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HomeMy WebLinkAbout2007-316 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 2007-2008 This agreement ("Agreement") 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 , 2007 . 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 forgoing 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 , 2007 , through September 30 , 2008 , 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. 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 . I 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 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 are set forth in Part II of Attachment II hereof. This funding will be used as shown in Part I of Attachment ll . i. The State's appropriated responsibility (direct contribution excluding any state fees, Medicaid contributions or any other funds not listed on the Schedule C) as provided in Attachment Il , Part II is an amount not to exceed $ 4 , 042 , 369 . 00 (State General Revenue, 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 orlocal contributions) as provided in Attachment Il , Part II is an amount not to exceed $ 803 , 169 . 00 (amount listed under the "Board of County Commissioners Annual Appropriations section of the revenue attachment) . b. Overall expenditures will not exceed available funding or budget authority, whichever is less , (either current year or from surplus trust funds) in any service category. Unless requested otherwise, any surplus at the end of the term of this Agreement in the 2 County Health Department Trust Fund that is attributed to the CHID shall be carried forward to the next contract period . c. Either party may establish service fees as allowed by law to fund activities of the CHD . Where applicable , such fees shall be automatically adjusted to at least the Medicaid fee schedule . d . Either party may increase or decrease funding of this 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 Budget Management. If the County initiates the increase/decrease, the County shall notify the CHID . 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 : County Health Department Trust Fund Indian River County Accounts Receivable 190027 th Street, Vero Beach , FL 32960-3383 5 . CHD DIRECTOR/ADMINISTRATOR. Both parties agree the director/administrator of the CHD shall be a State employee or under contract with the State and will be under the day-to-day direction of the Deputy 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 non-categorical 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 1 of each year (This is the standard quality assurance "County Health Profile" report located on the Office of Planning, Evaluation & Data Analysis Intranet site). 6 . ADMINISTRATIVE POLICIES AND PROCEDURES . The parties hereto agree that the following standards should apply in the operation of the CHD : a . The CHD and its personnel shall follow all State policies and procedures , except to the extent permitted for the use of county purchasing procedures as set forth in subparagraph b. , below. All CHD employees shall be State or State-contract personnel subject to State personnel rules and procedures. Employees will report time in the Health Management System compatible format by program component as specified by the State . b . The CHD shall comply with all applicable provisions of federal and state laws and regulations relating to its operation with the exception that the use of county purchasing procedures shall be allowed when it will result in a better price or service and no statewide Department of Health purchasing contract has been implemented for those goods or services. In such cases, the CHD director/administrator must sign a justification therefore, 3 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 CHID in accordance with the terms of this Agreement. State procedures must be followed for all leases on facilities not enumerated in Attachment IV. c . The CHID shall maintain books, records and documents in accordance with those promulgated by the Generally Accepted Accounting Principles (GAAP) and Governmental Accounting Standards Board (GASB) , and the requirements of federal or state law. These records shall be maintained as required by the Department of Health Policies and Procedures for Records Management and shall be open for inspection at any time by the parties and the public, except for those records that are not otherwise subject to disclosure as provided by law which are subject to the confidentiality provisions of paragraph 6 . i . , below. Books , records and documents must be adequate to allow the CHID to comply with the following reporting requirements : 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 CHID is responsible for assuring that all contracts with service providers include provisions that all subcontracted services be reported to the CHID 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 CHID shall be deposited in the County Health Department Trust Fund maintained by the state treasurer. These funds shall be accounted for separately from funds deposited for other CHDs and shall be used only for public health purposes in Indian River County. e . That any surplus/deficit funds , including fees or accrued interest, remaining in the County Health Department Trust Fund account at the end of the contract year shall be credited/debited to the state or county, as appropriate , based on the funds contributed by each and the expenditures incurred by each . Expenditures will be charged to the program accounts by state and county based on the ratio of planned expenditures in the core contract and funding from all sources is credited to the program accounts by state and county. The equity share of any surplus/deficit funds accruing to the state and county is determined each month and at contract year-end . Surplus funds may be applied toward the funding requirements of each participating governmental entity in the following year. However, in each such case, all surplus funds, including fees and accrued interest, shall 4 remain in the trust fund until accounted for in a manner which clearly illustrates the amount which has been credited to each participating governmental entity. The planned use of surplus funds shall be reflected in Attachment 11 , 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 CHID 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 CHID to carry out the programs specified in this Agreement. Any such subcontract shall include all aforementioned audit and record keeping requirements. h . At the request of either party, an audit may be conducted by an independent CPA on the financial records of the CHD and the results made available to the parties within 180 days after the close of the CHD fiscal year. This audit will follow requirements contained in OMB Circular A- 133 and may be in conjunction with audits performed by county government. If audit exceptions are found , then the director/administrator of the CHD will prepare a corrective action plan and a copy of that plan and monthly status reports will be furnished to the contract managers for the parties . L 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 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 CHID shall maintain confidentiality of all data , files , and records that are confidential under the law or are otherwise exempted from disclosure as a public record under Florida law. The CHD shall implement procedures to ensure the protection and confidentiality of all such records and shall comply with sections 384 . 29 , 381 . 0049 392 . 65 and 456 . 057 , Florida Statutes , and all other state and federal laws regarding confidentiality. All confidentiality procedures implemented by the CHD shall be consistent with the Department of Health Information Security Policies, Protocols , and Procedures , dated April 2005 , 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. I . The CHD shall abide by all State policies and procedures, which by this reference are incorporated herein as standards to be followed by the CHD , except as otherwise permitted for some purchases using county procedures pursuant to paragraph 6 . b . hereof. 5 m . The CHD shall establish a system through which applicants for services and current clients may present grievances over denial , modification or termination of services. The CHID will advise applicants of the right to appeal a denial or exclusion from services , of failure to take account of a client' s choice of service, and 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 CHID shall submit quarterly reports to the county that shall include at least the following : i. The DE385L1 Contract Management Variance Report and the DE580L1 Analysis of Fund Equities Report; ii. A written explanation to the county of service variances reflected in the DE3850 report if the variance exceeds or falls below 25 percent of the planned expenditure amount. However, if the amount of the service specific variance between actual and planned expenditures does not exceed three percent of the total planned expenditures for the level of service in which the type of service is included , a variance explanation is not required . A copy of the written explanation shall be sent to the Department of Health , Bureau of Budget Management. 6 p . The dates for the submission of quarterly reports to the county shall be as follows unless the generation and distribution of reports is delayed due to circumstances beyond the CND's control : i. March 1 , 2008 for the report period October 1 , 2007 through December 31 , 2007; ii. June 1 , 2008 for the report period October 1 , 2007 through March 31 , 2008 ; iii. September 1 , 2008 for the report period October 1 , 2007 through June 30 , 2008 ; and iv. December 1 , 2008 for the report period October 1 , 2007 through September 30 , 2008 . 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 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 . 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 Lack of Funds. In 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. 9. 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 , 2008 , it is agreed that the performance and payment under this Agreement are contingent upon an annual appropriation by the Legislature, in accordance with section 287.0582 , Florida Statutes . b . 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: Mayur Rao Jason Brown Name Name Business Manager Budget Director Title Title 1900 27" Street 1801 27th Street Vero Beach , FL 32960-3383 Vero Beach , FL 32960-3365 Address Address 772-794-7464 772-567-8000 Ext 1214 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. C. 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. 8 In WITNESS THEREOF , the parties hereto have caused this 24 page agreement to be executed by their undersigned officials as duly authorized effective the -Ts of October, 2007 . BOARD OF COUNTY COMMISSIONERS STATE OF FLORIDA FOR INDIAN RIVER COUNTY DEPARTMENT OF HEALTH rpi SIGNED BY SIGNED NAME: : Gary C . W eeler NAME : Ana M. Viamonte Ros, M. D. , M . P . H . TITLE :_ ".Chairman . TITLE : State Surneon General DATE : September 18 , 2007 DATE : 9a ��d �7 ATTESTED TO: SIGNED BY: SIGNED BY: �L� �l/lr NAME : Gel fb NAME : Miranda C Swanson , M. P. H . TITLE : 'FJe� v+H Clerk TITLE : CHD Director/Administrator DATE : D� 2u 2 o G7 DATE : � }� ml ulc ]� 7-M-7 r J.h. dAH UAi CLF I CMM7 LOUR` ,-? e S . 8emin ator APPROVED AS TO FORM A LEGAL SUFFICI Y B MARIAN SISTANT COUNTY A TO EY 9 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 Requirement 1 . Sexually Transmitted Disease Requirements as specified in FAC 64D-3, F. S . 381 and Program F. S. 384 and the CHD Guidebook. 2. Dental Health Monthly reporting on DH Form 1008'. 3. Special Supplemental Nutrition Service documentation and monthly financial reports as Program for Women, Infants specified in DHM 150-24' and all federal, state and county and Children. requirements detailed in program manuals and published procedures. 4. Healthy Start/ Requirements as specified in the Healthy Start Standards Improved Pregnancy Outcome and Guidelines 1998 and as specified by the Health 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. Chronic Disease Program Requirements as specified in the Community Intervention Program (CIP) and the CHD Guidebook. 8. Environmental Health Requirements as specified in DHP 50-4` and 50-21 ` 9. HIV/AIDS Program Requirements as specified in Florida Statue 384.25 and 64D-3. 016 and 3.017 F.A.C. and the CHD 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 1628 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. ATTACHMENT I (Continued) 10. School Health Services HRSM 150-25`, including the requirement for an annual plan as a condition for funding . 'or the subsequent replacement if adopted during the contract period . ATTACHMENT II INDIAN RIVER COUNTY HEALTH DEPARTMENT PART I. PLANNED USE OF COUNTY HEALTH DEPARTMENT TRUST FUND BALANCES Estimated State Share Estimated County Share of CHD Trust Fund of CHD Trust Fund Balance as of 09/30/07 Balance as of 09/30/07 Total 1 . CHD Trust Fund Ending Balance 09/30/07 3933331 348, 803 742, 134 2 . Drawdown for Contract Year October 1 , 2007 to September 30, 2008 13, 926 12, 349 26,275 3. Special Capital Project use for Contract Year October 1 , 2007 to September 30, 2008 4. Balance Reserved for Contingency Fund 407,257 361 , 1 52 768 ,409 October 1 , 2007 to September 30, 2008 Note: The total of items 2, 3 and 4 must equal the ending balance in item 1 . Special Capital Projects are new construction or renovation projects and new furniture or equipment associated with these projects, and mobile health vans . Pursuant to 154.02, F. S. , At a minimum , the trust fund shall consist of: an operating reserve, consisting of 7. 5 percent of the annual operating budget, maintained to ensure adequate cash flow from nonstate revenue sources. Y 5 ss5 M" Q ',"p A# + A R ' .`'#ix'` Raft ll! C¢S of Coptrlbntioos to Connty October 1, 2007 to September 2008 Ij State CAD County Total C® CE` < Fmil ' ru " (CB )( : on x � < n Total 1. GENERAL REVENUE - STATE 015040 ALG/CESSPOOL IDENTIFICATION AND ELIMINATION 0 0 0 0 0 015040 ALG/CONTR TO CHDS-AIDS PATIENT CARE 100,000 0 100,000 0 100,000 015040 ALG/CONTR TO CHDS-AIDS PREV & SURV & FIELD STAFF 0 0 0 0 0 015040 ALG/CONTR TO CHDS-DENTAL PROGRAM 0 0 0 0 0 015040 ALG/CONTR TO CHDS-MIGRANT LABOR CAMP SANITATION 699 0 699 0 699 015040 ALG/CONTR. TO CHDS-IMMUNIZATION OUTREACH TEAMS 11 ,375 0 11,375 0 11 ,375 015040 ALG/CONTR. TO CHDS-INDOOR AIR ASSIST PROG 9,939 0 9,939 0 9,939 015040 ALG/CONTR. TO CHDS-MCH HEALTH - FIELD STAFF COST 0 0 0 0 0 015040 ALG/CONTR. TO CHDS-SOVEREIGN IMMUNITY 0 0 0 0 0 015040 ALG/CONTRIBUTION TO CHDS-PRIMARY CARE 15,789 0 15,789 0 15,789 015040 ALG/FAMILY PLANNING 36,022 0 36,022 0 36,022 015040 ALGAPO - OUTREACH SOCIAL WORKERS CAT. 050707 0 0 0 0 0 015040 ALG/IPO HEALTHY START/IPO CAT 050707 0 0 0 0 0 015040 ALG/IPO-INFANT MORTALITY PROJECT CAT. 050707 0 0 0 0 0 015040 ALG/MCH-INFANT MORTALITY PROJECT CAT. 050870 0 0 0 0 0 015040 ALG/MCH-OUTREACH SOCIAL WORKERS CAT 050870 24,000 0 24,000 0 24,000 015040 ALG/PRIMARY CARE 204,314 0 204,314 0 204,314 015040 ALG/SCHOOL HEALTH/SUPPLEMENTAL 50,548 0 50,548 0 50,548 015040 CATE - ESCAMBW 0 0 p 0 0 015040 CLOSING THE GAP PROGRAM 0 0 0 0 0 015040 COMMUNITY TB PROGRAM 62, 114 0 62, 114 0 62,114 015040 DENTAL SPECIAL INITIATIVE PROJECTS 104,232 0 104,232 0 104,232 015040 DUVAL TEEN PREGNANCY PREVENTION 0 0 p 0 0 015040 ENHANCED DENTAL SERVICES 0 0 p 0 0 015040 FL CLPPP SCREENING & CASE MANAGEMENT 0 0 p 0 0 015040 FL HEPATITIS & LIVER FAILURE PREVENTION/CONTROL 0 0 p 0 0 015040 HEALTH PROMOTION &amp; EDUCATION INITIATIVES 0 0 p 0 0 015040 HEALTHY BEACHES MONITORING 10, 129 0 10, 129 0 10,129 015040 INDIGENT DENTAL CARE - ESCAMBIA 0 0 p 0 0 015040 LA LIGA CONTRA EL CANCER 0 0 0 0 0 015040 MEDIVAN PROJECT - BROWARD 0 0 0 0 0 015040 METRO ORLANDO URBAN LEAGUE TEENAGE PREG PREV 0 0 0 0 0 015040 PENALVER CLINIC - MIAMI-DADE 0 0 0 0 0 015040 PRIMARY CARE SPECIAL DENTAL PROJECTS 0 0 0 0 0 015040 PRIMARY CARE SPECIAL PROJECTS 0 0 0 0 0 015040 SPECIAL NEEDS SHELTER PROGRAM 0 0 0 0 0 015040 STATEWIDE DENTISTRY NETWORK - ESCAMBIA 0 0 0 0 0 015040 STD GENERAL REVENUE 0 0 0 0 0 015040 VOLUNTEER SCHOOL HEALTH NURSE GRANT 0 0 0 0 0 015050 ALG/CONTR TO CHDS 2,214,236 0 2,214,236 0 21214,236 GENERAL REVENUE TOTAL 2,843,397 0 2,843,397 0 2,843,397 2. NON GENERAL REVENUE - STATE 015010 ALG/CONTR TO CHDS-REBASING TOBACCO IF 27,287 0 27,287 0 27,287 015010 BASIC SCHOOL HEALTH - TOBACCO TF 70,001 0 70,001 0 70,001 015010 CHD PROGRAM SUPPORT 0 0 0 0 0 015010 FL HEPATITIS & LIVER FAILURE PREVENTION/CONTROL 0 0 0 0 0 015010 FULL SERVICE SCHOOLS - TOBACCO TF 74,304 0 74,304 0 74,304 Working Copy ATTACHMENT H. INDIAN RIVER COUNTY HEALTH DEPARTMENT Part IL Sources of Contributions to County Health Department October 1, 2007 to September 30, 2008 State CHD County Total CHD Trust Fund '_ CHD, Trust Fund Other (cash) Trust Fund (each) Contribanoii, "Coral 2. NON GENERAL REVENUE - STATE 015010 SUPER ACT PROGRAM ADM TR 13,710 0 13,710 0 13,710 015010 PACE EH 40,000 0 40,000 0 40,000 015010 PUBLIC SWIMMING POOL PROGRAM 0 0 0 0 0 015010 SUPPLEMENTAUCOMPREHENSIVE SCHOOL HEALTH - TOB TF 0 0 0 0 0 015010 TOBACCO PREVENTION & CESSATION PROGRAM 10,000 0 10,000 0 10,000 015010 VARICELLA IMMUNIZATION REQUIREMENT TOBACCO TF 6,088 0 6,088 0 6,088 015018 Summer Food Program 0 0 0 0 0 015020 ALG/CONTR. TO CHDS-BIOMEDICAL WASTE/DEP ADM IF 9, 142 0 9, 142 0 9,142 015020 ALG/CONTR. TO CHDS-SAFE DRINKING WATER PRG/DEP ADM 0 0 0 0 0 015020 FOOD AND WATERBORNE DISEASE PROGRAM ADM TF/DACS 0 0 0 0 0 015010 TITLEXXIISCHOOL HEALTH/SUPPLEMENTAL 98,347 0 98,347 0 98,347 NON GENERAL REVENUE TOTAL 348,879 0 348,879 0 348,879 3. FEDERAL FUNDS - State 007000 AIDS PREVENTION 57,873 0 57,873 0 57,873 007000 AIDS SEROPREVALENCE 0 0 0 0 0 007000 AIDS SURVEILLANCE 0 0 0 0 0 D07D00 BIOTERR SURVEILLANCE &amp; EPIDEMIOLOGY 86,336 0 86,336 0 86,336 007000 BIOTERRORISM PLANNING &amp; READINESS 96,868 0 96,868 0 96,868 007000 BIOTERRORISM HOSPITAL PREPAREDNESS 34,300 0 34,300 0 34,300 007000 COASTAL BEACH MONITORING PROGRAM 9,007 0 9,007 0 9,007 007000 PHHSBG/STEP UP FLORIDA HEALTHY COMMUNITIES 44,117 0 44, 117 0 44, 117 007000 DIABETES CONTROL PROGRAM 0 0 0 0 0 007000 FGTF/AIDS MORBIDITY 0 0 0 0 0 007000 FGTFBREAST & CERVICAL CANCER-ADMAN/CASE MAN 0 0 0 0 0 007000 FGTF/FAMILY PLANNING TITLE X SPECIAL INITIATIVES 0 0 0 0 0 007000 FGTF/FAMILY PLANNING-TITLE X 54,921 0 54,921 0 54,921 007000 FGTFAMMUNIZATION ACTION PLAN 16,534 0 16,534 0 16,534 007000 FGTF/WIC ADMINISTRATION 472, 186 0 472, 186 0 472,186 007000 FLORIDA PANDEMIC INFLUENZA 4,450 0 4,450 0 4,450 007000 WIC INFRASTRUCTURE 2007 45,000 0 45,000 0 45,000 007000 IMMUNIZATION FIELD STAFF EXPENSE 0 0 0 0 0 007000 IMMUNIZATION SPECIAL PROJECT 4,807 0 4,807 0 4,807 007000 IMMUNIZATION SUPPLEMENTAL 0 0 0 0 0 007000 IMMUNIZATION WIC-LINKAGES 0 0 0 0 0 007000 IMMUNIZATION-WIC LINKAGES 0 0 0 0 0 007000 MCH BGTF-GADSDEN SCHOOL CLINIC 0 0 0 0 0 007000 MCH BGTF-HEALTHY START IPO 0 0 0 0 0 007000 MCH BGTF-INFANT MORTALITY PROJECT 0 0 0 0 0 007000 MCH BGTF-MCI- /CHILD HEALTH 10,535 0 10,535 0 10,535 007000 MCH BGTF-MCH/DENTAL PROJECTS 0 0 0 0 0 007000 MCH BGTF-OUTREACH SOCIAL WORKERS 0 0 0 0 0 007000 PHHSBG/STEP UP FLORIDA! HEALTHY COMMUNITIES 0 0 0 0 0 007000 PHP-CITIES RESPONSE INITIATIVE 0 0 0 0 0 007000 PHP-CITIES RESPONSE INITIATIVE 2006-2007 0 0 0 0 0 007000 RAPE PREVENTION & EDUCATION GRANT 2007 0 0 0 0 0 007000 RAPE PREVENTION & EDUCATION GRANT 2008 0 0 0 0 0 007000 RISK COMMUNICATIONS 0 0 0 0 0 r ` P8I't Q�Y7$g`Df C1DD ;�'0 eutft- . .; r ' .. z x " WOW 1, 2007 to September Jq; ZM Slate CED Callao Total CHD £a.y, b �} x } MY S5`•... r. , ' `.. yP a Wf ,. � `'�Si..v.,. <<wal � Ta s��iy� 3. FEDERAL FUNDS - State 007000 RYAN WHITE 0 0 0 0 0 007000 RYAN WHITE - EMERGING COMMUNITIES 0 0 0 0 0 007000 RYAN WHITE-AIDS DRUG ASSIST PROD-ADMIN 35,000 0 35,000 0 35,000 007000 RYAN WHrFE-CONSORTIA 0 0 0 D 0 007000 SCHOOL HEALTH BASIC - MCH BLOCK GRANT 8,314 0 8,314 0 8,314 007000 STD FEDERAL GRANT - CSPS 0 0 0 0 0 D07000 STD PROGRAM - PHYSICIAN TRAINING CENTER 0 0 0 0 0 007000 STD PROGRAM INFERTILITY PREVENTION PROJECT (IPP) 0 0 0 p 0 007000 STD PROGRAM-INFERTILITY PREVENTION PROJECT (IPP) 0 0 0 0 0 007000 STEP UP FLORIDA! HEALTHY COMMUNITIES 14,706 0 14,706 0 14,706 007000 SYPHILIS ELIMINATION 0 0 0 0 0 007000 TESTING HIV SERONEGATIVE HEADQUARTERS 0 0 0 0 0 007000 TUBERCULOSIS CONTROL - FEDERAL GRANT 0 0 0 0 0 007000 WIC BREASTFEEDING PEER COUNSELING 2007 0 D p p 0 007000 WIC BREASTFEEDING PEER COUNSELING PROG FFY 2005 0 0 p 0 0 007000 WIC INFRASTRUCTURE 2006 0 0 0 D 0 015009 MEDIPASS WAIVER-HLTHY STRT CLIENT SERVICES 0 0 0 0 0 015009 MEDIPASS WAIVER-SORRA 0 0 0 0 0 015009 SCHOOL HEALTH-SUPPLEMENT-TANF 14,050 0 14,050 0 14,050 015075 Refugee Screening 0 0 p p 0 FEDERAL FUNDS TOTAL 1,009,004 0 1,009,004 0 1,009,004 4. FEES ASSESSED BY STATE OR FEDERAL RULES - STATE 001020 TANNING FACILITIES 3,207 0 3,207 0 3,207 001020 BODY PIERCING 270 0 270 0 270 001020 MIGRANT HOUSING PERMIT 0 0 p p 0 D01020 MOBILE HOME AND PARKS 12,222 0 12,222 D 12,222 001020 FOOD HYGIENE PERMIT 13,002 0 13,002 D 13,002 001020 BIOHAZARD WASTE PERMIT 10, 166 0 10, 166 0 10,166 001020 SWIMMINGPOOLS 40,095 0 40,095 0 40,095 001020 LIMITED USE WATER SYSTEMS 3,596 0 3,596 0 3,596 001020 PUBLIC WATER ANNUAL OPER PERMIT 0 0 0 0 0 001020 PUBLIC WATER CONSTR PERMIT 0 0 0 0 0 001020 NONSDWA SYSTEM PERMIT 0 0 0 0 0 001020 SAFE DRINKING WATER 0 0 0 0 0 001092 NON SDWA LAB SAMPLE 0 0 0 0 0 001092 OSDS VARIANCE FEE 0 0 0 0 0 001092 ENVIRONMENTAL HEALTH FEES 220 p 220 0 220 001092 OSDS REPAIR PERMIT 66,240 0 66,240 0 66,240 001092 OSDS PERMIT FEE 123,369 0 123,369 0 123,369 001092 1 & M ZONED OPERATING PERMIT 0 0 0 0 0 001092 AEROBIC OPERATING PERMIT 0 0 0 0 0 001092 SEPTIC TANK SITE EVALUATION 0 0 0 0 0 001170 LAB FEE CHEMICAL ANALYSIS 0 p 0 o D 001170 NONPOTABLE WATER ANALYSIS 0 0 0 0 0 001170 WATER ANALYSIS-POTABLE 0 p 0 0 0 010304 MQA INSPECTION FEE 0 0 0 0 0 r . .WariliggCopy ATTAC I Part a x " . u, v ` OcWber i} 2007 to Septmber ,3B, SWe CHR a 14 TOW CRD Aw s M . ' Trey ^' .; s�4�'�ed ' "�'r (aaah) FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL 272,387 0 272,387 0 272,387 5. OTHER CASH CONTRIBUTIONS - STATE 010304 STATIONARY POLLUTANT STORAGE TANKS 48,979 0 48,979 0 48,979 090001 DRAW DOWN FROM PUBLIC HEALTH UNIT -13,926 0 -13,926 0 - 13,926 OTHER CASH CONTRIBUTIONS TOTAL 35,053 0 35,053 0 35,053 6. MEDICAID - STATE/COUNTY 001056 MEDICAID PHARMACY 0 0 0 0 0 001076 MEDICAID TB 0 0 0 0 0 001078 MEDICAID ADMINISTRATION OF VACCINE 14,420 14,420 28,840 0 28,840 001079 MEDICAID CASE MANAGEMENT 0 0 0 0 0 001080 MEDICAID OTHER 0 0 0 0 0 001081 MEDICAID CHILD HEALTH CHECK UP 168,964 240,744 409,708 0 409,708 001082 MEDICAID DENTAL 99,982 142,458 242,440 0 242,440 001083 MEDICAID FAMILY PLANNING 6,613 59,517 66, 130 0 66,130 001087 MEDICAID STD 320 455 775 0 775 001089 MEDICAID AIDS 0 0 0 0 0 001147 MEDICAID HMO RATE 0 0 0 0 0 001191 MEDICAID MATERNITY 52,929 75,416 128,345 0 128,345 001192 MEDICAID COMPREHENSIVE CHILD 215,297 306,761 522,058 0 522,058 001193 MEDICAID COMPREHENSIVE ADULT 108,534 154,642 263, 176 0 263, 176 001194 MEDICAID LABORATORY 0 0 0 0 0 001208 MEDIPASS $3.00 ADM. FEE 70,532 70,532 141,064 0 141 ,064 MEDICAID TOTAL 737,590 1 ,064,946 1 ,802,536 0 1 ,802,536 7. ALLOCABLE REVENUE - STATE 018000 REFUNDS 600 0 600 0 600 037000 PRIOR YEAR WARRANT 0 0 0 0 0 038000 12 MONTH OLD WARRANT 0 0 0 0 0 ALLOCABLE REVENUE TOTAL 600 0 600 0 600 8. OTHER STATE CONTRIBUTIONS NOT IN CHD TRUST FUND - STATE PHARMACY SERVICES 0 0 0 151,831 151,831 LABORATORY SERVICES 0 0 0 142,071 142,071 TB SERVICES 0 0 0 0 0 IMMUNIZATION SERVICES 0 0 0 472,304 472,304 STD SERVICES 0 0 0 0 0 CONSTRUCTION/RENOVATION 0 0 0 0 0 WIC FOOD 0 0 0 2,072,068 21072,068 ADAP 0 0 0 348,438 348,438 DENTAL SERVICES 0 0 0 0 0 OTHER (SPECIFY) 0 0 0 0 0 OTHER (SPECIFY) 0 0 0 0 0 OTHER STATE CONTRIBUTIONS TOTAL 0 0 0 3,186,712 3,186,712 9. DIRECT COUNTY CONTRIBUTIONS - COUNTY 008030 BCC Contribution from Health Care Tax 0 0 0 0 0 �A� ",.RB ofCantribLLtiou9 to Coni eat f - .Odebor I, 2047 to ber,3 + a - aw4s ! .�Y.n. . . 31a ' C a l �. RM1y}' T�itYl CHIN ' r 9. DIRECT COUNTY CONTRIBUTIONS - COUNTY 008034 BCC Contribution from General Fund 0 803,169 803, 169 0 803, 169 DIRECT COUNTY CONTRIBUTION TOTAL 0 803,169 803, 169 0 803, 169 10. FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION - COUNTY 001060 VITAL STATISTICS FEES OTHER 0 1 ,429 1 ,429 0 1 ,429 001077 PRIMARY CARE FEES 0 257,193 257,193 0 257, 193 001077 CHILD CAR SEAT PROG 0 0 0 0 0 001077 COMMUNICABLE DISEASE FEES 0 137,439 137,439 0 137,439 001077 AIDS CO-PAYS 0 0 0 0 0 001094 LOCAL ORDINANCE FEES 0 96,685 96,685 0 96,685 001094 ADULT ENTER. PERMIT FEES 0 0 0 0 0 001114 NEW BIRTH CERTIFICATES 0 36,870 36,870 0 36,870 001115 DEATH CERTIFICATES 0 147,611 147,611 0 147,611 001117 VITAL STATS-ADM. FEE 50 CENTS 0 1 ,988 1 ,988 0 1 ,988 FEES AUTHORIZED BY COUNTY TOTAL 0 679,215 679,215 0 679,215 11. OTHER CASH AND LOCAL CONTRIBUTIONS - COUNTY 001009 RETURNED CHECK ITEM 0 0 0 0 0 001029 THIRD PARTY REIMBURSEMENT 0 39,034 39,034 0 39,034 001029 HEALTH MAINTENANCE ORGAN. (HMO) 0 0 0 0 0 001054 MEDICARE PART D 0 0 0 0 0 001077 RYAN WHITE TITLE I 0 0 0 0 0 001090 MEDICARE PART B 0 94,329 94,329 0 94,329 001190 Health Maintenance Organization 0 0 0 0 0 005040 INTEREST EARNED 0 0 0 0 0 005041 INTEREST EARNED-STATE INVESTMENT ACCOUNT 0 22,000 22,000 0 22,000 007010 U.S. GRANTS DIRECT 0 0 0 0 0 008010 Contribution from City Government 0 0 0 0 0 008020 Contribution from Health Care In not thin BCC 0 1 ,302,992 1 ,302,992 0 1 ,302,992 008050 School Board Contribution 0 4,000 4,000 0 4,000 010300 SALE OF GOODS AND SERVICES TO STATE AGENCIES 0 1,798 1,798 0 1 ,798 010301 EXP WITNESS FEE CONSULTNT CHARGES 0 0 0 0 0 010405 SALE OF PHARMACEUTICALS 0 0 0 0 0 010409 SALE OF GOODS OUTSIDE STATE GOVERNMENT 0 0 0 0 0 011000 GRANT-DIRECT 0 159,935 159,935 0 159,935 011000 GRANT - TLC 0 89,322 89,322 0 89,322 011000 GRANT-DIRECT 0 0 0 0 0 011000 GRANT-DIRECT 0 0 0 0 0 011000 GRANT-DIRECT 0 0 0 0 0 011000 GRANT-DIRECT 0 0 0 0 0 011000 GRANT-DIRECT 0 0 0 0 0 011000 GRANT-DIRECT 0 0 0 0 0 011001 HEALTHY START COALITION CONTRIBUTIONS 0 421 ,354 421 ,354 0 421 ,354 011007 CASH DONATIONS PRIVATE 0 0 0 0 0 012020 FINES AND FORFEITURES 0 0 0 0 0 012021 RETURN CHECK CHARGE 0 0 0 0 0 028020 INSURANCE RECOVERIES-OTHER 0 0 0 0 0 Working Copy ATTACHMENT H " rpt INDIAN RIVER COUNTY HEALTH DEPARTMENT Part H, Sources of Contributions to County Health Department October 1, 2009 to September 30, 2M State CAD - 'County Total CUD Trust Fund CAD TrwtFood . y.00W, : : 4, 001311)001311) Tru yma r (Coit) ' Contribution , TOW 11. OTHER CASH AND LOCAL CONTRIBUTIONS - COUNTY 090002 DRAW DOWN FROM PUBLIC HEALTH UNIT 0 -12,349 -12,349 0 -12,349 008060 Special Project Contribution 0 0 0 0 0 OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL 0 2,122,415 2, 122,415 0 2, 122,415 12. ALLOCABLE REVENUE - COUNTY 018000 REFUNDS 0 0 0 0 0 037000 PRIOR YEAR WARRANT 0 0 0 0 0 038000 12 MONTH OLD WARRANT 0 0 0 0 0 COUNTY ALLOCABLE REVENUE TOTAL 0 0 0 0 0 13. BUILDINGS - COUNTY ANNUAL RENTAL EQUIVALENT VALUE 0 0 0 323,898 323,898 BUILDING MAINTENANCE 0 0 0 159,031 159,031 INSURANCE 0 0 0 0 0 UTILITIES 0 0 0 153, 195 153, 195 GROUNDS MAINTENANCE 0 0 0 0 0 OTHER 0 0 0 0 0 OTHER (SPECIFY) 0 0 0 0 0 BUILDINGS TOTAL 0 0 0 636, 124 636,124 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 HUMAN SERVICES 0 0 0 76,632 76,632 OTHER COUNTY CONTRIBUTION (SPECIFY) 0 0 0 0 0 OTHER COUNTY CON'T'RIBUTION (SPECIFY) 0 0 0 0 0 OTHER COUNTY CONTRIBUTIONS TOTAL 0 0 0 76,632 76,632 GRAND TOTAL CHD PROGRAM 5,246,910 4,669,745 9,916,655 3,899,468 13,816, 123 Worlliug Copying ATTACHMENT IL N%4AN RW= COUNTY HEALTHD�1'A TMENT , Part; WI { A 9kk4 z ,� ,;'3F k.� OMeber I. ?00'y to September 3U, 3Q� QuarterlyEygmftum Itut t: _ x £ ^ QA rMM COMMUNICABLE DISEASE CONTROL: VITAL STATISTICS (180) 1 .68 0 0 19,408 22,015 17,745 21 ,925 0 81 ,093 81,093 Uv2AUNIZATION ( I01) 5.92 4,800 16,200 138,877 111 ,339 110,663 83,318 151,027 293, 170 444, 197 STD (102) 6.73 980 3,450 72,729 83,480 75,360 76,849 249,819 58,599 308,418 ALD.S. (103) 3.28 1,199 8,200 40,295 47, 109 35,050 38,775 148,331 12,898 161,229 TB CONTROL SERVICES (104) 2.24 240 1 ,650 30,830 22,420 34,836 33,580 108,283 13,383 121,666 COMM. DISEASE SURV. (106) 0.86 0 167 19,536 9,576 5,808 21 ,519 56,439 0 56,439 HEPATITIS PREVENTION (109) 0.00 0 0 0 0 0 0 0 0 0 PUBLIC HEALTH PREP AND RESP (116) 2.43 0 0 56,307 68,891 76,451 61 ,374 263,023 0 263,023 OMMUNICABLE DISEASE SUBTOTAL 23. 14 7,219 29,667 377,982 364,830 355,913 337,340 976,922 459, 143 1 ,436,065 B. PRIMARY CARE: CHRONIC DISEASE SERVICES (210) 1 .23 1 ,410 1 ,550 21 ,946 19,929 20,258 37, 125 79,406 19,852 99,258 TOBACCO PREVENTION (212) 0.00 0 0 181 360 6,533 2,926 10,000 0 10,000 HOME HEALTH (215) 0.00 0 0 0 0 0 0 0 0 0 W.LC. (221) 9.72 5,400 35,900 156,616 165, 112 125,326 162,636 609,690 0 609,690 FAMILY PLANNING (223) 9.73 3,350 9,750 146,032 164,903 140,314 151 ,412 283,251 319,410 602,661 IMPROVED PREGNANCY OUTCOME (225) 0.00 0 0 0 0 0 0 0 0 0 HEALTHY START PRENATAL (227) 4.86 523 12,929 73,029 74,604 81,228 73,395 0 302,256 302,256 COMPREHENSIVE CHILD HEALTH (229) 22.86 3,750 21 ,050 305,594 380,849 296,977 313,638 420,950 876, 108 1 ,297,058 HEALTHY START INFANT (231) 3. 12 260 5,821 45,511 49,625 44,574 33,358 0 173,068 173,068 SCHOOL HEALTH (234) 5.83 0 65,000 105,302 123,226 109, 118 68,297 401,943 4,000 405,943 COMPREHENSIVE ADULT HEALTH (237) 40.06 6,850 31 ,500 731,867 805, 113 683,383 756,965 1 ,368,439 1,608,889 2,977,328 DENTAL HEALTH (240) 11 .86 2,758 12,547 233,845 259,381 227,619 174,921 313,518 582,248 895,766 Healthy Start Interconception Woman (232) 0.00 0 0 0 0 0 0 0 0 0 RIMARY CARE SUBTOTAL 109.27 24,301 196,047 1,819,923 2,043, 102 1,735,330 1 ,774,673 3,487,197 3,885,831 7,373,028 C. ENVIRONMENTAL HEALTH: Water and Onsite Sewage Programs COASTAL BEACH MONITORING (347) 020 470 470 5,795 5,805 4,648 5,637 21 ,885 0 21 ,885 LIMITED USE PUBLIC WATER SYSTEMS (357) 035 65 370 6,919 3,860 9,541 6,324 17,319 9,325 26,644 PUBLIC WATER SYSTEM (358) 0. 13 12 115 3,388 914 6,861 11155 12,318 0 12,318 PRIVATE WATER SYSTEM (359) 1 .25 152 630 23,587 23,699 16,211 17,029 8,053 72,473 80,526 INDIVIDUAL SEWAGE DISP. (361) 6.22 2,040 5,395 92,334 108,570 107,631 128,631 393,449 43,717 437, 166 Group Total 8. 15 2,739 6,980 132,023 142,848 144,892 158,776 453,024 125,515 578,539 Facility Programs FOOD HYGIENE (348) 0.77 107 460 12,219 12,642 15,704 9,354 0 49,919 49,919 BODY ART (349) 0.01 2 1 51 160 76 242 529 0 529 GROUP CARE FACILITY (35 1) 0.47 164 245 9,062 9,883 7,498 8,593 35,036 0 35,036 MIGRANT LABOR CAMP (352) 0.03 4 30 581 11125 671 291 2,668 0 2,668 HOUSING,PUBLIC BLDG SAFETY,SANITATION (359)14 140 194 3,587 3,872 2,994 21762 0 13,215 13,215 MOBILE HOME AND PARKS SERVICES (354) 0.21 55 127 2,713 5, 170 1 ,483 4,374 13,740 0 13,740 SWIMMING POOLSBATHING (360) 0.97 330 1 ,018 16,431 14,730 16,191 15,824 56,858 6,318 63, 176 BIOMEDICAL WASTE SERVICES (364) 0.32 179 196 2,126 6,999 2,790 9, 105 15,765 5,255 21 ,020 ax INpL�Ni RSR COUNTY HEAI TS DitP �T ` Part eryicaa, And Expenditures By ProviBil s�riec'Aesa Witbia Eacb Letce s . .: October 1, 2007 to September 30, 2W as"' y Qwr1M'ty EzReadlhra P4a � .! + 4 ►►- ": 3 �sy..� ,'" �ra{t,,� ' 4thF� ' Gr +lpd Units w •Rd {*,.w Y�FIi'� sa ' 4''` YQaat]' OtV' C. ENVIRONMENTAL HEALTH: Facility Programs TANNING FACILITY SERVICES (369) 0.04 to 24 594 919 240 960 2,713 0 2,713 Group Total 2.96 991 2,295 47,364 55,500 47,647 51 ,505 127,309 74,707 202,016 Groundwater Contamination STORAGE TANK COMPLIANCE (355) 1 .79 170 434 31,740 33,511 38, 105 37,720 141,076 0 141 ,076 SUPER ACT SERVICE (356) 0.30 47 168 5,868 7,985 3,764 3,810 21,427 0 21 ,427 Group Total 2.09 217 602 37,608 41,496 41,869 41 ,530 162,503 0 162,503 Community Hygiene RADIOLOGICAL HEALTH (372) 0.00 0 0 0 0 0 0 0 0 0 TOXIC SUBSTANCES (373) 0.08 22 62 1,216 3,553 826 1 ,937 0 7,532 7,532 OCCUPATIONAL HEALTH (344) 0. 11 0 0 2,829 2, 120 21120 254 6,591 732 7,323 CONSUMER PRODUCT SAFETY (345) 0.00 0 0 0 0 173 0 173 0 173 INJURY PREVENTION (346) 0.00 0 0 0 0 0 0 0 0 0 LEAD MONITORING SERVICES (350) 0.00 0 1 35 31 55 84 0 205 205 PUBLIC SEWAGE (362) 0. 13 0 294 3,726 3,812 1 ,951 3,407 6,319 6,577 12,896 SOLID WASTE DISPOSAL (363) 0.24 0 12 2,544 2,962 3,819 3,947 13,272 0 13,272 SANITARY NUISANCE (365) 0.20 9 26 1,438 3,009 4,724 1 ,347 0 10,518 10,518 RABIES SURVER.LANCEICONTROL SERVICES (366115 37 105 6,347 5,264 432 1 ,868 0 13,911 13,911 ARBOVIRUS SURVEILLANCE (367) 0.00 0 3 76 45 76 76 0 273 273 RODENTlARTHROPOD CONTROL (368) 0.01 0 17 387 1 ,498 442 804 3,131 0 3, 131 WATER POLLUTION (370) 0.20 0 752 4,261 4, 114 5, 162 5,558 2,291 16,804 19,095 AIR POLLUTION (371) 0.08 0 45 1,499 1 ,462 2, 116 3,101 8, 178 0 8,178 Group Total 1 .20 68 1 ,317 24,358 27,870 21 ,896 22,383 39,955 56,552 96,507 NVIRONMENTALHEALTH SUBTOTAL 14.40 4,015 11,194 241 ,353 267,714 256,304 274, 194 782,791 256,774 1,039,565 SPECIAL CONTRACTS: SPECIAL CONTRACTS (599) 1 .00 0 0 16,999 16,999 16,999 17,000 0 67,997 67,997 PECIAL CONTRACTS SUBTOTAL 1 .00 0 0 16,999 16,999 16,999 17,000 0 67,997 67,997 OTAL CONTRACT 147.81 35,535 236,908 2,456,257 2,692,645 2,364,546 2,403,207 5,246,910 4,669,745 9,916,655 ATTACHMENT III INDIAN RIVER COUNTY HEALTH DEPARTMENT CIVIL RIGHTS CERTIFICATE The applicant provides this assurance in consideration of and for the purpose of obtaining federal grants, loans, contracts (except contracts of insurance or guaranty), property, discounts, or other federal financial assistance to programs or activities receiving or benefiting from federal financial assistance. The provider agrees to complete the Civil Rights Compliance Questionnaire, DH Forms 946 A and B (or the subsequent replacement if adopted during the contract period), if so requested by the department. The applicant assures that it will comply with: 1 . Title VI of the Civil Rights Act of 1964, as amended , 42 U .S.C. , 2000 Et seq . , which prohibits discrimination on the basis of race, color or national origin in programs and activities receiving or benefiting from federal financial assistance. 2. Section 504 of the Rehabilitation Act of 1973, as amended , 29 U .S.C. 794, which prohibits discrimination on the basis of handicap in programs and activities receiving or benefiting from federal financial assistance. 3. Title IX of the Education Amendments of 1972, as amended, 20 U . S. C. 1681 et seq . , which prohibits discrimination on the basis of sex in education programs and activities receiving or benefiting from federal financial assistance. 4. The Age Discrimination Act of 1975 , as amended, 42 U . S. C. 6101 at seq . , which prohibits discrimination on the basis of age in programs or activities receiving or benefiting from federal financial assistance. 5. The Omnibus Budget Reconciliation Act of 1981 , P. L. 97-35, which prohibits discrimination on the basis of sex and religion in programs and activities receiving or benefiting from federal financial assistance. 6. All regulations, guidelines and standards lawfully adopted under the above statutes. The applicant agrees that compliance with this assurance constitutes a condition of continued receipt of or benefit from federal financial assistance, and that it is binding upon the applicant, its successors, transferees, and assignees for the period during which such assistance is provided . The applicant further assures that all contracts, subcontractors, subgrantees or others with whom it arranges to provide services or benefits to participants or employees in connection with any of its programs and activities are not discriminating against those participants or employees in violation of the above statutes, regulations, guidelines, and standards. In the event of failure to comply, the applicant understands that the grantor may, at its discretion , seek a court order requiring compliance with the terms of this assurance or seek other appropriate judicial or administrative relief, to include assistance being terminated and further assistance being denied. ATTACHMENT IV INDIAN RIVER COUNTY HEALTH DEPARTMENT FACILITIES UTILIZED BY THE COUNTY HEALTH DEPARTMENT Facility Description Location Owned By Clinic, Dental , Vital Statistics, 1900 27"' Street County of Environmental Health , WIC , Vero Beach , FL 32960-3383 Indian River Administrative Headquarters 39 ,200 sq . ft. Gifford Health Center 4675 28t" Court Indian River County 10 ,642 sq ft Vero Beach , FL 32967- 1330 Hospital District Co-Located Site: WIC 12196 County Road 512 Treasure Coast Fellsmere , FL 32948-5463 Community Health ATTACHMENT V INDIAN RIVER COUNTY HEALTH DEPARTMENT SPECIAL PROJECTS SAVINGS PLAN IDENTIFY THE AMOUNT OF CASH THAT IS ANTICIPATED TO BE SET ASIDE ANNUALLY FOR THE PROJECT. CONTRACT YEAR STATE COUNTY TOTAL 2005-2006 $ $ $ 2006-2007 $ $ $ 2007-2008 $ $ $ 2008-2009 $ $ $ 2009-2010 $ $ $ PROJECT TOTAL $ $ $ SPECIAL PROJECT CONSTRUCTION/RENOVATION PLAN PROJECT NAME : LOCATION/ ADDRESS : PROJECT TYPE : NEW BUILDING _ ROOFING _ RENOVATION PLANNING STUDY _ NEW ADDITION OTHER SQUARE FOOTAGE : PROJECT SUMMARY : Describe scope of work in reasonable detail. NOT APPLICABLE ESTIMATED PROJECT INFORMATION : START DATE (initial expenditure of funds) : COMPLETION DATE : DESIGN FEES : $ CONSTRUCTION COSTS : $ FURNITURE/EQUIPMENT $ TOTAL PROJECT COST: $ COST PER SQ FOOT: $ #DIV/01 Special Capital Projects are new contruction or renovation projects and new furniture or equipment associated with these projects and mobile health vans. ATTACHMENT VI INDIAN RIVER COUNTY HEALTH DEPARTMENT PRIMARY CARE "Primary Care" as conceptualized for the county health departments and for the use of categorical Primary Care funds (revenue object code 015040) is defined as : "Health care services for the prevention or treatment of acute or chronic medical conditions or minor injuries of individuals which is provided in a clinic setting and may include family planning and maternity care." Indicate below the county health department programs that will be supported at least in part with categorical Primary Care funds this contract year: X Comprehensive Child Health (229/29) X Comprehensive Adult Health (237/37) X Family Planning (223/23) Maternal Health/IPO (225/25) X Laboratory (242/42) Pharmacy (241 /93) Other Medical Treatment Program (please identify) Describe the target population to be served with categorical Primary Care funds . The target population served with categorical Primary Care funds are the residents of Indian River County, who fall at or below 200% Federal Poverty. Does the health department intend to contract with other providers for the delivery of primary health care services using categorical (015040) Primary Care funds? If so, please identify the provider(s) , describe the services to be delivered , and list the anticipated contractual amount by provider. In addition , contract providers are required to provide data on patients served and the services provided so that the patients may be registered and the service data entered into HMS . No.