,106.983 Othertspecif%O 0 it 0 Other(specify) 0 0 0 0111cr Ispecify.l it 0 1) Other (specify) 9 0 0 OTHER STATE CONTRIBUTIONS NOT IN (:I1D TRUST FUND TOTAL 1) 1.358.6,'.8 1.358.628 TOTAL STATE CONTRIBUTIONS 3.777.047 1.358.628 5.135,675 M 4w ATTACHMENT 11 INDIAN RIVER COUNTY HEALTH DEPARTMENT Part 11, SOurces of Contributions to County Ilealtb Department CiID Trust Fuud (cash) Olhcr Contribulions Total COUNTY L BOAItD OF COIJNTY COAINIISSIONEItS ANNUAL API'tt01'RIATION5: 008030 (imms-Cuunty°'I'ax Direct 383:100 0 383.400 008034 Grants Cnn- Commsn Other 723,286 I) 723.286 BOARD OF COUNTY COMMISSIONERS ANNUAL APPROPRIATIONS TOTAL: 1.10606 0 1.106.486 2. FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION. 001077 Primary Care Fecs 151.810 0 151.810 001043 Communicable Disease Res 46.042 0 46.492 001094 Environmcnlai health Dees 61.255 0 61.255 0011141 New Birth Certificates 20.230 0 20.230 001115 Death Certificates 114,435 0 114,435 001116 CompulcrAccessFce 736 0 736 001060 V ital Statistics Fecs Other 0 0 0 001004 Chi 1d Car Seat Ping 0 0 0 001074 Adult Eruct- Permit Fees 0 0 0 001145 Primary Care Transfer Fees 0 0 0 001117 Vita} Stats -Adm. Fee 50 cents 1.445 0 1A45 001196 Water Analysis•Putablc 0 0 0 FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION TOTAL 446.003 0 4461.003 3. OTHER CASH, AND LOCAL CONTRIBUTIONS 040002 Draw down from Public Health Unit 0 0 0 001090 Medicare 65,188 0 65.448 408050 Grants'-Cnty Sch hoard Direct 400 0 4.000 008010 Grants Contracts. Fort Cities Direct 0 0 0 008033 County Contributions Far Facilities 0 0 0 008090 Grains other Local i3ovn't Direct 324.240 0 324,240 008095 (iranls Cnty Sect 403.102 Air Pol 0 0 0 008094 ReinlblRehate Luca] Guvn't 0 0 0 008031 County AIDS 1.ducation 18,000 0 18'000 OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL 411,724 0 311.728 4. ALLOCABLE REVENUE 011007 Cash Donations [,rival(: 0 1) 0 001029 Third Party Reimhursemem 15.520 0 15.520 010301 rxn Wimcss free Consullal Charges 0 0 0 045040 lntcrest Lmed Stale Investment 0 0 0 005051 ]merest rmed Local Investment 0 0 n 007010 U.S. Grants Direct 10 Cl 11) t} 0 0 008044 GmtslContracts other Agencies Direct 12.000 0 Q000 011098 Donation School Based Clinic 0 0 0 011099 Other GramslDanations Direct 62.160 0 62.160 012020 Fines and Forfeitures 0 0 0 018001 Refunds. Salary 53,{)00 0 53.000 018003 Refunds. other I'ersnnal Services 17.004 1) 17.000 018004 Refunds, lixpenscs 4.600 0 4.600 018006 Refunds. Operaling Capital Outhy I] II [} 018010 Refunds. Special Calvvr}, ll 11 0 018011 Refunds, Met u 0 0 01804 Refunds. CeniEled Forward 0 0 0 037000 Prior Year Warrant tt 0 0 038000 12 Month Old Winans SIII] n S00 010300 Sale of Goods and Sergi<" I# 0 11 010402 Rccycte Paper Salcs 0 0 0 010403 Fccs•Copies of Docu meats 3,920 0 3.920 ATTACHMENT fI INDIAN RIVER COUNTY HEALTH DEPARTMENT Part H. Sources of Contributions to County Health Department CHD Trust Fund (cash) Other Contributions Total COUNTY 5. ALLOCABLE REVENUE 010405 Sale ofphamtaccuticals 0 t1 0 011655 other Gran[ DOL. 0 0 0 012021 ;:ctum Check Charge 0 0 0 018005 Refunds Grants to local Gov't 0 0 0 029010 Sate of Fixed Assets 0 0 0 COUNTY ALLOCABLE REVENUE TOTAL 168-700 0 168.700 5. BUILDINGS: Annual Rental Equivalent Value 0 365.000 305.006 Maintenance 0 113.000 113.000 Other (specify) 0 0 0 Other(specify) 0 0 0 Other (speci ry) 0 0 0 OthCr(specify) 0 0 0 Other (specify) 0 0 0 BUILDINGS TOTAL 0 518.000 518.090 6. OTHER COUNTY CONTRIBUTIONS NOT IN CHD TRUST FUND Other County Contribution (spccify) 0 0 0 Other County COW!biniun (spccify) 0 0 0 Other County Contribution (specify) 0 0 0 Other County Contribution (speciry) 0 0 0 Other County Contribution (specify) 0 0 0 OTHER COUNTY CONTRIBUTIONS NOT IN C1I1) TRUST FUND TOTAL 0 0 0 TOTAL COUNTY CONTRIBUTIONS 2.133.117 518.000 2.351.117 GRAND TOTAL CHD PROGRAM 5.9!0.145 1.776.628 7.686.792 F-1 40 • ATTACHMENT lI INDIAN RIVER COUNTY IIEALTH DFPARTM CNT Part Ill. Planned Sia fling, Clients, Services, And Expenditures By Program Service Area Within Each Level Of Service October 1, 2000 to September 30, 2001 Quarterly F.xpendlture Pin" FTE's Clients 1st 2nd 3rd 4th Grand (0.40) Units Services (Whole dollars only) County state Totnl A. COMMUNICABLE DISEASE CONTROL: lmmmtixalio❑ (I DI) 7.41 0 28.500 86.864 130,864 MAO 86,862 191.812 199,642 391,454 STD (102) 4,03 340 3.520 36.787 36.787 36.787 36,787 55.916 91,232 147,148. A.I.D.S. (I D3) 6.66 3.800 8,500 50.700 50,701 50.700 50.702 87.205 155.598 202,803 TR Control Services ; 104) 3.66 2.500 4.980 38.668 38,668 38,668 38.668 47.949 106.724 153.672 Comm. Disease Snrv. (106) 0.54 0 630 9.780 9.779 9,779 9.781 0 31).119 39,119 Ilepatilis Prevention (109) 0.00 0 0 0 0 0 0 0 0 0 Vital Statistics (180) 1.23 0 0 12,451 12.450 UA51 12.450 49.802 0 49,802 COMMUNICABLE DISEASE SUBTOTAL 23.53 6.640 46,130 235,250 279,249 235.249 235.250 432,683 552.315 984,998 B. PRIMARY CARE: Chronic Disease Services (210) 231 12.500 35.800 28,965 28.964 28.964 28.966 0 115.859 115,859 Tobacco Prevent !on (2 t 2) 1.00 0 20 11.788 11.788 11,788 11.789 0 47,153 47,153 Home Health (2.15) 0.00 D D 0 0 0 0 0 0 0 W.I.C. (221) 8.20 4.900 27,000 78,194 78,193 78.194 18.193 0 312.774 312.774 Family Planning (223) 6.47 2.000 9,800 7(;:310 76.411 76.110 76,411 88,636 217,006 305,642 Improved Pregnancy Outcomc (225) 1.66 620 3.580 17,935 17:146 17.045 17.946 0 71.782 11.782 Healthy Stan Prenatal (227) 2.50 300 12.750 33.037 33.037 33.037 33,037 0 132.148 132.148 Comprehensive Child Real 1h (229) 2030 3,500 18,600 268,101 268.702 268,702 268,698 393.200 681,603 1.074.803 l Icahhy Stan lofant (23 1) 1.92 195 12,000 24,037 24,037 24,037 24,037 0 96.148 96.148 School Heallh (234) 7.02 0 45,000 87,342 87,342 87,342 87,342 4.000 345.368 349,368 Comprehensive Adult Ilealth (237) 21.53 6,000 36,700 329.674 329,674 329,674 329.674 744,741 573,955 1,318,696 Dental Health (240) 7.66 2,500 11.200 101'919 101.919 101,918 101.919 252.759 154,916 407,675 PRIMARY CARE SUBTOTAL 80.57 32.515 212.450 1.058.012 1.0511.0 13 1,058,011 1,058.012 1.483.336 2.748.712 4:232,048 C. ENVIRONMENTAL HEALTH: Private Water Syslcm (357) 1,65 600 2,050 23,567 2.3,567 23.568 23.567 44.306 49.963 95.269 Public Water System (3 58) 0,15 4 110 1,873 1.874 1.873 1,87.1 0 7;194 7;494 individual Sewng,e Disp. (361) 4.82 2:900 5,650 66.887 66,888 66,887 66,887 61,536 206,013 267,549 Food Hygiene (348) 0.60 70 310 6.982 6,982 6,982 6,982 27,918 0 27,928 Group Care raeility (35 1) 0.22 115 175 2,790 2,790 2.790 2,790 0 11,160 11.160 Migrant Labor Camp (352) 0.03 4 24 492 493 492 494 0 1.971 1,971 I Iausing,Public Bldg Safety,Sonilatiun (353) 0.06 25 80 773 773 713 774 3.093 0 3.093 Mobilc ]lomc and Parks Services (354) 0.60 85 330 7.162 7.162 7.162 7,162 0 28.648 28.648 Swimming Pools/Balhing(360) 0.79 280 665 9,39.1 9.394 9.393 9.398 0 37.579 37,579 Biomedical WasteServices(344) 0.58 150 180 6.898 6.898 6.898 6.897 12,140 15,451 27.591 Tanning Facility Services (369) (1.08 15 20 861 861 861 861 0 3.444 3,444 Rabies SurveiliancelControl Services (360 0.15 10 35 1.845 1.845 1.845 1.844 7379 0 7,379 Arbovirus Surveillance (367) 0.07 0 5 836 836 836 836 3,344 0 3.344 RodcutlArlluopod Conttal 1368) 0.05 0 65 (As 648 648 643 a 2.592 15L)2 Storage Tank Cnmptlance (355) 1.13 IUs 245 14.792 14,742 1:1.792 14,792 1) 59.168 51).168 Super AcT Seryice 435 6) 0.03 105 225 1,482 1.482 1.482 1.481 0 5 927 5.921 tkeupatianal Health (344) O.OS 1 0 0 n 96 11 0 96 96 Consumer Product Safely (34.5) DAI 0 0 148 149 141) 14") U 595 595 r ATTACHMENT III 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, HR'S 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. Act of 1973, as amended, 29 U.S.C. 794, 2. Section 504 of the Rehabilitation 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 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 appa.opriate judicial or administrative relief, to include assistance being terminated and further assistance being denied. CA 40 ATTACHMENT IV FACILITIES UTILIZED BY THE COUNTY HEALTH 'DEPARTMENT Facility Description Clinic, Vital. Statistics, Environmental Health Administrative Headquarters 37,000 sq. ft. Gifford Health Center 7,600 sq. ft. Co -Located Site WIC, PEPW Public Health Nursing Location awned By 1900 27th Street County of Vero Beach, FL 32960 Indian River 9690 28th Court School District Vero Beach, FL 32967 of Indian River County 12196 CR #512 Fellsmere Fellsmere, FL 32998 Medical Center C-1 ATTACHMENT V DESCRIPTION OF USE OF CHD TRUST FUND BALANCES FOR SPECIAL CAPITAL PROJECTS, IF APPLICABLE (From Attachment II, Part I) Dental Expansion Project, $100,072, to supplement the funding allocated for expansion of existing dental services. The health department funding will be dedicated to furnishing and supplying the new area. The project will be completed no later than August 15, 2001. Replacement of outdated and failing phone system, $72,000. The project will be completed no later than October 31, 2000. Addition of air handler for first floor, $40,000, to correct indoor air problems in the clinic area. The county is also contributing to this project. The project will be completed no later than December 31, 2000. Complete re -carpeting health department, i.e., Environmental Health, front stairway, and Auditorium, $15,000. The project will be completed no later than May 31, 2001. DESCRIPTION OF SPECIAL CONTRACTS (From Attachment II, Part III) Please list separately Special contracts are contracts for services for which there are no comparable srjrvices in the county health department core programs; no service codes in Departmental coding manuals; projects that are locally designed and have no standard statewide set of services and therefore cannot be accounted for within existing county health department programs. These contracts are coded to FLAIR bevel 5:599 and include some contracts formerly handled at the district offices such as epilepsy, colposcopy, Project WARM, community planning and special family planning and teen mother projects. :1 6 MotATTACHMENT VI ENVIRONMENTAL HEALTH - ESTIMATED ANNUAL FEE REVENUES FISCAL YEAR 2000 - 2001 EFFECTIVE 0710112000 FEE DEPOSIT Est. Annual Revenue DESCRIPTION AMOUNT AMOUNT Accruing to CHd TF PUBLIC SWIMMING POOLS AND BATHING PLACES 1. Annual Permit - Up to (and including )25,000 gallons 75.00 67.50 5,808.00 la Transferto headquarlers 750 2. More than 25,000 gallons 160.00 144.00 18,012.00 23 Transfer to headquarters 16 00 3. Exempted Condo Pools (over 32 units 50.00 45.00 2,350-00 3a Transferto hoadquatlers 5 00 OTHERFEES - Col loctod by the 12 dologated counties Broward. Dade, Duval, Hillsborough, Lee. Manatee, Collier. Palm Beach, Pinellas, Palk, Sarasota, Volusia, Escambia. Variances for Okalossa. Santa Rosa. Wallon counties are processed by Escambia County as follows: 1. Plan review (new construction) 275.00 275.00 2. Plan review for modification of original construction 100.00 100-00 3. Planfapplicalion review for bathing place development 275;00 275.00 4. Initial operating permit 125.00 125.00 5. Variance applications 240.00 216.00 51 Transler to Headquarters 24 d0 All other counties are to send the fee to Bureau of Facility Programs in Tallahassee or the Environmental Engineering section in Orlando as follows: I Flan review {new construction) 27500 27500 2. Plan review for modification of original construction 10000 100.00 3 Planlapphcation rovpew for balhrng glace development 27500 27500 4 Inifial operating permit 12500 12500 5 Variance applications 240.00 24000 MOBILE HOME & RECREATIONAL VEHICLE PARKS (FEES ARE PRORATED ON A QUARTERLY BASIS) 1. Annual permit for 5 to 14 spaces 50.00 45.00 900.00 la. Transfer to headquarters Soo 3.50 pe 2. Annual permit for 15 to 171 Space 6 space 6,052'00 2a. 'I ransfer to headquarters i41`" 3. Annual permit for 172 and above spaces 600.00 544,00 5,548.00 3a Transferto headquarters GO 00 MIGRANT LABOR CAMPS 1. Annual permit for jacIlities with 5.50 occupants 125-001 125.00 - 2. Annual p4=it for facilities with 51-100 occupants 225-40 225.00 - 3. Annual permit for facilities with over 100 occupants 500.00 500.00 BIOMEDICAL WASTE GENERATORS 1. Initial permit 55.00 220.00 2. Renewal at annual rmit(excepl physician office generaI leas than 251bs130 data) stmarked by October 1 55.00 55.00 5,780.00 "Must use County Healt11 [Department IBI (01-67) Page 1 9118100 6 r 4D FEE DEPOSIT Est. Annual Revenue DESCRIPTION AMOUNT AMOUNT Accruing to t;HD TF !. Renewal of annual permit(except physician office generating ass than 25lbs130 days) postmarked after October 1 75.00 75,00 1, Storage faoitities permit postmarked t)y October 1 55.00 55.00 3, storage facilities parnfit 2agtmaftd after October 1 75.00 75.00 4. Treatment facililies operating ermit by October 55,00 55.00 4. Treatment facilities operatIng permit after October 1 75.00 75-00 5. Transporter registration_ tone vehicle ostmarked by 1011 55.00 55.00 5, Trans orter registration (ona vehicle) after 10fi 1 75.00 75,00 5- Transporter registration additional vehicle 10-00 10.00 TANNING FACILITIES 1. Annual license fee i50.00 135.00 1,350.00 1a. Transfer to ileaoquarters 15 00 2. Fee for each additional device 55.00 49.50 800.00 2.a. Transfer to 1leadquarter5 _ 5,50 3. Late fee 25.30 25.00 BODY PERIERCING 1. Annual Licence Fee 150.00 135.00 la. Transfer to headquarters _ 1500 2.. Temporary Establishment 75.00 67-50 2a. Transfer to headquarters 750 3. Late fee 100.00 500.00 FOOD ESTABLISHMENTS 1. Annual Permit for FratemalfGivic 160.00 144.00 2,557.00 1 a. Transfer to headquarters 1600 2. Annual Permit School Cafeteria Operating for 9 months or less 130.00 117,00 2a. Transfer to headquarters 13.00 3. Annual Permit school Cafeteria Operating far more than 9 months 160.00 144,00 2,900.00 3a.. Transfer to headquarters 1600 4. Annual Permit for HospitalINursing, Food Service 210.00 189.00 1,814.00 4a Transfer to headquarters 21 00 5. Annual Permit for Movie Theaters 160-00 1 144.00 244.00' 5a TYangfef to headquarters 1600 B. Annual Permit for JailslPdsons 210.00 i89.00 220,00 6a. Transfer to headquarrers 21 00 7, Annual Permit for Bars/Lounges {Drink Service Only) 160.00 144,00 1,784,00 7a T(ansler to headquarters 1600 S. Annual Permit for Residential Facilities 110.00 99.00 1,587.00 6a Transfer to headttuarlers I I fat) 9. Annual Permit far Child Care Centers without G&F license 85.00 76.50 273.00 9a Transfer to headquiftrs - B 50 10, Annual Permit for Limited Food Service 85-00 76.50 532.00 f0a transfer to .headquarters 61 0 11. Annual Permit Other Food Service 160.00 144-00 509.00 Ila Transfer to headquarlers 11, r1!i 12. Plan Review 835Jhour $350huur 13. flood Worker Training 10.00 1000 "Must use County Health Department 181(01-67) Page 2 9/18100 4b 40 DEPOSIT Est. Annual Revenue DESCRIPTION AMOUNT FEE AMOUNT Accruing to CHD TF 14. R nest fur Ins iection 40.00 40.00 15. Reinspecllon (after the first reins action] 30.00 30-00 %. Late Renewal 25.00 25.00 17. Alcoholic Beverage Inspection Approval 30.00 30.0 ONSITE SEWAGE DISPOSAL PROGRAM (OSTDS) 25.00 23.00 30,719.80 1. Application for Parmitring of an onsite sewage treatment and dis dsal s stem which incudes 02plication and tan review for new and repair Permits 1 00 1 a. Transfer to headquarters 30,772.134 2. Site evaluation Tar a naw s stem moo55.2fl --4801 2a. Transferto headquarters _ 27,600.00 3. Site evaluation Tor a system repair or modification of s stem 40.00 36.80 320 _ 3a. Transfer to headquaders - 36.80 4. site re-evaluation, new or repair or modification 40.00 3.20 4a. ITansfer to headquarters - 5o.so 27,846.80 5. 'Permit for new systems, or modification to system 55.00 440 5a. Transfer to I>,e ldcluarlers 50,60 27,846.80 8. News stem ors stem modification installation inspection 55.00 440 6a Transfer to headquarters 7. Research fee to he collected in addrfion. and concanent with 500 00 the permit for a news stern installation fee until 613012002 ' 8. 'Re aira1.4o permit issuance which includes inspection 5a.oa 2G,715.$0 360 Ba. Transfer to headquarters 8b. Transfer to headquarters for training canter 500 6,34$.flD 9. in action of system previous) in use 50.00 46.00 4 00 9a Transfer to headquarters 4'Sfl O0 10. Reinspection fee per visit for site inspactions after system 25,00 23.OD construction approval 200 10a. Transfer to headquanels 23.00 4E30,04 11. Installation reinspection of non-compliant s stem per 25.00 each site visit 200 iia Transfer to headquarters 36.80 9217.00 12.5 stem abandonment permit, includes permit 40.00 issuance and inspection 3 20 12a. Transferfoheadquaders 138.00 12,000.00 13. Annual operatingpermit fee fors stems in IM and 150.00 e uivaleni areas, and far s stems receivin commercial waste 12 (10 - 13a Trarssfer to headquarters - 14. Amendments or changes to the operating permit durin 25,00 23.00 the permd period per change or amendment 200 Ida Translarlo hendquartov, _ 0 112 X52.00 15. Aerobic treatment unit operatingpermit per annum 150.00 00 12 0 - 15a Transfer to treadquarters - - 16. Tank manufacturers inspection per annum 104.00 50.00 11000 1 � a. 1 r8 nshe r fn F,P adquarir: a y 46.00 4400 230.00 17- Sepia a disposal service permit per annum _ 50.00 - Ila fransler to twa_dquarlers 23.00 161.OD 18. Additional charge per pum ut vehicle 25 On "Must use County Health Department 1131 (01-67) Page 3 9118100 is Transfer to headquarters 200 F. Installation reinspection of non -compliants stem per 50.00 46.00 Each site visit FEE aePofalT Est. Annual Revenue DESCRIPTION AMOUNT AMOUNT Accruing to C14D TF ssuance and inspection 1Ba. Transfertoheadquarteis 200 600 t9. Portable ortem ora toilet service permit per annum 50.00 46.00 138.00 19a. Transfer to headquarters On Transfer to headquarters 400 16 00_ 10. Review of application due to proposed amendments or 20. Additional charge per pumpout vehicle 25.00 23.00 00-00 - - 20a. Transfer to headquarters 1 00 11. Variance application for a single family residence per 150.00 21. SB to a stabilization facility inspection fee per annum 150.00 138.00 21a Transfer to headquarters 1200 22. se to a disposal site evaluation fee per annum 100-00 92.00 184'00 22a. Transfer to headquarters 8 00 23. Aerobic treatment unit maintenance entil permit per annum 25.00 2300 23.00 23a. Transfer to hp-ldquarlers GO 24. Variance nppl calion for a single family residence per 150.00 75.00 75.40 each iotorbuilding site 24a. Transfer to headquarters 75.00 25. Varlance application for a multi -family or commercial 200.00 100.00 300.40 building per each building site 25a. Transfer to headquarters 100 00 26. Inspection for construction of an injection well (Ft- Keys) 125.00 125.00 Performance-based Treatment Systems 1. Application for pe rmitting of a new performance -teased 125.00 115.00 !treatment s stem, which includes application and plan review la. Transferloheadquarlers 1000 2. Permit for now performance-based treatment system 125.00 115.00 2a. Transfer to headquarters 1000 3. Installation inspection for new performance-based systems 75.00 69.00 3a. Transfer to headquarters 6.00 6. Research fee to be collected in addition, and concurrent wilt] 500 s rrn the permit for a new perforniance-based system installation fee 4, Repair permit issuance whieh includes inspection 125.00 115.00 - 4a. Transfer to headquarters 10 00 5. Inspection of system previously In use 25.00 23.00 5a. Transfer to headquarters 200 5 ReinSnaction fee car visit for site inspections after system 25.00 23.00 is Transfer to headquarters 200 F. Installation reinspection of non -compliants stem per 50.00 46.00 Each site visit ra Transfer to headquarlers 4 00 1 S stem abandonment permil, includes permit 75-00 69.00 ssuance and inspection la Transfer to headquarters 600 D. Annual operatinQ pormil fee for performance•based _ 200.00 184.00 treatment system. Fee charged second Xear of operation On Transfer to headquarters 16 00_ 10. Review of application due to proposed amendments or 75.00 69,00 chap es after initial operating rmlt issuance. - - 10a T1,inslttr In neaelquarters b 00 11. Variance application for a single family residence per 150.00 7b,00 "Must use County Health Department IBI (01-67) Rage 4 9118100 • r 40 FEE DEPOSIT Est, Annual Revenue DESCRIPTION AMOUNT AMOUNT Accruing to CHD TF Bach lot or bull dln site 7500 I'la, Transfer lo headquarters - FEE COLLECTED AT HEADQUARTERS - Onsite Sewage 1. Application for mrtovative praduel approval 500 00 ers use only 2. Application for regrstralion including rnmal exam+nahon 75.00 ers use only Muarltlw�SUM 100 00 ers use 0111 3. Initial registration $00.00 ers use only 4. Renewal of re Istrali0n 5. Certificate of authorization each two•yar p000d 250 Oo ters use Only DRINKING WATER 337.50 1„ First Year Public WaterAnnual Operation Permit and 75Ao 67.50 Construction Permit - Limited Use 7 50 1a Transfer to headquaners 2. Second Year Public Water Annual flparallon Permit 3,080.50 74.04 63.00. Limited Use 700 2a. Transfer to headquaners 35.00 270.00 C Private Water Construction Permit -serving 3 or 4 40.00 non -rental residences 400 4a, Transfer Eo headquarters _ 31.50 72.00 S. Initial ODerating Permit Fee After March 31 of Any Year 35.00 3 50 5a. Transfer to headquarters 6. Non -SHWA Lala Sample Sam to CollectionrReview of Analytical Resulls7Fleallh Risk Interpretation): Delineated Area 50.00 50.00 Bacterial Sample Collection 40.00 40.00 Chemical Sample Collection 50.00 50.40 Combined Chemical microbiolo ical 55Xo 55.00 7. Reinspection of Private Water S stem 25.00 25.00 6. Reins action of Public Water S stem 40.00 40.00 9. Delineated Area Clearance Fee 50.40 50.00 10. Limited Use Commercia6 Re island S stem 15.00 15.00 11. United Use Commercial Pubtic Water S stem 25.40 25.00 1,tJt35. DO C7 eratin Parniit Fami Da Care Establishment 12. Limted Use Commercial Public Water System 0 eralin Permit 15.40 15'00 Family Day Care Establishment After March 31 of Any Year. Sale Drinking Water Act (Delegated Counties) ech Cate o. I throu h til treatment 1. Construction E2mnii F@k4G0 - _ lent, as defined In Ru99110, F.A.C.., with treatment other Sian disinfection a. Treatment lant - 5and above 7.500.00 T„500.04 b. Treatment plant - 1 up to 5 MGI] 6,000.04 6,000.00 c. Treatment lent - 0D u to ! MGD 4.000.00 4,040.00 d. Treatment lana - 0D u to .025 MGD 2,400.00 2,000.00 e. Treatment lane- .1 MGD 1,040.40 1,000.00 2. Construction ermiach Category IV treatment plant, as defined In Rule 62-69F.A-C-., with treatment other than _ distnfection o. Treatment lane - and above 7,500.40 7,500.00 b. Treatment plant -ID u la 5 k4G0 6,00D.00 & "Must use County Health Department IBI (01-67) Page 5 9118140 Ob 4b M -Must use County Health department IBI (41-67) Page 6 9118144