HomeMy WebLinkAbout2024-238CONTRACT 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 2024-2025
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, 2024. 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,
2024, through September 30, 2025, 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
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 11, Part II is an amount not to exceed $4,052,069 (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, or local contributions) as provided in Attachment II, Part II is an amount
not to exceed $806,623 (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 of the CHD.
Where applicable, such fees shall be automatically adjusted to at least the Medicaid fee
schedule.
d. Either party may increase or decrease funding of this contract during the term hereof by
notifying the other party in writing of the amount and purpose for the change in funding. If the
State initiates the increase 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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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
N. 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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g. The CHD may execute subcontracts for services necessary to enable the CHD to carry
out the programs specified in this contract. Any such subcontract shall include all
aforementioned audit and record-keeping requirements.
h. At the request of either party, an audit may be conducted by an independent certified
public accountant 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, 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 CHD shall not use or disclose any information concerning a recipient of services
except as allowed by federal or state law or policy.
j. The CHD shall retain all client records, financial records, supporting documents,
statistical records, and any other documents (including electronic storage media) pertinent to
this contract for 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 CHD 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 CHD shall implement procedures to ensure the protection and confidentiality
of all such records and shall comply with sections 384.29, 381.004, 392.65, and 456.057,
Florida Statutes, and all other state and federal laws regarding confidentiality. All confidentiality
procedures implemented by the CHD shall be consistent with the State's Information Security
Policies, Protocols, and Procedures. The CHD shall further adhere to any amendments to the
State's security requirements and shall comply with any applicable professional standards of
practice concerning client confidentiality.
I. The CHD shall abide by all State policies and procedures, which by this reference are
incorporated herein as standards to be followed by the CHD.
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 right to a fair hearing to the final governing authority
of the CHD. Specific references to existing laws, rules, or program manuals are included in
Attachment I of this contract.
n. The CHD shall comply with the provisions contained in the Civil Rights Compliance and
Non -Discrimination 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:
5
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:
March 1, 2025, for the reporting period of October 1, 2024, through
December 31, 2024; and
ii. June 1, 2025, for the reporting period of October 1, 2024, through
March 31, 2025; and
iii. September 1, 2025, for the reporting period of October 1, 2024
through June 30, 2025; and
iv. December 1, 2025, for the reporting period of October 1, 2024
through September 30, 2025.
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.
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8. TERMINATION.
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:
Mayur Rao
Name
Administrative Services Director II
Title
1900 27th Street
Vero Beach, FI., 32960-3383
Address
Mayur.rao(a-)-fl.health.gov
Email Address
772-794-7464
Telephone
For the County:
Kristin Daniels
Name
Budget Director
Title
1801 27th Street
Vero Beach, FI., 32960-3383
Address
kdaniels 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.
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 2024.
BOARD OF COUNTY COMMISSIONERS STATE OF FLORIDA
FOR INDIAN RIVER COUNTY DEPARTMENT OF HEALTH
� •�oaitii�sS.•^.
SIGNED BY- by:LA—�J—
NAME: Susan Adams Moseph A. Ladapo, M.D., Ph.D.
TITLE: Chairman '•9��;ER�C1LL: State Surgeon General
DATE: September 24, 2024
ATTESTED TO:
SIGNED BY:
NAME:
TITLE:
DATE:
Attest: Ryan L. Butler, Clerk of
Circuit Court and Comptroller
By:w a
a— Do" CWlk�
0
DATE: 12 - '�-U' g-9
SIGNED BY: G—
NAME: Miranda C Swanson, MPH
TITLE: CHD Director or Administrator
DATE:
ATTACHMENT
INDIAN RIVER COUNTY HEALTH DEPARTMENT
PROGRAM SPECIFIC REPORTING REQUIREMENTS AND PROGRAMS REQUIRING
COMPLIANCE WITH THE PROVISIONS OF SPECIFIC MANUALS
Some health services must comply with specific program and reporting requirements in addition to the Personal Health
Coding Pamphlet (DHP 50-20), Environmental Health Coding Pamphlet (DHP 50-21) and FLAIR requirements because of
federal or state law, regulation or rule. If a county health department is funded to provide one of these services, it must
comply with the special reporting requirements for that service. The services and the reporting requirements are listed
below:
Service
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)
4. Healthy Start/ Improved Pregnancy
Outcome
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.
Requirements as specified in the 2007 Healthy Start Standards and
Guidelines and as specified by the Healthy Start Coalitions in
contract with each county health department.
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.
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 -1 - Page 1 of 2
levels as documented in Florida SHOTS and supported by CHID
Guidebook policies and technical assistance guidance.
Environmental Health Requirements as specified in Environmental Health Programs
Manual 150-4* and DHP 50-21'
HIV/AIDS Program Requirements as specified in F.S. 384.25 and F.A.C. 64D-3.030
and 64D-3.031. Case reporting should be on Adult HIV/AIDS
Confidential Case Report CDC Form DH2139 and Pediatric
HIV/AIDS Confidential Case Report CDC Form DH2140.
Requirements as specified in F.A.C. 64D-2 and 64D-3, F.S. 381 and
F.S. 384. Socio -demographic and risk data on persons tested for
HIV in CHID 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 Estimated County
Share of CHD Trust Share of CHD Trust
Fund Balance Fund Balance Total
1. CHD Trust Fund Ending Balance 09/30/24 137724 1028368 1166092
2. Drawdown for Contract Year -137724 -400061 -537785
October 1, 2024 to September 30, 2025
3. Special Capital Project use for Contract Year 0 0 0
October 1, 2024 to September 30, 2025
4. Balance Reserved for Contingency Fund 0 628307 628307
October 1, 2024 to September 30, 2025
Special Capital Projects are new construction or renovation projects and new furniture or equipment associated with these projects, and mobile health vans.
Attach ment_II_Part_I - Page 1 of 1
ATTACHMENT II
INDIAN RIVER COUNTY HEALTH DEPARTMENT
Part II, Sources of Contributions to County Health Department
October 1, 2024 to September 30, 2025
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
015040 SWIMMING LESSONS VOUCHER PROGRAM
015050 CHD GENERAL REVENUE NON -CATEGORICAL
GENERAL REVENUE TOTAL
2. NON GENERAL REVENUE - STATE
015010 ENVIRONMENTAL BIOMEDICAL WASTE PROGRAM
015010 TOBACCO STATE & COMMUNITY HEALTHY BABY
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 ELC COVID ENHANCED DETECTION EXPANSION GRANT
007000 FAMILY PLANNING TITLE X - GRANT
007000 PUBLIC HLTH INFRASTRUCTURE & WORKFORCE/CENTRAL 1
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
State CHD
County
Total CHD
Trust Fund
CHD
Trust Fund
Other
(cash)
Trust Fund
(cash)
Contribution
Total
100,000
0
100,000
0
100,000
41,050
0
41,050
0
41,050
22,679
0
22,679
0
22,679
187,853
0
187,853
0
187,853
52,000
0
52,000
0
52,000
136,867
0
136,867
0
136,867
6,600
0
6,600
0
6,600
1,827,279
0
1,827,279
0
1,827,279
2,374,328
0
2,374,328
0
2,374,328
7,154
0
7,154
0
7,154
10,000
0
10,000
0
10,000
17,154
0
17,154
0
17,154
39,388
0
39,388
0
39,388
58,125
0
58,125
0
58,125
12,454
0
12,454
0
12,454
35,000
0
35,000
0
35,000
112,540
0
112,540
0
112,540
34,828
0
34,828
0
34,828
152,988
0
152,988
0
152,988
51,376
0
51,376
0
51,376
32,206
0
32,206
0
32,206
91,613
0
91,613
0
91,613
83,823
0
83,823
0
83,823
56,262
0
56,262
0
56,262
80,000
0
80,000
0
80,000
669,916
0
669,916
0
669,916
150,068
0
150,068
0
150,068
1,660,587
0
1,660,587
0
1,660,587
160,176
0
160,176
0
160,176
280,087
0
280,087
0
280,087
2,418
0
2,418
0
2,418
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
755
0
755
0
755
456
0
456
0
456
20
0
20
0
20
Attachment _II_Part_II - Page 1 of 3
ATTACHMENT II
INDIAN RIVER COUNTY HEALTH DEPARTMENT
Part II, Sources of Contributions to County Health Department
October 1, 2024 to September 30, 2025
Attachment _II_Part_II -Page 2 of 3
State CHD
County
Total CHD
Trust Fund
CHD
Trust Fund
Other
(cash)
Trust Fund
(cash)
Contribution
Total
001206 TANNING FACILITIES
300
0
300
0
300
001206 TATTO PROGRAM ENVIRONMENTAL HEALTH
1,565
0
1,565
0
1,565
001206 MOBILE HOME & RV PARK FEES
2,413
0
2,413
0
2,413
FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL
482,954
0
482,954
0
482,954
5. OTHER CASH CONTRIBUTIONS - STATE:
031005 GENERAL CLINIC RABIES SERVICES & DRUG PURCHASES
11,000
0
11,000
0
11,000
031005 CHD GENERAL REVENUE NON -CATEGORICAL
0
0
0
0
0
090001 DRAW DOWN FROM PUBLIC HEALTH UNIT
137,724
0
137,724
0
137,724
OTHER CASH CONTRIBUTION TOTAL
148,724
0
148,724
0
148,724
6. MEDICAID - STATE/COUNTY:
001057 CHD CLINIC FEES
0
5,284
5,284
0
5,284
001148 CHD CLINIC FEES
0
21,763
21,763
0
21,763
MEDICAID TOTAL
0
27,047
27,047
0
27,047
7. ALLOCABLE REVENUE - STATE:
001004 CHD STATEWIDE ENVIRONMENTAL FEES
9,564
0
9,564
0
9,564
ALLOCABLE REVENUE TOTAL
9,564
0
9,564
0
9,564
8. OTHER STATE CONTRIBUTIONS NOT IN CHD TRUST FUND • STATE
ADAP
0
0
0
200,806
200,806
PHARMACY DRUG PROGRAM
0
0
0
1,298
1,298
WIC PROGRAM
0
0
0
2,555,183
2,555,183
BUREAU OF PUBLIC HEALTH LABORATORIES
0
0
0
18,135
18,135
IMMUNIZATIONS
0
0
0
45,753
45,753
OTHER STATE CONTRIBUTIONS TOTAL
0
0
0
2,821,175
2,821,175
9. DIRECT LOCAL CONTRIBUTIONS - BCC/TAX DISTRICT
008040 CHD LOCAL REVENUE & EXPENDITURES
0
806,623
806,623
0
806,623
DIRECT COUNTY CONTRIBUTIONS TOTAL
0
806,623
806,623
0
806,623
10. FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION - COUNTY
001077 CHD CLINIC FEES
0
318
318
0
318
001094 CHD LOCAL ENVIRONMENTAL FEES
0
277,347
277,347
0
277,347
001110 VITAL STATISTICS CERTIFIED RECORDS
0
280,000
280,000
0
280,000
FEES AUTHORIZED BY COUNTY TOTAL
0
557,665
557,665
0
557,665
11. OTHER CASH AND LOCAL CONTRIBUTIONS - COUNTY
001029 CHD CLINIC FEES
0
3,693
3,693
0
3,693
001090 CHD CLINIC FEES
0
2,576
2,576
0
2,576
010300 MIGRANT LABOR HOUSING INSPECTION H•2A PROGRAM
0
1,000
1,000
0
1,000
011000 BLUE FOUNDATION COUNTY GRANTS
0
70,000
70,000
0
70,000
011000 REVENUE CONTRACT/MOA W/NO REPORTING REQUIREMENT
0
22,380
22,380
0
22,380
011000 HEALTHY START NURSE FAM PARTNERSHIP EXPAND CHD
0
99,512
99,512
0
99,512
011001 CHD HEALTHY START COALITION CONTRACT
0
2,141
2,141
0
2,141
Attachment _II_Part_II -Page 2 of 3
Attachment_II_Part_II - Page 3 of 3
ATTACIBMNT II
INDIAN RIVER COUNTY HEALTH DEPARTMENT
Part II, Sources of Contributions to County Health
Department
October 1, 2024 to September 30, 2025
State CHD
County
Total CHD
Trust Fund
CHD
Trust Fund
Other
(cash)
Trust Fund
(cash)
Contribution
Total
090002 DRAW DOWN FROM PUBLIC HEALTH UNIT
0
400,061
400,061
0
400,061
OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL
0
601,363
601,363
0
601,363
12. ALLOCABLE REVENUE - COUNTY
001004 CHD STATEWIDE ENVIRONMENTAL FEES
0
9,564
9,564
0
9,564
COUNTY ALLOCABLE REVENUE TOTAL
0
9,564
9,564
0
9,564
13. BUILDINGS - COUNTY
ANNUAL RENTAL EQUIVALENT VALUE
0
0
0
565,363
565,363
OTHER (Specify)
0
0
0
0
0
UTILITIES
0
0
0
227,968
227,968
BUILDING MAINTENANCE
0
0
0
127,663
127,663
WABASSO SITE - ANNUAL RENATL EQUIVALENT VALUE 0
0
0
86,118
86,118
WABASSO SITE - UTILITIES
0
0
0
34,725
34,725
WABASSO SITE - BUILDING MAINTENANCE
0
0
0
19,446
19,446
OTHER (Specify)
0
0
0
0
0
BUILDINGS TOTAL
0
0
0
1,061,283
1,061,283
14. OTHER COUNTY CONTRIBUTIONS NOT IN CHD TRUST FUND - COUNTY
EQUIPMENT / VEHICLE PURCHASES
0
0
0
0
0
VEHICLE INSURANCE
0
0
0
0
0
VEHICLE MAINTENANCE
0
0
0
0
0
OTHER COUNTY CONTRIBUTION (SPECIFY)
0
0
0
0
0
OTHER COUNTY CONTRIBUTION (SPECIFY)
0
0
0
0
0
OTHER COUNTY CONTRIBUTIONS TOTAL
0
0
0
0
0
GRAND TOTAL CHD PROGRAM
4,693,311
2,002,262
6,695,573
3,882,458
10,578,031
Attachment_II_Part_II - Page 3 of 3
Attachment -11 -Part -111 - Page 1 of 2
ATTACHMENT II
INDIAN RIVER
COUNTY HEALTH DEPARTMENT
Part III, Planned Staffing.
Clients, Services and
Expenditures By Program Service Area Within Each Level of Service
October 1, 2024 to September 30,
2025
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)
2.35
205
252
67,476
57,840
67,476
58,795
117,749
133,838
251,587
SEXUALLY TRANS. DIS. (102)
2.93
199
240
83,054
71,193
83,054
72,370
199,061
110,610
309,671
HIV/AIDS PREVENTION (03A1)
2.86
0
898
73,527
63,027
73,527
64,070
274,151
0
274,151
HIV/AIDS SURVEILLANCE (03A2)
0.06
0
30
1,322
1,133
1,322
1,151
4,928
0
4,928
HIV/AIDS PATIENT CARE (03A3)
3.24
130
245
104,875
89,898
104,875
91,383
372,593
18,438
391,031
ADAP (03A4)
0.71
142
3,905
17,254
14,790
17,254
15,035
64,333
0
64,333
TUBERCULOSIS (104)
1.36
21
131
43,378
37,183
43,378
37,797
159,549
2,187
161,736
COMM. DIS. SURV. (106)
8.05
0
19
194,677
166,876
194,677
169,635
725,865
0
725,865
HEPATITIS (109)
0.00
0
0
0
0
0
0
0
0
0
PREPAREDNESS AND RESPONSE (116)
1.17
0
1
35,222
30,192
35,222
30,691
131,327
0
131,327
REFUGEE HEALTH (118)
0.00
0
0
0
0
0
0
0
0
0
VITAL RECORDS (180)
3.00
10,857
39,404
60,252
51,647
60,252
52,501
0
224,652
224,652
COMMUNICABLE DISEASE SUBTOTAL
25.73
11,554
45,125
681,037
583,779
681,037
593,428
2,049,556
489,725
2,539,281
B. PRIMARY CARE:
CHRONIC DISEASE PREVENTION PRO (210)
1.23
0
74
25,247
21,641
25,247
21,999
94,134
0
94,134
WIC (21WD
10.01
2,478
30,869
205,120
175,828
205,120
178,733
764,801
0
764,801
TOBACCO USE INTERVENTION (212)
0.14
0
0
3,410
2,923
3,410
2,972
12,715
0
12,715
WIC BREASTFEEDING PEER COUNSELING (21W2)
1.56
0
2,496
23,557
20,193
23,557
20,526
87,833
0
87,833
FAMILY PLANNING (223)
3.78
115
205
106,962
91,688
106,962
93,204
236,269
162,547
398,816
IMPROVED PREGNANCY OUTCOME (225)
0.00
0
0
0
0
0
0
0
0
0
HEALTHY START PRENATAL (227)
0.63
1,158
5,013
17,743
15,209
17,743
15,460
0
66,155
66,155
COMPREHENSIVE CHILD HEALTH (229)
0.00
0
0
0
0
0
0
0
0
0
HEALTHY START CHILD (231)
0.59
1,027
4,729
15,740
13,492
15,740
13,715
0
58,687
58,687
SCHOOL HEALTH (234)
3.41
0
86,330
89,869
77,036
89,869
78,309
335,083
0
335,083
COMPREHENSIVE ADULT HEALTH (237)
0.00
0
0
0
0
0
0
0
0
0
COMMUNITY HEALTH DEVELOPMENT (238)
7.28
0
2,411
190,507
163,302
190,507
166,000
458,981
251,335
710,316
DENTAL HEALTH (240)
0.00
0
0
0
0
0
0
0
0
0
PRIMARY CARE SUBTOTAL
28.63
4,778
132,127
678,155
581,312
678,155
590,918
1,989,816
538,724
2,528,540
C. ENVIRONMENTAL HEALTH:
Water and Onsite Sewage Programs
COSTAL BEACH MONITORING (347)
0.14
123
123
5,715
4,899
5,715
4,981
21,059
251
21,310
LIMITED USE PUBLIC WATER SYSTEMS (357)
0.54
37
377
13,627
11,681
13,627
11,873
4,742
46,066
50,808
PUBLIC WATER SYSTEM (358)
0.05
0
2
1,184
1,015
1,184
1,030
29
4,384
4,413
PRIVATE WATER SYSTEM (359)
1.25
319
2,008
34,313
29,413
34,313
29,900
664
127,275
127,939
ONSITE SEWAGE TREATMENT & DISPOSAL (361)
7.88
2,936
11,743
173,500
148,724
173,500
151,182
284,265
362,641
646,906
Group Total
9.86
3,415
14,253
228,339
195,732
228,339
198,966
310,759
540,617
851,376
Facility Programs
TATTOO FACILITY SERVICES (344)
0.21
179
148
5,243
4,495
5,243
4,569
19,170
380
19,550
FOOD HYGIENE (348)
1.26
108
464
28,936
24,803
28,936
25,213
24,663
83,225
107,888
Attachment -11 -Part -111 - Page 1 of 2
Attachment _II_Part_III - Page 2 of 2
ATTACHMENT II
INDIAN RIVER
COUNTY HEALTH DEPARTMENT
Part III, Planned Staffing. Clients, Services and Expenditures By Program Service Area Within Each Level of Service
October 1,
2024 to September 30,
2025
Quarterly
Expenditure Plan
FTE's
Clients Services/
1st
2nd
3rd
4th
Grand
(0.00)
Units
Visits
(Whole dollars
only)
State
County
Total
BODY PIERCING FACILITIES SERVICES (349)
0.01
1
0
419
360
419
366
1,536
28
1,564
GROUP CARE FACILITY (351)
0.58
102
132
13,596
11,655
13,596
11,848
306
50,389
50,695
MIGRANT LABOR CAMP (352)
0.17
26
101
4,612
3,954
4,612
4,019
2,091
15,106
17,197
HOUSING & PUB. BLDG. (353)
0.13
1
29
3,848
3,298
3,848
3,353
66
14,281
14,347
MOBILE HOME AND PARK (354)
0.26
58
132
7,347
6,298
7,347
6,401
16,516
10,877
27,393
POOLSBATHING PLACES (360)
1.63
497
1,778
37,762
32,369
37,762
32,905
61,182
79,616
140,798
BIOMEDICAL WASTE SERVICES (364)
1.87
659
842
41,538
35,606
41,538
36,196
151,444
3,434
154,878
TANNING FACILITY SERVICES (369)
0.04
9
15
1,063
911
1,063
927
3,820
144
3,964
Group Total
6.16
1,640
3,641
144,364
123,749
144,364
125,797
280,794
257,480
538,274
Groundwater Contamination
STORAGE TANK COMPLIANCE SERVICES (355)
0.00
0
0
0
0
0
0
0
0
0
SUPER ACT SERVICES (356)
0.00
0
0
0
0
0
0
0
0
0
Group Total
0.00
0
0
0
0
0
0
0
0
0
Community Hygiene
COMMUNITY ENVIR. HEALTH (345)
0.10
0
320
2,896
2,482
2,896
2,523
55
10,742
10,797
INJURY PREVENTION (346)
0.16
0
0
5,715
4,899
5,715
4,981
21,027
283
21,310
LEAD MONITORING SERVICES (350)
0.12
0
0
1,786
1,531
1,786
1,557
59
6,601
6,660
PUBLIC SEWAGE (362)
O.87
7
77
19,213
16,469
19,213
16,742
463
71,174
71,637
SOLID WASTE DISPOSAL SERVICE (363)
0.00
0
0
27
23
27
22
0
99
99
SANITARY NUISANCE (365)
0.19
26
8
5,284
4,530
5,284
4,605
97
19,606
19,703
RABIES SURVEILLANCE (366)
0.16
56
142
4,666
3,999
4,666
4,065
83
17,313
17,396
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)
0.28
0
54
8,766
7,514
8,766
7,638
152
32,532
32,684
INDOOR AIR (371)
0.00
0
0
232
199
232
202
1
864
865
RADIOLOGICAL HEALTH (372)
0.00
0
0
22
19
22
19
0
82
82
TOXIC SUBSTANCES (373)
0.15
7
24
4,424
3,792
4,424
3,856
76
16,420
16,496
Group Total
2.03
96
625
53,031
45,457
53,031
46,210
22,013
175,716
197,729
ENVIRONMENTAL HEALTH SUBTOTAL
18.05
5,151
18,519
425,734
364,938
425,734
370,973
613,566
973,813
1,587,379
D. NONOPERATIONAL COSTS:
NONOPERATIONAL COSTS (599)
0.00
0
0
0
0
0
0
0
0
0
ENVIRONMENTAL HEALTH SURCHARGE (399)
0.00
0
0
10,801
9,259
10,801
9,412
40,273
0
40,273
MEDICAID BUYBACK (611)
0.00
0
0
27
23
27
23
100
0
100
NONOPERATIONAL COSTS SUBTOTAL
0.00
0
0
10,828
9,282
10,828
9,435
40,373
0
40,373
TOTAL CONTRACT
72.41
21,483
195,771
1,795,754
1,539,311
1,795,754
1,564,754
4,693,311
2,002,262
6,695,573
Attachment _II_Part_III - Page 2 of 2
ATTACHMENT III
INDIAN RIVER COUNTY HEALTH DEPARTMENT
CIVIL RIGHTS COMPLIANCE AND NON-DISCRIMINATION CERTIFICATE
The CHD agrees to complete the Civil Rights Compliance Questionnaire, DH Forms 946 A and B (or the
subsequent replacement if adopted during the contract period), if so requested by the Department.
The CHD assures that it will comply with 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.
Assurance of Civil Rights Compliance: The CHD 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, be excluded from participation in, be denied the benefits of,
or otherwise be subjected to discrimination under any program or activity for which 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 in recognition of the public interest to be served by such sale, lease, or
4. 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 III - Page 1 of 1
Attachment IV
Fiscal Year - 2024 - 2025
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
N/A
County Owned
County Commissioners
for Indian River County
36,475
70.84
8445 64th Ave, Wabasso,
Florida, 32970
Wabasso Site
N/A
County Owned
County 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
2023-2024*
2024-2025**
2025-2026***
2026-2027***
PROJECT TOTAL
PROJECT NUMBER:
PROJECT NAME:
LOCATION/ADDRESS:
PROJECT TYPE:
SQUARE FOOTAGE:
PROJECT SUMMARY:
ATTACHMENT V
INDIAN RIVER COUNTY HEALTH DEPARTMENT
SPECIAL PROJECTS SAVINGS PLAN
CASH RESERVED OR ANTICIPATED TO BE RESERVED FOR PROJECTS
STATE COUNTY
TOTAL
$ 0 $
0
$ 0
$ 0 $
0
$ 0
$ 0 $
0
$ 0
$ 0 $
0
$ 0
$ 0 $
0
$ 0
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:
CONSTRUCTION COSTS:
FURNITURE/EQUIPMENT:
TOTAL PROJECT COST:
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 9/30/24
** Cash to be transferred to FCO account.
*** Cash anticipated for future contract years.
Attachment_V - Page 1 of 1
Ron DeSantis
Mission: Governor
To protect, promote & improve the health
of all people in Florida through integrated ...
state, county & community efforts. QUQk. Joseph A. Ladapo, MD, PhD
HEALTH State Surgeon General
Vision: To be the Healthiest State in the Nation
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 2024-2025
Addendum
This Addendum to the CONTRACT BETWEEN INDIAN RIVER COUNTY BOARD OF COUNTY
COMMISSIONERS AND STATE OF FLORIDA DEPARTMENT OF HEALTH FOR OPERATION OF
THE INDIAN RIVER COUNTY HEALTH DEPARTMENTCONTRACT YEAR 2024-2025 dated the 1St
day of October 2024. between INDIAN RIVER COUNTY BOARD OF COUNTY COMMISSIONERS
AND STATE OF FLORIDA DEPARTMENT OF HEALTH hereby amends the effective date of the
contract to 02/04/2025.
This Addendum shall take effect on the date signed by both parties, whichever is later.
All provisions in the contract and any attachments thereto in conflict with this addendum shall be and
are hereby changed to conform with this addendum.
All provisions not in conflict with this addendum are still in effect and are to be performed at the level
specified in the contract.
This addendum and all its attachments are hereby made a part of the contract.
IN WITNESS THEREOF, the parties hereto have caused this 1 page addendum to be executed
by their officials thereunto duly authorized.
BOARD OF COUNTY COMMISSIONERS
FOR INDIAN RIVER COUNTY
SIGNED �q
BY:
NAME: e nd VAI U(d l DUl
TITLE: DP.{ ai'j" C lei
DATE: fe �V col � 1102c
Cc. Office of Budget and Revenue Management
Florida Department of Health
In Indian River County
1900 27th Street, Vero Beach, FL 32960
PHONE: 772/794-7400
WEBSITE: http://indianriver.floridahealth.gov
FloridaHealth.gov
STATE OF FLORIDA
DEPARTMENT OF HEALTH
SIGNED
BY:
NAME: Miranda C Swanson
TITLE: CHD Director or Administrator
DATE: February 4th, 2025
0 P -IAB Accredited Health Department
Public Health Accreditation Board