Backup Documents 10/26/2010 Item #10BHE.i.1� t
Charlie Crist
Governor
November 2nd, 2010
The Honorable Fred W. Coyle, Chairman
Board of County Commissioners
Collier County Government Center
3301 East Tamiami Trail
Naples, FL 34112
4
g
Dr. Ana M. Viamonte Ros.
State Surgeon General
RE: FY 2010 -11 Contract between the Board of Collier County Commissioners and the
Department of Health for Operation of the County Health Department
Dear Chairman Coyle:
Enclosed are four originals of the Core Contract between the Department of Health and Collier
County as approved at the October 26th, 2010 meeting of the BCC. After signature, please
contact me at (239) 252 -8206 or 5334 for courier pickup.
If you have any further questions, please feel free to contact me at (239) 252 -8206.
Sincerely,
Alan L. Fords
Director, Finance & Accounting
Enclosures (4)
//10
JU`.
Collier County Health Department
3301 Tamiami Trail E, Bldg H, Naples, FL 34112
Phone: (239) 252 -8200
INTEROFFICE MEMORANDUM
B
Jieor
County
Health
Department
Coring— C— mitred. _ Hrlping...Dedicoted
To the Wefineu of 0w Canmoniry
DATE: November 29, 2010
TO: Ann Jennejohn, Sr. Deputy Clerk
Minutes & Records Department
FROM: Alan Portis, Business Manager
Health Department
SUBJECT: Contract between the Collier County Board of County Commissioners
and the State of Florida for the Collier County Health Department
Contract Year 2010 -2011
Enclosed please find a fully executed original contract, as referenced above, (Agenda
Item #10B), which was approved by the Board of County Commissioners on Tuesday,
October 26, 2010.
If you should have any questions, please call me at 252 -8206.
Thank you.
Enclosures (1)
CONTRACT BETWEEN
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
AND
STATE OF FLORIDA DEPARTMENT OF HEALTH
FOR OPERATION OF
THE COLLIER COUNTY HEALTH DEPARTMENT
CONTRACT YEAR 2010 -2011
This agreement ( "Agreement ") is made and entered into between the State of Florida,
Department of Health ( "State ") and the Collier County Board of County Commissioners
( "County "), through their undersigned authorities, effective October 1, 2010.
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. Collier 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 Qf 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, 2010, through September 30, 2011, 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.
Environmental health services shall be supported by available federal, state and local
funds and shall include those services mandated on a state or federal level. Examples of
environmental health services include, but are not limited to, food hygiene, safe drinking
water supply, sewage and solid waste disposal, swimming pools, group care facilities,
migrant labor camps, toxic material control, radiological health, and occupational health.
b. "Communicable disease control services" are those services which protect the
health bf 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 11.
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 II, Part II is an amount not to exceed $ 7,190,087 (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,
other cash or local contributions) as provided in Attachment 11, Part I I is an amount not
to exceed $1,324,400 (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
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 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 CHD. The CHD will then revise the Attachment II and send a copy of the revised
pages to the Department of Health, Bureau of Budget Management.
e. The name and address of the official payee to who payments shall be made is:
County Health Department Trust Fund
Collier County
3301 Tamiami Trail E., Bldg. H
Naples, FL 34112
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,
and all county- purchasing procedures must be followed in their entirety, and such
compliance shall be documented. Such justification and compliance documentation shall
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be maintained by the CHD in accordance with the terms of this Agreement. State
procedures must be followed for all leases on facilities not enumerated in Attachment IV.
c. The CHD 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 CHD to comply with
the following reporting requirements:
The revenue and expenditure requirements in the Florida Accounting
System Information Resource (FLAIR).
ii. - The client registration and services reporting requirements of the
minimum data set as specified in the most current version of the Client
Information System /Health Management Component Pamphlet;
iii. Financial procedures specified in the Department of Health's Accounting
Procedures Manuals, Accounting memoranda, and Comptroller's
memoranda;
iv. The CHD is responsible for assuring that all contracts with service
providers include provisions that all subcontracted services be reported
to the CHD in a manner consistent with the client registration and
service reporting requirements of the minimum data set as specified in
the Client Information System /Health Management Component
Pamphlet.
d. All funds for the CHD shall be deposited in the County Health Department Trust
Fund maintained by the state treasurer. These funds shall be accounted for separately
from funds deposited for other CHDs and shall be used only for public health purposes in
Collier 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
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
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108 +
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 /administrator determines that an emergency
exists wherein a time delay would endanger the public's health and the Deputy State
Health Officer has approved the transfer. The Deputy State Health Officer shall forward
written evidence of this approval to the CHD within 30 days after an emergency transfer.
g. The CHD may execute subcontracts for services necessary to enable the CHD to
carry out the programs specified in this Agreement. Any such subcontract shall include all
aforementioned audit and record keeping requirements.
h. At the request of either party, an audit may be conducted by an independent CPA
on the financial records of the CHD and the results made available to the parties within
180 days after the close of the CHD fiscal year. This audit will follow requirements
contained in OMB Circular A -133 and may be in conjunction with audits performed by
county government. If audit exceptions are found, then the director /administrator of the
CHD will prepare a corrective action plan and a copy of that plan and monthly status
reports will be furnished to the contract managers for the parties.
i. The CHD shall not use or disclose any information concerning a recipient of
services except as allowed by federal or state law or policy.
j. The CHD shall retain all client records, financial records, supporting documents,
statistical records, and any other documents (including electronic storage media) pertinent
to this Agreement for a period of five (5) years after termination of this Agreement. If an
audit has been initiated and audit findings have not been resolved at the end of five (5)
years, the records shall be retained until resolution of the audit findings.
k. The CHD shall maintain confidentiality of all data, files, and records that are
confidential under the law or are otherwise exempted from disclosure as a public record
under Florida law. The CHD shall implement procedures to ensure the protection and
confidentiality of all such records and shall comply with sections 384.29, 381.004, 392.65
and 456.057, Florida Statutes, and all other state and federal laws regarding
confidentiality. All confidentiality procedures implemented by the CHD shall be consistent
with the Department of Health Information Security Policies, Protocols, and Procedures,
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.
m. The CHD shall establish a system through which applicants for services and current
clients may present grievances over denial, modification or termination of services. The
CHD will advise applicants of the right to appeal a denial or exclusion from services, of
failure to take account of a client's choice of service, and of his /her right to a fair hearing to
the final governing authority of the agency. Specific references to existing laws, rules or
program manuals are included in Attachment I of this Agreement.
n. The CHD shall comply with the provisions contained in the Civil Rights Certificate,
hereby incorporated into this contract as Attachment III.
o. The CHD shall submit quarterly reports to the county that shall include at least the
following:
i. The DE3851-1 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
DE3851-1 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.
p. The dates for the submission of quarterly reports to the county shall be as follows
unless the generation and distribution of reports is delayed due to circumstances beyond
the CHD's control:
L March 1, 2011 for the report period October 1, 2010 through
December 31, 2010;
ii. June 1, 2011 for the report period October 1, 2010 through
March 31, 2011;
iii. September 1, 2011 for the report period October 1, 2010
through June 30, 2011; and
iv. December 1, 2011 for the report period October 1, 2010
through September 30, 2011.
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,
2011, 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:
Joan M. Colfer, M.D., M.P.H.
Name
Director, Collier County Health Dept
Title
3301 Tamiami Trail E., Bldg. H
Address
Naples, Florida 34112
City
(239) 252 -8201
Telephone
For the County:
Marla Olsvig Ramsey
Name
Public Services Administrator
Title
3301 Tamiami Trail E., Bldg. H
Address
Naples, Florida 34112
City
(239) 252 -8383
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.
In WITNESS THEREOF, the parties hereto have caused this 29 page agreement to be
executed by their undersigned officials as duly authorized effective the 1St day of October, 2010.
BOARD OF COUNTY COMMISSIONERS
FOR COLLIER COUNTY
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SIGNED BY
NAME: F-F-F-ri W •
TITLE: btp.. v _
DATE: (>� 20tO
ATTESTEE TO:.
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SIGNED BYE.
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DATE: lyx*bw
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AWstan .onnty Attorney
STATE OF FLORIDA
DEPARTMENT OF HEALTH
SIGNED BY:
NAME: Ana M. Viamonte Ros, M.D., M.P.H.
TITLE: State Surgeon General
DATE: // Ii � 40
WOR4, �.i .l •a! � � :viii_ !►
TITLE:: C�HD Director /Administrator
DATE: 1 10 ) e�01 Q
9
ATTACHMENT 100
COLLIER 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 CHID Guidebook.
2. Dental Health
Monthly reporting on DH Form 1008 *. Additional reporting
requirements, under development, will be required. The
additional reporting requirements will be communicated upon
finalization.
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 (including the WIC
requirements detailed in program manuals and published
Breastfeeding Peer Counseling
procedures.
Program)
4. Healthy Start/
Requirements as specified in the 2007 Healthy Start
Improved Pregnancy Outcome
Standards and Guidelines and as specified by the Healthy
Start Coalitions in contract with each county health
department.
5. Family Planning
Periodic financial and programmatic reports as specified
by the program office and in the CHID 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 as
documented in Florida SHOTS, the assessment of various
immunization levels as documented in Florida SHOTS and
forms reporting adverse events following immunization.
7. Chronic Disease Program
Requirements as specified in the Healthy Communities,
Healthy People Guidebook.
8. Environmental Health
Requirements as specified in Environmental Health Programs
Manual 150-4* and DHP 50 -21*
9. HIV /AIDS Program
Requirements as specified in F.S. 384.25 and
64D -3.016 and 3.017 F.A.C. and the CHID Guidebook. Case
reporting should be on Adult HIV /AIDS Confidential Case
Report CDC Form DH2139 and Pediatric HIV /AIDS
Confidential Case Report CDC Form DH2140. Socio-
10
10.
11
12.
ATTACHMENT I (Continued)
demographic data on persons tested for HIV in CHD clinics
should be reported on Lab Request DH Form 1628 or Post -
Test Counseling DH Form 1628C. 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.
School Health Services Requirements as specified in the Florida School Health
Administrative Guidelines (April 2007).
Tuberculosis Tuberculosis Program Requirements as specified in FAC
64D -3, F.S. Specific Authority 381.0011(13), 381.003(2),
381.0031(6), 384.33, 392.53(2), 392.66 FS Law Implemented
381.0011(4), 381.003(1), 381.0031(1), (2), (6), 383.06,
384.23, 384.25, 385.202, 392.53 FS.381 and CHD
Guidebook.
General Communicable Disease Control Carry out surveillance for reportable communicable and other
acute diseases, detect outbreaks, respond to individual cases
of reportable diseases, investigate outbreaks, and carry out
communication and quality assurance functions, as specified
in the CHD Guide to Surveillance and Investigations.
*or the subsequent replacement if adopted during the contract period.
11
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ATTACHMENT H.
10B
COLLIER COUNTY HEALTH DEPARTMENT
Part H. Sources of Contributions to County
Health Department
October 1, 2010 to September 30, 2011
State CHD
County
Total CHD
Trust Fund
CHD
Trust Fund
bt4ei
(cash)
Trust Fund
(cash)
C44621"On .r :
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 PATIENT CARE NETWORK
0
0
0
0
0
015040
ALG /CONTR TO CHDS -AIDS PREV & SURV & FIELD STAFF
88,650
0
88,650
0
88,650
015040
ALG /CONTR TO CHDS- DENTAL PROGRAM
17,907
0
17,907
0
17,907
015040
ALG /CONTR TO CHDS - MIGRANT LABOR CAMP SANITATION
99,377
0
99,377
0
99,377
015040
MINORITY OUTREACH - PENALVER CLINIC - MIAMI -DADE
0
0
0
0
0
015040
PRIMARY CARE SPECIAL DENTAL PROJECTS
6,924
0
6,924
0
6,924
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
VARICELLA IMMUNIZATION REQUIREMENT
14,214
0
14,214
0
14,214
015040
HEALTHY START MED WAIVER - SOBRA
0
0
0
0
0
015040
HEALTHY START MED - WAIVER - CLIENT SERVICES
0
0
0
0
0
015040
JESSIE TRICE CANCER CTR/HEALTH CHOICE - MIAMI -DADE
0
0
0
0
0
01 5040
LA LIGA CONTRA EL CANCER
0
0
0
0
0
015040
MANATEE COUNTY RURAL HEALTH SERVICES
0
0
0
0
0
015040
METRO ORLANDO URBAN LEAGUE TEENAGE PREG PREV
0
0
0
0
0
015040
COUNTY SPECIFIC DENTAL PROJECTS - ESCAMBIA
0
0
0
0
0
015040
DENTAL SPECIAL INITIATIVES
3,295
0
3,295
0
3,295
015040
DUVAL TEEN PREGNANCY PREVENTION
0
0
0
0
0
015040
FL CLPPP SCREENING & CASE MANAGEMENT
0
0
0
0
0
015040
FL HEPATITIS & LIVER FAILURE PREVENTION /CONTROL
178,572
0
178,572
0
178,572
015040
HEALTHY BEACHES MONITORING
23,856
0
23,856
0
23,856
015040
ALG/IPO HEALTHY START /IPO
0
0
0
0
0
015040
ALG/PRIMARY CARE
307,852
0
307,852
0
307,852
015040
ALG /SCHOOL HEALTH/SUPPLEMENTAL
0
0
0
0
0
015040
CHILD HEALTH MEDICAL SERVICES
0
0
0
0
0
015040
COMMUNITY SMILES - MIAMI -DADE
0
0
0
0
0
015040
COMMUNITY TB PROGRAM
57,977
0
57,977
0
57,977
015040
ALG /CONTR. TO CHDS - IMMUNIZATION OUTREACH TEAMS
24,909
0
24,909
0
24,909
015040
ALG /CONTR. TO CHDS- INDOOR AIR ASSIST PROG
0
0
0
0
0
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
24,717
0
24,717
0
24,717
015040
ALG/FAMILY PLANNING
44,654
0
44,654
0
44,654
015050
ALG /CONTR TO CHDS
2,350,530
0
2,350,530
0
2,350,530
GENERAL REVENUE TOTAL
3,343,434
0
3,343,434
0
3,343,434
2. NON GENERAL REVENUE - STATE
015010
ALG /CONTR TO CHDS - REBASING TOBACCO TF
32,134
0
32,134
0
32,134
015010
ALG /CONTR. TO CHDS - BIOMEDICAL WASTE/DEP ADM TF
12,704
0
12,704
0
12,704
015010
ALG /CONTR. TO CHDS -SAFE DRINKING WATER PRG/DEP ADM
0
0
0
0
0
015010
BASIC SCHOOL HEALTH - TOBACCO TF
137,218
0
137,218
0
137,218
015010
CHD PROGRAM SUPPORT
0
0
0
0
0
015010
ENVIRONMENTAL HEALTH PACE PROJECTS
0
p
0
0
0
015010
FOOD AND WATERBORNE DISEASE PROGRAM ADM TF/DACS
0
0
0
0
0
015010
FULL SERVICE SCHOOLS - TOBACCO TF
114,545
0
114,545
0
114,545
Version:
4
Page 1 of 7
ATTACHMENT II.
10 B "14
COLLIER COUNTY HEALTH DEPARTMENT
Part H. Sources of Contributions to County
Health Department
October 1, 2010 to
September 30, 2011
State CHD
County
Total CHD
Trust Fund
CHD
Trust Fund
fter °,
(cash)
Trust Fund
(cash) C"Umi4a
Total
2. NON GENERAL REVENUE - STATE
015010
IMMUNIZATION SPECIAL PROJECT
12,368
0
12,368
0
12,368
015010
PUBLIC SWIMMING POOL PROGRAM
0
0
0
0
0
015010
TOBACCO ADMINISTRATIVE SUPPORT
46,000
0
46,000
0
46,000
015010
TOBACCO COMMUNITY INTERVENTION
140,000
0
140,000
0
140,000
015020
TRANSFER FROM ANOTHER STATE AGENCY
0
0
0
0
0
015020
TRANSFER FROM ANOTHER STATE AGENCY
0
0
0
0
0
015020
TRANSFER FROM ANOTHER STATE AGENCY
0
0
0
0
0
015060
Non - Categorical Tobacco Rebasing
0
0
0
0
0
NON GENERAL REVENUE TOTAL
494,969
0
494,969
0
494,969
3. FEDERAL FUNDS - State
007000
AFRICAN AMERICAN TESTING INITIATIVE (AATI)
0
0
0
0
0
007000
AIDS PREVENTION
217,508
0
217,508
0
217,508
007000
AIDS SURVEILLANCE
0
0
0
0
0
007000
BIOTERRORISM HOSPITAL PREPAREDNESS
29,000
0
29,000
0
29,000
007000
CHILDHOOD LEAD POISONING PREVENTION
0
0
0
0
0
007000
COASTAL BEACH MONITORING PROGRAM
20,910
0
20,910
0
20,910
007000
TUBERCULOSIS CONTROL - FEDERAL GRANT
123,788
0
123,788
0
123,788
007000
WIC ADMINISTRATION
2,123,683
0
2,123,683
0
2,123,683
007000
WIC BREASTFEEDING PEER COUNSELING
74,437
0
74,437
0
74,437
007000
STD FEDERAL GRANT - CSPS
0
0
0
0
0
007000
STD PROGRAM - PHYSICIAN TRAINING CENTER
0
0
0
0
0
007000
STD PROGRAM - PHYSICIANS TRAINING CENTER
0
0
0
0
0
007000
STD PROGRAM INFERTILITY PREVENTION PROJECT (IPP)
5,624
0
5,624
0
5,624
007000
SYPHILIS ELIMINATION
0
0
0
0
0
007000
TITLE X MALE PROJECT
75,565
0
75,565
0
75,565
007000
RYAN WHITE
0
0
0
0
0
007000
RYAN WHITE - EMERGING COMMUNITIES
0
0
0
0
0
007000
RYAN WHITE PART B SUPPLEMENTAL
0
0
0
0
0
007000
RYAN WHITE -AIDS DRUG ASSIST PROG -ADMIN
77,945
0
77,945
0
77,945
007000
RYAN WHITE- CONSORTIA
0
0
0
0
0
007000
STATE INDOOR RADON GRANT
0
0
0,
0
0
007000
NATIONAL COMPREHENSIVE CANCER CONTROL PROGRAM
0
0
0
0
0
007000
ORAL HEALTH WORKFORCE ACTIVITIES
0
0
0
0
0
007000
ORAL HEALTH WORKFORCE ACTIVITIES 2010 -2011
0
0
0
0
0
007000
PUBLIC HEALTH EMERGENCY RESPONSE HIN1
170,000
0
170,000
0
170,000
007000
PUBLIC HEALTH PREPAREDNESS BASE
132,847
0
132,847
0
132,847
007000
RAPE PREVENTION & EDUCATION GRANT
0
0
0
0
0
007000
IMMUNIZATION FIELD STAFF EXPENSE
0
0
0
0
0
007000
IMMUNIZATION SUPPLEMENTAL
40,408
0
40,408
0
40,408
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
FGTF /FAMILY PLANNING -TITLE X
80,527
0
80,527
0
80,527
007000
FGTF/IMMUNIZATION ACTION PLAN
65,886
0
65,886
0
65,886
007000
HEALTH PROGRAM FOR REFUGEES
69,860
0
69,860
0
69,860
007000
HEALTHY PEOPLE HEALTHY COMMUNITIES
33,541
0
33,541
0
33,541
Version:
4
Page 2 of 7
ATTACHMENT II. 10 B :41
COLLIER COUNTY HEALTH DEPARTMENT
Part H. Sources of Contributions to County Health Department
October 1, 2010 to September 30, 2011
State CHD County Total CHD
Trust Fund CHD Trust Fund Other r
(cash) Trust Fund (cash) Contribiation . Total
3. FEDERAL FUNDS - State
007000
HIV HOUSING FOR PEOPLE LIVING WITH AIDS
007000
HIV INCIDENCE SURVEILLANCE
007000
COLORECTAL CANCER SCREENING 2009 -10
007000
DIABETES PREVENTION & CONTROL PROGRAM
007000
FAMILY PLANNING - TITLE X
007000
FGTF /AIDS MORBIDITY
007000
FGTF/BREAST & CERVICAL CANCER -ADMIN /CASE MAN
007000
FGTF/FAMILY PLANNING TITLE X SPECIAL INITIATIVES
015009
MEDIPASS WAIVER -HLTHY STRT CLIENT SERVICES
015009
MEDIPASS WAIVER -SOBRA
015075
REFUGEE SCREENING
007055
ARRA Federal Grant - Schedule C
015075
Inspections of Summer Feeding Program
FEDERAL FUNDS TOTAL
4. FEES ASSESSED BY STATE OR FEDERAL RULES - STATE
001020
TANNING FACILITIES
001020
BODY PIERCING
001020
MIGRANT HOUSING PERMIT
001020
'MOBILE HOME AND PARKS
001020
FOOD HYGIENE PERMIT
001020
BIOHAZARD WASTE PERMIT
001020
PRIVATE WATER CONSTR PERMIT
001020
PUBLIC WATER ANNUAL OPER PERMIT
001020
PUBLIC WATER CONSTR PERMIT
001020
NON -SDWA SYSTEM PERMIT
001020
SAFE DRINKING WATER
001020
SWIMMING POOLS
001092
OSDS PERMIT FEE
001092
I & M ZONED OPERATING PERMIT
001092
AEROBIC OPERATING PERMIT
001092
SEPTIC TANK SITE EVALUATION
001092
NON SDWA LAB SAMPLE
001092
OSDS VARIANCE FEE
001092
ENVIRONMENTAL HEALTH FEES
001092
OSDS REPAIR PERMIT
001170
LAB FEE CHEMICAL ANALYSIS
001170
WATER ANALYSIS - POTABLE
001170
NONPOTABLE WATER ANALYSIS
010304
MQA INSPECTION FEE
001206
Central Office Surcharge
FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL
5. OTHER CASH CONTRIBUTIONS - STATE
010304
STATIONARY POLLUTANT STORAGE TANKS
090001
DRAW DOWN FROM PUBLIC HEALTH UNIT
OTHER CASH CONTRIBUTIONS TOTAL
Version: 4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
252,200
0
252,200
0
252,200
10,155
0
10,155
0
10,155
0
0
0
0
0
3,603,884
0
3,603,884
0
3,603,884
3,500
0
3,500
0
3,500
270
0
270
0
270
69,775
0
69,775
0
69,775
17,000
0
17,000
0
17,000
30,000
0
30,000
0
30,000
32,000
0
32,000
0
32,E
0
0
0
0
0
8,500
0
8,500
0
8,500
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
300,000
0
300,000
0
300,E
130,000
0
130,000
0
130,000
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
30,200
0
30,200
0
30,200
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12,500
0
12,500
0
12,500
0
0
0
0
0
633,745
0
633,745
0
633,745
0
0
0
0
0
107,109
0
107,109
0
107,109
107,109
0
107,109
0
107,109
Paae3of7
ATTACHMENT II.
COLLIER COUNTY HEALTH DEPARTMENT 10B t ■
Part H. Sources of Contributions to County Health Department
October 1, 2010 to September 30, 2011
State CHD County Total CHD
Trust Fund CHD Trust Fund Other'
(cash) Trust Fund (cash) C"tribtlion Total
6. MEDICAID - STATE /COUNTY
001056
MEDICAID PHARMACY
216,837
346,963
563,800
0
563,800
001076
MEDICAID TB
23,076
36,924
60,000
0
60,000
001078
MEDICAID ADMINISTRATION OF VACCINE
18,700
18,700
37,400
0
37,400
001079
MEDICAID CASE MANAGEMENT
15,000
15,000
30,000
0
30,000
001081
MEDICAID CHILD HEALTH CHECK UP
0
0
0
0
0
001082
MEDICAID DENTAL
524,179
838,742
1,362,921
0
1,362,921
001083
MEDICAID FAMILY PLANNING
0
0
0
0
0
001087
MEDICAID STD
5,706
9,131
14,837
0
14,837
001089
MEDICAID AIDS
21,153
33,847
55,000
0
55,000
001147
Medicaid HMO Capitation
0
0
0
0
0
001191
MEDICAID MATERNITY
0
0
0
0
0
001192
MEDICAID COMPREHENSIVE CHILD
3,574
5,718
9,292
0
9,292
001193
MEDICAID COMPREHENSIVE ADULT
5,525
8,840
14,365
0
14,365
001194
MEDICAID LABORATORY
0
0
0
0
0
001208
MEDIPASS $3.00 ADM. FEE
100
100
200
0
200
001059
Medicaid Low Income Pool
0
0
0
0
0
001051
Emergency Medicaid
0
0
0
0
0
001058
Medicaid - Behavioral Health
0
0
0
0
0
001071
Medicaid - Orthopedic
0
0
0
0
0
001072
Medicaid - Dermatology
0
0
0
0
0
001075
Medicaid - School Health Certified Match
0
0
0
0
0
001069
Medicaid - Refugee Health
0
0
0
0
0
001055
Medicaid - Hospital
0
0
0
0
0
001148
Medicaid HMO Non - Capitation
0
0
0
0
0
001074
Medicaid - Newborn Screening
0
0
0
0
0
MEDICAID TOTAL
833,851
1,313,964
2,147,815
0
2,147,815
7. ALLOCABLE REVENUE - STATE
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
ALLOCABLE REVENUE TOTAL
0
0
0
0
0
8. OTHER STATE CONTRIBUTIONS NOT IN CHD TRUST FUND - STATE
PHARMACY SERVICES
0
0
0
85,626
85,626
LABORATORY SERVICES
0
0
0
157,479
157,479
TB SERVICES
0
0
0
0
0
IMMUNIZATION SERVICES
0
0
0
1,186,952
1,186,952
STD SERVICES
0
0
0
0
0
CONSTRUCTION/RENOVATION
0
0
0
0
0
WIC FOOD
0
0
0
7,308,746
7,308,746
ADAP
0
0
0
2,429,923
2,429,923
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
11,168,726
11,168,726
Version: 4 Page 4 of 7
ATTACHMENT II.
COLLIER COUNTY HEALTH DEPARTMENT 10B
jolt
Part II. Sources of Contributions to County Health Department
October 1, 2010 to September 30, 2011
State CHD County Total CHD
Trust Fund CHD Trust Fund Other
(cash) Trust Fund (cash) Contribution Total
9. DIRECT LOCAL CONTRIBUTIONS - COUNTY
008030
Contribution from Health Care Tax
0
0
0
0
0
008034
BCC Contribution from General Fund
0
1,324,400
1,324,400
0
1,324,400
DIRECT
COUNTY CONTRIBUTION TOTAL
0
1,324,400
1,324,400
0
1,324,400
10. FEES
AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION - COUNTY
001060
CHD SUPPORT POSITION
0
225
225
0
225
001077
RABIES VACCINE
0
0
0
0
0
001077
CHILD CAR SEAT PROG
0
0
0
0
0
001077
PERSONAL HEALTH FEES
0
147,977
147,977
0
147,977
001077
AIDS CO -PAYS
0
0
0
0
0
001094
ADULT ENTER. PERMIT FEES
0
0
0
0
0
001094
LOCAL ORDINANCE FEES
0
669,100
669,100
0
669,100
001114
NEW BIRTH CERTIFICATES
0
55,300
55,300
0
55,300
001115
Vital Statistics - Death Certificate
0
226,000
226,000
0
226,000
001117
VITAL STATS -ADM. FEE 50 CENTS
0
3,500
3,500
0
3,500
001073
Co -Pay for the AIDS Care Program
0
0
0
0
0
001025
Client Revenue from GRC
0
0
0
0
0
001040
Cell Phone Administrative Fee
0
0
0
0
0
FEES AUTHORIZED BY COUNTY TOTAL
0
1,102,102
1,102,102
0
1,102,102
11. OTHER CASH AND LOCAL CONTRIBUTIONS - COUNTY
001009
RETURNED CHECK ITEM
0
0
0
0
0
001029
THIRD PARTY REIMBURSEMENT
0
440,801
440,801
0
440,801
001029
HEALTH MAINTENANCE ORGAN. (HMO)
0
0
0
0
0
001054
MEDICARE PART D
0
312,000
312,000
0
312,000
001077
RYAN WHITE TITLE 11
0
0
0
0
0
001090
MEDICARE PART B
0
192,860
192,860
0
192,860
001190
Health Maintenance Organization
0
0
0
0
0
005040
INTEREST EARNED
0
0
0
0
0
005041
INTEREST EARNED -STATE INVESTMENT ACCOUNT
0
0
0
0
0
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 Tax not thru BCC
0
0
0
0
0
008050
School Board Contribution
0
0
0
0
0
008060
Special Project Contribution
0
0
0
0
0
010300
SALE OF GOODS AND SERVICES TO STATE AGENCIES
0
0
0
0
0
010301
EXP WITNESS FEE CONSULTNT CHARGES
0
0
0
0
0
010405
SALE OF PHARMACEUTICALS
0
36,000
36,000
0
36,000
010409
SALE OF GOODS OUTSIDE STATE GOVERNMENT
0
0
0
0
0
011001
HEALTHY START COALITION CONTRIBUTIONS
0
502,362
502,362
0
502,362
011007
CASH DONATIONS PRIVATE
0
4,767
4,767
0
4,767
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
090002
DRAW DOWN FROM PUBLIC HEALTH UNIT
0
106,885
106,885
0
106,885
011000
GRANT DIRECT -NOVA UNIVERSITY CHD TRAINING
0
0
0
0
0
011000
COUNTY COMMISSION - LIP FUND
0
159,450
159,450
0
159,450
Version: 4 Page 5 of 7
ATTACHMENT II.
10B "1
COLLIER COUNTY HEALTH DEPARTMENT
Part II. Sources of Contributions to County Health Department
October 1, 2010 to September 30, 2011
State CHD County Total CHD
Trust Fund CHD Trust Fund Other
( —b) Trust Fund (cash) Contribution Total
11. OTHER CASH AND LOCAL CONTRIBUTIONS - COUNTY
011000 GRANT DIRECT- COUNTY HEALTH DEPARTMENT DIRECT SERVICES
0
0
0
0
0
011000 DIRECT -ARROW
0
0
0
0
0
011000 GRANT - DIRECT
0
424,021
424,021
0
424,021
011000 GRANT - DIRECT
0
0
0
0
0
011000 GRANT DIRECT- QUANTUM DENTAL
0
0
0
0
0
01 1000 GRANT DIRECT- HEALTH CARE DISTRICT PAHOKEE
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
011000 GRANT DIRECT -ARROW
0
0
0
0
0
010402 Recycled Material Sales
0
0
0
0
0
010303 FDLE Fingerprinting
0
0
0
0
0
007050 ARRA Federal Grant
0
0
0
0
0
001010 Recovery of Bad Checks
0
0
0
0
0
008065 FCO Contribution
0
0
0
0
0
011006 Restricted Cash Donation
0
0
0
0
0
028000 Insurance Recoveries
0
0
0
0
0
001033 CMS Management Fee - PMPMPC
0
0
0
0
0
010400 Sale of Goods Outside State Government
0
0
0
0
0
010500 Refugee Health
0
0
0
0
0
005045 Interest Earned -Third Party Provider
0
0
0
0
0
005043 Interest Eamed- ContractlGrant
0
0
0
0
0
010306 DOH/DOC Interagency Agreement
0
0
0
0
0
008040 BCC Grant/Contract
0
0
0
0
0
01 1002 ARRA Federal Grant - Sub - Recipient
0
0
0
0
0
OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL
0
2,179,146
2,179,146
0
2,179,146
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
525,048
525,048
GROUNDS MAINTENANCE
0
0
0
195,149
195,149
OTHER (SPECIFY)
0
0
0
0
0
INSURANCE
0
0
0
0
0
UTILITIES - TELEPHONE, ELECTRIC, WATER & SEWER
0
0
0
247,800
247,800
OTHER (SPECIFY)
0
0
0
0
0
BUILDING MAINTENANCE
0
0
0
74,342
74,342
BUILDINGS TOTAL
0
0
0
1,042,339
1,042,339
14. OTHER COUNTY CONTRIBUTIONS NOT IN CHD TRUST FUND - COUNTY
EQUIPMENTNEHICLE PURCHASES
0
0
0
0
0
Version: 4
Page 6 of 7
ATTACHMENT II.
COLLIER COUNTY HEALTH DEPARTMENT
10B
Part II. Sources of Contributions to County Health Department
October 1, 2010 to September 30, 2011
State CHD County Total CHD
Trust Fund CHD Trust Fund Mer
(cash) Trust Fund (cash) Contribution Total
14. OTHER COUNTY CONTRIBUTIONS NOT IN CHD TRUST FUND - COUNTY
VEHICLE INSURANCE 0 0 0 17,900 17,900
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 17,900 17,900
GRAND TOTAL CHD PROGRAM 9,016,992 5,919,612 14,936,604 12,228,965 27,165,569
Version: 4 Page 7 of 7
ATTACHMENT H.
COLLIER COUNTY HEALTH DEPARTMENT
10B '
Part III. Planned Staffing, Clients, Services, And Expenditures By Program Service Area Within Each Level Of SerAce
October 1, 2010 to September 30, 2011
Version: 1 Page 1 of 2
Quarterly Expenditure Plan
FrE's
Clients
1st
2nd
3rd
4th
Grand
(0.00)
Units
Services
(Whole dollars only)
State
Ety
Total
A. COMMUNICABLE DISEASE CONTROL:
IMMUNIZATION (101)
20.18
19,799
45,146
344,686
295,445
344,686
295,445
801,216
479,046
1,280,262
STD (102)
10.29
1,297
12,649
150,291
128,821
150,291
128,821
443,855
114,369
558,224
A.I.D.S. (103)
21.34
2,409
19,640
563,178
482,724
563,178
482,724
875,125
1,216,679
2,091,804
TB CONTROL SERVICES (104)
14.33
1,651
10,418
234,949
201,385
234,949
201,385
612,319
260,349
872,668
COMM. DISEASE SURV. (106)
6.99
0
7,974
139,612
119,668
139,612
119,668
300,600
217,960
518,560
HEPATITIS PREVENTION (109)
3.92
2,565
6,001
66,235
56,773
66,235
56,773
246,016
0
246,016
PUBLIC HEALTH PREP AND RESP (116)
7.24
0
378
139,022
119,161
139,022
119,161
427,812
88,554
516,366
VITAL STATISTICS (180)
3.34
11,469
40,745
45,342
38,865
45,342
38,865
0
168,414
168,414
COMMUNICABLE DISEASE SUBTOTAL
87.63
39,190
142,951
1,683,315
1,442,842
1,683,315
1,442,842 3,706,943
2,545,371
6,252,314
B. PRIMARY CARE:
CHRONIC DISEASE SERVICES (2 10)
0.93
44
1,223
15,551
13,330
15,551
13,330
18,048
39,714
57,762
TOBACCO PREVENTION (212)
3.77
0
3,091
58,230
49,911
58,230
49,911
216,282
0
216,282
W.I.C. (221)
41.26
18,738
138,369
617,393
529,194
617,393
529,194 2,280,870
12,304
2,293,174
FAMILY PLANNING (223)
2.19
5,313
10,902
76,875
65,893
76,875
65,893
285,536
0
285,536
IMPROVED PREGNANCY OUTCOME (225)
8.94
2,390
22,443
235,736
202,059
235,736
202,059
38,094
837,496
875,590
HEALTHY START PRENATAL (227)
15.53
1,550
42,272
219,879
188,467
219,879
188,467
306,060
510,632
816,692
COMPREHENSIVE CHILD HEALTH (229)
2.66
2,237
6,561
59,065
50,628
59,065
50,628
94,982
124,404
219,386
HEALTHY START INFANT (23 1)
3.95
776
16,983
63,022
54,019
63,022
54,019
121,650
112,432
234,082
SCHOOL HEALTH (234)
6.60
0
170,781
107,161
91,853
107,161
91,853
303,067
94,961
398,028
COMPREHENSIVE ADULT HEALTH (237)
5.71
1,850
9,224
147,420
126,360
147,420
126,360
281,390
266,170
547,560
DENTAL HEALTH (240)
15.78
4,009
26,604
317,680
272,297
317,680
272,297
408,030
771,924
1,179,954
PRIMARY CARE SUBTOTAL
107.32
36,907
448,453
1,918,012
1,644,011
1,918,012
1,644,011 4,354,009
2,770,037
7,124,046
C. ENVIRONMENTAL HEALTH:
Water and Onsite Sewage Programs
COASTAL BEACH MONITORING (347)
0.29
1,037
1,037
7,655
6,562
7,655
6,562
28,434
0
28,434
LIMITED USE PUBLIC WATER SYSTEMS (357)
0.63
262
1,402
13,300
1 1,400
13,300
11,400
14,566
34,834
49,400
PUBLIC WATER SYSTEM (358)
0.00
0
0
0
0
0
0
0
0
0
PRIVATE WATER SYSTEM (359)
0.00
0
0
414
355
414
355
0
1,538
1,538
INDIVIDUAL SEWAGE DISP. (361)
5.65
1,607
7,533
105,627
90,537
105,627
90,537
178,856
213,472
392,328
Group Total
6.57
2,906
9,972
126,996
108,854
126,996
108,854
221,856
249,844
471,700
Facility Programs
FOOD HYGIENE (348)
3.66
369
1,930
63,937
54,803
63,937
54,803
233,207
4,273
237,480
BODY ART (349)
0.00
1
2
50
43
50
43
186
0
186
GROUP CARE FACILITY (35 1)
1.37
437
809
22,599
19,371
22,599
19,371
0
83,940
83,940
MIGRANT LABOR CAMP (352)
2.34
116
711
42,705
36,604
42,705
36,604
90,831
67,787
158,618
HOUSING,PUBLIC BLDG SAFETY,SANITATION (350.))0
0
0
0
0
0
0
0
0
0
MOBILE HOME AND PARKS SERVICES (354)
0.52
107
261
8,199
7,028
8,199
7,028
30,454
0
30,454
SWIMMING POOLS/BATHING (360)
6.11
1,636
18,111
118,844
101,866
118,844
101,866
189,577
251,843
441,420
BIOMEDICAL WASTE SERVICES (364)
1.08
646
842
17,961
15,395
17,961
15,395
66,047
665
66,712
TANNING FACILITY SERVICES (369)
0.09
21
69
1,404
1,204
1,404
1,204
5,216
0
5,216
Group Total
15.17
3,333
22,735
275,699
236,314
275,699
236,314
615,518
408,508
1,024,026
Version: 1 Page 1 of 2
Version: 1 Page 2 of 2
ATTACHMENT II.
10B
COLLIER COUNTY HEALTH DEPARTMENT
Part III. Planned Staffing, Clients, Services, And Expenditures
By Program Service Area Within Each Level Of Service
October 1, 2010 to September
30, 2011
Quarterly Expenditure Plan
ITTE's
Clients
1st
2nd
3rd
4th
Grand
(0.00)
Units
Services
(Whole dollars only)
State
Gouty
Tow
C. ENVIRONMENTAL HEALTH:
Groundwater Contamination
STORAGE TANK COMPLIANCE (355)
0.00
0
0
0
0
0
0
0
0
0
SUPER ACT SERVICE (356)
0.23
158
258
3,823
3,277
3,823
3,277
14,200
0
14,200
Group Total
0.23
158
258
3,823
3,277
3,823
3,277
14,200
0
14,200
Community Hygiene
OCCUPATIONAL HEALTH (344)
0.20
0
306
3,090
2,649
3,090
2,649
5,965
5,513
11,478
CONSUMER PRODUCT SAFETY (345)
0.00
0
0
0
0
0
0
0
0
0
INJURY PREVENTION (346)
0.53
0
0
9,871
8,460
9,871
8,460
19,053
17,609
36,662
LEAD MONITORING SERVICES (350)
0.00
0
0
61
52
61
52
118
108
226
PUBLIC SEWAGE (362)
0.00
0
0
3
3
3
3
6
6
12
SOLID WASTE DISPOSAL (363)
0.00
0
0
25
22
25
22
49
45
94
SANITARY NUISANCE (365)
0.01
1
3
182
156
182
156
352
324
676
RABIES SURVEILLANCE/CONTROL SERVICES (366)00
0
0
0
0
0
0
0
0
0
ARBOVIRUS SURVEILLANCE (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)
0.00
0
0
0
0
0
0
0
0
0
AIR POLLUTION (37 1)
0.02
0
19
315
270
315
270
608
562
1,170
RADIOLOGICAL HEALTH (372)
0.00
0
0
0
0
0
0
0
0
0
TOXIC SUBSTANCES (373)
0.00
0
0
0
0
0
0
0
0
0
Group Total
0.76
1
328
13,547
11,612
13,547
11,612
26,151
24,167
50,318
ENVIRONMENTAL HEALTH SUBTOTAL
22.73
6,398
33,293
420,065
360,057
420,065
360,057
877,725
682,519
1,560,244
D. SPECIAL CONTRACTS:
SPECIAL CONTRACTS (599)
0.00
0
0
0
0
0
0
0
0
0
ENVIRONMENTAL HEALTH SURCHARGE (399) 0.00
0
0
0
0
0
0
0
0
0
SPECIAL CONTRACTS SUBTOTAL
0.00
0
0
0
0
0
0
0
0
0
TOTAL CONTRACT
217.68
82,495
624,697
4,021,392
3,446,910 4,021,392
3,446,910 8,938,677
5,997,927
14,936,604
Version: 1 Page 2 of 2
ATTACHMENT III
COLLIER 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:
Title VI of the Civil Rights Act of 1964, as amended, 42 U.S.C., 2000 Et seq., which prohibits
discrimination on the basis of race, color or national origin in programs and activities receiving or
benefiting from federal financial assistance.
2. Section 504 of the Rehabilitation Act of 1973, as amended, 29 U.S.C. 794, which prohibits discrimination
on the basis of handicap in programs and activities receiving or benefiting from federal financial
assistance.
3. Title IX of the Education Amendments of 1972, as amended, 20 U.S.C. 1681 et seq., which prohibits
discrimination on the basis of sex in education programs and activities receiving or benefiting from
federal financial assistance.
4. The Age Discrimination Act of 1975, as amended, 42 U.S.C. 6101 et seq., which prohibits discrimination
on the basis of age in programs or activities receiving or benefiting from federal financial assistance.
5. The Omnibus Budget Reconciliation Act of 1981, P.L. 97 -35, which prohibits discrimination on the basis
of sex and religion in programs and activities receiving or benefiting from federal financial assistance.
6. All regulations, guidelines and standards lawfully adopted under the above statutes. The applicant
agrees that compliance with this assurance constitutes a condition of continued receipt of or benefit from
federal financial assistance, and that it is binding upon the applicant, its successors, transferees, and
assignees for the period during which such assistance is provided. The applicant further assures that all
contracts, subcontractors, subgrantees or others with whom it arranges to provide services or benefits to
participants or employees in connection with any of its programs and activities are not discriminating
against those participants or employees in violation of the above statutes, regulations, guidelines, and
standards. In the event of failure to comply, the applicant understands that the grantor may, at its
discretion, seek a court order requiring compliance with the terms of this assurance or seek other
appropriate judicial or administrative relief, to include assistance being terminated and further assistance
being denied.
22
108 I`+
ATTACHMENT IV
COLLIER COUNTY HEALTH DEPARTMENT
FACILITIES UTILIZED BY THE COUNTY HEALTH DEPARTMENT
Facility
Description
Collier County Health
Department & Public
Services Building H
Immokalee Satellite
Golden Gate WIC Office
Location Owned By
3301 E. Tamiami Trail Collier County
Building H, Naples
419 North First Street Collier County
Immokalee
4945 Golden Gate Parkway Benderson
Unit 102, Naples Development
23
10B 'I
ATTACHMENT V
COLLIER 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
2003 -2004
2008 -2009
2009 -2010
2010 -2011
2011 -2012
PROJECT TOTAL
STATE
$ 170,526
$ 170,526
COUNTY
$ 113,684
$ 113,684
SPECIAL PROJECT CONSTRUCTION /RENOVATION PLAN
PROJECT NAME:
LOCATION/ ADDRESS:
PROJECT TYPE:
Renovation of CHID Offices
TOTAL
$ 284,210
$ 284,210 Balance
Building H of the Collier County Government Complex
NEW BUILDING ROOFING
RENOVATION X PLANNING STUDY
NEW ADDITION OTHER
SQUARE FOOTAGE: 0
PROJECT SUMMARY: Describe scope of work in reasonable detail.
The Collier County Health Department will be moving its Environmental Health Division from a satellite government complex
to the main building (Building H) of the government complex located on Tamiami Trail during 2005 -2006 when the
space becomes available. Medical Records will be recarpeted and the main lobby will get a information Kiosk to be staffed
by administration.
Other operating programs will also be reconfigured during the time frame 2005 -20010 including: School Health,
Disaster Preparedness, Family Health, Epidemiology, Vital Stats, Pharmacy, and clinic areas of Communicable
Disease. The Dental clinic will need to be expanded because of growth probably during the 2006 -20010 time frame.
Also it is anticipated that Information Systems, Finance & Accounting, Human Resources,
and the Director's Office will be renovated in 2007 -2010.
ESTIMATED PROJECT INFORMATION:
START DATE (initial expenditure of funds) :
COMPLETION DATE: 12/31/2010
$ 1,350,000
$ #DIV /0!
10/1/2005
DESIGN FEES:
CONSTRUCTION COSTS:
FURNITURE/EQUIPMENT
TOTAL PROJECT COST:
COST PER SQ FOOT:
Special Capital Projects are new construction or renovation projects and new furniture or equipment
associated with these projects and mobile health vans.
24
108 .1
ATTACHMENT V
COLLIER 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
2007 -2008
2008 -2009
2009 -2010
2010 -2011
2011 -2012
PROJECT TOTAL
STATE
$ 49,365
$ 49,365
COUNTY
$ 32,906
$ 32,906
SPECIAL PROJECT CONSTRUCTION /RENOVATION PLAN
PROJECT NAME:
LOCATION/ ADDRESS
PROJECT TYPE:
WIC Renovation
TOTAL
$ 82,271
$ 82,271 Balance
Building H of the Collier County Government Complex
NEW BUILDING _ ROOFING
RENOVATION X PLANNING STUDY _
NEW ADDITION OTHER
SQUARE FOOTAGE: 2300
PROJECT SUMMARY: Describe scope of work in reasonable detail.
The Collier CHD WIC operations are in critical need of additional space in Bldg. H due to rapid growth in recent
years. However, this growth cannot be accomodated within Bldg. H without extensive modifications to the
currently occupied spaces. A long -term plan has been developed to accomodate future growth as well as
alleviating the current lack of space. Given the large scope and lengthy time -frame to completion, this project
will be divided into three distinct phases. PHASE I will entail the relocation of all WIC operations in Bldg. H to
another county-owned building or commercially -own facility and all associated moving costs (network setup,
telephones, furniture, etc.) along with the demolition of current WIC spaces in Bldg. H. Phase II will commence
in FY 08 and will involve the actual construction of WIC spaces in Bldg. H. Phase III will start in FY 09 and will
involve relocating WIC operations back to Bldg. H.
ESTIMATED PROJECT INFORMATION:
START DATE (initial expenditure of funds) :
10/1/2007
COMPLETION DATE:
6/30/2010
DESIGN FEES:
$
30,000
CONSTRUCTION COSTS:
$
300,000
FURNITURE/EQUIPMENT
$
170,000
TOTAL PROJECT COST:
$
500,000
COST PER SQ FOOT:
$
217.3913043
Special Capital Projects are new construction or renovation projects and new furniture or equipment
associated with these projects and mobile health vans.
25
ATTACHMENT V
COLLIER 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
2007 -2008
2008 -2009
2009 -2010
2010 -2011
2011 -2012
PROJECT TOTAL
STATE
$ 66,000
$ 66,000
COUNTY
$ 44,000
$ 44,000
SPECIAL PROJECT CONSTRUCTION /RENOVATION PLAN
TOTAL
$ 110,000
$ 110,000
PROJECT NAME: Family and Personal Health Renovation
LOCATION/ ADDRESS: Building H of the Collier Government Complex
PROJECT TYPE: NEW BUILDING ROOFING
RENOVATION X PLANNING STUDY
NEW ADDITION OTHER
SQUARE FOOTAGE: 2500
PROJECT SUMMARY: Describe scope of work in reasonable detail.
This renovation will involve painting, replacing flooring, ceiling tiles, and some of the furniture. It will also re-
design the space to provide a more funtional working area for both staff and clients. A small conference room
will be removed to provide for a more open environment and facilitate improved air circulation /ventilation.
Although not confirmed, some of the staff seated in this area have experienced respiratory issues probably due
to dust and allergens found in the carpet, ceiling tiles, and furniture.
ESTIMATED PROJECT INFORMATION:
START DATE (initial expenditure of fund: 10/1/2012
COMPLETION DATE: 2/1/2013
DESIGN FEES: $ 10,000
CONSTRUCTION COSTS: $ 65,000
FURNITURE/EQUIPMENT $ 35,000
TOTAL PROJECT COST: $ 110,000
COST PER SQ FOOT: $ 40
Special Capital Projects are new construction or renovation projects and new furniture or equipment
associated with these projects and mobile health vans.
i
108 '
ATTACHMENT V
COLLIER 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
2007 -2008 $ $ $ -
2008 -2009 $ 120,000 $ 80,000 $ 200,000
2009 -2010 $ $ $ -
2010 -2011
2011 -2012
PROJECT TOTAL
$ 120,000 $ 80,000
SPECIAL PROJECT CONSTRUCTION /RENOVATION PLAN
PROJECT NAME: Dental Clinic Renovation and Expansion
LOCATION/ ADDRESS: Building H of the Collier Government Complex
PROJECT TYPE: NEW BUILDING ROOFING
RENOVATION X PLANNING STUDY
NEW ADDITION OTHER
SQUARE FOOTAGE: 1200
PROJECT SUMMARY: Describe scope of work in reasonable detail.
$ 200,000
Dental cannot currently meet all the community needs. There are primarily appointments for pediatric patients
and a limited number of adults. The Dental department itself is self- sustaining but cannot currently expand
services due to limited space and equipment. This renovation and re- design of the space will enable the
installation of two additional dental chairs and subsequently an additional dentist. An office and several walls will
be removed to provide space for the additional chairs and equipment while dramatically improving
ventilation /temperature which has been an ongoing facilities issue for the past several years.
ESTIMATED PROJECT INFORMATION:
START DATE (initial expenditure of funds) : 10/1/2011
COMPLETION DATE: 4/1/2012
DESIGN FEES:
CONSTRUCTION COSTS:
FURNITURE /EQUIPMENT
TOTAL PROJECT COST:
COST PER SQ FOOT:
$ 25,000
$ 150,000
$ 25,000
$ 200,000
$ 145.8333333
Special Capital Projects are new construction or renovation projects and new furniture or equipment
associated with these projects and mobile health vans.
27
ATTACHMENT VI 10B
COLLIER 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)
Family Planning (223/23)
_X Maternal Health /IPO (225/25)
Laboratory (242/42)
_X_ Pharmacy (241/93)
Other Medical Treatment Program (please identify)
Describe the target population to be served with categorical Primary Care funds.
Maternal and Child Health Primary Care funding is utilized to support clinical services for Pregnant
Women. Often these women are diagnosed diabetics and or hypertensive /preeclamptic and require
intensive interaction to assure accurate blood sugar readings, accurate administration of insulin or
routine and regular monitoring of edema and blood pressure. Funding is also utilized to support regular
well child visits as well as educating about the importance of routine preventive services such as
nutrition, exercise and nutrition.
Comprehensive Adult Health and Pharmacy —
The target populations to be served with these funds are the pregnant women; clients exposed to or
who have contracted reportable communicable diseases and emerging infections; persons needing
treatment for HIV /AIDS, Sexually Transmitted Diseases, and Tuberculosis; persons requiring
prophylactic treatment for exposure to communicable diseases such as rabies; persons entering the
country as refugees who require physical exams to ensure they do not have any communicable
diseases and that they are fully vaccinated against vaccine - preventable diseases; persons at risk for
certain communicable diseases such as Hepatitis; low income persons with diabetes and epilepsy
requiring assistance with medications and adults requiring vaccination against vaccine - preventable
diseases.
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10B
These funds provide the infrastructure to provide services to this population such as staff, medical
records, fiscal support, medication acquisition, and necessary equipment and supplies when there are no
other funding sources.
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.
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