HEALTH CARE FOR THE HOMELESS CO-APPLICANT BOARD MEETING AGENDA

Transcription

1 HEALTH CARE FOR THE HOMELESS CO-APPLICANT BOARD HHS HRSA PINELLAS COUNTY BOARD OF COUNTY COMMISSIONERS HEALTH CARE FOR THE HOMELESS GRANT #H80CS00024 MEETING AGENDA NOVEMBER 7, :00 PM 5:00 PM JUVENILE WELFARE BOARD, TH STREET N, CLEARWATER FL CONFERENCE CALL-IN: DIAL ; PASSCODE: TRAINING HCH Co-Applicant Boards: Strategies for Success Presented by the National Health Care for the Homeless Council 1. Chairman s Report i) Declaration of Conflicts of Interest ii) Approval of Minutes, October 3, Action/Vote iii) Unfinished Business/Follow-Up 2. Governance/Operations i) Site Visit Actions for Approval Daisy Rodriguez Update on Conditions (3/7 submitted; 3/7 lifted)... Informational Written Referral Agreement w/doh... Informational Credentialing & Privileging Policy & Procedure... Action/Vote ii) HCH Performance Dashboard Review Elisa DeGregorio... Informational iii) MMU/Bayside Health Clinic Calendar Melissa VanBruggen... Informational iv) Client Satisfaction Survey Results/Benchmarks Rhonda O Brien... Informational 3. Fiscal i) Notice of Awards (16-07; 16-08; 16-09; 16-10) Elisa DeGregorio... Action/Vote ii) New Funding Opportunities Elisa DeGregorio... Action/Vote 4. Clinical i) Credentialing & Privileging of Additional Providers Dr. Ravindra... Action/Vote Behavioral Health Providers/Attestation Letters ii) HCH Client Trend Reports Rhonda O Brien... Informational Medical No-Show Rates Dental 5. Other Updates i) HCH Monthly Update/Newsletter... Informational ii) New Business... Informational Adjournment Next Meeting: Tuesday, December 5, 3:00 pm Juvenile Welfare Board, th Street N., Clearwater, FL 33760

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3 Agenda: Health Care for the Homeless Co-Applicant Boards: Strategies for Success Pinellas County Health Care for the Homeless Program November 7, 2017 Welcome, Introductions Co-Applicant Board Requirements 101 Case Studies and Pro-Tips for Co-Applicant Board Effectiveness o David Modersbach: Alameda County, Oakland, CA o Stephanie Abel: Hennepin County, Minneapolis, MN Best Practices in Consumer Board Leadership: Katherine Cavanaugh Group Discussion/Q&A Speakers: David Modersbach: Grants Manager at Alameda County Health Care for the Homeless Program, Oakland, CA Stephanie Abel: Manager Integrated Care at Hennepin County Public Health, Minneapolis, MN Katherine Cavanaugh: Consumer Advocate at the National Health Care for the Homeless Council, Baltimore, MD Moderator: Michael Durham: Technical Assistance Manager at the National Health Care for the Homeless Council, Nashville, TN National Health Care for the Homeless Council PO Box Nashville, TN (615)

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5 TAB 1 CHAIRMAN S REPORT Meeting Minutes October 3, 2017

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7 Location of Meeting: Juvenile Welfare Board th Street North Clearwater, FL Minutes of the Monthly Meeting of the Health Care for the Homeless (HCH) Co-Applicant Board October 3, :00 pm Present at Meeting: Valerie Leonard 1, Clare Young (phone), Jerry Wennlund, Dianne Clark, Helen Rhymes and Lt. Haisch. Staff and community members present: Clark Scott, Melissa VanBruggen (phone), Daisy Rodriguez, Elisa DeGregorio, Dale Williams, Meghan Lomas, and Rhonda O Brien (phone). ( 1 Consumer) The regular meeting of the HCH Co-Applicant Board was called to order at 3:06 pm. i. Chairman s Report i. Conflicts of Interest: Ms. Rodriguez requested Board members review the agenda and notice and potential conflicts of interest. Dianne Clark noted a potential conflict with the Budget Period Progress Report agenda item. ii. iii. Approval of Minutes: A motion to approve the September meeting minutes was made by Jerry Wennlund and seconded by Clare Young. The Board unanimously approved the minutes. Unfinished Business/Follow-Up: none I. Governance/Operations i. Change in Scope: Ms. Rodriguez informed the Board that the Change in Scope was one of the items identified by the Site Visit as needing to be updated. Staff continue discussions with the PO regarding our understanding of the Scope of Project. Ms. Rodriguez reviewed each of the changes presented on the sheet provided in the meeting packet and detailed below. Ms. DeGregorio further explained to the Board the meanings of each Column on this form. She informed the Board that staff have spent a lot of time reviewing the scope and the County s relationships (contractual/referral) related to each of the services. We feel the Scope presented to the Board is the most appropriate reflection of the services and how they are provided at the Health Center. The following changes were proposed to the BOD for their consideration: a. Delete General Primary Care from Column I (as Pinellas County staff do not provide this service; remains in Column II for DOH). b. Delete Well Child services from Column II; and Add it to Column III as these services are provided by referral DOH, but since the services are not paid for by the Health Center, this would most appropriately align with Column III. c. Delete HCH Required Substance Abuse Services from Column III as we contract and pay for Substance Abuse Services currently. d. Delete Case Management from Column I and Column III, and keep the service in Column II. e. Delete Health Education from Column I and keep the service in Column II.

8 f. Add Outreach to Column II as DOH staff also provide this service in addition to Human Services staff. g. Delete Transportation from Column I and Add it to Column II as the County contracts with PSTA for transportation services (bus passes). h. Delete Translation from Column I, as DOH contracts for translation services for health center clients. i. Delete Mental Health Services from Column III, keeping it in Column II as DOH subcontracts for this service. j. Delete the Additional Service of Environmental Health Services completely from the Scope. Ms. Rodriguez reviewed the definition of this service and confirmed that we do not make referrals for this service for HCH clients. The question has been posed to the Project Officer regarding the removal of the Additional Service and staff hope to have clear guidance on Friday, when we speak to the PO. k. Delete Occupational Therapy from Column III, and Add it to Column II as this service is included with the County s contract with BayCare Home Care. l. Delete the Additional Service of Additional Enabling/Supportive Services completely from the Scope. Ms. Rodriguez reviewed the definition of this service and confirmed that we do not make referrals for this service for HCH clients. A motion was made by Jerry Wennlund to accept the Change in Scope as presented. The motion was seconded by Dianne Clark and unanimously approved by the Board. ii. HCH Performance Dashboard Review: Ms. DeGregorio presented the Board with the dashboard and explained this contains current data through August Last month s dashboard was missing a month s worth of data due to Irma s impact on staffing. Ms. DeGregorio walked through each item presented on the dashboard. Clinical Performance Measures are for the first two quarters of the year. These items are continuously monitored throughout the year by the QI team. Question was posed, What is Ischemic Vascular Disease? Ms. O Brien responded this covers certain heart diseases for which the appropriate treatment is the administration of blood thinners. The back of the dashboard addresses behavioral health services. Starting with Medication Assisted Treatment (MAT), which is displayed as quarterly data. The AHCA data was a previous grant. Once a new contract is finalized, updated data will be included here. Ms. DeGregorio informed the Board that any feedback is appreciated. Mr. Wennlund indicated the presentation of the dashboard is very clear, and trends can be seen. The inquiry was posed to the Board as to how they would like the dashboard presented moving forward (monthly or quarterly)? The consensus was to provide monthly, as this is being compiled by staff anyways. iii. Strategic Planning/Communications:

9 a. HCH Monthly Update/Newsletter: This is included as an FYI to the Board. If any partners have updates to be included, please share. Ms. Leonard asked if anyone other than herself at Pinellas Hope receives this. Ms. DeGregorio indicated she is unsure of location of those on the distribution list, but there are approximately 180 subscribers now. Ms. Leonard thought posting this at Pinellas Hope could be of benefit. This is more than acceptable, also if the newsletter is shared the new recipient can request to be added to the distribution list. Ms. Rodriguez reminded the team, this newsletter was a direct result from focus groups previously held, in which it was brought up that increased communication would benefit clients. iv. MMU/Bayside Clinic Calendar: Ms. VanBruggen presented the October calendars for Bayside and the MMU. She noted the following: October 12 th both sites will be closed due to DOH staff training; October th MMU services will be inside Bayside will have limited services; October 31 st both sites will be closed for medical, dental will be available at Bayside; and October 19 th Bay Area Legal will be back at Bayside. v. Patient Satisfaction Survey Results/Benchmarks: Ms. O Brien presented the client satisfaction results. There were 50 responses this month, which was pretty good given the closures due to Irma. Question 2 had three (3) never responses, the QI team will be reviewing the verbiage to ensure clients can understand what the question is asking. Question 7 had four (4) never responses. Ms. O Brien believes there may be a relation to the no show rates, as a lot of the missed appointments pertain to lab work follow ups. Ms. Leonard indicated that based upon her discussion with other clients, respondents may be confusing this due to Amy s (nurse) ability to connect with patients. When Amy s discussing these things, clients may not realize she asks certain questions to discuss their health goals. Ms. O Brien indicated she has had conversations with staff to stress the importance of coordinating health goals with the clients and not just writing one down. II. Fiscal i. Pinellas County 2016 Audit: Mr. Scott presented the findings from the Pinellas County audit, specifically the Single Audit as it relates to the review of federal grant funds. The single audit was included in the meeting packet and the full 2016 Certified Audited Financial Report can be found on the County website. In reviewing the single audit, Mr. Scott indicated that there was a significant deficiency identified in the audit. The finding was associated with the lack of physical documentations (i.e., an ) regarding the review of charges, the review happened in person for the H80 grant in this instance and reviewed information line by line. The procedures have been modified to address this finding. The audit and information are being provided to provide more transparency to the Board regarding the program s finances. Mr. Wennlund commented he has noticed more questions during single audits than in years past. Ms. Clarke noted that due to HITECH information requirements have increased for audits too. ii. Human Services Budget, HCH Program: Mr. Scott presented a financial report he generates on a monthly basis for management, which includes all Human Services funds, not just the Health Care for the Homeless Program. However, on page 3 of 5 starts with items associated with the Health Care for the Homeless Program (HCHP) - report runs one month behind and the information located in the columns to the right forecast the budget through year end. Starting with October invoices, the staff will be developing a financial report specific to the HCHP that includes all federal and non-federal funds specific to the HCHP. Some contract invoices (i.e., pharmacy) do not differentiate clients based upon participation in the HCHP or the Pinellas County Health Program. Staff are working to develop these splits. The reports presented here address grant

10 iii. iv. funding only. Page 4 of 5 has behavioral health costs, as required to be reported by the State of Florida. Ms. DeGregorio noted that staff efforts are working to make this report more tailored to the HCHP and present the information in a cleaner/easier to understand format. Notice of Awards: No new notices at this time. New Funding Opportunities: Ms. DeGregorio presented the Budget Period Progress Report (BPR). This BPR is to review progress for the current budget period and to present a budget for year 3 of funding. We report on progress from March YTD (grant year) and propose the overall budget for year 3 - $1,414,215 allocated to Pinellas County. Most costs are contractual. Working with Operation PAR as we address substance abuse. Pharmacy costs represented here are for 38% of overall pharmacy costs for Pinellas County clients. The scope within the BPR is associated with the Change in Scope requests discussed earlier in the meeting. Narratives touch on items that impacted the health center, such as Hurricane Irma and the van being out of service mostly due to mechanical and maintenance issues. Goals are presented from the beginning of the grant year (Mar) and from the calendar year to align with UDS targets. Quality Improvement awards have gone mostly to PCMH recognition/requirements and EHR upgrades. DSHII funding is being utilized to integrate data and referrals with behavioral health providers. Ms. DeGregorio noted the Financial Measures narrative has been updated (from the packet) to reflect $1,037 total cost per patient. Financial Measures will be added to the dashboard moving forward. Ms. Clark inquired if the financial cost per patient was benchmarked against private health insurance? No. Ms. DeGregorio explained the health center originally set these goals and had not previously included some non-federal expenses such as pharmacy. Mr. Wennlund indicated his organization utilizes medication samples and reflects these as in-kind contributions. Mr. Scott indicated that the County captures costs of medications, but does not reflect costs associated with medication assistance programs that clients are connected to within the financial reports. Ms. Clark recused herself from this item due to a conflict of interest. Helen Rhymes made a motion to approve submission of the BPR, which was seconded by Lt. Haisch. The Board unanimously approved the BPR submission as presented. III. Clinical i. Credentialing and Privileging of Additional Providers: Dr. Ravindra discussed the re-credentialing of all providers, dentists, and dental hygienists. The delineation of privileges for each provider was presented in the meeting packet. The Medical Executive Committee reviews the information and makes a recommendation for the Board. Jerry Wennlund made a motion to accept the recommendation of the Medical Executive Committee for re-credentialing and grant privileges to the providers presented, which was seconded by Valerie Leonard. The motion was unanimously approved. ii. HCH Client Trend Reports: Medical: Ms. O Brien presented the trend reports. There were 2,390 unduplicated clients with 5,862 encounters. 590 new patients are still necessary to meet target. We need 196 patients per month through the end of the year to meet target. The month of September was lower than normal, possibly due to the Hurricane which closed all sites for 5 days in the month. No-Show Rates: Ms. O Brien presented the No Show report. She noted that due to Irma, these numbers are not an accurate reflection as for 3.5 days of the 5 days the clinic was closed staff did not yet change appointments to canceled, thus they reflect no shows.

11 Dental: Ms. O Brien presented two dental reports. The first is HCHP clients receiving dental services at all dental sites, which may include duplicates clients can be seen at more than one site. The second shows clients just at the Bayside clinic. The inquiry was made regarding the waiting list for dentures. Ms. VanBruggen indicated that there is recurring denture funds, but the wait list is maintained to ensure funds are expended in the fairest way possible. There will be new funds beginning October 1 st. IV. Other Updates i. New Business: Ms. Rodriguez informed the group she had received information from the Federal Association of Community Health Centers regarding victims of Hurricanes Irma and Maria. Given the devastation of homes, for HRSA funding purposes, individuals that lost their homes due to the storms are considered homeless, although they may temporarily be residing with family members. Staff will explore how to document these individuals related to the Hurricane, as needed. The meeting was adjourned at 4:21 pm. The next meeting will be held at 3:00 pm on Tuesday, November 7, 2017, at JWB.

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13 TAB 2 GOVERNANCE/OPERATIONS Site Visit Follow-Up o Referral Agreement o Policies and Procedures HCH Dashboard Monthly Calendar Client Satisfaction Survey Results

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15 HUMAN SERVICES INTERLOCAL AGREEMENT FLORIDA DEPARTMENT OF HEALTH PINELLAS COUNTY THIS INTERLOCAL AGREEMENT is made and entered into by and between PINELLAS COUNTY, a political subdivision of the State of Florida, hereinafter called the "COUNTY," and the FLORIDA DEPARTMENT OF HEALTH, PINELLAS COUNTY HEALTH DEPARTMENT, an agency of the state of Florida providing public health services in Pinellas County, hereinafter called the "PROVIDER." WITNESSETH: WHEREAS, the COUNTY desires to continue to increase access to health care for the low-income uninsured residents of Pinellas County through the Pinellas County Health Program (PCHP) and the Healthcare for the Homeless (HCH) program; and WHEREAS, it is the goal of the COUNTY to increase access to quality healthcare, improve the health outcomes of low-income/high risk individuals, and reduce health disparities in Pinellas County; and WHEREAS, PROVIDER works with the COUNTY to provide health care services to adult (18-64 years) uninsured residents of Pinellas County; and WHEREAS the COUNTY contracts with PROVIDER to provide certain primary, specialty, dental, and behavioral healthcare under a separate contract for compensation; WHEREAS, funding for the HCH program is provided, in part, through a federal grant from the Health Resources and Services Administration (HRSA); and WHEREAS, PROVIDER has agreed to provide Required and Additional referral services for HCH clients in accordance with this Agreement at no cost to the COUNTY; NOW, THEREFORE, the parties hereto do mutually agree as follows:

16 Pinellas County Human Services Funding Agreement 1. Required and Additional Services. PROVIDER agrees to provide the following Required and Additional Services as defined in the HCH Scope of Project (Form 5a) (Attachment 1) by referral agreement: a. Voluntary Family Planning Services: Voluntary family planning services are appropriate counseling on available reproductive options consistent with Federal, state, local laws and regulations. These services may include management/treatment and procedures for a patient's chosen method, e.g., vasectomy, tubal ligation, placement of long-acting reversible contraception (LARC) (IUDs and implants). b. Well Child Services: Well child services are age appropriate preventive care and treatment for newborns through adolescents. At a minimum, these services must include regular/periodic physical exams and measurements; appropriate screenings and tests to assess vision, hearing, oral health, growth and development, and immunization status; and health education and counseling. c. Gynecological Care Services: Gynecological care services are the regular preventive assessment and appropriate treatment of conditions or disorders of the female reproductive system (with the exception of obstetrical services). At a minimum, these services must include pelvic and breast exams, cervical cancer screening, and the review of menstrual and reproductive history and gynecological symptoms. Basic gynecological ultrasounds are included in this category. Services may also include common gynecological procedures (e.g., colposcopy, hysterectomy, fibroid removal). Page 2 of 15

17 Pinellas County Human Services Funding Agreement d. Obstetrical Care Services: Obstetrical care services are the clinical assessment, management/treatment and coordination of services and referrals for the mother and fetus to maximize the outcome of the pregnancy. Such services extend from the mother's diagnosis of pregnancy thru the approximately six-week period following the delivery and can be divided into three components: 1) Prenatal; 2) Intrapartum (labor & delivery); and 3) Postpartum. Services include progressive risk assessments of mother, fetus and the newborn, and must be consistent with the individual health center provider's licensure, credentials, and privileging. i. Prenatal Care Services: Prenatal care services are the care and treatment to both the mother and developing fetus to include ongoing risk assessment and counseling. At a minimum, these services include regular screening (including labs and basic ultrasounds), ongoing monitoring of uterine and fetal growth, risk assessment, and counseling regarding childbirth, nutrition and any identified risks. ii. Intrapartum Care: Intrapartum care (labor & delivery) services are the care of a mother and newborn during labor and birth. At a minimum, these services include ongoing assessment and potential transfer to an appropriate delivery and postnatal care setting for the mother and/or newborn. iii. Postpartum Care: Postpartum care services are the care of the mother during the six-week period after childbirth. At a minimum, these services include the mother's postpartum checkup(s) along with appropriate follow-up treatment and education. Page 3 of 15

18 Pinellas County Human Services Funding Agreement e. Nutrition Services: Nutrition services prevent and treat diseases and conditions through nutritional assessment, diagnosis and treatment. These services may include medical nutrition therapy, nutrition education and counseling, and other interventions to enhance knowledge and impact behaviors related to healthy eating, nutrition and health. These services may include the nutrition services of a WIC program, if the WIC program is within the scope of project. 2. Provider Responsibilities PROVIDER shall require that all referral programs accept patients, provide services as recommended by PROVIDER, and refer the patient back to the health center with appropriate clinical support documentation for follow-up care as follows: a. Require that the referral program acknowledges and accepts referrals from health center staff for the above identified services and is be responsible for providing all health center patients with these services as deemed clinically appropriate upon review and assessment. b. Require that referred services will be made available to all health center patients identified by health center staff as requiring any of the above additional services, regardless of ability to pay. c. Require that all of the above identified services must be offered to health center clients on a sliding fee discount scale which must, at a minimum, be at the same level as the County offers its patients (See Attachment 1). d. Require that any Licensed Independent Practitioner (LIP), or Other Licensed or Certified Provider (OLCP) for the above identified services must be licensed, certified, or registered as verified through a credentialing process in accordance Page 4 of 15

19 Pinellas County Human Services Funding Agreement with applicable Federal, state, and local laws; and are assessed as competent and fit to perform the referred services through a privileging process. Ensure that referral program provides documentation as to such to the health center upon request. e. Require that the referral program provide documentation of the client s services back to the health center at time of discharge, or as appropriate, for follow-up care by the primary care physician. f. Ensure that protected health information (PHI) is managed in accordance with Section 12 herein. 2. Term of Agreement. The services of the AGENCY shall commence on October 1, 2017 and the agreement shall expire on September 30, This Agreement shall automatically renew under the same terms and conditions upon extension of grant funding or new grant award. 3. Performance Measures. The AGENCY agrees to submit a quarterly reports to the COUNTY. The COUNTY reserves the right to amend these data elements, performance measures, or reports as necessary to ensure that the overall programmatic purpose is demonstrated, quantified, and achieved. This report shall be submitted to the COUNTY no later than thirty (30) days following the end of the quarter. Where no activity has occurred within the preceding period, the AGENCY shall provide a written explanation for non-activity during the quarter. The report formats shall be prescribed and provided by the COUNTY. 4. Data Sharing. The AGENCY agrees to share data including as outlined in the Data Sharing Agreement (See Attachment 2) and provide program and other information in an electronic format to the Page 5 of 15

20 Pinellas County Human Services Funding Agreement COUNTY for the sole purpose of data collection, research and policy development. 5. Monitoring. a) AGENCY will comply with COUNTY and departmental policies and procedures. b) AGENCY will cooperate in monitoring site visits including, but not limited to, review of staff, fiscal and client records and provision of related information at any reasonable time. c) AGENCY will submit other reports and information in such formats and at such times as may be prescribed by the COUNTY. d) AGENCY will submit reports on any monitoring of the program funded in whole or in part by the COUNTY that are conducted by federal, state or local governmental agencies or other funders. e) If the AGENCY receives accreditation reviews, each accreditation review will be submitted to the COUNTY after receipt by AGENCY. All monitoring reports will be as detailed as may be reasonably requested by the COUNTY and will be deemed incomplete if not satisfactory to the COUNTY as determined in its sole reasonable discretion. Reports will contain the information or be in the format as may be requested by the COUNTY. If approved by the COUNTY, the COUNTY will accept a report from another monitoring agency in lieu of reports customarily required by the COUNTY. 6. Documentation. The AGENCY shall maintain and provide the following documents upon request by the COUNTY within three (3) business days of receiving the request. a. Articles of Incorporation b. AGENCY By-Laws Page 6 of 15

21 Pinellas County Human Services Funding Agreement c. Past 12 months of financial statements and receipts d. Membership list of governing board e. All legally required licenses f. Latest agency financial audit and management letter g. Biographical data on the AGENCY chief executive and program director h. Equal Employment Opportunity Program i. Inventory system (equipment records) j. IRS Status Certification/501 (c) (3) k. Current job descriptions for staff positions l. Match documentation 7. Disaster Response AGENCY will provide the COUNTY with a current copy of their Continuity of Operations Plan. AGENCY will participate in community disaster response operations as requested by the COUNTY. The COUNTY agrees to support previously approved funded programs for a period of at least sixty (60) days after a disaster has been declared, provided the program agrees to address needs for disaster response and recovery efforts as directed by the COUNTY, unless otherwise indicated by a superseding authority. The COUNTY will seek to leverage the skills and services of the AGENCY, as appropriate or applicable, however other disaster duties may be assigned. This period may be extended within the current contract period at the discretion of the Human Services Director. 8. Special Situations. AGENCY agrees to inform COUNTY within one (1) business day of any circumstances or events which may reasonably be considered to jeopardize its capability to continue to meet its Page 7 of 15

22 Pinellas County Human Services Funding Agreement obligations under the terms of this Agreement. Incidents may include, but are not limited to, those resulting in injury, media coverage or public reaction that may have an impact on the AGENCY s or COUNTY s ability to protect and serve its participants, or other significant effect on the AGENCY or COUNTY. Incidents shall be reported to the designated COUNTY contact below by phone or only. Incident report information shall not include any identifying information of the participant. 9. Cancellation. a) The COUNTY reserves the right to cancel this Agreement without cause by giving thirty (30) days prior notice to the AGENCY in writing of the intention to cancel, or with cause if at any time the AGENCY fails to fulfill or abide by any of the terms or conditions specified. Failure of the AGENCY to comply with any of the provisions of this Agreement shall be considered a material breach of the Agreement and shall be cause for immediate termination of the Agreement at the discretion of the COUNTY. b) In the event the AGENCY uses any funds provided by this Agreement for any purpose or program other than authorized under this Agreement, the AGENCY shall, at the option of the COUNTY, repay such amount and be deemed to have waived the privilege of receiving additional funds under this Agreement. c) In the event sufficient budgeted funds are not available for a new fiscal period or are otherwise encumbered, the COUNTY shall notify the AGENCY of such occurrence and the Agreement shall terminate on the last day of the then current fiscal period without penalty or expense to the COUNTY. 10. Assignment/Subcontracting. a) This Agreement, and any rights or obligations hereunder, shall not be assigned, Page 8 of 15

23 Pinellas County Human Services Funding Agreement transferred or delegated to any other person or entity. Any purported assignment in violation of this section shall be null and void. b) The AGENCY is fully responsible for completion of the Services required by this Agreement and for completion of all subcontractor work, if authorized as provided herein. The AGENCY shall not subcontract any work under this Agreement to any subcontractor other than the subcontractors specified in the proposal and previously approved by the COUNTY, without the prior written consent of the COUNTY, which shall be determined by the COUNTY in its sole discretion. 11. Amendment/Modification. In addition to applicable federal, state and local statutes and regulations, this Agreement expresses the entire understanding of the parties concerning all matters covered herein. No addition to, or alteration of, the terms of this Agreement, whether by written or verbal understanding of the parties, their officers, agents or employees, shall be valid unless made in the form of a written amendment to this Agreement and formally approved by the parties. Budget modifications that do not result in an increase of funding, change the purpose of this Agreement or otherwise amend the terms of this Agreement shall be submitted in the format prescribed and provided by the COUNTY 12. HIPAA a) The AGENCY agrees to execute a HIPAA Business Associate Agreement upon execution of this Agreement. b) The AGENCY is a Covered Entity and agrees to use and disclose Protected Health Information in compliance with the Standards for Privacy, Security and Breach Notification of Individually Identifiable Health Information (45 C.F.R. Parts 160 and 164) under the Health Page 9 of 15

24 Pinellas County Human Services Funding Agreement Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH Act) and shall disclose any policies, rules or regulations enforcing these provisions upon request. 13. Business Practices. a) The AGENCY shall utilize financial procedures in accordance with generally accepted accounting procedures and Florida Statutes, including adequate supporting documents, to account for the use of funds provided by the COUNTY. b) The AGENCY shall retain all records (programmatic, property, personnel, and financial) relating to this Agreement for three (3) years after final payment is made. c) All AGENCY records relating to this Agreement shall be subject to audit by the COUNTY and shall be subject to the applicable provisions of the Florida Public Records Act, chapter 119, Florida Statutes. In addition, the AGENCY shall provide an independent audit to the COUNTY, if so requested by the COUNTY. 14. Nondiscrimination. a) The AGENCY shall not discriminate against any applicant for employment or employee with respect to hire, tenure, terms, conditions or privileges of employment or any matter directly or indirectly related to employment or against any client because of age, sex, race, ethnicity, color, religion, national origin, disability, marital status, or sexual orientation. b) The AGENCY shall not discriminate against any person on the basis of age, sex, race, ethnicity, color, religion, national origin, disability, marital status or sexual orientation in admission, treatment, or participation in its programs, services and activities. Page 10 of 15

25 Pinellas County Human Services Funding Agreement c) The AGENCY shall, during the performance of this Agreement, comply with all applicable provisions of federal, state and local laws and regulations pertaining to prohibited discrimination. d) At no time will clients served under this Agreement be segregated or separated in a manner that may distinguish them from other clients being served by the AGENCY. 15. Interest of Members of County and Others. No officer, member, or employee of the COUNTY, and no member of its governing body, and no other public official of the governing body of any locality in which the program is situated or being carried out who exercises any functions or responsibility in the review or approval of the undertaking or carrying out of this program, shall participate in any decisions relating to this Agreement which affect his/her personal interest or the interest of any corporation, partnership, or association in which he/she is, directly or indirectly, interested; nor shall any such officer, member, or employee of the COUNTY, or any member of its governing body, or public official of the governing body, or public official of the governing body of any locality in which the program is situated or being carried out, who exercises any functions or responsibilities in the review or approval of the undertaking or carrying out of this program, have any interest, direct or indirect, in this Agreement or the proceeds thereof. 16. Conflict of Interest. The AGENCY shall promptly notify the COUNTY in writing of any business association, interest, or other circumstance which constitutes a conflict of interest as provided herein. If the AGENCY is in doubt as to whether a prospective business association, interest, or other circumstance constitutes a conflict of interest, the AGENCY may identify the prospective business association, interest or circumstance, the nature of work that the AGENCY may undertake and Page 11 of 15

26 Pinellas County Human Services Funding Agreement request an opinion as to whether the business association, interest or circumstance constitutes a conflict of interest if entered into by the AGENCY. The COUNTY agrees to notify the AGENCY of its opinion within (10) calendar days of receipt of notification by the AGENCY, which shall be binding on the AGENCY. 17. Independent Contractor. It is expressly understood and agreed by the parties that AGENCY is at all times hereunder acting and performing as an independent contractor and not as an agent, servant, or employee of the COUNTY. No agent, employee, or servant of the AGENCY shall be, or shall be deemed to be, the agent or servant of the COUNTY. None of the benefits provided by the COUNTY to their employees including, but not limited to, Worker s Compensation Insurance and Unemployment Insurance are available from COUNTY to the employees, agents, or servants of the AGENCY. 18. Governing Law. The laws of the State of Florida shall govern this Agreement. 19. Public Records. The AGENCY acknowledges that information and data it manages as part of the services may be public records in accordance with Chapter 119, Florida Statutes and Pinellas County public records policies. The AGENCY agrees that prior to providing services it will implement policies and procedures to maintain, produce, secure, and retain public records in accordance with applicable laws, regulations, and the AGENCY policies, including but not limited to the Section , Florida Statutes. Notwithstanding any other provision of this Agreement relating to compensation, the AGENCY agrees to charge any third parties requesting public records only such fees allowed by Section , Florida Statutes, and County policy for locating and producing public records during the term of this Agreement. Page 12 of 15

27 Pinellas County Human Services Funding Agreement 20. Conformity to the Law. The AGENCY shall comply with all federal, state and local laws and ordinances and any rules or regulations adopted thereunder. 21. Prior Agreement, Waiver, and Severability. This Agreement supersedes any prior Agreements between the Parties and is the sole basis for agreement between the Parties. The waiver of either party of a violation or default of any provision of this Agreement shall not operate as, or be construed to be, a waiver of any subsequent violation or default hereof. If any provision, or any portion thereof, contained in this Agreement is held unconstitutional, invalid, or unenforceable, the remainder of this Agreement, or portion thereof, shall be deemed severable, shall not be affected, and shall remain in full force and effect. 22. Agreement Management. Pinellas County Human Services designates the following person(s) as the liaison for the COUNTY: Tim Burns Pinellas County Human Services 440 Court Street, 2 nd Floor Clearwater, Florida AGENCY designates the following person(s) as the liaison: Melissa Van Bruggen Florida Department of Health-Pinellas County 205 Dr. Martin Luther King Jr Street, North St. Petersburg, FL (727) extension 4667 Page 13 of 15

28 Pinellas County Human Services Funding Agreement SIGNATURE PAGE FOLLOWS Page 14 of 15

29 Pinellas County Human Services Funding Agreement IN WITNESS WHEREOF, the parties hereto have caused this instrument to be executed on the day and year written below. PINELLAS COUNTY, FLORIDA, by and through its County Administrator By: Mark Woodard Date:, 2017 Florida Department of Health Pinellas County By: Title Date:, 2017 APPROVED AS TO FORM OFFICE OF COUNTY ATTORNEY By: Assistant County Attorney Page 15 of 15

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31 XIII. CREDENTIALING & PRIVILEGING The purpose of the policy and procedure is to assure that all Health centers assess the credentials of each licensed or certified health care practitioner to determine if they meet Health Center standards. This applies to all health center practitioners, employed or contracted, volunteers and locum tenens, at all health center sites. This policy and procedure was updated to meet the requirements in the Bureau of Primary Care s Compliance Manual, Chapter 5: Clinical Staffing released on August 28, 2017 and reviewed and approved by the Quality Improvement Committee and HCH Co Applicant Board. DEFINITIONS Credentialing is the process of assessing and confirming the license or certification, education, training, and other qualifications of a licensed or certified health care practitioner. Fitness for Duty means the ability to perform the duties of the job in a safe, secure, productive, and effective manner. Commented [DEN1]: Updated to reflect definition in the compliance manual Commented [DEN2]: Added to reflect definition in the compliance manual Licensed or Certified Health Care Practitioner is an individual required to be licensed, registered, or certified by the State of Florida. These individuals included, but are not limited to, physicians, dentists, dental hygienist, nurse practitioners, registered nurses, and certified medical assistants. These are divided into two categories: 1. Licensed Independent Practitioner (LIP): physician, dentists, nurse practitioners or any other individual permitted by law and the organization to provide care and services without direction or supervision, within the scope of the individual s licensed and consistent with individually granted clinical privileges (from Joint Commission on Accreditation of Health care Organizations (JCAHO) Comprehensive Accreditation Manual for Ambulatory Care). 2. Other licensed or Certified Practitioners: An individual who is licensed, registered, or certified but is not permitted by law to provide client care services without direction or supervision. Examples include, but are not limited to medical assistants, licensed practical nurses, and dental assistants. Primary Source Verification is verification by the original source of a specific credential to determine the accuracy of a qualification reported by an individual health care practitioner. Examples of primary source verification include, but are not limited to, direct correspondence, telephone verification, internet verification, and reports from credentials verification organizations. The Education Commission for Foreign Medical Graduates (EDFMG), the American Board of Medical Specialties, the American Osteopathic Association Physician Database, or the American Medical Association (AMA) Masterfile can be used to verify education and training. The use of credentials verification organizations (CVO s) or hospitals that meet JCAHO s Principles of CVO s is also an acceptable method of primary source verification. Privileging or competency is the process of authorizing a licensed or certified health care practitioner s specific scope and content of client care services. This is performed in conjunction with an evaluation of an individual s clinical qualifications and/or performance. Secondary Source Verification is not considered an acceptable form of primary source verification. This method may be used when primary source verification is not required. Examples of secondary source Pinellas County HCHP Policy & Procedure Manual Approved by HCH Co Applicant Board July 2, 2015 (rev )Page 52

32 verification methods include, but are not limited to, the original credential, notarized copy of the credential, a copy of the credential (when the copy is made from an original by approved Health Center staff). RESPONSIBILITY Applicant (LIP or Other Licensed or Certified Practitioner): Completes and provides required documentation for Credentialing and Privileging. Contracted Provider (Human Resources and the Program Hiring manager): Ensures applicant provides all documentation required by the organization, and in accordance with all federal, state, and local laws. Maintains documentation for the initial Credentialing and Privileging, and for the renewals. Makes documentation available for review by health center upon request. Quality Assurance Coordinator: For all contracted providers (within the health center s scope of services)(including non DOH contracted providers), reviews each organization s credentialing and privileging process and documentation to assess compliance. Presents site review to the Medical Executive Committee for review and approval. Commented [DEN3]: Updated to reflect responsibility of all contracted provider organizations; not just DOH. Commented [DEN4]: Adds responsibility to conduct review of all contracted provider organizations within scope. County Medical Director: Reviews and evaluates the DOH tracking templates and supporting documents, and gives approval for submission to the Medical Executive Committee for Credentialing and Privileging. Completes Verification of Fitness Form for DOH staff requesting privileges. Serves on the Medical Executive Committee. Medical Executive Committee: Reviews credentialing verification/attestations and Requests for Clinical Privileges for LIP s and OLCPs to ensure the requested privileges are within the Center s Scope of Project and gives approval. HCH Co Applicant Board: Delegates approval authority to an individual/committee for the review and approval of credentialing and granting of privileges to LIPs and Other Licensed or Certified Providers. Commented [DEN5]: Changed to reflect delegation of authority to Medical Executive Committee or an individual CREDENTIALING REQUIREMENTS FOR EMPLOYEES, INDIVIDUAL CONTRACTORS, VOLUNTEERS For health center employees, individual contractors, or volunteers, the health center will ensure verification of the following for the initial and recurring review (every two years) of credentials for all clinical staff members (licensed independent practitioners, other licensed or certified practitioners, and other clinical staff providing services on behalf of the health center): Commented [DEN6]: Entire section updated to reflect new compliance manual requirements Current Licensure, registration, or certification using a primary source: Education and training for initial credentialing using: o Primary Source for LIPs (unless the State licensing agency, specialty board or registry conducts primary source verification of education and training, the health center is not required to duplicate primary source verification when completing the credentialing process) o Primary or other sources (as determined by the health center) for OLCPs and any other clinical staff. Completion of a query through the National Practitioner Database ( Pinellas County HCHP Policy & Procedure Manual Approved by HCH Co Applicant Board July 2, 2015 (rev )Page 53

33 Clinical staff member s identity for initial credentialing using a government issued picture identification; Drug Enforcement Administration (DEA) registration; and Current documentation of basic life support training, as applicable. PRIVILEGING REQUIREMENTS FOR EMPLOYEES, INDIVIDUAL CONTRACTORS, VOLUNTEERS For health center employees, individual contractors, or volunteers, the health center will conduct privileging as follows for the initial granting and renewal of privileges (every two years) for clinical staff members (licensed independent practitioners, other licensed or certified practitioners, and other clinical staff providing services on behalf of the health center): Commented [DEN7]: Entire section updated to reflect the new compliance manual. Verification of fitness for duty (can be determined by a statement from the individual that is confirmed either by the director of a training program, chief of staff/services at a hospital where privileges exist, or a licensed physician designated by the organization. (See Sample Health Fitness Form, Appendix O, and Verification of Fitness Form, Appendix P.) Verification of immunization and communicable disease status (The Health Center utilizes the State of Florida s recommendations/standards for provider immunization and communicable disease screening); and For initial privileging, verification of current clinical competence via training, education, and as available, reference reviews. For renewal of privileges, verification of clinical competence via peer review or other comparable methods (for example, supervisory performance reviews) CREDENTIALING & PRIVILEGING OF CONTRACTED PROVIDERS 1. For all other contracted organizations providing clinical care within the health center s approved scope of services who employ Licensed Independent Practitioners and/or other licensed or certified health care practitioners will ensure that such providers are: a. Licensed, certified, or registered as verified through a credentialing process, in accordance with applicable Federal, state, and local laws; and b. Competent and fit to perform the contracted or referred services, as assessed through a privileging process. 2. All contracted providers within the health center s approved scope of services who employ Licensed Independent Practitioners and Other Licensed or Certified Health Care Practitioners, in accordance with contract terms and conditions, will be subject to a review of the organization s credentialing and privileging processes with documentation review by the health center s designated organization (the FL Department of Health in Pinellas County) at least once during the contract period term, or at a minimum every three (3) years. The findings from the credentialing and privileging review will be presented to the Medical Executive Committee for review and acceptance. Commented [DEN8]: Updated to reflect the new Compliance Manual Other Licensed or Certified Health Care Practitioners Commented [DEN9]: Original text to be replaced by above Pinellas County HCHP Policy & Procedure Manual Approved by HCH Co Applicant Board July 2, 2015 (rev )Page 54

34 1. Credentialing of other licensed or certified health care practitioners includes primary source verification of the individual s licensed, registration, or certification only. Education and training will include secondary source verification methods. Verification of current competence is accomplished through a thorough review of clinical qualifications and performance. Secondary source verification of the following will include: Government issued picture identification Immunization and PPD status; Drug Enforcement Administration registration (as applicable) Hospital Admitting privileges (as applicable), and Life support training (as applicable) 2. The Health center will query the national Practitioner Data Bank (NPDB) for each practitioner. 3. The determination that a LIP meets the credentialing requirements will be stated in writing by the Health Center s governing board. Ultimate approval authority is vested in the governing board which may review recommendations from the County Medical Director, or County Health Department Director. PRIVILEGING Privileging requirements will include the following: 1. Initial granting of privileges to LIPs and Other health care practitioners will be performed by the health center with ultimate approval authority vested in the governing board which may review recommendations from the County Medical Director, or Health Department Director, and the Medical Executive Committee. (See Request for Clinical Privileges, Appendix Q and R) 2. For other licensed or certified health care practitioners, privileging may be completed during the orientation process via a supervisory evaluation based on the job description. 3. Temporary privileges may be granted only in very limited circumstances listed below: Temporary privileges can be granted on a case by case basis when there is an important client care need that mandates an immediate authorization to practice for a limited period of time while the full credential information is verified and approved. Examples would include but are not limited to a situation where a physician becomes ill or takes a leave of absence and a LIP would need to cover the practice until their return, or a specific LIP has the necessary skill to provide care to a client that a currently privileged LIP does not have. In these circumstances temporary privileges may be granted by the Medical Director provided there is verification of current licensure and current competence. When an applicant with a completely clean application is awaiting review and approval of the Governing Board. Temporary privileges are not to be used for any other purposes. Temporary privileges may be granted for a limited period of time, not to exceed 120 days, by the Medical Director providing there is a verification of current licensure, relevant training or experience, current competence, and ability to perform the privileges requested. In addition the following must be completed: National practitioner Data Bank query have been obtained and evaluated The applicant has: A complete application No current or previously successful challenges to licensure or registration Pinellas County HCHP Policy & Procedure Manual Approved by HCH Co Applicant Board July 2, 2015 (rev )Page 55

35 Not been subject to involuntary termination of medical staff membership at another organization Not been subject to involuntary limitation, reduction, denial, or loss of clinical privileges. Privileging revision or renewal requirements are as follows: The revision or renewal of a LIP s privileges will occur at least every 2 years and will include primary verification of expiring or expired credentials a synopsis of peer review results for the 2 year period and/or any relevant performance improvement information. Similar to the initial granting of privileges, approval of subsequent privileges is vested in the governing board which may review recommendations from the County Medical Director, or County Health Department Director and Medical Executive Committee. The revision or renewal of privileges of other licensed or certified health care practitioners will occur at a minimum of every 2 years. Verification is by supervisory evaluation of performance that assures that the individual is competent to perform the duties described in the job description. DENIAL, MODIFYING OR REMOVING OF PRIVILEGES Appeals: For health center employees, individual contractors, and volunteers, the heath center has an appeals process for LIP s and certified health care practitioners if a decision is made to discontinue or deny clinical privileges. The appeals process includes the following: o The provider may request to see any applicable information relating to a privileging decision. o The appeal request must be in writing to the Medical Director. o The Medical Director will review the case a second time. o The Medical Director will discuss the case with the provider. o Individual information may be presented to the Medical Director, and the Medical Executive Committee to make an executive decision regarding a practitioner. Contracted Provider Organizations: Upon final review of a contracted provider s credentialing and privileging process, and if the organization s review is negative, the Medical Executive Committee may recommend to the health center to further investigate the organization to ensure compliance with the Terms and Conditions of the contracted providers Contract/Referral Agreement. The Medical Executive Committee may choose to suspend, or temporarily extend the approval period until a further investigation is conclusive and complete. The Medical Executive Committee has discretion as to the terms of the suspension or temporary privileges. Commented [DEN10]: New section in reference to review of contracted providers site review and follow up. Pinellas County HCHP Policy & Procedure Manual Approved by HCH Co Applicant Board July 2, 2015 (rev )Page 56

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37 Co Applicant Board October 2017 Mobile Medical Unit and Bayside Health Clinic HCH Medical Data Total Enrolled HCH Clients Appointment Data January October 32% 63% 5% Oct 16 Nov 16 Dec 16 Jan 17 Feb 17 Mar 17 Apr 17 May 17 Jun 17 Jul 17 Aug 17 Sep 17 Oct 17 Kept Appointments Cancelled/ Rescheduled No Show Source: FL DOH Unique # of Medical Clients Seen (Goal: 2980) Medical Encounters Jan 17 Feb 17 Mar 17 Apr 17 May 17 Jun 17 Jul 17 Aug 17 Sep 17 Oct 17 # Unique MMU Clients # Unique Bayside Clients Monthly Cumulative Source: FL DOH Cumulative HCH Dental Data Jan 17 Feb 17 Mar 17 Apr 17 May 17 Jun 17 Jul 17 Aug 17 Sep 17 Oct # MMU Medical Encounters # Bayside Medical Encounters Monthly Cumulative Cumulative Source: FL DOH Unique # of Dental Clients Seen (Goal: 300) Dental Encounters Jan 17 Feb 17 Mar 17 Apr 17 May 17 Jun 17 Jul 17 Aug 17 Sep 17 Oct Cumulative Jan 17 Feb 17 Mar 17 Apr 17 May 17 Jun 17 Jul 17 Aug 17 Sep 17 Oct Cumulative Dental Clients Cumulative Clients Source: FL DOH Dental Encounters Cumulative Dental Encounters Source: FL DOH Client Satisfaction Survey All Site January through October % % 80% 70% 69% 84% 64% 75% 88% 90% 86% 92% 82% 90% 78% 84% 85% 76% 73% 80% 78% 86% 82% 90% % % 40% % 20% 10% 0% 20% 8% 3% 1: Appt As Soon as Needed 18% 10% 9% 2: Afterhours Answers Medical Questions 14% 12% 12% 12% 10% 9% 10% 11% 10% 7% 6% 8% 1% 3% 4% 6% 1% 1% 2% 3% 4% 5% 3% 2% 3: Dr. Explaination Easily Understood 4: Staff Listen Carefully 5: Follow Up on Test Results 6: Staff Informed of Specialist Care 7: How Often Staff Talked About Goals 8: How Often Talk of Personal Problems 9: Frequency of Useful Information Source: EMS Data 10: Frequency of Overall Satisfaction Always Percent Usually Percent Sometimes Percent Never Percent Benchmark % Total questions answered Source: EMS Source: Data FL DOH Clinical Performance Measures Preventive Health Screenings and Goals Chronic Disease Management and Goals 120% 100% 80% 60% 40% 20% 0% 49% 50% 49% 100% 98% 99% 25% 25% 27% Cervical Cancer Tobacco Use Colorectal Cancer 90% 80% 92% Adult Weight 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 80% 91% 91% 65% Asthma Treatment Coronary Artery Disease 76% 75% 76% 80% 69% 74% 67% Ischemic Vascular Disease 66% Blood Pressure Control 44% 0% Diabetes Control 50% 51% 57% 57% Depression Screening 2016 Q1 Q3 Goal Source: UDS Report 2016 Q1 Q3 Goal Source: UDS Report Data Source: EMS calls, DOH Report and UDS Report Created by Pinellas County Human Services; Revised BM 9/26/2017

38 Behavioral Health Services MAT Treatment Mental Health Clients Mental Health Encounters Q1 Q2 Q # of clients receving Vivitrol # of clients recceiving Methadone Treatment # of clients receiving Buprenorphine Treatment Cumulative Source: Operation PAR Q1 Q2 Clients Cumulative Clients 2017 Source: Directions and Baycare Q1 Q2 Encounters Cumulative Encounters 2017 Source: Directions and Baycare 2 0 Patients with Behavioral Care Referral Patients with Behavioral Care Encounter Working on process to capture BH referrals 2 0 Series1 Series2 Series1 Series2 AHCA Funded Mental Health Stabilization Grant # of Encounters/Clients BayCare Total Encounters/Clients Total Encounters Total # of Clients *Average # of Encounters per Client 1.2 Source: AHCA Dashboard Referred to Agency VA PEMHS PCP ER/Hospital Refused N/A, Blank Windmoore Westcare Operation PAR Suncoast (Existing Client/Appt) Directions for Living Outpatient Services Psychiatrist (Community/Private) Existing Client Community Provider/Resources Boley/Boley FACT Baker Act Facility Other BayCare Referred to by Encounter June 2016 June # of Encounters 512 Source: AHCA Dashboard Assessment Outcomes/Interventions Interventions Assessment Outcomes BayCare Assessment Outcomes/Interventions % of Encounters per Outcome/Intervention 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Baker Act Stabilized Medication Management Case Management Therapy Refused NA Other Source: AHCA Dashboard Source: FL DOH Data Source: Monthly Report BayCare, Directions, AHCA Dashboard and DOH

39 November 2017 Mobile Medical Unit Calendar Monday Tuesday Wednesday Thursday Friday 1 No Services Staff Training 2 No Services Staff Training 3 St. Petersburg Salvation Army One Stop th St. South St. Petersburg, FL :30 AM 4:00 PM 6 Clearwater HEP 1051 Holt Ave. Clearwater, FL :30 AM 12:00 PM Staff meeting 1:30 pm - 4:00 pm 7 St. Petersburg SVDP Center of Hope th St. North St. Petersburg, FL :30 AM 5:00 PM 8 Clearwater Pinellas Hope th Ave. North Clearwater, FL :30 AM 5:00 PM 9 St. Petersburg Salvation Army ARC th St. North St. Petersburg, FL :30 AM 5:00 PM 10 No Services Veterans Day Observed 13 Clearwater HEP 1051 Holt Ave. Clearwater, FL :30 AM 5:00 PM 14 St. Petersburg SVDP Center of Hope th St. North St. Petersburg, FL :30 AM 5:00 PM 15 Clearwater Pinellas Hope th Ave. North Clearwater, FL :30 AM 5:00 PM 16 St. Petersburg Salvation Army ARC th St. North St. Petersburg, FL :30 AM 5:00 PM 17 St. Petersburg Salvation Army One Stop th St. South St. Petersburg, FL :30 AM 4:00 PM 20 Clearwater HEP 1051 Holt Ave. Clearwater, FL :30 AM 5:00 PM 21 St. Petersburg SVDP Center of Hope th St. North St. Petersburg, FL :30 AM 5:00 PM 22 Clearwater Pinellas Hope th Ave. North Clearwater, FL :30 AM 5:00 PM 23 No Services Thanksgiving Holiday 24 No Services Thanksgiving Holiday 27 Clearwater HEP 1051 Holt Ave. Clearwater, FL :30 AM 5:00 PM 28 St. Petersburg SVDP Center of Hope th St. North St. Petersburg, FL :30 AM 5:00 PM 29 Clearwater Pinellas Hope th Ave. North Clearwater, FL :30 AM 5:00 PM 30 St. Petersburg Salvation Army ARC th St. North St. Petersburg, FL :30 AM 5:00 PM **No Appointment Necessary, Walk-ups Preferred** Last appointment 30 minutes before closing time

40 November Bayside Health Clinic Calendar Monday Tuesday Wednesday Thursday Friday Saturday 1 Clearwater Bayside Clinic th St. N. Clearwater, FL :00am 5:00pm No Medical Services Dental & Eligibility Only 2 Clearwater Bayside Clinic th St. N. Clearwater, FL :00am 5:00 pm No Medical Services Dental & Eligibility Only 3 Clearwater Bayside Clinic th St. N. Clearwater, FL :00am 5:00pm 4 Clearwater Bayside Clinic th St. N. Clearwater, FL :00 am - 12:00 pm 6 Clearwater Bayside Clinic th St. N. Clearwater, FL :00 am 12:00 pm 5:00 pm to 8:00 pm Staff meeting 1:30 pm - 4:00 pm 13 Clearwater Bayside Clinic th St. N. Clearwater, FL :00am 8:00pm 7 Clearwater Bayside Clinic th St. N. Clearwater, FL :00am 8:00pm HCH Board Meeting 3:00 pm JWB 8 Clearwater Bayside Clinic th St. N. Clearwater, FL :00am 8:00pm 9 Clearwater Bayside Clinic th St. N. Clearwater, FL :00am 8:00pm 10 No Services Veterans Day Observed 11 No Services Veterans Day 14 Clearwater Bayside Clinic th St. N. Clearwater, FL :00 m 8:00pm 15 Clearwater Bayside Clinic th St. N. Clearwater, FL :00 am 8:00pm 16 Clearwater Bayside Clinic th St. N. Clearwater, FL :00am 8:00pm 17 Clearwater Bayside Clinic th St. N. Clearwater, FL :00am 5:00pm 18 Clearwater Bayside Clinic th St. N. Clearwater, FL :00 am - 12:00 pm 20 Clearwater Bayside Clinic th St. N. Clearwater, FL :00am 8:00pm 21 Clearwater Bayside Clinic th St. N. Clearwater, FL :00am 8:00pm 22 Clearwater Bayside Clinic th St. N. Clearwater, FL :00am 8:00pm Bay Area legal 4 pm to 7 pm 23 No Services Thanksgiving Holiday 24 No Services Thanksgiving Holiday 25 Clearwater Bayside Clinic th St. No. Clearwater, FL :00 am - 12:00 pm 26 Clearwater Bayside Clinic th St. N. Clearwater, FL :00am 8:00pm 27 Clearwater Bayside Clinic th St. N. Clearwater, FL :00am 8:00pm 28 Clearwater Bayside Clinic th St. N. Clearwater, FL :00am 8:00pm 29 Clearwater Bayside Clinic th St. N. Clearwater, FL :00am 8:00pm 30 Clearwater Bayside Clinic th St. N. Clearwater, FL :00 am - 5:00 pm **No Appointment Necessary, Walk-ups Preferred** Last appointment 30 minutes before closing time

41 100% 1. How often did you get an appointment as soon as you needed? Pinellas County l HCHP Patient Satisfaction Survey Results Report October 2017: Total surveys = How often did you get an appointment as soon as you needed? 54 90% 80% 70% 83% 84% 84% % 30 50% 40% 20 30% % 10% 2% 3% 12% N/A Never Sometimes Usually Always 0% Never Sometimes Usually Always

42 Pinellas County l HCHP Patient Satisfaction Survey Results Report October 2017: Total surveys = How often did you get an appointment as soon as you needed? 60 N/A Never Sometimes Usually Always Total Answers SVDP St Pete SVDP Clearwater SA 1 - Stop SA ARC Bayside Pinellas Hope HEP Tarpon

43 100% 90% 2. If you phoned after normal business hours, how often did you get an answer to your medical question as soon as you needed? Pinellas County l HCHP Patient Satisfaction Survey Results Report October 2017: Total surveys = If you phoned after normal business hours, how often did you get an answer to your medical question as soon as you needed? 80% 75% 75% % 63% 60% 20 50% 15 40% 30% % 20% 10% 10% 8% % Never Sometimes Usually Always 0 N/A Never Sometimes Usually Always

44 30 Pinellas County l HCHP Patient Satisfaction Survey Results Report October 2017: Total surveys = If you phoned after normal business hours, how often did you get an answer to your medical question as soon as you needed? N/A Never Sometimes Usually Always Total Answers SVDP St Pete SVDP Clearwater SA 1 - Stop SA ARC Bayside Pinellas Hope HEP Tarpon 0

45 100% 90% 3. How often did the doctor explain things in a way that was easy to understand? Pinellas County l HCHP Patient Satisfaction Survey Results Report October 2017: Total surveys = 67 91% 90% 90% How often did the doctor explain things in a way that was easy to understand? 80% % 60% 50 50% 40 40% 30 30% 20% 20 10% 0% 8% 0% 2% Never Sometimes Usually Always N/A Never Sometimes Usually Always

46 70 Pinellas County l HCHP Patient Satisfaction Survey Results Report October 2017: Total surveys = How often did the doctor explain things in a way that was easy to understand? N/A Never Sometimes Usually Always Total Answers SVDP St Pete SVDP Clearwater SA 1 - Stop SA ARC Bayside Pinellas Hope HEP Tarpon 0

47 100% 90% 4. How often did staff listen to you carefully and show respect for what you had to say? Pinellas County l HCHP Patient Satisfaction Survey Results Report October 2017: Total surveys = 67 91% 92% 92% How often did staff listen to you carefully and show respect for what you had to say? 80% % 60% 50 50% 40 40% 30 30% 20% 20 10% 8% % 0% 2% Never Sometimes Usually Always N/A Never Sometimes Usually Always

48 70 Pinellas County l HCHP Patient Satisfaction Survey Results Report October 2017: Total surveys = How often did staff listen to you carefully and show respect for what you had to say? N/A Never Sometimes Usually Always Total Answers SVDP St Pete SVDP Clearwater SA 1 - Stop SA ARC Bayside Pinellas Hope HEP Tarpon 0

49 100% 5. If you had a blood test, x-ray or other test, how often did someone follow up to give you the results? Pinellas County l HCHP Patient Satisfaction Survey Results Report October 2017: Total surveys = If you had a blood test, x-ray or other test, how often did someone follow up to give you the results? 37 90% 90% 90% 35 80% 80% 30 70% 25 60% 50% % 15 30% % 20% 10% 5 0% 0% 0% Never Sometimes Usually Always N/A Never Sometimes Usually Always

50 Pinellas County l HCHP Patient Satisfaction Survey Results Report October 2017: Total surveys = If you had a blood test, x-ray or other test, how often did someone follow up to give you the results? N/A Never Sometimes Usually Always Total Answers SVDP St Pete SVDP Clearwater SA 1 - Stop SA ARC Bayside Pinellas Hope HEP Tarpon 0

51 90% 80% 6. If you were referred to a specialist for a particular health problem, how often did the staff seem informed and up-to-date about the care you got from the specialist? Pinellas County l HCHP Patient Satisfaction Survey Results Report October 2017: Total surveys = 67 84% 81% 84% If you were referred to a specialist for a particular health problem, how often did the staff seem informed and up-to-date about the care you got from the specialist? 38 70% 35 60% 30 50% 25 40% % 15 20% 17% % 5 0% 0% 2% Never Sometimes Usually Always N/A Never Sometimes Usually Always

52 40 38 Pinellas County l HCHP Patient Satisfaction Survey Results Report October 2017: Total surveys = If you were referred to a specialist for a particular health problem, how often did the staff seem informed and up-to-date about the care you got from the specialist? N/A Never Sometimes Usually Always Total Answers SVDP St Pete SVDP Clearwater SA 1 - Stop SA ARC Bayside Pinellas Hope HEP Tarpon 0

53 100% 90% 80% 7. How often did someone talk to you about specific goals for your health? Pinellas County l HCHP Patient Satisfaction Survey Results Report October 2017: Total surveys = 67 85% 85% 78% How often did someone talk to you about specific goals for your health? 46 70% 35 60% 30 50% 25 40% 20 30% 15 20% 17% % 5% 5 3 0% 0% Never Sometimes Usually Always 0 0 N/A Never Sometimes Usually Always

54 Pinellas County l HCHP Patient Satisfaction Survey Results Report October 2017: Total surveys = How often did someone talk to you about specific goals for your health? N/A Never Sometimes Usually Always Total Answers SVDP St Pete SVDP Clearwater SA 1 - Stop SA ARC Bayside Pinellas Hope HEP Tarpon 0

55 100% 90% 8. How often did someone talk with you about a personal problem, family problem, alcohol use, drug use, or a mental or emotional illness? Pinellas County l HCHP Patient Satisfaction Survey Results Report October 2017: Total surveys = How often did someone talk with you about a personal problem, family problem, alcohol use, drug use, or a mental or emotional illness? 80% 80% 80% 76% % 40 60% % 25 40% 20 30% 15 20% 10% 0% 14% 9% 2% Never Sometimes Usually Always N/A Never Sometimes Usually Always

56 50 Pinellas County l HCHP Patient Satisfaction Survey Results Report October 2017: Total surveys = How often did someone talk with you about a personal problem, family problem, alcohol use, drug use, or a mental or emotional illness? N/A Never Sometimes Usually Always Total Answers SVDP St Pete SVDP Clearwater SA 1 - Stop SA ARC Bayside Pinellas Hope HEP Tarpon 0

57 100% 9. How frequently do you find useful the information provided to you by staff about available Community Resources? Pinellas County l HCHP Patient Satisfaction Survey Results Report October 2017: Total surveys = How frequently do you find useful the information provided to you by staff about available Community Resources? 90% 89% 55 80% 86% 86% 50 70% 40 60% 50% 30 40% 30% 20 20% 10 10% 5% 6% % 0% Never Sometimes Usually Always 0 0 N/A Never Sometimes Usually Always

58 Pinellas County l HCHP Patient Satisfaction Survey Results Report October 2017: Total surveys = How frequently do you find useful the information provided to you by staff about available Community Resources? N/A Never Sometimes Usually Always Total Answers SVDP St Pete SVDP Clearwater SA 1 - Stop SA ARC Bayside Pinellas Hope HEP Tarpon 0

59 100% 10. How often have you been satisfied with the overall services received? Pinellas County l HCHP Patient Satisfaction Survey Results Report October 2017: Total surveys = How often have you been satisfied with the overall services received? 90% 93% 90% 90% % 70% 50 60% 40 50% 30 40% 30% 20 20% 10 10% 6% 4 0% 0% 1% Never Sometimes Usually Always N/A Never Sometimes Usually Always

60 70 Pinellas County l HCHP Patient Satisfaction Survey Results Report October 2017: Total surveys = How often have you been satisfied with the overall services received? Total Answers SVDP St Pete SVDP Clearwater SA 1 - Stop SA ARC Bayside Pinellas Hope HEP Tarpon N/A Never Sometimes Usually Always 0

61 TAB 3 - FISCAL Notice of Award(s) Funding Opportunities

62

63 Page 1 A printer version document only. The document may contain some accessibility challenges for the screen reader users. To access same information, a fully 508 compliant accessible HTML version is available on the HRSA Electronic Handbooks. If you need more information, please contact HRSA contact center at , 8 am to 8 pm ET, weekdays. 1. DATE ISSUED: 10/23/ PROGRAM CFDA: SUPERSEDES AWARD NOTICE dated: 09/12/2017 except that any additions or restrictions previously imposed remain in effect unless specifically rescinded. 4a. AWARD NO.: 6 H80CS b. GRANT NO.: H80CS PROJECT PERIOD: FROM: 11/01/2001 THROUGH: 02/28/ BUDGET PERIOD: FROM: 03/01/2017 THROUGH: 02/28/ FORMER GRANT NO.: H66CS00382 NOTICE OF AWARD AUTHORIZATION (Legislation/Regulation) Public Health Service Act, Title III, Section 330 Public Health Service Act, Section 330, 42 U.S.C. 254b Affordable Care Act, Section Public Health Service Act, Section 330, 42 U.S.C. 254, as amended. Authority: Public Health Service Act, Section 330, 42 U.S.C. 254b, as amended Public Health Service Act, Section 330, 42 U.S.C. 254b, as amended Public Health Service Act, Section 330(e), 42 U.S.C. 254b Section 330 of the Public Health Service Act, as amended (42 U.S.C. 254b, as amended) and Section of The Patient Protection and Affordable Care Act (P.L ) Section 330 of the Public Health Service Act, as amended (42 U.S.C. 254b) Public Health Service Act, Section 330, as amended (42 U.S.C. 254b) Section 330 of the Public Health Service (PHS) Act, as amended (42 U.S.C. 254b, as amended) 8. TITLE OF PROJECT (OR PROGRAM): HEALTH CENTER CLUSTER 9. GRANTEE NAME AND ADDRESS: Pinellas County Board of County Commissioners 315 Court St Clearwater, FL DUNS NUMBER: BHCMIS # APPROVED BUDGET:(Excludes Direct Assistance) [ ] Grant Funds Only [X] Total project costs including grant funds and all other financial participation a. Salaries and Wages : $0.00 b. Fringe Benefits : $0.00 c. Total Personnel Costs : $0.00 d. Consultant Costs : $0.00 e. Equipment : $0.00 f. Supplies : $17, g. Travel : $2, h. Construction/Alteration and Renovation : $0.00 i. Other : $252, j. Consortium/Contractual Costs : $2,831, k. Trainee Related Expenses : $0.00 l. Trainee Stipends : $0.00 m. Trainee Tuition and Fees : $0.00 n. Trainee Travel : $0.00 o. TOTAL DIRECT COSTS : $3,104, p. INDIRECT COSTS (Rate: % of S&W/TADC) : $0.00 q. TOTAL APPROVED BUDGET : $3,104, i. Less Non Federal Share: $1,288, ii. Federal Share: $1,815, DIRECTOR: (PROGRAM DIRECTOR/PRINCIPAL INVESTIGATOR) Daisy Rodriguez Pinellas County Board of County Commissioners 440 Court St Fl 2 Clearwater, FL AWARD COMPUTATION FOR FINANCIAL ASSISTANCE: a. Authorized Financial Assistance This Period $1,815, b. Less Unobligated Balance from Prior Budget Periods i. Additional Authority $209, ii. Offset $0.00 c. Unawarded Balance of Current Year's Funds $0.00 d. Less Cumulative Prior Awards(s) This Budget Period e. AMOUNT OF FINANCIAL ASSISTANCE THIS ACTION $1,605, RECOMMENDED FUTURE SUPPORT: (Subject to the availability of funds and satisfactory progress of project) YEAR TOTAL COSTS 17 $1,414, $ APPROVED DIRECT ASSISTANCE BUDGET:(In lieu of cash) a. Amount of Direct Assistance $0.00 b. Less Unawarded Balance of Current Year's Funds $0.00 c. Less Cumulative Prior Awards(s) This Budget Period $0.00 d. AMOUNT OF DIRECT ASSISTANCE THIS ACTION $ PROGRAM INCOME SUBJECT TO 45 CFR SHALL BE USED IN ACCORD WITH ONE OF THE FOLLOWING ALTERNATIVES: A=Addition B=Deduction C=Cost Sharing or Matching D=Other [D ] Estimated Program Income: $ THIS AWARD IS BASED ON AN APPLICATION SUBMITTED TO, AND AS APPROVED BY HRSA, IS ON THE ABOVE TITLED PROJECT AND IS SUBJECT TO THE TERMS AND CONDITIONS INCORPORATED EITHER DIRECTLY OR BY REFERENCE IN THE FOLLOWING: a. The grant program legislation cited above. b. The grant program regulation cited above. c. This award notice including terms and conditions, if any, noted below under REMARKS. d. 45 CFR Part 75 as applicable. In the event there are conflicting or otherwise inconsistent policies applicable to the grant, the above order of precedence shall prevail. Acceptance of the grant terms and conditions is

64 NOTICE OF AWARD (Continuation Sheet) Date Issued: 10/23/ :03:15 AM Award Number: 6 H80CS acknowledged by the grantee when funds are drawn or otherwise obtained from the grant payment system. REMARKS: (Other Terms and Conditions Attached [ X ]Yes [ ]No) Electronically signed by Sheila Gale, Grants Management Officer on : 10/23/ OBJ. CLASS: CRS EIN: A2 19. FUTURE RECOMMENDED FUNDING: $0.00 FY CAN CFDA DOCUMENT NO. AMT. FIN. ASST. AMT. DIR. ASST. SUB PROGRAM CODE SUB ACCOUNT CODE G H80CS00024 $0.00 $0.00 HCH HealthCareCenters_16 Page 2

65 NOTICE OF AWARD (Continuation Sheet) Date Issued: 10/23/ :03:15 AM Award Number: 6 H80CS HRSA Electronic Handbooks (EHBs) Registration Requirements The Project Director of the grant (listed on this NoA) and the Authorizing Official of the grantee organization are required to register (if not already registered) within HRSA's Electronic Handbooks (EHBs). Registration within HRSA EHBs is required only once for each user for each organization they represent. To complete the registration quickly and efficiently we recommend that you note the 10 digit grant number from box 4b of this NoA. After you have completed the initial registration steps (i.e.,created an individual account and associated it with the correct grantee organization record), be sure to add this grant to your portfolio. This registration in HRSA EHBs is required for submission of noncompeting continuation applications. In addition, you can also use HRSA EHBs to perform other activities such as updating addresses, updating addresses and submitting certain deliverables electronically. Visit to use the system. Additional help is available online and/or from the HRSA Call Center at 877 Go4 HRSA/ Terms and Conditions Failure to comply with the remarks, terms, conditions, or reporting requirements may result in a draw down restriction being placed on your Payment Management System account or denial of future funding. Grant Specific Condition(s) 1. Due Date: Within 120 Days of Award Release Date Due Date: Within 120 Days of Award Release Date CIS Tracking Number: CIS Delete Service: Additional Enabling/Supportive Services Within 120 days of the release date of this award (i.e., the date HRSA ed you this Notice of Award), you MUST verify deletion, as required via the related EHB submission deliverable. To access the deliverable, go to your grant folder/handbook. 2. Due Date: Within 120 Days of Award Release Date Due Date: Within 120 Days of Award Release Date CIS Tracking Number: CIS Delete Service: Well Child Services Within 120 days of the release date of this award (i.e., the date HRSA ed you this Notice of Award), you MUST verify deletion, as required via the related EHB submission deliverable. To access the deliverable, go to your grant folder/handbook. 3. Due Date: Within 120 Days of Award Release Date Due Date: Within 120 Days of Award Release Date CIS Tracking Number: CIS Add Service: Occupational Therapy Within 120 days of the release date of this award (i.e., the date HRSA ed you this Notice of Award), you MUST verify implementation of this CIS, as required via the related EHB submission deliverable. To access the deliverable, go to your grant folder/handbook. Grant Specific Term(s) 1. (CIS Tracking Number: CIS ) This Notice of Award (NoA) reflects approval of a proposed change in scope as of 10/17/2017: Delete Service:Additional Enabling/Supportive Services Verification of deletion (see condition above) is REQUIRED to officially change your scope of project. This change in scope must be supported within the level of grant funds currently awarded. This approval in no way obligates the Health Resources and Services Administration (HRSA) to any future support. 2. (CIS Tracking Number: CIS ) This Notice of Award (NoA) reflects approval of a proposed change in scope as of 10/20/2017: Page 3

66 NOTICE OF AWARD (Continuation Sheet) Date Issued: 10/23/ :03:15 AM Award Number: 6 H80CS Delete Service:Well Child Services Verification of deletion (see condition above) is REQUIRED to officially change your scope of project. This change in scope must be supported within the level of grant funds currently awarded. This approval in no way obligates the Health Resources and Services Administration (HRSA) to any future support. 3. (CIS Tracking Number: CIS ) This Notice of Award (NoA) reflects approval of a proposed change in scope as of 10/21/2017: Add Service:Occupational Therapy Verification of implementation (see condition above) is REQUIRED for your CIS request to be officially included in your scope of project. This change in scope must be supported within the level of grant funds currently awarded. This approval in no way obligates the Health Resources and Services Administration (HRSA) to any future support. All prior terms and conditions remain in effect unless specifically removed. Contacts NoA Address(es): Name Role Daisy Rodriguez Program Director, Point of Contact darodriguez@pinellascounty.org Daisy M Rodriguez Authorizing Official darodriguez@pinellascounty.org Note: NoA ed to these address(es) Program Contact: For assistance on programmatic issues, please contact Clarice Wilkinson at: 5600 Fishers Ln Rockville, MD, cwilkinson@hrsa.gov Phone: (301) Division of Grants Management Operations: For assistance on grant administration issues, please contact Eric Brown at: 5600 Fishers Lane RM 10SWH03 Rockville, MD, Ebrown@hrsa.gov Phone: (301) Page 4

67 Page 1 A printer version document only. The document may contain some accessibility challenges for the screen reader users. To access same information, a fully 508 compliant accessible HTML version is available on the HRSA Electronic Handbooks. If you need more information, please contact HRSA contact center at , 8 am to 8 pm ET, weekdays. 1. DATE ISSUED: 10/23/ PROGRAM CFDA: SUPERSEDES AWARD NOTICE dated: 10/23/2017 except that any additions or restrictions previously imposed remain in effect unless specifically rescinded. 4a. AWARD NO.: 6 H80CS b. GRANT NO.: H80CS PROJECT PERIOD: FROM: 11/01/2001 THROUGH: 02/28/ BUDGET PERIOD: FROM: 03/01/2017 THROUGH: 02/28/ FORMER GRANT NO.: H66CS00382 NOTICE OF AWARD AUTHORIZATION (Legislation/Regulation) Public Health Service Act, Title III, Section 330 Public Health Service Act, Section 330, 42 U.S.C. 254b Affordable Care Act, Section Public Health Service Act, Section 330, 42 U.S.C. 254, as amended. Authority: Public Health Service Act, Section 330, 42 U.S.C. 254b, as amended Public Health Service Act, Section 330, 42 U.S.C. 254b, as amended Public Health Service Act, Section 330(e), 42 U.S.C. 254b Section 330 of the Public Health Service Act, as amended (42 U.S.C. 254b, as amended) and Section of The Patient Protection and Affordable Care Act (P.L ) Section 330 of the Public Health Service Act, as amended (42 U.S.C. 254b) Public Health Service Act, Section 330, as amended (42 U.S.C. 254b) Section 330 of the Public Health Service (PHS) Act, as amended (42 U.S.C. 254b, as amended) 8. TITLE OF PROJECT (OR PROGRAM): HEALTH CENTER CLUSTER 9. GRANTEE NAME AND ADDRESS: Pinellas County Board of County Commissioners 315 Court St Clearwater, FL DUNS NUMBER: BHCMIS # APPROVED BUDGET:(Excludes Direct Assistance) [ ] Grant Funds Only [X] Total project costs including grant funds and all other financial participation a. Salaries and Wages : $0.00 b. Fringe Benefits : $0.00 c. Total Personnel Costs : $0.00 d. Consultant Costs : $0.00 e. Equipment : $0.00 f. Supplies : $17, g. Travel : $2, h. Construction/Alteration and Renovation : $0.00 i. Other : $252, j. Consortium/Contractual Costs : $2,831, k. Trainee Related Expenses : $0.00 l. Trainee Stipends : $0.00 m. Trainee Tuition and Fees : $0.00 n. Trainee Travel : $0.00 o. TOTAL DIRECT COSTS : $3,104, p. INDIRECT COSTS (Rate: % of S&W/TADC) : $0.00 q. TOTAL APPROVED BUDGET : $3,104, i. Less Non Federal Share: $1,288, ii. Federal Share: $1,815, DIRECTOR: (PROGRAM DIRECTOR/PRINCIPAL INVESTIGATOR) Daisy Rodriguez Pinellas County Board of County Commissioners 440 Court St Fl 2 Clearwater, FL AWARD COMPUTATION FOR FINANCIAL ASSISTANCE: a. Authorized Financial Assistance This Period $1,815, b. Less Unobligated Balance from Prior Budget Periods i. Additional Authority $209, ii. Offset $0.00 c. Unawarded Balance of Current Year's Funds $0.00 d. Less Cumulative Prior Awards(s) This Budget Period e. AMOUNT OF FINANCIAL ASSISTANCE THIS ACTION $1,605, RECOMMENDED FUTURE SUPPORT: (Subject to the availability of funds and satisfactory progress of project) YEAR TOTAL COSTS 17 $1,414, $ APPROVED DIRECT ASSISTANCE BUDGET:(In lieu of cash) a. Amount of Direct Assistance $0.00 b. Less Unawarded Balance of Current Year's Funds $0.00 c. Less Cumulative Prior Awards(s) This Budget Period $0.00 d. AMOUNT OF DIRECT ASSISTANCE THIS ACTION $ PROGRAM INCOME SUBJECT TO 45 CFR SHALL BE USED IN ACCORD WITH ONE OF THE FOLLOWING ALTERNATIVES: A=Addition B=Deduction C=Cost Sharing or Matching D=Other [D ] Estimated Program Income: $ THIS AWARD IS BASED ON AN APPLICATION SUBMITTED TO, AND AS APPROVED BY HRSA, IS ON THE ABOVE TITLED PROJECT AND IS SUBJECT TO THE TERMS AND CONDITIONS INCORPORATED EITHER DIRECTLY OR BY REFERENCE IN THE FOLLOWING: a. The grant program legislation cited above. b. The grant program regulation cited above. c. This award notice including terms and conditions, if any, noted below under REMARKS. d. 45 CFR Part 75 as applicable. In the event there are conflicting or otherwise inconsistent policies applicable to the grant, the above order of precedence shall prevail. Acceptance of the grant terms and conditions is

68 NOTICE OF AWARD (Continuation Sheet) Date Issued: 10/23/ :44:07 AM Award Number: 6 H80CS acknowledged by the grantee when funds are drawn or otherwise obtained from the grant payment system. REMARKS: (Other Terms and Conditions Attached [ X ]Yes [ ]No) This NoA is issued to remove one or more Grant Conditions imposed on projects. Electronically signed by Sheila Gale, Grants Management Officer on : 10/23/ OBJ. CLASS: CRS EIN: A2 19. FUTURE RECOMMENDED FUNDING: $0.00 FY CAN CFDA DOCUMENT NO. AMT. FIN. ASST. AMT. DIR. ASST. SUB PROGRAM CODE SUB ACCOUNT CODE G H80CS00024 $0.00 $0.00 HCH HealthCareCenters_16 Page 2

69 NOTICE OF AWARD (Continuation Sheet) Date Issued: 10/23/ :44:07 AM Award Number: 6 H80CS HRSA Electronic Handbooks (EHBs) Registration Requirements The Project Director of the grant (listed on this NoA) and the Authorizing Official of the grantee organization are required to register (if not already registered) within HRSA's Electronic Handbooks (EHBs). Registration within HRSA EHBs is required only once for each user for each organization they represent. To complete the registration quickly and efficiently we recommend that you note the 10 digit grant number from box 4b of this NoA. After you have completed the initial registration steps (i.e.,created an individual account and associated it with the correct grantee organization record), be sure to add this grant to your portfolio. This registration in HRSA EHBs is required for submission of noncompeting continuation applications. In addition, you can also use HRSA EHBs to perform other activities such as updating addresses, updating addresses and submitting certain deliverables electronically. Visit to use the system. Additional help is available online and/or from the HRSA Call Center at 877 Go4 HRSA/ Terms and Conditions Failure to comply with the remarks, terms, conditions, or reporting requirements may result in a draw down restriction being placed on your Payment Management System account or denial of future funding. Grant Specific Term(s) 1. The grant condition stated below on NoA 6 H80CS is hereby lifted. R.6.2 Maintaining Accurate Scope of Project: Health center maintains its funded scope of project (sites, services, service area, target population and providers), including any increases based on recent grant awards. (45 CFR ) Based upon a review of your current scope of project, one or more services, sites, other activities and/or target population are not correctly reflected in the scope of project. Within 90 days, complete the appropriate change in scope (CIS) request/action necessary to correct the scope of project. Once the change in scope is submitted, respond to this condition by uploading a statement documenting the satisfactory completion of the CIS request/action. Please contact your project officer for additional assistance and/or information on the required elements of your response. (45 CFR (a) and 45 CFR ) All prior terms and conditions remain in effect unless specifically removed. Contacts NoA Address(es): Name Role Daisy Rodriguez Point of Contact, Program Director darodriguez@pinellascounty.org Daisy M Rodriguez Authorizing Official darodriguez@pinellascounty.org Note: NoA ed to these address(es) Program Contact: For assistance on programmatic issues, please contact Clarice Wilkinson at: 5600 Fishers Ln Rockville, MD, cwilkinson@hrsa.gov Phone: (301) Division of Grants Management Operations: For assistance on grant administration issues, please contact Eric Brown at: 5600 Fishers Lane RM 10SWH03 Rockville, MD, Ebrown@hrsa.gov Phone: (301) Page 3

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71 Page 1 A printer version document only. The document may contain some accessibility challenges for the screen reader users. To access same information, a fully 508 compliant accessible HTML version is available on the HRSA Electronic Handbooks. If you need more information, please contact HRSA contact center at , 8 am to 8 pm ET, weekdays. 1. DATE ISSUED: 10/26/ PROGRAM CFDA: SUPERSEDES AWARD NOTICE dated: 10/23/2017 except that any additions or restrictions previously imposed remain in effect unless specifically rescinded. 4a. AWARD NO.: 6 H80CS b. GRANT NO.: H80CS PROJECT PERIOD: FROM: 11/01/2001 THROUGH: 02/28/ BUDGET PERIOD: FROM: 03/01/2017 THROUGH: 02/28/ FORMER GRANT NO.: H66CS00382 NOTICE OF AWARD AUTHORIZATION (Legislation/Regulation) Public Health Service Act, Title III, Section 330 Public Health Service Act, Section 330, 42 U.S.C. 254b Affordable Care Act, Section Public Health Service Act, Section 330, 42 U.S.C. 254, as amended. Authority: Public Health Service Act, Section 330, 42 U.S.C. 254b, as amended Public Health Service Act, Section 330, 42 U.S.C. 254b, as amended Public Health Service Act, Section 330(e), 42 U.S.C. 254b Section 330 of the Public Health Service Act, as amended (42 U.S.C. 254b, as amended) and Section of The Patient Protection and Affordable Care Act (P.L ) Section 330 of the Public Health Service Act, as amended (42 U.S.C. 254b) Public Health Service Act, Section 330, as amended (42 U.S.C. 254b) Section 330 of the Public Health Service (PHS) Act, as amended (42 U.S.C. 254b, as amended) 8. TITLE OF PROJECT (OR PROGRAM): HEALTH CENTER CLUSTER 9. GRANTEE NAME AND ADDRESS: Pinellas County Board of County Commissioners 315 Court St Clearwater, FL DUNS NUMBER: BHCMIS # APPROVED BUDGET:(Excludes Direct Assistance) [ ] Grant Funds Only [X] Total project costs including grant funds and all other financial participation a. Salaries and Wages : $0.00 b. Fringe Benefits : $0.00 c. Total Personnel Costs : $0.00 d. Consultant Costs : $0.00 e. Equipment : $0.00 f. Supplies : $17, g. Travel : $2, h. Construction/Alteration and Renovation : $0.00 i. Other : $252, j. Consortium/Contractual Costs : $2,831, k. Trainee Related Expenses : $0.00 l. Trainee Stipends : $0.00 m. Trainee Tuition and Fees : $0.00 n. Trainee Travel : $0.00 o. TOTAL DIRECT COSTS : $3,104, p. INDIRECT COSTS (Rate: % of S&W/TADC) : $0.00 q. TOTAL APPROVED BUDGET : $3,104, i. Less Non Federal Share: $1,288, ii. Federal Share: $1,815, DIRECTOR: (PROGRAM DIRECTOR/PRINCIPAL INVESTIGATOR) Daisy Rodriguez Pinellas County Board of County Commissioners 440 Court St Fl 2 Clearwater, FL AWARD COMPUTATION FOR FINANCIAL ASSISTANCE: a. Authorized Financial Assistance This Period $1,815, b. Less Unobligated Balance from Prior Budget Periods i. Additional Authority $209, ii. Offset $0.00 c. Unawarded Balance of Current Year's Funds $0.00 d. Less Cumulative Prior Awards(s) This Budget Period e. AMOUNT OF FINANCIAL ASSISTANCE THIS ACTION $1,605, RECOMMENDED FUTURE SUPPORT: (Subject to the availability of funds and satisfactory progress of project) YEAR TOTAL COSTS 17 $1,414, $ APPROVED DIRECT ASSISTANCE BUDGET:(In lieu of cash) a. Amount of Direct Assistance $0.00 b. Less Unawarded Balance of Current Year's Funds $0.00 c. Less Cumulative Prior Awards(s) This Budget Period $0.00 d. AMOUNT OF DIRECT ASSISTANCE THIS ACTION $ PROGRAM INCOME SUBJECT TO 45 CFR SHALL BE USED IN ACCORD WITH ONE OF THE FOLLOWING ALTERNATIVES: A=Addition B=Deduction C=Cost Sharing or Matching D=Other [D ] Estimated Program Income: $ THIS AWARD IS BASED ON AN APPLICATION SUBMITTED TO, AND AS APPROVED BY HRSA, IS ON THE ABOVE TITLED PROJECT AND IS SUBJECT TO THE TERMS AND CONDITIONS INCORPORATED EITHER DIRECTLY OR BY REFERENCE IN THE FOLLOWING: a. The grant program legislation cited above. b. The grant program regulation cited above. c. This award notice including terms and conditions, if any, noted below under REMARKS. d. 45 CFR Part 75 as applicable. In the event there are conflicting or otherwise inconsistent policies applicable to the grant, the above order of precedence shall prevail. Acceptance of the grant terms and conditions is

72 NOTICE OF AWARD (Continuation Sheet) Date Issued: 10/26/2017 9:40:11 AM Award Number: 6 H80CS acknowledged by the grantee when funds are drawn or otherwise obtained from the grant payment system. REMARKS: (Other Terms and Conditions Attached [ X ]Yes [ ]No) This NoA is issued to remove one or more Grant Conditions imposed on projects. Electronically signed by Sheila Gale, Grants Management Officer on : 10/26/ OBJ. CLASS: CRS EIN: A2 19. FUTURE RECOMMENDED FUNDING: $0.00 FY CAN CFDA DOCUMENT NO. AMT. FIN. ASST. AMT. DIR. ASST. SUB PROGRAM CODE SUB ACCOUNT CODE G H80CS00024 $0.00 $0.00 HCH HealthCareCenters_16 Page 2

73 NOTICE OF AWARD (Continuation Sheet) Date Issued: 10/26/2017 9:40:11 AM Award Number: 6 H80CS HRSA Electronic Handbooks (EHBs) Registration Requirements The Project Director of the grant (listed on this NoA) and the Authorizing Official of the grantee organization are required to register (if not already registered) within HRSA's Electronic Handbooks (EHBs). Registration within HRSA EHBs is required only once for each user for each organization they represent. To complete the registration quickly and efficiently we recommend that you note the 10 digit grant number from box 4b of this NoA. After you have completed the initial registration steps (i.e.,created an individual account and associated it with the correct grantee organization record), be sure to add this grant to your portfolio. This registration in HRSA EHBs is required for submission of noncompeting continuation applications. In addition, you can also use HRSA EHBs to perform other activities such as updating addresses, updating addresses and submitting certain deliverables electronically. Visit to use the system. Additional help is available online and/or from the HRSA Call Center at 877 Go4 HRSA/ Terms and Conditions Failure to comply with the remarks, terms, conditions, or reporting requirements may result in a draw down restriction being placed on your Payment Management System account or denial of future funding. Grant Specific Term(s) 1. The grant condition stated below on NoA 6 H80CS is hereby lifted. Due Date: Within 120 Days of Award Release Date CIS Tracking Number: CIS Delete Service: Well Child Services Within 120 days of the release date of this award (i.e., the date HRSA ed you this Notice of Award), you MUST verify deletion, as required via the related EHB submission deliverable. To access the deliverable, go to your grant folder/handbook. 2. The grant condition stated below on NoA 6 H80CS is hereby lifted. Due Date: Within 120 Days of Award Release Date CIS Tracking Number: CIS Add Service: Occupational Therapy Within 120 days of the release date of this award (i.e., the date HRSA ed you this Notice of Award), you MUST verify implementation of this CIS, as required via the related EHB submission deliverable. To access the deliverable, go to your grant folder/handbook. 3. The grant condition stated below on NoA 6 H80CS is hereby lifted. Due Date: Within 120 Days of Award Release Date CIS Tracking Number: CIS Delete Service: Additional Enabling/Supportive Services Within 120 days of the release date of this award (i.e., the date HRSA ed you this Notice of Award), you MUST verify deletion, as required via the related EHB submission deliverable. To access the deliverable, go to your grant folder/handbook. 4. This Notice of Award (NoA) confirms the CIS verification as follows: Status: Service Deletion Confirmed Service Deleted Date: 10/23/2017 Verification Tracking No.: SCPV CIS Tracking No.: CIS This service is no longer included in the health center s scope of project: Well Child Services The grant condition stated below on NoA 6 H80CS is hereby LIFTED: Due Date: Within 120 Days of Award Release Date CIS Tracking Number: CIS Delete Service: Well Child Services Within 120 days of the release date of this award (i.e., the date HRSA ed you this Notice of Award), you MUST verify deletion, as required via the related EHB submission deliverable. Page 3

74 NOTICE OF AWARD (Continuation Sheet) Date Issued: 10/26/2017 9:40:11 AM Award Number: 6 H80CS To access the deliverable, go to your grant folder/handbook. 5. This Notice of Award (NoA) confirms the CIS verification as follows: Status: Service Deletion Confirmed Service Deleted Date: 10/23/2017 Verification Tracking No.: SCPV CIS Tracking No.: CIS This service is no longer included in the health center s scope of project: Additional Enabling/Supportive Services The grant condition stated below on NoA 6 H80CS is hereby LIFTED: Due Date: Within 120 Days of Award Release Date CIS Tracking Number: CIS Delete Service: Additional Enabling/Supportive Services Within 120 days of the release date of this award (i.e., the date HRSA ed you this Notice of Award), you MUST verify deletion, as required via the related EHB submission deliverable. To access the deliverable, go to your grant folder/handbook. 6. This Notice of Award (NoA) confirms the CIS verification as follows: Status: Service Addition Confirmed Date Operational in Scope: 10/23/2017 Verification Tracking No.: SCPV CIS Tracking No.: CIS This service is now included in the health center s scope of project: Occupational Therapy The grant condition stated below on NoA 6 H80CS is hereby LIFTED: Due Date: Within 120 Days of Award Release Date CIS Tracking Number: CIS Add Service: Occupational Therapy Within 120 days of the release date of this award (i.e., the date HRSA ed you this Notice of Award), you MUST verify implementation of this CIS, as required via the related EHB submission deliverable. To access the deliverable, go to your grant folder/handbook. All prior terms and conditions remain in effect unless specifically removed. Contacts NoA Address(es): Name Role Daisy M Rodriguez Authorizing Official darodriguez@pinellascounty.org Daisy Rodriguez Program Director, Point of Contact darodriguez@pinellascounty.org Note: NoA ed to these address(es) Program Contact: For assistance on programmatic issues, please contact Clarice Wilkinson at: 5600 Fishers Ln Rockville, MD, cwilkinson@hrsa.gov Phone: (301) Division of Grants Management Operations: For assistance on grant administration issues, please contact Eric Brown at: 5600 Fishers Lane RM 10SWH03 Rockville, MD, Ebrown@hrsa.gov Phone: (301) Page 4

75 Page 1 A printer version document only. The document may contain some accessibility challenges for the screen reader users. To access same information, a fully 508 compliant accessible HTML version is available on the HRSA Electronic Handbooks. If you need more information, please contact HRSA contact center at , 8 am to 8 pm ET, weekdays. 1. DATE ISSUED: 11/01/ PROGRAM CFDA: SUPERSEDES AWARD NOTICE dated: 10/26/2017 except that any additions or restrictions previously imposed remain in effect unless specifically rescinded. 4a. AWARD NO.: 6 H80CS b. GRANT NO.: H80CS PROJECT PERIOD: FROM: 11/01/2001 THROUGH: 02/28/ BUDGET PERIOD: FROM: 03/01/2017 THROUGH: 02/28/ FORMER GRANT NO.: H66CS00382 NOTICE OF AWARD AUTHORIZATION (Legislation/Regulation) Public Health Service Act, Title III, Section 330 Public Health Service Act, Section 330, 42 U.S.C. 254b Affordable Care Act, Section Public Health Service Act, Section 330, 42 U.S.C. 254, as amended. Authority: Public Health Service Act, Section 330, 42 U.S.C. 254b, as amended Public Health Service Act, Section 330, 42 U.S.C. 254b, as amended Public Health Service Act, Section 330(e), 42 U.S.C. 254b Section 330 of the Public Health Service Act, as amended (42 U.S.C. 254b, as amended) and Section of The Patient Protection and Affordable Care Act (P.L ) Section 330 of the Public Health Service Act, as amended (42 U.S.C. 254b) Public Health Service Act, Section 330, as amended (42 U.S.C. 254b) Section 330 of the Public Health Service (PHS) Act, as amended (42 U.S.C. 254b, as amended) 8. TITLE OF PROJECT (OR PROGRAM): HEALTH CENTER CLUSTER 9. GRANTEE NAME AND ADDRESS: Pinellas County Board of County Commissioners 315 Court St Clearwater, FL DUNS NUMBER: BHCMIS # APPROVED BUDGET:(Excludes Direct Assistance) [ ] Grant Funds Only [X] Total project costs including grant funds and all other financial participation a. Salaries and Wages : $0.00 b. Fringe Benefits : $0.00 c. Total Personnel Costs : $0.00 d. Consultant Costs : $0.00 e. Equipment : $0.00 f. Supplies : $17, g. Travel : $2, h. Construction/Alteration and Renovation : $0.00 i. Other : $252, j. Consortium/Contractual Costs : $2,831, k. Trainee Related Expenses : $0.00 l. Trainee Stipends : $0.00 m. Trainee Tuition and Fees : $0.00 n. Trainee Travel : $0.00 o. TOTAL DIRECT COSTS : $3,104, p. INDIRECT COSTS (Rate: % of S&W/TADC) : $0.00 q. TOTAL APPROVED BUDGET : $3,104, i. Less Non Federal Share: $1,288, ii. Federal Share: $1,815, DIRECTOR: (PROGRAM DIRECTOR/PRINCIPAL INVESTIGATOR) Daisy Rodriguez Pinellas County Board of County Commissioners 440 Court St Fl 2 Clearwater, FL AWARD COMPUTATION FOR FINANCIAL ASSISTANCE: a. Authorized Financial Assistance This Period $1,815, b. Less Unobligated Balance from Prior Budget Periods i. Additional Authority $209, ii. Offset $0.00 c. Unawarded Balance of Current Year's Funds $0.00 d. Less Cumulative Prior Awards(s) This Budget Period e. AMOUNT OF FINANCIAL ASSISTANCE THIS ACTION $1,605, RECOMMENDED FUTURE SUPPORT: (Subject to the availability of funds and satisfactory progress of project) YEAR TOTAL COSTS 17 $1,414, $ APPROVED DIRECT ASSISTANCE BUDGET:(In lieu of cash) a. Amount of Direct Assistance $0.00 b. Less Unawarded Balance of Current Year's Funds $0.00 c. Less Cumulative Prior Awards(s) This Budget Period $0.00 d. AMOUNT OF DIRECT ASSISTANCE THIS ACTION $ PROGRAM INCOME SUBJECT TO 45 CFR SHALL BE USED IN ACCORD WITH ONE OF THE FOLLOWING ALTERNATIVES: A=Addition B=Deduction C=Cost Sharing or Matching D=Other [D ] Estimated Program Income: $ THIS AWARD IS BASED ON AN APPLICATION SUBMITTED TO, AND AS APPROVED BY HRSA, IS ON THE ABOVE TITLED PROJECT AND IS SUBJECT TO THE TERMS AND CONDITIONS INCORPORATED EITHER DIRECTLY OR BY REFERENCE IN THE FOLLOWING: a. The grant program legislation cited above. b. The grant program regulation cited above. c. This award notice including terms and conditions, if any, noted below under REMARKS. d. 45 CFR Part 75 as applicable. In the event there are conflicting or otherwise inconsistent policies applicable to the grant, the above order of precedence shall prevail. Acceptance of the grant terms and conditions is

76 NOTICE OF AWARD (Continuation Sheet) Date Issued: 11/1/ :59:17 PM Award Number: 6 H80CS acknowledged by the grantee when funds are drawn or otherwise obtained from the grant payment system. REMARKS: (Other Terms and Conditions Attached [ X ]Yes [ ]No) This NoA is issued to remove one or more Grant Conditions imposed on projects. Electronically signed by Sheila Gale, Grants Management Officer on : 11/01/ OBJ. CLASS: CRS EIN: A2 19. FUTURE RECOMMENDED FUNDING: $0.00 FY CAN CFDA DOCUMENT NO. AMT. FIN. ASST. AMT. DIR. ASST. SUB PROGRAM CODE SUB ACCOUNT CODE G H80CS00024 $0.00 $0.00 HCH HealthCareCenters_16 Page 2

77 NOTICE OF AWARD (Continuation Sheet) Date Issued: 11/1/ :59:17 PM Award Number: 6 H80CS HRSA Electronic Handbooks (EHBs) Registration Requirements The Project Director of the grant (listed on this NoA) and the Authorizing Official of the grantee organization are required to register (if not already registered) within HRSA's Electronic Handbooks (EHBs). Registration within HRSA EHBs is required only once for each user for each organization they represent. To complete the registration quickly and efficiently we recommend that you note the 10 digit grant number from box 4b of this NoA. After you have completed the initial registration steps (i.e.,created an individual account and associated it with the correct grantee organization record), be sure to add this grant to your portfolio. This registration in HRSA EHBs is required for submission of noncompeting continuation applications. In addition, you can also use HRSA EHBs to perform other activities such as updating addresses, updating addresses and submitting certain deliverables electronically. Visit to use the system. Additional help is available online and/or from the HRSA Call Center at 877 Go4 HRSA/ Terms and Conditions Failure to comply with the remarks, terms, conditions, or reporting requirements may result in a draw down restriction being placed on your Payment Management System account or denial of future funding. Grant Specific Term(s) 1. The grant condition stated below on NoA (6 H80CS ) is hereby lifted. R.5.5 Billing and Collections Policies and Procedures: Health center has systems in place to maximize collections and reimbursement for its costs in providing health services, including written billing, credit and collection policies and procedures. (Section 330(k)(3)(F) and (G) of the PHS Act). Within 90 days, provide an action plan detailing the steps the health center will implement in order to comply with having policies and procedures in place that ensure appropriate charging, billing and collections, including updating the schedule of charges if appropriate OR provide board approved documentation that action(s) have been implemented resulting in compliance with this requirement. Please contact your project officer for additional assistance and/or information on the required elements of your response. (45 CFR (a) and 45 CFR ). 2. The grant condition stated below on NoA (6 H80CS ) is hereby lifted. R.3.1 Program Data Reporting Capacity: Health center has systems which accurately collect and organize data for program reporting and which support management decision making. (Section 330(k)(3)(I)(ii) of the PHS Act and 45 CFR ). Within 90 days, provide an action plan detailing the steps the health center will implement in order to comply with assuring appropriate systems are in place to collect data and support program data reporting requirements OR provide documentation that action(s) have been implemented resulting in compliance with this requirement. Please contact your project officer for additional assistance and/or information on the required elements of your response. (45 CFR (a) and 45 CFR ). All prior terms and conditions remain in effect unless specifically removed. Contacts NoA Address(es): Name Role Daisy M Rodriguez Authorizing Official darodriguez@pinellascounty.org Daisy Rodriguez Program Director, Point of Contact darodriguez@pinellascounty.org Note: NoA ed to these address(es) Program Contact: For assistance on programmatic issues, please contact Clarice Wilkinson at: 5600 Fishers Ln Rockville, MD, cwilkinson@hrsa.gov Phone: (301) Division of Grants Management Operations: For assistance on grant administration issues, please contact Eric Brown at: 5600 Fishers Lane RM 10SWH03 Rockville, MD, Ebrown@hrsa.gov Phone: (301) Page 3

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79 TAB 4 CLINICAL MEDICAL EXECUTIVE COMMITTEE REPORT PATIENT TREND REPORT: The medical trend report for September 2017 is attached. NO SHOW REPORT: The No Show report for January September 2017 is attached. DENTAL TREND REPORT: The dental trend report for September 2017 is attached. The 2017 patient target for unduplicated patients is 2,980.

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87 HCHP Trend Report for Unduplicated Patients & Qualified Medical Encounters by RM O'Brien Data source: NextGen EPM 8:50 AM; and 2016 Trend Reports Unduplicated Patients 2017 Totals 2016 Totals Calendar Month Monthly increase, all sites except Bayside Bayside ONLY monthly increase Monthly cumulative including Bayside Monthly cumulative including expanded clinic January February March April May June July August September October November 2157 December Total for year Calendar Month Monthly increase, all sites except Bayside Qualified Medical Encounters 2017 Totals Bayside ONLY monthly increase Monthly cumulative including Bayside 2016 Totals Monthly cumulative including expanded clinic January February March April May June July August September October November 5916 December Total for year

88 HCHP Unduplicated Patients report for CY 2017 by RM O'Brien Data source: NextGen EPM 8:50 AM 2017 Totals Location/Site Unduplicated Patient Count Percentage of Total Unduplicated Patient Count Pinellas Hope 185 7% Bayside % Salvation Army (ARC) 212 8% Salvation Army 1-Stop (St. Petersburg) 192 8% St. Vincent DePaul (Clearwater) 74 3% St. Vincent DePaul (St. Petersburg) 228 9% Homeless Emergency Project (HEP) 77 3% Totals (2559) %

89 HCHP Qualified Medical Encounter report for CY 2017 by RM O'Brien Data source: NextGen EPM 8:50 AM 2017 Totals: Qualified Medical Encounters Location/Site New: Established: Total of New & Established: Percentage of Total New and Established Pinellas Hope % Bayside % Salvation Army ARC % Salvation Army 1-Stop (St. Petersburg) % St. Vincent DePaul (Clearwater) % St. Vincent DePaul (St. Petersburg) % Homeless Emergency Project (HEP) % Totals (6478) %

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91 HCHP No Show Rate October 2017 Location/Site Scheduled Kept Appointments Cancelled/ Rescheduled Number of Shows Percentage Bayside % Homeless Emergency Project (HEP) % Pinellas Hope % Salvation Army (ARC) % Salvation Army 1-Stop (St. Petersburg) % St. Vincent DePaul (Clearwater) St. Vincent DePaul (St. Petersburg) % TS Shepherd Center Totals 1, %

92 HCHP No Show Rate January 2017 to October 2017 Location/Site Scheduled Kept Appointments Cancelled/ Rescheduled Number of No Shows Percentage Bayside 7,560 4, ,721 36% Homeless Emergency Project (HEP) % Pinellas Hope % Salvation Army (ARC) % Salvation Army 1-Stop (St. Petersburg) % St. Vincent DePaul (Clearwater) % St. Vincent DePaul (St. Petersburg) % TS Shepherd Center % Totals , ,591 32%

93 Florida Department of Health in Pinellas County HMS Reports Pointing to Server: CHD52VSSHDW02, Namespace: HMS LOGI Print Menu Button Name - Trend Report for MMU Dental Clients - Report ID# Saved By: DOHUSERS\VerrettAR Date File Saved: T08:31:03 Server Name:chd52vsdblogidev File Name: CountyMedical.MMU.Trend_Report_For_MMU_Dental_Clients Trend Report For MMU Dental Clients For Date the Range of: 1/1/2017 Thru 10/31/2017 Service Site Number of Patients Service Encounters PINELLAS PARK HEALTH CENTER TARPON SPRINGS HEALTH CENTER 2 2 MID COUNTY HEALTH CENTER ST PETE HEALTH CENTER-SPECIALTY CARE BAYSIDE CLINIC-MOBILE MEDICAL UNIT ST PETERSBURG HEALTH CENTER CLEARWATER HEALTH CENTER All Sites The sum of the patients at each service site will not equal the total unduplicated number of patients any time a patient receives treatment at more than one service site.

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95 Florida Department of Health in Pinellas County HMS Reports Pointing to Server: CHD52VSSHDW02, Namespace: HMS LOGI Print Menu Button Name - Trend Report for Bayside Dental Clinics - Report ID# Saved By: DOHUSERS\VerrettAR Date File Saved: T08:31:03 Server Name:chd52vsdblogi01 File Name: CountyMedical.MMU.Trend_Report_for_Bayside_Dental_Clinic Trend Report for Bayside Dental Clinic Unduplicated MMU/Safe Harbor Dental Patients at all PCMH Dental Clinics including the Bayside Dental Clinic From 1/1/2016 to 10/31/2017 Calendar Month PCHP NoMedHome MMU/BaySide Monthly Increase Cumulative April May June July August September October November December Totals for Year Percentages % % % 393 Unduplicated MMU/Safe Harbor Dental Patients at all PCMH Dental Clinics including the Bayside Dental Clinic Calendar Month PCHP MMU/BaySide NoMedHome Monthly Increase Cumulative January February March April May June July August September October Totals for Year Percentages % % % 638 Dental Encounters From 1/1/2016 to 10/31/2017 Calendar Month PCHP NoMedHome MMU/BaySide Monthly Increase Cumulative April May June July August