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Agenda 11/12/2013 Item #16D 911/12/2013 16.D.9. EXECUTIVE SUMMARY Recommendation to approve the FY13 -14 contract between Collier County and the State of Florida Department of Health for operation of the Collier County Health Department in the amount of $1,258,100. OBJECTIVE: To provide local funding to augment the level of public health services provided to the residents of Collier County. CONSIDERATIONS: Each year, the County enters into an agreement with the State of Florida Department of Health to provide funds and facilities for the provision of public health services. The attached represents the FY13 -14 contract effective October 1, 2013 through September 30, 2014. The agreement identifies the services that will be provided with the cost share between the State and the County. The total amount affected is $1,258,100. FISCAL IMPACT: The contract includes a direct contribution of $1,258,100 for public health programs. These funds are budgeted in the FY14 General Fund (001 - 155810) budget in the Public Health cost center. Administration costs of $311,000 are in addition to the contract program costs of $1,258,100 and are also included in the FY14 General Fund (001 - 155810) budget. GROWTH MANAGEMENT IMPACT: There is no Growth Management Plan impact associated with this item. LEGAL CONSIDERATIONS: This item has been approved for form and legality and requires a majority vote for Board action. - JAB RECOMMENDATION: That the Board of County Commissioners approve and authorize the Chairman to execute the annual contract with the State of Florida Department of Health for the operations of the Collier County Health Department. Prepared by: Alan Portis, Collier County Health Department Packet Page -1551- 11/12/2013 16.D.9. EXECUTIVE SUMMARY Recommendation to approve the FY13 -14 contract between Collier County and the State of Florida Department of Health for operation of the Collier County Health Department in the amount of $1,258,100. OBJECTIVE: To provide local funding to augment the level of public health services provided to the residents of Collier County. CONSIDERATIONS: Each year, the County enters into an agreement with the State of Florida Department of Health to provide funds and facilities for the provision of public health services. The attached represents the FY13 -14 contract effective October 1, 2013 through September 30, 2014. The agreement identifies the services that will be provided with the cost share between the State and the County. The total amount affected is $1,258,100. FISCAL IMPACT: The contract includes a direct contribution of $1,258,100 for public health programs. These funds are budgeted in the FY14 General Fund (001- 155810) budget in the Public Health cost center. Administration costs of $311,000 are in addition to the contract program costs of $1,258,100 and are also included in the FY14 General Fund (001- 155810) budget. GROWTH MANAGEMENT RKPACT: There is no Growth Management Plan impact associated with this item. LEGAL CONSIDERATIONS: This item has been approved for form and legality and requires a majority vote for Board action. - JAB RECOMMENDATION: That the Board of County Commissioners approve and authorize the Chairman to execute the annual contract with the State of Florida Department of Health for the operations of the Collier County Health Department. Prepared by: Alan Portis, Collier County Health Department Packet Page -1551- /01-N. 11/12/2013 16.D.9. COLLIER COUNTY Board of County Commissioners Item Number: 16.16.D.16.D.9. Item Summary: Recommendation to approve the FY13 -14 contract between Collier County and the State of Florida Department of Health for operation of the Collier County Health Department in the amount of $1,258,100. Meeting Date: 11/12/2013 Prepared By Name: AlonsoHailey Title: Operations Analyst, Public Service Division 10/21/2013 1:28:57 PM Approved By Name: AlonsoHailey Title: Operations Analyst, Public Service Division Date: 10/21/2013 1:45:45 PM Name: CarnellSteve Title: Purchasing/General Services Director Date: 10/25/2013 4:03:25 PM Name: BelpedioJennifer Title: Assistant County Attorney,County Attorney Date: 10/28/2013 9:53:15 AM Name: KlatzkowJeff Title: County Attorney Date: 10/28/2013 1:45:09 PM Name: FinnEd Title: Senior Budget Analyst, OMB Date: 10/31/2013 4:23:28 PM Name: OchsLeo Title: County Manager Date: 11/2/2013 10:31:03 AM Packet Page -1552- 11/12/2013 16.D.9. Packet Page -1553- 11/12/2013 16.D.9. 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 2013 -2014 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, 2013. 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 County Health Departments created throughout Florida. D. It is necessary for the parties hereto to enter into this Agreement 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 Agreement shall be effective from October 1, 2013, through September 30, 2014, 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. AFN Packet Page -1554- 11/12/2013 16.D.9. 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 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, immunisation, 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 CHID 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 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 II, Part II is an amount not to exceed $ 5,555,567 (State General Revenue, State Funds, Other State Funds and Federal Funds listed on the Schedule C). The State's obligation to pay under this contract is contingent upon an annual appropriation by the Legislature. ii. The County's appropriated responsibility (direct contribution excluding any fees, other cash or local contributions) as provided in Attachment 11, Part II is an amount not to exceed $ 1,258,100 (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 Packet Page -1555- WrJi FA 11/12/2013 16.D.9. County Health Department Trust Fund that is attributed to the CHD shall be carried forward to the next contract period. c. Either party may establish service fees as allowed by law to fund activities of the CHD. 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 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, Bureau of Budget and Revenue Management. e. The name and address of the official payee to who 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 Statewide Services. 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 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, Packet Page -1556- 11/12/2013 16.D.9. and all county- purchasing procedures must be followed in their entirety, and such compliance shall be documented. Such justification and compliance documentation shall be maintained by the CHD in accordance with the terms of this Agreement. State procedures must be followed for all leases on facilities not enumerated in Attachment 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 61, 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; N. 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 Packet Page -1557- LNJ 11/12/2013 16.D.9. remain in the trust fund until accounted for in a manner which clearly illustrates the amount which has been credited to each participating governmental entity. The planned use of surplus funds shall be reflected in Attachment Il, 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 Secretary for Statewide Services has approved the transfer. The Deputy Secretary for Statewide Services 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. 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. Packet Page -1558- a 11/12/2013 16.D.9. 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 and Revenue Management. REMAINDER OF PAGE INTENTIONALLY LEFT BLANK 6 a Packet Page -1559- 11/12/2013 16.D.9. 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: March 1, 2014 for the report period October 1, 2013 through December 31, 2013; ii. June 1, 2014 for the report period October 1, 2013 through March 31, 2014; N. September 1, 2014 for the report period October 1, 2013 through June 30, 2014; and iv. December 1, 2014 for the report period October 1, 2013 through September 30, 2014. 7. FACILITIES AND EQUIPMENT. The parties mutually agree that a. CHD facilities shall be provided as specified in Attachment IV to this contract and the county shall own the facilities used by the CHD unless 'otherwise provided in Attachment IV. b. The county shall ensure adequate fire and casualty insurance coverage for County- owned CHD offices and buildings and 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 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 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 a`� Packet Page -1560- 11/12/2013 16.D.9. 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. Availabilitv of Funds. If this Agreement, any renewal hereof, or any term, performance or payment hereunder, extends beyond the fiscal year beginning July 1, 2014, 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, MID-M.P.H. Name For the County: Steve Carnell Name Director, Florida Department of Health Public Services Division Interim Collier County Administrator Title 3339 E. Tamiami Trail, Suite 145 Naples, Florida 34112 Address (239)252 -8201 Telephone Title 3339 E. Tamiami Trail, Suite 217 Naples, Florida 34112 Address (239) 252 -8468 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. Ca tions. 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. a Packet Page -1561- 11/12/2013 16.D.9. In WITNESS THEREOF, the parties hereto have caused this 24 page agreement to be executed by their undersigned officials as duly authorized effective the 1Tday of October, 2013. BOARD OF COUNTY COMMISSIONERS FOR COLLIER COUNTY SIGNED BY: SIGNED BY: NAME: TITLE: DATE: ATTESTED TO: SIGNED BY: NAME: �. TITLE: DATE: 11�1 STATE OF FLORIDA DEPARTMENT OF HEALTH NAME: John H. Armstrong, MD TITLE: Surgeon General/Secretary of Health DATE: SIGNED BY: NAME: Joan M. Coffer. M.D.. M.P.H. TITLE: CHD Director /Administrator DATE: Approved as to form and legality Assistant County Attorney z> a I'D Packet Page -1562- 9 a 11/12/2013 16.D.9. 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 (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 Reauirement 1. Sexually Transmitted Disease Requirements as specified in F.A.C. 6413-3, F.S. 381 and Program F.S. 384. 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 and Children (including the WIC specified in DHM 150 -24* and all federal, state and county requirements detailed In program manuals and published Breastfeeding Peer Counseling procedures. Program) 4. Healthy Stan/ 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. 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 -615) and Rule 64D- 3.046, F.A.C. In addition, periodic reports as specified by the department pertaining to the surveillancernvestigation of reportable vaccine - preventable diseases, adverse events, vaccine accountability, and assessment of immunization 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 -4* and DHP 50 -21 * 8. HIV /AIDS Program Requirements as specified in F.S. 384.25 and F.A.C. 64D -3.030 and 64D- 3.031. Case reporting should be on Adult HIV /AIDS Confidential Case Report CDC Form DH2139 and Pediatric HIV /AIDS Confidential Case Report CDC Form DH2140. 10 0 Packet Page -1563- 11/12/2013 16.D.9. ATTACHMENT I (Continued) Requirements as specified in F.A.C. 64D -2 and 6413-3, F.S. 381 and F.S. 384. Socio - demographic and risk data on persons tested for HIV 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). 10. Tuberculosis Tuberculosis Program Requirements as specif ied in F.A.C. 64D -3 and F.S. 392. 11. 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 F.A.C. 64D -3, F.S. 381, F.S. 384 and the CHD Epidemiology Guide to Surveillance and Investigations. 'or the subsequent replacement if adopted during the contract period. Packet Page -1564- M cq F- Z W Q a F Z W CLF- W O wQ z O V W 3 O 0 0 W U m e z m W y tr F- N Z W Q a W O W z O V LL O W U) O W z a N a c3 � Hr N 7 7 ~ 0m � U cad iU Co .E 210 to C Co W cL li aI F- t9 0 a) CD v U Co C2 -9 '20-2 w (D LL M y 2 H O N r O Co LO LO O Co ai } O O r N C N C2 U M cc O O L L m } aEi 4Ei �C� C o 0 0 U�'� aM C N l0 N r 2—, L 3 �� m 0 'o 00 cep N ('O Co Cm O Co 9 Co O M 'j Co to LO 'o N ,O M > m m E O Co N r O Packet Page -1565- en C > L r n3 a> L d O E N w V a) O a O N a1 r L a> Rt CD E CL .5 Cr O m E 3 c U m O a 0 O C a� G fA G U 3 m c m Co m U aD f a CL U U 11/12/2013 16.D.9. N r 11/12/2013 16.D.9. 1. GENERAL REVENUE -STATE 015040 AIDS PREVENTION 19,261 0 19,261 0 19x61 015040 ALG /CESSPOOL IDEN71FICATION AND ELIMINATION 0 0 0 0 0 015040 ALG /CONTR TO CHDS -AIDS PATIENT CARE NETWORK 0 0 0 0 0 015040 ALG.'IPO HEALTHY START/IPO 0 0 0 0 0 015040 COMMUNITY SMILES - MIAMI -DADE 0 0 0 0 0 01 SO40 COUNTY SPECIFIC DENTAL PROJECTS - ESCAMBIA 0 0 0 0 0 015040 DUVAL TEEN PREGANCY PREVENTION - DUVAL 0 0 0 0 0 015040 FL CLPPP SCREENING & CASE MANAGEMENT 0 0 0 0 0 015040 HEALTHY START GENERAL REVENUE CHD 0 0 0 0 0 015040 HEALTHY STARTMED- WAIVER - CLIENT SERVICES 0 0 0 0 0 015040 LA LIGA- LEAGUE AGAINST CANCER • MIAMI -DADF. 0 0 0 0 0 015040 METRO ORLANDO URBAN LEAGUE - ORANGE 0 0 0 0 0 015040 MINORITY OUTREACH- PFNALVER CLINIC - MIAMI -DADE 0 0 0 0 0 015040 PREPAREDNESS GRANT MATCH 73,643 0 73,643 0 73,643 015040 SCHOOL HEALTH GENERAL REVENUE $0,855 0 80,855 0 80,855 015040 STATEWIDE DENTISTRY NETWORK - ESCAMBIA 0 0 0 0 0 015040 STD GENERAL REVENUE 0 0 0 0 0 015040 TREASURE COAST MIDWIFERY - MARTIN 0 0 0 0 0 015040 AIDS SURVEILLANCE 50,310 0 50,310 0 50,310 015040 ALG /CONTR TO CHDS -AIDS PATIENT CARE 140,000 0 140.000 0 140'000 015040 ALG/CONTR TO CHDS- SOVEREIGN IMMUNITY 0 0 0 0 0 015040 ALG /PRIMARY CARE 313,432 0 313,432 0 313,432 015040 COMMUNITY TB PROGRAM 167,738 0 167,738 0 167,738 015040 DENTAL SPECIAL INITIATIVES 642 0 6,542 0 6,542 015040 FAMILY PLANNING GENERAL REVENUE 36,794 0 36,794 0 36'794 015040 FL HEPATITIS & LIVER FAILURE PREVENTION /CONTROL 89,286 0 89,286 0 89.286 015040 HEALTHY START MED WAIVER - SOBRA 0 0 0 0 0 015040 JESSIE TRICE CANCER CTR/HEALTH CHOICE • MIAMI -DADE 0 0 0 0 0 015040 MANATEE COUNTY RURAL HEALTH SERVICES 0 0 0 0 0 015040 MIGRANT LABOR CAMP SANITATION 74,533 0 74,533 0 74,533 015050 NON - CATEGORICAL GENERAL REVENUE 1,678,132 0 1,678,132 0 1,678,132 GENERAL REVENUE TOTAL 2,730,526 0 2,730,526 0 2,730,526 2. NON GENERAL REVENUE- STATE 015010 ALG/CONTR. TO CHDS - BIOMEDICAL WASTE 13,131 0 13,131 0 13,131 015010 DOH INDIRECT 135,126 0 135,126 0 135,126 015010 PREPAREDNESS GRANT MATCH 0 0 0 0 0 015010 SCHOOL HEALTH TOBACCO TF 137,218 0 137,218 0 137.218 015010 TOBACCO COMMUNITY INTERVENTION 224,230 0 224,230 0 224,230 015010 ALG/CONTR. TO CHDS -SAFE DRINKING WATER PRG 0 0 0 0 0 015010 MEDICAID INCENTIVE FOR ELECTRONIC HEALTH RECORDS 47,046 0 47,046 0 47.046 015010 PUBLIC SWIMMING POOL PROGRAM 0 0 0 0 0 015010 TOBACCO ADMINISTRATION & MANAGEMENT 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 015020 TRANSFER FROM ANOTHER STATE AGENCY 0 0 0 0 0 015060 NON- CATEGORICAL TOBACCO REBASING 3.097 0 3,097 0 3,097 Version, 2 Page 1 of 7 'Y Packet Page -1566- 11/12/2013 16.D.9. - - 559,846 0 559,648 0 559,848 3. FEDERAL FUNDS- State 007000 ABSTINENCE EDUCATION GRANT PROGRAM 007000 AIDS PREVENTION 0 0 0 0 0 007000 BIOTERRORISM HOSPITAL PREPAREDNESS 255,477 0 255,477 0 255,477 007000 COASTAL BEACH MONITORING PROGRAM 22,374 0 22,374 0 22,374 007000 DENTAL SERVICES 19,324 0 18.324 0 18 324 007000 EPIDEMIOLOGY GY & LABORATORY CAPACITY FOR INFECTIOU, 0 0 0 0 0 007000 EXPANDED TESTING INITIAi1VE(ETI) p 0 0 0 0 007000 FGTFBREAST &CERVICAL CANCER -ADMIN /CASE 0 0 0 0 0 007000 MAN HEPATITIS B VACCINATION PILOT PROJECT p 0 0 0 0 007000 IMMUNIZATION AFIX 0 0 0 0 0 007000 IMMUNIZATION FIELD STAFF EXPENSE 0 0 0 0 0 007000 MCH BGTF- HEALTIiY START COALITIONS p 0 0 0 0 007000 MINORITY AIDS INITIATIVE 0 0 0 0 0 007000 MINORITY INVOLVEMENT IN HIV /AIDS 0 0 0 0 0 007000 PROGRAM PREGNANCY ASSOCIATED MORTALITY PREVENTION 0 0 0 0 0 007000 PUBLIC HEALTH PREPAREDNESS BASE 0 0 0 0 0 007000 RYAN WHITE 127,393 0 127,393 0 127,393 007000 RYAN WHITE -AIDS DRUG ASSIST PROG•ADMIN 0 0 0 0 0 007000 STATE OFFICE OF RURAL HEALTH 77.945 0 77,945 0 77,945 007000 STD FEDERAL GRANT • CSPS 0 0 0 0 0 007000 SYPHILIS ELIMINATION 0 0 0 0 0 007000 TOBACCO FAITH BASED PROJECT 0 0 0 0 0 007000 UNINTENDED/UNWANTED PREG -TEEN PREGNANCY 0 0 0 0 0 007000 PREV WIC BREASTFEEDING PEER COUNSELING 25,591 0 25,591 0 25,591 007000 ADULT VIRAL HEPATITIS PREVENTION & SURVEILLANCE 52 200 0 52,2W D 52-200 007000 AIDS SURVEILLANCE p 0 0 0 0 007000 CHRONIC DISEASE PREVENTION & HEALTH PROMOTION 0 0 0 0 0 007000 COLORECTAL CANCER SCREENING 10,500 0 10,500 0 10,500 007000 ENHANCE COMPREHENSIVE PREVENTION PLANNING AND 0 0 0 0 0 007000 IH EPIDEMIOLOGY &LABORATORY CAPACITY HAI p 0 0 0 0 007000 FGTF /AIDS MORBIDITY p 0 0 0 0 007000 FGTF/FAMILY PLANNING-TITLE X 0 0 0 0 0 007000 HIV HOUSING FOR PEOPLE LIVING WITH 76,501 0 76,501 0 76,501 007000 AIDS IMMUNIZATION FEDERAL GRANT ACTIVITY SUPPORT 0 0 0 0 0 007000 MCH BGTF•GADSDEN SCHOOL CLINIC 102,375 0 102,375 0 102,375 007000 MEDICARE RURAL HOSPITAL FLEXIBILITY PROGRAM 0 0 0 0 0 007000 MINORITY AIDS INITIATIVE TCE COLLABORATIVE 0 0 0 0 0 007000 PHP - CITIES READINESS INITIATIVE p 0 0 0 0 007000 PUBLIC HEALTH INFRASTRUCTURE 0 0 0 0 0 007000 RAPE PREVENTION &EDUCATION 0 0 0 0 0 007000 RYAN WHITE • EMERGING COMMUNITIES 0 0 0 0 0 007000 RYAN WHiTE•CONSORTIA 0 0 0 0 0 007000 STATEWIDE ASTHMA PROGRAM 0 0 0 0 0 007000 STD PROGRAM INFERTILITY PREVENTION PROJECT 0 0 0 0 0 007000 (IPP) TEENAGE PREGNANCY PREVENTION REPLICATION 5,624 0 5,624 0 5,624 007000 TUBERCULOSIS CONTROL - FEDERAL GRANT p 0 0 0 0 67.702 0 67,702 0 67,702 Version: 2 Page 2 of 7 Packet Page -1567- 11/12/2013 16.D.9. 3. FEDERAL FUNDS - State 007000 WIC ADMINISTRATION 015009 MEDIPASS WAIVER-HLTHY STRT CLIENT SERVICES 015009 MEDIPASS WAIVER -SOBRA 007055 ARRA FEDERAL GRANT • SCHEDULE C 015075 SCHOOL HEALTH TITLE XXI 015075 SCHOOL HEALTH 015075 REFUGEE HEALTH OIS075 SCHOOL HEALTH FEDERAL FUNDS TOTAL 4, FEES ASSESSED BV STATE OR FEDERAL RULES - STATE 001020 PUBLIC WATER ANNUAL OPER PERMIT 001020 NON -SDWA SYSTEM PERMIT 001020 SWIMMING POOLS 001020 TATTOFACILITY 001020 MOBILE HOME AND PARKS 001020 BIOHAZARD WASTE PERMIT 001020 TANNING FACILITIES 001020 MIGRANT HOUSING PERMIT 001020 FOOD HYGIENE PERMIT 001020 PRIVATE WATER CONSTR PERMIT 001020 PUBLIC WATER CONSTR PERMIT 001020 SAFE. DRINKING WATER 001092 OSDS PERMIT FEE 001092 AEROBIC OPERATING PERMIT 001092 NON SDWA LAB SAMPLE 001092 ENVIRONMENTAL HEALTH FEES 001092 1 & M ZONED OPERATING PERMIT 001092 SEPTIC TANK SITE EVALUATION 001092 OSDS VARIANCE FEE 001092 OSDS REPAIR PERMIT 001170 LAB FEE CHEMICAL ANALYSIS 001170 NONPOTABLE WATER ANALYSIS 001170 WATER ANALYSIS - POTABLE 001206 CENTRAL OFFICE SURCHARGE 001093 CHD ON -LINE BILLING FEE FEES ASSESSED BY STATE OR FEDERAL RULES TOTAL S. OTHER CASH CONTRIBUTIONS - STATE 010304 STATIONARY POLLUTANT STORAGE TANKS 090001 DRAW DOWN FROM PUBLIC HEALTH UNIT 031005 CHDTF CASH TRANSFER 010306 DOH /DOC INTERAGENCY AGREEMENT OTHER CASH CONTRIBUTIONS TOTAL 6. MEDICAID - SPATEICOUNTY 001056 MEDICAID PHARMACY Version: 2 1,389,497 0 1,389,497 0 089.497 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33,690 0 33,690 0 33,690 0 0 0 0 0 360.000 0 360.000 0 360,000 0 0 0 0 0 2,625,193 0 2,625,193 0 2,625,193 10,750 0 10,750 0 10,750 0 0 0 0 0 377,000 0 377,000 0 377,000 8,000 0 8,000 0 8,000 22,000 0 22,000 0 22,000 35,500 0 35,500 0 35,500 3,600 0 3,600 0 3.600 19,000 0 19,000 0 19,000 34,000 0 34,000 0 34,000 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 0 0 0 0 0 1,100 0 1,100 0 1,100 0 0 0 0 0 0 0 0 0 0 97,500 0 97,500 0 97.500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43,500 0 43,500 0 43,500 0 0 0 0 0 651,950 0 651,950 0 651,950 0 0 0 0 0 672,955 0 672,955 0 672,955 0 0 0 0 0 0 0 0 0 0 672,955 0 672,955 0 672,955 0 0 0 0 0 Page 3 of 7 Packet Page -1568- 11/12/2013 16.D.9. w ma�i�- AW- JIAIlJI,VVPIfY 001076 MEDICAIDTB 001078 MEDICAID ADMINISTRATION OF VACCINE 001079 MEDICAID CASE MANAGEMENT 001081 MEDICAID CHILD HEALTH CHECK UP 001082 MEDICAID DENTAL 001083 MEDICAID FAMILY PLANNING 001087 MEDICAID STD 001089 MEDICAID AIDS 001147 MEDICAID HMO CAPITATION 001191 MEDICAID MATERNITY 001192 MEDICAID COMPREHENSIVE CHILD 001193 MEDICAID COMPREHENSIVE ADULT 001194 MEDICAID LABORATORY 001208 MEDI PASS $3.00 ADM. FEE 001059 MEDICAID LOW INCOME POOL 001051 EMERGENCY MEDICAID 001058 MEDICAID- BEHAVIORAL HEALTH 001071 MEDICAID - ORTHOPEDIC 001072 MEDICAID- DERMATOLOGY 001075 MEDICAID - SCHOOL HEALTH CERTIFIED MATCH 001069 MEDICAID - REFUGEE HEALTH 00105S MEDICAID- HOSPITAL 001148 MEDICAID HMO NON - CAPITATION 001074 MEDICAID - NEWBORN SCREENING 001180 DENTAL MEDICAID HMO MEDICAID TOTAL 7. ALLOCABLE REVENUE -STATE 018000 REFUNDS 037000 PRIOR YEAR WARRANT 038000 12 MONTH OLD WARRANT ALLOCABLE REVENUE TOTAL 8. OTHER STATE CONTRIBUTIONS NOT IN CHD TRUST FUND - STATE 0 ADAP 0 OTHER (SPECIFY) 350 PHARMACY SERVICES 0 TB SERVICES 0 STD SERVICES 0 WIC FOOD 0 DENTAL SERVICES 0 OTHER (SPECIFY) 0 LABORATORY SERVICES 0 IMMUNIZATION SERVICES 0 CONSTRUCTION/RENOVATION OTHER STATE CONTRIBUTIONS TOTAL Version: 2 0 25,000 25,000 0 25,000 0 16.000 16,000 0 16,000 0 15,000 15,000 0 15,000 0 0 0 0 0 0 42,111 42,111 0 42,111 0 0 0 0 0 0 5,000 5,000 0 5,000 0 35,000 35,000 0 35,000 0 0 0 0 0 0 0 0 0 0 0 1,500 1,500 0 1,500 0 3.500 3,500 0 3,500 0 0 0 0 0 0 350 350 0 350 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 28.000 28,000 0 28,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171,461 171,461 0 171,461 2,585 0 2,585 0 2,585 0 0 0 0 0 0 0 0 0 0 2,555 0 2,585 0 2,585 0 0 0 1,923,379 1,923,379 0 0 0 0 0 0 0 0 146,868 146,868 0 0 0 0 0 0 0 0 0 0 0 0 0 6,241,311 6,24011 0 0 0 0 0 0 0 0 0 0 0 D 0 97,469 97,469 0 0 0 839,509 839,509 0 0 0 0 0 0 0 0 9,248,536 9,248,536 Packet Page -1569- Page 4 of 7 11/12/2013 16.D.9. ;f81on: 2 0 "471 Kill -I 008010 CONTRIBUTION FROM CITY GOVERNMENT 008020 CONTRIBUTION FROM HEALTH CARE TAX NOT THRU BCC 008040 BCC GRANT/CONTRACT 008030 CONTRIBUTION FROM HEALTH CARE TAX 008034 BCC CONTRIBUTION FROM GENERAL FUND DIRECT COUNTY CONTRIBUTION TOTAL 10. FEES AUTHORIZED BY COUNTY ORDINANCE. OR RESOLUTION - COUNTY 001060 CHO SUPPORT POSITION 001077 RABIES VACCINE 001077 PERSONAL HEALTH FEES 001077 CHILD CAR SEAT PROD 001077 AIDS CO -PAYS 001094 ADULT ENTER. PERMIT FEES 001094 LOCAL ORDINANCE FEES 001114 NEW BIRTH CERTIFICATES 001115 VITAL STATISTICS • DEATH CERTIFICATE 001117 VITAL STATS -ADM. FEE 50 CENTS 001073 CO -PAY FOR THE AIDS CARE PROGRAM 001025 CLIENT REVENUE FROM GRC 001040 CELL PHONE ADMINISTRATIVE FEE FEES AUTHORIZED BY COUNTY TOTAL 11. OTHER CASH AND LOCAL CONTRIBUTIONS - COUNTY 001009 RETUR NED CHECK ITEM 001029 THIRD PARTY REIMBURSEMENT 001029 HEALTH MAINTENANCE ORGAN, (HMO) 001054 MEDICARE PART D 001077 RYAN WHITE TITLE II 001090 MEDICARE PART B 001190 HEALTH MAINTENANCE ORGANIZATION 005040 INTEREST EARNED 005041 INTEREST EARNED -STATE INVESTMENT ACCOUNT 007010 U.S. GRANTS DIRECT 008050 SCHOOL BOARD CONTRIBUTION 008060 SPECIAL PROJECT CONTRIBUTION 010300 SALE OF GOODS AND SERVICES TO STATE AGENCIES 010301 EXP WITNESS FEE CONSULTNT CHARGES 010405 SALE OF PHARMACEUTICALS 010409 SALE OF GOODS OUTSIDE STATE GOVERNMENT 011001 HEALTHY START COALITION CONTRIBUTIONS 011007 CASH DONATIONS PRIVATE 012020 FINES AND FORFEITURES 012021 RETURN CHECK CHARGE 028020 INSURANCE RECOVERIES -OTHER 090002 DRAW DOWN FROM PUBLIC HEALTH UNIT 011000 GRANT - DIRECT ;f81on: 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1,258,100 1,258,100 0 1,258,100 0 1,258,100 1,258,100 0 1,258,100 0 0 0 0 0 0 0 0 0 0 0 131,700 131,700 0 131,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 580,250 580,250 0 580,250 0 54,000 54,000 0 54,000 0 270,000 270,000 0 270,000 0 3,500 3,500 0 3,500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1,039,450 1,039,450 0 1,039,450 0 0 0 0 0 0 1,122,858 1,122,858 0 1,122,858 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41,500 41,500 0 41,500 0 0 0 0 0 0 0 0 0 0 0 10,000 10,000 0 10,000 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 0 0 0 0 0 0 0 0 0 0 0 385,081 385,081 0 38S,081 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 396,165 396,165 0 396,165 0 256,766 256,766 0 256,766 Packet Page -1570- Page 5 of 7 n 11/12/2013 16.D.9. It. OTHER CASH AND LOCAL CONTRIBUTIONS- COUNTY 011000 DIRECT -ARROW 011000 GRANT- DIRECT 011000 GRANT DIRECT -ARROW 011000 GRANT DIRECT- HEALTH CARE DISTRICT PAHOKEE 011000 GRANT- DIRECT 011000 GRANT - DIRECT 011000 GRANT DIRECT -NOVA UNIVERSITY CHD TRAINING 011000 GRANT DIRECT - COUNTY HEALTH DEPARTMENT DIRECT SER 011000 COUNTY COMMISSION - LIP FUND 011000 GRANT - DIRECT 011000 GRANT DIRECT - QUANTUM DENTAL 011000 GRANT - DIRECT 011000 GRANT- DIRECT 010402 RECYCLED MATERIAL SALES 010303 FDLF FINGERPRINTING 007050 ARRA FEDERAL GRANT 001010 RECOVERY OF BAD CHECKS 008065 FCOCONTRIBUTION 011006 RESTRICTED CASH DONATION 028000 INSURANCE. RECOVERIES 001033 CMS MANAGEMENT FEE - PMPMPC 010400 SALE OF GOODS OUTSIDE STATE GOVERNMENT 010500 REFUGEE HEALTH 005045 INTEREST EARNED -THIRD PARTY PROVIDER 005043 INTEREST EARNED - CONTRACT /GRANT 001053 MEDICARE - PART A 011002 ARRA FEDERAL GRANT - SUB-RECIPIENT 011004 LOW INCOME POOL - SUBRECIPIENT 001003 WIRE TRANSFER FEE OTHER CASH AND LOCAL CONTRIBUTIONS TOTAL 12. ALLOCABLE REVENUE. COUNTY 018000 REFUNDS 037000 PRIOR YEAR WARRANT 038000 12 MONTH OLD WARRANT 001053 CLIENT REVENUE FROM NCO COUNTY ALLOCABLE REVENUE TOTAL 13. BUILDINGS-COUNTY 0 ANNUAL RENTAL EQUIVALENT VALUE 0 IT ALLOCATION & GOLDEN GATE RENTAL 0 LTILITIES 0 BUILDING MAINTENANCE 0 GROUNDS MAINTENANCE 0 INSURANCE 0 OTHER (SPECIFY) BUILDINGS TOTAL Version: 2 0 0 0 0 0 0 193,015 193,015 0 193.015 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 0 242,940 242,940 0 242,940 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 2,200 2,200 0 2,200 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 a 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 2,650,525 2,650,525 0 2,650,525 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 0 525,048 525,048 0 0 0 74,500 74,500 0 0 0 220,200 220,200 0 0 0 0 0 0 0 0 195,149 195,149 0 0 .0 0 0 0 0 0 0 0 0 0 0 1,014,897 1,014,897 Page 6 of 7 Packet Page -1571- w� 11/12/2013 16.D.9. 14. ZITHER COUNTY CONTRIBUTIONS NOT IN CHD TRUST FUND - COUNTY EQUIPMENT /VEHICLE PURCHASES VEHICLE INSURANCE VEHICLE MAINTENANCE OTHER COUNTY CONTRIBUTION (SPECIFY) OTHER COUNTY CONTRIBUTION (SPECIFY) OTHER COUNTY CONTRIBUTIONS TOTAL GRAND TOTAL CHD PROGRAM ersion: 2 0 0 0 0 0 0 0 0 16,300 16,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.300 16,300 7,243,057 5,119,536 12,362,593 10,279,733 22,642,326 Packet Page -1572- Page 7 of 7 7� 11/12/2013 16.D.9. A. COMMUNICABLE DISEASE CONTROL: IMMUNIZATION (101) 9.42 8,385 11,423 203,457 161,500 188,457 153,397 245,312 461,499 706,811 STD (102) HIV /AIDS PREVENTIONf03AI) 5.24 1,151 1,729 82,275 70,503 82,275 82,242 27,234 290,061 317,295 HIV /AIDS SURVEILLANCE (03A2) 6.21 1.789 2,249 92.010 78,845 92,010 91,974 265.348 89,491 354,839 HIWAIDS PATIENT CARE (03A3) 1.32 6 7 16,839 16,143 18.939 18,831 72.657 0 72,652 ADAP (03A4) 7.78 347 1,969 152,529 130,706 162,529 152:471 339,169 360,066 598,235 TB CONTROL SERVICES (104) 2.34 25 72 34,995 29,988 34,995 34,983 134,961 0 134,961 COMM. DISEASE SURV. (I D6) 8.40 819 3.620 156,978 145,949 166,978 151,921 465.356 156,470 621,826 HEPATITIS PREVENTION (109) 610 0 6,230 120,245 103,041 120.245 120,199 0 463,730 463,730 PUBLIC HEALTH PREP AND RESP(116) 1.87 2,139 2,970 32,568 27.908 32,566 32,555 125,599 0 125,599 REFUGEE HEALTH (I is) 4.64 0 468 86,521 74,142 86,521 86,489 289,484 44,189 333,673 VITAL STATISTICS (180) 6.29 1,234 4,743 133,624 114,505 133,624 133.573 478,137 37.199 515,326 171 10,496 40,150 37,706 32,311 37,706 37,692 0 145,415 145.415 COMMUNICABLE DISEASE SUBTOTAL 62.42 26.391 75,630 1.151,747 985,541 1,156,747 1,096,327 2,342,252 B, PRIMARY CARE: 2,048,110. 4,390,362 CHRONIC DISEASE SERVICES (210) TOBACCO PREVENTION (212) 1.4$ 307 2,561 37,711 29,461 37,711 27,702 87,585 45,000 132,585 WIC(2fWl) 3.54 0 8,463 63,192 54,651 63,192 63,168 244,203 0 244,203 WIC BREASTFEEDING PEER COUNSELING (21 W2) 35.30 11,941 91,697 538,325 488,778 538,325 538,136 2,103,564 0 2,103,564 FAMILY PLANNING (223) 1.21 0 1,645 13,840 11,860 13,840 13,836 53,376 0 53,376 IMPROVED PREGN ANCY OUTCOME (223) 2.51 1,748 1,966 59,131 80,670 99,131 89,107 328,039 0 328,039 HEALTHY START PRENATAL (227) 5.43 1,079 6,982 157,441 134,915 157,441 157,381 206,489 400,689 607,178 COMPREHENSIVE CHILD HEALTH (229) 9,71 1,532 8,384 150,660 131,958 150,660 155,597 190,796 398,079 588,875 HEALTHY START INFANT (23 1) 2.64 27S 791 44,836 39,852 44,836 44,823 0 174,347 174,347 SCHOOL HEALTH (234) 5.04 729 4,518 61,718 55,741 61,718 66,699 245,866 0 245,866 COMPREHENSIVE ADULT HEALTH (237) 6.73 0 284,934 151,262 76.773 96,262 91,222 317,855 97,664 415,519 COMMUNITY HEALTH DEVELOPMENT (238) 1.09 812 1,878 111,575 87,042 111,575 101,534 201,608 210,118 411,726 DENTAL HEALTH (240) 1.81 0 184 32.252 27,637 32,252 32,239 124,380 p 124,380 14.% 5,035 8.955 326,256 276,722 326,256 321.136 7,853 1,242,517 1.250,370 PRIMARY CARE SUBTOTAL 91.42 23,358 422,958 1,748.199 1,496,060 1,733 199 1,702,570 4,111,614 2,568,414 C. ENVIRONMENTAL HEALTH: 6,680,028 Water and Onske 80wage, Programs COASTAL BEACH MONITORING (347) LIMITED USE PUBLIC WATER SYSTEMS (357) 0.15 391 391 6,798 5,825 6,798 6,795 26,216 0 26216 PUBLIC WATER SYSTEM (358) 0.19 193 1,030 3,422 3,489 3,722 3,720 5,275 9,078 14,353 PRIVATE WATER SYSTEM (359) 0.00 p 0 24 21 24 24 47 46 93 INDIVIDUAL SEWAGE DISK 061) 0.01 p 14 119 102 119 118 0 458 458 Group Total 6.71 1,632 4,089 116,012 104,413 121,012 115,967 221,757 235,647 457,404 FaCHIty Programs 7.06 2,216 5,524 126,375 113,850 131,675 126,624 253,295 245,229 498,529 FOOD HYGIENE (348) BODY PIERCING FACILITIES SERVICES (349) 1.29 227 1,027 21,020 20,512 23,520 21,011 86,06.1 0 86,063 GROUP CARE FACILITY (35 1) 0.03 2 3 618 530 619 619 2,385 0 2,385 MIGRANT LABOR CAMP (352) 0.65 195 316 10,400 8.912 10.400 10,397 0 40,109 40,109 2.58 257 1,763 46.027 42,441 49,027 48,009 129.245 36,259 185,504 Version: 4 Page 1 of 2 �r Packet Page -1573- 11/12/2013 16.D.9. C. ENVIRONMENTAL HEALTH: Fat:illty Program HOUSING,PUBLIC BLDG SAFETY.SANITATION (353) 0.00 0 0 t2 11 12 13 24 24 48 MOBILE HOME AND PARKS SERVICES (354) 0.35 89 358 3,904 6.059 6,904 5,903 22,770 0 22,770 SWIMMING POOLS/BATHING (360) 3.29 1.676 19,104 69.692 59,720 69,692 69,664 130,160 138.608 268.768 BIOMEDICAL WASTE SERVICES (364) 1.07 852 915 21,704 19,599 21,704 21.497 84,704 0 84,704 TANNING FACILITY SERVICES (369) 0.00 17 47 1,047 1.847 2,097 1,748 6,647 92 6,739 Group Total 9.26 3,315 23,533 174,424 159,631 183,974 179,061 461,998 235,092 697,090 Groundwater Contamination STORAGE TANK COMPLIANCE (355) 0.00 0 0 0 0 0 0 0 0 0 SUPER ACT SERVICE (356) 0.03 28 38 1,557 1,334 1,557 1.556 6.004 0 6,004 Group Total 0.03 28 38 1,557 1,334 1,557 I,556 6,004 0 6,004 Community Hygiene TATTOO FACILITIES SERVICES 0.27 0 41 4,702 4,030 4,702 4,701 18,135 0 18.135 COMMUNITY ENVIR. HEALTH (345) 0.00 0 0 0 0 0 0 0 0 0 INJURY PREVENTION (346) 0.00 0 0 0 0 0 0 0 0 0 LEAD MONITORING SERVICES (350) 0.00 0 0 0 0 0 0 0 0 0 PUBLIC SEWAGE (362) 0.00 0 0 0 0 0 0 0 0 0 SOLID WASTE DISPOSAL (363) 0.00 0 0 0 0 0 0 0 0 0 SANITARY NUISANCE (365) 0.01 4 11 208 179 208 209 406 398 804 RABIES SURVEILLANCE/CONTROL SERVICES (366) 0.00 0 0 0 0 0 0 0 0 0 ARBOVIRUS SURVEILLANCE (3,67) 0.00 0 0 0 0 0 0 0 0 0 RODENTIARTHROPOD CONTROL (368) 0.00 0 0 28 24 28 27 54 53 107 WATER POLLUTION (370) 0.00 0 0 0 0 0 0 0 0 0 INDOOR AIR (371) 0.00 0 0 0 0 0 0 0 0 0 RADIOLOGICAL HEALTH (372) 0.00 0 0 58 50 58 59 114 111 225 TOXIC SUBSTANCES (373) 0.00 0 0 0 0 0 0 0 0 0 Group Total 0.28 4 52 4,996 4,283 4,996 4,996 18,709 562 19,271 ENVIRONMENTAL HEALTH SUBTOTAL 16.63 5,563 29,147 307152 279,098 322,202 312,237 740.006 480,883 1.220,889 D. NON - OPERATIONAL COSTS: NON-OPERATIONAL COSTS (599) 0.00 0 0 1,800 335 200 3,350 5,685 0 5,685 ENVIRONMENTAL HEALTH SURCHARGE (399) 0.00 0 0 3.000 3,000 13,500 24,000 43,500 0 43,500 MEDICAID BUYBACK (611) 0.00 0 0 5.533 5,532 5,532 5.532 0 22,129 22,129 NON - OPERATIONAL COSTS SUBTOTAL 0.00 0 0 ►0,333 8,867 19.232 32.882 49.t&S 22,129 71,314 TOTAL CONTRACT 170.47 55112 527,735 3.217,631 2,769,566 3.231-180 3,144,016 7,243.057 5,119,536 12,362,593 ��ersion: 4 Packet Page -1574- Page 2 of 2 jr 11/12/2013 16.D.9. 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: 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. 22 Packet Page -1575- G-1 11/12/2013 16.D.9. ATTACHMENT IV COLLIER COUNTY HEALTH DEPARTMENT FACILITIES UTILIZED BY THE COUNTY HEALTH DEPARTMENT Facility Descnntion Collier County Health Department & Public Services Building H Immokalee Satellite Golden Gate WIC Office CCHD Annex Location 3339 E. Tamiami Trail Building H, Naples 419 North First Street Immokalee Owned By Collier County Collier County 4945 Golden Gate Parkway Benderson Unit 102, Naples Development 3205 Beck Blvd Naples Packet Page -1576- Florida Department of Environmental Protection 23 11/12/2013 16.D.9. 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 2011 -2012 2012 -2013 2013 -2014 2014 -2015 2015 -2016 PROJECT TOTAL STATE $ 0 $ 0 $ 0 $ $ 0 SPECIAL PROJECT CONSTRUCTION/RENOVATION PLAN PROJECT NAME: LOCATION/ ADDRESS: PROJECT TYPE: NEW BUILDING _ ROOFING _ RENOVATION PLANNING STUDY _ NEW ADDITION OTHER SQUARE FOOTAGE: PROJECT SUMMARY: Describe scope of work in reasonable detail. ESTIMATED PROJECT INFORMATION: START DATE (rniUai expenditure of funds): COMPLETION DATE: DESIGN FEES: CONSTRUCTION COSTS: FURNITURE/EQUIPMENT TOTAL PROJECT COST: COST PER SO FOOT: $ $ #DIV /01 TOTAL $ 0 $ 0 Special Capital Projects are new construction or renovation projects and new furniture or equipment associated with these projects and mobile health vans. 24 Packet Page -1577- 0--,(