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Agenda 10/25/2016 Item #16D 7 16.D.7 10/25/2016 EXECUTIVE SUMMARY Recommendation to approve FY16-17 contract with the State of Florida Department of Health for the operation of the Collier County Health Department in the amount of $1,419,500 and also to approve an addendum to the contract to allocate an additional$249,220 to fill a funding gap due to state non-funding of the ACHA Medicaid match programs and authorizes necessary budget amendments. OBJECTIVE: To approve the FY16-17 Collier County Health Department annual core contract and an addendum to the contract providing additional local funding to fill a funding gap due to state non-funding of the ACHA Medicaid match programs. CONSIDERATIONS: Each year, the County enters into a core contract with the State of Florida Department of Health to provide funds and facilities for the provision of public health services. The attached represents the FY16-17 contract effective October 1,2016 through September 30,2017. The contract identifies the services that will be provided as well as the estimated cost share between the State and the County. The total amount of funding to be provided directly to the Department of Health in Collier County under the contract is $1,419,500. The County also provides $352,500 for Health Department facility and motor pool operating costs. In recent years, Collier County had been eligible to participate in Intergovernmental Transfer Programs (IGTs) with the State Agency for Health Care Administration (AHCA) whereby local governmental funding allocated for health-related service provision was matched with federal dollars. The use of the local dollars budgeted in the Collier County budget along with the additional match funds, went to community partners such as the County Health Department and David Lawrence Center. Under these programs the County Health Department had received a 20% match increase over and above the funds allocated in the County budget (an additional $249,220). These funds were used to provide a variety of public health services to those in need in Collier County. The authorization for the state/federal matching programs was not renewed at the state level for the fiscal year beginning July 1, 2015. The match funding noted above was not available to the County Health Department last fiscal year and the County was able to fill this funding gap. The County is again prepared to fill the funding gap in FY16-17 but may not be able to cover this funding loss in future fiscal years. The County Health Department has been and will be working with community partners and other appropriate agencies to develop strategies and alternative sources of funding. FISCAL IMPACT: The County General Fund (001) budget provides for the base County-Health Department contract of $1,419,500 as well as $352,500 to provide for Health Department facility and motor pool operating costs. If County funding is provided for the requested $249,220 contract addendum a budget amendment moving monies within the General Fund (001) and/or a General Fund supported operation will be necessary.This budget amendment will not impact planned operations. LEGAL CONSIDERATIONS: The contract is a standard form prepared by the State Department of Health. The Addendum was prepared by the County Attorney's Office to incorporate the supplemental funding of$249,220.This item is approved for form and legality,and requires majority vote for approval. -JAB GROWTH MANAGEMENT IMPACT: There is no Growth Management Plan impact associated with this executive summary. Packet Pg. 1501 16.D.7 10/25/2016 RECOMMENDATION: That the Board of County Commissioners approves and authorizes the Chairman to execute the annual core contract and the contract addendum with the State of Florida Department of Health for the operation of the Collier County Health Department and authorizes all necessary budget amendments. Prepared by: Alan Portis,Collier County Health Department ATTACHMENT(S) 1.Health Department Core Contract (PDF) Packet Pg. 1502 16.D.7 10/25/2016 COLLIER COUNTY Board of County Commissioners Item Number: 16.D.7 Item Summary: Recommendation to approve FY16-17 contract with the State of Florida Department of Health for the operation of the Collier County Health Department in the amount of $1,419,500 and also to approve an addendum to the contract to allocate an additional $249,220 to fill a funding gap due to state non-funding of the ACHA Medicaid match programs and authorizes necessary budget amendments. Meeting Date: 10/25/2016 Prepared by: Title: Operations Analyst—Public Services Department Name: Hailey Margarita Alonso 09/28/2016 4:42 PM Submitted by: Title: Operations Analyst—Public Services Department Name: Hailey Margarita Alonso 09/28/2016 4:42 PM Approved By: Review: Public Services Department Amanda O.Townsend Level 1 Sim.Reviewer 1-8 Completed 10/03/2016 9:26 AM Public Services Department Hailey Margarita Alonso Level 1 Division Reviewer Completed 10/04/2016 11:05 AM County Attorney's Office Jennifer Belpedio Level 2 Attorney of Record Review Completed 10/04/2016 11:30 AM Public Services Department Steve Carnell Level 2 Division Administrator Review Completed 10/04/2016 1:20 PM Office of Management and Budget Valerie Fleming Level 3 OMB Gatekeeper Review Completed 10/04/2016 2:41 PM County Attorneys Office Jeffrey A.Klatzkow Level 3 County Attorney's Office Review Completed 10/05/2016 8:41 AM Budget and Management Office Ed Finn Additional Reviewer Completed 10/05/2016 9:24 AM County Manager's Office Leo E.Ochs Level 4 County Manager Review Completed 10/14/2016 1:02 PM Board of County Commissioners MaryJo Brock Meeting Pending 10/25/2016 9:00 AM Packet Pg. 1503 (40eJ;uoo aaoo;uawpedaa y}geaH : 176oz) 4aea}uoo a1o0 2uewlJedaa gigeaH quawilaei}y tO U, D r as V CONTRACT BETWEEN a COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS AND STATE OF FLORIDA DEPARTMENT OF HEALTH FOR OPERATION OF THE COLLIER COUNTY HEALTH DEPARTMENT CONTRACT YEAR 2016-2017 This contract 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 1,2016. RECITALS A. Pursuant to Chapter 154, Florida Statutes, the intent of the legislature is to "promote, protect, maintain, and improve the health and safety of all citizens and visitors of this state through a system of coordinated county health department services." B. County Health Departments were created throughout Florida to satisfy this legislative intent through "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 created County Health Departments. D. It is necessary for the parties hereto to enter into this contract in order to ensure coordination between the State and the County in the operation of the CHD. NOW THEREFORE, in consideration of the mutual promises set forth herein, the sufficiency of which 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 contract shall be effective from October 1, 2016, through September 30, 2017, or until a written contract replacing this contract is entered into between the parties, whichever is later, unless this contract 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 Ill of Attachment 11 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. 1 0 ca (;aea;uoa eAoa;uaw;iiedaa 14f1e3H : 1760Z) ;oeJ;uoa woo luew edea :;uewgoe;;y ti 0 ca a C to Environmental health services shall be supported by available federal, state and local funds a 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 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 is set forth in Part II of Attachment II hereof. This funding will be used as shown in Part I of Attachment II. i. The State's appropriated responsibility (direct contribution'excluding any state 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 $ 6,159,689 (State General Revenue, State Funds, Other Stale 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 II, Part II is an amount not to exceed $1,419,500 (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 contract in the County Health 2 co (}3e.11uo3 aao3;uai 4Jedaa LPIeaH tr60Z) toe.;uoo woo iuewpede yIlee :;uawyoef;' ti D T C) 0- 4-. a, Department Trust Fund that is attributed to the CHD shall be carried forward to the next a 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 contract during the term hereof by notifying the other party in writing of the amount and purpose for the change in funding. If the State initiates the increase/decrease, the CHD will revise the Attachment II and send a copy of the revised pages to the County and the Department of Health, Office of Budget and Revenue 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, Office of Budget and Revenue Management. e. The name and address of the official payee to whom payments shall be made is: County Health Department Trust Fund Collier County 3339 E. Tamiami Trail, Suite 145 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 Secretary for County Health Systems. The director/administrator shall be selected by the State with the concurrence of the County. The director/administrator of the CHD shall ensure that non-categorical sources of funding are used to fulfill public health priorities in the community and the Long Range Program Plan. 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 Division of Public Health Statistics and Performance Management 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 CHID 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 3 r, (;aea;uoa woo;uat.upedea upleaH 176oZ) ;OW;uoa woo;uauapedea 4;lee :;uawgae;}y ti o co a a, Y V compliance shall be documented. Such justification and compliance documentation shall be maintained by the CHD in accordance with the terms of this contract. State procedures must be followed for all leases on facilities not enumerated in Attachment IV. c. The CHD shall maintain books, records and documents in accordance with the Generally Accepted Accounting Principles (GAAP), as promulgated by the 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 6.1, below. Books, records and documents must be adequate to allow the CHD to comply with the following reporting requirements: i. The revenue and expenditure requirements in the Florida Accounting Information Resource (FLAIR) System; 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 ail 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 this 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 4 o (}3e.14uo3 woo ivawpedea 441e0H : 1760Z) Peiwoo woo ;u3w1.ledaa y;ieaH :wawgoe;Iy o ti u) to rn d credited to each participating governmental entity. The planned use of surplus funds shall be a reflected in Attachment II, Part I of this contract, with special capital projects explained in Attachment V. 1. 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 Secretary for County Health Systems has approved the transfer. The Deputy Secretary for County Health Systems 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 contract. Any such subcontract shall include all aforementioned audit and record keeping requirements. h. At the request of either party, an audit may be conducted by an independent 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 contract for a period of five (5) years after termination of this contract. 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. 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 CUD, except as otherwise permitted for some purchases using County procedures pursuant to paragraph 6.b, 5 (pea;uoo woo;uewpedaa 4;leaH : b60Z) ;oea;uoa aaoa;uewp dea y;leaH :;uauagoe;;y a, ti c 0 ccia 4 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 contract. n. The CHD shall comply with the provisions contained in the Civil Rights Certificate, hereby incorporated into this contract as Attachment Ili. o. The CHD shall submit quarterly reports to the County that shall include at least the following: i. The DE385L1 Contract Management Variance Report and the DE580L1 Analysis of Fund Equities Report; ii. A written explanation to the County of service variances reflected in the year end DE385L1 report if the variance exceeds or falls below 25 percent of the planned expenditure amount for the contract year. However, if the amount of the service specific variance between actual and planned expenditures does not exceed three percent of the total planned expenditures for the level of service in which the type of service is included, a variance explanation is not required. A copy of the written explanation shall be sent to the Department of Health, Office of Budget and Revenue Management. p. The dates for the submission of quarterly reports to the County shall be as follows unless the generation and distribution of reports is delayed due to circumstances beyond the CHD's control: 1. March 1, 2017 for the report period October 1, 2016 through December 31, 2016; ii. June 1, 2017 for the report period October 1, 2016 through March 31, 2017; iii. September 1, 2017 for the report period October 1, 2016 through June 30, 2017; and iv. December 1, 2017 for the report period October 1, 2016 through September 30, 2017. 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. 6 (laea$uoo woo 4uaw1iedeO ini eH t760Z) ;oeJTuoo aaoo Tuawiedea quawt4Oe;3V C m V t6 b. The County shall ensure adequate fire and casualty insurance coverage for County a 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. Ali vehicles will be transferred to the ownership of the County and registered as County vehicles. The County shall ensure insurance coverage for these vehicles is available through either a self-insurance program or insurance purchased by the County. All vehicles will be used solely for CHD operations. Vehicles purchased through-the County Health Department Trust Fund shall be sold at fair market value when they are no longer needed by the CHD and the proceeds returned to the County Health Department Trust Fund. 8. TERMINATION. a. Termination at Will. This contract 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 contract become unavailable, either party may terminate this contract 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 contract 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 contract shall not be deemed to be a waiver of any other breach and shall not be construed to be a modification of the terms of this contract. 9. MISCELLANEOUS. The parties further agree: a. Availability of Funds. If this contract, any renewal hereof, or any term, performance or payment hereunder, extends beyond the fiscal year beginning July 1, 2017, it is agreed that the performance and payment under this contract 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 contract are as follows: For the State: For the.County: Stephanie Vick, M.S.,B.S.N.,R.N. Steve Carnell Name Name Administrator, Florida Department of Health in Collier County Public Services Division Administrator Title Title (;oea;uo3 eao0;uaLupede 4;leaH t?60Z) toea;uoo aaoo;uatupeda® }ieay :;uauayoe;;V ti r O tD r � 3339 E.Tamiami Trail, Suite 145 3339 E. Tamiami Trail, Suite 217 a Naples, Florida 34112 Naples, Florida 34112 Address Address (239) 252-5332 (239) 252-8468 Telephone Telephone If different contract managers are designated after execution of this contract, 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 contract. c. Captions. The captions and headings contained in this contract are for the convenience of the parties only and do not in any way modify, amplify, or give additional notice of the provisions hereof. In WITNESS THEREOF, the parties hereto have caused this 19 page contract, with its attachments as referenced, including Attachment I (two pages), Attachment II (six pages), Attachment III (one pages), Attachment IV (one pages), and Attachment V (one pages),to be executed by their undersigned officials as duly authorized effective the 15' day of October, 2016. BOARD OF COUNTY COMMISSIONERS STATE OF FLORIDA FOR COLLIER COUNTY DEPARTMENT OF HEALTH SIGNED BY: SIGNED BY: NAME: Donna Fiala NAME: Celeste Philip, MD, MPH Chairman TITLE: TITLE: Surgeon General and Secretary DATE: DATE: ATTESTED TO: SIGNED BY: SIGNED BY: NAME: NAME: Stephanie Vick, M.S., B.S.N., R.N. TITLE: TITLE: CHD Director/Administrator DATE: DATE: Approved as to form and legality op 8 Jennifer A.Belpedio �9 Assistant County Attorney oc,1G` (tae I;uo� a Ian luawlaedea �TieaFl : 1760Z) ;ae.quoD 9a00;uewpedaa ulleaH 4uauas.lae4 y Ci ca a a ATTACHMENT I 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(OHP 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 Reauirement 1. Sexually Transmitted Disease Requirements as specified in F.A.C.640-3,F.S.381 and F.S. Program 384. 2. Dental Health Periodic financial and programmatic reports as specified by the program office. 1 Special Supplemental Nutrition Service documentation and monthly financial reports as specified Program for Women,Infants and in DHM 150-24"and all federal,state and county requirements Children(including the WIC detailed in program manuals and published procedures. Breastfeeding Peer Counseling Program) 4. Healthy Start/improved Pregnancy Requirements as specified in the 2007 Healthy Start Standards Outcome and Guidelines and as specified by the Healthy Start Coalitions in contract with each county health department. 5. Family Planning Requirements as specified in Public Law 91.572,42 U.S,C.300, et seq.,42 CFR part 59,subpart A,45 CFR parts 74&92,2 CFR 215(OMB Circular A-110)OMB Circular A-102,F.S. 381.0051,F.A.C.84F-7,F.A.C.64F-16,and F.A.C.64F-19. Requirements and Guidance as specified in the Program Requirements for Title X Funded Family Planning Projects(Title X Requirements)(2014)and the Providing Quality Family Planning Services(OFP):Recommendations of CDC and the U.S.Office of Population Affairs published on the Office of Population Affairs website. Programmatic annual reports as specified by the program office as specified in the annual programmatic Scope of Work for Family Planning and Maternal Child Health Services,including the Family Planning Annual Report(FPAR),and other minimum guidelines as specified by the Policy Web Technical Assistance Guidelines. 6. Immunization Periodic reports as specified by the department pertaining to immunization levels in kindergarten and/or seventh grade pursuant to Instructions contained in the Immunization Guidelines-Florida Schools,Childcare Facilities and Family Daycare Homes(DH Form 150-815)and Rule 640-3.046,F.A.C. In addition,periodic reports as specified by the department pertaining to the surveillance/investigation of reportable vaccine- preventable diseases,adverse events,vaccine accountability, and assessment of immunization Anachmeni_I•Page 1 of 2 (peiwoo 0J03 luatupedea imeaH 60z) loe.m.roo woo wauspedaa queaH :luawgoenv ns .t•-• Ci Lt.) ATTACHMENT I(Continued) el) c.) re levels as documented in Florida SHOTS and supported by CHD Guidebook policies and technical assistance guidance. 7. Environmental Health Requirements as specified in Environmental Health Programs Manual 150-4and DHP 50-21* 8. HIV/AIDS Program Requirements as specified In F.S.384.25 and F.A.C.640-3,030 and 640-1031.Case reporting should be on Adult HIV/AIDS Confidential Case Report CDC Form DH2139 and Pediatric HIV/AIDS Confidential Case Report CDC Form DH2140. Requirements as specified In F.A.C.64D-2 and 64D-3,F.S.381 and F.S.384. Socio-demographlo and risk data on persons tested forli1V in CHD clinics should be reported on Lab Request DH Form 1628 in accordance with the Forms Instruction Guide, Requirements for the HIV/AIDS Patient Care programs are found in the Patient Care Contract Administrative Guidelines, 9. School Health Services Requirements as specified in the Florida School Health Administrative Guidelines(May 2012). Requirements as specified in F.S.381.0056,F,S,381.0057,F.S.402.3026 and F.A,C.64F-6, 10. Tuberculosis Tuberculosis Program Requirements as specified in F.A.C,64D- 3 and F.S.392. 11, General Communicable Disease Carry out surveillance for reportable communicable and other Control acute diseases,detect outbreaks,respond to individual cases of reportable diseases,Investigate outbreaks,and carry out communication and quality assurance functions,as specified In RAC.640-3,F.S.381,F.S.384 and the CHD Epidemiology Guide to Surveillance and Investigations. 12. Refugee Health Program Programmatic and financial requirements as specified by the program office. or the subsequent replacement if adopted during the contract period, Attachment -Pane 2 of 2 _ _ as (&Woo &05 waw ed O qle H : wog 19a111100 amp&awpedea qe H :uewgOqly § O . 0 o X o 2 . 0 t o 01 0 § % co g an @ § § c . . m . . a .. § . , 2 a E P 2 .% o 0 m G I to . \ 7 k k .. Q = ) 2 2�] ® EeIs . . c g ` Ik2 ) w 0 0 0 6 § E °t- § o. § CU ■ 7 cr . e 11.1 k n k } \ § § ® 2 ± e $c « O t {§ § . . VI w 2�d k _ ik2 2 S 2 /§3 . c . . § 0 LU 2 0 \ ) k « 2 k / \ k £ k _ k 2 $ $ k k Q. [R k E b ■ Cj 8 >- § .0 � t c a Q a. ? ) P 3 $ ) k$ © 3 7o 2 f5 ° _ C 3 $ \ © � U. $N k \ §q & ` ` Q _® ] 2 § / 5 % S/ 0 it 2 %+ o0 0 o 0 \ £$R �/ j ' & w co al (13equo3 eioo}uau pedea u31eaH : 1760Z) ;aeawoo woo luewpedaa y;leaH :luauluoeUy ,n r ATTACHMENT II a COLLIER COUNTY HEALTH DE�'AR't'MENT Pert II,Soarcoe of Contr butione to County Health Department October 1,2018 to September 80 2017 , State CH1) County Total CHD art Fetid ORDTrust Fuad Ocher (cash). :Trust Fuad {cash) Cootribut1on.:. .Total 1.GENERAL REVENUE•BTATE 016040 AIDS PATIENT CARE 140,000 0 140,000 0 1.10,000 016040 AIDS PREVENTION&SURVEILLANCE•GENERAL REVENUE 69,571 0 69,571 0 69,571 015040 CHD•TO COMMUNITY PROGRAM171,000 0 171,096 0 171,096 015010 DENTAL SPECIAL INITIATIVE PROJECTS 5,80G 0 6,806 0 5,800 016010 FAMILY PLANNING GENERAL REVENUE 61,257 0 64,57 0 01 257 0150.10 HEPATITIS AND LIVER FAILURE PREVENTION&CONTROL 89.286 0 89,283 0 89,286 016040 MIGRANT LABOR CAMP SANITATION 74,633 0 74,633 0 7.1,633 016040 PRIMARY CARE PROGRAM 313,432 0 313,432 0 313,432 015040 SCHOOL HEALTH SERVICES•GENERAL REVENUE 218,073 0 218,073 0 218.073 016050 CHD GENERAL REVENUE NON•CATEGORIQAL 1,810,023 0 1,810,023 0 1,810,023 GENERAL REVENUE TOTAL 2,962,077 0 2,962,077 0 2,962,077 2.NON GENERAL REVENUE•STATE 015010 STATE UNDERGROUND PETROLEUM RESPONSE ACT 3,665 0 3,605 0 3,665 015010 ENVIRONMENTAL BIOMEDICAL WASTE PROGRAM 13,898 0 13,898 0 13,898 015010 TOBACCO STATE AND COMMUNITY INTERVENTIONS 183,885 0 183,885 0 183,885 NON GENERAL REVENUE TOTAL 201,318 0 201,348 0 201,318 3.FEDERAL FUNDS•STATE 007000 AIDS DRUG ASSISTANCE PROGRAM ADMIN HQ 77,0.16 0 77,046 0 77,915 007000 BIOTERRORISM HOSPITAL PREPAREDNESS G40 0 640 0 640 097000 WIC BREASTFEEDING PEER COUNSELING PROD 52.687 0 62,587 0 52,587 007000 COASTAL BEACH WATER QUALITY MONITORING 16,478 0 16,178 0 10.478 007000 COMPREHENSIVE COMMUNITY CARDIO•P1100 36,000 0 35,000 0 35,000 007000 CMS•MCH PURCHASED CLIENT SERVICES 2014•20 t 6 13,600 0 13,600 0 13,500 007000 FAMILY PLANNING TITLE X•GRANT 107,412 0 167,412 0 167,412 007000 HPP VOLUNTEER MANAGEMENT 10,32.2 0 19,322 0 19,322 007000 IMMUNIZATION ACTION PLAN 72.552 0 72,652 0 72,552 007000 MCH SPECIAL PRJC7'UNPLANNED PREGNANCY 32,994 0 32,091 0 32,994 007000 BASE COMMUNITY PREPAREDNESS CAPABILITY 08,602 0 08,002 0 68,602 007000 BASE PUB HLTH SURVEILLANCE&EPI INVESTIGATION 67,822 0 67,822 0 67,822 007000 AIDS PREVENTION 238,086 0 238,080 0 238,086 007000 RYAN WHITE TITLE II GRANT/CHD CONSORTIUM 287,061 0 287,052 0 287,051 007000 IMPROVING STD PROGRAMS 5,624 0 5,02-1 0 5,62.1 007000 WIC PROGRAM ADMINISTRATION 1,205,577 0 1,205,677 0 1,205,577 016076 INSPECTIONS OP SUMMER FEEDING PROGRAM•DOE 1,500 0 1.500 0 1,500 016075 SUPPLEMENTAL SCHOOL HEALTH 33,090 0 33,690 0 33,660 016076 REFUGEE HEALTH SCREENING REIMBURSEMENT 699,651 0 699,661 0 693,651 FEDERAL FUNDS TOTAL 3,096,003 0 3,090.063 0 3,095,063 4,FEES ASSESSED BY STATE OR FEDERAL RULES•STATE 001020 CIID STATEWIDE ENVIRONMENTAL FEES 175,681 0 476,681 0 475,681 001092 CIID STATEWIDE ENVIRONMENTAL FEES 155,710 0 165,740 0 165;740 Alachmenl lLPnn_11.Pgae 1 at 3 (loea}uo3 aioa luawlJedea tilleaH : tr6OZ} 4oe.quoo aio3 luewlaedea u4leaH :4uawgoellti cr) ti u) to - ATTACHMENT.II Y CLIRCUNTYHEALTH DEPARTMENT COVO Part ti Soureee of Cootributzoaa to County Hoalth Dapartmettt Octobor 1 2018,to Soptember 80,2017 . a�b GHD Couunbr V rotal OED OthTrnet FqudC ,- Total or o'-i-',,..1 aeh} ( eh}W.,,.`Contribution Tta _.. . 001206 ON 91TE SEWAGE DISPOSAL PERMIT FEES 10,130 0 10,139 D 10;1311 001200 SANITATION CERTIFICATES(FOOD INSPECTION) 1,002 0 1,062 0 4,062 001206 SEPTIC TANK RESEARCH SURCHARGE , 1,710 0 1,7.10 0 1,740 001206 SEPTIC TANK VARIANCE FEES 50% 350 0 350 0 350 001206 PUBLIC SWIMMING POOL PERMIT FEES-10%HQ TRANSFER 26,314 0 26,314 0 26,311 001206 DRINKING WATER PROGRAM OPERATIONS 1,305 0 1,305 0 1,305 001206 REGULATION OF BODY PIERCING SALONS 30 0 30 0 30 091206 TANNING FACILITIES 353 0 363 0 353 001206 ONSITE SEWAGE TRAINING CENTER 1,135 0 1,135 0 1,135 061206 TATTO PROGRAM ENVIRONMENTAL HEALTH 1,380 0 1,380 0 1,380 001206 MOBILE HOME do RV PARK FEES 2,110 0 2,110 0 2,110 FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL 680,230 0 680,239 0 680,230 6.OTHER CASH CONTRIBUTIONS•STATE: 0 0 0 4) 0 090001 DRAW DOWN FROM PUBLIC HEALTH UNIT 0 0 0 9 0 OTHER CASH CONTRIBUTION TOTAL 0 0 0 0 0 6.MEDICAID•STATE/COUNTY: 001057 CED CLINIC FEES 0 91,600 94,600 0 91.600 0011-18 CHD CLINIC FEES 0 906,827 900,827 0 006,827 MEDICAID TOTAL 0 1,001,427 1,001,427 0 1,001,427 7.ALLOCABLE REVENUE'STATE= 018000 CHD CLINIC FEES 6,338 0 6,338 0 6,338 ALLOCABLE REVENUE TOTAL 6,338 0 6,338 0 0,336 8.OTHER STATE CONTRIBUTIONS NOT IN CIID TRUST FUND•STATE ADA, 0 0 0 1,168,490 1,408.490 PHARMACY DRUG PROGRAM 0 0 0 37.663 31.563 WIG PROGRAM 0 0 0 6,893,000 5,893.960 BUREAU OF PUBLIC HEALTH LABORATORIES 0 0 0 61,661 51,661 IMMUNIZATIONS 0 0 0 .117,783 .117,783 OTHER STATE CONTRIBUTIONS TOTAL 0 0 0 7,869,307 7,869,397 0,DIRECT LOCAL CONTRIBUTIONS•BCCITAX DISTRICT 008005 CHD LOCAL REVENUE&EXPENDITURES 0 1,419,500 1,419,600 0 1,410,500 DIRECT COUNTY CONTIIUBIITIONS TOTAL 0 1,419,500 1,419,500 0 1,419,600 10.FEES AUTHORIZED BY COUNTY ORDINANCE OR RESOLUTION•COUNTY 001077 CHD CLINIC FEES 0 275,100 275,100 0 275,100 001077 GENERAL CLINIC RABIES SERVICES&DRUG PURCHASES 0 7,000 7,000 0 7,090 601091 CHI)LOCAL ENVIRONMENTAL FEES 0 072,585 672,685 0 972,585 001110 VITAL STATISTICS CERTIFIED RECORDS 0 335.000 335,000 0 336,000 FEES AUTHORIZED BY COUNTY TOTAL 0 1,289,685 1,289,1195 0 1 289,685 Ahachment„IILPati !)•Pege 2 0 3 ca (peJ uo0 aao0 luaul}aedoa 431eaH : '60Z) ,3Ei;uop eio3 luawpedea y}IeaH :luawgo14ly r` 1: Ci in 6 >71 ATTACHMENT II a COLLI ER COUNTY HEALTH DEPARTMENT -he - Part II Sourcee:of Contribution to County Health Department d October 1,2410 to Soptember 110 2017 .,Stoto CHD Couaty Toti1 CID. -- .;n. _. - r . .T(teeb)Aa .T et Fund (acnab)..a __Contribution . •Total 11.OTHER CASH AND LOCAL CONTRIBUTIONS•COUNTY 001.029 CHD CLINIC FEES 0 63,030 • 63,030 0 03,030 001029 GENERAL CLINIC RABIES SERVICES&DRUG PURCHASES 0 3,000 3,000 0 3,300 001050 CHD CLINIC FEES 0 98,280 98,280 0 98,280 010303 CHD SALE OF SERVICES IN OR OUTSIDE OF STATE GOVT 0 600 600 0 600 010500 CHD SALE OF SERVICES IN OR OUTSIDE OF STATE GOVT 0 3,000 3,000 0 3,000 011000 RYAN 1VHI1'E 0 21,000 21,000 0 21,000 011000 CHD CLINIC FEES 0 10,000 10,000 0 10,000 011000 CHD CASH DONATION 1 NON•SPECIFIC 0 2,100 2,100 0 2,100 011000 EARLY LEARNING COALITION OF SOUTHWEST FLORIDA 0 60,900 60,900 0 60,900 011000 CHD LOCAL REVENUE&EXPENDITURES 0 290,220 249,220 0 249,220 011001 CHD HEALTHY START COALITION CONTRACT 0 629,458 529,458 0 529,468 012020 CHD LOCAL ENVIRONMENTAL FEES 0 26,000 26,000 0 26,000 090002 DRAWDOWN FROM PUBLIC HEALTH UNIT 0 541,343 5.41,343 0 541,343 OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL 0 1,007,031 1,607,931 0 1,607,931 12.ALLOCABLE REVENUE-COUNTY 018000 CHD CLINIC FEES 0 0,338 6,338 0 6.338 COUNTY ALLOCABLE REVENUE TOTAL 0 6,338 6,338 0 6,338 13.BUILDINGS•COUNTY ANNUAL RENTAL EQUIVALENT VALUE 0 0 0 625,048 625,048 IT ALLOCATION&GOLDEN GATE RENTAL 0 0 0 85,200 85,200 UTILITIES 0 0 0 188,200 188,200 • BUILDING MAINTENANCE 0 0 0 0 0 GROUNDS MAINTENANCE 0 0 0 195,149 195,149 , 1 INSURANCE 0 0 0 0 0 1 OTHER(Specify) 0 0 0 0 0 OTHER(Specify) 0 0 0 0 0 BUILDINGS TOTAL 0 0 0 993,597 993,607 14.OTHER COUNTY CONTRIBUTIONS NOT IN CHD TRUST FUND•COUNTY EQUIPMENT'/VEHICLE PURCHASES 0 0 0 63,600 63,600 VEHICLE INSURANCE 0 0 0 16,500 15,500 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 79,100 79,100 GRAND TOTAL CHD PROGRAM 6.946,065 0,324,881 12,270,946 8,9.12,094 21,213,040 Altodtmen_I I_Pan_l(.PaOes 3 al 3 cc (13ealuo0 aioo 1uawl.ledaa .i11eeH : 1760Z) 1oeiluo0 8.103 1uewpledaa y11eaH :luawyoellt+ co N: G tG0) 1- nTTACHMENT II n. ' COLL1ER COUNTY HEALTH DEPARTMENT Z Part III,Plannod Staffing,ClientsSoli-vivo end E:pondituroa By Program Service Aria Within Each Level of Service t.7 October;1 20)6 toSeptamber,80,2014 Quarterly Espeodlture Play `' I+TE a CUenta'Sarricea! tat 2nd • 3rd 4th Grand • , 004U1ute Vlaite o 6:1,14!/ooly � Ststo ' ,Coanty Total' = A. COMMUNICABLE DISEASE CONTROL: 1MMUNIZATION(101) 11.75 8,600 11.673 171,798- 200,381 171,798 900,382 214.705 629.594 744,359 SEXUALLY TRANS.918.(102 6.29 1,181 1,829 72,686 84.778 72,080 84.160 34,006 280,925 314.031 HI WAIDS PREVENTION(03A1) 5.01 1,041 I,961 79,660 52,914 79,000 92,013 331,147 8,000 345,117 HWV(AIDSSURVEILLANCE(03A2) 1.18 6 7 16,438 19,172 16;138 19,112 71,220 0 71.220 IIIVIAMDSPATIENT CARE,(03133) G.46 .102 2856 118,155 137,81.1 118,165 137,81.1 168,339 13,605 511 938 ADAP (03A4) 2.16 15 252 30,548 35,031 30,648 35,532 132.359 0 132359 TUBERCULOSIS(IPI) 6.82 722 3,657 112,088 132,052 113,088 132,952 393510 100,370 .193,880 COMM.DIE.SURV. (100) 7.27 0 5,769 120,508 140.858 1220,608 1-10,859 251,052 271,101 592,193 HEPATITIS (109) 1.50 1,515 1,815 2.1,I98 28.224 24,108 28,224 104.841 0 104844 PREPAREDNESS AND RESPONSE (l10) 4,25 0 08 78,069 91,058 78,060 91,058 301,254 37,000 338,254 REFUGEE HEALTH (118) 8,94 2,219 6,446 219,450 248,963 213,450 248,963 924,826 0 924,826 VITAL RECORDS(180) 3.20 12,87) 60740 .41,727 48,070 41,727 48,671 0 180,795 180,705 COMMUNICABLE DISEASE SUBTOTAL 64,89 M182. 86,877 1,081,225 1,201,116 1,08t 226 1.261;120 3.239 296 1,451,390 4,684,380 B. PRIMARY CARE; CHRONIC DISEASE PREVENTION PRO(2101 1.43 41 395 23,185 21,047 23,188 27,047 60,970 34,100 106.470 WIC(21W1) 28.77 12,877 97,893 360,891 420,035 366,891 420,935 1,663,652 0 1,503,652 TOBACCO USE INTERVENTION (212) 3,81 0 300 48,190 66,208 48,190 56,207 183,885 24,910 208,795 W(C BREASTFEEDING PEER COUNSELING(21W2) 2.38 0 2.907 17,993 20,087 17,993 20.587 77,060 0 77.900 FAMILY PLANNING(2231 •135 6,749 8,002 80,229 100,688 86,239 100,688 323,651 60,000 373,664 IMPROVED PREGGNANCYOUTCOME(225) 0.23 230 234 76,912 69,708 76,912 89,700 0 333,241 333,241 HEALTHY START PRENATAL(227) 10.93 1,022 6,703 166.730 103,304 105,730 193,103 188,607 529.468 718,801 COMPREHENSIVE CHILD HEALTH (220) 2.03 283 483 33,223 38,761 33.223 38,752 0 113,049 143,940 HEALT1(YSTART CHILD(231) 4.81 021 6,178 73.117 85,632 73417 85632 192.689 125,409 318,008 SCHOOL HEALTH (23 4) 8.49 0 478,373 103,137 120,297 103,137 120,296 301,072 85,795 4.10,8(17 1 COMPREHENSIVE ADULT HEALTH (237) 6.26 2,041 3,701 131.110 152.92.1 131,110 102,923 127,238 440,829 568,067 i COMMUNITY HEALTH DEVELOPMENT(238) 2.80 0 343 44,094 52,480 44,994 62,481 0 191.049 104,019 DENTALHEALTH(3.10) 15.30 4,061 0,0770 261,459 304,900 261,469 304900 5,806 1,127,032 1,132,838 PRIMARY CARE SUBTOTAL 91,12 28,725 614,295 1,426,183 1,063,821 1,420,483 1,663,820 3,090,935 3,089.672 6,180,607 C. ENVIRONMENTAL HEALTH Water sad One(1e&wage Programa COSTAL BEACH MONITOIUNG(3471 0.29 507 608 6.082 1,09.1 6,089 7,093 17,478 9,873 20.551 LIMITED USE PUBLIC%VFER SYSTEMS 1357) 0.71 228 2,169 12,150 14,178 12,16G 11,170 31 737 20,932 52,660 PUOLIC WATER SYSTEM(358) 0,00 0 0 9 •I 3 4 0 14 14 PRIVATE WATER SYSTEM (359) 0.06 2 88 1,390 1,029 1,196 1,629 0 6,050 0,050 ONSITE SEWAGE TREATMENT&DISPOSAL(361) 6.95 1,611 4,02.) 08.001 111'306 08,001 114,305 148,316 276,698 424,013 Group Total 7_.71 2,978 0,789 117,638 137,211 117,638 137,210 197,.130 312,507 509,697 Facility Programa TA'ITOOFACILITY SERVICES(34 4) 0.27 0 100 4,225 4.933 4.229 .1,938 11,401 11:`411 18.321 AilocIment,;6_Pon_I1),Page 1 012 (1.3e.quo3 eano luawliedea qireaH : V60Z) 13ei1uo3 0J03 luawpedea iilieaH :luatuipeliAl cr) al in Ci v- 6 .. . .'• - ''''-- '''' ' ''' '; : ' '' --- :.- , - A1'i,An!itiiFrii',.'1,. Ca .t- CL ' ..:2.--.,:-1-_,::::,-,,,1 - '.,' ' -'''''''''-, ''• -.•--.- : '- . ' COLLIER COUNTY HEALTH DEPARTMENT .- ,-..'-r.: ''..,----,-,,,.,'-', '.--:--• ':.-- 1:' .::-. 'r ' ''' '.'''.' •. 60Y01 of Sery Within Eue ' - i ii ' si;i4itie;firiiiEu)) Part III,Plinned Staffit48.C1187/L‘S0rv!0011 Ind Ell!t!!di!.91.ez../ 11477;,,,.,: ,-: . .,'• . ., ,,:::,.':-.''. 1-,''.-. . •" , .r6;:.' ...-1 .::.:-.1-.:".=:.,-;;'.::?..., '''' 14*ta!liEltpOic1.1t4!0'11111:, ;„.....,,;'.,- ',:':,,,,;,„‘':,-..;_';.::','-!:.•*,'S:','::,,..:1'''...‘. : .' .-.• vi'eli:.1-011;36§.§4)MF0,-, '.' . 4- ;-' .F4!1 '. :',•,...•:-...-',...". 411* a .nd ,-- -.:-.:..-:, '.-_':•.'-'-',:-. „, s- . _.:%.,..‘--,-'Ij..,..,; ''._,:),-.','.,.:',,I. ,; ',.','": -' .;.:'.,,,..-' - • .Uujta.''''.: ...: i1..• ' . ,..-:.-Cililiiiie dtilliiiiiiil.0''':-:--',.:- - '''...":-stat,a'''r.':County 941!'''''' . . .... ..,-,_„. - „ .. . .. . . ...,..._.... FOOD HYGIENE (3-18) 1.80 217 831 27,341 31 890 27,3.11 31,889 45,194 13.267 118,461 110DT PIERCING FACILITI ES SERVICES(149) 0.01 2 2 174 203 174 203 270 484 764 GROUP CARE FACILITY(360 054 137 173 3.126 0,828 8,420 0,820 0 36,609 36.800 MIGRANT LABOR CAMP(352) 2.17 110 773 31,600 36,962 31,690 36,961 88,768 48,545 131.203 HOUSING.f.c PUB.BLDG. (353) 000 0 0 2 2 2 1 0 7 7 MOBILE IIOME AND PARK (350 0,35 77 230 0,120 7,1/18 6,120 7,137 19,463 7,052 28,016 000LS/BATHING PLACES(3601 4.53 2,051 10,771 81,179 94,685 81,170 04,684 1)0,9)7 20-1,810 351,727 1.11051ED1CAL WAST'E SERVICES (364) LID 602 732 19,813 23,109 19,813 93,108 69,298 26,545 85,643 TANNING FACILITY SERVICES(369) 0.08 19 20 1,147 1,338 1,141 1,331 3,385 1.584 4,969 Croup Total 10,09 3,276 10,638 180,12) 210,088 180,121 210,082 374,688 405,724 780,412 Groundwater Contamination STORACR TANK COMPLIANCE SERVICES(355) 000 0 0 0 0 0 0 0 0 0 SUPER AC1'SERVICES(350) 0.01 4 20 253 200 253 MG 1,098 0 1,098 Group Total 0.01 4 20 269 206 253 206 1,098 0 1,008 Cotatounity Hygiene COMMUNITY ENVIR,HEALTH 1345) (100 0 0 0 0 0 0 0 0 0 INJURY PREVENTION(246) 0.94 0 0 14,068 17,108 14,1308 17,108 0 63,662 03,552 LEAD MONITORING SERVICES(350) 0.00 0 0 20 24 20 24 0 88 88 PUBLIC SEWAGE(362) (100 0 1) 0 0 0 0 0 0 0 SOLID WASTE utsrosm.sErtvice(363) 0.02 0 0 242 282 242 282 0 1,048 1,018 SANITARY NUISANCE(905) 0,00 0 0 84 08 84 99 0 366 305 RABIES SURVEILLANCE(30 0.00 0 0 0 0 0 0 0 0 0 ArtoortvittussuRvEm (307) um u 0 0 D 0 0 0 0 0 RODENT/ARTHROPOD CONTROL 13681 0.00 0 0 0 0 0 0 0 0 0 WATER 1,OLLUTIoN(370) 0.00 0 0 31 36 31 37 0 135 135 INDOOR AIR (371) aoo 0 0 0 0 0 a I) 0 0 RADIOLOGICAL HEALTH (372) 0,01 0 0 78 92 78 92 0 340 340 TOXIC SUBSTANCES(373) 0.00 0 0 0 0 0 0 0 0 0 Group-Total 0.97 0 0 15,123 17,11.40 16,123 17,012 0 05,528 65,5118 ENVIRONMENTAL HEALTH SUBTOTAL 19,24 6,657 26,447 313,135 365,235 313,135 006,230 512,939 783.819 1,356,735 D. NON•OPEItATIONAL COSTS; NONOPERATIONAL COSTS(599) 0.00 0 0 0 0 0 0 0 0 0 ENV/RONAIENTAL HEALTH SORCIIMIOE(199) 9.00 0 0 11,290 13,169 11,290 13,199 48,918 0 48,018 MEDICAID BUYBACK 1911) 0.00 ti 0 0 0 0 0 0 0 0 NON•OBERATIONAL COSTS SUBTOTAL 0.00 0 0 11,200 13,109 11,200 13,10.9 .18.018 0 48,018 TOTAL CONTRACT 0666 03,604 727,622 2,832,131 5,303.341 "-,832,133 3,303,339 6,940,009 5,321,881 12,270,046 Attachmtnl_11 Part_111-Pogo 2 or 2 (foeaguoO woo fuauatledaO utleaFi : tr6OZ) }peatuo woo f�taua tedaO ytleeH :}uausyae;4y N ti U) a r ar C co 0- ATTACHMENT ATTACHMENTIII 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,OH 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 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. Allachment_Ilt-Page 1 or 1 I 03 (peJ uo3 woo}uawpedaG u;leaH : tr60Z) 3oeJ}uoa woo ;UewpedaQ y;lee :auawgoemi 1,... N 11,Ci r tti o a gg 15 ri -se as G I d R CCCC E is R 4pN Q Li u� rte.. N 1•- G so EU -8 .g utro ! alro .r a to a a Ti t N 6RL •t eT r O N m Z •y Q >, a ,yee c +' Q b dd m `0 a oo = O oEo Ee ro0R c ou— UuzCN NC alt m a � = too ps °i E• coc �m0 -0 Ul0 0 > m + 0- LT fit� a Hi s 0 0 0 R o tH° U U U ro U c e c E x e Ns is c y a avL Q r 0 C3 G u m s W I R 07 d O O .... p aRI 0 c 10 0 n CW O r 00 R 7S. or O 0 ` 0 - 'r" Q) , p s. (a Li b "1 Q z o 0 a m o m (� _1 ti h US an ai a g a ' ▪ U e r a) 4. co `"' e R 1 mu7 4 a d o 0 "c i; a x $ p 4 E d — U. pp w U. a V q o 0 d _ N r � -- N 03 $ O Al r tet„ r" iq .H 84' — .it as M 0R D - M g R .i3 .r N R co R 26 R • L o U mt T 10 V7 T. R D'a Zi 0 0 A _ q J ti �.. — O (� 'C .X i 4' N — o g E 0 o IL c 'E o QU�t} O t+ N O y ami m I. U. alb CIL m W O U. vx m Z. 2 al {� Ili di C7 � co ai N m — o rysg U r>0 C4 d O = t. c'7 m r 0. t� co cq" z Ev z � z • 2 (loeawo3 wwoo ;uewiJedaa 41Ieej- : t'60Z) %3eJ}uo3 woo#uawpedea :tuawtpeny ti cd � CL ATTACHMENT V COLLIER COUNTY HEALTH DEPARTMENT SPECIAL PROJECTS SAVINGS PLAN nt CASH RESERVED OR ANT{CIPATED TO BE RESERVED FOR PROJECTS CONTRACT YEAR STATE COUNTY TOTAL 2015.2018' S 0 5 0 S 0 2016-2017" S D S 0 S 0 2017.2018"' S 0 $ 0 S 0 2018-2019"' S 0 S 0 $ 0 PROJECT TOTAL 5 0 5 0 S 0 SPECIAL PROJECTS CONSTRUCTIONIRENOVATION PLAN PROJECT NUMBER: PROJECT NAME: LOCATION/ADDRESS: PROJECT TYPE: NEW BUILDING ROOFING RENOVATION PLANNING STUDY NEW ADDITION OTHER SQUARE FOOTAGE; 0 PROJECT SUMMARY: Describe scope of work in reasonable detail. START DATE (lattiar expenditure of funds) COMPLETION DATE: DESIGN FEES: S 0 CONSTRUCTION COSTS: S 0 FURNITURE/EQUIPMENT: 5 0 TOTAL PROJECT COST: $ 0 COST PER SQ FOOT: S 0 Special Capital Projects are new construction or renovation projects and new lurniture or equipment associated with these projects and mobile health vans. 'Cash balance as of 9150116 "Cash to be transferred to FCO account. "'Cash anticipated tar future contract years. Atlachment V-Page 1 Cl 10 (loealuoa woo luawlaedaa 4lleaH : t'60Z) loealuoa woo luawlaedaa glleaH :luawgoelltf ti ci m ADDENDUM I TO CONTRACT BETWEEN a. COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS AND STATE OF FLORIDA DEPARTMENT OF HEALTH FOR OPERATION OF THE COLLIER COUNTY HEALTH DEPARTMENT CONTRACT YEAR 2016-2017 This Addendum is made this day of ,2016,and is added to and amends the 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 2016-2017("Contract"). The following underlined provision is added to Section 4 of the Contract to include non- recurring funding by the County to fill a funding gap resulting from loss of Low Income Pool funds previously provided by the Agency for Health Care Administration.: 4. FUNDING. The parties further agree that funding for the CHD will be handled as follows: a. The funding to be provided by the parties and any other sources is set forth in Part II of Attachment II hereof. This funding will be used as shown in Part I of Attachment II. * * * iii. The County's supplemental funding as provided in Attachment II, Part II, in an amount not to exceed $249,220(amount included in the calculation under the CHD Local Revenue&Expenditures section of the revenue attachment). IN WITNESS WHEREOF, the State and County have hereto executed this Addendum the day and year first above written. AS TO THE STATE: STA I OF FLORIDA DEPARTMENT OF HEALTH SIGNED BY: NAME: Celeste Phillip,MD,MPH TITLE: Surgeon General/Secretary of Health DATE: 1of2 (logia;uo3 9.400 tuauw}iedaa 1760Z) PeJi4uo3 0a03 luawpeda® mei :tuewgoe11coN 11)co fy a) a SIGNED BY: NAME: Stephanie Vick,M.S.,B.S.N.,R.N. TITLE:CHD Administrator DATE: AS TO THE COUNTY: Attest: BOARD OF COUNTY COMMISSIONERS FOR DWIGHT E.BROCK, Clerk COLLIER COUNTY By: By: ,Deputy Clerk Donna Fiala,Chairman Approved as to form and legality: Jennifer A.beipedio 2� Assistant County Attorney C,L\ it 2 of 2